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Objective: This opinion paper discusses certain recommendations of the House of Representatives Select Committee on Mental Health and Suicide Prevention pertaining to psychology, GP and psychiatric professions. Conclusions: The Committee's recommendations may compromise patient care by undermining the ability of private sector medical specialists in providing direct clinical treatment and their role in the coordination of multidisciplinary teams. Expanding private psychological therapies without GP and private psychiatry support might increase the reliance on public hospital emergency departments and public sector mental health services for severe disorders and suicidal crises. Psychiatrists and GPs need to engage in more effective policy advocacy with the Australian Government, in order to maintain their roles in leading private sector collaborative multidisciplinary care. [ABSTRACT FROM AUTHOR]

Objective: This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills.Method: An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed.Results: Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services.Conclusions: MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients' physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes the role forensic psychotherapy has in the assessment and treatment of mentally disordered offender patients, and its role in the supervision of individual therapists, staff groups or whole organisations which contain and manage this patient population.Conclusions: Forensic psychotherapy has a valuable role to play in the management of mentally disordered forensic patients. As forensic services continue to develop in Australia and New Zealand and interest in this field continues to grow, then the future of forensic psychotherapy looks bright. [ABSTRACT FROM AUTHOR]

The article presents the study which examined the introduction of a Conversational Model of Short Term Intensive Psychodynamic Psychotherapy in a public mental health service in Australia. The model was introduced in 10 multidisciplinary mental health clinicians at the Western Sydney Health District in New South Wales. In the study, papers published in the Royal Australian & New Zealand College of Psychiatrists journals since 1980 as of October 2014 were analyzed.

Objective: The purpose of this paper is to examine strategies that may facilitate the successful implementation of service-wide outcome measures in public mental health services. Conclusions: The available evidence suggests that a top-down approach to the introduction of state-wide routine outcome measurement across all public mental health services is likely to have only limited success. A centrally co-ordinated but locally directed bottom-up approach may be a more successful long-term strategy. Such an approach could make optimum use of a small team of “outcome experts”, while the use of strategies such as the development of local clinical guidelines would increase the co-operation and participation of the wider clinical community. An initial collection of clinical and social demographics could provide important contextual information on service populations and would initiate the administrative and communication networks that would need to be developed for later routine, multi-site data collection. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore young peoples' lived experiences of multidisciplinary mental health assessment in an intensive mental health day program. Method: Interpretative phenomenological analysis (IPA) was applied to data from semi-structured interviews with six males, aged 13–16 years. Member-checking interviews were conducted to ensure the trustworthiness of findings. Results: Analysis revealed three themes, 'therapy fatigue', '360 supports' and 'experiential assessment'. Participants had either attended many years of psychological therapy without significant change or had failed to engage with therapy. Participants' attitudes changed at the day program with intensive support and their own determination. Participants valued experiential elements of assessment such as music therapy and art therapy which helped them understand the service, get to know others and experience positive emotions. Conclusions: Unsuccessful psychological treatment can leave young people feeling jaded and reluctant to engage with services. The potential for iatrogenic harm should be monitored and alternative approaches, such as intensive, multidisciplinary treatment including music therapy and art therapy considered to help young people overcome therapy fatigue, regain hope and reengage with mental health services. [ABSTRACT FROM AUTHOR]

Objective: This paper outlines a rationale for expanding research and clinical innovations focused upon relapse prevention following a first episode of psychosis. Some general principles for further progress are extracted from an overview of the first-episode psychosis (FEP) relapse literature. A cognitive behaviour therapy intervention for relapse prevention for FEP, that has been developed at the Early Psychosis Prevention and Intervention Centre, is described to illustrate these principles. Conclusions: Further progress is needed in refining interventions specific to the prevention of relapse following FEP. Future progress is dependent upon improved understanding of the interaction of biological, interpersonal and psychological processes underpinning relapse. [ABSTRACT FROM AUTHOR]

Objective: To examine laws in three Australian jurisdictions that prohibit therapy to change or suppress a person's sexual orientation or gender identity.Conclusions: The laws in Victoria and the ACT provide inadequate protection for clinically appropriate psychiatric practice and may deprive patients of mental health care. [ABSTRACT FROM AUTHOR]

Art therapy encompasses both preventative and curative activities and aims to improve ways of engaging those who might be reticent in seeking more traditional forms of psychological support offered through ‘talking therapies’. The Longreach base of the Royal Flying Doctor Service in Queensland provides mental health support to people living in rural and remote locations in central western Queensland and has been complemented since 2006 by the addition of a full-time art therapist. This paper provides an overview of art therapy and a description of this innovative approach to addressing mental health needs in a rural and remote setting. [ABSTRACT FROM AUTHOR]

Objectives: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS).Methods: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016.Results: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy.Conclusions: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined how clinicians prepared and used interpreters during psychotherapeutic sessions. Topics covered include the strategies clinicians use to manage the dynamics of this process, factors affecting the provision of psychotherapy using interpreters and the role of the interpreter as a cultural consultant, community advocate and co-therapist.

The article discusses a study which aimed to describe the experiences of LGBT youth who used Rainbow SPARX, a form of computerised therapy for depression. Topics covered include the five main themes of feedback from patients, the suggestion by patients that there should be more sexuality-specific content in the computer program, and the ability of computerised therapies to be successfully modified for groups underserved by mainstream mental health interventions.

Objective: Developing a formulation is an important method of understanding the people we treat. Writing a formulation need not be seen as burdensome or difficult. Our objective is to provide a framework for the formulation process to make it more accessible for beginners.Conclusion: We describe a method that beginners can adopt easily and then build upon as their experience and knowledge broadens. [ABSTRACT FROM AUTHOR]

Objective: To reflect on the humour associated with one's cultural heritage, the mechanisms of humour in the cultures of many, and its role in the processes of psychotherapy. Conclusions: The practice of psychotherapy is enhanced by the therapist who maintains a sense of humour, who appreciates its development in his/her patients, and who respectfully uses it to assist in building the therapeutic alliance. Therapy is not so serious that laughter need be excluded from it. [ABSTRACT FROM AUTHOR]

Objective: Under policies implemented by the Australian Government, the success of community mental health care has increasingly relied upon general practitioners (GPs) assuming an enhanced role in the delivery of evidence-based psychological treatment. In undertaking this role, it is crucial that GPs significantly build upon limited training in evidence-based psychological therapies such as cognitive behaviour therapy (CBT). This pilot study investigates the potential role of CBT group supervision as a training model. Method: Two groups of GPs (n = 9) and one comparison group of psychiatric registrars (n = 4) completed eight 1.5 h sessions of CBT group supervision over an 8 month period. Pre- to post-training measures were taken of GP performance (skills, knowledge and confidence) and the mental health outcomes of their patients. On the completion of group supervision, focus groups were conducted for in-depth feedback. Results: Randomization tests indicated that GPs' confidence and knowledge in using CBT had improved over the course of group supervision. Results from focus groups confirmed that GPs' CBT skills had improved. Conclusions: Findings suggest that group supervision is a promising training model for psychiatry in primary care. Cognitive behaviour therapy should be replaced, however, with a briefer therapy model, such as brief CBT, better suited to a general practice environment. Future research needs to replicate these findings on a larger scale. [ABSTRACT FROM AUTHOR]