Adolescent self-mutilation: diagnosis & treatment

Self-mutilation is complicated and difficult to diagnose. Its incidence among adolescents has increased during the past 10 years. Most mental health professionals discover that the behavior has been part of patients' lives long before their initial visit and that patients have become very good at hiding their behavior. The literature on self-mutilation is increasing, but newer statistics, specifically about cutting and picking behaviors, need to be assessed. The disorder often co-exists with another disorder that requires psychotropic medications, the administration of which should be managed by psychiatric clinicians who specialize in children and adolescents. A multidisciplinary team is necessary to achieve the best outcomes.     

Cultural aspects of bipolar disorder: Interpersonal meaning for clients & psychiatric nurses

Bipolar disorder is a complicated mental illness to diagnose and treat. The symptoms of the disorder cause a multitude of fluctuations in mood and behavior, affecting the way individuals function and interact with others on a daily basis. Individuals diagnosed with bipolar disorder experience symptoms within a framework that is grounded in their cultural beliefs, values, and norms. Culture is a complex and personal biopsychosocial phenomenon that provides meaning within life for an individual, a group, or a community. It is essential that psychiatric-mental health (PMH) nurses understand the role of culture and integrate this knowledge into the biopsychosocial care of clients. The development and maintenance of the interpersonal therapeutic relationship between PMH nurses and their clients requires the use of a cultural framework, which refers to the connection of culture and cultural competence. The purposes of this article are to define culture and the process of cultural competence, provide a brief overview of bipolar disorder, propose the use of a cultural framework for bipolar disorder, and discuss the implications for PMH nurses who care for culturally and ethnically diverse clients.     

Special considerations in the treatment of college students with bipolar disorder

Bipolar disorder is a relatively common mental disorder that often has its onset during the college years. This means that students simultaneously face both the challenge of late adolescent development and the challenge of adapting to a major mental illness. As a further complication, the college environment is not well suited to the kinds of lifestyle changes that add stability to the lives of people with bipolar disorder. Treatment involves establishing an alliance, education about lifestyle changes, aiding adaptation to the illness, careful medication to minimize side effects, and loosening the affective constriction that can result from fear of relapse. Both the health care provider and student can use the culture of learning and self-discovery in the college setting to the treatment's benefit. As well, the provider can use the time-limited nature of college to lessen ambivalence about making long-term changes.     

Bloodless management of benign prostatic hyperplasia: medical and minimally invasive treatment options

Benign prostatic hyperplasia (BPH) is a medical condition affecting a wide range of the aging male population resulting in various degrees of lower urinary tract symptoms (LUTS). Today, a variety of medical therapies and minimally invasive BPH treatment modalities are available. Medical therapy includes α₁ blockers, 5α reductase inhibitors and combination therapy. When these options fail, surgery is indicated. Transurethral resection of the prostate (TURP) is still considered the gold standard surgical treatment for BPH. Nevertheless, numerous minimally invasive treatment alternatives are available that are comparable in effectiveness to TURP, with significantly less morbidity. In this article, current treatment options for BPH are reviewed with respect to their indications, long-term safety and efficacy in relieving BPH related LUTS. The selection of the type of BPH treatment should be based on the physician's experience, patient's co-morbidities as well as the prostate size and clinical disease progression.     

Child abuse: differential diagnosis, differential treatment

This study assessed the relationship between treatment intensity and rehabilitation at discharge of child abusers whose MMPI profiles revealed high levels of psychological distress. It should be noted that this sample does not represent the child abuser who requires only a support group or outpatient counseling. Because of repeated failures at other social service agencies coupled with the court selection process, this sample may be described as having been screened for intransigence, severity of symptomatology, and resistance to previous attempts at treatment. It is noteworthy that participation in treatment was court-ordered, thereby diminishing the possibility of improvement because of subject characteristics, emotional availability or stamina in the treatment process. In this exploratory study, the association between treatment intensity and assessed rehabilitation yielded a positive and statistically significant relationship. The client who received intense weekly treatment for longer durations was assessed as having a higher degree of rehabilitation. This finding is important particularly for a population that exhibited an abnormally high degree of psychological distress. As an initial investigation, results support the need for differential diagnosis and subsequent differential treatment of child abusers. Without differential diagnosis, treatment needs may go unrecognized; without intense and sustained treatment, the needs of the highly distressed child abuser may go unmet.     

Getting reluctant substance abusers to engage in treatment/self-help: a review of outcomes and clinical options

This review examines the results from 19 outcome studies, involving 1,501 cases, within 10 different clinical approaches to getting alcohol or drug abusers to engage in treatment or self-help. Each approach is summarized and its "success rate(s)" presented. Comparisons are made across various subcategories, such as alcohol vs. drug abusers, adolescents vs. adults, and experimental conditions vs. controls. A distinction is drawn between "Dual-Purpose" approaches, which combine engagement with counseling of the concerned person who originally sought help for the substance abuser, and "Engagement-Primary" approaches, which generally confine their efforts (through working with family members and others) to getting the substance abuser into treatment/self-help. "Best bet" clinical options are presented in terms of which particular approach appears to have the edge with which kind of substance abuser.     

Drama therapy in diagnosis and treatment

The author examines the use of drama therapy as a therapeutic and diagnostic tool that can help provide insights into personality and character and aid in the exploration of conflicts of children in therapy.     

Adolescent depression: Significant issues in diagnosis and treatment of constricted adolescents

This article examines depression in those adolescents who are constricted emotionally. Specific elements of ego organization are discussed with particular emphasis on loss, grieving, identification, and ego ideal. The authors examine characteristics of such adolescents from a socio-developmental-psychological perspective, utilizing data from the cases of two patients who presented remarkably differing profiles. In terms of treatment, differences in therapeutic style are illustrated to reflect the distinct levels of personality organization achieved by each of the patients. Constricted youth are distinguished from those youngsters who are depressed but are more typically oppositional and negativistic, and reveal a long standing history of chronic acting out.     

Assessment & treatment of persons with pedophilia

1. Like any other form of major mental disorders, pedophilia is an AXIS-I diagnosis that warrants psychiatric treatment. 2. The combination of anti-androgenic medications and individual/group psychotherapy are common treatments for pedophilia. 3. The social stigmatization of pedophilia brands mental health professionals who provide treatment for pedophiles as supporters of illegal sexual acts against children rather than as professionals treating a psychiatric disorder.     

Listening in a Multilingual World: The Challenges of Second Language (L2) Listening

Research into language acquisition and oral language use was examined in order to identify key factors that contribute to the successful acquisition of second language (L2) listening ability. The factors were grouped into three major domains: affective, cognitive, and interpersonal. It is claimed that in each domain, proficient L2 listeners have developed strategies, that is, plans of conscious action, in order to address persistent challenges of L2 acquisition. For the affective domain, the strategies concern development of resilience in order to maintain long-term motivation and investment of identity as an active user of the L2. For the cognitive domain, the strategies involve relearning the phonological system of the L2 as an independent system in order to counteract native language influences and using compensation tactics to supplement the influences of semantic organization of one’s native language. For the interpersonal domain, the strategies involve accommodation to communication styles and a task orientation to interaction. Research is reviewed from cognitive psychology, neurolinguistics, pragmatics, bilingualism studies, and language pedagogy, with the aim of identifying particular obstacles faced by L2 listeners and practical approaches used to cope with them.     

Career Counseling in Hong Kong: Meeting the Social Challenges

The article describes and examines the recent development of career development and counseling in Hong Kong in 3 major settings: school, university, and community. Convergence and divergence in career counseling between Hong Kong and the United States are discussed, in reference to a number of areas, including the freedom to choose and compromise, collectivism and individualism, school‐to‐work transition, use of tests, and types of career intervention. Areas of collaboration between the 2 regions are identified and discussed.     

Proprietary rehabilitation: Challenges and opportunities in the new millennium

Proprietary rehabilitation has developed into a distinct professional sector with procedures, practices, and philosophy that differ from those in the public rehabilitation program. As the new millennium commences, proprietary rehabilitation will face a variety of challenges and opportunities that could affect the future of this sector of the rehabilitation profession. Among these issues are changes in occupational information upon which many proprietary rehabilitation practices are based; increased opportunities for early intervention and establishment of disability management programs within industry; adjustment to the movement to a managed health care system; and the necessity to demonstrate fiscal efficacy of rehabilitation services to workers with compensable injuries. This article discusses these issues and suggests some ways in which those involved in proprietary rehabilitation can properly position themselves to address and benefit from these challenges and opportunities.     

Online Teaching in Social Work Education: Understanding the Challenges

There is a rapidly growing industry of online learning and distance education programs at the Master of Social Work and Bachelor of Social Work levels both within Australia and globally. A number of best practices have emerged from the literature that warrant consideration when delivering social work programs in online learning and distance education modes. Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education, including limited financial resources. Social work academics need to become aware and implement best practices in online learning and distance education e-teaching environments to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings. The purpose of this paper is to identify and discuss the challenges and benefits of distance education and online learning for consideration when providing a social work program in these delivery models.

IMPLICATIONS

• Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education.

• Social work academics need to become aware and implement best practices in the distance education and online teaching environment to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings.

     

Treatment of the bipolar client: Clinical social work contributions

The medicalization of bipolar disorder during the past two decades has tended to obscure the fact that it remains a disorder of uncertain etiology. Research has continued to support hypotheses that there are psychological and social, as well as biological, components of the onset and course of the disorder. Comprehensive treatment of the bipolar clinet thus requires intervention at all three of these levels. Social workers, with theiry psychosocial perspective, are well qualified to coordinate an overall treatment plan. The social worker's role includes six general intervention strategies.     

Ukraine's Joining the WTO: Realities and Challenges

In this paper we propose an analysis of the process of Ukraine's accession to the World Trade Organization (WTO) by focusing on the influence of the membership on the state as a whole and producers and consumers in different branches of economy. We point to positive and negative effects and analyze problematic issues putting obstacles in the way of Ukraine's joining the WTO.