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Essay Topics On Immigration In America
Friday, September 4, 2020
Introduction To The Activity Based Costing Accounting Essay Example For Students
Prologue To The Activity Based Costing Accounting Essay Conventional administrative bookkeeping is, best case scenario futile, and at the very least useless and misleading. ( Shank, 1994 ) The Relevance Lost: The ascent and fall of Management Accounting distributed by Theodore Johnson and Robert Kaplan in 1987 set apart as the radical ominous judgment of the customary costing framework. Conventional Costing System was created in mid 20 s when organizations were around 99 % work concentrated ( Kidd, 1994 ) , no automation ( Jan Emblemsvag, 2008 ) and creation strategies were grim. Critical changes in many creators stock market and creation designing interest progressively precise cost designations ( Krumwiede and Roth 1997 ) and focusing more on work productiveness may non be the best answer for the current twenty-four hours manufacture and administration associations ( Gunasekaran et al, 1999 ) . It was hailed as the start of modification for the better known to man of bookkeeping ( Sharman, 2003 ) . In the evil distinction book, their devaluation was fixated on the old fashioned cost designation procedure that mutilates creation cost for dynamic aims. Then again of providing answers for course, conventional costing framework had fizzled in unsurprising manners ( Daly, 2010 ) . Outline1 Activity Based Costing2 Second Phase of ABC: Activity-Based Management3 Activity-Based Budgeting4 ABC s booby trap and Time-Driven ABC: another ABC development?5 Impact of the new contemplations on the two organizations and adviser6 Decision Movement Based Costing In 1988, Cooper and Kaplan scattered the Activity Based Costing ( ABC ) framework to show signs of improvement of hinderances and the nutty spread spreading cost portion of conventional costing framework. Gunasekaran and Sarhadi ( 1996 ) ( Vol 1_1_4 ) found that the turn of events and indorsement of ABC had been animated and for the most part convinced by Cooper and Kaplan especially in the creation division. It is backbreaking to happen a scholarly or professional journal that does non talk about ABC in the bookkeeping universe and it quickly it started to generally disseminate to the non-fabricating part. It was seen to be the answer for the bearing bookkeeping requests of associations ( Sharman, 2003 ) . It was other than said that Activity-Based Costing is obviously the most significant administrative bookkeeping advancement ( Harrison A ; Sullivan, 1996 ) . Indeed some have depicted it as panacea for a wide range of occupations ( Doost, 1997 ) . Since so ABC plays a significant capacity as a bearing instruments and picked up its prevalence to the academicians, practicians and businesses. ABC was abdominal muscle initio planned by George Staubus in the United States during the 80 s. ABC was advanced as a framework that would chop down the level of discretionary cost designations related with customary bing frameworks and outcome in increasingly exact product costs ( Baird et al, 2004 ) . Numerous journalists often delineated ABC to one basic and ground-breaking word which is exact ( Cooper and Kaplan 1988 ; Dugdale, 1990 ; Innes and Mitchell 1991 ; Morrow, 1992 ; Bhimani and Piggott, 1992 ; Turney 1996 ; Krumwiede and Roth 1997 ) . Precision in stock costing is basic particularly in doing assurance what's more in alleviating association in cost diminishing and gainfulness goals. Mistakes made by ill-advised portion of expenses can take dark estimating, stock gainfulness and customer benefit heading conclusions ( Hardy et al, 2002 ) . ( Working paper arrangement 2004 ) The core of ABC is the action build ( Turney 1991 ) . Blending to Turney ( 1996 ) , ABC is a strategy which allocates expenses to stock fitting to the exercises and assets devoured or all things considered a technique for allotting circuitous expenses to be objects. Cost drivers and cost exercises are the footings interchangeable to ABC. ABC improves cost portion by using littler cost pools called exercises ( Wegmann, 2010 ) and expenses are so followed to these exercises by keys called cost drivers ( Cooper, 1990 ) . Gunasekaran et Al ( 1999 ) expressed that a definitive finish of ABC as a cost designation framework is to follow the creation costs produced by the creation of a decent or administration, each piece precise as pined for, to the causation exercises. ABC is non only balance for computing exact product costing, yet it plays a basic capacity in heading in pull offing costs. Ecological security EssayMany enormous organizations, which attempted to execute ABC during the 90s, deserted it due to change in competitory fortunes and the introduction of new and create heading devices. A significant number of the individuals who contended that ABC, albeit adequate in allotting cost, it does non needfully loan to the general efficacious of concern judgments ( Fladkj?r and Jensen, 2011 ) . The data gave by ABC might be irrelevant and non each piece exact as most clients accept. ABC is other than viewed as non vital for most organizations frameworks ( Fladkj?r and Jensen, 2011 ) . Kaplan and Anderson ( 2007 ) raised the example of Hendee Enterprises which is a Houston-based producer of awnings where they contended that the ABC bundle took three yearss to figure costs for the organization s 150 exercises, 10,000 requests and 45,000 line focuses ( Wegmann, 2010 ) . In 2003, Kaplan began to update the ABC framework when many contended that it is unnecessarily intricate and cut concentrated to execute. This has prompted the eagerly awaited new assault of ABC, the Time-Driven ABC ( TD-ABC ) . He guarantees that the new ABC advancement, TD-ABC, uncovers additional limit, forms quicker, ready to flexibly high truth and can be acceptable provided from bing IT-frameworks, for example, ERP ( Kaplan and Anderson, 2007 ) . Kaplan ( 2007 ) went again to reason that TD-ABC skirts the action definition stage and hence the assignment of expenses to different performed exercises. They other than contended that TD-ABC is a disentangled rendition of the current ABC framework at that cut ( Everaert A ; Bruggeman, 2007 ; Everaert et Al, 2008 ; Kaplan A ; Anderson, 2004 ; Max, 2007 ; A-ker A ; Adiguzel, 2010 ) . This was other than bolstered by Demeere et Al ( 2009 ) and Wegmann ( 2010 ) where TD-ABC is hail to be an improved action based costing framework contrasted with its old turn of events. TD-ABC contrasts from the bing ABC framework where the clasp gauges require to figure driver rates can be acquired by direct perception or by assessing executives ( Kaplan and Anderson, 2010 ) . This spares cut and can chop down the expense of execution and refreshing the framework. He farther contended that executives are viewed as the more reliable start refering truth of data on cut ingestion and exercises contrasted with bing ABC framework where data are gotten from representatives who will in general be predisposition. Thusly, with TD-ABC, chiefs can deliver precise data and brush less bloopers. Effect of the new contemplations on the two organizations and counselor Not long after its constitution, TD-ABC started to have a turning inclusion among academicians and a diverting figure from 9 to 67 in the time of 2003 to 2009. This was introduced by Google Scholar and since so TD-ABC has indicated a positive inclination in the on-line universe ( Alsamawi, 2010 ) . Demeree et Al ( 2009 ) other than started to recognize the account behind TD-ABC and tried TD-ABC at an outpatient facility. For case, Demeree et Al. ( 2009 ) actualized TD-ABC at an outpatient facility. They have assembled informations through direct perceptions and meetings with segment caputs and outpatient facility chiefs. To enroll distinctive clasp ingestions for important exercises a stop watch was used. This method was rehashed 3 months in this manner to ensure that predictable outcomes were gotten. This data array strategy was recorded as a triumph. Different essayists call attention to that TD-ABC brings applied deformities associated with the utilization of clasp estimations ( Cardinaels A ; Labro, 2007 ) . Gosselin ( 2007, p.649 ) presumed that TD-ABC is the latest improvement in the field of action based costing techniques, however accomplishes non work out the applied occupations worked in to ABC . Choice
Wednesday, August 26, 2020
Research design Essay Example | Topics and Well Written Essays - 1750 words
Exploration structure - Essay Example Suggestion to proficient application is incorporated. RCT conceivably forestalls predisposition and decreases perplexing Dauphin et al. (1999) had the option to come up a critical outcome concering the inclination and exactness in visual simple arrangement (VAS) while effectively utilizing the RCT. In this examination, they had the option to explore the qualities of VAS particularly in the estimation of symptomsââ¬â¢ power or recurrence. Before discovering this, the exploration examination included investigation tests under an anticipation preliminary including supplementation by cancer prevention agent nutrients and minerals of respondents who were 35-61 years assembled from everyone in France. There was incorporation of randomisation from tests preceding researching the genuine purpose of the investigation. a similar procedure was started during the first and second preliminaries. This implies the genuine general information were accepted to speak to the whole data got from the whole examples. This is an exceptional quality of the investigation since this will in the end think about the sort of information that will be utilized for the VAS. Along these lines, the investigation of Dauphin et al mirrors the real system engaged with RCT research structure. The RCT when all is said in done is attempting to make a deduction of a specific mediation by arbitrarily utilizing tests from the whole investigation test from a populace that ought to hence be haphazardly recognized as the treatment or intercession gatherings and control bunches individually (Bonita et al., 2006, p.50). The following is the real outline or structure exhibiting the general stream engaged with the RCT research configuration (Evidenced-Based Dentistry, 2013). One significant quality in utilizing RCT as found in the investigation of Dauphin et al. (1999) is the nearness of predictable outcome, as portrayed by the... In some clinical examinations, analysts might be anticipating a particular treatment reaction of some specific diseases to a given medication. In this explanation, they might have the option to contrast treatment gatherings and control bunches not getting the medicine. In utilizing a specific clinical investigation, the unwavering quality of a specific medication might be demonstrated viable or not in view of the related observational proof that one could produce through the utilized exploration plan. Moreover, there are a few examinations that would require exact estimation of the real experimental proof, so limiting the portion of predisposition and other prescient elements has gotten important. One of the most significant disadvantages in certain investigations is the consideration of plausible predisposition particularly in creating information preceding the real examination and introduction of results. There are numerous measurable techniques that could attempt to keep this from impacting the dependability of the examination. Be that as it may, one normal intelligent methodology in insights is to start irregular preliminaries because of choosing or procuring of information. The RCT has significant preferences and shortcomings, however the reality comes down to the abilities of the clients on how they ought to appropriately start the exploration configuration including its related procedure. The RCT is so incredible examination plan for whatever length of time that it attempts to speak to a general thought regarding the effect of a specific anticipation or medicines applied in a specific populace. Therefore, it could help decide a sum up finish of the general case. Albeit singular cases can't be completely decided, the RCT despite everything ends up being a productive examination plan that could be uninhibitedly incorporated inside the clinical investigations particularly in guaranteeing exactness of results and avoiding likely inclination.
Saturday, August 22, 2020
Argentina Crisis essays
Argentina Crisis papers To genuinely comprehend the Argentina Crisis you should initially recognize what has occurred with their administration inside the previous two years. Argentina has been in a horrible downturn for as far back as four years. IN December 1999 recently chose president Fernando De La Rua promised to reestablish the economy. At that point the financial plan was not looking so great. Economy serve, Jose Luis Machina anticipated the spending plan to over shoot the 5.2 billion dollar focus by 10%. In March Machina said overlook this and quit, to be supplanted by Ricardo Lopez Murphy. Murphy steps directly in introducing an extreme 4.45 billion dollar multi year grimness program with profound cuts in instruction. Troubled by these strategies six government authorities quit in dissent and power Murphy to leave. In March 2001 Domingo Cavallo a previous economy serve is named to attempt to rebuild the economy. In the previous two years Argentines have seen an excessive number of faces slide thro ugh workplaces. This made individuals begin to lose trust and expectation in their legislature. Not long after Cavallos arrangement the securities exchange accidents and three rating offices cut Argentinas FICO scores. In July 2001 Murphys severity bills are passed. Cutting state compensations and benefits by 13% and constraining a conclusion to spending shortfalls. Argentines trust in their legislature is presently totally lost. In November of that year individuals pulled back practically 1.3billlion dollars from their financial balances. This stressed Cavallo, so he requested a limitation on the measure of cash the pubic is permitted to pull back from their financial balances. This was additionally never really out the banks. The annuity supports that were taken are currently being changed into treasury bonds or government upheld advances to pay administration obligations. Argentina currently is in all out emergency. Joblessness has ascended to 18.3% and all associations are calling a strike. In December 2001 another authority stops, Finance secretary Daniel Ma ... <!
Marketing Research Essay Example | Topics and Well Written Essays - 1000 words - 1
Showcasing Research - Essay Example One of the essential objectives of showcasing research is recognizing and surveying how the changing components of the promoting blend sway on client conduct. Promoting research falls into two classifications relying upon target showcase: shopper advertising examination and business-to-business advertising research. Conversation The showcasing research process covers a series of stages, for example, assortment, association, and understanding of information. The planning of an exploration plan is a multifaceted undertaking as it includes choices, for example, the information sources to utilize, ways to deal with take, how to limit twists to the information gathered, the examination instruments to utilize, the arrangement of the testing plan, approach, and adherence to inquire about morals. An advertising research arranging process consolidates a progression of interconnected stages and each stage affects the stage going before or resulting to it. Phases of a Marketing Research Plan St age 1: Defining Research Problem The primary stage in a promoting research plan includes distinguishing proof of the issue or advertising issue (need). This stage comes after survey of the business circumstance (Wild and Diggines 50). The beginning period of the examination plan highlight the explanation or the exploration issue. When characterizing the issue, the scientist should develop a proper showcasing research structure. The issue ought not be excessively restricted yet should grasp the relevant issues that the examination tries to catch. It is basic to get cognizant knowledge into the nature, extension, and force of the issue preceding the definition of the issue. The expressed issue ought to mirror the organizationââ¬â¢s assets and ought to be communicated in a way that evidently recognizes the looked for circumstance (Housden 71). The issue for this situation includes situating of the new telephone in the market. Laying out the Research Objective The scientist ought to legitimize the requirement for inquire about just as characterizing the target of the exploration (Prasuraman and Krishnan 26). Laying out the examination objective is critical and the scientist needs to assess what the person looks to discover and why. What's more, the scientist ought to distinguish the information required just as the information sources. This involves examining the exploration reason and featuring the information required to finish the reason (Prasuraman, Grewal, and Krishnan 33). Research target involves objectives to be accomplished by directing exploration. One of the targets might be investigating some new item in the market. Various research goals lead to assorted research plans (Wild and Diggine 51). Stage 2: Planning Research Design The subsequent stage incorporates deciding the exploration configuration to be utilized. Selecting from the fitting technique is essential to the general accomplishment of the promoting research. The exploration technique to be embraced relies upon the examination reasoning that has been utilized. The planning of the exploration instrument is likewise critical (Zikmund and Babin 51). Stage3: Planning Sample The third phase of an examination plan fuses characterizing the example. The distinguishing proof of the example joins indicating who or which units should benefit the information required (Prasuraman and Krishnan 37). This stage lays the ground for planning of the example. The stage envelops initiating a critical thinking system and scientific models guided by the characterized crowd. The
Friday, August 21, 2020
Attitude and Knowledge Scale Essay Example | Topics and Well Written Essays - 750 words
Disposition and Knowledge Scale - Essay Example (3) ___ 29. The capacity of a person to adapt to pressure reduces in mature age. (4) ___ 30. All individuals ought to be required to resign at age 70. (5) ___ 31. Most matured people oppose change. (4) ___ 32. As individuals get old, they become progressively hard to get alone with. (3) ___ 33. More seasoned individuals are more apprehensive than more youthful individuals. (3) ___ 34. Most youngsters have troublesome speaking with matured people. (3) ___ 35. Numerous youngsters feel awkward within the sight of the matured. (2) ___ 36. Most youngsters would incline toward not to be around the older. (4) ___ 37. As an individual becomes more seasoned, decreases in all exercises develops. (2) ___ 38. The biggest dread of most more seasoned individuals is their own approaching passing. (2) ___ 39. In mature age, ailment is the steady friend of older people. (4) ___ 40. A great many people would prefer not to develop old. (3) ___ 41. The vast majority dread the possibility of developing old. (3) ___ 42. The vast majority see the older as weights upon society. (2) ___ 43. At the point when an individual is youthful, he/she will in general look on mature age as something that happens just to others. (2) ___ 44. Individuals in their nineties by and large don't have the foggiest idea what is happening around them. (4) ___ 45. It is ideal to utilize moderately basic language when conversing with more seasoned individuals. (4) ___ 46. More established individuals will in general react to questions more gradually than do more youthful individuals. (4) ___ 47. For most, mature age is portrayed by harshness and lament. (3) ___ 48. Most more seasoned individuals lament numerous things they did over the span of their lives. (3) ___ 49. Most more established individuals lament numerous things they don't do over the span of their lives. (3) ___ 50. As individuals develop more seasoned, they will in general be all the more requesting and conceited. (3) ___ 51. Most of older people appreciate being grandparents. (4) ___...I have a reasonable viewpoint of mature age and understand that the requirements of every single elderly individuals may not be the equivalent. On the off chance that there are some elderly individuals who understand forsaken and left, there are additionally numerous who may have an interesting get-up-and-go. I accept that as opposed to compassion, what elderly individuals require is sympathy. Every one of them are one of a kind people who have their very own individual history, thus all consideration ought to be taken to give every last one of them their very own space. The facts confirm that they may require help in performing numerous normal tasks of life. In any case, this I feel ought to be done in such a way which not just reinforces their fearlessness (that is on the off chance that they need any), yet in addition cause them to feel needed, cherished and act naturally. Once more, while doing this I might want to call attention to, that it is normal to fall into the conventional philosophy that all individuals require compassion and consideration. We ought to recollect that on the off chance that we are additional sort to elderly folks individuals, it is neither in view of their subject position nor for helpful causes however just in light of the fact that we are people. 2. One certainty of mature age is central. It is conceivably a physical detoriation of one's wellbeing.
Everything I Miss and Dont Miss About MIT
Everything I Miss and Donât Miss About MIT If you know anything about MIT, you know that theres a lot of numbers involved. You may know that most buildings are known better by their numbers than anything else, that the courses of study span between 1 and 24 (but not 13, 19, or 23) n 1 and 24 (but not 13), that important MIT milestones often have something to do with 3.14159 7 years ago on 3/14 around 2 p.m. I found out I got into MIT. And now, after all these years, that auspicious number still hovers over me. Its Pi Reunion weekend baby!!! Some people may sneer at how MIT folks seem married to their Brass Rats or gush about the beaver being natures engineer or attend a reunion named after Pi (that is a class reunion 3.14-ish years after graduation)â"and yes, Ive witnessed these responses in the wild since leaving schoolâ"but I love, love, love all these quirks and traditions. And to celebrateand mentally prepare for this frenzied weekend (activities include hanging by the pool at the Cosmpolitan, Red Rock Canyon hiking excursions, clubbing, brunches, getting together with both the closest of friends and familiar faces you still havent learned the names of, yet)Im just going to sit here a while and indulge in nostalgia What I miss about MIT: Making two packs of Shin ramen at midnight and feeling like its an okay the best way to do life Chatting up classmates around late night architecture studio with an ease that only comes with knowing an all-nighter was inevitable Taking the commiseration onto Gchatâ"i have nothing!!! no! iiiiiii have nothinggggggg #Treatyoself snacks at La Verdes at 3 am and trying to make a pack of four Vienna Fingers cookies last all the way to Burton Conner All-you-can-eat sushi at Yamato in Brighton for $25 a person Scoring guest meal passes and eating with friends in Maseeh/McCormick/dorms with meal plans The kind of pride that comes from knowing how to navigate the tunnels and a silent joy when its raining so hard that you have to take them A non-organized nighttime roof adventure that feels like a dream now but definitely happened Waking up to a Cinco de Mayo band playing on Memorial Drive after getting drunk for the first and only time in my life Watching leaves change on Mem Drive Watching snow accumulate on Mem Drive A dorm window facing Mem Drive and the Charles River and the Boston skyline is everything The Welcome MIT Families banner that reliably returns every CPW and Family Weekend (is that still around?) The tucked away desk with natural light, outlets, and total privacy in Rotch Library Reserving a conference room at McCormick for working hard/hardly working with all my lady friends What I dont miss: Working late at Steam cafe and seeing a giant mouse/rat??? scurry by Declaring war on teeny tiny mice in my dorm suite, the kind that can get under the door and travel between rooms with no problem (The weeks-long operation included duct-taping the bottom of my doors and gaps around closets, sprinkling my room with cotton balls soaked with peppermint oil, and enlisting my kind and capable suitemate to dispose of a dead mouse found in my room) The uncomfortable, often way delayed Megabus and Bolt rides from NY to Boston before and after the holidays Getting a zillion mysterious bruises in the process of attending a jampacked Macklemore spring concert Thinking Im going to do pretty well in a class and watching that hope dissipate The sluggish behemoth that is the Building 7 elevator The internal turmoil of feeling stupid for not running to catch the 1 bus in fear of looking stupid The MacGregor wind tunnel Cheers to all the little things.
Thursday, June 25, 2020
The Ethics of Client Suicide - Free Essay Example
Client suicide is one of the greatest fears of all counselors, and suicide prevention is a difficult and commonly avoided area of counseling. Suicide rates in the United States have steadily increased from 10.4 per 100,000 in 2000, to 13.4 per 100,000 in 2014. This is a 27.6 percent increase over 15 years. If this trend continues, the occurrence of suicide will be one issue that most counselors will unfortunately have to face at some point in their practice. There are many legal, moral, and ethical difficulties surrounding the topic that could ruin a career if not properly dealt with (Sommers-Flanagan and Shaw, 2017). Client confidentiality is of utmost importance, but when a client indicates that he or she may be suicidal, counselors have a duty to report this to family members and authorities. Contrary to common belief, there are several effective suicide treatments for adolescents and adults. Using these techniques, first counselors must help clients out of the actively suicidal state. Next they encourage and teach the client to develop the skills needed to create and uphold fulfilling, rewarding, and enjoyable lives (Meyers, 2017). In this paper I will explore an ethical dilemma involving suicide and highlight some of the areas of greatest difficulty in the event of a client death. For most counselors, an ethical dilemma is apparent when they encounter a confounding situation in which they feel hindered in their decision-making due to various factors. There may appear to be conflict between, or inconsistency among, the ethical standards. The situation could be so compounded that the ethical codes offer unhelpful guidance. A discrepancy between ethical and legal standards could materialize, or there may seem to be a conflict between the moral principles that underlie most ethical codes. If the correct route to take in a counselling situation is unclear, the ACAs ethical decision-making model may need to be employed (Forester-Miller Davis, 2018). When making an ethical clinical decision, it is essential to consider both personal bias (ACA, 2014, A.4.b) and level of professional competence (ACA, 2014, C.2.a). How is a counselor to proceed if a client has many symptoms of depression and suicidal ideation and fits into one of the most likely demographic categories for a suicide, but denies all thoughts of suicide? A 30-year-old client named John decides to speak to a counselor because he has been feeling down. His thirtieth birthday was a month ago, and since then he has been overwhelmed with the feeling that he is not where he expected to be at this point in his life. He married young and has been divorced for five years. He is estranged from his parents, who emotionally abused him for all of his childhood, and he does not have any siblings. He did not complete college and complains about his unrewarding and tiresome job. He lives alone and struggles to find a healthy balance for his life, saying that he usually only works, comes home, drinks excessive amounts of alcohol, and watches TV before falling into a restless sleep, repeating the cycle weekly. He mentions that he enjoyed hunting, but can no longer find the will to do even what he enjoys. He does not explicitly mention thoughts of suicide, but shows many of the warning signs. He states that he feels as though his current life is pointl ess and unimportant. After the third session, John commits suicide using one of the guns in his home. John showed signs of isolation and feelings of worthlessness. He had not expressed a true desire to improve his life, only that he recognized that there may be a problem, putting him in the contemplation stage of change. He had taken the first step of attending counseling, but he did not seem as though he would continue attending counseling long-term, stating on the third session that he did not think counseling was going to be as effective as he had hoped. His expression of his love of hunting indicates that he has access to firearms. Studies have shown that when there are no firearms in a household, there are fewer suicide deaths. John lived in a rural area where it has been shown that suicide attempts are more often successful than in urban areas (Westefeld, Gann, Lustgarten, and Yeates, 2016). John also had a high rate of alcohol consumption which is a factor in fifty percent of suicides (Firestone, 2018). The mind of a suicidal person is working against itself. A part of the client wants to live, while another part is self-destructive. All suicides have elements of both planning and of spontaneity. Therefore, therapists must act quickly and precisely if suicidal thoughts are stated in counseling. There are many thought patterns common in suicidal clients including self-hatred, hopelessness, isolation and pushing away loved ones, feeling like a misfit, and feeling like a burden. There are also many common behaviors like past suicide attempt(s), sleeplessness, anxiety and agitation, rage outbursts and low problem tolerance, risky behavior, alcohol use, sudden positive shift in mood, and any direct talk of suicide related behavior (Firestone, 2018). The stakeholders and main decision-makers in this situation should be a collaborative effort between the client and the counselor. If the counselor is still unsure of what to do or feels that the client is being untruthful or flawed in his assessment of himself after the first two sessions, the counselor should talk with other counselors for a second or third opinion on the plan of action (ACA, A.1.c, 2014). John should be heavily encouraged to continue counseling. The counselor does not want to hurt Johns already weakened sense of pride by suggesting that he may be suicidal, but neither does she want to avoid a life-threatening possibility. John does not have friends nearby or family that could be alerted. The only people who could offer him support are his co-workers. It would be a breach in confidentiality to alert them, however (Ethical, 2018). In one study, job/financial problems were found to be an issue in 22.5 percent of the suicide cases analyzed (Schiff et al., 2015). The counselor fears that John is not expressing his suicidal thoughts for fear of the consequences laid out in the informed consent agreement. John is in a high risk demographic group because he is male, white, and unmarried. However, this is also an extremely high false positive group (Fowler, 2012). John was also emotionally abused during his childhood. This puts him at a higher risk for psychopathology. He has trouble forming trusting relationships, as clearly evidenced by his relationship with his counselor. John, like many emotional abuse survivors, finds it difficult to form secure attachments and has trouble forming and maintaining interpersonal relationships. This also puts him at a heightened risk for suicide (Allbaugh et al., 2018). Clients may be asked to sign a no-suicide contract or a commitment to treatment contract. These can be helpful in certain instances, but if the counselor-client relationship is strained or new, clients can feel as though they are being made to sign the contract to shift moral blame away from the therapist in the event of a tragedy, although the contract is in no way legally binding. Suicide is the third leading cause of death among 15 to 24 year-olds (Canady, 2017). Seventy-one percent of psychotherapists report having at least one client who has attempted suicide, and twenty-eight percent of psychotherapists report having had at least one client die by suicide (Firestone, 2018). It is an unfortunately common event that most practitioners will experience in their careers. As difficult as it may be, if a client is presenting symptoms of depression and suicidal ideation, the best course of action is to ask the client directly if he is or is not considering suicide as an option. John should be asked to sign a commitment to treatment agreement. This could encourage him to take the counseling process seriously and could assist in his symptom improvement. He should be encouraged to exercise, eat well, and drink less alcohol; all mood and energy boosters. Exercise could help improve his quality of sleep. John appears to be suffering from depression. He could be referred to a doctor for an antidepressant, but there is limited evidence that medications have substantial impact on suicidal ideation and self-harm behaviors (Jobes, 2017). If he had family nearby, they might have been able to assist in removing the guns from Johns home and provide him with emotional support. John was asked by the counselor after the second session to put his firearms in a remote location that he does not have immediate access to. John denied the request, citing his need for protection in the event of a burglary, although he lives in a very safe area of the country. This is also an indicator that he is perhaps unreasonably paranoid, which is a warning sign for suicide. The only other option would have been to alert authorities, but if John was not suicidal, this could have made John turn away from counseling completely and send him deeper into his depression (Westefeld et al., 2016). Remember that he also did not express any suicidal ideation, making it a breach of confidentiality to alert anyone at that point. In the first session with John, a relatively high-risk client, the counselor should assess his current suicide risk. Next, she should communicate her intent to understand more about his life and what makes living difficult for him. Lastly, she should ask John if he would be willing to negotiate treatment options and devise a plan for managing his well-being, immediate risk removal, and symptom improvement. Suicidal states are often triggered by unbearably painful emotions associated with feeling abandoned, alone, alienated, and disconnected. John is experiencing all of these feelings. In those most vulnerable to suicide, the capacity to think clearly and flexibly collapses, and suicide emerges as a means of evading intolerable affliction. Treatments that focus on restoring the capacity to reflect on strong emotions, and to weather affective storms are emerging as highly effective in reducing the occurrence of suicide-related behaviors. Techniques aimed at improving forbearance for, and improved regulation of, intense affect include radical acceptance, mindfulness acceptance, insight-oriented interpretation, and mentalizing, to name a few. It is beneficial to use all elements to fit the needs of the client, but it is also advised to rely heavily on raising the patients curiosity and awareness of their emotions because suicidal clients are often phobic of negative or conflicting emotions. The most accurate predictor of suicide is past suicide attempts (Fowler, 2013). John has denied ever attempting suicide before. Clients presenting for treatment with active suicidal ideation and intent must be assessed for risk. A new counselor or counselor-in-training should conduct a formal suicide interview. Fowler (2012) says it is best to communicate interest in the clients suffering and to invite them to speak openly about their struggles. Counselors should work to understand the clients reasoning for wanting death and aim to create a sufficient empathic reply to their internal pain in the form of marked mirroring. Johns risk assessment came back as negative, so it was the counselors decision to not have John placed on suicide watch based on his results and the expert opinion of the counselor (ACA, E.2.c., 2014). Over the past 20 years there has been a shift in how psychoanalysts assess potentially suicidal clients. We now realize that, unfortunately, suicide risk factors mean little for prediction and prevention efforts. A positive aspect of the developments in suicide-related theory is the move away from the medical model. There is increased emphasis on the initial and ongoing clinical encounter, including use of comprehensive suicide assessment interviewing protocols and use of increasingly nuanced methods for clinicians to directly question patients about suicidal ideation. There are also methods for monitoring suicidal ideation and risk over time (Sommers-Flanagan and Shaw, 2017). The assessment of suicide risk usually rests on the admission from the client of suicidal ideation, either voluntarily communicated, reported by the patients significant others, or confirmed by skilled clinician examination. Most of the more commonly used screening tools for suicide risk, such as the the Ask Suicide?Screening Questions and the PHQ9 rely heavily on the self?report of suicidal ideation. Even expressed suicidal ideation is only a weak predictor of suicide, however (Berman, 2018). I think many counselors in this situation would feel the need to do something for John. He has many risk factors and many would say that it is obvious that he was suicidal, but he would not admit to suicidal ideation or planning. This puts the counselor between a metaphorical rock and a hard place. There is unfortunately nothing the counselor could have physically done to stop John. Justice and autonomy allow John to keep his firearms. Universality is apparent because any client would have to be treated in the same manner as John. Beneficence of the counselor toward John means that she has the clients best interest in mind and she trusts him to tell the truth, even though in this example he did not. Publicity stops the counselor from alerting Johns coworkers, the only possibility of people to provide emotional support in his life, of her concern. For counselors and counselors in training, client death is a difficult event to move past. The only thing we can do is be as prepared as possible if the event should occur. According to Veilleux and Bilsky (2016), training in suicide prevention does not prepare trainees or training programs for the cataclysm that a suicide can ensue. Suicide postvention procedures exist in other fields to help those affected, but mental health clinicians are forced to adhere to the ethical mandate of confidentiality. Therefore, therapist survivors are not free to openly grieve with others who knew the deceased. In combination, the feelings of responsibility related to the clients mental health and the ramifications of breaching confidentiality can leave the counselor with an often great burden that must be endured in solidarity. Understanding legal and ethical problems related to suicidality is important knowledge to have when counseling suicidal clients. Mental health care providers should grasp state laws pertaining to suicide, recognize legal challenges that are painstaking to defend against as a result of poor or incomplete documentation, and ensure the safety of client records and rights to privacy and confidentiality following the Health Insurance Portability and Accountability Act of 1996 that went into effect April 15, 2003 (Cramer, Johnson, McLaughlin, Rausch, Conroy, 2013).
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