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Let’s Talk about Children (LTC) is a structured intervention which aims to improve outcomes for children of parents with a mental illness. An enhanced form of training has been developed to support clinician uptake of this intervention. The purpose of this paper is to explore clinicians’ experiences of this form of training and of implementing LTC.

A qualitative research design was adopted, underpinned by social constructionism. Semi-structured interviews were conducted with adult community mental health clinicians (n=10) and were audio-recorded. The interview data were transcribed verbatim, coded and thematically analysed.

Participants experienced both the training and the LTC intervention as a step in the right direction, with the enhanced training seen as superior to standard online modules, but not sufficient for implementation in practice. Additional training support, partnership working with families and service partners and overcoming challenges by adapting the model are some strategies that may support routine implementation of LTC.

This study is the first to explore clinician experiences of this enhanced face-to-face training format followed by the implementation of LTC in an Australian context. Findings suggest strategies for enhancing clinician skills and confidence, improving fidelity to the model and identifying success factors for services looking to implement LTC. The potential value of face-to-face over online training and common barriers to implementation at an organisational level are identified and require further exploration in future studies.

This paper aims to understand the impact of emotional labour in specific health care settings and its potential effect on patient care.

Multi‐method qualitative ethnographic study undertaken in a large ICU in Sydney, Australia using observations from patient case studies, ward rounds and family conferences, open ended interviews with medical and nursing clinicians and managers and focus groups with nurses.

Clinician attitudes to death and dying and clinicians' capacity to engage with the human needs of patients influenced how emotional labour was experienced. Negative effects were not formally acknowledged in clinical workplaces and institutional mechanisms to support clinicians did not exist.

The potential effects of clinician attitudes on performance are hypothesised from clinician‐reported data; no evaluation was undertaken of patient care.

Health service providers must openly acknowledge the effect of emotional labour on the care of dying people. By sharing their experiences, multidisciplinary clinicians become aware of the personal, professional and organisational impact of emotional labour as a core element of health care so as to explicitly and practically respond to it.

The effect of care on clinicians, particularly care of dying people, not only affects the wellbeing of clinicians themselves, but also the quality of care that patients receive. The affective aspect of clinical work must be factored in as an essential element of quality and quality improvement.

This paper aims to evaluate service user (SU) and clinician acceptability of video care, including future preferences to inform mental health practice during COVID-19, and beyond.

Structured questionnaires were co-developed with SUs and clinicians. The SU online experience questionnaire was built into video consultations (VCs) via the Attend Anywhere platform, completed between July 2020 and March 2021. A Trust-wide clinician experience survey was conducted between July and October 2020. Chi-squared test was performed for any differences in clinician VC rating by mental health difficulties, with the content analysis used for free-text data.

Of 1,275 SUs completing the questionnaire following VC, most felt supported (93.4%), and their needs were met (90%). For future appointments, 51.8% of SUs preferred video, followed by face-to-face (33%), with COVID-related and practical reasons given. Of 249 clinicians, 161 (64.7%) had used VCs. Most felt the therapeutic relationship (76.4%) and privacy (78.7%) were maintained. Clinicians felt confident about clinical assessment and management using video. However, they were less confident in assessing psychotic symptoms and initiating psychotropic medications. There were no significant differences in clinician VC rating by mental health difficulties. For future, more SUs preferred using video, with a quarter providing practical reasons.

The study provides a real-world example of video care implementation. In addition to highlighting clinician needs, support at the wider system/policy level, with a focus on addressing inequalities, can inform mental health care beyond COVID-19.

Approximately 20 per cent of Australian children live with a parent who experiences mental illness. These children have poorer health and psychosocial outcomes than their peers. While family-focused practice (FFP) can improve these outcomes, family-focused service provision is inconsistent. The purpose of this paper is to understand clinicians’ experiences of FFP and associated workplace factors.

In-depth interviews were conducted with ten community mental health clinicians. Interviews were audio recorded and transcribed. Data were analysed using thematic analysis.

A global theme of “navigating rocky terrain” captured clinicians’ experiences of working with families. The rocky terrain encompassed both family complexity and workplace barriers to FFP. Clinicians navigated this terrain by using multiple strategies to support families, working in partnership with families and other clinicians and services, and drawing on personal resources. Interactive approaches to enhancing knowledge and skills were preferred over paper-based information. While an organisation-wide approach to support FFP was beneficial, clinicians continued to feel challenged in implementing FFP.

Working with families in which parents experience mental illness is affected by systemic issues at the family and organisational levels. Systemic approaches to both delivering and supporting this work are required. Partnership working and organisation-wide capacity building strategies emphasising interactive approaches to learning appear to have positive effects.

This study explores the challenges of FFP in a real-world multidisciplinary context where there has been a systemic approach to enabling this work. It highlights the challenges clinicians face in family-focused practice in spite of substantial organisational supports and suggests some approaches that might be effective. This is a topic which has received minimal attention in the literature.

This paper aims to provide a discussion and summary of a clinician survey exploring the experiences of suspected feigned autism.

This study is an online survey targeting a range of autism professionals, with varying levels of experience, working in different clinical settings.

Approximately half of the professionals who completed the survey reported experiencing situations of suspected feigning of adult autism across a range of clinical contexts and with various motivations. In terms of best indications of potential feigning, most clinicians reported “textbook” self-descriptions of problem behaviours with vague examples, as well as inconsistent presenting problems and mismatch with any known developmental history. Approximately half of clinicians expressed the view that autism was more difficult to feign than a psychiatric disorder and had experienced situations involving differences in professional opinion as to an individual autism diagnosis.

The survey is limited by a potential sample bias and no information regarding the clinical characteristics of those suspected to have feigned autism. However, these initial findings offer further questions for future research to pursue.

As an initial examination of practicing clinicians’ experiences of suspected feigned autism, the survey highlights the complexities of an autism diagnosis and suggests feigning is a potential clinical scenario. Some guidance as to when to suspect possible feigned autism is also offered, as well as a provisional assessment protocol.

Many mental health clinicians have delivered services digitally in response to the COVID-19 pandemic. Emerging research suggests that, despite some initial discomfort, therapists appear to adjust to remote working. The purpose of this study is to explore the views of clinicians working within a fully digital organisation towards digital service provision.

Clinicians (N = 52) providing digital mental health assessments and treatments at Healios anonymously completed a mixed-methods questionnaire.

In all, 85% of participants enjoyed working remotely and 71% thought they would continue to work online over the next 5–10 years. Of the participants, 40% reported low confidence in online work’s efficacy before working remotely, but 96% reported confidence at the time of questionnaire completion: suggesting confidence increased with experience. An exploratory “inverted” factor analysis generated a two-factor solution, grouping clinicians into two factors based on key views. Factor 1 was predominantly characterised by satisfaction with training received and factor 2 by quality of technical experiences (encountering problems less often and greater personal confidence in resolving them). Qualitative feedback described some benefits of, and barriers to, digital service provision. Clinicians reflected on a perceived change in cultural norms, with more openness to digital services following the COVID-19 pandemic. On a personal level, teletherapy was viewed more favourably with increased personal experience.

Clinicians’ confidence in providing services digitally is discussed, with reference to how this may be affected by extent of remote working experience and availability of technical support. Staff well-being within the digital workspace is also discussed.

This article aims to examine tensions between hybrid clinician managers' professional values and health care organisations' management objectives.

Data are from interviews conducted with, and observation of, 14 managerial participants in a Cancer Therapy Unit set in a large teaching hospital in New South Wales, Australia, who participated in a Clinical Leadership Development Program.

The data indicate that there are tensions experienced by members of the health care organisation when a hybrid clinician manager appears to abandon the managerial role for the clinical role. The data also indicate that when a hybrid clinician manager takes on a managerial role other members of the health care organisation are required concomitantly to increase their clinical roles.

Although the research was represented by a small sample and was limited to one department of a health care organisation, it is possible that other members of health care organisations experience similar situations when they work with hybrid clinician managers. Other research supports the findings. Also, this paper reports on data that emerged from a research project that was evaluating a Clinical Leadership Development Program. The research was not specifically focused on organisational professional conflict in health care organisations.

This paper shows that the role of the hybrid clinician manager may not bring with it the organisational effectiveness that the role was perceived to have. Hybrid clinician managers abandoning their managerial role for their clinical role may mean that some managerial work is not done. Increasing the workload of other clinical members of the health care organisation may not be optimal for the health care organisation.

Organisational professional conflict, as a result of hybridity and divergent managerial and clinical objectives, can cause conflict which affects other organisational members and this conflict may have implications for the efficiency of the health care organisation. The extension or duality of organisational professional conflict that causes interpersonal or group conflict in other members of the organisation, to the authors' knowledge, has not yet been researched.

Recovery is an important concept within mental healthcare policy. There is a growing expectation that clinicians adopt approaches that align with the recovery principles, despite significant disagreements about what recovery-oriented interventions might look like in practice. It is also unclear how recovery may be relevant to personality disorder. This paper aims to discuss these issues.

In total, 16 clinicians were interviewed at two mental health services in Melbourne, Australia. These clinicians had specialist training and experience in the treatment of borderline personality disorder (BPD) and provided insight regarding the meaning and relevance of the recovery paradigm in the context of BPD. Thematic analysis within a grounded theory approach was used to understand key themes identified from the interview data.

Thematic analysis suggested that clinicians understand recovery in three distinct ways: as moving towards a satisfying and meaningful life, as different ways of relating to oneself and as remission of symptoms and improved psychosocial functioning. Clinicians also identified ways in which recovery-related interventions in current use were problematic for individuals diagnosed with BPD. Different approaches that may better support recovery were discussed. This study suggests that practices supporting recovery in BPD may need to be tailored to individuals with BPD, with a focus on cultivating agency while acknowledging the creative nature of recovery.

Clinicians are in a strong position to observe recovery. Their insights suggest key refinements that will enhance the ways in which recovery in BPD is conceptualized and can be promoted.

Virtual reality (VR) is a novel technology that could be used in the assessment and/or treatment of deliberate firesetting. This study aims to develop an understanding of clinicians’ views of VR for deliberate firesetting, to identify areas where VR could potentially add value to current practice and any particular barriers to using VR in this context.

Through an online survey, 73 clinicians rated their agreement with nine potential benefits of using VR for firesetting and 11 potential barriers to using it. They also provided free text responses detailing the greatest perceived potential benefit and the greatest perceived barrier. Factors related to intent to use VR for firesetting in the future were explored.

Clinicians perceived the ability to safely expose clients to fire-related stimuli to be highly beneficial. However, clinicians were concerned about the possibility of re-traumatisation and logistic barriers. Previous experience of using VR with individuals who have set fires was significantly related to using it in the future.

Further research establishing the feasibility and effectiveness of using VR with individuals who have set fires may help alleviate clinicians’ concerns. Increasing opportunities for clinicians to experience a firesetting VR programme may widen the implementation of firesetting VR.

Previous research has only focused on clinicians’ perceptions of VR in the general field of forensic mental health and has failed to consider offence-specific applications.

The purpose of this paper is to introduce and explore stuckness as a felt phenomenon in psychiatric practice in order to stimulate clinicians in mental health settings to be on the lookout for stuckness and on the lookout for unexpected solutions to difficult clinical scenarios.

Signs of stuckness are looked at and then proposed causal factors of stuckness in clinical practice are reviewed. These are divided conceptually into four main groupings: patient factors, clinician factors, service factors and societal factors.

Although clinicians are encouraged to acknowledge when stuckness is present and to try to address possible causes with their patients, clinicians are also advised to work on understanding stuckness as a natural part of creative processes. It is suggested that services should draw on a psychoanalytic ethos to support staff to tolerate and respond to stuckness better.

Feeling stuck with patients’ partial recoveries or “revolving door” cycles is uncomfortable. In stretched psychiatric services in particular stuckness may go unnoticed, and instead the difficulty of the work with patients may inadvertently drive therapeutic mania or rejection of the patients, which can lead to harm. This paper offers a simple scheme to use when thinking about stuck patients in the psychiatric setting with the hope that this can stimulate clinicians to search for new creative solutions for patients.