A new model of therapist skill development is presented. Grounded in information processing theory, it provides a comprehensive framework that accounts for a range of phenomena encountered by trainers and trainees – for example, why different training methods are needed for different elements of therapist skill. The model features three principal systems: declarative, procedural and reflective (DPR). Reflection is identified as central to therapist skill development and, accordingly, a pivotal role is given to a reflective system, which enables therapists to reflect and build on their conceptual (declarative) knowledge and procedural skills. The DPR model incorporates a taxonomy of therapist skills, and explains why different skills develop in different ways at different rates. It highlights the centrality of therapists' perceptual skills, and of when-then rules, plans, procedures and skills (rules that determine when to implement what interventions with which patient under what conditions) in the development of therapist expertise. It makes a distinction between personal and professional selves (the self-schema vs. the self-as-therapist schema); and it identifies the role of the personal self in therapist skill development. While there are still many questions to be investigated, it is hoped that the model will stimulate researchers and provide guidance for trainers.

Recent publications have suggested that practising cognitive therapy (CT) techniques on oneself may be valuable in the development of cognitive therapists' clinical skills. The present study asks: Is this useful? If so, in what ways? We report a qualitative study of the experience of trainees undertaking a CT training course, which included an explicit self-practice (SP) and self-reflection (SR) component. Key features of the learning process were: (i) experiencing cognitive techniques from the client's perspective, and (ii) reflecting on this experience that led to (iii) a ''deeper sense of knowing'' of CT practices. The primary learning outcome was an enhancement of therapeutic understandings, which trainees reported to be both professionally and personally useful. Professionally, they reported deeper understanding of the therapist's role, the cognitive model and change processes. Personally, SP/SR led to greater understanding of themselves, and to the perception of CT as a useful tool for personal change. The data also suggested two other positive learning outcomes: an enhancement of therapist skills and therapist self-concept. We conclude that SP/SR may be a valuable component in CT training. Guidelines and recommendations for inclusion of SP/ SR in training courses are discussed.

BackgroundAboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community.ObjectiveThis study aimed to explore Aboriginal and Torres Strait Islander community members’ experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches.MethodsUsing qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings.ResultsFindings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake.ConclusionsWhen designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health approaches for improving the well-being of Aboriginal and Torres Strait Islander people.

The MindSpot Clinic produced treatment outcomes that were comparable to results from published clinical trials of iCBT. This model of service delivery represents an innovative method of providing accessible, low-cost, effective, and acceptable mental health services to many people who currently are not receiving care.

Chapter 1 provides an overview of this title, suggesting that low intensity cognitive behavioural therapy (LI CBT) represents a revolution in the delivery of mental health services; the dawning of a new values-based paradigm, which places improving access to effective psychological treatments as the guiding principle for the endeavour. The historical underpinnings of LI CBT are traced and defined. In the remainder of the chapter, a variety of ways in which LI CBT represents a quantum shift in the way mental health services and psychological treatments are delivered is illustrated, earning it the right to be truly termed a ‘new paradigm’