Psychosocial support use among men with cancer living in rural and regional areas

The main aim of the current study was to investigate formal and informal psychosocial support use among a sample of men with cancer living in rural and regional Australia, and to examine how use of psychosocial support is related to psychological, physical and social wellbeing.Master of Applied Science (Psychology

An evaluation of the CAST program using a conceptual model of school-based implementation

Therapeutic prevention and/or early intervention programs for children at risk of developing disruptive behaviour disorders are increasingly being implemented in schools. One such Australian school-based program is CAST: CAMHS (Child and Adolescent Mental Health Service) and Schools Together, an evidenced-based program treating children with emerging disruptive behaviour disorders in the early primary school years. The current evaluation examines the process of implementation of the CAST program in primary schools. By using a conceptual model of school-based implementation (developed by Greenberg, Domitrovich, Graczyk & Zins, 2005) the wide array of factors that can affect successful implementation at the school level were identified, and those elements critical to implementation quality were examined. Semi-structured individual and group interviews were conducted with a sample of 69 school personnel across 16 schools in the City of Ballarat and wider Grampians region of Victoria, in both government and Catholic primary schools. Results showed that schools were highly satisfied with the quality of CAST resources and personnel, and the implementation and delivery of sessions as planned. Aspects that impacted negatively on the implementation process were the lack of parental engagement; the lack of classroom follow-up in some schools; the level of readiness and pre-planning by the schools; and the availability of technical support. Greenberg’s conceptual model appears to be a useful framework to utilise in examining the implementation of the CAST model, as it allowed close examination of how the program was implemented within naturally occurring constraints. It allowed the identification of elements within the CAST model and the associated support system that must be maintained and nurtured by the collaborating parties, in addition to the factors at a school level that are potential barriers to effective implementation. Identification and examination of such factors assist in ensuring quality outcomes for school-based interventions in the future.C

Predictors of support service use by rural and regional men with cancer

Objective: The current study examined how sociodemographic, psychological, physical and social support variables predict participation in formal support services. Design: Cross-sectional study. Setting: Participants were recruited from oncology clinics, cancer specialist clinics and cancer support groups. Participants: Seventy-six men living outside major Australian cities, the majority with prostate cancer (n=55). Main outcome measures: Participants completed the Brief Symptom Inventory, the List of Physical Complaints, the Social Support Subscale of the Coping Resources Inventory and questionnaires related to levels of awareness of, and participation in support services. Results: Most (82%) of the men were aware of at least one formal service offering emotional support, and 49% of the men had used such a service. Telephone- and Internet-based services were the most used type of support. The only predictor of participation in a formal service was lower age. Conclusions: Use of a support service was not predicted by psychological or physical symptoms, levels of social support or distance from service centres. Attitudes to different types of services, and support services in general, might be more predictive of actual use. The current findings point to the potential of telephone- and Internet-based support as an acceptable means of formal support for rural and regional men who experience cancer-related distress. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc

Self-reliance and stoicism as predictors of distress following radical prostatectomy in the context of place of residence

A common form of treatment for Australian men with prostate cancer is a radical prostatectomy (RP). Although sociodemographic and medical factors have been found to be predictive of psychological distress following RP, the traditional masculine norms of self-reliance and stoicism are also implicated in poor psychological outcomes. The strength of the relationship between these masculine norms and distress may vary according to place of residence-specifically, living in regional/remote versus urban areas. The aim of the current study was to investigate these masculine norms as predictors of psychological distress among a sample of men who had received the same treatment for prostate cancer, in the context of place of residence. Participants were 447 men, aged between 42 and 77 years (M = 63.1, SD = 6.4), all of whom had undergone a RP within the previous 6 months. Participants completed self-report measures of psychological distress, physical functioning, self-reliance, and stoicism. As hypothesized, self-reliance and stoicism were independent and unique predictors of psychological distress, after controlling for sociodemographic and medical factors. Place of residence moderated the relationship between stoicism and distress, whereby the relationship was only significant for urban men. The relationship between self-reliance and distress was significant for all men regardless of place of residence. The current study takes an important step toward identifying potentially modifiable and context-specific factors that can impact the experience of psychological distress among men following RP

Barriers to accessing psychosocial support services among men with cancer living in rural Australia : Perceptions of men and health professionals

Little research has investigated formal psychosocial support use among men with cancer living in rural areas. The current study investigated perceived barriers to support service use among such men, within the framework of the Behavioral Model of Health Service Use. In a mixed methodology study, 82 men with cancer living in rural Australia were surveyed, and nine of these men, plus three health professionals, participated in semi-structured interviews. Reasons for not participating in formal support were sufficient informal support and subjective judgements about perceived need. Service availability was rarely endorsed by the men as a reason for non-participation, but was emphasised by health professionals. Identifying factors that impede or facilitate service use might enable rural men experiencing cancer-related distress to seek the extra psychosocial support they need. © 2011 by the Men's Studies Press, LLC. All rights reserved

The relationship between geographic remoteness and intentions to use a telephone support service among australian men following radical prostatectomy

Objective: The objective is to investigate the influence of characteristics related to place of residence (self-reliance and stoicism) on men's intentions to use a telephone support service following radical prostatectomy. Methods: A community sample of 447 prostate cancer patients (31% response), recruited via Medicare Australia, completed a survey to assess levels of self-reliance and stoicism, and beliefs about addressing emotional distress through using telephone support services. Results: Results indicated that the model was a partially mediated model. Geographic remoteness was directly related to intention, and indirectly related through stoicism and subjective norms. Conclusion: Men from rural and remote areas in Australia might face particular challenges in seeking support following treatment for prostate cancer. These challenges appear to relate to the influence of stoic attitudes and normative expectations, than to issues of access and availability. Addressing stoic attitudes in the clinical setting, through normalising emotional reactions to cancer diagnosis and treatment, and the act of help-seeking for emotional support, may be beneficial.Sons, Ltd

Intentions to use telephone and face-to-face support services: Attitudes of Australian men following prostatectomy

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Evaluation of Various Support Intensities of Digital Mental Health Treatment for Reducing Anxiety and Depression in Adults: Protocol for a Mixed Methods, Adaptive, Randomized Clinical Trial

BackgroundAnxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. ObjectiveThe primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. MethodsAustralian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). ResultsThe primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. ConclusionsThis is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. Trial RegistrationAustralian and New Zealand Clinical Trials Registry 12620000422921; https://tinyurl.com/t9cyu372 International Registered Report Identifier (IRRID)RR1-10.2196/4504

Video chat therapist assistance in an adaptive digital intervention for anxiety and depression : reflections from participants and therapists

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. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: journal abstract

Therapist training in video chat technology for use in an adaptive digital mental health intervention: Challenges, facilitators and implications for training models

Objective: This qualitative study investigated therapist training experiences, elements of skill acquisition, and barriers and facilitators associated with conducting assessments, and the delivery of low- and high-intensity therapist assistance delivered via video chat technology, adjunctive to a transdiagnostic digital mental health intervention programme for anxiety and depression. Methodology: In total, 34 semistructured interviews were conducted with 20 therapists. Twenty interviews explored experiences of training to administer a clinical assessment tool, and 14 additional interviews explored training experiences of delivering low- and high-intensity therapist assistance via video chat technology. Results: Reflexive thematic analysis identified three themes: video chat skill acquisition, competencies transferrable to video chat and video chat service quality. Training and supervision were identified as important to scaffold skill development, and therapists described surprise that their skill set was transferrable to video chat. The most cited barrier to the adoption of video chat was the management of risk and distress, along with environmental suitability. Frequently cited facilitators to the adoption of video chat included stable Internet connection, protocols and resources. Conclusion: The benefits of video chat technology and digital mental health interventions can be maximised through the expansion and integration of training into existing teaching curricula. If therapists are familiarised and competent to deliver mental health services via the Internet, as well as in person, the future adoption of blended and stepped-care models is likely to be increased. © 2023 The Authors. Counselling and Psychotherapy Research published by John Wiley & Sons Ltd on behalf of British Association for Counselling and Psychotherapy