Mandy Matthewson

Purpose: Understanding the lived experience of major trauma survivors who have engaged with recovery and rehabilitation services is a vital component of trauma system quality improvement. The purpose of this study was to explore the first 12 months of major trauma recovery from the perspectives of those with lived experience across different geographical locations (regional, rural and remote). Method: Semi-structured interviews and questionnaires were conducted with nineteen major traumatic injury survivors (aged 28 to 74 years; 78.9% male; 73.7% living in a regional area) who were on average 1.9 years post injury. Results: Interviews were thematically analysed, and four superordinate themes were generated: (1) communication in acute recovery, (2) transition from hospital to home, (3) service quality and accessibility, and (4) recovery beyond physical rehabilitation. Conclusion: Overall, the findings illustrate potential avenues to better support major traumatic injury survivors with their recovery, across a range of geographical areas.

Uncertainty is an unavoidable aspect of healthcare service provision, particularly for psychologists who often navigate complex ambiguous clinical scenarios, which can evoke negative responses and increase risk of adverse outcomes. This study explores the willingness of Australian psychologists to communicate uncertainty to clients, identifying facilitators and barriers to this process. We surveyed 70 Australian psychologists providing direct client care. The survey focused on barriers and facilitators to communicating uncertainty through responses to a vignette depicting a common therapeutic scenario featuring uncertainty. Thematic analysis was undertaken using Nvivo. Key themes describing barriers included psychologist's internalization of uncertainty as personal and professional inadequacy, fear of negative client reactions, and a lack of skills in effectively communicating uncertainty. Conversely, facilitators included comfort with uncertainty, external professional supports, and strong therapeutic relationships. The findings underscore the need for enhanced training of psychologists in uncertainty communication, focusing on developing adaptive responses and effective communication strategies. Addressing uncertainty is crucial given its inevitability, psychologist's pervasiveness discomfort with uncertainty and barriers to its communication. Future research should explore the nuanced experiences of psychologists in diverse practice settings working within a range of therapeutic modalities, and the impact of uncertainty on the therapeutic relationship.

Social disinhibition, the inability to behave in a manner consistent with social "rules" and norms, is one of the most commonly reported outcomes following brain injury. The experience of social disinhibition from the perspective of those with lived experience, however, remains poorly understood. The purpose of this study therefore was to increase understanding of how social disinhibition presents among those with a brain injury and how this might differ from the perspective of carers. Fourteen participants (nine acquired brain injury, five primary carers) aged 18 years and older participated in a 45-60-minute semi-structured interview. All interviews were thematically and inductively analysed using NVivo. Among participants with an acquired brain injury, four superordinate themes were generated, namely, "types of behaviour," "factors contributing to behaviour," "consequences of behaviour," and "insight." Four superordinate themes were also generated among carers and included "types of behaviour," "factors contributing to behaviour," "social environment" and "insight." The results of the current study highlight the complexity of socially disinhibited behaviours and the importance of developing appropriate, targeted treatment approaches.

Introduction: The aim of this study was to explore the experiences of voluntary reunification from the perspectives of adult alienated children and targeted parentsMethods: Nine adult alienated children and 12 targeted parents participated in semi-structured interviews which were transcribed verbatim and analyzed thematicallyResults: Six themes emerged in the data from the adult alienated children including catalysts for reunification, factors influencing reunification, adult alienated child relationships, the role of communication in reunification, adult alienated child understandings of alienation post reunification, and the role of therapy in reunification. Three themes emerged from the targeted parents including what is reunification, factors impacting reunification, and life after reunification.Discussion: Findings from the present study offer novel insights into the experience of voluntary reunification from the perspectives of both adult alienated children and targeted parents. They illustrate that voluntary reunification is a process that takes time. This process can span decades and can include periods of connection and rejection.

Objectives: Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition which causes a significant burden on the diagnosed individuals. Assessment and management are perplexing, often resulting in unsatisfactory outcomes. Existing research has only focused on patients’ perspectives of pain experiences, but scant evidence is available to understand the barriers that undermine effective pain management. Using an exploratory approach, this study examined these barriers from practitioners’ perspectives. Methods: Twelve semi-structured interviews were conducted with practitioners across disciplines who have experience in chronic pelvic pain management in males. Practitioners expressed their views and experiences in supporting men with CP/CPPS and what barriers they perceived when providing treatment for patients. Data were analysed using reflexive thematic analysis supported by NVivo software. Results: Five broad and interrelated themes were identified: (1) Where to Start, (2) Insufficient Resources, (3) Prioritisation, (4) Training and Confident Practice and (5) Constraints in Help-Seeking. Conclusions: Practitioners value multimodal management using a biopsychosocial approach; however, practical challenges prevent practitioners from choosing and applying this approach in clinical practice. The findings also identified some unique challenges faced by men with CP/CPPS consistent with previous evidence from patient perspective. Refining terminology, developing specific resources, and increasing psychosocial treatment options are urgently needed.

This study aimed to review the academic peer-reviewed and grey literature pertaining to current treatment protocols for mental health practitioners working therapeutically with adult survivors of severe parental alienation. The academic databases searched were Medline (Web of Science), PsycNET (APA), and Psychiatry Online. Grey literature searches were conducted through Google, professional websites, published books and Facebook. No peer-reviewed articles matching the inclusion criteria were located. However, four pertinent grey literature resources were discovered. It was found that there is a dearth of ethical standards and professional practice guidelines that include a comprehensive treatment protocol for mental health practitioners who work with adult survivors of severe parental alienation and more research needs to be undertaken. Also, to understand the degree, acuity, complexity, and severity of the developmental and ongoing acute trauma of severe parental alienation, a treatment protocol must be developed as well as a gold standard for competence, training, and ongoing professional development for mental health practitioners working with adult survivors.

This study explored parental alienating behaviours experienced by grandparents with limited or no contact with their grandchildren. Twelve alienated grandparents participated in semi-structured interviews investigating their experience of alienation. The data were analysed using an inductive thematic analysis approach. Alienated grandparents reported being exposed to 13 parental alienating behaviours used by the alienating parent. These behaviours are consistent with those reported by targeted parents and adult alienated children in other studies. This study showed that parental alienating behaviours also affects grandparent-child relationships. Further research is needed to better understand the impact of parental alienation on grandparents and the wider family system.

Objectives: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition. Despite recommendations for the inclusion of non-pharmacological treatment in the management of CP/CPPS, the focus has predominantly been on the inclusion of physical therapies with minimal discussion of psychological interventions. Therefore, this systematic review aimed to evaluate peer-reviewed studies of psychological interventions for men with CP/CPPS to determine their therapeutic efficacy and quality of intervention. Methods: The review was registered in PROSPERO and based on PRISMA 2020 protocol. The systematic literature search was conducted in six databases. Quantitative studies of psychological intervention for adult men with CP/CPPS that provided outcome measures of pain, quality of life and/or psychological symptoms were reviewed. The Oxford level of evidence and Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice were employed. Results: A total of 4,503 studies were reviewed; seven met the inclusion criteria. The included studies were randomised controlled trials, cohort, repeated measures, and case-series studies, with most including combined treatment for CP/CPPS. Cognitive therapy, cognitive behavioural therapy, or paradoxical relaxation training were found to be effective. However, high risks of bias were found in all included studies, limiting the generalisability and reliability of findings. Conclusions: Evidence is preliminary but shows promise for psychological treatment either as a combined or standalone treatment for CP/CPPS. However, there is a need to develop research with a more rigorous methodology to evaluate psychological treatments for men with CP/CPPS.

This study qualitatively investigated the mental health of adults exposed to parental alienating behaviours in childhood. Research suggests that exposure to parental alienating behaviours in childhood can have a profound impact on the mental health of those children later in life, including experiencing anxiety disorders and trauma reactions. An international sample of 20 adults exposed to parental alienating behaviours in childhood participated in semi-structured interviews on their experience and its impact. Four themes were identified: mental health difficulties, including anxiety disorders and trauma reactions, emotional pain, addiction and substance use, and coping and resilience. Intergenerational transmission of parental alienation was found. Confusion in understanding their experience of alienation, the mental health sequelae, and elevated levels of suicidal ideation were found. This study demonstrated the insidious nature of parental alienation and parental alienating behaviours and provided further evidence of these behaviours as a form of emotional abuse.