BackgroundDepression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. ObjectiveThe aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program.MethodsTaitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes.ResultsTaitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect.ConclusionsOverall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.

Background: Primary care transformation in Scotland aims to improve population health, reduce health inequalities and reduce GP workload. Two key strategies (formalised in April 2018 in the new Scottish GP contract though started in early 2016) are the expansion of the multidisciplinary team (MDT) and GP cluster working. Aim: To explore progress in the implementation of the GP contract in Scotland in terms of MDT and cluster working. Design and Setting: Qualitative study with key national primary care stakeholders (PCSs) (n=6) and Cluster Quality Leads (CQLs) in clusters serving urban high deprivation areas (n=4), urban mixed areas (n=4), and remote and rural areas (n=4). Methods: Semi-structured interviews with thematic analysis. Results: There was general support for the initial aims of the new GP contract but all interviewees felt that progress on both MDT expansion and cluster working was slow, even prior to the pandemic. None of the CQLs (and few PCSs) felt that GP workload had reduced significantly, nor that the care of patients with complex needs had improved. Lack of time and poorly developed relationships were key barriers, as was a lack of relevant primary care data, and additional support (including guidance, administration, training, and protected time). Conclusion: Key PCSs and CQLs in different areas of Scotland report limited progress in primary care transformation, only partly related to the pandemic. There is a need for better workforce planning and support if the new GP contract is to succeed in transforming primary care in Scotland.

Any man who is intelligent must, on considering that health is of the utmost value to human beings, have the personal understanding necessary to help himself in diseases, and be able to understand and to judge what physicians say and what they administer to his body, being versed in each of these matters to a degree reasonable for a layman.

INTRODUCTION: Social work supervision in statutory child protection settings is often confused with line management and has little focus on professional development, critical reflection and exploration of practice. Within Aotearoa New Zealand, the statutory child protection agency Oranga Tamariki (OT), is under considerable scrutiny regarding the management of risk, child abuse, and the over-representation of Ma ̄ori tamariki within the child welfare system. This article covers the first collection of findings from a larger supervision study.METHODS: Using critical reflection as the methodological lens, four experienced OT supervisors participated in a learning community where supervision recordings were brought to each meeting to improve reflective capacity, critical reflection and skills. Data were collected from the learning community and thematic analysis was undertaken to explore current supervision practice in OT.FINDINGS: The three themes generated from the learning community discussions were: supervisory skills/interventions; the structure of supervision; and working with emotion and trauma. These themes highlighted the significance of the learning community as a forum for supervisors to share their existing supervision practice together, “moving out of the safe zone” as they engaged in positive and constructive feedback with their colleagues in a supportive space.CONCLUSIONS: Reflective supervision, within statutory child protection, is essential for learning, critical reflection and cultivating robust decision making in social work practice. The creation and development of professional supervision spaces such as learning communities provide the basis for supervisors and supervisees to develop their skills and ensure accountable, anti-oppressive and ethical practice.

No abstract