HIV AND AIDS Continuing Education Units CEUS
7 Hours/CEU’s
Click here for full course text
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
may be transmitted or reproduced in any form, or by any means, mechanical or
electronic without written permission of Aspira Continuing Education.
1. Differentiate between HIV and AIDS
2. Identify causes
3. Learn epidemiology
4. Learn the historical framework related to the development of
HIV/AIDS
5. Become familiar with the impact HIV/AIDS on culture
6. Identify and recognize common stigmas associated with HIV/AIDS
7. Increase familiarity with the relationship between HIV/AIDS and
mental health
8. Increase familiarity with the relationship between HIV/AIDS and
substance abuse
9. Develop the ability to identify the characteristics and method of
assessment and treatment of people who live with HIV/AIDS.
Table of Contents:
1. Definitions
2. Causes
3. Epidemiology
4. History
5. Stigma
6. HIV/AIDS and Mental Health
7. HIV/AIDS and Substance Abuse
8. Cognitive Disorders
9. Summary
10. References
1. Definitions
Human immunodeficiency virus (HIV) is a lentivirus (a member of the
retrovirus family) that can lead to acquired immunodeficiency syndrome
(AIDS), a condition in humans in which the immune system begins to fail,
leading to life-threatening opportunistic infections. Previous names for the
virus include human T-lymphotropic virus-III (HTLV-III),
lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus
(ARV). Infection with HIV occurs by the transfer of blood, semen, vaginal
fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present
as both free virus particles and virus within infected immune cells. The four
major routes of transmission are unprotected sexual intercourse,
contaminated needles, breast milk, and transmission from an infected mother
to her baby at birth (Vertical transmission). Screening of blood products for
HIV has largely eliminated transmission through blood transfusions or
infected blood products in the developed world (Appay V, Sauce D, January
2008. "Immune activation and inflammation in HIV-1 infection: causes and
consequences". J. Pathol).HIV infection in humans is now pandemic. As
of January 2006, the Joint United Nations Program on HIV/AIDS (UNAIDS) and the
World Health Organization (WHO) estimate that AIDS has killed more than 25 million people
since it was first recognized on December 1, 1981. It is estimated that about 0.6 percent of the world's population is infected with HIV. In 2005 alone, AIDS claimed an estimated 2.4–3.3
million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth
and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans.
Antiretroviral treatment reduces both the mortality and the morbidity of HIV
infection, but routine access to antiretroviral medication is not available in
all countries. HIV primarily infects vital cells in the human immune system
such as helper T cells (specifically CD4+ T cells), macrophages, and
Human immunodeficiency virus Scanning electron micrograph of HIV-1 (in green) budding
from cultured lymphocyte. Multiple round bumps on cell surface represent sites of
assembly and budding of virions.
dendritic cells. HIV infection leads to low levels of CD4+ T cells through
three main mechanisms: firstly, direct viral killing of infected cells;
secondly, increased rates of apoptosis in infected cells; and thirdly, killing of
infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected
cells. When CD4+ T cell numbers decline below a critical level, cellmediated
immunity is lost, and the body becomes progressively more
susceptible to opportunistic infections (Appay V, Sauce D, January 2008.
"Immune activation and inflammation in HIV-1 infection: causes and
consequences". J. Pathol).
Eventually most HIV-infected individuals develop AIDS (Acquired
Immunodeficiency Syndrome). These individuals mostly die from
opportunistic infections or malignancies associated with the progressive
failure of the immune system. Without treatment, about 9 out of every 10
persons with HIV will progress to AIDS after 10-15 years. Many people
deteriorate much sooner. Treatment with anti-retrovirals increases the life
expectancy of people infected with HIV. Even after HIV has progressed to
diagnosable AIDS, the average survival time with antiretroviral therapy (as
of 2005) is estimated to be more than 5 years. Without antiretroviral therapy,
death normally occurs within a year. It is hoped that current and future
treatments may allow HIV-infected individuals to achieve a life expectancy
approaching that of the general public (Appay V, Sauce D, January 2008.
"Immune activation and inflammation in HIV-1 infection: causes and
consequences". J. Pathol).
Acquired immune deficiency syndrome or acquired immunodeficiency
syndrome (AIDS) is a set of symptoms and infections resulting from the
damage to the human immune system caused by the human
immunodeficiency virus (HIV). This condition progressively reduces the
effectiveness of the immune system and leaves individuals susceptible to
opportunistic infections and tumors. HIV is transmitted through direct
contact of a mucous membrane or the bloodstream with a bodily fluid
containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and
breast milk (Appay V, Sauce D (January 2008). "Immune activation and
inflammation in HIV-1 infection: causes and consequences". J. Pathol.)
This transmission can involve anal, vaginal or oral sex, blood transfusion,
contaminated hypodermic needles, exchange between mother and baby
during pregnancy, childbirth, or breastfeeding, or other exposure to one of
the above bodily fluids (Appay V, Sauce D, January 2008. "Immune
activation and inflammation in HIV-1 infection: causes and consequences".
J. Pathol).
AIDS is now a pandemic. In 2007, an estimated 33.2 million people lived
with the disease worldwide, and it killed an estimated 2.1 million people,
including 330,000 children. Over three-quarters of these deaths occurred in
sub-Saharan Africa, retarding economic growth and destroying human
capital. Genetic research indicates that HIV originated in west-central
Africa during the late nineteenth or early twentieth century. AIDS was first
recognized by the U.S. Centers for Disease Control and Prevention in 1981
and its cause, HIV, identified in the early 1980s (Appay V, Sauce D, January
2008. "Immune activation and inflammation in HIV-1 infection: causes and
consequences". J. Pathol).
Although treatments for AIDS and HIV can slow the course of the disease,
there is currently no vaccine or cure. Antiretroviral treatment reduces both
the mortality and the morbidity of HIV infection, but these drugs are
expensive and routine access to antiretroviral medication is not available in
all countries. Due to the difficulty in treating HIV infection, preventing
infection is a key aim in controlling the AIDS epidemic, with health
organizations promoting safe sex and needle-exchange programs in attempts
to slow the spread of the virus (Appay V, Sauce D, January 2008. "Immune
activation and inflammation in HIV-1 infection: causes and consequences".
J. Pathol).
2. Causes
AIDS is the most severe acceleration of infection with HIV. HIV is a
retrovirus that primarily infects vital organs of the human immune system
such as CD4+ T cells (a subset of T cells), macrophages and dendritic cells.
It directly and indirectly destroys CD4+ T cells. Once HIV has killed so
many CD4+ T cells that there are fewer than 200 of these cells per microliter
(μL) of blood, cellular immunity is lost. Acute HIV infection progresses
over time to clinical latent HIV infection and then to early symptomatic HIV
infection and later to AIDS, which is identified either on the basis of the
amount of CD4+ T cells remaining in the blood, and/or the presence of
certain infections (Appay V, Sauce D, January 2008. "Immune activation
and inflammation in HIV-1 infection: causes and consequences". J. Pathol).
Scanning electron micrograph of HIV-1, colored green, budding from a cultured lymphocyte.
In the absence of antiretroviral therapy, the median time of progression from
HIV infection to AIDS is nine to ten years, and the median survival time
after developing AIDS is only 9.2 months. However, the rate of clinical
disease progression varies widely between individuals, from two weeks up
to 20 years. Many factors affect the rate of progression. These include
factors that influence the body's ability to defend against HIV such as the
infected person's general immune function. Older people have weaker
immune systems, and therefore have a greater risk of rapid disease
progression than younger people. Poor access to health care and the
existence of coexisting infections such as tuberculosis also may predispose
people to faster disease progression. The infected person's genetic
inheritance plays an important role and some people are resistant to certain
strains of HIV. An example of this is people with the homozygous CCR5-
Δ32 variation are resistant to infection with certain strains of HIV. HIV is
genetically variable and exists as different strains, which cause different
rates of clinical disease progression (Mastro TD, de Vincenzi I, 1996.
Probabilities of sexual HIV-1 transmission).
Sexual transmission
Sexual transmission occurs with the contact between sexual secretions of
one person with the rectal, genital or oral mucous membranes of another.
Unprotected receptive sexual acts are riskier than unprotected insertive
sexual acts, and the risk for transmitting HIV through unprotected anal
intercourse is greater than the risk from vaginal intercourse or oral sex.
However, oral sex is not entirely safe, as HIV can be transmitted through
both insertive and receptive oral sex. Sexual assault greatly increases the risk
of HIV transmission as protection is rarely employed and physical trauma to
the vagina occurs frequently, facilitating the transmission of HIV. Other
sexually transmitted infections (STI) increase the risk of HIV transmission
and infection, because they cause the disruption of the normal epithelial
barrier by genital ulceration and/or microulceration; and by accumulation of
pools of HIV-susceptible or HIV-infected cells (lymphocytes and
macrophages) in semen and vaginal secretions. Epidemiological studies
from sub-Saharan Africa, Europe and North America suggest that genital
ulcers, such as those caused by syphilis and/or chancroid, increase the risk of
becoming infected with HIV by about fourfold. There is also a significant
although lesser increase in risk from STIs such as gonorrhea, Chlamydial
infection and trichomoniasis, which all cause local accumulations of
lymphocytes and macrophages (Mastro TD, de Vincenzi I, 1996.
Probabilities of sexual HIV-1 transmission).
Transmission of HIV depends on the infectiousness of the index case and the
susceptibility of the uninfected partner. Infectivity seems to vary during the
course of illness and is not constant between individuals. An undetectable
plasma viral load does not necessarily indicate a low viral load in the
seminal liquid or genital secretions. However, each 10-fold increase in the
level of HIV in the blood is associated with an 81% increased rate of HIV
transmission. Women are more susceptible to HIV-1 infection due to
hormonal changes, vaginal microbial ecology and physiology, and a higher
prevalence of sexually transmitted diseases. People who have been infected
with one strain of HIV can still be infected later on in their lives by other,
more virulent strains. Infection is unlikely in a single encounter. High rates
of infection have been linked to a pattern of overlapping long-term romantic
relationships. This allows the virus to quickly spread to multiple partners
who in turn infect their partners. A pattern of serial monogamy or occasional
casual encounters is associated with lower rates of infection. HIV spreads
readily through heterosexual sex in Africa, but less so elsewhere. One
possibility being researched is that schistosomiasis, which affects up to 50
per cent of women in parts of Africa, damages the lining of the vagina
(Mastro TD, de Vincenzi I, 1996. "Probabilities of sexual HIV-1
transmission).
Exposure to blood-borne pathogens
(CDC poster from 1989 highlighting the threat of AIDS associated with drug use)
This transmission route is particularly relevant to intravenous drug users,
hemophiliacs and recipients of blood transfusions and blood products.
Sharing and reusing syringes contaminated with HIV-infected blood
represents a major risk for infection with HIV. Needle sharing is the cause
of one third of all new HIV-infections in North America, China, and Eastern
Europe. The risk of being infected with HIV from a single prick with a
needle that has been used on an HIV-infected person is thought to be about 1
in 150. Post-exposure prophylaxis with anti-HIV drugs can further reduce
this risk. This route can also affect people who give and receive tattoos and
piercings. Universal precautions are frequently not followed in both sub-
Saharan Africa and much of Asia because of both a shortage of supplies and
inadequate training. The WHO estimates that approximately 2.5% of all HIV
infections in sub-Saharan Africa are transmitted through unsafe healthcare
injections. Because of this, the United Nations General Assembly has urged
the nations of the world to implement precautions to prevent HIV
transmission by health workers. The risk of transmitting HIV to blood
transfusion recipients is extremely low in developed countries where
improved donor selection and HIV screening is performed. However,
according to the WHO, the overwhelming majority of the world's population
does not have access to safe blood and between 5% and 10% of the world's
HIV infections come from transfusion of infected blood and blood products
(Source: The World Health Organization).
Perinatal transmission
The transmission of the virus from the mother to the child can occur in utero
during the last weeks of pregnancy and at childbirth. In the absence of
treatment, the transmission rate between a mother and her child during
pregnancy, labor and delivery is 25%. However, when the mother takes
antiretroviral therapy and gives birth by caesarean section, the rate of
transmission is just 1%. The risk of infection is influenced by the viral load
of the mother at birth, with the higher the viral load, the higher the risk.
Breastfeeding also increases the risk of transmission by about 4 % (Source:
The World Health Organization).
Misconceptions
A number of misconceptions have arisen surrounding HIV/AIDS. Three of
the most common are that AIDS can spread through casual contact, that
sexual intercourse with a virgin will cure AIDS, and that HIV can infect
only homosexual men and drug users. Other misconceptions are that any act
of anal intercourse between gay men can lead to AIDS infection, and that
open discussion of homosexuality and HIV in schools will lead to increased
rates of homosexuality and AIDS (Source: The World Health
Organization).
Pathophysiology
The pathophysiology of AIDS is complex, as is the case with all syndromes.
Ultimately, HIV causes AIDS by depleting CD4+ T helper lymphocytes.
This weakens the immune system and allows opportunistic infections. T
lymphocytes are essential to the immune response and without them, the
body cannot fight infections or kill cancerous cells. The mechanism of CD4+
T cell depletion differs in the acute and chronic phases.
During the acute phase, HIVinduced
cell lysis and killing of
infected cells by cytotoxic T cells
accounts for CD4+ T cell
depletion, although apoptosis may
also be a factor. During the
chronic phase, the consequences
of generalized immune activation
coupled with the gradual loss of
the ability of the immune system
to generate new T cells appear to
account for the slow decline in
CD4+ T cell numbers.
Although the symptoms of
immune deficiency characteristic
of AIDS do not appear for years
after a person is infected, the bulk
of CD4+ T cell loss occurs during
the first weeks of infection,
especially in the intestinal
mucosa, which harbors the
majority of the lymphocytes
found in the body. The reason for
the preferential loss of mucosal
CD4+ T cells is that a majority of
mucosal CD4+ T cells express the
CCR5 coreceptor, whereas a
small fraction of CD4+ T cells in
the bloodstream do so.
HIV seeks out and destroys CCR5
expressing CD4+ cells during
acute infection. A vigorous
immune response eventually
controls the infection and initiates
the clinically latent phase.
However, CD4+ T cells in mucosal tissues remain depleted throughout the
infection, although enough remain to initially ward off life-threatening
infections (Source: The World Health Organization).
Estimated per act risk for acquisition
of HIV by exposure route.
Exposure Route
Estimated infections
per 10,000 exposures
to an infected source
Blood Transfusion 9,000
Childbirth 2,500
Needle-sharing injection drug use 67
Percutaneous needle stick 30
Receptive anal intercourse* 50
Insertive anal intercourse* 6.5
Receptive penile-vaginal intercourse* 10
Insertive penile-vaginal intercourse* 5
Receptive oral intercourse*§ 1
Insertive oral intercourse*§ 0.5
* assuming no condom use
§ source refers to oral intercourse
performed on a man
Continuous HIV replication results in a state of generalized immune
activation persisting throughout the chronic phase. Immune activation,
which is reflected by the increased activation state of immune cells and
release of proinflammatory cytokines, results from the activity of several
HIV gene products and the immune response to ongoing HIV replication.
Another cause is the breakdown of the immune surveillance system of the
mucosal barrier caused by the depletion of mucosal CD4+ T cells during the
acute phase of disease.
This results in the systemic exposure of the immune system to microbial
components of the gut’s normal flora, which in a healthy person is kept in
check by the mucosal immune system. The activation and proliferation of T
cells that results from immune activation provides fresh targets for HIV
infection. However, direct killing by HIV alone cannot account for the
observed depletion of CD4+ T cells since only 0.01-0.10% of CD4+ T cells
in the blood are infected. A major cause of CD4+ T cell loss appears to
result from their heightened susceptibility to apoptosis when the immune
system remains activated. Although new T cells are continuously produced
by the thymus to replace the ones lost, the regenerative capacity of the
thymus is slowly destroyed by direct infection of its thymocytes by HIV.
Eventually, the minimal number of CD4+ T cells necessary to maintain a
sufficient immune response is lost, leading to AIDS (Source: The World
Health Organization).
January 26, 2010
Anger Management Continuing Education CEUs
Anger Management Continuing Education CEUs
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Become familiar with cultural influences on anger management
2. Become familiar with historical influences on anger management
3. Identify poor anger management symptomology
4. Utilize fundamental anger management techniques
5. Access vital anger management mental healthcare resources
Table of Contents:
1. Definitions
2. History and Culture
3. Anger Symptoms
4. Anger Management Techniques
5. Resources
6. References
1. Definitions
The term anger management typically refers to a system of psychological therapeutic techniques and exercises by which someone with excessive or uncontrollable anger can control or reduce the triggers, degrees, and effects of an angered emotional state.
2. History and Culture
Most civilized societies consider anger as an immature or uncivilized response to frustration, threat, violation, or loss. Instead, remaining calm, levelheaded, or “turning the other cheek” is considered more socially acceptable. This conditioning can cause inappropriate expressions of anger such as uncontrolled violent outbursts, misdirected anger or repressing all feelings of anger when it would be an appropriate response to the situation. Also, anger that is constantly “bottled up” can lead to persistent violent thoughts or actions, nightmares and even physical symptoms. Anger can also aggravate an already present mental health problem such as clinical depression
A large school of thought asserts that depression is essentially anger internalized. Perhaps this is due to the fact that many depressed persons react to stress by internalizing their anger in response to physical or mental abuse or neglect from parents or others. Another impact of the depression sufferer's denial of anger is that their interpersonal relationships are often unfulfilling. Anger can fuel obsessions, phobias, addictions and manic tendencies. Many people unable to express their anger appropriately will externalize it in furious activity which can result in clinical depression or even bipolar disorder. Anger can also intensify paranoia and prejudice, even in normal, everyday situations. People tend to express their anger either passively or aggressively through the fight-or-flight response (Lehrer, Paul M.; David H. Barlow, Robert L. Woolfolk, Wesley E. Sime, 2007. Principles and Practice of Stress Management, Third Edition). The flight response is often manifested through repression and denial of anger for safety. Aggressive behavior is associated with the fight response and the use of the verbal and physical power of anger.
Anger and rage are often conceptualized to be at opposite ends of an emotional continuum, mild irritation and annoyance at one end and fury or murderous rage at the other. Recently, Sue Parker Hall (2008) has challenged this idea; she conceptualizes anger as a positive, pure and constructive emotion, which is always respectful of others; only ever utilized to protect the self on physical, emotional, intellectual and spiritual dimensions in relationships. She argues that anger originates at age 18 months to 3 years in order to provide the motivation and energy for the individuation developmental stage whereby a child begins to separate from their careers and assert their differences. Anger emerges at the same time as thinking is developing therefore it is always possible to access cognitive abilities and feel anger at the same time (Parker Hall, 2008, Anger, Rage and Relationship: An Empathic Approach to Anger Management, Routledge, London).
Parker Hall (2008) proposes that it is not anger that is problematic but rage, a different phenomenon entirely; rage is conceptualized as a pre-verbal, pre-cognition, psychological defiance mechanism which originates in earliest infancy as a response to the trauma experienced when the infant's environment fails to meet their needs. Rage is construed as an attempt to summon help by an infant who experiences terror and whose very survival feels under threat. The infant cannot manage the overwhelming emotions that are activated and need a caring other to attune to them, to accurately assess what their needs are, to comfort and soothe them. If they receive sufficient support in this way, infants eventually learn to process their own emotions. Rage problems are conceptualized as the inability to process emotions or life's experiences either because the capacity to regulate emotion has never been sufficiently developed or because it has been lost due to more recent trauma (Schore, 1994). Rage is understood as 'a whole load of different feelings trying to get out at once' (Harvey, 2004) or as raw, undifferentiated emotions, which spill out when one more life event that cannot be processed, no matter how trivial, puts more stress on the organism than they can bear. Framing rage in this way has implications for working therapeutically with individuals with such difficulties. If rage is accepted as a pre-verbal, pre-cognitive phenomenon (and most sufferers describe it colloquially as 'losing the plot') then it follows that cognitive strategies, eliciting commitments to behave differently or educational programs are contra-indicated. Parker Hall proposes an empathic therapeutic relationship to support clients to develop or recover their organismic capacity (Rogers, 1951) to process their often multitude of traumas. This approach is a critique of the dominant anger and rage interventions including probation, prison and psychology models, which she argues does not address rage at a deep enough level (Parker Hall, 2008, Anger, Rage and Relationship: An Empathic Approach to Anger Management, Routledge, London).
Historically, therapists thought that venting angry feelings was healthy and appropriate based on Freud’s “Hydraulic Model” of energy. He believed that energy could build up to the point that it would overflow and flood the system. The release was called catharsis which was an emptying of emotional reservoirs. However, contemporary research does not support this theory. Carol Tavris (1982) concluded that people who vent their anger tend to become more rather than less angry. The research consistently demonstrates that free expression of anger and hostility resulted in measurably increased angry and negative feelings.
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Become familiar with cultural influences on anger management
2. Become familiar with historical influences on anger management
3. Identify poor anger management symptomology
4. Utilize fundamental anger management techniques
5. Access vital anger management mental healthcare resources
Table of Contents:
1. Definitions
2. History and Culture
3. Anger Symptoms
4. Anger Management Techniques
5. Resources
6. References
1. Definitions
The term anger management typically refers to a system of psychological therapeutic techniques and exercises by which someone with excessive or uncontrollable anger can control or reduce the triggers, degrees, and effects of an angered emotional state.
2. History and Culture
Most civilized societies consider anger as an immature or uncivilized response to frustration, threat, violation, or loss. Instead, remaining calm, levelheaded, or “turning the other cheek” is considered more socially acceptable. This conditioning can cause inappropriate expressions of anger such as uncontrolled violent outbursts, misdirected anger or repressing all feelings of anger when it would be an appropriate response to the situation. Also, anger that is constantly “bottled up” can lead to persistent violent thoughts or actions, nightmares and even physical symptoms. Anger can also aggravate an already present mental health problem such as clinical depression
A large school of thought asserts that depression is essentially anger internalized. Perhaps this is due to the fact that many depressed persons react to stress by internalizing their anger in response to physical or mental abuse or neglect from parents or others. Another impact of the depression sufferer's denial of anger is that their interpersonal relationships are often unfulfilling. Anger can fuel obsessions, phobias, addictions and manic tendencies. Many people unable to express their anger appropriately will externalize it in furious activity which can result in clinical depression or even bipolar disorder. Anger can also intensify paranoia and prejudice, even in normal, everyday situations. People tend to express their anger either passively or aggressively through the fight-or-flight response (Lehrer, Paul M.; David H. Barlow, Robert L. Woolfolk, Wesley E. Sime, 2007. Principles and Practice of Stress Management, Third Edition). The flight response is often manifested through repression and denial of anger for safety. Aggressive behavior is associated with the fight response and the use of the verbal and physical power of anger.
Anger and rage are often conceptualized to be at opposite ends of an emotional continuum, mild irritation and annoyance at one end and fury or murderous rage at the other. Recently, Sue Parker Hall (2008) has challenged this idea; she conceptualizes anger as a positive, pure and constructive emotion, which is always respectful of others; only ever utilized to protect the self on physical, emotional, intellectual and spiritual dimensions in relationships. She argues that anger originates at age 18 months to 3 years in order to provide the motivation and energy for the individuation developmental stage whereby a child begins to separate from their careers and assert their differences. Anger emerges at the same time as thinking is developing therefore it is always possible to access cognitive abilities and feel anger at the same time (Parker Hall, 2008, Anger, Rage and Relationship: An Empathic Approach to Anger Management, Routledge, London).
Parker Hall (2008) proposes that it is not anger that is problematic but rage, a different phenomenon entirely; rage is conceptualized as a pre-verbal, pre-cognition, psychological defiance mechanism which originates in earliest infancy as a response to the trauma experienced when the infant's environment fails to meet their needs. Rage is construed as an attempt to summon help by an infant who experiences terror and whose very survival feels under threat. The infant cannot manage the overwhelming emotions that are activated and need a caring other to attune to them, to accurately assess what their needs are, to comfort and soothe them. If they receive sufficient support in this way, infants eventually learn to process their own emotions. Rage problems are conceptualized as the inability to process emotions or life's experiences either because the capacity to regulate emotion has never been sufficiently developed or because it has been lost due to more recent trauma (Schore, 1994). Rage is understood as 'a whole load of different feelings trying to get out at once' (Harvey, 2004) or as raw, undifferentiated emotions, which spill out when one more life event that cannot be processed, no matter how trivial, puts more stress on the organism than they can bear. Framing rage in this way has implications for working therapeutically with individuals with such difficulties. If rage is accepted as a pre-verbal, pre-cognitive phenomenon (and most sufferers describe it colloquially as 'losing the plot') then it follows that cognitive strategies, eliciting commitments to behave differently or educational programs are contra-indicated. Parker Hall proposes an empathic therapeutic relationship to support clients to develop or recover their organismic capacity (Rogers, 1951) to process their often multitude of traumas. This approach is a critique of the dominant anger and rage interventions including probation, prison and psychology models, which she argues does not address rage at a deep enough level (Parker Hall, 2008, Anger, Rage and Relationship: An Empathic Approach to Anger Management, Routledge, London).
Historically, therapists thought that venting angry feelings was healthy and appropriate based on Freud’s “Hydraulic Model” of energy. He believed that energy could build up to the point that it would overflow and flood the system. The release was called catharsis which was an emptying of emotional reservoirs. However, contemporary research does not support this theory. Carol Tavris (1982) concluded that people who vent their anger tend to become more rather than less angry. The research consistently demonstrates that free expression of anger and hostility resulted in measurably increased angry and negative feelings.
CONFLICT RESOLUTION Continuing Education CEUs
CONFLICT RESOLUTION Continuing Education CEUs
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Define the process of conflict resolution
2. Learn specific conflict resolution techniques
3. Identify various theoretical approaches to conflict resolution
4. Identify the barriers to conflict resolution
5. Clinically address the barriers to conflict resolution
Table of Contents:
1. Definition
2. Causes
3. Assessment and Intervention
4. Resources
5. References
1. Definition
Conflict resolution includes several techniques and processes designed to decrease or manage conflict in relationships. The term "conflict resolution" is sometimes used interchangeably with the term dispute resolution or alternative dispute resolution. Conflict resolution may sometimes include negotiation, mediation and diplomacy.
Conflict resolution has been the source of research in animals such as dogs and primates (Frans de Waal, 2000). Studies have demonstrated that aggression is more common among relatives and within a group, than between groups. Instead of creating a distance between the individuals, however, the primates were more intimate in the period after the aggressive incident. These intimacies consisted of grooming and various forms of body contact. Stress responses, like an increased heart rate, usually decrease after these reconciliatory signals. Different types of primates, as well as many other species living in groups, show different types of conciliatory behavior. Resolving conflicts that threaten the interaction between individuals in a group is necessary for survival, hence has a strong evolutionary value. These findings contradicted previous existing theories about the general function of aggression, i.e. creating space between individuals (Konrad Lorenz), which seems to be more the case in group conflicts (Frans de Waal, 2000).
Conflict is an unavoidable consequence of natural disagreements resulting from individuals or groups that differ in beliefs, attitudes, values or needs. Conflict may also originate from past rivalries and personality differences. Other causes of conflict include attempting to negotiate prematurely or before necessary information is available. The following includes common sources of conflict:
• communication failure
• personality conflict
• value differences
• goal differences
• methodological differences
• substandard performance
• lack of cooperation
• differences regarding authority
• differences regarding responsibility
• competition over resources
• non-compliance with rules
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Define the process of conflict resolution
2. Learn specific conflict resolution techniques
3. Identify various theoretical approaches to conflict resolution
4. Identify the barriers to conflict resolution
5. Clinically address the barriers to conflict resolution
Table of Contents:
1. Definition
2. Causes
3. Assessment and Intervention
4. Resources
5. References
1. Definition
Conflict resolution includes several techniques and processes designed to decrease or manage conflict in relationships. The term "conflict resolution" is sometimes used interchangeably with the term dispute resolution or alternative dispute resolution. Conflict resolution may sometimes include negotiation, mediation and diplomacy.
Conflict resolution has been the source of research in animals such as dogs and primates (Frans de Waal, 2000). Studies have demonstrated that aggression is more common among relatives and within a group, than between groups. Instead of creating a distance between the individuals, however, the primates were more intimate in the period after the aggressive incident. These intimacies consisted of grooming and various forms of body contact. Stress responses, like an increased heart rate, usually decrease after these reconciliatory signals. Different types of primates, as well as many other species living in groups, show different types of conciliatory behavior. Resolving conflicts that threaten the interaction between individuals in a group is necessary for survival, hence has a strong evolutionary value. These findings contradicted previous existing theories about the general function of aggression, i.e. creating space between individuals (Konrad Lorenz), which seems to be more the case in group conflicts (Frans de Waal, 2000).
Conflict is an unavoidable consequence of natural disagreements resulting from individuals or groups that differ in beliefs, attitudes, values or needs. Conflict may also originate from past rivalries and personality differences. Other causes of conflict include attempting to negotiate prematurely or before necessary information is available. The following includes common sources of conflict:
• communication failure
• personality conflict
• value differences
• goal differences
• methodological differences
• substandard performance
• lack of cooperation
• differences regarding authority
• differences regarding responsibility
• competition over resources
• non-compliance with rules
Managed Care and Mental Behavioral Health CEUs
Managed Care and Mental Behavioral Health CEUs
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© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Define and become familiar with the fundamentals of managed care
2. Learn the history of managed care
3. Identify managed care program types
4. Learn and distinguish important national managed care laws
5. Utilize applicable managed care resources
Table of Contents:
1. Definition
2. History
3. Managed Care Program Types
4. Outcomes
5. Legal Updates
6. References
1. Definition
Managed care plans are health insurance plans that contract with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.
Restrictive plans generally cost less. More flexible plans cost more. There are three types of managed care plans:
• Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
• Preferred Provider Organizations (PPO) usually pay more if you get care within the network, but they still pay a portion if you go outside
• Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care
The term managed care is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques") organizations that use those techniques or provide them as services to other organizations ("managed care organizations"), or systems of financing and delivering health care to enrollees organized around managed care techniques and concepts ("managed care delivery systems"). According to the National Library of Medicine, the term "managed care" encompasses programs “intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.” The growth of managed care in the U.S. was preceded by the enactment of the Health Maintenance Organization Act of 1973. While managed care
techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has largely failed in the overall goal of controlling medical costs. Proponents and critics are also sharply divided on managed care's overall impact on the quality of U.S. health care delivery (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001, ISBN 0-8342-1726-0).
In his analysis of the American health care system (i.e., The Social Transformation of American Medicine), Paul Starr suggests that Ronald Reagan was the first mainstream political leader to take deliberate steps to change American health care from its longstanding not-for-profit business principles into a for-profit model that would be driven by the insurance industry. In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of HMOs, the first form of managed care. Managed care plans are widely credited with subduing medical cost inflation in the late 1980s by reducing unnecessary hospitalizations, forcing providers to discount their rates, and causing the health-care industry to become more efficient and competitive. Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts created widespread perception that they were more interested in saving money than providing health care. In a 2004 poll by the Kaiser Family Foundation, a majority of those polled said they believed that managed care decreased the time doctors spend with patients, made it harder for people who are sick to see specialists, and had failed to produce significant health care savings. These public perceptions have been fairly consistent in polling since 1997. The backlash included vocal critics, including disgruntled patients and consumer-advocacy groups, who argued that managed care plans were controlling costs by denying medically necessary services to patients, even in life-threatening situations, or by providing low-quality care. The volume of criticism led many states to pass laws mandating managed-care standards. Complying with these mandates increased costs. Meanwhile, insurers responded to public demands and political pressure by beginning to offer other plan options with more comprehensive care networks--according to one analysis, between the years 1970 and 2005 the share of personal
2. History
health expenditures paid directly out-of-pocket by U.S. consumers fell from about 40 percent to 15 percent. So although consumers faced rising health insurance premiums over the period, lower out-of-pocket costs likely evidence encouraged consumers to use more health care. Data indicating whether this increase in use was due to voluntary or optional service purchases or the sudden access lower-income citizens had to basic healthcare is not available here at this time (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001, ISBN 0-8342-1726-0).
By the late 1990s, U.S. per capita health care spending began to increase again, peaking around 2002. Despite managed care's mandate to control costs, U.S. healthcare expenditures has continued to outstrip the overall national income, rising about 2.4 percentage points faster than the annual GDP since 1970. Nevertheless, according to the trade association America’s Health Insurance Plans, managed care is nearly ubiquitous in the U.S.; 90 percent of insured Americans are now enrolled in plans with some form of managed care. The National Directory of Managed Care Organizations, Sixth Edition profiles more than 5,000 plans, including new consumer-driven health plans and health savings accounts (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001).
click here for full research text
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.
1. Define and become familiar with the fundamentals of managed care
2. Learn the history of managed care
3. Identify managed care program types
4. Learn and distinguish important national managed care laws
5. Utilize applicable managed care resources
Table of Contents:
1. Definition
2. History
3. Managed Care Program Types
4. Outcomes
5. Legal Updates
6. References
1. Definition
Managed care plans are health insurance plans that contract with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.
Restrictive plans generally cost less. More flexible plans cost more. There are three types of managed care plans:
• Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
• Preferred Provider Organizations (PPO) usually pay more if you get care within the network, but they still pay a portion if you go outside
• Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care
The term managed care is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques") organizations that use those techniques or provide them as services to other organizations ("managed care organizations"), or systems of financing and delivering health care to enrollees organized around managed care techniques and concepts ("managed care delivery systems"). According to the National Library of Medicine, the term "managed care" encompasses programs “intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.” The growth of managed care in the U.S. was preceded by the enactment of the Health Maintenance Organization Act of 1973. While managed care
techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has largely failed in the overall goal of controlling medical costs. Proponents and critics are also sharply divided on managed care's overall impact on the quality of U.S. health care delivery (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001, ISBN 0-8342-1726-0).
In his analysis of the American health care system (i.e., The Social Transformation of American Medicine), Paul Starr suggests that Ronald Reagan was the first mainstream political leader to take deliberate steps to change American health care from its longstanding not-for-profit business principles into a for-profit model that would be driven by the insurance industry. In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of HMOs, the first form of managed care. Managed care plans are widely credited with subduing medical cost inflation in the late 1980s by reducing unnecessary hospitalizations, forcing providers to discount their rates, and causing the health-care industry to become more efficient and competitive. Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts created widespread perception that they were more interested in saving money than providing health care. In a 2004 poll by the Kaiser Family Foundation, a majority of those polled said they believed that managed care decreased the time doctors spend with patients, made it harder for people who are sick to see specialists, and had failed to produce significant health care savings. These public perceptions have been fairly consistent in polling since 1997. The backlash included vocal critics, including disgruntled patients and consumer-advocacy groups, who argued that managed care plans were controlling costs by denying medically necessary services to patients, even in life-threatening situations, or by providing low-quality care. The volume of criticism led many states to pass laws mandating managed-care standards. Complying with these mandates increased costs. Meanwhile, insurers responded to public demands and political pressure by beginning to offer other plan options with more comprehensive care networks--according to one analysis, between the years 1970 and 2005 the share of personal
2. History
health expenditures paid directly out-of-pocket by U.S. consumers fell from about 40 percent to 15 percent. So although consumers faced rising health insurance premiums over the period, lower out-of-pocket costs likely evidence encouraged consumers to use more health care. Data indicating whether this increase in use was due to voluntary or optional service purchases or the sudden access lower-income citizens had to basic healthcare is not available here at this time (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001, ISBN 0-8342-1726-0).
By the late 1990s, U.S. per capita health care spending began to increase again, peaking around 2002. Despite managed care's mandate to control costs, U.S. healthcare expenditures has continued to outstrip the overall national income, rising about 2.4 percentage points faster than the annual GDP since 1970. Nevertheless, according to the trade association America’s Health Insurance Plans, managed care is nearly ubiquitous in the U.S.; 90 percent of insured Americans are now enrolled in plans with some form of managed care. The National Directory of Managed Care Organizations, Sixth Edition profiles more than 5,000 plans, including new consumer-driven health plans and health savings accounts (Peter R. Kongstvedt, "The Managed Health Care Handbook," Fourth Edition, Aspen Publishers, Inc., 2001).
Depression, Major Depression, and Depressive Disorders CEUs
Depression, Major Depression, and Depressive Disorders CEUs
Click here for full text
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
may be transmitted or reproduced in any form, or by any means, mechanical or
electronic without written permission of Aspira Continuing Education.
Course Objectives: This course is designed to help you:
1. Identify and diagnose Depressive Disorder
2. Become familiar with the historical framework concerning the inclusion
of Depressive Disorder in contemporary mental health and the DSM
3. Identify Depressive Disorder symptoms and related behaviors
4. Become familiar with common causes
5. Learn and apply widely accepted theoretical treatment approaches such
as Cognitive Behavioral Therapy
6. Access relevant resources
Table of Contents:
1. Definition and Types
2. History
3. Symptoms and the DSM-IV-TR
4. Causes
5. Treatment
6. Resources
7. References
2
1. Definition and Types
Depressive disorders and symptoms may vary and can include:
o Major depressive episode
o Atypical depression, a cyclical sub-type of major depression
where sleep, feeding and perception of pleasure are normal but
there is a feeling of lethargy
o Melancholic depression a sub-type of major depression
characterized by an inability to feel pleasure combined with
physical agitation, insomnia, or decreased appetite
o Psychotic depression, a sub-type of major depression combined
with psychotic or delusional perceptions
o Depressive Disorder Not Otherwise Specified
Depression (mood)
Postpartum depression, a depressive episode occurring within a year
of childbirth
Dysthymic disorder , a long-term low-grade depressive condition
Adjustment disorder with depressed mood, previously known as
"reactive depression"
Seasonal affective disorder (SAD), a depressed mood related to the
seasons
Depression is the fourth stage of the Kübler-Ross model (commonly
known as the "stages of dying")
(American Psychiatric Association (2000a). Diagnostic and statistical
manual of mental disorders, Fourth Edition, Text Revision: DSM-IV-TR.
Washington, DC: American Psychiatric Publishing, Inc.)
Major depressive disorder is also known as clinical depression or major
depression. It is a diagnosis contained in the Diagnostic and Statistical
Manual of Mental Disorders by the American Psychiatric Association.
Major depression is a serious illness that affects a person's relationships,
family, work or school life, sleeping and eating habits, social activities, and
general health. Those who suffer from a major depressive episode usually
exhibit a very low mood pervading all aspects of life and an inability to
experience pleasure in previously enjoyable activities. Other symptoms may
include the preoccupation with, or ruminating over, thoughts and feelings of
worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and
3
self hatred. Other symptoms include poor concentration and memory,
withdrawal from social situations and activities, reduced sex drive, and
thoughts of death or suicide. Insomnia is common: in the typical pattern, a
person wakes very early and is unable to get back to sleep. Hypersomnia, or
oversleeping, is less common. Appetite often decreases, with resulting
weight loss, although increased appetite and weight gain occasionally occur.
The person may report multiple physical symptoms such as fatigue,
headaches, or digestive problems; physical complaints are the most common
presenting problem in developing countries according to the World Health
Organization's criteria of depression. Family and friends may notice that the
person's behavior is either agitated or lethargic. Older depressed persons
may have cognitive symptoms of recent onset, such as forgetfulness, and a
more noticeable slowing of movements. In severe cases, depressed people
may have symptoms of psychosis such as delusions or, less commonly,
hallucinations, usually of an unpleasant nature (American Psychiatric
Association, 2000a. Diagnostic and statistical manual of mental disorders,
Fourth Edition, Text Revision: DSM-IV-TR. Washington, DC: American
Psychiatric Publishing, Inc).
Click here for full text
© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
may be transmitted or reproduced in any form, or by any means, mechanical or
electronic without written permission of Aspira Continuing Education.
Course Objectives: This course is designed to help you:
1. Identify and diagnose Depressive Disorder
2. Become familiar with the historical framework concerning the inclusion
of Depressive Disorder in contemporary mental health and the DSM
3. Identify Depressive Disorder symptoms and related behaviors
4. Become familiar with common causes
5. Learn and apply widely accepted theoretical treatment approaches such
as Cognitive Behavioral Therapy
6. Access relevant resources
Table of Contents:
1. Definition and Types
2. History
3. Symptoms and the DSM-IV-TR
4. Causes
5. Treatment
6. Resources
7. References
2
1. Definition and Types
Depressive disorders and symptoms may vary and can include:
o Major depressive episode
o Atypical depression, a cyclical sub-type of major depression
where sleep, feeding and perception of pleasure are normal but
there is a feeling of lethargy
o Melancholic depression a sub-type of major depression
characterized by an inability to feel pleasure combined with
physical agitation, insomnia, or decreased appetite
o Psychotic depression, a sub-type of major depression combined
with psychotic or delusional perceptions
o Depressive Disorder Not Otherwise Specified
Depression (mood)
Postpartum depression, a depressive episode occurring within a year
of childbirth
Dysthymic disorder , a long-term low-grade depressive condition
Adjustment disorder with depressed mood, previously known as
"reactive depression"
Seasonal affective disorder (SAD), a depressed mood related to the
seasons
Depression is the fourth stage of the Kübler-Ross model (commonly
known as the "stages of dying")
(American Psychiatric Association (2000a). Diagnostic and statistical
manual of mental disorders, Fourth Edition, Text Revision: DSM-IV-TR.
Washington, DC: American Psychiatric Publishing, Inc.)
Major depressive disorder is also known as clinical depression or major
depression. It is a diagnosis contained in the Diagnostic and Statistical
Manual of Mental Disorders by the American Psychiatric Association.
Major depression is a serious illness that affects a person's relationships,
family, work or school life, sleeping and eating habits, social activities, and
general health. Those who suffer from a major depressive episode usually
exhibit a very low mood pervading all aspects of life and an inability to
experience pleasure in previously enjoyable activities. Other symptoms may
include the preoccupation with, or ruminating over, thoughts and feelings of
worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and
3
self hatred. Other symptoms include poor concentration and memory,
withdrawal from social situations and activities, reduced sex drive, and
thoughts of death or suicide. Insomnia is common: in the typical pattern, a
person wakes very early and is unable to get back to sleep. Hypersomnia, or
oversleeping, is less common. Appetite often decreases, with resulting
weight loss, although increased appetite and weight gain occasionally occur.
The person may report multiple physical symptoms such as fatigue,
headaches, or digestive problems; physical complaints are the most common
presenting problem in developing countries according to the World Health
Organization's criteria of depression. Family and friends may notice that the
person's behavior is either agitated or lethargic. Older depressed persons
may have cognitive symptoms of recent onset, such as forgetfulness, and a
more noticeable slowing of movements. In severe cases, depressed people
may have symptoms of psychosis such as delusions or, less commonly,
hallucinations, usually of an unpleasant nature (American Psychiatric
Association, 2000a. Diagnostic and statistical manual of mental disorders,
Fourth Edition, Text Revision: DSM-IV-TR. Washington, DC: American
Psychiatric Publishing, Inc).
Anxiety Disorders
Anxiety Disorders
(Click here for full text)© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
may be transmitted or reproduced in any form, or by any means, mechanical or
electronic without written permission of Aspira Continuing Education.
1. Define various anxiety disorders
2. Evaluate and diagnose various anxiety disorders
3. Identify common causes of various anxiety disorders
4. Distinguish between different anxiety disorders
5. Utilize effective treatment approaches and techniques
Table of Contents:
1. Definitions
2. Diagnosis
3. Causes
4. Types
5. Treatment
6. Resources
7. References
2
1. Definitions
“Anxiety disorder” is a general term including several different forms of
abnormal, pathological anxieties, fears, and phobias. For clinical purposes,
"fear", "anxiety" and "phobia" have distinct meanings. Anxiety is distinctive
from fear because fear occurs in the presence of an external threat. Anxiety
is a psychological and physiological state characterized by cognitive,
somatic, emotional, and behavioral components. These components combine
to create an unpleasant feeling that is typically associated with uneasiness,
fear, or worry. Additionally, fear is related to the specific behaviors of
escape and avoidance, whereas anxiety is the result of threats that are
perceived to be uncontrollable or unavoidable. Anxiety is a normal reaction
to stress. It may help a person to deal with a difficult situation, for example
at work or at school, by prompting one to cope with it (American Psychiatric
Association. 2000. Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition, Text Revision. Washington DC: American Psychiatric
Association).
(Click here for full text)© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
may be transmitted or reproduced in any form, or by any means, mechanical or
electronic without written permission of Aspira Continuing Education.
1. Define various anxiety disorders
2. Evaluate and diagnose various anxiety disorders
3. Identify common causes of various anxiety disorders
4. Distinguish between different anxiety disorders
5. Utilize effective treatment approaches and techniques
Table of Contents:
1. Definitions
2. Diagnosis
3. Causes
4. Types
5. Treatment
6. Resources
7. References
2
1. Definitions
“Anxiety disorder” is a general term including several different forms of
abnormal, pathological anxieties, fears, and phobias. For clinical purposes,
"fear", "anxiety" and "phobia" have distinct meanings. Anxiety is distinctive
from fear because fear occurs in the presence of an external threat. Anxiety
is a psychological and physiological state characterized by cognitive,
somatic, emotional, and behavioral components. These components combine
to create an unpleasant feeling that is typically associated with uneasiness,
fear, or worry. Additionally, fear is related to the specific behaviors of
escape and avoidance, whereas anxiety is the result of threats that are
perceived to be uncontrollable or unavoidable. Anxiety is a normal reaction
to stress. It may help a person to deal with a difficult situation, for example
at work or at school, by prompting one to cope with it (American Psychiatric
Association. 2000. Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition, Text Revision. Washington DC: American Psychiatric
Association).
Online BBS Board of Behavioral Sciences Approved CEU's
Online BBS Board of Behavioral Sciences Approved CEU's
Online Continuing Education for LMFT, MFTI, LCSW, ASW
BBS ApprovedSatisfy your CE requirements conveniently anywhere you have online access.
Course Listing:
Domestic Violence/Spousal and Partner Abuse
Substance Abuse and Dependence
Law and Ethics (Califonia only)
HIV and Aids
Aging and Long Term Care
Child Abuse
Crisis Counseling
Cross Cultural Counseling
Managed Care
PTSD
Anxiety Disorders
Depressive Disorder
Medical Necessity
Cognitive Behavioral Therapy
Pychopharmacology
BipolarDisorder
Conflict Resolution
Anger Management
Assessment and Diagnosis
Elder Abuse
Family Therapy
Group Therapy
Human Sexuality
Online Continuing Education for LMFT, MFTI, LCSW, ASW
BBS ApprovedSatisfy your CE requirements conveniently anywhere you have online access.
Course Listing:
Domestic Violence/Spousal and Partner Abuse
Substance Abuse and Dependence
Law and Ethics (Califonia only)
HIV and Aids
Aging and Long Term Care
Child Abuse
Crisis Counseling
Cross Cultural Counseling
Managed Care
PTSD
Anxiety Disorders
Depressive Disorder
Medical Necessity
Cognitive Behavioral Therapy
Pychopharmacology
BipolarDisorder
Conflict Resolution
Anger Management
Assessment and Diagnosis
Elder Abuse
Family Therapy
Group Therapy
Human Sexuality
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