The importance of stress in the understanding of adolescent health and well‐being is widely documented. The measurement of adolescent stress has however been subjected to sufficient methodological and conceptual criticism in recent times to warrant a concerted re‐evaluation of the exercise. This study sought information on the nature of adolescent stressors, building on a previous instrument developed by the first author to ask adolescents themselves to inform the development of a pool of new items reflecting stressor experience and to advise on the wording of these items to comprehensively assess that experience. This pool of items was then administered as a self‐reported questionnaire to a large sample of school‐age adolescents (N>1000) together with a scale to assess the intensity of distress arising from stressor occurrence. Principal components analysis of the questionnaire yielded 10 internally reliable dimensions of adolescent stress, the nature of which were consistent with the available literature on adolescent stressor experience. Scales constructed from this PCA related positively to measures of anxiety and depression, and negatively to a measure of self‐esteem, suggesting that they were valid measures of adolescent stress. Test–retest reliability was good for all scales. The resultant Adolescent Stress Questionnaire (ASQ) is therefore suggested to have potential for the measurement of adolescent stress in both research and clinical contexts.
Clinical and health psychologists are, collectively, the most numerous of the professional subgroups represented by the Colleges of the Australian Psychological Society. The value of these professionals to the continued health and well‐being of the Australian society is important and this value is underscored by the commitment shown by Australian clinical and health psychologists both to intake‐level education and to the maintenance of continuing professional development once entry into the profession has been achieved. The present paper documents contemporary professional profiles of Australian clinical and health psychologists and relates these to previous information addressing this issue. Quite clearly, those now involved in clinical and health psychology are, by and large, highly educated professionals strongly committed to evidence‐based practice and to the pursuit of experiences which maintain and enhance their professional skills. The changing nature of the Australian health‐care system, however, poses escalating challenges for the profession and many appear to be migrating from the public to the private sectors of practice although they are still not well served by health‐care policies related to funding. Their experiences in this regard (and others) point to areas where a professional body such as the APS can further support these highly valuable professionals.
This paper describes rehabilitation principles and some specialised practice that could usefully inform the provision of acute in-patient care. A low secure rehabilitation setting is described using a method of case formulation to embed an envelope of care around an individual patient within a therapeutic ward milieu. This increases the collaboration and transparency around individual care planning and the capacity for self-reflection within the multi-disciplinary team, in a manner that may be applicable to other in-patient settings.
Two cases are presented from a project to develop psychodynamicinterpersonal (PI) therapy (Hobson's`Conversational Model') with long-term severe schizophrenia treated in a locked setting. We present two cases from a treatment development project including a description of the model and its use in this setting with some (anonymized) details of the therapy. The ward milieu can act as a container for disturbed dynamics during psychotherapy, but the lack of progress prior to the psychotherapy suggests that there is also the potential for the ward to reinforce or even replicate the disturbance in the patient's internal world. These complex interactions are considered in the light of the methodology for future studies. Preliminary outcome data and a description of the positive changes observed are included, but with a note of caution about the difficulty of interpreting outcome findings from single case studies in a complex treatment setting.
A move from institutional to community health care means that health service staff are increasingly requested to visit patients in their own homes. This undertaking is not without risk, particularly where the patient or the locality is unknown. There are no nationally available guidelines for formally assessing potential risk to a health worker before the home visit. A protocol for risk assessment and a safety schedule before making a home visit was therefore developed and is described in this article. The difficulties in carrying out a comprehensive risk assessment are outlined. Several ways in which the assessment of risk before home visits could be made more effective are suggested.
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