Adapting low intensity CBT interventions for clients with severe mental illness

Many people with severe mental illness (SMI) such as schizophrenia, whose psychotic symptoms are effectively managed, continue to experience significant functional problems. This chapter argues that low intensity (LI) cognitive behaviour therapy (CBT; e.g. for depression, anxiety, or other issues) is applicable to these clients, and that LI CBT can be consistent with long-term case management. However, adjustments to LI CBT strategies are often necessary and boundaries between LI CBT and high intensity (HI) CBT (with more extensive practitioner contact and complexity) may become blurred. Our focus is on LI CBT's self-management emphasis, its restricted content and segment length, and potential use after limited training. In addition to exploring these issues, it draws on the authors' Collaborative Recovery (CR; Oades et al. 2005) and 'Start Over and Survive' programs (Kavanagh et al. 2004) as examples. ----- ----- Evidence for the effectiveness of LI CBT with severe mental illness is often embedded within multicomponent programs. For example, goal setting and therapeutic homework are common components of such programs, but they can also be used as discrete LI CBT interventions. A review of 40 randomised controlled trials involving recipients with schizophrenia or other sever mental illnesses has identified key components of illness management programs (Mueser et al. 2002). However, it is relatively rare for specific components of these complex interventions to be assessed in isolation. Given these constraints, the evidence for specific LI CBT interventions with severe mental ilnness is relatively limited.

Brief motivational interviewing for depression and anxiety

Motivational interviewing (MI)can be applied as a brief, low intensity (LI) intervention of 1-4 individualised sessions (typically 45-60 minutes in duration), including screening, assessment feedback, and psycho-education. MI is a client-centred, directive therapeutic style that enhances readiness for change by helping clients explore and resolve ambivalence (Miller and Rollnick 2002). A summary of the key components of brief MI interventions is provided in Table 16.1. There is a well-established evidence base for MI in the treatment of substance misuse (particularly alcohol misuse; Moyer et al. 2002), as well as a growing evidence for the use of MI in the treatment of other mental disorders (e.g. depression, PTSD, OCD), as well as suicidality and physical health problems (Hettema et al. 2005). Brief MI intervention can be delivered as a standalone treatment or as a motivational prelude to pharmacological and/or other psychological treatments (Hettema et al. 2005). MI has been used as an accompaniment to cognitive behavioural therapy (CBT) in the treatment of both depression and anxiety for resolving ambivalence about change and developing strategies for responding to resistance (e.g. treatment attendance, homework/medication compliance; Arkowitz et al. 2008a, 2008b). This chapter will describe how to apply brief MI interventions to the treatment of depression and anxiety as applied to the case of Megan (see Box 16.1) along with some of the challenges and potential solutions to applying MI in practice.

The low-affinity site of the β1-adrenoceptor and its relevance to cardiovascular pharmacology

β-Adrenoceptor blocking agents (β-blockers) that at low concentrations antagonize cardiostimulant effects of catecholamines, but at high concentrations also cause cardiostimulation, have been appearing since the late 1960s. These cardiostimulant β-blockers, coined non-conventional partial agonists, antagonize the effects of catecholamines through a high-affinity site (β1HAR), but cause cardiostimulation mainly through a low-affinity site (β1LAR) of the myocardial β1-adrenoceptor. The experimental non-conventional partial agonist (−)-CGP12177 increases cardiac L-type Ca2+ current density and Ca2+ transients, shortens action potential duration but augments action potential plateau, increases heart rate and force, as well as causes arrhythmic Ca2+ transients and arrhythmic cardiocyte contractions. Other β-blockers, which do not cause cardiostimulation, consistently have lower affinity for β1LAR than β1HAR. These sites were verified and the cardiac pharmacology of non-conventional partial agonists confirmed on recombinant β1-adrenoceptors and on β1-adrenoceptors overexpressed into the heart. A targeted mutation of Asp138 to Glu138 virtually abolished the pharmacology of β1HAR but left intact the pharmacology of β1LAR. Non-conventional partial agonists may be beneficial for the treatment of peripheral autonomic neuropathy but probably due to their arrhythmic propensities, may be harmful for the treatment of chronic heart failure.

Low frequency of CHEK2 1100delC allele in Australian multiple-case breast cancer families : functional analysis in heterozygous individuals

A protein-truncating variant of CHEK2, 1100delC, is associated with a moderate increase in breast cancer risk. We have determined the prevalence of this allele in index cases from 300 Australian multiple-case breast cancer families, 95% of which had been found to be negative for mutations in BRCA1 and BRCA2. Only two (0.6%) index cases heterozygous for the CHEK2 mutation were identified. All available relatives in these two families were genotyped, but there was no evidence of co-segregation between the CHEK2 variant and breast cancer. Lymphoblastoid cell lines established from a heterozygous carrier contained approximately 20% of the CHEK2 1100delC mRNA relative to wild-type CHEK2 transcript. However, no truncated CHK2 protein was detectable. Analyses of expression and phosphorylation of wild-type CHK2 suggest that the variant is likely to act by haploinsufficiency. Analysis of CDC25A degradation, a downstream target of CHK2, suggests that some compensation occurs to allow normal degradation of CDC25A. Such compensation of the 1100delC defect in CHEK2 might explain the rather low breast cancer risk associated with the CHEK2 variant, compared to that associated with truncating mutations in BRCA1 or BRCA2.

Evaluation of the year 1 literacy and numeracy checkpoints assessments trial - 2010

The draft Year 1 Literacy and Numeracy Checkpoints Assessments were in open and supported trial during Semester 2, 2010. The purpose of these trials was to evaluate the Year 1 Literacy and Numeracy Checkpoints Assessments (hereafter the Year 1 Checkpoints) that were designed in 2009 as a way to incorporate the use of the Year 1 Literacy and Numeracy Indicators as formative assessment in Year 1 in Queensland Schools. In these trials there were no mandated reporting requirements. The processes of assessment were related to future teaching decisions. As such the trials were trials of materials and the processes of using those materials to assess students, plan and teach in year 1 classrooms. In their current form the Year 1 Checkpoints provide assessment resources for teachers to use in February, June and October. They aim to support teachers in monitoring children's progress and making judgments about their achievement of the targeted P‐3 Literacy and Numeracy Indicators by the end of Year 1 (Queensland Studies Authority, 2010 p. 1). The Year 1 Checkpoints include support materials for teachers and administrators, an introductory statement on assessment, work samples, and a Data Analysis Assessment Record (DAAR) to record student performance. The Supported Trial participants were also supported with face‐to‐face and on‐line training sessions, involvement in a moderation process after the October Assessments, opportunities to participate in discussion forums as well as additional readings and materials. The assessment resources aim to use effective early years assessment practices in that the evidence is gathered from hands‐on teaching and learning experiences, rather than more formal assessment methods. They are based in a model of assessment for learning, and aim to support teachers in the “on‐going process of determining future learning directions” (Queensland Studies Authority, 2010 p. 1) for all students. Their aim is to focus teachers on interpreting and analysing evidence to make informed judgments about the achievement of all students, as a way to support subsequent planning for learning and teaching. The Evaluation of the Year 1 Literacy and Numeracy Checkpoints Assessments Supported Trial (hereafter the Evaluation) aimed to gather information about the appropriateness, effectiveness and utility of the Year 1 Checkpoints Assessments from early years’ teachers and leaders in up to one hundred Education Queensland schools who had volunteered to be part of the Supported Trial. These sample schools represent schools across a variety of Education Queensland regions and include schools with:  - A high Indigenous student population; - Urban, rural and remote school locations; - Single and multi‐age early phase classes; - A high proportion of students from low SES backgrounds. The purpose of the Evaluation was to: Evaluate the materials and report on the views of school‐based staff involved in the trial on the process, materials, and assessment practices utilised. The Evaluation has reviewed the materials, and used surveys, interviews, and observations of processes and procedures to collect relevant data to help present an informed opinion on the Year 1 Checkpoints as assessment for the early years of schooling. Student work samples and teacher planning and assessment documents were also collected. The evaluation has not evaluated the Year 1 Checkpoints in any other capacity than as a resource for Year 1 teachers and relevant support staff.

The big picture : an integrated approach to fashion design education

This paper examines current teaching practice within the context of the Bachelor of Design (Fashion) programme at AUT University and compares it to the approach adopted in previous years. In recent years, staff on the Bachelor of Design (Fashion) adopted a holistic approach to the assessment of design projects similar to the successful ideas and methods put forward by Stella Lange at the FINZ conference, 2005. Prior to adopting this holistic approach, the teaching culture at AUT University was modular and divorced the development of conceptual design ideas from the technical processes of patternmaking and garment construction, thus limiting the creative potential of integrated project work. Fashion Design is not just about drawing pretty pictures but is rather an entire process that encapsulates conceptual design ideas and technical processes within the context of a target market. Fashion design at AUT being under the umbrella of a wider Bachelor of Design must encourage a more serious view of Fashion and Fashion Design as a whole. In the development of the Bachelor of Design degree at AUT, the university recognised that design education would be best serviced by an inclusive approach. At inception, Core Studio and Core Theory papers formed the first semester of the programme across the discipline areas of Fashion, Spatial Design, Graphic Design and Digital Design. These core papers reinforce the reality that there is a common skill set that transcends all design disciplines with the differentiation between disciplines being determined by the techniques and processes they adopt. Studio based teaching within the scope of a major design project was recognised and introduced some time ago for students in their graduating year, however it was also expected that by year 3 the student had amassed the basic skills required to be able to work in this way. The opinion concerning teaching these basic skills was that they were best serviced by a modular approach. Prior attempts to manage design project delivery leant towards deconstructing the newly formed integrated papers in order to ensure key technical skills were covered in enough depth. So, whilst design projects have played an integral part in the delivery of fashion design over the year levels, the earlier projects were timetabled by discipline and unconvincingly connected. This paper discusses how the holistic approach to assessment must be coupled with an integrated approach to delivery. The methods and processes used are demonstrated and some recently trialled developments are shown to have resulted in achieving the integrated approach in both delivery and assessment.

A probability-based approach for assessing the relationship between crash accidents and pavement properties

Skid resistance is a condition parameter characterising the contribution that a road makes to the friction between a road surface and a vehicle tyre. Studies of traffic crash histories around the world have consistently found that a disproportionate number of crashes occur where the road surface has a low level of surface friction and/or surface texture, particularly when the road surface is wet. Various research results have been published over many years and have tried to quantify the influence of skid resistance on accident occurrence and to characterise a correlation between skid resistance and accident frequency. Most of the research studies used simple statistical correlation methods in analysing skid resistance and crash data.----- ------ Preliminary findings of a systematic and extensive literature search conclude that there is rarely a single causation factor in a crash. Findings from research projects do affirm various levels of correlation between skid resistance and accident occurrence. Studies indicate that the level of skid resistance at critical places such as intersections, curves, roundabouts, ramps and approaches to pedestrian crossings needs to be well maintained.----- ----- Management of risk is an integral aspect of the Queensland Department of Main Roads (QDMR) strategy for managing its infrastructure assets. The risk-based approach has been used in many areas of infrastructure engineering. However, very limited information is reported on using risk-based approach to mitigate crash rates related to road surface. Low skid resistance and surface texture may increase the risk of traffic crashes.----- ----- The objectives of this paper are to explore current issues of skid resistance in relation to crashes, to provide a framework of probability-based approach to be adopted by QDMR in assessing the relationship between crash accidents and pavement properties, and to explain why the probability-based approach is a suitable tool for QDMR in order to reduce accident rates due to skid resistance.

Student engagement with an ePortfolio : a case study of pre-service education students

The emergence of ePortfolios is relatively recent in the university sector as a way to engage students in their learning and assessment, and to produce records of their accomplishments. An ePortfolio is an online tool that students can utilise to record, catalogue, retrieve and present reflections and artefacts that support and demonstrate the development of graduate students’ capabilities and professional standards across university courses. The ePortfolio is therefore considered as both process and product. Although ePortfolios show promise as a useful tool and their uptake has grown, they are not yet a mainstream higher education technology. To date, the emphasis has been on investigating their potential to support the multiple purposes of learning, assessment and employability, but less is known about whether and how students engage with ePortfolios in the university setting. This thesis investigates student engagement with an ePortfolio in one university. As the educational designer for the ePortfolio project at the University, I was uniquely positioned as a researching professional to undertake an inquiry into whether students were engaging with the ePortfolio. The participants in this study were a cohort (defined by enrolment in a unit of study) of second and third year education students (n=105) enrolled in a four year Bachelor of Education degree. The students were introduced to the ePortfolio in an introductory lecture and a hands-on workshop in a computer laboratory. They were subsequently required to complete a compulsory assessment task – a critical reflection - using the ePortfolio. Following that, engagement with the ePortfolio was voluntary. A single case study approach arising from an interpretivist paradigm directed the methodological approach and research design for this study. The study investigated the participants’ own accounts of their experiences with the ePortfolio, including how and when they engaged with the ePortfolio and the factors that impacted on their engagement. Data collection methods consisted of an attitude survey, student interviews, document collection, a researcher reflective journal and researcher observations. The findings of the study show that, while the students were encouraged to use the ePortfolio as a learning and employability tool, most students ultimately chose to disengage after completing the assessment task. Only six of the forty-five students (13%) who completed the research survey had used the ePortfolio in a sustained manner. The data obtained from the students during this research has provided insight into reasons why they disengaged from the ePortfolio. The findings add to the understandings and descriptions of student engagement with technology, and more broadly, advance the understanding of ePortfolios. These findings also contribute to the interdisciplinary field of technology implementation. There are three key outcomes from this study, a model of student engagement with technology, a set of criteria for the design of an ePortfolio, and a set of recommendations for effective practice for those implementing ePortfolios. The first, the Model of Student Engagement with Technology (MSET) (Version 2) explored student engagement with technology by highlighting key engagement decision points for students The model was initially conceptualised by building on work of previous research (Version 1), however, following data analysis a new model emerged, MSET (Version 2). The engagement decision points were identified as: • Prior Knowledge and Experience, leading to imagined usefulness and imagined ease of use; • Initial Supported Engagement, leading to supported experience of usefulness and supported ease of use; • Initial Independent Engagement, leading to actual experience of independent usefulness and actual ease of use; and • Ongoing Independent Engagement, leading to ongoing experience of usefulness and ongoing ease of use. The Model of Student Engagement with Technology (MSET) goes beyond numerical figures of usage to demonstrate student engagement with an ePortfolio. The explanatory power of the model is based on the identification of the types of decisions that students make and when they make them during the engagement process. This model presents a greater depth of understanding student engagement than was previously available and has implications for the direction and timing of future implementation, and academic and student development activities. The second key outcome from this study is a set of criteria for the re-conceptualisation of the University ePortfolio. The knowledge gained from this research has resulted in a new set of design criteria that focus on the student actions of writing reflections and adding artefacts. The process of using the ePortfolio is reconceptualised in terms of privileging student learning over administrative compliance. The focus of the ePortfolio is that the writing of critical reflections is the key function, not the selection of capabilities. The third key outcome from this research consists of five recommendations for university practice that have arisen from this study. They are that, sustainable implementation is more often achieved through small steps building on one another; that a clear definition of the purpose of an ePortfolio is crucial for students and staff; that ePortfolio pedagogy should be the driving force not the technology; that the merit of the ePortfolio is fostered in students and staff; and finally, that supporting delayed task performance is crucial. Students do not adopt an ePortfolio just because it is provided. While students must accept responsibility for their own engagement with the ePortfolio, the institution has to accept responsibility for providing the environment, and technical and pedagogical support to foster engagement. Ultimately, an ePortfolio should be considered as a joint venture between student and institution where strong returns on investment can be realised by both. It is acknowledged that the current implementation strategies for the ePortfolio are just the beginning of a much longer process. The real rewards for students, academics and the university lie in the future.

Embedding gifted education in preservice teacher education : a collaborative school-university approach

A country’s prosperity relies on the creative potential of its people. Educating gifted students must be a priority for educators and education systems if society is to capitalise on their potential to contribute to an economical and sustainable future. Given the importance of teachers in supporting academic achievement, educating preservice teachers on how to cater for gifted students commences the process as they can foster the implementation of current teaching practices that draw on substantial research into the education of gifted children. This study investigated preservice teachers’ perceptions for teaching gifted students after participating in a school-based intervention with gifted students. The teachers implemented differentiated curriculum activities that catered for the diverse needs of learners. Participants (n=22) were surveyed at the end of the program on their perceptions of how to differentiate the curriculum for meeting the needs of the student. Analysis of the survey indicated these preservice teachers agreed or strongly agreed they had developed skills in curriculum planning (91%) with well-designed activities (96%), and lesson preparation skills (96%). They also claimed they were enthusiastic for teaching (91%) and had understanding of school practices and policies (96%). However, only 46% agreed they had knowledge of syllabus documents with 50% claiming an ability to provide written feedback on the student’s learning. Furthermore, only 64% suggested they had educational language from the syllabus and effective student management strategies. Preservice teachers require direction on how to cater for diversity by building knowledge from direct gifted education experiences. The survey may be used as a diagnostic tool to determine areas for developing education experiences related to the education of the gifted for preservice teachers.

Wellness in higher education : a transformative framework for health related disciplines

The perceived benefits of Wellness Education in University environments are substantiated by a number of studies in relation to the place, impact and purpose of Wellness curricula. Many authors recommend that Wellness curriculum design must include personal experiences, reflective practice and active self-managed learning approaches in order to legitimise the adoption of Wellness as a personal lifestyle approach. Wellness Education provides opportunities to engage in learning self-regulation skills both within and beyond the context of the Wellness construct. Learner success is optimised by creating authentic opportunities to develop and practice self regulation strategies that facilitate making meaning of life's experiences. Such opportunities include provision of options for self determined outcomes and are scaffolded according to learner needs; thus, configuring a learner-centred curriculum in Wellness Education would potentially benefit by overlaying principles from the domains of Self Determination Theory, Self Regulated Learning and Transformative Education Theory to highlight authentic, transformative learning as a lifelong approach to Wellness.

An introduction to the constraints-led approach to learning in outdoor education

Participation in outdoor education is underpinned by a learner's ability to acquire skills in activities such as canoeing, bushwalking and skiing and consequently the outdoor leader is often required to facilitate skill acquisition and motor learning. As such, outdoor leaders might benefit from an appropriate and tested model on how the learner acquires skills in order to design appropriate learning contexts. This paper introduces an approach to skill acquisition based on ecological psychology and dynamical systems theory called the constraints-led approach to skills acquisition. We propose that this student-centred approach is an ideal perspective for the outdoor leader to design effective learning settings. Furthermore, this open style of facilitation is also congruent with learning models that focus on other concepts such as teamwork and leadership.

Critical reading comprehension in an era of accountability

This paper argues for the need for critical reading comprehension in an era of accountability that often promotes reading comprehension as readily assessable through students answering multiple choice questions of unseen texts. Based upon a 1 year study investigating literacy in Years 4–9 the ways strong-performing primary schools develop serious and in-depth reading for learning are explored. School and teacher features which allow for the development of sophisticated pedagogical repertoires and space for critical reading comprehension, without losing the complexity of curriculum offerings, are outlined. How one experienced middle primary teacher operates strategically, ethically and critically in supporting her ESL students to learn to read is illustrated. The teacher’s work is situated within the complex accountability demands faced by classroom teachers. This was accomplished by a teacher whose pedagogical repertoire has been assembled across a career teaching in low-SES high ESL communities in a school with a balanced literacy program and high level of collegial support. Risks for schools and teachers whose circumstances work against their capacities for prioritisation and strategic decision-making are identified and discussed.

Design education online : learning delivery and evaluation

Online learning has been recognised as an effective pedagogical method and tool, and is broadly integrated into various types of teaching and learning strategies in higher education. In practice, the use of Virtual Learning Environment (VLE) in higher education has become an integral strategy for quality education. The field of design education however has not been researched extensively in regard to online learning, delivery and evaluation. This paper discusses design education from an online learning perspective. It proposes an integrated framework with three key components for online learning via VLE including an interactive delivery structure, communication channels, and learning evaluation. Additionally, the paper describes and evaluates how VLE sites for two design units were built based on an integrated framework and student learning experiences. The results indicate that online design education should be integrated with various educational values and functional features in a systematic manner, and requires designing learning evaluation protocols as part of learning activities and communicative forms within online-based learning sites.

The high road or the low road? Alternatives for Australia's future

The OECD suggests that countries now have a choice. They can focus on development based on either:  competition via investment in technology and innovation - which is important in high knowledge industries and high innovation economies, or  competition via exchange rates and wages - which is important in industries producing standardised, lower-tech goods and services. The first route will maximise higher-skilled, higher-paid employment growth and living standards. Given the lack of control over the exchange rate, the second route requires competition based on wages. It is essential to understand that markets themselves won’t shift a country from one path to the other. These conclusions arise from the OECD’s recognition that technical progress - the creation of new products or the adoption of more efficient methods of production - is the main source of economic growth and enhanced quality of life. Technological change is, the OECD suggests, ...also the engine for job creation as higher wages and profits resulting from technology-induced productivity gains and lower prices lead to increased demand for new products from existing as well as new industries (1997: 4).Further, Competitiveness in high-technology industries is mainly driven by technology factors and much less by wage and exchange rate movements, while the reverse is true in low-technology industries (OECD 1996e: 12). The OECD has shown that sound macroeconomic conditions, such as the low inflation and reduced public sector debt visible in almost all member countries in the 1990s, are not enough to deal with high levels of unemployment and the need to increase levels of income: If economic performance is to improve, additional structural reform, which can increase innovation and the diffusion of technologies within and among national economies, seems necessary (OECD 1997: 4 Emphasis added).

Summary report : the high road or the low road? Alternatives for Australia's future

This document is a summary of the findings of the inaugural study commissioned by the Australian Business Foundation Limited. It was conducted by Professor Jane Marceau, Pro-Vice Chancellor (Research) at the University of Western Sydney Macarthur, Dr Karen Manley, Visiting Research Fellow at the University of Western Sydney Macarthur and Mr Derek Sicklen, Managing Director of Australian Economic Analysis Pty Limited. The full report is available from the Australian Business Foundation. The Australian Business Foundation Limited is a recently formed independent economic and industry policy think-tank. It has been established and sponsored by Australian Business Limited, a pre-eminent and long-standing industry association and business services network. The report is in three parts. The first reviews the key findings of contemporary international economic and innovation-oriented analyses of the characteristics of high growth economies. The second assesses the shape, structure and dynamics of Australian industry as these compare with the characteristics for successful economic development suggested in the literature. Finally, the report indicates the nature of urgently required policy directions.