Psychotherapy is a professional way of counseling and treatment of stress related behavior and emotions of human beings. In the recent past, the demand for brief therapy has been on the rise. This has prompted the introduction of cognitive therapy.
Cognitive therapy is a structured psychotherapy with well laid strategy and goal oriented. Cognitive therapy is widely practiced in the US. It has majorly concentrated on human behavior. Cognitive therapy ensures one gets in depth treatment and utilizes the therapy maximally (Crisp & Turner, 2010).
The approaches used in this therapy are quite different from the other therapy. It mostly engages the patient in oral interviews. With continuous interviews, it enables the Psychiatrist to overcome patients resistance to the therapy. In depth treatment gives tremendous therapeutic results assuring that the patient is in the road to full recovery soon.
The driving factor of cognitive therapy is the goal oriented sessions that keep both patient and doctor focused to assure the patient is well treated. A highly significant approach is by goal setting, which involves balancing of the structure and flexibility. The doctor gets the overview of the situation then outlines the core components of cognitive therapy to be employed to the patient (Davies, Banyard, Norman & Winder, 2010).
The basic approach by most Psychiatrists is to change certain part of ones lifestyle, and this in turn, will transform the whole system of this person. This is particularly significant since it ascertains the positive developmental behavior of the patient. Emotions, behavior and physiology, are connected factors in human life. Any change in a single factor affects the others.
The Psychiatrist assesses the strength and weaknesses of the patient and tackles the problem he has by strengthening his weakness. The Psychiatrist also continues this assessment with time cause as the sessions continues, time the patients lifestyle transforms as well. The doctors should always be understanding and emphatic to the patient.
Disorders Appropriate for This Therapy
Cognitive therapy helps to treat a number of psychological disorders. The main psychological disorder treated by this therapy is trauma. Here, it concentrates towards trauma behavioral change. Emphasis is mainly on observable changes in behavior and emotions. The psychiatrist assesses the patients symptoms and draws suitable remedy. The patient receives mind transformation to make him forget the traumatic experience. It helps the patient to view his/her critical problems as minor problems (Davies et al., 2010).
Another psychological disorder is depression. This therapy helps to ease up the pain of depression. It also assists to kill pessimistic ideas in a patient. The patient slowly regains hope and heightens his/her expectation in life.
Anxiety disorder is also another psychological disorder that cognitive therapy treats. It assists to ease up anxiety relapse in the mind. The therapeutic results make the patient maintain calmness and controls emotions. Rational emotions also fall under the category of psychological disorder treated by cognitive therapy. Similarly as the treatment of anxiety rational emotion takes the same approach.
Cognitive therapy has also proven to ease up impulse control disorder. The psychiatrists assist the patient in anger management and anger control. This is normally triggered by depression and excessive stress. It leads to the victim engaging in violence activity over petty issues (Davies et al., 2010).
Stress management is also another crucial focus for cognitive therapy. Stress that is mainly caused by relationship issues, work, and economic problems are better handled through cognitive therapy. This ensures the patient behavior transforms altogether, and betters his/her skills and social status.
As Mandrell (2006) highlights, Equine Facilitated Therapy (EFT) is the most recent adventure-based animal-assisted therapy where horses are used to facilitate the therapeutic process of patients with various disabilities. Unlike other animal-assisted therapies that focus on the animal-human relationship, EFT focuses on the experiences acquired by clients in the process of achieving the goals that have been set.
These experiences are aided by horse-related activities that are integrated into therapeutic sessions by a therapist to physically, emotionally, and mentally challenged patients. Horses are known to exhibit direct responses (respond emotionally), and therefore, participants have to make great psychological and physical adjustments to nurture relationships with horses.
This requires disabled individuals to develop physical abilities such as muscle control and mental constructs such as self-esteem. The physical abilities and mental constructs developed have a positive impact on the coping abilities of disabled individuals.
The Disability Statistics (2011) publication highlights that in 2000, over 54 million Americans were living with mental or physical disabilities. The figure has increased drastically, rendering more people disabled and unable to perform their daily functions. The recent EFT research findings as revealed by Debuse, Chandler & Gibb (2005) prove that EFT effectively complements medication given to patients with physical and mental disabilities such as spinal cord injury, autism, multiple sclerosis, ADHD and cerebral palsy.
To understand the new hope that EFT has brought to patients with mental and physical disabilities, it is important that we look at how EFT works with physical and mental disabilities.
EFT planning and Preparation
Fine (2010) elaborates that EFT works via the collaborative efforts of the horseman and therapist (psychotherapists or psychologists). The practicability of EFT is dependent on an individuals ability to interpret horse behavior. Horses differ in their focus-ability and temperament while individuals with mental and physical conditions are emotionally and physically disturbed hence making it difficult for disabled individuals to interpret horse behavior.
Therefore, a therapist has to model the behaviors and thoughts of an individual with the help of a horseman who knows the requirements of communicating to a horse effectively (forgiveness, consistency, patience, attention, and understanding) to ensure that an individual can interpret horse behavior. The outcome is a workable model that helps individuals respond positively to anxiety, anger, and fear while interacting with horses.
Additionally, during the planning and preparation process, the therapist and the horse professional modify the therapeutic space to include a broad environment (halters, bridles, arenas, hitching areas and bridles) that help individuals to interpret the behavior of the horse within its environment. The overall outcome is that manipulation of the horse environment by the therapist and horseman enhances how patients interact with horses and the environment.
As part of the preparation process, fun-based activities are created by the therapist and the horse professional before the beginning of the therapy sessions. As Mandrell (2006) puts across, fun-based activities are meant to reduce inhibitions, break barriers, and promote laughter. This helps individuals to relate well with horses and eradicate fears associated with EFT therapy such as loss of control, injury, and failure.
Therapeutic sessions
After breaking barriers and reducing inhibitions in physically and mentally disabled individuals, the therapist holds therapeutic sessions which are aimed at maximizing the therapeutic characteristics present in horses. Therapeutic sessions entail horse-related activities such as riding, handling, longing, grooming, and vaulting, among others. Such activities physically and mentally benefit disabled persons.
For instance, Janura, Peham, Dvorakova & Elfmar (2009) note that the repetitive movements of the horse that produce steady and rhythmic patterns, enable individuals with physical and mental disabilities such as cerebral palsy to actively learn how they can anticipate for postural changes. The overall effect is that the motions produced by a horse allow room for displacing the patients center of gravity, thus prompting balance and posture improvement.
This is ascertained by Casady & Nichols-Larsen (2004) who elaborate how horses stimulate balanced reactions and pelvic movements of individuals riding them, thus prompting the individuals to position themselves (adjust posture) while the horses are moving. Riding on a horse also enables an individual to learn new adaptive strategies and movements needed in maintaining the control of a dynamic or moving surface.
Additionally, when interacting with horses, individuals tend to use experimental behaviors such as visual examination and fine discrimination, among others, in a bid to examine how horses respond. This helps mentally and physically disabled individuals to self-manage their motor skills. Cumulatively, activities conducted in therapy sessions ensure that individuals improve their motor abilities through postural control, acquisition of motor skills, and increased strength that enables them to perform daily functional activities.
As individuals identify with horses, they can elicit their emotional responses, which tell more about their needs, wants, and behaviors. For instance, a mentally handicapped child leading a horse can elicit how she/he feels when guided or led by others. This is because the child is likely to set a horse free if she or he detests being guided/led by others. On the other hand, a child who appreciates being led/guided by others is likely to hold on to it most of the time.
The responses help address psycho-social issues experienced by persons with mental/physical disabilities. Besides exhibiting individual responses, the individual-horse bond helps disabled individuals to develop affection, respect, confidence, unconditional acceptance, mutual trust, responsibility, self-control, communication skills, and assertiveness.
These qualities help mentally/physically disabled individuals to interact with other people unconditionally and also express themselves better. More so, individual-horse interaction effectively equips physically and mentally disabled persons with language and speech development, problem-solving abilities, and social skills that help them improve their coping ability(Fine, 2010).
Processing the experience
Processing experiences take place after completion of therapeutic sessions or in-between the therapeutic sessions. The experiences are processed to determine whether the EFT sessions are successful. To process experiences, Hallberg & Irwin (2008) note that the therapist holds dialogues and spends time with a mentally or physically disabled person. This helps to analyze an individual regarding whether the individual has been able to therapeutically benefit from the EFT depending on the kind of disability.
For instance, a therapist may analyze whether a person with spinal cord disability has had any muscle spasticity improvement while riding a horse or whether an individual with multiple sclerosis has made any progress in his or her postural stability.
Additionally, the therapist may find out whether an individual with both mental and physical disabilities have psychologically improved (self-confidence, self -esteem, and behavior-wise). If an individual has not made any progress, the therapist might either increase the therapy sessions, therapy duration or model the therapeutic setting to get improved results.
Besides acting as a control mechanism, processing the experience has other profound benefits to the disabled persons. Fine (2010) states that talking about what is happening with mentally and physically disabled patients help patients focus on issues before an event, promote change during experiences, and reinforce change perceptions.
This is because the patients are motivated to express and reflect on their feelings and thoughts during their experiences, thus creating awareness of how they behaved and what they thought during their experiences. This enables patients to acquire new knowledge concerning the desired attitude/behavior. For instance, an ADHD patient who fails to finish grooming a horse can easily identify why she fails; due to impatience (could not withstand the one-hour required for grooming).
To make the individual more patient, the therapist could suggest that the patient pay more attention to how the horse feels rather than how long the process takes; how caressing the horse with a sponge and water, scrapping off excess water using sweat scraper, ragging it up and walking it until it is dry will make the horse more appreciative.
Conclusion
Conclusively, we can see that EFT, an adventurous animal-assisted therapy incorporating horses as therapeutic tools work by improving the coping capabilities of individuals with physical and mental disabilities. This is made possible by the collaborative efforts of the therapist and horseman who work together to develop an emotionally responsive model as well as a therapeutic setting that helps the mentally/physically disabled individuals to interact effectively with horses.
They must hold the breaking barrier activities to eradicate fears before the therapeutic sessions start. The activities put patients at ease, a prerequisite for deriving maximum benefits from the therapy sessions. Processing experiences act as a control mechanism that ensures individuals cognitively and physically improve as planned. Cumulatively, these processes make EFT effective therapy for improving the coping abilities of mentally and physically disabled persons.
References
Casady, R. L., & Nichols-Larsen, D. S. (2004). The effect of hippotherapy on ten children with cerebral palsy. Pediatric Physical Therapy, 16, 165-172.
Debuse, D., Chandler, C., & Gibb, C. (2005). An exploration of German and British physiotherapists views on the effects of hippotherapy and their measurement. Physiotherapy Theory and Practice, 21, 219-242.
Disability Statistics. (2011). Disability statistics. US disability Statistics. Web.
Fine, A. H. (2010). Handbook on animal-assisted therapy: Theoretical foundations and guidelines for practice. California, CA: Academic Press.
Hallberg, L., & Irwin, C. (2008).Walking the way of the horse: Exploring the power of the horse-human relationship. London, LDN: iUnivers.
Janura, M., Peham, C., Dvorakova, T., & Elfmar, M. (2009). An assessment of the pressure distribution exerted by a rider on the back of a horse during hippotherapy. Human Movement Sciences, 28, 387-393.
The study to be summarized and critiqued was undertaken in 2011 by Dejong and colleagues, and is titled Physical Therapy Activities in Stroke, Knee Arthroplasty, and Traumatic Brain Injury Rehabilitation: Their Variation, Similarities, and Association with Functional Outcomes.
Summary
The prospective observational cohort study employed a sample of 433 stoke inpatients, 429 total knee arthroplasty inpatients and 207 traumatic brain injury inpatients for the purposes of not only examining the similarities and differences in the mix of physical activities used in rehabilitation among patients from diverse impairment groups as observed in the sample groups, but also to investigate whether the same physical therapy activities are in any way associated with functional improvement across impairment categories (Dejong et al., 2011).
The justification for conducting this particular research was premised on the fact that relatively few studies had attempted to evaluate and address the relationship between physical therapy treatments and outcomes by specifically investigating the individual and collective contributions of all treatment strategies; that is, the researchers felt the need to disaggregate the unique and discrete contribution of each physical therapy activity and intervention that can be provided to the patient as a constituent of a general program of rehabilitation (Dejong et al., 2011).
Critique
The authors have given a comprehensive account of how the research study was conducted, including expounding on issues of research design, sample selection, inclusion criteria, site locations, as well as measures and instruments. The sample size used in the study is large enough to enable generalization of findings across the populations of individuals undergoing physical therapy activities for stroke, knee arthroplasty, and traumatic brain injury.
However, a major limitation of the study is that it included only patients admitted to inpatient rehabilitation institutions in the United States but failed to include inpatients from skilled nursing institutions or inpatients from other countries (Dejong et al., 2011). This implies that it may be a little bit challenging to generalize the study findings to stroke, knee arthroplasty and traumatic brain injury patients receiving their rehabilitation care in skilled nursing facilities.
Although the study brought into the fore important findings for practice as witnessed in the following section, it was also constrained by the fact that it focused primarily on physical therapy without concomitantly taking into account other forms of therapy such as occupational therapy and speech-language rehabilitation. Lastly, the study was constrained by the fact that it failed to take into account the interventions that physical therapists employed when patients took part in discrete physical therapy activities (Dejong et al., 2011).
Summary of Important Findings for Practice
The researchers were successful in demonstrating &how practice advances with one impairment group may or may not generalize to other patient groups and how we might learn from the experiences of working with other patient groups (Dejong et al., 2011 p. 1833). The researchers also found that gait and community mobility are the 2 physical therapy interventions that could be employed on all patients across the sample group; that is the interventions worked well for people with stroke, knee arthroplasty and traumatic brain injury.
Lastly, the researchers found that 3 physical therapy interventions, namely assessment time, bed mobility and transfers, were negatively correlated with discharge functional independence measure (FIM) motor outcomes in the sampled participants, thus discouraging physical therapists from using these physical therapy interventions to rehabilitate patients with stroke, knee arthroplasty and traumatic brain injury. In conclusion, the researchers feel that additional research is required to examine whether higher-level or more-integrated physical therapy activities are positively correlated with superior patient results.
Reference
Dejong, G., Hsieh, C.N., Putman, K., Smout, R.J., Horn, S.D., & Tian, W. (2011). Physical therapy activities in stroke, knee arthroplasty, and traumatic brain injury rehabilitation: Their variation, similarities, and association with functional outcomes. Physical Therapy, 91(12), 1826-1837.
Current research discusses the practicability of an ultrasound therapy in the treatment of low-back pain and knee osteoarthritis issues. It deals with the need to minimize side effect risks of a therapy course and help sufferers by all possible means. Throughout the research, the author stresses that safety measures are the key concept when dealing with patients who are subject to an ultrasound treatment course.
The study applies to a number of qualitative and quantitative studies to demonstrate that the research findings are credible and derived using proper data collection tools. All in all, the author concludes that the clinical use of ultrasound equipment positively influences the state of patients health and boasts an accepted level of safety.
Regarding the problem of chronic non-specific low-back pain (LBP), it is one of the most commonly met musculoskeletal disorders throughout developed countries. When it comes to treating this disorder, therapeutic ultrasound is frequently referred to by clinicians for disease recurrence to be stopped. However, despite the proven effectiveness of ultrasound intervention, many physiotherapists still continue to question its usefulness and criticize everyone who advocates for further methods implementation.
They stress that ultrasound may have an adverse effect on people with LBP since it transmits thermal energy. In the meantime, their opponents highlight that the beneficial aspects of the treatment course outweigh the risks related to the use of ultrasound equipment. The procedure causes soft tissue molecules vibrate from the interference of acoustic wave, which creates a molecular-based increase in temperature and excludes the presence of the outer heat. By engaging in such an activity, molecules increase nerve conduction velocity and stimulate a faster recovery process.
Future Research
Eventually, none of the two sides of debate shows the desire to accept proposed arguments, trying to refute those by a variety of counterarguments. Therefore, future research in the area is required to concentrate on the differential effects of various interventions into the treatment of NSCLBP patients. The author states that future investigation of the issue should be based on the measurement of electromyography parameters, such as normalized median frequency and mean frequency. Moreover, future research should critically focus on the shortcomings of the other studies and assess the outcomes in patients with chronic LBP considering the dose response.
Risk Assessment
The author identifies ultrasound intervention as a minimal risk procedure, which can be recommended for general use in medical practice. Nevertheless, the group of patients that has been reviewed in the study can be regarded as vulnerable since their disorders are often accompanied by a variety of complications. As a matter of fact, patients suffering from such diseases as knee osteoarthritis and chronic low-back pain are subject to falling more than others, for their vestibular apparatus is less stable compared to those who have no disorders of this kind.
Falls caused by musculoskeletal problems carry a huge danger to people having brittle bones, as they might lead to serious fractures. In addition, a sudden pain in the back could create a hazardous situation during crossing the street: a person might turn motionless for a moment and be run over by a car. Predicting all possible situations is impossible due to a wide number of possibilities. Nonetheless, the mentioned facts prove that sufferers from LBP refer to the category of vulnerable patients.
The American Occupational Therapy Association defines occupational therapy as a skilled treatment that aids individuals, both children, and adults to lead independent lives. Occupational therapists help different people with special needs such as accident victims and people with autism spectrum disorders to learn special skills that will help them lead independent and satisfying lives (Bryan & Gast2000, p. 558). In people with autistic disorders specifically, OT has advanced to include specialists who offer sensory integration skills critical in helping such patients to process information for playing and socializing.
Children form a big portion of people with Autism Spectrum of Disorders. Given that childhood is crucial to the development of a child, children with the above orders need special care and treatment to help them cope with their shortcomings so that they can develop into a normal adults. Occupational therapy comes in handy by using techniques developed by experts to help such children to better exercise control on their bodies and minds (Howard et al., 2005, p. 364). These children will in the long run be well equipped with a motor and social skills crucial for independent living. Precisely, occupational therapists help children with Autism Spectrum of Disorders in different ways.
They help in the facilitation of activities that aid the child in the course of interaction and communication with peers and caregivers. Here, specific play therapies are used to help the child to develop his/her motor and physical skills (Bryan & Gast2000, p. 563). Another important role that occupational therapists play is in the development of strategies that help autistic children learn how to transition between one or more settings. Furthermore, they help in coming up with adaptive techniques specifically to help invisible disabilities (Fombonne, 2005, p. 6).
Additionally, occupational therapists help in the provision of special interventions that aid the child in responding to information through his/her senses. Here, activities like swinging and playing with a ball are well suited to help the child learn how to manage his body in space.
One of the most commonly used and recommended play activities for children with Autism Spectrum of Disorders is martial arts. More often than not, children with Autism Spectrum of Disorders exhibit limited or no interest in sporting activities (Dawson &Watling, 2000, p. 420). Most sports activities require physical skills a place where most autistic children are challenged. Specialized Occupational therapy instructors who are well versed in the ADHD act have been known to help children significantly overcome their challenges thereby leading confidence filled productive life.
Perhaps contrary to many people, martial arts is not always associated with violence and requires less specific skills than other sports say baseball, basketball, or soccer. Occupational Therapy through martial arts is especially important in autistic children especially those with Aspergers type. The sport is especially good in integrating counting with sporting activity.
In Children with Autism Spectrum Disorder children (ASD) especially Aspergers type martial arts is crucial in improving their attention spans while reducing the childs dependence on stimming behavior. The latter is especially possible thanks to the repetitive movements associated with martial arts. Martial arts also help in managing motor planning problems while improving individual core strength and motor control. Besides, martial arts help autistic children I improving their socializing skills and disruptive behaviors that are common due to unutilized physical energy.
References
Bryan, L.C., Gast, D.L. (2000). Teaching on-task and on-schedule behaviors to high- functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30(6), 553-567.
Dawson, G., Watling, R. (2000). Interventions to facilitate auditory, visual, and motor integration in autism: A review of the evidence. Journal of Autism and Developmental Disorders, 30(5), 415-425.
Fombonne, E. (2005). Epidemiology of autistic disorder and other pervasive developmental disorder. Journal of Clinical Psychiatry, 66(10), 3-8.
Howard, J.S., Sparkman, C.R., Cohen, H.G., Green, G., Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments or young children with autism. Research in Developmental Disabilities, 26(1)359-383.
With the advancement of the profession of massage therapy, the requirement of its regulation becomes more relevant due to the necessity to standardize and ensure high-quality service provision. It is particularly important to impose legal regulation on the spheres dealing with health services to ensure the protection of the public. In the state of Georgia, the rules and governing laws for massage therapy provide clear and direct guidance on massage therapy practice. In particular, the state regulations establish professional requirements and competencies needed to be an authorized practitioner and the educational and licensure directions.
Under the law, massage therapists in Georgia operate with a specific following of the rules and regulations. According to them, a therapist is obligated to be a licensed practitioner to conduct as an authorized service provider, follow standards of care for the profession, and demonstrate professional competencies and qualifications (Rules and Regulations para. 1). Such regulations indicate a spectrum of responsibilities and obligations that a massage therapist should meet in order to have a right to serve the population within the state healthcare system. Indeed, according to Andraka-Christou et al., the inclusion of massage therapy as one of the services within the scope of pain clinics necessitates its compliance with state laws (13). Overall, massage therapists professional conduct is expected to meet the standards of quality care.
When discussing the ways in which rules and regulations protect a therapist, one should note that the professionals are protected from unlawful accuse of maltreatment. Indeed, since the work of massage therapists involves thorough documentation of the services and client work, any legal claims from clients will be accompanied by relevant documentation which is likely to protect a therapist (Rules and Regulations para. 1). Moreover, the inclusion of massage therapy into the insurance programs allows for safeguarding the playability for the services, which might be considered as a protection measure for therapists (Miccio and Cowen 12). Moreover, the protection of clients or patients is one of the pivotal concerns addressed by the rules and regulations. In particular, the responsibilities of a massage therapist under the law include a detailed list of specific measures to avoid violations of regulations and malpractice (Rules and Regulations para. 1-2). Therapists are encouraged to establish effective therapeutic relationships with clients to recognize and immediately address their concerns in a non-harmful way. Moreover, the entering of massage practice in the legal domain allows clients to file grievances in case of any violation.
Finally, the rules and regulations of massage therapy in Georgia define the scope of practice as the provision of services to clients with the aim of pain management and prevention of physical impairment (Rules and Regulations para. 3). In such a manner, massage therapists obtain a clear identification of the limits of their responsibilities, which helps them perform their services in a client-centered manner. In general, the definition of the scope of practice of a particular specialist allows for establishing the boundaries between the responsibilities of cooperating specialists facilitating the functioning of the legal provisions.
In conclusion, the rules and regulations applicable to massage therapy practice in Georgia provide a clear spectrum of guidelines for proper conduct. The responsibilities and duties of therapists who must be licensed to perform their work in Georgia are properly articulated with specific regard to therapists protection. The public served by massage therapists obtains healthcare, financial, and legal protection under regulations, which allows for adequate regulation of this field of practice.
The article under consideration is devoted to such a practice as canisterapia, a type of animal therapy, a method of medical and social rehabilitation using specially selected and trained animals therapy dogs. The authors decided to focus on the field of mechanical ventilation and the influence of specially trained dogs as the leading psychologists of patients. Together with the authors, I will try to understand this topic, study all the features of the mentioned type of ventilation, and find out which dogs can help using concrete examples.
Scientists have found that a dogs keen sense of smell can detect rare combinations of proteins in malignant tumors and distinguish between the clothes of healthy children and those of children with ASD. According to research by the Calgary Institute of Canada at Alberta Childrens Hospital, the dog can anticipate an epileptic seizure at least 20 minutes in advance (Hetland, 2017). Scientists and doctors observed 45 families with epileptic children experiencing seizures at least once a month (Hetland, 2017). Twenty families noted that dogs responded to the approach of a seizure, and in 10 of those, the animals tried to alert the child or their loved ones in the ways available to them (Hetland, 2017). It is impossible to claim that canister therapy cures all these diseases; it is still a way of social and medical rehabilitation and habilitation. However, there is a vast number of scientific studies confirming the positive effect of adding animal therapy to the main course of treatment.
Even though communicating with most dogs is pure pleasure, not every dog is capable of becoming a therapist. There are certain qualities that a dog must possess to pass the test of suitability a robust nervous system, low excitability, loyalty to other dogs, friendliness, and human orientation. It should initially show high emotional sensitivity to people and adapt quickly to the environment. Finding such a dog is difficult, but possible: you have to choose a breeder first, then look at the puppies parents, go to exhibitions, read about dogs . There is no consensus among canisteropia experts on which breeds are best suited for the job, so it is probably not about the breed. There is a relatively firm conviction that fighting breeds of dogs will be bad candidates for the role of therapy dogs: even though they can be pretty friendly, their character is rather harsh (Hetland, 2017). Experts do not recommend training a shelter dog as a therapy dog.
During training, not only the dog learns but also the owner because the essential thing in the process is the emotional connection between them. In training, the first thing that is stressed is self-regulation. Next, the adaptive capabilities of the handler are expanded, and through him, the dog learns to do everything he knows how to do. Besides working on everyday things like endurance, and unconditional, perfect obedience with a voice, a gesture, or movement of an eyebrow they develop a complex of correct reactions to those or other displays and features. People come to the practice sessions, and further, if the dog, by the results of internal testing, is recognized as ready, it is invited to the classes, where it first sits on endurance and observes how the owner works with another dog, or works itself in the light format, for example, is involved only several times during the session. Gradually, the pair get involved in full-fledged work and, in time, can participate in canister therapy sessions with patients under mechanical lung regulation.
Thanks to the collaborative work of the team of a nurse and a well-trained dog, the individual overcomes the difficulties they are facing, which previously were considered impossible, unnoticeably in play and with pleasure. In general, the entire activity is based on the game, which not only helps in overcoming difficulties but also lifts ones mood and brings pleasure during the period of mechanical ventilation (Hetland, 2017). As in any game, in the process of canister therapy, each participant makes an equal contribution. Dogs as assistants during therapy are an effective, helpful, and flexible intervention that can be implemented in the mechanical ventilation unit with sufficient program planning and supervision. In addition, assisted therapy dogs can be adapted to meet the needs of different situations, making this therapeutic method desirable for many patients, including those on mechanical ventilation.
Although research regarding the positive effects of human-animal interaction continues to grow, the specific mechanisms explaining and enhancing how the animal supports human well-being remain a hypothesis that needs further testing. The example of a 76 male and a 5-year-old golden retriever illustrates that the effect of dogs on the rate of recovery in the intensive care unit is significant. The authors, by studying the mechanism of ventilation separately through a case study and risk assessment, were able to prove the thesis of the positive effect of dogs as assistants in the period of recovery therapy. It is essential to understand how necessary and how this factor reduces the risk of postoperative recurrence. In addition, there is a high responsibility for the nurse who accompanies and supervises the dog.
Reference
Hetland, B., Bailey, T., & Prince-Paul, M. (2017). Animal assisted interactions to alleviate psychological symptoms in patients on mechanical ventilation. Journal of hospice and palliative nursing: JHPN: the official journal of the Hospice and Palliative Nurses Association, 19(6), 516.
Quadriplegia is a form of paralysis, paralysis defined as the loss of function for one or more muscle groups. (Paralysis, Paraplegia and Quadriplegia, 2010) Paralysis always has a negative impact on the victim and his or her loved ones. This condition often eliminates or reduces the function of muscles, tendons or joints that help control and regulate the basic body movements. (Burgunder, 2001) From the definition Quadriplegia is a type of cerebral palsy that often affects all the four limbs of the body. (Quadriplegia causes, symptoms, treatment, 2010) Quad means four, implying the four limbs, though the condition may involve the entire body trunk from the neck down. This paralysis is more often as a result of neck injuries. (Quadriplegia causes, symptoms, treatment, 2010) The condition limits the neuro-transmitted signals from reaching to these body parts. Quadriplegia ultimately affects the victims quality of life. In addition to loss of mobility, quadriplegia can affect digestive capabilities, bladder control and numerous other aspects of life. (Paralysis, Paraplegia and Quadriplegia, 2010) This paper seeks to establish the causes of Quadriplegia; symptoms and effects on an individuals life and offering care to the victims.
Causes and symptoms of Quadriplegia
The most common cause of Quadriplegia is cervical (neck) injuries which often result into the four limb paralysis. (Quadriplegia causes, symptoms, treatment, 2010)The injuries might be sustained as a result of an accident where the neck region is involved. This may range from car accidents, which is the most common cause, to falls. The traumatic injuries sustained on the spinal cord often lead to the paralysis manifested. The higher the injuries, the more severe the paralysis, injuries above the C4 level often require a ventilator or electrical implant for the person to breathe. (Quadriplegia causes, symptoms, treatment, 2010) This is due to the fact that the diaphragm is controlled by spinal nerves exiting in the upper part of the neck. (Spinal cord injury, 2010) Apart from the traumatic injuries, quadriplegia can result from other causes. Hereditary spastic Quadriplegia (HSD) refers to a group of disorders characterized by a progressive quadriplegia that can occur at a varied ages and is often accompanied by various symptoms. The pathophysiology of the HSD has been better understood by the advancement in molecular genetics which has made it easy to pinpoint the several gene loci involved. (Burgunder, 2001) Presently, the genes, a dominant form, spastin, one recessive form, quadriplegin, and two X-chromosamal forms phospholipoprotein and L1-CAM, have been described. The genes have been classified and described from a clinical phenotypic startpoint. HSD normally presents varied symptoms which may include: Muscle atrophy; decrease in the nerve vibration sense, sensory neuropathy with tropic disturbances of bones and the skin; striations in the retina; sensoryneural deafness due to acoustic nerve defects; dysarthria ataxia and limb ataxia; dementia; simple complex and partial seizures, atonic episodes; there may disorder pigmentation of the skin. Tumors of the spine may also lead to quadriplegia instances, tumors are abnormal tissue growths that are often found at a close proximity to the spine or inside the spine. (Praakshan, 1997) The tumor may be primary, beginning from the spine or may be secondary (metastatic move to the spine from other locations). These tumors often lead to neurological dysfunction which may cause paralysis in form of quadriplegia. (Spine Tumors, 2010) The metastatic tumors usually results from cancers like breast, lung renal and prostate. The higher the tumors on the spinal cord, the higher the chances of a quadriplegic condition.
The spine tumors can be diagnosed by several methods which include:
Magnetic resonance imaging (MRI) of the spine is the most common test. It will show the soft tissues and nerves of the spinal column.
X-rays will show vertebral fractures, common when the tumor invades the spinal bones.
CT scans show the bones more clearly and can help to determine the extent of the bony disease.
Other tests may include CT scans of the chest, abdomen and pelvis or a PET scan to determine where else the cancer may be.
Effects on an individuals life
After experiencing quadriplegia, individuals often develop the following common problems:
Deep vein thrombosis (DVT) and pulmonary embolism (EP), these conditions can be life threatening in some instances. (Spinal Cord Injury, 2010)The care providers are taught to identify and teach the affected individuals the signs of PE and DVT. The symptoms of PE include very extreme and sudden chest pain and difficulty in breathing. Blood is normally present in the sputum. (Spinal Cord Injury, 2010) The patients are normally advised to tell the care givers immediately they notice the problem. In the case of DVT, the care givers are advised to give the necessary medicine that slow down or halt the blood clotting process. Other methods that can be used to prevent the blood from clotting include: Pressure stockings which keeps blood moving in the legs and arms and thus reducing instances of blood clotting; Pneumatic boots, are plastic boots or leggings put on the patients foot on the pressure stockings or ace wraps. The boots are normally connected to the air pump machine, the pump normally tightens and loosens and this normally helps push blood back to the heart preventing the clots from forming; the vena cava filter, this is a special filter that is placed into the blood vessel to pick up blood clots. (Spinal Cord Injury, 2010) This often indicated if the other medicines and treatments provided are not sufficient enough to stop the DVT and the PEs.
Stress and depression, quadriplegia patients may often feel sad and hopeless about themselves due to the inability to use any of their limbs. This feeling is often dangerous as many patients often contemplate committing suicide or dying. The depression may last for a short duration or may be long-term. This feeling is more often brought by the feeling that one is depending on others to provide care, care givers often provide a range of equipment that helps the person to do some activities for themselves. But this often depends on severity of the paralysis; severe cases will require comprehensive care. (Praakshan, 1997) The most sufficient equipment for a quadriplegic patient is the wheelchair. However this good enough only if the paralysis is limited to the limbs, in addition, caution should be taken to prevent the patients from falling as their centre of balance normally shifts under they often have no body. To prevent falling care givers are advised to help the patient remember to lock the wheelchair while transferring to and from it and when conducting pressure shifts. (Spinal Cord Injury, 2010) This should be done slowly and carefully to prevent the patients from developing dizziness.
Therapy for Quadriplegic patients
Therapy is often indicated to help the patients improve their feeling and heal if possible. It is also offered to prevent the development of other complications and boost the patients self esteem and morale. Therapy for these patients often depends on the severity of the condition and may include:
Spinal cord treatment
This focuses on preventing further injury and enabling the patient to go back to normal and productive life within the limits of their disability. (Quadriplegia causes, symptoms, treatment, 2010) Its often done by prompt emergency treatment and provision of follow up care. The treatment includes conservative treatment for the pressure sores, debridement of necrotic tissue, optimization of nutrition, release of pressure and minimization of muscle spasticity. (Quadriplegia causes, symptoms, treatment, 2010)
Physical therapy
This therapy is indicated to help the patient increase his/her strength and endurance and improve coordination. (Sterlin, 2000)The physical therapists (PT) works with the patient to ensure that the muscles are strong, the skin is free from pressure sores and reduction of spasticity (movement of arms and legs when not required to). The PT also helps the patients to have a better control over the bladder and bowel and make better use of assistive devices such as wheelchairs and braces. (Spinal Cord Injury, 2010) The physical therapists offer the therapies using various methods such as hot packs, ice and sometimes use ultrasound.
Recreational therapy
This helps the patient participate in recreational activities such as sports and other pass times activities that are available in that particular community. Though the participation may be limited to observation and cheering since the patient is paralyzed in all the limbs. However, the intended objective of boosting the patients feeling is often achieved.
Rehabilitation
Patients who have suffered quadriplegia, especially as a result of accidents will normally develop psychological disorders such as stress and depression. Rehabilitation service is given by specially trained care givers who help the patient to learn how to deal with the changes in life that follows paralysis.
Vocational therapy
Vocational therapists offers the help required for the patient to make an assessment of his/her job skills. They go further to link up with the relevant agencies and state departments to obtain the required equipment and train the patient on its use. (Sterlin, 2000) Vocational therapists can assist the patient get new employment if he or she cant get back to the initial job. The vocational therapy is indicated for initially quadriplegic patients who have managed to restore some lost functions, especially in the arms.
Nursing care for quadriplegic patients
Nursing care for patients with spinal cord injuries demands continuous support, observation for detection of complications and if possible to offer corrective measures. (Nursing care for neurological patients, 2010) Patients with severe forms of Quadriplegia often require the services of a care giver around the clock. The patients may have developed conditions such as: autonomic dysreflexia, a condition that occurs when the body acts to a certain problem. The common mechanisms that result to dyreflexia include a full bladder or inability of the bowel to move. Autonomic dysreflexia often results to the blood pressure rising to dangerous levels and is often life threatening. (Spinal Cord Injury, 2010) Patients who experience this condition always require somebody to be around them and offer the necessary help. Quadriplegia and Paraplegia also affects the signals from the brain to the bladder resulting in a condition referred to as neurogenic bladder. This may result in partial or complete loss of bladder control and the patient fails to tell when the bladder is filled and or is emptying. Care givers will often try to work with the patient and help train his/her body to urinate at specific times. (Sterlin, 2000) Patients suffering from severe paraplegia may also present with Neurogenic bowel, a situation where by the brain and nervous system cannot control the bowel functions. (Spinal Cord Injury, 2010) Most patients often learn how to control their bowel functions. The bowel program helps the patients eliminate enough BM and keep down instances of bowel accidents. (Praakshan, 1997) Some pateints may have sustained Spinal cord injuries above the C4 and therefore affecting the function of the diaphragm. This pateints often require a ventilator or electrical impants to assist the person to breath. (Quadriplegia causes, symptoms, treatment, 2010)
Nursing care will include close observation to ensure that the patients is breathing. (Nursing care for neurological patients, 2010)
Conclusion
When one is involved in an accident that leads to a spinal cord injury or other conditions that lead to the development of quadriplegia, life for the individual and family members changes drastically. (Nursing care for neurological patients, 2010) Sometimes it may be so difficult for such individuals to accept that they are paralyzed. The individuals and his loved ones may feel so angry about themselves. Care givers are trained to offer help to the paralyzed individuals and help family members to understand how best they can help.
Reference list
Burgunder, J. (2001). Hereditary Spastic Paraplegia and quadriplegia. Berne: University of Berne.
Nursing Care for neurological patients. (2010). Web.
Paralysis, Paraplegia and Quadriplegia. (2010). Web.
Praakshan, S. (1997). Causes, symtoms and diagnosis of paralysis. New Delhi: Vistaar Publications.
There is no straightforward procedure for finding out whether a therapist is proficient in what s/he does or not. Whereas a therapists academic and professional accreditations and permits may be in order, they may not warrant their success in serving clients. This, however, does not underscore the need for a therapist to have proper training and be licensed. A therapist also needs to belong to a professional body as this is a pointer to whether s/he follows the professional ethics and principles. These bodies can also give background information on the therapist. Apart from academic and professional affiliation, there are personal qualities that a good therapist needs to possess.
Since therapy is a personalized service, a good therapist should develop rapport with the client during the duration of the therapeutic process. Camaraderie enhances empathy in the course of therapy. Heart ensures a balanced exchange in the interaction and discussion between the therapist and the client. They should focus on me and my tribulations, share when desirable, be client-centered, and listen attentively. Once a suitable bond or a professional working relationship is in place, I will be able to obtain the desired outcome from my therapy in the shortest time possible. With such an atmosphere in the therapy sessions, it is no doubt that feelings of being vulnerable, embarrassed, or abused will fade away.
The therapist should view the problem from my angle, i.e., they should be in my shoes so that he can understand my situation. They should also consult me in the designing of the session schedule. The session schedule should be consistent as this will contribute significantly to my sense of security, knowing that the therapist is committed to serving me. The way they design the schedule should be geared towards achieving the desired outcome in the most reasonable time possible.
I would also prefer a person who regards confidentiality highly. The therapist should not share the information gathered in our conversations during a therapy session. However, the therapist should use his judgment skills not to withhold vital information such as that I am contemplating harming myself. A competent therapist should leave me with a sense of consolation and self-confidence as an individual by using their therapeutic expertise and talent. This will make me begin to have a sense of hope and encouragement when the therapy session is over.
A therapists character, mindset, values, and ideals are more important than their particular modus operandi, method, or theoretical point of view in facilitating the success of therapy. These lay the framework upon which the whole therapeutic process is conducted. They determine the direction the process will take, allowing the therapist to take contingent measures as dictated by the uniqueness of each case.
The need to be a counselor can be motivated by various issues. Choosing a career path in counseling could be to the personal needs. A career path selected due to ones own needs will be aided or hindered by the same.
The desire to become a counselor can be motivated by the need to earn a living. The condition to make a living affects how one conducts the counseling sessionsthe need to achieve a living dictates how fees are charged. The counselor must charge prices that motivate him and covers his running costs. Motivation from monetary gains aids the counselor in the conduct of his work and thus delivers promising results to the client. On the other hand, if the counselor becomes money-oriented, he may charge higher fees or short design sessions which do not deliver value to clients.
One can also become a counselor due to having natural gifts for helping people. Some people are naturally gifted and may need to become counselors to exploit their talents and help troubled individuals. Having such abilities helps the counselor to be able to conduct counseling naturally. In addition, such counselors do their work with passion which is advantageous to the clients. However, if such counselors are not adequately trained, they may miss out on some professional ethics in the conduct of their practices.
One may also be motivated to become a counselor due to personal experiences in his life. Victims of rape, bomb blasts, landmines, civil war, domestic violence, terminal illnesses, and decrease sometimes become counselors. Such counselors are well versed in their area of specialization and are willing to help people undergoing similar situations. They understand their clients needs and thus can guide them to recovery and achieve the desired outcomes. However, such counselors might be objective as they use their personal experiences, whereas their clients needs are unique. What might have worked for the counselor might not work for everybody.
From the preceding reflection, therapy is a personalized service; thus, the client has to choose a therapist with whom they are comfortable. It has also come out that no matter what is the motivation for one to become a counselor, their efforts should be geared toward achieving the clients desired outcome in the most practical way.
In this randomized controlled crossover design, the authors assess the mood variations among eleven older adults (>65 years old) after completing a 6-minutes walking pace. Mood and motivation to accomplish mental tasks were estimated with a repeated-measures analysis of variance. To determine interconnections between physical activity and the magnitude of mood changes, a bivariate Pearson correlation was implemented. Various scales helped researchers measure mood (POMS-SF), mental and physical state (MPSTEF), gait (LED), and motivation (Likert). As the result, the study statistically proved that tiredness, nervousness, misperception, and energy levels were improved by 6 minutes of self-regulated physical training. Moreover, the magnitude in energy perception and fatigue was straightly related to gait speed.
The authors provide statistically trustworthy objective data that can be used in further studies. The article is written by Ph.D. professors and is published in a credible journal. The research provides the reader with recent authentic data estimating the impact of physical training with self-regulated tension on older adults mood and motivation. The study used primary data, all the scales and calculations are presented. The outcomes of the study can be used in guidelines of older peoples health improvement as it proves the importance of exercise in older age.
This article focuses on physical activity as a method of non-pharmacological treatment of various diseases, such as diabetes mellitus, Alzheimers disease, multiple sclerosis, cognitive activity, memory, etc. The authors of the study evaluated secondary data and presented the interconnections of an essential chain of mechanisms reflection on training processes such as enzymes, neurotransmitters, and ion channels positively influencing the cardiovascular system, cardiorespiratory system, improving the glycemic level and insulin response. The authors also suggested the implementation of virtual reality-based exercise requiring more movements for a player. The latter can be useful for people with computer-dependent lifestyles, low tolerance towards physical training, and children with intellectual disabilities.
The study is gathering a sustainable number of secondary resources providing the reader with a deep analysis of molecular mechanisms and their impact on the human body. The authors of the research are professors in chemical and pharmaceutical sciences, psychology, neuroscience, and biomedicine. The work was published in the Italian scholarly journal in 2019. The authors are objective and provide the reader with an in-depth analysis of the most essential studies on relevant topics. The study provides vast data analysis and helps comprehend the influences of various mechanisms and mediators on systems and organs. For instance, brain-derived neurotrophic factor (BDNF) activates neurons and glial cells that modify neurotransmission in various regions of the brain (Di Legro et al. 724). The study observes pathologies separately providing data on each disorder with understandable language.
The study observes various groups of the population with depression and anxiety symptoms and allows to track the interconnections between peoples sex, age, and various physical activities they experience. Symptoms of anxiety and depression are divided and observed separately providing statistical data and measurements. The authors show an adequate amount of objectivity and provide authentic data that can be used for further research. The study also emphasizes that physical training (except overtraining) plays a significant role in the non-pharmacological treatment of mental health disorders, particularly depression and anxiety. However, the existence of physical activity cannot prevent the initiation of mental health diseases (Paluska and Schwenk 177). Anxiety can be improved with acute exercise; nevertheless, the impact of routine training on anxiety is less clear and under-researched. Hence, the study highlights the questions of chronic training as an approach for mental diseases and raises a question of its further assessment. The structure of the article lets the reader rapidly orient in the topic choosing a literature review on depression or anxiety symptoms, proposed mechanisms for overtraining, and gathering more data on additional groups of populations.
The study is focused on the amount of physical activity and its impacts on depression and anxiety symptoms. The authors provided a vast analysis of secondary data including experimental and descriptive research, as well as meta-analyses and reviews. The authors of the study are professors in sports medicine and family medicine. The article was published in a journal in the USA. Even though the source was released in 2000, it provides trustworthy information and includes essential data about excessive physical activity on the human body and the impacts of overtraining on different systems and organs.
The article is useful in terms of a deeper understanding of the mechanisms of physical activity impact on systems of a human being. More importantly, it provides trustworthy data about trainings impact on cognitive abilities and highlights the promising targets that can be used for the treatment of neurodegenerative diseases. The innovative treatment of disorders connected with cognitive functions involves special types of physical exercises that can be individually set for a patient according to the variations of different substations in blood.
This article presents a study using the assessment of secondary data to disclose information about molecular mechanisms of muscle and brain interconnections influencing the hippocampus and consequently mood, education skills, and hunger. The author of the research is a Danish professor of Integrative Medicine. The article was published in a scholarly journal in Denmark in 2019. The recent data gathered about the myokines, the role of BDNF, and other regulating mechanisms allow to get access to up-to-date information and comprehend the impacts of physical activity on the human body better. The author does not defend any ideas or hypotheses, uses the information with no biases, and allows the reader to make his conclusions.
Works Cited
Boolani, Ali et al. Six Minutes of Physical Activity Improves Mood in Older Adults: A Pilot Study. Journal of Geriatric Physical Therapy, vol. 44, no. 1, 2021, pp. 18-24.
Di Liegro, Carlo Maria, et al. Physical Activity and Brain Health. Genes, vol. 10, no. 9, 2019, pp. 720-760.
Paluska, Scott A., and Schwenk, Thomas L. Physical Activity and Mental Health. Sports Medicine, vol. 29, no. 3, 2000, pp. 167-180.
Pedersen, Bente Klarlund. Physical activity and musclebrain crosstalk. Nature Reviews Endocrinology, vol. 15, no. 7, 2019, pp. 383392.