Depression is a chronic, recurring disorder that impacts children’s academic, interpersonal, and family functioning. The heritability of major depressive disorder (MDD) is likely to be in the range of 31% to 42%. This chapter begins with a brief overview of the etiology of depression. It presents a description of a cognitive behavioral therapy (CBT) intervention designed to be delivered in a group format, an individual interpersonal intervention, and an individual behavioral activation (BA) intervention that includes a great deal of parental involvement. The ACTION program is a manualized program that is based on a cognitive behavioral model of depression. There are four primary treatment components to ACTION: affective education, coping skills training (BA), problem-solving training, and cognitive restructuring. The chapter concludes with a brief discussion of universal therapeutic techniques to be incorporated into work with depressed youth regardless of the therapeutic orientation or treatment strategy.

Eating disorders (EDs) are a complex and comparatively dangerous set of mental disorders that deeply affect the quality of life and well-being of the child or adolescent who is struggling with this problem as well as those who love and care for him or her. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for the diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or ED. Treatment of eating disordered behavior typically involves a three-facet approach: medical assessment and monitoring, nutritional counseling, and psychological and behavioral treatment. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are also evidence-based approaches to treatment for AN. The treatment of EDs should be viewed as a team effort that integrates medical, nutritional, and mental health service providers.

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.

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.

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.

The importance of the functioning of mind and the limitations of medication has encouraged some clinicians to advance the use of psychotherapy. In the present period this is mostly in the form of cognitive behavioral therapy (CBT) for schizophrenia and psychosis, and this is strongly promoted in the British Psychological Society (BPS) publication “Understanding Psychosis and Schizophrenia: Why People Sometimes Hear Voices, Believe Things That Others Find Strange, or Appear Out of Touch With Reality, and What Can Help”. Although this document has not been received without criticism, it makes some very interesting reading for us as eye movement desensitization and reprocessing (EMDR) therapists and students of the Indicating Cognitions of Negative Networks (ICoNN) model. The meta-analyses that showed the most encouraging effect sizes were looking at two groups: treatment-resistant schizophrenia, and forms of psychotherapy that were highly specific and tailored according to case formulation, targeting delusions and auditory hallucinations.

This chapter covers major depression and discusses the syndrome of depression as defined by criteria in the various versions of the Diagnostic and Statistical Manuals (DSMs) issued before the newly minted DSM-5. It considers the prevalence in time and across national boundaries. The chapter discusses the role of events and genetics in bringing on depression. It provides the link between depressive behaviors and systemic inflammation, and reviews the efficacy, and side effects for various treatments. There has been speculation that brain-derived neurotrophic factor (BDNF) might play a causal role in creating symptoms of depression. Repetitive transcranial magnetic stimulation (TMS), which involves external application of an electrode, is a Food and Drug Administration (FDA)-approved treatment for major depression. In the clinical literature, exercise has demonstrated efficacy in ameliorating major depression. Cognitive behavioral therapy is as effective as antidepressants, although it may be slower to achieve results.

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.

Early group Eye Movement Desensitization and Reprocessing (EMDR) intervention following trauma may facilitate adaptive processing of traumatic event(s) and help prevent consolidation of traumatic memories following large-scale natural or man-made disaster. Group EMDR may also be usefully applied with homogenous groups, and where professionals are exposed to high levels of work-related stress. Writing is a useful clinical tool in narrative therapy, bibliotherapy and writing therapy. Written journaling to monitor behavior is commonly practiced between sessions of cognitive behavioral therapy. The Written Workbook Protocol allows close adherence to the EMDR Standard 3-Pronged Protocol at all steps until the end of the processing phase, when constraints of the group format come more dramatically into play. Cognitive interweaves necessary to clear potential blocks to processing are more difficult to tailor and implement in group. The potential power of “group cognitive interweaves” emerged spontaneously during multifamily group EMDR with tsunami survivors in Thailand.

This chapter focuses on anxiety disorders and deals with a discussion of the physiology of anxiety, including the major structures involved in the creation of a fear memory. It considers the mechanisms for extinction of conditioned anxiety. The chapter discusses the basic physiology of fear conditioning, specific anxiety disorders namely generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), and explains treatments. It then reviews the literature about how clients can talk about their fears to minimize them and how relabeling or reappraising of past events can be helpful. There is evidence suggesting that the basal ganglia, structures associated with the control of movement, are involved in the expression of OCD behaviors in subsets of those with OCD. Cognitive behavioral therapy is effective in the treatment of generalized anxiety. Selective serotonin reuptake inhibitors are also used in the treatment of anxiety disorders.

This chapter provides the reader with an awareness of key aspects of the other psychotherapies being used in schizophrenia and the other psychoses. In the Indicating Cognitions of Negative Networks (ICoNN) model, psychotic phenomena can lead us to the real pathological material of the dysfunctional memory network (DMN) that requires psychological metabolism through the use of eye movement desensitization and reprocessing (EMDR) therapy. The best evidence base for psychotherapy for psychosis and schizophrenia exists for cognitive behavioral therapy (CBT). The CBT community has merely been the best at gathering and publishing its research. Behavioral psychotherapy, which had its origins in learning theory, attributed mental disorder to faulty learning. From a pragmatic perspective this led practitioners to focus their therapeutic efforts on intervening with the psychotic symptoms, in addition to education of the family/carers, and seeking to enhance already present coping skills.

This chapter examines the theory of Cognitive Behavioral Therapy (CBT) and use of the theory as a model of supervision. It reviews the theory of CBT by examining a philosophical foundation, techniques and interventions, the role of the therapist, the process of change, and cultural issues. The chapter discusses the significance of utilizing a CBT approach to therapy within the supervisor-supervisee relationship. It also reviews the supervisor-supervisee relationship, looking specifically at goals and challenges, and follows with a case example. CBT can be used with adults, children, and older populations throughout an extensive continuum of mental and behavioral health diagnoses with couples, families, or individual concerns. CBT theory works to promote change in daily living. Relaxation and mindfulness techniques are used within the CBT approach to increase internal experiences and awareness and to decrease stress and tension that impact the client mentally, emotionally, and physically.

Pediatric bipolar disorder (PBD) has been associated with a number of negative behavioral, academic, and interpersonal outcomes for children and adolescents. It initially received a disruptive behavior disorder diagnosis. High rates of comorbid anxiety disorders have also been found in children with PBD. Psychoeducational psychotherapy (PEP) uses a biopsychosocial model and combines family therapy, psychoeducation, and cognitive behavioral therapy (CBT) techniques with the goal of helping families to better understand and manage the symptoms of PBD and coordinate more effective treatment. This chapter focuses on a description of PEP, including three key interventions of this therapeutic approach: Psychoeducation and Motto, Building a Tool Kit, and Thinking-Feeling-Doing. PEP is a manual-based treatment designed for youth with mood disorders and their caregivers, broken down into separate youth and caregiver sessions. Sessions focus primarily on psychoeducation and skills building and are delivered in individual family (IF-PEP) and multiple family formats (MF-PEP).

The content of the obsessions and compulsions varies among individuals with obsessive-compulsive disorder (OCD); however, there are five themes that are commonly experienced across both children and adults: contamination, symmetry/ordering, forbidden or taboo thoughts, harm, and hoarding. Notably, OCD becomes more gender balanced into adolescence and adulthood. Comorbid diagnoses are common among youth with OCD. Common comorbid disorders include anxiety disorders, tic disorders, attention deficit hyperactivity disorder (ADHD), and major depressive disorder. The etiology of OCD is multidetermined with behavioral, cognitive, genetic, and biological factors being implicated. This chapter describes three successful cognitive behavioral therapy (CBT) interventions: CBT with exposure and response prevention (ERP), family-based CBT with ERP, and cognitive therapy interventions that can be used in conjunction with ERP. Treatment guidelines for pediatric OCD suggest the most efficacious treatment is CBT with ERP, either alone or in combination with pharmaco-therapy for the most severe cases.

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.

The therapeutic alliance works based on the idea that the social worker is a willing participant whose primary concern is to support an older client’s effort for desired change. When considering theoretical orientations to treating an older adult that are consistent with the short-term constraints found in most mental health agencies, one is faced with a multitude of theories, some extended for older adults, most created for younger adults. Cognitive behavioral therapy (CBT) and various interpersonal psychotherapies are effective for older adults, though an older adult’s response to these therapies may have a different temporal course and require modifications in technique. Constructivist theory is a conceptual framework that is foundational to existential therapy, CBT, and narrative therapy. However, for older adults, reminiscence is a strength-based strategy employed to validate a sense of intimacy with the past, to integrate the many transitions of life, and as a preparatory method for death.

Anxiety disorders are the most common mental health conditions to impact school-aged children. A particular diagnostic subtype termed “separation anxiety disorder” accounts for the majority of referrals seen within child and adolescent psychological service delivery systems including schools. The developmental connection between childhood separation anxiety disorder and adolescent/ adult panic disorder has also been well documented in the literature. Associated features of separation anxiety include parent-child dysfunction, school attendance difficulties, and challenges to social functioning. Biological and environmental factors play a role in the development of separation anxiety disorder. Evidence-based interventions for children and adolescents with separation anxiety disorder include cognitive behavioral therapy (CBT), family therapy, pharmacological treatments, or a combination of these biopsychosocial therapies. Parental behaviors and parenting style are associated with increased risk for childhood anxiety, including separation anxiety disorder.

Social anxiety disorder (SAD) is characterized by a marked fear or anxiety about social situations in which the child or adolescent perceives that he or she may be scrutinized by others. This chapter reviews the current state of treatment for youth with SAD, beginning with a brief discussion of the etiology of social anxiety, followed by an overview of the empirical support for cognitive behavioral interventions. It reviews three empirically supported interventions for social anxiety in youth, such as the Coping Cat, cognitive behavioral group therapy for adolescents (CBGT-A), and social effectiveness therapy for children and adolescents (SET-C). The Many factors, including genetic, neurobiological, cognitive, and environmental, have been implicated in the development of SAD. The most efficacious psychological treatment for SAD is cognitive behavioral therapy (CBT). Despite SAD’s pervasiveness and multiple causes, efficacious cognitive behavioral treatment exists and is effective.

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.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. It talks about physiological calming and mindfulness. The author utilizes a biofeedback device for measuring how relaxed the kid can get. The word ’biofeedback’, in the child clinical world, can strongly activate many mental health professionals (MHPs), both for and against. Assuming kids are practicing the relaxation exercise at home, relaxing their muscles and the belly breathing are relatively easy to do. The author delivers mindfulness intervention usually later in the treatment, after the core strategies of behavioral activation, physiological calming, coping thoughts, thought testing, and problem solving have been delivered and sufficiently practiced. He lists six modules that he uses and what he says to kids about them. These modules include: agitating waits, mindful eating, mindful photography, meditation, body mindfulness and beauty walks.

Contemporary psychotherapy addresses behavioral issues of an older adult by focusing on the degree to which an older adult is able to cope positively with the environmental stressors converging on him or her. An environmental geropsychologist focuses on the environment component of Lewin’s equation and develops interventions to change older adults’ interpersonal and intrapersonal experiences with psychosocial stressors with interventions aimed at the environment. The theory of affordances states that the perceptions that older adults have of their physical environments have functional significance for older adults, and shape older adults’ behaviors. The tri-dimensional intervention model states that there is a comprehensive interaction among the cognitive, conative, and affective components in an older adult’s environment. All three components are the targets for intervention by an environmental geropsychologist. The conative component is the aspect of the brain that acts on one’s thoughts and feelings.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. The author explains how he introduces behavioral activation to a kid. It is harder for a kid to be depressed if he is doing fun things, and easy for kids to understand having fun. The brain releases higher doses of mood-lifting neurotransmitters when we socialize, are physically active, and are doing novel, fun things. Behavioral activation is a tried-and-true stable of CBT. A common presenting complaint among depressed or stressed kids is poor sleep. In the author’s practice, kids most complain about a difficulty falling asleep, followed by a difficulty staying asleep. A good starting point is to consider what a good sleep schedule looks like. This chapter shows some of the strategies for combating insomnia. Collectively, the recommendations try to create a comfortable context, a relaxed body, and an unfettered mind.

This chapter presents cognitive behavioral therapy (CBT)-based techniques for practicum and internship students and other clinicians. One of the most delightful things about kid clinical work is the number of surprising things that can happen. The frequency of surprising events goes down with time but they keep coming. Most parents will take over and correct the kid’s behavior. The goal is to try to have the kid put words to the feelings and thoughts that are driving the behavior. Whenever a kid acts toward the mental health professional (MHP) the first reaction is usually best if it is prosocial and authentic. A second theme is that MHPs do well to determine what the behavior means for the client and how the various choices the clinician has might affect both the alliance and the treatment plan. Most of the time this scenario comes up around the holidays or other occasions.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. Problem solving is another staple of CBT. The methodology for problem solving is a little bit different if it is done with an individual kid or in a family session. In research looking at what mediates benefits in family therapy, communications training and problem solving come out on top. This is a monstrously helpful technique. And it saves individuals and families all kinds of time and distress. The author appreciates that a mental health professional (MHP) gets extra data and can also try to be helpful with a wider range of problems that could be affecting the identified child client. The factors to be considered to introduce communications training and problem solving in a family or an individual session are: age, maturity level, and psychological mindedness of the child.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. Treatment planning is one of the most important aspects of child clinical work. Having measurable goals in place creates the opportunity to have a highly rewarding and dynamic termination to the work. A well-written treatment plan is a wonderful tool for dealing with petitions by parents or kids to terminate prematurely. The outline for treatment planning with a kid includes: review of impressions from the feedback session, explaining the rationale for treatment planning, soliciting the kid’s input and developing problem and goal statements, endorsement and cautions and bringing parents into the loop. There are three categories of treatment contracts in kid clinical work: cure, management, and damage control. In cure intervention plans, the mental health professionals (MHPs) and the family plan for a limited course of treatment.

This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. It talks about the techniques for facilitating adherence and responding to resistance. Nonspecific effects, when they derive from an artful and ethical clinician, are therapeutic practices that are not specific to any specific intervention model. Both nonspecific and specific effects are maximized to maximize adherence and outcomes while approaching the child clinical work. There are three elements to a therapeutic alliance: agreement about the goals, agreement about the methods, and the affective bond. A challenge in kid clinical work is that the mental health professional (MHP) needs to form an alliance with the parents, the kids, and, often, outside systems, many of whom may be at odds with each other. Probably more familiar to the kid would be an authority figure who engages a coercion cycle by getting more harsh or insistent.

Mental health professionals (MHPs) help clients battle successfully against their internal monsters and ghosts. As anxiety disorders usually have a high temperamental loading and mood disorders have a high relapse rate and can have a high temperamental loading as well, the author uses the cage metaphor. An MHP would have the opportunity to reaffirm that therapy is a place where truth is pursued first and foremost, and that MHP and the patient both do well to only speak the truth to each other. The author has found that play therapy can be very useful for traumatized kids who cannot tolerate the stress of cognitive behavioral therapy (CBT). Additional commentary is the session the author did after completing the evaluation and the treatment planning phases. Once the evaluation is concluded, the author attaches a log sheet for tracking the interventions done with a kid to one of the chart surfaces.

This chapter talks about the most common scenario, which is to do behavioral activation or physiological calming, coping thoughts, and then the parent session. It shows how to prepare a kid for the parent session. Engaging the parents has numerous potential benefits: strengthening the parent kid affective bond, enhancing kid compliance with therapy practice, resolving adjunctive issues that impact the prognosis of reaching the treatment goals, and increasing the odds that the kid will become skillful with, and continue to use, the cognitive behavioral therapy (CBT), especially post termination. The chapter shows some common questions and concerns about special time between the parents and the mental health professionals (MHPs). Parent sessions for divorced or separated parents is one of the more complex topics that child MHPs deal with routinely. However, there are common tensions that can interfere with this recommendation.

The Adult Protective Services (APS) workers use more formal risk assessment tools to determine the lethality of a situation in which an older adult is living. Social workers, health care workers, and clinicians are among the frontline professions who are able to assess maltreatment. The National Association of Social Workers (NASW) provides guidelines for working with caregivers of older adults. Having considered advanced general assessment and advanced assessment of family dynamics, there are also specific risk assessment areas that social workers would want to explore in interviewing older adults and their families. Cognitive behavioral therapy (CBT), person-centered therapy (PCT) and cognitive analytic therapy (CAT) have proven effectiveness for intervening with mistreated older adults by reducing fear, stress, and anxiety. Social workers and health care professionals are in prime positions to routinely assess for maltreatment. Research into effective forms of assessment and intervention in situations of older adult abuse is required.

This chapter provides an overview of some potential approaches for working with abused children and their families. Evidence-based practice is part of the National Association of Social Workers (NASW) Code of Ethics, which requires social workers to contribute to the evaluation of practice. Young children may respond well to music therapy, play therapy, and drama therapy. Emotional and psychological maltreatment can result in learning and behavioral problems in those who are abused. Intervention must focus on the entire family and provide physical, mental health, educational, and similar services to reverse the child’s developmental setbacks. Animal-assisted therapy (AAT) and animal-assisted activities (AAA) provide avenues for overcoming of emotional problems, experience trauma, suffer insecure attachment, and live with a myriad of health problems. Cognitive behavioral therapy is an effective means to decrease the psychological symptoms associated with the trauma of child maltreatment.

This chapter describes the Family, Integrated Treatment, Social Connection–Internet Addiction (FITSC-IA^TM) approach as an intensive, community-based, integrated approach to the treatment of adolescent Internet addiction. FITSC-IA assesses and treats adolescents in the context of their functioning within their families and social systems in order to implement real-time intervention and treatment approaches to stabilize the addictive behaviors and common co-occurring diagnoses, such as social anxiety and depression. The chapter discusses clinical assessment, parenting style and integrated treatment approach. It describes key components of the family agreement, including setting expectations, negotiation meeting, and agreement active period. Harm reduction and abstinence approach are also applicable in the treatment of Internet addiction. The chapter also describes social recovery and effective treatment approaches such as cognitive behavioral therapy, exposure therapy, community-based support groups, motivational interviewing, transition, and technology reintroduction plan in the treatment of adolescent Internet addiction.

This chapter provides an overview of the types of conditions and symptoms that make having sex painful, the interaction of such conditions with a person’s state of mental health as well as their relationship with their partner, and sex therapy approaches to treatment. The experience of pain is subjective—what makes one person writhe may be barely perceived by another—because of various factors, including individual differences in the brain, as well as the person’s past experience with pain and other adverse health events; the person’s psychological state; the person’s ability to cope with discomfort; and even the person’s relationships. The provider’s role in treating any type of chronic pain is not to help the pain disappear but to diminish its effects through better coping skills, including cognitive behavioral therapy, relaxation techniques, and communication with one’s partners.

This chapter presents a case study of a patient who received counseling for behavior-related concerns. The patient’s mother seemed ashamed to admit that her children’s father decided to be absent in their lives. This feeling appeared to be consistent with the patient’s feelings, as observed through her nonverbal behaviors of avoidance and silence during discussions about her relationship with her father. The mother appeared to feel guilty about the father’s lack of participation and tended to overcompensate by being involved in her children’s lives, especially in their medical and mental health treatment. The patient experienced difficulties with identity and relationships. The author chooses a cognitive behavioral approach, rational emotive behavior therapy (REBT). This approach focuses on the role of thinking and beliefs as the root cause of personal problems. The author felt good about the referral and the new opportunities for the patient to develop her self-expression skills.

Women are more likely than men to have insomnia. A family history of insomnia increases the likelihood of developing insomnia, especially if one’s mother had sleep difficulty. Some girls and women experience worse sleep in the 3–4 days before their menstrual period than at other times in their cycle. This is especially likely if they have premenstrual symptoms like depressed mood, irritability, appetite changes, and feeling tense. Pregnancy increases the risk of developing some other sleep disorders. Childbirth is a time when your sleep is bound to be totally disrupted. Women who develop persistent insomnia sometimes identify childbirth as the starting point of their poor sleep. Effective treatments are available for most sleep disorders. For insomnia, women make up the majority of volunteer participants in treatment studies. Cognitive behavioral therapy for insomnia works to reverse insomnia during most stages of life including young adulthood, midlife, and old age.

Cognitive behavioral family therapy (CBFT) involves assisting clients with changing their self-defeating or irrational beliefs to change their feelings and behaviors. It assumes that family relationships, cognitions, behaviors, and emotions have a mutual influence on one another; cognitive inference evokes emotion and behavior; and emotion and behavior can influence cognition. When this cycle occurs among family members, dysfunctional cognitions, behaviors, or emotions can result in conflict. CBFT includes the family members who are needed to help bring about change in the family. This chapter takes a close look at how cognitive behavioral therapy (CBT) and other behavioral therapies developed. The CBFT template is meant to be used as a guideline to learning the process of CBT with families. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and the client.

This chapter presents the intricate work of Marsha Linehan that has shown much efficacy in treating a specific population of clients, as well as others. It lists basic tenets of Dialectical Behavior Therapy (DBT) and the basic concepts used in conceptualizing and addressing a client’s concerns. DBT is a skills-based approach first targeted toward and found through extensive research to be highly effective with those experiencing extreme emotional dysregulation patterns, suicidal ideation, and non-suicidal self-injury consistent with a diagnosis of Borderline Personality Disorder (BPD). DBT is derived from cognitive behavioral therapy (CBT) with modifications specifically added for treating emotional dysregulation and related behaviors. The DBT therapist is highly flexible and uses a dialectical approach. There are four procedures for eliciting change in DBT clients: contingency procedures, exposure-based procedures, cognitive modification, and the didactic strategy of skills training itself.

This chapter presents a case study of a sensorimotor psychotherapy (SP) approach to eating disorder (ED) treatment. In contrast to traditional psychotherapeutic approaches, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and acceptance and commitment therapy (ACT), that lean heavily on the impact of thoughts on emotional experiences and somatic patterns, also known as top-down processing, SP also uses bottom-up processing, the effect that one’s somatic organization has on affect and affect regulation, cognitive functioning and specific beliefs about self and other. The very core of SP is four foundational principles that cultivate therapeutic presence and guide both content and quality of interventions: organicity, nonviolence, unity, body/mind/spirit holism. SP understands human experience through the lens of five core organizers: thoughts, emotions, and three somatic organizers. SP explores actions as a cycle with four stages: clarity, effectiveness, satisfaction, and relaxation.

This chapter introduces a behavioral therapy as a psychological approach to treatment that assumes that mental health problems derive from external forces that impinge the individual. It focuses on the empirical works of two major researchers, Ivan P. Pavlov and Burrhus F. Skinner, who developed learning theories that have serious implications for the treatment of emotional concerns. The chapter addresses the cognitive behavioral therapy movement, both historically and practically. Cognitive behavioral therapy, or CBT, has taken the behavioral therapy movement the internal versus external locus of influence boundary. It addresses how cognition, which is an internal psychological process involving language and perception, can be associated with behavioral techniques to improve case conceptualization and to affect treatment outcomes positively. The Cognitive Behavioral Therapist will first and foremost address the cognition and will try to change the thoughts that are associated with problem behaviors.

This chapter provides a general overview of the cognitive behavioral history, model, and techniques and their application to counseling practice. Cognitive behavior therapy (CBT) originally evolved out of two traditions, the behavior therapy tradition and the psychodynamic tradition. Behavior therapy was one of the first major departures from the more traditional, psychodynamically oriented approaches to therapy. Through the use of Socratic questioning, CBT involves an ongoing assessment of the person and the problems throughout the therapy experience and is very sensitive to the idiosyncratic nature of an individual’s problems. Once cognitive, behavioral, and emotive patterns are identified for change, the CBT therapist begins to introduce a variety of focused techniques to facilitate this process. Behavioral interventions can be especially helpful in promoting change in individuals who have a harder time making elegant core belief changes through cognitive methods.

Although the cognitive behavioral therapy (CBT) model directly emphasizes the use of cognitive and behavioral interventions as part of the therapeutic process, emotional and behavioral regulation strategies are included in CBT protocols. Such strategies are varied in nature, application, and efficacy depending on the clinical presentation of students as well as their own particular needs. Such strategies are varied in nature, application, and efficacy depending on the clinical presentation of students as well as their own particular needs. In other words, different emotional and behavioral regulation strategies will be effective for different students, and it might not be clear which will work the best. Therefore, therapists should feel free to try several different strategies. This chapter provides a brief description on: recognizing emotions and physiological triggers; relaxation training; mindfulness training; and additional behavioral regulation strategies. Therapists should consider both emotion and behavior regulation problems when working with students.

Feeding and eating disorders are characterized by eating behavior that results in health and/or psychosocial problems. This chapter includes two cases of diagnosed eating disorders—anorexia nervosa and bulimia nervosa. Anorexia nervosa is characterized by restrictive eating that leads to dangerously low body weight and disturbances in self-perceived shape or weight. Bulimia nervosa is a disorder that includes episodes of binge eating and compensatory behaviors (e.g., purging, exercising). Questions for consideration follow each case.

The misuse and abuse of substances such as alcohol and drugs put people at risk for short-term and long-term harm. This chapter highlights the cases of four individuals and one family who have diagnosed substance-related disorders such as alcoholism or opioid addition. Questions for consideration follow each case.

Bipolar disorder is a mental disorder that causes unusual shifts in mood, energy, concentration, and the ability to perform daily tasks. This chapter contains three cases of bipolar disorder in adults. These cases illuminate how the same disorder manifests in different people with different backgrounds, including an African American woman, a Caucasian man, and a young Caucasian woman. Discussions of intersectionality, substance use/abuse, and questions for consideration are also included.

The importance of diagnosing depression and providing subsequent treatment to nursing home residents has been acknowledged and supported by the Centers for Medicare & Medicaid. The Mood section of the Minimum Data Set (MDS) 3.0 includes the Patient Health Questionnaire, Nine Questions (PHQ-9), in order to help identify depression. Depression is also associated with other chronic diagnoses such as Alzheimer’s disease, Parkinson’s disease, cancer, and arthritis. Substance use is often seen in the nursing home as a co-morbidity of depression for older adults. Depression and the diagnosis of depressed mood is a significant concern for social workers in long-term care. The social worker should be familiar with key signs and symptoms of depression, as well as the current modes of intervention, drug treatment, and psychotherapy.

Sleep is vital to multiple physiological systems that maintain health; however, approximately 35% to 40% of the United States experiences a sleep disturbance. In this chapter, the authors discuss multisystemic dimensions of sleep-wake disorders. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) identifies 10 sleep-wake disorders: Insomnia Disorder, Hypersomnolence Disorder, Narcolepsy, Breathing-Related Sleep Disorders, Circadian Rhythm Sleep-Wake Disorders, Non-Rapid Eye Movement Sleep Arousal Disorders, Nightmare Disorder, Rapid Eye Movement Sleep Behavior Disorder, Restless Legs Syndrome, and Substance/Medication-Induced Sleep Disorder. Medical treatment modalities are often used to treat sleep–wake disorders, as well as cognitive behavioral therapy, behavioral therapy, and pharmacological approaches. Systemic clinicians are encouraged to treat sleep–wake disorders within the boundaries of their competence. A multisystemic approach to treating sleep–wake disorders may be recommended due to the impact that the disorders have on all members of the family.

This chapter describes the issues related to trauma and stress within the family dynamic. One common response to trauma and stress is posttraumatic stress disorder. Cognitive Behavioral Interventions are founded upon cognitive behavioral therapy strategies and are geared toward symptom reduction in traumatized children and families. Legal and ethical issues pertaining to family systems are numerous. The chapter addresses those most relevant especially in working with high-conflict family systems and cases involving trauma. These issues are grouped into three categories: getting started with family systems work, complexities of family systems work, and resolving ethical dilemmas. The chapter explores two important areas that set the stage for ethical decision making, scope of practice, and recording keeping. It introduces the use of a decision-making model to assist the systemic clinician when faced with an issue that falls into the clinical “gray area”.

The elimination disorders in this chapter involve the inappropriate elimination of urine or feces and are the result of trauma in a midlife female and an adolescent male. This group of disorders includes enuresis, the repeated voiding of urine into inappropriate places, and encopresis, the repeated passage of feces into inappropriate places. Questions for consideration follow the case conceptualizations.