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.
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- Go to chapter: Integrating Theories of Developmental Psychology Into the Enactment of Child Psychotherapy
Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).
In the therapeutic community (TC), the therapeutic and educational component that focuses specifically on the individual consists of the various forms of group process. The groups that are TC-oriented, such as encounters, probes, and marathons, retain distinctive self-help elements of the TC approach. This chapter provides an overview of general elements and forms of group process in the TC. Conventional psychotherapy and group therapy have not been particularly effective with substance abusers entering TCs for various reasons. Group tools are certain strategies of verbal and nonverbal interchange that are employed by participants to facilitate individual change in group process. There are two main classes of group process strategies: provocative tools and evocative tools. Provocative tools, hostility or anger, engrossment, and ridicule or humor, are most pointedly used to penetrate denial and break down deviant coping strategies such as lying.
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.
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.
This chapter clarifies treatment throughout the similarities as well as the differences between eye movement desensitization reprocessing (EMDR) therapy and sensorimotor psychotherapy in child treatment. Dysregulated arousal and overactive animal defenses biased by traumatic experience are at the root of many symptoms and difficulties observed in traumatized children. Traumatic or adverse experiences are encoded in memory networks in the brain. The adaptive information processing (AIP) looks at different components of the memory network: cognitive, emotional and somatic. EMDR therapy and its phases access not only the cognitive aspects of the memory, but the affective and bodily states. In working with children, microphones may add a playful approach to translating the body’s language. Oscillation techniques are also useful in helping children to shift their focus from dysregulated states to a more resourced experience, which supports flexibility in state shifting and increases awareness of different states.
Dryden has argued that there are various sources of influence that impinge upon the therapist and client as they seek to determine in which therapeutic modality to work. The rational emotive behavior therapy (REBT) model of disturbance emphasizes the role played by the individual’s Belief system in his or her psychological problems; this may influence its practitioners to work more frequently in the modality of individual therapy than in other modalities. Individual therapy is particularly indicated for clients who have profound difficulties sharing therapeutic time with other clients. Clients may move from modality to modality, and thus individual therapy, can be best viewed as part of a comprehensive treatment strategy. Some REBT therapists attempt to induct clients into REBT by involving them in pretherapy induction activities. Therapists can also impede client progress by failing to help clients to attain closure on a particular problem.
- Go to chapter: Simple or Comprehensive Treatment Intake Questionnaire and Guidelines for Targeting Sequence
This chapter explores several approaches in helping a client develop an Eye Movement Desensitization and Reprocessing (EMDR) targeting sequence plan to address the presenting problem(s). As with all psychotherapy approaches, it is important to obtain a full clinical history to identify stabilization needs, environmental management skills, and symptoms where EMDR reprocessing will be appropriate. The client’s presentation may fall into either being simple or comprehensive. For simple presentations, several possible targeting sequence plans are possible, depending upon the client’s dominant symptom. For those presenting with a dominant irrational belief, clustering all incidents within that belief will lend itself to a very efficient targeting sequence plan that addresses all prongs, past incidents starting with the Touchstone Event, present triggers, and future issues anticipating anxieties. The chapter presents Intake Questionnaire, guidelines for creating a Targeting Sequence Plan, and the Worksheets that are invaluable tools in assisting therapists in gathering the client’s information.
- Go to chapter: EMDR Assessment and Desensitization Phases With Children: Step-by-Step Session Directions
This chapter describes the procedural steps of the Assessment Phase and Desensitization Phase of the Eye Movement Desensitization and Reprocessing (EMDR) Standard Protocol with detailed scripts for steering a child through each phase. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. Assessment phase note section starts with Target Identification; this is a continuation of what began during the Client History and Treatment Planning Phase. The therapist should already have some idea of what the child may choose given previous target identification procedures such as Mapping and Graphing or other procedures for eliciting targets with children. Once the target has been selected, the therapist continues with Image, negative cognition (NC), positive cognition (PC), validity of cognition (VOC), emotion, subjective units of disturbance (SUD), and body sensation to move on to the desensitization phase.