How should we understand transgenderism, especially as it affects children and adolescents? Psychiatric manuals include transgenderism among mental illnesses (Gender Identity Disorder). Such inclusion is relatively recent, and even the words transsexual and transgender were coined only a few decades ago. Yet stories of children with an in-between gender have always been, albeit symbolically, a part of popular culture. Drawing on fairy tales, as well as from personal narratives and clinical studies, this book explains how "Gender Identity Disorder" manifests in children, critically evaluating various clinical approaches and examining the ethical and legal issues surrounding the care and treatment of these youths. The book argues that Gender Identity Disorder is not pathology, and that medicine and society should assist children in expressing themselves, without attempting to force them to adapt to a gender that does not match with their perceived identity.

Named a 2013 Doody's Core Title

Addressing the needs of America's most underserved areas for mental health services, " Rural Mental Health" offers the most up-to-date, research-based information on policies and practice in rural and frontier populations.

Eminent clinicians and researchers examine the complexities of improving mental health in rural practice and offer clear recommendations which can be adapted into current practice and training programs. They bring an incisive lens to factors that contribute to mental illness and prevent access to treatment areas. These include limited resources, reliance on urban models and assumptions, and pervasive misunderstanding of rural realities by policy makers. The text also addresses diversity issues in regard to rural mental health services. Key Features:

Focuses on best practices and new models of service delivery in rural populations Provides clear recommendations for adapting new models in current practice and training programs Takes a micro and macro approach to service delivery models Covers contemporary practice applications with specific populations in rural areas

After decades of neglect, researchers have begun to focus attention on the development and outcomes of girlhood aggression. This comprehensive volume provides an account of some of the pioneering research in the field. Its central aims are to highlight current understanding, identify key components for preventing and treating the complex array of problems experienced by aggressive girls, and raise new questions for future research. The perspectives presented by the authors highlight the diverse factors that moderate the emergence of aggression while offering insight into how to target that aggression at various stages of development. The problem is presented as a continuum from normative forms of behavior to extreme and serious attacks. The importance of relationships--particularly family relationships--is a theme that permeates the entire volume. A growing body of research indicates that aggression in girls is a predictor of long-term psychological, social, academic, health, and intergenerational problems. The knowledge provided by the authors has tremendous potential to inform practice with troubled girls, their families, and support systems.

By most accounts, people with a borderline personality disorder prove exceptionally difficult to treat. Divergent opinions abound about what, if anything, contributes to a positive outcome. Is it the quality of the relationship with the psychotherapist that is curative, in that the careful attunement of therapist to patient enables the development of a more secure attachment experience? Or is it the technical and structural parameters of the therapy i.e., therapist neutrality, frame issues, and defensive operations combined with skillfully formulated and timely interventions? Taken together, the findings of attachment research and object relations theory offer an integrated understanding of borderline personality disorder as an attachment disorder that relies on a pervasive false self for adaptation and personal connections. A particular corrective relationship experience, therefore, is necessary if positive personality changes and improved adaptive capacities are to result. In Another Chance to Be Real, Donald and Deanda Roberts propose a treatment approach, specific to those suffering from borderline personality disorder, that emphasizes both relational and technical variables as necessary in eliciting a positive treatment outcome."

Volume 3 relates the demography of health behavior to developmental and diversity issues. Unique discussions of the health behaviors of gay males, lesbians, persons with HIV, and caregivers themselves are included. Each volume features extensive supplementary and integrative matrial prepared by the editor, the detailed index to the entire four-volume set, and a glossary of health behavior terminology.

How can complicated grief be defined? How does it differ from normal patterns of grief and grieving? Who among the bereaved is particularly at risk? Can clinical intervention reduce complications?

Complicated Grief provides a balanced, up-to-date, state-of-the-art account of the scientific foundations surrounding the topic of complicated grief. In this book, Margaret Stroebe, Henk Schut and Jan van den Bout address the basic questions about the concept, manifestations and phenomena associated with complicated grief. They bring together researchers from different disciplines, providing a broad range of cultural and societal perspectives, to enable the reader to access the scientific knowledge base regarding complicated grief, on both theoretical and empirical levels.

The book is divided into four main sections:

• An exploration of the nature of complicated grief
• Diagnostic categorizations
• Contemporary research on complicated grief
• Treament of complicated grief

Illuminating the foundations and new innovations in research, Complicated Grief will be essential reading for professionals working with bereavement such as clinical psychologists, health psychologists and psychiatrists, researchers, as well as graduate students of psychology and psychiatry.

Margaret Stroebe is Professor at the Department of Clinical and Health Psychology, Utrecht University, and the Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands.

Henk Schut is Associate Professor at the Department of Clinical and Health Psychology, Utrecht University, The Netherlands.

Jan van den Bout is Professor of Clinical Psychology at Utrecht University, The Netherlands.

Contributors Paul Boelen, Kathrin Boerner, George Bonanno, Laurie Burke, Rachel Cooper, Atle Dyregrov, Kari Dyregrov, Francesca Del Gaudio, Ann-Marie Golden, Jennifer Jacobs, David Kissane, Rolf Kleber, Yeulin Li, Jeffrey Looi, Anthony Mancini, Mario Mikulincer, Michelle Moulds, Robert Neimeyer, Mary-Frances O'Connor, John Ogrodniczuk, William Piper, Holly G. Prigerson, Therese Rando, Beverley Raphael, Paul C. Rosenblatt, Edward Rynearson, Henk A.W. Schut, Phillip Shaver, Margaret S. Stroebe, Jan van den Bout, Marcel van den Hout, Birgit Wagner, Jerome C. Wakefield, Edward Watkins, Talia I. Zaider.

Psychosis and the Traumatised Self explores what it is like to experience psychosis for individuals with histories of childhood physical and sexual abuse. The book additionally explores how meaning expressed in psychosis might originate from the effects of abuse, but also long-term life difficulties, motivations, memories, social history, and struggles to narrate and understand. One chapter focuses on refugees who suffered trauma as adults and later became psychotic. Another chapter examines how trauma leads to the destruction of certainty and trust, thereby opening a pathway to persecutory ideas. Drawing on a developmental model of trauma, it is proposed that dissociated parts of the self that developed during childhood contribute to psychosis in adults when undergoing difficulties and stress. Presented with case illustrations, the book will be useful for those who work in the area of psychosis and abuse to understand the experiences of individuals, and how we might develop appropriate therapy and care.

Clinical Neuropsychological Foundations of Schizophrenia is the first practitioner-oriented source of information on the neuropsychology of schizophrenia. This volume demonstrates the growth in what is known about cognition in schizophrenia, its assessment, and how this informs clinical practice.

It provides the practicing clinical neuropsychologist, and other professionals working with persons with schizophrenia, with the knowledge and tools they need to provide competent professional neuropsychological services. It includes an overview of developmental models of schizophrenia and its associated neuropathologies, so that the clinician can fully understand how vulnerability and progression of the disorder influence brain development and functioning, and how cognition and functioning are associated with these changes. In addition, the volume covers contemporary evidence-based assessment and interventions, including cognitive remediation and other cognitive oriented interventions. Throughout, the research findings are synthesized to make them clinically relevant to clinical neuropsychologists working in outpatient or inpatient psychiatric settings.

The book is an invaluable resource for practicing professional neuropsychologists, clinical psychologists, psychiatrists, and neuropsychiatrists, as well as graduate students of these disciplines, interns, and postdoctoral residents and fellows who work with schizophrenic patients.

Sex offending, and in particular child sex offending, is a complex area for policy makers, theorists and practitioners. A focus on punishment has reinforced sex offending as a problem that is essentially other to society and discourages engagement with the real scale and scope of sexual offending in the UK. This book looks at the growth of work with sex offenders, questioning assumptions about the range and types of such offenders and what effective responses to these might be.

Divided into four sections, this book sets out the growth of a broad legislative context and the emergence of child sexual offenders in criminal justice policy and practice. It goes on to consider a range of offences and victim typologies arguing that work with offenders and victims is complex and can provide a rich source of theoretical and practical knowledge that should be utilised more fully by both policy makers and practitioners. It includes work on female sex offenders, electronic monitoring and animal abuse as well as exploring interventions with sex offenders in three different contexts; prisons, communities and hostels.

Bringing together academic, practice and policy experts, the book argues that a clear but complex theoretical and policy approach is required if the risk of re- offending and further victimisation is to be reduced. Ultimately, this book questions whether it makes sense to locate responsibility for responding to sexual offending solely within the criminal justice domain.

Lacan's psychoanalytic take on what makes a pervert perverse is not the fact of habitually engaging in specific "abnormal" or transgressive sexual acts, but of occupying a particular structural position in relation to the Other. Perversion is one of Lacan's three main ontological diagnostic structures, structures that indicate fundamentally different ways of solving the problems of alienation, separation from the primary caregiver, and castration, or having limits set by the law on one's jouissance. The perverse subject has undergone alienation but disavowed castration, suffering from excessive jouissance and a core belief that the law and social norms are fraudulent at worst and weak at best. In Perversion, Stephanie Swales provides a close reading (a qualitative hermeneutic reading) of what Lacan said about perversion and its substructures (i.e., fetishism, voyeurism, exhibitionism, sadism, and masochism). Lacanian theory is carefully explained in accessible language, and perversion is elucidated in terms of its etiology, characteristics, symptoms, and fundamental fantasy. Referring to sex offenders as a sample, she offers clinicians a guide to making differential diagnoses between psychotic, neurotic, and perverse patients, and provides a treatment model for working with perversion versus neurosis. Two detailed qualitative clinical case studies are presented-one of a neurotic sex offender and the other of a perverse sex offender-highlighting crucial differences in the transference relation and subsequent treatment recommendations for both forensic and private practice contexts. Perversion offers a fresh psychoanalytic approach to the subject and will be of great interest to scholars and clinicians in the fields of psychoanalysis, psychology, forensic science, cultural studies, and philosophy.

At age 3, Marla Comm was professionally diagnosed with autism but felt to have intellectual potential.
Both parents had socially-conformist values, so that Marla's anti-social behavior was unacceptable. Verbally abused by her parents, she was disciplined to become a normal child. It was never to be; her rigid, dysfunctional personality was not susceptible to change.
Now age 50, Marla's lack of social feeling, rigid routines, problematic language, poor imagination, inflexibility, repetitive tendencies, and ritualistic behaviors - are lifelong traits consistent with autism. Anxiety, one of her most debilitating symptoms, has left her unable to achieve conscious relaxation or put aside life's inevitable problems.
Daily chores frustrate Marla; however, it is nothing in comparison to the anger and self-mutilation she suffers when preparing meals in the kitchen.
Montreal is totally wrong for Marla. Years of struggling in the mainstream, with little or no support, have resulted in a condition of burnout, symptomatic of mental and physical exhaustion.
By having a personality complex with multiple co-morbidities, Montreal's environment worsens her misery by failing to meet her needs for affordable healthful food, human civility, supportive psychiatry, and adequate social services.
Inclement weather - half the year - prevents daily exercise. For Marla, it means countless days of suffering that only a loss of consciousness can relieve: call it a daytime oblivion of deep sleep, made possible with cheap wine and knock-out pills.
Gifted with a keen, long-term memory and intent on learning more about her neurological disorders, she has done extensive reading, inbits-and-pieces, over the years.
The reader will experience the life story of a highly intelligent autistic woman, consumed with dysfunctional behavior; the very same Marla who - in the next breath - can discuss with professional expertise the nuances of her mental disorders.

The rising popularity of unconventional treatment methods in Poland, not accepted by academic medicine, prompted the author to describe and interpret the social causes of this phenomenon and its diverse effects, as well as to forecast the future of such methods. These research results are the outcome of an analysis of more than 3,500 letters sent to the Polish State TV by viewers of a two-year-long series of programs offering unconventional psychotherapy. The analysis of the material enabled sociological reconstruction of everyday lay thinking of illness, health and medicine. The book also examined the relevance of classic socio-medical theories for the study of health behaviors associated with treatments offered by healers.

Why has the female body been marginalised in psychoanalysis, with a focus on female problems and pains only? How can we begin to think about body pleasure, power, competition and aggression as normal in females?

In Women's Bodies in Psychoanalysis, Rosemary Balsam argues that re-tracing theoretical steps back to the biological body's attributes is fruitful in searching for the clues of our mental development. She shows that the female biological body, across female gender variants and sexual preferences, including the 'vanished pregnant body', has been largely overlooked in previous studies. It is how we weave these images of the body into our everyday lives that informs our gendered patterning. These details about being female free up gender studies in the postmodern era to think about the body's contribution to gender rather than continuing the familiar postmodern trend to repudiate biology and perpetuate the divide between the physical and the mental.

There are four main areas explored:

clinical contributions on female development
assessments of past and present psychoanalytic theories in relation to the body
inner portraits of gender building blocks
a conscious and unconscious focus on the potentially procreative female body.

Women's Bodies in Psychoanalysis will be of particular interest to psychodynamic, psychotherapeutic and psychoanalytic practitioners, teachers, students, feminist academicians, college undergraduates, graduates and faculty in women's studies and gender studies.

Rosemary Balsam is Associate Clinical Professor of Psychiatry, Yale School of Medicine; Staff Psychiatrist, Yale University Student Mental Health and Counselling Services; Training and Supervising Analyst, Western New England Institute for Psychoanalysis.

Why has the female body been marginalised in psychoanalysis, with a focus on female problems and pains only? How can we begin to think about body pleasure, power, competition and aggression as normal in females? In Women's Bodies in Psychoanalysis, Rosemary Balsam argues that re-tracing theoretical steps back to the biological body's attributes is fruitful in searching for the clues of our mental development. She shows that the female biological body, across female gender variants and sexual preferences, including the 'vanished pregnant body', has been largely overlooked in previous studies. It is how we weave these images of the body into our everyday lives that informs our gendered patterning. These details about being female free up gender studies in the postmodern era to think about the body's contribution to gender - rather than continuing the familiar postmodern trend to repudiate biology and perpetuate the divide between the physical and the mental. There are four main areas explored: * clinical contributions on female development * assessments of past and present psychoanalytic theories in relation to the body * inner portraits of gender building blocks * a conscious and unconscious focus on the potentially procreative female body. Women's Bodies in Psychoanalysis will be of particular interest to psychodynamic, psychotherapeutic and psychoanalytic practitioners, teachers, students, feminist academicians, college undergraduates, graduates and faculty in women's studies and gender studies. Rosemary Balsam is Associate Clinical Professor of Psychiatry, Yale School of Medicine; Staff Psychiatrist, Yale University Student Mental Health and Counselling Services; Training and Supervising Analyst, Western New England Institute for Psychoanalysis.

"Still practicing" has several meanings. Still practicing suggests that the balance of heartaches and joys must not deter us from pursuing a clinical practice. At the same time, still practicing suggests that for the clinician "practice" never "makes perfect." We continue to refine our clinical instruments over our entire working lives. Framed by her previous work on the concept of emotional balance, Sandra Buechler investigates how vicissitudes in a clinical career can have a profound and lasting impact on the clinician's emotional balance, and considers how the clinician's resilience is maintained in the face of the personal fallout of a lifetime of clinical practice. At each juncture, from training to early phases of clinical experience, through mid and late career, she asks, what can help us maintain a vital interest in our work? How do we not burn out? Aimed at the nexus of the personal and theoretical, Still Practicing concentrates on the sadness, feelings of shame, and satisfactions inherent in practice, and encourages newcomers and veterans alike to make career choices mindful of their potential long-term impact on their feelings about being therapists. It poses a question vital to the life of the clinician: How can we strike a balance between the work's inevitable pain and its potential joy?

"Still practicing" has several meanings. Still practicing suggests that the balance of heartaches and joys must not deter us from pursuing a clinical practice. At the same time, still practicing suggests that for the clinician "practice" never "makes perfect." We continue to refine our clinical instruments over our entire working lives. Framed by her previous work on the concept of emotional balance, Sandra Buechler investigates how vicissitudes in a clinical career can have a profound and lasting impact on the clinician's emotional balance, and considers how the clinician's resilience is maintained in the face of the personal fallout of a lifetime of clinical practice. At each juncture, from training to early phases of clinical experience, through mid and late career, she asks, what can help us maintain a vital interest in our work? How do we not burn out? Aimed at the nexus of the personal and theoretical, Still Practicing concentrates on the sadness, feelings of shame, and satisfactions inherent in practice, and encourages newcomers and veterans alike to make career choices mindful of their potential long-term impact on their feelings about being therapists. It poses a question vital to the life of the clinician: How can we strike a balance between the work's inevitable pain and its potential joy?

Clinical Psychology is for students studying clinical psychology as part of an undergraduate programme in psychology, nursing, sociology or social and behavioural sciences. Undergraduate students who wish to know if postgraduate study in clinical psychology would be of interest to them will find this book particularly useful.

The book will inform students about:

• the profession of clinical psychology
• how to get onto a clinical psychology postgraduate training programme
• the way clinical psychologists work with children, adolescents and adults with common psychological problems
• the main models of practice used by clinical psychologists, and
• the scientific evidence for the effectiveness of psychological interventions.

There is a focus on both clinical case studies and relevant research, and the book includes summaries, revision questions, advice on further reading and a glossaryof key terms, all of which make it an excellent student-friendly introduction to an exceptionally interesting subject.

This book combines autobiography and innovative narrative research to create an original psychosocial perspective on the often taboo subject of sudden, unexpected child death. Beginning with the author's own experience, the book investigates manifold aspects of sudden, unexpected child death, including the professional rapid response; contemporary cultural reactions to death; theories of grieving; child death inquiries and popular media reporting. At the heart of the book are intimate personal stories, drawn from unprecedented psychosocial research on this topic, which combine to create a unique record of parent's experiences following the sudden and unexpected death of a child. Additionally, the book offers original guidance on the Biographic Narrative Interpretive methodology, which extends knowledge of group data analysis. The book will be of great methodological interest to the psychosocial community, as well as to health and social care professionals and lay readers interested in both sudden, unexpected child death and the wider field.

Most investigations of foreign-born migrants emphasize the successful adjustment and settlement of newcomers. Yet suicide, heavy drinking, violence, family separations, and domestic disharmony were but a few of the possible struggles experienced by those who relocated abroad in the nineteenth and twentieth centuries, and were among the chief reasons for committal to an asylum. Significant analysis of this problem, addressing the interconnected issues of migration, ethnicity, and insanity, has to date received little attention from the scholarly community. This international collection examines the difficulties that migrants faced in adjustment abroad, through a focus on migrants and mobile peoples, issues of ethnicity, and the impact of migration on the mental health of refugees. It further extends the migration paradigm beyond patients to incorporate the international exchange of medical ideas and institutional practices, and the recruitment of a medical workforce. These issues are explored through case studies which utilize different social and cultural historical methods, but with a shared twin purpose: to uncover the related histories of migration, ethnicity, and mental health, and to extend existing scholarly frameworks and findings in this under-developed field of inquiry.

Alcohol abuse is a major health problem in most parts of the world. This book focuses on the way in which alcohol affects the brain, with the aim of describing advances in the neuropsychology of alcoholism in a way that makes this work accessible to clinicians from a variety of backgrounds who treat people with alcohol-related problems.; The book is divided into four parts. Part One provides an introduction to the medical and neurological conditions that can result from alcoholism, and to the process of neuropsychological assessment. The problems involved in conducting research in this area are also considered. In Part Two, research that focuses directly on changes to the nervous system is surveyed. This includes studies of both the short-term and the chronic neurological changes in the brain caused by alcohol. In Part Three, studies of the neuropsychological effects of acute intoxication, social drinking and alcohol abuse are described. Finally, in Part Four, the implications of neuropsychological research for the assessment and management of patients with alcohol problems are considered.
The objective of this book is to collate the range of research work that is relevant to understanding how alcohol affects the brain. This includes both the acute and the chronic effects, at both the biological and physiological levels.

Prevention through appropriate behavior is the best weapon available to fight further spread of HIV infection. However, individuals take necessary actions to prevent diseases such as AIDS only when they are properly informed and they feel motivated to respond to the information they possess. In order to achieve a clearer understanding of these two facets of the prevention process, this book examines the interplay of the messages individuals receive about AIDS at the public level and the messages exchanged between individuals at the interpersonal level. The specific purpose of the book is to provide a theoretical and conceptual foundation for understanding the pragmatic concerns related to the AIDS crisis in the United States and other parts of the world. The book represents the first systematic examination of how theory informs our understanding of AIDS and communication processes. Contributors explore the issues from a variety of theoretical and conceptual viewpoints. Their goal is to stimulate thought which will lead to the pragmatic application of the ideas presented. The chapters focus on four general communication concerns: * interpersonal interaction as it relates to choices individuals make about safer sex practices, * theory and practice of public campaigns about AIDS, * intercultural issues, and * critical and descriptive approaches for understanding news coverage of AIDS.

The military imposes unique and often severe challenges to couples, which clinicians - particularly the growing numbers of civilian clinicians who see military couples - often struggle to address. These problems are only compounded by misunderstandings and misconceptions about what it means to be part of a specific branch of the military and part of the military as a whole. Handbook of Counseling Military Couples includes a clear, thorough introduction to military culture and to couple relationships in the military. But more than that, it provides readers with expert analyses of the special types of issues that come up for military couples and shows clinicians how to address them productively. In the chapters, readers will find the answers to questions such as how are military couples' rights different from those of civilians? What attitudes and beliefs about relationships might military members bring to a session, and how are those different from those of civilians? What is the state of marriage and divorce in each of the branches and within the military in general? For a particular treatment modality, how does research in with military members compare to that of civilians? When should particular treatment strategies be used, and why - and how?

This book highlights the emerging research and policy development efforts to address child and adolescent behavioral health in Sub-Saharan Africa, where mental health policy is at an early stage and in need of context-specific attention to its successes and shortcomings. A diverse range of researchers, with expertise on relevant policy in both the region as a whole and country-specific contexts, including Ghana, Kenya, Nigeria, Rwanda, South Africa, and Uganda, outline theoretically informed, culturally appropriate, evidence-based, and youth- and family-focused service models. The first work of its kind with an exclusive focus on the understudied region of Sub-Saharan Africa, this text: Provides an overview of the current state of child and adolescent behavioral health in the region Evaluates empirical work on risk and protective factors influencing behavioral outcomes Highlights emerging intervention research and dialogue on what works to improve child and adolescent behavioral health Offers insight and strategies on how to advance child and adolescent behavioral health in policy, research, and practice Child Behavioral Health in Sub-Saharan Africa: Towards Evidence Generation and Policy Development is a unique reference that offers guidance for current and future policy-makers, researchers, practitioners, and students as they seek to invest and engage in the healthy development of a future generation.

This study, based on extensive use of eighteenth-century newspapers, hospital registers and case notes, examines the experience of suffering from nervous disease - a supposedly upper-class malady. Beatty concludes that, far from the stereotyped portrayal of nervous patients in contemporary fiction, 'nervousness' was a legitimate medical diagnosis with a firm basis in eighteenth-century medical theory.

Trauma, Dissociation and Multiplicity provides psychoanalytic insights into dissociation, in particular Dissociative Identity Disorder (DID), and offers a variety of responses to the questions of self, identity and dissociation. With contributions from a range of clinicians from both America and Europe, areas of discussion include:

• the concept of dissociation and the current lack of understanding on this topic
• the verbal language of trauma and dissociation
• the meaning of children s art
• the dissociative defence from the average to the extreme
• pioneering new theoretical concepts on multiple bodies.

This book brings together latest findings from research and neuroscience as well as examples from clinical practice and includes work from survivor-writers. As such, this book will be of interest to specialists in the field of dissociation as well as psychoanalysts, both experienced and in training.

This book follows on from Valerie Sinason s Attachment, Trauma and Multiplicity, Second Edition and represents a confident theoretical step forward.