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.
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This chapter discusses the social psychology of humor, starting with a walk through how the presence of other people can make things seem funnier. It shows how humor can have a positive or a negative tone and it can focus on ourselves or on those around us. Self-enhancing humor makes stress tolerable. It can keep folks from viewing minor annoyances as unbearable disasters. The chapter sketches how humor can function to maintain the status quo. People who report using self-enhancing humor show less anxiety, neuroticism, and depression; better psychological well-being and self-esteem, and more extraversion, optimism, and openness to experience. When it comes to hierarchies, getting a feel for who’s cracking jokes and laughing can communicate who’s top dog. The chapter finally focuses on gender differences, and then sees how humor contributes to developing friendships, finding a date, and maintaining an intimate relationship.Source:
Cognitive behavioral therapy (CBT) with children addresses four main aims: to decrease behavior, to increase behavior, to remove anxiety, and to facilitate development. Each of these aims targets one of the four main groups of children referred to treatment. This chapter suggests a route for applying effective interventions in the day-to-day work of social workers who are involved in direct interventions with children and their families. An effective intervention is one that links developmental components with evidence-based practice to help enable clients to live with, accept, cope with, resolve, and overcome their distress and to improve their subjective well-being. CBT offers a promising approach to address such needs for treatment efficacy, on the condition that social workers adapt basic CBT to the specific needs of children and design the intervention holistically to foster change in children. Adolescent therapy covers rehabilitative activities and reduces the disability arising from an established disorder.
- Go to chapter: Overview of the Problem-Solving Therapy Process, Introductory Sessions, and the Case of “Megan”
This chapter presents the therapy manual detailing the specific treatment guidelines encompassing problem-solving therapy (PST). It is important during the initial sessions with a new client to develop a positive therapeutic relationship. Upon obtaining a brief version of the client’s story, it becomes important early in treatment to provide an overview of PST that includes a rationale for why it is relevant to, and potentially effective for, this individual. Problem solving can be thought of as a set of skills or tools that people use to handle, cope with, or resolve difficult situations encountered in daily living. Research has demonstrated that social problem solving is comprised of two major components. The first is called problem orientation. The second major component is one’s problem-solving style. The chapter also presents the case of a 27-year-old woman suffering from multiple concerns, including anxiety, depression, fears of “going crazy”, and prior alcohol abuse.
Clients with dissociative identity disorder (DID) or dissociative disorder not otherwise specified (DDNOS) live with a multiple reality disorder where parts are often living in the past and are not aware of where they are, the current date, or the time. The goal of this resource is to reduce the anxiety of parts living in the past and increase the client’s ability to differentiate the past from the present. Beginning with the host, adult, or other oriented parts, make a list of information that the disoriented parts need to be oriented and to decrease anxiety. Once the list is developed, install the list using dual attention stimulation (DAS). Useful items tend to be concrete and help differentiate the past from the present. If the client is being abused in some way in the present, often there are ways to differentiate the past from the present.
- Go to chapter: Constructive Avoidance of Present Day Situations: Techniques for Managing Critical Life Issues
The purpose of the constructive avoidance script is to assist clients in dealing with their anxiety or stress-provoking present day situations. Dissociative clients generally are phobic or avoidant of many activities such as medical procedures, going to the dentist, taking examinations, going for job interviews, and so forth due to the complex nature of their traumas, panic, anxiety, and other trauma-related problems. When the client is going to encounter a situation that has caused high stress or triggering in the past and has not completed eye movement desensitization and reprocessing (EMDR) target focusing on that issue, chances are that the ego states involved are not yet ready to deal with the situation. The client can practice with the parts before the upcoming event in sessions and as homework between sessions. This protocol assumes that clients have already established a Home Base and Workplace.
This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. There is a self-awareness questionnaire to assist clinicians in identifying potential problems that often arise in treatment, allowing for strategies to deal with them. Some clients may be able to talk about their trauma; however, the thought of processing it with the Standard EMDR Protocol may seem too overwhelming. In cases such as these, having the client develop a resource to address the “fear of the fear” may reduce the anxiety of reprocessing the traumatic memory.
The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.
This chapter demonstrates a sex therapist’s utilization of Eye Movement Desensitization and Reprocessing (EMDR) within the context of the 3-pronged approach to target issues related to sexual dysfunction. Clients undergoing EMDR treatment for sexual dysfunction may often feel anxious and vulnerable during their sessions. This may be because the act of processing certain sexual events may trigger physical arousal that may lead to feelings of embarrassment and anxiety. Sexual dysfunction is a very vast area of study. Each sexual dysfunction has its own diagnostic criteria, assessment, and treatment. It is very important for clinicians to gain enough training and supervision in sex therapy before using EMDR protocol. Clinicians who have not addressed their own inhibitions, guilt or shame about their sexuality may cause harm to clients and to themselves. This protocol works best within the context of ongoing couple therapy and sex therapy.
This chapter provides an overview of ways in which people can work to ensure a positive experience for their and thier social work practicum student. It offers some helpful, practical advice to guide the field instructor-student relationship. The chapter presents a checklist of “dos and don’ts”, and the chapter provides a great deal of practice-based wisdom for the field instructor. Many students choose to or must meet enormous responsibilities, and they balance complex schedules. Knowing about these circumstances from the beginning of the internship can dramatically decrease conflicts, stress, and unmet goals. Establishing open lines of communication so students will be proactive in seeking our input, guidance, or permission to meet changes and challenges can decrease anxiety, which will help ensure their maximum learning, growth, and performance in the practicum.
This chapter describes the need for a specific focus on counseling women and girls. It discusses the fundamental tenets of empowerment feminist therapy (EFT). Gender and gender differences are not inherently problematic; however, issues arise when they become markers for which individuals are esteemed or devalued. Violence against women is a serious public health issue in every country in the world. Violence against women and girls takes many forms, some of which are accepted cultural practices that have severe negative repercussions for females’ physical and psychological well-being. Child marriage and female genital mutilation are two of these cultural practices. Due in part to trauma, oppression, and gender-role expectations, women and adolescent girls experience the highest rates of anxiety, depression, and posttraumatic stress disorder (PTSD). Out of the feminist movement, and in response to the biases inherent in mental health treatment, feminist therapy came into existence.
Anxiety is often a normal reaction to stress, and there will always be situations that create stress and discomfort. In social work practice, recognition of the primary types of anxiety-related mental health disorders and the medications used to treat these disorders is an essential first step for comprehensive treatment. When medication alone is not enough, psychosocial interventions can assist the client in controlling anxious feelings. This chapter emphasizes the importance of being familiar with the medications and supplemental psychosocial interventions that can be effective in treating these disorders. Social work professionals often provide key services, including assessment and diagnostic and treatment services, to those who suffer from anxiety conditions. In terms of direct intervention efforts, many of the techniques described in the chapter can be used to help clients suffering from depression because the symptoms of anxiety and depression frequently overlap.
Anger, depression, and anxiety that cause distress are sometimes hard for clients to manage and gain control over. Deconstructing the problem to find out why such reactions are occurring does not lead to solutions; rather, it provides more reasons to suggest that a normal life is impossible. This chapter shows how identifying the effects of such descriptions slow down the progress of the person’s triumph over the problem. There is a special moment in a therapy session when a therapist suggests that the client “stand up for himself against the anger”. With clients who come to therapy and present with diagnoses, it is very important to remain respectful of their attempts to understand why they are experiencing distress. Externalizing a problem or diagnosis allows clients to separate themselves from the dominant stories that have shaped their lives and relationships.
This chapter offers an overview of the dynamic process of psychosocial adjustment and adaptation to chronic illnesses and disabilities (CIDs) and the key variables in coping and resiliency with such chronic and persistent mental and physical health conditions. It describes recommended treatment interventions to assist mental health counselors in helping others adjust in post disaster recovery and the rehabilitation process. There are a number of stage models offered in the literature regarding psychosocial adaptation to disability, trauma, crisis, grief, and loss. The overall intent and purpose of stage models of disability are to assist mental health practitioners with a conceptual clinical perspective of how the individual perceives the consequences of his or her CID and where he/she is at in terms of adjustment, response, and adaptation. It can also assist mental health practitioners in treatment planning and deciding what course of action needs to be facilitated through the rehabilitation process.
This chapter describes the growing impact of internet addiction on children and adolescents. It focuses on assessment methods that practitioners working with this population can use to measure and assess the behavior. The chapter explains how practitioners can develop their own screening tools of media use for children and adolescents. It outlines comprehensive parenting guidelines based on the developmental age of the child to best integrate technology at home. Issues of screen time impact a child’s moods and feelings. Children and adolescents who suffer from anxiety, especially social anxiety, are more likely to develop an addiction to technology. The chapter describes assessment methods such as Parent–Child Internet Addiction Test (PCIAT), which assists in clinical evaluation of children suspected to suffer from addiction and Problematic and Risky Media Use in Children Checklist. The chapter describes 3–6–9–12 prevention for screen addiction outlining steps parents can take at each child’s age.
Thomas (pseudonym for a composite student profile), in his final K–12 year, participates in five components of a multidimensional program for gifted students in a large school: Future Problem Solving (
FPS), Advanced Placement ( AP) courses, a noon-hour philosophy course taught by a retired professor, after-school lectures by community members, and small discussion groups focused on nonacademic development. He has an extremely high IQ, is known as an excellent musician, and recently was named a semifinalist in the Preliminary SAT( PSAT) merit-scholar competition. However, his only-average academic record has long frustrated teachers, who seem offended by his seemingly limp investment and who see an “attitude problem” in his lack of oral engagement and absent homework. Thomas has a quiet personality, typically avoids eye contact, and seems older than his age. He has taken no steps toward postsecondary education, and he will need financial aid if that is his direction. One of his teachers asks the school counselor to meet with him to assess needs and concerns, including those related to college applications. Before she meets with Thomas, the counselor arranges conversations with his current teachers, his single-parent mother, the orchestra teacher/conductor, and the gifted-education program coordinator. Only the one teacher has ever referred Thomas to the counselor.
APAmerican Literature and APAmerican History teachers both focus mostly on the missed assignments but note his serious alertness during class and brilliant insights on the papers he has submitted. The chemistry teacher expresses concern about Thomas’s sad demeanor but notes that he pays attention in class and does “ OK” academically. The orchestra director, who has worked with Thomas since elementary grades, calls him one of the most gifted and highly invested musicians he has known. He reacts emotionally when he listens to classical music.
The gifted-education teacher has learned that Thomas struggles with perfectionism—with essays stalled after he has discarded several eloquent thesis statements. He has told her that he doubts he can follow through worthily. About eye contact, Thomas once said he could not hear peers’ comments when distracted by the visual stimuli of faces. He despairs over circumstances in distressed countries. Nevertheless, he is a quiet leader on his
FPSteam. His mother describes her acrimonious divorce and the depression Thomas has struggled with since middle school. She worries about him, especially now, with his inertia about applications. She hopes, given the PSATresults, that he will now invest in the process, securing a scholarship. She feels incapable of helping him.
This chapter suggests that Irrational Beliefs (IB’s) play a major role in the creation of human disturbance, and that people make themselves disturbed mainly by escalating their goals, desires, and preferences into absolutistic musts and demands. Rational Emotive Behavior Therapy (REBT) hypothesizes that Irrational Beliefs rarely exist by themselves, but are preceded by or associated with rational ones. One can use modeling techniques with resistant clients by showing them that no matter how difficult they find it to reduce their disturbed feelings, as well as to reduce their anxiety and depression about these feelings. They can also read and learn about other very disturbed people who have used REBT, Cognitive Behavior Therapy (CBT), and other therapy methods to considerably help themselves. Encouraging clients to do an effective cost-benefit analysis of their various forms of resistance seems to be mainly a cognitive method of therapy.
This chapter presents a case study of a woman who finds a counselor for her 11-year-old son. The son’s family possessed many qualities characteristic of “growth-fostering relationships” defined in relational-cultural theory (RCT). The woman portrayed the son as a healthy young boy with few developmental problems or health concerns. The priorities for his counseling goals included: to assess the risk that he might harm himself and put in place interventions for safety; to determine what significant life events contributed to his anxiety and depression; to increase his feelings of connection to others; to reduce the occurrence of his nightmares; to support him in developing a stronger voice in order to ask for help when he needed it and to express his needs. Adlerian play therapy and mutual storytelling proved to be a good fit for him, and helped the author understand his view of self and his world.
This book provides us with what we need to sleep well. It provides the tools and techniques to reverse insomnia and improve sleep long-term. Insomnia, persistent trouble getting to sleep or staying asleep, affects our daytime functioning and wellbeing. The book breaks down the principles of cognitive behavioral therapy for insomnia (
CBT-I), the sleep program considered first-line treatment in the clinic, into a step-by-step and reader friendly program that can be easily followed at home. Written by a clinical psychologist and researcher who has worked in the sleep field for 40 years, the book uses data from a real patient to illustrate each step of the process. The book is complete with detailed sleep diaries, worksheets, and more, all of which are also available online to download and use on your own journey to sleeping better now and into the future. Guiding readers through this self-directed sleep therapy program, the book features updated information and new scientific findings on key topics for patients and health care providers including: tried-and-true CBT-Imethods of sleep management; successful cognitive therapy methods to deal with racing thoughts at bedtime; different sleep needs for women and men through life and health conditions; influence of nutrition, exercise, and sex on sleep in a brand-new chapter; depression, anxiety, and traumatic stress and how they intersect with sleep; and prescribed and non-prescribed medications, herbal remedies, and cannabis for sleep.
Sadness and anxiety are normal human emotions and stress is a normal occurrence in our lives. When we’re feeling somewhat down, anxious or stressed, we can benefit from exercise, relaxation, recreation, eating nutritious foods, allowing time for sleep, and talking to a friend. Clinical depression and anxiety are very common conditions. This chapter looks at what they are, what happens to sleep, and what helps recovery of mood and sleep. It outlines what is known about treating insomnia in three forms of clinical depression: major depression, Seasonal Affective Disorder, and Bipolar Disorder. Research on how people respond to natural disasters has told us that within the first months of disaster, many people develop signs of anxiety, depression and posttraumatic stress. With respect to sleep, people with posttraumatic stress disorder tend to get somewhat less deep sleep, longer periods of being awake during the night, and an overall shorter sleep duration.
As insomnia develops, one may start to worry about not sleeping. One of author’s friends had a stressful management position over which she started to lose sleep. She then feared that the lack of sleep would negatively affect her work performance. This made it even more difficult for her to sleep because the thought of underperforming increased her anxiety. One can see how this can become a cycle of worry and sleeplessness. This chapter discusses some of the common worries that are linked to insomnia. By examining these topics in the light of day, rather than ruminating during a sleepless night, we achieve a more balanced view of our sleep problem and its effects. Stressful thoughts at night have a way of expanding to fill the dark spaces around us. The chapter provides information that will help to bring one’s sleep-related worries down to earth.
Years of research have revealed that certain techniques reliably lead to improved quality and quantity of sleep and increased satisfaction with sleep. Together these techniques can be called “cognitive behavioral therapy for insomnia” (
CBT-I). In the mid-1990s two important reports were published on these techniques. These reports were based on meta-analyses. In a meta-analysis, the research data from many studies of a given treatment are carefully combined to provide the overall story on the treatment’s usefulness. In these particular meta-analyses, the authors reviewed studies that had compared CBT-Itechniques with no treatment or with a placebo treatment. Research shows that CBT-Iis useful even if one have some mild to moderate symptoms of anxiety or depression, or some long-lasting medical problem like chronic pain or cancer. This book shows how to deal with and overcome insomnia if one has insomnia that has lasted longer than 4 weeks.
This chapter presents a case study of a Caucasian high school student, who came to counseling because of her anxiety about school, music, family, and relationships. Based on the initial interactions, the patient appeared to be an introvert with adequate social skills. Her hyperawareness of others’ opinions of her, her avoidance of criticism, her unrealistic expectations of herself, and her fear of not performing well contributed to an almost constant state of anxiety. She continued to process the anxiety she experienced when multiple stresses started piling up in her life. The patient agreed she needed to be honest with her mom about her stress. By counseling, she developed skills for managing anxiety, lessened her dependence, and strengthened her internal locus of control. The most effective strategy involved role-playing, because she needed concrete interventions, and it helped her build confidence in her ability to implement what one practiced.
Emotionally focused therapy (EFT) is based on attachment theory and uses elements of experiential-humanistic approach and systems theory. Its work has primarily been used with couples, and it is applicable to family therapy. EFT is aimed at reducing stress and anxiety in adult relationships and creating (or recreating) more secure attachment bonds. EFT presents, as a theoretical basis, that therapy needs to engage the "real relationship of the inner psychological world of both partners to their interaction" and the contextual relationship as also a basis of each person's behavior in relationship to his or her intrapsychic experience. The EFT template is meant to be used as a guideline to learning the process of emotionally focused family therapy. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and client.
Trauma-Informed Approaches to Eating Disorders is clearly a much needed and long overdue book about treatment, written by a diverse group of clinicians and carefully edited to focus on the needs and strengths of clinicians. The complexities and challenges that undergird, surround, and even haunt the nature, diagnosis, treatment, management, and understanding of eating disorders (EDs)-in-relation-to-trauma are so great, even for veteran clinicians, that they can leave practitioners at any level of experience feeling helpless and exhausted. This book, in a way that would be appreciated by practitioners of acceptance and commitment therapy, accepts the reality of those feelings and is committed to improving treatment, understanding, and compassion. The book is designed to foster respect for complexity and link it to humility in the presence of tragedy, tribulations, and suffering, framed all too often by our own shortcomings as healers. EDs are dangerous, ubiquitous, usually chronic in nature, and difficult to treat. Anorexia nervosa (AN) has the highest fatality rate (4%) of any mental illness. Bulimia nervosa reveals a fatality rate of 3.9%. EDs offer an enormous challenge to therapists because of their complexity, which includes severe medical risk, co-occurring anxiety, depression and personality disorders, an addiction component, and body image distortion—all of this within a mediadriven culture of thinness in which starving and purging can for some become lifestyle choices. This complexity is further exacerbated by the presence of painful life experiences or trauma. The book elucidates the connection between trauma and EDs by offering a trauma-informed phase model, as well as chapters describing the ways in which various therapeutic models address each of those phases. It offers an in-depth exposition of a fourphase model of trauma treatment.
The aim of genetic research on depressive disorders is to clarify the distal causal mechanisms that lead to individual differences in risk for developing these conditions. Genetic influences on unipolar depression overlap considerably with those for Generalized Anxiety Disorder (GAD), as well as those for NE. This suggests that genetic influences may drive comorbidity across anxiety and depressive disorders. Bipolar disorder (BD) and schizophrenia have shared genetic influences, as do bipolar and unipolar depressive disorders. The classic animal model of depression derived from studies of dogs exposed to repeated, uncontrollable, inescapable shocks. Animal models hold promise for helping to potentially identify endophenotypes of depression that could be useful targets for neuroscience or genetic approaches in humans. All the major theoretical models of the etiology of depressive disorders invoke mechanisms that are instantiated in biological processes including reactivity to emotionally salient stimuli and stress reactivity.Source:
Posttraumatic stress, whether big T or little t, is a distortion of perception. Something terrible happened in the past, and today, feelings—anxiety, helplessness—erupt into the person’s consciousness, even though there is currently no present danger. The standard eight phases of eye movement desensitization and reprocessing (EMDR), with targeted sets of bilateral stimulation (BLS), have the reliable effect of moving this distorted perception to clarity and objectively accurate understanding of past and present realities. EMDR therapy targets and resolves the dysfunctionally stored memories that are the basis of an individual’s psychopathology. Typically, this means focusing EMDR procedures on specific disturbing memories. However, for some clients, at least some of the time, the only point of entry into the dysfunctional memory network will be an idealization defense—a behavior, or an image of self or others, that contains positive affect.
Adventure therapy, or therapy in an outdoor setting, has many origins. Most researchers agree that adventure therapy evolved from the Outward Bound tradition. In the 1960s and 1970s, Outward Bound gained reputation as an alternative treatment to incarceration for delinquent adolescents. Early researchers of adventure therapy posited that change occurred because of Hahn’s orientation toward character development. Activities that required the engagement of clients were seen as essential change elements of adventure therapy. Activities and consequences may be core elements of adventure therapy; however, their effectiveness was suspected without an empathic connection to staff. Adventure therapy seemed to work with clients who had experienced trauma, exhibited conduct-problem behaviors, or suffered from lack of trust, interpersonal problem-solving deficiencies, depression and anxiety. However, more research is needed to define the underlying basis for change within this population when treated in the outdoors.
- Go to chapter: Second Helpings: AEDP (Accelerated Experiential Dynamic Psychotherapy) in the Treatment of Trauma and Eating Disorders
Second Helpings: AEDP (Accelerated Experiential Dynamic Psychotherapy) in the Treatment of Trauma and Eating Disorders
Accelerated experiential dynamic psychotherapy (AEDP) is an attachment-oriented, emotion-focused model of psychotherapy and trauma treatment. This chapter details the course of AEDP treatment for clients with active eating disorders (EDs). It uses vignettes and a transcript from a live therapy session to highlight salient concepts and illustrate AEDP interventions in action. AEDP is fundamentally an experiential model. AEDP uses two versions of the triangle of experience to conceptualize the process and the piece of work. The first represents what AEDP calls the client’s self-at-best, or the resilient self. The second represents what AEDP calls the client’s self-at-worst, or compromised self. At the beginning of treatment, AEDP interventions are focused on building safety and regulating anxiety so that core affect can surface. Metaprocessing is an essential element of any AEDP treatment process. It undoes our clients’ aloneness with dysregulating new experiences and helps them to metabolize them instead.
- Go to chapter: Thriving Versus Succumbing to Disability: Psychosocial Factors and Positive Psychology
Perhaps the most crucial and significant question rehabilitation researchers have sought to answer over the past several decades is: How is it that some persons with disabilities appear to excel and succeed in life beyond all expectations, whereas others seemingly succumb or yield to the limits imposed by their disabilities and society? This chapter explores the multiple factors that contribute to this dichotomy. It focuses on disability from a salutogenic orientation (focusing on the traits of healthy and successful persons) as opposed to the traditional pathological approach (focusing on the reasons and treatment of those beleaguered with ongoing mental and physical health problems) (Antonovsky, 1987). The chapter briefly explores several of the more common disabling conditions in the United States, specifically substance use disorder (SUD), depression, anxiety, and suicide. It also explores the literature behind positive psychology and also the environmental and social barriers that obstruct wellness.
Developing and delivering online courses can feel especially overwhelming when little or no guidance or support is provided. Instructors bring their own strengths as well as their deficits to the online learning environment, where some of these strengths and deficits are magnified. Online teaching requires planning, focus, diligence, thoughtfulness, and attention to detail to the curriculum and instruction. This chapter explores the variables that can ultimately determine the success of the instructor and offers strategies that help instructors manage their thoughts/emotions and mediate stress. The strategies serve as a platform for exploring strategies to allay fear and anxiety. Practical strategies such as Prepare, Assert, Consistent, and Embrace technology (PACE) and the ABC Model are good options for instructors seeking solace to unmanageable stress. Finally, instructors must demonstrate they CARE if students are to succeed and experience online learning for what it truly is a viable vehicle to accessible education.
Elimination disorders include encopresis and enuresis; both conditions can have medical as well as emotional origins. Research demonstrates comorbidity of elimination disorders in children already diagnosed with sensory processing disorder, attention deficit/hyperactivity disorder, anxiety, depression and conduct disorder or oppositional defiant disorder. Systemic clinicians use a variety of interventions based on their theoretical focus and framework such as: ecosystemic structural family therapy, narrative therapy, behavioral family therapy, and intergenerational family therapy. This chapter addresses interventions associated with the various therapeutic approaches for elimination disorders. Given the social, environmental, family functioning and transgenerational factors, using a family systems approach when working with children diagnosed with an elimination disorder would seem to be an acknowledged treatment practice and review of the research has demonstrated that systemic treatment is effective. The chapter also presents a case study that illustrates how the interaction of family members influences behaviors in the system.Source:
This book is an essential tool for online instructors and serves as a companion for instructors regardless of their experience with online teaching. It is designed to help develop a roadmap for the next online class. The book presents information on the research on online teaching for those who are more interested in the basis of online instruction. Chapters 1 and 2 familiarize new online instructors with the fundamental technology and practical applications of delivering content online within the helping fields. This includes a review of basic education platforms and a glossary of key terms and definitions. Chapter 3 addresses the typical fears and anxieties associated with teaching online in the helping vocations. Chapter 4 focuses on the student experience and perspectives of online courses based on a brief guided questionnaire of open-ended questions. Chapter 5 surveys the research into online education and addresses the quality concerns associated with online classes and programs. Chapter 6 presents a roadmap of practical steps to course design and building, tech-tool use, communication techniques, and many more considerations for a successful semester. Chapter 7 provides practical tips to learners, and useful samples for instructors to use in preparing them to become online learners. Chapters 8 and 9 share tips, best practices and stories from experts and instructors in the helping professions. Chapter 10 presents recommendations on what not to do based on authors experiences and those of other online instructors in the helping professions. Chapter 11 focuses on the ethical considerations in online teaching. Chapter 12 looks at the evolving technological environment around online learning. Chapter 13 discusses pedagogy and technology in the helping professions. The final chapter provides encouragement to readers who are beginning the process of course design and delivery and includes a To Do list for preparing online course and semester.
Fibromyalgia or the fibromyalgia syndrome (FMS) is a chronic pain disorder characterized by fatigue, muscle pain, tenderness, and sleep difficulties. This syndrome is referred as “soft-tissue rheumatism”. Fibromyalgia is a disorder that intrudes upon the daily life of people and is a worldwide phenomenon. Fibromyalgia might also include other symptoms such as concentration and memory problems, labile mood, depression, anxiety, sleep problems, painful menstrual cramps, and numbness. Because FMS has no relevant organic pathology, it is placed in the realm of medically unexplained physical symptoms. Recent studies are providing early evidence for the use of eye movement desensitization and reprocessing (EMDR) therapy for chronic pain patients. Also, EMDR therapy is being used for other pain conditions, including fibromyalgia. Therefore, the EMDR Fibromyalgia Syndrome Protocol created includes the three-pronged protocol and an in-depth history of the client’s FMS and trauma. More research is needed to support this new protocol.
Whatever symptoms or suspicions may exist in the prediagnostic period, whatever fears are entertained, the diagnosis of life-threatening illness always comes as a shock. The time of the diagnosis is often described as a turning point; a time of crisis when one’s whole orientation toward life changes. Faced with a profound threat to personal mortality, some individuals will experience posttraumatic growth, experiencing a sense of personal strength, heightened spirituality, renewed relationships, and reordered priorities. The diagnosis of life-threatening illness creates an intense crisis filled with anxiety, strong emotional reactions, and many personal and interpersonal issues. Clients should not neglect other formal sources of support. Many services, including transportation, nursing, home care, support groups, meals, counseling, and even financial help, may be available. A life-threatening illness is likely to change relationships with other people.
This book offers an in-depth look at the ways in which contemporary undergraduate students may differ from past generations, as well as noting how some things never change, such as needs related to finding social support, romantic intimacy, and academic achievement. It first provides a brief overview of the various developmental transformations that are taking place within the many levels of cognitive, affective, and physiological development of emerging adults. The book then considers the typical counseling concerns that counselors can expect to meet across the academic year. Next, it addresses the social concerns of students as they seek to find the best way to fit in on campus. It addresses the growing diversity of college campuses as well as provides counselors with guidance on helping their clients connect into the campus community. Then, the book moves into ways to assist clients who are facing unexpected hurdles, including grief over the loss of significant others; difficulties with self-esteem and self-image presented by the competitive culture of college-age females; and navigational challenges in romantic relationships that may be more intense and sexually tinged than prior high school relationships had been. Specific mental health disorders that frequently appear in the college-age population are also addressed in the book. The book provides guidelines for treatment and intervention that are relevant to college counselors working within a brief counseling framework. Topics include eating disorders, substance abuse, depression, anxiety, self-injury, suicidal students, obsessive-compulsive disorder, and impulse-control disorders. Finally, the book provides readers with ideas for promoting student well-being beyond the counseling office.
There are several aspects related to being intrinsically motivated that are important to everyone. The first is persistence. A second area is creativity. Stress and anxiety are lower when we are intrinsically motivated. Self-determination theory (SDT) is a large-scale model for motivation. In addition, SDT allows for the discussion of social development, individual differences, and cultural factors that can assist or impede a person’s progress. Competence is the need to be effective in our environment. Three areas to keep in mind with competence are cognitive competence, social competence, and performance competence. Relatedness is the need to develop long-term secure relationships with people. Cognitive evaluation (CE) theory explains and predicts how an external action affects your intrinsic motivation. Organismic integration (OI) theory focuses on understanding how people acquire, internalize, and then integrate extrinsic reinforcers. Causality orientations (CO) theory is used to explain individual differences in the motivational forces that cause behavior.Source:
Individuals have beliefs and judgments about their ability to successfully complete an activity or task. In the motivation world, people call these expectations. In addition to expectations, people also have a value system associated with the expectation. Modern versions of expectancy value (EV) are still descendants of Atkinson’s work and are based on achievement performance, persistence, and choice. Within the task-value beliefs there are four components: attainment value, intrinsic (interest enjoyment) value, utility value, and cost. There are emotional components to success and failure or even the expectancy of the two. In addition to the poor performance, people tend to try and avoid making a mistake, quit early, and lose interest rapidly. This pattern, fear of failure leading to performance-avoidance goals, leads to poor adjustment skills and anxiety. Related to the performance and mastery concepts is an implicit theory of intelligence.Source:
- Go to article: EMDR and Nonpharmacological Techniques for Anxiety Prevention in Children Prior to Invasive Medical Procedures: A Randomized Controlled Trial
EMDR and Nonpharmacological Techniques for Anxiety Prevention in Children Prior to Invasive Medical Procedures: A Randomized Controlled Trial
Nonpharmacological Techniques (NPT) have been suggested as an efficient and safe means to reduce pain and anxiety in invasive medical procedures. Due to the anxious and potentially traumatic nature of these procedures, we decided to integrate an eye movement desensitization and reprocessing (EMDR) session in the preprocedure NPT. The main purpose of this study was to evaluate the efficacy of one session of EMDR in addition to the routine NPT. Forty-nine pediatric patients (Male = 25; Female = 24) aged 8–18 years (M = 13.17; SD = 2.98) undergoing painful and invasive medical procedures were randomized to receive standard preprocedural care (N = 25) or a session of EMDR in addition to the standard nonpharmacological interventions (N = 24). Participants completed the anxiety and depression scales from the Italian Psychiatric Self-evaluation Scale for Children and Adolescents (SAFA) and rated anxiety on a 0–10 numeric rating scale. Participants in the NPT+EMDR condition expressed significantly less anxiety before the medical procedure than those in the NPT group (p = .038). The integration of EMDR with NPT was demonstrated to be an effective anxiety prevention technique for pediatric sedo-analgesia. These results are the first data on the efficacy of EMDR as a technique to prevent anxiety in pediatric sedo-analgesia. There are important long-term clinical implications because this therapy allows an intervention on situations at risk of future morbidity and the prevention of severe disorders.
- Go to article: A Case Study: The Integration of Intensive EMDR and Ego State Therapy to Treat Comorbid Posttraumatic Stress Disorder, Depression, and Anxiety
A Case Study: The Integration of Intensive EMDR and Ego State Therapy to Treat Comorbid Posttraumatic Stress Disorder, Depression, and Anxiety
This study used a quantitative, single-case study design to examine the effectiveness of the integration of intensive eye movement desensitization and reprocessing (EMDR) and ego state therapy for the treatment of an individual diagnosed with comorbid posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The participant received 25.5 hr of treatment in a 3-week period, followed with 12 hr of primarily supportive therapy over the next 6-week period. Clinical symptoms decreased as evidenced by reduction in scores from baseline to 6-week follow-up on the following scales: Beck Depression Inventory (BDI) from 46 (severe depression) to 15 (mild mood disorder), Beck Anxiety Inventory (BAI) from 37 (severe anxiety) to 25 (moderate anxiety), and Impact of Events Scale from 50 (severe PTSD symptoms) to 12 (below PTSD cutoff ). Scores showed further reductions at 6-month follow-up. Results show the apparent effectiveness of the integration of intensive EMDR and ego state work.
This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure (IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment, and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and performed significantly better than IE for all variables. These findings provide preliminary support for EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a life-threatening cardiac event.
- Go to article: Randomized Controlled Trial on the Provision of the EMDR Integrative Group Treatment Protocol Adapted for Ongoing Traumatic Stress to Female Patients With Cancer-Related Posttraumatic Stress Disorder Symptoms
Randomized Controlled Trial on the Provision of the EMDR Integrative Group Treatment Protocol Adapted for Ongoing Traumatic Stress to Female Patients With Cancer-Related Posttraumatic Stress Disorder Symptoms
This randomized controlled trial extended the investigation previously conducted by Jarero et al. (2015) which found that the eye movement desensitization and reprocessing Integrative Group Treatment Protocol adapted for ongoing traumatic stress (EMDR-IGTP-OTS) was effective in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. The current study sought to determine if the results could be replicated and if the treatment would also be effective in reducing symptoms of anxiety and depression. Participants in treatment (N = 35) and no-treatment control (N = 30) groups completed pre, post, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed that the EMDR-IGTP-OTS was effective in significantly reducing symptoms of PTSD, anxiety, and depression, with symptoms maintained at 90-day follow-up and with large effect sizes (e.g., d = 1.80). A comparison of the treatment and no-treatment control groups showed significantly greater decreases for the treatment group on symptoms of PTSD, anxiety, and depression. No significant correlation was found when exploring the relationship between scores on the Adverse Life Experiences scale and scores indicating pretreatment severity of PTSD, anxiety, and depression. This study suggests that EMDR-IGTP-OTS may be an efficient and effective way to address cancer-related posttraumatic, depressive, and anxious symptoms.
- Go to article: Effects of the EMDR Couple Protocol on Relationship Satisfaction, Depression, and Anxiety Symptoms
The aim of the present study was to evaluate the effect of the eye movement desensitization and reprocessing (EMDR) Couple Protocol on the relationship-satisfaction, depression, and anxiety levels of couples. This protocol differs from standard EMDR procedures in that the partners are together in the treatment session, and engage in bidirectional stimulation simultaneously. The treatment targets are disturbing events that the couples have experienced together. Couples have the opportunity to accept, recognize, and witness each other's recovery process during the session. The EMDR Couple Protocol consists of eight phases, and it was developed for couples wanting to improve their relationship. The study sample consisted of 18 couples suitable for the application of the EMDR Couple Protocol. Treatment was provided by an EMDR Europe Level 2 EMDR psychotherapist to the couples. The mean number of sessions was 14.27 ± 4.04. The couples showed significant improvement between pre-EMDR, post-EMDR, and at three months follow-up with large effect sizes for relationship satisfaction (η² = 0.944), depression (η² = 0.385), and anxiety (η² = 0.258). The present study evaluating the effectiveness of the EMDR Couple Protocol showed a positive effect on the relationship-satisfaction, depression and anxiety symptoms of the couples. The EMDR Couple Protocol appeared to be safe and effective.
- Go to article: Targeting Cognitions, Emotions, and Behaviors in a Complex Case of Tourette Syndrome: Illustration of a Psychophysiological Perspective
Targeting Cognitions, Emotions, and Behaviors in a Complex Case of Tourette Syndrome: Illustration of a Psychophysiological Perspective
Recent research stresses that cognitive and affective processes are implicated in Tourette Syndrome (TS) and might influence treatment. The cognitive-behavioral and psychophysiological (CoPs) approach posits that negative appraisals and maladaptive action-planning elicit negative emotions and behaviors that increase muscular tension and thus the urge to tic in TS. Hence, the CoPs targets cognitive-behavioral and affective processes increasing tension prior to tic onset. This article provides clinically novel information in the implementation and utility of the CoPs approach in a severe case of a young man with TS and a range of comorbidities marked by negative cognitions and emotions as well as planning deficits with a long-term follow-up. He received 14 sessions of CoPs therapy. Tic severity significantly decreased post-treatment with maintenance up to 36-months. The process measure of action-planning improved significantly from pre-treatment to 12-months follow-up. Results support the feasibility and acceptability of the CoPs in treating complex TS cases.
- Go to article: Depression, Anxiety, and Stress Burdens Among Jordanian Patients With Type 2 Diabetes Mellitus
Purpose: To assess the levels and prevalence of depression, anxiety, and stress and to identify factors associated with these emotions among Jordanian patients with type 2 diabetes mellitus. Methods: This descriptive study recruited 149 participants through a convenience sampling technique. Depression, anxiety, and stress burdens were measured through Arabic short version of Depression, Anxiety, and Stress Scale (DASS-21; Lovibond & Lovibond, 1995). Results: There were 28.8%, 49.5%, and 33.5% of participants who had moderate-to-extremely severe levels of depression, anxiety, and stress, respectively. The depression, anxiety, and stress burdens were associated with patients’ gender and educational level, and the highest level of depression, anxiety, and stress burdens levels were associated with the presence of diabetes complications and other chronic illness. Conclusion: The findings from this study can guide the health providers to address psychological status for patients with type 2 diabetes mellitus in their care plans.
This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented.
- Go to article: A Critical Review of Attentional Threat Bias and Its Role in the Treatment of Pediatric Anxiety Disorders
A Critical Review of Attentional Threat Bias and Its Role in the Treatment of Pediatric Anxiety Disorders
Threat bias, or exaggerated selective attention to threat, is considered a key neurocognitive factor in the etiology and maintenance of pediatric anxiety disorders. However, upon closer examination of the literature, there is greater heterogeneity in threat-related attentional biases than typically acknowledged. This is likely impacting progress that can be made in terms of interventions focused on modifying this bias and reducing anxiety, namely attention bias modification training. We suggest that the field may need to “take a step back” from developing interventions and focus research efforts on improving the methodology of studying attention bias itself, particularly in a developmental context. We summarize a neurocognitive model that addresses the issue of heterogeneity by broadly incorporating biases toward and away from threat, linking this variation to key neurodevelopmental factors, and providing a basis for future research aimed at improving the utility of threat bias measures and interventions in clinical practice.
- Go to article: A Close Look Into Coping Cat: Strategies Within an Empirically Supported Treatment for Anxiety in Youth
A Close Look Into Coping Cat: Strategies Within an Empirically Supported Treatment for Anxiety in Youth
The Coping Cat protocol has shown both efficacy and effectiveness in the treatment of youth anxiety across numerous randomized controlled trials (RCTs), leading to its designation as an empirically supported treatment. The treatment is completed in two phases. In the first phase, children are taught a series of coping skills outlined using the FEAR plan acronym. The FEAR plan is then practiced in exposure tasks during the second phase of treatment. To illustrate implementation of both phases, and highlight core treatment components (i.e., exposure, flexibility within fidelity), a case description is presented. Directions for future research are discussed.