Recovery in action: Challenges for practice

Assignment guidelines Students are asked to outline a case example concerning a service user they have worked with, involving a challenging presentation; offering a case history and a critical appraisal of the intervention(s) deployed. The student will reflect also on recovery issues in relation to their chosen case example. The aim of this assignment is for you to demonstrate your understanding of the implementation of recovery in practice and some of the challenges faced when implementing an intervention. All cases have their own challenges, therefore when writing up your assignment, you can choose to focus on a service user with any mental health issues, and i.e. you do not need to be limited to the mental health presentations covered in this module. Use the sample essay to guide you on assignment style and the types of critical discussions you may cover in relation to implementing recovery focused care. In addition, use the guide below to assist you to structure your assignment.

1. Introduction – (approx. 50 words) This is a statement of intent – i.e. what it is you will be doing in the assignment.

2. Main Body – (up to 2700 words) Case study critical discussion

Introduce the service user – the age, gender, ethnicity, (please ensure that confidentiality is maintained and a statement should be written to confirm that confidentiality has been maintained. Do not mention the service user’s real name or the name of the clinical service they are under.) Include the setting, (the service where they are in receipt of care), any cultural considerations, co-existing conditions, (physical health, substance misuse for example), pre-existing conditions, any communication/language issues, spiritual and religious issues, socioeconomic status – (finance, housing etc.), psychosocial – (employed/unemployed? Social network?), Legal – Mental Health Act? Medication?
Presenting issues. What are the needs? Precipitating factors – current causes, what are the factors leading up to presentation? Service user’s views on current presentation. Has a diagnosis been made? Intervention
Critically reflect upon the implementation of one intervention. What is being implemented and why? How was it facilitated? Challenges in relation to recovery, for example were there any issues related to collaboration and patient centred care, (both recovery themes)? Were there any other challenges to implementing recovery approaches? Give examples and ensure that all points asserted are supported by relevant literature, (which should be no more than 10 years old, unless it is considered classic text).

3. Conclusion (approx. 250 words) What is it you have learned by reflecting on this case study in relation to the implementation of recovery in practice?

LEARNING RESOURCES 9.2 Optional Materials I WOULD LIKE MY ESSAY TO BE BASED ON AN INPATIENT ON A MENTAL HEALTH WARD WITH PARANOID SCHIZOPHRENIA. I HAVE ALSO GOT AN EXAMPLE ESSAY ON AN EATING DISORDER WHICH I WOULD LIKE U TO FOLLOW TO COMPLETE MINE. I HOPE THIS EXAMPLE WILL HELP YOU KNOW THE PATTERN TO FOLLOW TO COMPLETE MY ESSAY ON PARANOID SCHIZOPHRENIA.

EXAMPLE ESSAY

Jade (a pseudonym), 17 years old, was referred to the unit of my recent placement, by a local eating disorders service. They had received a referral from her GP who surmised that she may have anorexia nervosa (AN). Two practitioners from the service conducted an assessment with Jade and they were sufficiently concerned at the risk of serious physical complications as a result of substantial weight loss to warrant admission. Jade agreed to an informal admission to the unit. AN includes features such as a refusal to maintain healthy body weight, as standardised by the Body Mass Index (BMI), and a persistent and disproportionate fear of weight gain (Cromby et al, 2013). AN is deemed as multifactorial in its nature, part of which is concerned with the psychological well-being of the individual, and in many instances familial and social elements are evident in the development of the condition (Turner and Baldock, 2017).

Case history: Jade was accompanied to the unit by her mother. It was noticeable from the outset that there was uneasiness between Jade and her mother, evidenced in part by Jade’s choice to sit with distance between them. The original referral from the GP had expressed concern about conflicts within the family. The literature on the subject of family influence in people with eating disorders is broad in its nature, and includes issues such as consistently high levels of adverse childhood experiences, early separation and child abuse in many cases (Jacobi et al, 2014). Eisler et al (2013) suggest a note of caution where assigning causality to the family is concerned as the evidence for dysfunction or specified behavioural patterns is inconsistent across families. Jade was invited to share her thoughts about the development of her issue with eating, and she suggested that the family had begun talking about it in the last few weeks. This contrasted with her mother’s suggestion that they had been concerned about Jade’s ‘preoccupation with dieting’ for the last 18 months. This discussion in some way illustrated how individuals with AN often dissociate themselves from their eating disorder as ‘a problem’, and something that others are unnecessarily concerned about, from the perspective of the person with AN (Aherne and Bell, 2015). This theme continued throughout the discussion, with expressions of distress from Jade’s mother, and indifference from Jade herself. What was apparent during this interview was that Jade’s eye contact was fleeting at best, and she sat during the process with her feet up on the seat and her knees tucked up to her chin; to the observer a regressive posture, i.e. childlike. Regressive behaviour in people with eating disorders is not uncommon, and according to Farnham (2011) may, besides offering some notion of the young persons’ mind set in the challenging climate of a mental health assessment, also potentially, point to the origins of their condition, in terms of seeking sanctuary through the need to avoid the responsibilities and expectations that arrive with maturity. During discussion, it emerged that Jade had experienced some difficulty around 18 months earlier concerning an ex-boyfriend. Jade confided that her virginity was ‘still intact’ and this was ‘under threat’ during that time, and led to her breaking off the relationship. She said that she had heard some ‘horror stories’ about first sexual encounters and this had made her very anxious about the prospect of sex. A study by Bullard (2013) involving a group of women aged between 18 and 23 years, indicated that a common reason for the early development of food refusal was the delay or interruption of sexual maturity. Reasons for this could include the experience of childhood sexual abuse, family dysfunction or psychosexual disturbances resulting from distorted beliefs about sex (as perhaps in Jade’s case), or distressing sexual experiences (Walters & Hamilton, 2003; Mughal & Price 2014).

Case history goes on to identify potential causative indicators and other important issues such as protective factors in Jade’s case, and profiling her family/social network. You could use a genogram or socio-gram to develop a picture of the family/social network. A major challenge faced by the team was the issue of feeding against Jade’s will. Having been a ‘picky eater’ as identified by her mother, Jade had long had a difficult relationship with food. When a person experiences an eating disorder, it frequently brings sufferer and parent, often the mother, back into a relationship concentrating on food and feeding but in a far more fraught and painful manner

(Bowyer 2016). This role is taken on by staff members once the individual is admitted to a mental health or eating disorder unit, and, as offered as a note of caution by Turnbull (2015), a process of transference may occur, whereby the association with eating and parental control may extend to the nurse, regardless of her or his good intentions. There was evidence of this as Jade resisted and reminded the attending staff member that ‘she isn’t a child’. Such a situation places the nurse in a position of dilemma whereby the autonomy of the service user is compromised by the duty of care to preserve health and life, i.e. an act of beneficence. As suggested by Treasure et al (2013), it is easy to perpetuate negative outcomes in attempting to promote recovery in a person with AN, e.g. coercive re-feeding may further augment food avoidance behaviour, and anxiety expressed by the professional may be mirrored by the service user; this is particularly problematic where the eating disorder represents a coping mechanism. Whilst Jade found the eating ritual difficult to bear, she responded well to therapeutic approaches which attended to her anxieties/emotional disturbances, especially where food was not part of the discussion. The desire to decide on what is best for oneself and to orchestrate one’s own recovery is, according to Colton and Pistrang (2008), key to sustained coping. By some contrast, a study by Westwood and Kendall (2014) suggests, at least in some cases, that on reflection, many young people reported resentment at first, but appreciation of the firm management of their treatment and condition later on. Where control may present as a problem in the individual’s case, the professional is left with a dichotomy to address. In the case of Jade, openness about the need to re-feed, whilst difficult at the outset, was met with some degree of understanding later on when she developed a different mind-set about her condition.

Alternatively, the author could continue by addressing other treatment issues such as family work, and a particular challenge could be that of engaging Jade and her family without appearing to take sides and reinforcing views about where blame may be located in the relationship (supported by relevant literature)

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Health Organization Case Study

Research a health care organization or a network that spans several states within the U.S. (Example: United Healthcare, Vanguard, Banner Healthcare, etc.). ****I Prefer United Healthcare**** more info on the organization’s webpage.

As an Example Review “Singapore Airlines Case Study.” Prepare a 1,000-1,250-word paper that focuses on the organization or network you have selected. Your essay should assess the readiness of the health care organization or network in addressing the health care needs of citizens in the next decade and include a strategic plan that addresses issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Airlines Case Study (student paper)

Singapore Airlines was created in 1972 following a separation from Malaysian Airlines. In the wake of reorganization, Singapore Airlines undertook aggressive growth, investing and trading to maximize profitability and expand market share. Through this change, a new company philosophy emerged, ?Success or failure is largely dictated by the quality of service it provides? (Wyckoff, 1989). By reinventing the company infrastructure and introducing new initiatives focused on excellence in customer service, Singapore Airlines became a global leader in the service industry, elevating existing standards among competitors. Evaluation of Workforce Management Program The strategy widely utilized by Singapore Airlines to ensure differentiation in an increasingly competitive market was its attention to in-flight service. ? Good flight service [was] important in its own right and is a reflection of attention to detail throughout the airline? (Wyckoff, 1989). This statement perpetuated the belief that excellence in service was directly tied to the careful selection and individual performance of in-flight crews charged with the responsibility of fulfilling the needs of individual passengers and exuding the levels of service demanded by the organization. Applicants destined to work as flight stewards were drawn from a very young population, typically spanning the ages of 18-25 years of age with high school equivalency against the English system of education. Selection of applications was competitive largely due to the degree of skill, poise, and experience required of its candidates. These policies led to the on-boarding of a highly skilled and youthful workforce with positive attitudes and a willingness to be trained. Critique of this approach revealed several disadvantages. The most significant being the potential for greater turnover when hiring a younger population as opposed to an older, more experienced crew. Experience alone would play some role in the development of new employees, as greater experience would bring greater poise and confidence. However, in light of the predominant population Singapore Airlines catered to, a younger in-flight crew would remedy the awkwardness likely to be encountered by older clients being served by older crew members. In addition, a younger crew would likely be more accepting of new procedures and less cynical of the requirements of employment. In light of the young demographic most desired in this role, recruitment, training and ?conversion? processes were both stringent and comprehensive. All aspects of in-flight service, including training related to terminology, amenities and food preparation were provided in great detail, as were training for emergency preparedness and response to every potential scenario encountered in the air and on the ground. Formalized on-boarding, training and continued development were the hallmarks of the comprehensive workforce program. Even well into a crew member?s employment, on-going training and cyclical evaluation provided a mechanism for employees to be aware of individual performance and gain exposure to methods of continuous improvement. With an on-going plan of evaluation, communication, and development, the workforce was well-positioned for high levels of performance and quality improvements. Though it would seem that Singapore Airlines? work management program suited the organization well, it greatly narrowed the pool of applicants and kept many, well-qualified and experienced candidates from positions that would create diversity among the largely homogeneous workforce and place the organization in a better position to serve populations whose ethnic origins were not of Asian descent. If the organization aims to be the leader in an increasingly global marketplace, the workforce must mirror the diverse needs and perceptions of the greater population. Advertising Campaign Singapore Airlines is known in the airline industry for its quality of service. This emphasis on customer service and customer satisfaction is largely reflective of the Asian culture for which the company embodies. Attention to detail, impeccable presentation, and care for others are traits synonymous with countries of Asian heritage. Similarly, Asian countries revere conservatism, organization and hierarchy (Allik, n.d.) so, it would follow that young Asian individuals demonstrate the same gracious, caring behaviors to others. The expectation of ?gentle, courteous service? is consistent with these norms and with the approaches taken by the organization. So much are these standards and stereotypes linked to Asian culture and the epitome of service, that the symbol applied to the airline is that of a young Asian woman. This image is resoundingly more beguiling and traditional, recognized by nearly 50% of consumers over typical marketing imparted by competitors, with a marginal recognition of 9.6%. In light of the positive impact and recognition of the existing marketing campaign, it was considered advisable to retain the current marketing strategy. Systems for Measuring Service Quality Singapore Airlines has two primary components involved in measuring service quality. The first is a system to measure customer complaints and compliments for every 10,000 passengers. The second measurement is a comparative rating of airline services prepared by the International Research Associates (INRA). The first component, customers? complaints and compliments, stayed relatively the same despite rapid organizational expansion. This type of analysis has shown a generally high satisfaction level, but could be skewed due to the vast areas the complaints and compliments could cover; from ticket sales and baggage areas to in-flight crews. To address this concern the complaints were split between the areas. However, to get an accurate barometer of customer satisfaction, it was recommended that the airline conduct routine surveys of customers. Often, customers submitting comments fell into one of two categories; those having complaints or those having compliments. The second component to gauge customer satisfaction involved the INRA surveys. The airline executives paid particular attention to these scores as they indicated levels of satisfaction among the general consumer population and identified areas requiring continuous improvement. In 1973 Singapore Airlines scored 68, in 1974 the company scored 74 and in 1979 they scored 78. The scores of 39 other airlines demonstrated that two other competitors, Cathy Pacific and Thai International, were improving rapidly. This provided one indicator of competitive advantage. In order for Singapore Airlines to stay ahead of their competitors they would need to evaluate their position against industry leaders and determine if changes would be needed to stay competitive, particularly with respect to customer service and customer satisfaction (Wyckoff, 1989). Plan to Introduce Slot Machines Singapore Airlines has responded to many changes in order to differentiate itself within an increasingly competitive market place. One responsive action was to remove sleepers, replacing them with a business class section. Reactions from consumers were less than favorable. The move strayed from what consumers came to expect of elite levels of customer service, which were in large part, due to the attention paid to the personal needs of its elite customers.

Although intended to be innovative and distinctive, the inclusion of slot machines on transatlantic flights was another idea met with considerable consumer dissatisfaction. While potentially generating a new stream of revenue, the idea only worked to incite passengers with a new category of charges.

In addition to generating cost for the consumer, the machines took valuable space away from seats and posed problems in light of weight restrictions (Time, 1981). These changes only compounded issues and introduced new problems such as the potential for in-flight injury, rather than improving in-flight services. While there was some opportunity for revenue, initially, the gains would last for a season and were not expected to extend out into the long-term. Conclusion The Singapore Airlines Case Study highlights both effective as well as ineffective management approaches within the company. The subsequent analysis and evaluation of company operations and strategies offer a compelling glimpse of organizational design and leadership amid change, as well as provide a platform for future discussions of organizational development and change management. Group evaluation of organizational design, organizational decision-making, and organizational process at Singapore Airlines yielded some recommendations for new approaches to address complaints, become more mainstream in an increasingly diverse market space, and become more innovative without losing sight of the customer service focus that has made Singapore Airlines so successful.

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Planned Parenthood Case Study Essay

Planned Parenthood

This is part of a case study project on an interest group called Planned Parenthood www.plannedparenthood.org

The website is provided above and the following things need to be found:

1. Washington DC lobbying efforts (who are their allies on the Hill and why)

2. Exposure in the Media (Print, Digital, TV)

3. Issue Network (Other Interest Groups they collaborate with and why)

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Drug Pricing Case Study Assignment

Drug Pricing Case Study

Blovnox was approved by the US Food and Drug Administration in 2016 for the treatment of patients with chronic lymphoma. The dosing is 30 milligrams per day three times a week. Patients are on treatment for an average of 7 weeks. The cost per 10 milligrams is $615. The cost per patient is about $39,000. A randomized clinical trial recently demonstrated that Blovnox is also effective in treating patients with Multiple Sclerosis (MS). The dosing is 12 milligrams per day for 5 days per year. At the drug?s current price, that works out to $3,700 per patient per year. Equivalent MS medications are priced at about $60,000 per year. Suppose you were a brand manager for Blovnox. If you leave the price of Blovnox unchanged, you potentially lose out on a lot of revenue when Blovnox is used in MS patients. If you increase the price of Blovnox so that it costs $60,000 per year for MS patients, the price for lymphoma patients would increase to $630,000 per year, a price that would put it well above the price of comparable cancer drugs.

What would you do?
What information would you want to know before you made your decision?
What analyses would you want to perform?

Just answer this question from your thought and your thinking and ideas ( no need references at all)please write two completely different paragraphs to answer this question,(No identical answer for these two paragraph please)every paragraph 140 wards…..total one page

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Case study Question & Answer Assignment

Students need to choose a case study from their workplace. Ideally this is a case that the student is directly working with. Alternatively the student can use a case that the organisation is involved in. Students should get the permission of their supervisor to use the case details in this scenario. Students need to use appropriate measures to protect the privacy of their clients.

The case study must provide enough details to answer all the following questions.

1. Identify the approach used in working with the client. (refer to the reading Plan intervention with clients ) Marks 10

2. Identify other approaches that may have been appropriate to this case and discuss why. Marks 10

3. Outline how the client’s needs for services was assessed in consideration of: a. Severity of client needs b. Services offered by the organisation c. Community and family support d. Other resources you might access e. Your own skills and capacity to deal with the client’s issues. Marks 30

4. Identify the goals in working with the client Marks 10

5. Identify any specialist services that were accessed for this client and discuss why. If the client was not referred students need to identify appropriate services that the client may have been referred to. Marks 10

6. Identify legal obligations relevant to the case. Marks 10

7. Identify how the case was monitored. Marks 10

8. Identify the organisation policy regarding ongoing support and transition and discuss how the policies applied in this case. Marks 10

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