An individual’s identity development, including his or her preferred gender identity, is a lifelong process, which starts with the earliest interactions with the world. The concepts of gender identity have been explored, studied, debated, and discussed for decades and are currently going through a resurgence of examination, especially in Western cultures. This chapter provides an overview of gender identity development, beginning with an explanation of terms, followed by an exploration of theoretical perspectives which includes cognitive developmental theory, social learning theory, gender schema theory and feminist theory. Topics include current research and perspectives on how gender identity evolves in children and recent shifts in understanding atypical gender identities, including transgender, gender neutral, and gender fluid identification. Finally, implications and strategies for mental health professionals are discussed, especially related to counseling those who are experiencing conflict or distress surrounding issues of gender and gender identity.

One of the most important findings from the original battered woman syndrome (BWS) research was the existence of a three-phase cycle of violence that could be described and measured through careful questioning of the battered woman. This chapter describes the cycle, updates it by adding information from the courtship period, and divides the third phase into several different sections where appropriate so that there may not be any loving contrition or even respites from the abuse at times during the relationship. Teaching the woman how her perception of tension and danger rises to an acute battering incident after which she experiences feelings of relief and then gets seduced back into the relationship by the batterer’s loving behavior, often similar to what she experienced during the courtship period, has been found to be helpful in breaking the cycle of violence that keeps the woman in the relationship.

Many developmental models view human growth from a space of lack or abundance, a perpetual fulcrum swinging from the word survive at one end to thrive at the other. This chapter discusses Urie Bronfenbrenner’s bioecological theory of human development to conceptualize female adolescent and young adult development. The contextual focus of this theory provides a global framework for counselors to view young women as individuals who both influence, and are influenced by, their surroundings. Customs, beliefs, and the government all play a role in the development of children and adolescents. When young females overcome the stigma associated with mental health services, they typically seek treatment in one of two primary settings: community mental health centers and schools. Relational-cultural theory (RCT) is an evolving feminist model of human development that views connection to others as essential to growth and disconnection as a major cause of disrupted functioning.

This chapter discusses the assessment and laboratory findings, imaging, diagnosis and management of ascites. A common complication of cirrhosis is ascites, or the accumulation of fluid in the abdominal cavity. Ascites that develops from cirrhosis is associated with portal hypertension. The patient with cirrhosis and ascites may complain of increased weight gain, lower extremity edema, and abdominal bloating or distension. Physical examination findings may reveal a distended or even tense abdomen, positive fluid wave, dullness to abdominal percussion, and peripheral edema. Routine laboratory testing, such as complete blood count, complete metabolic panel, and liver function testing, should be performed with new-onset ascites and at routine return visits. Patients with cirrhosis and ascites can develop electrolyte imbalances and renal failure. Ultrasound is helpful to determine whether ascites is present if there is any uncertainty upon physical examination. Patients should abstain from alcohol consumption and avoid using nonsteroidal anti-inflammatory drugs.

This chapter describes many of the theories that involve taxonomies. Most taxonomies of love begin in the same place: The language of love is examined, whether through an examination of film, literature, music, or firsthand accounts of people about their love life. The three primary love styles are eros, storge, and ludus. Eros is a passionate kind of love that is characterized by strong emotions and intense physical longing for the loved one. With storge, should the lovers break up, there is a greater chance than with other love styles that they remain friends. Ludus commonly is displayed by people who prefer to remain single and who see love as a game of conquest and numbers. A pragmatic lover hesitates to commit to a relationship until he or she feels confident of finding the right partner. The different love styles also correlate with some other personality traits.

This chapter describes the current trends toward greater gender equality in couple relationships, what keeps old patterns of gendered power alive, and why equality is so important for successful relationships. Relationship vignettes like the ones just described are common. Sharing family and outside work more equitably is only part of the gender-equality story. Gender ideologies are replicated in the way men and women communicate with each other and influence the kind of emotional and relational symptoms men and women present in therapy. Stereotypic gender patterns and power differences between partners work against the shared worlds and egalitarian ideals that women and men increasingly seek. The concept of relationship equality rests on the ideology of equality articulated in philosophical, legal, psychological, and social standards present today in American and world cultures. The four dimensions of the relationship equality model are relative status, attention to the other, accommodation patterns, and well-being.

This chapter explores the relationship between gender and power. Gendered power in couple relationships arises from a social context that has given men power over women for centuries. When practitioners fail to take account of social context, however, they may run the risk of inadvertently pathologizing clients for legitimate responses to oppressive experiences. The term gender is a socially created concept that consists of expectations, characteristics, and behaviors that members of a culture consider appropriate for males or females. Consequently, an individual’s ideas about gender may feel deeply personal even though they are a product of social relationships and structures. Strong social forces work to keep social power structures, including gender inequality, in place. The continued presence of gendered power structures in economic, social, and political institutions still limits how far many couples can move toward equality. Today, ideals of equality compete with the institutional practices that maintain gender inequality.

Inflammatory bowel disease (IBD) is a broad diagnosis that includes two major chronic diseases: ulcerative colitis (UC) and Crohn’s disease (CD). IBD is typically diagnosed in young adulthood. Smoking has been associated with a higher risk of developing CD. UC is an inflammatory disease of the mucosa of the colon and rectum. Typical symptoms include bowel movement urgency, tenesmus and bloody diarrhea. CD is a chronic inflammatory disorder of the alimentary tract. It is associated with high levels of proinflammatory cytokines. Referral to a gastroenterologist specializing in IBD may be needed. To confirm diagnosis, a flexible sigmoidoscopy is necessary in cases of UC and a colonoscopy is necessary in cases of CD. The goal for treatment of IBD is to suppress the immune system and help heal the bowel. Initial treatment for patients with mild to moderate UC includes 5-aminosalicyclic acid compounds.