Resilience is the desired outcome of trauma focused therapy. We all naturally believe we are resilient and can handle anything. Most of the time we can logic or think through our circumstances and push aside emotions and beliefs in order to accomplish goals, survive and get by. Sometimes however, our experiences seem to have more power than we would like to admit and there seems to be a disconnect between what we logically know and what we actually feel. Trauma treatment bridges the gap between logic and the felt sense and helps individuals and families feel grounded.
https://groundedwithin.com/
This ppt will help students who are want to have a detailed idea about marriage counselling or couple counselling. This ppt is developed for the purpose of achieving curriculum objectives for post graduate students.
This ppt will help students who are want to have a detailed idea about marriage counselling or couple counselling. This ppt is developed for the purpose of achieving curriculum objectives for post graduate students.
Ethical reasoning: decision science, biases, and errorsJohn Gavazzi
The workshop explores ways to teach ethical reasoning using decision science, cognitive errors, and biases as part of being human. Categories include: the need to act fast, too much information, insufficient evidence, faulty memory processes, and tribal knowledge.
Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status.
The Assessment, Management, and Treatment of Suicidal PatientsJohn Gavazzi
This PowerPoint is a companion to The Ethics and Psychology Podcast #25: The Assessment, Management, and Treatment of Suicidal Patients. Dr. John Gavazzi speaks with Dr. Sam Knapp about assessing, managing and treating the suicidal patient. Please read the disclaimer and the note on competence in dealing with suicidal patients. The podcast or video meets the requirements for Pennsylvania Act 74 requirements for all mental health professionals in Pennsylvania.
Trauma and PTSD of children - physiological implications. History of Trauma Focused Cognitive Behavioral Therapy, principles of practice and Case Presentation.
Psychotherapy, Psychologist and Relationship Counselling in Mumbai, IndiaPsychotherapist
There are many types of counsellors and varied topic-centred types of counselling, such as: marital counselling, drug and alcohol counselling, career counselling, health counselling etc.
As any clinician knows, every year witnesses the introduction of new treatment models. Invariably, the developers and proponents claim superior effectivess of the approach over existing treatments. In the last decade or so, such claims, and the publication of randomized clinical trials, has enabled some to assume the designation of an "evidence-based practice" or "empirically supported treatment." Training, continuing education, funding, and policy changes follow.
An overview of evidence-based therapeutic components that aid in the reduction of the rate of return or recidivism of ex-offenders going back to prison.
Legal, Clinical, Risk Management and Ethical Issues in Mental HealthJohn Gavazzi
The program outlines the fundamental differences between clinical issues, legal questions, risk management strategies, and ethical issues. While overlap exists, ethical questions arise when there are two competing ethical principles at odds. The course will reference both the ACA and the NBCC Code of Ethics. Clinical issues deal with treatment-oriented concerns. Legal issues concern state, federal, and case law, as well as statutes and regulations. Risk management typically focuses on reducing liability. Several case examples will be given to demonstrate how these issues overlap and are important to high quality of care.
Ethical reasoning: decision science, biases, and errorsJohn Gavazzi
The workshop explores ways to teach ethical reasoning using decision science, cognitive errors, and biases as part of being human. Categories include: the need to act fast, too much information, insufficient evidence, faulty memory processes, and tribal knowledge.
Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, parentification, extreme dependence, or even placing the therapist in a god-like or guru status.
The Assessment, Management, and Treatment of Suicidal PatientsJohn Gavazzi
This PowerPoint is a companion to The Ethics and Psychology Podcast #25: The Assessment, Management, and Treatment of Suicidal Patients. Dr. John Gavazzi speaks with Dr. Sam Knapp about assessing, managing and treating the suicidal patient. Please read the disclaimer and the note on competence in dealing with suicidal patients. The podcast or video meets the requirements for Pennsylvania Act 74 requirements for all mental health professionals in Pennsylvania.
Trauma and PTSD of children - physiological implications. History of Trauma Focused Cognitive Behavioral Therapy, principles of practice and Case Presentation.
Psychotherapy, Psychologist and Relationship Counselling in Mumbai, IndiaPsychotherapist
There are many types of counsellors and varied topic-centred types of counselling, such as: marital counselling, drug and alcohol counselling, career counselling, health counselling etc.
As any clinician knows, every year witnesses the introduction of new treatment models. Invariably, the developers and proponents claim superior effectivess of the approach over existing treatments. In the last decade or so, such claims, and the publication of randomized clinical trials, has enabled some to assume the designation of an "evidence-based practice" or "empirically supported treatment." Training, continuing education, funding, and policy changes follow.
An overview of evidence-based therapeutic components that aid in the reduction of the rate of return or recidivism of ex-offenders going back to prison.
Legal, Clinical, Risk Management and Ethical Issues in Mental HealthJohn Gavazzi
The program outlines the fundamental differences between clinical issues, legal questions, risk management strategies, and ethical issues. While overlap exists, ethical questions arise when there are two competing ethical principles at odds. The course will reference both the ACA and the NBCC Code of Ethics. Clinical issues deal with treatment-oriented concerns. Legal issues concern state, federal, and case law, as well as statutes and regulations. Risk management typically focuses on reducing liability. Several case examples will be given to demonstrate how these issues overlap and are important to high quality of care.
Response GuidelinesRead the posts of your peers and respond to.docxronak56
Response Guidelines
Read the posts of your peers and respond to at least two. Try to choose those that have had the fewest responses thus far. For each response, identify other community resources that might be available in a case like the one your peer described. What crisis and confrontation skills might be necessary in assisting with the case presented?
Peer one’s posting
Discuss, while protecting confidentiality, a case example of codependency, dual diagnosis, addiction, or substance abuse you have encountered during your clinical field experience.
Client is a 55-year-old African-American male. He is widowed and currently resides alone. Last year he lost his wife to cancer. The client was diagnosed with HIV approximately 25 years ago but indicated that his wife was not “positive.” The client indicated having multiple concerns with his ability to eat, sleep, function from day to day, and that he is oftentimes afraid of what he might do to himself. Client was asked and also assessed for suicidal ideations, and was administered a PHQ-9 to assess if client should be further evaluated for depression or to determine if current symptoms are a result of “normal” grief. The client also expressed that he has a known opioid addiction to prescription pain pills. While in therapy, the client repeatedly expressed how much he was currently in pain.
Utilizing information from the course readings, describe the approach you used when working with these presenting issues, and how do you determine which approach would be most effective?
The intern and supervisor let the client express himself and his reasons for coming into the facility, as he presented himself to be in a crisis. One particular approach that the intern attempted to use with the client was motivational interviewing by expressing empathy, offering reflective listening, attempting to help the client develop self-efficacy, and attempting to understand where the client is and where he would like to be. The intern wanted to determine and help to strengthen the client’s motivation overcome his addiction in order to link him to other services, such as that could help provide pharmacological treatment, address physical health needs, and locate other social support systems that can be beneficial to helping his current presenting issues.
However, the client came to therapy and dropped out of therapy after the first session and did not keep his follow-up appointment for his HIV care, per the client’s primary physician. Thus, it is hard to decipher if the patient came to therapy because he wanted help dealing with his mental incapacities and his physical health or whether this was an outcry for an attempt to retrieve pain medications. Although Koehn and Cutcliffe (2012) suggest that instilling hope in individuals with addictions is a necessary component for clients to stay in therapy, Wachholtz, Ziedonis, and Gonzalez (2011) suggest that it is oftentimes more difficult to treat patients with ...
PURPOSEBefore any nursing plan of care or intervention can be im.docxmakdul
PURPOSE
Before any nursing plan of care or intervention can be implemented or evaluated, the nurse assesses the individual through the collection of both subjective and objective data. The data collected are used to determine areas of need or problems to be addressed by the nursing care plan. This assignment will focus on collecting subjective assessment data, synthesizing the data, and on identifying health/wellness priorities based on the findings. The purpose of the assignment is two-fold:
· To recognize the interrelationships of subjective data (physiological, psychosocial, cultural/spiritual, and developmental) affecting health and wellness
To reflect on the interactive process between self and client when conducting a health assessment
Category
Description
Health History
Provide a comprehensive health history narrative that includes: demographic data; perception of health; past medical history; family medical history; review of systems; developmental considerations; cultural considerations; psychosocial considerations; and collaborative resources.
Reflection
Reflect on the interaction with the interviewee holistically. Consider the interaction in its entirety: include the environment, your approach to the individual, time of day, and other features relevant to therapeutic communication and the interview process (if needed, refer to your text for a description of therapeutic communication and the interview process). Be sure your reflection addresses each of these questions: How did your interaction compare to what you have learned? What went well? What barriers to communication did you experience? How did you overcome them? Were there unanticipated challenges to the interview? Was there information you wished you had obtained? How will you alter the approach next time?
Grammar, Spelling, Clarity of Thought
Writing should reflect your synthesis of ideas based on prior knowledge, newly acquired information, and appropriate writing skills. Scoring of your work in written communication is based on proper use of grammar, spelling, and how clearly you express your thoughts and reasoning in writing.
Total
PREPARING THE ASSIGNMENT:
A Health History Worksheet that can be used to help you organize the Family Medical History information you will obtain from the Adult Participant is located in the Resources section of the Expand page for Unit 2. The use of this tool is optional. There are three parts to this assignment.
Health History Assessment (50 points)
Using the following components of a health history assessment and your textbook for explicit details about each category, complete a health assessment/history on an individual of your choice. The person interviewed must be 18 years of age or older and should NOT be a family member or close friend. The purpose of this restriction is to avoid any tendency to anticipate answers or to influence how the questions are answered. Your goal in choosing an interviewee is to simulate the ...
learning objectives 16 16.1 Who seeks therapy and what are the goa.docxcroysierkathey
learning objectives 16 16.1 Who seeks therapy and what are the goals of therapy? 16.2 How is the success of psychotherapy measured? 16.3 What are some of the factors that must be considered to provide optimal treatment? 16.4 What psychological approaches are used to treat abnormal behavior? 16.5 What roles do social values and culture play in psychotherapy? 16.6 What biological approaches to treating abnormal behavior are available? Most of us have experienced a time or situation when we were dramatically helped by talking things over with a relative or friend. Most therapists, like all good listeners, rely on receptiveness, warmth, and empathy and take a nonjudgmental approach to the problems their clients present. But there is more to therapy than just giving someone an opportunity to talk. Therapists also introduce into the relationship psychological interventions that are designed to promote new understandings, behaviors, or both on the client’s part. The fact that these interventions are deliberately planned and systematically guided by certain theoretical preconceptions is what distinguishes professional therapy from more informal helping relationships. An Overview of Treatment The belief that people with psychological problems can change—can learn more adaptive ways of perceiving, evaluating, and behaving—is the conviction underlying all psychotherapy. Achieving these changes is by no means easy. Sometimes a person’s view of the world and her or his self-concept are distorted because of pathological early relationships that have been reinforced by years of negative life experiences. In other instances, environmental factors such as an unsatisfying job, an unhappy relationship, or financial stresses must be the focus of attention in addition to psychotherapy. Because change can be hard, people sometimes find it easier to bear their present problems than to challenge themselves to chart a different life course. Therapy also takes time. Even a highly skilled and experienced therapist cannot undo a person’s entire past history and, within a short time, prepare him or her to cope adequately with difficult life situations. Therapy offers no magical transformations. Nevertheless, it holds promise even for the most severe mental disorders. Moreover, contrary to common opinion, psychotherapy can be less expensive in the long run than alternative modes of intervention (Dobson et al., 2008; Gabbard et al., 1997). Numerous therapeutic approaches exist, ranging from psychoanalysis to Zen meditation. However, the era of managed care has prompted new and increasingly stringent demands that the efficacy of treatments be empirically demonstrated. This chapter will explore some of the most widely accepted psychological and biological treatment approaches in use today. Although we recognize that different groups of mental health professionals often have their own preferences with respect to the use of the terms client and patient, in this chapter we use ...
Counseling Strategies Action & Maintenance
By: Linda L. Barclay PH.D. LPCC/S LICDC
CHD 635
Chemical Dependency
"Recovery from addictions requires lifestyle changes"
"Recovery from addictions requires developing and working with relapse prevention or maintenance plans."
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
1. FROM TRAUMA TO RESILIENCE:
NAVIGATING THE EFFECTS OF
RELATIONAL PTSD
2. OBJECTIVES
1. Locate and use additional assessment resources for the assessment and
treatment of PTSD resulting from relational or betrayal trauma.
2. Identify internal and external factors contributing to traumatic responses in
clients who are in relationships with persons struggling with some form of sex
addiction.
3. Develop a treatment plan with grounding strategies and mindfulness techniques
that will help the client be objective and self-regulate.
4. Identify personal beliefs or cognitions that may contribute to or exacerbate the
traumatic response and train clients to challenge those core beliefs.
5. Use these tools at the best time in treatment for the intervention of Relational
PTSD.
YOU WILL BE ABLE TO…
3. SORTING IT OUT
AND PUTTING THE
PUZZLE TOGETHER
Identify
Identify internal and external factors such as personal
beliefs or cognitions, relationships, etc. that may
contribute to or exacerbate the traumatic response.
Test
Test and measure emotional tolerance relative to
their experience, history and relationships as well as
their ability to work through those issues.
Assess Assess for the type of client you are serving and lay a
foundation appropriate for their healing needs.
4. “CRAZY LAND”: THE EXPERIENCE OF RELATIONAL TRAUMA
Cognitive and Emotional
• Anger
• Anxiety
• Depression
• Difficulty making decisions
• Disorientation and Confusion
• Dissociation
• Emotional dysregulation & fluctuation
• Intrusive thoughts (AKA “Crazy land”)
• Personality Disorders
• Suicidal thoughts
Behavioral and Physical
• Aggression (Verbal and/or Physical)
• Eating Disorders
• Self-harm
• Sexual Acting Out
• Sleep Disturbance/Nightmares/Dreams
• Substance Abuse (Alcohol, Pills, Stimulants)
• Suicidal Gestures, Threats or Attempts
5. ASSESSMENT: STANDARDIZED TESTS/TOOLS
- PTSD Assessments:
1. PTSD Symptom Scale (PSS) & PTSD Symptom Scale Interview (PSSI): Public Domain
2. Post Traumatic Stress Index Revised (PTSI-R): Available through collaboration with a CSAT
- Trauma Assessments:
1. Betrayal Bond Index (BBI): Available for free at www.recoveryzone.com
2. Inventory for Partner Anxiety, Stress, and Trauma (IPAST): Available through CSAT
- Dissociative Assessments: Dissociative Experiences Scale (DES), Dissociative Disorders Interview
Schedule (DDIS), Multidimensional Inventory of Dissociation (MID) – Available by permission/training
- Other Assessments (fee assessed unless otherwise indicated)
1. Partner Sexuality Survey (PSS): Available at www.recoveryzone.com
2. Sex Addiction Assessments (SAST, SARA; ISST - free): Available at www.recoveryzone.com
- PROS (Thorough and Inclusive Perspective, Correlations, Collaboration, Visual Aid for the experience)
- CONS (Permission, Cost, Training, Accessibility, Time)
6.
7. PTSI-R CATEGORIES:
INFORMATION TO CONSIDER IN TREATMENT
• General PTSD symptoms
• The tendency to reproduce the same emotional state as the original trauma
• Identifies trends of attachments toward the abusive, dangerous and threatening
• Chronic negative Self-Perception and Shame
• Damaged or Distorted Affect Regulation System from early childhood trauma; Personality Disorders
• Trends toward blocking, calming, escaping, numbing, self-soothing, etc.
• Traits of Avoidant, Disengaged, Dissociative, Fragmented
• Self-Deprivation trends: Avoidant of affirmation, compliments, praise, pleasurable experiences
• Chronic compartmentalization – things to deal with and engage in things to perpetually avoid
• Depression, reduced energy, difficulty shifting thought processes, difficulty with abstraction, ritualistic
• Trauma based drive, energy, hyperactivity…they just can’t stop and actually want more energy or to do more.
14. ASSESSMENT: THE CLINICAL INTERVIEW
• Still the most helpful, reliable, cost effective and can always be improved
• Presentation & Recognition of Problem: Experience vs. Knowledge Base – Where do gaps need to be filled?
• Biological/Health Background: How much of their experiences, responses or reactions have a potential or
correlated health issue? What is the baseline for their self-care? Any other unaddressed or concurrent
trauma?
• Psychological/Emotional/Cognitive Info.: What is their overall emotional and mental healthy picture?
• Social/Relationship Information: How healthy is their family of origin? Friends? Past relationships?
• Willingness to change/heal: What are they willing to commit to for peace of mind and healthy relationships?
• Treatment and Relapse history: What have they been treated for? Is this a recurring problem? Is there a
pattern of breakdown in treatment?
• History of Sexual education and experiences: Addressing the abused, uneducated and taboo factors and
preventing its continuance in the existing or future relationships or repeating the cycle with children.
• Collaborative information will be crucial – if you’re given permission to obtain it.
15. TRADITIONAL APPROACHES
Co-Dependent
• Clients are labeled as “co-dependent” or “co-
addicts” and treated within the 12 step
framework.
• Early in treatment clients are asked to explore
“their part” of the dysfunctional relationship.
• Symptoms of PTSD may have been pathologized
instead of validated and normalized.
• Clients asked to participate in Addiction
Recovery Program (ARP), COSA (historically co-
dependent of a sex addict) or Sexaholics
Anonymous (S-Anon) support groups.
Traumatized
• The model first addresses the relational trauma
that occurred in the relationship with the Sex
Addict.
• It acknowledges the PTSD symptoms a partner
experiences following discovery and disclosure.
• Specific trauma experiences are addressed.
• Clients are asked to participate in Addiction
Recovery Program (ARP) or Partners of Sex
Addicts (POSA) support groups.
TAKING A BROADER APPROACH WITH MORE EDUCATION…
17. CLIENT TYPE DEFINED
• Blindsided: Just experienced discovery or forced disclosure. They may have had no idea that their
partner was a sex addict. They may say, “My marriage was great before this.” Naïve or in denial
about relational problems. They will be in a trauma reaction at intake and may present as
unregulated, raging, crying uncontrollably, appear paranoid, depressed, extremely anxious, numb,
incongruent.
• Co-dependent: This client may have known for years that “something was wrong” within the
relationship either through discovery or staggered disclosures from the addict. They may have
adapted to the addict's behaviors in an attempt to cope with overwhelming emotions. This client
may have engaged in behaviors they are ashamed about and resistant to discussing in the beginning
of treatment (ex. increasing sexual contact with addict). May present as calm, minimizing and/or
overwhelmed.
• Co-addicted: Relationships, sex, love, alcohol, drugs, food…may present as detached and ambivalent at
intake, numb with a flat affect or no emotion regarding acting-out behaviors.
• Affect Dysregulated/Personality Disorder: Present as super agreeable, make you feel like you’re the
best therapist ever, hyper-focused on addict, seem contained but exhibit incongruence.
18. PLANNING TREATMENT:
INGREDIENTS FOR RESILIENCE
A Moldable Task
Approach
1
Identifying,
developing and
applying positive
resources
2
Grounding
strategies,
mindfulness and
self-regulation
3
Challenging
negative core
beliefs
4
TALK LESS – EXPERIENCE MORE!
19. TASK APPROACH: MOLDABLE AND INTERCHANGEABLE
1. Cope with the trauma of Discovery and/or Disclosure (Separate truth from lies; identify trauma)
2. Establish Safety (Setting healthy Boundaries, Perspective and Intention)
3. Deal with the Emotional Aftershock (Get in tune with emotion, Be aware of Negative Beliefs,
Recognize Hope)
4. Understand the Nature of Addiction (Getting Educated about the Addiction, the Illogical, and the
Confusing)
5. Communicate Feelings (Develop healthy, grounded communication skills)
6. Develop a Plan for Support and Self-Care (Create and Enhance a Support System, Locate and work
with a Therapist, Develop and practice Grounding Techniques & Tools)
7. Create a Recovery Plan (Learn to Affirm self, work through Personal Craziness, Balance self &
develop the ability to Forgive)
20. DEVELOPING POSITIVE RESOURCES
Who should
know?
Who can help?
Who can
support &
validate me?
What additional
resources are
there?
1. Learn to Identify Healthy People.
2. Determine what is necessary to
share.
3. Get a therapist.
4. Gather collections of supportive
traits, objects, people, places,
locations, activities.
5. If struggling with addiction or
personality disorders, consider other
treatment alternatives first (Substance
abuse treatment, DBT groups)
21. GETTING GROUNDED
Establishing Healthy Boundaries
• Recognize Reality
• Identify Needs & Consider Options
• Visualize the Outcome (Peace)
• Empowering the Self
• Action Steps (Specific & Time Sensitive)
• Evaluate (Boundaries vs. Self-
Regulation)
• Revise (if necessary)
Reconstructing Self Regulation
• Clinging to the 5 senses (real data)
• Separating Stories from Experience
• Identifying Emotions & Sensations
• Separating Self from Others
• Recognizing Patterns & Triggers
• Creating and/or Asking for Help
• Putting it into perspective and words
• Self-care (Meditation, Exercise,
Nutrition, Talents, Friends, Affirmation)
22. OLDIES BUT GOODIES:
EXPERIENTIAL GROUNDING AND MINDFULNESS TECHNIQUES
• Dialog inside out: Get in tune with the most distressed part of yourself and interact with it as if it
were your child, friend or other close person in need of comfort, nurturing and validation
• Drawing the experience (Anger, Sadness, Betrayal, etc.)
• Exercise/Nutrition
• Fragmentation Exercise: Facts, Emotions and Awareness in a Mosaic
• Hobbies, Interests & Talents
• Journaling
• Meditation – Just basic awareness of breath and thought
• Yoga
23. TRANSFORMING BELIEFS
• Knowing the difference between Healthy and Unhealthy
beliefs.
• Developing awareness of the physical effects of beliefs.
• Recognizing where beliefs come from & how they are
reinforced.
• Having a clear vision of the possibilities – to challenge and
transform unhealthy beliefs.
• Identifying supportive people for clarification and
reflection.
• Give the Self: Affirmation, Compassion, Forgiveness, Love,
Mercy, etc.
24. EMILY: A WALK IN
HER FOOT STEPS
• Presentation (Body language, Emotional tolerance,
Separation of Self from Spouse).
• Assessment (DES, IPAST, PTSI-R; Body language, Emotional
tolerance, Separation of Self from Spouse)
• Homework: Identify assets/resources, fears, questions in the
context of Online Assessments.
• Follow up: Begin to establish awareness between reality and
story, fact and belief, emotions; Teach about Boundaries.
• Homework: Boundary steps, Self-Regulation practice, Support
System Acquisition.
• Follow up: Identify Patterns over lifespan (Beliefs,
Communication, Coping vs. Reaction, etc.), Develop lists of
unhealthy beliefs and trauma experiences to address.
• Continue to Enhance Awareness, Boundaries, Emotional
tolerance, Self-care.
• Utilize EMDR, Ego State work, CBT
A case study from
beginning to end with
healthy doses of
acceptance, affirmation,
normalizing, regulating,
reflecting, inviting, etc.
