Aspects of Mental Health Promotion - Literature review Example

Aspects of Mental Health Promotion – Part and II Part I – 2,508 words Introduction Mental health means no signs of anxiety, depression or mental health problems (Westerhof and Keyes, 2010, p. 110). On the other hand, the World Health Organization (WHO) explained that mental health refers to people with well-balanced mental health and is capable of dealing with their own feelings and thinking as they effectively manage the challenges they encounter in life. In line with this, mental health is composed of three (3) major components known as well-being, ability to function well physically, and desire to effectively function within a community. In general, health promotion is all about being able to positively enhance health and prevent illnesses through the use of health educational intervention which can help people prevent diseases. In line with this, mental health promotion is all about health promotion that is more directed on the mental aspect of a person. Often times, mental health promotion aims to further improve the mental well-being of people and carers. Started sometime in 1975, health promotion in UK was focused on preventing the spread of diseases caused by either behavioural, environmental, physical, or lifestyle factors (i.e. alcohol consumption during pregnancy, obesity prevention, health eating and smoking cessation, etc.) (Nick, 2009, p. 78). In 2008, the European Commission together with the World Health Organization acknowledged mental health illnesses as 5 out of 10 major causes of disability all over the world. To improve mental health strategies between 2013 to 2020, a new resolution known as the WHA65.4 was developed to create comprehensive strategies and policies based on the responses coming from social and health sectors (World Health Organization, 2013). Mental health promotion is all about creating public awareness in terms of preventing mental health problems. For this reason, mental health promotion is considered important topic in public health. In general, Alzheimer’s disease, schizophrenia, alcoholism and obsessive-compulsive disorder among others can increase the risks for untimely deaths caused by accidents on top of having higher risks for more physical illnesses (Nick, 2009, p. 80). For these reasons, mental health problems are considered as one of the most serious and most important topic in public health (Katz and Pandya, 2013, p. 363). In UK, the Mental Health Foundation (2014) reported that 1 in 4 people tend to experience mental health problem each year. Specifically the prevalence rate of depression in UK is 1 in 5 older people (Mental Health Foundation, 2014). In general, dementia such as Alzheimer’s disease is a degenerative health condition related to loss of memory, cognitive impairment and communication problems (Prince, Prina and Guerchet, 2013, p. 1). Worldwide, people more than 60 years of age who requires long-term care intervention is roughly 13% of the entire global population (Alzheimers Disease International, 2013). As of 2012, Quince (2013) reported that the prevalence rate of dementia in UK among individuals between the ages of 65 up to 80 years of age is 1 in 14. The prevalence rate of dementia among individuals more than 80 years of age is 1 in 6 (Quince, 2013).  a. Thesis Statement Mental health promotion is essential because it educates the parents on how children can be protected from developing mental health disorders. 2. Development of a Child A child’s developmental stages can be traced using the Erikson’s eight stages of psychosocial development (Nevid, 2009, p. 349). Based on the theory of Erikson, a child during each of the eight (8) stages of psychosocial development can have either a positive or a negative effect particularly when it comes to solving social and psychology related conflicts. In line with this, Pressley and McCormick (2007, p. 145) explained that it is possible for a child to develop well in case the child was able to successfully had a healthy social interaction in his environment. To establish virtue of “hope” during the infancy stage, parents and Caregivers should resolve the child’s feeling of uncertainty about their feelings and experiences with other people (Carducci, 2009, pp. 188 – 189). In general, child abuse and neglect can make the child isolate themselves from the crown because of fear or their inability to trust other people (Child Welfare Information Gateway, 2013, p. 4). Assuming that the child failed to receive adequate and reliable care from his caregivers, the child is more likely to develop a great sense of mistrust (Engler, 2013, p. 140). In case the child is certain that his or her basic needs are properly met, the child is expected to be able to develop generalized feelings with other people around his or her environment (Carducci, 2009, p. 189). When this happens, the child will be able to develop a higher sense of trust. Between 1 to 3 years of age, Carducci (2009, p. 189) explained that the child is expected to develop the virtue of “will” by being able to overcome the psychosocial crisis of shame and doubt and so on. Considering that the child was not able to resolve the conflict crisis, negative factors such as mistrust, shame and doubt, guilt and inferiority among others will predominate in the child’s life as he or she reaches old age (Engler, 2013, p. 140). 3. Barriers to Effective Child Development Effective child development is essential towards having a sound and well-balanced mental health status. Unfortunately, quite a lot of barriers can impede the development of effective child development. These barriers include: (1) inequality during early childhood years caused by poverty (Walker et al., 2011); (2) failure to protect the child from the risks of developing psychological and behavioural problems (Biglan et al., 2012); (3) early exposure to violence (Fazel et al., 2012); (4) stressors like adverse events, chronic strains, or traumas such as physical or sexual abuse and neglect (Kieling et al., 2011), racial, gender, ethnic or social-class discrimination or inequalities (Thoits, 2010), school or outside school bullying (Chaux and Molano, 2009), disoriented family or family dysfynction (Lee et al., 2011), homeless children living on streets, imprisonment, lack of educational opportunities, and insufficient income (Funk, Drew and Knapp, 2012), teenage pregnancy (Satyanarayana, Lukose and Srinivasan, 2011), and becoming a victim of child trafficking among others (Abas et al., 2013). In relation to child abuse and neglect, inflicted head injury can damage the child’s developing brain which could eventually result to either emotional difficulties or delays in mental development (Child Welfare Information Gateway, 2013, pp. 2 – 3). Likewise, Benjet (2010) also identified the following negative life experiences to adversely affect the mental health of an individual: (1) war-related violence; (2) long-hours of work in a dangerous environment; (3) female genital mutilation which makes some girls experience posttraumatic stress disorder as well as depression; (4) discrimination; (5) poverty; and (6) experiencing violence within the family circle. Nutritional status of a person can affect their cognitive ability (Cecilia et al., 2011). By minimizing the risks wherein the child can be exposed to psychologically harmful events like bullying or physical and psychological abuse among others, there is a higher chance wherein the child could avoid developing behavioural, emotional, and mental health disorders (Biglan et al., 2012). Unfortunately, children with parents who suffer from mental health disorders like severe depression or psychosis are the ones who do not have quality-of-living since they do not receive proper parenting guidance nor have the opportunity to become exposed to nurturing environments (Bee et al., 2014). Taking a closer look at the “Maslow’s hierarchy of needs theory”, each child should first receive adequate support for their physical needs such as food, water, and air before satisfying their safety and security needs (i.e. housing and financial stability), belongingness and love (i.e. good relationship with family members and friends), self-esteem needs (i.e. establishing self-respect and receiving admiration from other people), and self-actualization needs (Bergin and Bergin, 2012, p. 44; Eltayeb et al., 2012). Because of poverty, a lot of children who failed to satisfy their physical needs are unable to satisfy their safety and security needs, belongingness and love, self-esteem needs, and self-actualization needs (Bergin and Bergin, 2012, p. 44). 4. Strategies in Place To ensure that each child is safe from developing mental disorders, UK health practitioners strongly promote the need to implement effective strategies for mental health promotion (Stewart-Brown and Schrader-Mcmillan, 2011). Likewise, the UK government has come up with several laws and policies to support children’s mental health development (legislation.gov.uk, 2007). 4.1 Mental Health Promotion After examining the impact of educational intervention in students’ mental health problem awareness, Yamaguchi, Mino and Uddin (2011) found out that the use of educational interventions such as contact condition, video-based contact condition, and educational condition can effectively improve their knowledge (18 out of 23) and attitude on people with mental illnesses (27 out of 34). Based on the meta-analyses systematic review that was conducted by Weare and Nind (2011) particularly with regards to the implementation of mental health promotion strategies in schools, the authors found out that the use of this particular mental health promotion strategy can create a positive effect not only on child development processes but also to their family members and the rest of the community. Aside from care givers, parents are the ones who normally attend to the specific needs of their children. Therefore, parents have something to do with whether or not the child could develop a sense of trust or mistrust during their infancy stage. For this reason, continuously encouraging and motivating parents and the rest of the community members to participate in mental health education programmes is very important behind a successful mental health promotion (Tew et al., 2012; Weare and Nind, 2011). To ensure that mental health promotion in schools are effective, Weare and Nind (2011) strongly suggest the need to integrate and link mental health promotion topics in the entire school curriculum and students’ academic learning, improving teachers’ teaching skills, enhancing the schools’ ethos, creating a strong relationship with the students’ parents, offering parenting education concerning their child’s mental health, encouraging the students to become actively involved in their community among others. Aside from encouraging all schools to integrate mental health promotion in the school curriculum (Weare and Nind, 2011), other strategies that can be equally useful and effective when it comes to promoting mental health promotion is through the use of social media in public communication (Neiger et al., 2012). Using social media tools such as Facebook, etc., public health and social workers can reach out to more people all over the world. For example, social workers can write a brief message concerning the role of parents in their child’s mental health development. By encouraging parents to read, the message can spread virally to the social workers’ friends and friends of their friends, etc. 4.2 The Influence of Law and Policy on Children’s Mental Health In general, legislations can be used to protect human rights of people with mental health disorders (World Health Organization, 2014). For instance, in relation to the European Conventions and UN laws on human rights, equality and justice, the UK government implemented the “Equality Act 2010” which aims to promote inclusion when treating people with mental health disorders (HM Government, 2011). “Mental Health Act 2007” purposely broadened range of healthcare professionals who can have the right to treat patients with mental health disorders (i.e. nurses, occupational therapists, psychologists, social workers, etc.) (Great Britain - Department of Health, 2012, p. 7). Furthermore, “Mental Health Act 2007” also provides the general public with clear and more simplified policies concerning the legal process when treating people with mental health disorders (Malatesti and McMillan, 2010, p. 32). Amended in 2002, the “Children Act 1989” requires all people including parents, the local authorities and other related agencies to protect and safeguard the welfare of each child (Macqueen, Bruce and Gibson, 2012, p. 87). As such, Macqueen, Bruce and Gibson (2012, p. 87) epxlained that parents are given the right, duties and responsibility to provide the basic needs of each child as well as protect them from any forms of abuse and neglect. 5. Recommendation Report In general, failure to satisfy the physical needs of a child is one of the main reasons why people suffer from mental illnesses and show signs of misbehaviour (Bergin and Bergin, 2012, p. 44). Therefore, the UK government should come up with special programmes that can effectively support the basic needs of children who are living in poverty. In the process of satisfying the children’s basic needs, there is a higher chance wherein these children can find ways to meet their safety and security needs, the need to create a sense of belongingness and love, self-esteem needs, and self-actualization needs Within the community circle, parents are the ones who have a great impact over the child’s mental health development. In the process of providing the child with a safe environment to develop mentally, emotionally, and physically, the child will have a lesser chance of developing early signs of mental health problems. For these reasons, one of the best and most effective mental health prevention approach is to create useful and effective teaching interventions that will encourage more parents to learn on how they can improve their attitude and the use of effective parenting style when establishing a long-term positive parent-child relationship (Stewart-Brown and Schrader-Mcmillan, 2011). By encouraging more parents to spend more time developing a positive relationship with their children, health care professionals who promote mental health and wellness will be able to play their role in terms of protecting vulnerable children from having negative childhood experiences. There are other ways in which the health care professionals can effectively conduct mental health promotion. For instance, to be able to reach out to more parents, health care professionals who are assigned to promote mental health and wellness should take time to learn on how they can take advantage of using the latest social media tools and social media networking sites like Facebook, MySpace, etc. Using the modern and most latest information and communication technology, health care professionals who are assigned to promote mental health and wellness can easily attract more parents to read what they have to say about protecting their own child’s physical, psychological, and mental health developmental process. Likewise, the use of the Internet and social networking sites will enable the health care professionals have the opportunity to exchange messages with parents who are interested in this particular topic and has specific question they want to ask concerning their child’s mental health development. Another way to promote mental health is to encourage the health care professionals to work together with the school administrators and staff. As a common knowledge, social and environmental challenges being faced by teenagers are totally different from the social and environmental challenges being faced by younger children. Therefore, in the process of building close ties with the local schools and universities in each geographic region, the health care professionals can easily identify and target a specific group of children and parents. For example, on this particular day, the health care professionals may prefer to educate parents whose child is between the ages of 5 to 6. Therefore, the health care professionals can set a meeting with a particular school administrator and school staff about their desire to provide free health teachings to all parents with children between 5 to 6 years of age. References Abas, M., Ostrovschi, N., Prince, M., Gorceag, V., Trigub, C. and Oram, S. 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Social Factors and Recovery from Mental Health Difficulties: A Review of the Evidence. The British Journal of Social Work , 42(3), pp. 443-460. Thoits, P. (2010). Stress and Health. Journal of Health and Social Behavior, 51(1), pp. S41-S53. Walker, S., Wachs, T., Grantham-McGregor, S., Black, M., Nelson, C., Huffman, S.L., Baker-Henningham, H., Chang, S.M., Hamadani, J.D., Lozoff, B., Gardner, J.M.M., Powel, C.A., Rahman, A. And Richter, L. (2011). Inequality in early childhood: risk and protective factors for early child development. The Lancet, 378(9799), pp. 1325-1338. Wand, T. (2011). Real mental health promotion requires a reorientation of nursing education, practice and research. Journal of Psychiatric and Mental Health Nursing, 18(2), pp. 131-138. Weare, K. and Nind, M. (2011). Mental health promotion and problem prevention in schools: what does the evidence say? Health Promotion International, 26(1), pp. i29-i69. Westerhof, G. and Keyes, C. (2010). Mental Illness and Mental Health: The Two Continua Model Across the Lifespan. Journal of Adult Development, 17, pp. 110-119. WHO. (2014). WHO Mental Health and HUman Rights Project. [Online] Available at: http://www.who.int/mental_health/policy/en/ [Accessed April 13, 2014]. World Health Organization. (2013). Draft comprehensive mental health action plan 2013–2020. EB132/8. World Health Organization. Yamaguchi, S., Mino, Y. and Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: A narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65(5), pp. 405-415. Part II – 2013 words 1. Introduction The second part of the assignment will focus on discussing how mind and body works together followed by discussing three (3) theories in mental health such as psychoanalysis, cognitive behaviourism, and humanism. After thoroughly discussing these three (3) theories, the current UK government’s mental health strategies will be tackled in details. 1.1 Thesis Statement Understand how mind and body works is important because it allows the social care workers to effectively deliver holistic care to patients with mental health problems. 2. How Mind and Body Works The human mind and body works together in such a way that a physically healthy body affects how the mind works (Lake, 2007, p. 35). For instance, when a person is physically ill, there is a higher chance wherein the mind will not be able to function well (Gorman and Anwar, 2006, p. 144). On the other hand, the human mind can also affect how the body works (Rio, 2014, p. 22). When managing cases related to child abuse and neglect, Coon et al. (2011) strongly suggest the need to encourage the child to participate in outdoor exercise such as walking or running since the use of this particular strategy is more effective in terms of enabling the child feel more revitalized and develop positive engagement by decreasing their feeling of anger, confusion, depression, and tension. Furthermore, Coon et al. (2011) found out that young students enjoy more and are more satisfied with outdoor as compared to indoor activities. For these reasons, making it a habit to exercise regularly can improve not only the physical health of a person but also their mental and emotional health (Kotecki, 2011, p. 210). 3. Three (3) Theories in Mental Health (i.e. Psychoanalysis, Cognitive Behaviourism and Humanism) Applicable in the study of mental health, psychoanalysis is uses observation method in psychotherapy (Basavanthappa, 2007, p. 284). By setting “goal-oriented systematic approach”, cognitive behavioural therapy was purposely designed to treat emotional, behavioural, and cognitive dysfunction (Sharma, Atri and Branscum, 2013, p. 174). As a response to reductionist behavioural approach, humanism focuses on interpreting the different world-views through the use of phenomenological framework (Price, 2007, pp. 23 – 24). It means that the use of humanism aims to gather the subjective response of the person involved as it assumes that all people are intrinsically good and self-determined as they continuously strive harder to achieve their personal growth (Price, 2007, p. 24). Psychoanalysis was first derived from Sigmund Freud’s theory on psychosexual development (Rogers and Pilgrim, 2010, p. 4). When using the psychoanalysis method, psychiatrists are able to carefully observe all factors that may adversely affect a person’s attitude, behaviour, and emotions. During the observation phrase, psychiatrists may ask himself what makes this person feel unhappy about his life? What makes him feel depresses or angry? Does it have anything to do with a previously failed relationship? In the process of encouraging people with mental health problems to talk about their previous life experiences, psychiatrists can generate more clues at the time of pointing out unconscious factors that has negatively affected the person’s attitude and behaviour towards life in general (Basavanthappa, 2007, p. 284). Psychoanalysis is based on the principle that both normality and abnormality are interconnected with one another (Rogers and Pilgrim, 2010, p. 4). With this in mind, most psychiatrists who choose to conduct a psychoanalysis test tend to link their diagnostic on patients with various psychiatric terms. For instance, a person who often times isolate themselves from other people can be linked to having “schizoid defences” (Rogers and Pilgrim, 2010, p. 4). On the other hand, individuals who habitually feel angry and continuously blame other people for their wrong doings can be linked to having obsession on paranoid position (Rogers and Pilgrim, 2010, p. 5). Cognitive behavioural therapy was created by combining both cognitive and behavioural approach in psychology (Mennuti, Christner and Freeman, 2012, p. 7). Cognitive behaviourism is totally different from psychoanalysis. Instead of linking diagnostic results on various psychiatric terms, therapists who uses cognitive behavioural approach focuses on determining the link in patients’ emotional and behavioural problem with their individual thought of “self, world, and future” (Sharma, Atri and Branscum, 2013, p. 175). In most cases, children’s behaviour and emotions, whether positive or negative, is highly dependent on how they interpret a given situation (Mennuti, Christner and Freeman, 2012, p. 5). In conducting behavioural experiments and verbal communication method, therapists who perform cognitive behavioural therapy should carefully examine how the patient feels, think, and behaves through the use of social learning theories as well as the classical and operant conditioning theories (Cash, 2006, pp. 197 – 198). Humanism is totally different from psychoanalysis and cognitive behavioural therapy. Instead of applying observational method used in psychoanalysis or interpreting the patients’ cognitive abilities and behaviour, humanism is more focused on gathering subjective or phenomenological approach in analyzing the unique world-views of each person (Price, 2007, pp. 23 – 24). Instead of focusing on identifying and analyzing the negative attitude, feelings and behaviour of each patient (i.e. psychoanalysis and cognitive behavioural approach in psychology), humanism is more focused on analyzing the unique personality of each person which strongly affects how he or she would react to outside forces and subsequently solve his or her own problems in life (Maddi and Costa, 2009, p. 5; Freeth, 2007, p. 17). Psychoanalysis as an assessment technique can provide psychiatrists with a comprehensive conceptual framework concerning mental illnesses (Rogers and Pilgrim, 2010, p. 5). Therefore, psychiatrists can explain why certain people act in certain ways. In relation to causal theory, Rogers and Pilgrim (2010, p. 5) explained that the unconscious past experiences of each person can affect their current conscious actions. Even though the use of psychoanalysis has been effective in borderline symptomatology and psychosomatic disorders (Guimon and de Filc, 2001, p. 138), this approach was criticized for not being able to accurately communicate the scope of its claims as a complete therapeutic method in the field of psychology (Jordan, 2008, p. 19). In line with this, Jordan (2008, p. 19) revealed that some faults were identified in Freud’s theory on sexuality in early childhood experience. Cognitive behavioural therapy is effective in terms of teaching patients how to perceive their negative feelings, emotions and behaviour (Sharma, Atri and Branscum, 2013, p. 175; Mennuti, Christner and Freeman, 2012, p. 4). Even though cognitive behavioural therapy is widely used in treating mental health problems (i.e. anger, aggression, ADHD, childhood anxiety disorders, depression and psychosis) (Mennuti, Christner and Freeman, 2012, pp. 3 – 4, 306, 407; Chorpita, 2007, p. 3; Cash, 2006, p. 197), there are still some flaws that can be identified with regards to the said theory (Sharma, Atri and Branscum, 2013, p. 175). “Cognitive distortion” is referring to mistakes on how a person thinks (Mennuti, Christner and Freeman, 2012, p. 7). With regards to adapting the use of cognitive behavioural theory in real world scenarios, Sharma, Atri and Branscum (2013, p. 175) argued that the process of linking the patients’ emotional and behavioural problems with their individual thoughts of “self, world, and future” can eventually create cognitive distortions. It means that patients who are severely depressed tend to see themselves as someone who is powerless and incompetent as they perceive others to be judgmental and disapproving. Therefore, patients with negative thoughts and feelings tend to perceive their future as useless and unrewarding (Sharma, Atri and Branscum, 2013, p. 175). The clinical goal of cognitive behavioural therapy is to learn how they can self-monitor their own feelings, thoughts and behaviour (Sharma, Atri and Branscum, 2013, p. 175). Because of their negative views in life, it is unlikely for this group of people to achieve the targeted clinical goal (Sharma, Atri and Branscum, 2013, p. 175). Contrary to the argument made by Sharma, Atri and Branscum (2013, p. 175) with regards to the presence of cognitive distortions, Pucci (2006, pp. 95 – 96) clearly explained that therapists should learn how they can effectively use the presence of “cognitive-emotive dissonance” as a guide on how they should introduce positive reinforcement to each patient. By doing so, the therapist can have a higher chance of being able to easily convert the patients’ negative feelings, behaviours, and emotions into something that is positive. As a person-centred approach in psychological treatment, humanism technique is more focused on conducting positive evaluation process with regards to determining a person’s personal qualities and capabilities (Maddi and Costa, 2009, p. 5; Freeth, 2007, p. 16). It means that the personal values of each person can be used as a strategy in treating mental health disorders (Price, 2007, p. 24). Aside from promoting the application of rationality and human reasoning method, humanistic psychology enables the therapists to effectively explore transpersonal and spiritual spheres in emotional development (Freeth, 2007, p. 17). However, the only way for humanism approach to be effective is through the use of open-communication method (Tee, Brown and Carpenter, 2012, p. 31). By establishing two-way communication line, Tee, Brown and Carpenter (2012, p. 31) explained that psychologists and therapists will be able to easily facilitate trust and establish a good relationship with the patients. 4. Current UK Government’s Mental Health Strategies The UK government has recently identified and implemented several strategies to ensure that each person in UK is able to benefit from good physical and mental health. Stated under the article entitled “No Health without Mental Health”, the UK government aims to play an active role in meeting the economic and social challenges needed to prevent mental health problems (HM Government, 2011, p. 3). For instance, to improve both health and mental health services throughout the United Kingdom, the UK government has planned to invest £400 million in making psychological therapies available to all people who are suffering from severe physical and mental health problems (HM Government, 2011, p. 3). To ensure that mental health services are effective and properly commissioned, public sectors like the public health and social care organizations and the NHS was made responsibility in managing the public funds needed for them to provide the best healthcare services to all people (HM Government, 2011, p. 68). Work-related stress can significantly affect the mental health of a person. For this reason, the UK government will be assigning the HSE to ensure that the welfare of each employee is properly taken care of (HM Government, 2011, p. 79). On the hand, children who live in poverty are the ones who are more prone to suffering from mental health problems. Therefore, the UK government will be assigning to DfE to oversee the welfare of families and children who are on a more disadvantaged side (HM Government, 2011, p. 79). Unwanted teenage pregnancy and sexually transmitted diseases can also cause serious mental health problems. With this in mind, the UK government will be assigning the DfE and DH to develop useful health promotion strategies that can effectively reduce the number of teenage pregnancies each year (HM Government, 2011, p. 79). 5. Conclusion and Recommendations Being able to understand how mind and body works is a significant part of being able to provide or deliver holistic care to patients with mental health problems (Kotecki, 2011, p. 210). Since the human mind and body works hand-in-hand, it is necessary to make sure that each individual could receive both health education on physical fitness and psychological therapy when treating patients with mental health problems. Psychoanalysis, cognitive behaviourism and humanism has its own set of strengths and weaknesses when it comes to treating people with mental health disorders. Since mind and body works together in maintaining mental health, the best psychological approach in treating mental health disorders is to gain a better understanding about the interaction process between each person’s affection, cognitive abilities, the given situation, and physiological factors such as malnutrition or lack of exercise, and its behavioural components (Mennuti, Christner and Freeman, 2012, p. 6). By knowing how each one of these factors are interrelated with one another, psychologists can become more effective in terms of being able to convert negative thoughts and behaviour into something that is positive. References Basavanthappa, B. (2007). Psychiatric Mental Health Nursing. 1st Edition. New Delhi: Japypee Brothers Medical Publishers. Cash, A. (2006). Wiley Concise Guides to Mental Health: Posttraumatic Stress Disorder. NJ: John Wiley & Sons. Chorpita, B. (2007). Modular Cognitive-behavioral Therapy for Childhood Anxiety Disorders. NY: The Guilford Press. Coon, J., Stein, B. K., Stein, K., Whear, R., Barton, J. and Depledge, M. (2011). Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review. Environmental Science and Technology, 45(5), pp. 1761-1772. Freeth, R. (2007). Humanising Psychiatry and Mental Health Care: The Challenge of the Person . 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