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Deliberate practice exercises provide trainees and students an opportunity to build competence in essential interpersonal therapy skills while developing their own personal therapeutic style. These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns. Each of the first 10 exercises focuses on a single skill, including developing an interpersonal inventory of patients'relationships, building social skills, and helping patients connect with their own thoughts and emotions and empathize with others. Two comprehensive exercises follow in which trainees integrate these essential skills into a single session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

This book offers a critical examination of the field of trauma work using a decolonial lens, recentering narratives and approaches to healing in a more inclusive, culturally responsive way than that offered by dominant Eurocentric approaches. As trauma is a universal experience, a colonized paradigm for responding to trauma re-introduces problematic dynamics of domination and subjugation that are inimical to healing. Decolonizing Trauma Healing offers a new paradigm for how psychologists and other mental health providers can learn to properly understand and work with people whose lives, psyches, and souls have been damaged by exposure to trauma. Dr. Laura S. Brown introduces her decolonial, humble, culturally responsive (DHCR) model of trauma healing practice. It urges readers to abandon the concept of cultural competence and other approaches that maintain a Eurocentric perspective, in favor of a decolonial method that re-centers the sufferer's lived experience, with an understanding of the subtle ways in which the colonial mindset underlies the causes of trauma as well as our traditional conception of trauma healing. As a member of a colonized and marginalized culture, as well as in her work as a trauma healer, Dr. Brown serves as an inspiration for readers who want to understand why the traditional approach to trauma care has been insufficient, and all those who are ready to do the work needed to bring the field to a new level of clarity and rigor.

An authoritative introduction to behavior therapy as well as a comprehensive resource for those with a firm background in this area. This book clearly and methodically introduces the behavioral perspective to readers new to cognitive-behavioral therapy, while also applying a fresh lens for connecting theory, research, and practice for more experienced practitioners. Instead of matching interventions with client populations or diagnoses, the authors emphasize a framework and set of principles that are broadly applicable to adult clients. Readers will learn how therapists use a behavioral perspective to conceptualize their clients, their problem areas, and the therapeutic process. The chapters facilitate systematic, coherent, and flexible thinking about people and their behavior, and they offer guidance for addressing both common and novel clinical problems not addressed in standard therapy manuals. This third edition includes: New chapters on problem‑solving therapies, self‑management interventions, and contemporary ethical and professional issues. A renewed focus on interventions for strengthening mindfulness and acceptance skills. Expanded discussions of behavioral case formulation and treatment planning. Extensive updates in clinical research.

This book offers a concise, practical guide to ethical and legal concerns related to therapists'sexual feelings and fantasies. The psychotherapy profession has always struggled to deal openly with therapists'sexual feelings. Between the often unavoidable fact of sexual attraction, and the potential crossing of boundaries and sexual relationships with clients, there exists a wide range of assumptions, beliefs, feelings, and daydreams that often are suppressed and unspoken—sometimes with devastating consequences. This candid, practical book addresses three distinct areas related to therapists'sexual feelings: sexual attractions to clients (including sexual fantasies, dreams, and arousal); the violation of sexual boundaries with clients (including consensual therapist-patient sexual involvement); and forensic issues, including therapists who testify in cases where therapist-patient sex is at issue. The authors offer an extensive review of widespread and changing approaches to this topic in the history of psychotherapy, alongside a comprehensive look at current standards and research findings. They also provide important information for fact and expert witnesses, examining the evolving ethical and legal standards surrounding sexual relationships between therapists and clients, and discuss how to respond to clients to report having been sexually involved with a prior therapist. Incisive reflection questions encourage readers to recognize and respond appropriately to their own feelings in the therapy room.

This book details the history, science, and practice of Functional Family Therapy (FFT), an evidence-based model practitioners can use to understand families, the problems they face, and how to enable families to create real and lasting change. Functional Family Therapy (FFT) has evolved from a theory taught only in universities to become a treatment model implemented in more than eight countries and ten languages. It features specialized training, certification, and systemic fidelity processes that are used worldwide. FFT has been recognized in recent years as one of the premier evidence-based family intervention models for working with adolescents with problem behaviors. Chapters describe the evolution of the theory and extensive research support for FFT, provide overviews of each stage of treatment, and offer practical guidance for using FFT in a variety of contexts including juvenile and adult justice, child welfare, foster care, and behavioral health; using FFT in community contexts, including training and supervision and measuring and integrating client feedback; and using cutting-edge technological advances to better deliver optimal outcomes for families.

This book describes a relationship-focused approach to the conduct of cognitive behavioral therapy (CBT) called therapeutic relationship-focused CBT, offering readers a broad conceptualization of the therapeutic relationship by integrating literature that cuts across theoretical frameworks, and applies this conceptualization to illustrate how the therapeutic relationship can be used as both a facilitator of change as well as a central agent of change within the cognitive behavioral framework. In addition to acknowledging important theoretical and empirical scholarship on the therapeutic relationship that has been advanced by renowned CBT scholars, the book highlights and integrates important insights from scholars who operate outside of the cognitive behavioral framework. In addition, it provides clinical guidance for developing, maintaining, and enhancing the therapeutic relationship throughout the course of CBT, and provides case illustrations to support the notion that some of the very best CBT occurs in the context of an issue happening in real time, in session, within the therapeutic relationship. Chapters emphasize that the incorporation of a focus on the therapeutic relationship in CBT has the potential to enhance outcomes and promote treatment engagement for clients. The volume is divided into two parts. The first part on contextual foundations describes theory, discourse, empirical research, and some clinical applications of general aspects of the therapeutic relationship. Part two of the book summarizes clinical guidance for the implementation of therapeutic relationship-focused CBT, showing how the therapeutic relationship can facilitate CBT techniques like cognitive restructuring, social problem solving, exposure, and schema modification. The author discusses how to address sensitive issues that may not typically be addressed in the CBT literature, such as negative client reactions to therapists and vice versa. Guidance for repairing ruptures in the working alliance and ending therapy is also provided. Together, the volume presents a vivid description of a therapeutic relationship-focused CBT that brings together key scholarly advancements on the therapeutic relationship, translates them into clinical guidance, and establishes a foundation for future empirical research and clinical practice.

This book shows mental health providers how to envision crises as time-limited windows of opportunity—as tipping points clients can seize to achieve new insights and move in positive directions in their lives. Most mental health practitioners have been taught to do risk assessments and to reduce danger to their clients and those around them. However, many providers lack a thorough understanding of the cause and nature of mental health crises and struggle to safely and successfully provide crisis intervention. Instead of seeking to return clients in crisis to their previous baseline, providers can seize the opportunity presented by crises and tip them toward rapid resolution. In Part One of the book, J. Scott Fraser outlines his Process of Change model, a clear and concrete approach to understanding crises in their proper context; engaging with clients through their values, culture, and language; honoring their goals; and breaking cycles of crisis for good. In Part Two, he shows how different types of crises—trauma, suicidality, grief, intimate partner violence, and sexual assault—reflect similar vicious cycles. Real life case studies illustrate the Process of Change model in action, demonstrating how each of those cycles can be tipped toward resolution by embracing the contextual process of change perspective.

This book is a practical guide to the evidence-based Cognitive Restructuring (CR) for PTSD program, which has been specifically designed to meet the unique needs of people with serious mental illness. Posttraumatic stress disorder (PTSD) is very common among persons with serious mental illness (SMI). Unfortunately, it often leads to more severe psychiatric symptoms, greater impairment in psychosocial functioning, poorer physical health, and a higher use of acute care services among people with SMI. Yet despite major advances in the treatment of PTSD in the general population, PTSD has remained underdiagnosed and underaddressed among people with SMI, and treatments for this population have been relatively neglected. This practical, hands-on guide gives clinicians the tools they need for screening, detecting, and treating PTSD in their clients with SMI, including schizophrenia, bipolar disorder, major depression, and borderline personality disorder. Chapters summarize research and theory regarding the interaction between PTSD and SMI, provide nuts and bolts strategies for implementing the authors'Cognitive Restructuring for PTSD program, and offer guidance for overcoming clinical challenges to trauma treatment such as psychotic symptoms, low distress tolerance, emotion dysregulation, hopelessness, and cognitive impairment. Chapters also feature in-session dialogues with case vignettes that follow three unique clients as they participate in the CR for PTSD program. Handouts and worksheets for delivering the CR for PTSA program are available in the Appendix of the book as well as in printable versions online (https://www.apa.org/pubs/books/treatment-posttraumatic-stress-disorder-serious-mental-illness) under the Resources tab. These online resources also include the educational handouts and worksheets translated into Spanish, a supplemental chapter on The BREATHE Program: A Brief PTSD Intervention for Persons with SMI in Special Settings, and the BREATHE Treatment Program Manual.

This second edition gives mental health professionals the tools they need to treat patients who suffer from infertility or pregnancy loss, as well as new guidance for processing their own reproductive traumas. Prospective parents who experience infertility or pregnancy loss deal with a host of physical and psychological consequences. For many individuals and couples experiencing reproductive trauma, their ideal future has fallen apart, leaving them bereft and hopeless. Author Janet Jaffe demonstrates how helping professionals can work with patients'reproductive stories to help them grieve, cope, and heal while underscoring how clinicians'own reproductive stories impact their lives and their therapeutic work. With updates in research and new, more diverse case examples, this edition has been expanded to offer a more holistic understanding of reproductive trauma, including coverage of LGBTQ+ parents and their unique needs and experiences. It also reviews advances in reproductive technology and their ethical implications—including cryopreservation, third-party reproduction, and genetic testing—as well as how social and cultural factors influence parents'reproductive stories.

Fully revised and updated, this pocket handbook for clinical assessment covers a comprehensive range of neurological, neuropsychological, neuropsychiatric, and neurobehavioral syndromes and disorders. Now in its fourth edition, this ready reference helps the busy clinician or doctoral-level trainee select from among hundreds of tests and assessment techniques in clinical neuropsychology. It guides clinicians in developing tailored, hypothesis-driven approaches for assessing patients with a broad range of common neuropsychological syndromes and neurological disorders. This book is an invaluable diagnostic guide designed to fit into a lab coat pocket for accessible and immediate use. Major updates to the new edition include: A revamped approach to contemporary neuropsychological assessment that incorporates cultural factors, mood, emotion and affect, medications, cognitive functioning and electrophysiology data, as well as emerging trends including tele-neuropsychology, positive neuropsychology, and consumer‑focused reports. New and expanded coverage of topics including updates on neurodegenerative disorders and mild cognitive impairment (MCI); lifestyle interventions to maximize cognitive functioning in MCI and dementia; chronic traumatic encephalopathy (CTE), autoimmune disorders, and motor disorders. An increased emphasis on neuropsychiatric syndromes. New topics include intellectual disabilities, the impact of marijuana and alcohol on cognitive functioning, anxiety disorders/PTSD, and an expanded focus on mood disorders. Updated online resources to support teaching and learning through neuroimaging figures and video demonstrations of exam techniques, and extended reading lists that have been expanded and more fully integrated into assessment chapters.

Now in its third edition, Integrated Behavioral Health in Primary Care details the relevant updates in the field for behavioral health care practitioners and offers targeted clinical assessment and intervention strategies that will meet the future needs of educators, students, and clinicians. Drawing on comprehensive research evidence and the authors'decades of clinical experience, this book offers practical guidance for behavioral health care practitioners who want to work more effectively in the fast-paced and complex setting of primary care. Chapters provide an overview of the key foundational concepts and applications of behavioral health within the primary care setting, and detail the competencies required for optimal assessment and intervention outcomes. The authors give detailed, practical advice for addressing common behavioral health concerns including depression, anxiety, health behaviors, pain disorders, substance misuse, and other pertinent problems, as well as special issues such as managing suicidal risk. Key updates to this third edition include: An expanded exploration of core competencies and clinical practice management skills; A review of the neuromatrix theory of pain model, as well as additional important considerations for assessing and treating fibromyalgia and other pain disorders, and; Assessment and intervention guidelines for opioid misuse.

This book provides an overview of the science and practice of relational savoring, a brief, guided reflection exercise that helps clients reconnect with memories of being closely connected with another person. Positive connection with others provide essential psychological benefits. Yet for many therapy clients, it is all too easy to overlook these positive moments. Relational savoring helps clients reflect on and value these experiences and relationships, to achieve improved relationship satisfaction and better emotion regulation. This book blends research, theory, expert clinical guidance, and compelling case examples to show how therapists can use the relational savoring approach with clients. Therapists first help clients choose an appropriate memory to savor, then guide them through a reflection exercise where they reflect on the emotions, thoughts, and significance associated with a close-connected experience occurring within an attachment relationship (e.g., parent-child or intimate partnerships). Relational savoring is an ideal complement to other, ongoing interventions. Alternatively, the approach can be used on its own. Given its versatility, effectiveness, and brevity, this intervention will be a welcome addition to any therapist's toolkit.

Now in its second edition, A Practitioner's Guide to Telemental Health is significantly updated with coverage of current best practices, evidence-based recommendations, and attention to nuanced refinements of telemental health in the face of recent accelerated growth in the field, due in part to the Covid-19 pandemic. Telemental health, or TMH, has become integral to nearly all aspects of behavioral health service, including research and delivery of treatment, assessment, psychoeducation, training, supervision, and consultation. This has removed significant barriers to care access for many underserved groups; however, it also means that the field overall must build its capacity to provide TMH. This book is for seasoned clinicians as well as new providers preparing to enter the mental and behavioral health care professions. Its chapters provide a guide for increasing TMH competencies, which require keeping up-to-date with the scientific evidence base and ongoing collegial discussion with informed leaders in the clinical, ethical, and legal realms. Readers will benefit from the research presented, as well as the description of practical steps they can take to ensure they are providing rewarding, safe, and quality TMH care for their patients.

In this empirical yet deeply humanistic work, Golan Shahar investigates the dynamic relationship between personality and social factors in complex depression, identifying avenues for research and offering hope for sufferers and treatment providers. Shahar synthesizes research and clinical wisdom to enhance our understanding of complex depression, a mental illness defined by its chronicity, heterogeneity, and serious consequences including suicide. He focuses on Melanie Klein's object relations theory and depressive position, reconceptualizing both from a transtheoretical perspective, with an emphasis on four key factors: demeaning affect; affect regulation; maladaptive schemas and scripts; and a time axis consisting of past, current, and projected future experiences. Shahar also explores how individuals externalize self-critical feelings, in turn creating a malignant social environment and a vicious cycle of self-recrimination. To explain this toxic relationship, Shahar presents ecodynamics, a novel theory examining relationship patterns between the self and their social contexts. The book offers tools and procedures for assessing complex depression and guidelines for integrative psychotherapy. Case examples, including the author's profound personal investigation into his stepfather's suicide, vividly demonstrate the causes and consequences of complex depression.

This book captures solution-focused therapy's essence, which distinguishes it from problem-focused approaches that have dominated the psychotherapy profession for over a century. What do therapists and clients talk about when therapy is effective? The development of solution-focused therapy (SFT) has been guided by the ongoing effort to answer this question. Solution-focused therapy is a collaborative approach that invites clients to describe what they want from therapy and apply the knowledge and skills they already have toward achieving it in the shortest time possible. The three main tasks of solution-focused therapy include setting a direction based on what the client wants from therapy, building on exceptions and other resources that are already happening and available in the client's life, and exploring progress toward desired outcomes. The three main techniques of SFT are asking, listening, and amplifying. When practicing purely solution-focused therapy, the therapist does little outside of these activities. Solution-focused principles and practices reflect the core values, ethical codes, and practice standards of professional associations and licensing boards in psychology, counseling, social work, and other helping professions. SFT has proven useful with persons from a variety of cultures and contexts, and on an array of concerns including trauma, substance misuse, and suicide prevention. It is well suited to the time constraints, third-party requirements, and other practical realities facing today's therapists and clients.

In this third edition, Judith Jordan explores the history, theory, and practice of relationship-centered, culturally oriented psychotherapy as a tool for building meaningful connections in a world of increasing isolation. This essential primer is ideal for students and practitioners alike, guiding them through the ins and outs of relational–cultural therapy (RCT). New to this edition is real-world research and guidelines related to distance learning, working with marginalized groups, and working towards social justice. Jordan built RCT upon the understanding that people need social and emotional connections to flourish. In a digital era full of uncertainty and disconnection, it is more important than ever to mend relational resilience and reestablish positive, growth-fostering relationships. The therapist therefore works to deepen their bond with the client to help them build similar bonds outside of therapy. They work with the client's relational images based on positive and negative experiences to manage expectations and teach relationship-building skills.

This book offers a comprehensive review of current research and theoretical approaches​ to pediatric obesity. Pediatric obesity is a significant public health concern that currently affects 1 in 5 children and adolescents. Prevention and treatment of this complex health condition requires a multifaceted approach that acknowledges the intersecting roles of gender, race and ethnicity, socioeconomic status, and other factors that play key roles in the onset and maintenance of pediatric obesity. Written for mental health clinicians, as well as medical practitioners such as physicians, nurses, dietitians, and exercise physiologists who care for children and adolescents, this helpful resource offers a comprehensive review of current research and theoretical approaches, as well as clear descriptions of effective strategies to prevent and treat pediatric obesity. Through a lens of diversity, equity, and inclusion, the authors incorporate cutting edge research and their extensive clinical experience and expertise as they review evidence-based treatments that can be incorporated into various settings, including primary care, mental health, and specialty medical care clinics as well as schools and community organizations. With a special focus on psychological factors, including mental health conditions that frequently co-occur with pediatric obesity, this book incorporates case examples, treatment guidelines, and reproducible handouts to make addressing pediatric obesity more accessible to clinicians and practitioners.

Now in its third edition, The Art and Science of Mindfulness offers a deeper understanding of the concept of mindfulness and explores its potential as a core clinical skill and a way to increase the well-being of both clients and clinicians. This book is written for anyone in the helping profession that may be looking for a great resource to better understand mindfulness practices. The three authors are very credible in their fields of study with decades of experience and published peer reviewed articles between them. The book is broken down into sections which include the basics of the effectiveness of mindfulness, different areas of mindfulness, and the future of mindfulness research. —Doody's Review Service Mindfulness helps us to see clearly so that we can make choices grounded in reality and respond to life with wisdom. However, seeing clearly is difficult because the lens through which we view the world is blurred by our parents, teachers, relationships, and society, and they influence our perceptions on conscious and subconscious levels. Practicing mindfulness helps us remove the filters, biases, and preconceived ideas that shape our perceptions and cloud our consciousness. At the deepest level, mindfulness is about freedom: freedom from reflexive patterns, freedom from reactivity, and, ultimately, freedom from suffering. This book navigates how mindful awareness is fundamental to the therapy process, and shows how mindful practice can help therapists and clients cultivate and connect with this deeper awareness. It also aims to present mindfulness as: an important dimension of clinical training with unique contributions toward fostering attention, empathy, presence, and awareness of our own biases and assumptions an empirically supported clinical intervention effective across a wide range of populations a means of fostering self-reflection and self-care for clinicians a way to expand the profession's focus on pathology to include positive growth and development New to this edition is a comprehensive overview of the evidence supporting the neurochemical basis of intention, attention, and attitude; a discussion of implicit bias and how it interferes with connecting mindfully with clients; a discussion of new mindfulness-based interventions and ways to apply mindfulness in therapy, and more.

This book expands on APA's 2017 Multicultural Guidelines by exploring additional research and providing students and professionals with practical applications for clinical practice, teaching and training, research, and consultation. As codevelopers of the guidelines, the authors provide their unique expertise in multicultural psychology, explaining how to develop cultural responsiveness and humility and become attuned to the diversity of human needs and experiences. They also describe how to create constructive dialogues about social identity and build fruitful bidirectional relationships with clients, students, and organizations, among others. This book takes an intersectional and ecological approach that considers a variety of cultural factors at multiple levels, ranging from small to large groups, to societal and cultural forces, and to historical changes. Within this layered ecological model, each of the ten guidelines is explored in depth in its own chapter, including illustrative case examples and discussion questions. The book concludes with a comprehensive review that ties the ten multicultural guidelines together and highlights key takeaways, as well as providing future considerations for how multicultural psychology will evolve.

This groundbreaking volume, published by the American Psychological Association in partnership with the International Union of Psychological Science, provides a detailed guide to clinical diagnosis by psychologists and other health professionals based on the eleventh revision of the World Health Organization's International Classification of Diseases (ICD-11). The ICD-11 was adopted by the World Health Assembly in 2019 and came into effect as the global standard for health information and reporting in 2022. The ICD is the diagnostic system for mental disorders most widely used by mental health professionals around the world in their day-to-day clinical practice. This edited volume offers a step-by-step approach to diagnosis, giving mental health professionals around the world the tools they need to apply ICD-11 diagnostic requirements for mental, behavioral, and neurodevelopmental disorders as the basis for delivering high quality, evidence-informed care. A psychological approach to diagnosis is a conceptually driven, person-oriented, biopsychosociocultural formulation that integrates pertinent history, behavior, symptoms, phenomenology, and functioning. A psychological approach focuses on psychological mechanisms and principles as an aspect of diagnostic practice and case formulation, regardless of professional discipline. The chapters of this book cover the major groupings of mental disorder as well as related areas that are important parts of psychological practice, such as sexual dysfunctions, sleep-wake disorders, and relationship problems and maltreatment. The authors of this book are leading global experts in each area, many of whom were integrally involved in developing the respective sections of the ICD-11. Authors describe the overarching logic for the classificatory arrangement and the elements of a psychological approach to the set of disorders discussed in each chapter, including psychological models for conceptualizing their symptoms and recommendations for psychological assessment. The chapters also discuss presentations and symptom patterns for each major group of disorders, specifiers and subtypes, the threshold between normal variation and disorder, differential diagnoses, co-occurring disorders, developmental course, cultural and contextual considerations, and gender-related features. A Psychological Approach to Diagnosis is the first comprehensive training resource on WHO's ICD-11 classification of mental, behavioural and neurodevelopmental disorders. It provides practicing psychologists and other mental health professionals, primary care clinicians, educators, and trainees with essential tools for the competent practice of diagnosis using the ICD-11 as a framework.

Structural Analysis of Social Behavior (SASB) helps clinicians and researchers make objective assessments of relationship patterns, and enables clients to improve their social interactions. SASB can help identify connections between clients'current symptoms, and their current and historical relationship patterns. The SASB coding system serves as the basis for case formulation, which in turn informs the choice of interventions used in a variety of therapeutic approaches. SASB can also be used to evaluate the effectiveness of interventions, thus keeping therapy on track. This book summarizes over 50 years of research and clinical practice with SASB, and demonstrates how it can be used with any therapeutic approach. It has been traditionally used with patients who are comorbid, often rehospitalized, dysfunctional, and suicidal, although it can be used with any clinical population. SASB offers providers a therapy compass that helps clarify where the client is now, and pointing in the direction they need to go in order to reach their therapy goals.

This book examines shame and anger, their relationship with one another, and how mental health providers can work with each of them to produce therapeutic change. Although very different emotions, shame and anger are highly related in therapy. Because shame and anger have both adaptive and maladaptive forms, intervention differs depending on what type of shame or anger is being experienced and in what sequence they occur. Therapists need to consider the type of shame or anger they are dealing with and how the two emotions interact before they can make process diagnoses of what is occurring at different moments in a session. This book emphasizes the benefits of accessing and experiencing shame and anger viscerally to promote emotion change in therapy. It teaches therapists how to help clients access their shame or anger in a safe therapeutic setting to make this emotion amenable to transformation, and create new narratives based on the transformed feelings.

This book provides clinicians, consultants, and healthcare administrators with a roadmap to establishing a systemic, patient-centered, family-oriented behavioral health service that is integrated into a healthcare setting. Healthcare that goes beyond biomedical issues to address our whole biopsychosocial selves, produces better outcomes for patients and families. Integrating behavioral health into medical settings requires an understanding of the interplay of multiple systemic layers in American healthcare. The existing literature on integration largely fails to address the'big picture'of integrated services and systems, including operations, clinical processes, and financial sustainability elements.A Systemic Approach to Behavioral Healthcare Integration summarizes the literature on the impact of integrating behavioral health care into medical settings, on the role of families in health maintenance and chronic disease management, and on team science and applying family systems theory/relational science to the teams that are now essential to healthcare.

Trainees with competence problems are common in professional psychology training programs. This comprehensive resource guides trainers and administrators as they navigate the challenges involved in supporting these trainees. Trainees with problems of professional competence (TPPC) have difficulty acquiring and/or maintaining developmentally appropriate levels of functional or foundational competence, with deficits in skills, functioning, attitudes, ethical practice, and/or interpersonal behaviors. These situations can be stressful for all involved, from trainees facing difficult feedback and remediation, to trainers navigating their responsibility to both educate and gatekeep, to administrators and other stakeholders who uphold academic standards and assist trainees in their educational experience. Problems of professional competence are complex, often involving assessment, evaluation, relational, ethical, and even legal challenges. Although excellent resources exist to guide trainees, trainers, and training programs through these challenging situations, no centralized, comprehensive source of information has been available until now. The editors and chapter authors bring together incredible depth and breadth of knowledge, experiences, and practical guidance in this volume.

This book examines the training and supervision of psychotherapists, with a focus on psychotherapy efficacy and key issues facing psychotherapy training programs today. While some therapists are more effective than others, good training and supervision can provide all clinicians with the skills and tools to become effective practitioners. Considerable research has shown the broad efficacy of psychotherapy, but there are still many clients who do not fully benefit from therapy, some who don't benefit at all, and even some who get worse as a consequence of therapy. The overall goal of training and supervision, and efforts to study these practices, should be to enhance the current degree of effectiveness that has been reached in psychotherapy. This book offers innovative knowledge on how to better understand and improve training by relying on the reflections, research discoveries, and collaborative work of psychotherapy scholars who represent a diversity of theoretical orientations, methodological expertise, and levels of experience.

Deliberate practice exercises help trainees achieve competence in essential psychodynamic therapy skills and apply them in a range of clinical situations while honing their own personal style and language. These exercises present role-playing scenarios in which two trainees act as a patient and a therapist, switching back and forth under the guidance of a supervisor. The therapist improvises appropriate and authentic responses to patient statements organized into two difficulty levels—intermediate and advanced—that reflect common patient questions and concerns. Each of the first 12 exercises focuses on a single skill, such as engaging in a therapeutic inquiry, deepening emotional experience, pointing out defenses, making transference interpretations, and providing corrective emotional experiences. Two comprehensive exercises follow in which trainees integrate these essential skills into a single psychodynamic therapy session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

Deliberate practice exercises allow students and trainees to rehearse foundational schema therapy skills so that they can build competence and hone their own personal therapeutic styles. Each book in the Essentials of Deliberate Practice series contains customized role-playing exercises in which two trainees act as a client and a therapist, switching back and forth under a supervisor's guidance. The trainee playing the therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—reflecting common issues encountered by schema therapists. The first 12 exercises focus on skills derived from schema therapy's three stages—bonding and emotional regulation, mode change, and autonomy—and include limited reparenting, psychoeducation about schema modes, and empathic confrontation. Following these are two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into a single session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

Ruptures in the therapeutic alliance are common. If left unresolved, they can lead patients to drop out, among other poor outcomes. Repairing therapeutic ruptures is an important process that is relevant for practitioners of all theoretical orientations. This volume collects the work of 12 teams of scholars and clinicians, each of whom is expert in a different therapeutic context or theoretical approach, to describe clinical challenges in resolving common therapeutic ruptures. The authors use case studies to describe realistic, complex clinical examples of rupture and provide strategies and principles therapists can use to help navigate these challenges more successfully with their patients. As therapists and patients work together their alliance can come under strain, sometimes because of disagreements over therapeutic goals, and sometimes due to a lack of trust and respect. These moments of stress where the relationship has ruptured are challenges, but also opportunities for growth.

This book summarizes attachment processes across the lifespan and reviews clinical applications with infants, children, adolescents, and adults. Attachment theory is often mischaracterized as focusing solely on maternal influences in early childhood, but developmental science has explored the important roles that other attachment figures play throughout one's life, including foster parents, social peers, and romantic partners. Following the history and evolution of attachment research, this book translates foundational knowledge into clinical practice by reviewing interventions such as parent training techniques, attachment‑based family therapy, and mentalization‑based therapy. These attachment-based interventions are differentiated from other, harmful treatments that have been erroneously linked to attachment theory, being labeled by their proponents as “attachment therapy.” Key concepts such as internal working models and secure vs. insecure attachment scripts are described, as are important assessment measures like the strange situation procedure and the adult attachment interview. Special features highlight notable topics and controversies in attachment theory and research and present case studies that bring clinical guidance to life.

This book highlights common factors as a psychotherapeutic treatment and offers related techniques that can be used as rubrics to improve clinical practice and training. The authors discuss five key common factors: the therapeutic relationship, motivation, corrective experiencing, insight, and self‑efficacy, which serve as heuristics for therapists of any background. Each factor is broken down into a set of core principles, intervention concepts, and example techniques, such as motivational interviewing skills, confronting distress to move towards change, adopting a multicultural orientation, and empowering clients. Deliberate practice methods are provided so that clinicians can rehearse common factor approaches and integrate them into their own work. Reviewing past efforts to define actionable common factors—including the contextual model of therapy—as well as transtheoretical studies and techniques, the book provides a uniquely well‑defined common factors model of treatment and paves the way for future innovations.

This volume demonstrates both how hypnotic techniques can supplement science-based clinical interventions and how clinicians can use hypnosis with the assurance of a strong empirical foundation to guide their practice. Hypnosis affords clinicians a brief, efficient, and cost-effective methodology to address a wide range of psychological conditions and disorders. While hypnosis has carved a well-earned place in the field of psychological science and clinical practice, views of hypnosis as gimmicky or fantastical are still stubbornly rooted in our collective consciousness, thanks to media-driven, outmoded, and inaccurate notions. Evidence-Based Practice in Clinical Hypnosis details the scientific evidence for and the clinical practice of hypnosis to treat a range of problems and symptoms, including anxiety, depression, acute pain, chronic pain, and other behavioral problems. Included are chapters on working with anxiety, depression, acute pain, chronic pain, and other behavioral medicine problems, as well as a chapter on working with children and adolescents. Contributors review the empirical evidence for the effectiveness of hypnosis for the problem under consideration, offer illustrative case materials, and provide examples of specific hypnotic inductions and suggestions.

Childhood has long been recognized as a developmental process. This book examines parenting through a similar lens, offering mental health providers a mentalizing framework for working with parents at all stages of parental development. Parenting is a developmental process that fluctuates and transforms throughout the lifespan. To support working with parents, the authors present a mentalizing approach that considers the current socio-cultural environment and its impact on the developmental process of parenting. This approach integrates a wealth of psychodynamic clinical research, theory, and practice. This book provides the reader with principles to inform evaluation, formulation, and treatment in their work with parents. It provides clinical examples followed by clinical formulations offering illustrations of the application of one approach to diverse clinical challenges in the context of working with parents, grandparents, and other caregivers.

This innovative book explores a range of well-established risk factors for clinical depression and links them to targeted, evidence-based treatments. Clinical depression is the single leading cause of mental health disease in the world, and the need for effective treatments has never been greater. In recent years, the volume of theory and research on a range of psychosocial risk factors for depression has grown dramatically. Fortunately, many of these risk factors are modifiable, making them ideal targets for treatment. Unlike other books that focus on intervention from a specific conceptual vantage point, such as cognitive-behavioral or acceptance and commitment therapy, this book's innovative approach targets the client's underlying vulnerability or risk factor and links it to specific, evidence-based treatment. In each chapter, leading authorities on a particular risk factor evaluate the literature, discuss implications for treatment, and present a case example to demonstrate how therapists can use the techniques with clients.

Deliberate practice exercises allow students and trainees to rehearse foundational dialectical behavior therapy (DBT) skills and strategies to respond effectively and flexibly to diverse, complex clinical presentations and situations. Each book in the Essentials of Deliberate Practice series contains customized role-playing exercises in which two trainees act as a client and a therapist, switching back and forth under a supervisor's guidance. The trainee playing the therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—reflecting common issues encountered by DBT practitioners. The first 12 exercises each focus on a single skill, such as validating clients, encouraging commitment to therapeutic goals, teaching problem-solving skills, and working with clients in crisis or expressing suicidal ideation. Following these are two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into a single DBT session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

This fully updated second edition presents theory, research, and practice guidelines for short term, evidence based individual treatment for adults experiencing the effects of complex relational trauma. Disrupted narrative and emotional processes are common effects of complex trauma, and emotion focused therapy for trauma (EFTT) is well suited to address these difficulties. Clients with complex trauma often suffer long term challenges after repeated exposure to violence and betrayals of trust, typically by attachment figures in the form of child abuse and neglect. The authors bring more than 25 years of research and clinical expertise to this evidence-based treatment model, which enables therapists to skillfully navigate the unique challenges facing these clients. Chapters present practical aspects of EFTT alongside supporting research, allowing clinicians from different theoretical perspectives to either apply the complete package, or integrate aspects of the model into their current practice. This comprehensive and essential resource is fully updated with current developments in research, clinical practice, and training.

This user-friendly, practical guide summarizes everything therapists need to know about setting up, growing, and protecting their independent therapy practice. In this book, a team of experienced psychologists with diverse experiences and perspectives guides readers through the common and not-so-common challenges inherent in managing an independent practice. Given that the COVID pandemic has changed therapy from a service typically delivered in person to one often conducted via teleconference, therapists need to ensure that their practice meets the changing needs of their clients as well as themselves. The chapters flow from initial preparation for successful independent practice and creating a business plan, to closing or selling a practice, and everything in between, including: Helping clients find you Preparing for emergencies Self and community care Legal, insurance, and financial issues The authors also provide key resources including professional guidelines relevant to therapists, recommendations for responding to subpoenas and submitting records testimony, providing information to professional will executors, and semi-structured interviews and assessments with different types of clients.

This book shows how silence around taboo topics can undermine therapy goals, as well as the teaching, practice, and profession of psychotherapy more broadly. It gives readers the skills they need to recognize and overcome barriers to speaking up. The authors describe current and historical contexts that can make frank discussions of certain topics difficult, and present factors that play a role in self-silencing. Strategies including questions for reflection and group exercises can help readers build the courage to talk more openly, honestly, and directly in the therapy room and beyond. Chapters focus on a variety of topics that can be difficult to discuss openly including physical difference and disability, sexual orientation, sexual reactions to clients, therapist feelings of anger, oppression, white supremacy culture, religion, money and fees, and death and dying.Speaking the Unspoken seeks to create dialogue, by encouraging the reader to deepen their understanding of these underexamined topics and improve their ability to help clients and strengthen the profession.

This comprehensive text describes a multimethod approach to assessing psychological and behavioral features of bipolar spectrum disorders alongside important contextual considerations. It provides mental health professionals with valuable empirical and interpretive support as they answer assessment questions for diagnostic and decision-making purposes. Chapters are written by assessment psychologists who are renowned for their expertise and contributions in developing and researching specific assessment instruments or topics. Contributors provide key information about widely used interview methods, self-report measures, and performance-based tests, including the MMPI-3, the SPECTRA, the Rorschach test, and cognitive and neuropsychological evaluations. They also review diagnostic criteria from the DSM-5-TR and the ICD-11. Additional chapters review special considerations for differential diagnosis, including comorbidity with medical conditions, distinguishing bipolar spectrum disorders from other disorders with similar traits, and accounting for multicultural factors. Two in-depth case examples provide comprehensive illustrations of the multimethod evaluation process with an adolescent and an adult.

Deliberate practice exercises provide trainees and students an opportunity to build competence in essential rational emotive behavior therapy (REBT) skills while developing their own personal therapeutic style. These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns. Each of the first 12 exercises focuses on a single skill, such as psychoeducation, assessing and disputing irrational beliefs, helping clients differentiate maladaptive vs. adaptive behaviors and emotions, teaching clients the ABC model, and developing homework assignments. Two comprehensive exercises follow in which trainees integrate these essential skills into a single REBT session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

Psychosocial factors, such as caregiver support and patients'expectations for quality of life after surgery, can have a strong impact on surgery outcomes. This book presents evidence-based approaches to presurgical psychological assessment across a broad range of medical conditions. Psychologists and other mental health professionals are increasingly included within the preoperative evaluation process for patients preparing for major surgery. Presurgical psychological assessment (PPA) aims to assess both the risk factors for poor surgical outcome, as well as patient strengths and resources that can have a positive impact on surgery results. This book presents evidence-based approaches to PPA across a broad range of medical conditions. Chapters outline a flexible model and practical tips for conducting PPA. They also offer selection and administration guidelines for psychological testing and clinical interviews, and information about relevant ethical and legal issues. Chapters review specific surgical areas in which PPAs are routinely conducted, including metabolic and bariatric, gynecologic, spinal procedures, gender embodiment, breast cancer treatment and prevention, solid organ transplant, deep brain stimulation, and treatment for temporal lobe epilepsy.

Deliberate practice exercises allow students and trainees to rehearse systemic family therapy (SFT) skills to develop basic competence and hone their own personal therapeutic style.In these exercises, two or more trainees role-play couples or family therapy sessions with one trainee acting as the therapist and the others acting as clients, rotating through these roles under a supervisor's guidance. The trainee playing the therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common problems and concerns encountered by SFT practitioners. The first 12 exercises each focus on a single skill, such as building a therapeutic alliance, deescalating conflicts, establishing rules and boundaries, and addressing diversity issues. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate these essential skills into a single SFT session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

This book describes training, supervision, and consultation with specialized cognitive behavior therapy (CBT) approaches, to ensure proper implementation across a variety of clinical contexts. Although CBT is sometimes portrayed as a single treatment method, the expert contributors in this volume describe a diverse collection of cognitive behavioral theories and techniques, such as exposure therapy, acceptance and commitment therapy, dialectical behavior therapy, and child behavior management. Contributors also review application guidelines for a variety of settings, including public schools, inpatient and outpatient medical settings, and diverse client populations representing different religious and spiritual beliefs, cultural and ethnic backgrounds, and sexual and gender minorities. For each approach and setting, contributors describe key concepts and techniques, explain the characteristics of good and bad training cases, survey common trainee mistakes and supervision obstacles, and also address common ethical issues. This book is intended for CBT trainees and practitioners who seek training in specialized areas, and those trained in other theoretical orientations who seek to adapt CBT techniques to their practice.

Deliberate practice exercises help students and trainees rehearse fundamental child and adolescent psychotherapy skills to develop basic competence and hone their own personal therapeutic style. Each book in the Essentials of Deliberate Practice series contains customized exercises consisting of role-playing scenarios in which two trainees act as a client and a therapist, switching back and forth under the guidance of a supervisor. The trainee playing the therapist improvises appropriate and authentic responses to a series of client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common problems and concerns encountered by practitioners who work with children and adolescents. The first 12 exercises each focus on a single skill, such as observing and elaborating on play, exploring identity through a multicultural orientation, and addressing difficult issues like safety concerns and sex. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate these essential skills into a single session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines and forms to help trainers and trainees get the most out of training are also provided.

Deliberate practice exercises help clinicians develop competence in fundamental motivational interviewing skills to better assist clients with change goals, like quitting addictive behaviors and developing healthier habits, and to improve treatment engagement and retention.These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns. The first 12 exercises focus on specific skills, such as offering simple and complex reflections and affirmations, eliciting change talk, supporting client autonomy, and collaboratively mapping session agendas. These are followed by two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into one session.Step-by-step instructions guide participants through the exercises, identify criteria for skill mastery, and explain how to monitor and adjust difficulty. Guidelines and forms to help trainers and trainees get the most out of training are also provided.

The Thriving Therapist provides an integrative, holistic, and developmentally sensitive path to assist therapists in assessing their unique needs and proactively structuring sustainable self-care practices, in alignment with their values. Self-care shouldn't feel like a burden. Professional self-care can be enjoyable, personally meaningful, and sustainably integrated into mental health practitioners'lives. Included in this book are diverse and vital resources that help practitioners: Go beyond one-off activities to create a self-caring lifestyle; Strengthen the guiding values by which they live and work, in order to prevent burnout and embody wellness; Cultivate mindful awareness of their needs both personal and professional, with special attention to the alignment of the person-practitioner-work environment; Build powerful inner resources such as gratitude, self-compassion, forgiveness, and humor to soothe in response to threats and bounce back from daily challenges; Implement and sustain healthy lifestyle habits that transform “simply getting by” into more easeful and meaningful living, including neurophysiological supports, meditation and subtle energy practices, mindful media consumption, and community-building.

Clients often seek therapists'input for dealing with ethical dilemmas in their lives, but there is little guidance for therapists in how to do this. This book shows therapists how to serve as ethical consultants who help clients balance their personal needs with their sense of responsibility to others. Dr. Bill Doherty blends decades of clinical experience with personal and philosophical insights to frame the skills and knowledge therapists need to act as ethical guides while respecting client autonomy. He calls for a shift from psychotherapy's individualistic focus towards a more relational one that includes ethical connections to others. Doherty presents the LEAP‑C model, a framework for ethical consulting that utilizes the traditional therapeutic skills of listening, exploring, affirming, and offering perspective, while also challenging clients to recognize ethical issues they don't perceive. Using detailed case examples, Doherty provides a roadmap for addressing common client dilemmas, such as keeping and ending commitments, having affairs, lying and deceiving, and causing psychological or physical harm to others. He also provides guidelines for citizen therapists to lend their expertise to help solve larger societal concerns, such as political polarization and police–community relations.

Addressing the critical intersection between mental health and the legal system, this book presents a competency-based approach to clinical practice with justice-involved couples and families.Author Corinne C. Datchi demonstrates that couple and family interventions are vital components of rehabilitation for both youth and adults, supporting positive family involvement and enhancing solutions to delinquency and crime. Chapters lay out essential data about juvenile and criminal justice systems, correctional populations, family systems theory, and forensic mental health issues, incorporating an understanding of these factors into the systemic assessment, case conceptualization, intervention, and treatment of clinical problems.A compelling case study brings this foundational knowledge to life, with a focus on systems thinking and scientific knowledge, and illustrates the functional competencies necessary to work effectively with couples and families in the juvenile and criminal justice system. The book outlines evidence on couple and family-focused interventions with justice-involved populations, and demonstrates how to use this information about effective therapeutic models.The volume is the first in the APA Fundamentals of Clinical Practice With Couples and Families Series that illustrates the application of specialty professional competencies in this area.

The therapeutic relationship, more than any particular technique or intervention, is the key to therapeutic success. Positive regard is a crucial component of that relationship. This book reconsiders the role of positive regard in contemporary psychotherapies. Positive regard, along with the therapist's empathy and genuineness, is one of Carl Rogers'three'necessary and sufficient'conditions for therapeutic change. However, positive regard is the least well-researched and most misunderstood of the three conditions. It has long been conceived as a potential ingredient in the formation and development of an effective therapeutic relationship, but many therapists in recent decades have considered positive regard a dubious ingredient, too oblivious to human frailty and malevolence, and too susceptible to a therapist's potential for collusion with patients'defenses and resistance to change. Written for a variety of psychotherapists, this book offers an investigation into the efficacy of positive regard by examining its history, evolution, misperceptions, criticisms, and value. The authors argue for a broader acceptance of the role of positive regard across diverse patients and therapies.

This empirically grounded, clinical guide for transdiagnostic emotion-focused therapy describes techniques used to transform the deep core emotional vulnerability—sadness, loneliness, shame, and fear—that underlies the diagnostic clusters of depression, anxiety, and related disorders. Emotion-Focused Therapy is an effective transdiagnostic treatment for the common symptoms that underlie depression, anxiety, and other related disorders. Given the high comorbidity of mental health symptoms and our growing understanding of psychopathology, transdiagnostic treatments are becoming more and more common. This book conceptualizes Emotion-Focused Therapy (EFT) as a transdiagnostic approach for treating a variety of mental health problems by accessing and transforming the underlying vulnerability of the core emotional pain and, in light of this, examining clusters of symptoms such as anxiety. The authors use elements of a modular approach that is the culmination of a decade-long research program. They target some symptom-level presentations, as well as the underlying emotional vulnerability that manifests in depression, anxiety, and other related disorders. This approach integrates a range of symptom-level EFT tasks, including tasks aimed at facilitating regulation of emotional distress, as well as tasks that specifically target self-worrying, rumination, perfectionism, and other discrete symptoms. Strategies that target clusters of symptoms, such as two-chair dialogues and self-interruption, are illustrated through richly detailed session transcripts. This book helps mental health professionals enable their clients to access emotional vulnerability, facilitate emotional regulation, guide emotional transformation processes, and engage in healthy interpersonal experiences.

Perfectionism is growing more prevalent among young people today, with increasing numbers of children admitting they feel pressure to be, or appear to be, perfect. This book describes perfectionism's mental health costs and effects on achievement, explaining the myriad and often surprising ways children and adolescents exhibit perfectionism in their family, school, and social environments. Most important, the authors suggest clinical interventions to help perfectionistic children regain perspective, and accept their limitations. Authors Gordon L. Flett and Paul L. Hewitt expertly summarize relevant studies, demonstrating that perfectionism is pernicious and requires a complex and multi-faceted approach to prevention and treatment. A clinically-focused section rounds out the book, with concrete steps counselors and educators can take to help build resilience and adaptability. 2023 Prose Award Finalist