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Clinical mental health internship (2)
Clinical mental health internship
Internships are part and parcel of the learning program, and one can fully understand what is meant by being in the field for what they are studying for. I am taking Clinical mental health, and an internship comes along as an essential aspect of my career. Therefore, the internship focusing on what will be learned and its benefits will add to my job. Thus with this in mind St. Luke’s Behavioural Health center would be an appropriate place to have my internship. Intermountain Centers Flagstaff, AZ, would also be very reasonable for my internship.
The two centers focus on making sure that the mental health of their patients is well looked after. The two centers are also well known for their excellent quality care and the ability for interns to learn from them perfectly. The two centers are also strict in following all the states’ requirements about practicum and internship (Behavioral Consultation Services, n.d.). With the experience obtained from these two institutions, I hope to work with one of them in the future. However, even if not so, I will be one of the best in the field due to the experience I will get from the internship.
References
St. Luke’s Behavioral Health | Steward Family Hospital | Phoenix, AZ. (n.d.). Www.stlukesbehavioralhealth.org. https://www.stlukesbehavioralhealth.org/Intermountain Centers Flagstaff, AZ | Behavioral Consultation Services. (n.d.). Intermountain Centers. Retrieved June 17, 2021, from https://intermountaincenters.org/arizona/flagstaff/
Clinical Depression
Clinical Depression
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Clinical Depression
Introduction to Clinical Depression
Mental health is an integral part of a person’s wellbeing. Like other health components, such as physical health, our minds give us clues when all is not well. Different mental health disorders present various symptoms used in diagnosis. Clinical depression is a mental health disorder that can happen to anyone regardless of age, gender, or any other characteristic. The main aspect of clinical depression is a profound feeling of deep sadness and low mood that goes on for at least two weeks. The impact on one’s mood and emotional state affects different areas of life.
Clinical depression has several symptoms used in diagnosis according to the DSM-V. One of these symptoms is the persistent feelings of sadness almost all the time. A depressed individual also shows diminished interest or a total lack of interest in everyday activities that they enjoyed before. Another sign of depression is persistent feelings of guilt and worthlessness without explanation. Fourth, an individual is diagnosed with depression when they experience thoughts of suicide recurrently, which may result in an attempt or plan to commit suicide. Other symptoms include excessive fatigue, loss of concentration, indecisiveness, and changes in weight and appetite. Clinical depression negatively affects the patient and the people around them, such as their family, friends, and colleagues. If untreated, clinical depression could lead to dangerous behavior like substance abuse, ruined relationships, sleeping problems, physical illness, and suicide.
Research on Therapeutic Modalities Effectively Treating Clinical Depression in Group Settings
Thimm & Antonsen explored the effectiveness of cognitive-behavioral group therapy for patients with clinical depression. One hundred forty-three patients took part in the study, with 88 of these analyzed during the outcome. It was found that 30% of patients recovered from depression, and 44% showed remarkable improvement (Thimm & Antonsen 2014). The researchers used the Beck Depression Inventory to measure the outcome of the program. CBT has long been recognized as a valuable and effective treatment option for clinical depression; therefore, group CBT was expected to work as well. The study found CBT to be effective due to the significant number of patients who recovered. One of the benefits of group CBT is that it is a cost-effective measure as several patients are treated simultaneously. Patients also feel that their illness is normal and learn from each other’s experience with depression.
Aguilera and colleagues conducted another study to determine the efficiency of GCBT in treating clinical depression among a group of Latinos. The study was conducted in a primary care facility where 96 patients participated in multiple sessions of group CBT. One of the main challenges experienced in the program was a high dropout rate and failure to adhere to the program. The program offered 16 sessions of GCBT, but half of all patients failed to attend 50% of the sessions. It was concluded that the more the sessions attended, the lower the depressive symptoms the patients showed over time (Aguilera et al., 2018). Group CBT was found to be an effective intervention in this case.
Clinical depression tends to be a common issue for women during and after pregnancy. Since pregnancy and childbirth can be challenging experiences, it is imperative that women get the support they need to preserve their mental health through this journey. Group therapy would be helpful for expecting women and new mothers to share experiences and know that they can recover from depression as others have. Oral and Tuncay published their findings on group interpersonal psychotherapy (IPT-G) in the International Journal of Group Psychotherapy. Twenty-two Turkish women diagnosed with clinical depression took part in the study with Social Adaptation Self-Evaluation Scale and Beck Depression Inventory as measures (Oral & Tuncay, 2021). The interventions went on for twelve weeks, and at the end of the study, it was found that group interpersonal therapy decreased depression levels and improved social adaptation of the women in the study.
Similarly, Monk conducted a study on the effectiveness of group interpersonal therapy to treat women with prenatal depression in a study titled “Effectiveness of Group Interpersonal Psychotherapy in Treating Women with Prenatal Depression.” The findings were published on the US National Library of Medicine website. The article explains that roughly 10-15% of women experience prenatal depression, causing suffering for the women as well as developmental problems for the infants after birth (Monk 2015). Group Interpersonal therapy is one of the most effective treatment options for prenatal depression, as shown in the study. One hundred sixteen pregnant women took part in the twelve-week program. The participants were split into three groups. One was treated with IPT-G, the second received treatment as usual, while the third group received no treatment (Monk 2015). The group that received group therapy with five to eight other women was found to have the highest recovery rate than the other two groups.
Depression among adolescents is a serious issue as it could lead to lifelong problems if left untreated. Some people think of depression as only affecting adults, but adolescents also suffer from mental health disorders such as clinical depression. Parents, guardians, and teachers need to look out for symptoms of depression among teenagers exhibiting behavioral problems. Keles and Idsoe examined the effects of group cognitive-behavioral therapy on adolescents. They published the results in an article titled “A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression.” The researchers reviewed the literature on the topic and found 23 studies that involved both post-intervention and follow-up comparisons of results (Keles & Idsoe, 2018). The studies involved a control group and treatment group CBT was found to be more effective than control conditions in both comparisons.
Moore et al. examined whether cognitive behavioral therapy is as effective as it is made out to be in the treatment of clinical depression. The study focused on research articles published on various sites such as PubMed, Cochrane, PsycInfo, and EMBASE. The common factor in the reports analyzed is that they all used the Beck Depression Inventory as a measure of outcomes. The studies compared two groups, control groups and those receiving CBT. The study found that CBT is a viable intervention for treating clinical depression in adults, given the significant effect of the therapy on depressive symptoms among patients (Moore et al., 2017). Similarly, group CBT was shown to be effective among a group of patients with autism. Patients showing signs of depression were split into two groups, one receiving group CBT and the other individual treatment. The Depression Anxiety Stress Scales was used to measure the outcomes of treatment (McGillivray & Evert, 2014). The patients who received CBT showed lower scores on the scale compared to those who did not.
Barth et al. compared the efficiency of various treatment therapies for patients with clinical depression. These treatments include cognitive behavioral therapy and interpersonal therapy in group settings. The researchers, in this case, examined previous studies done on seven psychotherapeutic interventions. These interventions include short-term psychodynamic therapy, behavioral activation, and problem-solving therapy, in addition to CBT and interpersonal therapy. The study’s main aim was to find out the efficiency of the different treatments in individual and group settings (Barth et al., 2016). It was concluded that interpersonal therapy was most effective in treating clinical depression compared to the other interventions.
Challenges of the Therapeutic Modalities
One of the main challenges that the researchers experienced in their studies is the significant dropout rate among participants. The length of the intervention varied, with most of them lasting twelve weeks. For many people, twelve weeks is a long time to attend treatment, especially when one is already feeling better. Many of the studies cited patients dropping out as one of the challenges in measuring the intervention program’s efficacy. When patients who complete the study show high recovery rates, it indicates that the treatment would have been even more effective had all the patients remained with the treatment schedule. A perfect example of this is the study conducted by Thimm & Antonsen, in which 17.5% of participants dropped out (Thimm & Antonsen, 2014).
Another challenge in the studies is homogeneity. Most of the studies involve participants with different characteristics. These include pregnant women, individuals with autism, adolescents, and adults. All of these groups respond differently to therapy, meaning that efficiency will vary from one group to another. The procedure of treatment also tends to be different. For example, group therapy involves a different number of individuals, meaning it is challenging to find the best number of people for group therapy. The number may affect the efficacy of the intervention.
Implications to Social Work Practice in Group Settings.
One of the significant implications of the study is the use of control measures. Some of the control measures in the studies include the use of waitlist controls and control groups (Barth et al., 2016). Such measures should be considered unethical as they could adversely affect patients who need treatment for clinical depression. Proving the efficiency of group therapy should take a backseat to the patient’s wellbeing. Future practitioners should find a different way of measuring the efficiency of group treatment without putting patients at risk.
The dropout rate for patients with clinical depression is another concern during the study. One way to address this is to assess patients’ suitability to group therapy to reduce patient dropout rates. Some of the characteristics that should be analyzed include attachment style, chronicity of problems, personality disorders, among others (Thimm & Antonsen, 2014). All these should be considered indicators of how suited a patient will be to group therapy instead of other forms of treatment.
Conclusion
In summary, clinical depression is a serious mental disorder that should be treated as soon as possible. The DSM-V elaborates on the symptoms, diagnosis, and treatment of patients with clinical depression. If left untreated clinical depression will have severe adverse effects on individuals and those around them. Various studies have been carried out to examine the effectiveness of cognitive-behavioral therapy and interpersonal therapy in treating clinical depression in group settings. Group therapy offers advantages such as the feeling of support and cohesion among patients, giving them hope of recovery. These studies show that the two interventions are effective in treating clinical depression among different groups of people. Mental health is a crucial part of a person’s wellbeing, so people should treat the best treatment in case of mental illness.
References
Aguilera, A., Bruehlman-Senecal, E., Liu, N., & Bravin, J. (2018). Implementing group CBT for depression among Latinos in a primary care clinic. Cognitive and behavioral practice, 25(1), 135-144.
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., … & Cuijpers, P. (2016). Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis. Focus, 14(2), 229-243.
Keles, S., & Idsoe, T. (2018). A meta-analysis of group cognitive behavioral therapy (CBT) interventions for adolescents with depression. Journal of adolescence, 67, 129-139.
McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of autism and developmental disorders, 44(8), 2041-2051.
Monk, C. (2015) “Effectiveness of Group Interpersonal Psychotherapy in Treating Women With Prenatal Depression.” ClinicalTrials.gov.
Moore, L. M., Carr, A., & Hartnett, D. (2017). Does group CBT for depression do what it says on the tin? A systemic review and meta-analysis of group CBT for depressed adults (2000–2016). Journal of Contemporary Psychotherapy, 47(3), 141-152.
Oral, M., & Tuncay, T. (2021). Effectiveness of group interpersonal psychotherapy among women with major depression in Turkey. International Journal of Group Psychotherapy, 71(1), 180-202.
Thimm, J. C., & Antonsen, L. (2014). Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC psychiatry, 14(1), 1-9.
Climate Change
Climate Change
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Summary
They are various issues affecting our world today with some being priority while others are being left out, while most people do not recognize climate change as a priority this has changed especially with the current voters. Climate change is said to be one issue that if it is not addressed it will affect so many generations to come. We are looking at climate change with a particular interest in the Paris agreement that is geared to reduce climate change while shedding right on what US withdrawal from the agreement means and its implications.
Introduction
Climate change is a global issue that has in recent years got global attention since most of the disasters in today’s society are attributed to this change. According to recent studies the temperature is becoming warmer and has risen one degree Fahrenheit in the last 100 years, they have been various rallies to protest on the need of the world leaders to do something about this change with most of the protestors being young people. The issue is a global one that requires wider attention especially in developing countries who are mostly experiencing the effects of this change despite them being the least responsible.
The Paris Agreement
The Paris agreement is a new agreement that was adopted to fight climate change in December 2015 under the United Nations Framework Convention on Climate Change (UNFCCC). The agreement required countries to submit their plans that outline the actions they sought to take to avoid, cope and adapt to climate change after 2020 with plans on how to reduce the greenhouse gas being one of the main issues. The objective of this agreement is to ensure economic development and sustainable food production while preventing interference with the climate system. The objective led to the main goal of the agreement which is that the global temperature increase to be below 2 degrees Celsius above pre-industrial levels while limiting it to 1.5 degrees Celsius above the preindustrial level (Rogelj et al., 2016).
Withdrawal of US from the Paris Agreement
While this agreement required all hands on deck since its effects cannot be combated with any army or resources, the withdrawal of Trump in 2017 caused a stir considering the US and China have been referred to as the highest emitters of Carbon dioxide. Some made inferences of this action to be history repeating itself since during George Bush Presidency he withdrew from the Kyoto Protocol (Meyer, 2019).
They are various reasons why Trump resorted to leaving the agreement, one is the ties that his administration has with the fossil fuel industry and that the actions to regulate climate change will seek to benefit these companies. Also, the decision of Trump going for reelection played a part since especially for his constituency which seemed to be glad when he withdrew from the agreement and the fact that various senators in his administration campaigns are funded by the industries. Trump to have never acknowledged that climate change is an issue caused by the people and he blamed that the agreement was intended to punish the US by comparing its responsibility with those of other countries neglecting the fact that the more emissions by a country the greater the responsibility accorded. The American first viewpoint from Trump also was a factor since he believes that the agreement undermined the country’s competitive edge while affecting the energy and employment sectors. Lastly, Trump’s reign seems to want to destroy Obama’s legacies and policies that he enacted while he was in power and the Paris agreement was one among his political legacies.
Implications of US Withdrawal
While Trump’s withdrawal according to him is not a major issue, it affects the compliance of the agreement in various ways. First, the agreement was seen as the backbone of the regime of global climate that facilitated the climate governance effectiveness and the US withdrawal undermines its universality where is involved both developing and developed countries, unlike the Kyoto Protocol. Secondly, the US withdrawal affected the leadership required for the governance of the action, US, China, and EU are the leadership and the Brexit negotiations and crises affecting EU leaves only China; this deficit affects the agreement implementation. Thirdly, while other countries reaffirmed their commitment even after the US withdrawal, the exit might affect other countries’ initiatives towards climate change leading to the target set by the agreement unachievable. Also, the US exit reduces the emission space of other countries while increasing their mitigations while increasing its emissions space and lower mitigation cost this eventually will not only make the agreement target more difficult to achieve but also expensive. The US too was supposed to help finance the developing countries in the common but differentiated agreement responsibility so they can achieve the target while adapting to climate change. The country too played a big part in donating climate financing to the developing countries but since Trump’s presidency, the country’s donations have decreased. Additionally, the US withdrawal will affect the opportunity window of mitigating climate since the 10 years after it was put in action are essential in achieving the targets as the anthropogenic emissions are expected to improve without reliance on the advancement in technology. Lastly, the decreased funding in climate research by the US will not only undermine the negotiations for future climate but also compromise the future quality of IPCC reports (Zhang et al., 2017).
However, while Trump seems to justify his action towards moving out of the agreement insisting that it places stress on the country with minimal gains the exit is expected to cause more implications. One of the mains implication is on the gender equality, climate change is unjust since it affects people who hardly play a role in its causes and the climate action should address this inequality while respecting all human rights. With most of the majority world population of poor people being women, the impacts of climate change will continue to increase the levels hence they should play a role in addressing the change (Schramek & Harmeling, 2001).
Additionally, in various areas in the US climate change which has been said to getting warmer is believed to be decreasing the air quality and increasing heat-related deaths with the elderly and children being at the most risk. The pollen season has also been reported to be lengthening which may extend the habitat for mosquitoes and ticks increasing the exposure of people to vector-borne diseases. Unfortunately, the temperature is only bound to increase in the North East areas as indicated in the diagram (“Climate Impacts in the Northeast | Climate Change Impacts | US EPA”, 2020).
Lastly, according to the report by the National Climate Assessment, the effects of climate change are being felt especially by the low-income earners and the few marginalized communities who hardly have any capacity to cope with the problem. Moreover, the people who rely on the climate, farmers, tourism, and fisheries are vulnerable to the effects and while the countries past our borders are affected the trade among us will be affected. Lastly, the riding temperature is changing the precipitation and reducing the snowpack which in turn affects the water quality we rely on (“Fourth National Climate Assessment”, 2018).
Conclusion
From the discussion below it is clear that climate change is a global challenge from the 195 countries that joined together to mitigate its risks under the Paris agreement. Unfortunately, while the US exit from the agreement insists that is what is best for the country the effects will not only affect the developing countries that relied on its financing but also on the people in the country. Just recently, the Australian fire that started late last year was finally put odd after not only destroying a lot of vegetation and killing very many animals but led to the migration of some animals, this is the impacts of climate change that we should expect if nothing is to be done. While Trump seeks to recognize that his voters will support him because of his voters’ continued bid of withdrawal from the agreement it is time he recognizes that the effects of climate change have no borders and will end up affecting the same. There is no tomorrow for climate change it is time to act now and hope that the landslides, floods, tsunamis, hurricanes, and earthquake being experienced all over the world becomes a story of the past.
References
Climate Impacts in the Northeast | Climate Change Impacts | US EPA. 19january2017snapshot.epa.gov. (2020). Retrieved 3 March 2020, from https://19january2017snapshot.epa.gov/climate-impacts/climate-impacts-northeast_.html.
Fourth National Climate Assessment. Nca2018.globalchange.gov. (2018). Retrieved 3 March 2020, from https://nca2018.globalchange.gov/.
Meyer, R. (2019). The Indoor Man in the White House. The Atlantic. Retrieved 3 March 2020, from https://www.theatlantic.com/politics/archive/2019/01/trump-withdraws-paris-agreement/579733/.
Rogelj, J., den Elzen, M., Höhne, N., Fransen, T., Fekete, H., & Winkler, H. et al. (2016). Paris Agreement climate proposals need a boost to keep warming well below 2 °C. Nature, 534(7609), 631-639. https://doi.org/10.1038/nature18307Schramek, C., & Harmeling, S. (2001). G20 and climate change [Ebook] (p. 12). CARE Climate. Retrieved 3 March 2020, from http://www.indiaenvironmentportal.org.in/files/file/G20-REPORT.pdf.
Zhang, H., Dai, H., Lai, H., & Wang, W. (2017). U.S. withdrawal from the Paris Agreement: Reasons, impacts, and China’s response. Advances In Climate Change Research, 8(4), 220-225. https://doi.org/10.1016/j.accre.2017.09.002