Greenland Essays - Geography Of Greenland, Greenland, Free Essays

Greenland Essays - Geography Of Greenland, Greenland, Free Essays Greenland Greenland The geography of Greenland is quite ironic considering its name. Greenland is Located in the northern part of North America. It is between the Arctic Ocean and the North Atlantic Ocean, northeast of Canada. Greenlands area is approximately 2,715,600 square kilometers. Its area is slightly more than 3 times the size of Texas. It is the largest island in the world. It is also primarily by the Davis Strait and Baffin Bay and from Iceland on the east, by the Denmark Strait. Greenlands terrain is flat to a gradually sloping icecap. It covers everything but a narrow, mountainous, rocky coast. Its climate has cool summers and very cold winters! During the summertime in the southern part of Greenland, the average Temperature is 48 Fahrenheit. The climate of Greenland is generally dry. People have lived on Greenland for about 5, 000 years, the earliest belonging to what are called the Independence I, Saqqaq, and Independence II cultures. Greenland is the source of many weather changes in the Northern Hemisphere. Their natural

Writer

The Stay at Home Parent/Writer The Stay at Home Parent/Writer The Stay at Home Parent/Writer By Guest Author This is a guest post by Rhonda Franz. If you want to write for Daily Writing Tips check the guidelines here. The great thing about being a writer with young children is the material. There’s emotion (good or bad) in everything from how their first word was â€Å"NO,† to the way they walk when they’ve put their pants on backwards. The difficult thing about writing with young kids at home is that they’re young, and, well, they’re at home. Children in the high-maintenance stages between birth and Kindergarten make for an extremely busy, sometimes overwhelming, season in a mom and dad’s life. In order to manage writing- and the business of writing- from home, it’s important to treat it as the job it is, and expect family members to do the same. Have a Routine Children generally behave best when they know what to expect. If it works in your household to get a little writing done during the day, make sure your children have specific activities to work on, and/or special toys they get to play with only during that time. For toddlers and preschool-aged children, consider letting them use this time to look at books, â€Å"write† with their crayons, markers, or pencils, or, if they have one, work on their own toy laptop computer. Then sit down, get to work, and don’t feel guilty about your children having to entertain themselves for a few minutes; it’s good for them. Novelist Barbara Kingsolver once said that she has always written while her children were in someone else’s care. That’s absolutely the best thing to do, but if you’re a stay-at-home parent with babies or toddlers (or both), and don’t choose daycare, the children are in your care. It’s essential to have a regular time- even if it’s when they’re sleeping- to work when they won’t require constant attention. Get up a couple of hours early, stay up a few hours late: whatever suits you and your family. Certain Time, Same Place Again, this touches on routine. If you plan to write while they’re around, try to do it at a certain time, or certain times, throughout the day. Of course, of course parents have to be flexible and deal with emergencies and crying babies and so on and so forth: ‘tis the life of the home manager. But the more consistent you are in making time for writing, the more it will become a habit, and therefore, just a normal part of your day, and of your child’s day. Sitting in front of a computer looks different than teaching piano lessons or tutoring students in your home. The only visible action is that of your fingers on the keyboard. It can be difficult to get children (and sometimes, spouses) to take you seriously when you’re interacting with computer screen or notebook. Call it your â€Å"writing work,† or â€Å"writing job,† but refer to it as what it is: serious business. It’s up to you to set the tone. If your computer usually sits in an open place, move it to a particular room or area of the house while you write. This way, you set up a distinction between Mommy or Daddy cruising mindlessly around the web and actual work being done. Save the cruising for after the children are in bed. Make Notes Place list paper, sticky notes, tablets, scrap paper, pencils or pens, in desks, the kitchen drawer, under the changing pad, and by your bedside. When an idea strikes during the day, it’s likely you’ll only have mere seconds to jot it down before your toddler heads for the stairs. Get Out of the House There’s always something calling out for attention in a house: laundry, phone messages, unpaid bills, dust. If you are fortunate enough to have someone who can occasionally watch your children, or you can take advantage of a local Mom’s Day Out or community program, consider getting out of the house and going to your local library, bookstore, or coffee house to write. Plant yourself in a corner and relish the fact that someone else gets paid to sweep that floor. Multitasking is Great, But†¦ it isn’t always the most effective way to get something done. Use certain blocks of time to write, and certain blocks of time to do household chores. When you’re at the writing time, do not get distracted by the overloaded trash bin, or the dirty dishes in the kitchen sink. When ideas come to you while working on those tasks, jot down ideas on the nearest piece of paper. Do not get immersed in a household responsibility. Remind yourself that you will see to those jobs during the time you’ve made to work on chores. If you are easily distracted, see the above information about escape. Remember Your Priorities There are days when your children require special attention. This is a good day to shut down the computer, put away your notebook, and concentrate on the reason you’re staying home in the first place. Your writing can always be revised; your children can’t. Rhonda Franz spent seven years teaching other people’s children before taking a leave to raise her own. She learned to keep paper and pens everywhere in her house after using a Crayola marker to write a phrase on a disposable diaper. You can read more about her views on writing in public places at Freelance Writing Gigs. She’s a regular contributor at ParentingSquad.com, and writes on a variety of topics at her own blog, Coffeehouse Mom. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Freelance Writing category, check our popular posts, or choose a related post below:Useful Stock Phrases for Your Business EmailsTry to vs. Try andGrammar Review #1: Particles and Phrasal Verbs

The Weary Blues and The Negro Speakers of Rivers by Langston Hughes Essay

The Weary Blues and The Negro Speakers of Rivers by Langston Hughes - Essay Example The narrator is occupied with the sadness of the notes and tones of the blues music. The narrator feels as if the piano is moaning (lines 10, 18), which shows the extent of sadness that is being depicted from the musician’s state of mind and his selection of the blues song. The song is about how the musician is going to survive and be happy instead of all the miseries, sadness, and worries he possesses, like when he sings, â€Å"I's gwine to quit ma frownin'/ And put ma troubles on the shelf† (lines 21-22). But all of a sudden, he again becomes depressed, and says that his anguish is going to be so stressful that he wishes he could die, like he says, â€Å"I got the Weary Blues/ And I can't be satisfied./ Got the Weary Blues/ And can't be satisfied--/ I ain't happy no mo'/ And I wish that I had died† (lines 25-30). This change of mood tells that he is not being very effective in putting off his worries, despite all his efforts to stay happy. He keeps on playing t ill late night; and, when he goes to bed, he dreams of himself as a rock with no emotions or a dead man. The musician is a Negro in the poem. And he is sad. This refers to the poet himself, because Hughes was an African-American, and was also a victim of racism. Hence, the poem talks about his own gloom and shattered state of mind, because he has to go through emotional turmoil due to his race. â€Å"The Negro Speaks of Rivers† Langston Hughes, being an African-American poet, suffered from racial discrimination in the early twentieth century in America. However, he tried to survive the currents of racism, and struggled to spread the message of love and equality through his poetry. This poem speaks about the unity of people through the imagery of river. The poem starts with the poet mentioning that he has known rivers since ages. Starting lines, â€Å"I've known rivers/ I've known rivers ancient as the world and older than the flow of human blood in human veins†, hold t he imagery of river, which the poet uses to show the connection of all human life on earth. He mentions Euphrates, Congo, Nile, and Mississippi, which shows that he is talking about life from the beginning of civilization till the American Civil War. Euphrates shows the origin of civilization â€Å"when the dawns were young†. He claims to be united with the whites living near the Congo, when he says that he built his hut â€Å"near the Congo†. The white race also served as slaves of the Egyptians who built the pyramids, and the poet mentions his looking at the Nile and raising the pyramids, trying to associate himself with the whites. His mentioning of Mississippi and Abe Lincoln going down the New Orleans reminds us the setting free of the slaves, with the Mississippi river symbolizing human blood belonging to all races. The poet repeats that, â€Å"My soul has grown deep like the rivers†, which means that he has identified his true identity, because one who be comes familiar with his soul recognizes who he actually is. Since, the river symbolizes human life in this poem, and its flow symbolizes the flow of blood in the veins of all humans, this refers to the fact that all humans are linked to each other, since all of them have the same blood in their veins, because they have the same father, Adam, and the same mother, Eve. Hence, the poet has tried to link himself with all races on the

Similarities and differences Assignment Example | Topics and Well Written Essays - 500 words

Similarities and differences - Assignment Example (Wagner ) That said research continues to be pursued to determine how beneficial animal therapies are in treating a multitude of disorders, ailments, and other unpleasant issues of the human condition. One of the current uses of animals in therapy is in treating children you have a fear of reading. Such fears can develop due to several different causes. Individuals with legitimate disabilities or difficulties reading may fear the judgment and criticism of their peers, which can manifest in them suffering low self-esteem. Animals, however, unlike people, never pass judgment and can be a comforting and encouraging presence on children, particularly dogs. Multiple reading programs have been developed that involves matching children with dogs and asking these children to read to the dogs. This can, not only improve, their desire to read, but, also, provides them a sense of comfort and relaxation. Ideally such a program’s overall goals are to associate reading with positive experiences and animals can participate in that in unique and endearing ways. ("TDI: Therapy Dogs International") Children are not the only ones that benefit from the inclusion of animal therapy in their live s. The elderly, particularly those that live in institutionalized settings, are occasion to very high rates of loneliness, depression, and a huge detachment, very often, from the world around them. For both alert and non-alert patients, distinct differences are apparent in their behaviors. The physical contact and gentle interaction and companionship of an animal grants these individuals that sense of necessary comfort.(Ptak 10) One of the most saddening side-effects suffered from the brave men and women who serve in this country’s military is Post Traumatic Stress Disorder. This is a very serious condition that can have hugely negative effects on the psychological, emotional, and physical day to day existences of our veterans. Research is showing that

Overseas Aid & International Development Essay Example for Free

Overseas Aid International Development Essay International development can only be defined holistically as improvement of human lives and enhancement of the people’s social welfare. International development constitutes the following; provision and/or improvement in sectors of health, education, governance, gender equity and equality, infrastructural facilities, environment, economic empowerment, foreign aid, disaster preparedness and human rights. In order to know the status of the welfare in any society, there are some indicators that can be used and these include the following; the literacy level, poverty level, life expectancy and GDP per capita. Generally, these indicators have been reported to improve over the past and this has not been possible without involvement of development partners. These development partners include CBO ’s, NGO’s , multilateral development agencies and bilateral donors among others. This paper will focus on Catholic Relief Services (CRS ) approach to international development and outline its contribution to the achievement of the MDG’s . CRS is a non governmental organization that was started back in 1943 by United States’ catholic bishops. Its main aim was to resettle those people who were displaced by the Second World War especially in Europe. It is based on Christian religious practices and specifically on catholic doctrine. Ten years later the situation in Europe was regaining its normalcy state and the organization expanded its activities to other parts of the world that include Africa, Eastern Europe, Latin America, Caribbean, Asia and middle east. Other than provision of relief services, the organization has been in the fore front in breaking the vicious cycle of poverty through sustainable community based development initiatives. This has been mainly through its focus in key sectors in the word’s economies and its main activities have been carried out in the following areas; agriculture, emergency response, health including HIV /AIDS , education, microfinance and peace building. It has been active in championing policy issues regarding global poverty, hunger, conflict resolution management and transformation, migration, HIV/AIDS, human trafficking, gender and inequality (http://crs. org/ ). According to the organization â€Å"Catholic Relief Services complements its humanitarian and development experience with policy analysis and advocacy to address root causes of poverty, conflict, and marginalization. CRS examines issues that are dramatically impacting the safety and well-being of poor and vulnerable people worldwide based on the principles of Catholic social teaching, primary among them the protection of the dignity of the human person. †(http://crs. org/ ) Millennium development goals are goals that were set by members of the United Nations and international organizations and aimed to be achieved by 2015. This followed after the adoption of United Nations millennium declaration during the 2000 millennium summit by the member states heads (http://www. un. org/millennium/). The aim of these MDG’s was to foster social and economic development in the poverty stricken countries in the world. There was a major concern on the increase in poverty among many people all over the world and this trend needed urgent redress to stop and reverse it. Following the chapters of the United Nations millennium declaration eight goals were set and named the millennium development goals. These included the following; poverty reduction and hunger eradication, promotion gender equality and women empowerment, improvement of maternal health, eradicate illiteracy through provision of primary education to children all over the world, reverse the trend of HIV/AIDS infections, reduce the death of children under five years of age, promote environmental sustainability and enhance partnership in global development(http://www. undp. org/mdg/basics. shtml). The catholic relief services activities have been intertwined with these millennium development goals and this is a clear indication that achievement of these MDG’s will mean attaining the objectives of the CRS and vice versa. The reason is because the goals can not be achieved without the focus on the sectors addressed by the CRS and thus the CRS can be viewed as an urgent and a partner in the realization of the millennium development goals. The reason for focusing on the CRS is because of its massive contribution and huge network that covers the different corners of the world. Though it is based on Christian virtues and catholism, it has never been crippled or shorthanded by the diversity in people’s background ranging from religion, race tribe, geographical location and nationality. It has always focused on its key objectives and as a result many people have benefited so much from the organization’s activities. Its approach to social issues has been guided by the people’s needs and its immense contribution has saved the lives of many. Most of the beneficiaries of its serviced have risen to great heights and human suffering has highly reduced in those areas it has been reported to operate. The spirit of giving, volunteer ship and promotion peaceful coexistence has been demonstrated by the organization where mutual understanding has prevailed in areas where hostility, hatred, destruction, disasters and political instability has rocked claiming lives of many people. As globalization continues to shape the lives of people, there always arise challenges that need unity and cooperation to be addressed. It is this reason that the CRS has gone beyond its religious cocoons and joined hands with re rest of the world to alleviate human suffering and this is a good example that organizations and states should follow if the world would be a better and safer place for human beings to live. I will now focus on the specific contributions of the CRS towards the achievement of the millennium development goals. Most developing countries highly depend on agriculture. This has been their only resource that has enabled them to survive through acquisition of the basic human needs that include food, clothing, shelter, health services and basic education. However as a result of climatic changes, the agriculture sector has faced many challenges that need to e addressed in order to guarantee its vital contribution and sustainability to the many people who rely on it for their daily life. The challenges need massive investment on technology and skills which must be accompanied by financial costs. Since most of these poor people can not afford them, their poverty escalates day by day. CRS has developed partnership programs with poor local communities by providing advice, research services and inputs to improve agricultural production. It has worked closely with local agencies to ensure programs on environmental matters and agriculture are properly implemented to benefit the poorest in the communities and families all over the world. It seeks to strengthen the local poor communities and encourage them to champion their development without relying on external enforcement. Increased food production will ensure hunger is completely eradicated and people can even have surplus to sell and procure other basic needs in their lives. This will reduce poverty and reduce diseases which have been closely associated with malnutrition. Sexual exploitation which has very much been exacerbated by the need to earn money to buy basis needs will reduce leading to drastic decline in HIV/AIDS infections (Little D. M, Clifford J. M, 2005, 122-127). In the education sector, CRS has made huge contribution to promotion of basic education in different areas of the world. Its activities have increased the access and quality of education to many poor and marginalized populations. This has been aimed at enhancing peace and justice in all communities and has been mainly in areas where crisis has been reported. Their services extend to those areas with relative stability and those that are recovering from the crisis. The organization provides support to schools in local areas where the largest population of the poor are believed to live. In their effort to ensure the poor access quality education and participate fully in community projects, it introduced food assisted education (FAE ). Since mid 1990’s girl child education, teachers support, hygienic education and services for students have also been rolled out. It has also helped to put up education infrastructural facilities and sensitization of members of the communities especially parents to get involved in educational matters for their children. These education activities have an objective of reaching the poor and marginalized members of the society especially the children. As a result poverty is expected to reduce with the decrease in the level of illiteracy all over the world. Poverty will then reduce and thus the millennium development goals are well taken care of by the CRS programmes (Singer H. W, Ansari J. A, 1988, 35-58). CRS is widely involved in emergency responses that ensure that those affected are not denied their right to live with dignity. It therefore works closely with members of the communities affected to ensure their disaster preparedness capacities are strengthened and restored. In times of complex emergencies and natural disasters, the CRS commits itself in life saving livelihood support and strengthening of the entire civil society. To them, peace is of necessity and violent conflict should be prevented. The organization therefore conducts emergency health operations that are usually aimed at supporting the already existing health institutions and ensure those in need of health services and basic medical attention are attended to. Distribution of relief food and technical support to farmers to increase food production is also a vital role played by the CRS. Those who may not have shelters are assisted with temporary shelters and to some larger extend, the organization contribute materials to construct permanent shelters. CRS also ensures conflicts are prevented, properly managed if they arise, resolved peacefully and transformation is achieved within the soonest time possible through addressing the root cause. Marginalized and vulnerable groups receive special attention including expectant women children, aged and those infected with HIV/AIDS (Megan Landon M, 2006, 165-190). In the health sector, the CRS has actively involved local communities to solve problems themselves through empowering them to make sound decisions. They normally use the catholic social teaching which acts as a subsidiary principle. It involves volunteers from different parts of the world who donate their services to those most in need of them and can not afford them. Such programs reduce child mortality, HIV/AIDS infections and reduce deaths that result from inadequate maternal services for women. Social justice is therefore restored and human rights and dignity is fostered. On similar grounds the organization has been very much concerned with AIDS which has been threatening to wipe human beings out of the face of the earth. Research has indicated that as much as poverty has been cited as the cause of the increase in infections of the disease among human beings, it is also an effect. CRS has therefore initiated programmes all over the world with an estimated expenditure of at least $120million and over four million beneficiaries in the year 2007 alone. This has been the trend over the past up to date and as the pandemic deepens its roots, the expenditure has kept on rising. Finally, as the rate of unemployment increases, many people are engaging in self employment to earn their living. Majority of the unemployed are poor and the women who have no collaterals to access financial services from commercial banks. This has increased sexual exploitation which is skewed towards women. This has been taken care of by the microfinance service in CRS that provides affordable loan and financial services to the self employed women. Economic empowerment is very important weapon in war against HIV/AIDS, illiteracy, inequality, hunger, diseases and all other poverty related problems that human beings encounter. This is the major concern of the CRS and the core of millennium development goals. Citing an example of progress in the contributions towards achieving the millennium development goals will directly highlight a major activity carried out by the CRS and therefore the CRS deserves all manner of support in implementation of its goals and objectives if millennium development goals will ever be achieved. Other organizations and governmental entities have already joined hands with CRS such as USAID , USDA , UNDP , The Inter-American Development Bank, Education ministries among many others (http://www. management-issues. com/2006/8/24/research/financial-services-firms-hostile-towards-women. asp ). Conclusion CRS is just but one of the many organizations that has been actively involved in ensuring millennium development goals are achieved. Both the millennium development goals and the CRS have so much in common and it may not be easy to separate the influence of one to the other. While the CRS is concerned with the issues that impact safety and social welfare of the minor marginalized and vulnerable groups of people, the MDGs outline these issues themselves and sets a target and specific time duration through its objectives when the problems should be reduced to manageable magnitude. It is a lifetime process to completely do away with these problems and challenges and thus, unless otherwise, the CRS should only live to see full redress of the problems. At the same time, achievement of the MDG’s in the year 2015 will set the agenda for the next step in millennium development goals. References About the MDGs: Basics, Retrieved from http://www. undp. org/mdg/basics. shtml on 5th June, 2009 UNITED NATIONS MILLENNIUM DECLARATION, Retrieved from http://www. un. org/millennium/ PDF, on 5th June, 2009 Little D. M, Clifford J. M, (2005), International aid: the flow of public resources from rich to poor countries, Aldine Transaction Singer H. W, Ansari J. A, (1988), Rich and Poor Countries: Consequences of International Economic Disorder, Rutledge Megan Landon M, (2006), Environment, health and sustainable development, McGraw-Hill International Catholic relief service, Retrieved from http://crs. org/ on 5th June, 2009 Financial services firms hostile towards women Retrieved from http://www. management-issues. com/2006/8/24/research/financial-services-firms-hostile-towards-women. asp on 5th June, 2009

To Kill a Mockingbird: Jem Grows Up :: To Kill a Mockingbird Essays

  Ã‚  Ã‚  Ã‚  Ã‚  To Kill A Mockingbird, by Harper Lee, has won many prestigious awards and is still a very classic and appreciated book in our society today. Jem, a character in the book, grows up and realizes that you have to step in someone else’s shoes to understand why they make the decisions that they make. Once Jem saw that the knot-hole in the tree was filled with cement he started crying because he stepped into Boo Radley’s shoes. Also, When Jem learned that Mrs. Dubose had died, he stepped into her shoes and then felt sorry for her.   Ã‚  Ã‚  Ã‚  Ã‚  One way that shows that Jem grows up and realizes that he has to step in someone else’s shoes to understand why they make the decisions that they make is when he discovers that Nathan Radley filled the knot-hole in the tree with cement. He told Jem that he filled the tree with cement due to the fact that the tree was dying, when it was obviously not. Boo was communicating with them by placing gifts in the knot-hole. Jem steps into Boo’s shoes at that point and figures out that all Boo was trying to do was communicate with the children, and putting gifts in the knot-hole was the only way he knew how to without getting a lot of attention from the public. Jem knows that if he were locked up in his own house for that long, he would try to communicate and have a little fun with children that he sees playing around in the neighborhood. That is why he cries; he knows that Boo is just trying to be nice and communicate with them, and he just doesn’t un derstand why Nathan Radley would cut that communication between his brother and the children   Ã‚  Ã‚  Ã‚  Ã‚  Another way that shows that Jem grows up and realizes that he has to step in someone else’s shoes to understand why they make the decisions that they make is when he learned that Mrs. Dubose had died. When he was reading to Mrs. Dubose, he hated it, and he hated her for making him do it for so long. Once he learned that Mrs. Dubose was a morphine addict, and that her fits were from it, he ate all of his bad comments about her. He stepped into her shoes and saw everything from her perspective. He knew that if he were in her position, he would have probably done the same thing.

Managed Care Essay

As recently as 1960, before the onset of managed mental health care, the roles of psychiatrists, psychologists, and clinical social workers tended to be distinct. Psychiatrists had the overall responsibility of patient care, conducted psychotherapy, prescribed medication, and supervised hospital care. Clinical psychologists conducted testing and provided group therapy and other therapeutic modalities in institutions and hospitals. Clinical social workers performed comprehensive psychosocial assessments, counseled regarding family issues, and created discharge plans for patients in social services agencies. At that time, the mental health field was far from overcrowded. With psychiatrists’ shift in emphasis, clinical social workers and clinical psychologists assumed more responsibility in mental health treatment, and psychotherapy, in particular. The proliferation of managed care companies during the 1980s furthered the increased involvement of clinical social workers and clinical psychologists. Because of improved training and the less-expensive nature of their services, clinical social workers and clinical psychologists were more involved in providing psychotherapy to patients suffering from mental illness. (Committee on Therapy, Group for the Advancement of Psychiatry, 1992). Conflict in Roles According to Gibelman & Schervish managed health care companies have continued this trend of expanding the roles and responsibilities of nonmedical providers–primarily clinical social workers and clinical psychologists–while narrowing the scope of psychiatric practice. Managed health care companies see clinical social workers in particular as an economical, substitutable source of labor for both clinical psychologists and psychiatrists in the treatment of patients suffering from mental illness. Presently, clinical social workers provide a wide array of services to clients with mental illness in a variety of settings and at all functional levels of practice. Clinical social workers practice in institutions, hospitals, school systems, clinics, correctional facilities, and private practices. They function in positions of direct service, supervision, management, policy development, research, community organization, and education and training. Clinical social workers frequen tly perform assessments and arrange and develop services. In these roles they serve as gatekeepers and treatment providers. For some time, clinical social  workers have performed the largest portion of psychotherapeutic work done in the United States. Clinical social workers provide as much as 65 percent of all psychotherapy and mental health services (1997). Payers have begun to ask, â€Å"What type of therapist is the most cost-effective?† and â€Å"What is the advantage of paying one profession higher fees than another for rendering the same service?† when an objective review of empirical studies shows that there is no absolute proof that one profession can perform psychotherapy better than another. Such research leads managed care companies to conclude that many of the cheaper sources of labor in the mental health field, such as clinical social workers, are as effective in administering treatment to patients suffering from mental illness as other more-expensive practitioners (Gibelman & Schervish, 1997) Individual verse Group Practice With managed care’s influence, outpatient treatment, and private practice, in particular, has become a viable and increasingly important role for clinical social workers. Although mental health clinics and other institutions provide the greatest opportunity for clinical social workers, a growing number are now carrying out services in a primary setting of solo or group private practice (Gibelman & Schervish, 1996). In 1995, 19.7 percent of NASW members cited private solo and group as their primary practice, and 45.5 percent as their secondary practice setting (Gibelman & Schervish, 1997). Findings indicate that the proportion of clinical social workers entering and practicing as private practitioners continues to grow (Gibelman & Schervish, 1996). The future treatment of patients in solo private practice may be in jeopardy, as managed care companies force clinical social workers and other mental health care providers to join group practices. In group practices, clinical social workers, in combination with other mental health practitioners, provide individual and group therapy, family interventions, and a variety of other services, all through one office (Shera, 1996). These groups provide â€Å"one-stop shopping,† as well as greater access to less-expensive professionals, such as master’s-level clinical social workers. Managed care companies find that group practices are more efficient and cost-effective in the management of a population of patients (Johnson, 1995). As managed care companies continue to reduce reimbursement dollars, changes in multidisciplinary team structures are inevitable, with even more  reliance on master’s-level service providers. Practitioner distinctions already have begun to diminish in favor of more team-oriented models, with the boundaries between the uniqueness of the individual disciplines beginning to blur (Eubanks, Goldberg, & Fox, 1996). Psychiatrists often head the team, coordinating services in conjunction with psychotherapists and other mental health care providers on the treatment team. However, it is not unusual for a clinical psychologist or even a clinical social worker to lead the team, with the psychiatrist relegated to the role of psychopharmacology consultant rather than an active team member (Brooks & Riley, 1996). Treatment In addition to changing the role of mental health practitioners and the structure of treatment teams, managed care has forced the clinical social work profession and the mental health field in general, to examine how its members provide care. Managed care companies are exploring new ways they can provide the most effective services to more people under increasing resource constraints (Shera, 1996). The transition from fee-for-service to managed mental health care services has created an entirely new culture for mental health care providers and consumers (Geller, 1996). Practitioners must accommodate their treatment to the preferences of managed care. Otherwise, they risk a decrease in referrals, which could ultimately lead to loss of status and income. Managed health care companies have exerted influence on the ways that mental health practitioners conceptualize their practice, forcing treaters to modify therapeutic interventions and practice protocols significantly (Shera, 1996). Brief therapy now appears to be the preferred mode of intervention (Gibelman & Schervish, 1996). Long-term psychotherapy has been virtually eliminated for all but private-pay patients. Managed care companies find that studies of short- and long-term therapy suggest that brief approaches are as good as or better than long-term treatment, except in special cases (Lazarus, 1996). The majority of interventions distinguishing themselves in comparative outcome studies are based on behavioral or cognitive-behavioral theories. These treatments tend to be goal- and present-oriented, behaviorally specific, symptom-directive, advice giving, educational, collaborative, and aimed toward the resolution or amelioration of symptoms in relatively brief periods (Johnson, 1995). The  shift in preference to brief modes of therapy by managed care organizations has changed expectations for therapists. Theoretical orientation of practitioners has become of great interest as managed care companies look fo r practitioners who use brief treatment methods (Giles, 1993). The practitioners most significantly affected by managed care’s shift in preferred mode of treatment have been those who provide the extensive and intensive treatments of psychoanalysis and psychodynamic psychotherapy, predominantly clinical psychologists. Their emphasis on Freudian psychotherapies, which generally have a very long duration of outpatient care and discouraging results in the outcome literature, have been, criticized heavily (Giles, 1993). Emerging models of psychotherapy endorsed by managed care organizations assume that the psychotherapeutic process occurs in pieces over time. In these models, psychotherapy functions as an active working relationship between the patient and the therapist, whereby the goal is defined as change rather than cure. Managed care companies’ focus on resolving patients’ acute symptoms, rather than ridding them of their mental health conditions, has led to the gradual disappearance of the use of the psychodynamic model as the dominant framework in the treatment of individuals suffering from mental illness (Edwards, 1997). Recently, group treatments have received attention as a cost-effective means of treatment (Iglehart, 1994). A group format allows a number of patients struggling with similar life issues to come together and benefit by interacting with one another and a therapist, the group leader (Shapiro, 1995). Managed care companies support group designs, relying on numerous studies that demonstrate the efficacy of short-term therapeutic groups using behavioral and cognitive-behavioral approaches. Managed care organizations find group treatment inexpensive relative to other treatment methods, because one practitioner can treat many clients at once, significantly reducing billable hours of treatment incurred. The potential of group treatment to alleviate the psychological problems of large numbers of people at relatively low cost makes group therapy an attractive option for managed care companies (). Despite the utility gains, however, managed care companies do not rely on group treatments as wide ly as might be expected, primarily because of patients’ resistance to group treatment. Some patients find the idea of group treatment difficult to accept because they have a hard time  understanding how they will benefit. Many patients prefer individual treatment sessions, where they have the therapist’s undivided attention. These patients may be embarrassed about their problems and reject the notion of others besides their therapist providing input. The logistics of setting up short-term groups, along with current therapist practice patterns, present additional impediments to managed care’s use of group therapy (Crespi, 1997). Nevertheless, the immediate cost-effectiveness of groups, coupled with documented positive outcomes, has made the modality particularly appealing in mental health delivery systems and provides a compelling argument for their use (Crespi,1997). Projection Managed health care organizations have influenced the delivery of services in the mental health field considerably and will undoubtedly continue to do so (Eubanks et al., 1996). Whether the developments instituted by managed care companies are greeted with pleasure, indifference, or hostility, general agreement exists that the treatment of patients suffering from mental illness will be irrevocably changed as managed care continues to alter drastically the delivery, definition, and outcome of treatment that patients receive. In the future, indicators (Iglehart, 1994) suggest that nonpsychiatric practitioners will emerge as the dominant providers of treatment. According to Giles (1993), managed care companies will expect nonmedical practitioners, such as clinical social workers to provide the bulk of outpatient care in the mental health care field. Clinical social workers are cost-effective, fully qualified providers of mental health care services in the eyes of managed care companies. Distinctions between master’s-level and doctoral-level providers will become more evident as master’s-level practitioners assume primary responsibility for direct mental health services, and doctoral-level providers assume more administrative, supervisory, and research-oriented roles (Crespi, 1997). The rapid increase in managed care’s influence, accompanied by the reduction of referrals to more-expensive specialists, suggests that demand for clinical psychologists will continue to diminish (Johnson, 1997). As managed health care organizations restrict consumer choice of providers, many mental health professionals, such as clinical psychologists, may have difficulty joining reimbursement plans (Gibelman & Schervish, 1997). Despite the shift away  from doctoral-level providers and the narrowing role of the medical practitioner in the treatment regime of managed care companies, psychiatrists will likely have an essential and continuing role in the mental health care system. According to Giles (1993), managed mental health care still needs medical practitioners for their knowledge of psychopharmacology and experience in prescribing medications. Scientific literature has demonstrated that psychotropic medications are an effective and essential treatment component for most psychiatric illnesses, and psychiatrists, being physicians, are currently the only ones who can prescribe these drugs with the knowledge to do so effectively. Another likely development with the influence of managed health care is the rarity of the solo practitioner (Crespi, 1997). Individual practitioners and small group practices will likely remain, but will probably represent a much smaller proportion of psychotherapists (Committee o n Therapy, 1992). With commentators predicting a demise in solo private practice, practitioners will either have to affiliate with managed mental health care groups or forego clients with insurance in favor of those able to afford private payment (Gibelman & Schervish, 1996). The psychotherapist who decides to operate outside of the managed care system faces not only a degree of professional isolation, but also limitations in referrals and remuneration (Committee on Therapy). The managed care initiatives sweeping the nation have profoundly affected the ways that clinical social workers and other mental health practitioners deliver services to people suffering from mental illness (Shera, 1996). As these changes continue, clinicians working in a managed care environment will more often practice time-limited psychotherapeutic interventions and, in all but the rarest cases, the practice of unregimented intensive psychotherapy and psychoanalysis will take place outside of the confines of the managed care a rena. For the majority of mental health care consumers, therapeutic work will focus on precipitating stressors and acute exacerbation that may be treated within the reimbursable framework (Committee on Therapy, 1992; Crespi, 1997). Finally, with managed care’s increasing influence, use of outcome measurement and management will continue. Quantifiable data will play a larger role in treatment decisions. Funding sources of mental health care services will increasingly seek quantitative methods to measure the quality  and efficiency of different interventions to guide their purchasing decisions (Johnson, 1997). As managed care companies look for hard data to determine the most effective professionals and treatments, mental health care providers will have to quantitatively demonstrate effectiveness of interventions and treatment through evidence of patient improvement (Gibelman & Schervish, 1996). Thus, the ability to implement and participate in outcomes measurement processes is vita l for any practitioner who wishes to operate in the managed care environment. Conclusion Despite widespread criticism and various efforts at reform, managed care companies continue to expand. Clinical social workers currently involved in the mental health field, as well as incoming social work students interested in mental health, must take heed of the rapid developments in the field. Although the changes resulting from the influence of managed care present many challenges, they also create many opportunities for mental health care providers, and for clinical social workers in particular. To take advantage of these opportunities, clinical social workers, and the institutions educating them, must be prepared (Geller, 1996). Many clinicians currently practicing, as well as current and incoming graduate students, lack information on the breadth of these developments (Crespi, 1997). Clinical social workers must actively seek out continuing education courses, conferences, and journal articles discussing developments in the field related to managed mental health care to be better informed. In addition, schools of social work must update their curricula for incoming students to reflect the realities of changes in managed care. Graduate schools must educate future social workers regarding developments, providing students with the information and skills necessary to survive in this evolving culture (Shera, 1996). Many social work programs are discovering that traditional curricula are no longer adequate to prepare students for practice in the era of managed care. Managed care’s emphasis on the provision of mental health services at contained costs requires specialized practice skills, particularly rapid assessment, brief treatment, and the ability to document treatment outcomes. Social work educators must incorporate these elements into their programs. As managed care continues to expand and evolve, social work educators need to continue to evaluate its  effect on the training of current and potential clinical social workers. Educators in the field, along with graduate school instructors and administrators, must make the necessary changes to provide clinical social workers with the ability to adapt to the changing environment. Collaboration with managed care is necessary for professional survival (Eubanks et al., 1996). Clinical social workers have an enormous role in the treatment of people suffering from mental illness and have a real opportunity to play a major role in managed mental health care (Shera, 1996). Clinical social workers must rise to the challenge.