According To The First Amendment Of The United States...

According to the First Amendment of the United States Constitution, the people of the nation are entitled to the freedom of speech, but not all speech is the same. The internet provides us with an infinite amount of information, grants us access to virtually everything we could want and acts as an unrestrained vehicle of communication. In the day and age where technology is advancing and social media and internet are of rising importance, the Supreme Court of the United States has been faced with the challenge of deciding what constitutes a true threat made on social media websites. The First Amendment of the United States Constitution states that Congress shall make no law respecting an establishment of religion, or prohibiting the free†¦show more content†¦In this case, the interstate commerce would be defined as the Internet. Anthony Elonis was convicted of making threats against his ex-wife, and a FBI agent and charged with five counts of violation of 18 U.S.C  § 875(c), the federal anti-threat statute. Elonis had posted comments of his Facebook that were interpreted as threats towards not only his ex-wife but to other people in his life shortly after experiencing his wife leaving him and the loss of his job. During his trial, Elonis argued that his posts were a form of â€Å"artistic expression† that help him deal with the events he was experiencing in his life. The dialect that he used in some of the posts was said to address similar ideas as many popular rap songs, in a similar violent manner but Elonis insisted that they did not refle ct any of his personal values or beliefs as a person. He continued to argue that although the people reading his posts might have possibly perceived them as threats, he could not be convicted of making threats because he never intended to threaten anyone. The term â€Å"threat† generally means a communication with an intent to cause fear and Elonis claims that he never intended to communicate a â€Å"true threat.† Elonis argued that the United States Government must be able to prove that there was a subjective intent to harm or injure another, in accordance to the First Amendment. This means that the government must be able to confirm and be able to provide evidence that Mr. ElonisShow MoreRelatedI Had A Dream Speech By Martin Luther King Jr.1684 Words   |  7 Pagesgatherings have impacted the United States civilization as we know it. Our freedom of speech and the freedom to associate ourselves with who we please has helped the United States nation grow in development and tolerance. The ability to speak and act on our actions will have an effect on our posterity and how they will live and how their generation will think. 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Section 1 of the 14th Amendment of the United States constitution states that All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. â€Å"It is important for every citizen of a country to know their rights and responsibility so as to be able to exercise and discharge such rights and responsibilities accorded to them by the constitution when necessary. TheRead MoreFlag Desecration Synthesis Essay1321 Words   |  6 PagesFlag Should Not Be Protected The United States is known for being ‘land of the free’, a nation with a Declaration of Independence, as well, as a Constitution protecting the rights of it’s citizens. Wars have been fought and many people have died so we could have the rights that present today. 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Marijuana Prohibition Canada Free Essays

The Controlled Substances Act (Marijuana Prohibition) CLN-4U Unit One Essay Cailey Bazik CLN 4U – Unit One Essay Controlled Substances Act Marijuana Prohibition The Controlled substance act pertaining to Marijuana has been a long on going battle as to whether marijuana should be legal in Canada and taken out of this act. The law behind the drug has a long history and many failed attempts at decriminalization. There are both positive and negative effects to this law, but I believe the positive effects weigh out the negative and that because of this marijuana will be legal in the near future. We will write a custom essay sample on Marijuana Prohibition Canada or any similar topic only for you Order Now The Marijuana laws in Canada today are unresolved, as superior courts have ruled all cannabis laws to be of â€Å"no force or effect†. Although the federal level of courts have made this ruling it has not caused any changes to other Canadian jurisdictions, the Criminal Code or the Controlled Substances Act. (â€Å"Legal History of Cannabis in Canada) The Controlled Drugs and Substances Act was passed in 1996 by the government under Prime Minister John Cretien. It is Canada’s federal drug control statue. This act outlines penalties for possession, trafficking and production of the substances established as illegal, including Marijuana. â€Å"Controlled Drugs and Substances Act) Canadian laws pertaining to drugs began in 1908 with the opium act, which was replaced by the opium and narcotic drug act in 1920. Marijuana however was not added to the confidential restricted list until 1923. (â€Å"Legal History of Cannabis in Canada†) Marijuana and the laws surroundin g the issue only started to receive attention in the 1930’s and even then it was very minimal. It wasn’t until the 1960’s where problems arose with the law. At this time the maximum penalty for possession of small amounts of cannabis was 6 months n prison and a $1000 fine. A government injury was commissioned and public hearings were held to analyze the law over a period of three years. A report on the findings of this inquiry was published in 1972. The â€Å"La Dain Commission† suggested that penalties for can ibis possession be abolished, but to not legalize the substance. Of course this proposal was denied, along with other potential law reforms over the years. (â€Å"here to help†) In Recent Years the fight for the decriminalization of Marijuana has been more persistent. Research showed that Marijuana for medical use could help a number of ailments and disieses. Medical Marijuana in Canada was made legal in 2001 for things such as HIV, AIDS, multiple sclerosis, spinal cord disease and injury, anorexia severe pain, seizures and persistent muscle spasms. (â€Å"Legal History of Cannabis in Canada†) Along with the boost in medical use came a boost in personal use. According to a report from the United Nations Canada is the highest in marijuana use in the industrialized world and more than four times the global rate. â€Å"Canadian Pot Use Four Time Global Rate†) In May 2002 Chretien introduced a bill to decriminalize marijuana for personal use. This bill was denied mainly because of pressure from the U. S and a threat to slow down border crossing between the two countries. Paul Martin in 2004 tried to pass an almost identical bill, which was also rejected. (â€Å"Legal History of Cannabis in Canada†) It was in 2007 when Justice Mini ster Rob Nicholson and the conservative minority government introduced Bill C-26, which presented mandatory minimum sentences for drug offenders (â€Å"Controlled Drugs and Substances Act†). A recent poll released by Toronto’s Forum Research showed that majority of Canadians support relaxing marijuana laws. In fact it showed that 65 % of Canadians support either the decriminalization in small amounts or legalization and taxation of the substance. (Ballingall) Unfortunately with the new mandatory minimum sentences it seems our laws do not reflect societies views. (Wood, Antweiler) Although it seems Canadians and Americans are in favour of decriminalizing Marijuana it is important to understand the reason these laws are there in the first place. Marijuana is harmful to ones health and to youth. The president of the Canadian Police Association believes Canadians are trying to decriminalize marijuana prematurely. He says supporters of change are overlooking the risks. â€Å"We don’t have the tools and the training available to us now to ensure that people aren’t driving cars, for example, or operating machinery, while they’re impaired by Marijuana† he said. â€Å" There are all kinds of implications that I don’t think people are considering carefully enough†¦ Its still a harmful substance ultimately† (Ballingall) That being said there are many negative effects to having the prohibition of Marijuana in place. The Union of B. C municipalities passed a resolution summoning research be done looking into the legalization of marijuana. They came to the conclusion that the prohibition has been ineffective in deterring youth use, and production of the plant. (Wood, Antweiler) It seems that other measures need to be taken in order to ensure the youth of Canada don’t use drugs recreationally, and criminalizing marijuana has little effect. Researchers from the University of British Columbia and Simon Fraser’s university have estimated B. C’s marijuana market would be worth more than $500 million annually. Unfortunately most of the revenue goes to criminal organizations. (Wood, Antweiler) This number is based on one province alone, think of how much this number would go up if the whole country were involved in their research. The profiting of criminal organizations in turn causes more violence, guns and other illegal activity in the country. If Canada were to legalize and tax cannabis the government would then receive all the profits, this money could fund government programs such as health care, social assistance and education. It would also significantly decrease criminal activity, and save money in courts and jails. One of the main reasons in the past for the prohibition on marijuana was the negative response from the U. S, however there are now 12 states that have decriminalized Marijuana (Wood, Antweiler) meaning there is less pressure from our bordering Country. This and the obvious preference of legalization from Canadian citizens means it is only a matter of time before marijuana is officially decriminalized, taken out of the Controlled Drugs Act, the criminal code and consistent laws in all Canadian jurisdictions. This I believe will come first, and potentially government controlled sales and taxation shortly after. It would be insane for the government to not take seize the opportunity to bring in so much revenue for the country. It seems as though the prolonged struggle to legalize marijuana still needs time and The Controlled Substances Act will remain as it is for a while longer. Although there are potentially many positive effects to decriminalization and controlled sales for taxation It is clear Canada still need the time to prepare to ensure it is done safety, effectively and not detrimental to youth. Canadians may be ready for a change and the government will eventually have to surrender, regardless of minor health issues cannabis causes. Bibliography 1. ) Ballingall, Alex. â€Å"Canada. † Thestar. com. The Toronto Star, 20 Nov. 2012. Web. 21 Feb. 2013. http://www. thestar. com/news/canada/2012/11/20/marijuana_legalization_or_decriminalization_backed_by_most_canadians_poll. html. 2. ) â€Å"Canadian Pot Use Four times Global Rate. † Canadian Pot Use Four times Global Rate. N. p. , 10 July 2007. Web. 21 Feb. 2013. http://www. canada. com/nationalpost/news/story. html? id=67996149-9dee-4a3a-a86e-f7a022274658. . ) â€Å"Controlled Drugs and Substances Act. † Wikipedia. Wikimedia Foundation, 02 Oct. 2013. Web. 21 Feb. 2013. http://en. wikipedia. org/wiki/Controlled_Drugs_and_Substances_Act. 4. ) Hathaway, Andrew. â€Å"Legal History and Cultural Experience of Cannabis. † Www. heretohelp. ba. ca. N. p. , 2009. Web. 21 Feb. 2013. http://www. heretohelp. bc. ca/visions/cannabis-vol5/the-legal-history-and-cultural-experience-of-cannabis. 5. ) â€Å"Legal History of Cannabis in Canada. † Wikipedia. Wikimedia Foundation, 02 Apr. 2013. Web. 21 Feb. 2013. http://en. wikipedia. org/wiki/Legal_history_of_cannabis_in_Canada How to cite Marijuana Prohibition Canada, Essay examples Marijuana Prohibition Canada Free Essays The Controlled Substances Act (Marijuana Prohibition) CLN-4U Unit One Essay Cailey Bazik CLN 4U – Unit One Essay Controlled Substances Act Marijuana Prohibition The Controlled substance act pertaining to Marijuana has been a long on going battle as to whether marijuana should be legal in Canada and taken out of this act. The law behind the drug has a long history and many failed attempts at decriminalization. There are both positive and negative effects to this law, but I believe the positive effects weigh out the negative and that because of this marijuana will be legal in the near future. We will write a custom essay sample on Marijuana Prohibition Canada or any similar topic only for you Order Now The Marijuana laws in Canada today are unresolved, as superior courts have ruled all cannabis laws to be of â€Å"no force or effect†. Although the federal level of courts have made this ruling it has not caused any changes to other Canadian jurisdictions, the Criminal Code or the Controlled Substances Act. (â€Å"Legal History of Cannabis in Canada) The Controlled Drugs and Substances Act was passed in 1996 by the government under Prime Minister John Cretien. It is Canada’s federal drug control statue. This act outlines penalties for possession, trafficking and production of the substances established as illegal, including Marijuana. â€Å"Controlled Drugs and Substances Act) Canadian laws pertaining to drugs began in 1908 with the opium act, which was replaced by the opium and narcotic drug act in 1920. Marijuana however was not added to the confidential restricted list until 1923. (â€Å"Legal History of Cannabis in Canada†) Marijuana and the laws surroundin g the issue only started to receive attention in the 1930’s and even then it was very minimal. It wasn’t until the 1960’s where problems arose with the law. At this time the maximum penalty for possession of small amounts of cannabis was 6 months n prison and a $1000 fine. A government injury was commissioned and public hearings were held to analyze the law over a period of three years. A report on the findings of this inquiry was published in 1972. The â€Å"La Dain Commission† suggested that penalties for can ibis possession be abolished, but to not legalize the substance. Of course this proposal was denied, along with other potential law reforms over the years. (â€Å"here to help†) In Recent Years the fight for the decriminalization of Marijuana has been more persistent. Research showed that Marijuana for medical use could help a number of ailments and disieses. Medical Marijuana in Canada was made legal in 2001 for things such as HIV, AIDS, multiple sclerosis, spinal cord disease and injury, anorexia severe pain, seizures and persistent muscle spasms. (â€Å"Legal History of Cannabis in Canada†) Along with the boost in medical use came a boost in personal use. According to a report from the United Nations Canada is the highest in marijuana use in the industrialized world and more than four times the global rate. â€Å"Canadian Pot Use Four Time Global Rate†) In May 2002 Chretien introduced a bill to decriminalize marijuana for personal use. This bill was denied mainly because of pressure from the U. S and a threat to slow down border crossing between the two countries. Paul Martin in 2004 tried to pass an almost identical bill, which was also rejected. (â€Å"Legal History of Cannabis in Canada†) It was in 2007 when Justice Mini ster Rob Nicholson and the conservative minority government introduced Bill C-26, which presented mandatory minimum sentences for drug offenders (â€Å"Controlled Drugs and Substances Act†). A recent poll released by Toronto’s Forum Research showed that majority of Canadians support relaxing marijuana laws. In fact it showed that 65 % of Canadians support either the decriminalization in small amounts or legalization and taxation of the substance. (Ballingall) Unfortunately with the new mandatory minimum sentences it seems our laws do not reflect societies views. (Wood, Antweiler) Although it seems Canadians and Americans are in favour of decriminalizing Marijuana it is important to understand the reason these laws are there in the first place. Marijuana is harmful to ones health and to youth. The president of the Canadian Police Association believes Canadians are trying to decriminalize marijuana prematurely. He says supporters of change are overlooking the risks. â€Å"We don’t have the tools and the training available to us now to ensure that people aren’t driving cars, for example, or operating machinery, while they’re impaired by Marijuana† he said. â€Å" There are all kinds of implications that I don’t think people are considering carefully enough†¦ Its still a harmful substance ultimately† (Ballingall) That being said there are many negative effects to having the prohibition of Marijuana in place. The Union of B. C municipalities passed a resolution summoning research be done looking into the legalization of marijuana. They came to the conclusion that the prohibition has been ineffective in deterring youth use, and production of the plant. (Wood, Antweiler) It seems that other measures need to be taken in order to ensure the youth of Canada don’t use drugs recreationally, and criminalizing marijuana has little effect. Researchers from the University of British Columbia and Simon Fraser’s university have estimated B. C’s marijuana market would be worth more than $500 million annually. Unfortunately most of the revenue goes to criminal organizations. (Wood, Antweiler) This number is based on one province alone, think of how much this number would go up if the whole country were involved in their research. The profiting of criminal organizations in turn causes more violence, guns and other illegal activity in the country. If Canada were to legalize and tax cannabis the government would then receive all the profits, this money could fund government programs such as health care, social assistance and education. It would also significantly decrease criminal activity, and save money in courts and jails. One of the main reasons in the past for the prohibition on marijuana was the negative response from the U. S, however there are now 12 states that have decriminalized Marijuana (Wood, Antweiler) meaning there is less pressure from our bordering Country. This and the obvious preference of legalization from Canadian citizens means it is only a matter of time before marijuana is officially decriminalized, taken out of the Controlled Drugs Act, the criminal code and consistent laws in all Canadian jurisdictions. This I believe will come first, and potentially government controlled sales and taxation shortly after. It would be insane for the government to not take seize the opportunity to bring in so much revenue for the country. It seems as though the prolonged struggle to legalize marijuana still needs time and The Controlled Substances Act will remain as it is for a while longer. Although there are potentially many positive effects to decriminalization and controlled sales for taxation It is clear Canada still need the time to prepare to ensure it is done safety, effectively and not detrimental to youth. Canadians may be ready for a change and the government will eventually have to surrender, regardless of minor health issues cannabis causes. Bibliography 1. ) Ballingall, Alex. â€Å"Canada. † Thestar. com. The Toronto Star, 20 Nov. 2012. Web. 21 Feb. 2013. http://www. thestar. com/news/canada/2012/11/20/marijuana_legalization_or_decriminalization_backed_by_most_canadians_poll. html. 2. ) â€Å"Canadian Pot Use Four times Global Rate. † Canadian Pot Use Four times Global Rate. N. p. , 10 July 2007. Web. 21 Feb. 2013. http://www. canada. com/nationalpost/news/story. html? id=67996149-9dee-4a3a-a86e-f7a022274658. . ) â€Å"Controlled Drugs and Substances Act. † Wikipedia. Wikimedia Foundation, 02 Oct. 2013. Web. 21 Feb. 2013. http://en. wikipedia. org/wiki/Controlled_Drugs_and_Substances_Act. 4. ) Hathaway, Andrew. â€Å"Legal History and Cultural Experience of Cannabis. † Www. heretohelp. ba. ca. N. p. , 2009. Web. 21 Feb. 2013. http://www. heretohelp. bc. ca/visions/cannabis-vol5/the-legal-history-and-cultural-experience-of-cannabis. 5. ) â€Å"Legal History of Cannabis in Canada. † Wikipedia. Wikimedia Foundation, 02 Apr. 2013. Web. 21 Feb. 2013. http://en. wikipedia. org/wiki/Legal_history_of_cannabis_in_Canada How to cite Marijuana Prohibition Canada, Papers

Occupational Therapy Rehabilitation Programs

Question: Describe about the Occupational Therapy for Rehabilitation Programs. Answer: Introduction Rehabilitation programs are crucial for resuming the active lifestyle and recover soon from the injury or illness, that involves disability. The rehabilitation and recovery programs generally targets enhancement of patients willingness for recovery and support for easy and faster recovery process from the chronic illness. However, setting up goals is one of the preliminary steps, which determines the efficiency and time for recovery process. There are several injuries or illness, which needs assistance and support for faster recovery; for instance total knee replacement, total hip replacement, bone fracture and other major injuries (Abraham Michie, 2008). Several barriers can hinder the proper procedure of rehabilitation technique, whereas there are some factors or strategies that can influence the rehabilitation and recovery procedure. To set the goals and priorities for rehabilitation and recovery process, health models or theories are used by the health care professionals, for en suring the patients needs has been prioritized during the health care planning. In this context, the health care professional should assess the patients needs thoroughly before planning the rehabilitation sessions. Support is one of the crucial aspects in the recovery and rehabilitation processes. It is because, empowerment of a disabled patient helps in stimulating them for faster recovery. Here in this assignment, the focus is the patient, Mr. X, who has knee replacement and facing difficulties in coping with his status and disabilities. Thus, based on his status and needs, his rehabilitation sessions would be planned. Here, in this assignment, the factors that were hindering the patients engagement in the recovery and rehabilitation will be discussed with the help of recovery related theories (Bertisch et al., 2014). On the other hand, the strategies that would help the patients engagement and their recovery would be included in this assignment. Finally, the barriers, facilitators and the recommended strategies would be summarized to provide a brief overview. Identity of the client During my job period at a rehabilitation centre, I met one client Mr. X, who was facing difficulties in engaging with rehabilitation and recovery from severe illness. The client Mr. X is a 55 years old male, who have severe arthritis and suffering from severe pain at his left knee and mobility impairment. The medical professional recommended total knee replacement or arthroplasty of his left knee. After a successful surgery, the recovery period was quite difficult for Mr. X, as it was very difficult for him to stay at bed as a disable person. He was a cheerful and active person before is surgery. Now, his condition was not feasible to support his previous active role. Thus, he is becoming anxious and depressed due to his disability. The impaired mobility of Mr. X was making him demotivated hindering his social involvement. The patient needs appropriate rehabilitation and recovery strategies for his faster and easy recovery. Mr. X was having negative pain perception and poor perceived self-efficacy as well as pessimistic personality traits, which were significantly hindering his efficient engagement with the rehabilitation and recovery process (Bright et al., 2014). He was a negative perception that movements can cause additional pain except the surgical pain, which along with the persistent postoperative pain symptoms were the cause behind his poor quality of rehabilitation. All of these consequences were leading to his decreased activity after rehabilitation and reduced social involvement along with increased psychological issues. Psychological consequences of the illness Orthopedic surgery usually needs many months of rehabilitation for getting a successful outcome; however, there are several psychological factors that can influence pain perceptions of the patient, compliance with the rehabilitation and the outcomes from the patient treatment after orthopedic surgeries like a total knee replacement surgery. Total knee replacement is a complicated illness, which involve the replacement of knee with an artificial knee joining. The complicated surgery needs a long-term recovery and during this period, severe pain and disability usually stimulates the onset of negative psychological issues in the patients. Patients need proper care and support for better adherence with the recovery and rehabilitation processes after a total knee replacement surgery (Bright et al., 2011). It has been revealed from several literatures that the mobility impairment and loss of autonomy or independence causes isolation and behavioral changes in the patient. It has been seen t hat most of the patients shows non-adherence with the rehabilitation processes, due to depression and anxiety related symptoms. It has been argued that there is a strong relationship between psychological symptoms and pain and disability, this prevalence of psychological symptoms are high in the pre and postoperative stages in the patients, who have undergone knee and hip replacement. It has been revealed from the previous literatures that the depressive symptoms in knee and hip replacement are higher, i.e. 33.6 % in one study, compared to coronary heart diseases, cancer or diabetes (Bright et al., 2011). However, age is a key determinant of the psychological consequences of the knee replacement surgery. However, reviewing previous literatures, it has also been found that throughout the recovery period, the psychological symptoms are reduced gradually, with the decrease in pain and disability. It has been revealed that 12 months postoperative no further reduction in the depressive symptoms were found compared to 3 months postoperative. Studies have shown that treating patients with psychotherapy before the surgery can lead to better results after the total knee replacement surgery. However, studies have also shown that proper management and emotional support had led to better results with the patients having depressive or anxious behavior. However, it has been see n in many previous cases that the support of physiotherapist and other medical professionals reduced the time for recovery along with the symptoms of psychological consequences. Barriers in engaging the client in rehabilitation Lack of support is one of the major barriers in engaging clients in rehabilitation. In case o Mr. X, it has been noticed that he was not adhered to the treatment procedure, which was one of the key reason behind his extended recovery time. On the other hand, the willingness of the patient is another key barrier for the patients recovery, because, until the patient is not adhering with the rehabilitation process, the success of the process would be doubtful. Moreover, the education and awareness of the patient is very important in this context (Ellis-Hill, Paynem Ward, 2008). Until the patient becomes aware of his status and the importance of his compliance with the rehabilitation process, the patients adherence with the treatment procedure would not be assured. In case of Mr. X, it has been noticed that he was aware of his current condition, but he was not aware of the pros and cons of the rehabilitation process and the importance of his compliance with the rehabilitation process. O nce he will be aware about the facts, his adherence with the rehabilitation and recovery process will be enhanced. The unclear perception of the patient about the pros and cons of the recovery process is a key barrier. Negative perception, psychological issues and stress are the factors that can delay the recovery process by stimulating the negative perception about the disorder. In the case of Mr. X, he was not willing to take his medicines an d physiotherapies, due to severe pain and showed depression and anxiety. The behavioral changes affected his communication with the medical professionals and physiotherapist, which further worsened his recovery process. Lack of support from the medical professionals and the family, relatives and dear ones are also the major factor that acts as a barrier of engagement of the patient with the rehabilitation process. In this context, it has been revealed that the support from the patients family is lost, due to the independence of the patient. In the case of Mr. X, he was lacking the support from family and friends, which is the major reason behind his depression. One current study by Gollwitzer (1999) highlighted that the patients who got support from their family and friends, recover easily and faster, compared to the patients who do not get family support. Moreover, the lack of family and peer support is a major cause behind the negative emotions, which leads to the psychological problems, further reducing the patients recovery rate. Low progress takes more time to recover and longer recovery time reduces patients compliance and adherence with the treatment and rehabilitation process. As it takes more time to recover from the disabled state, loss of independence for longer period makes the patient anxious, agitated and irritated. This Happened to Mr. X, as he was facing difficulties in engagin g with the rehabilitation and recovery process after his total knee replacement surgery. Lack of competency in the medical professionals attending the patient in recovery or rehabilitation is another factor that can be a barrier of faster and easy recovery of a patient undergoing total hip and knee replacement. In case of Mr. X, lack of the development of professional relationship with the health care professional was the key cause of his reduced compliance with the rehabilitation process and delay in progress of the recovery process (Hall et al., 2010). Mr. was unable to maintain a good communication with the medical professionals, due to the lack of positive communication skills of the nurse or other medical professionals attending him. In this context, he was attending the rehabilitation process with low adherence and reported lack of motivation and support from the care providers including physiotherapist and other health care practitioners. Lack of patients assessment before setting the goals can lead to negative consequences or can lead to the unavailability of the patients support from the other health care professionals. These factors are responsible for patients non-adherence with the rehabilitation process and delayed recovery process. Moreover, lack of assessment of patients priorities also hinders the patients efficient recovery, because, the patients actual needs are not addressed during the rehabilitation procedure, leading to unrealistic goal settings, which does not provide expected outcomes. Thus, goal setting is a very important factor that can influence the patient engagement and lack of which can hinder the rehabilitation and recovery process. Pain perception is another factor that can hinder a patients recovery and rehabilitation compliance. It is because, orthopedic patient usually have a perception that movement of the limb or the surgical area will put additional strain on their body, causing massive pain additional to the surgical pain. Unchanged perception leads to their decreased mobility, which is beyond the expectation in a rehabilitation process. This leads to stiffness of joints or other surgical area and persistence of the pain in the joints or other surgical areas, which hinders patients compliance with the rehabilitation and follow-up sessions. However, while concerned about the return of the patient to work after the orthopedic surgery and rehabilitation process, not only the physical and emotional status of the patient and support from his family and medical professionals are important, rather, support from the organization, other employees and other support groups are also have significant role. Harding an dWilliams (1995) identified lack of information access, lack of support group, lack of understanding and collaboration from the employer were the most important barrier for a patient to return to his work. Thus, it can be said that persona, clinical, occupational and health service factors are also important for the patient to return to his work. Factors influencing engagement in rehabilitation After orthopedic surgery including total joint replacement, i.e. total knee replacement or total hip replacement surgery, the total recovery and getting back to normal life before surgery, is a time consuming process. The recovery can be influenced and progress can be faster by the help of some facilitators of rehabilitation. One factor identified that has an important role in facilitating patients engagement in the rehabilitation process is knowledge about ones limit and motivating the patient for physical training and movement of the surgical body parts. Patient-centered approach- A patient centered approach in the rehabilitation sessions can influence the patients engagement in the recovery and rehabilitation process. It is because, the patient-centered approach tend to prioritize the patients needs from every aspects, including the physical, psychological, social and emotional. Patients well being is dependent upon all of these aspects and it contributes to patients overall recovery and gaining the normal life back (Harding Williams, 1995). Emotional support with respect and dignity- The most important factor-facilitating patients recovery and well-being is emotional support. In case of Mr. X, he was lacking an emotional support. Showing respect and dignity towards the patient, without any kind of biasness is the key of engaging and empowering the patient in his work. While handling patients like Mr. X, the practitioner should show respect towards the patient and prioritize patients feelings and perceptions. It enhances patients positive perception about the therapeutic procedure and engage patient with the rehabilitation procedure (Harris, 2006). Goal setting based on patients needs- Goal setting is the basic step in the rehabilitation and recovery process after an orthopedic surgery. Goal setting determines the probability of getting expected outcomes through the rehabilitation process. In this context, assessment of the patients needs is very important. Assessing the physical and psychological status of the patient helps the health professional to understand the actual needs of the patient, based on which the therapeutic goals of rehabilitation are established. It enhances the possibility of getting success easier and faster. In contrast, setting unrealistic goals, without assessing the patients needs reduces the chance of getting success from the rehabilitation process (Kayes McPherson, 2012). Therapeutic alliance- Therapeutic alliance is referred to the relationship between the patient and health care professional. It is a very important facilitator of engaging patient in rehabilitation process after orthopedic surgery, through which Mr. X has undergone. Several literatures identified therapeutic alliance as an important determinant of patient engagement and positive health outcomes following rehabilitation. For this, the health care practitioners should have required skills and competence including good communication and coordination with the patient. Providing value to the patients view during the therapeutic work can help to enhance patients trust towards the therapist, which in turn can establish a positive relationship within the patient and the health care practitioner (Kayes et al., 2015). Family support and engaging patients family in rehabilitation- Mr. X did not received enough family support, which is one of the significant determinants of the positive health outcomes following rehabilitation. Thus, in person-centered care, engaging patients family in the procedure is helpful. Involving patients family provides a homely environment to the patient, which eliminates the discrimination of the patient as a disabled person, thereby encouraging his engagement through the procedure. Psychotherapy and counseling- Literatures has suggested that there is a significant connection between poor recovery and related outcomes with stress and depression related symptoms. Thus, different literatures suggested that the psychotherapy and counseling during the rehabilitation is helpful for reducing this psychological hindrance of patients engagement in the rehabilitation process. Enhancing self-esteem and self-management- Self-management is the key concept in the rehabilitation process. As in knee replacement surgery, patient temporarily looses independence; it also reduces patients self-esteem. Thus, the therapists should support the patient to be encouraged and be independent. For this, self-management skills should be taught (Levack, Kayes Fadyl, 2010). Educational health promotion- Patient must understand the importance of rehabilitation process in his life and its effect upon his working and independent life. In case of Mr. X, due to lack of proper knowledge, the negative pain perceptions were enhancing, reducing his compliance with the rehabilitation process. Social support- Social support is another important factor that can facilitate patients engagement in rehabilitation. Social support can help to reduce patients isolation and can enhance self-esteem, thereby enhancing compliance with the therapeutic process. While considering patients return to work after rehabilitation process, there are some other factors influencing their continuous recovery and adoption in the workplace. The most important factor is the occupational factors. Supporting the patients engagement with the recovery process, the employers and other employees should consider the patients condition and should help him to cope with the situation. It has been seen that, a patient returning to the workplace after a surgery, often treated as disabled person and sympathized, which hinders the patients emotional well being, because, an active person is being considered as a disabled or physically challenged person and discriminated from peers in the workplace (McPherson, Kayes Kersten, 2014). This discrimination can lead to depressive symptoms, affecting his behavior. The patient becomes anxious and agitated, hindering his continuous recovery and returning to normal lifestyle. Theory supporting rehabilitation To enhance Mr. Xs engagement with the rehabilitation process, theoretical models can be used for better understanding and strategy implementation. One renowned theory can be used here, the health belief model. The health belief model emphasizes on the perception of a person about the effect of health issues upon their lives and help to plan actions for helping patients engagement in health promoting activities. This model helps to predict and explain health behaviors, by focusing on the attitudes and perception of individual. Figure: Health belief model (Source: Mudge, Stretton Kayes, 2013) According to the health belief model, patients tend to compliance with the therapeutic procedure to prevent, screen for or control ill health, once they believe that they are susceptible to such a condition, that can have a serious negative impact upon their lives and a course of therapeutic action might be beneficial in reducing susceptibility or severity of the ill condition. Moreover, the patient should believe that the benefits of the action would outweigh the barriers. In case of Mr. Xs case, the health belief model is suitable because, it emphasizes on patients perception for negative consequences of not engaging with the therapeutic actions. However, for aligning the case with the health belief model, health promotion education is very important, which will make Mr. X aware of the pros and cons of the rehabilitation and its important in returning back to his normal life. In this context, his perception about pain and severity of his condition can be modified by his therapists support. In addition, the health education can modify his perceived benefits from rehabilitation and barriers of his engagement, which will be reduced by him once he is aware about all the facts (Mudge, Kayes McPherson, 2015). From his perceived severity, threats related to non-compliance with the rehabilitation would be understood by Mr. X, which will encourage him to stay engaged with the rehabilitation process and adhere to the therapeutic actions. Engagement of Mr. X with a positive health behavior will stimulate his recovery, which in turn help him to get back his normal life in short period and return to his job. The health care professional has to change the perception of Mr. X that rehabilitation and embedded physical exercise sessions would enhance his pain, rather than giving him relief. Here, the therapist is solely accountable for encouraging Mr. to be aware of the fact that rehabilitation is the best way to get back to his normal active life, without any hindrance. In addition to the health belief model, self-regulation theory can be used here, to enhance Mr. Xs engagement in the rehabilitation and recovery process. This theory can help people who are experiencing sickness behavior. The sickness behavior is one kind of behavior that arises during ill health condition, like Mr. Xs depression, anxiety and other related symptoms. According to this theory, a conscious personal management involves the process of guiding feelings, perceptions and behaviors to reach personal goals. There are four components of self-regulation, standards of desirable behavior, motivation to meet standards, monitoring of situations and thoughts that precede breaking said standards and willpower (Nieuwenhuijsen et al., 2006). The self-regulation model and its component can be used by the health care professional to motivate Mr. X towards rehabilitation engagement and enhancing his self-esteem and self-management skills to stimulate the rehabilitation process and returnin g to work. Recommended strategies for practice Cognitive behavioral approaches- the cognitive behavioral approach include psychotherapy and behavioral therapies, which are helpful for Mr. X to be motivated and being engaged with the rehabilitation process. Here, the therapist should show dignity and respect to modify his perception about the rehabilitation process. In addition, these behavioral therapies will help Mr. X to control his psychological issues, which are hindering the patient engagement. Motivational interviewing and therapeutic alliance- Motivating interview of Mr. X by his therapist and the employer can help him to be engaged in the rehabilitation process and cope with his working life after returning to his work. Motivational interviewing can help him to understand the importance of his rehabilitation process in his recovery and returning to his work. However, the interviewer should show respect and dignity towards Mr. X for providing value to his words and make a trustworthy relationship (Petrie, Jago Devcich, 2007). Facilitating physical activity- Physical activity is one of best strategy to improve patients engagement and recovery process. Physical activity helps to enhance patients self-dependence, which is the key reason behind Mr. Xs depression and changed behavior. However, the physiotherapist should make him aware about the correct physical activity and the limit, which will give him relief, rather than increasing pain. Health promotion- Health promotion is a key strategy that helps in enhancing patients awareness about the condition and recommended actions. Mr. Xs professionals were unable to promote his health outcomes due to failure in establishing a good relationship with him and due to lack of competence in making him aware of the benefits of the process. Thus, health promotion will help Mr. X to understand the importance of the compliance with the rehabilitation and change is perceived benefits and threats, thereby motivating his engagement (Siegert, McPherson Taylor, 2004). Summary This assignment highlighted the case of Mr. X, who was suffering from severe pain and psychological issues after his total knee replacement surgery. The assignment highlighted some barriers including lack of motivation, lack of family support, lack of educational knowledge about the importance of rehabilitation and lack of therapeutic alliance, which hindered his engagement with the therapeutic processes and recovery. 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