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The purpose of this article is to qualitatively explore participant and therapist experiences of the therapeutic alliance, perceived benefits, challenges, and areas for improvement when using video chat as a mode of therapist assistance within an adaptive digital mental health intervention. In total, 74 semistructured interviews were completed with participants and therapists who participated in an adaptive clinical trial. The participant interviews explored experiences of attending a clinical assessment via video chat and experiences of receiving low- or high-intensity therapist assistance via video chat. Interviews completed with therapists explored their experience of administrating a clinical assessment tool and delivering therapist assistance, both via video chat. Reflexive thematic analysis identified four themes: using video chat, characteristics of therapeutic relationships, task-specific experiences, and utility and adoption of video chat. Both participants and therapists were able to adapt to the modality of video chat and develop positive therapeutic alliances. They reported satisfaction with video chat for conducting clinical assessments and delivering therapist assistance. Concerns were identified by both participants and therapists with low-intensity therapist assistance. This study identified elements of task-specific experiences and human characteristics as more influential in participant and therapist experience than the modality of video chat technology. Implications for assessing suitability for the modality of video chat and low- and high-intensity models of therapist assistance are discussed. Public Significance Statement: This study advances the field of digital mental health intervention as it qualitatively explores participant and therapist experiences of clinical assessments and therapist assistance delivered via video chat technology. It highlights the adaptability and effectiveness of using video chat as a mode of therapist assistance and the utility of this support to increase program motivation and engagement for participants. Clinicians can use the insights to improve experiences of video chat therapy both within digital mental health interventions and therapy more broadly. [ABSTRACT FROM AUTHOR]

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk‐in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof‐of‐concept study investigating the acceptability and short‐term effectiveness of an online walk‐in family therapy service, Walk‐in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk‐in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre‐session, post‐session, and at 6 weeks follow‐up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi‐structured interview data. Post‐session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post‐session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well‐received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk‐in delivery model. This proof‐of‐concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk‐in, telehealth model to meet the rising demand for therapeutic support for families in distress. [ABSTRACT FROM AUTHOR]

Sexuality is a central aspect of human experience but there is evidence that this is largely constrained, pathologised or ignored in mental health settings. We conducted in-depth interviews with 22 psychologists, psychiatrists and mental health nurses working across a variety of settings in four Australian cities. Sexuality was most often perceived as relevant in the mental health setting when it was simultaneously constructed as dangerous. Participants located this danger in sexual expression itself or within individuals who, because of mental illness, lacked the autonomy required to successfully engage in 'safe' sex. We discuss these findings and their implications for research and professional practice. [ABSTRACT FROM AUTHOR]

There is growing pressure on health and welfare services to provide more efficient and effective services. For one thing, the world's ageing population is resulting in increased pressure on healthcare costs and the availability of government funding. At the same time, community expectations of quick and easy access to high‐quality client‐centred services is growing. Single session ideas can make a valuable contribution to responding to these somewhat competing factors, by providing a basis for effective, efficient, client‐centred, accessible services. This article begins with a functional definition and description of single session therapy (SST), which is used to inform article sections on the attitudinal, clinical, and organisational implications, and ends with ideas for implementing the approach into services, thus, putting SST to work. [ABSTRACT FROM AUTHOR]

Couple conflict, which includes conflict over parenting practices, continues to be a topic of considerable interest to family therapists. Following parental separation, resolution or management of conflict over children has a special urgency. 'High‐conflict' cases present some of the most complex systemic and clinical challenges. In this first of two related articles in this issue of ANZJFT, we set out key ideas – some old, some new – about parental conflict from the divorce literature. We present Australian data on separated parents' reports, which found significant conflict at three different points in time after separation and consider the clinical implications. We suggest that while 'high conflict' has an intuitive feel as a descriptor for difficult post‐separation disputes, it has limited utility as a blanket term to inform research and practice. The article acts as a conceptual backdrop to an earlier paper (Smyth & Moloney, 2017), in which we consider the dynamics of enduring 'high conflict.' We suggest that these cases might be qualitatively different to those cases in which intensely felt disputes develop but then recede. We also suggest that amongst enduring 'high conflict' cases there are likely to be cases with especially challenging dynamics such as interparental hatred. [ABSTRACT FROM AUTHOR]

Objective: This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills.Method: An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed.Results: Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services.Conclusions: MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients' physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes. [ABSTRACT FROM AUTHOR]

Background: Currently, little is known about mental health nurses’ management of antipsychotic medication side effects. Aims: This study examined how Australian mental health nurses’ attitudes and service processes influence the assessment of antipsychotic medication side effects. Methods: Participants were included if they were registered nurses in Australian mental health settings. An online questionnaire was distributed via email. Multivariate logistic regression was used to examine associations between attitudes and awareness, and use of antipsychotic medication assessment tools. Results: Only one quarter of the respondents were currently using a tool. In cases where the service had a clear system for agreeing responsibility about monitoring consumers between primary and secondary care, respondents were three times more likely to still be using one or more tool. When the service had reliable systems in place to remind staff that side effect assessments were due, respondents were five times more likely to continue using assessment tools. Conclusion: Australian mental nurses are not routinely using antipsychotic medication side effect assessment tools. The routine use of assessment tools would improve if systems were implemented to enhance their use. [ABSTRACT FROM AUTHOR]

The crystalline form of methamphetamine, commonly known as crystal meth (crystal methamphetamine) or ICE, is a highly-addictive and powerful stimulant. Users of crystal meth often require emergency care, and are associated with a substantial burden of care by emergency care providers. The aim of the present qualitative study was to explore health professionals' experiences of providing care for patients affected by ICE who presented to the emergency department ( ED). Nine semistructured interviews were conducted. The major theme, 'staying safe', was revealed, in which participants described their experiences of being exposed to potentially unsafe situations, and their responses to challenging behaviours, including aggression. The findings highlight the need for ED staff to understand the nature of ICE use and its adverse impact on the mental and physical health of users. Furthermore, it is clear that establishing and maintaining safety in the emergency care setting is of utmost importance, and should be a priority for health-care managers. [ABSTRACT FROM AUTHOR]

A growing body of research suggests that single session therapy (SST) can offer an efficient and effective service. In order to complement this research a recent exploratory study set out to examine client experiences of participating in a service offering single session family therapy. Telephone interviews were conducted with twenty‐five clients to explore their experience of SST and their satisfaction with the service they had received. Although the study was limited in scope and design, the results suggest that (i) most clients found SST had been helpful and responsive to their needs and (ii) most respondents did not report being discomforted or discouraged at the prospect that their contact with the service might involve one or two contacts. Though a small minority of clients expressed some concerns that SST might indicate a lack of availability of service, these worries were alleviated once they had met the therapist. Practitioner points: SST therapy is a framework for family therapy practice that is generally experienced by clients as helpful and responsive to their needs.Therapists can maximize their potential effectiveness with clients by viewing every contact with families as complete in itself.SST therapy offers opportunities for family therapists to make their services more accessible. 名字代表什么？来访者在单次会面治疗中的经历 越来越多的研究表明, 单次会面治疗能够提供有效且高效的干预。作为这一研究的补充, 近期开展的一项探索性的研究调查了一项单次会面家庭治疗服务中来访者的经历。通过与25位来访者的电话访谈, 该研究探索了他们的治疗经历以及服务满意度。虽然该研究在范围和设计上都有局限性, 但是结果似乎显示（1）绝大多数来访者认为单次会面治疗有用, 能够回应他们的需求, 以及（2）大多数调查对象对于自己跟服务提供者将会有一到两次的接触这一事实并不感到不安或者灰心。虽然有一小部分来访者表示了担心, 认为单次会面治疗可能说明服务的供不应求, 但是他们的疑虑都在见到治疗师之后得到缓解。 对实务工作者的启示: 单次会面治疗作为一种家庭治疗实践的框架, 被来访者普遍认为是有效且回应需求的。为了实现治疗效果的最大化, 治疗师可以把每一次与家庭的接触当成是一次完整的会面。单次会面治疗为家庭治疗师提供了机会, 让他们提供的服务能为更多人所用。 关键词：单次会面治疗；来访者治疗结果；家庭治疗；评估；短期治疗 [ABSTRACT FROM AUTHOR]

Globally, addiction to “ICE” (crystal methamphetamine) is increasing and presents emergency health care services personnel with a number of challenges. This paper reports the first of two major themes arising from a qualitative study investigating health professionals' experiences' managing people presenting to the Emergency Department (ED) after taking “ICE.” The theme “Caring for people who use ‘ICE’ when presenting to EDs” comprises five subthemes. These are: (a) expecting the unexpected: “they're just off their heads”; (b) complexity of care: “underlying trauma and emotional dysregulation”;(c) connecting and relationships: “engaging in a calm and helpful way”; (d) coordinating care and teamwork: “keeping them quiet and away from everybody”and (e) learning and reflection: “we need to rethink our treatment options.”These findings highlight the complexity and resource-intensity associated with providing emergency care to persons affected by ICE, and the need for thoughtful strategies that can further develop the capacity and capability of health professionals to provide optimal care to people using ICE. [ABSTRACT FROM AUTHOR]

The article examines the psychiatric aspects of climate change and discusses how psychiatrists can deal with climate anxiety. Topics discussed include a growing number of studies describing significant distress over climate change in some populations such as obsessive-compulsive disorder, solostalgia, place-based distress, disavowal and psychoterratic syndrome. Also mentioned is the importance of fostering active hope and engagement as pathways to addressing climate change distress.

In Australia the movement toward evidence based practice was supported by the first National Mental Health Strategy. For mental health clinicians the shift from evaluating process to outcome measurement also brought greater focus on specific disorders and targeted interventions, raising questions about the efficacy and effectiveness of treatment. The gap between research and practice is well documented, and has engendered much debate particularly in regard to empirically supported treatments ( ESTs) and the technologies to widely disseminate practice whilst supporting treatment adherence. In this paper we first, describe the Attachment Based Family Therapy ( ABFT) model before giving consideration to the criticisms of ESTs, and reviewing the dissemination of ABFT in Australia, and the perspectives of Australian clinicians in respect to the model and its relevance to their practice. Finally, we turn to the mission of this Special Issue which is to increase the awareness of ABFT primarily amongst practicing clinicians as we introduce the selected papers that demonstrate the application of the model to a variety of clinical presentations, and clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: Research has revealed limitations in the provision of in-person services to families with a new speech generating device (SGD), both in Australia and overseas. Alternative service models such as parent training, peer support and telepractice may offer a solution, but their use with this population has not been researched to date. Method: Using interviews and focus groups, this study explored the experiences and opinions of 13 speech-language pathologists and seven parents regarding alternatives to in-person support and training for families with a new SGD. Data were analysed using grounded theory. Themes explored in this paper include the benefits and drawbacks of alternative service models as well as participants' suggestions for the optimal implementation of these approaches. Result: Participants confirmed the utility of alternative service models, particularly for rural/remote and underserviced clients. Benefits of these models included reduced travel time for families and therapists, as well as enhanced information access, support and advocacy for parents. Conclusion: Participants viewed the provision of ongoing professional support to families as critical, regardless of service modality. Additional issues arising from this study include the need for development of organizational policies, resources and training infrastructure to support the implementation of these alternative service models. [ABSTRACT FROM AUTHOR]

The gay and lesbian community suffers higher rates of discrimination, mental health problems, and relationship break-up than their heterosexual counterparts. In this paper we analyse the challenges confronting same-sex couples, and the implications for couple education and therapy with same-sex couples. We describe some similarities in the challenges confronting heterosexual and same-sex couples (e.g., negotiation of shared realistic relationship expectations, effective communication). These similarities suggest existing evidence-based approaches to couple therapy and relationship education are likely to assist same sex couple relationships. We also describe distinctive challenges for same-sex couples (e.g., homophobic discrimination, internalised homophobia, and low support from many families for same sex relationships). These distinctive challenges suggest some adaptation of existing approaches to couple education and therapy could enhance their relevance and effectiveness to same sex couples. [ABSTRACT FROM AUTHOR]

The article presents the author's views on his presentation during first GANZ(Gestalt Australia and New Zealand) conference whose theme was "Being on the Edge." He mentions how he acknowledge and advocate a more meaningful way for Aaboriginal and Torres Strait Islander people of Australia. It further discusses a model developed by the New Zealand Association of Psychotherapists to integrate and acknowledge Maori in psychotherapeutic practice.

This article is an exploration of family therapy in Australia based on interviews with seven leading Australian family therapists: Max Cornwell, Carolyn Quadrio, Ron Perry, Laurie MacKinnon, Brian Stagoll, Banu Moloney and Jim Crawley. It explores the attributes and qualities of what makes a good family therapist and seeks to understand how the next generation of therapists can generate a new enthusiasm for family therapy. [ABSTRACT FROM AUTHOR]

An interview with psychotherapist Maggie Kline is presented. When asked to give a background about her self, Maggie mentions that she started as a teacher, working with traumatised children, before she dicovered Gestalt therapy back in 1978. She talks about her experience as a therapist for almost 30 years. She also tackles her stay in Australia to teach the Somatic Experiencing training.

Few studies have examined the practice wisdom of expert supervisors. This study addresses this gap by exploring how experienced supervisors manage difficulties in supervision in the context of the supervisory relationship. The supervisors were a purposive sample of 16 senior members ofthe profession with considerable expertise in supervision. In-depth interviews were first conducted with the supervisors. An interpersonal process recall method was then used to explore their reflections on one of their DVD- recorded supervision sessions. Analysis of transcripts was completed using a modified consensual qualitative research method. Major difficulties included the broad domains of supervisee competence and ethical behavior, supervisee characteristics, supervisor countertransference, and problems in the supervisory relationship. Supervisors managed these difficulties using 4 key approaches: relational (naming, validating, attuning, supporting, anticipating, exploring parallel process, acknowledging mistakes, and modeling); reflective (facilitating reflectivity, remaining mindful and monitoring, remaining patient and transparent, processing countertransference, seeking supervision, and case conceptualizing); confronta- tive (confronting tentatively, confronting directly, refusing/terminating supervision, taking formal action, referring to personal therapy, and becoming directive); and avoidant interventions (struggling on, withholding, and withdrawing). Two brief case studies illustrate the process of applying these strategies sequentially in managing difficulties. The study highlights the importance of relational strategies to maintain an effective supervisory alliance, reflective strategies-particularly when difficulties pertain to clinical material and the supervisory relationship-and confrontative strategies with unhelpful supervisee characteristics and behaviors that impede supervision. [ABSTRACT FROM AUTHOR]

This article examines integrity provisions from the stance of a member of the public who wishes to make a complaint regarding practitioner sexual boundary violation. A hypothetical case scenario applicable to practitioners in a range of psychotherapeutic and social care occupations is presented. Relevant sections of the ethical codes of key Australian voluntary professional associations are then compared. These associations are the Royal Australian and New Zealand College of Psychiatrists, the Australian Psychological Society, the Australian Association of Social Workers, as well as the Australian Counselling Association and the Psychotherapy and Counselling Federation of Australia, which have recently made a joint agreement to establish the Australian Register of Counsellors and Psychotherapists. An analysis of the provisions of relevant national, state and territory boards, complaint commissions and professional associations, (defined for the purposes of this article as “integrity bodies”), highlights significant inequities in clients' rights regarding complaints. [ABSTRACT FROM PUBLISHER]

The article describes a study which determined the working conditions of psychiatric nurses and colleagues who are working as family therapists in rural regions in Australia. The study employs a participatory action research (PAR) strategy, which involved the research participants as co-researchers. It cites several challenges confronting the rural nurses including the feeling of professional isolation and the long geographical distances to be traveled.

From the ground of Gestalt therapy and the field of Equine Facilitated or Assisted Psychotherapy emerged Gestalt Equine Psychotherapy (GEP). This article introduces the reader to the relatively new therapeutic approach of Gestalt Equine Psychotherapy. As far as the author is aware, there are two centres or programs offering Gestalt Equine Psychotherapy in the world - the Gestalt Equine Institute of the Rockies (GEIR) and Gestalt Equine Psychotherapy Australia (GEPA). This article begins with my personal experience with horses, and is followed by an introduction to GEP, the process of GEP, and the role of the therapist in GEP. Some brief cases are offered to give a taste of what the work may look like. Finally, some limitations to this approach are noted. [ABSTRACT FROM AUTHOR]

As Australia's population ages, there is concern that mental health professionals may not be prepared to deal with the increasing number of older people. The present study conducted a postal survey of Australian psychologists and counselors to ascertain whether older clients are less likely to be diagnosed with depression and are regarded less favorably than younger clients. Respondents received one of two versions of a vignette describing a depressed female client. The vignettes differed only in whether the fictitious client was aged 42 or aged 72. Responses were received from 414 psychologists and 293 counselors, representing a response rate of 38%. In general, response patterns did not differ between psychologists and counselors. Most respondents correctly identified depression regardless of the client's age. Attitudes toward treating the older client were consistently less favorable than for the younger client. The older client was rated as significantly less able to develop an adequate therapeutic relationship, to have a poorer prognosis, and to be less appropriate for therapy; and the therapists felt less competent in treating her and were less willing to accept her as a client. The evidence of an age bias has significant implications for the education and training of psychologists and counselors. [ABSTRACT FROM AUTHOR]

This is the first of four papers about working with psychosis in a newly established post of psycho-analytic psychotherapist in an acute psychiatric unit in Australia. In this paper the author gives an account of some early impressions and experiences with staff and patients, particularly connected with an unacknowledged grief in the aftermath of psychosis. The author next discusses some of the psycho-analytic theory about psychosis which he found containing and helped make some sense of his experiences. He then introduces a case study of an exploratory psycho-analytic psychotherapy with a 40-year-old man suffering from a bi-polar disorder. The beginning of the therapy is described when this man revealed feelings of grief and despair about his illness. Being able to face and bear these feelings enabled him to begin to mourn what was irretrievably lost because of his illness and to contemplate what might still be possible. The author describes some of the early themes and one session in detail, and discusses how fluctuations in contact with the client reflect his retreat to a pathological organization in the mind. This psychic retreat was dominated by a psychotic process, and the retreat offered refuge from a dread of fragmentation and the pain of mourning and loss. [ABSTRACT FROM AUTHOR]

The aim of this Australian based qualitative study was to better understand key drivers for mental health nurses to undertake training in psychotherapy, and how these capabilities are integrated into their clinical practice. Open ended reposes from a national survey of 153 mental health nurses were supplemented with data from 12 semi-structured interviews of nurses with rich experience of integrating psychotherapy and mental health nursing capabilities. Key findings emerging from the thematic analysis were that mental health nurses are providing uniquely holistic psychotherapeutic services to consumers with often complex conditions, despite overtly hostile clinical and policy contexts. These often very well qualified mental health nurse psychotherapists are different to the traditional identity of either a nurse or psychotherapist. Recommendations from the findings of this study are that where appropriately qualified, mental health nurses be granted eligible provider status for existing Medicare funding items. Finally, training and building foundational capabilities in psychotherapy is highly recommended for all mental health nurses., (© 2020 Australian College of Mental Health Nurses Inc.)

Criticizes Bob Adler's Interim Report on the contemporary situation of psychiatric training programs and the issue of marginalization of psychotherapists in Australia. Concerns regarding deficiencies in psychotherapy components of training programs; Problems in the marginalization of psychotherapists; Proposals made by the Section of Psychotherapy to the Fellowships Board.

The article announces developments and activities related to family psychotherapy in Australia and New Zealand for 2000. The Drummond Street Relationship Center, an organization of psychotherapists in Carlton, Victoria will facilitate a course which will investigate the process of couple therapy from a psychodynamic perspective, it will run from April to December. Meanwhile, a congress dubbed as Inaugural Pan Pacific Family Therapy Congress will be conducted on September 4 to 8 in Melbourne, Victoria. Moreover, Bruce Hart, author of the paper "Re-authoring the Stories We Work By: Situating the Narrative Approach in the Presence of the Family Therapists" had his work reprinted in one of the journals of family therapy in Ireland.

The article presents a report from the president of the Australian and New Zealand Family Therapy Association, Inc., an association of family therapist in Australia and New Zealand, on the latest development within the organization including its current state in terms of publication and nomination of posts to its members as of 1999. The president reported that the publication remained constant in providing relevant and accurate information concerning issues related to family therapy. According to him it is a manifestation that the journal is in good hands and the editors have maintained their efficiency and expertise in their profession. Likewise, he also announced the newly appointed officers in the organization and the schedule of the conferences to be facilitated by the group.