Postpartum Contraception Essay Example for Free

Postpartum Contraception Essay Postpartum contraceptive methods are those used by breast feeding women before twenty six days after they have given birth. Basing on the NICE guidelines, the advice on how to use these methods should be explained to the patients before their second postpartum week. The breast feeding women are allowed to use the lactational amenorrhoea method but they are not recommended to use the COCP (combined oral contraceptive pills) method by the World Health Organization before the first 42 days postpartum because it’s illegal (outside the license) (WHO, 2006). Below are some of the postpartum contraceptive methods. The contraceptive methods; The combined contraceptive pills (to the breast feeding women) This contraceptive method to breast women brings about some hormonal out comes on the quantity of milk and its quality too. If these pills are taken before 24 weeks postpartum, they affect the baby’s growth. In a previous review of randomized controlled trials held to clarify this case, the review reassured women that hormonal contraceptive method has no strong effects on the baby’s growth. On the other hand, the World Health Organization recommended that, breast feeding mothers before 24 weeks of postpartum should not use the combined contraceptive pills because its use is outside the license (WHO, 2006). Sterilization Basing on the guideline of Royal College of Obstetricians and Gynecologists, it shows that women should be alert about the consequences and the increasing rates at which sterilization fails before the postpartum period (Johnson, Edelman and Jensen, 2003). Lactational Amenorrhoe This method is scientifically proved to be effective in preventing unwanted pregnancies, given to a woman, in less than 24 weeks postpartum. As Johnson, Edelman and Jensen (2003) states, she does not experience virginal bleeding after the first seven weeks postpartum, and if she can fully breast feed the baby day and night. Progestogen injectables If this method is used before 42 days of postpartum, it means, that it has been used illegally by the applicant (outside their license). According to Johnson, Edelman and Jensen, (2003), if injectables are used in the early periods of postpartum, it may result into excessive bleeding. It is therefore, recommended that it should be used after 42 days of breast feeding. This may prolong bleeding if applied when not breast feeding in five days of delivery. Emergency contraceptive method This method is not required before twenty one days postpartum and it can be used even if the woman is breast feeding. The IUD may be used after one month postpartum. Implants and the progestogen only pills It is recommended by World Health Organization that this method should not be applied in the first 42 days postpartum (WHO, 2006). On the other hand, in the United Kingdom, this method is commonly used by women before 42 days postpartum since it is proved that it has no effect on the quantity of breast milk and the fact that it does not affect the growth of the baby during this specified period. The following have to be noted for application of POP As noted by (Guillebaud (1993) if its application is started after the first two weeks, there is need for some additional contraception and need to clarify that the woman is not pregnant. If the woman starts to experience constant menstrual cycles again, she has to begin the applying POP including the period of five days without the necessity for additional barrier methods. For Etonogestrel implants Guillebaud (1993) explains that, this can be applied between the first 21 to 28 days of delivery. If it exceeds from 28 days, there is need to apply additional contraception methods for a week. Barrier methods (condoms, cervical caps and diaphragms); Condoms It has been proved by scientists that condoms are eighty seven percent effective when used without any other protective measure. And said to be ninety eight percent effective if used with another measure of protection (spermicide). Every time you have sex, it is recommended that you use condoms (Guillebaud, 1993). Diaphragm As Guillebaud (1993) explains, scientifically, this method is said to be ninety eight percent effective that is if used correctly. It has to fitted by the doctor and used when having sex. Conclusion From what has been discussed above, there are many postpartum contraceptive choices a breast feeding woman can use like POP, COCP, barrier methods such as condoms, cervical caps and condoms, progestogen only pills, and others. Some women are using the COCP method, for example, women in UK, before the first 42 days postpartum and yet it is not recommended by WHO. We there by strongly conclude that women should be keen when taking postpartum contraceptives for the seek of their healthy and the child they have, it is important that they should follow the recommendations of the World Health regarding postpartum contraceptives. Reference Guillebaud, J (1993): Postpartum Contraception: Unnecessary before three weeks: BMJ, Vol. 307, 6918; p 1558-61 Johnson L, Edelman A, and Jensen J (2003): Patient satisfaction and the impact of written material about postpartum contraceptive decisions: AMJ Obstet Gynecology; Vol. 188, 5, p, 1201-5 WHO (2006): Medical eligibility criteria for contraception: Available online at: www. who. int/reproductive-health/public/mec/mec. pdf

Korn :: essays research papers

In the early '90s, heavy music looked to be going the way of the dinosaurs: Well-heeled Brit-pop and well-scrubbed pop-punk were thoroughly dominating the guitar-rock landscape, and the few surviving old-school metal acts seemed hopelessly unable to adapt. But somewhere within the vast, murky Southern California wasteland, a dynamic new species was being born, a forward-thinking beast that disregarded the mistakes of heavy bands past while meshing dark, urban rhythms and low-tuned guitar sludge with violent, expressionist blasts of hip-core noise. That and the wildly emotional vocals of JONATHAN, which alternated between a bourbon-smooth croon and a viscerally sharp howl, made for a revolutionary mix that redefined heavy rock better than anyone had in a decade. The result was a monster 1994 self-titled debut album that went solid platinum, and by the time 1996's Life Is Peachy was released, this beast had a fanbase over two million strong--and a legion of musical imitators so large it threatened to saturate the planet. It was time for a change of rules. Hence KORN's latest, greatest slab, aptly titled FOLLOW THE LEADER. From the broadened musical and emotional scope to the much beefier production values to the stunning cover art courtesy of Spawn-creator Todd McFarlane, FOLLOW THE LEADER is indeed an ambitious and deeply satisfying outing for the band. And while there is considerably more hype surrounding this rightly anticipated disc, JONATHAN is quick to put things in perspective. "Our only goal was to take our time on this album," he says. "Because I knew we had it in us to do something great. To full integrate both (previous) albums and put out a record we could be proud of...we wanted to do some phat shit." "I think working with a new producer and going into a new studio helped us grow musically as a band," adds guitarist MUNKY. "All of us really have that fire again about being excited about a record...We all feel like we grew, like when you grow out of some old shoes; your feet are all crammed in forever and you know you need to buy a new pair, but you need to save up the money to do it. We kind of saved up our confidence and made that leap into our new shoes." Fans of old-school KORN needn't despair--the new shoes kick just as much ass as the old pair. "Freak On A Leash" is a molotov cocktail of scathing, psychedelic guitar runs, hypno-groove bass grind, hip-hop jungle drumming, all sliced in two with an ingeniously placed scat line reminiscent of PEACHY opener "Twist." Then there's "Children Of The

Reward System in Educational Settings Essay

The reward systems used in educational settings originates from psychology of behavior that specifically gives specific emphasis on promoting good discipline in educational settings. Education institutions are able to make significant differences in children’s behavior through setting out definite rules and stipulating sanctions and rewards for violating them. The fundamental nature of such systems is the idea that students can choose how to conduct themselves. Therefore, by rewarding and recognizing good behaviors whereas bad ones are punished, it is believed that students will aspire to choose good behaviors. A number of psychologists argue that in most cases education institutions focus on rectifying bad behaviors only rather than recognizing or reinforcing good behavior among students. They therefore criticize such an approach as being too basic because it eliminates the framework within which students’ conduct occurs and leaves total liability up on individual for their behavior. Although such criticizing arguments have been put forward, reward systems have been widely adopted in most education institutions especially primary and secondary schools. There are argued to impact positively on student’s behavior and performance as well as to teachers (Kohn, 1993). In regard to this, psychologists have explained the reward systems using a number of learning theories which relates the psychology and education disciplines. Learning is the means through which cognitive, emotional, and environment influences and experiences suitable for enhancing, acquiring, or making ones skills, knowledge, and values are brought together. Thus, the learning process puts emphasis on events that occur in the learning environment and this is explained by a number of learning theories. The learning theories clarify on how animals and people learn thus aiding us to understand the inherent complex learning process. All the learning theories which have been put forward by various psychologists are grouped into three categories: cognitive, behavior, constructivism and social-cognitive. Motivation of students is the basic necessity to guarantee success of any education enterprise. The dynamics of motivation can be explained as the types of academic and social goals which students brings into the classrooms, motivating elements of such goals, and the existing reward systems that together control the quantity and quality of learning as well as the will to keep on learning (Deci & Ryan, 1986). Motivation has been categorized by psychologists into four groups: instrumental motivation, achievement motivation, intrinsic motivation, and social motivation. However, more than one type of motivation may occur to a student at a given time. Instrumental motivation as a type of motivation is exclusively extrinsic because students carry out tasks as they are influenced by probable final consequences such as the probability of acquiring material rewards or keeping away from a reprimand. Therefore, in cases of such motivation, teachers are supposed to ensure that tasks being performed are put in contexts that students perceive pleasant. Social motivation argues that students execute tasks in order to please people they admire, respect or whose views are of significance to them. In regard to this social motivation, rewards have no significance although tangible as well as immaterial. Besides, rewards are correlated expressly to the perceived association between the learners and the teachers or instructors whose underpinning activities such as praise and approval are considered important. Achievement motivation involves students learning and hoping for success and it has three components: cognitive drive –whereby students attempts to satisfy identified ‘need to know’; self enhancement –learners satisfy the call for self-respect; affiliation –learners seek support from others; Intrinsic motivation is characterized by the absence of external rewards hence tasks are undertaken for the pleasure and satisfaction they bring the students. It appears to be fundamental to high quality participation in an undertaking as well as being self-terminating and self-maintaining. Curiosity and a desire to meet challenges may characterize the learning of students motivated in this style (Ardord, 2006). To clearly explain the system of reward in schools, a few theories are explained. Maslow’s theory of motivation focuses on a person’s striving for excellence and he explained this through ‘hierarchy of human needs’. Maslow pointed out that every human being is a ‘wanting animal’ hence he supposed that an individual’s behavior at any given time is dominated by his/her needs that have largest potency. As lower level psychological needs of a person are sufficiently achieved, the needs for higher level psychological needs come in handy. In the context of education, Maslow’s theory argues that students cannot and/or are not willing to learn or put more effort if their basic needs are not provided or met. Therefore, students require psychological needs to be met alongside their safety feelings and a sense of belonging. Such leads to spontaneous sense as learners who are hungry will not concentrate, nor will learners who are bullied and neither will learners who perceive to be outsiders and without friends. According to Maslow, learners are motivated if they are self-actualized and any hindrances affects learning environment considerably (Ibid, 2006). Skinner came up with a theoretical framework referred to as operant conditioning to explain that human beings cannot learn best without being provided or promised with a reward. He argued that human beings like every other organisms makes a direct and anticipated response –operant- when they are aware that there is a reward. Therefore, in cases where a response happens and emphasized, there is increased probability that it will happen again when a comparable stimulus is present. Hence, skinner argued that student’s tend to learn best when behavioral change occurs. In his experiment, Skinner had come up with learning units referred to as ‘contingencies of reinforcement’. These are sequences within which behaviors or responses are followed by reinforcing stimuli. The outstanding learning principle in this theory states that behaviors/responses are naturally produced without bring out stimuli. Besides, such behaviors are operants as their production can be instrumental in punishing or reinforcing consequences among students. Therefore, this theory is useful in understanding a person’s learning, social interaction, and human development via making open a number of normal law relationships created into human life by God. Thus, the theory concurs on the necessity to have a system of reward in schools based on students’ behavior which seems notable (Tayo, 2001). Penn in his work argues that in self-worth theory, motivation is the one of most vital factors to determine the attitude of learners as well as their behavior as a sense of self-respect. The answer to self-worth is learner’s perception of his/her own capability particularly when compared to others. If an imaginary hierarchy of self-worth is drawn, learners will tend to give ability the first priority, followed by effort and performance. The theory as claimed can be explained by equating both worth and ability. The author quoting other psychologists writes that applying personal goal-setting arrangements (gives learners a chance to define their own criteria for success), outcome-based evaluation and instruction (slower learning students experience success without competing with faster learning students), attribution learning (facilitates uninterested learners to consider failure being the lack of effort instead of ability), and cooperative learning activities (facilitates learners in understanding that individual effort contributes to personal as well as group goals) removes barriers to achieving motivation and redirects learners’ behavior far away from letdown-avoiding activities in educational settings (Penn, 2002). Extrinsic and intrinsic motivation theories differ only in terms of goals that different student have. Intrinsic motivation argues that students study just for the sake. The learners derive personal satisfaction as well as learning new ideas from learning and regard the m as a reward (Anti-Bullying Network, 2000). On the other hand, extrinsically motivated students are influenced by outside influences for instance praise from peer and teacher, attaining good grades, and/or any other form of reinforcement a peer or teacher can offer. Some people have argued that intrinsically motivated students tend to learn more as compared to those who are extrinsically motivated. Reason may be because intrinsically motivated learners as well extrinsically motivated. However, extrinsically motivated learners are seldom motivated intrinsically. Extrinsic rewards encompasses use of tangible rewards such as payments and gifts so as to keep learners interested in particular subjects as well as motivate them (Deci & Ryan, 2002). Intrinsic motivation has for a long time been criticized for its unconstructive influence on intrinsic motivation as well as being claimed to have a short term effect. In regard to intrinsic motivation, learners have the feelings of self-determination, pride, and competence. However, students are highly interested in activities when they are motivated by gifts, prizes, grades, or money as long as they received anticipated reward. Therefore, with time a student who receives a reward for their performance in a particular subject, they gradually become interested in it and develop intrinsic motivation. A big difference exists between tangible rewards (candy, money, certificates) and verbal rewards (praise, positive feedback). Tangible rewards influences intrinsic motivation negatively and destroy self-regulation (Wilson & Corpus, 2001). Conclusion Although the reward system has for a long time been applied in schools, a couple of issues need to be addressed if it will remain effective. Teachers and parents needs to be consistent in using rewards and sanctions, the reward system whether individual, cooperative or competitive should be monitored on regular basis, keeping-off from rewards that have monetary worth or those that indicates that school tasks are of no value, and making certain that rewards are deserved and genuine rather than being routine (Anti-Bullying Network, 2000). Whichever the reward system an education institution adopts, a positive culture in schools is established reason being efforts and good behaviors of the pupils are recognized. Thus, most students tend to put more effort so as to achieve established rewards and as a result the overall performance of school improves.

Essay about President John F. Kennedy´s Man on the Moon...

In 1961, the United States of America was embroiled in the Cold War with the Soviet Union. This confrontation was taking place not only on land, sea and air, but in space as well. On May 25th, 1961 recently elected US President John F. Kennedy addressed a joint session of Congress, during which he outlined his now famous Man on the Moon challenge. It was through this ambitious dream that the creation of the National Aeronautical Space Administration (NASA) came about, which President Kennedy challenged to put a man on the moon by the end of the decade. Although he didnt live to see the achievement of his dreams, the United States successfully landed Astronauts Neil Armstrong and Edwin Buzz Aldrin on the moon on July 20, 1969 and†¦show more content†¦The implications of the Soviet Union being ahead of the US in the space race went far beyond national prestige. As stated in the opening sentence, the US and the Soviet Union were in a non-shooting Cold War at the time of th e speech. There was great concern that if the Soviet Union were to take a large lead in being able to put larger payloads into space, they could potentially place weapons there which would effectively nullify the US policy of Mutually Assured Destruction (MAD) as outlined by President Kennedys Secretary of Defense Robert McNamara as early as 19614. President Kennedy also took the opportunity to chide not only Congress but himself as well by stating I believe we possess all the resources and talents necessary. But the facts of the matter are that we have never made the national decisions or marshaled the national resources required for such leadership. We have never specified long-range goals on an urgent time schedule, orShow MoreRelatedAnalysis Of President John F. Kennedy s Short Term As President Of The United States1544 Words   |  7 PagesEssay- President John F. Kennedy MSgt Corey B. 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Not only Kennedy was extremely liked by people, he was also rated above the majority of presidents America had, with the exception of Abraham Lincoln and George Washington. Basically, what reallyRead MoreSpace Travel : President John F. Kennedy1168 Words   |  5 PagesUniversity Space Travel On May 25, 1961 president John F. Kennedy delivered a speech of an ambitious goal to send an American to the moon and return him safely to earth by the end of the decade. â€Å" I believe that this nation should commit itself to achieving the goal, before the decade is out, of landing a man on the moon and returning him safely to earth† (kennedy, 1961). With this speech Kennedy created a new period in space exploration in the united states. AmericaRead MoreJohn F. Kennedy : A President With A Different Sense Of Confidence1178 Words   |  5 PagesJohn F. Kennedy: A President with A Different Sense Of Confidence One of President John Kennedy’s famous quotes was, â€Å"A man may die, nations may rise and fall, but an idea lives on† (Brainy Quotes), and as the 35th president of the United States, his ideas for the country are still living on. Not only Kennedy was extremely liked by people, he was also rated above the majority of presidents America had, with the exception of Abraham Lincoln and George Washington. Basically, what reallyRead MoreThe World Of The Soviet Union1699 Words   |  7 Pageshave be if the United States never landed on the moon, but instead the Soviet Union was successful at sending cosmonauts to the moon and were the first humans to ever step foot on a celestial body? This is what I wanted to explore in my research, this is all subjective we cannot go back in time to see what the outcome would have been if it never happened the way it did. 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President John F Kennedy was masterful at this skill and the words he spoke and the dreams he invited us to share are as pow erful today as they ever were. Our cultural memory of John F. Kennedy was shaped within a very narrow time frame. Kennedy, born in 1917, was only forty-six yearsRead MoreJohn F. Kennedy s President Of The United States1813 Words   |  8 PagesJohn F. Kennedy When John F Kennedy served as the 35th president of the United States his overall goal was to issue civil rights for everyone. Fortunately, he was very successful in doing so when he achieved this goal before being assassinated. Many people would argue his presidency was a failure due to the Cuban missile crisis that almost started a nuclear war, however, due to Kennedy s leadership we were able to come to a peaceful agreement. John F Kennedy was successful in office because heRead MorePresident John F. Kennedy1220 Words   |  5 PagesPresident John â€Å"Jack† Fitzgerald Kennedy was born May 29, 1917 in Brookline, Massachusetts to Rose Kennedy and Joseph P. Kennedy. John F. Kennedy, also known as JFK, had three brothers and five sisters. Young John, â€Å"Jack† as he was known by, attended a boarding school for boys in Connecticut. Here he was active in football, golf, tennis, and basketball. Once Jack graduated Choate in 1936, he entered Harvard. It was while he w as studying at Harvard that he injured his back while playing football,Read MoreJohn F. Kennedy Assassination1618 Words   |  7 PagesJohn F. Kennedy Assassination Was John F. Kennedy’s assassination a single shooter or was it a conspiracy? Since November 22, 1963 people around the world have wondered who it was that shot President Kennedy, and what for. So many questions have formed around this event, not just about who the shooter was, but also questions like what might the world have been like today if the shooting didn’t happen? The Kennedy assassination has been a mystery for many years. A lot of people hear about the different

Van Gogh Art And Art - 1161 Words

Vincent Van Gogh, born on March 30, 1853 and died on July 29, 1890, at age 37, became the most highly regarded Post Impressionist artist of his lifetime. Van Gogh’s works became notable for color, emotion, and beauty, influencing 20th century artists. When Van Gogh turned 27 he decided to start painting, but started showing signs of insanity. His work didn t fit the tradition of art at the time. When Van Gogh started reaching his most influential years, society at the time declared him unstable. After Van Gogh committed suicide, his art started getting noticed. Van Gogh the artist, ignored in life, painted art that people didn t consider fit at the time. Later after Van Gogh passed on, people started to see his work as art. When Van†¦show more content†¦Even though Van Gogh, the first artist to have mixed impressionism and expressionism, sold only one painting in his lifetime, he remained a true genius. Some would say that Van Gogh failed to use impressionism to its correct form, but he wasn’t doing things by the book, he mixed two types of art and made a new style that we use today, known as post-impressionism. Look at â€Å"Starry Night† painted in June 1889, with oil paint on a canvas, sizing at 2†² 5†³ x 3†² 0†³. He painted an obvious masterpiece, a mixture of impressionism and expressionism. He painted what he saw this out of his window at the asylum, it all seemed realistic to him. His art has changed modern art by the way we use his techniques to pull the view into the paintings, to make it seem like they are in the painting themselves. It helps to involve the reader. We see his work as inspiring, eye opening, even mind opening. He didn t always try t o impress people; he didn t care that people didn t notice his work most of the time. He just painted because it made him feel better, like the story where he would eat yellow paint because it was a happy color, and he thought it would bring him happiness. The painting â€Å"Irises† painted in 1889, using oil paint on a canvas, sizing at 2†² 4†³ x 3†² 1†³, helped him with his hallucinations (Harrison). In this same year he painted three of his sunflower paintings, these pieces are well known, just not is

Case 20 Randell Corp - 5323 Words

Case 20: Rondell Data Corporation John A. Seeger Bentley College Damn it, hes done it again! Frank Forbus threw the stack of prints and specifications down on his desk in disgust. The Model 802 wide-band modulator, released for production the previous Thursday, had just come back to Franks Engineering Services Department with a caustic note that began, This one cant be produced, either. . . . It was the fourth time Production had kicked the design back. Frank Forbus, director of engineering for Rondell Data Corp., was normally a quiet man. But the Model 802 was stretching his patience; it was beginning to look just like other new products that had hit delays and problems in the transition from design to production†¦show more content†¦How does it look in Engineering, Frank? Ive just reviewed the design for the second time, Frank replied. If Ron Porter can keep the salesmen out of our hair, and avoid any more last minute changes, weve got a shot. Ive pulled the draftsmen off three other overdue jobs to get this one out. But, Dave, that means we cant spring engineers loose to confer with your production people on manufacturing problems. Well, Frank, most of those problems are caused by the engineers, and we need them to resolve the difficulties. Weve all agreed that production bugs come from both of us bowing to sales pressure, and putting equipment into production before the designs are really ready. Thats just what were trying to avoid on the 802. But I cant have 500 people sitting on their hands waiting for an answer from your people. Well have to have some engineering support. Bill Hunt broke in, So long as you two can talk calmly about the problem Im confident you can resolve it. What a relief it is, Frank, to hear the way youre approaching this. With Kilmann (the previous director of engineering) this conversation would have been a shouting match. Right, Dave? Dave nodded and smiled. Now theres one other thing you should both be aware of, Hunt continued. Doc Reeves and I talked last night about a new filtering technique, one that might improve the signal-to-noise ratio of the 802 by a factor of two. Theres a chance Doc can come up with itShow MoreRelatedContemporary Issues in Management Accounting211377 Words   |  846 Pagesgovernment: the calculating self, hybridization, and performance measurement Liisa Kurunmaki and Peter Miller  ¨ 10. Analytics of costing system design Eva Labro 11. Understanding management control systems and strategy Kim Langfield-Smith v vii xi 1 20 42 69 92 117 146 166 198 217 243 x CONTENTS 12. Management accounting, operations, and network relations: debating the lateral dimension Jan Mouritsen and Allan Hansen 13. Trends in budgetary control and responsibility accounting

Structures of Subjectivity Explorations in Psychoanalytic

Question: Discuss about the Structures of Subjectivity for Explorations in Psychoanalytic. Answer: Introduction: Sigmund Freud, one of the forefathers of psychology is the founder of psychoanalysis. He developed several theories (Freud, 2012) that have formed the basis of "Psychoanalytic therapy." There is a growing incidence of mental health problems in the present world necessitating the implementation of psychotherapeutic approaches as they make deep-seated changes in emotional and personality development (Strupp, 2013). This therapy is the effective choice for patients with specific emotional concern. In this context; the essay explains the psychoanalytic therapy for Peter, a 40 years old single male, who is currently seeking the psychoanalytic therapist to end his struggle with interpersonal conflicts. The essay explains the process of psychoanalytic therapy in the context of the case study, the stages and techniques of therapy, and the goals of therapy. The essay further presents the critique of psychoanalytic therapy. It briefly explains the key contributions of the psychoanalytic therap y and its limitations. The paper also provides recommendations on how psychoanalytic therapy can further evolve to improve its efficacy in therapy. Lastly, the essay elaborates the applications of other models that can overcome the limitations of psychoanalytic therapy. According to Lionells et al., (2014), there are three stages of psychoanalytic therapy identified which are the "initial, middle and the late stage." During the initial phase, the therapist tends to know about the patient and establish a therapeutic relationship. In the context of Peter, the therapist may tend to know his characterological style, dangerous situation ruling his behavior and his defensive maneuvres. The therapist may note clients initial resistance to the process and early transferential process for using it in future when the better understanding of the clients past life will shed light on the "present transferential responses." During the middle stage, the therapist tends to learn the feelings of the visitor for a significant person in the childhood. The two main techniques used at this stage are analysis of transference and analysis of resistance (Stolorow et al., 2014). At this stage, the resistance to the treatment and the transference process becomes more pronoun ced and vital part of therapy. At this stage, the therapist can explain and relate between the "the inner unconscious conflicts or desires and disease." Therefore, it will help Peter to realize and comprehend thereby allowing him to experience wider choices in life. At this stage, Peter's present decision-making could no longer be a cloud by his past distortions. It is at this stage of treatment where Peter will be made to work through his conflicts. This may have the good effect on the client. In the late stage of psychoanalytic therapy also called as resolution stage, there is a consolidation of new changes in the client. The therapist understands the clients old pattern in the context of past and old memories that were repressed. Also, at this stage, interpersonal conflicts resulting in maladaptive behavior are resolved in the therapeutic situation. This stage may include repetition of transference and hence the therapist reveals some of the clients problems and helps them to fac e reality. The treatment is terminated when the patient can solve the transference independently (Peterfreund, 2016). In this essay, we will emphasize more on the middle stage of psychoanalytic therapy and its goals. The ultimate goal of any psychotherapy is the improvement and enhancement in patients physical and mental health to their sense of well-being. The aim is to help patients to manage their life more effectively (Dreher Sandler, 2013). The goal of the psychoanalytic therapy is to analyze the components contributing towards Peters interpersonal conflict and the way these components are effecting his relationship with himself and with others (Hall, 2013). The therapist then intends to study the patient by bringing out the characteristic through selective inattention. Further, the treatment goal is to focus on how Peter is maintaining is relationship with others as well as his behaviour and tendencies (Lionells et al., 2014). After analysing these components the goal of the therapist is to determine the reason contributing to his current behaviour and factors causing him to hold onto it (Pet erfreund, 2016). The two main techniques used at this stage are Free association, dream analysis, analysis of transference and analysis of resistance (Atwood Stolorow, 2014). During free association, Peter will be encouraged to speak everything that is in his mind. The therapist may start with an investigation, which may include in-depth questions allowing the client to reflect on himself. The therapist will analyze the responses as patterns and deduce the cause of interpersonal conflict by exploring, rephrasing and summarizing the patients narrations. The process of reflection will allow the therapist to understand Peter and alter his perception by the process called as Reframing Barker, (2013). During dream analysis, the therapist investigates the repressed feelings that are expressed in dreams uncovering the unconscious material (hidden motives and fears). This technique helps to provide insight into a peters present functioning. At this stage, the goal is to alter the perception that is damaging to Peter and contributing towards interpersonal conflict. The therapist intends to help the client in healthy decision-making. The client is assisted to make healthy choices and act accordingly without external influences and anxiety. The importance of overcoming anxiety is because "anxiety and depression" are resultant of past interactions and are the cause of conflict between the conscious and unconscious (Dreher Sandler, 2013). While analysing transference, the therapist identifies the feelings to be resolved. It requires confrontation of Peters wishes, guilt and defenses and any discrepancies in clients conversation. At this stage, the treatment goal is to analyse the conflicts contributing to resistance. For example, Clients resistance towards revealing behavior patterns, fantasies to the therapist and are manifested as cancelling appointments or avoiding consideration. Therefore, the goal of therapy is to iden tify and eliminate the resistance using countertransference. At this stage, the goal is to identify the best treatment approach. This is continued until a stage is attained where the client will have cathartic experience indicating he can be cured (Benecke et al., 2016). The psychoanalytic therapy is in use since a century and has generated a great body of research about its key contribution. Psychoanalysis has contributed to basic understanding of the maladaptive and adaptive psychological development as per Eysenck, (2013). It continues to contribute towards an understanding of "depression and its treatment." According to Strupp, (2013) a major meta-analysis of psychoanalysis indicates positive outcomes in 80% of the clients treated with psychotherapy. A significant statistics is available on the benefits of psychotherapy, which indicates a long lasting effect of psychoanalytic therapy on the clients. The study released by "American Psychological Association" in the field of mental health has shown similar results in 2010 (). With the review of 16 meta-studies on the effectiveness of talk therapy used in psychoanalysis, it was concluded that 90% of the people who underwent psychoanalysis have benefited and it lasted long after the termination of tr eatment. These contributions of psychoanalytic therapy are note worthy and indicate the strength of the therapy. By virtue of this approach, several people with range of difficulties such as interpersonal conflict, addiction, anxiety and depression, relationship based problem and hidden emotional concerns were successfully treated with this technique (Summers, 2013). The technique was also successful when used for patients with personality disorder, learning disabilities, eating disorders, insomnia, and various types of phobias (Wampold Imel, 2015). In addition to its strength, the psychoanalytic therapy is subjected to several limitations. The key limitation is the cost and length of treatment (Wright, 2013). This therapy is comprised of several sessions and is not covered by health insurances. This may limit the accessibility for those with financial difficulties. The psychoanalysis consumes several weeks and months depending on the severity of the mental illnesses which may be difficult for working clients to stick to the schedule which defeats the purpose of the treatment method used. Further, there is a lack of consensus of the effectiveness of psychoanalysis among the practitioners. The Psychiatrists and other mental health professionals continue to practice psychoanalysis although it is less common today than in the years past. This is due to the criticism of both Freud and psychoanalysis in extreme terms. The criticism towards psychoanalytic approach relates to the changes that have taken place in mental health care and psychoanalytical diagnosis" over time (Schmidt Schimmelmann, 2013). Wright, (2013) Criticized that the psychoanalytical theories are heavily based on the clinical case studies. It is criticized that these theories are not enough for experimental research and is regarded as pseudoscience. Atwood Stolorow, (2014) Argued that theory of psychoanalysis are falsifiable. There is a lack of clinical evidence supporting the casual claims of psychoanalysis as mentioned by (Freud, 2012). This constitutes the major limitation of psychoanalysis. Various alternate models have been suggested to overcome the limitations of the psychoanalysis psychotherapy. According to the paper The Efficacy of Psychodynamic Psychotherapy published by "American Psychological Associations" Cognitive Behavioural Therapy or CBT have scientific base and its benefits are as large as any other psychotherapies (Tasca et al., 2014). According to Hofmann et al., (2012) more than 160 studies have concluded CBT to be only evidence-based options. This psychodynamic model has been scientifically proven to be effective in alleviating interpersonal distress and emotional conflicts. Using the elements of CBT in psychotherapy will improve its efficacy as this is the form of behavioral treatment, which is problem-focussed and allows the concerned individual to see the relationship between feelings, thoughts and beliefs and subsequent actions. It includes combination of other therapies such as "dialectical therapy", and "rational emotive behaviour therapy" (Summe rs, 2013). Therefore, it is recommended to collate the psychoanalytic therapy with CBT to minimize the downside of psychoanalytic approach. It combines the principles of "behavior and cognitive psychology" (Benecke et al., 2016). The factor that distinguishes CBT from the former therapy is the greater focus on the concerned individual rather than the past (Schmidt Schimmelmann, 2013). CBT places importance on thinking. It helps the client to overcome dysfunctional assumptions and automatic thoughts to gain perspective that is more realistic. Unlike the psychoanalytic therapy, CBT tends to be of short duration even for serious emotional problems. Similar to psychoanalytic therapy, CBT has long lasting effect on the client even after the termination of the sessions. It introduces the patient in this case- Peter to set of principles that he can apply at any time and point of his life (Hind et al., 2014). In the given case study, Peter can be provided with collaborative treatment including both CB T and psychoanalytical approach that may help him resolve his interpersonal conflicts. Another alternate treatment option considering Peters case study is "patient-centered therapy" developed by Carl Rogers. This therapy includes humanistic approach and deals with individuals perception about himself or herself consciously Rogers, (2013). In contrast to psychoanalytic therapy, this client-centred counselling does not emphasize on how the therapist can interpret the client's unconscious ideas and thoughts. Instead, this technique, the counselor understands the patients experiences from their point of view while being open and genuine. This therapy has been found effective in facilitating the relationships and personal growth of the individuals by enhancing their inner strength, self-awareness and identity (Morgan Yoder, 2012). This therapy is applicable in the range of cognitive difficulties such as personality disorders, alcohol addictions and eating disorders. Also, this therapy, allows the client to have control over the content and pace of sessions. Using the eleme nts of person-centered therapy in psychotherapy will improve its efficacy and hence is recommended for resolving interpersonal conflicts of Peter. The other advantage of this therapy is its non-directive form of communication where the therapist treats clients being non-judgmental. Conclusively, the author agrees that the psychoanalytic therapy is a beneficial approach keeping aside the cost and time limitations. The use of techniques such as free association and dream analysis ensures positive results to the clients. However, the limitations of this therapy may overcome by incorporating the elements of "patient centered therapy" developed by Carl Rogers and CBT. No matter what therapy is used it is essential to incorporate empathy to understand the clients current predicament. Care and compassion fasten the problem solving method to achieve a good positive resultfor the client. References Atwood, G. E., Stolorow, R. D. (2014).Structures of subjectivity: Explorations in psychoanalytic phenomenology and contextualism. Routledge. Barker, P. (2013). Reframing: The Essence of Psychotherapy? 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