Divorce is a lengthy developmental process and, in the case of children and adolescents, one that can encompass most of their young lives. This chapter explores the experience of divorce from the perspective of the children, reviews the evidence base and empirical support for interventions. It provides examples of three evidence-based intervention programs, namely, Children in Between, Children of Divorce Intervention Program (CODIP), and New Beginnings, appropriate for use with children, adolescents, and their parents. Promoting protective factors and limiting risk factors during childhood and adolescence can prevent many mental, emotional, and behavioral problems and disorders during those years and into adulthood. The Children in Between program is listed on the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-Based Programs and Practices. The CODIP and the New Beginnings program are also listed on the SAMHSA National Registry of Evidence-Based Programs and Practices.
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This chapter reviews the empirical support for such a multifaceted approach by considering selected neurodevelopmental concerns and medical variables that present as obstacles to healthy neurodevelopment. It discusses select neuro-developmental prenatal complications that can be prevented or ameliorated through behavioral interventions with the pregnant mother. The chapter addresses the deleterious effects of legal substances on the developing fetus, but professionals should be vigilant about preventing or reducing intrauterine exposure to illicit substances as well. Tobacco is a legal substance that, when used during pregnancy, has the potential to harm both the mother and fetus. Of particular concern with tobacco use are the detrimental health risks, such as hypertension and diabetes, which adversely affect the cerebrovascular functioning of pregnant women. The process of neurodevelopment is complex and represents a dynamic interplay among genetics, behavior, demographics, the environment, psychosocial factors, and myriad physiological factors.
This chapter explains the theoretical basis for motivational interviewing (MI). It reviews the empirical evidence for the use of MI with diverse populations in forensic settings. MI involves attention to the language of change, and is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. It is now internationally recognized as an evidence-based practice intervention for alcohol and drug problems. MI involves an underlying spirit made up of partnership, acceptance, compassion, and evocation. The chapter discusses four key processes involved in MI: engaging, focusing, evoking, and planning. It also describes five key communication microskills used throughout MI: asking open-ended questions, providing affirmations, offering summarizing statements, providing information and advice with permission, and reflective statements.
The baby boom cohort brings with it multiple types of substance abuse. Bisexual older adults have more co-occurring psychological problems than heterosexual older adults, older gay males, and older lesbians. An interesting finding is that immigration is contributory to older adult substance abuse. Older adults with alcohol-abuse problems do not seek help for their problems. Rather, they are often identified as having an alcohol-use problem when seeking care for other medical or psychological problems. Social workers assessing an older adult for alcohol abuse often confuse symptoms of possible alcohol abuse with dementia. Prescribing opioids and synthetic opioids to an older adult is complicated. An older adult can suffer from many forms of inner tension. Combining motivational interviewing with cognitive behavioral therapy is shown to be more effective for treating substance abuse that either therapeutic modality alone.
In the therapeutic community (TC), recovery is viewed as a change in lifestyle and identity. It is a view that can be contrasted with the conventional concept of recovery in medicine, mental health, and other substance abuse treatment approaches. In the public health experience of treating opioid addiction and alcoholism, drug abuse is viewed as a chronic disease, which focuses treatment strategies and goals on improvement rather than recovery or cure. The TC view of recovery extends much beyond achieving or maintaining abstinence to encompass lifestyle and identity change. This chapter outlines this expanded view of recovery and details the goals and assumptions of the recovery process. It presents the TC view of right living, which summarizes the community teachings guiding recovery during and after treatment. The terms “habilitation” and “rehabilitation” distinguish between building or rebuilding lifestyles for different groups of substance abusers in TCs.
Therapeutic communities (TCs) are designed to enhance the residents’ experience of community within the residence. This chapter explores how the physical environment of the TC, its setting, facilities, and inner environment, can contribute to this perception and affiliation with community. Its separateness from the outside community in addition to its living spaces, furnishings, and décor are all utilized to promote affiliation, a sense of order, safety, and right living. TCs for the treatment of addiction are located in a variety of settings, which may be determined by funding sources and the external resistance to or acceptance of rehabilitation programs. Within the context of the TC perspective, privacy is considered an earned privilege based on the individual’s social and psychological growth. There are four physical features of the inner environment that instantly identify what is unique about a TC program: the front desk, the structure board, wall signs, and decorative artifacts.
This book provides the foundations and training that social workers need to master cognitive behavior therapy (CBT). CBT is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that CBT and practice represents a strongly supported approach to social work education and practice. The book covers the most common disorders encountered when working with adults, children, families, and couples including: anxiety disorders, depression, personality disorder, sexual and physical abuse, substance misuse, grief and bereavement, and eating disorders. Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating CBT’s effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients.
In the therapeutic community (TC) perspective, the substance abuse disorder is not distinct from the substance abuser. A picture of dysfunction and disturbance of individuals entering treatment reflects a more fundamental disorder of the whole person. This chapter presents the TC view of the disorder in the context of current biomedical, social, and psychological understanding of chemical dependency. Overall, the picture that individuals present when entering the TC is one of health risk and social crises. In the TC perspective, drug abuse is a disorder of the whole person, affecting some or all areas of functioning. In the TC view, social and psychological factors are recognized as the primary sources of the addiction disorder. Substance abusers themselves cite a variety of reasons and circumstances as causes of their drug use. TC policy on the use of pharmacotherapy is currently undergoing modifications.
In the therapeutic community (TC) perspective, the core of addiction disorder is the “person as a social and psychological being” how individuals behave, think, manage emotions, interact, and communicate with others, and how they perceive and experience themselves and the world. This chapter details the TC view of the person in terms of typical cognitive, behavioral, emotional, social, and interpersonal characteristics. Residents in TCs display a variety of cognitive characteristics associated with their substance abuse and lifestyle problems. Residents in TCs have difficulties experiencing, communicating, and coping with feelings. Their lack of emotional self-management is associated with much of their self-defeating social behavior. The social and interpersonal context of community life in the TC provides a setting for the emergence of all varieties of guilt. Although the TC view of the person pictures a typical profile of characteristics and problems, it does not necessarily depict an addictive personality.
The therapeutic community (TC) for addictions descends from historical prototypes found in all forms of communal healing. A hybrid, spawned from the union of self-help and public support, the TC is an experiment in progress, reconfiguring the vital healing and teaching ingredients of self-help communities into a systematic methodology for transforming lives. Part I of this book outlines the current issues in the evolution of the TC that compel the need for a comprehensive formulation of its perspective and approach. It traces the essential elements of the TC and organizes these into the social and psychological framework, detailed throughout the volume as theory, model, and method. Part II discusses the TC treatment approach, which is grounded in an explicit perspective that consists of four interrelated views: the drug use disorder, the person, recovery, and right living. The view of right living emphasizes explicit beliefs and values essential to recovery. Part III details how the physical, social organizational, and work components foster a culture of therapeutic change. It also outlines how the program stages convey the process of change in terms of individual movement within the organizational structure and planned activities of the model. Part IV talks about community enhancement activities, therapeutic-educational activities, privileges and sanctions, and surveillance. The groups that are TC-oriented, such as encounters, probes, and marathons, retain distinctive self-help elements of the TC approach. Part V depicts how individuals change through their interaction with the community, provides an integrative social and psychological framework of the TC treatment process, and outlines how the basic theory, method, and model can be adapted to retain the unique identity of contemporary TCs.
When Charles, a 46-year-old divorced male with an extensive psychiatric history of depression, substance abuse, and disordered eating resulting in a suicide attempt, erratic employment, and two failed marriages, began treatment with a clinical social worker trained in dialectical behavior therapy (DBT), he was an angry, dysphoric individual beginning yet another cycle of destructive behavior. This chapter provides the reader with an overview of the standard DBT model as developed by Linehan. Dialectical behavior therapy, which engages vulnerable individuals early in its treatment cycle by acknowledging suffering and the intensity of the biosocial forces to be overcome and then attending to resulting symptoms, appears to be the model most congruent with and responsive to the cumulative scientific and theoretical research indicating the need for the development of self-regulatory abilities prior to discussions of traumatic material or deeply held schema.
The treatment of the suicidal individual is perhaps the most weighty and difficult of any of the problems confronted by the clinical social worker. Some frequent comorbid pathology with suicidal behavior includes alcoholism, panic attacks, drug abuse, chronic schizophrenia, conduct disorder in children and adolescents, impulse control deficits, schizophrenia, and problem-solving deficits. Suicidal harmful behavior appears in all ages and characterizes clients in a large spectrum of life. There are four types of suicidal behavior namely rational suicider, psychotic suicider, hopeless suicider and impulsive or histrionic suicider. This chapter presents some primarily cognitive techniques for challenging suicidal automatic thoughts. Recent reports suggest that individuals suffering from alcohol or substance abuse are at an increased risk both for attempting, and for successfully completing, a suicidal act. The therapist must develop an armamentarium of cognitive techniques, and the skills to use these effectively in ways that are appropriate for each individual client.
This book serves as a practice resource for social workers by making accessible the vast territory covered by the social, cognitive, and affective neurosciences over the past 20 years, helping the reader actively apply scientific findings to practice settings, populations, and cases. It features contributions from social work experts in four key areas of practice: generalist social work practice; social work in the schools and the child welfare system; in health and mental health; and in the criminal justice system. Each of the chapters is organized around practice, policy, and research implications, and includes case studies to enhance practice application. The impact the environment has on neural mechanisms and human life course trajectories is of particular focus. It is divided into four sections. Section A includes chapters devoted to social-cognitive neuroscience conceptualization of empathy, mirror neurons, complex childhood trauma, the impact of trauma and its treatment through discussion of posttraumatic stress disorder (PTSD). Section B covers child maltreatment and brain development, transition of youth from foster care, social work practices in schools for children with disabilities, and managing violence and aggression in school settings. Section C deals with several issues such as substance abuse, toxic stress and brain development in young homeless children and traumatic brain injuries. Neuroscientific implications for the juvenile justice and adult criminal justice systems are explained in Section D.
This chapter considers addiction generally without reference to the specific chemical to which an addiction develops. It discusses the neuroscience of addiction. The chapter presents the story on how addictive chemicals change the brain. Research on brain changes with addiction does provide useful information on when recovering persons are more susceptible to relapse. The chapter discusses the understanding based on animal work, and considers the heterogeneity of addictive patterns in people. It explores some of the findings on genetic variations associated with the risk of addiction to drugs of abuse. The chapter then provides specific information on how to screen and initiate treatment. In the United States, opiate agonists like buprenorphine and methadone are legal and considered to be treatment. Mandated treatment is as effective as voluntary treatment, probably because alcoholics often get convinced of the wisdom of change in the course of treatment.
- Go to chapter: Intersectoral Collaboration: Mental Health, Substance Abuse, and Homelessness Among Vulnerable Populations
Intersectoral Collaboration: Mental Health, Substance Abuse, and Homelessness Among Vulnerable Populations
Substance abuse is a significant problem among persons who are homeless. This chapter explores the application of addiction recovery management (ARM) principles for developing practice skills in the recovery process among vulnerable populations. It examines demographic and social action factors that may impede or foster successful completion of this long-term recovery for persons who are experiencing home insecurity. The chapter offers insight for forensic social workers about how to engage diversity and differences in practice, as well as advance human rights and social, economic, and environmental justice. Analytic concepts in forensic social work can enhance the capacity of educators to prepare practitioners to be effective in closing the gap that exists for racial disparities in treatment approaches and programs. Critical race theory can be used to develop guiding principles for competency-based education and outcomes that address the gaps in existing systems of care.
The desensitization of triggers and urge reprocessing (DeTUR) method is an urge reduction protocol used as the center of an overall methodology for the treatment of a wide range of chemical addictions and dysfunctional behaviors. It was initially introduced as a stop smoking protocol at the first eye movement desensitization and reprocessing (EMDR) conference. The basis or foundation is the adaptive information processing (AIP) using bilateral stimulation (BLS) as outlined in EMDR to uncover and process the base trauma(s) or core issues as the underlying cause behind the addiction. DeTUR accesses positive experience through positive body states while the EMDR protocol addresses positive experience through affect and positive and negative cognitions. The cognitive or therapeutic interweave as taught in the EMDR Institute basic training is the therapist’s best tool to aid clients during this desensitization or reprocessing phase.
This chapter examines the medical, psychosocial, and vocational characteristics, challenges, and rehabilitation needs of emerging populations of individuals with psychiatric disabilities, and introduces a recovery-oriented approach to providing responsive services to individuals with psychiatric disabilities. It explores integrated, evidence-based, and emerging practices to facilitate better recovery and rehabilitation outcomes for these populations. The onset of psychiatric disabilities occurs during critical years when major changes are occurring in the areas of identity formation and cognitive, psychosocial, psychosexual, and career development. Many individuals with psychiatric disabilities receive their health care in emergency departments and intensive care units and not until their secondary conditions create medical crises. Substance use disorders (SUDs) often co-occur with psychiatric disabilities. The principles of recovery align with the core values and principles of rehabilitation counseling. Illness management and recovery (IMR) is an evidence-based practice for equipping individuals with the knowledge and skills they need to self-manage their disabilities.
- Go to chapter: Substance Use and Co-Occurring Psychiatric Disorders Treatment: Systems and Issues for Those in Jail, Prison, and on Parole
Substance Use and Co-Occurring Psychiatric Disorders Treatment: Systems and Issues for Those in Jail, Prison, and on Parole
This chapter describes how mental health and substance use interact with criminal justice involvement. It examines the common assessment and intervention strategies for co morbid mental health and substance abuse in forensic population and settings. The chapter gives a brief review of how substance use disorders co-occur with psychiatric disorders. The chapter describes prevalence of co-occurring disorders such as anxiety/depression, bipolar disorders, psychotic disorders, personality disorders, and posttraumatic stress disorder in general. It then discusses prevalence of psychiatric disorders in the prison/jail systems. The chapter also describes medication-assisted therapies for opioid use disorders and, treatment and aftercare services. It explores two of the most common types of treatments for those in the CJS, cognitive behavioral therapy (CBT) and 12-Step groups. The chapter further reviews two CBT programs, aggression replacement training and strategies for self-improvement and change.
This chapter covers information about psychopharmacology for the behavioral health clinician. It offers some basic information about drugs: how drugs enter the system, how they are cleared from the body, and how they are distributed. The chapter explains the concepts of tolerance and withdrawal. It provides the background necessary for understanding what might be read in the Physicians’ Desk Reference (PDR), a manual issued annually by pharmaceutical houses in collaboration with the Food and Drug Administration (FDA) and published by PDR Network providing information regarding side effects, FDA-approved indications, and half-lives of each drug currently available in the market. The chapter then covers the major categories of psychotropic agents available in the United States. It provides information regarding how drugs are discovered and how the FDA evaluates them. The chapter reviews the distinction between practicing medicine and offering information.
The comorbidity of post-traumatic stress disorder (PTSD) and substance abuse gives sufficient reason to treat patients who are addicted with eye movement desensitization and reprocessing (EMDR). The concept of addiction memory (AM) and its importance in relapse occurrence and maintenance of learned addictive behavior has gained growing acceptance in the field of addiction research and treatment. The name craving extinguished (CravEx) was given to this EMDR strategy because craving seemed to vanish during EMDR reprocessing of the addiction memory in some of the patients. CravEx, as part of a treatment for comorbid addictive clients, focuses on reprocessing of the addiction memory thus leading to stabilization in the addiction. Major traumas can impact on addictive behaviors and are important to include in treatment planning. Anecdotal reports from clinicians indicate an effect of the reprocessing of the addiction memory in patients addicted to heroin or psychostimulants.
Many clinicians and researchers who work with adolescents classify the adolescent problems into two general categories of difficulties: externalizing problems and internalizing problems. Externalizing problems are difficulties that affect the external world of adolescents, such as drug abuse, delinquency, and engaging in risky behaviors. The adolescent who is abusing drugs is likely to also be engaged in risky sexual behaviors and delinquency. The discovery of and experimentation with drugs are common for adolescents and vary primarily from socially acceptable and legal drugs such as caffeine, cigarettes, and alcohol to socially rejected and illegal drugs, ranging from marijuana to heroin and cocaine. Unfortunately, adolescents often do not think that drug abuse is harmful, despite the fact that both alcohol consumption and marijuana use have short-term and long-term negative effects. However, sexuality during adolescence has the potential to become a serious health concern.
The incidence of sexual assault and harassment experienced by members of the U.S. Armed Forces has reached epidemic proportions. Its victims often suffer from devastating, lifelong consequences to their careers, health, relationships, and psychological well-being. This book is written for mental health clinicians to help in understanding and treating military sexual trauma (
MST). It addresses the complex circumstances of victims of sexual abuse in the military and how clinicians can meet the unique challenges of treating these clients. The book describes how MST differs from other forms of military trauma such as combat, and discusses its prevalence, neurobiology, and social contexts as well as unique stressors of betrayal, injustice, struggles with issues of reporting and disclosure, and impact on relationships and sexuality. It reviews current evidence-based interventions and offers insights on treating specific symptoms within MST, such as post-traumatic stress disorder (PTSD), anxiety, substance abuse, sleep disorders, and sexual dysfunction. Chapters discuss how a variety of psychotherapies can be used to treat MST, including prolonged exposure, cognitive processing, Eye Movement Desensitization and Reprocessing ( EMDR), Seeking Safety, acceptance and commitment therapy, and somatic experiencing, as well as the Warrior Renew MST group therapy program. Clinicians who work with veterans and active duty personnel will find the book an essential guide to working with MST survivors.
Active Minds offers many resources for individuals with mental illnesses and allies. Suicide prevention website provides information about wealth and how to support someone who may be experiencing suicidal thoughts. American Psychological Association (APA) is a national organization for psychologists that are also dedicated to improving public access to information and services related to psychology. The government website for mental health provides a directory of government mental health programs as well as general information related to mental health. A national addiction recovery program aimed at building skills that help to combat addictive behaviors offering meetings in many communities as well as online. OK2TALK is an online support community for young adults living with mental illness. Community members are supported in sharing and learning from the stories of others in a stigma-free environment.
This book is a comprehensive guide to the basics of mindful hypnotherapy (MH), incorporating everything you need to understand the approach, apply it to clients in your clinical practice, and use it for your own personal edification and growth. MH is a treatment that combines the qualities from two highly effective and well-established treatment approaches: mindfulness and hypnotherapy. These approaches have separately been shown to be effective in the treatment of a wide array of disorders ranging from elevated stress or adjustment problems to more debilitating conditions such as major depressive disorder, posttraumatic stress disorder (PTSD), substance use disorders, chronic pain, anxiety disorders, and more. This book is intended to be an additional tool in a therapist’s toolbox—a new approach that delivers a mindfulness-based intervention within a hypnotic context. The book is divided into three sections. The first section (Foundations) provides the conceptual basis for MH, research, discussion of hypnotic abilities, and basics for formulating hypnotic inductions and suggestions. The second section (Mindful Hypnotherapy by Session) provides a treatment manual for MH over eight sessions. It includes transcripts, hypnotic inductions, and guidance for individualization and tracking progress using the Mindful Self-Hypnosis Daily Practice Log. The third section (Conclusion) provides an overview of training and personal growth toward becoming a mindful hypnotherapist. This MH approach is long overdue, and over the course of the past 40 years, the fields of hypnotherapy and mindfulness have been compared and contrasted phenomenologically, physiologically, and neurologically. MH is an intervention that intentionally uses hypnosis (hypnotic induction and suggestion) to integrate mindfulness for personal or therapeutic benefit.
This chapter offers a summary of the Seeking Safety Model, which is designed to address both posttraumatic stress disorder (PTSD) and substance use disorder (SUD). It focuses in particular on its relevance to military sexual trauma (
MST). Conventionally, most SUD treatment programs focused on attaining stabilization or abstinence before addressing mental illnesses. Seeking Safety is an evidence-based therapy that has been widely used to treat people with a history of trauma and substance abuse. The primary goal of Seeking Safety is to encourage client safety by building coping skills in relation to both trauma and substance abuse. Seeking Safety offers 25 topics that address cognitive, behavioral, and interpersonal skills. A clinician’s report says that veterans appear to be more difficult to engage in treatment than other groups. The Seeking Safety approach is a low-cost model that was designed for public-health relevance, which can be implemented across all levels of care.Source:
Peer aggression is a pervasive and costly problem in schools. Physical aggression, which consists of hitting or pushing others, and verbal aggression, which includes threatening, name-calling, and teasing, have long been recognized as the most common forms of aggression, especially among boys. All forms of aggressive behavior have been associated with various maladaptive outcomes throughout childhood and adolescence such as increased substance use, academic underachievement, and negative peer relationships. To determine best-practice strategies to prevent and intervene with aggressive behavior, it is crucial to understand the etiology of anger and aggression. Many aggression prevention programs are rooted in the ecological framework of development, with programming occurring across many settings in the school, and include both school staff and parents. Coping power; walk away, ignore, talk, seek help (WITS); and preventing relational aggression in schools everyday (PRAISE) are three evidence-based interventions that focus on aggression and victimization prevention.
- Go to chapter: Evidence-Based Interventions for Persistent Depressive Disorder in Children and Adolescents
Depression in children and adolescents is a serious, potentially life-threatening problem. Traditionally, depression has been diagnosed using two primary categories: major depressive disorder (MDD) or dysthymic disorder (DD). When compared with youth diagnosed with MDD, children and adolescents with persistent depressive disorder (PDD) are at increased risk for having a comorbid psychiatric disorder. The most common treatments of depression include various forms of interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychotropic medication. This chapter provides summary of the step-by-step implementation of IPT for depressed adolescents (IPT-A). Many youth struggle with chronic, sometimes debilitating depression for extended periods of time, leading to underachievement, secondary substance abuse, school failure and drop-out, violent or self-harming behavior, and even death by suicide. Clearly, evidence-based psychotherapeutic interventions are needed.
This chapter consists of six case histories of boys who resided at Ocean Tides. The information was culled from their files, the clinical consultant’s interviews with the boys when they were in residence, and aftercare information. Their names have been changed to protect their identities, and permissions to include their stories in the chapter were granted where possible. These cases were selected to provide a sampling of the Ocean Tides boys; their backgrounds, personal, and psychological hurdles; and the outcome of their experience at Ocean Tides. The Ocean Tides program was there for these boys providing care, guidance, counseling, and family support systems in the role of surrogate parents sometimes for more than a year of their young lives, and other times forging relationships with these young men that would last a lifetime.
Substance users have substantially reduced rates of use of preventive health care services, and reduced rates of compliance with prescribed medical treatment. Primary care providers are frequently overwhelmed and may be reluctant to address substance-related problems given few resources. Direct collaboration with a behavioral health specialist (BHS) co-located within the primary care clinic results in increased efficiency and better treatment outcomes. There are excellent resources available for the BHS who will provide tobacco abuse interventions in the primary care setting. A number of behavioral factors should be considered in effectively addressing substance use and abuse in the primary care setting. Primary care providers should also be alert to unexplained vague symptoms, somatic complaints, difficulty with sleep, anxiousness, frequent life disruptions or chaotic lifestyle, and a family history of mental health problems or substance abuse.
- Go to chapter: Evidence-Based Interventions for Tourette’s and Other Chronic Tic Disorders in Children and Adolescents
Evidence-Based Interventions for Tourette’s and Other Chronic Tic Disorders in Children and Adolescents
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists two chronic tic disorder diagnoses, namely, persistent motor or vocal tic disorder (PMVTD) and Tourette’s disorder (TD). Both disorders require symptom onset before age 18 years and require the clinician to rule out alternative causes of tics, including substance abuse and other medical conditions. Tics may be categorized as either simple or complex. Children with tic disorders may be most impaired by comorbid conditions and associated features, including deficient social skills, sleep problems, anxiety and/or depression, obsessive-compulsive disorder (OCD) symptoms, and attention deficit hyperactivity disorder (ADHD) symptoms. A review conducted in 2007 found that only two approaches—habit reversal therapy (HRT) and exposure and response prevention (ERP)-have adequate evidence to treat tic disorders and TD. Tourette’s disorder and other chronic tic disorders are childhood-onset conditions characterized by sudden, involuntary movements or vocalizations.
Youth suicide is a significant public health problem both in the United States and in other countries. Evidence-based interventions for youth suicidal behavior include both community- and school-based approaches. Suicidal behavior which includes suicidal ideation, suicide-related communication, suicide attempts, and suicide represents a continuum of behaviors that affects hundreds of thousands of adolescents, young adults, and their friends and families each year. This chapter discusses several of these interventions, social, crisis hotlines and social media, psychopharmacological interventions, hospitalization, dialectical behavior therapy (DBT), and school-based suicide prevention programs. School-based mental health professionals are typically the most appropriate persons to lead universal information sessions. The chapter provides a brief guide to the implementation of a school-based, three-tier model of youth suicide prevention. Students who are identified as being at risk of suicidal behavior typically have significant mental health problems, particularly mood disorders, substance-related disorders and disruptive behavioral problems, respectively.
A specific phobia is characterized by an excessive and persistent fear of a specific object or situation that almost always provokes a negative avoidant response. Treatment of specific phobias in children is particularly important because phobias may persist over the course of a lifetime, and may result in other disorders such as anxiety, mood, and substance-use problems. Heritability is thought to play a modest but significant role in the development of specific phobias, with up to one third of the variance of specific phobias explained by genetic factors. This chapter discusses cognitive behavioral therapy (CBT) and one-session treatment (OST), a specific variant of CBT, as well as the role parents may play in the treatment process. It briefly comments on systematic desensitization, which has historically been used to treat specific phobias in children and adolescents.
The book examines various theories of aging including a contrast between the strengths-based person-in-environment theory and the pathologically based medical model of psychological problems. It advocates truly engaging with the older client during the assessment phase, and discusses a variety of intervention modalities. The book integrates an advanced clinical social work practice with in-depth knowledge of evidence-based practice as well as geriatric medicine, psychiatry and gerontology. The social worker must evaluate the status of the client’s housing, transportation, food, clothing, recreation opportunities, social supports, access to medical care, kinship and other factors considered important by the social worker or the client. Constructivist theory is a conceptual framework that is foundational to existential therapy, cognitive behavioral therapy (CBT), and narrative therapy, which are effective for older adults. Stigma associated with race, ethnicity, and sexual orientation produce psychosocial stressors that converge on older clients. The book discusses several medical conditions affecting older adults such as Alzheimer’s disease, arthritic pain, diabetes and various types of cancers. Older adults may also suffer from substance abuse-related problems, hypersexuality, and various types of abuse such as neglect. The book also highlights the problems faced by the older adult LGBT community and those suffering from HIV disease. It ends with discussions on care and residential settings for the older adults, and palliative care and euthanasia.
This chapter lists and examines essential criteria to consider when assessing patient stability and readiness for the standard eye movement desensitization and reprocessing (
EMDR) procedural steps. In considering a patient’s suitability and readiness for standard reprocessing, five kinds of issues need to be considered: medical concerns; social and economic stability; behavioral stability; mood stability; and complex personality and dissociative disorders, life-threatening substance abuse, and severe mental illness. Depersonalization and derealization as expressions of primary structural dissociation are frequently the only dissociative symptoms in patients with posttraumatic stress disorder (PTSD). The chapter reviews standardized assessment tools that can assist clinicians in assessing symptom severity, screening for dissociative disorders, and monitoring treatment progress and outcomes. The trauma assessment packet includes four test instruments, along with three research and clinical articles, which together provide a comprehensive assessment of trauma histories at different ages.
This chapter talks about psychoactive substances that are commonly misused or abused by older adults. It is important for a psychologist to understand the psychopharmacological dynamics of each substance, how they are administered by an older adult, the symptoms of intoxication and withdrawal, and the psychosocial consequences experienced by the older adult misusing or abusing psychoactive substances. Unlike younger adults, older adults are more likely to avoid illicit substances such as cocaine, heroin, methamphetamine, psychedelics such as lysergic acid diethylamide (LSD) or mescaline, and designer drugs. Historically, the psychoactive substance of choice was alcohol. There are two general types of opioid psychoactive substances: naturally occurring opioids and synthetic opioids. Naturally occurring opioids include opium and its derivatives morphine and codeine, and heroin, which is a chemical manipulation of morphine. Unfortunately, many older adults suffer with chronic pain from cancer, arthritis, or injuries, causing a need for opioid medications.Source:
Older adults experiencing cognitive decline and any of the dementias are suffering in ever increasing numbers. With the aging of the baby-boom generation, the incidence of cognitive decline and dementia will exponentially escalate over the coming years. With this coming tsunami of dementia, older adults experiencing dementia, as well as their family members and caregivers, will need the services of psychologists. Psychologists are needed to help families recognize the importance of end-of-life planning for an older adult when first diagnosed with a dementia. When an older adult understands that he or she has responsibility for and choice in the decision to abuse a psychoactive substance, there is a greater probability of successful treatment and recovery from a substance abuse problem. Psychologists are in a unique position to assess whether older abuse is occurring and, when discovered, to intervene with advocacy initiatives.Source:
This book provides a comprehensive model for effectively blending the two main postmodern brief therapy approaches: solution focused and narrative therapies. It harnesses the power of both models the strengths-based, problem-solving approach of solution focused therapy (SFT) and the value-honoring and re-descriptive approach of narrative therapy to offer brief, effective help to clients that builds on their strengths and abilities to envision and craft preferred outcomes. The book provides an overview of the history of both models and outlines their differences, similarities, limitations, and strengths. It then demonstrates how to blend these two approaches in working with such issues as trauma, addictions, grief, relationship issues, family therapy, and mood issues. Each concern is illustrated using a case study from practice that focuses on individual adults, adolescents, children, or families. Sample client dialogues and forms are included to help the clinician guide clients in practice. SFT has provided therapists with new tools for working with clients who are dealing with substance abuse. The book provides a summary of research findings that have shown the effectiveness of the solution focused approach over the problem-focused approach. The narrative model invites clients to construct a new presentation in a problematic story (narrative) and develop a script for a preferred future (solution focused), with a newly crafted character, instigating new strategies for actions (solution focused), based on exceptions.
Psychiatric disability refers to a psychiatric disorder associated with functional limitations that prevent achievement of age-appropriate goals. The nomenclature and diagnostic criteria for psychiatric disabilities vary widely, however, across the mental health, rehabilitation, and social security disability systems. Common mental disorders refer to psychiatric disorders that are less disabling than serious mental illness but still impact role functioning. Depression is probably the widest-ranging psychiatric disorder in terms of severity and duration. Substance abuse disorder is among the most common co-occurring disorders in all psychiatric disabilities, affecting 50" of people with psychiatric disabilities at some point in their lifetime. Anxiety disorders are highly comorbid with other psychiatric diagnosevs, including other anxiety disorders, mood and eating disorders, and schizophrenia spectrum disorders. Victimization of people with psychiatric disabilities is a serious public health problem, as they are 11 times more likely to be victimized by violence and crime than the general population.
This chapter highlights the basic biomedical knowledge essential for interpreting medical information and understanding how medications work in the body. Fundamental issues about the brain and nervous system are discussed in a practical and simplified manner with an emphasis on those issues most relevant to social work. In psychopharmacology, the study of how medications work at the molecular level is called "pharmacodynamics". The neuron cell is the basic unit of the brain, and neuronal activity is central to the thought, action, or feeling that results. As an impulse travels along the axon and prepares to enter the synaptic gap, neuronal activity results. This process occurs in five basic stages: synthesis, storage, release, receptor binding, and termination. Most professionals agree there are biological and biochemical processes that increase the possibility of drug addiction, or what is often characterized as drug "dependence".
This chapter explores ways to talk with clients of all ages whose lives have been intruded upon by dangerous habits such as substance abuse, eating disorders, self-harm, and obsessive-compulsive disorders (OCD). The assumption of a therapist using solution focused narrative therapy (SFNT) is that the client’s attempt to cope with situations in his or her life has led to habits and activities that have become dangerous to the client’s well-being and possibly others in his or her life. The therapist therefore does not confront the client, but rather seeks best hopes from the client regarding what the client wants to better in his or her life. It is the hope of the therapist that by working with the client to achieve what the client wants, he or she will see a need to give up the habit and feel empowered to create a preferred future.
This chapter reviews the characteristics and typologies of intimate partner violence (IPV) perpetrators as well as methods to determine their level of lethality and motivation to change. Many perpetrators are treated in batterer intervention programs (BIP) which attempt to change their cognitive and behavioral patterns, thus discontinuing their abusive acts. Many perpetrators have a history of child abuse. They may have been physically, sexually, or emotionally abused, have witnessed IPV, or have been maltreated in some other manner. Substance abuse may also co-occur with IPV. Some researchers suggest that substance abuse is involved in anywhere from 20 to 80 of domestic violence cases. Although most traditional research and the literature addressing IPV between heterosexual couples focuses on female victims and male perpetrators, increasingly men are being recognized as the victims of female perpetrators.
The nature and specialty of addictions counseling is unique from general mental health counseling and as a result presents distinct ethical concerns for practitioners. This chapter reviews and discusses the unique ethical considerations in addictions counseling. It clarifies the distinction between addictions counseling as a counseling specialty and the field of substance abuse treatment and evaluation. The chapter provides a discussion of considerations for ethical addictions counseling practice. Prior literature has established common ethical issues experienced by practitioners providing addictions treatment. These include ethical issues related to: professional identity and certification; settings issues; privacy, confidentiality, and privileged communication; informed consent; mandatory clients; multiple roles and relationships; settings issues; counseling adolescents and minors; and issues of diversity multiculturalism. Addictions counselors must utilize self-care and consultation (among other behaviors) in order to resolve potential values conflicts that may arise in the provision of substance abuse counseling.
Substance misuse, abuse, and substance use disorders constitute a major public health crisis in the United States. This places a tremendous strain on the nation’s healthcare system. Social workers are advocating for policy changes aimed at preventing and reducing the serious adverse consequences of substance abuse disorders. This chapter underscores the importance of addressing prevention and treatment with various population groups and includes the following three subsections: Practice, Research, and Policy for substance misuse, abuse, and addiction. The development of policies that support healthcare reform and treatment is vital for addressing the major public health crisis of substance use disorders. Social workers have played an important role throughout history in working with the complex problems of addictive disorders. The education and training of social workers and all healthcare professionals about the issues associated with addiction is critical to reducing stigma and providing competent and quality treatment services.
- Go to chapter: Disability at Developmental Stages: Adolescence (Ages 13–18) and Emerging Adulthood (Ages 19–25)
This chapter covers the developmental stage of adolescence and a relatively recently conceptualized development stage of emerging adulthood, comprising a total of 12 years of life. It discusses topics such as crime and violence against individuals with disabilities, substance abuse among
IWDs, the “thrills and chills” personality, and traumatic onset disabilities. While experiencing biological changes and gaining more individuation, adolescents and emerging adults begin vocational exploration, decide upon higher education, and initiate romantic, sexual relationships. For both adolescents with and without disabilities, body image and physical attractiveness become very important. Traumatic onset disabilities are more common during the adolescent years, and, in particular, spinal cord injuries, traumatic brain injuries, and alcohol and substance abuse are typically acquired in adolescence.
Social work has a long-standing commitment to healthcare and the recognition of the inextricable link to quality of life and well-being across the lifespan. This book emphasizes the critical importance of health for all members of society and the significant role of social work in the field. It presents essential information about health and social work critical to understanding today’s complex health care systems and policies. The book is intended as a core text for masters of social work (MSW) and advanced bachelor of social work (BSW) courses on health and social work, social work and health care, health and wellness, social work practice in health care, and integrative behavioral health taught in social work, public health, and gerontology. The book is organized into three parts containing 18 chapters. The first chapter describes the role of social work in healthcare. The second chapter discusses ethics and values in healthcare social work. The next three chapters present social determinants of health, intersectionality, and social work assessment. Chapter six discusses health promotion and public health. Chapter seven presents integrated behavioral healthcare. Chapter eight describes substance misuse, abuse, and substance-related disorders. Chapters nine and ten discuss palliative care, end-of-life care, correctional healthcare, and psychosocial care. Chapter 11 describes children and family health. Chapter 12 explores healthcare and work with older adults and their caregivers. Chapters 13 to 15 delve on immigrants and refugee health, health and HIV/AIDS, and LGBTQ health. Chapters 16 and 17 describe healthcare and disability, and healthcare and serving veterans. The final chapter discusses future direction of healthcare and social work.
Social workers, both in the community and within the Veterans Administration (VA), provide a comprehensive range of services to a broad demographic of veterans. Service provision for veterans can address a wide range of issues including aging, homelessness, reintegration, sexual assault, physical and psychological war injuries, and substance abuse. Research-informed practice allows social workers to effectively address the special needs of veterans. This chapter discusses the landscape of social work practice with veterans and the interconnectedness of research, policy, and service delivery. It offers an introduction to working with veterans from a practice, policy, and research perspective. Social workers should have a working knowledge of military culture, the impact of deployment, subsequent redeployments, reintegration, and adjustment to civilian life. It is essential for social workers to have knowledge about the physical and psychological aspects of trauma, particularly war-related trauma.
Child and Adolescent Counseling Case Studies:Developmental, Relational, Multicultural, and Systemic Perspectives
This book aids counselor educators, supervisors, and counselors-in-training in assisting children, adolescents, and their families to foster coping methods and strategies while navigating contemporary issues. It promotes the essence of counselor growth, and deals with conceptualization of the client’s presenting problems along with personal and client goals, step-by-step accounts of the happenings in counseling sessions, and counseling outcome. Case studies were written in contexts that reflect the fact that children and adolescents are part of larger systems family, school, peer, and community. Systemic context, developmental and relational considerations, multicultural perspectives, and creative interventions were infused in the cases. Time-efficient methods, such as brief counseling, were used in some of the cases. The case studies selected highlight contemporary issues and relevant themes that are prevalent in the lives of youths (i.e., abuse, anxiety, giftedness, disability, social media and pop culture, social deficits and relationships, trauma, bullying, changing families, body image, substance abuse, incarcerated family members, race and ethnicity, and sexual identity and orientation). These themes capture both the child and adolescent perspectives and are designed to provide breadth and depth during classroom discussions and debriefing.
- Go to chapter: EMDR Therapy and the Recovery Community: Relational Imperatives in Treating Addiction
This chapter examines eye movement desensitization and reprocessing (EMDR) therapy as a powerful healing mechanism in the treatment of addiction and provides insights on future directions. Francine Shapiro’s early writing about integrating EMDR into the treatment of addictive disorders offers sound guidance for introducing EMDR therapy to someone seeking recovery from chemical dependency or other compulsive behaviors often described under the umbrella of addiction. The culturally sensitive EMDR therapist may not impose their biases about the utility of any one model of recovery on their clients; rather, the therapist may facilitate an experience where the client can discover which path can best serve him or her. EMDR therapy, by design, can address several issues: the spiritual, the lifestyle, the cognitive, the somatic, and the historical facets of addiction. EMDR is usually referred as the “missing piece” in addiction treatment care.
Unhealed trauma causes distress in the body. When the nature of the distress overrides a person’s existing system for coping, or the trauma is not processed, survivors may numb themselves or seek a more pleasurable experience to escape. Such behavior is a completely natural response to unprocessed trauma. This book continues challenging the existing paradigms for treating addiction and related issues. Despite the longstanding existence of professional treatment in North America, recidivism is high. People are still dying at alarming rates not just from the opioid crisis that dominates news headlines, also from the impact of alcohol, cocaine, nicotine, and other maladaptive behaviors. Moreover, the social isolation and collective trauma caused by the
COVID-19pandemic added fuel to an already raging fire, revealing massive cracks in a system for care that is barely functional. In the authors’ assessment, no single drug, substance, or behavior is the culprit—the real issue is the untreated trauma that lurks underneath, causing people to seek out the relief of these substances in the first place. The literature and practice knowledge in the field of addictions have long identified untreated posttraumatic stress disorder as a relapse risk factor. There is a rich history of eye movement desensitization and reprocessing ( EMDR) therapy’s role in helping to heal addiction at a holistic level due to the long-established connection between unprocessed trauma and addiction. EMDRtherapists must remember that EMDRtherapy is a complete system of psychotherapy and ought to be honored as such when conceptualizing cases connected to compulsive behavior, substance use disorders, or other addictions.
Individuals of diverse cultures suffer from substance use disorders (
SUDs). These individuals and the families that love them face devastating adverse consequences. It is crucial for research to continue to develop best practices and policies that address the public health emergency that exists across all socioeconomic levels, races, genders, cultures, and so on. This chapter highlights the importance of addressing the current public health crisis of substance abuse and SUDswith various population groups from different cultural backgrounds. It emphasizes client-centered practice from an intersectional perspective with a special focus on families. Health practices and policies that decrease disparities in healthcare are important to the well-being of marginalized groups from different cultures. Culture and its impact on perceptions, beliefs, and behaviors of different groups are critical to developing evidence-based treatments for substance abuse that are efficacious.