This chapter aims to help clinicians learn stabilization interventions for use in the Preparation Phase of eye movement desensitization and reprocessing (EMDR) treatment. Using these interventions will aid clients in developing readiness for processing trauma, learning how to manage symptoms of dissociation, dealing with affect regulation, and developing the necessary internal cohesion and resources to utilize the EMDR trauma-processing phase. Earlier negative experiences stored dysfunctionally increase vulnerability to anxiety disorders, depression, and other diagnoses. When assessing a client with a complex trauma history, clinicians need to view current symptoms of post-traumatic stress disorder (PTSD) or depression as reflections of the earlier traumas. The chapter outlines the strategies dealing with dissociative symptoms, ego state work, and internal stability that help clinicians to develop an individualized treatment plan to successfully guide the client through the EMDR phases of treatment.

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.

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.

When Charles, a 46-year-old divorced male with an extensive psychiatric history of depression, substance abuse, and disordered eating resulting in a suicide attempt, erratic employment, and two failed marriages, began treatment with a clinical social worker trained in dialectical behavior therapy (DBT), he was an angry, dysphoric individual beginning yet another cycle of destructive behavior. This chapter provides the reader with an overview of the standard DBT model as developed by Linehan. Dialectical behavior therapy, which engages vulnerable individuals early in its treatment cycle by acknowledging suffering and the intensity of the biosocial forces to be overcome and then attending to resulting symptoms, appears to be the model most congruent with and responsive to the cumulative scientific and theoretical research indicating the need for the development of self-regulatory abilities prior to discussions of traumatic material or deeply held schema.

An initial psychological assessment should take place on the first appointment with the patient. This chapter focuses on tools that are useful for the advanced practice nurse (APN) in an outpatient clinic setting. Screening tools are one way for the APN to identify depression. Several screening tools exist for use in an outpatient setting. These include the Beck Depression Inventory, the Center for Epidemiological Studies Depression scale, the General Health Questionnaire, and the Patient Health Questionnaire. Along with depression, the APN should also screen for a possible eating disorder. Patients may be sensitive about weight, so one should approach this subject with care. Motivational interviewing can be used to address weight, weight loss, and management. Motivational interviewing is a form of counseling that uses focused conversation in collaboration with the patient in order to strengthen his or her motivation toward a goal and commitment to change.

Because geriatrics content is typically offered during the second year of the baccalaureate program, elementary simulations allow faculty to introduce foundational content essential to the care of older adults. Examples of content reinforced through the use of scenarios has included (a) differentiating delirium, dementia, and depression and (b) distinguishing normal from abnormal changes of aging. This chapter briefly describes care of an older adult with congestive heart failure (CHF). It provides brief discussion on implementation of simulation-based pedagogy in our individualized teaching area, educational materials available in our teaching area and related to our specialty and specific objectives of simulation usage within a specific course and the overall program. It then provides suggestions/key features to replicate or improve recommendations for further use. The chapter finally discusses how simulation-based pedagogy has contributed to improved student outcomes, expert recommendations and words of wisdom and evaluation of best practice standards and use of credentialed simulation faculty.

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.

Toxic stress is the negative effect of the environment on the stress systems of young children who lack the buffering influence of secure adult relationships. It disrupts the structure of the developing brain and can result in permanent changes that have long-term consequences on future education, vocational abilities, and health outcomes. Toxic stress can begin as early as infancy, when infants’ needs are not met adequately and consistently. Infants exposed to high levels of cortisol, the ‘stress hormone’, are more likely to develop adult stress-related diseases later in life, as well as altered brain growth and shortened life spans. Exposure to toxic stress, including poverty and violence, during early childhood increases the risk for a number of negative health outcomes as adults, including depression, cardiovascular disease, cancers, and asthma. Toxic stress can also be caused by homelessness, bullying victimization, and witnessing community violence.