Communion, defined as a shared journey of honoring each other’s being in and with the world, becomes a scared relational space for Professional Self-Hood. Professional Self-Hood has been defined as an internal embodiment and an external expression of nursing, the compilation of influences of being in and being with the world. Entering into communion to stretch in uncomfortableness begins the movement to unlearn, relearn, reaffirm, and recommit to the ongoing evolution of a just and caring version of ourselves as professionals, embodied and made visible as our Professional Self-Hood.
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In this study, survival analysis is used to examine time to rearrest for both domestic violence and nondomestic violence crimes among a cohort of domestic violence offenders (N = 286) over a 10-year period. In addition, risk factors for rearrest such as demographic, offending history, and batterer treatment variables are examined to determine their influence on domestic and nondomestic violence recidivism. Overall, the results suggest that approximately half of domestic violence offenders are rearrested. Furthermore, among those who are rearrested, they are rearrested fairly quickly and for generalized (both domestic and nondomestic violence offenses) versus specialized offending. Risk factors associated with both types of rearrest included age, marriage, and domestic violence offense history. Several additional risk factors were unique to rearrest type. Study limitations are explicitly stated and policy implications are discussed.
The firearm mortality rate in West Virginia (WV) increased over the past four years and is currently 50% higher than the national rate. These alarming statistics, combined with the urban-to-rural shift in firearm injuries, prompted this 10-year epidemiologic overview. To the best of the authors’ knowledge, the current study stands alone as the only report of its kind on firearm injuries in the rural setting of southern WV. Firearm injuries were common in White males within the age range of 20–49 years. Assault, which is typically identified as an urban problem, was found to be the most common injury in the study population. In our data series, injury severity score was the strongest predictor of mortality, followed by self-inflicted cause of injury and trauma to the neck/head region.
College counseling has entered an era that promises to be radically different than any time in its previous 100-year history. College students in this 21st century are more technologically advanced than previous generations and more likely to take virtual classes than previous generations of college students. Traditional services provided by the college counseling center are: individual and group counseling, psychoeducational groups, evaluation and assessment, career counseling, consultation to faculty and staff, medication management and resident advisor (RA) training. Nontraditional services are defined as virtual counseling, advising, and related services offered via distance technology. College counseling centers have long offered types of self-instructional services. They will need to address social media in ways that are both ethically sound and also able to effectively engage college students in seeking counseling services. The counselor can administer the Dimensions of a Healthy Lifestyle Scale (DHLS) to the client and then discuss the findings.
The purpose of the study was to develop an institutional care model that reflected staff nurses’ perceptions of what nursing means to them. Swanson’s (1991) care theory concepts were compared to the nurses’ responses to evaluate if this middle-range theory could support a theoretically based institutional care model. It was discovered that the theoretical concepts of knowing, being with, enabling, doing for, and maintaining belief found in Swanson’s (1991) care theory were expressed by the nurses. A care model was created that provided a visual display and guided nursing practice at this institution.
- Go to article: 33rd International Association for Human Caring Conference Caring Connections: Research, Practice, Education
In 1920, in America, psychology was dominated by two main currents. The first was a tendency to reduce life to habit, and the second was to establish differences between humans by test. The second tendency, toward testing, had burst suddenly on the scene with the coming of the Binet tests to America in 1905. The idea of contextualized relationships determined by perceptual interpretation challenged the notions that had sprung up around behaviorism that the brain was empty, functioning only as a router between environmental stimulus and motor response. The idea, still vivid in American psychology during the 1920s, that psychology was “the science of mental life” was reinforced and extended by the diffusion of Gestalt psychology through American psychology over the coming decades, as the rest of these reviews of theory and practice will show.
Gordon Allport, addressing the American Psychological Association (APA) as its president in September 1939, observed that psychology, over the preceding 50 years, had divided into its pure and applied aspects. Troland was a socialist, and proposed that a “technology of behavior” be devised to maximize human happiness. In his comprehensive psychological system, Troland proposed a hedonic theory of motivation: Behavior depends on the quantity of pleasure to which it is related. Taken together, Troland and Miles represent the flowering, during this decade, of two persisting areas of psychological applications: consultation on the design of technologies in which human sensory and perceptual characteristics interact with equipment and devices, and the study of the effects of drugs of various kinds on human performance. Within psychiatry, psychology had long had allies, and during the 1930s some powerful ones became associated with psychology and supported its aims to develop a parallel nonmedical psychotherapy system.
The year 1945 saw the culmination of many developments in psychology since the 1920s, which led to two major coalitions being formed. The first of these was represented in the reorganization of the American Psychological Association (APA). The most important aspect of this reorganization was the consensus that theory, applications, and clinical activities, formerly represented by separate organizations and carrying on their affairs at a distance from each other, were indeed all parts of a unitary entity, psychology. Psychologists advanced their own comprehensive views of behavioral science as a complex system. The perception that psychology was a united front continued to be a successful strategy, which further confirmed its presence within the spectrum of physical and social sciences. Social psychology, which in previous decades was a melange of crowd psychology and anthropological ideas, acquired a perceptual and cognitive focus.
The 1950s, in American society as well as psychology, were characterized by two pairs of opposites: liberty versus repression and conformity versus creativity. Repression of suspected Communists and other left-leaning individuals was in full swing at the beginning of the decade, driven by long-standing partisan enmity as well as fresh anger over the loss of atomic superiority to Soviet Russia. Many of those who had been instrumental in the creation of the bonds between them had died or retired to other interests, and a new generation of psychiatrists emerged to question the qualifications of what they saw as psychiatrists practicing without medical licenses. Cognition and internal states also emerged in the 1950s versions of theories of motivation. Applied cognitive psychology, in its 1950s incarnation, interested Eddie, Helen’s husband, and he occasionally read articles by aviation psychologists working on contract for the Office of Naval Research.
The 1960s were brought to the United States on television. In ensuing decades, psychologists would engage in inconclusive debates about whether violence on TV had social effects. Ultimately, psychologists’ isolation in the academy, their cultural backgrounds, and their focus on integrating individuals by adjustment and assimilation rather than on managing immediate mass social change pushed psychology, as a field, to the periphery of civil rights, at least as they pertained to color. The pages of psychology’s journal of record, the American Psychologist, recorded few traces of the Vietnam conflict, a central feature of American life in the second half of the 1960s. Counseling psychologists concentrated on civilian problems. Hospital clinicians worked to develop ways to implement the new community mental health system. The combined effect of the Community Mental Health Act and the Great Society’s medical programs was a further infusion of energy and resources into rapidly developing clinical psychology.
By any measure, the 1970s and 1980s were marked, for psychology, by a continual upward change in professional self-designations as indicated by membership in the American Psychological Association (APA), a marker of the increase in the number of practicing psychologists now well distributed in all areas of U.S. culture. Psychology entered the 1970s as a well-established, lucrative coalition of professions. While some of its activity over the rest of the decade could be understood as directed toward meeting the challenge of selfless public service, for the most part psychologists were interested in career advancement. The response of officially organized psychology in the 1970s to these political and social events was the same as it had been during the preceding two decades the creation of further interest groups reflected as new divisions in the APA. Clinical psychology continued to contend with medical psychiatry for authority in treating mental illness.
One of the reflections of the rise of postmodernism in the American Psychological Association (APA) was the inclusion, for the first time, of psychoanalysts as official members of its coalition in Division 39 (a reflection of the gradual decoupling of psychoanalysis from medicine). The APA added a division of clinical neuropsychology, another specialty area where the advances in both cognitive and brain studies translated into an acceptable medical support occupation for psychologists. Psychologists increasingly found employment, during the ‘80s, advising clients, for a fee, of the best way to present themselves to juries, recommending with indifferent success changes in legal language in the direction of more accessibility and understandability, and offering expert testimony on clients’ mental states, as psychiatrists had been doing for at least a century. The theoretical models of health psychology that began to emerge about this time share characteristics with both Bandura and Cialdini.
In psychology, it was a prosperous year. It was 6 years since President George H. W. Bush signed a proclamation designating the 1990s as “The Decade of the Brain”, and 4 years before the American Psychological Association (APA) would pronounce the succeeding decade “The Decade of Behavior”. Since 1990, Peace Psychology, Group Psychology and Group Psychotherapy, and Society of Addiction Psychology had also been added. The Human Genome Project was about halfway through the process of mapping the entire human genome. For years, the sentiment in much of psychology, especially among the more senior members of the profession, was that as Howard Kendler put it in a 1999 article psychology could not scientifically prescribe correct moral behavior, and that psychologists should separate their scientific activity and their roles as private citizens, speaking out for social causes only outside of the official structure of the psychological coalition.
- Go to article: Aaron T. Beck’s Dream Theory in Context: An Introduction to His 1971 Article on Cognitive Patterns in Dreams and Daydreams
Aaron T. Beck’s Dream Theory in Context: An Introduction to His 1971 Article on Cognitive Patterns in Dreams and Daydreams
Aaron T. Beck developed a rudimentary theory of dreams in the early years of cognitive therapy (1969-1971) that he presented to both psychoanalysts and behavior therapists. This article will examine the historical conditions that fostered Beck’s cognitive dream theory. Beck’s early psychoanalytic dream research taught him the virtues of social science research and catalyzed his shift towards the cognitive model. Once the cognitive model was in place he returned to dreams to help position himself politically in the national therapeutic scene. The 1971 article reprinted in this special issue is evidence of his effort to reach out to psychoanalysts with his new cognitive model. Beck’s dream work, once he allied with behavior therapists, fell out of public view, but the current interest in psychotherapy integration has brought renewed attention to dreams in cognitive therapy.
- Go to article: The Ability to Control One's Thoughts Alleviates the Adverse Effects of Negative Life Events on Depression
The Ability to Control One's Thoughts Alleviates the Adverse Effects of Negative Life Events on Depression
Although negative life events are a risk factor for developing depression, cognitive control can help maintain one's mental health. However, whether thought-control ability (TCA) can alleviate the adverse effects of negative life events on depression is unclear. Therefore, two studies were conducted to test if it does, by having participant's complete measures of negative life events, TCA, and depression. Study 1, which included 140 healthy young adults, showed TCA mediated the relationship between negative life events and depressive symptoms, and that TCA also moderated the relationship between negative life events and depressive symptoms. Study 2 recruited patients with major depressive disorder (MDD) to test whether the findings could be generalized to individuals with MDD. Study 2 found TCA also mediated the relationship between negative life events and symptoms of MDD. Suggesting that improving the ability to control negative thoughts in daily life help maintain mental health and prevent depressive symptoms.
Microaggressions are the reflection of implicit bias toward people with oppressed identities in the way of subtle insults and slights. Microaggressions can be expressed verbally, behaviorally, and environmentally, and due to the ambiguous nature of the microaggressions and the possible power difference between the perpetrator and the target, it is not usually easy to respond to microaggressions. As a minority, disabled people are also targets of microaggressions as a reflection of the ableist worldview. Growing research on ableist microaggressions shows that those daily experiences are linked to lower levels of well-being. Existing in an ableist society, counselors may also commit ableist microaggressions which would impact the counseling outcomes. However, through reflection and accountability, counselors can address those ruptures and help their clients more effectively. Also, counselors can validate their client’s experience of microaggressions and work with them on possible micro-interventions. As possible targets or allies, counselors also can respond to ableist microaggressions to make the invisible visible, educate the perpetrators, or disarm microaggressions that are impacting disabled people daily.
This chapter considers specific abnormal grief reactions that would require grief therapy. It is important to understand why people fail to grieve. The chapter examines the types of abnormal or complicated grief and sees how the clinician can diagnose and determine these cases. Complicated mourning manifests in several forms and has been given different labels. It is sometimes called pathological grief, unresolved grief, complicated grief, chronic grief, prolonged grief, delayed grief, or exaggerated grief. The chapter lists two principal reasons for the continuing dialogue and debate about complicated mourning: financial support for research and reimbursement from third-party payers for treatment. It describes four clinical manifestations of complicated mourning. There are a number of clues to an unresolved grief reaction. The chapter describes 12 clues for identifying complicated mourning.
It is argued that an examination of various abnormal psychology textbooks reveals that they read more like political propaganda than fair, valid science. All of the examined texts conformed closely to the psychiatric medical model as represented by the latest version Diagnostic and Statistical Manual of Mental Disorders (DSM). Occasional critiques were levied at the DSM, but they were invariably dismissed and not debated in any serious manner. All of the texts involved in this study invoked the name of psychiatric critic Thomas Szasz and either dismissed his ideas without adequate representation or stated that he need not be taken seriously because he is too radical or possibly disturbed. All manner of assertions were present in these tomes as to the validity of the biogenic etiology of the disorders discussed without either presenting valid empirical evidence to support the assertions or discussing the rich and varied literature that refutes the biogenic hypotheses. It is concluded that students are not being served by these expensive textbooks and should be exposed to a variety of primary source material representing the many sides of conflict within the mental health field.
- Go to article: Abortion in the Web of Relationship: Negotiating the Abortion Decision Through a Lens of Care
Does the public abortion debate in the United States bear any relation to women’s private discourse about their abortion experiences? In this work—a qualitative study of the abortion narratives of 20 women—I argue that the familiar pro-choice and pro-life frameworks that have dominated public abortion discourse do not begin to provide a suitable forum for the collective expression and understanding of women’s personal abortion stories. By focusing on the conflicting rights of the parties involved, these frameworks leave us poorly equipped to understand how women experience abortion as members of social networks where interdependence and connection are important. While the debate emphasizes conflicting rights, women articulate their experiences with abortion in ways that emphasize relationship, care, and connection to others. By drawing on the work of theorists such as Dorothy Smith, Jean Baker Miller, Carol Gilligan, and Georg Simmel, I illuminate the misappropriation of women’s abortion experience in the public debate, relating this phenomenon to the social-structural context in which it and other exclusions of subordinate groups occur.
- Go to article: About Ethnicity, Fitting In, and Acting Out: Applying the Person–Environment Fit Framework to School Misconduct
About Ethnicity, Fitting In, and Acting Out: Applying the Person–Environment Fit Framework to School Misconduct
Starting from a person–environment fit framework, this study investigates whether ethnic congruence—the percentage of co-ethnics in a school—relates to school misconduct and whether congruence effects differ between ethnic minority and majority students. Moreover, we investigate whether eventual associations are mediated by friendship attachment, perceived teacher support, and general school belonging. Multilevel analyses of data from 11,759 students across 83 Flemish secondary schools show that higher ethnic congruence is associated with lower levels of school misconduct but only for ethnic minority students. This effect was not mediated by friendship attachment, nor by teacher support, but it was mediated by general school belonging. We conclude that ethnic minority students in schools with a higher percentage of peers of co-ethnic descent are less likely to break the school rules because they feel more contented in the school context, which is congruent with the person–environment fit framework.
Many Eye movement desensitization and reprocessing (
EMDR) clients process in a straightforward manner with few direct therapeutic interventions on the part of the clinician. For others, however, processing to completion without any additional interventions is unlikely. The reasons for blocked processing are varied and multifaceted. This chapter explores guidelines for facilitating abreactions, strategies for blocked processing, and applying more proactive interventions for achieving full treatment effect. These interventions are intended to mimic a natural progression toward resolution. Clinicians who are trained in EMDRtherapy are already familiar with many of the strategies particularly the strategies for clients who present with affect regulation difficulties or with complex trauma. Clinical supervision and/or consultation in these cases are always recommended. This chapter explores, three types of client responses—normal, overaccessing, and underaccessing—and strategies the clinician can apply when the client displays either low or high levels of emotions and/or blocked processing.
- Go to article: Absolute and Relative Involvement in Homicide Offending: Contemporary Youth and the Baby Boom Cohorts
Absolute and Relative Involvement in Homicide Offending: Contemporary Youth and the Baby Boom Cohorts
Recent concerns have been expressed that youths are an increasingly violent segment of U.S. society. This report explores such claims by presenting alternative dimensions with which trends in youth violence can be interpreted. Using Uniform Crime Reports and U.S. Bureau of the Census data for 1958-1993, rates of arrests for murder, taken to represent absolute levels of involvement in this form of violence, are analyzed for trends among 15- to 19-year-olds. Relative involvement, operationalized as the ratio of arrest rates for those aged 15-19 to those of the remainder of the population, is also analyzed for trends. A pronounced upward trend since the mid-1980s in both rates and ratios of arrests for murder is found for ages 15-19, resulting in this group now having the highest levels of absolute and relative involvement in murder arrests of any age category, a distinct departure from previous years. As a context for interpreting these levels, the involvement of current 15- to 19-year-olds is shown to exceed by a considerable margin the involvement of similarly aged cohorts of baby boomers, a youth group formerly the object of considerable public concern. Research is encouraged that addresses the multifaceted sources contributing to this dramatic societal shift in age-related patterns of arrests for murder and, by assumption, involvement in homicide offending.
The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.
The Absorption Technique for Children is a protocol that was derived from the work of Arne Hofmann who based his work on an adaptation of “The Wedging Technique”. The absorption technique for children is a resource technique that supports children in creating resources for present issues and future challenges such as dealing with a difficult teacher or handling a disagreement with a classmate and so forth. This chapter uses resource installation for stressful situations. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. The absorption technique, and the constant installation of present orientation and safety (CIPOS) technique, are excellent ways to encourage children to work with eye movement desensitization and reprocessing (EMDR) step-by-step even if they are not prepared to work with the worst issue in the beginning.
This chapter focuses on consideration of two kinds of abuse: abuse that takes place within a church and abuse that takes the place of a church. In the first, the pastor is usually unaware of the abuser, and in the second, the pastor often is the abuser. The spiritual ramifications when trusted religious leaders use people for sexual gratification are enormous. Gartner described how children abused by spiritual leaders can develop a crisis of faith, believing that somehow they have betrayed God. There is also a problem of the heterosexual abuse of children and adults by clergy of all denominations. Psychotherapists can perform preventative and even ameliorative work in churches by meeting with church leadership to help train them in identifying and dealing appropriately with sex abuse in the church. With regard to spirituality and religion, it’s important that the abused person is treated psychologically and also spiritually.
- Go to article: Abused and Rejected: The Link Between Intimate Partner Violence and Parental Alienation
Previous studies have demonstrated a connection between intimate partner violence (IPV) and a child’s alienation from the abused parent, but little is known about the relationships between the type of IPV, aspects, and severity of a child’s alienation, and the target parent’s gender. This study assessed the presence of an IPV history (verbal and physical aspects) among parents who identify as targets of their children’s unreasonable rejection. Also investigated were associations between the form of IPV and manifestations of a child’s alienated behavior, parent’s gender and type of IPV, and parents’ gender and degree of the child’s alienation. Self-identified alienated parents (n = 842) completed an online survey that included an IPV screening measurement (Hurts, Insults, Screams, Threatens screening tool) and a measure of the parent’s perception of their child’s alienated behaviors (Rowlands Parental Alienation Scale). The majority identified as IPV victims and reported a higher level of verbal than physical abuse. More mothers than fathers identified themselves as IPV victims. As a group, IPV victims rated their child as more severely alienated than did non-IPV alienated parents. Mothers were more likely than fathers to report physical aggression by the other parent and more likely than fathers to assess their child’s alienated behaviors as more severe. Victims of physical violence reported their children were less likely to withhold positive affection from them. This knowledge may assist in earlier identification of the alienation process and greater recognition, legitimacy, funding, and opportunities for enhanced collaboration among stakeholders. This, in turn, may lead to improvements in prevention, intervention, and accountability, thus helping to interrupt alienation processes.
- Go to article: Abused Women or Abused Men? An Examination of the Context and Outcomes of Dating Violence
The present study examines the controversial issue of whether women and men are equally abused in dating relationships. Undergraduate and graduate students (n = 874) completed a survey about their experiences and perpetration of psychological, sexual, and physical aggression within dating relationships. To enable a more contextualized understanding of these phenomena, motives for and outcomes of dating violence were also assessed. Women and men reported comparable amounts of overall aggression from dating partners, but differed in the types of violence experienced. Women were more likely to experience sexual victimization, whereas men were more often the victims of psychological aggression; rates of physical violence were similar across genders. Contrary to hypotheses, women were not more likely to use physical violence in self-defense than men. However, although both genders experienced similar amounts of aggressive acts from dating partners, the impact of such violence is more severe for women than men.
Abuse, neglect, and mistreatment in the nursing facility are difficult topics, particularly because there is an expectation that dedicated care is being given to vulnerable frail older adults and those with disabilities. Elder abuse is a deliberate act or failure to act that initiates or creates a risk of harm to an older adult. Abuse can be divided into physical abuse, sexual abuse, domestic abuse, psychological abuse, financial abuse, and neglect. The abuse often occurs at the hands of a caregiver or a person whom the elder trusts. All social workers, along with all other members of the nursing facility team, are generally considered mandated reporters. In all states, licensed social workers are required to report suspected or actual abuse, neglect, or mistreatment. Reporting abuse does not mean that the social worker is liable for its occurrence nor true verification of its occurrence. It is valuable for the social worker to be familiar with the definitions of abuse and to carefully review their facility’s policy defining abuse, neglect, and mistreatment and their particular policy of the mandatory reporting law. Policies can vary from facility to facility, and the social worker should not assume that every facility, even in the same state or region, handles these issues in the same manner.
Dealing with hostile interpersonal relationships at work has been the topic of many popular books and workshops. Yet, with the exception of sexual harassment, there is surprisingly little mention in the organizational research literature on the nature, extent, and costs of abusive work interactions. These more frequent, more tolerated, and, thus, more damaging interpersonal interactions involve hostile verbal and nonverbal nonphysical behaviors directed by one or more persons towards another. The primary aim is to undermine the other to ensure compliance. In this study, we examined the extent to which students experienced nonsexual nonphysical abusive behavior on their jobs, the impact of this experience on job satisfaction, the characteristics of the actor and target, and responses to these behaviors, particularly turnover. The results indicate that although most of the students had very positive interactions at work, exposure to abusive behavior was familiar, was relatively frequent, and had a negative impact on the targets. The actors tended to be bosses and older than the targets. The quality of the interpersonal relationships at work was related to job satisfaction and intention to leave. The implications of these results are discussed with respect to individual, situational, and organizational factors that may be related to the presence and impact of abusive interpersonal interactions. Avenues for research on the nature, extent, and impact of these behaviors at both the individual and organizational levels are identified.
This study adds to the available literature on female-perpetrated intimate abuse by examining Dutton’s (2007) theory of the abusive personality (AP) in a sample of 914 women who had been involved in dating relationships. Consistent with the AP, recalled parental rejection, borderline personality organization (BPO), anger, and trauma symptoms all demonstrated moderate-to-strong relationships with women’s self-reported intimate psychological abuse perpetration. Fearful attachment style demonstrated a weak-to-moderate relationship with psychological abuse perpetration. A potential model for explaining the interrelationships between the elements of the AP was tested using structural equation modeling (SEM). Consistent with the proposed model, recalled parental rejection demonstrated relationships with BPO, trauma symptoms, and fearful attachment. Similarly consistent with the model, trauma symptoms demonstrated a relationship with anger; and BPO demonstrated strong relationships with trauma symptoms, fearful attachment, and anger. Additionally, anger itself had a strong relationship with women’s self-reported perpetration of intimate psychological and physical abuse. Contrary to the proposed model, fearful attachment had a nonsignificant relationship with anger when this relationship was examined using SEM.
As best friends in a small Midwestern town, Jon and Stephen, both extremely bright and inquisitive, often talked with each other about their dreams of jobs they would have as adults. Throughout childhood, made alive through imaginative play, their wide-ranging ideas about careers were inspired largely by television and movie characters. They were enthralled with the idea of “special powers” to save the universe, but soon realized that “superhero” wasn’t a career. A few years later, they considered becoming crime scene investigators, lawyers, emergency room doctors, and, briefly, even astronauts. Jon and Stephen were inseparable and were regarded by the elementary school’s Gifted and Talented (G/T) coordinator as the most academically advanced students in her memory. They loved to learn, had vivid imaginations, and inspired their classmates and each other to “dream big” about the future. They were big fish in a little pond (e.g., Marsh, 1987; Salchegger, 2016).
Then Jon’s family relocated to an affluent suburban neighborhood on the West Coast after his father took a position in Silicon Valley. Jon, in middle school, had to adjust to a new set of expectations and found the adjustment quite challenging—in fact, far more so than he had imagined. Surrounded by a large group of intense and extremely driven students, who all seemed to aspire to top-tier universities, and struck by the harsh realization that he was no longer one of the very best students, Jon now felt as if he were a fish out of water. He was plagued with self-doubt about his abilities and future educational and career prospects. Compared to the other students, who had long positioned themselves to earn coveted spots in the local
STEM-oriented magnet high school, Jon felt inadequately prepared to compete and felt his excitement for learning fading quickly. Once a confident and enthusiastic student, Jon was immobilized by his fear of making mistakes, especially in the presence of his new peers, and he began to retreat from others both at school and at home. He had difficulty dealing with even minor setbacks and grew to resent the students who seemed ambitious and competitive. Adopting a defensive posture, Jon downplayed the importance of thinking about future goals; in his own words, it was “stupid” to worry too much about college and career. Although he generally maintained respectable grades (mainly to make his parents happy and to keep their anxieties at bay), he refused to take the most challenging courses at school and stopped taking academic risks. Since he was getting mostly As and Bs and an occasional C on his report card, Jon’s parents were not alarmed by the changes in his behavior and failed to notice that he had turned away from learning. His academic self-concept had taken a major hit.
In contrast to Jon, Stephen remained in the same small Midwestern school district for the remainder of his precollege years and continued to feel passionate—about everything! Stephen’s parents encouraged him to indulge his intellectual curiosity and explore every subject that captured his interest. But Stephen had difficulty narrowing his interests for the sake of establishing career direction. When he was first exposed to chemistry, for instance, he quickly memorized the periodic table and spent many nights at the dinner table teaching his younger brother everything he had learned about each element. Later, when introduced to physics, he could hardly contain his excitement about quantum field theory, cosmic inflation, fluid dynamics, and a host of other topics. Of course, he also loved math and was eager to learn computer languages. Adept not only in
STEMsubjects, Stephen also excelled in and enjoyed writing, history, and politics. However, because the school district was small and lacked resources, he often learned advanced content on his own by reading books and searching the Internet. The local public high school he attended offered few Advanced Placement ( AP) courses, and school officials believed they could not justify offering additional APcourses just for him. Without his friend Jon, he had no intellectual peer with whom he could share ideas and interact meaningfully. As his precollege years progressed, Stephen did not gain sufficient clarity about educational and career direction to focus his efforts on developing any particular interest to a high level outside of the classroom.
The study of men’s violence against their intimate partners is segregated from the study of other forms of violence. Comparing intimate partner violence (IPV) to other violence, however, allows one to examine whether the motivation and the legal response are similar. I examine whether men’s assaults on partners are particularly likely to have a control motive, whether women’s assaults on partners are particularly likely to be motivated by self-defense, and whether intimate partner violence is less likely to be reported to the police and legally sanctioned. The evidence casts doubt on the feminist approach, which has dominated the study of IPV. I suggest that a theory of instrumental violence provides a better understanding of IPV. Such an approach recognizes a variety of motives and emphasizes the role of conflict in intimate relationships, sex differences in strength and violence, and the importance of chivalry. Finally, I suggest that social scientists who study IPV should be more careful in their descriptive terminology.
The process of learning academic skills is more difficult for some students than others. It is the responsibility of school psychologists to identify those students who might struggle in the absence of additional assistance from school personnel, as well as to identify what type of assistance students need. By effectively implementing a multitiered system of supports (
MTSS), school psychologists can objectively evaluate the quality of instruction provided to all students, identify students who need intervention, and evaluate whether intervention is sufficient. This chapter describes the importance of considering the environment in which learning is occurring, measures that can be used to assess group and individual response to tiers of instruction, and factors to consider in developing interventions that meet individual students’ instructional needs. The importance of promoting equity and social justice when selecting and interpreting assessment instruments and interventions is also discussed.
- Go to article: Academic Literacy and Cognitive Processing: Effects on the Examination Outcomes of Speech-Language Pathology Students at a South African University
Academic Literacy and Cognitive Processing: Effects on the Examination Outcomes of Speech-Language Pathology Students at a South African University
This study was conducted in the South African context, where education is in a state of transition. One of the central issues in higher education is the development of academic literacy. However, as a result of an inadequate focus on educational linguistics and a lack of explicit instruction in academic literacy, many students do not achieve their full potential. This study focuses on aspects of academic literacy in the examination responses of a group of students studying in the discipline of speech-language pathology. The purpose of the study was to determine whether or not there is a relationship between the students’ academic literacy skills and their ability to answer examination questions. By means of an exploratory retrospective longitudinal record review, the examination scripts of 20 students were rated for evidence of various academic literacy skills. The ratings were highly correlated to the actual examination marks in both years of study, suggesting that there is a need to incorporate explicit instruction in academic literacy to develop students’ metacognitive processes while reading and writing for academic purposes.
- Go to article: Academic–Practice Partnership: Benefits of Collaboration Between Service and Academia
Academic–practice partnerships are fundamental to advance nursing excellence and human caring, and improve safety and quality outcomes. Collaborative strategies were formed between two organizations in Southern California. In alignment with both organization’s mission of diversity, equity, and inclusion, this joint effort benefits the community at large including elevating clinical experiences, leadership opportunities, shared programming, and professional development. This mutual partnership interprofessional investment led to the formation of several faculty/service nursing development consortiums resulting in increased commitment to attain higher academic achievements, pursue scholarly work, and improve the human condition.
This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.
- Go to article: Acceptability of a Cognitive Behavior Therapy Intervention to Implantable Cardioverter Defibrillator Recipients
Acceptability of a Cognitive Behavior Therapy Intervention to Implantable Cardioverter Defibrillator Recipients
We aimed to assess cardiac patients, acceptance of cognitive behavior therapy (CBT); determine if gender was associated with treatment engagement (session attendance and utilization of intervention strategies); and relate engagement to outcome. Of 193 patients receiving an implantable cardioverter defibrillator (ICD) who agreed to participate in a randomized controlled trial, 96 were randomized to CBT. Measures of treatment acceptance indicated that most participants rated counseling as “very to extremely helpful.” Gender was associated with only one treatment engagement index. Symptoms of depression and post-traumatic stress improved from baseline to 6- and 12-month follow-up. Number of counseling session attendance was not associated with outcome. Reported utilization of two of the six CBT strategies (modifying faulty thinking, correcting cognitive distortions) was associated with a better treatment outcome. In conclusion, a CBT intervention was well received by ICD patients. There was some indication that treatment engagement related to better treatment outcomes.
- Go to article: Acceptability of a Stage-Matched Expert System Intervention for Domestic Violence Offenders
Most interventions for men who batter are standardized and “one-size-fits-all,” neglecting individual differences in readiness to change. A multimedia expert system intervention based on the transtheoretical model (the “stage model”) was developed as an adjunct to traditional court-mandated programs. The expert system assesses stage of change, decisional balance, self-efficacy, and processes of change and provides immediate individualized stage-matched feedback designed to increase readiness to end the violence. Fifty-eight male batterer intervention program clients were invited by agency staff to complete an expert system session and an evaluation of the program; 33 men were recruited at program intake and the remainder from ongoing groups. Responses to the intervention were very positive. For example, 87% of participants reported that they found the program to be easy to use, and 98% said it could probably or definitely help them change their attitudes or behaviors. Findings provide encouraging evidence of the acceptability of this stage-matched approach to intervention for domestic violence offenders.
In recent years, the rural hospital closure crisis has escalated with 2015 closure rates six times higher than in 2010. The National Rural Health Association (2020) reported that currently one in three rural hospitals may be at risk of closure. Much of the blame for closures has long been attributed to factors external to rural communities, such as reduced Medicare reimbursement, a declining rural economy, provider shortages, and being located in states that did not expand Medicaid under the Affordable Care Act. Improving equity in access to care has been an ongoing concern throughout most of the past half century, and rural access to care has been a particularly persistent problem. Improving equity in access to care has been an ongoing concern throughout most of the past half century, and rural access to care has been a particularly persistent problem. This chapter focuses on the Acceptability Scale.
Acceptance and commitment therapy (ACT) is a behavioral intervention designed to increase and improve psychological flexibility. Psychological flexibility, from the ACT perspective, is defined as contacting the present moment fully, as a conscious human being, experiencing what is there to be experienced and working to change behavior such that it is in the service of chosen values. The therapeutic work explored in ACT counters the problem solving approach. Clients are taught to be aware of their thoughts and emotional experiences. An important feature of the therapy is that the therapist approaches these issues with humility and compassion for the client’s experience. Many clients who have experienced military sexual trauma (
MST) have limited their lives in a number of ways in an effort to control or prevent fear or fear-related experiences such as anxiety or difficult memories.Source:
This chapter explores the key concepts, tools, and strategies for coaching people toward improved health, well-being, and performance using Acceptance and Commitment coaching (AC coaching), a holistic and multi-component coaching version of Acceptance and Commitment Therapy (ACT). AC coaching is a pragmatic form of coaching, underpinned by functional contextualism and relational frame theory. The chapter introduces the ramp model of AC coaching, emphasizing the need for clients to expend effort and take the time to practice (both within and between sessions), and to develop and regularly apply the skills that enable psychological flexibility and improved health, well-being, functioning, quality of life, and flourishing. Coaching theory and practice revolve around helping motivate clients to achieve their values-based goals and live purposeful lives. Coaching theory assumes that clients are whole, functioning people who are looking to improve their lives.
Partner aggression is a major public health concern. Batterers’ intervention programs (BIPs) are commonly used as an alternative to incarceration for offenders who have been arrested for domestic assault. Historically, BIPs have shown little effectiveness in reducing partner aggression. This article presents a new BIP based on acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999). ACT is a third-wave therapy that builds on the cognitive-behavioral tradition, focusing on increasing psychological flexibility by promoting acceptance and mindfulness processes. Several lines of evidence support the use of ACT in the treatment of partner aggression. Achieving Change Through Values-Based Behavior (ACTV; Lawrence, Langer Zarling, & Orengo-Aguayo, 2014) was developed based on ACT principles with a specific focus on feasibility and transferability to the community correctional setting and court-adjudicated treatment. ACTV incorporates experiential skills training and uses innovative methods to engage participants and teach the ACT processes. This article details the components of ACTV, including a case study to illustrate one participant’s journey through the program. We also present preliminary pilot data, which look promising with respect to reductions in domestic assault and violent recidivism.
- Go to article: Acceptance and Commitment Therapy: A Systematic Literature Review of Prevention and Intervention Programs for Mental Health Difficulties in Children and Young People
Acceptance and Commitment Therapy: A Systematic Literature Review of Prevention and Intervention Programs for Mental Health Difficulties in Children and Young People
Acceptance and commitment therapy (ACT) is increasingly being used to treat mental health difficulties, however there is a paucity of reviews concerning ACT with children.
To examine the literature about ACT interventions for child and adolescent mental well-being.
Searches for articles reporting on ACT interventions to prevent/reduce child mental health difficulties were undertaken. Methodological quality was assessed and a narrative synthesis was used to summarize findings about mental health symptoms and psychological flexibility.
Ten articles were identified focusing on prevention and intervention for anxiety, depression, obsessive compulsive disorder, anorexia nervosa, and trichotillomania. Most studies found that mental health symptoms reduced following an ACT intervention and psychological flexibility increased. However, findings indicate that other active interventions also led to the same changes.
ACT is a promising intervention for adolescent mental health, although further research is needed to establish whether reductions in mental health symptoms are due to an increase in psychological flexibility.
- Go to article: Acceptance and Commitment Therapy for People Experiencing Appearance-Related Distress Associated With a Visible Difference: A Rationale and Review of Relevant Research
Acceptance and Commitment Therapy for People Experiencing Appearance-Related Distress Associated With a Visible Difference: A Rationale and Review of Relevant Research
People may have a visibly different appearance due to various causes, such as congenital conditions, injury, disease, or medical treatment. Some individuals with a visible difference experience social anxiety and isolation, body image dissatisfaction, shame and self-stigma, psychological trauma, and challenges managing their condition. In this article, we synthesize the relevant literature and present the theoretical rationale for the application of Acceptance and Commitment Therapy (ACT), a third-wave behavioral therapy combining mindfulness skills and value-driven action, to those experiencing distress relating to an unusual or altered appearance. We also outline how ACT may be tailored to the specific considerations of this population and recommend next steps in researching its acceptability and clinical effectiveness.
- Go to article: Acceptance-Based Behavioral Therapy: Treating Anxiety and Related Challenges. Lizabeth Roemer and Susan M. Orsillo. The Guilford Press, 2020, 318 pages.
- Go to article: Access to Information About Harm and Safety in Contamination-Related Obsessive-Compulsive Disorder
The present study examined the accessibility of harm and safety information regarding threat-relevant and threat-irrelevant stimuli in analogue contamination-related obsessive-compulsive disorder (OCD) participants. High OCD participants (N = 24) and low OCD participants (N = 27) generated lists of reasons why four specific situations (using a public restroom, going cliff diving, reading at the library, going to the museum) might be harmful and why they might be safe. Results revealed that, in comparison to the low OCD participants, high OCD participants were able to generate significantly more items on why using a public restroom might be harmful and significantly fewer items on why using a public restroom might be safe. However, no significant differences were found between the two groups in their ability to generate items regarding harm and safety for other situations. Furthermore, number of safety items predicted contamination group status independent of harm items. Content analysis of the harm items generated for using a public restroom revealed concerns primarily related to contagion and disease. Accordingly, the number of items generated for using a public restroom showed a marginal association with disgust levels. The implications of these findings for understanding cognitive biases underlying contamination-related OCD are discussed.
This chapter provides an overview of didactic and clinical accommodations, including information on accommodating the various forms of assessment that are used in health science programs. It offers specific guidance with regard to accommodating overnight call, students with color-vision deficiency, autism spectrum disorders, blood-borne diseases and those who are deaf and hard-of-hearing. A section on the inclusion of service animals helps programs develop appropriate protocols for animals that may be entering the clinic. Throughout the chapter, practice examples afford the reader an opportunity to apply the guidance to real student scenarios, while case examples provide a legal framework for determining reasonable clinical accommodations. Determining accommodations is an interactive process between the student and the disability resource professional (
DRP) or responsible campus entity. The chapter helps DRPsand institutions understand how to work collaboratively to determine and implement reasonable accommodations in all types of health science education settings.
This chapter discusses the need for organizational transparency and accountability. Social work leaders and managers have a responsibility to clients, as well as various regulatory systems, to ensure that programs are operating ethically and legally. It is imperative that social work leaders and managers have a comprehensive understanding of the various regulations that guide daily functions and develop judicious habits that safeguard clients, employees, and the organization from manifold risks. Various committees can be developed to oversee compliance with a number of regulations, including financial regulations, safety, and overall risk prevention aims, along with policies and procedures outlined as organizational expectations. Organizational expectations offer the foundation for organizational and programmatic goals to be established. Finally, the chapter briefly revisits the concept of mentoring or grooming staff for the purpose of succession planning and dismantle some of the processes inherent to succession planning.
For the rehabilitation industry, it is suggested that a rehabilitation-focused accreditation quality model is the best fit as a quality framework for advancing the performance of organizations that provide medical rehabilitation services. In an era where health care expenditures are so significant, value-based rehabilitation in a pay-for-performance environment may be the only way to competitively lower care costs, improve care quality, and drive better patient outcomes. The accreditation model provides the blueprint to cost containment through outcomes. To understand and appreciate the value of accreditation for medical rehabilitation as a quality framework, it is important that accreditation be considered within its evolutionary context in relation to the dynamics of the broader health care industry. Accreditation as a quality framework was constructed by the rehabilitation industry in response to environmental pressures to demonstrate a commitment to quality.
- Go to article: Acculturation, Gender Stereotypes, and Attitudes About Dating Violence Among Latino Youth
This study examined the relationship between personal characteristics (gender, acculturation, belief in gender stereotypes, recent dating experiences), and attitudes and knowledge about dating violence in urban Latino youth (N = 678). All participants completed self-administered surveys at school. Relative to girls, boys held more problematic (proviolence) attitudes about dating violence and reported less knowledge about dating violence and its consequences. Teens who were more traditional (less acculturated), those who endorsed gender stereotypes, and those who reported recent fearful dating experiences tended to report less knowledge about abuse and lower endorsement of nonviolent attitudes. Multivariate analyses revealed that all four personal variables predicted dating violence knowledge. By contrast, attitudes were predicted by endorsement of gender stereotypes only, or gender stereotypes and gender. Implications for dating violence interventions and future directions for research are explored.
- Go to article: Achievement Goals in Students With Learning Disabilities, Emotional or Behavioral Disorders, and Low IQ Without Special Educational Needs
Achievement Goals in Students With Learning Disabilities, Emotional or Behavioral Disorders, and Low IQ Without Special Educational Needs
This study focuses on the goal orientations of students with and without special educational needs (SEN). The sample (mean age 13 years, 10 months) was composed of 37 students with low IQ, but without SEN; 37 students who were diagnosed as having learning disability (LD); and 37 students having emotional or behavioral disorders (ED). The groups were matched by IQ and gender. The results showed that students without SEN scored significantly higher in mastery goal orientation, significantly lower in performance-avoidance orientation, and had a lower work-avoidance orientation than students with LD or ED. Students with ED showed a significantly lower performance-approach orientation than students without SEN and students with LD. Results from correlational and regression analyses showed that SEN is always an explaining variable for goal orientation and that group differences cannot be explained by IQ, gender, actual achievement, self-estimation of achievement, and school anxiety.
This article describes an educational innovation whereby two independent, neighboring schools of nursing developed a cooperative program with each school teaching half the courses in an accelerated baccalaureate nursing program for second career students. The model was designed to increase enrollment and share faculty resources, thereby addressing the nursing shortage. The new curriculum was built on the caring framework and philosophies of each institution and then melded to create more than the sum of its parts. Lessons learned describe challenges encountered and solutions found. Finally, thought is given to the future evolution of a program dedicated to compassionate excellence.
- Go to chapter: Achieving the Quadruple Aim in Healthcare With Evidence-Based Practice: A Necessary Leadership Strategy for Improving Quality, Safety, Patient Outcomes, and Cost Reductions
Achieving the Quadruple Aim in Healthcare With Evidence-Based Practice: A Necessary Leadership Strategy for Improving Quality, Safety, Patient Outcomes, and Cost Reductions
Evidence-based practice (
EBP) is a seven-step problem-solving approach to the delivery of healthcare that integrates the best evidence from well-designed studies with a clinician’s expertise and the values/preferences of the patient/family. This chapter discusses the importance of EBPin achieving the quadruple aim in healthcare, describes the current state of EBPin healthcare, including EBPcompetencies, identifies the barriers and facilitators of EBP, and discusses the key leadership strategies to ignite and sustain EBPin healthcare. It briefly describes EBPcompetencies for practicing registered nurses and advanced practice nurses in real-world clinical settings. Leaders must first understand that EBPis the direct pathway to achieve the quadruple aim in healthcare and be willing to invest in it knowing that healthcare quality and safety will be enhanced, population health outcomes will improve, healthcare costs will diminish, and clinician job satisfaction will increase as EBPdiffuses throughout the organization.
This book is a clinically relevant reference guide for health care trainees, medical providers, and active allied health professionals who work with patients and clients suffering from all aspects of insults to the brain. Not limited to traumatic brain injuries, the book provides easy-to-follow formatting by providing information involving all aspects of acquired injuries to the brain and related clinical outcomes. Each chapter provides an overview of a subtype of brain injury, accompanied by history, pathophysiology, etiology, epidemiology, clinical presentation, other diagnostic considerations, treatment, prognosis, and clinical synopsis. Stroke is an enormous public health problem as it is one of the leading causes of both death and disability worldwide. Stroke symptoms, with very few exceptions, begin with the sudden onset of focal neurological deficits, which are confined to a vascular territory. Treatment of stroke can generally be divided into three categories: acute stroke management, rehabilitation, and secondary stroke prevention. Acquired brain injury (ABI), at any age, is a significant public health concern. It is particularly problematic in the elderly considering the increased rates of mortality and morbidity following ABI in this population. Optimal rehabilitation of ABI requires a multidisciplinary approach of trained rehabilitation specialists at appropriate timing and with appropriate intensity. Brain injury rehabilitation requires a comprehensive treatment program to reduce impairments and to restore function, participation, and quality of life. Useful case studies are also provided for most conditions described in the book.
Traumatic brain injury (TBI) causes two injury types: primary and secondary. In infants and young children, nonaccidental TBI is an important etiology of brain injury and is commonly a repetitive insult. TBI is by far the most common cause of acquired brain injury (ABI) in children and is the most common cause of death in cases of childhood injury. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) issued validated prediction rules to identify children at very low risk of clinically important TBI, which is defined as TBI requiring neurosurgical intervention or leading to death. The range of outcomes in pediatric TBI is very broad, from full recovery to severe physical and/or intellectual disabilities. Children and adolescents who have suffered a TBI are at increased risk of social dysfunction. Studies show that these patients can have poor self-esteem, loneliness, maladjustment, reduced emotional control, and aggressive or antisocial behavior.
Acquired brain injury (ABI), at any age, is a significant public health concern. It is particularly problematic in the elderly considering the increased rates of mortality and morbidity following ABI in this population. The aging brain demonstrates changes in the synthesis of key neurotransmitter, including dopamine and serotonin, and other chemicals important to brain health, such as brain-derived neurotrophic factors (BDNF). Formal diagnosis of various ABI causes may be relatively simple when given proper history and diagnostic tools. Prognosis following ABI is largely dependent on the etiology and the severity of injury and lesion location in the brain. Microvascular changes in the aging brain lead to attenuated cerebral blood flow, reduced vascularization of brain parenchyma, and increased cerebrovascular risk. Prevention of TBI for older adults should include behavioral and environmental adjustments to reduce fall risk.
This chapter explains paradigms of neurorehabilitation and explores the interdisciplinary and transdisciplinary nature of brain injury rehabilitation. Optimal rehabilitation of acquired brain injury (ABI) requires a multidisciplinary approach of trained rehabilitation specialists at appropriate timing and with appropriate intensity. Brain injury rehabilitation requires a comprehensive treatment program to reduce impairments and to restore function, participation and quality of life. Vocational rehabilitation specialist assesses an individual’s functional level and vocational potentials. Guiding principles for rehabilitation include all areas of therapy, namely, physical, occupational, cognitive, and speech-language therapy. Early functional rehabilitation in poststroke and traumatic brain injury (TBI) patients has been shown to improve functional outcomes and may decrease “learned nonuse.” Neurorehabilitation in the context of ABI continues to be a demanding challenge, which requires clinical translational approaches involving a multidisciplinary team.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies 10 separate classes of substances related to significant substance abuse concerns. Of the 10 separate substance classes, four have more clearly documented patterns of pathophysiological sequelae and demonstrated impact on cognitive functioning. These substance categories include alcohol, inhalants, sedatives/hypnotics/anxiolytics, and stimulants. The remaining six substance clusters include caffeine, cannabis, opioids, hallucinogens, tobacco, and other or unknown substances. This chapter discusses the specific impact of each of these separate classes of drugs and related acquired brain injury on cognitive and emotional functioning. The clinical presentation associated with acquired brain injury related to substance use/misuse is variable. Most importantly, the patient will need to gradually reduce his benzodiazepine use so as not to facilitate “rebound anxiety.” Consideration should be given to anxiolytic medications that are not benzodiazepines, as well as to cognitive behavioral therapy, potentially including interceptive exposure.
- Go to chapter: ACT-AS-IF and ARCHITECTS Approaches to EMDR Treatment of Dissociative Identity Disorder (DID)
This chapter describes key steps, with scripts, for the phases of therapy with a dissociative identity disorder (DID) client, and for an eye movement desensitization and reprocessing (EMDR) session with a DID client. In brief, the method employs the artful use of EMDR and ego state therapy for association and acceleration, and of hypnosis, imagery, and ego state therapy for distancing and deceleration within the context of a trusting therapeutic relationship. It is also endeavoring to stay close to the treatment guidelines as promulgated by the International Society for the Study of Trauma and Dissociation. The acronym ACT-AS-IF describes the phases of therapy; the acronym ARCHITECTS describes the steps in an EMDR intervention. Dual attention awareness is key in part because it keeps the ventral vagal nervous system engaged sufficiently to empower the client to sustain the painful processing of dorsal vagal states and sympathetic arousal states.
This chapter explains the process of solution focused narrative therapy (SFNT) and offers suggestions for the therapist’s use of conversational questioning. SFNT therapy comprises six steps: best hopes, mapping the effects of the problem, constructing the preferred story, exception gathering, preparing the presentation of the preferred future and moving up the scale, and summarizing and inviting clients to watch for success. The most important step is beginning therapy. The therapist begins the session by introducing himself, learning the names of those attending, and asking the same question of all present. The chapter also presents an exercise, which may help to identify traits, values, and actions that help readers present their best self to their clients, particularly clients that are challenging.