Effective Customer Service Strategy Tourism Essay Example

Effective Customer Service Strategy Tourism Essay Over the last two decennaries, cultural touristry has moved from a niche market into the mainstream of the touristry industry being one of the fastest turning facets of touristry. Consisting a rich and diverse cultural heritage ensures universe s capacity to pull international cultural tourers, giving cultural touristry a competitory advantage in the extremely competitory touristry concern ( World Cultural Tourism Association web site, hypertext transfer protocol: //kasct.co.kr/eng/intro01.htm ) . Furthermore, non-traditional tourers are progressively demanding for service quality that is considered as value for money ( Sharpley and Forster, 2003 ) . Supplying service quality therefore will assist bettering satisfaction of visitants and this is believed to take to reiterate visits, positive word-of-mouth and increased international trial ( Ramsaran-Fowadar, 2007 ) . 1.2. Background of survey Increasing acknowledgment of the importance of heightening service quality in cultural heritage scenes appeared merely since the late 1990s witnessing a renewed involvement in travelers to rediscover the yesteryear ( Boyd and Timothy, 2003 ) . And, with 1 billion of international travelers expected in 2012, among the many motives for traveling, sing cultural sites and detecting new traditions and imposts rank high on traveler s list. Amidst cultural attractive forces, museums are considered to be the most popular attractive force, normally followed by art galleries and memorials ( McKercher, 2004 ) . For case, France started the operations every bit early as the 1950 s by incorporating originally independent museums, and today Louvre Museum in Paris is the most visited museum in the universe with 8,800,000 visitants in 2011 ( beginning: The Art Newspaper ) . Hence, in order to derive competitory advantage, museum service suppliers should concentrate on the ways to pull more cultural visitants by analyzing visitants perceptual experiences on the service quality provided at their attractive forces. We will write a custom essay sample on Effective Customer Service Strategy Tourism specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Effective Customer Service Strategy Tourism specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Effective Customer Service Strategy Tourism specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In the national context, the Mauritanian touristry has now evolved into a genuinely planetary industry and is seeking ways to place its image as a cultural touristry finish contemplating its vision to pull two million tourers by the twelvemonth 2020. During the startup of the International Museum Day in May 2012 themed Museums in a changing World, New Challenges New Aspirations, the president of the Mauritius Museums Council, Goorah Beebeejaun said The 21st century is dedicated to the civilization. We have a new function to play.A We must introduce and make over constructs to advance our civilization, which is an unconventional instruction. Therefore, puting underscoring on the demand of analyzing the importance of efficient service quality bringing in museums in order to supply fulfilling experiences to visitants. 1.3. Research Problem An effectual client service scheme has the potency to better visitant dealingss to such an extent that it should take to betterments in the museum s repute and image, and more chances for growing through enhanced visitant and user satisfaction. However, clients may hold different values and different evidences for appraisal so they may comprehend the same service in different ways ( Edvardsson, 1996 ; Rowley, 1999 ) even if the service bringing procedure has been standardised. . This basically means using an evidence-based model, like SERQUAL to place exactly what each visitant group values, and so clearly pass oning this to all frontline employees. Hence, this thesis serves the intent of evaluate the service quality bringing procedure at LAventure du Sucre and its consequence on Customer Satisfaction. 1.4. Research Aims Adjacently, the survey aims at turn toing the undermentioned aims: To look into whether the quality of services provided meet the degree of visitant s outlooks // general outlooks prior visit to the sugar museum ; Measuring visitants perceptual experiences of quality of service experienced at LAS ; Identifying the characteristics of service that reveal the strong and weak countries ( spreads ) throughout the service bringing procedure utilizing the SERVQUAL theoretical account ; To find degree of client satisfaction achieved at the museum by carry oning a quantitative questionnaire study. 1.5. Chapter Breakdown To be more expressed and concise, the thesis comprises of interconnected chapters as outlined below: Chapter 1 is an overview on how bringing of quality services affects visitants experiences at museums, which are portion and package of cultural touristry both globally every bit good in the national context. Chapter 2 reviews the turning literature on service quality, understanding the importance of its execution in the service bringing procedure and how it relates to Customer Expectations, Perceptions and Satisfaction taking into consideration the construct of Museums as a service house and cultural attractive force. Chapter 3 gives a brief history of attractive forces, specifically museums in Mauritius in add-on to a background of the company and how it place and distinguish itself among its rivals staying to service quality committednesss at the top direction degree. Chapter 4 formulates the research methodological analysis sketching the research procedure carried out for roll uping informations on service quality bringing and client satisfaction at the museum in order to carry through the aims set out in the study. Chapter 5 presents the existent findings of the study conducted along with needed analysis. Chapter 6 offers appropriate suggestions and recommendations after analyzing the findings to react to existent demands and outlooks of visitants. Chapter 7 concludes the thesis by critically measuring the relationship between service quality bringing and client satisfaction and supplying an analytical grasp to dig into farther research on how to value the cardinal participants in service quality, that is the clients.

Vapour Compression Refrigeration System Essays

Vapour Compression Refrigeration System Essays Vapour Compression Refrigeration System Essay Vapour Compression Refrigeration System Essay The Carnot cycle refrigeration performs the reverse effect of the heat engine because it transfers energy from a low level of temperature to a high level of temperature. The refrigeration cycle requires the addition of external work for its operation. The diagram of the equipment and the temperature entropy diagram of the refrigeration cycle. The process which constitute the cycle are: 1-2 Adiabatic compression. 2-3 Isothermal rejection of heat. 3-4 Adiabatic expansion. 4-1 Isothermal addition of heat. All the process in the Carnot cycle are thermodynamically reversible . Process 1-2 and 3-4 isentropic. The withdrawal of heat from low temperature source in process 4-1is the refrigeration step and is the entire purpose of the cycle. All the other processes in the cycle function so that the low temperature energy can be discharged to some convenient high temperature sink. VAPOUR COMPRESSION CYCLE The vapour compression cycle is the most widely used refrigeration cycle in practice. In this cycle vapour is compressed, then condensed to a liquid, following which the pressure so that fluid can evaporate at low pressure. The standard vapour compression cycle is shown in temperature enthalpy diagram. The process constituting the standard vapour compression cycle are: 1-2 Reversible and adiabatic compression from saturated vapour to condenser pressure. 2-3 Reversible rejection of heat at constant pressure, causing de-superheating and condensation of refrigerants; 3-4 Irreversible expansion at constant enthalpy from saturated liquid to the evaporated pressure; 4-1 Reversible addition of heat at constant pressure causing evaporation to saturated vapour. PERFORMANCE OF THE STANDARD VAPOUR COMPRESSION CYCLE With the help of pressure-enthalpy diagram, the significant quantities of the standard vapour compression cycle will be determined. These quantities are the work of compression, heat rejection rate, refrigerating effect, COP, volume rate of flow per KW of refrigeration and power per KW of refrigeration. The work of compression in KJ per kg is the changes in enthalpy in process 1-2 of (H1-H2). The difference in enthalpy is a negative quantity, indicating the work is done on the system. The heat rejection in KJ/kg is the heat transferred from the refrigerants in process 2-3,which is (H3-H2). The value of H3-H2 is negative, indicating that the heat is transferred from the refrigerant . The value of the heat rejection used in sizing the condenser and calculating the required flow quantities of the condenser cooling fluid. The refrigerants effect in KJ/kg is the heat transferred in process 4-1, or H1-H4 . The COP of the standard VCRS is the refrigerating effect is divided by the work of the compression: COP=(H1 -H4 )/(H2 -H1 ) The volume flow rate in m3 /s is computed at the compression inlet or state point 1, the volume flow rate is the rough indication of physical size of the compressor. The power per KW of refrigerant is the inverse of the COP, and efficient refrigeration system has low value of power per KW of refrigeration but high COP. ACTUAL VAPOUR COMPRESSION CYCLE The actual vapour compression cycle suffer from insufficiencies compared with the standard cycle. There are also other changes from standard cycle, which may be intentional or unavoidable. The essential difference between actual and standard cycle appear in pressure drops condenser and evaporator, in the sub cooling of liquid leaving the condenser, and in the superheating of evaporator leaving the evaporator . The standard cycle assumes no drop in pressure in condenser and evaporator. Because of friction, however, the pressure of the refrigerants drops in actual cycle. The results of these drops in pressure are that compression process between 1-2 require more work than the standard cycle. Sub cooling of the liquid in the condenser is a normal occurrence and serves the desirable functions of insuring that hundred percent liquid enter the expansion valve. Superheating of the vapour usually occur in the evaporator and is recommended as a precautions against droplet of liquid being carried over in the compressor. The final difference in actual cycle is that the compression is no longer isentropic and there are inefficiencies due to friction and other losses. DEPARTMENT OF MECHANICAL ENGINEERING NATIONAL INSTITUTE OF TECHNOLOGY, RAIPUR CERTIFICATE This is to certify that the project work titled â€Å"DESIGN OF CAPILLARY TUBE FOR AN AIR CONDITIONER† submitted by Nikita Mishra (07119030), Sourabh Das (07119049), Tushar Raj (07119052) , Vikram Kumar Yadav (07119055), Ramlesh students of B Tech final year of Mechanical Engineering during the academic year 2010-11 in partial fulfillment of the requirements for the award of the degree of Bachelor of Technology ,Raipur is a presentation of work done by them. This certification does not necessarily endorse or accept any statement made, opinion expressed or conclusion drawn as recorded in the report. However , it only signifies the acceptance of the report for the purpose for which it is submitted. APPROVED BY: Under The Guidance of: Dr. S. Sanyal Mr R. Salhotra H. O. D Reader, Deptt. Of Mechanical Engineering, Deptt. Of Mechanical Engineering, National Institute of Technology, National Institue of Technology, Raipur Raipur Acknowledgement We would like to extend our profound gratitude to our guide, Mr. R. SALHOTRA for his kind help during initial stages of our work. We are deeply indebted to him for his valuable guidance, suggestions and constant encouragements throughout the work. It is our pleasure to acknowledge the cooperation given by other staff members of Mechanical Engineering Department. No work can be completed without the encouragement of family members and friends. We thank them all for always being there for us. We thank all people involve directly or indirectly in completion of work.

CLINICALLY DISCUSS THE KNOWLEDGE AND SKILLS REQUIRED FOR NURSING Essay

CLINICALLY DISCUSS THE KNOWLEDGE AND SKILLS REQUIRED FOR NURSING LEADERSHP IN AN INTERPERSONAL TEAM - Essay Example The mental health care sector in United Kingdom has in the last few years focused on transformational leadership as it seeks to improve the quality of service and patients outcome ((Allen, Gilbert & Onyett 2009). Some of the fundamentals of leadership include interpersonal relationship skills, empowerment of individuals, ability to instill confidence in others and ability to apply the problem-solving process. In today’s rapidly changing practice environment, nurse leaders are challenged to exert effective leadership in order to promote effective organization and increase individual productivity. The nurse leadership in UK mental institutions is expected to develop strategies capable of enabling followers to cope with inevitable changes within the mental healthcare setting as well as adapt to such changes in a positive way (Allen, Gilbert & Onyett 2009). This paper explores the knowledge and skills required for nursing leadership in an interpersonal team. Leadership Theories an d Models Effective nurse leadership requires knowledge of various leadership theories, principles and the use of such theories to guide all actions within the healthcare setting. ... Creative leadership can be demonstrated by ability to apply professional knowledge, personal power, and cultivation of appropriate personal values in the process of delivering care. The need for creative leadership has been triggered by increased diversity of staff and clients, significant shift from formal leadership to self-managed teams, and emergence of nurse leaders who serve as team leaders, internal consultants as well as sponsors. Owing to such changes, nurse leaders should demonstrate several competencies including effective, innovative and creative problem solvers, change makers, technology masters, team players, effective communicators, and ambassadors (Clark 2008). These competencies have become a necessity in the current highly dynamic mental health care setting in UK. The common leadership styles or models include the autocratic, democratic and laissez-faire leadership styles. Autocratic leadership styles involves making of decisions at the leadership or individual leve l without consulting other stakeholders within the healthcare setting. This form of leadership has been associated with several negative impacts including bad feelings among other workers, undercover retaliations, increased resistance, conflicts, low morale and low productivity. On the other hand, the democratic approach entails involvement of other people in the decision making process although the final decision may finally come from the leadership after consultations. A democratic leadership style takes into consideration ideas of other stakeholders and factors in such ideas in coming up with the final decision (Nagelkerk 2005). This way, followers are made to feel that they are part of

Human Resources Administration Assignment Example | Topics and Well Written Essays - 500 words - 1

Human Resources Administration - Assignment Example The third step is in the wake of understanding that more efforts would be needed to move things from one place to another if unions are formed, and hence it would be a good idea to do away with the same, right from the outset of such understandings. The fourth step is in making the employees comprehend that if they avoid unions, they will reap the rewards themselves because more work will be done in a lesser amount of time, and hence their benefits would be ensured easily. The fifth and last step is in the form of gaining an idea that unions leave a very negative perspective of the company and no employee would like to be seen as a hindrance within the smooth working tenets of an organization. Hence forming unions needs to be avoided at all costs. The reason for choosing these five points is because they give an overall view of how the unions need to be avoided at all costs. It also makes one realize where the negativity creeps in and what needs to be done to make sure that the employees remain steadfast with their respective domains. The cost, time and effort factors are pertinent for any business and should always be thought out of as such. If these aspects are not properly covered, then unions will come in and hence the focus of the organization would shift as a result of the same. Employees would ask for more favors from the organizational tenets and there would be more instances of collective demonstrations and upheaval for all the wrong reasons (Ferris, 2012). From an organizational standpoint, this cannot be tolerated at all because these document how improper the standards of the individuals working within the organizations are at the end of the day. It also dictates the anomaly that comes about for an organization be cause it has to see which employees are loyal to the core, and which ones are creating problems for its business operations,

Acute Care Nurse Practitioner Interview Nursing Essay Example for Free

Acute Care Nurse Practitioner Interview Nursing Essay The Advanced Practice Nurse (APN) I interviewed is FS; she is an Acute Care Nurse Practitioner (ACNP) with the department of Urology at Saint Louis University Hospital (SLUH) and has been licensed and board certified since 2010. FS graduated in 2005 from Goldfarb School of nursing in Saint Louis earning her bachelor of science (BSN) and then took an intensive care staff position with Missouri Baptist hospital for two years. With two years of experience she felt she needed to continue her education in nursing and enrolled in a Saint Louis University (SLU) ACNP program. She realized after the first year that trying to work full time and take classes was too much for her, so she decided to quit her job to focus full time on her studies. Her first position as an ACNP was with the trauma department step down floor at SLUH in 2011. This position was advertised in newsprint and after sending in her resume she was contacted to for an interview in person. My first interaction with FS was last fall when I was teaching Advance Trauma Care for Nurses as she was one of the students that I recognized from the trauma department. We struck up a conversation and I basically did a mini interview then and she since has given me contacts for preceptors this summer. Last week I notified her regarding this interview and she informed me to meet her at noon in her office where we discussed questions listed according to the description of assignment for a total of 30 minutes. Personal history including education FS received a Bachelor of Science degree from Georgetown University in Economics and International Business. When working out a problem or learning a new skill she likes to get the general picture and start gradually focusing in on specifics similar to deductive theory. She knew she wanted to work in a hospital setting, from there to a surgical floor, and now she has focused in on Urology. She learned the Urology department at SLUH wanted to bring in two or three APN’s on service to round and be first assistants in the operating room through networking with other APN’s in the hospital. When she interviewed for the position she had a great working relationship with that service already. They knew she was punctual along with having familiarity with documentation system. She basically had been marketing herself before she even knew it by having a proactive relationship with consults. Description of current practice FS does not currently have a formal job description since her position is new and she is the first APN to fill this newly developed role with this service. Other than being told she would round on patients in the hospital, write orders, discharge patients, and first assist in the operating room she has no formal written description. When she applied for her position she was informed it would be a lateral move with no increase in pay or benefits. FS arrives to the hospital at 0600 similar to an intern or second year resident. Every morning she receives report from night float of any new patients or issues to existing patients who have been admitted. Information is gathered on labs and radiology films that have been completed and she uses this information when her first patient assessment is completed early that morning. The fellow or senior resident will round on each patient to discuss labs, radiology, and patient assessments. From this a plan is developed what needs to be done that day to move forward before the attending rounds with the team to discuss the same items. From this point she may go to the operating room to first assist if it is her patient or write new orders on the other patients assigned to their service. If she happens to be first assistant she will follow the patient back to their room and write post operation orders. Her role is very similar to a second year surgery resident duties. Description of APN functions using the APN core competencies. Working in an inner metropolitan city hospital that has many ethnicities has been challenging. She has had to learn certain customs, body posture, and position can have either a positive or negative impact in perception from the patient with regard to attitude of care they are receiving. She has learned from staff of the same ethnicity or watched family and friends interact with one another on proper cultural customs. The first of two main core competencies FS uses is clinical and professional leadership with fellow APN’s and physicians discussing assessments and plan of care. The second of two core competencies is consultation with other services and the nursing staff in consideration to patient care and goals (Cooke, Gemmill, Grant, 2008). APN’s have additional competencies but these are the two main descriptions FS uses daily. FS has worked through many challenges as an APN the last few years. Some of the minor issues have been the acceptance from other services that do not have APN’s. Over time other services have become accustomed to consults from APN’s by her demonstrating knowledge, professionalism, and kindness. The biggest challenge she has faced is an overabundance additional patient work load since the department will no longer have residents this year. She has the attending’s blessing to hire more APN’s and they will take on more direct patient care. Issues confronting the APN in current practice FS reports there are no real issues she faces at present other than just continue to work on suturing skills in the operating room. She stays current in Urology by attending grand rounds along with reading and presenting journal articles. She also has the luxury of having a fellow who has been a great source of knowledge. Perceived impact on APN role pursuant to current healthcare developments, changes, and national recommendations. It is my personal belief APN’s will be one of the fastest growing professions in the coming years when the Affordable Health Care Act takes place. It appears that many physicians will probably be in specialized services along with the APN. In addition, APN’s will be the majority of primary care in the future as more individuals will seek wellness physicals and the baby boom generation is nearing 70 years of age.

The Dada Movement - Russian Avant-Garde on the Internet Essay -- Explo

The Dada Movement - Russian Avant-Garde on the World Wide Web Russia witnessed an artistic revolution during the turn of the 20th century that attempted to overturn art's place in society. Today, we are witnessing a new revolution that is growing at an alarming rate and attracting a variety of people every day. This phenomenon is known as the Internet. The World Wide Web is more than a medium for education and research, but serves as a tool for preserving and glorifying the treasures of art. This paper will argue that through the Internet, society still inhabits the world created by the Russian avant-garde whose legacy lives on in art, dance, music, and social groups. Members of the Dada movement in Pre-Revolutionary Russia found themselves unable to communicate the excitement of the avant-garde, however, with the Internet, that excitement is once again re-lived. The International Dada Archive of the University of Iowa is an example of the how the Internet is used as a tool to immortalize the works of the Dada movement. The purpose of the archive is to preserve and spread the written word of the Dada movement. Unlike contemporary art, the artist and writers of the Dada movement did not aim to create eternal works of art and literature (Shipe 2). Tristan Tzara and Hugo Ball, leaders of the movement, reacted against World War I and wanted to open the way to a new art and a new society. Though Dadaists published books and displayed their work, the real spirit of Dada was in events: cabaret performances, demonstrations, confrontation, distribution of leaflets, and small magazines (Shipe 2). These documents exist but can only be found within diaries, audiences, newspaper accounts, and throwaway leaflets. The documents are made a... ...ormation concerning all types of art within the click of a mouse. Because millions of people have access to the Internet, art itself will have a greater appreciation and a broader understanding. The World Wide Web is more than a medium for education and research, but serves as a tool for preserving and glorifying the treasures of art. Works Cited Heartfield, John. Available: http://burn.ucsd.edu/heart.htm. Mital-Underground. Available: http://www.mital-u.ch/index.html. Turner, Ron. Available: http:// www.connect.net/ron/dada.html Shipe, Timothy. International Dada Archive, University of Iowa Libraries. Iowa City: University of Iowa. Available: http://www.uiowa.edu/dada/about.html 1997. Stoppard, Tom. Travesties. New York: Grove Press, 1975. Zygonov, Victor. The Nuemerz Manifesto. Available: http:// www.smalltime.com/nowhere/neumerz/manifesto.htm.

Case Study-Eating Disorder

Sarah is a sixteen year old girl. She is in the tenth grade and until recently was an optimistic and energetic young girl. Sarah’s mother has began to worry about her lately. Her mother recently found a bottle of diet pills hidden in her room. She has also noticed that Sarah’s behavior has been changing in the past few months. Sarah’s mother is unaware that Sarah’s boyfriend has been reducing her to tears lately by commenting that she has been gaining weight. Her mother has also found her looking in the mirror a lot more than usual. When she looks in the mirror she often sucks in her stomach and is complaining that she is not beautiful. As a result, Sarah has been going off food for days to the point of starvation. Then after days without food she breaks down and eats nearly everything that she can find in her refrigerator. Sarah’s weight has significantly dropped in the past few weeks. It is important to intervene immediately in Sarah’s life and get her help. When individuals with eating disorders get help early on during the disorder there is a high success rate of long-term recovery. Sarah is part of one the highest rated risk groups for eating disorders. People between the ages of ten to twenty-five are at the most risk for developing an eating disorder. Sarah is entering her teenage years and is encountering a lot of changes with her boy and her emotions. Eating disorders are also usually referred to as female diseases. Eating disorders are not limited to females. Sarah is a young women that is starting to feel pressure from her boyfriend to lose weight. Sarah is just beginning to have issue with her weight and food. Individuals with eating disorders often do not recognize that they have a problem or will not admit that they have a problem. The two most common forms of eating disorders are anorexia nervosa and bulimia. They are similar to each other and are both very harmful to an individual. Anorexia is characterized by an obsession with weight gain and self-distorted body image. Individuals with anorexia have a body weight that is 85 percent below their normal weight for their height and age. They maintain a low body weight by starving themselves, over-exercising, using diet pills, or vomiting. The effects of this eating disorder are emotional, physical, social, and psychological. It is a very serious disorder. There are two types of anorexia. The restricting type and the bingeing and purging type. When people think of anorexia they most commonly think of the restricting type which is characterized by individuals not participating in any bingeing or purging behaviors. The binging and purging type of anorexia is when the individual does participate in bingeing and purging behaviors by using laxatives, self-inducing vomiting, or over-exercising(DSM-IV-TR; American Psychiatric Association, 2000). Bulimia, like anorexia, is characterized by one’s obsession with weight. This type of eating disorder involves an individual having recurrent binge eating followed by purging behaviors. The use of laxatives, diuretics, and other medications help the individual with the purging. Over-exercising and a self-distorted body-image are a large part of bulimia. Persons with bulimia feel they have no self-control over their binges and purges. Their binging and purging behaviors happen often and occur at least once a week for three months (DSM-IV-TR; American Psychiatric Association, 2000). Eating disorders are very serious and will not typically get better without treatment. It is often difficult to get people with eating disorders to get help, because they don’t think that they have a problem or they are scared of gaining weight. One of the most important aspects of treating anorexia nervosa is to have the patients gain weight and restore nutrition. In some cases their weight can be so low that hospitalization is necessary. In Sarah’s case, and most other cases, she can be treated as an outpatient with therapy. For long-term recovery it is critical to get the person who has an eating disorder help as soon as the problem is obvious. The longer the person with an eating disorder waits to get help the longer it will take to recover and the risk of relapse increases. Anorexia and bulimia can also so a lot of damage to a person’s body physically if it left untreated. This will only make individuals feel worse in the long run because they leave he/she looking and feeling terrible (Holtkamp, Hebebrand, & Herpertz-Dahlmann, 2004). In severe cases of anorexia and bulimia inpatient care is needed. Inpatient care has access to 24-hour a day clinical care and is a very structured environment. This may be just what the patient needs because many times the lives of patients with eating disorders are not very organized. There are ifferent levels of care in the hospital that gives the patients the option to â€Å"step-up† or â€Å"step-down† to. One reason that patients with eating disorders are placed in inpatient care in a hospital is when they also have a psychiatric disorder. Their psychiatric disorder may also require some special care that interferes with an eating disorder. Sarah is not at the point of needing inpatient care. In p atient care is usually only implemented in severe cases of anorexia or bulimia. Cognitive-behavioral therapy is one of the most effective types of therapy for bulimia. This type of therapy is highly structured and involves active participation of the patient. This type of therapy focuses on the thoughts and feelings that the patients have about eating and food. One of the main goals is establish a positive relationship with food. Along with establishing a positive relationship with food, cognitive-behavioral therapy focuses on creating a positive self-image and increasing self-esteem. Creating a positive self-image is a vital component in recovery. Cognitive-behavioral therapy emphasizes the importance of consuming regular meals (Mitchell, & Peterson, 1999). In order to determine if the patient is consuming regular meals and snacks he/she keeps detailed journals of what he/she eats and writes self-evaluations. During cognitive-behavioral therapy there are a few other aspects that have been helpful when to use for patients with bulimia. Identifying cues for when the bingeing or purging behaviors are going to occur helps the patient reduce his/her behavior by recognizing the cue and stopping themselves before they binge or purge. Patients with eating disorders do not have a healthy or regular meal schedule. Establishing a normal meal schedule and even a meal plan for what they are going to eat at each meal will help enforce regularity into the patients’ life. Research findings show that cognitive-behavioral therapy is successful in reducing bingeing and purging behaviors in individuals with bulimia nervosa. Reduction rates range from 40 percent to 97 percent (Mitchell, & Peterson,1999). For anorexia nervosa, cognitive-behavioral therapy has been found to be effective when used as individual therapy and group therapy combined. Using group therapy and individual therapy has resulted in a reduction in relapse and symptoms returning. Although it can be used for anorexia nervosa it is not the most effective treatment option for anorexia nervosa, but it is one of the most effective or bulimia. One problem with cognitive-behavioral therapy is that at the end of this therapy many patients still have some symptoms; that increases the risk for a relapse in the future. Nutritional counseling is an essential part of treatment for eating disorders. It can be done with the counselor that they are seeing for their cognitive-behavioral therapy or it can be a completely different counselor that is specialized in dietary nutrition. During nutritional therapy the patient learns about the importance of healthy eating. The patient is also taught about the effects on his/her mental and physical health when they deprive their body of the basic nutritional needs. Teaching patients’ to have a positive relationship with food is one of the most important aspects of treatment for individuals with eating disorders, because if he/she keeps a negative view of food then they will not be able to gain weight. Nutritional counseling sets up a new diet that includes the patient keeping a daily journal of what they eat. During nutritional counseling the patients’ learn that they need to eat food to be able to live and that they can eat food without feeling bad about themselves. Group therapy provides a supportive network of individuals who have the same eating disorder to share time and experiences with one another. During group therapy individuals can discuss their goals for the future, ways to change his/her behaviors, and alternate coping strategies. Group therapy for individuals with anorexia and bulimia is not always the most effective form of treatment. There are several advantages and disadvantages in group therapy. Group therapy allows individuals to share and teach about their own experiences with their eating disorder. Group therapy many not be appropriate for all individuals, but for those whom it is, they seem to benefit greatly. Patients with eating disorders often feel rejected by their families and friends, and when they are with other patients who are suffering from eating disorders then they will gain acceptance and feel cared about. Forming friendships with other patients in the group can help prevent a binge or take someone out of a depressed mood by a making a simple phone call. However, individuals with eating disorders also suffer from anxiety and are closed off to others, so putting them in a group therapy may not be that effective (Holtkamp, Hebebrand, & Herpertz-Dahlmann, 2004). They will not be willing to cooperate and share with others. Also, one cannot force individuals to be part of a group therapy and many people will not volunteer to be part of a group. One concern that therapists have with group therapy is that patients can get negative ideas from each other. For example if one patient is unaware of a type of medication that is used to induce vomiting he/she may try this as a new method. Patients may, also feel too much pressure from the other individuals in the group and withdraw themselves from the rest of the group and lie about their progress. Patients with anorexia and bulimia often show a low level in serotonin (Ferguson, La Via, & Crossan, 1999). Low levels of serotonin are often associated with depressive disorders and anxiety disorders. Many individuals who are suffering from an eating disorder such as anorexia or bulimia are also diagnosed with an anxiety or depressive disorder. Some of these disorders include social phobia, obsessive compulsive disorder, major depressive disorder, dysthmic disorder, and substance abuse. Medication is often used in treating anorexia and bulimia, because of the cormobidity with other mental disorders. The main purposes of using medication are to treat other psychiatric conditions, reduce sensitivity to stress, reduce anxiety and weight restoration. Medications have shown to be effective in these areas. Medication should not be the only type of treatment for an individual with an eating disorder. When using medication with another type of therapy, such a cognitive-behavioral or family therapy, should be implemented. The use of medication in the treatment for anorexia has not shown significant effects(Ferguson, La Via, & Crossan, 1999). When the use of fluoxetine, an antidepressant, was combined with nutritional and behavioral treatment, it has shown some effects in preventing relapse. It did not improve the mood or stimulate appetite in individuals. It has been shown to be most effect in the treatment of anorexia once there has been some weight gain and improvement in self-esteem. The use of pharmacology is much more promising for patients with bulimia. It doesn’t work for everyone with bulimia, but the use of antidepressants has resulted in significant reduction in bingeing and purging behaviors. The most popular form of antidepressants used are SSRI’s and Prozac has shown the best results for reducing behaviors associated with bulimia. When using medication for the treatment of anorexia and bulimia is important to follow several guidelines to protect the patients’ health. Doing a medical background check of the patient and his/her family health is important before beginning the patient in any type of medication. The use of medication should not take place until after nutritional rehabilitation has begun and the patient has already chosen another form of therapy to participate in while he/she is taking medication. A treatment method that is often overlooked is self-help. It is often overlooked because it very few medical professionals are involved in this type of treatment. This method involves the patient with an eating disorder becoming part of a group that is composed of people who have eating disorders or joining a community group that will have a high level of support. Support is one of the most important aspects that a person with an eating disorder needs in his/her life in order to have long-term success and a low relapse rate. There are many self-help groups for patients with eating disorders all over the world that are committed to helping individuals recover from an eating disorder. Self-groups may not be for everyone. It is important for individuals with an eating disorder to also have support from the people that are important in his/her life. Family and friends are the people that they interact with everyday and it is essential for the patient to have support from people that they are in contact with on a daily basis. Having support from family members is very helpful in treatment. Since family members are the people that the patient is most likely around the most it is important for them to understand the therapy process and be there for their family member when he/she needs them. In many cases, the family members and the way that a family functions can be part of the reason that the patient has developed an eating disorder. Most cases of eating disorders do not have direct causes because of the patients’ issues with food and weight. Problems within the family is one of the top causes for eating disorders. Family therapy is a popular option for patients with eating disorders the main goal of family therapy is to reduce family dysfunction and reorganize the family to help with the reduction of dysfunction. Family therapy involves the participation of the entire immediate family. During family therapy the role of the therapist is to provide the family with communication skills, conflict resolution skills, and support skills. Teaching family members how to have realistic expectations for one another and to develop strong and united relationships is another important aspect of the family. Family therapy is especially important to use with children and adolescents.