This document summarizes an article examining the cognitive-behavioral model of relapse prevention for treating alcoholism. It provides an overview of relapse prevention, describing its history and key techniques such as coping skills training and cue exposure treatment. The article discusses socio-demographic and intrapersonal factors that influence relapse risk. It also outlines theoretical foundations and criticisms of relapse prevention approaches.
William Allan Kritsonis, PhD
Hall of Honor (2008)
William H. Parker Leadership Academy, Graduate School
Prairie View A&M University - The Texas A&M University System
Aftermath of Suicide: Research Principles & PrioritiesFranklin Cook
Strategic Direction 4, Surveillance, Research, and Evaluation, excerpted from Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines. See http://bit.ly/principlescan for a blog post on the document.
This document discusses nursing diagnosis, which is the second phase of the nursing process where nurses use critical thinking to interpret assessment data and identify client strengths and problems in order to formulate nursing diagnoses. It provides details on the history and development of nursing diagnosis through organizations like NANDA International, and outlines the 13 domains and associated classes that make up NANDA's standardized nursing diagnosis terminology.
The document summarizes research on the processes of change in systemic family therapy (SFT). It begins by defining SFT process research and distinguishing between mechanisms of change (mediators) and contexts of change (moderators). It then reviews process research on the major schools of family therapy, finding limited research on modern schools like Bowen and psychoanalytic therapy. More research exists for cognitive-behavioral, strategic, experiential, and structural models, especially as used in empirically supported treatments. Postmodern schools like solution-focused and narrative therapies have more process research due to their popularity in individual therapy. Overall, the review finds research support for strengthening family functioning, reframing problems systemically, externalizing issues, focusing on
As Hall says; “To look at and listen to self is often too difficult without the help of a significant figure (nurturer) who has learned how to hold up a mirror and sounding board to invite the behaver to look and listen to himself. If he accepts the invitation, he will explore the concerns in his acts and as he listens to his exploration through the reflection of the nurse, he may uncover in sequence his difficulties, the problem area, his problem, and eventually the threat which is dictating his out-of-control behavior.”
Sister Callista Roy's Adaptation Model views the person as an adaptive system that interacts constantly with the environment. The person's main task is to maintain integrity in the face of environmental stimuli through integrated, compensatory, or compromised adaptation. The model assesses a person's physiological, self-concept, role function, and interdependence adaptive modes and can be used in research, practice, education, and administration settings. While comprehensive, the model has been criticized as complex, abstract, and limited by an individualistic perspective.
Dementia And Aggression Psy 492 M7a2 Levea. Bhannah06
The document summarizes several studies that examined ways to reduce aggression in dementia patients through improved care methods. The studies found that:
1) Aggression decreased when medications like haloperidol were reduced or withdrawn and patients received care in special dementia units.
2) Caregiver training on understanding dementia and patient-centered care led to fewer aggressive behaviors from patients, lower caregiver stress, and less need for physical restraints.
3) Understanding factors like medical issues, communication problems, and patient histories that could influence behaviors helped develop more effective multi-faceted care approaches.
With better training and patient-centered care, facilities saw reduced costs from things like medications and hospitalizations, along with improved
William Allan Kritsonis, PhD
Hall of Honor (2008)
William H. Parker Leadership Academy, Graduate School
Prairie View A&M University - The Texas A&M University System
Aftermath of Suicide: Research Principles & PrioritiesFranklin Cook
Strategic Direction 4, Surveillance, Research, and Evaluation, excerpted from Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines. See http://bit.ly/principlescan for a blog post on the document.
This document discusses nursing diagnosis, which is the second phase of the nursing process where nurses use critical thinking to interpret assessment data and identify client strengths and problems in order to formulate nursing diagnoses. It provides details on the history and development of nursing diagnosis through organizations like NANDA International, and outlines the 13 domains and associated classes that make up NANDA's standardized nursing diagnosis terminology.
The document summarizes research on the processes of change in systemic family therapy (SFT). It begins by defining SFT process research and distinguishing between mechanisms of change (mediators) and contexts of change (moderators). It then reviews process research on the major schools of family therapy, finding limited research on modern schools like Bowen and psychoanalytic therapy. More research exists for cognitive-behavioral, strategic, experiential, and structural models, especially as used in empirically supported treatments. Postmodern schools like solution-focused and narrative therapies have more process research due to their popularity in individual therapy. Overall, the review finds research support for strengthening family functioning, reframing problems systemically, externalizing issues, focusing on
As Hall says; “To look at and listen to self is often too difficult without the help of a significant figure (nurturer) who has learned how to hold up a mirror and sounding board to invite the behaver to look and listen to himself. If he accepts the invitation, he will explore the concerns in his acts and as he listens to his exploration through the reflection of the nurse, he may uncover in sequence his difficulties, the problem area, his problem, and eventually the threat which is dictating his out-of-control behavior.”
Sister Callista Roy's Adaptation Model views the person as an adaptive system that interacts constantly with the environment. The person's main task is to maintain integrity in the face of environmental stimuli through integrated, compensatory, or compromised adaptation. The model assesses a person's physiological, self-concept, role function, and interdependence adaptive modes and can be used in research, practice, education, and administration settings. While comprehensive, the model has been criticized as complex, abstract, and limited by an individualistic perspective.
Dementia And Aggression Psy 492 M7a2 Levea. Bhannah06
The document summarizes several studies that examined ways to reduce aggression in dementia patients through improved care methods. The studies found that:
1) Aggression decreased when medications like haloperidol were reduced or withdrawn and patients received care in special dementia units.
2) Caregiver training on understanding dementia and patient-centered care led to fewer aggressive behaviors from patients, lower caregiver stress, and less need for physical restraints.
3) Understanding factors like medical issues, communication problems, and patient histories that could influence behaviors helped develop more effective multi-faceted care approaches.
With better training and patient-centered care, facilities saw reduced costs from things like medications and hospitalizations, along with improved
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
This study evaluated the diagnostic efficiency and clinical utility of the personality disorder (PD) criteria in the Structured Clinical Interview for DSM-IV (SCID-II) by assessing each criterion on four measures: 1) convergent validity with other criteria for the same PD, 2) divergent validity from other PD criteria, 3) relationship to dimensions of the Five-Factor Model of personality, and 4) association with functional impairment. The study found that only Borderline PD criteria met standards on all four measures. Histrionic and Obsessive-Compulsive PD criteria performed well on the first three measures but not the fourth. Schizotypal PD criteria met three measures but not the relationship to Five-Factor traits
This document discusses several prominent nursing theories including Orem's Self-Care Deficit Theory, Roy's Adaptation Theory, Pender's Health Promotion Model, and the Health Belief Model. It defines key concepts of each theory such as self-care, adaptation, health, and perceived susceptibility. For example, it explains that Orem's theory focuses on nursing to support self-care when patients are limited, while Roy's theory views people as adaptive systems that interact with their environment. The theories provide frameworks for understanding health behaviors and guiding nursing practice.
This document discusses transformational and transactional leadership styles in managing violence and crises in UK regional maximum security forensic mental health hospitals. It examines how leadership styles impact organization structure, change management, multidisciplinary collaboration, staff motivation and retention, and legal/ethical nursing practices. Studies show transformational leadership is more effective than transactional leadership for conflict management, improving performance, and organizational effectiveness in clinical settings. Personality traits like extraversion are also correlated with transformational leadership abilities.
1. Interpersonal Psychotherapy (IPT) is based on attachment theory and posits that psychological distress arises from an interaction between acute interpersonal stressors, biological and psychological vulnerabilities, and social context.
2. IPT targets interpersonal relationships and social support as the primary mechanisms of change, with the goal of improving communication and social networks. While IPT acknowledges biological factors, it does not directly target them.
3. Over time, IPT has become more rigidly defined in research settings, focusing on symptom change for specific diagnoses. This has limited creativity and innovation in the approach based on clinical experience. A new model is needed that better integrates clinical practice and research.
This document discusses risk factors for esophageal cancer and confounding in epidemiological studies. It lists several risk factors for esophageal cancer including age, gender, gastroesophageal reflux disease, tobacco/alcohol use, and certain medical conditions. It then discusses three criteria for a variable to be considered a confounder in epidemiology: 1) it must be associated with both the exposure and outcome, 2) it must be unequally distributed among exposure groups, and 3) it cannot be on the causal pathway between exposure and outcome. The document also describes two types of confounders - qualitative and quantitative - and provides examples of confounding.
The Shift from "Ordinary" to "Extraordinary" Experience in Psychodynaimc Supe...James Tobin
Presented by James Tobin, Ph.D. at the American Psychological Association annual conference in 2012, this paper argues that psychotherapists-in-training often rely on various forms of social etiquette when relating to their patients and conducting treatment. He argues that an important goal of supervision is to help the trainee cultivate a clinical attitude and environment which is "extraordinary" in nature, an interpersonal and intrapsychic space unencumbered by political and benevolent tendencies. Dr. Tobin describes the modeling component of supervision in which the supervisee is exposed to a new way of being in the atmosphere of the supervisor's mindfulness, independence, spontaneity, creativity, and subversiveness.
The AACN Synergy Model is a framework that matches patients' characteristics and needs with nurses' competencies in order to optimize patient outcomes. The model has 8 patient characteristics (resiliency, vulnerability, etc.) and 8 nurse competencies (clinical judgment, advocacy, caring practices, etc.) that are evaluated on a continuum. When patient needs and nurse competencies are well-matched, synergy occurs and the best outcomes can result. The document provides details on each of the patient characteristics and nurse competencies, including examples to illustrate where patients and nurses may fall on the various continua.
This chapter discusses career opportunities in nursing and preparing for the nursing school entrance exam. There is a high demand for nurses due to an aging population and technological advances. Nurses work in hospitals, doctors' offices, long-term care facilities, patients' homes, and communities. The chapter outlines educational requirements to become a nurse and the importance of this book for preparing for the entrance exam.
The Shift from "Ordinary" to "Extraordinary" Experience in Psychodynamic Supe...James Tobin, Ph.D.
In this paper, presented to Division 39 (Psychoanalysis) at the 2012 APA Conference in Orlando, Florida, Dr. Tobin argues that the trainee and novice clinician may create a therapeutic setting in which the therapist manifests an attitude and demeanor drawn largely from standards forms of interpersonal interaction and the mores constituting typical social discourse. Clinical supervision may also reflect an investment in restricted forms of experience, thus leading to “sterile supervision” characterized by defensive processes and false manifestations. Dr. Tobin argues that the clinical situation is an "extraordinary" social experience that sacrifices most forms of standard social discourse in order to create an open space in which therapist and patient are unhindered by that which normally is. Supervision, therefore, should be focused on developing in the supervisee a therapeutic persona mobilized by the trainee's experience of new freedoms encountered in supervision.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
Interpersonal psychotherapy for postpartum depression. (Grigoriadis & Ravitz,...Sharon
This article reviews interpersonal psychotherapy (IPT) as an effective treatment for postpartum depression (PPD). IPT focuses on addressing the important interpersonal changes and challenges that women face during the postpartum period. Evidence from studies supports IPT as a treatment for PPD. The principles and guidelines of IPT can be easily integrated into primary care settings to help patients work through interpersonal difficulties arising during the postpartum period. IPT is particularly relevant for PPD as it addresses the stressors women experience at this life transition.
Nursings fundamental patterns of knowingJijo G John
Carper's (1978) theory outlines four fundamental patterns of knowing in nursing: empirics, ethics, aesthetics, and personal knowing. The theory aimed to formally express nursing knowledge, establish nursing's professional identity, and convey nursing's contributions to healthcare. It also sought to create expert nursing practice. Emancipatory knowing was later added by Chinn and Kramer to recognize social barriers to health and critique the other patterns of knowing. The patterns represent different ways of understanding situations and responding with skilled nursing actions.
The document provides guidelines for the management of acne vulgaris (AV) from an expert work group. It addresses important clinical questions in the diagnosis and treatment of AV, including grading systems, microbiological and endocrine testing, topical and systemic therapies, physical modalities, complementary therapies, and the role of diet. While several grading systems have been described, no universal system is recommended due to variability. Treatment is guided by a stepwise approach based on acne severity.
Hildegard Peplau published her theory of interpersonal relations in nursing in 1953, which was influenced by Harry Stack Sullivan's interpersonal theory. Peplau's theory focuses on the therapeutic relationship between nurse and patient and identifies four phases of that relationship: orientation, identification, exploitation, and resolution. The theory outlines six primary and six secondary roles for nurses.
This article discusses challenges in medical education and training physicians to provide patient-centered care. It makes three key points:
1) While medical training focuses on developing scientific and technical skills, it often lacks training in communication, teamwork, and caring for patients as whole people. Competency-based training aims to remedy this.
2) Effective medical education requires focusing on the needs of students, not just imparting knowledge. It must develop both intellectual and moral virtues in trainees so they understand their role and can provide personalized, compassionate care.
3) Training physicians to care for patients means prioritizing student-centered education. Educators must model patient-centered care, facilitate learning, and
Dr. William Allan Kritsonis, School Law, Student Sexual Harassment, Bullying, Due Process, Discrimination, Assault, Freedom of Expression, Legal Rights of Students, Teachers, Administrators.
In 2004, Dr. William Allan Kritsonis was recognized as the Central Washington University Alumni Association Distinguished Alumnus for the College of Education and Professional Studies. Dr. Kritsonis was nominated by alumni, former students, friends, faculty, and staff. Final selection was made by the Alumni Association Board of Directors. Recipients are CWU graduates of 20 years or more and are recognized for achievement in their professional field and have made a positive contribution to society. For the second consecutive year, U.S. News and World Report placed Central Washington University among the top elite public institutions in the west. CWU was 12th on the list in the 2006 On-Line Education of “America’s Best Colleges.”
Dr. William Allan Kritsonis, Dissertation Chair for Rhodena Townsell, Dissert...William Kritsonis
This document summarizes a dissertation defense presented by Rhodena Townsell on January 26, 2009. The dissertation examined the career trajectories of successful rural African American school administrators. Through interviews with 6 rural African American administrators, the study identified 3 main themes that influenced their career pathways: 1) a determination to do well, despite childhood barriers, 2) feeling isolated yet connected to rural communities, and 3) an ability to endure challenges such as lower pay and isolation as the only African American administrator.
Dr. Jon E. Travis - NATIONAL FORUM JOURNALS - www.nationalforum.comWilliam Kritsonis
This article summarizes a study that used a Delphi panel of homeland security experts to design an undergraduate program in homeland security. The panel identified key content areas and subjects that should be included in such a program. They identified 8 major content areas as most important: security issues, emergency management, risk management, threat analysis, technology, introduction to homeland security, fusion/intelligence, and training and development. Within these areas, the panel identified 23 subjects as essential to the program, which were later narrowed down to 13 core subjects that experts agreed should make up the curriculum of an undergraduate homeland security degree.
Dr. William Allan Kritsonis - American Disability Act - Equity in Education f...William Kritsonis
This document discusses the history and key cases related to laws protecting individuals with disabilities. It begins with early cases establishing the right to education for individuals with disabilities. It then outlines the passage and purpose of major laws like Section 504 of the Rehabilitation Act of 1973, the Education for All Handicapped Children Act (later IDEA), and the Americans with Disabilities Act of 1990. The document also summarizes requirements and protections provided by these laws, as well as important cases that set legal precedents, such as Pennsylvania Assoc. for Retarded Children v. Commonwealth of PA and Mills v. Board of Education.
Student Discipline In Schools - School Law - Dr. William Allan KritsonisWilliam Kritsonis
- Student discipline in schools is governed by rules to maintain order and protect student rights, as outlined in the Texas Education Code and Constitution. Schools must establish clear, consistently enforced rules and provide due process for students.
- Teachers can remove disruptive students from the classroom temporarily. More serious offenses require placement in disciplinary alternative education programs. Expulsion is reserved for only the most serious situations like weapons or drug offenses.
- Schools must balance authority to enforce rules with protecting student civil liberties. The legal framework aims to keep students in school when possible through disciplinary programs instead of expulsion.
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
This study evaluated the diagnostic efficiency and clinical utility of the personality disorder (PD) criteria in the Structured Clinical Interview for DSM-IV (SCID-II) by assessing each criterion on four measures: 1) convergent validity with other criteria for the same PD, 2) divergent validity from other PD criteria, 3) relationship to dimensions of the Five-Factor Model of personality, and 4) association with functional impairment. The study found that only Borderline PD criteria met standards on all four measures. Histrionic and Obsessive-Compulsive PD criteria performed well on the first three measures but not the fourth. Schizotypal PD criteria met three measures but not the relationship to Five-Factor traits
This document discusses several prominent nursing theories including Orem's Self-Care Deficit Theory, Roy's Adaptation Theory, Pender's Health Promotion Model, and the Health Belief Model. It defines key concepts of each theory such as self-care, adaptation, health, and perceived susceptibility. For example, it explains that Orem's theory focuses on nursing to support self-care when patients are limited, while Roy's theory views people as adaptive systems that interact with their environment. The theories provide frameworks for understanding health behaviors and guiding nursing practice.
This document discusses transformational and transactional leadership styles in managing violence and crises in UK regional maximum security forensic mental health hospitals. It examines how leadership styles impact organization structure, change management, multidisciplinary collaboration, staff motivation and retention, and legal/ethical nursing practices. Studies show transformational leadership is more effective than transactional leadership for conflict management, improving performance, and organizational effectiveness in clinical settings. Personality traits like extraversion are also correlated with transformational leadership abilities.
1. Interpersonal Psychotherapy (IPT) is based on attachment theory and posits that psychological distress arises from an interaction between acute interpersonal stressors, biological and psychological vulnerabilities, and social context.
2. IPT targets interpersonal relationships and social support as the primary mechanisms of change, with the goal of improving communication and social networks. While IPT acknowledges biological factors, it does not directly target them.
3. Over time, IPT has become more rigidly defined in research settings, focusing on symptom change for specific diagnoses. This has limited creativity and innovation in the approach based on clinical experience. A new model is needed that better integrates clinical practice and research.
This document discusses risk factors for esophageal cancer and confounding in epidemiological studies. It lists several risk factors for esophageal cancer including age, gender, gastroesophageal reflux disease, tobacco/alcohol use, and certain medical conditions. It then discusses three criteria for a variable to be considered a confounder in epidemiology: 1) it must be associated with both the exposure and outcome, 2) it must be unequally distributed among exposure groups, and 3) it cannot be on the causal pathway between exposure and outcome. The document also describes two types of confounders - qualitative and quantitative - and provides examples of confounding.
The Shift from "Ordinary" to "Extraordinary" Experience in Psychodynaimc Supe...James Tobin
Presented by James Tobin, Ph.D. at the American Psychological Association annual conference in 2012, this paper argues that psychotherapists-in-training often rely on various forms of social etiquette when relating to their patients and conducting treatment. He argues that an important goal of supervision is to help the trainee cultivate a clinical attitude and environment which is "extraordinary" in nature, an interpersonal and intrapsychic space unencumbered by political and benevolent tendencies. Dr. Tobin describes the modeling component of supervision in which the supervisee is exposed to a new way of being in the atmosphere of the supervisor's mindfulness, independence, spontaneity, creativity, and subversiveness.
The AACN Synergy Model is a framework that matches patients' characteristics and needs with nurses' competencies in order to optimize patient outcomes. The model has 8 patient characteristics (resiliency, vulnerability, etc.) and 8 nurse competencies (clinical judgment, advocacy, caring practices, etc.) that are evaluated on a continuum. When patient needs and nurse competencies are well-matched, synergy occurs and the best outcomes can result. The document provides details on each of the patient characteristics and nurse competencies, including examples to illustrate where patients and nurses may fall on the various continua.
This chapter discusses career opportunities in nursing and preparing for the nursing school entrance exam. There is a high demand for nurses due to an aging population and technological advances. Nurses work in hospitals, doctors' offices, long-term care facilities, patients' homes, and communities. The chapter outlines educational requirements to become a nurse and the importance of this book for preparing for the entrance exam.
The Shift from "Ordinary" to "Extraordinary" Experience in Psychodynamic Supe...James Tobin, Ph.D.
In this paper, presented to Division 39 (Psychoanalysis) at the 2012 APA Conference in Orlando, Florida, Dr. Tobin argues that the trainee and novice clinician may create a therapeutic setting in which the therapist manifests an attitude and demeanor drawn largely from standards forms of interpersonal interaction and the mores constituting typical social discourse. Clinical supervision may also reflect an investment in restricted forms of experience, thus leading to “sterile supervision” characterized by defensive processes and false manifestations. Dr. Tobin argues that the clinical situation is an "extraordinary" social experience that sacrifices most forms of standard social discourse in order to create an open space in which therapist and patient are unhindered by that which normally is. Supervision, therefore, should be focused on developing in the supervisee a therapeutic persona mobilized by the trainee's experience of new freedoms encountered in supervision.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
Interpersonal psychotherapy for postpartum depression. (Grigoriadis & Ravitz,...Sharon
This article reviews interpersonal psychotherapy (IPT) as an effective treatment for postpartum depression (PPD). IPT focuses on addressing the important interpersonal changes and challenges that women face during the postpartum period. Evidence from studies supports IPT as a treatment for PPD. The principles and guidelines of IPT can be easily integrated into primary care settings to help patients work through interpersonal difficulties arising during the postpartum period. IPT is particularly relevant for PPD as it addresses the stressors women experience at this life transition.
Nursings fundamental patterns of knowingJijo G John
Carper's (1978) theory outlines four fundamental patterns of knowing in nursing: empirics, ethics, aesthetics, and personal knowing. The theory aimed to formally express nursing knowledge, establish nursing's professional identity, and convey nursing's contributions to healthcare. It also sought to create expert nursing practice. Emancipatory knowing was later added by Chinn and Kramer to recognize social barriers to health and critique the other patterns of knowing. The patterns represent different ways of understanding situations and responding with skilled nursing actions.
The document provides guidelines for the management of acne vulgaris (AV) from an expert work group. It addresses important clinical questions in the diagnosis and treatment of AV, including grading systems, microbiological and endocrine testing, topical and systemic therapies, physical modalities, complementary therapies, and the role of diet. While several grading systems have been described, no universal system is recommended due to variability. Treatment is guided by a stepwise approach based on acne severity.
Hildegard Peplau published her theory of interpersonal relations in nursing in 1953, which was influenced by Harry Stack Sullivan's interpersonal theory. Peplau's theory focuses on the therapeutic relationship between nurse and patient and identifies four phases of that relationship: orientation, identification, exploitation, and resolution. The theory outlines six primary and six secondary roles for nurses.
This article discusses challenges in medical education and training physicians to provide patient-centered care. It makes three key points:
1) While medical training focuses on developing scientific and technical skills, it often lacks training in communication, teamwork, and caring for patients as whole people. Competency-based training aims to remedy this.
2) Effective medical education requires focusing on the needs of students, not just imparting knowledge. It must develop both intellectual and moral virtues in trainees so they understand their role and can provide personalized, compassionate care.
3) Training physicians to care for patients means prioritizing student-centered education. Educators must model patient-centered care, facilitate learning, and
Dr. William Allan Kritsonis, School Law, Student Sexual Harassment, Bullying, Due Process, Discrimination, Assault, Freedom of Expression, Legal Rights of Students, Teachers, Administrators.
In 2004, Dr. William Allan Kritsonis was recognized as the Central Washington University Alumni Association Distinguished Alumnus for the College of Education and Professional Studies. Dr. Kritsonis was nominated by alumni, former students, friends, faculty, and staff. Final selection was made by the Alumni Association Board of Directors. Recipients are CWU graduates of 20 years or more and are recognized for achievement in their professional field and have made a positive contribution to society. For the second consecutive year, U.S. News and World Report placed Central Washington University among the top elite public institutions in the west. CWU was 12th on the list in the 2006 On-Line Education of “America’s Best Colleges.”
Dr. William Allan Kritsonis, Dissertation Chair for Rhodena Townsell, Dissert...William Kritsonis
This document summarizes a dissertation defense presented by Rhodena Townsell on January 26, 2009. The dissertation examined the career trajectories of successful rural African American school administrators. Through interviews with 6 rural African American administrators, the study identified 3 main themes that influenced their career pathways: 1) a determination to do well, despite childhood barriers, 2) feeling isolated yet connected to rural communities, and 3) an ability to endure challenges such as lower pay and isolation as the only African American administrator.
Dr. Jon E. Travis - NATIONAL FORUM JOURNALS - www.nationalforum.comWilliam Kritsonis
This article summarizes a study that used a Delphi panel of homeland security experts to design an undergraduate program in homeland security. The panel identified key content areas and subjects that should be included in such a program. They identified 8 major content areas as most important: security issues, emergency management, risk management, threat analysis, technology, introduction to homeland security, fusion/intelligence, and training and development. Within these areas, the panel identified 23 subjects as essential to the program, which were later narrowed down to 13 core subjects that experts agreed should make up the curriculum of an undergraduate homeland security degree.
Dr. William Allan Kritsonis - American Disability Act - Equity in Education f...William Kritsonis
This document discusses the history and key cases related to laws protecting individuals with disabilities. It begins with early cases establishing the right to education for individuals with disabilities. It then outlines the passage and purpose of major laws like Section 504 of the Rehabilitation Act of 1973, the Education for All Handicapped Children Act (later IDEA), and the Americans with Disabilities Act of 1990. The document also summarizes requirements and protections provided by these laws, as well as important cases that set legal precedents, such as Pennsylvania Assoc. for Retarded Children v. Commonwealth of PA and Mills v. Board of Education.
Student Discipline In Schools - School Law - Dr. William Allan KritsonisWilliam Kritsonis
- Student discipline in schools is governed by rules to maintain order and protect student rights, as outlined in the Texas Education Code and Constitution. Schools must establish clear, consistently enforced rules and provide due process for students.
- Teachers can remove disruptive students from the classroom temporarily. More serious offenses require placement in disciplinary alternative education programs. Expulsion is reserved for only the most serious situations like weapons or drug offenses.
- Schools must balance authority to enforce rules with protecting student civil liberties. The legal framework aims to keep students in school when possible through disciplinary programs instead of expulsion.
Writing for Professional Publication in National Refereed Journals, PPT, by D...William Kritsonis
This document provides guidance on writing for professional publication in refereed journals. It discusses reasons for writing, both professional and personal, and how to get started. The author notes that brilliant ideas, luck, and knowing the right people can lead to publication. Different types of articles are discussed, including practical, review, theoretical, and research pieces. Tips are provided on quantitative and qualitative research, writing books, working with editors, dealing with rejection, developing style, and finding motivation even if writing is not lucrative. The overall message is to write about topics of importance to readers, have fun with the process, and be true to yourself.
Eisenman, russell explanations from undergraduates nfaejWilliam Kritsonis
Undergraduate and graduate counseling students listened to two audio recordings and wrote explanations. Their explanations were rated as either simple or complex. All undergraduate explanations were rated as simple, simply describing what was said. All graduate student explanations were rated as complex, providing critical assessment. However, three graduate students made an error in clinical thinking by claiming religious belief in God speaking indicated schizophrenia. The study shows graduate students demonstrated more complex thinking, but educators need to address clinical reasoning errors.
Dr. John Hamilton, Texas A&M University at TexarkanaWilliam Kritsonis
This document discusses the principal's role in implementing Response to Intervention (RTI) to improve student reading achievement. RTI uses data-driven instruction and interventions based on student needs. The principal plays a critical role in establishing a systemic culture with high expectations and supporting the development of an effective reading program through RTI. While studies have found both direct and indirect relationships between leadership and student achievement, RTI meets the requirements for identifying learning disabilities and can improve outcomes when implemented well under a principal's guidance.
Dr. Fred C. Lunenburg, The Generation and Verification of Theory: A Bridge to...William Kritsonis
National FORUM Journals, William Allan Kritsonis, PhD, Editor-in-Chief (Founded 1983)
Dr. Fred C. Lunenburg, The Generation and Verification of Theory: A Bridge to the Continuing Quest for a Knowledge Base
Dr. David E. Herrington, PhD Dissertation Chair for CHENG-CHIEH LAI, PVAMU/Th...William Kritsonis
Dr. David E. Herrington, PhD Dissertation Chair for CHENG-CHIEH LAI, PVAMU/The Texas A&M University System, 2008. Committee Members: Dr. William Allan Kritsonis, Dr. Camille Gibson, Dr. Tyrone Tanner, Dr. Pamela T. Barber Freeman
Dr. William Allan Kritsonis
Editor-in-Chief
NATIONAL FORUM JOURNALS
(Founded 1983)
Over 5,000 professors published. A group of national refereed periodicals.
James D. Laub, Dissertation Proposal Defense, Dr. William Allan Kritsonis, Di...William Kritsonis
This dissertation proposal examines the rural school superintendency. The study aims to analyze governance challenges faced by rural superintendents and identify factors contributing to high turnover rates. If completed, the research could help stabilize the superintendent role and impact training. The proposal outlines qualitative and quantitative research questions, hypotheses, limitations, and plans to survey 150 superintendents across 5 southwestern states. Chapter outlines include sections on rural districts, superintendents, challenges, and leadership.
Dr. William Allan Kritsonis, Dissertation Chair for Donald Ray Brown, Jr., Di...William Kritsonis
This dissertation examines factors that influence recidivism rates for African American males enrolled in middle school disciplinary alternative education programs. The study collected data on program structure, best practices, teacher efficacy scores, parental involvement, and social skills curriculum from six DAEP campuses. The results found no significant relationship between these variables and recidivism rates. The study aimed to identify practices to improve outcomes for students in alternative education.
Dr. William Allan Kritsonis, School Law - Educaitonal Law & Policies - Personnel Issues and the Law - Employment - Litigation - Court Cases - Due Process - Legal Issues and Trends - Discrimination
School Law - Educational Law & Policies - Litigation Issues - Educational Administration and Supervision - Dr. William Allan Kritsonis, Professor, PVAMU, The Texas A&M University System
Dr. William Allan Kritsonis, Public School Law, School Law, School Legal Issues, Educational Laws & Policies
Professorial Roles
Dr. Kritsonis has served in professorial roles at Central Washington University, Washington; Salisbury State University, Maryland; Northwestern State University, Louisiana; McNeese State University, Louisiana; and Louisiana State University, Baton Rouge in the Department of Administrative and Foundational Services.
In 2006, Dr. Kritsonis published two articles in the Two-Volume Set of the Encyclopedia of Educational Leadership and Administration published by SAGE Publications, Thousand Oaks, California. He is a National Reviewer for the Journal of Research on Leadership, University Council for Educational Administration (UCEA).
In 2007, Dr. Kritsonis was invited to write a history and philosophy of education for the ABC-CLIO Encyclopedia of World History.
Currently, Dr. Kritsonis is Professor of Educational Leadership at Prairie View A&M University – Member of the Texas A&M University System. He teaches in the PhD Program in Educational Leadership. Dr. Kritsonis taught the Inaugural class session in the doctoral program at the start of the fall 2004 academic year. In October 2006, Dr. Kritsonis chaired the first doctoral student to earn a PhD in Educational Leadership at Prairie View A&M University. He has chaired over 18 doctoral dissertations. He lives in Houston, Texas
Nasrin Nazemzadeh, DissertationTitle page, Abstract, and Table of Contents, D...William Kritsonis
Nasrin Nazemzadeh, DissertationTitle page, Abstract, and Table of Contents, Dr. William Allan Kritsonis, Dissertation Chair, PV/Member of the Texas A&M University System
Dr. William Allan Kritsonis, Dissertation Chair for Steven Norfleet, Disserta...William Kritsonis
This document outlines a proposed dissertation study on effective school practices that are important for the achievement of African American learners. The study aims to identify practices implemented by school leaders that can improve academic outcomes for African American students. It will survey African American college freshmen on how they rated their high schools in terms of effective practices. It also aims to determine if there is a relationship between students' ratings and their early college achievement. Qualitative interviews will further explore students' perspectives on various effective practices. The goal is to enhance implementation of practices that resonate with African American students and motivate academic success.
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews. See: www.nationalforum.com
Running head: NURSING PROBLEM 1
NURSING PROBLEM 2
Nursing Problem
Student’s Name
Institutional Affiliation
Date
Specialization: Nursing Practitioner.
As a nursing practitioner, the major roles include the assessment of the needs of the patients. A nursing practitioner also orders and interprets test from laboratories, they do illness and disease diagnosis, medication prescription and formulate plans for treatment. There are a number of challenges that face the nurse in their field of practices. This paper will focus to discuss the hazards in the workspace of these practitioners. It will also seek to find a way of solving these challenge using innovative means.
The Problem of Interest
Hazard in The Nursing Field.
The nursing field of practice is one of the most dangerous places of working as one does work in a delicate environment where one is in the risks of being infected or even injuring oneself. Nurses are faced with a number of risks in daily job activities. Some of these hazards include injuries, flu germs, hand washing –related dermatitis and pathogens that are based in the blood among others.
According to the report produced by OSHA, about 5.6 million of 12.2 million workers are under the risk of being exposed to blood borne pathogens. This is a big number of health workers under the risk meaning that soon there will be a shortage of health nursing or health workers in general. Moreover, the rates of risks are higher in the health care industry than any other industries. This industry has registered around 35000 injuries covering different parts of the body. These range from the shoulders, hands, feet, and back. These statistics are according to the Bureau Labor Statistics (Gooch, 2015).
Apart from the acute injuries discussed, they also suffer harm exposed on their hands. From a recent study carried out in the University of Manchester, the health workers that follow protocols are 4.5 times exposed to skin damage risks. The report also reported up to 25 percent of cases of irritant contact dermatitis.
These individuals also get exposed to infectious diseases in their areas of practice. One of the most commonly contacted infection is Hepatitis B (HBV). This is infection can be contacted via blood contact, feces, saliva, and semen. This instrument of spreading the infection is in contact with the patient and also the needles (Gooch, 2015). Nursing practitioners also risk exposure to toxic substances in the clinical environment. Radiation is another risk that comes majorly from the ionizing radiation. Complications associated with radiation include skin cancer, leukemia, and cancer among others. One comes to contact with this radiation in the instances of performing x-ray scans. Another challenge that faces nursing.
Running head: NURSING PROBLEM 1
NURSING PROBLEM 2
Nursing Problem
Student’s Name
Institutional Affiliation
Date
Specialization: Nursing Practitioner.
As a nursing practitioner, the major roles include the assessment of the needs of the patients. A nursing practitioner also orders and interprets test from laboratories, they do illness and disease diagnosis, medication prescription and formulate plans for treatment. There are a number of challenges that face the nurse in their field of practices. This paper will focus to discuss the hazards in the workspace of these practitioners. It will also seek to find a way of solving these challenge using innovative means.
The Problem of Interest
Hazard in The Nursing Field.
The nursing field of practice is one of the most dangerous places of working as one does work in a delicate environment where one is in the risks of being infected or even injuring oneself. Nurses are faced with a number of risks in daily job activities. Some of these hazards include injuries, flu germs, hand washing –related dermatitis and pathogens that are based in the blood among others.
According to the report produced by OSHA, about 5.6 million of 12.2 million workers are under the risk of being exposed to blood borne pathogens. This is a big number of health workers under the risk meaning that soon there will be a shortage of health nursing or health workers in general. Moreover, the rates of risks are higher in the health care industry than any other industries. This industry has registered around 35000 injuries covering different parts of the body. These range from the shoulders, hands, feet, and back. These statistics are according to the Bureau Labor Statistics (Gooch, 2015).
Apart from the acute injuries discussed, they also suffer harm exposed on their hands. From a recent study carried out in the University of Manchester, the health workers that follow protocols are 4.5 times exposed to skin damage risks. The report also reported up to 25 percent of cases of irritant contact dermatitis.
These individuals also get exposed to infectious diseases in their areas of practice. One of the most commonly contacted infection is Hepatitis B (HBV). This is infection can be contacted via blood contact, feces, saliva, and semen. This instrument of spreading the infection is in contact with the patient and also the needles (Gooch, 2015). Nursing practitioners also risk exposure to toxic substances in the clinical environment. Radiation is another risk that comes majorly from the ionizing radiation. Complications associated with radiation include skin cancer, leukemia, and cancer among others. One comes to contact with this radiation in the instances of performing x-ray scans. Another challenge that faces nursing.
This document provides an overview of a health education course offered at Roosevelt College. The 3-unit, 54-hour course is taught over the summer term to 2nd year Bachelor of Science in Nursing students. The course aims to teach students concepts, principles, and strategies for clinical and classroom teaching. It also helps students develop skills in designing teaching plans using the nursing process framework. The document further provides details on course objectives, content, and theories that will be covered, including perspectives on teaching and learning in healthcare.
A CRITICAL ANALYSIS OF USING ROY S ADAPTATION MODEL IN NURSING RESEARCHKate Campbell
This summarizes a research article that analyzes 10 studies using Roy's Adaptation Model as a conceptual framework. Most studies supported RAM as an effective framework, with RAM playing a significant role in managing research direction and facilitating participant adaptation. The four adaptive modes, three environmental stimuli, and regulator/cognator subsystems were generally utilized appropriately. RAM was found most useful for studies focusing on individual adaptation to medical treatments like cancer therapy. The analysis concludes RAM is a flexible and useful model for guiding different aspects of nursing research.
This research article examines the ethical dilemmas faced by palliative care physicians through surveys and interviews with 30 palliative care specialists in Mexico.
The study identified 113 common dilemmas, most frequently regarding sedation, home administration of opioids, and institutional regulations. It was observed that truth-telling and bidirectional trust between patients and providers are core to palliative medicine ethics. The most prominent virtues among participants were justice and professional humility. Physicians in palliative care see themselves most importantly as educators and advisers who provide medical assistance.
The research aims to better understand the values that guide decision-making in palliative care in order to improve care for patients at the end of life. It finds rediscovering virtues in clinical practice can
Workshop 4
Reginald Finger, MD, MPH
Jiajoyce Conway, DNP, CRNP
Avoiding Epidemiologic Traps
1
Ecologic Fallacy
The ecologic fallacy, simply stated, is the error made when one makes incorrect inferences about an individual or small group’s probability of having a certain characteristic, based on the probability of that characteristic in the population from which that individual or small group comes.
Let’s look at an example:
Ecologic Fallacy
Let’s say that we know that in a University with lower and upper campuses, that because upper campus houses graduate and honors programs, that the average GPA of students on upper campus is higher.
Does it follow that in a particular introductory psychology class offered to students from across the campus, if the professor tabulates the GPA of students enrolling in that class, that the ones from upper campus will have a higher GPA than those from lower campus?
3
Ecologic Fallacy
Not necessarily!
The mistake the psychology professor would make with such an assumption would be to substitute risk at the population level for risk at the individual level. The population-level difference in GPA, in this case, is attributable to the influence of students who probably are not going to take introductory psychology.
Confounding
Consider the following: 7 of 110 women, and 17 of 100 men, are positive for a new viral antibody “N” on when screened with a blood test. The odds ratio is 3.01, easily significant with a chi-square test.
However … look what happens when the data are analyzed by who has or has not ever lived outside the U.S.:
5
Confounding
Among those having lived outside the U.S., 15/50 men and 3/10 women (both 30%) have the N antibody. Among those never having lived outside the U.S., 2/50 men and 4/100 women have N antibody (both 4%).
The odds ratio in each group is 1.00 – there is actually no relationship at all between gender and having the N antibody. It only appeared so because of a statistical fluke.
Confounding
This is an example of what is known as confounding. The relationship between gender and the N antibody is confounded by whether the person has lived outside the U.S. Confounding occurs when the relationship between “A” and “C” is distorted (in either direction) by “B”, which is associated with “A”, and, independent of its relationship with A, is associated with “C”.
7
Bias
Confounding is an illustration of what is known as “bias” – that is, a situation where an unrelated factor obscures the true outcome.
Bias can come from a number of sources: four of the most common are recall bias, nonresponse bias, selection bias, and publication bias.
8
Selection Bias
If, for instance, hospital workers are surveyed for their opinions about the medical care system and their responses considered representative of the population at large, the result will be inaccurate as the result of selection bias. Hospital workers are likel.
The document describes the use of the Roy Adaptation Model in caring for a patient diagnosed with breast cancer who underwent breast-conserving surgery. The Roy Adaptation Model evaluates patients across four modes of adaptation: physiologic, self-concept, role function, and interdependence. The case study applies the nursing process based on the Roy Adaptation Model by assessing the patient in the four modes and identifying nursing diagnoses to develop a holistic care plan. The goal is to increase the patient's adaptation through meeting needs across the four modes of the model.
The document discusses nursing practice and responsibilities. It notes that nursing practice is established through customs, formal consideration, and institutional arrangements. Over the past decade, nurses have been asked to demonstrate that their practices are effective. This has led to a focus on using evidence-based practices to improve patient outcomes and healthcare quality and safety. The essay will discuss the differences between rituals in nursing practice and evidence-based practice, and how encounters between taught practices and actual clinical practices can impact nursing students.
A Problem Solving Intervention for hospice caregivers a pilot study.pdfSabrina Ball
This pilot study tested a Problem Solving Intervention (PSI) with 29 informal caregivers of hospice patients to improve their coping and problem-solving skills. PSI is a structured, cognitive-behavioral intervention that teaches problem definition, alternative generation, decision making, and solution implementation. After completing three PSI sessions, caregivers reported lower anxiety, better problem solving skills, and feeling less negatively impacted by caregiving. They also perceived PSI as helpful for discussing challenges and developing plans to address them. The study provides preliminary evidence that a problem-solving approach may benefit hospice caregivers and warrants further research.
Recovery from Addictions in Healthcare workers - by Ann Sparks (research synt...Ann Hinnen Sparks
This document provides background information for a proposed qualitative study examining the experiences and perceptions of healthcare practitioners in long-term recovery from addiction. The study aims to understand how perceptions of stigma, social support, and spirituality change throughout the recovery process. 18 participants who entered non-punitive recovery programs at least 5 years prior will be interviewed. Modeling and Role Modeling theory guides the study by taking a holistic, client-centered approach. Key concepts of stigma, social support, and spirituality are defined. The proposed method is a phenomenological analysis of interviews to identify themes in practitioners' recovery journeys and how their views have changed over time.
Pender's health promotion model from 1982 explains factors that influence healthy behaviors. The model identifies individual characteristics, cognitions regarding behaviors, and interpersonal/situational influences as impacting behavioral outcomes. It draws from expectancy value theory and social cognitive theory. Research has applied the model to areas like cancer screening, HIV care, smoking cessation, and health behaviors in homeless women. The model provides a framework for nurses to assess factors impacting patients' health behaviors and design interventions accordingly.
This case study explores the use of Roy's Adaptation Model in caring for a 60-year-old male patient diagnosed with post-infarct seizure and cerebrovascular accident. Utilizing the nursing process and Roy's model, the study assessed alterations in the patient's adaptive modes of physiologic needs, self-concept, role function, and interdependence. The study concluded that CVA patients experience adaptive problems in all four modes and recommended the use of Roy's model to guide nursing care and promote adaptive responses to improve patient outcomes.
An Intervention To Improve Respiratory Therapists Comfort With End-Of-Life CareBrooke Heidt
This study evaluated a one-day educational program aimed at improving respiratory therapists' (RTs) comfort and skills in dealing with end-of-life care. RTs frequently care for critically ill patients but receive little training in palliative care. A survey assessed RTs' comfort, perceived role, and knowledge regarding end-of-life care, before and after participating in the program. The program, consisting of presentations, discussions, and role-playing, significantly increased RTs' comfort with end-of-life care, perception of their role, and knowledge based on pre- and post-surveys. However, longer-term impacts require further evaluation.
Nursing research theories . One of the most popular and effective theory applicable in the conceptual framework of the research study. Describe with examples of conceptual framework.
Week 4 School resourcesGrand TheoriesTheories can be classif.docxjessiehampson
Week 4 School resources
Grand Theories
Theories can be classified based on their levels of abstraction. The scope of grand theories is very broad and, therefore, they don't lend themselves easily to application and testing. Grand theories are less abstract than conceptual models, but the concepts that compose them are still relatively abstract and general, and the relationships cannot be tested empirically (Fawcett, 1995)1.
Let's begin our exploration of grand theories with Sr. Callista Roy's adaptation model. The principal premise behind this model is that individuals are adaptive systems that cope with change through adaptation, and nursing helps to facilitate this adaptation of individuals during health and illness.
Middle Range Theories
Middle-range theories originate from grand theories. They are less abstract and comparatively more focused and narrower in scope, which implies that they are made up of concepts and propositions that are testable. The development of the concept of caring as the central concept to nursing gave rise to several theories focused on caring. The most prominent of these caring theories is Madeleine Leininger's theory of culture care.
Madeleine Leininger: Culture Care: Diversity and Universality Theory
Culture plays an important role in every healthcare setting. Integrating culture with care is an effective way of guiding thought processes, actions, and decisions within that culture.
Leininger's theory takes into account the cultural beliefs and values of individuals and groups to provide satisfying and culturally congruent nursing care. Culture exhibits both diversity and universality. While diversity includes different ways of practicing care, universality refers to the common elements in care. While adopting this model, it is important to incorporate cultural differences into nursing assessments, interventions, and care plans.
The culture care theory stresses the importance of cultural care and the need to be sensitive to the role of culture in health and healing. Consider this case. A South East Asian female patient admitted to a U.S. hospital for gynecological complaints felt that she was in a hostile healthcare environment, in the midst of caregivers who were not friendly or sensitive to her needs. Everything, starting from the admission procedure, routine questioning, and physical assessment to the diet she was served, sent out negative signals to the patient. Had the attending nursing and other healthcare professionals been sensitive to her cultural differences and taken the trouble to make her feel comfortable, this turn of events could easily have been avoided. Culturally competent nurses can create positive environments where patients feel accepted and their cultural norms, beliefs, and practices are respected.
This model is relevant to education, research and practice.
Education
Research
Practice
Leininger's model is helpful to nurse educators to teach the importance of transcultural nursing to stud ...
NursingResearchMethods and CriticalAppraisal for Escoutsgyqmo
Nursing
Research
Methods and Critical
Appraisal for Evidence-Based
Practice
NINETH EDITION
Geri LoBiondo-Wood, PhD, RN,
FAAN
Professor and Coordinator, PhD in Nursing Program, University of Texas
Health Science Center at Houston, School of Nursing, Houston, Texas
Judith Haber, PhD, RN, FAAN
2
The Ursula Springer Leadership Professor in Nursing, New York
University, Rory Meyers College of Nursing, New York, New York
3
Table of Contents
Cover image
Title page
Copyright
About the authors
Contributors
Reviewers
To the faculty
To the student
Acknowledgments
I. Overview of Research and Evidence-Based
Practice
Introduction
4
kindle:embed:0006?mime=image/jpg
References
1. Integrating research, evidence-based practice, and quality
improvement processes
References
2. Research questions, hypotheses, and clinical questions
References
3. Gathering and appraising the literature
References
4. Theoretical frameworks for research
References
II. Processes and Evidence Related to Qualitative
Research
Introduction
References
5. Introduction to qualitative research
References
6. Qualitative approaches to research
References
7. Appraising qualitative research
5
Critique of a qualitative research study
References
References
III. Processes and Evidence Related to
Quantitative Research
Introduction
References
8. Introduction to quantitative research
References
9. Experimental and quasi-experimental designs
References
10. Nonexperimental designs
References
11. Systematic reviews and clinical practice guidelines
References
12. Sampling
References
13. Legal and ethical issues
References
6
14. Data collection methods
References
15. Reliability and validity
References
16. Data analysis: Descriptive and inferential statistics
References
17. Understanding research findings
References
18. Appraising quantitative research
Critique of a quantitative research study
Critique of a quantitative research study
References
References
References
IV. Application of Research: Evidence-Based
Practice
Introduction
References
19. Strategies and tools for developing an evidence-based practice
References
7
20. Developing an evidence-based practice
References
21. Quality improvement
References
Example of a randomized clinical trial (Nyamathi et al., 2015)
Nursing case management peer coaching and hepatitis A and B
vaccine completion among homeless men recently released on
parole
Example of a longitudinal/Cohort study (Hawthorne et al., 2016)
Parent spirituality grief and mental health at 1 and 3 months after
their infant schild s death in an intensive care unit
Example of a qualitative study (van dijk et al., 2015) Postoperative
patients perspectives on rating pain: A qualitative study
Example of a correlational study (Turner et al., 2016) Psychological
functioning post traumatic growth and coping in parents and
siblings of adolescent cancer survivors
Example of a systematic Review/Met ...
Similar to Hart karern_e[1]._relapse_prevention_for_alcoholism (20)
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
1. DOCTORAL FORUM
NATIONAL JOURNAL FOR PUBLISHING AND MENTORING DOCTORAL STUDENT RESEARCH
VOLUME 3 NUMBER 1, 2006
RELAPSE PREVENTION FOR ALCOHOLISM
Karen E. Hart William Allan Kritsonis, PhD
PhD Student Professor
College of Juvenile Justice and Psychology PhD Program in Educational Leadership
Prairie View A&M University Prairie View A&M University
Fulbright Scholar Member of the Texas A&M University System
Visiting Lecturer (2005)
Oxford Round Table
University of Oxford, Oxford, England
Distinguished Alumnus (2005)
Central Washington University
College of Education and Professional Studies
ABSTRACT
This article examines the utility of the Cognitive–Behavioral model for circumventing
relapse in the treatment of alcoholism. In addition to providing an overview of the
conceptual framework for this approach, the specific techniques used as well as their
rationale will be explored. Finally the article will present critiques of this relapse
prevention methodology and highlight prospective trend(s) for its use in the future.
Introduction
T
he term relapse is used frequently in psychological circles and thus has caused the
tendency for many to minimize its complexity. Its use often abounds with negative
connotations, which conjure images of failure on the part of the client and even perhaps
the therapist. Although not often discussed, there are gradients of relapse in terms of frequency,
duration, intensity and causation.
1
2. DOCTORAL FORUM
NATIONAL JOURNAL FOR PUBLISHING AND MENTORING DOCTORAL STUDENT RESEARCH
2_________________________________________________________________________________________
Purpose of the Article
The purpose of this article is to examine the utility of the Cognitive–Behavioral model for
circumventing relapse in the treatment of alcoholism. In addition to providing an overview of the
conceptual framework for this approach, the specific techniques used as well as their rationale
will be explored. Finally the article will present critiques of this relapse prevention methodology
and highlight prospective trend(s) for its use in the future.
According to the Webster’s New World Dictionary (1996), relapse is a Latin derivative
of relapsus which means to slip or slide back. Relapse Prevention (RP) is a commonly employed
cognitive-behavioral approach that seeks to identify and prevent situations which place persons
in recovery in high risk situations. These are instances in which the person’s attempts to resist
engaging a certain behavior are in jeopardy of being compromised. This may include triggers
such as people, places or activities/events (Witkiewitz & Marlatt, 2004).
RP is perhaps best defined by Witkiewitz and Marlatt (2004) who saw it as an
intervention designed to circumvent and control the relapse of those receiving treatment for
additions and/or problem behaviors. Relapse ought to be considered as both an out come as well
as a process inclusive of any problems the individual may experience during behavior change
efforts. During the person’s efforts to change a behavior, it is very likely that he/she will
experience a lapse or pause of some kind in adaptive behavior. This setback is often followed by
reengaging in the behavior that was previously identified as problematic which is known as a
relapse (Witkiewitz & Marlatt, 2004). RP is deemed by Witkiewitz and Marlatt (2004) to have
an invaluable role in the ongoing development of therapeutic intervention. Hence they advise
that by the conjoint use of cognitive-behavioral models of relapse and RP techniques, maximum
assistance will be provided for persons seeking to abstain or modify for psychological distress
and problematic behaviors.
History of Relapse Prevention
RP dates back to Marlatt’s work on alcohol addiction in the 1970s. As cited in Simonelli
(2005), it mirrored the disease model that was prevalent during that time, and therefore slighted
the role of psychological and situational factors in this phenomenon. He and Gordon later
revamped this theory in 1985 in order to account for the client’s exposure to, and coping skills
in, high risk situations. This not only aided the initiation and continuation of alcohol use, but also
increased the probability for relapse. In 1998, Marlatt and Gordon reconceptualized their
approach to Relapse Prevention; with relapse framed now as an inflection point from which the
client made a choice about future behaviors there was a greater emphasis on skills training,
practice and mastery (Larimer, Palmer & Marlatt, 1999).
In his self control program developed in 1996, Marlatt saw relapse as a failed attempt by
the individual to modify a particular (negative) behavior pattern or to develop new optimal ones.
Others have used time as a defining trait of relapse, for example re-engaging in x for y
days/weeks. At best relapse ought to be considered as a continuous variable, rather than a
3. KAREN E. HART AND WILLIAM ALLAN KRITSONIS
___________________________________________________________________________________________3
dichotomous one, to include both time and quantity as pivotal indices in the process. This view
facilitates the client taking a greater degree of empowerment, which is beneficial for recovery
(Simonelli, 2005).
Originating from Marlatt’s groundbreaking work with alcoholics in 1978, RP as a
cognitive-behavioral model of the relapse process has been widely accepted as it focus on both
the factors at work high risk situations but also the person’s response in it. If there is a low level
of self efficacy the individual may be persuaded into giving in to the craving/desire which is
unfortunately followed by feelings of self blame due to a perceived loss of control (Witkiewitz &
Marlatt, 2004).
RP makes use of role-play techniques in order to assess a person’s response in overt and
covert high-risk situations. This also has secondary gain as it educates the individual about the
potential for relapse, the process and habits/tendencies that bring aid in relapse. RP has been
useful in addressing numerous psychological problems including mood disorders, substance use,
eating disorders, sexual offending and anxiety disorders just to name a few (Witkiewitz &
Marlatt, 2004).
Research on RP indicates that it has a delayed emergence effect with continuous
improvement over time as opposed to other methods. This is best explained by the possibility
that there is a lapse-relapse learning curve where the high risk of a lapse in the wake of
treatment is followed by advances in coping skills which counteract the likelihood of relapse
further on. A study by Irvin et al (1999) showed that in terms of treating substance abuse RP
works better for alcohol users (cited in Witkiewitz & Marlatt, 2004).
Treatment Considerations
Socio-Demographic
The literature proffers several socio-demographic antecedents which must be considered
when designing a RP program. Related to relapse is the amount of education namely less than 12
years with obtaining a GED as the highest, lower socioeconomic status, and ethnicity (non-
Hispanic women). Additional variables cited by Larimer et al, (1999) include low self efficacy or
the lack of confidence in one’s ability to succeed at a task; negative emotions such as anger,
depression, anxiety and boredom; the lack of a social support network; and the original level of
addiction and withdrawal symptoms.
Intrapersonal Variables
Witkiewitz and Marlatt (2004) enumerate several intrapersonal determinants that make
one susceptible to relapse during treatment. They include the following:
4. DOCTORAL FORUM
NATIONAL JOURNAL FOR PUBLISHING AND MENTORING DOCTORAL STUDENT RESEARCH
4_________________________________________________________________________________________
1. Self-efficacy which is the extent that individual feels confident and able to execute the
behavior required during the treatment process. Despite the usefulness of this concept, it
continues to be elusive to measure as the self reports traditionally employed fail to
measure it in circumscribed contexts.
2. Outcome expectancies where the individual’s expectations of the future affects how
he/she will respond. This is based on the anticipation of positive versus negative
outcomes, the cogency of the belief and results of this expectancy in the past.
3. Cravings have been widely studied in addiction but its role in addition continues to be
misunderstood. In moving beyond the subjective feeling/craving to the cue exposure
mechanisms that fuel it RP has been met with success.
4. Motivation is pivotal to RP as it encompasses both the motivation to engage in the
problematic behavior as well as the motivation to change. DiClemente and Hughes’ 1990
transtheoretical model of motivation, cited in Witkiewitz and Marlatt (2004) aptly
delineate the five stages of readiness for change: precontemplation, contemplation,
preparation, action and maintenance.
5. Coping, in particular behavioral approach coping via meditation exercises have been
linked to decreased addictive behaviors, interpersonal and psychological problems within
a year of treatment. Despite this success the foundational cognitive behavioral processes
of coping continue to be elusive.
6. Emotional States, in particular negative affect, has been inextricably tied to relapse and
the perpetual engagement in problem behaviors.
Interpersonal Variables
The interpersonal determinants which include the quality, availability and functionality
of social support have proven predictive of RP. One should be reminded though that many of the
psychological issues to which RP has been applied have social isolation as a major contributing
factor for its initiation and maintenance (Witkiewitz & Marlatt, 2004).
Theoretical Cornerstones
Cognitive-Behavioral Coping Skills Therapy (CBST) has evolved since its introduction
by Marlatt in 1970. It is now a collaboration of treatment approaches aimed at increasing a
client’s cognitive and behavioral for the lasting change of problem behaviors such as alcohol
dependence and psychiatric disorders. Despite the variation in CBST in terms of duration,
modality, content and treatment setting it is known for two cornerstones. Firstly, they adhere to
Bandura’s social learning theory and see coping deficits for life and alcohol cues as precursors
for substance dependence. Secondly, it utilizes individualized skills training by modeling, role
5. KAREN E. HART AND WILLIAM ALLAN KRITSONIS
___________________________________________________________________________________________5
playing, instruction and behavioral rehearsal to compensate for deficits (Longabaugh &
Morgenstern, 1999).
According to Longabaugh and Morgenstern (1999), CBST views substance dependence
and all other forms of psychopathology as maladaptive learning hence it strives to have them
unlearned and replaced with adaptive responses. Apart from its historicity in the field of
alcoholism treatment CBST continues to be ranked highly for its clinical and cost effectiveness
which is attributed to the context that treatment is delivered in and when it is a part of a
comprehensive ongoing intervention (Longabaugh & Morgenstern, 1999).
Treatment Options
Several variations of RP have been devised and offer promise for success in the future
which reconceptualize relapse as a multidimensional system with complexities that require
simultaneous attention to the client’s disposition(s), behavioral contexts as well as past and
current experiences with the cessation of problem behaviors. As such it concedes that there are
numerous considerations for what triggers and influences relapse such as client background,
psychological states, cognitive processes and coping skills (Witkiewitz & Marlatt, 2004).
Among the recent psychological tools that have been employed in preventing relapse
during the treatment of alcoholism, Coping Skills Training (CST) and Cue-Exposure Treatment
(CET) have been met with a great measure of success. According to Monti and Rohsenow (1999)
it is opined that these techniques lessen the chances that a client will relapse in urge provoking
situations because of feeling overwhelmed.
Coping Skills Training
CST has been a work in progress for several decades and originates from the social
learning paradigm. Monti and Rohsenow (1999) postulate that alcohol relapse is likely when the
client has limited coping skills to cope with stressful or high risk situations, when it is expected
that drinking will be pleasurable and the individual’s belief that he/she is unable to cope without
drinking. The therapist strives to build the client’s coping skills repertoire for subsequent use in
high risk situations for the resumption of drinking. This is accomplished by teaching clients
which skills to use in such cases, social skills training is given to enable sobriety in relationship
selection all which work to build the self-efficacy of the client thereby increasing the continued
use and mastery of skills (Monti & Rohsenow, 1999).
These go further to endorse the use of CST given earlier research which highlighted
deficits in the coping abilities of alcoholics especially in situations with the risk for relapse. The
use of role play exercises have proven useful in reordering behavioral choices and increasing
feelings of self-efficacy. In light of the role that negative emotional states play in relapse,
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bolstering self efficacy has tremendous utility in ameliorating such feelings (Monti & Rohsenow,
1999).
In terms of the treatment process, CST traditionally commences by assessing the client’s
area(s) of vulnerability across biological, psychological, intrapersonal and interpersonal domains.
Special attention is paid to risk factors for the latter by an inventory of conflict resolution, refusal
and primary social skills. Finally the extent of the client’s exposure to alcohol cues is
determined. Studies indicate that CST enables the client to generate specific coping responses in
a shorter period of time which strongly predicted the frequency and duration of relapse – if it
occurred at all (Monti & Rohsenow, 1999).
Information obtained from Monti and Rohsenow (1999) indicate that of the CST
Techniques, there are four (4) extensively used ones. They are:
1. Relapse prevention training in which a specific high relapse risk situation is simulated
and the client is taught appropriate skills for use there
2. Social or communication skills training seeks to build the client’s social relationship via
interpersonal training to minimize conflict, develop sober support, and/or facilitate
lifestyle change
3. Urge-specific coping skills training is a significant component of CET and will be
described later
4. Cognitive-behavioral mood management
Cue-Exposure Treatment
Cue-Exposure Treatment (CET) endeavors to educate the client about the various alcohol
related triggers that fuel their urge to engage in drinking. During the therapy, the client is taught
diverse coping strategies and engages in mass practice while in a safe environment for later
generalization to real life (Longabaugh & Morgenstern, 1999).
As an off-shoot of learning and social learning theories, CET acknowledges the
relationship between alcohol-related environmental cues and consumption relapse. Classical
conditioning purports that the repeated pairing of alcohol with naturally occurring emotions,
places, and persons results in a conditioned response that can aid in relapse (Monti & Rohsenow,
1999). Social learning theory suggests that certain cues hold salience and because of this
relevance as per positive effects can prompt alcohol consumption. It is these cues that short-
circuit the client’s coping ability, and beliefs about such, by activating various cognitive and
neurochemical reactions. Studies on CET advise that treatment should reduce the client’s
reactance to the cues by their repeated exposure to it in a safe environment, and offer practice in
using coping skills in the presence of alcohol cues (Longabaugh & Morgenstern, 1999).
Various CET program for substance use modulate their level of cue exposure in
accordance with the client’s treatment goal. For those who desire moderate drinking strategies
may include them sniffing, tasting, then decreasing sizes of sips and lengthening intervals
between them. Others where the goal of abstinence may involve the client acting out the stages
of drinking (picking up, looking at, smelling the drink) without actually consuming any. By so
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doing treatment providers are able to tailor the skills training to the client’s specific needs by
identifying his/her triggers (Longabaugh & Morgenstern, 1999). Despite the limited amounts of
controlled studies that have been conducted on CET, these authors suggest that evidence is
promising an endorsement of it given its ability to reduce the severity of alcohol consumption
and the more frequent use of urge-specific coping skills independently.
Criticisms of Relapse Prevention
No therapeutic approach is with critique and several concerns have been raised in the
literature regarding RP techniques. Marlatt’s theory has been criticized for its hierarchical
classification of factors that influence relapse (Witkiewitz & Marlatt, 2004). In terms if the
specific methods described earlier, it is difficult to expose participants in research studies and
CET programs to all the potential real-life situations that they will encounter. At worse, it would
be grave ethical breech to explore the gamut of alcohol consumption with persons already having
challenges in this area. In such cases imagery exposure or vicarious learning is used (Monti &
Rohsenow, 1999).
Constrained by ethical considerations regarding experimental design studies with human
subjects, in many of the theories and models of RP cannot be fully tested to their empirical
fullness. One potential remedy with hope of redressing this lies in the use of computing
techniques that allow simulation studies to index the trajectory, severity and variability of
symptoms during the course of treatment (Witkiewitz & Marlatt, 2004).
Ethical concerns may also arise from the use of Urge-specific CST/CET techniques as the
client is (actually) given alcohol as a primer for subsequent situations that call for his/her
resistance. Given the addictive quality of alcohol and other substances with which this technique
has been used and the fact that the participant’s are often in non-resident facilities their cognitive,
physical and emotional well-being becomes a concern. Programs that employ these methods
claim to provide adequate supervision, therapist care and terminal observations at the end of the
session for residual effects (Monti & Rohsenow, 1999).
Regrettably, the veracity of CBST’s effectiveness has not been conclusively proven for
several reasons. Firstly, one must consider that CBST calls for mastery and the application of
coping skills to real life situations before the therapist can actually attest to the client’s
acquisition of it. Research needed to fully determine this would have to be longitudinal and is
therefore cost prohibitive. Also because of the cut backs to therapy by managed care, clients are
often not provided with the timeframe needed to accomplish this (Longabaugh & Morgenstern,
1999). Despite the existence of Alcoholics Anonymous (AA) and other group self help program
from the 1940s there has been renewed interest in these 12 step facilitation programs (TSF). This
is due in great measure to the managed care has reduced the amount of time and intensity of
professional addiction (Humphreys, 1999).
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Concluding Remarks
In conclusion, the future of RP is promising and it remains a therapeutic approach to
addiction that is in high demand. The goal of the article is to examine the utility of the
Cognitive–Behavioral model for circumventing relapse in the treatment of alcoholism. Plans for
RP include broadening its focus to include components of other therapies. These would include
motivational interviewing to increase a client’s desire for change; the inclusion of a referral
module to one of the successful addiction/behavior change groups such as AA; the inclusion of
the client’s significant other(s) in the treatment process; the use classical conditioning to
extinguish responses; and the use of psychosocial techniques and pharmacological therapy in
combating addiction to alcohol (Longabaugh & Morgenstern, 1999).
References
Humphreys, K. (1999). Professional interventions that facilitate 12-step self help group
involvement. Alcohol Research and Health, 23(2), 93-98.
Larimer, M. E., Palmer, R. S. & Marlatt, G. A. (1999). Relapse prevention: An overview of
Marlatt’s cognitive-behavioral model. Alcohol Research and Health, 23(2), 151-160.
Longabaugh, R. & Morgenstern, J. (1999). Cognitive-behavioral coping-skills therapy for
alcohol dependence. Alcohol Research and Health, 23(2), 78-85.
Monti, P. M. & Rohsenow, D. J. (1999). Coping –skills training and cue-exposure therapy in the
treatment of alcoholism. Alcohol Research and Health, 23(2), 107-115.
Simonelli, M. C. (2005). Relapse: A concept analysis. Nursing Forum, 40(1), 3-10.
Webster. (1996). Encyclopedic unabridged dictionary of the English language. New York, NY:
Gramercy Books.
Witkiewitz, K. & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems.
American Psychologist, 59(4), 224-235.
Formatted by Dr. Mary Alice Kritsonis, National Research and Manuscript Preparation Editor,
NATIONAL FORUM JOURNALS, Houston, Texas. www.nationalforum.com