bluuebunny/crossref_metadata_2025 huggingface dataset:
Legal issues for transgender people: a review of persistent threats
Authors: Green Jamison
Published: October 2017

Background
The legal status of transgender (trans) people is in constant flux. Over the past 70 years, gradually increasing transgender visibility, national and global advocacy, and, more recently, widespread Internet access, communication, and broadening support from allies, have all contributed to successful campaigns that have improved transgender lives and legitimised transgender. Still, traumatic interactions with the legal system or policing agencies remain plentiful. This is a very general overview of the most common legal issues confronting trans people. It aims to inform medical and mental health providers about the trepidation with which their patients and clients must engage legal systems, and the scope of their concerns, which ultimately affect their health. This review relies upon reports generated by advocacy organisations based on population surveys in several countries, the projects undertaken by legal and human rights advocacy groups, the topics most frequently discussed in academic texts examining transgender legal issues, and draws upon the author’s personal advocacy experience. The most complicated and persistent issues are identity recognition, family law and relationship issues, adverse discrimination and anti-transgender violence and its aftermath. Criminal law, almost universally, treats trans people according to the lowest common denominator, their genital status, which supposedly supports expediency and “safety”. Global legal and human rights efforts remain desperately needed to lift transgender people from the margins of society and provide them with equal opportunities to lead healthy and fulfilling lives. Access to appropriate and meaningful health care is a crucial element necessary to affirm the humanity of any person.
Caring for transgender people: looking beyond the hype
Authors: Ong Jason J. , Russell Darren B. , Wylie Kevan
Published: October 2017

This special issue of Sexual Health presents a collection of articles that addresses issues facing transgender individuals that are particularly challenging. Issues covered range from sexual health education in schools, the need for accurate epidemiological measurements, the perils of inaccurate diagnostic labels of transgender children, legal issues, the disproportionately high prevalence of HIV and sexually transmissible infections (STIs), and the role of primary care. We need to think critically, constructively and compassionately about transgender people. Particularly, we must look beyond the hype and objectively consider the evidence, without forgetting the people who are trying to cope with feelings that may be causing them great distress.
Royal language and reported discourse in sixteenth-century correspondence
Authors: Evans Mel
Published: October 2017

This paper investigates the formal and functional dimensions of reported discourse in sixteenth-century correspondence. It focuses on how letter-writers report the utterances – spoken, thought and written – of high-status sources (namely, the king or queen), in order to assess how the early modern reporting system compares with the present-day equivalent. The early modern values of authenticity, verbatim reporting and verbal authority are examined. The results taken from the Parsed Corpus of Early English Correspondence (PCEEC) suggest that early modern writers prefer to present royal language using indirect reports with semi-conventionalised linguistic features that clearly mark the authority of the source. Only an elite few, associated with the Court, use direct speech. The paper suggests that reporting practices distinguish between speech and writing, with the latter showing nascent signs of anxiety over verbatim reporting. I argue that these trends arise from the larger cultural shift from oral to written records taking place throughout the early modern period.
Colloquialization in journalistic writing
Authors: Rühlemann Christoph , Hilpert Martin
Published: October 2017

Recent analyses of written text types have discovered significant frequency increases of colloquial or conversational elements, such as contractions, personal pronouns, questions or the progressive. This trend is often referred to as colloquialization. This paper presents a new perspective on colloquialization, with a special focus on the discourse markerwell. The paper is divided into two parts. In the first part, we present new evidence of colloquialization on the basis of the TIME Magazine Corpus (Davies 2007), which allows analyses of diachronic change in recent written American English. The focus of our analysis is on highly frequent “inserts” (Biber et al. 1999: 56), which are elements such as discourse markers (e.g.,wellandoh), backchannels (yeah, uh-huh, etc.), and hesitators (uhandum, etc.). We conclude that inserts significantly increase diachronically in TIME. In the second part of the paper, we focus on the elementwellin its function as a discourse marker. Through a combination of quantitative and qualitative analytical steps, we analyze its diachronic development in terms of its structural contexts and its pragmatic functions, fleshing out how the process of colloquialization has affected its usage in recent written American English. We argue that the integration of corpus linguistic and pragmatic methods in this case study represents a new step towards the field of corpus pragmatics, that is, “the rapprochement between corpus linguistics and pragmatics and an integration of their key methodologies” (Rühlemann and Aijmer 2014: 23).
How the initiation and resolution of repair sequences act as a device for the co-construction of membership and identity
Authors: Huensch Amanda
Published: October 2017

This conversation analytic paper investigates how speakers self-position or are other-positioned as members of a certain social group (e.g., competent speakers of a language) through other-initiated repair. Findings illustrate the complexity of linguistic membership categories by demonstrating that they continually shift depending on local interactional goals and documenting how shifts are accomplished. The different levels and types of linguistic and cultural knowledge that are invoked in instances of repair on specific lexical items demonstrate the complexity of linguistic membership categorization, and this indicates a need to problematize the use of a priori and overly-vague labels like ‘non-native speaker’. Findings contribute to our understanding of the functions of other-initiated repair and the mechanisms of co-constructing membership (categorization) and thus social identity in interaction. They also raise questions about the relationship between amounts and types of knowledge and further our understanding of the construction of expert/novice categories via knowledge displays and negotiation.
“Are men sexually harassed?”
Authors: Mueni Joy , Clifton Jonathan
Published: October 2017

SinceMacKinnon’s (1979)ground-breaking work in which she coined the term sexual harassment, there has been very little consensus as to what it actually is. Using callers’ stories of male sexual harassment taken from Kenyan talk radio, the purpose of this paper is to analyse the in situ production of an emic definition of (male) sexual harassment. Further, using positioning theory as a methodology, this paper aims (1) to make visible the gendered identity work that defining, or not defining, an event as male sexual harassment occasions and (2) to show how hegemonic masculinity is achieved through stories and their evaluation by the radio host and other callers who talk certain masculinities into being as normative and others as deviant.
Experiencing the interpreter’s role
Authors: Hokkanen Sari
Published: October 2017

This paper proposes an affective approach to examining the interpreter’s role. More specifically, it suggests that, by considering the interpreters’ subjective feelings of involvement and detachment related to an interpreted event, we can examine the ways in which their role is constructed, within and through a combination of personal, social, and material factors related to the setting and the interpreter’s working conditions. As an example, I take the case of simultaneous interpreting in two religious settings, which I have studied with autoethnography. Thus, I analyze my experiences of interpreting in two religious settings and contrast these experiences to an “ideal” model of the interpreter’s role in such settings: that of the fully involved participant. The analysis indicates that, while an internalized ideal model of role may provide a point of reference for reflection, the actual experience of role emerges in a complicated interaction between personal, social, and material aspects.
Socio-technical issues in professional translation practice
Authors: Ehrensberger-Dow Maureen , Massey Gary
Published: October 2017

According to the International Ergonomics Association, a focus on organizational ergonomics recognizes that people work within socio-technical systems that encompass tools, equipment, and computer interfaces as well as other actors in their professional environment and networks. In recent research, we have started investigating such socio-technical factors from an ergonomic perspective. Observations at professional workplaces, responses to questionnaires, and in-depth interviews with translators suggest that their perceived self-determination is more important to the success of socio-technical change than the technological developments themselves. A lack of involvement in decision-making at the workflow level may explain why so many translators have been resistant to taking new technology on board. We discuss how a feedback culture could mitigate many socio-technical issues by giving translators a voice in change and empowering them to contribute to organizational learning and growth.
Knowing in translation practice
Authors: Olohan Maeve
Published: October 2017

This paper addresses the relationship between practice and knowledge in translation. It employs practice theory to conceptualize ‘knowing-in-practice’, introducing a theoretical approach to translation studies that enables an analytical focus on the practice of translating, rather than on the cognitive processes of translators or the textual features of translations. Against this practice-theoretical backdrop, knowing is construed as an emergent phenomenon that is sited in translation practice. Drawing on an empirical analysis of translating in a research organization, the paper then illustrates how this situated and embodied knowing is materially and discursively mediated and transpires in translation practice. Through its interdisciplinary approach, this research offers new sociological perspectives on the human and material interdependencies constituting translation in the workplace.
War and cultural heritage: the case of religious monuments.
Authors: Mylonopoulos D. , Moira P. , Kikilia K.
Published: October 2017

This chapter outlines the various international agreements, treaties and legal frameworks governing the treatment of cultural sites in general and religious sites in particular, during times of war. The chapter highlights cases where the destruction of religious sites has been punished by international war tribunals, but equally it notes systematic international weaknesses in site protection; for example, whereby internal disputes in countries do not involve international conflict and thus are not in violation of agreed regulations.
Finite Distortion Sobolev Mappings between Manifolds are Continuous
Authors: Goldstein Paweł , Hajłasz Piotr , Reza Pakzad Mohammad
Published: October 2017

We prove that if $M$ and $N$ are Riemannian, oriented $n$-dimensional manifolds without boundary and additionally $N$ is compact, then Sobolev mappings in $W^{1,n}(M,N)$ of finite distortion are continuous. In particular, $W^{1,n}(M,N)$ mappings with almost everywhere positive Jacobian are continuous. This result has been known since 1976 in the case of mappings in $W^{1,n}(\Omega,{\mathbb R}^n)$, where $\Omega\subset{\mathbb R}^n$ is an open set. The case of mappings between manifolds is much more difficult.
Transdiagnostic Assessment and Case Formulation
Authors: Boettcher Hannah , Conklin Laren R.
Published: October 2017

This chapter describes a transdiagnostic, emotion-focused approach to case formulation that facilitates individualized application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). We begin by highlighting the advantages of dimensional assessment and classification in the domain of emotional disorders. Next, we describe the elements of case conceptualization essential to the UP, including assessment of strong uncomfortable emotions, aversive reactions to emotional experiences, and efforts to escape or avoid these experiences. We provide examples of such processes, suggestions for how to elicit relevant information from patients, and a worksheet for conducting case formulation within the UP framework. Finally, we preview a recently developed self-report instrument that uses dimensional assessment to yield a transdiagnostic profile of emotional disorder features, which may further facilitate treatment planning.
The Unified Protocol for Posttraumatic Stress Disorder
Authors: Gallagher Matthew W.
Published: October 2017

With the publication of DSM-5, posttraumatic stress disorder (PTSD) is no longer considered an anxiety disorder, but there is extensive evidence that PTSD is associated with high levels of comorbid mood and anxiety disorders. Although effective treatments exist for PTSD (e.g., Cognitive Processing Therapy), current treatments were not designed to target the full range of comorbid conditions associated with this disorder, and it is unclear whether these treatments are effective for comorbid conditions for individuals with PTSD. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), therefore, has great promise as a potential treatment for PTSD. This chapter reports the results of a case series of the UP for three individuals with a primary diagnosis of PTSD. Results of the UP were promising, with all three reporting a significant drop in symptoms of PTSD, anxiety, and depression. Implications for evaluating the UP as an alternative treatment for PTSD are also discussed.
The Unified Protocol for Eating Disorders
Authors: Boisseau Christina L. , Boswell James F.
Published: October 2017

This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, and other specified feeding or eating disorders. We focus on the five core treatment modules, highlighting aspects of each one that are particularly relevant to eating disorders and discuss the evidence supporting their use. Next, using clinical case examples from both residential and outpatient settings, we illustrate how each of these core modules can be applied to the treatment of eating disorders. Finally, we provide recommendations for future applications of the UP in this population.
The Unified Protocol for Insomnia Disorder
Authors: Bullis Jacqueline R. , Sauer-Zavala Shannon
Published: October 2017

Sleep disturbance is a frequent complaint, both in isolation and in the context of other conditions, such as depression and anxiety. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was designed to be applicable to any disorder characterized by nonacceptance of negative emotions and subsequent attempts to suppress or avoid the emotional experience. This chapter provides a rationale for why the UP may be an appropriate treatment for sleep difficulties like insomnia. We will provide an introduction to insomnia, including the defining characteristics and a review of the relevant literature. Next, we discuss how to conceptualize the maintaining processes in insomnia from a transdiagnostic perspective, and then utilize a case example of a patient who was successfully treated for insomnia with the UP. Finally, we review in detail how core treatment skills were implemented to address sleep disturbance in the context of comorbid anxiety and mood difficulties.
The Unified Protocol for Borderline Personality Disorder
Authors: Sauer-Zavala Shannon , Bentley Kate H. , Wilner Julianne G.
Published: October 2017

Borderline personality disorder (BPD) is a severe, difficult-to-treat psychiatric condition that represents a large proportion of treatment-seeking individuals. This disorder is characterized by high rates of co-occurrence with depressive and anxiety disorders, and recent explanations for this comorbidity suggest that these disorders share biological vulnerabilities and functional maintenance factors. Given the commonalities among BPD and other emotional disorders, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was clinically applied to five individuals who met criteria for BPD and at least one comorbid emotional disorder. This chapter will highlight the theoretical rationale for considering BPD an emotional disorder, underscoring the use of the UP with this population. In addition, detailed case presentations of two individuals with BPD treated with the UP will be presented to illustrate the ways in which UP skills can be flexibly applied within this diagnostic group.
Motivational Interviewing to Promote Self-Management
Authors: Phillips Rebecca , Hogden Anne , Greenfield David
Published: October 2017

Motivational interviewing is an empathetic approach for facilitating behavior change. Clinicians can use this approach to support individuals with chronic health conditions to identify opportunities for behavior change and develop a plan for working toward their goals, recognizing the importance of self-management. The aim of this chapter is to provide a description of motivational interviewing, highlighting how this approach can be used to promote self-management. This chapter (a) provides a brief overview of motivational interviewing, (b) presents evidence about the effectiveness of motivational interviewing, (c) discusses how motivational interviewing can be used in practice with an emphasis on its use to promote self-management for individuals with chronic health conditions, and (d) summarizes key considerations when using motivational interviewing to promote self-management for individuals with chronic health conditions.
Self-Management of Addictive Behaviors
Authors: Radoncic Vanja , Marcoux Betty , Hien Denise
Published: October 2017

In the past couple of decades, a number of evidence-based psychosocial treatment approaches to treat people with addiction problems has significantly increased. Evidence-based practices of interventions that improve health outcomes incorporate different treatment modalities including psychosocial and cognitive behavioral therapy treatments for addiction. These treatments promote changes in individual’s behaviors, thought processes, emotion regulation, and social functioning. An increased capacity to better understand factors contributing to addictive behaviors facilitates the self-management approach. This approach considers addiction in the context of chronic impairment and encourages individuals to be active in creating their own goals and determining the type of intervention that is most appropriate for them.
Self-Management of Pain
Authors: Hadjistavropoulos Thomas
Published: October 2017

Most chronic pain sufferers are treated primarily with biocentric approaches (e.g., pharmacological therapy, surgery) that do not adequately address the often devastating physical, social, and psychological pain sequalae. Self-management programs have the potential of filling a gap not only by assisting with pain management (e.g., facilitating the optimization of participation in prescribed treatments) but also by addressing the psychosocial consequences of pain. Self-management programs have been delivered in a variety of formats (e.g., through the use of groups, self-help books, and technology). With some inconsistencies in the literature, studies of the effectiveness of pain self-management have yielded promising results, although effect sizes tend to be small to moderate. More research is needed to clarify inconsistencies across studies and to directly compare the efficacy of different modes of program delivery.
Reflecting on RAINBOW Experience and Tools Learned
Authors: West Amy E. , Weinstein Sally M. , Pavuluri Mani N.
Published: October 2017

Session 11 of the RAINBOW treatment protocol focuses on the internalization and consolidation of treatment gains, as well as reflections on the treatment process and experience, in preparation for the end of treatment. Session 11 is conducted individually with the child, followed by a portion with child and parents. The child and therapist create a Rainbow Binder with all of child’s therapy materials completed during the course of treatment. Through this activity, therapist and child review the concepts and skills learned in RAINBOW and ways to apply RAINBOW skills to future situations. The RAINBOW binder is shared with the parents to facilitate further consolidation of treatment skills and gains, as well as to celebrate the family’s successes. Last, the family is prepared for the end of treatment via discussion of ways to maintain gains post-treatment.
Purging Disorder
Authors: Keel Pamela K. , Forney K. Jean , Kennedy Grace
Published: October 2017

Purging disorder (PD) is characterized by purging after consumption of normal or small amounts of food in individuals who are not underweight and experience fear of gaining weight or undue influence of weight or shape on self-evaluation. This chapter provides a description of PD along with brief case vignettes. PD predominantly affects women, occurring in 1–5% of women during the course of their lifetime. No evidence-based treatments have been established specifically for the treatment of PD. However, patients with PD have been included in randomized controlled trials examining the efficacy of enhanced cognitive–behavior therapy for transdiagnostic treatment of eating disorders, integrative cognitive–affective therapy, and family-based treatment. Each is designed to address some factors relevant to the maintenance of purging in PD, but more work is needed to address the full range of problems encountered by these patients.
Eating Disorders and Disordered Eating in the LGBTQ Population
Authors: Arcelus Jon , Fernández-Aranda Fernando , Bouman Walter Pierre
Published: October 2017

An overall increased prevalence of eating disorders psychopathology has been reported among the LGBTQ population, particularly among gay men. For some transgender people transitioning post puberty, pressure to conform to a social gender role with the body of their assigned gender may precipitate body dissatisfaction and eating disorders as a consequence. For gay men in particular, trying to conform to specific roles, and the effect of the media, may also affect body dissatisfaction. In addition, concurrent mental health problems such as anxiety and depression may make the LGBTQ population more vulnerable to developing eating disorders. Helpful interventions for eating disorders in the LGBTQ population include addressing the maintaining factors of the eating disorder through therapy; improving interpersonal skills; and considering specific themes for this population, such as coming out, fears of rejection, and personal/societal acceptance.
Role Transitions
Authors: Weissman Myrna M. , Markowitz John C. , Klerman Gerald L.
Published: October 2017

Depression associated with role transitions occurs when a person has difficulty coping with a life change that affects her mood and requires different behavior or modifications in one or more close relationships. This chapter includes the definition of role transitions and outlines the goals and strategies for IPT therapists working with this problem area. The aims of treating depression associated with a role transition are to understand what it means to the patient: what the patient has lost, what the new situation demands, what might be gained, what expectations the person and others have in relation to that change, and how capable the person feels of meeting them. Depressed patients tend to exaggerate the benefits of the old situation while minimizing the negatives. Developing new skills is an important part of the transition recovery process. Case examples are included.
Interpersonal Deficits (Social Isolation; No Life Events)
Authors: Weissman Myrna M. , Markowitz John C. , Klerman Gerald L.
Published: October 2017

This chapter covers the definition, goals, and strategies of the problem area regarding interpersonal deficits. Interpersonal deficits, loneliness, social isolation, or a paucity of attachments may be chosen as the focus of IPT if none of the other interpersonal problem areas exist. If any of the other problem areas can be found (grief, role disputes, or role transitions), the therapist should not use interpersonal deficits as the focus of therapy. IPT is a treatment designed to address life events, but this category covers those patients who present without acute life events. Case examples are included to illustrate the presenting problems and treatment strategies for two patients in whom this focus of interpersonal deficits was used: one had trouble making friends after college and the other had difficulties establishing romantic relationships with women.
Depression in Medical Patients
Authors: Weissman Myrna M. , Markowitz John C. , Klerman Gerald L.
Published: October 2017

Depression treatment that is coordinated with care for comorbid chronic conditions improves control of both the depression and the chronic medical disease. Interpersonal counseling (IPC) and briefer forms of IPT for depression have been introduced in medical practice and primary care to accommodate providers’ time constraints and different levels of training of mental health care providers. IPC is best used with patients who have low levels of depressive symptoms, or distress, and where more highly trained therapists are not available but health personnel are interested in providing counseling. There is high interest in developing briefer approaches for depression treatment in medical patients, a wealth of evidence-based choices, and much work to be done. A case example is given of a college student with comorbid depression and diabetes.
Trauma- and Stress-Related Disorders
Authors: Weissman Myrna M. , Markowitz John C. , Klerman Gerald L.
Published: October 2017

This chapter covers the use of IPT for patients with trauma- and stress-related disorders, namely posttraumatic stress disorder (PTSD) and adjustment disorders. Psychotherapies for PTSD have almost invariably focused on exposing patients to reminders of past traumas, but some patients refuse or cannot tolerate this approach. In contrast, IPT focuses not on the traumatic event but rather on its devastating interpersonal consequences. In IPT patients are not asked to confront and reconstruct the trauma but rather to improve how they handle their daily social interactions. The limited research on IPT for PTSD has had exciting outcomes. Use of IPT in this area is still new, however, and more research is needed to understand its efficacy in veterans and other traumatized populations.
Goal Focused Positive Psychotherapy
Authors: Conoley Collie W. , Scheel Michael J.
Published: October 2017

Goal Focused Positive Psychotherapy presents the first comprehensive positive psychology psychotherapy model that optimizes well-being and thereby diminishes psychological distress. The theory of change is the Broaden-and-Build Theory of positive emotions. The therapeutic process promotes client strengths, hope, positive emotions, and goals. The book provides the foundational premises, empirical support, theory, therapeutic techniques and interventions, a training model, case examples, and future directions. A three-year study is presented that reveals that Goal Focused Positive Psychotherapy (GFPP) was as effective as cognitive-behavioral therapy and short-term psychodynamic therapies, which fits the meta-analyses of therapy outcome studies that no bona fide psychotherapy achieves superior outcome. However, GFPP was significantly more attractive to the clients. Descriptions are provided of the Broaden-and-Build Theory, therapy goals based upon clients’ values and personal meaning (i.e., approach goals and intrinsic goals), identification and use of clients’ personal strengths (including client culture), centrality of hope and hope theory, the implicit theory of personal change or the growth mindset, and finally Self-Determination Theory. The techniques and interventions of GFPP as well as the importance of the therapist’s intentions during therapy are presented. GFPP focuses upon the client and relationship while not viewing psychotherapy as a set of potent scripted treatments that acts upon the client. Goal Focused Positive Supervision is presented as a new model that supports the supervisee’s strength-based self-definition rather than a pathological one or deficit orientation. Training that includes the experiential learning of GFPP principles is underscored.
When you meet: assessing obsessive-compulsive disorder
Authors: Bream Victoria , Challacombe Fiona , Palmer Asmita , Salkovskis Paul
Published: October 2017

This chapter provides a practical guide to assessing obsessive-compulsive disorder (OCD) that is both informative to the inexperienced clinician and addresses questions raised by the experienced clinician. It will summarize the diagnostic criteria for OCD, including advice on making a differential diagnosis when presented with symptoms that are associated with other disorders; for example, differentiating OCD from psychosis, generalized anxiety disorder, or health anxiety. It will guide the reader through the process of conducting a thorough assessment of the patient’s presenting problems, including OCD and any comorbid problems. The chapter will offer guidance on how to engage the person with OCD and promote trust. There is clear guidance on risk assessment, differentiating between primary risk factors (which clinicians are typically very good at assessing), and secondary risk factors (which may easily be overlooked). Advice on structuring an assessment and on appropriate assessment tools is provided.
Beyond the fundamentals
Authors: Bream Victoria , Challacombe Fiona , Palmer Asmita , Salkovskis Paul
Published: October 2017

This chapter provides guidance on some of the issues of complexity, using a number of examples, including case illustrations of mental contamination, post-traumatic stress disorder, and perfectionism. There is a detailed consideration of incorporating compassionate mind work on shame. As obsessive-compulsive disorder (OCD) has a great impact on others around the individual, we focus on working with the involvement of family members in symptoms. The chapter also covers adaptations of standard treatment (group and intensive treatment). We consider how to make best use of supervision, including a detailed discussion of OCD-specific competences and metacompetences, as part of continued development as a therapist. There is an outline for how we might prevent OCD in the future, including disseminating understanding of OCD.
Setting the scene
Authors: Bevington Dickon , Fuggle Peter , Cracknell Liz , Fonagy Peter
Published: October 2017

This chapter begins with an analysis of the fraught organizational and economic circumstances of work with the target population, and the demands these place upon workers, illustrated with four extended case scenarios. After this, the chapter covers in broad terms the solutions that AMBIT seeks to offer, describing the coherent structure of AMBIT by means of its “wheel” diagram. Four main areas of activity to be held in balance make up the quadrants of the wheel: working with your client, your team, and your networks, and learning at work. These are surrounded by four sets of paired, and often mutually contradictory, elements of a principled stance for workers. Emphasis is placed on the inevitability of being out of balance, justifying attention to structures that support the restoration of balance, and longer-term sustainability. At the wheel’s center, the load-bearing “axle” is mentalizing, which Chapter 2 addresses.
Working with your team
Authors: Bevington Dickon , Fuggle Peter , Cracknell Liz , Fonagy Peter
Published: October 2017

Describing the second quadrant of its “wheel,” AMBIT advocates purposeful effort to create relational contexts within the team to support colleagues’ mentalizing, even under pressure. Strong, individual, “keyworking” relationships with clients (facilitating epistemic trust) are the primary delivery mechanism facilitating change. However, such work is stressful, which inevitably threatens workers’ ability to mentalize clients, other professionals, and themselves. The balancing of autonomy (creating authentic relationships) against healthy dependence (maintaining mentalizing) is related to research evidence on team/organizational climate and culture, and to ideas about learning in organizations, especially from aircraft “near misses.” Activities and techniques for sustaining this focus are described, including a disciplined technique for help-seeking peer-to-peer conversations called “Thinking Together,” and techniques of graded assertiveness in challenging a team member whose behavior is hard to make sense of. The chapter concludes with discussion of more formal supervision, and some of the challenges involved in working in this way.
Managing Chronic Health Concerns
Authors: Walcott Christy M. , Kazmerski Jennifer S.
Published: October 2017

The chapter “Managing Chronic Health Concerns,” in School Mental Health Services for Adolescents, reviews biopsychosocial influences on learning and behavior and presents service models targeted for youth with chronic medical conditions. Systemic issues (e.g., racial disparities, disjointed delivery of care, poor communication) are reviewed, with the conclusion that school-based services for chronically ill adolescents are essential to a high-quality continuum of care. This chapter provides strategies for identifying students and reviews common school-based support mechanisms for chronically ill youth. Three common health conditions—asthma, diabetes, and obesity—are highlighted. Finally, this chapter proposes a service delivery model that embraces a behavioral and developmental-ecological framework and focuses on school as a central context, with integration of services across home, school, and medical settings.
Classroom-Based Services for Adolescents With Mental Health Needs
Authors: Kern Lee , Custer Beth , Zaheer Imad
Published: October 2017

The chapter “Classroom-Based Services for Adolescents With Mental Health Needs,” in School Mental Health Services for Adolescents, describes a classroom-based three-tiered framework of prevention and intervention that is efficient and cost-effective. A rationale is provided for why the three-tiered framework, typically applied at the school-wide level, is also a good fit for individual classrooms. Following the rationale, the chapter provides details of specific interventions across the three tiers that have solid or emerging evidence for effectiveness in secondary settings. For each intervention, a rationale is provided, followed by specific procedures and strategies for implementation, as well as research to support the effectiveness of the intervention. The chapter ends by discussing broader implementation issues in the form of individual barriers teachers face and larger systemic barriers in secondary school settings.
Consultation and Collaboration to Increase Integrity in School Mental Health
Authors: Coles Erika , Massetti Greta M.
Published: October 2017

The chapter “Consultation and Collaboration to Increase Integrity in School Mental Health,” in School Mental Health Services for Adolescents, describes the indirect service delivery model of school consultation, in which a consultant works with a consultee (e.g., teacher, school staff), who in turn provides direct service to a client. The importance of treatment integrity in the process is highlighted. Imperative to the process of school consultation is defining and measuring treatment integrity, or the degree with which a treatment is adhered to, the competence of the individual delivering the treatment as intended, and the extent to which the treatment can be differentiated from other existing treatments. Issues and challenges of measuring and increasing integrity are discussed.
Treatment of Depression and Bipolar Disorder
Authors: Rynn Moira , Crits-Christoph Paul , Brent David , Findling Robert , Wagner Karen Dineen
Published: October 2017

This chapter reviews the current status of the adult literature on mood disorder treatments for both psychosocial and psychopharmacological treatments. This is followed by an appraisal of the same treatment for adolescents. The chapter finds that there are only limited data from methodologically rigorous trials in pediatric bipolarity. Evidence suggests that monotherapy using certain drugs may be useful in the treatment of young patients with mania and related mood states. A consistent theme from the extant literature is that a substantial number of patients do not respond to all types of monotherapy. Therefore, investigators have begun to explore combination pharmacotherapy. It seems that simultaneous treatment with more than one agent may be a rational form of intervention for some patients. Pediatric bipolarity is a chronic condition associated with substantial dysfunction and suffering. There are few methodologically sound pharmacological treatment studies, thus more research on this topic is sorely needed.
Treatment of Anxiety Disorders
Authors: Foa Edna B. , Franklin Martin , McNally Richard J. , McLean Carmen , Pine Daniel
Published: October 2017

The chapter starts with an overview of the treatment of anxiety disorders in the fields of child and adolescent clinical psychology and psychiatry. Before reviewing what is known about the treatment of anxiety disorders in adolescence, the chapter first provides a brief overview of the history and rationale for cognitive behavioral therapy, pharmacotherapy, and their combination in the treatment of youth with anxiety disorders. The chapter concludes by stating that much more needs to be done to establish the efficacy and safety of medication augmentation for adolescents with anxiety disorders; clinically it is known that many are treated with this strategy, but the literature supporting this approach has yet to be developed.
Treatment of Substance Use Disorders
Authors: Szobot Claudia
Published: October 2017

This chapter reviews psychosocial and pharmacological approaches to the treatment of substance abuse in adolescents. Effective early intervention is crucial because it can play a preventive role in later years. Treatment is complicated by several factors: (1) adolescents use multiple substances; (2) rates of comorbid psychiatric disorders are high; (3) substance abuse is common in family members; and (4) adolescents rarely seek treatment voluntarily but are usually coerced after experiencing school, legal, or medical problems. Treatment programs must be designed specifically for adolescents, and the intensity of treatment should be based on the severity of drug use and the associated combination of risk and protective factors. Among psychosocial approaches, family therapy has a relevant role. The use of medication is complex and depends on the drug used and the presence of comorbidities. Despite the need for advances in this area, there are evidence-based approaches to offer for substance-abusing adolescents.
Conclusion: Successes Since the First Edition and Pressing Issues for the Future of Adolescent Mental and Behavioral Health
Authors: Romer Daniel
Published: October 2017

Despite improvements in the delivery of care for adolescent mental and behavioral conditions since the first edition of this book, many challenges remain. This concluding chapter highlights some of the most pressing issues. These include the need for more mental health care practitioners, a greater evidence base for the treatment of adolescent conditions, and more focus on reducing family poverty. Given the high rates of gun violence, including homicides and suicides, efforts are needed to reduce access to these weapons. Promising directions in research and the need for a national youth development strategy are also discussed.
Narrative and the Phases of Care
Authors: Freitag Lisa
Published: October 2017

In her book Moral Boundaries political scientist and ethicist Joan Tronto suggested a new way of evaluating care, as an action rather than an emotional state. She approached care in four phases, each of which has an associated virtue guiding how a caregiver might act. This chapter evaluates the four phases of care and their virtues (attentiveness, responsibility, competence, and responsiveness), extending their use to the care of children with special needs. The applicability of Tronto’s phases and their virtues is demonstrated by applying them to a complex parent narrative: Vicky Forman’s This Lovely Life. Forman’s narrative, examined with principle ethics, offers an unsolvable dilemma of children’s rights vs. parental autonomy. Examination using Tronto’s theories offers a new way to analyze parent caregiving and raises ethical questions not previously considered. This provides the groundwork for evaluation of the moral work involved in extreme caregiving.
Responsiveness
Authors: Freitag Lisa
Published: October 2017

One of the most overlooked moral responsibilities of parenting is nurturing a child’s unique personality and providing guidance toward an independent future. Children with delays in development depend on parents for prolonged periods, for physical care and for nurturing their emerging personhood. Following theories of family holding and identity formation proposed by Hilde Lindemann, this chapter analyzes the moral task of upholding identity for children whose special needs include speech or developmental delays. The parent must encourage the emergence of a child’s personhood in the absence of verbal confirmation, guard the child’s unique potential, and avoid imposing on the child their own desires. Nurturing an identity for a child who may never be able to refute it is a task requiring exquisite openness to a child’s nonverbal responses. The parent must create a unique life story for a child who may never be able to verbalize it for themselves.
Holding the Future
Authors: Freitag Lisa
Published: October 2017

Long wait lists for services and a dearth of people willing to work as caregivers ensure that many people, particularly with intellectual disabilities, continue to live with their aging parents. Informed by a personal narrative of a successful future for a person with intellectual disabilities, this chapter proposes three components that are essential for success. Adults with disabilities can benefit from establishing a life outside their parents’ home. They also need place to work and inclusion in the community. The communities created by L’Arche and the Brothers of Charity, where caregivers live and work together with people with intellectual disabilities, provide one model for care. The extent of current need makes it impossible to provide this for everyone, but some of the lessons learned from “living with” people with disabilities can perhaps be carried over into existing group homes or even institutional care settings.
Conclusion
Authors: Freitag Lisa
Published: October 2017

Joan Tronto has proposed that our society would be improved if we placed care, rather than profit, at the center of our lives. A “caring democracy” would concentrate on ensuring that all of its members are both well cared-for and free to care for themselves and others. This chapter recommends that we begin to consider the necessity of care by advocating for parents who are providing extreme caregiving for their children. We must make visible the important work they are doing. We also might benefit from the lessons they have learned by spending their lives listening to the sometimes nonverbal voices of their dependent children.
Dispersion of Contaminants
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter describes the pathways and dynamics of chemical contaminants within the various structural layers. In the atmosphere, the chemical contaminants are transferred by diffusion, turbulence, plume dispersion, long-range transport, and tropospheric-stratospheric interchange. They are transferred to the hydrosphere by surface deposition, rainout, and washout. They are transferred to the lithosphere by surface flow and penetration, and are transferred within the biosphere by food-chain concentration.
Fate of Chemicals
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter discusses how, following their release into the environment, chemicals may be converted into different forms and/or transferred within and between the atmosphere, hydrosphere, lithosphere, and biosphere. It reviews the physical and chemical processes by which specific pollutants and classes of pollutions may be altered and ultimately dispersed within each of the components of the environment. The role of biogeochemical cycles in the movement of pollutants from the abiotic to the biotic environment is reviewed. Ultimate sinks for pollutants are discussed as are pollutant residues in the environment.
Effects of Contaminants on Human Health
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter describes the methodology used for evaluating potential human health effects resulting from exposure to environmental chemicals. It discusses the concept of the dose-response relationship, and reviews the processes by which chemicals may be delivered to and absorbed by the body. Concepts of the metabolic transformation of absorbed chemical are provided, as are the potential for storage and excretion. It explores the biological mechanisms and pathways underlying specific responses to chemical contaminants, which range from disruption of physiology to alteration of biochemical pathways and hereditary material. A discussion of responses due to exposure to mixtures of chemicals is provided.
Effects of Contaminants on Environmental Quality
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter reviews the potential for adverse environmental effects which may occur due to chemical pollutants. These include biological effects in domestic animals and livestock, ornamental plants, and crops and forests, and disruptions of terrestrial and aquatic ecosystems. They also include safety issues, such as atmospheric visual range reductions due to light-scattering particles, health issues such as stratospheric ozone reduction caused by fluorocarbons, aesthetic nuisances, and economic issues related to chemical odorants and foliar damage of commercial vegetation. The role of air pollution in climate change is also presented using an historical perspective, as is the potential environmental effects of such change.
Risk Assessment
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter describes the characterization of risk and the application of risk assessment methodologies by governments, corporations, and special interest groups so as to identify the nature and extent of known and potential risks to public health and welfare from exposure to environmental chemicals. It discusses the nature of risk, including perceived vs. real rick, risk identification and quantification, and risk communication. It reviews the different approaches that may be used in risk assessment and provides specific applications of risk analysis, including the setting of exposure limits and/or emission limits and the specification of control technologies to reduce emissions of chemicals.