Category: Psychology

CHILD DEVELOPMENT THEORY AND PRACTICES

child development theory
Child development theory

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Child Development Theory and Practices

Introduction

Childhood development is the theory and practice of procedures to ensure that the child is given the proper resources, guidance and nutrition to see them through their infancy up to middle school. Child development can also be the biological, social and psychological change in a child as they grow. However, it is supported by the various efforts and developmental models chosen and taken by their parents and guardians. Indeed, the development of a child involves aspects such as pedagogical development and the development of the various biological systems in the body.

The whole process is geared towards achieving total autonomy in the child. Children are exposed to many issues at an infant age. The most challenging of these issues is the introduction of new diet.  Children often have to begin feeding on supplementary diet that is different from mammary milk after they attain the age of twelve months. Child development policies and strategies ensure that these steps and stages in the development of the child are done incrementally and professionally to achieve desired impact (Bevans, Riley & Forrest, 2010).

Background on child development

Child development has been a source of scientific and medical research over the last few decades. Policies in child development often relate to the ability of the parent to help them achieve autonomy. However, with regard to theories in child development, the concern has often been about the emotional and physical relationship of the child and the mother. Many studies have been done on issues in child development. They have since resulted in aspects of child treatment, immunization and even nutrition.

The most significant theories in child development are the Developmental theories and the attachment theories (Warner, 2007). It is necessary however to realize that although most of the theories on child development have hardly been refuted, they have not been unanimously approved as well. Child development is often the cause of controversy in many policy development forums. There are particular goals that need to be achieved in child development but many different approaches to achieve these theories.

Where child development in a biological context is concerned, the physical change in the body of a child as they move from childhood to puberty is often a marvel in scientific research. Many children often realize a particular affinity for certain objects, games and pleasantries as they grow. However, there is likely that a child’s growth potential is achieved by the time they reach puberty (Bevans, Riley & Forrest, 2010). Children however do not easily learn the psychomotor skills on their own.

The exposure the child gets as they grow often determines how well they grow with regard to psychological and emotional development. There is indeed a direct relationship between the child’s environment and their eventual personality traits. More so, the adaptability of the child at the infancy stage is higher than at any other stages in their development. This is why child development theory and practice takes center stage among many pediatric research and education practices (Capel, 2012).

Child development however exceeds past growth. For instance, when a child grows, organs do not just grow, they are specialized. The same is the case for the various body cells and senses. They become bigger (grow) and better at their functions (develop). Child development theories thus take all these issues into account. However, with regard to the aspects and determining factors in child development; it is often the case that cases of child development complications are often treatable.

Medical research asserts that since the mind of the child keeps changing and growing, it is often the case that children may outgrow behavioral and psychological issues. There is however contention on the possibility of child brain research towards the treatment of regressive growth involving limbs and other bodily organs with a rich nervous system (O’Connor & McCartney, 2007).

Child Development Theories

Child development theories assess the growth and development of the child; the mitigating factors and the various aspects of the growth. Theories try and explain why phenomena such as development of limbs, ability to walk, talk and read as well as the growth of the intuition in a child occurs as it does. The major categories children are classified into often include; newborns, infants, toddlers, preschoolers, school-aged children and adolescents. These different categories of children often exhibit different traits.

This is why models are often specific to the category and explain how growth takes place from one category to the next. There are various theories formulated towards contributing to child development policies. However, this paper will discuss two main theories; child development theories and child attachment theories. These theories help scientists assess various growth factors and inhibitors to proper development of the child (Rigby, 2007).

Child development theories assess and explain the factors behind a child’s development. The most common of these theories is the ecological systems theory. The ecological systems theory was first proposed by Urie Bronfenbrenner. He proposed four categories for child biological development. These include; microsystem, mesosystem, exosystem and macrosystem. The microsystem of the child is the nervous and cardio vascular system. The mesosystem defines the muscular system in the body.

The exosystem defines the skin organ of the body and all systems that interact with the external environment while the macrosystem defines the organ system in the body. A child’s development is expected to take place simultaneously in all these four stages. The theory also proposes that each of these subsystems contains particular norms and principles that guarantee development in a symbiotic manner. The relationship between the systems defines how well or retarded growth in a child is.   

The child attachment theory defines the psychological, evolutionary and ethological development of a child. The theory asserts that interpersonal relationships between human beings are based on the development and proliferation of psychological needs. These needs stem from the child’s emotional upbringing and contact with the environment they live in. It is thus a concern that needs to be addressed by care givers.

The child’s evolutionary needs have to do with the child’s nutrition and socialization. Aspects such as early schooling, introduction to sporting activities and involvement in household chores contribute greatly to child development. It is thus critical to achieve these early. However, ethological (behavioral) growth in a child is cultured from the observations the children make on their own. This is why the environment one raises a child in must be protected from unnecessary exposure.   

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Early Childhood Education Theories

Early childhood education theories discuss the development of the child as they progress through school from introduction to later stages in school. For instance; the Development Integration Approach in child development discusses child development on aspects such as; physical, social, emotional, language and cognitive skills. Physical development is assessed through measures such as the body mass index (BMI) that evaluates the mass against the height of the child. Social and emotional development skills are the skills the child acquires from interacting with other children and adults.

Language can be considered in two aspects; the first language the child was exposed to; known as L1 and the other languages follow as L2, L3…However, language can also be the ability of the child to learn etiquette, euphemism and other necessary language skills at an early age. Cognition in a child is the most observable change. Abilities such as reading, learning and concentrating however take time to develop in a child. The ability to use language properly is very important to the child’s growth as it makes them able to communicate (Warner, 2007).

The other common theory in early childhood education is the socio-cultural learning theory. This theory asserts that the impact of the child’s social experiences as well as their cultural disposition affects their individual thinking and the development of their mental processes. This is why it is important to raise children in environments that elicit such growth potential.

All the same, whatever environment the child finds themselves in is able to affect their mental and psychological health either positively or negatively. The theory by Lev Vygotsky proposes that cognition should be trained by the child’s care givers since it occurs on a social context. Allowing children to play and undertake certain responsibilities early prepares them for such responsibilities in the future (O’Connor & McCartney, 2007).

For instance, early driving classes make the child develop an intuitive sense that helps them discern the path to take while on the road and the decisions that can help them avoid accidents and dangerous driving. Socio-cultural learning also presents the argument that a child born in cultural practices will likely learn them and embrace them early if they are exposed to them from the onset.      

Conclusion

Early childhood development is a phenomenon that has been observed by scientists across the world for centuries. Indeed, aspects of child development such as the development of psychomotor skills, cognitive development and physical development often relate to the child’s culturalization. Most care givers are advised to monitor the path through which the child takes in their development actualization pattern in order to grow into the anticipated adults society envisions.

However, there are biological factors in child development and growth that do not really have anything to do with the care givers but actual parents. Genetic factors are often difficult to deal with as they are as the result of recessive genes since childhood. In such cases that these recessive genes lead to visible impaired limbs, it is necessary to seek medical attention to know how to handle these cases (Ogunnaike, 2015). Children should always be brought up in environments where they feel safe and able to interact freely with all persons in their vicinity. Since most of what they learn is acquired from vision, it is important to invest on the child’s environment and control it as much as possible without interfering with it.  

References

Bevans, K. B., Riley, A. W., & Forrest, C. B. (2010). Development of the healthy pathways child-report scales. Quality of Life Research, 19(8), 1195-214. 

Capel, C. M. (2012). Mindlessness/mindfulness, classroom practices and quality of early childhood education. The International Journal of Quality & Reliability Management, 29(6), 666-680. 

Rigby, E. (2007). Same policy area, different politics: How characteristics of policy tools alter the determinants of early childhood education policy. Policy Studies Journal, 35(4), 653-669.

O’Connor, E., & McCartney, K. (2007). Examining teacher-child relationships and achievement as part of an ecological model of development. American Educational Research Journal, 44(2), 340-369.

Ogunnaike, Y. A. (2015). Early Childhood Education and Human Factor: Connecting Theories and Perspectives. Review Of Human Factor Studies, 21(1), 9-26.

Warner, M. E. (2007). Child care and economic development: Markets, households and public policy.International Journal of Economic Development, 9(3), 111-121.

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Erikson’s Psychosocial Development theory

development theory
Erikson’s Psychosocial Development theory

Erikson’s Psychosocial Development theory: Stages Case Study

Divorce or parents separation is associated with behavioral issues displayed by children. This is because family separation is a challenging obstacle for the whole family. Children are usually not emotionally mature to understand the situation; therefore, their stress and frustrations are often manifested by changing some aspects of their behavior.  Erikson’s psychosocial development theory indicates that human undergo through a series of developmental stages. These include; Trust vs. Mistrust, Autonomy vs. shame, initiative vs. guilt, industry vs. inferiority and identity vs. confusion (Burn et al. 2013).

Explanation of John’s behavior

In this case, John developmental stage falls under identity vs. identify confusion stage of the Erikson’s psychosocial development theory. This indicates that John’s behavior is driven by feelings of frustration, confusion and anger. These negative emotions are associated with diminished school performances and achievements. The fact that he leaves school early without permission or late of school in the past 60 days indicated   that he could be indulging in risky behavioral activities such as alcohol and drugs (Bowden & Greenberg, 2010).

 Two priority nursing concerns and nursing interventions

 The main characteristic of divorce is impaired parenting. This refers to the inability of either parent to maintain or establish an environment that promotes optimum development of John. Therefore, the two priority nursing concerns are (Paul, 2016):

  1. Poor academic performance related to social isolation, poor family cohesiveness and lack of communication.

Intervention:  The nurse should use active listening to explore the child developmental expectations and needs within the context of socio-cultural influences. This will be achieved by interviewing the child in absence of his care taker in order to make him express his frustrations freely (Burn et al. 2013).

  1. Incidence of psychological trauma related to social isolation, changes in family unit and maladaptive coping skills.

Intervention: The parenting styles and behaviors should be examined including the child’s environment, type of interaction and presence of other behavioral problem.  The nurse should institute neglect/abuse protection measures if risk of neglect and abuse is suspected (Murphy, 2012).

Reference

Bowden, V. & Greenberg, C. (2010). Children and their families. Philadelphia: Lippincott Williams & Wilkins.

Burns, Catherine, Dunn, A., Brady, M., Starr, N. B., Blosser, C. (2013). Pediatric Primary Care, 5th Edition. [VitalSource Bookshelf Online].

Murphy, M. (2012). Parental divorce: Relationship between ego strengths and impact of divorce on adult children from an Eriksonian perspective. Retrieved from http://library.argosy.edu

Paul, H. (2016). How to Talk to Your Kids about Your Divorce, by S. Rodman. Child & Family Behavior Therapy, 38(2), 184-189. Retrieved from http://dx.doi.org/10.1080/07317107.2016.1172892

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Sensory Impairment Essay Paper

Sensory Impairment
Sensory Impairment

Sensory Impairment

An individual experiencing sensory impairment may face quite a number of challenges in life. With respect to higher level needs that are defined in Maslow’s hierarchy of needs. A visually challenged individual may find it harder to actualize these higher level needs. The higher level needs that include self-actualization, self-esteem and love and belonging needs, are among the particular needs that this paper will try to elaborate on how challenging they are to a visually challenged individual to meet them.

Love and belonging is nature to most if not all human beings.  These needs depict the nature of the interpersonal relationships that are adopted by most humans. However, for a Sensory Impairment person. It may be quite difficult for them to find a sense of belonging in an environment that does not favor him or her. Creating interpersonal relationships with people without actually seeing their physical appearance will be the main issue to be dealt with.

Consequently, self-esteem needs are quite important in Maslow’s hierarchy. But for a Sensory Impairment person, attaining this needs may be a challenge. They may find it extremely hard to gain confidence. It might be quite difficult for this particular individual to be able to satisfy his or her desire to be valued by other people when he or she is visually challenged.

Lastly, self-actualization needs is on the pinnacle of Maslow’s hierarchy. Self-actualization entails five key things that are key to human beings. However, for visually challenged individuals, to fully satisfy their self-actualization need may prove to be hard if the person has not yet accepted the impairment condition that faces him or her.

The nursing intervention that would be applied by a registered nurse may include the following practices. First of all when meeting the patient, the nurse will have to make a good first impression. Reason being first impression go a long way into helping visually impaired patients feel cared for.

This also helps in creating a healthy relationship between the two parties (Treas & Wilkinson, 2013). Second of all, the nurse would help the patient meet their self-esteem and self-actualization goals by helping then get to know the environment they are staying in. This would help them feel confident by not requiring aid all the time to perform the basic life activities from time to time.

Therefore, for a visually impaired individual, the attainment of the love and belonging, self-esteem and self-actualization goals may be a cumbersome task. However, with the application of the right nursing intervention by a registered nurse. The attainment of these needs in the long run may be an overcome able situation.

References

Treas, L. S., & Wilkinson, J. M. (2013). Basic nursing: concepts, skills, & reasoning. FA Davis.

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Social Attraction: Social Psychology

Social Attraction
Social Attraction

Social Attraction

Social attraction between people is very important. Aspects of social attraction such as love, understanding and care are difficult to explicate because they often go against many norms in life. It is crucial to ensure that these aspects are maintained along a certain line and many people keep it that way. For instance, love is governed by respect, trust and mutual understanding. Care is a precept of responsibility and authority while understanding stems from knowledge and wisdom (Anders, et.al, 2016).

Attraction between people has one key aspect to it; beauty. What anyone would find attractive is often the aspect of life that they feel is appealing to them. Beauty and attraction may have a lot in common but they are not common to all (Anders, de Jong, Beck, Haynes& Ethofer, 2016). This is why it is important to analyze social factors that generate stereotypes about beauty and attraction.  

Beauty is defined as the experience of pleasure or satisfaction based on perception. That is why beauty can only be seen and not felt (Anders, et.al, 2016). What people see as beautiful is often a creation of their social setting. For instance, people who hardly encounter persons of a different race may deem them to be more beautiful or less beautiful depending on their socialization (Weidenfeld& Leask, 2013). In many social setups, beauty is displayed by models on newspapers, article magazines and websites.

It is a form of influence that ends up making the person to feel that what they see as beautiful is not as beautiful or appealing as they suppose. Beauty is thus a form of influence that is borne out of what the society considers to be appealing or not. Beauty is however the greatest contributor to perceptions about attraction (Launay& Dunbar, 2015). Where there is attraction, beauty is often a factor that is critical and central to the theme.

Beauty is a concept that makes up most of the arguments and concepts about attraction. Attraction is vital to any relationship between people because it obscures the feeling of human weakness and inequity. Man is known to be imperfect and very unsymmetrical in many ways. Beauty however is the concept of perfection without prejudice and need to approve other concepts within the person observed.

Beauty makes it possible for people to overlook human inequities that are ever existent and often profoundly the cause for the use of derogative words on people (Sprecher, Treger, Fisher, Hilaire & Grzybowski, 2015). What is not attractive is often despised and chastised. It is vital to remember that perception is simply an illusion that may not be similarly felt by another person (Anders, et.al, 2016). More often than not, the feeling that one is able to achieve a particular attraction or not is all about what they perceive to appeal to them. This is what beauty is all about.

The concept of beauty or appeal in attraction is very complicated because attraction between people can be out of many reasons as well. However, the urge to go beyond the necessary to please the other person is borne out of a need for appreciation or the desire to do right. This can be considered as beauty of purpose or the innocence of decision and motivation. Beauty is about purity and sanctity. There is often a significant appeal from society to get things done but hardly a similar motivation in attraction.

As explained by Talamas, Mavor& Perrett (2016) Attraction is about the traits that make one seem to have a beautiful character and to some extent, beautiful build and look. It applies to both persons of the male and those of the female gender (Talamas, Mavor& Perrett, 2016). Other traits that accompany beauty include; hard work, diligence and determination. They often seem to be of an enlightenment that sparks influence among people. Although affluence is more influential than these traits, it follows that one would find another person with such traits likely to be attractive.

However much there may be aspects that one looks for in an attractive partner beside their physical appeal, the appeal of the self is the most important (McGinley, et.al, 2015). Attraction is about having a similar feeling towards a person at all times without altering the feel of the person based on the circumstance. Beauty is thus best explained by the features one possesses. These features make it possible for the person to ultimately influence a feeling of desire in another person.

It is about the makeup women put on or the expensive suits men wear. It is about making the other person like what one already likes (Ioerger, Henry, Chen, Cigularov& Tomazic, 2015). Attraction can thus be predetermined and premeditated. It is a factor that can easily be manipulated in people’s minds and an issue that is hardly the cause for divisive argument.

According to Englis, Solomon, & Ashmore, (2014), various cultures perceive beauty differently. This is because beauty often defines how attractive one is and since there is a difference between values from one culture to another, there is also a difference in factors making up beauty. However, as per Vacker & Key (2013), despite the variations in perception across various cultures, beauty remains to be one of the most influential factors in establishing attraction between people.

The current generation of the 21st century regards beauty as an outward appearance of an individual that is desired. Therefore, they support the definition that beauty refers to what can be seen by the eye to be appealing. However, before the current perception and definition of beauty, various cultures had unique features which if present in an individual, he or she is regarded as being attractive (Englis, Solomon & Ashmore, 2014.

The character of a person was a big determinant in whether the person is seen as beautiful or not. This is because there were people who could be attractive, win other people’s hearts, and influence others by just interacting with them. In such a case, beauty becomes defined by the intrinsic features that a person possess and not their outward appearances. Societies which belief in both intrinsic and extrinsic beauty believe that the existing inequality in appearance between people should not be a major cause for regarding someone as not being beautiful.

There are various stereotypes that are related to attraction. As explained by Vacker & Key (2013), most people tend to think that people naturally get attracted to those individuals whom they have certain common features with. This stereotyping concept involves both men and female, and in this example, the proponents of this belief argue that the existing high number of integration, interaction, marriage, and business establishments between people of the same ethnicity proves that people get attracted to others whom they share certain common features. Perceptions that people with same characteristics or origin easily see each other as beautiful is also based on culture.

In this regard, it is easier for a person to recognize\e another person as being beautiful if both of them share a common culture or origin.  Another stereotyping about beauty is that it is more pronounced in women as compared to men (Englis, Solomon & Ashmore, 2014). Therefore, it is easier for men to regard women as being beautiful as compared to seeing other men as a beautiful. As a result, it is expected that attraction will flourish easily between men and women as compared to between men and men. (Vacker and Key, 2013). 

There has been a misconception about love and beauty especially when it comes to how these two feelings ate expressed by people. As explained by Diessner, et.al (2012), most people find it difficult to distinguish love from beauty. This is because both of the two feelings give one the desire to be or like another person so much.  However, it should be noted that love and beauty are different in the sense that love develops between individuals irrespective of whether they are beautiful or not.

In other words, one does not need to be beautiful or to possess certain features for them to be loved by another individual. Moreover, love takes a long time to appear, and in most cases, it comes involuntarily and gives little consideration to both outward and inward appearance of a person. On the other hand, attraction is mostly felt as a result of existing beauty between the attracting individuals. Moreover, it considers features that are present in an individual and may end if a person changes in certain ways. Also, attraction can be felt only after a short time whereas love mostly lasts forever (Vacker & Key, 2013).

There are various theories of beauty. However, Denis Dutton’s and Andrew Park provocative theory offers the best insight into the current beauty trends surrounding attraction (Diessner, et.al, 2012). They do believe that beauty is specific to an individual. However, it is also a part of human nature that has very deep evolutionary origins. 

Other existing theories such as the typical beauty theory of Ruskin and the vital beauty theory try to explain the essential characteristics of an individual that constitute their beauty status. Therefore, they help propagate the notion that a person can improve his or her beauty through effort

There are two major forms of beauty that are inexistent at the moment. These are; augmented beauty and natural beauty. Whereas naturally beauty is acquired naturally and one may possess it from the time they are born, augmented beauty is acquired artificially (Diessner, et.al, 2012). To acquire augmented beauty, a person uses various artificial beauty products and solutions to enhance their appearance by becoming more beautiful than they were previously.

Even though both these two types of beauty makes one attractive, there are various concerns about the longevity of augmented beauty. It is argued that it may cause attraction just for a short period and in the long term, the attraction may cease to exist as some of the beauty features will fail to reciprocate themselves positively. On the other hand, natural beauty is always desired as it creates the true picture of an individual on others thereby aiding in establishing trust.

The importance of being beautiful has caused some individuals to become beautiful. This is because, without beauty, a person may not be attractive to others. As a result, they may end up feeling dejected and living a lonely life. Since human beings are social species, it is wise to put in effort to enhance beauty so as to live a comfortable and soothing life with many admirers as compared to living unfulfilling life as a result of low beauty levels.

Therefore, as Englis, Solomon and Ashmore (2014) argues, it is more sensible to put in effort so as to improve a person’s beauty as compared to leaving it the way it is and undergoing a tough social life (as Englis, Solomon and Ashmore, 2014).

Many people consider the feeling of attraction to be related to the symmetrical shape of the person, shape or thing. Many people are attracted to beauty and not value. There is thus the general feeling that most human beings will often proverbially ‘read a book by its cover.’ This is a concern among persons who mask their attractive qualities by not being very outgoing and expressive about their characters.

It is thus important to ensure that one is always able to express their ‘inner beauty’ where the outer beauty does not appeal to many people in order for the rest of society to find them attractive (McGinley, Zhang,Mattila& O’Neill, 2015). This is critical in the world where perception is often the main reason for attention on certain details. This means that beauty is a form of influence that is borne out of what the society considers to be appealing or no.

Even though this is contextual, it has led to development of various techniques of acquiring beauty through artificial techniques. These means have often been sought by individuals who feel that they are not appealing in terms of beauty.

References

Anders, S., de Jong, R., Beck, C., Haynes, J., & Ethofer, T. (2016). A neural link between affective understanding and interpersonal attraction. Proceedings of the National Academy of Sciences of the United States of America, 113(16), E2248-E2257. doi:10.1073/pnas.1516191113

Diessner, R., Solom, R. C., Frost, N. K., Parsons, L., & Davidson, J. (2012). Engagement with beauty: Appreciating natural, artistic, and moral beauty. The Journal of Psychology, 142(3), 303-29. Retrieved from http://search.proquest.com/docview/213828232?accountid=45049.

Englis, B. G., Solomon, M. R., & Ashmore, R. D. (2014). Beauty before the eyes of beholders: The cultural encoding of beauty types in magazine advertising and music television. Journal of Advertising, 23(2), 49. Retrieved from http://search.proquest.com/docview/236550542?accountid=45049

Ioerger, M., Henry, K. L., Chen, P. Y., Cigularov, K. P., & Tomazic, R. G. (2015). Beyond Same-Sex Attraction: Gender-Variant-Based Victimization Is Associated with Suicidal Behavior and Substance Use for Other-Sex Attracted Adolescents. Plos ONE, 10(6), 1-16. doi:10.1371/journal.pone.0129976

Launay, J., & Dunbar, R. M. (2015). Playing with Strangers: Which Shared Traits Attract Us Most to New People? Plos ONE, 10(6), 1-17. doi:10.1371/journal.pone.0129688

McGinley, S., Zhang, L., Mattila, A., & O’Neill, J. (2015). Attraction to Hospitality Companies: How Processing Fluency Moderates Value Fit. Journal of Human Resources in Hospitality & Tourism, 14(1), 25-44. doi:10.1080/15332845.2014.904171

Mitteness, C. R., DeJordy, R., Ahuja, M. K., & Sudek, R. (2016). Extending the Role of Similarity Attraction in Friendship and Advice Networks in Angel Groups. Entrepreneurship: Theory & Practice, 40(3), 627-655. doi:10.1111/etap.12135

Sprecher, S., Treger, S., Fisher, A., Hilaire, N., & Grzybowski, M. (2015). Associations Between Self-Expansion and Actual and Perceived (Dis) Similarity and Their Joint Effects on Attraction in Initial Interactions. Self & Identity, 14(4), 369-389. doi:10.1080/15298868.2014.1003592

Talamas, S. N., Mavor, K. I., & Perrett, D. I. (2016). Blinded by Beauty: Attractiveness Bias and Accurate Perceptions of Academic Performance. Plos ONE, 11(2), 1-18. doi:10.1371/journal.pone.0148284

Vacker, B., & Key, W. R. (2013). Beauty and the beholder: The pursuit of beauty through commodities. Psychology & Marketing (1986-1998), 10(6), 471. Retrieved from http://search.proquest.com/docview/230393591?accountid=45049

Weidenfeld, A., & Leask, A. (2013). Exploring the relationship between visitor attractions and events: definitions and management factors. Current Issues In Tourism, 16(6), 552-569. doi:10.1080/13683500.2012.702736

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Intellectual Disability: Research Paper

Intellectual Disability
Intellectual Disability

About 1 percent of the entire population has intellectual disability, which is a considerable disorder in adaptive as well as intellectual function in the early stages of development (Aveyard 2014). Individuals with the intellectual disabilities rate of developing mental illness are greater in comparison to the whole population, however, challenges in communication, access to services, literacy means that mental issues in persons with intellectual disability are inadequately recorded.

Moreover, the majority of persons with intellectual disability exhibit challenging behaviors, meaning characters of intensity, duration, and frequency that endangers their physical safety or those around them or even restricts accessing community services.

For a long period, there have been concerns that psychotropic medicine especially, antipsychotics are overused as such prescribed for problem behavior instead of diagnosing mental sickness, regardless of insufficient proof on their effectiveness. Nonetheless, getting an accurate amount of psychotropic in persons with learning disabilities is intricate, while present literature is limited due to varying descriptions.

In spite of inadequate proof from policy context, there is no detailed assessment of psychotropic in adults with learning disability in United Kingdom primary care conducted, while results from other nations cannot be generalised due to variations in health care provisions as well as practices (Guerzoni & Zuleeg 2011).                                     

Proof demonstrates that psychotropic use in entire population has been increasing tremendously for the past years, however, few studies have investigated that the patterns used to prescribe psychotropic among persons with intellectual disability. Regarding deinstitutionalization, creating warrens of psychotropic use, adverse effects and efforts to minimise its use to individuals with learning disability through the implementation of prescription standards are not clear. Furthermore, with the large as well as representative sample size, it is apparent that there are increased rates of mental illness, challenging behavior and psychotropic medicine among people with intellectual disability.

Research Question

  1. Do challenging behaviors among persons with learning disabilities result from mental impairments?
  2. Are social workers faced with challenges caring for persons with learning disabilities?

Research Objectives

  1. To establish whether or not challenging behaviors among persons with learning disabilities result from mental impairments
  2.  To understand some of the challenges that come with caring for persons with learning disabilities

Hypothesis

  1. H0:       Challenging behaviors among persons with learning disabilities do not result from mental impairments
  2. H1:       Challenging behaviors among persons with learning disabilities do not result from mental impairments
  3. H0:       Social workers caring for persons with learning disabilities do not undergo challenges that wear them down
  4. H1:       Social workers caring for persons with learning disabilities undergo challenges that wear them down

What is challenging behavior?

An individual’s conduct may be regarded as challenging if it threatens their safety or those around, particularly care or even contributes poor life quality. In addition, such behaviors can influence their capacity to participate in routine activities. Challenging behaviors consist of self-harm, destructiveness and aggression among others. Communication determines the way in which people express their needs.

In the event that communication is problematic, it may extremely discourage individuals leading to challenging behavior. If such behavior contributes to desire results, it may be repeated over and over. Challenging behaviors are common in persons with problems that impact communication and the brain including learning disability, and dementia (Economist Intelligence Unit 2011).          

Challenging behavior or behaviors that challenge are culturally anomalous behaviors of frequency or duration that endangers their safety or others. In most cases, an individual must display trends that are a threat to services for a significant timeframe. Seriously challenging behaviors are not transient occurrences. According to the National Institute for Health and Care Excellence (NICE), challenging behavior is a concept that is associated with aggression, stereotype, and agitation or self-harm, withdrawal, and sexual misconduct (NICE 2016).

Additionally, challenging behavior involves persons whose conduct present considerable challenges to services. This comprises of behaviors that are associated with mental health issues. Challenging behaviors are widely used among persons with learning or intellectual disability, in addition to those with autism. Nonetheless, there are other groups that can be regarded to have challenging behaviors such as those with dementia and serious mental issues.

Impact of challenging behavior

             Challenging behavior is described as ‘socially unacceptable behavior’, ‘bad behavior’ (Craver 2015). The term also reflects a challenge to those concerned. It indicates that something is not working well, and it needs to be rectified and stopped. Behavior is challenging if it causes harm to another individual, or prevents them from fulfilling certain things in their lives. Challenging behaviors are detrimental to the lives of the affected persons and those around them. Hence, dealing with challenging behaviors requires careful handling in a way that supports the safety and well-being of people and others

Aggression and assault

In a study conducted by 76 social care workers in institutions that provide intellectual disability services, three-quarter of respondents had faced aggression, self-harm, and disruptive behavior. Recent studies of employees working with persons with dementia discovered that roughly three-quarter of workers faced fearful events during their work (Springer et al. 2013). The most common reported cause was physical assault. Among the respondents sampled, a fifth said they had been injured, a quarter experienced fears during interaction, and half of the interviewees stated that they adopted a more personal centered style while others learned to be more vigilant.

This study gives indications of nature and level challenging behavior experienced by staff in care homes for people with dementia.  Recent studies of perception of severe behavior and fear of assault showed that the degree of fear was greater when staff was exposed to challenging behavior. Researchers, however, found unclear evidence for the relationship between the quantity of challenging behavior and the level of fear of assault. 

References

Emerson, E. 2011, Challenging behaviors. Available from http://www.amazon.co.uk/Challenging-Behaviour-Eric-Emerson/dp/0521728932/280-1066416-6180644?ie=UTF8&camp=1634&creative=19450&creativeASIN=0521728932&l            inkCode=as2&redirect=true&ref_=as_li_ss_tl&tag=mentalhealt08 [25th May 2016].

Guerzoni B. and Zuleeg F. 2011, Working away at the cost of aging. Brussels: European Policy Centre. Available from:http://www.epc.eu/documents/uploads/pub_1265_working_away_at_the_cost_of_ageing. pdf ,[25th May 2016].

Hayes, S. A., & Watson, S. L. 2013. The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of autism and developmental disorders, 43(3), 629-642.

Mental health center 2016, Oppositional defiant disorder. Available from http://www.webmd.com/mental-health/oppositional-defiant-disorder?page=222 [25th May 2016].

National Center for Learning Disabilities. 2012, What are learning disabilities? Available from http://www.ncld.org/types-learning-disabilities/what-is-ld/what-are-learning-disabilities [25th May 2016].

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Differential Reinforcement of Alternate behavior

differential reinforcement of alternate behavior
Differential reinforcement of alternate behavior

BEHAVIORAL CHANGE PROJECT: Differential reinforcement of alternate behavior

1. Author: Felicia Omotosho

2. Title: a) An investigation of differential reinforcement of alternate behavior on adults with autism who exhibit self-injurious behavior.

            b) An investigation of differential reinforcement of alternate behavior on individuals with Developmental Disabilities Who Engage in Inappropriate Sexual Behavior

3. Participant(s) and setting: a) 4 adults with autism at a community day program setting

                                               b) 2-4 adults with developmental disabilities

4. Behavioral definition (only): a) Self-injurious Behavior (SIB)

                                                   b) Inappropriate sexual behavior

5. Social significance of the target behavior:

 Some people with developmental disabilities often develop inappropriate behaviors such as self injury, risky sexual behaviors or aggressiveness. These behaviors are taboo in most communities and are associated with negative consequences. In this context, it is important to equip the care givers with appropriate best reinforcement strategies in order to reduce the incidences of this inappropriate behavior in people with developmental disabilities. The aim of this study is to evaluate the strengths and weakness of Differential Reinforcement of Alternate behavior (DRA) in managing inappropriate behavior in people with developmental disabilities (Bloom and Lambert, 2015).

6. Measurement system (include session length):

 The selected participants are individuals with developmental disorders who have engaged in inappropriate behavior that need to be rectified. The data measurements that will be gathered include participant’s age, gender, diagnosis, inappropriate behavior, and expected outcome after integrating the proposed intervention.

The session for each participant will be 5-15 minutes per day, per week (5 days). The sessions will be 10 min in duration, with 5-minn break between each session. The Multi-element design will be used during functional analysis, and the subsequent analysis will apply the reversal designs (Athens & Vollmer, 2010).

7. Reliability (include IOA procedures, formula, computations)

  Reliability will be determined using interobserver agreement (IOA). This will be calculated as follows; two independent observers will collect data of the inappropriate behavior. The observations will be divided into 10-s bins and the number of the responses will be scored in each bin.  The smaller number of responses observed in each bin will be divided by larger of the observed responses and converted into percentages.

The interobserver agreement (IOA) scores is >90%.  The generalized matching equations (GME) provide robust, reliable and precise information about the best alternative between 2 or more available reinforcement and a response allocation. The logarithmic GME version is as follows (Athens & Vollmer, 2010);

Log (B1/B2) = a log (R1/R2) + log b

Where B1 and B2 are frequency of responding to the reinforcement method,

 R1 and R2 are the relative response rates from obtained reinforcement from the alternative

Y intercept (b) is the bias of independent relative reinforcement rates and slope (a) is the function reflecting sensitivity reinforcement rates,

8. Procedures

 The sessions will be conducted by trained clinicians who will serve as experimenters. The observers will be clinicians (will receive in-vivo training on behavioral observation). The observers will seat behind a one-way mirror. The data will be collected on laptop and desktop, which will provide real time and scoring events in terms of frequency (disruption, aggression, SIB or screaming) and duration (escape from instructions or response time etc). The sessions will be conducted 4-16 times daily for five days in a week.

 Before performing the experimental analyses with the participants, a reinforce assessment will be done using procedures described by Piazza et al. (1999). The reinforcing efficacy will be achieved using appropriate activities such as use of praising words, toys, musical instruments or physical contact.

Baseline:

 The functional analysis of baseline will be performed as identical as the reinforcement assessment, but only that is associated with problem behavior. To obtain a baseline data, each instance of inappropriate behavior will result in delivery of reinforcement from the instructor. During this assessment, no programmed consequences will be put in place to ensure appropriate behavior so as to collect the baseline data that will be used for comparison purposes.

In addition, equal concurrent schedules of reinforcement will be put in place for both the problem and appropriate behavior. The intervals will be selected based and described and will consist of 30s during the delivery of a reinforcer and 30 s after reinforcing.

Intervention (complete and precise):

 Equal concurrent reinforcement schedules will be put in place for both inappropriate behavior and expected appropriate behavior after intervention. The intervals will be timed and the data will be collected in the same manner as in baseline analysis. For all participants, after the interval reinforcer access is complete, it will be removed and timer will be reset for another response.

9. Experimental design:

 The experiment design used in this study is phenomenological qualitative research design. This is because the study explores on how humans experience certain phenomena. The design sampling strategy is the purposive sampling which provides samples that are highly representatives of the targeted population. The research method also saves time, effort and money (Bloom and Lambert, 2015).

10. Graph (simply describe the scales of the horizontal and vertical axes and conditions):

The vertical axis will consists of responses (both for appropriate and inappropriate behavior) per time intervals versus the number of sessions attended. This will help in identifying the impact of differential reinforcement of alternate behavior on individuals with Developmental Disabilities in generating appropriate behavior (Bloom and Lambert, 2015).

References

Athens, E. S., & Vollmer, T. R. (2010). An investigation of differential reinforcement of alternative behavior without extinction. Journal of Applied Behavior Analysis, 43(4), 569–589. http://doi.org/10.1901/jaba.2010.43-569

 Bloom, S.E., and  Lambert, J.M. (2015). Implications for practice; Resurgence and differential reinforcement of alternative responding: Journal of applied behavioral analysis 48(4):781-784 doi: 10.1002/jaba.266. Epub 2015 Oct 19.

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Alzheimer Disease: Genetic Disorders

Alzheimer Disease
Alzheimer Disease

Alzheimer Disease: Genetic Disorders

Question 1

 Despite the fact that Federal law aims at protecting people from being discriminated based on their own genes, the Genetic Information Nondiscrimination Act (GINA) has a loophole in that it only apply to health insurance. It does not state anything regarding insurance companies that sell disability, life insurance and long term care insurance. In reality, insurance companies are designed to operate in such a way that people purchase policies but only few percentages of the people insured will use them.

This is to ensure that policies selling are sustainable. However, through genetic testing, people identified with potential risk of developing chronic health condition based on the genetic markers identified are likely to purchase life or disability insurance because they already know that they will develop the chronic disease down the road, making it unsustainable (Feldman, 2012).

The Early onset familial Alzheimer disease (Efad) is a dominant genetic disease, which is caused by single gene mutation. The disease is caused by mutant gene which is inherited from one generation to the other. APOE testing is important health care domain because it aids confirming the disease, or to predict who has the potential of developing the disease in the future. 

However, the tests help people to ponder knotty ethical dilemma and life questions. For instance, of one is 25 years old and have a parent who have suffered with the disease, would it be advisable to understand your fate so as to plan and escape it ( Strobel, 2013).

  The results of Genetic testing for Alzheimer disease can be devastating if a person carries they carry genes for Early Onset Familial Alzheimer disease. Some people can even decide to end their lives prematurely to avoid facing the health complication associated with the disease. In addition, there is little information on effective treatment options, predictive tests for APOE testing is important in preparing families and patients for  decisions that needs to be made such as advance care planning.

It helps in confirming diagnosis, and in developing care plans. The testing informs patient’s family about the diagnosis of Alzheimer disease, and to prepare them financially or have them fill advance directives where necessary. The testing may also facilitate prevention whereby people to make behavior changes such as exercising so as to improve hypertension and other health issues that can negatively impact patient’s cognition (Sheffrin, Stijacic Cenzer, & Steinman, 2016).

Question 2

Most of chronic diseases today are treated using trial and error drug methods. However, pharmacogenomics technological advancement has ensured that physicians are able to match the drugs with right patients, and according to their genetic profile. This ensures that people get the appropriate therapy from the start, and without any complication. This is because healthcare providers are able to prescribe the best drug therapy, thereby speeding their recovery and eradicates potential side effects. Research evidence indicates that this approach can reduce mortality rates by 100,000 and more than 2 million hospitalization rates annually in the USA (Seyerle & Avery, 2013).

 Alzheimer disease may occur at any age but its onset is usually at around 40 years. The rate of disease occurrence increases exponentially with age. Alzheimer treatment protocol begins with the diagnosing the patient with Alzheimer disease. The patient baseline functionally and psychiatric state is assessed. If patient condition is mild at diagnosis, the patient begins treatment with acetylcholinesterase inhibitor. 

The patient is assessed after 2- 4 weeks, and a stable dosage is established, and the patient is advised to visit the clinic after every 3-6 weeks to continue the treatment. If the patient is not tolerating the medication, the healthcare provider changes to another type of acetylcholinesterase inhibitor until, patient are re-evaluated until the appropriate medication is achieved (Bradford et al., 2011). This protocol highlights that treatment of Alzheimer is basically trial and error as shown in Fig 1 below.

However, the pathogenesis of Alzheimer disease as well as drug metabolism is regulated genetically, and by numerous gene interactions.  Alzheimer patients respond moderately to conventional medicine such as donepezil, galantamine, memantine and rivastigmine; with doubtful cost effectiveness.  This implies that the healthcare provider must put the following factors into account when choosing the type of cholinesterase inhibitor include a) the dosage, frequency and availability of medication, and b) the number of drugs need to achieve the intended therapeutic dosage.  This calls for further assessment of patient’s inherent factors and their ability to deal with medication’s side effects.

The previous pharmacogenomics studies indicated that therapeutic response for this disease is specific to genotype that contains apolipoprotein E.  According to these studies, the pharmacogenomics factors may account for 60 to 90% of drug variability in disposition of drugs and in pharmacodynamics. Therefore, modifying the protocol to integrate genomics in management of Alzheimer disease in clinical practice will foster effective therapeutic optimization which will help to develop cost-effective pharmaceuticals, thereby improving drug safety and efficacy (Dua et al., 2011).

References

Bradford, T. W., Onysko, M.K., Stob, C., Hazlewood, K. (2011). Treatment of Alzheimer disease.  American Family Physician 2011 retrieved from http://www.aafp.org/afp/2011/0615/p1403.html

Dua, J., Gupta, A., Pachuari, K., Dewangan, S. (2011). Pharmacogencomics- a boon for chronic disease. International journal of Pharma and Bio Sciences 2(2); B- 424

Feldman, E. A. (2012). The Genetic Information Nondiscrimination Act (GINA): Public Policy and Medical Practice in the Age of Personalized Medicine. Journal of General Internal Medicine, 27(6), 743–746. http://doi.org/10.1007/s11606-012-1988-6

Seyerle, A. A., & Avery, C. L. (2013). Understanding Genetic Epidemiology: The Potential Benefits and Challenges of Genetics for Improving Human Health. North Carolina Medical Journal, 74(6), 505–508.

Sheffrin, M., Stijacic Cenzer, I., & Steinman, M. A. (2016). Desire for predictive testing for Alzheimer’s disease and impact on advance care planning: a cross-sectional study. Alzheimer’s Research & Therapy, 8, 55. http://doi.org/10.1186/s13195-016-0223-9

Strobel, G. (2013). Early onset familial AD: Genetic testing and counseling for Early Onset Alzheimer Disease. Retrieved from http://www.alzforum.org/early-onset-familial-ad/diagnosisgenetics/genetic-testing-and-counseling-early-onset-familial

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Active Duty Military and Alcohol

Active Duty Military and Alcohol
Active Duty Military and Alcohol

Active Duty Military and Alcohol

1.      Introduction

Active duty military is understood as the younger workforce serving the military workforce, where many of the enlisted force comes in between the age of 17 through 24 years old; while seniors of active duty comprises of 27 through 34 years (Wooten, 2015). They are those who are directly or indirectly involved in mobilized military operation including combat.  Alcohol abuse has always been common among these active duty military, making ubiquitous practice of heavy drinking as nothing new to the American military system (Larson et al., 2014).

Considered as an accepted custom, drinking is simply considered by military army as a reward for their hard work, and as a commodity that ease their personal tensions since socializing with drinks promotes camaraderie (O’Brien, Oster, & Morden, 2013; Westermeyer & Kimbrel, 2013). There is no denying the fact that heavy drinking is conditioned by the easy availability of alcohol beverages which military personnel received at a reduced rate.

The essay looks into how alcohol consumption has become common among those in active duty military, and how there are risks involved in drinking like physical decline and mental and psychological comorbidities. The essay also provides a conceptual approach towards prevention and treatment of alcohol related issues in military department, by taking up certain structured measures taken up by the government to prevent the cause and spread of alcohol consumption.

  • Active Duty Military and Alcohol Related Matters in the United States

2.1. Identifying unique PROBLEMS IN Active Duty Military

Earlier, the combat at the Vietnam War caused many military men to become addicted to drugs in 1960 and 1970s, since many were serviced with drugs to make them tolerate the challenges of war environment (O’Brien et al., 2013). Reportedly there was misuse of drugs during this time, and this misuse has been attributed towards the military personnel using drugs for pain relieving and mental trauma issues.

Over the years, prescription of drugs has simply increased because of the availability of more drugs, and because of the wider prescription of medications, followed by intake of alcohol among the military department (O’Brien et al., 2013). This increase in intake of alcohol among military personnel has come to be associated with the recent military combats at Iraq and Afghanistan.

Such increase in the intake of alcohol emanates from many issues associated to their work, like the challenges of war, the stress involved with their work, and experiencing traumatic events that triggers off mental and psychological issues (Robert M. Bray, 2006; Cook, 2007; O’Brien et al., 2013). Many of those engaged in military operations at Iraq and

Afghanistan showed that they have been experiencing stress and strains over long deployments, extreme combat exposure, facing physical injuries, traumatic brain injuries, and post-traumatic stress disorder (PTSD), thereby making them to easily succumb to alcoholic abuse (NIDA, 2011).

Wide availability of prescribing drugs also culminates toward drug abuse. According to the report by NIDA (2011, p. 1), “soldiers screened 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk  for related harmful behaviors (e.g., drinking and driving, using illicit  drugs).” Alcohol usage has also been strongly identified with Post-Traumatic Stress Disorder (PTSD), which comes from the traumatic experiences that military members experienced during the war (Leskin, 2015).

Such suffering culminates towards the victim to fail in becoming good parents and good members of the society, owing to lack of communication and social skills. To quote (NIDA, 2011, p. 1) again, “Mental illness among military personnel is also a major concern. In another study of returning soldiers, clinicians identified 20 percent of active and 42 percent of reserve component soldiers as requiring mental health treatment.

Drug or alcohol use frequently accompanies mental health problems and was involved in 30 percent of the Army’s suicide deaths from 2003 to 2009 and in more than 45 percent of non-fatal suicide attempts from 2005 to 2009.”

Many of the military personnel also consume alcohol simply to experience pleasure. The pursuit of pleasure through alcohol makes them to forego pain, and feel normal or feel euphoric for some time. The reward in term of such sensations allows them to release neurotransmitters called endorphins, thereby experiencing psychological and physiological exhilaration (O’Brien et al., 2013). Such engagement does not lead to any constructive behaviors, but only makes the person to become nonproductive and harmful in nature. Excess of alcohol consumption makes them to suffer from hijacking or from the aberration of normal brain function, thereby making them to become active in their work or when they are deployed.

Excess of alcohol consumption among active duty military men are known to lose their productivity or contract alcohol related diseases that leads to premature death (O’Brien et al., 2013). The difficulty with this situation is that many of them are left untreated, or do not undergo treatment. Thus, the prevention and remedies for alcohol abuse is not only a matter of diagnosis, but it is also about treating the alcohol abusing patients among active duty service members, and also among those in post-deployment stage.  

2.2. Comparative Analysis of Active Duty Military with the OVERALL POPULATION of the United States

Although not in similar excess trend with the military personnel, American civilians often resorts to binge drinking occasionally (Cucciare et al., 2015). Access drinking as a problem of the society has simply become a part of American culture, which is slowly degrading the public health and safety system. Even among civilians, alcoholism has always been the problem and the disease, making the National Institute on Alcoholism and Alcohol Abuse (NIAAA) since 1970 to identify ‘alcohol abuse’ as the main national health priorities (Cook, 2007).

Alcoholism related issues such as drunk driving, domestic violence, and other alcohol related abuse is nothing new to the American citizens. Thus, taking social context into perspective, the Americans suffer from innate propensity towards alcoholism, making alcohol consumption a part of their innate culture.

The abuse of alcohol among military and civilians has been acknowledged by the United States military department as having adverse effects on the user’s health and behavior, as well as to their civilian families. It is true that alcohol usage is considered illegal for those who are under the age of 21 in the country, but rampant availability of liquor continue to have negative impact on the functioning of the society as a whole.

This excess of alcohol consumptionhas always been fairly consistent and studies by Westermeyer & Kimbrel (2013) that heavy drinking among military men are always twice as much as military men, and military men also consumes four times higher than military women, while military women consumes twice as more than civilian women. Thus, civilians are as likely to develop alcohol consumption disorders as any military personnel.

Research by Bray et al., (1991) shows that while military people are more likely to consume more alcohol than the civilians, drugs and tobacco are consumed more by the civilians. Drinking within the military group is again higher with the younger military men and women, and even among civilians, intake of alcohol is higher among the younger men and women.

Civilians as well as military efforts to deal with alcohol and drug issues are also directed towards solving the issues of the younger people, so that alcoholic and addiction do not grow on them. Again, many of the military men who suffer from alcohol addiction are higher among unmarried men, which is similar to civilians (Bray et al., 1991). In fact, when demographic comparisons among the unmarried alcoholic men are taken up, addiction and alcohol rate consumption remains the same.

2.3. Treatments and Other Practical Remedies for the issues relevant to the Active Duty Military population

Given the alcohol availability, any military personnel become vulnerable to addiction and are put to risk. To solve the issues of alcohol related issues, several researchers, public health entities, host of government agencies, and laws are working together in the country. Prevention policies in terms of detecting drinking problem at an early stage, and holding specific intervention remains as the best remedy to cure alcoholism.

Treatment and practical remedies in regard to alcohol consumption should initially start with educating the population on how alcohol consumption can lead to risky behavior and how it is harmful to their health (O’Brien et al., 2013). In military department, such policies are enforced during the training process, although effective acknowledgement among the military unit remains inapplicable.

Standard drinking level, like the requirement of not exceeding 14 standard drinks per week for men and 7 drinks per week for women can be imposed or made known to the people, in order to avoid excess consumption (O’Brien et al., 2013). Among military personnel as well as the civilians, environmental strategies prevent alcohol problems remain effective.

These include, raising minimum legal drinking age (21); enforcing the legal minimum purchasing age; increasing taxes on alcoholic drinks; offering no discount to any alcohol beverages; and holding the liquor retailer to be responsible for any issues that comes out of alcoholic drinks (O’Brien et al., 2013). In the words of Cook (2007, p. 1), excess of alcohol consumption can be maneuvered by “both public and private, to reduce excess drinking directly – education, persuasion, counselling, treatment, sanctions of various sorts, [and by ] restricting availability or raising the price – licensing, product and sales regulation, liability rules, taxes, partial or complete bans”.

Owing to many alcohol related cases in military department, the department itself in the United States has also been undertaking comprehensive steps over the past many years to solve these complex issues. Certain legal measures have been taken up by the United States Government to control excess of alcohol consumption among US military personnel from 1980s onward.

This initially started with the Supreme Court of the country declaring in 1988 that the ‘Department of Veterans Affairs’ as not responsible towards paying benefits of alcoholic drinks for the military veterans, since such benefits always results into willful misconduct (O’Brien et al., 2013). In regard to the Department of Defense’s (DoD’s) specifically, they offered series of policies that could help in controlling and preventing the use of alcohol.

The DoD’s effort started in 1970s, when the department passed “The Controlled Substances Act of 1970”, targeting to reduce the usage of drugs at the outset, and later towards smoking and tobacco consumption (Robert M. Bray, 2006). Later, the act also targeted the consumption of alcohol by detection at an early stage and undergoing intervention through law enforced testing (like the urinalysis testing program).

Since legal court disbanded this testing program, DoD later came up with a new measurement that stated that alcohol consumption does not live up to military performance standards (Bray, 2006; Harbertson et al., 2016). Vietnam War and it subsequent result like the prevention of the atrocious war memories that led to high substance abuse among war veterans led to the department to again re-enforced drug and alcohol testing, and emphasizing zero tolerance policies on alcohol and drugs while on duty (Robert M. Bray, 2006; Cook, 2007).

The turn of the millennium saw the DoD and its policies continuing to condemn alcohol abuse (binge or heavy), and other drugs usage, since such abuse brings down the health and the military readiness (active participation) of the military personnel, and since the country needs to maintain high standards of performance and discipline. All such measures are expected deployment military department to decrease their alcohol intake, and perform better as a unit.

3.      Finding and Conclusion

It is seen that alcohol abuse remains substantially common among the military personnel that requires stringent efforts on the part of the government (laws and acts), the DoD, medical institutions, and other individual and public efforts to solve and mitigate the issues. Since the Americans involvement in world politics has become popular and regular, military deployment and combat is expected to continue for the American military department.

Contextualizing such issues, the institutions and laws trying to prevent the abuse should use structured approach that will target the entire military populations of the country, and try to mitigate the issue. In this way, the risk to develop alcohol abuse and disorder emanating from such abuse becomes less relevant and less probable in nature. Taking a comprehensive approach to decrease alcohol abuse will allow the fostering of opportunities for military personnel during and after deployment in the field.

It also means that there will be more positive role models for the younger and older citizens to look up to, and also for their own military peer. These efforts to curb alcohol abuse are expected to make military personnel to appreciate and become culturally responsive to military lifestyles and structures.

References

Bray, R. M. (2006). Department of Defense survey of health related behaviors among active duty military personnel: A Component of the Defense Lifestyle Assessment Program. RTI International, (December), 1–307.

Bray, R. M., Marsden, M. E., & Peterson, M. R. (1991). Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians. American Journal of Public Health, 81(7), 865–869. http://doi.org/10.2105/AJPH.2014.301901

Cook, P. J. (2007). Paying the Tab: The Costs and Benefits of Alcohol Control. Princeton: Princeton University Press. Retrieved from https://books.google.co.in/books?id=pMpThh2C6ccC&dq=THE+COST+AND+BENEFITS+OF+ALCOHOL+CONTROL…AUTHOR+PHILLIP+J.+COOK.&source=gbs_navlinks_s

Harbertson, BR, H., EY, A., NL, M., & PT, S. (2016). Pre-deployment Alcohol Misuse Among Shipboard Active-Duty U.S. Military Personnel. American Journal of Preventive Medicine, 51(2), 185–194.

Larson, M. J., Mohr, B. A., Adams, R. S., Wooten, N. R., & Williams, T. V. (2014). Missed Opportunity for Alcohol Problem Prevention Among Army Active Duty Service Members Postdeployment. American Journal of Public Health, 104(8), 1402–1412. http://doi.org/10.2105/AJPH.2014.301901

Leskin, G. (2015). Preventing Substance Abuse in Military Members and Their Families. Prevention Tactics, 9(14), 1–10.

M.A., C., A.G., S., M.A., M., J.C., T., G.M., C., X, H., & B.M., B. (2015). Associations between deployment, military rank, and binge drinking in active duty and Reserve/National Guard US servicewomen. Drug and Alcohol Dependence, 153, 37–42.

NIDA. (2011). Substance Abuse among the Military , Veterans , and their Families. National Institute on Drug Abuse, (April), 1–2.

O’Brien, C. P., Oster, M., & Morden, E. (2013). Substance Use Disorders in the U.S. Armed Forces. Washington DC: National Academy of Sciences.

Westermeyer, J., & Kimbrel, N. A. (2013). Substance Use Disorders Among Military Personnel. In B. A. Moore & J. E. Barnett (Eds.), Military Psychologists’ Desk Reference. New York: OUP USA.

Wooten, N. R. (2015). Military Social Work: Opportunities and Challenges for Social Work Education. Journal of Social Work Education, 51(1), S6–S25. http://doi.org/10.1007/s11121-011-0234-5

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Mental Health: Recovery Principles & Clinical Recovery

Mental Health: Recovery Principles & Clinical Recovery
Mental Health: Recovery Principles & Clinical Recovery

Mental Health: Recovery Principles & Clinical Recovery

Introduction

The concept of recovery oriented practice has increasingly become a prominent concept in mental health policy internationally. This notion originated from consumer perspectives that challenged traditional beliefs about course of mental health disorders and the effective treatment strategies, and it has become widely conceptualized that recovery  oriented care is a deeply unique process that changes a person’s attitudes, feelings, values, goals and skills with the aim of improving life limitations caused by the mental illness (Doran et al., 2015). Using Janet’s case study Version 1 and Version 2, this essay expounds on the concept of recovery oriented care by focusing on recovery principles; and elaborating how mental health recovery principles differ from clinical recovery principles.

Recovery principles

 Recovery principles refer to the collective approach used to respond to the mental health distress by supporting empowerment, autonomy and retention of hope.  Fundamentally, the recovery principles focus on the benefit of acknowledging a person as a whole instead of defining them by their deficits or difficulties (Evans et al., 2017).

In this context, recovery is supported through the implementation of collaborative and consultative treatment strategies to people with mental health issues. These strategies place the client at the center of care and emphasize on individuals strengths to support their self determination.

The recovery principles are core to the professional standards for Australian and New Zealand mental health includes uniqueness of an individual, autonomy, rights and attitude of their carers, treating mentally ill people with dignity and respect, collaborative care enhanced through effective communication (Mental Health Commission, 2012).

 Based on recovery principles, helping patients who experience mental health issues with psychotic clinical issues, such as bipolar disorder and schizophrenia, requires a range of skills and attitudes that are developed from sound knowledge foundation as well as inquisitive approach.  The core recovery principle in this group of attributes is the ability to establish a respectful support and collaborative relationship (therapeutic alliance) with the client, their relatives, friends and their loved ones (Slade et al., 2014).

The main challenge for clinical practice during the recovery paradigm is the capacity to remain responsive to the patient’s change and family/loved ones concerns. However, this is vital because client’s capacity to exercise autonomy during decision making may fluctuate over time. For instance, the client may change their desired treatment approach frequently or the client’s family may hold different opinions about the best treatment.

Therefore, the recovery principles enable the provider to develop the capacity to ‘be with’ instead of insisting on the standard clinical practice. For instance, in Janet’s Case study Version 2, “the psychiatrist was happy to reduce drugs after 10 days when Janet told her how horrible they were” (O’Hagan, 2014, p.227).

 From this analysis, the healthcare provider should understand their own feelings and values to this practice. This is because their personal ethical beliefs and values could make them to inadvertently exhibit judgmental behaviors which could compromise care.  The mental health care providers should perform rigorous and regular clinical supervision so as to retain clarity in nursing practice (Evans, Nizette, & O’Brien, 2017).  

Clinical supervision is one of the recovery principle recognized as professional standard for Australian as well and New Zealand mental health nurses. In addition, it is evident that recovery principles are based on reflective care that is not influenced by the individual’s personal values or ethics. These principles emphasize on self determination and collaborative partnership.

For instance, in  Janet’s case study version 2,Through collaborative treatment approaches, Janet  was able to overcome the sexual abuse trauma; she is better, and now works as a mental health nurse, where she uses her experience to guide other mentally ill patient (O’Hagan, 2017, p.228).

The difference between recovery principles and clinical recovery

Recovery can be viewed through different lenses – personal experience (set of workforce competencies/practices) or clinical recovery process. This personal recovery approach is viewed as the post institutional service philosophy because it challenges the bedrock of traditional mental health system (Barder, 2012).

Clinical recovery is a concept that emerged from the expertise of mental health care providers, and it entails treating of psychosocial symptoms so as to restore functioning or to bring back the patient’s life back to normal. Recovery principle differs in clinical recovery in that the concept emerged from expertise of people who have lived the experienced or mental illness (Hapell et al., 2013).

On the other hand, recovery principle dwells on a deep unique change of a person’s values, attitudes and feelings with the aim of living a satisfactory life within the daily life limitations associated with the illness. It is basically creating a new purpose and meaning in client’s life as she or he grows beyond the catastrophic event associated with the mental illness (Williams et al., 2012).

As depicted in Janet case study Version 1, the traditional healthcare system perceives mental illness with no legitimacy. Most clients experience major mental health issues as frightening, desolate and also destructive. This is because the pain in mentally ill clients is at par with grief and torture of surviving a battle field or that of being accused of heinous crime (Leah, 2012).

The only difference is that the latter experiences have legitimacy and the society has a well defined pathway for their justice and recovery; and surviving them is perceived as heroic and is admirable. On the other hand, mental health is met with fear, reproach and pity.  

Unlike clinical recovery, recovery principles recognize the importance of person recovery in that mental illness is perceived as a full human experience; therefore, it does not support justification for segregation, cruelty and coercion. A society that has person recovery mind concepts has place for people with mental health illness because seeks to provide a better pathway to better life (O’Hagan, 2014).

Another aspect of clinical recovery that acts as bedrock of the unfortunate traditional belief is community’s abdication of responsibility for the mentally ill people to the profession and services. In the current society, people seek answers to human problems from state- authorized profession institutions. 

Although to some extent this has been of benefit, it is associated with overdependence of deficit oriented institutions and professionals. Their reputed monopoly on expertise has disabled the mentally ill clients by keeping the stuck in the healthcare services as indicated by Janet’s case study version 1, “the mental health system is responsible for the Janet’s terrible state (O’Hagan, 2014, p. 224).

The devaluation of mental illness in conjunction with community abdication has is associated with naïve community consensus around client’s safety, which is based on discriminative assumption that mentally ill people are not responsible of their behavior, and that the mental health institutions and services must take responsibility of their behavior  through tightly controlled approaches (Gilburt et al., 2013).

The clinical recovery approach develops unsustainable assumptions that mentally ill persons must be controlled like robots; they lack freewill and those mental health institutions and professionals have magical powers to predict and that the strict measures towards the mentally ill people is meant to establish a safer community.

Unfortunately, the unrealistic demands have led to increase in risk adverse practices such as liberty restrictions, locked doors and compulsory treatment just as those experienced by Janet Version 1 case study (Berglund, 2012; Ivey et al., 2012).

Clinical recovery is important, but focusing on clinical recovery alone makes the patient to feel defined by their mental health problem, thereby exacerbating the problem. This approach also makes a person to neglect other aspects of lives that could be cultivated and potentially lead to improved wellbeing (Evans & Brown, 2012).

Most of the clinicians identify  mental illness experiences such as  hearing voices a focus of clinical recovery, which not only make it problematic, but also leads to waste or resources in order to get rid of personal idiosyncrasies that otherwise would be  the patient’s assets if well understood and work with using the best approaches possible.

On the contrary,  the recovery principles of the mental health service  seek to design treatment strategies for mental illness is  that does not only keeping people out of acute crisis so that they can lessen their  dependency and burden to the community. The strategies contemplate the possibility of holistic recovery instead of focusing on clinical issues only, which in most cases could be resolved (Le Boutillier et al., 2015).

Conclusion

 Mentally ill people are human beings too; they have rights as other citizens and must be allowed to participate in their local communities. To ensure that the mentally ill patients are socially included in the community’s daily life, the society and mental health professions will be required to change their traditional beliefs and unfortunate assumptions about mental health. In this context, the final frontier is eradicating the barriers that prevent people from experiencing their entitlements as the other citizens.

This involves transformation of “treat clinical symptoms- and recover” world view. In addition, the mental health systems should give priorities to treatments strategies that help the mentally ill patient to continue re-engaging with their life. However, the most important and the broadest challenge is the societal change.

This implies that the mental health professionals should collaborate with people with lived experienced of mental illness to become partners and social activists who challenge the erroneous stigmatizing assumptions associated with mentally ill people which prohibits them from enjoying the same citizenship entitlements as other people in the community.

References

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