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Research into the intergenerational effects of the Holocaust has focused on traumatization of the survivors' children, and has yet to explore adaptive responses in succeeding generations. In this study, 10 semi-structured interviews were conducted with Australian adult grandchildren of Holocaust survivors. Interpretive phenomenological analysis identified six themes: connection and discomfort with the Holocaust's salience, reckoning with a legacy of trauma, insecurity and survival strategies, the value of a strong education, family is everything, and valuing a communal outlook. These findings imply that the Holocaust's traumatizing effects linger for multiple generations, but responding in adaptive ways benefits relationships within survivor families. [ABSTRACT FROM AUTHOR]

Background: Difficulties with inhibitory control have been identified in eating disorders (EDs) and neurodevelopmental disorders (NDs; including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder), and there appear to be parallels between the expression of these impairments. It is theorised that impairments in inhibitory control within NDs may represent a unique vulnerability for eating disorders (EDs), and this same mechanism may contribute to poorer treatment outcomes. This review seeks to determine the state of the literature concerning the role of inhibitory control in the overlap of EDs and neurodivergence. Method: A scoping review was conducted to summarise extant research, and to identify gaps in the existing knowledge base. Scopus, Medline, PsycInfo, Embase, and ProQuest were systematically searched. Studies were included if the study measured traits of ADHD or autism, and symptoms of ED, and required participants to complete a performance task measure of inhibitory control. Where studies included a cohort with both an ND and ED, these results had to be reported separately from cohorts with a singular diagnosis. Studies were required to be published in English, within the last 10 years. Results: No studies explored the relationship between autism and EDs using behavioural measures of inhibitory control. Four studies exploring the relationship between ADHD and EDs using behavioural measures of inhibitory control met selection criteria. These studies showed a multifaceted relationship between these conditions, with differences emerging between domains of inhibitory control. ADHD symptoms predicted poorer performance on measures of response inhibition in a non-clinical sample; this was not replicated in clinical samples, nor was there a significant association with EDs. Both ADHD and ED symptoms are associated with poor performance on attentional control measures; where these diagnoses were combined, performance was worse than for those with a singular diagnosis of ADHD. This was not replicated when compared to those with only ED diagnoses. Conclusion: Impairments in attentional control may represent a unique vulnerability for the development of an ED and contribute to poor treatment outcomes. Further research is needed to explore the role of inhibitory control in EDs, ADHD and autism, including the use of both self-report and behavioural measures to capture the domains of inhibitory control. [ABSTRACT FROM AUTHOR]

As a cultural trauma, the Holocaust exerted negative psychological effects on many survivors, with such effects often extending to their families. Research has explored these effects with respect to the survivors' children and grandchildren, but the experiences of the next generation have yet to be canvassed. Knowledge about resilience in Holocaust survivor families is also comparatively sparse. In this exploratory study, 10 semi‐structured interviews were conducted with Australian great‐grandchildren of Holocaust survivors, garnering perspectives concerning the genocide's impact on family functioning. Six superordinate themes were identified through Interpretive Phenomenological Analysis: The experience of being raised by the third generation, honoring traumatic family histories, the need to move on, proudly identifying with the Holocaust, valuing achievement and ambition, and the importance of not taking things for granted. The findings suggest that multiple generations within survivor families grapple with the lingering negative effects of the Holocaust. Concurrently, attempting to redress these effects has the potential to benefit family dynamics and processes. [ABSTRACT FROM AUTHOR]

Self-disclosure is a necessary component of group self-practice/self-reflection (SP/SR), a teaching method whereby (trainee) psychotherapists engage in reflections with their peers and the facilitator on the self-practice of therapeutic techniques on personally relevant experiences. The making of personal disclosures by nature and within a professional educational environment can be associated with challenging emotions and must be managed appropriately by trainees and facilitators. This study aimed to understand how participants navigate and benefit from this self-disclosure process. In semistructured interviews, eight clinical psychology trainees recounted their experiences, decision-making processes, and the associated learning outcomes of selfdisclosures made and witnessed during a group cognitive behaviour therapy (CBT) program using SP/SR principles. Four themes were developed: "to disclose or not to disclose," "the virtuous (and nonvirtuous) cycle of self-disclosure," "sitting in the other chair," and "making it safer, making it better." Trainees described that the CBT program using SP/SR helped them to understand and empathize with client self-disclosure and their role as a psychologist in supporting this process and facilitated their understanding of psychotherapist selfdisclosure. Recommendations for effective and safe promotion of self-disclosure in SP/SR are made. [ABSTRACT FROM AUTHOR]

Self-practice/self-reflection (SP/SR) supports understanding and delivery of cognitive behavioral therapy (CBT) in participants by facilitating reflection on the practice of CBT techniques on personally relevant experiences. To date, little is known about the online potential of SP/SR training, particularly relevant through the course of the COVID-19 pandemic which saw an increase in online teaching and training delivery. The present study examined the perspectives of ten trainee therapists and three clinical educators (facilitators) on the experience, benefits, and challenges of participating in and facilitating an online CBT group integrating SP/SR principles. Reflective thematic analysis of semistructured interviews led to two trainee themes ("experiencing the other chair" and "learning to be a CBT therapist") and two facilitator themes ("learning to facilitate online" and "reflections on unexpected gains"). Facilitators and trainees described the online platform as a suitable delivery format, providing a comparable experience to in-person teaching and an authentic therapeutic experience to facilitate trainees' understanding of delivering CBT generally and in a telehealth context. Some trainees noted challenges being vulnerable online and all facilitators noted being less likely to push trainees to experience and express difficult thoughts and emotions online. Recommendations are provided to enhance learning in similar groups in psychology training. [ABSTRACT FROM AUTHOR]

Accurate and reliable assessment of clinical competencies in clinical psychology training requires the use of a range of assessment methods. In addition to traditional written assignments, exams, and clinical supervisor ratings, there is a growing recognition that objective and structured performance-based exams are also required. The objective structured clinical examination (OSCE) is a well-established assessment method that involves a series of assessment stations in which students perform structured clinical tasks, mostly with simulated patients (SPs), while being independently rated by examiners. Several clinical psychology programmes in Australia have started conducting OSCE but descriptions of clinical psychology OSCE are lacking. In this paper, we describe the OSCE in four universities. Challenges, limitations, and practical issues of this form of assessment, in addition to similarities and differences between OSCE are explored. To promote best practice in the assessment of clinical competencies, we offer seven tips to clinical psychology trainers on setting up an OSCE for their programme. The OSCE has the potential to improve the reliability, validity and authenticity of competency assessments in clinical psychology programmes. We hope these OSCE descriptions and tips will encourage programmes to introduce the OSCE and spur further research into this form of assessment. [ABSTRACT FROM AUTHOR]

Within psychology, interest in simulation has grown, with publications on role‐play and objective structured clinical examinations emerging. This study examines the impacts of simulation‐based education on students' clinical competence and confidence when compared with traditional case‐based education. The perceived alignment between simulation‐based education and clinical practice is also considered. Twelve first‐year clinical psychology students participated in this mixed methods study. Participants completed two objective structured clinical examinations, during which their clinical competence was rated using the Global Rating Scale and Cognitive Therapy Scale—Revised. Following the first examination, participants were randomly allocated to the simulation‐ or case‐based education conditions, where they engaged with video simulations or written case study, respectively. Clinical competence was then assessed post‐intervention, and consenting participants completed a follow‐up focus group. Post‐intervention, those in the simulation‐based education condition rated their confidence in applying knowledge learnt to real‐world settings higher than did those in the case‐based education condition. The simulated‐based education group also showed increased competence as rated on the Global Rating Scale and Cognitive Therapy Scale—Revised; however, this improvement was not greater overall than that observed in the case‐based education group. From a qualitative perspective, several themes emerged, including a "disconnect" between case‐based materials and clinical practice and the importance of explicit instructions in guiding student learning. From a student perspective, simulation‐based education is preferred over case‐based education as a clinical education approach. However, there is no clear evidence that simulation‐based education enhances clinical skill performance over and above case‐based education. KEY POINTS (1) Students in the simulation‐based education condition rated their confidence in applying knowledge learnt to real‐world settings significantly higher than those in the case‐based education condition. (2) Students engaging in simulation‐based education prefer explicit instructions regarding the learning objectives of activity to guide their learning (3) While students regard simulation‐based education more favourably than they do casebased education, as yet there is no clear evidence that simulation‐based education enhances clinical skill performance over and above case‐based education. [ABSTRACT FROM AUTHOR]

The 2019 Australian Psychology Accreditation Council's Accreditation Standards for Psychology Programs require clinical psychology education providers to focus on building and assessing competencies. There is limited evidence regarding the most effective methods of teaching competent practice. Threshold concepts are those which change the way a learner views a topic once understood. Threshold concepts comprise a novel approach to teaching and learning in higher education which have not yet been applied to clinical psychology education. The identification and application of threshold concepts in other practice-based health care education was reviewed to assess their utility in clinical psychology education. A search of published articles related to threshold concept theory and practice-based health care disciplines was conducted and those papers which used empirical methods to identify threshold concepts were reviewed. Nine articles where threshold concepts were identified in five practice-based health care disciplines including occupational therapy, medicine, physiotherapy, paediatric surgery and prosthetics, were found. A number of threshold concepts found in other disciplines had relevance to competencies required by the standards for clinical psychology practice, predominantly with reference to competent application of psychological interventions. The literature suggests that threshold concepts are a promising area of educational innovation with strong potential to improve clinical psychology education. Identifying these concepts could assist clinical psychology educators to develop curriculum to meet the Australian standards and facilitate learners' movement through the essential learning thresholds. [ABSTRACT FROM AUTHOR]

Objective: Clinical placement is an essential aspect of student training in professional postgraduate psychology. However, students can be exposed to risk during clinical placement. Further, anecdotal evidence suggests that barriers may hinder formal reporting of adverse events occurring during placement. The objective of this study was to investigate the incidence and nature of psychology students' exposure to risk during clinical placement. This study also sought to explore key stakeholders' perceptions of risks to students engaging in placement. Method: A sequential explanatory mixed‐method design was utilised. The quantitative element of the study involved a questionnaire capturing the experiences of 70 students currently undertaking clinical psychology placement in healthcare services within Australia. This was followed by qualitative semi‐structured interviews with 10 industry‐based stakeholders associated with clinical placements across seven Australian universities. Results: Preliminary evidence indicates that psychology students can experience adverse events while on clinical placement, and that industry‐based stakeholders can also encounter professional risk resulting from student contact. Low uptake of formal incident reports among students was demonstrated. The quality of risk‐related training was shown to vary across the industry, indicating a need for streamlined training approaches to risk management. Finally, strategies to support students and supervisors were raised. Conclusions: Novice students may be inadequately prepared for the risks arising in unpredictable clinical placement milieu. They may also be unaware of their rights and avenues for reporting. Further support and resources designed to equip health services and universities for student exposure to risk during placement is warranted. [ABSTRACT FROM AUTHOR]

Parenting is a fundamental life domain with increasing evidence suggesting the parenting role has the capacity to inform and promote mental health recovery. Two reviews examined the current tools available to assess parenting in the context of recovery. Review one identified 35 quantitative measures of parenting used in interventions for parents with mental health problems. None of these measures appeared to consider parenting from a recovery orientation. Review two identified 25 measures of personal recovery; however, none appeared to consider the parenting role. Despite the fundamental life role of parenting, our ability to measure these constructs appears limited. Further research is warranted into the development of a measure of recovery that considers the parenting role. [ABSTRACT FROM AUTHOR]

Objective: Trainees across the healthcare sector contend with ubiquitous risk during clinical placement. This has prompted educative action to enhance student competency in unpredictable clinical environments. The objective of this pilot study was to evaluate the impact of Risk Aware, an online blended simulation‐based learning program, upon student preparedness and confidence for clinical placement. Method: A sequential explanatory mixed‐methods design was utilised to evaluate Risk Aware. The Risk Aware program was trialled on 149 first‐year professional psychology postgraduate students across seven Australian universities prior to their first clinical placement. Repeated measures t‐tests investigated the impact of Risk Aware learning modules upon student knowledge and confidence; descriptive statistics and analysis of frequencies summarised student competency following Risk Aware (N = 120). Follow‐up qualitative interviews explored the nature of student knowledge and confidence, and student impressions of Risk Aware (N = 8). Results: Preliminary quantitative findings demonstrated significant increases in student knowledge and confidence (p < 0.05), and low‐to‐average competence, after Risk Aware. Qualitative results corroborated increases in student knowledge and confidence and pointed to early signs of clinical competency. Student impressions of Risk Aware were generally positive and included suggestions to improve program usability. Conclusions: Findings highlight Risk Aware's capacity to increase students' ability to identify and detail responses to risks arising during placement. Further field testing to ascertain students' application of skills is required. Results will inform program modifications to enhance future Risk Aware iterations. [ABSTRACT FROM AUTHOR]

Objective The aims of this study were to investigate the association between feedback and anxiety, while also exploring the feedback and support experiences of graduate nurses. Design This study used a mixed methods approach. Setting Participants completed an online survey. Subjects The study included 107 Australian graduate nurses. Main outcome measures Anxiety and feedback. Results Using bivariate regression a negative relationship was identified between feedback and anxiety. Further analysis using one-way analysis of variance revealed that participants who received regular and quality feedback and support, reported the lowest anxiety. The second aim was assessed by reviewing participants' subjective comments regarding their experiences as graduate nurses. Results revealed high variability in feedback and support experiences. The data gathered suggests graduate nurses experience anxiety during their transition from university to professional nursing. Conclusion The provision of regular feedback and support was associated with reduced anxiety in graduate nurses. These preliminary findings highlight the importance of regular and appropriate feedback and support to facilitate learning, successful role transition and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Objective Structured Clinical Examinations ( OSCEs) are a well-known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open-ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector. [ABSTRACT FROM AUTHOR]

This study examined the effect of absorption on women's emotional and cognitive processing of erotic film. Absorption was experimentally manipulated using 2 different sets of test session instructions. The first, participant-oriented, instruction set directed participants to absorb themselves in the erotic film presentation, imagining that they were active participants in the sexual activities depicted. The second, spectator-oriented, instruction set directed participants to observe and assess the erotic film excerpt as impartial spectators. The participant-oriented instruction set was found to elicit greater subjective absorption in women than the spectator-oriented instruction set, and women reported greater subjective sexual arousal in the former set compared with the latter. Thus, it appears that the degree to which a woman becomes absorbed in an erotic stimulus may affect her subsequent subjective sexual arousal. Also, women reported greater degrees of positive affect when they took a participant-oriented perspective than when they viewed the erotic materials as impartial spectators. Thus, participants who were highly absorbed in the erotic film excerpt were more likely to view the stimulus favorably. By contrast, the degree to which women became absorbed in the stimulus had no effect on their reported negative affect. Future directions for examining female response patterns are suggested. [ABSTRACT FROM AUTHOR]

Objectives: Individuals who have a parent with mental illness are more likely to experience mental illness than their contemporaries. As such, it is valuable to examine potential psychological resources, which might assist these individuals to experience good mental health throughout their lifespan. We aimed to learn how clinicians perceive self‐compassion, and how it can be incorporated into therapy with clients who have parents with mental illness. Design: A qualitative interview design was employed to explore clinicians' perspectives and experiences. Methods: Eight mental health clinicians experienced in working with clients who have parents with mental illness were interviewed. Interpretative phenomenological analysis was used to establish themes representing the clinicians' perspectives and experiences of incorporating self‐compassion into their work. Results: This study found that clinicians were generally positive about incorporating self‐compassion into interventions with clients who are children of parents with mental illness. The participants noted barriers to self‐compassion for these clients, namely a poor sense of self and divided loyalty between self and family. Participants recommended taking time and care, building rapport and involving others when cultivating self‐compassion with those who have parents with mental illness. Conclusions: This group of clinicians viewed self‐compassion as relevant to clients whose parents have mental illness and believe it can be introduced therapeutically in various ways. Suggestions are made for tailoring self‐compassion training to the needs and experiences of this group. [ABSTRACT FROM AUTHOR]

Issue addressed: Australia's ageing population has growing health care needs, challenging timely health service provision. In rural and regional areas, older Australians have poorer health care outcomes and higher rates of potentially preventable hospital (PPH) admissions. The objective of this study was to identify Australian Governmental initiatives designed to reduce PPH of older adults (65 years and over) in rural and regional areas. Methods: An internet search, underpinned by an environmental scan methodology, was utilised to systematically search the websites of Australian government health departments for relevant initiatives. Stakeholder interviews were then conducted to enrich the findings of the environmental scan. Thematic analysis was utilised to analyse all data. Results: We identified 13 initiatives currently in existence in Australia that fulfilled the search criteria. Stakeholder interviews revealed a range of other local interventions in rural communities across the country, driven largely by community need and a lack of health service accessibility. Conclusions: The identified small number of Governmental health initiatives designed to reduce the PPH of older people living in rural and regional Australia may indicate gaps in the provision of services designed to enable older adults to remain at home and avoid subsequent hospital admissions. So what?: A coordinated, systemic approach to health promotion targeting older people in rural and regional areas should be explored, with a focus on collaboration between sectors (including primary care, allied health and prehospital services). [ABSTRACT FROM AUTHOR]

Teachers are uniquely placed to comment on the psychosocial functioning of their students. In particular, teacher report of symptoms and functional impairment is crucial in a diagnostic assessment of Attention-deficit Hyperactivity Disorder (ADHD). For adolescents, however, schooling structures and other factors can influence the reliability of teacher reports. Clarity is needed for both clinicians and researchers regarding the interteacher reliability across different domains in the assessment of adolescents. This study investigated interrater reliability of teacher reports of adolescents using data from the 72-month follow-up of the National Institute of Mental Health (NIMH) Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) when participants were 13–15.9 years old. For adolescents with a history of ADHD (MTA; N = 177–210), and a normative comparison group (Local Normative Control Group [LNCG]; N = 100–125), intraclass correlations (ICC) were examined between Math and English teacher reports of ADHD symptoms, externalizing behavior, scholastic competence, and social functioning. Results indicate poor to moderate reliability in the assessment of adolescents with a history of ADHD for core ADHD symptoms, social functioning and scholastic competence, and moderate to good reliability of externalizing behavior. Interteacher reliability was better for the normative comparison group in all domains except social functioning, which was also poor to moderate. Clinicians and researchers should be aware of potential inconsistencies in teacher reports and where possible collect multiple teacher reports to maximize reliability. Further implications for research and clinical practice are explored. Public Significance Statement: Teacher-reported symptoms and functioning of adolescents are important for the assessment and management of Attention-deficit Hyperactivity Disorder (ADHD), however, there are likely to be discrepancies between the ratings different teachers provide. This study demonstrates that teacher reports of adolescent functioning vary considerably, particularly regarding social functioning and ADHD symptoms. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionDeliberate practice (DP) is recommended as a new approach to facilitate the acquisition of discrete therapeutic skills, however, its implementation and effectiveness in psychotherapy remains unclear.A systematic search on DP for therapeutic skills among psychotherapy trainees and psychotherapists yielded eleven studies for inclusion. Nine were randomized controlled studies (RCTs), including seven unique RCTs, and two were within-group studies.Risk of bias was assessed as “high” for one RCT, “some concerns” for the remaining RCTs, and “serious” for within-group studies. All RCTs found the DP group performed better than the control group. All studies involved efforts to improve performance based on learning objectives and iterative practice but varied in the source of expert guidance and feedback. The included studies provide limited insight into best practice for delivering DP.The results highlight the paucity of research in this field; however they offer insight into current applications of DP and provide preliminary empirical support DP for as a model for promoting the development of discrete therapeutic skills. Given the rapid dissemination of DP publications and manuals in psychotherapy, future research is strongly encouraged. [ABSTRACT FROM AUTHOR]

The mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19. We searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17th February 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95 % prediction intervals. The meta-analysis included 401 studies, representing 458,754 participants across 58 countries. Pooled prevalence of depression was 28.5 % (95 % CI: 26.3–30.7), anxiety was 28.7 % (95 % CI: 26.5–31.0), PTSD was 25.5 % (95 % CI: 22.5–28.5), alcohol and substance use disorder was 25.3 % (95 % CI: 13.3–39.6) and insomnia was 24.4 % (95 % CI: 19.4–29.9). Prevalence rates were stratified by physicians, nurses, allied health, support staff and healthcare students, which varied considerably. There were significantly higher odds of probable mental health disorders in women, those working in high-risk units and those providing direct care. Majority of studies used self-report measures which reflected probable mental health disorders rather than actual diagnosis. These updated findings have enhanced our understanding of at-risk groups working in hospitals. Targeted support and research towards these differences in mental health risks are recommended to mitigate any long-term consequences. • High rates of mental health disorders in hospital healthcare staff during COVID-19 • Pandemic factors beyond the hospital need to be considered. • Mental health impacts present in other professions besides nurses and physicians • At risk groups identified and need to be the focus of mental health strategies [ABSTRACT FROM AUTHOR]

This review provides a meta-analysed male:female prevalence ratio of oppositional defiant disorder (ODD) during middle childhood in non-referred children. It also analyses sex differences in prevalence across cultures and over time. A systematic search for studies via the following sources was conducted: PsycInfo, Web of Knowledge, Medline Complete, Scopus, EMBASE, InfoRMIT, Psychological and Behavioural Sciences Collection, Cochrane Library, PubMed and ProQuest Health. The studies presented in two previous systematic reviews were also added to the search results. Inclusion/exclusion criteria were then applied and final studies were appraised for their methodological quality. Nineteen independent effect sizes met full inclusion criteria (aggregated sample N = 44,107). Overall, the prevalence of ODD was significantly higher in boys than girls (RR = 1.59, 95 % CI [1.36, 1.86], p < 0.001), with the male:female prevalence ratio found to be 1.59:1. Sex differences in prevalence were significant in Western (RR = 1.80, 95 % CI [1.55, 2.10], p < 0.001) but not non-Western cultures (RR = 1.08, 95 % CI [0.76-1.53], p > 0.05). Sex differences in prevalence were significant in studies published prior to and post the year 2000 (RR = 1.57, 95 % CI [1.22, 2.02], p < 0.001; RR = 1.64, 95 % CI [1.35, 2.00], p < 0.001), and were consistent between these two periods (Q, 1 = 0.36, p = > 0.05). The sex differences in ODD prevalence are discussed within the context of (i) predominant theories of sex differences in externalising behaviours, and (ii) departure from the sex-differences pattern found for other disruptive behavioural disorders. [ABSTRACT FROM AUTHOR]

This article reports a strengths-based intervention to support parents with mental illness and their children in adult mental health settings: "Let's Talk About Children" (LTC) intervention. A qualitative methodology was adopted with parent participants receiving LTC in adult mental health and family services. The benefits for parents receiving LTC were described through in-depth interviews with 25 parents following the delivery of the program. Interview data identified an impact on parental self-regulation—mainly through a change in a sense of agency as a parent—and skill building, once a clearer picture of their child's everyday life was understood. This study outlines the benefits of talking with parents about the strengths and vulnerabilities of their children during routine mental health treatment. The role for self-determination of parents in preventive interventions for children is an important consideration for mental health recovery, and it also helps to break the cycle of transgenerational mental illness within families. [ABSTRACT FROM AUTHOR]

• There is variation in the social functioning of adolescents with a history of ADHD • Latent Profile Analysis revealed four distinct social profiles • Group level descriptions of social impairment do not represent this diversity Social impairment is a hallmark of Attention-deficit/hyperactivity disorder (ADHD), but the extent of variation in adolescent social strengths and weaknesses is unclear. We compared teacher-reported characteristics of social functioning in adolescents with a history of ADHD (N = 340), and without ADHD (N = 182) from the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) at 72-month follow-up (13 – 15.9 years-old). Latent profile analysis of teacher-reported cooperation, assertion and self-control on the Social Skills Rating System (SSRS), was used to identify "social profiles". Their associations with clinical features were explored. Significant differences in social functioning were identified between adolescents with a history of ADHD, and without ADHD (ES = 0.54 – 0.77). Four distinct social profiles were identified in adolescents with a history of ADHD: unskilled (N = 24, 7%) , low average (N = 144, 42%) , average (N = 141, 41%) , and skilled (N = 31, 9%). Profiles with worse social functioning (low average, unskilled) displayed more symptoms of inattention, hyperactivity/impulsivity, oppositionality, depression, global impairment, and were less liked, more rejected and ignored by peers than average and skilled. Social profile membership was not associated with sex, anxiety symptoms, or remittance / persistence of ADHD. Social functioning in adolescents with a history of ADHD is variable, and associated with worse symptomology, global functioning, and peer relationships, irrespective of persistence or remittance of ADHD. Group level summaries of social difficulties in ADHD may be inadequate given nearly half of adolescents with a history of ADHD presented with average or skilled social profiles. [ABSTRACT FROM AUTHOR]

Introduction: In adolescents and young adults, self-compassion has been positively associated with wellbeing and negatively associated with psychological distress. One population of youth who may draw particular benefit from self-compassion are those who have parents with mental illness. This qualitative study explored the perspectives and experiences of self-compassion among a group of young adult children of parents with mental illness.Methods: A purposive sample of ten Australian emerging adults aged 18-25 years (3 men, 6 women and 1 non-binary person) participated in individual semi-structured telephone interviews. Interpretative Phenomenological Analysis was used to examine and interpret participants' experiences and perspectives of self-compassion.Results: Participants described self-compassion as personally relevant and beneficial, although difficult to engage in. Some participants had learnt about, and actively practiced self-compassion, and offered advice for others. Conversely, others described self-compassion as difficult to practice and outlined barriers to self-compassion, from society and family life. Although participants identified common negative social conceptions of self-compassion, they articulated how self-compassion could be valuable for those who have parents with mental illness.Conclusions: Results indicate the perceived importance of self-compassion along with barriers and facilitators of self-compassion for young adults who have parents with a mental illness. Implications for clinical practice and suggestions for future research are presented. [ABSTRACT FROM AUTHOR]

Objective: A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods: A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results: Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expanded-scope paramedics, health promotion and the role of paramedics as key members of local communities. There were no studies specifically related to the paramedic role in health education, although many papers referred to health education as one of many roles paramedics engage in today. Conclusion: This review highlights a broadening of paramedicine's traditional scope of practice, and an indication of how vital paramedics could be to local communities, particularly in rural and remote areas. An expanded role may help address health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers. What is known about the topic?: A broadening of paramedicine's traditional scope of practice has been linked to improvements in health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers, such as rural and remote Australia. Health education, as well as health promotion, primary health care and chronic disease management, have been proposed as potential activities that paramedics could be well placed to participate in, contributing to the health and well-being of local communities. What does this paper add?: This paper identifies and synthesises literature focusing on paramedic-initiated health education in the Australian context, assessing the current health education role of paramedics in metropolitan, rural and remote areas. It provides an understanding of different geographical areas that may benefit from expanded-scope prehospital practice, indicating that the involvement of paramedics in health education in Australia is significantly determined by their geographical place of work, reflecting the influence of the availability of healthcare resources on individual communities. What are the implications for practitioners?: Today's paramedics fill broader roles than those encompassed within traditional models of prehospital care. Rural and remote communities facing increasing difficulty in obtaining health service provision appear to benefit strongly from the presence of expanded-scope paramedics trained in health promotion, primary injury prevention, chronic disease management and health education: this should be a consideration for medical and allied health practitioners in these areas. Australian paramedics are uniquely placed to 'fill the gaps' left by shortages of healthcare professionals in rural and remote areas of the country. [ABSTRACT FROM AUTHOR]

Let's Talk About Children is a manualised intervention for parents with a mental illness that aims to impact positively on family dynamics. Previous evaluations focused on parents with an affective disorder. The purpose of this study was to evaluate the intervention for parents with various mental illnesses and explore parents' self-reported views regarding the impact of the intervention. A quasi-experimental approach was employed to compare outcomes for parents who received Let's Talk About Children plus treatment as usual (n = 20) with a wait list control (treatment as usual) group (n = 19), using family functioning and parenting stress questionnaires. Questionnaires were completed 2 weeks prior to receiving the intervention and 4 to 6 weeks after the final session. The wait list parents completed the same questionnaires at two time periods, 6 weeks apart. Semi-structured interviews were conducted after the intervention. Both intervention and control groups showed improvements in parenting and family functioning. Interview data highlighted (1) increased insight, (2) normalising of the illness in the family, (3) family communication changes, (4) the importance of supporting the parenting role and (5) suggestions for additional supports. There are possible issues regarding the influence of psycho-education when giving participants information about the nature of the research. [ABSTRACT FROM AUTHOR]

Background: A considerable number of people with a mental illness are parents caring for dependent children. For those with a mental illness, parenting can provide a sense of competence, belonging, identity and hope and hence is well aligned to the concept of personal recovery. However, little research has focused on the recovery journey of those who are parents and have a mental illness. This randomised controlled trial aims to (i) evaluate the effectiveness of an intervention model of recovery for parents (Let's Talk about Children) in three different mental health service sectors and (ii) examine the economic value of a larger roll out (longer term) of the parent recovery model. Methods: A two arm parallel randomised controlled trial will be used with participants, who are being treated for their mental illness in adult mental health, non-government community mental health or family welfare services. The study will involve 192 parents, who are considered by their treating practitioner to be sufficiently well to provide informed consent and participate in an intervention (Let's Talk about Children) or control group (treatment as usual). Participant randomisation will occur at the level of the treating practitioner and will be based on whether the randomised practitioner is trained in the intervention. Outcomes are compared at pre, post intervention and six-month follow-up. Recovery, parenting and family functioning, and quality of life questionnaires will be used to measure parent wellbeing and the economic benefits of the intervention. Discussion: This is the first randomised controlled trial to investigate the efficacy of a parenting intervention on recovery outcomes and the first to provide an economic evaluation of an intervention for parents with a mental illness. An implementation model is required to embed the intervention in different sectors. Trial registration: The trial was retrospectively registered: ACTRN12616000460404 on the 8/4/2016. [ABSTRACT FROM AUTHOR]

Objective The use of self-practice and self-reflection has been proposed as an efficacious strategy in the training of therapists. It has been argued to enhance therapist skills, and a key factor in the development of expertise. This systematic literature review investigated the effect of self-practice and self-reflection on therapist skills development. Method Studies were identified through Medline, Academic Search Complete, PsychINFO, PsycARTICLES, Proquest, ISI, CINAHL, Cochrane, and Scopus databases. Additional studies were identified through lateral searches of relevant papers' reference lists and direct correspondence with authors of unpublished material. The selection criteria were studies that investigated the effect of self-practice and/or self-reflection on therapist skill development. There was no restriction on sample sizes, design of studies, dates of publication, or peer-reviewed papers. All studies were published in English. Results Ten studies were included in this review. A thematic analysis was undertaken to analyse qualitative data. Due to inconsistency in the variables investigated across the quantitative studies, quantitative results were not subject to a meta-analysis but simply reported. Finally, qualitative and quantitative data were juxtaposed in a meta-synthesis. Conclusion The meta-synthesis revealed inconsistencies between the qualitative and quantitative literature and a gap in relation to declarative knowledge. Methodological limitations across studies are discussed and recommendations for future research provided. [ABSTRACT FROM AUTHOR]