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Despite infidelity being a highly traumatic experience, not all couples end their relationship after discovery of the affair. The present study provides insights into the experience of couples who remained together after having experienced infidelity by one partner. Narrative inquiry methods were used to undertake and analyze in-depth interviews with eligible participants from eastern Australia who responded to advertisements. The key themes acknowledged by participants as reasons for maintaining the relationship were motivation to stay together, treasuring acts of kindness, meaning making, and social support. However, the reconciliation process was tortuous and involved forgiveness, seeking counseling, managing memories, vicarious learning, and changing couple dynamics. In rebuilding the relationship, a modification often took place, resulting in a shift in the power dynamic. The article outlines professional considerations for counselors and other therapists in relation to professional practice. (Contains 1 table.)

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 of the 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); confrontative (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. (Contains 1 table.)

Describes development over five years of Australia's Hunter Region Health Promoting Schools Project, noting barriers to health-promoting schools, examining the new approach to health promotion, discussing the minimum set of health-promotion actions for reducing risk behaviors (increasing knowledge and skills, modifying availability of products, changing the environment, and improving role models), and looking at the project's guiding principals. (SM)

Increasing numbers of lesbian, gay and bisexual ( LGB) adults are entering into parenthood. Previous studies indicate many of these parents receive little or no support from their families of origin due to family members' negative attitudes toward homosexuality. This study looks at the extent to which LGB parents report a lower sense of connectedness to family of origin and friendship networks than heterosexual parents and whether this has an impact on psychological wellbeing in either of these groups. Data were derived from two studies of parents: Work, Love, Play, a study of Australian and New Zealand LGB parents (n=324); and the Longitudinal Study of Australian Children, a population-based study of young children and parents (n=6460). Structural equation modelling was used to explore the relationships between: parent sexuality and family/friendship connectedness, family/friendship connectedness and psychological wellbeing, parent sexuality and psychological wellbeing. LGB parents reported feeling less connected to their families of origin but more connected to their friendship groups than heterosexual parents. Counter to previous studies, we found no difference in the psychological wellbeing of LGB parents compared to heterosexual parents when examining the direct effect of sexuality on psychological wellbeing. Clinical implications for counsellors and family therapists are discussed. [ABSTRACT FROM AUTHOR]

Relationship education and couple counseling services have been targeted to groups differing in severity of marital problems. However, there is evidence that couples seeking these services may be more similar than previously thought. We examined profiles of couples attending both services across eight community relationship service agencies in Australia; 460 participants (230 couples) completed a preservice survey. Multivariate analysis found that those seeking couple counseling had more children, more serious relationship issues, higher depression and aggression, lower education, and more financial difficulty. Modeling was also undertaken by gender. Differentiated profiles of couples seeking different relationship services are useful to inform service delivery and professional training. [ABSTRACT FROM AUTHOR]

This article explores lesbian, gay, bisexual, and transgender (LGBT) parents' sense of connection to their families, friends, and communities. The study compares LGBT parents who live in inner metropolitan areas with those living in outer metropolitan and regional and rural areas. We also look at experiences of discrimination and being out about sexuality in various community settings. Data for this article were drawn from the Work, Love, Play study of 455 Australian or New Zealand LGBT parents. Over half the participants lived in outer metropolitan or regional and rural areas. Parents living in outer metropolitan or regional and rural areas were less likely than those living in the inner city to feel connected to their local community or to be out in community settings, while also having less contact with the LGBT community. Their children were also more likely to experience homophobic bullying or discrimination at school. [ABSTRACT FROM AUTHOR]

Objectives To determine whether elder abuse can predict mortality and disability over the ensuing 12 years. Design Population-based prospective cohort study of women aged 70 to 75 in 1996; survival analysis. Setting Australia. Participants Twelve thousand sixty-six women with complete data on elder abuse. Measurements Elder abuse was assessed using the 12-item Vulnerability to Abuse Screening Scale ( VASS) subscales: vulnerability, coercion, dependence, and dejection. Outcomes were death and disability (defined as an affirmative response to 'Do you regularly need help with daily tasks because of long-term illness, disability or frailty?'). Results In 1996, 8% reported vulnerability, 6% coercion, 18% dependence, and 22% dejection. By October 2008, 3,488 (29%) had died. Mortality was associated with coercion (hazard ratio ( HR) = 1.21, 95% confidence interval ( CI) = 1.06-1.40) and dejection ( HR = 1.12, 95% CI = 1.03-1.23), after controlling for demographic characteristics, social support, and health behavior but not after adding chronic conditions to the coercion model. Over the 12 years, 2,158 of 11,027 women who had reported no disability in 1996 reported disability. Women who reported vulnerability ( HR = 1.25, 95% CI = 1.06-1.49) or dejection ( HR = 1.55, 95% CI = 1.38-1.73) were at greater risk of disability, after controlling for demographic characteristics, social support, and health behavior. The relationship remained significant for dejection when chronic conditions and mental health were included in the model ( HR = 1.40, 95% CI = 1.24-1.58). Conclusion Specific components of vulnerability to elder abuse were differently associated with rates of disability and mortality over the ensuing 12 years. [ABSTRACT FROM AUTHOR]

The author describes the evolution of the counseling profession in Australia within the broader historic and sociocultural context. The process of professionalization is outlined, particularly over the past 15 years, and data on the demographic, professional, and practice characteristics of counselors are reviewed. Future professional directions and challenges are explored. [ABSTRACT FROM AUTHOR]

In the absence of comprehensive Australian data on the counselling and psychotherapy profession, this study aimed to examine the profile of professionals affiliated with the Psychotherapy and Counselling Federation of Australia (PACFA) to inform future policy and service planning. PACFA's first workforce survey was undertaken in 2004. This cross-sectional survey was mailed and e-mailed to all members of the 41 professional associations affiliated with PACFA. A total of 316 full responses were received. This paper presents findings related to demographics, training and specialisation, theoretical orientation, professional affiliations, work and practice settings, and work roles. The study provides a baseline for future workforce surveys and a resource for policy development for the profession. [ABSTRACT FROM AUTHOR]

The Psychotherapy and Counselling Federation of Australia (PACFA) is a self‐regulating professional peak body, comprising more than 40 professional associations for counselling and psychotherapy in Australia. It represents over 3000 individual practitioners from a range of counselling and psychotherapy backgrounds. This paper describes the decade‐long national consultative processes among practitioners, educators, and professional associations, which has resulted in a unique umbrella structure for member associations. This umbrella structure, the federation, has the potential to embrace and unite the field of psychotherapy and counselling, while maintaining the individual identity and purposes of member associations, in Australia. After describing the development, structures, and goals of PACFA, the paper outlines its major achievements. It then describes an important project on Self‐Regulation in Counselling and Psychotherapy. The objectives of this project are to investigate and further develop an Australian professional self‐regulation model, building on the community consultation processes initiated by PACFA in the mid‐1990s. This paper provides a review of key issues for self‐regulation, explores the options available in the Australian context, the model development to date, and outlines the national consultative processes currently under way to address the challenges facing the profession in Australia. We also discuss the importance of the dialogic and consensual processes adopted by PACFA in establishing a legitimate and credible voice for the profession as a whole in Australia. The paper ends with an overview of some challenges to the future of counselling and psychotherapy in Australia. La Fédération de psychothérapie et de counseling d'Australie (FPCA) est un conseil professionnel supérieur autogéré, comprenant plus de 40 associations professionnelles pour le counseling et la psychothérapie en Australie. Il représente plus de 3000 praticiens ayant des expériences variées en counseling et en psychothérapie. Cet article décrit les longs processus consultatifs nationaux de la décennie parmi les praticiens, les enseignants et les associations professionnelles, lesquels ont résulté en une structure unique chapeautant toutes les associations. Cette structure, la fédération, a le potentiel d'englober et d'unir les champs de la psychothérapie et du counseling, tout en maintenant l'identité individuelle et les buts des associations en Australie. Après avoir décrit le développement, les structures et les buts de la FPCA, cet article souligne les réalisations majeures de celle‐ci. Il décrit ensuite un projet important d'autogestion en counseling et psychothérapie. Les objectifs de ce projet sont d'examiner, puis de développer un modèle d'autogestion professionnel australien, érigé sur les processus de consultation communautaires initiés par la FPCA au milieu des années 1990. Cet article présente une revue des enjeux‐clés pour l'autogestion, il explore les options disponibles dans le contexte australien ainsi que le développement du modèle jusqu'ici et il souligne les processus consultatifs nationaux actuellement en branle pour aborder les défis auxquels fait face la profession en Australie. Nous discutons aussi de l'importance des processus dialogiques et consensuels adoptés par la FPCA dans l'établissement d'une voix légitime et crédible pour la profession à travers toute l'Australie. Cet article se termine avec une vue d'ensemble de certains défis futurs pour le counseling et la psychothérapie en Australie. La Federación de Psicoterapia y Consejo de Australia (FPCA) es un organismo profesional supremo autorregulado, que comprende a más de cuarenta asociaciones profesionales de consejo psicológico y psicoterapia de Australia. Representa a más de 3000 individuos que practican la profesión con antecedentes que varían entre el consejo y la psicoterapia. Este trabajo describe el proceso de consulta nacional de diez años entre quienes ejercen la profesión, educadores, y asociaciones profesionales que dio como resultado una estructura paraguas para las asociaciones miembro. Esta estructura paraguas, federación, posee el potencial para abarcar y unir el campo de la psicoterapia y el consejo, a la vez que mantener la identidad individual y los propósitos de las asociaciones que pertenecen a ella, en Australia. Después de describir el desarrollo, estructuras y metas de la FPCA, el trabajo delinea los logros más importantes de la FPCA. Describe después un proyecto muy importante sobre autorregulación en consejo y psicoterapia. Los objetivos del proyecto son investigar, y avanzar en el desarrollo de un modelo australiano de autorregulación profesional, sobre las bases del proceso de consulta iniciado por la FPCA en la mitad de la década de los noventa. Este trabajo proporciona una reseña de aspectos clave para la autorregulación, explora las opciones disponibles en el contexto australiano, el desarrollo del modelo al presente, y bosqueja los procesos de consulta nacional que actualmente se realizan para abordar los desafíos que enfrenta la profesión en Australia. También se discute la importancia de los procesos dialógicos y consensuales adoptados por la FPCA al establecer una voz legítima y creíble de la profesión como un todo en Australia. El trabajo termina con un panorama de algunos retos para el futuro del consejo y la psicoterapia en Australia. [ABSTRACT FROM AUTHOR]

Background: Older women are at increasing risk of various forms of familial violence, yet detection is poor and very little is known of the long-term health effects of this psychosocial problem. The effectiveness of the 'Vulnerability to Abuse' Screening Scale (VASS) in predicting three year health outcomes was investigated among women enrolled in the Australian Longitudinal Study on Women's Health, now known as Women's Health Australia.Methods: The sample comprised a cohort of 10,421 women aged 73-78 who completed the 1996 and 1999 postal surveys (attrition rate 19.5%). The Time 2 sample had a small bias towards lower risk for elder abuse at Time 1 and better health on SF-36 and self-rated health. The VASS is a 12-item self-report measure with 4 factors: vulnerability, coercion, dependence and dejection.Results: Overall, physical health (PCS) declined while mental health (MCS) increased over the three year period. Decline in physical health was predicted by only the dejection factor, but not by factors which seem to more directly measure abuse. The predictive validity of the VASS for three year mental health outcomes was given partial support. Three of the four VASS factors (dejection, vulnerability, and coercion) predicted decline in mental health at the univariate level, however, after adjusting for confounders, only one VASS factor (dejection) independently predicted decline in mental health.Conclusions: While the VASS shows some promise as a marker of health risk in older women, only the dejection factor proved consistently predictive of declining health status. Further research is needed to determine longer term predictive validity of the scale and to gain a clearer picture of how abusive experiences impact on older women's health. [ABSTRACT FROM AUTHOR]

Objective: To examine associations between poor mental health and sociodemographic, psychosocial and health related variables in midlife Australian women. Method: The random population-based sample comprised 13,961 Australian women aged 45-50 years who participated in the baseline postal survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The outcome measure, poor mental health status, was measured by the Mental Health Index (MH) of the SF-36. Results: Sociodemographic factors associated with poor mental health were low educational levels, being unemployed or engaged solely in home duties, and non-English speaking background (European). Health related factors independently associated with poor mental health were having five or more visits to the doctor in the past year, menopausal status (surgical and perimenopausal less exercise, and smoking 20 or more cigarettes per day. Among psychosocial variables, low satisfaction with partner or close relationships, low perceived social support outside family, and more life-events over the past 12 months were independently associated. Conclusion: The findings suggest a number of areas in which preventive interventions could be strengthened to improve quality of life among mid-aged women. These include policy changes to promote and support more education and employment opportunities for women before they reach midlife, increase understanding of the link between health risk behaviours and psychological well-being, and provide counselling services to improve women's relational and psychosocial circumstances. [ABSTRACT FROM AUTHOR]

Our objective was to examine associations between self-reported sexually transmitted infections (STIs) and sociodemographic, lifestyle, health status, health service use and quality of life factors among young Australian women; and their use of family planning and sexual health clinics and associations with health, demographic and psychosocial factors. The study sample comprised 14,762 women aged 18-23 years who participated in the mailed baseline survey for the Australian Longitudinal Study on Women's Health, conducted in 1996. The main outcome measures are self report of ever being diagnosed by a doctor with an STI, including chlamydia, genital herpes, genital warts or other STIs, and use of family planning and sexual health clinics. The self-reported incidence of STI was 1.7% for chlamydia, 1.1% genital herpes, 3.1% genital warts, and 2.1% other STIs. There was a large number of demographic, health behaviour, psychosocial and health service use factors significantly and independently associated with reports of having had each STI. Factors independently associated with use of family planning clinic included unemployment, current smoking, having had a Pap smear less than 2 years ago, not having ancillary health insurance, having consulted a hospital doctor and having higher stress and life events score. Factors independently associated with use of a sexual health clinic included younger age, lower occupation status, being a current or ex-smoker, being a binge drinker, having had a Pap smear, having consulted a hospital doctor, having poorer mental health and having higher life events score. This study reports interesting correlates of having an STI among young Australian women aged 18-23. The longitudinal nature of this study provides the opportunity to explore the long-term health and gynaecological outcomes of having STIs during young adulthood. [ABSTRACT FROM AUTHOR]

Background: While families headed by same-sex couples have achieved greater public visibility in recent years, there are still many challenges for these families in dealing with legal and community contexts that are not supportive of same-sex relationships. The Work, Love, Play study is a large longitudinal study of same-sex parents. It aims to investigate many facets of family life among this sample and examine how they change over time. The study focuses specifically on two key areas missing from the current literature: factors supporting resilience in same-sex parented families; and health and wellbeing outcomes for same-sex couples who undergo separation, including the negotiation of shared parenting arrangements post-separation. The current paper aims to provide a comprehensive overview of the design and methods of this longitudinal study and discuss its significance., Methods/design: The Work, Love, Play study is a mixed design, three wave, longitudinal cohort study of same-sex attracted parents. The sample includes lesbian, gay, bisexual and transgender parents in Australia and New Zealand (including single parents within these categories) caring for any children under the age of 18 years. The study will be conducted over six years from 2008 to 2014. Quantitative data are to be collected via three on-line surveys in 2008, 2010 and 2012 from the cohort of parents recruited in Wave1. Qualitative data will be collected via interviews with purposively selected subsamples in 2012 and 2013. Data collection began in 2008 and 355 respondents to Wave One of the study have agreed to participate in future surveys. Work is currently underway to increase this sample size. The methods and survey instruments are described., Discussion: This study will make an important contribution to the existing research on same-sex parented families. Strengths of the study design include the longitudinal method, which will allow understanding of changes over time within internal family relationships and social supports. Further, the mixed method design enables triangulation of qualitative and quantitative data. A broad recruitment strategy has already enabled a large sample size with the inclusion of both gay men and lesbians.

Objective: Does the provision of a nurse-based intervention lead to smoking cessation in hospital patients?, Methods: At tertiary teaching hospital in Newcastle, Australia, 4,779 eligible (aged 18-80, admitted for at least 24 hours, and able to provide informed consent) and consenting (73.4%) in-patients were recruited into a larger cross-sectional survey. 1,422 (29.7%) smokers (in the last 12 months) were randomly assigned to control (n = 711) or intervention group (n = 711). The brief nurse-delivered intervention incorporated: tailored information, assessment of withdrawal, offer of nicotine replacement therapy, booklets, and a discharge letter. Self-reported cessation at 12 months was validated with CO and salivary cotinine., Results: There were no significant differences between groups in self-reported abstinence at three or 12 months post intervention, based on an intention to treat analysis. At three months, self-reported abstinence was 27.3% (I) and 27.5% (C); at 12 months was 18.5% (I) and 20.6% (C). There were no differences in validation of self-report between intervention and control groups at 12 months., Conclusion: This brief nurse-provided in-patient intervention did not significantly increase the smoking cessation rates compared with the control group at either three or 12-month follow-up., Implications: A systematic total quality improvement model of accountable outcome-focused treatment, incorporating assertive physician-led pharmacotherapy, routine assessment and recording of nicotine dependence (ICD 10 coding), in- and outpatient services and engagement from multidisciplinary teams of health professionals may be required to improve treatment modalities for this chronic addictive disorder.