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BackgroundFew studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation. ObjectiveThe intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises. MethodsOver a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only. ResultsA total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3). ConclusionsBoth groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing the clinical impact of the tailored text messages, and utilizing designs with additional power to test for between-group effects.

A previous case-series evaluation of a six-session guided self-help (GSH) approach with 15 people with bulimia nervosa (BN) showed significant reductions across all measures, including binge eating, self-induced vomiting, weight concern, shape concern and dietary restraint. However, the reduction of binge eating and self-induced vomiting was inferior to that achieved in more behavioural approaches. A further 10 people with BN were treated with an eight-session cognitive GSH, where the two extra sessions had a more behavioural focus. Although both conditions significantly decreased levels of binge eating and self-induced vomiting at post-treatment evaluation (with large effect sizes), comparisons of these two GSH conditions showed that an addition of two sessions did not significantly improve outcome on either of the behaviours. Cognitive GSH seems to be a worthwhile candidate for a first-step treatment in BN, but further improvements in this approach can be considered. (Contains 2 tables.)

Objective: This study sought to understand the perspectives of young people (12-25 years) with experience of mental health services on what makes for youth-friendly mental health services. Method: A purposive strategy was used to recruit 32 young people aged 12-25 years with diverse backgrounds, through mental health and youth services. Six semi-structured group interviews were undertaken and one individual interview. We were especially interested in aspects that facilitated or obstructed young people from seeking help, and key experiences across their consumer journey. Transcripts were analysed thematically to identify shared experiences and perspectives across the interviews. Results: Five key themes emerged: the central role that teachers, school counsellors, parents, and friends play in help seeking and responding to crisis; the impact of fear, uncertainty, and stigma in decision-making and engaging with services; finding the right therapist and effective help; ways to improve flexibility and ease of access; the need for better quality consumer information for accessing a mental health service. Discussion: The results of the study have implications for the design of mental health services, providing important insights that can increase young people’s engagement with services, and ultimately, improve the mental health and well-being of young people in Australia. [ABSTRACT FROM AUTHOR]

While it is well recognized that family relationships have a significant impact on child mental health and vice versa, little research has examined the impact of living with a child with mental health problems (MHPs) on family relationships for their siblings. This report aims to synthesize the existing literature and comment on the current state of evidence. An electronic search of publications from 1990 to 2011 was conducted and 22 studies were included. The findings show that families of children with MHPs have less positive (e.g. less supportive) and more negative (e.g. more conflictual, aggressive) sibling relationships and more negative parent-sibling relationships compared to control families. Exceptions were sibling relationships in families of children with conduct disorder (more positive) and anxiety disorders (not significantly different from controls). Limitations of the existing literature include the types of measures used and the use of single informants. Methodological guidelines for future studies are outlined. [ABSTRACT FROM AUTHOR]

Objective: Acne vulgaris is a dynamic, complex condition that is notoriously difficult to evaluate. The authors set out to critically evaluate currently available measures of acne severity, particularly in terms of suitability for use in clinical trials.Design: A systematic review was conducted to identify methods used to measure acne severity, using MEDLINE, CINAHL, Scopus, and Wiley Online. Each method was critically reviewed and given a score out of 13 based on eight quality criteria under two broad groupings of psychometric testing and suitability for research and evaluation.Results: Twenty-four methods for assessing acne severity were identified. Four scales received a quality score of zero, and 11 scored ≤3. The highest rated scales achieved a total score of 6. Six scales reported strong inter-rater reliability (ICC>0.75), and four reported strong intra-rater reliability (ICC>0.75). The poor overall performance of most scales, largely characterized by the absence of reliability testing or evidence for independent assessment and validation indicates that generally, their application in clinical trials is not supported.Conclusion: This review and appraisal of instruments for measuring acne severity supports previously identified concerns regarding the quality of published measures. It highlights the need for a valid and reliable acne severity scale, especially for use in research and evaluation. The ideal scale would demonstrate adequate validation and reliability and be easily implemented for third-party analysis. The development of such a scale is critical to interpreting results of trials and facilitating the pooling of results for systematic reviews and meta-analyses. [ABSTRACT FROM AUTHOR]

Background: Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g. are they assessed for mental health problems? Do they receive appropriate psychological treatment?). Aims: The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e. treatment utilisation). Methods: Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. Results: The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). Conclusions: The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined. [ABSTRACT FROM AUTHOR]