Frank Deane
University of Wollongong, Psychology, Faculty Member
Objective: There is a high prevalence of complex psychological distress after a traumatic brain injury but limited evidence of effective interventions. We examined the feasibility of Acceptance and Commitment Therapy after a severe... more
Objective: There is a high prevalence of complex psychological distress after a traumatic brain injury but limited evidence of effective interventions. We examined the feasibility of Acceptance and Commitment Therapy after a severe traumatic brain injury using the criteria, investigating a therapeutic effect, and reviewing the acceptability of measures, treatment protocol, and delivery method (in a dyad of two clients and a therapist). Method: Two male outpatients with severe traumatic brain injury and associated psychological distress jointly engaged in a seven session treatment program based on Acceptance and Commitment Therapy principles. Pre-and post-treatment measures of mood, psychological flexibility, and participation were taken in addition to weekly measures. Results: The intervention showed a therapeutic effect with one participant, and appeared to be acceptable for both participants with regard to program content, measures, and delivery mode by in a dyad. One participant showed both significant clinical and reliable change across several outcome measures including measures of mood and psychological flexibility. The second participant did not show a reduction in psychological inflexibility, but did show a significant drop in negative affect. Significant changes pre-to post-treatment for measures of participation were not indicated. Qualitatively, both participants engaged in committed action set in accordance with their values. Conclusions: This study suggests that Acceptance and Commitment Therapy may be feasible to be delivered in a dyad with individuals who have a severe traumatic brain injury. A further test of its potential efficacy in a phase II clinical trial is recommended.
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ABSTRACT A program designed to prepare long-stay “hard-to-place” psychiatric inpatients for successful community placement was evaluated. Fifteen patients in the Intensive Learning Center (ILC) program were assessed at 5- and 10-month... more
ABSTRACT A program designed to prepare long-stay “hard-to-place” psychiatric inpatients for successful community placement was evaluated. Fifteen patients in the Intensive Learning Center (ILC) program were assessed at 5- and 10-month intervals following baseline. In addition, their functioning was compared to a criterion related comparison group of 26 patients who had been transferred to community placements 18 months earlier. Two informant driven measures were used: The Rehabilitation Evaluation of Hall and Baker (REHAB), (Baker & Hall, 1988) and, Adaptive Behavior Scale (ABS), (Nihira, Foster, Shellhaas, & Leland, 1975). The results indicated significant improvement in the ILC patients adaptive functioning after 5 months, but this improvement was not consistently sustained at the 10 month follow-up. Comparisons between the ILC and community groups were made at 10 months and suggested considerable overlap in functioning between the two groups. The implications of the findings for program development and implementation as well as for discharge planning are discussed.
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... The bond in the partnership is consistent with the core therapeutic relationship issues described by Rogers (1957), and Bordin (1994 ... outcome in community psychiatry and case management located five studies assessing the... more
... The bond in the partnership is consistent with the core therapeutic relationship issues described by Rogers (1957), and Bordin (1994 ... outcome in community psychiatry and case management located five studies assessing the relationship in these contexts (Howgego et al., 2003 ...
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This study explores the effects of anxiety on driving performance in a sample of 35 individuals with cognitive impairment who underwent driving reassessment 2 weeks after neuropsychological assessment. Participants completed measures of... more
This study explores the effects of anxiety on driving performance in a sample of 35 individuals with cognitive impairment who underwent driving reassessment 2 weeks after neuropsychological assessment. Participants completed measures of test, state and driving anxiety prior to the neuropsychological assessment. Measures of state anxiety were re-administered immediately before and after the on-road driving test. Higher anxiety before the on-road test was associated with fewer errors, although regression analyses showed that anxiety was not a unique predictor of driving performance. The results suggest that anxiety has a positive influence on driving performance but does not predict driving assessment outcome. Occupational therapists and driving instructors were better judges of the effects of anxiety on driving performance than were the participants themselves. Implications of these findings for clinical and medico-legal contexts are discussed.
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Research Interests: Management, Psychiatry, Depression, Australia, Treatment Outcome, and 17 moreFamily Practice, Comorbidity, Curriculum, Humans, Substance Abuse, General, Female, Male, Data Collection, Graduate medical education, Mental Disorders, Middle Aged, Adult, Patient Care Team, Medical Audit, Dual, and Substance-Related Disorders
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Mental illness affects one in five Australians in any given year and depression, anxiety and substance abuse are the most prevalent of the mental health problems. Mental illness is traditionally managed with medication and psychological... more
Mental illness affects one in five Australians in any given year and depression, anxiety and substance abuse are the most prevalent of the mental health problems. Mental illness is traditionally managed with medication and psychological intervention but exercise and diet have also been shown to be related to mental illness and are associated with improvements in mental health. The present article aims to describe the background and practical issues arising from the establishment of diet and exercise assessments and intervention for people receiving treatment for depression and anxiety in general practice settings. Patients were referred by their general practitioners, and attended sessions either in rooms at their practitioner's surgery or at a central clinic location. The program involved an initial assessment, four individual consultations with a dually qualified dietitian and exercise physiologist, and a final assessment. Issues in the process of assessing mental health, diet quality, physical fitness and physical activity behaviours are described as are key components of the tailored treatment programs. Strategies for improving motivation and adherence such as adjusting frequency of sessions, use of homework and means of communication are highlighted.
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This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed... more
This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed 13 studies that sought to investigate consumer perspectives. Only one study asked consumers about experiences of recovery. Most evaluations did not adequately assess consumers' views, and active consumer participation in research was rare. Supporting an individual's recovery requires commitment to a recovery paradigm that incorporates traditional symptom reduction and improved functioning, with broader recovery principles, and a shift in focus from illness to well-being. It also requires greater involvement of consumers in the implementation of case management and ownership of their own recovery process, not just in research that evaluates the practice.
Research Interests: Management, Psychiatry, Health Promotion, Health Behavior, Mental Health, and 16 moreEvaluation, Consumer Behavior, Public Health, Consumer, Humans, Recovery, Consistency, Case Management, Public health systems and services research, Convalescence, Paradigm, Evaluations, Psychiatric Services, Consumer Participation, Psychiatric, and Client
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The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females,... more
The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were weaker in the older age groups. Having lower perceived need for autonomy and believing that prior mental health care was helpful was significantly associated with higher intentions to seek future professional mental health care. Implications for prevention and overcoming barriers to seeking mental health care are suggested.
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ABSTRACT Several variables have been associated with the tendency to seek psychological help. For example, attitudes, psychological distress, and treatment fearfulness have all been associated with mental health professionals and whether... more
ABSTRACT Several variables have been associated with the tendency to seek psychological help. For example, attitudes, psychological distress, and treatment fearfulness have all been associated with mental health professionals and whether individuals seek help from counsellors. The aims of this study were: (1) to examine whether individuals seek help from mental health professionals, and (2) to assess the validity and utility of a short form of the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS) for assessing prison inmates' helpseeking attitudes. In addition, the relative impact of components of treatment fearfulness and psychological distress on helpseeking attitudes was assessed. Results were consistent with previous research, and indicated that male inmates (N= 173) have similar scores on the ATSPPHS to other male samples. Stigma-related treatment fears and psychological distress were significant unique predictors of attitudes toward professional psychological helpseeking. Factor analysis revealed a single general factor for the ATSPPHS. The potential utility of the brief version of the ATSPPHS was also supported. Suggestions are made for further research with this population and with the two versions of the helpseeking attitude measure.
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Research Interests: Australia, Risk Taking, Adolescent, Students, Humans, and 7 moreFemale, Alcohol Drinking, Male, Young Adult, Universities, Questionnaires, and Adult
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Research Interests: Psychology, Health Promotion, Psychotherapy, Mental Health, Primary Health Care, and 36 moreRisk assessment, Adolescent, Family Practice, Prevention, Probability, Thinking, Identification, Humans, Needs Assessment, General, Role, Physical Health, Female, Therapy, School Health, Male, Physicians, Regression Analysis, Mental Disorders, New South Wales, Mental Health Care, Help Seeking, Psychological distress, Questionnaires, Suicidal Ideation, High School Student, Reluctance, Health surveys, Risk Assessment, Youth & Adolescence, Adolescent Behavior, Treatment Refusal, Attempted Suicide, Medical, Protective Factor, and Severity of Illness Index
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This study explores a range of barriers that parents encountered in accessing mental health services. The study also explored whether parents experienced similar barriers to accessing services in 2003 and 2013. One hundred and thirty-four... more
This study explores a range of barriers that parents encountered in accessing mental health services. The study also explored whether parents experienced similar barriers to accessing services in 2003 and 2013. One hundred and thirty-four parents of young people attending an initial assessment at a Child and Adolescent Mental Health Service (CAMHS) or headspace centre completed a questionnaire assessing 10 general barriers to care. These data were compared to those collected from 129 participants at CAMHS in 2003. The ranking of barriers to mental health care for their children was similar for both survey years, with 'wait time being too long' and 'help being too expensive' the two highest ranked barriers. Cost factors were related to not knowing that the services did not charge fees and having to take time off work to attend appointments. Multiple referral steps and uncertain wait times were the main concerns regarding wait times. The overall strength with which barriers were endorsed remained relatively low; however, at least 40% of the sample agreed they had experienced four of the barriers in both years. Despite relatively low endorsement of barriers, there are substantial proportions of parents who experienced some barriers to services, and services should continue working to reduce them to facilitate timely access. There is a particular need for more service-related information to clarify that public sector mental health services do not charge fees. Methods such as rapid initial assessment and actively managing wait lists may go some way to reducing perceived wait time barriers.
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Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual... more
Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. The sample consisted of 220 substance-dependent individuals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regress...
This study aimed to evaluate the efficacy of a diet and exercise lifestyle intervention on mental health outcomes for patients currently being treated for depression and/or anxiety in primary care. Patients (n=119) referred by general... more
This study aimed to evaluate the efficacy of a diet and exercise lifestyle intervention on mental health outcomes for patients currently being treated for depression and/or anxiety in primary care. Patients (n=119) referred by general practitioners to the 12-week randomised controlled trial were assigned to either an intervention of six visits to a dual qualified dietitian/exercise physiologist (DEP) where motivational interviewing and activity scheduling were used to engage patients in individually-tailored lifestyle change (focussed on diet and physical activity), or an attention control with scheduled telephone contact. Assessments conducted at baseline (n=94) and 12 weeks (n=60) were analysed with an intent-to-treat approach using linear mixed modelling. Significant improvement was found for both groups on Depression, Anxiety and Stress Scale (DASS) scores, measures of nutrient intake and total Australian modified Healthy Eating Index (Aust-HEI) scores. Significant differences b...
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Suicide prevention remains a challenge across communities in North America and abroad. We examine a suicide prevention effort that is widely used, termed gatekeeper training. There are 2 aims: review the state of the evidence on... more
Suicide prevention remains a challenge across communities in North America and abroad. We examine a suicide prevention effort that is widely used, termed gatekeeper training. There are 2 aims: review the state of the evidence on gatekeeper training for suicide prevention, and propose directions for further research. Studies were identified by searching MEDLINE (PubMed) and PsycINFO from inception to the present for the key words suicide, suicide prevention, and gatekeeper. In addition, a manual scan of relevant articles' bibliographies was undertaken. Gatekeeper training has been implemented and studied in many populations, including military personnel, public school staff, peer helpers, clinicians, and Aboriginal people. This type of training has been shown to positively affect the knowledge, skills, and attitudes of trainees regarding suicide prevention. Large-scale cohort studies in military personnel and physicians have reported promising results with a significant reduction...
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Caring for young people is a challenge that requires a full approach to general practice along with additional skills and knowledge. Research indicates that "youth friendly" GPs need to (1) practice in youth friendly... more
Caring for young people is a challenge that requires a full approach to general practice along with additional skills and knowledge. Research indicates that "youth friendly" GPs need to (1) practice in youth friendly environments that include youth friendly support staff, (2) know about the developmental stages of adolescence and have skills for developing rapport with young people across these
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ABSTRACT This study describes a project that aimed to train people with mental illness in introductory research skills to support the development of a Clubhouse. Eight mental health consumers from the Illawarra region in New South Wales,... more
ABSTRACT This study describes a project that aimed to train people with mental illness in introductory research skills to support the development of a Clubhouse. Eight mental health consumers from the Illawarra region in New South Wales, Australia were recruited to participate in the project. The group met weekly over a 10-week period to participate in training sessions. The training program focused on increasing familiarity and confidence with research related activities considered useful for Clubhouse members. Measures related to Familiarity with the Clubhouse model, Clubhouse Role Confidence, Research Self Efficacy, and Familiarity with Research Terminology were completed by six of eight participants before and after training. There were significant improvements in consumer's familiarity with components of the Clubhouse and research terminology. There was also increased confidence in performing roles relevant to research activities in Clubhouse settings but no significant improvements in Research Self efficacy related to more general research skills. There is a need for future research to confirm the findings in larger trials with a control condition.
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The present study tests the perceived norms hypothesis in relation to different levels of heavy episodic drinking (HED) among university students. In 2007, 303 students from residence halls and the School of Psychology at the University... more
The present study tests the perceived norms hypothesis in relation to different levels of heavy episodic drinking (HED) among university students. In 2007, 303 students from residence halls and the School of Psychology at the University of Wollongong, Australia, completed a questionnaire about their alcohol consumption and associated attitudes and behaviors. Between-groups analyses of variance (ANOVAs) revealed significantly higher AUDIT (Alcohol Use Disorders Identification Test) scores among students in higher-frequency HED groups. Students who engaged in HED tended to underestimate their own drinking when comparing themselves with others. Improving the accuracy of perceptions about one's own drinking in relation to others (normative information) may help reduce levels of HED among students.
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Research Interests: Psychology, Health Promotion, Psychotherapy, Mental Health, Primary Health Care, and 36 moreRisk assessment, Adolescent, Family Practice, Prevention, Probability, Thinking, Identification, Humans, Needs Assessment, General, Role, Physical Health, Female, Therapy, School Health, Male, Physicians, Regression Analysis, Mental Disorders, New South Wales, Mental Health Care, Help Seeking, Psychological distress, Questionnaires, Suicidal Ideation, High School Student, Reluctance, Health surveys, Risk Assessment, Youth & Adolescence, Adolescent Behavior, Treatment Refusal, Attempted Suicide, Medical, Protective Factor, and Severity of Illness Index
... High levels of fear and symptom severity (Ehlers, Hofmann, Herda, & Roth, 1994; Taylor & Deane, 2000) as well as diagnostic complexity (Ehlers et al., 1994; also see Taylor, Deane, & Podd, 2002, for a review) have been... more
... High levels of fear and symptom severity (Ehlers, Hofmann, Herda, & Roth, 1994; Taylor & Deane, 2000) as well as diagnostic complexity (Ehlers et al., 1994; also see Taylor, Deane, & Podd, 2002, for a review) have been found to characterise this population. ...