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By F. Narkam. Southern Polytechnic State Univerisity.

First buy 25mg hydroxyzine, a misconception of what constitutes health- care products exists: one immediately thinks of "heroic" surgical proce- dures, trauma care, and other life-saving efforts or conditions that typically occur unexpectedly and require an immediate response and the infusion of extensive resources on the part of the healthcare system. In many ways the types of clinical procedures the layperson is likely to associate with healthcare are among the least marketable of services. In a life-and-death situation factors other than the image presented by a marketer determine where patients are sent for treatment, which will typically be the closest facility (in the case of emergency care) or the best facility (in the case of trauma care). These are decisions made by clinicians or emergency med- ical personnel, not by the consumer. The most important consideration here, though, is the fact that these are rare events. Fewer than 1 in 11 Americans are admitted to a hos- pital each year, and only a minority of these cases involve life-threatening conditions. Common causes for hospital admission include childbirth, man- agement of chronic conditions, diagnostic tests, and other conditions unlikely to be matters of life and death. In comparison, the majority of the population visits a physician at least once during the year, and most of those who do use physician services report more than one visit. A large portion of the population is under pharma- ceutical management, and virtually everyone purchases over-the-counter drugs at some point. This is not to mention those who purchase fitness equipment, self-help books, health food, and a variety of other supportive goods and services. Ultimately, many healthcare purchases are not in response to a health need (and certainly not an urgent need), but in response to a want. One has only to look at the hot areas in the provision of health services today: business is booming for cosmetic surgery, laser eye surgery, skin care, and The Challenge of Healthcare M arketing 33 medically supervised weight-loss programs.

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As an example order hydroxyzine 25mg on-line, consider the pass-around project I instituted involving collage imagery and paper plates. After this was completed I in- structed members to pass the plate to their right and to keep doing so (at predetermined times) until their original image was in front of them. This low-functioning client chose the panda bear image, and other mem- bers within the group framed the picture by coloring the rim, accenting it 6. How- ever, as it reached the fifth member of the group (an infantalized and angry youth placed out of the home for the first time, whom I will call Tony), this member maliciously scribbled over the collage image. As no rebuff was forthcoming, he anxiously awaited the next project, and on this one he wrote derogatory epithets. It was only upon Tony’s leaving the group that the verbal processing of respect, feelings expression, and trust could be explored. However, it is important to note that Tony’s imagery (what he chose and drew individually) provided a secondary level to the discussion. In review- ing his image I believed it metaphorically described his deep sense of loss, fear, and feelings of entrapment (see Figure 6. By the time Tony had passed his plate there was very little room left for others to interact. They were consequently relegated to reinforcing the spider’s trap by adding circles of color. When Tony returned to the group, timid and apologetic, the discussion focused on empathy, not merely for how Tony had defaced others’ art (and therefore lost trust) but for the feelings of loneliness that all individuals feel 6. Through the symbolism of Tony’s plate, and the subsequent interpretation, the feed- back became central as the group members explored the possible fear be- hind Tony’s anger in a mutual partnership. The importance of a mutual un- derstanding cannot be overstated, as it is the very foundation on which objective empathic awareness is based. One of the benefits of utilizing art therapy within the therapeutic hour is that it allows members to practice new ways of behaving in a safe and supportive atmosphere. To take advantage of this, I often link directives from one week to the next in an attempt to reinforce goals and strengthen the skills reviewed in the prior group meeting.

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