Current Controlled Trials ISRCTN03704676. http://dx.doi.org/10.1186/ISRCTN03704676.

Objectives: Family violence is a public health issue. It occurs in many forms, is most commonly directed at woman and children, and contributes significantly to death, disability, and illness. This study was conducted in the clinical staff in a large metropolitan hospital and aimed to determine levels of family violence training, self-perceived knowledge and confidence, specific clinical skills, and barriers to working effectively in the area. Methods: A short, targeted online survey was designed to capture the required information. Descriptive statistics were calculated, and free-text responses were analyzed using qualitative content analysis. Results: Survey responses were received from 534 staff (242 nurses, 225 allied health, 67 medical). Sixty-five percent had received some form of family violence training, mostly of short duration (1–3 h); 72% reported having little or no confidence working in the area, while 76% indicated that they had little or no knowledge in the area. Longer duration training was associated with an increase in knowledge and confidence ratings. Family violence screening rates and knowledge of several specific family violence clinical skills (how to appropriately ask clients about family violence and family violence risk factors) were also low. Thirty-four percent indicated that they did not know what to do, when a patient disclosed experiencing family violence. The most commonly indicated barriers to working effectively in this area were suspected perpetrators being present, perceived reluctance of patients/clients to disclose when asked, and time limitations. Conclusion: This research provides a useful snapshot of clinical staff perceptions of their family violence skill levels in a large metropolitan Australian tertiary hospital. It highlights the need for further in-depth training in clinical health professionals in family violence. The research will allow for family violence training to be tailored to the needs of the professional discipline and clinical area.

Objective The advantages and effectiveness of Internet interventions have been established. Little is known about the critical processes of change in Internet‐delivered interventions and of the psychological experience of users. These are both clinically relevant and have a link to the overall outcome of therapy. The goal of this article was to gain an insight into the important therapeutic processes in an 8‐week supported online self‐administered CBT‐based treatment for depression. Method Respondents were participants (N = 88) in a randomised controlled trial with an initial score of 14–28 on the Beck Depression Inventory (BDI‐II), who completed at least one module of the online intervention, and at least one Helpful Aspects of Therapy (HAT) questionnaire. Analysis The HAT data were analysed using descriptive–interpretative qualitative analysis to (i) identify helpful and hindering events, (ii) describe key events and (iii) describe the corresponding impacts of these events on the clients. Results In total, six helpful events were reported (provision of information, core CBT activities, mindfulness, platform accessibility and usability, supporter, personal stories and examples) and eight associated impacts (applying new coping skills/behavioural change, awareness and insight, improved well‐being, support/validation, expression/relief, self‐efficacy/empowerment/sense of achievement, personal connection). In total, five hindering events were identified (platform features/design, external factors, internal factors, supporters' feedback and content of the programme) and five associated impacts (disappointment, frustration/irritation, confusion, mood deterioration and being self‐critical/blaming) were reported. Conclusions The current results support previous findings that CBT principles are important in online delivery. The role of the supporter emerges as a key ingredient in online delivery worthy of further investigation.

Objectives: Assisting patients who are experiencing family violence is an important issue for health services. Rates of screening for family violence in general hospital settings in Australia are unclear. This study was conducted to obtain data on hospital family violence screening rates and health service users’ perceptions of the screening process, in a large metropolitan hospital in Australia. Methods: Clients from the clinical caseloads of social work and psychology staff were invited to participate in a tablet administered, online survey of their family violence screening experiences, within the health service. Results: A total of 59 surveys were completed by hospital users, who had been treated in areas including the emergency department, acute inpatient wards, sub-acute and rehabilitation units, and outpatient clinics. Less than half the sample reported being screened for family violence at the health service. One-quarter of the respondents reported disclosing family violence concerns, with one-fifth wanting to disclose, but not feeling comfortable to do so. The majority of respondents who disclosed family violence felt supported by the response of the staff member and were provided with information they found helpful. However, further work could be done to improve screening rates, environmental and organizational factors to promote users feeling comfortable to disclose, and staff responses to disclosures. Conclusion: The results of the survey will be used to inform the development of a hospital-wide family violence training initiative aimed to improve staff knowledge, confidence, rates of screening, and clinical responses to family violence.

Parents' song lyric messages may support their children during the parents' illnesses and through the children's developmental transitions and possible bereavement. Some parents use song writing for catharsis and to encourage their children's continuing attachment with them after death. Through promoting parent-child connectedness and emotional expression, therapeutic song writing can be a valuable oncologic supportive care modality.