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.

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.

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.

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 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).

This chapter traces the development of Mother-Friendly Care and describes its core tenets along with supporting statistical information. The manual includes implementation strategies for the evidence-based nursing care training programs of such organizations as Lamaze Institute for Normal Birth and AWHONN, and supports the WHO-Unicef “Ninth Step of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding. Discourage the routine circumcision of newborn males for nonreligious reasons policy allows parents access to all information regarding keeping an intact penis or circumcision is paramount to aid parents in making an informed decision that is not based on religion or traditional values alone. Health care providers should aid new parents in making an informed decision regarding keeping an intact penis or circumcision. Understanding long- and short-term outcomes, safety, harms, and benefits will assist parents. Circumcision carries the risk of surgical mishap, adhesions, meatitis, meatal ulceration, infections, and bleeding.

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.

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.

Routine intrapartum care practices in the United States frequently obstruct physiologic childbirth, even among healthy women who desire to birth naturally. Most women who give birth in the United States receive numerous obstetrical interventions, including some form of pharmacological pain relief like epidural analgesia and anesthesia despite potential negative impacts on maternal and fetal circulation, labor progress, and normal birth rate. Research demonstrates that intrapartum hydrotherapy may facilitate physiologic birth and decrease routine obstetric interventions that characterized maternity care in the United States. Clinical practices are often influenced by factors unrelated to research and optimal practices and outcomes. Cultural factors and the practice styles of individual health care providers all impact women’s choices for pain-relief methods, including labor and birth in water. The midwife is in a key position to act as a catalyst for institutional change in promoting a safe alternative or adjunct to analgesia and anesthesia in childbirth.

Abnormal uterine bleeding (AUB) is one of the most common patient concerns in the adolescent population. AUB is defined by menstrual bleeding that occurs outside of the normal range and can include irregular bleeding patterns; prolonged or short bleeding episodes; and heavy or light bleeding. In order to determine abnormal bleeding amounts and/or patterns, it is important to understand the normal parameters for a menstrual cycle in this age group. Nurses and healthcare providers must collect as much information as possible about the menstrual bleeding to help determine the appropriate plan of care.

This chapter discusses disaster planning for pregnant and postpartum individuals and their infants, and provides guidelines for care whether evacuating or sheltering in place. Because injuries are common during disasters, it provides guidelines for assessment and management of minor trauma. More attention has been given to the need for disaster preparedness as a result of terrorist attacks and natural calamities, such as devastating hurricanes, tornadoes, wild-fires, tsunamis, and earthquakes, in various parts of the world. Despite these incidents, the public is still not adequately prepared to respond to a major disaster. Obstetric and Neonatal Nursing (AWHONN) position statement encourages nurses to participate in all phases of disaster planning. Obstetric, neonatal, and women’s health care providers can serve a vital role in addressing the many health needs of pregnant individuals, new mothers, and infants and reduce risk and morbidities.

Anemia is a common medical disorder of pregnancy. Two of the most common causes of anemia during pregnancy are iron deficiency and physiologic anemia caused by blood volume expansion greater than the red blood cell mass. However, other inherited and acquired causes of anemia should not be overlooked. Iron requirements increase significantly during pregnancy and, unfortunately, many individuals start pregnancy without sufficient stores to meet the increased demands. Health care providers need to educate individuals about the importance of taking an iron supplement during pregnancy and dietary sources of iron. This chapter addresses assessment of anemia during pregnancy, management, and patient education. Anemia may be characterized several ways such as by the causative mechanism, whether inherited or acquired, by a reduction in the number of red blood cells (RBCs) or the RBC size (mean corpuscular volume–MCV), which results in decreased ability to carry oxygen to tissues.

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.

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.

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.

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.

This chapter examines the conditions under which women and men give each other care when at least one partner has diabetes and explores the ways in which care, as well as the health status of both partners, is often influenced by gendered power structures. It offers clinicians and health care professionals suggestions for how to identify and address this potential gender disparity. Stereotypical gender relations appear to increase levels of stress, especially for women. Little attention has been given to the impact of gendered power on the daily acts of care and attending that intimate partners give each other in the course of routine life. Gender training thus shapes how partners respond to diabetes care. The gendered power structure organizing couple relationships limits men’s involvement in providing care. For many couples, response to illness triggers and maintains automatic gender patterns and hierarchies without conscious thought or deliberate choice.

The Zika virus (ZIKV) and other viruses and/or vector-borne diseases are emerging infectious global health threats. This chapter reviews current knowledge of Zika infection, including risk of exposure, presentation, and potential maternal and fetal effects. It provides guidelines for preventing and managing this infection during pregnancy based on data that are known at this time. Although the chapter focuses on Zika infection, health care providers need to stay informed about all new emerging infectious agents that may pose a threat to their patients. Those who care for women and infants are encouraged to stay informed by frequently reviewing websites and guidelines provided by the Centers for Disease Control and Prevention, the American Academy of Nurse Practitioners, Nurse Practitioners in Women’s Health, the American College of Obstetricians and Gynecologists, the Society for Maternal–Fetal Medicine, the American Academy of Pediatrics, the Infectious Disease Society of America, and any other relevant organizations.

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 chapter provides several suggestions to injured individuals related to goal setting, using social support, and managing the mood by thinking positively, focusing on what one can control, and even laughing. As future health care professionals, coaches, sport and exercise psychologists, or even parents, it is important to understand the possible negative ramifications of injury while simultaneously understanding that there are steps people can take to minimize their chances of getting injured and steps to improve their well-being during the injury process. Delays in recovery suggest the importance of delaying day after competition practices to minimize chances of injury due to physical fatigue, slower cognitive function, and suppression of lower body power.

Clinicians currently being trained or recently trained in eye movement desensitization and reprocessing (EMDR) therapy face a range of issues when introducing EMDR therapy into their practice settings. To support clinicians in educating their systems, resources are available from both the EMDR International Association (EMDRIA) and the EMDR Humanitarian Assistant Programs (EMDR HAP) online stores. Coordination of care with other professionals involves educating them about the approach and the methods that we use. Decisions on scheduling the length of each treatment session depend on treatment setting, stage of therapy, stability of the patient, experience of the clinician, the treatment plan, and systems issues. Patients will be appreciative of their gains, and these initial experiences are essential to clinicians’ professional development. When most clinical issues arise during EMDR reprocessing, the Adaptive Information Processing (AIP) model informs the selection of standardized procedures.

Writing clear and descriptive clinical case notes is very different from most other types of writing. This chapter provides an overview on writing clear, concise, and effective case notes. Counselors have an explicitly stated legal and ethical duty to create and maintain client records on every client. Failure to maintain adequate records could form the basis of malpractice as it breaches the standard of care expected from a mental health professional. Counseling students should remember that like all other counseling training, developing good, clear, and concise clinical writing skills takes time and comes through experience. The practicum and internship placements are good beginning points for developing good clinical writing skills.

This chapter presents a review of adaptive behavior assessment from conceptual, technical, and practical perspectives. Although adaptive behavior is a construct with relevance across multiple disability populations served by rehabilitation professionals, its greatest relevance concerns persons with intellectual disabilities (ID). This chapter presents adaptive behavior assessment within an ID context. It begins by describing the population of persons with ID and how they are defined through federal legislation and professional associations. Specific focus is placed on the growing importance of adaptive behavior in the process of identifying persons with this disability. The chapter then presents a review of standardized and informal approaches to adaptive behavior assessment. To illustrate its professional importance and use of best-practice approaches, the chapter then addresses three practice areas where adaptive behavior assessment plays a key role in contemporary practice with persons with ID, including death penalty evaluations, community-based habilitation, and culturally responsive assessment.

No other single individual or health care provider has more influence on the personal health and wellness of a child with a disability than the parent. To date, however, much research concerned with the well-being of parents of children with disabilities has not captured their experiences from the perspective of the parents themselves. Qualitative methods permit researchers to study selected issues in depth, and they produce a wealth of detailed information that increases understanding of the cases and situations studied. This chapter identifies specific sources of challenges related to raising a child with a disability as expressed by parents themselves. Specifically, it investigates the following research questions: (a) What are the principal stressors and challenges for parents of children with disabilities? and (b) What supports and services do parents identify as being needed to deal with the stress and challenges of their responsibilities?.

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.

A person-centered collaborative approach to drug withdrawal requires a trusting relationship between the patient and healthcare providers. In difficult cases, the patient will need a person-centered collaborative team effort involving the prescriber, a therapist or counselor, the patient, and the patient’s family or social network. Person-centered drug withdrawal calls on the clinician to express many human qualities, including empathy, honest communication about the dangers of staying on psychiatric drugs and the dangers of withdrawing from them, and a respectful relationship that empowers the patient to make decisions and to manage his or her own life. When a patient explores or considers the possibility of psychiatric drug withdrawal, the prescriber should explore the patient’s fears and anxieties about the withdrawal process. Many individuals have experienced severe withdrawal reactions after temporarily running out of medication or after abruptly trying to stop the medications on their own.

All of a woman’s prior life experiences and her individual way of facing these experiences influence how she approaches childbearing. Whether pregnancy is planned or unintended, relished or endured, birth is a turning point. Every woman’s childbearing journey is uniquely informed by prior life experiences, and the journey itself becomes a part of her very being. This chapter examines the influence of prior life experiences, as they affect childbearing outcome, describes how childbearing experiences and outcomes can have a lifelong impact and discusses how health professionals can use life course theory to evaluate undermining social determinants affecting childbearing outcome. It poses critical questions about life course theory as it pertains to America’s maternal health crisis. It is an opportunity to think about the effects of prior life and health experiences on maternal morbidity and mortality. The solutions to this national epidemic lie in interdisciplinary, imaginative conversation and problem solving.

The prenatal care provider needs to determine whether pregnant individuals or those contemplating pregnancy are at risk for offspring with genetic abnormalities or birth defects, including those caused by environmental exposures. A carefully elicited medical, genetic, family, and personal history will give important information about potential genetic problems. All pregnant individuals and those considering a future pregnancy should be offered carrier screening for cystic fibrosis, spinal muscular atrophy, and hemoglobinopathies (American College of Obstetricians and Gynecologists [ACOG], 2017a). A referral to a genetic counselor is essential when patients are at risk for genetic problems. All patients may wish to consider preconception and/or prenatal screening or diagnostic tests to determine risk to their offspring. If a patient requests repeat screening, ACOG recommends referral to a provider with genetics expertise to review previous results and determine the benefits and limitations of the request for subsequent rescreening.

This chapter summarizes factors influencing maternal health, morbidity, and mortality in the United States, examines themes in the key informant interviews and describes a road map for nursing advocacy and practice that promotes maternal health in the United States. A growing shortage of maternal healthcare providers, the lack of diversification of the workforce that reflects the face of America, and closure of rural facilities continues to be a problem. Scaling up the availability of midwifery care, especially in rural and underserved areas, is a widely proposed solution. The nursing profession is central to implementing the road map toward equity. As the largest cadre of health professionals in the nation, nurses provide a substantial amount of care to America’s mothers. Early life experiences, social, psychological, and environmental factors, are critical social determinants. Examining these factors from life course theory perspective can help healthcare providers understand the gestalt of women’s lives.

This chapter shows some opening remarks for mental health professionals (MHPs) and trainees who are new to doing cognitive behavioral therapy (CBT) and positive psychology (PP) treatments with kids suffering from an internalizing disorder. It reviews the parental lunacy concept and presents some overview comments regarding positive ethics and multiculturalism. MHPs need to know how to heal pain as well as how to promote joy and meaning in kids, teens, and their families. Ethics should focus not only on how a few psychologists harm patients but also on how all psychologists can do better at helping them. This view of ethics is called positive or active ethics. Kid clinicians operating predominantly from a perspective of maximizing understanding, healing, and happiness can be filled with a sense of purpose, flow, and self-efficacy. Minority youth are treated differently than Caucasian youth when interacting both with traditional mental health systems.

This chapter focuses on eligibility and other rules governing immigrants’ access to federal public benefits programs. The major federal public benefits programs have always prevented some non-US citizens from securing assistance. In determining an immigrant’s eligibility for benefits, it is necessary to understand not only the federal rules but also the rules of the state in which an immigrant resides. However, many federal agencies have not specified which of their programs provide federal public benefits. The confusion stems from the complex interaction of the immigration and welfare laws, differences in eligibility criteria for various state and federal programs, and a lack of adequate training on the rules as clarified by federal agencies. Immigrants’ rights advocates, health care providers, and state and local governments organized to persuade federal agencies to clarify the limits of the laws. Federal agencies have worked to reduce the chilling effect of status-related questions on benefits applications.

This chapter helps the reader to understand what a needs assessment is and be acquainted with a framework within which to conduct a needs assessment. and to be familiar with the core concepts of a needs assessment. It helps the reader to be familiar with strategies that encompass a needs assessment. Needs assessments can be carried out by a wide cast of people. Social workers and public health workers, as well as city planners, can carry out needs assessments, as can government organizations. Local citizens or groups of people can also be responsible for carrying out a needs assessment. The chapter provides an overview of strategies to develop a needs assessment. When used in combination with a health behavior framework, a needs assessment can help one determine the needs of a community and attempt to build community support for this resource or policy change through media advocacy and coalition building.

This chapter focuses on integrative approaches to trauma therapy, crisis intervention, and disaster response. The purpose of the chapter is to identify and explain best practices for integrative mental health responses aimed at supporting survivors of trauma, crises, and disasters. While each unique situation requires a tailored response, this chapter describes the basic principles that apply to nearly all emergent, mass casualty, and traumatizing events.

Older adults who are not only living longer, but actually in better health too, could boost the economy by virtue of their longer periods of productivity, their ability to earn and save more income over time, and their purchases and consumption of more goods. Furthermore, because of their accumulated wisdom, skills, and talents, they have much that they can contribute to our social environment. This chapter focuses on the longevity dividend and the importance of mobilizing all sectors of the society to realize the opportunities and address the challenges of an aging society. It includes demographic information related to aging in the United States as compared with that of other countries, as well as a discussion about the detrimental effects of ageism on older adults and on society as a whole. It is especially important for gerontology professionals to understand and avoid ageism.

In addition to traumas that heterosexual and cisgender people experience, queer and transgender people face a heterosexist and cissexist culture, in which marginalization and trauma against them is normalized or minimized. In this chapter, the experience of hate crimes and violence, relational and interpersonal trauma, religious based-trauma, and sociocultural and political-based trauma are covered in relation to how it impacts Lesbian, Gay, Bisexual, Trans, and Queer (LGBTQ) people. Clinical and counseling implications are discussed. The increase in mental health challenges is explained via the minority stress model. Implications for diagnosis and trauma-informed practices for queer and transgender people are discussed. Additionally, the role of the mental health professional as a social justice advocate is explored, including how social justice frameworks can be incorporated in the counseling environment.

Posttraumatic stress disorder (PTSD) is a condition that is characterized by profound neurochemical and neuroendocrine changes in the central nervous system (CNS). The physical response to trauma, in those susceptible to its development, can induce physical and behavioral changes. Understanding the impact of these neural changes is the basis for developing a rational medication therapy regimen for a client diagnosed with PTSD. The use of these medications is vital for symptom management so that the benefits of counseling can be realized. This chapter will discuss the neuronal and pathophysiological impact of trauma on the brain while subsequently describing how medications can impact symptom improvement. Medications that are discussed in this chapter include the use of antidepressants, antipsychotics, and other novel agents used in the pharmacotherapy of PTSD. Both U.S. Food and Drug Administration (FDA)-approved medications and “off-label” medications are explored.

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.

This chapter focuses on introducing the reader to theories about stress and crisis and on promoting basic stress management and crisis intervention skills. Stress and crisis often intersect with trauma and disaster events and are foundational aspects of the scaffold being created, in the first four chapters of this book, for grasping the profound effects that stress, crisis, disaster, and trauma can have at individual and systemic levels.

In the early 20th century, asthma was considered as one of the “Holy Seven” psychosomatic disorders and thus was thought to be amenable to psychological therapy. In multiple case reports, hypnosis has been reported to have beneficial effects on the subjective aspects of asthma, which include symptom frequency and severity, coping with asthma-specific fears, managing acute attacks, and frequency of medication use and health visits. Asthma is treated with a combination of anti-inflammatory and bronchodilator medications that typically are inhaled. Hypnosis may also be efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals. There are several additional hypnotic techniques, such as breathing techniques, subconscious exploration, and age regression, which can be useful in the treatment of patients with asthma. Patients can be taught to use some of these techniques through self-hypnosis on an as-needed basis.

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.

The fundamental challenge in partnering with persons with diabetes to improve health outcomes is that while the clinical treatment and education occur in the health care provider’s office, patients’ health behaviors occur on an ongoing basis outside the provider’s office, in the patient’s home, school, community, and workplace. Without insulin, the glucose accumulates dangerously in the blood causing the symptoms of diabetes and damaging body organs. The disease develops gradually as normal glucose tolerance progresses to impaired glucose tolerance to overt diabetes under the influence of risk factors such as obesity, inactivity, genetics, and a high carbohydrate diet. The early stages of diabetes may be asymptomatic; however, as hyperglycemia worsens, frequent urination, frequent thirst, fatigue, and weakness will occur. Diabetic neuropathy correlates directly with the duration of diabetes and the degree of poor glucose control.

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.

This chapter reviews theories that are particularly useful in explaining child maltreatment: biological, social-relational, neurobiological, psychodynamic, learning, and cognitive theories. Biologically based theories addresses children’s physical development, and social–relationally based theories addresses interaction between children and their parents, is highly useful for understanding and intervening in child abuse, particularly with young children. Neurobiological theories focus on children’s brain development as influenced by traumatic events, particularly child maltreatment. Child Abuse Prevention and Treatment Act (CAPTA) defined child abuse and neglect and established mandatory reporting policies. Child neglect is failing to provide for a child’s basic needs, including physical, educational, emotional needs, or medical care. CAPTA categorizes child maltreatment as physical abuse, sexual abuse, emotional abuse, or neglect. Social workers, other health care professionals, and laypersons have the responsibility of not only understanding the past but also making changes for a better future.

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.

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.

For mental health professionals, sexual anatomy needs to be more than a catalogue of body parts and labels; it also must include information about what may be the client’s viewpoint of their anatomy and the social myths that can affect perception. In this edition, there is information about cisgender bodies and transgender bodies, gender affirmation surgery, as well as people who identify as intersex, who may have a gender that does not fit into the gender binary or male/female social construct. This chapter paints the stages of sexual development in broad strokes, in part because little has been written about this topic in regard to sexual or gender minority youth. Still, it is helpful to have such a framework so that the provider can determine whether a client’s complaints are typical or outside the norm of peers.

The Personal Growth Program to Heal Trauma (PGP-HT) is a dynamic, interactive, and solution-focused approach for exploring posttraumatic growth and resiliency. Mostly, it provides an opportunity for early identification, assessment, and recommended interventions to deal with a range of issues affecting the mind, body, and spirit of trauma survivors. Essentially, the PGP-HT provides a model for helping others to show up and receive help from professionals and other natural supports; pay attention to their mind, body, and spirit with the intention to heal their trauma; and be open to the outcomes with the journey they began. The PGP-HT is adaptive, flexible, organized, and has intentions to offer guidelines to disaster mental health counselors as a structured approach for cultivating resiliency for healing trauma. It also has the potential for healing empathy fatigue and other professional fatigue syndromes that draw energy away from one’s mind, body, and spirit.

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.

An effective maternal care workforce is sufficient in numbers, diversified by skills, and appropriately distributed to meet the needs of the population. The critical issues destabilizing the work-force and creating barriers to maternal care are the increasing need for maternal care providers, both midwives and obstetricians, and the geographical maldistribution of the workforce across the globe. This chapter describes projections about the shortage of the maternal care workforce and the closure of maternity care sites, especially in rural America. It discusses maternal mortality and severe maternal morbidity in relation to workforce issues and availability of maternity care sites in the United States. The chapter then identifies current and emerging strategies to develop a diversified workforce and site accessibility for maternal care, especially in rural America. It ends with posing critical questions and discussion points about the crippling of health and the loss of life among America’s mothers.

The training and credentialing process in behavior analysis are similar to that of medical professionals or other licensed behavioral health providers such as clinical psychologists, clinical social workers, school psychologists, and marriage and family therapists. This chapter outlines the steps behavior analyst trainees need to take to become a credentialed behavior analyst. It discusses the differences between practicum, internship, and fieldwork experiences. To set behavior analyst trainees on the path to success, the chapter provides some guidelines to help one's self-reflect before to begin their journey and offered information about what they should expect from supervision. One can find that supervised learning experiences are crucial for all practitioners (e.g., nurses, physicians, medical technicians, dentists, dental hygienists, counselors, therapists, social workers, and teachers) and a significant part of the training that will help them relate to other medical, mental, and behavioral health services providers.

Physical activity for older adults has become a central feature of our culture. Physical activity programs intended for older adults call for an understanding of the social, psychological, and physical factors that influence their receptivity and effectiveness in supporting individual well-being. This chapter is organized into three sections, each addressing older adult social integration and physical activity in specific ways that are applicable to health professionals. Section one defines key terms, presents concepts on aging, and offers evidence to enhance well-being through social integration and physical activity. Section two provides a practical approach to working with older adults through physical activity that includes benefits, guidelines, recommendations, opportunities and barriers to physical activity, and a resource guide to best practices and approaches for older adults. In section three, two cases, based on individuals the authors have worked with, provide physical activity progressions and considerations for social integration.

This chapter focuses on a major occupational hazard associated with working in the human service field. The work exposure to traumatic material through compassionate listening, case reviews, working during a pandemic, responding to a fatality, delivering a death notification, and attending to acts of hate and terrorism and so much more requires an understanding of how each event has the potential to affect mental health workers in profound ways. There is a cost of caring, and human service professionals owe it to themselves—as well as to those for whom they work, to colleagues, and to loved ones—to learn about vicarious trauma and to understand how to intervene as needed, while creating healthy strategies for self-care.

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.

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.

There are several misconceptions and assumptions that can reduce the effectiveness of counseling with children and adolescents. New therapists and counselors in training may need to ultimately unlearn assumptions that they carried with them—knowingly or not—before entering professional training programs. This chapter reviews some common misconceptions and assumptions made by counselors at all levels. The field of motivational interviewing has emerged to address the resistance to change and the challenges associated with preparing clients for change. It seems that rational, irrational, positive, and negative thinking are important to untangle when working with children and adolescents. The goal is to help clients to challenge erroneous thinking, distortions, or faulty interpretations that lead them to negative outcomes as well as help them to anchor their academic, interpersonal, and other efforts in an effective understanding of their current abilities, skills, and context.

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.

This chapter focuses on the period when the structural family therapy (SF) was beginning to mature, around the mid-1970s. It provides more information about the continuing evolution of SF. It also provides some of the basic concepts of SF as well as resources where a reader can gain more knowledge of SF, such as reading materials, training centers, programs to train to be a structural family therapist. The structural family therapist pays attention to the evolution of roles in the family and introduces interventions that change the roles of family members and thus the structure of the family. SF allows the therapist to intervene with any part of the system and utilizing multiple perspectives as the system is connected through patterns of interaction. The goal of this approach is to restructure how a family has organized itself through dysfunctional interactions between its members, alleviating symptoms in patients.

In conducting psychological assessments to identify psychopathology, it is essential that clinicians continue to engage in activities that help them remain current on the state of the science. The models to conceptualize psychopathology, the diagnostic criteria, and the instruments used to inform clinicians in arriving at diagnoses and treatment plans continue to evolve. The assessment of psychopathology is rooted in knowledge of the empirical evidence of the diagnostic criteria, and a lack of current information of the empirical evidence can lead to faulty application of assessments or incorrect conclusions regarding diagnoses. Interviews, behavioral observations, self-report inventories, psychological testing, historical/medical record review, functional assessment, and clinical judgment are all necessary in the formation of a diagnostic picture that provides an accurate depiction of clients’ current issues and the selection of interventions that are likely to be the most effective.

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.

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.

The U.S. Citizenship and Immigration Services (USCIS; 2016c) under the U.S. Department of Homeland Security delineates the complex law and path to citizenship as it relates to immigrants, refugees, and asylum seekers. The etiology of the worldwide epidemic of immigrants, refugees, and asylum seekers is clear. It is war that is at the foundation of all human suffering as millions are forced to relocate geographically. This epidemic of person-made disaster points to the overall lack of respect and empathy for human life perpetrated by brutal governments, religious zealots, and other indigenous tribal warring groups. Disaster mental health responders who commit to work with specific indigenous populations of global cultures require a much different approach to provide culturally sensitive interventions and strategies. This chapter offers some guidelines to mental health professionals to begin working globally with the new culture of immigrants, refugees, and asylum seekers.

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.

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.

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.

Helping people with disabilities to identify, request, and implement reasonable accommodations in various educational, community, and employment settings is a hallmark of the rehabilitation counseling practice. The rehabilitation counseling process is guided by comprehensive assessments of the client’s aptitudes, achievement, skills, interests, and values, and it is essential that clients who require accommodations to participate in valid assessments have access to those accommodations. Testing accommodations are legal, ethical, and best-practice imperatives for rehabilitation and healthcare professionals, and they are viewed as a fundamental right of participation in educational, human service, community, and vocational environments. For the purpose of testing accommodations, it is most helpful to examine categories of limitations as opposed to categories of disability. It is most useful to match the types of accommodations with the specific types of limitations. The chapter considers limitation in the areas of cognitive and neurological abilities, motor abilities, and sensory abilities.

Sexuality is a core part of human identity. Physicians, nurse practitioners, or educators who work in gynecology, obstetrics, urology, endocrinology, or family practice can help women, men, and couples cope with the sexual and emotional tensions that may occur before, during, and after pregnancy. They can offer information and suggestions for women trying to recover their sexuality after having a baby, or normalize that men sometimes have erectile dysfunction when they are trying to impregnate their partner. This chapter describes models of sexual behavior such as human sexual response, circular desire, dual control model, and systemic model. In terms of sexuality and intimacy, healthcare providers and mental health providers have not been trained to ask couples before, during, and after pregnancy about the state of their relationship and the effect of childbearing upon it. Lesbian, gay, bisexual, and transgender (LGBT) couples who want to have children may also seek services.

The U.S. health care system is a highly complex and often volatile mixture of free enterprise, philanthropy, and public sector health care. It is also the most expensive health care system in the world both in per capita dollars spent and in the proportion of national economic output spent on health care. This chapter provides a general overview of the organizational structure of the U.S. health care system; in particular, how dollars are allocated to health care purchase in terms of the facilities, services, technologies, and human resources that comprise the resources of the health care system. Significant attention is also devoted to the structure of the health care “safety net” generally defined as the clinics, hospitals, and individual health care providers that care for a disproportionate share of the poor, the uninsured, those afflicted by stigmatizing health conditions, and persons otherwise isolated from the mainstream health care system.

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.

Health care delivery models increasingly rely on social workers and social worker case managers because of their specialization in identifying and meeting the needs of patients postdischarge. This includes accessing the necessary care and treatment resources in the community, such as elder care services, fraternal/religious organizations, government programs, meal delivery services, and pharmacy assistance programs. This chapter presents a general definition of the role of the health care social worker along with a discussion of the issue of role ambiguity and confusion. It outlines some of the differences between health care social workers and the other related disciplines. The chapter identifies new trends in collaborative teamwork and highlights the role and/or lack of the social worker. Health care social work needs to be viewed as the professional “bridge” that links the patient; the multidisciplinary, interdisciplinary, transdisciplinary, and pandisciplinary teams; and the environment.

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.

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 focuses on the recovery process, emphasizing the importance of both physical and cognitive rest. Emotional signs and symptoms may be prominent during the first weeks of recovery, as the student may feel “off” and edgy. The chapter highlights the importance of communication and collaboration-and having a clear plan-before the student with a concussion returns to school. It opens with a section on recovery in the first days following a concussion, including removal from play for athletes and an overall limitation of activities for all students with concussions. The student should not engage in physical activity until cleared by a health care professional with experience in diagnosing and managing concussions, such as a physician or athletic trainer. This chapter describes return-to-school and return-to-play progressions along with a discussion of how to determine when students are ready to return to academic and physical activities.

Language and communication are crucial for establishing culturally safe environments of care for Lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allied (LGBTQIA+) populations. This chapter helps the reader to understand the concept of implicit bias; reflect upon how that may affect our own biases and assumptions related to care. It explains differences between concepts of sex, gender, gender expression, gender identity, and sexual orientation and the associated terminology. The chapter enables the reader to utilize communication skills that are inclusive and welcoming to LGBTQIA+ populations. Health care providers and the direct care staff who assist in providing care can play a significant role in improving LGBTQIA+ health care by learning about their own biases, becoming aware of the systemic barriers to care that LGBTQIA+ patients face, and learning communication skills that create patient-centered care that is inclusive and welcoming.

Health and wellness coaching involves strategies that health care professionals can provide to individuals/clients/consumers to assist them in maintaining good health. These efforts can also be directed toward helping patients to improve unhealthy conditions in order to prevent illness or disease. The inclusion of complementary and alternative medicine (CAM) with an emphasis on wellness and health is often associated with the medical model in a number of health care settings, and fits well with both the strength-based and holistic approaches of social work, counseling, and coaching. The chapter discusses prevention, wellness counseling and health and wellness coaching, and the various CAM approaches currently used in health care. It discusses each aspect of wellness counseling from the perspective of the social work practitioner. The chapter includes aspects of CAM and its relevance to social work practice.

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.

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.

Acute care hospitals and ambulatory health care facilities employ more social workers than other settings including individual and family services, schools, and state and local government agencies. The number of practicing health care professionals continues to rise and health care is now the largest employer in the United States. Acute care hospitals often include medical and surgical units, and patients need services that are required to be supervised by licensed medical personnel. Ambulatory settings provide diagnosis, treatment, and care that is not inpatient, and the treatment and care do not require the specialized services. This chapter identifies dialysis social work in nephrology settings as ambulatory care. It provides case exemplars to highlight acute and ambulatory care social work and the processes that are involved in assessment, intervention, and treatment. The chapter explicates areas of strength and concern in the present state of acute and ambulatory care social work practice delivery.

The passage of the 1996 Health Insurance Portability and Accountability Act (HIPAA) was originally an effort by Congress to ensure portability of health insurance between jobs for American workers. This chapter provides a brief overview of HIPAA regarding mental health services, compliance issues for providers, filing and investigating complaints, violation penalties, a list of terminology, and resource links for more detailed information. Patients must be informed of their rights and are required to sign the appropriate forms authorizing the health care provider to obtain and/or provide information to other health care providers as relevant. All psychotherapy notes recorded on any medium by a mental health professional such as a licensed counselor or psychologist must be kept by the author and filed separately from the rest of the patient’s medical records to maintain a higher standard of protection.

Over the years, health care professionals from many disciplines have contributed to the knowledge base supporting palliative and end-of-life care. This chapter presents a brief description of the nurses who led the development of nursing as a profession as a context for other nursing leaders who contributed to the science and practice of palliative and end-of-life care. It describes nurse leaders whose sustained work influenced end-of-life care in seven major areas: uncovering and combating the conspiracy of silence, making meaning for children and adults as they live with the chronicity of a life-threatening illness, promoting team-based collaborative approaches to care, managing pain and symptoms of children and adults, integrating bereavement as part of patient-centered and family-focused dying care, conducting research, and educating nurses to improve care of people at the end of life.