1.What political, economic, and technological factors allowed Spain and Portugal to explore new trade routes?
Spain and Portugal were able to explore new trade routes due to different motives which were political, economic and technological. Christian militancy and stability helped created a purpose since they were looking to explore to other geographical destinations. By attacking cities, Portugal inherited better intelligence and more flexibility to sail down the coasts. They were able to use improved devices and ships that could move faster and more economically. The ships were equipped with better sails and which enabled them to go quicker and fight if necessary. While exploring they found new locations and land which led to easier routes to trade.
Why were the Spanish able to establish a territorial empire in the New World?
The Spanish were able to establish a territorial empire in the New World after Christopher Columbus was able to find new stretches of land. After the Columbus voyage, Magellan sailed around the globe, which ended up taking his life. Colonial empires were established with political influence. The Spanish had a larger population and more resources, and Americas was introduced to new diseases that deteriorated their ability to fight back. Since the Spanish offered new markets for trade, which were inevitably less expensive, it helped establish an empire into the New World.
What were the long-term political effects of the Protestant Reformation.
The Protestant Reformation brought many political long-term effects, which eventually led to long viscous wars and conflict. The Reformation was a movement which established new beliefs and practices of the Roman Catholic Church and divided territorial lines between Christians. During the earlier times, the church would raise money for forgiveness and sins until Martin Luther deemed this type of behavior unacceptable and challenged other preachers to debate. Luther believed in his faith and in Jesus Christ and used the printing press to distribute his principles. All of this ultimately led to the “Counter-Reformation”, also known as the Catholic Reformation.
4.Who was Machiavelli and what political advice did he advocate?
Machiavelli was an Italian author and political thinker who paved the way for modern democracy during the Western Civilization. He wrote books about power and advocated very controversial material to shock and educate his readers, most notably the book titled “The Prince”. He believed the population was ignorant and could not be trusted and ultimately wanted those to learn how God did it. He wanted to separate the church from the state and create something that didn’t exist. He thought the end idea of the end justifies the means and the end is what counts.
5.What were the most important elements of the Columbian exchange?
The Columbia Exchange was the transfer of people, animals and plants between continents, which occurred during the 15th and 16th centuries. One of the most important elements of the exchange was the transfer of people, which brought the misfortune of an array of deadly diseases, including smallpox and influenza. Not every element of the exchange was quite as devastating, it also resulted in the exchange of plants and animals which helped the New and the Old World increase their population. By doing this, they altered their diet and lifestyle and were introduced to the horse which helped them hunt and fight. Lastly, the exchange brought cultural exchanges. These cultural changes, with land and resources, brought economic opportunities.
6.How did the Atlantic system affect Europe, Africa, and the Americas?
The Atlantic System affected Europe, Africa and the Americas since the trading system was taking thousands of slaves from Africa to Europe and the Americas. The slaves were bought at an inexpensive rate and expected to work on plantations, fields, and in the construction industry. Since they were considered property, they were sold as goods and services. This also played a huge role in the growth of the economy and developed large financial institutions which helped facilitate business relations across greater distances with larger profits. It was the beginning of capitalism. Since the slave trade was profitable, it was imperative the crew kept the slaves alive during transport; even though the conditions were severe and treatment was unbearable.
Discuss the events that led to the decline of the Mughal Empire?
The events that led to the decline of the Mughal Empire was that Aurangzeb was trying to control many colonies at the same time which was impossible to control. He was also didn’t have many allies and had a lot of enemies which made the empire more vulnerable. His religious policy had also impacted empire . The wars of succession that plagued Delhi from 1707 to 1719 too weakened the empire. The trail of weak successors further damaged the integrity of the empire.
2. Why did Peter the Great wish to modernize Russia on the Western Model?
He wanted to turn Russia into a great power because at the time when he became tsar, it was a a backwards, old-fashioned nation. He believed that Western Europe offered the best model for a progressive, modern, technologically advanced country. This was because the European countries like France, Britain, Holland and Sweden were the great powers of the age.
How did events in the eighteenth century lead to industrialization in the nineteenth century? What was the most important catalyst for industrialization?
After the growth of population and technological improvement in the late 18th centuries, people started to change their lives and started to work in factories. New tools, machines, and the development of other innovations all led to the industrialization. Coal was a great invention and became a key factor in the success of industrialization.there was also mining technology which ensured that more coal could be extracted to power the factories and run railway trains and steamships.The most important catalyst for industrialization was the invention of electricity Using electricity also promoted longer work days because they no longer needed to end when the sun went down.
Discuss the significance of the Factory Act of 1833 and the Mine Act 1842?
The Factory Act of 1833 was an attempt to establish a regular working day in the textile industry. It restricted the length of time that children worked and partially stopped the employment of children under 9 . It included that Children (ages 14-18) must not work more than 12 hours a day with an hour lunch break. Children (ages 9-13) must have two hours of education per day. The Mines Act of 1842 was also a legislation introduced to ensure that boys under the age of 10 were prohibited from being used as labor in coal mines.
SNHU Diagnosis of More than One Mental Health Condition Response
SNHU Diagnosis of More than One Mental Health Condition Response.
Chapters 7 and 8 explore the various mood, anxiety, obsessive-compulsive, and stressor-related disorders. One issue of concern with these disorders is comorbidity: the situation that occurs when multiple diagnostic conditions occur simultaneously within the same individual. Watch this brief clip, What About Bob Therapy Scene, from the film What About Bob (1991). While exaggerated for comedic effect, Bob’s description of a wide variety of symptoms brings up some questions and concerns.In your initial post, address the following:What are some pros and cons of diagnosing someone (e.g., Bob) with more than one condition?Comorbidity is especially common between the mood and anxiety/OCD/trauma disorders. Why do you think that is?Consider the track that you have selected for your final project (i.e., biological, psychological, sociocultural). How might an individual who adopts the perspective of your track explain the issue of comorbidity?Cite from the text readings to support your answers.In your peer responses, try to engage with classmates who offered differing responses regarding comorbid disorders than your own. What elements of comorbidity did they perhaps not consider?
SNHU Diagnosis of More than One Mental Health Condition Response
How does Southeast Asian Cultural Background Affect House Purchase Decision in Australia?
online dissertation writing How does Southeast Asian Cultural Background Affect House Purchase Decision in Australia?. RESEARCH PROPOSAL WORKING TITLE How does Southeast Asian Cultural Background Affect House Purchase Decision in Australia? RESEARCH QUESTION AND INDUSTRY PROBLEM [20%*] MAIN QUESTION How does Southeast Asian Cultural Background Affect House Purchase Decision in Australia? SUB-QU 1 What are the criteria for Southeast Asia countries when they are purchasing properties in Australia? SUB-QU 2 What are the cultural-related factors, their ranking and where do they come from? SUB-QU 3 How do these cultural factors influence Southeast Asian buyers’ decisions when choosing to buy a property in Australia? Australia is a multicultural and developed country. With the increasing number of immigrants, Australia has formed its own unique culture and embraced the culture of many different countries. It is believed that the increase in population has not only brought new impetus to social progress, but also stimulated local economy and increase employment opportunities. Among all these factors, what cannot be ignored is the need for immigrants to find a place to settle down, which means purchase a property in Australia. According to ABS, in 2016-17, net overseas migration (NOM) figure reaches 262,500 persons, which is 27.3% (56,300) more than in 2015-16. Since Australia is a safe country and Melbourne has been rated as the most liveable city in several years, this feature has attracted foreign investments and foreigners coming all the way to settle in Australia, and people coming from Southeast Asian countries are not an exception. With the Australia’s stable economy environment and beneficial government investment policies, more and more overseas investments has been attracted, and among them, property investments have taken up a larger increasing proportion. According to the annual report 2017-2018 from foreign investment review board (FIRB), the leading two countries are USA and China for foreign investments and in real-estate industry, China invested $12,667.7 million in this past financial year, which is the biggest percentage in this sector. Meanwhile, the social conflict occurred in relation to the house price drivers, cultural factors such as Fengshui, superstition of numbers, morality information, religion and other cultural factors are playing roles towards property acquisitions nowadays in Australia. As a result, a large number of investors are from overseas, and among them, Southeast Asian country purchasers are occupying larger percentage. This article will mainly focus on Southeast Asian backgrounds. According to the geography area, Southeast Asian countries include Singapore, Philippian, Thailand, Indonesia, Malaysia, Hong Kong and mainland China (Wikipedia, Southeast Asian). This article will mainly focus on the following countries: Singapore, Indonesia, Malaysia, Hong Kong and mainland china. It is mainly based on the above countries as illustrated examples, and trying to find the correlation between cultural factors and property purchase decision factors. It will also demonstrate how and to what extent cultural factors would affect people from Southeast Asia buying properties in Australia. From a broad perspective, culture is referring to the general form of material and spiritual wealth created in the historical practice of human society. Narrowing it down, it is a form of social ideology and behaviour, including belief, art, law, ethics, religion, social customs, and so on (Gibler, Karen M, Nelson, Susan L 2003).This paper examines on the behaviour of culture that has led to housing purchase decisions because of the influence of customs, as well as the impact extent of culture on housing purchase decision-making. According to Gibler, Karen M, Nelson, Susan L (2003), subculture is often a mode of life that includes both values and concepts shared with the main culture, as well as its own unique characteristics. It affects the thoughts and behaviours of people in a direct way. To make this article more objective, lots of literature review were conducted and it is found that most research papers in recent years only focus on the analysis of the rational factors when buying a property, and the published researches are mainly talking about consumers’ culture-related behaviours in a general sense(Gibler, Karen M, Nelson, Susan L 2003).It is noted that the research gap is that not many paper has investigated the relationship between the systematic cultural background and house purchase decision from Southeast Asian backgrounds in Australia in the last decades. This research is to provide new insights towards customer behaviour in terms of property purchase. Secondly, it will identify and investigate the correlation between cultural backgrounds and property purchase decision in Australia for people from Southeast Asian. By detailing the main question into three sub questions, the first element in this article that will be discussed is what criteria Southeast Asians will consider when buying a home in Australia. After discussing these factors and conditions, and then it will extend to what cultural factors are among all these criteria and where are they coming from. Finally, it will further explore the correlation of these two variables and to quantify the extent that cultural factors influencing the decision of people from Southeast Asia backgrounds to buy a property in Australia. Researching this problem would have its significance in the real estate industry. It can help marketers to better understand the factors behind the buying behaviour patterns of real estate consumers, and can guide the proportion of cultural factors in the decision-making process of consumers. This will also provide developers with better market information, allowing them to consider these irrational factors more in the future, enabling marketers to influence consumers with more targeted marketing methods, and thereby increasing sales performance and maximize profit. In the long run, if the finding factors are an important factor, then it can guide developers to take these factors into account when designing the project which better meets the needs and requirements of the market, which means they can accurately identify the target customers and decisively determine their location of construction, layout of projects and marketing campaign points. Moreover, it can have a certain impact on the Australian residential culture as well. The developers and real estate agents will need to understand property buyers’ purchasing behaviours across different cultural backgrounds in order to provide them with the property or services to meet their preferences. This will ensure a sustainable and attractive market, especially for foreign buyers. LITERATURE REVIEW [40%*] CRITERIA FOR SOUTHEAST ASIAN COUNTRIES WHEN THEY ARE PURCHASING PROPERTIES IN AUSTRALIA According to Wu and Teng (2011), it found out when customers plan to purchase a particular product or service, they will need to aim for a purchase intention. The same principle could be applied to house purchases, it noted both purchase intention and decisions are two important phases and they have direct links between two factors (Ajzen, 1991; Han and Kim, 2010; Kunshan and Yiman, 2011). They are providing the behavioural proof to prove that the purchase decisions are sometimes involve many factors and not only limited to the factual and objective factors. Property purchase is a big decision and several important factors would need to be considered and compared before making this final decision. Getting to know the intention for decision of property is not adequate, then the articles relating to property purchase factors are shedding lights on the topic. There are several house features would have impact on property purchase decision and they are the design of the property, internal and external designs, finishing and quality of the building (Adair et al., 1996; Daly et al.. 2003; Sengul, Yasemin and Eda, 2010; Opuku and Abdul-Muhmin, 2010). These findings can provide evidence on objective factors when people purchasing properties. Apart from that, based on these findings, another article illustrates the factors for Southeast Asian countries when purchasing properties and it took Malaysia as an example, the conclusion demonstrates that five variables are the most important factors among seven factors in terms of property purchase. They are finance, distance and accessibility, developer reputation, superstition (numbers and ghost), features of the property and spaces for living. (Chia, et. al, 2016). Relying on these findings, it is evident that when purchasing house in Australia, customers tend to focus on these attributes and compare the results with their intentions so that to rank them based on their priorities, which lead to property purchase in the end. Several past studies found that the financing information is the most significant factor and could have major impact on how people would make the decision for house purchase (Adair et al., 1996; Daly et al., 2003; Kaynak and Stevenson, 2007; Sengul et al. 2010; Xiao and Tan, 2007). In the context of Malaysia, the study by Razak, Ibrahim, Hoo, Osman and Alias (2013) proved that financial consideration, especially property price, has a very strong impact on house purchase intention. Adullah et al (2012) states that there are similar criteria when purchasing a property in Malaysia which include property location, internal design, developer brand and family life-cycle stages. These findings could provide some research evidence towards the factors affecting property purchase decision in Australia for Southeast Asians. Further literature review would carried towards the other two questions as follows. CULTURAL RELATED FACTORS RANKING AND REASONS From the empirical studies, it is observed that Chinese tend to be easily affected by group decision and morality information than American when making property value judgements (Justin DHow does Southeast Asian Cultural Background Affect House Purchase Decision in Australia?
Please answer discussion question and respond to two student posts . Human sexuality
Please answer discussion question and respond to two student posts . Human sexuality. Help me study for my Psychology class. I’m stuck and don’t understand.
Do you think children conceived by donor sperm and/or egg insemination should be told about this? Why or why not. Cite and think outside of the box. Please Respond to 2 posts from other classmates.
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Yes I do believe that children conceived by donor sperm should know. This is because we as humans have a natural tendency to want to know where we came from what we are made of such as different cultures and do we have any other siblings or relatives. It will also open their minds and eyes to the many different ways women can have children for themselves and their friends. And then one must ponder what if this child is born to parents of the same sex? Or the woman couldn’t carry her pregnancy to full term thus forcing her to use donor eggs or surrogacy. This will eventually end up being a topic of discussion for that family so be forth coming once a child is old enough to understand. In my opinion it’s always better that our children learn all their information about themselves from us the parents because society has a way of being cruel by twisting something so beautiful and thoughtless into a shameful selfish act. So being open and honest is the only way I see all the information given will be true and correct. We must remember we shape our relationships with our children and keeping the slightest of secrets can be detrimental in the long run.
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Dyanna Barajas Professor Addison Bio/Psyc 1110 February 2020Children who are conceived by donor sperm and/or egg insemination should be told how they are created. They should be told how they are created because their parents might be gay, lesbian, those who arent able to have kids naturally and those who have issues. There is children who have a lot of questions when they realize they do not look like their parents. I think when a child or children realize how they don’t look like their parents, that will be hard topic to talk about because they might not understand yet they will still need to be told how they were created.
Please answer discussion question and respond to two student posts . Human sexuality
Counseling methods used in substance abuse treatment
Counseling methods used in substance abuse treatment. Therapy techniques have become increasingly important methods in the treatment of people with various forms of substance abuse (“SA”) issues. Particularly in an age of managed care 1 , the pressure to provide quick but intensive solutions to them is intense. Fortunately, there are several schools of counseling whose techniques are amenable to these requirements. While the specifics of interventions and therapies will depend on conditions such as the substance(s) used, the severity of the problem(s) being addressed, and the desired short and long term outcomes, the techniques can be used individually or in a more eclectic combination. Studies which will be examined here show brief treatment can be effective for a range of problems. One of their primary advantages is that since they are less costly, more people can be reached with fixed governmental financial resources. In addition, the methods can be tailored to the specific needs of an individual client. The term “brief therapy” as discussed herein consists of several treatment approaches derived from a number of theoretical schools. They have been selected for use in the treatment world for a variety of reasons. This paper does not intend to be an exhaustive cataloging of them. In fact it will examine only the three most commonly used of the eight discovered in a search of the primary U.S. database of substance abuse treatment methodologies (SAMHSA, 2010) that the author has personal experience with. The three are supported by significant research, while others, such as Existential Therapy, have not been, and in fact some schools of treatment may by their nature not be subject to such scrutiny. The counseling methods found are: Cognitive-Behavioral Therapy Strategic Therapy Interactional Therapy Humanistic Therapy Existential Therapy Brief Psychodynamic Therapy Brief Family Therapy Time-Limited Group Therapy Brief Therapy Defined Brief therapy is a process that uses rapid assessment (sometimes as little as five minutes; more generally an hour or two), immediate client engagement (sometimes forced by courts and other law enforcement agencies but in all cases dependent upon the skill of the clinician (CSAT, 1998) and the proper assessment of client eligibility in the first place), and laser-like focused training in ways of implementing change. The duration of brief therapies found ranges from one to more than three dozen sessions, with typical numbers of visits of between six and twelve (Heather, 1994). Research concerning relative effectiveness of brief versus longer term therapies for a variety of presenting complaints is mixed. However, there is evidence suggesting that brief therapies are often as effective as lengthier treatments for properly-selected groups of clients. Cognitive-Behavioral Therapy Cognitive-behavioral therapy (CBT) derives, in part, from both behavioral and cognitive theories. While sharing a number of concepts and methods in common, CBT is also distinct in many ways from these other therapies (Carroll, 1998). CBT uses the teaching of new learning processes to help individuals reduce their drug use. It works by helping clients recognize risky situations in which they are likely to use, find ways of avoiding those situations, and cope more effectively with them if they cannot avoid them. It also teaches them to addresses their inner feelings and outward behaviors related to their substance abuse (Carroll, 1998). To achieve these goals, cognitive-behavioral SA therapists use three basic methods: (1) functional analysis, (2) coping skills training, and (3) relapse prevention (Rotgers, 1996). Functional Analysis This analysis attempts to identify the precursors and outcomes of substance abuse which serve as triggers. Precursors can come from emotional, social, cognitive, situational, environmental, and physiological domains (Miller, 1980). The functional analysis should also focus on the quantity, breadth and effectiveness of the client’s coping skills. While a major weight in CBT is on recognizing and fixing deficiencies in coping skills, the therapist also analyzes the client’s strengths and adaptive skills (DeNelsky and Boat, 1986). Coping Skills Training A major component in cognitive-behavioral therapy is the development of appropriate coping skills. Deficits in coping skills among substance abusers may be the result of a number of possible factors (Carroll, 1998). They may have never developed these skills, possibly because the early onset of substance abuse and/or early family dysfunction impaired the development of age-appropriate skills. Or, earlier developed healthy coping skills may have been diminished by the actual use of substances as the client’s main method of coping with life. Also, some clients continue to use skills that were suitable to an earlier age but are no longer apt or useful. Others clients may have some good coping skills but for some reason are blocked from using them. However these defects originated, one of the main goals of CBT is to help the individual cultivate and use coping skills that can handle high-risk situations without having to return to their learned coping skill: more drug use. Relapse Prevention The third part of CBT is relapse prevention. While one can find many theories of relapse (Donovan and Marlatt, 1993), the most common one cited is that of Annis and Davis (1989). Relapse prevention relies a thorough initial functional analyses, identification of triggers (people, places and things), and coping skills, but adds more training in which the therapist deals directly with the thinking involved in relapse process and works on getting the individual to be more effective in coping with that thinking. The two main advantages of CBT are a) that it is generally brief in length and b) flexible in implementation. CBT is usually done in 12 sessions over 12 weeks (Carroll, 1998). Sessions include basic ones that deal with substance-related issues (cravings, saying “no” to offered substances, crisis planning) and general problem-resolution skills as well as more specialized topics that are more general (usually social and communication skills) based on the individual assessment. For example, a 12-session CBT for cocaine use has shown that this length of treatment is enough to develop and maintain cocaine abstinence, (Carroll, 1998). Unfortunately, however, not all clients will significantly improve in that number of sessions. If that occurs, the initial CBT experience can still form the foundation of a more thorough treatment plan. Brief Psychodynamic Therapy Psychodynamic therapy (“PT”) attempts to treat the unconscious thoughts that result in the behavior the client presents at assessment. The goals of psychodynamic therapy are self-awareness and seeing the influence of the past on the present. In its brief form, this approach teaches the client to view unresolved conflicts and behaviors that have grown out of previous dysfunctional relationships and behaviors and that show up in the need and desire to use substances. Many different methodologies of brief psychodynamic psychotherapy have developed from psychoanalytic theory and have been used clinically to treat many disorders. A reasonable body of research supports the use of these methodologies (Crits-Christoph and Barber, 1991). Short-term PT generally has been seen to be the most effective when used as part of a more comprehensive treatment program that includes such aversive tools as urine screening, psycho-education and some of the newer psychopharmacological treatments. Brief PT also seems to be more effective after a period of abstinence has been achieved. It may also be more useful with people of only moderate severity in their abuse. Regardless, the therapist must be well-versed in SA pharmacology, the subcultures of substance abuse, and 12-Step programs. Ten major approaches to short-term psychodynamic psychotherapy were discovered in a search of the SAMHSA database (SAMHSA, 2010; Crits-Christoph and Barber, 1991). They are: Mann’s Time-Limited Psychotherapy (TLP) Sifneos’ Short-Term Anxiety-Provoking Psychotherapy (STAPP) Davanloo’s Intensive Short-Term Dynamic Psychotherapy (ISTDP) SE Psychoanalytic Psychotherapy The Vanderbilt Approach to Time-Limited Dynamic Psychotherapy (TLDP) Short-Term Dynamic Therapy of Stress Response Syndromes Brief Adaptive Psychotherapy (BAP) Dynamic Supportive Psychotherapy A Self-Psychological Approach Interpersonal Psychotherapy (IPT) While these approaches differ in some or many ways depending on the extent to which they use supportive versus challenging techniques, focus on short-term or long-term problems, have a goal of managing symptoms or undertaking more fundamental personality change, or are inward or outward directed, they all adhere to some of the basic tenets of psychotherapy: the value of the therapeutic alliance, working with defense mechanisms and resistance, and transference, This list is not exhaustive; numerous others, perhaps less well known, or modifications to them are not considered here. Many of these approaches have developed from clinical experience and are thus based on more anecdotal evidence, and some have been researched minimally, if at all. The number one factor that seems to determine a successful outcome of PT is the therapeutic alliance that develops (Luborsky et al., 1985). This seems to be true independent of the specific school of therapy. Psychodynamic therapy has always viewed the relationship as crucial and the means by which change occurs. Of all the brief techniques mentioned, PT places the greatest emphasis on the therapeutic relationship and provides the most detailed and thorough description of how to build and maintain this relationship. Another critical underlying concept of psychodynamic theory — and one that can be of great benefit to all therapists — is the concept of insight. Psychodynamic approaches regard insight as a most valuable kind of self-knowledge, particularly with respect to past conflicts and present world-views and the insight into repressed feelings. Insight can arrive quickly or slowly, but the goal of brief PT is to streamline the process. Luborsky et al. give an example of a client who feels depressed and angry and then drinks who then realizes that his anger toward his father that he thinks lead him to use is stimulated by another abusive person in his life, perhaps at work. This learned insight then gives the client the opportunity to interrupt the behavior. Brief Group Therapy Group psychotherapy is the most common mode of treatment of substance abuse disorders. It is different from other types of group therapy, such as family therapy, in that groups tend to be a) open-ended and b) formed with people who are generally strangers to each other. The lessons learned in the group are then practiced in the client’s external social network. The client then returns to the group to describe his/her success/failure and the group processes this. Group therapy is cited as standard SA treatment for a number of reasons. In actual practice, groups let the client see how their disease has progressed in themselves and in the members of their social network. It lets them experience their own success and the successes of other group members in an environment of mutual support and hope. The curative factors associated with group psychotherapy, defined by Irvin Yalom, the elder statesman of group therapy, specifically address the issues of hope, universality and insight seen through others, and a number of other issues specific to the SA clients (Yalom, 1995). In addition, Alcoholics Anonymous (AA) and many other 12-Step groups have long recognized the importance of how the fellowship of a group can end the deep and painful isolation associated with substance abuse. At the same time, such groups foster a level of connectedness with those who have a common purpose which is to drastically and permanently alter their lives. From this angle, brief psychotherapy groups offer significant opportunity to maximize the efforts of the client and the therapist. Research shows that most clients improve through group therapy in a brief amount of time – typically 8 to 12 weeks (Garvin et al., 1976). Garvin’s research suggests that brief group therapy can approach that of longer term therapy in fostering change, if that therapy is more goal-oriented, more structured and more directive than long-term group therapy. SAMHSA identifies seven methods of group therapy (SAMHSA, 2010): Brief cognitive group therapy Cognitive-behavioral group therapy Strategic/interactional therapy Brief group humanistic and existential therapies Group psychodynamic therapy Modified dynamic group therapy (MDGT) Modified interactional group process (MIGP) The preferred time for brief group therapy is no more than 2 sessions per week (except in residential treatment where it usually occurs daily). Sessions are typically 1½ to 2 hours in length. Given the much shorter residential course of treatment that generally occurs under managed care, one can question the use of a process-intensive group and suggest that psycho-educational groups be used instead. However, even though today’s client may not spend more than three to five days in detox on an inpatient unit, much work can be done by the client in this brief time. As mentioned before, directive educational groups are an additional necessity but are not generally sufficient by themselves. Groups with expert, active facilitation, but which still adhere to a formal, can quickly build cohesion and act as powerful tools for clients to move on to their next level of treatment. Group therapy is usually most effective if members have been able to develop their roles in the group, to perform in these roles, and to learn from the feedback they receive. Groups usually need time to define themselves, develop cohesion, and become a safe environment for the members. Of course, with any treatment, members have to have cleansed their bodies and minds of the most drastic serious effects of their recent use before gaining much benefit from the group. Because of this, the time frame of the member’s participation in the group must address his or her own therapeutic goals as well as any externally-imposed limit. Modified Interactional Group Process Brief therapy based on the Modified Interactional Group Process (“MIGP”) is a combination of the work of several theorists, primarily Irvin Yalom (Yalom, 1995). MIGP differs significantly from psycho-educational groups used in treatment. While both types of groups offer learning experience required for a newly-sober client, combining one with the other has the most clinical effect. The psycho-educational group is more directive, with the therapist as the main figure. Even with this, however, the dynamism of the process itself, even in a psycho-educational format, enables clients to make connections and build relationships that will support their recovery. The features that make MIGP different other group processes are the greater activity of the leader and his or her creation of a safe environment that allows group members to examine inter-personal relationship issues without excessive emotional reticence. This feeling of safety is greatly enhanced by the therapist’s enforcement of adherence to group rules and norms over the course of the group’s life. The critical importance of confidentiality, the group’s acting in a responsible, adult fashion, and the need for self-disclosure must all be supported by the therapist. Beginning and ending on time, making sure each member has a place in the group, and addressing absences set examples of boundaries the members may not have previously experienced in their chaotic, dysfunctional lives and contribute to the development of a safe therapeutic environment. By doing this, the leader trains the clients to realize that they, not he or she, the primary agents of change. The group becomes a safe place to give and to receive support. And although traditionally SA were once significantly confrontational, MIGP is less threatening and far more supportive. Yalom bases this on the belief that denial and other defense mechanisms become more fixed when a person is attacked. Consequently, group members are encouraged to support one another and look for areas of commonality rather than use more shame-based interactive styles that attempt to “break through denial.” Conclusion There are many counseling techniques available for substance abuse treatment. Some have been rigorously studied and others rely more on anecdotal reports. Some are based on well-researched and time-established theories of personality and behavior and others are new. This paper has not been an attempt to exhaustively catalog all of them but rather to assess some of the most popular and, in this day of managed care and limited governmental budgets, most cost-effective means of providing some meaningful treatment to a larger population than can be served by what is still the gold standard to substance treatment: 30-90 days of residential treatment followed by 3-6 months of weekly aftercare groups. Brief Psychodynamic Therapy (Crits-Christoph and Barber, 1991) Therapy (Theorist) Length of Treatment Focus Major Techniques Time-Limited Psychotherapy (Mann) 12 sessions Central issue related to conflict about loss (lifelong source of pain, attempts to master it, and conclusions drawn from it regarding the client’s self-image) Formulation, presentation, and interpretations of the central issue Interpretation around earlier losses Termination Short-Term Anxiety-Provoking Psychotherapy (Nielsen and Barth) Usually 12 to 15 sessions Unresolved conflict defined during the evaluation Early transference interpretation Confrontation/clarification/interpretations Intensive Short-Term Dynamic Psychotherapy (Laikin, Winston, and McCullough) 5 to 30 sessions; up to 40 sessions for severe personality disorders Experiencing and linking interpersonal conflicts with impulses, feelings, defenses, and anxiety Relentless confrontation of defenses Early transference interpretation Analysis of character defenses SE Therapy (Luborsky and Mark) 16 for major depression, 36 for cocaine dependence Focus on the core conflictual relationship theme Supportive: creating therapeutic alliance through sympathetic listening Expressive: formulating and interpreting the CCRT; relating symptoms to the CCRT and explaining them as coping attempts Vanderbilt Time-Limited Dynamic Psychotherapy (Binder and Strupp) 25 to 30 sessions Change in interpersonal functioning, especially change in cyclical maladaptive patterns Transference analysis within an interpersonal framework Recognition, interpretation of the cyclical maladaptive pattern and fantasies associated with it Brief Adaptive Psychotherapy (Pollack, Flegenheimer, and Winston) Up to 40 sessions Maladaptive and inflexible personality traits and emotions and cognitive functioning, especially in the interpersonal domain Maintenance of focus Interpretation of the transference Recognition, challenge, interpretations, and resolution of early resistance High level of therapist activity Dynamic Supportive Psychotherapy (Pinsker, Rosenthal, and McCullough) Up to 40 sessions Increase self-esteem, adaptive skills, and ego functions Self-esteem boosters: reassurance, praise, encouragement Reduction of anxiety Respect adaptive defenses, challenge maladaptive ones Clarifications, reflections, interpretations Rationalizations, reframing, advice Modeling, anticipation, and rehearsal Self Psychology (Baker) 12 to 30 sessions, not rigidly adhered to Change intra-psychic patterns. Incorporate more diverse representations of others and changes in information processing Analysis of the mirroring, idealizing, and merger transferences Supportive, empathic Interpersonal Psychotherapy (Klerman) Time limited; for substance abuse, the trials have been 3 and 6 months Eliminating or reducing the primary symptom; improvement in handling current interpersonal problem areas, particularly those associated with substance abuse Exploration, clarification, encouragement of affect, analysis of communication, use of the therapeutic relationship and behavior-change techniques Counseling methods used in substance abuse treatment
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