Cognitive Behavioural Therapy Essay Example for Free

Cognitive Behavioural Therapy Essay Cognitive Behavioural Therapy (CBT) is recommended by the NICE guidelines as an effective treatment for many mental health problems, specifically depression and all of the anxiety disorders. But is it a therapy open to all? When Professor Lord Layard wrote his paper: â€Å"Mental Health: Britain’s Biggest Social Problem? † in 2005, he noted that: â€Å"16% of adults of working age have a mental illness† Of these 16%, he stated that, only a quarter were utilising any type of treatment. It was this sort of finding that lead to his recommendation to increase accessibility to proven therapies such as CBT. This was achieved with the roll out of the Improved Access to Psychological Therapy (IAPT) programme. The diagram below shows how the IAPT programme has been divided up into 3 steps: It is this stepped approach that will contribute to overcoming some of the barriers that societies diversity may have with accessing CBT. What might these barriers be? One of the first barriers an individual faces may be around the concern of being stigmatised. It may be too hard for them to think about accessing CBT therapy for fear of what others may think. They may not want to take time off work to attend sessions for fear of it impacting negatively on their career prospects. The stepped care model means they are able to receive the lowest appropriate service tier support. This may mean that an individual is able to access therapy using guided self-help, allowing them to work through the programme in their own time and at their own pace. Online programmes such as â€Å"Fearfighter† and â€Å"Beating the Blues† allow the individual to access therapy where and when they like. Not only do these sort of programmes overcome the fear of stigma but they also overcome the issue of long waiting lists meaning that the individual can access treatment on their terms almost instantaneously. Only if this level of support proves unsuccessful will the individual then be â€Å"stepped up† to the high intensity support. These internet CBT programmes also overcome geographical difficulties, as long the individual has access to the internet and phone. In my opinion the internet is one of the main ways in which barriers may be removed. Morland et al (2011) conducted a study on the effectiveness of CBT delivered via video conferencing compared to the â€Å"traditional in-person†. The results indicated that the outcomes were just as effective. A promising move for those that are unable to access traditional CBT as a result of their location or possible mental health issue, for example those suffering agoraphobia. At the core of CBT is the individual’s motivation to learn and change. This in itself can lead to difficulties, especially in children and young people. Often this â€Å"group† is being taken to therapy rather than choosing to go. Hudson (2005) found that large numbers of youngsters were not responding to the CBT treatment that they were receiving. As far as children and young people are concerned there seems to have been limited research onto the success of CBT treatment. The first controlled trials did not take place until the early 1990s and the majority of research has focused on the impact of CBT on adults. Even so the NICE guidelines on Depression in Children and Young People recommended the use of CBT, firstly, rather than pharmacological interventions. So how has CBT been adapted to incorporate children and young people, whose very cognition and emotional stages differs from that of adults? There have been some creative adaptations to the CBT model such as â€Å"Think Good Feel good†. Here the concept of CBT is broken down into easy to manage bites. There is also a lot of use of cartoons and speech bubbles, allowing the young person to access their thoughts and feelings in a safe way. The need to use more non-verbal techniques to help the young person to engage in the process such as, storytelling, drawing and games is also highlighted in this book. O’Reilly et al (2009) have also developed an interesting approach to using CBT with children and young people. They have created a game called â€Å"gNAtenboroughs Island† which is played by the youngster alongside a therapist. Each session introduces another core CBT concept to the young person, such as the connection between thoughts, feelings and behaviours. These are presented in a non-threatening way and also a way that may be more engaging to this age group. Cerangolu (2010) found that video games could enhance the therapeutic experience. They could help facilitate the therapeutic relationship as young people may be more willing to relate to a therapist that is ready to engage and understand their normal way of playing. Also sitting side by side rather than at the conventional â€Å"ten to two† setting also may make the young person relax. How the game is played can also reveal the young person cognitive style. As technology develops so do the opportunities to engage young people in therapy. Apps for smartphones are constantly being developed that allow the young person to access their homework in a more user friendly way, to record their thoughts and emotions instantaneously. To allow them to engage in therapy in the same way that they engage in their life. Homework may be a part of CBT therapy that causes a young person to disengage, especially as the very word may cause them to have negative connotations. Gaynor et al (2006) found that compliance toward completing homework dropped the further into therapy a young person was. It is important that the therapist and client work together to agree the homework and that the young person is encouraged to set their own, as this may encourage a â€Å"buy in â€Å"to its importance. It may be that the therapist stays away from using the language of school and calls it â€Å"practise work† or â€Å"work for self†. Initially I saw CBT treatment as regimented and unmoving, but the more I have researched the barriers that different people may encompass when thinking of embarking on treatment the more I realise that CBT is indeed structured but there is an innate flexibility about how it is delivered. It is this flexibility that allows people from different backgrounds to engage in a CBT approach that sees them as an individual rather than specific disorder.

Daniel Millers Material Cultures: Why Some Things Matter Essay example

In the introduction to Material Cultures: Why Some Things Matter, Daniel Miller describes the book as part of the second stage of the development of material culture studies. The first stage was the recognition by writers such as Appadurai and Bourdieu as well as Miller that material culture is important and worthy of study. The second stage is the argument made in this book: that it is crucial to focus on "the diversity of material worlds" without reducing these material worlds to symbols for "real" social processes nor cloistering them in sub-studies of like objects. That things matter has already been ascertained; this books intends to investigate "why some things matter" more than others and in particular contexts. Miller claims a focus on objects themselves that does not however "fetishize" :What we may regard as unique to our approach is that we remain focused upon the object that is being investigated but within a tradition that prevents any simple fetishization of material form. Indeed we feel that it is precisely those studies that quickly move the focus from object to society in their fear of fetishism and their apparent embarrassment at being, as it were, caught gazing at mere objects, that retain the negative consequences of the term ‘fetishism.’ It is for them that Coke is merely a material symbol, banners stand in a simple moment of representation or radio becomes mere text to be analyzed. In such analysis the myriad diversity of artefacts can easily become reduced to generic forms such as ‘text’, ‘art’, or ‘semiotic.’ In such approaches it is not only the objects that remain fetishized but also, as Latour (1993) has argued with resp ect to the fetishism within debates about science, it is the idea of ‘society’ as ... ...usic is a good example. Besides the aural experience of listening to music, there is the physical experience of the bass vibrating your body; that feeling is directly related to the nature of the medium by which you are listening. The stereo with four foot speakers or the kitchen radio are things that matter too. CDs come into one’s possession bearing, besides music, artistic cover art, printed lyrics, and the thanks to families and deities by the musicians involved. Things are polyvalent, and things are made up of other things and attached in literal and figurative ways to still other things. And I think it is worth gazing a bit more intently at those objects and all their physical, sensual attributes. That fear of objects does not seem to be entirely gone; there is still a tendency to switch rapidly to the social and symbolic valences of those sensual experiences.

Cleopatra Leader

Cleopatra VII was a remarkably intelligent woman with great charisma and political astuteness. The ancient historian, Plutarch, stated that â€Å"to know her was to be touched with an irresistible charm. Her delightful manner of speaking was such as to win the heart. † (Bradford 14). She utilized these assets to win over the favor of two of the most powerful man of Ancient Rome, Julius Caesar and Marc Antony. Cleopatra is portrayed as being manipulative, conniving; and accused of utilizing her relationships for the advancement for power and the expansion of her empire.Although this is true, there were stark differences in the two relationships Cleopatra had with each man. She reached out to Caesar in her time of no power and continued to be submissive to him throughout their relationship. Even though there was a speculated love connection between the two, Caesar never lost sight of his priority as a politician and did not concede to every one of his mistresses’ requests .While a reversal of roles occurred with Marc Antony, she had the upper hand and he eventually became fiscally and emotionally dependent on her. In addition, he was easily manipulated, thus Cleopatra frequently got her way. Overall, the territorial gain and the power she had over him proved that Cleopatra’s relationship with Marc Antony was more politically beneficial than with Julius Caesar. Firstly, Cleopatra’s submissiveness and political dependency on Julius Caesar proved to be less beneficial in contrast to her relationship Marc Antony.In 48BC, she was a young 22 year old trying to regain her Ptolemaic throne from her brother, she knew he was the most powerful in the world and understood that that the Roman Consul was the only one who could aid her. Bradford noted that Cleopatra realized the â€Å"only one weapon that her brother, back by his powerful advisers, did not have [was]-her sex. † (70) The speculation that she was sneakily presented to him rolled up in a carpet displayed her submissiveness to his authority and beckoning for his help in regaining her throne.Caesar managed to initially appease Cleopatra’s desire for power by reading her father’s will and forcing her brother, Ptolemy XIII, and herself to rule together. Later he gained managed to gain more power for her by commanding her to â€Å"marry† her younger brother, Ptolemy XIV, for she would hold all of the power due to his age. This pretense was set up in order to make her complacent but still remained a superior force with his diplomatic choice. By having both the siblings rule he abided to Egyptian law and did not panic the people and cause them to rebel.

Federal State And State Government - 890 Words

The United State Constitution provides the authority and power of the federal and state government’s jurisdictions (Cropf, 2008). This means that both federal and state governments maintain their own separate laws and officials that govern over the territories and citizenry. The one part of governing left out of the initial constitution but picked up later was the local governments. Local government levels connects to the federal system through the state processes of governing. The local levels of government authority comes under the state constitutions and laws. One other part of the local government principles of authority comes under the Dillon Rules. The Dillon Rules or in some states Dillon Laws, are the principle’s that local governments have only the authority provided them by state government. The other process that grants decision making power at the local level is called â€Å"Home Rule†, which is set in the state legislature of some states. One e xample is the State of Virginia has a Dillon Rule process of government. The interactions between the federal and state governments is outlined in the US Constitution and also outlining the relationship between the states (Cropf, 2008). The Constitutional relationships between the states allows for each state to accept the other states laws cross borders, court decisions and moving across borders and extradition. Additionally, privileges and immunities of all citizens are consistent throughout the country and in allShow MoreRelatedFederal Government And The United States1498 Words   |  6 Pages Federal Government The United States of America government is called the federal government and is the republic of the fifty states which constitute the United States. It also constitutes the capital districts and several other territories. Now the government is made up of three different branches and they are the Executive, Legislature, and the Judicial. 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