Best practice in early psychosis intervention for Australian indigenous communities: indigenous worker consultation and service model description.

Objective: The aim of this study was to identify promising elements of best practice relevant to mainstream mental health service (MHS) delivery of early psychosis intervention (EPI) to Indigenous communities. In a companion paper, a comprehensive literature review identified a promising service model with potential for delivering EPI: an Indigenous sub-team embedded within a mainstream health service.

Method: This paper describes a consultation process with Indigenous Mental Health Workers (IMHWs) in south eastern Queensland.

Do childhood callous-unemotional traits drive change in parenting practices?

This study examined the relationship between callous-unemotional (CU) traits and parenting practices over time in a mixed-sex community cohort (N = 1,008; 52.6% boys), aged 3 to 10 years (M = 6.5, SD = 1.

Clinical indicators for routine use in the evaluation of early psychosis intervention: development, training support and inter-rater reliability.

Aim: Clinical practice improvement carried out in a quality assurance framework relies on routinely collected data using clinical indicators. Herein we describe the development, minimum training requirements, and inter-rater agreement of indicators that were used in an Australian multi-site evaluation of the effectiveness of early psychosis (EP) teams.

Methods: Surveys of clinician opinion and face-to-face consensus-building meetings were used to select and conceptually define indicators.

Appraising evidence for intervention effectiveness in early psychosis: conceptual framework and review of evaluation approaches.

The literature that is relevant to evaluation of treatment effectiveness is large, scattered and difficult to assemble for appraisal. This scoping review first develops a conceptual framework to help organize the field, and second, uses the framework to appraise early psychosis intervention (EPI) studies. Literature searches were used to identify representative study designs, which were then sorted according to evaluation approach.

Learning to 'talk the talk: the relationship of psychopathic traits to deficits in empathy across childhood.

Background: Psychopathy is characterised by profound deficits in the human tendency to feel and care about what other people feel, often known as 'affective empathy'. On the other hand, the psychopath often has intact 'cognitive' empathy skills, that is, he is able to describe what and why other people feel, even if he does not share or care about those feelings. Despite a rapidly advancing neuroscience of empathy, little is known about the developmental underpinnings of this psychopathic disconnect between affective and cognitive empathy.

A measure of cognitive and affective empathy in children using parent ratings.

The construct of "empathy" embodies a number of characteristics necessary for psychological health in children. Surprisingly, most research has been based solely on children and adolescent report and observational measures despite evidence that multi-informant assessment is fundamental to the accurate measurement of such constructs. We present research documenting the development and validation of a brief parent-report measure of child empathy targeted at the formative years for the development of empathic skills, through to adolescence.

Contemporary management of aggression in an inner city mental health service.

Objectives: From 2002 to mid 2003, Royal Brisbane and Women's Hospital Mental Health experienced increased patient - staff aggression and staff injury which resulted in staff conflict and recruitment difficulties. Strategies introduced to reduce the frequency and impact of aggression in the mental health service were evaluated.

Method: By mid 2003, incident data indicated increasing aggressive incidents.

Do clinical pathways really improve clinical performance in mental health settings?

Objective: Royal Brisbane and Women's Hospital (RBWH) Mental Health developed and trialled two clinical pathways on psychosis and depression between 2001 and 2003 with the aim of improving a range of clinical and financial parameters. There was a strong commitment from senior management, appropriate resources were allocated and there was adequate staff support. Following a 6-month trial, the pathways were reworked extensively and combined into an acute inpatient pathway.

A naturalistic comparison of two right unilateral electroconvulsive therapy dosing protocols: 2-3X seizure threshold versus fixed high-dose.

The aim of this study was to compare the outcomes associated with two differing right unilateral (RUL) electroconvulsive therapy (ECT) dosing protocols: 2-3X seizure threshold (2-3X ST) and fixed high dose (FHD) at 353 mC. A retrospective chart review was performed to compare patient outcomes during the implementation of two different dosing protocols: 2-3X ST from October 2000 to May 2001 and FHD from June 2001 to February 2002. A total of 56 patients received ECT under the 2-3X ST protocol, and 46 received ECT under the FHD protocol.

"GP Psych Opinion": evaluation of a psychiatric consultation service.

Objective: To evaluate a hospital-based psychiatric consultation service for patients referred by general practitioners (GPs), and the effect on its use of a focused marketing strategy aimed at GPs.

Design And Setting: Postal survey of GPs in the catchment area (inner north Brisbane, Queensland), September to November 2003; and assessment of referrals, March to August 2003.

Main Outcome Measures: Patient referrals, satisfaction among GPs who had referred, and awareness and opinions of the service among GPs who had not referred, compared with results of a similar survey conducted before marketing.

Disentangling the underlying dimensions of psychopathy and conduct problems in childhood: a community study.

The psychometric and predictive validity of callous-unemotional (CU) traits as an early precursor of conduct disorder and antisocial behavior were assessed. A community sample of children (4-9 years of age) were tested 12 months apart with the Antisocial Process Screening Device (APSD; P. J.

A tale of three pathways: the experience of RBWH Mental Health.

Objectives: Australian research has identified that there are significant variations between service providers in terms of clinical management of patients with comparable presenting problems. Internal audits within the facility at Royal Brisbane and Women's Hospital revealed that these variations occurred between wards, treating teams and psychiatric consultants. Given the increasing emphasis on evidence-based practice, it was decided that the literature should be reviewed to determine what the standard of care should be.