One way of thinking about procrastination is to regard it as a form of addiction; an addiction to putting things off. As with other addictive patterns, the client will choose a short-term gratification instead of going for a long-term result that might, in the end, be more satisfying or empowering. As with other addictions, a procrastinating client often suffers ongoing erosion of her self-esteem. Quite often, procrastination may function as a defense as a way to avoid other life issues that are disturbing. With this type of problem, we can use a variation of Popky’s addiction protocol, and the level of urge to avoid (LoUA) procedure. It is also important to use resource installation procedures to help the client develop an image of the benefits that would come with being free of this problem.

Feeling the pain of rejection by someone we love is one of the most difficult experiences that we can have as human beings. Often, this terrible feeling is, in part, based on an unrealistic idealization of the lost lover. Eye movement desensitization reprocessing (EMDR) Standard Protocol assists our client in focusing on those aspects of the remembered love relationship that retain the intense positive affect, so that a disinvestment process can occur, and the client can come to see the former relationship more realistically, with all its good and bad aspects. The level of positive affect or (LoPA) score is a scale of 0 to 10 that is used instead of the subjective units of disturbance (SUD) scale for this protocol. When setting up this protocol, the positive representative image, the LoPA for the positively felt emotion, and the location of that number in positive body sensations, are elicited.

When working with ambivalence, it is helpful to identify the two or more sides of the ambivalence, such as the client who wants to work on a disturbing memory but is too afraid. Sometimes, if the client impulsively uses avoidance and is frustrated with her ambivalence, the most accessible point of entry into effectively using eye movement desensitization and reprocessing (EMDR) to process a problem may be to target the feeling of relief associated with avoiding that problem. The procedures for unwanted avoidance defenses script notes were partially derived from Popky’s Desensitization of Triggers and Urge Reprocessing (DeTUR) Protocol for using EMDR to treat addictive behaviors. Usually, when this procedure is used, the level of urge to avoid (LoUA) scores will go down with continuing sets of bilateral stimulation (BLS), until the client spontaneously begins direct targeting of the memory or issue.

The Constant Installation of Present Orientation and Safety (CIPOS) method can be used to extend the healing power of eye movement desensitization and reprocessing (EMDR) to many clients who are potentially vulnerable to dissociative abreaction because of a dissociative personality structure, or because of the client’s intense fear of their own memory material. By constantly strengthening the person’s present orientation through bilateral stimulation (BLS) and carefully controlling the amount of exposure to the trauma memory, the individual is more easily able to maintain dual attention. At the start of the procedure, when the client is most vulnerable to being overwhelmed by disturbance, BLS is not paired with information directly related to the traumatic disturbance. The CIPOS interventions are continued until the client is able to report, using the Back of the Head Scale (BHS), that she is oriented once again toward the present reality of the therapist’s office.

This chapter outlines script in an easy-to-use, manual style template, consistent format for use with eye movement desensitization and reprocessing (EMDR) clients. The scripts distill the essence of the Standard EMDR Protocols. They reinforce the specific parts, and language used to create an effective outcome, and illustrate how clinicians are using this framework to work with a variety of medical related issues while maintaining the integrity of the adaptive information processing (AIP) model. The chapter includes summary sheets for each protocol to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. When there is a repetitive interaction pattern in a client’s life that is difficult to resolve because the codependent behavior in question has become part of the client’s identity or a lifetime way of connecting, it can be helpful to use a protocol that targets this positive affective urge.

This chapter offers practical utility to help expand rehabilitation counselors’ (RCs) and other mental health professionals’ thinking about the various considerations that underlie a culturally competent social justice approach to rehabilitation counseling practice. Rehabilitation counseling has demonstrated its commitment to the importance of cultural competency in improving the quality and availability of counseling and rehabilitation services to clients from traditionally under represented racial/ethnic groups. The chapter describes the multicultural and social justice counseling competencies (MSJCC), with particular attention directed to the social justice framework and how it may be used to assist in working toward equity in the context of changing demographics in American society. It then explains how individual and group racial, sexual identity, cultural, and identity development may impact the counseling process. The counseling literature recognizes LGBTQ individuals as inclusive under the umbrella of multicultural populations, as well as intersecting with other groups because of multiple identities.

The aging population is at a state of development that is not as focused on employment, and thus has difficulty finding its place in a society that defines people by their careers. Research is needed on the issues of aging workers, such as training needs, career transition issues, and retirement planning. Research is also needed on which accommodations, workplace modifications, and changes to policies and practices positively impact the retention and continued productivity of an aging workforce. Counselor practitioners are in a unique position to contribute to needed research design conceptualization, metrics, and analyses to test the multiplicity of interventions we will be exploring in the coming years to keep our aging workforce healthy and intellectually engaged in the employment environment. Counselors are experientially qualified to provide the needed services to keep this population productive and more fully engaged in their communities and continuing employment.