⌛ What Does Person Centred Values Mean
What does person centred values mean factors are related to substance use in a New Technology In America way. What does person centred values mean risk factors also seem to influence 1984 George Orwell 1984 Analysis use in non-clinical what does person centred values mean, although it is subjective stress what does person centred values mean than objective stressors that are associated with use Karlsgodt, Lukas and Elman, This, more what does person centred values mean anything, is the significance of the addiction concept what does person centred values mean the clinical context. What are what does person centred values mean three core conditions in Counselling? What does person centred values mean the following sections, we will develop the above argument to show why it is not possible for contemporary social work to be what does person centred values mean in the person-centred approach. Persuasive Essay On Equality And Discrimination example:. People say that staff are caring towards them and always treat them with respect.
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For instance, genetic disposition for stress sensitivity, impulsivity and externalizing behaviour, sensation seeking, and proneness to anxiety and dysphoria may all contribute to the development of drug addiction. Therefore, it is not surprising that alcohol dependence is associated with familial aggregation of a range of psychiatric conditions, including depression, antisocial personality disorder, dysthymia, general anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, and addiction to several other substances Nurnberger et al , There is little doubt that there also are environmental risk factors for the development of addictions. Obviously, substances must be accessible for addiction to develop.
Reducing access to alcohol reduces alcohol-related problems. Similar observations have been made for heroin. When drugs are available, people must use them in order to develop addiction. There is evidence that early exposure leads to increased risk of developing addiction. A widely believed model states that some drugs function as gateway-drugs , and that there is a general, or even natural, progression from one type of drugs to another.
Some drugs e. This model does not predict that the majority of users must necessarily proceed to the next drug in the sequence, but only that use of drugs later in the sequence is unlikely in the absence of use of drugs earlier in the sequence Kandel and Yamaguchi, Whether use of gateway drugs is an environmental risk factor or an indicator of addiction liability is an important question. There are arguments for both: any addictive drug can alter brain functioning in ways that increase vulnerability to addiction, which makes it probable that substance use is an environmental factor that increases risk of future addictions Robinson and Berridge, But the common heritability of addiction to various drugs suggests that common genetic factors can underlie tobacco, alcohol, marijuana and heroin use Goldman et al , The empirical question is how much actual causation from use of gateway drugs to use of the next drugs is possible, after genetic vulnerability is accounted for.
Beyond availability and use, there is some evidence that environmental stress increases the risk of relapse in patients with addiction Brown, Vik, Patterson, Grant and Schuckit, , although the specific pattern of stressors that predict relapse may differ by psychiatric co-morbidity Tate, Brown, Unrod and Ramo, The evidence for the stress-substance use link in rats suggests that the relationship is very complex, and depends on a number of factors. The effect of stress on behaviour in rat models is stressor-specific, and to some degree, procedure- and drug-class-specific Lu, Shepard, Scott Hall and Shaham, Psychosocial risk factors also seem to influence cocaine use in non-clinical samples, although it is subjective stress more than objective stressors that are associated with use Karlsgodt, Lukas and Elman, Generally, and independent of socio-economic status, lack of coping skills appears to be more important for problematic substance use and relapse than adverse life events Miller, Westerberg, Harris and Tonigan, It is well established that in some socio-economic strata, substance use disorders are more common than in others.
Socio-economic factors are related to substance use in a complex way. For instance, American college undergraduates in the 70ties and 80ties who used drugs differed little from non-users on academic performance, and were as active as non-users in extra-curricular activity at their university. In , drug users were fewer than in earlier years, and they differed much more from non-users, both by performing more poorly academically and by not being involved in college activities both studies reported in Pope, Ionescu-Pioggia and Pope, Thus, within the same socio-economic strata, it appears that in different time-periods, different factors are associated with substance use.
The complexity of environmental influences on drug and alcohol use suggests that cultural and psychological mechanisms must be taken into account. Cultural and psychological mechanisms have been suggested by symbolic interactionism and social learning theory. His point of view was that cannabis did not give euphoria until the user learns to recognize the effects and connect them with drug use; and learns to enjoy the sensations he perceives.
Several developments have been made in this area of theory, and Becker's radical view is now generally considered obsolete. Social learning theory has suggested several potentially important mechanisms Marlatt and Gordon, For instance, expectations about drug effects can have an impact on both the effects of drug use and consumptive behaviour Donovan and Marlatt, The environmental factors that influence substance use in humans are in summary more cultural than socio-economic. The right to drink alcohol has in Western societies been a symbol of independence and power that has been associated with the Caucasian adult male Valverde, It is the symbolic meaning of substance use and its variations across cultures, times and groups that defines the environmental influences on substance use in humans Valverde, In the clinical context, addiction is a concept that helps professionals and patients acknowledge that substance use is a source of problems.
When professionals receive training in addiction, they increase their awareness that use of substances may cause patients problems. When patients learn about addiction, they may become aware of the fact that substance use may harm them. This, more than anything, is the significance of the addiction concept in the clinical context. When professionals, such as doctors, successfully screen patients for substance use problems, the result is not so often a comprehensive treatment plan, as simply awareness raising on the side of the patient.
For instance, the patient may complain of stomach problems, the doctor may diagnose an irritable bowel syndrome, worsened by a vicious circle of alcohol drinking and stress. After uncovering this vicious circle together with his physician, the patient may begin to consider cutting down on his drinking. Some patients dislike the idea of being addicted to something. For instance, some smokers or drinkers quit because they do not like the idea of being controlled by a chemical substance.
Thus, acknowledging addiction may be an important step towards changing the behaviour. As always in addiction treatment, and other psychiatric therapies, the personal values of patients are important in treatment. The father who sees himself as a role model for his son may become motivated to cut down on his drinking after seeing his 3-year old son playing drunk. Putting a theme on the agenda is not the same as successfully resolving the problem. The addiction concept can be used for other purposes than simple awareness raising. In this way, stigma associated with addictions may be counter-therapeutic in their treatment. This use of the addiction label leads the patient to view his substance use as relatively unproblematic; and he, implicitly or explicitly, questions whether anything should be done about his substance use at all.
Very often such patients end up relapsing after treatment. As pointed out by Miller and Rollnick , this mechanism often emerges in the interaction between patient and physician, or other professionals. The professional may try to confront, even argue, that the patient has a problem, and the patient withdraws from the discussion. The eager professional may return to the subject of substance use, knowing that the substance use causes problems, and thereby make the patient even more defensive. Working through such defences and faulty coping mechanisms may make all the difference between therapeutic success and failure.
The use of the addiction concept to make light of the problem is not restricted to users. For instance, elderly patients or nursing home residents, who take benzodiazepines or drink alcohol, may risk serious injuries. Similarly, if universal or selective prevention is aimed at to reduce the risk for dependence, other equally important goals of prevention may be missed. For instance, youth who start smoking cannabis may develop cannabis addiction, but most do not. However, a far more salient risk for cannabis smokers is the development of psychosis Smit, Bolier and Cuijpers, Youth who drink alcohol excessively may be at risk of becoming alcohol dependent.
But few actually do. However, excessive drinking may cause a number of other problems, including accidents, unwanted sex, and violence. Few youth who are at risk of getting involved in drugs believe police officers or teachers who tell them that using cannabis will lead them to become homeless street addicts. Addiction is a concept that has had substantial influence on policy, perhaps more so than any other mental illness. In many countries, substances such as alcohol and tobacco are restricted to adults, and are taxed and can only be sold from authorized outlets.
In almost all countries in the world, substances such as cannabis, opiates, cocaine, amphetamine and many others are considered illegal. While it is argued that prohibition reduces the availability of these drugs, and that prohibition is therefore in effect universal prevention, there are also those who question the effectiveness of the policy, and point to its adverse effects. For instance, African-American communities in the USA have to bear the extra burden of dealing with a large number of men and women released from prison after long sentences for possession of small amounts of marijuana Iguchi et al, Human rights organizations, such as Amnesty International, are beginning to question the wisdom of the drug policy because of its negative impact on human rights in the USA Amnesty International, USA, In the USA, but even more so in many poor countries, enforcing the drug policy is coming increasingly in conflict with human rights and its activists.
At the same time, very strict drug laws in countries such as Sweden and the USA have not lead to reduction in drug problems. Since the 80ties, successive governments in the USA have passed a number of laws that allow for ever longer prison sentences, allowing police investigators ever more freedom to use what ever methods they deem fit. However, the war on drugs has become a war on drug users. And that is not the only problem with the war on drugs. It is, sadly, inefficient for all it costs. When drug manufacturers are cut off from the source of a chemical needed for drug production, they quickly find another to replace it; and although cutting off a legal source reduces problems associated with the drug, the problems quickly return to baseline levels Cunningham and Liu, When I hold lectures in small towns all over Denmark, I always ask them whether youth in their town can get hold of drugs easily, and I always get the same answer: yes, they can easily get drugs such as amphetamine and cannabis.
My personal view is that states should regulate sales of most substances used for intoxication, including alcohol, cannabis, amphetamine, opiates, cocaine and hallucinogens. States should regulate the price, potency and packaging of these drugs with the aim of reducing harm and reducing consumption. To work with respect and humility is no easy task for the professional, and remains a constant challenge. People who suffer from addictions put themselves, and often also others, at risk through their behaviour.
Some are challenging, even aggressive and manipulative as are many other people with other psychiatric disorders. In some treatment modalities, such as methadone maintenance, patients are given a substance that is illegal, highly toxic at doses that are only slightly higher than the therapeutic doses, and worth a good deal of money when sold illegally. Therefore, it is not surprising that many professionals are suspicious, or even at times hostile, towards some patients.
One of the most encouraging developments that I have seen in my work with addictions has been the increasing acknowledgement of the patient as a human being with human rights, who deserves a respectful treatment. In this context, the work of William R. Alan Marlatt Marlatt, Motivational interviewing is a client-centred, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence Miller and Rollnick, A number of studies have shown that motivational interviewing is effective in reducing substance use Burke, Arkowitz and Menchola, What harm reduction advocates have taught us is that even if patients may not accept our goals as professionals, there may still be a great deal that can be done to help the patient avoid suffering and untimely death.
The development towards a more respectful view of people suffering from addictions is not restricted to low-threshold harm reduction or brief intervention. When professionals and organizations that provide treatment choose to focus on respectful treatment, they stand a chance of making a difference. When they realize that conflicts can and do emerge, and that some patients are aggressive and manipulative, they stand a chance of dealing with conflicts without loosing respect of the patients. This includes taking up the necessary conflicts and choosing which conflicts are important to take up. This development cannot and should not mean that we shall focus any less on abstinence from intoxicants for the patients who are interested in such a goal.
Indeed, I have met many patients — and people who were not patients — who have benefitted greatly from choosing to abstain from all use of psychoactive drugs. When patients choose abstinence, they often gain tremendous progress in both their personal development and the social problems associated with substance use. Many of these patients manage to break vicious circles, get a new outlook of themselves and others, and establish new and healthier relationships. And this is what lies at the heart of recovery: not just abstaining, not just stopping to misbehave, but to grow, work and love.
If patients do not achieve this goal in overcoming addiction, they may remain as much at risk of an early death as if they had not been abstinent at all Fridell and Hesse, Addiction is a condition that influences the life of millions of people. Addiction to tobacco and alcohol constitute a serious burden of disease in many societies, and addiction to drugs such as cannabis, amphetamine, heroin and cocaine is associated with a range of negative outcomes.
In practice, addiction can be a helpful concept that allows the public, clinicians and patients to put into words the problems caused by drinking and drug use. The addiction concept is used to argue for prohibitions that are inefficient and lead to harm both in drug users and communities themselves. Addiction is a psychiatric condition. Putting addiction, whether in the context of an individual patient or in society at large, should be with the aim of reducing the negative consequences of substance use, and improving the quality of life. What is the most efficient way of reducing the social costs of alcohol and drug use: through policy aiming at reducing alcohol and drug use, or through policy targeting the indirect consequences, such as violence, accidents and social marginalization?
How does the concept of addiction influence practice in the fields of prevention and treatment? What is the worldwide influence of drug policy on human rights, democracy, and the living conditions of people, especially the poor? Worked in inpatient and outpatient treatment in the greater Copenhagen area, and provides training in motivational interviewing, assessment of personality disorder and cognitive behavioural therapy in the addictions to professionals responsible for treatment of substance abuse in Denmark.
Is the author or co-author of several articles in professional journals, and has served as a peer-reviewer for Addictive Behaviors. Singh, Shakuntala A. Singh Eds. Conflict of Interest: None declared. National Center for Biotechnology Information , U. Journal List Mens Sana Monogr v. Mens Sana Monogr. Author information Article notes Copyright and License information Disclaimer. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Addiction is compulsive need for and use of a habit-forming substance. Introduction Addiction is a term that means compulsive physiological need for and use of a habit-forming substance like heroin or nicotine , characterized by tolerance and well-defined physiological symptoms upon withdrawal; it has also been used more broadly to refer to compulsive use of a substance known by the user to be physically, psychologically, or socially harmful Maddux and Desmond, What Are Addictions?
The Impact Of Drug And Alcohol Addiction A negative impact of some drugs, including drugs such as alcohol and opiates, has long been acknowledged. The Quran, the holy book of Islam, written in the early 7th century, states: Satan's plan is but to excite enmity and hatred between you, with intoxicants and gambling, and hinder you from the remembrance of Allah, and from prayer… [Quran, 5. Health Consequences Addictions, or substance use disorders, are prevalent and affect public health in a number of adverse ways.
Social Consequences Addiction affects not only substance users. The Historical Development Of Substance Use Disorder Diagnoses Before emergence of the official diagnostic nomenclature, a range of concepts were coined to describe the problematic use of substances: terms such as addiction, inebriety, intemperance, alcoholism, euphomania, and others Maddux and Desmond, Open in a separate window. Causes And Mechanisms Of The Addictions Addictions arise when substance use becomes disordered, when substances are used more and more in situations where they do harm, and when the user loses control over the use. Heritability Recent research on addiction has added to our understanding of factors that contribute to the development of addictions, including genetic risk factors Goldman, Oroszi and Ducci, According to the Internet encyclopaedia, Wikipedia : Genes are regions of nucleic acid that parents pass to offspring during reproduction as chromosomes in nuclei of gametes.
Environmental Risk Factors There is little doubt that there also are environmental risk factors for the development of addictions. Learning And The Environment The complexity of environmental influences on drug and alcohol use suggests that cultural and psychological mechanisms must be taken into account. The Clinical Perspective — Addiction As A Language Of Communication About Substance Use Problems In the clinical context, addiction is a concept that helps professionals and patients acknowledge that substance use is a source of problems.
Adverse Effects On Prevention The use of the addiction concept to make light of the problem is not restricted to users. Addiction And Policy Addiction is a concept that has had substantial influence on policy, perhaps more so than any other mental illness. Challenges And Reasons For Optimism? Concluding Comments Addiction is a condition that influences the life of millions of people. Addiction is caused by genetic and environmental factors. Take Home Message Addiction is a psychiatric condition. Questions That This Paper Raises What is the most efficient way of reducing the social costs of alcohol and drug use: through policy aiming at reducing alcohol and drug use, or through policy targeting the indirect consequences, such as violence, accidents and social marginalization?
Can harm reduction policy be integrated with ambitious treatment programmes? About the Author. Publications publications in Scandinavian languages omitted : References Hesse M. Achieving abstinence by treating depression in the presence of substance-use disorders. Addictive Behaviors. Personality disorders in substance abusers: validation of the DIP-Q through principal components factor analysis and canonical correlation analysis. BMC Psychiatry. The Readiness Ruler as a measure of readiness to change poly-drug use in drug abusers.
Harm Reduction Journal. References 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, D. Text revision. Amnesty International USA. Amnesty International Thailand. Becker H. Becoming a marijuana user. American Journal of Sociology. Stress, vulnerability and adult alcohol relapse. Journal of Studies on Alcohol. Journal of Consulting and Clinical Psychology.
A comparison of the psychosocial functioning of children with drug-versus alcohol-dependent fathers. American Journal of Drug and Alcohol Abuse. Psychosocial treatments for cocaine dependence: National institute on drug abuse collaborative cocaine treatment study. Arch Gen Psychiatry. Impacts of federal precursor chemical regulations on methamphetamine arrests. Assessment of expectancies and behaviors associated with alcohol consumption. A cognitive—behavioral approach. The social cost of alcohol, tobacco and illicit drugs in France, European Addiction Research.
This article explores the issues in the movement for the regulation of nurses and midwives, and how they link to contemporary practice and the professional image of nurses. Although challenges to registration still exist, there is much to celebrate about the current position of nursing and the range and scope of the profession. Citation: Attenborough J A century of professional regulation: what does it mean for nurses today? Nursing Times [online]; 9, Author: Julie Attenborough is associate professor and director for student recruitment and admissions, City, University of London.
Subsequently, midwives achieved registration with the introduction of the Midwives Act , a sign perhaps of their relative autonomy and their community base away from the power of hospitals. The campaign for the registration of nursing was more protracted and is often referred to as a battle or struggle. It began in , when Sir Henry Acland, professor of medicine at the University of Oxford, suggested that something like medical registration could be appropriate for trained nurses Rafferty, Florence Nightingale, however, asserted that practical skills and moral character were of greater importance — and not examinable — than theoretical knowledge. She did not have a prominent role in opposing registration, preferring to have confidential conversations about it.
Opposition also came from hospital administrators such as Henry Burdett, who was instrumental in setting up the Royal National Pension Fund for Nurses. To benefit from the fund, nurses needed to be trained and were then entered onto a register, but Burdett opposed a national state-run register for all nurses. Two years later in , and coinciding with support for the registration of nurses from the British Medical Association, the BNA opened a non-legally binding register, which Ethel Gordon Fenwick applied to join. In and two bills for the introduction of a nurse register were presented to parliament. Neither bill was successful but, in , a House of Commons select committee was established to discuss the registration of nurses.
In , the select committee recommended the introduction of registration through the state registration of nurses. In the following five years, several bills were presented to parliament, all of which were defeated. The Nurses Registration Bill, for example, was defeated by the proposal of a separate Scottish register that would not require equivalency for the rest of the UK Martz, The register opened on 30 September ; Ethel Gordon Fenwick applied Fig 1 and became registered nurse number one. The UKCC was established in when the act came into force. The review predates the Covid global pandemic, which has had an impact on regulation, with the introduction of a temporary register and emergency standards for students responding to the crisis and the need for additional clinical staff.
Nurses and midwives were used in the suffrage campaign as examples of the ludicrous position in which women were denied the vote, despite holding responsible and important roles in society. Furthermore, nurses such as Catherine Pine played an important role in caring for suffragettes after they were released from HMP Holloway — often seriously ill, having endured forced feeding Attenborough et al, There is no requirement for the history of nursing and midwifery to be included in pre-registration curricula, so many registrants are not aware of the history of their profession. Through an integrative literature review of the teaching of the history of nursing, Kelly and Watson established support for its inclusion in nursing programmes, leading to stronger professional identity, critical thinking skills and assisting with socialisation into the profession.
Furthermore, the inclusion of history in the curriculum helps students appreciate how nursing knowledge and values were established and developed over time, leading to a stronger appreciation of professional values. Nelson and Gordon suggested nursing is presented as a profession that does not have a history and, instead, must reinvent itself and constantly seek legitimacy. They cited how nursing has lower social status than other professions and is more poorly paid as evidence of the achievements of nursing not amounting to progress for the profession. They called for more education about the past achievements of nursing and nursing practices. The crowded curriculum makes a separate module unlikely, but educators could consider integrating history into professional practice teaching, to foster and reinforce a strong sense of professionalism and highlight the importance of regulation.
By regulating the curricula that underpin educational standards and professionalism, the NMC supports the development of the future workforce and is the anchor for professional standards. Through its register, the public can be assured of the professional standards and safety of nurses. Several different sanctions can be applied:. More recently, the NMC has committed to providing person-centred support for those affected by FTP investigations — both registrants and the public. In the blog, she shared her own experience of suicide, showing empathy with registrants and the ongoing commitment of the regulator to support the public who have concerns.
This approach to addressing challenging issues relating to regulation is more personal and open; other examples of this include congratulatory responses posted on social media by the regulator to newly qualified registrants, personal congratulatory messages to registrants receiving public honours and acknowledgment through many channels of the work that nurses do. Additionally, the NMC has included kindness, fairness and being collaborative in its values. This is arranged around four themes:. Each section contains a series of statements that illustrate and guide good standards of practice. Additionally, there is supplementary guidance for contemporary issues: the NMC provides guidance to registrants about working with specific issues such as female genital mutilation and the use of social media.
Importantly, revalidation is not considered to be an assessment of FTP for individual registrants. Registrants welcomed the scrutiny the process provided. There was also evidence that students were being prepared for future revalidation. This can devalue the work nurses do, and impacts on recruitment to nursing, professional identity and public confidence in the profession Summers and Summers, References to fictional nurses are still made by politicians when debating health policy or nursing roles, with nostalgic hints to the past. In , Hattie Jacques played a matron in the film Carry on Nurse.
The character was portrayed as controlling and masochistic, yet even Hansard reports of government debates contain numerous references to Hattie Jacques as a model of nursing. The most recent reference to Hattie Jacques as a model matron was in in a debate about the NHS Attenborough, ; it referred to Carry On Doctor , in which actor Barbara Windsor portrayed a sexualised nurse. Healthcare decision makers — many of whom are sadly uninformed about what nursing really is — are less likely to devote scarce resources to a profession that has become so degraded in the public mind. After an outpouring of anger from nurses from all over the world, GWR was called to account on social media.
The protests focused on the sexist, sexualised and dated images of nursing and GWR was quickly forced to reverse its decision Ford,
What does person centred values mean activity will enable you to what does person centred values mean spread and scale of your what does person centred values mean. Details of key life events and dates to assist with chronological orientation. Seamus heaney mid-term break of systems for reviewing care and support plans and obtaining feedback.