Assignment Essay

Assignment Essay Writing Services

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Quality Oriented Assignment Essay Writers

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Research Paper Writing Service

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Nursing Essay Writing Service

Nursing Essay Writing Service
Writing an essay is not always easy. Actually, in most of the times, students struggle to write it. This is especially true for those individuals who do not enjoy writing. Other nursing students do not fully understand the process of writing a nursing essay. There are yet others who lack the time needed to work on their essays. This nonetheless does not mean that you cannot submit a quality essay if you fall under any one of these categories. Actually, it is quite easy to come up with an acceptable essay in the field of nursing by ordering for nursing essay writing service. Among the reliable sources of this kind of writing services is our website. We have passionate nursing writers who are always glad to assist nursing students. You can therefore bet that you will always get an acceptable essay whenever you contact us.
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Most importantly, for your nursing essay to earn you a good grade, it should be free from any traces of plagiarism. As a result of this, you must be sure to paraphrase information from other sources. In addition, you should fully cite your paper. Generally, you should be guided by APA writing guidelines when citing your essay. If there is something that you do not fully understand about this writing style then it would do you a great deal of good to order for our nursing essay writing service. We shall, without doubt, be sure to deliver you a paper that is original. Lastly, your nursing essay ought to be free from typographical errors. You make sure of this by keenly proofreading it prior to handing it in for marking.

Quality Assessment Paper Writing Service

Assessment Paper Writing Service Online

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Why you should work with our Assessment Paper Writers

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Leadership Essay Writers

Leadership Essay Writers
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Quality Leadership Essay Writing Aid at Cheap Prices
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Government Assignment Writing Help

Government Assignment Writing Help
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Taxation Law Assignment Writing Help

Taxation Law Assignment Writing Help
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Top Ten Assignment Writing Firms that you can Trust
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Write my Paper

Write my Paper
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History Term Paper Writers

History Term Paper Writers
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How to Write the Best Outline for an Essay

How to Write the Best Outline for an Essay
Before you can write the first draft of an essay, you are supposed to create an outline. The purpose of an outline is to help you write a well organized essay. An essay outline also helps one not to forget any main or sub-main points when writing the first draft. Moreover, it is important in ensuring that your essay not only has a logical flow but also that it does not contain unnecessary repetitions or omissions of key information. It then goes without saying that if you want to write an impressive essay, then you must be sure to create an outline first before you can write the introduction, body and conclusion of your essay. Are you a student and you are not sure about how to write the best outline for an essay? If affirmative, then you should consider ordering for essay writing assistance.
Key Requirements of Writing an Essay Outline
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The Structure of an Essay Outline
The basic structure of an essay outline should among other clearly highlight: introduction, main ideas to be included and the conclusion. In the introduction, you ought to clearly state the thesis statement and be sure to capture the readers’ attention. When outlining the main ideas, you should ensure that you have at least three of such ideas. The ideas should also be outlined in the most logical manner possible indicating the sub-main points under each main point. Lastly, you must outline the conclusion by highlighting the information that you will include in it. You do not have to spend sleepless nights worrying over this academic task our online tutors who know how to write the best outline for an essay can assist you at very affordable prices.

Juvenile Diversion Bill Being Introduced in Florida Senate Session 2021

Juvenile Diversion Bill Being Introduced in Florida Senate Session 2021
Please provide a one page summary of this legislation, which was introduced today. I got word from a GOP friend, Christian Minor, that Florida State Senator Perry is going to be pushing this strongly. It appears to align with our platform. Can you please do a quick summary that includes:

1) substance of bill
2) champions of bill (elected and outside groups in Florida except for the Florida Rights Restoration Coalition because they already support it)
3) impact on returning citizens and families
4) likelihood of passage
5) alignment with platform priorities

Not looking for a book, just one page with your best assessment.

https://www.flsenate.gov/Session/Bill/2021/274

Juvenile Diversion Bill Being Introduced in Florida Senate Session 2021
Name
Institutional Affiliation
The Brief Legislation Assessment of SB 274: Juvenile Diversion Program Expunction
This bill relates to the juvenile diversion program expunction. It would be an amendment to S.943.0582, F.S. that required the department of law Enforcement to erase the non-judicial arrest records for particular minors that have completed the diversion program for any offence successfully instead of only the misdemeanour offence. It is also looking to amend the S.985.126, F.S by authorizing that the minor who has completed the diversion program successfully for any offence instead of only the first-time misdemeanour offence lawfully deny or choose not to acknowledge certain information availing an effective date.
The Department of Juvenile Justice will be responsible for implementing particular programs such as accountability and program support, prevention, intake and detention, residential and correctional facilities, probation and community corrections and administration. This bill will positively affect the returning citizens and families as these youth will be redirected into opportunities for programming, rehabilitation and restoration. Confidentiality in the non-judicial records will ensure that the chances that also include education and employment for the young individuals are not jeopardized, increasing the possibility of them becoming productive, contributing and autonomous individuals. This growth subsequently benefits their families and society in general.
The bill is expected to take effect on 1 July 2021 hence the Florida Senate did make it law, and it is expected to become operational on that particular date. The Juvenile Justice system is focussed in ensuring that those who go through their processes become better productive individuals. The non-confidentiality would lead to unwarranted adverse impacts, yet the minor successfully completing the diversion program meant that further delinquency proceedings would not happen. The legislature hebe finds it a public requirement that criminal history records for these minors that are expunction recipients due to successfully completing the diversion program remain confidential and exempted from public records’ requirements.

References
Senator Perry. Florida Senate – 2021 SB 274. Retrieved from https://www.flsenate.gov/Session/Bill/2021/274/BillText/Filed/PDF
The Professional Staff of the Committee on Governmental Oversight and Accountability. (2020). The Florida Senate: BILL ANALYSIS AND FISCAL IMPACT STATEMENT. Retrieved from https://www.flsenate.gov/Session/Bill/2020/1292/Analyses/2020s01292.go.PDF

Substance abuse and mental health

Substance abuse and mental health

Students Name
Institutional Affiliation

Mental health and drug abuse intersect because some illegal drugs can cause a person to experience the symptoms of mental health problems. On the other hand, mental health issues can lead one to drug use and alcohol. People with mental health often turn to drugs for self-medication. Also, nearly exposure to stress and trauma lead to mental disorders that cause the users to turn to substance use. Studies have found that many addicts are also diagnosed with other mental disorders (Watkins,2011). Both long-term and short-term drug abuse causes mental health issues such as hallucinations, anxiety, and depression among other issues.
People who are addicted to drugs roughly suffer from anxiety and mood disorders. Dealing with drug abuse is even more difficult when you have mental disorder problems. Both mental health issues and drug disorders affect an individual’s performance. According to (Watkins,2011) concurring substance abuse and mental health issues are common than many people think. The two issues correlate and affect each other. Research done by The Journal of the American Medical Association found that roughly 5o percent of individuals with mental disorders abuse drugs. At least 37 percent of the drug users abused alcohol.
People with mental illness and drug use problems experience behavioral changes, physical changes, and social changes. Behavioral changes include lack of motivation, sudden mood swings, paranoia, and unexplained change in personality (Watkins,2011). The physical changes include bloodshot eyes, sudden weight loss. Unusual smells in the breath and tremors. The social changes include legal problems related to substance abuse, unexplained need for money or financial problems, and deterioration of relationships. However, the relationship between substance abuse and mental health disorder does not completely define causality. For example, long term use of marijuana causes prolonged psychotic reactions while alcohol deepens the symptoms.
References
Watkins, K. (2011). A national survey of care for persons with co-occurring mental and substance use disorders. Psychiatric Services, 52(8), 1062-1068.

US Foreign Policy

US Foreign Policy
What is the premise of The World: A Brief Introduction and why is Richard Haas uniquely competent and credible to elucidate and advance his assessment of global relationships now?
2. What are the four components of essential knowledge and understanding that Haas asserts are necessary for American foreign policy success and what are the implications of American citizens comprehending and acting upon that knowledge and understanding?
3. Identify, describe and provide examples of three alternatives to the current President’s foreign policy to implement “real” American foreign policy leadership inside and outside the USA and what are the implications of each of these alternatives? Why are Americans largely inattentive to relationships, obligations and complications in foreign policy?

US Foreign Policy
Name:
Institution:

US Foreign Policy
1. Richard Haas, the President of the council on foreign affairs for eighteen years, discusses the world in one of his latest books, which came just before Corona started. Richard Haas’s premise about the world is that we live in a world where whatever happened in history can affect lives today. According to the author, currently, Coronavirus is the major problem, where next time it might be another disease. Years ago, terrorism was the bigger issue, attacking countries, such as the united states. The issue has currently shifted to cyber terrorism, where attackers hack confidential government accounts to manipulate the American election system. The book helps the readers get the answers to the current and past issues and why the world is a complicated space (Cox, and Stokes, 2018). On the other hand, the author explains that various current factors, such as climate change and globalization, are things that the world needs to respond to for a change, but not opt-out. According to Hass, the world cannot be ignored, since we are all connected to the world, there is no choice apart from understanding it for better choices.
Richard Hass is competent to elucidate and advance his assessment of global relationships now is to make people understand the world of economy and every aspect that influence the American economy (Nyshanbayev, and Tolen, 2020). For instance, Hass emphasis on the relationship between the united states and china and how the two nations should build a relationship based on selective cooperation, despite competition. Hass states that” the goal of the united states’ foreign policy is to regain the ties, and not finish or stop the ties. According to the book, Hass explains that cutting ties with the united states would make it challenging for the united states to deal with certain issues, such as dealing with climate change issues in North Korea (Cox, and Stokes, 2018). Richard Hass’s book concerning the world is a platform for bringing change in the united states, especially in strengthening its relationship with other countries to build healthy foreign affairs.
2. According to Richard Hass, foreign policy begins at home, where as much as the world needs from the American leadership, the united states should put its house in order by being disciplines and restrained in activities it wants to do in foreign countries. For American foreign policy success, the united states should promote a collective response to global challenges, advance North American economic integration, and promote energy self-sufficiency. According to Hass, the world is not a domination of one or a particular superpower, but a product of international relations.
The united states citizens can be impactful in foreign policy by being involved and applying the knowledge in learning their communities, which can assist in providing alternative routes for foreign policy development (Gift, and Monten, 2021). On the other hand, the public could use the knowledge to understand international links based on their community and participate in foreign policymaking. The American citizens still uphold Washington’s words that were meant to advise the united states. 1789, words stated that the country should avoid entangling with other alliances, which has been a mindset to many citizens, especially Triumphs followers. The American citizens are still on isolationism, hence not paying attention to the united states’ complications.
3. The three alternatives to the current President’s foreign policy in the united states include re-joining the united nation human rights council and a council representative who is a seasoned human rights defender. Another alternative includes selecting a foreign service office that will represent the united states at the united nations in place of political appointees (Nyshanbayev, and Tolen, 2020). Additionally, the third alternative includes rescind Trumps’ policy concerning the visa ban on the international criminal court staff and appoint an effective, jurist of the state department office of global criminal justice with a better experience. The current united states foreign policy is designed to implement the “real” American foreign policy leadership within and outside the united states.
The alternatives are meant to attain Biden’s promises, such as the goal to develop and repair international alliance and restore American leadership internationally. It will be a challenging journey for the current administration, especially in restoring American leadership abroad, but bringing back the protection of human rights as stated in the Vienna Convention on diplomatic relations will be a huge step and provision of Visas ICC staff (Cox, and Stokes, 2018). On the other hand, the current policy will enable the bar American citizens to provide expert advice to the ICC, hence doing away with trumps unconstitutional decisions, especially increasing political capital to be spent on the federal civil suit. On the other hand, the current administration will revive the American support for international justice, especially on the Afghanistan portfolio, which has been an unresolved issue for a long time.
Americans’ largely inattentive to relationships, obligations, and complications in foreign policy have been contributed by the citizens’ attitude, especially after Trump’s policies broke foreign relationships, including the relationship with China (Cox, and Stokes, 2018). The biggest worry in most citizens is that China will be more powerful than the united states due to the ongoing conflict between China, Russia, and the united states. The Americans are aware that Biden has a huge task, especially in understanding the politics of foreign policies and dealing with the COVID-19 challenges and China’s assertiveness.
The Americans understand how challenging it have an agreement between reformists and restorationists and how difficult it may be to depart from Trump’s isolationism. Biden’s democratic aspect of foreign policy is similar to that of Obama, hence expected to follow Obama’s footsteps, especially on national security. According to Ellen Laipson, Biden is “inheriting a country in crisis” and undergoing competing priorities ways and congressional challenges that may not be handled in the middle of the pandemic (Gift, and Monten, 2021). Dealing with economic inequality, recreating the united states’ economy, and dealing with racism are top issues that the citizens expect the current foreign policy to deal with before making other foreign economic and security moves.

References
Cox, M., & Stokes, D. (Eds.). (2018). US foreign policy. Oxford University Press.
Gift, T., & Monten, J. (2021). Who’s Out of Touch? Media Misperception of Public Opinion on US Foreign Policy. Foreign Policy Analysis, 17(1), 128-139.
Nyshanbayev, N., & Tolen, Z. (2020). WHY STABLE WORLD ORDER NEEDS DECISIVE LEADERSHIP: THEORETICAL ANALYSE. InterConf.

Case Report – Assessing and Formulating Psychosis

Case Report – Assessing and Formulating Psychosis
Name

Course
Professor
University
The City and State
Date
Case Report “Rita”
Introduction
This case report focuses on the assessment and formulation of Rita’s psychosis condition. This report will be under the guidelines of Cognitive Behavior Therapy for psychosis (CBTp) formulation models refer to fundamental theoretical issues, key existing literature, and their links to actual practice. The formulation, which is the hypothesis in an individual’s challenges that will link theory to practice, will help develop the treatment plan and reflect on the lessons acquired. Notably, Rita is not the patient’s name but a pseudonym so that confidentiality can be maintained. Also, some information in the client’s medical context has been disguised. Still, the report balances the provision of minimum information to capture the pertinent issues while not depriving the reader of fundamental information required.
At the beginning of the therapy, the treatment duration had been agreed upon to be a minimum of 16 sessions as per the clinical recommendations given by the CBTp programme. The main objective of these sessions will be a reduction in distress and improved functioning. At the development of this case report, seven sessions had already been undertaken.
Client’s Biographical Data and Current Circumstances
Rita is a 26-year-old female of Black Caribbean origin. Rita was born and raised in London and is currently single. She left home at the age of 14. She has reported dealing with verbal and physical abuse from her mother, prompting her to move to her aunt’s place, where she lived for a year. Her aunty tried to cope with her behaviour prompting but could not do it any further; hence, Rita moved into a hostel. At the hostel, other girls would bully Rita. Rita did not meet with her biological father until the age of 16. She is the firstborn to four siblings from her mother’s side. She remains in contact with their family. Her relationship with her mother, conflicted. However, she has a good relationship with her aunt, who has remained supportive of her. Currently, she lives in a 24/hr supported placement and is unemployed. She was volunteering part-time, but since the placement of the lock does, she stopped.
Development of Problems.
Rita is well known to mental health services. She came into contact with services at the age of 16. She struggled with depression and anxiety for over 15 years. She has heard voices from childhood. She has experienced childhood sexuality. This research literature will draw causal links between childhood trauma and psychosis particularly the presence of comorbid depression (Garcia et al., 2016), anxiety disorder (Reiff et al., 2012, 2) and extensive auditory hallucinations (Reiff et al., 2012, 2).
Current Treatment
Rita is under the care of a CMHT. She is under the Care Programme Approach receives care from a psychiatrist who reviews her every three months. She has a diagnosis of paranoid schizophrenia. She is prescribed Clozapine, and Aripripizole Rita referred for CBTp for her care coordinator’s voices and anxiety.
Previous Psychological Treatment
2015 – 6 talking therapy sessions on how to manage difficult situations.
2016– 16 sessions of CBT trauma-focused therapy.
Presenting Problems
Rita’s main presenting problems would like to get psychological help with difficulties related to managing hearing voices (interpreted by her as the devil) and anxiety. Rita also described experiencing low mood, feeling ’empty’ at times, lacking motivation, low energy and being exhausted. She experiences distressing voices which are derogatory and threatening in nature. Over the past few months, her voices have increased in frequency, duration, and intensity.
To cope with distressing emotions and ‘voices’, Rita described spending time at home and in bed, where she feels safer, avoiding family and friends, not going outside much, ‘ not doing some of the things she enjoyed doing. Rita described several more helpful coping strategies: listening to music, painting, self-care, writing poetry and going to church but is currently unable to attend church services.
Scores on Personalised Measures and Standardised Measures:
Cognitive-behavioural therapy (CBT) is an empirically supported approach that has gained widespread application in treating substance abuse disorders. The intervention uses standardised and personalised measures to assess the present health problem and measure the progress and effectiveness attained by the implemented interventions. Self-report standardised measures for voice interviews were used in the first stages of the Psychotic Symptom Rating Scales (PSYRATS). Thus would facilitate a beneficial discussion and gaining critical information in Rita’s experiences.

PSYRATS: Voice Hearing Scoring Sheet
1. Frequency 2
2. Duration. 3
3. Location. 3
4. Loudness 4
5. Beliefs Re: Origin. 3
6. Amount of negative content of voices. 3
7. Degree of negative content. 3
8. Amount of distress. 3
9. Intensity of distress. 3
10. Disruption to life caused by voices. 2
11. Controllability of voices. 4

PSYRATS: Haddock et al, 1999

It was explained that PSYRATS would provide a baseline and we would complete it again midway and at the end of therapy to measure and explore any changes. During the assessment process, we also discussed idiosyncratic and personalised measures, including conviction, belief in cognitions, pre-occupation, distress and mood. For example, Rita rated her anxiety of going out at 80% (with 0% being not anxious and 100% being the most anxious she had ever felt). She also rated low mood and fear at 90% using the same scale. She rated the belief in her voice ‘you are not good enough’ at 80% (with 0% not believing it at all, and 100% true).
Given the indicators of high levels of anxiety and depression being linked to hearing voices, Rita also completed two further standardised outcome measures, the Generalised Anxiety Disorder Questionnaire (GAD-7) (Spitzer et al. 2006); and the Patient Health Questionnaire (PHQ-9) (Kronenke et al. 2001). She scored 16 on the GAD-7, indicating severe anxiety, and 18 on the PHQ-9, indicating severe depression. These will also be repeated midway and at the end of therapy.
Risk Issues
The risk was assessed as part of the assessment. Rita reported that she hears voices which she interprets as the devil’s voice saying negative and derogatory things about herself. At times the devil’s voice has been so intrusive that she has attempted to harm herself and end her life. In the past, she has attacked people due to the voices. No current plans or intent to act on them or to harm others. A safety plan was in place, and Rita said that she would seek help in a crisis. Risk and mood were reviewed at every session. Strong protective factors are her aunty and her Christian faith.
Goals
Rita identified, and we collaboratively agreed and prioritised the following goals. These were reviewed regularly and smartened as therapy progressed.
• To enhance strategies to distract and cope with voices.
• To enhance strategies to cope with anxiety and depression.
• To increase meaningful activity and improve social networks and relationships/connections with others. We made this goal more concrete as therapy progressed
I.e.: –
• To cope with and distract voices better with meaningful activities e.g.
• Participating in art therapy x1 a week
• Reconnecting and seeing family members and a couple of old friends
• Joining in her church service online once a week.
• Daily exercise and increasing gradually.
Assessment Process
In CBTp, the therapeutic process is conceptualised via a series of fundamental steps that will reduce Rita’s symptoms and disability through a change in beliefs about the symptoms. Fundamentally, a robust therapeutic alliance is developed for the treatment to be successful. The therapist is to adopt the “collaborative empiricism” strategy that entails working jointly with Rita to better understand her experiences, thoughts, feelings, and goals (Landa, 2017, 7). The therapist is expected to be empathetic and normalise engagement with Rita to understand the problem the same way the patient will understand it. Rita is to describe her experience, the process they take to making their conclusions, and the process taken in developing their individual beliefs. Engagement will be incorporated entirely through the therapeutic relationship despite it being categorised as the initial step in the therapeutic process (Landa, 2017, 7).
For each session, the CBTp’s structure will be essential for maximising predictability and reducing anxiety levels, increase Rita’s investment and involvement in the treatment process, helping to exercise memory, and developing meta-cognitive skills. In the initial minutes of the sessions: Rita and the therapist are to carry out several activities: a complete mood check, quantifying the severity of symptoms, setting up the session’s agenda, and setting up the order of topics for discussion. During the session, the therapist is to review any assignments given, assess Rita’s progress during the session and transitions, relate topics to previous discussions, and the whole treatment plan. After the session, issues to be handled include reviewing upcoming topics, making plans for the upcoming sessions, assessing Rita’s perception of the session, what is helpful and what was not helpful, finalising the mood check and reviewing any assignments.

Formulation
The formulation development within CBTp will help Rita and her therapist gain a better understanding of the links between her early experiences, primary schema, obstructive thinking patterns, and maintaining the prevailing symptoms (Hardy, 2017, 3). Essentially, this stage will inform the intervention taken as it points out the changes that should be taken to handle the distressing symptoms.
The initial sessions focussed on Rita’s presenting problems: difficulties related to managing hearing voices that she interpreted to be the devil’s voice and anxiety. The ABC model was incorporated as the basic framework to understand and formulate the voices and delusional beliefs. Through the framework, the acronym “ABC” simplifies the cognitive process such that A represents the activating event that is particular observable experiences, B is the belief including the thoughts and beliefs of the mentioned events and C representing the consequences both emotional and behavioural consequences to the thoughts and beliefs (Landa, 2017, 6). The ABC model was hence taught to Rita so that she could construct her thoughts and beliefs.

Anomalous experience
Beliefs about experience
Consequences

I went outside in the afternoon. My mood is low, anxious thinking about my past.

I hear the voices of 3 women and two men. Sometimes it can be three or 5 of them.

Sometimes they are loud and other times they are low.
I can hear them throughout the day night. They are mostly when I am alone and worse when I am stressed, low or anxious.
“Just give up “what is the point “just end it, end your life.
“you are not good enough *you are ugly and useless’ ‘no one likes you, “they think you are weird.
“stay in, don’t go out< it is not safe.”
“I will be ok, just carry on.

The voices are devil, tormenting me for the things I did in the past.
The voices are powerful. I have no control (belief 60%). I have to listen to them. I have no choice but to take the battering.
I can’t resist them; they just get louder and won’t stop.
The voices of the devil want me to give up and end my life. They are strong but not strong that I will follow through (65).
The voices are right. I am worthless, not good enough, incapable of believing this 70%.
They are right; they are right. I am weird and not normal.
I must do what the voices say and not go out and stay in bed. I will not be harmed. I am not open to judgement, hurt and pain.
It’s intolerable, distressing, painful and tiring. I can’t cope with it.
Sometimes I feel like giving up on life.
Emotions:
Anxious
Low
Scared
Shameful
Hopeless

Physiology
Fatigue
Sleep problem
Tense
Palpitation
Behaviour
Withdrawn
Stay in bed ruminating, and can’t sleep.
Give the voices my full attention. Listen to the voices and stop what I was doing ( “take the battering”).
The urge is to follow their instructions.
Stay at home.

Figure 1: ABC Formulation for Voices

While undertaking the ABC, Rita and the therapist were able to identify the most troublesome challenges, determine Rita’s thinking habits, consider how Rita behaves to them, and look at how unrealistic or unhelpful the thinking or behaviour habits were and look into opposite ways in which the habits could become more helpful to solve the challenges. Finally, these new ways were to be tried again and selecting the workable ones. The guiding principle in this therapy is that Rita’s emotional reactions result from their perception of distinct events as per Beck’s Model of Emotional difficulties (Lester, 2020). After this framework, Rita was able to relate to the entire process understanding how distinct events were triggering her distress, which was very unhelpful considering the reactions she made towards the triggers. Essentially, Rita identified that her challenges were mainly inherent such that the beliefs she had towards these voices were playing a huge part on how she was reacting towards them.
The information collected from the initial sessions was used to develop the formulation collaboratively. This meant having a maintenance formulation illustrating how Rita was interpreting the voices she heard and the impact of the interpretations in her feelings and behaviours. The maintenance formulation was the starting point for Rita’s CBTp as we helped identify the interventions for her thoughts and behaviours. The upcoming sessions could help in building up the formulation and even undertaking further symptoms and past experiences leading to yielding information to guide in a longitudinal formulation., the longitudinal formulation would draw from Rita’s early experiences to aid in understanding how particular beliefs were formed and the interpretations to the event. The therapist is hence able to better understand how Rita responds to particular situations and helps her identify and make better responses to thinking and behavioural patterns.
Notably, while the formulation is done together with Rita’s important input, the complex case formulation should be utilised as the main feature in team meetings to offer support to steam treatment planning, with respect to Rita, her childhood abuse from her mother and the bullying from other girls in the hostel affected the world and self-view. Rita’s primary beliefs included “I am not good enough, I am weird, I am not normal, I am incapable, I am worthless, people are cruel and cannot be trusted, even those close to me, other people are judgemental and can’t see weaknesses, people are dangerous, evil and the world is unsafe. Understandably, Rita gets to interpret the auditory hallucinations negatively and as threats.
According to Haggard (2017), citing the learned helpless model by Abramson in 1978, depression results from a depressive attributional style where the bad results are seen to originate personally.. Stable and global faults of character. In relation to Rita, her interpretations of the voices are attributed to her incapacities, such as not being normal, not being good enough, worthless, and even incapable. Lester (2020) indicated that the distorted and biased inferences arise from negative emotional states within clinical challenges. Rita’s cognitive processes and attributional biases demonstrate emotional reasoning that tends to relate the external events to herself and blame herself for all the wrong things. Rita also externalises bias through the voices where she sees them as an external cause (from the devil) and is powerful and in control.
In relation to Rita’s hallucinations, the therapist incorporated Socratic questioning to explore the connections made by Rita and determine that the primary hallucinations were causing her distress and making her not be in control of her thoughts (Sivec and Montesano, 2013, 460). The voices were powerful as Rita would comply with what they said that she would not even leave the house so that she does not meet the “evil people”, cause emotional stress as she feels anxious and scared and adversely impactful on her functioning as she chooses to stay in bed all day long. An assessment of Rita’s beliefs specifically on the origin of the voices, her triggers are mainly when she is alone and feeling stressed, she hears the voices of five individuals (three women and two men) that keep telling her to give up, she is ugly, useless and even not good enough. These voices control her as she chooses to stay alone even further and avoid her family and friends. An understanding of the nature of her triggers to the voices can be connected to child abuse, neglect, and lack of nurturing that she did not receive from her present mother and the absent father. Like other children, Rita did not grow in a normal family where parents are seen as protectors. Being sexually abused by her cousin and even being bullied by other girls in her hostel would reaffirm her that she was also not good for the outside world, which was also not treating her well enough.
In this case, the therapist recognises that Rita has lived a lonely life. It was time to normalise alternatives such as the possibility of experiencing voices and still live a normal, productive and happy life (Landa, 2017, 20). Normalising Rita’s experience entailed referring to famous and successful persons such as Anthony Hopkins to try and inspire hope and reassurance of better wellbeing in the future.
Developmental History
According to Reed et al. (2008), childhood trauma has been linked to several mental health challenges such as depression, anxiety and psychosis. The hallucinations and delusions are linked to childhood trauma in terms of the problematic thinking styles originated from abuse and other childhood disadvantages. The hallucinations have been seen to come from sourcing elucidating difficulty in accurately attributing experiences, specifically the inner thoughts to the internal or external sources.
Rita pointed out several traumatic experiences that could be linked to the development of psychosis and being cognitively vulnerable. In her childhood years, Rita stated that she experiences both verbal and physical abuse from her mother. She was neglected and never nurtured as a child should be. She also experienced bullying in primary school, secondary school and at the hostel too. At the age of 9, she was sexually abused by her cousin. Also, her biological father was not present in almost her entire childhood life as she met him at 16. These traumatic experiences demonstrate how Rita could develop negative beliefs about herself and believe them to be true. This is because neither her home nor school environment was conducive for her as a child. She, therefore, grew knowing that her environment is an unsafe place that cannot be trusted. This prompted her to run away from home and live with her auntie, which she could not do so for long due to her behaviour. While she now has a better relationship with her auntie, she now prefers living along as she believes that letting other individuals into her space will only be hurting her. Hence, the reason she left home at the age of 14 to live alone.
Rita also started using illegal drugs at the age of 10, and has been to prison on remand are other significant events that demonstrated rejections from the society. Individuals who engage in illegal drugs have always indicated that they lack the right guidance and support they require, especially in their depressive periods. This is evident in Rita’s life who has been living alone and unlived life since her childhood. The depressive symptoms and psychosis worsened when she went to prison as it is not an environment that is loving. The early events contributed to the development of fundamental predictors that are affiliated with developing psychosis. The emergence of later events would wholesomely cause a problematic emotional and interpersonal adaptation, higher sensitivity levels to interpersonal stress such as the emotional over-involvement, poor prosocial coping skills, withdrawal and an impoverished reflective function. These are the symptoms that Rita is dealing with, and with her feeling that she has no control over her emotions, thoughts and beliefs, she lives as if they are true.
Current Triggers and Modifiers
Rita indicated that her present triggers and modifying factors would increase in frequency, intensity, and duration whenever she is alone and when she is stressed, low or anxious. With the lockdown placed for the pandemic, Rita cannot engage in any volunteering, and she still has no job. This causes her a lot of stress which triggers the negative voices. Notably, Rita provided several helpful coping strategies that she could incorporate, such as listening to music, painting, self-care, writing poetry and going to church but currently unable to attend church services.
Maintenance Process
Rita’s maintaining factors included staying alone at home and in bed, avoiding family and friends or any interactions, and not engaging in things she enjoys doing. These are the safety behaviours which primarily entail being alone. Nonetheless, the loneliness meant that Rita would focus on her difficulties by giving the voices full attention, ruminating and worrying extensively. To this effect, Rita fails to do any functional things that would help her with the negative voices and the adverse impact.
Each of the triggering events for the voices that caused the childhood trauma led to increased fear and apprehension for Rita and would have the anomalous experiences of having the urge to listen to the voices and believe them. Rita appraising the emotional and cognitive changes was affected by the prevailing beliefs about herself and her world: “I am not good enough, I am ugly and useless, Stay in and don’t go out as it is not safe”. The positive symptoms’ maintenance processes created the hypothesis that Rita’s reasoning and attributional style, depression, anxiety. Using safety behaviours and incorporating coping strategies to suppress the voices appraised her to be suffering from psychosis.
Cognitive models have pointed out several cognitive and behavioural mechanisms attributed to the susceptibility to psychosis leading to traumatic experiences. One of them is the shared developmental and maintenance factors operating in psychosis cases and present in PTSD (Larkin and Read, 2008). The model is built upon the work by Morrison on the integrative cognitive approach to hallucinations and delusions. It states that hallucinations and delusions could be representative of distinct points on a spectrum of responses to trauma mediated by the shared mechanisms such as one’s attributional style or interpretations of voices, fundamental to this model is the concept that the traumatic experiences lead to negative beliefs about oneself, the world and others (Valmaggia et al., 2008). These held beliefs create distressing interpretations of even ambiguous situations, highly prevalent with psychotic patients. Research has indicated that these beliefs, especially those that arise as an adversarial impact of trauma, are affiliated with psychotic experiences (Smith et al., 2006, 163). Also, it has been suggested that transparency on the link between the traumatic event and the content and form of psychotic experiences will determine whether the individual is considered psychotic suffering from previous trauma impacts.
From the formulation diagram, Rita’s interpretations of the voices, the maintenance factors and safety behaviours offer guidelines on the CBTp treatment plan. The interventions incorporated will focus on handling Rita’s challenges and achieving her goals for the better quality of life and reduced distress. As illustrated below, the maintenance cycles for anxiety and depression to Rita;s case were drawn out to illustrate the vicious cycles that play out to maintain them. When Rita felt anxious, it made sense to do things that reduced the anxiety. She would try and reduce it by avoiding the feared situation entirely (Centers for Clinical interventions, n.d.). The avoidance instantly reduced the anxiety as one has not put themselves in a distressing situation. Nonetheless, the avoidance only reduces it in the short run and worsens it for the long run. The same cycle continues for the depression.
Figure 2 & 3: Maintenance Cycles Relating to Rita’s Depression and Anxiety

In the evolving formulation, the longitudinal formulation based model develop[ed by Morrison (2017) was utilized as it allowed a historical formulation yjay incorporating life experiences and beliefs created hence validating the experiences and creating an optimism for change to happen (7). Rita’s beliefs on the voices she was hearing demonstrated a close affiliation to the negative self attributes she developed and to her earlier experiences.

Figure 4: Morrison formulation diagram

Cognitive Behavioral Interventions In Progress and Being Considered for Rita’s Treatment

Intervention Reasons
Care Programme Approach Under the care of Community Mental Health Team (CMHT) In this intervention, Rita receives psychiatric care for the diagnosis of paranoid schizophrenia. She undergoes care review after every three months. She is also taking medical prescriptions of Clozapine and Aripiprazole given by her care coordinator to deal with the voices and anxiety.
Empathic Exploration In this intervention, the therapy will be focussing on dealing with distress related to the delusions (Pinninti and Gogineni, 2016). Rita, the 26-year-old, believes that the voices she keeps hearing are the devil, tormenting her for the things she did in her past. In the case, the therapist will explain that he understands that it is scary for Rita whenever she is alone, and the voices start tormenting and talking negatively about her. This wants Rita to reduce her defensive position and open up on her distress (Pinninti and Gogineni, 2016). The follow-up steps will focus on bringing in new information on the orient coping strategies, such as how she has been dealing with the situations for the past few weeks. The therapist is trying to get useful information on the listing coping strategies that will be effective for Rita. Considering Rita’s conditions, enrolling Rita into groups engaging in art, constantly staying with family and close ones, and even a gym should reduce the time she spends alone.

The normalisation of Psychotic Symptoms This has been considered the antidote to stigma, and catastrophizing will need to be avoided entirely. Mental illnesses are common with at least one in every four persons experiencing it regardless of their age, gender, ethnicity or other traits (Hardy, 2017). Notably, each individual does have the capability to overcome the symptoms by positively viewing them. Normalisation in Rita’s case would involve informing her on the rate at which individuals are dealing with depression, anxiety and hallucinations. The main focus is to look into the links between her traumatic childhood experiences and her overall personal safety view. The process will be about normalising her experiences through providing success stories of persons that have gone through a similar journey. With her consent and an understanding that this will help her with her condition, Rita is also included in groups of people dealing with psychosis. In these interactions, Rita learns about the prevalence of the symptoms she is facing and helps her understand the journey she needs to take to deal with the issue.

Cognitive Restructuring The main objective of this intervention is to compassionately challenge and restructure the auditory hallucinations (Mankiewicz and Turner, 2014). It will begin with an evidential analysis of the content within the delusional beliefs. The next step is a reattribution of the beliefs about the voices. Here, Rita identifies the existence of repetitive negative internal dialogues that are happening in his thoughts. These dialogues precipitated the experiences she had with the auditory hallucinations, while the voices represented her fundamental worries about her life (Mankiewicz and Turner, 2014). In conjunction with the information gained from the normalisation discussions, Rita will be on the path to understand the functional affiliations between the voices, the derogatory beliefs, and the concerns she had towards her life. Over time, Rita is encouraged to practice identifying the internal thoughts daily and when they normally happen, which is evidently at her lonely times. Restructuring these unhelpful cognitive experiences would begin by implementing several better self-statements such as she is beautiful and not being punished for anything for she has not hurt anyone.
From that point, Rita will practice to reframe the negative appraisals of her experiences, identify the cognitions inducing depression and anxiety then replace them with proof and better self-statements (Mankiewicz and Turner, 2014).

Discussion
This research on the assessment of psychosis would present fundamental lessons that I would not have gained if I did not take the entire process. One evident thing was that an assessment of psychosis is a complex process that needs to be done articulately to ensure that the desired objectives are attained. In this case, I understood the five stages incorporated into Cognitive Behavioral Therapy for psychosis (CBTp) and the importance of each one of them. These stages include engagement, assessment, formulation, goals, intervention and even relapse work. It became evident how a collaborative treatment alliance between the client and the therapist streamlines this complex process. Therefore, as a therapist, it is prudent that one builds their collaborative skills to improve the interactions’ quality. The process also ensured that I understood that mental health conditions could affect anyone and arise from anything. Therefore, the development of listening skills is fundamental to understanding the patient’s situation.
Notably, extensive research has been done on assessment and intervening on the psychotic issue. Therefore, it is the therapist’s responsibility to be conversant with the many interventions existing since they will need to find the best approaches that will work for their clients. A cohesive treatment plan will understand the patient entirely and recommend an effective approach after an analysis of all the effective ones existing.

References
Abramson, L.Y., Seligman, M.E. and Teasdale, J.D., 1978. Learned helplessness in humans: critique and reformulation. Journal of abnormal psychology, 87(1), p.49.
Beck, A. T. (1976). Cognitive therapy and emotional disorders. New York: International Universities Press
Center for Clinical interventions, 2021. The Vicious Cycle of Anxiety. [ebook] p.1. Available at: [Accessed 7 February 2021].
Center for Clinical interventions, 2021. The Vicious Cycle of Depression. [ebook] p.1. Available at: https://www.cci.health.wa.gov.au/-/media/CCI/Mental-Health-Professionals/Depression/Depression—Information-Sheets/Depression-Information-Sheet—04—Vicious-Cycle-for-Depression.pdf [Accessed 7 February 2021].
García-Mieres, H., Ochoa, S., Salla, M., López-Carrillo, R. and Feixas, G., 2016. Understanding the paranoid psychosis of James: Use of the repertory grid technique for case conceptualisation. World journal of psychiatry, 6(3), p.381.
Haggard, P., 2017. Sense of agency in the human brain. Nature Reviews Neuroscience, 18(4), p.196.
HARDY, K., 2017. Cognitive-behavioural therapy for psychosis (CBTp).
Landa, Y., 2017. Cognitive Behavioral Therapy for Psychosis (CBTp) An Introductory Manual for Clinicians. Mental Illness Research, Education and Clinical Center, pp.1-28.
Larkin, W. and Read, J., 2008. Childhood trauma and psychosis: evidence, pathways, and implications. Journal of postgraduate medicine, 54(4), p.287.
Lester, D., 2020. HOPELESSNESS AND SUICIDE. THE LAST WEEK OF THE LIFE OF ARTHUR INMAN; A STUDY OF HIS DIARY, 1(1), p.108.
Mankiewicz, P.D. and Turner, C., 2014. Cognitive restructuring and graded behavioural exposure for delusional appraisals of auditory hallucinations and comorbid anxiety in paranoid schizophrenia. Case reports in psychiatry, 2014.
Morrison, A.P., 2017. A manualised treatment protocol to guide delivery of evidence-based cognitive therapy for people with distressing psychosis: learning from clinical trials. Psychosis, 9(3), pp.271-281.
Pinninti, N. and Gogineni, R., 2016. Brief Cognitive Behavioral Therapy Interventions for Psychosis. [online] Psychiatric Times. Available at: [Accessed 2 February 2021].
Reiff, M., Castille, D.M., Muenzenmaier, K. and Link, B., 2012. Childhood abuse and the content of adult psychotic symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), p.356.
Sivec, H.J. and Montesano, V.L., 2013. Clinical process examples of cognitive-behavioural therapy for psychosis. Psychotherapy, 50(3), p.458.
Smith, B., Fowler, D.G., Freeman, D., Bebbington, P., Bashforth, H., Garety, P., Dunn, G. and Kuipers, E., 2006. Emotion and psychosis: links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research, 86(1-3), pp.181-188.
Valmaggia, L.R., Tabraham, P., Morris, E. and Bouman, T.K., 2008. Cognitive-behavioural therapy across the stages of psychosis: prodromal, first episode, and chronic schizophrenia. Cognitive and Behavioral Practice, 15(2), pp.179-193.

Criminal Justice and Interpersonal Communication

Directions
Respond to ONE discussion topic questions below. Your responses should apply the unit concepts and connect the concepts to the discussion questions.

Due Dates
1. Initial posts: Respond to ONE topic question below by Wednesday, 11:59 pm CT. All responses should address all parts of the topic question.
2. Response posts: Respond to at least two other students’ posts by Sunday, 11:59 pm CT. If differences of opinion occur, debate and support your viewpoint professionally.
It is very important that you post in each unit’s discussion because your postings do count as part of your class participation score. Discussions make the class more enjoyable and informative for all.
Unit Topic Discussion Questions
1. Describe and discuss how the corpus delicti of a crime differs from the statutory elements that must be proved to convict a particular defendant of committing that crime.
2. Explain the legal concept of insanity defense distinguishing it from psychiatric explanations of mental illness. Do you believe this is a valid defense? Why or why not? Use the information you have learned thus far in the course to solidify your answer.

Unit 2 – Discussion
No unread replies.No replies.
Are you a good listener? Personal communication improvement ultimately comes down to substituting effective behaviors for the behaviors you have determined to be ineffective in your communication with others. Seldom do we simply stop “doing” a behavior, which has become a habit with us. We are more likely to improve when we have a better behavior to do instead.
This unit, when you’re with someone who needs understanding or they just want to share their day, be generous and say to yourself: for the next 30 seconds, (or 5 minutes, or whatever) “I will forget my own concerns and give this person my full attention.”
Share with us what happened and if you noticed any change in how the conversation went.
What specific course concepts from your readings relate to your listening example? How can you use these concepts to improve your own listening skills?
You should respond to a minimum of two classmates’ posts.

Unit 2 – Journal Entries
Submit Assignment
• Due Sunday by 11:59pm

• Points 6

• Submitting a text entry box or a file upload
Journal Suggestions
You are to keep a journal throughout Units 1-6 of this course. Journal entries should document observations of interpersonal communication interactions throughout each week. You will post a minimum of two journal entries per week. Each entry should provide an analysis of your communication. Each journal entry should answer one of the questions below (you will answer two questions each week). Entries should identify a relationship to a course concept or term and finally summarize how the interaction could be improved.
Remember, to document your observations, relate to course concepts and indicate ways to maintain or improve.
You should clearly label each entry and post them in one word document or use the text entry feature in Canvas. If you submit two different posts, it may appear that your first post disappeared but your instructor will be able to see each submission. Each entry should be approximately 150-200 words.
This Unit’s Journal Entries
This unit, while observing your own communication patterns, or that of the people around you, try to find examples that reflect the following:
• How satisfied are you with your self-concept? How satisfied are you with your current level of self-esteem? How does this impact your communication with others?
• The Johari Window is a tool to help you understand who you are. Review the model page 56 and develop the model as it reflects your perception of your 4 selves.
• Do you have the need to be perfect, to be strong, to please others, to hurry, or to take on too many responsibilities? Discuss your self-destructive beliefs and how you can replace them with more positive ones.
• Provide an example of the ways men and women differ in their listening behaviors. DeVito offers some excellent material on listening, based on the reading, what are some of your own strengths and weaknesses? What can you do to improve your listening skills?
• How can you improve your listening behaviors on the job or in school? With a significant other? A parent? A child? A friend?

This is the book that is being used.
https://bookshelf.vitalsource.com/#/
Login: noresnancy23@gmail.com
Password: Beto1996.
The Books are called Criminal Justice a brief Introduction and Interpersonal Communication
Criminal Justice and Interpersonal Communication
Student Name
Institute:

Criminal Justice and Interpersonal Communication
Topic Discussion Question Two
Legal insanity in criminal justice systems means the mental state of a person when committing a crime. Legal insanity defense cvan be accepted if the person lost their reasoning capability or diagonised with a mental illness at the time of committing the crime. According to the law, the court may judge the accused as innocent because the defedant could not distinguish between right and wrong or could not control their action due to the mental disorder (Math, Kumar, and Moirangthem, 2015). According to the legal dictionary, an insane person is a person that cannot distinguish between fantasy and reality. Mostly insanity is characterized by low level of intelligence and inability to reason like a normal human being. In case a person is considered mentally ill, during the criminal case, a plea of not guilty is presented because based on insanity when the accused committed the crime. Although the definition of criminal insanity is different in various jurisdictions, some jurisdictions use the MNaghten rule, others the model penal code, and the impulse test.
On the other hand, mental illness, according to the American psychiatric association, is a health condition that leads to changes in thinking, behaviors, and emotions. Mental illness leads to distress and affects a person’s normal functioning based on their emotions, personal life, and relationships. The insanity defense is a valid type of defense because the accused could not distinguish between right or wrong during a crime commission. Additionally, the defendant had a mental disorder that influenced how the brain works, affecting the ability to think straight, control emotions, and behave morally (Math, Kumar, and Moirangthem, 2015). According to t research, a mental disease is considered psychosis and not neurosis. According to the current thoughts, there is no definition for mental disease, but a mental disease is a social maladjustment and legal incompetence.
Unit 2-Discussion
Listening in communication is the act of mindfully hearing another person and understanding the words uttered. Listening is essential in every conversation, especially in building relationships and in solving problems. Additionally, listening involves providing undivided attention to someone else, according to Carl Rogers (Krivosheyeva, Zuparova, and Shodiyeva, 2020). According to Stephen Covey, seeking to understand others is more important than seeking to be understood. Most of the time, people judge behaviors for not listening carefully to what people are saying. Listening to a person share their desires and concerns for thirty seconds without interrupting is another level of listening. Listening for thirty minutes and giving the person full attention is not quite easy, especially when most information about the day is relatable (Krivosheyeva, Zuparova, and Shodiyeva, 2020). After about twenty seconds of listening and giving full attention, the conversation changed, and the attention shifted. What disrupted my listening skill was a topic that was so relatable, and I found myself talking about it instead of listening.
The rule of good communication is listening, then speaking when the other person is done speaking. To become an attentive listener and avoid interrupting, the speaker is learning to focus on the speaker but looking them directly in the eyes. If the mind wanders, learn to back to the conversation. Additionally, don’t interrupt before the speaker finishes to talk. Interrupting before the speaker finishes talking shifts the conversation and the focus, which is not right (Krivosheyeva, Zuparova, and Shodiyeva, 2020). On the other hand, listen for key messages, and show the speaker you are listening to. For instance, some of the signs to show you are listening are nodding the head, leaning forward, and acknowledging the other person. Also, be prepared to listen in mind to avoid interruptions. Through the above concepts, one can learn and improve listening skills for long hours without interrupting.
Journal Entries
You don’t need to be perfect, strong, please others, or take too many responsibilities to fit in. Self-defeating believes that are associated with panic and anxiety, especially when one does not fulfill various beliefs. Everyone has belief systems that influence their attitude towards themselves and towards others. Self-defeating believes those beliefs or negative views concerning the world and oneself, mostly anxiety and panic attacks (Chevarie-Cossette, 2019). Some of the most common self-deafening beliefs include the need to achieve something so bad, perfectionism, and the constant need for approvals. In case the self-defeating beliefs are not satisfied, a person can e left hurt, anxious, and bitter with other peoples. For instance, those with the belief that they need to achieve . People with self-defeating thoughts are never satisfied with themselves; for instance, the perfectionists will never be fulfilled and accept their imperfections. (Chevarie-Cossette, 2019). To change self-defeating thoughts, an individual can learn to develop beliefs and goals that are more realistic and less provoking. Also, replacing negative thinking with positive thinking, having relationships with positive people, and avoiding mistaken beliefs at all costs.
Self-concept is also known as an encompassing awareness about oneself, which is developed based on the perception created from life experience, and knowledge gained. How you think of yourself at a given moment is important, according to Carl Rogers. I am not so contented with my self-concept because I feel my current self-concept is hoped by the experiences I have encountered, affecting my self-esteem (Karwowski, and Lebuda, 2017). My current self-esteem level is above average, although not satisfied at the moment. Having a positive belief about myself has boosted my self-esteem, hence having confidence and being optimistic. My level of self-esteem has helped me get out of my comfort zone and solve issues and work towards my goal.
On the other hand, the level of self-esteem has enhanced positive decision making and knowing how to react at a given moment. The current self-esteem level is not where I want it to be; hence I need to shift to a healthy self-concept (Karwowski, and Lebuda, 2017). The level of self-esteem has affected my communication with others, especially wanting to hear what pleases me as a way of avoiding stress. Developing a healthy concept assists in having self-confidence and choosing healthy conversations that boost our self-esteem.

References

Chevarie-Cossette, S. P. (2019). Self-defeating beliefs and misleading reasons. International Journal of Philosophical Studies, 27(1), 57-72.
Karwowski, M., & Lebuda, I. (2017). Creative self-concept: A surface characteristic of creative personality.
Krivosheyeva, G., Zuparova, S., & Shodiyeva, N. (2020). INTERACTIVE WAY TO FURTHER IMPROVE TEACHING LISTENING SKILLS. Academic Research in Educational Sciences, (3).
Math, S. B., Kumar, C. N., & Moirangthem, S. (2015). Insanity defense: Past, present, and future. Indian journal of psychological medicine, 37(4), 381.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy

When first introduced, cognitive behavioral therapy (CBT) was unlike any other therapeutic approach. For years, psychotherapeutic techniques were driven by psychoanalytic theories. These techniques were time consuming, leaving many therapists frustrated with the length of time involved in helping their patients achieve a sense of relief. With the development of CBT, however, therapists were able to help their patients heal more quickly. This poses the questions: If CBT is more efficient than other techniques, why isn’t it used with all patients? How do you know when CBT is an appropriate therapeutic approach?

This week, you examine CBT and its use across individual, family, and group modalities.

Required reading

https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.

Chapter 9, “Cognitive Behavioral Family Therapy”
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.

Chapter 8, “Cognitive Behavioral Therapy”
Chapter 21, “Psychotherapeutic Approaches with Children and Adolescents”
pp. 793–802 only
Chapter 22, “Psychotherapy with Older Adults”
pp. 840–844 only
Discussion: Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings
Photo Credit: Getty Images

There are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in individual, group, and family settings, consider challenges of using this approach with groups you may lead, as well as strategies for overcoming those challenges.

To prepare:

Review the videos in this week’s Learning Resources and consider the insights provided on CBT in various settings.
Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources.

RESPOND TO THIS DISCUSSION POST

Cognitive behavior therapy has been one of the most popular ways to help people who are having problems with their mental health. This kind of therapy can be used with one person, with a family, or with a group. Even though cognitive behavior therapy can be used in all of these places, there are some differences in the techniques and sessions that are used.

One thing that group therapy, family therapy, and individual therapy all have in common is that they all add the core components. According to research, the five parts of cognitive behavior therapy are psychoeducation, developing a fear hierarchy, preventing exposure and response, cognitive strategies, and preventing generalization and relapse (Kose et al., 2017). No matter where you are, the main parts will be used. Cost is a big difference between sessions with a group and sessions with just one person. Research suggests that group cognitive-behavioral therapy (CBT) may be cheaper than individual CBT because it can be given to more than one person at once (Olmstead et al., 2019). Changes can be made in individual cognitive behavior therapy, which is another difference. Kose et al. (2017) say that CBT systems are different for each person. Several studies have shown that a customized version of CBT can be effective in treating symptoms like anxiety and other problems. Because there are more people in a group setting, cognitive behavior therapy may not be as easy to change. Also, unlike individual therapy, everyone in a family therapy session takes part. For instance, when treating children with mental health problems, the parents are also involved. Parents have been involved in more than just clinics. Parents are also responsible for doing homework with their children to help the benefits of treatment spread, make it easier on the family, and help the child understand the problem (Kose et al., 2017).

Even though group cognitive behavior therapy has a lot of benefits, it also has some problems. When looking at the news from this week, there were several examples of problems or difficulties. Some people may think that people with the same condition will have the same needs, but that may not be the case, according to PsychExamReview (2019). Specific signs of a certain disorder in a person could be missed because the therapist’s attention will be less focused on each client because they will have less time to be detailed. The PsychExamReview (2019) also talked about how symptoms can be normalized or how members can be compared to each other. Anorexia nervosa, for example, can be hard to deal with in a group setting. According to research, anorexia nervosa is an eating disorder in which a person restricts their energy intake, which causes them to lose weight, has a strong fear of gaining weight or acts in a way that keeps them from gaining weight, and has trouble understanding their body shape (Saure et al., 2022). A member might try to compare himself or herself to someone else who looks smaller or in worse shape. This might not help them get where they want to go. This could also make them less likely to change because they might not take their own problems seriously if they think that other people have it worse.

Sources

Each source presented is considered scholarly. The sources were utilized from the school library database as well as google scholar. The sources were also peer-reviewed. The authors were compliant with ethical standards as well as had an extensive educational background on the topics presented.

PDFs

https://doi.org/10.1007/s10882-017-9559-8

https://doi.org/10.1016/j.jsat.2019.02.001

https://doi.org/10.2147/prbm.s246056

References

Kose, L. K., Fox, L., & Storch, E. A. (2017). Effectiveness of cognitive behavioral therapy for individuals with autism spectrum disorders and comorbid obsessive-compulsive disorder: A review of the research. Journal of Developmental and Physical Disabilities, 30(1), 69–87. https://doi.org/10.1007/s10882-017-9559-8

Olmstead, T. A., Graff, F. S., Ames-Sikora, A., McCrady, B. S., Gaba, A., & Epstein, E. E. (2019). Cost-effectiveness of individual versus group female-specific cognitive behavioral therapy for alcohol use disorder. Journal of Substance Abuse Treatment, 100, 1–7. https://doi.org/10.1016/j.jsat.2019.02.001

PsychExamReview. (2019). Cognitive therapy, CBT, & and group approaches (intro psych tutorial #241) [Video]. YouTube. https://www.youtube.com/watch?v=A2_NN1Q7Rfg

Saure, E., Ålgars, M., Laasonen, M., & Raevuori, A. (2022). Cognitive behavioral and cognitive remediation strategies for managing co-occurring anorexia nervosa and elevated autism spectrum traits. Psychology Research and Behavior Management, Volume 15, 1005–1016. https://doi.org/10.2147/prbm.s246056

Health Policy Analysis Paper

Health Policy Analysis Paper

Abstract Executive Summary
Obesity is the manifestation of excess fat in the body. As a lifestyle condition, it predisposes most people to other chronic health conditions, which results in immobility and even death. Obesity is additionally a long-term condition, in case it is not immediately handled. For children, researchers have identified a need for a holistic approach to identifying people at risk and tackling the likelihood of the spread of lifestyle diseases. Obesity in America had increased in triple folds in 2011 compared to its levels in 2011. It is one of the most alarming crises in the American public (American Heart Association, 2016). Through research and observations, many policymakers have become aware of an increased attraction to junk food that is outlined to be overall detrimental to people’s health. According to empirical research, one-third of children and adolescence in America are overweight or obese (Seguin et al, 2017, p2). Parents and caregivers are identified to play a major impact in preventing this risky and unhealthy behavior. Consistent exposure of children to unhealthy eating habits is the number one cause of obesity in the US. The creation of nutritional awareness is key in preventing the spread and manifestation of obesity. This can be achieved through education.
State the Problem
With the evolution and technological advancement, people became aware of the different types of foods around them. They also realized the benefits of eating healthy and its impacts in avoiding diseases and other disorders that may be harmful to our general health such as diabetes, obesity, cardiopathy, and hypertension among others. Junk foods like hamburgers are getting popular across the world, and it is regarded as a traditional American meal. It is advisable to treat junk foods as a once-in-a-while treat and not regular foods. While hamburgers have their nutritional values such as provision and maintenance of iron levels in the blood and vitamin B-12 that is vital for the blood, its disadvantages which include unwanted weight gain and its effects outweigh its benefits.
Most junk foods contain higher levels of calories. For example, researchers identified that normal hamburgers served in a fast-food restaurant contain 942 calories (Stein, 2017). With a lack of proper exercise to burn the calories, the eater is susceptible to weight gains and an increase in cholesterol levels in the blood and saturated fats (Stein, 2017). This results in obesity which predisposes the eater to diabetes. The burger contains high levels of sodium which can cause higher blood pressure within the body. This increases the risk of heart diseases (Anne, 2017). Being healthy can be termed as the absence of illness (Sartorius, 2006). Designation of the hamburger as junk food is because its limitation when consumed heavily outweighs its advantages. The meat on the burger contains iron that is essential for the blood cells. Also, it has vitamin B-12 that helps in rebuilding the red blood cells in the body (Anne, 2017). This is vital for pregnant women and breastfeeders. The food is also rich in proteins that aid body muscle development.
For a healthy life, healthy eating is vital. Junk foods result in lifestyle diseases that are harmful and could cause disastrous effects in someone’s life. Hamburgers are a great example of junk food as they contain high levels of calories, cholesterol, and saturated fats that require a lot of energy to burn. Since most people don’t do regular exercise, the accumulation of these elements within the body results in illnesses and disorders that pose a grave danger to the human body. That said they have their advantages and nutritious value. They are recommended to eat only once in a while as a treat but not treated as a regular meal. However, often people are hooked to eating burgers at the corner fast food because of the enticing tastes due to the ingredients that seem to add value to the taste, unlike average healthy foods that have less fattening effects. Furthermore, it is logical to argue that once in a while people will have the perfect excuse to say they do not have the time to eat other foods. Burgers can be consumed while driving or walking back to work hence saving time. Most Americas work double shifts to make ends meet and therefore having a meal that could save time is essentially the “best meal”.
Gaining weight during pregnancy could lead to cases of obesity in both mothers and risks passing the same symptoms to children. Over time of consuming such unhealthy diets, there is an overload of the energy-giving micronutrients to cells. Metabolic syndrome and more risky conditions can develop hence increasing the risk of other diseases. In the recent past obesity and fattening, related diseases like metabolic syndrome have been known to be the main cause of abnormal medical conditions and increase in death rates, besides just reducing the quality of life. Gaining weight can reduce the self-esteem of an individual and at the same time reduce the activities one can freely engage in. Medics who define metabolic syndrome usually have difficulty. Although people who are slim can also have similar symptoms the risk of the occurrence is higher in people who gain weight by consuming unhealthy foods such as hamburgers. The effects of gaining weight can only be reversed by consuming less healthy meals and replacing them with prescribed healthy foods. As observed from the burger-making process, the meatballs are rolled together with fats. It is logical to argue that the excess fat in the burgers is likely to increase the chances of weight gain because of the extra energy density. A comparison between the different available macronutrients reveals that fats have more density than other food substances. A relationship between the lipids in hamburgers and weight gain is critical if anyone is to avoid weight gain they need to understand how much is too much.
Background
The biggest task in the fight against obesity lies in the caregivers within the society. This is because they are the first point of contact for most children. Caregivers are tasked with the need to ensure that the child receives the best diet and nutrition, and a good perspective on what a healthy lifestyle should look like. Research identifies that the best approaches to childhood-based obesity should prioritize strategies to improve socio-cultural facilities such as neighborhood walkability, increased access to leisure and exercise facilities, and more spaces for physical activities (Elbel et al, 2016, p2). Schools, homes, and all social facilities should prioritize these aspects
Fast foods contain a lot of sodium that increases the risks of stroke, heart conditions, and the possibility of kidney malfunctions. The science behind sodium causing all these circumstances suggests that a lot of sodium in the body increases blood pressure and because when macronutrients are digested the sodium will overwork the kidney. Somewhat, the kidney will have to absorb back more fluids to be retained in the body. In return, the heart has a burden to pump more fluids, therefore, creating blood pressure as each vital body organ strains to function. Another condition that may develop because of excess sodium includes kidney stones. People might be surprised why there is too much salt in hamburgers, and that is because over time salt has been used to not only flavor but preserve food. It is safe to assume that the amount of salt used to preserve the ingredients used in preparing hamburgers including cheese, bread, and meats is preserved using salt. Furthermore, unlike homemade healthy meals the amount to levels higher than the preferred levels. Reducing the levels of sodium in meals requires a commitment to stay off foods that contain high levels of sodium. Staying off foods that contain ingredients that are processed foods in restaurants such as the ones in hamburgers. While it would be impossible to stay out of restaurants at all people would need to order food that contains lower sodium such as vegetables with fruit toppings.
Alternatives
Child obesity has reached epidemic levels in the US presenting the health department with a unique problem on how to adequately address the public and even cater for the treatment of children. One critical aspect identified is the role that society plays in propagating child obesity. Parents in the US are discouraged from buying processed foods. The trend in buying processed food is identified to stem from ineffective family-work schedules where children become less likely to be given good food and are provided processed substitute foods. Klass (2018) a reporter in The New York Times states that for all children regardless of their health status good parental decisions on nutrition are central to their well-being. Parents are encouraged to avoid high-calorie foodstuffs, such as carbonated drinks and oil/ fatty foods. According to researchers, fast foods are typically high calorie, high in fat, high in saturated and trans-fat, high in a sugar high in sodium, and simple carbohydrates (Ananya, 2017). This is a factor that should be made aware through civic education for all.
Schools and the government in cooperation with health departments should take more responsibility in providing relevant education to the community relative to food, eating habits, and nutrition. The dangers of obesity should be made clear to children. There is also a need for schools to change their mode of preparation of foods served to children. According to health analysis reports most schools to have far lower food preparation standards. Chen (2019) identifies that schools in the US have far lower standards governing their food preparation compared to fast-food restaurants. This becomes a key problem, especially for parents who try to control their children eating habits at home, as they are reversed at school.
Preferred Alternative With Justification
Researchers posit that increased monitoring of the trend needs to be established and centrally managed. This is key to defining the problem accurately and reaching the bottom of the issue. Being largely a lifestyle disease, there is a need for a holistic approach to help tackle the problem. Sanyaolu et al (2019) identify that the problem with obesity is one that manifests and persists from childhood through adulthood. Their research further points out that there is a need for a combination of strategies that includes better diet information, exercise, physiological and psychological approaches in the control and prevention of childhood obesity. The primary method should aim at providing adequate education that encourages an appropriate diet. Sanyaolu et al (2019) secondary prevention strategies should also be implemented mainly targeting child obesity by preventing children from attaining bad eating habits and sustaining them over time as they can persist into adulthood. Cheung et al (2016) identify that obesity in early life is absolutely necessary to prevent further chronic diseases in adulthood. As such creating adequate strategies from a young age is key.
Conclusion
Obesity is primarily about control of mind and self and having a good support system that primarily works to help young children reinforce these tendencies. The ability to control the intake of food and the type of food is majorly nested in parents for children. Parents are their first point of contact and they adequately prevent too much intake of food, and more significantly unhealthy food. From a young age, obesity can spiral into adulthood where it may predispose people to more health risks. The good news is that it is reversible but requires adequate education and consistency

References
American Heart Association (2016) “Overweight in Children.” American Heart Association , http://www.heart.org/HEARTORG/HealthyLiving/HealthyKids/ChildhoodObesity/Over
weight-in-Children_UCM_304054_Article.jsp#.WrCwlhPwYfF
Anne Melodie,( 2017)“Any Benefits in Eating Hamburger”. SFGATE, N.p Unknow, November
“http://healthyeating.sfgate.com/benefits-eating-hamburger-5204.html”
Ananya Mandal,MD. (2017) “Obesity and Fast Food.” News Medical Life Science,
https://www.news-medical.net/health/Obesity-and-Fast-Food.aspx
Chen Grace. (2019) “Why Fast Food is “Healthier” Than School Lunches: The Shocking USDA
Truth.”
Public School Review, February 28, 2021
Cheung, P., Cunningham, S., Narayan, K., & Kramer, M. (2016). Childhood Obesity Incidence in
the United States: A Systematic Review. Childhood Obesity, 12(1), 1-11. https://doi.org/10.1089/chi.2015.0055
Elbel, Brian et al. (2016) “Neighborhoods, Schools And Obesity: The Potential For Place-Based
Approaches To Reduce Childhood Obesity”. PLOS ONE, vol 11, no. 6, 2016, p. e 0157479. Public Library Of Science (Plos), doi:10.1371/journal.pone.0157479.
Klass Perry, M.D. (2018) “Do Parents Make Kids Fat?. The New York Times, JAN. 8, 2018,

Sartorius, Norman. N.p., 2006. Web. 4 Dec. 2017. “https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/”

Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and Adolescent
Obesity in the United States: A Public Health Concern. Global Pediatric Health, 6, 2333794X1989130. https://doi.org/10.1177/2333794×19891305

Seguin, Rebecca A. et al. (2017) “Farm Fresh Foods For Healthy Kids: Innovative Cost-Offset
Community Supported Agriculture Intervention To Prevent Childhood Obesity And Strengthen Local Agricultural Economies”. Journal Of Nutrition Education And Behavior, vol 49, no. 7, 2017, p. S120. Elsevier BV, doi:10.1016/j.jneb.2017.05.10
Stein Natalie, (2017) “The Bad Effects of Burgers”. SFGATE, N.p Unknow.
“http://healthyeating.sfgate.com/bad-effects-burgers-11402.html”

Social movements

Social movements

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Social movements
Social movement occurs when certain groups form an alliance to mobilize other people in order to achieve their social or political goal. Movements make and manipulate meanings. One of the lessons learnt is that Movement frame contentious politics, this happened when Ayodhya military framed an attack on Muslims in order to defend Hindus cultural heritage (Snow and Benford 1992:137). Two, movement define, crystallize and build collective identities, this attack was to recreate a religious identity and define Muslims as outsiders.
When individuals and group of people exceed traditional bounds, they may bring about major changes in social strategy. Media broadcast of the destruction of the Babri mosque in India increased the rate of riots across the country. This is because it lay ground for social movement. Social movements frame specific criticisms that dignify claims, connect them to others and help to produce a united identity. It goes beyond how their goal formed strategically, establish on agreement between contenders and opponents.
The key concept in this topic is the power of movement. Several of the most tactics for social movements depend on the structural fact of mass demonstration, the strike and boycott. By mobilizing, the group can interfere with the smooth operations of the country, convincing other parties to convey. Social movement illuminates solidarity that has shared meaning within certain groups and political cultures and make them feel connected. The larger the social networks the more likely movement tend to spread and be sustained.
I will conclude by mentioning that social movements are resolute , either with the goal of pushing towards giving political voice to those without or a strategy to get people to help them get what they hope to achieve. Social movement seem less about organizational interest and more about individuals seeing an opportunity to bring people to a common goal. Therefore, In order to bring about social change upon the societies, strategies, procedures and context in which the states operates has to change.

This assignment is related to your Chapter 8 (Salkind) material. Make sure you save a copy of your answers to all the questions from this assignment to use in your discussion this week! I suggest taking a picture of your answers or copy and pasting them into a word document.
Imagine you’ve just started a small business, and you just launched your social media page for your business. You’re curious about how many “likes” other similar new small businesses get on their posts, so you collect data from 19 similar new businesses on the number of likes they received on their most recent post and you found the following answers:
Likes Received on Similar Pages
320
320
340
340
345
345
350
350
350
350
350
350
350
355
355
360
360
375
375

Flag question: Question 1
Question 1
Construct a line plot of the data. Use number of likes received as your x axis and frequency (number of businesses with each value) as your Y axis. Create your line plot and then upload it here (if you create it on your computer, save and upload the file; if you create it with pen and paper, take a photo and upload that). If you are using an iPhone you will need to convert the picture to a .jpeg format, we will NOT be able to read images submitted in the .HEIC format.
Upload

Flag question: Question 2
Question 2
Calculate the mean for the dataset (above). Round your answer to three decimal places.

Flag question: Spacer
I’m going to help you out a little bit here, and I’m going to give you the standard deviation for this dataset:
s = 14.033

Flag question: Question 3
Question 3
How many businesses are above the mean in this dataset?
Group of answer choices

11

6

5

13

Flag question: Question 4
Question 4
How many are below the mean?
Group of answer choices

12

6

13

5

Flag question: Question 5
Question 5
Calculate the z score for the business that received 320 likes. Round your answer to three decimal places.

Flag question: Question 6
Question 6
Calculate the z score for the businesses that received 340 likes. Round your answer to three decimal places.

Flag question: Question 7
Question 7
Calculate the z score for the business that received 345 likes. Round your answer to three decimal places.

Flag question: Question 8
Question 8
Calculate the z score for the businesses that received 350 likes. Round your answer to three decimal places.

Flag question: Question 9
Question 9
Calculate the z score for the businesses that received 375 likes. Round your answer to three decimal places.

Flag question: Question 10
Question 10
On your first post you received 368 likes. You want to know what percentage of the new business population gets more likes than you (that is, what percentage of the population gets 368 likes or more (Hint: use the z table in the appendix of your textbook to answer this question). Note, you are examining what percentage of the total population has more likes, NOT just this sample, so you need to use the table to answer this question! Show your work on this. To get full credit, you must demonstrate all calculations, values you used from the appendix, and steps you took to get your answer (that is, your answer must include the z score, the area under the curve that you found in the appendix, and how you came to your final answer).
p
0 words

Flag question: Question 11
Question 11
If you randomly select a new business from social media, and count the number of likes on their recent post, what percentage of the time would that business have between 315 and 350 likes? (Hint: use the z table in the appendix of your textbook to answer this question)? To get full credit, you must demonstrate all calculations, values you used from the appendix, and steps you took to get your answer (that is, your answer must include the z score, the area under the curve that you found in the appendix, and how you came to your final answer).

The Purnell Model for Cultural Competence

Nursing homework help
NURSE LIFE

After studying Module 1: Lecture Materials & Resources, discuss the following:

The Purnell Model for Cultural Competence and its relevance for advanced practice nurse.
The importance of effective communication that promotes cultural competence.

Submission Instructions:

APA 7 edition is a must.

NO WEBSITES ALLOWED FOR REFERENCE OR CITATION. 500 words at least