Using a digital personal recovery resource in routine mental health practice: feasibility, acceptability and outcomes.

BACKGROUND: Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. AIMS: We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. METHODS: Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data; and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. RESULTS: In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. CONCLUSIONS: In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation.

Outcomes and change processes of an established family education program for carers of adults diagnosed with a serious mental health condition.

BACKGROUND: Family education programs (FEPs) target caregiving-related psychological distress for carers of relatives/friends diagnosed with serious mental health conditions. While FEPs are efficacious in reducing distress, the mechanisms are not fully known. Peer group support and greater mental health knowledge are proposed to reduce carers' psychological distress by reducing stigmatising attitudes and self-blame, and strengthening carers' relationship with their relative. METHODS: Adult carers (n = 1016) who participated in Wellways Australia's FEP from 2009 to 2016 completed self-report questionnaires at the core program's start and end, during the consolidation period, and at a 6-month follow-up. Those who enrolled early completed questionnaires prior to a wait-list period. We used linear mixed-effects modelling to assess the program's effectiveness using a naturalistic wait-list control longitudinal design, and multivariate latent growth modelling to test a theory-based process change model. RESULTS: While there was no significant change over the wait-list period, psychological distress, self-blame and stigmatising attitudes significantly decreased, and communication and relationship quality/feelings increased from the core program's start to its end. Changes were maintained throughout the consolidation period and follow-up. Peer group support significantly predicted the declining trajectory of distress. Peer group support and greater knowledge significantly predicted declining levels of self-blame and stigmatising attitudes, and increasing levels of communication. CONCLUSIONS: This is the first study to quantitatively validate the mechanisms underlying the effect of FEPs on carers' psychological distress. Peer group support is key in modifying carers' appraisals of their friend/relatives' condition. Continued implementation of FEPs within mental health service systems is warranted.

Isometric Posterior Chain Peak Force Recovery Response Following Match-Play in Elite Youth Soccer Players: Associations with Relative Posterior Chain Strength.

: The purpose of this study was to determine changes in two tests of lower limb isometric posterior chain force (IPC-F) following 90 min of match-play in elite youth soccer players and the interaction between relative strength and recovery profile. 14 players (age: 16 ± 2 years) performed 3 × 3 second IPC-F tests unilaterally at 30° and 90° of knee and hip flexion pre- and post-match, +24 h, +48 h, and +72 h post-match. Peak force was recorded for both limbs, combined and expressed relative to bodyweight (N/kg). A two-way repeated measures analysis of variance was performed to determine differences in force output between joint angles, time intervals and subjects. As there was no interaction between angle and time (p = 0.260), we report the change between timepoints as mean Δ in 90° + 30° IPC-F. Relative to pre-match IPC-F, there were significant decreases post (Δ = -18%; p > 0.001) and at +24 h (Δ = -8%; p = 0.040), no significant difference at +48 h (Δ = 0%; p = 0.992) and a significant increase at +72 h (Δ = +12%; p = 0.005). There was a large inter-individual variability in recovery profile at both angles and substantial differences between post-match deficits at 90° (-10.8%) compared to 30° (-20.7%). Higher pre-match IPC-F was correlated with the magnitude of IPC-F deficits at both angles and all time points (r = 0.56 to 0.70, p = < 0.01) except for post-match 90°. Regular IPC-F monitoring to determine the magnitude of match-induced fatigue and track recovery may help inform decision-making regarding modifications to individual players training load, particularly as there is a large inter-individual variability in response to competition. Further research is warranted to better understand and address the finding that stronger players showed larger force deficits and slower recovery following match-play.