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Strong and Confident Warrior

Strong and Confident Warrior

Surefire Ways To Master Your Self Confidence  Efforts. This Book Is One Of The Most Valuable Resources In The World When It Comes To Getting Serious Results In Your Life.

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Quantum Confidence With The Morry Method

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Depression and Single Parents

Campbell (1998), in her study of 189 divorced or never-married mothers from three ethnic racial groups, investigated the variables related to strengths in single mothers. Three qualities, namely, self-esteem, mastery, and lack of depression, consistently indicated strength for all groups. Nevertheless, the author noted that single mothers successfully developed numerous strategies for coping with excessive social pressures levied against them. The oppression they experienced appeared to have a negative impact on their ability to access inner strength and empowerment. Similar findings were reported by Ebin (1996), who, in a comparative study of single mothers and married mothers, found that married mothers had lower self-esteem than their single counterparts. Low self-esteem, low income, and lack of control over one's life explained the variance in depression. Marital status had only an indirect effect on depression via its effects on self-esteem. An altogether unexpected set of...

Summary on Preventive Cardiology in Athletes

Determinants of young people's involvement in sports and physical activity are complex. First, gender and social-cultural factors influence sports involvement. For example, the level of sedentariness with increasing age seems greater among girls and among those from less resourceful backgrounds.29 Among psychological factors, enjoyment is particularly important and is consistently associated with participation in sport and PA. Other important determining factors comprise feelings of competence, control, autonomy, self-efficacy, positive attitudes to PA and sport including perceived benefits and decreased barriers to sport and PA, and having personal goals that focus on effort and improvement.30 In terms of social and environmental factors, there is substantial evidence that family and peer modeling and support correlate with sport and PA levels of young people. Further, access to appropriate environments can enhance their participation.30 A full understanding can only be achieved...

Pain Behaviors and Marital Relations

In a couple with a history of satisfactory premorbid marital relations, the partner tends to be solicitous of the patient in the early stages of the illness, tends to adopt a very sympathetic and supportive attitude toward the patient, and actively engages in reinforcing pain behaviors. Yet, in the long run, in the absence of any discernible improvement in the patient's condition or, worse, further deterioration, the spouse may experience an increased sense of frustration and unexpressed grievance. A common problem encountered in family therapy in the area of communication is the feeling on the part of the well spouse that he or she has lost the right to give vent to negative feelings. From the patient's perspective, the problem is equally complex. Feelings of dependency combined with the loss of self-esteem lead to withdrawal and an unwillingness to communicate good as well as bad feelings. Patients and partners alike fall prey to poor communication, and under those circumstances...

Educating Cardiac Patients and Relatives

Spouses and family have a very important place in the rehabilitation of patients with coronary heart disease (CHD). Their involvement has the potential of facilitating the process and improving the outcome. The most important source of social support for a cardiac patient is family, particularly his or her spouse. Positive social support is important for the prognosis of CHD patients. This entails emotional (understanding and acceptance of feelings), appraisal (good advice and opportunity to discuss how to manage the new life situation), informational (knowledge about CHD, risk factors, and lifestyle), and instrumental (help with practical problems) support. These aspects should be included in comprehensive cardiac rehabilitation and secondary prevention. In terms of support, it is also the case that too much support from family to the patient can create over-protectiveness and decrease the patient's self-efficacy and own initiatives in rehabilitation.

Suggestibility and Compliance

Appearing to have special knowledge about the alleged offense. This special knowledge may seriously mislead the police and the courts to assume the suspect's guilt erroneously. Suggestibility correlates with anxiety, lack of assertiveness, poor self-esteem, and low intelligence (56).

Motivation and control

However, the opposite may be experienced by the person with the pain, in that they may feel that they can cope, can do something about the situation, or at least participate. It is a kind of self-confidence. There is a sense of being in control, of being motivated to do something or to comply with recommendations. Some people talk about being challenged by the situation, or being called on by God or other spiritual or personal ethic to cope. There may be comments about a sense of responsibility, or about 'owning the pain'. The person may have had previous experience of the pain. There may be a motivation to find things out, to seek help and support. There may be a willingness to talk to others about the pain and to benefit from others' experiences. The question of motivation is also related to a sense of self-efficacy (Bandura 1977), and feelings of being in control (Wallston 1989). The person in pain, particularly in chronic pain, may or may not feel in control of things. If the...

The Meaning of Social Support

Shows that different forms of social support may have differential effects in terms of benefit for a CHD patient. For instance, too much instrumental support given by the spouse to the patient could create over-protectiveness and decrease the patient's self-efficacy and own initiatives in rehabilitation. A randomized intervention study by Berkhuysen et al.13 showed that over-protectiveness by a spouse, as assessed by the patient, counteracted self-efficacy and thus decreased patients' confidence in their ability to make positive changes. Itkowitz et al.14 showed that too much attention by the spouse to cardiac symptoms may contribute to negative outcomes of rehabilitation. Selective focus on the expression of CHD symptoms may unwittingly serve to reinforce emotional distress.

The social stigma of psychiatric disorder

I think people with physical CFS need more doctors' support and people to believe in them instead of thinking it's in the head. People need plenty of support, they didn't want to have CFS. I have found that some doctors can utterly destroy your self confidence and I never want to see another one again.

Cognitive behavioural models of chronic fatigue syndrome

Surawy et al. (1995) expanded this earlier formulation to include an explanation of predisposing factors. They suggest that predisposed people are highly achievement orientated and base their self-esteem and respect from others on their ability to live up to certain high standards. When such people are faced with precipitating factors which affect their ability to perform, such as a combination of excessive stress and an acute illness, their initial reaction is to press on and keep coping. This behaviour leads to exhaustion. In making sense of the situation a physical attribution for the exhaustion is made, which protects their self-esteem by avoiding the suggestion that their inability to cope is a sign of personal weakness. Physical attributions result in people focusing on the somatic rather than emotional aspects of their illness. Symptoms which could be physiological concomitants of chronic psychological distress or inactivity, or both, such as fatigue, poor concentration and...

Patient Related Factors

Note, attendance at CR is related to illness representations. A recent randomized trial examined the efficacy of a brief three-session in-hospital intervention to change beliefs about a myocardial infarction in comparison to usual care.12 Three months after discharge from the hospital, the intervention group returned to work at a significantly faster rate and had fewer angina symptoms. Having favorable attitudes towards the behavior and high levels of self-efficacy (confidence in one's ability to successfully perform the behavior) have been associated with successful performance of health behaviors.13

Cognitive Theories of Gender Development

In one version of gender schema theory, Bem (1981) proposes that children develop gender schemas by virtue of the pervasive gender messages in society and that sex-typing occurs when children's self-concept and self-esteem gets assimilated into gender schemas. Interestingly, Bem's theory also focuses on individual differences in the degree of being sex-typed. She asserts that individual differences schemas and sexism schemas can replace gender schemas when children are encouraged to process information according to the variability within groups and the historical roots and consequences of sex discrimination (Bem, 2000).

Relevant Factors from the PostMI Period

Information from the patient's physical and mental recovery, from the social environment and from the workplace should be added to the information from the pre- and acute MI phase when preparing for an early return to work or for a decision to advise a change of job or even a permanent withdrawal from working life. For the CR team the following questions need answers Has the patient regained the desired physical work capacity or is there a persisting disability Is the patient motivated to resume work, or is he or she limited by poor self-confidence Is there an exaggerated perception of disability with the onset of psychosomatic complaints, as tends to occur after 2-3 months of sickness absence

The Role of Cardiac Rehabilitation Psychological Support and Stress Management

Psychosocial factors play an important role in the prevalence and in the progression of coronary artery disease. This has consequences for the provision of psychosocial support within the framework of a CR service. The psychological expertise within the CR team should advise the employer on means of limiting a stressful work environment in patients where mental stress or strain at the workplace has been reported. Patients may be helped by participating in stress management classes or in special cases through individual counseling by a psychologist. Overprotection by family and friends and the attitude of work colleagues and supervisors may extend sickness absence. Here clear and timely information from the CR team is invaluable Anxiety and depression should be diagnosed early post-MI and treated if indicated with pharmacotherapy. Repeated mental reinforcement within the CR program may help the patient to regain self-confidence and trust in the ability to face work demands.

Who Is the Patient Psychological Factors Readiness to Change

Several years ago Prochaska and DiClemente17 identified six stages relating to the process of behavioral modification (Figure 26-1), conditioning our educational approach to a patient. An acute event, such as the occurrence of myocar-dial infarction, often shortens the three first stages, so patients in cardiac rehabilitation are most often in an action stage. At this phase, emphasis will be put on encouraging self efficacy for dealing with obstacles, counteracting the feeling of loss by reiterating health and quality of An other important psychological component to assess is the patient's locus of control, which means the tendency for the patient to attribute life events to internal factors depending on his willingness and behavior or to external factors such as a hazard or other people. In the latter, the process of nutritional change will be longer and more difficult, involving the need to improve the patient's health beliefs, self-efficacy and empowerment. A person's social life...

Unconditional Positive Regard

Carl Rogers (1961) defines unconditional positive regard as a warm regard for him sic as a person of unconditional self-worth of value no matter what his condition, his behavior, or his feelings (p. 34). Unconditional positive regard suggests warmth, caring, respect, and a nonjudgmental attitude.

Social Cognitive Theory

Bussey and Bandura's (1999) most recent account proposes that children's development of sex-typed knowledge and competencies is promoted by modeling, enactive experience, and direct tuition. As in previous versions of their theory, observational learning continues to take center stage as the major conveyor of gender-typed information. Through cognitive functions such as attentional and representational processes, symbolic conceptions derived through modeling are able to be translated into behavioral courses of action. Whether children will actually perform the learned behaviors, however, will depend on the incentive motivators (i.e., direct, vicarious, or self-evaluative) associated with the outcomes. Through these social experiences, children also develop outcome expectancies and self-efficacy beliefs that become linked to sex-typed roles and conduct. These cognitions are then expected to regulate children's sex-typed behavior. For example, if a girl observes other girls in her...

Specific Strategies for Sexual Counseling for Selected Cardiac Conditions

Few studies have explored interventions for sexual counseling post-MI. Varvaro17 found that patients who received a nursing instructional program had fewer concerns about sexual activity, and better adaptation to family role and work. The treatment group showed a trend for increased self-confidence (P 0.059) in resuming sexual activity over time and the largest decrease in adjusting to sexual intercourse over time, reflecting the positive effect of the intervention. Froelicher and colleagues14 used a teaching-counseling program on exercise to assess return to usual activities participants completed eight sessions on risk factor modification and post-MI adjustment. The rate of return to physical activities was not significantly different between groups, and most patients returned to sexual activity, driving, and outdoor activities by 3 weeks post-MI. Steinke and Swan8 tested a videotape for sexual counseling post-MI which demonstrated improved knowledge in the experimental group at 1...

Intrinsic Motivation Theories

Until recently, intrinsic motivation researchers like Deci and Ryan and Csikszentmihalyi have dealt with conditions, components, and consequences of intrinsic motivation without making a distinction between intrinsic motivation as a state versus intrinsic motivation as a trait-like characteristic. However, interest in trait-like individual differences in intrinsic motivation is growing particularly among educational and sport psychologists (see Amabile et al., 1994 Gottfried, 1990 Harter, 1998 Nicholls, 1989 Schiefele, 1991). These researchers define this enduring intrinsic motivational orientation in terms of three components (1) preference for hard or challenging tasks, (2) learning that is driven by curiosity or interest, and (3) striving for competence and mastery. The second component is most central to the idea of intrinsic motivation. Both preference for hard tasks and striving for competence can be linked to either extrinsic or more general need-achievement motivation....

Some Day I Am Going to Leave This

The above information was obtained during several sessions. Some observations were made. First, she was very unsure about herself, and for whatever reason, her self-esteem was compromised. Second, she was frightened of someone or something. Third, the marital relationship was strained. Fourth, she was probably in an abusive situation, although there was no evidence to support this view. It was her general demeanor, which seemed to convey fear, that led to the hypothesis of abuse. distress. The chronicity of her stressful family life may also have contributed to the psychophysiological nature of the headache. She remained in psychotherapy for about 18 months. Psychotherapy did not altogether alleviate her headaches, although they were substantially modified. Her self-esteem was vastly improved, and eventually Rose did leave her husband. Following the separation, her husband contacted her therapist seeking counseling. Rose was unwilling to take part in joint therapy. This man was...

Illness perceptions and functioning

Causal attributions do, however, appear to be associated with psychological adjustment and the experience of fatigue in CFS patients who have been ill for quite some time. Two studies have shown that psychological attributions for CFS are negatively associated with fatigue, but positively related to distress, while physical attributions show the opposite pattern (Heijmans and de Ridder 1998 Moss-Morris et al. 1996b). Attributing illness to a germ, immune system or factors such as pollution has also been shown to be protective of self-esteem, while attributions such as current stress and past trauma are associated with lower self- esteem (Moss-Morris 1997). It appears that physical attributions protect self-esteem and psychological well-being, but at the expense of fatigue levels.

Cognitive and Behavioral Both Are Required

Rewards to be given as soon as possible after a person has practiced a desired behavior. Self-recording of success in a task is a simple but effective way to do this. Patients set goals and work up through these in small steps, ticking off the boxes as they progress. A facilitator reviews the progress with the goals at regular times, also congratulating (rewarding) the patient. In a group program reporting these successes to the whole group is a powerful added reward for many people. The steps should always be set by the patient and be small to allow for many rewards. Each small step forward builds further confidence that the person can succeed (technically often called self-efficacy ) and makes it more likely that the they will attempt the next step. Deliberately building up self-efficacy in this way is a common element of CB treatments. A number of the other common techniques used in CB based programs have recently been summarized in a review by Michael Von Korff.1

HOME and Socio Emotional Development

Although not actually an index of social competence per se, having an internal locus of control is considered salient for good mental health and adaptive functioning (Rotter, Chance, & Phares, 1972). We reported low, but significant, correlations between the Early Childhood HOME and locus of control orientation at age 6 to 8 years (Bradley & Caldwell, 1979a). More recently we examined relations between the Early Adolescent HOME and self-efficacy beliefs for European American and African American children ages 10 to 15 (Bradley & Corwyn, 2001). We found low to moderate correlations for self-efficacy beliefs pertaining to both school and family but nonsignificant relations for self-efficacy beliefs pertaining to peers. This latter finding was not surprising in view of the fact that self-efficacy beliefs tend to reflect experiences in particular situations (in this case peer groups) (Bandura, 1997). Findings by Bakeman and Brown (1980) Lamb et al. (1988) Erickson, Stroufe, and Egeland...

Roles and pain behaviour

In further studies of larger groups, and using other models, such as the Family Adaptability and Cohesion Evaluation Scale (Olson et al. 1984), Roy and Thomas (1989) found the families to be operating at the 'chaotic' level of functioning. This study concentrated in particular on the relationship of the couples, and focused on roles rules decision making discipline and leadership. The spouses tended to be performing at a more effective level, although they were affected themselves. Interestingly there was no difference between short-term pain and long-term pain situations, suggesting that the effects happen early. Simmonds et al (1998) argue that the impact of the chronic pain on the family is related to their health beliefs and coping strategies as a family, as did Snelling (1994). This would also reflect societal and cultural influences. Keefe et al (1998) also found that pain-coping strategies influenced self-ratings of self-efficacy of sufferers and spouses. Roy (1992) notes with...

Working with an Asian American Client

Simon, an East Asian international student, referred himself to the university counseling center after about one year of studying in the United States. Simon reported low self-esteem, difficulty concentrating, and problems with socializing. His stated goal for therapy was to become more assertive in his interactions with others (Christopher, 2001, p. 124). In particular, Simon expressed a desire to become more similar to his American roommates and less like other international students from his homeland.

Correcting Negative Female Workplace Behaviors

Women try to avoid being criticized they often take it personally. Women are socialized to derive their self-worth from external, rather than internal, sources therefore, they tend to react excessively to others' opinions, whether positive or negative. Women are more likely to hold grudges for long periods.

Issues of Measurement in Applied Behavior Analysis

Identification of the target behavior may appear to be a relatively simple task. In a given setting (e.g., the home, school, or workplace), there is general agreement as to the problems of the clients whose behaviors need to be changed and as to the general goals of the program. Global or general statements of behavioral problems are usually inadequate for actually beginning a behavior modification program. For example, it is insufficient to select as the goal alteration of aggressiveness, learning deficits, speech, social skills, depression, psychotic symptoms, self-esteem, and similar concepts. Traits, summary labels, and personality characteristics are too general to be of much use. Moreover, definitions of the behaviors that make

Psychotherapy Treatment Of Nuclear Symptoms And Associated Problems

There are several problems often associated with bipolar disorders that may worsen the quality of life of patients and therefore deserve special attention. Patients may run into problems during their adjustment to a diagnosis common reactions to receiving a diagnosis of a severe, chronic illness are denial, anger, ambivalence, and anxiety (Goodwin and Jamison 1990). It is essential for the clinician to respond appropriately in order to to improve illness awareness, treatment compliance, and avoid self-esteem problems (Colom and Vieta 2002a, 2002b). Another problem that should be carefully addressed by therapists is a patient's feeling of loss and grief after the loss of real or abstract objects, such as a job (which is mentioned by 70 of patients and their partners as the most relevant difficulty in the long term Targum et al. 1981 ), job status (which affects more than 30 of patients Harrow et al. 1990 ), economic status, and loss of love relationships and family support. All of...

Diabetes and Sexual Dysfunction

The actual volume of research on the impact of sexual dysfunction in diabetics on marital relations is meager and somewhat dated. Most of the studies reported that sexual dysfunction produced significant problems in marriage (Jensen, 1986 Schiavi et al., 1995 Schmitt and Neubeck, 1985 Schreiner-Engel et al., 1987). Jensen (1986), in an investigation of 101 insulin-treated diabetics (50 women and 51 men) who were followed for 6 years for sexual dysfunction, reported that the men more often used the disease as an alibi for their sexual dysfunction, had lower bodily self-esteem, and reported more sexual dysfunction. Both groups reported almost in equal proportion that daily life was troublesome. However, the most significant finding of this study was that the role adopted by patients, such

Identifying Evaluating and Exploring Client Problems and Goals

You see, when in public, I worry more than the average person about being scrutinized and negatively judged. My anxiety about this is manifest through sweating, constant worry about being inadequate, and avoidance of most, but not all, social situations. What I'd like to do in therapy is build my self-confidence, increase my positive self-talk, and learn to calm myself down when I'm starting to get upset. Once you've identified a primary problem in collaboration with your client, attention should turn to a thorough analysis of that problem, including emotional, cognitive, and behavioral aspects. Seek answers to a list of questions similar to the following. As you read the questions, think about different client problems (e.g., panic attacks, low self-esteem, unsatisfactory personal relationships, binge eating or drinking, vocational indecision) that you might be exploring through the use of such questions

Promotion of Mistrust

Few researchers have directly investigated the influences of messages focused on the equality of all races and or silence about race in terms of their consequences for children's development. However, scholars have emphasized that children of color socialized from an egalitarian perspective may have unrealistic expectations concerning intergroup relations and, consequently, unable to comprehend and cope with experiences involving racial bias (Smith, Fogle, & Jacobs, in press Spencer, 1983 Stevenson, 1995). Spencer (1983) also noted that lack of direct instruction and discussion about race among parents of color means that traditional views and prevalent stereotypes remain unchallenged. Supporting this perspective, Bowman and Howard (1985) found that Black youth who were not taught anything about race had lower self-efficacy scores than did recipients of proactive racial ethnic socialization strategies. In addition, Kofkin and colleagues (Kofkin et al., 1995) found correspondence...

Changes With Aging

Aging may affect all aspects of the nervous system, from mental status to motor and sensory function and reflexes. Age-related losses may take their toll on the mental function of an elderly person. These include the deaths of loved ones and friends, retirement from valued employment, diminution in income, decreased physical capacities including impairments in vision and hearing, and perhaps decreased stimulation or growing isolation. In addition, biologic changes affect the aging brain. Brain volume and the number of cortical brain cells decrease, and both microanatomic and biochemical changes have been identified. Nevertheless, most men and women adapt well to getting older. They maintain their self-esteem, they alter their activities in ways that are appropriate to their changing capacities and circumstances, and eventually they ready themselves for death. The lifetime prevalence of major depression meeting formal diagnostic criteria is 5 to 10 in men and 10 to 20 in women....

Messages Sent Versus Messages Received

Reported more frequent race-related socialization were less likely than other children to demonstrate pro-Black attitudes, suggesting that either parent's intended messages about racial pride may have been interpreted by children as negative messages about African Americans or that parents failed to report their own behaviors accurately. Interestingly, in Marshall's (1995) study, parents' reports of ethnic socialization were significantly correlated with children's ethnic identity stage, whereas children's reports were not. Thus, a variety of questions concerning the correspondence between parents' reports of racial ethnic socialization and both children's reports of racial ethnic socialization and children's outcomes (e.g., group identification, self-esteem) need to be explored. This is especially important given the overemphasis on proactive, explicit, verbal, messages among researchers studying racial ethnic socialization to date. That is, we need to explore both how racial ethnic...

Midgley And Adler 1984 Reference

Self-efficacy Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215. Bandura, A. (1994). Self-efficacy The exercise of control. New York W. H. Freeman. Borkowski, J. G., Carr, M., Relliger, E., & Pressley, M. (1990). Self-regulated cognition Interdependence of metacogni-tion, attributions, and self-esteem. In B. Jones & L. Idol (Eds.), Dimensions of thinking and cognitive instruction (Vol. 1) (pp. 52-92). Hillsdale, NJ Erlbaum. Covington, M. (1992). Making the grade A self-worth perspective on motivation and school Reform. New York Cambridge University Press. Eccles, J. S., Wigfield, A., Flanagan, C., Miller, C., Reuman, D., & Yee, D. (1989). Self-concepts, domain values, and self-esteem Relations and changes at early adolescence. Journal of Personality, 57, 283-310 Harter, S. (1985). Competence as a dimension of self-evaluation Toward a comprehensive model of self-worth. In R. L. Leahy (Ed.), The development of the self. New York...

The Cardiovascular Prevention and Rehabilitation CVPR Program Hospital

The multidisciplinary team use a common approach to lifestyle change in patients and families. This is based on the stages of change model proposed by Prochaska and DiClemente,14 which recognizes that individuals are not equally ready to change their behavior at a given point in time. Those who are ready and motivated are more likely to change. The team draws on various methods to increase motivation, overcome barriers, and develop strategies. For example, motivational counseling15 can provide a way to work with ambivalence, to increase motivation and self efficacy, to set goals, and to create a management plan.

Prevalence And Psychological Consequences Of Exposure To Community Violence

Based on the community violence studies of the early 1990s, between 44-82 of school-aged children and youth are exposed to community violence, depending on definitional criteria, methodology, and sample characteristics (Overstreet, 2000 Stein, Jaycox, Kataoka, Rhodes, & Vestal, 2003). According to the early studies, by the end of elementary school, almost all children residing in high crime innercity areas of Washington and New Orleans had heard (98 ) or witnessed (90 ) moderate to severe levels of violent occurrences (Richters & Martinez, 1993 Osofsky, Wewers, Hann, & Fick, 1993). School-aged children exposed to community violence are at risk for an array of problematic behavior including lower self-competence (Farver, Ghosh, & Garcia, 2000), high levels of distress (Martinez & Richters, 1993), depression (Durant, Getts, Cadenhead, Emans, & Woods, 1995), post-traumatic stress disorder (Fitzpatrick & Boldizar, 1993 Jaycox, Stein, Kataoka, Wong, Fink, Escudero, & Zaragoza, 2002),...

Mohammed Abdul Hannan

Everyone should, of course, be pleased when such behaviors diminish. However, it is very dispiriting for a young person to learn that he or she is regarded by adults as someone who is likely to be a problem for others as well as for himself or herself. It is very discouraging for a young person to try to make a positive life when he or she is confronted by the suspicion of substance use and abuse, unsafe sexual practices, and a lack of commitment to supporting the laws and mores of society. What sort of message is sent to youth when they are spoken of as inevitably destined for trouble unless parents or practitioners take preventive steps How do such messages affect the self-esteem of young people, and what is the impact of such messages on their spirit and motivation

Making Decisions about Hospitalization and Referral

There are several reasons why hospitalization may not be the best option for moderately or severely suicidal clients (although it is probably always the best option for extremely suicidal clients). For some clients, hospitalization itself is traumatic. They experience deflated self-esteem and may regress to lower functioning, becoming cut off from more socially acceptable support networks. Severely suicidal clients who are employed and have adequate social support networks may, in some instances, be better off without hospitalization. In such cases, you might increase client contact, perhaps even meeting for brief sessions every working day.

User Friendly Assessment and Information Gathering Strategies

A relationship-building assessment procedure that provides a rich interpersonal interaction between young clients and counselors is the What's good about you question and answer game (D. Dana, personal communication, September 1993 J. Sommers-Flanagan & Sommers-Flanagan, 1997). The procedure also provides useful information regarding child adolescent self-esteem. Initially, it is introduced as a game with specific rules The What's good about you game provides insights into client self-perceptions and self-esteem. Some youth have difficulty clearly stating a talent, skill, or positive personal attribute. They sometimes identify possessions, such as I have a nice bike or I have some good friends, instead of taking personal ownership of an attribute I am a good bike rider or My friendly personality helps me make friends. Similarly, they may describe a role they have (e.g., I am a good son ) rather than identify personal attributes that make them good at the particular role (e.g., I am...

Cognitive evaluation and pain

Ciccone and Grzesiak (1984) have identified eight types of schemata created or used by people with chronic pain. There is the awful nature of the experience being under external control mislabelling somatic sensations cognitive rehearsal the importance of self-efficacy immediate gains rather than those in the longer term poor opinion of self injustice. The creation or formulation of schemata depends very much on the situation as interpreted by the individual. Expectations are important (Anderson and Pennebaker 1980) in labelling the symptoms or feelings. Pain schemata can be more clear or memorable than others (Morley 1993), consisting of all sensory information including social factors and personal meaning (Katz and Melzack 1990). They are particularly vulnerable to the media, as are many illness representations. These may not be medical diagnoses, but they influence the behaviour (Leventhal et al. 1988). The interrelatedness of emotions, motivation and cognition are seen as vital to...

Exercise Program 10 Minutes per Patient

Cising program after CR is no time no one can claim not to have 10 minutes free once or twice during the day. The training effect comes from increasing the number of repetitions in that fixed time. Patients are asked to practice at least once per day. Initial levels are deliberately set low because of the behavioral laws that (1) behaviors that are punished, (through pain, tiredness, soreness, etc.) die out and (2) the easier it is, the more likely it is they will succeed, thus rewarding them and raising their self-efficacy for exercise at the same time. They rate each exercise on a 10 cm line on two qualities (1) on a scale very pleas-ant very unpleasant and (2) as very high effort very low effort. The center of both lines is marked as just right. They record their program on charts and score each set on both 10 cm lines on each occasion. As they become fitter, the effort scores become easier, and after 3 successive days of scoring a set lower on effort than just right they can add...

Association Of Agentic Extraversion And Affiliation With Two Neurobehavioral Systems

In humans, the incentive state is associated with subjective feelings of desire, wanting, excitement, elation, enthusiasm, energy, potency, and self-efficacy these are distinct from, but typically co-occur with, feelings of pleasure and liking (Berridge, 1999 Watson & Tellegen, 1985). This subjective experience is concordant with the nature of the lower-order traits of social dominance, achievement, endurance, persistence, efficacy, activity, and energy that all load strongly on the agency personality factor, and with the adjectives defining the subjective state of positive affect that is so closely associated with agentic extraversion ( activated, peppy, strong, enthused, energetic Watson & Tellegen, 1985). Therefore, we have proposed that agentic extraversion reflects the activity of a behavioral approach system based on positive incentive motivation.

Who Does What An Exploration of Family Roles

Another study investigated the association between physical symptoms including headaches (79 ), stomach discomfort (62 ), and back pain (61 ) and work and family roles in a group of 403 women, 25 to 55 years of age (Barnett et al., 1991). Work in itself was not a negative factor, but combined with a positive marriage or partnership, women were more likely to reap physical health benefits from the rewards of their altruism toward their fellow workers and from positive support from supervisors. However, worries at work contributed to complaints of high levels of physical symptoms. The authors stated, The significant interactions between women's family roles and particular work factors underscore the need to incorporate into our research paradigm the non-workplace lives of female as well as male workers (p. 99). They also reported absence of studies of male workers examining the effects of either partnership or parental status on the relationship between workplace factors and physical...

Mediating Mechanisms Motivation versus Anxiety

The developmental predictions regarding how susceptible children are to CL and AL might be further explained by differences in the mechanisms that are triggered by these labels. Mainly, there are two main explanations that have been used to interpret the significant effects in the gender labeling studies. Initially, the results were explained in terms of motivational factors (e.g., Bradbard et al., 1986 Davies, 1986, 1989 Helper & Quinlivan, 1973 Montemayor, 1974). For example, cognitive theories suggest that children do not explore, choose, or perform well in opposite-sex tasks because they are motivated to define themselves according to the gender norms set forth by society. In this view, children make value judgements according to their self-categorization as either a boy or a girl and seek to behave in ways consistent with these values. Similarly, the proposed mechanism by social learning or social cognitive theory is also motivation. Children's motivation to avoid doing well or...

Psychosocial and Supportive Care

Honing social and interpersonal skills is an important developmental milestone during adolescence. Cancer treatment for these patients must accommodate this important developmental process. We have discharged a patient from the intensive care unit to allow her to attend her senior prom, and readmitted her when the party was over. Yet boundaries must be set, so that treatment effectiveness is not compromised to keep a social calendar. Certainly, cancer therapy causes practical problems in social arenas. Adolescent and young adult patients, who are developmentally dependent on peer-group approval, often feel isolated from peers by their experience the cancer patient's issues are illness and death, while their peers are consumed by lipstick and homework. All adolescents agonize over their personal appearance and hate to be singled out or to appear different. In adolescents with cancer, having to be isolated from peers and society by having a disease that makes them different and having...

Voluntary False Confessions

Alternatively, a voluntary false confession may result from the individual's unconscious need to expiate guilty feelings through receiving punishment. The guilt may concern real or imagined past transgressions or, occasionally, may be part of the constant feeling of guilt felt by some individuals with a poor self-image and high levels of trait anxiety.

IOpiates and Affiliative Behavior

Ance in high-SC subjects, such that the high- and low-SC groups became statistically indistinguishable in their responses to either film. This suggests that the differences in affiliative stimulus-induced feelings of affection and warmth and heat tolerance between high- and low-SC subjects are in part due to variation in opiate functioning. Although differences between the two groups did not appear to be related to social desirability and its correlates (self-esteem, diffidence), other unmeasured factors that might affect affiliative ratings to affiliative film material (e.g., attachment styles, rejection sensitivity, mate experiences) need to be controlled in future research.

Return to Work after Coronary Interventions

One of the objectives of coronary interventions is to enable patients to return to work. This is also one of the aims of the cardiac rehabilitation programs offered to these patients. The inability to resume professional activities after coronary interventions may constitute a stress (and therefore a risk factor) for the patient due to a loss of self-esteem and earnings.

The Impact of Psychiatric Illnesses

There has been a considerable amount of research on the manner in which certain functional psychiatric illnesses can affect the reliability of testimony (78,79). Thus, anxiety increases a suspect's suggestibility and depression can lead to feelings of guilt and poor self-esteem that render a suspect vulnerable to providing a false confession (52). Psychiatric illness may also render a person unfit for interview by virtue of its effect on cognitive processes or because of associated thought disorder (80,81). However, careful questioning that avoids the use of leading questions and coercive pressures can often elicit reliable testimony. That a suspect suffers from an illness, such as schizophrenia, does not necessarily mean that he or she is unfit for interview (82) such an opinion would depend on the likely demand characteristics of the interview and the functional assessment by the doctor.

Academic Selfperceptions And Mental Health

But more importantly, we found that variations in mental health related to the trajectories of change in risk status. These results were summarized in Figure 14.3. The incliners had significantly higher self-worth than the decliners at Time 2 even though they were performing more poorly in terms of their grades (see Figure 14.4) at that time. Furthermore, when they were adolescents (at Time 4), they still had significantly higher self-worth in addition, they were more satisfied with their lives and reported higher levels of ego resilience and less anger than the decliner group. We looked at the issue of co-occurrence in one other way (Roeser & Eccles, 1998). Using only the middle cohort of children in the CAB study (those in Grade 2 at the start of the study), we clustered the children based on indicators of academic motivation (ability self-concept and academic valuing) and mental health (a composite of scores on depressive affect, self-esteem, and anger scales) when they were in...

Lay Led Self Care Management Programs

One model of a lay-led generic chronic-disease self-management program that has been adopted worldwide is known in the UK as the Expert Patient Programme, developed at Stanford University by Kate Lorig.10 In this program, two specially trained lay-people who have a chronic illness, using a manual and a preordained script, lead a group of other patients with chronic illnesses through a 2 hours a week, 6-week program. It involves problem solving, decision making, and confidence building to increase self-efficacy goal setting relaxation techniques and educational sessions on managing pain increasing activity levels and dealing with medical personnel. Evaluations have shown that it reduced hospital admissions and use of healthcare resources, increased feelings of self-efficacy, knowledge about the

Sex Differences In Personality Traits Coping And Stressrelated Psychiatric Disorders

Gender differences in personality styles and coping responses have been well documented (see Table 10.1 for a summary of these). In a classic review of research, Maccoby and Jacklin (1974) reported that men are more assertive and dominant than women, and that women are more anxious than men. Feingold (1994) extended these findings in a meta-analysis and reported that men are more assertive and have higher self-esteem, whereas women have higher levels of extraversion, anxiety, trust, and nurturance. On the other 1. Men are more assertive and have higher self-esteem than women.

Program Structure

Of patients receiving pacemakers is rising, and this is also a group suitable for exercise-based rehabilitation. The use of implantable cardioverter defib-rillators to prevent sudden death is increasing, and with it the referral of such patients to cardiac rehabilitation. Most programs are still gaining experience in this area,3 but it is becoming apparent that the training benefits include an improvement in self-confidence, increased functional capacity, and an enhanced quality of life.


There may well be economic consequences to the chronic pain, in terms of lost or reduced opportunities to work. Issues of compensation and litigation may compound the issue (Skevington 1995 Melzack and Wall 1996). The sense of self-worth associated with being a productive independent person will be affected. Self-esteem or lack of it can be very influential in determining an individual's reaction to chronic pain. Ability or desire to cope constructively with the pain may be reduced if a sense of low esteem, depression, loss of

Approval Disapproval

Clients who seek their interviewers' approval may be feeling temporarily insecure or suffering from longstanding needs for approval. Strong needs for approval may stem from feeling rejected and disapproved of as a child. Giving approval can be a powerful therapeutic technique. Interviewer approval can enhance rapport and increase client self-esteem. It also fosters dependent relationships. When a client's search for approval is rewarded, the client is likely to resume a search for approval when or if the insecure feelings begin again.

Chronic Pain

Physical therapy is often the cornerstone of the treatment of chronic pain (103). Interventions include general conditioning for problems like fibromyalgia, desensitization for reflex sympathetic dystrophy, and stretching or strengthening particular muscle groups. In addition, therapy such as transcutaneous electrical nerve stimulation, heat, and massage may benefit certain pain problems. There has been limited controlled research in this area, but anecdotally a graduated physical exercise program appears to be an important intervention in the treatment of many chronic and persistent pains. Whether this represents the impact of the therapy itself, the ongoing relationship with a helping, caring professional, or improvement in self-efficacy when success is achieved is unclear. Regardless, there are reasonable data to suggest that physical therapy is essential for the adequate treatment of chronic and persistent pain.

Positive emotions

Physical and emotional symptoms are common as are cognitive and psychological ones. In this chapter we shall concentrate on the physical-emotional aspects. Physically the patient may feel tired with a loss of appetite, or they might have feelings of restlessness and tearfulness. There my be disruption of sleep with depressed thoughts reverberating in the wakeful periods. A sense of apathy may dominate their approach to life, with perhaps a sense of hopelessness, worthlessness and poor self-esteem. There may be feelings of guilt (Minghella 1992). There seems to be a tendency for women to be more likely to suffer from depression (Haley et al. 1985). There does not seem to be any evidence that a depressive reaction to pain is a personality factor. It seems to be a changeable reaction rather than a fixed personality characteristic. Scores on the depressive scale of personality inventories of people in pain change after treatment (Sternbach 1974), and self-esteem scores improve also after...

Heart Failure

A 1999 review summarized instruments used in clinical studies up to then.49 A review to 2005 identified over 150 intervention studies in heart failure using HRQoL assessments.34 This reflects in part the increased attention to pharmacological management of this population. Heart failure groups have been examined using a number of generic HRQoL instruments.5051 A number of disease-specific HRQoL measures have been published for use with patients with heart failure, for instance the Chronic Heart Failure Questionnaire,52 the Minnesota Living With Heart Failure Questionnaire (MLHF),10 and the Kansas City Cardiomyopathy Questionnaire (KCCQ).53 The MLHF is the most widely used but there are promising psychometric profiles emerging in work with the more recently developed KCCQ. The MLHF questionnaire is a 21-item instrument which includes physical and psychological impairments that patients often relate to their heart failure. The KCCQ contains 23 items and measures physical limitations,...


Found social and occupational discrimination (91). All these factors can lead to personality problems, which include feelings of insecurity, low self-esteem, and dependency. Individuals with these personality traits are likely to be highly suggestible and may strive to please interviewing officers by giving answers that seem plausible and consistent with the external cues provided, even though the responses are known to be untrue.

Healthcare Provider

The multidisciplinary nature of CR offers a valuable forum for educating patients, motivating behavior change, monitoring behavior change, reinforcing messages, and providing feedback to patients. The multidisciplinary CR team's effectiveness at promoting adherence can be enhanced through the diverse skills base of the CR team. For example, the exercise specialist can encourage safe, effective, and regular practice of exercise strategies in a manner which promotes increased self-efficacy and habit formation the dietician can illustrate how to substitute healthier behaviors or products rather than asking patients to undertake a loss-focused strategy of removing unhealthy aspects of their dietary lifestyle the psychologist can help manage psychological distress that may inhibit adherence and, furthermore, may provide inputs to the other members of the CR team in relation to motivating and rewarding behavior change.

Selfworth Theory

Covington is concerned with children's need to maintain positive self-esteem particularly when they are faced with repeated failure experiences in school and other skill-based activity settings. Covington (1992) defined the motive for self-worth as the tendency to establish and maintain a positive self-image, or sense of self-worth. Because children spend so much time in classrooms and are evaluated so frequently there, Covington argued that they must protect their sense of academic competence in order to maintain their sense of self-worth. One way to accomplish this goal is by using those causal attribution patterns that enhance one's sense of academic competence and control attributing success to ability and effort and failure to insufficient effort (Covington & Omelich, 1979 Eccles et al., 1982). Attributing failure to lack of ability is a particularly problematic attribution that students usually try to avoid. However, school evaluation, competition, and social comparison make it...


The personal meaning of the model is what is important, often socially determined through our relationships with others, individuals or groups (Braine et al. 1984). One of the most important concepts is that of self, what we think we are like ourselves. This relates to the esteem with which we hold ourselves and the potential which we see for ourselves (Rogers 1961). It also involves a sense of ability to cope with various aspects of our life, our self-efficacy (Bandura 1977). This affects our thought processes, problem solving, persistence in pursuing goals, decision making when choices have to be made, and dealing with uncertainty and stress.

Learned Helplessness

Self-Efficacy Training Self-efficacy training has also been used to alleviate learned helplessness. For example, Schunk and his colleagues have done several studies designed to improve elementary school-aged children's (often low-achieving children) math, reading and writing performance through (see Schunk, 1994 Pintrich & Schunk, 2002). The training often includes skill training, enhancement of self-efficacy, attribution retraining, and training children how to set goals. Modeling often is an important aspect of this type of training. A number of findings have emerged from this work. First, the training increases both children's performance and their sense of self-efficacy. Second, attributing children's success to ability has a stronger impact on their self-efficacy than does either effort feedback, or ability and effort feedback (e.g., Schunk, 1983). Third, training children to set proximal, specific, and somewhat challenging goals enhances their self-efficacy and performance....

The Chapman Family

Jenkins, in her late 30s presented with a lifelong history of headaches, emotional neglect, a brutal rape as a teenager, and desertion by her fiance on the day of her wedding. Eventually, she married a man who was domineering and generally disregarded her opinion. She rarely expressed any opinions, as she deemed them to be valueless. In short, her self-esteem was highly compromised. Her life centered around her two daughters, Ellen, age 11, and Sandra, age 9, and her job in the health-care field. Mr. Jenkins valued his wife as a fine homemaker and a very good mother.

The School Context

In addition to familial influences, researchers have emphasized the significance of adolescents' perceptions of the school environment in studies of contextual-level influences on adolescent development (Epstein & Karweit, 1983 Kuperminc, Leadbeater, Emmons, & Blatt, 1997 Minuchin & Shapiro, 1983 Roeser & Eccles, 1998). Perceptions of the school climate, or the quality of interactions and feelings of trust, respect, and support that exist within the school community, have been found to influence (both concurrently and prospectively) students' self-esteem, psychological adjustment, level of anxiety, problem behavior, academic self-concept (Grobel & Scharzer, 1982 Kuperminc et al., 1997 Roeser & Eccles, 1998), and school behavior (Hoge, Smit, & Hanson, 1990 Sommer, 1985).


Lazarus (1991), in his cognitive motivational-relational theory of emotion, argues that the attributions made in the appraisal of a potential threat play an important part of our emotional response (see also Chapter 4). The motivational aspect refers to the current drive to do something about the situation. The cognitive appraisal of the situation assesses its meaning to the individual. He described primary and secondary appraisal. The first refers to the assessment of the relevance of the situation to personal goals, its potential effect on self-esteem and personal commitments. Secondary appraisal relates to responsibility, blame or credit, coping potential, whether the future of the situation will lead to improvement or deterioration. The emotional outcomes from such an appraisal, for example, could be anxiety if there is uncertainty shame if a sense of personal failure is the result of the appraisal sadness if loss is identified.

The meaning of pain

However, there can be seen to be a fourth kind of meaning of pain, and that is the meaning given to the individual as self-knowledge gained through the way in which they cope with the experience. The self-concept is one of the main concepts created in the process of cognitive development. It plays a major role in the outcome of the pain experience. We have considered some aspects of it above in looking at self-esteem, attributions of responsibility and self-efficacy for example. An awareness of the changing, developing nature of the self-concept must play an important part in planning care Self-efficacy and control The appraisal of the self and the situation is related to control and coping. Self-efficacy is an important part of motivation too (Bandura 1977). The sense of control is seen as being two dimensional, either an external locus or an internal locus (Rotter 1966). Some argue that a positive appraisal of self is more important than sense of control (Wallston 1989 Victor et al...


Cloning Dolly

In the public imagination, Dolly became a breakthrough in the struggle against perishability, and many pondered the possibility of extending life through facsimiles. Some simply hoped that cloning technology would make it possible to recreate loved ones from preserved tissue (in the mode of Creator, starring Peter O'Toole) from recently deceased children or favorite pets, but, inevitably, self-love conquered, and the idea of perpetuating oneself became a preoccupation of wistful dreamers. Richard Dawkins, the evolutionist and popular science writer, stated his own preference to recreate himself through cloning and challenged the rest of us

Employment Status

Unemployed and retired individuals are at a higher risk for suicide (Kposowa, 2001). Loss of employment can produce emotional distress for people of any age, sex, or ethnic background emotional distress as a contributor to suicidal behavior has been closely linked to substance abuse and depression (Overholser, Freiheit, & DiFilippo, 1997). Individuals who have retired sometimes report experiencing a loss of personal identity, meaningfulness, and self-esteem, which may be related to the increase in suicide after age 60.


Depression can range from normal sadness triggered by loss or mourning to a severe feeling of overwhelming hopelessness. Depression is often accompanied by loss of appetite, fatigue, sleeping problems, poor concentration, inability to enjoy normally pleasurable activities, and low self-esteem. Many cases of severe depression appear to be caused by imbalanced chemistry in the brain. Low levels of certain neurotransmitters, including serotonin and norepinephrine, can produce depression. Synthesis of these neuro-transmitters is dependent on both amino acid precursors and enzyme systems that contain essential micronutrients.3 5 Therefore, optimum diet and nutrition can enhance neuro-transmitter levels in the brain and influence mood.

Preparation for Bias

Parents' preparation for bias, like parents' cultural socialization, has been hypothesized to protect children from threats to their self-esteem and well being posed by the race-related stressors they encounter (Spencer, 1983 Spencer & Markstrom Adams, 1990). However, empirical studies regarding the influences of preparation for bias on youth have produced inconsistent results. A few studies have supported the view that preparation for bias serves the sorts of protective functions that scholars have proposed. (Bowman & Howard, 1985 Knight et al., 1993 Spencer, 1983). However, other studies have indicated that children are negatively affected by parental socialization regarding the existence of racial barriers (Fordham & Ogbu, 1986 Marshall, 1995 Smith, Atkins, & Connell, 2003). For instance, in a study of southern African American fourth-grade children, Smith, Atkins, and Connell (2003) found that children's perceptions of racial barriers significantly predicted lower reading and math...

Pyd And The Five Cs

Inspection of the modification indices suggested several changes to improve model fit. Considering that we found high intercorrelations among the indicators, modifications to allow correlated residual errors among the indicators were implemented. Specifically, residuals from three indicators, social competence, academic competence, and self-worth, were allowed to correlate on the assumption that scores on these scales, having all come from the Harter SPPC scale (Harter, 1998), shared method variance not accounted for by the model. The freeing of these residuals resulted in a significantly better model (x2 1455, df 144 p .01 RMSEA 0.073 GFI 0.92 CFI 0.96 NNFI 0.95). The modification indices suggested that for the revised model indicated that model fit could be further improved by correlating two more pairs of residuals positive identity with academic competence and positive identity with social competence. Such relations may reflect the theoretically and empirically established...

Test Anxiety

In addition, we know that academic performance anxiety predicts decreases in self-worth over the junior high school transition (Lord, Eccles, & McCarthy, 1994) which in turn predicts increases in depression, truancy, dropping out of school and alcohol use over the secondary school years (Eccles et al., 1998). Academic performance anxieties in late middle childhood also predict lowered educational and occupational aspirations much later in life (Vida & Eccles, 1999). For example, using Structural Equation Modelling (SEM) with data from our MSALT study, Vida and Eccles investigated the relation of sixth- and seventh-grade academic performance anxieties to occupational values, a sense of personal efficacy for jobs in business and science, and ability self- concepts for skills in leadership, independence and intellectual activities at age 20. The results from this analysis are illustrated in Figure 14.7. After controlling for actual GPA in junior high school, intellectual anxieties in...

Reactive Covariance

More probable as an explanatory framework is evidence documenting how reactive covariance patterns between infant temperament and subsequent caregiver behavior patterns can be moderated by a variety of nontemperamental infant and adult characteristics (Slabach et al., 1991). For example, trajectories of caregiver response patterns toward their difficult infant have been shown to be moderated by factors such as infant gender (Maccoby et al., 1984), maternal substance abuse (Schuler, Black, & Starr, 1995), and maternal attitudes about how responsive they should be toward their infant (Crockenberg & McCluskey, 1986). Similarly, level of environmental chaos in the home has been shown to moderate the relation between infant difficult temperament and lower parental self-efficacy beliefs, with this relation occurring significantly more often in low chaos as opposed to highly chaotic homes (Corapci & Wachs, 2002). The overall pattern of findings supports a hypothesis that infant temperament...

Why Am I Doing This

However, Nicholls (1989) also suggested that the ego-goal orientation becomes more prominent for many children as they get older, in part, because of developmental changes in their conceptions of ability and, in part, due to systematic changes in school context. Dweck and her colleagues (see Dweck, 1999) also predicted that performance goals should get more prominent as children go through school because they develop a more entity view of intelligence as they get older and that children holding an entity view of intelligence are more likely to adopt performance goals. Evidence supports these predictions (see Dweck, 1999 Midgley, 2002). In terms of mental health and engagement, this developmental shift is likely to lead more to increased disengagement and lower self-esteem for those children who have difficulty with school-based learning tasks. In this section, we have reviewed the evidence for changes in children's goals for doing school work. Because interest...


Researchers interested in the remediation of these motivational difficulties have turned increasingly to programs targeting both cognitive and motivational components. These studies illustrate both the need to attend to both motivational and cognitive factors, and the fact that different kinds of strategy instruction are more or less effective in enhancing performance, depending on how they influence motivation. This work now needs to be extended to children of different ages to determine whether the strategy instruction and motivation enhancement techniques need to be modified for younger and older children. Further, work is needed to develop programs that integrate various approaches, particularly those approaches associated with self-efficacy, goal setting, and self-regulation. More broadly, however, as valuable as these individual-focused programs are, they are likely to have little lasting benefit if home and school environments do not facilitate and support the changes....


Anxiety, depression, and reduced self-confidence are common reactions to a coronary event. Failure to address these issues means a prolonged negative response from a patient toward their illness and poor psychological adjustment is predictive of subsequent mortality.13 The ideal means to reassure a patient is for the cardiac rehabilitation nurse to have an individual consultation with the patient and his or her family. It is important that the multidisciplinary approach is well coordinated with the involvement of all relevant staff as required.

Feeling Validation

Feel supported and more normal because of their interviewer's validating comments. However, this is a controversial issue because some theorists believe that directive and supportive techniques such as feeling validation enhance self-esteem only temporarily, based on the therapist's input rather than real or lasting change in the client. In addition, when therapists liberally use feeling validation, it can foster dependency. As a therapeutic technique, feeling validation contains approval and reassurance, both of which usually produce positive feelings in the recipient. This may be why friends or romantic partners offer each other frequent doses of feeling validation. Enhanced client self-esteem or feelings of normality (perhaps only temporarily).

Self Efficacy Theory

Bandura has also proposed a social cognitive model of motivated behavior that emphasizes the role of perceptions of efficacy and human agency in determining individuals' achievement strivings. Ban-dura (1977) defined self-efficacy as individuals' confidence in their ability to organize and execute a given course of action to solve a problem or accomplish a task. In his more recent writings (Bandura, 1994), Bandura characterizes self-efficacy as a multidimensional construct that can vary in strength, generality, and level (or difficulty). That is, some people have a strong sense of self-efficacy and others do not some individuals' efficacy beliefs encompass many situations whereas others have narrow efficacy beliefs and some individuals believe they are efficacious even on the most difficult tasks, whereas others do not. As in expectancy-value theory, Bandura's self-efficacy theory focuses on expectancies for success. Although Bandura distinguished between two kinds of expectancy...

Late Effects

Given the high cure rates for testicular cancer, the long-term impact of surviving cancer and its treatment has gained importance. While undergoing treatment, fear of cancer, sleep disturbances, and cognitive dysfunction occur frequently ( 21 . After therapy, a minority of patients (10-15 ) report continued fear of cancer, sleep disturbances, and inability to concentrate, complete tasks, or think clearly. Symptoms of anxiety or depression persist in 30 of survivors at an average of 9 years after therapy compared to 5 of controls 22 . Conversely, other investigators have found no difference in the level of psychological functioning of long-term survivors versus normal controls 23 . Some have even reported improvement in areas such as personal optimism, family relationships, perceived quality of life, and self respect 24 .