Cognitive-reminiscence therapy and usual care for depression in young adults: study protocol for a randomized controlled trial

Background
Depression is a common affliction for young adults, and is associated with a range of adverse outcomes. Cognitive-reminiscence therapy is a brief, structured intervention that has been shown to be highly effective for reducing depressive symptoms, yet to date has not been evaluated in young adult populations. Given its basis in theory-guided reminiscence-based therapy, and incorporation of effective therapeutic techniques drawn from cognitive therapy and problem-solving frameworks, it is hypothesized to be effective in treating depression in this age group.

Methods and design
This article presents the design of a randomized controlled trial implemented in a community-based youth mental health service to compare cognitive-reminiscence therapy with usual care for the treatment of depressive symptoms in young adults. Participants in the cognitive-reminiscence group will receive six sessions of weekly, individual psychotherapy, whilst participants in the usual-care group will receive support from the youth mental health service according to usual procedures. A between-within repeated-measures design will be used to evaluate changes in self-reported outcome measures of depressive symptoms, psychological wellbeing and anxiety across baseline, three weeks into the intervention, post-intervention, one month post-intervention and three months post-intervention. Interviews will also be conducted with participants from the cognitive-reminiscence group to collect information about their experience receiving the intervention, and the process underlying any changes that occur.

Discussion
This study will determine whether a therapeutic approach to depression that has been shown to be effective in older adult populations is also effective for young adults. The expected outcome of this study is the validation of a brief, evidence-based, manualized treatment for young adults with depressive symptoms.

Youth justice: challenges in responding to young people convicted of sexual offences

The clinical and criminological literature on adolescents who have committed sexual offences indicates that a pathologisation of young people and a labelling or overly punitive response is likely to be more harmful than rehabilitative. Accordingly, therapeutic counselling and diversionary schemes are seen as preferable to custodial terms in most instances. For adolescents convicted of sex offences, clinicians identify the benefits of comprehensive therapeutic care which involves family and is sensitive to the young person's context and culture. The benefits of this approach are documented and, although data are limited, indications are that recidivism is reduced where adolescents are provided with specialised counselling to encourage positive and non-abusive behaviours. Yet each jurisdiction experiences difficulties in ensuring the provision of equitable and comprehensive therapeutic services, particularly to regionally or remotely located youth. This paper draws on data from a national study of the services to children and adolescents with sexualised or sexual offending behaviours. With attention to the difficulty in providing services to regionally or remotely located adolescents, this paper identifies challenges around lengthy remand terms, the provision of pre-offence diversionary programs, and the provision of specialised services for young people serving community orders. For example, jurisdictions with the largest geographic service areas face enormous difficulties in providing specialised supervision for community-based orders. At present there are several jurisdictions where regionally and remotely located adolescents may serve the duration of a youth justice order without receiving sepcialised counselling to assist them in modifying their behaviours. The paper identifies the risks where specialised counselling cannot be provided, but also identifies specific initiatives designed to fill these gaps in service provision to youth justice clients. 

Client self-assessment in community aged care: A comparative study involving older Australians and their case managers

Self-assessment of support needs is a relatively new and under-researched phenomenon in domiciliary aged care. This article outlines the results of a comparative study focusing on whether a self-assessment approach assists clients to identify support needs and the degree to which self-assessed needs differ from an assessment conducted by community care professionals. A total of 48 older people and their case managers completed a needs assessment tool. Twenty-two semi-structured interviews were used to ascertain older people’s views and preferences regarding the self-assessment process. The study suggests that while a co-assessment approach as outlined in this article has the potential to assist older people to gain a better understanding of their care needs as well as the assessment process and its ramifications, client self-assessment should be seen as part of a co-assessment process involving care professionals. Such a co-assessment process allows older people to gain a better understanding of their support needs and the wider community aged care context. The article suggests that a co-assessment process involving both clients and care professionals contains features that have the capacity to enhance domiciliary aged care.

Home space : youth identification in the Greek diaspora

This article draws on a larger study on schooling and diaspora using the case of the Greek community of Melbourne, Australia to examine processes of identification of young people with access to minority cultures. The Melbourne Greek community is long-standing, diverse, and well-established. Because of this, the young people involved in this study provide insights into cultural processes not related in any direct sense to migration. In most cases, it was their grandparents or great-grandparents who migrated. Many have 1 parent with no ancestral link to Greece. In this context, the motivations for and ways of expressing Greekness have the potential to illustrate identification as ambivalent. This article explores the centrality of “home” in these young people's representations of self. Following de Certeau, the argument is made that their everyday experience can be interpreted as an act of “anti-discipline.” As “users” of the Greekness, they are bequeathed through family, community, and schooling; and they use “tactics” of cultural redeployment that allow creative resistance and reinterpretation of both “Greekness” and “Australianness.”

Professional views on the management of sex offenders in the community

Sex offender registration and community notification schemes form an increasingly important part of public policy relevant to the management of known sex offenders in the community. Critics of these policies not only point to the lack of empirical evidence that is currently available to support their impact on reoffending, but also the disproportionate and potentially iatrogenic effects that they have on offenders. However, there have been few attempts to understand these issues from the perspective of those practitioners who work on a daily basis with sex offenders in the community. These professionals are uniquely placed to contribute to an understanding of effective risk management and, as such, this article presents an analysis of the perspectives of a group of experienced practitioners and how this practice-based wisdom might inform the development of sex offender public policy.

Crossing boundaries : acts of citizenship among migrant youth in Melbourne

This paper focuses on how migrant youth in Melbourne with experience of direct or indirect migration negotiate cross-cultural engagements and tensions between family, community and the greater society in which they are supposed to participate as political subjects. It examines whether the meaning and interpretation of citizenship in Australia allows migrant youth to act as full and active citizens with all the contradictions and difficulties inherent in acting as “a bridge between two worlds”. By voicing the personalised journeys of young people dealing with uneasy questions of dis-placement, identity and belonging, this paper examines the complex ways through which migrant youth negotiate and in some cases bridge intercultural tensions within a multicultural society.

Antisemitism and Jewish children and youth in Australia’s Capital Territory schools

Issues pertaining to religion and Australian schools have generated a significant amount of controversy and scholarly attention in recent years, and much of the attention in the religion and schools debate has focused on Muslim and non-religious children’s experiences (Erebus International, 2006; Halafoff, 2013). This article, by contrast, explores the manifestations of antisemitism as experienced by Jewish children and youth in Canberra schools. It considers the characteristics of antisemitism; when and why it occurs; its impact on the Jewish children and young people; and also the responses to it by them, the schools and the Jewish community. Based on focus groups with the Jewish students and their parents, the study reveals that antisemitism is common in Canberra schools, as almost all Jewish children and youth in this study have experienced it. The findings from this study suggest that there is a need for more anti-racism education. Specifically there is an urgent need for educational intervention about antisemitism, alongside education about religions and beliefs in general, to counter antisemitism more effectively and religious discrimination more broadly in Australian schools.

More than a game : the impact of sport-based youth mentoring schemes on developing resilience toward violent extremism

This paper draws upon the findings of an evaluation of “More than a Game”, a sport-focused youth mentoring program in Melbourne, Australia that aimed to develop a community-based resilience model using team-based sports to address issues of identity, belonging, and cultural isolation amongst young Muslim men in order to counter forms of violent ex-tremism. In this essay we focus specifically on whether the intense embodied encounters and emotions experienced in team sports can help break down barriers of cultural and religious difference between young people and facilitate ex-periences of resilience, mutual respect, trust, social inclusion and belonging. Whilst the project findings are directly rel-evant to the domain of countering violent extremism, they also contribute to a growing body of literature which con-siders the relationship between team-based sport, cross-cultural engagement and the development of social resilience, inclusion and belonging in other domains of youth engagement and community-building.

Personal, musical and social benefits of singing in a community ensemble: three case studies in Melbourne (Australia)

Australia has a diverse, multilayered society that reflects its rich musical life. There are many community choirs formed by various cultural and linguistically diverse groups. This article is part of an ongoing project, Well-being and ageing: community, diversity and the arts (since 2008), undertaken by Deakin University and Monash University, that explores the cultural diversity within Australian society and how active music engagement fosters well-being. The singing groups selected for this discussion are the Skylarkers, the Bosnian Behar Choir, and the Coro Furlan. The Skylarkers and the Bosnian Behar Choir are mixed groups who respectively perform popular music from their generation and celebrate their culture through music. The Coro Furlan is an Italian male choir who understand themselves as custodians of their heritage. In these interpretative, qualitative case studies semi-structured interviews were undertaken and analyzed using Interpretative Phenomenological Analysis. In this approach there is an exploration of participants’ understanding of their lived experiences. The analysis of the combined data identified musical and social benefits that contribute to participants’ sense of individual well-being. Musical benefits occurred through sharing, learning and singing together. Social benefits included opportunities to build friendships, overcome isolation and gain a sense of validation. Many found that singing enhanced their health and happiness. Active music making in community choirs and music ensembles continues to be an effective way to support individuals, build community, and share culture and heritage.

Indicators for evaluating cancer organizations' support services: performance and associations with empowerment

Community-based cancer organizations provide services to support patients. An anticipated benefit of these services is patient empowerment. However, this outcome has not been evaluated because of the lack of validated health-related empowerment questionnaires in the cancer context. In this validation study, the authors assessed the extent to which 16 indicators used by the Canadian Cancer Society (CCS) and the Cancer Council Victoria, Australia (CCV) to evaluate their services were associated with health-related empowerment.

Mentoring programs for indigenous youth at-risk

There is a range of risk factors that may make young people of any ethnicity more likely to engage in antisocial behaviours. These factors include the young person’s own attitudes; relationships within the family; and growing up in communities where there is widespread violence, alcohol and other substance abuse, poverty, poor health and poor-quality housing. Indigenous young people face the additional challenges ofdispossession, discontinuity of culture and intergenerational trauma.A strong connection to culture—coupled with high self-esteem, a strong sense of autonomy, and with living in cohesive, functioning families and communities—can be protective factors that result in Indigenous young people choosing productive life pathways.Mentoring is a relationship intervention strategy that can assist in building some of these protective factors. A growing body of research demonstrates that mentoring can have powerful and lasting positive effects in improving behavioural, academic and vocational outcomes for at-risk youth and, to a more limited extent, in reducing contact with juvenile justice systems.In an Indigenous context, mentoring is a particularly promising initiative because it fits well with Indigenous teaching and learning styles and can help to build strong collective ties within a community.Mentoring programs can involve adult or peer mentors and can be implemented in a range of ways, such as one-on-one or in groups.Although positive results can be achieved with single-intervention mentoring for at risk youth, integrating mentoring into broader programs produces a greater level of positive change.The way the mentoring program is run and the nature of the relationship between mentor and mentee are crucial in determining the outcomes of youth mentoring programs.

Reflections on doing inclusive research in the 'making life good in the community' study

BACKGROUND: The involvement of people with intellectual disability in research is framed as inclusive, denoting their active participation in its processes. However, questions are raised about ownership and control, genuineness of involvement, and the need for honest accounts to develop practice. Such issues are particularly pressing in Australia, where there is the absence of a strong self-advocacy movement to partner with academics or hold them to account. METHOD: Action research was used to reflect on and progressively refine the support provided by a research mentor to a co-researcher with intellectual disability employed on a large multimethod study. RESULTS AND CONCLUSIONS: Accepting the co-researcher's strengths and designing support on the job rather than teaching them to "pass" before venturing out in the field are important in ceding control. Support required for a co-researcher is more than practical and involves developing a relationship that can actively challenge views and foster reflection. Ownership of questions and disseminating of outcomes are hampered by contextual factors such as tender processes, short-term positions, and a failure to acknowledge the support required to present findings.

Community aged care case managers transitioning to consumer directed care: more than procedural change required

Consumer directed care (CDC) is increasing in community aged care. However, limited information is available to successfully transition social workers and other case managers to their new role. This paper reports on a case study of six senior case managers who supervised staff in three Australian community-aged care agencies as they transitioned from agency directed care to consumer directed care. A change management framework was used to analyse the qualitative data collected in 12 semistructured interviews. A key finding is that changes in values, attitudes, and organisational culture are needed before staff can fully implement CDC principles of service user self-determination, empowerment, and choice. Process changes needed to assist staff transition to CDC are: using a change management strategy that maximises certainty; monitoring and responding to feelings of anxiety through ongoing consultations; and providing ongoing education and support in group sessions.

A case study about the supported participation of older men with lifelong disability at Australian community-based Men's Sheds

Background This article presents an insight into the supported participation of older men with a lifelong disability in community Men's Sheds. We draw on a subsample of men from a 3-year study that explored how older people with a lifelong disability could be supported to transition to retirement from sheltered workshops. Method Data arose from a range of sources – both quantitative and qualitative – and are structured here into a descriptive case study about how mentors at Men's Sheds provided support to older men (n = 9) with lifelong disability. Findings Older men with disability want to enjoy an active retirement similar to their peers without disability. These men can join mainstream community groups such as Men's Sheds, provided they are offered just the right amount and type of support. Conclusion Men's Sheds are largely untapped community resources where men with disability are welcome, provided that appropriate support is offered to the members of the shed.