Cognitive Interventions Essay Example for Free

Cognitive Interventions Essay Introduction Cognitive behavior therapy includes many types of therapy and can be applied in a variety of circumstances. Dialectical behavior therapy (DBT) is most commonly known for use on clients with borderline personality disorder (BPD). However, DBT is becoming more popular and often used when working with adolescents. Some adolescents participate in nonsuicidal self-injury (NSSI). Counselors find DBT is an effective therapy to help youth acquire the coping skills needed to stop NSSI. A review of DBT, and adolescents suffering with NSSI will better help one to understand why this technique is beneficial. NonSuicidal Self-Injury NSSI is defined as the direct and intentional destruction of ones own body tissue without an intent to die. Therefore, any form of self mutilation not intending to result in suicide qualifies as NSSI. The number of adolescents practicing NSSI is alarming. Youth practicing NSSI include both sexes and every racial and ethnic group. This alarming behavior is not secluded to any particular type of adolescent. NSSI often appears in the form of cutting with sharp objects, scratching, hitting, burning, and inserting objects under the skin. These behaviors typically develop between the ages of 12-14, indicating that adolescent years are particularly vulnerable to such practices. In addition to NSSI, these behaviors are often in conjunction with other self-harming behaviors like eating disorders, substance abuse, and depression. Puberty can be an extremely difficult time for many people and adolescents cannot reason and rationalize as adults can; therefore, youth often develop self-harming issues because they lack proper coping skills. Last, NSSI specifically refers to injuries not acquired while attempting suicide; however, 50-75% of those with a history of NSSI have also attempted suicide at least once. As one can see, NSSI is an alarming behavior that needs attention (Choate, 2012). Addressing the Issue NSSI is a prevalent and serious issue that must be properly handled. Counselors and people working with NSSI youth must have an understanding of the complexity of this matter and be familiar with treatment options. DBT is an excellent method to attempt to help adolescents overcome NSSI behavior. The effectiveness of DBT has been shown in at least seven controlled trials conducted by four independent research teams. DBT shows the most improvement, when compared to prior therapy options, to treat NSSI (Choate, 2012). DBT uses a comprehensive multimodal 16-week treatment approach for NSSI. The multimodal addresses skills for interpersonal effectiveness, self-regulation, and distress tolerance; provides structure to motivate, reinforce, individualize, and generalize these skills; and identifies and alters learned behavior patterns leading to NSSI. This therapy treatment includes individual therapy, family therapy, multifamily training groups, and telephone consultations for those involved in the process. Additionally, a support team for the counselors is a part of this process. Counseling NSSI adolescents is an extremely stressful position so it is important for counselors to have professional peers to share their thoughts. DBT therapy for NSSI adolescents can be practiced in many settings, including inpatient or outpatient treatment (Choate, 2012). Interventions and Techniques Individual Therapy A primary counselor is paired with the adolescent through the DBT process. The relationship between the primary counselor and the client is extremely important. The key goal for the counselor is to help the adolescent develop skills for coping with stressful thoughts, events, and emotions. An important aspect in the client therapist relationship is for the counselor to convey acceptance, validity, and trust. The primary counselor needs to remain calm and listen with interest yet without showing much emotion. A client must not see a counselor react to stories of self-harm in the way a parent or peer might react. The goal for the counselor is to show an understanding of the self-harming behavior while conveying acceptance and validating the adolescents thoughts and actions (Choate, 2012). The counselor shows acceptance; however, the goal is to create change. Although the counselor balances acceptance and change, the counselor continually challenges the client to alter any negative behavior hindering ones life quality. Ultimately the thought is that acceptance and validation will facilitate self-change while change will facilitate self-acceptance. If the adolescent is reluctant to change the harmful behavior, the counselor may spend more sessions building trust and showing validation before attempting change. Additionally, a client may find it difficult to trust the counselor is the client believes the counselor will report NSSI episodes to the adolescents parents. A balance must be created between client trust, parental rights, and confidentiality. With a proper balance allowing the youth comfort, yet abiding by regulations, an adolescent will be able to build the relationship required to develop change (Choate, 2012). Assessments should be conducted during the initial interviews with the client. These initial evaluations are either conducted informally with an interview or formally with a structured interview and self-report tool. The DBT model allows the counselor to integrate assessment results into four DBT target treatment areas. Specific behaviors and areas are written into a treatment plan with goals for the client (Choate, 2012). Target areas: A) Decreasing life-threatening behaviors B) Decreasing behaviors that interfere with therapy C) Decreasing behaviors that interfere with life quality D) Increasing behavioral skills (Choate, 2012). As the treatment begins, the goal is to help the client determine the events, thoughts, or feelings one has prior to the NSSI occurrence. If one can determine factors contributing to the negative behavior, one can start to alter circumstances leading to NSSI and ultimately change the behavior. Clients are asked to maintain diary cards documenting behaviors and actions surrounding NSSI behavior. The diary cards address problem behaviors, immediate prior events leading to problem behavior, vulnerability factors, entire chains of events prior to problem behavior, and consequences from the behavior. Upon review of the cards the counselor can help the client identify triggers of NSSI behavior and find alternative life choices or thoughts to cope better with given situations (Choate, 2012). Multifamily Skills Training Groups The individual session emphasizes focus on assessment, client trust, and identifying the problem. Along with identifying problems, individual therapy does encourage behavior change. However, multifamily group therapy focuses on skill sets needed to facilitate change. To implement behavior changes and develop coping skills, the adolescents must be aware of thoughts, feelings, and actions; tolerate the pain and stress associated with unpleasant life events, regulate emotions better, and become effective at communicating emotions. The DBT approach focuses on building four essential skills: A) Mindfulness B) Distress tolerance C) Emotion regulation D) Interpersonal effectiveness Additionally, a fifth skill was added: Walking the middle path (Choate, 2012). Skill Sets Skill Set One: Core Mindfulness Mindfulness is acknowledging ones emotions, thoughts, and physical experiences without trying to end them, numb them, or avoid them. Learning to observe, describe, and experience emotions without judgment and while in control of ones attention is the core of mindfulness. As adolescents become more aware of emotions in the present, they develop a better understanding of their own emotions and reactions (Choate, 2012). DBT uses a model with three states of mind to teach mindfulness. The three mind-states are reasonable mind, emotion mind, and wise mind. Reasonable mind is controlled primarily by logic. Emotion mind is regulated significantly by emotions. Wise mind synthesizes all the ways of knowing to develop knowing through intuition, using deep inner wisdom. Often time groups sessions will use acting or charades to have participants learn to understand these types of mindfulness (Choate, 2012). Group members are taught to observe their thoughts by awareness. The clients are encouraged not to multitask but rather to focus on one task at a time. The exercise of focusing on one task at a time is referred to as one-mindfulness. Focusing on one aspect at a time allows the client to recognize and understand the emotions related to the specific task. Skill Set Two: Emotion Regulation Emotion regulation helps group members learn to recognize, observe, and describe emotions. Additionally, this skill set teaches one to regulate intense and painful emotions, regulate vulnerability to negative emotions, and increase positive emotions. The clients begin to realize they have control over their emotions and behaviors. When one learns to alter responses to emotions it is both empowering and liberating (Choate, 2012). Ways of teaching emotion recognition often include listening to music or watching a movie. The goal is to have the client react to something, recognize, and observe ones own emotion. As clients recognize emotions they are asked to discuss the responses both mentally and physically connected with the emotional reactions. Group members are taught to respond to ones own emotions with self-compassion and acceptance. Often one may believe an emotional response is wrong, silly, or unjustified. Once one understands that every emotion is justified one can accept the emotion and find a healthy response to that emotion (Choate, 2012). Another aspect of emotion regulation includes reducing vulnerability by maintaining better physical health. Eating well, sleeping sufficiently, exercising regularly, and avoiding substance abuse will help one regulate emotions by maintaining physical health. Ones physical health can weaken ones mind-state, and the person will be more vulnerable to NSSI and other self-harming episodes (Choate, 2012). Skill Set Three: Interpersonal Effectiveness The goal of interpersonal effectiveness is for one to maintain personal values and beliefs while improving relationships. An example of teachings in this module is that group members are often asked to remember the acronym DEAR MAN to help remember the key components of this skill set. The components: Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, and Negotiate. The best method for learning this skill set is role play. Often the facilitator will pair up group members and role play a variety of situations using DEAR MAN (Choate, 2012). Skill Set Four: Distress Tolerance Stress tolerance relates to ones ability to effectively accept emotional pain, in any given situation, that cannot be changed at the time. Once one can tolerate and accept unpleasant situations, one can more effectively cope. Further skills would help the client to self-soothe and distract from emotionally painful situations (Choate, 2012). Distress tolerance skills have two categories. The first category is skills for accepting reality, and the second is skills for crisis survival. Skills for accepting reality teach clients how to accept everyday life even when it is unpleasant. Deep-breathing is a common practice for this skill. Skills for crisis survival follows more of a distraction method. The goal may be for the client to find an alternative task, practice self-soothing, or take a break. Whatever the activity change is, the goal is to distract one from the crisis and prevent self-harming behavior (Choate, 2012). Skill Set Five: Walking the Middle Path This particular skill set works with the adolescent and family members to help those involved alter polarized thinking and live a more balanced lifestyle. The first step is to encourage participants to abandon black and white thinking and recognize the gray area. People often need to realize that any given situation can be viewed in multiple ways, and often everyone would benefit from viewing incidents through multiple perspectives (Choate, 2012). Common issues between adolescents and parents include strict or lenient parenting; thinking lightly of serious matters, or judging harshly common adolescent behavior; and pushing away, or holding too tightly. Adolescents and parents are asked to determine where they believe themselves and others to be regarding these topics, and try to come to an agreement regarding how to alter behavior and meet in the gray area (Choate, 2012). Communication and listening are key factors involved in developing this skill set. Positive reinforcement is taught to be used whenever possible as parents often think to punish negative behavior rather than reward the positive actions. Reconciling family differences can be a key component when attempting to help an adolescent stop NSSI behavior (Choate, 2012). Effectiveness of DBT for NSSI The treatment for NSSI that has the most positive support is DBT. DBT is the high standard of therapy for reducing suicide and self-destructive behavior among clients with BPD. The effectiveness of DBT has been shown in many trial studies. Not as many studies have been conducted regarding DBT and NSSI with adolescents; however, a DBT model has been created for adolescents and shows very promising results. DBT is the highest regarded method for at risk youth. Certainly, much can always be learned regarding human nature and therapy, and not all people will respond to the same treatment; therefore, this method is certainly not effective every time, but it does seem very beneficial (Choate, 2012). Summary Nonsuicidal Self-injury is a serious issue. As one can see, action needs to be taken to save youth from such harmful behavior patterns. Cognitive behavior therapy, specifically dialectical behavior therapy, has many excellent interventions and strategies to help adolescents facing NSSI (Choate, 2012). DBT uses individual therapy, group therapy, and family therapy to help adolescents with NSSI. Individual sessions focus on trust with the counselor, and identifying and acknowledging negative emotions, and behavior patterns. Additionally, the primary therapist will help the client find healthy ways to change behavior patterns and cope with life stressors (Choate, 2012). Group therapy focuses on building the skills needed to accomplish the desired changes. The five core skills sets include: core mindfulness, emotional regulation, interpersonal effectiveness, distress tolerance, and walking the middle path. Many methods are used to teach and practice these techniques (Choate, 2012). Studies continue to determine the effectiveness of DBT with adolescents involved in NSSI. However, DBT is the standard therapy for adults facing similar issues with BPD. Additionally, DBT seems very promising as an effective method for treating NSSI adolescents. References Choate, L. H. (2012, January). Counseling adolescents who engage in nonsuicidal self-injury: A dialectical behavior therapy approach.. Journal of Mental Health Counseling, 34(1), 56-71. EBSCOhost.

Perspectives of the Characters in The Young Housewife :: Young Housewife Essays

Perspectives of the Characters in The Young Housewife From the first stanza we decipher that there is a young housewife moving about her husbands house in negligee. Some important questions that come to my mind are: Is she alone?, and why is she moving? The answer to both of these questions we do not know. Is this young housewife dancing around the house in her negligee because her and her husband had a wonderfully romantic night, or is she merely shuffling along performing her wifely chores and duties? Better yet, does the young housewife really exist, or is she just a fantasy of the passer-by? This brings me to my next question . . .Is the narrator a man or a woman? It seems very easy to assume that the narrator is a man, because the author is a man, but other than that there is no real evidence proving narrative gender. In stanza one all we know about the narrator is that they are alone in a car. In stanza two all we know is that the narrator compares the young housewife to a "fallen leaf". And in stanza three, the final stanza, as the narrator passes on by, he or she bows, and smiles. As far as I am concerned the passer-by could be a female who is a close friend or relative who is merely commenting on the housewife as they pass by her house. To me The Young House Wife is about beauty, not beauty from a young fertile woman alone in negligee, but the beauty of everyday, the beauty of life. This driver, who is her passer-by compares the housewife to a fallen leaf. This fallen leaf could mean many things. The narrator could be insinuating that the young housewife is in a fallen state, maybe trapped in some kind of extra-marital sin perhaps. Maybe the narrator is trying to warn us that the housewife is sick and perhaps that is why she is not yet properly dressed though the morning is almost at an end. The meaning that I prefer to take with me is somewhat different from these perspectives. I would like to think of the young housewife as the beauty of autumn.

Cultural Diversity in America

Diversity is an important part of American culture. Cultural diversity has helped to shape the way we live everyday as well as the different foods we eat. What really thought me about diversity is that it is not limited just too racial or ethnic groups but other minority groups. The new information I have learned about diversity still has not changed my views. I think it is important to learn about others cultures and backgrounds. Without knowledge about other cultural groups we would only have stereotypes to go off of. Stereotypes without proper knowledge can lead to discrimination or prejudices.I did learn about my own ethnic background and how far we still need to go. The Hispanic people are still the lowest paid. Recently we are still fighting against prejudice in regards to immigration laws. There are many ignorant people that view all Hispanic people should not be in this country. Some automatically think we all come from Mexico. Which is not the case, both my parents are Ameri can and my mother’s parent are from the US. On my dad’s side my grandmother was from Mexico as well as my grandpa who fought in WWII, Vietnam, and Korean War.He is a real hero and it is unfair that he has fought for our freedom but some would want him deported. Trends in immigration are steadily rising and should continue to do so. In 2050 the White population will become a minority and the minority groups will become the majority. There are many cultures that strive to migrate to the United stated to live out the American dream. Our country was built by immigrants trying to escape a country they could no longer believe in. Those people wanted freedom to believe and live the way they wanted too.That is still the dream of all immigrants to move on to a new country and build a better life for themselves and their families. The major challenge the United States faces due the diversity of its people is losing the American culture in the mist of all the different cultural g roups. Also American will suffer from prejudice and discrimination against those immigrants because they are different. Even though American risks losing its culture due to diversity it is also a benefit. The diversity in American culture can teach everyone to be more tolerant of different ethnic groups.Also it helps improve American culture by adapting to new culture traditions and celebrations. In order to foster acceptance and cultural pluralism in the United States, we need to start living with an open mind and heart. We also need to create an education program to teach everyone about each other and their cultural backgrounds. Also by adapting to different cultural traditions we can participate in that culture. For example, In the United States we celebrate the Chinese New Year and CInco De Mayo.Also we need to find a way to stop depending on stereotypes to teach us about different groups. The media is also portraying different groups of people a certain way. I have always found that the news media try to find the most ignorant person to interview or someone that could prove that ethnic stereotype correct. There are many examples of this in recent news for example, The interview with Sweet Brown and her famous line â€Å" Ain’t nobody got time for that† or the interview of Antoine Dodson and all the funny YouTube videos that it has turned out.The media also does some good for example all the media coverage they do on gay rights as well as coverage on the Travon Martin case. With the Travon Martin case we saw a man that was prejudice against a young black male and kill him. The media tried to do their best to show how wrong Zimmerman was in the situation. Showing these types of issues in the media it shows people it is not ok to hate or to take a young life because you are ignorant to their cultural background.Individually I know I have been prejudice against certain groups and knew the way I was acting was wrong. What I found I needed to work on is to be more accepting of everyone and treat others the way I want to be treated. I would not want to be discriminated against and I found no one else does either. I think we also need to live life and not judge people by the way they look but by their actions. The United States as a whole needs to teach its people that prejudice is still alive and discrimination is still happening.The United States also needs to review its anti-discrimination laws and make sure they are still valid and revise the ones that need to be improved with our changing times. I also think there should be cultural diversity appreciation month that teaches about different cultures not just African Americans or Hispanic culture but about, Asian cultures and Middle Eastern cultures as well. We also need to start teaching children young to be accepting of everyone since they are our future. You are a reflection of then and they are a reflection of you.

The Surprising History of Black People in Germany

The German census does not poll residents on race, following World War II, so there is no definitive number of the population of black people in Germany. One report  by  the European Commission against Racism and Intolerance  estimates there are 200,000 to 300,000 black people living in Germany, although other sources guess that number is higher, upwards of 800,000.   Regardless of the specific numbers, which dont exist, black people are a minority in Germany, but they still are present and have played an important role in the countrys  history.  In Germany, black people are typically referred to as Afro-Germans (Afrodeutsche) or black Germans (Schwarze  Deutsche).   Early History Some historians claim that the first, sizable influx of Africans came to Germany from Germanys African colonies in the 19th century. Some black people living in Germany today can claim ancestry dating back five generations to that time. Yet Prussias colonial pursuits in Africa were quite limited and brief (from 1890 to 1918), and far more modest than the British,  Dutch and French powers. Prussias South West African colony was the site of the first mass genocide committed by Germans in the 20th century. In 1904, German colonial troops countered a revolt with the massacre of three-quarters of the Herero population in what is now Namibia. It took Germany a full century to issue a formal apology to the Herero for that atrocity, which was provoked by a German extermination order (Vernichtungsbefehl). Germany still refuses to pay any compensation to the Herero survivors, although it does provide foreign aid to Namibia.   Black Germans Prior to World War II After World War I, more blacks, mostly French Senegalese soldiers or their offspring, ended up in the Rhineland region and other parts of Germany. Estimates vary, but by the 1920s, there were about 10,000 to 25,000 black people  in Germany, most of them in Berlin or other metropolitan areas. Until the Nazis came to power, black musicians and other entertainers were a popular element of the nightlife scene in Berlin and other large cities. Jazz, later denigrated as Negermusik (Negro music) by the Nazis, was made popular in Germany and Europe by black musicians, many from the U.S., who found life in Europe more liberating than that back home. Josephine Baker in France is one prominent example. Both the American writer and civil rights activist W.E.B. du Bois and the suffragist Mary Church Terrell studied at the university in Berlin. They later wrote that they experienced far less discrimination in Germany than they had in the U.S. The Nazis and theBlack Holocaust When Adolf Hitler came to power in 1932, the racist policies of the Nazis impacted other groups besides the Jews. The Nazis racial purity laws also targeted gypsies (Roma), homosexuals, people with mental disabilities  and black people. Precisely how many black Germans died in Nazi  concentration camps  is not known, but estimates put the figure at between 25,000 and 50,000. The relatively low numbers of black people in Germany, their wide dispersal across the country and the Nazis focus on the Jews were some factors that made it possible for many black Germans to survive the war.   African Americans in Germany The next influx of black people to Germany came in the wake of World War II when many African-American GIs were stationed in Germany.   In Colin Powells  autobiography My American Journey, he  wrote  of  his tour of duty in West Germany in 1958 that for ... black GIs, especially those out of the South, Germany was a breath of freedom —  they could go where they wanted, eat where they wanted and date whom they wanted, just like other people. The dollar was strong, the beer good, and the German people friendly. But not all Germans were as tolerant as in Powells experience. In many  cases, there was resentment of the black GIs having relationships with white German women. The children of German women and black GIs in Germany were called occupation children† (Besatzungskinder) — or worse.  Mischlingskind  (half-breed/mongrel child) was one of the least offensive terms used for half-black children in the 1950s and 60s.   More About the Term 'Afrodeutsche' German-born blacks are sometimes called Afrodeutsche (Afro-Germans)  but the term is still not widely used by the general public. This category includes people of African heritage born in Germany. In some cases, only one parent is black But just being born in Germany does not make you a German citizen. (Unlike many other countries, German citizenship is based on the citizenship of your parents and is passed on by blood.) This means that black people born in Germany, who grew up there and speak fluent German, are not German citizens unless they have at least one German parent. However, in 2000, a new German naturalization law made it possible for black people and other foreigners to apply for citizenship after living in Germany for three to eight years. In the 1986 book, Farbe Bekennen  Ã¢â‚¬â€Ã‚  Afrodeutsche Frauen auf den Spuren Ihrer Geschichte, authors May Ayim  and  Katharina Oguntoye  opened up a debate about being black in Germany. Although the book dealt primarily with black women in German society, it introduced the term Afro-German into the German language  (borrowed from Afro-American or African American) and also sparked the founding of a support group for blacks in Germany, the ISD (Initiative Schwarzer Deutscher).