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Essay Instructions: First of all I got a zero on my last assignment I used through you guys because it was cited too much in the paper and they said I plagerized so I need to make sure on this next assignment that we aren't using citations and papers that have been used before?? I included the paper that was used before because it goes with my final assignment which is unit 7. Below unit 7 assignment is the directions for my assignment.


UNIT 7 ASSIGNMENT THAT YOU GUYS DID FOR ME THAT THEY SAID I PLAGERIZED...


A Bipolar Diagnosis: A case study of Miranda
Miranda is a sixteen year-old second-generation Chinese-American girl who is suspected of manifesting bipolar disorder. Miranda?s specific, proposed diagnosis according to Appendix D of the DSM-5 is ?Bipolar 2 Disorder, in which the primary symptom presentation is recurrent depression accompanied by hypomanic episodes (a milder state of mania in which the symptoms are not severe enough to cause marked impairment in social or occupational functioning or need for hospitalization, but are sufficient to be observable by others)?(APA, 2013). However, there are also some indications that drug use may be provoking her symptoms.

Miranda comes from a very high-achieving family that places considerable weight upon academic success. Throughout most of her scholastic life, Miranda has excelled in school but her sophomore year of high school her grades began to decline. According to Miranda?s mother (who is a self-described ?stay at home mom?), her daughter?s work habits became increasingly erratic.
Sometimes Miranda would stay up all night ostensibly doing homework but would be really talking with her friends on her computer. When confronted by her father about this behavior, Miranda cheerfully told him that she could study in between classes in school and seemed unperturbed by his anger. Miranda, even when she seemed to be working hard and chattered on about her extravagant plans to go to an Ivy League school would have little to show for her efforts working at night. Other days Miranda would say she was so tired she couldn?t possibly go to school and lost all interest in her extracurricular activities such as music. Her teachers described her as either overly talkative and ?social? and distracted in class or extremely tired to the point of falling asleep during lectures.
Miranda is described as having a high IQ, particularly in math, but also as being a very sensitive child. However, she has always had many friends and was well-liked at school until recently. Miranda has a self-admitted perfectionist streak and tends to see things in black and white?either she is a success or a failure, in her estimation. However, as her mood swings became more erratic, she began to lose some of her closest friends. Miranda began to hang out with an uncharacteristically ?cooler? crowd and stay out late in defiance of her curfew which she had never done before. Her mother does not like Miranda?s new boyfriend, who she says she suspects of doing drugs. Miranda has begun to wear all-black clothing and her mother is worried that she is going down a bad path.
Miranda?s apparent rebellion is all the more inexplicable to her mother and father because both are immigrants from China from whom a profound level of obedience was expected when they were growing up. They describe themselves as holding Miranda to similar standards and have always sought to ensure that their child upholds the tenants of their culture. Although not extremely religious, both parents describe their worldview as coming from a Confucian tradition which stresses obedience from children and a profound respect for parental authority. They find it shocking and disturbing that their child is not honoring this perspective in her actions and is acting in a manner they consider defiant and ungrateful to all they have sacrificed for her. They also state that Miranda?s behavior is causing considerable friction between the two of them and is having a negative impact upon their marriage. Regarding the family?s mental health history, Miranda?s mother was once diagnosed with depression after Miranda?s grandmother died and took antidepressants for a brief period of time but both parents say that they do not place much stock in therapy and believe that Miranda is just ?acting out? rather than has a mental disorder.
When asked how she perceives this behavior Miranda says that her parents have always been overly protective and have stifled her creativity. Miranda points to the fact that her older brother was a disappointment to the family (he never finished college) and says that she has been subjected to additional pressure to achieve. Her brother is described as ?lazy? by the parents, often sleeping late and hanging out with a ?bad crowd? as a teenager. Miranda refuses to talk about her relationship with her boyfriend or answer questions about substance abuse, even in private. She says that her parents hold her to a different standards than those of her other friends and attributes her poorer grades to her teacher?s unfairness and prejudice against her. ?Just because I?m an Asian girl they expect me to be smarter than everyone else. Well, I?m not smart, I can?t help it.?
To evaluate the mental health of Miranda requires several cultural factors to be taken into consideration when contextualizing her situation. Given their first-generation immigrant status, Miranda?s parents may be more likely to interpret their daughter?s behavior as disobedience and defiance rather than a mental health issue, given that viewing such actions through a psychoanalytic lens is not part of their tradition. However, the fact that both Miranda?s mother and brother have shown signs of mental illness in the past indicates that Miranda?s issues may have a biological basis. Her parents are not receptive to the idea of treating their daughter with medications for a psychological condition despite the fact that most mental health practitioners concur that some form of pharmaceutical treatment is necessary in addressing the needs of patients exhibiting bipolarity, which is the diagnosis suggested by Miranda?s pediatrician (Duffy et al 1998). Should the evaluative process indeed result in a bipolar diagnosis, ensuring that Miranda receives appropriate psychopharmacological intervention may prove challenging, given her parents are even somewhat reluctant to allow that there may be a need for therapeutic counseling. But it is also possible that Miranda?s symptoms may be linked to using drugs although Miranda has never admitted to using any form of illegal substance or alcohol.
Because of Miranda?s age, there are concerns that normal adolescent rebellion may be interpreted as a mental illness. It is not unusual for adolescents to experience a search for identity at Miranda?s age within American culture. Because Miranda?s parents grew up in China, they may be uncomfortable with the extreme individualism tolerated by American culture. In America it is considered normal for teens to engage in a certain amount of limit-testing that may not be acceptable in other cultures. Additionally, mental illness as a whole is more stigmatized in Chinese culture, which may make Miranda?s parents more reluctant to acknowledge that their daughter may have a mental health issue and are more eager to view her issues as self-willed (Alonso et al 2008, cited by Unite for Sight website).
Ethical concerns which naturally arise when treating Miranda are attached to her age. Treating Miranda from a therapist?s perspective requires a certain level of trust and confidentiality that might not be seen as acceptable when viewed through her parents? Chinese-American worldview which does not accept a rigid and individualistic division between parent and child. According to the ACA Code of Ethics, 2014, as well as being culturally sensitive to the family as a whole and not imposing individualistic dictates upon the parents in terms of precisely how they should raise their child, even when treating minors ?counselors recognize the need to balance the ethical rights of clients to make choices, their capacity to give consent or assent to receive services, and parental or familial legal rights and responsibilities to protect these clients and make decisions on their behalf? (A2C & A2D). The need for effective counseling of Miranda and ensuring honesty must be balanced out with her parents? rights and cultural worldview. For example, if Miranda were to be found in engaging in risky behavior, ideally Miranda would be persuaded to discuss this with her parents versus the therapist automatically ?telling? on Miranda (unless Miranda appeared to be at considerable physical risk). Similarly, Miranda?s need for treatment should be acknowledged by the therapist. If making a recommendation for a particular medication for Miranda, the therapist should be prepared to answer her parents? concerns and explain why bipolarity (if such a diagnosis is warranted) requires more than ?discipline? to quell Miranda?s behaviors.

ASSIGNMENT I NEED TO DO:
Unit 9 Assignment: Diagnosis and Treatment Planning
For the final assignment in Unit 9, you will draw on the DSM-5 mental disorder you selected in Unit 3 and the case study you created in Unit 7 to formulate a comprehensive DSM-5 diagnosis that includes the principal diagnosis, medical conditions, and other conditions that may be a focus of clinical attention (V and Z codes), develop an effective treatment plan for addressing this client's presenting symptoms and issues, and discuss how social systems impact the assessment and treatment process.

To successfully complete this project, you will be expected to:
1.Evaluate contemporary approaches used for the assessment and diagnosis of individuals.
2.Apply the DSM-5 to the diagnosis of a child or an adult.
3.Incorporate current research and diagnostic resources used in the counseling profession in the treatment planning process.
4.Design an effective treatment plan based on the assessment information collected.
5.Evaluate the impact of social systems on the diagnosis and treatment planning process.

To achieve a successful project experience and outcome, you are expected to meet the following requirements.
1.Describe the methods you would use to assess and diagnose this client, based on the case study you developed. Discuss the strengths and weaknesses of these approaches to evaluate which methods would be most appropriate for your client.
2.Develop a comprehensive DSM-5 diagnosis for the client that includes the principal diagnosis, medical conditions, and other conditions that may be a focus of clinical attention. Use the template provided in the assignment resources. Provide a rationale for any choice of diagnosis you have made. Describe the advantages and limitations of using the DSM-5 to diagnose this client.
3.Develop a treatment plan for working with this client. What information would you gather during the assessment and diagnosis process to assist you in formulating a treatment plan for this client? How would you incorporate current research and diagnostic resources used in the counseling profession to develop a treatment plan that effectively addresses this client's presenting symptoms and issues? Describe the links you are making between the assessment process, the diagnosis, and the approach you will take with the client during therapy. Support your choice of therapy approach with references to the professional literature. Describe the following elements in your treatment plan and use specific examples to illustrate your ideas:
?Focus of therapy.
?Goals for the client.
?Specific interventions used to help the client reach his or her goals.
4.Explain the larger environments and social systems that would need to be considered when diagnosing this client and formulating a treatment plan. Discuss the ways in which managed care companies, the health care system, school systems, the policies within your own agency, or other social, political, or economic systems might impact the diagnosis and treatment planning process with this client.
Attach a copy of the case study you wrote for the assignment as an appendix to your final project assignment.

Essay Instructions: Tasks:
- Consider one of the following case studies and set out the ethical landscape for it. What do you see as the ethical issues in these cases? Why? What information is needed, and what is given in order to make a proper decision? What principles or approaches are relevant to that decision? How would you handle the case?
- Your comments about resolution should take the form of suggestions for which you can give reasons. One important academic journal for the field is Philosophy, Psychiatry and Psychology. There is also an on-line Journal of Ethics in Mental Health, edited at McMaster University. Since you could become a greater expert in the area you choose than either the instructor or the marker, you should engage in careful exposition of your subject. Do not however, assume that the reader of your paper is completely uninformed about the area of discussion
* FOCUS on clarity and setting up the ethical landscape explicitly !

Options:
a. Recognizing the stressful and demanding nature of the clerical life, the Roman Catholic archdiocese of N. has appointed you to provide counseling to troubled priests. Using the service is purely voluntary, although strong encouragement is given to priests who have had some prior problems (e.g. drinking problems) to use it. Father X has come to you, and has admitted that over the years he has had to struggle with a powerful sexual attraction to young men and boys. He does not seem to be a predator by nature, but he has disclosed that he has engineered opportunities to have sex with altar servers in some previous postings. He has never admitted this to any archdiocesan official (at least not outside the confessional), and he is struggling once again with an attraction to certain early adolescents in his current parish. Actually acting on this attraction would, of course be an offense under the Criminal Code, and bring (more) disrepute to the Church. What should you do about this?

b. Mr. Y has been under treatment with you for deep bouts of depression. When he has been depressed in the past, he has had trouble complying with treatment provisions. To put it bluntly, once his mood improves and stabilizes, he goes off his medication. Lately, however, this tendency has been limited by the fact the prescribed anti-depressives have had little effect, and he has abandoned them even sooner. He has said that if he continues to feel this bad, he may as well just stop living, and he has considerable difficulty managing the activities of daily living. Only family pressure even gets him out of bed in the morning. You have raised the possibility of Electro-convulsive therapy (ECT) with him. While he has shown some interest in it because of the reported success in cases of severe depression, he has also expressed serious misgivings: “I hear it scrambles your brain,” he says, and “people lose many of their memories from all stages of their lives.” Would you pursue the possibility of this treatment further with him? If not, why not? If so, why, and how would you deal with the misgivings? What rights does Mr. Y have in the case? Are there any alternative therapies available in such cases? What would justify proposing one?

c. As a psychiatric nurse in a hospital, you have been assigned the duty of administering prescribed medication to Ms. Z, for her extreme and debilitating anxiety. Because you have had the opportunity to observe her on every shift you have worked since her admission, you have noticed a distinct worsening of her condition. There has been both physical and mental/emotional deterioration since admission. While a small amount of the decline took place before the medication was prescribed, it has moved on much more quickly since the course of medication began. Your fellow nurses have also noticed it, and the symptoms, such as insomnia, severe mood swings and violent outbursts have made patient management a real problem. You suspect that the medication may be involved, and you have taken the matter up with the attending psychiatrist, Dr. Q, who insists that the condition cannot be as bad as it is presented, and that whatever irregularities there are will stabilize once the patient becomes acclimatized to the medication. However, Dr. Q has many patients and so has only carried out brief, cursory examinations of Ms. Z since the medication began. The psychiatric resident supports Dr. Q’s view, noting the doctor is the local authority on the treatment of this condition. What would you do about this case?

d. You have been working for some time with a famous (and award winning) laboratory scientist, Professor L., who has been diagnosed with Bipolar Personality Disorder. As is common with the condition, he has periods both of extreme elation, and deep depression, and sometimes the transitions between the periods are abrupt. His condition can be managed medically, but he has had the experience of achieving a great deal during the periods of elation. In fact he has told you that those have been the periods when he can do the most work, and solve the most difficult problems in his research. It appears that he is right about this. Consequently he goes off his medication whenever there is work pressure or he suspects that doing so will induce an up phase. He is quite definite that this action is necessary for his scientific success. Unfortunately, he is also an addictive personality and has a history of alcoholism. When he reaches his peak moods, he begins to binge drink and becomes abusive, even violent towards those with whom he lives and works. As the depressive phase sets in, the drinking continues, perhaps as an attempt to self-medicate. He becomes incoherent, misses appointments, and does embarrassing things when he does show up at a class or academic function. His work grinds to a halt, and he has been known to try to destroy some of the output of the peak-mood period. Colleagues have to cover for him in classes and make excuses on his behalf at conferences and lectures. His own sense of the futility of this depressive phase induces him to seek help. The chair of his department suspects that you have been seeing the man, and she has asked you to intervene, if you are seeing him, in order to ensure that his moods are kept even. Nevertheless, the department’s promotional material always mentions this professor’s achievements prominently. What should you do?

Essay Instructions: Task 1

Select one aspect of your life style to work on over the next four weeks. This might be related to diet, fitness, health etc. Select one aspect which you will be able to specifically focus on over the four week period.

Set out your plans for the goal setting intervention on. Explain why you have selected this area and what you hope to achieve over the four week period. You must also include some theoretical background research on goal setting and its applications(500 words approx). Any research gathered must be fully referenced.



WE DID OUT A QUESTIONAIRRE FOR THIS IN CLASS, SEE BELOW PLEASE

Smart Goal Setting

Following are components of an efective goal-one that describes performance standards that will "tell us what good behaviour looks like"
The SMART acronym can help us remember these components.


Specific: The goal should idientfy a specific action or event that will take place

Measureable: The goal and its benefits should be quantifiable

Achieveable: The goal should be attainable given available resources

Realistic: The goal should require you to stretch some, but allow the likehood of success

Time Framed: The goal should state the time period in which it will be accomplished


Here are some tips that can help you set effective goals:-

1. Develop several goals. A list of 5 to 7 items gives you several things to work on over a period of time.

2. State goals as declarations of intention , not items on a wish list "I want to eat healthier" lacks power. "I want to eat 5 pieces of fruit and veg every day by week 4 "is intentional and powerful"

3. Attach a date to each goal. State what you intend to accomplish and by when. A good list should include some short - term (e.g. daily) and longer term goals (e.g. weekly / monthly)

4. Be specific. " To train harder" is too general; " to increase my training to 4 times per week; twice in the gym and two 30 minute runs " is better. Sometimes a more general goal can become the long term aim,and you can idientify some more specific goals to take you there.

5. Share your goals with someone who cares if you reach them. Sharing your intentions with your parents, your best friend, or your teacher will help ensure success.

6. Write down your goals and put them where you will see them. The more often you read your list the more results you will get.

7. Review and revise your list. Experiment with different ways of stating your goals. Goal setting improves with practice so play around with it.


LONG TERM AND SHORT TERM GOALS:-

The following boxes were filled in;

Personal health / Wellness goals:(e.g. nutrition, lifestyle, etc)
. eating healthy
. stop smoking
. build my fitness levels up again
. exercise more
. relieve stress

Action steps for above Personal health;
Make a diet plan for next 4 weeks. Replace my smoking with exercise. Go to the gym or exercise more. Set a gym plan in action for 4 weeks, motivate my stress levels into exerrcise.

Fitness Goals
. Finding more time to train
. build up my cardio fitness
. tone my body

Action steps for above Fitness goals:-
Draw up a weekly time sheet , try fitting more training into your lifestyle. When I walk turn it into running and walking and sprinting to build up my endurance. Do more weights at a heavier weight and more reps to tone up myy body

Psychological Goals( e,g. relaxation, time management, etc)
. Time management
.Stress relief

Action steps for above Fitness Goals:-
Leave earlier or get up earlier to leave. Find strategies to relief the stress


SMART Goals Worksheet:

Stop Smoking
Wanting to stop smoking by this 4 week plan because I want to concentrate on my fitness statis and start exercising on a full time basis, maybe after the 4 weeks start a new sport


What I Need To Do To Reach This Goal?
Each week reduce my cigeratte in , replace my smoking habit with exercise or an activity which will keep my mind off them. Keep my motivation levels at a high at all times, so my cravings don't get the better of me.

Where am I Now:-
I am smoking at least 10-15 cigarettes a day , I tend to cut down dramatically and concentrate on my fitness or completely stop all together.

Gains To Self:-
Feeling more healthier in my self being
Extra money to the things I need and like
My lungs will be healthier
Will make my skin look younger and fresher
May live longer

Losses To Self:-
My friends will not like the thought of me not smoking when out for a night
My mood will change for the first few weeks

Gains To Important others:-
Wont smell smoke off me when I walk into a room
They could be encouraged to stop smoking as well and join an exercise club
Team-mates saying my performance is better
Would have more money to go out with family and friends

Losses To Important Others:-
May lose a smoking partner at break or lunch
May take my mood swings out on others who are close to me , which would upset them

Disapproval of Others:-

Self Approval:

Self- disapproval

The above three I haven't filled anything in on as I can't think of anything to write
Customer is requesting that (freelancewriter) completes this order.

Essay Instructions: Reflecting on Personal Beliefs and Values

Develop and post narrative paragraphs, supported by the literature and research, of your reflections and conclusions in regard to the skills, knowledge, and professional attributes that you have developed throughout your program of study and Integrative Project. Focus on writing narrative paragraphs for the following elements of the Reflections and Conclusions section of your Integrative Project:
•How do your own beliefs, cultural background, life experiences, attitudes, values, and biases influence your ethical views and professional practice within your specialization?
•What are some of the ethical dilemmas that could arise?
•What are some of the issues and challenges that might arise when working with diverse client populations?

this is the work I done so far. please follow suit.
My Integrative Project will be a brochure and a webpage will target Veterans of the Iraq and Afghanistan Wars. This will include all races, religions, both male and female, and the age group 18 thought 65 years of age. The webpage will also help those veterans Post Vietnam War and after words. The brochure will be writing in simple English that a avenge person can understand. The brochure is to help those understand what PTSD is and what they can do to get over it or have at least a better quality of life with PTSD. I will be showing the Iraq and Afghanistan Veterans that are active and deactivate the brochure to see if they can understand it and if it is any help to them.
I will also show the Military Psychiatrists and Psychologists the brochure to see if everything in the brochure is proper and written right on PTSD for the veterans. I will include in the brochure where to find help for PTSD for themselves and their family. What they can do to help themselves when they are under stressful time. Like they can listen to peaceful music, meditation, exercise, or even sit by them self in peace and quiet.
My research in the area of Post Traumatic Stress Disorder (PTSD) has the capacity to be particularly valuable to the field of educational psychology today in light of the new generation of at-risk individuals returning from combat. Individuals returning from military combat are among the most vulnerable demographics to PTSD and its related consequences of emotional instability, psychological despair, substance abuse and a host of other war-related dissonances. In the wake of the protracted conflicts in Iraq and Afghanistan, it has become increasingly apparent that there is a need to prepare through better understanding for a new generation of individuals that are highly vulnerable to the PTSD and its related consequences. The research that I have conducted therefore considers PTSD in light of several different qualitative research approaches with the intent of verifying its pertinence in the field of educational psychology.
These will lend insight into the various ways that PTSD might be better understood, especially with a focus on the way that this effects family and children of combat veterans. For practitioners of educational psychology, it is important to understand parental PTSD as a predicator of the emotional, educational and social orientation of the child. This discussion is preempted by the understanding that many veterans are almost inevitably prone to some degree of the condition known as PTSD. This may be characterized as “an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.” (NIMH, 1) In the particular case of this discussion, military combat is a cause of PTSD that can have devastating long-term outcomes for soldiers, their families and especially their children. In the case of the current War in Iraq for example, where the United States has experienced heavy combat losses, where civilian casualties have been massive and where soldiers are under a constant threat of ambush or attack from an unwavering local opponent, the occurrences of PTSD have been extremely high.
For the generation of children now in their early education, many will have experienced direct exposure to a parent who is a combat veteran. And as findings demonstrate, it is very common for such veterans to return home with continued difficulty coping with the inherent trauma that is exposure to wartime conditions. Indeed, “studies estimate that as many as 500,000 troops serving in Iraq and Afghanistan will suffer from some form of psychological injury, with PTSD being the most common.” (Eliscu, 58) The outcomes of this condition will run a wide range of symptoms that impact the ability of individuals to cope with the pressures of everyday life, to relate to those who have not experienced the traumas of war, and heightened propensities toward violence, toward crime, toward alcoholism, toward substance abuse and toward depression. Such is to say that the real and tangible outcomes of this condition suggest a detectable sociological problem potentially afflicting in some degree an entire class of Americans and rendering their children vulnerable to dysfunctional homes, physically abusive parents and irrational behavior in a primary caretaker or role model. These conditions can also be compounded by the financial strains of unemployment which also are often associated with PTSD.
This denotes that comprehensive research on the subject should help to improve the understanding within the field of psychology of the dangers and risks facing the children of combat veterans. This may help such practitioners to identify signs of this risk in children and take measures to mitigate said risk.
An Intervention Approach to Children of Combat Veterans with PTSD
As the wars in Iraq and Afghanistan have plodded on, the consequences to our servicemen and women have only grown greater. Those who have served the United States in these particularly protracted and violent conflicts are experiencing a range of physical and psychological consequences that account for a generation of individuals suffering from Post-Traumatic Stress Disorder. Moreover, the consequences of PTSD are taking a toll on the families to which these military personnel are returning, with the symptoms of depression, mood swings, substance abuse, severe panic attacks and violent or abusive behavior impacting the children of combat veterans. The research conducted here under the umbrella of educational psychology is intended to produce the groundwork for effective intervention methods where these at-risk children are concerned. The discussion below will drive the nature of such intervention by helping to characterize and produce features for identifying children who are at a high-risk of the consequences of parental PTSD related to combat experiences.

First and foremost, this requires a fuller understanding of the experiences of combat veterans returning home from places such as Iraq and Afghanistan. Even as our study focuses on the impact of PTSD on the children of returning combat veterans, we are able to predict certain tendencies in response to combat situations also using the field of educational psychology as our lens. This is because for many combat veterans, a predisposition to post-combat disturbances can be predicted according to childhood experiences. According to the text by Ford (2009), one group of researchers “assessed high-risk children’s exposure to maltreatment, abuse and other traumatic stressors beginning the in first year of life and have re-assessed their participants several times over the course of between a decade and more than two decades. Morgan and colleagues (2008), and Vasterling and colleagues (in press) have applied this proactive approach to military personnel, measuring their bodily and psychological stress reactivity while they were still in training prior to deployment to hazardous war-zones such as in Iraq.” (p. 52)
This denotes that there may be a cyclical connection between traumatic childhood experiences, combat-related trauma and the eventuality of traumatic childhood experiences for children of combat veterans. This imposes an interesting set of questions upon our research, primarily as these relate to the experiences of the children of combat veterans. It is often the case that involvement in the military is familial in nature. Many who enlist for service are the children of former servicemen and women, often encouraged by familial commitment to American military service or by an upbringing within the context of a military community. This means those as we draw connections between childhood traumas and susceptibility to PTSD following later combat, we can begin predicts and preemptively treat the emotional and psychological consequences for the child growing up in a military community or a service-oriented family. Certainly, such children can be characterized as being in a high-risk group both for such consequences of parental PTSD as family dysfunction, physical abuse and emotional tumult and as being high-risk for PTSD resulting from their own eventual service experiences.
One feature that only magnifies this risk is the tendency on the part of servicemen and women to avoid treatment. Many choose to grapple with the emotional trauma privately, with the repercussions to this approach often being felt by the family. According to the research conducted by Gould et al (2007), this is because there is a tendency on the part of military personnel to view psychological illness as being stigmatized. Social, cultural and personal factors prevent many from seeking the necessary treatment. As a result, it is often so that children of returning combat veterans are at high-risk but without the necessary attention or intervention on the part of educational institutions or psychological support systems. According to Gould et al, “Within both the military and civilian populations, stigma is a serious issue preventing help-seeking and reducing quality of life. The results suggest that TRiM [Trauma Risk Management] is a promising antistigma program within organizational settings” (p. 505)
This may help to inform the intervention strategy to which our research inclines the field. By executing a form of Trauma Risk Management that is geared toward identifying and treating veterans and their families, it is possible to engage at-risk children who might otherwise slip through the cracks of the system without detection. As the discussion above shows, it is up to the military and educational institutions to identify at-risk children preemptively and to subsequently engage they and their families in Trauma Risk Management strategies.
Ultimately, the research encountered in this area denotes that PTSD can create a negative environment for a family and its children. It is rare that the consequences of this combat-related disorder do not extend beyond the impacted individual to disrupt the functionality of the family unit. The research that has been conducted here throughout is intended to inform the steps necessary for conducting a meaningful intervention. As the research shows here, a failure to do so could result in a perpetual cycle of psychological instability and combat-related disorder from parent to child. By identifying these risks early and engaging in meaningful treatment strategies, we have an opportunity to improve the mental health prospects for the children of combat veterans, many of whom will themselves be exposed to the psychological risks inherent to military service.
The present research project is intended to provide guidance for an intervention program relating to Post-Traumatic Stress Disorder (PTSD). In particular, because this project is initiated from an Educational Psychology perspective, the emphasis will be on the impact that PTSD may have on the families of those impacted and particular on children. With a generation of soldiers returning from combat situations in Iraq and Afghanistan, there are countless new cases of PTSD emerging every day in the United States. This impacts families and children directly. Therefore, the research conducted here is driven by the need to better understand PTSD, the impact it has on combat-veterans and the toll that this levies on families and children. The sources consulted and annotated here are intended to provide a comprehensive basis for the research conducted thereafter.
The National Institute of Mental Health (2007) provides our research with the most basic and grounded definition of Post Traumatic Stress Disorder. Here, one of the leading organizations in the mental health community provides our research with a concise overview on the nature of the condition, its usual causes, the leading identifying symptoms and some courses of treatment. Of particular value as we delve further into the interest of promoting an intervention are the various links from the website in question that lead to various organizations or support groups centered on PTSD. These denote that there are group therapy, family therapy, child support and other such intervention groups, many of which are likely to present as valuable advocacy as we move toward a more pronounced intervention strategy.
This condition is further elaborated by the article in Rolling Stone chronicling the experiences of Blake Miller, a solider made iconic by a photograph taken of him during the war in Iraq. Though the photograph would be used to represent U.S. troops as bold, gritty and heroic, the article describes Miller as one of countless soldiers returning from the war with a bevy of symptoms of Post Traumatic Stress Disorder (PTSD). Nicknamed the Marlboro Marine, the article tells of Miller’s traumatic experiences during the war and, most importantly to our studies, tells of the Miller’s vain effort to return to some state of normalcy. As the article reports, “Miller's nightmares, insomnia, heightened alertness, self-imposed isolation and persistent recollections of his seven months in Iraq are all classic symptoms of PTSD, an anxiety disorder that results from exposure to an event so psychically frightening that the aftershocks continue for months or even years. Studies estimate that as many as 500,000 troops serving in Iraq and Afghanistan will suffer from some form of psychological injury, with PTSD being the most common. Miller hasn't been to a doctor in over a year, and, like so many vets, he seems to have fallen off the government's radar.”
This is an important point of consideration because for far too many soldiers returning from Afghanistan and Iraq, it is common to lose contact with the government for which they have sacrificed so much. In the case of the subject of the article here, we find a strong impetus from some mode of intervention, particularly given the subject’s proclivity toward substance abuse and violent thought patterns. Where our study is concerned, this article denotes the need for more effective contact and better mental health treatment plans between the government and its discharged soldiers.
The Ford (2009) text is a valuable and comprehensive overview of the condition known as PTSD as well as its various causes, symptoms, incarnations and courses of treatment. This serves as an ongoing reference text with particular relevance to understanding the impact that PTSD may bear on the individuals afflicted as well as on the friends, families and support systems surrounding them. The text addresses PTSD with a detailed consideration of its characteristics as a mental disorder, with specific assessment of its epidemiology, etiology and neurobiology that can lead to this condition. This helps us to recognize in the course of this research path that there are a bevy of characteristics that might predispose one to a PTSD response to traumatic events, that there are biological as well as emotional reasons for the impact levied by PTSD and that those who suffer from the condition may exhibit a wide variance of symptoms that many not always immediately point to PTSD.
The text helps us to recognize that often PTSD symptoms will emerge gradually and intensify without treatment. This means that a condition which may appear to the afflicted as manageable may yet spiral out of this individual’s control. Accordingly, the Ford text offers a wide range of treatment avenues which are intended to respond to the individual needs exhibited by individuals suffering with PTSD. The text even enters into a discussion on how best to prevent PTSD, indicating that while it may not be possible to avoid traumatic events, it is possible to respond to said events by working toward immediate counseling, coping and confrontation of a trauma. The disorder can often be produced in the eventuality that one fails to confront initially traumatic events.
Likewise, the article by Gould et al (2007) is constructive in building toward research that is based in the notion of intervention. The primary foci of this article are both the management of effective intervention strategies and the reduction of the influence that social stigma plays on preventing sufferers of PTSD from seeking treatment. This is particularly so where, as in our study, military service is concerned. That is because the military carries with it a distinct set of cultural tendencies which defy the rational pursuit of treatment. There is, the article explores, a certain stigma related to admitting emotional or mental disorders among military servicemen that prevents many from seeking or receiving treatment. This helps us to understand in our research that intervention may come up against the obstacle of individual subject resistance. This denotes a second level of interest in the article in question related directly to its assessment of Trauma Risk Management. This offers are particular mode of intervention designed to arm those vulnerable to the condition, such as combat or military veterans, with the mental instruments to cope with its consequences.
This denotes that there do exist myriad treatment options and approaches. According to the text by Hersen & Biaggio (2000), there are arrays of treatment modes which may be relevant to the present condition. In this discussion, a focus on Post Traumatic Stress Disorder (PTSD) contributes to the selection of the Brief Therapy approach, a method of cognitive behavior therapy which is particularly suited to the notion of examining fears and removing the irrational schema through which these fears are maintained and magnified. To this end, the text by Hersen & Biaggio stresses this idea that less nuanced approaches to therapeutic treatment have tended to cast too broad a net when attempting to treat disorders. Accordingly, the text reports “that clinicians must consider interventions that address the client’s full range of symptoms and advocates a symptom-focused, rather than disorder-based approach to treatment planning.” (Hersen & Biaggio, 6) This points to the chief identifying features of brief therapy, which though it encapsulates an array of differing treatment approaches, refers to a host of approaches which pay a focus to the specific nature of a problem and the application of direct intervention. This is to say that brief therapy persists with an emphasis on drawing on current experiences in order to make immediate changes in the client’s perception and interpretation of events. This will be closely considered in the design of an effective intervention strategy.
Where the Hersen & Biaggio text focuses on a behavioral treatment mode, the text by Lipsey & Wilson (1993) focuses on the implications of treatment strategies relating to mental or emotional disorder. The article makes the argument that through meta-analysis, it is possible to accurately evaluate the usefulness or effectiveness of selected treatment strategies. The text does not focus directly on PTSD but instead considers this as one of many possible mental health maladies for which treatment options must be evaluated. Accordingly, the study would find that meta-analysis confirms the value and at least partial effectiveness of behavioral therapy as a way to reduce or reverse the effects of certain emotional illnesses. According to the article in question, “Lipsey and Wilson found that well-developed psychological, educational and behavioral treatments generally have meaningful positive effects. The authors conclude that the first 15 years in which the meta-analysis techniques were used yielded not only dozens of well-executed, systematic meta-analytic reviews demonstrating the usefulness of this technique, but also evidence of the effectiveness of a wide variety of psychological, educational, and behavioral treatments.” (p. 1181) At the very least, this should stand as a way to examine and verify modes of intervention or treatment selected by the present study.
The research by Spinazzola et al (2005) points to the problem of PTSD treatment which tends to largely overlook those suffering from a severity of overlapping symptoms. The primary argument made by the article in question is that the comorbidity between PTSD and certain conditions that are viewed as excluding factors for the isolation of the PTSD condition is sufficiently high to reconsider this approach. Indeed, one might support the argument from the research endeavor reported in the article that many of the severe psychological conditions that might prevent direct treatment of PTSD constitute, in combination with PTSD, their own unique syndromes.
According to the article, “severe comorbid psychopathology, a common feature of treatment-seeking individuals with PTSD, emerged as the predominant reason for exclusion across studies.” (p. 425) Given that this is a common feature among many of the combat-veterans considered in our intervention, it is clear that treatment methodologies concerning PTSD should also be trained toward the treatment of psychopathology and the correlating condition produced by the overlapping of this and PTSD. This will be essential to our consideration when designed a suitable intervention program that accounts for an array of overlapping symptoms. Where our study is concerned, this should dispel the notion that intervention should only focus on the PTSD and should instead contribute the perspective that such treatment is likely to require a comprehensive knowledge of related or overlapping conditions as well.
The article by Van der Kolk et al (2007) indicates that there is a need to promote treatment approaches that are not strictly drug-based. Quite frequently in today’s psychological treatment discipline, the article argues, the knee-jerk reaction is for therapists to match subjects with pharmacological treatment strategies in order to achieve rapidly detectable results. There is cause to consider that this strategy is not an effective way to approach PTSD. This is primarily because PTSD, in and of itself, is not inherently a chemical, biological or inborn disorder. Frequently traceable to specific events and therefore to specific cognitive processing disorders, the article by Van der Kolk et al (2007) proceeds from the position that it may not be most optimal to treat PTSD with drug course strategies.
The study in question would include 88 participants, all of whom had been previously diagnosed with PTSD and related symptoms denoting a stress-related disorder. The study would use the DSM-IV-approved Clinician Administered PTSD Scale and the Beck Depression Inventory-II in order to measure subjects both before and after treatment intervention. Subsequently, individuals were divided into pharmacological and therapeutic treatment groups. The former were given a selective serotonin reuptake inhibitor (SSRI) called fluoxetine while the latter will be given a placebo and engaged in an eye movement desensitization reprocessing (EMDR) therapy.
The major impetus for the research is quite a compelling one. According to van der Kolk et al (2007), “comparing the relative effectiveness of pharmacotherapy versus exposure therapy is particularly relevant in the treatment of PTSD, since the SSRIs are widely used to treat PTSD, particularly in primary care and health maintenance organization (HMO) settings, where little attention may be paid to helping patients ‘process’ their traumas.” (p. 2) The research ultimately supports this assumption, revealing that roughly 75% of adult-onset participants receiving therapeutic treatment would show ‘end-state functioning’ according to the aforementioned measurement tools. This would compare to a stunning 0% achievement of end-state functioning for those just receiving the SSRI. This is a particularly eye-opening to our study as we consider possible intervention strategies, with the proper caution being taken where drug-based treatments are concerned.
In support of the claims expressed in the article by Van der Kolk (2007), this article goes further to suggest modes of treatment for PTSD which are highly cognitive in nature. This helps to serve as a counterpoint to the tendency toward the use of pharmaceutical treatment in virtually all mental health circumstances. Here, the authors support the use of a strategy called ‘mindfulness,’ which promotes an intensive probing of a condition so as to get to it roots. By promoting this strategy of greater intellectual investigation of a condition, treating therapists can help to uncover some of the more complex individual roots to one’s pathos. According to Vujanovic et al (2011), “in recent years, clinicians and researchers have observed the increasing presence of mindfulness in Western mental health treatment programs. Mindfulness is about bringing an attitude of curiosity and compassion to present experience.” (p. 24) This suggests a degree of ideological progress in the field of Western mental health treatment that diverges from a collective dependency on pharmaceutical-based treatments. We are inclined to view this as more relevant to the construction of a meaningful intervention strategy for the subjects of the present study.
The text by Weiner et al (2003) is intended to provide an umbrella reference to the field of educational psychology. This apprises us of the relevance of childhood development, family circumstances and individual needs to the psychological growth of the individual. Ultimately, our study will focus on the impact levied by PTSD on individuals and their families. The impact levied on children in particular is of importance. The text by Weiner et al offers a synthesis of idea on how mental health properties and contexts can effect children, helping us to draw a direct connection to the likely consequences of untreated PTSD in a parent returning from military combat.