In a 2-page paper, address the following: 1. Briefly describe how supportive and interpersonal psychotherapies are similar. 2. Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor. 3. Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

In a 2-page paper, address the following: 1. Briefly describe how supportive and interpersonal psychotherapies are similar. 2. Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor. 3. Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

CRITICAL HOSPITAL ROLES IN DISASTERS
Evaluations of ED disaster preparedness consistently yield the same finding: EDs are better prepared than they used to be, but still fall short of where they should be (Schur et al., 2004). A survey conducted by CDC in 2003 gives a comprehensive picture of hospital preparedness in the years following September 11 (Niska and Burt, 2005). Hospitals vary widely in the degree to which they have prepared for the range of possible threats. At the time of the survey, almost all hospitals (97.3 percent) had plans for responding to natural disasters because holding natural disaster drills is a requirement for accreditation by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO). More than 80 percent of hospitals had plans for chemical (85.5 percent) and biological (84.8 percent) threats, and more than 70 percent had plans for nuclear and radiological (77.2 percent) and explosive (76.9 percent) threats.

The remainder of this section reviews the current status of and recommended actions for enhancing hospital preparedness across five critical hospital roles during disasters: maintaining surge capacity, carrying out planning and coordination with the wider health and public safety communities, conducting training and disaster drills, protecting the hospital and its staff, and performing surveillance.

Surge Capacity
Hospitals in most large population centers are operating at or near full capacity. In many cities, hospitals and trauma centers have problems dealing with a multiple-car highway crash, much less the volume of patients likely to result from a large-scale disaster. During emergencies, hospitals can do a number of things to free up capacity and extend their resources, but there are serious physical limitations on this expansion of their capabilities. Surveys indicate that the numbers of available beds, ventilators, isolation rooms, and pharmaceuticals may be insufficient to care for victims of a large-scale disaster (Kaji and Lewis, 2004). The Rhode Island nightclub fire (discussed further below) demonstrated that even medium-sized incidents can overwhelm local hospital capacities (Hick et al., 2004). The frequent ambulance diversions and ED boarding discussed earlier in this report also signal limitations on hospital surge capacity.Establishing Context With Urgent Care Centers Essay

The issue of capacity is an immediate problem because many hospitals and their EDs are already maximizing their existing capacity after years of capacity shedding designed to reduce costs. According to the American

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Hospital Association (AHA), 60 percent of hospitals were operating at or over capacity in 2001 (The Lewin Group, 2002). Many hospitals have already opened up additional beds in an effort to alleviate overcrowding, but continue to face nursing shortages and staffing issues in supporting the existing beds (Derlet and Richards, 2000; Asplin and Knopp, 2001).

The limiting factor in the ability to respond to a disaster will vary by hospital and by type of disaster. An important limiting factor is the availability of specialists who can treat the types of cases resulting from a disaster event. For an event involving a rare biological or chemical agent, there may be limited expertise in the community. For more common types of events, such as blast injuries, the limitation will likely be an inadequate supply of surgical specialists (including neurosurgeons, orthopedic surgeons, and burn surgeons) to treat the volume of cases requiring their specialized services. While other staff, such as emergency physicians, critical care specialists, and nurses, are important, they are less likely to represent a major constraint on the ability to treat additional patients. One way in which hospitals can alleviate staff shortages is to use emergency medical services (EMS) personnel as physician extenders. In many disaster scenarios, the prehospital component is over in 1–2 hours, making a large number of EMS personnel available just as hospital activity is peaking.Establishing Context With Urgent Care Centers Essay

Physical space is an important consideration, but probably not the most critical factor. Hospitals can add to available capacity on short notice by halting elective admissions and discharging noncritical patients. In addition, they can sometimes use ED hallways, inpatient hallways, and nonclinical areas to house victims in an emergency. According to the CDC survey, however, only 61 percent of hospitals had developed plans for the use of nonclinical space in such cases (Niska and Burt, 2005). In some instances, particularly a