The Long Term Effects of Child Sexual Abuse Essay Example for Free

The Long Term Effects of Child Sexual Abuse Essay Abstract Childhood sexual abuse is a serious concern that has been associated with long term effects amongst survivors. Using secondary data, this qualitative piece of research explores the long term effects of child sexual abuse in later adult life. The purpose for this study is to create awareness to professionals that sexual abuse effects continue long after the abuse stops thus, sufficient knowledge on the characteristics of the abuse. The long term effects focuses on three developmental domains; emotional social and behavioural. The emotional aspect looks at depression, feelings of guilt and anxiety. The social aspect focuses on relationships and intimacy, and the behavioural aspect will discuss issues self-destructive behaviours. Results from the research highlight that the long term effects are not consistent across the three domains. Thus, child sexual abuse is viewed as a risk factor, as opposed to an actual cause to the effects. Nevertheless, knowledge on the long term effects is imperative, to provide appropriate support and services. Research recommendations are discussed. Acknowledgments The writing of this dissertation has been one of my biggest challenges thus far; as emotional as it was, I am pleased that I decided to follow through with my chosen topic. I have learnt so much in the process, both academically and personally. This dissertation would not have been possible without the support and guidance of several individuals. First and foremost, I would like to give thanks to God for providing me with the strength and courage to undergo such a huge challenge. I would like to say a special thank you to my beloved family and friends who have given me their support and understanding over the past five months. I am really grateful to be blessed with such wonderful people, may God bless you all. I would like to express my deepest gratitude to my dissertation tutor, Tricia Ayre. Thank you for your invaluable assistance from the beginning to the end. Your support has meant a lot and kept me on the right tracks. Thanks. Thanks to my manager and colleagues at my final year placement who also showed me a generous amount of support. A great effort has been put into enabling children to disclose their abuse, interventions and laws to protect survivors from such abuse. However, how the abuse effects the survivors has received comparatively little attention, (Nelson and Hampson 2008). Research has documented that survivors are more prone to suffer from physical, social emotional, cognitive and behavioural problems than non survivors, (Piper 2008, Nelson and Hampson 2008, Sanderson 2002). This is vital knowledge; as such effects are likely to have an impact on the survivor’s well-being. The aim of the research is to explore the long term effects of CSA in three developmental domains; Social, Emotional and Behavioural. The three domains are associated with The Framework for the Assessment of Children in Need and their Families, (Department of Health 2012). Each domain plays a vital role in the developmental needs of a child, interruptions in one or more of the domains can lead to a child not meeting their full potential, (Department for Education and Skills 2004). The Framework for the Assessment of Children in Need and their Families, highlights the importance of these specific developmental domains in order for a child to achieve, it is for this reason why I have chosen to explore these areas. The emotional aspect will discuss depression, feelings of guilt and anxiety. The social aspect will focus on relationships and intimacy, and finally the behavioural aspect will discuss issues self-destructive behaviours. CSA can leave survivors with both short and long term effects. This view is supported by Ferguson (1997), ‘as well as the immediate effects of such abuse seen in childhood, findings from research have reported how the impact of CSA can affect the lives of adult survivors. ’ â€Å"Sexual abuse is a traumatic and damaging experience which can affect a child’s capacity for trust, intimacy, mental health and emotional development and ability to achieve both educationally and socially†,( London Child Protection Committee 2005). As a result of the damage caused, it is likely for survivors to come into contact with professionals and services to address issues they may be undergoing. However, not all victims will disclose that they are survivors of CSA due to shame and embarrassment. In some cases, the individuals may not be aware that their present issues are related to their past abuse therefore will not feel the need to make the professional aware. Only 27 per cent of abused women attending general practices disclosed childhood abuse to their doctors, (Mammen and Olsen 1996). Therefore, it is important for professionals to have sufficient knowledge of the long term effects of CSA, as unknowingly may well be working with survivors. Long term effects of CSA can interfere with survivor’s mental health and well being, for these reasons social workers are likely to work with such service users, empowering them to reach their full potential. Thus it is imperative that social workers are aware of and familiar with the symptoms and long term effects associated with childhood sexual abuse, to gain a better understanding of how to support such service users, (Hall and Hall 2011). I have taken an interest in this subject for a number, as whilst undergoing my social work placement in a women’s prison, I worked with offenders with drug and alcohol misuse. A number of women disclosed that as a child, they had experienced a form of sexual abuse as a child. Anecdotally, many of the women used substances to control their emotions or repress the painful memories from their childhood. Research findings from Nesse (1994) states that drugs artificially induces pleasure or blocks normal suffering and are routinely used to block defences; such as pain and anxiety. Substance misuse can lead the individual to experience issues in areas such as social, emotional, and behavioural, (National Institute on Drug Abuse 2004). Without the prisoner disclosing their past abuse, or the professional not being aware of the long term effects caused by CSA, the effects of the abuse can go unnoticed. Consequently issues surrounding their drug misuse are addressed however; the underlying problem of CSA still remains. As a newly qualified social worker, it is important that I am aware of both the short and long term effects of CSA, as there is a likelihood of meeting with survivors in my work environment. Being able to identify the effects, would allow me to develop a more effective way of addressing the service users immediate needs, making sure they are aware of the supportive services available in the community. Therefore conducting this piece of research would have a positive contribution towards my professional development, as I would be equipped with sufficient knowledge and understanding, prior going into practice. Conducting research into this field I believe will also have a positive impact on my personal development, as I am a survivor of CSA. Although it is important for professionals working with survivors to be aware of the effects, it is equally important for the survivors themselves to be aware that the effects can continue long after the abuse stops. Through considerable media attention public awareness on CSA has increased throughout the years, though CSA is not a recent phenomenon. CSA is a social problem that has been of concern during earlier historical periods, (Conte 1994). According to Jeffery (2006), prior to the 1960’s there was very little mention of CSA. CSA and incest was seen as a taboo, (La Fontaine 1988). As this taboo was often shared by the victim, family and professional the problem remained widely unrecognised, (Bentovim et al 2009). In 1908 the Incest Act was established and incest became illegal. However, this era was still seen as ‘The time of silence’, as it was literally impossible to think about disclosing or debating sexual abuse, such acts were not accepted and viewed as forbidden. (Carlsson 2009). The Children Act in 1948 introduced child care departments to be set up in local authorities. Under the 1948 Children Act, it became the duty of a local authority to receive the child into care in cases of abuse or neglect, (Spicker 2007). In the 1940’s there was an interest in CSA by social scientists; large scale studies of sexual practices were conducted, these were known as the Kinsey studies. Findings showed that a number of participants had a sexual experience as a child with an adult, (Jeffery 2006). Even in the light of these and other studies, there remained widespread public and professional denial that CSA took place, Jeffery (2006). However this could be explained, â€Å"Before the 1970’s the justice system was not receptive to CSA: children viewed as presumptively unreliable; hard to prove abuse; general climate of disbelief; little or no training for police or prosecutors on how to investigate, recognize, and prove child abuse†, (Bala 2006). The growth of the woman’s movement was a turning point for CSA; the role of women in society had shifted, women were now encouraged to speak out about their experiences, as supposed to being ashamed and having to suppress feelings. Sanderson (2002) argued that from this exchange of information and the sharing of experiences it became evident that CSA was a common rather than an isolated experience which many women had experienced. In the 1980’s there was an increase in awareness and concern about sexual abuse of children, this was displayed in the increase of reported incidents of child abuse. Professionals were now playing a more active role in protecting children from such abuse; however this was later criticised, as they were seen as acting too quickly in removing children from their parents. In 1987, over 100 children were removed from their families on emergency Place of Safety Orders on the basis of a diagnosis of sexual abuse made by two paediatricians at a hospital in Middlesbrough, (Munro 2007, p. 21). Following the media outcry these events led to a public inquiry, famously known as The Cleveland inquiry. The message from the inquiry was that professionals needed to take a more legalistic approach to collecting evidence, (Munro 2007, p. 21) Two years later, The Children’s Act 1989 was passed, although it was not implemented until 1990. The Children Act 1989 gave every child the right to protection from abuse and exploitation and the right to inquiries to safeguard their welfare, (Batty 2005). The introduction of the Children’s Act, allowed professionals to intervene in cases they suspected a child was likely to suffer from significant harm. From the 1990’s a number of laws and legislations were put in place to prevent and detect cases of CSA, and prosecute abusers. The Protection of Children’s Act was passed in 1999; it aimed to prevent paedophiles from working with Children, (Batty 2005). In 2003, The Sexual Offences Act was passed; it criminalises all sexual activity with a child under the age of 16, (The Crown Prosecution service 2012). In addition to the increase of laws introduced, CSA has triggered a major reaction in the media; as a result CSA has received increasing public attention, (Ferguson 1997). Jeffery (2006) suggested that the increase in reported incidents of CSA over the years is related to a better understanding of the signs and symptoms of abuse and better inter-agency working. Although there has been an increase in the number of reported incidents, CSA is still largely hidden and unreported, so it is difficult to get an accurate picture of the extent of different forms of abuse, (London Child Protection Committee 2005). Pereda et al (2009) reviewed 65 studies from 22 different countries and concluded that the global prevalence of CSA is estimated at 19. 7 per cent for females and 7. 9 per cent for men. The highest prevalence rate of CSA geographically was found in Africa with 34. 4 per cent. This was mainly due to the high rate of abuse in South Africa. South Africa has many migrant workers; due to lack of job opportunities in their vicinity parents left their children alone for weeks to months with relatives or minders, while they travelled to distant places. This exposed the children to all sorts of abuse, especially sexual abuse, (Madu and Peltzer 2000). On the other hand, Europe displayed the lowest prevalence rate with 9. 2 per cent. However, even the lowest prevalence rate includes a large number of victims who need to be taken into account, (Wihbey 2011). Chapter Two 2. 0Methodology This dissertation was conducted to explore and critically examine the current literature on the long term effects of CSA, focusing on three specific domains; social, emotional and behavioural. To begin with, I attended tutorials that primarily focused on how to write and structure a dissertation. With the knowledge gained I was able to compose my first stage proposal form, at this point I identified my dissertation topic, title, rationale and aim. I was then allocated a supervisor; through one to one meetings and emails, I sought advice and guidance on the best approach that suited my dissertation topic. Targets and deadlines were also agreed upon as time management was essential. To aid my literature search I also sought advice from the librarian at the University of West London. All Material used for this dissertation solely relied upon secondary data sources. Data was gathered from the University of West London and The British library. Search engines such as Google and Yahoo were used to search web resources. I initially began by using the phrase ‘Long term effects of CSA’; however the results produced were broad, I decided to narrow my results by searching for the three domains individually, e. g. ‘Behavioural effects of CSA in adulthood’. I then read through the results provided, those that were significant to my research I printed off. Reading the literature thoroughly, I highlighted relevant points, using different colour highlighters for each domain. Findings from this dissertation were presented using qualitative research. As CSA is a sensitive topic, it was important that the approach used suited the content of the dissertation. Qualitative research aims to describe and explain relationships, where quantitative research predicts casual relationships, (Family health international 2011). Presenting the data using qualitative research allowed me to explore the subject in great detail. Family health international (2011) states that qualitative research provides information about the ‘human’ side of an issue; giving the nature of the dissertation I believed this design was the most appropriate. When athering information for the literature review, I primarily focused on literature published in the United Kingdom. However, the research presented was insufficient; I therefore furthered my search to various countries. For this reason, this study will not be based solely in the United Kingdom. The dissertation aimed to reflect both females and males experience of CSA. However, a considerable amount of literature gathered had used female participants. As Jehu (1991 cited in Forensic Psychology Practice 1999) highlighted, in regards to research and treatment literature, male survivors have been neglected. Jehu (1991 cited in Forensic Psychology Practice 1999) further explained, ‘ from a cultural perspective, there appears to be some ‘societal reluctance’ to recognise boys as victims of abuse rather than willing participants in sexual encounters’. As mainly female participants were used, it could be argued that the research is not a representative sample of CSA survivors, this could possibly interfere with the study’s validity. Validity is used to determine whether research measures what it intended to measure and to approximate the truthfulness of the results, (Tariq 2009). It is also possible that the gender specific sample could generate significant bias. As I am a survivor of CSA, it is important to acknowledge that my past experiences are likely to affect how I interpret findings gathered from the research. This could cause possible issues surrounding bias, again affecting the validity of the dissertation. Although material used for this research was based on secondary data sources, if I was to conduct primary research on my chosen topic, a number of ethical issues would have to be taken into consideration, due to the complex and sensitive nature of the subject. Firstly, I would need to ensure that full consent is gained from all participants as this protects the individuals from harm and protects the researchers from having their project deemed invalid or unethical, ( Helping Psychology 2009). It is also important, that I inform participants that they have the right to withdraw from the study at any time. Confidentially is another ethical issue that needs to be implemented when carrying out primary research. ‘The assurance of confidentiality carries with it the implication that non-researchers cannot discover the respondents identity’, (Jamison 2007). In this circumstance, confidentially is necessary as it is possible survivors taking part have not disclosed their abuse. Holmes (2004, p. 120) stated; ensuring that transcripts do not include participant’s names was a way to protect participant’s confidentiality. According to Ghate and Spencer (1995, p. 79), the most important concern when undertaking such research is the after effects of the interview on the survivors, as it may trigger and painful memories. Thus it is essential that researchers carefully balance ethical principles, so that collection of data can occur without harm to participants. Ghate and Spencer (1995, p. 79) suggested that post interviewing would be useful for participants who might have found the interview stressful. Chapter Three 3. 0Literature Review According to Office of the United Nations High Commissioner for Human Rights, (2012) Article 1 the definition of a child is â€Å"every human being below the age of eighteen years unless, under the law applicable to the child, majority is attained earlier. † Sexual abuse can be defined as an umbrella term as existing definitions of childhood sexual abuse are diverse and cover a wide range of factors. Sexual abuse can occur in several forms, these include intercourse, attempted intercourse, oral genital contact, fondling of genitals directly or through clothing, exhibitionism or exposing children to adult sexual activity or pornography, (Putnam 2003). For the purpose of this research, the following definition will be used; ‘CSA is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent or for which the child is not developmentally prepared and cannot give consent,’ (World Health Organisation 1999). . 1Factors contributing to the impact of CSA CSA effects can vary from no apparent effects to very severe ones, such as depression and self-injurious behaviours. The impact CSA can have on an individual can differ according to a multiple of factors. Cited in Piper (2008, Ullman 2003) is in support of this view, he concluded that the degree of impact CSA has on a person varies, studies demonstrated the follow ing influencing factors; age of the child abuse, duration of the abuse, frequency of the abuse, relationship with the offender, severity of the ssault and reactions to disclosure. A number of researchers have established that the age at the onset of abuse is an important factor that can influence the impact of CSA; however researchers share contradicting views in regards to what age the abuse has the most impact on the survivor. Corby (1993 p. 123) supports the view that both the short and long term consequences of sexual abuse are less harmful in the younger children, because of the lack of awareness of the social stigma attached to sexual abuse. Gomes-Schwartz (1990 p. 07) found that their 7 to 13 years age group experienced more adverse reaction than did children in their 4 to 6 years. In contrast, Living Well (2010) suggested earlier onset is linked to greater impact. Baker and Duncan (1985) found that majority of women reporting most perceived ill-effects were abused before the age of 10. Cited in Corby (1993 p. 123, Beitchman et al 1991) raised an important argument; they suggested that age needs to be considered in conjunction with other variables. Studies have found a link between the duration of the abuse and the trauma of CSA. Barriere (2005 cited in Sanderson 2006) reported an ongoing sexual relationship with repeated contacts is generally more traumatic and usually produces more sexual abuse effects than a single contact. Browne and Finkelhor (1986 ) reviewed 11 studies and found that six confirmed the longer the duration of the abuse went on, the more traumatic was the effect on the victim. However, it must be addressed that there are many instances of one –off abuses that can have a traumatic effect on victims; this could be the case if the abuse is linked with violence, (Corby 1993, p. 24). If the abused knows their abuser, it is said that the impact of the abuse is much greater, than being abused by an unfamiliar person. Barriere (2005, cited in Sanderson 2006) supports this view as she states the closer the emotional relationship, the greater the emotional trauma. A reason for the increased trauma could possibly be due to betrayal of trust. CSA can occur in multiple forms, from asking or pres suring a child to engage in sexual activities to behaviour involving penetration. The type of sexual activity the victim is exposed to can influence the impact of the abuse. Groth (1982, p. 129-144. ) has differentiated between the child rapist, who uses force, power, and threats in the sexual abuse, and the abusers who takes the more slow approach and often with considerable affection. The effects on the child will be different. Nevertheless, it is important to stress the effects of any type of sexual abuse can cause considerable damage to the individual, (MacFarlane et al 1986, p. 10). When a child discloses their sexual abuse, it is important to remember the reaction can contribute to how the child will cope from their sexual abuse experience, (Allnock 2010). Conte and Schuerman (1987) found that a supportive response was an important factor in reducing the extent of long term problems following sexual abuse. 3. 2Reasons for limited research Over the past years CSA has received much public attention however, majority of research has focused on the victims as children; comparatively little work has been published on the long term consequences, (Cahill et al 1991). CSA researchers are faced with a number of challenges. The definition of CSA is a reason to why there is lack of research. As there is no universal definition researcher’s definitions can differ, and as a result depending on the definition used in the study findings can vary. The lack of research in the long term effects of CSA is also due to the difficulties in establishing casual connections between the abuse and the later affects years after the abuse. The greater the gap between the abuse event and the later behaviour the less chance there is of casually linking the two because of the existence of more intervening variables†, (Corby, 1993 p107). Effects found in survivors are not always exclusive to the childhood sexual abuse and may reflect other underlying issues, (Sanderson 2002, p. 54). Conducting studies in sensitive areas such as CSA has been proven to be difficult; therefore research in such fields may be limited. Willows (2009, p. 7) found â€Å"People who have experienced abuse in childhood may be understandably reluctant to share their experiences, especially in a research setting†. A study conducted on the ethical issues in research on sensitive topics noted that, participants who had experienced child abuse were more likely to report distress after participating in research, due to remembering the past. However, researchers also found that these participants were more likely to report that participation was helpful, (Decker et al 2011). According to Sanderson (2002, p. 5) another difficulty in assessing the long term effects of childhood sexual abuse, is that through the repression of the trauma, or dissociation, survivors of such abuse may possibly not consciously remember the abuse experience. Therefore findings gathered from research could be effected, interfering with the validly and reliability of the study. Despite the difficulties in undertaking research in the long term con sequences of CSA, a number of authors have made positive contributions to such a high profile topic, (Briere and Elliot 1994, Sanderson 2002, Hall and Hall 2011). Research has documented that CSA survivors are more prone to suffer from social, emotional and behavioural problems than non survivors; difficulties include, however are not limited to, anxiety depression, guilt, difficulty with interpersonal relationships, self-destructive behaviours and lowered self-esteem, (Piper 2008). It is important to be mindful that the effects and degree of such abuse varies from person to person. 3. 3Emotional There have been numerous studies examining the association between a history of CSA and emotional distress, (Sanderson 2002, Beitchman et al 1992, Mullen and Fleming 1999). Emotional effects most commonly experienced by survivors of CSA focus on depression, problems of guilt, low self-esteem and anxiety†, Sanderson (2002 p. 57). Amongst the category of emotional distress, depression has been found to be the most commonly reported symptom among survivors, and empirical findings support this view, (Cahill et al 1991). World Health Organisation (20 12) provides a definition of depression; â€Å"Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration†. Hall and Hall (2011) documented that survivors may have difficulty in externalizing the abuse, thus thinking negatively about themselves. Ratican (1992) furthered this view by describing the symptoms of survivors’ depression to feeling down, having suicidal ideation, disturbed sleeping and eating patterns. The onset of depression has been associated with CSA in numerous studies, cited in Briere and Elliott (1994). Lanktree et al (1991) reported that adults with a history of CSA may have as much as four-time greater chance of developing depression than do individuals with no such abuse history. Beitchman et al (1992) agrees that depression is a significant issue to survivors of CSA. Reviewing eight studies they were able to identify six of the eight identified association between CSA and depression. Similarly, Briere and Runtz (1985, cited in Cahill et al 1991) found a positive correlation, in their survey of undergraduate women, those who had been sexually abused as a child reported experiencing more depressive symptoms in the preceding 12 months compared to non-abused participants. Although there is thorough research to support the correlation between CSA and depression, a small percentage of researchers failed to find a significant difference. Herman’s (1981 p. 56) found that the difference between participants from abused backgrounds and those from non-abused backgrounds proved to be statistically non-significant. His study demonstrated that 60 per cent of abused survivors reported depression, in relation to 55 per cent of the control group. In some cases, no connection was found; Fromuth (1986) undertook research and no relationship were found between depression and CSA survivors. However, her sample consisted of women with the average age of 19. 4 years, whereas majority of the other studies involved older participants. This could possibly indicate that the onset of depression is more likely to develop in later adult life. Having analysed my literature, low self-esteem was another long term effect commonly identified in CSA survivors. Robson (1988) defined self-esteem as â€Å"the sense of contentment and self-acceptance that stems from a person’s appraisal of his/her own worth, significance, attractiveness, competence and ability to satisfy aspirations†. Studies have implicated CSA in lowering self-esteem in adults, (Mullen and Fleming 1999, Herman and Hirchman 1981,). Bagley and Ramsay (1986) documented a low self-esteem rate of 19 per cent with participants from a sexual abuse background in comparison to 5 per cent among the control group. Herman and Hirchman (1981 cited in Cahill 1991) study, they found that 60 per cent of abused victims reported ‘predominantly negative self-image’ in relation to 10 per cent of their control group. Further evidence to support lowered self- esteem in sexually abused survivors is displayed in Jehu et al study (1985 cited in Sanderson 2002); using the Battle Self Esteem Questionnaire, they reported that 86 per cent of sexually abused women generated scores indicating low self-esteem. Roman’s et al (1996 cited in Mullen and Fleming 1999) agrees that low self- esteem is a significant issue to survivors of sexual abuse. The study showed a clear relationship between the two factors. From their findings, they noted that the impact of the abuse contributed to participant’s level of self- esteem. Those who reported the more intrusive forms of abuse, such as penetration, experienced lower levels of self-esteem. CSA is, by nature, threatening and disruptive, and may interfere with the survivor’s sense of security; therefore it is likely that victims of such maltreatment are prone to chronic feelings of anxiety, (Briere and Elliot1994). Sedney and Brook (1984) found from their college sample, 59 per cent of those participants who had history of sexual abuse suffered from anxiety and nervousness in contrast with 29 per cent of those who had no history of abuse. Briere and Elliot (1994) conducted further research and found that sexually abused adults became anxious in intimate or close relationships or frightened when interacting with authority figures, due to being exposed to sexual acts throu gh manipulation, coercion or power tactics upon a child who is not developmentally capable of understanding or consenting to such acts, (Walding 2002). It has been shown that survivors of CSA frequently take personal responsibility for the abuse; this often translates into feelings of guilt, (Hall and Hall 2011). MacMillan Dictionary (2012) defines guilt as â€Å"a feeling of being ashamed and sorry because you have done something wrong†. Hall and Hall (2011) went on to report that survivors often blame themselves and internalize negative messages about themselves. Tsai and Wanger (1978) reported the feeling of guilt could be accounted for by three important factors; due to sexual abuse being a secret act, the abused feels such acts is shameful therefore should not be disclosed to others. Secondly if during the abuse, if the abused experiences any physical or sexual pleasure, this causes them to feel guilty. The third factor is that the abused may feel guilty for not stopping the abuser by not disclosing the abuse and in some way ‘allowed’ it to continue. Jehu et al (1985) provides clinical evidence to reflect Tsai and Wanger (1978) theory. In their study 82 per cent of survivors blamed themselves for the abuse; this was mainly down to their feeling of guilt. 3. 4Emotional Discussion Depression, anxiety, low self-esteem and guilt were identified as the emotional long term effects most commonly displayed in CSA survivors. The four effects highlighted are all issues of identity, confidence and self-worth. In addition to sexual abuse, it is likely the survivor may have undergone emotional abuse from the abuser. This can also contribute to the survivor’s lack of identity and confidence, (Campling 1993). Mollon (2005, cited in Sanderson 2006) states ‘an individual’s cohesive sense of self and core identity is like the individual’s ‘psychological clothes’, without which the individual is naked, exposed and vulnerable’. As impaired sense of self can lead to vulnerability, reoccurrence of abuse is possible thus the adult may come into contact with a social worker for example, rape or domestic violence. This would suggest that working with CSA survivors, social workers would not only need to have understanding of their signs and symptoms but the manner in which they are going to work with them. Social workers would need to carefully consider the most appropriate intervention when working with such service users as it is likely, survivors would be vulnerable. It is important for professionals not to impose their own views, but to empower survivors to define and build on their own sense of self, that is not dependent on external definitions, (Sanderson 2006). Depression and anxiety disorders are both mental health issues. This would need to be considered by the professional involved in the context of the intervention, as well as risk and safeguarding concerns. 3. 5Social The long-term effects of CSA may also extend beyond victims themselves to impact survivors’ interpersonal relations with significant individuals in their lives, (Dilillo 2001). Research and clinical observations have long suggested that CSA is associated with both initial and long term alterations in social functioning†, (Briere and Elliot 1994). Hall and Hall (2011) reported that symptoms correlated with childhood sexual abuse may hinder the development and growth of relationships therefore survivors may experience a variety of interpersonal effects. Mullen a nd Fleming (1999) state in circumstances when the survivors shared a close relationship with the abusers there impac t is likely to be more profound. Isolation is a social long term effect that survivors of CSA may suffer from. â€Å"It has been observed that sexually abused children tend to be less socially competent and more socially withdrawn than no abused children†, (Briere and Elliot 1994). This is echoed in Courtois (1979) study, findings showed that 73 per cent of sexually abused survivors expressed feelings of isolation and feelings of being different from others. Lew (1988 p. 54) reported that isolation in some cases was something that was learnt from the survivor’s hildhood experience. As a way of keeping the abuse a secret, isolation was often reinforced by the abuser. The lack of ability to trust in relationships has been identified in literature, and is considered a major and significant problem. Mullen and Fleming (1999) provided an explanation into why this might be the case, they stated fears of trust or establishing interpersonal boundaries could stem from the breach of trust and the exploration of vulnerability experienced in the abuse. From the findings gathered in her research, Alexander (1992) stated that the history of CSA was found to be related to insecure and disorganised attachments in adult life. Sanderson (2002, p63) applied the view that the experience of CSA created a fear of intimacy amongst survivors. As a direct response there is a constant search for numerous transient relationships, in preference to stable and constant relationships. Jehu et al (1985) research reflects the work of Sanderson, 77 per cent of their survivors reported that it was ‘dangerous to get close to anyone because they always betray, exploit or hurt you’. A small amount of research has demonstrated that adult survivors of childhood sexual abuse experience greater parental challenges than mothers with no history of abuse, (Dilillo 2001). Cohen (1995) conducted numerous investigations and found differences between abused and non-abused mothers in relation to their parenting skills. Women who had been abused performed less well on the all seven scales on the Parenting Skills Inventory, particularly in areas that assed role support, communication and role image. Van Scoyk et al (1991) provided an explanation into why previously abused parents lack particular parenting skills. They reported these individuals may possibly have inadequate opportunity to observe and learn from healthy, effective parenting models. However, Coleman and Widom (2004 cited in Brick 2005) disagreed with literature found and stated a history of CSA does not necessarily entail that one will have interpersonal dysfunction. In their study, they found amongst those who were abused about 40 per cent of females and 60 per cent of males were in long term relationships. In addition 90 per cent of participants did not commit infidelity with multiple partners. 3. 6Social Discussion Social workers must strive to establish and maintain the trust and confidence of service users, (General Social Care Council, 2012). Research into the long term social effects has shown that, survivors of CSA could possibly have difficulties in building relationships. Therefore, this could have an impact on the working relationship between the survivor and social worker. Trust is an essential factor in building an effective rapport with service users, (Crowther and Cowen 2011). Given the nature of the trauma, disruptions may arise in the survivor’s sense of safety and ability to trust. For that reason, it is important that social workers are equipped with an understanding of how to build and maintain the trust of survivors, as this may differ from working with service users with no history of abuse. Effective training in this area could possibly avoid issues that may sabotage the working relationship between the social worker and survivor. Therefore, more specialist knowledge would be advantageous. Furthermore, the power dynamics of the relationship may well have an impact on the rapport between the survivor and social worker. Fear of authority could influence the survivor’s perception of social workers. As abusers of CSA are often authority figures who exert their power, survivors may learn to fear authoritative figures, (Croft 2008). The inability to grow and develop healthy relationships for some survivors could possibly raise safeguarding concerns. For example, such effect could perhaps interfere with the attachment between a parent and child, resulting to issues effecting parenting capacity. Dr John Bowlby, founder of the attachment theory believed the earliest bonds between a child and care-giver have a great impact on the child that continues throughout their life, (Cherry 2012). However, due to early experiences in their own childhood, parents may become over-protective in order to protect their child from experiencing the same traumas. Conversely in some cases, this could promote the opposite behaviour and the parent become under-protective as it is difficult to display affection and closeness. In either circumstance the child may experience difficulty in achieving and meeting their full potential, due to impaired or inadequate relationships with the parent. Social workers along with other working professionals have the statutory duty to protect children who are at risk. This is in accordance to section 47 of the Children’s Act 1989, (Northamptonshire Local Safeguarding Children Board 2012). Parenting capacity is one of the three domains for The Framework for assessment of children and families and is essential in securing the best outcomes for the child, (Parker and Bradley 2003, p. 19). Disruptive attachment can cause issues with the child’s emotional warmth, stimulation, guidance, boundaries and stability. 3. 7Behavioural According to Thompson (2012) it is possible that repressed or forgotten abuse may manifest itself in adult life by out-of-control behaviours which can lead to the abuse of self and/or others. According to research evidence, early sexual experiences often have an influence on later sexual behaviour, (Herman 1981, Randolph and Mosack 2006, Wooden 2010). Randolph and Mosack (2006) quoted â€Å"When early sexual experience is abusive, it can exert specific effects on subsequent sexual behaviours†. Findings from their research found that, survivors of CSA engaged in risky sexual behaviour at higher rates than individuals who had not experienced such abuse, (Randolph and Mosack 2006). A number of studies furthered Randolph and Mosack findings and reported that risky sexual behaviour in adults previously abused was exhibited in many forms; having many sexual partners, failing to use condoms during intercourse increasing the risk of sexually transmitted infections and having anal sex, (Batten et al, 2001, Wingood and DiClemente, 1997). Herman (1981, p. 84) research echoed these findings, within her sample of sexually abused survivors 35 per cent of the women had a ‘ repertoire of sexually styled behaviour’, it was found they behaved in such manner for attention and1 affection. Wooden, (2010) provided an explanation as to why some adults with a history of CSA may participate in risky sexual behaviour. He stated that sexual abuse could result in the abused to disregard their own humanity therefore, perform sexual acts in a more promiscuous way. Rape and Sexual abuse centre (2011) provided their account of why survivors take part in such behaviours; they stated that due to survivor’s childhood experience it was possible that they were incapable to separating sex from affection, which then leads to promiscuity or impaired arousal. Thompson (2012) also made a contribution and stated that sexual promiscuity was a way of the survivors taking control of their feelings. In contrast to the above findings, Fromuth (1983) found no significant difference between promiscuous behaviour and the previously abused women who participated in the research. Riley (2011, p. 127) stated that in some cases victims could take the opposite direction and avoid sex entirely. She stated that the abused may often refuse to take part in sexual activity to remain in control of their own body, unlike when they were abused against their will as a child. Krahe et al (1999) found that female survivors of CSA were at risk of suffering from abuse in later life. Moore and Long (2002) suggested that abuse could occur in the form of adult sexual assault, physical abuse or psychological maltreatment. They also stated that a number of factors could increase a woman’s vulnerability towards abuse; learned manipulative behaviour, beliefs and attitudes, low self-esteem and learned helplessness. Survivors of childhood sexual abuse may compulsively attach themselves to unsuitable partners, who frequently resemble their abuser, Sanderson (2002, p62). Russell (1986, p. 2) found that 65 per cent of participants from sexual abuse backgrounds were victims of subsequent or attempted rape, in comparison to 36 per cent of non-abused participants. In addition, her findings also displayed that an average of 43 per cent of women had been subjected to physical violence by husbands or partners compared with 18 per cent of the control group. Bauserman an d Davis (1996 cited in Randolph and Mosack 2006), concluded that the relationship between CSA and adult sexual behaviour may depend on whether the individuals viewed the early sexual experience in a positive or negative way. Research has highlighted another effect of childhood sexual abuse; self-destructive behavior. Van der Kolk et al (1991) quoted â€Å"childhood trauma such as sexual abuse contributes heavily to the initiation of self-destructive behaviour’†. Erdmans and Black (2008) noted the different forms of self-destructive behaviour; self-mutilation, alcohol abuse, eating disorders and in some cases suicide. Wonderlich et al (2001) believed that this behaviour is presented as a result to reduce emotional distress associated with their abuse. Hiebert-Murphy and Woytkiw, (2000) added self-destructive behaviour was a maladaptive coping strategy for managing negative- self direct feelings. The experience of being abused as a child may increase a person’s risk for alcohol-related problems as an adult, (Windom 1993). Scher ;amp; Twaite, (1999, cited in Lee et al 2008) explained survivors may turn to alcohol as a means to block out psychological pain as they dissociate from their traumatic memories. Evidence to support this view can be seen in Langeland and Hartgers (1998) study; they found a significantly higher prevalence of issues surrounding alcohol in abused women than in the non- abused women. A positive correlation was also identified in Peters (1984, cited in Sanderson 2006, P. 126) research, 17 per cent of participants subjected to sexual abuse during their childhood had symptoms of alcohol abuse, compared to 4 per cent of the control group. However, Fleming et al (1998) study displayed conflicting results. There was no relationship found between alcohol intake and a history of CSA. Fleming et al (1998) argued that, the relationship between childhood sexual abuse and the development of adult alcohol problems needed to be researched further, as there is a sufficient amount of evidence to suggest that CSA alone is not a causative factor in the development of alcohol abuse. Eating disorders is another form of self-destructive behaviour. Research indicates a possible relationship between sexual abuse and the development of an eating disorder, (Myers 2005). Nelson and Hampson (2008) suggested a significant number of survivors have issues with food for a variety of reasons; determination to exercise control over their lives, self-hatred, reactions to oral assault, self -comfort in compulsive eating and in extreme cases sometimes the eating disorder is adopted as a wish to die. Johnson et al (2002 cited in Sanci et al 2008), conducted a longitudinal study among 782 participants and found that CSA was a risk factor for eating disorders in early adulthood. Oppenheimer et al (1986) found that women with anorexia and bulimia also reported a high incidence of childhood sexual abuse. Sanci et al (2008) reported discrepant findings, as some studies found that CSA was no more prevalent in females that were not subjected to such abuse. Another form of self-destructive behaviour that could possibly manifest into adulthood as a result of CSA is self injurious behaviour (Briere and Elliot, 1994 and Mundy, 2010) Klonsky and Moyer (2008) defined self injurious behaviour as ‘the causing of intentional, direct damage to one’s body tissue without suicidal intent’. Self injurious behaviour can be displayed in many forms such as cutting, burning or bruising, (Mundy 2010). Briere and Elliot, (1994) reported in their research, that self injurious behaviour is aimed to reduce the psychic tension associated with extremely negative guilt, intense depersonalization and feelings of helplessness. Similar to CSA, self injurious behaviour is often a source of humiliation and shame and grows in secrecy, (Mundy 2010). The pleasure gained from self injurious is not so much the inflicting of physical pain, but the cessation of emotional pain, Mundy 2010). Findings to support the view that individuals from a sexually abused background are likely to conduct self injurious behaviour can found in Gibson and Crenshaw (2010) research, a sample of individuals with self injurious behaviour took part in study and it was found that, 93 per cent of participants reported a history of childhood sexual abuse. The study also identified the more severe, the longer the durati on of the abuse or the more frequent the abuse took place the greater the risk of engaging in self injurious behaviour during their adult life. Briere (1984) also provides findings to support this view; it was found during his community study that 31 per cent of survivors expressed a desire to harm themselves, in comparison to 19 per cent of the non-survivors. 3. 8Behavioural Discussion The long term behavioural effects of CSA can raise safeguarding issues as such behaviours can cause significant harm to the survivor as well as the risk of others. Social work is a profession that works with a wide range of individuals in a number of different situations and settings. Alcohol and Drugs are related to a number of issues involving social services. Goodman (2009, p. ) quoted ‘clients will bring with them multiplicity of concerns; relationship issues, financial problems, housing, risk of offending, health (physical and mental) and behaviour problems. For this reason, it is imperative that CSA knowledge is not limited to social workers in the child protection field. However, it should be extended across the board, as the lon g term effects of CSA can present themselves in different situations. Chapter Four 4. 0Discussion The primary aim of the dissertation was to gain an understanding of the long term effects of CSA in three different domains; social, emotional and behavioural. A review of research suggest that although, there is existing evidence to indicate that survivors of CSA are likely to experience lasting effects in adulthood, findings are inconsistent and further research is required. The inconsistency within the results across all domains, has led me to conclude that CSA is in fact a risk factor, rather than a sole cause of the long term effects. When reviewing the literature, a number of CSA authors were in disagreement of the association between CSA and the long term effects in the different domains. Sharland et al (1996, p. 5) states that evidence supporting the effects of child sexual abuse can not be viewed as reliable as most of the evidence has been anecdotal, or based on unrepresentative or small samples. For this reason, it is not always clear to what extent a given study has identified the unique effects of CSA, (Briere and Elliot 1994). According to Ferguson (1997) ‘a well designed and controlled study following the child victims of CSA into adulthood, would enable the effects of such abuse to be monitored and allow data on possible confounding variables to be collected’. Unfortunately not only will this be expensive but also time consuming, thus as previously discussed in the literature review it is important to note that undertaking research in sensitive topics such as CSA can be difficult, and as a result is likely to be restricted. With respect to the literature, patterns emerged in relation to the period the research was published. Majority of the CSA research was carried out in the late 1980’s and 1990’s. Although up-to-date statistics on the prevalence of CSA were referred to, current studies relating to the effects of CSA were limited. The sudden rise in research can be linked with the increased awareness and concern of CSA at the time. â€Å"†¦ it was not until the 1980’s that the existence of CSA, in particular, fully entered the public consciousness†, (Pence and Wilson 1994). The lack of recent research may lead me to believe that society still views CSA as a taboo and unpalatable. It is also possible to propose that other types of sexual abuse have diverted the attention away from CSA. For example, sexual exploitation has recently received a great deal of public attention. In a recent report Barnardos (2012) stated that, child sexual exploitation has become a major child protection issue for communities across the UK. As a result of the increase of interest in the other forms of sexual abuse, CSA has been overlooked. The leading writers in the subject appear to be John Briere and David Finkelhor. Both authors published their research between the period of 1980 and 1990. I found that whilst gathering literature for my review I commonly came across both authors, also many other authors commonly referred to their work. Briere’s focused his work on all forms of child abuse and how the abuse affects the survivor’s psychosocial functioning as an adult, (Goldstien 1992). Finkelhor is best known for his conceptual and empirical research on child sexual abuse this is reflected in his publications, (Durham 2006). The most common long term effect highlighted in the literature was depression. Research illustrates, of all the long term effects depression is the most frequently reported symptom amongst CSA survivors, (Briere and Elliot 1994, Sanderson 2002, Lanktree et al 1991). A plausible explanation to why depression is reported as the most frequent effect, can be due to the fact survivors are more likely to seek medical help for this effect in comparison to effects such as guilt or self-injurious behaviour. A number of survivors of CSA who visit their doctors are acutely distressed and depressed, (Mammen and Oisen 1996). Chapter Five 5. 0Conclusion/Recommendations The study demonstrates that the relationship between long term effects in the three domains; emotional, social, behavioural and the history of CSA abuse is inclusive. Therefore, the inconsistency of findings suggests that CSA can be viewed as a risk factor as opposed to a cause for the wide range of long term effects amongst survivors of CSA. Despite the increase in research, further research is required to enable a more in-depth understanding of the long term effects with a more representative sample of survivors. As literature gathered mainly focused on female survivors, results cannot be generalised. With the purpose of improving the quality of professional’s intervention as well as relevant strategies being developed to support survivors. Having undertaken secondary research on the long term effects of CSA, I would recommend that social workers and related practitioners not just in the child protection field but across all sectors have more adequate training in identifying survivors of CSA to ensure they can provide the appropriate care, treatment, support, and also more awareness on effectively handling disclosures. The outcome of this could possibly increase the numbers of disclosures made and may also prevent survivors of CSA suffering in silence. Personally and professionally, I have successfully gained a better understanding on the journey a number of individuals may experience as a survivor of CSA. Although as a survivor of such abuse, prior to conducting the research I was conscious of some of the effects present however, was not fully aware of the severity and the significant implications such abuse had on not only the life of the survivor, but also on other significant individuals in their lives. I believe having such knowledge will have a positive impact on both my personal and professional development as a social worker. Before undertaking the research, I was always reluctant to speak about my experience of CSA; I tended to repress my memories as a way of coping with the abuse. However, increasing my awareness on the topic I believe, has given me the confidence to feel comfortable within myself to openly disclose my past. The research has allowed me to understand that in fact, sexual abuse effects continue long after the abuse stops. I am now able to identify that many of my current issues stem from my history of abuse; as a result a sense of self-blame has been removed.

Summitry Analysis and Diplomacy

Summitry Analysis and Diplomacy This essay represents the perfect and imperfect world of summitry and it also discusses on how summitry can be integrated as a constructive mode of diplomacy. Summitry has indeed changed the landscape of political interactions between states and political leaders across the globe over the past years. In respect to this, Churchill questioned the crowd during one of the House of Commons meeting in 1953, if there is not at the summit of the nations the wish to win the greatest prize of peace, where can men look for hope? (Churchill cited in Eban, 1983, p. 360). The idea behind Churchills statement is that, it explains on how summitry can be an instrument in getting states actors to gather at one place to discuss on international political issues among them (Dunn, 1996, p. 4). Ideally, summits not only have been used as a tool to break down intense barriers between nation states leaders, but it has also helped state leaders to be more focused in addressing issues of their concerns in the best possible way. Although, in the real world of summitry, this is not always the case. As Plischke argues in Modern Diplomacy: It should not be regarded as an instant elixir for the assuagement of crisesà ¢Ã¢â€š ¬Ã‚ ¦to dissimulate relief from the realities of inter-governmental ailment (1979, p. 186). To begin with, this essay will discuss both on some of the possible strengths and flaws of the different types summits. It also argues on how summitry can be infused as a tool of a constructive means of diplomacy and it will also unearth some factors that could help determine the success of summits. The first part of this essay discusses on how summitry could be a tool in the engagement of public diplomacy and followed by with an insight on how timing is crucial in initiating a summit. Meanwhile, the second part of this essay details on how summitry could provide an opportunity for state leaders to administrate and show their capabilities in winning a summit. The perfect and imperfect world of Summitry Summits are designed in such a way where each and every one of them has various themes and different objectives to be fulfilled. One must be able to segregate the different types of summits and its goals in order to further the understanding on the roles of summits. For instance, bilateral, multilateral, regional and global summits. Now, this boils down to one question, how effective are these summitries in resolving the targeted issues? The answer to this is rather subjective. Since each summit has its different purpose, the measure of success would vary as well and therefore it is difficult to layout the positive and negative aspects of summitry in general (Melissen, 2003, p. 4). For instance, the Yalta summit in 1945 and the Paris Conference of Parties 21 (COP 21) in 2015 are seventy years apart and may have little significant in common. Hence, generalising summits into one big picture would be very difficult. Looking at the different types of summits, the Rio Earth Summit or also known as United Nations Conference on Environment and Development (UNCED) was one of the largest intergovernmental global climate conference ever organised. It was represented by over one hundred and eighty countries and participated by over one hundred states and government leaders across the globes. It was indeed a media magnet event that catches the attention of the news and broadcasters from all over the world (Dunn, 1996, p. 220). This calls for an engagement in public diplomacy for state and government leaders. The purpose of the summit was to synthesise the global economic landscape or development towards a more forward looking context which takes into account on the preservation of the environment (The Editors of Encyclopà ¦dia Britannica, 1998). Dunn also mentioned in Diplomacy at the Highest Level: It was hoped that this serve as a blueprint for how the nations of the world could preserve the environment and achieve sustainable development in the twenty-first century (1996, p. 222). In relation to this, the Rio Earth Summit were seen to be a quite symbolic kind of summitry (Dunn, 1996, p. 249). This is due to the nature of the summit in which it possesses a propaganda value to it that could be either used for good purpose or just for the sake of winning the hearts of the domestic and general audiences through their participation. Not only it was the largest and the most costly climate change summit that was ever held, but it was also attended by hundreds of state leaders from all over the world. Hence, the opportunity to engage in public diplomacy was pretty massive (Palmer, 1992). To put it briefly, attending such an eventful summit was worth every moment of being noticed by the public considering the number of media coverage during that time was enormous. According to Dunn, attending the summit was very much an attestation to these state leaders in showing their relentless commitments towards the preservation of the environment regardless if they did not agree upon the discussed agendas during the meeting. They want to be perceived as a leader who cares about just everything and they wish to give an impression to the general public that they are trying to make some changes (1996, p. 249). This approach is often used as a form of public diplomacy and indeed, it can be considered as a constructive mode of diplomacy. For example, Bush used the opportunity to be seen as a good leader by attending the summit despite of the series of situations that was going on in the US during that time. His hands were tight with different kinds of issues including his upcoming re-election. Hence, to be seen under the limelight were one of the many ways for him to attain more credits from the domestic audiences (Dunn, 1996, p. 233). As stated by Hamilton and Langhorne in The Practice of Diplomacy, air travel and television cameras have made world statesmen of the humblest party hacks (1995, p. 221). Having said that, summit has not only been beneficial for s tate leaders but also for the politicians in hope to enhance their status in the public from meeting all these world leaders. In respect to this, symbolic summits are not just limited to this kind of agenda, but it could also exemplify the relations between nations through summits. To support this statement, as documented by Dunn in Diplomacy at the Highest Level: The handshake on the White House lawn between Yasser Arafat and Yitzhak Rabin in 1993 was equally important as an attempt to symbolize the new era of relations between Israel and the Palestinian people (1996, p. 248). On the other side of this coin, level of preparation process in terms of timing also matters in ensuring the success of a summit. Regardless of its positive strand in the engagement of public diplomacy, Rio Earth Summit was barely a mere success. For instance, Rio Earth Summit was not a perfect timing for countries like the US. Considering that US was perceived to be the paramount actor in this conference, but in the actual fact, the US delegations were really keeping their heads down throughout the meetings (Dunn, 1996, p. 233). How does timing has got anything to do with this? In the case of the US, the countrys economy was going through a recession and as mentioned earlier, President Bush was also due for his nearing re-election. One of his main concerns were also the risk of committing into any agreement on the sustainable developmental programmes that was discussed during the summit. The potential results from agreeing to any agreements from the summit were rather ambiguous as i t could jeopardise the USs employment level even further and also, his fear for losing the trust and his wealthy conservative supporters from both the political parties the US (Dunn, 1996, p. 233). Hence, this explains for the quiet actions from the US delegation at Rio Earth Summit. Therefore, the summit could have been more favourable if the US did not have to hold back due to their situations back home. In addition to this, US was not the only one who were torn in leading the conference, the EC (European Community) could have also done a greater job at it but of all the EC state members, only Germany was set on making an equitably significant amount of commitment towards the agreement. The rest of the other EC state members like Italy and France were on the same boat as the US due to their respective issues in their home countries (Dunn 1996, p. 233). As articulated by Weihmiller, Doder and Newsom in U.S.- Soviet Summits, that, timing of a summit has been seen as one of the criti cal factors in ensuring the success of a summit (1986, p. 98). In retrospect, the issue on timing were noticeably reflected during the Kennedy Khrushchev summit in 1961 at Vienna which severely affected the resolution to the root of the problem. It was too soon to be holding another summit as the Paris summit of the year before that were not settled yet and to top it all, the issues with Berlin previously has lead this summit to a total flop (Weihmiller et al., 1986, p. 99). In this context, when summit is initiated at a wrong time, it could lead to a waste of resources and also, affecting diplomatic relations between state leaders as the subject discussed during the conference remains unresolved. Therefore, it remains debateable to as whether or not if summitry can be an elixir or regarded as an effective mode of diplomacy. On a brighter side, summits could also provide room for state actors or non-state actors to show their capabilities in leading a summit especially on international level that could not be consummated on a lower level (Dunn, 1996, p. 251). This has been seen on some climate change conferences such as the recent Paris Agreement (COP 21), Kyoto Protocol (COP 3) or even Copenhagen Agreement (COP 15) in 2009. The European Union (EU) in particular. The EU has tremendously manifested the world with their pro-climate change leadership. What they are doing is an incontestably positive in attracting other state members to follow their footsteps. As Maljean-Dubois and Wemaera states in their journal, Carbon Climate Law Review, EU has always claimed a climate leadership role in the climate negotiations, leading by example with its ambitious climate policy (2016, p. 3). That said, summitry is not only impactful in terms of public diplomacy, but it is also a constructive method in improving diplo matic relations through positive movements by a bold leader such as the EU. Although to be fair, the United States were one of the first and the most powerful supporters of international climate change and environmental agreements. However, the limelight has shifted to the EU as the major leader in global environmental scene (Kelemen and Vogel, 2009). In light of this, summitry can also give a fair opportunity for leaders from small nations to represent themselves on the highest league table and hence, making them more noticeable in the global diplomatic arena. This was proven when the Small Island Developing states (SIDS) and the Alliance of Small Island States (AOSIS) managed to turn the table at the COP 15 at Copenhagen in 2009 (de à gueda Corneloup and Mol, 2013). Climate change is a threat for small island nations especially those of which nations which are prone to extreme weather conditions. As stated by de à gueda Corneloup and Mol in International Environmental Agreemen ts, The raise of sea temperature threatens marine ecosystems, on which small island populations usually strongly depend (2013, p. 282). The SIDS were able to negotiate through the representative organisation, AOSIS and be heard by the rest of the other state members at COP 15. Being in a vulnerable position themselves, this has helped them to initiate action plans through several leadership skills and remained as significant as other state members at the summit. Their perseverance has lead them to some fairly successful negotiations especially on the 1.5 ÃÅ'Ã…  C target as it was finally embedded in the Copenhagen Accord (de à gueda Corneloup and Mol, 2013). However, summits on climate change are often being seen as highly sensitive area and often associated to the level of power that the state actors have. For instance, considering SIDS state members are seen to be on a weaker side as they have very little power on the international level, structural power of state actors is oft en regarded as a determining factor in any international negotiations (de à gueda Corneloup and Mol, 2013). As disclosed by Ambassador Dessima Williams of Grenada at the COP 15 summit: We went in, AOSIS fought for everything we could come out withà ¢Ã¢â€š ¬Ã‚ ¦as you could see we didnt come out with much (Wasuka cited in de à gueda Corneloup and Mol, 2013, p. 291). To put it briefly, no matter how much effort has been pumped into these summits by these weaker states, level of structural power of state actors is still one of the major determinant in negotiation process on any international summits. Summit: yes or no? What can be concluded based on the arguments above is that, despite of its contestations on the effectiveness and its constructive role in diplomacy, summitry has become an indispensable means of convention both on regional and international level. As Dunn argues in Diplomacy at the highest level: Summitry has evolved considerably in the post-war period. From being an exceptional and therefore high-profile event, summitry has developed to become a frequent and routine instrument of international diplomacy (Dunn, 1996, p. 265). However, one cannot deny that summitry has its substantive risks particularly on how the timing matters in initiating a summit especially involving states from all across the globe. The aim of a summit is not to only discuss on the subject of interests, but also to produce a fair outcome by the end of the meetings. Or else, the effort of organising a summit will be in vain if nothing comes out of it. Hence, it is crucial to take into account timing as one of the important factors during the preparation period. Although to be fair, factors like economic recessions and political instability of other state members are something that is rather inevitable. In this respect, the power position of ones state has also been a major determinant in ensuring the success of reaching the summits objectives. On a lighter note, summitry has been proven to be an effective mechanism for some weaker states to be prominent in the global arena despite for its limited structural power. In addition to this, summitry also has a unique nature that it could be use as tool in promoting public diplomacy especially in a global scale summit. This has been utilised as a best practice by state leaders and diplomats in pursuit of grabbing the attention of the public eye including the media. Especially in an era of free flow of information, state leaders and diplomats find summits to be quite amusing as public opinions matters in todays world of politics. Regardless of the outcome of the summit, these leaders do not walk out of the conference with empty handed. Some walk out of the summit with pride and several accomplishments, but in many instances, most of them walk out with just one thing, a free publicity to themselves. Which how I would like to put it as, free-riding at its best.

Shakespeares Macbeth - Innocent and Naive Macbeth :: GCSE English Literature Coursework

Innocent and Naive Macbeth      Ã‚  Ã‚   Innocence is a quality that few people take to their grave, although all are born with it. At some point in one's life, an event or circumstance removes that shield from both moral and legal guilt, whether in one's own eyes or in the eyes of another. In such a case, innocence is cast off, or innocence can be stolen. Both are true of Macbeth in William Shakespeare's tragic work Macbeth. The hero's innocence and naà ¯vetà © make him vulnerable prey for those who feel completely at home in a subhuman realm of malice and disintegration - the witches and Lady Macbeth. Inevitably, Macbeth is eventually worn down enough to be pushed into this dark and evil abyss by his wife, Lady Macbeth, who leaps frantically in after him to join the witches where they are most at home. The robbery of Macbeth's innocence begins with allowing the witches to brainwash him with their predictions forcing him to step closer and closer to the edge of their dismal abyss. They take advantage of the surplus of ambition that had served him so well in his desire for victory over Macdonwald and use it to instill in him the need to be King. Still, desire is not enough for Macbeth and he is thus driven "to seek certainty as his one objective. He wants certainty from the witches . . . at whatever cost" (Campbell 228). Macbeth, however, is not completely lost yet; honour and justice remain in him, and although it takes him some time to fully consider the consequences of the witches' words on him, he rejects his horrible thoughts of murder and postpones all action: "If chance will have me king, why,chance may crown me, / Without my stir" (I. iii.143-144). For the time being, Macbeth's true essence is in control, that of loyalty and honour. However, Macbeth again undergoes a change of heart in scene four, at the announcement of Malcolm as the Prince of Cumberland and as successor to the throne of Scotland, the same throne upon which Macbeth had his eyes set upon. The effect of the King's proclamation on him can be seen through his reaction: The Prince of Cumberland! that is a step, On which I must fall down, or else o'er-leap, For in my way it lies. Stars, hide your fires! Let not light see my black and deep desires; The eye wink at the hand; yet let that be, Which the eye fears, when it is done, to see .

Integrating Students with Exceptionalities Essay -- Education

The delivery of education for students with exceptionalities has evolved from complete segregation to the provision of education within regular classes (Andrews & Lupart, 2000). Integration will be successful if the necessary supports and services are in place within the education system. Regrettably, the public special education system currently in use in Ontario is not meeting the needs of integrating students with exceptionalities in regular class settings. Even now, many educators believe that segregation of students with disabilities is justified and not prejudiced (Valeo, 2009). To abolish segregation from the Ontario public school system there is a definite need for strategies. Although there are challenges, there are numerous methods to promote inclusion through integration of exceptional students to include them in standard curriculum classrooms. One of the challenges that Ontario school professionals face is the amalgamation of regular and special education. This integrated system values, supports individual differences, and works in response to the various strengths, challenges, and experiences of all students. (Andrews & Lupart, 2000). The most debated issue for school professionals and advocates is whether a unified system provides students with better opportunities to learn. The reason for this debate is that school professional question if this type of system will diminish options for exceptional students to receive the individually adapted instruction them (Boscardin, 2005). The goal of inclusion through integration is to make available instructional strategies that effectively produce acceptable educational results for exceptional students, and can be implemented in a manner promoting inclusion. Educators must a... .... (2000). The Inclusive Classroom: Educating Exceptional Children. Scarborough: Nelson Thomson Learning. Boscardin, M. L. (2005). The administrative role in transforming secondary schools to support inclusive evedence based practices (Vol. 33). American Secondary Education. Dixon, S. (2005). Inclusion - Not Segregation or Integration Is Where a Student with Special Needs Belonds. The Journal of Educational Thought, 33-53. Harpell, J. V., & Andrews, J. (2010). Administrative Leadership in the Age of Inclusion: Promoting Best Practices and Teacher Empowerment. The Journal of Educational Thought, 189-210. Tomlinson, C. (2001). How to differentiate instruction in mixed ability classrooms . Alexandria: Association for Supervision and Curriculum. Valeo, A. (2009). Education’s enduring prejudices: disability at the door. Dordrecht: Springer Science+Business Media B.V.

Alcohol Advertising: The Cause of Underage Drinking? Essay -- essays

Alcohol Advertising: The Cause of Underage Drinking?   Ã‚  Ã‚  Ã‚  Ã‚  The question, â€Å"Is alcohol advertising the cause of underage drinking?† seems to flow through the minds of many American families. The answer to the question largely depends upon the families view on drinking in general. Some homes encourage drinking every once in a while, for social purposes; while others condemn it all together. The topic is very controversial with several factors weighing in such as religion, family background, and health. Despite the differing views, statistics have shown that underage drinking has reached a new height this past year. What is the cause of this rise in adolescent drinking? I will be reviewing the work of four different authors in an attempt to answer this question.   Ã‚  Ã‚  Ã‚  Ã‚  Dina Berta grew up with alcohol in her home and believes that alcohol is a part of American life, and is a normal accompaniment to most social events. She said, â€Å"Most Americans enjoy drinking on a regular basis.† She feels that Americans are too â€Å"uptight† and that drinking socially, even underage, is not a problem. George Hacker and Robyn Suriano disagree with her and they feel that underage drinking has become a serious problem and that children are drinking more heavily at a younger age. Suriano states, â€Å"alcohol is the most abused drug in the country, and the number of children trying alcoholic beverages before they reach 18 has doubled in the past decade.† Hacker agrees with this point by giving the statistic that 4.1 million kids younger than 18 tried alcohol in the year 2000. Hacker also states his belief that when the youth drink, they drink heavily and excessively. Suriano and Hacker both agree that the cause of excessive underage drinking is advertisements.   Ã‚  Ã‚  Ã‚  Ã‚  The subject of alcohol advertisements negative effects on the behaviors of young people is very diverse. Most liquor and beer companies agree with Berta that the purpose of alcohol advertisings is to encourage drinkers to try new brands, not to promote excessive drinking. Hacker states, â€Å"despite the intent of the industry, research shows that alcohol advertising does influence young people.† He strongly disagrees with Berta, stating that the advertisements have a negative effect. â€Å"It preprograms them to drink and drink excessively for a â€Å"good time.† ... ...ge drinking and she gives a list of recommendations that all parents should go by in order to alleviate the problem. The opinions of these four authors prove that alcohol advertising is an extremely controversial topic. When questioning American’s youth, you will get varied responses, similar to the conflicting opinions of the authors. Some homes side with Dina Berta and Jon Kate, while others agree more with Robyn Suriano and George Hacker. Alcohol industries see eye to eye with Berta and Kate. Berta feels advertising is fine and that drinking is a normal part of American culture. Kate feels that there is a problem with underage drinking but that advertisements are not the cause. Robyn Suriano and George Hacker feel underage drinking is a big problem and action needs to take place in order to reduce underage drinking. Hacker blames advertisements while Suriano feels the problem stems from both advertisements and the family. As shown, the topic is very debatable, depending largely on personal upbringing and experiences. Hence, the question still remains, â€Å"Are alcohol advertisements the cause of underage drinking?†   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  

CANDLE MAKING IP

Mr.. Meekly Sibyl for lending the book related on the study and for teaching us how to make our product. Mr.. And Mrs.. Romeo F. Aquinas and Mr.. And Mrs.. Ariel Peter M. Seeding for their support to the researchers not only financially but also morally. Their batches from Ill-Titanium. Especially, Sherry Barras, Anomie Lazars, and Jenny Pictorial. ABSTRACT A candle is a solid block of wax with an embedded wick which is ignited to provide light, and sometimes heat, and historically was used as a method of keeping time. A candle manufacturer is traditionally known as a chandler.Various devices have been invented to hold candles, from simple tabletop candle holders, to elaborate chandeliers. For a candle to burn, a heat source is used to light the candles wick, which melts and vaporizes a small amount of fuel, the wax. Once vaporized, the fuel combines with oxygen in the atmosphere to form a flame. This flame provides sufficient heat to keep the candle burning via a self-sustaining cha in of events: the heat of the flame melts the top of the mass of solid fuel; the liquefied fuel then moves upward through the wick via capillary action; the liquefied fuel finally vaporizes to urn within the candle's flame.Chapter I I. Introduction Candles were once used as a source of light and were simple and plain, without color or fragrance. They came in standard sizes and shapes. Now candle making is an art form and candles have become decorative works of art that come in an infinite variety of shapes, sizes, colors and fragrances. They are generally used to create a peaceful, romantic ambiance and are treasured for their relaxing effect. Candles have recently become a big part of home decor and this has encouraged the development of new techniques and materials.The materials you use will determine the quality of your candles but each candle will require a different combination of materials and techniques. Good note taking will allow you to determine what works and what doesn't and when you perfect your candle, you will be able to reproduce it. Whatever doesn't work, can be melted down again and re used. Candle scraps and pieces of shaved wax can all be kept and recycled so nothing goes to waste. Candles were meant to be burned so no matter how beautiful your candle comes out, remember it isn't done until it burns well so keep working t it until you get a good smokeless, even burning candle.Ill. Statement of the Problem This study aims to determine the compare commercial candles to a homemade candle. The objectives of this study are the following: ; To know how long is the duration of the candle ; To know if the candle is smokeless IV. Significance of the Study Candles represent a classic example of the process of combustion. When enough heat is applied, the wax of a candle starts to oxidize. The paraffin reacts with oxygen to produce carbon dioxide and water, and also heat and light. The flame is the visible part Of this exothermic reaction – wher e the reaction is energetic enough to produce visible light.Here are some more facts about candles. V. Scope and Limitation of the Study Our study is about candles using the materials we will use. To know how to make candles and the duration of the candles. To know more about candles and to enhance our knowledge about candles. VI. Definition of Terms Fragrance- a pleasant, sweet smell. Duration- time during which something continues. Exothermic reaction- chemical reaction accompanied by the evolution of heat. Oxidize- combine or become combined chemically with oxygen. Combustion- the process of burning something.Ambiance- atmosphere of a place. Http://www. Overexploitation. Com/library/complaining. Asp CHAPTER II Review Of Related Literature I. Local Literature In the Philippines candles have come a long way since their initial use. Although no longer man's major source of light, they continue to grow in popularity and use. Today, candles symbolize celebration, mark romance, soothe the senses, define ceremony, and accent home decors casting a warm and lovely glow for all to enjoy. II. Foreign Literature Candles were also commonplace throughout Europe.In England and France, Candle making had become a guild craft by the 1 13th century. These candle makers made candles from fats saved from the kitchen or sold their own candles from within their shops. During the middle Ages in Europe, The popularity of candles is shown by their use in Candles and in Saint Lucy festivities. Tallow, fat from cows or sheep, became the standard material used in candles in Europe. The Tallow Chandlers Company of London was formed in about 1300 in London, and in 1456 was granted a coat of arms. Dating from about 1330, the Wax Chandlers Company acquired its charter in 1484.By 141 5, Tallow candles Were used in Street lighting. The trade of the chandler is also recorded by the more picturesque name of â€Å"congresswomen†, since they oversaw the manufacture of sauces, vinegar, soa p and cheese. The unpleasant smell of tallow candles is due to the glycerin they contain. For churches and royal events, Candles from beeswax were used, as the smell was usually less unpleasant. The smell of the manufacturing process was so unpleasant that it was banned by ordinance in several cities. The first candle mould comes from 15th century Paris.The first American colonists discovered that bayberries could be used to make candles, but the yield was very poor. Fifteen pounds of boiled bayberries would provide only one pound of wax. Http://en. Wisped. Org/wick/History_of_candle_making http://www. Candles. Org/about_history. HTML CHAPTER Ill l. Methods and Procedures Materials Paraffin Wax Palette Knife Wick Scent Spoon Double Boiler Crayons Water Scissors Methods Twisted Candles 1. Roll out the upper part of the candle until it is about mm (1/4 in) thick. Leave the bottom 2. CM (in) unrolled so that it can fit into a candle holder.If the candle cracks whilst rolling, then it h as become too hard. Soften it by dipping it for three seconds at 71 co (1 60 OF) and then waiting for thirty seconds. 2. Hold the candle upside-down, with the unrolled base in one hand and the flattened part nearest the base between the thumb and forefinger of your other hand. 3. Pull the candle slowly upwards, sliding it between your thumb and forefinger and turning it steadily. 4. Repeat the process to give a more exaggerated twist. 5. Trim the base flat and allow the candle to cool for one hour. Floating Rose Candles 1.Melt the wax, heat it to 71 co (OFF), and prime the wicks. 2. Switch off the heat, and add twelve drops of perfume to the wax. 3. Carefully pour out the wax on to the paper so that it forms layers about mm (h in) thick, and allow it to cool until it is rubbery. 4. Cut petal shapes with the pastry cutter or palette knife. You will need petals of different sizes. Curve them with your fingers. 5. Squeeze two small petals around a wick and build up a rose flower. Wax t hat has cooled too much and become brittle can be softened with a hair dryer. 6.

Critical Incident Analysis Essay

Engagement with a service user can be a challenging process which needs to be reflected upon by the individual nurse (van Os et al 2004). When a critical or unique incident arises reflection enables the practitioner to assess, understand and learn through their experiences (Johns, 1995). It was also suggested by Jarvis (1992) that reflection is not just thoughtful practice but a learning experience. This assignment is a reflective critical incident analysis of an engagement encounter on a community placement recently using Gibbs (1998) Reflective Cycle (Appendix 1,3). In maintaining confidentiality (NMC, 2004) and privacy, even for reflective pursuance (Hargreaves, 1997), pseudonyms will be used. I will also further reflect on a teaching session I contacted following this incident. Critical Incident analysis During a recent clinical placement with the local CMHT there was a distress call from parents of a client, Mat. An immediate visit by the two co-coordinators and me, followed without checking, or doing a risk assessment. This visit resulted in aggressive and abusive encounter and Mat was then admitted to hospital, (Appendix 2). This incident is critical to me as it presented a learning opportunity as well as a risk of physical harm to me and the nurses with me. As I look back on this incident there are several issues that relate to the role of the nurse. When I look back at this incident, I felt anxious but my thoughts were that this was a learning experience even when it was clear I was the main focus of the aggressive threats (Fazzone, et al, 2000) I knew I needed to remain calm and to assess for escape routes. I made mental notes of these but still I was not sure and everything was happening so fast and my mentor was already telling us what to do. Being able to remain calm could have help and I feel this was a positive thing. As I reflect if I had panicked visibly this could have encouraged Mat to have a real go. It also helped us to remain in control as we walked out of the house. This could have reassured her parents that the nurses were confident of what they were doing. This incident was bad as an engagement with the client did not go well resulting with the client going into hospital. This is usually distressing for most people although hospital is regarded as a place of safety in these circumstances. Even guidelines to the mental health act (MHA, 1983) acknowledge this that hospital can be distressing to others. On a positive note the situation was handled well and no physical harm was done to anyone. It was also a learning opportunity for me, as I gained an insight and now the opportunity to reflect on relevant issues related to risk assessment and management in the community. When the message was received about Mat, a decision was made promptly to visit. On each planned visit I would get an update and I was expected to find out more about the client as well. This usually focused on risk and other necessary background information which would help me understand the intervention and interactions with that client. I took this to be good practice and put one in an informed position. I don’t recall Rita finding exactly what was going on from the parents neither did we check documentation on his file. There are protocols and guidelines on managing risk in the community and the local team had its own arrangements. A good risk assessment through the CPA process will minimise distress to staff, carers and the patient in service provision in the community (Manthorpe and Alaszewski, 2000). All these are resources which are available and it is the nurse’s responsibility to use or adhere to them. Rita is a senior CPN and knew about this client. Maybe she decided to react straight on the basis of the cues she picked from her short conversation with the parents making use of her clinical experience and knowledge of the service user (Benner, 2001; DOH, 2007). She could have considered the clinical need and prioritised and as this was an emergency, practice and theory rarely converge in these circumstances depending on what you perceive to be the link between practice and theory (Welsh and Swann, 2002). Mat could have felt provoked by three strangers walking into his place. Nurses are expected to respect the client and more so in their own homes. Manley and McCormack (1997) contended that the client should be respected and given autonomy and choice and some do feel aggrieved if this is breached. The situation was different in this case as Mat lived with his parents who had invited us and opened the door for us. But this could appear Mat as clear case of invasion of his privacy or space. Although Mat was clearly unwell I feel seeing a crowd rushing into your house will make anyone uneasy and feel disrespected. When Mat was clearly aggressive Rita informed us to leave. This was logical for safety and as nurses are not to be subjected to abuse. The trust and across the NHS there are ‘zero tolerance policies’ (DH, 1999) on violence to staff. The NMC has also emphasised the need for employers and government to consider the human rights of the nurses while the Healthcare Commission has called for a balanced between protecting the healthcare staff and protecting patients’ rights. (Healthcare Commission, 2007). Without a prior risk assessment this decision could have been meant to create pace and time for risk to be considered. The space created may have been meant to allow space and time for Mat to calm down as well. Under the Health and safety at work (1974) we had responsibility to follow the employer’s safety procedures. I did not see explicit measures and effort being put to de-escalate the situation at that moment. I am of the opinion that this could have helped and saved the stress of involving police and the hospitalisation which followed. I think this way, as by the time they got to hospital I was informed that Mat was apologetic for his attack especially on me. Maybe with a bit of time he could have calmed down. The decision taken by the nurse could have been based on the need to protect the safety not only of the staff and the parents who appeared vulnerable but also for Mat’s safety. Rita could have felt the need to fulfil that requirement of her role duty of care as a nurse (NMC, 2004) and moral duty towards the vulnerable parents. In all this I assumed a back seat role. This was in line with my position as a student as I had to be aware of my limitations (NMC, 2006). I was not sure of how to react, whether to wait for cues from my mentor or to take the initiative was on my mind. On reflection I have to agree with Irving and Hazlett (1999), who observed that working with people with challenging behaviour puts strain on the nurse’s interpersonal skills and weaknesses in this area are more evident in such situations. This could also have helped as I could have reacted in a way to aggravate the situation as I was target in this aggression. Working in a team requires professionals to be aware of each individual’s role and not to contradict one another so I acknowledged that Rita was taking the lead role. In light of the risk posed by Mat a decision was made to involve the police. This is not an easy decision to make if one considers the impact this will have on the client. Even the staff’s time consumed by this can be enormous. In this case Rita had to spend the rest of her day involved on this issue. My mind kept telling me that there could have been an alternative approach somewhere, but Rita could have made the right choice as after MHA (1983) assessments carried out by other professionals; a consultant and ASW, it was felt there was a need for Mat to be in hospital. In decision making Rita might have considered the vulnerability and the stress the parents could have been going through. Nurses also have to look after the interest of the public or carers as in this case (NMC 2004). After reflecting on what transpired on this day I feel there are things that could have been done differently. This does not suggest that anything was done in any wrong way, neither that my suggestions are better. Most of my suggestions are grounded in the benefit of hindsight which might not have been available to Rita at the time. The staff could have taken their time and risk assessed before rushing out to see the client. Rita could have explored about the risk posed from the parents (DH, 2007). This could not have breached any confidentiality and eventually could have helped reduce further distress on all involved. This could clearly have quantified the level of risk and appropriate arrangements for interventions made. This could have involved a full MHA (1983) assessment with the right personnel in attendance. If the risk was high for the parents police could have been involved in the first instance to minimise risk. Policies and procedures are there to give guidelines and they could have proved to save the day in this incident. It is the responsibility of staff to adhere to them (NHS SMS, 2005). Once we were at Mat’s place more effort could have been put to de-escalate the situation or to give him more space to calm down. Mat appeared prepared to talk to Rita and not the rest of us, even if it was on racial grounds. This issue could have been addressed later after he was composed highlighting how his behaviour was inappropriate. NHS SMS, (2007) has emphasised on this in nits guidelines. Since he was unwell benefit of the doubt could have allowed Mat to speak to appropriate staff in the situation and this could have saved hospitalisation or involvement of other professionals. Such positive risk (Morgan 2004) taking could have saved distress on the part of the client and carers and resources of time and number of agencies and professionals involved. Further to positive risk taking, staff from CMHT could have involved the Home Treatment Team. This could have helped Mat to remain at home with an increased level of support as Mat settled down fairly quickly once in hospital. It was also realised that his level of medication was quite a low dose and there were other factors triggering a relapse. HTT team could have given support and assurance to the parents in line with holistic care and moral agency, (Manley and McCormack, 1997). A discussion with the parents could have been considered to ascertain how they felt about Mat staying home with the support from HTT. After being involved in this incident and reflection I have considered several issues as regards my professional position and development. I have identified that risk assessment is varied and circumstantial to the environment. I have to be aware of the risk considerations and then to equip myself with the right skills and tools to meet my responsibilities (Rew and Ferns, 2005). The tools provided such as policies and procedures are there to complement and minimise risk and not to hinder our work. It is my professional duty to be aware of these and make use of them where they are available. As I go into my last clinical placement I will make sure I am aware of these polices and adhere to them. Following the critical incident I carried out a teaching session during my clinical placement which I will reflect upon also using the Gibbs’ Reflect Cycle. Teaching session reflection I planned for a teaching session on Risk Management as an issue I had identified in the incident I reflected upon. This was also a rare incident with this CMHT. Violence to anyone is distressing so when I looked at the role of the nurse as a teacher, RCN (2006) statement on violence and the professional expectations, I felt the need to share my knowledge on the topic. I delivered a presentation on the topic of risk management with focused reference to the incident. The participants were all the 8 staff members who attended the staff meeting for that afternoon. In preparation I encountered encouragement and support from some team members but challenges were also there. In planning the teaching I looked at the subject area and relevance to the prospective audience. The language in terms of jargon and the method of teaching was considered looking at my position as teacher and learner as well as the adult professional participants. I had hoped to use power point but this was not available. The room and timing of the session were determined by doing the session during a weekly staff meeting which provided for teaching or presentation session (appendix 5). From the onset anxiety set in as I was trying to decide what exactly I was going to focus on (Haward, 2004). This was mainly so as I was going to deliver a teaching to people who I was sure knew the subject matter better than me. Awareness of my limitations was glaring me in the face. The subject of risk is such a vast area and being specific can be a mammoth task. This happened early on in my placement and I was still getting familiar with the team. My confidence was low at the start of preparations and on delivering the session. The participants were from different professions including the team manager. It was more difficult as most of my support was from my mentor who happened to be in hospital on the day. On the day of the incident I was given time to reflect on what had happened. This was good for me as this set the ball rolling for the planning and delivering of the teaching session. As part fulfilment my studies I was aware that I needed to present a teaching session (appendix 4). This was good as it helped me decide on what to do. This reflection also helped me understand that one of the most important issues in mental health if not heath and social care at large is risk management. I got support and encouragement from my mentor and another newly qualified staff. Positive feed back and realising how my confidence had grown in those twenty minutes I had delivered the teaching felt very rewarding for my efforts. The challenges of deciding on the subject and planning of the teaching were unnerving. I was aware of my disadvantaged position that I was going to teach people who in all probability knew and had more experience on the subject than me, which who did not help my confidence regardless of what Thompson, (2004) suggested. This was not helped by one member of staff who encouraged me to abandoning the teaching on the last point. He was not clear on his reasons but maybe felt he was doing me a favour. The timing of the teaching at the end of a staff meeting was not favourable and conducive for such a topic which could be very dry. The planned media of delivery of power-point was not available although contingency plans were in place. See appendix 5. Teaching requires preparation. The first consideration was who I was to teach. Knowing that I was going to teach experienced practitioners in their own area of practice was un-nerving. When you teach something you need to impart some knowledge and you want to make worthwhile the student’s time. I was not sure what I should teach on. I had to find a topic which I would be able to research on and give some interesting knowledge that would be valued by my audience. This was partly achieved by basing my teaching on the critical incident that everyone was aware of. Reflective learning was achieved by the presentation which focussed on a known incident allowing the participants to discuss issues around that incident and relate it with the theory. Cropley (1981) contends that adults learn best when encouraged to relate learning to their experience. Baud, et al (1985) also talked about leaning being enhanced by the use of experience, ideas and the reflective process and looking at the outcomes. In a group with nurses and other professions social workers, occupational therapists, doctors and psychologists as well as an administrator the language was important (Haward, 2004). This is an issue I had not seriously considered initially on the basis that this was one team which had been together for a long time. But during my presentation I quickly realised that this was not the case when I had to elaborate or explain certain terms as well change substitute some terms as I continued. This lack of consideration could have left the participant uncomfortable or miss to fully benefit from the session. When teaching adults you need to treat them as adults and the same treatment should be expected from them (Knowles, 1984) making choose the androgogal approach. Although I was the one teaching my position was peculiar as I was aware that I could be the one with the least knowledge on the subject in the room. I managed to realise and accept this short coming in knowledge on the basis that I cannot know everything. I also accepted that preparing and delivering this session makes me a learner and teacher at the same time. My learning was not limited to the researched material but also the discussions during the session and the experience of delivering the session, increasing my confidence (Thompson, 2004). One important consideration was the environment. The need to ensure basic intrinsic needs (Maslow, 1987) of physiological comfort and safety could not be overlooked. This was initially not an issue as the room was prepared for the meeting. But as the time dragged on tiredness might have become a factor although this was not explicit. I was aware of this; I can recall trying to go through my presentation before anyone excused themselves. The timing of the session at the end of the meeting was good in that the largest audience was available after the team meeting and the meeting room was prepared already. Also this did not affect the work of any staff as they were all scheduled to be available at that time. Initially there was passivity but progressively participation improved as questions were discussed among the participants. My fear was that this will be centred on me as the teacher (Quinn, 2000). Being aware of my limitation my audience could have missed out on those areas I could not fully articulate. Handout were prepared and used for this session. Personally I would have preferred to use power point for two reasons. Firstly I am used to using power point and I can manipulate the presentation (Sammons, 1997). I am someone who likes to use the latest technology and aids available especially with environmental awareness on my mind. The second reason is that power point will help to divert some attention from me the presenter. This was topic so crucial that the student and mentor should work closely in partnership. In this way I will have gained more from getting a closer insight into what informed the mentor’s actions and a practical view of the issues at hand. The rest of the team members will also benefit more broaden view point (Jasper, 2003). With hindsight I could have discussed with the staff member who was discouraging me from carrying the teaching, challenging his position. Some practitioners are only concerned about doing the minimum to do the job, treating education as an extra to necessity, described by Conway (1996) as ‘traditionalists’ and by Houle (1980), as ‘Laggards’ who resist both learning and new ideas. The topic of risk assessment is such a vast topic and given the opportunity I had on this occasion I could do justice to this important issue. I could revisit my ability to set work towards realistic goals that are achievable within my personal and professional life (Cropley, 1981). This was a learning opportunity which I will nurture and utilise to develop myself and other professionals. Critical incidents are learning opportunities for everyone concerned staff and clients alike. My role as nurse requires me to be an educator and a health promoter. To this end a teaching session on such an incident should include experienced staff and clients in preparations and delivery where possible (Manthorpe and Alaszewski, 2000). I will also consider delivering a similar teaching to educate the clients as well especially those who were part of such an incident (NHS SMS, 2007). Conclusion After this process of reflection I can realise the importance of life long learning (DH, 2001). In nursing there are many challenging situations which are so varied; one is expected to fully appreciate the need to continuous update and keeping one self abreast with skills and knowledge. Challenging situations occur on a daily basis and unless we are prepared for them the quality of care will suffer. Some of these incidents will leave staff at the ‘end of their wits’ and may affect their confidence. More skills and knowledge will become hand especially in challenging engagement situations where there will not be time to look up things. Clinical supervision will form a big part in maintaining and improving competency. Competency as a nurse is critical and justifies need for PREP (NMC, 2004a) for transition for newly qualified nurses and need for life long learning requirements of KSF standards (DH, 2003) Reflection will help one to identify areas for personal and professional development. This will go a long way helping the KSF and clinical governance requirements (Scally and Donaldson, 1998). All these factors to enhance the nurse’s knowledge and skills are prerequisites for responsibility and authority which underpin accountability. Skills and knowledge in professional practice brings the ability to exercise professional judgement.