Psychology

Biopsychosocial is a model or an approach that portrays biological, psychological and social factors play a very important role in human functioning in relation to diseases and illness (Plante, 2005).

 The importance for using Biopsychosocial Evaluation is that it is a useful tool in gathering all-important information on the client. The most crucial information obtained from a client is presentation of problems, previous treatments, medications, family history as well as current mental stasus.This form also happens to be the protocol form used for new clients in the horizon for intakes, which is very helpful to the therapists. I found this form is useful in helping the therapist build a rapport since it shows the client that we are leaving no stone unturned in terms of getting all the possible information we could use to better serve the client.

DISCUSSION
The most crucial step when one discovers that he has depression is to understand how it affects you and its origin. Many people who are faced by psychological depression mostly originate from primary support. When focus on the person I assessed I discovered that this problem mostly originate from family disorganization.

Findings
Primary support is very important when dealing with depression (Plante, 2005). From my assessment, I discovered that the origin of the 11-year-old caucasin female child depression is hopelessness originating from parents divorce. She has withdrawn from her mum who could be of great help to her and the dad is emotionally not available. She was diagnosed with adjustment disorder with depressed mood. All that she needs is socialize with others and family reunion. Some of the abilities and strengths of the victims enable them to cope with the problem.

CONCLUSION
A comprehensive evaluation of the patient should be done which should be conducted through interviews. Ecological information is gathered from the client or from the family.

Victims with depression disorders are required to undergo family therapy concurrent with medical management. A clinical  therapy should be taken for 2-4 months for one hour and a 3-6 months assessment completed by an intern and a supervisor.

When a child is born, various developments begin to take place that continue through adolescence and all the way to adulthood.  While a child develops in all areas, cognitive development takes place alongside other forms of development. It refers to development in terms of perception and reasoning, language development, information processing, intelligence and other areas of brain development.  Since all these areas of cognitive development have been extensively studied by different psychologists, this paper shall narrow down to language development. In addition, it shall explain the issue of language development at different stages during infancy and the factors that can facilitate and hinder the whole process.

Language Development During Infancy
During the process of brain development in children, the ability to comprehend, communicate and produce spoken language develops. This process takes place as infants use their sight and hearing senses to acquire information from the surrounding and learn to process meaning of that information. They use their own senses to imitate the sounds from their environment and end up creating their own sounds so as to communicate. Language development is a normal process in children and takes place effectively if the brain is normal and the senses are functioning properly (Oswalt, 2007).

Since language development is greatly influenced by the environment, it is very important to have babies exposed to people who are communicating to help them develop language efficiently and effectively. Due to this, care takers and the parents are advised to communicate and interact with children regularly. At this point, it is important to discuss language milestones during infancy.

At birth, infants usually communicate through crying. However, it is important to note that even at this particular stage, they also learn about spoken language. Since their vision is not usually developed to enable them see far, they copy the mouth movement of their caretakers and by the second and the third month, they learn to make exaggerated vowels especially when they are emotional. This is facilitated by the development in their lynx. At the third month, infants begin making some consonants sounds and by the fourth month, they begin putting the vowel and the consonant sounds together.  It is at this stage that they become very fond of blowing bubbles so as to practice controlling their mouth and their lips as their brain continue to learn how to interpret communication. At the five month they begin using the non verbal communication as well as learning the sound patterns in their environment. Babbling begins at the sixth month which allows them to learn how to imitate a whole sentence as well as forming verbal thoughts (Oswalt 2007).

Major developments take place during the last half of their first year, as more accomplishments are noticed during this stage. By the seventh month, they learn how to speak with other people, other than speaking at the same time and they can even initiate a conversation. In the eighth month, they learn how to connect the sounds with idea and thoughts and they also continue to add new consonants and new vowels. Babies then begin to say their first words, and by the end of that year they may have about three words in their vocabulary. However, they may only be in a position to speak a few words although they may comprehend more words.

According to the studies of Oswalt (2007), it is during the first half of the second year that toddlers begin to use more words but they can use one word to refer to different objects. They learn the names of people who are important to them and the names of their play objects. In addition, they use word with emotion emphasis to put up a question or a request. At the second half of their second year, they begin using telegraphic speech as they can put two words together to form a simple phrase. Although their sentences are usually very basic, they can name their body parts and talk about them. The more they grow, the more their words increase although they may not be in apposition to pronounce all the words perfectly. Various researches show that at infancy stage, children usually have the ability of learning multiple languages.

Importance of Language Development
There are many achievements that occur during the early childhood but language development is the only one which is the most visible. Since language has very many and different functions, language development is very essential and significant.  Through language development, a child gains social understanding since she can understand what is happening in the surrounding.  In addition, the child can learn how to interact with the immediate family members and other people in the society which in turn helps in development of other social skills. The same helps the children learn about the world and the environment.

After acquiring a language, children are usually in a better position to share their experiences with their peers and their parents and the same promotes learning. In addition, they can be in a position to communicate precisely about their needs. During the early infancy, children only cry as a way of communication and they are often misunderstood.  With acquisition of a language, such instances are greatly reduced or even eliminated.

Language skills are very important during the schooling years since they help greatly in learning how to read and write. Research has indicated that language skills are very important in reading since children with good language skills are also very effective in reading and writing.  This clearly illustrates that language development forms a foundation for future education achievements. In addition, a problem in self expression and understanding others can be eliminated as it leads to other emotional adjustment and psychosocial problems (Mandleco, B.H. 2004).

Comparison Between a Media and a Scholarly Resource
The information about language development is available both in media and scholarly articles. Both may address the same issue, but a scholarly article is usually written by professionals after conducting research to verify the information but a media article may contain information that is not verified and can be written with any interested person even if the person is not a professional in that particular area.

For a long time, there have been issues indicating that language development during infancy is affected by various factors like the watching of the television.  Many people have in turn written about the same. For the purpose of this research, a media article by Park (2009) and a scholarly article by Zimmerman, Christakis,  Meltzoff (2007) shall be reviewed. Both articles address the issue of language development and specifically how television watching affects children below the age of two years. The two articles contain the same information since they state that TV watching during this period of child development slows down the rate of language development. Both clearly illustrate that television watching by children below the age of two years is destructive and should not be recommended at all. 

The articles clearly illustrate that television watching reduces the time for interaction between the child and the parents or the caregivers, and since the interaction facilitates language development, children who watch television are bound to experience some problems in the acquisition of language. Majority of the children who watch television at this age also have their parents affected by the same such that communication between the infant and parent becomes very limited. The same studies argue that although children learn from what they hear, television is a passive mode of communication and does not provide the same effect as parent-child communication. Moreover, when the television is on, children spend more time in silence and solitude than they do in social interaction. Both conclude that even the DVDs that are designed to help children in cognitive development have the same effect since they reduce verbal communication (Park 2009,  Zimmerman, Christakis  Meltzoff, 2007).

Nevertheless, anyone researching using the two articles is bound to notice some outstanding differences. Information may be the same and accurate but one would be tempted to rely more with information from a scholarly article. This is due to the fact that such information is more comprehensive, apart from being compiled by professionals.  The scholarly article reports empirical research findings from a research that was conducted to research the issue of the effect of television watching by children below the age of two years. The methodology, results and analysis are clearly illustrated and explained before making any conclusions. On the other hand, the media article reports about the research findings of other people since the author has not conducted any research on the same.

Information from the scholarly material is more specific, hence why it can be more reliable. Although the bracket age is 0-2 years, the study only addresses children between eight to sixteen months. Specific issues that relate to the watching of the television are reviewed extensively.   The issue is also discussed from different perspectives for instance it is mentioned that poor language development can also lead to increased watching of the television. The fact is the scholarly article deals with the issue comprehensively and extensively.  On the contrary, the media article seems only to summarize findings from different sources.  As the author is short of information, it is not possible to provide comprehensive information and to discuss different issues. However, both articles are useful but for education purposes it would be advisable to rely on information from scholarly articles.

Application
The information about language development is very important and is significance to each and every person. It can be applied by someone as a member of the society, as a professional and also as a parent.  As a professional one can use the information to provide professional guidance the caretakers and the parents on issues concerning language development in children.  Information can be provided on the importance of interaction between the child and the caretakers on enhancing language development. It would also be important to provide the caretakers with information concerning language development at various stages during infancy period. Moreover, one can use the information to diagnose language impairment during practice.

As a parent, the information is equally important.   I will be in a position to engage my children in effective communication to foster their language development.  Sometimes parents fail in parenting due to lack of enough knowledge on issues concerning development in young children.  I will also be in a position to monitor the rate of development as it is vey important, since one can identify a problem and seek help immediately.   Moreover, with the knowledge of the importance of language development during infancy in other areas like reading and writing, I will use all the measures to ensure that language development in my children takes place effectively.

Finally, as a responsible member of the society, I can use the information to ensure that all children in the society develop effectively. This can be achieved by arranging seminars and workshops with an aim of equipping parents and care takers on the knowledge of language development in children. Moreover, since various research findings have revealed that watching television for children below two years is destructive, I can put up campaigns that will discourage the caretakers and the parents from exposing their infants to television before the age of two years.  Given that there are social policies that protect children, the issue of children DVDs should be addressed therein so as limit or eliminate them from the market.  Advertisement about the same should be eliminated from the media to reduce the influence that makes ignorant parents purchase them and eventually use them while raising their children (Park 2009,  Zimmerman, Christakis,  Meltzoff, 2007).

Conclusion
Language development as highlighted earlier in this research is very significant since it is a visible achievement. It starts right from birth and continues systematically as other forms of development.  It becomes more sophisticated as the child progresses in age.  In each stage, a child learns something new until finally the language is effectively acquired. Although a child at this stage usually has the ability to acquire many languages, she learns first the language of the parents or the caretakers. There are barriers to effective language development like above discussed issue of television watching. All factors that limit verbal communication between the infant and caretakers affect the issue of language development. Since language is vey important in the life of a human being,  measures ought to be taken to ensure language development more so in infant stage takes place effectively.

A Comparison on the Data Analysis Method of the Studies

There are two research studies that are similar in the area of interest specifically having the sample population who are Filipinos working in the States.  The difference of the sample population between the studies is that the current study investigates the reasons why Filipino overseas contract workers chose to migrate and work in a foreign land rather than in their native land, Philippines, while the other study focuses on the levels of stress among Filipino registered nurses in the States.  The multicultural study on Filipino overseas contract workers in the US would require the use of both quantitative and qualitative types of data (Appelbaum et al, 2009).  On the other hand, the other research focusing on the levels of stress among Filipino registered nurses in the US made use of the Expanded Nursing Stress Scale (ENSS).  The similarity of the two studies is that both used a mixed method gathering data based on the responses of their respective sample population.

The multicultural study on Filipino overseas contract workers in the US and its data will be better understood when the responses are expressed in a descriptive form and in quantitative information.  Thus, the current study utilized a mixed method, which is quantitative and qualitative.  The data are based on the following questions asked to the sample population the better acceptability of Filipinos in US, what is the major reason that attracts some Filipinos to US, is there gender skewness in the movement of some Filipinos to the US (American Psychological Association, 2002), and the level of protection of legalities of these Filipino as overseas contract workers in the US.  The quantitative information, according to the study, are those percentage of Filipino population in US across different periods of time, 

A data analysis method used on the study that explores the stress levels of Filipino registered nurses in US emphasizes on the use of a scale called Expanded Nursing Stress Scale (ENSS) by French et al. (2000) without any need for identifying information.  Thus, the study concealed the identities of the participants. 

Upon comparison, it is noted that the current study does not use any measuring scale to gather important and pertinent data of the sample population.  The topic of interest is limited to the reasons and motivations on why Filipino overseas workers chose to migrate in the US.  Hence, there is no appropriate scale to facilitate in the process of data gathering.  I am therefore confident in the method of data analysis for the current study.  The challenge is to administer the structured questionnaire and interview as efficient as possible.  Additionally, the most updated and recent statistics should be secured for the purpose of having reliable data.  The ethics of confidentiality and privacy are two ethical issues that is crucial to social researchers who, by the very core of their research, typically requests participants to share them their perception, attitudes, thoughts, and experiences (Gregory 2003).  The question of ethics also plays into the method of data analysis when it comes to protecting the identities of individuals and the companies they work for.   The modification that should be applied to the current study is to omit any identifying information of the sample population upon data analysis and interpretation. 

Counseling may be defined as therapy through talk and expression of feelings and thoughts. Rogers (2007, p. 85) defines counseling as a relationship between two people in a democratic atmosphere of understanding and respect, and that most counseling sessions fail because of the failure to establish such a relationship. A counselor listens to a clients needs, responds appropriately and mediates to achieve the outcomes that the client desires. Counseling skills are more of an art than a science and should be combined with genuine concern and empathy for the patients and their families. Skills such as listening and reflecting cannot be taught and can only be acquired through experience and a genuine desire to help another person. It is different from plain communication because counseling requires some form of action afterwards in the hopes of positive change. (Nelson-Jones 2005, p. 19) As such, counselors must always be vigilant against imposing their own personal value systems and be reflective in their practice, constantly monitoring for personal reactions and thoughts that might mar the therapy (Rennie 1998, p. 5).

Among the most basic of counseling skills include the ability to make effective and positive communication with the client and for the client to be, regardless of the context with which the counseling is being sought (Sanders 1996, p. 4). Anybody can use counseling skills to help another person, but counseling is formal, with specific goals and outcomes. It is also bound within certain contract of ethical practices of confidentiality and professionalism. (Bond 2000, p. 33)

Integrative Counseling
The integrative theory of counseling, as the name implies, involves the fusion of several school of thoughts about counseling. It collates the best practices among diverse ideas in order to provide the best experience for the client as well as the counselor. Counseling as a general concept, may be defined as therapy through talk and expression of feelings and thoughts. Rogers (2007, p. 85) defines counseling as a relationship between two people in a democratic atmosphere of understanding and respect. A counselor listens to a clients needs, responds appropriately and mediates to achieve the outcomes that the client desires. Counseling skills are more of an art than a science and should be combined with genuine concern and empathy for the patients and their families. Skills such as listening and reflecting cannot be taught and can only be acquired through experience and a genuine desire to help another person.  It is different from plain communication because counseling requires some form of action afterwards in the hopes of positive change. (Nelson-Jones 2005, p. 19) As such, counselors must always be vigilant against imposing their own personal value systems and be reflective in their practice, constantly monitoring for personal reactions and thoughts that might mar the therapy (Rennie 1998, p. 5).

Because patients are unique in terms of their illness and personal circumstances, counselors should be able to use a variety of techniques depending on the situation of the patient, and this is the essence of integrative counseling. The cornerstone of any counseling is based on the presumption that mental and emotional illnesses are related to how people perceive and respond to life events and situations, and as such, are largely functions of the persons coping mechanisms (Clark 2007, p. 108). Counselors should be able to apply knowledge of psychotherapy to reduce the emotional and psychological distress of the patient as well as the distress of their loved ones. These techniques are part of a long-term management and intervention program because their benefits take months to manifest and require constant and consistent provision of support from the counselors.

Theories of Counseling
What is confusing about counseling theories is that is so easy to create one, while anchored on another. The basic ones include psychoanalysis introduced by Freud. Initially, Freud maintained that behaviors are motivated by repressed sexual desires. Later, this psychoanalysis was reconstituted to mean that man behaves out of certain emotional, social, or physical need. The behaviorist theory led by Watson and Skinner believes that man reacts to a system of rewards and punishments, that their behaviors are responses to the perception of consequences. The third is the humanistic theory where the counselor is perceived to act as a catalyst in order to bring the client to a sense of clarity and self-empowerment. The rest of the theories are just variations on these three basic theories of counseling. (Gregoire  Jungers, 2007, p. 61)

All three have their own merits and are responsive to the times when they were created. None is better than the other. I do not believe that counselors should rigidly subscribe to one idea alone. Counseling deals with human beings, who are inherently mutable and cannot be boxed into certain theories. Each client is his or her theory and story because each life is unique in its circumstances. To impose one type of theory is to deny the inherent uniqueness of individuals.

Gestalt The Whole Person
Gestalt counseling and therapy follows a humanistic approach to psychotherapy. That is, dealing with problems that make up human life, e.g. love, fear, pride, self actualization, belonging, individuality, and creativity among others. A cornerstone of this form of counseling is that it encourages the free-flowing awareness (Joyce and Sills, 2001) of ones thoughts and emotions. When the clients are able to acknowledge and deal with their personal issues, the individual comes to a better understanding of himself and others as well. (Joyce and Sills, 2001) It is also person-centered meaning that it lends itself more to personal relationships in the client-therapist interaction and the main goal is to push the client to a state of realization of ones self. The Gestalt therapy is more realistic and rational as compared to other therapies that focus on past events that may not have any relevance to the clients current situation. (Clarkson, 2001)

In Gestalt therapy, the therapist affirms orgasmic trust between herhim and the client as well as nurtures or encourages the client to be confident and have a faith in their own thoughts. The hallmark of Gestalt therapy lies in the ability of a client to articulate feelings and own his freedom and limitations so as to live a fulfilling life and contribute to the lives of the others. (Clarkson, 2001) Genuineness is essential in the Gestalt counseling or therapy session. This means that the therapist should not exhibit a facade or a professional front.  It is all about being you in this therapy and indeed, this increases the odds of the client experiencing constructive growth and behavioral change. The therapist-client relationship is transparent letting each other in on the flowing emotions in the here and now moment and even when a client may feel uncomfortable to let out some feelings or attitudes, this should not happen on the part of the therapist. (Clarkson, 2001)

Another core concept in the Gestalt relationship between client and clinician is that of unconditional positive regards to the client. Notably, human beings tend to relate better with some individuals than others.  It may therefore be difficult to show acceptance and positive regards to some clients especially when the feelings they express are contrary to the therapist morals and values. Nonetheless, Gestalt therapy points out that therapeutic healing is more likely to occur when the client has positive regards for the client, irrespective of the current feelings or emotions being expressed i.e. anger, hate, fear, pride, disgust, confusion and so on. That is, the therapist should prize the clients in a total rather than a conditional way (Rogers, 1980, p 115 -116).

Empathy is perhaps the most important and facilitative aspects of the gestalt psychotherapy (Rogers, 1980). That is, herhis ability to sense the feelings and meaning to feelings expressed by the client and communicate them back in an understanding way. (Adams, 1986) The therapist must explore the clients world and classify underlying meanings that the clients may be oblivious of. In this client- therapist relationship it is all about listening, active listening and understating for that matter. (Joyce and Sills, 2001)  The session is characterized by non-judgmental, sensitive communication. In cases where these feelings are not understood then seeking clarification using a paraphrase of the client word expresses understanding and leads to self awareness, for example, I hear your say that you are unable to understand why you are always furious with your wifehusband, why do you think that is the case (Adams, 1986)

The Therapeutic Relationship
How then a therapist should perceive a client Frankfurt (1971, p. 6) defines a person as a creature with the capacity to fulfill needs and desires in ways that indicate free will and reasoning. The person is able to identify these needs and desires and acts in deliberation and free will in order to achieve such desires. The person, acting in such capacity, is fully aware of the motivations that lead him or her to such actions. A person is a unique creature and stands apart from other animals because humans have the ability to deliberate on desires and make the appropriate choices and actions based on their free will. The persons free will and reasoning enables him to make appropriate actions and whether to repress these desires or pursue its fulfillment. Unlike animals that are driven by instinct and basal needs, a person has the ability to exercise his free will and reason and make a choice on what actions to take. Raz (2006, p. 3) elevates the concept of personhood further to emphasize the role of reason in the exercise of free will. Raz maintains that it is reason that determines if an individual is truly using his free will or not. Given a variety of desires and needs, the person, guided by reason, decides on what desires to act on, if at all. The choices are based on the individuals ability to evaluate and prioritize desires and recognize motivations and ascribe to them values of right and wrong. (Watson, 1987, p. 217) All these things, a counselor must keep in mind to best provide the help needed.

The Dignity of Self and the Roles of the Counsellor
As far as counselling is concerned, the main task of the counsellor is to facilitate the self-discovery and to empower the client to make positive choices that would change his or her life for the better. Much of the job of a counsellor is all about uplifting the individuals sense of personhood and help the client claim that sense of personal responsibility and empowerment. Of course this can only be achieved by subscribing to Carl Rogers core conditions of counseling. First, counseling can only be achieved with direct, personal and psychological contact second, that the client is assumed to be in a state of vulnerability or weakness that requires outside intervention or help third, that the therapist is the stable factor in the relationship and thus provides the anchor for the relationship to progress and achieve its goals fourth, the counselor of therapist has sincere benevolent feelings for the client irrespective of their differences in values and beliefs, fifth, that the therapist has a genuine understanding or empathy for where the client is coming from or the clients frame of reference and last, that the positive feelings of the therapist towards the client is made known and clearly felt by the client. (Barrett-Lennard 1998, p 86). All of these core conditions are based on the fundamental ideas of a persons basic liberties and rights and these are implicit to a therapeutic relationship, only brought to formality by Rogers (Thorne 2003, p. 36).

Reflections
Indeed the main task of a counselor is to be able to help the person feel empowered. Rather than making the individual feel helpless, the best counselors give their clients the sense of control and decision over their own lives. As much as possible, the counselor must leave very little footprints in their clients lives because the guidance that they give creates an empowered individual capable of self-determination and self-actualization. The journey towards liberation is not solely the clients responsibility alone. While ultimately the choice to do so is in the client, such a choice cannot be arrived at without the counselors help (Prout  Brown 2007, p. 223).  Indeed the job of a counselor requires extraordinary people skills because it involves the treatment of an emotional malady, which is already complex all by itself. I am cognizant of the many issues that can sometimes get in the way of the proper dispensing of counseling and therapy.

As with any other type of relationship, the success of a counselor-client relationship is dependent upon mutual trust and respect. Of course, the therapeutic relationship between counselor and client is unique because of the dynamic of power that exists between the two. Given the nature of therapeutic situations, patients often feel helpless, emotional, and rarely have time to deliberate their decisions. Control and power is perceived to be in the hands of professionals such as counselors, whose decisions can decide matters of that have profound effects of a persons quality of life. There is always an imbalance of power in a counselor-client relationship (Feltham 1999, p. 9) and it is so easy to fall into a dictatorial relationship. As such, counselors should demonstrate sensitivity, empathy, and they should exhaust all means to make patients feel that they control their decisions, especially decisions regarding their own body and their life. The perception of power is based on the counselors clinical and professional expertise and the ability to help a patient in distress. By virtue of their education and experience, counselors are thus able to provide care and healing services to patients. Counselors themselves do not make claim to that power, it exists naturally when patients seek their help and expertise. 

When there is an imbalance in power, then it is but natural to assume that patients or clients put their trust in the power of counselors and other health care professionals to give them the assistance that they need. Therefore it is very important that counselors live up to this trust and the responsibilities of power. To do so, counselors must have the competencies and skills needed to provide therapeutic services. This is the reason why minimum standards of competencies and education are required before counselors become clinical practitioners. Of course it is not enough that counselors pass standardized exams they must constantly engage in learning as newer, better modalities of practice come to light. An important part of this knowledge is the ability to acknowledge limitations and the willingness to seek help from other professionals in order to provide the client with the best possible care. The power to help necessitates the ability to ask for help as well if it means saving a life or improving the quality of life of patients.

Another important element of trust is the expectation of professional conduct. Counselors are expected to behave within a certain code of conduct as prescribed by their profession. This includes the provision that counselors are expected to at all time maintain appropriate professional boundaries in and therapeutic relationships with clients, and that all activities and discussion are related to the health needs of the patient. This includes the implicit agreement that all exchanges between client and counselor are confidential and that such confidentiality cannot be breached, unless the client becomes a danger to himself or to another person. It is only within these strict provisions can confidentiality between client and counselor be broken. The law generally protects such confidentiality, but will also uphold the need to break it. (Jenkins 1997, p. 128)

Another component of a counselor-client relationship is respect. A big part of respect is the ability to suspend any form of judgment and focus on the clinical task at hand. Whether we agree or not, counselors are also prone to passing judgement, especially since they are not the ones facing the illness. What is important is that these judgements and feelings should not be allowed to affect the counselors clinical decisions. Often counselors are preoccupied with dispensing their duties and addressing the specific mental and emotional needs of the client, that they have the tendency to forget to consider the whole patient.

Indeed a therapeutic relationship is highly focused and purposeful. The centre of all endeavours is the achievement of therapeutic goals. A big part of this relationship is the ability to use positive communication to achieve such ends. For a therapeutic communication be successful, counselors must be able to present themselves in a manner that is professional and credible. A big part of communication in a therapeutic relationship is non-verbal or based on actions. Normal communication is not always possible depending on the situation of the client, and counselors must be able to explore other avenues of communication without diminishing the essence of the message. Patients constantly judge counselors based on their manner and character, and a therapeutic relationship can only be established if the patient feels comfortable with the counselor. To do, counselors must convey a sense of warmth and genuine concern, framed within a professional demeanor (Clark 2007, p. 47).

In light of all these things, it is therefore important that counselors have a solid sense of self before they can present themselves properly to their clients and establish a successful therapeutic relationship. All of the previous elements are based on the counselors intimate knowledge of themselves and see their duties as counselors in the context of the clients experiences. Of course counselors must judgments on clinical knowledge. However, as Carper (1978) argues in her work, there are other forms of knowing apart from clinical or scientific knowledge, and these other forms of learning have equal weight and importance in this profession. It is not enough that counselors are trained in the science of therapy and psychology. Equally important, perhaps even more so when dealing with disturbed individuals, is that counselors have the emotional sensitivity to gain the trust of their patients and make them feel that their counselors only have their best interests at heart.

Conclusion
Counselors must take a holistic or client-centered approach in order to keep their clients highly functional in spite of their emotional and mental impairments. By employing a client-centered approach, counselors are thus able to design a program that is tailor-made to adapt to the individuals unique needs and circumstances and this can only be achieved by nurturing a relationship that encourages open communication, communication wherein clients are willing to bare their innermost fears and emotions (Feltham 1999, p. 24).   Counselors provide for their clients needs by lessening their disabilities and  dependency, while advocating for the dignity of the person as human beings, regardless of age, gender, race, sexuality, social class, education, lifestyle, and religious or political beliefs. In simple terms it means that in a counseling relationship, the expertise of the counselor takes a backseat behind the patients needs. Counselors must serve to facilitate instead of dictate, and thus create a democratic atmosphere where the counselor and client are engaged on equal ground (Barrett-Lennard 1998, p. 53).

Indeed the ability to listen and respond to human distress are attributes that humanity must have in order to survive. Such attributes are especially essential in therapy as well, especially for counselors who are front liners in providing care that makes a direct impact of the lives of people. Of course professional knowledge is a given, but in order for this to be of any help to anyone, counselors must have the sense of self that will help them maneuver through different kinds of situations and navigate a successful and effective therapeutic relationship.

In everyday life, we have to cope with situations that require extremely hard work. Although this is crucial for success and financial benefits, employees may suffer from severe health problems. This is due to the fact that occupational demands can exert a negative effect on the individuals well-being. Societies during the industrial and post-industrial era, have been nurtured with the belief that pressure on workforce is necessary for organizations and companies to achieve their goals. However, there is a growing awareness that this view should be challenged and employers and policy makers should focus on protecting workers health and well-being. To do so, it is crucial to obtain an in depth analysis and understanding of the causal mechanisms that lead to work-related stress. In this regard, the present paper will attempt to investigate the impact of work-related stress on employees health.

Introduction
Nowadays, most workers face great challenges due to occupational demands. The majority of organizations and companies invest a lot on labor. Under this perspective, workers are considered assets and companies profit and financial prosperity is analogous to employees efforts (Tennant, 2001). In a similar vein, employers tend to blame their staff, when their business does not gain enough profit. In these cases, employees experience strict work conditions, unnecessary pressure and even face the possibility of losing their jobs. The present study seeks to reveal some of the health hazards posed to workers due to increased pressure at work.

Stress at work
It is true that we all need some motive to appreciate our work and even obtain pleasure from it. This is why people rush to meet deadlines. If our work environment was devoid of deadlines, workers would probably not have much to do and may even find themselves bored. This is a waste of workforce, given that productivity and profits largely depend on workers ability to complete their tasks within certain time lines (Tennant, 2001). In addition, modern life is full of struggles, satisfactions, frustrations and endless demands.

For most individuals, stress is the rule and an inevitable aspect of life. Although it is generally considered harmful and counter-productive, there is also the view that it may carry beneficial effects. Stress can motivate people to be more productive and to cope more effectively with pressuring situations, maximizing their potential (Bambra, 2007). However, it can have a negative impact when it exceeds peoples coping ability. At such an instance, stress may even compromise peoples physical and mental health. Financial activities are constantly changing and employers are struggling to produce products that meet consumers needs (Bambra, 2007). In this respect, workers are placed under a great amount of pressure to meet the challenges of a constantly evolving labor market. As consumers demands change, so do workers expertise and required qualifications. For example, a company dealing with phones may discover that mobile phones without internet services are no longer in demand. The company will maximize its efforts to ensure that enough stock is available for sale (Tennant, 2001). These increased demands may generate additional stress.

Work-related stress poses a great danger to physical, mental and social well-being. Working involves the use of physical, emotional and cognitive resources. For example, if an individual strains in manual work, like carrying a heavy load, he or she may experience bodily pains. The same applies for people who do demanding brainwork, which may lead to mental fatigue and compromise their psychological well-being. In light of these observations, we can assume that work-related stress not only adversely influences workers physical health, but its effects extend to psychological functioning. Stress at work is a reality and may have a positive component, namely it can motivate workers and increase their productivity- maybe this sentence is not necessary and should be erased.

As mentioned earlier, most organizations are constantly facing time and environment changes hence pressure at work urges workers to cope with the novel circumstances.  Most governments have recognized the fact that work settings pose a great danger to health. Policies to ensure workers safety have been implemented. The U.S. National Institute for Occupational Safety and Health (NIOSH) has established categories of prevention and has developed a summary of intervention levels. Primary prevention refers to any action to protect the health of people who have not yet become sick.
Secondary prevention involves early detection and prompt and effective efforts to manage illness at an early stage, before major complications arise (for example, reversing high blood pressure and preventing arterial plague formation before a heart attack occurs). Tertiary prevention consists of measures to reduce or eliminate long-term impairments and disabilities and minimize suffering due to an existing illness (for example, rehabilitation and return to work after a heart attack) (Landsbergis, 2009).
Impact of work-related stress on health

Rapid economic growth and sharp rise in consumer needs may create occupational demands intolerable for workers, leading to inadequate coping. Through this pathway, pressure arises among employees. Stress escalates and the majority of workers become vulnerable to depression or insomnia. There are also occupational consequences such as job dissatisfaction, decreased commitment to the organizations agenda (Bambra, 2007), decreased performance and failing to report to duty or non attendance. Ellis argues that in early stages, work-related stress can stimulate the body and enhance occupational performance, hence the phrase I perform better while under pressure. However, if this condition continues unmanaged and the body is further stimulated, productivity will eventually decline and the persons health will degenerate (Allis, 2005).

There is a wide variation on how people react to work-related stress and these reactions depend on the amount and the duration of stress. Typical symptoms include insomnia, loss of mental concentration, anxiety, depression, sexual problems, alcohol and drug use, diabetes, heart disease, migraine, headaches, high blood pressure, digestive problems, skin rushes, sweating, blurred vision, tiredness and sleep problems, muscular tension, stomach and back problems. Work-related stress may interfere with family life. There are cases where spouses fail to fulfill their conjugal obligations.- this I think should be erased- Employees emotional and sexual life can be adversely affected, due to mood swings, poor appetite and demoralization.

In a study conducted by Greiner et al., (1998), in a random sample of over 300 German medical doctors and consultants, several job-related variables and sociodemographic data were assessed, including time-related parameters work, and specific categories of accidents (moving vehicle and work-related). Occupational stress was found to be related to weekly working hours, lunch-break duration and age. The number of moving vehicle accidents was significantly correlated with the incidence of work-related accidents during the last year. There was no evidence that medical doctors working longer weekly hours were more likely to be involved in a driving or work-related accident per se, but they did tend to report more accidents during house visits. Moving vehicle accidents were best predicted by the onset of working day, as well as the number of dependent children (more children were associated with fewer accidents). Furthermore, work-related accidents were significantly more frequent in larger communities and when surgeries lasted longer (Tennant, 2001).

There has been an ongoing observation on the impact stress has on peoples general health. One out of ten people we meet in everyday life is over stressed at any given moment. Scientists agree that stress causes detectable chemical changes in the brain, and these changes can influence health status (Cornforth, 2007). Stress has been associated with numerous somatic complaints, cancer and chronic fatigue syndrome. Women are vulnerable to menstrual disorders. Hormonal imbalances as a result of stress may trigger the symptoms of fibroid tumors and endometriosis, leading to infertility and sexual dysfunction (Greiner et al., 1998). High blood pressure, heart attacks and stroke are also serious stress-related cardiovascular conditions.

Stress may interfere with female sexuality and cause sexual difficulties such as decreased desire and vaginal dryness. As outlined earlier, emotional problems may also arise including depression, anxiety and sleep deprivation. Gastrointestinal disorders, for example, ulcers and lower abdominal cramps constitute frequent manifestations of stress. In most cases, people suffering from work-related stress are more vulnerable to infections due to dysfunction of the immune system (Greiner et al., 1998). As noted earlier, work-related stress not only affects physical functioning, but also disturbs psychological well-being. It may have major psychological consequences. Busy schedules, arguments between colleagues or line managers with their junior staffs, accountants under pressure to settle bills or inconveniences due to traffic jam are all paradigms of typical situations where work-related stress may emerge.

Under pressure, the body exhibits intense physiological reactions, similar to those when the individual is threatened and has to make a choice between life and death. This is an unpleasant situation and can produce a large amount of bodily tension. Workers with lots of duties, responsibilities and worries due to deadlines, respond to stress in a hyper-vigilant way. In fact, there are workers who have to deal with similar situations throughout their working lifespan. Such long-term exposure to stress may be translated to serious health problems and long-term complications. This is what is referred to as chronic stress, which actually disorganizes almost every bodily system. It may contribute to the emergence of hypertension, myocardial infraction, impotence and even premature aging.

It would be of paramount importance not only to examine the impact of work- related stress on health but also to delineate its causes and devise proper management strategies. In most cases, employees generally agree that work is a major source of stress in everyday life. This is vividly outlined in comments like I had a very busy day or had a stressful day with my client or my boss does never understand. As noted in an earlier article published by Bupas Health Information Team in the context of Health and Safety Executive Survey (Greiner et al., 1998), one out of six working individuals in the UK report that their job is very or extremely stressful. Work-related stress is also one of the commonest reasons for sick leave (Bupa, 2008).

Some of the causes associated with stress include vulnerable and miserable working conditions, prolonged working periods, disturbed colleagues relationships, diminished job security, transport and commute difficulties, company management and low salaries and wages (Greiner et al., 1998). There are employees who feel under worked or overworked or feel that their job description does not match their qualifications, for example, when one is supposed to serve as an accountant but assigned as the front office manager or receptionist. In these cases, work does not provide satisfaction to the employee. In rare cases, people report a particular cause of work-related stress. Work-related stress may arise due to sudden, unexpected pressure or in the context of a set of stressful factors that progressively develop.

As mentioned earlier, pressure is inevitable at the work place. In strict sense, no work without pressure is feasible, therefore employees need to develop appropriate coping skills, to deal with stress successfully. The negative aspects of work-related stress need to be pruned in a number of ways. For example, every employer should display interest on how employees function at work, thus boosting their self-esteem and increasing their productivity. Good management of time is necessary, for example, when one is caught up in traffic and cannot get to work in time, an effective strategy would be to leave home earlier. If one is faced with many deadlines and tasks to perform, it would be extremely useful to prioritize them according to importance and urgency (Cornforth, 2007). Through team work, one can delegate some of the work to other colleagues. Break and relaxation is also highly recommended. There are employees who want to do many tasks in parallel, instead of doing one task at a time. Managers should create a good working environment, where each employee can feel comfortable and accepted (Foss, 1998). Organizations should at least, have a health and safety officer who can ensure that proper mechanisms have been implemented to safeguard workers from manageable causes of work-related stress.

Conclusion
Work-related stress is a phenomenon that will continue to affecting employees lives. We have emphasized the associations between working conditions and stress. It is clear that we cannot eradicate it from our reality as workers, and for this reason I strongly underline the need to develop effective coping skills. Government and state authorities should implement measures that address basic workers needs and rights, to protect them from health risks due to work-related stress. Any employer or organization who deliberately fails to provide a comfortable working environment should be considered to commit an offense. In addition, a specific policy should be established to compensate working personnel for physical and psychological suffering due to work-related stress.

The relationship between the psychological state of being of a person and that persons behavior is a subject that has been studied for a long time and whose insights have been critical in not only understanding human behavior but also how this behavior can be or is responsible for the various disorders that people suffer from. Human beings, unlike animals, have an innate ability to exhibit behavior that is representative of the persons state of mind, past events, and nature of relationships one has been able to have in the past. It is almost as if mankind will never let go of any of the issues one experiences in life (Freud, 2005). Therefore, there comes a time when some unspoken truths or undisclosed secrets seemingly turns against their keeper and forces one to disclose them not by way of speech but through actions. These and many other closely interrelated aspects constitute the wide field of psychoanalysis. Apart from seeking to offer insight into the relationship between human behavior and hisher psychological state of being, psychoanalysis, as it was developed by Sigmund Freud - a renown physician from Austria, is also widely applicable as a method that is used in the investigative study of the working of the human mind and a method applicable in the treatment of ailments which have an emotional or psychological basis (Freud, 2005). In other cases, psychoanalysis has been used to give a generalized description of the many theories that have been formulated and fronted to explain the behavior of human beings. This paper endeavors to offer a concise and succinct description of the psychoanalytic treatment situation, method, and attitude and then to provide a thorough discussion of how psychoanalysis relates to the goals of interpreting transference and resistance.

Psychoanalytic Treatment
Freud, who is undoubtedly the father of psychoanalytic treatment and theory, proposed a set of ways which he believed played a critical role in determining the final state of a client who was suffering from a certain psychological or mental condition (Freud, 2005). A typical aspect in his approach to psychoanalysis is the case where he presumes that a given analytical patient, whom he gave the name of an analysand, is put or finds oneself in a position where one is able to change ones feelings and behavioral pattern into verbal words or statements (Freud, 1989). This is important because only what is put into words or verbalized is able to be communicated to the analyst so that the appropriate methods of treatment can be sought and used on the client. This ability of the analysand to verbalize ones thoughts is in essence the only way through which there can be an uncovering of the underlying state of mind or psychological climate in order to be addressed appropriately.

Human Suffering and the Subconscious Mind
According to Freud, many people who suffer from psychological and mental conditions are not fully able to understand what they are going through on their own (Freud, 2005). Therefore, there is always a need for the analyst to ensure that the client is brought to the point where heshe is able to be made to understand that one is sick or suffering from some condition as proved by ones behavioral patterns or the other symptoms that are either as a result of exhibiting the given behavior or directly attributable to a certain psychological condition that has been studied and documented in the past. This state of suffering by such clients is usually an unconscious one which they can live with andor fail to admit that is indeed a threatening condition in need of being addressed medically (Freud, 1989).

Such clients experience internal conflicts unconsciously and, therefore, require the analyst to uncover the possible causes of these conflicts through a process which allows the client to verbalize ones thoughts. These thoughts can be dreams, fantasies, or free associations which the client might have kept deep within ones heart without necessarily desiring to do so. The analyst, using the training and skills derived from psychoanalysis and the relationship between behavior and mental state, is able to get the client to a point where one is able to actually understand the problem with one or to have an idea of what might be the key contributing factors (Freud, 1989). The most critical factor in psychoanalytic treatment is for the client to cooperate with the analyst throughout the process. Otherwise there is the risk of absolute failure to help the client  this is in spite of the client sometimes claiming to have no problem whatsoever. Over time, it has come to be established and widely accepted in the field of psychoanalysis that clients are in more ways than they think their own worst enemies, often having to bottle up emotions andor feelings that eat them up, causing mental and psychological distress whose symptoms are exhibited by the client (Freud, 2005). 

From Childhood to Adulthood
A key aspect of the theories put forth by Feud was that the past has a great role it plays in the present lives of many people  and that this is the leading cause of many psychological and mental disorders (Freud, 1989). Psychoanalytical treatment, therefore, is committed to uncovering the past encounters of clients as a key part in the process of helping them get over their symptoms and to a normal life. Without planning it, people have tended to bring the past with them into the present. And, surprisingly, there is no selection between good and bad aspects of the past which people bring to the present (Freud, 1989). Instead, any issues that had a particularly significant effect or impact on a person somewhere in the days gone will tend to replay in the present depending on the frequency with which the present aspect related to or resembling a past event is able to appear in ones life and on the nature of the particular situation or phenomenon as far as its impacts on the client then were (Bettleheim, 1984).

In essence, an issue which happened to a client in the past and had a great impact  for instance caused some severe suffering, pain, anger, or even joy  will likely cause the client to respond more vividly to events in the present life which remind one of the past encounters. All issues, both negative and positive, have an equal level of interplay in the later life of the one affected (Freud, 1989).  A good example is a case of a person who was abused or molested by a father while in ones childhood. While one is an adult, this person will tend to be bothered a lot by any acts of violence in society and the symptoms will be likelihood that such a person will resent any man who appears to have the looks or mannerisms of ones father. Therefore, without any warning, such a person will react negatively, even violently to a person of this nature. Given an opportunity, such people can always cause harm to the people who resemble the figures in their earlier lives who hurt them (Freud, 2005). On the positive side, a client will tend to love ladies in adulthood who look like their mother who was all but very caring and loving toward them while they were young. They will seek to defend them, keep them from danger, and literally go the extra mile just to make sure the person is pleased.

Serial killers are typical examples of people who can be helped only when their past is clearly investigated and they are able to verbalize their thoughts (Bettleheim, 1984). It has been established that most serial killers are acting out of anger from the past, where their victims are people who exhibit characteristics that are similar with people in their past lives who did something horrible or detestable. In the present, therefore, these killers are usually reminded of something so bad that if they did not pay back for the atrocities committed against them at that time, then they have a chance to do it now. A typical example is of a serial killer whose mother used to have multiple extramarital affairs when his father was away from home. The mother would threaten him if he dared reveal her illicit affairs with other men. In the present life, this serial killer seemed to have a deep-seated hatred for what he termed as loose women. He daily went ahead and killed any that he came across (Freud, 1989).

Psychoanalytical Treatment Methods
The treatment for any psychoanalytical problem finds its roots in the ability of the client to have an understanding of the problem one has as well to be in a position to at least express verbally what one thinks is the cause of the symptoms. The analyst will never be in a position to fully underpin the possible cause of the symptoms if a client will show a tendency to fail to cooperate with the analyst. Therefore, the treatment is commensurate with the willingness of the client to cooperate fully and to let go of resistances and transference that one may try to exhibit. a key stage is preparation when the analyst prepares a model to be used or followed by the client (Freud, 1989). The analyst also utilizes this time to assess the ability of the client to respond to the treatment. Although the actual procedures followed to treat clients using psychoanalysis differ from client to client depending on their personalities and state of being as far as the conditions are concerned, the main procedure entails first of all identifying the symptoms. These are usually to be found in the behavior of the client andor ones confessions.

Quite often than not, though, it is the clients behavior that drives the analyst to inquire from one about events in childhood or in the past that could have a direct or indirect link to the current observable signs (Fonagy, 2001). Once this has been done and the analyst and the client have come to a consensus regarding the possible cause, a prescription is made depending on the severity of the problem. For instance, clients who are suicidal may require a lot more sessions with the analyst, preferably with several breaks in between the sessions in order for the client to be allowed time to rest and for the analyst to assess the progress and determine the next course of action or approach. Commonly handled or treated conditions using psychoanalysis are hysteria and psychosis, although there has been treatment of other ailments like conversions, phobias, obsessions, compulsions, anxiety, sexual dysfunctions, relationship problems, depression, and  character problems like workaholism, hyperemotionality, hyperseductiveness, meanness, shyness, and obnoxiousness (Freud, 1989). As can be deduced from the wide array of the conditions, treatment can include therapy or even medication for certain conditions. What is paramount and unique about the treatment is that it is based not on medical tests because most, if not all, of the conditions diagnosed using psychoanalytical approaches cannot be medically diagnosed.

There are special models and procedures that have been adopted by various analytical organizations such as the American Psychological Association (APA) to be followed by analysts when treating clients of different problems. As earlier mentioned, the client must first of all express a willingness to know the cause of ones problem (Freud, 2005). This will then be taken by the analyst as the first indication that the client is fit and worthy an analysis. This is an important aspect because unless an analyst is able to recommend one for analysis, nothing can be done (Bettleheim, 1984). Therefore, there relationship between an analyst and the client is key to ensuring that treatment is successful. In all the cases of psychoanalytic treatment, the main approach is the so-called conflict theory, where the analyst tries to figure out what is the cause of the clients internal conflicts leading directly to the observed symptoms. Usually, the analyst would vary conditions in which the client is left. For instance, the analyst would do something that will normally cause anger or irritability on the part of the patient and then watch keenly how the client reacts. Likewise, the analyst can allow the client to lie on a couch or seat in the room, all alone, and then after some time come back to assess any new developments or patterns in behavior (Bettleheim, 1984).

In some cases, play therapy has been used as have been story therapy and art therapy depending on the particular condition of the client and sometimes the age and gender. For instance, psychoanalytical play therapy has been known to greatly assist children who have problems like depression and poor memory (Freud, 1989). Story telling also helps children to replace their negative attitudes about certain people or things with positive ones. For instance, children who are exceedingly mean because they were brought up under deprived situations will tend to recover significantly when they are told stories about fellow children who benefitted or got rewarded for being kind and generous to other people in the society (Freud, 1989). Playing also has the effect of dispelling negative thoughts by occupying the mind and if repeated over time alongside other group therapies, even adult clients have been known to recover from problems like depression and different phobias (Freud, 1989).

Resistance and Transference
Freud never stopped emphasizing that the relationship between the analyst and the client is the most important factor in psychoanalysis. This, said he, was because the analyst is in most cases the only person that will be patient and close enough to the client to allow the client to open up and so assist in pointing out the potential root causes of the problem. There is a direct or indirect relationship between the problem and the behavior of the client and this ought to be uncovered by the client (Bettleheim, 1984). That is why any exhibition of resistance tendencies by the client and the entire process is put into a state of jeopardy. The aim of psychoanalysis has been, among other things, to ensure that there is neither transference nor resistance by the client because this hampers the process. The two are different but closely related.

Resistance in psychoanalysis is no different from that in medicine  the client refusing to cooperate with the analyst for reasons that have been described by Freud as being either primary or secondary (Malcom, 1981). In essence, the client thinks or believes that there is no use or value to be derived from the entire process and so either refuses to answer questions, or to change the behavioral patterns. They can even totally refuse to discuss anything with the analyst, never make an effort to remember any detail, or even refuse to think. Such clients believe that by doing this they gain from their illness. According to Freud, the primary gains from resistance are internal and are having more suffering in exchange for the symptoms being exhibited. Secondary or external gains are those physical, financial, and social benefits the client thinks will get by continuing to be ill. They believe that if they cooperate with the analyst then the illness will somehow be treated and so they will lose these benefits.

On the other hand, transference entails the passing on from the past into the present of feeling that were exhibited then. It is more like having certain nerves excited whenever a certain event or person that reminds one of the past is sensed. Past events play a great role in the lives of people. As earlier mentioned, these things can have a leading role in the determination of the current behaviors. According to Freud, transference is responsible for a lot of problems dealt with in psychoanalysis. This explains the importance of seeking to dig into the clients past and present events. Unless this is done, no worthwhile intervention can be made in their problems, especially when they are resistant. The most serious impediment to psychoanalytic treatment is transference resistance, where the client will not admit that one ever had certain childhood emotions, feelings, desires, and general experiences which could be having a significant impact on the present situation and state of the client (Malcom, 1981).

Conclusion
Owing to the realization by psychologists of the effects the past has on the present (transference) and how clients tend to resist treatment for primary and secondary gains, psychoanalysis was fronted as the tool and approach to treatment of such conditions that cannot be effectively treated without there being an insightful understanding of the underlying causes of these problems. Psychoanalysis has come in handy to deal with cases which medical procedures could not effectively address. The client is left with the analyst who uses all possible approaches  including tricks and other seemingly unethical approaches  to have the client open up or behave in manner that can help find a possible cause of the symptoms. Only then can any form of meaningful intervention psychoanalytically can be applied. All psychoanalytical approaches aim to treat psychological as well as emotional causes of suffering, and Freuds theory on the subject have directed most of them. The underlying factor in the entire process is for there to be cooperation on the part of the client.

There are many types of eating disorders. Examples of such are anorexia nervosa, binge eating and bulimia nervosa, to name a few (Learn basic terms and information on a variety of eating disorder topics, 2010). There was such a surprise to learn about the consequences of eating disorders. This is a disease that can affect everyone. It is a life-threatening, serious problem (Learn basic terms and information on a variety of eating disorder topics, 2010)that involves the perception of beauty in our time today. Many models have died because of the pressure of our society to be thin. These kinds of disorders affect the person, physiologically, cognitively and most importantly psychologically. Surprisingly, a large number of deaths have been caused by the mental illness provided by the disorder.

The section about eating disorders has been very accurate in terms of providing information about the disease. Statistics and tables were also provided that gives real life examples of the dangers of the eating disorder. One example was also given on the death of a young model because of complications due to anorexia. Treatments were also provided on the textbook, which was largely helpful in understanding the disorder.

I believe that the first approach to a potential victim of the disorder is information. Accurate information and statistics with tables and pictures should be provided to create a picture of the disorder. It is important that I give my friend the information needed and make him understand the disease. Once I get his interest, I would confront him that he may be a victim of an eating disorder. Victims need to feel that life is precious and everyone loves him the way he is. He must feel loved by closest to him. We will not know for sure if someone is a victim, they tend to hide the disease. It is better that we spread information about the disease because prevention is better than cure.

Research Questions
The research attempted to answer four main questions What kind of information concerning the patients state and treatment do family members and older patients ask nurses and physicians in the emergency department To what extent do older patients and families comprehend the information provided by the emergency department Do older patients and members families get satisfied with the information they receive from the staff in emergency department What is the difference between older patients and family members preferences for, understanding of, and satisfaction with, the information supplied to them by the emergency departments staff (Majerovitz, 1997)

Method of Study
The study used descriptive research method to examine the two samples which comprised of 71 older patients and 32 family members using semi structured interviews as the basic research instruments. The two samples were drawn from the emergency department of a suburban teaching hospital which is associated to a school of medicine. The research measured four different kinds of variables. The variables included communication between older patients and their family members with the staff in the emergency department, type of information provided by the emergency department staff, patients and family members understanding of information provided, the level of satisfaction of information and the difference between the patients and family members preferences to, understanding of and satisfaction with the information provided by the emergency department staff (Majerovitz, 1997). In assessing whether the samples understood the information provided by the emergency department, the research used two coders which were rated according to the samples responses to open-ended questions, using defined coding criteria. The system of coding yielded inter-rater reliability Inter reliability refers to the degree to which coders or raters agree. It is used to address stability of the rating system. In this study it was applied in measuring the consistency of the raters in the coding criteria. The following raters were utilized in the coding criteria

Complete understanding For complete understanding, responses were supposed to comprise of two elements coded as being complete. The first element referred to accurate knowledge of diagnosis, treatment or test expressed in technical or lay terms. The second element was the presence of at least one piece of extra information demonstrating an understanding of the information.

Partial understanding Responses were coded as partial understanding when they included names of the tests, treatments or conditionsin technical or lay termswithout explanatory information.

Little understanding The coding system considered a response as little understanding when information provided lacked specific details in relation to the treatment, test, condition or diagnosis (Majerovitz, 1997).

Findings of the research
Most of the family members desired to have more access and information regarding the patients. However, they do not satisfactorily understand the information offered from the emergency department. Patients wanted to be actively involved in their medical care and desired to be always informed about their condition while being attended in the emergency department. Despite this fact, most of the older patients chosen for this study indicated very little understanding of their treatment or condition. This was evident because majority of the older patients did not complain about the inadequacy of the information provided by the staff that attended them in the emergency department and were quite reluctant to give the specific complaints regarding the kind of information they were given because they did not understand what it meant. It was also found out that even though in most cases the older patients understanding of their medical condition was vague, they believed that they knew and understood what was happening to them (Majerovitz, 1997).

Just like the older patients, family members also were also found to have been unsatisfied with the information they received concerning their patients. However, unlike the older patients, family members were expressed their dissatisfaction more willingly and explain their complaints more specifically. The older patients assertiveness could not be attributed to age difference between them and their families because the average age of the interviewed family members was 61 years therefore, there was negligible age difference between the two (Majerovitz, 1997).

Internal and external validity of the study
The study concludes that there are explicit communication problems among older patients, their families and the physicians. This research lacks both internal and external validity. First, the sample may not have been exactly representative and adequate for making conclusions because it excluded the non-English speakers as well as patients with dementia (Majerovitz, 1997). These are the groups that were likely to offer the more responses regarding the communication problems they encountered which would have made the inferences of the study more externally valid. Again, interviews alone were not sufficient research instruments. Other instruments such as observations would have improved the internal validity of inferences. This is because, by using observation, the researcher would have eliminated the threads to validity such as the accurateness of data collected from the sample. On external validity, the inferences of this study cannot be relied upon because the study was conducted in a sub- urban region, with only one emergency department (Majerovitz, 1997). However, different communication issues exist in different geographical locations.

The selected sample was also not valid because it comprised of middle case and white respondents from a sub- urban region. This implies that the findings from this sample cannot be generalized beyond the chosen population. However, the research design improved the validity of the research inferences in that the study utilized descriptive design which best aids in explaining given conditions using large many interviews and subjects.

Validity and reliability measures
Validity is the degree to which the research instruments, samples and design are able to accurately measure what they were aimed at measuring. Reliability on the other hand, refers to the consistency and accuracy of the results of a study. This implies that if the same question is asked to a respondent, heshe should give the same answer In the case of this study, reliability is measured in terms of inter-rater reliability. The raters applied in the study were able to rate the interviewee in the same way, thus giving credit to the reliability of the study. The authors of this study have specified on the validity of their study in terms of the lack of enough instruments on the study (us of interviews only), the geographical limitations of the study and the lack of proper timing for data collection.

Problems with reliability and validity
The major problem with the validity of the inferences made on this study basically lies on the fact that for the findings of a study to be valid, they must be universally applicable. This implies that even if the research is conducted in a different place, the same findings would be made. However, due to the fact that the sample of the study was not valid because it involved only white and middle class respondents from only one a sub urban hospital, then the findings are not valid.

There are a number of methods that can be used to conduct researches in psychology. These methods have been discussed in detail hereafter. The method adopted in research depend the field of psychology and the problem in question.

We will assume a case of depression and show how research methods can be used to come up with conclusions.

Naturalistic Observation  This method involves observation of the behavior in its natural settings. Operational definition of depression in this state will be a state a state of low mood and aversion to activity.

Naturalistic observation will in this case involve observing individuals who are suspected of being depressed and evaluate how their behavior is different from a conventionally agreed normal state.
 
b) Co-relational  This study finds involves comparing two traits and in this case one trait would be the temperament of the individual suspected of being depressed before and after the diagnosis. It can also be a comparison between an individual thought to be depressed and one who is normal.
A positive correlation would indicate similarity and logic in the temperaments of the two individuals while a negative correlation would indicate disparity in the temperaments of the two individuals.

c) Experimental  involves having an independent variable and treating two or more groups of subjects differently with respect to the independent variable.

The independent variables (IV) are the individuals thought to be normal, while the dependent variable (DV) is the individual suspected of depression.

is the duration taken to identify colours. The operational definition of breastfed  babies aged one who have been breast fed for one year. Operational definition of formula fed - babies aged one who have been formula fed for one year. The operational definition of identifying colours- would be to pick the correct coloured toy when shown the colour wanted. The experiment can be conducted in a laboratory. We have to seek permission of parents in a hospital and select newborn babies who can be breastfed and those who can be formula fed and from this the babies required for the experiment will be chosen. There will be two different groups, one with twenty mothers who will be only breastfeeding their babies for one year and another group with twenty mothers who will be only formula feeding their babies for one year. The mothers who are breastfeeding will be having a same diet plan and the mothers who are formula feeding will use the same formula powder. After one year, the breastfed babies and formula fed babies will be placed in two different rooms and will be shown a colour on a screen, for example blue, then the baby will be urged to pick up a toy that is blue in colour. The duration taken for each baby to identify the correct coloured toy will be recorded. The possible results of the experiment may show that babies who have been breastfed may have taken a shorter time to identify the wanted colour when compared to babies who have been formula fed. The results could also be vice versa or having not much difference in the comparison.

d) Case Study  This involves a thorough and in depth study of the level of intelligence of a particular subject , as in this case the subjects would be a sibling  who has been breastfed for one year and a sibling who has been formula fed year. Thus, the mother should have at least two children, one being breastfed and another being formula fed. One important thing to keep in mind is the siblings should have a similar diet plan as they are growing. The study may involve observing the siblings intelligence level at each stage of their lives. For example at age two, how many alphabets can the siblings identify The intelligences tested can also be based on multiple intelligences and each task assigned to the siblings must be the same. The study may be conducted till they reach the age of seven and a final written test comprising of mathematical and language based questions  can be done to complete the study and compare the results. Possible results the sibling who was breastfed might be stronger in terms of kinestatic intelligence as compared to the sibling who was formula fed.

e) Survey method  A method used to pose questions to a large population in order to get results based on the hypothesis. For this case, it may be possible to conduct a survey of mothers who have breastfed and mothers who have formula fed and seek their responses to questions in relation to the duration they have breastfedformula fed and their childs intelligence level. The questions could be based on multiple intelligences, for example At which age did your child manage to say all the alphabets in the alphabet  When did your child first tried to read  When did you child first cycled The survey could also be done in an interview format with parents to know in depth about the differences between a breastfed child and a formula fed child. The survey may take into consideration of the age of the mothers, the children and the mothers health habits and other factors that may affect breastfeeding and formula feeding.

My Stand
It was interesting to come up with different research strategies based on the five methods asked in this TMA. Lets look at the five different methods in depth, the first being naturalistic observation, for the hypothesis mentioned, this method has a strong point of being able to observe the childrenbabies in their natural setting let it be home or school, somewhere the childrenbabies are familiar of but it would not be an ideal one simply because no interference is allowed thus little or no control is allowed. All we have to do is to just observe the behaviour of the children and there may be no chance of altering their diet plan. The children may also behave more appropriately assuming that someone is observing them. The results may also be based on personal judgement and biasness hence the results that come out of this method may not be accurate. The correlational method has its advantage of being able to control the duration of the babies being breastfed but the biggest disadvantage would be the other variable where only one testactivity can be done to see the relationship between the two variables. This is where defining intelligence would be hard as we can categorize intelligence into multiple intelligences. And it is difficult to distinguish the cause and effect of a correlational study. It may not be necessarily true that a child who may be breastfed may achieve more correct answers as the element of multiple intelligence is missing and the test maybe only using onetwo of the multiple intelligences.

The survey method is a good method to get a mass response from many mothers and a lot of data can be collected to compare the results but the results may not be very accurate as parents may not choose to answer the questions truthfully as they may not want to condemn their own children. Lacking truth itself may cause the results to be inaccurate. The case study method has the strength of allowing the subject to be studied in depth, in this way the subject may be clearly studied for all the different type of intelligences as they grow up and then be compared. Since the subjects are siblings, it makes it more accurate as intelligence can also be inherited. The weakness would be to find the appropriate subject and the duration taken to complete the study. The final method which is the experimental method allows us to take control of the whole study, the strength is that we can have two controlled groups, one breast fed and one formula fed and the duration can be fixed. The diet, health habits and other factors can be totally controlled which may give a more accurate result. One weakness would be the setting of the experiment, it is no longer natural and this may hinder the behaviour or thinking skills of the subject involved. But the cause and effect of the experiment can be clearly seen as the variables are controlled. In my opinion, the experiment method would be most appropriate as the weaknesses can be corrected such as creating a more natural environment is possible. The strength of being able to clearly focus on two groups of equal sample and control the mothers and childrens intake of food and their health habits allows for powerful observations to be done when the experiment is being conducted. The duration taken for the baby to identify the colour is crucial as well as the babys behaviour can also be observed. The results on whether breastfed babies are more intelligent than formula fed babies can be closely derived from an experimental method.

Cognitive Psychology

Question 1
Perhaps the three most influential tenets in my field of specialization in psychology would be an integrative combination of structuralism, functionalism and associativism. From these major tenets emerged various theories of psychology, most notably the behaviorism movement which ultimately led to the birth of cognitive psychology as a science. They have encompassing influences not only in my field but also in various specializations in psychology.

Structuralism, functionalism and associativism are still the underlying schools of thought of many theories.  These are both still widely used in neuroscience which is of significance to clinicians nowadays due to findings that implicate malfunctions or damage in parts of the brain that cause psychopathologies  that is, for organic disorders. Functionalism also plays a big role especially in cognitive neuroscience as it attempts to explain the processes by which all functions of the central nervous system are done. Theories or findings in cognitive neuroscience are primarily developed around structuralism and functionalism in identifying parts of the brain and their respective functions.

In cognitive neuroscience, for instance, where we get information about organic psychological or mental conditions and functionality, structuralism still has its influences especially in checking for pathologies and what areas of the brain are adversely damaged. This in turn would guide what treatment or intervention to use, depending on which areas of the brain are damaged. Structuralism is still apparent in theories that attempt to simplify things by explaining it according to its significant partitions  be it real or conceptual ones. Functionalism complements it especially in examining the physiological or conceptual processes of the different parts of the central nervous system.

Focusing on my field, it is imperative that I be guided in my practice with various studies, findings, new theories or principles that would point or suggest a fitting intervention or treatment to use. Updates from where I take useful information include research or results of studies in neuroscience, cognitive psychology, developmental or child psychology among others. Even in assessing clients, the various theories we use like theories of personality and psychological theories that explain psychological conditions are largely cushioned by structuralism, functionalism and associativism. Freuds theory of personality for instance, speaks of different structures of personality, each one having a distinct function for maintaining homeostasis. More recent theories like attachment theories have at its seat, an associativist view of a psychological phenomenon, attachment problem.

To achieve my ultimate goal as a practitioner  which is to maximize the benefit of interventions to be used to the best interest of the client, I have to approach clients issues using a holistic view. This means that I need to be updated with recent findings in areas like cognitive psychology, social or cultural psychology, biopsychology, developmental or child psychology as well as various other fields which may be significant for helping a particular client.

With cognitive psychology as one of the best contributor to the clinical practice, its theories have helped the practice achieve great lengths, especially in psychological assessment and interventions. Keys to this are perception, memory, attention and consciousness, cognitive neuroscience and mental representation and data manipulation. For cognitive neuroscience as key to the three tenets I have already mentioned why.

Out of the seven underlying themes in cognitive psychology, I believe cognitive neuroscience, memory, and mental representation or data manipulation evolved from either from the structuralism, functionalism or associativism schools of thought.

In theories of memory, cognitive psychologists propose various models. One traditional model suggests that the structure of memory is composed of three stores, namely the sensory store which holds small amounts of information for a short period, the short  term store which contains limited amounts of data, also for brief periods but longer than that of the sensory store while the long term store contains huge knowledge and keeps it indefinitely. The other theories do not quite differ significantly in that it also proposes that memory is composed of recent, short  term as well as long  term memory. However, one that is commonly adhered to by psychologists today is the alternative model, that there is a working memory which is composed of the three stores sensory, short  term and long  term. However, it is so called working memory because it contains data from all stores that has recently been activated (Sternberg 2006).

Considerable amounts of theories have sprung up from research or studies aimed at examining various hypothesis or to come up with an answer to what seems to be just a body of theories most of which have not actually been accepted or verified as guiding principles or truths.
In order to be able to assess if such theories adhered to are sound, practitioners must therefore keep abreast with results of studies or research and other forms of examination.

In clinical practice, the best tool for verifying whether indeed the theories adhered to are sound, are the clients themselves. It can be gathered by self  reports, interviews, therapy sessions, behavioral observations, even the progression of symptoms during the course of treatment is a source of information to validate theory  grounded inferences. A good source for this (practice  based evidence) is also the research papers of other practitioners in the field.

For instance, taking the associativists templates theory of memory as an example, it suggests that the mind processes scene or visual information faster once a template has already been there  or if traces of the same scene appear in ones memory, especially so if it is associated with a particular affect. Thus, that there occurs automaticity in recall of the affect associated with the similar template or with the present scene that has reached a subjects senses. A study however, conducted by Nummenmaa et. al. (2010) reveals otherwise. It was found that semantic processing of visual scenes is faster than their affective processing and that semantic categorization precedes affective evaluation.

Although affective valence can be extracted from minimal visual input, its encoding does not hold primacy over semantic recognition. The biases that emotional content exerts over cognitive processes (for example, on selective visual attention) would occur after semantic recognition of scene objects. Thus, affective analysis is contingent on attentive object identification. Nevertheless, the present results do not undermine the claims that affective information is prioritized over nonemotional information by the cognitive system. Rather, the present study qualifies this claim by suggesting that the prioritization of affective information must occur after semantic processing of visual information, which can lead to a perceptual and attentional bias toward affective scenes (Nummenmaa, et. al. 2010).

In another area, cognitive neuroscience, practitioners handling cases of post  traumatic stress disorder, other anxiety disorders, depression, eating disorders, and psychosis frequently report of clients repeated visual intrusions corresponding to a small number of real or imaginary events, usually extremely vivid, detailed, and with highly distressing content (Brewin et. al. 2010). The same phenomenon was often labeled as hallucinations, memory intrusions, flashbacks and often patients ended up with a variety of possible reasons for it, and forms of treatment.

In a recent study however, it was found that both memory and imagery appear to rely on common networks involving medial prefrontal regions, posterior regions in the medial and lateral parietal cortices, the lateral temporal cortex, and the medial temporal lobe (Brewin et. al. 2010). Thus previous theoretical model was replaced after evidence from cognitive psychology and neuroscience implies distinct neural bases to abstract, flexible, contextualized representations and to inflexible, sensory-bound representations. We revise our previous dual representation theory of posttraumatic stress disorder to place it within a neural systems model of healthy memory and imagery. The revised model is used to explain how the different types of distressing visual intrusions associated with clinical disorders arise, in terms of the need for correct interaction between the neural systems supporting S-reps and C-reps via visuospatial working memory (Brewin et. al. 2010).

These major updates and changes in models warn clinical practitioners to approach every treatment plan or intervention with caution because apparently, as is evident by the study earlier presented, some theories are as good as the last study that developed it. Thus, it is wiser for the profession and beneficial to the clients well  being that constant update and validation be taken to allow immediate reversals of prior inferences or diagnoses and keep or manage the damage at the least possible level.

Though I adhere to the structuralism, functionalism and associativism as influential tenets underlying theories in cognitive psychology, it would not be wise to be espoused to a particular inference as it would cause more harm than good to the clients welfare.

Question 2
There are common ethical concerns in the clinical psychology practice namely exploitative relationships, beneficence and nonmaleficence as well as informed consent. Practitioners may consciously or unconsciously exploit relationships with clients in the arrangements fees, sexual relationships or intimacies with patients, patients relatives or friends of the clients whom the therapist met in the course of the therapeutic treatment  even after the therapeutic treatment is concluded. There is a window period for this though however, any relationships outside the therapeutic relationship with the client, supervisees, trainees and their friends or relatives are generally unethical.

To avoid this, practitioners must not allow multiple relationships to exist in her therapeutic relationships with clients. It is not only disruptive to the program, it may also add to the distress or cause it during the course of the therapy. Thus, a psychologist should consider it an imperative to discuss issues about creating boundaries even from the start of the process.

On the issue of informed consent, a clients right to confidentiality is foregone where his  her as well as other peoples lives or persons are under threat of being hurt. For instance, when there is a threat of suicide (client) or assault (other people), the therapist is duty bound to disclose the matter in the interest of everyones safety. The clients right here is violated in cases when his  records or case notes are used for research purposes without consent and may therefore file a complaint to correct the offense.
Another form of violating this is when the therapist fails to protect or prevent access to files about the clients case. The advent of technology has made note  taking and recording very convenient of therapists but it is not without disadvantages. For instance, when record  keeping of the therapist is done via electronic data processing and another person was able to access a clients file (virtually or physically), the incidence of failure to prevent access to the file and taking extra steps like implementing controls (physical and technological) to disallow unauthorized viewing of a clients records constitutes an offense.

For beneficence and nonmaleficence, it is the therapists duty to ensure that the client receives utmost care and protection of his  her well  being with the therapist taking initiatives to ensure the clients utmost interest is protected. In assessing a client for instance, the therapist does not just rely on available data to complete the assessment on time. It is not so much as getting the job done but more for arriving at an accurate diagnosis to guide treatment and therefore prevent the client from harmful effects interventions that were guided by incorrect inferences, he  she can prevent the adverse effects of possible reversal of diagnosis by collaborating with other professionals in the field to validate or get inter  rater reliability of her assessment. When in doubt therefore, the decision factor to choose must be that which is most beneficial to the client in the present and the long  run.

The interest of beneficence and nonmaleficence is also not honored when a therapist does not disclose to the client other alternative courses of treatment which may be applicable to the clients case. There is a good number of alternative treatment for psychological disorders and nowadays, disclosure of such seem to be low. Others attribute it to the fact that there are no economic incentives involved in the disclosure of treatment options to the patient. Unlike when the prescribe, practitioners get incentives for extending prescriptions.

The same should be observed by researchers in the field of psychology particularly in studies involving experiments using human subjects. There are pharmaceutical companies, who, through doctors or practitioners, offer medications or treatment courses via charity. With this, they are actually conducting research to measure efficacy of a medical product.  The clients consent is gathered but for those who are in the less developed countries, clients in the lower socio  economic status often do not fully understand the extent of the consent for which they are signing. Details about possible side  effects and if the medication will on them or not are not fully disclosed to them.

In other methods of research like social immersion or naturalistic observation, psychologists conducting such studies sometimes do not realize the effect they have on the clients in the course of the study. Often this is done without the clients consent to eliminate Hawthorne effect. However, there is an impact left behind when psychologists finish and withdraw from the clients immediate or social environment so that it becomes a necessity to debrief.

There may be more cases of violations of this primary client protection in their therapeutic relationships with psychologists. But whatever the complications and when faced with a novel situation where choice is a difficulty, the breaking factor that psychologists must consider is this would it be beneficial to the client