This book offers an innovative, trans-diagnostic approach to enhancing self-control in adolescents based directly on personality and social psychological science. It thus fills a void. While several books address specific disorders such as ADHD, poor school performance, and aggression, this is one of the first books to translation social and personality psychology research into a set of generally applicable treatment strategies. This literature as a whole is not well known to cognitive behavioral therapists or other applied mental health professionals and will be a valuable addition to their clinical knowledge base.
Because the interventions described in the book target the underlying processes common to self-control (rather than to specific diagnostic entities), clinicians do not have to master a treatment manual for each individual disorder. Instead, they are provided with treatment tools that they can modify and use flexibly with the large number of adolescent referred because of problems with self-control, who typically present with a range of symptoms and co-morbid disorders.

Originally published in 1972, this fully revised edition was published in 1991 and provides a classic study of humanity s capacity for evil.

The human species is capable of the most appalling cruelty. Why is this and where does our capacity for such destructiveness come from? In "Human Destructiveness," Anthony Storr explores these important questions.

In seeking to shed light on such brutal phenomena as genocide, racial conflict and other large-scale manifestations of violence, he cautions against easy extrapolations from individual behaviour to the behaviour of groups and nations, though he offers illuminating discussions of aggressive personality disorders, sadomasochism and the mechanisms of paranoid delusion. Most provocatively, he locates the propensity for mass outbreaks of cruelty in the imagination: to be able to see fellow human beings as wholly evil requires an imaginative capacity not found in other species.

Combining wide scholarship, humane intelligence and a graceful style, "Human Destructiveness" provides an illuminating study of some of the darkest corners of the human psyche."

An aberrant belief is extreme or unusual in nature. In the most serious cases these beliefs cause emotional distress in those who hold them, and typify the core symptoms of psychological disorders. Each of the chapters in this volume seeks to examine the role that biases in reasoning can play in the formation of aberrant beliefs. The chapters consider several conjectures about the role of reasoning in aberrant belief, including the role of the jumping to conclusion bias in delusional beliefs, the probabilistic bias in paranormal beliefs, the role of danger confirming reasoning in phobias, and the controversial notion that people with schizophrenia do not succumb to specific forms of reasoning bias. There are also chapters evaluating different theoretical perspectives, and suggestions for future research. Aberrant Beliefs and Reasoning is the first volume presenting an overview of contemporary research in this growing subject area. It will be essential reading for academics and students in the fields of human reasoning, cognitive psychology and philosophy, and will also be of great interest to clinicians and psychiatrists.

Shortly before and during World War II many European psychoanalysts found refuge in South America, concentrated in Buenos Aires. Here, together with local professionals, they created a strong, creative and productive psychoanalytic movement that in turn gave birth to theoretical and clinical contributions that transformed psychoanalysis, psychology, medicine and culture in South America. The Pioneers of Psychoanalysis in South America is a collection of those pioneers' papers, and introduces the reader to a body of ideas and advancements, many of which have had limited and piecemeal exposure within the psychoanalytic community in the rest of the world until now. The editors Nydia Lisman-Pieczanski and Alberto Pieczanski present original papers and essays, many of which have never before been published in English; those that have been translated were rarely presented in context. Each one of the chapters is accompanied by a scholarly introduction written by psychoanalysts, many of whom personally knew the pioneers and their oeuvres in depth, tracing the roots of their ideas in the European analytic schools. The Pioneers of Psychoanalysis in South America is divided into six main sections: Psychoanalytic process Psychoanalytic technique Metapsychology Psychoanalysis of children Culture and society Psychosomatic medicine. Nydia Lisman-Pieczanski and Alberto Pieczanski provide a coherent guide to the seminal ideas and practices of the South American psychoanalysts who have made major theoretical and clinical contributions to the advancement of the psychoanalytic discipline. The chapters present the material in a way that is accessible to psychoanalysts from across the globe and will enable them to incorporate the ideas and practices outlined here into their everyday psychoanalytic work. It will also be of interest to psychoanalytic psychotherapists, academics interested in the history and development of psychoanalytic ideas and psychoanalysis, and advanced students. The following link leads to an video interview featuring Nydia Lisman-Pieczanski and Alberto Pieczanski by the Washington Center for Psychoanalysis for the History Project, where they open up about their stories, their marriage, and their new book: https://www.routledge.com/posts/8996

Minding the Body: The Body in Psychoanalysis and Beyond outlines the value of a psychoanalytic approach to understanding the body and its vicissitudes and for addressing these in the context of psychoanalytic psychotherapy and psychoanalysis. The chapters cover a broad but esoteric range of subjects that are not often discussed within psychoanalysis such as the function of breast augmentation surgery, the psychic origins of hair, the use made of the analyst's toilet, transsexuality and the connection between dermatological conditions and necrophilic fantasies. The book also reaches 'beyond the couch' to consider the nature of reality television makeover show. The book is based on the Alessandra Lemma's extensive clinical experience as a psychoanalyst and psychologist working in a range of public and private health care settings with patients for whom the body is the primary presenting problem or who have made unconscious use of the body to communicate their psychic pain. Minding the Body draws on detailed clinical examples that vividly illustrate how the author approaches these clinical presentations in the consulting room and, as such, provides insights to the practicing clinician that will support their attempts at formulating patients' difficulties psychoanalytically and for how to helps such patients. It will be essential reading for psychoanalysts, psychologists, psychiatrists, mental health workers, academics and literary readers interested in the body, sexuality and gender.

First published in 1989. Routledge is an imprint of Taylor & Francis, an informa company.

Anxiety sensitivity (AS) is the fear of anxiety sensations which arises from beliefs that these sensations have harmful somatic, social, or psychological consequences. Over the past decade, AS has attracted a great deal of attention from researchers and clinicians with more than 100 peer-reviewed journal articles published. In addition, AS has been the subject of numerous symposia, papers, and posters at professional conventions. Why this growing interest? Theory and research suggest that AS plays an important role in the etiology and maintenance of many forms of psychopathology, including anxiety disorders, depression, chronic pain, and substance abuse. Bringing together experts from a variety of different areas, this volume offers the first comprehensive state-of-the-art review of AS--its conceptual foundations, assessment, causes, consequences, and treatment--and points new directions for future work. It will prove to be an invaluable resource for clinicians, researchers, students, and trainees in all mental health professions.

Attachment theory posits that the need for attachment is a life-long phenomenon that becomes especially relevant in times of crisis or trauma. When adults experience illness, accidents, assaults, psychological difficulties or losses, their attachment-behavioural systems are activated, motivating them to seek help and support from family and friends and/or from helping professionals. However, the resulting request for help is affected and shaped by earlier experiences regarding the support and trustworthiness of attachment figures. Can others be trusted? Is it safe to show vulnerability? How should one behave to increase the likelihood of receiving the help needed? Adult Attachment Patterns in a Treatment Context provides an integrated introduction to the subject of adult attachment. Research into adult attachment patterns offers professional helpers a theoretically sound insight into the dynamics underlying a range of client behaviours, including some of the more puzzling and frustrating behaviours such as denying obvious pain or continually pushing the professional for more personal involvement. Sarah Daniel shows how applying knowledge of attachment patterns to treatment settings will improve the way in which professionals engage with clients and the organization of treatments. This book will be relevant to a range of helping professionals such as psychotherapists, psychologists and social workers, both in practice and in training.

Winner of The American Board and Academy of Psychoanalysis (ABAPsa) Book Prize for 2015 Transsexuality and the Art of Transitioning: A Lacanian approach presents a startling new way to consider psychoanalytic dilemmas of sexual difference and gender through the meeting of arts and the clinic. Informed by a Lacanian perspective that locates transsexuality in the intermediate space between the clinic and culture, Oren Gozlan joins current conversations around the question of sexual difference with the insistence that identity never fully expresses sexuality and, as such, cannot be replaced by gender. The book goes beyond the idea of gender as an experience that gives rise to multiple identities and instead considers identity as split from the outset. This view transforms transsexuality into a particular psychic position, able to encounter the paradoxes of transitional experience and the valence of phantasy and affect that accompany aesthetic conflicts over the nature of beauty and being. Gozlan brings readers into the enigmatic qualities of representation as desire for completion and transformation through notions of tension, difference and aesthetics through examining the artwork of Anish Kapoor and Louise Bourgeois and the role played by confusion in the aesthetics of transformation in literature and memoir. Each chapter of the book presents a productive take on understanding the psychoanalytic demand to sustain and consider the dilemma that the unconscious presents to the knowledge and recognition of gender. Fundamentally, this work understands transsexuality as a creative act, rich with desire and danger, in which thinking of the transsexual body as both an analytic and a subjective object helps us to reveal the creativity of sexuality. Ideal for psychoanalysts, psychologists, psychiatrists and social workers as well as students of psychoanalysis, cultural studies, literature studies and philosophy, Transsexuality and the Art of Transitioning offers a unique insight into psychoanalytic approaches to transsexuality and the question of assuming a position in gender.

In 1995, the APA division on clinical psychology created a task force to compile a list of empirically validated procedures. Those left off the list were deemed invalid, leading to much controversy in the field of mental health service. Adding to the controversy are mental health corporations and HMOs that are using or planning to use the task forceAEs lists to determine which interventions they will reimburse for and which they will not. Empirically Supported Therapies responds to this recent interest in basing practice on the empirical validation of interventions and treatments. Organized into two parts, the first comprises theoretical issues surrounding the development and promotion of empirically validated interventions. In the second part, contributors examine some of the validated interventions as illustrations of the issues involved in the debate. Presenting a balanced examination of a controversial topic, Empirically Supported Therapies is a much needed contribution to the literature for professionals in clinical and counseling psychology, human services, interpersonal violence, social work, developmental psychology, and nursing.

The consequences of apparent moral failings in an individual are something that can be seen frequently in the media and in everyday life. One issue that is rarely addressed in public discussion about someone's 'lack of conscience' is any thought as to how the conscience actually functions. In The Conscience and Self-Conscious Emotions in Adolescence, Frans Schalkwijk presents a new definition of the conscience as a psychic function in which self-conscious emotions and empathy are dominant. Schalkwijk combines current scientific research into empathy, shame and guilt as well as his rich clinical experience to create a wealth of information for clinicians working with children and adolescents. This book is a superb guide for operationalizing the diagnostics of the conscience, presenting a developmental approach to the theory and diagnostics of the conscience and integrating psychoanalytic, cognitive behavioural, social, psychological and neurobiological theories. Research has shown that human behaviours are often enacted well below our potential cognitive level. In this book, a balance is found between affective and cognitive aspects of the conscience. Accessibly written and incorporating case studies and detailed notation throughout, this is a highly practical work ideal for psychoanalysts, psychiatrists, psychologists, students and professionals working with children, adolescents and adults.

An aberrant belief is extreme or unusual in nature. In the most serious cases these beliefs cause emotional distress in those who hold them, and typify the core symptoms of psychological disorders. Each of the chapters in this volume seeks to examine the role that biases in reasoning can play in the formation of aberrant beliefs. The chapters consider several conjectures about the role of reasoning in aberrant belief, including the role of the jumping to conclusion bias in delusional beliefs, the probabilistic bias in paranormal beliefs, the role of danger confirming reasoning in phobias, and the controversial notion that people with schizophrenia do not succumb to specific forms of reasoning bias. There are also chapters evaluating different theoretical perspectives, and suggestions for future research. Aberrant Beliefs and Reasoning is the first volume presenting an overview of contemporary research in this growing subject area. It will be essential reading for academics and students in the fields of human reasoning, cognitive psychology and philosophy, and will also be of great interest to clinicians and psychiatrists.

First published in 1989. Routledge is an imprint of Taylor & Francis, an informa company.

A journey of new routes of healing with/by Indigenous and non-Indigenous participants is shared under the Two Eyed-Seeing Perspective of Elder Albert Marshall. The Universal Human Right of Indigenous self-determination and Relationality are the togetherness presented in a "mangrove tree" that lives between salty and sweet waters emerging as a protective place of rich ecosystems. The relatuhedron (shapes of relationality) a co-construction of a home, a Wigwam, Long House, Maloca, Ue, crystalizes knowledge and practices in the process of individual and community healing and cultural transactions. A set of neologisms such as relatuhedron, pedagomiologies, and social grammars, is proposed to challenge our views of mental health, healing, cultural transactions, stereotypes, recovery, and public policy and include simplicities and complexities required to support Indigenous well-being. It is a "machine of possibilities" for students and professionals working with/by and for Indigenous communities. In this book healing is presented as a process through scholarly practice and reflection. Healing is a process of emergence of meaning by improving relationality with the self, nature and others, in a practical approach to socio-cultural transformations. In sum, healing is based on individual and community processes both honoring and respective Indigenous knowledge and scientific research to create endless opportunities for well-being. This book presents healing as a process of growth, a complex, dynamic and evolutive journey of transforming how we stablish and maintain relationships with the self, nature and others inside of our cultural negotiations.

Winner of The American Board and Academy of Psychoanalysis (ABAPsa) Book Prize for 2015 Transsexuality and the Art of Transitioning: A Lacanian approach presents a startling new way to consider psychoanalytic dilemmas of sexual difference and gender through the meeting of arts and the clinic. Informed by a Lacanian perspective that locates transsexuality in the intermediate space between the clinic and culture, Oren Gozlan joins current conversations around the question of sexual difference with the insistence that identity never fully expresses sexuality and, as such, cannot be replaced by gender. The book goes beyond the idea of gender as an experience that gives rise to multiple identities and instead considers identity as split from the outset. This view transforms transsexuality into a particular psychic position, able to encounter the paradoxes of transitional experience and the valence of phantasy and affect that accompany aesthetic conflicts over the nature of beauty and being. Gozlan brings readers into the enigmatic qualities of representation as desire for completion and transformation through notions of tension, difference and aesthetics through examining the artwork of Anish Kapoor and Louise Bourgeois and the role played by confusion in the aesthetics of transformation in literature and memoir. Each chapter of the book presents a productive take on understanding the psychoanalytic demand to sustain and consider the dilemma that the unconscious presents to the knowledge and recognition of gender. Fundamentally, this work understands transsexuality as a creative act, rich with desire and danger, in which thinking of the transsexual body as both an analytic and a subjective object helps us to reveal the creativity of sexuality. Ideal for psychoanalysts, psychologists, psychiatrists and social workers as well as students of psychoanalysis, cultural studies, literature studies and philosophy, Transsexuality and the Art of Transitioning offers a unique insight into psychoanalytic approaches to transsexuality and the question of assuming a position in gender.

Why do so many women with gambling addiction relapse?

Lifelong recovery requires much more than to just stop gambling. Women s groups provide long-term benefits and support and have proven to be highly successful in promoting recovery from gambling addiction. By following the story of a real women s group for problem gambling over the course of a year, Liz Karter explains how, for women, both the cause of and the cure for gambling addiction lies in relationship.

Karter shows clearly how learning to face and cope with real life situations and relationships is essential to maintain recovery. She shares the themes which run through each women s group, such as fear of trusting others, and the guilt, shame and risk associated with being truly seen and heard. "Women s Groups for Problem Gambling" shows that with a combination of specialist intervention, women s group support, courage and compassion, women can learn to stop running from their addiction and instead find joy and support in building relationships and communities.

This highly accessible book provides a unique opportunity to gain a very personal insight into the group process, both for therapists and clinicians and for women wishing to better understand their addiction. "

How can we, analysts, evaluate whether analysis is generating transformations in our patients? Time for Change: Tracking Transformations in Psychoanalyses. The Three-Level Model focuses on the question of how to observe changes in psychoanalysis. The IPA Project Committee on Clinical Observation and Testing offers a tool, a heuristic, or a guide for refining, conceptualizing, and systematizing clinical observations about patient transformations: The Three-Level Model for Observing Patient Transformations (3-LM). It seeks to enhance clinical observations, making them more accurate and more useful for theory testing and theory building through a systematic analysis of clinical material.The 3-LM goes from clinic to theory, from implicit to explicit theory, from unquestioned hypotheses to reviewed hypotheses enriched by the work on the clinical material after its discussion by several participants with different perspectives.Firstly, the 3-LM seeks to make a careful characterization of the patient and his/her problems and capacities when (s)he enters analysis.Then, it observes later moments of his/her treatment and the positive or negative changes that have occurred during treatment, what has not changed, the relevance of changes, and how changes are explained. Reports are elaborated in each group which state the convergences and divergences that emerged during the group discussion. This book presents the model and the outcome of having worked with it. Approximately 700 analysts from different parts of the world have participated in these clinical observation groups. It has been applied to adult patients, adolescents and children, as well as in analytic training. This tool has proved useful and friendly for analysts, for it rescues and re-values the richness of the clinical experience between analyst and patient. It also allows exercising our abilities and clinical sharpness as well as acquiring precision when communicating our work. It provides the analyst with one way to monitor his/her work in a more subtle and meticulous way, offering a second look at the material for the benefit of both analyst and patient.

The consequences of apparent moral failings in an individual are something that can be seen frequently in the media and in everyday life. One issue that is rarely addressed in public discussion about someone s lack of conscience is any thought as to how the conscience actually functions. In "The Conscience and Self-Conscious Emotions in Adolescence, " Frans Schalkwijk presents a new definition of the conscience as a psychic function in which self-conscious emotions and empathy are dominant.

Schalkwijk combines current scientific research into empathy, shame and guilt as well as his rich clinical experience to create a wealth of information for clinicians working with children and adolescents. This book is a superb guide for operationalizing the diagnostics of the conscience, presenting a developmental approach to the theory and diagnostics of the conscience and integrating psychoanalytic, cognitive behavioural, social, psychological and neurobiological theories. Research has shown that human behaviours are often enacted well below our potential cognitive level. In this book, a balance is found between affective and cognitive aspects of the conscience.

Accessibly written and incorporating case studies and detailed notation throughout, this is a highly practical work ideal for psychoanalysts, psychiatrists, psychologists, students and professionals working with children, adolescents and adults.

"

Psychoanalysis can make a huge difference in the lives of patients, their families and others they encounter. Myths have developed, however, about how psychoanalysis should end - what patients experience and what analysts do. These expectations come primarily from accounts by analysts in the analytic literature which are often perpetuated in an oversimplified form in teaching. Patients' perspectives are rarely presented. I her book, Judy Leopold Kantrowitz seeks to address this omission. Exploring the accounts of 82 former analysands, she illustrates the rich diversity of psychoanalytic endings and ways of maintaining analytic benefits after ending; in presenting patients' experiences Kantrowitz provides correctives for some myths about termination. Myths of termination: What patients can teach psychoanalysts about endings is not a book that seeks to refute or support any specific idea about a best way of ending analysis, but rather to show that there are countless ways of having a satisfactory conclusion to the process. Nor is the author espousing any particular analytic theory. Kantrowitz sets out to show that an oversimplified view of psychoanalytic endings not only diminishes an appreciation of the diversity of psychoanalytic outcomes but may also interfere with the creativity of individual psychoanalysts. In this book, former analysands describe and illustrate how their analyses ended. They reflect on the effect of non-mutual endings due to external factors (moving, retirement, illness or death) or psychological factors (wishing to avoid facing some issue); the impact of post-analytic contact; and the ways in which they have held on to their analytic benefits after ending their analyses. Myths of termination confronts and refutes the myths about the termination phase of psychoanalysis that are passed from generation to generation. It is a refreshing and insightful study that will be welcomed by psychoanalysts, psychodynamic therapists, such as clinical psychologists, social workers, and others trained or in training to do clinical work.

Neurofeedback is utilized by over 10,000 clinicians worldwide with new techniques and uses being found regularly. Z Score Neurofeedback is a new technique using a normative database to identify and target a specific individual's area of dysregulation allowing for faster and more effective treatment. The book describes how to perform z Score Neurofeedback, as well as research indicating its effectiveness for a variety of disorders including pain, depression, anxiety, substance abuse, PTSD, ADHD, TBI, headache, frontal lobe disorders, or for cognitive enhancement. Suitable for clinicians as well as researchers this book is a one stop shop for those looking to understand and use this new technique.

This book will demonstrate how to use novel, systematic method for recognizing psychological adaptive mechanisms (known in psychoanalytic theory as ego defenses) in clinical encounters. This clinical method is based in published theoretical and empirical studies of these mechanisms over the past 14 years as well as working with successive classes of mental health trainees of varying disciplines at the University of Colorado. The result is an approach that trainees both apprehend and find useful. This work will offer the mental health disciplines, and even wider audiences, a platform both for 1) clinical use in everyday practice, 2) continuing clinical studies of adaptive psychology as well as 3) direct application of psychological adaptive mechanisms theory in clinical research that will improve the diagnosis and treatment of persons with mental or emotional disorders.
This an important empirical model for understanding how humans adapt to the stressful experiences of their lives. They have developmental, biological, and evolutionary significance and all of these will be discussed in the book. Psychological Adaptive Mechanisms are observable behaviors that range on a developmental hierarchy from the Primitive defenses of normal early childhood and of major mental illness in adults, through the Mature defenses of fully functioning adulthood. They also serve to limit and to direct the human anxiety response, giving the "fight or flight" reaction to threat many more than those two classically described behavioral options.These mechanisms are likely transduced by the brain and, in providing wider ranges of adaptive behavior, most probably reflect an evolutionary selection towards greater flexibility of adaptation.

The third edition of "Social Anxiety: Clinical, Developmental, and Social Perspectives" integrates examinations of social anxiety, shyness, and embarrassment with the research on social anxiety disorder subtypes, biological theories and cognitive-behavioral or pharmacological treatment outcome studies. Clinicians, social and developmental psychologists and behavioral geneticists have all conducted research over the past ten years which is essential to furthering our understandingand treatment of social anxiety disorders. This book weaves together research findings gathered by renowned minds across these various disciplines, anddeals with both theory and research. It explores what constitutes social anxiety, assesses the condition and its relationship to other psychological disorders, exploring the biological basis and treatment approaches as well. Coverage includes key issues not discussed fully by other books, including related disorders in adults and children, relationship to social competence and assertiveness, perfectionism, social skills deficit hypothesis, comparison between pharmacological and psychosocial treatments, and potential mediators of change in the treatment of social anxiety disorder. From the Author: Although social anxiety disorder (social phobia) is widely researched topic in psychiatry, other disciplines, such as social and developmental psychology, have independently been studying the same phenomena for many years. Yet, there has been very little cross-discipline communication and integration. The main objective of the book is to integrate the findings on social anxiety from various disciplines, including clinical psychology, psychiatry, social psychology, neuroscience, and developmental psychology.
The most comprehensive source of up-to-date data, with review articles covering a thorough delineation of social anxiety, theoretical perspectives, and treatment approachesConsolidates broadly distributed literature into single sourceEach chapter is written by an expert in the topic area, providing more fully vetted expert knowledge than any existing workIntegrates findings from various disciplines clinical, social and developmental psychology, psychiatry, neuroscience rather than focusing on only one conceptual perspectiveProvides a complete understanding of a complex phenomenon, giving researchers and clinicians alike a better set of tools for furthering what we know"

How do bereaved people come to terms with their loss? What factors are important in successful coping?

The death of a loved one is one of the most painful experiences that we have to encounter. If the loved one is a child or partner the experience can be especially devastating. How do we cope? Do our families provide sufficient support? Would professional help be better?

In this book, originally published in 1992, the author provides an in-depth study of the many aspects of bereavement and the grieving process. With ample support from personal accounts of bereaved people, she examines the experience of bereavement: what can go wrong, the importance of social networks, both family and professional, and looks at how society s attitudes to death and dying can affect our ability to cope. There are specific chapters on the death of children in childhood, adolescence and adult life, and on the death of a partner.

The result is a book that will be of importance to all those who have regular contact with the dying and bereaved."

"Homicide Survivors: Misunderstood Grievers" is about families that have faced murder and how they have dealt with the trauma. It offers an interpretation of personal accounts of homicide survivors in order to understand the particular nature of homicide bereavement. The author herself a homicide survivor, Judie Bucholz offers a unique perspective and experiential base for examining the phenomenon of homicide bereavement. Her intent is to help the reader understand the homicide griever's situation both as one who grieves and one who grieves within a social context, as one who confronts horrific death at the personal level as well as at the social level.

Now more than ever there is a need to ensure that best practices are being used in residential programs. As the focus on costs and outcomes increase, residential programs must clearly demonstrate that the interventions provided are efficient and effective. Readers will learn how to: Create strength-based, empowering and healing environments; Better engage and partner with children, adolescents and families, in meaningful ways; Support those who have experienced trauma and loss, and to prevent and eliminate the use of restraint and seclusion; Respect and include cultural indices in practices; Train, mentor, supervise, support and empower staff about how to deliver promising and best practices, and evidence-informed and evidence-based interventions; and Track long-term outcomes, and create funding strategies to better support sustained positive outcomes. This book encourages readers to think strategically about how agencies, communities and systems can identify and implement actions that lead to positive change and how to work more collaboratively to improve the lives of children and adolescents who have experienced emotional and behavioral life challenges and their families.