Healthy body image is critical to adolescent development, and teens often diet and worry about their weight and appearance. However, for some youth these concerns become fixed and distorted, resulting in psychopathology. Eating disorders, particularly binge-eating disorder, anorexia nervosa, and bulimia nervosa, are serious, complex chronic disorders, which can be life-threatening. Differential diagnoses for eating disorders include: cardiac valvular disease, malabsorption syndromes; inflammatory bowel disease; chronic infections; thyroid disease; hypopituitarism, Addison disease; central nervous system lesions; cancer; and other psychiatric disorders including depression, obsessive-compulsive disorder, anxiety, and substance abuse. Eating disorders are difficult to treat, especially when presenting with comorbid diagnoses, and treatment depends on the severity of the illness. Primary health care providers play a critical role in assessment, monitoring of treatment progress, screening for and managing medical complications, and coordinating care with psychiatric and nutritional professionals.

The initial recognition of the need for a genetics referral may arise when a nurse suspects a genetic contribution to disease because of personal or family medical history and/or findings from a physical assessment. Family history is a valuable and cost-effective tool that is often underutilized in clinical practice. Many common genetic conditions result from complex interactions between genetic and environmental factors. It is critical to collect information about potential environmental exposures to help inform a patient’s risk assessment. Health care professionals should become familiar about toxic environmental agents that are common in their specific geographic location. A growing number of Food and Drug Administration (FDA) approved drugs have labeling that includes pharmacogenomic information, which can be used to optimize drug dosage and prevent adverse and life-threatening drug reactions in a patient or family member.

Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing”. The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: time, fiscal restraint, and failure of the system to support a full staff of nurses, so those employed are working at full capacity. It is important to recognize that different practice settings have varying needs. One size does not fit all. Yet the requirements for nursing assessments, developing a plan of care, coordinating care with other health care providers, implementing interventions, and evaluating care outcomes are a requirement of all.

This chapter focuses on office automation and systems that are useful in the mental health field, along with principles to be aware of when considering the use or purchase of such systems. Most managers have to rely on input from outside in order to form an opinion about how to resolve complex issues. The complexity of the issue increases significantly when the current federal health care laws are incorporated into the task of choosing appropriate clinical information management software. The significance of Health Insurance Portability and Accountability Act (HIPAA) would seem to dictate at least a brief foray into its content because it lays the foundation for virtually everything that is happening in the clinical information management (CIM) realm. The information provided in the chapter can give a backdrop by which current practices can be examined for goodness of fit with the available client information management systems.

Pediatric primary care providers (P-PCPs) are involved in the primary care of children and adolescents with developmental and behavioral issues. The purpose of ongoing developmental behavioral screening in a primary care medical home is to identify problems early. These early interventions improve the long-term outcomes for children and adolescents. This chapter focuses on some of the more common neurological and psychiatric disorders that are encountered by children and adolescents in the primary care medical home setting and the ways in which the P-PCP can better identify a mental health disorder as early as possible through screening and intercept the problem with evidence-based interventions to promote better behavioral health outcomes. However, even with early intervention, some of the mental health disorders are chronic, long-term disorders requiring lifelong attention and treatment. It covers bipolar I disorder, depressive disorder, conduct disorder, obsessive-compulsive disorder, schizophrenia, and trauma- and stressor-related disorders.

This chapter explains a set of guidelines to help mental health professionals and clients move away from the gender stereotypes that perpetuate inequality and illness. Identifying dominance requires conscious awareness and understanding of how gender mediates between mental health and relationship issues. An understanding of what limits equality is significantly increased when we examine how gendered power plays out in a particular relationship and consider how it intersects with other social positions such as socioeconomic status, race, ethnicity, and sexual orientation. To contextualize emotion, the therapist draws on knowledge of societal and cultural patterns, such as gendered power structures and ideals for masculinity and femininity that touch all people’s lives in a particular society. Therapists who seek to support women and men equally take an active position that allows the non-neutral aspects of gendered lives to become visible.

The preschool child is generally 3 to 5 years of age. At 3 years old, the child is becoming a real person. The preschool years are an important time to prepare children to be successful in school. It is critical to identify and address the problem of social behavior readiness long before a child enters school. Parents need to be partners with other professionals in helping their children to succeed. They need to learn about their child’s growth and development and to be aware of unusual behavior changes and/or regressions to work with pediatric primary care providers (P-PCPs) to intercept potential behavioral problems. This chapter addresses the assessment, screening, diagnosis, and treatment of preschoolers with behavioral health problems. It also discusses assessing for school readiness and strategies to intercept potential and identified behavioral health problems in preschool-age children to help the child become ready to succeed in school.

This chapter focuses on more integrated approach or process for developing a health intervention for ethnic minority groups that incorporates accepted principles of medicine and scientific methodology. The changing demographic has led to complex challenges in the U.S. health care system. The delivery of effective health care services hinges on health care professionals’ ability to recognize varied understandings of and approaches to health care across cultures. Health care providers may employ different strategies to increase participation of service users by bridging barriers to communication and understanding that stem from these racial, ethnic, cultural, and linguistic differences. In the context of health or health care improvement, little debate exists concerning the recognized need to help ethnic minority patients maintain and restore health. There are two general approaches for developing culturally appropriate health interventions. The first approach is from science to practice and the second approach is from practice to science.

Pediatric primary care providers (P-PCPs), who are educated about resiliency, are in the unique position to assess child and family strengths, identify behaviors indicative of stress, and offer guidance and recommend services to help build child, adolescent, and family resilience. This chapter presents the evidence for building resiliency in children and the role of P-PCPs, which includes attention to the office environment and structure, comprehensive assessment, ongoing support, and community referrals. Building resiliency in children intercepts the impact of adversity on a child’s emotional, social, and behavioral health. Analysis of the results of screening tools completed by the parents and the child, appropriate assessment questions, office-based interventions, and timely referrals to therapy in community resources are critical components of the behavioral health assessment to enable the P-PCPs to intercept problems and build child, adolescent, and family resiliency.