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Cultural malpractice: The growing obsolescence of psychol- ogy with the changing U buy trileptal 150mg free shipping. An appraisal of the relationship between women and psy- chotherapy: 80 years after the case of Dora discount 600 mg trileptal fast delivery. Roles discount 300mg trileptal overnight delivery, identities purchase trileptal 300 mg, and sexual orientation: Homosexuality, het- erosexuality, and bisexuality. An investigation of the effect of male therapists’ views of women on the process and outcome of therapy with women. Gender differences in the diagnosis of mental disorders: Conclusions and controversies of the DSM-IV. Counseling with Native American Indians and Alaska Natives: Strategies for helping professionals. Psychologists’ attitudes and practices re- garding erotic and nonerotic physical contact with patients. Asian cultural values and the counseling process: Current knowledge and directions for future research. Sexist discrimination may ac- count for well-known gender differences in psychiatric symptoms. The role of sexual orientation in multicultural counseling: Integrating bodies of knowledge. Symposium presented at the annual conference of the American Association of Marriage and Family Therapy, San Francisco. Men’s and women’s gender role journeys: A metaphor for healing, transition, and transformation. Merger and fusion in lesbian relationships: A problem of diagnosing what’s wrong in terms of what’s right. Bridging sepa- rate gender worlds: Why men and women clash and how therapists can bring them to- gether. Therapist-patient sex as sex abuse: Six scientific, professional, and practical dilemmas in addressing victimization and rehabilitation. Sexual involvement with therapists: Patient assessment, subsequent therapy, forensics. The (mis)treatment of men: Effects of client gender role and life-style on diagnosis and attribution of pathology. Levels of evidence for the models of mechanisms of therapeutic change in family and couples therapy. Depression and schizophrenia in women: The intersection of gender, race/ethnicity, and class. SECTION III SPECIAL I SSUES FACED BY COUPLES CHAPTER 15 Managing Emotional Reactivity in Couples Facing Illness: Smoothing Out the Emotional Roller Coaster William H. I have to manage my pain AND my marriage" As psychotherapists, we can forget that our clients are biological crea- tures, that they have bodies as well as minds, and that body and mind are intimately connected. How our bodies function impacts not only our emo- tional lives but also the emotional lives of those with whom we are close. And, conversely, our emotional lives and the interpersonal contexts in which we live affect our physical and biological functioning. Since illness is considered to be the domain of medicine, therapists often are untrained and uninterested in dealing with these issues, despite their prevalence in the general population. Yet the emotional and relational dynamics that are of interest to therapists play a critical role in determining how in- dividuals and couples cope with illness, and the presence of illness in the family often has a profound impact on the individual and relational func- tioning. Therapist reluctance to address medical illness in couples can also be compounded by countertransference issues. Confronting serious illness in patients can arouse therapists’ own fears of mortality and feelings of impotence in the face of overwhelming pain, loss, and disability. Illness in one fam- ily member can have not only emotional but physical repercussions for other family members, especially spouses.

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Concerning the muscles of the pelvic girdle: (a) The majority of the gluteus maximus merges with the iliotibial tract buy 600 mg trileptal. In the pelvis: (a) The anteroposterior view of the plain radiograph is taken with the legs rotated externally trileptal 600mg free shipping. The sacral surface is lined by fibrocartilage and the iliac surface by hyaline cartilage generic 150mg trileptal fast delivery. The Stork’s view to assess instability of the pubic symphysis is taken standing on each leg buy trileptal 150mg with mastercard. Change in alignment of the superior surface of the pubic rami of more than 3 mm is abnormal. In pelvimetry: (a) Routine assessment of the female pelvis is performed before delivery. In the hip joint: (a) The fovea capitis to which the ligamentum teres is attached is not covered in cartilage. Regarding the femur: (a) MRI has a high sensitivity and specificity in detecting avascular necrosis of the femoral head. The ilio-femoral ligament is attached to the anterior inferior iliac spine and to the inter-rochanteric line, and is anterior to the femoral neck. Judet’s views of the acetabulum and femoral head give information on the anterior and posterior columns of the acetabulum. Intracapsular fractures of the femoral neck can compromise the blood supply to the head of the femur as the circumflex arteries may be torn. This gives rise to a high incidence of avascular necrosis of the femoral head or non-union. Hence the inferior surface of the femur is nearly horizontal despite the shaft being oblique. In the lower limb: (a) The patella is a sesamoid bone within the quadriceps tendon. In the lower limb: (a) The rectus femoris arises from the anterior superior iliac spine. The sartorius and tensor fascia lata arise from the anterior superior iliac spine. The rectus femoris inserts into the base of the patella and by the patellar ligament to the tibial tuberosity. This insertion is the same for the other muscles which form the quadriceps femoris; vastus – lateralis, medialis and intermedius. In the knee joint: (a) The anterior cruciate ligament has low signal intensity on T1- and T2- weighted sagittal scans. Regarding the lower legs: (a) The muscles of the anterior compartment are more prone to be affected by compartmental syndrome. Coronal images show medial and lateral collateral ligaments, sagittal images show menisci, cruciate ligaments and articular cartilages. The anterior part is called ligament of Humphrey and the posterior part, ligament of Wrisberg. They can be mistaken for a tear of the posterior horn of the lateral meniscus or for loose bodies in front of or behind the PCL. A tunnel view of the intercondylar fossa of the upper end of the tibia is used to detect intra-articular opacities. Hence during Doppler ultrasound for venous thrombosis, excess pressure with the probe will obliterate the lumen and it cannot be visualized. However, this is a sign to be elicited with the probe held transverse to the vein, to ensure patency of veins. In the ankle and the foot: (a) The deltoid ligament lies medially, deep to the flexor tendons.

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