Imogen Rehm

What Role Can Avatars Play in e-Mental Health Interventions? Exploring New Models of Client–Therapist Interaction

In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and among peers. Avatars are digital self-representations, which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified (1) in the formation of online peer support communities; (2) replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3) using avatar technology to facilitate or augment face-to-face treatment; (4) as part of serious games; and (5) communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement by (1) facilitating the development of a virtual therapeutic alliance; (2) reducing communication barriers; (3) promoting treatment-seeking through anonymity; (4) promoting expression and exploration of client identity; and (5) enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

Non-participation in education, employment, and training among young people accessing youth mental health services: demographic and clinical correlates

ABSTRACT Objective: The aim of this study was to investigate participation in employment, education, or training among a national cohort of young people presenting to youth-specific mental health services across Australia, and identify the key demographic and clinical correlates of non-participation. Method: Clinician and self-reported demographic and clinical characteristics were ascertained for 57,644 young people aged 15–25 years presenting to a national youth-specific mental health service between 1 April 2013 and 31 March 2015, including level of participation in education, employment, or training in four categories (not participating, not in the labour force, partial participation, and full participation). Results: The results showed that these young people are very vulnerable to non-participation in employment, education or training. Characteristics most strongly associated with non-participation were being Aboriginal or Torres Strait Islander, male, homeless, diagnosed with a substance use disorder, or having a neurodevelopmental disorder in young adulthood. Discussion: The results extend understanding of the major risk factors associated with non-participation in employment, education, or training for help-seeking young people. Distinct patterns emerged across the three non-participation groups suggesting that support must be tailored to individual needs. Supporting those who experience mental illness to re-engage is essential to buffer against the long-term impacts. Holistic, integrated services that can incorporate mental health and vocational services are crucial for prevention, early intervention, and treatment.

Psychological treatments for trichotillomania: Update and future directions

Objective: This paper aims to provide an overview of evidence-based psychological treatments for trichotillomania. Conclusions: Advances in the understanding of the phenomenology of trichotillomania has led to the augmentation of behavioural treatments with dialectical behaviour therapy and acceptance and commitment therapy. Further studies of treatment component efficacy and cognitive behavioural models are required.

Development of a Suicidal Ideation Detection Tool for Primary Healthcare Settings: Using Open Access Online Psychosocial Data

BACKGROUND Suicidal patients often visit healthcare professionals in their last month before suicide, but medical practitioners are unlikely to raise the issue of suicide with patients because of time constraints and uncertainty regarding an appropriate approach. INTRODUCTION A brief tool called the e-PASS Suicidal Ideation Detector (eSID) was developed for medical practitioners to help detect the presence of suicidal ideation (SI) in their clients. If SI is detected, the system alerts medical practitioners to address this issue with a client. The eSID tool was developed due to the absence of an easy-to-use, evidence-based SI detection tool for general practice. MATERIAL AND METHODS The tool was developed using binary logistic regression analyses of data provided by clients accessing an online psychological assessment function. Ten primary healthcare professionals provided advice regarding the use of the tool. RESULTS The analysis identified eleven factors in addition to the Kessler-6 for inclusion in the model used to predict the probability of recent SI. The model performed well across gender and age groups 18-64 (AUR 0.834, 95% CI 0.828-0.841, N = 16,703). Healthcare professionals were interviewed; they recommended that the tool be incorporated into existing medical software systems and that additional resources be supplied, tailored to the level of risk identified. CONCLUSION The eSID is expected to trigger risk assessments by healthcare professionals when this is necessary. Initial reactions of healthcare professionals to the tool were favorable, but further testing and in situ development are required.

Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion

In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients.