Describe Emotional freedom technique which has contributed to own self awareness. Provide a reason why EFT informs clinical practice. Demonstrate self awareness in practice

Subject: Historical Overview of Higher Education In Nursing

Conduct a University Library search identifying three major events (e.g. Colonial Era, Industrial Era, etc.. that have influenced the development of higher education. Prepare a 700 ? 1,050-word paper in APA format that includes a historical overview of the three major events and compare how these three events shaped higher education.
Content and Organization
70 Percent Points Possible Points Earned Comments
All key elements of the assignment are covered in a substantive way.
? identify three major events that have influenced the development of higher education
? compare how these three events shaped higher education 12
The content is comprehensive, accurate, and/or persuasive.
The paper develops a central theme or idea directed toward the appropriate audience.
The paper links theory to relevant examples of current experience and industry practice and uses the vocabulary of the theory correctly.
Major points are stated clearly; are supported by specific details, examples, or analysis; and are organized logically.
Writing reflects graduate-level critical thinking, interpretation, and analysis.
The introduction provides sufficient background on the topic and previews major points. 0.5
The conclusion is logical, flows from the body of the paper, and reviews the major points. 0.5
Readability, Style, and Mechanics
30 Percent
Paragraph transitions are present and logical and maintain the flow throughout the paper. 0.5
The tone is appropriate to the content and assignment. 0.5
Sentences are complete, clear, and concise. 0.5
Sentences are well-constructed, with consistently strong, varied sentences. 0.5
Format uses section headings, organizes logically. Refer to the APA Manual, section 3.32, for proper use of headings.

0.5
Grammar, punctuation, and spelling are correct

0.5
Cites at least 3 original, scholarly sources according to APA standards.
1
Total 100 Percent Points Possible Points Earned
17 Comments:

Essay Title :
What is the nature and purpose of Ethical Frameworks and how does ethical practice involve working positively with diversity and difference?

when writing this essay please consider the fact that i am an African living in Britan. i am disable. the following is an email i received from my tutor which includes reading list. i want all the bibliography, works cited, etc to come from the following books and handouts which is mentioned in the email from my tutor:

EMAIL FROM TUTOR:
I think you are the ones who might be doing the ethics essay. Some have asked for reading. You don?t have to go into all individual differences in the essay but reading about them can help put you into the shoes of others.

The docs which start eth opp above are handouts and exercises. Don?t be overwhelmed- just see what is helpful for you.

Tim Bond for the general stuff, yes,
The Therapeutic Relationship (Petruska Clarkson)
BACP Ethical Framework (bacp.co.uk)
The Mirror Crack?d--really good (ANNE KEARNS)
?good fences make good neighbours??
Being White in the Helping Professions (JUDY RYDE)
Black Issues in the therapeutic process (ISHA MCKENZiE-MAVINGA)
the chapter on gay affirmative
Guidelines for LGBT- an A4 sized thing, bright pink- good brief read, might just get you thinking about working with any stigmatised minorities

Don?t forget that differences are all kinds- think culture in the broadest sense=- and what happens when we think someone is the same as us?

Handouts1

mkSame-Sex Relationships, an Historical Overview

My intention in this presentation is to look at some of the main religious influences on our attitudes to homosexual relationships in Britain. The law banning consenting sex between two adult men was repealed in Britain in 1967. The origins of this common law can be traced back to the decision by King Henry VIII to incorporate the Church's condemnation of homosexuality into secular governance in 1533. Even then, the attempt to outlaw and punish those who preferred sex with their own gender was nothing new.
One of the earliest recorded laws so far found on the matter is usually regarded as the Holiness Code of Leviticus, which is generally considered well over 3,000 years old. Verse 20:13 reads: "If a man also lie with mankind as he lies with a woman, both of them have committed an abomination: they shall surely be put to death." This passage has been used throughout the intervening centuries by innumerable religious sects and governments to justify the imprisonment, torture, and execution of people imagined, rightly or wrongly, to be gay.
Not all Jews and Christians have accepted it without question. Many, such as John Selby Spong, have pointed out that surrounding passages also call for the execution of teenagers who are rude to their parents, and describe the wearing of polycotton shirts as an abomination in the eyes of Adonai. That has a certain surreal humour value, unless you happen to know of someone who was murdered or driven to suicide by the unrelenting hatred of the supposedly godly.
Many scholars also look to Persian religion as a source of sanction against homosexuality. Whilst Zoroastrianism has not had a prominent influence on British attitudes, it has arguable! had an indirect influence via its impact on Judaism, Christianity and Islam. In its earliest form, the religion of Persia was polytheistic and had no laws against gay sex ~ a fairly common circumstance back then, given that polytheism tends to embrace diversity. For most of those ancient religions, an individuals sexual preferences were essentially a matter of personal taste, rather than a matter of morality or spirituality.
When the prophet Zarathushtra converted the Persians to monotheism, he appears to have made no comment on the matter either. It was not until the writing of the Vendidad many centuries later, between 200 and 400CE, that we find the first Persian sanction. Fargad 8, Verse 32 states ~ "The man that lies with mankind as man lies with womankind, or as woman lies with mankind, is the man that is a Daeva; this one is the man that is a worshipper of the Daevas, that is a male paramour of the Daevas."
The word Daeva is usually translated as meaning a devil, though originally it signified one of the Shining Ones, or gods. Ahura Mazda was asked, in Verse 27, how a Zoroastrian may cleanse themselves of the sin of homosexuality. He responded ~ "For that deed there is nothing that can pay, nothing that can atone, nothing that can cleanse from it; it is a trespass for which there is no atonement, for ever and ever."
It is curious that the word used to criticise homosexuals can mean either a devil or a shining god. The Phoenician or Canaanite religion had priests known as qedeshim. For a time they were part of early Hebrew religion too, though the Old Testament recommended their expulsion. This Canaanite word originally meant holy man, though the King James and various other translations render it as sodomite. The feminine term, qedeshoth, is conventionally translated as prostitute. These religious castes were primarily devoted to the goddess Asherah, also called Astarte. Historians hotly debate wether this caste offered sexual services in addition to the more conventional priestly ones. Certainly in the minds of a great many Bible translators they did. Modem-day devotees of Asherah take the concept of sacred sexuality very seriously.
Victorian schoolteachers would often fmd their Classics classes a little difficult when the euphemistic 'unspeakable sin of the Greeks' reared its head in poetic and philosophical texts. Way back in 630BCE, the Greek poet Alcman composed poetry for a lesbian wedding. Same-sex marriages are nothing new. The word lesbian itself, of course, derives from the Greek. The isle of Lesbos was once the home of poet, playwright, and headmistress Sappho, most of whose poetry to the beautiful girls in her Finishing School was repressed and burnt by the Vatican. Enough survived that people two thousand years later should speak of lesbians and sapphics. As well as being a literary genius, the bisexual Sappho was also a priestess to the goddess Aphrodite. Not only did the ancient world invent the idea of same-sex weddings, but it had no particular problem with gay priests or priestesses either. It should be noted that Romano-Greek definitions of sexual identity were not structured by the issue of gender, such as our views are today. For the Mediterranean cultures the social status of the two partners was far more crucial than the gender, and defined what erotic acts were considered socially acceptable. They had no concepts of gay, straight or bisexual. Only ideas of high caste and low caste. Such sexual laws as those cultures had then, mostly dealt with issues of class rather than gender.
The Greeks also gave us such now-outmoded words for gay men as uranians and catamites, both terms derived from the names of old gods. Greek myth attributed the invention of homosexual love not to some fiendish devil, but to the most beautiful of all the Olympians ~ Apollo himself. His was the first male-male partnership, when he fell in love with the beautiful prince Hyacinthus. The mighty warriors of Sparta so admired Hyacinthus and his love for the radiant sun god, that every summer they held a three-day festival in his honour, which still occurs in some places today.
The Egyptians referred to homosexual activity in a variety of mythical and cultural contexts. They have even left us what may well be the earliest tomb of two male lovers. Khnum-hotep and Ni-ankh-khnum were courtiers, unrelated by blood, who took the unusual step of being buried together in the same tomb. One of the wall paintings shows them with arms round each other, an act of intimacy almost unknown in Egyptian art ~ even for heterosexual married couples.
The Greeks, Romans and Egyptians were apt to engage in apotheosis - the process by which the recently deceased are elevated beyond the realms of minor ancestral spirits and into the ranks of demigods. One of the last pagans to be apotheosised was Antinous. This classically handsome young man was the lover of the Emperor Hadrian (he of the Scottish wall), who took the throne in the year 117CE, dying in 138. Greek-bom Antinous was loved for a few short but passionate years, before he drowned in the Nile at the age of about 20. A spontaneous reverence for the lost youth soon sprang up, along with tales of his rising from the grave to become an immortal god. When Hadrian heard of this, he responded by instituting a state cult. At least seven large temples were built across the Empire to this sanctified figure, and a whole city was built in his honour on the banks of the Nile.
Festivals were instituted in honour of Antinous, most notably his death on October 28th and birth on November 27th. Whilst Britain was part of the Roman Empire, these festivals were marked here too, indeed they are still marked by some modem pagans. In the numerous small shrines built to him, he was (and still is) honoured as a patron of the arts, of male beauty, and seen as a general protector and guide to the dead. Whilst the impact of Antinous on British attitudes has not been large, it is worth noting that whilst for some faiths homosexuals are devils, for others they are gods!
Whilst the attitudes of Mediterranean polytheist religions is well documented, the views of the faiths from Northern Europe are less well known. Some commentary has, however, survived. The Hellenic writer Diodorus, back in 400BCE, described, with some degree of surprise, how the Celts had no concepts of social dominance within the sexual arena, but "...they weave around other males in a strange frenzy. They are accustomed to sleeping on the ground upon hides of wild beasts and indulge together ?with male partners on both sides for sex." At much the same time Aristotle spoke of "...those nations which openly approve of sexual relations between men, such as the Celts and certain others."
The Christian commentator Bardaisan wrote in the early 3rd century that "In the countries of the north, in the lands of the Germans and those of their neighbours, handsome young men assume the role of wives towards other men, and they celebrate marriage feasts." Fellow Christian historian Eusebius ofCaesarea, wrote in the 4th century that "Among the Gauls, the young men marry each other with complete freedom. In doing this, they do not incur any reproach or blame, since this is done according to custom amongst them." Commentary on lesbian relationships is harder to find, largely because the mostly male historians of that period had little interest in what women got up to.
Whilst we cannot say that every single tribe followed the same pattern, the suggestion is that same-sex love was not considered odd or strange, or something to be stamped out. The Fenechus law codes of Ireland, which changed little under Christian rule, make no specific mention of homosexuality. The Tain bo Cualigne myth, itself committed to writing by monks during a period when Ireland maintained both Christian and Druid traditions, contains some beautiful love poetry sung by the warrior Cuchulainn over the corpse of his dead companion Ferdiad. The poem describes them as "men ~who shared a bed", and does so in entirely sympathetic terms.
During the 19th century it was common for European writers to refer to homosexuality as either the German .or the English vice, different predilections being associated with different countries. Whether this was in any way a hang-over of those early tribal attitudes, or simply a matter of nationalist stereotyping, is hard to say.
We have already mentioned Leviticus as a source for justifying later laws against gay unions. Another Biblical tale frequently quoted is that of Sodom and Gomorrah. Two angels visit Lot in the city, and the men of the city gather in a mob outside demanding to "know" the visitors ~ which a good many have taken to mean rape, though this is not actually stated. Many theologians have considered angels as essentially sexless, neither male nor female. The attempted rape (if such a thing took place at all) of a genderless entity could hardly be constituted as a homosexual act, or a heterosexual one either. Quite how it should be labelled is anyone's guess. Many commentators have focussed on the sin of Sodom as being inhospitality towards strangers, not a particular sexual predilection. By the end of the first century CE, an increasing number of Jewish and Christian thinkers, such as the historian Josephus, promoted the idea that the sin of Sodom was homosexuality. It is ironic that this tale should have been made into one of sexual morality, given that Lot's apparently religiously acceptable response to the mob was to offer his own two daughters up to be raped instead. Scarcely an icon of sexual probity.
Despite the proscriptions, there have been vicars, priests, rabbis and so forth over the centuries who have broken with tradition to bless same-sex unions. Often ending up in a good deal of trouble for doing so. In recent years those religions that stigmatise homosexuality have seen growing lobbies from within to either change their views entirely, or to distinguish between the sinner and the sin ~ that is, to tolerate gays so long as they are celibate. Much of the latter argument has been largely in response to assorted unproven psychological theories claiming genetic origins for homosexual desire. Those who subscribe to such ideas have inclined to the view that me urge is taken out of the realm of choice (and therefore can scarcely be condemned), it being only the decision to act on the urge that carries a moral value.
Pressure to change laws in Britain has been growing since the Victorian age, and has come primarily from secular and humanist sources. Whilst some religious voices have been in favour of liberalisation, the loudest have usually been conservative ones. Britain has yet to see the more extreme examples from America of evangelists picketing the funerals of gay people, and screaming abuse at the mourners. However, we still have many examples of people who feel it their moral right to spit at, or beat up suspected gays. Or to kick them to death, or bomb gay pubs. The views of such people are not bom in a moral vacuum, but out of generations of people being indoctrinated with the socially-sanctioned notion that homosexuality warrants violence or death.
In concentrating primarily on those religions that have had a strong influence on our British legal and moral system, I have not touched upon the wealth of sources from the Far East. Acceptance of same-sex marriages was common in China, as was nanshoku in Japan. Nor have I mentioned the diverse array of practices amongst the native tribes of North and Central America, some of which had third and fourth genders. Nor have we looked at practices in India, nor at the love poetry of Muslims such as Abu Nuwas and later medieval writers. Suffice to say that world is a vast and diverse place. Gay marriage is not some bit of contemporary political correctness. It is a long tradition, with its roots in the polytheist faiths of the ancient world, that has continued to grow and develop throughout the prominence of monotheism and secular humanism.
The earlier quote from the Vendidad relates specifically to how Zoroastrians are expected to behave. It makes no proscription as to the behaviour of non-believers. Clearly it is the right of each religion to demark what is and is not acceptable for their own followers. In exploring the attitudes of varying faiths, it is not my intention to suggest that religion A adopt the views of religion B, simply to comment on the source of those views. However, I would like to emphasise my personal view that the world would probably be a happier place if religions focussed on instructing their own devotees, and did not attempt to impose their laws on the world at large.
A review by Robin Heme
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Handout 2

What are the potential abuses of these kinds of power in the relationship between counsellor and client?

This exercise should be done bearing in mind everything you know about ethics, moral values, cultural identity and working with difference. Think about the differing constraints between the context of the counselling; eg private practice, doing outsourced work for EAPs (Employee Assisted Programmes) or other agencies, employment by the NHS or other agencies.

Ability to offer or withhold rewards, privileges or specialist services
Power to compel or punish the other into compliance
Having specialist knowledge or training
Possession of knowledge and the ability to communicate effectively
Power invested by law or status
Status of the two parties in relation to each other
Ability to meet the other?s emotional needs
Sexual power
Cultural power- belonging to the dominant culture (gender, race, sexuality, etc)
Social, class based power
Coping power- being more able to cope or function, emotionally or practically, than the other
Economic power
Being in possession of the territory
Any other kinds?



Janet Dowding 02.2010 saved as power
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Handout3

Attitudes Toward Difference Survey: The Riddle Scale
Put a check next to each statement with which you agree. Bracket the 2-3 consecutive statements that reflect your current range of thinking about lesbian, gay, bisexual, and transgender (LGBT) people.
___ 1. Homosexuality is unnatural and immoral. LGBT people are emotionally or psychologically ill.
___ 2. LGBT people should participate in reparative therapy or any other treatment available to help them change their sexual orientation.
___ 3. We should have compassion for LGBT people. They can?t be blamed for how they were born.
___ 4. LGBT people didn?t choose to be the way they are. If they could somehow become heterosexual, they would surely do so.
___ 5. Homosexuality is a phase that many people go through and most grow out of.
___ 6. LGBT people need our support and guidance as they wrestle with the many difficult issues associated with their lifestyle.
___ 7. I have no problem with LGBT people, but see no need for them to flaunt their sexual orientation publicly.
___ 8. What LGBT people do in the privacy of their own bedroom is their business.
___ 9. LGBT people deserve the same rights and privileges as everybody else.
___10. Homophobia is wrong. Society needs to take a stand against anti-LGBT bias.
___11. It takes strength and courage for LGBT people to be themselves in today?s world.
___12. It is important for me to examine my own attitudes so that I can actively support the struggle for equality that LGBT people have undertaken.
___13. There is great value in our human diversity. LGBT people are an important part of that diversity.
___14. It is important for me to stand up to those who demonstrate homophobic attitudes.
___15. LGBT people are an indispensable part of our society. They have contributed much to our world and there is much to be learned from their experiences.
___16. I would be proud to be part of an LGBT organization, and to openly advocate for the full and equal inclusion of LGBT people at all levels of our society.

Attitudes Toward Difference Survey Scoring Guide
Find the numbers below that correspond to the bracketed range on your survey. Read the attitude and characteristics that encompass this range. According to the Attitudes Toward Difference Scale developed by psychologist Dorothy Riddle, this is where you stand with regard to lesbian, gay, bisexual and transgender (LGBT) people.
1-2 Repulsion: LGBT people are strange, sick, crazy and aversive.
3-4 Pity: LGBT people are somehow born that way and it is pitiful.
5-6 Tolerance: Life for LGBT people is hard; anti-gay attitudes just make things worse.
7-8 Acceptance: Homosexuality is a fact of life that should neither be punished nor celebrated.
9-10 Support: The rights of LGBT people should be protected and safeguarded.
11-12 Admiration: Being LGBT in our society takes strength.
13-14 Appreciation: There is value in diversity. Homophobic attitudes should be confronted.
15-16 Nurturance: LGBT people are an indispensable part of society.
Adapted from: Riddle, D. (1985). "Homophobia Scale." In Opening Doors to Understanding and Acceptance. ed. K. Obear and A. Reynolds. Boston: Unpublished essay.
Your Rating:
1-4 Your personal feelings may be preventing you from accepting and respecting LGBT people.
5-8 You are somewhat accepting, but may not be willing to actively work against anti-LGBT bias.
9-12 You are willing to provide support and work toward equal rights for LGBT people.
13-16 You are able to fully embrace LGBT people as equal and valuable members of the community.
Food for Thought:
Are your attitudes toward LGBT people based upon experience or preconceptions?
Are you as accepting of LGBT people as you are of people from different racial, ethnic or religious backgrounds? Why or why not? Have you ever had an LGBT friend? How might your attitudes help or hinder you from being an ally for LGBT people? What can you do educate yourself about LGBT issues and improve your attitude with regard to LGBT people?
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Handout 4



Acceptance
One of Rogers? core conditions for counselling was ?unconditional positive regard?. Acceptance is a major aspect of this.

Much has been written about what unconditional positive regard might mean and what the difficulties are. One of the other core conditions is that of congruence, or genuineness. What are the conflicts between congruence and acceptance?

Classifying, stereotyping, prejudice
As human beings we are naturally prone to organising our world by classifying things:
?these things are furniture- this is a table, but that is a chair?
?that is a wren and that is a blackbird?

- and we do it with our fellow human beings:
?You are male, you are female?,
?you are black, she is white?

This leads to: ?you are like me, you are not like me?

? and stereotypes are born:
?men can?t express their feelings?,
?women can?t read maps?,
?black people can run faster?

And the judgements and assumptions based on the stereotypes creep in:
Scots are mean with money,
gay relationships never last,
black boys drive too fast,
These are clearly a barrier to seeing people as individuals.

It happens. We are all prejudiced, and we have all grown up absorbing the values and norms of society. However we can be aware of which ones are still active which dormant, and which have truly been changed by life experience.

Why is acceptance a prized attitude in counsellors?
An attitude of acceptance enables the client to feel free to explore their difficulties
? Without judgement
? Knowing that the therapist will not become involved in their lives
? Without having the opinions or values of the counsellor imposed on them
? Whilst maintaining their autonomy (ie no advice!)
? With the minimum of shame, which interrupts the process

As a counsellor the aim is to accept the client?s
? worth
? experience
? thoughts, feelings, desires and fantasies-
? identity and culture
? the validity of their values, even if they are different

?The subject matter of psychotherapy includes fantasies, fears, and feelings which patients find very hard to acknowledge, even to themselves? psychotherapy is a medium where the normal rules of social encounters are suspended and where it is safe to regress at times into kinds of behaviour which would be quite inappropriate in another setting.?
Holmes and Lindley quoted by Bond in Ethics of Counselling , 2000, p151

Acceptance of the client?s experience involves listening for the emotional rather than literal truth? clients often use metaphor, or use highly emotional language in order to convey the complexities of their inner world. Even when you suspect that another person might experience the same thing quite differently, it is the client?s experience which leads to the necessary understanding.

Acceptance of the person rather than their behaviour

Person centred theorists suggest that respecting the person and accepting their worth might be distinguished from the counsellor? feelings about behaviour.

Clients may exhibit judgemental, hostile, prejudiced or narrow views- they may admit to disloyalty, cruelty, to lying or cheating, to hurting someone else; they may appear to be incapable of love or empathy for others or for themselves? they may offend you your values or your principles? the behaviour may be out there in the world or in the room with you.

(NB Whether s/he admits it initially or not, the client may have come because s/he doesn?t like the behaviour either.)

The behaviour may be due to
? outmoded childhood survival strategies
? an avoidance of negative feeling- sadness, fear
? defence against shame
? entrenched patterns of relating
? a lack of self-worth
? unresolved trauma
? a history of being bullied or neglected
-and so on.

The following examples might illustrate this point:
? a teacher who tells you that she enjoys humiliating her pupils
? a man who makes it clear that a woman?s place is in the kitchen
? a client who swears aggressively throughout the session
? a client who considers beatings from her partner to be justified or normal
? a manager who brags to you about sexually harassing his staff

Acceptance of the client?s identity and culture

Person centred theorists haven?t generally paid a great deal of attention to cultural difference.

A cautionary note:

It?s vital for counsellors to be self-aware about their morals beliefs and values, to examine how thoroughly they have questioned those that they were brought up with to arrive at their own.

Where your values beliefs and morals are so different from the client?s and when the behaviour in question is related to the culture or identity of the client, beware the pull to ?love the sinner, hate the sin?. Taking homosexuality as an example: It is oppressive to cloak feelings of disapproval, repulsion or negative views of homosexuality in a warm but less than genuine regard for the client.

?Gay clients have no desire to be confronted by therapists who warmly offer to help them with a poor situation. In fact, such an attitude is one of the subtler forms of homophobia. Therapists who are unable to accept homosexuality as a positive and potentially creative way of being should recognize this fact and not take on gay clients: their fear, anxiety and ambivalence will inevitably be conveyed to their clients?.

(Woodman and Lenna, 1980) quoted in Pink Therapy Vol 2: Ed. Davies and Neal Therapeutic perspectives on working with lesbian, gay and bisexual clients. 2000, p100.

To summarise:
Acceptance in the Rogerian sense is an acceptance of the client?s experience and inner world.

Acceptance of this need not require you to like their behaviour (or allow it, if it violates your boundaries). However acceptance that it is as it is may help you to stay open enough to find out what lies behind it.

?Acceptance? can be experienced by some stigmatised minorities as patronising or pathologising; they might ask:

?What is there to accept? Who are you to say that I am alright by you? Are you judging that my way of being in the world is less valid than yours??


What are the challenges to us as counsellors in aiming to be congruent and accepting?

Where might your limits lie?

Which clients do you feel that you really could or should not work with?

Janet Dowding March 2010 Saved as Acceptance

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Handout 5

How does your internalised oppression operate?

In what ways does the way that you identify hold you back?

Do you stand in your own way because you have embedded beliefs about how your identity makes you unacceptable to others?

Think about which of your cultural identifiers make you a member of a stigmatised minority- even if it is mainly only in certain situations.

Have you internalised injunctions about how women, or (substitute your sexual orientation, religious background, ethnicity, etc) should be or behave?

If you are not in the dominant culture in your workplace, do you imagine that there is only so far that you can progress and still be liked by other people?

Do you sometimes feel / fear that people see you as a stereotype and not as an individual?

Do you find yourself acting out stereotypes?

Do you start to believe the stereotypes?

Are you hyper-critical of yourself, of others like you, of others different to you?

Do you blame your identity for a lack of self-esteem?

Do you blame your identity for a lack of academic or career progress?

Do you skimp on self-care or settle for less than what you really need?

Do your feelings of difference stop you from getting close to people?

Do you tone down your culturally determined behaviour to blend in or make yourself more acceptable, when with people not like you? (e.g. as a man in a group of women, be less macho / as an American, tone down your accent , as a Christian, choose not to mention your religious beliefs.)

If the stereotype about your identity is that you are prone to anger, do you spend a lot of time trying to be nice?

Do you wear a mask in certain situations either to hide an aspect of your identity or to make you acceptable in spite of your difference?

If the stereotype about your identity is that you are vulnerable, do you minimise your needs?
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Handout 6

AN ETHICAL DECISION MAKING MODEL


1. Identify the situation or problem and write a clear description

2. Whose problem is it?
? Practitioner?s dilemma?
? Shared dilemma?
? Organisational dilemma?
Consider all relational aspects

3. Check out relevant ethical frameworks and the law
? What is required by law?
? What is prohibited by law?

4. Consider the principles and values underlying the counselling work
? Beneficence ? what decisions and actions will achieve the greatest good?
? Non-maleficence ? what decisions and actions will cause the least harm?
? Justice ? what decisions and actions will be fairest for all parties concerned?
? Autonomy ? what decisions and actions respect and maximise opportunities for individuals to implement their own choices?
? Fidelity ? what decisions and actions honour the trust placed in the practitioner?
? Self-respect ? how should the practitioner?s own need for the above principles and values be taken into account?

5. Identify all available support

6. Identify all possible courses of action

7. Review each possibility by identifying which principles/values are brought into conflict by each one, and consider the impact and likely consequences of each.

8. Select the appropriate course of action. Take into account three tests:
? Universality ? could your chosen course of action be recommended to others? Would you condone it, if it was done by someone else?
? Publicity ? could I explain my chosen course of action to other practitioners? Would I be willing to have my actions and rationale exposed to scrutiny in a public forum?
? Justice ? would I do the same for other clients/counsellors in a similar position? Would I do the same if the client/counsellor was well known or influential (or was not)?

9. Document the above process carefully

10. Evaluate the outcome
? Was the outcome as you hoped?
? Had you considered all relevant factors?
? Would you do the same again in similar circumstances?

11. Review any personal impact the situation has caused
? How has this situation affected me?
? Can I identify any skills or knowledge areas that need to be developed?
? Has any need for personal therapy emerged?


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Handout 7

Boundary problems and dual relationships

Dual relationships are seldom neutral. It is necessary to consider their impact on counselling process and entering into them calls for careful consideration, not least because of the boundary issues involved.

? Direct dual relationships e.g. client and trainee; trainee and supervisee; line management and supervision; supervisee and friend
? Indirect dual relationships e.g. counselling someone when you know their partner; acting as a consultant for a training course when one of the students is a current client of yours; counselling a client who is the supervisee of your supervisor; counselling a client who is the supervisee of a colleague

In these situations it is necessary to consider confidentiality and the potential for compromising the efficacy of specific roles. Ethical principles that come into play include justice, fidelity and self-respect.

? Crossing boundaries - usually involves consideration, negotiation and has the client?s needs in the foreground eg client arrives with a flat tyre and without their mobile phone, so you offer the use of your phone or negotiating seeing a client twice weekly when your usual practice is once weekly.
? Breaking boundaries ? usually involves the intentional or unintentional use or abuse of a client, financially, emotionally or sexually

?A board-certified psychiatrist saw a woman in individual therapy for ten years. During the course of the therapeutic relationship, he negotiated with her to sell her two of his boats, sight unseen. Additional transactions involved sales of her personal property to him: Waterford crystal, china, and a silver service, the last of which as appraised at $1,600 but was purchased by the psychiatrist for $200. In the same year he accepted a refrigerator and a dining table with six chairs as gifts. During the course of these commercial trasactions, the patient had run up a significant bill with the psychiatrist. She sold her father?s coin collection to the psychiatrist for $1,000 as a means of getting one of the boats into the water. Within a year, the back repossessed the boat and the patient declared bankruptcy.?

(Norris, Gutheil and Strasburger 2003)

This seems improbable but illustrates the potential power of a practitioner. Less obvious forms of exploitation or enmeshment might include taking on a client with issues beyond your competance because of the need for work; over running sessions because of enjoying the client?s company; continuing to see a client within an organisational setting when they are no longer entitled to counselling, because of feeling no one else can help.

Breaking sexual boundaries

A US studies (Pope 1988) showed that on average 8.3% of male mental health professionals and 1.7% of female mental health professionals had sexually engaged with clients. Given that the respondents willingly gave this information it is reasonably to expect that others had sexually engaged with clients but did not want to disclose this.

Practitioners who sexually engage with clients often thought of as ?a scheming, malicious therapist overpowering ? perhaps by physical force ? a reluctant client? (Pope 1988 p.222). This is a misconception.

Common scenarios (from Pope 1988 p.223)


Role Trading therapist becomes the ?patient? and the wants and needs of the therapist become the focus of the treatment
Sex Therapy therapist fraudulently presents therapist-client sexual intimacy as a valid treatment for sexual or other kinds of difficulties
As if? therapist treats positive transference as if it were not the result of the therapeutic situation
Svengali therapist creates and exploits an exaggerated dependence on the part of the client
Drugs therapist uses drugs or alcohol as part of the seduction
Rape therapist uses physical force, threats, and/or intimidation
?True Love? therapist uses rationalizations that attempt to discount the professional nature of the relationship with its attendant responsibilities and dynamics
It just got out of hand therapist fails to treat the emotional closeness that develops in therapy with sufficient attention, care and respect
Time out therapist fails to acknowledge and take into account that the therapeutic relationship does not cease to exist between scheduled sessions or outside the therapist?s office
Hold me therapist exploits client?s desire for non-erotic physical contact and client?s possible difficulties distinguishing between erotic and non-erotic contact


Therapist risk factors (Norris, Gutheil and Strasburger 2003)

? Life crises
? Transitions
? Therapist illness
? Loneliness and the impulse to confide
? Idealisation and the ?special patient? ? ?I don?t usually do this with my clients, but??.?
? Pride and shame (this couldn?t happen to me: I know what I?m doing)
? Problem with setting limits
? Denial

These are a variety of circumstances that may create vulnerability for the therapist and so increase the likelihood of using a client or clients to resolve the sense of uncertainty, loneliness, stress etc, as well as evoking feelings that skew judgement and inhibit finding support and help.

Factors increasing client vulnerability

? a pattern of seeking enmeshment
? the difficulty of challenging therapist behaviour
? previous experience of boundary violations, especially early in life
? shame and self-blame
It is important to remember that whatever is happening for the client, it is always the practitioners responsibility to maintain appropriate boundaries. Boundary violations are never the fault of clients.

Damage done by therapist-client sexual contact (Pope 1988)

? Ambivalence ? feelings of alternately or simultaneously wanting to get away from the therapist and cling to or protect the therapist
? Feelings of guilt ? affected clients feel to blame, although the responsibility always rests with the therapist
? Sense of emptiness and isolation ? a sense of being cut off and worthless
? Sexual confusion ? including traumatic memories, avoidance of sex or compulsive sex
? Impaired ability to trust ? others and themselves for having trusted the therapist
? Identity, boundary and role confusion ? harm is done to the sense of a separate self and the ability to establish and maintain boundaries
? Emotional liability ? strong feelings including anxiety or depression that can overwhelm
? Suppressed rage
? Increased suicidal risk
? Cognitive dysfunction ? especially with attention and concentration

These affects are very similar to the affects of early trauma, rape and assault.

Approaching sexual feelings in counselling

The intimacy inherent in counselling gives rise to strong feelings ? positive and negative. Sexual feeling can be particularly problematic as:

? issues of sexuality are often neglected on counsellor training courses
? the problem is often downplayed or denied amongst professionals
? discomfort inhibits or blocks conversation about the sexual feelings that commonly arise for practitioners. For instance, research has shown supervisees are often reticent to talk about sexual feelings arising in their work in supervision (Webb and Wheeler 1998)



References

Norris, D., Gutheil, T. and Strasburger, L. (2003) ?This Couldn?t Happen to Me: Boundary Problems and Sexual Misconduct in the Psychotherapy Relationship? in Pyschiatric Services http://psychservices.psychiatryonline.org. Vol. 54. No.4.

Pope, K. (1988). ?How Clients are Harmed by Sexual Contact with Mental Health Professional: The Syndrome and its Prevalence? in Journal of Counselling and Development. Vol 67.

Webb, A. and Wheeler, S. (1998) ?How honest do counsellors dare to be in the supervisory relationship?: an exploratory study? in British Journal of Guidance and Counselling. Vol. 26. No. 4.



? Sarah Hawtin 2007

XXXX

Handout 8

Boundaries and the therapeutic framework



What are boundaries? What might they look like in the counselling relationship? Why are they important?

Boundaries form the limits of therapy and include time, place and emotional, psychological and sexual limits. Boundaries include the recognition that practitioner and client may well have different expectations and hopes about what is possible.

? Time/place ? expectations may be influenced by prior ideas about counselling; feelings of needing help and/or feeling able/unable to cope; implications of what is offered ? short term/long term; time limited and open ended

? Emotional, psychological and sexual limits ? need to recognise the constellation of feelings that cluster around relationships past and present; need, dependency, love, desire, security, frustration, abandonment, fear/anxiety, hate, jealousy etc etc

A practitioner needs to convey their commitment, understanding and willingness to help without becoming involved in a ways that:

? perpetuates the state/s a client is seeking to resolve
? primarily serves the counsellor
? undermines the client?s capacity to build trust in themselves, their feelings and their ability to act


Contracts

Contracts are mutually agreed limits ? usually including time, place, duration, confidentiality, payment and goals (do more of this in the working alliance weekend). Forming a contract is part of an open exploration of expectations and hopes. It makes boundaries transparent, therefore suppporting a client?s autonomy and helps with negotiation.


Boundaries and confidentiality ? the ideal and the actual

The most idealistic image of therapy is of the closed door, sealed against any intrusion. This can be taken literally and symbolically i.e. the idea of dedicated time, free from outside interference and with the total focus being the client. However, the reality is there are duties that may conflict. For instance, the duties of confidentiality and care may collide if there is a likelihood of self-harm or harm to another.

Mark Aveline (2001) has highlighted the professional, ethical, legal and employment obligations that are part of therapeutic working (see Figure 1 below). The responsible practitioner cannot ignore the realities of those institutions or individuals who are potentially affected by counselling.




Figure 1 ? Possible stakeholders in the counselling process.



The function of the therapeutic framework

The therapeutic framework is the constellation of boundaries or limits to working. This is always ?holding? (providing consistency, safety and in some instances a reparative relationship) and may also be illuminating (highlighting patterns of behaviour and feeling).

The use of the therapeutic framework varies between approaches:

? person-centred ? has a reputation for flexible boundaries, including variable length sessions. This needs to be understood as a proactive process of negotiation in reponse to client need, rather than being reactive.
? psychodynamic ? the framework is more consciously encorporated, because of wanting to ?use? the frame as a way of coming to understand a client more fully. The emphasis on transference also raises the need for appropriate and safe holding.



References

Aveline, M. (2001). ?Complexities of practice: psychotherapy in the real world? in eds. Palmer Barnes, F. and Murdin, L. Values and Ethics in the Practice of Psychotherapy and Counselling. Buckingham: Open University Press.


? Sarah Hawtin 2007
XXXXX

Handout 9

Working with Transgender Clients
Tina Livingstone
B.Ed Hons, Dip Couns
Introduction
For the purposes of this document I shall refer to the client group as T, rather
than transvestite, transgender or transsexual, partly because counselling may
precede any clinical diagnosis and partly because it is an inclusive, though not
ideal, identifier for a rainbow of trans-identities that seems too diverse to
quantify into a tripartite system.
I write from the perspective of a non ?Trans, Client Centred counsellor with 15
years personal experience within the trans-community. Currently working in
private practice, my T clients are from all areas and walks of life, and include
those who self identify as transsexual, transvestites, and transgendered
people, those with clinical diagnosis of transsexualism, people pre- and post
gender transition, pre and post reassignment surgery, those struggling with
gender issues and indeed those struggling with other issues.
N.B
It is wrong to assume that T clients always come to counselling with gender
based issues, though there is no doubt that these can provide another layer of
difficulty even when the source of the struggle lays elsewhere
As with the rest of the population contact with myself as a counsellor often
occurs at a crossroads / dilemma junction or is the result of cumulative stress;
in the case of T clients such need may occur pre-, during, and/or post clinical
treatment. My clients come to me through advertisement and on
recommendation within the trans-community itself.
My professional experience is that the relevance of counselling to the
emotional and psychological health of T people is both significant and diverse.
The emotional / psychological pressure of being in a socially stigmatised
minority being one of the primary pressures.
It is my belief that ideally those who work with T clients should have some
grounding in the issues arising, relevant legislation, and current clinical
treatment, thus enabling connection with the clients frame of reference and
facilitating informed practice. (It can be off putting for a client to be met as a
curiosity or questioned about process and equally challenging for the
counsellor not to know what the client is talking about - detracting from
therapeutic process in both cases)
My experience is that the Humanistic approaches, acknowledging the right to
self autonomy, and providing a suitably empathic and non judgemental basis
for therapeutic process, are most useful with these clients.

XXXXX

Write a review paper using the attached template on ," Is it best practice to isolate MRSA patients in the hospital environment?"

Inclusion Criteria
? Reviews on nursing MRSA patients
? Reviews highlighting MRSA patients experiences in Hospital
? Reviews on MRSA Infection Control in Hospital

Search Strategy
The search will be limited to English language papers published after 2000.
The data bases to be searched will include:
? Cochrane
? TRIP
? CINAHL
? Medline
? National Guidelines Clearing House (NGC)
? PubMed Clinical Queries
? Johanna Briggs
? EBSCO

Initial search terms will be combinations of:
MRSA, Best Practice, Isolation, Infection Control, Nursing, MRSA Patients, Literature Review, Hospital

Choose a clinical site and complete the following assignment:

1. Name the site. = New Horizons Healthcare
2. What is the organizational type = not-for-profit
3. Describe the units/services within the organization.
4. How is the organization financed? = Private money
5. What insurance is accepted? Medicare, Medicaid, Commercial
6. What are the patient demographics? = mixed
7. How is quality care defined? Is patient safety part of the definition? Is the term evidenced-based practice used in any definitions?
8. How are quality patient outcomes defined and measured?
9. Are awards/rewards given for excellence in patient care?
If yes, how are the award recipients determined? To whom are the awards given?
10. Does the environment facilitate communication within health care teams? If yes, how is this accomplished?
11. What technology, if any, is employed in the practice setting? = Electronic medical record/billing - example *** how it is used.
12. What part does nursing play in the selection, use, and evaluation of technology?
13. Are there any policy changes you would suggest? No, because clinicians were involved in setting up
14. Would you seek employment in this institution or one like it? - YES


Minimum requirement of 1000-1500 words and 5 scholarly resources. You are free to make this up using the guidelines above
Customer is requesting that (Writergrrl101) completes this order.

1. Select an area of interest in the mental health field(must
be a diagnosis that is in the DSM).
2. Organization of paper
A. Develop a case study(approximately one typed page).
Include psychiatric symptoms, treatments (past and
current), and pertinent clinical date.
B. Determine DSM IV axes.
C. Review of issues in care and expert opinions.
D. Integrate expert opinions regarding treatment into
paper.
E. Recommendations for nursing and own personal growth.
F. Reference page.
3. Paper should approximately 4-5 pages
(double-spaced, 1" margins) plus one reference page,
Current APA format.
4. Summarize paper integrating your references into the
paper with your clinical example.
5. Use a minimum of four (4) references on reference page
including DSM IV.
*In body of text, acknowledge appropriate source.
*Use current professional/journal articles( must be less
than 5 years old).
*Computer abstracts must include references.
*Do not use the dictionary as a reference.

ANSWERE question 1 or Question 2 your pick, an then question 3. Label question 1 or 2 and then 3 need at least 1 reference for each and article selection for question 3 WILL UPLOAD ADDITION READING FOR INFORMATION AT LEAST ONE page for each question with references no direct quotes paraphrase only.
Question 1
Whether you work in a clinical, academic, or most any other institution, you see quality improvement projects in progress. Do you question whether any of the projects that you see being used should have IRB approval? Do you know if these projects were approved by the IRB? Do you think that they meet the criteria for IRB review? Why?
Question 2
From your experience, have you been involved with a health care institution, school, or project that has used benchmarking as a quality improvement tool? If so, discuss how this was used and positive/negative aspects. If you have not been involved with benchmarking, find an article reporting a project utilizing benchmarking as a quality improvement tool. Discuss the findings.
Question 3
Select an article that focuses on a clinical intervention that has been implemented as part of a study. Did the researchers use a conceptual model to guide the study? How did the model fit the study (application to practice, improve generalizability of findings)? If the study did not have a model described, what model do you think may have fit and why



There are faxes for this order.

This project is to 1) explore the role 2) the needed educational preparation and 3) the importance of the role in the changing healthcare environment for these specific nurse practitioner specialty certifications: 1) Adult Nurse Practioner 2) Adult psychiatric and Mental Health Nurse Practitioner 3) Family Nurse Practitioner 4) Family Psychiatric and Mental Health Nurse Practitioner 5) Gerontological Nurse Practitioner 6) Occuptational Health Nurse Practitioner and 7) Emergency Nurse Practitioner. I would like the paper to include Credentialing process for each (ie Board certification through american nurses credentialing center of the american academy of nurse practitioners, etc.). It would be great if it also includes Florida and Alabama schools where these specialties can be obtained and a sample of courses required or number of school hours or clinical hours needed to sit for boards or to get degree in the particular specialties above. If Florida and Alabama Universities do not have all of these specialties then please include other southern universities that may offer some of these specialties.

Page 1: If you were planning a new undergraduate nursing program, what is one nursing theory (grand or middle-range) that you would incorporate into the curriculum? Explain your reasoning.

- 2 references for page 1

Page 2: Select a grand or middle-range nursing theory. Provide a description and an example (from the literature or your own experience) of how this theory could be used in two of the following educational areas:

Practical (vocational)
Associate
Baccalaureate
Masters
Doctoral
Staff development
- 2 references for page 2

Criteria:

Advanced Practice Roles in Nursing
Compare and contrast the roles of the Nurse Practitioner, Nurse Educator, Nurse Informaticist and Nurse Administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration and research.
Selected Advanced Practice Role
Examines regulatory and legal requirements for the state of Massachusetts.
Describe the professional organizations available for membership based on your selected role (FNP).
Identify required competencies including certification requirements for your selected role.
Predict the organization and setting, population and colleagues with whom you plan to work.
Leadership Attributes of the Advanced Practice Role
Determine your leadership style: Participative leadership. http://psychology.about.com/library/quiz/bl-leadershipquiz.htm
Identifies leadership attributes you currently possess, and attributes you may need to develop.
Determine how to attain and evaluate those missing attributes.
Health Policy and the Advanced Practice Role
Visit the Robert Wood Johnson Foundation http://www.rwjf.org/en/topics/rwjf-topic-areas/health-policy.html and identify a health policy issue. Conduct a review of literature and address the following:
Describe the current policy and what needs to change; justify your conclusions with citations from the literature.
Provide the process required to make the change with key players and parties of interest.
Explain how you could lead the effort to make or influence the change in policy.
Predict the effect on health care quality if the change in policy is implemented.


Criteria
WEIGHT
Advanced Practice Roles in Nursing:

Compare and contrast the roles of the Nurse Practitioner, Nurse Educator, Nurse Informaticist and Nurse Administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration and research.

Individual Advanced Practice Role:

Examines regulatory and legal requirements for the state in which you plan to practice.
Describe the professional organizations available for membership based on your selected role.
Identify required competencies including certification requirements for your selected role.
Predict the organization and setting, population and colleagues with whom you plan to work.

Leadership Attributes of the Advanced Practice Role:

Determine your leadership style: http://psychology.about.com/library/quiz/bl-leadershipquiz.htm
Identifies leadership attributes you currently possess, and attributes you may need to develop.
Determine how to attain and evaluate those missing attributes.

Health Policy and the Advanced Practice Role:

Visit the Robert Wood Johnson Foundation http://www.rwjf.org/en/topics/rwjf-topic-areas/health-policy.html and identify a health policy issue. Conduct a review of literature and address the following:

Describe the current policy and what needs to change; justify your conclusions with citations from the literature.
Provide the process required to make the change with key players and parties of interest.
Explain how you could lead the effort to make or influence the change in policy.
Predict the effect on health care quality if the change in policy is implemented.

RESEARCH TOPIC: THE DYNAMICS OF DOMESTIC VIOLENCE AND THE RESULTING EFFECTS ON CHILDREN

DOWN BELOW IS THE FORMAT THE RESEARCH PAPER NEEDS TO BE IN.

THIS PAPER NEEDS TO BE OBJECTIVE NOT SUBJECTIVE.
As a result, this paper requires that you -
Conduct in-depth research on a specified social issue or problem and understand its impact on diverse families
Identify, describe, discuss, and evaluate a relevant theoretical framework appropriate for understanding and working with families affected by the chosen issue or situation
Develop a thorough understanding of the how theory and effective intervention relates to social work practice

All work should be double-spaced and typed, following APA guidelines. The body of the paper (excluding title page, reference page, etc.) should be at least 10-12 pages long, cite references throughout, and include a reference page. Since this paper is worked on throughout the quarter, your topic is expected to be well researched and developed.

RESEARCH PAPER FORMAT

The following outline is designed to help you organize your research paper. Use the headings in your paper to ensure organization, coherence, and clarity. Make sure that you address each aspect . If the use of subheading would help with completeness, coherence, organization, and clarity please feel free to use them.

Introduction
Brief overview of topic
Thesis statement

Discussion of Problem Area or Issue
Description of the issue or problem area to be addressed in paper. Describe any precipitating events or contributing factors. (Think along the micro---macro continuum)
Extent -statistics on incidence- of the issue / problem area
Who is affected? And are there any groups more affected than others? (Groups= race, ethnicity, social class, age, gender, region, etc) How are they affected? To what extend do dimensions of diversity play a contributory or influencing role? What traditional or non-traditional ways of coping are used to deal with the problem area / issue?
Describe and discuss the significance of this issue or problem area. Why is this issue or problem important?
How does it impact the family? Describe and evaluate its impact on diverse family forms. Does it impact all types of families in similar ways or is there different impact for different kinds of families? Describe protective or risks factors that may influence the level of impact.
Identify and describe underlining or coexisting dynamics/issues involved. How do these underlying or coexisting issues exacerbate your primary problem area?
Summarize societal perception of families who struggle or deal with the issue / problem area

Theoretical Framework or Approach
Identify, describe, and evaluate* major theoretical, conceptual, or developmental framework(s) or family therapy approach(s) to explain and help us understand this topic.
Identify and describe major propositions, assumptions, or concepts of the theory.
Identify key individuals associated with this approach. What is known about them?
What evidence is there in the literature to support the use of this theory for this particular topic / issue / problem area? Describe and assess the evidence that exists.
Apply the theory to your specific topic / issue / problem area.

Intervention
Identify, discuss in depth, and analyze a treatment and prevention intervention that has documented effectiveness and proven results. Usually, treatment interventions address issues and problem-situations; whereas, prevention interventions enhance clients capacities to reduce the likelihood of issues or problem-situations emerging or worsening. It is possible that an intervention could have both a treatment and prevention component.
Explain the role and function of the social worker / family worker
Describe techniques used and specific goals focus on with family as you summarize the process of implementation
What research supports the use of the intervention and its techniques? Describe and assess the research that exists. What evidence exists that this intervention and its techniques are effective? How has this intervention been evaluated and by whom?
Policy
Identify a policy that deals with your particular issue or problem
Describe its key components, its impact on families; its implications
Suggest possible ethical, ideological or philosophical perspectives, and values that serve as a backdrop for the chosen policy
Identify any issues with its implementation
Describe the policy effects on family work as social worker attempts to assist families that are challenged with this issue or problem area


Other Pertinent Areas:
Identify and describe value, ethical, and legal implications for the social worker addressing and preventing this issue or problem with families
Describe issues relating to social and economic justice
Base on your research suggest a solution to this issue or problem area

Conclusion
Summarize the topic and your findings ??" pull the information together in a systematic and logical manner. Your concluding comments need to recap thesis and relevant findings.

Reference list
List only references cited within the body of the work.
Use appropriate APA style & format.




*Evaluation of Theory
Source: Zastrow & Kirst-Ashman (2010). Understanding human behavior and the social environment

Application to client situations
In what ways is the theory relevant to the practice of social work? In what ways does the theory provide a means to help us think about our clients and how to help them? To what degree does the theory guide our assessment and practice?
Extent to which theory coincides with social work values and ethics
Does the theory involve underlying assumptions that are congruent with the mission, values, and ethics of social work? For example, does it recognize the benefits of and does it celebrate human diversity?
To what degree does it reflect the participation, voices, strengths, ways of knowing, and experiences of males and females; wealthy and poor; Caucasians and people of color; gay men, lesbians, bisexuals, and heterosexuals; old and young; and people with varying abilities or disabilities?
In what ways does the theory help us and the people with whom we work to reach their fullest potential? To what degree does it assist us in understanding and transforming those with whom we work and our society?

Existence and validity of other comparable theories
Is this theory best suited for the issue/ problem situation, the practice context, and the client population?
Which concepts in the theory have the most relevance to you and your work with the client population?
Are there other theories that adhere better to the above two criteria (application to client situation and extent of congruence)? If so, which theory should be chosen to guide assessment and practice?

In narrative format, provide a personal essay incorporating the following

1. Discuss the personal qualities and attributes that you think will be useful as well as those that you feel need further development in the pursuit of Doctor of nursing practice.

2. Provide your own definition and discuss cultural cultural competence and ethical values.

3. Discuss how a doctoral education in nursing practice will impact your future goal.

4. Explain the integration of your leadership skill set that reflects the needs and current trends of society from a local to international level.

5. The clinical project will be the integrating exercise for this doctor of nursing practice program. Expand on this by discussing your clinical project idea reflecting your creativity, innovation and passion.

XXXXXX Should be 3-5 pages double spaced. Personally I was born and raised in Africa where mental illness is regarded as a curse and not treated as it should. I worked in medicine and surgery before I became a psych nurse and ultimately became a nurse practitioner in psychiatry. Currently working with mobile crisis unit a division of the psych emergency room. Please I want my background to be depicted in the essay since personal reference is also required. I also have a nephew that is autistic.XXXXXXX

What we need: Title page, introduction, and methods section for a survey of 500 people (survey attached) in the Portland ME area. The goal of the study is to determine the reaction of the patient base to the use of business terminology in medicine IE: when doctors think of or call patients customers. We hope to find interesting data based upon our other questions about the feelings toward modcern healthcare in the general public.

This is the Survey:
Questionnaire

1. Have you been to see physician in the last 12 months?

2. Do you ever recall anyone in the medical field referring to you as a customer?

3. Would you prefer to be called (1) Customer (2) Patient?

4. Do you find the term customer inappropriate in a medical setting?

5. Does business terminology have a place in clinical medicine?

6. Have you ever worked in the healthcare industry?

7. Do you think of yourself as your doctor?s customer or as a patient?

8. Does visiting your physician seem like an impersonal experience?

9. Have you or a family member changed physicians within the last 12 months?

10. A doctor goes to work to. . .
A. Help people
B. Earn a living



Feel free to change this as needed, so long as the gist is preserved.

The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective.
While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC.
To prepare:
Review the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.
Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes?
Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.
If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the library and at credible online sources on the role of the nurse informaticist.
Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC.
A recent change in our EHR was the adaptation of a different time out version. The problem was the nurses were not notified. We open up the EHR and the time out section was not there, a week later a new version showed up. the issue we were never notified of any of this changes and so were scrambling for answer which the managers and informatics specialists failed to provide us with.

Write an 8 page paper in the latest edition of APA format for the following Dermatology case study listed below, involving the 33 year old patient that presents with a rash.
Deduce these three dermatological differential diagnoses for this particular patient writing about the important key features of each diagnosis, including clinical findings in the physical exam, treatment and epidemiological statistics concerning incidence (which means the percentage of how often each diagnosis occurs in the human population which can help in determining which diagnosis is more likely) with related evaluation and treatment and include health promotion/prevention strategies for each:
1) atopic dermatitis (aka eczema),
2) psoriasis,
3) contact dermatitis
Dermatology Case Study:
History of present illness (HPI): A 33-year old has come to your office concerned about a rash of 2-weeks duration located behind the knees and elbows bilaterally. It is itchy, red, somewhat raised, and dry. At times it has had clear drainage.
Past medical history (PMH): Health history is non-contributory; the patient is well overall with no regular medications and ibuprofen for the occasional headache.
Review of systems (ROS): There has been no fever or chills, weight loss, and no CV/Resp/GI/GU symptoms.
EXAM: (Include in the paper for each diagnosis a description of the physical findings which would support the selected diagnoses.)
Here is an outline for each diagnosis that will help with paper organization and to guide the case study development.
1. Approach to symptom evaluation ? here are the important key features of each diagnosis
a. Age
b. Onset
c. Systemic manifestations
d. Health status and living situation
e. Lesion/problem description and distribution region/s
f. Epidemiology (how often it occurs and in what age group in the human population)
g. Risks: Products, environmental (to include school and work)
h. Self-treatment methods
2. Common Primary Skin Lesions
3. Common Secondary Skin Lesions
4. Trauma ? this section may not be relevant to the three diagnoses chosen.
5. Pharmacological Preparations
a. OTC (stands for over the counter medication. Which can be purchased without a prescription.)
b. Prescription medication
i. Topical
ii. Systemic
6. Health promotion/prevention strategies
Here are references to use in addition to the attached textbook and other attachments.
This is the textbook that is attached.
Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2011) Primary care: The art and
science of advanced practice nursing (3rd ed.). Philadelphia, PA: F.A. Davis.
ISBN-13: 978-0-8036-2255-5

Web Sites:
http://www.docmec.com/my_case_study_view.php?spid=3
Doc Mec

http://webs.wichita.edu/nursing_clp/dermatology_preview/case.htm
Dermatology

http://www.dermvic.org/cases.html
Dermatology Case Studies and Resources

http://www.aad.org/
American Academy of Dermatology

http://www.modernmedicine.com/dermcounselor
Dermatology diagnosis counselor site

Written essay of 500 words describing the nature of my professional goals and time frame for completing the program of study (post masters Nurse practitioner program). Evidence supporting the nature of the clinical placement commitments necessary to fulfill the clinical objectives of the certificate. (this program is a 600 hour clincial experience which will be done in 8 hour days in my hometown local physician offices). The on line course is 21 credit hours full time status. Some of my professional goals are: Assuring I have the proper guidance and continuous application of medical procedures being provided in the highes professional proficiency, Capable of providing a wider scope of services to a more diverse group of patients, to be the best of who I can become with regards to my profession, aspire to advance my expertise to be able to closely monitor the development of individuals in their pursuit of a healthier existence.

(Choice of writer: Sunshine or Pam)

DIRECTIONS FOR THE WRITER:

This is a reading report. You are to read the fax that consists of material from the book. Then answer the three part questions to write the report.
* * This is APA style.* *

Name of book:

Austrian, Sonia G. (2005). Mental disorders, medications, and clinical social work, Third
Edition. New York: Columbia University Press.

*Answer these questions. This report contains three parts:

A) A summary of MAIN points from the reading (focus on two or three points) please do not write straight off the reading;

B) A set of questions for discussion (after reading the material, think of TWO questions that you would like to ask.) Write these two questions at the end of the paper or separate paper. (The questions you formulate should be something that caught your attention during the reading and you would like to ask something new to help you gain further knowledge.) and;

C) Some external source ( 1-one only) (other than assigned reading) to support/detract the reading. Information from this other source should be a short paragraph. Reference it APA style. ** Please do not use most of the paper on this other source. Make sure that the paper is based MOSTLY on your own summary of the reading material.

NOTE : Writer, please do not get sentences straight off the book. Summarize what you read for the paper. FOCUS ON TWO THINGS ONLY (TOPICS). Make your point clearly.

Thank You.

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A. Concepts, principles and understandings

As a result of this course, students:

1. Formulate the right clinical questions
2. Perform an extensive literature review and synthesis
3. Identify how this search will influence the practice of the Advance Practice Nurse ( APN) or Nurse Educator (NE)

B. Attitudes, interests and appreciation

The students also:

1. Begin to develop an understanding of the importance of providing evidence based care.
2. Awareness of the elements important to Evidence Based Practice.

C. Habits, conduct and skills

1. Collaborate with other health care professionals and/ or library science staff to perform an extensive, well organized, literature search.
2. Disseminate findings in a cogent, well organized paper



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B.SC Nursing program. please note articles refrenced to must have been published after 2002. Summarize the information obtained from each resource by identifying the strengths and weaknesses of each article, in separate paragraphs. Use of tables or graphs is acceptable in APA format. Articles should come from PEER-REVIEWED JOURNALS.Discuss rationale for selecting your topic and describe its impact on clients, nurses, and healthcare delivery.Summary of articles should include Prefer nursing research journals, Non-research journals like Nursing week,NursingTimes,.The summary will include an overview of the article, specific information about th study or review, including but not limited to, participant sample, study design, location, and outcomes. The summary must be short, clear version of the article. This section will be 1-2 paragraph .Analysis:Critically analyze the information from the articles and describe the findings clearly and succintly. Describe two additional questions that remains. Describe merits and short comings of the reaserch.SUMMARY: provide brief closing remark about your research question and provide synthesis of the articles. This section will be from 1/2-1 page. Reference page:Follow the APA guidelines closely.
Research article will include 1. a summary or abstract, a description of the research, Methods used to complete study, Results of the outcome, and a discussion of the signifance of the results.
Use "PICO" Format. P means population/disease(age,gender, ethnicity, disease state or character), I means Intervention(exposure to disease, prognostic factor, treatment or diagnostic test, patient perception, risk behavior), C means Comparison(no disease, placebo, absence of risk factor) and O means Outcome(risk of disease, accuracy of diagnosis, rate of occurence)."Pico" that involves Therapy, Etiology, Diagnosis Diagnostic test, Prevention, Prognosis and meaning.

***
You may change above chosen topic and write on any of these topics to "management of diabetic neuropathy in a clinical setting" OR "Nursing intervention will lower diabetic neuropathy in a hospital and homecare setting" . send E-mail if you require further clarifications.

NO DIRECT QUOTES WILL SEND TOOLS TO ACCESS AND HAVE # ARTICLE FOR DATA BASE NEED TO ADD ARTICLE A I CANN ACCESS AND NEED GOOD REFERENCE PAGE WILL NEED TO DOWNLOAD ARTICE WILL SEND EXAMPLE
Assignment 2: Asking the Clinical Question: Developing the Evidence Matrix
The focus of this assignment will be asking the clinical question from the practice issue/problem within the student's area of professional practice (identified in Assignment 1: Making the Case). Will send copy Communication among nurses and doctors in the Hospice setting. WILL SEND COPY OF MAKING THE CASE DONE ON HOSPICE The student is expected to: Construct a PICO with a corresponding question; identify key search terms related to the question; describe EBP models that may be useful in framing the question for searching. You are asked to use your work your searching to complete this assignment.

While this assignment does have a due date, you will continue to build your foundational base from the evidence for your question(s). This is an evolutionary process. When selecting the best evidence, it is important to know where to look and refine your searching as you progress in your reading and synthesis of the evidence. You will continue to refine your question as you dig deeper into the evidence.

According to Craig (2007), "knowing which type of study design would best answer the question enables rapid sorting of the retrieved studies such that studies with the most appropriate study design take precedence" (pg. 31). For example, questions about effectiveness of an intervention would lend themselves to systematic reviews of randomized controlled trials. Questions about causation would be more likely to be found in case-control or cohort studies. Qualitative research would be a more appropriate search for questions about perceptions, attitudes and beliefs.

Using the tools below (you can expand and make more useful for your needs), begin your search of databases. You are also asked to begin your evidence review matrix from your database search. Identify at least four (4) sources of evidence from your database search. As you review your research evidence, grade the recommendations. Guided by Chapter 35, use Assessing Health Care Recommendations (Table 35-1: Users' Guide for the Validity of Health Care Recommendations) to complete this discussion.

US Preventive Health Guidelines Recommendations
Grading Recommendations
EBP Example
Evidence Levels

Database Development

Review Matrix

Consider a variety of tools available to you in formulating your questions, identifying search terms, and optimal study designs according to the question.
USE TO RUBERIC BELOW
Rubric:

1/1: "Burning question" identified, using PICO to guide question. () Population, intervention , comparison outcome

3/3: Description of at least 2 EBP model(s) appropriate for practice/burning question; critique similarities and differences of models.

2/2: Identifies clinical question that prompts evidence search; Identifies key search terms; describes how determined.

2/2: Identifies and describes "hits" and possible need for further refinement of question.

4/4: Identifies at least four (4) levels of evidence, beginning the Evidence Review Matrix. (Attach Evidence Review Matrix). Critically evaluates recommendations from Users' Guide; Describes the relationship between levels of evidence and grades of recommendations

6/6: Summarize work re: how you will build on this beginning search.

2/2: APA; Scholarly writing; professional style; referenced work.

20/20






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Critiquing a review article. Complete a summary of the main points and findings. Describe it in a scholarly (using critical thinking) manner, but also in a way that someone from outside the area can understand.

Refernces:

Ariely, D., & Norton, M. I. (2011). From thinking too little to thinking too much: a continuum of decision making. Wiley Interdisciplinary Reviews: Cognitive Science, 2(1), 39??"46. doi:10.1002/wcs.90

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217??"237. doi:10.1016/j.cpr.2009.11.004

Hello, I am a new customer and have never used this service before and hope the work meets my expectations. For this order, I need editing for my dissertation on Chapter 1 and Chapter 2 only. I am waiting to receive Chapter 3 back from my chair and will place that order separately when I receive it back. PLEASE ONLY ADDRESS THE COMMENTS MADE IN CHAPTERS 1 & 2 FOR EDITING OF THIS ORDER. My computer crashed and I am unable to send some of the articles in which the references are not listed. I paid a professional editor to go through and check the majority of the APA formatting and other than the table on contents, it should be fine. I placed the order based on the number of pages in which comments are made so please let me know if you feel the amount charged is fair. If I am please with the results (which I really hope I am) I would like to use you guys for the rest of my dissertation experience. Please feel free to contact me with any questions or concerns you might have.

Thanks,
RW

Length: 2,000 words
Identify Asthma, either acute or chronic.
Through the use of the qualitative research and autobiographical literature, explore how one patient/person, or a group of patients/people, has/have experienced this illness.
To do this you will need to identify common illness experience themes that encapsulate the experience of being ill for the individual and/or their families. You will need to refer to the relevant qualitative research literature and show evidence of a conceptual understanding of how these identified themes illustrate the ill persons and/or
their families experience.

Assessment Criteria
Introduction gives background to the topic and states precisely what the essay intends to
cover.
Body of essay shows evidence of critical analysis, synthesis and evaluation of relevant
qualitative research literature.
The essay contains a coherent, appropriately substantiated and well-developed line of
argument.
Conclusion draws evidence together, does not over-generalise.
Well-structured, logically sequenced presentation in appropriate English (see Assignment
Presentation Requirements).
Correct referencing technique (see Assignment Presentation Requirements).
At least 8 qualitative research articles (identified from the qualitative research databases)
used to support the arguments.( must be in last 5 years)

S501 Structured Critical Reflection Paper #1?A Pre-Assignment: In preparation for this written assignment you are to read the following:

Shipler, D. (2005). The working poor: Invisible in America. New York: Vintage

Walls, J. (2005). The glass castle. New York: Scribner.

This paper is to be an integration of your critical thinking (see intellectual standards for critical thinking, p. 3) and reflections, inclusive of your feelings, beliefs, values, self-awareness, and related claims as supported by the assigned readings and supportive literature. Be mindful that critical thinking is, ?the art of analyzing and evaluating thinking with a view to improving it? (Paul & Elder, 2006, p. 4). Gibbs and Gambrill (2005) define critical thinking as ?a unique kind of purposeful thinking in which we use standards such as clarity and fairness. It involves the careful examination and evaluation of beliefs and actions in order to arrive at well-reasoned decisions? (p. 11). It is thinking about our thinking processes and being explicit as well as transparent about those processes in order to facilitate improved thinking for learning. Many good ideas are not communicated because authors fail to think about the purpose of the assignment. Good writing is a reflection of good thinking.

Your paper is to take the above definitions into consideration as you reflect and write utilizing the intellectual standards for critical thinking (www.criticalthinking.org). The paper is worth a total of 10 points and is due on September 16th. You must use APA 6th Edition for the appropriate format, citations, and referencing of your paper. The paper should be at least 5 pages and absolutely no more than 7 pages in length. You will need to be concise ? don?t waste words summarizing the texts ? you may assume that your instructor has read both books! We want you to REFLECT on them. You may write in first person (?I?), however, this is to be a scholarly work. Suggested supportive text: Encyclopedia of Social Work (NASW, 2008) to be helpful. A grading rubric is provided and you must turn in a completed grading rubric (self-assessment) with your paper?papers will not be accepted for grading without a completed rubric.

*The paper utilizes the DEAL (Ash & Clayton, 2004) model of critical reflection. The paper should have 4 distinct sections (headings) as well as 4 sub-sections within the Articulate Learning section (be sure to use APA levels for sub-headings) as delineated below. Papers that do not address the entire model, inclusive of all sections and questions, will not be viewed as a completed assignment. The paper should include the 4 sections below:

I. Describe: In detail and as objectively (honestly) as possible, describe your experience reading the texts. This is not to be a book report or rehash of the text, but is to be an objective (honest) description of your experience (understanding & knowledge) with the text. Your experience may include gut reactions, questions provoked, and how the texts affected your thinking about the poor. You should begin this section with ?In preparation for this reflection paper, I read the texts, reflected on my life experiences, and then identified the following key themes in my experience reading the texts ??

II. Examine: Identify specific aspect of the text that captured your attention, thoughts, and/or feelings. In this section, you are to relate your personal/professional experiences, as appropriate and relevant, that illustrate the concepts the authors discuss (in the context of scholarly reflection). This must be addressed in the context of the following questions (notice that these primarily relate to objective # 3 in your syllabus):

What forms of discrimination, and oppression (sexism, racism, heterosexism, ageism, classism, and/or ableism) did you observe in the experiences discussed by the authors? What societal challenges (bureaucracy, income, health care, child care) contributed to the experiences? What role do you think race and/or ethnicity plays with regard to poverty?

III. Articulate Learning: This is a 4-part structure requires a fair amount of reflective thought. The DEAL model (describe, examine, articulate learning) is an assignment designed to generate, document, and deepen your learning (Ash & Clayton, 2004). This last, 4-part section is critical to the entire process. Simplistic and reductionistic answers are inadequate. For example it is not enough to say, I learned about poverty among the working poor by reading the texts and It matters because it is important to social work and in the future I will be more empathic of others. These examples do not exhibit critical thinking?these statements merely report and poorly at that. Use sub-headings for this section of the paper as well. The 4-part structure for this section includes:
a. What did I learn?
b. How did I learn it?
c. Why does it matter?
d. What will I do in the future, in light of the learning?

IV. A brief summary paragraph.
Summarize your thoughts and conclusions.


Note about grading: An A grade, 10 points, is viewed as exceptional work as demonstrated by a well developed discussion exhibiting a broad range of knowledge as well as critical thinking. A passing grade is a C (average work). Only papers below a C will be allowed a re-write and only to bring the grade to a passing C (7.7?7.5 points), therefore writers scoring 7.1 points or below will be allowed to re-write and re-submit your paper. This will be allowed for this initial writing assignment only. Late papers will result in a loss of points.

Grading Scale:
100-98% A+ 97-95% A 94-92% A-
91-88% B+ 87-85% B 84-82% B-
81-78% C+ 77-75% C 74-72% C-
71-68% D+ 67-65% D 64-62% D-
61-0% F

References

Ash, S.L., Clayton, P.H. (2004). The articulated learning: An approach to guided reflection and
assessment. Innovative Higher Education, 29(2), 137-154.

Gibbs, L. & Gambrill, E. (2005). Critical thinking in clinical practice: Improving the quality of
judgments and decisions (2nd ed.). Hoboken, NJ: John Wiley and Sons.

Paul, R., & Elder, L. (2006). The miniature guide to critical thinking and tools. Dillon Beach,
CA: Foundation for Critical Thinking.








Intellectual Standards* for Critical Thinking Description Questions
Clarity Clearly stated ideas with detail in the descriptions that serve to clarify statements. Are my ideas clearly stated and are my examples of the topic clear to the reader? Did I provide examples? Can I elaborate?
Accuracy Statements or claims that are supported with evidence (citations) and are factually correct. Did I support my claim with evidence? How do I know this to be truthful? How can I validate my claim? Did I use too much anecdotal experience to support my claim?
Relevance Statements that are key to the primary thesis and connect to a central point. Are my statements connected to the topic? How is what I discussed of concern to the overall issue?
Depth The discussion and conclusions reflect the complexity of the issue. Have I covered the complexity of the issue? Are there other themes that need to be explored to do the issue justice?
Logic Reasoning that makes sense and conclusions that are in keeping with statements made throughout the discussion. Does the introduction match my conclusions? Did I put forth and follow a line of thought that makes sense? Are my conclusions a reflection of the complexity of the issue discussed?
Breadth The discussion reflects multiple viewpoints and possibilities. What would another perspective include? Is there another way to interpret this? Did I research alternative perspectives? Can I turn my discussion upside down for a different vantage point?

*see www.criticalthinking.org

















S501: Grading Rubric Structured Critical Reflection #1

You must self-evaluate your paper in accordance with this grading rubric. The completed rubric must accompany your paper. Evaluate each section, circling the designated box in accordance with your self-evaluation. IS* stands for?Intellectual Standards for Critical Thinking (see page 3).
Section evaluated A
2?points B
1.8?points C
1.6?points D?F
1.35-0?points
Describe Description with clarity, accuracy, & relevance using objectivity and coherence in relating the experience of reading the texts. Description is clear, accurate & demonstrates objectivity in relating the experience of reading the texts. Some detail with clarity and objectivity, but lacks consistency throughout section. Significant lack of detail, objectivity, and evidence of disjointed presentation of section.
Examine Identification of relevant issues presented with clarity & accuracy. Questions explored & discussed with, depth, breadth, and logic. All claims are supported with evidence. Identification of a issue and explored with clarity. Some depth & breadth in the discussion. Claims are supported. Some identification of an issue, thoughts, feelings & beliefs are not clearly examined, with at least 2 IS*. Issue thoughts, feelings & beliefs are not clearly examined with little evidence to support claims or little to no utilization of IS*.
Articulate Learning All aspects of the 4-part structure are fully addressed and clear evidence of learning is articulated with IS* fully evidenced. All aspects of the 4-part structure are addressed and some evidence of learning is articulated with IS*. Most aspects of the 4-part structure are addressed and some evidence of learning is articulated, but inconsistent IS*. Aspects of the 4-part structure are unclear and little evidence of learning is articulated with no IS*.
Use of APA style & format Grammar, APA style and format are used correctly throughout the paper. Only minor problems with grammar & APA style and format. Most of the paper uses correct grammar & APA style and format. Many problems with grammar and/or APA style. e.g., no page numbers for direct quotes.
General quality of writing Paper is very well written, organized in accordance with the assignment, no errors in grammar, spelling, and punctuation. Paragraphs and sentences are well developed and clear. Paper is well written, very few errors in grammar, spelling, and punctuation. Paragraphs and sentences are developed. Paper is generally well written and organized with some problems with grammar, spelling, and punctuation. Some lack of clarity. Paper is not very well written. Many problems with grammar, spelling, and punctuation
*IS?critical thinking standards

Student comments: Student Score________
(Please provide comments to support your score and claims)

I am a nursing student, I am a born again Christian, I believed on speaking tongue, divine healing, I believed that God is the healer ultimate healer of all. I do everything according in God words. I have attached a called "strength finding with my top 5 themes" Hope that help you build the essay on how to explore my integrate your faith into a personal style of leadership and how can I anticipate accomplishing integrating on my leadership style in the clinical setting. I also go church every Sunday at the Victorville, CA "Assembly of God". Here is the website if you need more information about the church and mission. http://www.vfassembly.org/.

I also attached several journal for you to see what is the best journal reference is the best for the assignment. there is a minimum of 3 references 2 of the reference need to be journal article. I also attached the rubric and the assignment instructions which is very important to get the full points. Thank you.
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