This book was conceived out of the authors' shared vision to synthesize key neurobiological developments with effective developments in clinical practice to offer both understanding and practical guidance for the many practitioners working to heal people burdened with traumatic sequelae. It is unique in bringing in all levels of the brain from the brainstem, through the thalamus and basal ganglia, to the limbic structures, including the older forms of cortex, to the neocortex. The book looks at the neurochemistry of peritraumatic dissociation (PD) and explores the effects on neuroplasticity and the eventual structural dissociation. Individual chapters focus on the definition of PD and tonic immobility (TI) and their associations with posttraumatic psychopathology, and review disturbances in self-referential processing and social cognition in posttraumatic stress disorder (PTSD) related to early-life trauma. Separate chapters focus on the modulatory role of the neuropetides in attachment as well as autonomic regulation, and highlight 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. The book while increasing awareness of different parts of the self and ultimately creating a more stable sense of self, also incorporates psychoanalytic, cognitive behavioral, and hypnotic methods, as well as specific ego state, somatic/sensorimotor therapies, eye movement desensitization and reprocessing (EMDR), and variations of EMDR suitable for working with trauma in the attachment period. The latter methods are explicitly information-processing methods that address affective and somatic modes of processing.
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This book is intended to provide to the eye movement desensitization and reprocessing (EMDR) clinician advanced tools to treat children with complex trauma, attachment wounds, and dissociative tendencies. It covers key elements to develop case conceptualization skills and treatment plans based on the adaptive information processing (AIP) model. A broader perspective is presented by integrating concepts from attachment theory, affect regulation theory, affective neuroscience, and interpersonal neurobiology. These concepts and theories not only support the AIP model, but they expand clinicians’ understanding and effectiveness when working with dissociative, insecurely attached, and dysregulated children. The book presents aspects of our current understanding of how our biological apparatus is orchestrated, how its appropriate development is thwarted when early, chronic, and pervasive trauma and adversity are present in our lives, and how healing can be promoted through the use of EMDR therapy. In addition, it provides a practical guide to the use of EMDR within a systemic framework. It illustrates how EMDR therapy can be used to help caregivers develop psychobiological attunement and synchrony as well as to enhance their mentalizing capacities. Another important goal of the book is to bring strategies from other therapeutic approaches, such as play therapy, sand tray therapy, Sensorimotor Psychotherapy, Theraplay, and Internal Family Systems (IFS) into a comprehensive EMDR treatment, while maintaining appropriate adherence to the AIP model and EMDR methodology. This is done with the goal of enriching the work that often times is necessary with complexly traumatized children and their families.
This book represents a compilation of years of theoretical and clinical insights distilled into a specific theory of disturbance and therapy and deductions for specific clinical strategies and techniques. It focuses on an explication of the theory, a chapter on basic practice, and a chapter on an in-depth case study. A detailed chapter follows on the practice of individual psychotherapy. Using rational emotive behavior therapy (REBT) in couples, family, group, and marathons sessions is highlighted. The book commences with a note on the general theory underpinning the practice of REBT, outlines its major theoretical concepts and puts forward an expanded version of REBT’s well-known ABC framework. It then considers aspects of the therapeutic relationship between clients and therapists in REBT, deals with issues pertaining to inducting clients into REBT, and specifies the major treatment techniques that are employed during REBT. A number of obstacles that emerge in the process of REBT and how they might be overcome are noted. The book then distinguishes between preferential and general REBT (or cognitive-behavior therapy [CBT]) and specifies their differences. Individual, couples, family and group therapies are explained. The book talks about the Rational Emotive Behavioral Marathon, a highly structured procedure that is deliberately weighted more on the verbal than on the nonverbal side. The authors’ 8-week psychoeducational group for teaching the principles of unconditional self-acceptance in a structured group setting is described. The book concludes with a discussion on the concept of ego disturbance, REBT treatment of sex difficulties using the cognitive-emotive-behavioral approach, and REBT’s effectiveness with hypnosis.
Psychotherapy is foundational to both mental health and psychiatric nursing. In psychotherapy, one must constantly reflect on oneself and one's part in the evolving process as well as constantly assess the person receiving care. Both partners grow in an effective therapeutic relationship. The nurse's growth is in the development of competencies and skills that are then taken forward to others. Thus, the concept of “becoming” a nurse psychotherapist is an important part of the therapeutic process. This book, in examining this process in depth and breadth, is an important addition to this body of knowledge. It guides the novice psychiatric advanced practice registered nurse (
APRN) into the role of a psychotherapist, not so much as in the context of “how-to” but in the necessary process of “becoming ready” to function in this capacity before applying techniques. It helps the nurse prepare to handle the content of other “how-to” texts and to use it therapeutically. Because of American Nurses Credentialing Center certification requirements, all psychiatric APRNprograms have introductory course content on at least two modes of psychotherapy, cognitive behavioral therapy, motivational interviewing, and so forth. However, it is often assumed that the process of applying these techniques will flow naturally. The authors have translated their own experience as psychotherapists into teaching strategies to be used during clinical supervision and to provide tools for psychiatric APRNstudents and graduates pursuing this area of practice.
This book provides the clinician with the important knowledge, tools, and resources to meet the surgeon general’s recommendations. It provides strategies and evidence-based information for the delivery of best care to persons identified and diagnosed with a substance use disorder. Additionally, it follows the guidelines of identifying the disease of substance use disorders, without using the highly negatively charged and outdated vocabulary of patient blaming addiction. The opioid epidemic in the United States, and the pandemic that has affected all parts of the globe, has resulted in many lives being lost and destroyed. The book gives the healthcare provider insight into the neurobiological origins of substance use disorders, the most current statistics, definitions and vocabulary, tools for evaluation and treatment, and an overview of the pharmacological and nonpharmacological interventions available to the prescribing and nonprescribing healthcare professional. This practical guide can become the practitioner’s first go-to tool in the fight for providing effective, evidence-based care to those with substance use disorders. The book is divided into four parts. The first part defines substance use, misuse, and abuse and describes the tools and techniques used for assessment of substance use disorders. The second part deals with identification of substance use disorders such as alcohol use disorder, tobacco use disorder, cannabis use disorder, hallucinogenic use disorder, stimulant use disorder and opioid use disorder. The third part deals with pharmacology and substance use disorders. It explains detoxification and maintenance treatment across the lifespan. The final part talks about nonpharmacological treatments for substance use disorders. The nonpharmacological treatments include: complementary and alternative medicine, psychotherapeutic treatments, care for substance use disorders in the clinic and community, and the innovations and programs addressing the opioid epidemic.
This book describes the foundational elements of counseling and psychotherapy with children and adolescents. It includes updates and expanded material about clients’ affect, trauma, substance abuse, progress monitoring, self-care, referral for medication, and mindfulness. Of particular interest is a series of new elements including elements addressing sexual and gender identity, social media, sexuality and harassment, and rules for use of technology. All of these topics have become increasingly important in counselors’ conceptualization of children and adolescent clients and therapy. The book emphasizes the conditions and processes of creating growth within the child, explicating the process of assisting growth and self-inquiry. There are new sections on grounding feelings in the body, teaching tools for distress tolerance, and highlighting the importance of progress monitoring. The book discusses teaching skills for negotiating social conflict—a substantial stressor for children and adolescents. It provides guidance on cocreating individual and family rules for use of technology. It also addresses frequent misconceptions and mistaken assumptions followed by the discussion on crisis intervention, effective referral skills, cultural competency and mandated reporting. The book then addresses issues such as coming to terms with one’s own childhood and adolescence and the rescue fantasy. There is a succinct introduction to interventions (i.e., including a list of more comprehensive texts on counseling with children and adolescents) and an updated review of techniques often used in work with children and adolescents (e.g., play therapy, brief, solution-focused therapy). For ease of reading the word caregiver will be used to indicate a parent, legal guardian, foster parent, and so on. The book focuses on counselor self-care and provides guidance for setting boundaries, knowing their edge, practicing within competency, and assessing and planning personal self-care. Finally, it closes with a brief overview of how to use the text for transcript analysis in training programs.
Social workers are the number one providers of mental health services in the United States. This book describes the realities of the contemporary American mental health system and the impacts on clients and social workers. It takes a critical perspective on the lack of quality care for those among society’s most vulnerable individuals, the mentally ill. Unlike other texts that address mental health and illness, the book focuses on the issues and policies that create challenges for social workers in the mental health system and obstacles to a continuum of excellent mental healthcare. The book also focuses on ways that social workers can help improve the overall functioning of the mental health system. One theme of the book is that mental health diagnosis, treatment, and access to care are lacking due to an insufficient knowledge base. That is, some mental disorders are not yet well understood, and therefore, responses can be inappropriate or inadequate. The critical perspective ensures that an examination of mental health treatments, especially pharmacologic therapy, does not focus exclusively upon the benefits to clients taking prescribed medications. The book digs deeper to ask who benefits when clients take psychotropic drugs. With a focus on social work innovation in mental healthcare, the book provides descriptions of promising policies and practices to improve mental healthcare in the United States. This includes new drug and brain stimulation or neuromodulation techniques and expanded social work prevention efforts. The book is recommended as a primary text for mental health courses in
MSWprograms. It can also be used in upper level undergraduate college courses in social work, typically BSWprograms. The book finally ensures that social work students will not only understand the issues of their clients (micro level) but understand mental health issues in a broader societal context (macro level).
This book examines new research regarding battered women and cross-cultural and cross-national issues, and addressed issues ranging from murder--suicide in domestic violence cases to proposed legislation and congressional resolutions. It reflects new research on traumatic responses, and addresses trauma-informed and trauma-specific psychotherapy, interventions with youth in juvenile detention centers, information from government task forces regarding children exposed to violence and juvenile justice, and new findings regarding the application of psychology to the legal system. Some of the battered women who already have been identified with a mental disorder that is exacerbated by the abuse or those who develop battered woman syndrome and posttraumatic stress disorder (PTSD) from the abuse itself may need some psychotherapy to help them heal and move on with their lives. The link between sex trafficking and domestic violence has also become much better known within the last 10 years. The concept of learned helplessness has been quite useful in expert witness testimony to help jurors understand how difficult it is for women to leave the relationship and why some women become so desperate that they must arm themselves against batterers. To eradicate domestic violence and violence in the community, people must stop modeling both sexist and violent behavior and change the divorce laws to empower children and abused women so they are no longer victimized by the abusers.
The inner subjective world of the mind was historically relegated to the margins of social science, confined instead within the traditional domains of psychology and psychoanalysis. In the seven years since the first edition of this book was written, many developments in the fields of neuroscience and psychotherapy that were just beginning to appear on the horizon have received a massive increase in interest and study. Eye Movement Desensitization and Reprocessing (
EMDR) is so profoundly guided by the adaptive information processing ( AIP) model, it is crucial to examine how it measures up to researched neurobiological models of consciousness and information processing. The book is written with language that is not only technical but also suitable as an introduction to the neural underpinnings of consciousness and EMDR. It examines pertinent neuroscience research related to the understanding of consciousness, information processing, and traumatic disorders of consciousness. The book first presents with basic research in the neurosciences relevant to online/wakeful information processing, which includes sensation, perception, somatosensory integration, cognition, memory, emotion, language, and motricity. The second section examines the neuroscience research relevant to disorders of consciousness, which include anesthesia, coma, and other neurological disorders. Major focus is given to the disorders of type I posttraumatic stress disorder ( PTSD), complex PTSD/dissociative disorders, and personality disorders. The third section presents the reader with an examination of neuroscience research relevant to chronic trauma and autoimmune function. A number of medical illnesses, collectively known as “medically unexplained symptoms”, are examined. These include fibromyalgia, chronic fatigue syndrome, reflex sympathetic dystrophy, systemic lupus erythematosus, type 1 diabetes, Hashimoto’s thyroiditis, Graves’ disease, multiple sclerosis, Sjögren’s syndrome, and rheumatoid arthritis. The final section examines the foregoing material with respect to the AIPmodel. It explores treatment implications vis-à-vis the various types of PTSDand the presentations of medically unexplained symptoms.
This book has two main goals: to provide descriptions of specific eye movement desensitization and reprocessing (EMDR) therapeutic “tools” and, by incorporating these tools, to develop an overview of an Adaptive Information Processing (AIP) model of the treatment of complex PTSD. The development of EMDR-related tools has been ongoing since the introduction of EMDR three decades ago. What will EMDR be in 2030? Unfortunately, the field—the field of psychotherapy for trauma-related disorders—has at times had a kind of dissociative disorder. Some therapists identify with one theoretical approach, and others are strong adherents of another identity. Often, these two “identities” do not communicate sufficiently, and sometimes they mistakenly think they have to fight with each other. Clearly, the author’s primary identification as a therapist is with EMDR-related methods based on an AIP approach, but the author attempting in the following chapters to also integrate the concepts and methods of cognitive approaches—approaches that are not only useful, but at times essential in the treatment of dissociative clients. The chapters of this book are divided into four parts. The first, comprising Chapters 1 and 2, is an overview of the application of the AIP model to complex PTSD and other dissociative conditions. The second part, Chapters 3 to 6, presents ways of treating (i.e., resolving) psychological defenses that are often linked intrinsically to disturbing memories but can be conceptually defined as separate entities because defenses typically contain dysfunctional positive affect, as opposed to the disturbing affect within memories of traumatic events. The third part, Chapters 7 to 14, focuses on several issues important in the EMDR treatment of dissociative conditions. And Chapters 15 to 17 are detailed case reports illustrating how these AIP “tools” can be employed in actual treatment sessions.