CCI's clinical research team have published over 200 peer-reviewed journal articles and books about mental disorders and their treatment.
You can use Google Scholar to view our most recent and full list of publications.
CCI Senior Clinical Psychologist and Professor of Psychology Peter McEvoy has published several informative articles about mental disorders and their treatment on the Conversation, a media outlet that publishes educational articles written by Australian academics.
In the section below are brief overviews and links to recent research publications and presentations involving CCI staff. We started posting these summaries in November 2019.
Glenn Waller et al.
International Journal of Eating Disorders
Why did we do this study?
Across the world, the coronavirus pandemic has led to a dramatically different way of working for mental health professionals who treat eating disorders. As a result of social distancing, many clinicians have needed to transfer from conducting therapy face-to-face to delivering via videoconference or telephone (known as telehealth). Clinicians at the Centre for Clinical Interventions (CCI) have also faced this transition to telehealth. Many clinicians feel nervous about delivering therapy via telehealth while sticking to interventions that are based on strong research evidence. This paper aimed to rapidly develop guidelines for delivering cognitive behavioural therapy for eating disorders (CBT-ED) via telehealth.
How did we do this?
Dr Bronwyn Raykos from CCI was part of a group of 22 international clinicians specialising in eating disorder treatment who developed the guidelines.
What did we find?
Key points in the guidelines include:
How will we use it (or how can it be used)?
CCI will be applying these guidelines in therapy conducted by telehealth, and will be seeking feedback from clients who have experienced this transition to telehealth to gain further insights into their experiences.
Elizabeth A Newnham, Nickolai Titov, & Peter McEvoy
The Lancet Planetary Health
Australia has recently experienced an unprecedented bushfire crisis with tragic deaths, large-scale devastation to the environment and animals, and immense economic impacts. The physical and emotional toll on emergency services personnel are also serious concerns. While many people will adjust to the loss and trauma they have experienced over time, some will have long-term mental health problems. The government and non-government mental health sectors responded promptly to the crisis in late 2019 and early 2020, but it is important to prepare services to support people experiencing ill-effects in the longer term.
We wrote a commentary to highlight the need to consider short- and long-term responses to mental health impacts of bushfires and other natural disasters in Australia, which are increasing in frequency and intensity.
The Australian Government’s National Bushfire Recovery Agency established a National Bushfire Recovery fund, with $76 million from $2 billion allocated to mental health. This funding has supported counselling, telehealth services, trauma-informed care, community grants, and youth mental health services. We need to ensure there is adequate funding for mental health services in regional areas into the future, along with surge capacity when required. Australia has high quality telehealth services that can circumvent some access barriers. The Australian Government’s Productivity Commission draft report outlines a range of strategies for appropriately resourcing mental health services into the future, which will help to support the resilience of communities.
This article aims to increase awareness of the mental health needs of the community, and advocate for appropriate funding for evidence-based services, particularly as natural disasters increase in frequency and intensity due to climate change.
Glenn Waller & Bronwyn Raykos
Psychiatric Clinics of North America
Eating disorders, such as Anorexia Nervosa and Bulimia Nervosa, involve significant disturbances in how people eat. For example, a person with an eating disorder may severely restrict how much they eat, or repeatedly eat large quantities of food and then try to compensate for this through behaviours such as vomiting or excessive exercise. Many treatments for eating disorders try to alter these unhelpful eating behaviours. The treatments do this, in part, by using what are known as behavioural methods. Some examples are teaching people with eating disorders practical skills such as food preparation and food shopping, making them face their fears related to eating and / or their body using exposure (e.g. eating feared foods, looking at one’s body in the mirror), and normalising their eating patterns and weight. All behavioural methods aim to reduce or eliminate problematic behaviours by teaching people new ways to eat and relate to their body.
Behavioural methods form a part of many evidence-based treatments for eating disorders such as cognitive behavioural therapy (CBT) and family-based treatment (FBT). We sought to determine whether behavioural methods are necessary for treatments of eating disorders to be effective.
Dr. Bronwyn Raykos, Senior Clinical Psychologist at CCI, and Professor Glenn Waller from the University of Sheffield, reviewed research that has focused on behavioural methods across different treatment settings, eating disorder diagnoses and age groups.
We found that:
Behavioural interventions are necessary for eating disorder recovery. Doing things differently can be very anxiety-provoking for clients and even for clinicians, but is essential to get the best outcomes. At CCI, we continue to encourage our clients to try things that might feel scary at first (such as eating three meals and 2-3 snacks per day), including feared foods, or looking at their body in the mirror so they have the best chance of achieving a full recovery. In family-based treatment, parents are encouraged to help their young person make these changes. Clinician’s anxiety is also a focus of our supervision sessions.
Peter M. McEvoy, Katharina Targowski, Diana McGrath, Olivia Carter, Anthea Fursland, Marilyn Fitzgerald, & Bronwyn Raykos
International Journal of Eating Disorders
Why did we do this study?
Eating disorders can have a profound and pervasive impact on the perceived burden, quality of life, and overall psychological wellbeing of people who support an individual with an eating disorder. Clinical practice guidelines recommend that carers of people with an eating disorder be offered education and information on the nature, course, and treatment of eating disorders, and opportunities to participate in self-help and support groups. However, many carer interventions are time-consuming for the carer and expensive for health services. The aim of this study was to evaluate the impact of a brief, two-session carers’ intervention on carer burden, self-efficacy (carers’ confidence in their ability to help their loved one), skills, knowledge, negative family interactions, distress, and accommodating behaviours (the carer altering their lifestyle to make room for the eating disorders). We hoped that the brief intervention would help to reduce carer burden, negative family interactions, distress, and accommodating behaviours, and increase self-efficacy, skills, and knowledge about eating disorders.
We ran a randomised controlled trial comparing carers who received the intervention immediately to carers who received the intervention after a waitlist period.
We found a large positive impact on carer burden, self-efficacy, skills, knowledge, and negative family interactions. In contrast, carer anxiety, depression, an accommodating behaviours did not change more in the intervention group than the waitlist control group. Carers might need additional support to help them manage their own emotional symptoms, and may need more time to adjust their lifestyle so that they are making fewer accommodations for their loved one’s eating disorder.
The demonstrated effectiveness of this brief carers’ intervention across a range of important outcomes meant that it was imperative that it continued to be offered at CCI. We are also sharing our teaching materials with other health services who wish to deliver the intervention.
Peter M. McEvoy, Matthew P. Hyett, Sarah Shihata, Jordan E. Price, & Laura Strachan
Clinical Psychology Review
Intolerance of uncertainty is a trait reflecting the degree to which an individual hold negative beliefs about, and experiences aversive emotions in response to, unpredictable events. People who are high on intolerance of uncertainty, or IU for short, can experience intense emotions in anticipation of uncertain negative outcomes, regardless of their actual probability. The fear is to the unknown – not knowing whether a negative outcome will occur in a situation can be experienced as more distressing than knowing for sure that something bad will happen. IU has been found to be associated with a range of anxiety-related disorders, depression, and eating disorders. However, it was unknown how strong these associations were, whether IU was particularly important for some disorders compared to others, and whether a range of methodological factors could explain these differences. If IU contributes to emotional disorders, then it is important for us to understand these relationships so that we can effectively target them in treatment. The aim of this study was to quantify the strengths of association between IU and symptoms of anxiety disorders, obsessive compulsive disorder, depression, and eating disorders.
We conducted a meta-analysis, which means we reviewed and combined the results from all studies in the literature that examined the relationship between IU and symptoms of anxiety disorders, obsessive compulsive disorder, depression, and eating disorders. In total, we combined 181 studies, which included 52,402 participants, and 335 independent effect sizes. This is the most definitive study of these relationships published to date.
Overall we found a moderate (.51) correlation between IU and the mental disorders included in our study, which suggests that higher levels of IU are indeed associated with more severe symptoms of emotional disorder. The strength of association was similar across the disorders, although it was more strongly associated with generalised anxiety disorder than for eating disorders, and it was stronger for depression than for obsessive compulsive disorder. Overall, the relationship between IU and symptoms was slightly stronger in non-clinical than clinical populations, for women than for men (but not for all disorders), and for some measures of IU than others.
This study demonstrates that the relationships between IU and symptoms of anxiety disorders, obsessive compulsive disorder, depression, eating disorders are robust. Patients with these disorders are likely to find it difficult to cope with uncertainty in some important areas of their lives. Clinicians should assess IU in their clients, include it in their case formulations and treatment plans, and help their clients to develop confidence in their ability to manage uncertainty. Clinicians at CCI are well trained in assessing and treating IU.
Laura M. Smith, David M. Erceg-Hurn, Peter M. McEvoy, Louella Lim
Journal of Affective Disorders
CCI has a psychological treatment programme for bipolar disorder. One of the aims of the programme is to help people to feel more confident about their ability to manage their bipolar illness, also known as self-efficacy. When people lack confidence in their ability to manage their own illness it can lead to poorer quality of life, coping and difficulties in sticking with treatment plans. We wanted to evaluate how effective our treatment is at improving our bipolar patients’ self-efficacy, but discovered there was no existing scale we could use to do this. Therefore, we decided to develop one.
We developed a preliminary scale and then spent many years collecting completed measures from everyone who attended the CCI Bipolar Programme.
We were able to show that our scale is a brief, valid and reliable way of measuring self-efficacy in people who have bipolar disorder.
We have already been using this scale to measure outcomes in our Bipolar Group programme and it has been used in other treatment settings as an outcome measure. We hope it will be used more broadly in psychological treatment programmes for people with bipolar disorder.
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