Saturday afternoon concurrent sessions #02

Tracks
Ballroom 2
Saturday, April 27, 2019
1:30 PM - 3:00 PM

Speaker

Dr Tamara Street
Wesley Medical Research

How to effectively contribute to shared care in rural Australia: Translating findings from medical care

1:30 PM - 1:40 PM

Abstract

Background: Adverse health outcomes are typically higher for Australians residing in rural and remote areas as compared to those residing in metropolitan areas. Specialist services are typically limited in remote areas. Non-metropolitan patients with chronic or complex conditions are often required to access health services from a team of health professionals. To improve patient outcomes, health professionals need to be skilled in practices that support continuity of patient care across a multi-disciplinary and geographically diverse health service team. Psychologists and other allied health professionals can apply findings from recent medical care coordination research to enhance their collaborative care practices.

Aims/objectives: This paper describes the combined outcomes of: (1) a systematic review of barriers and facilitators of achieving continuity of care between health services for non-metropolitan patients; and (2) a case study of the implementation of a shared care service connecting non-metropolitan patients and clinicians with metropolitan specialists. The case study provides insights from three stakeholder groups comprising of patients; referring clinicians; and medical specialists. Findings from medical care coordination are highlighted to indicate professional practice opportunities for psychologists and other allied health practitioners to enhance their participation in provision of shared health care.

Implications: To improve health outcomes for patients, all health practitioners involved in shared care need to take responsibility for implementing strategies that will achieve continuity of care. Recommendations are provided with regard to: communication; collaboration; role clarity; education; resourcing; and information sharing. Unintended barriers to shared care, for example financial disincentives for participation, are identified to initiate discussion on policy implications.

Conclusions: The clinical knowledge gained in this study from a broad range of Australian allied health professionals is important for health practitioners to advance their effective participation in shared health care teams. Implementation of the recommended strategies will ensure that health professionals engage in practices that promote continuity of care to facilitate improved patient outcomes. The research reviewed was purposively limited to Australian studies as the scope was to identify professional practice opportunities for improving participation in provision of shared health care in Australia. Some professional practice recommendations may therefore not be relevant in other countries.

Biography

Dr Tamara Street is a Research Manager and a Senior Research Fellow at Wesley Medical Research. She is a Registered Psychologist and Personal Trainer. With her expertise in the areas of behaviour change management, occupational health and safety, training and performance enhancement, she has worked as a consultant for both private business and public sector clients and is an experienced applied researcher. Tamara was awarded the Wesley Research Institute’s prestigious 'scientific researcher of the year' in 2014 in acknowledgement of her contributions to health research. Today Tamara will be taking about findings from medical shared care research and the implications for recommended professional practice for health practitioners.
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Ms Jasmin Turner
Royal Adelaide Hospital

Correlates of post‐traumatic growth following childhood and adolescent cancer: A systematic review and meta‐analysis

1:40 PM - 1:50 PM

Abstract

Background: There are growing rates of paediatric cancer incidence and survival. Consequently, there is an increasing population of people who have lived through the potentially traumatic experience of cancer during early years of their life. Three prior qualitative reviews had been conducted on post‐traumatic growth in children, with one review also reporting some quantitative findings. Despite the importance of understanding post-traumatic growth and related variables in children and adolescents, there had been no quantitative systematic review or meta‐analysis on the topic of post-traumatic growth and paediatric cancer. This review provides the first systematic review and meta-analysis on post‐traumatic growth in individuals affected by cancer in childhood and adolescence, and explores the factors important for post-traumatic growth and its facilitation after paediatric cancer survival.

Objective: The objective was to identify the demographic, medical, and psychosocial correlates of post‐traumatic growth in individuals of any age who were affected by paediatric cancer. Findings identify protective factors that may facilitate post‐traumatic growth, allowing for directed social support, intervention, and follow‐up care.

Method: A systematic search based on the key concepts “post‐traumatic growth,” “neoplasms,” and “paediatric” retrieved 905 records from online databases: Embase, Ovid MEDLINE, PILOTS: Published International Literature on Traumatic Stress, PsycINFO, and Web of Science. Eligible studies were appraised as excellent quality with a high level of interrater reliability. The results of 18 studies were synthesised.

Results: Post‐traumatic growth shared small, negative associations with time since diagnosis and time since treatment completion. Small, positive associations were found with age at diagnosis, age at survey, post‐traumatic stress symptoms, and social support, after the removal of outliers. Post‐traumatic growth was positively and moderately associated with optimism. Combined results suggest that post-traumatic growth may follow a curvilinear pathway across the lifespan.

Conclusion: Post-traumatic growth shared a positive association with optimism and social support, which is valuable information for individuals, caregivers, community, and clinicians. Targeted personal support, structured group events, clinical intervention, and education, may facilitate social support, optimism, and post-traumatic growth. Longitudinal research in individuals affected by paediatric cancer would allow an examination of the effects of predictive variables on post-traumatic growth over time

Biography

Jasmin's research has examined post-traumatic growth following childhood cancer, forgiveness following interpersonal transgressions, and the working conditions of female beer-sellers in Cambodia. Her clinical and research interests comprise health psychology and enhancing well-being; functional neurological disorders; the impact of difficult medical diagnoses such as neurological conditions and cancer; end-of-life; post-traumatic growth; interventions for sleep problems in infants, children, and adults; and sexuality and gender orientation and identity. Jasmin is a clinical psychologist registrar who co-established a clinical psychology service within the Stroke/Neurology Unit at the Royal Adelaide Hospital in 2017. She enjoys providing high quality and evidence based psychological services to adults who have functional neurological disorders, neurological conditions, and stroke survivors. With over a decade of experience locally and internationally, Jasmin has been involved in a range of positions including as a psychologist, speaker, facilitator, counsellor, case manager, mentor, and educator. Jasmin has worked across a broad range of settings including hospital, private practice, refugee and asylum seekers, social justice advocacy, family therapy, sexual assault, youth homelessness, substance use, and disability.
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Ms. Archna Ranganathan
Deakin University

Prevalence and adolescent predictors of young adult intimate partner violence in Australia

2:00 PM - 2:10 PM

Abstract

The study examined the predictors of Intimate Partner Violence (IPV) in reference to their influence on intimate relationship formation. This longitudinal study investigated a comprehensive set of predictors of IPV perpetration and victimization: poor family management, family conflict, family history of antisocial behavior, parental attitudes favorable towards antisocial behavior, depression, antisocial behavior, drug abuse, interaction with antisocial peers, bullying victimization, alcohol abuse, non-completion of Year 12, continuing further education since secondary school, parents education level attained, and their employment status.

A sample of emerging adults from the Australian population (N = 2,884; 51.63% females) completed measures at two-time points; during adolescence (M(age)=14.99 years, SD= 0.41), and again during emerging adulthood (M(age)=21.08 years, SD= 1.65). Multinominal regression analysis was conducted and relative risk ratio (RRR) was calculated. Belonging to older age group, alcohol and drug abuse, mother’s employment status, and having a family history of antisocial behavior emerged as unique predictors for IPV perpetration and victimization, and the results indicated important gender differences in adulthood.

Contrary to past research, bullying victimization, witnessing family conflict, possessing favorable attitudes towards antisocial behaviour, and depression were found to have no significant effect in predicting emerging adult IPV perpetration and victimization. Alcohol abuse emerged as a unique predictor for IPV perpetration and victimization. The findings have implications for developing gender relevant prevention interventions incorporating alcohol use as a major focus on preventing IPV among adolescents and emerging adults.

Biography

Archna Ranganathan is a PhD candidate in the School of Psychology at Deakin University. She is conducting her research in the area of intimate partner violence (IPV) among adolescents. She is exploring risk and protective factors of IPV among youth. Her fourth year project was also based on IPV and examined the issue among migrant women in Australia.
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Dr Hunter Mulcare
Western Health

Helping an extremely claustrophobic breast cancer patient complete radiotherapy using exposure therapy and no medication

2:10 PM - 2:20 PM

Abstract

Case Study: Helping an extremely claustrophobic breast cancer patient have radiotherapy using short term exposure therapy and no medication.

Issue: A breast cancer patient with extreme claustrophobia was referred to psychology as their anxiety was preventing them from completing radiotherapy.

Approach: The patient was seen on a weekly basis with two initial assessment sessions (one an in-vivo assessment) and then completed four sessions of exposure therapy. The patient was exposed to the radiation therapy machine, lying underneath it for increasingly longer periods of time in a pose that simulated her eventual treatment. A high level of liaison between radiation therapists, radiation oncologists and the psychologist was required for this outcome to occur.

Key findings: After four sessions of exposure therapy the patient went from being unable to enter the treatment room to lying underneath the radiation treatment machine long enough to have treatment (90-120 seconds). She was then able to complete radiotherapy treatment without incident; this prevented her from having to have a mastectomy.

Implications: This case demonstrates that short term psychological intervention can be effective in treating a severe psychological condition that was threatening to prevent medical treatment. If the option for psychological intervention was not available patients like this may opt for no treatment (poorer health outcomes), have a medically more invasive and costly treatment (mastectomy) or required a costly and high level of intervention (daily heavy sedation).

Conclusion: A psychologist working in radiotherapy can provide short-term effective treatment of claustrophobia that would have otherwise prevented radiotherapy. Psychological intervention of this sort was not only successful, enabled the optimal medical treatment but was also cost-effective in comparison to the other alternatives for this patient.

Biography

I'm a psychologist who works primarily with medically unwell patients. Currrently I work in Psycho-Oncology with cancer patients at Sunshine Radiotherapy Centre in Melbourne. I was also previously working at Northern Health running the psycho-oncology clinic there. I've also worked in drug addiction and general practice psychology. I work using CBT and also Schema Therapy (which is my favourite). I also co-host "Two Shrinks Pod" a podcast about psychological issues, theories and working in psychology (www.twoshrinkspod.com). I completed a D.Psych (Health) at the University of Melbourne, my thesis was on lung cancer patient information needs and seeking. Because I'm a sucker for punishment I am completing a masters of clinical psychology through Swinburne University. Below is a list of some research I've been involved in: Oncology related research articles: Mulcare, H. Kashima, Y. Milgrom, J. Bishop, M. Wirth, A. Wheeler, G. & Schofield, P. (2013). Avoidant adjustment predicts lower information seeking in people with lung cancer. Psycho-oncology. 22 (3)540-547. Mulcare, H. Schofield, P. Kashima, Y. Milgrom, J. Bishop, M. Wirth, A. & Wheeler, G. (2011). Adjustment to cancer and the information needs of people with lung cancer. Psycho-oncology 20 (5): 488-496. Oncology related posters & conference presentations Hulbert-Williams, N., Hulbert-Williams, L. & Mulcare, H. (2012). Measuring psychological adjustment to cancer : confirmatory psychometric analysis of the Mini-MAC in a UK and Australian cancer sample. Oral presentation at the 17th World Congress of Psycho-oncology, Brisbane Australia, November 2012. Alexander, N., Bevans, H., Davies, S., Kessner, K., Mulcare, H., Stalker, L., Szendroe, A. & Wallace, E. (2012). Developing an allied health service in a new radiotherapy centre in Melbourne’s West. Poster presentation at the 17th World Congress of Psycho-oncology, Brisbane Australia, November 2012. Mulcare, H. Poker, C., & Schofield, P. (2011). How many screened patients does it take to see a psychologist? Oral Presentation at the 16th World Congress of Psycho-oncology, Antalya Turkey, 16-20 October 2011. Mulcare, H., Fox, C., & Schofield, P. (2011). “A bit scared to know too much, but wanting to know at the same time”: A qualitative study on the information needs in people with lung cancer. Poster Presentation at the 16th World Congress of Psycho-oncology, Antalya Turkey, 16-20 October 2011. Mulcare, H. (2011). Referral patterns and client attendance to the Northern Health Oncology Psychologist: Implications for Supportive Care Screening. Poster Presentation at Supportive Care in Cancer Conference Melbourne 2011.
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Mrs Jennifer Kemp
Precious Minds

Perfectionism in a chronic illness context: Helping clients thrive using behavioural and compassion-based strategies

2:20 PM - 3:00 PM

Abstract

Perfectionism is a trans-diagnostic process that can maintain and exacerbate many common mental and physical health problems, as well as interfere with treatment adherence and goal attainment.

Researchers have been exploring perfectionism as a personality construct for decades, with particular focus on its measurement and relationship with mental health disorders, yet perfectionism from a behavioural perspective remains an area almost entirely unexplored.

Using a behavioural approach to help clients change their perfectionistic health behaviours offers a new way of conceptualising these problems and structuring treatment. This opens opportunities to target specific patterns of behaviour in order to improve health, facilitate wellbeing and support goal attainment.

This workshop will present a functional contextual behavioural formulation of perfectionism. We will explore treatment strategies that can unhook our clients from unhelpful perfectionistic responding and build flexibility and compassion.

Participants will have the opportunity to observe and practice an intervention, as well as reflect on their own helpful and unhelpful patterns of perfectionistic responding as a therapist.

Biography

Jennifer Kemp BSc(Psych)Hons, GradDipAppSc(Psychology of Coaching), MPsych(Clinical), MAPS Senior Clinical Psychologist, Cystic Fibrosis Statewide Service, Royal Adelaide Hospital and Private Practice, Adelaide Australia Jennifer is a practicing clinical psychologist who works as the Senior Clinical Psychologist within the Cystic Fibrosis Unit at the Royal Adelaide Hospital and in private practice. Jennifer applies contextual behavioural science, specifically using Acceptance and Commitment Therapy and Compassion-Focused Therapy with a clients ranging from adolescence to adulthood, most of whom have chronic health conditions. Jennifer recently presented on both perfectionism and treatment adherence in chronic illness at the ACBS World Conference in Montreal, Canada and APS Congress in Sydney in 2018. Prior to training in clinical practice, Jennifer worked in organisational psychology, in particular in the field of coaching, training and organisational change. She is an experienced facilitator and has delivered a range of accredited training programs.

Session Chair

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Jennifer Kemp
Precious Minds


Volunteer

Stella Delloso
University of Adelaide

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Christianna Digenis
University of Adelaide

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Justyna Pollok
The University of Adelaide

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