This chapter helps readers to understand the main characteristics of the three major types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating. It also examines each disorder from a neurobiological perspective, including genetic factors when known, neuroimaging results, the understanding of neurotransmitter dysregulation, cognitive performance, and various types of treatment. The chapter then presents the consideration of the unique challenges associated with comorbidity, societal pressure, and medical implications. Eating disorders are increasingly common, debilitating, and potentially life-threatening disorders that are clearly linked in their neurobiological basis. Mental health professionals should be aware of the signs and symptoms of eating disorders, as individuals might not disclose their eating habits as readily as their mood, anxiety level, or other symptoms. Treatment is complex, as no medication has been shown to be consistently effective, and each eating disorder will bring with it specific goals.

This chapter explores the impact of acculturation on three diverse U.S. populations: Hispanics, represented by a specific focus on Mexican immigrants; African Americans; and Native Hawaiians. It reviews relevant acculturation theories developed to explain cultural and psychological changes occurring in racial and ethnic populations in the United States as a result of interactions with the majority racial/ethnic population. The chapter presents Berry’s model of acculturation in particular, as a helpful theoretical model for clinicians working in neuropsychological rehabilitation to use for understanding psychological issues related to acculturation pressures. It also highlights the unique historical context of acculturation for each ethnic group and its effect on their acculturation experience as well as mental and physical health outcomes. The chapter provides rehabilitation psychologists and counselors with culturally relevant assessment and intervention recommendations for working with ethnically diverse clients.

Alzheimer’s disease (AD) and related cortical dementias are a major health problem. Patients with AD and related dementia have more hospital stays, have more skilled nursing home stays, and utilize more home health care visits compared to older adults without dementia. This chapter discusses the role of family caregivers and how they interact with in-home assistance, day care, assisted living, and nursing homes in the care of an individual with dementia. It also discuss important transitions in the trajectory of dementia care, including diagnosis, treatment decision making, home and day care issues, long-term care placement, and death. It highlights the importance of caregiver assessment, education, and intervention as part of the care process. Dementia caregivers are at risk of a variety of negative mental health consequences. Another important moderating variable for dementia caregiver distress is self-efficacy.

A concussion is a type of mild traumatic brain injury (mTBI) that can result in a constellation of problematic symptoms. These include cognitive, physical, emotional, social, and behavioral symptoms, all of which can affect students’ well-being and performance in school. However, because concussions are largely a neurometabolic injury, they are not likely to show up on an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Similarly, students with a history of learning disabilities, attention deficit hyperactivity disorder (ADHD), or other developmental disorders may also be at higher risk, as are those with sleep disorders or previous mental health problems, including anxiety, depression, and other psychiatric disorders. Much of the emerging research on postmortem brains of athletes who developed chronic traumatic encephalopathy (CTE), a chronic degenerative brain disorder, indicates that both concussions and subconcussive blows can be risk factors.

A national expert on managed care was invited to help explain what counselors were up against as they tried to be recognized as providers on insurance plans. Managed health care plans negotiate lower prices with therapists so that employers can give their employees discounted services. There are three types of managed health care plans: health maintenance organization (HMO), preferred provider organization (PPO) and point of service plan (POS). All licensed counselors who work with insurance and managed care plans must use the national provider identifier (NPI) number when filing an insurance claim. The specter of managed care has caused anxiety and frustration for counselors, but many times the issues can be tackled with an old-fashioned problem-solving approach. A medical billing software system allows the counselor to keep patient information on the computer and send claims directly to a clearinghouse that will format and send the claim to the insurance carriers.

This chapter begins with a discussion of the importance of a clear understanding of psychiatric diagnoses for all allied health professionals. Given the historical prevalence of psychiatric diagnoses, it is a good use of our time to review the seminal diagnostic systems that inform diagnosis in clinical counseling. Clinical counselors and other mental health professionals may be the first health care providers to have established any type of therapeutic relationship with their client, revealing information that previously had never been a focus of any other professionals’ clinical attention. The accurate diagnosis of psychiatric conditions leads to appropriate referrals, selection of the most appropriate evidence-based treatments, and ultimately amelioration or elimination of problematic symptoms that negatively impact health and functioning. The most commonly used diagnostic system for psychiatric conditions worldwide is the International Classification of Diseases (ICD) system.

African Americans constitute approximately 14% of the American population. They have been an integral part of this society since its conception, yet they face a myriad of issues. These issues include health issues, employment issues, health insurance issues, racism, and discrimination. In the area of employment, the unemployment rate for Blacks is more than twice as high as the White population, and the poverty rate is approximately three times as high. Racism and poverty are manifested in African American incarceration rates. The term African American as a descriptor includes many segments of the American population, including populations brought to America from West Africa during the slave trade. Many African American children have self-respect and positive self-esteem despite the specter of racism and discrimination. Religion and spirituality are an important part of American culture and this is no less so for the African American community.

This chapter offers a practical approach for facilitating disaster mental health and stress debriefing groups using a combination of crisis response models; specific guidelines for structuring such interventions and responding to individuals and groups; and resources to assist in personal and professional growth in the specialty area of disaster mental health response. Additionally, three case scenarios are provided at the end of the chapter for the purpose of practicing the skills of disaster mental health and stress debriefing interventions. Initially, the preintervention and planning stage is critical in assessing, coordinating, and communicating with others on the disaster team concerning the trauma survivors’ psychological, spiritual, and medical/physical level of functioning. The ethical and competent disaster mental health practitioner knows that he or she should never force emotions or shame individuals for not disclosing, especially early on in the grieving and healing process.

The specialization of forensic expert testimony in mental health has traditionally been precluded for counselors and dominated primarily by psychologists and psychiatrists. This chapter focuses on the applicable laws related to providing expert testimony and their impact on how counselors must prepare and present their findings in court. It outlines legal definitions and differences in deposing or discovery testimony versus trial testimony. Knowing the order and relevant issues involved at each procedural step becomes important regarding testimony preparation. A practical look at the specific skills counselors should have in order to effectively work in the forensic field is discussed next as well as specific strategies in preparing for and testifying in a courtroom. The growing need for forensic mental health evaluators plays a significant role in scientifically and methodologically providing the court with valuable knowledge in helping to render more informed decisions.

To develop an appreciation for the electronic health record (EHR) it is important to understand the barriers to its adoption among mental health professionals. This includes the belief that it is easier and more convenient to document care using paper and pen. The chapter mentions a scenario, where even if the emergency room personnel were able to gain access to the patient’s paper medical record, they would have had a hard time understanding the record’s content. Another common problem with the paper record is the lack of organization especially under circumstances in which the patient has multiple mental health issues. After addressing a major concern with EHRs among mental health professionals and the inherent problems with paper records, the chapter focuses on the functionality that makes the EHR an appealing proposition. When health care data are stored electronically, the capability to share data among health care providers is heightened.