Discussion Question: Transference And Countertransference

Assignment 1: Discussion Question: Transference and Countertransference

By Saturday, August 22, 2015, respond to the discussion question. Submit your responses to the appropriate Discussion Area. Use the same Discussion Area to comment on your classmates’ submissions and continue the discussion untilWednesday, August 26, 2015.

At an inpatient residential treatment facility, a depressed client unrelentingly begs the attending consultant for a weekend discharge pass. While begging for the pass, the client states, “You remind me so much of my brother. He was always such an easygoing, kind person. Whatever you decide is fine. I trust my brother so much to make wise decisions. You are so much like him. So I trust you will make the right decision.” The consultant finally agrees and allows the patient to be discharged. The consultant is aware that the client has attempted suicide two times in the past. The consultant does not take the time to check with the licensed on-site clinician in charge before signing the weekend discharge slip. Answer the following questions:

  1. What issues of transference are displayed by the client? Explain in your own words.
  2. Did the consultant act ethically by allowing the client to be discharged? Discuss.
  3. Is it possible that countertransference played a part in how the consultant acted? If so, how?
  4. What are the other pitfalls facing consultants in the mental health profession?
  5. What ethical guidelines would you follow if you were a consultant in the mental health profession?

medical coding ICD 10 PCS Coding assignmen

M132 Module 08 Coding Assignment

 

Build the correct ICD 10 PCS code based on the documentation in the Operative Report documentation given under each Case Study.

 

1. Case #1

 

PREOPERATIVE DIAGNOSES:

1. A 37 weeks intrauterine pregnancy.

2. Previous cesarean section with rupture of membranes.

 

POSTOPERATIVE DIAGNOSES:

1. A 37 plus weeks gestation.

2. Previous cesarean section with spontaneous rupture of membranes.

3. Pelvic adhesions.

 

ANESTHESIA: Spinal.

 

PROCEDURE PERFORMED: Repeat low-transverse cesarean section.

 

FINDINGS: Male infant, 6 pounds, 5 ounces. Apgars 9 and 9.

 

ESTIMATED BLOOD LOSS: 800 mL.

 

The patient’s condition after surgery, the patient tolerated the procedure well.

 

PERTINENT HISTORY AND PHYSICAL: The patient is a 20-year-old black female, gravida 2, para 1-0-0-1, last normal menstrual period 08/02/2006, EDC 05/08/2007, 37-5/7th weeks gestation, she presented to L D with spontaneous rupture of membranes, history of previous cesarean section in 2009 for CPD.

 

PAST MEDICAL HISTORY: She denies allergies.

 

MEDICATIONS: She is on prenatal vitamins.

 

MEDICAL SURGICAL: She denies any significant history except for C-section in 2006.

 

SOCIAL HISTORY: She denies ethanol, tobacco, or drugs.

 

PSYCHIATRIC HISTORY: Noncontributory.

 

FAMILY HISTORY: Noncontributory.

 

PHYSICAL EXAMINATION: Vital Signs: Temperature, the patient is afebrile, pulse 94, respiratory rate 20, BP 97/50, fetal heart tone was 140 to 145. HEENT was within normal limits. Neck is supple. Chest: Cardiovascular, Sl and S2 regular without gallop or murmur. Lungs: Clear both fields. Breasts: No masses or tenderness. Abdomen: Gravid. Pelvic: Cervix was 50% effaced, 1 to 2 cm dilated, presenting part was vertex at -2 station, there was gross fluid, clear and Nitrazine was positive. The patient was therefore taken to the operating room for a repeat low-transverse cesarean section.

 

OPERATIONAL TECHNIQUE: The patient was brought to the operating room and under spinal anesthesia, was prepped and draped in the usual manner for a gynecologic abdominal operation. Through the old suprapubic Pfannenstiel skin incision, the abdominal cavity was entered into after much difficulty because of the pelvic abdominal adhesion. Following entry into the abdominal cavity, the bladder peritoneum was identified, reflected down. Following that, a midline low-transverse incision was made at the lower uterine segment with a knife and carried down into the uterine cavity without any difficulty. The incision was then extended to the level of the round ligament on both sides. Following which a male infant in vertex position was delivered with vacuum and handed over to the nursery staff in attendance. Birth weight was 6 pounds 5 ounces. Apgar was 9 and 9. Placenta was manually delivered. After remnants of the placental membranes have been removed from the uterine cavity, the uterine cavity was then closed with #1 chromic continuous interlocking suture. Hemostasis was verified and found to be adequate. The ovaries and tubes were inspected and found to be within normal limits. The abdominal cavity was copiously irrigated. The abdominal cavity was then closed in layers. The pyramidal muscle was closed with 2-0 interrupted suture, the fascia was closed with #1 Vicryl continuous suture in two halves and the skin was closed with staples. The patient tolerated the procedure well and left the operating room, awake, conscious, and in excellent condition.

 

ESTIMATED BLOOD LOSS: 800 mL

 

ICD-10-PCS Code: Click here to enter text.

 

 

 

2. Case Study #2

Electroencephalogram

 

 

Description: This is an 18-channel digital EEG recording done on this 79-year-old male with a chief complaint of altered mental status .This patient is also on insulin for diabetes.

 

There is diffuse slowing and disorganization in the background consisting of medium-voltage theta rhythm at 4-6 Hz seen from all head areas. There was faster activity at beta range from the anterior. Eye movements and muscle artifacts are noted. EKG artifacts at 76 per minute were noted. Hyperventilation and Photic stimulation were not completed.

 

Findings: This is a moderately abnormal record due to diffuse slowing and disorganization of the background, with the slowing being at theta range. There is indication of a moderate encephalopathic condition. Clinical correlation is required to rule out a structural lesion.

 

ICD-10-PCS Code: Click here to enter text.

 

 

3. Case #3

 

PREOPERATIVE DIAGNOSIS: Cardiogenic shock.

 

POSTOPERATIVE DIAGNOSIS: Cardiogenic shock.

 

PROCEDURE PERFORMED: Insertion of extracorporeal membrane oxygenation circuit.

 

ANESTHESIA: General.

 

OPERATIVE INDICATIONS: The patient a 52-year-old African American male who previously had placement of a HeartMate II left ventricular assist device. The device seems to be nonfunctional at this time despite multiple pressor support. He has continued to develop cardiogenic shock and multisystem organ failure. ECMO circuit is indicated to help stabilize him prior to a planned device exchange.

 

OPERATIVE TECHNIQUE: The patient was placed on the OR table in the supine position. General anesthesia was induced. He was prepped and draped in the usual sterile fashion. A small transverse incision was made in the right groin and right femoral artery and vein isolated. A 10-mm Hemashield graft was then sewn end to side to the common femoral artery after administration of intravenous heparin. The Hemashield graft was then tunneled subcutaneously to

exit the skin in the upper thigh. A 29-French percutaneous venous cannula was then placed in the femoral vein without difficulty. The cannula was then attached to the ankle circuit and flow initiated. There was excellent flow with excess of 6 liters per minute. Transesophageal echo showed good cannula placed in the right atrium. There was significant coagulopathic bleeding from the femoral artery which took in excess of 2 hours to control with various hemostatic agents. Eventually, hemostasis was assured and the wound closed in layered closure of Vicryl and subcuticular stitch for skin. The patient was returned to the ICU in critical condition.

 

 

ICD-10-PCS Code: Click here to enter text.

 

 

 

4. Case Study #4

 

Report of Operation

Preoperative Diagnosis: Retained products of conception

Postoperative Diagnosis: Retained products of conception

Procedure: Suction and D and C

Estimated blood loss: 50 cc

Fluids: 150 cc LR

Urine Output: 10 cc clear

Anesthesia: Spinal

Specimens: Products of Conception

Complications: None

Condition: Stable to Recovery Room

 

Procedure: The patient was taken to the operating room where spinal anesthesia was found to be adequate. She was prepped and draped in the normal sterile fashion and placed in the dorsal supine position lithotomy. A bivalve speculum was placed in the vagina. The cervix was adequately visualized. The anterior cervix was grasped with a one-tooth tenaculum and uterus was gently pulled forward. The uterus was gently sounded to approximately 7 cm and dilated to 10 mm. A 10 mm suction curet was then gently advanced into the uterus. The suction device was attached and suction was started and suction dilation and curettage was performed gently without difficulties. Some products of conception were obtained through the suction canister. Three passes were done with the suction curet. Excellent hemostatsis was noted. The one-tooth tenaculum was removed from the anterior lip of the cervix. The patient was noted to be hemostatic. All instruments were removed. The patient tolerated the procedure well and was taken to the recovery room in stable condition.

 

 

ICD-10-PCS code: Click here to enter text.

8-5a. Extrinsic Versus Intrinsic Motives

Live Chat

8-2. Theories of Motivation

Although psychologists agree that it is important to understand why humans and lower animals do things, they do not agree about the precise nature of motivation. Let’s consider various theoretical perspectives on motivation.

8-2a. The Evolutionary Perspective

The evolutionary perspective notes that many animals are neurally “prewired”—that is, born with preprogrammed tendencies—to respond to certain situations in certain ways (Macedo & Machado, 2014; Shackelford & Hansen, 2014). Spiders spin webs by instinct . Birds build nests by instinct. Bees “dance” instinctively to communicate the location of food to other bees.

These instinctive behaviors are found in particular species. That is, they are species-specific and are inborn. They are genetically transmitted from generation to generation.

Psychologists have asked whether humans have instincts, and if so, what kind and how many. More than a century ago, psychologists William James (1890) and William McDougall (1908) asserted that humans have instincts that foster survival and social behavior. James numbered love, sympathy, and modesty as social instincts. McDougall compiled 12 “basic” instincts, including hunger, sex, and self-assertion. Other psychologists have made longer lists, and still others deny that people have instincts. The question of whether people have instincts—and what they might be—remains unresolved.

A Fixed Action Pattern

George Diebold/Photodisc/Getty Images

In the presence of another male, Siamese fighting fish (Betta splendens) assume stereotypical threatening postures in which they extend their fins and gills and circle one another. If neither male retreats, there will be conflict.

What Are These Infant Monkeys Doing, and Why Are They Doing It?

© Harlow Primate Lab/University of Wisconsin

Do organisms have innate drives to obtain sensory stimulation, manipulate objects (like these young rhesus monkeys), and explore the environment? The monkeys appear to monkey around with gadgets just for the fun of it. No external incentives are needed. Children similarly enjoy manipulating gadgets that honk, squeak, rattle, and buzz, even though the resultant honks and squeaks to do not satisfy physiological drives such as hunger or thirst.

8-2b. Drive-Reductionism and Homeostasis

Sigmund Freud believed that tension motivates us to behave in ways that restore us to a resting state. His views are similar to those of the drive-reduction theory of learning, as set forth by psychologist Clark Hull in the 1930s (Hergenhahn & Henley, 2013).

According to Hull, primary drives such as hunger, thirst, and pain trigger arousal (tension) and activate behavior. We learn to engage in behaviors that reduce the tension. We also acquire drives—called acquired drives—through experience. We may acquire a drive for money because money enables us to obtain food, drink, and homes, which protect us from crime and extremes of temperature. We might acquire drives for social approval and affiliation because other people, and their goodwill, help us reduce primary drives, especially when we are infants. In all cases, reduction of tension is the goal. Yet some people appear to acquire what could be considered excessive drives for money or affiliation. They gather money long after their material needs have been met, and some people find it difficult to be alone, even briefly.

Primary drives like hunger are triggered when we are in a state of deprivation. Sensations of hunger motivate us to act in ways that will restore the bodily balance. This tendency to maintain a steady state is called homeostasis . Homeostasis works like a thermostat. When the temperature in a room drops below the set point, the heating system turns on. The heat stays on until the set point is reached. Similarly, most animals eat until they are no longer hungry. But many people eat “recreationally”—as when they see an appealing dessert—suggesting there is more to eating than drive reduction.

8-2c. The Search for Stimulation

Physical needs give rise to drives like hunger and thirst. In such cases, we are motivated to reduce the tension or stimulation that impinges on us. However, in the case of stimulus motives, organisms seek to increase stimulation.

A classic study conducted at McGill University in Montreal during the 1950s suggests the importance of sensory stimulation and activity. Some “lucky” students were paid $20 a day (which, with inflation, would now be more like $200) for doing nothing—literally. Would you like to “work” by doing nothing for $200 a day? Don’t answer too quickly. According to the results of this study you might not like it at all.

In this experiment, student volunteers were placed in quiet cubicles and blindfolded (Bexton et al., 1954). Their arms were bandaged so that they felt little if anything with their hands. They could hear nothing but the dull, continuous hum of air conditioning. Many slept for a while, but after a few hours of sensory-deprived wakefulness, most felt bored and irritable. As time went on, many grew more uncomfortable. Many students quit the experiment during the first day despite the financial incentive. Many of those who remained for a few days found it hard to concentrate on simple problems for days afterward. For many, the experiment did not provide a relaxing vacation. Instead, it produced boredom, discomfort, and disorientation.

Humans and other animals appear motivated to seek novel stimulation. Even when they have been deprived of food, rats may explore unfamiliar arms of mazes rather than head straight for the food source. Animals that have just copulated and thereby reduced their primary sex drives often show renewed interest in sex when presented with a novel sex partner. People (and nonhumans) take in more calories at buffets and smorgasbords than when fewer kinds of food are available (Wansink & Shimizu, 2013; Yip et al., 2013). Children spend hour after hour playing video games for the pleasure of zapping virtual people or monsters (Ferguson & Olson, 2013).

Truth or Fiction

· Getting away from it all by going on a vacation from all sensory input for a few hours is relaxing.

· T

· F

Stimulus motives provide an evolutionary advantage. Animals that are active and motivated to explore and manipulate their environment are more likely to survive. If you know where the nearest tall tree is, you’re more likely to escape a leopard and transmit your genes to future generations.

But note that survival is more or less a question of defending oneself or one’s group against dangers of one kind or another. In the following section, we see that many psychologists believe people are also motivated to develop their unique potentials, even in the absence of external threat.

8-2d. Humanistic Theory

Humanistic psychologists such as Abraham Maslow (1908–1970) suggest that human behavior is not just mechanical and aimed toward survival and the reduction of tension. Maslow believed that people are also motivated by a conscious desire for personal growth. Humanists note that people tolerate pain, hunger, and many other kinds of tension to obtain personal fulfillment.

“Such is the state of life, that none are happy but by the anticipation of change: the change itself is nothing; when we have made it, the next wish is to change again.”

—Dr.  Samuel Johnson  , English writer, editor, and lexicographer (1735–1752)

Maslow believed that we are separated from other animals by our capacity for self-actualization , or self-initiated striving to become what we believe we are capable of being. Maslow considered self-actualization to be as important a need in humans as hunger. The need for self-actualization pushes people to strive to become concert pianists, chief executive officers, or best-selling authors—even when they have plenty of money to live on.

Maslow (1970) organized human needs into a hierarchy. Maslow’s hierarchy of needs ranges from physiological needs such as hunger and thirst, through self-actualization (see Figure 8.1). He believed that we naturally strive to climb this hierarchy.

Fig. 8.1. Maslow’s Hierarchy of Needs

© Cengage Learning®

© iStockphoto.com/gaspr13

What do you do when you’re no longer hungry? Maslow believed we progress toward higher psychological needs once basic survival needs have been met. Where do you fit in this picture?

Critics of Maslow’s theory argue that there is too much individual variation for the hierarchy of motives to apply to everyone. Some people whose physiological, safety, and love needs are met show little interest in achievement and recognition. Some artists devote themselves fully to their craft, even if they have to pass up the comforts of a warm home or alienate their families. And many children from broken and unsafe homes strive to achieve in school (Noltemeyer et al., 2012).

8-2e. Cognitive Perspectives on Motivation

Cognitive theorists note that people represent their worlds mentally. As in Piaget’s cognitive developmental theory, they see people as natural scientists who strive to understand the world so that they can predict and control events. Therefore, people try to eliminate inconsistencies—or, as we saw in the case of the Seekers at the beginning of the chapter—discrepancies in information so that their ability to make sense of the world remains whole.

Children also attempt to create consistency between their own gender and what experience teaches them that boys and girls are expected to do in their cultural settings. As soon as they come to understand whether they are male or female, they begin to imitate the behavior of older people of the same gender (Halim et al., 2013; Ruble et al., 2006). According to cognitive-dissonance theory, people are generally motivated to hold consistent beliefs and to justify their behavior. That is why we are generally more likely to appreciate what we must work to obtain.

Each theory of motivation may have something to offer. Drive-reduction theory may explain why we drink when thirsty, but stimulus motives might explain why we go clubbing and drink alcohol. Each theory might apply to certain aspects of behavior. As the chapter progresses, we will describe research that lends support to each theory.

#1- 1 typed page- In this chapter- 8- the author discussed several theories of motivation. There are 5 specific theories discussed on pages 192-195. Please pick 2 theories to compare anmd contrast. Be sure to do both. Which theory do you agree with and why?

Live Chat Assignment # 2- 1 typed page- What is the difference between extrinsic and intrinsic motives? The textbook begins the discussion of this topic on page 205. In answering this question, please refer to at least one additional, credible source. In most situations would you say that you are intrinsically motivated or extrinsically motivated to do something? Explain your answer. Why do you think this is?

8-5a. Extrinsic Versus Intrinsic Motives
Do you want to do well in this course? If you do, why? Carol Dweck (2009) finds that achievement motivation can be driven by performance or learning goals, or both. For example, are you motivated mainly by performance goals, such as your grade in the course? If so, it may be in part because your motives concern tangible rewards such as getting into graduate school, landing a good job, reaping approval from your parents or your instructor, or avoiding criticism. Performance goals are usually met through extrinsic rewards such as praise and income. Parents of children who develop performance goals are likely to respond to good grades with rewards such as toys or money and to respond to poor grades with anger and removal of privileges.

“When I was young I thought that money was the most important thing in life; now that I am old I know that it is.”

— Oscar Wilde , Irish dramatist, novelist, and poet (1854–1900)
Or is it learning goals that mainly motivate you to do well? That is, is your central motive the enhancing of your knowledge and skills—your ability to understand and master the subject matter? Learning goals usually lead to intrinsic rewards, such as self-satisfaction. Students who develop learning goals often have parents with strong achievement motivation who encourage their children to think and act independently. Parents and teachers help children develop learning goals by showing warmth and praising them for their efforts to learn, exposing them to novel and stimulating experiences, and encouraging persistence (Dweck, 2006, 2009). Children who are stimulated in this way tend to set high standards for themselves, associate their achievements with self-worth, and attribute their achievements to their own efforts rather than to chance or to the intervention of others.

Many of us strive to meet both performance and learning goals in our courses as well as in other areas of life. Grades are important because they are connected with tangible benefits, but learning for its own sake is also of value and can provide great pleasure.

The Family Tree For Humanistic And Positive Psychology

For this assignment, build a “family tree” for humanistic and positive psychology, showing their connections and divergences from their origins in social and developmental psychology to their current contentious relationship. The “family tree” may be organized in terms of the key individuals whose work laid the foundation for the two disciplines today, or a combination of key individuals and their approaches, or through the various psychological concepts to which the two disciplines have been applied. “Cousins” and unexpected ancestors such as transpersonal psychology and B. F. Skinner, respectively, may be included. Several free sources of genograms (family tree templates) are available online and may be used. The presentation of the genogram should be followed with 2-3 pages of explanation and description of your approach. Citations do not need to be included in the genogram itself but should be included in the text after the image.

Support your assignment with at least three scholarly resources. In addition to these specified resources, other appropriate scholarly resources, including older articles, may be included.

 

Length: 3-4 pages, not including title and reference pages, but including genogram.

Course Code: PSY7011-8

Course Start Date: 05/29/2017

Section: Mental Health and Happiness

Week: 7

Activity: Build an Intellectual Genealogy for Humanistic and Positive Psychology

Activity Due Date: 07/16/2017

Activity Description

For this assignment, build a “family tree” for humanistic and positive psychology, showing their connections and divergences from their origins in social and developmental psychology to their current contentious relationship. The “family tree” maybe organized in terms of the key individuals whose work laid the foundation for the two disciplines today, or a combination of key individuals and their approaches, or through the various psychological concepts to which the two disciplines have been applied. “Cousins” and unexpected ancestors such as transpersonal psychology and B. F. Skinner, respectively, may be included. Several free sources of genograms (family tree templates) are available online and may be used. The presentation of the genogram should be followed with 2-3 pages of explanation and description of your approach. Citations do not need to be included in the genogram itself, but should be included in the text after the image.

Support your assignment with at least three scholarly resources. In addition to these specified resources, other appropriate scholarly resources, including older articles, may be included.

Length: 3-4 pages, not including title and reference pages, but including genogram

Your assignment should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards where appropriate. Be sure to adhere to Northcentral University’s Academic Integrity Policy.

Upload your assignment using the Upload Assignment below.

Learning Outcomes

2.0    Assess key research, theory, and applications in the history of psychology. 5.0    Interpret research into historical influences on the development of the field of psychology.

Resources

Articles Reference Instruction Adams, N. (2012). Skinner’s Walden Two: An anticipation of positive psychology?  http://proxy1.ncu.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=pdh&AN=2012-04823-001&site=ehost-live

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Hogan, J. D. (2000). Developmental psychology: History of the field.  http://proxy1.ncu.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=pzh&AN=2004-12701-003&site=ehost-live

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Lubek, I. (2000). Understanding and using the history of social psychology.  http://proxy1.ncu.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=mnh&AN=11054729&site=eds-live

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Rowan, J. (2004). Some history of humanistic psychology.  http://proxy1.ncu.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=pdh&AN=2015-56971-001&site=ehost-live

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Waterman, A. S. (2013). The humanistic psychology-positive psychology divide: Contrasts in philosophical foundations.  http://proxy1.ncu.edu/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=pdh&AN=2013-12501-001&site=eds-live

Read Article

Yen, J. (2010). Authorizing happiness: Rhetorical demarcation of science and society in historical narratives of positive psychology.

 

 

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