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How often do psychologists use interoceptive exposure to treat panic disorder?

Interoceptive exposure (IE) is one of the single most critical components of cognitive behaviour therapy for panic disorder, as supported by research. International studies suggest, however, that psychologists often avoid using IE with their clients, and that when they do use it, they frequently do not do so in ways consistent with evidence-based best practice. The same studies suggest that negative beliefs about exposure may underpin these treatment decisions.

Researchers investigated the use of IE within a population of Australian and New Zealand psychologists. The aim was to find out how much IE is used, and whether use of IE was associated with psychologists’ beliefs about exposure and personal characteristics, such as level and type of training. Participants (N = 164) completed questionnaires seeking demographic information, as well as information about type of treatment used for panic disorder, how treatment is implemented, negative beliefs about exposure therapy, general risk orientation and self-reported treatment outcomes.

Participants used a broad range of treatment approaches for panic disorder and implemented exposure in widely varying ways, often not consistent with evidence-based practice. For those who did not use IE at all, or use it as indicated, results suggested that they are influenced by negative beliefs about exposure therapy, which was positively related to lower success rates in treatment outcomes.

The findings suggest a need for further research into the quality of current training methodologies, supervision practices and ongoing professional development standards for exposure therapy techniques in Australian and New Zealand contexts.

https://doi.org/10.1080/13284207.2022.2035651

Acting on benefit-finding has advantages.

As the prevalence of food hypersensitivity rises worldwide, the approach families take to raising children with food hypersensitivity can significantly impact their psychological wellbeing.

Benefit-finding, defined as identifying favourable aspects from adverse situations, can help families cope. However, little is known about the processes by which benefit-finding occurs for different family members. To address this knowledge gap, a recently published multi-centre study compared benefit-finding processes through semi-structured interviews with 11 regional Australian families, including 48 nuclear family members.

This study identified a benefit-finding process hierarchy, consisting of three sequential levels. Each higher-ranked benefit-finding process introduced additional cognitive and behavioural skills associated with increased biopsychosocial wellbeing. At its basic level, benefit-finding Step 1- It Could Be Worse, families found relief in recognising that others may be facing even tougher challenges. At Step 2- Silver Lining, families were uplifted when they reflected on the positives they perceived from their hardship. At Step 3- Action Advantage, families acted on their positive reflections by developing advantageous thoughts and actions to improve their situation. Parental training facilitated the use of Action Advantage benefit-finding by parents in this study, highlighting potential value in developing Action Advantage benefit-finding training.

Findings suggest potential advantages to establishing family management plans that address the biopsychosocial wellbeing of each family member, and encourage fathers to adopt a more involved role. Benefit-finding psychoeducation and whole-family management plans are suggested to assist families to move more swiftly from surviving with ad hoc individualistic approaches, to thriving by using an adaptive, cohesive, family approach. This study gave voice to all family members, ensuring that the emergent theory was grounded in lived experience. The findings offer healthcare providers, educators, and families, benefit-finding process theory and practical advice to support improved biopsychosocial family functioning.

https://doi.org/10.1111/fare.12648

Strategies to enhance Australian psychologists’ as research leaders.

Psychologists from the NSW public health sector recently published an article on barriers to psychologists engaging in research, and therefore working fully within the Scientist-Practitioner (S-P) model.

The S-P model functions best when clinicians can critically evaluate the literature to inform practice, as well as use their clinical expertise to develop research feeding back into the evidence-base. Despite an expectation that psychologists contribute to the S-P model, often barriers prevent psychologists embedding research into clinical roles. The piece explores common barriers and enablers and outlines initiatives of the South Eastern Sydney Local Health District (SESLHD) Psychology Research and Improvement Committee to address this issue.

A survey of the SESLHD psychology workforce identified lack of protected time and funding, and a perceived lack of knowledge as the primary barriers to research involvement. Through the development of a Research Community of Practice (CoP-R), SESLHD psychologists come together to share ideas and resources on effectively engaging in research. Another initiative is an annual research poster competition to showcase psychologists’ work from across the district. In 2020, the Committee held a Research Forum for SESLHD psychologists and academics from three major NSW universities that led to the development of numerous clinician/academic research partnerships aimed at addressing some identified barriers.

Despite these initiatives, there is more to be done to address barriers to public sector psychologists engaging in research.

To optimise use of psychologists’ training in research skills (that actually distinguishes us from other professions), Smith & Thew (2017) suggest a research component be built into roles. This may require changes at state policy and organisational levels, with budget allocations and the inclusion of research involvement within industrial awards. Such ongoing organisational and managerial sponsorship, along with funding allocation, is central to creating a culture that genuinely values and supports research activities by public health psychologists.

https://doi.org/10.1080/00050067.2021.1981743