This chapter discusses comprehensive school crisis interventions, identifies the characteristics that define a crisis, finds ways to assess for the level of traumatic impact, and determines what interventions can be provided to help with response and recovery. It highlights the PREPaRE Model of crisis prevention and intervention. There are six general categories of crises: acts of war and/or terrorism; violent and/or unexpected deaths; threatened death and/or injury; human-caused disasters; natural disasters; and severe illness or injury. Children are a vulnerable population and in the absence of quality crisis interventions, there can be negative short- and long-term implications on learning, cognitive development, and mental health. Evidence-based interventions focusing on physical and psychological safety may be implemented to prevent a crisis from occurring or mitigate the traumatic impact of a crisis event by building resiliency in students. Crisis risk factors are variables that predict whether a person becomes a psychological trauma victim.
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- Go to chapter: Evidence-Based Interventions for Major Depressive Disorder in Children and Adolescents
Depression is a chronic, recurring disorder that impacts children’s academic, interpersonal, and family functioning. The heritability of major depressive disorder (MDD) is likely to be in the range of 31% to 42%. This chapter begins with a brief overview of the etiology of depression. It presents a description of a cognitive behavioral therapy (CBT) intervention designed to be delivered in a group format, an individual interpersonal intervention, and an individual behavioral activation (BA) intervention that includes a great deal of parental involvement. The ACTION program is a manualized program that is based on a cognitive behavioral model of depression. There are four primary treatment components to ACTION: affective education, coping skills training (BA), problem-solving training, and cognitive restructuring. The chapter concludes with a brief discussion of universal therapeutic techniques to be incorporated into work with depressed youth regardless of the therapeutic orientation or treatment strategy.
Divorce is a lengthy developmental process and, in the case of children and adolescents, one that can encompass most of their young lives. This chapter explores the experience of divorce from the perspective of the children, reviews the evidence base and empirical support for interventions. It provides examples of three evidence-based intervention programs, namely, Children in Between, Children of Divorce Intervention Program (CODIP), and New Beginnings, appropriate for use with children, adolescents, and their parents. Promoting protective factors and limiting risk factors during childhood and adolescence can prevent many mental, emotional, and behavioral problems and disorders during those years and into adulthood. The Children in Between program is listed on the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-Based Programs and Practices. The CODIP and the New Beginnings program are also listed on the SAMHSA National Registry of Evidence-Based Programs and Practices.
Children and youth with serious emotional, behavioral, and social difficulties present challenges for teachers, parents, and peers. Youth who are at risk for emotional and behavioral disorders (EBD) are particularly vulnerable in the areas of peer and adult social relationships. The emphasis on meeting academic standards and outcomes for children and youth in schools has unfortunately pushed the topic of social-emotional development to the proverbial back burner. This chapter emphasizes that social skills might be considered academic enablers because these positive social behaviors predict short-term and long-term academic achievement. Evidence-based practices are employed with the goal of preventing or ameliorating the effects of disruptive behavior disorders (DBD) in children and youth. An important distinction in designing and delivering social skills interventions (SSI) is differentiating between different types of social skills deficits. Social skills deficits may be either acquisition deficits or performance deficits.
Eating disorders (EDs) are a complex and comparatively dangerous set of mental disorders that deeply affect the quality of life and well-being of the child or adolescent who is struggling with this problem as well as those who love and care for him or her. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for the diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or ED. Treatment of eating disordered behavior typically involves a three-facet approach: medical assessment and monitoring, nutritional counseling, and psychological and behavioral treatment. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are also evidence-based approaches to treatment for AN. The treatment of EDs should be viewed as a team effort that integrates medical, nutritional, and mental health service providers.
Asthma, a pulmonary condition, is a chronic respiratory disorder typified by persistent underlying inflammation of tissues, airway obstruction, congestion, hyperresponsive airways, and the narrowing of smooth airway muscle. Asthma is one of the most common chronic medical conditions in children and is the leading cause of school absenteeism. This chapter describes childhood asthma, including its causes and triggers. It elucidates the extant research supporting treatment of the disorder and provides step-by-step empirically based interventions to ameliorate asthmatic symptomatology in children. The psychological underpinnings of asthma have been investigated in the field of psycho-neuroimmunology (PNI), which examines the interplay of the central nervous system, neuroendocrine, and immune system with psychological variables and their relation to physical health. Researchers have shown that relaxation and guided imagery (RGI), written emotional expression, yoga, and mindfulness therapy improve pulmonary lung functioning, decrease rates of absenteeism, and improve overall quality of life.
This chapter reviews the empirical support for such a multifaceted approach by considering selected neurodevelopmental concerns and medical variables that present as obstacles to healthy neurodevelopment. It discusses select neuro-developmental prenatal complications that can be prevented or ameliorated through behavioral interventions with the pregnant mother. The chapter addresses the deleterious effects of legal substances on the developing fetus, but professionals should be vigilant about preventing or reducing intrauterine exposure to illicit substances as well. Tobacco is a legal substance that, when used during pregnancy, has the potential to harm both the mother and fetus. Of particular concern with tobacco use are the detrimental health risks, such as hypertension and diabetes, which adversely affect the cerebrovascular functioning of pregnant women. The process of neurodevelopment is complex and represents a dynamic interplay among genetics, behavior, demographics, the environment, psychosocial factors, and myriad physiological factors.
An individual’s identity development, including his or her preferred gender identity, is a lifelong process, which starts with the earliest interactions with the world. The concepts of gender identity have been explored, studied, debated, and discussed for decades and are currently going through a resurgence of examination, especially in Western cultures. This chapter provides an overview of gender identity development, beginning with an explanation of terms, followed by an exploration of theoretical perspectives which includes cognitive developmental theory, social learning theory, gender schema theory and feminist theory. Topics include current research and perspectives on how gender identity evolves in children and recent shifts in understanding atypical gender identities, including transgender, gender neutral, and gender fluid identification. Finally, implications and strategies for mental health professionals are discussed, especially related to counseling those who are experiencing conflict or distress surrounding issues of gender and gender identity.
Traumatic brain injury (TBI) causes two injury types: primary and secondary. In infants and young children, nonaccidental TBI is an important etiology of brain injury and is commonly a repetitive insult. TBI is by far the most common cause of acquired brain injury (ABI) in children and is the most common cause of death in cases of childhood injury. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) issued validated prediction rules to identify children at very low risk of clinically important TBI, which is defined as TBI requiring neurosurgical intervention or leading to death. The range of outcomes in pediatric TBI is very broad, from full recovery to severe physical and/or intellectual disabilities. Children and adolescents who have suffered a TBI are at increased risk of social dysfunction. Studies show that these patients can have poor self-esteem, loneliness, maladjustment, reduced emotional control, and aggressive or antisocial behavior.
This chapter includes information related to the clinical evaluation of a concussion that a child might receive in a medical setting. It discusses guidelines for appropriate use of smartphone concussion evaluation apps. This chapter examines a brief section on the future of concussion assessment. The Acute Concussion Evaluation (ACE) can help the school concussion team obtain information regarding the injury, including the cause, severity, any amnesia, loss of consciousness (LOC), and any early signs. The computerized neurocognitive assessment typically measures player symptoms, verbal/visual memory, attention span, working memory, processing speed, response variability, nonverbal problem solving, and reaction time. Neurocognitive tests, sideline assessments, and smartphone apps can help district staff and parents determine the severity of a student’s symptoms. A neuropsychological assessment to assess cognitive functioning, memory, speed, and processing time may also be administered.
As everyone knows, true creativity comes from simple formulas and the memorization of data. This chapter focuses on divergent thinking tests, which are still the most common way that creativity is measured. Guilford derived the core ideas behind divergent thinking as well as many popular measures. The people who score the Torrance Tests are specifically trained to distinguish responses that are truly original from those that are just bizarre. There are other tests that measure creativity, but most are either a variation on divergent thinking or use some type of raters. For example, the Evaluation of Potential Creativity (EPOC) has begun to be used in some studies and may be promising, but is still largely rooted in a mix of divergent thinking scoring and raters. Another test is the Finke Creative Invention Task, which is clever but also requires raters for scoring.
The Big Five, which this chapter discusses in more detail, are extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience. Each of these five factors represents a continuum of behavior, traits, and inclinations. There are some popular personality measures that use different theories, such as Eysenck’s Personality Questionnaire, which looks at extraversion and neuroticism as well as psychoticism. The personality factor most associated with creativity is openness to experience. Indeed, one way that researchers study creativity is by giving creative personality tests. Being open to new experiences may also help creative people be more productive. King found that people who were creative and high on openness to experience were more likely to report creative accomplishments. DeYoung and S. B. Kaufman, of course, are not the only people to blend or split different factors of personality to present new models. Fürst, Ghisletta, and Lubart suggest three factors: plasticity, divergence, and convergence.
This chapter explores three ’classic’ studies of creativity and mental illness. The first is Jamison whose focus is on the connection between bipolar disorder and creativity. The second is Andreasen, who used structured interviews to analyze 30 creative writers, 30 matched controls, and first-degree relatives of each group. The writers had a higher rate of mental illness, with a particular tendency toward bipolar and other affective disorders. The third major work is Ludwig, who utilized the historiometric technique. All three studies have come under serious criticism. Many of the studies of Big-C creators are historiometric, akin to Ludwig’s work. Some such studies claim that eminent creators show higher rates of mental illness. A much more common approach is to look at everyday people and give them measures of creativity and mental health. Typically, researchers look at what are called subclinical disorders—in other words, they’re not clinically significant.
One school admissions area that already uses creativity is gifted admissions—which students are chosen to enter gifted classes, programs, or after-school activities. Both education and business play great lip service to creativity. Puccio and Cabra review the literature on creativity and organizations and do a nice job of highlighting how every couple of years, a new report from industry emphasizes the importance of creativity. It is important to note that there is a large inconsistency between gender differences on creativity tests and actual creative accomplishment. Although gender differences on creativity tests are minor or nonexistent, differences in real-world creative accomplishment are large and significant. This chapter shows how creativity can play a role in admissions and hiring. Hiring measures tend to have better validity, even the general mental ability (GMA) measures; even if minorities score lower, the accuracy of prediction is consistent by ethnicity.
Creative people are also often seen as being outsiders and eccentric. Sen and Sharma’s examination of creativity beliefs in India tested beliefs about the Four P’s and found that creativity was more likely to be described as a holistic essence of an individual, and less likely to be focused on the product or process. Romo and Alfonso studied Spanish painters and found that one of the implicit theories that the painters held about creativity involved the role of psychological disorders. Plucker and Dana found that past histories of alcohol, marijuana, and tobacco usage were not correlated with creative achievements; familial drug and alcohol use also was not significantly associated with creative accomplishments or creative personality attributes. Humphrey, McKay, Primi, and Kaufman did find that illegal drug use predicted self-reported creative behaviors even when openness to experience was controlled.
Depression is sometimes referred to as the common cold of psy-chopathology. Consistent with this aphorism, epidemiological studies demonstrate that depressive disorders are indeed rather common across the life span. Given the importance of the social relationships and context to understanding depression, it seems likely that culturally informed and diverse research will yield important findings about those critical components of human cognition, emotion, and social relationships that underlie risk for depression, as well as those that serve to aid in recovery from these disorders. Most researchers believe it is unlikely there is a direct effect of hormones on depression, but rather that they indirectly increase risk via any one of several mechanisms, including: the effects of hormones on brain development, the development of secondary gender characteristics that are generated by these hormones, or the hormonal changes that occur during the pubertal transition may interact with life events and the social context.Source:
Depressive disorders are characterized by etiological heterogeneity, which means that many diverse causal factors or causal pathways can lead to the same clinical outcomes. Women are at higher risk for depressive episodes beginning at early adolescence and then throughout the life span. Unipolar depressive disorders can onset at any point in the life span, but are most prevalent in late adolescence through early to mid-adulthood. Bipolar disorder (BD)s generally onset before mid-adulthood; new cases are rare thereafter. More severe cases of unipolar and bipolar disorders are characterized by a chronic/recurrent course. Both unipolar and bipolar disorders are commonly comorbid with other forms of psychopathology; overall severity and poorer outcome over time is associated with comorbidity. If gender differences are of interest, the effects of potential etiological factors are measured in persons of both genders and their associations with depressive disorders are statistically compared across genders.Source:
This chapter focuses on office automation and systems that are useful in the mental health field, along with principles to be aware of when considering the use or purchase of such systems. Most managers have to rely on input from outside in order to form an opinion about how to resolve complex issues. The complexity of the issue increases significantly when the current federal health care laws are incorporated into the task of choosing appropriate clinical information management software. The significance of Health Insurance Portability and Accountability Act (HIPAA) would seem to dictate at least a brief foray into its content because it lays the foundation for virtually everything that is happening in the clinical information management (CIM) realm. The information provided in the chapter can give a backdrop by which current practices can be examined for goodness of fit with the available client information management systems.
Many developmental models view human growth from a space of lack or abundance, a perpetual fulcrum swinging from the word survive at one end to thrive at the other. This chapter discusses Urie Bronfenbrenner’s bioecological theory of human development to conceptualize female adolescent and young adult development. The contextual focus of this theory provides a global framework for counselors to view young women as individuals who both influence, and are influenced by, their surroundings. Customs, beliefs, and the government all play a role in the development of children and adolescents. When young females overcome the stigma associated with mental health services, they typically seek treatment in one of two primary settings: community mental health centers and schools. Relational-cultural theory (RCT) is an evolving feminist model of human development that views connection to others as essential to growth and disconnection as a major cause of disrupted functioning.
One of the best known psychologists of the 20th century was Jean Piaget. The memory he described was from when he was about 2 years old, a kidnapping attempt in which his nurse tried to protect him. According to the storehouse metaphor, memory is kind of a warehouse. When one remembers an event from one’s life, one looks through this warehouse. Remembering a past event is also a kind of simulation, a simulation of what happened in the past, rather than a veridical reproduction of the past. In fact, our best understanding is that brains are massively parallel simulation devices. Constructive theories deal with filling in gaps at encoding as the event transpires, whereas reconstructive theories deal with filling in gaps at retrieval as one tries to remember the event. When thinking about memory illusions it is important to make a similar distinction.
This chapter describes many of the theories that involve taxonomies. Most taxonomies of love begin in the same place: The language of love is examined, whether through an examination of film, literature, music, or firsthand accounts of people about their love life. The three primary love styles are eros, storge, and ludus. Eros is a passionate kind of love that is characterized by strong emotions and intense physical longing for the loved one. With storge, should the lovers break up, there is a greater chance than with other love styles that they remain friends. Ludus commonly is displayed by people who prefer to remain single and who see love as a game of conquest and numbers. A pragmatic lover hesitates to commit to a relationship until he or she feels confident of finding the right partner. The different love styles also correlate with some other personality traits.
This chapter focuses on an area that has been at the center of the debate between the approaches: processing ambiguous words and sentences. Interestingly, an important factor for ambiguity resolution appears to be the frequency of the different meanings of the ambiguous words. Subordinate- bias effect is as follows: in a neutral, nonbiasing context, words that are balanced cause longer reading times than words that are either unbalanced or unambiguous. Different languages impose different rules about how grammatical categories may be combined. In the garden path model, sentence processing happens in two stages: an initial structure building stage in which the only information that is used is syntactic, and then a second stage in which the structure is checked against semantic and pragmatic information. Constraint-based models take a very different approach to how sentences are initially parsed and how mistakes are sometimes made.
Delirium, also known as acute confusional state, organic brain syndrome, brain failure, and encephalopathy, is a common occurrence among medical and surgical patients and causes extensive morbidity and mortality. This chapter provides an updated review of delirium, including pathophysiological correlates, clinical features, diagnostic considerations, and contemporary treatment options. The defining features of delirium include an acute change in mental status characterized by altered consciousness, cognition, and fluctuations. The chapter explores the risk factors for delirium. These can be divided into two categories: predisposing factors and precipitating factors. Imbalances in the synthesis, release, and degradation in gamma-aminobutyric acid (GABA), glutamate, acetylcholine, and the monoamines have also been hypothesized to have roles in delirium. GABA is the primary inhibitory neurotransmitter in the central nervous system (CNS) and medications such as benzodiazepines and propofol have known actions at GABA receptors and have been associated with delirium.
The researchers were specifically interested in whether they would get more incorrect responses depending on the type of sentence. From a certain perspective, passive sentences are more complicated than active sentences and so perhaps it is the case that passives are more difficult simply because they are more complicated. It appears that the important difference between subject cleft and actives on one hand, and passives on the other, is that the order of the roles is reversed between them: in active sentences, the agent comes first. Indeed, there is a growing body of evidence that languages allow English speakers to structure their utterances in a way that can flag certain parts of the sentence as particularly important or worthy of special attention. Recently, psycholinguists have been interested, too, in how information structure influences language processing.
- Go to chapter: Integrating Theories of Developmental Psychology Into the Enactment of Child Psychotherapy
Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).
This chapter links facets of personality, and other individual differences among people, to aspects of their sense of humor, including the way that they use comedy in their lives and the kinds of jokes they generate and appreciate. The study of personality back in the 1940s had grown quite convoluted. It had started in ancient times, when Hippocrates, of the legendary oath, proposed four temperaments. He thought that personality arose from different proportions of fluids in the body, creating a popular link between personality and physiology. By the late 1800s, Sir Francis Galton, brilliant half-cousin of Charles Darwin and noted polymath, reasoned that any important aspect of personality ought to make it into the language. He fashioned a taxonomy based on a dictionary. Humor and creativity relate to each other in curious ways. But both are also correlated with extraversion and intelligence.Source:
- Go to chapter: A Developmentally Grounded and Integrative Clinical Approach for Treating Complex Trauma and Dissociative Disorders in Children
A Developmentally Grounded and Integrative Clinical Approach for Treating Complex Trauma and Dissociative Disorders in Children
Children are exposed to distress, violence, and trauma even before they are born. In-utero and early childhood exposure can contribute to severe medical and psychological consequences. Children who have been exposed to such traumatic events often arrive at the psychotherapist’s office with emotional and behavioral symptoms suggestive of reactive attachment disorder (RAD), post-traumatic stress disorder (PTSD), and dissociation. This chapter reviews relevant theories of dissociation integrated with theories of development to provide a summary of how attachment impacts dissociation. With a developmentally grounded theory of dissociation, the chapter describes clinical interventions for treating the dissociative sequelae of attachment trauma in children. This theoretical framework offers a developmentally grounded and integrative framework for working with children with complex trauma and dissociation. Symptoms of dissociation are common with PTSD, but an extreme response to trauma can be dissociation and dissociative disorders.
The study of the properties of language can be divided up into roughly five, somewhat overlapping categories: sound system, word structure, sentence structure, meaning, and real-world use. In spoken languages, segments are sounds—each language has a set of sounds that are produced by changing the positions of various parts of the vocal tract. The sound system of language is actually studied in two main parts: phonetics, phonology. Phonemes can be combined to make words, and words themselves have an internal structure and can even be ambiguous based on this structure. Syntax is the study of how sentences are formed. There are two noun phrases (NPs) in the sentence—the artist and a paintbrush. The field of semantics is concerned with meaning in language and can be divided into two major parts: lexical and propositional.
This chapter examines disability identity as a unique area in which the clinician working with individuals with brain injuries must become culturally competent. It begins with an overview of the disability rights movement and its influence on disability identity as a construct. Legislative and regulatory scaffolding for societal responsiveness to and acceptance of individuals with disability exists, but it requires further refinement. Social agencies have been created to support the process of adaptation to disability culture and are attempting to foster development of disability identity through networking resources for employment and socialization. The chapter then discusses critical issues in cultural competence and how these intersect with ethical practice in working with individuals and families with neurorehabilitation needs. It concludes with suggestions regarding cultural competence that transcend individual diagnoses.
Primary progressive aphasia (PPA) is the term applied to a clinical syndrome characterized by insidious progressive language impairment that is initially unaccompanied by other cognitive deficits. This chapter describes several variants of PPA and more than one etiology. It explains three main variants of PPA, namely, semantic Variant of PPA (svPPA), nonfluent/agrammatic variant of PPA (nfvPPA) and logopenic variant of PPA (lvPPA), and also describes criteria for their diagnoses. The defining symptom of PPA is the presence of a language impairment for at least 2 years in the absence of any other significant cognitive problem. Assessment of other cognitive domains is challenging because many tests of memory, attention, executive functioning, and visual-spatial skills rely on language processes in some manner. There are no drug therapies proven to arrest progression of signs and symptoms of PPA due to frontotemporal lobar dementia (FTLD) or Alzheimer’s disease (AD) pathologies.
Coverage of obesity in the popular press has reached a fever pitch in recent years. By far, the most common definition of obesity uses the body mass index (BMI) to determine who is overweight or obese. A person's BMI is a ratio of his or her weight to height. Many times BMI is criticized for the false positives, where very muscular people are deemed to be obese despite ultralow body fat levels. Waist circumference or waist-to-hip ratio (WHR) measures something called “abdominal or central obesity”, a condition that is closely related to negative health outcomes such as cardiovascular disease. The costs to society of obesity and related health issues are tremendous. Women, ethnic and racial subgroups, and those of low socioeconomic status (SES) all display higher rates of obesity than the overall population. Obesity is much more common in certain racial and ethnic subpopulations, as compared with Caucasian Americans.
The idea of the mad genius persisted all the way to modern times and was even promulgated in scientific circles. Not only was genius mad, but it was associated with criminality and genetic degeneration. The empirical research relevant to the mad-genius issue uses three major methods: the historiometric, the psychometric and the psychiatric. The historical record is replete with putative exemplars of mad genius. The mental illness adopts a more subtle but still pernicious guise-alcoholism. In fact, it sometimes appears that alcoholism is one of the necessities of literary genius. Psychopathology can be found in other forms of genius besides creative genius. Of the available pathologies, depression seems to be the most frequent, along with its correlates of suicide and alcoholism or drug abuse. Family lineages that have higher than average rates of psychopathology will also feature higher than average rates of genius.Source:
This chapter talks about questions related to how speakers and hearers influence each other. It looks at research on dialogue, and especially how a dialogue context influences speakers. Speakers have an impact on their listeners. The goal of a dialogue is successful communication and so it would make sense that a speaker would pay careful attention to the needs of a listener and do things like avoid ambiguity and package information in a way that flags particular information as important or new to the listener. Ambiguity may be avoided depending on the speaker’s choice of words and so a natural question is whether, and when, speakers appear to avoid ambiguous language. In terms of pronunciation, speakers reduce articulation and intelligibility over the course of a dialogue. There are some constraints and preferences on how to interpret pronouns and other coreferring expressions that appear to be structural or syntactic in nature.
Dementia is an umbrella term for conditions such as Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), vascular dementia (VaD), and frontotemporal dementia (FTD). Under that umbrella, FTD, also known as frontotemporal lobar degeneration (FTLD), can be further categorized to define a group of neurodegenerative disorders resulting from a progressive deterioration of the cells in the anterior temporal and/or frontal lobes of the brain. More specifically, ventromedial-frontopolar cortex is identified with metabolic impairment in FTD. This chapter elaborates on the history, epidemiology, pathophysiology, clinical features, treatment, and outcomes of FTD. The history and background section of each of the FTD categories highlights the evolution of the disease conceptualization. The FTD subtypes are conceptualized in three categories: neurobehavioral variant, motor variant, and language variant. The chapter illustrates the features of all three categories of FTD.
Neurorehabilitation has become more of a global phenomenon and is not necessarily limited to industrialized or Westernized societies. Culture often connotes concepts of race and ethnicity when discussed in the context of health care disparities. Socioeconomic and other demographic variables make up the majority of the balance on discussion regarding culture in health care. Multicultural neurorehabilitation must emphasis “multiple”, and do so in a dynamic manner. In other words, at any given time, multiple cultures operate in each interaction and in each therapy delivered in the neurorehabilitation setting. Recently, there has been increased interest and research into the newly developing field of cultural neuroscience. Several models are available to conceptualize the influence of culture in human functioning. The most persuasive model is one that mirrors a dynamic, ecological system.
This chapter presents how eye movement desensitization and reprocessing (EMDR) therapy and Theraplay can be used together when treating children with a history of complex trauma. Theraplay focuses on the parent-child relationship as the healing agent that holds within it the potential to cultivate growth and security in the child. The chapter shows some core concepts that help define and illuminate the application of Theraplay. Now that a clear review of basic Theraplay principles has been provided, people need to look at EMDR therapy and the adaptive information processing (AIP) model in conjunction with Theraplay and Theraplay core values. Early in its development, Theraplay integrated parental involvement into its therapeutic model. During the reprocessing phases of EMDR therapy, Theraplay can be very helpful in providing different avenues for emotion regulation and for the repairing of the attachment system.
The concept of Mild cognitive impairment (MCI) makes a lot of sense in that individuals are typically not “normal” one day and “demented” the next. In theory, especially for progressive neurodegenerative conditions, such as Alzheimer’s disease (AD), frontotemporal dementia (FTD), the development of dementia may take months or years. The clinical syndrome of MCI due to AD can be identified via a neuropsychological evaluation or less-sensitive cognitive screening measures. Much of what we are learning about MCI, and therefore refining its diagnostic criteria, is coming from two large-scale studies of cognition and aging: Alzheimer’s Disease Neuroimaging Initiative (ADNI) and Australian Imaging, Biomarkers and Lifestyle (AIBL). According to the most recent research diagnostic criteria for MCI due to AD, evidence of beta-amyloid deposition, neuronal injury, and/or other biochemical changes needs to be seen to increase confidence of the etiology of MCI. Cholinesterase inhibitors remain the primary pharmacological treatment for AD.
This chapter helps readers to understand the main characteristics of the three major types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating. It also examines each disorder from a neurobiological perspective, including genetic factors when known, neuroimaging results, the understanding of neurotransmitter dysregulation, cognitive performance, and various types of treatment. The chapter then presents the consideration of the unique challenges associated with comorbidity, societal pressure, and medical implications. Eating disorders are increasingly common, debilitating, and potentially life-threatening disorders that are clearly linked in their neurobiological basis. Mental health professionals should be aware of the signs and symptoms of eating disorders, as individuals might not disclose their eating habits as readily as their mood, anxiety level, or other symptoms. Treatment is complex, as no medication has been shown to be consistently effective, and each eating disorder will bring with it specific goals.
Unlike laypeople, psychologists believe people can measure personality using reliable scientific tools. Indeed, the whole field of psychometrics is dedicated to measuring differences between people in various psychological concepts, including personality. Personality assessment combines a variety of theories and methods, including common sense, probability theory and statistical testing. Life record data (L-data) deals with a person’s life history or biographical information. The main task of personality psychologists is to demonstrate that the assessment methods they use are, in fact, measuring specific personality traits, and that they are accurately doing so. In recent years, there has been an increased interest in alternative methods for objectively assessing personality. One compelling example is the Implicit Association Test (IAT). An aim of psychophysiological measurement is to elucidate the biological processes underlying factor-analytically derived dimensions of personality. There are several scientific investigations of the reliability and validity of astrology as a tool to assess personality.
This chapter suggests that the dysexecutive syndrome associated with vascular dementia (VaD) is caused by impairment in separate but related cognitive concepts; that is, pathological inertia, mental bradyphrenia, disengagement, and temporal reordering. During the late 19th and early 20th centuries, cerebrovascular dementia was a well-established clinical syndrome. Multi-infarct dementia (MID) generally became associated with all types of vascular syndromes. Recent research suggests the presence of considerable overlap between the neuropathology underlying Alzheimer’s disease (AD) and VaD. Patients diagnosed with VaD tend to produce hyperkinetic/interminable perseverations, suggesting an inability to appropriately terminate a motor response. Other aspects of the dysexecutive syndrome associated with VaD revolve around constructs related to interference inhibition, flexibility of response selection, and sustained attention. From the view point of diagnosis, the neuropathology of VaD often differentially impacts the frontal lobes, whereas the neuropathology associated with AD revolves more around circumscribed temporal lobe involvement.
The multicultural movement in counseling and psychology has begun to provide scholars and practitioners with contextually relevant, systems-based ecological approaches to counseling as alternatives to the traditional theoretical models of human behavior and intervention that are based on Western dominant culture. This chapter provides awareness of the complexity of multicultural issues among individuals with disabilities and discusses culturally sensitive strategies to work with people with disabilities (PWDs). It reviews legislative mandates related to diversity and multiculturalism in rehabilitation and addresses the relationship between disability and culture in the scope of rehabilitation practice. The chapter introduces multiculturalism and multicultural counseling models as a therapeutic framework and provides guidelines to help psychologists increase their cultural sensitivity. It also provides strategies to work with individuals with disabilities from minority backgrounds.
This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.
This chapter integrates elements and strategies of internal family systems (IFS) psychotherapy into eye movement desensitization and reprocessing (EMDR) therapy with complexly traumatized children. It shows a description of healing a part using in-sight with a child. In-sight involves having the client look inside to find and work with parts that he or she sees or senses and describes to the therapist. The IFS therapist starts by ensuring the client’s external environment is safe and supportive of the therapy. In a self-led system, polarizations are absent or greatly diminished, leaving more harmony and balance. However, when and how the self is formed may be seen and conceptualized through different lenses in adaptive information processing (AIP)-EMDR and IFS. According to the AIP model, the human brain and biological systems are shaped by the environmental experiences they encounter.
This chapter presents the most salient psychological theories of personality. Personality is a core determinant of individual differences in everyday behaviors. The chapter discusses the difference between what psychologists broadly refer to as normal and what they regard as abnormal or clinical/mental illness. If one looks for an Elvis among personality psychologists, Sigmund Freud would be the one. During the mid-20th century, behaviorism emerged as a dominant paradigm for understanding human behavior, including personality. Although the social cognitive theory of personality has its origins in the radical behaviorist tradition, it emerged in clear opposition to it. According to the lexical hypothesis, historically, the most important and socially relevant behaviors that people display will eventually become encoded into language. Indeed, personality disorders are defined as long-standing, pervasive, and inflexible patterns of behavior and inner experience that deviate from the expectations of a person’s culture.
Dementia pugilistica (DP) is a form of chronic traumatic encephalopathy (CTE) that involves gross impairment of cognitive and motor functioning due to repetitive blows to the head from boxing. Rapidly increasing in popularity among fight fans and fighters is mixed martial arts (MMA). In the area of sport-related concussion, there are two other frequently used terms that are necessary to distinguish from DP and CTE: postconcussion syndrome (PCS) and second impact syndrome (SIS). The classical clinical signs and symptoms of DP include combinations of dysarthria, incoordination, gait disturbance, pyramidal and extrapyramidal dysfunction, and cognitive impairment. Some media reports about concussion and the potential link between repetitive concussions and long-term problems include eye-catching and emotionally provocative titles. This chapter has provided an overview of the many complex issues surrounding the effects of repeat concussive trauma, particularly in sports.
This chapter differentiates intelligence and related constructs such as creativity and intellectual giftedness, which helps people to better understand each construct. Sternberg proposed a way to classify the various approaches to studying the intelligence-creativity relationship. Guilford’s Structure of the Intellect (SOI) model is probably the most explicit, with divergent thinking specifically identified as one of his five cognitive operations. The relationship between intelligence and giftedness has also received substantial attention. Every gifted education program has a formal assessment procedure to identify potential participants, and creativity assessments are often included in the battery of measures in these identification systems. The Marland Definition suggests that giftedness and talent are manifest in six areas: general intellectual ability, specific academic aptitude, creative or productive thinking, leadership ability, visual and performing arts, and psychomotor ability. It has been extremely influential and is still used by many school districts in their identification of talented students.
The inclusion of parents and family caregivers throughout the phases of eye movement desensitization and reprocessing (EMDR) therapy is essential for best treatment outcome with highly traumatized and internally disorganized children. Parental responses that create dysregulation in the child’s system also appear to be related to the parent’s capacity to reflect, represent and give meaning to the child’s internal world. This chapter shows a case that exemplifies how the caregiver’s activation of maladaptive neural systems perpetuates the child’s exposure to multiple and incongruent models of the self and other. Helping parents arrive at a deeper level of understanding of their parental role using the adaptive information processing (AIP) model, attachment theory, regulation theory and interpersonal neurobiology principals will create a solid foundation. The thermostat analogy is designed to assist parents in understanding their role as external psychobiological regulators of the child’s system.
This conclusion presents some closing thoughts on key concepts discussed in the preceding chapters of this book. The book attempts to contribute to improving children’s lives by providing a comprehensive and effective treatment protocol. To enhance treatment efficacy and improve the trajectory for children’s lives, case conceptualization in child psychotherapy must integrate developmental theory, neuroscience, and best practice models into clinical practice. The book reviews some of the latest research on attachment and neuroscience that impacts case conceptualization in child psychotherapy. In 1989, Shapiro proposed a new treatment approach she entitled eye movement desensitization (EMD) and, later, eye movement desensitization reprocessing (EMDR) to treat trauma. After reviewing the major theories of attachment and Schore’s current rendition that he labels self-regulation theory, the book offers a foundation for therapists to use develop-mentally grounded theory through the lens of adaptive information processing (AIP) to treat attachment issues in clients of all ages.
This chapter shows an overview of the techniques that are used to measure language processing. It shows at the things psycholinguists do when designing experiments in order to ensure that their results are valid. Online measures include any measure considered to give information about language processing as it happens. The prototypical off-line measure is the questionnaire—literally asking people for their judgments about what they’ve just encountered. In fact, all kinds of data can be collected from questionnaire studies. The button press task is perhaps the most versatile of all the things that people can do to collect data involving response times. The conscious responses discussed about here are vocal response. Like eye-tracking, event-related brain potentials (ERPs) help to understand the technique if people know a bit about the response measured—in this case, the brain. In many ways, functional magnetic resonance imaging (FMRI) can be considered the complement to ERPs.
This chapter discusses the social psychology of humor, starting with a walk through how the presence of other people can make things seem funnier. It shows how humor can have a positive or a negative tone and it can focus on ourselves or on those around us. Self-enhancing humor makes stress tolerable. It can keep folks from viewing minor annoyances as unbearable disasters. The chapter sketches how humor can function to maintain the status quo. People who report using self-enhancing humor show less anxiety, neuroticism, and depression; better psychological well-being and self-esteem, and more extraversion, optimism, and openness to experience. When it comes to hierarchies, getting a feel for who’s cracking jokes and laughing can communicate who’s top dog. The chapter finally focuses on gender differences, and then sees how humor contributes to developing friendships, finding a date, and maintaining an intimate relationship.Source:
The genetic causes of obesity are often separated into to two types: monogenic and polygenic. Monogenic obesity refers to forms of obesity that result from very rare mutations in single genes. In the case of polygenic obesity, any single gene susceptibility would have a very small effect, but taken together, the cumulative effect of several susceptibilities leads to a substantially increased risk of obesity. There are many other pieces of compelling evidence for the environmental causes of obesity. The prevalence of obesity in the United States has been the highest in the world, though the prevalence of obesity is rising in both developed and developing nations around the globe as they adopt “Western” lifestyles of decreased physical activity and higher consumption of cheap, calorie-dense foods. There is another theory that “genetic drift” and “predation release” caused obesity to simply become neutral to our ancestors, as opposed to detrimental.
So here the authors are, caught between two worldviews. In one camp, they have educators and academics, attempting to overthrow the “old guard”—those of them who define giftedness through the narrow lens of IQ tests. They are hoping to establish a raison d’etre for gifted education—a field with a wobbly foundation. In the other camp, the authors have parents and the psychologists who specialize in working with the gifted, railing against the externalizing of giftedness. They want the inner world of the gifted to be recognized and appreciated. Controversy has dogged the study of giftedness since its inception, and is likely to continue into the foreseeable future. Multiple views will somehow have to learn to coexist. The psychology of giftedness is a fledgling. An impressive number of people think they know more about the gifted than one does and they are delighted to share their opinions.Source:
This chapter provides a brief historical overview to explain how neuroscience has evolved to what we know it as today. It focuses on the modern history of some of the most relevant aspects of neuroscience. The chapter examines specific, important clinical cases, significant neuroscience milestones, and important treatment modalities that have been implemented and that have led us to this point in our history. Modern neuroscientists have strongly influenced the collective understanding of brain-based functioning and have guided the field to where it stands today. The chapter discusses important ethical considerations in the neurosciences, as well as special areas of focus that generate an increased level of consideration, from the public and often from the media. There are thousands of individual cases that have contributed to neuroscientific understanding throughout history. Examination of behavior and follow-up analysis of brain tissue have helped neuroscientists understand brain-based functioning.
The brain plays a role in influencing the immune system, controlling our sleep, and developing our personality. This chapter provides a straightforward overview of our current knowledge and understanding of normal brain functioning. The nervous system is divided into the central nervous system and peripheral nervous system. The peripheral nervous system communicates with the central nervous system to allow for interaction with the environment. The somatic nervous system is responsible for responding to environmental stimuli by connecting the voluntary skeletal muscles with cells that are responsive to sensations, such as touch, vision, and hearing. It comprises afferent nerve cells that connect the eyes, ears, skin, and skeletal muscles to the central nervous system, allowing sensory information to be transmitted to the brain. Healthy brain functioning requires a multitude of stable neurochemicals, structural anatomy, communication among different brain regions in different hemispheres, and an overall healthy nervous system.
The Transmissible spongiform encephalopathies (TSEs) form a group of illnesses, characterized by a pathological form of the native prion protein, which results in a rapidly progressive neurodegenerative illness. They also are responsible for Gerstmann-Strâussler-Scheinker (GSS) syndrome and fatal familial insomnia (FFI), and they have been produced experimentally in several other animals. Creutzfeldt-Jakob disease (CJD) is the most common TSE in humans. Human prion diseases have three etiologies: (a) sporadic, (b) genetic, and (c) acquired. Human prion diseases are important to understand because of their underlying pathophysiology, public health implications, and clinical features that often result in misdiagnosis. This chapter reviews the historical discovery of prion diseases and the formulation of the prion hypothesis. It explores prion hypothesis and the neuropathogenesis of prion diseases. The chapter ends with a description of the diagnosis, prognosis, and experimental treatment of human prion diseases.
This chapter describes spirituality, religiousness, and indigenous/folk belief systems in a multicultural context. The majority of religion and health research to date has primarily focused on persons with life-threatening diseases and conditions, as persons facing death may use religion to help them accept their condition, come to terms with unresolved life issues, and prepare for death. In contrast, rehabilitation patients who suffer acute injuries or chronic progressive disorders may live for decades after the onset of their condition and use religious and spiritual resources to help them cope with their disability, give new meaning to their lives based on their newly acquired disabilities, and help them to establish new goals. The chapter then explains the different ways rehabilitation psychologists can address religious and spiritual beliefs with individuals from different faith traditions.
This chapter provides some questions and answers so that people can see for themselves. Most theories of love predict that, as time goes on, the passion in a relationship will begin to falter. According to the triangular theory of love, passion is the quickest component of a relationship to develop but also the quickest to die down. If they always need the thrill of the early days of a relationship, they may find themselves flitting from one relationship to the next without ever experiencing any deeper satisfaction. A mismatch of stories is not as obvious as disagreement over political beliefs, the desire to have children, or religious affiliation, but it can be just as challenging to a relationship. When people end serious relationships, they often go through a period in which they are just not ready to enter a new relationship.
Psycholinguist is someone who studies phenomena in the intersection of linguistics and psychology. The whole endeavor of psycholinguistics often finds a home in the broader research field of cognitive science—an interdisciplinary field that addresses the difficult question of how animals, people, and even computers think. The centrality of language in the daily lives means that any disruption to the ability to use it may be keenly felt—the worse the disruption, the more devastating the impact. From the beginning of psychology, there has been an interest in language. In psychology, behaviorism was a movement in which the study of mental states was more or less rejected, and the idea that one could account for human behavior in terms of mental states or representation was discounted. This book covers a number of topics that are very much relevant in current psycholinguistics, including child language acquisition, sign language, language perception, and grammatical structure.
Dementia with Lewy bodies (DLB) is a clinical syndrome characterized by progressive dementia, cognitive fluctuations, visual hallucinations (VH), and parkinsonism. In 1961, Okazaki, Lipkin, and Aronson reported two patients with dementia and parkinsonism with cortical neuronal inclusions similar to the brain-stem Lewy bodies (LB) seen in Parkinson’s disease (PD). LBs are intra-cytoplasmic neuronal inclusions containing α-synuclein and ubiquitin. There are other associated pathological features in DLB such as spongiform change neuronal loss, and Alzheimer’s disease (AD) pathology includes amyloid plaques and neurofibrillary tangles (NFTs). DLB and other entities such as PD and multiple system atrophy (MSA) have been grouped under the term synucleinopathies due to the existence of α-synuclein inclusions in the brain. The central feature required for a diagnosis of DLB is the presence of dementia: a progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational function.
Most school-based interventions aimed at preventing obesity have focused on a few key areas: improving the food offered in school, increasing opportunities for physical activity, health and nutrition education curricula, and screening youth for overweight and obesity. Positive effects on physical activity are encouraging because developing good habits early may help prevent obesity later in life. Many obesity prevention programs have looked at adding health, nutrition, and physical education courses to the school day. One initiative that has been proposed is to screen children and teens for obesity in schools, similar to the hearing and vision screenings that already take place. Some schools also collect body mass index (BMI) data on students for surveillance purposes, where information is anonymous and used to track whether certain school policies are effective in reducing rates of obesity for the school, district, or state as a whole.
To truly understand how important and central memory is to us, it is important to understand what life is like for people who experience memory loss, or amnesia. This chapter examines the amnestic syndrome, which has been widely studied and the knowledge of which has significantly influenced theories of memory. The abilities and nonabilities of those with amnestic syndrome demonstrate that there are multiple independent systems of memory. The chapter also examines two controversial diagnoses, the main feature of which is memory loss dissociative identity disorder (DID) and psychogenic or dissociative amnesia. It discusses a form of memory loss that does not fit the technical definition of amnesia because it eventually affects not just memory but all cognition: Alzheimer’s disease (AD). AD is common among older adults and demonstrates how a worsening loss of memory and cognition can lead to a complete disruption of everyday life.
- Go to chapter: Toolkit #3—Healthy Thinking and Positive Imagery: Overcoming Negative Thinking and Low Motivation
This chapter explains the third toolkit, Healthy Thinking and Positive Imagery, and addresses two significant barriers to effective problem solving: that of negative thinking and feelings of hopelessness. The two activities in this toolkit to help people overcome negative thinking habits include: the “ABC” model of healthy thinking, and reverse advocacy role-plays. The “ABC Model of Healthy Thinking” was introduced as a means by which to better identify one’s negative thinking in order to eventually dispute such inaccuracies with more positive self-statements. A second tool to help individuals overcome their negative thinking involves an in-session role-play procedure and is aimed at helping patients change their maladaptive beliefs and distorted perceptions of external stimuli. Other potential barriers to coping effectively with stressful problems are feelings of hopelessness and poor motivation characteristic of a negative problem orientation.
Rehabilitation providers who work with service members and veterans face significant cultural challenges that may impact the rehabilitation process. Part of this challenge is maintaining an awareness that any individual engaged in rehabilitation could have had prior military service that could impact rehabilitation care. This chapter provides an overview of military culture, including specific aspects of this culture that may affect the rehabilitation process, the various co-occurring disorders that are common in military/veteran populations, and resources and programs that are particularly useful when working with service members and veterans. Service members and veterans face unique challenges and stressors that are over and above some of the routine sources of stress that others face in the workplace. Stress can come from participating in combat, including exposure to traumatic events, risk of injury, and fears about deployment.
This chapter describes an overview of the procedures that a neuropsychologist may apply to a range of similar referrals in the area of civil capacities. It explores the presentation of a framework developed by the American Bar Association/American Psychological Association (ABA/APA) working group on capacity issues and provides more specific guidance regarding assessment tools. Decision making is a complex cognitive process that involves multiple brain regions and brain systems. Injuries to the prefrontal cortex are common in dementia and are often linked to changes in decision-making abilities. Key differences between clinical assessments and those for capacity evaluations include knowledge of relevant legal and ethical issues, a functional assessment, and an ability to present neuropsychological data to lay readers. Research on medical consent capacity and financial capacity highlight the importance of the assessment of calculation, executive function, and verbal memory as part of any test battery.
This chapter presents several strategies, analogies, and metaphors to address dissociation from different angles and perspectives. Clinicians will have a wide range of methods of introducing and explaining dissociation to children. Analogies and stories that help children understand the multiplicity of the self may be presented during the preparation phase of eye movement desensitization and reprocessing (EMDR) therapy. A good way of introducing the concept of dissociation is by using the dissociation kit for kids. Stimulating interoceptive awareness is a fundamental aspect of the work needed during the preparation phase of EMDR therapy with dissociative children. Visceral, proprioceptive, as well as kinesthetic-muscle awareness should be stimulated. The installation of present resolution (IPR) was inspired by an exercise developed by Steele and Raider. In this exercise, the child is asked to draw a picture of the past traumatic event followed by a picture of the child in the present.
In our success-oriented culture, optimal development of giftedness often is construed as fulfilling one’s potential for greatness. In humanistic psychology, optimal development has been conceptualized differently. Self-realization can be understood in terms of Maslow’s self-actualization, Dabrowski’s secondary integration, Jung’s individuation, or other theoretical perspectives of human development. The goals of inner development involve deepening the personality, overcoming conflicts, and actualizing one’s potential for becoming one’s best self. Many parents of the gifted complain that their children are the ones exerting the pressure. Their speed of learning and quest for knowledge often exceed their parents’ comfort level. The purpose of parent guidance is to foster “optimal development” through early intervention and prevention of social and emotional problems. Assessment can act as a prelude to family therapy. Family therapy usually involves a commitment to several successive sessions to deal with family interactions.Source:
This chapter focuses on the modulatory role of the neuropetides in attachment as well as autonomic regulation, discussing sympathetic and parasympathetic arousal, particularly dorsal vagal and ventral vagal regulation as suggested by polyvagal theory. The probable role of the endogenous opioid system in the modulation of oxytocin and vasopressin release is discussed with a view toward the elicitation of both relational and active defensive responses are reviewed. Porges’ Polyvagal Theory delineates two parasympathetic medullary systems, the ventral and dorsal vagal. Brain circuits involved in the maintenance of affiliative behavior are precisely those most richly endowed with opioid receptors. Avoidant attachment is commonly associated with parental figures that have been rejecting or unavailable and refers to a pattern of attachment where the child avoids contact with the parent. The similarity of severe posttraumatic presentations to autism suggests that the research with regard to social affiliation in autism spectrum.
This chapter explores how a love researcher goes from having a conception or even a theory of love to actually constructing a love scale. A love scale provides a way to test the validity of a theory. A love scale enables couples to assess one aspect of their compatibility. A love scale provides individuals and couples an opportunity to enhance their love relationships. The one important thing to remember is that as measuring instruments love scales are far from perfect. Love scales are no different from scales for measuring intelligence or personality. An investigator might simultaneously measure intimacy with the intimacy subscale of the Triangular Love Scale and observe a couple in interaction, looking for behaviors signifying trust, caring, compassion, and communication. No scientist today believes that it is possible to capture the entire phenomenon of love through scientific study or through scales that are geared to measure love.
During the installation phase, the child can experience a felt positive belief about himself or herself in association with the memory being reprocessed. Children with history of early and chronic trauma have difficulty tolerating positive affect. Enhancing and amplifying their ability to tolerate and experience positive emotions and to hold positive views of the self are pivotal aspects of eye movement desensitization reprocessing (EMDR) therapy. This chapter shows a script that may be used with children during the body scan phase. Assisting children in achieving emotional and psychological equilibrium after each reprocessing session as well as ensuring their overall stability are fundamental goals of the closure phase of EMDR therapy. The reevaluation phase of EMDR therapy ensures that adequate integration and assimilation of maladaptive material has been made. The future template of the EMDR three-pronged protocol is a pivotal aspect of EMDR therapy.
Chronic alcohol use has been related to various linked disorders when used in excess, particularly when this excessive use becomes chronic. It is important for clinicians to clarify the amount and type of alcohol being consumed and the frequency of this consumption when considering its potential role in any neuropsychological profile. The most commonly reported terms found in the literature include alcohol-induced persisting dementia (APA), alcohol-related dementia, and Korsakoff’s syndrome (KS). This chapter provides some synthesis of this literature to offer some clarity on cognitive dysfunction as it relates to alcohol and the manifestation of dementia as a result of chronic use, including discussion of the classic KS and related presentations. Alcohol dependency is commonly associated with a number of neurological impairments including deficits in abstract problem solving, visuospatial and verbal learning, memory function, perceptual-motor skills, and even motor function.
- Go to chapter: The Effects of Acculturation on Neuropsychological Rehabilitation of Ethnically Diverse Persons
This chapter explores the impact of acculturation on three diverse U.S. populations: Hispanics, represented by a specific focus on Mexican immigrants; African Americans; and Native Hawaiians. It reviews relevant acculturation theories developed to explain cultural and psychological changes occurring in racial and ethnic populations in the United States as a result of interactions with the majority racial/ethnic population. The chapter presents Berry’s model of acculturation in particular, as a helpful theoretical model for clinicians working in neuropsychological rehabilitation to use for understanding psychological issues related to acculturation pressures. It also highlights the unique historical context of acculturation for each ethnic group and its effect on their acculturation experience as well as mental and physical health outcomes. The chapter provides rehabilitation psychologists and counselors with culturally relevant assessment and intervention recommendations for working with ethnically diverse clients.
The primary goals of the assessment phase are to access the memory network containing traumatogenic material and to access and activate the cognitive, affective, and somatic aspects of the memory. Since the reprocessing phases of eye movement desensitization and reprocessing (EMDR) therapy follow immediately after the assessment phase, the clinician should have prepared potential interweaves in case the child’s processing of the memory gets blocked. Children with complex trauma histories may already have sensitized sympathetic systems that make them prone to being in fight flight mode even in the face of safety. The chronically traumatized children present with sensitized dorsal vagal systems. Current caregiving and attachment behaviors have the potential for activating the attachment system, and with it past dysfunctional attachment experiences. One of the best adjunct approaches that can be used within a comprehensive EMDR treatment is sandtray therapy.
- Go to chapter: Overview of the Problem-Solving Therapy Process, Introductory Sessions, and the Case of “Megan”
This chapter presents the therapy manual detailing the specific treatment guidelines encompassing problem-solving therapy (PST). It is important during the initial sessions with a new client to develop a positive therapeutic relationship. Upon obtaining a brief version of the client’s story, it becomes important early in treatment to provide an overview of PST that includes a rationale for why it is relevant to, and potentially effective for, this individual. Problem solving can be thought of as a set of skills or tools that people use to handle, cope with, or resolve difficult situations encountered in daily living. Research has demonstrated that social problem solving is comprised of two major components. The first is called problem orientation. The second major component is one’s problem-solving style. The chapter also presents the case of a 27-year-old woman suffering from multiple concerns, including anxiety, depression, fears of “going crazy”, and prior alcohol abuse.
The incorporation of a skill-building phase and eye movement desensitization reprocessing (EMDR) games can greatly enhance and facilitate the utilization of EMDR therapy with children who have a history of complex trauma. Some EMDR games work with cognitive skills, others work with emotional skills, while others work with the body and the language of sensation. The use of positive cognition cards offers a great opportunity to play and use a wide range of card games. This chapter exemplifies how to use negative cognition games. Feeling cubes contain different basic emotions appropriate for children. Clinicians can purchase plain wooden cubes and write different feelings on the cube. A wide range of card games can be used with the feeling cards. The memory wand offers another playful approach to the process of identifying traumatic events with children. The chapter shows a playful way of exploring and identifying parent-child interactions.
This chapter focuses on the whole life span of a relationship. It reviews some of the kinds of love and discusses how researchers understand the temporal course of those kinds of love. The chapter considers the effects of cohabitation on couples and what happens as these couples move on to marriage. It also discusses mechanisms that help or hinder couples in the maintenance of their relationships. The chapter examines the usual means of ending relationships: breakup and sometimes divorce. Compassionate love has been called “pure love”, “selfless love”, and “altruistic love”, as well as many other things. It features prominently in religion as well as in literature about love, and often can be found in caregiving relationships. A negative relationship also existed between cohabitation and marital quality. Edenfield and colleagues conducted a study that relates these relationship maintenance strategies to adult attachment styles.
The basic goals of phase one are to develop a working relationship and a therapeutic alliance and to determine if the level of expertise of the eye movement desensitization and reprocessing (EMDR) clinician is adequate for the complexity of the case. Other goals are to develop a comprehensive treatment plan and case formulation. EMDR therapy was developed as a form of treatment to ameliorate and heal trauma. Clinicians working with complex trauma must have substantial understanding of the adaptive information processing (AIP) model and the EMDR methodology. During phase one, the clinician works on creating an atmosphere of trust and safety so a therapeutic alliance can be formed with the child and the caregivers. This chapter shows an example of how medical issues can affect the quality of the parent-child communications. The adult attachment interview (AAI) gives us the view of the presence of the experiences in the parent’s life.
This chapter focuses on identifying and working with dissociative symptoms and dissociative disorders in a therapeutic context, providing a road map to assist with the pacing and planning of clinical interventions. Rapid eye movement (REM) sleep can be conceptualized as a household strength processor that can accommodate the usual processing requirements of daily life. Posttraumatic stress disorder (PTSD) has been historically defined as requiring a trauma that is outside the range of normal human experience. Hypoarousal and parasympathetic activation that are an intrinsic part of dissociative symptoms are much more difficult to assess. The original painful memories live on in flashbacks and nightmares as well as in reenactments of the unconscious dynamics captured from the family of origin’s enactments of perpetration, victimization, rescuing, and neglect. Excessive sympathetic nervous system activation is easily construed to be an indicator of psychopathology.
This chapter reviews the disturbances in self-referential processing and social cognition in posttraumatic stress disorder (PTSD) related to early-life trauma. It talks about the neural underpinnings of self-referential processing and examines how they may relate the integrity of the default mode network (DMN). The chapter describes the deficits in social cognition, with a particular focus on theory of mind in PTSD and the neural circuitry underlying direct versus avert eye contact. It then addresses the implications for assessment and treatment. Johnson demonstrated that self-referential processing is associated with the activation of cortical midline structures and therefore overlaps with key areas of the DMN in healthy individuals. Healthy individuals exhibited faster responses to the self-relevance of personal characteristics than to the accuracy of general facts. Less activation of the medial prefrontal cortex (PFC) was observed for the contrast of self-relevance of personal characteristics relative to general facts as compared to controls.
This chapter explores multicultural variables to consider when providing neurorehabilitation services to inpatients in an acute neurorehabilitation center. It presents case studies of inpatients who have recently suffered brain injuries, strokes, and other conditions that have led to acute and/or chronic disability and potential cognitive changes. The acute and/or chronic disability and potential cognitive changes are in need of physical, occupational, and speech therapy to address declines in functioning due to cognitive changes and physical disability, as well as medical treatment to manage secondary conditions. The chapter then looks at several cases that involve clinicians working with patients and families from diverse backgrounds and of varying English-speaking abilities. It examines how culture, education, religion, and language may affect the clinical evaluations of patients in acute neurorehabilitation settings and at a clinician’s experience in providing multicultural neurorehabilitation.
Child psychotherapy is different than any other type of adult-child relationship. A trained mental health professional is using clinical skills to help a child find the answers to the problems he or she has encountered. This chapter outlines the most common symptoms in child psychotherapy. Anxiety is one of the most common symptoms of childhood, but the etiology and manifestation of anxiety varies. Anxiety is a symptom of many other disorders, including generalized anxiety disorder (GAD), separation anxiety, obsessive-compulsive disorder, panic disorder, social phobia and other specific phobias, selective mutism, mood disorders, and post-traumatic stress disorder. Gifted children tend to have higher levels of anxiety because they can think about things they are not yet emotionally prepared to manage. The chapter discusses clinical interventions for common issues of childhood, along with resources for children, directions for parents, and references for parents, caregivers, educators, and therapists alike.
This chapter discusses the implications of using personality inventories in the context of identifying bad or problematic traits, such as narcissism, machiavellianism, and psychopathy. Evolutionary theory states that behaviors, traits, and genetic materials survive only if they are adaptive to the environment the organism finds itself in. As evidence has revealed, conduct disorder in children is a good marker for predicting psychopathy and antisocial outcomes in later years. Although personality tests are rarely used for the purpose of educational selection, scores on these tests correlate with several educational performance outcomes. The chapter examines current trends in online personality profiling in the context of consumer behavior. The market for online dating is huge and growing and an increasing number of single individuals subscribe to these services in order to find their ideal partners. Faking is an important criticism as many organizations will ask new applicants to undergo a personality assessment.
- Go to chapter: Integrating Theories of Developmental Psychology to Form a Comprehensive Approach to Treatment
This chapter explores theories of human development, also referred to as developmental psychology, as a knowledge base for professionals to integrate theory into case conceptualization in child psychotherapy. It provides a brief overview of the significant contributions of developmental psychology to the field of child psychotherapy that impact case conceptualization in the clinical treatment of children. Many theorists have shaped the study of human development, including Buford Jeanette Johnson, Anna Freud, Jean Piaget, Lev Vygotsky, Urie Bronfenbrenner, Erik Erikson, Jerome Kagan, John B. Watson, B. F. Skinner, Albert Bandura, Lawrence Kohlberg, Jerome Brunner, Robert J. Havighurst, and Emmy Werner. Collectively, their theories propose explanations of all aspects of human development, including psychosexual, cognitive, social, psychosocial, behavioral, and neurological development, along with memory, information processing theories, and resilience. The chapter includes educational theory in order to understand how children are challenged to learn not only internally, but also externally, as well.
Intelligence is a hypothesized quality whose ontology, etiology, and scale must be inferred through indirect means. Personal definitions of intelligence are not the same as constructs of intelligence. Psychological constructs are highly technical, painstakingly crafted, and subjected to rigorous theoretical examination and empirical testing. Intellectual abilities are organized at a general level into two general intelligences, viz., fluid intelligence and crystallized intelligence. Intelligence is the sum total of all cognitive processes. It entails planning, coding of information and attention, as well as arousal. Given his personal history and society’s attitudes toward heredity, that Galton concluded that the development of genius, must be understood in terms of hereditary processes. The chapter concludes with two tables presenting definitions of intelligence provided by several prominent historical and living intelligence theorists. They convince readers that human intelligence is a fascinating and complex subject, and to provide a foreshadowing of many of the essential issues.
International Society for the Study of Trauma and Dissociation (ISSTD)’s professional training institute offers comprehensive courses on childhood dissociation that are taught internationally and online. This chapter briefly cites some of the theories that have emerged in the dissociative field. One system, the apparently normal personality (ANP) enables an individual to perform necessary functions, such as work. The emotional personality (EP) is action system fixated at the time of the trauma to defend from threats. As with the Adaptive Information Processing Model (AIP) in eye movement desensitization and reprocessing (EMDR), each phase brings reassessment of the client’s ability to move forward to effectively process trauma. There are many overlapping symptoms with Attention Deficit Hyperactive Disorder (ADHD) and dissociation that often mask the dissociation. The rate of diagnosis of pediatric bipolar disorder has increased 40 times in the last ten years.
This chapter suggests some new directions that personality research is, or should be, taking as well as the future agenda of this research. In contrast, personality psychology provides us with a solid evidence base that people can lean on when searching for answers about human nature. Personality refers to the stable and consistent patterns we observe in how people behave, feel, and think. Associations between personality and intelligence have been found on the measurement level and hypothesized at a conceptual level. It is supposedly human nature not to trust humankind to provide the unselfish responses in questionnaires, or to possess an adequate level of self-awareness. Admittedly, this trend has been changing. An increasing number of organizations are using self-report personality measures and even laypeople seem to accept the notion of questionnaires more kindly than before.
- Go to chapter: A Problem-Solving Approach to Understanding Psychopathology: A Diathesis-Stress Model
This chapter provides an overview of a conceptual model that explains the role that social problem solving (SPS) plays regarding adaptive versus maladaptive reactions to stressful life events, both major and minor in nature. This model describes the interplay among three related systems, each of which provides for a level of analysis regarding stressful events, problem solving, and health/mental health outcomes. System I is a distal system and represent the first level of analysis that focuses on the relationship between certain genetic factors and early childhood life stress. System II, the proximal system, focuses on later life and the interactions among major negative life events, daily stressors, and various neurobiological systems that are etiologically related to extant distress. The third system, System III, is the more immediate level of analysis and represents a more microanalytic perspective that addresses the interactions among stressful stimuli, various brain components, and emotions.
Frontotemporal dementia (FTD) is the third leading cause of dementia in large pathological series but tends to have an earlier age of onset than Alzheimer’s disease (AD) and Lewy body dementia, the most frequent and second most frequent forms of dementia. Semantic dementia (SD) includes impairment in the understanding of the meanings of words and difficulty in identifying objects. Semantic primary progressive aphasia, also known as SD, includes difficulties with naming and single-word comprehension although grammar and fluency are often spared. SD is a disorder that involves loss of semantic memory, anomia, receptive aphasia, and an actual loss of word meaning. The chapter presents some assessment tools that are those conducted by a psychologist or a neuropsychologist. Such an evaluation should include a clinical interview and neuropsychological examination. SD has been associated with ubiquitin-positive, TAR-DNA-binding protein-43 (TDP-43)-positive, tau-negative inclusions.
Alzheimer’s disease (AD) and related cortical dementias are a major health problem. Patients with AD and related dementia have more hospital stays, have more skilled nursing home stays, and utilize more home health care visits compared to older adults without dementia. This chapter discusses the role of family caregivers and how they interact with in-home assistance, day care, assisted living, and nursing homes in the care of an individual with dementia. It also discuss important transitions in the trajectory of dementia care, including diagnosis, treatment decision making, home and day care issues, long-term care placement, and death. It highlights the importance of caregiver assessment, education, and intervention as part of the care process. Dementia caregivers are at risk of a variety of negative mental health consequences. Another important moderating variable for dementia caregiver distress is self-efficacy.
This chapter focuses on educational purposes for the promotion of research. It helps the practitioners to study the available evidence and use professional discretion in their prescribing decisions, being fully aware of known potential risks as well as benefits. The literature describes the use of opioid antagonists in a number of different disorders, some of them traumatic stress and attachment-related disorders, as well as dissociative disorders. Self-injurious behavior is common in the more severe traumatic stress syndromes. It also happens to be one of the diagnostic criteria of borderline personality disorder (BPD), a diagnosis that has been associated with childhood abuse and attachment conflicts. Pathological gambling is thought to provide rewards through endogenous opioid effects on the mesolimbic dopamine system. Fibromyalgia is a chronic pain disorder that is thought to result from the type of autonomic system dysfunction to which traumatic stress disposes.
In theory, the construction of an autobiographical memory begins with a retrieval model being generated in the brain. This retrieval model activates general knowledge about the self, which is used to retrieve episodic memory details consistent with the desired memory. Autobiographical memory is a complicated skill that results from the union of episodic memory and an abstract concept of self laid out over time. This transformation of episodic into autobiographical memories results in forgetting of some incidents, and mashups the details from two or more separate incidents into a single memory that feels like it happened to the self at a particular point in time. Autobiographical memory is said to serve at least three important functions: identity, directive, and social. Autobiographical memories also serve as guides for future behavior. A function of autobiographical memory is to create and strengthen bonds between people.
Vascular dementia (VaD) is an umbrella term representing a clinical grouping with inherent heterogeneity in its clinical manifestations reflecting a variability in its underlying etiology. This chapter discusses specific presentations that can fall under the VaD heading. It includes discussion of multi-infarct dementia (MID) and dementia associated with lacunar states (LSs), as well as Binswanger’s disease (BD), which remains embroiled in controversy. The chapter discusses cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and moyomoya disease due to their clinical overlap. The etiology of MID is in many ways the same as the etiology of cerebrovascular disease (CVD) in general and even late-life dementia. The term MID itself is used to describe a disorder characterized by a stepwise deterioration of cognitive functioning associated with strokes or accumulated transient ischemic attacks (TIAs).
Desensitization is a complex and important phase of eye movement desensitization reprocessing (EMDR) therapy. This chapter covers child-friendly strategies and interweaves that support and stimulates the social engagement system, maintain dual awareness and kindle children’s integrative capacities. It presents advanced strategies and interweaves that can facilitate the assimilation of memories of trauma and adversity as well as to promote vertical and horizontal integration. Shapiro developed a strategy to jump-start blocked processing that she called ‘the cognitive interweave’. According to Shapiro, clients spontaneously move through the three plateaus of information processing: responsibility, safety, and control/power, to a more adaptive perspective during reprocessing. Most children injured and traumatized in the adult-child relationship carry within the responsibility of the event. Mindful awareness in EMDR is pivotal during the reprocessing phases. The use of nonverbal communication strategies can greatly facilitate the process for children working on memories of events occurring pre-verbally.
The ideas of Aristotle, Socrates, and Plato all contribute to the foundation of our understanding of the nature of human intelligence. Their ideas on topics as diverse as the origin of ability, the mind-body relationship, and general inquiry methods continued to inspire thinkers centuries later and influenced those who shaped modern psychology and intelligence theory. This chapter provides an overview of recent research on how people’s beliefs about intelligence impact their behaviors, a body of research that has significant implications for education. The emergence of reliable genetic and neurological research methodologies is creating a new area of study in which environmental, biological, and psychological facets of intelligence are studied simultaneously. Structure of Intellect (SOI) model represents a very different approach to theories of intelligence. Recent technological advances have encouraged explorations into the relationship between brain function and specific types of cognitive functioning.
This chapter provides information for therapists to integrate theories of neuroscience into the practice of child psychotherapy. Neuroscientists have described how the brain develops, documented the impact of external experiences on the developing brain, and integrated theories of neurodevelopment and neuroplasticity into our understanding of the impact of our interpersonal relationships on our brain. The chapter focuses on developmental trauma disorder and the research on the impact of trauma on children. The majority of the research on trauma in children has focused on the assessment and diagnosis of Post traumatic stress disorder (PTSD); however, there are a limited number of studies that have documented the efficacy of the treatment of PTSD in children. The chapter reviews diagnoses specific to neurodevelopment, including autistic spectrum disorders (ASD) and sensory processing disorders (SPD).
The work directed toward increasing the child’s ability to tolerate and regulate affect, so that the processing of traumatic material can be achieved, is initiated during the preparation phase. The process of providing the neural stimulation to improve the child’s capacity to bond, regulate, explore, and play should begin during the early phases of eye movement desensitization and reprocessing (EMDR) therapy. The Polyvagal theory presents a hierarchical model of the autonomic system. In complexly traumatized children, the development of this system has been compromised due to the early dysregulated and traumatizing interactions with their environments and caregivers. When describing the various forms of bilateral stimulation (BLS), go over the different options and practice with the child. If the child went through the calm-safe place protocol successfully, motivating the child to actually use it when facing environmental triggers is an important goal.
- Go to chapter: Cultural Variables and the Process of Neuropsychological Assessment in the Neurorehabilitation Setting After Brain Injury
Cultural Variables and the Process of Neuropsychological Assessment in the Neurorehabilitation Setting After Brain Injury
Neuropsychological assessment involves the administration of a battery of tests that assess a variety of cognitive domains to obtain a clinical picture of brain behavior relationships. Within the inpatient rehabilitation setting, neuropsychologists often perform various functions, including neuropsychological assessment, psychotherapy, and assistance with adjustment issues for patients and their families. This chapter discusses some of the common cultural issues that impact neuropsychology in an inpatient rehabilitation setting. It focuses on potential sources of bias that can threaten the validity of neuropsychological tests. The chapter also examines the process of the neuropsychological evaluation within the inpatient setting when working with individuals from diverse cultural backgrounds. It deals with a complex composite of sociodemographic factors that include education, socioeconomic status (SES), race, ethnicity, language, and worldview, all of which interact with one another to influence brain-behavior relationships.
This chapter highlights mesolimbic dopamine (ML-DA) system as central to the experiences of affiliation, attachment urge when under threat, attachment urge during experience of safety, and to the distress of isolation and/or submission. As the midbrain defense centers hold the capacity for stress-induced analgesia (SIA), the tendency to dissociation, which is established with disorganized attachment in very early life, is considered to be secondary to modifications of their sensitivity. Trauma survivors have a default setting that keeps them in threat mode, whether triggered easily by memories of physical danger or separation distress. In a secure attachment relationship, the child can learn the rewards of interaction without threat. The frozen indecision is replaced by a disconnection from the experience of the moment, which relieves the distress. Environmental stress alters the nursing behavior of the mother rat so that she ceases to do so much licking/grooming.
This chapter talks about the representation of language in the brain— including what parts of the brain are known to be involved in language. It talks about how multiple languages are represented and interact in bilingual speakers. The most important lobes for language are the temporal lobe and the frontal lobe. In terms of language, in right-handed people it is the left hemisphere that supports the majority of language function. There are two areas in particular that appear to be especially important for language: an area toward the front of the brain in the frontal lobe that includes Broca’s area and an area more or less beneath and behind the ear toward the back of the temporal lobe called Wernicke’s area. Broca’s aphasia is characterized by difficulty with language production—with effortful, slow speech, and the striking absence of function words like prepositions, determiners, conjunctions, and grammatical inflections.