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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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 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).
- Go to chapter: A mother-friendly hospital, birth center, or home birth service discourages nonreligious circumcision of the newborn.
A mother-friendly hospital, birth center, or home birth service discourages nonreligious circumcision of the newborn.
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.
- Go to chapter: The Midwife as Catalyst: Promoting Institutional Change With Intrapartum Immersion Hydrotherapy
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. AUBis 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 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.
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 RBCsize (mean corpuscular volume– MCV), which results in decreased ability to carry oxygen to tissues.
- 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.
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.
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.
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: 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.
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 IDcontext. It begins by describing the population of persons with IDand 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.
- Go to chapter: Giving Parents a Voice: A Qualitative Study of the Challenges Experienced by Parents of Children With Disabilities
Giving Parents a Voice: A Qualitative Study of the Challenges Experienced by Parents of Children With Disabilities
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.
- Go to chapter: Screening for Genetic Disorders and Genetic Counseling—Preconception and Early Pregnancy
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, ACOGrecommends 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.
- Go to chapter: Understanding and Responding to Affectional and Transgender Prejudice and Victimization
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.
This book serves as a clinical guide to assist clinicians in prescribing psychotropic medications to address mental health conditions. It is used to assist clinicians to understand the key aspects of psychopharmacology. This is the first practical guide for novice and experienced nurse practitioners for explaining and choosing appropriate psychiatric medications. This clinical reference is ideal for students and all clinically oriented healthcare professionals since it provides concise, bulleted-style text for easy access to pertinent information. The book offers readers a broad understanding of the key aspects of psychotropic medications used in general psychiatry and primary-care settings and includes strategies to ease medication decision-making and evidence-based best practices to select and manage psychotropic medications. It is organized into two parts. Part I begins with an overview of general pharmacological principles and a brief overview of neurotransmitters, and covers the rationale for medication use and the risks and benefits of the major classes of psychotropic medications. Part II includes medications across drug classes that are divided by age population and includes practice management strategies, safety considerations, drug interactions, identification of side effects and adverse reactions, basic laboratory test recommendations, treatment options, and self-management strategies. The book ends with important concepts for patient and/or caregiver education and advocacy. It is intended for clinical healthcare providers, including physicians, nurses,
APRNs, and other healthcare clinicians who need a practice guide, test review, or clinical resource guide that is easy to access and use.
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.
Trauma Counseling, 2nd Edition:Theories and Interventions for Managing Trauma, Stress, Crisis, and Disaster
This book is a much-needed update that offers an in-depth and comprehensive exploration of the variety of relevant issues concerning clients’ traumatic, crisis-related, and disaster events that commonly are encountered by professional counselors and other mental health professionals. The textbook is framed, theoretically, within a systemic paradigm, including important recent physiological and neurobiological understandings of the impact of trauma on individuals. The book is organized into six sections. Section I offers a foundation for understanding the various trauma-associated issues. In fact, it tries, with a great deal of intentionality, in the first three chapters, to construct a trauma scaffold of foundational knowledge, upon which students can build increasingly more complex conceptualizations of more nuanced clinical issues associated with trauma. Section II explicates relevant constructs, such as loss and grief; these constructs continue to build upon and expand the trauma scaffolding of the first section. It also offers information about the traumatic events that may be experienced by specific age groups, people who are vulnerable, and other particular populations. Section III begins with his explication of the moral psychology of evil. Section IV presents a broader systemic context for understanding the effects of trauma on groups of people. Section V analyzes assessment methods and interventions associated with psychological trauma. It identifies and discusses the larger scope of integrative approaches to trauma, crisis, and disaster intervention, thus emphasizing the importance of more systemic models. Section VI begins by presenting ethical perspectives on trauma work. It explicates vicarious traumatization, highlighting the need for counselor selfawareness. It also focuses on the importance of mindfulness-based self-care for counselors, encouraging clinicians to be healing counselors rather than wounded healers.
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.
- 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.