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.
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Grief counseling refers to the interventions counselors make with people recent to a death loss to help facilitate them with the various tasks of mourning. These are people with no apparent bereavement complications. Grief therapy, on the other hand, refers to those techniques and interventions that a professional makes with persons experiencing one of the complications to the mourning process that keeps grief from progressing to an adequate adaptation for the mourner. New information is presented throughout the book and previous information is updated when possible. The world has changed since 1982; there are more traumatic events, drills for school shootings, and faraway events that may cause a child’s current trauma. There is also the emergence of social media and online resources, all easily accessible by smart phones at any time. Bereavement research and services have tried to keep up with these changes. The book presents current information for mental health professionals to be most effective in their interventions with bereaved children, adults, and families. The book is divided into ten chapters. Chapter one discusses attachment, loss, and the experience of grief. The next two chapters delve on mourning process and mediators of mourning. Chapter four describes grief counseling. Chapter five explores abnormal grief reactions. Chapter six discusses grief therapy. Chapter seven deals with grieving for special types of losses including suicide, violent deaths, sudden infant death syndrome, miscarriages, stillbirths and abortion. Chapter eight discusses how family dynamics can hinder adequate grieving. Chapter nine explores the counselor’s own grief. The concluding chapter presents training for grief counseling.
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.
- Go to chapter: Two Approaches to Developing Health Interventions for Ethnic Minority Elders: From Science to Practice and From Practice to Science
Two Approaches to Developing Health Interventions for Ethnic Minority Elders: From Science to Practice and From Practice to Science
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.Source:
This chapter discusses the client’s ability to self-regulate and handle high levels of affect. The maintaining factors of the effects of trauma- or anxiety-based disorders include fear, avoidance, and loss of control. Building or reinforcing coping strategies allows the client to regain some sense of control over what is happening, which, in turn, can have a positive impact on the fear and avoidance. Many novice Eye Movement Desensitization Reprocessing (EMDR) therapists report additional performance anxiety when their client is a mental health professional. Hyperarousal after a traumatic experience is normal. It occurs when a person’s brain believes that person is at risk again because it misreads an external signal or trigger. Grounding techniques can be taught very easily to clients and are another tool to help the client prepare for dealing with a possible abreaction while undergoing EMDR therapy.
This book focuses on the key issues surrounding multicultural neurorehabilitation for a wide range of health care professionals. The study of traumatic brain injury has seen a clear evolution in the sophistication, breadth, and depth of findings concerning neuroepidemiology as it affects racial and ethnic minorities. As large-scale epidemiological studies increasingly include and distinguish individuals of color and linguistic minorities together with religion, sexual orientation, physical disabilities, place of residence, and key socioeconomic variables that interact with race/ethnicity, more information will be available to make changes in policy, training, and clinical service delivery. Neuropsychological assessment involves the administration of a battery of tests that assess a variety of cognitive domains to obtain a clinical picture of brain behavior relationships. Within the inpatient rehabilitation setting, neuropsychologists often perform various functions, including neuropsychological assessment, psychotherapy, and assistance with adjustment issues for patients and their families. The book discusses some of the common cultural issues that impact neuropsychology in an inpatient rehabilitation setting. Considerations of race and ethnicity, disability culture, military and veteran culture, and cultural aspects of religiousness and spirituality are all considered in the book. The authors in the book wrote from their own perspectives as clinicians and researchers, representing diverse cultural backgrounds and neurorehabilitation contexts and roles. Hopefully, the book will generate more discussion, research, and literature on multicultural neurorehabilitation.
This book represents a compilation of years of theoretical and clinical insights distilled into a specific theory of disturbance and therapy and deductions for specific clinical strategies and techniques. It focuses on an explication of the theory, a chapter on basic practice, and a chapter on an in-depth case study. A detailed chapter follows on the practice of individual psychotherapy. Using rational emotive behavior therapy (REBT) in couples, family, group, and marathons sessions is highlighted. The book commences with a note on the general theory underpinning the practice of REBT, outlines its major theoretical concepts and puts forward an expanded version of REBT’s well-known ABC framework. It then considers aspects of the therapeutic relationship between clients and therapists in REBT, deals with issues pertaining to inducting clients into REBT, and specifies the major treatment techniques that are employed during REBT. A number of obstacles that emerge in the process of REBT and how they might be overcome are noted. The book then distinguishes between preferential and general REBT (or cognitive-behavior therapy [CBT]) and specifies their differences. Individual, couples, family and group therapies are explained. The book talks about the Rational Emotive Behavioral Marathon, a highly structured procedure that is deliberately weighted more on the verbal than on the nonverbal side. The authors’ 8-week psychoeducational group for teaching the principles of unconditional self-acceptance in a structured group setting is described. The book concludes with a discussion on the concept of ego disturbance, REBT treatment of sex difficulties using the cognitive-emotive-behavioral approach, and REBT’s effectiveness with hypnosis.
This chapter defines emerging disabilities; explores medical, psychosocial, and vocational implications of emerging disabilities that distinguish them from traditional disabilities; and provides demographic characteristics of individuals who are most vulnerable to acquiring emerging disabilities. It examines some social and environmental trends that have contributed to the development of emerging patterns and types of disabilities including advances in medicine and assistive technology, globalization, climate change, poverty, violence and trauma, the aging American populace, and disability legislation. Psychological and physical trauma from warfare, violent crime, intimate partner violence, and youth violence can result in permanent physical, cognitive, and psychiatric disabilities. Diagnostic uncertainties, misdiagnoses, and skepticism on the part of medical providers are frequently associated with emerging disabilities. Women also represent a population that is at an increased risk of acquiring emerging disabilities and chronic illnesses. Rehabilitation systems are still not fully prepared to address the multifaceted needs of individuals with emerging disabilities.
Rational emotive behavior therapy (REBT) marathons may take from 10 to 14 hours. Institute marathons are led only by professional therapists who have been solidly trained in individual and group REBT and who have also had special marathon training. A typical rational emotive behavioral marathon begins with the leader welcoming the participants, explaining to them that everything that goes on in the group will be strictly confidential and is to be subsequently discussed only with other group members. The problem-solving and cognitive restructuring part of the marathon is usually repeated several times. Each part of REBT approach starts with a strong, evocative lecture for understanding and handling a major aspect of emotional disturbance, followed by an experiential exercise that all the participants are encouraged to perform. Participants are given active-directive instructions to take on goal-seeking and homework assignments, and are practiced in carrying out REBT thinking, encountering, and skill training.
This chapter defines chronic pain, types, and causes; describes medical characteristics of two emerging chronic pain conditions namely chronic migraines and fibromyalgia; and discusses symptomology, diagnosis, and treatment issues associated with these conditions. It explores the medical, psychosocial, and vocational aspects of chronic pain, and examines the characteristics of populations most likely to experience chronic pain. The chapter presents recommendations for providing responsive rehabilitation counseling services to the growing numbers of individuals living with chronic pain who are served by rehabilitation counselors across all employment settings. As myths about chronic pain are so prevalent, rehabilitation counselors must carefully examine their own potential biases and misconceptions about chronic pain, its causes, and treatment. Complementary health approaches are often used by people with chronic pain and may include yoga, spinal manipulation, massage therapy, heat and cold applications, meditation, acupuncture, herbal medicines, vitamins, and minerals.
This chapter highlights topic areas in which research is needed to more fully understand the nature and needs of people with emerging disabilities, and examines current trends in rehabilitation counseling research and how investigations with people with emerging disabilities are compatible with these trends. It describes types of emerging disabilities for which health care, community living, and vocational experiences should be investigated more thoroughly in future research. The chapter addresses methodological and data analytic strategies that rehabilitation researchers can use to study the complex, multidimensional needs of people with emerging disabilities. Intervention studies that promote evidence-based practices will be increasingly important in future emerging disabilities research. Multivariate data analytic technique that provides opportunities to more effectively model the complexity of the real world in which people with emerging disabilities live is multilevel modeling (MLM), also known as hierarchical linear modeling (HLM).
Community engagement is a dynamic multi-facilitated, multi-stakeholder endeavor that makes impact measurements allusive. This chapter discusses the role of critical service learning as a backdrop for ethical engagement; and aims to graft existing professional frameworks and theory as tools for guiding and reflecting practice in community engagement with the aim of minimizing ethics violations in the community. Community-engaged learning models, such as service learning, have been shown to impact students in several areas, including self-efficacy, deeper learning of course material, reducing stereotypes, and fostering critical thinking. Students entering resource-poor communities have preconceived notions about why residents currently occupy their socioeconomic status. Ethical community engagement must emphasize the inherent capacity of individuals and communities to understand and respond to social issues. Community engagement presents a difficult duality; many students will participate in it to develop professional skills particularly within education, social work, and health professions.
This chapter introduces the current evidence-based brief interventions that derive from the theories of health behavior. It reviews theories of health behaviors that inform the types of behavioral health interventions that utilize in the practice of behavioral health care. Health beliefs are attitudes, values, and knowledge about medical care, physicians, and disease that influence an individual’s behavior toward health care services. Consumer satisfaction was added as an outcome of health services utilization to reflect the increasing buying power and medical knowledge of the health of the health care consumer. Analysis of preventive health behavior was examined with regard to numerous health conditions and the preventive behaviors thereof, such as influenza inoculation, screening programs for genetically inherited diseases, breast cancer, and high blood pressure. The provision of all services from a single health care provider will help establish a relationship in which the patient trusts and confides.
This chapter reviews the research on expect respect, second step, and the recognize, understand, label, express, and regulate emotions (RULER) program, curricula with outcome data from US schools for step-by-step implementation by mental health professionals in the hopes of ameliorating this serious epidemic and enhancing the academic, behavioral, social, and emotional functioning of children and adolescents. School bullying and peer victimization are pervasive phenomena that affect many youth. Bullying may inflict harm or distress on the targeted youth including physical, psychological, social, or educational harm. Direct bullying is a relatively open aggressive act on the targeted youth, whereas indirect bullying is not directly communicated to the student being targeted. Moreover, physical, verbal, relational, and damage to property have been identified as specific forms or dimensions of bullying. Positive Behavioral Interventions and Supports (PBIS) is an evidence-based framework for reducing a wide variety of problem behavior in school settings.
- Go to chapter: Evidence-Based Interventions for Working With Culturally Diverse Children and Families
This chapter provides information on the best ways of providing optimal services for culturally and linguistically diverse (CLD) children and their families. One factor that significantly influences child well-being is whether the child is raised in a low-socioeconomic-status household. Despite the challenges and complexities involved in service provision, professionals have an ethical and professional responsibility to appropriately assess and intervene when diverse students struggle. Assessing language proficiency, acquiring relevant background information and selecting and using appropriate assessment tools are considered best practices when working with English language learners (ELLs). The evidence-based practice movement has become a professional priority given the importance of identifying effective interventions that can enhance service delivery to children, adolescents, and adults. The chapter concludes with a bibliography of readings and resources to assist mental health professionals in delivering high-quality services.
This chapter addresses the key principles of sport, exercise, and performance psychology. It reflects the broadening of sport psychology studies to encompass more widespread human performance research. The most well-established model explaining factors likely to increase the chance of injury is Williams and Andersen’s Stress-Injury Model. They proposed that a history of stress, insufficient coping resources, and personality characteristics, all of which increase the stress response, increase susceptibility to injury. Integrated model of response to sport injury is intended to demonstrate the dynamic and complicated nature of the injury and rehabilitation experience. Most athletic trainers are educated on the body, thus they know how to identify the injury, treat the body part, and create a rehabilitation program to initiate recovery and return to play; however, they also spend a great deal of time with injured athletes and are privy to their frustrations. This connection between injured athlete/performer and health care provider is significant as research has found better adherence to rehabilitation programs when athletes believe their health care professional cares about their well-being.
In older adults, sexual activity declines as a result of multiple causes like medical illness, disability, psychological problems, and social constructs that exist in institutional settings. Another phenomenon of older adult sexuality is that many older adults are aging without major health problems that would limit their sexual functioning. Older men often reveal their problem with erectile dysfunction to a health care provider or social worker. There are multiple approaches to treating erectile dysfunction in older men. The first and primary intervention is referral to an urologist. Functional problems contributing to the decline in sexual activity of older women include co-occurring anxiety or depression, urinary incontinence, thyroid conditions. Many older adults suffering from various forms of dementia become sexually disinhibited and show increasing hypersexuality as their cognitive deficits increase. Social workers have an opportunity to provide psychoeducation to families and caregivers in managing hypersexuality exhibited by patients suffering from dementia.
The Adult Protective Services (APS) workers use more formal risk assessment tools to determine the lethality of a situation in which an older adult is living. Social workers, health care workers, and clinicians are among the frontline professions who are able to assess maltreatment. The National Association of Social Workers (NASW) provides guidelines for working with caregivers of older adults. Having considered advanced general assessment and advanced assessment of family dynamics, there are also specific risk assessment areas that social workers would want to explore in interviewing older adults and their families. Cognitive behavioral therapy (CBT), person-centered therapy (PCT) and cognitive analytic therapy (CAT) have proven effectiveness for intervening with mistreated older adults by reducing fear, stress, and anxiety. Social workers and health care professionals are in prime positions to routinely assess for maltreatment. Research into effective forms of assessment and intervention in situations of older adult abuse is required.
Chronic pain syndromes are composed of a multifactorial relationship between biologically based neurological triggers and pathways; psychologically mediated moods, emotions, and behaviors; and socially developed responses, interactions, and consequences. The complex interplay between these factors can devastate a patient’s quality of life, as well as make the diagnoses, treatment, and ongoing management of chronic pain syndromes by health care professionals exceedingly difficult, resulting in psychological and physical disability. In chronic pain, the imprinted signals and perceived pain may persist for several weeks, months, or even years after the original injury has healed. Treatment of chronic pain creates yet another dimension of complexity, as it requires a multimech-anistic, multimodal, or multidisciplinary approach for effective management. Chronic pain often is mixed nociceptive and neuropathic or primarily neuropathic and is associated with imprinted neuroanatomical and chemical changes in the peripheral and central nervous systems, which results in abnormal processing.
Chronic renal failure poses a singular challenge for health professionals who deal with illness-related disability and rehabilitation. The course of progressive chronic kidney disease (CKD) leading to renal failure often spans many years; during the period before dialysis or renal transplantation is undertaken, the patient may experience disabilities related to cardiovascular disease, anemia, malnutrition, metabolic bone disease, neuropathy, muscle wasting, and acid-base and electrolyte disturbances. Dialysis treatment and transplantation significantly prolong the lives of patients with renal failure. A better understanding of the pathophysiological basis for many of the disabling aspects of chronic renal failure has led to therapies that may reduce the frequency and/or severity of these aspects of the disease. Prevention of disability and rehabilitation has become increasingly important as the number of patients treated with dialysis therapy and renal transplantation has become more common.
Research and interest have grown over the past two decades about the impact of chronic illness on sexuality and relationships. Today, with the realization that with better quality of life individuals and couples may sustain some interest in sex, many national organizations that advocate for various chronic conditions now have website information, pamphlets, and books on the topic of sexuality, for example, the American Cancer Society. Medical and mental health providers who work with people with one particular illness may have some advantage in that their knowledge about sexual effects can be focused, but the provider who sees people with a broader array of medical problems, may need a systematic approach to collecting and understanding information in order to provide optimal treatment. The specific needs of people who identify as sexual and gender minority must be included in consideration of treatment.
Using a sex-positive framework to understand sexuality, the person’s own experience and meaning-making that is important, rather than social norms regarding sexual behavior. Insight and knowledge into sexuality require that providers pay attention to their own development, but our training reflects the reluctance of our culture as a whole to “go there” and attend to this aspect of the self of the provider, which is perhaps one of the most important tools providers have for treating clients. For most providers, learning how to address sexual topics requires specialized training that may be difficult to access, requiring travel and other expense. Providers need to have a thorough understanding of issues faced by sexual- and gender-minority identified clients in order to provide ethical treatment to everyone seeking services. Providers can become more comfortable with sexuality by seeking sex-positive instructors, reading more about sexuality, and seeking appropriate supervision with clients.
In men, the sexual response from desire to arousal to climax tends to be more linear and reflective of the Masters and Johnson model, as men experience a considerably more automatic response to sexual stimulation than do women, though clinically men sometimes resonate with Basson's responsive model of desire when it is described. It is noteworthy that, until a few decades ago, problems related to erectile function and ejaculation were thought to be primarily psychogenic; treatment consisted of psychoanalysis or marginally successful behavioral interventions. Currently, the field of sexual medicine believes that male sexual dysfunction is mainly due to physical problems. But there is still a place for mental health professionals in treating male sexual dysfunction, since medical interventions are not always dependable or effective on their own, and there still exist cases that are more psychological than physical.
When parents are not comfortable giving their children words for some of the most powerful physical and emotional experiences they will have in life, a veil of secrecy is created around the subject of sex that children carry with them into adulthood. Whether one want to embrace sex therapy as a niche for their practice, or one want to be a provider who “does” sex, this book is a clear, pragmatic entrance into helping clients of all kinds resolve sexual concerns—a raft of sorts to help navigate what can be a confusing area of human experience. In this updated version of the text, the author have worked with intention to be inclusive of sexual and gender minorities by not only updating the specific chapter regarding serving their needs, but by referring to current research about this population throughout. It becomes a book one can turn to again and again when almost any client presents with a sexual concern, reminding that there exists an approach and information to calmly tackle common, and uncommon, sexual problems. The book is a straightforward, inclusive, plain language textbook designed to take the provider who knows very little or who might be uncomfortable about sex to a place of knowledge and competence. This new edition covers: current research on sexual and relationship issues in sexual/gender minorities (
S/GM); updated approaches to considerations of gender identity; the application of mindfulness in the treatment of sexual problems; expanded information regarding the sexological ecosystem; treatment of out of control sexual behavior and the new compulsive sexual behavior disorder ICD-11 diagnosis; and ethical considerations in making referrals of S/GMclients.
This book, as well as its previous editions, presents the fundamental principles for effectively securing funds for health and human service projects and research. It describes an approach with which to think about and engage in grant writing and takes the reader step-by-step through the process of grantsmanship, from its basic components to an understanding of what is required to implement a successful grant project. It is organized into seven parts, moving the reader from identifying a competitive idea (Part I, Getting Started) to writing the narrative (Part II, Writing a Competitive Grant Application), developing an appropriate budget (Part III, Preparing a Budget), identifying an effective project structure (Part IV, Models for Proposal Development), submitting the proposal (Part V, Submitting the Proposal), understanding the review process and grant critiques (Part VI, Life After a Grant Submission), and finally managing the associated grant activity and building from one grant to the next (Part VII, Strategies for Managing a Grant Award). The book emphasizes principles and approaches versus procedural details associated with any single grant submission. This edition includes expanded coverage of key areas such as how to write an effective aims page, considerations for specific types of study designs, and how to write a compelling literature review. It also includes details on mentorship within the grantwriting process and the implementation of a funded project. This book also helps readers gain an appreciation of how grant writing fits into a career path and how to develop ideas in a systematic way so that one funded project builds logically onto the next.
- Go to chapter: Contemporary Issues and Counseling Tropisms: Leaning Toward Promise With Children and Adolescents
Mental health professionals who work with students must be well-versed in the protective factors that maximize youth academic, social and personal success. One can and must cultivate healthy communities and teach youngsters to advocate for themselves as one advocate for them. Significant research points to strategic ways one can strengthen schools, families and communities. All too often, violence, substance abuse, bullying, sexual assault, suicidal ideation and more threaten student well-being. The profession calls upon professional school and mental health counselors to be ethical, skilled, culturally attuned and ready to engage in prevention and intervention as they work with students and families. This chapter expresses familiarity with social challenges to healthy child development. It helps to recognize the crucial role of professional school and clinical mental health counselors in the cultivation of positive school and community contexts. The chapter hypothesizes counseling from a strengths-based, curious, and creative stance.
This chapter describes the current status of caregiving in the United States. Who are caregivers and what tasks they routinely do are discussed. The diversity of caregiving is also considered. Physical, psychological, social, and financial ramifications of caregiving are described along with benefits reported. The chapter concludes with recommendations on how healthcare professionals can support caregivers.
This book aims to continue inquiry into the evolving nature and all too frequent fragility of late life relationships and the grand challenge of social isolation. It do by documenting author’s current understanding of the complex and multidimensional nature of the interrelated issues of social relationships and health in late life, and the promising health and human service practices that have emerged to lessen the negative impacts of weakened relational ties for older adult health and well-being. The book explores from multiple disciplinary perspectives the characteristics and significance of a wide range of social relationships that, when taken together, can determine the extent to which older adults will be at risk of being socially isolated, disengaged, lonely, and otherwise at risk in late life. It considers the influence on older adult social health of trends in multigenerational family relations, friendships, grand parenting, love, intimate and sexual relationships, divorce and widowhood, and interactions with community and healthcare providers and other public entities. It highlights innovative and alternative forms of community and later life relationships that can serve to forestall or prevent altogether social isolation and loneliness. Given the significance placed on the quality of our social lives in preparing us for a satisfying old age, it explores as well a variety of strategies for bolstering older adult social health and community engagement. While one’s physical health status in late life may not be able to be dramatically altered for the better, it argues that one’s social health and the relationships that comprise one’s social life can. Whether you are an older adult yourself or a professional or family caregiver of an older adult, you have the capacity to shore up potential gaps in the integrity of your own or another person’s social world.
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.
All counselors, regardless of setting, will work with clients affected by addiction. There is no longer a question as to whether or not individuals can become addicted to behaviors. That question has been unequivocally answered through decades of empirical data and scholarship, evidence from clinical work and successful treatment approaches, and changes in diagnostic manuals, global classifications of diseases, and definitions of addiction. Now, the pressing question is how to best prepare counselors and other mental health professionals to effectively serve individuals with behavioral addictions. Researchers, clinicians, and neuroscientists are making great strides in understanding behavioral addictions and collecting evidence regarding effective interventions, assessments, and treatment strategies. This chapter provides an information related to the nature of addictive behaviors, helpful strategies for recognizing and identifying behavioral addictions, and a public health model to guide conceptualizations of behavioral addictions.
The self-awareness of how to take care of oneself will enable one to hold an emotionally demanding vocation beyond the career's honeymoon phase. This chapter addresses how to prioritize self-care in a field that ironically forgets it occasionally and introduce the process of finding a comfortable, worldview-fitting therapeutic model. Developing self-care means looking after one's own well-being. This can include transforming internal dialogue, practicing boundaries, and consistently practicing mindfulness related to these. The hope of developing self-care is to alleviate the stress of life as it begins to be heavy rather than waiting until it feels like responsibilities are teetering out of control. There are four types of self-care: physical, cognitive, emotional, and spiritual. The chapter helps the reader to know how to maintain self-advocacy in self-care both short and long term for a greater overall well-being physically, emotionally, cognitively, and spiritually.
There is a natural hierarchy within most families, with parents and primary caregivers as leaders. When the family hierarchy is unbalanced, serious problems arise. It is the strategic family therapist's job to realign the family by teaching parents and primary caregivers how to lead. Once the natural balance and order in the family is achieved, problems dissipate. Strategic therapists took the concept of the positive feedback loop and made it central to their model. Strategic family therapists believe that to change family organizational patterns and therefore alleviate the identified problem, the routine in which the clients communicate with one another must be altered. This chapter discusses the tools therapist may use: directives, prescribing the symptom, unbalancing, therapeutic double bind, reframing, restraining, and using metaphors throughout the session to assist the family or individual to make changes in their lives.
Suicide is a problem that knows no cultural boundaries. As the minority population in the United States continues to grow, it is essential for health and mental health providers to develop culturally relevant prevention and intervention efforts to address these at-risk populations. Risk and protective factors vary across culture and ethnicities, as do attitudes and perspectives regarding suicide acceptability. Intervention and prevention efforts should be guided by culturally relevant risk and protective factors for suicide and an understanding of attitudes toward suicide among the target population. This chapter explores the diverse demographic and ethnic profile of suicidal behavior in the United States and reviews known psychosocial risk factors for suicide within these cultural groups. It reviews the critical factors related to culture to be considered when conducting a risk assessment with suicidal clients. The chapter explores the treatment of suicidal individuals from culturally competent and evidence-based practice perspectives.
Eating disorders are complex and difficult to treat. One of the most significant reasons for difficulty with respect to treatment is not only the degree to which these disorders can be life threatening, but perhaps more significantly, the degree to which the eating disorder fights tooth and nail to ensure its survival. Strong emotional reactions, often referred to as countertransference reactions, to patients with an eating disorder are common and can range from care and concern to frustration and rage. Acknowledging and identifying one's own countertransference reactions can help both the person feeling them and the patient as well. This is particularly true for treatment providers who can risk harm to themselves and/or the patient if countertransference reactions remain unidentified. By contrast, when countertransference reactions are identified and appropriately understood the treatment provider may learn more about himself or herself as well as the patient, which ultimately can benefit treatment.
One of the historical pillars of rehabilitation counseling has been the use of assessment throughout the rehabilitation process. With this historical emphasis, it is not surprising that the focus on assessment and the methods and techniques used have changed and evolved. As a result, students, practitioners, and researchers are on a constant quest for updated and current information to guide and inform practice, policy, and research. This constant quest for updated and comprehensive information is directly relevant to the assessment of individuals typically served by rehabilitation and mental health practitioners and is the focus of this book. To date, there has not been a book that has been able to provide a comprehensive discussion of topics applicable to service delivery across both setting. This book attempts to fill this gap. One factor that guided the development of this book was the authors’ goal to provide both the foundational information necessary to understand and plan the assessment process and combine this material with information that is applicable to specific population and service delivery settings. To achieve this goal, each of the chapters is written by leaders in the field who have specialized knowledge regarding the chapter content. The chapters provide practical hands on information that allows for easy incorporation of the material to rehabilitation and mental health practice. To further strengthen practical application, case studies and templates have been incorporated where applicable to highlight specific key aspects to promote application to service delivery. Second, this is the first assessment book to be developed after the Council on Rehabilitation Counselor Education and Council on the Accreditation of Counseling and Related Programs merger. Finally, the authors hope that the readers of this book can apply this information to enhance the overall quality of life of the individuals they work with, especially individuals with disabilities.
This book primarily benefits those who do not know a lot about eating disorders or who have not had any formal education with respect to the complexities of these disorders. This book is organized into several parts designed to address different aspects of eating disorders. The part I describes what eating disorders are and who develops them, including a brief history as well as signs and symptoms of the disorders, and who is likely or less likely to develop an eating disorder. Part II of the book describes factors that can be considered risk factors, co-occurring factors, or consequences of having an eating disorder. These factors are discussed in terms of whether they are biological or medical, psychological, interpersonal, or sociocultural in nature. The part III guides the reader through how to identify those who might be at risk for developing an eating disorder and how to effectively refer someone for an evaluation. This section includes a discussion of what types of professionals should be part of treating someone with an eating disorder and important sources of support who should be involved in the treatment process or kept informed about how treatment is progressing. The part IV describes prevention and treatment efforts commonly used and a brief overview of their effectiveness. It also includes a chapter on identifying and managing one's own emotional reactions to someone with an eating disorder. Finally, the book concludes with several scenarios designed to illustrate for the reader what an eating disorder might "look like" in the real world and what initial treatment efforts might entail.
Service providers who work with people with sensory disabilities need to be aware of the various aspects that affect employment, social inclusion, and access to community services. Often, an interdisciplinary approach is necessary to reduce and/or eliminate barriers for people with sensory disabilities. This chapter addresses some of those factors, as well as services and technology to remove barriers and improve the lives of people with sensory disabilities. It examines the interactive effects of hearing disabilities and visual disabilities, and presents evidence-based strategies for people with sensory disabilities to use for navigating social and vocational landscapes. The chapter examines cultural implications of sensory disabilities, and common myths held by employers and the public. Finally, it discusses vocational issues such as employment discrimination, insufficient accommodations in the workplace, and the importance of services targeting effective employability and job placement, and some implications of the Americans with Disabilities Act.
In the field of family therapy, there is a need for working with families struggling with medical problems. The collaboration of both medicine and psychology in addressing the particular familial and individual issues that occur in dealing with illness have led to the medical family therapy (MedFT) model. MedFT represents a meta framework that encompasses overarching principles within which any mode of psychotherapy can be practiced. What sets MedFT apart from other family therapy theories is the routine collaboration with medical professionals as well as seeing illness as part of the systems. Collaboration is a primary aspect; medical family therapists need to have an understanding of the medical system to embrace a multidisciplinary team approach with physicians and other healthcare providers. The hope is that the MedFT therapist will aid the family, along with the medical staff, traverse illness and journey united together in coping with the effects of illness.
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.
- Go to chapter: Health Beliefs, Care, and Access of Individuals and Families From Diverse Backgrounds
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.
- Go to chapter: Religion and Disability: Clinical, Research, and Training Considerations for Rehabilitation Professionals
Religion and Disability: Clinical, Research, and Training Considerations for Rehabilitation Professionals
It is clear that laypersons, health professionals, and researchers are interested in addressing the importance of religion in society and in health care. However, if we are to use religion effectively to improve the health of individuals, there is a need to better educate current rehabilitation professionals and students about religion, to critically evaluate the existing literature on disability and religion, and to develop practical suggestions for rehabilitation professionals to appropriately use religion to promote positive health outcomes. Rehabilitation professionals need to collaborate with faith-based organizations to improve the physical and mental health of persons with disabilities, as well as their ability to reintegrate back into their communities. Such collaborations are particularly important given the resources that are available in most community churches (e.g., church vans, counseling services) to assist persons with disabilities with transportation and provision of social support.
Though the American Counseling Association Code of Ethics for professional counselors provides subsections for each area of practice related to clinical work and research, Section I engages in the more meta task of exploring how ethical dilemmas are actually resolved. In determining actions related to ethical dilemmas in their work with clients, the public, or other clinicians, counselors work to resolve these dilemmas with direct and open communication with all involved stakeholders. The chapter includes cases, assessed using the Corey, Corey, Corey, and Callanan (2015), Cottone (2001), and Forester-Miller and Davis (2016) models. This chapter highlights the resolving ethical issues including, protecting clients from harm, unacceptable business practices, deceased clients, interdisciplinary teamwork, and policies that are potentially harmful to clients.
Healthcare providers (HCPs) including gynecologists, urologists, endocrinologists, nurse practitioners, nurses, doulas, and more have regular contact with women and their partners during the transition to parenthood. This book provides an overview of the relationship and sexual challenges faced by couples during this life passage; information on assessing and treating common sexual concerns; approaches to brief counseling; and guidelines for when to refer to a mental health professionals or sex therapist for more intensive help. The book is organized in three parts containing 11 chapters. The first part comprises five chapters. The first two chapters describe the journey to parenthood, and provide an overview of sexuality and sexual health. The next three chapters focus on assessment, diagnosis, and treatment of women’s and men’s sexual problems. Part two comprises three chapters. Chapter six focuses on couples that make up the growing population facing problems of infertility. Chapter seven discusses sexuality and intimacy during pregnancy. Chapter eight covers the postpartum period. Part three comprises three chapters. Chapter nine deals with support for Lesbian, Gay, Bisexual, and Transgender (LGBT) parents. Chapter ten discusses sexuality counseling, which talks about types of interventions that every HCP or mental health provider can put into practice. The final chapter on intensive sex therapy covers topics that will be of interest to MHPs that have, or are interested in attaining, a broader perspective and training on human sexuality and relationships. The book is written for two audiences: HCPs and mental health providers and is strictly focused on the sexual and emotional intimacy of couples.
Sex therapy addresses sexual function, but goes beyond offering information and solutions to dig deeper into an understanding of why the sexual symptom occurred. Like other psychotherapists, sex therapists rely on a variety of theoretical approaches to organizing and treating presenting problems, for example, emotionally focused therapy, narrative therapy, cognitive-behavioral therapy, family therapy, and so on. This chapter discusses Murray Bowen’s Intergenerational Theory. Mental health professionals will be familiar with the symptoms and treatment of posttraumatic stress disorder (PTSD). Symptoms commonly associated with PTSD, such as flashbacks and nightmares, can interfere with sexual function. Sexual difficulties related to PTSD include the development of a sexual aversion, low desire and problems with arousal, anorgasmia, and painful intercourse. The chapter describes interventions such as deep diaphragmatic breathing, rapid eye movement desensitization, body-centered approaches, and cognitive therapy. Finally, the chapter discusses perinatal depression, its risk factors, and interventions.
This chapter begins with a discussion of the importance of a clear understanding of psychiatric diagnoses for all allied health professionals. Given the historical prevalence of psychiatric diagnoses, it is a good use of our time to review the seminal diagnostic systems that inform diagnosis in clinical counseling. Clinical counselors and other mental health professionals may be the first health care providers to have established any type of therapeutic relationship with their client, revealing information that previously had never been a focus of any other professionals’ clinical attention. The accurate diagnosis of psychiatric conditions leads to appropriate referrals, selection of the most appropriate evidence-based treatments, and ultimately amelioration or elimination of problematic symptoms that negatively impact health and functioning. The most commonly used diagnostic system for psychiatric conditions worldwide is the International Classification of Diseases (ICD) system.
The assessment of sex and relationship problems is dependent, in part, on the setting in which issues are presented, the training of the provider, and practical matters such as time constraints. In the PLISSIT model, P stands for permission, LI and SS stand for limited information and simple suggestions, and IT stands for intensive therapy. Initial assessment of sexual problems is nearly always the same, whatever the setting. The following six-step assessment will cover most any situation: establishing rapport; defining the problem; ruling out medical and other organic causes; if no medical cause, or if there are medical causes and the mental health professional is working in collaboration with healthcare provider, establishing a realistic goal; providing information and suggestions that may resolve the problem; and if two or three attempts to resolve the problem with information and suggestions is ineffective, treating or referring for treatment with intensive therapy.
The Changing Face of Health Care Social Work, 4th Edition:Opportunities and Challenges for Professional Practice
This fourth edition of the book covers basic and advanced concepts related to the delivery of social work services in health care settings. When health care is responsive to those in need, the provision of services must be equitable, safe, timely, efficient, effective, evidence-based, and patient-centered while simultaneously exemplifying best practices for all. As pressure for quality services continues to increase, however, the equitable distribution and availability of affordable health care has changed. This has left many providers and patients alike filled with expectation and speculation as to what constitutes essential health care service delivery. The book advocates a proactive stance for health care social workers and is designed to serve as a practical guide for understanding and addressing the philosophy of practice in our current health care environment. Suggestions are made for achieving ethical time-limited, evidence-based social work practice in these settings. At the end of each chapter, a “Summary and Future Directions” section is provided that will help social workers to understand what can be expected and how to prepare for the practice changes needed in order to remain viable clinical practitioners. The book is designed as a practical guide to help social workers understand the roots of social work practice, stressing the importance of the person-in-environment and person-in-situation while utilizing strength’s perspective employing this information as a foundation for embracing the changes to come. As a skilled professional, the incorporation of evidence-based social work practice will need to serve as the cornerstone of all we do while always taking into account the uniqueness and situation-based strategy needed to help each individual patient/client/consumer.
For the health care social worker, flexibility to accommodate federal, state, and local policy changes, as well as adjusting to the changing roles of other health care professionals, has become the state of practice. In addition, predicting future trends and having knowledge of strategic management are required to forecast what changes will need to take place. As health care continues to advance, issues such as living with chronic pain only magnifies the social and emotional pain that people suffer. This makes the psychosocial aspects of self-care and providing services critical regardless of the technology available. If social workers do not respond to these demands, then they will be replaced with other professionals who perform similar functions. This chapter reviews the factors critical to the understanding and further development of health care social work. It highlights professional issues and challenges and highlights suggestions for the future.
This chapter highlights the importance of identifying a concussion team leader (CTL) one person in the building who is responsible for facilitating the concussion team. The school nurse is essential in collaborating with district administration in the formulation of a concussion management policy. A signed release of information (ROI) is important to allow the school to receive and discuss medical information related to a concussion with a student’s health care provider. It is also essential that the concussion team model include a procedure for periodic review of the team structure and the concussion management policy, given the changes in concussion protocol that grow out of research. This chapter includes a discussion of maintaining student privacy through following Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations.
Battered women themselves are terrified about being labeled with a mental illness especially since so many are threatened into silence by their batterers who tell them that everyone will think they are “crazy”. While health service providers are now better trained in identification of both health and mental health needs of battered women and their children, there is still little understanding of what to do after identification. The Public Health Model for community distribution of health and mental health services may be a way to conceptualize all of the health services that battered women need to have in place for both prevention and intervention. The legal system also contributes to the primary prevention and intervention with women who are victims of intimate partner violence. Secondary prevention programs attempt to use the early identification of domestic violence victims as a way to prevent the development of further psychological and physical injuries.Source: