Outcomes of an Australian Nursing Student-led School Vision and Hearing Screening Programme

Nursing students typically do not undertake clinical training in school settings. However, they are well placed to have a role in providing health screening and education in schools or community health venues under supervision of qualified nurses. This study provides a description and outcomes of a vision and hearing screening programme delivered by university nursing students working out of a student-led clinic situated in an underserved, largely Aboriginal and Torres Strait Islander community in regional Australia. Screening and follow-up data collected from 741 elementary school children indicated some important population patterns and trends, with nearly 30% having identified problems. Anecdotal evidence suggested children who gained treatment had improved school performance. Challenges to follow-up and confounding variables are discussed and a suggestion for future research is offered

Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

Copyright © 2016, Chinese Nursing Association. Production and hosting by Elsevier B.V.Objectives Little is known about the differences between urban and rural gamblers in Australia, in terms of comorbidity and treatment outcome. Health disparities exist between urban and rural areas in terms of accessibility, availability, and acceptability of treatment programs for problem gamblers. However, evidence supporting cognitive-behaviour therapy as the main treatment for problem gamblers is strong. This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy (CBT) treatment program offered to urban and rural treatment-seeking gamblers. Methods People who presented for treatment at a nurse-led Cognitive-Behavioural Therapy (CBT) gambling treatment service were invited to take part in this study. A standardised clinical assessment and treatment service was provided to all participants. A series of validated questionnaires were given to all participants at (a) assessment, (b) discharge, (c) at a one-month, and (d) at a 3-month follow-up visit. Results Differences emerged between urban and rural treatment-seeking gamblers. While overall treatment outcomes were much the same at three months after treatment, rural gamblers appeared to respond more rapidly and to have sustained improvements over time. Conclusion This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help

Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers.

BACKGROUND: Problem gambling is a growing concern as governments become more reliant on gambling revenue particularly from increases in gambling casinos. It is widely reported that problem gamblers experience both high levels of comorbid mental health issues and subsequent disability that comes with such. To date, there have been few measures tested with problem gamblers that are a good measure of this disability. The Work and Social Adjustment Scale (WSAS) is a five-item measure of disability, which is used widely in a number of clinical settings including gambling. METHOD: The reliability and validity of the WSAS were examined in 171 outpatient problem gamblers who presented to a cognitive behavior therapy service in Adelaide, Australia. Subjects were assessed by trained cognitive behavior therapists and offered individual outpatient, group, or inpatient treatment. All subjects signed consent for their clinical data to be used and completed a battery of outcome measures at assessment, discharge, and 1-, 3-, and 6-month follow-up. RESULTS: The internal consistency of the WSAS was excellent among problem gamblers. A principal component analysis generated a single factor of disability. The WSAS has good concurrent validity with measures of gambling and comorbid anxiety and depression. The WSAS also shows promise as a measure of improvement in a clinical service. CONCLUSION: The WSAS has excellent reliability and sound validity among a treatment-seeking problem gambling population. Understanding disability related to gambling may offer insights into the long-term success of gamblers completing treatment. This instrument needs further refinement in a more rigorous experimental setting

Cognitive-behavior therapy for problem gambling: a critique of current treatments and proposed new unified approach

This is an Accepted Manuscript of an article published by Taylor & Francis in the Journal of Mental Health on 18 October 2016, available online: http://www.tandfonline.com/10.1080/09638237.2016.1207235 BACKGROUND: There is evidence supporting the use of cognitive-behavioral therapy (CBT) in the treatment of problem gambling. Despite this, little is known about how CBT works and which particular approach is most effective. This paper aims to synthesize the evidence for current CBT and propose a more unified approach to treatment. METHODS: A literature review and narrative synthesis of the current research evidence of CBT for the treatment of problem gambling was conducted, focusing on the underlying mechanisms within the treatment approach. RESULTS: Several CBT approaches were critiqued. These can be divided into forms of exposure therapy (including aversion techniques, systematic desensitization and other behavioral experiments) those focusing on cognitive restructuring techniques (such as reinforcement of nongambling activity, use of diaries, motivational enhancement and audio-playback techniques and third wave techniques including mindfulness. Findings, in relation to the treatment actions, from this synthesis are reported. CONCLUSIONS: The debate surrounding the treatment of problem gambling has been conducted as an either/or rather than a both/and discourse. This paper proposes a new, unified approach to the treatment of problem gambling that incorporates the best elements of both exposure and cognitive restructuring techniques, alongside the use of techniques borrowed from mindfulness and other CBT approaches

The impact of gambling on rural communities worldwide: A narrative literature review

Gambling has become a popular activity in both urban and rural settings. Although the prevalence and participation of gambling is well known, little has been reported regarding the impacts of gambling on rural communities. Therefore, a narrative literature review approach was adopted to examine what is known regarding gambling in rural communities. This article describes the prevalence and types of gambling that are popular in rural communities around the world. It identifies the benefits and highlights the potential harm caused by a person’s gambling and the impact this has on families and the wider rural community. There are both benefits and risks associated with increased availability of gambling opportunities. Specific vulnerable groups within rural populations are identified within this context and how different countries respond to rural gambling is explored. A number of strategies based on a public health approach are recommended to ensure that gambling remains as harmless an activity as possible in rural communities. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Cognitive-behavior therapy for problem gambling: a critique of current treatments and proposed new unified approach

This is an Accepted Manuscript of an article published by Taylor & Francis in the Journal of Mental Health on 18 October 2016, available online: http://www.tandfonline.com/10.1080/09638237.2016.1207235 BACKGROUND: There is evidence supporting the use of cognitive-behavioral therapy (CBT) in the treatment of problem gambling. Despite this, little is known about how CBT works and which particular approach is most effective. This paper aims to synthesize the evidence for current CBT and propose a more unified approach to treatment. METHODS: A literature review and narrative synthesis of the current research evidence of CBT for the treatment of problem gambling was conducted, focusing on the underlying mechanisms within the treatment approach. RESULTS: Several CBT approaches were critiqued. These can be divided into forms of exposure therapy (including aversion techniques, systematic desensitization and other behavioral experiments) those focusing on cognitive restructuring techniques (such as reinforcement of nongambling activity, use of diaries, motivational enhancement and audio-playback techniques and third wave techniques including mindfulness. Findings, in relation to the treatment actions, from this synthesis are reported. CONCLUSIONS: The debate surrounding the treatment of problem gambling has been conducted as an either/or rather than a both/and discourse. This paper proposes a new, unified approach to the treatment of problem gambling that incorporates the best elements of both exposure and cognitive restructuring techniques, alongside the use of techniques borrowed from mindfulness and other CBT approaches

Treatment Completion in a Cognitive Behaviour Therapy Service for Problem Gamblers: Clinical Outcome Study

Increased access to gambling is proving to be a great burden on the individuals who partake, their families and society in general. Despite growing evidence for the use of Cognitive-Behaviour Therapy (CBT) with problem gamblers, important questions remain unanswered regarding those individuals who do not respond to CBT. This paper compares gamblers who are considered 1) treatment completers, 2) drop-out following an initial assessment and, 3) drop-out after commencing treatment from a specialized CBT service. The results indicate a number of differences between the groups in regard to gambling severity and behaviour, demographic profile and variations in overall psychopathology

Outcomes of an Australian Nursing Student-led School Vision and Hearing Screening Programme

Nursing students typically do not undertake clinical training in school settings. However, they are well placed to have a role in providing health screening and education in schools or community health venues under supervision of qualified nurses. This study provides a description and outcomes of a vision and hearing screening programme delivered by university nursing students working out of a student-led clinic situated in an underserved, largely Aboriginal and Torres Strait Islander community in regional Australia. Screening and follow-up data collected from 741 elementary school children indicated some important population patterns and trends, with nearly 30% having identified problems. Anecdotal evidence suggested children who gained treatment had improved school performance. Challenges to follow-up and confounding variables are discussed and a suggestion for future research is offered

The New England 4G framework for the treatment of a common health concerns: a gambling case analysis.

Approaches using self-help have proved successful at treating a range of mental and physical conditions. Guidance by a trained worker enhances the effects of self-help materials, in particular those based on Cognitive-Behavior Therapy. In the United Kingdom, the Improving Access to Psychological Therapies (IAPT) program was introduced to provide better outcomes for people experiencing mild or moderate anxiety and depression. This stepped care approach included low intensity, guided self-help offered by a newly trained workforce of Psychological Wellbeing Workers. The IAPT program has been extensively evaluated and shown to be cost effective and leads to positive treatment outcomes. This paper describes how the IAPT model has been adapted for use in Australia with gamblers. Two case studies illustrate the application of this guided approach to systematically accessing existing self-help treatments for problem gamblers. Assessment information is gathered, before a plan of action, including a problem statement and achievable goals, is agreed upon by the worker and the person with the gambling problem. The worker then gives the person options based on self-help CBT interventions and, once an option has been chosen, the worker guides the person as they work through various activities. The benefits of this approach are discussed

Working with Children and Young People with Learning Disabilities and Comorbid Mental Health/ Autism/ Challenging Behaviour Conditions: A Workforce Development Project

London South Bank University (LSBU) are pleased to present a project report for Health Education England on the staffing needs for Children and Young People with a learning disability, mental health problem and challenging behaviours. Many families have complained about poor services. People have told us about: • Poor access and referral to services • A lack of awareness by staff of the things that matter to people with learning disability • Not getting the right support • Having services not near to where we live • People being sent to hospital or long term residential services This project report talks about who are the most suitable staff needed to help to improve services to offer high quality, family centred care packages, working across health and social care services. The aims are to provide the right care for Children and Young People (CYP) closer to their homes and families. The information was collected from looking at published reports and hearing about people’s experiences of service changes taking place today. The report will be shared with the group who will make recommendations for better services to the Government