College counseling has entered an era that promises to be radically different than any time in its previous 100-year history. College students in this 21st century are more technologically advanced than previous generations and more likely to take virtual classes than previous generations of college students. Traditional services provided by the college counseling center are: individual and group counseling, psychoeducational groups, evaluation and assessment, career counseling, consultation to faculty and staff, medication management and resident advisor (RA) training. Nontraditional services are defined as virtual counseling, advising, and related services offered via distance technology. College counseling centers have long offered types of self-instructional services. They will need to address social media in ways that are both ethically sound and also able to effectively engage college students in seeking counseling services. The counselor can administer the Dimensions of a Healthy Lifestyle Scale (DHLS) to the client and then discuss the findings.
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The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.
The Absorption Technique for Children is a protocol that was derived from the work of Arne Hofmann who based his work on an adaptation of “The Wedging Technique”. The absorption technique for children is a resource technique that supports children in creating resources for present issues and future challenges such as dealing with a difficult teacher or handling a disagreement with a classmate and so forth. This chapter uses resource installation for stressful situations. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. The absorption technique, and the constant installation of present orientation and safety (CIPOS) technique, are excellent ways to encourage children to work with eye movement desensitization and reprocessing (EMDR) step-by-step even if they are not prepared to work with the worst issue in the beginning.
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.
- Go to chapter: ACT-AS-IF and ARCHITECTS Approaches to EMDR Treatment of Dissociative Identity Disorder (DID)
This chapter describes key steps, with scripts, for the phases of therapy with a dissociative identity disorder (DID) client, and for an eye movement desensitization and reprocessing (EMDR) session with a DID client. In brief, the method employs the artful use of EMDR and ego state therapy for association and acceleration, and of hypnosis, imagery, and ego state therapy for distancing and deceleration within the context of a trusting therapeutic relationship. It is also endeavoring to stay close to the treatment guidelines as promulgated by the International Society for the Study of Trauma and Dissociation. The acronym ACT-AS-IF describes the phases of therapy; the acronym ARCHITECTS describes the steps in an EMDR intervention. Dual attention awareness is key in part because it keeps the ventral vagal nervous system engaged sufficiently to empower the client to sustain the painful processing of dorsal vagal states and sympathetic arousal states.
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.
This chapter introduces readers to the Active Client Engagement (ACE) model, which includes acquiring information, creating a context for collaboration, and evocation of clients’ strengths and resources. As with the strengths-based principles, each facet of ACE works in concert with and is dependent on the others. Together the three components assist with creating a focus in therapy and strengthening the therapeutic alliance. Additionally, the three aspects of ACE are interventive. The chapter introduces methods for gathering client information and using routine outcome monitoring (ROM). An additional part of this chapter involves ways to match clients’ communication styles. The chapter examines two different processes for gathering information: (a) routine outcome monitoring (ROM) in practice (including feedback-informed treatment [FIT]) and (b) interviewing for strengths. The processes are meant to make early contacts and what follows treatment-wise seamless.
Serving in the military presents many challenges, opportunities, and risks. Recently, the suicide rates among military service members and veterans have trended upward and reached unprecedented levels. Research has found that the primary motive for suicide attempts among military personnel is a desire to reduce or alleviate emotional distress, similar to motives reported by those in nonmilitary samples. This chapter highlights the individuals who are currently serving or have served in the military as they are specific populations due to their importance and distinct vulnerability. It explores the statistics, epidemiology, and trends in active military personnel and veteran suicide. In addition, the chapter draws specific risk factors (psychiatric, sociodemographic, interpersonal, and other associated factors) for military personnel and veterans from evidence-based research. The chapter also presents protective factors identified in literature for military service members and veterans. Finally, it explores treatment considerations and interventions for active military personnel and veterans.
This chapter discusses that brief therapy usually calls for an active, directive therapeutic stance. One of the biggest myths pervading a good deal of the literature on psychological treatment is that therapists should not give advice. In direct contrast to Karasu’s position, London a true visionary, pointed out that “action therapy” often calls for arguments, exhortations, and suggestions from therapists who are willing to assume responsibility for treatment outcomes. Karasu, like many theorists, overlooks the fact that a good deal of emotional suffering does not stem solely from conflicts but is the result of deficits and missing information. When hiatuses and lacunae result in maladaptive psychological patterns, no amount of insight will remedy the situation it demands a system of training whereby the therapist serves as a coach, model, and teacher. The major issue is to decide when certain methods are likely to be helpful or harmful.
This chapter reviews the adaptive information processing (AIP) model, which is the theoretical foundation of the eye movement desensitization and reprocessing (
EMDR) approach to psychotherapy. It examines how the concept of memory networks has evolved from its roots to the way it is used in EMDR therapy. The concept of dual attention can be viewed as a state in which consciousness is in balance and where attention can fluidly shift between current sensory perceptions and relevant memory networks. The chapter also reviews research on the specific effects of trauma and early developmental deficits on information processing. The chapter considers what theory and outcome data suggest regarding the effects of different modes of bilateral sensory stimulation during EMDR reprocessing. For clinicians and patients with significant training and experience in models of verbal psychotherapy, initial experiences of optimal responses to EMDR therapy can seem dramatically rapid and comprehensive.
This chapter describes about the methods designed to expand the use of the eye movement desensitization and reprocessing (EMDR) adaptive information processing (AIP) model to clients with strong psychological defenses. It uses the term psychological defense to describe any mental action, or behavior that has the function and purpose of blocking the full emergence into consciousness of posttraumatic disturbance. The chapter describes the methods, for targeting and resolving psychological defense, facilitate therapy moving more easily, more quickly, and more effectively for many people with complex posttraumatic stress disorder (complex PTSD). It also addresses the types of incongruity through specific targeting with bilateral stimulation (BLS). Separate types of personality parts respond differently to focused sets of BLS; therefore, it is useful to think of three categories of dissociated parts: Oriented, adaptive, and effective “normal-appearing” parts, “Trauma-reliving” parts and Parts that prevent “trauma-reliving” parts.
Hypnosis has been found effective in altering cognitive and affective states. Since negative affective states lead to relapse, using hypnosis as a treatment modality to reduce and control anxiety, anger, and other negative affects may be helpful in reducing potential triggers to relapse. Given a counterconditioning model, if individuals can learn to not only reduce negative affect but also substitute positive affective states when in high-stress situations, they may develop the skills necessary to prevent the vicious cycle back to drug and alcohol abuse. Failing “to address patient’s needs for alternative methods of achieving altered states of consciousness” may be part of the reason for relapse. Staying abstinent or, conversely, relapsing is a function of intrapersonal determinants and interpersonal determinants. Using hypnosis to modify any of these determinants may be helpful with augmenting abstinence and preventing relapse.
Alcohol and other drugs (AOD)/substance use on college campuses has been an ongoing challenge for campus administrations, health services and health promotion, housing, and counseling centers. The misuse of substances by college students has a significant physiological, emotional, economic, and academic cost. Students are frequently unaware of the impact marijuana use may have on academic performance and motivation. Brief intervention (BI) and treatment have been shown to be effective treatment modalities at reducing high-risk substance abuse behaviors. Counseling centers may consider allowing for at least one session of motivational interviewing to increase the likelihood of clients following through on referrals to comprehensive substance use assessment, self-help groups, or treatment. Counseling center staff, even those with limited AOD treatment experience, can feel empowered to use the screening, brief intervention, referral to treatment (SBIRT) model. Group therapy is one of the most widely used treatment modalities for substance use.
This chapter explains a set of guidelines to help mental health professionals and clients move away from the gender stereotypes that perpetuate inequality and illness. Identifying dominance requires conscious awareness and understanding of how gender mediates between mental health and relationship issues. An understanding of what limits equality is significantly increased when we examine how gendered power plays out in a particular relationship and consider how it intersects with other social positions such as socioeconomic status, race, ethnicity, and sexual orientation. To contextualize emotion, the therapist draws on knowledge of societal and cultural patterns, such as gendered power structures and ideals for masculinity and femininity that touch all people’s lives in a particular society. Therapists who seek to support women and men equally take an active position that allows the non-neutral aspects of gendered lives to become visible.
This chapter presents several models for approaching the problems that can occur during supervision and offers practical suggestions to help supervisor’s and clinician’s challenging situations lead to supervisee growth and a stronger supervisee-supervisory relationship. Problems are inevitable, but unlike customer service at a bank, there is not an outside department charged with solving them; however, successfully resolving problems can lead to more growth and development than a smooth journey ever could. The chapter offers different approaches for ‘thinking outside the box’ and moving things forward when problems and challenges occur in supervision. Narrative therapy helps clients to reauthor or “re-story” their lives to be more in line with their values and hopes instead of constrained by their problems. Narrative supervision is grounded in social constructionism, which emphasizes the postmodern tenets of collaboration, nondirectiveness, and multiple perspectives.
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 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.
Although there has been an increase in federal spending on suicide prevention, the overall number of suicides in United States has actually increased over the past several years. It is important to understand the epidemiological trends, prevalence, and incidence rates of adult suicidality to understand why our effectiveness at reducing adult suicide rates has been so limited. Further, in order to improve existing prevention and intervention efforts, identification of relevant risk and protective factors among adults is essential. This chapter deconstructs myths and misconceptions related to suicide among adults, and provides an overview of empirically grounded strategies for effective assessment and treatment of this population. Although the presence of a diagnosable mental disorder, specifically depression, raises an adult’s risk potential, many adults without a diagnosis may be suicidal. Sociodemographic and psychiatric risk and protective factors should be assessed to aid in determining suicide risk to fully assess and plan treatment.
This chapter helps the reader to be familiar with the concept of an advanced specialization practicum. The overarching goal is to learn core competencies for assessment, intervention, consultation, and systems-level pedagogical supports. There is an increasing need for school psychologists with expertize in high school transition and postsecondary evaluations as well as dual enrollment collaborative evaluations. Clinic-based examples of specialized practica might include forensics evaluation through a law clinic or adjudicated youth programs, inpatient or outpatient hospital units, community mental health agencies, and private practice. The chapter describes important considerations for pursuing a variety of advanced practicum experiences, including coordinating postsecondary transition services, conducting forensic evaluations, and working within settings that utilize a medical model. To secure disability services at the college level, eligible students are required to submit acceptable documentation.
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.
Patients who present with affect dysregulation suffer from a variety of clinical and sub-clinical impediments to their daily functioning. Affect dysregulation is an affective style that can be conceptualized as having four main components. One is a distorted and unnecessarily intense qualitative appraisal of routine stimuli and interpersonal contact. Thus, the intensity of the emotional reaction does not correspond to that indicated by the environmental trigger. The second is an accompanying psychophysiological hyperarousal. Psychophysiological markers can range from elevated heart rate and rapid breathing to the bradycardic rhythms of the freeze response that also result from autonomic nervous system arousal. The third component consists of emotional, cognitive, and/or behavioral manifestations of affect dysregulation. These frequently include the internal experience of being flooded or overwhelmed with emotion and feeling out of control. Cognitively, a person may suffer from extreme anticipatory anxiety or rumination.
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.
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.
Increasing rates of eating disorders are found among males, individuals of all ages, and from an increasing diversity in terms of culture and ethnicity. This chapter discusses the prevalence rates of eating disorders among males and females. There are identifiable differences between those of a different age, sex, race/ethnicity, and socioeconomic status when it comes to eating disorder diagnoses and issues related to eating disorders such as body image dissatisfaction. Understanding these differences can help us understand why some people struggle with eating disorders and related issues and others do not, though it remains important to be wary of stereotyping for any group as making an assumption about the presence or absence of an eating disorder based on what is currently known can mean someone with an eating disorder will be overlooked and not get the treatment he or she needs.
- Go to chapter: Alexithymia, Affective Dysregulation, and the Imaginal: Resetting the Subcortical Affective Circuits
Alexithymia, Affective Dysregulation, and the Imaginal: Resetting the Subcortical Affective Circuits
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.
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.
This chapter explores the nature of trauma-related anger and resentment, and examines the impact that may have on our life. Anger is a natural emotion in response to something that is wrong, a violation, or something that should not have happened. The fury of rage can be frightening for both the person experiencing it and for others around him or her and it may lead to regrettable behavior, such as fights or self-destructive acts. Resentment is unresolved anger resulting from not addressing angry feelings associated with hurt or injustice from the past. Forgiveness is a topic that comes up frequently in a course on healing sexual trauma and in particular when discussing anger and justice. The root cause of anger for many people is a lingering feeling of injustice. Radical acceptance means being clear-eyed about what happened by breaking the silence and telling our truths.
Anger is a curious phenomenon and an ambiguous psychological state. While it is generally viewed as a negative emotion to be addressed in psychological therapy, it is likewise often seen as a positive emotion. Anger tends to be seen as, and often is, empowering, at least in the short run. It can often coerce and direct other people’s behavior, establish social dominance, and aid in acquiring additional resources. But in the long run, an excessive level of anger can lead to health problems, poorer relationships, and diminished occupational functioning. Psychological therapy has been shown to be effective in treating anger problems. There are few research studies specifically on the use of hypnosis in treating anger. However, anger reduction may occur when hypnosis is targeted toward reduction of anxiety and stress.
In 2010, antidepressants were the second most frequently prescribed medications in the United States. The most widely used are the selective serotonin reuptake inhibitors (SSRIs) with sertraline and citalopram leading the pack in 2010. Research on brain neuro-genesis indicates that the older antidepressants can cause the growth of new astrocytes in the brain. Drugs that specifically suppress the removal of serotonin from the synapse, including all the SSRIs and venlafaxine, have a particular capacity to produce these life-ruining and life-threatening reactions. Although some antidepressants have a lesser capacity to do so, all antidepressants have the potential to produce overstimulation and mania, as well as behavioral reactions such as violence and suicide. Antidepressants should not be given to patients with a history of bipolar disorder and when possible, patients with a history of manic-like behavior should be withdrawn from these drugs.
Antipsychotic drugs work by producing indifference and apathy without any specific effect on psychotic symptoms. The antipsychotic drugs have many short-term adverse effects that may lead the clinician, patient, or family to consider medication reduction or withdrawal, including Parkinsonism, dystonias, akathisia, sedation, and apathy. Tardive dyskinesia-often called TD-is a movement disorder caused by antipsychotic drugs that can impair any muscle functions that are partially or wholly under voluntary control, such as the face, eyes, tongue, neck, back, abdomen, extremities, diaphragm and respiration, swallowing reflex, and vocal cords and voice control. Antipsychotic drugs, including the newer ones, can cause neuroleptic malignant syndrome (NMS), which can be fatal in 20” of untreated cases. Long-term exposure to any antipsychotic drug carries severe risks, and a plan for eventual withdrawal should always be part of the treatment. Patients on antipsychotic drugs should be regularly evaluated and physically examined for symptoms of TD.
Anxiety disorders are the most common form of mental illness, with a prevalence rate of 18” in the United States and 15” in Europe. In Germany, almost 40” of psychotherapy patients are diagnosed with an anxiety disorder. Anxious or phobic patients feel psychophysiological symptoms, such as sweating, palpitations, tachycardia, hypertension, and muscle spasms, which, in some cases, lead to fatigue or exhaustion. In terms of cognition, they have unrealistic and dysfunctional thoughts about the phobic objects. A significant problem is that most of these patients behaviorally avoid objects and situations of which they are anxious or phobic. This might be the only reason why exposure-based therapies are so effective. Unlike cognitive behavioral psychotherapy, for which exposure is the empirically validated treatment of choice, there is, to date, insufficient scientific evidence for the effectiveness of hypnosis/hypnotherapy for anxiety disorders.
This chapter provides an overview of the neurophysiology underlying the innate human response of anxiety. Knowledge regarding the brain’s response to normal levels of stress and how it responds in a healthy manner will help clarify the various ways the brain can misfire and produce debilitating symptoms and outcomes. Posttraumatic stress disorder (PTSD) is an unhealthy emotional reaction to the experienced trauma. Inability to control stress can lead to release of neurochemicals and alterations in the hypothalamic-pituitary-adrenal (HPA) axis, which can result in both central nervous system (CNS) and parasympathetic nervous system (pNs) dysregulation. The mental health provider should be familiar with various anxiety disorders, so to diagnose more accurately, because treatment differs depending upon the specific anxiety disorder diagnosis. Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder in general clinics, but it is one of the least frequently diagnosed anxiety disorders in specialized anxiety clinics.Source:
Children and teens with anxiety disorders share some common patterns in their thinking and response. They share core difficulties in accurately appraising specific situations, experiences, and other stimuli. Enhancing self-regulation, that is, shifting one’s attention in order to control and modulate one’s psychophysiological reactivity, emotions, thoughts, and behavior leads to various, individualized goals for treating anxious youth with hypnosis, cognitive behavioral therapy (CBT), and other mind-body approaches. Chronic childhood anxiety, the earliest and most frequent mental disorder among youth, has a potentially lifelong negative impact on self-regulation, learning, memory, and social behavior. Despite the dearth and variable quality of research, hypnosis offers a valuable adjunct to psychological interventions in the treatment of childhood anxiety, presenting as anxiety disorders, anticipatory and medical procedural anxiety, primary care presentations, or “normal nervous” responses to developmentally based situational stressors.
Relationships are important to our happiness but, as it turns out, things are not quite as straightforward as this proposition would seem to imply. The first important observation that we can make of this association is that the perception of social support appears to be more significant to happiness than objective indicators of social support. Objective indicators of social support such as number of friends and frequency of social activity show small and sometimes nonsignificant relationships with happiness. One possibility is that the correlation between satisfaction with one’s relationships and satisfaction with life is simply a product of method invariance. The chapter focuses on how different types of relationships affect happiness. But this approach has a tendency to ignore the common relationship dynamics that might impact happiness across relationships. It also focuses on three dynamics of happy relationships: capitalization, gratitude, and forgiveness.Source:
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.Source:
This chapter examines the experience of internalized oppression within the Asian American community. It provides an introduction to the theoretical and applied literature that addresses the critical issue of how to challenge the internalization of one’s oppression. The critical educational disparities continue to be mirrored in employment, occupational, and income disparities. Parallel to these educational and employment risks, Asian Americans have also been found to be at risk for health disparities. In terms of mental health, posttraumatic stress disorder and depression are common in Cambodian and Vietnamese American refugees. As a continuation of these colonial experiences, Asians who immigrated to the United States were also looked down upon, considered of lower status, and were thus discriminated against, exploited, and, at worst, violently attacked and murdered. Cultural racism occurs when the values, norms, and beliefs of a group encourage often leading to the oppression of racial groups deemed inferior.
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 lists and examines essential criteria to consider when assessing patient stability and readiness for the standard eye movement desensitization and reprocessing (
EMDR) procedural steps. In considering a patient’s suitability and readiness for standard reprocessing, five kinds of issues need to be considered: medical concerns; social and economic stability; behavioral stability; mood stability; and complex personality and dissociative disorders, life-threatening substance abuse, and severe mental illness. Depersonalization and derealization as expressions of primary structural dissociation are frequently the only dissociative symptoms in patients with posttraumatic stress disorder (PTSD). The chapter reviews standardized assessment tools that can assist clinicians in assessing symptom severity, screening for dissociative disorders, and monitoring treatment progress and outcomes. The trauma assessment packet includes four test instruments, along with three research and clinical articles, which together provide a comprehensive assessment of trauma histories at different ages.
This chapter begins by describing various practical assessment issues related to the effective implementation of emotion-centered problem-solving therapy (
EC-PST). It first describes major areas of clinical assessment relevant to EC-PSTincluding: assessment of general social problem solving abilities and attitudes; assessment of current and previous SPSactivities; assessment of problems, stressful difficulties, major negative life events, and/or traumatic events recently or currently experienced by a given client or client population; and assessment of outcome variables related to presenting problems and emotion reactivity vulnerabilities. The chapter then provides treatment guidelines to assist the reader to best determine what form or version of EC-PSTor training sequence should be implemented with a given individual. To foster effective treatment planning and clinical decision-making specific to EC-PST, it provides a series of frequently asked questions for therapists unfamiliar with this approach.
This chapter focuses on practical assessment issues related to the effective implementation of problem-solving therapy (PST). When comparing an individual’s Social Problem-Solving Inventory-Revised (SPSI-R) scores with the normative data provided in the manual, raw scores are converted to standard scores such that the total SPSI-R score as well as each of the five major scale and four subscale scores have a mean of 100 with a standard deviation of 15. If the referral problem is specific, or if PST is being provided to a group that was constituted around a common diagnosis, other checklists may exist or can be developed that include common problems related to that diagnosis or group theme. Group treatment can be preferable in those situations where multiple clients are able to serve as sources of feedback to each other regarding both problem-solving skill acquisition and implementation.
This chapter describes the growing impact of internet addiction on children and adolescents. It focuses on assessment methods that practitioners working with this population can use to measure and assess the behavior. The chapter explains how practitioners can develop their own screening tools of media use for children and adolescents. It outlines comprehensive parenting guidelines based on the developmental age of the child to best integrate technology at home. Issues of screen time impact a child’s moods and feelings. Children and adolescents who suffer from anxiety, especially social anxiety, are more likely to develop an addiction to technology. The chapter describes assessment methods such as Parent–Child Internet Addiction Test (PCIAT), which assists in clinical evaluation of children suspected to suffer from addiction and Problematic and Risky Media Use in Children Checklist. The chapter describes 3–6–9–12 prevention for screen addiction outlining steps parents can take at each child’s age.
Assessment of academic achievement in reading, writing, and mathematics is a crucial part of most assessments of culturally and linguistically diverse (CLD) children and adolescents. This chapter discusses general issues that psychologists and other practitioners need to consider, including timing of the assessment in the second language (L2), cultural knowledge and bias, impact of oral language proficiency (OLP) on performance, and previous experience with the types of achievement testing done in Organization for Economic Cooperation and Development (OECD) immigrant-receiving countries. It explains specific academic assessment strategies, and interprets assessment results. The chapter provides a discussion of the diagnosis of learning disabilities (LDs). It analyses the strengths and problems associated with using discrepancy definitions, response to intervention (RTI), and the Diagnostic and Statistical Manual of Mental Disorders and shows how the research on typical development and differentiating L2 and LD can be applied.
This chapter provides guidelines for psychologists to use when assessing behavioral, social, and emotional functioning of culturally and linguistically diverse (CLD) children and adolescents. It begins by describing the typical methods psychologists use to assess these areas, and analyzing them in terms of their effectiveness and validity with CLD children and teens. The chapter then proposes that psychologists use an adaptation of Mash and Hunsley’s developmental systems approach (DSA) to assess CLD children and adolescents. It then discusses specific issues involved in assessment of CLD children and adolescents who display inattentive and hyperactive–impulsive behaviors, externalizing behaviors, internalizing behaviors, and severe social problems. The chapter specifically addresses questions involving the use of the Diagnostic and Statistical Manual of Mental Disorders with CLD children and adolescents to diagnose specific disorders such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, anxiety and mood disorders, and autism spectrum disorders (ASDs).
Assessment of intelligence and diagnosis of intellectual disability in culturally and linguistically diverse (CLD) children and adolescents are controversial and challenging. This chapter discusses some of these controversial and challenging issues, and describes methods of assessing intelligence in CLD children and adolescents, that is, individuals whose language and cultural backgrounds are significantly different from the normative group of most standardized Intelligence quotient (IQ) tests. It addresses several issues that psychologists need to consider when evaluating intelligence, including developing rapport; fluid and crystallized intelligence; adaptive behavior; using IQ tests to establish IQ/achievement discrepancies to diagnose learning disabilities; and determining when to use formal IQ tests. The chapter then turns to a discussion of the strengths and weaknesses of assessment techniques, including several types of intelligence tests, and offers alternative approaches for evaluating intelligence that can help to overcome some of the difficulties, including modifying test administration, dynamic assessment, and ecological assessment.
This chapter provides guidelines for psychologists on the assessment of oral language proficiency (OLP) of culturally and linguistically diverse (CLD) children and adolescents who study in their second language (L2). It discusses the issues that should be considered in the assessment of OLP, including the aspects of oral language that should be assessed in L1 or L2, the factors that should be considered in interpreting assessment data, and the advantages and challenges of assessing children in their L1. The chapter then describes specific methods for assessing OLP. It discusses issues involved in interpretation of data from OLP assessments, including a discussion of the diagnosis of a language disorder. The chapter also explains specific tasks and observational schedules that psychologists might find helpful when conducting assessments of OLP.
This chapter describes the assessment phase of the standard eye movement desensitization and reprocessing (
EMDR) protocol for treating posttraumatic stress disorder (PTSD). The two main purposes of the Assessment Phase are to access key aspects of the maladaptive memory network and to establish baseline measures for the level of disturbance in the target, rated with the subjective units of disturbance (SUD) scale, and the felt confidence in a positive self-appraisal, rated with the Validity of Cognition ( VoC) scale. In the Assessment Phase, one identifies the image or other sensory memory, negative cognition (NC), positive cognition (PC), specific emotion, and body location of the felt disturbance. The focus of the therapeutic work in EMDR reprocessing sessions is on the reorganization of the memory network. The last step in the standard assessment phase of the selected target is identifying the location of physical sensations associated with the maladaptive memory network.
In the early 20th century, asthma was considered as one of the “Holy Seven” psychosomatic disorders and thus was thought to be amenable to psychological therapy. In multiple case reports, hypnosis has been reported to have beneficial effects on the subjective aspects of asthma, which include symptom frequency and severity, coping with asthma-specific fears, managing acute attacks, and frequency of medication use and health visits. Asthma is treated with a combination of anti-inflammatory and bronchodilator medications that typically are inhaled. Hypnosis may also be efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals. There are several additional hypnotic techniques, such as breathing techniques, subconscious exploration, and age regression, which can be useful in the treatment of patients with asthma. Patients can be taught to use some of these techniques through self-hypnosis on an as-needed basis.
Several diverse and unique groups within society are at an elevated risk for suicidality. These at-risk groups are frequently isolated from the larger society, either through stigma, being disenfranchised, separateness, exclusion, and/or sociodemographic characteristics. Although a number of at-risk populations exist, this chapter focuses on three groups: the homeless, Native Americans, and incarcerated individuals. It highlights the prevalence of risk for each of these populations as compared to the larger societal norms. The chapter draws population-specific risk and protective factors from evidence-based research. Membership in at-risk groups poses additional issues and complications for individuals experiencing suicidality. In addition, mental health professionals working with individuals need to become aware of the unique risk and protective factors that may exert further influence on these groups. Professional and personal awareness is essential for mental health clinicians engaging, assessing, and treating members of these and other at-risk populations.
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.
The neurobiology of posttraumatic stress disorder (PTSD) and the effects of lifetime trauma on an individual have been covered extensively in the literature over the past two decades. This chapter reviews some of the relevant trauma-related neurobiology literature as it applies to military sexual trauma (
MST), both in men and in women. The presentation of premilitary factors is structured around three major areas in the neurobiology of traumatic stress: early life trauma and the emergence of the emotional response; lifetime cumulative effect of trauma and the hypothalamic pituitary axis (HPA); and additional factors contributing to long-term vulnerability or resiliency. The brain and behavioral patterns are molded in parallel with early life experience. When a child develops the ability to recall events, he or she experiences the beginning of autobiographical memory. Primary affective states originate in the reticular activating system (RAS) of the brain.
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 describes the importance of individual differences and the importance of identifying a person’s strengths in addition to their problems or deficits. The goal is to assess the adolescent’s unique personality characteristics that can contribute to helping him change his behavior rather than focus on only assessing psychopathology and reaching a diagnosis. The notion of individual differences, that every person is a unique individual, is one of the foundations of modern psychology. The chapter focuses on the problems and troublesome nature of talking with these youngsters. It provides both rationales and practical strategies for conducting interviews that are useful for rehabilitation plans with court-adjudicated adolescent male juvenile delinquents. Juvenile delinquents present a special challenge to the professional mental health interviewer. A successful interview is defined by the types and amount of information revealed that is useful for treatment and rehabilitation.
A simple illustration of sociornetric technique is the grouping of children in a dining room. The technique of letting girls place themselves works out to be impracticable. It brings forth difficulties which enforce arbitrary, authoritative interference with their wishes, the opposite principle from the one which was intended a free, democratic, individualistic process. The best possible relationship available within the structure of interrelations defines the optimum of placement. This is the highest reciprocated choice from the point of view of the girl. The factors entering into sociometric assignment are numerous the psychological organization of every cottage, the sociometric saturation point for minority groups within them, the social history of the new girl, to mention a few. The greater the original affinity between the newcomer and the prominent members of the group the better will the newcomer be accepted by the whole group.
Autoimmune diseases are characterized by cyclical relapses and remissions resulting from impairment in the immune system whereby cells of one’s own immune system attack certain cells and tissues within one’s own body, misidentifying them as cells of foreign organisms. This chapter aims at showing how this knowledge can be realized in the treatment of people with autoimmune disorders. The use of hypnosis and imagery create a special opportunity to affect the immune system in ways that enhance a quicker resolution of an acute relapse of an autoimmune disorder and promote the patient’s progress into a state of remission. The field of psychoneuroimmunology postulates that the central nervous system and the immune system communicate with each other on a regular basis. The chapter presents some case example presented to illustrate the use of a variety of therapeutic techniques with healing imagery that were enhanced by the use of hypnosis.
- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.
It appears that sets of bilateral stimulation (BLS) have the potential to invite unfinished traumatic experience into awareness. This can be a problem for clients who are dissociative, or who are on the verge of being overwhelmed by a traumatic memory. The memory can feel more real than the real situation the patient is in, and the experience can be one of nontherapeutic retraumatization. For clients who are potentially dissociative, the degree of orientation to the present situation can be assessed through the use of the back of the head scale (BHS). This procedure allows both therapist and client to be able to closely monitor and maintain the dual attention aspect of successful trauma processing; the simultaneous co-consciousness of the safe present and the traumatic past. The use of the BHS throughout a therapy session can be very useful in insuring that client is staying present while reprocessing disturbing memories.
Book bannings and burnings have long been part of authoritarian regimes, whether aristocratic, fascist, or communist. During the 20th century many books, such as Tropic of Cancer, were banned in the United States because of their perceived “obscene” sexual material. Book bannings are intended to prevent others from reading a book. In recent memory, probably few books have come to epitomize the debates on banned books more than the Harry Potter series, written by J. K. Rowling. Books that are challenged are very often books that are targeted toward youth, yet still contain edgy content such as sexuality, violence, occult themes, profanity and drug references. The relative dearth of research on books is probably the result of several factors. Newer media such as video games, social media, and old standbys such as movies and television, tend to get most of the focus.
For the dissociative client, therapy must begin and proceed with cautious vigilance regarding the client’s ability to maintain a sense of safety and orientation to the present. A client may initially have a great fear, or reluctance, to disclose, or to consciously access, personal information, memories, attitudes, emotions, physical sensations, and other mental actions. The identification of therapy goals is important, not only to structure treatment planning and therapy sessions, but also to help the client impose some increased clarity on the confusing push and pull of separate internal self-states. There are many therapeutic interventions that can help the dissociative client untangle the confusing, often contradictory, structure of internal parts. Very useful preparation procedure, especially for clients who have inadequate attachment experiences early in life and/or repeated trauma, is the Early Trauma Protocol (ETP) developed by Katie O’Shea (2009).
This chapter outlines the basic practice of rational emotive behavior therapy (REBT) and considers aspects of the therapeutic relationship between clients and therapists in REBT. It provides the major treatment techniques that are employed during REBT. REBT is an active-directive form of psychotherapy in that therapists are active in directing their clients to identify the philosophical source of their psychological problems and in showing them they can challenge and change their irrational musturbatory evaluations. REBT therapists tend to be appropriately humorous with most of their clients because they think that much emotional disturbance stems from the fact that clients take themselves and their problems. REBT therapists not only offer them “affective” empathy but also offer them philosophic empathy. Effective practitioners of REBT are usually comfortable with behavioral instruction and teaching and with providing the active prompting that clients often require if they are to follow through on homework assignments.
The research over the past 40 years led to the validation that living in a domestic violence family can produce psychological effects called the battered woman syndrome (BWS). Over the years, it has been found that the best way to understand violence in the home comes from listening to the descriptions obtained from those who experience it: victims, perpetrators, children, or observers. The understanding of domestic violence reported was learned from the perceptions of the courageous battered women who were willing to share intimate details of their lives. The theory of learned helplessness suggests that they give up the belief that they can escape from the batterer in order to develop sophisticated coping strategies. Learned helplessness theory explains how they stop believing that their actions will have a predictable outcome. The abuse of alcohol and perhaps some drugs is another area that would predict higher risk for violent behavior.
This chapter discusses how the criminal justice system treats battered women over the past 40 years. In the United States, advocates who began working with battered women in the 1980s believed that the most important step to end threats of violence was to punish the batterer and hold him accountable for his misconduct. To do this the legal system had to be encouraged to take action whenever domestic violence was raised. A study of the needs for victims of intimate partner violence commissioned for the Colorado legislature found that over two thirds of the women in prison stated that they had been abuse victims. Other areas of the civil rights laws have also been used to better protect battered women. The gender bias, including sexism and racism, for women coming before the criminal justice system continues to make it difficult for women to seek safety and protection.
Attachment theory provides a rich conceptual framework for understanding issues that arise in intimate partner violence (IPV) that have not been well studied in adults. Attachment was initially conceived as a neurobiological-based need for the purpose of safety and survival. Moreover, through the attachment process individuals develop an internalized set of beliefs about the self and others, known as “internal working models”. In adult relationships, attachment processes are activated by way of a cognitive-affective-behavioral triad. Woman who engage in the commercial sex industry have a much higher risk of contracting a sexually transmitted disease. An interesting phenomenon that ties use of pornography on the Internet together with the sexual abuse of women and children has been found in the legal community. It is known that early sexualization of children may cause interpersonal difficulties that may make it more difficult to recognize the cycle of violence engaged in by the batterer.
The US Centers for Disease Control and Prevention (CDC) has conducted studies about adverse health conditions and health risk behaviors in those who have experienced intimate partner violence (IPV). The high numbers of women who report childhood abuse and IPV and receive no assistance in healing from the psychological effects obviously will be seen in medical clinics, often too late to stop a disease process that might have been prevented had their posttraumatic stress disorder (PTSD) responses been dealt with earlier. One of the most negative and lasting effects of IPV on women appears to be the impact on the women’s body image, which is related to their self-esteem. Although the health care system has attempted to deal with battered women, in fact both the structure and function are not set up to be helpful, especially when chronic illnesses are exacerbated by environmental stressors such as living with domestic violence.
The first interagency intervention programs were organized by activists in the battered women’s movement in the late 1970s. They focused on effecting changes in the way the police and courts handle individual domestic abuse cases, and included a rehabilitation component as an integral part of a larger intervention strategy. These programs valued the existence of education or counseling for men as important, but viewed them as secondary to criminal justice reform work. Given that any program for batterers is situated in the same public sphere as the battered women’s movement, any definition of accountability ideally should include an explicit commitment to cooperate with shelter programs. The experience of the Domestic Abuse Intervention Project (DAIP) and other communities has been that victim-blaming practices and collusion with batterers are likely to occur when battered women and shelter advocates are actively involved in the planning, implementation, monitoring, and evaluation of the intervention process.
This chapter addresses training considerations regarding clinical hypnosis and mindfulness, standards of training in clinical hypnosis, development as a mindful hypnotherapist, competency, and future research. Training for MH should include a firm understanding of both hypnosis and mindfulness. Workshops in clinical hypnosis and application in practice are essential to deepen understanding. Likewise, workshops, retreats, and personal experiences of mindfulness can be extraordinarily helpful in understanding the phenomenology of mindfulness and can allow a clinician to integrate mindfulness in clinical work more adroitly. This book provides the basics of MH, guidance, and transcripts for use in clinical practice. It encourages therapists to begin to utilize MH as may be appropriate in their clinical practice and mindful self-hypnosis in their personal self-care. Workshops on MH as well as training in the rich foundational knowledge in hypnosis and in mindfulness practices can be an important source of developing competency in these methods.
This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. The author explains how he introduces behavioral activation to a kid. It is harder for a kid to be depressed if he is doing fun things, and easy for kids to understand having fun. The brain releases higher doses of mood-lifting neurotransmitters when we socialize, are physically active, and are doing novel, fun things. Behavioral activation is a tried-and-true stable of CBT. A common presenting complaint among depressed or stressed kids is poor sleep. In the author’s practice, kids most complain about a difficulty falling asleep, followed by a difficulty staying asleep. A good starting point is to consider what a good sleep schedule looks like. This chapter shows some of the strategies for combating insomnia. Collectively, the recommendations try to create a comfortable context, a relaxed body, and an unfettered mind.
This chapter introduces a behavioral therapy as a psychological approach to treatment that assumes that mental health problems derive from external forces that impinge the individual. It focuses on the empirical works of two major researchers, Ivan P. Pavlov and Burrhus F. Skinner, who developed learning theories that have serious implications for the treatment of emotional concerns. The chapter addresses the cognitive behavioral therapy movement, both historically and practically. Cognitive behavioral therapy, or CBT, has taken the behavioral therapy movement the internal versus external locus of influence boundary. It addresses how cognition, which is an internal psychological process involving language and perception, can be associated with behavioral techniques to improve case conceptualization and to affect treatment outcomes positively. The Cognitive Behavioral Therapist will first and foremost address the cognition and will try to change the thoughts that are associated with problem behaviors.
The long-term use of benzodiazepines causes severe cognitive and neurological impairments, atrophy of the brain, and dementia, and the newer sleep aids should be considered a potential but unproven risk in this regard. Some of the most severe cases of chronic brain impairment (CBI) occur after years of exposure to benzodiazepines. This chapter examines the risk of increased mortality associated with benzodiazepines and closely-related sleep aids when given in relatively small doses for short periods of time in the treatment of insomnia. All of the benzodiazepines and the more common prescribed sleep aids are addictive. Opiate and opioid withdrawal tends to be more predictable than psychiatric drug withdrawal. Like the abuse of stimulants and benzodiazepines, abuse of opiates and opioids can result in unlawful acts. The chapter addresses legally used opioids, involving mild-to-moderate abuse or dependence as found in patients who can often be safely withdrawn in an outpatient setting.
This chapter reviews the burgeoning body of information on prolonged grief disorder (PGD), a construct that has been heretofore titled complicated grief, traumatic grief, and pathological grief with subcategories including interrupted, delayed, and absence of grief. It also reviews the literature on the treatment of PGD with hypnosis and presents a case example of hypnosis-aided behavioral treatment in a case of spousal bereavement. Healthy adjustment to bereavement has been described by several theoretical models. These models share several features including focus on resilience and adaptation, premise that adaptation requires strategies in a multitude of situations, the importance of developing and operationalizing coping strategies, and the role that the sociocultural context plays in the adaptation process. Hypnotherapy is a valuable approach to treat bereavement. The chapter presents a hypnotic-mediated approach that emphasizes reconnecting and restoration aspects of PGD treatment.
- Go to chapter: The Best of Intentions: What Goddard Teaches us about the Development of Intelligence (and the Rough-and-Tumble World of Science)
The Best of Intentions: What Goddard Teaches us about the Development of Intelligence (and the Rough-and-Tumble World of Science)
This chapter presents a balanced overview of the man and his work to illustrate the complicated history of intelligence theory and testing. In 1904 the French government commissioned a group of experts to create a mechanism for identifying low-achieving students who would benefit from special education services. Henry Herbert Goddard brought the Binet-Simon scale to the United States and translated it into English, replacing mental level with mental age. Feeble-minded was the original term for the highest of the low-performing groups, but the descriptor came to be an all-encompassing term that confounded low intellectual functioning with other problems including epilepsy, substance abuse, and evidence of moral deficiency. Obama signed Rosa’s Law, mandating that the phrases mental retardation and mentally retarded be removed from federal health, education, and labor policy and replaced with intellectual disability and person with an intellectual disability.Source:
This chapter discusses the learning process in detail and provides suggestions about how to set the stage for continued learning and growth, starting during the supervision process and hopefully extending throughout one’s professional career. The troubling findings on the lack of evidence connecting supervision to clinical growth have had the impact of prompting a competency movement within clinical training, attempting to more directly connect training to objectively measurable outcomes. The chapter examines how both excellence and lifelong learning can be achieved. Active learning in which new knowledge and understanding is integrated with existing knowledge is critical to improving and growing from experience. Reflection is the cornerstone of active learning, emphasizing the purposeful, critical analysis of knowledge and experience in order to achieve deeper meaning and understanding and greater conceptual flexibility. Distinguished clinical teachers in medicine identified three basic phases of reflection: anticipatory reflection, reflection-in-action and reflection-on-action.
Risman posits a tension between an individual’s interest in relationship equality and a social system still imbued with gender expectations and assumptions. Given the growing evidence that equality enhances relationship satisfaction and stability, the author’s are interested in what processes or situations help couples move in the direction of greater equality. Couples vary widely in the extent to which gender is central to their family organization, but three fairly distinct patterns emerge: postgender, gender legacy, and traditional. The institutional tensions between gender hierarchy and the ideal of marital equality described in the scholarly literature on family are articulated frequently by couples. Three factors stimulate a move toward equality in couples are awareness of gender issues, dual commitments to family and work, and situational pressures. Traditional couples need help in defining the meaning of relational equality for themselves within external definitions of male and female roles.
There are a multitude of biological and medical factors associated with eating disorders. Some of these factors help to explain why an eating disorder might develop to begin with, whereas many others are serious consequences of being chronically malnourished or using dangerous weight control methods. This chapter discusses the various factors that are associated in some way with eating disorders: brain function; genetics; medical factors; vital signs and laboratory values; cardiovascular factors; oral and gastrointestinal health; neurological problems; endocrine system and diabetes; skeletal health; dermatologic; and nutritional factors. It examines biological factors that may put an individual at risk for developing an eating disorder. Generally speaking, the biological factors are likely risk factors, meaning that they predate the onset of the disorder though that is not always clear. The medical factors by and large represent consequences or costs associated with having a particular eating disorder diagnosis.
This chapter focuses on the racial identity development of Black or African American college students and of students who identity as biracial or multiracial. Although racial identity development theories do not support biological distinction between racial groups in the United States, they recognize how different conditions of domination or oppression of various groups have influenced their construction of self. In this chapter Black is used to refer to the racial identity of U.S.-born persons of African descent who may categorize themselves as Black, Black American, African American, or Afro Caribbean. The term biracial is used to describe persons with two parents of differing monoracial or multiracial descents. It is worth noting that some individuals may claim Black racial identity although neither of their parents identify as Black, such as the case of civil rights activist Rachel Dolezal. This chapter goes in depth into such alternative experiences of Black identity development.
The body dysmorphic disorder (BDD) and olfactory reference syndrome (ORS) have proven resistant to easy classification. BDD is characterized by a constant worry about one or more self-perceived defects or imperfections concerning physical appearance that are not visible or appear insubstantial to others. ORS is under the category of “Other Specified Obsessive- Compulsive and Related Disorder” and has to do with the conviction that the body or its functions are offensive to others and focuses on the affected individual’s embarrassment. Both BDD and ORS can be conceptualized using the Adaptive Information Processing (AIP) model adopted in this chapter to explain the phenomenology of ORS and BDD and therefore predict successful outcomes with Eye Movement Desensitization and Reprocessing (
EMDR) Therapy. If the genesis can be established as an earlier shaming or humiliating event, EMDR therapy can be successfully used to desensitize the event and allow AIP.
This chapter discusses a randomized controlled trial to test the possibility of healing bone fractures using hypnosis. Hypnosis was chosen as an adjunctive treatment for fracture healing not for its clinical utility per se, since simple fractures, not requiring surgery, generally heal themselves with orthopedic care and cast immobilization during a normative course of repair. Despite the magnitude of functional, medical applications that have been documented, there have been few randomized clinical trials exploring the potential use of hypnosis for accelerating structural healing. However, applications of hypnosis used expressly for tissue healing continue to be underutilized, with the exception of impressive case reports from the domain of dermatology, which have documented hypnotically accelerating the healing of severe burns by attenuating the size and depth of the burn and moderating the usual course of edema and inflammatory progression.
For decades, televisions have been referred to as “boob tubes”. The “tube” side of the slang term referred to the huge cathode-ray tubes that powered the viewing screen in the Stone Age of television. This basic belief persists, that time spent on entertainment media, particularly visual media is associated with reduced intelligence or academic performance. On the other hand, some investigators are examining whether newer forms of media can be used to promote learning. This chapter examines these concerns and beliefs and elucidates to what degree consuming entertainment media influences our academic achievement. Children who had watched fast-paced cartoon had reduced executive functioning compared to an educational show, or to perform a controlled drawing task. The American Academy of Pediatrics (AAP) has released a host of policy statements on media issues. These have ranged from media violence to “Facebook Depression”, the belief that time spent on social media causes depression.
This chapter discusses a suggested game of working with borderline personality disorders in the partial hospitalization program (PHP)/intensive outpatient program (IOP) setting. It reviews the challenges of working with the borderline personality patient and parent. The chapter discusses the individual, group, family, and milieu issues that exist when the borderline personality belongs to the patient, and family issues that arise when the borderline personality appears in the parent. In terms of the individual challenges, whether in treatment planning or individual therapy, many borderline patients is treatment savvy but claim that nothing yet has helped their problems. In group therapy sessions, individuals with borderline personality play a number of extreme and difficult roles that are challenging for the clinician. Clinicians and treatment teams often experience countertransference toward patients with borderline personality disorder. The clinician and clinical staff should practice mindfulness and objectivity about patient attacks and maintain a professional demeanor.
Different experiential, psychophysiological, and neurobiological responses to traumatic symptom provocation in post-traumatic stress disorder (PTSD) have been reported in the literature. The term bottom-up processing is used in sensorimotor psychotherapy, a somatic approach to facilitate processing of unassimilated sensorimotor reactions to trauma. Lanius found this approach useful in dealing with dissociative symptoms and adapted it to be used in conjunction with bilateral stimulation (BLS), as part of a comprehensive treatment approach for individuals with complex post-traumatic stress disorder (C-PTSD) and dissociative symptoms. When we use the Standard eye movement desensitization and reprocessing (EMDR) Protocol, we work with sensorimotor, emotional, and cognitive aspects of information. Bottom-up processing is a way to work with issues of dissociation. Traumatic memories appear to be timeless, predominantly nonverbal, and imagery-based. Somatic memory is an essential element of traumatic memory; trauma memories, at least in part, are encoded at an implicit level.
The breastfeeding and bonding eye movement desensitization and reprocessing (EMDR) Protocol refers not only to breastfeeding but also to bonding because they are interconnected. If breastfeeding is not only considered as a challenging performance, but its difficulties are seen as critical knots that should be processed because they are linked with dysfunctionally stored memories, the effects will be much more evident and pervasive. The Breastfeeding and Bonding EMDR Protocol addresses the state of crisis, the difficulties, and the distress connected to breastfeeding similar to a recent traumatic event even if it would not be considered a major traumatic event. The selective use of EMD, EMDr, and EMDR depends on the level of focus and the installation of resources useful to deal with the mother’s new role and tasks. This timely focused intervention for breastfeeding difficulties may have high great preventive value and very significant consequences on her psychophysical health.
Extraversion, openness to experience, agreeableness, authoritarianism, and religious fundamentalism can help predict who’s funny and who will appreciate different kinds of gags. Humor can have direct effects on physical health and psychological well-being; it can buffer folks against the slings and arrows of daily hassles. A keen understanding of ways that people develop jokes can helps to generate and appreciate them, which might make their social interactions more fun or help the occasional speech, toast, or presentation. Relaxation and meditation probably have a better impact on psychological well-being than humor does. Developing optimism would probably have a more direct effect on handling stress than becoming a comedian would. If the thought of being funny for its own sake makes sense, or at least means appreciating wit when it’s around, that’s the best justification for developing a good sense of humor.Source:
Student developmental models that can be used to understand various students in groups and their development include identity models, such as Chickering and Reisser’s model, as well as Levinson’s model; psychosocial models, such as Erikson’s model; intellectual and ethical developmental models, such as Perry’s model; moral developmental models, such as Kohlberg’s model; cognitive models, such as Piaget’s and Vygotsky’s models; and experiential models, such as Kolb’s model. For a broad and universal understanding, these and other student developmental theories are integrated into the group theory. This chapter provides a discussion of group theory in relation to various salient student development theories. It addresses a brief introduction about the need for inclusion and multicultural awareness for students and student groups. The chapter discusses aspects for understanding successful student group development regarding group types, group leader guidelines, group processes, and learning reflection of student groups through a multicultural lens.
Many adults understand the pressures of having multiple responsibilities that require attention in a variety of life circumstances. Whether giving attention to work, friends, school, religious activities, romantic relationships, family, or even recreation, adulthood requires the ongoing ability to multitask a variety of expectations and responsibilities. Before reaching adulthood, each person has experienced influences that affect how we think, feel, and react to life’s circumstances. This chapter offers professionals and educators one model for understanding these influences and their impact on college students who oftentimes are transitioning to a new world of adult responsibilities for the first time. Ecological theory originally developed out of the work of Urie Bronfenbrenner (1977) within the field of developmental psychology. The concepts described in Bronfenbrenner’s ecological theory offer a number of important implications for supporting students in a college setting.
Mindful hypnotherapy (MH) is a secular intervention that draws upon Buddhist concepts and philosophy to formulate hypnotic suggestions and interventions. As such, MH is suitable for therapists and clients with a wide array of faiths and beliefs. This chapter presents a few Buddhist concepts and stories to give readers a basic, contextual understanding of where our secular MH intervention originated. It presents a select set of Buddhist teachings that inform some of the core concepts of MH in the hopes that it will prompt further independent exploration. Just like the mindfulness interventions that came before MH, the chapter presents a version of the origins of mindfulness that is filtered through author’s own experiences and cognitive filter. A common refrain throughout Buddhism and secular mindfulness interventions alike is to experience things for yourself and base your understanding on what you directly observe to be true.
When children are exposed to toxic environments for many years of their childhood, they may have a difficult time even imagining a calm or safe place. Fort Tent has been adapted from Francine Shapiro's Calm Place exercise. This adaptation is designed to better suit children's needs. Abused and neglected children have very few internal and external resources to enhance the original Calm Place. The initial goal of this intervention is to create a specific experience of a Calm Place. The Fort Tent Calm/Safe Place (Fort Tent) is an intervention designed to help create safety within the constructs of the therapy office. This creative intervention heightens present moment experience of safety in real time. The Fort Tent allows clients who need a more concrete, kinesthetic intervention to be involved in the development of the safe place, thus empowering them to have a level of control in their own sense of safety.
Self-care is critical when someone works with clients or patients who have experienced trauma. Providers might also be dealing with their own trauma history. Burnout is possible, as are compassion fatigue and secondary traumatic stress. Burnout is a gradual process. Secondary traumatic stress can be gradual but can also happen suddenly. Burnout is a process during which a person disconnects from work and relationships. The common causes of burnout are overwork, unrealistic expectations, lack of sense of coherence, perfectionism, and codependency and overinvolvement. Compassion fatigue appears to be relatively common among those who work with abuse survivors. Countertransference is a psychoanalytic term that has relevance to trauma work. Providers should take time to take care of their bodies. This means getting enough sleep, eating nutritious foods, exercising, connecting with others, and maintaining a spiritual life.Source:
The Butterfly Hug was originated and developed by Lucina Artigas during her work performed with the survivors of Hurricane Pauline in Acapulco, Mexico, 1997. For the origination and development of this method, Lucina Artigas was honored in 2000 with the Creative Innovation Award by the eye movement desensitization and reprocessing (EMDR) International Association. By 2009, The Butterfly Hug had become standard practice for clinicians in the field while working with survivors of man-made and natural catastrophes. The “Butterfly Hug” provides a way to self-administer dual attention stimulation (DAS) for an individual or for group work. This chapter explains many uses for the Butterfly Hug. During the EMDR Standard Protocol, some clinicians have also used it with adults and children to facilitate primary processing of a fundamental traumatic memory or memories. Use of the Butterfly Hug in session with the therapist can be a self-soothing experience for many trauma-therapy clients.
Residential placement is indicated when a youngster becomes unmanageable at home, when outpatient- or community-based treatment does not work, or when it is mandated by the court. In discussing the successful rehabilitation of juvenile delinquents, Romig emphasizes that the focus should be on teaching the delinquents skills “that have been documented as improving their subsequent community behavior”. Adolescents in general are often portrayed as being in a state of constant emotional upheaval and unwilling to communicate with adults in a socially appropriate manner. An effective residential program should provide opportunities for participating in special activities to enhance the self-esteem and skill development of its residents. Treatment at Ocean Tides is grounded in the belief that successful rehabilitation results from a combination of a good program and talented, committed people. At Ocean Tides, a positive orientation is used in a variety of specific ways in the program to rehabilitate the residents.
This chapter illustrates three important elements such as individual and institutional betrayal trauma, and reparative individual and institutional experiences. Military sexual trauma (
MST) survivors receive psychological care from a wide swath of mental health professionals, within the context of both veteran and civilian institutions. The therapeutic orientations draws a combination of cognitive, dialectical behavioral, and relational-cultural theories, will influence the way we conceive of MST. A caregiver having cognitive, emotional, and physiological reactions of love, protectiveness, affiliation, and nurturing toward an infant buffers against the huge responsibility and effort it takes to provide sufficient care. Therapists may be able to gain clinical traction with MST survivors by understanding that MST almost always includes experiences of both individual and institutional betrayal. A therapeutic environment where mutual empathy and empowerment are present can provide an antidote to the patient’s previous environments, lacking in empathy and rife with disempowerment.
Cancer-related fatigue (CRF) has long been recognized as one of the most difficult symptoms to manage during cancer treatment, and it remains one of the most common unrelieved symptoms following chemotherapy, radiation, or surgery. Fatigue accounts for substantial levels of disability and contributes greatly to the overall burden of illness, as it may disrupt physical, mental, and social functioning as well as psychosocial adjustment. Although standard care usually involves recommendations for exercise or medications, many patients cannot or do not exercise; medications are not especially effective and cause problematic side effects for many patients. Hypnosis is one potential alternative that seems promising in the treatment of CRF. Hypnotherapy is a safe, nonpharmacological treatment that has shown considerable promise as a method of addressing cancer-related symptoms, and research demonstrates that hypnosis can be integrated into treatment programs for cancer patients and survivors.
This chapter explores whether it is possible to improve the happiness. If boosting people’s happiness is achievable, this begs the question of how: how can people change their happiness. The chapter explains some of the most effective techniques found by psychological science to increase happiness. But before that it examines successful treatments for happiness. Religious traditions from both the East and the West have emphasized meditation and contemplation as paths to spiritual well-being. One meditation practice has shown great promise, however, for enhancing happiness: Loving-kindness meditation. Happy people deal with the unpleasant circumstances in their lives in a healthy way, and one effective way to deal with the bad stuff in people’s life appears to be grateful reappraisal. The chapter considers comprehensive treatment packages, also referred to as “shotgun” treatments, designed to improve one’s happiness.Source:
Qualitative methods help researchers examine the nuances and complexities in relationship processes. In developing grounded theory, researchers are able to explore the systemic interactions between partners and identify and explain variations in the ways in which couples respond to each other and to the larger society. Grounded theory researchers begin with sensitivity to the research topic, but start with no predetermined hypotheses. Using gender equality as a sensitizing lens provides a framework through which to address this question, helps explain the meaning and nuance underneath the surface of couple interaction, and helps us explore the link between what couples do in their lives together and the larger social context. The lens of gender equality that we bring to our studies of couple life involves the four interrelated aspects of relationships such as relative status, attention to the other, accommodation patterns, and well-being.
This chapter provides basic career counseling and advising information for college counselors, advisors, and student affairs professionals. Career counseling services include career counseling, testing, career planning and development interventions, cooperative education and experiential career education, and job placement and employment services. Career interest inventories may be inappropriate for students with severe mental or emotional disturbances. The chapter discusses several most popular inventories used for career and academic planning. The self-directed search (SDS) classifies an individual into six different personality-work typologies. A number of computer-based programs have been developed to assist clients and students in career exploration. Career planning resources have become very popular and can play a helpful role in providing additional information regarding career choice. The career functioning assessment (CFA) provides a conceptual framework to assess a client’s current occupational functioning and serves as a starting point for assessing future career success.