This paper describes the development and preliminary findings of a program designed to prevent the development of anxiety and depressive symptoms in children aged 10 to 13 years. Using a universal prevention approach, a total of 594 children were randomly assigned on a class-by-class basis to either a 10-session family group CBT program (FRIENDS) routinely implemented as part of the school curriculum, or to a comparison group. Pre-post intervention changes were examined universally, and for children who scored above the clinical cut-off for anxiety at pretest. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms, regardless of their risk status, than the comparison group at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced improvements at posttest. Overall, these preliminary results appear to support the benefits of a school-based universal cognitive-behavioural intervention program. Implications of this study are discussed, and long-term follow-up measures are currently underway.

The goal of the Murdoch Early Intervention Program (MEIP) was to replicate the intensive early intervention program designed by Lovaas for children with severe developmental disability and autism. This paper describes the objectives, methods, and the results as of 24 months. Although MEIP differs from Lovaas's model in several respects, and the children have been generally less capable at the outset, results are interpreted tentatively as being as predicted. Four of 9 experimental children have shown signs of approaching normal levels of functioning whereas 1 of 5 control children has made significant progress. Improvements in the remainder of the children are rated as moderate to minimal. These preliminary results are presented to encourage others working with children with autism and other difficult-to-teach children to publish their methods and results. The small number of children in any one locality, and the high cost of controlled studies indicates the necessity for accumulating findings across service providers.

Recent investigations have demonstrated a renewed interest in the role of avoidance in depression; however, little is known of which specific forms of avoidance — cognitive, behavioural or experiential — are important in this context. This study examined (a) the relationship between depression, rumination and these subtypes of avoidance, and (b) the proposal that the abstract/analytical nature of ruminative thought is linked to experiential avoidance. A nonclinical sample (N = 101) of undergraduate students completed self-report measures of depression, rumination, avoidance and mood state and viewed a low mood emotion-eliciting video stimulus. Participants' written summary of the film clip was independently rated for the degree to which it was abstract or concrete. Rumination, depression and cognitive, behavioural and experiential avoidance were all significantly correlated and remained so when anxiety was controlled. Further, reduced concreteness of description of the film clip was associated with experiential avoidance and rumination. Taken together, the findings underscore the value of clinicians being attentive to experiential avoidance in the assessment and treatment of depression.

In 2001 we evaluated a universal prevention trial of anxiety during childhood, and also examined the effects of the program on levels of depression. Participants were 594 children aged 10—13 years from seven schools in Brisbane, Australia, who were randomly assigned to an intervention or control group on a school-by-school basis. The intervention was based on the group CBT program FRIENDS (Barrett, Lowry-Webster & Holmes, 1999a, 1999b, 1999c). Results were examined universally (for all children) and for children who scored above the clinical cut-off for anxiety at pre-test. At 12-month follow-up, intervention gains were maintained, as measured by self-reports and diagnostic interviews. Eighty-five per cent of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were diagnosis free in the intervention condition, compared to only 31.2% of children in the control group. Implications of these findings are examined, alongside limitations and directions for future research.

Over the past decade, promoting the psychological wellbeing of adolescents has been the subject of increasing interest. To this end, a number of scales have been constructed that specifically assess life satisfaction among adolescents. Using specific selection criteria, the present study reviewed the psychometric properties of five life satisfaction measures available for use with adolescent populations. These scales were the Students' Life Satisfaction Scale, the Satisfaction With Life Scale, the Perceived Life Satisfaction Scale, the Comprehensive Quality of Life Scale – School Version, and the Multidimensional Students' Life Satisfaction Scale. Suggestions for future research are also discussed.

The present paper presents the results of a longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years. Participants were allocated to either a school-based cognitive-behavioural intervention or to a monitoring group, and completed standardised measures of anxiety, depression and coping style. Young people identified as “at risk” of an anxiety disorder were assessed for a clinical diagnosis with a structured diagnostic interview. Findings showed universal intervention as potentially successful in reducing symptoms of anxiety and increasing coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention was potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in addition to the implications and limitations of this study and directions for future research.

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Asperger's syndrome is a relatively newly diagnosed developmental disorder within the autistic spectrum. Children and adults with Asperger's syndrome have an intellectual ability within the normal range but due to their unusual profile of cognitive, social and emotional abilities are vulnerable to the development of a secondary mood disorder. This paper provides an explanation of the abilities associated with Asperger's syndrome, and modifications to cognitive behaviour therapy (CBT) for this very unusual client group. In particular, the paper emphasises the importance of affective education for this clinical population and describes a new strategy used in cognitive restructuring, namely, the emotional toolbox. The paper concludes with a brief description of a current evaluation study of the effectiveness of CBT to treat anxiety and anger in children who have Asperger's syndrome. However, the strategies described in this paper can also be used with adults with Asperger's syndrome and applied to other clinical populations.

As theories of bereavement have evolved, so too have evidence-based interventions to mitigate complications in post-loss adaptation. This article reviews one line of programmatic research grounded in a conceptualisation of grieving as an attempt to reaffirm or reconstruct a world of meaning challenged by loss. Anchored in therapeutic encounters with the bereaved, a meaning reconstruction approach to loss has grown over the past 15 years to generate an increasingly substantial research base, as well as to develop and refine a wide array of contributions to psychological assessment and therapy. By summarising the major models, measures and methods resulting from this collaborative work, it offers an introduction to meaning reconstruction for those unfamiliar with it, noting its contributions to date, its areas of future development, and its relevance for clinical practice.

The Revised Child Anxiety and Depression Scale (RCADS) is a 47-item self-report measure intended to assess children's symptoms corresponding to selected DSM-IV anxiety and major depressive disorders. The scale comprises six subscales (e.g., Separation Anxiety Disorder; Social Phobia; Obsessive Compulsive Disorder; Panic Disorder; Generalised Anxiety Disorder; and Major Depressive Disorder). To date, only one normative study of youth has been published with results providing strong initial support for the reliability and validity of this new measure (Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000). The present investigation provides additional psychometric data derived from an Australian sample comprising 405 youth aged 8 to 18 years. In general, the data were found to be consistent with those reported in the initial normative study. Internal consistency for the overall scale and its subscales was found to be adequate. Good convergent validity was demonstrated through moderate to strong correlations between the subscales of the RCADS with scores on the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). Confirmatory factor analysis suggested reasonable fit for the six-factor model by Chorpita et al. (2000). Notwithstanding the need for additional validation, it is concluded that the RCADS is a promising instrument for use in both clinical and research settings.

Effective treatments for common anxiety and mood disorders exist, yet epidemiological studies reveal that the unmet need for treatment in the community remains high. This study investigates the significance of the initial delay to first seek professional help in this unmet need for treatment in an Australian sample. Help-seeking history was retrospectively reported by 273 new referrals to a specialist anxiety treatment clinic who had a primary diagnosis of an anxiety (78%) or mood disorder (22%). Clinical, demographic and attitudinal variables were tested as potential predictors of length of the delay. Average help-seeking delay was 8.2 years (range 0–72 years). Younger age at symptom onset and slower problem recognition were associated with delayed help-seeking, and older people were more likely to report longer delays. We conclude that delays to first seek treatment are long and contribute significantly to the unmet need for treatment for anxiety and mood disorders, and that lack of problem recognition is a significant barrier to help-seeking.

Social anxiety is a common, debilitating psychological problem. In the present study, two meta-analyses examined the efficacy of virtual reality exposure therapy for social anxiety. The first meta-analysis tested whether virtual reality exposure therapy reduces social anxiety more than a waitlist control condition. The results of the first meta-analysis, consisting of six studies and 233 participants, showed a significant overall effect size, indicating that virtual reality exposure therapy was effective in reducing social anxiety. The second meta-analysis tested whether the standard treatment for social anxiety, which includes in vivo or imaginal exposure, leads to greater effects than virtual reality exposure therapy. The second meta-analysis, consisting of seven studies and 340 total participants, showed essentially no difference in effect sizes between virtual reality exposure and in vivo or imaginal exposure. The results of the two meta-analyses support the use of virtual reality in the treatment of social anxiety.

The aim of this randomised controlled trial was to examine the efficacy of an Attention-deficit/ hyperactivity Disorder (ADHD)-specific, Enhanced (Level 5) Group Triple P intervention. Twenty families with a child with clinically diagnosed ADHD aged between 5 and 9 years participated. Families were randomly assigned to either an enhanced intervention group (Enhanced Group Triple P; EGTP) or a wait list (WL) condition. Using parent reports of child behaviour, parenting practices and family functioning in addition to teacher reports of child behaviour in the school environment, parents in the EGTP condition reported significant reductions in intensity of disruptive child behaviour problems, aversive parenting practices and increases in parental self-efficacy when compared to the WL condition. Parents' reports at 3-month follow-up indicated the gains in child behaviour and parenting practices achieved at post-intervention were maintained.

Adult levels of subjective quality of life (SQOL) are remarkably stable on a population basis. This has been explained through the operation of a homeostatic system that acts to maintain each individual's SQOL within a narrow range. However, there are good reasons to expect this homeostatic system to come under severe challenge during adolescence. Many of the variables thought to be involved in the homeostatic process are undergoing marked change during this period, including the balance between primary and secondary control, perceived social support, and interaction with parents. In order to test the stability of SQOL and the influence of these other variables, a sample of 279 adolescents between the ages of 12 to 17 years were recruited. It was found that the SQOL of the older adolescents lay below the predicted range for adults, thereby supporting the idea of a strong challenge to homeostasis during this period. A new scale to measure perceived control was found to possess a useful two-factor structure of primary and secondary control. Moreover, both of these factors, together with social support, predicted levels of SQOL, even though the levels of primary control decreased with age. Finally, adolescents who perceived an authoritarian parenting style experienced a higher SQOL than those who perceived an unengaged style. These findings contribute to our understanding of SQOL homeostasis.

Clinical perfectionism has been implicated as a transdiagnostic construct involved in the aetiology, maintenance, and course of a wide range of Axis I disorders. Typically characterised by the setting of unrealistically high standards for performance, perfectionism has been suggested to be associated with a number of negative psychological outcomes. Moreover, it has been suggested that the process in which perfectionists set and strive for their high performance standards, including the way in which they revaluate such standards, may be maintained by a number of maladaptive cognitive, affective, and behavioural constructs. However, how such factors may differ across adaptive and maladaptive dimensions of perfectionism remains unclear. This article reviews the adaptive and maladaptive conceptualisations of perfectionism and critically examines the empirical literature pertaining to the cognitive-behavioural model of clinical perfectionism. In addition, we also review outcomes of intervention studies that have focused on altering dysfunctional cognitions when treating clinical perfectionism. Clinical implications of these findings and directions for future research are also explored.

Depression is a serious mental health problem, affecting more young people than ever before. This research reports on the short-term effectiveness of an Optimism and Lifeskills Program for preventing depression in preadolescents. A randomised, controlled trial was conducted with students about to make their transition to high school, in a private girls school. Self-report questionnaires were used to assess the program's effect on depressive and lonely symptoms, attributional style and self-worth, in a sample of 47 grade 7 girls at posttest and 6-month follow-up. Results showed fewer depressive symptoms and more positive self-worth in the intervention group compared to the control group at 6-month follow-up. This research indicates that depression prevention programs can be effective in the short-term and can provide valuable skills to young people making their transition to high school. Implementation issues and suggestions for further research on primary prevention for mental health in schools are discussed.

This paper evaluates the impact of a large scale campaign to encourage increased protection from solar ultra violet radiation (UVR). Broadly representative household surveys were conducted both before and after the campaign. The initial survey showed high levels of awareness of a skin protection message. The survey following the campaign showed large increases in awareness of the campaign slogan. There were high levels of reporting about taking extra precautions for sun protection and of encouraging other people, particularly children, to increase their sun protection. Within the limitations of the design, the results are interpreted as demonstrating an impact of the campaign. There is high community awareness of the need to take precautions against overexposure to solar UVR, coupled with high knowledge of appropriate behaviours and increased reporting of actually taking these precautions.

A safety behaviour is an overt or covert strategy employed in order to prevent a feared outcome from occurring. These behaviours can, however, prevent the disconfirmation of unhelpful beliefs, and may make the feared outcome more likely to occur (Salkovskis, 1991). The current study extends Harvey's (2002a) investigation of safety behaviours in insomnia by developing a questionnaire measure designed to assess the use of safety behaviours that are employed to promote sleep and cope with tiredness. A development sample of 132 individuals with and without insomnia was employed to develop the 32-item Sleep-Related Behaviours Questionnaire (SRBQ). The SRBQ showed good internal consistency and was able to discriminate normal sleepers from those with insomnia. Interestingly, most safety behaviours were associated with impairment in both sleep and daytime functioning. This highlights that day- and night-time processes may be interlinked in insomnia, and stresses the importance of research and treatment focusing on both the day and night. Future research is needed to further investigate the psychometric properties of the SRBQ, and to explore the relationships between safety behaviours and dysfunctional beliefs about sleep.

The high prevalence of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity is well established, with comorbidity rates often between 30 and 50%. However, despite the high prevalence of this comorbidity, very few researchers have explored specific treatments for individuals who present with comorbid PTSD and MDD. Further, there has not been explicit examination of the mechanisms through which MDD influences trauma-focused therapy. As individuals with comorbid PTSD and MDD often present with a more chronic course of impairment and in some instances, a more delayed response to treatment, the need for such research is imperative. It will be proposed that there is merit in targeting depression within the treatment of comorbid PTSD and MDD. Accordingly, in this article we review explanations for the high PTSD and MDD comorbid relationship and highlight variables likely to explain such comorbidity. Theoretical accounts for how depression impedes optimal recovery from PTSD and the associated empirical findings are illustrated. We consequently argue that there is a need to develop and test treatments that target both PTSD and MDD symptoms. Directions for future research are highlighted.

Psychological mindedness (PM) has long been considered to be an important mediator of therapy outcome. However, to date, definitions of PM have been typified by linguistic imprecision and lack of conceptual clarity. Further, most definitions and measures of PM have approached the task from a psychodynamic perspective, thus limiting the use of this construct by clinicians and researchers from other theoretical perspectives. In this paper, previous definitions and self-report measures are reviewed and a new definition proposed. It is argued that PM is best conceptualised as a form of metacognition: a predisposition to engage in metacognitive acts of inquiry into how and why people behave, think, and feel in the way that they do. A new model, based on this definition, suggests that PM may be assessed by measuring individuals' metacognitive processes of self-reflection and insight, circumventing many of the problems associated with previous self-report measures of PM. Research into individual differences in propensity for PM, self-reflection, and insight may well provide the clinician with additional tools with which to facilitate purposeful, directed change in both clinical and nonclinical populations.