In 1920, in America, psychology was dominated by two main currents. The first was a tendency to reduce life to habit, and the second was to establish differences between humans by test. The second tendency, toward testing, had burst suddenly on the scene with the coming of the Binet tests to America in 1905. The idea of contextualized relationships determined by perceptual interpretation challenged the notions that had sprung up around behaviorism that the brain was empty, functioning only as a router between environmental stimulus and motor response. The idea, still vivid in American psychology during the 1920s, that psychology was “the science of mental life” was reinforced and extended by the diffusion of Gestalt psychology through American psychology over the coming decades, as the rest of these reviews of theory and practice will show.

Gordon Allport, addressing the American Psychological Association (APA) as its president in September 1939, observed that psychology, over the preceding 50 years, had divided into its pure and applied aspects. Troland was a socialist, and proposed that a “technology of behavior” be devised to maximize human happiness. In his comprehensive psychological system, Troland proposed a hedonic theory of motivation: Behavior depends on the quantity of pleasure to which it is related. Taken together, Troland and Miles represent the flowering, during this decade, of two persisting areas of psychological applications: consultation on the design of technologies in which human sensory and perceptual characteristics interact with equipment and devices, and the study of the effects of drugs of various kinds on human performance. Within psychiatry, psychology had long had allies, and during the 1930s some powerful ones became associated with psychology and supported its aims to develop a parallel nonmedical psychotherapy system.

The year 1945 saw the culmination of many developments in psychology since the 1920s, which led to two major coalitions being formed. The first of these was represented in the reorganization of the American Psychological Association (APA). The most important aspect of this reorganization was the consensus that theory, applications, and clinical activities, formerly represented by separate organizations and carrying on their affairs at a distance from each other, were indeed all parts of a unitary entity, psychology. Psychologists advanced their own comprehensive views of behavioral science as a complex system. The perception that psychology was a united front continued to be a successful strategy, which further confirmed its presence within the spectrum of physical and social sciences. Social psychology, which in previous decades was a melange of crowd psychology and anthropological ideas, acquired a perceptual and cognitive focus.

The 1950s, in American society as well as psychology, were characterized by two pairs of opposites: liberty versus repression and conformity versus creativity. Repression of suspected Communists and other left-leaning individuals was in full swing at the beginning of the decade, driven by long-standing partisan enmity as well as fresh anger over the loss of atomic superiority to Soviet Russia. Many of those who had been instrumental in the creation of the bonds between them had died or retired to other interests, and a new generation of psychiatrists emerged to question the qualifications of what they saw as psychiatrists practicing without medical licenses. Cognition and internal states also emerged in the 1950s versions of theories of motivation. Applied cognitive psychology, in its 1950s incarnation, interested Eddie, Helen’s husband, and he occasionally read articles by aviation psychologists working on contract for the Office of Naval Research.

The 1960s were brought to the United States on television. In ensuing decades, psychologists would engage in inconclusive debates about whether violence on TV had social effects. Ultimately, psychologists’ isolation in the academy, their cultural backgrounds, and their focus on integrating individuals by adjustment and assimilation rather than on managing immediate mass social change pushed psychology, as a field, to the periphery of civil rights, at least as they pertained to color. The pages of psychology’s journal of record, the American Psychologist, recorded few traces of the Vietnam conflict, a central feature of American life in the second half of the 1960s. Counseling psychologists concentrated on civilian problems. Hospital clinicians worked to develop ways to implement the new community mental health system. The combined effect of the Community Mental Health Act and the Great Society’s medical programs was a further infusion of energy and resources into rapidly developing clinical psychology.

By any measure, the 1970s and 1980s were marked, for psychology, by a continual upward change in professional self-designations as indicated by membership in the American Psychological Association (APA), a marker of the increase in the number of practicing psychologists now well distributed in all areas of U.S. culture. Psychology entered the 1970s as a well-established, lucrative coalition of professions. While some of its activity over the rest of the decade could be understood as directed toward meeting the challenge of selfless public service, for the most part psychologists were interested in career advancement. The response of officially organized psychology in the 1970s to these political and social events was the same as it had been during the preceding two decades the creation of further interest groups reflected as new divisions in the APA. Clinical psychology continued to contend with medical psychiatry for authority in treating mental illness.

One of the reflections of the rise of postmodernism in the American Psychological Association (APA) was the inclusion, for the first time, of psychoanalysts as official members of its coalition in Division 39 (a reflection of the gradual decoupling of psychoanalysis from medicine). The APA added a division of clinical neuropsychology, another specialty area where the advances in both cognitive and brain studies translated into an acceptable medical support occupation for psychologists. Psychologists increasingly found employment, during the ‘80s, advising clients, for a fee, of the best way to present themselves to juries, recommending with indifferent success changes in legal language in the direction of more accessibility and understandability, and offering expert testimony on clients’ mental states, as psychiatrists had been doing for at least a century. The theoretical models of health psychology that began to emerge about this time share characteristics with both Bandura and Cialdini.

In psychology, it was a prosperous year. It was 6 years since President George H. W. Bush signed a proclamation designating the 1990s as “The Decade of the Brain”, and 4 years before the American Psychological Association (APA) would pronounce the succeeding decade “The Decade of Behavior”. Since 1990, Peace Psychology, Group Psychology and Group Psychotherapy, and Society of Addiction Psychology had also been added. The Human Genome Project was about halfway through the process of mapping the entire human genome. For years, the sentiment in much of psychology, especially among the more senior members of the profession, was that as Howard Kendler put it in a 1999 article psychology could not scientifically prescribe correct moral behavior, and that psychologists should separate their scientific activity and their roles as private citizens, speaking out for social causes only outside of the official structure of the psychological coalition.

This chapter focuses on consideration of two kinds of abuse: abuse that takes place within a church and abuse that takes the place of a church. In the first, the pastor is usually unaware of the abuser, and in the second, the pastor often is the abuser. The spiritual ramifications when trusted religious leaders use people for sexual gratification are enormous. Gartner described how children abused by spiritual leaders can develop a crisis of faith, believing that somehow they have betrayed God. There is also a problem of the heterosexual abuse of children and adults by clergy of all denominations. Psychotherapists can perform preventative and even ameliorative work in churches by meeting with church leadership to help train them in identifying and dealing appropriately with sex abuse in the church. With regard to spirituality and religion, it’s important that the abused person is treated psychologically and also spiritually.

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.

Acceptance and commitment therapy (ACT) is a behavioral intervention designed to increase and improve psychological flexibility. Psychological flexibility, from the ACT perspective, is defined as contacting the present moment fully, as a conscious human being, experiencing what is there to be experienced and working to change behavior such that it is in the service of chosen values. The therapeutic work explored in ACT counters the problem solving approach. Clients are taught to be aware of their thoughts and emotional experiences. An important feature of the therapy is that the therapist approaches these issues with humility and compassion for the client’s experience. Many clients who have experienced military sexual trauma (MST) have limited their lives in a number of ways in an effort to control or prevent fear or fear-related experiences such as anxiety or difficult memories.

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.

Acquired brain injury (ABI), at any age, is a significant public health concern. It is particularly problematic in the elderly considering the increased rates of mortality and morbidity following ABI in this population. The aging brain demonstrates changes in the synthesis of key neurotransmitter, including dopamine and serotonin, and other chemicals important to brain health, such as brain-derived neurotrophic factors (BDNF). Formal diagnosis of various ABI causes may be relatively simple when given proper history and diagnostic tools. Prognosis following ABI is largely dependent on the etiology and the severity of injury and lesion location in the brain. Microvascular changes in the aging brain lead to attenuated cerebral blood flow, reduced vascularization of brain parenchyma, and increased cerebrovascular risk. Prevention of TBI for older adults should include behavioral and environmental adjustments to reduce fall risk.

This chapter explains paradigms of neurorehabilitation and explores the interdisciplinary and transdisciplinary nature of brain injury rehabilitation. Optimal rehabilitation of acquired brain injury (ABI) requires a multidisciplinary approach of trained rehabilitation specialists at appropriate timing and with appropriate intensity. Brain injury rehabilitation requires a comprehensive treatment program to reduce impairments and to restore function, participation and quality of life. Vocational rehabilitation specialist assesses an individual’s functional level and vocational potentials. Guiding principles for rehabilitation include all areas of therapy, namely, physical, occupational, cognitive, and speech-language therapy. Early functional rehabilitation in poststroke and traumatic brain injury (TBI) patients has been shown to improve functional outcomes and may decrease “learned nonuse.” Neurorehabilitation in the context of ABI continues to be a demanding challenge, which requires clinical translational approaches involving a multidisciplinary team.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies 10 separate classes of substances related to significant substance abuse concerns. Of the 10 separate substance classes, four have more clearly documented patterns of pathophysiological sequelae and demonstrated impact on cognitive functioning. These substance categories include alcohol, inhalants, sedatives/hypnotics/anxiolytics, and stimulants. The remaining six substance clusters include caffeine, cannabis, opioids, hallucinogens, tobacco, and other or unknown substances. This chapter discusses the specific impact of each of these separate classes of drugs and related acquired brain injury on cognitive and emotional functioning. The clinical presentation associated with acquired brain injury related to substance use/misuse is variable. Most importantly, the patient will need to gradually reduce his benzodiazepine use so as not to facilitate “rebound anxiety.” Consideration should be given to anxiolytic medications that are not benzodiazepines, as well as to cognitive behavioral therapy, potentially including interceptive exposure.

This chapter explains the process of solution focused narrative therapy (SFNT) and offers suggestions for the therapist’s use of conversational questioning. SFNT therapy comprises six steps: best hopes, mapping the effects of the problem, constructing the preferred story, exception gathering, preparing the presentation of the preferred future and moving up the scale, and summarizing and inviting clients to watch for success. The most important step is beginning therapy. The therapist begins the session by introducing himself, learning the names of those attending, and asking the same question of all present. The chapter also presents an exercise, which may help to identify traits, values, and actions that help readers present their best self to their clients, particularly clients that are challenging.

Action Research (AR) is a “form of collective, self-reflective enquiry undertaken by participants in social situations in order to improve the rationality, coherence, adequacy or justice of their own social or educational practices, as well as the understanding of these practices and the situations in which these practices are carried out”. AR is a rich methodology and is a powerful approach for counselors to consider while improving their personal lives, counseling practice, and work with communities. This chapter introduces counselors to historical influences, key concepts, and essential approaches to AR. It discusses various approaches to inquiry in AR including first, second and third person approaches, participatory AR, and practitioner AR. First-person inquiry is a uniquely reflective process of inquiry. Through first-person inquiry one can develop their personal lives or professional practice through cycles of reflection, action, and evaluation.

This chapter addresses application of Eye Movement Desensitization and Reprocessing (EMDR) therapy within the three prongs of past, present, and future for bringing memories of attachment trauma to an adaptive resolution. Therapists are provided methods that help ensure safety and efficiency during desensitization and reprocessing of traumatic memories and triggers. For example, therapists can narrow the focus and restrict the associations to additional traumatic memories as needed to ensure safe reprocessing. Therapists may alter the sequence of past, present, and future prongs if it’s clinically necessary to ease clients into addressing the past. Attachment-Focused Trauma Therapy for Adults (AFTT-A) therapists apply cognitive interweaves that assist clients with accessing aspects of the healthy internal system developed through AFTT-A to assist clients with bringing painful memories to an adaptive resolution.

This chapter explores the unfolding of the phases of EMDR therapy as children go through developmental stages. Infants, toddlers, and preschoolers may express significant variation simply because of developmental processes and achievements. The chapter summarizes adaptations that may be helpful to consider through each phase of child development as the client and therapist simultaneously move through the phases of EMDR therapy. Mentalizing in parent-child relationships is a co-occurring theoretical and clinical intervention that is included through all the phases of EMDR therapy. With infants, toddlers, and preschoolers, the history taking, case conceptualization, and treatment planning are integrated with the goals of the preparation phase. Young children are often brought to therapy by parents who are concerned about clinical, emotional, behavioral, regulatory, and situational issues. Therapists and parents are active participants in the child’s therapy. Alternating bilateral stimulation can be taught in many ways using toys.

This chapter discusses the modifications of using Eye Movement Desensitization and Reprocessing (EMDR) therapy with preteens and adolescents while staying true to the eight phases. The difference between employing EMDR therapy with adults versus preteens and teens lies primarily in history taking, preparation, pacing of the phases, the therapist’s attunement to the client, and the therapeutic relationship. Many of the clinical decisions and procedural considerations for working with preteens and adolescents occur within the first two phases: the History Taking, Case Conceptualization, and Treatment Planning Phase and the Preparation Phase. In order to guide the EMDR therapy process, gathering a thorough history from both the client and caregiver is necessary. Exploring the client’s positive relationships, including favorite teachers, coaches, and beloved family members, can be used as resources and cognitive interweaves (CI) during EMDR therapy. Pacing refers to the timing of when to apply the various phases of EMDR therapy.

This chapter presents a review of adaptive behavior assessment from conceptual, technical, and practical perspectives. Although adaptive behavior is a construct with relevance across multiple disability populations served by rehabilitation professionals, its greatest relevance concerns persons with intellectual disabilities (ID). This chapter presents adaptive behavior assessment within an ID context. It begins by describing the population of persons with ID and how they are defined through federal legislation and professional associations. Specific focus is placed on the growing importance of adaptive behavior in the process of identifying persons with this disability. The chapter then presents a review of standardized and informal approaches to adaptive behavior assessment. To illustrate its professional importance and use of best-practice approaches, the chapter then addresses three practice areas where adaptive behavior assessment plays a key role in contemporary practice with persons with ID, including death penalty evaluations, community-based habilitation, and culturally responsive assessment.

This chapter considers addiction generally without reference to the specific chemical to which an addiction develops. It discusses the neuroscience of addiction. The chapter presents the story on how addictive chemicals change the brain. Research on brain changes with addiction does provide useful information on when recovering persons are more susceptible to relapse. The chapter discusses the understanding based on animal work, and considers the heterogeneity of addictive patterns in people. It explores some of the findings on genetic variations associated with the risk of addiction to drugs of abuse. The chapter then provides specific information on how to screen and initiate treatment. In the United States, opiate agonists like buprenorphine and methadone are legal and considered to be treatment. Mandated treatment is as effective as voluntary treatment, probably because alcoholics often get convinced of the wisdom of change in the course of treatment.

This chapter focuses on conceptualizing addiction in relationship to the experience of trauma. It briefly covers some of the major theoretical orientations used to understand how addiction develops in individuals with diagnosable substance use disorders and co-occurring trauma. The chapter highlights the importance of social neuroscience and identifies stigma-related obstacles to recovery. The chapter concludes with discussions of treatment approaches and strategies as well as the counseling implications of co-occurring substance use and trauma disorders.

The nature and specialty of addictions counseling is unique from general mental health counseling and as a result presents distinct ethical concerns for practitioners. This chapter reviews and discusses the unique ethical considerations in addictions counseling. It clarifies the distinction between addictions counseling as a counseling specialty and the field of substance abuse treatment and evaluation. The chapter provides a discussion of considerations for ethical addictions counseling practice. Prior literature has established common ethical issues experienced by practitioners providing addictions treatment. These include ethical issues related to: professional identity and certification; settings issues; privacy, confidentiality, and privileged communication; informed consent; mandatory clients; multiple roles and relationships; settings issues; counseling adolescents and minors; and issues of diversity multiculturalism. Addictions counselors must utilize self-care and consultation (among other behaviors) in order to resolve potential values conflicts that may arise in the provision of substance abuse counseling.

Counselors serve an important role in the lives of youth. They provide safe spaces for children to express their emotions, fears, thoughts, and worries. Supporting children and adolescents of special populations and marginalized statuses requires that counselors (a) recognize how personal bias may impact the counseling process; (b) utilize culturally competent, theory-based techniques in counseling; (c) understand how socioeconomic status, poverty, race, gender, and sexual orientation impact children and adolescents; and (d) utilize practical, strength-based approaches to counseling. Counselors remain committed to the work of building strength-based, culturally competent, and inclusive practices. The counselor’s efforts to provide culturally responsive strategies and interventions will greatly influence the success of counseling diverse populations of children and adolescents. With this in mind, clinicians must remain critically reflective of their worldviews and biases and commit to the life-long process of cultural competence.

For professional school counselors and clinical mental health counselors to serve students with disabilities and adequately advocate within the comprehensive school and community contexts, they must first understand the legislation that exists. Congress set these legislations in place to protect the rights of students with disabilities and assure them access, inclusion, and a free and appropriate public education. This chapter helps to identify the disability categories under the Individuals with Disabilities Education Act and the common characteristics of giftedness. It recognizes legislative mandates that apply to education of children and adolescents with disabilities and giftedness in grades Pre-K through 12. The chapter describes postsecondary transition issues for adolescents with disabilities entering postsecondary institutions. It expresses the connection between identity and disability. The chapter explains the role of the professional school counselor and clinical mental health counselors when working with students with disabilities and those classified as gifted.

Trauma work with children and adolescents remains challenging on all levels and becomes increasingly complex when violence permeates various domains of life. Counselors must also consider the reciprocal relationships between trauma and neurological, psychological, social, cultural, and systemic factors that alleviate or exacerbate the experience of trauma. Early identification, assessment, and intervention remain critical components of trauma recovery. The inclusion of trauma-informed interventions such as emotional awareness and regulation, as well as mindfulness skills can help children and adolescents diminish symptoms that overwhelm internal coping mechanisms. This chapter helps readers to distinguish the complexity and range of trauma experienced by children, identify the neurobiological, social, psychological, and academic impact of trauma causing events on children, and recognize various trauma-informed and creative interventions when working with children and adolescent clients, as well as important considerations for school counselors.

This chapter opens with a brief discussion of interventions that students who have sustained concussions may receive outside of school in a rehabilitation setting and at home. Students who have sustained concussions typically require short-term adjustments while they are still symptomatic. The chapter discusses appropriate school-based educational plans in relation to symptom clusters. The chapter addresses extracurricular involvement of students and special grading considerations during recovery. It includes guidance to help school teams determine if a child with persistent postconcussion symptoms requires a 504 plan or further evaluation for an individualized education program (IEP). Students who are eligible for IEPs under the traumatic brain injury (TBI) category may require significant modifications to the curriculum in order to be successful academically. Finally, the chapter concludes with a note on dealing with students who may malinger or continue to report symptoms when they have actually resolved.

The individual psychology of Alfred Adler is based on a holistic and phenomenological understanding of human behavior. Adlerians believe that all behavior has a purpose and occurs in a social context, noting that one’s cognitive orientation and lifestyle is created in the first few years of life and molded within the initial social setting, the family constellation. The Adlerian theory purports that humans are all social beings and therefore all behavior is socially embedded and has social meaning. Adlerian psychotherapy is a psychoeducational, present/future-oriented, and time-limited approach. The Adlerian approach is a contemporary therapy as it is cognitive behavioral, culture-sensitive/ multicultural, and integrative. The four stages of Adlerian therapy are as follows: relationship, assessment, insight and interpretation and reorientation. This is believed to be a good strategy because the Adlerian theory gives counselors an overall framework from which to use a host of other methods that might appeal to them.

The Individual Psychology of Alfred Adler provides a rich theoretical foundation for what has developed into Adlerian psychotherapy. This chapter defines the basic tenets of Adler’s theory of personality and therapy. Adler’s theory is grounded on the idea that childhood experiences are crucial to the psychological development, and that children, who are by nature in an inferior position to parents and other adults, strive to achieve some sense of superiority. Adler ’s work represents a psychological theory that acknowledges the influence of social factors on the personality. In efforts toward understanding the lifestyle, Adler viewed humans’ unique approaches to life through the lenses of the life tasks. These tasks included: the work task, the social task, and the sexual task. Adler believed that encouragement, the act of promoting courage within someone else, was the cornerstone of therapy and could inspire clients toward growth, healthy adaptation, and functioning in life.

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.

To set the stage for what counselors need to know, this chapter introduces the reader to an overview of theories that lay a foundation for working with adult clients. It provides a discussion of theoretical perspectives that relate to both individual development and contextual factors. To capture this intersection of influence, the chapter highlights Erikson’s (1950, 1963) psychosocial stage model, along with contextual and life span perspectives of adult development. It introduces the transition perspective, delving into the transition process itself. Adults face times that are increasingly challenging. A central theme in our current social context is change, reflecting the dynamic impact of forces across demographic, social, cultural, technological, political, and historical domains. A theory is a set of abstract principles that can be used to predict facts and to organize them within a particular body of knowledge.

This chapter provides therapists with tools for teaching children advanced affect management skills. The goal for teaching children resourcing, coping skills, enhancing mastery experiences is to assist the child in creating his/her own toolbox of skills to be used in therapy and in daily life for more advanced coping. Therapists can begin by teaching the child about relaxation and then explore with the child current methods that the child already uses to relax. With guided imagery, the child is asked to choose a comfortable place to sit in the office and select a real or imaginary favorite place where the child feels most comfortable. In addition to breathing, guided imagery, progressive muscle relaxation, children can be taught other ways to help calm themselves. If the child becomes overwhelmed by affect, the child is likely to attribute the discomfort to the eye movement desensitization reprocessing (EMDR) therapy and the therapeutic process.

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.

Advertisements differ from fictional media in that they are purposely intended to change behavior. This chapter shows how influential are advertisements on our behavior, what “tricks” do advertisers use to influence behavior, and how do the influences of advertisements compare to fictional media. Advertising is a subset of marketing. Advertisements are designed to make the public aware of a product, as well as to provide a pitch for why that particular product is superior to its competitors. False advertisements tried to entice consumers with lofty but untrue claims of benefits and to hide weaknesses or financial liabilities with their products. One form of advertising that has been controversial is product placement. One other area that is controversial is advertisement directed at children. Children are thought of as being particularly vulnerable given that they are less adept than adults at reality testing.

This chapter sheds light on how the managed care system works as well as the counselor's role in managed care and the importance of advocacy and issues related to payment and reimbursement. It offers a starting point to understand the system, and counselors must continue to seek more resources, join organizations and build networks with other counselors and change makers to become active members of the professional community. Managed care is an integral part of the healthcare system, and it is imperative for counselors to be able to understand the system in order to navigate it better. Counselors can anticipate the issues that are related to cost and payments and can provide more efficient service to the clients, if they understand how managed care system operates. The chapter demystifies the issues of payment for counseling services, specifically third-party billing, managed care, medical assistance programs, and other issues therein.

Emotional dysregulation is a key component of posttraumatic stress disorder (PTSD). It is important to understand the basic neurophysiology of stress and how it influences a survivor’s ability to cope. The mechanism involved in stress includes the connections among the hypothalamus, the pituitary gland, and the adrenal gland. Glucocorticoids influence metabolism and immune function, and send signals back to the brain about the stressor. Low cortisol levels immediately after a trauma may also be a risk factor for developing PTSD. The sympathetic nervous system (SNS) secretes catecholamines during stress, which help to consolidate memories. When military personnel have a history of childhood abuse and subsequent military sexual trauma (MST), they may be particularly vulnerable to developing PTSD. Anticipatory anxiety is also one of the greatest barriers in engaging clients in treatment. Mindfulness can be described as any practice that brings clients back to the present moment.

One reason mainstream providers shy away from treating sexual issues is that they want to avoid feeling possible discomfort if a client or couple reports that they engage in kink, or sexual practices outside of what is considered by many people to be “normal”; that is, penis-vagina intercourse between a heterosexual man and heterosexual woman, or what is sometimes referred to as “vanilla” sex. These fears are reflective of a centuries old, deeply held myth that sexual activity conducted without purpose of reproduction is “deviant” or “perverse.” Alternative sexual practices, or what the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition labels as paraphilias, may include BDSM (letters that can stand for bondage/domination, domination/submission, sadism, sado-masochism, or masochism), sexual acts involving articles of clothing or particular objects, fetishistic cross-dressing, and/or sexual role-play. Education regarding kinky sex and its devotees can help providers become more accepting and empathic when people who practice kink seek treatment.

Ideas and attitudes about gender and orientation have been rapidly transforming, challenging mainstream thinking about what it means to be male or female; gay, straight, bisexual, or asexual; or having a fluid identity, that is, having a gender identity or orientation that changes. Affirming therapy does not simply mean the provider is merely “LGBTQ+-friendly.”.The affirming provider must understand at a much deeper level the experience of being a member of a sexual minority group who may face social stigma, discrimination, homo-and/or transphobia, and fears related to coming or being out to family friends, and coworkers, and who have increased risk of anxiety, depression, substance abuse, and attempting or succeeding in suicide. This chapter focuses on a selection of the particular issues that providers must attend to in themselves as well as the LGBTQ+ client or couple. It describes sexual dysfunction and treatment in the sexual minority population.

This chapter describes what happens after a concussion, from the immediate changes in neurochemistry to the signs and symptoms that may be present in the days, weeks, and months following the event. It discusses the neuropsychological effects, including cognitive, physical, emotional/mood, and sleep symptoms. This chapter also describes dangers signs, which could be indicative of a more serious brain injury. It explains possible long-term effects of concussion, including complications associated with multiple concussions, postconcussion syndrome, second impact syndrome, chronic traumatic encephalopathy (CTE), and suicide. Concussion symptoms provide clues related to what is going on in the child’s or adolescent’s brain. Concussions often go unreported because individuals are unaware that an injury has occurred. Some may also consider the injury not severe enough to warrant medical attention. In some cases, the effects of concussions are so intense, and individuals become so distraught, that they become suicidal.

This chapter guides one forward after the third week of sleep therapy. It presents a chart called Calculating Your Week 3 Sleep Efficiency. By entering the sleep diary answers for Questions 1 to 7 in the top section of the chart one can calculate the sleep efficiency. The chapter also presents Six Steps to Solid Sleep for week 4: go to bed only when sleepy and not before your threshold bedtime; maintain a regular threshold rise time in the morning; use the bed only for sleeping; leave the bed if one can’t fall asleep or go back to sleep within 10–15 minutes, return when sleepy, and repeat this step as often as necessary during the night; if sleepiness is overwhelming, one may take a short nap (set aside no longer than 45 minutes) in the afternoon, between 1:00 and 4:00 p.m; and maintain a sleep diary.

A psychologist must confront many prejudices against older adults that are manifested in most people in non-older adult cohorts. Clinical psychologists specializing in geropsychology work with individual older adults; family members of older adults, including spouses/partners, siblings, and adult children; and caregivers when treating the psychological problems experienced by older adults and dealing with issues of caregiving to older adults experiencing mental illness, dementia, and/or psychological reactions to co-occurring medical illnesses. Unfortunately, despite the fact that older adults are affected by the forces of ageism and stigma, and the fact that community psychologists strive to understand and improve social inequalities and to enable empowerment of marginalized people, there is a significant dearth of research in the field of community psychology. There are four types of ageism: personal, institutional, intentional, and unintentional. The majority of older adults have experienced age discrimination and stigmatization at some time after the age of 65.

This chapter focuses on the strategies that use neocortical resources of imagery to increase affective mentalization as well as, possibly reset them to allow increased adaptive, relational, and intersubjectivity capacity. Brain organization reflects self-organization; and human emotions constitute the fundamental basis the brain uses to organize its functioning where parent-child communication with regard to emotions directly affects the child's ability to organize his- or herself. Alexithymia and affective dysregulation play a significant role in that they constitute profound barriers for the effective treatment of traumatic stress syndromes and dissociative disorders by directly interfering with emotional processing as well as contributing to emotional destabilization. Traumatic stress and early childhood trauma has been associated with alexithymia, affective dysregulation, and deficits with regard to affective mentalization. Mentalization has been described as the ability to read the mental states of others through the brain’s mirror system.

Based on public opinion polls, a substantial number of people worldwide don’t only think about aliens, but think they exist and have visited our planet. The aliens are defeated not by man, but by nature: they are killed by exposure to Earth’s bacteria. The War of the Worlds was massively more popular in helping the image of “aliens” become ensconced in our cultural consciousness. The story of Betty and Barney Hill is both an archetypal story of an otherworldly encounter and the prototypical story of an alien abduction. One of the popular television programs on the History Channel is Ancient Aliens, which purports to use archaeological and historical analyses to demonstrate how human culture and development has been extensively shaped by contact with extraterrestrials. The claims of governmental conspiracies over a crashed unidentified flying objects (UFO) and ancient visitation from aliens have both been thoroughly examined and found wanting.

Allied and clinical mental health case management is a systems-of-care and strength-based model of care that transcends professional affiliations. Systems-of-care and strength-based approaches are framed by addressing the full scope of the health needs of the patient or client across areas of activity and participation and capitalizing on the patient or client's resources for health recovery while maintaining the efficient use of treatment care resources. The successful implementation of a systems-of-care and strength-based model of care by allied and clinical mental health case managers depends on the use of appropriate training, and skills as well as a case referral system that minimizes service discontinuities. This chapter presents a systems-of-care and a strength-based approach to allied health case management likely to result in superior mental health function and well-being for patients or clients, their families or significant others, and care providers.

This chapter focuses on some of the more commonly utilized complementary and alternative medicines (CAMs) that are purported to cure various physical health problems. It explores some of the history and background of the treatments then delves into what the research says about their effectiveness for various problems. The chapter covers chiropractic manipulations of the spine, which are often used not only for neck and back problems, but a myriad of physical ailments. It describes the ancient art of acupuncture, in which needles stuck into our skin in specific locations reportedly help to increase health. The chapter talks about the pills and remedies of homeopathy, and reviews vitamins and herbal supplements. Acupuncture is a Non-evidence-based treatment (non-EBT) for any and all conditions. To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy.

Alzheimer’s disease (AD) presents one of the most urgent health care issues of our time. AD is a disease of the brain and mind, and as such, neuropsychology has an essential and evolving role to play in addressing this growing public health concern. Measurement of key cognitive functions, such as delayed recall of recently presented information, is crucial in the diagnosis and monitoring of the disease. In addition to the importance of advancing scientifically informed disease-specific measurement of cognition, neuropsychology has a growing role to play in the design and implementation of nonpharmacological interventions for AD. The neuropathological hallmarks of AD are senile plaques (SP), neurofibrillary tangles (NFTs), and cell and synapse loss in multiple brain areas. Granulovacuolar degeneration (GVD) has long been recognized to be present in the brains of AD patients.

This chapter helps the reader to understand the history of the Americans with Disabilities Act (ADA), specific components of the ADA and how the ADA provides resources to older adults and people with disabilities. The ADA, while groundbreaking, was not initially intended for people with disabilities rather than for older adults. As time progressed, however, the benefits of the ADA were much more far-reaching than originally intended, especially for aging adults with disabilities. The individual titles of the ADA have had some dramatically positive and specific impact for older adults wishing to remain in their homes or in their communities as long as possible. Although the ADA is still in its young adulthood, the benefits of the ADA have only grown as new and further linkages, such as the ADRCs, have developed in all regions of the United States.