Hot Cross Bun Formulation

Hot Cross Bun Formulation The purpose of this study is to reflect on the package of care offered to a client and to critically evaluate the evidence base for the model which might be considered best practice for a specific client problem, or issue. This entails identifying a particular clients presenting issues while describing the evidence that is available for a suitable therapeutic approach, or model which would promote best practice. The study will reflect on a client who has been diagnosed with post- traumatic stress disorder (PTSD) as a result of a road traffic accident (RTI) and concentrates on the use of imaginal exposure therapy (IET) for the treatment of symptoms. Triggers and maintenance factors contributing to the clients deteriorating well-being will be explained using formulation as well as the protective and predisposing elements that were explored in therapy. Relevant literature will be cited throughout and appropriate research articles that have been critically reviewed will be discussed. Pre sentation, referencing and informed consent are consistent with the School of Health and Social Cares guidance and have been adhered to throughout this assignment. Introduction PTSD is an anxiety disorder that can develop after exposure to one or more terrifying events, in which grave physical harm occurred or was threatened. It is a severe and ongoing emotional reaction to an extreme psychological trauma. The trauma may involve someones actual death or a threat to the individuals or someone elses life. The PTSD sufferer is affected to a degree that usual psychological defenses are incapable of coping. Reports of battle-associated stress appear as early as the 6th century BC. PTSD-like symptoms have been recognised in many combat veterans in many conflicts since. These symptoms have been called shell shock, traumatic war neurosis, and Post-Traumatic Stress Syndrome (PTSS). The modern understanding of PTSD dates from the 1970s, largely as a result of the problems that were still being experienced by Vietnam veterans. The term Post Traumatic Stress Disorder was coined in the mid-1970s. Early in 1978, the term was used in a working group finding presented to the Committee of Reactive Disorders of the American Psychiatric Association. The term was formally recognised in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. Although a controversial diagnosis when first introduced, PTSD has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual him or herself (i.e., the traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of trauma. DSM-IV-TR criteria for PTSD In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1). Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning. PTSD is unique among other psychiatric diagnoses because of the great importance placed upon the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis unless the patient has actually met the stressor criterion which means that he or she has been exposed to an historical event that is considered traumatic. Clinical experience with the PTSD diagnosis has shown, however, that there are individual differences regarding the capacity to cope with catastrophic stress so that while some people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome. Such observations have prompted a recognition that trauma, like pain, is not an external phenomenon that can be completely objectified. Like pain, the traumatic experience is filtered through cognitive and emotional processes before it can be appraised as an extreme threat. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds, some more protected and some more vulnerable to developing clinical symptoms after exposure to extremely stressful situations. Although there is a renewed interest in subjective aspects of traumatic exposure, it must be emphasised that exposure to events such as rape, torture, genocide, and severe war zone stress, are experienced as traumatic events by nearly everyone. The National Institute for Clinical Excellence (NICE) has published guidance to help the National Health Service (NHS) recognise and treat people who develop PTSD after traumatic events. Recommendations include psychological treatment in the form of trauma-focussed cognitive behavioural therapy (CBT) and/or a course of anti-depressant medication while receiving therapy. Trauma-focussed CBT focuses on a persons distressing feelings, thoughts (or cognitions) and behaviour and helps to bring about a positive change. In trauma-focused CBT, the treatment concentrates specifically on the memories, thoughts and feelings that a person has about the traumatic event. Imaginal exposure therapy (IET) is a component of trauma-focused CBT and involves revisiting the traumatic memory or memories in a safe and controlled environment so that the intensity of the individuals anxious and fearful reactions (thoughts, emotions, physical sensations and behaviours) is reduced. Clients are exposed to the trauma memory by repeatedly describing the events of the trauma aloud until the anxiety response is reduced. This process is referred to as habituation. The treatment aims to eventually eliminate the fearful responses so that the client can face a feared situation without experiencing anxiety or fear. The goal IET is to process the trauma memories and to reduce distress and avoidant behaviours that the traumatic memory evokes. CBT, as we know it today, is a result of a group of modern related therapies that have empirical psychological support. There have been two main influences to modern CBT and these are behaviour therapy (BT), as developed by Wolpe, Skinner and others in the 1950s and 1960s and cognitive therapy (CT) as developed by Beck and others in the 1960s and 1970s (Westbrook, et al. 2011, p2). Freudian psychoanalysis had dominated the psycho-therapeutic world since the late 1800s, but in the 1950s, Eysneck and others in the psychological community questioned the lack of empirical evidence to support psychoanalysis. As a result, BT developed within the academic and scientific psychology community, basing its methodology on observable events between stimuli and response. Despite the success of BT, there was still some dissatisfaction with what was seen as the limitations of a purely behavioural approach (Westbrook, et al. 2011, p3). Beck and others were developing ideas about CT as early as the 1950s; these ideas focussed on mental processes such as thoughts, beliefs and our interpretation of events, and continued to maintain an empirical approach to validate its theory to the psychological world (Westbrook, et al. 2011, p3). Although Beck was not the first to link faulty behaviour with irrational thought and unhealthy emotions, his work revolutionised the psychology world a nd continues to be used today. Background to the Client Throughout this assignment the client will be referred to as T. Protecting the clients identity complies with the British Association for Counselling and Psychotherapy (BACP) and the British Association of Cognitive and Behavioural Psychotherapies (BABCP) guidelines regarding client anonymity as described in the Ethical Framework for Good Practice and fulfils the requirements of the Universitys School of Health and Social Cares policy on confidentiality. T was seen in a primary care setting with a counselling service that offers short to medium term therapy for clients over the age of 16 years. She was referred to the service by her GP. She is a 25 year old female who is married with two boys aged 7 and 5 years. She is currently unemployed and lives in social housing with her husband who works in a local factory. T was raised and lived in an area where the 2007 Index of Deprivation (ID2007) indicates deprivation is 110.6% higher than the national average. There is a higher proportion of the working age population claiming incapacity benefit than the County average (Area Action Partnership). T first went to her GP shortly after being released from hospital after an RTA. She was a front seat passenger and received injuries to her face, arms and legs which included severe bruising, cuts and a temporal mandibular joint (TMJ) injury. Three months after the accident T continued to experience nightmares and flashbacks. The GPs letter to the service noted the clients deterioration and the original diagnosis of acute stress disorder (ASD) that had been diagnosed in the first month following the accident was amended to PTSD. Several studies have provided convincing evidence that early CBT treatment of ASD reduces the possibility of the development of PTSD (Moulds, et al. 2009, p16). ASD was introduced into the fourth edition of the diagnostic statistical manual (DSM) in 1994. The diagnostic criteria for ASD (Appendix A) are similar to those of PTSD, but differ in two fundamental areas. Firstly, ASD can only be diagnosed in the first month following the traumatic event and secondly, ASD includes a greater emphasis on dissociative symptoms (American Psychiatric Association, 1994). During their consultation, the GP noted that T had become withdrawn and distanced from her family and friends, she reported feeling like she was watching the world from inside a bell jar, this dissociative symptom is described as derealisation, and is common in ASD patients (Simeon and Abugel, 2006, p86). The GP assessed T using the Patient Health Questionnaire (PHQ 9) and the General Anxiety Disorder Assessment (GAD 7) which resulted in scores of 15 and 19 respectively. These scores indicate that T was suffering with moderate to severe anxiety with depression. T was seen over a period of 13 sessions. The duration of each session lasted between 1 hour and 90 minutes. Longer sessions were included to provide sufficient time for sharing the trauma history and allow time for anxiety levels to decrease (Leahy and Holland, 2000, p197). The contract between the counselling service and T was explained. This included informed consent to tape sessions, confidentiality and its limitations and an evaluation of risk. Evaluation of risk is an important part of the therapeutic process and is done throughout therapy. It involves assessing the client, the environment and also the therapists own personal and professional limitations (Mueller, et al. 2010, p 65). CORE OM was used to calculate a risk score and also to assess Ts suitability for therapy. The Cognitive Therapy Rating Scale as developed by Safran and Segal was not available to the therapist during the first session, but subsequent reviewing of the scale indicated that T was a suitable candidate for cognitive behavioural interventions. CORE OM score is shown below in figure 1. Prior to developing a treatment plan, the therapist socialised the client to CBT explaining the evidence that supported using CBT interventions for PTSD. (Bryant, et al. 1999) and (Westbrook, et al. 2011, p81-83). First session therapist notes detailed Ts past history, the development of problems and the protective factors in her life (Appendix B). T was clear about what she wanted from therapy. Her problems fell into three main areas: (1) Nightmares, poor sleep, anxiety around bedtime, which resulted in an increased irritability with others; (2) Avoiding travelling in any form of transport, which resulted in her relying on others to take her children to school and other social or sporting events; (3) Withdrawing from friends and family, which led to her isolating herself socially. She believed that if she avoided all forms of transport and stayed inside, she would reduce the chances of experiencing any flashbacks or getting very panicky which she found extremely distressing and frig htening. T and the therapist created a Problem and Goal form to capture this information (Appendix C) and agreed to discuss the problems and goals again when the treatment plan was formulated. The specific client issue selected is Post Traumatic Stress Disorder (PTSD). PTSD is defined as a common anxiety disorder that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened (DSM-IV-TR: 463). The DSM-IV-TRs criteria are precisely written as: exposure to a traumatic event, persistent re-experience of the event, avoidance of the stimuli, persistent avoidance of increased arousal, duration of disturbance and impairment of social occupational or other important areas of functioning. Within the criteria there are subsets portraying greater detail of the types of symptoms that may be experienced by the client (Appendix A). T was seen over a period of 13 sessions. The duration of each session lasted between 1 hour and 90 minutes. Longer sessions were included to provide sufficient time for sharing the trauma history and allow time for anxiety levels to decrease (Leahy and Holland, 2000, p197). The contract between the counselling service and T was explained. This included informed consent to tape sessions, confidentiality and its limitations and an evaluation of risk. Evaluation of risk is an important part of the therapeutic process and is done throughout therapy. It involves assessing the client, the environment and also the therapists own personal and professional limitations (Mueller, et al. 2010, p 65). CORE OM was used to calculate a risk score and also to assess Ts suitability for therapy. The Cognitive Therapy Rating Scale as developed by Safran and Segal was not available to the therapist during the first session, but subsequent reviewing of the scale indicated that T was a suitable candidate for cognitive behavioural interventions. CORE OM score is shown below in figure 1. Prior to developing a treatment plan, the therapist socialised the client to CBT explaining the evidence that supported using CBT interventions for ASD. (Bryant, et al. 1999) and (Westbrook, et al. 2011, p81-83). First session therapist notes detailed Ts past history, the development of problems and the protective factors in her life (Appendix B). T was clear about what she wanted from therapy. Her problems fell into three main areas: (1) Nightmares, poor sleep, anxiety around bedtime, which resulted in an increased irritability with others; (2) Avoiding travelling in any form of transport, which resulted in her relying on others to take her children to school and other social or sporting events; (3) Withdrawing from friends and family, which led to her isolating herself socially. She believed that if she avoided all forms of transport and stayed inside, she would reduce the chances of experiencing any flashbacks or getting very panicky which she found extremely distressing and frigh tening. T and the therapist created a Problem and Goal form to capture this information (Appendix C) and agreed to discuss the problems and goals again when the treatment plan was formulated. The therapist asked T if she could recall her most recent experience of a flashback (Figure 2a). T reported that the pattern of events leading to feeling panicked or experiencing a flashback were the same. She would make an effort to do a certain activity, but flashbacks and panic were triggered by (in particular) smells or sounds that could not be avoided. The hot cross bun formulation in figure 2a tracks events from leaving the house, hearing cars and smelling petrol, which was the trigger point. On this occasion T reported having a clear memory of being trapped in the car (which was also her recurring nightmare), she could remember smelling petrol and hearing the screeching of brakes. Her brain misinterpreted these signs for an actual threat, creating distorted thinking: Ive got to get home something terrible is going to happen, hostile emotions; fear, anxiety and terror, unpleasant physiological reaction; heart pounding, shaking, feeling nauseous, which led to her avoidant behavi our to reduce her anxiety and escape her perceived fearful situation. Flashbacks are defined in DSM IV as a recurrence of a memory, feeling, or perceptual experience from the past (American Psychiatric Association,1994). Another example of a flashback involved T sitting in her garden when a neighbour was mowing the lawn with a petrol engine lawn mower. T could smell the petrol and this triggered a flashback to the events of the RTA. The therapist encouraged T to follow the formulation and create her own diagram based on her experience in the garden (Figure 2b). T and the therapist were able to look at both diagrams and see that the pattern was similar. A sound or smell was identified as the trigger in both examples. Her thought process, affect and physiology were similar, but crucially, this led again to her avoidant behaviour. Hot Cross Bun Formulation Event/Trigger: Walking to the shop to buy milk, hearing the cars and smelling petrol Flashback of being trapped in the car Thoughts: Im going to die, Ill never see me children again Ive got to get away from here Ive got to get home, something terrible is going to happen Behaviour: Emotions: Escape the situation Fear Tearful Terror Anxiety Physiology: Heart pounding, Nausea, Tense, Sweating, Shaking Based on Hot Cross Bun (Padesky, 1993) Hot Cross Bun Formulation (originally hand drawn by client) Event/Trigger: Sitting outside in the garden, having a cup of tea Hearing neighbour start up his lawn mower Smelling petrol from the lawn mower Flashback of fear of being burned alive Thoughts: Oh God! Its happening again Ive got to get inside the house. Ill be safe there Behaviour: Emotions: Tearful Fear Needing to get inside the house Terror Anxiety Physiology: Heart pounding, Nausea, Tense, Sweating, Shaking, Based on Hot Cross Bun (Padesky, 1993) T and the therapist discussed the process of recording details in this format and agreed that it gave them both a greater understanding of Ts situation. This collaborative approach is characteristic of CBT and was necessary when working towards a treatment plan for factors that needed to be targeted in therapy and homework setting. Padesky and Greenberger (1995, p6) explain the importance of the client and therapist working as a team, particularly as clients may have an expectation that the therapist is going to fix them. Milton (2009, p104) agrees adding that the therapist also plays the role of a trainer, encouraging the client to become an observer of themselves in order to challenge their thoughts, feelings and beliefs. Westbrook et al (2011, p238) cites Kazantzis et al (2002) in providing evidence of greater improvement in those clients who complete homework. T was keen to monitor any anxiety provoking scenarios at home using the hot cross bun model. She was aware that if her se cond goal was to be achieved (Appendix C) she needed to reduce and eventually eliminate her avoidant behaviour (Wells, 1997, p49-50). A treatment plan was discussed and agreed with T based on her problem list and goals for therapy (Appendix C). The treatment plan included the following elements: Pyscho-Education Grounding and Safety Work Imaginal Exposure Therapy Cognitive Restructuring Relapse Management The session on psycho-education gave T the opportunity to learn about her symptoms, and to recognise and anticipate them for effective management. Fisher, (1999) states that psycho-education is an essential element for stabilising a trauma client. Briere and Scott (2006, p87) agree, adding that psycho-education provides the client with accurate information about the nature of their trauma, which gives them a greater understanding of their situation. Psychoeducation involved justification of use of IET, a history of our learning experience and the fight or flight response. Regular reference was made to the clients formulation so that she could understand how and why her threat response had been activated. Once T understood her anxiety response in relation to her experiences, she felt ready to continue onto the next stage of therapy. Grounding and safety work was completed prior to IET. Herman (1997, p155) argues that the central task of the first phase of trauma therapy must be safety. The client needs to feel safe within themselves; learning grounding and safety skills gives the client the opportunity to manage potential uncontrolled flashbacks. This also formed part of Ts relapse management in the later stages of therapy. Once safety and grounding work was completed, the therapeutic process moved onto the trauma itself using IET. Throughout therapy there were opportunities to explore Ts present situation and past events. This information was initially written down in a mind map format and shared with T during the session. As additional information was gathered in subsequent sessions this was written in longitudinal format (Figure 3). From the information gathered, the client recognised how and why she had always been the rescuer in the family. This included an age inappropriate responsibility when her father had left the family home and T had taken on the role of carer to her distraught mother and siblings. She suffered an emotional breakdown at the age of 14, over whelmed by the pressure of doing well at school so that she could get a good job and support the family. T recognised how this belief system developed after her father left and how it was effecting how she saw herself in the present. During therapy T and the therapist discussed the importance of this belief and how it had allowed her to cope during those years growing up. The therapist asked what purpose this belief served in her life now when she was happy with her family and well supported by her husband. She no longer needed to be the rescuer. T and the therapist explored how this belief may be affecting what was happening to her when she was fearful of having a flashback. T concluded that she needed to add I must always cope to her beliefs in Figure 3 and I cant cope to her thought process. T recognised the contradiction between this thought and her rescuer belief. Longitudinal Formulation Early Experiences 5 years old, Dad leaves family home Oldest of four children, Takes on a helping role Later supports mother through depression Breakdown at school aged 14 years due to self- imposed pressure Met future husband aged 16,Pregnant at 17 years and married at 18 years old Beliefs Its my responsibility to take care of everyone and make things right I must always cope Assumptions and Rules I must be perfect and do everything right, otherwise I will let everyone down If something goes wrong it will be my fault Critical Incident Car Accident Activation of Beliefs Its my responsibility to save everyone Automatic Thoughts I should have got B out of the car. I didnt do everything I could have I failed. I cant cope with this Behavioural Emotions: Avoidance Fear Social withdrawal Anxiety Fearful to go outside Guilt Fearful to travel in any transportation Worry Physiology Poor Sleep Tense Heart Pounding Sweating The goal of IET is to expose the client to the memory of the trauma rather than to relive the trauma itself. Ts therapy involved her retelling the story initially in the past tense and then in the present tense. An important part of the healing process was encouraging T to bring those traumatic memories to mind, in a safe and trusting environment, while remaining in the present. The client learns through repetitive description, that the memory of the event is not dangerous and will also allow habituation to take place (Zayfert and Becker, 2008, p127). T decided that she would record the sessions on the voice recorder section of her mobile phone and listen to the recordings at home as part of her homework. Zayfert and Becker (2008, p130) emphasise how critical listening to the tapes at home is as the repetition is vital if the exposure is going to be successful. The therapist explained that T would be asked to close her eyes and describe the events of that day. Leahy and Holland (2000, p 198) suggest breaking the clients story down into smaller parts if there are a series of traumatic events. T was asked to recall the events of that day in terms of chapters; several chapters were listed (Appendix D). Ts experienced anticipatory anxiety at the thought of retelling the story and this was discussed. The therapist reassured her she would be experiencing the memory, that the RTA was not happening right now and that she was safe in the room and could open her eyes at any time. T began at a point in time when she felt safe and ended the narration at a point in time when again she felt out of danger. The therapist explained the Subjective Units of Distress (SUDS) Rating Scale and then T began narrating her story in the past tense and was allowed to do this uninterrupted; the therapist only intervening to check on Ts anxiety. Ts SUDS score was noted for each chapter (Appendix D col A). At the end of each session, T was given time to process her experience before leaving. T gave the therapist feedback on how she felt sessions had gone, and what, if anything she had learned. The next session involved the client narrating the story, but this time in the present tense. T found this difficult at first and often resumed the past tense. T and the therapist had discussed the likelihood of this happening and T agreed that the therapist would prompt her to return to the present tense. SUDS scores were again noted (Appendix D col B). T reported being surprised at the change in scores from the previous week. There were certain sections of the story that T found very difficult to narrate; these sections were narrated without much detail. After discussing this briefly, T and the therapist listened to the recording of the present tense narration. T recorded SUDS levels herself (Appendix D col C) and once complete, the three SUDS scores were examined and discussed. T noted how scores had both increased and decreased from first narration to second narration, but that all scores had reduced on her first listening to the tape. T was then asked to grade the chapters and chose five (the most anxiety provoking) to work on. The five chapters were listed chronologically (figure 4) and then in order of their anxiety rating (figure 5). For the next five sessions each chapter was narrated and listened to repeatedly until Ts SUDS rating had dropped; starting with the least and working towards the most anxiety provoking. The therapist asked questions relating to the clients senses and emotions and physiology so that her memories were fully activated (Leahy and Holland, 2000, p197). To Ts surprise, narrating in the present tense and sensory questioning produced additional memories that T had not remembered in the previous narrations. Figure 4 Chronological Order 1Â  Car flips over upside down smell of petrol 2Â  Wood coming towards the car 3Â  The car door wont open (Ts recurring nightmare) 4Â  B is not moving 5Â  G is screaming at T to get them out of the car Figure 5 Order of Severity Least to Worst 5 4 3 2 1 Wood coming towards the car Car flips over upside down smell of petrol G is screaming at T to get them out of the car The car door wont open (Ts recurring nightmare) B is not moving The therapist noted the five chapters as hot spots (Figure 6) and asked T what her thoughts were when she brought the scene to mind. These were also noted together with the emotion that went with them. The therapist was able to challenge Ts distorted thoughts through cognitive restructuring which included her rescuer belief that she was somehow responsible for getting everyone out of the car that day. Once SUDS levels had been reduced for all five chapters Appendix E), T was able to say out loud her re-evaluation statement for each chapter accepting and believing it. Fig 6 Re-Evaluation of Peak Experiences Hot Spot Thought Belief Emotion Re-Evaluation The car has flipped Ive survived the crash Fear I did not burn to death. Over onto its top; there but now Im going to burn I did not die, I did survive Is a smell of petrol to death the experience and I am safe now. Its over. THIS IS A FACT Wood from a fence is The wood is going to hit Fear The wood did not hit me or anyone else. Flying towards the car me. Ill never see my boys I did survive the experience. I am safe. again. My children are safe. Its over. THIS IS A FACT The car door wont open. Its not going to open, Terror I was not trapped. I did get out of the car. It just wont budge at all Im trapped. I am not trapped now, I am safe now. Its over. THIS IS A FACT B goes limp and his head Oh my God! B is dead Terror B did not die. He did survive the accident Falls forward He is safe now. Its over. THIS IS A FACT Sister G screams to T to I must break the window. Fear We all got out of the car. We did not die. Get them all out of the car I have to get us all out. We are all safe now and its over. If I dont break the window THIS IS A FACT Were all going to die Outcomes and Personal Reflection Ts post therapy CORE score of 31 (figure 7) represents a mean score of 0.912 (9.12) and falls within the healthy range of the Core measure. As there is a mean difference of over 5, this, according to CORE measurement indicates a clinical and reliable change (CORE ims). Fig. 7 Core OM Results Pre and Post therapy Pre Post Well Being 14 06 Functioning 21 05 Risk 02 00 Problems 42 20 Total 79 31 Ts presentation improved in the finals stages of therapy. Her cuts and bruises had healed well and she was no longer suffering with TMJ. T reported healthier sleeping patterns, but still with occasional dreams. She believed that she had spent so much time listening to her chapter on being trapped in the car that she became fed up of listening to it, rather than it provoking any anxiety. She was able to travel as a passenger in a car, and also to drive the car herself, but did not feel ready to drive on her own in the car. As a result understanding her an

Salvador Dali Essay -- Biographies Painter Artist Essays

Salvador Dali Salvador Dali, was born Salvador Felipe Jacinto Dali i Domenech at 8:45 a.m., Monday, 11 May 1904, in the small town, in the foothills of the Pyrenees, of Figueres, Spain, approximately sixteen miles from the French border in the principality of Catalonia. His parents supported his talent and built him his first studio, while he was still a child, in their summer home. Dali went on to attend the San Fernando Academy of Fine Arts in Madrid, Spain, was married to Gala Eluard in 1934 and died on 23 January 1989 in a hospital in the town he born. Dali did not limit himself to one particular style or medium. Beginning with his early impressionistic work going into his surrealistic works, for which he is best known, and ending in what is known as his classic period, it becomes apparent just how varied his styles and mediums are. He worked with oils, watercolors, drawings, sculptures, graphics and even movies. Dali held his first one-man show in Barcelona in 1925 where his talents were fir st recognized. He became internationally known when some of his paintings were shown in the Carnegie International Exhibition in Pittsburgh in 1928. The next year he joined the Paris Surrealist Group and began his love affair with Gala who became more than just his lover, she was his business manager, muse and greatest inspiration. Surrealism emerged from what was left of Dada in the early 1920’s and unlike Dada, a nihilistic movement, Surrealism held a promising and more positive view of art and because of this won many converts. It began as a literary movement in a Paris magazine. What they held in common was their belief in the importance of the unconscious mind and its manifestations, as was stressed by Freud. They believed that through the unconscious mind a plethora of artistic imagery would be unveiled. Both of these movements were also anti-establishment and they rejected the traditional Western Judeo-Christian beliefs and moral values and believed that reason and log ic had failed man’s quest for self-knowledge. The Surrealists differed from Dada in one other, ideological aspect. The Surrealists believed that man could indeed improve the human condition, the major difference between the two movements. A few years before his marriage to Gala in 1934, Dali emerged as a leader of the Surrealist Movement. Although Dali was intrigued with the Surrealist tech... ...n his childhood. This particular work is officially considered a work of surrealism but Dali’s shift from Surrealism through the very means that got him into surrealism, paranoiac-critical method, are apparent. Around the time Dali was working on his eighteen large canvases, he returned to his Catholic upbringing and renewed his vows with Gala in Spain. In 1974 Dali opened the Teatro Museo Dali in the town in which he grew up, Figueres. Gala died in 1982 and Dali’s health began to fail. There was later a fire in Gala’s castle in which Dali was severely and consequently his health deteriorated further. Two years later he had a pacemaker implanted and spent his life almost in total seclusion. On 23 January 1989, Salvador Felipe Jacinto Dali i Domenech died in a hospital in Figueres because of heart failure and respiratory complications. Works Cited Dali, Salvador. English translation by Haakon M. Chevalier. The Secret Life of Salvador Dali. New York, NY: 1942. De La Croix, Horst, Richard G. Tansey, Diane Kirkpatrick. Art Through The Ages. Harcourt Brace Jovanovich, Publishers; New York, NY: 1991. Moorhouse, Paul. Dali. Brompton Books Corporation; New York, NY: 1993.

Nation Convention On The Rights Of The Child Education Essay

United Nations Convention on the Rights of the Child ( UNCRC ) creates the consciousness of the predicaments of kids in poorness or who are being discriminated against. Thus, issues refering to kids are given higher precedence during policy-making in international every bit good as national dockets. UNCRC recognizes the kid as an person who is entitled to his rights as a member of the community. It sets the basic criterions for local authoritiess to supply for and to protect the kids in footings of basic demands like wellness, nutrition, instruction and other facets. It was adopted by United Nations in 1989 as a tool to protect the best involvement of the kid and to guarantee that every kid enjoy equal rights to life, endurance and development. Since 1989, UNCRC has been adopted by all but two states. As states are obliged to do regular studies to the UN Committee on the Rights of the Child, the province authoritiess have moral duties to supply for the kids as stated by the UNCRC. State authoritiess are besides farther required to carry through certain demands when using for AIDSs from international bureaus. One of the conditions may be to supply for and to protect kids ( Bellamy, 2005: p.30 ) . In add-on, since the bend of the century, authorities organic structures and international bureaus have focused largely on the rights of kids. Most of the United Nations ( UN ) millenary development ends are focused on the realisation of the rights of kids, such as to convey kids out of poorness, rights to wellness, endurance and instruction ( Bellamy, 2005: p.8 ; Woodhead, 2007 as cited in Woodhead & A ; Moss, 2007 ) . Further to UNCRC avowal on rights of instruction, the UN Committee on the Rights of the Child interprets instruction as kid ‘s right to larning and development which start from birth ( Woodhead, 2007 as cited in Woodhead & A ; Moss, 2007 ) . As such, much significance is given to Early Childhood Education and Care ( ECEC ) in policies development globally. Surveies have shown intercession in early childhood may be important for the development of a kid. Early childhood instruction and attention ( ECEC ) may be referred to high quality attention for immature kids from birth. It includes educating parents to supply and care for kids in the facets of wellness, nutrition, larning and development ( Annan, 2001: p.63 ) . An baby, from the twenty-four hours he is born, needs quality attention. Inadequate nutrition and unhealthy life conditions may adversely impact a kid ‘s development and ability to larn. As such, quality attention and instruction from birth may hold positive consequence on kids ability to larn ( Engle, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) . Children may hold equal opportunity to travel out of the poorness rhythm through early instruction as early intercessions may hold positive benefits in the long tally ( Grantham-McGregor, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ; Rosemberg & A ; Pu ntch, 2003 ) . Through early intercessions, these kids may be exposed to values and cognition that may non be inculcated in their place. For illustration, they may larn societal and cognitive accomplishments which may be utile when they attend formal schooling. With the cognition and life accomplishments acquired in schools, they may be able to lend to their community. Therefore, ECEC may be utile tool for province authoritiess and international bureaus to protect act in the best involvements of the kid and to protect kid ‘s rights. Economic benefits may be generated from investings in ECEC. Governments and international bureaus invest in early childhood attention and instruction as the economic benefits generated from investing in ECEC will churn greater additions in the hereafter because it may take down wellness and societal hazards, like offense rates. Children who are gainfully engaged in acquisition may be able to lend to the economic system in future. Foreign investors may put in a state if there are skilled workers who are able to work in their industries. Investing in kids will supply them with the necessary accomplishments to pull investings and to hike the economic system of the state ( Barnett as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) . In conformity to the non-discrimination rule in UNCRC, all kids may be given equal opportunities in life. Governments and international bureaus may be committed to guarantee all kids have the same rights to instruction. Every kid may hold a right to instruction as kids will larn cardinal values like moral and ethical values, acceptable attitudes in community every bit good as basic accomplishments. For illustration, if kids populating in poorness are non educated, they may non be able to achieve cognition to assist them travel out of the poorness rhythm. There are different ECEC programmes to provide to the demands of peculiar community of kids. In developing states, female parents may necessitate to be educated on taking attention of their kids. For illustration, the mother-child instruction programme in Turkey provides others support for female parents in footings of kid wellness issues. Mothers are taught to take attention of their kids and educates female parents on kid wellness, rearing accomplishments every bit good as to back up kid ‘s development ( Annan, 2001 ; Bekman, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) . In developed states where wellness attention are more advanced, the kids may necessitate support in holistic development. In United Kingdom, the effectual pre-school and primary instruction prepare kids for primary schools ( Sylva, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) Surveies have shown that the more effectual programmes include all facets such as wellness, nutrition and development every bit good as parental and community engagement. Nimnicht ( 2009 ) as cited in Siraj-Blatchford & A ; Woodhead ( 2009 ) concur intercession programme for kids may be effectual if they is active engagement from all the stakeholders such as familes, communities and the regulating organic structures. This is in the instance of PROMESA in Columbia, whereby the households and communities are actively involved in the programmes. As such, UNCRC may do a difference if there are commitment and active engagement from regulating organic structures, international bureaus, communities and households to advance kid ‘s right ( Woodhead, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) . It may be disputing to supply quality early childhood attention and instruction to battle poorness. The province of kids ‘s wellness and development are adversely affected in kids populating in poorness. The relevancy of early childhood theoretical accounts, societal and cultural context, co-ordination within households, communities and authorities organic structures play an of import function in developing appropriate intercession programme to assist kids in poorness ( Woodhead, 2006 ; Siraj-Blatchford & A ; Woodhead, 2009 ) . For illustration, in the instance of a developed state, like USA, one of the aims of ECEC is to enable adult females to hold equal engagement in the work force and to enable kids to larn and socialise ( Penn, 2005 ) . As early intercession to control poorness may non be the chief precedence, ECEC is left to private operators which result in inequalities in quality of programme ( Tayler, 2009 as cited in Siraj-Blatchford & A ; Woodhead, 2009 ) . Inequality of quality and entree as private sectors tend to provide to the flush and non put up in poorer parts of the states. For illustration, in USA, ECEC is left to single suppliers so the quality of attention and instruction is variable and there is unjust entree to these services ( Penn, 2005 ) . Individual suppliers are besides more likely to put up ECEC Centres in urban countries and this may be incompatible with the authorities purpose to supply quality instruction for all kids. In the instance of a underdeveloped state, like Malawi, the ECEC set up in rural countries are community-based with hapless plan and unqualified staff. Policies develop at national degree may non be implemented consequently at land degree due to miss of resources. There may be unqualified instructors, irrelevant course of study every bit good as deficiency of support from the households and community. For illustration, the kids may necessitate to work to back up the households. In some instances where there is AIDS in the households, they may be ostracized by the communities and hence ECEC programmes may non be accessible to them ( Clark & A ; Tucker, 2010 ) . As such, the effectivity of early childhood instruction and attention may non be positive and therefore kids in some of the poorest states may non profit from UNCRC. In the twelvemonth 2000, UN millenary development ends were established to better the societal and economic conditions of developing states ( Bellamy, 2005 ) . Majority of the ends were related to kids and are expected to be achieved by 2015. Some of these ends include cut downing poorness, bettering wellness and life conditions, primary instruction, gender equality and households. However, statistics have shown that there has non been much betterment since these ends were set. Childs are still populating in poorness and hapless wellness. Diseases such as HIV, TB and malaria are prevailing ( Bellamy, 2005 ) . International bureaus have been working with some of the poorest states to guarantee that precedences of international AIDSs go to kids for wellness and development. These strategies have non been successful due to hapless co-operation between province and local authoritiess and the communities ( Bellamy, 2005 ) . Although many states have become more flush in the last decennary, the hapless still remain hapless as the spread between the rich and hapless states widen. This may be due to worsen in international AIDSs, struggles and war every bit good as to inappropriate usage of supports province authoritiess. Therefore kids in poorness may still be populating in hapless conditions ( Annan, 2001 ) . UNCRC may be an international jurisprudence, besides, the legal legal power in the states which have adopted it, it calls upon the moral duties by province authorities for enforcement ( Annan, 2001 ) . In order for UNCRC to do a difference to kids, province authoritiess and international bureaus must be committed puting kids in first precedence. All determinations in nation-building every bit good as economic growing should be considered with the rights of kids in head. In add-on, all stakeholders, such as, international bureaus, authorities organic structures, communities, households and kids need to play their portion in accomplishing the aims set by UNCRC.

Kill A Mockingbird By Harper Lee - 1577 Words

To Kill a Mockingbird: To Kill a Mockingbird revolves around the time period of the 1930’s in the Southern part of the United States. The protagonist of this story is Scout, a tomboy, who narrates the story from her perspective when she is older. (She was part of this story herself from ages 6-9). The first many chapters of the book is about Scout’s life in school, and how she grows up in her neighborhood streets. She spends her days with her father, Atticus Finch. The main topic and climax of this book is about the court case of African American man, Tom Robinson, who had been accused of raping and beating a poor white girl, Mayella Ewell. Atticus Finch was a lawyer who defended Robinson and was also his alibi. You know the truth, and the truth is this: some Negroes lie, some Negroes are immoral, some Negro men are not to be trusted around women—black or white. But this is a truth that applies to the human race and to no particular race of men. There is not a person in this courtroom who has never told a lie, who has never done an immoral thing, and there is no man living who has never looked upon a woman without desire. Not only did Atticus defend Tom as an individual with these words he recited, but for all African Americans. In the end, Robinson is stated guilty even though he committed no crime; he was proclaimed guilty because of his skin color. Tom Robinson was killed by policeman when trying to runaway from prison and, soon after the court case, did Mayella’sShow MoreRelatedKill A Mockingbird By Harper Lee1049 Words   |  5 PagesTo Kill a Mockingbird: How a Story could be based on True Events in Everyday LifeDaisy GaskinsCoastal Pines Technical Collegeâ€Æ'Harper Lee was born in Monroeville, Alabama. Her father was a former newspaper editor and proprietor, who had served as a state senator and practiced as a lawyer in Monroeville. Also Finch was known as the maiden name of Lee’s mother. With that being said Harper Lee became a writer like her father, but she became a American writer, famous for her race relations novel â€Å"ToRead MoreTo Kill a Mockingbird by Harper Lee1000 Words   |  4 Pagesworld-wide recognition to the many faces of prejudice is an accomplishment of its ow n. Author Harper Lee has had the honor to accomplish just that through her novel, To Kill a Mockingbird, a moving and inspirational story about a young girl learning the difference between the good and the bad of the world. In the small town of Monroeville, Alabama, Nelle Harper Lee was born on April 28, 1926. Growing up, Harper Lee had three siblings: two sisters and an older brother. She and her siblings grew up modestlyRead MoreKill A Mockingbird By Harper Lee1290 Words   |  6 PagesHarper Lee published To Kill a Mockingbird during a rough period in American history, also known as the Civil Rights Movement. This plot dives into the social issues faced by African-Americans in the south, like Tom Robinson. Lee felt that the unfair treatment towards blacks were persistent, not coming to an end any time in the foreseeable future. This dark movement drove her to publish this novel hopeful that it would encourage the society to realize that the harsh racism must stop. Lee effectivel yRead MoreKill A Mockingbird By Harper Lee873 Words   |  4 PagesIn the book, To Kill a Mockingbird, Harper Lee illustrates that â€Å"it’s a sin to kill a mockingbird† throughout the novel by writing innocent characters that have been harmed by evil. Tom Robinson’s persecution is a symbol for the death of a mockingbird. The hunters shooting the bird would in this case be the Maycomb County folk. Lee sets the time in the story in the early 1950s, when the Great Depression was going on and there was poverty everywhere. The mindset of people back then was that blackRead MoreKill A Mockingbird By Harper Lee963 Words   |  4 Pagesgrowing up, when older characters give advice to children or siblings.Growing up is used frequently in the novel To Kill a Mockingbird by Harper Lee. Harper Lee uses the theme growing up in To Kill a Mockingbird to change characters opinion, develop characters through their world, and utilizes prejudice to reveal growing up. One major cause growing up is used in To Kill a Mockingbird is to represent a change of opinion. One part growing up was shown in is through the trial in part two of the novelRead MoreKill A Mockingbird By Harper Lee1052 Words   |  5 PagesTo Kill a Mockingbird by Harper Lee takes place in Maycomb County, Alabama in the late 30s early 40s , after the great depression when poverty and unemployment were widespread throughout the United States. Why is the preconception of racism, discrimination, and antagonism so highly related to some of the characters in this book? People often have a preconceived idea or are biased about one’s decision to live, dress, or talk. Throughout To Kill a Mockingbird, Harper Lee examines the preconceptionRead MoreHarper Lee and to Kill a Mockingbird931 Words   |  4 PagesHarper Lee and her Works Harper Lee knew first hand about the life in the south in the 1930s. She was born in Monroeville, Alabama in 1926 (Castleman 2). Harper Lee was described by one of her friends as Queen of the Tomboys (Castleman 3). Scout Finch, the main character of Lees Novel, To Kill a Mockinbird, was also a tomboy. Many aspects of To Kill a Mockingbird are autobiographical (Castleman 3). Harper Lees parents were Amasa Coleman Lee and Frances Finch Lee. She was the youngestRead MoreKill A Mockingbird By Harper Lee1695 Words   |  7 PagesIn To Kill a Mockingbird Harper Lee presents as a ‘tired old town’ where the inhabitants have ‘nowhere to go’ it is set in the 1930s when prejudices and racism were at a peak. Lee uses Maycomb town to highlight prejudices, racism, poverty and social inequality. In chapter 2 Lee presents the town of Maycomb to be poverty stricken, emphasised through the characterisation of Walter Cunningham. When it is discovered he has no lunch on the first day of school, Scout tries to explain the situation to MissRead MoreKill A Mockingbird By Harper Lee1876 Words   |  8 PagesThough Harper Lee only published two novels, her accomplishments are abundant. Throughout her career Lee claimed: the Presidential Medal of Freedom, Pulitzer Prize for Fiction, Goodreads Choice Awards Best Fiction, and Quill Award for Audio Book. Lee was also inducted into the American Academy of Arts and Letters. This honor society is a huge accomplishment and is considered the highest recognition for artistic talent and accomplishment in the United States. Along with these accomplishments, herRead MoreKill A Mockingbird, By Harper Lee1197 Words   |  5 Pagessuch as crops, houses, and land, and money was awfully limited. These conflicts construct Harper Lee’s novel, To Kill a Mocking Bird. In To Kill a Mocking Bird, Lee establishes the concurrence of good and evil, meaning whether people are naturally good or naturally evil. Lee uses symbolism, characterization, and plot to portray the instinctive of good and evil. To Kill a Mocking Bird, a novel by Harper Lee takes place during the 1930s in the Southern United States. The protagonist, Scout Finch,