Psychology homework helpPsychology-LMHC#1 DISCUSSION week 5
$10.00
Is treatment planning important and/or necessary in substance
abuse counseling? Why or why not?Is it important for treatment plan
goals to be measurable? Why or why not? Provide an example of a
treatment plan goal that is in fact measurable.How do the stages of
change relate to treatment planning?#2: Overview and Objectives
$10.00
The following article was published in MD Health.� It
discusses the harmful consequences of smokeless tobacco.� All too
often addictions counselors do not address issues such as smokeless
tobacco (or gambling, for example).� In addition to the discussion
question noted on the syllabus, please discuss your understanding
of smokeless tobacco as an addiction and ideas you have about how
you would approach it clinically with a client.�
Smokeless tobacco poses a cardiovascular risk
October 6, 2004 By Doug Kaufman
1. LOUIS (MD Consult) – The cardiovascular risks of cigarette
smoking are well known, as are the oral cancer risks of using
smokeless tobacco. But a paper published in the September 27, 2004
Archives of Internal Medicine sheds new light on the cardiovascular
risks of smokeless tobacco. “It’s not as harmless as it might
seem,” said lead author Dr. Ritesh Gupta of the Cardiology
Department at the University of Alabama School of Medicine. Dr.
Gupta and colleagues Dr. Hitinder Gurm and Dr. John R. Bartholomew
reviewed previously published studies about smokeless tobacco when
all three were at the Cleveland Clinic in Ohio. The impetus was a
case they saw at the clinic. “We got interested in the fact that
there’s not much information out there looking at smokeless tobacco
and cardiovascular risk,” he said. “We wanted to explore that in
greater detail and see what’s actually been published and bring it
out for everybody to share.”
They did an extensive case and literature review of all
medical articles about smokeless tobacco published since 1965. “To
our surprise, there’s quite a dearth of sound clinical research in
this area of public importance,” he said. “So, we wanted to
highlight that and bring out everything that had been done so far,
so you could go to one source and get all the information to build
on with further research.” Cigarette smoking has a well-established
link to cardiovascular risk, with multiple studies finding “almost
a causal relationship between cardiovascular mortality and
smoking,” Dr. Gupta said. “Such has not been the case with
smokeless tobacco.”
However, studies examining such cardiovascular risk factors
as hypertension, diabetes and lipid levels have noted risks
involving smokeless tobacco. For instance, smokeless tobacco
increases blood pressure. “(Smokeless tobacco) increases systolic
pressure by about 21 millimeters of mercury, which is quite
significant, and increases diastolic blood pressure by up to 14
millimeters of mercury – again, quite significant. It can increase
the heart rate up to 19 beats per minute. Again, quite
significant.”
— Dr. Ritesh Gupta �
“It increases systolic pressure by about 21 millimeters of
mercury, which is quite significant, and increases diastolic blood
pressure by up to 14 millimeters of mercury – again, quite
significant,” Dr. Gupta said. “It can increase the heart rate up to
19 beats per minute. Again, quite significant.” The long-term
risks, particularly when the relationship between smokeless tobacco
and hypertension is considered, haven’t been as consistent. “In
healthy volunteers, it’s been seen that maybe it doesn’t affect
blood pressure as much as it does in certain other patients who are
more likely to develop blood pressure (problems),” he said.
“Similarly, looking at the lipid profile, we have found there are
conflicting reports in the literature. But overall, it seems that
use of smokeless tobacco is associated with the worst lipid
profile, including 2.5 times adjusted risk for hypercholesteremia,
or total cholesterol greater than 240.” Studies have also found,
Dr. Gupta said, that people using at least 150 grams of smokeless
tobacco a week have a three-fold greater risk of developing
diabetes.
“These are all studies that have been published elsewhere,”
he said. “We were able to compile all this and present it in a
fashion that would lead to further research and give anybody
interested in the subject an avenue to look at, in totality.”
A Swedish study of approximately 135,000 patients, conducted
between 1971 and 1974, reached some interesting conclusions. The
study divided patients into three groups – ex-smokers currently
using smokeless tobacco, cigarette smokers and non-tobacco users.
“There was no follow-up done on these patients, so there’s
always the possibility of some crossover,” Dr. Gupta said. “But
what they found from this study was there was a 1.4 times (greater)
risk of cardiovascular mortality in patients who used smokeless
tobacco, compared to non-users. That’s a very important finding in
itself. The study is limited in its methodology, but it does give
us a very important insight into some of the adverse cardiovascular
profile that can be associated with just smokeless tobacco use.”
Smokeless tobacco has a well-established causative link to oral
cancer, cancer of the larynx, cancer of the esophagus and many
other body organs, Dr. Gupta said. “That’s a known fact,” he said.
“The 1986 U.S. Department of Health and Human Services report
indicated there was a 50-fold increase in the relative risk of oral
cancers in smokeless tobacco users compared to controls – people
who did not use any form of tobacco product. Those are really
telling figures. We need to bring to the forefront that use of
smokeless tobacco is not as harmless as some people think it might
be. It may be a little less risky to use smokeless tobacco compared
to cigarette smoking, but definitely it’s much more than people who
do not use any form of tobacco products.”
Doctors should be aware of the risks represented by smokeless
tobacco. “We physicians are very good at taking the history of
smoking, of cigarette intake, very seriously,” Dr. Gupta said. “But
when it comes to other tobacco products, I think what’s lacking is
mainly awareness in terms of the use, in terms of quantifying the
use, and also in terms of what kind of risk factors it (involves).
We also found certain research showing that use of smokeless
tobacco may be an indication for use of cigarettes in later years.”
There is a “disturbing trend” of marketing smokeless tobacco
to the youth of our country.
— Dr. Ritesh Gupta��
There is also a “disturbing trend” of marketing smokeless
tobacco to the youth of our country, he said. “People are starting
to use smokeless tobacco at earlier ages,” he said.One study of
about 400 teenagers between the ages of 12 and 18 found that 12.7
percent of them had used smokeless tobacco in the last month, and
four percent of them became regular users over a four-year
follow-up period, Dr.Gupta said. “So that is a very telling
statistic,” he said. “It brings to point … that people who are
using smokeless tobacco at a very early age are more likely to
start using smokeless tobacco on a regular basis. We know for a
fact that it’s harmful, and some of these people may end up using
cigarette smoking as another form of tobacco intake.” Physicians
need to encourage patients who use smokeless tobacco to quit.
Nicotine replacement therapy, behavioral interventions such as
telephone counseling and self-help manuals, group therapy and
sustained-release bupropion have all proven effective in helping
people stop a smokeless tobacco habit, he said. “We just need to
counsel patients more aggressively to seek these therapies,” Dr.
Gupta said.
Related Information Story List Core Collection Journal
Articles
Reducing tobacco use among youth. Heyman RB – Pediatr Clin
North Am – 01-APR-2002; 49(2): 377-87
>From NIH/NLM MEDLINE
Treating tobacco use and dependence: an evidence-based
clinical practice guideline for tobacco cessation. Anderson JE –
Chest – 01-MAR-2002; 121(3): 932-41
>From NIH/NLM MEDLINE
Health effects associated with smokeless tobacco: a
systematic review.
Critchley JA – Thorax – 01-MAY-2003; 58(5): 435-43
>From NIH/NLM MEDLINE
Smokeless tobacco and cardiovascular disease. Asplund K –
Prog Cardiovasc Dis – 01-MAR-2003; 45(5): 383-94
Copyright 2004 Elsevier Inc. All rights reserved.
https://allaplusessays.com/order (Links to an external site.)Links
to an external site.
Bookmark URL:
/das/stat/view/41544960-2/mnfp?nid=147743&sid=0&pos=3&date=week
PLEASE PLEASE follow Professors comments, it is a Men and
Women Groups no specific topic. Or Women only.
This is not a theoretical paper, no references. It is the
application of your experience at your site. Write from the “I”
perspective. Notice the prompts include “What will you do when…”
“What are your site’s specific…” and “What are your
responsibilities…” notice the prompts are about you not
theoretical. It appears you were not able to clearly cover the
prompts due to writing from a theoretical perspective instead of an
applied “I” perspective. Remember it is 3-4 full content page
paper. Content closely related to the prompts. At times the writing
is unclear. The Writing Center is available to you, information in
syllabus.
#3 Crisis Intervention & Workplace Violence Prevention
$10.00
What types of crisis intervention do you (or will you)
perform at your site?
What will you do when a client expresses suicidal ideation?
Homicidal ideation? Child abuse? Elder abuse?
What are your site’s specific safety plans/protocols in case
of various crises (ie. suicidal/homicidal ideation, etc.)?
What are your responsibilities when those safety
plan/protocols are initiated?
#4 Clinical Documentation $10.00
What are your various documentation responsibilities at your
site? What are some of the easiest aspects of documentation?
What are some of the difficult aspects of documentation?
Include a de-identified example of your documentation in this
week’s paper (e.g., progress note, treatment plan
"Is this question part of your assignment? We Can Help!"










Other samples, services and questions:
When you use PaperHelp, you save one valuable — TIME
You can spend it for more important things than paper writing.