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Introduction: Prevalence of distress in cancer patients is established at approximately 50%, yet uptake of psychosocial support is minimal. Objective: This study aimed to understand why clinically distressed oncology patients choose not to access psychosocial support, including whether this differs by geographic location. It also aimed to determine the proportion of rural and metropolitan patients experiencing clinical levels of distress, and of these, the proportion who do not wish to access support. Design: The study used a cross‐sectional design. Two hundred and ninety‐eight Australian cancer patients completed an online survey, including the Distress Thermometer and open‐ended questions about reasons for declining support. Descriptive statistics and content analysis were used to analyse the data. Findings: More than half (56%) of participants reported experiencing clinically significant levels of distress. Of these, almost half (47%) declined psychosocial support. Content analysis of reasons for declining psychosocial support resulted in six main concepts: I don't need support; I'm using personal resources to cope; negative perceptions and attitudes; life doesn't stop for cancer; I'm focussed on fighting cancer; and systemic barriers. Rural cancer patients most often indicated using personal resources to cope, while metropolitan participants most commonly indicated not needing support. A range of subconcepts were also identified. Perceiving distress as manageable or transient was almost exclusively reported by metropolitan participants, while stigma was almost exclusively reported by rural participants. Discussion: The findings provided greater depth of insight into reasons cancer patients decline psychosocial support and identified several qualitative differences in the reasons provided by metropolitan and rural patients. Recommendations are provided for clinicians, in particular for clinicians who work with rural cancer patients and their supporters. Conclusion: These findings can inform equitable resourcing of psychosocial support in rural areas and the adaptation of psychosocial interventions to be more flexible and responsive to individual needs. This may help increase patient uptake of support, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Purpose. To examine psychosocial and well-being concerns throughout the cancer experience, from prediagnosis to survivorship. Whilst most oncology research focuses on patients, the role and experiences of families and caregivers are increasingly recognised as a core component of health service delivery. Moreover, research suggests that geography is an important consideration, with evidence of rural inequities in health service provision and access. Aims. (i) To examine the unique patient and caregiver experiences of rural people in three rural cancer treatment centres in New South Wales (NSW) and (ii) to examine the barriers to rural patients and caregivers accessing psycho-oncological support in NSW. Methods. A convergent parallel mixed-method evaluation of the psychosocial experiences of rural patients and caregivers accessing cancer services through three health services in rural NSW was undertaken (N = 125). Measures of psychological distress as well as quantitative and qualitative barriers data were collected. Results. Approximately, one-third of the participants reported moderate to severe distress. Patients and caregivers reported systemic, intrapersonal, interpersonal, and pandemic-specific barriers in accessing quality psychosocial healthcare. Conclusions. These results suggest that cancer patients and caregivers in rural NSW may experience elevated levels of psychological distress and barriers in accessing psychosocial care. The combination of high psychological need for patients and caregivers with reduced availability of psychosocial support services has substantial implications for psychological wellbeing and service provision. Underdetection of psychosocial need and a lack of support services pose a significant challenge for rural people with cancer and for those who care for them; this must be an urgent priority for quality improvement and equitable healthcare provision. [ABSTRACT FROM AUTHOR]

This study examined the extent to which telehealth placements are feasible for developing perceived competence as a psychologist and are an acceptable training modality for provisional psychologists. Fifteen provisional psychologists who undertook a postgraduate placement using telehealth completed an online survey. Acceptability and attitudes towards future telehealth service provision were assessed via Likert scales and open-ended questions. Feasibility was assessed via comparison using Wilcoxon Rank Signed tests of pre- and post-placement self-efficacy using the Psychology Counsellor Self-Efficacy Scale. Open-ended questions were analysed using content analysis. Participants reported high satisfaction with the telehealth placement. Perceived self-efficacy improved between pre- and post-placement on all competencies except for research. Students reported that a telehealth placement enabled them to improve in all areas, with particular benefits including rapport building, therapeutic questioning, and management of safety and ethical concerns. Challenges of a telehealth placement included assessing mental status, isolation from peers, and technical difficulties. Students reported positive attitudes towards future use of telehealth. Telehealth appears to offer an acceptable, feasible and valuable training experience for developing competence for provisional psychologists. Undertaking a telehealth placement may help prepare clinicians for future use of telehealth, especially in relation to ethics and risk management. What is already known about this topic: (1) Psychologists typically report a reluctance to utilise telehealth and uptake has remained low prior to COVID-19 despite changes in Medicare. (2) Limited training in telehealth, especially around ethical issues and managing risk, is a key barrier to telehealth utilisation amongst psychologists. (3) Only very limited research has examined the use of telehealth placements in tertiary training, despite the need to pivot to telehealth placements during COVID-19. What this topic adds: (1) This study highlights that telehealth placements are both feasible and acceptable for developing competence and skill in trainee psychologists. (2) Telehealth placements equipped provisional psychologists with enhanced skills specific to telehealth service provision including managing ethical and safety concerns online. (3) Provisional psychologists who completed a telehealth placement reported an intention to utilise telehealth in future service provision. [ABSTRACT FROM AUTHOR]

Objective: Depressive disorders are prevalent and associated with significant burden. Although effective treatments exist, many individuals do not seek help. The current study aims to examine the barriers to help-seeking for depressive symptoms in an Australian sample, and to examine the utility of Health Belief Model (HBM) factors in predicting the likelihood of future help-seeking in relation to depressive disorders. Method: The study used a cross-sectional design. One hundred and eighty Australians aged over 18 completed the current study (Mage = 35.85; SD = 13.43; 76.1% female). Results: The most influential treatment barriers in this sample related to direct costs, indirect costs, and a belief that treatment from a psychologist was not needed. Regression analysis indicated that 49% of the variance in intention to seek help from a psychologist was associated with HBM variables. Level of perceived treatment benefit was the strongest predictor of help-seeking intention. Conclusion: In order to increase help-seeking for depressive disorders, public health campaigns must enhance perceptions about the benefits of psychological treatment and government policy and/or treatment providers must work to reduce the direct and indirect costs of psychological treatments within Australia. Key Points What is already known about this topic: (1)Depressive disorders are prevalent conditions and are associated with significant burden. (2)While effective psychological treatments for depression exist, few seek treatment. (3)The Health Belief Model has been used to investigate help-seeking intention in anxiety disorders, but not depressive disorder. What this topic adds: (1)Individuals with depressive symptom in Australia experience a number of barriers to accessing treatment. (2)The Health Belief Model can predict a significant amount variance in help-seeking intention for individuals with depressive symptoms. (3)Perceived treatment benefit is the strongest predictor of help seeking intention. [ABSTRACT FROM AUTHOR]