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Course Learning Outcomes

  1. Demonstrate awareness and understanding of the lived experience, including the effects of stigma and discrimination for people experiencing mental illness, their significant others, and the community.
  • Critically reflect on self and own attitudes relating to mental health.
  • Write in an academic format and use APA 7 style formatting and citations.
  • ESSAY FORMAT
  1. INTRODUCTION
  1. BODY:
  • TEEL

T: *Topic sentence about the topic to be addressed (Personal view/s)

E: *Evidence (incitations)

E: *Explain the (incitations) and views

L: *Linking sentence- summarising the above discussion based on the writer’s view unless otherwise and linking it to the next paragraph or topic

  1. CONCLUSION
  • Use academic journals and textbooks.
  • 20 References.

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QUESTIONS OF THE ASSESSMENT ESSAY

Word Length: 1500 (+/-10%)

To complete this assignment, you are required to use the case study (provided below) to assist with your discussion on the effects of stigma, the value of lived experience and the role of family and community on the recovery of the individual. Lastly, you are required to critically reflect on self and own attitudes relating to mental health.

Case Study: Discussion Questions

1. What special challenges does anorexia nervosa pose for family relationships? And how does it affect clients in their roles as children, spouses, and parents?

2. A lot of research has focused on the role of the media and standards of beauty and the thin ideal in the aetiology of anorexia nervosa. Is there more or less pressure on adolescent girls and young adult women to be thin and what about pressures for attractiveness?

3. Was there a better way for Charlotte’s mother to intervene? Or would any intervention have brought similar results?

4. Why was Karen inclined to overlook her initial suspicions about Charlottes behaviours? Was there a better way for the roommate to intervene?

5. How might high schools and universities better identify individuals with serious eating disorders? What procedures or mechanisms has your school put into operation?

6. No treatments have consistently been effective for adults with anorexia nervosa. If you were a counsellor treating a university student with the condition, how might lived experience and a wrap-around support treatment approach assist recovery? Why?

MARKING SCALE

 High Distinction 100-85%Distinction 84-75%Credit 74-65%Pass 64-50%Fail Below 50%
Understanding of the condition and the value of lived experience.   40%Excellent demonstration in understanding of the disorder and insightful ability to identify lived experience and explain the value.   Demonstrates depth of understanding, highly structured arguments, and innovative thought.Very good demonstration in understanding of the disorder and sound ability to identify lived experience and explain the value.   Demonstrates a very high level of understanding with coherent arguments and sound critique on major points.Good demonstration in understanding of the disorder and reasonable attempts to identify lived experience and explain the value.   Demonstrates a coherent understanding with some evidence and critique on major points.Satisfactory demonstration in understanding of the disorder and attempts to identify lived experience and explain the value.   Demonstrates an understanding with evidence and descriptive arguments present.Insufficient demonstration in understanding of the disorder and limited/absent attempts to identify lived experience and explain the value.   No attempt is made to articulate an argument. The discourse comprises only sentences and/or quotes without formulating them into an argument.  
Demonstrates an understanding of stigma and the condition symptoms, possible contextual factors and impact related to family, community, and the recovery of the individual.   40% Excellent discussion of the effects of stigma, the role of family and community, on recovery.   Provides compelling and accurate evidence. The importance and relevance of all pieces of evidence are clearly stated. The discussion is approached from different angles with evidence. The author considers the evidence, or alternative interpretations of evidence, which could be used to refute or weaken the discussion, and thoughtfully responds to it. All the evidence is discussed collectively to draw conclusions.Very good and concise discussion of the effects of stigma, the role of family and community, on recovery.   Provides accurate evidence that supports critique of major points. The importance and relevance of all pieces of evidence are clearly stated. The discussion is approached from different angles with evidence. Author acknowledges that counterevidence or alternative interpretations exist and there is discussion of these. Good attempts to discuss the effects of stigma, the role of family and community, on recovery. With some omissions or misunderstandings.   Provides necessary evidence to support main discussion. Author acknowledges some of the most obvious counterevidence and alternative explanations. There is limited discussion of these.Satisfactory attempt to discuss the effects of stigma, the role of family and community, on recovery. With several omissions or misunderstandings.   Evidence provided to support the discussion. Author acknowledges some of the most obvious counterevidence and alternative explanations. There is limited/no discussion of these.Unsatisfactory attempt to discuss the effects of stigma, the role of family and community, on recovery.     Either limited or absent evidence provided and or there are numerous factual mistakes, omissions, or oversimplifications in the discussion. There is no acknowledgement of counterevidence or alternative interpretations.
Demonstrates a critical selfreflection on own attitudes pertainingExcellent and perceptive selfappraised viewpoints towardsEvidence of very good awareness in self-appraised viewpoints towardsEvidence of good awareness in selfappraised viewpoints towardsEvidence of satisfactory awareness in selfappraisedLimited or absent evidence of awareness in selfappraised
to mental health.    10%mental health and the identification of meaningful and or unique intrapersonal impacts.mental health and the identification of expressive and or innovative intrapersonal impacts.mental health and clear identification of own intrapersonal impacts.viewpoints towards mental health and some identification of intrapersonal impacts.viewpoints towards mental health and or unclear identification of intrapersonal impacts.  
Presentation.   5%     Exemplary professional presentation/little to no grammatical and spelling errors/clear, logical writing.   Within acceptable word limit range.    Excellent reading and application of academic literature/excellent professional presentation/ minor grammatical and spelling errors/clear, logical writing.   Within acceptable word limit range.    Good reading and application of academic literature/good professional presentation/some grammatical and spelling errors/mostly clear and logical writing.   Within acceptable word limit range.    Satisfactory reading and application of academic literature/beginning professional presentation/many grammatical and spelling errors/some unclear writing.   Over or under acceptable word limit range.    Insufficient reading and application of academic literature/unprofessi onal presentation/ multiple grammatical and spelling errors/ writing is often unclear, making it difficult to read.   Over or under acceptable word limit range.
APA 7.   5%  All APA style citations, references, and formatting are correct with no errors.  Almost all APA style citations, references, and formatting are correct with minor errors.Most APA style citations, references, and formatting are correct with some errors.More than half of APA style citations, references, and formatting are correct but with multiple errors.  Less than half of APA style citations, references, and formatting are correct.  

Case Study – Charlotte 

Charlotte grew up in a north-eastern suburban town and lived in the same house for her entire life. Her father is a lawyer, and her mother is an assistant principal at the town’s high school. Her sister, Holly, is 4 years younger. Charlotte’s parents have been married for almost 20 years. Aside from the usual sort of disagreements, they get along well. They are not particularly touchy-feely; it’s always a little awkward when having to hug her grandparents on holidays because charlotte and her family just never do that sort of thing at home. That’s not to say that her parents are uninterested or don’t care. Far from it, even though Charlotte’s parents both have busy work schedules, one of them would almost always make it to her track and cross-country meets and to Holly’s soccer games.  

In high school, Charlotte took advanced-level classes and earned good grades. She also got along quite well with her teachers and ended up graduating in the top 10 percent of the class. This made her mother proud, especially since she worked at the school. Charlotte’s mother would get worried that she might not be doing her best and “working to her full potential.” She liked to look over her work before turning it in and would make sure that Charlotte left plenty of time to study for tests. In addition to schoolwork, the track and cross-country teams were a big part of high school for Charlotte. She started running in junior high school because her parents wanted her to do something athletic; she was never coordinated enough to be good at sports like soccer. Charlotte was always a little bit chubby when she was a kid. Charlotte wasn’t exactly overweight, but everyone used to tease her about her baby fat. Running seemed like a good way for Charlotte to lose extra weight; it was hard at first, but gradually she got better and by high school Charlotte was one of the best runners on the team. Schoolwork and running didn’t leave her much time for anything else. Charlotte got along fine with the other kids at school, but basically hung out with just a few close friends. 

In her beginning semester of university Charlotte(18-years of age) was awarded a full track and cross-country scholarship. Charlotte had never felt so much pressure before because her scholarship depends both on her running and on maintaining a credit grade average, therefore she was stressed

out much of the time. During the first semester, almost all her girlfriends in university had experienced the “first year weight gain” – it was a common joke among everyone when up late studying and pizza was ordered. For others it didn’t really matter if weight was gained, but for Charlotte it did. She was having trouble keeping up during cross-country practices, having to drop out of a couple of races because she felt so awful and out of shape. Her coach called her aside about a month into the season, wanting to know what she was eating, and he told her the weight she had gained was undoubtedly hurting her performance. He said she should cut out snacks and sweets and stick to salads and include additional workouts. It was the pressure from her coach, teammates, and herself that first led Charlotte to dieting, which was easy given the university food bordered on inedible, so Charlotte didn’t mind sticking to salads, cereal, or yogurt. Occasionally allowing pasta, but only without sauce. She eliminated dessert, except for fruit on occasion. If anyone commented on her small meals, Charlotte told them that she was in training and gearing up for cross-country meets. Once charlotte started dieting, the incentives to continue were everywhere. She even received an invitation to a party given by a type of exclusive association that only invited the most attractive first-year women. Things were going so well that she figured it couldn’t hurt to stick to the diet a little longer. Charlotte was on a roll. She remembered all the people who she had seen on television who couldn’t lose weight even after years of trying and she began to think of her frequent hunger pangs as badges of honour, symbols of an ability to control her bodily urges. She set a new goal for her weight, hit the gym more often and began skipping breakfast altogether. Of course, this made her even hungrier, yet she did want to increase her meal sizes. So, she often paced herself with something like crackers which she broke into several pieces and only allowed herself to eat one piece every 15-minutes. The few times she did this in the presence of her friends she got weird looks and comments. Finally, Charlotte started eating alone. She began to worry about how she would handle Christmas dinner as Holidays are a big deal in her family, they get together with her aunts and uncles and grandparents, and of course there was a huge meal. She couldn’t bear the stress of being expected to eat such fattening foods. The mere thought of the meats, stuffing, gravy, and sweet desserts made her sick. She told her mother that there was a team Christmas dinner for those who lived too far away to go home. Charlotte knew this would disappoint her mother, but she just couldn’t deal with trying to stick to her diet with all her family around, nagging her to eat more.

Charlotte couldn’t believe it when the scale indicated her goal weight. She felt that she still had excess weight to lose. Some of her friends were beginning to mention that she was looking too thin, as if that’s possible. She wasn’t sure what they meant; she still feeling chubby when they said she was too skinny. Charlotte didn’t know who was right, but either way she didn’t want people seeing her body. Charlotte began dressing in baggy clothes that would hide her physique. She thought about the overweight people her friends and her had snickered about in the past and she just couldn’t bear the thought of anyone doing that to her. In addition, even though Charlotte was running her best times ever, she knew there was still room for improvement. She too had started to get really stressed about her studies. She had been managing to keep up throughout the semester, but she studied nonstop. Bringing notes to the gym to read on the treadmill, and she wasn’t sleeping more than an hour or two at night. Even though Charlotte was exhausted, she continued and began to find it hard to be around other people. Listening to her friends talk about their exam schedules only made her more frantic, she had to get back to her own studying. The cross-country season was over, so her workouts had become less intense. Instead of practicing with the team, Charlotte was expected to create her own workout schedule. Constant studying left her little time for exercise, yet she was afraid that cutting back on any workouts would cause weight gain. For Charlotte it seemed logical to keep up with exercise and eat less to continue to lose weight. Difficult though it was, this regimen worked out for her, she did fine on her final exams. At this point, she weighed around 40kg,  and her body mass index was at an unhealthy low.

After final exams, Charlotte went home for semester break for about a month and right away her mother started; she thought Charlotte spent too much time at the gym every day and that she wasn’t eating enough. More than once she commented about her looking too thin, like she was a walking skeleton. Charlotte’s mother tried to get her to go to a doctor, but she adamantly refused. Dinner at home was the worst for her so eventually she refused saying she is going to eat at a

friend’s house or at the mall. When Charlotte was at home, she felt like her mother was watching her every move. Although she was worried about the upcoming semester and indoor track season, Charlotte was looking forward to getting away from her parents. When Charlotte returned to school, she vowed to do a better job at keeping on top of classes and with her practice and cross-country meets schedule, she realised that the only way to devote more time to schoolwork was to cut back on socialising with friends. So, she hasn’t seen much her friends this semester and she didn’t bother to go to meals at all anymore, opting instead to grab a coffee or a soda and drinking it on my way to class. Charlotte stopped going out on the weekends and barely even seen her roommate Karen. Even though her running was great and finally she was able to stick to her diet, everyone thinks she was not taking good care of herself. Charlottes mother called her coach and roommate, and she had called the dean of student life, because that’s who got in touch with Charlotte and suggested that she go to the health centre for an evaluation. After this , Charlotte began to increasing distance herself from her family, her mother had gone behind her back after she told her that everything was fine. Charlotte felt she was doing her best to keep in control of life and wished that she could be trusted to take care herself.

When Karen first met Charlotte back at the beginning of semester, she thought they would get along great. She seemed a little shy but like she’d be fun once you got to know her better and she was cool when they had moved into a place together. Early on, a bunch of Karen and Charlotte’s  friends from university started hanging out together for meals or parties on the weekends. Charlotte was pretty and lots of guys would hit on her, but she never seemed interested. From day one, Charlotte took her academics and track seriously and though she appeared super busy with practices and running she always had her readings done for class. She was sort of an inspiration to us, though Karen knew that Charlotte also worried constantly about her studies and her performance in Cross-Country meets. She would get nervous before races. Sometimes she couldn’t sleep, and Karen would wake up in the middle of the night and see Charlotte pacing around her room. When Charlotte told Karen that her coach suggested a new diet and training regimen, it sounded like a good idea. Karen first realised that something was wrong when Charlotte started acting a lot less sociable. She stopped going out with their friends on weekends, and a couple of times Karen caught her eating by herself on the other side of campus. When she did see Charlotte eat, it was never anything besides vegetables and only a tiny portion and she wouldn’t even finish it. There wasn’t any food in the fridge that was hers except for cans of Diet Coke and a bag of baby carrots. Also, Karen had begun noticing that her roommate’s clothes were starting to look baggy, and hang off her. A couple of times she asked Charlotte if she was doing okay, but this only made her defensive. Karen kept believing her until she returned from Christmas. Indeed, Charlotte had dropped off the face of the earth, she almost never saw her, even though they were roommates. Karen got up around 8:00 or 9:00am, and Charlotte was already be gone. When Karen went to bed around midnight, Charlotte still wasn’t back and her bedroom was immaculate; bed made, books and notepads stacked neatly on her desk. When Karen did bump into Charlotte, she looked awful. She was way too thin, with dark circles under her eyes, she seemed like she had wasted away; her skin and hair were dull and dry. Karen was pretty sure that something was wrong, but she told herself that it must just be the stress of the upcoming exams and she figured that if there were a problem, Charlottes parents would notice it and do something about it over semester break. 

When Charlotte came back to campus, Karen was surprised to see that she looked even worse than during finals. When Karen asked how her break was, she mumbled something about being sick of her mother and happy to be back at school. As the semester got under way, Charlotte further distanced herself from her friends. There were no more parties or hanging out at meals. Karen and the others were all worried, but no one knew what to do. One time, Charlottes mother sent Karen a message on Facebook and asked if she had noticed anything strange going on with her daughter. Karen wasn’t sure what to write back, feeling guilty, like she was tattling on her roommate and friend, but also realising that she was in over her head and that she needed to be honest. So, in her reply Karen provided details about Charlottes odd eating habits, how she was exercising a lot and how she had become antisocial. A few days later, Charlotte approached Karen and said she had just met with one of the deans, who told her that she’d need to undergo an evaluation at the health centre before she could continue practicing with her team. Charlotte asked point-blank if Karen had been talking about her to anyone, and she told Charlotte how her mother had contacted her and asked if Karen had noticed any changes in Charlotte over the past several months, and Karen honestly replied to Charlotte’s mother, yes. Charlotte stormed out after the confrontation, Karen knew how important the team is to Charlotte, so she presumed that she’ll be going to the health centre soon. 

Some Readings and Resources

Byrne, L., Roper, C., Happell, B., & Reid-Searl, K. (2016). The stigma of identifying as having a lived experience runs before me: Challenges for lived experience roles Journal of Mental Health. doi:http://dx.doi.org/10.1080/09638237.2016.1244715 .

Frost, B.G., Tirupati, S., Johnston, S. et al. An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges. BMC Psychiatry 17, 22 (2017). https://doi.org/10.1186/s12888-016-1164-3

Gillard S, Edwards C, Gibson S, Holley J, Owen K. New ways of working in mental health services: a qualitative, comparative case study assessing and informing the emergence of new peer worker roles in mental health services in England. Southampton (UK): NIHR Journals Library; 2014 Jul. PMID: 27466663.

Honey, A., Boydell, K.M., Coniglio, F. et al. Lived experience research as a resource for recovery: a mixed methods study. BMC Psychiatry 20, 456 (2020). https://doi.org/10.1186/s12888-020-02861-0

Jacob K. S. (2015). Recovery model of mental illness: a complementary approach to psychiatric care. Indian journal of psychological medicine, 37(2), 117–119. https://doi.org/10.4103/0253-7176.155605

Ridley, Sophie & Martin, Robyn & Mahboub, Lyn. (2016). Learning from Mental Health Lived E_x_p_e_r_i_e_n_c_e_ _a_n_d_ _t_h_e_ _I_n_f_l_u_e_n_c_e_ _o_n_ _S_t_u_d_e_n_t_s_’ _P_r_a_c_t_i_c_e_._ _A_u_s_t_r_a_l_i_a_n_ _S_o_c_i_a_l_ _W_o_r_k_._ _7_0_._ _1_-9. 10.1080/0312407X.2016.1235718.

Suomi, A., Freeman, B & Banfield, M. (N.d). Framework for the engagement of people with a lived experience in program implementation and research. Centre for Mental Health Research. Australian National University. https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/anu-lived-experience-framework.pdf

Sweeney, A., Filson, B., Kennedy, A., Collinson, L., & Gillard, S. (2018). A paradigm shift: relationships in trauma-informed mental health services. BJPsych advances, 24(5), 319–333. https://doi.org/10.1192/bja.2018.29

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