Health care and health outcomes for adolescent mothers and their children may be a result of a complex interaction between socioeconomic, psychological, and familial factors. To examine a health professional perspective on the important issues in providing health care for adolescent mothers, transcripts of seventeen interviews with health professionals were analysed. Social support was considered an important aspect influencing the health of adolescent mothers and their children. This included family support, peer support and organisational support. Opportunities for health professionals to promote good social support for young mothers include role modelling supportive care and supporting adolescents' decision making, providing referrals to peer support groups, and understanding barriers to accessing organisational support. The best outcome for adolescent mothers is when their role as mother is supported by the family and wider support network.

Psychiatric nursing is a stressful profession associated with high levels of burnout. Previous research has demonstrated that burnout in psychiatric nurses can be reduced via training that improves behaviour modification skills. However, the minimum amount of training required to demonstrate a beneficial effect is unclear. We evaluated the impact of a 4-day behaviour modification training program on stress, burnout, and therapeutic attitudes in nurses who were in frequent daily inpatient contact with patients with severe mental illnesses. Nurses working in the same wards served as a control group. Training improved therapeutic attitudes but did not alter self ratings of job-stress and burnout. The need for multi-pronged approaches to the prevention and treatment of burnout in psychiatric nurses is discussed.

Clinician optimism is an important factor in achieving treatment outcomes in counselling contexts. Currently, there are no measures of mental health clinician optimism which report substantial psychometric validation. This study sought to assesses the validity and reliability of the Therapeutic Optimism Scale (TOS). 223 mental health clinicians working in a range of clinical settings were administered the TOS and convergent and discriminate validity were established. Test–retest reliability was established over a period of 1 month. The TOS was found to achieve acceptable reliability (Cronbach's α = .68) and yielded consistent scores over a one month period (r = .68, p < .01). Factor analyses revealed a 3-factor solution reflecting (1) General Treatment Outcome Expectancy, (2) Personal Treatment Outcome Expectancy, and (3) Pessimism. These findings support the utility of the TOS for research purposes, but further revision is recommended to enhance the reliability of the scale.

Family involvement in the rehabilitation counselling process is increasingly being recognised as an important component of rehabilitation success. This may be particularly true for persons who have an acquired or traumatic brain injury (TBI). For such individuals the emotional and psychosocial functioning of their family and caregivers has been associated with a variety of functional, psychosocial, and employment outcomes. Addressing the needs of family members is an important component of providing effective rehabilitation counselling services, but one that has received little attention in the rehabilitation counselling literature. This article reviews current research on the frequently identified needs of families and caregivers of persons with TBI, the family and situational variables that have been explored for their relationship to family needs, and the extent to which these needs are met. Clinical and research implications for rehabilitation counsellors are identified.

Fifty patients with myocardial infarction were recruited from a hospital based Cardiac Education and Assessment Program (CEAP) in Sydney, Australia. The Exercise Motivation Inventory-2 (EMI-2) and the Depression, Anxiety and Stress Scale (DASS) were administered prior to commencement in the program and re-administered by telephone interview at 5-month followup. Four exercise adherence measures were completed: attendance, exercise stress test, self-report ratings and a 7-day activity recall interview. There was a 46% adherence rate for MI patients during the hospital based CEAP. Of those individuals who completed CEAP, 91% obtained functional improvement on the exercise stress test. For the 38 patients who were followed-up by telephone interview at 5 months, 71% were exercising according to CEAP prescription. Higher levels of anxiety were associated with lower levels of self-reported exercise adherence. The 3 strongest motivations for exercise in this group of MI patients were all health related; wanting to be free from illness, maintaining good health and recovering from the effects of coronary heart disease. The discussion highlights the implications of these findings for cardiac rehabilitation programs and the need for empirically driven guidelines for measuring exercise adherence.

The Helping Hands program commenced in 1999 and partners volunteers with mental health consumers for support and to increase social contact, recreational and friendship opportunities. The aim of the present study is to describe the evolution and sustainability of the program over the first 6 years. A description of consumers accessing the program using recovery-oriented measures and traditional measures of behavioural functioning is also provided. Service data was collected on the development of the program, service utilisation, volunteer participation and funding patterns. Cross-sectional measures of recovery and baseline and follow-up Health of the Nation Outcome Scales (HoNOS) were collected on 27 participants. Results showed that the Helping Hands program has evolved significantly since start-up with the development of numerous recreational, health and support groups and 48 active volunteers and 62 active clients. Consumer feedback indicates that the service increases the quality of life of participants considerably. Current clients showed less severe disability at referral than did the original group. There were improvements in the area of relationships on the HoNOS for those who had baseline and follow-up measures. The high volunteer participation rates and positive consumer outcomes represent significant value in return for the modest level of funding.

Few studies report long term follow-up of community gatekeeper training programs that aim to facilitate help-seeking for suicide and there are none in Aboriginal communities. This study aimed to determine long term effects of the Shoalhaven Aboriginal Suicide Prevention Program (SASPP), which used community gatekeeper training as its primary strategy. Following consultation with the Aboriginal community, a brief questionnaire and semi-structured interview was completed by 40 participants who attended a community gatekeeper workshop 2 years earlier. Fifteen of the 40 participants stated that they had helped someone at risk of suicide over the 2-year follow-up period. Intentions to help and confidence to identify someone at risk of suicide remained high. A significant relationship was found between intentions to help prior to the workshop and whether participants had actually helped someone at risk of suicide. Correlations suggested a link between intentions to help, and subsequent help provision. However, it is unclear whether workshop attendance contributed to this effect. Future prevention programs need to be customised to specific Aboriginal communities to reduce barriers to helpseeking behaviour.

Objectives: This study aimed to: (a) ascertain levels of satisfaction with pharmacy services, and (b) identify possible barriers to pharmacy services utilisation among older adults in New Zealand. Method: Data was collected using a mailed questionnaire. Participants were older adults randomly selected from the general electoral roll (N = 180). Results: While satisfaction with pharmacy services was found to be generally high among older adults, considerable dissatisfaction was evident in relation to the cost of medication. Conclusions: While dissatisfaction was expressed with the cost of prescriptions, at present this does not appear linked to a failure to uplift medication. Physical access to pharmacy services may be compromised by disabling health problems, particularly among those living alone.

This article begins by reviewing some findings contained in the recent report: Gender, Workplace Injury and Return to Work (2005), before elaborating a relational perspective on gender and its importance to rehabilitation counselling. The article presents data about gender and injury in and out of workplaces, with a special interest in gendered data. Data is also presented about gender of rehabilitation counsellors, before reflecting on the complexity associated with gendered professionals and injured older men. The article draws on Australian data sets, and takes a critical sociological approach.

The present study investigated the transtheoretical model of behaviour change in relation to exercise adoption and maintenance in a sample of 140 women. The aim was to examine the relationship between the stages of exercise change, and the constructs of processes of change, costs and benefits of exercising, self-efficacy, and self-rated health. Analyses revealed that the processes, pros, cons, self-efficacy, and self-rated health were significantly associated with stage of exercise adoption. Specifically, the processes fluctuated, pros and self-efficacy increased, and cons decreased across the stages from precontemplation to maintenance. A stage exercise adoption perspective may be particularly useful for understanding how women adopt and sustain exercise regimes.

People with disabilities often face physical, social, and psychological barriers in daily life because of inaccessible structures and disability prejudice. The online medium's physically, nontaxing capacity for participation as well as a lack of visually mediated cues can potentially eliminate such barriers. This study discursively explored the psychological meaning of what it meant to be online for people with disabilities, focusing on possibilities for operating beyond their standard practices in daily life. Participants were recruited from various disability organisations in New Zealand and were invited to take part in an online interview. The notion of transcending barriers to participation formed a broad pattern in participants' data. This talk comprised 3 linguistic resources: life-altering, overcoming physical barriers, and disconnecting disability. Each resource offered participants a highly positive and significant transformation in subjectivity, enabling people with disabilities to be positioned as equal members of society.