Can Counselling Assist with Smoking Cessation?

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Student I.D. Number: ___81150106___________________________

Surname: _Dooley____________________________

First Name: _Elizabeth_____________________________

Module Name: __ final year project

Assignment Title: _fyp

Word Count: 2,210________

In relation to this submission, I have read and am aware of the Institutes Policy on Exam Procedures and Plagiarism.

Student Signature: __Elizabeth Dooley________________________ Submission Date: 14 /01 / 2013

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Percentages Title and abstract: 5% the proposed research question is how can counseling assist smokers in quitting their addiction?

Chapter 1: Literature review/Justification for the Study: 25% Over the past three decades smoking has been recognized as a health risk. Dispite government warnings and aids to assist in quiting the habit/addiction. Many countries including Ireland have banned cigarette smoking in public places, bars resturaunts, and in febury 2012 a proposed new legislation was put before the dail to ban ciggerette smoking in parks, beaches and cars with children passengers. Example health- medical card holders, who’s general practicioners bills and prescription medication that smokers suffering chronic coughs and chest infections and lung problems and hospital bills are paid by the government health boards. street clean up general The cost to the ex-checker is colossal. The government makes 567 million on cigerettes sales each year. The health services costs 268 per year. In recent times there is huge loss to contra-ban ligetimate and illegmitted ciggeretts that are sold on the black market. these cigerettes are manufactured from unknown substances. And are more harmful than the legally sold cigerettes obtained in shops. In a documentary it was discovered that cigerettes were made from sweepings from the floor. Some people will do just about anything for money.
According to the world health organization. About 200 million of the world's one billion smokers are women. The tobacco industry targets women in order to increase its consumer base and to replace those consumers who quit or who die prematurely from cancer, heart attack, stroke, emphysema or other tobacco-related disease.
Girls and boys start using tobacco for different reasons, and tobacco use harms women and men differently. Approximately 1.5 million women die every year from tobacco use. Understanding and controlling the tobacco epidemic among women is an important part of any tobacco control strategy.
Far fewer women than men use tobacco. Globally, about 40% of men smoke as compared with nearly 9% of women. However, the epidemic of tobacco use among women is increasing in some countries. More research is needed to understand trends in tobacco use among women.
• Men need to be held accountable so that their actions and attitudes are examined also in the light of social and cultural norms, policies and practices, and not just biology. Norms, policies and practices can and do change
• Women and men need to work together for greater gender equality and not merely blame each other for the inequalities and inequities. This means that men's awareness needs to be raised concerning the causes and results of their attitudes and actions on the people in their lives for the benefit of all

Although it has been well advertised about the dangerous effects that cigarette smoking can cause . It was believed that by raising the price of a packet of cigerettes would deter individuals from smoking. This has had a significant effect on people quitting. Thus many continue dispite the warnings. What else can be introduced to assist smokers in becoming non smokers? having spoken to many individuals who requested to quit ciggerettes smoking and failed to remain abstinent. One can only express bewilderment at such reports. smoking bans in public places and the long list of aids, and assistance available such as telephone helplines set up by the health executives, who contact ex-smokers monthly to encourage and find out how they are coping. Smoking cessessation courses. There is an abundance of support available such as internet access to telephone helplines and reading material litreture, self help books authors like allen car has written many books namely “ easy way to stop smoking” which is very inspirational and gives graphic detail about the ingredients that are used to make a ciggerette. Other information leaflets on quiting cigerettes are available in many doctors surgeries and resourse centres. During our discussions I learned of the many nicotine replacement patches that work up to twelve hours and twenty four hours, Nicorette gum which is obtainable in three flavors, these can be purchased over the counter at pharmacies and in recent times it has come to light that particular type of medication by the name of champix with a strength of 0.5miligrams and 1miligram which are film-coated tablets that relieve cravings and with-drawl symptoms are obtainable from general practitioners through perscriptions. Other quit smoking aids can be purchased over the counter at any pharmacitucals nation wide. If an individual is hospitalized with respiratory or cardiovascular difficulties they gain the privalige of being reffered to a smoke cessation officer and will be seen as an outpatient. Individual smokers have the option of one-to-one or group meetings. One cannot help but wonder why wait until individuals are diagnosed with a chronic or terminal illness before they are offered counseling to assist them to stop smoking. Rather than wait until medical problems have developed. Most of the time it is too late for these individuals as the damage is already inevitable and irreversable. Other important considerations for individuals to stop smoking is the growth in the increased number of individuals smokers suffering from cancer related illnesses. Researchers have linked these illnesses or fear of such diseases with lack of success in staying quit. Example anxiety, panic disorders and agoraphobia being the underlying cause of some individual smokers continuing to smoke regardless of warnings. These findings have been researched by neumerous professionals in the field. Example alan car suggests that

Research Question:3% smoking is recognized as an addiction by the government, general practitioners, nurses, counselors etc, how can counseling help individual smokers to quit ciggerette smoking. Why don’t the government subsidize smoking cessation courses or individuasl counseling if they want to irradacate smoking from society. The difficulty individual are experiencing in staying abstint from smoking addiction. it is obvious from the introduction that enough is not being done to prevent individuals from taking up the habit of smoking. Is there sufficient help provided? Are these aids reaching the right people? Example those who are most vulnerable the lower socioeconomic class. Who arearently have to deal with poverty, voilence, neglect or deprivation etc. Or, are they missing the point? Do they want to stop there faviouite pass time? Or is this so called bad habit their only escape. As these questions suggest there is ambivilance and resistance involved with individual heavy smokier as to wheather they want to quit or not. what is the underlying cause preventing individuals from qiuting their addiction. To address the latter it is proposed to perform a qualitive research study on volunteers to revise what has already been done and hopefully this may help highlight gaps in former studies or may show the difficulty is with the afore mentioned smoker. Aims/Objectives: 2% To research to find out what has already been attempted by the counseling and explore and review their footsteps and find a gap and fill it or plug it. to come to the conclusion and define “cigarette smoking” as a very bad habit as minister for forestry states . Devise a plan of action to aid participants to quit smoking and provide a back up plan in case of relapse.
My aim is to work ethically by following guidelines of professional body’s of which I am associated with Various professional associations such as association of professional counselors and psychotherapists (APCP),the British Psychological Society (BPS) and the American psychological association (APA) issues guidelines for the treatment of humans and animals participating in research. In some countries, data may also fall within the remit of a data protection Act which , in its most general form, allows an individual access to any information held electronically about them and, in research, allows the participant control over the use of such material. (martin et n.d.) (p, 70). The above named list a number of recommendations which fall into general categories of consent, deception, debriefing, withdrawl, confidentially and protection of participants.
My hope and asperations is to gain knowledge and experience and recognize my strengths and weaknesses. Chapter 2: Design and method: 10% in other words proposal and technique. Sample: 5% Data collection: 10% Data for this research proposal has been gathered from books, journal articles and websites, e.g. world health organization, American psychiatry association, guidelines diagnostic manual of mental health, ethical codes guidelines, cancer society, interviews, survays, statistics, Pilot study: 5% Case study Amanda is female age 40 has been smoking since she was 17, she has asthma and recurrent chesty cough, chest infections, has been hospitalized once suffering with pneumonia/ plursey, she has been diagnosed as being in the early stages of cordio obstructive pulmonary disease.(COPD) At first Amanda swore she would never put a cigarette on her lips however this was short lived. Unfortunately amanda’s father died suddenly. this was a devastating for this lady as she and her father had become very close after her mother’s death after a long illness of emphysema. All of amandas family advised her to stop smoking reminding her of their mothers fate. Dispite neumerous attempts at quiting she contacted the smokers quit line and managed 3 months smoke free. 8yrs later she continues to light up. Although this smoker has spent almost E3,000.00 on hypnosis, and another E1,000.00 on patches, she also visited Lourdes in the hope of gaining strength to quit and obtain a cure. How ever she did manage to abstain from smoking for all of 6months. At first she would allow herself one cigarette per day and this gradually increased to 10, then 20 until she reached 40 per day. During all of this Amanda had a visiting a herbalist on a monthly bases and counseling every 2 weeks. Since her mothers death her family members leaned on her for their needs at first she was delight with the attention and felt it distracted her from dealing with her own grief as while caring for her siblings. Thus this only prolonged her own grief. She always wondered why she did not grieve her mother and began to belive she may have been holding resentment towards her mother. She spent many hours looking inwardly releasing past hurts. And one day realizing she could no longer help others until she first helped herself. Amanda announced she was taking some time out to grieve her mother and that she would not be available to help others for sometime. Her words fell on deaf ears. When she tried to quit smoking she would receive a phone calls from her siblings to perform tasks that the could easily perform them selves. By this time amandas health had declined and seeing how selfish her siblings were she did not have the heart nor the energy to help them. She felt very alone upon informing her family members about her health issues and receiving no compassion in return. What did Amanda do to stop smoking? She changed her diet to a mediterianian diet this meant spending hours preparing meals, she began with a glass of cool boiled water with a slice of lemon then a fruit smoothy and nibbled on fruit pieces throughout the morning. Amanda walked 2 miles in the morning and again in the evening and was on her feet most of the day chopping fruit and vegetables for her daily meals which included smoothies, fruit pieces for between meal snacks and home made soup and stirfried vegatables and some to nibble on. And salad for her break at work she also carried around a mixture of nuts in her pocket. She said she felt great and shed 2 stone, changed her wardrobe and performed regular ‘fengshui’ around her home and coached others to perform feng shui on their homes to and they too stoped smoking. The above case study is an example of how some individual smokers quit without professional assistance, one would presume self motivation was the key determinant in this case. Unfortunately not everyone is motivated nor has the time to put in such dedecation. Amanda also became very assertive and her confidence grew. In other research the questionnaire was inlisted, in this example the faggerstorm questionnaire is a test for nicotine dependence

Data analysis: 5% Validity and reliability: 5% Validity of the faggerstorm questionnaire Ethics: 5% See appendix B, APCP Chapter 3: Proposed outcome/ dissemination my proposed outcome is to create a quit smoking programme for individuals and groups. The americans are having great success with the 12 step programme which is currently being applied to quitting smoking programmes. I plan to work in collaboration with them via their website and litreture they suggest to learn more. Time scale and resources: 5% I began my research in may 2012 on the guidance of jane alexander and continued throughout the following months up until December I guess researching is a cintinous process. I have attended several classes on litreture review and have read greshams book and thomas’s book on litreture review and have reviewed a number of websites on the topic and consulted my peers in class and by email.

Reference Academic writing/referencing within the assignment and reference list: 10%
(APCP.ie 2011) (An assessment of nicotine dependence among pregnant adolescents. 1999) (DSM_IV_TR 1995-2012) (Eysenck's personality and tobacco/nicotine dependence in male ever-smokers in Japan. 2006) (Older adults and smoking: Characteristics, nicotine dependence and prevalence of DSM-IV 12-month disorders. 2011) (Relationship of DSM-IV-based depressive disorders to smoking cessation and smoking reduction in pregnant smokers. 2006)
(kendra cherry 2011)
(soceoeconomic status 2012)
Institute of Social and Preventive Medicine, University of Geneva, Switzerland. etter@cmu.unige.ch

(http://www.ihrc.ie/foi/ 1998)

Institute of Social and Preventive Medicine, University of Geneva, Switzerland. etter@cmu.unige.ch http://nicotinefreedom.com/thank-you Appendices

Appendix A

Counseling agreement

Counselling Agreement

Your Welfare Our primary goal here is your Wellbeing, Welfare and Safety.
Is Paramount For you to gain an understanding of your experiences and your self.

Confidentiality Everything in the Counselling session is confidential unless you or another’s welfare is at risk.
There are three conditions
Harm to your self
Harm to others.
I will seek your consent to contact your doctor or psychiastrist on the matter. Childrens first act. Child abuse (current or present) will be reported to the duty of care officer at the health board.
If in the event the above topics arise. I will discuss the matter with you. As client consent is paramount with in therapy. Before any further steps are taken.

My profession requires me to be in continual supervision where any names or identifying characteristics will be altered to ensure confidentiality. Notes of our sessions will be recorded in order to assist you the client further. These can be viewed by two people myself the counsellor and you if requested. I must also abide by ACPC code of ethics.

Practicalities You can text me In emergencies and to cancel or change appointment time. Fee as agreed will be _______ Sessions will be held on __________@___________

Clients Commitment I ask you to attend as agreed and give at least 24 hrs cancelation notice otherwise the fee for the missed session needs to be paid. I would ask you to assess the Counselling process and to be open about that; the duration of counselling is always open for discussion. We will do reviews so there is an opportunity for both of us to try to comment on this process.

My Qualifications I am a pre-accredited counsellor trained in counselling skills and psychotherapy practices, having a good deal of practical experience. My supervision is there to ensure that I am working in the best possible way for your welfare.

My Commitment I intend to support you with all of my skills in an open and honest way, giving sincere feedback whenever possible to assist you to find your own solutions and autonomy. working in the best possible way for your welfare

. Plan of Action I would encourage you to decide what you wish to talk about, to be honest , open and to explore your experiences to express emotion and because this can be of great benefit. Consent Do you agree to working by these guidelines? Y/N

Exceptions Number If the answer is No and give exceptions: describe

Date Client Contact Completed on _________________

Therapists Signature ___________________________________________

Clients Name (Block Letters) _____________________________________

Client’s Signature _____________________________________

Parent/Guardian( if necessary) _____________________________________

If you have any concerns about this therapist please contact national counselling and psychotherapy institute of Ireland at Walton house, Lonsdale road. The national technology park, castletroy, limerick. Telephone Number: (061) 216288.
For office use only
Client name: ¬¬______________________________________________________________
Date of birth:______________________________________________________________
General practitioner name and number:________________________________________
Medical history : ___________________________________________________________
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Medication:_______________________________________________________________
Family member contact number:_______________________________________________
Other comments____________________________________________________________
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Anything you would like to add: ________________________________________________
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The above named is a member of the association of counsellors and psychotherapists (APCP) and also a member of the british association for counselling and psychotherapy (BACP)

Apendex B below APCP