The Clinician's Guide describes in detail a range of strategies for assisting people with severe hoarding: Strategies for engaging with clients who hoard. Guidelines for assessing harm potential.
Author: Michael A. Tompkins
The cat lady. The couple who won't let anyone in their apartment. The old man with all that junk in his yard. Their severe hoarding puts them, and often others, at risk for injury, disease, and even death. Most deny needing help, and for this reason, professionals are desperate to find more effective ways to offer and provide assistance to them. In response to this growing public health problem, Clinician's Guide to Severe Hoarding refines our understanding and presents in depth and innovative alternative to traditional interventions. Arguing that although treatment for hoarding can be effective for those who are open to help, people with severe hoarding are not. The Clinician’s Guide to Severe Hoarding describes an alternative strategy to help those who adamantly refuse help and yet face significant health and safety risks due to the hoarding problem – harm reduction. This client-centered approach takes readers through harm reduction plan development, team building, goal setting, client collaboration, and progress assessment. The Clinician’s Guide also explains that a successful harm reduction plan may encourage clients to seek further help, and offers insights into working with special populations such as people who hoard animals and children who exhibit hoarding behavior. The Clinician's Guide describes in detail a range of strategies for assisting people with severe hoarding: Strategies for engaging with clients who hoard. Guidelines for assessing harm potential. Guidelines for creating a harm reduction plan, building a harm reduction team, and conducting and evaluating home visits. Skills for client self-help: decision making, time management, and more. Guidelines for navigating the ethical and legal issues that arise in assisting people who hoard. Readings, links, and other resources. With its practical common-sense approach to a complex problem, Clinician's Guide to Severe Hoarding is a unique volume not only for mental health practitioners, but also other professionals who assist people who hoard, such as home health aides, social workers, and professional organizers.
This Second Edition of Treatment for Hoarding Disorder is the culmination of more than 20 years of research on understanding hoarding and building an effective intervention to address its myriad components.
Author: Gail Steketee
Publisher: Oxford University Press
Revision of: Compulsive hoarding and acquiring. 2007.
Author: Vladan Starcevic, MD, PhDPublish On: 2009-12-02
from very mild to extreme, when the person seems completely preoccupied with the hoarding activity. In the most severe cases, there is no room to store any more objects and the home of the affected person is extremely unkempt.
Author: Vladan Starcevic, MD, PhD
Publisher: Oxford University Press
Using the practical yet comprehensive approach found in the first edition, the author considers each anxiety disorder's clinical complexity while simultaneously using an integrative orientation toward finding clinical solutions. The author considers the presentation of each disorder as it occurs and is treated in the "real world" of clinical practice. Finally, the volume addresses effective therapeutic procedures and recommendations, including pharmacological and psychological treatment approaches. A true "must read" for any psychiatrist interested in anxiety disorders.
Hoarding Disorder is associated with a particularly chronic course and poor prognosis for standard treatments using medication and cognitive behavioral therapy. This may be due to many individuals displaying a striking lack of awareness ...
Author: Jon E. Grant
Publisher: Oxford University Press
Clinical Guide to Obsessive Compulsive and Related Disorders is a complete, comprehensive overview of OCD and related disorders (trichotillomania, excoriation disorder, hoarding disorder, body dysmorphic disorder, and tic disorders). The book covers underlying causes, clinical presentations and treatments. The book serves as a primer for clinicians in training and those already in practice who have little if any background in these disorders. It discusses the pharmacological and psychosocial treatments for both adults and children with an emphasis on providing practical information for clinicians to use in their everyday practices. Based on the DSM-5, the book uses the latest evidence-based information regarding treatments including medication options, behavioral therapies, alternative treatments, and recent developments in surgical treatment. This book will provide students, residents, interns and even veteran clinicians with a basic understanding of OCD and disorders that are often associated with OCD. In addition, members of the public and those affected by these disorders may use this book to enhance their personal knowledge of the subject matter presented.
Crossref Tompkins, M. A. (2014). Clinician's guide to severe hoarding. New York, NY: Springer New York. Tompkins, M. A., & Hartl, T. L. (2009). Digging out: Helping your loved one manage clutter, hoarding & compulsive acquiring.
Author: Chasson, Gregory S.
Publisher: Hogrefe Verlag
Hoarding disorder, classified as one of the obsessive-compulsive and related disorders in the DSM-5, presents particular challenges in therapeutic work, including treatment ambivalence and lack of insight of those affected. This evidence-based guide written by leading experts presents the latest knowledge on assessment and treatment of hoarding disorder. The reader gains a thorough grounding in the treatment of choice for hoarding – a specific form of CBT interweaved with psychoeducational, motivational, and harm-reduction approaches to enhance treatment outcome. Rich anecdotes and clinical pearls illuminate the science, and the book also includes information for special client groups, such as older individuals and those who hoard animals. Printable handouts help busy practitioners. This book is essential reading for clinical psychologists, psychiatrists, psychotherapists, and practitioners who work with older populations, as well as students.
In Recognizing and Treating Hoarding Disorder, she includes not only what it's like for the person who has it, ... Hoarding, and Compulsive Acquiring and Clinician's Guide to Severe Hoarding: A Harm Reduction Approach “For people living ...
Author: Carol Mathews
Publisher: W. W. Norton & Company
The first clinical guide to this psychiatric illness, officially recognized by the DSM in 2013. Everybody has heard the statements “she’s a pack rat” or “he’s a hoarder,” but how many of us really know what that means? Pathological hoarding was first formally conceptualized as a syndrome separate from OCD in the early 1990s, yet it wasn’t until 2013 that hoarding received formal psychiatric diagnostic criteria in the DSM. How can a mental health professional who sees clients in an office determine if hoarding is a factor in a client’s life? Here, Carol Mathews provides readers with the first-ever comprehensive clinical book on hoarding, covering every aspect of the disorder. Topics include: epidemiology and impact; screening tools and clinical interview tools for assessment; differential diagnosis and co-occurring disorders; when to suspect mild cognitive impairment and dementia; hoarding behaviors in children; how to differentiate normal keeping of items from hoarding; animal hoarding; the neurobiology of hoarding disorder; treatments, both psychopharmacological and otherwise; self-help options; and the impact of hoarding on the family.
The website lists clinicians who treat HD and specifically those who have received this specialized training. REFERENCES AND RESOURCES Bratiotis, C., Schmalisch, ... Clinician's guide to severe hoarding: A harm reduction approach.
Author: Steven Walfish
Publisher: Oxford University Press
Handbook of Private Practice is the premier resource for mental health clinicians, covering all aspects of developing and maintaining a successful private practice. Written for graduate students considering the career path of private practice, professionals wanting to transition into private practice, and current private practitioners who want to improve their practice, this book combines the overarching concepts needed to take a mental health practice (whether solo or in a group) from inception, through its lifespan. From envisioning your practice, to accounting and bookkeeping, hiring staff, managing the practice, and running the business of the practice, a diverse group of expert authors describe the practical considerations and steps to take to enhance your success. Chapters cover marketing, dealing with insurance and managed care, and how to choose your advisors. Ethics and risk management are integrated throughout the text with a special section also devoted to these issues and strategies. The last section features 26 niche practices in which expert practitioners describe their special area of practice and discuss important issues and aspects of their specialty practice. These areas include assessment and evaluation, specialized psychotherapy services, working with unique populations of clients, and more. Whether read cover-to-cover or used as a reference to repeatedly come back to when a question or challenge arises, this book is full of practical guidance directly geared to psychologists, counselors, social workers, and marriage and family therapists in independent practice.
People who suffer from organic hoarding tend to hoard objects such as rotting food and garbage as well as bodily waste. ... The Hoarding handbook: A guide for human service professionals. ... Clinician's guide to severe hoarding.
Author: Jon Carlson
Publisher: SAGE Publications
Category: Family & Relationships
The SAGE Encyclopedia of Marriage, Family and Couples Counseling is a new, all-encompassing, landmark work for researchers seeking to broaden their knowledge of this vast and diffuse field. Marriage and family counseling programs are established at institutions worldwide, yet there is no current work focused specifically on family therapy. While other works have discussed various methodologies, cases, niche aspects of the field and some broader views of counseling in general, this authoritative Encyclopedia provides readers with a fully comprehensive and accessible reference to aid in understanding the full scope and diversity of theories, approaches, and techniques and how they address various life events within the unique dynamics of families, couples, and related interpersonal relationships. Key topics include: Assessment Communication Coping Diversity Interventions and Techniques Life Events/Transitions Sexuality Work/Life Issues, and more Key features include: More than 500 signed articles written by key figures in the field span four comprehensive volumes Front matter includes a Reader’s Guide that groups related entries thematically Back matter includes a history of the development of the field, a Resource Guide to key associations, websites, and journals, a selected Bibliography of classic publications, and a detailed Index All entries conclude with Further Readings and Cross References to related entries to aid the reader in their research journey
Behaviors felt to be less predictive included: aggressive complaining about a need for higher medication doses; drug hoarding during periods of reduced symptoms; requesting specific drugs; acquisition of similar drugs from other medical ...
Author: Gary W. Jay
Publisher: CRC Press
Category: Health & Fitness
As headache and facial pain are two of the most common medical complaints, it is essential that clinicians are well equipped to handle these issues. Clinician's Guide to Chronic Headache and Facial Pain is designed for all clinicians dealing with these syndromes in daily practice-whether in the outpatient, emergency, or ambulatory setting. Features
Written by the developers of this groundbreaking treatment, this manual is the first to present an empirically supported and effective CBT program for treating compulsive hoarding and acquiring.
Author: Gail Steketee
Publisher: Oxford University Press
The problem of compulsive hoarding and acquiring is more widespread than commonly believed. It often goes undiagnosed, either because sufferers are ashamed of their compulsions or because they dont believe it is a problem that merits professional attention. As much as two percent of the U.S. population suffers secretly from this condition. However, compulsive hoarding can be an emotionally exhausting, uncontrollable, and sometimes dangerous problem. Written by the developers of this groundbreaking treatment, this manual is the first to present an empirically supported and effective CBT program for treating compulsive hoarding and acquiring. This guide gives clinicians the information to understand hoarding and proven tools to help clients overcome their compulsive behaviors. It teaches individuals how to recognize errors in thinking and uses both imagined and real exposures to teach them the skills they need to manage their problem. Home visits by the clinician are a part of the treatment, as well as consultations with other professionals who might assist if necessary. Homework exercises include behavioral experiments to test personal beliefs about possessions, developing an organization plan and filing system, and sorting and organizing items room-by-room. Designed to be used in conjunction with the corresponding workbook, this therapist guide provides numerous assessment and intervention forms to help clients use the methods described in this program. Complete with case examples and strategies for dealing with problems, this user-friendly guide is a dependable resource that no clinician can do without. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)
Reports of severe physical punishment and exposure to animal cruelty by inmates convicted of felonies and by university students. Child Abuse & Neglect, 21(1), 59–82. Nathanson, J. N., & Patronek, G.J. (2011). Animal hoarding: how the ...
Author: Lori R. Kogan
Publisher: Academic Press
Clinician’s Guide to Treating Animal Companion Issues: Addressing Human-Animal Interaction is the first of its kind—a groundbreaking resource for mental health professionals who want the knowledge, skills and awareness to successfully work with pet-owning clients. The book trains clinicians across multiple disciplines to feel more comfortable and confident addressing companion-related issues—both when those issues are the primary reason for seeking therapy or a critical component in better understanding client needs. The book uses current human-animal interactions theories as a foundation to explore pet-related issues utilizing behavioral, cognitive behavioral, family systems, humanistic and contemporary psychodynamic therapeutic orientations. Users will find sections on the many issues that arise during the lifespan of pet owners (e.g., children, young adults, elderly), as well as issues pertinent to specific populations (e.g., men, homeless, ethnically diverse). Additional topics include the violence link, pet death and bereavement, and behavioral issues. As the first book to approach human-animal interactions (HAI) from a multi-theoretical perspective, it helps clinicians appropriately acknowledge and incorporate relevant HAI issues within therapy to achieve goals. Provides practical information for immediate use in practice Focuses on common issues relating to companion animals Addresses bereavement, attachment, behavior, and more Includes interactive readings, case studies and therapeutic exercises Contains multiple theoretical orientations (behavioral, cognitive behavioral, family systems, humanistic and psychodynamic approaches)
Author: Yvonne M D'Arcy, MS, CRNP, CNSPublish On: 2011-01-28
Some of the behaviors that are less predictive of addiction include, hoarding drugs, asking for a specific medication or dose or self escalating doses one or two times. Behaviors which seem to be more predictive of addiction are ...
Author: Yvonne M D'Arcy, MS, CRNP, CNS
Publisher: Springer Publishing Company
Designated a Doody's Core Title! "This is an excellent resource that is essential for all primary care providers." Score: 100, 5 Stars.--Doody's Medical Reviews "[P]ractitioners who oversee the treatmentof chronic pain in the adult population will likely find thisnew reference an invaluable addition to their bookshelf."--Dimensions of Critical Care Nursing "This book is highly recommended; it will be an indispensable addition to the professional library of every nurse practitioner who manages patients with chronic, persistent pain." Margaret H. Granitto, RN, MSN, CRNP Georgetown University School of Nursing and Health Studies Presented in a clear, systematic format, this clinically oriented book provides nurses and physicians with quick access to much-needed pain management guidelines. With a unique focus on treatment options for patients with chronic persistent pain, this guide provides critical guidance on managing difficult conditions such as fibromyalgia and neuropathic pain. The text expertly assists practitioners in assessing pain in a variety of patient populations and provides professional insight on selecting patient-appropriate medications and interventions to achieve optimal pain management for adult patients. Key Features: Contains the newest guidelines on how to use a combination of pain screening tools to accurately assess the nature, intensity, and occurrence of patient pain Provides information on new medications and combinations of medications to use for chronic pain Presents essential information on safe prescribing and screening tools such as the Opioid Risk Tool (ORT) and screening tools for aberrant behaviors Provides strategies for utilizing nontraditional treatment options such as acupuncture, energy therapies, and psychological and coping strategies
The classical picture, in which patients can spend hours on rituals, is easyto diagnose, although the most severe cases present ... In the OCD spectrum, the decision to add a new diagnosis of “hoarding disorder” (Mataix-Cols et al., ...
Author: Joel Paris, MD
Publisher: OUP USA
The Intelligent Clinician's Guide to the DSM-5 examines the latest version of the DSM and offers mental health practitioners a critical guide for understanding the positive aspects of DSM-5, but also its limitations. Written in a lively voice by a celebrated professor of psychiatry and featuring the latest in psychiatric research and debate, this book is necessary reading for all mental health practitioners using the DSM.
The clinical breakdown for total scores, according to OCD severity, is: 0–7 (subclinical), 8–15 (mild), ... of three items each according to symptom presentation: washing, checking, ordering, obsessing, hoarding, and neutralizing.
Author: Jan van Niekerk
Publisher: New Harbinger Publications
As a clinician, you know how difficult it can be to treat clients with obsessive-compulsive disorder (OCD) using a one-size-fits-all approach. This powerful and evidence-based guide offers a variety of customizable treatment strategies-made simple and practical-for helping clients with OCD. Written by a psychologist and expert in treating obsessive-compulsive disorder, A Clinician’s Guide to Treating OCD combines powerful, evidence-based therapies to help you create a concise and customizable treatment plan. The methods including cognitive behavioral therapy (CBT), exposure and response prevention therapy (ERP), inference-based therapy (IBT), metacognitive therapy (MCT) and acceptance and commitment therapy (ACT), are presented in an easy-to-follow format, incorporate the newest research, and offer a wide range of skills for helping OCD clients. The standalone treatment protocols outlined in each chapter represent a specific model and procedure for addressing the mechanisms underlying the OCD. In addition, you'll find worksheets and online resources to help you create individualized treatment programs to best suit your clients’ needs. If you're looking for a simple, customizable approach to treating clients with OCD, this book has everything you need to get started.
In M. Hersen & M. Biaggio, (Eds.), Effective brief therapies: A clinician's guide. ... also: Personality Disorders HOARDING Hoarding has been widely recognized as a serious problem by elder service workers but has been almost completely ...
Author: Irving B. Weiner
Publisher: John Wiley & Sons
Psychologists, researchers, teachers, and students need complete and comprehensive information in the fields of psychology and behavioral science. The Corsini Encyclopedia of Psychology, Volume Two has been the reference of choice for almost three decades. This indispensable resource is updated and expanded to include much new material. It uniquely and effectively blends psychology and behavioral science. The Fourth Edition features over 1,200 entries; complete coverage of DSM disorders; and a bibliography of over 10,000 citations. Readers will benefit from up-to-date and authoritative coverage of every major area of psychology.
Int J Geriatr Psychiatry 12:1060–1061 Fitzgerald PB (1997) “The bowerbird symptom”: a case of severe hoarding of ... Ann Clin Psychiatry 16:27–34 Grant JE, Potenza MN (2004) Pathological gambling: a clinical guide to treatment.
Author: Bankole A. Johnson
Publisher: Springer Science & Business Media
The spectrum of addiction disorders presents practitioners with numerous challenges—among them the widening gap between a growing evidence base and the translation of this knowledge into treatment outcomes. Addiction Medicine addresses this disconnect, clearly explaining the role of brain function in drug taking and other habit-forming behaviors, and applying this biobehavioral framework to the delivery of evidence-based treatment. Its state-of-the-art coverage provides clinically relevant details on not only traditional sources of addiction such as cocaine, opiates, and alcohol, but also more recently recognized substances of abuse (e.g., steroids, inhalants) as well as behavioral addictions (e.g., binge eating, compulsive gambling, hoarding). Current behavioral and medical therapies are discussed in depth, and the book’s close attention to social context gives readers an added lens for personalizing treatment. An international panel of expert contributors offers the most up-to-date information on: Diagnosis and classification Neurobiological and molecular theories of addiction Behavioral concepts of addiction Clinical aspects of addiction to a wide range of substances, including opiates, stimulants, sedatives, hallucinogens, alcohol, nicotine, and caffeine Science-based treatment options: pharmacotherapy, pharmacogenetics, potential vaccines, brief and compliance-enhancing interventions, cognitive behavioral treatment, behavioral management, and other psychosocial interventions Behavioral addictions—including compulsive eating, Internet messaging, and hypersexuality—and their treatment Addiction in specific populations, including adolescents, the elderly, pregnant women, and health care professionals Legal, disability, and rehabilitation issues At once comprehensive and integrative, Addiction Medicine is an essential text and a practice-expanding tool for psychiatrists, health psychologists, pharmacologists, social workers, drug counselors, trainees, and general physicians/family practitioners.
Author: Yvonne M D'Arcy, MS, CRNP, CNSPublish On: 2011-02-24
Some behaviors that are considered aberrant but not addictive include the following: □ Requesting specific drugs □ Aggressive complaining about the need for higher doses □ Drug hoarding during periods of reduced symptoms ...
Author: Yvonne M D'Arcy, MS, CRNP, CNS
Publisher: Springer Publishing Company
"This book is a comprehensive, very specific, clinical guide for health care providers..."--Dimensions of Critical Care Nursing "This well-written and well-organized book is a much needed 'middle ground' resource between oversimplified introductions to pain management and a thick textbook."--Clinical Nurse Specialist "The Compact Clinical Guide to Acute Pain Management provides an excellent overview of the processof pain management for adult patients in any setting."--Critical Care Nurse This book provides much-needed guidelines that are presented in an easy-to-use, systematic format for quick access to core concepts on acute pain management. It is designed to help busy practitioners accurately assess pain in a variety of patient populations, and select patient-appropriate medications and interventions to achieve optimal pain management for adult patients. Intended for use in primary care, internal medicine, and acute- and long-term care settings, this book covers the topics of acute pain assessment, both pharmacologic and nonpharmacologic treatment options, current information from national guidelines, along with regional anesthesia techniques, patient-controlled analgesia, and epidural pain management. Key Features: Offers important new perspective on combination use of pain scales to accurately predict individual pain management needs for more customized and effective management Delivers information on how to treat acute pain in hospitalized patients who also suffer from chronic pain and substance abuse Offers new information on opioid polymorphisms and their surprising effect on pain medication effectiveness Includes a special chapter on managing pain in difficult-to-treat patient populations This is an essential reference for primary care providers in clinics, hospitals, specialty care, and critical care to assess pain in general populations and provide tips for performing pain assessment on patients with acute pain.
An unemployed man with a severe depressive episode voices the intent to kill his wife, children, and himself because he feels that ... A university student behaves secretively and engages in hoarding, entirely unlike his past behaviors.
Author: Laura Weiss Roberts
Publisher: American Psychiatric Pub
In the video above, listen to the author, Dr. Roberts, discuss with Chief of Staff John M. Oldham the challenges that medical residents face in managing their own mental health and wellbeing. Professional ethics and decision making have become areas of heightened critical inquiry, as well as matters of normal but challenging psychiatric practice. Informed by the extensive clinical experience of the author and guest contributors, A Clinical Guide to Psychiatric Ethics approaches the ethical aspects of mental health care -- both subtle and dramatic -- with clarity, coherence, and optimism. This engaging text functions as both a review and a guide to issues on the horizon, as well as those encountered every day. The Guide achieves these objectives by employing several strategic features: Structured logically into three parts (Fundamentals, Caring for Special Populations, and Evolving Topics), the book takes the reader from the general to the specific and from the traditional to the emergent. Case scenarios at the end of each chapter not only focus the individual reader on the chapter's concepts and issues, but also may be used in independent study or small-group discussions. The text emphasizes real experience over remote theories, attuning readers to clinical realities with keen sensitivity. It does not offer simple answers, but provides guideposts to impart information, foster skill development, and encourage openness, collaboration, and self-reflection among both veteran clinicians and trainees. Significant focus is given to the care of individuals from distinct populations (e.g., children and veterans) and care occurring in unique contexts (e.g., small communities), underscoring the book's broad usefulness. The material is thoroughly current, aided by useful lists, tables, and figures to enhance its accessibility. A Clinical Guide to Psychiatric Ethics provides a trustworthy compass and expert companion for those traveling with their patients along the ethical frontier of mental illness.
Author: Michael Tarren-SweeneyPublish On: 2013-10-30
Two studies have described children in foster care who are chronic excessive eaters (hyperphagia), but who are neither obese nor growth impaired (Ayoob et al., 1994; ... drinking and food maintenance (hoarding, storing, stealing, etc.) ...
Author: Michael Tarren-Sweeney
The Assessment Checklist series, created by Michael Tarren-Sweeney, provides the world’s first standardised caregiver-report measures of a range of attachment- and trauma-related mental health difficulties experienced amongst children growing up in foster, adoptive, kinship and residential care. This clinical manual provides essential guidance for child and adolescent mental health clinicians who use the Assessment Checklist measures, including the Assessment Checklist for Children (ACC), the Assessment Checklist for Adolescents (ACA) and the Brief Assessment Checklists (BAC), as part of their specialized assessments of children and adolescents in care. Split into three parts, the book explores all aspects of using and interpreting the Checklist series. Part 1 provides an overview of the Assessment Checklist measures, the rationale for their development and instructions on how to use the measures for clinical assessment, screening and treatment monitoring. Part 2 provides expert guidance to clinicians on interpreting Assessment Checklist score profiles and provides detailed information about several specific types of mental health difficulties measured by them. Part 3 describes the development and psychometric properties of the various Assessment Checklist measures, including information about their validity and reliability. It also introduces several new measures that are under development. Ideal for clinical child psychologists, child and adolescent psychiatrists, child psychotherapists and clinical social workers looking to improve the quality and depth of their clinical assessments with children and adolescents, this book provides essential guidance on professional use of the Assessment Checklist measures.
They became obsessed with food, subscribing to food magazines, hoarding food if they had the opportunity, and developing unusual obsessive rituals around food consumption. They experienced severe emotional distress, including increased ...
Author: Margit Berman
This clinician manual presents the Accept Yourself! Program, which is derived from empirically supported interventions (including Acceptance and Commitment Therapy and Health At Every Size) that have a demonstrated ability to enhance women’s mental and physical health. This book offers a clear, research-based, and forgiving explanation for clients’ failure to lose weight, helpful guidance for clinicians who are frustrated with poor client weight loss outcomes, as well as a liberating invitation to clients to give up this struggle and find another way to achieve their dreams and goals.