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.

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.

This chapter explores the unfolding of the phases of EMDR therapy as children go through developmental stages. Infants, toddlers, and preschoolers may express significant variation simply because of developmental processes and achievements. The chapter summarizes adaptations that may be helpful to consider through each phase of child development as the client and therapist simultaneously move through the phases of EMDR therapy. Mentalizing in parent-child relationships is a co-occurring theoretical and clinical intervention that is included through all the phases of EMDR therapy. With infants, toddlers, and preschoolers, the history taking, case conceptualization, and treatment planning are integrated with the goals of the preparation phase. Young children are often brought to therapy by parents who are concerned about clinical, emotional, behavioral, regulatory, and situational issues. Therapists and parents are active participants in the child’s therapy. Alternating bilateral stimulation can be taught in many ways using toys.

This chapter discusses the modifications of using Eye Movement Desensitization and Reprocessing (EMDR) therapy with preteens and adolescents while staying true to the eight phases. The difference between employing EMDR therapy with adults versus preteens and teens lies primarily in history taking, preparation, pacing of the phases, the therapist’s attunement to the client, and the therapeutic relationship. Many of the clinical decisions and procedural considerations for working with preteens and adolescents occur within the first two phases: the History Taking, Case Conceptualization, and Treatment Planning Phase and the Preparation Phase. In order to guide the EMDR therapy process, gathering a thorough history from both the client and caregiver is necessary. Exploring the client’s positive relationships, including favorite teachers, coaches, and beloved family members, can be used as resources and cognitive interweaves (CI) during EMDR therapy. Pacing refers to the timing of when to apply the various phases of EMDR therapy.

Alcohol and other drugs (AOD)/substance use on college campuses has been an ongoing challenge for campus administrations, health services and health promotion, housing, and counseling centers. The misuse of substances by college students has a significant physiological, emotional, economic, and academic cost. Students are frequently unaware of the impact marijuana use may have on academic performance and motivation. Brief intervention (BI) and treatment have been shown to be effective treatment modalities at reducing high-risk substance abuse behaviors. Counseling centers may consider allowing for at least one session of motivational interviewing to increase the likelihood of clients following through on referrals to comprehensive substance use assessment, self-help groups, or treatment. Counseling center staff, even those with limited AOD treatment experience, can feel empowered to use the screening, brief intervention, referral to treatment (SBIRT) model. Group therapy is one of the most widely used treatment modalities for substance use.

This chapter presents an overview of intrapsychic theories, cognitive theories, behavioral and environmental theories, biological theories, and integrative theories. Past ideas about the nature of adolescent development serve as foundations for current adolescent developmental theories. In many ways, the adolescent years are the culmination of childhood; hence, in order to truly understand adolescence a review of what happens in the years leading up to adolescence can help clarify the nature of adolescents. Although the early biological process of puberty begins to develop several years before adolescence, in Freud’s theory puberty and adolescence are considered roughly equivalent. Adolescents experience a reawakening of and an obsession with sexuality. Studies indicate that occurrences of eating disorders, obsessive-compulsive patterns, and self-reports of same-sex attraction surface during the adolescent years as a result of the reawakening of the underlying subconscious conflicts.

Many clinicians and researchers who work with adolescents classify the adolescent problems into two general categories of difficulties: externalizing problems and internalizing problems. Externalizing problems are difficulties that affect the external world of adolescents, such as drug abuse, delinquency, and engaging in risky behaviors. The adolescent who is abusing drugs is likely to also be engaged in risky sexual behaviors and delinquency. The discovery of and experimentation with drugs are common for adolescents and vary primarily from socially acceptable and legal drugs such as caffeine, cigarettes, and alcohol to socially rejected and illegal drugs, ranging from marijuana to heroin and cocaine. Unfortunately, adolescents often do not think that drug abuse is harmful, despite the fact that both alcohol consumption and marijuana use have short-term and long-term negative effects. However, sexuality during adolescence has the potential to become a serious health concern.

This chapter provides therapists with tools for teaching children advanced affect management skills. The goal for teaching children resourcing, coping skills, enhancing mastery experiences is to assist the child in creating his/her own toolbox of skills to be used in therapy and in daily life for more advanced coping. Therapists can begin by teaching the child about relaxation and then explore with the child current methods that the child already uses to relax. With guided imagery, the child is asked to choose a comfortable place to sit in the office and select a real or imaginary favorite place where the child feels most comfortable. In addition to breathing, guided imagery, progressive muscle relaxation, children can be taught other ways to help calm themselves. If the child becomes overwhelmed by affect, the child is likely to attribute the discomfort to the eye movement desensitization reprocessing (EMDR) therapy and the therapeutic process.

This chapter presents several strategies, analogies, and metaphors to address dissociation from different angles and perspectives. Clinicians will have a wide range of methods of introducing and explaining dissociation to children. Analogies and stories that help children understand the multiplicity of the self may be presented during the preparation phase of eye movement desensitization and reprocessing (EMDR) therapy. A good way of introducing the concept of dissociation is by using the dissociation kit for kids. Stimulating interoceptive awareness is a fundamental aspect of the work needed during the preparation phase of EMDR therapy with dissociative children. Visceral, proprioceptive, as well as kinesthetic-muscle awareness should be stimulated. The installation of present resolution (IPR) was inspired by an exercise developed by Steele and Raider. In this exercise, the child is asked to draw a picture of the past traumatic event followed by a picture of the child in the present.

This chapter addresses gender and identity issues in PK–12 education, including gender fluidity, students who identify as transgender and the transitioning process, students who identify as LGBTQ+, and general school-based advocacy and safety issues. This chapter offers ways to create safe and affirming spaces for LGBTQ+ students in schools. It serves as a foundation for seeking more knowledge to best serve these affinity groups. Scholarly support and practitioner recommendations for school-based support including student-led groups, staff training, parent education, and safe school culture curriculum are presented.

Tosha and Erik are the two school counselors in a large suburban elementary school. For 5 years, they have worked to create a school counseling program aligned with their state’s framework, which was developed with the ASCA National Model in mind. This year, they are hosting a school counseling intern, Tony, from a program in the school of education at a local university. Although the school counselors are grateful to have an intern with fresh eyes and new ideas, they wonder whether the supervision will require too much time and divert their attention from the report they must write prior to a visit by the state department of education later in the year. At the initial interview, Tosha and Erik learn that because Tony had already had several education classes, his program advisor suggested that he take some electives in areas of interest. During his student-teaching experience, he had been intrigued by creative and artistic students and therefore opted to take a few courses in gifted education. He is excited to be working with Tosha and Eric and wants to know if he might work with gifted students and find out how the gifted-education program is currently serving them.

Alzheimer’s disease (AD) presents one of the most urgent health care issues of our time. AD is a disease of the brain and mind, and as such, neuropsychology has an essential and evolving role to play in addressing this growing public health concern. Measurement of key cognitive functions, such as delayed recall of recently presented information, is crucial in the diagnosis and monitoring of the disease. In addition to the importance of advancing scientifically informed disease-specific measurement of cognition, neuropsychology has a growing role to play in the design and implementation of nonpharmacological interventions for AD. The neuropathological hallmarks of AD are senile plaques (SP), neurofibrillary tangles (NFTs), and cell and synapse loss in multiple brain areas. Granulovacuolar degeneration (GVD) has long been recognized to be present in the brains of AD patients.

This chapter helps the reader to understand the history of the Americans with Disabilities Act (ADA), specific components of the ADA and how the ADA provides resources to older adults and people with disabilities. The ADA, while groundbreaking, was not initially intended for people with disabilities rather than for older adults. As time progressed, however, the benefits of the ADA were much more far-reaching than originally intended, especially for aging adults with disabilities. The individual titles of the ADA have had some dramatically positive and specific impact for older adults wishing to remain in their homes or in their communities as long as possible. Although the ADA is still in its young adulthood, the benefits of the ADA have only grown as new and further linkages, such as the ADRCs, have developed in all regions of the United States.

Meeting academic demands, getting along with roommates, dealing with new social pressures, questioning career choices, managing finances, and other new responsibilities of the college experience can give rise to unexpected and undesired stress and anxiety. While event-related stress does not cause anxiety disorders on its own, it can worsen symptoms of a preexisting anxiety disorder or trigger an anxiety disorder in someone who may be predisposed. The symptoms of anxiety disorders generally involve disturbances in mood, thinking, and behavior. This chapter assesses the different classifications of anxiety disorders. Types of anxiety disorder includes generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and specific phobias. The chapter evaluates effective treatment and intervention strategies for college student population. Among other psychotherapy approaches, cognitive-behavioral therapy (CBT), relaxation therapy (RT), and mindfulness-based stress reduction (MBSR) have received considerable empirical support in the treatment of anxiety disorders.

The chapter will serve as an overview of the ASCA National Model and provide a clear connection with the translation from an aspirational ideal of school counseling to the reality of school counseling practice. The four main components of the National Model will be presented, including define, manage, deliver, and assess. This chapter will address and provide examples as to how these components are often offered in current models of PK–12 education—both in brick-and-mortar schools and online academies.

International Society for the Study of Trauma and Dissociation (ISSTD)’s professional training institute offers comprehensive courses on childhood dissociation that are taught internationally and online. This chapter briefly cites some of the theories that have emerged in the dissociative field. One system, the apparently normal personality (ANP) enables an individual to perform necessary functions, such as work. The emotional personality (EP) is action system fixated at the time of the trauma to defend from threats. As with the Adaptive Information Processing Model (AIP) in eye movement desensitization and reprocessing (EMDR), each phase brings reassessment of the client’s ability to move forward to effectively process trauma. There are many overlapping symptoms with Attention Deficit Hyperactive Disorder (ADHD) and dissociation that often mask the dissociation. The rate of diagnosis of pediatric bipolar disorder has increased 40 times in the last ten years.

Assessing fidelity or adherence to the phases of Eye Movement Desensitization Reprocessing (EMDR) therapy is important for a variety of reasons, both for clinical purposes and for research purposes. Treating therapists need to assess fidelity in clinical practice in order to ensure that the therapist is using all eight phases of EMDR therapy without omitting important words, procedural steps, or phases of the treatment. By using a Fidelity Questionnaire, the therapist can monitor his or her own adherence to the phases in order to improve practice and prevent therapist drift. In spite of the positive treatment outcomes reported in the studies of EMDR therapy with adult clients, methodological concerns have contributed to a mixed response to the assessment of the efficacy of EMDR therapy. Therapists who make any changes to the protocol or omit any pieces of the protocol should document their clinical decision making for the modification or deletions.

This chapter reviews the types of assessment tools that cover all phases of development, including emotional, social, developmental, educational, and psychological. In developmentally grounded psychotherapy, a multimodal approach to assessment is necessary. A multimodal approach covers direct interviews of parents and children, interviews of parents and other caregivers, observations in the office and in the child’s natural environment, and the implementation of standardized measures. Child and adolescent personality assessment tools are more likely than adult tools to look at emotional, social, and behavioral functioning because personality disorders are not diagnosed until at least age 18, when children reach adulthood. Ultimately, assessment tools are used to verify the therapist’s clinical impressions to guide diagnosis and treatment planning. The diagnosis only benefits the clinical process because it guides treatment planning and clinical interventions.

This chapter describes the third of the eight phases, the Assessment Phase of Eye Movement Desensitization and Reprocessing (EMDR) therapy that is related to the developmental stages of children from infant to adolescent. It explains the procedural steps with detailed explanations of the techniques and skills necessary for successfully steering a child or teenager. It is essential for the therapist to recognize that eliciting the procedural steps for the phase is impacted by the child/teen’s level of development, and scripts for the procedural steps need to be adjusted into child/teen language. The chapter provides instructions to the therapist with scripts for each of the procedural steps. The assessment phase starts with Target Identification and Organization, which is a continuation of Phase 1 and the therapist continues with image, Negative Cognition (NC) and Positive Cognition (PC), Validity of Cognition (VoC), emotion, Subjective Units of Disturbance (SUD), and body sensation.

This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.

Medication therapy management (MTM) remains a challenging endeavor to optimally implement in the homeless population. Working in various settings in collaboration with other health professionals, pharmacists are spearheading patient-centered efforts to optimize MTM and assist the homeless with attaining health insurance and continuity of care. In the case of MTM, homeless persons may face significant hardship in not only procuring and using effective drug therapy, but also in following-up with their providers and establishing provider–patient relationships that will help them to meet their target therapeutic goals. This chapter enumerates a review of the more common barriers to MTM in the homeless population, followed by a number of practical applications of MTM in optimizing the health of the homeless. In order to appreciate the value and role that stable MTM can offer the homeless, the chapter briefly discusses perspectives on homeless health and the concept of MTM.

Child psychotherapy is different than any other type of adult-child relationship. A trained mental health professional is using clinical skills to help a child find the answers to the problems he or she has encountered. This chapter outlines the most common symptoms in child psychotherapy. Anxiety is one of the most common symptoms of childhood, but the etiology and manifestation of anxiety varies. Anxiety is a symptom of many other disorders, including generalized anxiety disorder (GAD), separation anxiety, obsessive-compulsive disorder, panic disorder, social phobia and other specific phobias, selective mutism, mood disorders, and post-traumatic stress disorder. Gifted children tend to have higher levels of anxiety because they can think about things they are not yet emotionally prepared to manage. The chapter discusses clinical interventions for common issues of childhood, along with resources for children, directions for parents, and references for parents, caregivers, educators, and therapists alike.

Women are very familiar with the experience of being evaluated by their physical attractiveness. This socialization intersects across all stages of a woman’s development beginning in early childhood. Too often, college women’s beliefs about their own attractiveness influence their self-worth. This chapter provides an overview of the “beauty pageant effect”, a phenomenon in which college women compete against one another based on their physical appearance. In addition, exploration of the beauty pageant effect suggests that social comparison theory, evolutionary psychology, and realistic comparison theory play a significant role in the interactions of college women. The chapter presents negative impacts of this type of competition and discusses a brief overview of clinical implications. Prevention work needs to target all women on campus and especially any at-risk populations, such as women with a history of mood disorder, socially isolated students, and those with a personal or family history of eating disorders.

This chapter focuses on the racial identity development of Black or African American college students and of students who identity as biracial or multiracial. Although racial identity development theories do not support biological distinction between racial groups in the United States, they recognize how different conditions of domination or oppression of various groups have influenced their construction of self. In this chapter Black is used to refer to the racial identity of U.S.-born persons of African descent who may categorize themselves as Black, Black American, African American, or Afro Caribbean. The term biracial is used to describe persons with two parents of differing monoracial or multiracial descents. It is worth noting that some individuals may claim Black racial identity although neither of their parents identify as Black, such as the case of civil rights activist Rachel Dolezal. This chapter goes in depth into such alternative experiences of Black identity development.

Blocking beliefs questionnaire can be used by therapist to discern the Blocking Beliefs of children and adolescents. It is adapted from questions in Thought Field Therapy and the Blocking Belief Questionnaire. Frequently, therapists are not aware when children and teens are saying things that are actual Blocking Beliefs and are slowing down, looping or preventing processing. The adult statements/Blocking Beliefs are listed first in the questionnaire followed by examples of words that a child/teen might use to express his or her Blocking Beliefs. Children and teenagers often state their issues in more concrete and specific ways than adults. It is the therapist’s job to identify the child/teen’s Blocking Belief and translate it into more generalizable terms. Once therapists have identified possible Blocking Beliefs, the beliefs can be targeted directly with the Assessment Phase and then reprocessed to enable continued processing on previous targets.

This chapter describes the external and internal physical changes and the brain. The hormonal changes of puberty initiate drastic growth in the body and organs of adolescents. Recent advances in brain-imaging technologies such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans have contributed greatly to understanding of brain development in adolescence. Similar to what happens during infancy, the early adolescent’s brain begins a process of overproduction, which is an increase in neural connections in the brain’s gray matter. The development of gray matter follows a pattern of maturation from the back of the brain to the front of the brain. By eliminating unused synapses the adolescent brain becomes more efficient and is able to process mental functioning at an accelerated speed. The amygdala is a small, almond-shaped structure in the midbrain charged with emotional expression.

The goal of the Body Scan Phase is to guide the child/teen through the steps to achieve a clear body scan. The therapist asks the child/teen to scan his or her body using the script. A set of bilateral stimulations (BLS) is done, if any sensation is reported. The discomfort is reprocessed fully until it subsides, if a discomfort is reported. Then the body scan is done again to see if there are still any negative sensations. BLS is done to strengthen the positive feeling, if a positive or comfortable sensation is reported. The Body Scan Phase often occurs during the session immediately following the Installation Phase, when the client has achieved a Validity of Cognition (VoC) of 7. Typically a session would not begin with Body Scan Phase unless the previous session ended at the conclusion of the Installation Phase.

This chapter presents a case study of a 16-year-old high school student who was identified as biracial and a product of divorce. He reported living with his White mother, stepfather, and younger half-sibling, and frequently visited with his Hispanic father and stepmother. The patient was an academically gifted student with a keen interest in science and math, and informed his interest in pursuing medical school in the future. He reported that beyond his family, his biracial identity did not influence him much. The patient was diagnosed with social anxiety, which appeared to be a more appropriate diagnosis. To accomplish the therapeutic goals, the author utilized a mixture of cognitive behavioral and humanistic strategies along with mindfulness with the patient. The mix of strategies was useful for the patient as he enjoyed the cognitive behavioral strategies that reminded him of his areas of strength.

Student developmental models that can be used to understand various students in groups and their development include identity models, such as Chickering and Reisser’s model, as well as Levinson’s model; psychosocial models, such as Erikson’s model; intellectual and ethical developmental models, such as Perry’s model; moral developmental models, such as Kohlberg’s model; cognitive models, such as Piaget’s and Vygotsky’s models; and experiential models, such as Kolb’s model. For a broad and universal understanding, these and other student developmental theories are integrated into the group theory. This chapter provides a discussion of group theory in relation to various salient student development theories. It addresses a brief introduction about the need for inclusion and multicultural awareness for students and student groups. The chapter discusses aspects for understanding successful student group development regarding group types, group leader guidelines, group processes, and learning reflection of student groups through a multicultural lens.

This chapter presents a case study of a 14-year-old African American female. She had strong beliefs in the family system and felt protective of her children. She was in trouble at school due to bullying other students through social media comments. Her suspension from school for texting inappropriate pictures prompted her mother to bring her to counseling. The author’s initial concerns focused on addressing the patient’s feelings of sadness and hopelessness related to her low self-esteem. The therapeutic alliance is the foundation for counseling effectiveness. The counseling goal centered on increasing the patient’s self-esteem and decreasing her reliance on approval by friends via social media. Using brief solution-focused therapy with her was a good choice. By coming to terms with her feelings of sadness and hopelessness and recognizing the effect of her sexualized behaviors, the patient made positive changes in her lifestyle.

Many adults understand the pressures of having multiple responsibilities that require attention in a variety of life circumstances. Whether giving attention to work, friends, school, religious activities, romantic relationships, family, or even recreation, adulthood requires the ongoing ability to multitask a variety of expectations and responsibilities. Before reaching adulthood, each person has experienced influences that affect how we think, feel, and react to life’s circumstances. This chapter offers professionals and educators one model for understanding these influences and their impact on college students who oftentimes are transitioning to a new world of adult responsibilities for the first time. Ecological theory originally developed out of the work of Urie Bronfenbrenner (1977) within the field of developmental psychology. The concepts described in Bronfenbrenner’s ecological theory offer a number of important implications for supporting students in a college setting.

This chapter presents a case study of a Caucasian high school student, who came to counseling because of her anxiety about school, music, family, and relationships. Based on the initial interactions, the patient appeared to be an introvert with adequate social skills. Her hyperawareness of others’ opinions of her, her avoidance of criticism, her unrealistic expectations of herself, and her fear of not performing well contributed to an almost constant state of anxiety. She continued to process the anxiety she experienced when multiple stresses started piling up in her life. The patient agreed she needed to be honest with her mom about her stress. By counseling, she developed skills for managing anxiety, lessened her dependence, and strengthened her internal locus of control. The most effective strategy involved role-playing, because she needed concrete interventions, and it helped her build confidence in her ability to implement what one practiced.

This chapter serves as an introduction to building a comprehensive school counseling program (CSCP). In a CSCP, school counselors serve as collaborative leaders advocating for systemic change using data and incorporating an equity lens with every decision made. CSCPs are developed, delivered, and maintained to promote student success in academic, career, and social/emotional domains. Examples of how varying school districts throughout the United States approach school counseling programs are included. This chapter also provides guidance for school counselors through the process of developing a CSCP. Scholarly support for the benefits of a CSCP are presented, and practical application of the model, including the benefits of a CSCP for multiple stakeholders, are discussed.

This chapter focuses on helping children to further develop their skills in self-reflection, mindfulness, and somatic awareness, along with managing triggers and learning calming techniques. It discusses contracting with self-states for new responses or roles that enhance mastery of daily skills. Empowerment and learning calming techniques will improve the child’s overall functioning-an integral step toward stabilizing the child for trauma processing. Building somatic literacy is needed with dissociative children so they can begin to understand and express what they are feeling. Incorporating physical exercise to build affect regulation, increase mind-fullness, and also expand window of tolerance is essential for calming down the overactive stress-response system. The chapter examines how to help dissociative children to increase their capacity to manage traumatic triggers. The key to healing dissociative children is seeing beyond the triggers and acting-out behavior and discovering the true source of the child’s impairment-the fractured mind that drives the behavior.

Cardiovascular disease (CVD) remains the leading cause of death in older homeless people. Traditional CV risk factors, such as hypertension, diabetes, smoking, and hyperlipidemia, and nontraditional CV risk factors, such as substance abuse, psychological stress, and lack of diagnostic and preventative medical care, contribute to CVD in this population. Barriers to CV prevention and treatment in homeless individuals include their environment, lack of access to care, substance dependence, mental illness, food insecurity, and medication non-adherence. Healthcare models that provide Housing First and just-in-time care by non-judgmental multidisciplinary teams have been shown to improve the CV health of people who are homeless. CV health requires prevention, as well as prompt intervention, and close follow-up. CV healthcare practice adaptations for homeless clients include ascertaining living conditions, improvising the physical exam, scheduling longer clinic appointments with frequent follow-up, prioritization of the plan of care, and simplification of the medication regimen.

This chapter provides basic career counseling and advising information for college counselors, advisors, and student affairs professionals. Career counseling services include career counseling, testing, career planning and development interventions, cooperative education and experiential career education, and job placement and employment services. Career interest inventories may be inappropriate for students with severe mental or emotional disturbances. The chapter discusses several most popular inventories used for career and academic planning. The self-directed search (SDS) classifies an individual into six different personality-work typologies. A number of computer-based programs have been developed to assist clients and students in career exploration. Career planning resources have become very popular and can play a helpful role in providing additional information regarding career choice. The career functioning assessment (CFA) provides a conceptual framework to assess a client’s current occupational functioning and serves as a starting point for assessing future career success.

Eighth grade is a time of distinct change and transition. In this chapter, we discuss the significant decisions eighth graders are asked to make regarding careers and how they can be supported to make these choices. Information on high school secondary track options, how to work with parents, and examples from a school counselor and district leaders are provided.

Ninth grade is a critical transition year where students’ academic habits and choices set the stage for future possibilities. In this chapter we address the importance of career and college advising as well as assisting students in developing individual learning plans to map how they will approach preparing for their future. Interventions focus on self and career exploration as well as the development of strong academic habits and dispositions.

In this chapter, we focus on career development and environmental influences for 10th graders and we highlight how Super’s Life-Span Life-Space theory and Social Cognitive Career Theory can be useful for conceptualizing these students. We also discuss factors that influence students’ career and postsecondary decision-making and goal-setting. Finally, we offer suggestions for addressing many of the internal and external factors that can negatively affect career and college readiness.

In this chapter, we focus on helping students narrow down their future plans and engage in exploratory activities to more concretely prepare for their postsecondary transitions. We review Social Cognitive Career Theory and the Theory of Career Construction as frameworks for designing career and college readiness interventions. Finally, we highlight interventions to help students identify and hone in on strengths as well as to gather more information about themselves and details associated with potential future options.

In this chapter, we discuss interventions to help students take the final steps needed for their postsecondary transitions. Also, we reference the Theory of Career Construction in conceptualizing the career developmental needs of 12th-grade students in addition to focusing on the importance of values clarification. Interventions we highlight target summer opportunities, self-advocacy, and final career and college preparation.

In this chapter, we discuss second and third grade students with emphasis on the development of career and college readiness capital. We explore the importance of social emotional learning for the development of prosocial behavior and employability skills and the benefits of service learning. Parent involvement in career readiness is included with strategies for assisting parents to build skills for helping their children explore careers.

Late childhood is a pivotal time in career and college readiness. We examine the role and influence of cognitive development as well as peer support and gender identity development. We also explore the development of efficacy, self-regulation, and executive functioning and discuss their connection to career and college readiness. Finally, this chapter culminates with a discussion of how to support students during the fifth- to sixth-grade transition.

Middle school students love to learn about themselves including their interests, values, and aptitudes. In this chapter, we review developmental milestones occurring in middle school, the impact of social media use, middle school career interventions, and the integration of technology in the career counseling curriculum. In addition, we explore ways to engage parents and faculty and introduce career and technical education.

In this chapter, we review career development strategies specific to PreK–first grade. Special attention is given to students psychosocial, cognitive, and gender development related to career. We focus on play therapy techniques in classroom lessons and innovative content integration such as the use of problem-based learning and design model thinking to promote career efficacy. Finally, we highlight techniques for helping teachers develop career strategies for the classroom and for parents to begin to develop career and college mindsets in the home.

Caregiving is the act of tending to the needs of children, elderly adults, or sick or disabled individuals. Caregivers may perform duties such as cleaning, shopping, cooking, managing household finances, administering medication and other health care-related duties, and helping with activities of daily living. For those who have mostly or only performed unpaid caretaking duties, career transitions can be difficult to navigate. Caregivers who have to work outside of the home and maintain caretaking responsibilities are often perplexed by the logistics of balancing the two sets of competing responsibilities. Some caretakers may be at greater psychological risk due to the factors that triggered the need to seek employment along with the interruption this change may have on their identity. Career counselors are in a position to help caregivers traverse this new and unfamiliar occupational terrain.

This chapter briefly discusses the history of the Caregiver Support Act and its specific components and explains how the Caregiver Support Act provides resources to older adults and people with disabilities. It provides an overview of the current status of family members serving as caregivers, with special attention to grandparents raising grandchildren. It then discusses a current profile of relative caregivers raising children in the United States; reasons for the increase in relative caregiving; and issues facing grandparents raising grandchildren. It also provides some background into the literature and promotes an awareness of issues that grandparents face as primary caregivers. A literature review examines some of the current issues and services needed. The chapter discusses resources and services designed to meet the needs of grandparents raising grandchildren, and reviews programmatic responses through the national resources. Finally, the chapter outlines some best practice interventions for review in the text.

This chapter address a number of areas that will affect the lives of people as they age or people who are older adults. Philosophical paradigms, statistics, evidence-based approaches, dealing with the media, making people aware of new technologies, and preparing for communities to best deal with issues of aging are all major issues of concern. It provides a range of issues; however, the chapter provides an overview of the most significant ones to be addressed or to require intervention. It cites 10 major challenges that the future will bring, in reality, policy advocates will have to be prepared to address and deal with these challenges by using innovative strategies for policy development and policy change. The chapter addresses policy development and program design to meet the needs of an aging and ability-challenged society are unique challenges.

Thomas (pseudonym for a composite student profile), in his final K–12 year, participates in five components of a multidimensional program for gifted students in a large school: Future Problem Solving (FPS), Advanced Placement (AP) courses, a noon-hour philosophy course taught by a retired professor, after-school lectures by community members, and small discussion groups focused on nonacademic development. He has an extremely high IQ, is known as an excellent musician, and recently was named a semifinalist in the Preliminary SAT (PSAT) merit-scholar competition. However, his only-average academic record has long frustrated teachers, who seem offended by his seemingly limp investment and who see an “attitude problem” in his lack of oral engagement and absent homework. Thomas has a quiet personality, typically avoids eye contact, and seems older than his age. He has taken no steps toward postsecondary education, and he will need financial aid if that is his direction. One of his teachers asks the school counselor to meet with him to assess needs and concerns, including those related to college applications. Before she meets with Thomas, the counselor arranges conversations with his current teachers, his single-parent mother, the orchestra teacher/conductor, and the gifted-education program coordinator. Only the one teacher has ever referred Thomas to the counselor.

The AP American Literature and AP American History teachers both focus mostly on the missed assignments but note his serious alertness during class and brilliant insights on the papers he has submitted. The chemistry teacher expresses concern about Thomas’s sad demeanor but notes that he pays attention in class and does “OK” academically. The orchestra director, who has worked with Thomas since elementary grades, calls him one of the most gifted and highly invested musicians he has known. He reacts emotionally when he listens to classical music.

The gifted-education teacher has learned that Thomas struggles with perfectionism—with essays stalled after he has discarded several eloquent thesis statements. He has told her that he doubts he can follow through worthily. About eye contact, Thomas once said he could not hear peers’ comments when distracted by the visual stimuli of faces. He despairs over circumstances in distressed countries. Nevertheless, he is a quiet leader on his FPS team. His mother describes her acrimonious divorce and the depression Thomas has struggled with since middle school. She worries about him, especially now, with his inertia about applications. She hopes, given the PSAT results, that he will now invest in the process, securing a scholarship. She feels incapable of helping him.

Concurrent with the release of Education and Identity in 1969, the United States was at the nexus of social unrest and expanding funding and support for educational initiatives. The decades of the 1950s and 1960s saw a great increase in research and practice focused on developmental theorists working in the area of higher education. At the forefront of this work was theorist Arthur Chickering. The primary construct of Chickering’s (1969) work is the Seven Vectors of Development. The vectors are: (a) developing competence, (b) managing emotions, (c) moving through autonomy toward interdependence, (d) developing mature interpersonal relationships, (e) establishing identity, (f) developing purpose, and (g) developing integrity. This vector addresses competence across three domains: intellectual, physical and manual, and interpersonal. This chapter briefly outlines Chickering’s life work, and ways in which practitioners can apply his theory to their daily interactions with college students.

This chapter assists the therapist in conceptualizing how to use the eight phases of eye movement desensitization and reprocessing (EMDR) therapy with each age group of children; infants through adolescents. It addresses the developmental stages of each age group and how to apply the phases of EMDR therapy. Then, where appropriate, assessment forms, instructions, and/or scripts are included for children 0 to 6 years of age and preteens and teenagers. Therapists may guide parent involvement by teaching basic parenting skills. As part of the initial phases of EMDR therapy, the therapist integrates standardized infant/toddler assessment processes as recommended by Early Headstart programs. Alternating bilateral stimulation can be taught in many ways using toys. Trauma reprocessing phases with infants through 14 months will most likely need parents as assistants in expressing what may be the child’s traumatic event, emotions, and body sensations.

The population of geriatric homeless individuals diagnosed with serious mental illness is a largely underrepresented subpopulation in the research literature despite the notion that this population is one of the most vulnerable to negative outcomes due to physical, mental, and psychosocial factors. This chapter briefly summarizes the separate impact of each of these three factors: being homeless, being in the geriatric population, and being diagnosed with a serious mental illness (SMI). In addition, the chapter illustrates how these three factors combined impact overall subjective quality of life and poor outcomes for mental health through the use of a case vignette of a homeless, geriatric individual with a severe mental illness. It also provides case example illustrating that high comorbid substance abuse along with an SMI (i.e., dual diagnosis) associated with complex medical conditions create seemingly insurmountable challenges for the interdisciplinary care team.

Classroom engagements and lessons are an important part of the role of school counselors. Classroom guidance allows for systemic change and collaboration with the teachers. Classroom guidance should be implemented in PK–12 settings and focus on academics, career, and personal/social domains consistent with a comprehensive school counseling program. This chapter will focus on developmentally appropriate and culturally relevant classroom guidance lessons/presentations for each level of school counseling. A discussion of relevance, scholarly support, best practice, classroom management strategies and practical application will be provided.

This chapter describes a general script for ending a session as well as directions for closing an incomplete session. The Closure Phase of eye movement desensitization and reprocessing (EMDR) therapy occurs any time the therapist needs to end a session. Once the therapist has assisted the child/teen in transitioning to a more comfortable state, the last goal of the closure phase is to prepare the child/teen and parent for in-between sessions. An incomplete session is one in which a child/teen’s material is still unresolved, that is, he or she is still obviously upset or the Subjective Units of Disturbance (SUD) is more than 1 and the Validity of Cognition (VoC) is less than 6. The Closure Phase often occurs during the session immediately following the Body Scan Phase, when the client has achieved a clear body scan.

This chapter helps the reader to be familiar with the role coalitions play in advocacy and policy development and to understand the various types of coalitions that affect the policy landscape. It also helps the reader to be familiar with the various roles that exist within groups and coalitions that contribute to the success or non-success of the group process. A number of strategies can be used to develop initiatives to impact one’s advocacy efforts. These strategies can be used to promote the development of new programs and services and can include the use of and/or development of coalitions, the media and media advocacy, and consumer advocates. The chapter addresses each of these strategies in greater depth. It outlines a variety of issues related to coalitions, group development, and coalition building for aging policies and programs.

This chapter describes Piaget’s formal operational stage, thinking in context, and educating adolescents. According to Piaget, during the formal operations stage adolescents advance in their ability to assess questions in scientific ways. Engaging in hypothetico-deductive reasoning does not just occur when adolescents are trying to solve complex questions about math and science. Adolescents have the ability to manipulate and talk about concepts such as love, the future, and God in very tangible ways. Adolescents develop perspective taking, which is the ability to understand the thoughts, emotions, and behaviors of others. In order for adolescents to be successful at social interactions, in which they will be engaged quite often, they need to understand other people. Adolescents value the ability to make independent decisions and consider this to be an integral part of the transition into adulthood.

A Cognitive Interweave (CI) is the elicitation of an adaptive perspective by the therapist that is offered when reprocessing is stuck. A therapist can use a CI when the child/teen is looping, when time is running out, or when it is necessary to expedite the session so that the client does not remain in a highly activated state. The therapist introduces new material without relying on the child/teen to provide it. It is a ‘light touch’ to elicit certain information from the child/teen’s Neuronetworks. It is important for the therapist to be familiar with the child/teen’s culture and the current genre of that child/teen’s reality. The therapist uses one or more questions to guide the client to find an answer drawn from the child/teen’s own internal wisdom. The therapist may use Socratic questioning to access the child/teen’s own logic and to resume the child/teen’s own natural processing.

Stewart and Tray are the seventh- and eighth-grade school counselors in a new middle school in a large urban district with a diverse student population. Wintercrest Middle School has been a magnet school for science, technology, engineering, and mathematics (STEM) for only 3 years. Currently students can take Algebra I, Geometry, Honors Biology, and semester classes in Advanced Computing, Introduction to Physics, Robotics, and Trigonometry. Logistically, the magnet school functions as a school within a school, with students attending classes in one wing of the school building. Teachers and students who are not involved in the magnet school are located in two other wings on the opposite side of the school. During the past school year, Tray and Stewart have sensed tensions in the school in various relationships, including within, between, and among teams of teachers, between parents and teachers, among students, and between administrators and teachers. Mr. Wallace, their building principal, has seen the explosive outcomes of some of these tensions and has encouraged the counselors to investigate the current school climate.

This chapter provides an overview of the historical, developmental, medical, and contemporary considerations regarding college student development as they apply to college counseling centers. It describes documented significant transition from who provided counseling, to the focus of counseling what remains constant is the need to remain current with regard to continuing changes in higher education. The expansion of vocational services paved the way for college counselors to begin addressing social and personal concerns in a counseling context and provided momentum for universities to expand the role of college and university counseling centers. The chapter addresses historical foundations of college counseling, originating with faculty providing services to that of a specialized, highly trained staff of mental health professionals composed of psychiatrists, psychologists, counselors, social workers, psychiatric nurses, and others. Information from research and national surveys has been included to underscore the important changes in college mental health.

Students may enter higher education with a strong set of ideals, firm models of career options, and certain confidence in their ultimate direction; however, it is not uncommon for students to begin college unprepared for life after graduation, let alone housing assignments and first semester coursework. This chapter focuses on the difficulties surrounding the major choice, the factors that influence decision making, career theories in student affairs, and campus and community resources available to assist students in gathering important data about their major and career choices. Selecting a college major and making career decisions are not easy, and require self-knowledge, self-examination, and research on what is available in the world of work. Essential to student success is the ability of student affairs professionals to accurately recognize when students are struggling and make an appropriate referral for career counseling, academic support services, or personal counseling.

College upperclassmen often undergo the divergence from an often supportive environment into a period marked by new role-taking and responsibilities and they frequently experience an unfamiliar range of stressors as well as physical and psychological changes. This chapter begins with an introduction to the many common transitions and stressors experienced by college students. College upperclassmen face a period of incredible opportunity, growth, and excitement as they move toward graduation. Yet, with these opportunities and transitions comes the inevitable ambiguity and uncertainty inherent in any major life transition. The chapter concludes with a discussion of the implications for counseling professionals. As counselors, people will benefit from ongoing attention to the varied, dynamic needs of college upperclassmen in order to provide them with the support and challenge needed to promote ongoing development as they embark on the next steps of their life journeys.

Community colleges serve a critical role within higher education. An open access system can be both affordable and flexible; community colleges prepare students for the increasing need for skilled and educated individuals in the workforce. Although community colleges serve different goals, two primary goals are academic and vocational preparation. The vocational-technical pathway was developed to prepare individuals for entry-level positions in business and industry. Academic advisers support community college students who are preparing to transfer by advising in courses that will transfer as well as assisting with the application processes. Career centers and career counselors at community colleges offer all students a range of services. These services include providing career assessment and counseling, offering job and internship search assistance, reviewing resumes and cover letters, and sponsoring mock interviews. Regardless of the community pathway a client participates within the focus remains providing support to individuals pursuing their personal and professional aspirations.

Old age brings with it unique challenges in diagnosis, treatment, and care; dementia complicates these issues even more. Improving the management and care of persons with dementia has positive implications for patients, caregivers, and physicians alike. Two types of secondary complications can be analyzed in relation to dementia: conditions that arise outside of the dementia and then conditions that appear to develop due to the neurological degeneration inherent in dementia. Examples of psychiatric complications include depression, anxiety, and psychosis. Medical problems consist of issues such as stroke, cardiovascular problems, cancer, infections, orthopedic issues, diabetes, nutritional disorders, vision and hearing problems, as well as general pain. The high comorbidity of dementias with other psychiatric and medical issues can complicate the diagnosis and treatment of patients with dementia. Issues in the central nervous system (CNS) have long been looked at as possible predictors of dementia.

The typical age of onset for many severe psychotic disorders is late adolescence through early adulthood, an age range coinciding with the college population. Clearly, college counseling centers can play an important role in retention of students with severe mental disorders. This chapter presents a case example of how to make a referral. Due to the high-profile tragedies at Virginia Tech and other campuses, college counselors are under pressure to share concerns regarding students and to provide mandated counseling and assessment. The treatment of eating disorders continues to be very challenging for college counseling centers. College counselors have reported an increase in students presenting with self-injurious behaviors (SIBs) for some length of time. It has only been recently that college officials began to acknowledge students with autism and Asperger’s syndrome. Psychoeducational groups have become popular on virtually all college campuses.

This concluding chapter presents brief summaries of the chapters of the book. The chapters in the book have covered a wide range of theories, concerns, and perspectives. Chapter content has implications for policy and practice. School professionals can incorporate the information and recommendations in them into their current services to ensure that gifted students receive needed support. School counselors respond every day to students who feel different, perhaps painfully different, from those around them—at home, at school, or in the community. Those counselors are distinguished in the school context by rare skills and perspectives that can be used to help gifted students make sense of themselves, value their differentness, and embrace their complex feelings and sometimes perplexing behaviors. Change can happen in either direction because of life events or circumstances. Moving out of impasse and accomplishing developmental tasks can contribute to increased motivation for underachievers.

This chapter presents a case study of an 11-year-old male whose supportive parents brought him to counseling with concerns about how his anxiety significantly affected his daily life. He expressed feelings of fear about his life, and isolated and withdrew from others as a consequence. The patient’s school records indicated problems with focus, but with intervention, he made substantial progress in reading. He exhibited no physical issues at birth and as an infant. About a year later, he received diagnoses of attention deficit hyperactivity disorder (ADHD) and an anxiety disorder. He was aware of his inability to control his emotional reactions, and understood the impact this had on himself and others, but did not know how to implement change. The adults in his world reported significant problems with inattention and hyperactivity, depressed mood, and somatic problems, along with a broad executive dysfunction affecting his ability to regulate his own behaviors.

College students must make sexual choices; more clearly define their sexual identity; and consistently consider sexual health in order to maintain a strong and positive holistic sense of self. College counselors should be able to provide accurate information on a wide variety of sexual issues as well as a safe environment for students to determine what is best. Educating students about everything from vocabulary to communicating with partners about topics such as sexual concerns and safe sexual practices are the areas in which clients will most likely need assistance. Lesbian, gay, bisexual, and transgender (LGBT) college students have additional factors, their sexual identity and orientation that can greatly influence their college experiences. It is vital that college counseling centers provide relevant, accessible information and materials, as well as helpful referrals, for specialized information regarding safe sex, contraception, and sexual health.

The transition from secondary school to college is marked with the significant and empowering rite of passage, high school graduation. This chapter presents an overview of college student development to provide counselors with a broad perspective on how the counseling center traffic might appear based on student classification and season. While each group of students will bring in issues with similar themes in counseling, their depth and engagement with the topic may be quite different based on client age. In general, counselors will notice an increasing maturity that grows with each year of college experience. This developing cognitive and emotional maturity significantly influences the atmosphere in the counseling office and the work that will be accomplished. The transition from adolescent to adult is a fascinating period and college counselors are in a prime position to witness and positively affect this powerful transformation.

School counselors collaborate, consult, and coordinate resources. They partner with community agencies, empower parents and families, advocate for students, and are probably part of the leadership team in their schools. Every day school counselors probably make lists of tasks that must be accomplished and then prioritize those according to level of urgency. When prioritizing student needs, the needs of gifted students may not rise to the top in the mind of the school counselor. Most educators equate "gifted" with high-achieving, perfectionistic, perhaps slightly eccentric students who have helicopter parents. School counselors work with gifted students regularly. These students come with a variety of different concerns ranging from typical developmental needs to mental health concerns that warrant immediate attention and service. While gifted students are no more or less likely to experience concerns tied to mental health, they do experience the world differently by nature of being gifted.

This chapter presents a case study of a 9-year-old Caucasian child who lived with his paternal grandparents in a small rural community. The patient attended a local private school where he received individualized education accommodations based on school-level evaluations, asserting that his learning is being impacted by behavioral deficits. Media outlets also played a large role in his life as he reportedly spent a large amount of his formative years locked inside of his bedroom with a television and video games. According to Erikson’s theory of psychosocial development, at 9 years of age the patient was in the industry versus inferiority stage of development. Based on his developmental level and age, the author used a child-centered play therapy modality to facilitate the therapeutic process. Based on his grandmother’s report of the patient’s behavior, he developed some of the skills needed for treatment to be considered successful.

This chapter presents over 100 interventions using art, drama, music, writing, dance, and movement that school counselors can easily incorporate into their practices with individual students and groups, and in classroom settings. These creative interventions, based on the American School Counselor Association (ASCA) National Model framework, support the key student domains of academic, career, and personal/social development. The chapter provides a wider variety of modalities as well as easy-to-follow step-by-step instructions for each intervention. It focuses on creative interventions in the academic domain for sand tray for special needs groups. The purpose of this technique is to develop and refine social skills through expressive sand tray technique among children with special needs or children in general. Sand tray groups can be conducted in a play therapy room, counselor’s office, or any art/sand tray room at the school.

This chapter presents over 100 interventions using art, drama, music, writing, dance, and movement that school counselors can easily incorporate into their practices with individual students and groups, and in classroom settings. These creative interventions, based on the American School Counselor Association (ASCA) National Model framework, support the key student domains of academic, career, and personal/social development. The chapter provides a wider variety of modalities as well as easy-to-follow step-by-step instructions for each intervention. It focuses on creative interventions in the career domain for garden of care, and exploring occupations through sand tray and miniatures. The purpose of the Garden of Care is to teach students to nurture a living organism, develop a sense of responsibility, learn to work with others to accomplish a task, and cultivate a sense of community.

This chapter presents over 100 interventions using art, drama, music, writing, dance, and movement that school counselors can easily incorporate into their practices with individual students and groups, and in classroom settings. These creative interventions, based on the American School Counselor Association (ASCA) National Model framework, support the key student domains of academic, career, and personal/social development. The chapter provides a wider variety of modalities as well as easy-to-follow step-by-step instructions for each intervention. It focuses on Creative Interventions in the personal/social domain for conflict garden, a cup of community, and feelings of nature, personal pizza party, pocket pillows, and remembrance bead bracelet. The Conflict Garden is an expressive group-counseling approach in which students create a metaphor for their family of origin in order to gain insight into their current conflict and potential resolutions. Processing postsession feelings is intense and can be overwhelming, especially when exploring painful life events.

Crisis and trauma are terms that have become alarmingly common in the United States. This chapter talks about crisis and trauma interventions which involve those of both an individual nature, students who do harm to themselves and of a mass nature, and students who do harm to multiple students or perpetuate events that threaten the safety of many students. Suicide is the second leading cause of death among college students. Risk factors for suicide include traumatic or stressful life events, prior attempts, isolation and lack of emotional support, and access to a suicide method. Safety usually involves a battery of activities: notifying parents or guardians, possible hospitalization, post hospitalization plan, medication, ongoing counseling, spiritual support for many, continued assessment, possible group counseling, support group, and so forth. The crisis management team (CMT) must communicate with campus administration, faculty, students, and legal authorities during crisis times.

Considering the documented increase in mental health concerns, violence and trauma, the role of the school counselor related to prevention and response to these and other school crisis will be discussed. Trends in current scholarly literature point to the increase in student/family depression and anxiety related to the current pandemic which scholars suspect will result in a significant increase in student suicidal ideation and mental health concerns.

This chapter describes career counseling considerations for African American Men, Latino Men, and Asian American Men. Interpersonal and systemic discrimination are still prominent in society, leading to elevated social and health risks for African American males. Creative career interventions could be beneficial for African American males. Narrative therapy allows clients to tell their unique stories to counselors open to learning new contexts and ways of dealing with challenges and problems within the clients’ realm of possibilities. Counselors using career counseling strategies should remember the unique needs of the populations with which they are working. Feminist theory has been extremely useful in working with marginalized populations, and this orientation can be expanded by the use of relevant career assessments. Asian Americans encounter counselors who promote individualism and focus on the needs of the client without consideration for the impact on the family.

This chapter explores the unique experiences of various groups of culturally diverse women who work in the United States and highlights common barriers faced by all culturally diverse women. It presents two career counseling theories, social cognitive career theory (SCCT) and narrative career counseling theory, which the career counselors may use to empower clients. The chapter discusses specific techniques and resources that might be beneficial to the career development of culturally diverse women across theoretical approaches. Many culturally diverse women will experience injustices that are due to racism, discrimination, oppression, sexism, and heterosexism. Career counselors working with culturally diverse women have the capacity to be agents of social change. These professionals contribute to the creation of a career demographic in the United States that is representative of the actual makeup of the nation by helping culturally diverse women anticipate possible challenges and construct proactive coping strategies.

Implementing data-driven school counseling interventions helps ensure school counseling program efficacy. School counselors benefit from being knowledgeable regarding the various types of data available in schools and having the skills to appropriately analyze assessment results to drive school counseling interventions and implement systemic change. Data can be used to advocate for equity and inclusion and identify opportunities for engagement.

Diagnosis of a dissociative disorder in children and adolescents is often ignored, as clinicians are not well acquainted with what dissociative behaviors look like. This chapter examines overlapping symptoms and comorbidity of dissociative disorders with posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), bipolar disorder (BP), psychosis or schizophrenia, obsessive-compulsive disorder (OCD), eating disorders, substance use disorders, and reactive attachment disorder (RAD) to help the clinician discern unique differences for accurate diagnosis. There is a strong need for more research and education among clinicians on the overlapping symptoms of mood dysregulation, traumatic experiences, and dissociation. Research and clinical assessments that methodically utilize valid and normative childhood trauma and dissociative measures, and that explore detrimental family dynamics would greatly benefit the field and the families we serve by helping clinicians accurately distinguish between pediatric BP and dissociative disorders.

Geriatric homelessness (GH) is a significant and growing social, political, economic, and humanistic issue throughout the United States. This chapter presents case studies that will highlight the GH in four urban areas and among veterans. It defines geriatric homelessness, outlines its general dimensions, explicates its two primary etiologies (loss of employment and the lack of affordable housing in the areas where most homeless persons are located), and gives examples of the diversity of the problem and attempts at solutions in four cities and among veterans. The case examples show that the solution to the medical and psychological issues in the GHP involves much more than traditional medical practices and therapies. The solutions, involving among others politics, economics, and housing, are those of communities and localities acting to positively affect the lives of individuals and families of all ages, particularly the growing population of GHPs in the United States.

Delirium, also known as acute confusional state, organic brain syndrome, brain failure, and encephalopathy, is a common occurrence among medical and surgical patients and causes extensive morbidity and mortality. This chapter provides an updated review of delirium, including pathophysiological correlates, clinical features, diagnostic considerations, and contemporary treatment options. The defining features of delirium include an acute change in mental status characterized by altered consciousness, cognition, and fluctuations. The chapter explores the risk factors for delirium. These can be divided into two categories: predisposing factors and precipitating factors. Imbalances in the synthesis, release, and degradation in gamma-aminobutyric acid (GABA), glutamate, acetylcholine, and the monoamines have also been hypothesized to have roles in delirium. GABA is the primary inhibitory neurotransmitter in the central nervous system (CNS) and medications such as benzodiazepines and propofol have known actions at GABA receptors and have been associated with delirium.

Dementia pugilistica (DP) is a form of chronic traumatic encephalopathy (CTE) that involves gross impairment of cognitive and motor functioning due to repetitive blows to the head from boxing. Rapidly increasing in popularity among fight fans and fighters is mixed martial arts (MMA). In the area of sport-related concussion, there are two other frequently used terms that are necessary to distinguish from DP and CTE: postconcussion syndrome (PCS) and second impact syndrome (SIS). The classical clinical signs and symptoms of DP include combinations of dysarthria, incoordination, gait disturbance, pyramidal and extrapyramidal dysfunction, and cognitive impairment. Some media reports about concussion and the potential link between repetitive concussions and long-term problems include eye-catching and emotionally provocative titles. This chapter has provided an overview of the many complex issues surrounding the effects of repeat concussive trauma, particularly in sports.

Dementia with Lewy bodies (DLB) is a clinical syndrome characterized by progressive dementia, cognitive fluctuations, visual hallucinations (VH), and parkinsonism. In 1961, Okazaki, Lipkin, and Aronson reported two patients with dementia and parkinsonism with cortical neuronal inclusions similar to the brain-stem Lewy bodies (LB) seen in Parkinson’s disease (PD). LBs are intra-cytoplasmic neuronal inclusions containing α-synuclein and ubiquitin. There are other associated pathological features in DLB such as spongiform change neuronal loss, and Alzheimer’s disease (AD) pathology includes amyloid plaques and neurofibrillary tangles (NFTs). DLB and other entities such as PD and multiple system atrophy (MSA) have been grouped under the term synucleinopathies due to the existence of &#945-synuclein inclusions in the brain. The central feature required for a diagnosis of DLB is the presence of dementia: a progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational function.

Depression and anxiety are the most prominent psychological issues on college campuses and in counseling centers. Cognitive, affective, and behavioral anxiety-related symptoms are specific to the particular type of anxiety disorder one is experiencing. Cultural variables impact the prevalence and presentation of symptoms and level of help-seeking behaviors. Individual counseling is an effective means for treatment and relapse prevention of depression- and anxiety-related symptoms and is a primary treatment modality within college counseling. Group counseling is another efficacious treatment for depression and anxiety. Self-help resources can be provided online, during outreach presentations, or suggested as a lower level intervention for students who present to the counseling center with mild symptoms and impaired functioning. Computerized cognitive behavioral therapy (cCBT) and e-mail cognitive behavioral therapy (eCBT) are newer methods for remotely treating anxiety and depression. Uses of social media are current and relevant ways for connecting with students.

Depression is common in older adults and associated with poor medical and mental health outcomes, including increased risk for suicide. Homeless older adults are at increased risk for developing depression. The clinical presentation of depression in older adults and younger adults often differs. Having an appreciation for these differences allows clinicians to better diagnose and treat this vulnerable population. This chapter provides case example highlighting the common themes of the presentation, diagnosis, and treatment of depression in the homeless older adult population. Research and advocacy are warranted to ensure that older homeless individuals with a major depressive disorder receive optimal assessment and treatment of their depression. The chapter discusses barriers to adequate detection and treatment of depression in older homeless adults, as well as assessment and treatment strategies. It covers identification and treatment of grief. The chapter reviews promising directions for future strategies to decrease depression among older homeless adults.

Depression, once referred to as the common cold of mental health, remains a consistent problem for young adults. Depression and its frequent companion, anxiety, along with many other factors, lead to mental health crises among college students. This chapter provides information for counselors working with college students who present with symptoms of depression and, to some degree, comorbid depression and anxiety. It presents depression and its effect on college students. The chapter presents a case scenario to provide an example of way in which depression and anxiety may combine in presentation. It discusses screening for anxiety and depression as comorbid disorders. The chapter provides techniques for treatment planning and prevention, cultural considerations, and college and university mental health outreach programing related to depression and comorbid anxiety and depression. It highlights several existing outreach programs, provided supplemental programming ideas, and suggested resources for counselors in developing outreach programs on their campuses.

Skin problems are one of the most common presenting complaints of homeless persons to emergency departments and community clinics, estimated at 20% of such visits. Adult homeless suffer the usual skin diseases common to nonhomeless adults, but in addition can suffer more frequent infections, dermatitis, and wounds related to their compromised living status. This chapter focuses on the diagnosis, treatment, and triage of common skin complaints in homeless adults. Hospital admission should be considered whenever fever, chills, tachycardia, hypotension, or severe or rapidly progressing infection or other admission criteria are present. Additionally, if outpatient treatment is unrealistic given limited social or logistical challenges, admission may be appropriate even without the aforementioned standards, in order to ensure appropriate critical treatments and resolution. The chapter provides case example for infestations, bites and infections, wounds, neoplasms, and rashes.

For therapists, the Desensitization Phase can bring many challenges including; learning how to stay out of the way of the client’s reprocessing, knowing when the client is stuck or looping and, deciding when a cognitive interweave is indicated. With child/teen clients, the therapist may need to change types of bilateral stimulation (BLS) more often to keep the child/teen engaged. The therapist may also need to include more activity in working with younger children as they reprocess the memory through play therapy, art therapy, drawing, or other expressive psychotherapeutic tools. It is the role of the therapist to be patient and diligent in attunement to the unique reprocessing of the individual child/teen in order to bring the disturbance to a Subjective Units of Disturbance (SUD) of 0, making it possible to proceed to the Installation Phase of Eye Movement Desensitization and Reprocessing (EMDR).