Therapeutic Relationships In Mental Health

Therapeutic Relationships In Mental Health The remit of this essay is to explore and discuss the concept of therapeutic relationships in mental health and what is involved in building these relationships. The question is in two parts, so in the first part of the essay, the author wishes to explore the meaning of a therapeutic relationship and discuss what is needed from the nurse and service user to maintain this. In the second part, the author will choose two key elements that contribute to a therapeutic relationship in mental health nursing and discuss the importance they have. The two key elements that have been chosen is communication, both verbal and non verbal, and the importance of these elements in a relationship between a nurse and a service user. To achieve this goal the author will use various resources available, for example the internet, literature from class and appropriate reading materials. Main Body Building relationships is central to nursing work, (Nursing Times) and extremely important in mental health nursing. A therapeutic relationship involves respect, empathy and genuineness (Callaghan and Waldock 2006). Both the nurse and service user should show respect for each other and the nurse should respect the beliefs of the service user, even if they do not agree with these. The relationship should be person centred, allowing the service user to be at the core of their care plans etc, their beliefs and wishes must be respected at all times. Service users must be at the centre of their care and recovery. Choices and decisions should be made by them. If there are any changes to be made to a care package, the service user must be informed and have their say. In a therapeutic relationship the nurse will support the service user in all aspects of their care and recovery. With reference to the quote in question, did it at my level and pace all the time, (Brown and Kandirkirira 2007) t his is vital in recovery and for a therapeutic relationship. The nurse must work alongside the service user and support them in aiming for the goals that the service user has made and not what the nurse expects them to be able to do. The service user should always remain at the centre of their recovery and to develop such a relationship, the nurse should share their knowledge of the illness, which gives the service user an understanding of what they are experiencing and some control on the situation and both will be able to take an active role in the management of the illness, (Owen 2004).The nurse should be able to show empathy, being able to put themselves in the service users position and imagine how they would feel and how they would wish to be treated, accurate empathy is always empowering, since it represents an understanding and acceptance of the speakers feelings (Millenson 1995). This skill shows the service user that the nurse has taken on board what has been said and that they can put themselves in the individuals situation. Those involved in the therapeutic relationship should always show genuineness and hold non judgmental attitudes towards each other. Genuineness is based on the ability of the practitioner to be open with his patientIt will help to reassert the patient as the centre of the treatment and promote the patients trust in the practitioner and his treatments, (Owen 2004). The nurse should want to work alongside the service user and offer support when needed to achieve and maintain this relationship. The people have the right and the duty to participate individually and collectively in the planning and implementation of their health care, (World Health Organisation 1978). A therapeutic relationship does not occur overnight, it takes time and a great deal of trust is essential between the nurse and the service user. Trust is very important for the relationship to develop and if this is achieved the service user will accept the nurses support and advice on treatments available and also work alongside each other instead of the nurse suggesting that they know best as they are the professional. patients themselves value therapeutic relationships which offer respect, trust and care and it seems that such relationships may in themselves prove to be healing in the broadest sense. (Mitchell and Cormack 1998). If trust is maintained throughout the development of the relationship the service user will begin to realise that the nurse does in fact care about their situation and does wish to support them on their road to recovery offering support and advice when necessary. The trust gained from both people should help each other to begin feel at ease the more they meet with each other and the service user may slowly begin to open up to the nurse and enable them to talk about how they are really feeling, what may scare them and accept their advice and support. It will also show the service user that they are at the centre of their care and that they will work at their own pace and when they are ready to take that one step further down their path to recovery, they will. A key element that contributes to a therapeutic relationship in mental health nursing is the use of verbal communication. One very important aspect of this is asking open questions, which the service user is unable to reply with a simple yes or no answer. This will allow the nurse to gain a deeper understanding of how the service user really feels (Burnard 1992). This also shows the service user is at the centre of their care and maybe they will begin to talk openly and freely about their true feelings as this type of questions show the nurse does care for them and wants to support them in the best possible way, it allows the nurse to empathise, if they can get a true account of the feelings the service user has. The empathy shown may encourage the service user to talk openly more often as they know that they will not be judged for having some of these feelings and thoughts. Another important aspect of verbal communication is reflecting and clarifying what has been said by the service user. Reflection requires the nurse to say back to the service user what they have said to ensure they understand fully. Clarifying is required by both the nurse and service user. The nurse may ask a closed question, which allows the service user to answer simply yes or no, or a single answer to be definite, to ensure they get the true meaning of what the service user is saying and in turn the nurse can explain their understanding of the illness or situation that the individual finds themselves in and what support and services are available and how they can go about setting these up, together, enabling the service user to make decisions after being given the choice to do so. When the nurse gives their views to the service user, any specialist language, for example jargon, should be avoided as this may act as a barrier within the therapeutic relationship as the nurse is not taking into account if the service user understands what is being said to them. This binds in with the core elements of a therapeutic relationship as the nurse will show empathy, genuineness and trust will increase working at the level and pace of the service user. The nurse must be aware of their tone of voice, (Stickley and Freshwater 2006) when speaking to the service user, to make sure they dont come across as patronising or uncaring. This may create a challenge in maintaining the relationship as the service user may feel belittled by the nurse and in turn may close up and not speak about how they are truly feeling therefore the relationship will not develop and there wont be any trust. Another element of verbal communication is the nurse should not be quick to problem solve, (Stickley and Freshwater 2006). Allowing the service user to think of approaches of overcoming the problems that may occur during their recovery process highlights that they are at the centre of their care and shows that they have the final decision in their care and or treatment. If the nurse moves in quickly to try and help the service user, it may come across as patronising and that they are trying to take control of the situation as they have not took the time to a sk what the service user wants and may cause a barrier between the nurse and the service user. The second key element that contributes to therapeutic relationships in mental health is the use of non verbal communication. This element is extremely important in maintaining a therapeutic relationship and being aware of the skill involved is vital. The most important skill is sitting in a mirrored position, not sitting face on in front of the patient but to the side and leaning slightly in showing they are ready and willing to listen (Stickley and Freshwater 2006), sitting behind a desk can act as a barrier and come across as authoritative (Burnard 1992) and may cause the service user to feel uneasy, deterring them from opening up and feeling unable to trust the nurse. The nurse should be sitting comfortably and in a way that does not make the service user feel uncomfortable in any way. The use of eye contact is paramount in maintaining a therapeutic relationship but knowing when and how to use the skill is the key. Too much eye contact may cause the situation to intensify and bot h the nurse and service user may feel uncomfortable. Not enough eye contact may convey a lack of interest in what the service user is trying to tell them and may cause the therapeutic relationship to come to an end and the service user may not show what they are truly feeling or thinking at this time. Another important aspect of non verbal communication is listening, The role of the listener therefore is a privileged one and one that can promote healing, (Stickley and Freshwater 2006). Listening is probably one of the greatest skills a nurse can achieve. Listening is, the nurse hearing what the service user is saying and understanding what is being said, not what the nurse thinks they are saying. effectiveness largely depends on the nurses ability to listen and detect cues for therapeutic enquiry, (Stickley and Freshwater 2006). Thus again shows the nurse has picked up on the detail of the statement from the service user and can reflect back to the service user what has been said to clarify their understanding and to reassure the service user that they are being listened to. This will help the service user to build trust in the nurse as they will have a feeling of acceptance and that someone is listening to them. Conclusion It can now be seen that there are many key elements that contribute to a therapeutic relationship and the list is endless. A therapeutic relationship requires a lot of time and trust on both parts and the core skills required from a nurse is empathy, trust and genuineness. As the author stated she was only looking at two key elements that contribute to this relationship and feels further investigation may be required into other elements to fully understand the importance and why such skills are acquired to build a relationship with a service user and the difficulties they may come across in maintaining a therapeutic relationship. One thing the author has achieved is the importance of person centred care and how essential it is to involve and listen to the service user in all aspects of their care.

Cash for Organs

Sheila Rivers ENG 101/MWF Oct. 29, 2012 Mr. Viquesney Cash for Organs Charity should be the only basis for organ donation. On the other hand, cash compensation for donating organs should be an option and legalized. With the overwhelming need for organs and not enough donors in the United States, an open, regulated, and legal cash-for-organs market is needed to balance the need and shortage of organs. There will always be a need for organ donations.According to the United Network for Organ Sharing (UNOS), as of October 2012 there are 116,421 men, women, and children on the organ transplant waitlist to receive hearts, livers, kidneys, and other human organs. With a total of only 8,280 donors alive and deceased so far this year, the need for donated organs far exceeds the donation of organs. This need for donated organs leaves a large gap in transplants and consequently patients wait months, even years on the waiting list for donated organs. Every ten minutes another name is added to th e national organ transplant waiting list.By the time patients get on the waiting list they have been evaluated by a transplant doctor and is in end stage organ failure. According to (organdonor. gov) right now, there are more than enough people waiting for an organ to fill a football stadium twice over. On average, 18 people die every day waiting for a transplant that never happens as a direct result of the lack of organ donations. Patients that can afford it will travel to other countries to purchase organs on the black market to save their life. The National Organ Transplant Act (NOTA) passed in 1984, made the buying and selling of human organs in the United States illegal.Over all too many people die each year waiting for a donated organ that is not available to save their life. The option to sell an organ should be solely left up to the individual who wants to do so, as long as the procedure and all the risks that are involved are fully understood. If someone decides to sell and organ to who ever they want, for a momentary compensation they should have the right to do so. It will not only save the life of the recipient, but also financially compensate the donor in return. After all it is their body and the government should not have the right to tell people that selling an organ for compensation is illegal.With so many people dying and waiting for a life saving organ transplant, this would decrease the deaths and wait time for an organ. In 1988 Iran became one of the first Nations to permit and regulate payment and other incentives for living donor transplants. As a result, the number of renal transplants performed substantially increased such that in 1999, the renal transplant waitlist was completely eliminated. Currently, Iran has no renal transplant waiting list. With results such as this, proves that cash for human organs can potentially eliminate the transplant waitlist in the United States.A number of transplant experts have been convinced tat provid ing financial incentives to organ sources, as an alternative to altruistic organ donation needs careful reconsideration. By permitting an open, regulated, and legal cash-for-organs market this could save the lives of the people who suffer and die daily because of kidney failure while waiting for a donated kidney. The director of Kidney Health Australia said â€Å"if it was carefully regulated in a way that avoided any potential abuse and was organized by the government or some other process that was meaningful, a pilot would be worthwhile doing† [Mathew].If there were some kind of compensation for organ donations, more people would be interested and willing to become organ donors. The kidney is the only organ a person can sell or donate and safely continue to live without. Even though we are born with two kidneys a person can live a full and normal life with just one, in addition to living just as long as a person with two. In the case of a kidney, a love donor is capable of living successfully after a transplant surgery, because over the years surgeries have become safer and less invasive for the donor with less down time.According to the registry data from UNOS, research has shown that a kidney from a live donor is the best option for long-term transplantation. Over the years the number of living donors have steadily decreased while the deceased donors have increased, although the increase in not enough to offset the decrease. NOTA was also created to address the critical organ donation shortage and improve the organ matching and placement process. As said, â€Å"Due to the high success rate of organ transplants over the years it has made getting an organ more difficult.Improved survival rates and the expectation that organ replacement will enhance quality of life have encouraged more doctors and their patients with organ failure to opt for transplantation† [Klein]. The early organ transplants performed routinely had a high mortality rate; the major issue was the patients’ immune system rejected the foreign organ. Throughout the years with the introduction of medicine has helped lower the mortality rate due to the rejection of the foreign organ and organ transplants have become more routine and less experimental.To their surprise, donors do not understand or know how many lives are saved or can be saved simply by donating organs. There are no age requirements to being an organ donor. The fact is everyone can be an organ donor; anybody under the age of eighteen has to have a parental consent. The process of convincing individuals to be an organ donor is challenging, and some of these challenges are a lack of knowledge, fear of premature death, and the lack of trust of the medical profession. Most people do not know what the process of organ donation is and how it works to save lives.People feel that if the doctor knew they where an organ donor he/she would not put as much effort into saving their life because of thi s. If people had a better understanding and more knowledge about the process of organ donation more people would be willing to donate organs to help save lives. Charity should not be the only option for organ donation. When charity is the only option the donor do not have the right to give their organ to who they wish. With so many people on the waitlist for an organ transplant and way to few donors there needs to be another way to attract donors.The cash for organ program that has shown a success in other countries should be looked at on a more serious note. Due to the shortage sever shortage of donated organs that has led to needless death of so many people, the cash for organs seems to be a very legitimate way to save lives. Until modern medicine can completely grow fully develop human organs there will always be a need for human organs and the fastest way to obtain organs for transplant is to offer monetaury compensation.The compensation for human organs will open up a market fo r willing donors. Bibliography optn. transplant. hrsa. gov unos. org Klein, Andrew S. , MD, director of Cedar’s-Sinai Medical Center Declining Organ Donations, Causes Widening Need Gap, Life Science, 22 March 2010 Ahad, Ghods J. , Dr. ‘Iranian Model of Paid and Regulated Living-Unrelated Kidney Donation. † Cjasn. asnjournals. org N. p. , n. d. Web Page 1 www. unos. org Page 2 www. optn. transplant. hrsa. gov Page 2 Andrew S. Klein, MD, director of Cedar’s-Sinai Medical Center

Personal Essay

The negative is so easy to dwell on for most people, but here's what I remember err most from the situations that Eve been put through because of my mom's habit of fleeing. I remember going to work with my dad, so that we could both make what little money we could to put food on the table. Remember the good laughs we had when we would be able to get a frozen pizza, or a gallon of milk and eat like kings. I remember being strong. I know that when I'm in a place of need, my father would kill to make it better, and although we ere struggling to afford everyday needs, I knew that if kept a smile, my dad would keep one too.Through learning that had to do everything that I could in order to keep my mind away from the negative as well as keep my body moving to support me and m y dad, tried my very best in school. There were times when I couldn't make it through a day b cause Of pure exhaustion but I had to keep moving in order to strengthen the bonds of not only me and my dad, but all of my friends and teachers that supported me through this rough attach in my life.My family means everything to me, and those values run deeper than anything g know. Never did turn my back on someone just because they made a mistake. This was the last time my mom ever left me, and she has come back since and has done every hinge to work with me to strengthen our con injection again. She didn't need to do any of this. She has left and came back quite a few times through my life, and although this was the w resort, would not turn my back on family.No matter how devastated I was during the incident, I love, I quickly let my mother back into my life, and do not regret that by any means. TomorroWs a new day in life. When the sun comes out, I know that its time t 0 work. I have found true meaning to forgive and forget, and make the best of whatever RL am given. Fight and strive for a better life, and if everything goes well, I'll become a Bette r man. A man who is not dragged down by anything, big or small, but still has the heart and dedication to work hard and never stagger my beliefs or values. Personal Essay Personal Responsibility Essay Terriers Howard Gender September 12. 2013 Kate Though Furthering your education can be a encouraging and discouraging decision; really when you have everyday life situations and experiences. Today's average adult is working, taking care of children, and also dealing with unexpected life events and with all those things going on they continue to strive for success. Continuing education on top of all those responsibilities can add great stress, but It can be accomplished.Myself has seen my mother raise children, work, and continue education. Her advice to me was to accomplish success in life with goal settings, vision, and mental preparation. Collegial (2004-2007), â€Å"Goal setting is the process of deciding on something you want, planning how to get it, and then working towards the objective†. The way to attain long term goals Is to to set short term goals first, which are more attainable In smaller steps.Short term goals are Like stepping stones they are designed In smaller moderation to obtain the bigger picture, which is to accomplish the long term goal, which will lead to greater success. A person can set to achieve a short term goal within a short period of time from one day until one week, or even six months whether than a long term goal which can take years. You can see short term progression much greater than long term every time you accomplish a short term goal, a pat on the back Is in demand, and means that you are one step closer to your long term goal.The funny thing about goal setting Is that you should always set long term goals first to give yourself a window, and to place goals in order of importance. You should always set long and short term meaningful goals Goal eating also involves maintaining specific, measurable, achievable, realistic and time targeted goals to become attainable. Discouragement will come along, but time management and goal setting will give you an outlook on your lives plan. Life is a l esson within Itself you have to start somewhere to end up somewhere.Vision meaning the act or power of anticipating that which will or may come. Vision Is another technique required to become successful at furthering your education. Vision is an outlook that one has for themselves to see the future a pictures of Seibel future based plans which can be perceived mentally during dreams or life images. Vision is needed to stay focused and on track to become successful, and also the foundation for success, one must have vision to know there place In life or what attain the perceived images and dreams.Vision is also needed to remain determined when life's unexpected events arouse you can always go into your subconscious thoughts and remember your vision you have for yourself to continue your successful journey. Mental preparation is another technique helpful and needed to have a successful education experience. Mental preparation is very important for an adult who is continuing education, working , being a parent, and a spouse to help keep ones sanity and to accomplish having academic needs met.Mental preparation can help one cope better with stress, the ability to separate, but not completely forget about life stresses. Practicing on how to focus on keeping what is important together at that present time. To prepare yourself for furthering education you have to put yourself on the top of list as number one proper rest, exercise, good eating habits re needed to stay healthy and have adequate mental awareness and energy to deal with the extra meal on your plate.Good study habits and ample study time is needed to be successful in your furthering education, completing assignments early not waiting until the last minute to turn them in, which can lead to a major stresses. You have to make scheduled school days less stressful plan other activities on other day if possible, doing so will enhance your education, this will give you confidence, control, and mental energy in doing such strategies will lead to better education experience.Personal responsibility is being accountable for your own decisions and actions, and having self respect for yourself and others to become successful. Having to maintain personal life, being in the work force, and continuing education can all be a bit much, but is attainable with determination, patience , support, and focus to become successful. All one needs is to have a vision of lives path, set goals to attain the vision â€Å"road blocks don't mean failure, repeating goals make it stick† (The Numerous foundation, 1995-2013). Also mental preparation to make the furthering education experience much easier.

Fahrenheit 451 Quotes

When Ray Bradbury wrote Fahrenheit 451 in 1953, television was gaining popularity for the first time, and Bradbury was concerned about its increasing influence in everyday peoples lives. In Fahrenheit 451, the contrast between passive entertainment (television) and critical thought (books) is a central concern. Many of the quotes in Fahrenheit 451 emphasize Bradbury’s argument that passive entertainment is mind-numbing and even destructive, as well as his belief that worthwhile knowledge requires effort and patience. The following quotes represent some of the most significant ideas and arguments within the novel. â€Å"It was a pleasure to burn. It was a special pleasure to see things eaten, to see things blackened and changed. With the brass nozzle in his fists, with this great python spitting its venomous kerosene upon the world, the blood pounded in his head, and his hands were the hands of some amazing conductor playing all the symphonies of blazing and burning to bring down the tatters and charcoal ruins of history.† (Part 1) These are the opening lines of the novel. The passage describes Guy Montags work as a Fireman, which in this dystopian world means that he burns books, rather than putting out fires. The quote contains details about Montag using his flamethrower to destroy a stock of illegal books, but the language the quote employs contains much more depth. These lines serve as a declaration of the central motif of the novel: the belief that humans prefer the easy, gratifying path over anything that requires effort. Bradbury uses lush, sensual language to describe the act of destruction. Through the use of words like pleasure and amazing, burning books is depicted as fun and enjoyable. The act of burning is also described in terms of power, suggesting that Montag is reducing all of history to tatters and charcoal with his bare hands. Bradbury uses animal imagery (the great python) to show that Montag is operating on a primitive and instinctive level: pleasure or pain, hunger or satiation. â€Å"Coloured people dont like Little Black Sambo. Burn it. White people dont feel good about Uncle Toms Cabin. Burn it. Someones written a book on tobacco and cancer of the lungs? The cigarette people are weeping? Bum the book. Serenity, Montag. Peace, Montag. Take your fight outside. Better yet, into the incinerator.† (Part 1) Captain Beatty makes this statement to Montag as a justification for book-burning. In the passage, Beatty argues that books cause trouble, and that by eliminating access to information, society will achieve serenity and peace. The statement underscores what Bradbury sees as the slippery slope leading to dystopia: intolerance of ideas that cause discomfort or unease. â€Å"I dont talk things. I talk the meaning of things. I sit here and know Im alive.† (Part 2) This statement, made by the character Faber, emphasizes the importance of critical thought. For Faber, considering the meaning of information—not just passively absorbing it—is what enables him to know [hes] alive. Faber contrasts talk[ing] the meaning of things with simply talk[ing] things, which in this passage refers to meaningless, superficial information-sharing or absorption devoid of any context or analysis. The loud, flashy, and virtually meaningless TV shows in the world of Fahrenheit 451, are a prime example of media that does nothing more than talk[ing] things. In this context, books themselves are merely objects, but they become powerful when readers use critical thought to explore the meaning of the information the books contain. Bradbury explicitly links the act of thinking and processing information with being alive. Consider this idea of aliveness in relation to Montags wife Millie, who is constantly passively absorbing television and repeatedly attempts to end her own life. â€Å"Books arent people. You read and I look around, but there isnt anybody!† (Part 2) Montag’s wife, Millie, rejects Montag’s efforts to force her to think. When Montag tries to read aloud to her, Millie reacts with increasing alarm and violence, at which point she makes the above statement. Millies statement encapsulates what Bradbury sees as part of the problem of passive entertainment like television: it creates the illusion of community and activity. Millie feels that she is engaging with other people when she is watching television, but in fact she is simply sitting alone in her living room. The quote is also an example of irony. Millies complaint that books arent people is supposed to contrast with the human contact she feels when watching television. In fact, however, books are the product of human minds expressing themselves, and when you read you are making a connection with that mind over time and space. â€Å"Stuff your eyes with wonder. Live as if youd drop dead in ten seconds. See the world. Its more fantastic than any dream made or paid for in factories. Ask for no guarantees, ask for no security, there never was such an animal.† (Part 3) This statement is made by Granger, the leader of a group that memorizes books in order to pass the knowledge on to a future generation. Granger is speaking to Montag as they watch their city go up in flames. The first part of the statement implores the listener to see, experience, and learn about as much of the world as possible. He likens the mass-produced world of television to a factory of false fantasies, and argues that exploring the real world brings greater fulfillment and discovery than factory-made entertainment. At the end of the passage, Granger concedes that there never was such an animal as security—knowledge may very well bring discomfort and danger, but there is no other way to live.