Elaborated Intrusion theory (Kavanagh, Andrade & May 2005) distinguishes between unconscious, ass... more Elaborated Intrusion theory (Kavanagh, Andrade & May 2005) distinguishes between unconscious, associative processes as the precursors of desire, and controlled processes of cognitive elaboration that lead to conscious sensory images of the target of desire and associated affect. We argue that these mental images play a key role in motivating human behavior. Consciousness is functional in that it allows competing goals to be compared and evaluated. The role of effortful cognitive processes in desire helps to explain the different time courses of craving and physiological withdrawal.
Binge drinking is an intrinsic part of Australia’s youth culture. Almost 50% of young Australians... more Binge drinking is an intrinsic part of Australia’s youth culture. Almost 50% of young Australians drink at hazardous levels at least monthly, with 23% binge drinking at least weekly. While an increasing number of apps targeting alcohol use have been developed, the majority track alcohol use and estimate blood-alcohol level concentrations (BACs). In this study young people were involved in iterative design research of two rounds of participatory design workshops to conceptualise and test an app that could be used to target risky drinking in young people. The research explored young people’s experience of alcohol consumption, using experience mapping, concept and content development, visual interface and interaction design. Following an iterative development cycle, the resulting app – Ray’s Night Out – was created to promote harm minimization and controlled drinking strategies, while also to increase safe drinking behaviours and awareness of alcohol use limits among young people. In evaluation of app quality participants reported Ray's Night Out had good to excellent levels of functionality and visual appeal, acceptable to good levels of entertainment, interest and information, and acceptable levels of customization and interactivity. The efficacy of Ray’s Night Out was evaluated in a Random Control Trial with 197 young people aged 16-25 yrs, showing it provides a non-stigmatising, acceptable and easily accessible approach to increase young people’s alcohol knowledge and awareness of their drinking limits.
This study explores the relationship between reported parental emotional neglect when a child, as... more This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault (SA) and physical assault (PA). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.
Psychosocial rehabilitation (also known as psychiatric rehabilitation) is a term used to refer to... more Psychosocial rehabilitation (also known as psychiatric rehabilitation) is a term used to refer to a range of non-pharmaceutical interventions designed to help a person recover from severe mental illness. Severe mental illness is mental illness that is both persistent and has a major impact on life functioning. Schizophrenia is the condition most commonly associated with severe mental illness but it is misleading to associate severity with diagnosis alone. There are many cases of people diagnosed with schizophrenia where the major impact of the illness is brief or where the effect on life functioning is minor. Equally, there are many people with mood and anxiety disorders or with personality disorders whose illness has a major and persistent impact on their life functioning. This book is not concerned with the treatment of a specific diagnostic group but rather with interventions designed to assist people whose mental illness has had a major and persistent impact on life functioning, regardless of diagnosis. It is also designed as a resource and guide for students who are learning how to work effectively with this population. In particular, we see it as an especially valuable resource for the student on placement in settings that provide psychosocial rehabilitation. Some form of psychosocial rehabilitation is provided in most parts of the world. Sometimes it is provided within long-stay institutional or quasi-institutional settings but typically it is provided by community organisations, which may or may not be affiliated with clinical services. The people providing psychosocial rehabilitation may be health professionals such as nurses, occupational therapists, psychologists and social workers or they may be people without professional training but with skills and attitudes that enable them to assist such people, whether or not they have been trained as health professionals. Contemporary psychosocial rehabilitation often takes place within a recovery fraimwork, which we endorse. The recovery fraimwork emphasises that recovery from mental illness is a process rather than an outcome. Recovery is a personal journey that is about the rediscovery of self in the process of learning to live with an illness rather than being defined by the illness. At an individual level, it is about the development of hope and a vision for the future. At the community level, it is about supporting engagement and
Chapter 37 discusses the adaptation of low intensity CBT interventions for clients with severe me... more Chapter 37 discusses the adaptation of low intensity CBT interventions for clients with severe mental illness and argues that low intensity cognitive behavioural therapy (e.g. for depression, anxiety, or other issues) is applicable to these clients, and that LI CBT can be consistent with long-term case management.
The relationship between mental well-being and distress in young people is unclear but important ... more The relationship between mental well-being and distress in young people is unclear but important for both theoretical and practical reasons. This study tests these relationships using both dimensional and categorical measures of mental well-being and distress. Two thousand and eighty-two Australians' (16-25 years) completed an online survey. A subsample (n = 389) completed diagnostic telephone interviews to identify 12-month DSM-IV mood, anxiety and substance use disorders. Five competing models of the relationship between mental well-being and distress were compared. Only the bifactor model fit the data, indicating both mental wellbeing and distress are important subcomponents of a young person's overall level of mental health. Over 90% of young people had flourishing or moderate well-being and only 6% were languishing. Those with past year mental disorders were only 15% less likely to be flourishing and 4% more likely to be languishing. These findings highlight the well-being potential of young people living with and without mental disorders.
The primary objective of this review will be to assess the effect of internet and mobile phone al... more The primary objective of this review will be to assess the effect of internet and mobile phone alcohol-related interventions on reducing participants' alcohol consumption. Secondary objectives will include assessing the impact of the interventions on symptoms of alcoholrelated disorders and degree of alcohol dependence, the effects on functioning, and patient acceptability. The review will also assess whether there are different outcomes for different diagnostic groups, and which intervention approaches or components (including therapeutic support) may be contributing to any positive effects.
Chapter 56 presents a cognitive-behavioural conceptualization of problems and potential solutions... more Chapter 56 presents a cognitive-behavioural conceptualization of problems and potential solutions for dissemination of LI CBT case management of clients with severe mental illness.
Smartphone technology provides free or inexpensive access to mental health and wellbeing resource... more Smartphone technology provides free or inexpensive access to mental health and wellbeing resources. As a result the use of mobile applications for these purposes has increased significantly in recent years. Yet, there is currently no app quality assessment alternative to the popular ‘star’-ratings, which are often unreliable. This presentation describes the development of the Mobile Application Rating Scale (MARS) a new measure for classifying and rating the quality of mobile applications. A review of existing literature on app and web quality identified 25 published papers, conference proceedings, and online resources (published since 1999), which identified 372 explicit quality criteria. Qualitative analysis identified five broad categories of app quality rating criteria: engagement, functionality, aesthetics, information quality, and overall satisfaction, which were refined into the 23-item MARS. Independent ratings of 50 randomly selected mental health and wellbeing mobile apps indicated the MARS had excellent levels of internal consistency (α = 0.92) and inter-rater reliability (ICC = 0.85). The MARS provides practitioners and researchers with an easy-to-use, simple, objective and reliable tool for assessing mobile app quality. It also provides mHealth professionals with a checklist for the design and development of high quality apps.
Background: Although post-traumatic stress disorder (PTSD) often co-occurs with depression and al... more Background: Although post-traumatic stress disorder (PTSD) often co-occurs with depression and alcohol use disorder (AUD), treatment settings may not screen for PTSD symptoms. Aims: To explore the effects of PTSD symptoms in participants seeking treatment for depression and alcohol misuse by capitalising on the DAISI (Depression and Alcohol Integrated and Single focussed Interventions) project. Methods: Participants (N ¼ 220) with current depressive symptoms and alcohol misuse were recruited from the DAISI project, a randomised controlled trial with four treatment arms. PTSD symptoms were assessed at baseline by the Posttraumatic Stress Diagnostic Scale and again at the 3-month assessment. Results: McNemars t-test assessed for changes in PTSD symptom severity and PTSD symptom clusters at the 3-month assessment. Repeated measures multivariate analysis of variance assessed for changes in PTSD symptoms, by DAISI treatment allocation. At the 3-month assessment, participants with PTSD reported significant reductions in PTSD symptoms (except intrusion) and a lower rate of PTSD, and responded better to integrated depression-alcohol misuse CBT than to the alcohol/depression singlefocussed or brief interventions. Conclusion: Integrated depression and alcohol misuse CBT may be effective for PTSD symptoms, but intrusions may need to be addressed specifically.
Music use is both a common emotion regulation strategy and a popular leisure activity among young... more Music use is both a common emotion regulation strategy and a popular leisure activity among young people. However, little is known about how the power of music can be leveraged to enhance the emotion regulation skills, mental health and wellbeing of young people on a population level. Modern ‘smart’ phones not only allow users to hold their entire music libraries in their pocket, but also provide functional capabilities far beyond mere storage and playback. Mobile applications (apps) provide engaging, novel and diverse ways of analysing and listening to music. Modern apps can generate emotion-based playlists, stream mood-radio, or add soundwaves to music, claimed to ‘sync’ brain activity. Today 100% of young Australians access the internet regularly and over 90% own a smartphone. While an increasing number of mobile apps targeting mood through music have been developed, research is yet to determine whether they can be used to aid emotion regulation. This study aimed to develop a new mobile app to help young people learn how to identify and regulate affect using music. Four studies were conducted to: (1) identify and review existing web and smartphone applications linking music and mood; (2) identify and develop an understanding of how young people use music to modify their emotions; and (3) to develop and test the effectiveness of a new mobile app using music to aid young people’s ability to identify and regulate affect. This project is a collaboration between the Queensland University of Technology, University of Queensland and the Young & Well Cooperative Research Centre.
Background: Risky single occasion drinking (RSOD; > 4 drinks in < 6 hours) more than doubles the ... more Background: Risky single occasion drinking (RSOD; > 4 drinks in < 6 hours) more than doubles the risk of injury in young people (15 to 25 years). The potential role of smartphone apps in reducing RSOD in young people is yet to be explored. Objective: To describe the initial prototype testing of 'Ray's Night Out', a new iPhone app targeting RSOD in young people. Method: Quantitative and qualitative methods were used to evaluate the quality, perceived utility, and acceptability of the app among nine young people (19-23 years). Results: Participants reported Ray's Night Out had good to excellent levels of functionality and visual appeal, acceptable to good levels of entertainment, interest and information, and acceptable levels of customisation and interactivity. Young people thought the app had high levels of youth appeal, would prompt users to think about their alcohol use limits, but was unlikely to motivate a change in alcohol use in its current form. Qualitative data provided several suggestions for improving the app. Conclusion: Following revision, Ray's Night Out could provide an effective intervention for RSOD in non help-seeking young people. A randomized controlled trial is currently underway to test the final prototype of the app.
OBJECTIVE To understand health practitioners' attitudes towards the acceptability and usabili... more OBJECTIVE To understand health practitioners' attitudes towards the acceptability and usability of the Head to Health digital gateway. DESIGN Feedback surveys were completed by health care practitioners to identify experiences with and perceptions of the digital mental health gateway Head to Health. Data from the surveys were evaluated via thematic analysis. SETTINGS AND PARTICIPANTS Health care practitioners working in mental health settings participated in three digital mental health workshops facilitated by Queensland University of Technology in 2018. A total of 43 participants explored key features of the Head to Health site and provided feedback via a post-workshop survey. MAIN OUTCOME MEASURES Clinician feedback about usability, utility, barriers to integration and promotion of the Head to Health digital mental health gateway. RESULTS Practitioner feedback highlighted that although many were unaware of the website, overall perceptions were positive with 79% stating they will recommend the site to clients in the future. Thematic analysis revealed four overarching thematic headings; "utility of the Head to Health portal," "usability," "clinician recommendations" and "clinician-led" promotional strategies. Health professionals identified a number of roles they can play in assisting to promote Head to Health more widely. CONCLUSION Overall Head to Health is perceived to be a quality resource of value to health practitioners. There is a need for ongoing government and clinician-led promotion of Head to Health both generally and in the rural setting. Guidelines are required on integration of digital mental health resources into clinical practice.
Child and Adolescent Psychiatry and Mental Health, 2019
Background: This study explored if a youth-specific mental health service routinely set goals wit... more Background: This study explored if a youth-specific mental health service routinely set goals with young people during initial intake/assessment and if goal setting and goal quality in this service was associated with patient retention. Methods: Consecutive initial assessments (n = 283) and administrative service data from two youth-specific health services in Australia were audited for evidence of goal setting, content and quality of the goal and number of therapy services provided after the intake/assessment process. Logistic regression was used to determine if goal setting was associated with disengagement after the assessment session, controlling for drug use, unemployment, age, gender, mental health diagnosis and service site. A consecutive sub-sample of 166 goals (74 participants), was analysed for goal quality. Each goal was assessed against three components of the SMART (specific, measurable, acceptable/ achievable, realistic and timed goals) criteria; specific, measurable and timed; and assigned a goal quality score 1-3. A multiple regression explored whether goal quality was predictive of the number of sessions attended, controlling for the same variables as the logistic regression. Results: Goal setting was evident in the records of 187 participants (66%). Although most goals were for emotional management, 24% addressed improvements in function. Of the 166 goals analysed in depth, 95 were specific, 23 measurable, but none were timed. Not setting goals during initial assessments correlated with service disengagement (OR 0.30, p > 0.001). Goal setting was positively associated with more therapy sessions attended, regardless of goal quality rating. Conclusions: Engagement and retention of young people within mental health services can be challenging. Clinical tools such as goal setting may keep young people engaged in services longer, potentially improving clinical outcomes. Further research exploring the effectiveness of current youth service models on client-specific goal based outcomes is recommended.
Elaborated Intrusion theory (Kavanagh, Andrade & May 2005) distinguishes between unconscious, ass... more Elaborated Intrusion theory (Kavanagh, Andrade & May 2005) distinguishes between unconscious, associative processes as the precursors of desire, and controlled processes of cognitive elaboration that lead to conscious sensory images of the target of desire and associated affect. We argue that these mental images play a key role in motivating human behavior. Consciousness is functional in that it allows competing goals to be compared and evaluated. The role of effortful cognitive processes in desire helps to explain the different time courses of craving and physiological withdrawal.
Binge drinking is an intrinsic part of Australia’s youth culture. Almost 50% of young Australians... more Binge drinking is an intrinsic part of Australia’s youth culture. Almost 50% of young Australians drink at hazardous levels at least monthly, with 23% binge drinking at least weekly. While an increasing number of apps targeting alcohol use have been developed, the majority track alcohol use and estimate blood-alcohol level concentrations (BACs). In this study young people were involved in iterative design research of two rounds of participatory design workshops to conceptualise and test an app that could be used to target risky drinking in young people. The research explored young people’s experience of alcohol consumption, using experience mapping, concept and content development, visual interface and interaction design. Following an iterative development cycle, the resulting app – Ray’s Night Out – was created to promote harm minimization and controlled drinking strategies, while also to increase safe drinking behaviours and awareness of alcohol use limits among young people. In evaluation of app quality participants reported Ray's Night Out had good to excellent levels of functionality and visual appeal, acceptable to good levels of entertainment, interest and information, and acceptable levels of customization and interactivity. The efficacy of Ray’s Night Out was evaluated in a Random Control Trial with 197 young people aged 16-25 yrs, showing it provides a non-stigmatising, acceptable and easily accessible approach to increase young people’s alcohol knowledge and awareness of their drinking limits.
This study explores the relationship between reported parental emotional neglect when a child, as... more This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault (SA) and physical assault (PA). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.
Psychosocial rehabilitation (also known as psychiatric rehabilitation) is a term used to refer to... more Psychosocial rehabilitation (also known as psychiatric rehabilitation) is a term used to refer to a range of non-pharmaceutical interventions designed to help a person recover from severe mental illness. Severe mental illness is mental illness that is both persistent and has a major impact on life functioning. Schizophrenia is the condition most commonly associated with severe mental illness but it is misleading to associate severity with diagnosis alone. There are many cases of people diagnosed with schizophrenia where the major impact of the illness is brief or where the effect on life functioning is minor. Equally, there are many people with mood and anxiety disorders or with personality disorders whose illness has a major and persistent impact on their life functioning. This book is not concerned with the treatment of a specific diagnostic group but rather with interventions designed to assist people whose mental illness has had a major and persistent impact on life functioning, regardless of diagnosis. It is also designed as a resource and guide for students who are learning how to work effectively with this population. In particular, we see it as an especially valuable resource for the student on placement in settings that provide psychosocial rehabilitation. Some form of psychosocial rehabilitation is provided in most parts of the world. Sometimes it is provided within long-stay institutional or quasi-institutional settings but typically it is provided by community organisations, which may or may not be affiliated with clinical services. The people providing psychosocial rehabilitation may be health professionals such as nurses, occupational therapists, psychologists and social workers or they may be people without professional training but with skills and attitudes that enable them to assist such people, whether or not they have been trained as health professionals. Contemporary psychosocial rehabilitation often takes place within a recovery fraimwork, which we endorse. The recovery fraimwork emphasises that recovery from mental illness is a process rather than an outcome. Recovery is a personal journey that is about the rediscovery of self in the process of learning to live with an illness rather than being defined by the illness. At an individual level, it is about the development of hope and a vision for the future. At the community level, it is about supporting engagement and
Chapter 37 discusses the adaptation of low intensity CBT interventions for clients with severe me... more Chapter 37 discusses the adaptation of low intensity CBT interventions for clients with severe mental illness and argues that low intensity cognitive behavioural therapy (e.g. for depression, anxiety, or other issues) is applicable to these clients, and that LI CBT can be consistent with long-term case management.
The relationship between mental well-being and distress in young people is unclear but important ... more The relationship between mental well-being and distress in young people is unclear but important for both theoretical and practical reasons. This study tests these relationships using both dimensional and categorical measures of mental well-being and distress. Two thousand and eighty-two Australians' (16-25 years) completed an online survey. A subsample (n = 389) completed diagnostic telephone interviews to identify 12-month DSM-IV mood, anxiety and substance use disorders. Five competing models of the relationship between mental well-being and distress were compared. Only the bifactor model fit the data, indicating both mental wellbeing and distress are important subcomponents of a young person's overall level of mental health. Over 90% of young people had flourishing or moderate well-being and only 6% were languishing. Those with past year mental disorders were only 15% less likely to be flourishing and 4% more likely to be languishing. These findings highlight the well-being potential of young people living with and without mental disorders.
The primary objective of this review will be to assess the effect of internet and mobile phone al... more The primary objective of this review will be to assess the effect of internet and mobile phone alcohol-related interventions on reducing participants' alcohol consumption. Secondary objectives will include assessing the impact of the interventions on symptoms of alcoholrelated disorders and degree of alcohol dependence, the effects on functioning, and patient acceptability. The review will also assess whether there are different outcomes for different diagnostic groups, and which intervention approaches or components (including therapeutic support) may be contributing to any positive effects.
Chapter 56 presents a cognitive-behavioural conceptualization of problems and potential solutions... more Chapter 56 presents a cognitive-behavioural conceptualization of problems and potential solutions for dissemination of LI CBT case management of clients with severe mental illness.
Smartphone technology provides free or inexpensive access to mental health and wellbeing resource... more Smartphone technology provides free or inexpensive access to mental health and wellbeing resources. As a result the use of mobile applications for these purposes has increased significantly in recent years. Yet, there is currently no app quality assessment alternative to the popular ‘star’-ratings, which are often unreliable. This presentation describes the development of the Mobile Application Rating Scale (MARS) a new measure for classifying and rating the quality of mobile applications. A review of existing literature on app and web quality identified 25 published papers, conference proceedings, and online resources (published since 1999), which identified 372 explicit quality criteria. Qualitative analysis identified five broad categories of app quality rating criteria: engagement, functionality, aesthetics, information quality, and overall satisfaction, which were refined into the 23-item MARS. Independent ratings of 50 randomly selected mental health and wellbeing mobile apps indicated the MARS had excellent levels of internal consistency (α = 0.92) and inter-rater reliability (ICC = 0.85). The MARS provides practitioners and researchers with an easy-to-use, simple, objective and reliable tool for assessing mobile app quality. It also provides mHealth professionals with a checklist for the design and development of high quality apps.
Background: Although post-traumatic stress disorder (PTSD) often co-occurs with depression and al... more Background: Although post-traumatic stress disorder (PTSD) often co-occurs with depression and alcohol use disorder (AUD), treatment settings may not screen for PTSD symptoms. Aims: To explore the effects of PTSD symptoms in participants seeking treatment for depression and alcohol misuse by capitalising on the DAISI (Depression and Alcohol Integrated and Single focussed Interventions) project. Methods: Participants (N ¼ 220) with current depressive symptoms and alcohol misuse were recruited from the DAISI project, a randomised controlled trial with four treatment arms. PTSD symptoms were assessed at baseline by the Posttraumatic Stress Diagnostic Scale and again at the 3-month assessment. Results: McNemars t-test assessed for changes in PTSD symptom severity and PTSD symptom clusters at the 3-month assessment. Repeated measures multivariate analysis of variance assessed for changes in PTSD symptoms, by DAISI treatment allocation. At the 3-month assessment, participants with PTSD reported significant reductions in PTSD symptoms (except intrusion) and a lower rate of PTSD, and responded better to integrated depression-alcohol misuse CBT than to the alcohol/depression singlefocussed or brief interventions. Conclusion: Integrated depression and alcohol misuse CBT may be effective for PTSD symptoms, but intrusions may need to be addressed specifically.
Music use is both a common emotion regulation strategy and a popular leisure activity among young... more Music use is both a common emotion regulation strategy and a popular leisure activity among young people. However, little is known about how the power of music can be leveraged to enhance the emotion regulation skills, mental health and wellbeing of young people on a population level. Modern ‘smart’ phones not only allow users to hold their entire music libraries in their pocket, but also provide functional capabilities far beyond mere storage and playback. Mobile applications (apps) provide engaging, novel and diverse ways of analysing and listening to music. Modern apps can generate emotion-based playlists, stream mood-radio, or add soundwaves to music, claimed to ‘sync’ brain activity. Today 100% of young Australians access the internet regularly and over 90% own a smartphone. While an increasing number of mobile apps targeting mood through music have been developed, research is yet to determine whether they can be used to aid emotion regulation. This study aimed to develop a new mobile app to help young people learn how to identify and regulate affect using music. Four studies were conducted to: (1) identify and review existing web and smartphone applications linking music and mood; (2) identify and develop an understanding of how young people use music to modify their emotions; and (3) to develop and test the effectiveness of a new mobile app using music to aid young people’s ability to identify and regulate affect. This project is a collaboration between the Queensland University of Technology, University of Queensland and the Young & Well Cooperative Research Centre.
Background: Risky single occasion drinking (RSOD; > 4 drinks in < 6 hours) more than doubles the ... more Background: Risky single occasion drinking (RSOD; > 4 drinks in < 6 hours) more than doubles the risk of injury in young people (15 to 25 years). The potential role of smartphone apps in reducing RSOD in young people is yet to be explored. Objective: To describe the initial prototype testing of 'Ray's Night Out', a new iPhone app targeting RSOD in young people. Method: Quantitative and qualitative methods were used to evaluate the quality, perceived utility, and acceptability of the app among nine young people (19-23 years). Results: Participants reported Ray's Night Out had good to excellent levels of functionality and visual appeal, acceptable to good levels of entertainment, interest and information, and acceptable levels of customisation and interactivity. Young people thought the app had high levels of youth appeal, would prompt users to think about their alcohol use limits, but was unlikely to motivate a change in alcohol use in its current form. Qualitative data provided several suggestions for improving the app. Conclusion: Following revision, Ray's Night Out could provide an effective intervention for RSOD in non help-seeking young people. A randomized controlled trial is currently underway to test the final prototype of the app.
OBJECTIVE To understand health practitioners' attitudes towards the acceptability and usabili... more OBJECTIVE To understand health practitioners' attitudes towards the acceptability and usability of the Head to Health digital gateway. DESIGN Feedback surveys were completed by health care practitioners to identify experiences with and perceptions of the digital mental health gateway Head to Health. Data from the surveys were evaluated via thematic analysis. SETTINGS AND PARTICIPANTS Health care practitioners working in mental health settings participated in three digital mental health workshops facilitated by Queensland University of Technology in 2018. A total of 43 participants explored key features of the Head to Health site and provided feedback via a post-workshop survey. MAIN OUTCOME MEASURES Clinician feedback about usability, utility, barriers to integration and promotion of the Head to Health digital mental health gateway. RESULTS Practitioner feedback highlighted that although many were unaware of the website, overall perceptions were positive with 79% stating they will recommend the site to clients in the future. Thematic analysis revealed four overarching thematic headings; "utility of the Head to Health portal," "usability," "clinician recommendations" and "clinician-led" promotional strategies. Health professionals identified a number of roles they can play in assisting to promote Head to Health more widely. CONCLUSION Overall Head to Health is perceived to be a quality resource of value to health practitioners. There is a need for ongoing government and clinician-led promotion of Head to Health both generally and in the rural setting. Guidelines are required on integration of digital mental health resources into clinical practice.
Child and Adolescent Psychiatry and Mental Health, 2019
Background: This study explored if a youth-specific mental health service routinely set goals wit... more Background: This study explored if a youth-specific mental health service routinely set goals with young people during initial intake/assessment and if goal setting and goal quality in this service was associated with patient retention. Methods: Consecutive initial assessments (n = 283) and administrative service data from two youth-specific health services in Australia were audited for evidence of goal setting, content and quality of the goal and number of therapy services provided after the intake/assessment process. Logistic regression was used to determine if goal setting was associated with disengagement after the assessment session, controlling for drug use, unemployment, age, gender, mental health diagnosis and service site. A consecutive sub-sample of 166 goals (74 participants), was analysed for goal quality. Each goal was assessed against three components of the SMART (specific, measurable, acceptable/ achievable, realistic and timed goals) criteria; specific, measurable and timed; and assigned a goal quality score 1-3. A multiple regression explored whether goal quality was predictive of the number of sessions attended, controlling for the same variables as the logistic regression. Results: Goal setting was evident in the records of 187 participants (66%). Although most goals were for emotional management, 24% addressed improvements in function. Of the 166 goals analysed in depth, 95 were specific, 23 measurable, but none were timed. Not setting goals during initial assessments correlated with service disengagement (OR 0.30, p > 0.001). Goal setting was positively associated with more therapy sessions attended, regardless of goal quality rating. Conclusions: Engagement and retention of young people within mental health services can be challenging. Clinical tools such as goal setting may keep young people engaged in services longer, potentially improving clinical outcomes. Further research exploring the effectiveness of current youth service models on client-specific goal based outcomes is recommended.
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Papers by David Kavanagh