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Background:Following the 2010-2011 floods and cyclones that affected 78% of Queensland, Australia, a State-wide mental health response was established. The response plan included a 24-hour access line. This study examines the effectiveness of the mental health screening program conducted via the State-wide health call center (13HEALTH) in 2012.Methods:Callers to the 13HEALTH line were screened to assess the impact of the disaster. The 13HEALTH clinicians administered the Primary Care-Posttraumatic Stress Disorder Scale (PC-PTSD) screening measure. Those scoring more than two on the PC-PTSD Scale were provided information on the emotional impact of disasters and a referral to the post-disaster specialist mental health program (SMHP). For calls related to those under 18, a single-item question assessed behavioral or emotional changes since the natural disasters. Those with identified changes were offered a referral to a post-disaster SMHP.The study evaluates the relationship between disaster exposure and the likelihood of 13HEALTH callers experiencing physical health concerns and unacknowledged mental health symptoms. The program’s cost for the 12 months of 2012 was assessed using data from the financial contract.Results:In 2012, there were 205,064 calls to 13HEALTH: 19,708 identified as residing in a flood or cyclone-affected area, 7,315 adults indicated they were personally affected, and 907 scored more than two on the PC-PTSD Scale. Only 700 agreed to a referral to the SMHP. There were 290 children under 18 assessed as at risk; 207 accepted a referral to a SMHP.Regions that experienced a greater impact from the floods and cyclones were 1.3-2.3 times more likely to report being personally affected by the floods and cyclones. Similarly, these regions had more callers scoring more than two on the PC-PTSD Scale. The total cost of the 13HEALTH program for 2012 was $53,284 (AU) across all age groups.Conclusion:The 13HEALTH general health post-disaster screening program demonstrates opportunistic screening may assist identification of those with unmet mental health needs. The data indicate an increased likelihood of personal exposure in the more affected regions with an increased risk of unrecognized psychological symptoms as assessed by the PC-PTSD Scale. However, more than 20% declined referral to a SMHP.

Correctional officers (COs) work in high-stress environments, frequently experience critical incidents and have shown high levels of burnout. The current review synthesizes and evaluates literature on determinants of CO well-being. The review followed the Joanna Briggs Institute approach for mixed-method systematic reviews. Eligible studies measured subjective or psychological well-being in frontline COs. Studies of disorder absence or nonfrontline COs or associated professions were excluded. Searches of psychology and criminal justice databases including PsycINFO (EBSCOhost) and Criminal Justice (ProQuest) were completed in June 2021, and data were synthesized using a convergent segregated approach. A total of 29 studies were included and explored individual, interpersonal, and organizational determinants of well-being. Key themes identified by thematic synthesis of qualitative research included job satisfaction, personal growth, and coping. COs can experience well-being, however, further research into determinants of CO well-being is required.

OBJECTIVE The current study aimed to assess the new theoretical model of PTG, alongside a measure of posttraumatic stress symptoms (PTSS) due to the ongoing distress that is often experienced by trauma survivors. The study examined the direct pathway to PTG and PTSS through previously identified predictors including core belief disruption, event centrality, and rumination, with the addition of self-disclosure as a predictor variable. METHOD Participants (N = 231) who had experienced a traumatic event were recruited through online forums and completed an anonymous survey. Factor analysis revealed 2 distinct types of disclosure: helpful and unhelpful. Hypotheses were tested using hierarchical regressions. RESULTS The findings supported a combination of event centrality, core-belief disruption, deliberate rumination, and helpful disclosure significantly predicting PTG, with event centrality and unhelpful disclosure being significant predictors of PTSS. CONCLUSIONS The current findings provide support for the direct pathway described in the model of PTG, and that PTSS and PTG share some similar predictors, as well as distinct differences. These findings have the potential to assist clinicians and researchers in recognizing factors that are likely promote the development of PTG. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction:Following natural disasters, rural general practitioners (GPs) are expected to undertake several roles, including identifying those experiencing psychological distress and providing evidence-informed mental health care. This paper reports on a collaborative mental health program developed to support a rural GP practice (population Methods:The program provided specialized disaster mental health care via the placement of a clinician in the GP facility. In collaboration with the GP practice, the program offered opportunistic screening using the Primary Care Posttraumatic Stress Disorder (PTSD) Scale (PC-PTSD) for probable PTSD as the primary measure and the Kessler 6 (K6) as a secondary measure. Those scoring higher than two on the PC-PTSD scale were referred to the mental health clinician (MHC) for further assessment and treatment.Results:Sixty screening assessments were completed. Fourteen patients (male = 3; female = 11) scored higher than two on the PC-PTSD. The referred group PC-PTSD mean score was 3.14 and K6 mean score of 19. Those not referred had a PC-PTSD mean score = 0.72 and K6 mean score = 7.30. The treatment and non-treatment groups differed significantly (PC-PTSD: P Conclusion:A post-disaster integrated GP and mental health program in a rural community can assist in identifying individuals experiencing post-disaster psychological distress using opportunistic psychological screening. The findings indicate that collaborative mental health programs may effectively support rural communities post-disaster.

Intersex people have diverse bodies and identities but are unified by experiences of pathologisation, enduring human rights violations, stigmatisation, and mental health issues stemming from shame ...

Objective Understandings of the biological mechanisms underpinning posttrauma responses are limited. This pilot study aimed to expand research in this area by examining the relationship between DNA methylation of stress genes nuclear receptor subfamily 3 group C member 1 (NR3C1) and FK06 binding protein 5 (FKBP5) with an array of posttrauma responses of posttraumatic stress disorder (PTSD) symptom severity, posttraumatic growth (PTG), and resilience. Method First-year paramedicine students (N = 47) completed self-report measures of PTSD symptom severity, PTG, and resilience and provided a saliva sample for methylation analysis. Surrogate variable analyses identified covariates after which generalized regression models were performed to identify genomic sites significantly associated with PTSD symptom severity, PTG, or resilience. Results Methylation of different FKBP5 and NR3C1 sites was significantly associated with PTSD symptom severity, PTG, and resilience. Methylation in FKBP5 site cg07485685 was a predictor of both PTSD symptom severity and resilience in opposite directions. Conclusions This is the first study investigating methylation changes in PTG, and overall the results suggest that NR3C1 and FKBP5 methylation is associated with both positive and negative posttrauma responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective: Using a cohort of foster and kin carers, the research examined the underlying factor structure of the Parental Stress Scale (PSS; Berry & Jones, 1995). A hypothesized underlying two-dimensional theoretical model was explored. Background: With the growing demands on the foster care system, including poor retention and recruitment of foster carers, there is an urgent need to explore the positive and negative factors that may influence carers continued engagement in the role. Method: The factor structure of the PSS was examined in a sample of foster and kin carers in Australia (N = 324). The PSS consists of 10 statements addressing stressful aspects of parenting and eight statements addressing satisfying aspects of parenting. Exploratory factor analysis (EFA) explored the underlying theoretical structure of the scale as determined by the developers. Confirmatory factor analysis (CFA) was used to confirm whether four factors would sustain reduction to a two-dimensional (satisfaction–stress) model. Results: EFA and CFA supported a two-dimensional moderately correlated model measuring parent stress and parent satisfaction. The Parent Stress Index IV Short Form provided concurrent validity for the PSS stress subscale and previous analyses have also identified the strength of these dimensions over time, cohorts, and contexts. Conclusion: The current study supports using the subscale scores in research with foster carers and potentially other populations to better capture both stress and rewards and satisfaction related to their parenting role. Implications: Application of the PSS subscales can assess interactions or moderating effects of parenting in specific cohorts, making the PSS a valuable instrument to examine the balance between stress and reward for parents, foster parents and others who are “parenting” children.

Background Epigenetic aging is associated with a plethora of negative health outcomes and increased mortality. Yet, the dynamicity of epigenetic age after exposure to trauma and the factors that influence epigenetic age are not fully understood. This research evaluated longitudinal changes in epigenetic age before and after exposure to work-related trauma among paramedicine students. We further investigated psychological and social risk (psychological distress, posttraumatic stress disorder/PTSD symptom severity, professional quality of life) and protective factors (social support and organisational membership) that drive epigenetic aging at both time points. Methods The study comprised of 80 samples of University paramedicine students including 40 individuals at two time points – t0 (baseline) and t1 (post-trauma exposure). Epigenome-wide analysis was performed from t0 and t1 saliva using the Illumina EPIC arrays that cover >860k probes. Data analysis was performed using R via generalized regression models. The epigenetic age was calculated based on the Horvath algorithm, GrimAge and SkinBloodAge were calculated using the Horvath online calculator, and p-value for significance was corrected using the FDR method for multiple testing corrections. Results The epigenetic age at t0 and t1 were highly correlated with chronological age and with each other (r = 0.84–0.94). Baseline epigenetic age and follow-up epigenetic age were significantly associated with risk factors of psychological distress and PTSD symptom severity. Among the protective factors, a sense of psychological organisational membership at the start of the paramedicine course as measured at baseline significantly reduced epigenetic age at baseline and post-trauma exposure. On the other hand, receiving social support acted as a protective factor only after exposure to trauma (follow-up), decreasing epigenetic aging at follow-up. GrimAge acceleration at follow-up was significantly associated with increased PTSD symptom severity at baseline and follow-up. Moreover, increased social support at baseline and follow-up was associated with reduced follow-up GrimAge acceleration. Conclusion These results demonstrate that epigenetic aging is dynamic and changes after exposure to trauma. Additionally, results demonstrate that different risk and protective factors influence epigenetic aging at different times. In conclusion, the research identified risk and protective factors associated with epigenetic aging pre- and post-trauma exposure, with implications for health and well-being among individuals exposed to trauma.

Commercial sexual exploitation affects between 5,000 and 7,000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects; however, there is no published research that focuses on whether healing and growth outcomes are possible for survivors of commercial sexual exploitation. The narratives of 26 girls and women (13–18 years) were taken at two time points during participation in a 6-week group psychoeducation and art therapy program, which was delivered across three nongovernmental organizations in Kathmandu, Nepal. Thematic analysis of the data was undertaken. Themes emerging from Time Point 1 were psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG; new possibilities, relating to others, and personal strength). The themes emerging from Time Point 2, were empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others, and personal strength). These outcomes were seen alongside ongoing distress. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and, if so, ways in which PTG can be facilitated or promoted.

Much research has sought to understand factors that predict both positive and negative posttrauma outcomes. Social support is one factor that has been widely investigated, primarily as a buffer against the negative effects of stressful life events. While receiving social support has claimed much empirical attention attesting to its positive impact on psychological outcomes following exposure to trauma, the influence of giving social support has received less empirical attention. The current study aimed to assess the influence of giving as well as receiving social support on psychological outcomes in two trauma-exposed samples: flood survivors (N = 351) and firefighters (N = 337), controlling for perceptions of trauma severity. The study used the Brief 2-Way SSS, a measure of both receiving and giving, emotional and instrumental support. Results indicated that although giving social support showed a significant bivariate relationship with depression and stress in the firefighter sample, the unique contribution of giving social support was found only for posttraumatic growth. In contrast, the influence of social support on measures of depression, anxiety, and stress was seen through the receipt of social support. These findings provide support for the value of examining both receiving and giving social support, as they may have differential impacts in buffering against the impact of trauma exposure on psychological outcomes.

Research investigating the impacts of raising children with various disabilities has predominantly been cross-sectional and deficit focused. This one-year project used a salutogenic framewo...

This article offers a reflection on how we might co-design with and for care amid the era of digital economy through a critique of current approaches to supporting mental well-being outside of therapy. Lenses of care theory and posttraumatic growth guide this critique, examining six themes of creative approaches that have been identified through a thematic review of 83 existing interventions: online communities, digitisation and re-design of psychology intervention, biometrics and data-driven, creative sharing of stories, symbolic engagements, and creative offerings of comfort and encouragements of self-care. In particular, approaches that lie within the sharing economy are scrutinised, presenting neoliberal drives that oppose its values of fairness and equity. Involvement of trusted others in the co-design of care entanglements is proposed, suggesting that these involvements would allow for reciprocal care encounters to be personalised towards those who have experienced trauma and their trusted others.

Psychological aspects of living with nuclear energy and technology have interested researchers since their inception, yet a review of the research to date is yet to appear. Following an historical overview of the literature highlighting general thematic and methodological trends, this paper reports on a systematised review of qualitative and mixed methods research on psychological aspects of living with nuclear energy and technology. The historical overview shows how early studies focused on the psychological impacts of the atomic bombs, and living with the spectre of nuclear war. Later research often explored psychological aspects of living with civilian technologies such as nuclear power, and was typically quantitative in approach. Recently, the qualitative and mixed methods literature has expanded. In our systematised review, 26 qualitative and mixed methods studies were found to report on psychological experiences such as living near nuclear power plants and living through a nuclear accident, with common themes described including a lack of trust in authorities, the importance of biography in constituting psychological experience, and factors such as familiarity and sense of place in mediating perceptions. The literature as a whole points to the need for further qualitative research in the area, including more in-depth approaches.

With the rising numbers of children in need of out-of-home care, child protection services look to foster and kin carers to play a leading role in the lives of children unable to live with their birth families. The current study examined placement, carer, and child characteristics related to perceived foster parent stress in a sample of 158 foster and kin carers in Queensland, Australia. Carers completed a self-report online survey that assessed parenting stress, and carer perceptions of the child in their care and the child protection system. Overall, foster carers reported high stress, with 20% in the clinical range on the Parenting Stress Index (PSI-4-SF). This stress was significantly higher for those providing care for children with carer-reported high emotional and behavioural problems. Both foster carer stress and the child's emotional and behavioural challenges were significantly related to placement factors, such as, the length of time the child had been in their current placement, and the child protection court order under which the child had been placed. The findings of the study highlight the challenges to caregivers in out-of-home care and the need for individualised services, resources and supports for caregivers under stress.

Background Cultural intelligence reflects the competence to adapt to new cultural settings. Universities offer students various opportunities to gain cultural learning and develop cultural intelligence. However, there has been little empirical research to compare the effects of cultural learning and other related psycho-social factors in this process. Objective This study explores the importance of cultural learning and identifies the unique contribution of cultural education in universities to health care students' cultural intelligence. Design Cross-sectional survey study. Methods 271 health care students completed a survey measuring social desirability, demographics, personality, prior cultural exposure, previous cultural learning and cultural intelligence. Results Hierarchical regressions showed that cultural learning could affect cultural intelligence and its three components (i.e., metacognition, cognition, motivation, and behaviour) under the control for related psycho-social factors. However, its effect on the behavioral component was not significant. Considering the different types of cultural learning, overseas study experiences were more related to cultural intelligence, compared to in-class cultural learning. Conclusion Cultural learning, especially overseas study experiences, plays a significant role in the development of health care students' cultural intelligence.

Introduction Applications or “mobile apps” are a potentially important source of assistance for serving and ex-serving Defence members with mental health problems. PTSD Coach Australia is a modified version of an application developed by the US Department of Veteran Affairs. Clinician perceptions of mobile apps are important as they influence the dissemination and adoption of apps. This study aimed to explore the perceptions of PTSD Coach Australia by clinicians with experience in assisting Defence members with mental health problems. Method The study involved two samples of participants who were asked about their perceptions of PTSD Coach Australia. The first involved 33 clinicians who participated in one of five focus groups. The second comprised 30 clinicians who were individually interviewed by telephone. Qualitative responses to questions regarding PTSD Coach Australia were analysed to identify representative themes. Participants in the focus group sample also rated the app on the user version of the Mobile Apps Rating Scale (uMARS). Results On the uMARS, clinicians rated the mobile app's subjective quality as ‘average’ to ‘good’. Participants generally saw the app as a useful to help track symptoms, improve engagement and help implement strategies between sessions. However, they also expressed concerns with the app not being user-friendly (e.g. too wordy, poor layout/navigation) and having technical issues (freezing or crashing on Android devices). Discussion PTSD Coach Australia is generally seen as being acceptable and useful by mental health clinicians. However, it is important to include their concerns in future developments of PTSD Coach Australia and similar mobile apps in order to maximize their utilisation in Defence members., Highlights • Mental health clinicians rated the PTSD Coach Australia mobile app’s subjective quality as ‘average’ to ‘good’. • Mental health clinicians believe that the app may help clients improve self-awareness and practice coping strategies. • Military apps should address clinician concerns about technical problems, aesthetics and utility for military personnel.

BACKGROUND PTSD Coach Australia is an app for serving and ex-serving defense members and was adapted for the Australian context in 2013 from PTSD Coach, which was created in the United States. OBJECTIVE This study aimed to provide a user-centered evaluation of the app from the perspective of serving and ex-serving members of the Australian Defence Force. METHODS Qualitative data were collected in response to questions to participants in 1 of 5 workshops (n=29) or in telephone interviews (n=24). Quantitative data were collected using the user version of Mobile Apps Rating Scale (uMARS). RESULTS Analysis of the qualitative data demonstrated mixed support for the app. While some people found it extremely useful, especially as an adjunct to therapy, others pointed out limitations and cautioned against the app potentially triggering symptoms in people with PTSD. This perceived risk was usually found to stem from frustration with the app’s functionality rather than its content. Participants spoke about the helpful and unhelpful aspects of the app and barriers to its use and made suggestions for improvement. Many participants encouraged its continued use and highlighted the need for it to be promoted more broadly, as many were not aware of it until they were invited to participate in this research. CONCLUSIONS PTSD Coach Australia was seen in a positive light by some participants, but others thought it had too much text and the potential to trigger a traumatic response in users with PTSD. A need to update the app was also a common comment as was the need to increase awareness of the app’s existence.

Background PTSD Coach Australia is an app for serving and ex-serving defense members and was adapted for the Australian context in 2013 from PTSD Coach, which was created in the United States. Objective This study aimed to provide a user-centered evaluation of the app from the perspective of serving and ex-serving members of the Australian Defence Force. Methods Qualitative data were collected in response to questions to participants in 1 of 5 workshops (n=29) or in telephone interviews (n=24). Quantitative data were collected using the user version of Mobile Apps Rating Scale (uMARS). Results Analysis of the qualitative data demonstrated mixed support for the app. While some people found it extremely useful, especially as an adjunct to therapy, others pointed out limitations and cautioned against the app potentially triggering symptoms in people with PTSD. This perceived risk was usually found to stem from frustration with the app’s functionality rather than its content. Participants spoke about the helpful and unhelpful aspects of the app and barriers to its use and made suggestions for improvement. Many participants encouraged its continued use and highlighted the need for it to be promoted more broadly, as many were not aware of it until they were invited to participate in this research. Conclusions PTSD Coach Australia was seen in a positive light by some participants, but others thought it had too much text and the potential to trigger a traumatic response in users with PTSD. A need to update the app was also a common comment as was the need to increase awareness of the app’s existence.

This study examined the relationships between posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across 10 countries and assessed the factorial invariance of the standardized inventory assessing PTG and PTD, the PTGDI-X, the expansion of the PTGI-X (Tedeschi et al., 2017). We also investigated the roles of social and cognitive factors in PTG and PTD. Data were collected from participants who identified that their most stressful life experience met the definition of trauma in Australia, Germany, Italy, Japan, Nepal, Peru, Poland, Portugal, Turkey, and the US. The participants completed the PTGDI-X and inventories measuring posttraumatic stress disorder symptoms, and predictor variables such as reexamination of core beliefs, centrality of the event, rumination, and disclosures. Results identified universal aspects such as equivalence of factor loadings of the PTGDI-X and the impact of positive/negative disclosure on PTG and PTD. Results also revealed culture-specific aspects, including the relationships between PTG and PTD, and different patterns of cognitive predictors for PTG and PTD. The current study offered the insight that, for the first time using international data, positive and negative post-trauma changes are not likely to be on opposing ends of one dimension, and it is essential to use the PTGDI-X to better understand both positive and negative aspects of post-traumatic experiences.

Australia looks to be one of those lucky countries that adopted an early public health response limiting community transmission of COVID-19 and avoiding the levels of acute hospitalization and fatality seen in other settings. Yet the pandemic came on the back of the largest bushfire season the country had seen which itself followed a sequence of climatic disasters involving drought, cyclones and floods. The social and economic impact of the COVID-19 response has been substantial with widespread loss of employment, social dislocation and health fears sparked across the nation. Findings from risk modeling and population surveillance provide preliminary evidence of increased burden of psychological distress, morbidity and risk of suicide resulting from the current crisis. We also highlight the mental health risk that may arise from increased sedentary behavior with the introduction of lockdown and physical distancing measures. We also outline the potently valuable role of drawing on salutogenic models including resilience and post traumatic growth research for individual and broader community level need. Refereed/Peer-reviewed

Objectives: Natural disasters confront individuals, communities and governments with the challenge of rebuilding and addressing psychosocial sequelae. With the increasing number of natural disasters it is timely to evaluate the efficacy of interventions and strategies to address the mental health needs of individuals and the community. Method: An evaluation of literature related to the psychological impact of natural disasters, treatment efficacy and government strategies to confront the social and psychological impact of natural disasters for the period 1983-2016 was undertaken. Results: Epidemiological studies following natural disasters despite the use of differing psychological measures demonstrate significant psychological morbidity - anxiety (7-42%), complicated grief (28-41%), depression (6.5-38%), post-traumatic stress disorder (11-89%) and substance misuse (1.3-24%). Intervention studies post-disaster demonstrate efficacy variability. Conclusions: The increase in the number and impact of meteorological and hydrological events since the 1980s and the psychological, social and economic consequences of these events has resulted in the development and implementation of government policies to confront the immediate and long-term adverse outcomes. The focus is typically on resources and infrastructure redevelopment with less focus on social and mental health interventions with long-term evaluation of interventions uncommon. The consequence of natural disasters emphasizes the importance developing strategies to ensure effective evaluated psychosocial interventions are available across at-risk communities.

Most people will experience a traumatic event within their lifetime. One commonly recognized response to trauma exposure is posttraumatic stress disorder (PTSD). The biological underpinnings of PTSD, including epigenetic mechanisms of DNA methylation and gene expression, have been studied intensively. However, psychological posttrauma responses vary widely and can include positive outcomes, such as posttraumatic growth (PTG) and, more commonly, resilience. The aim of this systematic review was to summarize the current DNA methylation and gene expression data with respect to three potential posttrauma responses: PTSD, PTG, and resilience. A literature search identified 486 studies, 51 of which were deemed eligible for inclusion (total N = 10,633). All included studies examined PTSD and consistently implicated DNA methylation and gene expression changes in hypothalamic-pituitary-adrenal axis and inflammatory genes. Ten studies acknowledged resilience as a posttrauma response, but only two studies examined epigenetics and gene expression using a scale to measure resilience. Low resilience was associated with gene expression patterns in immune and dopamine genes, and high resilience was associated with a blunted inflammatory response. No studies examined epigenetic or gene expression changes associated with PTG. These findings highlight a focus on pathogenic research, which has failed to adequately acknowledge and measure positive posttrauma outcomes of PTG and resilience. Future research should examine DNA methylation and gene expression changes associated with PTG and resilience in addition to PTSD in order to gain a more comprehensive picture of an individual's well-being following exposure to trauma.

Aim - A standardised tool was needed to measure a generalist dietitian’s confidence about working with clients experiencing psychological issues in order to effectively evaluate mental health-related professional development activities. The aim of this study was to develop, pilot and validate a robust instrument that measures a generalist dietitian’s professional confidence for working with clients experiencing psychological issues. Methods - The Dietetic Confidence Scale (DCS) was developed. Two cross-sectional samples of practicing dietitians (n = 185; 458) from various settings and locations were recruited. Study 1: principal components analysis (PCA) helped refine scale items and derive a model, which was then validated using confirmatory factor analysis (CFA, Study 2). Cronbach’s alpha estimated scale reliability. Correlations assessed associations between factors. Results - Study 1: A 13-item, two-factor solution accounted for 69.1% of the total variance. Total Cronbach’s α = 0.92. Dietetic confidence was associated with: (i) Confidence using the Nutrition Care Process and (ii) Confidence Advocating for Self care and Client care. Study 2: The CFA supported the proposed scale and model. A Good Fit Index of 0.95 indicated a strong fit. Item-factor correlations ranged from r = 0.50 to 0.91. The final scale showed good reliability (α = 0.93). Conclusions - This is the first self-efficacy scale for dietetic practitioners subjected to PCA and CFA using two independent samples. The DCS is a psychometrically robust instrument with strong internal consistency. It can be used to measure dietetic confidence about working with clients experiencing psychological issues and to highlight areas where additional support or training may be needed. Further validity and reliability testing is needed to enhance scale generalisability and use.

The number of children in need of out-of-home care (OOHC) continues to increase in Australia, and numbers of kin carers (relatives of the cared-for) match or exceed those of foster carers. Like foster carers, kin carers have a vital role in OOHC, yet kin carers typically receive less training and fewer support services. The carer role is complex and demanding, and the wellbeing of foster and kin carers is vital to the ongoing provision of OOHC to children who cannot live with their parents. The current research explores the perceived wellbeing of foster and kin carers, with attention to the different experiences of the two groups. A cohort of 210 foster and 116 kin carers completed an online survey that assessed stress, role satisfaction, mental health, perceptions of the child in their care, and access to services that support their role. While overall wellbeing was similar for the two groups, kin carers reported greater stress and mental health concerns than foster carers. The two groups also differed on demographic variables, including the age of the carers, training for the caring role and the length of time they have been in the caregiving role. Furthermore, kin carers reported accessing fewer services, training, and support; and had significantly less contact with service providers as compared to foster carers. In response to the increased number of children placed with kin, government and private service providers need to consider their foster and kin care policies and service delivery practices to include training, support, and access to services for all carers, with specific attention to improving carer wellbeing and satisfaction.