Case Study: Neglect

This case involves a 16 year old male and subsequently four of his younger siblings. In elementary school, the client earned â€Å"A† and â€Å"B† grades. However, this did not continue in high school. Additionally, the once active boy began to isolate. He stopped playing basketball and spent more time in the counselor’s office just to avoid the other children as they often made fun of him. The client began seeing the school counselor when he was ten years old. His parents were both alcoholics and were involved in using and selling illegal substances. The living conditions at home were unbearable. There was often no food, electricity, or water in the home. The client reported that the windows were only screen, leaving the home freezing. The client also reported that his parents would lock him and his siblings in their room to ensure they did not tell authorities the truth about what was going on in the house. This typically occurred when the parents got word that the police or the Department of Family Services was on their way over. There was five children in this family, the client was the oldest, four child were currently still in the home. In addition to the neglect the client experienced, he also experienced abuse. This case study mentioned one obvious incident. When the client returned to his parent’s home after staying with his aunt’s because of neglect charge, he came back to school with a broken arm. This was the only indication of physical abuse during this case study, however the client did not discuss what happened. Additional physical abuse or any other type of abuse is unknown. This client was also responsible for his siblings. He made sure they were dressed and feed for school. He also assisted his siblings with their homework. This responsibility left no time for him resulting in poor grades and his social life decreased. The client also displayed symptoms of hopelessness, suggesting depression. The school counselor made note of possible diagnoses, however, it does not appear that the counselor ever made an official diagnosis. The counselor did mention Depression as a primary diagnosis due to the client’s negative doom related vocabulary. Treating this client for depression may be helpful. To meet a diagnosis of Depression the individual must experience at least five of the following symptoms in the same two weeks: depressed mood, weight loss or gain, too much or too little sleep, increased or decreased psychomotor activity, fatigue, feelings of worthlessness, poor concentration, or suicidal ideation. These symptoms must be significant enough to cause marked impairment in work or school. This client did display many of these symptoms. For example, the therapist stated that the client said the word â€Å"hopeless† often. The client also looked underweight, had difficulty in school both academically and socially, and did not receive the proper amount of sleep (DSM-IV-TR). Finally, these symptoms must be more severe than the common blues everyone experiences from time to time. While this client was probably suffering with some degree of depression, there were other factors which better explain these symptoms. This client was the victim of child neglect and abuse. As noted above the children in this family often went without their basic needs. This is a better explanation for the client’s symptoms than depression because when placed in a more nurturing environment, the client’s symptoms dissipated. The client displayed this change in behavior when the courts sent the children to the aunt’s home after the client called the Department of Family Services to file the neglect report. During this time, all the children were going to school clean and feed. The children’s homework, including the client’s was completed. This dissipation of symptoms was seen a second time when the client was placed in foster care. Again, he was going to school clean and feed and with homework completed. Once at his foster parent’s home, the client was also able to go back to playing basketball again. During the course of the client and school counselor relationship, the client saw the counselor on a weekly basis. The school counselor designed these meetings to assist the client in problem solving with regard to caring for his younger siblings. The counselor’s recognition of the client’s needs in this regard was definitely a factor in the client’s ability to make it through this difficult time. This is not always the case in turn causing the client to feel that therapy does not work. Additionally, the counselor did not push the client for information or action so a healthy relationship was able to develop. The counselor was able to slowly earn the client’s trust by showing him she was there for him. This benefited the client in a number of ways. He was able to develop a positive supportive relationship with an adult role model and he was able to gain the courage and strength to put an end to the neglect he was experiencing. As the client progressed in his problem solving and decision making skills the therapist should modify the methods and goals of the therapy sessions. Once the client moved from his biological parents and later adopted, his roles and responsibilities changed drastically. With the new family he lived as a normal child, he was clean, well feed, and rejoined the school’s basketball team. He no longer had to care for younger children in a parenting capacity. At this point therapy should move the focus to resolving the issues of abuse and neglect so the client can come to terms with his past. The use of psychoanalytic therapy would be an appropriate therapeutic method. With this type of therapy the client is able to talk out his issues. With the help of the therapist, the client will learn how to forgive and cope with these issues. What is unfortunate in this case is the fact that the other children ended up going back to the parents. Shortly after that reunification, the old ways came back. However, since the client was not there to act as the caregiver for the other children, the oldest sister took over that role. Here the cycle continues. Although the other children were not as open with the school counselor, they need close monitoring just as their bother received in the past. This close monitoring may be able to stop further neglect and abuse from occurring. Additionally, it would be wise to continue monitoring and providing therapeutic services to this client. There may still be some deep seeded issues he will need to deal with. Finally, the client will need help adjusting to his new family and the issues they have brought him, specifically the separation of his adoptive parents. In addition to ensuring that this client is adjusted in his new life, additional support and therapy can monitor the presence of future mental health related problems. Posttraumatic Stress Disorder is often seen in individuals who have experienced abuse. Because of the life situations this client had endured as a child, he is susceptible for Posttraumatic Stress Disorder. If this disorder develops, the client will experience flashback type symptoms. This may hinder his ability to cope with past and future life events. Additional problems associated with Posttraumatic Stress Disorder include impulsive behaviors, insomnia, nightmares, avoidance issues, poor concentration, hypervigilance, and increased startle response. Because Posttraumatic Stress Disorder occurs after the individual experiences the trauma, symptoms may not appear until later in adulthood. Also common in individuals with Posttraumatic Stress Disorder is alcoholism and substance abuse. Again, this client is at a higher risk for these issues because of the genetic component of both alcoholism and substance abuse. A diagnosis of alcohol abuse or dependence includes behaviors that include neglect of responsibilities. Individuals who abuse alcohol also will continue to use despite the fact that they know it is causing problems in their life both physically and socially. With continued therapy and support, the client will be able to work out these childhood issues and therefore decrease the probability of future problems. Continued support will also give the client the skills necessary to cope with life’s stressful events. The client will be equipped with the tools need to deal with his problems in a healthy way as opposed to turning to drugs and alcohol. Continued therapy will also allow the client to work out any feelings he may have regarding his siblings who were sent back to his parents. This aspect was not noted in the case study; however, he may harbor feelings of guilt or regret, knowing that his siblings are still in a neglectful situation. It would also be beneficial to the client to join support groups in order to increase his support system. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: Author.      

Four stages of the learning cycle Essay

During our final chapter, we discussed the four stages of the learning cycle. The four stages of transformational learning are as follows: recognizing a significant problem, confronting it intensely, finding a solution, then integrating a new perspective and a new set of assumptions into ones’ life pattern. I think that a lot of times people go through life not realizing when they have a problem. Therefore, acknowledging your problem is most definitely the first step in learning from it. When you realize that there is a problem, you must confront the problem head on to find a solution. Once you have found a solution, you need to incorporate it into your life. These four stages are important in any learning experience. The transformational experience that I will use for my example is very personal. I used to be in a very abusive marriage. My marriage was damaging to me as a person, and damaging to my children because it prohibited me from making anything of myself. I would always make excuses for my lack of productivity, stating that I couldn’t do anything with my life because my husband wouldn’t let me. Finally, in 2011, I realized that I was wasting my life. The only thing that my daughter was ever going to learn from me, was how to let someone else run there life and impact her choices. We would never have had a normal life! When I realized what I was doing to myself and to my kids, I knew that I had a significant problem. I confronted the problem, and I was very intense about it. I tried marriage counseling, personal counseling, and biblical counseling. I tried talking with my ex, and I sought advice from many people whom I really believed could help. After exhausting my resources, I knew that the only logical solution was to take my children out of the abusive situation and start from scratch. I chose to go first to the police for help, and then to battered women’s shelter. The women’s shelter helped us to move away and start over. I have now been away from him for a little over two years, and I am in my first healthy relationship. By integrating my new perception, I was able to go farther in the past year than I ever did in all of the years of my former relationship. I am now a business owner, I am in school, and I am getting married to a wonderful man who loves me and my children. My children now get to grow up in a loving family and a healthy environment. I am now able to say with confidence that I am doing my best to be an example for them. This was most definitely a transformational learning experience for me. I think that in my experience the main stage that applied in my life, was the integration stage. It is often easier to recognize a problem, and even to find a solution, than it is to follow through on change. Often times the follow through is not so simple. There were numerous times during that relationship where I knew the problem, and the solution was apparent, however I didn’t believe in myself to integrate the solution it into my life. I believe that truly integrating a new perspective, and changing your assumptions is a very difficult stage to master. I am glad that I was able to make it through that final stage, and to become the person I am today. I still have a long way to go, but I am proud to be so far from who I once was.

DQ1 Essay Example | Topics and Well Written Essays - 250 words - 2

DQ1 - Essay Example The court system in the United States is dual comprising of the state courts and the federal courts. Unlike the traditional system of organization where power is central, these systems work side by side with exclusive jurisdiction. There are several courts each having its own structure and procedure. The court system is very open. Any person can present a dispute in court at any time. Contrary to traditional organizations where all the decisions concerning the organization are made at the helm, the court system resolves disputes within its jurisdiction without consulting with the Supreme Court. In addition, the court system is a defender of human rights. They are important in protecting basic rights such as freedom of speech and equality to all. The courts encourage right to speech that is inhibited in the traditional organizations systems. Furthermore, the court is different from traditional organizations because they ensure that the system of governance is federal. A federal system limits the power of government by sharing and dividing power between other states. This distribution of power is important as it prevents tyranny (Howard,

The use of prophylactic antibiotics to reduce the instances of Research Paper

The use of prophylactic antibiotics to reduce the instances of surgical site infections - Research Paper Example We will write a plan for the implementation and evaluation of this plan and its application guidelines. In the interest of covering the trend of electronic health records, the plan will involve the use of newer technologies in maintaining a 100% antibiotic prophylaxis rate. While much has been written concerning which medications to use, when and how, I will take the Stetler Model to use newer technologies to improve upon current problems and provide new ideas to that extent. Phase 1: Introduction and Preparation A great many strides have been made since the advent of antibiotics that have helped cure infection and even prevent them from happening. In surgical care, because the body is being necessarily invaded normal flora can be translated to areas in which they become pathogenic and cause infection and disease (Wells, 2009) . Surgical site infections occur as a result of these bacteria and cause disease in the following manners: Incisional Deep (muscle and fascial layers) Subcutan eous (cellulitis) Organ or Space (Abscess or Meningitis) Further, research conducted by White (2007) shows how despite national recommendation guidelines many hospital surgical teams fail in achieving a 95%+ rate of surgical antibiotic prophylaxis to prevent post-operative infections which can occur as late as 30 days after the procedure (Wells, 2009). The most common soft tissue infectionsare gram positive organisms and are easily treated or prevented, but if allowed to infect areas of the body without prior treatment they can reproduce and cause abscesses, then the chance of damaging infections where organ function is compromised can be adequately controlled using the Stetler model to be implemented here. Appendix 1 will show the replication of the National Research Council Wound Classification. Interest Interest in this topic stems from insight to the needs we have at present to improve some of the antiquated paper systems in place with one that provides for the needs of the pati ent population, accounting for human error, that will be incurring a surgical procedure and that would be all patients from pediatric to geriatric. The need to limit infection as a complication of an already difficult medical practice is tantamount to improving post-operative infection outcomes where co-morbidities are not common place, but rare and limited. Patient Population and Clinical Settings As mentioned, almost every patient will at one time need a surgical procedure. However, each operation is different and carries risks unique to itself. A colectomy will certainly need different antibiotic treatment than a simple cyst removal or even a transplant operation, however the pre-surgical needs are all the same. Each patient needs to meet with the anesthesiologist, the operating surgeon if they haven't prior to the date, and nursing staff who will be caring for them throughout the process. In each, be it an outpatient facility, hospital, or clinic, appropriate treatments should b e administered and proper documentation followed. Validation and Literature Review A complete and thorough review of current literature regarding surgical prophylaxis was performed using Google Scholar for literature review, PubMed, and text sources. Search target parameters included 'surgical prophylaxis error', 'nursing surgery error', 'pre-surgical antibiotics' and 'surgical infection'. After a thorough review,

Ethical Issue Essay Example | Topics and Well Written Essays - 2000 words

Ethical Issue - Essay Example The meaning of ethical issues is dealing with or regarding the principles or morals of morality (MacNair, 2003). Ethical issues are concerning the rights and wrongs in conduct, expressing or involving moral approval, in reference to principles of conduct, which are regarded correct, particularly those of a given group or profession for instance nursing. Basic values of saving life, as well as alleviating suffering, is shared by a member of the nursing and medical professions (Bandman, 2002). Codes of honesty, confidentiality and colleagueship, are also anticipated in these groups. Nevertheless, the spirit of obedience and servitude, questioned by Mitchell (2008), but influenced by a majority of nurses, has led to numerous differences in the manner in which dilemmas are tackled and the context in which doctors and nurses regard their professional ethics. This paper will give a comprehensive overview of an ethical issue and its relationship to the ethical and legal aspects of nursing o r other health care professions. It will include an exploration of the pro and con sides of the ethical issue and take a stand on the issue and also critically evaluate the current impact of the ethical issue. ... A majority of the stands nurses presume in this dilemma are persuaded by their own values and beliefs (Bandman, 2002). The consequences, at times, are harsh to both the nurse and the patient. Therefore, how does a nurse provide her services to a patient who has gone through an abortion, when the nurse regards abortion as murder? Should the nurse, with very different values, support the patient’s right to decide her autonomy? Pro Side of the Issue The most frequent reasons why women consider abortion are: Unable to care or support for the child. Birth control failure. Nearly half of all women who have gone through an abortion made use of a contraceptive technique in the month they got pregnant (MacNair, 2003). To stop the birth of a child with harsh medical problems or birth defects. Such defects are frequently unidentified until routine second-trimester assessments are carried out. To terminate an unwanted pregnancy. Mental or physical conditions, which jeopardize the pregnant woman’s health when the pregnancy is continued. Pregnancy resulting from incest or rape. All these are strong reasons why abortion is considered (Bandman, 2002). I also think that a pregnant woman ought to have access to a harmless, legal abortion if she requires one. I endorse a pregnant woman's right to harmless, legal abortion since centuries of history tells us that women are going to make the final decision regarding abortions whether they are legal and safe, or not. Furthermore, when the act is not safe and legal, these women might die terribly or be damaged permanently meaning that they might become barren (MacNair, 2003). Therefore, the pro side of this issue is that it saves women the possibility of going through an unsafe and illegal abortion. In my dream utopia, there would

Corporate Governance Case Study Example | Topics and Well Written Essays - 500 words

Corporate Governance - Case Study Example There was the lack of faith since the association was not sufficient enough. There was also lack of faith making the affiliation have some distance. During the old times, firing was mantle and euphemized. Long ago, Corporate embraced the straightforward system of firing to outline dismissals. Many panels took some pleasure in announcing to the world that they dismissed an individual (Feintzeig 1). While currently, staff are sent off softly with a declaration that the leader would step down to be with family for some time or follow other importance. However, at present, businesses go to the extent of declaring that the bosses have been dismissed and even go a step forward to give features. Supervising and dismissal is an element of the board of directors because, corporate supremacy is their responsibility. The board of directors presides over the corporation keeping an eye on the organization and stands for the concern of the company’s shareholders. Companies must have their director’s vote for by the investors. Therefore, they have a fiduciary obligation to their investors, who are their firm’s proprietor. The managers as well as commercial officials can be apprehended legally responsible for deteriorating to convene their fiduciary obligation to investors (Feintzeig 2). Firing for cause is based on little set of reasons in connection to the worker’s conduct such as disobedience. It means that the action by the worker has permanently injured the connection among the boss and the worker. While in termination with no reason, the worker is being dismissed for motives that do not connect to bad behavior. Those dismissed are normally given some money. Being fired for or no grounds, when the employee did not do anything, depends on the service rank and particularly on whether the worker is on at-will member of staff. The stigma of being dismissed was a major shock. It also consequences to despair, increase prime rates and scarcity in

The Case Concerning the Pellian Workers Party (PWP) Assignment

The Case Concerning the Pellian Workers Party (PWP) - Assignment Example All the members of PWP are residents of Pell and the group receives financial support from ordinary well wishers, who are Pellians. PWP’s actions are not relate with the state. As such, it is clear that the actions of PWP are not the same as armed attack as contained in the customary international law. Q2. In determining the legitimacy of NAIOS to initiate a joint self-defense against PWP as in Article 5 of NAIOS and Article 51, United Nations Charter, there must be ascertainment that the actions of PWP qualify for armed attack as provided by the two Articles. Looking the case, PWP are just insurgents whose actions are criminal in nature and the scope of their actions remains affairs internal to Pell and Aldor. Therefore, the NAIOS has no mandate to launch military revenge in group self-defense. However, NAIOS can provide Pell and Aldor with assistance to effectively deal with their internal