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.

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.

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.

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 EMDR therapy 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.

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.

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.

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 STEM subjects, 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 AP courses 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.

One of the primary functions of the K–12 education system is to prepare children to be ready for college or a career. Central to college and career readiness is students’ proficiency in three key academic skill areas: reading, writing, and mathematics. Given the importance of academic skills, a core skill for school psychologists is the ability to collect and use assessment data that inform an intervention targeting students’ academic skills. This chapter introduces readers to the importance of evaluating the environment in which a student is receiving instruction, assessment instruments used within schools for identifying and monitoring the progress of students with academic intervention needs, and the three tiers of multi-tiered system of support (MTSS). This chapter reviews the essential components of academic assessment and intervention as well as couches them within a MTSS. It describes the relevance of social justice in implementing academic MTSS.

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.

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.

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.

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 DRPs and 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.

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.

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.

Action Research (AR) is a “form of collective, self-reflective enquiry undertaken by participants in social situations in order to improve the rationality, coherence, adequacy or justice of their own social or educational practices, as well as the understanding of these practices and the situations in which these practices are carried out”. AR is a rich methodology and is a powerful approach for counselors to consider while improving their personal lives, counseling practice, and work with communities. This chapter introduces counselors to historical influences, key concepts, and essential approaches to AR. It discusses various approaches to inquiry in AR including first, second and third person approaches, participatory AR, and practitioner AR. First-person inquiry is a uniquely reflective process of inquiry. Through first-person inquiry one can develop their personal lives or professional practice through cycles of reflection, action, and evaluation.

This chapter introduces readers to the Active Client Engagement (ACE) model, which includes acquiring information, creating a context for collaboration, and evocation of clients’ strengths and resources. As with the strengths-based principles, each facet of ACE works in concert with and is dependent on the others. Together the three components assist with creating a focus in therapy and strengthening the therapeutic alliance. Additionally, the three aspects of ACE are interventive. The chapter introduces methods for gathering client information and using routine outcome monitoring (ROM). An additional part of this chapter involves ways to match clients’ communication styles. The chapter examines two different processes for gathering information: (a) routine outcome monitoring (ROM) in practice (including feedback-informed treatment [FIT]) and (b) interviewing for strengths. The processes are meant to make early contacts and what follows treatment-wise seamless.