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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]

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]

Early maladaptive schemas (EMSs) have been hypothesized to be associated with interpersonal problems. Furthermore, a stronger contention is that EMSs impact negatively on, or cause, interpersonal problems. The aims of this meta‐analysis were (a) to assess the strength of the association between EMSs and interpersonal problems, (b) clarify which EMSs are most strongly associated with interpersonal problems, (c) examine any possible moderators on the relationship between EMSs and interpersonal problems, and (d) examine whether any empirical evidence exists supporting a causal relationship between EMSs and interpersonal problems. A comprehensive systematic literature search and meta‐analysis were conducted using the PRISMA guidelines for systematic reviews. A total of 49 empirical studies were reviewed investigating EMSs and interpersonal problems. EMSs were found to have a moderate positive association with interpersonal problems with different EMSs having small to moderate effect sizes. To date, there has been limited evidence supporting a causal effect of EMSs on interpersonal problems. Possible limitations and avenues for future research were discussed. [ABSTRACT FROM AUTHOR]