In recent years, the assessment of the risk of violence has been one of the most discussed issues in the medical and legal community. This problem is actively discussed in the field of forensic psychology. Assessing the risk of involving criminals in serious incidents is essential for the practice of involuntary treatment in psychiatric hospitals. The precision of any prognosis is necessary to increase the effectiveness of control over such patients at the level of preventive measures and during crisis interventions. Various cases of possible risks, which are often encountered by forensic experts, are sometimes displayed in numerous television shows, where specialists, as a rule, efficiently cope with the tasks assigned. One such project is the American TV series Criminal Minds (Davis, 2014), which has been broadcast on the CBS channel since 2005. As an example, it is possible to consider one of the episodes of this program, which presents a vivid case of one of the characters mental disorders and the ways that professionals resort to solve the problem.
Psychological Literature Review
As scientific peer-reviewed articles, such works are used as Risk Assessment in Criminal Sentencing written by Monahan and Skeem (2016) and Assessment Practices and Expert Judgment Methods in Forensic Psychology and Psychiatry: An International Snapshot by Neal and Grisso (2014). Both papers have up-to-date information and can be used to draw specific conclusions regarding the role of forensic psychologists in assessing risks related to criminal offenses. Monahan and Skeem (2016) claim that risk assessment should be connected first of all with the search for possible solutions to current problems and not with attempts to pass sentences.
The authors also note that forensic psychologists have a rather large responsibility since these professionals should understand quite precisely what type of problem they are dealing with and whether the issue can be resolved through the treatment of the accused when imposing a particular punishment (Monahan & Skeem, 2016). Neal and Grisso (2014) note that over the past few decades, the field of forensic psychology has moved far enough to draw competent conclusions based on the assumptions of specialists in this area. The development of this medical sphere makes it possible to exclude potential errors related to sentencing in certain criminal cases and also allows accurately assessing possible risks (Neal & Grisso, 2014).
The article written by Monahan and Skeem (2016) includes the authors thoughts regarding the importance of forensic psychology in the modern judicial system. The work has a clear structure and key findings, which are the logical conclusion of the study. Neal and Grisso (2014) present several diagrams and tables in their work, in which they show the approaches used by different specialists to assess risks, and also demonstrate the dynamics of certain techniques implementation in the process of psychologists professional activity. This paper also has rather clear arguments and logical conclusions. The two studies were published not long ago and are peer-reviewed works. Therefore, both articles are relevant and can be used as additional sources for the analysis of risk assessment in the sphere of forensic psychology.
Media Portrayal
As the television show to analyze the story from the perspective of forensic psychology, the American series Criminal Minds was chosen (Davis, 2014). This project has been broadcast on television for a rather long time, and today, thirteen seasons have been submitted. The main characters of the program regularly encounter strange and unexplained cases that have a relationship to crime and often cannot be explained logically. The team of experienced specialists continually faces strange and mysterious situations, many of which are directly related to the psychology and deviant behavior of criminals. A significant moment is a fact that in most cases, the characters successfully solve challenging situations and find solutions to the seemingly most difficult problems. Perhaps, that is why the show has quite a lot of popularity among viewers and is considered one of the most well-known projects related to forensic science.
The subject of the study is the ninth episode of the tenth season of the series. Experts find out that on the territory of northern Virginia, there is a dangerous and utterly unpredictable maniac who continually devises sophisticated methods of murder and certainly has an unstable psyche. As Hilton, Simpson, and Ham (2016) note, measuring the risk of violence is always the assessment of people to determine what will lead them to commit criminal acts in the future. It is what the main characters are doing. They try to find the motives for the killers behavior and understand what exactly makes him commit unreasonably brutal crimes. At the same time, the task of specialists is complicated by the fact that they have very little time as more and more new victims are found, and the police cannot cope independently and catch the maniac. The assessment of risks, in this case, must take place at a deep level as there is undoubtedly some regularity in all the murders committed. That is why the characters of the series need to determine who can be the next potential victim of this mentally unhealthy person. A described case has quite a tight relation to the stated topic under research and can be considered as one of the examples of criminologists and forensic psychologists work.
Another issue faced by one of the characters of the series is working with a strange woman who hides her past. In the course of events, it becomes clear that she has some mental deviations and can be dangerous. According to Brown and Singh (2014), the task of forensic psychologists is to assess potential risks timely and determine whether this or that case deserves particular attention or not. Moreover, specialists need not only to make an accurate prediction about the cause of a specific disorder but also ensure that a potential criminal will not harm the surrounding people (Guyton & Jackson, 2015). Therefore, the work of the series characters aims at solving all these problems, and the portrayal of some vivid examples of professionals practice is entirely accurate.
Conclusion
Thus, a described episode of the series presents rather vivid examples of the cases that forensic psychologists have to face when assessing potential risks. The work of these specialists is characterized by control over the condition of patients who are capable of committing inadequate criminal actions. The reviewed scientific literature has quite relevant arguments and conclusions, which reveal the need for carefully planned work on risk assessment in this area. As potential implications, the creators of the series offer several storylines that show how the work of forensic psychologists can be realized, as well as what measures they take to avoid the dangerous consequences of mental disorders in criminals.
References
Brown, J., & Singh, J. P. (2014). Forensic risk assessment: A beginners guide. Archives of Forensic Psychology, 1(1), 49-59.
Davis, J. (Creator). (2014). Criminal minds [Video file]. Web.
Guyton, M. R., & Jackson, R. L. (2015). Violence risk assessment. In R. L. Jackson & R. Roesch (Eds.), Learning forensic assessment: Research and practice (2nd ed.) (pp. 131-161). New York, NY: Routledge.
Hilton, N. Z., Simpson, A. I., & Ham, E. (2016). The increasing influence of risk assessment on forensic patient review board decisions. Psychological Services, 13(3), 223-231.
Monahan, J., & Skeem, J. L. (2016). Risk assessment in criminal sentencing. Annual Review of Clinical Psychology, 12, 489-513.
Neal, T. M., & Grisso, T. (2014). Assessment practices and expert judgment methods in forensic psychology and psychiatry: An international snapshot. Criminal Justice and Behavior, 41(12), 1406-1421.
Psychological profiling, frequently referred to as offender profiling, is identifying the most probable characteristics of a criminal from his or her behavior at the crime scene. This serves to help police investigators narrow down and prioritize a pool of most likely suspects. (Psychological Profiling) Terrorists are, presumably, the hardest category of criminals to profile due to the lack of both legal and academic consensus about the scope of terrorism (McGuirk, 2018). Without an exact definition of where a certain type of crime begins and ends, it is difficult to design any standardized image of a personality that is most inclined to commit it.
A way to smooth the possible misunderstandings is the application of scientific approaches rather than non-scientific ones since the former provides a clearer conceptual framework and methodology. In addition, the scientific method involves testing and validating the accuracy of the outcomes with the help of the relevant disciplines, for instance, investigative psychology (McGuirk, 2018). It is worth mentioning as well that deductive techniques are not suitable in the context of terrorism. Crime scenes may be seriously destroyed, and detail may differ substantially from one location to another, which allows for no deduction.
Therefore, inductive methods are preferable in scientific profiling, specifically, the techniques that rely on past criminal records. From those, it is possible to guess the key characteristics of the offenders, hence the most probable trends in their activity. The two most widespread types of inductive profiling are inductive generalization and statistical argument. The first approach lies in designing a profile from observations by finding similarities among several events. The second presupposes calculating a statistical correlation between previous crimes and the characteristics of those who committed them (McGuirk, 2018). For the above reasons, these two techniques are currently prevalent in the psychological profiling of terrorists, and the majority of the profiles combine both for maximal accuracy.
References
McGuirk, N. K. (2018). An evaluation of the theory and the practice of terrorist profiling in the identification of terrorist characteristics. University of Birmingham.
Police officers who are involved in shootings are exposed to excruciating psychological circumstances. Many agencies have put in place programs that address psychological needs of police officers who are involved in shootings. Criminal enforcement agencies need to come up with effective programs to help their officers who have been involved in shootings to return to work.
Discussion
Law enforcement agencies need to have specific protocols that assess psychological needs of all police officers who are likely to be involved in shootings. They need to hire qualified mental health professionals who are conversant with various challenges that police officers encounter in their specific working environments. Every officer that is assigned a potentially dangerous criminal task needs to work with a companion. A companion helps an inexperienced officer understand occupational risks he is likely to get exposed (Trompette Corey Schmid and Tracy par. 3).
Law enforcement officers usually reflect on their physical and psychological reactions to a shooting incident, immediately after it has taken place. The emotional and psychological state of an officer needs to be assessed to make sure he provides an accurate report on what happened. Officers need to be encouraged to participate in debriefs to help them cope with difficult situations they are exposed to. Their families should be included in various psychological interventions used to make such officers recover from their psychological problems (Trompette Corey Schmid and Tracy par. 5). In some instances, law enforcement officers may need to seek further psychological interventions to aid their recovery.
In some deadly combats, some officers may feel that they did not do enough to reduce the harm other innocent bystanders were exposed to. Some officers get a guilty conscience after such incidents because they feel they have failed to perform as expected. A single evaluation may not conclusively determine the psychological condition of an officer after getting involved in a shooting incident (Trompette Corey Schmid and Tracy par. 7). Law enforcement administrators need to allow officers involved in shootings to be cleared first by mental health professionals before they resume their duties.
Conclusion
Police officers need to be assisted to overcome different psychological problems they experience after getting involved in shootings. Senior police administrators need to rely on the expertise of mental health experts to assess psychological conditions of their junior officers.
Works Cited
Trompetter, Phillip S., David M. Corey, Wayne W Schmidt, and Drew Tracy. Psychological Factors after Officer-Involved Shootings: Addressing Officer Needs and Agency Responsibilities. The Police Chief Magazine. The Police Chief Mag., 2013. Web.
Indeed, violence sometimes results from factors such as an individuals desire for financial gain or from an individuals repeated exposure to violent behavior in his or her social environment. Sometimes, however, it also happens in a motiveless fashion. Violence is never truly without motive, but its motives may be so complex and elusive that it appears motiveless. In all cases, but particularly in cases of violence that appear to have no motive, internal or individual factors may be critical in understanding the cause of such behavior. A variety of different biological and psychological influences and mechanisms have been considered over the years.
Biological Factors
Initially, it was thought that criminal behavior resulted from a primitive instinct that increased some peoples likelihood of behaving criminally. It was assumed that people who behave like criminals have biologically different brains. The idea is that criminals are born biologically destined to behave violently or antisocially, regardless of their social environment.
There exists a mistaken tendency to use interchangeably the terms biological and genetic. Genetic influences are only one type of biological influence on behavior. There are (at least) two different types of biological influences: genetic influences and biological environmental influences. Genetic influences refer to the blueprints for behavior that are contained in a persons chromosomes. Chromosomes contain deoxyribonucleic acid (DNA), the genetic material a person inherits from his or her biological parents, which is referred to as genotype.
It is theoretically possible for a person to carry genes that influence behavior; the behavior they express would be the phenotype of those genes. We know that DNA predetermines some aspects of an individuals phenotype, such as eye color or hair type. Whether, and how strongly, it affects the behavior of an individual is the question many researchers study.
Lombroso, the 19th-century biologist, was interested in genetic influences and considered them the single most important influence in determining criminal behavior. He did not consider the differential biological influences of genetics versus environment. (Calhoun, 2000)
As the 20th century wore on, psychologists continued to make interesting discoveries about learning and violent behavior. However, one finding consistently emerged: Although learning was related to violent behavior, learning theories alone could not fully explain violence in human beings. As an example, consider the principle of imitation: It states that children may learn to be violent by imitating an adults aggression. (Calhoun, 2000)
The literature that implicates testosterone as an important cause of violence may seem strong, but research is rarely as clear as it appears at first glance. There are inconsistencies. Some research points to aggression and dominance/hostility as being related to testosterone and other research fails to find that dominance/ hostility measures are related to sex hormones. Some research notes a testosterone-aggression relationship in both males and females; other research finds it only for males. Reducing testosterone demonstrated that in different men, it plays different psychological roles, and there is no clear evidence that it might effectively reduce violence in all violent males.
Despite this, some consistencies emerge: Clearly, testosterone may play some role in causing aggressive behavior in at least some offenders. What factors might account for the inconsistencies found in the aforementioned literature?
Another theory suggests that high testosterone levels might have social and psychological implications as well as biological ones and that a person might need to be exposed to social problems in addition to the biological factors to develop a markedly violent tendency.
A second hormone that has been implicated more recently is cortical. Cortical is the hormone that regulates our bodies reactions to stress. It is involved with the immune system and with sex hormones as well. A few studies have linked low levels of cortical with a tendency to be aggressive. (Spath, 2003)
Environmental and Social Factors
Most people believe that if a child either witnesses or is the target of violence from a parent, then he or she is destined to become a violent person. This isnt the case. Having a violent parent does increase the risk. However, most children of violent parents do not grow up to become violent themselves. If you compare children of nonviolent parents to children of violent parents, you would indeed see that proportionately, more children of violent parents were violent themselves. Therefore, it is clear that having violent parents is detrimental, in that it increases the risk of violence in a child. However, having violent parents by no means dooms any given child to becoming violent. As stated before, most children of violent parents still wont grow up to become violent.
Some children who are exposed to violent psychosocial environments do become violent; many other children who are similarly exposed do not. This fact led researchers to hypothesize that some children are vulnerable to noxious circumstances, whereas others are resilient or invincible that is, resilient children survive and cope well despite terrible circumstances (Werner & Smith, 1982). For example, consider two siblings a brother and a sister who grow up watching their parents fight violently with each other.
The brother is ultimately violent with his own family, but the sister never uses violence as an adult. Why did the brother adopt and imitate his parents violence, whereas the sister remained relatively less vulnerable? Westley Dodd, a notorious serial killer who kidnapped, sexually abused, and brutally murdered several children in the northwest United States, had siblings who evidenced no signs of serious violent behavior.
What makes one child resilient and another child vulnerable? One possible difference between resilient and vulnerable children is their biology. Perhaps unfortunate genetic influences or biological environmental influences serve to weaken some children, thus making them vulnerable. On the other hand, perhaps positive biological influences strengthen some children, thus making them resilient. The fact that children are differentially vulnerable suggests that biology may be an important difference between violent versus nonviolent people.
According to desensitization theory, television violence may so accustom people to violence that they do not notice it anymore. It occurs when people encounter something shocking so often that after a while it fails to provoke any emotional response at all. One example of desensitization is the response of most people in major U. S. cities to homeless individuals. Many years ago, the sight of someone living on the street was shocking and upsetting to most Americans. Today, however, most New Yorkers can walk past a homeless person and feel virtually nothing because they see homeless individuals so frequently.
Several studies have suggested that the same principle may operate in the case of television violence. These researchers have found evidence for desensitization after the watching of shows such as violent talk shows and more typical depictions of TV violence. Perhaps watching hundreds of thousands of violent acts on television desensitizes us to violence so much that we consider real violence to be ordinary and unavoidable.
On the other hand, the literature is not in complete agreement here: At least one recent study has found no evidence for desensitization. That study examined reactions to graphic depictions of extreme violence and found that people tended to evidence normal fear reactions rather than become desensitized (Davis & Mares, 1998). In general, this suggests that while desensitization may take effect for more typical depictions of violence, more extreme forms of violence generally still evoke a reaction in individuals who are watching.
All of these theories contribute to a possible explanation of the relationship between television violence and aggression in television watchers. However, because all three theories postulate a causal relationship, they must at this point be viewed as speculative.
Psychodynamic Factors
Freud believed that aggression was a normal but unconscious impulse that is repressed in well-adjusted people. However, if the aggressive impulsive is particularly strong or repressed to an unusual degree, then some aggression can leak out of the unconscious and the person may be aggressive against a random, innocent victim. Freud called this displaced aggression, and this theory might explain an attack of senseless violence, labeling it as aggression that was too repressed and has broken through to the surface.
The most significant criticism of Freuds hypotheses is that they were based on his interactions with patients, rather than on any data obtained through experimentation. Despite this, some psychoanalytic theory is widely accepted as valid. For example, the idea that unconscious motives and childhood events are important in understanding adult behavior is a cornerstone of much modern psychological theory. However, other ideas of Freuds are much less widely accepted. For example, the notion that every person has a natural, built-in aggressive impulse that must be repressed does not have scientific support. (Joseph, 2004)
The understanding that all violence is not the same encompasses the issue of motivation, not just intent. Certainly, human beings are not the only animals that are violent -almost any animal, including an insect, can deliberately inflict harm. The difference between human aggression and the aggression of other animals seems to lie in motivation. Although any animal can engage in instrumental aggression (aggression that has as its purpose the achievement of a separate goal), only humans engage in hostile aggression (aggression performed to harm the victim). For example, hitting a woman over the head to steal her purse is instrumental aggression.
The motive is not ultimately to harm but to gain the purse. The extent of her injuries may affect what the offender is ultimately charged with, but psychologically it does not affect the motivation for the violence. Of course, one always hopes for no, or at most minor, injuries, but even if a victim is ultimately killed to get her purse, the motivation remains instrumental.
This distinction may seem heartless, but in terms of understanding what causes violence, it is important. An instrumental motive should not and does not imply that it is insignificant if the consequences of violence are damaging or lethal. It is always horrible if a purse-snatching victim dies. Nevertheless, it is important to understand whether the motive was instrumental or hostile because hostile aggression appears to involve significantly different causes and risk factors.
Domestic Violence
Scientists have endeavored to locate male violence within a biological framework, arguing that anger and thus violence is an innate instinct, genetically determined and therefore often not under the control of the individual perpetrator. This implies that mens aggression and their violence against women are in some way at least understandable, if not justifiable.
Human beings always have choices (and hence responsibilities for their behavior); we are not pre-programmed like a machine. Indeed people who have lived with abuse may have more motivation for avoiding it later in life since they have seen the damage it can inflict.
Alternative theories propose that adult violence is learned behavior, the result of an abusive childhood in which the emerging adult either becomes an abuser or remains a victim long into adulthood. Consequently, children suffering at the hands of a violent parent carry that experience forward into adulthood, thus continuing the cycle of violence for many generations.
Such explanations may gain credibility, especially with the wider public, as they create and sustain a myth that somehow domestic violence occurs within deviant families thus reassuring the average man and woman that it does not happen to them. Others, however, challenge these beliefs, maintaining that significant numbers of children from violent homes develop into non-violent adults.
Adopting a particular theoretical stance determines where one locates the cause of the problem and therefore where the focus of intervention lies. For example, if domestic violence is a result of individual deviance or inadequacy, there is no need for society at large to make major changes to its structures and functions. In this instance, the solution to the problem might lie in setting up treatment centers for the violators, offering them aggression management therapy, and at the same time supporting the women through assertiveness training and therapy.
Whereas such interventions may transform a range of individuals, or advantage some couples, offering them as a major solution does not acknowledge the complex and multi-dimensional elements often present in violent relationships. Conversely, if the problem is located solely at the level of society or the culture within which we live, the inference is that an individual within that society is relatively powerless to effect change and the status quo will continue.
It has long been established that domestic abuse and violence can have devastating effects on an individuals mental well-being. This section outlines research previously undertaken in this field, including recent debates around healthcare needs about the mental well-being of domestic violence survivors.
Research suggests that the physical and emotional effects of living in an abusive relationship can have a detrimental impact on the childs future ability to operate as a parent. In contrast, other theorists believe that because of their own experiences some children from abusive homes work extremely hard to ensure they attain positive parenting attitudes and skills. However, what is certain is that children are influenced by their childhood experiences and that to be situated in an abusive and violent home must be exceptionally challenging for any child.
There is not the space to address this issue in depth; however, before accepting the notion that abused children do in turn become abusers one needs to ask: How does one explain the many abused children who do not become abusers, conversely what of those that abuse but have never suffered abuse themselves? Such theories do not explain why daughters from an abusive home do not automatically move into abusive adult relationships or necessarily accept the male domination that perpetuates domestic abuse.
3Childrens responses to witnessing their mother being assaulted by their father vary according to the sex, age, and stage of development of the child and their role in the family. Other factors that may influence outcomes are the 6extent and frequency of the violence, repeated separations and moves, economic and social disadvantage, and special needs that a child may have independent of the violence.
The continuing contact between the child and a violent parent remains a contentious issue. Contact orders may be made by a court allowing the father continuing access to the child or children, even when the family has taken residence in a refuge.
Definitions of crime prevention conceive it as 9the anticipation, recognition, and appraisal of a crime risk and the initiation of some action to remove or reduce it (NCPI, 1986), and yet another envisions it as efforts to reduce the risks of criminal events and related misbehavior by intervening in their causes. While useful, none of the above definitions grapples with what has emerged in recent years as a powerful doctrine applied to almost all private endeavors and most tax-payer financed programs 1on both sides of the Atlantic: the focus on the results of activities, as distinct from processes and intents.
The concept of treatment as crime prevention flows out of the positivist school of criminology which developed in the early 1800s and became rooted in British empiricism, Darwinian determinism, and Comtes sociological determinism (Jeffrey, 1977). It focused not on the legal and moral aspects of crime and punishment which the positivists rejected out of hand but on sociological, psychological, and biological aspects of crime.
It was, in short, a scientific approach to crime control. Proponents of this approach concentrated on the offender, not on the offense, hoping that treatment would rehabilitate him. Under this scheme, crime could best be addressed by healing the criminal, rather than punishing him; this ultimately gave rise to the modern concept of the correctional system. Its guidance as to crime prevention is thus primarily directed to causes within the individual and his treatment and ultimate redemption through rehabilitation.
Conclusion
Target hardening treats the place where crime occurs as opposed to the offender or their socio-economic surroundings. As such it is both a forerunner and component of contemporary environmental crime prevention planning. Target hardening increases the efforts that offenders must expend to reach their intended rewards by making them more difficult to attain. As a long-established approach to crime prevention, its development can be traced back to the beginnings of civilization and may be found across a wide range of applications, from the construction of communal devices such as city walls and gates to the strengthening of entryways by individual property owners. In both Britain and the
In Britain, target hardening of individual properties has been one of the major criteria that police use in presenting Secure By Design Awards to residential and commercial estates. However, British research on offenders decision making has shown that the choice of which residences to burgle is largely based on environmental cues gathered from the periphery of the target area (e.g. at the entrance to the neighborhood), as distinct from the target itself, no matter how well fortified it was. In the United States, other studies have provided only limited confirmation that protective devices and target hardening are important in protecting properties from burglaries. Moreover, there is evidence that builders are concerned that target hardening may lessen the attractiveness and marketability of developments.
The number of projects in various aspects of domestic abuse is growing almost daily. Readers wishing to keep abreast of developments are advised to utilize the web addresses and contact addresses found within the appendices. Some organizations undertake excellent work related to specific minority groups; for example, women who have specific needs as a result of a disability, their sexual orientation, their immigration status, or their ethnic or religious background. Increased interest in various aspects of the phenomena including domestic violence within the workplace, amongst refugees, against men, and lesbians, means that the literature is rapidly expanding.
References
Joseph Rowntree Foundation a8~Understanding what children say about living with domestic violence, parental substance misuse or parental health problems. Joseph Rowntree Foundation research finding. (2004). Web.
Calhoun J. A. Crime Prevention in the New Millennium, NCPC: Washington, D.C. (2000). Web.
Chemtob, C., & Carlson, J. a15~Psychological Effects of Domestic Violence on Children and Their Mothers. International Journal of Stress Management, Vol. 11 (3): 209-226 (2004).
Gordon, K., Burton, S. & Porter, L. a~Predicting the Intentions of Women in Domestic Violence Shelters to Return to Partners: Does Forgiveness Play a Role? Journal of Family Psychology, Vol. 18 (2): 331-338 (2004).
Jeffrey 2C. R. Crime Prevention Through Environmental Design, second edition, Sage: Beverly Hills, CA. (1977).
Mullender, A., Rethinking Domestic Violence: The Social Work and Probation Response. Routledge, London 1996.
Mullender, A., 12 Reducing Domestic Violence&What Works? Meeting the Needs of Children. Crime Reduction Series. Policing and Reducing Crime Unit, Home Office, London. 2000.
NCPC 2 (National Crime Prevention Council) Designing Safer Communities: A Crime Prevention Through Environmental Design Handbook, NCPC: Washington, D.C. (1977).
NCPC (National Crime Prevention Council) Are We Safe? National Crime Prevention Survey, NCPC: Washington, D.C. (1999).
Peterman, L. & Dixon, C. a~Domestic Violence Between Same-Sex Partners: Implications for Counseling. Journal of Counseling & Development, Vol. 81(1):40 a 48 (2003).
Spath, R. a14~Child Protection Professionals Identifying Domestic Violence Indicators: Implications For Social Work Education. Journal of Social Work Education, Vol. 39(3): 497- 519 (2003).
Vandello, J. & Cohen, D. (2003) a~Male Honor and Female Fidelity: Implicit Cultural Scripts That Perpetuate Domestic Violence. Journal of Personality and Social Psychology Vol. 84 (5): 997-1010 (2003).
Werner, E. E., & Smith, R. S.. Vulnerable but invincible: A study of resilient children. New York: McGraw-Hill (1982).
Through this course, I have developed a much clearer understanding of trauma and its psychological and behavioral manifestations, neurobiology and physiology, effects on survivors, PTSD diagnostic criteria, and treatment approaches. Traumatized clients present with various adaptive and pathological reactions based on their age or developmental stage, recurrent exposure, psychological functioning, culture, etc., (Mills & Hulbert-Williams, 2012). Moreover, direct exposure, re-experiences of trauma, and the nature of the stressor (e.g., parental abuse, accident) also affect trauma-related responses.
It is now clear to me that traumatized individual exhibits either a gradual improvement intolerance or an exacerbation of symptoms. While some individuals display effective cognitive coping and resilience, others show pervasive adverse reactions, such as social dysfunction, attention deficit, and maladaptive behavior. After exposure to trauma, most survivors experience intrusion symptoms that manifest within days or persist until a later developmental stage due to delayed expression. Van der Kolk (2015) states that in most cases, the reliving and re-experiencing of the trauma affect the survivors emotional response and determines how well he or she copes with the symptoms. While in most trauma victims these repetitive intrusion symptoms increase tolerance, others show symptoms of hyperarousal and avoidance that are characteristic of PTSD (APA, 2013). In my understanding, the traumatic memory of these people is impaired; therefore, every memory replay serves to enhance sensitization and emotional stress.
Exposure to trauma also involves dissociative reactions ascribed to limbic system alterations. Van der Kolk (2015) describes dissociation as an information organization process that results in compartmentalized experiences. In dissociative reactions, the integration of components related to the trauma into conscious memory does not occur. Thus, survivors may experience desensitization and depersonalization to minimize distressing beliefs and feelings.
Through learning the neurobiology of trauma, most of the symptoms related to PTSD now make sense to me. The activation of the fight, flight, or freeze reaction and elevated cortisol and adrenaline concentration accounts for the DSM V criterion E symptoms of aggression, hypervigilance, reckless behavior, exaggerated startle response, loss of focus, and sleep disturbances (APA, 2013). If the flight response is not possible, the individual freezes a form of dissociation or derealization meant to decrease sensitization and distress. Based on the understanding of these neurobiological and physiological processes, the focus of trauma-focused cognitive behavioral therapy is to develop individualized, needs to be based, and strengths have driven interventions that will ensure effective coping strategies. These strategies may include psychoeducation, relaxation training, affect modulation or expression (self-talk), etc.
Rest of the Course
Throughout the remainder of this course, I anticipate learning appropriate treatment protocols for different client categories based on affective responses to traumatic events. Specifically, I expect to learn effective treatments for traumatized children and adolescents including psychotropic medications as well as methods of identifying trauma triggers (Schneider, Grilli, & Schneider, 2013). These concepts will be critical in creating behavioral plans tailored to adolescent needs. This developmental stage is characterized by negative affect, and therefore, a strong therapeutic relationship is required when treating traumatized adolescents.
I also look forward to learning how to control my counter-transference and emotions when treating a client. I recognize that uncontrolled emotional stimulation by a therapist can hamper trust and commitment from the traumatized individual. Working with trauma survivors exposes the therapist to compassion fatigue related to hearing gruesome stories of abuse or trauma narrated by victims. I anticipate learning about compassion fatigue manifestations and coping methods for professionals.
References
American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA.
Mills, S., & Hulbert-Williams, L. (2012). Distinguishing between treatment efficacy and effectiveness in post-traumatic stress disorder (PTSD): Implications for contentious therapies. Counselling Psychology Quarterly, 25(3), 319-330. Web.
Schneider, S. J., Grilli, S. F., & Schneider, J. R. (2013). Evidence-based treatments for traumatized children and adolescents. Current Psychiatry Reports, 15, 332341. Web.
van der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. London, UK: Penguin Books.
Parkinsons disease is one of the most complicated and challenging health conditions in elderly people. In 2000, an estimated one million people in the U.S. suffered the symptoms and consequences of this neurodegenerative disorder (Baatile, Langbein, Weaver, Maloney & Jost, 2000). According to Parkinsons Disease Foundation (2011), approximately ten million people all over the world live with Parkinsons disease.
The risks and incidence of PD increase with age. Much has been written and said about the incidence, prevalence, physical and neurological factors of Parkinsons disease. Unfortunately, little is known about the emotional and spiritual implications of PD for the quality of life and wellbeing. The future research must focus on the analysis of the spiritual and emotional aspects of Parkinsons disease and possible ways to improve psychological, emotional, and spiritual wellbeing of elderly people with PD.
Parkinsons Disease (PD): A Brief Overview
Parkinsons Disease (PD) is a serious neurodegenerative disorder that affects approximately one million people in the U.S. (Baatile et al, 2000; Parkinsons Disease Foundation, 2011). The disease is usually characterized by the following symptoms: impaired gait, bradykinesia, rigidity, tremors, diminished expression, kyphotic posture, seborrhea, and sialorrhea (Baatile et al, 2000, p.529).
PD is the disease of elderly people, since its early onset usually happens between 40 and 60 years of age (Baatile et al, 2000). However, one form of PD can be particularly dangerous for teens (Baatile et al, 2000). PD is believed to be caused by the lack of dopamine in the human brain (Baatile et al, 2000). In rare cases, head trauma can trigger the development of PD (Baatile et al, 2000).
Scientists were able to identify and describe the genetic factors and predictors of PD, but the exact mechanisms of PD, especially in teens, remain unknown (Baatile et al, 2000). PD is a complex disorder that affects all spheres of life and produces heavy influences on physical, emotional and spiritual wellbeing. Given the complexity of the disorder and its effects on patient wellbeing, its physical, neurological, emotional, and spiritual aspects need to be better understood.
Parkinsons Disease: Physical Aspects
There is an emerging consensus that physical difficulties, including movement disorders, are a hallmark of PD; they severely reduce individuals ability to function and cope with even the simplest physical tasks, for example, walking, turning around, writing, etc. (Morris, 2000).
The past years witnessed a rapid growth in professional understanding of movement disorders in PD patients (Morris, 2000). Of these, bradykinesia (reduced speed and amplitude of movements) is the most common physical symptom affecting more than 80% patients with PD (Morris, 2000). Other movement disorders include akinesia, freezing episodes, impaired postural control, tremor, and numerous adaptive responses that manifest through muscle weakness, reduced activity, and reduced aerobic capacity (Morris, 2000).
Movement disorders in PD subjects are caused by disruptions of the neurotransmitters responsible for the functioning of motor cortical regions in the human brain (Morris, 2000). Low levels of dopamine disrupt the activity of supplementary motor areas and make motor activity in individuals with PD extremely problematic.
They may feel that the speed and size of their movements have reduced. They may fail to initiate movement or cease it. Difficulties with terminating movements are the major predictors of slips and falls in people with PD (Morris, 2000).
Anhedonia is another problem PD subjects experience low levels of physical pleasure (Isella et al, 2003). Again, the lack or absence of physical pleasure in individuals with PD is caused by the disruptions in neurological mechanisms (Isella et al, 2003). Simultaneously, the psychological and emotional consequences of anhedonia cannot be overstated, since PD subjects who cannot experience physical pleasure also feel apathy and lack motivation to improve their physical and emotional condition (Isella et al, 2003).
Physical therapy strategies have a potential to reduce the severity of movement disorders in people with PD. Physical therapy does not influence the disease process per se but can help to improve the lives and wellbeing of PD patients through teaching and training (Keus et al, 2007).
Researchers suggest that physical therapy and exercises, in particular, increase the levels of dopamine and speed up its metabolism; consequentially, functional independence of patients with PD increases (Baatile et al, 2000). This is, probably, why the neurological aspects of Parkinsons disease need to be better understood.
The Neurological Aspects of Parkinsons Disease
Parkinsons disease (PD) is a neurological disorder, which is caused by the disruptions in neurotransmitters and low levels of dopamine metabolism. The growing evidence suggests that the motor impairments in PD patients are accompanied by progressive neuropsychological impairments (Mattay et al, 2002).
It is generally believed that degeneration of the substantia Ingra pars compacta (SNpc) with subsequent depletion of dopamine in the putamen and resulting disruption of basal ganglia-thalamocortical loops results in the classical motor signs and symptoms of PD. (Mattay et al, 2002, p.156)
Dysfunctional changes in supplementary motor areas (SMA) lead to akinesia, whereas neurological changes in the motor cortex lead to the development of bradykinesia (Mattay et al, 2002). Whether or not all these changes develop simultaneously or follow a coherent sequence is difficult to define (Braak et al, 2003).
Braak et al (2003) suggest that neuronal damage preceding the development of PD physical, neurological, and cognitive symptoms follows a predetermined sequence. Although neurological mechanisms predetermine and predict the development of PD in elderly patients, the emotional and spiritual aspects of the disease deserve particular attention.
Parkinsons Disease: A Matter of Emotions
That Parkinsons disease (PD) is the source of multiple emotional problems and complications is a well-known fact. Emotional functioning is one of the most problematic areas in professional PD research. On the one hand, elderly people with PD experience significant difficulties with interpreting emotional information and expressions of others (Clark, Neargarder & Cronin-Golomb, 2008).
On the other hand, depression and apathy are the most common emotional products of PD. Unfortunately, emotional recognition impairments in PD patients are poorly understood (Clark et al, 2008).
Depression is believed to be one of the most complex emotional complications of PD. Depression in PD subjects is more frequent than in the age-matched population (Schrag, Jahanshahi & Quinn, 2001). Depression in PD subjects is a complex product of multiple factors and influences.
Statistically, 19.6 percent of patients with PD experience the signs and symptoms of depression (Schrag et al, 2001). Disease severity contributes to depression in individuals with PD (Schrag et al, 2001). The percentage of depressed patients at initial stages of PD is lower than that at later stages (Schrag et al, 2001). PD subjects with cognitive impairments and akinesia are more susceptible to the risks of depression than individuals without these symptoms (Schrag et al, 2001).
Postural instability is a frequent factor of depression in PD subjects (Schrag et al, 2001). Patients who experience a recent deterioration in their condition report higher levels of depression and apathy (Schrag et al, 2001). However, that the severity of depression in PD subjects depends on the way patients themselves interpret the severity of their health condition (Karlsen, Larsen, Tandberg & Meland, 1999; Schrag et al, 2001).
These emotional difficulties are further accompanied by sleep disorders, emotional distress, and the lack of emotional energy and motivation (Karlsen et al, 1999). All these difficulties reduce the quality of life in elderly people with PD. Apparently, PD is not merely a matter of neurology but a serious factor of emotional difficulties in elderly people. Therefore, it is imperative that emotional consequences and inconsistencies of Parkinsons disease are examined and understood.
Parkinsons Disease: Reconsidering Spirituality
Unfortunately, little is known of the spiritual aspects of Parkinsons disease (PD). McNamara, Durso and Brown (2006) suggest that patients with PD express low interest in spiritual development and religiosity. In the meantime, PD brings profound spiritual and psychological meanings into the lives of adult children, whose parents were diagnosed with PD (Blanchard, Hodgson, Lamson & Dosser, 2009). It seems that children of PD patients are more vulnerable to spiritual changes than their parents with PD.
Like any chronic illness, PD affects family relations and changes family members perceptions about the entire family landscape (Blanchard et al, 2009). Surprisingly or not, PD diagnosis helps children to improve their relations with elderly parents (Blanchard et al, 2009). However, spiritual concerns of PD subjects need to be better understood.
The gap in research regarding the effects of PD on patients spirituality continues to persist. The future research must focus on the analysis of the emotional and spiritual issues of PD and the development of effective methods of coping with the spiritual and emotional complexities of Parkinsons disease.
Conclusion
Parkinsons disease is a serious neurological disorder. PD affects an estimated ten million people worldwide. PD is a disease of elderly, since its early onset usually happens between 40 and 70 years. The most common symptoms of PD include muscle weakness, reduced activity, and reduced aerobic capacity.
That disruptions of neurotransmitters and low levels of dopamine are responsible for the development of PD has been abundantly established. Simultaneously, little is known of the emotional and spiritual aspects of PD. PD subjects experience depression and apathy. They express low interest in spirituality and religiosity. The future research must focus on the analysis of the spiritual and emotional aspects of Parkinsons disease and possible ways to improve psychological, emotional, and spiritual wellbeing of elderly people with PD.
References
Baatile, J., Langbein, W.E., Weaver, F., Maloney, C. & Jost, M.B. (2000). Effect of exercise on perceived quality of life of individuals with Parkinsons disease. Journal of Rehabilitation Research and Development, 37(5), 529-534.
Blanchard, A., Hodgson, J., Lamson, A. & Dosser, D. (2009). Lived experiences of adult children who have a parent diagnosed with Parkinsons disease. The Qualitative Report, 14(1), 61-80.
Braak, H., Tredici, K.D., Rub, U., Vos, R.A., Steur, E.H. & Braak, E. (2003). Staging of brain pathology related to sporadic Parkinsons disease. Neurobiology of Aging, 24, 197-211.
Clark, U.S., Neargarder, S. & Cronin-Golomb, A. (2008). Specific impairments in the recognition of emotional facial expressions in Parkinsons disease. Neuropsychologia, 46(9), 2300-2309.
Isella, V., Iurlaro, S., Piolti, R., Ferrarese, C., Frattola, L. & Appollonio, I. (2003).
Physical anhedonia in Parkinsons disease. Journal of Neurological and Neurosurgical Psychiatry, 74, 1308-1311.
Karlsen, K.H., Larsen, J.P., Tandberg, E. & Meland, J.G. (1999). Influence of clinical and demographic variables on quality of life in patients with Parkinsons disease. Journal of Neurological and Neurosurgical Psychiatry, 66, 431-435.
(2007). Evidence-based analysis of physical therapy in Parkinsons disease with recommendations for practice and research. Movement Disorders, 22(4), 451-460.
Mattay, V.S., Tessitore, A., Callicott, J.H., Bertolino, A., Goldberg, T.E., Chase, T.N., Hyde, T.M. & Weinberger, D.R. (2002). Dopaminergic modulation of cortical function in patients with Parkinsons disease. Annals of Neurology, 51, 156-164.
McNamara, P.M., Durso, R. & Brown, A. (2006). Religiosity in patients with Parkinsons disease. Neuropsychiatric Disease and Treatment, 2(3), 341-348.
Morris, M.E. (2000). Movement disorders in people with Parkinson disease: A model for physical therapy. Physical Therapy, 80(6), 578-597.
Parkinsons Disease Foundation (2011). Statistics on Parkinsons. Parkinsons Disease Foundation. Web.
Schrag, A., Jahanshahi, M. & Quinn, N.P. (2001). What contributes to depression in Parkinsons disease? Psychological Medicine, 31, 65-73.
Exploring the effects of internal and external factors that can influence nutritional decisions is important for determining the patterns associated with healthy populations. While the connections between unhealthy diets and morbidity have been previously established, researchers have to focus on discovering what specific psychological or medical factors contribute to the effectiveness of nutritional intake, requirements, or counseling.
Psychological Factors and Nutrition
Psychological factors that influence nutritional patterns or the need for counseling are associated with what patients feel or think. In most cases, they are difficult to describe due to their dependence on such factors as individuals upbringing, lifestyles, and overall attitudes toward healthy living. It has been identified that psychological stress, mood, beliefs, values, and general habits can have both long- and short-term influence on nutrition. For instance, a patients values and beliefs can contribute to food choices on a regular basis while mood and emotional struggles (e.g., stress, anxiety, depression) lead to the short-term changes in diet.
When exploring psychological factors that affect nutritional patterns, it is important to mention nutritional counseling, which is a relatively new mental health care field (King, 2017). During nutritional counseling sessions, a patient can identify and treat his or her psychological issues that lead to dietary imbalances. Psychological problems can also lead to the lack of adherence to nutritional sessions and the inability of a patient to manage the identified issues. Overall, psychological factors are considered secondary and less visible, even to patients who experience them. For ensuring the development of healthy nutritional intake that contributes to the improvement of well-being, the balance in requirements, and adherence to counseling, psychological factors should be identified, assessed, and addressed.
Clinical Factors and Nutrition
Clinical factors also play an important role in determining nutritional requirements, intake, and counseling. In individuals who suffer from conditions that limit their health, nutritional habits, choices, and intake can change dramatically. On the one hand, those who recover from such diseases as cancer that caused significant muscle loss are required to increase their nutritional intake and consume high-calorie food. On the other hand, patients diagnosed with obesity or heart disease are advised to limit the caloric intake of some foods and substitute them with healthier options to facilitate recovery. Therefore, clinical factors that can affect patients nutritional intake, requirements, and counseling needs are associated with vital indicators such as blood pressure, cholesterol levels, BMI, previous conditions and treatments (e.g., surgeries, medications), history of nutrition, substance abuse, food allergies, and so on (The Scottish Public Health Observatory, 2017). Any patient characteristics that can be improved or deteriorated because of food intake are all associated with patients nutrition.
Nutritional counseling may not only help patients identify the psychological reasons behind some food choices but also assist in adhering to the dietary changes that have been recommended to patients because of their clinical diagnoses. Importantly, nutritional counselors set a goal of preventing drug-nutrient interactions that can harm patients well-being; for instance, individuals who have been prescribed such medications as monoamine oxidase inhibitors are required to follow a tyramine-controlled diet to avoid dietary interference with their medication ( Nutrition counseling, 2018, para. 2). In conclusion, it is important to mention that clinical and psychological factors usually interact and thus influence patients adherence to nutritional counseling, dietary choices, and the desired nutritional intake for improving the overall health outcomes.
References
King, L. (2017). What is nutritional counseling? Web.
I love nursing because it is known to promote wellness in people. I have a passion for taking care of sick and physically disabled people. As a nurse, I am supposed to care for healthy people the same way I provide care to sick people. Nurses are required to develop a relationship with their clients. This is to enable trust and connection between clients and nurses. A client needs to trust a nurse during the process of care so as to improve the quality and outcome of care. Nursing does not only come into practice during curative care. Preventive and therapeutic situations also require nursing practice.
My personal philosophy of nursing therefore focuses on four important areas in the field of nursing. This includes the clients, society, the environment, and the relationship between these three areas. According to me, society is the hospital and its entirety. It includes nurses, doctors, patients, and the various roles they play in the provision of care. The environment is the surrounding in which the hospital is located. It involves the different homes and structures where the patients, doctors, and nurses live. Clients, who are also the recipients of care, belong to a family with relatives and friends. Their family has a supportive role to play in ensuring optimal care. Therefore the nurse doe not only provides care only to a patient but also equips the patients entire family to provide a supportive role that helps to increase the outcome of health care. Hence the client, the society, and the environment interact in a synergic manner in order to increase care outcome.
Background and experience
I have worked as a volunteer nurse on several occasions. This experience has proved to be fulfilling. It has helped me realize my interests and areas of passion. I am also currently pursuing a course in nursing that will enable me to further develop this interest. A graduate degree may offer all the required knowledge for practice however it is not sufficient for advanced nursing practice. There is the need to combine the knowledge learned in theory with clinical experience to enable nurses to be competitive enough for advanced nursing practice. Advance practice nurses have to be committed to learning as they practice. This learning is also expected to be extended to others and not only the individual practicing nurses. They have to offer leadership to other nurses in terms of the promotion of learning.
In order to become a nurse, one has to undergo intensive training just like any other profession. During this formal training, nurses obtain a lot of information that can be used in the promotion of health. The training that nurses receive puts them in a better position to provide preventive care to both sick and healthy people. To healthy people, nurses play a role in primary disease prevention (Johantgen and Newhouse 127). They are involved in initiating education programs that inform people about the risk factors contributing to diseases. For instance, nurses would advise people on the dangers of smoking and alcohol use or abuse as well as informing them about healthy diets. As facilitators of primary prevention care, nurses can also identify patients with risk factors such as high blood pressure and help them reduce the risk through healthy living. In addition to primary prevention, nurses play an important role in secondary and tertiary prevention of diseases where disease detection has been done.
The major components of advanced practice nursing
Expert clinician
Clinical expertise is the most important aspect that forms the foundation of advanced nursing. It is considered to be a cornerstone that supports the advanced nursing practice. It involves specialization within a specific area or field in nursing. In order for the nurse to provide comprehensive care to the recipient of care, there is a need for integration and partnership in terms of approach to the delivery of care.
Nurse researcher
Generating, synthesizing, and utilizing evidence from research is an important component of advanced nursing practice. Advanced practicing nurses have to be able to come up with ways based on research that is innovative in improving the quality of care given to the client and improving the organization of the health care system.
Nurse educator
The other component is education and leadership. Advanced practicing nurses are leaders and educators in various capacities within the location where they are. Wherever place they work from they have to bear in mind that they are supposed to initiate and implement change. They have to come up with new and improved ways of effective and efficient delivery of care such that health systems, the public, the community, and health policies are influenced (Lee and Manley 437).
Consulting nurses
Consulting nurses use effective communication and collaboration with the clients and other stakeholders in the field in order to improve practice. The nurses have the ability to collaborate and consult with their colleagues and other practitioners at all levels. This includes national level, regional levels, local levels, and international level.
Works Cited
Johantgen, Meg and Robin Newhouse. Advanced Practice Nurse Outcomes: 1990-2008: A Systematic Review. Nursing Economic 29.5 (2011): 123-129. Print.
Lee, Susan and Bessie Manley. Nurse Director Rounds to Ensure Service Quality. Journal of Nursing Administration 12.3 (2008): 435-444. Print.
The issue of relatives being next to a patient during critical medical processes never seems to stop being topical. The sphere might have changed, becoming more of an ethical dilemma, although studies always highlighted the negative effects such events may have on relatives, especially those with an unfortunate outcome. Thus, they might be allowed, but the medical staffs responsibility is to consider the impact their presence will have. The selected article, Psychological effects on patients relatives regarding their presence during resuscitation, studies whether relatives are subject to psychological problems after being witnessing cardiopulmonary resuscitation (CPR) (Soleimanpour et al., 2017). The findings might reveal valuable data concerning the ever-relevant issue.
The articles analysis will target its objectives, methodology, and results. The study aimed to discover the effects of relatives presence during resuscitations and compare a group that received sufficient support to the one that did not (Soleimanpour et al., 2017). Thus, based on that, its design is a controlled clinical trial (Soleimanpour et al., 2017). The participants were divided into two groups after undergoing a rigorous selection process that excluded relatives with psychological disorders (Soleimanpour et al., 2017). The intervention group had people willing to be present during a relatives CPR, and a person who offered support was assigned to them (Soleimanpour et al., 2017). Meanwhile, the control one included the contingent not used to attending CPRs, and its members did not receive any assistance during the procedure (Soleimanpour et al., 2017). About three months after witnessing a relatives CPR, the participants were surveyed on anxiety and depression (Soleimanpour et al., 2017). The results reveal that the control group had higher risks of those phenomena and post-traumatic stress disorder (Soleimanpour et al., 2017). Thus, the study highlights the importance of offering support to relatives.
The results present in the article might be relevant to clinical practice. They show that the issue is not allowing relatives to witness CPR but ensuring their mental support during the procedure. While it will not directly impact practice, the implications will ensure that the general goal of not harming anyone is intact. The study has a solid methodology but noticeable limitations, as it was conducted within one medical center. Future studies could expand the scope and the sample size to confirm the findings. However, the recommendations are still viable for implementation as of now.
As far as relatives presence during resuscitation is concerned, it is interesting to analyze the patients demographics and discover the cases when people are more inclined to witness the procedure. It is reportedly more common for relatives to be present during a childs cardiopulmonary resuscitation (CPR) than when performed on an adult. The article titled Family presence during resuscitation: extending ethical norms from pediatrics to adults studies both cases and argues for the latters acceptance (Vincent & Lederman, 2017). The study might reveal the barriers to relatives participation and its benefits.
The analysis will reflect the articles essential points, starting from the objectives. The study aimed to analyze the ethical side of relatives attending CPR performed on a child and discover how those principles apply to adult resuscitation (Vincent & Lederman, 2017). A systematic review of 26 sources was used to achieve the goal (Vincent & Lederman, 2017). The results suggest that a relatives presence during an adult family members CPR is more justified than during pediatric resuscitation, as it has more benefits and should be normalized.
Clinical practice may use the findings depending on their interpretation. Some medical organizations may choose to allow relatives to present at both child and adult resuscitation, while others might restrict access to the former. The articles strength is in its literature scope, but it has a flawed premise against pediatric CRP that creates a bias. Future studies could focus on justifying relatives presence in any form of resuscitation and applying a more experimental approach.
An important aspect of discussing whether relatives should be allowed during a family members resuscitation is the reasons a physician may forbid their presence. While the patients side deserves to be considered, it is also essential to mind the concerns of those who perform the procedure. The article Relatives presence during cardiopulmonary resuscitation studies the issues from the physicians perspective (Enriquez et al., 2017). The findings might help understand the logic behind restricting relatives presence and contribute to resolving the issue.
The article has a well-defined structure, making it easier to analyze it. The studys objective is to determine whether it is more common to allow or avoid relatives presence during resuscitation and the potential reasons (Enriquez et al., 2017). The main method was surveying about 3,000 Spanish-speaking physicians (Enriquez et al., 2017). The results show that about a quarter of the respondents would allow family members to be present during a patients resuscitation, and it is likely to be a child patient (Enriquez et al., 2017). The most common reasons for avoiding them are a possible misinterpretation of a physicians actions or speech and a relatives failure to cope with the situation (Enriquez et al., 2017). Thus, the study presents solid arguments against relatives presence during resuscitation.
While the results may be in favor of avoiding relatives, they also reveal physicians fears, and those could be the target of changes in clinical practice. Having a person explaining the procedure and consoling family members may be beneficial for both sides. The study is solid in its design but has limitations in the sample size, which is skewed towards pediatricians. Future studies could have a wider and more varied scope of participants.
Soleimanpour. H., Tabrizi, J. S., Rouhi, A. J., Golzari, S. E. J., Mahmoodpoor, A., Esfanjani, R. M., & Soleimanpour. M. (2017). Psychological effects on patients relatives regarding their presence during resuscitation. Journal of Cardiovascular and Thoracic Research, 9(2), 113-117. Web.
Psychotherapy is a sensitive practice that requires the therapist to be able to handle the client with dignity and respect to avoid possible premature termination before attaining the set goals. Generally, both parties should dedicate themselves to ensuring they work together toward the recovery process. The counselor is responsible for creating a friendly environment where the patient feels free and motivated to participate in the activities performed. Limited therapeutic alliance, cultural competence and induced aspect of the minority status are key contributors to the early dissolution of the patients treatment.
The therapy process requires commitment and determination to achieve desired results. To develop a working relationship that can facilitate effective client recovery, the physiotherapist should agree with the patient concerning the goals and tasks to achieve the objective and create a strong bond between them. When such an environment is established, the clients will feel part of the process and valued by the physician hence dedicating themselves to the treatment with less denial. The alliance will enable the whole program to reach the set target (Anderson et al., 2019). Similarly, it is necessary for the therapist to understand the cultural perspective of the client. When physiotherapists have sufficient knowledge of norms and beliefs, it will be easier to avoid using terminologies or behaviors that can offend the patient. Furthermore, the patient should feel respected irrespective of the minority status. In a case where the client detects some element of discrimination, the likelihood of withdrawing from the service is high.
In summary, premature termination of the therapeutic process depends on the nature of the relationship between the patient and therapist. It is significant for counselors to make clients feel that they have their interests at heart. Therapists should be mindful of the patients cultural background to minimize misunderstandings that might result in the closure of the recommended psychological treatment before completion. When all the aspects are maintained, reducing the untimely patient withdrawal from the therapeutic service will be easier.