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Objective: Parent-only cognitive-behavioural therapy (CBT) interventions have promise for youth with anxiety disorders. Fear-Less Triple P (FLTP) is one such intervention that has been found comparable to child-focused CBT. Although traditionally administered in six sessions, a one-day workshop format of FLTP was developed to improve accessibility. The current study compared the effectiveness of the six-session and one-day workshop formats. Method: Seventy-three youth (mean age, 8.4 years; 74% male) were randomized to traditional FLTP (6-week group) or the one-day workshop format. Anxiety diagnostic status, self- and parent-reported anxiety symptoms scores, independent evaluator-rated improvement, treatment satisfaction, and measures of family functioning were included to assess treatment outcome. Data were collected prior to treatment, and 1-week, 6-months, and 12-months following treatment. Results: Both conditions resulted in significant improvement in child anxiety symptom scores per parent report (on both questionnaire and diagnostic interview measures). Furthermore, significant decreases in sibling anxiety were observed in both treatment conditions. There were no statistically significant differences between conditions on any outcome measure. Conclusions: Results of this study add to the growing evidence that brief, low-intensity, parent-only interventions can effectively target child psychopathology. These brief interventions are ideal for families for whom the resources and time required to commit to a standard multi-week intervention are prohibitive. Registration of Clinical Trials: This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12615001284550). [ABSTRACT FROM AUTHOR]

To date, limited research has been undertaken regarding the interplay between differentiation of self (DoS), parental involvement, and the prevalence of psychological symptoms in emerging adults (EA) aged between 18 and 25 years in Australia. The current study aims to assess whether there is an association between mental health symptoms, perceptions of parental warmth, involvement, and autonomy support and indicators of DoS, including self‐regulation capacity and emotional reactivity. In a study of 129 undergraduate students aged between 18 and 30 years, greater DoS, involving both lower emotional reactivity and the ability to take an 'I position' in relation to others, was found to be associated with fewer depressive and anxiety symptoms in EA. In addition, EA who demonstrated lower levels of emotional reactivity (higher DoS) had lower scores in depressive and anxiety symptoms. Parenting variables of caregiver warmth and autonomy granting were also found to be related to lower depressive and anxiety symptoms as well as greater DoS in EA. Regression models show that there were main effects for DoS on depressive symptoms; however, parenting behaviours were not found to moderate this relationship. Overall, this research is important as it supports Bowen's (1978) theorising in relation to the relationship between DoS and mental health, and consideration of the contribution of parenting variables to indicators of well‐being in EA. In this, family therapy has a role in educating both young adults and their parents in how best to promote independence and autonomy for improved psychological health. Further research should focus on the complexity of parenting controlling behaviours on mental health symptoms in EA. [ABSTRACT FROM AUTHOR]

Much of the discourse regarding social care practice focuses on the differences between the various professions, practice fields, geographical, and organizational contexts involved in the provision of social care. This study surveyed Australian social care practitioners' (N = 438) perceptions of influence on their practice and what similarities and differences existed in these perceptions. Eighteen influential factors were identified with minimal differences across the participants' profession, practice field, organizational sector, or geographical context. These findings suggest that a common ground of experience exists that can be used as a basis for critical discussions and interdisciplinary practice and, thereby, provide a foundation for more consistent and integrated service delivery and outcomes. [ABSTRACT FROM AUTHOR]

Background Anorexia nervosa (AN) is a prevalent, serious mental disorder. We aimed to evaluate the cost-effectiveness of family-based treatment (FBT) compared to adolescent-focused individual therapy (AFT) or no intervention within the Australian healthcare system. Method A Markov model was developed to estimate the cost and disability-adjusted life-year (DALY) averted of FBT relative to comparators over 6 years from the health system perspective. The target population was 11-18 year olds with AN of relatively short duration. Uncertainty and sensitivity analyses were conducted to test model assumptions. Results are reported as incremental cost-effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Results FBT was less costly than AFT. Relative to no intervention, the mean ICER of FBT and AFT was $5,089 (95% uncertainty interval (UI): dominant to $16,659) and $51,897 ($21,591 to $1,712,491) per DALY averted. FBT and AFT are 100% and 45% likely to be cost-effective, respectively, at a threshold of AUD$50,000 per DALY averted. Sensitivity analyses indicated that excluding hospital costs led to increases in the ICERs but the conclusion of the study did not change. Conclusion FBT is the most cost-effective among treatment arms, whereas AFT was not cost-effective compared to no intervention. Further research is required to verify this result. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine the trajectory of symptom remission and affective functioning throughout the course of two family-based treatments for adolescent anorexia nervosa (AN): conjoint family-based treatment (FBT) and parent-focused treatment (PFT). Method Participants were 107 adolescents ( Mage = 15.5 years, SD = 1.5) with a primary diagnosis of AN who participated in a randomized clinical trial comparing FBT ( N = 55) and PFT ( N = 51). Patient weight and self-reported assessments of dietary restraint and positive and negative affect were recorded at regular intervals throughout treatment. Results Multilevel models revealed increases in weight (β = 0.33, p < .001) and positive affect (β = 0.03, p < .001), and decreases in dietary restraint (β = -0.03, p < .001) and negative affect (β = −0.04, p < .001) over the course of treatment. No significant effects emerged by treatment type. Discussion These findings suggest that PFT may bring about comparable trajectories of weight gain and reduced dietary restraint as conjoint FBT, despite adolescents not being directly involved in treatment. These findings also highlight that the exclusively behavioral focus throughout both PFT and FBT is associated with significant increments in positive affect and significant reductions in negative affect. [ABSTRACT FROM AUTHOR]

Child abuse commonly occurs within the context of multiple risk factors, in particular parental mental health and/or drug and alcohol problems. As no one agency can address all these factors, inter‐agency collaboration is paramount to the protection of vulnerable children, especially in families with a complex array of problems. This paper outlines a range of recommendations to improve collaboration between child protection workers and mental health/drug & alcohol (MH/D&A) clinicians from the perspective of Keep Them Safe‐Whole Family Team (KTS‐WFT) clinicians. Taking referrals from child protection, the KTS‐WFT offers interventions to families with parental MH/D&A problems where there are child protection concerns. As part of a larger evaluation of a KTS‐WFT site, 10 KTS‐WFT clinicians participated in in‐depth interviews. Analysis of the interviews identified collaboration with child protection as a primary theme. Participants reported a number of barriers to effective collaboration; in particular, participants reported challenges with information sharing and confidentiality, inconsistency in terms of the level and style of collaboration, tensions between the different theoretical paradigms that underpin practice for MH/D&A clinicians vs. child protection workers, and insufficient clarity around processes and expectations. Consistent with the identified barriers, primary recommendations to improve collaboration were to improve information sharing, overcome silo ways of thinking, manage risk together more consistently, and develop consistent processes and expectations. [ABSTRACT FROM AUTHOR]

Objective Anorexia nervosa (AN) is often first diagnosed in the adolescent years. The treatment with the greatest evidence during this time is family-based treatment (FBT). In FBT, siblings are expected to attend treatment sessions; however, sibling well-being during this time has not been well researched. This study aimed to explore sibling well-being when the ill child was initially diagnosed with AN and after FBT had been completed. Method Eighty-five parents and 55 siblings of adolescents with AN completed the Strengths and Difficulties Questionnaire at diagnosis. In addition, 88 parents and 46 siblings completed the Strengths and Difficulties Questionnaire after finishing treatment. Results Mothers and fathers reported siblings to have lower levels of conduct problems in comparison with population norms. Mothers also reported lower levels of prosocial behaviours. Siblings reported higher levels of emotional difficulties and hyperactivity in comparison with their peers. There were no differences in reported psychosocial well-being of siblings between diagnosis and following FBT. Conclusions Siblings of adolescents with AN have poorer psychosocial adjustment than their peers, both before and after FBT. Clinicians and parents are encouraged to be aware of sibling difficulties and seek additional support if required. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To Identify whether early weight gain in family-based treatment (FBT) predicted greater weight and remission at end of FBT and 12-month follow-up. Method Eighty-two adolescents, with anorexia nervosa, participated in a randomized control trial comparing brief hospitalization for medical stabilization and hospitalization for weight restoration to 90% expected body weight (EBW) (1:1), followed by 20 sessions of FBT. Sixty-nine completed trial protocol. Receiver operating characteristic analyses were conducted investigating whether early weight-gain in FBT predicted outcomes at end of FBT and 12-month follow-up. Participants were analyzed according to their original randomization and as a combined set. Binary logistic regression was used to control for randomization arm effect in combined set analysis. Results Weight gain greater than 1.8 kg at FBT Session 4 predicted greater %EBW (99.18 SD = 6.93 vs. 92.79 SD = 7.74, p < .05) and remission at end of FBT (46% vs. 11%, p < .05) and at 12-month follow-up (64% vs. 36%, p = .05). Binary logistic regression confirmed weight gain greater than 1.8 kg predicted remission ( p < .05) while treatment arm randomization did not add significantly to the model. Discussion Early weight gain has potential to distinguish likely responders in FBT from those who may need more intensive intervention to achieve remission offering the potential to improve outcomes. © 2015 Wiley Periodicals, Inc (Int J Eat Disord 2015; 48:919-922). [ABSTRACT FROM AUTHOR]

There is little published data on the prevalence of psychological distress among individuals and couples seeking counselling and mediation services from non-government organisations ( NGOs). This national cross-sectional study establishes the prevalence of psychological distress among clients seeking family and relationship counselling and mediation services from Relationships Australia. A national sample of 1,365 clients attending services in April to May 2012 completed the 10-item Kessler Psychological Distress Scale ( K10) after their first counselling or mediation session. Individual counselling ( M = 23.01, SD = 8.97, 95% CI [22.05-23.97]) and couple counselling ( M = 21.63, SD = 8.10, [20.86-22.41]) clients reported a mean K10 score comparable to those reported by clinical studies of clients with anxiety or affective disorders. One quarter to one fifth of these clients reported very high psychological distress. Clients accessing mediation services had a mean score of 18.13 ( SD = 7.76; [17.51-18.75]), and one tenth of clients reported very high distress. These elevated rates of very high psychological distress suggest that mental health issues may be a significant problem for a large proportion of clients accessing counselling and mediation NGO services provided under Family Support Programs ( FSP) funding. Implications for screening for mental health and appropriate treatment planning are discussed. [ABSTRACT FROM AUTHOR]