Coronary heart disease refers to the failure of coronary circulation; a common form of disease affecting the heart and an important cause of premature death.
Coronary heart disease takes two principle forms.
Angina Pectoris and Myocardial infarction or Heart attack.
According to medical dictionary- Angina pectoris is a disease of the heart marked by sharp pain in the chest.
Characteristics of the Disease;
The symptoms of angina pectoris are periodic chest pains. Usually located behind the steps sternum and frequently radiating into the left shoulder and arm. The major came of these severe attacks of pain is an insufficient supply of oxygen is the heart due to plugging of the coronary arteries by deposit of fatly material.
Angina is generally precipitated physical or emotional exertion and is commonly relieved by rest or medication.
Myocardial infarction is a much more serious disorder and is the leading cause of death in the united state today. Like angina pectoris, myocardial infraction is caused by an insufficient supply of oxygen to the heart. The oxygen insufficiency is more extreme than in angina pectoris. Result from-
1. Coronary artery disease.
2. A general curtailment of the hearts blood supply through atherosclerosis, Or from coronary occlusion.
3. A sudden abstraction of a large coronary artery by deposits or a blood clot.
In both instances parts of the heart muscle die.
The American heart association lists seven factors related to increased risk for CHD.
0. Age
1. Sex (Males are at a greater risk)
2. Cigarette smoking
3. Elevated blood pressure.
4. Elevated serum cholesterol.
5. An increase in the size of the left ventricle of the heart as reverted by electrocardiogram.
6. Diabetes
The risks for heart disease generally increase with the number and severity of these factors.
Saturday, March 8, 2014
Wednesday, March 5, 2014
Concept of Reliability
Test reliability is the consistency of scores obtained by the same persons when retested with the identical test or with an equivalent from of the test (Anastasi & Urbina, 2005).
The concept of reliability underlies the computation of the error of measurement of a single score, whereby we can predict the range of fluctuation likely to occur in a single individual’s score as a result of irrelevant or unknown chance factors.
It has been used to cover several aspects of score consistency.
Test reliability indicates the extent to which individual differences in test score are attributable to true differences in the characteristics under consideration and the extent to which they are attribute to chance errors.
Measure of test reliability make it possible to estimate what proportion of the total variances of test score is error variance.
Since all types of reliability are concerned with the degree of consistency or agreement between two independently derived sets of scores, they can all be expressed in terms of a correlation coefficient.
The concept of reliability underlies the computation of the error of measurement of a single score, whereby we can predict the range of fluctuation likely to occur in a single individual’s score as a result of irrelevant or unknown chance factors.
It has been used to cover several aspects of score consistency.
Test reliability indicates the extent to which individual differences in test score are attributable to true differences in the characteristics under consideration and the extent to which they are attribute to chance errors.
Measure of test reliability make it possible to estimate what proportion of the total variances of test score is error variance.
Since all types of reliability are concerned with the degree of consistency or agreement between two independently derived sets of scores, they can all be expressed in terms of a correlation coefficient.
Limitations of Person centered counseling
The limitations of person centered theory are also noteworthy;
1. The approach may be too simplistic, optimistic, leisurely and unfocused for client in crisis or who need more structure and direction (Seligman 2006).
2. The approach depends on bright, insightful, hard working clients for best results. It has limited applicability and is seldom employed with the severely disabled or young children (Thompson & Henderson 2007).
3. The approach ignores diagnosis, the unconscious, developmental theories and innately generated sexual and aggressive drives. Many critics think it is overly optimistic.
4. The approach deals only with surface issues and does not challenges the client to explore deeper areas. Because person centered counseling is short term, it may not make a permanent impact on the person.
5. The approach is more attitudinal than a technique based. It is void of specific techniques to bring about client change (Moon 2007).
1. The approach may be too simplistic, optimistic, leisurely and unfocused for client in crisis or who need more structure and direction (Seligman 2006).
2. The approach depends on bright, insightful, hard working clients for best results. It has limited applicability and is seldom employed with the severely disabled or young children (Thompson & Henderson 2007).
3. The approach ignores diagnosis, the unconscious, developmental theories and innately generated sexual and aggressive drives. Many critics think it is overly optimistic.
4. The approach deals only with surface issues and does not challenges the client to explore deeper areas. Because person centered counseling is short term, it may not make a permanent impact on the person.
5. The approach is more attitudinal than a technique based. It is void of specific techniques to bring about client change (Moon 2007).
Strengths and Contributions of Person centered counseling
Person centered counseling’s unique aspects include the following;
1. The approach revolutionized the counseling profession by linking counseling with psychotherapy and demystifying it by making audiotapes of actual sessions and publishing actual transcripts of counseling sessions (Goodyear 1987).
2. The person centered approach to counseling is applicable to a wide range of human problems, including institutional changes, labor-management relationships, leadership development, career decision making and international diplomacy. For instance, Cornelius-White 2005 has found the person centered approach can be effective in promoting multicultural counseling. Likewise Lemoire and Chen 2005, have argued that the person centered approach seems to have the potential to create the necessary conditions that counteract stigmatization, allowing adolescents who are associated with a stigmatized sexual minority group to cope with their sexual identity in a manner that is more constructive for them.
3. The approach has generated extensive research (Tursi &Cochran 2006). It initially set the standard for doing research on counseling variables, especially those that Rogers 1957 deemed necessary and sufficient to being about therapeutic change.
4. The approach is effective in a number of settings, person centered counseling helps improve psychological adjustment, learning and frustration tolerance and decrease defensiveness. It is appropriate in treating mild to moderate anxiety states, adjustment disorders, and conditions not attributable to mental disorders, such as uncomplicated bereavement or interpersonal relations (Seligman 1997)
5. The person centered approach may be especially helpful in working with clients who have experienced tragedies since it allows them to struggle though emotion and actually become less affected in time by fully realizing feelings related to tragedies (Tursi & Cochran 2006).
6. The approach focuses on the open and accepting relationship established by counselors and clients and the short term nature of the helping process.
7. The basics of the approach take a relatively short time to learn. With its emphasis on mastering listening skills, person centered counseling is foundation for training many paraprofessional helpers. Furthermore it is the basis for several new and emerging approaches to treatment and it is frequently combined with other theoretical orientations to counseling such as cognitive and behavioral (Prochaska & Norcross 2007.
8. The approach has positive view of human nature and continues to evolve.
1. The approach revolutionized the counseling profession by linking counseling with psychotherapy and demystifying it by making audiotapes of actual sessions and publishing actual transcripts of counseling sessions (Goodyear 1987).
2. The person centered approach to counseling is applicable to a wide range of human problems, including institutional changes, labor-management relationships, leadership development, career decision making and international diplomacy. For instance, Cornelius-White 2005 has found the person centered approach can be effective in promoting multicultural counseling. Likewise Lemoire and Chen 2005, have argued that the person centered approach seems to have the potential to create the necessary conditions that counteract stigmatization, allowing adolescents who are associated with a stigmatized sexual minority group to cope with their sexual identity in a manner that is more constructive for them.
3. The approach has generated extensive research (Tursi &Cochran 2006). It initially set the standard for doing research on counseling variables, especially those that Rogers 1957 deemed necessary and sufficient to being about therapeutic change.
4. The approach is effective in a number of settings, person centered counseling helps improve psychological adjustment, learning and frustration tolerance and decrease defensiveness. It is appropriate in treating mild to moderate anxiety states, adjustment disorders, and conditions not attributable to mental disorders, such as uncomplicated bereavement or interpersonal relations (Seligman 1997)
5. The person centered approach may be especially helpful in working with clients who have experienced tragedies since it allows them to struggle though emotion and actually become less affected in time by fully realizing feelings related to tragedies (Tursi & Cochran 2006).
6. The approach focuses on the open and accepting relationship established by counselors and clients and the short term nature of the helping process.
7. The basics of the approach take a relatively short time to learn. With its emphasis on mastering listening skills, person centered counseling is foundation for training many paraprofessional helpers. Furthermore it is the basis for several new and emerging approaches to treatment and it is frequently combined with other theoretical orientations to counseling such as cognitive and behavioral (Prochaska & Norcross 2007.
8. The approach has positive view of human nature and continues to evolve.
Techniques of Person Centered Counseling
For person centered therapists, the quality of the counseling relationship is much more important than techniques (Glauser & Bozarth 2001) Rogers 1957 believed there are three necessary and sufficient conditions of counseling;
1. Empathy
2. Unconditional positive regard (acceptance, prizing)
3. Congruence (genuineness, openness, authenticity, transparency)
Empathy may be subjective, interpersonal or objective (Clark 2004, Rogers 1964) Often it is a combination of all three. In therapeutic situations empathy is primarily the counselor’s ability to feel with clients and convey this understanding back to them, This may be done in multiple ways but essentially empathy is an attempt to think with, rather than for or about, the client and to grasp the client’s communications, intentions and meaning (Brammer et al 1993). Rogers 1975 noted “The research keeps piling up and it points strongly to the conclusion that a high degree of empathy in a relationship is possibly the most potent and certainly one of the most potent factors in bringing about change and learning.
Unconditional positive regard also known as acceptance, is a deep and genuine caring for the client as a person-that is, prizing the person just for being (Rogers 1961, 1980)
Congruence is the condition of being transparent in the therapeutic relationship by giving up roles and facades (Rogers 1980. It is the “counselor’s readiness for setting aside concerns and personal preoccupation and for being available and open in relationship with the client (Moon 2007)
Since 1980, person centered counselors have tried a number of other procedures for working with clients, such as limited self disclosure of feelings, thoughts and values (Corey 2005). Clients, however, grow by experiencing themselves and others in relationship (Cormier & Cormier 1998). Therefore, Rogers 1967 believed that significant positive personality change could not occur except in relationships.
Methods that help promote the counselor-client relationship include, but are not limited to, active and passive listening, accurate reflection of thoughts and feelings, clarification, summarization, confrontation and general or open-ended leads. Questions are avoided whenever possible (Tursi & Cochran 2006).
1. Empathy
2. Unconditional positive regard (acceptance, prizing)
3. Congruence (genuineness, openness, authenticity, transparency)
Empathy may be subjective, interpersonal or objective (Clark 2004, Rogers 1964) Often it is a combination of all three. In therapeutic situations empathy is primarily the counselor’s ability to feel with clients and convey this understanding back to them, This may be done in multiple ways but essentially empathy is an attempt to think with, rather than for or about, the client and to grasp the client’s communications, intentions and meaning (Brammer et al 1993). Rogers 1975 noted “The research keeps piling up and it points strongly to the conclusion that a high degree of empathy in a relationship is possibly the most potent and certainly one of the most potent factors in bringing about change and learning.
Unconditional positive regard also known as acceptance, is a deep and genuine caring for the client as a person-that is, prizing the person just for being (Rogers 1961, 1980)
Congruence is the condition of being transparent in the therapeutic relationship by giving up roles and facades (Rogers 1980. It is the “counselor’s readiness for setting aside concerns and personal preoccupation and for being available and open in relationship with the client (Moon 2007)
Since 1980, person centered counselors have tried a number of other procedures for working with clients, such as limited self disclosure of feelings, thoughts and values (Corey 2005). Clients, however, grow by experiencing themselves and others in relationship (Cormier & Cormier 1998). Therefore, Rogers 1967 believed that significant positive personality change could not occur except in relationships.
Methods that help promote the counselor-client relationship include, but are not limited to, active and passive listening, accurate reflection of thoughts and feelings, clarification, summarization, confrontation and general or open-ended leads. Questions are avoided whenever possible (Tursi & Cochran 2006).
Goals of Person centered counseling
The goals of person centered counseling center around the client as a person not his or her problem. Rogers 1977 emphasize that people need to be assisted in learning how to come with situations. One of the main ways to accomplish this is by helping a client become a fully functioning person who has no need to apply defense mechanisms to everyday experience. Such an individual becomes increasingly willing to change and grow. He or she is more open to experience, more trusting of self perception, and engaged in self exploration and evolution (Rogers 1961). Furthermore, a fully functioning person develops a greater acceptance of self and other and becomes a better decision maker in the here and now. Ultimately a client is helped to identify, use and integrate his or her own resources and potential (Boy & Pine 1983)
Role of the counselor in Person centered counseling
The counselors role is holistic one. He or she sets up and promotes a climate in which the client is free and encouraged to explore all aspects of self (Rogers 1951, 1980). This atmosphere focuses on the counselor client relationship, which Rogers describes as one with a special “I-Thou” personal quality. The counselor is aware of the client’s verbal and nonverbal language, and the counselor reflects back what he or she is hearing or observing (Braaten 1986). Neither the client nor the counselor knows what direction the sessions will take or what goals will emerge in the process. The client is a person in process who is “entitled to direct his or her own therapy’(Moon 2007). Thus, the counselor’s job is to work as facilitator rather than a director. In the person centered approach, the counselor is the process expert and expert learner. Patience is essential (Miller 1996).
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