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Items filtered by date: May 2014

Saturday, 24 May 2014 14:47

Theoretical Orientation to Therapy

            Theoretical orientation is a prevalent way of defining a therapist, in psychotherapy (Egan, 2007). Individual practicing therapists have a theoretical method or approach to which they adhere while helping clients. Although it is fundamental that therapists have to have knowledge of a variety of theoretical approaches, aligning to a specific theory that compliments the counselor’s personal style and expertise, and makes them feel comfortable enables them to have a good base from which to work with clients effectively (Okun, 2007). Similarly, having knowledge of a variety of theoretical approaches enables the counselor to work with counselors who conform to different approaches, with ease.

In accordance to my personal style, knowledge, and strengths, I believe that solution-focused and family systems theories are methods with which I feel comfortable practicing.  In this paper, the purpose is to demonstrate my personal orientation to theory and the connection between these approaches and my personal strengths, in relation to my prospective work with families and children. I also discuss the likely interventions that I will implement, in accordance with the solution-focused and family systems theory. Finally, a current therapeutic situation will be discussed, in relation to the theoretical approach.

 The Family Systems Theory

            The practical application of the family systems theory has a variety of definite advantages (Egan, 2007). It is a common believe among therapists that the family of origin has an influence on an individual beginning from childhood to adulthood. The family systems approach emphasizes the need for a therapist to appreciate the influence of the current family structure on an individual. The most significant advantage of the family systems theory is the inclusion and recognition of the different entities within the family that influences the individual’s thought processes, behavior or character, coping strategies, and the capacity for social interaction with individuals, in the outside world. This attribute of the family systems theory is fundamental for therapists, especially those who work with young persons who are at an early stage of coming to terms with a domestic violence relationship.

            The clinic at which I am involved in clinical practicum has a focus on a client-centered approach. However, I have opportunities to practice psychoeducation, focusing on their family of origin and how it impacts their decisions as adults, as well as identifying their ideas of a healthy relationship and situations in which they are most comfortable. This is the initial step from which we proceed to the examination of how the relationship between the client and people around them influences the client’s children. In a majority of cases where the client can recognize their connection to the family of origin and its impact on the health of their adult relationships and choices, the client gets the motivation to disengage themselves and their children from an abusive relationship.

Therefore, considering the ages of children, it may be necessary to have sessions that involve the family of the client, in the process of therapy. However, it is important to recognize that involving the client’s family may cause problems that may not have been present in the implementation individual therapies.  For instance, the ages of children and size of the family can become obstacles in making an application of the family systems theory.  This is because the therapist has to move from dealing with an individual history and viewpoint to incorporating diverse views. In addition to the firsthand opportunity of watching the interaction between the individual and family, the therapist has a role to ensure that every member of the family is accorded an equal measure of fair treatment while also ensuring that all individual members enjoys confidentially and that their story is expressed and heard.

The risk is that the counselor may be triangulated into the family. Therefore, counselors must take precautions and ensure that they do not form alliances or take sides with individual members of the family. This can be a challenge especially when the individual member of the family was engaged in therapy with a single member of the family.It is also vital for a counselor to feel comfortable with the family while ensuring they are sensitive to the individual needs of the family members. Sensitivity to individual needs may vary with the size of the family and the age of the targeted client.  The age range of clients in the clinic where I am attached is wide. Clients have a range of age 20 to age 60. Therefore, I get a chance to interact with clients’ children, ranging from age five to age 20, on average. Lastly, I am engaged with many family members, and, so, sometimes it can be an overwhelming task to take note of the individual communication style, point of view, and alliances between members of the family involved, in the therapeutic process.

 Personal Style, Theoretical Orientation, and Initial Interview Strategy

            Since an early age, I have learned to be a straightforward person. I always do things in a systematic way that conforms to logic. For example, when faced with scenarios that involve choices, I always choice the shortest course of action. I know and believe that the past has a bearing in what we do in our current and future lives. I also understand that none can change their past. Therefore, it is not wise to spend a lot of the counseling time reliving the past. In this regard, I believe that all persons have the ability to change their current status provided they get a proper motivation to change. The implication of this belief is that I embrace the solution-based therapy as an adjunct approach to the family systems foundation of my personal theoretical orientation to therapy, in helping clients. 

 I also have beliefs that are related to the solution-focused theory, which incorporate into the practice of therapy. For example, I believe that the client has a significant role to play in the planning of therapy and development of their treatment goals. This belief blends well with the client-oriented approach applied by therapists, in the clinic at which I am completing my clinical practicum. The choices that come from within an individual can have a lasting effect that those from outside sources such as the therapist. Outside sources can have good intentions but may not be accepted easily by the client, as their individual target goals for the therapeutic process. In addition, I acknowledge the potential of self-motivation, in attaining therapeutic goals set by the client. Envisioning positive outcomes is a fundamental step in realizing therapeutic goals (O’Connell, 2012). For this reason, I embrace the application of self-talk. I promote asking the client to envision their life without the problem so that they realize the importance of working towards making the problem disappear and, hence, achieving therapeutic goals. 

Lastly, I believe that making summarizations at the end of individual sessions is important in reinforcing messages. Summarizations reinforce to the individual that the therapist took note of their expressions. In addition, it gives therapists an opportunity to restate the problem in different ways so that the client can have different perspectives of the problem. This enables the client to think of possible solutions that may have not been apparent to them. This is specifically useful for victims of domestic violence, whom I work with, in the clinical setting. At the beginning, the client is usually in a crisis and cannot solve the problem effectively. The recap or summarization enables the client to redefine their problem and think of potential solutions as they now can understand the problem better.

 Diagnostic Assessment, Goals, and Interventions

            In a sample case, a couple came to the clinic for counseling. The wife came complaining that the husband was dealing with their 7-year old son inappropriately. The son, who is in second grade, sometimes refuses to go to school. Sometimes, the couple is able to force him to school, but sometimes they are unable to convince him to go to school, and the boy stays home the entire day. Struggles to make the boy to get dressed and prepare for school marked the beginning of a routine day for the family.

The problem was that the parents differed about the best approach to make the child change his attitude towards school. While the husband preferred to beat the boy and force him to school, the wife preferred a softer approach. Therefore, the difference in approach made couple part ways and the boy remained with the husband, who would force the boy to school every morning. The wife wanted a method to make the husband agree to her soft approach of handling the boy, or get her son out of the custody of his father. I arranged to meet the couple and the boy for counseling, utilizing the family systems approach.

 I like using self-motivation with the clients. In many occasions, clients who come to the clinic are those that have minimal or no control over their lives, children, and homes. Therefore, asking the couple to state their goals resulted in them keeping quiet, without providing any answer. Generally, there are some silent goals that individuals have such as wanting the end of abuse, wanting to feel better, or wanting their children handed back to them. After the start of the discussion about what their situation would be like without the problem, it took a couple of sessions for the couple to begin to conceptualize the specifics of the things that needed to happen such as making their son go to school voluntarily, solve their differences, and other things that needed to happen to enjoy a relief. 

After the identification of client goals, the next step was to create a strategy to move towards these goals. Usually, it is important to start with simple, achievable steps. I normally work backwards from the goal to the strategies. For example, for the couple who wanted to solve their marital problem and find a way to make the child go to school, I assisted the couple to identify strategies that would assist in meeting the goals of therapy. During the discussions, it became apparent that the boy did not like the school because his friend had told him nice things about their school, and so he wanted to change schools. He had not told his parents because he thought that his father would beat as he always did. The parents agreed to a change of school and a non-violent approach to handling their son.

 Challenges, Strengths, and Ethical Implications

            The challenge in utilizing the family systems approach to counseling is that couples may not be in good terms at the time when they come to the clinic for counseling. For example, the wife and husband were living in different homes, making it difficult to arrange for a joint session. The husband was reluctant to agree to be involved. However, after a few failed replies to the invitation for therapy, he finally accepted. The other challenge was that the couple’s child was too young to be considered an independent family member. However, the case was not too complex to warrant questioning the validity of contribution of the young child to the solution arrived at during the counseling process. It is also fundamental to note that the family members agreed to participate voluntarily and agreed on the solution, without any form of coercion or influence from the counselor, in accordance with the law and professional ethics. 

The most important thing in utilizing the solution-focused therapy is to define the problem and identify specific goals for the therapeutic process (Zankas, 2008). However, the achievement of these things requires the client to take certain steps first, depending on the problem. For example, the client may need to contact their family and talk to them about their situation. They could also identify opportunities for a sustainable job. After the client and the therapist identify the end goals, they should begin to work together to actualize those goals. The strength of the family systems approach to therapy is that is based on the principle that the whole is important than the sum of its parts (Egan, 2007). Through the involvement of the entire family, individual members of the family perceive the sense that every individual member of the family is important to the process of identifying the solution to the problem.

This is important in ensuring that the individual members of the family buy into the solution agreed upon by the members as assisted by the therapist. The other advantage is that the clients are the ones who identify a preferred solution to their problem. In the sample case, the resulting solutions were developed based on the consideration of the effect on the child.  The therapy was successful in creating a solution for the couple, in that they not only agreed to transfer the son to his preferred school, but also agreed to reunite and live together as a family. The counseling process created a platform where every member of the family had time to talk and be heard fairly. This allowed them to listen to each other without anyone among them dominating the discussions as they would happen in a non-counseling setting.

Perhaps, solution-focused therapy acting as an adjunct method to the family systems also contributed immensely to the creation of an accurate solution. The systems theory perceives psychological problems of an individual as arising from the individual’s current environment and inter-generational family system (Zankas, 2008). From an ethical point of view, the therapist should respect and guard confidences of every individual client. The information obtained from every family member should be treated as if the individual were in a session for an individual therapy. The therapist should refuse to discuss with individual members separately because doing so will foster the development of unproductive alliances among the members of the family. 

In relation to my experience, my initial affective response was that the couple’s case was a case of misunderstanding. Several cases that involve parents differing over their children’s behavior include some aspect of variation among the parents, with respect to responding to the behaviors of the children. From their discussions and expression of emotions, I realized that the couple had been lacking an appropriate platform to talk and listen to each other. It became apparent that the husband had been having his way because of his violent nature, without considering the views of his wife. However, when he got the chance to listen to her and think about his actions, he realized that he had boiled things over, in their marriage. Of course, there are a few things that I would have done differently, with respect to the application of the family systems therapy.

For instance, the schedule of the counseling sessions was spread across a two-week period. Perhaps, well spaced sessions may provide to the clients adequate time to think about themselves, and whether they are ready to commit to certain decisions. Short period may rush the clients to making conclusions without sufficient thought. The clinic to which I am attached emphasizes client-focused approach to therapy. Therefore, this theory is a perfect fit because it encourages therapists to compliment clients. The focus is on identifying the things that work best for the client. I begin from there to help the client pursue their goals as identified. It is important to begin by acknowledging the significance of the fact the client took the first step to honor the appointment to come for counseling. Recognizing and acknowledging the client’s awareness of the state of their life and their willingness to seek help and take action are a motivation to the client. From there, I can help the client set strategies and timelines for the attainment of the therapy goals.


            I believe that the best method to assist clients is for a therapist to adopt a personal theoretical approach while having a basic knowledge of various theories. It is also fundamental to realize that therapists who are flexible and willing to borrow from other theoretical approaches accord their clients the benefits associated with utilizing multiple opinions and different theoretical approaches. In accordance with my personality profile and interests, I believe that the solution-focused approach to therapy is the best foundation for interventions, particularly utilizing it as an adjunct to the family systems theory. The clinic to which I am attached has a client strategy that suits the application of these theories. Therefore, I can apply goals and strategies related to these theories within my choice of the clinic.


Egan, G. (2007). The Skilled Helper: A Problem-Solving Management Approach to Helping (8th Ed.). Belmont, CA: Brooks/Cole

O’Connell, B. (2012). Solution-Focused Therapy. Thousand Oaks, CA: Sage

Okun, B. (2007). Effective Helping: Interviewing and Counseling Techniques (7th Ed.). Pacific Grove, CA: Brooks/Coke

Zankas, S. (2008). Ethical Issues in Couples and Family Therapy. Retrieved November12, 2013, from https://umdrive.memphis.edu


Published in Education
Saturday, 24 May 2014 14:43

Ethical Considerations

 Ethical Considerations

 In any kind of research, emphasis on the stipulated ethical standards is extremely crucial. This kind of emphasis helps in strengthening the validity of outcomes. When a research is characterized by low ethical standards, the level of validity is compromised significantly. This is also inherently associated with the reliability of results within the entire research framework. The other pertinent implication of ethical considerations is that they help in the mitigation of conflicts. The absence of ethical considerations can immensely contribute towards the emergence of conflicts in research. This analysis focuses on the different ethical considerations in the research framework of medical billing fraud.

 Ethical Concerns for Researcher Positionality

There are various issues of ethical concern that are directly associated with the researcher’s posionality. Firstly, there is the ethical issue of potential bias within the framework of data collection. Bias undermines the efficiency attained within the entire research, and this can also hamper the levels of reliability. Apart from bias, manipulation of information or data is another perspective of ethical concern (Boyle, 2011). When data is manipulated in any way, the ethical standards of the entire research are immensely undermined. This aspect underlines the extensive significance of preventing any kind of manipulation in the research.


In research involving human subjects, coercion is one of the most critical issues of ethical concern. Coercion occurs when the different participants are forced to give information within the data collection phase of the research. This is an action that is tantamount to the violation of the fundamental tenets of ethics in research. The issue of medical billing fraud involves extensive involvement of human beings at different stages of data collection. For instance, some participants will take part in filling interviews or questionnaires (Boyle, 2011). Such participants must not be coerced into giving certain information or taking a given path while responding. During this research, the prevention of coercion will be massively essential towards bolstering credibility and reliability.


Apart from coercion, anonymity is another critical aspect of ethical importance within the research framework. In essence, this involves the protection of identity of the different participants. While evaluating organizational trends in medical billing fraud, anonymity is massively essential. It will help in terms of ensuring that the participants who provide essential information are not victimized by colleagues or organizational leaders. The violation of this ethical stipulation can easily expose the participants to numerous perils and hence compromise the quality of research.


As a pertinent aspect of ethical consideration in research, confidentiality is inherently connected to anonymity. This ethical consideration will be massively vital in terms of boosting the privacy of databases for the research. Information on medical billing fraud in an organization must be treated with the highest standards of confidentiality (Boyle, 2011). This aspect of ethical consideration is also immensely crucial because it enhances the privacy of details related to the participants’ identity. The disclosure of the identity of participants would be tantamount to the violation of the basic tenets of medical research.


 The framework of ethical consideration is also characterized by an analysis of privacy standards. Privacy is directly associated with the details or crucial records of participants. Based on the basic tenets of privacy, there should be no public disclosures on the names or details of participants. While evaluating the issue of medical billing fraud, disclosures of the participants’ identity will be averted. In view of such an approach, the highest standards of ethical research will be maintained.

 Informed Consent

As an aspect of ethical concern in the evaluation of medical billing fraud, informed consent facilitates for the alleviation of coercion. The involvement of employees must be done strictly on voluntary basis. When the principle of informed consent is not used in dealing with research participants, reliability is undermined immensely. On the other hand, the standard of research validity is greatly bolstered when informed consent is used continuously during the different stages. In essence, informed consent is an excellent platform that ensures that no participant is forced to provide information about different aspects of the research.

 Role of IRB in the Research

Approval from the IRB is immensely crucial in this research. The research cannot be started if the IRB has not approved it. In addition to approval, there are various roles that will be played by the IRB in this research. This board will evaluate the validity of the different strategies that have been developed for the attainment of the stipulated standards of ethics (Boyle, 2011). Additionally, the review board can also help in terms of providing feedback on the different areas that need improvement in the analytical framework of the research.


This analysis puts the different ethical considerations of research into perspective. There is the ethical issue of potential bias within the framework of data collection. Bias undermines the efficiency attained within the entire research, and this can also hamper the levels of reliability. The issue of medical billing fraud involves extensive involvement of human beings at different stages of data collection.


Boyle, P. (2011). Medical ethics, Georgetown: Georgetown University Press


Published in Education
Saturday, 24 May 2014 14:41

Insider vs. Outsider Action Research

Insider vs. Outsider Action Research


Insider and outsider action research is associated with various differences. While insider action research is conducted by an individual within his or her own organization, the former action research is performed by an external party. In most cases, the external party in outsider action research has minimal familiarity with the internal environment in which he or she is evaluating (Craig, 2008). In contrast, the researcher in insider action research is excellently familiar with the internal environment and operational systems in the area of focus. The most notable advantage of outsider action research is that it is associated with minimal bias. On its part, insider action research enhances the standards of accuracy within the framework of data collection.

 Insider Action Research for Medical Billing Fraud

For my proposal on medical billing fraud, I will use insider action research. Based on this kind of research, I will have an excellent chance to align the entire research program to the identified area of focus. As an insider, familiarity with the internal organizational systems will be vital towards collecting accurate data. In any research framework, the accuracy of data collection is a vital element that influences the quality of findings. This will be strongly enhanced by the use of the insider action research method.

Apart from accuracy in data collection, this method will be vital in terms of enhancing the reliability of findings (Craig, 2008). This is a vital attribute in any research because it is also associated with excellent standards of validity. The use of outsider action research might hinder the project’s outcome because of inadequate understanding of the line of focus. This can also undermine the validity of findings.


Craig, D. V. (2009). Action research essentials, Hoboken, NJ: John Wiley & Sons


Published in Education
Saturday, 24 May 2014 14:38

Role of Action Research


Role of Action Research

Action research is an essential investigative tool that helps in addressing a given problem or improving a targeted area. This kind of research is conducted by the main beneficiaries of the findings. At the organizational level, the role of action research is extensive. From the perspective of organizational development, action research facilitates for effectiveness in the implementation of change. This kind of research has excellent platforms from which change can be implemented within an organization. For instance, organizational leaders can use action research to determine the most effective platforms of communication. This promotes organizational development.

The role of action research in organizational development can also be evaluated on the basis of alignment to organizational challenges. This type of research is immensely crucial in the development of solutions for specific problems. This is a vital aspect of organizational performance and is strongly aligned to the framework of organizational development. It is also fundamentally pertinent to highlight action research as a vital component in the enhancement of organizational learning (Brannick, 2009).The efficiency of organizational operations is inherently dependent on the availability of reliable information on the different organizational systems.

For instance, the human resource manager might be interested in determining the various factors affecting the performance of staff members.  This information can be obtained through an action research framework that is specifically aligned to the desired area of focus. Based on such an aspect, action research is a vital component of learning in any organization. In modern organizational settings, action research is considered as an essential tool that is more or less indispensable from the perspective of development and learning.


Brannick, T. (2009).Doing action research, Thousand Oaks, CA: SAGE


Published in Education
Saturday, 24 May 2014 14:34

Insurance in Wisconsin

Insurance in Wisconsin

Insurance is predominantly regulated by states. This essay provides an overview of the duties of Wisconsin’s Office of the Commissioner of Insurance (OCI) in addressing major types of insurance and the insurance funds offered by the state of Wisconsin. The McCarran Ferguson Act (1945) defines the roles of the federal and state government in regulating insurance. The act allows states to have regulatory authority over insurance matters.

  Role of Office of the Commissioner of Insurance (OCI)

The Office of the Commissioner of Insurance (OCI) is a body that was established in 1871 via a legislation process. OCI has great owners in ensuring that the insurance injury meets the citizen’s needs living in Wisconsin. Some of the major tasks of OCI include; reviewing the proposed insurance policies available for sale in Wisconsin so as to determine if these policies meet the Wisconsin laws requirements. OCI is responsible for monitoring licensed companies and other applicant companies so as to determine their status.

The office is also responsible for conducting financial examinations of foreign and domestic insurers so as to determine if they comply with Wisconsin laws. It implements, creates and enforces laws that cover agents, companies and brokers. OCI analyzes and examines rates filed by insurance companies so as to evaluate whether they are unfairly discriminatory, inadequate and excessive. The office has the task of providing information to consumers in Wisconsin and processes and investigates the complaints filed by consumers. The office also deals with processing and investigating administrative actions filed against insurers and agents who have violated the insurance laws of Wisconsin (OCI, 2013).

  Types of insurance coverage in Wisconsin

The statutory provisions of Wisconsin dealing with insurances and the duties and powers of OCI are stated in chapter 600 to 655. The administrative rules of OCI are states in chapter 1 to 555 of Wisconsin Administration Code. The rules and statutes apply to various types of insurance. Some of the insurances types are discussed below; Auto insurance is a must insurance cover for all drivers in Wisconsin. The policy has specific minimum limits for personal injury, damage liability and injury caused by motorists who is insured. Charges for personal injury are $50,000 per incident and $25,000 per person.

The uninsured is $50, 000 per incident and $25, 000 per person for body injury. Property damage is $10,000 2011-12) Legislative Session, 2011). These are the minimum coverage costs that are renewed on a yearly basis. The cost applies to policies issued. Commercial liability insurance is another type of cover. Businesses in Wisconsin can protect their property against losses through the commercial liability insurance by claiming for compensation from an insurance company. The worker’s compensation insurance is a commercial liability insurance that is required by all businesses in Wisconsin. This subtype insures against work related death and injury, and it is basically a remedy for employees in these cases.

Credit insurance is a cover meant to protect a person obtaining a credit card and loan at the time of credit transaction. The insurance pays a portion or all of the credit balance that is outstanding when a claim is filed. This is based on any case that is outlined within the policy such as unemployment, disability and death of the obligor. Credit insurance unlike other types of insurance covers is more expensive, and they have a strict policy limitation (Wisconsin legislation, 2011).Crop insurance covers farmers in cased of damage of crops and other aspects that lead to crop loss.

A private insurance company and the Federal Crop Insurance Corporations do cover for crop insurance. Another type of insurance cover in Wisconsin is the disability income insurance. The cover replaces a portion of an employee’s income for a given period of the event when an employee is not an employee suffering from illness or injury. The flood insurance covers damages and losses of property caused by flood. Floods can cause household mechanical damages and damage of structures and also high cost of cleaning. The local insurance agents in Wisconsin do administer the National Flood Insurance program.

There are the home owners insurances that compensate a client in cases of belongings and house losses. When buying a home, it is essential to insure the house based on its market value and replacement costs. The insurance cover also compensates for other special riders like antiques, jewelry, firearms, and other vital personal property. Homeowner insurances also cover cases of negligence for damages of insured property and protection of somebody in cases of injury (The Legislative Audit Bureau, 2009).Life insurance has the benefit in cases where a form of annuity and cash payments is compensated to the beneficiaries when the insured dies.

Life insurance can be purchased separately or provided by an employer. Life insurance can be the cash value insurance also known as whole life or term insurance. Premiums for term insurance are lower than the cash value. Long term care insurance does deal with the provision of medical services and other services needed for an extended disability or illness. This policy ca n covers a wide range of care levels which are covered with Medicare. Last are the segregated insurance Funds. Wisconsin has the Local Government Property Insurance Fund and the Sate LIFE Insurance Fund stipulated under chapter 605 and 607 (National Association of Insurance Commissioners, 2011). OCI administers these funds.

The sole custody of the fund’s assets is under the State Treasurer. The local government property insurance fund has the purpose of negotiating reasonable prices for property insurance that are available for local government properties under tax support. Such properties include libraries, schools, government building, and motor vehicles. The fund claim service and provides policy to the policy holders. The State Life Insurance Fund provides life insurance cover of a maximum amount of $10,000 to all the state residents of Wisconsin who have purchased a policy from the state Life insurance fund. The fund distributes to the net profits every year among the policy holders. Wisconsin is the only state that provides its states with a life insurance program or plan (NAIC, 2013).


Legislative Audit Bureau (2013) Wisconsin state insurance programs. Retrieved from


On November 29, 2013

Legislative Session (2012) Legislature changes to Wisconsin law automobile insurance contracts


On November 29th 2013

OCI publications (2013) general outline of Wisconsin insurance law. Retrieved from


On November 29, 2013

The National Association of Insurance Commissioners (NAIC) (2013) insurance industry generally and insurance practices. Retrieved from


On November 29, 2013

NAIC (2013) Consumer Information Source. Retrieved from



On November 29, 2013

Published in Education
Saturday, 24 May 2014 14:30

Surrogacy: Laws and Ethics

 Surrogacy: Laws and Ethics

Few medical procedures that aid fertilization are as controversial as surrogacy (Anderson, 2010). However, there are some basic facts to keep in mind about legal issues relating to surrogacy. The surrogate or gestational mother has the legal right to keep custody of the child even when the child is not related to her genetically (Human Fertilization Embryology Authority, 2013). Also, arrangements involving surrogacy are not enforceable legally in many jurisdictions, even when it involves signing of contracts and compensation or payment of expenses to the surrogate. The third basic fact is that the gestational mother or surrogate remains the legal mother of the child until parenthood has been transferred through adoption.

Analysis of the Case Study

John and Sheila Baldinucci are just custodians of the child. As at the current status, they are not the legal parents to the child. Although the surrogate mother voluntarily gives up her parental rights for a fee, leaves the hospital some hours after the birth of the child, and has not seen the child since, there still remains a legal dilemma as regards adoption. The danger is that the law allows the legal mother to change her mind and want to keep the child even when she is not related to the child genetically.

This implies that without enforcing adoption of the child, there is a risk that the gestational mother may want to claim custody of the child, especially considering that the Agency that arranged for the procedure has refused to pay her for breaching the contract agreements. To protect the child and grant it legal rights to inheritance, John and Sheila Baldinucci must apply for an adoption or guardianship of the child.Although she is an American citizen, the claim for adoption Sheila is not in order.

This is because the procedure for adopting a child born to a foreign surrogate mother follows a similar procedure as for a child born out-of-wedlock (U.S. Department of State Foreign Affairs, 2013). The father is the only person that can make a legitimate claim of parentage of the child. The requirement is that the father must prove citizenship of the United States and a blood relationship to the child.

The surrogate mother and agency that organized the surrogacy arrangement had a contract, with respect to disclosure of information and payment agreements.Therefore, the surrogate mother violates the contract by agreeing to publish her story and picture on a magazine. She does not disclose her name, but the picture could be traced to reveal her real identity. In a way, she risks harm to the child because the foster parents could be traced, as well. Refusal to pay the surrogate mother is not ethical.

Although contracts related to surrogacy may not be enforceable under the law, the agency should pay her, in accordance with the agreement. It is difficult to determine whether that was agreed on in the contract. Perhaps, the opportunity to make money from her story was unforeseen. This refusal may jeopardize adoption or the transfer of parentage as the surrogate mother may institute a claim for the child.


Anderson, P. (2010). “An Evaluation of Surrogacy Law and Its Potential Development in the UK: Is there a Clear Way Forward?” London: King’s College London

Human Fertilization Embryology Authority (2013). “Legal Issues around Surrogacy”. Retrieved Nov. 25, 2013, from www.hfea.gov.uk/1424.html#8267

U.S. Department of State Foreign Affairs. (2013). “Acquisition of U.S. Citizenship By Birth Abroad To U.S Citizen Parent”. Retrieved Nov. 25, 2013, from http://www.state.gov/documents/organization/86757.pdf


Published in History
Saturday, 24 May 2014 14:28

Qualitative Studies

Qualitative Studies

            There are three types of output that are generated from qualitative studies, and they are taxonomy, themes, and theory. Study shows that these outputs are useful in a number of ways such as revealing of insights into how the context of an event, generation of hypotheses about causal links among access, cost and quality services, and the fostering of improved measurement of multifaceted interventions. Taxonomy is defined as a system for classifying multifaceted complex situations in respect to the common conceptual dimensions and domains. In the field of health care services research, researchers always evaluate multifaceted interventions that are implemented in the real world and not in the controlled conditions.

Examples that are used in taxonomy concept are the quality improvement efforts in the hospital setting, goal setting for older adults with dementia, integrated health systems, and systems for health maintenance organizations.Themes are said to be the general propositions that emerge from detail rich experiences and diverse concepts of participants and the do provide recurrent and unifying concepts based on the subject of inquiry. It has been discovered that themes evolve not only from the angle of conceptual sub-codes and codes like in the taxonomy concept but from the codes relationships, and the link data has to be present.

Theory in qualitative studies helps to emphasize the nature of causal relationships and correlative relationships which delves into the systematic reasons for the phenomena of inquiry, experiences, and events. It has been discovered that theory explains and predicts phenomena. Researchers in qualitative studies should be aware that a comprehensive concept of theory always integrates data tagged with conceptual sub-codes and codes.


Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative Data Analysis for Health Services Research: Developing Taxonomy, Themes, and Theory. Health Services Research42(4), 1758-1772. Doi:10.1111/j.1475-6773.2006.00684.x


Published in Education

Qualitative Studies in Health Services Research

Qualitative studies have not been common in health services research. However, they are gradually becoming popular due to researchers interest in using description to understand a health related phenomena. Qualitative studies in health service research strive to develop concepts that aid in the understanding of a phenomenon. Special emphasis is accorded to meaning, experience and the view of participants involved in the study (Gagliardi, & Dobrow, 2011).  Qualitative research thus emphasizes on finding the meaning that people place on events, processes and structures revolving around their lives.

Similarly, qualitative research enables a researcher to gather data on the participant's perception and assumptions of various health related issues. Data for a qualitative study is thus collected using methods such as observations and interviews.The two common qualitative research approaches are grounded theory and phenomenology. Grounded theory is a qualitative method used to establish a theory based on collected data. Grounded theory has its roots in sociology and functions on the basis that people attach meaning to events through experience and social interaction.  It is the meaning that people attach to their experiences that eventually shape their behavior.

Grounded theory, therefore, strives to develop theories and also modify existing theories depending on the data collected. Phenomenology, on the other hand, focuses on understanding how participants understand the phenomena of experiences they face (Al-Busaidi, 2008). Phenomenology strives to understand the psychology of participants. Phenomenology does not strive to create a theory from collected data, but strives to understand the structures of consciousness as experienced by participants of a research study. Phenomenology emphasizes on the description of the world through the experiences of participants of the study. Researchers cannot, therefore, use external literature as supporting evidence.


Al-Busaidi, Z. (2008). Qualitative research and its uses in healthcare. Sultan Qaboos university medical journal. Vol. 8(1): 11-19

Gagliardi, A. & Dobrow, M. (2011). Paucity of qualitative research in general medical and health services. BMC Health Services Research. 11:268 doi: 10.1186/1472-6963-11-268


Published in Nursing
Saturday, 24 May 2014 14:22

A Nurse’s Fundamental Duties

A Nurse’s Fundamental Duties

The Hippocratic Oath and the Nightingale pledge are vows that nurses take upon their graduation from nursing school. Many student nurses do not comprehend the magnitude of these oaths at the time of their graduations. It is only after the nurse begins to professionalism executing his or her duties as a nurse that the importance of the oath becomes clear. The fundamental duties of a nurse require that he is able to execute his nursing duties to the best interest of the patient. Nurses are also required to engage in activities that promote the health and well-being of the patient.

Nurses can execute this task by engaging, in preventive measures to eliminate the risk of illness or by alleviating the suffering of the sick. The Hippocratic Oath and Nightingale pledge guide nurses in their profession and the quest to provide quality patient care.  Nurses also use the oaths to practice nursing with integrity. Integrity refers to the ability of a nurse to perform his nursing roles while at the same time upholding the privacy and confidentiality rights of the patient (Kilpi, 2000). Similarly, the oaths are fundamental in the process of decision making. Nurses are tasked with the duty of patient care. It is nurses who note any significant changes in the health of a patient.

Nurses are thus tasked with the duty of making decisions that influence the patient’s well-being. Nurses must make ethical decisions that advocate for and protect the patient’s safety and health, and at the same time uphold the rights of the patient. Nurses follow the code of ethics when making decisions that relate to patient care. The code of ethics was created using the Hippocratic and Nightingale oaths as its basis. The decisions that nurses make are in the best interest of the patient and recognize the role of the patient’s family and community (Kilpi, 2000).


Kilpi, H. (2000). Patient’s autonomy, privacy and informed consent. IOS press


Published in Nursing
Saturday, 24 May 2014 14:16

Tenet Healthcare Foundation

Tenet Healthcare Foundation

 The issue of medical fraud is massively sensitive towards the provision of quality health care services across the country. Within the framework of this research, the fraudulent billing detected at the Tenet Healthcare Foundation is the main issue of analysis in terms of medical fraud. Based on the immense significance of this analytical framework, it is pertinent to evaluate the most effective theoretical perspectives that are aligned to the issue of medical billing fraud. In view of this perspective, the fraud management lifecycle theory will be the fundamental theoretical framework. This theory is massively essential in terms of dissecting the pertinent issue of medical billing fraud. It provides excellent elements for addressing the extensive challenge of medical billing fraud even from the perspective of the Tenet Healthcare Foundation. In addition to an evaluation of the theoretical foundation, the analysis includes an elucidation of the main research question of the study.

 Theoretical Foundation

The fraud management lifecycle theory is the core of the entire research. In essence, this theory provides an exceptional platform for a systematic evaluation of the issue of medical billing fraud. This theory has essential components or elements which may be integrated into the analytical framework of medical fraud at the Tenet Healthcare Foundation. This theory can be integrated into the issue of medical billing fraud based on eight stages. The first phase based on this theory is deterrence (Baker & Baker, 2010). During this stage, the theory emphasizes on the need to strategize and implement adequate mechanisms for averting potential fraud.At the Tenet Healthcare Foundation, numerous platforms of deterrence were available. These mechanisms would have been massively beneficial in terms of averting medical fraud even before it had rocked the organization. The second stage within the framework of this theoretical mechanism is the prevention stage.

In this stage of the theory, immense emphasis is placed on the establishment of the relevant avenues for protecting an organization from any fraudulent actions. While the preventive and deterrence stages are different, they can be combined especially if an organization is experiencing one or more constraints in terms of resources (Baker & Baker, 2010). When an organization has sufficient platforms for preventing fraud, extensive resources can be protected. The third pertinent stage of this theory involves detection. This is a pertinent phase that involves the accurate identification of potential threats of fraud. It is massively essential to enhance the accuracy levels of the detection system.

High levels of accuracy facilitate for the relevant interventional strategies. In contrast, the absence of the relevant mechanism of accuracy contributes negatively towards the efficiency of the chosen intervention.Detection occurs when the previous two stages have not been implemented accordingly. This perspective is an indicator that the detection stage occurs when there in an element of fraud within the organizational system. It is massively essential for an organization like the Tenet Healthcare Foundation to have an effective framework for detection. For instance, early detection facilitates for adequate intervention for the fraud (Baker & Baker, 2010).

Mitigation is the next phase within the framework of the fraud management lifecycle theory. The mitigation phase is focused on the reduction or stoppage of the different causative factors for fraud. Mitigation is also essential in that it prevents an escalation of the fraud in an organization.The next stage involves analysis. This stage zeros in on a comprehensive evaluation fraud in terms of the causative attributes, the responsible employees, and implications on organizational performance. For instance, analysis would have helped in determining the actual ramifications of fraud on the organizational performance of Tenet Healthcare Foundation.

The next phase involves policy. This is vital in terms of changing the overall legal framework and administrative mechanisms used by an organization. Investigation is the penultimate stage of the theory. It caters for the determination of the liable employees and the extent of fraud. Prosecution is the final stage of the theory. Excellent standards of balance in the different eight phases are massively pertinent in fraud management in health care organizations such as the Tenet Healthcare Foundation (Baker & Baker, 2010). The theory has been widely integrated into the interventional framework for fraud across numerous organizations.

 Research Question

What strategies can be used to prevent medical billing fraud at the Tenet Healthcare Foundation?

This research question is highly extensive since it involves numerous variables. Firstly, the question will greatly bolster the mechanism of evaluating the different causative factors of medical billing fraud. The second aspect involves the evaluation of the implications of fraud on an organization like the Tenet Healthcare Foundation. Additionally, this research question will help in determining the efficiency of different interventional measures.


The analysis provides an excellent theoretical foundation of the issue of medical billing fraud. The fraud management lifecycle theory has been identified as an essential basis of the research. The different stages of this theory can be integrated into the preventive blueprint of fraud at any health care organization. The analysis has also provided an overview of the research question. The question is vital in that it involves an evaluation of numerous variables on the issue of medical billing fraud.


Baker, J. J., & Baker, R. W. (2010). Health Care Finance: Basic Tools for Nonfinancial Managers. Boston, MA: Jones and Bartlett Publishers.


Published in Nursing
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