Studies reveal that healthy and functional families exist in virtually all cultures. Health and well-being in these families are an interactive process associated with positive relationships and outcomes. In families, being healthy and well involves ethical accountability, such as promoting good relationships and balancing the give-and-take among members. In regard to health and wellness, one cannot assume that healthy individuals necessarily come from continuously healthy and well-functioning families. Communication is concerned with the delivery and reception of verbal and nonverbal information between family members. It includes skills in exchanging patterns of information within the family system. In fact, highly resilient individuals, who successfully overcome adversities, do well in life. A healthy marriage is complex and multidimensional. Roles in healthy and well-functioning families are clear, appropriate, suitably allocated, mutually agreed on, integrated, and enacted.
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The practice of behavior therapy has many features in common with that of other forms of psychotherapy, for example, the development of a collaborative working relationship between client and therapist. Behavior therapy is distinguished by its use of particular techniques to address specified problems, by its allegiance to psychological experimentation, and by its commitment to empirical validation. In application to the treatment of anxiety and related disorders, behavior therapy drew inspiration from studies of classical conditioning and experimental neurosis. Systematic programs of gradually confronting feared situations therapeutically, in the imagination or in real life, are familiar features of contemporary behavioral practice with anxious clients. Behavioral assessment is designed to provide detailed information that focuses and directs behavioral treatment. Treatment techniques involving self-control and self-management are viable because clients can alter the contingencies affecting their own behavior.
This chapter specifically focuses on violence in the nation’s schools by providing: an overview of youth violence including risk and protective factors, assessment items for preventing violence, and suggestions of intervention/prevention strategies for reducing youth violence and its impact. The professionals involved with the aftermath of violence have specific roles related to severity assessment and determining clinical needs. Counselors should gather information from multiple sources on multiple issues as no one personality profile for a violent youth or target exists. Focusing on behaviors and placing those behaviors in a social-ecological context provides the clearest understanding of potential risk and directs treatment options and modalities. The success of violence prevention programs though can never be perfect. Violence will sometimes still occur, leaving students to deal with the physical, emotional, cognitive, behavioral, and spiritual consequences.
- Go to chapter: Enhancing Client Return After the First Session, and Alternatively Dealing With Early Termination
This chapter explores two separate occurrences in the counseling process: clients who do not return after the first session, and effectively dealing with early termination of counseling. Most practitioners are all too familiar with one or both of these phenomena in counseling and are often left wondering what happened during the process for it to end prematurely or to never begin. The chapter addresses probable reasons why clients do not return following the first session and offers practical strategies regarding how to minimize this occurrence. Professional disclosure provides clients with answers to many questions they might otherwise have about the process, policies, and procedures. Treatment goals and length of treatment will vary depending on counselor theoretical orientation. Cognitive behavior therapy, is usually short term, focusing primarily on symptom reduction through the development of client coping skills and self-efficacy, and less emphasis on the client-counselor relationship.
Trauma-Informed Approaches to Eating Disorders is clearly a much needed and long overdue book about treatment, written by a diverse group of clinicians and carefully edited to focus on the needs and strengths of clinicians. The complexities and challenges that undergird, surround, and even haunt the nature, diagnosis, treatment, management, and understanding of eating disorders (EDs)-in-relation-to-trauma are so great, even for veteran clinicians, that they can leave practitioners at any level of experience feeling helpless and exhausted. This book, in a way that would be appreciated by practitioners of acceptance and commitment therapy, accepts the reality of those feelings and is committed to improving treatment, understanding, and compassion. The book is designed to foster respect for complexity and link it to humility in the presence of tragedy, tribulations, and suffering, framed all too often by our own shortcomings as healers. EDs are dangerous, ubiquitous, usually chronic in nature, and difficult to treat. Anorexia nervosa (AN) has the highest fatality rate (4%) of any mental illness. Bulimia nervosa reveals a fatality rate of 3.9%. EDs offer an enormous challenge to therapists because of their complexity, which includes severe medical risk, co-occurring anxiety, depression and personality disorders, an addiction component, and body image distortion—all of this within a mediadriven culture of thinness in which starving and purging can for some become lifestyle choices. This complexity is further exacerbated by the presence of painful life experiences or trauma. The book elucidates the connection between trauma and EDs by offering a trauma-informed phase model, as well as chapters describing the ways in which various therapeutic models address each of those phases. It offers an in-depth exposition of a fourphase model of trauma treatment.
A national expert on managed care was invited to help explain what counselors were up against as they tried to be recognized as providers on insurance plans. Managed health care plans negotiate lower prices with therapists so that employers can give their employees discounted services. There are three types of managed health care plans: health maintenance organization (HMO), preferred provider organization (PPO) and point of service plan (POS). All licensed counselors who work with insurance and managed care plans must use the national provider identifier (NPI) number when filing an insurance claim. The specter of managed care has caused anxiety and frustration for counselors, but many times the issues can be tackled with an old-fashioned problem-solving approach. A medical billing software system allows the counselor to keep patient information on the computer and send claims directly to a clearinghouse that will format and send the claim to the insurance carriers.
This chapter begins with a discussion of the importance of a clear understanding of psychiatric diagnoses for all allied health professionals. Given the historical prevalence of psychiatric diagnoses, it is a good use of our time to review the seminal diagnostic systems that inform diagnosis in clinical counseling. Clinical counselors and other mental health professionals may be the first health care providers to have established any type of therapeutic relationship with their client, revealing information that previously had never been a focus of any other professionals’ clinical attention. The accurate diagnosis of psychiatric conditions leads to appropriate referrals, selection of the most appropriate evidence-based treatments, and ultimately amelioration or elimination of problematic symptoms that negatively impact health and functioning. The most commonly used diagnostic system for psychiatric conditions worldwide is the International Classification of Diseases (ICD) system.
Perhaps one of the most interesting skills one can learn in working with persons with disabilities is to assess what their mental and physical residual capabilities are in order to transfer these abilities into work skills. This chapter explores and discusses samples of a mental functional capacity evaluation (MFCE) and physical functional capacity evaluation (PFCE), then illustrates how each of these types of assessments may be used in establishing an appropriate work setting for clients with disabilities. MFCE and PFCE tend to be most often used in Social Security court hearings in an effort to determine whether an individual is capable of working at any job commensurate with his or her skills and abilities. The primary difference between both types of evaluations is that MFCEs assess an individual’s cognitive and emotional capacity, whereas a PFCE focuses exclusively on an individual’s physical capabilities.
- Go to chapter: Boats and Sharks: A Sensorimotor Psychotherapy Approach to the Treatment of Eating Disorders and Trauma
Boats and Sharks: A Sensorimotor Psychotherapy Approach to the Treatment of Eating Disorders and Trauma
This chapter presents a case study of a sensorimotor psychotherapy (SP) approach to eating disorder (ED) treatment. In contrast to traditional psychotherapeutic approaches, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT), that lean heavily on the impact of thoughts on emotional experiences and somatic patterns, also known as top-down processing, SP also uses bottom-up processing, the effect that one’s somatic organization has on affect and affect regulation, cognitive functioning and specific beliefs about self and other. The very core of SP is four foundational principles that cultivate therapeutic presence and guide both content and quality of interventions: organicity, nonviolence, unity, body/mind/spirit holism. SP understands human experience through the lens of five core organizers: thoughts, emotions, and three somatic organizers. SP explores actions as a cycle with four stages: clarity, effectiveness, satisfaction, and relaxation.
This chapter conceptualizes the preparation phase in three parts for teaching and learning purposes. The preparation phase of the four-phase model is not a one-and-done event. It is visited and revisited often during the therapeutic journey. The first part of preparation is stabilization, sometimes referred to as case management. It is the sine qua non for the remaining parts. The goal here is to make sure that the client is externally safe, as well as internally stable. A second part of the preparation phase is developing skills and resources. Among these are skills that involve changing internal states (self-soothing) and containment of disturbing affect. The third aspect of the preparation phase focuses on short-term successes in which the client gains mastery and confidence in dealing with changeable life circumstances, something of a personal trainer approach.