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As I climbed 15-feet on a wooden ladder on top of an old platform, next to a wall of leather gray flesh, I caught a smell of fresh manure, which immediately cleared my sinuses . Trying to hide my fear of my wife with a poker face, and already feel a little uncomfortable, so we were an old man who advised one in his right hand a hammer in a bamboo cradle seat held on this fragile stage seemingly gentle giant mammoth £ 8,000. As the sweat dripped from her forehead, I knew there was no turning back the break in the humid jungle while perched on an elephant that we planned so excited. Finally, we elephant trekking in Thailand,. Apart from the slow run rough, and my thighs are chafed over the pages of this enormous beast peaceful was his leisurely stroll through the woods with his “magnificent and unique flora on top of one animal Strongest former life, an unforgettable experience for both of us.
Recently, when I was about elephant trekking in the reveries of Thailand, I started on an old video that thought is used in the outhouse “field title:” The elephant in the living room. “It’s a ridiculous story of the family, which was supposed to operate normally with an elephant walking in the real life of their stay. It illustrates the dynamics of co-dependent, to enable a dysfunctional family, family members of alcoholics and disputes over the presence of alcoholism in the family.
Try to imagine the conversations in quality family time – the TV or just relax together, if the elephant in the living room to encounter a tramp, things and hit them. It stinks, ton of hay and eating bananas every day, it takes half the living space, and it makes the trumpet sound throughout the day. Then try to imagine convincing your children, friends and family members, to keep secret, and that elephants do not exist. The idea is that if you hold long enough that it does not really exist, and it is not really an elephant, it is enough to move himself. Some things, like colds, Poison Ivy, stress and headaches usually disappear with time. Chronic illness and addiction to lifestyle (eg alcoholism, drug addiction, obesity, gambling, etc.) on the other side continues to grow with time. Ignore a chronic problem, it is rarely disappear for good, because of adverse effects continues, the effect of all those involved.
My initial objective of this article is to proclaim that not only the elephant is really, but it is not, despite our efforts to do so are ignored. Lying on the elephant bigger and stronger, and will continue to dominate the house. While we recognize and acknowledge their existence, we can take the first step to get out of denial and on the road to recovery. The “it” is that I am referring to what I call “poly-have behaviors. Secondly, I would like to introduce Addictions Recovery Measurement System (ARMS) as a measurement tool for monitoring progress of clinicians. In a sense, the system simulates the instructions old elephants master direction for me. “Dig your heels in the elephant’s neck, and cling to their foreheads, kick and go right to left with left, and go to where the elephant to stop eating bananas, you hammer on the head, for his thick skin, otherwise attract attention. ”
Behaviour of medical experts and health psychologists must take into account biological, psychological and socio-cultural in the examination on individual health. They have long emphasized the role that life experiences multi-dimensional (eg, traumatic events, negative effects of stress on the immune system, endocrine systems, gastrointestinal and cardio-vascular diseases, unhealthy / dangerous styles life and choices in poor health to ensure compliance with the regiments of prevention, etc.), play in the development, care, and prevention of physical illnesses. In 1990, 50 percent mortality (more than 1 million deaths per year) combined with the U.S. top 10 causes of death in addictive behaviors such as smoking, poor eating habits and activity, abuse alcohol, drug abuse and risky sexual practices (McGinnis and Foegen, 1994).
Some medical experts are now expected that U.S. number one problem of health, it is no longer heart disease or cancer, but a deadly condition known as “X syndrome”. This condition is described as a combination of several metabolic problems such as obesity, high blood pressure, insulin resistance, and / or abnormal cholesterol, all linked to poor diet and lack of exercise. The sum is more great that the parties in this syndrome. Every problem is a metabolic risk for other diseases separately, but together they multiply the chances of potentially fatal diseases such as heart disease, cancer, diabetes and stroke, etc. You indicate that up to 25% of adults currently have syndrome X, and the ranks and grow in this example, that 30.5% of our Nations’ adults are morbidly obese (100 pounds or more above the ideal weight and BMI = 30>), and that two-thirds or 66% of adults are overweight (BMI = 25>). As the U.S. population is now over 290 million euros, some estimate that up to 73 million Americans of all forms of awareness and education benefits or behavioral treatment. This fact does not account for 25% addicted to nicotine, 13.4% (NiMH) with alcoholism, and many millions more who are dependent psychotropic substances and other addictive disorders such as pathological gambling, pornography, and extreme religious trends, etc.
In this regard health crisis, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Commission on Accreditation of Rehabilitation Centres (CARF), the two continue to seek review of the quality of health care as the disciplines of health care is generally not common rule of this result took standardized measures. The result of the measurement of research data in their entirety ambulance inspections, remains a priority. In many countries, the results of future evaluations are related legislative resources, demonstrating the effectiveness of mandatory treatment program. To add to the confusion, there are differences in the definition of results, the two paradigms: relationship (1) The current system of health care is set up to focus on acute rather than chronic diseases. It focuses on a single model in the syndrome, the only marker of treatment response or success is specific symptom reduction. consumers (2) Health care is increasingly in favor of a multi-dimensional model considers the work a number of areas of life that affect the evolution of patient care. Evidence-based meta-analysis studies also claim the predictive power of life functioning variables to predict production and its importance for treatment planning on a single model, which has been little empirical support.
My purpose in writing this article is to educate not only the other to draw attention to these complex issues, but also strategies and practical tools for clinicians to offer advantages in attacking these problems.
The measurement system of detoxification and rehabilitation (ARMS) was developed to assist health care providers:
First provide the highest quality of patient care that improves patients’ overall health
Second document effectiveness of reducing health risks and costs of health care
3rd Compliance assessments U. S. Preventive Services Task Force evidence-based prevention and recommendations for early detection of diseases
4th Support U.S. Department of Health Healthy People 2010 national initiatives
5th Regulatory CARF and JCAHO performance measures for
Help the sixth current healthcare system from a model of change for reducing symptoms of the traditional emphasis on a multidimensional model of comprehensive prevention
7th Maintaining the integrity and effectiveness of treatment programs for sustainability of health care
The weapon is a standardized multi-dimensional integration as the combination of twelve clinical evaluation and innovative primary and the extent of support for providers and consumers of health services with the following seven objectives: level of initial treatment response predictions Diagnostic care recommendations progress departure management proposes the provision and measurement of results. The patient’s progress ARMS tracking system also includes a performance based holistic health and well-being of the system point of non-confrontation. A single unit provides unbiased screen, and reassess a patient’s original condition biopsychosocial medical indicators prognostic indicators of treatment progress and outcome indicators after treatment. This measurement system motivate patients to monitor progress in six (PD) Progress Weight admission to discharge to coordinate continuity of patient care by multiple providers simultaneously. The coat of arms includes a comprehensive system of forecasting tools with a treatment capacity of progress and results measurement system that shows visually the journey of a patient recruitment for improvement. The performance target of processing measurement results better, more targeted and clinically validated treatments to meet the individual needs of patients through ongoing research.
The measurement system of detoxification and rehabilitation with an arsenal of tools to assess and forecast, Booth is equipped, and the result of measuring instruments, to give you the war against the poly-substance and behavioral addictions . We must remember that more than 440,000 Americans die annually from smoking alone (for example, that in 1205 a day etc.), costs $ 75 billion in direct medical costs. We must remember that there are 300,000 adults die each year from obesity (for example, 822 per day, etc.), with United States dollars 117 billion we spend on diseases related to the obesity annually (National Health and Nutrition Examination Survey, 1994). We must also consider using the 100,000 annual deaths related to alcohol (for example, is 274 per day, etc.), with 184.6 billion we spend on this issue (Tenth Special Report to Congress, June 2000). Only these three dependencies lifestyle are only caused 840,000 deaths per year (for example, from 2301 per day, etc.), with a total cost of 376.6 billion dollars annually to U.S. taxpayers. We must recognize that we are not longer afford to ignore the elephant in the living room of America “- the multidimensional problems associated with people of multiple behavioral addictions. A Call to Arms” in the fight against the murderers of the tip of Americans have Poly-behaviors.
For more information: http://www.geocities.com/drslbdzn/Behavioral_Addictions.html
James Slobodzien, Psy.D., CSAC, Hawaii is a licensed psychologist and certified consultants, substance abuse earned his doctorate in clinical psychology. He is accredited with the National Register of Health Service Providers in Psychology. He has 20 years experience working in mental health mainly in the fields of alcohol or drugs and behavioral addictions in hospital, prison, court and settings. He is Associate Professor of Psychology and also maintains a private practice as a consultant on mental health.
What you hear real music? Dr. James Jones suggests that listening is not true advise, inform or try to solve problems. Listening is just to hear what you have to say troubled teens. Parents often have a teenager with feedback comments are advisory to respond or not to accept in any way. These responses are similar ‘or close the conversation and does not promote further dialogue.
closed responses also “discount” from the other person.
open answers are much more productive way of communicating with a rebellious adolescent. These responses are not judgmental, and I do not suggestions or solutions. The answer is simply to accept what is said. These responses reflect both the content and the feelings of the child is in your project as a parent.
Set in the book to let children by Dr. James Jones, he gives an example of parent response closed and an example response of parents open.
Closed-parent reaction
Teenager:
My science teacher gave me a “C” on the science project. I can not believe it!
Parent:
First I told you to type, but you’ll never listen to you?
2nd Do not complain, we get what we deserved.
The third teacher is not unjust, what do you spoil this moment?
They are called “closed responses” because they fight effectively close communication between parents and adolescents. They are usually “put down” in the form of advice or criticism.
Open responses from parents
Teenager: I can not believe Mr. Green gave me a “C” on my science project after weeks on stupidity.
Parent: I think you’re very disappointed (feelings) only the opportunity to make a “C” with a lot of work. (Summary)
Teenager: In addition, he gave Don “A” because he had planned to Mr. Green suggested.
Parent: I right? You feel angry (feelings) because Mr. Green is unfair. (Summary)
Teenager: You should feel better! Anyway, I learned much of my project, it was really hard!
Parent: So, despite the disappointment (feelings) level, you’ll be happy (feeling) you put your project difficult? “(Content)
Teenager: Yeah! , I think I am, but I thought I would be an “A” for sure. Hey … What to eat?
Hark!
* When a troubled teenager asks you to listen and start giving advice, you have not done what they asked.
* If a teenager fight you to listen, and you start to tell him why he should not feel that way, you trample on his feelings.
* When a rebellious adolescent asks you to listen and you feel that something will not solve his problem, you must drop it, may seem strange.
* Listen! You hear that your teenager has asked, do not speak or simply listen.
* Advice is cheap, you can be the same Dear Abby and Billy Graham in the newspaper.
* Your teen may act for themselves. It is not defenseless. Maybe discouraged and frustrated, but not defenseless.
* If you do something for your teenager that he can do for you, you are contributing to his fear and weakness.
* But if you accept that the mere fact that your teen feels what he feels, whatever irrational, then you can stop trying to convince and understand about the company, was behind this irrational feeling . And if this is clear, the answers are clear and will not rely on consulting.
* So please listen and hear your teenager difficulties. And if you want to talk, wait a minute for your turn, and he’ll listen.
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