71470_fm_ptg01.indd 2 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) Crisis Intervention Strategies Eighth Edition Richard K. James University of Memphis Burl E. Gilliland Professor Emeritus, University of Memphis Australia Brazil Mexico Singapore United Kingdom United States Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. 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Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 2 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) Crisis Intervention Strategies, © 2017, 2013, Cengage Learning Eighth Edition WCN: 02-200-203 Richard K. James, Burl E. Gilliland ALL RIGHTS RESERVED. No part of this work covered by the copyright Product Director: Jon David Hague herein may be reproduced or distributed in any form or by any means, Product Manager: Julie Martinez except as permitted by U.S. copyright law, without the prior written permission of the copyright owner. Content Developer: Elizabeth Momb Product Assistant: Stephen Lagos For product information and technology assistance, contact us at Marketing Manager: Margaux Cameron Cengage Learning Customer & Sales Support, 1-800-354-9706. Content Project Manager: Rita Jaramillo For permission to use material from this text or product, Art Director: Vernon Boes submit all requests online at www.cengage.com/permissions. Further permissions questions can be e-mailed to Manufacturing Planner: Judy Inouye [email protected]. Production Service: MPS Limited, Lynn Lustberg Library of Congress Control Number: 2015913300 Text and Cover Designer: Student Edition: Cheryl Carrington ISBN: 978-1-305-27147-0 Cover Image: Teradat Santivivut/Getty Images Loose-leaf Edition: ISBN: 978-1-305-86637-9 Compositor: MPS Limited Cengage Learning 20 Channel Center Street Boston, MA 02210 USA Cengage Learning is a leading provider of customized learning solutions with employees residing in nearly 40 different countries and sales in more than 125 countries around the world. Find your local representative at www.cengage.com. Cengage Learning products are represented in Canada by Nelson Education, Ltd. To learn more about Cengage Learning Solutions, visit www.cengage.com. Purchase any of our products at your local college store or at our preferred online store www.cengagebrain.com. Printed in the United States of America Print Number: 01 Print Year: 2016 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 2 1/9/16 3:01 PM (cid:13)(cid:13)(cid:96)(cid:96)(cid:136)(cid:136)(cid:204)(cid:204)(cid:105)(cid:105)(cid:96)(cid:96)(cid:202)(cid:202)(cid:220)(cid:220)(cid:136)(cid:136)(cid:204)(cid:204)(cid:133)(cid:133)(cid:202)(cid:202)(cid:204)(cid:204)(cid:133)(cid:133)(cid:105)(cid:105)(cid:202)(cid:202)(cid:96)(cid:96)(cid:105)(cid:105)(cid:147)(cid:147)(cid:156)(cid:156)(cid:202)(cid:202)(cid:219)(cid:219)(cid:105)(cid:105)(cid:192)(cid:192)(cid:195)(cid:195)(cid:136)(cid:136)(cid:156)(cid:156)(cid:152)(cid:152)(cid:202)(cid:202)(cid:156)(cid:156)(cid:118)(cid:118)(cid:202)(cid:202) (cid:22)(cid:22)(cid:152)(cid:152)(cid:118)(cid:118)(cid:136)(cid:136)(cid:221)(cid:221)(cid:202)(cid:202)(cid:42)(cid:42)(cid:192)(cid:192)(cid:156)(cid:156)(cid:202)(cid:202)(cid:42)(cid:42)(cid:12)(cid:12)(cid:19)(cid:19)(cid:202)(cid:202)(cid:13)(cid:13)(cid:96)(cid:96)(cid:136)(cid:136)(cid:204)(cid:204)(cid:156)(cid:156)(cid:192)(cid:192)(cid:202)(cid:202) (cid:47)(cid:47)(cid:156)(cid:156)(cid:202)(cid:202)(cid:192)(cid:192)(cid:105)(cid:105)(cid:147)(cid:147)(cid:156)(cid:156)(cid:219)(cid:219)(cid:105)(cid:105)(cid:202)(cid:202)(cid:204)(cid:204)(cid:133)(cid:133)(cid:136)(cid:136)(cid:195)(cid:195)(cid:202)(cid:202)(cid:152)(cid:152)(cid:156)(cid:156)(cid:204)(cid:204)(cid:136)(cid:136)(cid:86)(cid:86)(cid:105)(cid:105)(cid:93)(cid:93)(cid:202)(cid:202)(cid:219)(cid:219)(cid:136)(cid:136)(cid:195)(cid:195)(cid:136)(cid:136)(cid:204)(cid:204)(cid:92)(cid:92)(cid:202)(cid:202) (cid:220)(cid:220)(cid:220)(cid:220)(cid:220)(cid:220)(cid:176)(cid:176)(cid:136)(cid:136)(cid:86)(cid:86)(cid:105)(cid:105)(cid:152)(cid:152)(cid:136)(cid:136)(cid:176)(cid:176)(cid:86)(cid:86)(cid:156)(cid:156)(cid:147)(cid:147)(cid:201)(cid:201)(cid:213)(cid:213)(cid:152)(cid:152)(cid:143)(cid:143)(cid:156)(cid:156)(cid:86)(cid:86)(cid:142)(cid:142)(cid:176)(cid:176)(cid:133)(cid:133)(cid:204)(cid:204)(cid:147)(cid:147) In the spring of 2015, I was honored by my undergraduate and master’s degree alma mater, Eastern Illinois University, with a lifetime achievement award. In my acceptance speech, I spoke to the writing, research, and service paths that led to that award. But I also spoke to something much more important than those “things” I did. Indeed, it is what I believe has been my greatest achievement in 50 years of doing counseling and teaching and is best represented by two people who attended that ceremony. I would like to introduce them to you now and say why this book is dedicated to them. First is Steve Allen, Ed.S., who was an intern of mine in 1973–74 in the Title III ESEA Intensive Care Unit innovative education program for socially and emotionally maladjusted children in Mattoon, Illinois. Of the roughly hundred interns I have supervised, Steve was the best. Steve went on to become a world class K–12 school counselor in rural east-central Newman, Illinois. He garnered enough well deserved honors and recognition over the course of his career to also be recognized by Eastern Illinois University as a lifetime achievement recipient for the work he has done in innovative teaching, counseling, and educational practices. The second person is Kay Dorner, Ph.D., who was a junior high school student I counseled in Mattoon, Illinois, in 1968. Kay has had a distinguished career as a psychologist in private prac- tice and as an administrator in high schools in California and Oregon. Among her noteworthy achievements has been the principalship of a Bill and Melinda Gates small school grant to estab- lish Technology High School in Rohnert Park, California. She is presently working as a school psychologist in Central Point, Oregon. But those are not the reasons this eighth edition is dedicated to these two outstanding therapists and educators. The real reason is that both of these individuals have fought through many of the crises’ snares and traps in this book that could have easily defeated them. Put in life’s furnace and fired, they came out tempered steel. Many in their place would have turned to cinders and burned up. Neither Steve nor Kay did and, in fact, they grew stronger from the adversity they have faced. I am honored and humbled that both of these fine people believe that I have had some influ- ence on their lives by counseling and teaching them. Both of them have felt indebted to me, but it is really I who am indebted to them for what they have become and I have become with them. They have repaid the debt they felt they owned me for that counseling and teaching back in the 1960s and 1970s over and over with the many lives they have touched and changed for the better. They are my legacy and best epitaph. They have, indeed, paid it forward. My fervent hope for any of you neophytes starting out in this business is that you can also mani- fest the sterling character, strength, compassion, skills, resiliency, and empathy that these two pro- fessional human services workers possess and continue to pay forward in 2015. If this book helps you in some way to do that, then I have done my job. Dick James Professor of Counselor Education University of Memphis Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 3 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) Brief Contents Basic Training: 1 Crisis Intervention Theory and Application 01 1 Approaching Crisis Intervention 03 2 Culturally Effective Helping in Crisis 27 3 The Intervention and Assessment Models 48 4 The Tools of the Trade 73 5 Crisis Case Handling 96 6 Telephone and Online Crisis Counseling 116 Handling Specific Crises: 2 Going Into the Trenches 143 7 Posttraumatic Stress Disorder 145 8 Crisis of Lethality 203 9 Sexual Assault 240 10 Partner Violence 286 11 Family Crisis Intervention 331 12 Personal Loss: Bereavement and Grief 373 13 Crises in Schools 429 On the Home Front: 3 Crisis in the Human Services Workplace 481 14 Violent Behavior in Institutions 483 15 Legal and Ethical Issues on Crisis of Trauma 518 16 Human Services Workers in Crisis: Burnout, Vicarious Traumatization, and Compassion Fatigue 546 No Man’s Land: 4 Facing Disaster 577 17 Disaster Response 579 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 4 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) Contents Basic Training: 1 Crisis Intervention Theory and Application 01 CHAPTER 1 Characteristics of Effective Approaching Crisis Intervention 3 Crisis Workers 23 A Brief History of Crisis Intervention 3 Life Experiences 23 Grassroots Movements 5 Personal Characteristics 24 The Importance of Volunteerism 6 Rewards 25 The Need for Institutionalism 6 Summary 25 The Media and the Societal Impetus CHAPTER 2 for Crisis Intervention 7 Culturally Effective Helping in Crisis 27 The Case Against Too Much “Helping” 8 Multicultural Perspectives in Crisis Definitions of Crisis 8 Intervention 27 Individual Crisis Definitions 9 Core Multicultural Attributes 28 Behavioral Emergencies 9 Culturally Biased Assumptions 29 Systemic Crisis Definitions 10 Universal Versus Focused Views 30 Metastasizing Crisis 11 Working on the Individualist/Collectivist–High/ Characteristics of Crisis 11 Low-Context Continuum 30 Transcrisis States 12 Emic Versus Etic Models Transcrisis Differentiated From Posttraumatic of Multiculturalism 33 Stress Disorder 13 Awareness of Both Ecology and Multicultural Transcrisis Points 13 Competencies 36 Theories of Crisis and Crisis Shortcomings of a Multiculturalist Intervention 14 Approach to Crisis Intervention 38 Basic Crisis Intervention Theory 14 Culturally Effective Helping During a Crisis 39 Expanded Crisis Theory 15 Positive Aspects of an Effective Multicultural Applied Crisis Theory 18 Counselor 40 Crisis Intervention Models 19 When in Rome, Italy . . . or Georgia 41 The Equilibrium Model 19 Language Barriers 42 The Cognitive Model 19 Religion and Spirituality 42 The Psychosocial Transition Model 19 Support Systems 43 The Developmental-Ecological Model 20 Occupation as a Cultural Barrier 44 The Contextual-Ecological Model 20 Geographic Locale as a Cultural Barrier 45 Psychological First Aid 20 The Dilemma of Local Consultation 45 The ACT Model 22 The Necessity of Acting 46 Playbook/Game Plan Model 22 Training 46 Eclectic/Integrated Crisis Where It Stands Now . . . Sorta 47 Intervention Theory 22 Summary 47 v Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. 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Predispositioning/Engaging/Initiating Handling Crisis Cases Versus Long-Term Contact 50 Cases 96 Task 2. Problem Exploration: Defining Case Handling at Walk-In Crisis Facilities 97 the Crisis 51 Types of Presenting Crises 97 Task 3. Providing Support 52 Case Handling at a Community Mental Health Default Task: Safety 53 Clinic 100 Task 4. Examining Alternatives 54 Task 5. Planning in Order to Reestablish Police and Crisis Intervention 102 Control 55 Changing Role of the Police 102 Task 6. Obtaining Commitment 56 Police and the Mentally Ill/ Task 7. Follow-up 56 Mentally Disturbed 102 The Crisis Intervention Team (CIT) Program 103 Assessment in Crisis Intervention 58 Assessing the Severity of Crisis 58 Transcrisis Handling in Long-Term The ABCs of Assessing in Crisis Therapy 107 Intervention 58 Anxiety Reactions 107 The Triage Assessment System 59 Regression 108 The Triage Assessment Form 59 Problems of Termination 108 Alternate Forms of the TAF 67 Crisis in the Therapy Session 109 Psychobiological Assessment 68 Psychotic Breaks 109 Assessing the Client’s Current Emotional People With Borderline Personality Functioning 69 Disorder 110 Assessing Alternatives, Coping Mechanisms, Counseling Difficult Clients 113 and Support Systems 71 Ground Rules for Counseling Difficult Assessing for Suicide/Homicide Potential 71 Clients 113 Summary 71 Confronting Difficult Clients 114 Confidentiality in Case Handling 114 CHAPTER 4 Summary 114 The Tools of the Trade 73 Introduction 73 CHAPTER 6 Listening in Crisis Intervention 73 Telephone and Online Crisis Counseling 116 Open-Ended Questions 73 Introduction 116 Closed-Ended Questions 74 Case Handling on Telephone Restatement and Summary Crisis Lines 117 Clarification 74 Telephone Counseling Owning Feelings 75 Strategies 119 Facilitative Listening 78 Making Psychological Contact 119 Basic Strategies of Crisis Intervention 79 Defining the Problem 120 Climate of Client Growth 82 Ensuring Safety and Providing Support 121 Communicating Empathy 82 Looking at Alternatives and Making Plans 121 Communicating Genuineness 85 Obtaining Commitment 122 Communicating Acceptance 86 Errors and Fallacies 122 In the Field 87 Regular, Severely Disturbed, Acting in Crisis Intervention 88 and Abusive Callers 123 Directive Intervention 89 Understanding the Regular Caller’s Agenda 124 Collaborative Counseling 90 Handling the Severely Nondirective Counseling 90 Disturbed Caller 126 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 6 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) Contents ■ vii Other Problem Callers 129 Predispositioning 137 Handling the Problem Callers 131 Texting 140 Hotlines 132 Virtual Reality 140 Need for Training 141 The Internet’s Growing Role in Crisis Intervention 134 Legal, Ethical, and Moral Issues of Telephone and Behavioral Telehealth 134 Internet Counseling 141 The Appeal of Online Counseling 135 Problems of Online Counseling 136 Does It Work? 141 Netiquette 137 Summary 142 Handling Specific Crises: 2 Going Into the Trenches 143 CHAPTER 7 Psychotropic Medication 176 Posttraumatic Stress Disorder 145 Individual Intervention Stages 176 Introduction 145 Emergency/Outcry 176 Extinguishing Intrusive Images 177 Background 146 Numbing/Denial 177 Dynamics of PTSD 148 Reflection and Transition 179 Diagnostic Categorization 148 Integration 181 Complex PTSD 150 Group Treatment 181 Conflicting Diagnoses 151 Support Groups 181 The Question of Preexisting The Life Adjustment Group 187 Psychopathology 151 Family Treatment 188 Neurophysiological Responses 152 Eye Movement Desensitization and Affective-State-Dependent Retention 153 Reprocessing (EMDR) 189 Children and Neuropathology 153 The Controversy Over EMDR 189 Incidence, Impact, and Trauma Type 153 EMDR Therapy 190 Incidence 153 Children and PTSD 192 Residual Impact 154 Diagnostic Criteria for Children 192 Importance of Trauma Type 154 Support Systems 194 Vietnam: The Archetype 155 Types of Trauma 194 Intrusive-Repetitive Ideation 159 Etched Memories 195 Denial/Numbing 159 Developmental Issues 195 Increased Nervous Symptom Arousal 160 Other Responses to Type I Trauma 196 Dissociation 160 Type II Traumas 197 Social Supports 161 Intervention Strategies 197 Maladaptive Patterns Characteristic of Therapy 198 PTSD 162 Moving Beyond the Trauma 200 The Traumatic Wake of Iraq Summary 201 and Afghanistan 163 The Comprehensive Solider Fitness Program 164 CHAPTER 8 Components of Treatment Crisis of Lethality 203 for Adults 165 Background 203 Assessment 165 The Scope of the Suicide Crisis 203 Phases of Recovery 170 Suicide and the Moral Dilemma 204 Importance of Acceptance 171 The Dynamics of Suicide 206 Risks of Treatment 172 Psychological Theories 206 Multiphasic/Multimodal Treatment 173 Sociological Theory 207 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 71470_fm_ptg01.indd 7 1/9/16 3:01 PM (cid:13)(cid:96)(cid:136)(cid:204)(cid:105)(cid:96)(cid:202)(cid:220)(cid:136)(cid:204)(cid:133)(cid:202)(cid:204)(cid:133)(cid:105)(cid:202)(cid:96)(cid:105)(cid:147)(cid:156)(cid:202)(cid:219)(cid:105)(cid:192)(cid:195)(cid:136)(cid:156)(cid:152)(cid:202)(cid:156)(cid:118)(cid:202) (cid:22)(cid:152)(cid:118)(cid:136)(cid:221)(cid:202)(cid:42)(cid:192)(cid:156)(cid:202)(cid:42)(cid:12)(cid:19)(cid:202)(cid:13)(cid:96)(cid:136)(cid:204)(cid:156)(cid:192)(cid:202) (cid:47)(cid:156)(cid:202)(cid:192)(cid:105)(cid:147)(cid:156)(cid:219)(cid:105)(cid:202)(cid:204)(cid:133)(cid:136)(cid:195)(cid:202)(cid:152)(cid:156)(cid:204)(cid:136)(cid:86)(cid:105)(cid:93)(cid:202)(cid:219)(cid:136)(cid:195)(cid:136)(cid:204)(cid:92)(cid:202) (cid:220)(cid:220)(cid:220)(cid:176)(cid:136)(cid:86)(cid:105)(cid:152)(cid:136)(cid:176)(cid:86)(cid:156)(cid:147)(cid:201)(cid:213)(cid:152)(cid:143)(cid:156)(cid:86)(cid:142)(cid:176)(cid:133)(cid:204)(cid:147) viii ■ Contents Interpersonal Theory 207 Treatment of Adults 259 Existential-Constructivist Framework 207 Discovery and Admission 259 Other Explanations 208 Grounding 260 Characteristics of People Who Commit Validation 262 Suicide 209 Extinguishing Trauma 262 Similarities Between Suicide and Homicide 210 Prolonged Exposure/Cognitive Analyzing Suicide/Homicide Notes/Videos 210 Restructuring 263 Myths About Suicide 211 Grief Resolution 264 Support Groups for Adult Survivors 266 Assessment 213 Suicide Clues 213 Sexual Abuse in Childhood 266 Assessment Instruments 214 Dynamics of Sexual Abuse in Childhood 267 Clinical Interview 215 Dynamics of Sexual Abuse in Families 268 Using the Triage Assessment Form Phases of Child Sexual Abuse 270 in Addressing Lethality 216 Intervention Strategies With Children 271 Intervention Strategies 218 Assessment 271 The Three I’s 218 Therapeutic Options 272 Older Adults 229 Need for Affirmation and Safety 273 Guidelines for Family, Friends, Regaining a Sense of Control 273 and Associates 232 Education 274 The Psychological Autopsy 234 Assertiveness Training 274 Postvention 235 Intervention Strategies for Child Sexual Abuse: Losing a Client to Suicide 238 The Case of Elizabeth 274 Summary 239 Disclosure 275 Immediate Aftermath 275 CHAPTER 9 Prosecuting the Perpetrator 277 Sexual Assault 240 Interviewing the Child 277 The Scope of the Problem 240 Preparing the Child for Testimony 278 Underreporting 241 Aftermath 279 Defining Rape: The Unique Situation Counseling 279 of Sexual Abuse/Rape Survivors 241 Group Counseling 279 The Dynamics of Rape 242 Boundary Issues 280 Social/Cultural Factors 242 Group Support Work With Nonoffending Personal and Psychological Factors 242 Parents 280 Myths About Rape 243 Preventing Revictimization 281 Date and Acquaintance Rape 246 Individual Counseling 281 Date Rape Risk 246 Summary 284 Preventing Date, Acquaintance, and Other CHAPTER 10 Forms of Rape 247 Partner Violence 286 Intervention Strategies for Rape and Introduction 286 Battery: The Case of Melody 248 Immediate Aftermath 248 The Incidence of Partner Violence 287 The Following Three Months 253 Emerging Approaches to Partner Adult Survivors of Childhood Sexual Violence 288 Abuse 255 Dynamics of Partner Violence 290 Psychological Trauma and Sequelae 255 Psychosocial and Cultural Dynamics 290 False Memories 256 Psychological Factors 293 Intervention Strategies for Adult Survivors: Stressors 294 The Case of Heather 257 Myths About Battering 295 Assessment 257 Profiling the Batterer 296 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. 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