As part of the Australian Government’s recommended stepped care model of mental healthcare, ‘e-Mental Health’ services (low-intensity online mental health interventions and resources) are becoming a much more important part of our mental health system.
With 1 in 5 Australians experiencing mental health difficulties, low intensity interventions can provide an ideal option for individuals with mild-moderate mental health symptoms where other options (e.g. psychologist referral, medication) might not be suitable. However, e-Mental Health services need not be an either-or choice when compared with face-to-face treatment. In fact, e-Mental Health services can fill multiple roles in the space between an individual seeking help from their GP and accessing treatment with a Psychologist, from initial psychoeducation and increasing acceptability of face-to-face services for first-time help-seekers, to crisis support between appointments, to providing interim support and brief intervention for busy periods where they may be on a waitlist.
Below is a brief guide to the range of e-Mental Health services available (Table 1), as well as an outline of the various roles e-Mental Health can play, and which services are most appropriate.
All listed programs have been developed by credible sources, such as the Australian Government, universities, and national nongovernment organisations.
Table 1. e-Mental Health Service categoriesHere is an outline of some of the ways e-Mental Health can be used to help our clients:
Head to Health
Previously ‘mindhealthconnect’, this is the Australian Government’s portal to mental health information and e-Mental Health services. It enables consumers to search for information and receive advice about their mental health needs.
|Telephone and Webchat||Telephone and online chat services, most often free and used for crisis support, information-seeking, or brief counselling.||
|Psychoeducation Websites||Freely accessible websites providing mental health information, and often general tips and strategies for wellbeing.|
|Online programs||Online self-guided courses that are either transdiagnostic (i.e. targeting common core mental health symptoms), or address a specific problem (e.g. Social Anxiety, PTSD). Some programs offer limited guidance from a therapist via phone or email. The majority of programs are free, with a few being low-cost.|
|Apps||Easy and convenient to use (as they are mobile- or tablet-based). However, due to the number of apps available on the market and the relative ease in creating them (compared to the more comprehensive online programs), many do not have experimental validation. As such, it is important to thoroughly check the content and credentials of any app before referring to it.||
1. As crisis support:
- Telephone and webchat services are a great option for clients to contact if they need immediate support out of hours or between appointments with their healthcare professional.
- Apps such as the BeyondNow Suicide Safety Planning app can help clients and their healthcare professional create a strong, structured plan for dealing with ongoing crises and distress.
2. Psychoeducation for first-time or hesitant help-seekers:
- Head to Health, the government’s mental health information portal, is a great place to direct clients to in the first instance.
- Psychoeducation websites are fantastic tool for providing information about general stress and wellbeing, specific diagnoses (e.g. generalised anxiety, eating disorders), or specific problem areas (e.g. parenting, relationship issues, work stress) to first time help-seekers.
- Online programs (particularly the transdiagnostic programs that don’t focus on a specific diagnosis, such as myCompass) are a great option for help-seekers who are hesitant or uncertain about face-to-face mental health intervention.
3. Interim support:
- If clients are on a waitlist or aren’t able to access timely support due to situational circumstances, online programs and apps can provide a great option to help them start working on their wellbeing in the meantime (which also means they can hit the ground running when they are able to commence face-to-face intervention).
4. To complement face-to-face treatment:
- Online programs and apps can help build on the skills being taught in therapy, such as CBT strategies, mindfulness and positive psychology. Whilst using these resources as a complementary tool can involve a little extra work on the part of the clinician (i.e. to be able to get to know the programs available and find ones that complement their work), it can really help to strengthen and reinforce the work done in session.
There is a lot written in social media and print about being a good parent, good enough parent, ‘the best you can be parent’. We hear of the importance of looking after ourselves as parents before or so we can best look after our little people. Anyone who has travelled by aeroplane will have heard the air hostesses instructing parents to put on their own oxygen masks first before attending to their child. It seems counterintuitive, but let’s look at the detail as to why this matters.
Self-care – who takes care of the parent? When the parent is constantly giving to others, do they ever think about how much they are giving of themselves? It’s probably not something that parents ask themselves or even consider often, until they are overwhelmed, feeling exhausted and irritable with their children. Then comes the guilt because they are not being the parent that they ideally want to be.
Let’s put it simply. We cannot give what we haven’t got. So if you, as a parent, are not looking after yourself, not showing yourself the love you show your loved ones, not treat yourself the way you want others to treat you (i.e., with respect), this not only affects you but potentially every member of your family.
Children can be viewed as the barometers of the parent’s functioning. Their behavioural outbursts or emotionality or sensitivity may reflect their parents’ imbalance of ‘all work and looking after the family’ but not themselves. When the parents are balanced (i.e., calm, consistent, non-reactive) there is a much better chance the children will be too. Hence the very important flow on effect of parent self-care.
Self-care includes aspects such as sufficient sleep, regular physical movement, nutrition, rest and relaxation, social connection, and engagement in pleasurable activities. Self-care is giving yourself a break, to recharge, taking time off. Self-care shows you matter. It models to your family the importance of your needs, that each member of the family is important. It reduces stress. Self-care is good for your well-being and that of your family.
Further engagement in each of these aspects of self-care demonstrates and models to your little people important life, coping and self-regulation skills. This is much more powerful than anything you could say or ‘lecture’ your child about. Demonstrating to your child that when you’re frustrated you engage in deep breathing, or when you’re anxious you run a bath, or at the end of the day if you’re tired you go to bed a bit earlier, and so on, are invaluable life lessons.
Self-care doesn’t have to be time intensive. Even engaging in breathing exercises for 2 minutes or watching the clouds, or listening to your preferred music is likely to shift your energy and provide you with a little joy. Getting up a little earlier than your little people to plan or consider your intentions for the day, perhaps whilst you sip a cup of tea, is also important self-care. You’ll likely be more calm, and therefore more intentional in your interactions with your loved ones and less reactive overall.
Our team of highly skilled and professional clinical psychologists are able to compassionately support your journey to being the parent you want to be, that makes your heart sing, a parent who prioritises their own self-care because they acknowledge their own importance and their own needs; and that ultimately flows on to a more contented family. Opening yourself to growth by learning and incorporating skills such as relaxation and mindfulness of thoughts and emotions techniques, means you are prioritising your own wellbeing and that of each member of your family.
As human beings, we are encoded to survive by avoiding things that are likely to cause us pain, which we have learnt in the past to induce pain or which is stressful or unpleasant: be it that giant spider sitting on the clothing line, that shoulder pain that has been ongoing for a while, or an article that you have promised to write for your upcoming practice newsletter.
In the initial phases, avoidance can work very well. By just using the part of the clothes line that the spider has not occupied, by not thinking about the article I need to write or by working around my sore shoulder, I can pretend that everything is ok and continue on my merry way. We work around it. The problem is that things very seldom remain the same. My resident clothesline spider decides to expand his territory and take up more and more of my clothesline, my shoulder pain worsens to a point that I cannot reach up beyond my shoulder and my practice manager starts sending me “reminder emails” that I cannot avoid anymore. Whilst some avoidance can be a very successful strategy to keep us safe from stressful situations, unpleasant experiences or threats, it can also become counter productive
So what have I learnt about avoidance?
1. Avoidance can be helpful when threats are real. If that spider on the clothesline turns out to really be that gastly dangerous “it’ll kill a grown man within an hour” species that Australia seems prone to having, avoiding it is probably a good idea. We can never totally avoid all the things that we want to avoid. It is seldom that avoidance makes things go away. The spider is still on the line, my shoulder still hurts and the looming newsletter article deadline is still there.
2. Avoidance feeds fear and is an all consuming voracious creature. The more we avoid the greater the problem often becomes. This is particularly so with anxiety. The more anxious I feel, the more I avoid. The more I avoid, the more anxiety I feel. As time goes by, our world becomes smaller and smaller and we feel more and more trapped.
3. Avoidance prevents us from learning that something different can happen or that what we were so fearful of is not as bad as we expected it to be. It prevents us from really experimenting and checking it out, to determine if something is really a threat or not.
What have I learnt to do about it?
1. Acknowledge the problem. We cannot do anything about a problem until we acknowledge it. For me, it was acknowledging that I had a problem in my shoulder (and in all likelihood had torn a ligament), that I was frightened of that spider and that the thought of having to sit down and write an article brought back traumatic memories of writing my thesis.
2. Start small. Be it writing notes on what you’d like to include in the article, finding out about physiotherapists or reading up about whether your resident spider is indeed as dangerous as you imagined it to be. Keep pushing yourself to be at the edge of your comfort zone. Don’t try to aim for the big wins. Small sustainable goals are more likely to get you there. Remember the tortoise and the hare.
3. Get support and help. Having someone to walk you through the journey can be invaluable. It helps give you perspective, keeps you accountable and gives you someone to whine to at the end of the day. This is particularly so if you have been avoiding a situation because of traumatic experiences. Until you stop avoiding, it will continue to intrude in your life and limit you. It might be uncomfortable but keep practicing and trying. Eventually it becomes the new normal.
To quote loosely from Vivian Greene, perhaps life is not about trying to avoid the storms but learning how to dance in the rain. Now excuse me whilst I get a broom to try to relocate my eight-legged friend for the fifth time before I head out for my physiotherapy appointment.
Positive, supportive relationships can help us withstand many of the expected or unexpected challenges life might throw at us. At times of stress, knowing there is at least one special other to turn to, who we can trust to hear and respond to us, strengthens our capacity to cope. Conversely, when that need for support at a critical time is not met, we can feel profoundly hurt by those we rely on for care
and comfort. At these times, instead of pulling together to face life’s difficulties, partners can become disconnected and even hostile with each other.
This is where a trained couples therapist can help. As health professionals, you are likely to be caring for patients who are going through just the kinds of difficult life events that can place strain on relationships. Here are a few tips on how you can encourage your patients to seek help for their relationship.
At Benchmark Psychology, we have psychologists trained in Emotionally Focused Therapy (EFT) for Couples. According to recent studies, 90% of couples who see a well-trained Emotionally Focused Therapist experience improvement, and 70% report full repair of their relationship. Unfortunately, many couples are reluctant to seek therapy because of a range of fears and misconceptions, and
couples therapy is often seen as a last resort before breaking up.
Here are some common concerns couples have about therapy -
1. The therapist will take sides.
We are trained to recognise and understand how both partners contribute to their pattern of disconnection and distress, and to assist partners to understand the painful emotions that underlie their partners’
attempts to reach them.
2. The therapist will tell us we should break up.
The decision about whether to continue in a relationship always belongs to the couple. The role of an EFT therapist is to help couples understand how their relationship has gone wrong, and to guide them, for as long as they are willing to try, in how to repair it.
3. We are too far gone; the situation is hopeless.
Even longstanding problems can be resolved or improved with EFT. The intensity of distress does not indicate the relationship cannot be improved.
4. Talking about our problems will make things worse.
Many couples have experienced that their own attempts to talk about their problems have made things worse, so this concern is understandable! However, an EFT Therapist is trained to create a safe space where problems can be discussed productively. In many cases, the therapist will be able to help partners see each other’s struggles in new ways that open the door to healing and reconciliation.
5. Couples therapy is a waste of time and does not work.
EFT has years of research demonstrating its effectiveness in helping couples improve their relationships, and follow-up studies show these improvements are long lasting. EFT is one of a handful of couple therapies designated as empirically supported by the American Psychological Association (APA).
6. We (or he or she) need individual therapy first.
A growing body of evidence suggests that successful couple therapy can reduce an individual’s symptoms of depression, anxiety, posttraumatic stress and other psychological disorders. At the very least, a stronger, more supportive relationship will reduce the suffering both partners experience when one is struggling with a psychological disorder. Couple therapy may not be the only treatment needed when a partner has significant psychological symptoms can help partners to join hands in working together on the challenges they are facing individually.
Adapted from Ruth Jampol, PhD, Licensed Psychologist Certified EFT Therapist,
Supervisor-in-Training Board of Directors, Philadelphia Center for EFT
Written by By Dr Cate Hearn
Shy or Self-Conscious
Compared to other children their own age, socially anxious children appear shyer and more self-conscious. They may:
- Find it hard to talk to other children
- Find it hard to make new friends
- Feel left out or awkward, or worry they’ll embarrass themselves
- Have less well developed social skills than children their own age
- Dislike being the centre of attention
- Worry a lot about their appearance
- Worry that their friends don’t really like them
- Be quiet in large social situations
- Speak softly to those they don’t know well
Socially anxious children fear and avoid a range of social situations. They may:
- Avoid new social situations
- Make excuses not to go, by saying, “I’m just a homebody”, “I don’t feel like going”, “I don’t like parties”
- Dread sports days or swimming carnivals
- Dislike giving orals or talks in class
- Be too anxious to raise their hand/answer questions in class
- Play alone often
Tummy pains, headaches
Anxiety and worry can manifest in physical symptoms, and socially anxious children may:
- Report pains in the stomach, headaches, nausea or sore/aching arms/legs especially before school or social events
- Become withdrawn or irritable before social events or before school
Won't they just grow out of it?
Research shows that a great many children with social anxiety do not just ‘grow out’ of it.
Left untreated, social anxiety can persist and cause significant interference in children’s lives. Child friendly cognitive behaviour therapy for social anxiety can help children overcome social anxiety.
At Benchmark Psychology, we have a number of therapists who can provide child friendly therapy to socially anxious children. Ask for Dr Cate Hearn (who’s PhD thesis was in child and adolescent social anxiety), Dr Alison Bocquee, Dr Kylee Forrest, Dr Jasmine Pang or Dr Leona Chun.
Something’s not quite right
James was like any other 9-year-old, but at the first mention of school his whole body would shrink and he would stare at the floor. Even though he had some good friends and wasn’t being bullied, he really didn’t like school. He didn’t have any ‘obvious’ issues, but he just couldn’t seem to keep up with the schoolwork and even started to call himself ‘the dumb kid’.
Chloe needed constant help to do her homework and was embarrassed to read in front of others. She was losing her confidence and every day became a battle to make it through the afternoon. Her parents were worried because they could see that if they didn’t do something she would be left behind, and their cheerful little girl would slowly withdraw away.
Parents are the experts on their children. They know their children better than anyone else, and they know when things aren't quite right.
Ryan has always seemed a little different from his brother. He didn’t play the same games and would spend hours alone, lost in “Ryan’s World”. He seemed to be a bright kid, but he never quite got it when it came to friends. One moment he would be smiling up at his parents and the next he would be on the ground. His parents were lost for how to help him.
The myth of watch and wait
These stories are ones we hear every day. Unfortunately, parents concerned about their child’s development are all too often told to ‘watch and wait’. They’re told that they are just ‘anxious’ parents and that their child’s problems are ‘just a phase’. These messages are not only invalidating for parents – they leave children behind and leave families and educators lost.
The path to helping children develop begins with understanding.
Parents are the experts on their children. They are number one. They know their children better than anyone else, and they know when things aren't quite right. Trusting this intuition as a parent and getting support as soon as possible, can help children reach their potential and be the best they can be before a small problem becomes a big one.
Finding a path for your child
Sometimes parents feel like they’ve tried everything to help their child and nothing seems to make much difference. They feel like they are sailing in the dark – not knowing which direction to turn. The real issue is that often we don’t have a clear understanding of the child’s thinking style or view of the world.
The path to helping children who are experiencing challenges in their social, emotional, behavioural, or academic development begins with understanding. A developmental assessment can provide this key and open up the pathway to change.Assessments for children can include a range of developmental areas. For example, cognitive assessments help parents to understand their child’s way of looking at the world.
Assessments for children can include a range of developmental areas. For example, cognitive assessments help parents to understand their child’s way of looking at the world, and can detect if a child is struggling to keep up, if they need more help, or if they have difficulty with a particular area of learning (such as problems with reading or paying attention). Assessments can also target specific developmental challenges, such as Autism Spectrum Disorders or Asperger’s Syndrome, Attention Deficit Hyperactivity Disorder, and clinical anxiety.
At Benchmark Psychology, we have a team of clinicians experienced in a range of developmental assessments for children and young people. Assessments are conducted directly by registered a clinical psychologist or clinical neuropsychologist with experience in assessments and postgraduate university qualifications.
We only use the gold-standard measures for assessment, such as the Weschler Intelligence Scale for Children (WISC), Weschler Individual Attainment Scale (WIAT), and Autism Diagnostic Observation Schedule (ADOS-2).
Every family is engaged in their child’s assessment process from start to finish. Parents receive a written report, outlining the assessment steps, the findings, and detailed recommendations to help parents decide where to from here. Parents also attend a feedback session with the clinician to go through the report together, discuss the results, and ask any questions.
Benchmark Psychology also offer families full assessment packages at a low cost (compared to other psychological practices in South-East Queensland).
To find out more or book an assessment today, call (07) 3349 5511 or visit benchmarkpsychology.com.au/services/cognitive-assessment/ for information about cognitive assessments or
benchmarkpsychology.com.au/autism-spectrum-disorders-assessment/ for autism spectrum disorders assessment.
This post was written for us by Dr Grace Sweeney and Dr Richard Wellauer from Benchmark Psychology.