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Clinical Psychologist

Impact factor: 0.536 Print ISSN: 1328-4207 Online ISSN: 1742-9552 Publisher: Wiley Blackwell (Blackwell Publishing)

Subject: Clinical Psychology

Most recent papers:

  • Culturally informed case conceptualisation: Developing a clinical psychology approach to treatment planning for non‐Indigenous psychologists working with Aboriginal and Torres Strait Islander clients.
    Meegan Kilcullen, Andrew Day.
    Clinical Psychologist. October 13, 2017
    Background In the context of the Australian Psychological Society's formal apology and the increasing awareness of the need to develop interventions that improve the social and emotional wellbeing of clients who identify from Aboriginal and Torres Strait Islander cultural backgrounds, this article considers the clinical psychology case conceptualisation. The primary aim of any case conceptualisation is to inform intervention and, in the initial stages of treatment, is considered important in helping the psychologists to develop a stronger therapeutic relationship whilst also providing a reference point from which to evaluate treatment progress. In other words, it enables practitioners to develop a coherent set of explanatory inferences—based in theory—that describe and explain why the person has a particular problem at a particular time. Method The model draws together mainstream case formulation processes with culturally specific understandings of social and emotional health and wellbeing. A worked case example is used in this article to illustrate how the non‐Indigenous psychologist can integrate influence of the broader social and cultural context into the case conceptualisation to enhance culturally responsive practice. Results The proposed model provides the psychologist with an entry point for understanding an individual's experience within a broader socio‐historical–political context. The model may help the practitioner to identify areas in which he or she needs to develop their cultural intelligence. Conclusions Developing and enhancing culturally responsive practice is a practical way in which clinical psychologists can meaningfully participate in “active reconciliation” within a clinical psychology encounter.
    October 13, 2017   doi: 10.1111/cp.12141   open full text
  • External Shame as a Mediator between Paranoia and Social Safeness in Psychosis.
    Paula Castilho, Ana Margarida Pinto, Ricardo Viegas, Sérgio Carvalho, Nuno Madeira, Maria João Martins.
    Clinical Psychologist. September 14, 2017
    Background The overactivation of the threat‐defence system combined with an underdeveloped affiliative system has been emphasised as important in psychosis, usually leading to negative affect and impaired social functioning. Difficulties in feeling safe and content in relationships with others, common in individuals with psychotic symptoms, have been linked to two specific outputs of the threat‐defence system: Paranoid ideation and external shame. This study sought to explore the associations between paranoid ideation, external shame, and social safeness. Methods Participants diagnosed with psychotic disorders (N = 37) completed a series of self‐report questionnaires. Results Results showed a significant negative association between social safeness and external shame and frequency of paranoid ideation, while external shame was positively associated with both frequency and distress of paranoid ideation. Results revealed that the relationship between frequency of paranoid ideation and social safeness was mediated by external shame. Conclusions These findings suggest that feelings of being inferior and subordinate in the eyes of others increases vulnerability to difficulties in social connectedness and safeness. Treatment for paranoid ideation could benefit from integrating strategies to help patients deal with shame.
    September 14, 2017   doi: 10.1111/cp.12136   open full text
  • Delusion‐like beliefs in anorexia nervosa: An interpretative phenomenological analysis.
    Jessica E O'Connell, Sarah Bendall, Elisabeth Morley, Chia Huang, Isabel Krug.
    Clinical Psychologist. September 04, 2017
    Objective Quantitative evidence suggests that a subset of individuals with anorexia nervosa (AN) may hold beliefs pertaining to food, body image, and appearance that are delusional in nature. The present study extended this research through qualitatively exploring beliefs held by AN patients and the consequences of holding such beliefs. Method Five participants receiving inpatient treatment for AN took part in semi‐structured interviews, which were transcribed and analysed according to the principles of interpretative phenomenological analysis. Results Two superordinate themes emerged: “Delusion‐like beliefs,” which detailed participants’ conviction that their bodies responded to food and exercise differently to others and thus they must engage in disordered behaviours to remain at a normal weight; and “Process,” which captured the ways in which participants maintained their beliefs and addressed their variable relationship with insight. Conclusions The current findings suggest that anorectic cognitions can take a delusional quality and thus may not be overvalued ideas only.
    September 04, 2017   doi: 10.1111/cp.12137   open full text
  • The impact of parental hoarding on the lives of children: Interviews with adult offspring of parents with hoarding disorder.
    Clare S. Rees, Shanelle Valentine, Rebecca A. Anderson.
    Clinical Psychologist. August 04, 2017
    Background Hoarding disorder is associated with significant impairment for the individual such as lower rates of employment and social isolation. However, less is known about the impact of this condition on the children of people with hoarding disorder (HD). No qualitative research to date has focussed exclusively on the experiences of adult offspring of parents with hoarding difficulties. The present qualitative study set out to investigate the experiences of adult offspring of parents with hoarding difficulties, exploring the present, and longer‐term impacts of parental hoarding. Method Seven females between the ages of 35 and 62 years were interviewed using a semi‐structured format; all reported parental hoarding within the clinically significant range. Interpretative phenomenological analysis was utilised to analyse interview transcripts. Results Four superordinate themes were extracted from the data: psychological and emotional outcomes, coping strategies, perceptions of parental hoarding, and impact on relationships. Conclusions The research demonstrated the significant impacts of parental hoarding on their offspring, both individually and on a relational level. The outcomes of this research provide clinical implications for working with this population, as well as suggestions for future research.
    August 04, 2017   doi: 10.1111/cp.12135   open full text
  • Alexithymia in parents and adolescents with generalised anxiety disorder.
    Maria Francesca Paniccia, Santino Gaudio, Alessia Puddu, Michela Di Trani, Antonios Dakanalis, Simonetta Gentile, Vincenzo Di Ciommo.
    Clinical Psychologist. July 21, 2017
    Background The relationship between generalised anxiety disorder (GAD) and alexithymia has been poorly studied in adolescents. The present study examined the alexithymia levels in adolescents with GAD and their parents compared with healthy control participants (adolescents and their parents). Method The sample included 300 participants: 50 adolescents with GAD and 50 healthy adolescents, 13–18 years of age, and their 200 parents (100 mothers and 100 fathers). The Schedule for Affective Disorders and Schizophrenia for School‐Age Children was performed to evaluate adolescents’ mental health while the 20‐item Toronto Alexithymia Scale was performed to assess alexithymia levels in both adolescents and their parents. Results Adolescents with GAD showed a significantly higher rate of alexithymia when compared with control adolescents. The mothers of adolescents with GAD showed an alexithymia score higher than did the controls’ mothers. The fathers of the two groups showed no differences of in their rate of alexithymia. Moreover, in the clinical sample, adolescent and maternal alexithymia scores were not correlated, while significant directed correlations were found between these adolescents and their own fathers. Conclusions Our findings show an association between GAD and alexithymia in adolescents. A significant presence of alexithymic traits in the mothers of the patients with GAD was shown. An intergenerational transmission of alexithymia could be supposed but this cannot be a linear mechanism. The assessment of alexithymia in adolescents with psychological disorders, and in their parents, could be useful to plan a more targeted therapeutic approach.
    July 21, 2017   doi: 10.1111/cp.12134   open full text
  • The effects of Compassion Cultivation Training (CCT) on health‐care workers.
    Janina Scarlet, Nathanael Altmeyer, Susan Knier, R. Edward Harpin.
    Clinical Psychologist. July 05, 2017
    Background The main objective of this pilot study was to investigate the effects of the Compassion Cultivation Training (CCT) on various aspects of burnout and job satisfaction in health‐care workers. Specifically, this study sought to investigate whether CCT reduces work‐related burnout, interpersonal conflict, as well as increases of mindfulness, compassion toward the self, fears of compassion, and job satisfaction scores. Method Participants consisted of 62 adults, who identified as health‐care workers between the ages 22 and 80. All participants completed an 8‐week CCT course and filled out questionnaires related to self‐compassion, fears of compassion, mindfulness, burnout, job satisfaction, and interpersonal conflict. The questionnaires were administered by email during the first, middle, and last weeks of CCT, as well as 1 month after completion of CCT (follow‐up). Results The results for this study demonstrated significant improvements in participants’ self‐compassion, mindfulness, and interpersonal conflict scores. In addition, the results indicated marginally significant improvements in self‐reported job satisfaction scores. No differences were observed on the burnout measure due to possible floor effects. Conclusions The general conclusions of this study are that CCT may be helpful at improving several aspects of health in health‐care providers, such as self‐reported mindfulness, self‐compassion, compassion toward others, and interpersonal conflict. The implications of this study are that this training may promote mental health resilience in health‐care workers, improve patient care, and may be helpful in burnout prevention. Further implications and future directions are discussed.
    July 05, 2017   doi: 10.1111/cp.12130   open full text
  • Application of a mindfulness and compassion‐based approach to the at‐risk mental state.
    Tara Hickey, Barnaby Nelson, Graham Meadows.
    Clinical Psychologist. July 05, 2017
    Background Psychological interventions based on mindfulness and compassion approaches have demonstrated improved outcomes across a range of disorders. However, the application of these approaches to the at‐risk mental state (ARMS) has received little attention to date. This paper explores their potential to enhance treatment of the ARMS. Methods This article follows guidelines developed by the UK Medical Research Council and the US National Institute of Health on developing and evaluating complex interventions. The paper (1) describes the ARMS, treatment and outcomes, (2) explores relevant literature on mindfulness and compassion, (3) discusses the likely processes of change involved in a mindful compassionate approach, (4) provides a rationale for integrating mindfulness and compassion into treatment of the ARMS, and (5) offers recommendations to enhance knowledge and treatment in this area. Results Common ARMS experiences include attenuated psychotic symptoms, depression, anxiety, insecure attachment style, and difficulties with daily functioning. In particular, voice tones are often hostile or critical and paranoia is associated with a self‐attacking inner dialogue. Mindfulness and compassion are emotion regulation strategies that have the potential to tone down these threatening experiences by enhancing a sense of safety and reassurance. However, the potential impact of mindfulness and compassion on attachment style and feelings of social connectedness warrants further investigation. Conclusions Mindfulness and compassion approaches are unique strategies that have the potential to significantly advance treatment of the ARMS. It is timely that a mindfulness and compassion‐based intervention for the ARMS is developed and evaluated according to best practice guidelines.
    July 05, 2017   doi: 10.1111/cp.12132   open full text
  • The relevance of self‐compassion as an intervention target in mood and anxiety disorders: A narrative review based on an emotion regulation framework.
    Amy Louise Finlay‐Jones.
    Clinical Psychologist. July 05, 2017
    Background There is growing interest in self‐compassion as a possible treatment target for individuals with depression and anxiety disorders. Understanding self‐compassion within an emotion regulation (ER) framework of mood and anxiety disorders has the potential to generate insights into the clinical relevance of self‐compassion in the treatment of depression and anxiety. The aim of the current review was to integrate evidence and theory from the self‐compassion, ER, and mood and anxiety disorders literatures to highlight directions for research and inform clinical applications. Methods A review of the cross‐sectional and experimental quantitative literature pertaining to self‐compassion, ER, and mood and anxiety disorders was undertaken, guided by established models of ER in mood and anxiety disorders. Evidence from clinical and non‐clinical studies was included. Results There is preliminary support for an ER framework of self‐compassion and mood and anxiety disorders: in particular, there is evidence that self‐compassion is linked to factors that represent key mechanisms in ER models of depression and anxiety, including affective experiences, ER capacities, and propensity to deploy specific ER strategies. However, research with clinical populations is limited. Conclusions An ER perspective may provide a useful framework for guiding research and clinical work on self‐compassion and mood and anxiety disorders. Further research is required to comprehensively test the relationship between self‐compassion and various aspects of the ER model, and to examine mediators and moderators of compassion‐based interventions with clinical samples.
    July 05, 2017   doi: 10.1111/cp.12131   open full text
  • An evolutionary model to conceptualise masculinity and compassion in male teenagers: A unifying framework.
    James N. Kirby, Peter G. Kirby.
    Clinical Psychologist. July 05, 2017
    Background The period of adolescence can be a challenging time for boys, particularly in forming their own self‐identity and reputation. In the school context, boys can often adopt a “tough” masculine image (e.g., alpha male) out of fear of being coined weak or being seen as inferior among their peer group. Thus, for an adolescent boy to adopt a compassionate self‐identity at school is a risk to his reputation because to be compassionate can also be viewed as being weak by one's peer group. Yet both of these views of “weak” are misconceptions of what it means to be masculine and compassionate. Method This article examines masculinity and compassion through an evolutionary perspective, with an aim to demonstrate how compassion can help adolescent boys with hegemonic masculine identities. Results This article focuses on the following areas in understanding masculinity and compassion in boys: (1) evolutionary and biological approaches to masculinity and compassion, (2) adolescence and reputations, (3) the role of environment, (4) interventions, and (5) a series of recommendations for future research exploring links between compassion and masculinity. Conclusion Collectively, this article proposes that masculinity and compassion need to be understood in terms of evolutionary models to help better understand how these constructs function and what factors facilitate and inhibit them.
    July 05, 2017   doi: 10.1111/cp.12129   open full text
  • Compassion focused therapy for eating disorders: A qualitative review and recommendations for further applications.
    Stanley R. Steindl, Kiera Buchanan, Kenneth Goss, Steven Allan.
    Clinical Psychologist. July 05, 2017
    Background People suffering from an eating disorder (ED), or more generally with eating, body image, and weight concerns, have been found to experience high levels of self‐criticism, self‐directed hostility, and shame. Furthermore, these individuals tend to have difficulties generating and activating affiliative and self‐soothing emotions. Methods Compassion focused therapy (CFT) specifically addresses these issues, and CFT for eating disorders (CFT‐E) was designed to incorporate the development and practice of compassion for self and others into standard ED treatment programs to assist with these issues. Results This article describes (1) the theoretical rationale for cultivating compassion for self and others as part of ED treatment, (2) the adaptation and incorporation of CFT‐E within ED treatment programs, and (3) a qualitative review of the current evidence base for CFT‐E. Conclusions Finally, the article will explore recent and potential future developments in CFT‐E, and recommendations for the use of CFT‐E in clinical practice, including its application for those who present with other eating and weight concerns (such as being overweight or obese), and various modes of inpatient and community‐based delivery.
    July 05, 2017   doi: 10.1111/cp.12126   open full text
  • Predicting outcomes for anxious children receiving group cognitive‐behavioural therapy: Does the type of anxiety diagnosis make a difference?
    Allison M. Waters, Trisha A. Groth, Helena Purkis, Clair Alston‐knox.
    Clinical Psychologist. June 19, 2017
    Background Cognitive‐behavioural therapy (CBT) is an efficacious treatment for anxiety disorders in children and adolescents, yet not all young people improve. Understanding predictors of treatment response can inform treatment improvements in order to enhance outcomes. Aim The purpose of this study was to compare treatment outcomes following group‐based CBT for children with different anxiety disorders (social phobia (SocP), separation anxiety disorder (SAD), generalised anxiety disorder (GAD), specific phobia (SP)) to determine whether differential outcomes from group‐based CBT are related to type of diagnosis. Method Participants were 205 clinically anxious children between 4 and 12 years of age. Treatment outcomes were assessed using clinician‐rated diagnostic interviews, parent‐report, and child‐report symptom measures. Ninety‐seven children completed a long‐term follow‐up assessment 6 or 12 months after treatment. Results Children with a principal diagnosis of SocP and GAD had a poorer post‐treatment outcome compared to children with a principal diagnosis of SP and SAD. Poorer outcomes persisted in children with a principal diagnosis of SocP by the follow‐up assessment compared to children with the other anxiety disorders. Conclusions These findings are consistent with recent studies that have found poorer outcomes from CBT for youth and adults with SocP, and emphasise the need for further research into treatments that target specific factors that could improve outcomes.
    June 19, 2017   doi: 10.1111/cp.12128   open full text
  • The Non‐Suicidal Self‐Injury Expectancy Questionnaire: Factor structure and initial validation.
    Penelope Hasking, Mark Boyes.
    Clinical Psychologist. May 31, 2017
    Background Models of non‐suicidal self‐injury (NSSI) typically focus on the role of emotion regulation in NSSI, yet recent work supports a role for NSSI‐related cognitions. NSSI outcome expectancies may offer important clues about who is at risk of NSSI, who is able to cease the behaviour, and who is at risk of relapse. Yet, so far, there is no reliable and valid means of assessing these cognitions. We developed, and reported on initial validation, of an NSSI Expectancy Questionnaire. Methods A total of 49 statements reflecting possible outcomes of NSSI were administered to 496 undergraduate students. Results Principal axis factoring revealed five factors (Affect Regulation, Negative Social Outcomes, Communication, Pain, Negative Self‐Beliefs), which differentiated people with a history of NSSI from people with no NSSI history. Correlations with measures of self‐efficacy, emotion regulation, and NSSI functions offer convergent and discriminant validity. Conclusions The questionnaire appears to be a reliable and valid measure of NSSI outcome expectancies that could be a useful addition to the measurement toolkit when investigating cognitive variables related to NSSI.
    May 31, 2017   doi: 10.1111/cp.12127   open full text
  • Pilot study of acceptance and commitment therapy for irritable bowel syndrome: A preliminary analysis of treatment outcomes and processes of change.
    Nuno B. Ferreira, David Gillanders, Paul G. Morris, Maria Eugenicos.
    Clinical Psychologist. April 11, 2017
    Background The aim of this study was to investigate the efficacy and proposed processes of change of acceptance and commitment therapy (ACT) in improving the outcomes of irritable bowel syndrome (IBS). Methods A total of 56 consecutive patients recruited from a specialist clinic were included in the study and completed an ACT treatment protocol (one‐day group workshop plus self‐help manual). Assessments of process (acceptance of IBS) and outcome variables (symptom severity, avoidance behaviours, quality of life, and gastrointestinal anxiety) were carried at four time points (assessment, pre‐treatment, post‐treatment, and follow‐up). Results A significant increase in the acceptance of IBS and improvement in all outcome variables was observed from pre‐ to post‐treatment and follow‐up (effect sizes medium to large). Improvements in all outcomes were associated with increases in acceptance of IBS. Changes in acceptance of IBS from pre‐ to post‐treatment were a significant predictor of improvements in outcomes from pre‐treatment to follow‐up. Conclusions Results support the efficacy of a brief ACT protocol in improving IBS outcomes and maintaining therapy effects at six‐month follow‐up. Preliminary support for the treatment process proposed was also found.
    April 11, 2017   doi: 10.1111/cp.12123   open full text
  • Construing a therapeutic relationship online: An analysis of videoconference sessions.
    Sabrina Cipolletta, Eleonora Frassoni, Elena Faccio.
    Clinical Psychologist. March 10, 2017
    Objective The aim of this study is to investigate the elements that characterize the formation of a therapeutic relationship when the sessions are conducted through videoconference. Method Conversation analysis was used to analyse the first three counselling sessions with five clients, for a total of 15 sessions. Results The phenomena detected in the conversational sequences dealt with the following issues: starting up (early definition of the problem, motivation to use a communication technology, and therapeutic rules), technological ruptures (interruptions and multimedia repair), environment, privacy, and going beyond videoconferencing, such as inter‐session contact and moving from videoconferencing to face‐to‐face meetings. The analysis of relational asymmetries also highlighted the relational dominance of the therapist. A series of these phenomena could be ascribed to the online modality; other ones are common in face‐to‐face sessions. The frequent request to integrate online sessions with face‐to‐face sessions might indicate that online psychotherapy is seen as a complement to face‐to‐face psychotherapy more than as a substitute for it. Conclusions The potential of online psychotherapy is still underestimated and further studies should be conducted on the specificities of the computer‐mediated communication within the therapeutic relationship.
    March 10, 2017   doi: 10.1111/cp.12117   open full text
  • Acceptance and Commitment Therapy delivered in a dyad after a severe traumatic brain injury: A feasibility study.
    Diane L. Whiting, Frank P. Deane, Grahame K. Simpson, Joseph Ciarrochi, Hamish J. Mcleod.
    Clinical Psychologist. March 07, 2017
    Objective There is a high prevalence of complex psychological distress after a traumatic brain injury but limited evidence of effective interventions. We examined the feasibility of Acceptance and Commitment Therapy after a severe traumatic brain injury using the criteria, investigating a therapeutic effect, and reviewing the acceptability of measures, treatment protocol, and delivery method (in a dyad of two clients and a therapist). Method Two male outpatients with severe traumatic brain injury and associated psychological distress jointly engaged in a seven session treatment program based on Acceptance and Commitment Therapy principles. Pre‐ and post‐treatment measures of mood, psychological flexibility, and participation were taken in addition to weekly measures. Results The intervention showed a therapeutic effect with one participant, and appeared to be acceptable for both participants with regard to program content, measures, and delivery mode by in a dyad. One participant showed both significant clinical and reliable change across several outcome measures including measures of mood and psychological flexibility. The second participant did not show a reduction in psychological inflexibility, but did show a significant drop in negative affect. Significant changes pre‐ to post‐treatment for measures of participation were not indicated. Qualitatively, both participants engaged in committed action set in accordance with their values. Conclusions This study suggests that Acceptance and Commitment Therapy may be feasible to be delivered in a dyad with individuals who have a severe traumatic brain injury. A further test of its potential efficacy in a phase II clinical trial is recommended.
    March 07, 2017   doi: 10.1111/cp.12118   open full text
  • Early maladaptive schemas in people with a fear of blushing.
    Peter D. Drummond, Sally J. Gatt.
    Clinical Psychologist. February 14, 2017
    Background An extreme concern about blushing in front of others is associated with negative automatic thoughts about the social costs of blushing, but the beliefs that underlie these automatic thoughts are unknown. Methods To investigate this, 136 participants filled out questionnaires concerned with fear of blushing, social interaction anxiety, and early maladaptive schemas. Results Fear of blushing was strongly associated with social interaction anxiety, emotional inhibition, and maladaptive schemas in the domain of disconnection and rejection. Specifically, a combination of emotional inhibition and social isolation and alienation was associated with fear of blushing, over and above other maladaptive schemas. Social interaction anxiety mediated the association between these maladaptive schemas and fear of blushing. Conclusions Beliefs about feeling different from other people, and a strong need to hide private thoughts and feelings to avoid social disapproval, may be particularly important for triggering a fear of blushing. Thus, addressing these beliefs in schema‐based therapy could be useful for managing this fear.
    February 14, 2017   doi: 10.1111/cp.12114   open full text
  • Substance‐related and addictive disorders as mediators between borderline personality disorder and aggressive behavior.
    Francesca Martino, Marcantonio M. Spada, Marco Menchetti, Elena Lo Sterzo, Michele Sanza, Paola Tedesco, Cecilia Trevisani, Domenico Berardi.
    Clinical Psychologist. February 14, 2017
    Background Impulsivity is considered a core clinical feature in borderline personality disorder (BPD). Evidence also indicates that impulsivity is part of the biological vulnerability for BPD. The purpose of the study was to verify if the presence of substance‐related and addictive disorders (SRADs) may increase impulsivity and aggression in BPD. Methods Eighty patients (27 with BPD, 26 with BPD and SRAD, 27 with other personality disorders (OPDs)) completed a comprehensive assessment for personality disorder symptoms, impulsivity, and aggressive behaviour. Results BPD patients with SRAD showed higher scores on impulsivity and aggression compared with other groups. Furthermore, no significant difference was observed between BPD and OPD patients on impulsivity and aggression. Conclusion The presence of SRAD was found to be a mediator between BPD and impulsive and aggressive behaviour. The findings are discussed and directions for future research presented.
    February 14, 2017   doi: 10.1111/cp.12115   open full text
  • Investigating the depression‐anxiety link in clients receiving Integrative Counselling.
    Antigonos Sochos, Marina Kotonou.
    Clinical Psychologist. January 30, 2017
    Objective The aim of this article was to investigate how anxiety and depression impact upon each other over the course of a counselling intervention. Method A single‐group repeated measures quasi‐experimental design was employed. Data were collected at four time points: at pre‐therapy assessment and at first, third, and last sessions. The sample consisted of 562 predominantly white British clients receiving Integrative Counselling at North Kent Mind, UK. Two measures were used: the Generalised Anxiety Disorder (GAD) Scale to measure anxiety and the Patient Health Questionnaire (PHQ) to measure depression. Results Clients improved in both dimensions at every measurement point. Path analysis suggested that anxiety and depression remained interlinked throughout treatment but they presented different effect profiles. They both appeared to have a premature effect on the other, but they did so in different ways. Conclusions The therapeutic relationship may be a crucial factor in understanding the premature effect observed and future research should utilise direct measures of the relationship.
    January 30, 2017   doi: 10.1111/cp.12113   open full text
  • Aboriginal and Torres Strait Islander health and wellbeing: Social emotional wellbeing and strengths‐based psychology.
    Meegan Kilcullen, Anne Swinbourne, Yvonne Cadet‐James.
    Clinical Psychologist. January 28, 2017
    Objective Addressing the continued health disparities between Australia's Indigenous and non‐Indigenous peoples requires a multi‐sector approach in which the discipline of psychology has a central role. These disparities are partially driven by a lack of culturally appropriate methods of health delivery. This study aimed to explore urban Aboriginal and Torres Strait Islanders’ perceptions of health and wellbeing through social emotional wellbeing and strengths‐based frameworks. Methods A qualitative study was conducted with 19 urban Australian Aboriginal and Torres Strait Islander people. Data was collected via individual semi‐structured interviews and focus groups. Thematic analysis was conducted to identify strengths‐based themes within the data. Results Several attributes and values emerged from participants’ understandings of enhancing mental health and wellbeing. These included acceptance, respect, forgiveness and integrity, honesty, courage, empathy, mindfulness, and spirituality. Conclusions There are similarities between the central tenets of the strengths‐ and values‐based frameworks and a model of social emotional wellbeing. It is important to note that these attributes and values are understood at the individual, community, and cultural level. Each of these attributes and values are intricately linked to being mentally healthy and having strong cultural identity. These similarities may provide an avenue for shared cross‐cultural understandings and knowledges of mental health and wellbeing that will support culturally appropriate service delivery.
    January 28, 2017   doi: 10.1111/cp.12112   open full text
  • Treatment adherence in adolescent psychiatric inpatients with severe disruptive behaviour.
    Sjoukje B. B. de Boer, Albert E. Boon, Anna M. de Haan, Robert vermeiren.
    Clinical Psychologist. December 21, 2016
    Objective To examine pre‐treatment characteristics associated with dropout in 224 adolescent psychiatric inpatients (mean age 17.1 years) with severe disruptive behaviour. To date, little is known about the factors predicting dropout among adolescents treated for severe disruptive behaviour. This is surprising, as dropout is a major problem in this specific group. Method Dropouts (n = 77) and completers (n = 147) were compared on known risk factors for dropout, such as severity of externalising problems and disorders, ethnic minority status, male gender, and lower academic functioning, as well as on other factors considered relevant: behavioural characteristics, including age of onset and different types of disruptive behaviour. Within dropout, withdrawal (termination against the advice of the therapist; n = 40) and pushout (termination against the wish of the client; n = 37) were distinguished. Results Two characteristics significantly predicted dropout: early onset of disruptive behaviour and cannabis usage prior to treatment. Within the dropout group no differences were found between withdrawals and pushouts. Conclusions Predicting dropout among adolescent psychiatric inpatients with severe disruptive behaviour is difficult. The two predictors found were already present at the time of admission and are therefore considered unalterable. However, they can be used to pinpoint individuals with higher chance at dropout, who in turn can be offered tailored interventions aimed at improving the therapeutic relationship.
    December 21, 2016   doi: 10.1111/cp.12111   open full text
  • A feasibility study of group‐based cognitive behaviour therapy for older adults in residential care.
    Katrina Anderson, Tushara Wickramariyaratne, Annaliese Blair.
    Clinical Psychologist. December 15, 2016
    Objective This study examined the feasibility of providing older adults living in residential aged care with group‐based cognitive behavioural therapy (CBT) for depression and anxiety. Method Eighteen participants with subclinical to mild anxiety and/or depression were divided equally into a treatment group and a control group, with treatment consisting of a manualised CBT program for older adults with depression and anxiety. The residents who participated in the group program provided an accurate representation of “real‐world” residential aged care facilities (RACF) populations; many with comorbid physical problems, mild cognitive impairment and functional decline, and a mean age of almost 80 years. Results The residents showed that not only could they successfully engage in psychotherapy, they were able to experience the benefits such as building their skills and resilience, receiving validation and emotional support from their fellow residents and fostering friendships and social networks. Encouragingly, the treatment group also showed fewer depressive symptoms post‐treatment. Conclusions Group‐based psychotherapy should continue to be explored as a strategy to promote good mental health in RACFs, with further studies focusing on the feasibility of recruiting and treating clinical populations in this setting.
    December 15, 2016   doi: 10.1111/cp.12109   open full text
  • Evaluation of a brief community‐based mindfulness intervention for people with multiple sclerosis: A pilot study.
    Elizabeth Spitzer, Kenneth I. Pakenham.
    Clinical Psychologist. November 17, 2016
    Objective Mindfulness‐based interventions can improve quality of life (QoL) in people with multiple sclerosis (PwMS); however, the potential benefits of brief mindfulness group programs delivered in community settings have not been investigated with this population. This pilot study evaluated a brief (five‐session) community‐based group mindfulness program for PwMS. Method Participants were 23 PwMS recruited through Multiple Sclerosis Queensland, Australia. The study had a single intervention condition with pre‐intervention, post‐intervention and eight‐week follow‐up assessments. Primary outcomes were QoL, psychological distress and fatigue, and secondary outcomes were mindfulness, self‐compassion, and acceptance. Results Analyses revealed improvements in psychological distress, perceived stress, the mental health QoL dimension, mindfulness, self‐compassion, and acceptance. All participants agreed they would recommend the program to others with multiple sclerosis and most reported that the program was helpful and enjoyable. Qualitative data showed that participants gained in present moment awareness, coping skills, self‐compassion, acceptance, support, and changed perspectives. Conclusions Results suggest that brief mindfulness interventions may improve psychological wellbeing in PwMS; however, a longer intervention period or programs that incorporate mindful movement activities may be needed to bring about improvements in physical health QoL dimensions and fatigue.
    November 17, 2016   doi: 10.1111/cp.12108   open full text
  • Factor structure and psychometric properties of the new multidimensional depression scale in a non‐clinical sample.
    Mohammad Darharaj, Mojtaba Habibi, Michael J. Power, Sanaz Pirirani, Faezeh Tehrani.
    Clinical Psychologist. October 26, 2016
    Objective The New Multidimensional Depression Scale (NMDS) is a recently developed scale that measures emotional, cognitive, somatic, and interpersonal symptoms of depression comprehensively. Therefore, the aim of this study was to explore factor structure and psychometric properties of the Persian version of the NMDS in a group of community participants. Method A total of 559 Iranian university students and staff members (including 263 males and 296 females) aged 18–60 years were selected by convenience sampling to complete a battery of tests including the New Multidimensional Depression Scale, Beck Depression Inventory‐II, Oxford Happiness Inventory, Beck Anxiety Inventory, and Short Form Health Survey. Results Factor analysis of the Persian version of the NMDS confirmed its original four‐factor structure. Furthermore, the results indicated its satisfactory internal consistency (Cronbach's α ranging from .89 for the somatic subscale to .93 for the cognitive subscale). Additionally, significant positive correlations between the NMDS scores with anxiety and cognitive and somatic‐affective symptoms of depression and the significant negative correlations between its scores with happiness, mental health, and physical health indicated convergent and divergent validity of the NMDS, respectively. Conclusions These results supported the reliability and validity of the Persian version of the NMDS for the assessment of depression symptoms in non‐clinical groups.
    October 26, 2016   doi: 10.1111/cp.12106   open full text
  • The specificity of the biosocial model to borderline traits.
    Duncan Gill, Wayne Warburton, Ken Beath.
    Clinical Psychologist. October 12, 2016
    Background A number of theories have been proposed to account for the development of borderline personality disorder (BPD). The biosocial model considers emotional dysregulation to be central to the disorder, caused in turn by an emotionally vulnerable child being raised in an invalidating environment. This aetiological model is potentially too broad, as many of these constructs may be equally important to other mental health conditions, making the model non‐specific to BPD. Method We sought to contrast the explanatory value of the constructs identified by the biosocial model of BPD to an alternate form of psychopathology (chronic worry), using a nonclinical sample (N = 271), via the completion of self‐report questionnaires. Results Childhood emotional vulnerability had a similar relationship to chronic worry as to borderline traits, with emotional dysregulation playing an important role in both disorders. Contrary to the biosocial model′s predictions, the interaction effects between the childhood antecedents were not found to play an important role in either psychopathology. Conclusion The lack of an interaction effect between invalidating parenting and emotional vulnerability suggests that this aspect of the biosocial model may not be a strong predictor of BPD. Key elements of the biosocial model may have utility as more generic predictors of psychopathology.
    October 12, 2016   doi: 10.1111/cp.12104   open full text
  • Suicidal women may risk their lives but not their social relationships.
    Ashleigh J Pasculli, Keith M Harris.
    Clinical Psychologist. September 09, 2016
    Objective Risk‐taking is an important but understudied suicidal factor, particularly concerning women. This study examined a broad range of risk behaviours and perceptions that might aid the early detection of suicidality by clinicians and gatekeepers. Method A purposive anonymous online survey, preferable for collecting data on stigmatised issues, produced a sample of 273 Australian/New Zealand women (aged 18–67 years) covering a broad spectrum of suicidal factors and risk‐taking behaviours. Participants completed items on risk‐taking perceptions and behavioural willingness, and the Suicidal Affect‐Behavior‐Cognition Scale. Demographic factors were controlled for in partial correlations and hierarchical regression modelling, which tested the validity of risk‐taking variables as predictors of suicidality. Results Suicidality was positively associated with willingness to engage in infidelity, not wearing seatbelts or motorcycle helmets, and negatively associated with interpersonal risk‐taking (unwillingness to endanger social relationships). Hierarchical regression modelling revealed these risk‐taking perceptions and behaviours explained 34% of the variance in women's suicidality, after accounting for age and ethnicity. Conclusions This study demonstrated that some types of commonplace risk‐taking, or avoidance, may serve as important indicators or warning signs for suicidal crises in women. Clinicians should consider possible underlying psychological distress when encountering these symptoms and behaviours.
    September 09, 2016   doi: 10.1111/cp.12103   open full text
  • The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist's perspective.
    Penelope Richards, Susan Simpson, Tarun Bastiampillai, Giada Pietrabissa, Gianluca Castelnuovo.
    Clinical Psychologist. August 05, 2016
    Objective In this article, we investigate therapist views on their experiences using a technological adjunct (goACT) to traditional, face‐to‐face psychotherapy. goACT is a web‐based mobile interactive software application that facilitates an interactive platform, allowing therapists to connect with their clients between face‐to‐face psychotherapy sessions. Method Participants were six provisional psychologists and seven patients. Data were collected at two post‐therapy focus groups in order to qualitatively understand therapist experience of goACT as a therapy adjunct. Data were analysed utilising thematic analysis. Results Four main themes emerged: (1) “discretional use of goACT” linked to therapist preferences and client suitability; (2) “therapist concerns” linked to boundaries, workload, technological glitches, and therapeutic risks; (3) “goACT expands the parameters of therapy” through increased opportunities to provide care and connection with patients and increased access to the process of therapy; and (4) “goACT enhances therapy” through reciprocal responsibility and guided empowerment. Therapists in this study were more open to the use of technology in therapy than has been reported in previous research and did not find that it affected their workload. Conclusion Therapists indicated that when aligned to the specific needs of individual patients, an advanced mobile and web‐based interactive software application (goACT) has the potential to enhance engagement, rapport, and patient empowerment in face‐to‐face psychotherapy.
    August 05, 2016   doi: 10.1111/cp.12102   open full text
  • Accelerated outpatient individual cognitive‐behaviour therapy for panic disorder: A case study.
    Bethany M. Wootton, Amy MacGregor.
    Clinical Psychologist. August 05, 2016
    Objective Panic disorder (PD) is a common mental health condition which causes substantial disability. It is well known that cognitive‐behavioural therapy (CBT) is an effective treatment for PD and this treatment is generally provided in 8–14 weekly sessions. A small number of preliminary studies have now investigated the efficacy of accelerated or intensive CBT in the treatment of PD and have found promising results. However, many of these existing treatment formats do not allow for optimal learning, since sessions are administered daily which does not allow time for the client to practice the skills between sessions. Method The aim of this study was to investigate the feasibility of an accelerated CBT (aCBT) approach where treatment was provided three times per week (90‐min sessions) over a two‐week period (six sessions in total) using a case study design. The participant completed a structured diagnostic interview to confirm diagnosis and outcome measures were administered at baseline, post‐treatment, and three‐month follow‐up. Results The results indicated that the participant significantly reduced symptoms of PD over a two‐week period and no longer met diagnostic criteria for PD at three‐month follow‐up. Importantly, the participant also found the treatment format to be highly acceptable. Conclusions The results demonstrate the preliminary acceptability and efficacy of this aCBT approach in the treatment of PD.
    August 05, 2016   doi: 10.1111/cp.12100   open full text
  • Diagnosis and dialogue in acute child and adolescent mental health care.
    Aidan Kelly, Paul Rhodes, Chloe MacDonald, Kristof Mikes‐Liu.
    Clinical Psychologist. July 27, 2016
    Objective Debate concerning the diagnosis of mental health problems has accelerated since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5). Despite this, little is known about how multi‐disciplinary teams work together in the face of differing views. Method Constructionist thematic analysis was used to analyse data from semi‐structured interviews conducted with 20 mental health clinicians based at three acute child and adolescent mental health care units. Case discussions in team meetings were also observed. Results Views regarding diagnosis were largely a function of the role of team members and stratified according to hands‐on involvement with young people. Nurses saw it as the least relevant to their practice, clinical psychologists and other allied health professionals were the most critical, and psychiatrists were the most pragmatic about the benefits. Despite these differences, and with a few exceptions, team unity was possible through dialogue regarding formulation. Conclusion Despite academic debates regarding diagnosis, professionals in acute mental health settings can work together effectively if united by psychological formulations.
    July 27, 2016   doi: 10.1111/cp.12101   open full text
  • Improving accessibility of cognitive behavioural therapy for children and adolescents: Review of evidence and future directions.
    Marthinus J. Bekker, Kathleen M. Griffiths, Paula M. Barrett.
    Clinical Psychologist. June 23, 2016
    Background Despite great progress in Cognitive Behavioural Therapies (CBTs) for children and adolescents over the last two decades, as many as four out of five young people who could benefit from therapy are not accessing it. The demand on available services, the stigma of mental health difficulties, costs and time demands of treatment, and geographic isolation are some of the many barriers to effective treatments. Method The aim of this narrative review is to explore the literature on alternative formats of delivery that have the potential to reach more young people by lessening the barriers to access. Group delivery, intensive and brief formats, electronic and remote formats, and preventive approaches are considered with relevant literature in each area explored. Results There is a substantial body of evidence, including some large‐scale controlled trials, to support the group delivery of CBTs for children and adolescents. Preventive approaches also show great promise with some positive results from controlled trials. Intensive and brief delivery formats are emerging as an area of promise but to date they have not been the subject of large‐scale controlled trials. Similarly, there is emerging evidence of the effectiveness of electronic CBT formats. Although each of these areas has been progressing, no direct comparison between these alternative approaches were found. Conclusions Although evidence is developing for alternative formats of delivery that can be effective as well as reducing the barriers to accessing them, there remains a relative paucity of large‐scale and controlled studies except those involving standard delivery formats. Further research validating alterative formats, their relative effectiveness and their impact on reach is necessary.
    June 23, 2016   doi: 10.1111/cp.12099   open full text
  • Familial factors relating to alexithymic traits in adolescents with psychiatric disorders.
    Michela Gatta, Laura Balottin, Stefania Mannarini, Giulia Chesani, Lara Del Col, Andrea Spoto, Pier Antonio Battistella.
    Clinical Psychologist. June 20, 2016
    Objective Few studies have explored alexithymia at the family level. Nevertheless since family interactions have a crucial role in supporting the adolescents'development, the relationship between the emotional functioning of adolescents with psychiatric disorders and that of their parents is an interesting field to explore. Having established that a close relationship exists between adolescents'alexithymia and psychiatric symptoms, the present study aims to explore the link between alexithymic traits in parents and in their children, and between alexithymia and parental bonding perceived. Method The sample included 143 participants: adolescents with an ICD‐10 psychiatric diagnosis (13–18 years), referred to a Childhood, Adolescence and Family Unit, and their parents. They were all assessed for alexithymia (Toronto Alexithymia Scale) and parental bonding perceived (Parental Bonding Instrument), while adolescents’ psychiatric symptoms were measured using different scales (Youth Self Report and Symptom Checklist‐90‐R). Results In conjunction with an alexithymic collusion within the parental couple, parents’ emotional impairments predicted analogous problems in offspring. An intergenerational transmission of alexithymia emerges not only from mother to child but also from father to child. Moreover, the adolescents'emotional awareness was affected by the perception of their mothers’ and fathers’ parenting styles. Parents’ alexithymic traits, combined with children's perception of a neglectful parenting style, appear to be linked with emotional difficulties and therefore with a higher risk of psychological disorders in offspring. Conclusions Studies focused on the intergenerational transmission of alexithymia and on the family emotional functioning will contribute to design more focused and acceptable treatments for adolescents and for families as well.
    June 20, 2016   doi: 10.1111/cp.12098   open full text
  • Clinical competencies and training needs of psychologists working with adults with intellectual disability and comorbid mental ill health.
    Joyce Man, Maria Kangas, Julian Trollor, Naomi Sweller.
    Clinical Psychologist. April 28, 2016
    Objectives Psychologists play a pivotal role in meeting the mental health needs of people with intellectual disabilities. The aim of this study was to investigate the perceptions of Australian psychologists who work with adults with intellectual disabilities and mental ill health regarding their clinical competencies, workplace supports and training needs. Method One hundred and nine psychologists in Australia completed a self‐report online survey exploring clinical attitudes and practices when working with adults with intellectual disabilities and mental ill health. Provisional, generalist and clinical psychologists from a range of disability and non‐disability work settings were recruited. Results Findings revealed that provisional, generalist and clinical psychologists reported no significant differences in levels of agreement on self‐perceived clinical competencies in conducting mental health assessments. Psychologists in private practice and in non‐government organisations reported more adequate workplace resources to support mental health assessments for people with intellectual disabilities than did psychologists in government settings. Psychologists across work settings expressed similar views in self‐perceived clinical competencies and workplace training supports. The majority of psychologists reported limited formal academic training in intellectual disabilities and expressed a need for continual and specialised training in mental health and intellectual disabilities. Conclusions Implications for further training in mental health and intellectual disabilities highlight the need to cater to the specific needs of psychologists in the field.
    April 28, 2016   doi: 10.1111/cp.12092   open full text
  • Characteristics of non‐suicidal self‐injury in women accessing internet help sites.
    Emma B. Black, Helen Mildred.
    Clinical Psychologist. April 15, 2016
    Background This article aimed to examine and compare the frequency of occurrence of a broad range of non‐suicidal self‐injury (NSSI) behaviours in an international sample of women. Methods Female participants with NSSI (n = 464) were recruited via a range of websites and completed a questionnaire examining 17 different types of NSSI types and their frequency, severity, and duration. Results Prevalent acts were cutting, scratching, and word carving; cutting and scratching occurred frequently, whilst word carving most often occurred as a single episode. Analyses revealed significant differences between Australian and U.S. participants, with U.S. participants having significantly higher rates of cutting, wound interference, carving, scratching, and sharp object sticking. Participants also reported on other self‐harm methods not assessed by the questionnaire. Conclusions Word carving may be qualitatively different from other forms of NSSI. More severe NSSI methods (e.g., bone breaking) are less prevalent than less dangerous methods (e.g., scratching). Participants considered a range of indirectly harmful or suicidal behaviours as self‐injury contrary to researcher or clinician understanding. Finally, there may be cultural differences in relation to NSSI between countries where such behaviours are common, although further research is required to determine this.
    April 15, 2016   doi: 10.1111/cp.12094   open full text
  • Personal agency in women's recovery from depression: The impact of antidepressants and women's personal efforts.
    Claire Cartwright, Kerry Gibson, John Read.
    Clinical Psychologist. April 15, 2016
    Background Women are twice as likely to experience depression and use antidepressants as men. Personal agency protects against depression; however, social factors contribute to lower levels of agency in women. Aims This study examines women's experiences of using antidepressant treatment along with the other activities and practices they engage in to support their recovery from depression. It aims to understand how these experiences promote or diminish women's sense of agency in regard to their recovery. Method Fifty women took part in telephone interviews focusing on experiences of antidepressants as well as personal efforts to recover. A thematic analysis examined the agency‐promoting and agency‐diminishing experiences of using antidepressant treatment and engaging in other activities. Results Antidepressants promoted agency when they gave women relief from depressive symptoms, allowing women to become more proactive in recovery. Women engaged in a range of activities they believed assisted recovery and hence enhanced agency. These included exercise, gaining social support, and engaging in therapy. Some, however, had shifted to long‐term antidepressant use. Failed attempts to discontinue due to severe withdrawal symptoms, fear of a relapse, and the biochemical model of depression created a sense of dependence on antidepressants and thereby diminished personal agency in relation to recovery. Conclusions Antidepressants can support women to become agential in their recovery. However, long‐term use signifies greater dependency on antidepressants, and personal agency is seen as insufficient. The fear of withdrawal symptoms and the biochemical model undermine women's sense of personal agency in relation to recovery.
    April 15, 2016   doi: 10.1111/cp.12093   open full text
  • Predictors and moderators of outcomes and readmission for adolescent inpatients with anorexia nervosa: A pilot study.
    Eva Vall, Tracey D. Wade.
    Clinical Psychologist. April 15, 2016
    Objective This pilot study investigated predictors, moderators, and mediators of outcome and readmission in adolescents receiving specialist inpatient treatment for anorexia nervosa. Method Adolescents (n = 40) aged between 14 and 17 years (mean = 15.42) were assessed at admission and discharge from a specialist inpatient programme and again at three‐month follow‐up on the following outcome variables: eating disorder pathology, quality of life (QOL), and body mass index (BMI) centile. Readmissions to hospital were recorded over the three months post‐discharge period. Potential predictors were drawn from theoretical models. Results Readmission during the three‐month follow‐up period was less likely for first presentations. Higher baseline purging, concern over mistakes, perfectionism, ineffectiveness, and mood intolerance were associated with higher levels of eating disorder pathology and poorer QOL over all points of follow‐up. Driven exercise moderated weight outcomes such that higher levels of baseline exercise resulted in a lower BMI centile at follow‐up. Greater weight gain during treatment predicted higher BMI centile at follow‐up, and increased perfectionism during treatment predicted a greater likelihood of being readmitted within three months of discharge. Conclusions Weight gain during inpatient treatment should be encouraged to improve later weight outcomes. Focusing on the prevention of growth in perfectionism may be useful in improving psychological outcomes as will prioritising the elimination of purging and improved emotional regulation and self‐efficacy. Efforts should be made to reduce driven exercise to promote better weight‐related outcomes.
    April 15, 2016   doi: 10.1111/cp.12091   open full text
  • Early maladaptive schema, social functioning and distress in psychosis: A preliminary investigation.
    Christopher D.J. Taylor, Sean F. Harper.
    Clinical Psychologist. December 10, 2015
    Background Cognitive models of psychosis suggest that negative schema confer vulnerability to and maintain psychotic symptoms. However, few studies have investigated schema among individuals with psychotic symptoms, and research has yet to investigate associations between early maladaptive schema and social functioning and distress. The current preliminary study aimed to investigate these issues. Methods A cross‐sectional design was utilised. Participants with experience of psychosis (n = 20) completed questionnaires measuring early maladaptive schema, social functioning, and global distress. Results Social functioning was significantly associated with two schema: dependency and enmeshment. Eight schema were significantly associated with distress. However, a cross‐sectional design and small sample size limit the generalisability of the results. Conclusions These results suggest that early maladaptive schema may have an important role in psychosis, and could be considered as part of psychological therapies that seek to enhance social functioning and reduce distress.
    December 10, 2015   doi: 10.1111/cp.12082   open full text
  • Meta‐cognitive beliefs about worry and pain catastrophising as mediators between neuroticism and pain behaviour.
    Marcantonio M. Spada, Harriet Gay, Ana V. Nikčevic, Bruce A. Fernie, Gabriele Caselli.
    Clinical Psychologist. November 13, 2015
    Background The present study explored the relationship between neuroticism, meta‐cognitive beliefs about worry, pain catastrophising, and pain behaviour. Methods A non‐clinical convenience sample of 308 participants completed the following four measures in this cross‐sectional study: Neo Five‐Factor Inventory, Meta‐Cognitions Questionnaire 30, Pain Catastrophising Scale, and the Pain Behaviour Checklist. Results A multiple‐step multiple mediator analysis was employed to test a model in which (1) positive meta‐cognitive beliefs about worry would mediate the relationship between neuroticism and pain catastrophising and (2) negative meta‐cognitive beliefs about worry would mediate the relationship between pain catastrophising and self‐reported pain behaviour. We also hypothesised that the combined effects of meta‐cognitive beliefs about worry and pain catastrophising on self‐reported pain behaviour would be independent of neuroticism. Results supported the proposed structure with pain catastrophising and meta‐cognitive beliefs about worry mediating fully the effect of neuroticism on self‐reported pain behaviour. Conclusions These findings identify, for the first time in the literature, a link between meta‐cognitive beliefs about worry and both self‐reported pain behaviour and pain catastrophising. The implications of these findings are discussed.
    November 13, 2015   doi: 10.1111/cp.12081   open full text
  • A preliminary analysis of a competence assessment tool for postgraduate training programmes in clinical and forensic psychology.
    Leanne Humphreys, Rocco Crino, Ian Wilson, Timothy Hannan.
    Clinical Psychologist. October 22, 2015
    Background The extent to which clinical competency development is assessed throughout postgraduate training programmes in professional psychology in Australian universities is variable, with significant differences in assessment philosophies and methodologies across academic institutions, and between clinical and field supervisors. Few competency assessment tools exist, and those that do have demonstrated limited psychometric support to date. This study reports the results of a preliminary analysis of a competence assessment tool developed for use within cognitive‐behaviourally oriented postgraduate training programmes of clinical and forensic psychology. Methods A working party of academics identified core competencies being taught within the programmes and articulated behavioural descriptions of each competency, graded across skill levels. Participants (n = 43) were students enrolled in postgraduate training programmes of clinical and forensic psychology participating in a 1 day per week, year‐long placement within a university‐based psychology clinic. Students were assessed utilising the competence assessment tool at a point midway through their placement and again at the conclusion of the placement. Result Preliminary analyses demonstrated that the Clinical Skills Assessment Tool is a psychometrically sound assessment instrument. Conclusion The development of a clinical competence assessment tool for use within postgraduate training programmes of clinical and forensic psychology supports the assertion that such programmes enhance the competencies they are designed to develop.
    October 22, 2015   doi: 10.1111/cp.12080   open full text
  • The contribution of metacognitive beliefs and dysfunctional illness beliefs in predicting health anxiety: An evaluation of the metacognitive versus the cognitive models.
    Robin Bailey, Adrian Wells.
    Clinical Psychologist. September 27, 2015
    Background In the cognitive model dysfunctional beliefs about symptoms and illnesses are pivotal in the conceptualisation of health anxiety. The metacognitive model offers an alternative view in that health anxiety is linked more to beliefs about thinking, that is metacognitive beliefs. This study sets out to test the relative contribution of each type of belief to health anxiety as a rigorous test of each of the respective models. Method In the present study, 377 participants completed measures of neuroticism, health anxiety‐related dysfunctional beliefs and metacognitive beliefs. Results Metacognitive beliefs explained a significant and large proportion (49 %) of the variance in health anxiety, when controlling for dysfunctional beliefs and neuroticism. They were found to be the strongest independent predictors of health anxiety. Conclusions Overall, the findings indicate that metacognitive beliefs have a role in predicting health anxiety and may be more important than the symptom‐related beliefs emphasised in cognitive models. The clinical implications of these findings are briefly considered.
    September 27, 2015   doi: 10.1111/cp.12078   open full text
  • “It has taken me a long time to get to this point of quiet confidence”: What contributes to therapeutic confidence for clinical psychologists?
    Aisling McMahon, David Hevey.
    Clinical Psychologist. September 15, 2015
    Background Within clinical psychology, there is a broad training and range of practice. However, most clinical psychologists practice psychotherapy and this study explored what relates to confidence in therapeutic practice. Method An online survey was distributed to Irish psychologists. Three‐quarters of the survey participants constituted 46% of the total population of Irish health service psychologists, the remainder working in various non‐health service settings. Clinical psychologists practising psychotherapy were the focus of this study (N = 170). Results Psychotherapy practice was a dominant activity for nearly all clinical psychologists but only 13% believed that their psychology training fully equipped them to practice psychotherapy and nearly one‐half felt limited confidence for therapeutic work. More confident clinical psychologists were more satisfied with the psychotherapy knowledge and skills gained during clinical psychology training, more satisfied with their supervisory support, had spent longer in personal therapy, and had more years of experience. Conclusions Perceived quality of psychotherapy training during clinical psychology training provides an essential foundation for therapeutic confidence. Ongoing access to satisfying supervision in post‐qualification practice also supports confident therapeutic work. In addition, the significance of substantial experience of personal therapy for confidence points to its inclusion as a valuable part of clinical psychology training.
    September 15, 2015   doi: 10.1111/cp.12077   open full text
  • A systematic review and meta‐analysis of behaviourally based psychological interventions and pharmacological interventions for trichotillomania.
    Reneta Slikboer, Maja Nedeljkovic, Steven J. Bowe, Richard Moulding.
    Clinical Psychologist. July 21, 2015
    Background Trichotillomania (hair‐pulling disorder) is a debilitating and distressing disorder associated with great secrecy and shame. A lack of understanding regarding interventions for Trichotillomania contributes to poor routine outcomes for the disorder. Method This systematic review and meta‐analysis assessed the efficacy of behaviourally based psychological interventions and pharmacological interventions for trichotillomania compared to a range of control groups. Participants were adults who have been diagnosed with trichotillomania. A systematic search was conducted of the Cochrane library, EBSCOhost, MEDLINE before 1966, and Google Scholar for relevant randomised controlled trials. Results Of the total 462 records identified, 12 studies were included in the quantitative synthesis, and nine studies were included in meta‐analyses. Conclusions Analyses revealed that—from medication approaches—fluoxetine was not found to be efficacious. However, N‐acetyl cysteine, clomipramine, and olanzapine showed potential for the treatment of trichotillomania. Regarding psychotherapy, behaviour therapy showed superior efficacy when compared to a passive control group. However, when behaviour therapy was compared to an active control group (progressive muscle relaxation, supportive therapy), both conditions showed similar efficacy in treating trichotillomania. It was concluded that the psychological mechanisms in trichotillomania may be more complex than the behavioural model indicates. Implications and limitations are discussed.
    July 21, 2015   doi: 10.1111/cp.12074   open full text
  • Positive psychological correlates of successful weight maintenance in Australia.
    Sharon Robertson, Matthew Davies, Helen Winefield.
    Clinical Psychologist. July 07, 2015
    Background Weight loss maintenance is a complex and an enduring problem. A substantial amount of research and subsequent treatments have been based on behavioural and medical interventions with limited success. Much less is known regarding reliable psychological predictors of successful weight maintenance, especially those related to the field of positive psychology that aims to improve health and happiness. This cross‐sectional study is among the first to explore the positive psychological differences between successful maintainers (defined as losing 10% body weight and maintaining this for at least 12 months) and non‐maintainers in a non‐clinical Australian population. Method Participants were 250 Australian residents, aged between 18 and 65 years, who had attempted to lose weight over the last 12 months. An online survey method recorded satisfaction with life, positive and negative affect, gratitude, flourishing, strengths, and hope. Results Results suggest there are significant differences in some positive psychological variables between successful maintainers and non‐maintainers in this population. Maintainers reported significant differences in frequency of positive mood and the agentic thinking component of hope, both correlates of psychological health. In addition, maintainers engaged in more frequent diet, exercise, and self‐weighing behaviours in comparison with non‐maintainers. Conclusions Given the lack of success regarding weight maintenance in general, it may be important to recognise that in addition to the 10% weight loss recommended for better physical health, the addition of specific behavioural and positive psychological variables to existing treatment protocols may improve mood and motivation, in the service of encouraging more effective weight maintenance behaviour.
    July 07, 2015   doi: 10.1111/cp.12073   open full text
  • How can a donkey fly on the plane? The benefits and limits of animal therapy with refugees.
    Danielle Every, Kayleigh Smith, Bradley Smith, Joshua Trigg, Kirrilly Thompson.
    Clinical Psychologist. July 07, 2015
    Background Humanitarian migrants experience higher rates of mental illness than the resident population, limiting their social and economic opportunities and contributions. Effective interventions are thus critical to improve the settlement outcomes. Many therapists employ narrative and expressive therapies because of their holistic approach to both trauma and psychosocial stressors, and their benefits for working with people with limited English literacy. A potential non‐language‐based intervention that has been effective with other groups, but which has not yet been evaluated in relation to refugees, is animal‐assisted therapy. Animal therapy has been shown to reduce social isolation, increase well‐being and reduce the symptoms of anxiety and depression in general and clinical populations. However, there is a need to understand if and how these benefits apply to refugees. Methods We used open‐ended questions presented in an online survey for Australian therapeutic and support practitioners working with refugees. Results We found that interactions with animals in school and community settings have positive outcomes for increasing social interaction, building trust, and reducing difficult behaviours, especially with children. Some clients are more timid around animals, and some express specific cultural concerns about the type of animal. Practitioners recommended that clients are approached individually about their views on animals prior to including animals in therapy or community activities. They also recommend avoiding assumptions about particular cultures and animals, as these are not universal. Conclusions Culturally appropriate animal therapy may thus be a complementary therapy that improves the therapeutic relationship, overall well‐being, and settlement outcomes, especially with refugee children.
    July 07, 2015   doi: 10.1111/cp.12071   open full text
  • The relationship between early maladaptive schema, psychopathic traits, and neuroticism in an offender sample.
    Michael Daffern, Flora Gilbert, Stuart Lee, Chi Meng Chu.
    Clinical Psychologist. May 14, 2015
    Background Psychopathy is a complex and controversial diagnosis of significant clinical and forensic interest. However, little is known about how individuals with psychopathy interpret and construct their interpersonal environment. This is of critical importance to our understanding of psychopathy and the development of psychological treatments. The aim of this study was to explore the relationship between early maladaptive schema (EMS), neuroticism, and psychopathic traits in an offender sample. Methods Sixty‐eight offenders participating in pre‐sentence psychiatric and/or psychological intervention completed psychological tests measuring EMS, neuroticism, and psychopathy. Results Consistent with theorising and empirical evidence supporting the presence of different types of psychopathy, the profile of EMS in this sample was significantly different for participants with higher levels of neuroticism. Participants with higher levels of neuroticism had higher scores on the following EMS: abandonment, mistrust/abuse, emotional deprivation, practical incompetence, vulnerability to harm, failure to achieve, insufficient self‐control, subjugation, pessimism/worry, emotional inhibition, and defectiveness/unlovability. Conclusions Higher neuroticism, irrespective of severity of psychopathic traits, is associated with a broad range of dysfunctional and pervasive beliefs about oneself and others.
    May 14, 2015   doi: 10.1111/cp.12069   open full text
  • Brief reminiscence intervention improves affect and pessimism in non‐clinical individuals: A pilot study.
    Kelly L. James, Sunil S. Bhar.
    Clinical Psychologist. May 03, 2015
    Whereas reminiscence‐based interventions that focus on reducing depression and pessimism have been shown to be effective, most studies have employed longer term treatments. There has also been a tendency for reminiscence‐based studies to focus on the benefits of reminiscence for older adults, with few studies involving younger adults. This study examined the efficacy of a one‐session reminiscence‐based intervention for reducing depressed affect and pessimism in younger adults. A total of 26 non‐clinical participants were administered a one‐to‐one guided interview in which they were encouraged to recall past problem‐solving successes, and the lessons learnt from these successes. Measures of affect, pessimism, and mastery were administered pre‐ and post‐interview. Levels of depressed affect, mastery, and pessimism significantly improved following the interview, compared with baseline levels. Changes in mastery were associated with changes in pessimism, but not with changes in depressed affect. This study suggests that a one‐session reminiscence‐based intervention may significantly contribute to the improvements in depressed affect, pessimism, and mastery in a younger cohort. It also suggests that the improvement in pessimism may be accounted for by improvement in self‐mastery.
    May 03, 2015   doi: 10.1111/cp.12068   open full text
  • From eating identity to authentic selfhood: Identity transformation in eating disorder sufferers following psychotherapy.
    Claudia Cruzat‐Mandich, Fernanda Díaz‐Castrillón, Tatiana Escobar‐Koch, Susan Simpson.
    Clinical Psychologist. April 28, 2015
    Background The following article illustrates the development of the identity configuration process of Chilean female patients with an eating disorder (ED) following successful psychotherapeutic treatment. Method This was a qualitative, descriptive study, which explored patients' subjective perspectives. In‐depth interviews were conducted with 20 female patients, and data were analysed according to procedures established by the Grounded Theory method. Results Four dimensions of identity were identified: (1) self‐image as idealised versus imperfect; (2) knowledge of one's inner world; (3) impulse control; and (4) life goals. Transcending these themes was the central notion of identity and a shift in this identity from someone who defines themselves by their eating disorder toward a more authentic and complex sense of self. Conclusion Results suggest that successful treatment facilitates the construction of an authentic identity, which includes developing a more realistic and complex understanding of themselves and their emotional and physical needs.
    April 28, 2015   doi: 10.1111/cp.12067   open full text
  • Paranoia in the general population: A revised version of the General Paranoia Scale for adults.
    Célia Barreto Carvalho, Marina Sousa, Carolina Motta, José Pinto‐Gouveia, Suzana Nunes Caldeira, Ermelindo Bernardo Peixoto, Joana Cabral, Allan Fenigstein.
    Clinical Psychologist. April 01, 2015
    Background Paranoid ideation has been regarded as a cognitive and a social process used as a defence against perceived threats. According to this perspective, paranoid ideation can be understood as a process extending across the normal–pathological continuum. Methods In order to refine the construct of paranoid ideation and to validate a measure of paranoia, 906 Portuguese participants from the general population and 91 patients were administered the General Paranoia Scale (GPS), and two conceptual models (one‐ and tridimensional) were compared through confirmatory factor analysis (CFA). Results Results from the CFA of the GPS confirmed a different model than the one‐dimensional model proposed by Fenigstein and Vanable, which comprised three dimensions (mistrust thoughts, persecutory ideas, and self‐deprecation). This alternative model presented a better fit and increased sensitivity when compared with the one‐dimensional model. Further data analysis of the scale revealed that the GPS is an adequate assessment tool for adults, with good psychometric characteristics and high internal consistency. Conclusion The model proposed in the current work leads to further refinements and enrichment of the construct of paranoia in different populations, allowing the assessment of three dimensions of paranoia and the risk of clinical paranoia in a single measure for the general population.
    April 01, 2015   doi: 10.1111/cp.12065   open full text
  • Competency‐based training and assessment in Australian postgraduate clinical psychology education.
    Bruce Stevens, Judy Hyde, Roslyn Knight, Alice Shires, Rebecca Alexander.
    Clinical Psychologist. March 11, 2015
    Background Competency‐based training and assessment is considered the best practice internationally in postgraduate clinical psychology education. In Australia, there are still some ways to go as programmes begin to integrate competency‐based pedagogical models into clinical training and assessment. Further understanding of the strengths and challenges of these models will be useful to educators interested in developing a competency‐based approach. Methods A structured literature review was carried out using the databases PsychInfo, PubMed, and PsychArticles. Keywords were: competency, and “training” or “assessment” or “model” or “clinical” or “psychology” or “medicine” or “allied health.” Articles had to be written in the English language and published in peer‐reviewed journals. Relevant book chapters and web references from professional accreditation bodies were also assessed for inclusion. A total of 54 references were utilised in the review. Results The review supports the relevance of competency‐based learning and teaching. It draws on seminal benchmarking work from the international literature and considers the strengths and limitations of competency‐based approaches to clinical health training and assessment. The review provides support for the ongoing progression towards competency‐based training models in Australian postgraduate clinical psychology. Conclusions Competency‐based training and assessment methods offer educators sophisticated mechanisms for ensuring that clinical psychology graduates are prepared to meet the demands of professional practice and public accountability. Further efforts at integrating competency‐based training models into Australian postgraduate curriculum, and associated research into the outcomes, are necessary to ensure a pedagogical culture of best practice in this country.
    March 11, 2015   doi: 10.1111/cp.12061   open full text
  • The role of personality and coping in adjustment disorder.
    Beatriz Vallejo‐Sánchez, Ana M. Pérez‐García.
    Clinical Psychologist. March 11, 2015
    Background Numerous studies have found that both personality and the coping strategies used in response to stress play important roles in the development of mental health problems, particularly adjustment disorder (AD), which is characterised by the onset of different emotional symptoms or behaviour in response to an identifiable stressor. Methods The aim of this study was to analyse the differences between 80 outpatients (68% female, average age 36) diagnosed with AD at a mental health unit and 80 controls (48% female, average age 39; people subjected to similar stress but with no psychopathology) with regard to personality, coping, and certain socio‐demographic variables. Results Patients presented less extraversion and a considerably greater neuroticism than the control group. They employed disengagement strategies to a greater extent and humour strategies less frequently than the control group. Conclusions The results contribute to clarify a controversial diagnostic category that has been the subject of very little research. They also provide guidelines for intervention.
    March 11, 2015   doi: 10.1111/cp.12064   open full text
  • Maternal perinatal anxiety: A review of prevalence and correlates.
    Liana S. Leach, Carmel Poyser, Kate Fairweather‐Schmidt.
    Clinical Psychologist. March 04, 2015
    Background A growing body of research has examined maternal anxiety symptoms and disorders during the perinatal period. This systematic review provides an update of the literature reporting on the prevalence and risk factors for maternal perinatal anxiety. Methods Three databases (PubMed, PsycInfo and Web of Science) were searched to identify articles focused on the prevalence and risk factors for maternal perinatal anxiety published between 2006 and 2014. Initially, 1416 unique papers were identified, and 98 papers met the inclusion criteria for the review. Results Maternal perinatal anxiety is common. The number of studies reporting prevalence estimates for perinatal anxiety disorders has grown; however, there is wide variation in reported estimates (2.6–39% for “any anxiety disorder”). Prominent risk factors identified included socio‐economic disadvantage, history of poor mental health, adverse circumstances around the pregnancy and birth, and poor quality partner relationships. Complexities in reviewing this literature include significant heterogeneity in study methodology. Conclusions There is a substantial evidence‐based reporting prevalence estimates and identifying the key risk factors for maternal anxiety during the perinatal period. However, there is further need to synthesise the available literature in a meaningful way in order to translate findings into useful screening tools and intervention programs.
    March 04, 2015   doi: 10.1111/cp.12058   open full text
  • Training in acceptance and commitment therapy fosters self‐care in clinical psychology trainees.
    Kenneth I. Pakenham.
    Clinical Psychologist. February 15, 2015
    Background Despite the need for training in self‐care for clinical psychology trainees (CPTs), research is limited, with little progress in the evaluation of effective approaches for teaching self‐care. This study investigated the effects on self‐care in CPTs of an acceptance and commitment therapy (ACT) university course with an explicit focus on self‐care skills in addition to ACT competencies. Methods Fifty‐seven CPTs completed a questionnaire to evaluate the self‐care course components (2011 to 2013), and a subsample of 22 CPTs completed measures of self‐care self‐efficacy, and the importance of self‐care training at the beginning and end of the course. Results All CPTs found the course helpful in fostering self‐care, and 73.7% reported one or more behavioural self‐care changes. Most frequently reported self‐care changes and helpful course components were related to the six ACT therapeutic processes. Pairwise t‐tests showed that self‐care self‐efficacy significantly increased from the beginning to the end of the course and that student views on the importance of self‐care training remained stable over the course duration. Conclusions Findings support the interweaving of training in psychotherapy competencies and self‐care skills via a self‐as‐laboratory approach within an ACT framework.
    February 15, 2015   doi: 10.1111/cp.12062   open full text
  • The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population.
    Richelle Anne Pinto, Mandy Kienhuis, Monique Slevison, Andrea Chester, Annie Sloss, Keong Yap.
    Clinical Psychologist. February 12, 2015
    Background Although a growing number of studies have demonstrated the efficacy of Acceptance and Commitment Therapy (ACT) for the treatment of psychological disorders, the effectiveness of transdiagnostic group ACT programmes in an applied clinical setting requires further evaluation. Methods The current study examined the effectiveness of a 10‐week ACT transdiagnostic group programme delivered in a private psychiatric hospital. Pre‐ and post‐treatment outcomes were measured in 55 adults presenting with various psychiatric diagnoses. Treatment processes were also analysed. Results At post‐intervention, participants demonstrated significantly greater valued living, cognitive defusion, and acceptance. No significant differences were evident in participants' mindfulness. Significant improvements were also evident on depression, anxiety, stress, functional disability, satisfaction with life, and personal well‐being. Reliable change indices were also calculated and revealed reliable improvements in a range of outcomes for 27% to 46% of participants. Participant attendance rates, clinician adherence to the manualised ACT content, and patient satisfaction were all high. Conclusions Collectively, results provided support for the effectiveness of ACT in increasing psychological flexibility and improving psychological symptoms in a transdiagnostic population. However, the current study also showed that many patients did not respond to the intervention and further research is recommended to ascertain predictors of treatment response.
    February 12, 2015   doi: 10.1111/cp.12057   open full text
  • Maternal fatigue, parenting self‐efficacy, and overreactive discipline during the early childhood years: A test of a mediation model.
    Raelene Lesniowska, Angela Gent, Shaun Watson.
    Clinical Psychologist. January 14, 2015
    Background Fatigue is common among mothers of infants and young children and associated with a range of negative parenting outcomes. Little is understood, however, about the mechanisms by which fatigue may impact on parenting, particularly among mothers beyond 12 months post‐partum. This study investigated the relationship between maternal fatigue and overreactive discipline, and whether parenting self‐efficacy mediates this relationship. Methods Participants were 252 Australian mothers of 1–4 years old children. Levels of fatigue, parenting self‐efficacy, and overreactive discipline were recorded via a self‐report questionnaire. Results A simple mediation model analysis provided support for the direct effect of fatigue on overreactive discipline, as well as the mediation of this relationship by parenting self‐efficacy. Conclusions These findings suggest fatigue may contribute to overreactive discipline in mothers of young children via two pathways: directly, and indirectly via parenting self‐efficacy. Interventions that support mothers to manage fatigue and maintain a sense of parenting self‐efficacy while facing ongoing exhaustion may promote the use of more effective and less adverse discipline responses with children.
    January 14, 2015   doi: 10.1111/cp.12056   open full text
  • The protocol for a randomised controlled trial (RCT) of a brief intervention for parents of children experiencing sibling conflict.
    John A. Pickering, Matthew R. Sanders.
    Clinical Psychologist. January 13, 2015
    Background Conflict among siblings is linked with potentially lifelong social, cognitive, and behavioural problems. Parents of siblings play a crucial role in the development of both the positive and negative relationships of their children. Despite this, relatively few parenting programmes specifically address how to manage sibling relationships marked by elevated levels of conflict. Methods This article presents the rationale, protocol, and potential implications of a randomised controlled trial evaluating a tailored version of the Triple P‐Positive Parenting Program for managing sibling conflict. This body of research seeks to illustrate how an evidence‐based parenting intervention can be successfully deployed to reduce rates of sibling conflict while improving children's social, emotional, and behavioural problems and enhancing parent competence and confidence. Conclusions Although sibling conflict is among the most widely reported and frequently cited concerns for parents, this is the first time a Triple P intervention has been used to target sibling conflict directly. If the intervention is found to be effective, it is hypothesised that the availability of an evidence‐based parenting programme focusing on sibling conflict will be highly appealing to parents and help engender a further destigmatisation of the notion of parents seeking parenting support.
    January 13, 2015   doi: 10.1111/cp.12051   open full text
  • Parental resilience: A neglected construct in resilience research.
    Susana Gavidia‐Payne, Bianca Denny, Kate Davis, Andrew Francis, Merv Jackson.
    Clinical Psychologist. January 07, 2015
    The substantial focus of resilience research on childhood well‐being has resulted in limited knowledge regarding other aspects of resilience in families, such as that of parents. Informed by literature in childhood and family resilience, in this review, we progress conceptual understanding by focusing on parental resilience. The definition of parental resilience, as the capacity of parents to deliver a competent and quality level of parenting to children despite the presence of risk factors, is offered here as a worthwhile framework through which to explore variables thought to contribute to resilience among parents. A conceptual model is proposed whereby parental psychological well‐being and self‐efficacy, family functioning, and social connectedness are specifically addressed, with each posited as playing an important role in parents’ ability to deliver high‐quality parenting. In addition to these factors, how parents accommodate adversity and find meaning in their everyday lives within their families is hypothesised to be an important process in understanding parental resilience.
    January 07, 2015   doi: 10.1111/cp.12053   open full text
  • The impact and utility of computerised therapy for educationally alienated teenagers: The views of adolescents who participated in an alternative education‐based trial.
    Theresa Fleming, Mathijs Lucassen, Karolina Stasiak, Matthew Shepherd, Sally Merry.
    Clinical Psychologist. January 05, 2015
    Background Computerised cognitive behavioural therapy (cCBT) has the potential to increase access to therapy for underserved groups. We aimed to explore the views of adolescents attending alternative education (AE) programmes who participated in a trial of immediate compared with delayed cCBT (SPARX). Methods Semi‐structured interviews and brief satisfaction questionnaires were completed post‐cCBT (n = 39, 24 male, 15 Māori, 12 Pacific Island, 30 with Children's Depression Rating Scale scores indicating symptoms of depression, all 13–16 years old). Interview findings were analysed using a general inductive analysis. Results Those with and those without symptoms had similar views. Most reported they completed all seven levels of cCBT and experienced it as helpful and fun. Most considered that cCBT had benefited them, primarily in terms of increased calmness or reduced anger and fighting. Participants described cCBT as different from counselling, with cCBT seen as freeing and empowering although potentially less responsive to personal needs. Most considered that cCBT might increase help‐seeking and thought it should be offered to all their peers as targeting individuals would not succeed and all would benefit. Conclusions Educationally alienated adolescents considered cCBT beneficial and thought it should be offered universally in AE and similar programmes.
    January 05, 2015   doi: 10.1111/cp.12052   open full text
  • Posttraumatic growth, posttraumatic stress symptoms, and psychological health in traumatically injured patients in mainland China.
    Yanbo Wang, Huixia Shen, Haixia Xie.
    Clinical Psychologist. November 18, 2014
    Background Traumatically injured patients experience psychopathological and positive changes after the traumatic injury. Whether positive changes are related to better psychological health is an intriguing question that has emerged in the literature. Methods One hundred thirty‐two participants completed the study. Demographic and injury data and degree of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) were collected at baseline (within 3 months after injury). PTG, PTSD, depression, satisfaction with life, and psychological well‐being measures were collected at a 1‐year follow‐up. Results PTG was positively associated with PTSD in the early stage of traumatic injury but was unrelated with PTSD at the 1‐year follow‐up. PTG at different time points significantly predicted psychological health outcomes. Delayed PTSD rather than early PTSD was the significant predictor of psychological health outcomes. Conclusions The results support the adjustment value of PTG, and health‐care providers should address both positive and psychopathological changes to promote the recovery of traumatically injured patients.
    November 18, 2014   doi: 10.1111/cp.12049   open full text
  • Development of the Arabic versions of the Impact of Events Scale‐Revised and the Posttraumatic Growth Inventory to assess trauma and growth in Middle Eastern refugees in Australia.
    Carine Davey, Robert Heard, Chris Lennings.
    Clinical Psychologist. July 02, 2014
    Background The current study reports on the development of an Arabic version of the Revised version of the Impact of Events Scale (IES‐R). The IES‐R was developed to assist in exploring the relationship between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) among a sample of 40 Middle Eastern participants from a refugee background. Method The psychometric properties were investigated on two recently translated Arabic versions of the Posttraumatic Growth Inventory (PTGI) and the adapted IES‐R. The current IES‐R was developed using World Health Organization (WHO) principles in establishing the comprehensibility, reliability, and validity of translated scales. Results Good discriminant validity and good reliability for the scale were identified. Factors analysis supported a four‐factor solution for the PTGI and a three‐factor solution for the IES‐R; however, the small sample size suggests the obtained factor structure is likely unstable. Conclusion The Arabic version of the IES‐R is a promising scale to assess posttraumatic stress symptoms in Middle Eastern Refugees.
    July 02, 2014   doi: 10.1111/cp.12043   open full text
  • Intimate partner violence and women's presentations in general practice settings: Barriers to disclosure and implications for therapeutic interventions.
    Peter Mertin, Shane Moyle, Kate Veremeenko.
    Clinical Psychologist. March 11, 2014
    Background There has been a small number of studies investigating the disclosure of intimate partner violence (IPV) in general practitioner settings in Australia, with the evidence being that partner violence is largely undisclosed. Drawing on previous research in this area, the main aim of this study was to investigate the rate of disclosure to general practitioners in women with known IPV backgrounds. Method Subjects were recruited through two domestic violence services in metropolitan Adelaide. Women were interviewed about their relationship history, help‐seeking behaviour during the relationship, and assessed on the somatization, depression, and anxiety scales of the Symptom Checklist 90 Revised. Results Of the 87 women who sought medical help during their relationship, 43% reported disclosing a history of IPV to their general practitioner. Sixty‐nine per cent of women were given a diagnosis of depression, with treatment being offered mostly in the form of medication, and 25% of women were referred for counselling. Conclusions Results confirm that IPV remains largely undisclosed in general practice settings, with the potential for presentations to be misdiagnosed. Implications for clinical psychologists, where there may be similar rates of undisclosed partner abuse, include the need for better identification of abuse victims, and a sound determination of the most appropriate course of therapeutic interventions.
    March 11, 2014   doi: 10.1111/cp.12039   open full text
  • Self‐esteem mediates the associations among negative affect, body disturbances, and interpersonal problems in treatment‐seeking obese individuals.
    Laura Salerno, Gianluca Lo Coco, Salvatore Gullo, Rosalia Iacoponelli, Marie Louise Caltabiano, Lina A. Ricciardelli.
    Clinical Psychologist. January 24, 2014
    Background This study investigated the relationship among negative affect, body image disturbances (BID), and interpersonal problems, and the mediating effect of self‐esteem in a group of treatment‐seeking obese individuals. Methods Four hundred twenty‐two obese patients (85 males and 337 females) completed standardised measures that assessed negative affect, BID, self‐esteem, and interpersonal problems. Results Structural equation modelling showed that obese individuals with greater negative affect and BID reported higher interpersonal problems and that self‐esteem mediated the relationships among negative affect, BID, and interpersonal problems. Conclusions The mediating role of self‐esteem in the relationship between interpersonal functioning and psychological distress needs to be considered when selecting psychologically based interventions that aim to improve the well‐being of treatment‐seeking obese patients.
    January 24, 2014   doi: 10.1111/cp.12036   open full text
  • The unique symptom profile of perimenopausal depression.
    Zoe Gibbs, Stuart Lee, Jayashri Kulkarni.
    Clinical Psychologist. January 14, 2014
    Background Perimenopause is associated with increased depression symptoms in women. Symptoms at this time are thought to be qualitatively different from those in childbearing years, and to present with milder symptoms of depression, increased agitation, and fatigue. This research aimed to determine whether depressive symptoms during perimenopause can be distinguished from those in the childbearing years. Methods Seventy‐four depressed women who were either perimenopausal (n = 40) or in their childbearing years (n = 34) were recruited (M = 40.11; SD = 11 years). Participants completed a series of questionnaires relating to depression (Beck Depression Inventory‐II), various mood states (Profile of Mood States), and changes in sleep patterns. Results Univariate relationships between symptoms and perimenopausal status were assessed. All significant variables (anger‐hostility, depression, tension‐anxiety, fatigue‐inertia, and changes in sleep quality) were analysed via logistic regression. Mood profile at these two different life stages were differentiated based on lower levels of depression symptoms and tension‐anxiety, and increased levels of anger‐hostility, fatigue‐inertia, and sleep disturbance in the perimenopausal women as compared with the childbearing group. Conclusions This research supports the unique presentation of perimenopausal depression. The identification of a unique symptomatic profile provides targets for intervention and allows for different treatment options.
    January 14, 2014   doi: 10.1111/cp.12035   open full text
  • Young people's expectations, preferences, and experiences of therapy: Effects on clinical outcome, service use, and help‐seeking intentions.
    Clare Watsford, Debra Rickwood.
    Clinical Psychologist. January 07, 2014
    Background Young people represent a vulnerable age group for mental health concerns and tend not to seek help. Exploring factors that influence young people's engagement in therapy and clinical outcomes is crucial. This study examined the relationships between young people's expectations, preferences, and actual experience of therapy on their clinical outcome, mental health care service use, and help‐seeking intentions. Gender and age effects were also explored. Methods A quantitative prospective research method was utilised. Participants included a total of 228 young people aged 12 to 25 years who completed an initial survey on contact with a youth mental health service and 102 who completed an online follow‐up survey 2 months later. Results Results showed that young people's actual experiences of therapy and their preference to be personally committed to therapy were positively associated with the outcome variables. No significant associations were evident for initial expectations. No age or gender effects was found. Conclusions These initial findings suggest that initial expectations may not be well formed for youth and appear not to be relevant to young people's engagement or outcomes, and are less important than motivation and actual experiences. Youth‐focused mental health services need to ensure a positive early experience to promote early intervention and relapse prevention.
    January 07, 2014   doi: 10.1111/cp.12034   open full text
  • Brief report: Collecting self‐defining memories outside therapy.
    Martina Luchetti, Nicolino Rossi, Ornella Montebarocci.
    Clinical Psychologist. November 06, 2013
    Objective The aim of this study was to test the Self‐Defining Memory Task (SDM Task)—i.e., the possibility to retrieve personally meaningful memories in an experimental context. Methods A sample of young adults (N = 36) were asked to recall personal memories in response to different sets of instructions: self‐defining memory instructions versus detailed/non‐detailed autobiographical memory instructions. Participants' subjective ratings of memory qualities and behavioural measures were considered, such as latency and narrative duration times. Results Self‐defining memories were rated as more important and emotionally intense compared to other autobiographical memories. The use of detailed memory instructions, however, increased the time of retrieval and the duration of the narrative, eliciting more remote memories, compared to non‐detailed instructions. Conclusions The SDM Task seemed to be more likely to elicit the personally meaningful memories that might be shared with a significant other or in a therapeutic context. Research in autobiographical memory processes constitutes valuable material for clinical psychologists.
    November 06, 2013   doi: 10.1111/cp.12032   open full text
  • A pilot trial of psychological therapy groups for the very old in residential care: Clinical and logistical issues.
    Annaliese C. Blair, Michael J. Bird.
    Clinical Psychologist. November 05, 2013
    Background This study sought to evaluate the clinical effectiveness and practical viability of groups loosely based on cognitive behaviour therapy (CBT) principles for older frail residents of an aged‐care facility with anxiety and/or depressive symptoms. Methods Six residents (mean age 88 years) participated in 8 weekly sessions of group psychotherapy. All had multiple physical comorbidities and loss of physical independence; one participant had a diagnosis of dementia. Results After the program, two participants significantly improved on the Beck Depression Inventory II, while one worsened slightly. Despite difficulties with recruitment, participants were highly engaged and managed group processes, such as confidentiality and turn taking, well. Participants highly valued the program. The trial revealed a number of challenges to group therapy for this population. Clinically, participants had difficulties with goal setting and refused formal homework tasks. Facilitators modified sessions to flow with the group and used experiences raised by participants to illustrate conceptual and practical lessons. Logistical issues also emerged, and we make a number of suggestions for future practice. Conclusions Despite challenges unique to running psychological therapy groups in residential aged‐care facilities, this pilot shows it is possible to work around them and that frail old residents can contribute to, and potentially benefit from, the process of group therapy.
    November 05, 2013   doi: 10.1111/cp.12031   open full text
  • The role of neuroticism in insomnia.
    Clint G. Gurtman, Rachel McNicol, Jane A. McGillivray.
    Clinical Psychologist. October 28, 2013
    Objectives While it has been proposed that certain personality traits are predisposing factors for insomnia, the nature of these traits and mechanisms through which they contribute to insomnia has been understudied. Methods In the present study, 88 participants with self‐reported insomnia took part in an online assessment of normal personality functioning, insomnia severity, sleep‐related cognitive distortions, pre‐sleep arousal, and negative affect. Results Participants scored high on personality measures of neuroticism and openness, and low on conscientiousness, relative to a normal sample. Neuroticism was found to relate to insomnia severity through the mediating effects of sleep‐related cognitive distortions, pre‐sleep arousal, and to a much lesser degree negative affect. Conclusions These results further support the notion of neuroticism being a predisposing factor for insomnia, suggest a pathway for this relationship, and may have implications for individual responses to the treatment of insomnia.
    October 28, 2013   doi: 10.1111/cp.12029   open full text
  • Therapeutic relationship and dropout in youth mental health care with ethnic minority children and adolescents.
    Anna M. Haan, Albert E. Boon, Joop T.V.M. Jong, Charlotte A.M.L. Geluk, Robert R.J.M. Vermeiren.
    Clinical Psychologist. October 28, 2013
    Background Dropout in youth psychotherapy is high, especially for ethnic minority patients. An important determinant of dropout is the quality of the therapeutic relationship. This study evaluated the association between the therapeutic relationship and dropout in therapy with ethnic minority youth. Method Our study was done in a community youth mental health care institution. Seventy patients were included who were dropouts or completers of psychotherapy. The therapeutic relationship was measured with an instrument (i.e., the Child version of the Session Rating Scale (C‐SRS)) that was completed each session by the patient. For each patient, the treatment termination status (dropout or completer) was indicated. A General Estimation Equation (GEE) was conducted to indicate whether the course of total C‐SRS scores during therapy differed for dropouts and completers. Results The course of the scores differed significantly between dropouts and completers. Both groups started with similar scores, but on average, the scores of dropouts decreased during therapy, while the scores of completers increased. Conclusions Our results indicate that if there is a drop in the rated quality of the therapeutic relationship (i.e., monitor the difference between the present C‐SRS score with the previous scores), the therapist should communicate this with the patient. This could lead to an improvement of the therapeutic relationship and a decrease in dropout.
    October 28, 2013   doi: 10.1111/cp.12030   open full text
  • Self‐criticism, dependency, and adolescents' externalising and internalising problems.
    Rui C. Campos, Avi Besser, Cristina Morgado, Sidney J. Blatt.
    Clinical Psychologist. September 05, 2013
    Objectives The present study examines the role of dependency (interpersonal relatedness) and self‐criticism (self‐definition) in internalising and externalising problems. Methods Three hundred forty‐six suburban Portuguese high‐school students age 14–18 (mean = 16.14, standard deviation = 1.19) responded to the Depressive Experiences Questionnaire and the Youth Self‐Report. The impact of depression, measured by the Children's Depression Inventory, on the relationship of dependency and self‐criticism on internalising and externalising problem behaviours was examined. Results Both self‐criticism and dependency, controlled for level of depression, were associated with internalising behaviour problems in both girls and boys. Gender differences, however, were observed in externalising problems. Externalising problems in boys were also associated with self‐criticism. But externalising problems in girls were not associated with psychological variables and thus may be more a function of environmental rather than psychological factors. Conclusions Implications of these findings for intervention are discussed.
    September 05, 2013   doi: 10.1111/cp.12024   open full text
  • Towards a model for student selection in clinical psychology.
    Robert Schweitzer, Nigar Khawaja, Esben Strodl, Jason Lodge, Joe Coyne, Robert King.
    Clinical Psychologist. September 03, 2013
    Background Selection of candidates for clinical psychology programmes is arguably the most important decision made in determining the clinical psychology workforce. However, there are few models to inform the development of selection tools to support selection procedures. The study, using a factor analytic structure, has operationalised the model predicting applicants' capabilities. Method Eighty‐eight clinical applicants for entry into a postgraduate clinical psychology programme were assessed on a series of tasks measuring eight capabilities: guided reflection, communication skills, ethical decision making, writing, conceptual reasoning, empathy, and awareness of mind and self‐observation. Results Factor analysis revealed three capabilities: labelled “awareness” accounting for 35.71% of variance; “reflection” accounting for 20.56%; and “reasoning” accounting for 18.24% of variance. Fourth year grade point average (GPA) did not correlate with performance on any of the selection capabilities other than a weak correlation with performance on the ethics capability. Conclusions Eight selection capabilities are identified for the selection of candidates independent of GPA. While the model is tentative, it is hoped that the findings will stimulate the development and validation of assessment procedures with good predictive validity which will benefit the training of clinical psychologists and, ultimately, effective service delivery.
    September 03, 2013   doi: 10.1111/cp.12025   open full text
  • Children in foster care: What behaviours do carers find challenging?
    Olivia Octoman, Sara McLean, Julie Sleep.
    Clinical Psychologist. September 02, 2013
    Background Children placed in care because of abuse or neglect can display a range of challenging behaviours that can be difficult for foster carers to manage. While much is known about the prevalence of behavioural disorders among children in care, little quantitative information exists about which behaviours are problematic for carers. Method Two hundred and one foster carers of children aged 4–12 were asked to rate a range of potentially problematic behaviours via online survey. Items were drawn from existing clinical measures, a review of the practice literature, and focus group consultation. Results Principal component analysis yielded four distinct profiles of behaviours that carers identified as problematic. The first component reflected cognitive difficulties (e.g., executive functioning, language, and memory problems). Component 2 comprised sexual or otherwise risky behaviours (e.g., drug or alcohol use). Component 3 contained behaviours of an aggressive, controlling, and violent nature (e.g., enjoying upsetting others). Component 4 contained anxiety‐based behaviours (e.g., obsessive compulsive behaviour). Collectively, these four factors accounted for almost 60% of the variance. Conclusions Four discrete profiles of problem behaviours were identified. These distinct groups of behaviour serve as a focus for targeting supports that may ultimately help enhance foster placement stability.
    September 02, 2013   doi: 10.1111/cp.12022   open full text
  • Severity of insomnia, disordered eating symptoms, and depression in female university students.
    Caterina Lombardo, Gemma Battagliese, Chiara Baglioni, Monica David, Cristiano Violani, Dieter Riemann.
    Clinical Psychologist. September 02, 2013
    Background Insomnia is one of the most common sleep disorders, and it frequently co‐occurs with several other psychiatric conditions. The relationship between insomnia and eating disorders is supported by clinical evidence indicating that patients with eating disorders experience poor sleep even if they rarely complain of it. Furthermore, indirect evidence comes from studies indicating that poor sleep predicts obesity and several studies also evidence that restrictive‐type eating disorders are associated to objective reduction of sleep quality. Methods One thousand nineteen female university students volunteered for participating to the study. Valid and reliable questionnaires were used and the mediating role of depressive mood assessed. Results Evidence was found that increased severity of insomnia is associated with higher severity of disordered eating. Both insomnia and disordered eating symptoms were related to depression. The mediation analysis evidenced that both the direct path linking insomnia symptoms and eating disorder symptoms are significant and also the indirect paths related to the mediation of depression. Conclusions These findings support the existence of both a direct and an indirect relationship between insomnia symptoms and eating disorder symptoms.
    September 02, 2013   doi: 10.1111/cp.12023   open full text
  • Narrative studies of recovery: A critical resource for clinicians.
    Paul Rhodes, Adele De Jager.
    Clinical Psychologist. July 30, 2013
    Background The recovery movement has made significant gains in the past two decades providing a consumer‐driven paradigm for mental health service provision. Narrative inquiry is an established research method that allows for the synthesis of recovery stories, enabling them to be considered as a source of evidence that can facilitate a dialogue between consumers and clinicians. Method A systematic review of narrative studies of recovery is presented, including a synopsis of four studies and an amalgamation of themes. Results Key themes were that recovery from severe psychiatric is possible, that recovery involves a journey towards a meaningful life rather than simply the amelioration of symptoms and that despite the pivotal role of self‐determination a trusted network of support is vital. Conclusions Findings from this review serve as a reminder to clinicians to be wary of personal side effects when making diagnoses, to consider hidden strengths in assessment and therapy, and to access community members as a valuable resource where possible.
    July 30, 2013   doi: 10.1111/cp.12021   open full text
  • Socioecological factors associated with fathers' well‐being difficulties in the early parenting period.
    Monique Seymour, Melissa Dunning, Amanda Cooklin, Rebecca Giallo.
    Clinical Psychologist. June 18, 2013
    Background Well‐being difficulties such as depression, anxiety, stress, and fatigue are common among fathers. However, little is understood about factors that might place fathers at increased risk of well‐being difficulties or protective factors that reduce the likelihood of experiencing these problems. The aim of the present study was to use a socioecological perspective to explore a range of individual and microsystem factors associated with depression, anxiety, stress, and fatigue in fathers. Methods The study sample consisted of 133 Australian fathers of young children, aged 0–6 years, who had completed a parent well‐being survey. Results Multiple regressions revealed that a range of individual and microsystem factors significantly explained variance in depression, anxiety, stress, and fatigue, including poor sleep quality, a number of coping strategies, parental self‐efficacy, and social support. Conclusions Fathers are at risk of experiencing a range of well‐being difficulties. Implications for potential targets for interventions to improve the well‐being of fathers are discussed.
    June 18, 2013   doi: 10.1111/cp.12016   open full text
  • Thinking yourself fat: The perceived relationship between thoughts and body shape.
    Juliett S. Dubois, Trish Altieri, Adrian Schembri.
    Clinical Psychologist. May 20, 2013
    Background Thought–shape fusion (TSF) is a cognitive bias associated with eating disorder psychopathology. The association among TSF, body image, and eating behaviours was examined in a sample of Australian males and females in addition to whether or not the different components of TSF (Interpretation and Concept) equally predicted disordered body image and eating behaviours. Methods A community sample of 167 females and 31 males with no history of an eating disorder completed questionnaires measuring eating disorder pathology and body image. Results TSF significantly correlated with measures of disordered eating behaviours and distorted body image. However, females were more likely to experience TSF than males, with TSF Interpretation accounting for higher levels of disordered body image and eating behaviour than TSF Concept. Conclusions Future research should aim to clarify or establish gender differences in an eating disordered population to further investigate whether or not the cognitive bias known as TSF should be addressed in treatment approaches.
    May 20, 2013   doi: 10.1111/cp.12015   open full text
  • A controlled study of personality traits in female adolescents with eating disorders.
    Lois J. Liley, Hunna J. Watson, Elizabeth Seah, Lynn E. Priddis, Robert T. Kane.
    Clinical Psychologist. May 14, 2013
    Background Among adults, personality traits have been implicated in the development and maintenance of eating disorders (EDs); whether these findings extend to youth is unknown. The aim of this study was to investigate personality traits of adolescents with EDs. Methods A case‐control approach was performed by comparing a clinical group of female adolescents with EDs (n = 23) to a control group of adolescents in the general community (n = 26) on personality traits of inhibited, self‐demeaning, and borderline tendency. Controls were frequency‐matched to cases on age and sex, were drawn from a similar geographic catchment area, and observed in the same year as clinical cases. Results The clinical group demonstrated significantly higher scores on self‐demeaning (F(1,47) = 41.39, p < .001, η2 = .075), borderline (F(1,47) = 24.50, p < .001, η2 = .093), and inhibited (F(1,47) = 13.33, p = .001, η2 = .014) personality styles. Adjustment for affective symptomatology diminished the strength of these relationships, but personality pathology still demarcated the group with clinical EDs. Conclusions The well‐established link between personality pathology and EDs in adults generalised to adolescents.
    May 14, 2013   doi: 10.1111/cp.12012   open full text
  • Dysregulated behaviours in bulimia nervosa—A case‐control study.
    Sónia Ferreira Gonçalves, Bárbara César Machado, Carla Martins, Isabel Brandão, António Roma Torres, Paulo Machado.
    Clinical Psychologist. May 14, 2013
    Background Bulimia nervosa (BN) is often related to self‐control difficulties and to dysregulated behaviours. This study aimed to evaluate the frequency of self‐injurious behaviour, suicide attempts, and other dysregulated behaviours in BN, using two control groups (a healthy group and a general psychiatric group), and also to examine the association between these behaviours and alleged sexual abuse in BN. Method Women (N = 233) aged between 13 and 38 years old were evaluated using a semi‐structured interview. Results Participants with BN reported more self‐injurious behaviours, suicide attempts by drug intake, and poor control in smoking and illicit drugs use compared with participants in both control groups. Participants with BN also reported more spending behaviours when compared with the general psychiatric control group. The use of illegal drugs and medication was significantly related to alleged sexual abuse in BN participants. Conclusions This study concluded that BN is often related to dysregulated behaviours, and clinicians must take into account the multi‐impulsive spectrum behaviours of BN in their evaluation and treatment of BN.
    May 14, 2013   doi: 10.1111/cp.12013   open full text
  • Eating disorder symptomatology, body image, and mindfulness: Findings in a non‐clinical sample.
    Emma Prowse, Miles Bore, Stella Dyer.
    Clinical Psychologist. May 06, 2013
    Background There has been increasing interest in the use of mindfulness‐based interventions in treating various disorders and conditions; however, evidence to support the application of mindfulness‐based treatments for eating disorders is limited. The current study was designed as a preliminary investigation of the relationship between mindfulness and eating disorder symptoms to provide an avenue for further research and to inform treatment. Underlying factors, including body image, sense of self, identity, and quality of life, were also investigated in order to increase understanding about eating disorders. Method A battery of self‐report questionnaires was administered online to first year psychology students from an Australian University (n = 411). Results “Observing” as a mindfulness skill was related to higher reported eating disorder symptoms; however, the mindfulness skills “acceptance without judgment” and “action with awareness” were associated with lower eating disorder symptoms. Conclusions These findings are consistent with theoretical support for a possible role of mindfulness‐based interventions in treating eating disorders.
    May 06, 2013   doi: 10.1111/cp.12008   open full text
  • Depression in the community setting: Development and initial validation of the Daily Goals Scale.
    Yasmin Asgari, Lina Angela Ricciardelli.
    Clinical Psychologist. May 06, 2013
    Background Several studies have demonstrated that constructing simple daily goals in the form of positive activities alleviate depressed mood. However, currently there is a paucity of scales for assessing the setting of simple daily goals. The purpose of the current study was to evaluate the psychometric properties of the Daily Goals Scale (DGS), a new scale designed to measure the propensity to set and achieve small daily goals. Methods This study examined the construct validity and reliability of this new scale in a community‐based sample of (N = 178) men and women (aged 18–70 years). All participants were asked to complete the DGS, along with the Mood and Anxiety Symptom Questionnaire, Automatic Thoughts Questionnaire, Negative Disposition, Adaptive Bias Scale, and Hope Scale. Results The results provided evidence for the scale's factorial validity. Findings also showed that the DGS was internally consistent. Moreover, both convergent and discriminant validity were demonstrated. Notably, the DGS negatively correlated with anhedonic depression, but it was unrelated to the measure of anxiety. Conclusion The DGS demonstrated adequate psychometric properties and is an easy‐to‐use self‐report measure of the propensity to set and achieve small daily goals.
    May 06, 2013   doi: 10.1111/cp.12011   open full text
  • Exploring the in‐session reflective capacity of clinical psychology trainees: An interpersonal process recall study.
    Sophie Burgess, Paul Rhodes, Val Wilson.
    Clinical Psychologist. May 06, 2013
    Background Reflection‐in‐action, or the capacity to “think on your feet” is recognised as a critical skill for clinical psychologists, but challenging for trainees who may cope poorly with ambiguity and be consumed by anxiety. This study aims to explore the in‐session reflective capacity of trainees and identify their training needs. Method Twenty seven episodes of therapy conducted by 10 trainees were collected using Interpersonal Process Recall. Data analysis was conducted according to the principles of grounded theory. Results Trainees became distressed when their planned interventions did not match with the complexity of the client or account for challenging interpersonal interactions. Trainees could acknowledge this distress and still engage in fleeting and rudimentary reflection, but many, lacking sufficient technical knowledge or confidence, retreated to the safety of non‐directive counselling. Conclusion These findings support the development of a systematic approach to teaching reflective practice in clinical training.
    May 06, 2013   doi: 10.1111/cp.12014   open full text
  • Predictors for treatment expectancies among young people who attend drug and alcohol services: A pilot study.
    Diem Tran, Sunil Bhar.
    Clinical Psychologist. May 06, 2013
    Background Problematic substance use among young people is a major public health problem. Despite availability of services, attrition rates among young people with substance use are high. Past studies have found treatment expectancies to be an important predictor of treatment retention and outcomes. Methods The current pilot study aimed to explore predictors of treatment expectancies among 25 young people between 18 and 21 who attended a youth Drug Health Services in Victoria, Australia. Twenty‐five participants were administered self‐report questionnaires. Multiple regression analyses were conducted to examine the strongest predictors of treatment expectancies. Results Treatment expectancies were most strongly predicted by satisfaction with past services. These expectancies were also associated with first impressions of the current service. Young people's expectancies about drug and alcohol treatment are shaped by past experiences with services and by early impressions of the current service. Conclusions This study highlights the importance of past and early service satisfaction for treatment expectancies. Given the small sample size employed in the current study, larger studies are required to support such findings.
    May 06, 2013   doi: 10.1111/cp.12009   open full text
  • Considerations in providing shared‐care psychological treatment for clients who have alcohol or other drug misuse problems.
    Erol Digiusto, Rowena Friend, Robert G. Batey, Richard P. Mattick.
    Clinical Psychologist. April 03, 2013
    Background Many people who have alcohol or other drug (AOD) misuse problems also have comorbid psychosocial and behavioural problems such as depression, anxiety, unstable treatment motivation, sleep disorders, chronic pain, post‐traumatic stress disorder, and suboptimal medication adherence. Agencies which provide treatment for such people commonly have limited resources for effectively addressing these problems. Methods A telephone survey of psychologists and clinical psychologists in 12 New South Wales (NSW) postcode areas was conducted to investigate attitudes towards providing treatment for AOD clients. Results The participation rate was 67%, and 61% of participants indicated they were “definitely” (52%) or “probably” (9%) interested in providing services for AOD clients. Thirty‐nine per cent of interested participants indicated that they would always be willing to bulk‐bill Medicare to cover services for AOD clients, and only 7% of interested psychologists indicated that they would never be willing. Almost two thirds of interested participants indicated a delay of no more than one week to see new clients. Conclusions It would be worthwhile and feasible for private‐practice psychologists and clinical psychologists to develop shared‐care arrangements with AOD treatment providers and other related health services. We believe they should endeavour to do so, and we offer suggestions to assist in addressing that goal.
    April 03, 2013   doi: 10.1111/cp.12007   open full text
  • Relationship between self‐reflectivity, Theory of Mind, neurocognition, and global functioning: An investigation of schizophrenic disorder.
    Laura Giusti, Monica Mazza, Rocco Pollice, Massimo Casacchia, Rita Roncone.
    Clinical Psychologist. March 26, 2013
    Background People with schizophrenia show impairments in metacognitive function, including awareness and monitoring of one's mental processes (Self‐Reflectivity (SR)), recognition of the fallibility of one's thoughts, and the ability to infer others' emotions and intentions (Theory of Mind (ToM)). The aim of the present study was to explore whether SR and ToM play a key role in influencing the global functioning of persons affected by schizophrenia. Methods Twenty persons with schizophrenia were recruited before hospital discharge and compared with 17 controls. Clinical, neurocognitive, and global functioning assessments were performed. The Beck Cognitive Insight Scale was used to assess: (1) Self‐Reflectiveness, which allows subjects with psychosis to objectively observe their cognitive distortions, and (2) Self‐Certainty, which reflects rigid confidence in their own beliefs (over‐confidence). ToM assessment included verbal and non‐verbal measures. Results Our study confirms the semi‐independent nature of the metacognitive functions of ToM abilities and the cognitive insight domain. In fact, by multiple regression model analyses, only the Self‐Reflectiveness deficit was found to be the best predictor of low global functioning in schizophrenia and represents a target for rehabilitation interventions to remediate the processes that cause fallible interpretations of daily events. Conclusions Our results encourage a new trend in the cognitive‐behaviour therapy of schizophrenia to be complemented with metacognitive approaches.
    March 26, 2013   doi: 10.1111/cp.12006   open full text
  • Postgraduate clinical psychology students' perceptions of an Acceptance and Commitment Therapy stress management intervention and clinical training.
    Kenneth I. Pakenham, Johanna Stafford‐Brown.
    Clinical Psychologist. October 12, 2012
    Background Research into stress management interventions for clinical psychology trainees (CPTs) is limited, despite evidence indicating that these individuals are at risk for elevated stress, which can negatively impact personal and professional functioning. This study explored: (1) CPTs' perceptions of a previously evaluated Acceptance and Commitment Therapy (ACT) stress management intervention; and (2) their satisfaction with clinical training and suggested programme changes. Methods Fifty‐six postgraduate clinical psychology students completed questionnaires. Qualitative and quantitative data concerning students' views of an ACT stress management intervention and clinical training were collected. Results Most CPTs reported that they would recommend the intervention to other CPTs and that they found it personally and professionally useful. The majority of participants also reported marked improvement on indicators of psychological flexibility. Qualitative data suggested three broad structural changes to clinical training (better preparation prior to commencing clinical work, reduced workload, and better organisation), some of which have implications for curriculum development. Conclusions Findings support the use of an ACT stress management intervention for addressing CPT stress and the integration of self‐care into the curriculum.
    October 12, 2012   doi: 10.1111/j.1742-9552.2012.00050.x   open full text
  • Psychological distress of fathers attending an Australian early parenting service for early parenting difficulties.
    Rebecca Giallo, Amanda Cooklin, Nikki Zerman, Renzo Vittorino.
    Clinical Psychologist. May 29, 2012
    Background:  Early parenting centres are in a unique position to identify and provide support to fathers experiencing mental health difficulties. However, the extent to which fathers attending these services experience mental health difficulties is not known. This study aimed to assess fathers' mental health, identify specific clinical profiles based on the severity and pattern of self‐reported symptoms of depression, stress, anxiety, and fatigue and identify factors associated with poorer mental health. Methods:  Participants were 144 fathers admitted to a residential programme. Socio‐demographic information and symptoms of depression, anxiety, stress, and fatigue were collected using standardised instruments. Results:  The proportion of fathers reporting distress in the clinical ranges for stress, anxiety, and depression were 17%, 6%, and 9%, respectively. Latent class analysis identified two distinct groups or clinical profiles of fathers, representing mild (84%) and high distress (16%). Poor physical health, severity of child's sleep disruption, low socio‐economic position, and poor self‐care were associated with high distress. Conclusions:  Fathers attending early parenting services are at risk of experiencing significant levels of distress, anxiety, stress, and fatigue. Early Parenting Services can play a critical role in screening and identifying fathers experiencing poor mental health and link them into appropriate mental health support.
    May 29, 2012   doi: 10.1111/j.1742-9552.2012.00044.x   open full text