Grief is the process that occurs before people come to acceptance. It can be a painful experience involving many different feelings. Losses includes health issues, loss of a career, loss of relationships, an unborn child, and/orability or desire to have children. Experiencing loss and grieving may include physical, emotional, social, and spiritual responses. Grieving is essential for coming to terms with and processing the trauma and resultant losses. Trauma and its accompanying sense of loss may result in a terrible sense of disappointment and failure. Working with mental health professionals and other survivors can be extremely helpful in working through the grieving process. The grieving process involves acknowledgment and acceptance of loss. Psychotherapy is a process of “re-parenting” the inner child who may have had less than ideal caretaking. The neural connections in the brain can heal and change with new experiences.

This chapter focuses on informal caregiving among minority groups. It also focuses on context of caregiving and discuss the various specific challenges caregivers of minority older adults face. The chapter examines some of the specific caregiving interventions tailored for families of color and discuss the implications for practice, policy, and research. Medical advances and greater longevity point to healthier and longer lives for many, but both formal and informal caregiving remain a concern as individuals age and develop conditions that require care. Caregivers are often able to realize the positive aspects of caregiving when they are not struggling with financial or social support challenges. Despite the vast literature on caregiving in general, research pertaining to the needs and experiences of racial/ethnic minority older adults and their caregivers is limited, particularly for American Indians, Pacific Islanders, specific Asian American and Latino subgroups, and religious minorities groups such as Muslim Americans.

The inclusion of parents and family caregivers throughout the phases of eye movement desensitization and reprocessing (EMDR) therapy is essential for best treatment outcome with highly traumatized and internally disorganized children. Parental responses that create dysregulation in the child’s system also appear to be related to the parent’s capacity to reflect, represent and give meaning to the child’s internal world. This chapter shows a case that exemplifies how the caregiver’s activation of maladaptive neural systems perpetuates the child’s exposure to multiple and incongruent models of the self and other. Helping parents arrive at a deeper level of understanding of their parental role using the adaptive information processing (AIP) model, attachment theory, regulation theory and interpersonal neurobiology principals will create a solid foundation. The thermostat analogy is designed to assist parents in understanding their role as external psychobiological regulators of the child’s system.

The basic goals of phase one are to develop a working relationship and a therapeutic alliance and to determine if the level of expertise of the eye movement desensitization and reprocessing (EMDR) clinician is adequate for the complexity of the case. Other goals are to develop a comprehensive treatment plan and case formulation. EMDR therapy was developed as a form of treatment to ameliorate and heal trauma. Clinicians working with complex trauma must have substantial understanding of the adaptive information processing (AIP) model and the EMDR methodology. During phase one, the clinician works on creating an atmosphere of trust and safety so a therapeutic alliance can be formed with the child and the caregivers. This chapter shows an example of how medical issues can affect the quality of the parent-child communications. The adult attachment interview (AAI) gives us the view of the presence of the experiences in the parent’s life.

Alzheimer’s disease (AD) and related cortical dementias are a major health problem. Patients with AD and related dementia have more hospital stays, have more skilled nursing home stays, and utilize more home health care visits compared to older adults without dementia. This chapter discusses the role of family caregivers and how they interact with in-home assistance, day care, assisted living, and nursing homes in the care of an individual with dementia. It also discuss important transitions in the trajectory of dementia care, including diagnosis, treatment decision making, home and day care issues, long-term care placement, and death. It highlights the importance of caregiver assessment, education, and intervention as part of the care process. Dementia caregivers are at risk of a variety of negative mental health consequences. Another important moderating variable for dementia caregiver distress is self-efficacy.

The work directed toward increasing the child’s ability to tolerate and regulate affect, so that the processing of traumatic material can be achieved, is initiated during the preparation phase. The process of providing the neural stimulation to improve the child’s capacity to bond, regulate, explore, and play should begin during the early phases of eye movement desensitization and reprocessing (EMDR) therapy. The Polyvagal theory presents a hierarchical model of the autonomic system. In complexly traumatized children, the development of this system has been compromised due to the early dysregulated and traumatizing interactions with their environments and caregivers. When describing the various forms of bilateral stimulation (BLS), go over the different options and practice with the child. If the child went through the calm-safe place protocol successfully, motivating the child to actually use it when facing environmental triggers is an important goal.

This chapter starts with an examination of the normative aspects of parental care by considering the benefits that are experienced by children when they are reared by a parent or parents. A review of parental care is helpful in that it can guide peoples exploration of the challenges and difficulties faced by children who do not reside in parental care. The chapter advances a relationship-building framework used to explore the policies, practices, and research that are needed to promote more optimal outcomes for children and their caregivers. The importance of positive relationships, connections, and the sense of belongingness will be established as critical aspects of normative living and development for children. The chapter explores why and how kinship care should be fully developed as a formal intervention. It establishes benchmarks and guides that direct attention to meeting the needs of children who do not have the benefit of parental care.

This chapter considers the well-being of caregivers. Child safety is an important topic in kinship care for multiple reasons, not the least of which is that children are placed into relative’s homes as a strategy to end the maltreatment that brought them to the attention of the child welfare system. It is important that children experience both physical and psychological safety, but for many children who have been victims of maltreatment, psychological safety can be more difficult to achieve. Multiple strategies and suggestions for instilling a sense of psychological safety are offered for use by caregivers and child welfare workers. Kinship caregivers face a significant amount of scrutiny. Despite the fact that research reveals multiple and significant benefits associated with kinship care, many professionals question whether placement with kin is in a child’s best interest.

This chapter entails a review of “system readiness”, and discusses methods for conducting evaluations and research related to capacity building through system change. Moreover, with advocacy research being paramount in kinship care practice, its use in kinship care is addressed, covering the use of advocacy research strategies and methods for translating research findings into kinship care policy and practice. When service systems are ready for change, they are best served by a trained and supported workforce that is able to intervene and support families using culturally appropriate, evidence-based practice models. A probe into how evidence-based practices can become more effective in realm kinship care is offered. Children in kinship care not only need effective and supportive caregivers, but also need effective child welfare policies and programs. System of Care has been one approach used in child welfare to bring about necessary changes to local programming.

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.

This chapter gives an overview of the conditions and child vulnerabilities that can disrupt relationship building. In the context of parenting and/or adult-to-child caregiving, theoretical understanding of the importance of human relationships, connections, and alliances has been guided by major models, including evolutionary psychology, attachment theory, social learning, social cognition theory, social development theory, and social control theory, bioecological systems theory and human behavioral genetics theory. Relationship formation is critical in positioning caregivers to serve in a “curative” role in assisting children to make gains and recover from the experiences of not having normal parental experiences. Kinship caregivers are in a unique position to help children develop relational competence. Relational competence is a person’s ability to appropriately interact with others and to develop meaningful relationships and connections. The caregiver can help the child reconnect or restore broken relationships.

The family unit shapes the child’s intellect, and influences the child’s ability to cope with the phenomenological forces that can affect his or her mental well-being. The family teaches children how to be good citizens in society. Most importantly, family helps shape children’s identity development so that they can be proud of their cultural heritage, their background, and what they can offer to the world. Children in kinship care are found to maintain more connections with their families and communities; and they experience fewer disruptions in relationships. Children who reside in relative care, risk experiencing a host of negative outcomes including substance abuse, criminal system involvement, mental health disorders, early pregnancy, and education insufficiencies, to name just a few. Relative caregivers are often willing to be permanent resources for children through either adoption or guardianship and their preferences should be valued and considered in relation to the child’s best interest.

This chapter focuses on federal policy and provides information on how to access local state policies pertaining to kinship care. Also, attention is devoted to illustrating different strategies that can be used to incentivize states’ use and support of kinship caregivers. The chapter presents a policy analysis framework to guide readers in approaching a critical analysis of federal policies and their effect on kinship caregivers. Federal and state policies can influence the extent to which state-level programming is geared toward establishing and supporting curative relationships for children by supporting their caregivers. A policy advocacy approach that promotes relationship building for children in kinship care is offered. The chapter considers the social and environmental conditions that have led to high rates of nonparental care, the economic impact, and the related political and policy response.

This chapter contains an illustration of the changing nature of family life in the United States as those changes are manifested in the types of kinship caregiving arrangements in operation today. It also contains information about nontraditional types of kinship caregiving arrangements, including a discussion of men and older adult siblings as caregivers and the advantages and disadvantages of nontraditional types of caregiving arrangements. It explores some of the cultural considerations inherent in various ethnic family caregiving relationships. Caregivers can experience isolation and severe financial hardships, with many living far below the poverty line. Kinship caregivers are critically important in helping children develop relational competencies. Informal and formal kinship caregivers have similar experiences in raising children, but those who provide care outside the context of the child welfare systems or without legal standing may have fewer resources and avenues of support.

Pediatric bipolar disorder (PBD) has been associated with a number of negative behavioral, academic, and interpersonal outcomes for children and adolescents. It initially received a disruptive behavior disorder diagnosis. High rates of comorbid anxiety disorders have also been found in children with PBD. Psychoeducational psychotherapy (PEP) uses a biopsychosocial model and combines family therapy, psychoeducation, and cognitive behavioral therapy (CBT) techniques with the goal of helping families to better understand and manage the symptoms of PBD and coordinate more effective treatment. This chapter focuses on a description of PEP, including three key interventions of this therapeutic approach: Psychoeducation and Motto, Building a Tool Kit, and Thinking-Feeling-Doing. PEP is a manual-based treatment designed for youth with mood disorders and their caregivers, broken down into separate youth and caregiver sessions. Sessions focus primarily on psychoeducation and skills building and are delivered in individual family (IF-PEP) and multiple family formats (MF-PEP).

Many children experience the death of someone close to them before the age of 18 years. This chapter reviews the effects of bereavement on children’s functioning and the risk and protective factors that exacerbate or mitigate grief-related problems. It provides step-by-step instructions for two evidence-based interventions for school-aged children and adolescents. Childhood traumatic grief refers to a condition in which children develop trauma-related symptoms that interfere with their ability to appropriately mourn a death. The Family Bereavement Program (FBP) is a theory-based intervention for parentally bereaved children and their surviving caregivers. The child component focuses on increasing self-esteem, reducing negative appraisals of stressful events, strengthening youths’ relationships with their caregivers, strengthening coping skills, and increasing adaptive emotional expression. The Grief and Trauma Intervention (GTI) is commonly implemented in schools and community-based settings after children’s exposure to a traumatic, violent, or disastrous event.

This chapter includes a discussion of the practice-oriented framework for service use delineated by Yeatts, Crow, and Folts and the caregiver identity theory articulated by Montgomery and Kosloski. Throughout history, family members, most often women, have been the primary providers of care for individuals, young and old, who are in need of assistance. What has occurred in the past century is significant growth in the number of family members who are providing care and expansion of the responsibilities that these family caregivers now assume. The steady expansion of family caregiving has been mirrored by the steady expansion of research focused on caregivers and interventions to support them. The behavioral model of services utilization has been used to study the use of a wide range of health services by older adults and caregivers.

Older adult abuse is a multifactorial problem that includes problematic relationships among the older adult and spouse/partner, cohabitating with adult children, and caregivers left unsupervised with an older adult. Researchers focusing on the etiology of abuse of older adults need to place a greater emphasis on the characteristics of the abuser as a predicting variable rather than the characteristics and stereotypes of the victim as the responsible predictor of the abuse. The perpetrators of abuse against older adults, in most cases, are those who have an interpersonal relationship with the older adult. Nurses are in an ideal position to be vigilant about the status of older adults under their care, evaluating risk factors for abuse on assessment of the older adult, as well as looking for signs of abuse during their care. Older adults are usually viewed as victims of crime, rather than perpetrators of crime.

One of the most widely known, researched, and disseminated therapeutic interventions for traumatized children and adolescents is trauma-focused cognitive behavioral therapy (TF-CBT). The TF-CBT model being implemented today began when several clinical researchers combined their similar trauma-focused interventions into a single model with the most efficacious components. The new model combined well-established cognitive behavioral, learning, and family therapy theory and techniques with emerging research on childhood posttraumatic stress disorder (PTSD), neuroscience, and child development. The result was a relatively short-term, manualized intervention that included both the child and the nonoffending caregiver in the treatment process and could be implemented in a wide variety of settings. TF-CBT contains specific goals for the child and the nonoffending caregiver. TF-CBT caregiver goals include helping nonoffending caregivers cope effectively with their own emotional distress while supporting their child’s recovery.

Child development researchers have converged on the findings that children, particularly young children, are developing emotionally, socially, and cognitively in the context of their relationships with their caregivers and that these relationships have an impact on the child’s future development. Filial therapy models aim to employ the power of the caregiver relationship to improve a child’s social and emotional development. This chapter defines a therapeutic model for young children that include: the infant/child’s caregiver in the therapeutic process and goals of improving various aspects of the caregiver-child relationship, child outcomes, and caregiver functioning. It also includes elements of direct instruction and/or coaching from the counselor. There are three evidence-based models that fit this definition of filial therapy and are used regularly in clinical practices: Attachment and Biobehavioral Catch-up (ABC), Child-Parent Psychotherapy (CPP), and Parent-Child Interaction Therapy (PCIT).

Concerns over the increasing prevalence and severity of children’s mental health issues have led to calls for interventions that focus on the family. In a report of the Surgeon General’s Conference on Children’s Mental Health, the United States’ national action agenda included the development of cost-effective, empirically validated prevention and intervention strategies that engage families. Similarly, during a Surgeon General’s workshop on the prevention of child abuse, speakers declared a need for age-appropriate, family-centered, and culturally competent services and reached a consensus that educating parents early is essential in the prevention of child maltreatment. A form of filial therapy, child parent relationship training (CPRT) teaches parents to use child-centered play therapy (CCPT) skills with their children. Based on attachment theory, CPRT espouses that a secure bond between parent and child is mandatory for children’s healthy development.

This chapter provides insight into the demographics of aging, and an overview of potential benefits and challenges of using technology to help older adults. It outlines four interconnected challenges of an aging population. With the expected increase in care needs that coincides with an aging population, the first challenge is the question of how to provide relevant high quality-care to older persons. Second, with fewer caregivers available in relation to the growing population in need, we can expect that the relative burden of care experienced by caregivers will increase. The third challenge is to increase the relative number of healthy and independent seniors by taking a more proactive approach with prevention and health maintenance strategies. The final challenge addressed concerns the development of health care systems and policy changes that are more inclusive of needed assistive technologies and medical devices.

The goals of the Preparation Phase are to explain Eye Movement Desensitization and Reprocessing (EMDR) therapy to children and caregivers, assess the client’s resources to prepare for trauma reprocessing, and to teach the "mechanics" of EMDR therapy. This chapter addresses how presenting EMDR therapy to children and teenagers may vary. Therapists can assess children’s resources and skills through direct questioning, interactional activities, and observation. The child’s responses from Phase 1 can be incorporated and expanded during the Preparation Phase. Professionals working in the child welfare system have an opportunity to work with attachment issues and model healthy adult-child interactions. Explaining the mechanics of EMDR therapy entails describing and demonstrating bilateral stimulation (BLS), establishing the client’s Safe/Calm Place for use during the Desensitization Phase, and teaching emotional literacy. Also, the therapist educates the client with self-soothing/calming techniques, the Stop Signal, the Distancing Metaphors, containers, and resources during the Preparation Phase.

The needs of toddlers and pre-school children (ages 1 to 5) are often dismissed during times of loss, with many assuming these children do not understand death. This chapter examines growing awareness of loss and death in this age group and considers their growing cognitive and verbal capacities. It explains temperament, attachment style and learning ability as facets of what influences responses to death and loss. The chapter also examines the role of religion and other cultural aspects of loss, generally inculcated by caregivers. It describes maturational losses such as loss of the fully attuned caregiver, expectations of “good behavior” and birth of a sibling. It emphasizes the importance of consistent caregiving, structures and routines for older preschoolers. The chapter reviews play therapy best practices and addresses the notion of a “Grief check-up” as a form of intervention.

Interacting with persons with progressive declines in cognitive function poses a wide range of challenges, not only for families and care providers, but for the person with dementia as well. This chapter briefly discusses two activities that offer participants opportunities to develop and apply positive approaches to interacting with persons with dementia. In Activity 1, Dementia Communication and Empathy, participants are asked to role play scenarios where persons with dementia endeavor to communicate with their caregiver. Insight and increased empathy are promoted through the challenges participants' experience, not only in understanding the message being communicated, but also the challenges of conveying even a simple message while impaired by physical and/or cognitive limitations. Activity 2, Enhancing Students' Therapeutic Interaction Skills with Older Adults with Dementia, brings participants into the community to interact directly with persons with dementia.

Most schools are composed of various problem-solving teams to support student learning. Common teams include behavior support teams, response-to-intervention teams, academic support teams, student-support teams, grade-level teams, and teams for individualized education programs. Often these teams bring together a range of professionals and caregivers whose task it is to work together to solve problems. The success of these teams often hinges on the competence of the individual members to solve problems and their willingness and ability to work together. Many of the engagement strategies and motivational interviewing (MI) techniques can be integrated into the work of school-based problem-solving teams. This chapter discusses the strategies that problem-solving teams can use to support students, particularly those facing significant academic and/or behavioral challenges. It focuses on this population because the challenges in supporting students with complex presentation are well known.

This chapter describes the current status of caregiving in the United States. Who are caregivers and what tasks they routinely do are discussed. The diversity of caregiving is also considered. Physical, psychological, social, and financial ramifications of caregiving are described along with benefits reported. The chapter concludes with recommendations on how healthcare professionals can support caregivers.

The field of gerontechnology is described along with how research endeavors can be aided by gerontechnology. Practical applications that enhance the daily life of older adults and their caregivers are also discussed. Caveats of appropriate use of gerontechnology are considered. The chapter concludes with discussion of family technologists who can support older adults and their primary caregivers.

This chapter focuses on Americans at risk for poor economic and health outcomes as they age—women, people of color, and lesbian, gay, bisexual, and transgender (LGBT) individuals. It identifies older women, people of color, and members of the LGBT community as being at risk for poverty during their later years. The chapter then explains the impact of caregiving responsibilities, partner status, and living arrangements on economic security of older adults at risk and highlights the detrimental effect of health inequities on their health outcomes. It stresses the importance of preventive health services for older adults at risk. Understanding the needs and risks of women, people of color, and LGBT individuals is an important part of working in the field of gerontology. The Practical Application presented at the end of the chapter focuses on how to develop that understanding.

There is a natural hierarchy within most families, with parents and primary caregivers as leaders. When the family hierarchy is unbalanced, serious problems arise. It is the strategic family therapist's job to realign the family by teaching parents and primary caregivers how to lead. Once the natural balance and order in the family is achieved, problems dissipate. Strategic therapists took the concept of the positive feedback loop and made it central to their model. Strategic family therapists believe that to change family organizational patterns and therefore alleviate the identified problem, the routine in which the clients communicate with one another must be altered. This chapter discusses the tools therapist may use: directives, prescribing the symptom, unbalancing, therapeutic double bind, reframing, restraining, and using metaphors throughout the session to assist the family or individual to make changes in their lives.

This chapter details the elements of counseling with children and adolescents that are essential to setting a solid stage for deeper work. It covers the techniques addressing the initial contact and important contextual issues, such as setting up a child- and adolescent-friendly office space. Initial contact sets the stage for the therapeutic alliance. Research has shown that educating clients about counseling improves treatment progress and outcome, attendance, and helps to prevent premature termination. Counseling provides a safe, nonjudgmental space in which clients can self-reflect; identify strengths; experiment with new ideas of self and ways of being; and learn effective emotional regulation, relationship, and life skills. Beginning counseling can be quite stressful for some children and their caregivers, and breaking down barriers is essential. Once relationships are established and counseling is flowing naturally, both the counselor and the client feel more relaxed.

Family caregiving and support are perhaps the most essential elements in their disabled loved ones’ adjustment for response to disability. This chapter first explores the prevalence of caregiving in America, including demographic information about who the typical caregiver is and what the situational circumstances are for these individuals. It is followed by providing a definition of the types of caregiving support generally provided by loved ones, as well as the nuanced differences between unpaid family care versus paid formal care. This segues into a brief exploration into the significant family role caregiving entails and its impact on each member. The chapter then discusses caregiver abuse as well as the often painful decision to place a loved one in a long-term care facility. Finally, it explores strategies for counselors to be able to support family caregivers in caring for their loved one while maintaining their own mental and physical health needs.

Family, friends, and social networks are important to people throughout the life span. Family members can provide social support and resources, increasing an older person’s emotional outlook and self-esteem. On the other hand, family relationships can have negative effects, causing long-term stress and undermining an older person’s health. This chapter outlines the roles that family, friends, and social networks play in older adults’ lives. They are all vital to the physical, psychological, and social well-being of older adults. The chapter explores family, friends, and social networks of older adults, with a particular focus on intimate relationships, relationships between older people and their adult children, and the various roles grandparents play in the lives of their grandchildren. It outlines the responsibilities of family caregivers. Given the toll caregiving can take, the Practical Application presented at the end of the chapter highlights the importance of tending to the needs of the caregiver.

This chapter reviews very briefly the major constructs used in the field of occupational stress: stress and distress, burnout and job engagement, and compassion fatigue and compassion satisfaction (CS) and describes some key findings for professionals, volunteers, and family caregivers. It focuses on what is known about what helps caregivers deal with their personal and job stress, current exciting interventions being done in the field of caregiving, and reflections on major challenges and hopes for future developments in the field. Stress and distress in caregivers is often referred to as psychiatric disturbance. Interventions to decrease stress, distress, burnout, and compassion fatigue and promote job engagement and CS involve the creation of a healthy work environment as well as individuals, whether professionals, volunteers, and even family caregivers, realizing the importance of developing self-awareness and self-care practices and integrating these practices into their lives.

Popcorn Night is a term that was coined to assist caregivers in providing a calm and comfortable night for their child following a desensitization session. Following the reprocessing of a memory, the therapist works with the caregivers to manage the possible emerging behaviors and assist with a log to track any changes in symptomology. Engaging caregivers and other outside support in eye movement desensitization and reprocessing (EMDR) therapy with kids leads to better outcomes as it provides additional support and additional information about the child's functioning. Popcorn Night is an instructional handout and log that helps guide caregivers in structuring a carefree and supportive evening after desensitization and track emerging symptoms or behaviors in the time between sessions. It is important to be transparent, flexible, and hopeful with this intervention as it can both inform treatment and encourage commitment to continued growth through EMDR.

There are many good nursing homes in the United States, staffed by dedicated and competent people who alleviate the institutional and bureaucratic feel of these facilities. Yet remaining in one’s own home is the ideal way to get long-term care, according to most surveys of Americans. The problem is that adequate in-home assistance is hard to obtain and even harder to afford. This chapter summarizes a variety of long-term care options, most of which are innovative, attractive, and promising, though some represent only slight improvement over the traditional nursing home. It examines informal versus formal caregiving, and culture change in nursing homes. The chapter reviews home modifications and home care alternatives; analyzes long-term care insurance, public and private; and describes the options for caring for people with dementia. It compares palliative care and hospice care and examines alternative explanations for the Buchwald phenomenon and their impact on hospice use.

The Universal Declaration of Human Rights attests to the rights of the family as the natural and fundamental group in society entitled to protection by the society and the State. Moreover, family support is the critical factor in enabling many older persons to remain in their own homes and within the community. Reciprocity is often given as a motive for helping and providing care to an older adult. Feelings of commitment and affection also motivate caregivers. One of the most pressing needs for caregivers is respite, that is, temporary relief from caregiving. It is usually provided at home but is also provided in a nursing home where persons leave their relative for a short time. The federal government mandates that states give preference to grandparents over other blood relatives when placing a child in foster care.

This chapter explores ways to help children reveal their inner world, make meaning of their disturbing symptoms, and elicit significant information from caregivers and others for accurate assessment. The clinician’s synchronicity with the child promotes the therapeutic alliance and positive transference that will be carried forward even during the struggles that inevitably occur in the treatment process. Assessment also involves administering checklists to parents and children, as these can be invaluable tools for confirming dissociative symptoms. Dissociative children can display subtle shifts in consciousness when switching from one state to another. The chapter suggests questions to explore dissociative symptoms with children and adolescents. The Adolescent Dissociative Experiences Scale (A-DES) is a commonly used checklist to assess for dissociative symptoms. Utilization of dissociative checklists and careful questioning about dissociative symptoms revealed important information about how they coped with their traumatic histories.

Families of persons with brain injuries are thrown into the complicated and costly world of medical rehabilitation unprepared for the profound changes and challenges that face them. The experience often forces families to redefine their roles and the nature of their supporting relationships. This chapter provides a broad-based foundation for a rehabilitation counseling understanding of the family experience of brain injury through a biopsychosocial lens. It illustrates two case studies to highlight professional supports, planning for future caregiving, and an insider’s perspective on family interactions with professionals. The chapter reviews the psychosocial impact of brain injury on the family, its challenges with change, and post-injury family needs. Finally, the chapter concludes with a discussion of best-practice professional approaches toward supporting families that feature environmental resources, innovations, empowerment, and effective professional-family collaborations.

This chapter reveals the personal stake one has in the face of three forces of a nation dealing with rapid demographic changes. It addresses long-term care policy and the realities of care giving in a nation where one does not raise their children to be long-term caregivers. As such, many Americans will find themselves receiving care from non-English-speaking immigrants. The chapter examines the nature of retirement security and insecurity and the new realities of living longer while relying on personal responsibility to ensure that one cannot find themselves in poverty as they grow old. It focuses on three groups: Latinos and Mexican American elderly; women, including those who are growing older; and millennials and other younger generations, who will face the consequences of our actions and inactions. The chapter presents a road map which is based on a very different narrative, and addresses politics and economics of aging.

All the cases that come before an evaluator are difficult and high-conflict, but some cases bring special circumstances that pose additional dilemmas to the evaluator. The general guidelines for parenting plan are to provide stability for the child. Young children, especially those younger than age 3, need a parenting plan that preserves their primary attachment with their primary caregiver parent. Children who are exposed to long-term parental conflict are more likely to have academic problems; to be more aggressive, sexually active, anxious, depressed, and withdrawn; to abuse alcohol and other illegal substances; and to come into conflict with the juvenile and adult justice systems. A parent who has been away or absent for a lengthy period needs to build trust gradually and allow the child to get to know him or her. There are probably other guidelines one can think of that are also reasonable for all cases.

This chapter discusses the concept of care as the medium through which all community grows. It examines care as a term of art for community use and describes the relationship between family and rehabilitation counseling within the context of care. The chapter defines care in terms of the family ethos and a preliminary model emerges. Family roles are subject to change and shift in their interrelationships as the group adapts to the reality of care and support for the person with a disability. By building from the values that link care to community, the chapter explains a new understanding of how rehabilitation counseling enters into the caring relationship as a value-driven profession and to provide support for the caring family. Facilitating family care is justified by the assumed connection between family participation in rehabilitation efforts and optimal client outcomes.