This chapter aims to help clinicians learn stabilization interventions for use in the Preparation Phase of eye movement desensitization and reprocessing (EMDR) treatment. Using these interventions will aid clients in developing readiness for processing trauma, learning how to manage symptoms of dissociation, dealing with affect regulation, and developing the necessary internal cohesion and resources to utilize the EMDR trauma-processing phase. Earlier negative experiences stored dysfunctionally increase vulnerability to anxiety disorders, depression, and other diagnoses. When assessing a client with a complex trauma history, clinicians need to view current symptoms of post-traumatic stress disorder (PTSD) or depression as reflections of the earlier traumas. The chapter outlines the strategies dealing with dissociative symptoms, ego state work, and internal stability that help clinicians to develop an individualized treatment plan to successfully guide the client through the EMDR phases of treatment.
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- Go to chapter: Stabilization Phase of Trauma Treatment: Introducing and Accessing the Ego State System
This chapter presents an overview of the restorative justice movement in the twenty-first century. Restorative justice, on the other hand, offers a very different way of understanding and responding to crime. Instead of viewing the state as the primary victim of criminal acts and placing victims, offenders, and the community in passive roles, restorative justice recognizes crime as being directed against individual people. The values of restorative justice are also deeply rooted in the ancient principles of Judeo-Christian culture. A small and scattered group of community activists, justice system personnel, and a few scholars began to advocate, often independently of each other, for the implementation of restorative justice principles and a practice called victim-offender reconciliation (VORP) during the mid to late 1970s. Some proponents are hopeful that a restorative justice framework can be used to foster systemic change. Facilitation of restorative justice dialogues rests on the use of humanistic mediation.
This chapter describes some of the recent restorative justice innovations and research that substantiates their usefulness. It explores developments in the conceptualization of restorative justice based on emergence of new practices and reasons for the effectiveness of restorative justice as a movement and restorative dialogue as application. Chaos theory offers a better way to view the coincidental timeliness of the emergence of restorative justice as a deeper way of dealing with human conflict. The chapter reviews restorative justice practices that have opened up areas for future growth. Those practices include the use of restorative practices for student misconduct in institutions of higher education, the establishment of surrogate dialogue programs in prison settings between unrelated crime victims and offenders. They also include the creation of restorative justice initiatives for domestic violence and the development of methods for engagement between crime victims and members of defense teams who represent the accused offender.
- Go to chapter: Integrating Theories of Developmental Psychology Into the Enactment of Child Psychotherapy
Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).
This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.
The basic goals of phase one are to develop a working relationship and a therapeutic alliance and to determine if the level of expertise of the eye movement desensitization and reprocessing (EMDR) clinician is adequate for the complexity of the case. Other goals are to develop a comprehensive treatment plan and case formulation. EMDR therapy was developed as a form of treatment to ameliorate and heal trauma. Clinicians working with complex trauma must have substantial understanding of the adaptive information processing (AIP) model and the EMDR methodology. During phase one, the clinician works on creating an atmosphere of trust and safety so a therapeutic alliance can be formed with the child and the caregivers. This chapter shows an example of how medical issues can affect the quality of the parent-child communications. The adult attachment interview (AAI) gives us the view of the presence of the experiences in the parent’s life.
This chapter lays the foundation for facilitative leadership from the unique social work perspective. Social work’s Code of Ethics and social work practice principles contribute to the value-based leadership that is part of the facilitative leader’s core. Among the important expectations of social work leadership are cultural sensitivity and competence. Five discussion areas have been selected as essential to facilitative leadership from a social work perspective: inclusion, strengths-based leadership, power and the difference between power over and power with, oppression and social justice, and the elusive but critically important concept of empowerment. There are different types of power and power relationships such as productive power and destructive power. Being conscious of privilege and oppression are precursors to understanding social injustice and working toward social justice. The social work program identifies social justice as a professional obligation of social workers to attempt to improve the quality of all people’s lives.
International Society for the Study of Trauma and Dissociation (ISSTD)’s professional training institute offers comprehensive courses on childhood dissociation that are taught internationally and online. This chapter briefly cites some of the theories that have emerged in the dissociative field. One system, the apparently normal personality (ANP) enables an individual to perform necessary functions, such as work. The emotional personality (EP) is action system fixated at the time of the trauma to defend from threats. As with the Adaptive Information Processing Model (AIP) in eye movement desensitization and reprocessing (EMDR), each phase brings reassessment of the client’s ability to move forward to effectively process trauma. There are many overlapping symptoms with Attention Deficit Hyperactive Disorder (ADHD) and dissociation that often mask the dissociation. The rate of diagnosis of pediatric bipolar disorder has increased 40 times in the last ten years.
This chapter focuses on case studies of installation, body scan, closure, and reevaluation of eye movement desensitization and reprocessing (EMDR). The installation phase is concerned with integrating the positive cognition (PC) with the targeted memory. The PC should be checked for ecological validity and rated on the validity of cognition (VOC) scale. Closure is important at the end of any therapy, and particularly so after EMDR desensitization. As such, it is important to allow sufficient time for closure, debriefing, safety assessment, and homework. As with any therapy, clients will sometimes find that something occurs that disrupts the therapeutic plan. Modeling, education on social skills, and testing out new behaviors will now be the focus of therapy. This may be an unexpected crisis, such as a relationship breakdown or being diagnosed with cancer, and clients will need support in making adjustments in their present life.
This book was conceived out of the authors' shared vision to synthesize key neurobiological developments with effective developments in clinical practice to offer both understanding and practical guidance for the many practitioners working to heal people burdened with traumatic sequelae. It is unique in bringing in all levels of the brain from the brainstem, through the thalamus and basal ganglia, to the limbic structures, including the older forms of cortex, to the neocortex. The book looks at the neurochemistry of peritraumatic dissociation (PD) and explores the effects on neuroplasticity and the eventual structural dissociation. Individual chapters focus on the definition of PD and tonic immobility (TI) and their associations with posttraumatic psychopathology, and review disturbances in self-referential processing and social cognition in posttraumatic stress disorder (PTSD) related to early-life trauma. Separate chapters focus on the modulatory role of the neuropetides in attachment as well as autonomic regulation, and highlight mesolimbic dopamine (ML-DA) system as central to the experiences of affiliation, attachment urge when under threat, attachment urge during experience of safety, and to the distress of isolation and/or submission. The book while increasing awareness of different parts of the self and ultimately creating a more stable sense of self, also incorporates psychoanalytic, cognitive behavioral, and hypnotic methods, as well as specific ego state, somatic/sensorimotor therapies, eye movement desensitization and reprocessing (EMDR), and variations of EMDR suitable for working with trauma in the attachment period. The latter methods are explicitly information-processing methods that address affective and somatic modes of processing.