The transtheoretical model of behavior change is an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, provides strategies, or processes of change to guide the individual. The model is composed of constructs such as: stages of change, processes of change, levels of change, self-efficacy, decisional balance; the transtheoretical model is known by the abbreviation "TTM" and sometimes by the term "stages of change", although this latter term is a synecdoche since the stages of change are only one part of the model along with processes of change, levels of change, etc. Several self-help books—Changing for Good and Changing to Thrive —and articles in the news media have discussed the model, it has been called "arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has attracted criticism". James O. Prochaska of the University of Rhode Island, Carlo Di Clemente and colleagues developed the transtheoretical model beginning in 1977.
It is based on analysis and use of different theories of psychotherapy, hence the name "transtheoretical". Prochaska and colleagues refined the model on the basis of research that they published in peer-reviewed journals and books; this construct refers to the temporal dimension of behavioural change. In the transtheoretical model, change is a "process involving progress through a series of stages": Precontemplation – "People are not intending to take action in the foreseeable future, can be unaware that their behaviour is problematic" Contemplation – "People are beginning to recognize that their behaviour is problematic, start to look at the pros and cons of their continued actions" Preparation – "People are intending to take action in the immediate future, may begin taking small steps toward behaviour change" Action – "People have made specific overt modifications in modifying their problem behaviour or in acquiring new healthy behaviours" Maintenance – "People have been able to sustain action for at least six months and are working to prevent relapse" Termination – "Individuals have zero temptation and they are sure they will not return to their old unhealthy habit as a way of coping"In addition, the researchers conceptualized "Relapse", not a stage in itself but rather the "return from Action or Maintenance to an earlier stage".
The quantitative definition of the stages of change is the most notorious feature of the model. However it is one of the most critiqued in the field of smoking cessation, where it was formulated, it has been said that such quantitative definition does not reflect the nature of behaviour change, that it does not have better predictive power than simpler questions, that it has problems regarding its classification reliability. Communication theorist and sociologist Everett Rogers suggested that the stages of change are analogues of the stages of the innovation adoption process in Rogers' theory of diffusion of innovations. Stage 1: Precontemplation People at this stage do not intend to start the healthy behavior in the near future, may be unaware of the need to change. People here learn more about healthy behavior: they are encouraged to think about the pros of changing their behavior and to feel emotions about the effects of their negative behavior on others. Precontemplators underestimate the pros of changing, overestimate the cons, are not aware of making such mistakes.
One of the most effective steps that others can help with at this stage is to encourage them to become more mindful of their decision making and more conscious of the multiple benefits of changing an unhealthy behavior. Stage 2: Contemplation At this stage, participants are intending to start the healthy behavior within the next 6 months. While they are now more aware of the pros of changing, their cons are about equal to their Pros; this ambivalence about changing can cause them to keep putting off taking action. People here learn about the kind of person they could be if they changed their behavior and learn more from people who behave in healthy ways. Others can influence and help at this stage by encouraging them to work at reducing the cons of changing their behavior. Stage 3: Preparation People at this stage are ready to start taking action within the next 30 days, they take small steps that they believe can help them make the healthy behavior a part of their lives. For example, they tell their friends and family.
People in this stage should be encouraged to seek support from friends they trust, tell people about their plan to change the way they act, think about how they would feel if they behaved in a healthier way. Their number one concern is: when they act, will they fail? They learn that the better prepared they are, the more they are to keep progressing. Stage 4: Action People at this stage have changed their behavior within the last 6 months and need to work hard to keep moving ahead; these participants need to learn how to strengthen their commitments to change and to fight urges to slip back. People in this stage progress by being taught techniques for keeping up their commitments such as substituting activities related to the unhealthy behavior with positive ones, rewarding themselves for taking steps toward changing, avoiding people and situations that tempt them to behave in unhealthy ways. Stage 5: Maintenance People at this stage changed their behavior more than 6 months a
Emotionally focused therapy
Focused therapy and emotion-focused therapy are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy, systemic therapy, attachment theory. EFT is a short-term treatment. EFT approaches are based on the premise that human emotions are connected to human needs, therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationships. Emotion-focused therapy for individuals was known as process-experiential therapy, it is still sometimes called by that name. EFT should not be confused with emotion-focused coping, a category of coping proposed by some psychologists, although clinicians have used EFT to help improve clients' emotion-focused coping. EFT began in the mid-1980s as an approach to helping couples. EFT was formulated and tested by Sue Johnson and Les Greenberg in 1985, the first manual for focused couples therapy was published in 1988.
To develop the approach and Greenberg began reviewing videos of sessions of couples therapy to identify, through observation and task analysis, the elements that lead to positive change. They were influenced in their observations by the humanistic experiential psychotherapies of Carl Rogers and Fritz Perls, both of whom valued present-moment emotional experience for its power to create meaning and guide behavior. Johnson and Greenberg saw the need to combine experiential therapy with the systems theoretical view that meaning-making and behavior cannot be considered outside of the whole situation in which they occur. In this "experiential–systemic" approach to couples therapy, as in other approaches to systemic therapy, the problem is viewed as belonging not to one partner, but rather to the cyclical reinforcing patterns of interactions between partners. Emotion is viewed not only as a within-individual phenomena, but as part of the whole system that organizes the interactions between partners.
In 1986, Greenberg chose "to refocus his efforts on developing and studying an experiential approach to individual therapy". Greenberg and colleagues shifted their attention away from couples therapy toward individual psychotherapy, they attended to its role in individual self-organization. Building on the experiential theories of Rogers and Perls and others such as Eugene Gendlin, as well as on their own extensive work on information processing and the adaptive role of emotion in human functioning, Rice & Elliott created a treatment manual with numerous outlined principles for what they called a process-experiential approach to psychological change. Elliott et al. and Goldman & Greenberg have further expanded the process-experiential approach, with detailed manuals of specific methods of therapeutic intervention. Goldman & Greenberg presents case formulation maps for this approach. Johnson continued to develop EFT for couples, integrating attachment theory with systemic and humanistic approaches, explicitly expanding attachment theory's understanding of love relationships.
Johnson's model retained the original three stages and nine steps and two sets of interventions that aim to reshape the attachment bond: one set of interventions to track and restructure patterns of interaction and one to access and reprocess emotion. Johnson's goal is the creation of positive cycles of interpersonal interaction wherein individuals are able to ask for and offer comfort and support to safe others, facilitating interpersonal emotion regulation. Greenberg & Goldman developed a variation of EFT for couples that contains some elements from Greenberg and Johnson's original formulation but adds several steps and stages. Greenberg and Goldman posit three motivational dimensions— attachment, identity or power, attraction or liking—that impact emotion regulation in intimate relationships; the terms emotion-focused therapy and focused therapy have different meanings for different therapists. In Les Greenberg's approach the term emotion-focused is sometimes used to refer to psychotherapy approaches in general that emphasize emotion.
Greenberg "decided that on the basis of the development in emotion theory that treatments such as the process experiential approach, as well as some other approaches that emphasized emotion as the target of change, were sufficiently similar to each other and different from existing approaches to merit being grouped under the general title of emotion-focused approaches." He and colleague Rhonda Goldman noted their choice to "use the more American phrasing of emotion-focused to refer to therapeutic approaches that focused on emotion, rather than the original more English term focused." Greenberg uses the term emotion-focused to suggest assimilative integration of an emotional focus into any approach to psychotherapy. He considers the focus on emotions to be a common factor among various systems of psychotherapy: "The term emotion-focused therapy will, I believe, be used in the future, in its integrative sense, to characterize all therapies that are emotion-focused, be they psychodynamic, cognitive-behavioral, systemic, or humanistic."
Greenberg co-authored a chapter on the importance of research by clinicians and integration of psychotherapy approaches that stated: In addition to these empirical findings, leaders of major orientations have voiced serious criticisms of their preferred theoretical approaches, while encouraging an open-minded attitude toward other orientations
Providence, Rhode Island
Providence is the capital and most populous city of the U. S. is one of the oldest cities in the United States. It was founded in 1636 by Roger Williams, a Reformed Baptist theologian and religious exile from the Massachusetts Bay Colony, he named the area in honor of "God's merciful Providence" which he believed was responsible for revealing such a haven for him and his followers. The city is situated at the mouth of the Providence River at the head of Narragansett Bay. Providence was one of the first cities in the country to industrialize and became noted for its textile manufacturing and subsequent machine tool and silverware industries. Today, the city of Providence is home to eight hospitals and seven institutions of higher learning which have shifted the city's economy into service industries, though it still retains some manufacturing activity; the city is the third most populous city in New England after Worcester, Massachusetts. Providence was one of the original Thirteen Colonies. Williams and his company were compelled to leave Massachusetts Bay Colony, Providence became a refuge for persecuted religious dissenters, as Williams himself had been exiled from Massachusetts.
The city was burned to the ground in March 1676 by the Narragansetts during King Philip's War, despite the good relations between Williams and the sachems with whom the United Colonies of New England were waging war. In the year, the Rhode Island legislature formally rebuked the other colonies for provoking the war. Providence residents were among the first Patriots to spill blood in the lead-up to the American Revolutionary War during the Gaspée Affair of 1772, Rhode Island was the first of the Thirteen Colonies to renounce its allegiance to the British Crown on May 4, 1776, it was the last of the Thirteen Colonies to ratify the United States Constitution on May 29, 1790, once assurances were made that a Bill of Rights would become part of the Constitution. Following the war, Providence was the country's ninth-largest city with 7,614 people; the economy shifted from maritime endeavors to manufacturing, in particular machinery, silverware and textiles. By the start of the 20th century, Providence hosted some of the largest manufacturing plants in the country, including Brown & Sharpe, Nicholson File, Gorham Manufacturing Company.
Providence residents ratified a city charter in 1831 as the population passed 17,000. The seat of city government was located in the Market House in Market Square from 1832 to 1878, the geographic and social center of the city; the city offices outgrew this building, the City Council resolved to create a permanent municipal building in 1845. The city offices moved into the Providence City Hall in 1878. During the American Civil War, local politics split over slavery as many had ties to Southern cotton and the slave trade. Despite ambivalence concerning the war, the number of military volunteers exceeded quota, the city's manufacturing proved invaluable to the Union. Providence thrived after the war, waves of immigrants brought the population from 54,595 in 1865 to 175,597 by 1900. By the early 1900s, Providence was one of the wealthiest cities in the United States. Immigrant labor powered one of the nation's largest industrial manufacturing centers. Providence was a major manufacturer of industrial products, from steam engines to precision tools to silverware and textiles.
Giant companies were based in or near Providence, such as Brown & Sharpe, the Corliss Steam Engine Company, Babcock & Wilcox, the Grinnell Corporation, the Gorham Manufacturing Company, Nicholson File, the Fruit of the Loom textile company. From 1975 until 1982, $606 million of local and national community development funds were invested throughout the city. In the 1990s, the city pushed for revitalization, realigning the north-south railroad tracks, removing the huge rail viaduct that separated downtown from the capitol building and moving the rivers to create Waterplace Park and river walks along the rivers' banks, constructing the Fleet Skating Rink and the Providence Place Mall. Despite new investment, poverty remains an entrenched problem. 27.9 percent of the city population is living below the poverty line. Recent increases in real estate values further exacerbate problems for those at marginal income levels, as Providence had the highest rise in median housing price of any city in the United States from 2004 to 2005.
The Providence city limits enclose a small geographical region with a total area of 20.5 square miles. Providence is located at the head of Narragansett Bay, with the Providence River running into the bay through the center of the city, formed by the confluence of the Moshassuck and Woonasquatucket Rivers; the Waterplace Park amphitheater and riverwalks line the river's banks through downtown. Providence is one of many cities claimed to be founded on seven hills like Rome; the more prominent hills are: Constitution Hill, College Hill, Federal Hill. The other four are: Tockwotten Hill at Fox Point, Smith Hill, Christian Hill at Hoyle Square, Weybosset Hill at the lower end of Weybosset Street, leveled in the early 1880s. Providence has 25 official neighborhoods, though these neighborhoods are grouped together and referred to
Brown University is a private Ivy League research university in Providence, Rhode Island. Founded in 1764 as the College in the English Colony of Rhode Island and Providence Plantations, it is the seventh-oldest institution of higher education in the United States and one of the nine colonial colleges chartered before the American Revolution. At its foundation, Brown was the first college in the U. S. to accept students regardless of their religious affiliation. Its engineering program was established in 1847, it was one of the early doctoral-granting U. S. institutions in the late 19th century, adding masters and doctoral studies in 1887. In 1969, Brown adopted a New Curriculum sometimes referred to as the Brown Curriculum after a period of student lobbying; the New Curriculum eliminated mandatory "general education" distribution requirements, made students "the architects of their own syllabus" and allowed them to take any course for a grade of satisfactory or unrecorded no-credit. In 1971, Brown's coordinate women's institution, Pembroke College, was merged into the university.
Undergraduate admissions is selective, with an acceptance rate of 6.6% for the class of 2023. The university comprises the College, the Graduate School, Alpert Medical School, the School of Engineering, the School of Public Health and the School of Professional Studies. Brown's international programs are organized through the Watson Institute for International and Public Affairs, the university is academically affiliated with the Marine Biological Laboratory and the Rhode Island School of Design; the Brown/RISD Dual Degree Program, offered in conjunction with the Rhode Island School of Design, is a five-year course that awards degrees from both institutions. Brown's main campus is located in the College Hill Historic District in the city of Providence, Rhode Island; the University's neighborhood is a federally listed architectural district with a dense concentration of Colonial-era buildings. Benefit Street, on the western edge of the campus, contains "one of the finest cohesive collections of restored seventeenth- and eighteenth-century architecture in the United States".
As of August 2018, 8 Nobel Prize winners have been affiliated with Brown University as alumni, faculty members or researchers. In addition, Brown's faculty and alumni include five National Humanities Medalists and ten National Medal of Science laureates. Other notable alumni include eight billionaire graduates, a U. S. Supreme Court Chief Justice, four U. S. Secretaries of State and other Cabinet officials, 54 members of the United States Congress, 56 Rhodes Scholars, 52 Gates Cambridge Scholars 49 Marshall Scholars, 14 MacArthur Genius Fellows, 21 Pulitzer Prize winners, various royals and nobles, as well as leaders and founders of Fortune 500 companies; the origin of Brown University can be dated to 1761, when three residents of Newport, Rhode Island drafted a petition to the General Assembly of the colony: Your Petitioners propose to open a literary institution or School for instructing young Gentlemen in the Languages, Geography & History, & such other branches of Knowledge as shall be desired.
That for this End... it will be necessary... to erect a public Building or Buildings for the boarding of the youth & the Residence of the Professors. The three petitioners were Ezra Stiles, pastor of Newport's Second Congregational Church and future president of Yale. Stiles and Ellery were co-authors of the Charter of the College two years later; the editor of Stiles's papers observes, "This draft of a petition connects itself with other evidence of Dr. Stiles's project for a Collegiate Institution in Rhode Island, before the charter of what became Brown University."There is further documentary evidence that Stiles was making plans for a college in 1762. On January 20, Chauncey Whittelsey, pastor of the First Church of New Haven, answered a letter from Stiles: The week before last I sent you the Copy of Yale College Charter... Should you make any Progress in the Affair of a Colledge, I should be glad to hear of it; the Philadelphia Association of Baptist Churches had an eye on Rhode Island, home of the mother church of their denomination: the First Baptist Church in America, founded in Providence in 1638 by Roger Williams.
The Baptists were as yet unrepresented among colonial colleges. Isaac Backus was the historian of the New England Baptists and an inaugural Trustee of Brown, writing in 1784, he described the October 1762 resolution taken at Philadelphia: The Philadelphia Association obtained such an acquaintance with our affairs, as to bring them to an apprehension that it was practicable and expedient to erect a college in the Colony of Rhode-Island, under the chief direction of the Baptists. Mr. James Manning, who took his first degree in New-Jersey college in September, 1762, was esteemed a suitable leader in this important work. Manning arrived at Newport in July 1763 and was introduced to Stiles, who agreed to write the Charter for the College. Stiles's first draft was read to the General Assembly in August 1763 and rejected by Baptist members who worried that the College Board of Fellows would under-represent the Baptists. A revised Charter written by Stiles and Ellery was adopted by the Assembly on March 3, 1764.
In September 1764, the inaugural meeting of the College Corporation was held at Newport. Go
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood in Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is ranked 1st among research-oriented medical schools by U. S. News and World Report. Unlike most other leading medical schools, HMS does not operate in conjunction with a single hospital but is directly affiliated with several teaching hospitals in the Boston area; the HMS faculty comprises of 2,900 full- and part-time voting faculty members consisting of assistant and full professors, over 5,000 full- and part-time, non-voting instructors. The majority of the faculty receive their appointments through an affiliated teaching hospital. Harvard Medical School was founded on September 19, 1782 after President Joseph Willard presented a report with plans for a medical school to the fellows and the president of Harvard College, it is the third-oldest medical school in the United States, founded after the Perelman School of Medicine at the University of Pennsylvania and Columbia University College of Physicians and Surgeons.
The founding faculty members of Harvard Medical School were John Warren, Benjamin Waterhouse, Aaron Dexter. Lectures were first held in the basement of Harvard Hall and later in Holden Chapel. Students purchased tickets to five or six daily lectures; the first two students graduated in 1788. In the following century, the medical school moved locations several times due to changing clinical relationships. In 1810 the school moved to Boston at. In 1816 the school was moved to Mason Street and was called the Massachusetts Medical College of Harvard University in recognition of a gift from the Great and General Court of Massachusetts. In 1847, the school was moved to Mason Street to be closer to Massachusetts General Hospital. In 1883 the school was relocated to Copley Square. Prior to this move, Charles William Eliot became Harvard's president in 1869 and found the medical school in the worst condition of any part of the university, he instituted drastic reforms that included raised admissions standards, formal degree program, defined it as a professional school within Harvard University that laid the groundwork for its transformation into one of the leading medical schools in the world.
In 1906, the medical school moved to its current location in the Longwood Medical Area. The Longwood campus's five original marble-faced buildings of the quadrangle are used for laboratories and research space. Harvard Medical School faculty have been associated with a number of important medical and public-health innovations: In mid-1847, Professor Walter Channing's proposal that women be admitted to lectures and examinations was rejected by the President and Fellows of Harvard College. Nonetheless, Harriot Kezia Hunt was soon after given permission to attend medical lectures, but in 1850 this permission was withdrawn. In 1866 two women with extensive medical education were denied admission. In 1867 a single faculty member's vote blocked the admission of Susan Dimock. In 1872 Harvard declined a gift of $10,000 conditioned on medical school admitting women medical students on the same term as men. A similar offer of $50,000, by group of ten women including Marie Elizabeth Zakrzewska, was declined in 1882, a committee of five was appointed to study the matter.
After the medical school moved from North Grove Street to Boylston Street in 1883, professor Henry Ingersoll Bowditch's proposal that the North Grove Street premises be used for medical education for women was rejected. In 1943 a dean's committee recommended the admission of women, the proportion of men and women being dependent on the qualifications of the applicants. In 1945, the first class of women was admitted. By 1972 about one fifth of Harvard medical students were women. In 1850 two black men, Daniel Laing, Jr. and Isaac H. Snowden, were admitted to the school, but they were expelled under pressure from faculty, other students, who objected. In 1968, in response to a petition signed by hundreds of medical students, the faculty established a commission on relations with the black community in Boston. By 1973 the number of black students admitted had tripled, by the next year it had quadrupled. Harvard Medical School has gone through many curricular revisions for its MD program. In recent decades, HMS has maintained a three-phase curriculum with a classroom based pre-clerkship phase, a principal clinical experience, a post-PCE phase.
The pre-clerkship phase has two curricular tracks. The majority of students enter in the more traditional Pathways track that focuses on active learning and earlier entry into the clinic with courses that include students from the Harvard School of Dental Medicine. Pathways students early gain exposure to the clinic through a longitudinal clinical skills course that lasts the duration of the pre-clerkship phase. A small portion of each class enter in the HST track, jointly administered with MIT; the HST track is designed to train physician-scientists with emphasis on basic physiology and quantitative understanding of biological processes through courses that include PhD students from MIT. Admission to Harvard Medical School's MD
Dialectical behavior therapy
Dialectical behavior therapy is an evidence-based psychotherapy that began with efforts to treat Borderline Personality Disorder. DBT has been proven useful in treating mood disorders, suicidal ideation, for change in behavioral patterns such as self-harm, substance abuse. DBT evolved into process in which the therapist and client work with acceptance and change-oriented strategies, balance and synthesize them, in a manner comparable to the philosophical dialectical process of hypothesis and antithesis, followed by synthesis; this approach is designed to help people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts and behaviors to help avoid undesired reactions. A modified form of cognitive behavioral therapy, DBT was developed in the late 1980s by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with borderline personality disorder and chronically suicidal individuals.
Research on its effectiveness in treating other conditions has been fruitful. Research indicates DBT might help patients with symptoms and behaviors associated with spectrum mood disorders, including self-injury. Recent work suggests its effectiveness with sexual abuse survivors and chemical dependency. DBT combines standard cognitive behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance and mindful awareness derived from Buddhist meditative practice. DBT is based upon the biosocial theory of mental illness and is the first therapy, experimentally demonstrated to be effective in treating BPD; the first randomized clinical trial of DBT showed reduced rates of suicidal gestures, psychiatric hospitalizations, treatment drop-outs when compared to treatment as usual. A meta-analysis found that DBT reached moderate effects in individuals with borderline personality disorder. Linehan observed "burn-out" in therapists after coping with "non-motivated" patients who repudiated cooperation in successful treatment.
Her first core insight was to recognize that the chronically suicidal patients she studied had been raised in profoundly invalidating environments, therefore, required a climate of loving-kindness and somewhat unconditional acceptance, in which to develop a successful therapeutic alliance. Her second insight involved the need for a commensurate commitment from patients, who needed to be willing to accept their dire level of emotional dysfunction. DBT strives to have the patient view the therapist as an ally rather than an adversary in the treatment of psychological issues. Accordingly, the therapist aims to accept and validate the client's feelings at any given time, nonetheless, informing the client that some feelings and behaviors are maladaptive, showing them better alternatives. DBT focuses on the client acquiring new skills and changing their behaviors, with the ultimate goal of achieving a "life worth living", as defined by the patient. In DBT's biosocial theory of BPD, clients have a biological predisposition for emotional dysregulation, their social environment validates maladaptive behavior.
Linehan and others combined a commitment to the core conditions of acceptance and change through the principle of dialectics and assembled an array of skills for emotional self-regulation drawn from Western psychological traditions, such as cognitive behavioral therapy and an interpersonal variant, "assertiveness training", Eastern meditative traditions, such as Buddhist mindfulness meditation. One of her contributions was to alter the adversarial nature of the therapist-client relationship in favor of an alliance based on intersubjective tough love. All DBT can be said to involve 4 components: Individual – The therapist and patient discuss issues that come up during the week and follow a treatment target hierarchy. Self-injurious and suicidal behaviors, or life-threatening behaviors, take first priority. Second in priority are behaviors which, while not directly harmful to self or others, interfere with the course of treatment; these behaviors are known as therapy-interfering behaviors. Third in priority are quality of life issues and working towards improving one's life generally.
During the individual therapy, the therapist and patient work towards improving skill use. A skills group is discussed and obstacles to acting skillfully are addressed. Group – A group ordinarily meets once weekly for two to two and a half hours and learns to use specific skills that are broken down into four skill modules: core mindfulness, interpersonal effectiveness, emotion regulation, distress tolerance. Therapist Consultation Team – A therapist consultation team includes all therapists providing DBT; the meeting serves to support the therapist in providing the treatment. Phone Coaching – Phone coaching is designed to help generalize skills into the patient's daily life. Phone coaching is limited to a focus on skills. No one component is used by itself. DBT skills tra
Harvard University is a private Ivy League research university in Cambridge, with about 6,700 undergraduate students and about 15,250 postgraduate students. Established in 1636 and named for its first benefactor, clergyman John Harvard, Harvard is the United States' oldest institution of higher learning, its history and wealth have made it one of the world's most prestigious universities; the Harvard Corporation is its first chartered corporation. Although never formally affiliated with any denomination, the early College trained Congregational and Unitarian clergy, its curriculum and student body were secularized during the 18th century, by the 19th century, Harvard had emerged as the central cultural establishment among Boston elites. Following the American Civil War, President Charles W. Eliot's long tenure transformed the college and affiliated professional schools into a modern research university. A. Lawrence Lowell, who followed Eliot, further reformed the undergraduate curriculum and undertook aggressive expansion of Harvard's land holdings and physical plant.
James Bryant Conant led the university through the Great Depression and World War II and began to reform the curriculum and liberalize admissions after the war. The undergraduate college became coeducational after its 1977 merger with Radcliffe College; the university is organized into eleven separate academic units—ten faculties and the Radcliffe Institute for Advanced Study—with campuses throughout the Boston metropolitan area: its 209-acre main campus is centered on Harvard Yard in Cambridge 3 miles northwest of Boston. Harvard's endowment is worth $39.2 billion, making it the largest of any academic institution. Harvard is a large residential research university; the nominal cost of attendance is high, but the university's large endowment allows it to offer generous financial aid packages. The Harvard Library is the world's largest academic and private library system, comprising 79 individual libraries holding over 18 million items; the University is cited as one of the world's top tertiary institutions by various organizations.
Harvard's alumni include eight U. S. presidents, more than thirty foreign heads of state, 62 living billionaires, 359 Rhodes Scholars, 242 Marshall Scholars. As of October 2018, 158 Nobel laureates, 18 Fields Medalists, 14 Turing Award winners have been affiliated as students, faculty, or researchers. In addition, Harvard students and alumni have won 10 Academy Awards, 48 Pulitzer Prizes and 108 Olympic medals, have founded a large number of companies worldwide. Harvard was established in 1636 by vote of the Great and General Court of the Massachusetts Bay Colony. In 1638, it acquired British North America's first known printing press. In 1639, it was named Harvard College after deceased clergyman John Harvard, an alumnus of the University of Cambridge, who had left the school £779 and his scholar's library of some 400 volumes; the charter creating the Harvard Corporation was granted in 1650. A 1643 publication gave the school's purpose as "to advance learning and perpetuate it to posterity, dreading to leave an illiterate ministry to the churches when our present ministers shall lie in the dust".
It offered a classic curriculum on the English university model—many leaders in the colony had attended the University of Cambridge—but conformed to the tenets of Puritanism. It was never affiliated with any particular denomination, but many of its earliest graduates went on to become clergymen in Congregational and Unitarian churches; the leading Boston divine Increase Mather served as president from 1685 to 1701. In 1708, John Leverett became the first president, not a clergyman, marking a turning of the college from Puritanism and toward intellectual independence. Throughout the 18th century, Enlightenment ideas of the power of reason and free will became widespread among Congregational ministers, putting those ministers and their congregations in tension with more traditionalist, Calvinist parties; when the Hollis Professor of Divinity David Tappan died in 1803 and the president of Harvard Joseph Willard died a year in 1804, a struggle broke out over their replacements. Henry Ware was elected to the chair in 1805, the liberal Samuel Webber was appointed to the presidency of Harvard two years which signaled the changing of the tide from the dominance of traditional ideas at Harvard to the dominance of liberal, Arminian ideas.
In 1846, the natural history lectures of Louis Agassiz were acclaimed both in New York and on the campus at Harvard College. Agassiz's approach was distinctly idealist and posited Americans' "participation in the Divine Nature" and the possibility of understanding "intellectual existences". Agassiz's perspective on science combined observation with intuition and the assumption that a person can grasp the "divine plan" in all phenomena; when it came to explaining life-forms, Agassiz resorted to matters of shape based on a presumed archetype for his evidence. This dual view of knowledge was in concert with the teachings of Common Sense Realism derived from Scottish philosophers Thomas Reid and Dugald Stewart, whose works were part of the Harvard curriculum at the time; the popularity of Agassiz's efforts to "soar with Plato" also derived from other writings to which Harvard students