Define what psychosocial interventions are – there relationship with person centred care and recovery.

Assignment on case SCENARIO

Present your work in a standard assignment format

Present your work written in the third person.

The word count for this assignment is: 2500 . Harvard style referencing. 28 to 30 references. All references should be ten years or less. Assignment will be checked for plagiarism

Credible sources only such as NICE, RCN, JOURNALS AND ARTICLES. All   UK sources please. Clear and fluent academic style writing.

KEY POINTS

RECOVERY MODEL- RECOVERY STAR

5Ps (Presenting problem, predisposing factors, precipitating factors(triggers), perpetuating factors and protective factors)

Psycho-education- Timeline and stress bucket

Psycho-social intervention- Relapse intervention, using research and credible literature, quantitative and qualitative, talk about strengths and limitations.

Apply Jamie to all stages, must be person centred

Addressing learning outcomes 1,5,6 . All must be addressed

Learning outcome 1- Recognise and relate biomedical, psychological and social processes to common disorders and an understanding of mental health and illness.

Learning outcome 5- examine the theoretical assumptions and therapeutic processes associated with psychosocial intervention in the context of mental health nursing.

Learning outcome 6- analyse and evaluate the effectiveness of psychological interventions.

Explore a psychosocial intervention and demonstrate understanding of the theoretical assumptions and therapeutic processes associated with that intervention in the context of mental health nursing and recovery, including methods of evaluating the effectiveness of the intervention in developing person-centred mental health care.

Assignment 2 Guidance

After reading the scenario carefully you will choose a suitable psychosocial intervention to help facilitate recovery for the individual and their carer/family.

The case scenario is Presents in the recovery phase of early onset psychosis

Jamie is 18 years old; he lives with his dad in a two-bedroom house. His parents divorced 5 years ago; his mum has since remarried and has another son Simon.

He has limited contact with his mum and has never met his younger brother. Jamie has recently had a first episode of psychosis and is doing well since starting olanzapine 12 months ago.

Although Jamie is no longer experiencing psychotic symptoms, he noticed that he feels tired easily and can get short of breath when walking any great distance.

As his level of activity has decreased Jamie has put weight on. He never really learned to cook, he and his father’s main diet is centred around eating Kentucky fried chicken and going to his local chip shop. Jamie has recently started college part-time, redoing his Maths and English GCSEs something that he has been wanting to do for a while.

Jamie has indicated to you that he would like to lose weight as he is struggling to get into his clothes and feels negative about himself, which is getting him down, affecting his mood and confidence.

Jamie would also like to be more social able and get out more, he often finds it difficult talking to the other students, believing that he has nothing interesting to say and his weight is a barrier to him joining in activities as he often feels slow and sluggish and unable to participate fully.

He also worries about disclosing his mental health difficulties as he doesn’t want to be labelled a ‘nutter’.

Jamie’s mother has recently made contact, she feels bad that they have become distanced and wants him to have a relationship with his brother. She fears his dad isn’t looking after him properly and he might become unwell again. Jamie’s dad had to give up work when Jamie was unwell as he couldn’t leave him alone in the house as there was no one to stay with him. He often worries about his future now he has mental health difficulties. He knows his mother has contacted Jamie and is angry and concerned about how this will affect Jamie’s mental health particularly as he has been doing so well and is finally going to college. Jamie came home after college to find his parent arguing, he could hear them talking about his mental health, how delicate he is and that he may never get better again.

You must initially show your understanding of the purpose and rationale of psychosocial interventions and their relevance to developing person-centred mental health care (LO 5)

You must briefly introduce the case scenario and demonstrate your understanding of the individual and carer/family physical, psychological and social circumstances that are impacting their mental health and wellbeing (LO 1)

You must ensure that that you demonstrate a thorough understanding of the theory that underpins your chosen psycho-social intervention and how it relates to developing person-centred mental health care (LO 5). Show best practice (NICE guidelines) ensure it is current, qualitative and quantitative, use both to strengthen your argument. Show person centered approach, the collaborative point of recovery with the patient and bring in your arguments about the research on recovery.(explore)

You must ensure that you demonstrate how you will work in partnership with your case scenario and apply the psycho-social intervention (LO 5)

You must ensure that that you discuss (using suitable literature) the potential benefits and limitations of the psycho-social intervention for your chosen case scenario (LO 6).

Introduction:

Consider outlining what this assignment will do – which is to apply a psychosocial intervention in a person-centred way to your chosen case study. LO5&6

Define what psychosocial interventions are – there relationship with person centred care and recovery. Outline a model of recovery and discuss how psychosocial interventions can promote recovery. (for psychosocial intervention after briefly talking about the different types, choose Relapse prevention for this case incorporate a bit of CBT, and for model of recovery use recovery star after discussing the various types of recovery model and the rationale for choosing them.) LO5&6

Lead the reader to the stages you will undertake to identify a suitable psychosocial intervention for your chosen case. LO5&6

Main Body:

Demonstrate the person centeredness of your chosen psychosocial intervention based on your chosen case. In each paragraph, ask yourself “so what” does it mean for Jamie

Consider introducing and utilising the 5p’s to determine and support your chosen intervention for your case. Use this formulation to present your case identifying the current risks and areas where psychosocial interventions can be used.( talk about the rationale for using any chosen intervention and also talk about the rationale of using 5Ps . psycho-education is important such as stress bucket and timeline should be used for this essay.) also identify the risk and talk about it. LO1

In choosing an intervention demonstrate its theoretical, philosophical, and psychological underpinnings showing your understanding of the purpose and rationale of the chosen psychosocial interventions and its relevance to developing person-centred mental health care.( define person centred care in mental health and what makes all the chosen intervention person centred?) LO5&6

You must ensure that you demonstrate how you will work in partnership with your case scenario and breaking down how you would clinically apply the psycho-social intervention. LO5&6

You must also critically appraise the relative strengths and weaknesses of your chosen intervention ensure that that you discuss (using suitable literature). LO5&6

You may wish to revisit the 5p’s and how with blue sky thinking if your intervention were to work how would this impact or change the clinical risk formulation. LO1

Conclusion:

Present a summary of the main body and process written about and promote how your chosen psychosocial intervention could enhance person centred care for others who may have similar presentations to your chosen case.

Some resources to use

The 5ps Kuyken, W., Padesky, C.A. & Dudley, R. (2009).

Mac neiln et al(2012)

Delivering person centred care in nursing by Bob Price (2019)

Did the policies of the Reagan administration strengthen or weaken the United States?

Discussion

Min word count 250

In these discussion forums, you are allowed and encouraged to use outside resources for your responses.

Did the policies of the Reagan administration strengthen or weaken the United States?

Response to Ashford

Min word count 150

Ronald Reagan restored a neglected U.S. military and bridged our alliances,leading in the eventual defeat and fall of the Soviet Union. He had a vision that America would be back to doing great things. His goal was not to just heal our economy but to make America have growth in jobs and being the investment leader of the world. He spoke of changed and executed that. He redesigned the taxation system to make it equal for everyone. He dropped the tax rate from 70% to 28%. He reduced non-defense spending and subsidies and price controls. He included welfare cuts decreasing the number of state employees,and halting radical student protesters. Some of President Ronald Reagan’s’ budget cuts weakened the lower and middle classes his presidency ultimately did strengthen the United States as a result of Reaganomics his role in ending the Cold War and changing the ways of the government to better serve the people. The economy recovery tax of 1981 was a start,he believed the solution to problems was trust. He was the first president to write to a Soviet leader which lead to Reagan and Gorbachev meeting five times,which lead to the Range Nuclear Forces Treaty. Overall I feel he did a pretty good job in turning things around for the country.

How should governments respond to health crises that deal with sexual behaviors?

AIDS epidemic

Word count min 200

You should not use any outside sources beyond the actual document to complete these assignments. Your submissions are intended to be your own analysis and reflections, not based on what you found on the internet or work you did with another student in the class (either past or present).

In 1981, the U.S. medical community noticed a significant number of gay men living in urban areas with rare forms of pneumonia, cancer, and lymph disorders. The cluster of ailments was initially dubbed Gay-Related Immune Disease (GRID), but when similar illnesses increased in other groups, the name changed to Acquired Immune Deficiency Syndrome (AIDS). The mid-1980s saw a number of advances toward understanding and treating the disease, but no vaccine or cure was forthcoming. Gay advocacy and community-based organizations began providing services and pressuring government to increase funding for finding a cure and helping victims.

In the following 1983 testimony before a congressional committee, three representatives of social service organizations sharply criticized the Reagan administration’s limited response to the AIDS crisis, advocated increased federal funding, and warned that AIDS was a societal “time bomb” likely to have grave consequences beyond the gay community. In 1995 AIDS became the leading cause of death for Americans aged 25 to 44. One of the witnesses, Mel Rosen of the Gay Men’s Health Crisis in New York City summed up the diagnosis of HIV: “When a person is told he or she has AIDS it is not like hearing that they have cancer, for example. When you have cancer you are told what the diagnosis, prognosis and treatments are. When you are told that you have AIDS you are hearing that you have a time bomb inside of you, that any day you will get an opportunistic infection and one of these infections would kill you, usually within 3 years.”

Read the attached document and answer the following questions:

What is the opinion of the author of this document concerning the federal government’s response to the AIDS epidemic?

How should governments respond to health crises that deal with sexual behaviors?

AIDS Epidemic.docx

What does Reagan mean when he says, “government is not the solution to our problem; government is the problem?” What are those problems?

Reagan’s first inaugural address

Min word count 200

You should not use any outside sources beyond the actual document to complete these assignments. Your submissions are intended to be your own analysis and reflections, not based on what you found on the internet or work you did with another student in the class (either past or present).

Riding a wave of dissatisfaction with the country’s economic problems and apparently diminished strength in world affairs, Ronald Reagan was elected president in 1980. An excellent public speaker, Reagan reshaped the nation’s agenda and political language effectively than any other president since Franklin D. Roosevelt. He made conservativism seem progressive, rather than an attempt to turn back the tide of progress. His 1981 inaugural address reflected how he made freedom the watchword of what came to be called the Reagan Revolution – an effort to scale back the scope of government, lower taxes, and rekindle the Cold War. Americans, he insisted, should look to their own efforts, not to the government to solve the country’s problems. Doing so would reinvigorate the American tradition of respect for “freedom and dignity of the individual.” He ended by invoking the time-honored idea that the United States has a mission to serve as a “beacon” of freedom for people throughout the world. In his public appearances and state papers, Reagan used the word “freedom” more often than any other president before or since.

Read the attached document and answer the following questions:

How does Reagan define freedom?

What does Reagan mean when he says, “government is not the solution to our problem; government is the problem?” What are those problems?

Ronald Reagan Inaugural Address.docx

Based on the results in Table 1 above, what might be a recommendation for improving the internal validity of the stepping test?

. Measurement Internal and External Validity

Below is an example of a study to determine the reliability of a new “step test” to measure functional ability. The step test involved having each subject step forward as far as they could with one leg three times. The time (seconds) it took to perform the 3 repetitions was recorded. 241 healthy subjects aged 18-65 completed the study. One rater tested all subjects. Distance (cm) is a continuous variable so ICC and paired t-test was used to compare reliability between trials.

Table 1. Average Time (seconds) and Standard Deviation (SD) by Trial and p-values between Trials.

1. Based on mean changes from trial 1 to trial 3, and the paired-test p-values, describe internal validity concerns in terms of the type of bias that may be present?

2. Based on the results in Table 1 above, what might be a recommendation for improving the internal validity of the stepping test?

What types of clients and professionals can you generalize these results to? Is this concept internal or external validity?

• The following vignette is from: Rozenfeld, 2017. Test-retest reliability of myofascial trigger point detection in hip and thigh areas.

BACKGROUND: Myofascial trigger points (MTrP’s) are a primary source of pain in patients with musculoskeletal disorders. Reliable MTrP palpation is necessary for their diagnosis and treatment.

OBJECTIVE: To evaluate intra- and inter-rater reliability of MTrP recognition in hip and thigh muscles.

DESIGN: Reliability study.

SUBJECTS: 21 soldiers and officers referred to a military outpatient clinic in Israel (15 males and 6 females, mean age 21.1 years) with lower extremity musculoskeletal pain. Inclusion criteria: 18-30 years old. Exclusion criteria: history of fibromyalgia.

METHODS: Two experienced physical therapists performed the examinations and were blinded to the subject medical condition and previous MTrP evaluation. Each subject was evaluated four times (twice by each examiner) in a random order. The evaluation was performed on both legs and included a total of 16 locations in several areas of the quadriceps and gluteus muscles.

STATISTICS: The outcome of current presence of a MTrP was dichotomous (yes, no). Kappa was used to determine intra-rater reliability for each physical therapist (intra-rater reliability) and between physical therapists (inter-rater reliability)

RESULTS: Below are Kappa values for different areas of the quadricep muscle.

Physical Therapist 1    Physical Therapist 2    Inter-rater

Rectus femoris            -0.04                            -0.02                            -0.04

Middle VMO                 0.66*                            0.77*                            0.64*

Distal VMO                  0.53*                            0.73*                            0.73*

Middle VL                    -0.02                            0.23                             -0.04

Distal VL                      0.46*                            0.64*                            0.63*

* p<0.05

VL=vastus lateralis; VMO=vastus medialis oblique

Answer the following questions based on the above results:

1. What statistical test was accomplished by having each physical therapist perform two exams on each subject?
2. Which physical therapist demonstrated higher intra-rater reliability?
3. Which muscle demonstrated the highest inter-rater reliability?
4. If a physical therapist had limited time to perform a clinical exam for active MTrP in the hip and thigh muscles, what specific areas would you recommend?
5. What types of clients and professionals can you generalize these results to? Is this concept internal or external validity?

Interpret the following statistics from reliability studies.   Check all results that reflect good reliability.

Measurement reliability. For attributes that are measured on a continuous scale, two common reliability statistics are correlation (r) and paired t-test. The intra-class correlation coefficient (ICC) is interpreted the same way as the Pearson correlation coefficient (e.g. larger ‘r’ means stronger correlation between two different measurement methods, or higher reliability). A paired t-test can be used to compare the difference in value between two measurement methods on the same set of subjects. If the paired t-test p-value is <0.05, the two measurement methods are significantly different in how they measure the same attribute (i.e., “poor” reliability).

For categorical variables (such as diagnosing or predicting a condition as yes/no), a common reliability statistic is Cohen’s Kappa. Kappa measures category agreement between two raters. Kappa usually ranges from 0 to 1 (it is possible to get a kappa <0, but it is not common). Although there are many ways to interpret Kappa values, a common method is as listed below (Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977:33;159-174).

• <0 = agreement less than “chance” (50/50 chance with a dichotomous variable, like a coin toss) – this is possible but does not occur often (Viera AJ, Garrett JM Understanding interobserver agreement: the kappa statistic. Fam Med 2005;37;360-63.)
• 0 = agreement equivalent to “chance”
• <0.4 = slight to fair reliability
• 4-0.6 = moderate reliability
• 61-0.8 = substantial reliability
• 81-1 = near perfect agreement

Use your knowledge from previous modules and module 7 lectures, and the above information to answer the questions below.

• Interpret the following statistics from reliability studies.   Check all results that reflect good reliability. (1 each, total 7)

__ r = -0.85

__ ICC = +0.9

__ Paired t-test p=.006

__ Paired t-test p=.85

__ kappa=0.2

__ kappa=0.9

For each question shown below, identify its weakness and improve the question by re-wording.

Survey Question Development. For each question shown below, identify its weakness and improve the question by re-wording.

• How satisfied are you with your diet and weight?
  1. Very Satisfied
  2. Satisfied
  3. Unsatisfied
  4. Very Unsatisfied

• What is your current age?
  1. Under 18 years
  2. 18-29 years
  3. 29-39 years
  4. 39-49 years
  5. Over 49 years

• What is the highest level of school you have completed?
  1. High school diploma
  2. Bachelor’s degree
  3. Doctorate degree

• Don’t you think that there should be a tax on soda in order to reduce the prevalence of obesity?
  1. Yes
  2. No
  3. No Opinion

• How would you rate your general health?
  1. Good
  2. Average
  3. Poor
  4. Very poor
  5. Awful

In your own words, describe your current quality of life.

. Label the following survey questions as Quantitative or Qualitative

____ A survey with 10 questions asking subjects to rate different aspects of their quality of life after a brain injury using a scale from 0-10. This survey results in a total score from 0 (poor) -100 (good).

____ A question asking persons with brain injury: “In your own words, describe your current quality of life.”

____ An open-ended question asking college students: “What are the current causes of stress in your life?”

____ A question asking college students: Rate your current stress level on a scale from 1-5

Discuss the capital structure of the company using the company’s balance sheet in the context of the Modigliani and Miller and trade off theories on capital structure and prepare a constructive critique of these theories.

Discuss the capital structure of the company using the company’s balance sheet in the context of the Modigliani and Miller and trade off theories on capital structure and prepare a constructive critique of these theories. Your discussion should involve various balance sheet items such total equity, total debt, and other relevant information. • See example paper