This chapter discusses comprehensive school crisis interventions, identifies the characteristics that define a crisis, finds ways to assess for the level of traumatic impact, and determines what interventions can be provided to help with response and recovery. It highlights the PREPaRE Model of crisis prevention and intervention. There are six general categories of crises: acts of war and/or terrorism; violent and/or unexpected deaths; threatened death and/or injury; human-caused disasters; natural disasters; and severe illness or injury. Children are a vulnerable population and in the absence of quality crisis interventions, there can be negative short- and long-term implications on learning, cognitive development, and mental health. Evidence-based interventions focusing on physical and psychological safety may be implemented to prevent a crisis from occurring or mitigate the traumatic impact of a crisis event by building resiliency in students. Crisis risk factors are variables that predict whether a person becomes a psychological trauma victim.

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.

Divorce is a lengthy developmental process and, in the case of children and adolescents, one that can encompass most of their young lives. This chapter explores the experience of divorce from the perspective of the children, reviews the evidence base and empirical support for interventions. It provides examples of three evidence-based intervention programs, namely, Children in Between, Children of Divorce Intervention Program (CODIP), and New Beginnings, appropriate for use with children, adolescents, and their parents. Promoting protective factors and limiting risk factors during childhood and adolescence can prevent many mental, emotional, and behavioral problems and disorders during those years and into adulthood. The Children in Between program is listed on the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-Based Programs and Practices. The CODIP and the New Beginnings program are also listed on the SAMHSA National Registry of Evidence-Based Programs and Practices.

Children and youth with serious emotional, behavioral, and social difficulties present challenges for teachers, parents, and peers. Youth who are at risk for emotional and behavioral disorders (EBD) are particularly vulnerable in the areas of peer and adult social relationships. The emphasis on meeting academic standards and outcomes for children and youth in schools has unfortunately pushed the topic of social-emotional development to the proverbial back burner. This chapter emphasizes that social skills might be considered academic enablers because these positive social behaviors predict short-term and long-term academic achievement. Evidence-based practices are employed with the goal of preventing or ameliorating the effects of disruptive behavior disorders (DBD) in children and youth. An important distinction in designing and delivering social skills interventions (SSI) is differentiating between different types of social skills deficits. Social skills deficits may be either acquisition deficits or performance deficits.

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.

Asthma, a pulmonary condition, is a chronic respiratory disorder typified by persistent underlying inflammation of tissues, airway obstruction, congestion, hyperresponsive airways, and the narrowing of smooth airway muscle. Asthma is one of the most common chronic medical conditions in children and is the leading cause of school absenteeism. This chapter describes childhood asthma, including its causes and triggers. It elucidates the extant research supporting treatment of the disorder and provides step-by-step empirically based interventions to ameliorate asthmatic symptomatology in children. The psychological underpinnings of asthma have been investigated in the field of psycho-neuroimmunology (PNI), which examines the interplay of the central nervous system, neuroendocrine, and immune system with psychological variables and their relation to physical health. Researchers have shown that relaxation and guided imagery (RGI), written emotional expression, yoga, and mindfulness therapy improve pulmonary lung functioning, decrease rates of absenteeism, and improve overall quality of life.

This chapter reviews the empirical support for such a multifaceted approach by considering selected neurodevelopmental concerns and medical variables that present as obstacles to healthy neurodevelopment. It discusses select neuro-developmental prenatal complications that can be prevented or ameliorated through behavioral interventions with the pregnant mother. The chapter addresses the deleterious effects of legal substances on the developing fetus, but professionals should be vigilant about preventing or reducing intrauterine exposure to illicit substances as well. Tobacco is a legal substance that, when used during pregnancy, has the potential to harm both the mother and fetus. Of particular concern with tobacco use are the detrimental health risks, such as hypertension and diabetes, which adversely affect the cerebrovascular functioning of pregnant women. The process of neurodevelopment is complex and represents a dynamic interplay among genetics, behavior, demographics, the environment, psychosocial factors, and myriad physiological factors.

This chapter presents the anatomy review of the human heart. The human heart is a hollow four-chambered muscle that is responsible for pumping blood throughout the body. The heart lies in the mediastinum in the thorax, pointing toward the left of the midline. The heart consists of four main layers: the pericardium, epicardium, myocardium, and endocardium. The epicardium is the outermost layer of the heart muscle. The middle layer of the heart is called the myocardium. The innermost layer of the heart is the endocardium. The heart is divided into right and the left side. The right side of the heart contains the right atrium and right ventricle. The left side of the heart contains the left atrium and left ventricle. The heart has four valves: tricuspid valve, mitral valve, aortic valve, pulmonary valve; acting as tiny doors that keep the blood moving in one direction.

The chapter explores how to measure the electrical direction for the P wave, the QRS complex, and the T wave, as well as for other forces. It provides a method for determining the direction of the electrical force for any of these waves, or complexes, on the electrocardiograph (EKG). The heart produces electrical and mechanical energy on a continuous basis. Both forms of energy come from specialized cardiac muscle fibers. These fibers provide electrical signals and mechanical energy that physically pumps the blood. Although the EKG does not show that mechanical energy, it can be used to measure a variety of electrical events. When a force is abnormal in size or direction, it may indicate that the specific part of the heart producing the force is abnormal. Therefore, learning the normal electrical direction of forces in the heart provides a simple and scientific way of understanding and interpreting an EKG.

This chapter explains various types of heart blocks such as premature atrial contraction, sinus arrest and asystole. It explains various types of pacemakers such as ventricular pacemaker and artrial pacemakers. Junctional rhythm is a regular rhythm. A P wave is frequently not seen because the rhythm originates in the AV junctional node. Junctional rhythm may be a manifestation of digitalis toxicity, sick sinus syndrome, and acute inferior wall infarction. Pauses are most commonly caused by premature atrial contractions (PACs) that do not conduct down to the ventricle and generate a QRS complex. These are called nonconducted PACs (NCPACs). Asystole is a prolonged period of no electrical activity. Cessation of function of the sinus node is called sinus arrest. Normally, when sinus arrest occurs, another pacemaker must take over, such as the junction or the ventricles. Ventricular pacemaker rhythm demonstrates a vertical electrical artifact (EA) at the beginning of the QRS.

This chapter presents the case examples of pressure and volume overload on the left ventricle and provides list of criteria for the diagnosis of Left Ventricular Hypertrophy (LVH) on the electrocardiogram (EKG). It also describes and explains how to identify ST changes in LVH and LVH simulating anterior wall infarction on the EKG. LVH refers to an increase in the wall thickness or dilation of the left ventricle. LVH is often the result of increased pressure, or volume, within the left ventricular chamber. Mitral regurgitation (MR) occurs when the mitral valve allows the backflow of blood from the left ventricle into the left atrium. The most common cause of pressure overload is hypertension (HTN). Hypertrophy of the left ventricle increases the amplitude of the left ventricular forces, because more mass generates more electricity. In LVH, the frontal plane, the horizontal plane, or both may show increased QRS amplitude.

This chapter presents an overview of the restorative justice movement in the twenty-first century. Restorative justice, on the other hand, offers a very different way of understanding and responding to crime. Instead of viewing the state as the primary victim of criminal acts and placing victims, offenders, and the community in passive roles, restorative justice recognizes crime as being directed against individual people. The values of restorative justice are also deeply rooted in the ancient principles of Judeo-Christian culture. A small and scattered group of community activists, justice system personnel, and a few scholars began to advocate, often independently of each other, for the implementation of restorative justice principles and a practice called victim-offender reconciliation (VORP) during the mid to late 1970s. Some proponents are hopeful that a restorative justice framework can be used to foster systemic change. Facilitation of restorative justice dialogues rests on the use of humanistic mediation.

This chapter describes some of the recent restorative justice innovations and research that substantiates their usefulness. It explores developments in the conceptualization of restorative justice based on emergence of new practices and reasons for the effectiveness of restorative justice as a movement and restorative dialogue as application. Chaos theory offers a better way to view the coincidental timeliness of the emergence of restorative justice as a deeper way of dealing with human conflict. The chapter reviews restorative justice practices that have opened up areas for future growth. Those practices include the use of restorative practices for student misconduct in institutions of higher education, the establishment of surrogate dialogue programs in prison settings between unrelated crime victims and offenders. They also include the creation of restorative justice initiatives for domestic violence and the development of methods for engagement between crime victims and members of defense teams who represent the accused offender.

This chapter explores traumatic grief and loss and discusses various treatments for it. It focuses on mindfulness-based interventions for specific use in traumatic grief with bereaved parents. Traumatic grief appears relatively responsive to the psychosocial approach, particularly when it includes exposure elements, such as retelling the story of the loss, reutilization, and building tolerance to the emotions associated with loss. More recently, Thieleman, Cacciatore, and Hill have presented evidence for a mindfulness-based, psychosocial approach for specific use in traumatic grief with bereaved parents. Western culture’s interest in mindfulness has grown exponentially, and practices have been integrated into a variety of general, psychotherapeutic treatment approaches including acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), mindful- ness-based cognitive therapy (MBCT), and mindfulness-based stress reduction (MBSR). Of all mindfulness practices, one of the most cost-effective strategies to help providers working with bereaved parents is meditation.

This chapter highlights key elements of adolescent growth and development and outlines communication strategies to serve as a guide for health care clinicians. It provides a summary of research findings on the adolescent female bereavement response to an early pregnancy loss prior to 20 weeks gestation like miscarriage, ectopic pregnancy, or elective termination. To gain a greater understanding of the adolescent response to pregnancy loss, it is helpful to review normal adolescent emotional and psychological development. Erik Erikson’s classic developmental theory offers an outline of the psychosocial tasks of adolescents. Blos described three separate phases of adolescence: early, middle, and late, which evolve throughout the transition from childhood to adult hood. Sanders’s integrated bereavement theory has been used to organize grief responses and the bereavement process. When adolescents have experienced an early pregnancy loss they will experience grief responses that are physical, emotional, social, and cognitive in nature.

This chapter aims to give the behavioral health specialist (BHS) a basic understanding of pain, knowledge about how to effectively evaluate chronic pain, and a description of effective pain management techniques. Knowledge of the biological and psychological basis of pain is important to understanding the experience of chronic pain. A biopsychosocial assessment is the foundation for providing behavioral health treatment to the chronic pain patient. Chronic pain is less responsive to treatments commonly used for acute pain such as opioid analgesia and avoiding physical activity. A multidisciplinary team approach can substantially improve outcomes in chronic pain treatment. Whatever the format of service provision, utilizing multiple interventions such as physical therapy/exercise, emotional management, pacing, and medication, rather than a single modality can substantially improve outcomes for chronic pain. Providing psychoeducation about chronic pain can be an important strategy.

Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.

Respiratory disorders are the most common causes of illness and hospitalization in children. Respiratory disorders range from mild and self-limiting to life-threatening. Pediatric respiratory health is promoted through prevention, early detection, treatment of disorders, and education efforts. This chapter reviews common pediatric respiratory disorders, explores etiology of pediatric respiratory disorders, and discusses specific care of pediatric clients with respiratory disorders. Newborns have less mucous production, making them more susceptible to infection. Throughout childhood, infants/preschoolers have larger tongues, tonsils, and adenoids, which can cause airway obstruction even in the absence of disease. The common cold is the most common upper respiratory infection (URI) or nasopharyngitis. The causes of a URI include rhinoviruses, parainfluenza, and the respiratory syncytial virus (RSV). Pediatric disorders that affect the lower respiratory tract can be short- or long-term conditions depending upon the cause.

Musculoskeletal disorders are some of the most common causes of illness and hospitalization in children due to their active nature. This chapter reviews common pediatric musculoskeletal disorders, etiology of pediatric musculoskeletal disorders, and pediatric-specific care of musculoskeletal disorders. The musculoskeletal system supports the body structure and provides for client movement. Skeletal growth is most rapid during infancy and adolescence. Injury to the epiphysis can affect bone growth. The most common pediatric musculoskeletal disorders involve pediatric trauma. Torticollis is a symptom that causes a child’s chin to be rotated to one side and the head to the other side. The two most common disorders that can cause torticollis include: Congenital muscular torticollis, and Acquired torticollis. Osteomyelitis is an infection of the bone that occurs most often in infancy or between the ages of 5 and 14 years.

The endocrine or ductless glands work with the nervous system to regulate the body’s metabolic processes. Hormones interact with specific target organs to create an effect on the body. This chapter reviews the pathophysiology behind the metabolic system in pediatric clients. It describes nursing care required for pediatric clients with various metabolic conditions. The chapter explores instruction necessary for families of clients with metabolic conditions. Most of the glands and structures of the endocrine system develop during the first trimester of fetal development. Hormonal control is immature until approximately 18 months of age, leaving the infant prone to dysfunction of the endocrine system. Hundreds of hereditary biochemical disorders affect the metabolism. As the infant adjusts to life, symptoms can rapidly emerge that are life-threatening. The most common endocrine dis.

The Senior House Calls program (SHC) was started as a component of the Texas Tech University Health Sciences Center School of Nursing (TTUHSC SoN) practice program through a 2-year grant from a local foundation. Operated as part of the Larry Combest Community Health and Wellness Center (LCCHWC), it primarily serves the needs of vulnerable elders in the area. SHC is a nurse-managed clinical service for homebound elders that provides comprehensive primary care through advanced practice nurses who are employees of the SoN. The goal of this program is to provide access to a continuum of community-based services for the elderly population in the city of Lubbock, as an alternative to institutional care. Family therapy services are provided in the SHC program; those needing more intensive therapy are referred to appropriate services. SHC is largely funded through Medicare since almost 99” of its patient volume is covered by Medicare.

Nurse-managed wellness centers (NMWC) are practice settings that are community based, directed by an advanced practice nurse, and staffed by public health nurses, advanced practice nurses, and other members of an interdisciplinary health care team. The wellness center model stresses primary prevention and facilitates self-care of the individual with regard to health care strategies and decision making. Freestanding NMWC services include health promotion and disease prevention activities that focus on primary and secondary prevention strategies as well as wellness programs. Students from various health care disciplines, such as nursing, pharmacy, social work, physical therapy, and nutrition, actively participate in NMWC activities. Students benefit in multiple ways because clinical assignments at NMWCs expose them to real-life situations that individuals, families, and groups experience beyond the boundaries of the acute care setting. Wellness centers complement existing primary care services. NMWCs are effective and achievable models of health care delivery.

The 19130 Zip Code Project at the Community College of Philadelphia (CCP) started as a curriculum innovation: the CCP Department of Nursing’s response to the national shift toward community-based health care. The project resulted in the refocusing of the nursing curriculum and the development of partnerships with CCP’s neighbors in the 19130 zip code. It also is an excellent example of a nurse-managed wellness center without walls. The Zip Code Project has put down deep roots in the neighborhood and in the nursing curriculum. It has produced a community-based model for educating local health professionals and a service-learning model for enhancing health service delivery by local agencies. The faculty arranged community-based clinical experiences for nursing students in the neighborhood surrounding CCP. Although CCP sits in the middle of the zip code, faculty knew little about community-based health care services in the community.

This chapter talks about monitoring equipment, and procedural sedation and analgesia (PSA). In addition to respiratory suppression, the medications used for PSA may suppress the autonomic nervous system’s ability to adequately respond to hypovolemia; therefore, close monitoring of vital signs is important for the well-being of patients. PSA medications promote a rapid recovery stage with minimal postprocedure impairment. Patients need to be observed until there is no risk of cardiorespiratory depression or compromise; monitoring vital signs, including level of consciousness (LOC), with ability to intervene quickly with resuscitation efforts if needed. The rapid response system (RRS) provides critical care expertise when intensive care unit (ICU) level care is needed for compromised patients outside of the ICU, including radiology. The RRS is the radiology nurse’s resource when patients have adverse reactions to sedation, procedures, or diagnostic tests.

The learning landscape continues to evolve as new technological tools enable teachers to deliver robust learning experiences. It is important to help teachers, administrators, and students know where to begin so that the transition to virtual learning is smooth, without educational loss. This chapter consists of two sections: current trends and issues in technology integration and technological pedagogical content knowledge. The first section briefly reviews the trends in instructional or educational technologies that are causing administrators, teachers, and students to reflect on and modify their thinking about learning and educational content delivery. The second section explores constructivism, the scientific underpinnings of nursing informatics, and ethics. Nurse educators must also address the ethical challenges brought about by this evolving learning landscape. After reading this chapter, one can understand current trends and issues, as well as the influence of nursing informatics and ways to approach new ethical dilemmas.

Healthcare is in a state of rapid change. Although practice environments have become more complex, educational delivery methods have remained stagnant. Innovative technologies provide opportunities to enhance nursing student learning and help nursing programs become more responsive to changes in the practice environment; however, obstacles may hinder successful implementation. With the increasing complexity of today’s health care environment, innovations in nursing curricula are necessary. This chapter explores some of the general challenges associated with the integration of innovative educational technologies, as well as some challenges unique to virtual simulation. It helps the reader to analyze the challenges of integrating educational technologies into nursing education associated with faculty, administrators, and students. It also helps the reader to examine practical and philosophical barriers related to technology integration and explores challenges unique to the adoption of virtual simulation.

Simulation has many advantages for nursing education, some of which include creating safe learning environments for students and reinforcing information learned in the classroom; it also has the advantage of being available in inclement weather as well as 24 hours a day for student access. Simulation in nursing is one of many methods used for teaching students. Teaching and learning in a virtual learning environment has many advantages for administrators, faculty, and students. One of the advantages includes the use of other disciplines to help create or participate in a virtual world learning experience. The virtual learning environment can be created to look similar to real communities, disaster areas, or homes, with avatars populating that environment. The advantage to using virtual reality, rather than a real-life experience, is that in real life, students could be immersed in an environment that could cause them harm.

This chapter provides practical strategies for nursing care related to sleep promotion and prevention and treatment of sleep disorders in pediatric primary care settings, acute care settings, and schools. In children with sleep disorders, inadequate sleep does not often result in excessive daytime sleepiness, but in behavioral difficulties such as inattention, hyperactivity, cognitive dysfunction, and/or scholastic problems. Nurses who see children in the primary care setting can take an active role in the evaluation and assessment of all children’s sleep health and provide follow-up care and ongoing treatment monitoring for children who have sleep disorders. In the acute care setting, nurses can incorporate regular treatment plans for a child’s sleep disorder during hospitalization and should be aware of potential for obstructive sleep apnea (OSA)-related perioperative complications for children undergoing adenotonsillectomy. School nurses have the opportunity to promote healthy sleep and improve behavior and school performance in children at risk.

This chapter describes the relevance of critical thinking and the related process and philosophy of evidence-based practice (EBP) to cognitive behavior therapy and suggests choices that lie ahead in integrating these areas. Critical thinking in the helping professions involves the careful appraisal of beliefs and actions to arrive at well-reasoned ones that maximize the likelihood of helping clients and avoiding harm. Critical-thinking values, skills and knowledge, and evidence-based practice are suggested as guides to making ethical, professional decisions. Sources such as the Cochrane and Campbell Collaborations and other avenues for diffusion, together with helping practitioners and clients to acquire critical appraisal skills, will make it increasingly difficult to mislead people about “what we know”. Values, skills, and knowledge related to both critical thinking and EBP such as valuing honest brokering of knowledge, ignorance and uncertainty is and will be reflected in literature describing cognitive behavior methods to different degrees.

This chapter describes the Coping Skills Program, an innovative, school-based, universal curriculum for elementary-school aged children that is rooted in cognitive behavior theory. Rooted in cognitive behavior theory, the Coping Skills Program consists of carefully constructed metaphorical fables that are designed to teach children about their thinking; about the connections among their thoughts, feelings, and behavior; and about how to change what they are thinking, feeling, and doing when their behavior causes them problems. The chapter provides a thorough description of the Coping Skills Program and how it is implemented through a discussion of relevant research-based literature, and the theoretical underpinnings underlying this cognitive behavior approach with school-aged children. It also includes the results of preliminary testing of the Coping Skills Program. The research-based literature shows that cognitive behavior approaches are among the interventions commonly used by social workers to help young children in school settings.

This chapter describes nursing care for sleep disorders in the primary care setting. The most prevalent sleep disorders in adults and older adults, and those most commonly seen in primary care settings are insomnia, sleep-disordered breathing, and restless legs syndrome. There is a compelling need for widespread access to sleep assessment and treatment among the large population of primary care clients who have sleep disorders-many of which are currently undetected. Primary care providers, especially nurses, are in an ideal position to assess, implement, and evaluate sleep promotion and sleep disorders treatment in primary care clients. The reach, adoption, implementation, and long-term maintenance of sleep promotion and sleep disorders treatment is most likely to be successful if implemented at the practice/organizational level. Nurses, especially advanced practice nurses play a pivotal role in implementing and evaluating policies and procedures to assure the translation and uptake of these important services.

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.

Adolescence is a particularly intense stage of development. During the time of life between prepubescence and young adulthood, youth are challenged by accelerated mental, emotional, cognitive, and physical changes. The ordinary biopsycho-social stressors of adolescence, in conjunction with extraordinary environmental conditions, harmful external stimuli, and the dearth of resources that are associated with lower class and ethnic social status, tend to disrupt homeostasis and thwart positive youth development (PYD). Poor, ethnic minority youth are at disproportionate risk of negative social outcomes. The majority of these disparities involve externalizing factors, such as teen pregnancy, academic underachievement, and antisocial peer-group affiliation, as well as violent victimization and offending. The basic mission of F.I.T. an acronym for Focus, Initiative, and Tenacity Camp is to empower disadvantaged, ethnic minority youth by means of fostering positive social and emotional development.

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.

Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).

This chapter describes the characteristics, epidemiology, pathophysiology, and treatment of movement disorders: periodic limb movement disorder (PLMD) and restless legs syndrome (RLS) and suggests implications for nursing practice. Parasomnias and movement disorders are associated with many behaviors that occur in proximity to the sleep period during sleep stage transitions, or during REM or NREM sleep. Movement disorders, in particular, are associated with significant impairment in quality of life and possibly negative cardiovascular consequences. Both groups of conditions occur in adults and children. Although some conditions are occasional, benign, and self-limiting, others are persistent and associated with significant sleep loss and/or the risk of injury to self and others. Nursing care for movement disorders and parasomnias is focused on patient education, providing appropriate reassurance regarding benign and self-limiting behaviors, a safe environment, and symptom control where necessary. Sleep hygiene, avoiding caffeine, and regularly scheduled sleep-wake cycle often reduces negative consequences.

This chapter examines the cultural and relational contexts of postpartum depression. Postpartum depression (PPD) is a debilitating, multidimensional mental health problem that affects 10"-15” of new mothers and has serious consequences for women, children, families, and marriages. Although women’s experience of postpartum depression has been the subject of considerable recent study, nearly all of this work has been interpreted within a medical or psychological frame. The chapter looks at a social constructionist lens to this body of research through a meta-data-analysis of recent qualitative studies of PPD. Though hormonal changes as a result of childbirth are related to depressive symptoms after childbirth, biological explanations alone cannot explain postpartum depression. A social constructionist approach to postpartum depression focuses on how the condition arises in the context of ongoing interpersonal and societal interaction. Climbing out of postpartum depression is an interpersonal experience that requires reconnection with others.

Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. As is so often true for social work, the opportunity is associated with need. For social workers, in their role as advocates and clinicians, this unmet need would seem to create an obligation. This chapter argues that, if choosing to accept the obligation, social workers can become catalysts for vitally needed change within the medical field. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating Cognitive behavior therapy’s (CBT) effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients. While this chapter discusses the clinical benefits and techniques of CBT, it also acknowledges the likelihood that social work will have to campaign for its implementation in many medical settings.

Children are exposed to distress, violence, and trauma even before they are born. In-utero and early childhood exposure can contribute to severe medical and psychological consequences. Children who have been exposed to such traumatic events often arrive at the psychotherapist’s office with emotional and behavioral symptoms suggestive of reactive attachment disorder (RAD), post-traumatic stress disorder (PTSD), and dissociation. This chapter reviews relevant theories of dissociation integrated with theories of development to provide a summary of how attachment impacts dissociation. With a developmentally grounded theory of dissociation, the chapter describes clinical interventions for treating the dissociative sequelae of attachment trauma in children. This theoretical framework offers a developmentally grounded and integrative framework for working with children with complex trauma and dissociation. Symptoms of dissociation are common with PTSD, but an extreme response to trauma can be dissociation and dissociative disorders.

School social workers provide direct treatment for a multitude of problems that affect child and adolescent development and learning; these problems include mood disorders, attention deficit hyperactive disorder (ADHD), disruptive behavior disorders, and learning disorders, as well as child abuse and neglect, foster care, poverty, school drop out, substance abuse, and truancy, to name but a few. This chapter examines four constructs that are important when working with students. These constructs include: assessment and cognitive case conceptualization, the working alliance, self-regulated learning, and social problem solving. The chapter discusses the development of attainable and realistic goals is a critical component both of self-regulated learning and social problem solving. The chapter examines the problem of academic underachievement and four constructs that are critically important when working with children and adolescents in school settings. Academic underachievement is a serious problem affecting the lives of many children.

This chapter offers a review of selective literature on complex childhood trauma. It explains a case study demonstrating the use of meditative dialogue, a collaborative practice through which client and therapist are able to work together to develop empathy and compassion toward self and others during psychotherapy sessions. Thompson and Waltz described an inverse relationship between exposure to trauma and subsequent posttraumatic stress disorder symptom severity, and self-compassion. Recent neuroscience research has begun examining the effects of meditation practices on specific areas of the brain through neuroimaging studies. Clinical trials on the use of meditative dialogue in psychotherapy with survivors of complex childhood trauma, looking at the brains of the clients, and using magnetic resonance imaging (MRI) to measure changes, would help to demonstrate its efficacy and move it into the realm of evidence-based practices.

This chapter explains a set of guidelines to help mental health professionals and clients move away from the gender stereotypes that perpetuate inequality and illness. Identifying dominance requires conscious awareness and understanding of how gender mediates between mental health and relationship issues. An understanding of what limits equality is significantly increased when we examine how gendered power plays out in a particular relationship and consider how it intersects with other social positions such as socioeconomic status, race, ethnicity, and sexual orientation. To contextualize emotion, the therapist draws on knowledge of societal and cultural patterns, such as gendered power structures and ideals for masculinity and femininity that touch all people’s lives in a particular society. Therapists who seek to support women and men equally take an active position that allows the non-neutral aspects of gendered lives to become visible.

This chapter presents how eye movement desensitization and reprocessing (EMDR) therapy and Theraplay can be used together when treating children with a history of complex trauma. Theraplay focuses on the parent-child relationship as the healing agent that holds within it the potential to cultivate growth and security in the child. The chapter shows some core concepts that help define and illuminate the application of Theraplay. Now that a clear review of basic Theraplay principles has been provided, people need to look at EMDR therapy and the adaptive information processing (AIP) model in conjunction with Theraplay and Theraplay core values. Early in its development, Theraplay integrated parental involvement into its therapeutic model. During the reprocessing phases of EMDR therapy, Theraplay can be very helpful in providing different avenues for emotion regulation and for the repairing of the attachment system.

One of the emerging approaches to explaining the normative spike in adolescent risk-taking, with delinquent/antisocial behavior as one expression, is based on recent advances in developmental neuroscience. Brain imaging studies have identified two main processes for which co-occurrence in the healthy adolescent brain directly impacts delinquent behavior. The first neuropsychosocial process implicated in heightened risk-taking involves sudden and dramatic changes in activity in the limbic system that coincides with puberty. The second process is associated with a developing ability to self-regulate behavior that continues to mature into the early 20s. Mindfulness meditation may be an effective method for reducing delinquency in juvenile justice involved youth because of its association with increases in self-regulation. The juvenile justice system was built on the argument that children and youth are less culpable for criminal and delinquent behavior than adults, making adolescence a mitigating circumstance in determining the state’s response to youth criminality.

Most Behavioral Group Therapy (BGT) with children and adolescents include aspects of problem solving or social skills training or both. This chapter describes group workers can make an important contribution to children, families, and schools through preventive and remedial approaches. Social skills training grew out of the clinical observation and research that found a relationship between poor peer relationships and later psychological difficulties. The social skills program taught the following four skills: participation, cooperation, communication, and validation/support. The chapter focuses on the unique application of behavioral treatment using groups with an emphasis on assessment, principles of effective treatment, and guidelines for the practitioner. It also focuses on the use of the group in describing these aspects of BGT. The primary goal of using BGT with children is enhancing the socialization process of children, teaching social skills and problem solving, and promoting social competence.

This chapter describes the toxic stress often experienced by young homeless children and the effect that this type of stress can have on brain development, behavior, and lifelong health. Mental health and cognitive challenges are abundant among homeless families. Stress can affect maternal cardiovascular function and restrict blood supply to the placenta, potentially reducing fetal nutritional intake or oxygen supply, and lead to reduced fetal growth, increased risk of placental insufficiency, preeclampsia, and preterm delivery. Trauma in early childhood has clear neurological and developmental consequences, especially with regard to brain development and executive functioning. The chronic release of two stress hormones glucocorticoids and cortisol can have damaging effects on neurological functioning and lifelong health. Similarly, exposure to high levels of cortisol inhibit neurogenesis in the hippocampus, further impacting executive functioning and the ability to distinguish safety from danger, a symptom of posttraumatic stress disorder (PTSD).