Over the past 25 years there has been a growing recognition of the importance of working with families of persons with severe mental illnesses such as schizophrenia, bipolar disorder, and treatment-refractory depression. Family intervention can be provided by a wide range of professionals, including social workers, psychologists, nurses, psychiatrists, and counselors. This chapter provides an overview of two empirically supported family intervention models for major mental illness: behavioral family therapy (BFT) and multifamily groups (MFGs), both of which employ a combination of education and cognitive behavior techniques such as problem solving training. Some families have excellent communication skills and need only a brief review, as provided in the psychoeductional stage in the handout “Keys to Good Communication”. One of the main goals of BFT is to teach families a systematic method of solving their own problems.

The clinical social worker typically interfaces with older adult clients and their families in a variety of settings, providing diverse services ranging from assessment to clinical treatment to referral. This chapter discusses the ways in which cognitive behavior therapy (CBT) techniques can be used by social workers across different milieu to assist elderly clients who may be suffering from depression. These settings include the client’s home, an inpatient or outpatient mental health facility, a hospital or medical setting, a long-term care facility, or a hospice setting. The chapter provides an overview of how cognitive behavior techniques can be integrated throughout the range of services social workers may provide to elderly clients. Clinical examples demonstrate the use of CBT in a variety of settings. For many older adult clients, issues related to the need for increasing dependence on family, friends, and paid caretakers may become the central focus of counseling.

Community-based epidemiological studies find that when grouped together, anxiety disorders are the most common mental health conditions in the United States apart from substance use disorders. Anxiety disorders are also associated with substantial impairments in overall health and well-being, family functioning, social functioning, and vocational outcomes. This chapter includes a brief description of the anxiety disorders followed by a more detailed review of the cognitive behavior interventions indicated for these conditions. Social phobia is the most common anxiety disorder in the United States. Panic attacks are sudden surges of intense anxiety that reach their peak with 10 minutes and involve at least 4 of a list of 13 symptoms. Another somewhat less common anxiety disorder is obsessive compulsive disorder. The chapter discusses the posttraumatic stress disorder (PTSD). Two anxiety management procedures, breathing retraining and deep muscle relaxation, have been subject to some level of empirical investigation for certain anxiety disorder.

The idea of the mad genius persisted all the way to modern times and was even promulgated in scientific circles. Not only was genius mad, but it was associated with criminality and genetic degeneration. The empirical research relevant to the mad-genius issue uses three major methods: the historiometric, the psychometric and the psychiatric. The historical record is replete with putative exemplars of mad genius. The mental illness adopts a more subtle but still pernicious guise-alcoholism. In fact, it sometimes appears that alcoholism is one of the necessities of literary genius. Psychopathology can be found in other forms of genius besides creative genius. Of the available pathologies, depression seems to be the most frequent, along with its correlates of suicide and alcoholism or drug abuse. Family lineages that have higher than average rates of psychopathology will also feature higher than average rates of genius.

This chapter integrates elements and strategies of internal family systems (IFS) psychotherapy into eye movement desensitization and reprocessing (EMDR) therapy with complexly traumatized children. It shows a description of healing a part using in-sight with a child. In-sight involves having the client look inside to find and work with parts that he or she sees or senses and describes to the therapist. The IFS therapist starts by ensuring the client’s external environment is safe and supportive of the therapy. In a self-led system, polarizations are absent or greatly diminished, leaving more harmony and balance. However, when and how the self is formed may be seen and conceptualized through different lenses in adaptive information processing (AIP)-EMDR and IFS. According to the AIP model, the human brain and biological systems are shaped by the environmental experiences they encounter.

This chapter presents an overview of supervision and a brief introduction to several models of clinical supervision. It discusses the essential tasks and functions of supervision and the roles of the supervisor. Supervisee-centered psychodynamic supervision focuses on the content and process of the supervisee’s experience, examining the supervisee’s resistances and anxieties. As with psychodynamic and person-centered supervision, cognitive behavioral supervision infuses the supervision process with many of the techniques and theoretical concepts of the underlying theoretical orientation. Systemic supervision, based upon the theoretical perspective of systemic family systems therapy, is characterized by focusing importance and attention on the similarities between family systems and supervisory systems. The emphasis is on the supervisor using skills and approaches that correspond with the supervisee’s level of development. Developmental models of supervision are based on the assumption that clinicians in training pass through predictable stages of development as they gain increased knowledge and skill.

Scholarship on ethnic minority families and aging has wrestled implicitly or explicitly with the understanding of a theoretical dichotomy not uncommon in the field of sociology as a whole: the role that culture plays as either an epiphenomenon and/or as an integral element of the social structure. Interpretations of that basic structural versus cultural duality may derive from broader ideological perspectives, but they may also reflect a superficial framing of the concept of culture in scholarly analyses of ethnic minority families. This chapter presents a review of ethnographic literature on minority families and aging that is grounded in both racial/ethnic and feminist perspectives. It discusses three major topics that emerged as most salient in recent ethnographic studies: the concepts of familism, family obligations, and filial piety; the role of living arrangements, urban/rural space, and the neighborhood context on family experiences; and intergenerational relations, health, and caregiving.

This chapter considers aging in place both within larger community and societal contexts as well as through description of the unique experiences of older Latinos or Hispanics, African Americans, Asian Americans, Native Americans, and Pacific Islanders. In addition to racial and ethnic status, aging in place may also be influenced by changes in longevity, family demographics, caregiving, and household structures. Most considerations of aging in place emphasize the importance of the fit between the physical environment and the individual to successfully age. The recent addition to the model of the individual life course and historical change now offers a means to recognize three particularly influential components of aging in place relevant for African Americans, Latinos, Asian Americans, Native Americans, and Native Hawaiian/Pacific Islanders: social capital, the impact of the social environment, and acculturation. The characteristics of assisted-living residences or assisted-living facilities vary across the United States.

This chapter explores how gender equality is related to the relationship processes that construct two different models of motherhood. It examines how the experiences and meanings of motherhood are created and maintained within the context of ongoing interactions among mothers, fathers, and children. The idea of “mother” was frequently raised by both women and men in interviews in the Contemporary Couples Study (CCS), even though interview questions did not specifically ask about motherhood. Mothering is inextricably linked with ideas of femininity and gender which vary across history and cultures. Our goal was to accurately understand how our interviewees viewed mothering and to identify the interpersonal processes that account for variations in meanings as they relate to gender equality in couple relationships. Traditional couples consciously believe that mothering young children is a gendered talent and deliberately divide family responsibilities following the model of separate-sphere parenting.

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.

This chapter discusses the concepts, underlying principles, benefits, and challenges of using “whole-family” approaches in social work. It articulates the theory and skills associated with family engagement as part of a human rights and social justice framework for social work practice in forensic settings. The chapter describes the ethical imperatives and evidence base supporting the use of family group decision making (FGDM) in regulatory settings. It engages whole families as partners in the use of FGDM in child protection and youth justice. The chapter also describes the theory, empirical support, and skills in use of FGDM, or family group conferencing (FGC). It concluded with an example of how alert forensic social workers must be to the potential for their best intentions to collide with the tenants of responsive practice and a quote from a child protection social worker who worked closely with the author on a pilot project using FGC.

This chapter explains Victim-Offender Dialogue (VOD), its history and development, its characteristics, and its procedures. Concerns about victim forgiveness, are more explicit in VOD because the nature of the crimes involves the taking of human life or other heinous act and the impossibility of ever returning life to the one murdered or restoring a survivor’s life to what it was before the murder. Part of the cautiousness about the use of restorative justice for violent crime was concern that it might revictimize victims. VOD is an outgrowth of victim-offender mediation (VOM) and is similar in its central focus on the relationship between victim and offender. Victims, family members, and offenders describe the process of the meeting as a conversation. Although the dialogue belongs to the victim and offender, the facilitator begins the process, helps with transitions, invites breaks as needed, and remains a constant, readily alert, and cementing presence throughout.

This chapter examines three different models of family group conferencing (FGC): the New Zealand style model, the Wagga Wagga model from Australia, or the New Zealand Family Group Decision Making model. Besides its focus on youthful offenders, FGC is being applied with increasing frequency to juvenile and adult offenders as part of their reentry process. In New Zealand, FGC grew out of a crisis in the juvenile justice system. The Children, Young Persons, and Their Families Act of 1989 established statutory officials called youth justice coordinators who are responsible for convening and facilitating the FGC, monitoring the Act, recording agreements or plans, and communicating the results to appropriate people and agencies. The coordinator is most often a social worker. The New Zealand model of FGC is unique because it is legislated and administered under the welfare and social sector rather than the criminal justice sector.

This chapter examines the history and development of circles and delineates the attributes of the circle process. Circles as a restorative justice approach, is distinct from Victim-Offender Mediation (VOM) and Family Group Conferencing (FGC) in its continual attention to the details that must be in place and tended in order for the work of the circle to be productive. Regardless of the context in which circles are used, the purpose of circles is to create a safe, nonjudgmental place to engage in a sharing of authentic personal reactions and feelings that are owned by each individual and acknowledged by others, related to a conflict, crisis, issue, or even to reactions to a speaker or film. The outer supports of a circle process consist of five structural elements: ritual, behavioral guidelines, a talking piece, circle keeping, and consensus decision making. Circles, regardless of type, are often referred to as peacemaking circles.

This chapter presents an interaction between the provider and the patient’s mother. The culture of the emergency department (ED) adds to the communication problems in this interaction. There are several cultural values and beliefs of a family that might conflict with the cultural values and beliefs of an ED. From a cultural perspective, the provider managed the intercultural issues related to the hospital organization’s culture and the family’s culture. The health provider role and the communication role in this interaction are linked by the need to overcome the difficulties presented by Health Insurance Portability and Accountability Act (HIPAA) in a setting. The provider had to follow the organization’s and HIPAA’s policies regarding communication. HIPAA is intended to protect patient’s health information and give them complete control over who has access to the data or to any information about their health including if they are in a hospital/ED or not.

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.

Patients and/or family members often do not understand why patients are discharged from the hospital more quickly than they expect. By understanding patients’ and family members’ concerns about discharges, providers can assess, in advance, the content and interpersonal communication that will be needed to effectively share information and enhance decision making. Health literacy is an important component of effective health communication. Providers must recognize the education level of the patient and/or family member and use language choices that are appropriate for the other communicator’s understanding. In particular, providers should avoid technical jargon, like medical vocabulary or terminology in communication with patients and family members. The provider suggests that perhaps the patient had not taken her hypertensive medication as prescribed. Health care providers, by definition, are part of a unique culture and as such have learned a new language medical terminology.

This chapter presents an interaction between the provider and the patient. Insurance and managed care had impacted the provider-patient communication. It was the provider’s role to explain to patients about their speedy discharge. The provider utilizes verbal communication strategies to minimize the patient’s concerns. Communicating emotionally charged information, like a great deal of health communication, can be enhanced by providers developing strategies for dealing with patients’ or family-members’ responses. Recognizing which contexts and situations, like postpartum discharges for new parents and post-emergency room visits for children with acute respiratory symptoms, can benefit from preplanned communication strategies and will make it much easier for providers. The scenario shows a common response by hospitalized patients they are shocked to learn they are being discharged before they feel ready to leave. The provider uses active listening to demonstrate that he or she is hearing the patient’s concerns and using empathy to enhance their relationship.

This chapter presents an interaction between the provider and the patient. The provider played an important role in helping the patient with his nursing problem. Nonverbal communication is not only a power tool for sending messages, but it can also be very problematic if the sender is unaware of the impact of his or her behavior. For the nursing staff, it is likely their role is to enter a breadth of data on every patient’s electronic record. Unlike paper records, many electronic documents require data entry on a fixed computer. Efforts need to be made in hospitals to find ways to position computers, or use movable computers, in order to nonverbally illustrate to patient and families that the staff is more patient focused than computer focused. Role perception is a difficult area in health care organizational communication.

This chapter helps the reader to identify three ethical issues arising for clinical nurses in the provision of person-and family-centered care (PFCC). Those ethical issues are ensuring that the patient’s voice has primacy over that of the nurse, honoring the choices of the patient even when they conflict with those of the nurse, and engaging with family as the patient directs. Nurses interview all patients on admission to the hospital. Assessing the patient’s physical and emotional condition, learning needs and orienting the patient to the care environment are well-established nursing responsibilities. Using strategies to elicit the patient’s values, beliefs, and care preferences, negotiating plans and providing emotional support are all within the purview of the clinical nurse. Nurses are also influential in promoting other disciplines to work more collaboratively with patients and family members given their central role in the acute care setting.

This chapter helps the reader to understand the types of health care decisions faced by patients/families, to describe several types of advance care planning and documentation, and to understand the role of the surrogate decision maker in health care settings. It discusses the role of cultural background on the communication and decision-making processes and also important components of the communication process between the health care team and patients/surrogates. The chapter presents the role of the nurse in the communication and decision-making processes in health care situations and strategies to minimize conflict in the health care decision-making process. Making decisions in health care settings is challenging for patients, surrogates, nurses, and other members of the multidisciplinary health care team. Advance care planning is essential for any persons with significant health challenges or advanced age, and is recommended for all adults.

Closings of interactions require effective nonverbal behaviors as well as verbal communication. Nonverbal behaviors can be used to communicate to patients that a provider wants to have a collaborative relationship and not an authoritarian, paternalistic relationship. Providers using feedback to clarify what patients or family members communicate and demonstrate that they are listening and assimilating the information they are being given. In the enhanced interpersonal communication, the provider has nonverbally decreased the power differences in the relationship by having the patient remain dressed during their conversation, sitting across from the chief executive officer (CEO) at eye level, and only having the patient put on a gown when it was needed for the examination portion of the visit. The provider takes the time needed to empower and educate the patient, including how long it will likely take to get the results, thereby eliminating that aspect of the unknown from patient’s concerns.

This chapter presents two different interactions among the provider, patient, and family members. The patient’s diagnosis has impacted the communication. The patient’s and wife’s age affect the communication with the provider. Health Insurance Portability and Accountability Act (HIPAA) made communication more challenging for providers, patients, and family members. The nonverbal behaviors had positively impacted the exchange of information in the second scenario. The media’s portrayal of chronic diseases, such as diabetes, affects how patients respond to such a diagnosis. Older patients often need more time to process information. In addition, the emotionally charged diagnosis of diabetes, especially for an older couple, should be expected to generate many questions and some difficulty processing the information. Feedback for clarification is very important to interpersonal communication and feedback comes from nonverbal cues like head nodding or eye movements.

This chapter describes the importance of research-based practice, the research method, evaluating the science and ethics of research and careers in adolescent development. The theories that guide research and practice in adolescent development now were generated through a rigorous and ongoing process of scientific investigation. Issues relating to health, school, delinquency, parenting, family, relationships, and dating are just a few of the many areas that use the ideas generated by the study of adolescent development to benefit adolescents in practice. Questions in adolescent development must be approached using the scientific method. Maybe playing violent video games is linked with aggression in adolescence, but as adolescents enter young adulthood playing violent video games impacts people in different ways. A college degree or knowledge in adolescent development can be applied to many fields of work.

A disorganized patient is one who behaves in a manner that lacks order, appears illogical, is unpredictable, or otherwise seems to reflect impaired cognitive functioning and demonstrate neuropsychiatric symptoms. The patient with chronic disorganization may be discharged to a nursing home or group home, or to family members with home services. Communication between the treating team at the hospital and the outpatient providers will take place within the context of specific agency or organizational policies and procedures. It is very important, however, that helpful structures, routines, nursing actions, medications, or other interventions be shared with the aftercare services so that they can be replicated as much as possible. Inpatient staff may also want to share triggers to agitation and disorganization that have been identified. This will require clear and probably written instructions for the caregivers, family members, and any staff involved in the aftercare environment.

This chapter utilizes the case example and current literature to understand the transition model when working with relationship transitions. It discusses different types of transitions involving changes in family and other interpersonal relationships such as: partnering relationships; divorce; widowhood; remarriage; parenting issues; grandparenting issues; eldercare; death of a parent; and friendships. Across relationship transitions, recurring issues include intimacy, belonging, and mattering. Changes involve role gains and role losses, and culture is a key consideration when working intentionally with the clients. Discussion includes issues and examples related to situation, self, support, and strategies. A “Coping Keys Worksheet” is included as an informal assessment regarding coping strategies which may modify the situation, change the meaning of a situation, and/or manage reactions to stressful relationship transitions.

This chapter highlights the key relevance of family and social context in Internet addiction disorder (IAD) subjects, through the development of a novel, holistic framework for assessment, the IMPROVE tool. It presents IAD in clinical practice with an illustrative case. The IMPROVE tool contains elements of some of the mechanisms investigated in the Family Accommodation Scale and Accommodation and Enabling Scale for Eating Disorders, through which parenting factors may shape the development of an internet-overuse problem. The chapter describes each item in IMPROVE tool in detail. The items include Internet Inventory, Monitor Over Time, Parenting Factors, Real-World Activities, Other Mental Health Conditions, Vulnerability Factors and Extra Help or Assistance Needed. It is important, when embarking on a treatment pathway, to have a clear idea of how advanced the IAD may be in a particular child, as differing levels of severity will require different strategies.

This chapter presents an interaction between the provider and the patient. The context, emergency department (ED) versus other settings, changes each communicator’s perceptions and expectations of the interaction. Power impacts the interpersonal communication of both interactants. The provider’s interpersonal communication in the scenario impacts the information exchange. Some nonverbal communication behaviors have impacted the patient’s perception of the provider. The emotion of the situation contributes to the communication problems and/or solutions. The provider’s use of explanation and information sharing impact the patient’s decision making. Health communication by its very nature is often emotionally charged. In such situations, information sharing can be lessened due to the emotional state of the patient and/or family member. Using empathic listening and communicating an awareness of the patient’s or family member’s situation is a good way to build trust and enhance the interpersonal relationship that providers are trying to develop.

Most families exist in some type of homeostatic balance, and the loss of a significant person in the family group can unbalance this homeostasis and cause the family to feel pain and to seek help. Specific factors that affect the mourning process and influence the degree of family disruption have been identified. These include stages in the family life cycle; roles played by the deceased; power, affection, and communication patterns; and sociocultural factors. This chapter discusses how family dynamics can hinder adequate grieving. The concept of family therapy is based on the belief that the family is an interactional unit in which all members influence each other. The characteristics of individual family members help determine the character of the family system, but this family system is more than the sum of its individuals’ characteristics.

The importance of engaging families of psychiatric patients in the hospitalization process has been acknowledged for decades. Family engagement in a patient’s treatment has been shown to decrease risk of relapse, improve recovery and promote the well-being of the entire family. Despite efforts by organizations worldwide to eliminate the stigma attached to psychiatric illness, society has been slow to react. The general public often treats psychiatric patients differently than any other group of medical patients. Psychiatric nurses strive to develop a dialogue with families that convey a genuine concern for the patient and the family. In talking with the family, the nurse should keep in mind that it is not uncommon for family members to experience difficulty asking questions or not to know what questions to ask. Patients and family members experience many conflicting and intense emotions at the time of admissions, and family members may have many concerns.

Children and adolescents depend on many systems to foster their social, emotional, personal, and developmental needs. School leaders, school counselors, communities, families, mental health counselors, and representatives from all systems in a child’s life need to collaborate and integrate care to produce the best outcomes for every child. This chapter identifies the many systems that impact child and adolescent development. It describes ecological systems theory and recognizes the many different types of families. The chapter explains how counselors in schools and mental health settings can adopt a systemic view of child and adolescents. It illustrates the impact of culture in the systems in which children and adolescents are embedded. The chapter explains how counselors can assist in collaborating with and connecting systems for best treatment outcomes. It outlines best practices for counselors working with children and adolescents.

While high-income nations have experienced increasing life expectancy as a consequence of better healthcare and healthier lifestyles, this does not mean that the size of the aging population will be the highest globally. The issue of HIV and older adults will continue to be a public health issue across the globe and will require the attention of factors related to socioeconomic context as well as sexual health and education. Regardless of the income of specific nations, families provide essential and important support for elders. The support of the oldest-old and those who require long-term supports and services earlier in life will be the most pressing issue for all nations going forward—rich and poor alike. These issues, in and of itself, is a great reason to participate and learn about international issues and global aging so that we can in fact face the challenge of change in our aging world.

Social workers have continued to serve the individuals, families, and communities that are the most vulnerable and affected by social and behavioral influences on health as well as a fragmented healthcare system. This chapter summarizes the healthcare issues raised throughout the book, contemplate factors that will drive future healthcare policy and practice decisions, and considers the future roles of social workers in healthcare. Social workers are already the dominant behavioral health workforce, with most direct care, especially for low-income people, being delivered by social workers. These skills are increasingly important to healthcare today. In order to be prepared to play an integral role in the healthcare of the future, social workers need education that equips them with competence and confidence. They need to understand and be able to articulate what they can contribute to interprofessional care of the complex and sometimes disenfranchised healthcare recipient.

Parents of children and adolescents newly diagnosed with cancer face many new tasks and responsibilities. Interventions designed to assist families in making short- and long-term adjustments to the chronic cancer experience focus on reducing parents’ stress, enhancing coping, improving physical and psychological states, and supporting family and interpersonal functioning. The author and her research team developed the Family Strength–Oriented Therapeutic Conversations intervention (FAM-SOTC intervention) to aid family development of competencies for caregiving and navigation of life tasks. FAM-SOTC intervention processes are focused on families’ responses and adaptations to stressors due to illness. This chapter explores the integration of guided participation (GP) practice components—issues, processes, and competencies— with the FAM-SOTC model. The goal of this integration is to contribute to the operational features of the intervention. It provides a case study showing the depth and breadth of the teaching–learning that was engaged through the relationship-based therapeutic conversation.

Over the last decade, there has been tremendous growth in scholarly and professional interest in grandparents raising grandchildren. This chapter refers to grandparents who are raising their grandchildren as custodial grandparents and their families as grandfamilies. Despite the many negatives often linked to grandparent caregiving, such grandparents are dedicated to the welfare of their grandchildren, are resilient and resourceful in coping with the challenges of raising a grandchild, and must be understood in terms of the social–interpersonal, developmental, cultural, and policy-related contexts in which they care for grandchildren. Good physical health is also protective in nature for custodial grandparents, though not all research supports this conclusion. Relative to physical health, the mental health concerns of grandparents raising their grandchildren has received less attention. Life-span developmental theory emphasizes multiple antecedents of developmental change.

This chapter elucidates the connection between education and work, and presents a history of education among African Americans. It examines the current state of education and discusses the achievement gap, including consideration of theories that attempt to explain it for example, oppositional culture theory, stereotype threat, and critical race theory. The chapter also discusses, within critical race theory, the impact of discrimination, teacher perceptions, and academic placement into special education and gifted programs. It explains factors related to better academic outcomes among African Americans including the influence of the family, attitudes and beliefs of the student, and aspects of the school environment including teachers and extracurricular activities. The chapter examines the benefits of historically Black colleges and universities. It focuses on work outcomes among African Americans, and examines areas related to success in African American careers and general thoughts on how to improve educational and career outcomes for African Americans.

This chapter provides an overview of forensic psychology in family court. It highlights the changing modern family and child custody issues. Two areas that might be considered only collateral to family issues are domestic violence and suicide. Suicide was included in this chapter for several reasons: There is an upsurge of teen suicides, which includes children still living with their family of origin; suicide is a major research area for forensic psychologists; and forensic psychologists are in a particularly good position to conduct psychological autopsies when the circumstances require them. Domestic violence was included because even though it is not necessarily limited to family members, it is a problem that does occur in families. Forensic psychologists may be called in to evaluate domestic violence either as a collateral issue to child custody issues or for direct evaluation and testimony.

This chapter explores the impact of completed suicide on family survivors. An understanding of the grief process for this unique group is outlined. Family members are not the only survivors; clinical professionals are dramatically impacted by the death of a client. The chapter explores a review of the impact and influence of a client suicide on treating clinicians and an examination of professional important considerations following a client suicide. The suicide of a family member, friend, or colleague is often profound and far reaching across many areas of life. Survivors frequently struggle between trying to make sense of the loss, managing their grief, and living their life. Unfortunately, the suicide of a loved one can become a risk factor for suicide for survivors. It is important for practitioners to be able to effectively work with the surviving family and friends.

This chapter explores how intergenerational connections can benefit communities and families. It presents stories, research, and conversations to better understand the value of strengthening intergenerational relationships and families as a path to increasing social connections and improving health and well-being for all ages and for society as a whole. The chapter focuses on innovative programs and case studies on intergenerational relationships within and outside of the family context offer practice tips and strategies that can be adapted and adopted for professional and personal growth. It is not enough to say that communities that are good to grow old in are also good to grow up in. Just because a curb that is cut for accessibility is good for a wheelchair and a stroller does not mean their occupants will ever cross paths and get to know each other. Intentional intergenerational engagement needs to become the norm.

The overarching vision in writing this book was to make guided participation (GP) as a practice of teaching and learning accessible, useful, and available to others to critique and develop. Opportunities for GP activity abound in many environments and settings of life, providing inspiration and strategies for its practice. The first section of this chapter is a discussion of what authors learned about GP through the chapters the contributors wrote. The second section sketches next steps and questions for accomplishment of authors aim. The care responsibilities, constructed in the context of the family’s environment and the resources and competencies of family members, include managing chronic and acute illness, preventing illness, and promoting health. In many respects, the contributors to this book were guides to the book’s editors in bringing out and making plain the kind of teaching–learning authors had experienced or anticipated through GP.

Preparing families with a child who is technology dependent to transition from the hospital healthcare team holding primary responsibility for caregiving to a state of readiness for family-independent caregiving at home is a complex process layered with many physical, mental, and emotional challenges. To help illustrate these challenges and an approach to addressing them through guided participation, this chapter provides a story illustrating the common concerns and triumphs experienced by families and clinicians alike and highlighting learnings discovered through working with the story characters. It is the hope, and the purpose of this chapter, that the telling of this story supports nurses and interdisciplinary team members in better understanding their patients’ challenges and care, and in turn helps them be better prepared to partner with families via guided participation to achieve a successful transition to care at home.

This chapter describes how the death of various family members impacts a child’s life. Professionals should be prepared to discuss the impact of the death of other family members within this context, as in the case of the death of a parent. Like the death of a parent, the death of a sibling can also be a life-altering experience for a child. The chapter discusses the strength of the sibling relationship, specific factors that impact that relationship, and how it influences a child’s grief after the death of a sibling. It also describes the strength of the grandparent/grandchild relationship and the different circumstances that might impact a child’s grief after the death of a grandparent. Another circumstance that impacts a child’s grief after the death of a grandparent is when a grandparent has a life-limiting or terminal illness.

This chapter briefly describes palliative and end-of-life care, benefits of palliative care, and the role of palliative social workers. The aim of palliative care is to improve quality of life for the patient and family. Palliative care specialists facilitate communication among the patient, healthcare providers, and family members to better understand the illness and goals of care. Palliative care is delivered in a wide range of settings and with different models of care. These settings include: inpatient facilities, including intensive care units (ICUs), emergency departments, outpatient settings, community-based settings, long-term care facilities, and home-based settings. Palliative care is a deeply rewarding practice area because it involves developing and using advanced clinical skills, is stimulating and challenging, involves interdisciplinary collaboration, and, most importantly, offers the opportunity for making a very meaningful contribution to patients and family members as they experience one of the most important transitions in their lives.

This chapter introduces the topics of developmental theories and disability and chronic illness. It asserts that many areas of professional practice, both in medicine and in the other helping professions, are organized around the developmental stages of life. New demographic changes will result in more professional specialties, including academic education and training. Three factors that will bring individuals with disabilities (IWDs) into the broader American culture are the growing population of IWDs; IWDs moving away from stigma management to identity politics; and the media portraying IWDs in more accurate and realistic ways. Next, the chapter discusses the combination of disability and developmental stages, including the ways in which disability affects developmental stages; the major theories of responding to a disability; and consideration of disability as an opportunity for growth and development. It illustrates cultural considerations, family issues, and the intersectionality of disability and cultural differences.

A gender-inclusive approach to studying grandparenthood can be enhanced by using a framework that combines elements of life-course, feminist, and critical perspectives along with the concept of ambivalence. Such a framework encourages researchers to examine the connection of larger social forces such as gender relations to the experience of grandparent–grandchild relationships over time. The inequality and contradictions that characterize institutional arrangements, such as gendered expectations regarding paid work and family responsibilities, are directly linked to the ways grandparents negotiate relationships with their children and grandchildren across the life course. This chapter outlines a conceptual framework for studying grandparenting in the context of gender relations. It applies to a critical review of the literature on grandparents. The chapter concludes by suggesting directions for future research.

This chapter explores the practice of a pediatric clinical nurse specialist (CNS)who uses guided participation (GP) processes to advance the care of children and families at a community hospital, identifies potential outcomes, and offers questions for reflection. Making use of GP methods when working directly with nursing and interdisciplinary colleagues is not only possible it is highly desirable and it is achievable. It provides a built-in opportunity for staff to experience directly what the children and families they work with could also experience if staff were to engage with them in this manner. Further, the CNS can identify that parallel process explicitly for staff, assisting them not only with developing competencies in the care of children and families—thereby lowering anxiety levels about taking care of children—but also in developing competencies in the practice of GP.

The presence of multiple chronic conditions (MCC) in children is a growing concern in the United States as increasing numbers of children confront MCC. Advances in the management of neonatal and pediatric illness have reduced mortality and increased survival rates for acutely/critically ill children who confront such issues as birth asphyxia, prematurity, congenital anomalies, trauma, child abuse, and metabolic, genetic, oncologic, and hematologic disorders. Children with MCC require the coordination of numerous healthcare services for effective management of their chronic health needs. Maintaining the child in the home environment necessitates meeting healthcare needs, optimally managing acute illness, and minimizing exacerbation of their chronic illness through coordinated outpatient care. Parents are the primary caregivers for children with MCC. Guided participation provides a mechanism for mutual goal setting and assisting families with managing the complexities of the journey that they are on with their child.

As most educators are well aware, children benefit when their parents are involved in all aspects of their education. This is true for high-performing students as well as low-performing students, and for students with and without special needs. Unfortunately, not all parents are actively involved in school. This chapter explores ways of using the motivational interviewing (MI) strategies, to gain greater parent involvement in schools, as well as to provide assistance with positive parenting practices. It first provides a rationale and discusses common challenges in achieving this goal. Next, it presents strategies that can be used at each MI process—engaging, focusing, evoking, and planning. The goal of the chapter is to describe the use of MI strategies in everyday interactions with families. In addition, it situates these strategies within a structured consultation model that can be applied in longer interactions and meetings with parents.

Motivational interviewing (MI) occurs in the context of conversation; thus, it requires that people be willing and able to engage in social interaction. Unfortunately, many of the less involved families, teachers, and students are inaccessible in some way, either unwilling or unable to attend school meetings or simply unwilling or unable to talk about change. This chapter presents a model for examining the common contextual barriers to change in schools and for overcoming these barriers. The personal qualities of the consultant or liaisons for the school are the foundation for successful invitations and discussions about change. The chapter describes some of these qualities. It also introduces literature that provides carefully documented methods for reaching even the most challenging families in order to get our foot in the door and to initiate meaningful conversations about change.

In order to understand the current state of the African American family, one must understand its history in the United States. This chapter begins with a historical examination of the African American family. It discusses what authors such as Billingsley, Hill, and Nobles have determined to be the strengths of African American families (strong kinship bonds, flexible family and gender roles, strong religious orientation, and strong work ethic and achievement orientation) with current research to support their ideas. Next, the chapter describes single-parent families along with the problems with the current knowledge of the topic. It also describes a program that has been developed to support African American families and discusses parenting behavior such as different parenting styles and the use of physical punishment. The chapter then discusses the unique role of African American fathers. Finally, it describes the problems with current research methodology concerning African American families.

This chapter brings guided participation (GP) into view at the intersection of healthcare and school in coordinated work with children who have a complex chronic health condition and their families. It highlights the functions of nurses, in hospital or community, within this cross-disciplinary and across-setting team. These functions put nurses in a position to develop and maintain GP through multiple phases of the child’s development and changes in the health condition and schooling. The chapter illustrates GP processes in operation for relationship development and teaching and learning for navigation of some of the issues that may be relevant for school-age children and adolescents who are transitioning from hospital to home, community living, and school. It also illustrates the functions of nurse and other members of the child’s healthcare and school team with a case example of an adolescent who anticipated and experienced a heart transplant.

Parents who abuse substances place their children at environmental, biological, and psychological risk of developing dysfunctional or maladaptive behaviors. Adolescent children of substance-abusing parents are likely to confront a constellation of stress factors within the family and larger ecosystem. Depending upon individual characteristics, such as temperament, intellectual abilities, and personality, as well as a host of environmental factors, some teens may have the resiliency to bounce back and even learn from adverse experiences related to their parents’ substance use. However, those who falter under the burden of parental substance use and its correlates may need help getting back on track developmentally. This chapter outlines the demographic patterns and the risk and protective factors faced by adolescents with a substance-abusing parent. It presents assessment and treatment issues and strategies for working with adolescents in various stages of development.

Theories of individual and family development provide an important knowledge base for direct social work practice. These theories are particularly helpful in the data collection and assessment phase of helping because they direct the practitioner to explore the potential significance of issues that individuals and families commonly face at different stages of development. Although individual and family development theories are primarily explanatory, they often provide general ideas for intervention.

Individual and family development theories can best be studied together, as families are made up of individuals and 66% of individuals live within families. This chapter focuses specifically on the individual development theory of Erikson, and the family life cycle theory of Carter and McGoldrick within a changed and continually changing social context. There are also discussions of Kohlberg’s moral stages of development and Gilligan’s feminist perspective on moral development.

Because the United States is increasingly culturally diverse, these developmental theories are viewed through a cultural lens. Family assessment tools including the ecomap (Hartman & Laird, 1983), genogram and culturagram that can help clinicians apply development theories to their work with individuals and families are presented.

The process of screening is typically a much briefer process than that which is involved in an assessment process. With regards to eating disorders specifically, there are multiple screening tools that can be used to help determine if someone shows signs of an eating disorder, thereby warranting a more formal assessment. Likewise, there are multiple assessment tools designed to confirm the diagnosis, determine the severity of the symptoms, and help inform the type and mode of treatment. This chapter briefly summarizes some commonly used screening and assessment tools for eating disorders. The SCOFF screening tool is one of the briefest screening tools for eating disorders and is commonly used. A thorough evaluation includes a medical assessment, psychological assessment, nutritional assessment, and family assessment. Each can provide invaluable information that can aid in the diagnosis and treatment of someone with an eating disorder.

This chapter explores the usefulness of rational emotive behavior therapy (REBT) in working with couples and families. REBT encourages self-direction by promoting rational thoughts and minimizing the need for support or approval from others. As such, the importance of assertiveness in leadership endeavors is emphasized in REBT. Rational thoughts lead to assertiveness; irrational beliefs tend to result in either passivity or aggression. When assertive, individuals are poised to promote self-interests and social interests in a functional and effective manner. By responding to challenges or adversity in rational ways, individuals will position themselves as leaders while developing cumulative skill sets adaptable to a variety of settings. REBT encompasses many behavioral theories and methods, such as operant conditioning and in vivo desensitization procedures. REBT emphasizes the use of behavioral techniques to assist families with changing their basic philosophic assumptions, as well as their thoughts, feelings, and actions.

Some counselor education programs have a Clinical Mental Health Counseling track and either a School Counseling or Marriage, Family, and Child Counseling (MFCC) track. Other programs may have all three and a nonclinical track from which students may choose. This chapter focuses on courses taught in the MFCC track. It summarizes some of the most helpful information to consider when prepping to teach a course in this track. These courses focus on helping students gain the necessary knowledge, skills, and attitudes to work with couples and families and introduce students to the theory, philosophy, and methods of systems work. The chapter focuses discussions and activities on topics such as systems theories, evidence-based interventions, contextualizing families, and cultural factors relevant to marriage. Courses in the MFCC track take a considerable amount of time to prepare. Like marriage, family, and child counseling, these courses are a spider web of processes.

Individuals of diverse cultures suffer from substance use disorders (SUDs). These individuals and the families that love them face devastating adverse consequences. It is crucial for research to continue to develop best practices and policies that address the public health emergency that exists across all socioeconomic levels, races, genders, cultures, and so on. This chapter highlights the importance of addressing the current public health crisis of substance abuse and SUDs with various population groups from different cultural backgrounds. It emphasizes client-centered practice from an intersectional perspective with a special focus on families. Health practices and policies that decrease disparities in healthcare are important to the well-being of marginalized groups from different cultures. Culture and its impact on perceptions, beliefs, and behaviors of different groups are critical to developing evidence-based treatments for substance abuse that are efficacious.

This chapter concerns the population of children who experience a parent’s incarceration for offenses related to alcohol and other substances. The children of parents incarcerated for substance-related offenses face the same challenges experienced by any child of a substance-involved parent, compounded by the difficulties associated with parental incarceration in jail or prison. These children must not only deal with their own sense of loneliness, fear, anxiety, and abandonment brought on by parental incarceration, but with the societal stigma of a parent who has done something “bad"; that is, abused substances. They require increased sensitivity by social workers and other caregivers who appreciate that they want and need an ongoing relationship with their parent. An integrated and coordinated array of “wraparound” intervention services to meet the needs of the parents, children, and substitute caregivers are necessary to help achieve a more hopeful and successful life for themselves and their families.

This chapter discusses how substance abuse affects relationships and family processes of parents and children and identifies assessment issues for substance abuse from a family perspective. It describes current evidence-based treatment approaches for parental substance abuse. Couple- and family-based approaches have demonstrated robust and broad positive effects in the treatment of the corrosive effects of substance abuse on the family. Reductions in substance use, partner violence, and relationship conflict serve to benefit parenting and communication patterns within the family environment, which are, in turn, linked to more positive child adjustment. As with all family therapy approaches, however, engaging family members in the treatment process is challenging. Development of alternative modalities of couples-based treatment, such as one-person family approaches, may offer comparable benefits within a more flexible and acceptable treatment modality. The chapter discusses the future directions, highlighting the important gaps between current empirical and clinical literatures.

This chapter focuses on who is involved in the treatment of eating disorders, the various levels of care, modes of treatment, and treatment approaches available to individuals dealing with an eating disorder and their families. It provides an introduction to what forms and approaches of treatment are commonly used. The American Psychiatric Association recommends that a team of professionals be actively involved in the treatment of someone with an eating disorder. This reflects the highly complex nature of eating disorders and the need to be sure that not only the individual's psychological health is being attended to but also his or her nutritional needs and medical well-being. This team is referred to as a multidisciplinary treatment team and at minimum should include a licensed mental health professional, a licensed medical professional, and a registered dietitian.

From the beginning of the profession, social workers have stressed the importance of respect for clients from diverse backgrounds. The most recent Code of Ethics advises social workers to understand cultural differences among clients, to demonstrate competence in working with people from different cultures, and to work against discrimination based on immigration status. This chapter discusses the culturagram, a family assessment instrument that grew out of the recognition that families are becoming increasingly culturally diverse and that social workers must be able to understand cultural differences among and within families. Completing a culturagram for a family can help a clinician develop a better understanding of the sociocultural context of the family, which can shed light on appropriate interventions to take with the family. The chapter examines the ten aspects of the culturagram and provides case vignettes.

Solution-focused narrative therapy (SFNT) is an integrated model of two postmodern language-based therapies working within a non-pathological approach. The therapist and client are collaborators in developing a solution-oriented narrative framework for a re-authoring process of the client's life. A collaboration of this kind abandons the idea that the therapist is the expert solving problems. This process allows the client to develop hope for an alternative future. The therapy model does not assume that there is something referred to as client resistance. This chapter offers ideas on working with individuals as well as families. In SFNT, problems are identified separately from the client's identity. The client and the problem are separated to allow the client a better objective view of the situation they are facing. The therapist holds the viewpoint that each client possesses the needed abilities, skills, and further tools to solve those challenges and any change that is essential.

The recognition of difficulties and challenges faced by the whole family has led to the development of family-centered approaches that provide various services and supports across the life span. Key goals of family-centered programs are to enhance resilience and increase opportunities for positive outcomes. This chapter examines families’ responses and adjustments to the impact of chronic illness and disability (CID). It presents information on psychosocial adaptation, family resilience and empowerment, family assessment in service provision, and cultural perspectives on family attitudes toward disability. The chapter examines the differential impacts of various disability experiences upon the family system, tools, and strategies for assessing family functioning, and interdisciplinary interventions aimed toward supporting families to adapt and optimize functioning. It discusses important cultural considerations and examines cultural factors. Finally, the chapter presents ideas for future directions for policy and research development to improve supports to families who are supporting members with disabilities.

A diagnosis of schizophrenia is terrifying and demoralizing to both the client and family members and has, until recently, been associated with dread and despair, the anticipation of a lifetime of chronic struggle, and a bewildering journey through the quagmire of psychiatric institutions and treatments. This chapter focuses on schizophrenia while noting the additional psychotic disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for the purpose of honing in on issues of intersectionality and resiliency. Gaining greater understanding about the nature of schizophrenia and other psychotic disorders requires the development of more effective strategies for treatment at the onset and with long-term chronic conditions. Evidence-based practice points to a combination of psychopharmacological and psychosocial interventions. The recovery model approach, based on hopes and lived experience, emphasizes the centrality of the individual's desires and initiative in relation to treatment planning.

This chapter highlights the experiences of those with mental illness. It also offers a picture of the families of those with mental illness, and the challenges family members face. The chapter examines the responses of individuals to the experience of psychiatric hospitalization. Most often, psychiatrists prefer to focus on the biomedical factors of illness rather than the concerns of the lived experiences of patients. While social workers and other mental health professionals can seek to understand the symptoms and treatments for individual patients, it is critical to hear the voices of those with mental illness. Many celebrities such as actors, writers, musicians, and sports figures have come forward to acknowledge and talk about their own mental health challenges. The chapter identifies the special challenges of families coping with schizophrenia. It offers a number of recommendations for the delivery of services within psychiatric hospitals.

This chapter reflects on how this book focuses on aging as a global phenomenon and attempts to see how our local knowledge plays in Indonesia or Bolivia, to compare what we think we know about our own ageways with what can be learned about the thoughts of other cultures on the subject. This chapter identifies 13 major global themes and describes how the world community—through the United Nations and nongovernmental organizations—is responding to the burdens that economic and demographic changes are placing on older people and their families. The chapter concludes with a call to readers for global leadership.

Solution-focused therapy (SFT) is a future-focused, postmodern approach to psychotherapy that is based on how the therapist and client co-construct language in order to shift the conversation from a focus on problems to a focus on solutions. In SFT, it is not essential to know the source of the problem in order to help the client create a solution. The assumption in SFT is that a small change will produce larger change. Therefore, the goal is to solve the problem by making small changes. SFT takes a distinctly postmodern approach, focusing on developing a preferred future. While the preferred future is the focus, there are opportunities, once the preferred future is defined, to explore past experiences in the form of exception gathering. Seeking exceptions with family members once the preferred future is defined empowers individuals to notice the strength within themselves and their family members.

This chapter provides a vivid glimpse of the conflict and emotional distress experienced by social workers who grew up with substance-abusing parents. It shares four personal stories of Robert: shame, denial, and the family secret, Sonia: an immigrant’s perspective on parental substance abuse and domestic violence, Andrew: effects of substance abuse on the family system across generations, and Emily: poverty, chaos, and fear overcome by resilience. Their narratives illustrate many of the dynamics and treatment issues in their personal stories. These poignant narratives provide people with a glimpse inside the hearts and minds of social work colleagues who have struggled to make sense of their own pain. Robert’s story clearly illustrates the confusion that Children of Substance-Abusing Parents (COSAPs) experience in not being able to openly discuss “the family secret”. All identifying details have been changed to protect the identities of family members.

Multiple interpersonal and sociocultural factors can have a negative influence on eating disorder behaviors and related concerns. Some factors associated with family, peers, and the media, when examined together, have been found to result in a higher degree of body dissatisfaction and a greater likelihood of how much control over food intake someone is exerting. This chapter examines some of the influences found among interpersonal factors, including peers and family, and sociocultural influences including mass media, social media, and video games. Interpersonal relationships in the form of friendships and relationships with family members can influence how someone views his or her body and the degree to which he or she desires to pursue the thin ideal. By contrast, when these relationships are more supportive, they can be a buffer against other factors that may contribute to the development of an eating disorder.

Arguably, nurses may subconsciously view their role as a private relationship between patients and their families and themselves, the individual nurse. In the same vein, nurses studied nursing in college, not political science or law, alternative pathways that might have indicated an intention to become active in politics. This chapter describes U.S. governmental structures and the policy process. It details points of influence in policy formation. The chapter explores the unique contribution of nurses in policy formation. The chapter develops a learning agenda for enhancing personal political influence. In such cases, identification of additional stakeholders and subsequent coalition building is a valuable way to foster a nursing presence. Finally, nursing involvement in health policy may be focused on health care, but activities directed toward the broader social determinants of health are a worthy contribution as well.

Multiracial individuals are at the forefront of the country’s significant demographic changes, yet, despite robust growth over the past several decades, the multiracial population has only recently been fully acknowledged by the U.S. Census Bureau and thus only officially accounted for in recent years. Despite the elimination of some legal barriers to interracial relationships, interracial couples continue to experience discrimination, inappropriate comments, and rejection based on their relationship status. This chapter discusses monoracial parents of multiracial children. Decades of developmental research suggests that parenting and family processes play important roles in youth development and have been linked to overall youth well-being. It briefly highlights the research that focuses on the experiences of multiracial individuals and discusses the racial identity development of multiracial individuals as well as the microaggressions these individuals experience in their everyday life. The chapter provides some clinical considerations through a case example.

Many individuals with eating disorders will not self-refer for treatment or seek an evaluation; therefore, the ability of friends, family, and others to recognize signs and symptoms of an eating disorder is crucial. This chapter discusses the role various individuals can play in the identification and referral of someone suspected of having an eating disorder, what happens after a referral is made, and what can be done to increase the chances that an individual will follow-through on a referral. Educators and other school personnel are also in a position to be among the first to know about or to be informed about a problem that may indicate the presence of an eating disorder. In many cases, athletes may be more at risk for developing an eating disorder than the general population. Although work itself is not necessarily a cause of an eating disorder, job-related stress may exacerbate eating disorder symptoms.

This concluding chapter discusses grandparenthood and provides a brief description about the book. In this book, authors have presented multiple perspectives bearing on a deeper, multileveled understanding of grandparenthood, including the cultural/historical, developmental, ecological, cultural and cross-cultural dimensions, as well as from a clinical/family systems perspective. It attempts to understand the current and changing nature of grandparenthood, including the impact of changing historical and interpersonal contexts as well as the diverse roles that grandparents perform in families. Indeed, families today are different than before. With the increase in longevity and life expectancy leading to greater expansion of research on aging and the family, coupled with the growth of the grandparenthood literature, it is clear from the chapters in the book. The chapter concludes with future directions.

The author’s approach to counseling is typically grounded in a systemic perspective, where he uses a directive approach, especially when family issues are involved. This chapter presents a case study of a 15-year-old Caucasian female from a middle-income family. Her parents were divorced and she had one sibling. The therapeutic challenge consisted of helping the patient process the difficult feelings she experienced toward her mother, and remain connected, or loyal, to their relationship. The patient attended counseling and focused on taking responsibility for her thoughts and feelings, and acting on them in an appropriate manner, regardless of how she perceived the behaviors of those around her. She recognized her growth and embraced it, knowing it meant she had to be responsible for herself after counseling, accepted her mother as a good person and understood that she received her mother’s best efforts.

It is not uncommon for children, adolescents, and families to seek counselors’ services when they are in crisis. Despite a growing literature base in school crisis prevention, intervention, and preparedness, there is a relatively scant literature base addressing mental health crisis intervention for professional counselors. This chapter addresses elements pertinent to crisis intervention, including mandated reporting, and associated trauma or grief. Children understand and process grief and trauma differently based on developmental and cognitive ability levels. Unfortunately, it is not uncommon for children to experience traumatic events before reaching adulthood. As an example, international studies document that child sexual abuse, physical abuse, or domestic violence affects approximately 25% of children. War, natural disasters, motor vehicle accidents, violence, terrorist acts, and refugee experiences can all contribute to trauma reactions. Regrettably, if left untreated, complications associated with unresolved trauma or grief can last well into adulthood.

Although people of various cultures have sought counseling for many years, it is only in the last 40 years that multicultural counseling has been studied as its own field in the counseling arena. "Culture" is a term that extends beyond race and ethnicity; it can refer to characteristics such as age, gender, sexual orientation, disability, socioeconomic status, education, geographical location and profession. As marriage and family therapy begins to gain acceptance across various cultures, therapists will increasingly work with clients of widely varying cultural backgrounds, life experiences, and worldviews. Culturally sensitive family therapists may take a cultural history of their clients, using the genogram, for example, before any assessments, forming judgments, or initiating interventions. The culturagram is a particular type of genogram, which tracks cultural issues such as immigration status; time in community; language spoken; health beliefs; cultural and religious institutions; oppression, discrimination, bias, and racism; and so forth.

An interprofessional simulation program introduces junior pediatric residents and novice nurses to common conditions seen in hospital setting, with scenarios designed to augment diagnostic and management skills. It also designed to enhance teamwork and communications and to ensure teams are prepared to take appropriate steps in escalation of care. Challenges confront pediatrics educators today in terms of providing high-quality learning opportunities and optimal exposure to a wide variety of conditions. The basic team for each simulation consists of a resident and pediatric nurse; ancillary personnel may also participate. The ability to communicate effectively takes on special importance for pediatricians, who treat children of all ages and sizes, most often with highly limited understanding or the ability to express themselves verbally. While communication with young patients requires finesse and knowledge of age-appropriate language, it is often the family, usually distraught and in crisis, that proves the most challenging to interact with.

Narrative therapy is a postmodern approach that respects the client as the expert of his or her destiny. It acknowledges how a person's perceptions and experiences result in certain beliefs and actions. Narrative therapy is based on the idea that a person's life and relationships are shaped by the "stories" a person creates or, are created for them in relationships. The narrative therapist assists clients to resolve their problems by helping them to separate themselves from the problems that keep them from fulfilling lives, assisting them to challenge how they currently live, and negotiating a newer, more preferred story. The narrative therapist empowers the client to "reauthor" his or her life by identifying unique outcomes and deconstructing the problem's effect on their life. Therapy emphasizes the requirement of changing the narrative in order to change how the client interacts with the problem.

HIV/AIDS has changed from being a death sentence to being a long-term illness due to advances in medications. In spite of these medical advances, HIV/AIDS continues to be a threat to the Latinx community. Social workers should be knowledgeable about the biology, medications, risk factors, and socio-cultural issues of HIV/AIDS. Latinx are the largest minority group in the United States and come from about 20 different countries with different histories and different journeys of immigration. The Latinx community is very diverse, and the information included in this chapter discusses the major Latinx groups. There are emergent Latinx groups and a dearth of research studies. This chapter focuses specifically on Latinx families, which are central in the Latinx culture. Families are considered essential for the functioning of the individual and of communities. HIV/AIDS infects individuals and affects the entire family system and communities.

This chapter provides an overview of the dynamics of families with substance-abusing parents, the impact on their children, and the most effective treatment approaches for children of various ages, ranging from those impacted by prenatal maternal substance use to older children, adolescents, and adults. Such children are found in every socioeconomic and ethnic and racial group in the United States and in every setting ranging from pre-schools to community agencies, to colleges and universities, to hospitals and mental health facilities, and in the private offices of mental health clinicians. Children of parents with alcohol-and drug-use disorders are often unable to experience such an environment and are at an increased risk for lifelong problems. It is the responsibility of all clinicians to understand the dynamics of young and adult children of substance-abusing parents (COSAPs) and how to best help them lead more productive and happier lives.

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.

Health issues and care impact all people. This chapter takes an intersectional approach in looking at people from diverse cultural and ethnic backgrounds, as well as other intersectional factors such as social-economic status, education, age, immigrant status, and gender that impact on their health issues and access. A major factor that influences access to healthcare is immigration status. Some immigrants came when they were children and have lived in the United States for most of their lives. Other immigrants are recent arrivals and may have initially come as visitors, students, or with work permits. While children of immigrants now attend schools that teach about healthy life practices, adult migrants did not benefit from learning about preventive health measures. In addition to holding varied views on prevention, members of an immigrant family may pursue different health providers.

Mental illness can be both a cause and a consequence of homelessness. People with mental health problems are more likely to become homeless than those without mental disorders. The mentally ill who are most at risk of homelessness have serious mental illnesses such as schizophrenia and bipolar disorder. This chapter examines the relationship between homelessness and mental illness and substance abuse. It examines the risk factors for homelessness as well as special groups such as homeless families, women and children, and veterans. It also examines the recent rise of homelessness and related societal responses. The chapter discusses the role of homeless courts and the shelter system. Responses to homelessness include Housing First and Treatment First model approaches. The National Alliance on Mental Illness policy recommendations are discussed, as are the recommendations of the National Alliance to End Homelessness. Finally, the chapter addresses the role of social workers in reducing homelessness.

Native Americans are a young and growing population. Poverty, racism, and trauma are common factors in the lives of many Native people, and these provide a context for significant social and health disparities. It is also important to recognize the resilience and tenacity that have allowed Native people to survive as distinct cultural and political groups in spite of centuries of colonization. Helping professionals can play an important role in assisting Native clients to access needed services and nurture their resilience. Professionals can also bring a strong grounding in social justice to combat many of the struggles that affect Indigenous Peoples. This chapter discusses the demographic profile of the Native American population. It also discusses the psychosocial risks and needs of Native Americans. The chapter provides the assessment treatment approaches for social and health problems, although few have been developed or adapted for Native Americans.

This chapter focuses on issues associated with intimate partner violence (IPV). It examines the impact on survivors of IPV as well as on families, communities, and societies. The chapter presents theories for contextualizing and understanding IPV as well as offering strategies for counseling survivors of IPV.

Asian immigrant experiences are vastly diverse and intersectional, depending on the specific family’s immigration/migration history, pre-immigration experiences, social class, generational and acculturation status, post-migration experiences, racial and ethnic identities, religious and linguistic traditions, legal status, and social identities. This chapter discusses cultural aspects that are often shared by Asian immigrant families, while acknowledging that the degree to which such cultural values are shared may vary within the population. Hence, practitioners are encouraged to assess and explore the specific contexts of each family. The chapter notes that while it focuses the discussions on Asian immigrants, it also uses the terminology Asian Americans to refer to Asians in the United States broadly. The chapter chooses to use both terminologies in order to capture the experiences of families that may include both immigrants and their family members (e.g., their children) who were born and raised in the United States.

Communication in healthcare differs from daily discourse. Tightly kept secrets, devastating prognoses, and hopes and fears are addressed in the service of bringing solace to individuals and families. Effective communications are the critical element upon which accurate diagnoses and culturally relevant treatment plans are constructed. Effective communication facilitates disease prevention, health promotion, and redemption for those facing life-threatening conditions. Of utmost importance when working with vulnerable youth and families, effective communication is a vital skill that must be taught to healthcare providers. The use of feedback teaching and learning for the enhancement of communications among vulnerable youth and their families does not have a substantial body of evidence in the scientific literature. Feedback teaching and learning begins with informed nurses and other health professionals. The primary objective of this teaching strategy is the enhancement of patient- and family-centered communications with vulnerable youth and their families.

With the increase in health care social workers engaging with patients as part of a collaborative team, documentation may also require coordination of other medical and lay individuals serving on the team. Social workers who work in health care settings realize the importance of accurate documentation and record keeping because they have been forced to become skilled in identifying and responding to the needs of the patients and their families. Whether a social worker is involved in indirect health care practice (focusing on health care policy and advocacy or health care administration) or direct practice (involving health-related assessment, intervention, prevention, and alleviation of negative situations), accurate and comprehensive documentation skills remain essential for quality intervention. Accurate record keeping in the health care environment is central to the concept of identifying treatment goals and measuring objectives as part of evidence-based practice. Accurate record keeping is essential for quality social work practice.

Older people are part of interdependent family systems, giving and receiving support of all kinds and performing important functions for their families. In both developing and developed countries, some older adults provide economic support for younger family members. This chapter provides an overview of informal and formal systems of care, with a special emphasis on family caregiving. Understanding who provides what kinds of care, and why, in different cultures is a complicated task because ideas about who should provide a specific type of care are deeply embedded in each culture. How deeply those values are held and how powerfully they can be challenged by shifting economic and demographic change is a question that is considered implicitly throughout this chapter. The chapter begins, however, by considering why caregiving is such a crucial issue for both families and societies—the stress and burden it places on the caregiver.

The composition of groups in group counseling ranges from couples to families to large groups of individuals. Across this range of compositions, common goals include self-understanding, personal growth, and building on inner resources. Group counseling involves individuals who come together to form a social system with norms and expectations, who interact with each other as well as with the leader, who share needs and experiences, who exchange supports, and who form an identity as members of the group. In group counseling, the group context and the group process constitute the treatment intervention. This chapter elaborates on the core assumptions and values of each theoretical approach. It describes how each theoretical approach can be uniquely applied in group and family settings. The chapter explains the general therapeutic factors in group and family settings as well as the different styles of leadership that can be adopted during the group process.

The family is the most basic social institution throughout the world. Families are studied in many disciplines, including anthropology, demography, economics, family studies, geography, gerontology, psychology, public health, social work, and sociology. This chapter explores what contemporary families look like around the globe, with a special focus on older members. This is a challenge, because one of the major characteristics of families is their diversity. The chapter begins with a brief example of the variability in contemporary definitions of the family. It then examines how population aging and global interconnections (specifically, economic and social factors) have changed the structure of families. Next, the chapter examines the living arrangements of older adults and their families, and looks at relationships within families. Finally, it explores macro- and microlevel factors that influence family functioning, and presents two important emerging roles of older adults in families.

Emotionally focused therapy (EFT) is based on attachment theory and uses elements of experiential-humanistic approach and systems theory. Its work has primarily been used with couples, and it is applicable to family therapy. EFT is aimed at reducing stress and anxiety in adult relationships and creating (or recreating) more secure attachment bonds. EFT presents, as a theoretical basis, that therapy needs to engage the "real relationship of the inner psychological world of both partners to their interaction" and the contextual relationship as also a basis of each person's behavior in relationship to his or her intrapsychic experience. The EFT template is meant to be used as a guideline to learning the process of emotionally focused family therapy. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and client.

This chapter provides brief description on family systems trauma (FST) motivational phone call. The FST motivational phone call script questions were designed based on key marketing outcomes found in Neil Rackham’s (1995) book: SPIN Selling. The steps for successfully implementing the FST motivational phone call are (a) understanding why FST motivational phone calls are important; (b) understanding the SPIN theory behind the FST motivational phone call; (c) the FST motivational phone call scripts; (d) the stick and move technique; and (e) effective closing remarks. There are three primary reasons why the FST motivational phone calls are important for trauma treatment of the child and the family: (a) Parent involvement is key to successful trauma treatment; (b) the value of a soft start-up versus a harsh start-up; and (c) the value of engaging the village or extended family members before treatment begins, not after.

Family and fathers play a critical role in many African American communities and life; however, social-historical factors, such as racism, contribute to the multiple challenges they face as witnessed in the case of a patient’s family system, as described in the chapter. The need to protect the patient’s family, possibly from the violence he witnessed in his community, became a larger burden for him. He was willing share the reasons for his criminal behavior. While his physical health was generally good, his psychiatric evaluations revealed diagnoses of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, bipolar disorder, and intermittent explosive disorder. Being imprisoned physically did not concern him because it provided him some protection from the turmoil in his family and community. However, his psychological imprisonment seemed to impede his adolescent identity development. Overall, the patient worked toward physical liberation, but more so toward liberation of his multiple incarcerated identities.

This chapter focuses on the clinical treatment of four impaired grandfamilies in rural areas. The approach and experience are similar to grandfamilies in urban areas, especially inner cities, but their social/economic situation may be more desperate and culturally enhanced, and with few resources. The first case study involves the treatment of a child from a toddler through his adolescent years the lens is on resilience. The second one looks at grandfamilies from a family systems approach. The third explores the impact of early trauma and transgenerational influences on the adult children and grandchildren. The fourth case study examines the role of the judicial system and the need for clinicians to advocate in the courts on behalf of grandfamilies. In all four of the cases, the chapter implements a holistic, but personalized, approach to mitigate the negative impact of substance- and alcohol-use disorders, family abuse, transgenerational effects, and cultural influences.