I am a researcher and psychologist based in Melbourne, Australia. My research focuses on advancing understanding and treatment of mental health difficulties using digital technologies, particularly smartphone apps, online therapies and virtual reality. Also interested in understanding the mechanisms of, and developing novel treatments for, unusual experiences such as hearing voices and psychosis. Address: Melbourne, Victoria, Australia
Background Depression and anxiety are prevalent in youth populations and typically emerge during ... more Background Depression and anxiety are prevalent in youth populations and typically emerge during adolescence. Repetitive negative thinking (RNT) is a putative transdiagnostic mechanism with consistent associations with depression and anxiety. Targeting transdiagnostic processes like RNT for youth depression and anxiety may offer more targeted, personalised and effective treatment. Methods A meta-analysis was conducted to examine the effect of psychological treatments on RNT, depression and anxiety symptoms in young people with depression or anxiety, and a meta-regression to examine relationships between outcomes. Results Twenty-eight randomised controlled trials examining 17 different psychological interventions were included. Effect sizes were small to moderate across all outcomes (Hedge's g depression = −0.47, CI −0.77 to −0.17; anxiety = −0.42, CI −0.65 to −0.20; RNT = −0.45, CI −0.67 to −0.23). RNT-focused and non-RNT focused approaches had comparable effects; however, those...
BACKGROUND There is currently an increased appetite and acceptance of technology-enabled mental h... more BACKGROUND There is currently an increased appetite and acceptance of technology-enabled mental health care. To adequately harness this opportunity, it is critical that the design and development of digital mental health technologies is informed by the needs and preferences of end-users. Despite young people and clinicians being predominant users of such technologies, little research has examined their perspectives on different digital mental health technologies. OBJECTIVE The current study aimed to (i) understand what technologies young people, both within youth mental health services and the general population, have access to and use in their everyday lives, and what applications of these technologies they were interested in to support their mental health; (ii) explore what technologies youth mental health clinicians currently used within their practice, and what applications of these technologies they were interested in to support their clients’ mental health. METHODS Youth menta...
Ownership and regular use of digital technologies such as smartphones is growing increasingly pre... more Ownership and regular use of digital technologies such as smartphones is growing increasingly prevalent in people experiencing severe mental illness such as psychosis. Mobile devices such as smartphones, computer-based applications, and online programs or websites have unique capabilities, which show promise for enhancing and supporting current psychological treatments for psychosis. Clinicians might soon be able to utilise these technologies to improve engagement and delivery of standard interventions, help clients self-manage their symptoms and monitor clinical changes outside of therapy sessions, and develop more tailored treatments using advanced methods of assessment. This chapter provides an overview of the current research in digital technologies for the psychological treatment of people with a psychotic disorder, including discussion of barriers and facilitators to engagement, limitations of the current literature, and the ethical implications of utilising these technologies...
Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental heal... more Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental health. At any time or place, individuals can be transported into immersive and interactive virtual worlds that are fully controlled by the researcher or clinician. This capability is central to recent interest in how VR might be harnessed in both treatment and assessment of mental health conditions. The current review provides a summary of the advantages of using VR for assessment in mental health, focusing on increasing ecological validity of highly controlled environments, enhancing personalization and engagement, and capturing real-time, automated data in real-world contexts. Considerations for the implementation of VR in research and clinical settings are discussed, including current issues with cost and access, developing evidence base, technical challenges, and ethical implications. The opportunities and challenges of VR are important to understand as researchers and clinicians look t...
Common approaches to the psychological treatment of distressing voice hearing experiences, such a... more Common approaches to the psychological treatment of distressing voice hearing experiences, such as cognitive behavioural therapy, aim to promote more adaptive cognitive, emotional and behavioural responses to these experiences. Digital technologies such as smartphones show promise for supporting and enhancing these treatments by linking immediate therapeutic settings to the context of daily life. Two promising technologies include ecological momentary assessment and intervention (EMA/I), which may offer a means of advanced assessment and support in daily life, and inform the tailoring of interventions to suit individual needs. In this study, a highly novel intervention approach was developed involving four face-to-face sessions with a psychologist blended with EMA/I between sessions in order to improve coping with distressing voice hearing experiences. The authors describe the background and development of this approach alongside a single case illustration, which supported feasibility and acceptability. This study details how digital technologies such as EMA/I may be used in future as clinical tools to enhance standard psychological treatments and clinical care of people with persisting and distressing experiences.
Background: Voice-hearing experiences can be distressing and impairing, and existing psychologica... more Background: Voice-hearing experiences can be distressing and impairing, and existing psychological treatments show modest effectiveness. Ecological momentary assessment and intervention (EMA/I) are two promising approaches which may be used as digital tools to support and enhance existing psychological therapies. The aim of this study was to investigate the potential clinical utility of smartphone-based EMA/I in a blended, coping focused therapy for voice-hearing experiences. Method: This pilot RCT focused on feasibility, acceptability and preliminary estimations of efficacy. Thirty-four participants with persisting and distressing voices were randomised to receive the four-session intervention alongside treatment-as-usual (TAU) or TAU-only. Results: Findings supported the feasibility and acceptability of the approach, with good engagement and satisfaction rates, and clinical outcomes showed the intervention holds promise for improving coping, overall severity of voices and to some degree their negative impact. Conclusion: This is the first examination of the use of EMA/I in a blended therapy for psychotic experiences, with findings suggesting these technologies show promise as clinical tools.
Background: Smartphone-based ecological momentary assessment and intervention (EMA/I) show promis... more Background: Smartphone-based ecological momentary assessment and intervention (EMA/I) show promise for enhancing psychological treatments for psychosis. EMA has the potential to improve assessment and formulation of experiences which fluctuate day-today , and EMI may be used to prompt use of therapeutic strategies in daily life. The current study is an examination of these capabilities in the context of a brief, coping-focused intervention for distressing voice hearing experiences.
Background Depression and anxiety are prevalent in youth populations and typically emerge during ... more Background Depression and anxiety are prevalent in youth populations and typically emerge during adolescence. Repetitive negative thinking (RNT) is a putative transdiagnostic mechanism with consistent associations with depression and anxiety. Targeting transdiagnostic processes like RNT for youth depression and anxiety may offer more targeted, personalised and effective treatment. Methods A meta-analysis was conducted to examine the effect of psychological treatments on RNT, depression and anxiety symptoms in young people with depression or anxiety, and a meta-regression to examine relationships between outcomes. Results Twenty-eight randomised controlled trials examining 17 different psychological interventions were included. Effect sizes were small to moderate across all outcomes (Hedge's g depression = −0.47, CI −0.77 to −0.17; anxiety = −0.42, CI −0.65 to −0.20; RNT = −0.45, CI −0.67 to −0.23). RNT-focused and non-RNT focused approaches had comparable effects; however, those...
BACKGROUND There is currently an increased appetite and acceptance of technology-enabled mental h... more BACKGROUND There is currently an increased appetite and acceptance of technology-enabled mental health care. To adequately harness this opportunity, it is critical that the design and development of digital mental health technologies is informed by the needs and preferences of end-users. Despite young people and clinicians being predominant users of such technologies, little research has examined their perspectives on different digital mental health technologies. OBJECTIVE The current study aimed to (i) understand what technologies young people, both within youth mental health services and the general population, have access to and use in their everyday lives, and what applications of these technologies they were interested in to support their mental health; (ii) explore what technologies youth mental health clinicians currently used within their practice, and what applications of these technologies they were interested in to support their clients’ mental health. METHODS Youth menta...
Ownership and regular use of digital technologies such as smartphones is growing increasingly pre... more Ownership and regular use of digital technologies such as smartphones is growing increasingly prevalent in people experiencing severe mental illness such as psychosis. Mobile devices such as smartphones, computer-based applications, and online programs or websites have unique capabilities, which show promise for enhancing and supporting current psychological treatments for psychosis. Clinicians might soon be able to utilise these technologies to improve engagement and delivery of standard interventions, help clients self-manage their symptoms and monitor clinical changes outside of therapy sessions, and develop more tailored treatments using advanced methods of assessment. This chapter provides an overview of the current research in digital technologies for the psychological treatment of people with a psychotic disorder, including discussion of barriers and facilitators to engagement, limitations of the current literature, and the ethical implications of utilising these technologies...
Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental heal... more Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental health. At any time or place, individuals can be transported into immersive and interactive virtual worlds that are fully controlled by the researcher or clinician. This capability is central to recent interest in how VR might be harnessed in both treatment and assessment of mental health conditions. The current review provides a summary of the advantages of using VR for assessment in mental health, focusing on increasing ecological validity of highly controlled environments, enhancing personalization and engagement, and capturing real-time, automated data in real-world contexts. Considerations for the implementation of VR in research and clinical settings are discussed, including current issues with cost and access, developing evidence base, technical challenges, and ethical implications. The opportunities and challenges of VR are important to understand as researchers and clinicians look t...
Common approaches to the psychological treatment of distressing voice hearing experiences, such a... more Common approaches to the psychological treatment of distressing voice hearing experiences, such as cognitive behavioural therapy, aim to promote more adaptive cognitive, emotional and behavioural responses to these experiences. Digital technologies such as smartphones show promise for supporting and enhancing these treatments by linking immediate therapeutic settings to the context of daily life. Two promising technologies include ecological momentary assessment and intervention (EMA/I), which may offer a means of advanced assessment and support in daily life, and inform the tailoring of interventions to suit individual needs. In this study, a highly novel intervention approach was developed involving four face-to-face sessions with a psychologist blended with EMA/I between sessions in order to improve coping with distressing voice hearing experiences. The authors describe the background and development of this approach alongside a single case illustration, which supported feasibility and acceptability. This study details how digital technologies such as EMA/I may be used in future as clinical tools to enhance standard psychological treatments and clinical care of people with persisting and distressing experiences.
Background: Voice-hearing experiences can be distressing and impairing, and existing psychologica... more Background: Voice-hearing experiences can be distressing and impairing, and existing psychological treatments show modest effectiveness. Ecological momentary assessment and intervention (EMA/I) are two promising approaches which may be used as digital tools to support and enhance existing psychological therapies. The aim of this study was to investigate the potential clinical utility of smartphone-based EMA/I in a blended, coping focused therapy for voice-hearing experiences. Method: This pilot RCT focused on feasibility, acceptability and preliminary estimations of efficacy. Thirty-four participants with persisting and distressing voices were randomised to receive the four-session intervention alongside treatment-as-usual (TAU) or TAU-only. Results: Findings supported the feasibility and acceptability of the approach, with good engagement and satisfaction rates, and clinical outcomes showed the intervention holds promise for improving coping, overall severity of voices and to some degree their negative impact. Conclusion: This is the first examination of the use of EMA/I in a blended therapy for psychotic experiences, with findings suggesting these technologies show promise as clinical tools.
Background: Smartphone-based ecological momentary assessment and intervention (EMA/I) show promis... more Background: Smartphone-based ecological momentary assessment and intervention (EMA/I) show promise for enhancing psychological treatments for psychosis. EMA has the potential to improve assessment and formulation of experiences which fluctuate day-today , and EMI may be used to prompt use of therapeutic strategies in daily life. The current study is an examination of these capabilities in the context of a brief, coping-focused intervention for distressing voice hearing experiences.
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