022 comparative effectiveness of counselling providers with different qualifications
DESCRIPTION
ISCRR reportTRANSCRIPT
-
1of14 Report#091322.34R1CounsellingEvidenceReview
TransportAccidentCommission&WorkSafeVictoria
Evidence Service
Comparative effectiveness of counselling providers with different qualifications
August 2013
Plain Language Summary Aftertrauma(e.g.acarcrashorinjury),peoplecanhavelonglastingmentalhealthproblems,likeanxietyordepression.Counsellorstrytohelpthesepeoplecopebetter.Counsellorscanhavedifferenttypesoftraining.Thereisnotenoughresearchtotellifthetypeoftrainingeffectspatientcare.
-
2of14 Report#091322.34R1CounsellingEvidenceReview
TransportAccidentCommission&WorkSafeVictoria
Evidence Service Comparative effectiveness of counselling providers with different qualifications
August 2013
Executive Summary Background
Peopleaffectedbytraumacanexperienceongoingmentalhealthsymptoms.Counsellingisoneformoftreatmentthataimstohelppeoplebettercopewiththeirexperienceoftraumaandtheresultingsymptoms.Counsellingproviderscanvaryconsiderablyintheirleveloftraining.Thisreportsoughttoreviewtheevidencethatcomparestheeffectivenessofcounsellingproviderswithdifferentqualifications.Onehighqualitysystematicreviewoffiverandomisedcontrolledtrialswasfoundandusedasthebasisofthisreport.
Does the qualification of the counselling provider effect outcomes for people after trauma?
Thereviewfoundthatthesmallnumberofstudiesavailabledoesnotallowconclusionstobedrawnabouttheeffectsofprofessionalcounsellingproviderscomparedtoparaprofessionalcounsellingprovidersformentalhealthoutcomesinpeoplefollowingtrauma.
Glossary Professionalcounsellingproviders
Peoplewithspecialisedprofessionaltrainingforthetreatmentofanxietyanddepression,includingpsychiatristsandpsychologists.Nursesandcounsellorsmaybeincludedinthisgroupifspecialistmentalhealthtrainingwasacompulsorypartoftheirdegree.
Paraprofessionalcounsellingproviders
Mentalhealthcareworkers,paidorvoluntary,whowereunqualifiedwithrespecttopsychologicaltreatmentforanxietyanddepressivedisorders.
-
3of14 Report#091322.34R1CounsellingEvidenceReview
TransportAccidentCommission&WorkSafeVictoria
Evidence Service
Comparative effectiveness of counselling providers with different qualifications Evidence Review
August 2013 Emma Donoghue, Natasha Dodge
-
4of14 Report#091322.34R1CounsellingEvidenceReview
CONTENTS
ACKNOWLDEGEMENTS............................................................................................................................4BACKGROUND..........................................................................................................................................5METHODS.................................................................................................................................................6RESULTS...................................................................................................................................................7DISCUSSION..............................................................................................................................................9CONCLUSION............................................................................................................................................9SUMMARYTABLES.................................................................................................................................10DISCLAIMER............................................................................................................................................12CONFLICTOFINTEREST..........................................................................................................................13REFERENCES...........................................................................................................................................14
ACKNOWLDEGEMENTS
TheauthorswouldliketothankFionaChomley,LaurenMcKirdy,KarenTait,JaneReidandGulsunAlifortheirassistancewithscopingofthetopicforthisreport.
-
5of14 Report#091322.34R1CounsellingEvidenceReview
BACKGROUND
Trauma and mental health
Followingtraumaticevents,psychologicaldistressiscommon.1Traumatisedpeoplecanexperienceemotionalupset,increasedanxiety,sleepandappetitedisturbance,oradditionalreactionssuchasfear,sadness,guiltoranger.1Oftenthepsychologicalsymptomsofdistresssubsideinthedaysandweeksfollowingthetraumaticevent,howeverforsomepeoplethesesymptomspersistanddevelopintolongerlastingproblems.1Motorvehicleaccidentsarecommonlyassociatedwithanxiety,depressionandposttraumaticstressdisorder(PTSD).2Similarly,peopleinjuredintheworkplacecansufferpsychologicaldistress(suchasanxiety,depressionandPTSD),sometimestoagreaterdegreethanthoseinjuredoutsidetheworkplace.3Eachyear,around20%ofAustraliansaged1685(aroundthreemillionpeople)experiencesymptomsofamentalhealthdisorder(suchasdepression;anxietyorasubstanceusedisorder).4In20102011,thestateofVictoriahadthehighestnumberofpatientsandMedicaresubsidisedmentalhealthservices,amongallStatesandTerritories.4,5InAustralia,mentalhealthdisordersareoftenmanagedbygeneralpractitioners(GPs).4In20102011,themostcommonwaysthatGPsmanagedpatientspresentingwithmentalhealthproblemswasusingoneoracombinationof:medication,provisionofadviceorcounselling,andreferralforspecialisedmentalhealthcare.4,5Counselling and qualifications
Counsellingisoneinterventionthataimstohelppeoplebettercopewithdifficultlifecircumstancessuchas:griefandloss;communicationandrelationships;workandcareer;stress,anxietyanddepression;lifetransitions;parenting;selfesteem;spirituality;anddifficultiescausedbyaddictions,traumaandabuse.6InAustraliathereisnolegislativerecognitionofcounsellingasadistinctprofessionandtherearenoregulationstogoverntheuseofthetermcounsellor,asisthecaseforregulatedprofessionssuchaspsychologyandsocialwork.7Counsellingpractitionersaregenerallydrawnfromdiverseprofessionalandtheoreticalbackgrounds,withvaryinglevelsoftrainingrangingfromdoctorallevelthroughtodiplomasofoneyearorless.7AlthoughpeakbodiessuchasthePsychotherapyandCounsellingFederationofAustraliaprovidesasetoftrainingstandardsformembership,counsellorsarenotrequiredtoregisterinordertopractice.7CounsellingissubsidisedthroughtheAustralianMedicareBenefitsSchedule(MBS),butonlyifitisprovidedbypsychiatrists,psychologists,andsomealliedhealthprofessionals(specifically,socialworkers,mentalhealthnursesandoccupationaltherapists).4
-
6of14 Report#091322.34R1CounsellingEvidenceReview
Intended purpose of the review
TheTransportAccidentCommission(TAC)andWorkSafeVictoria(WSV)requestedareviewoftheevidencetocomparetheeffectivenessofcounsellingproviderswithdifferentqualifications.Thisreportsoughttoanswerthefollowingquestion:
Doesthequalificationofthecounsellingprovidereffectoutcomesforpeopleaftertrauma?
METHODS
Methodsareoutlinedbrieflybelow.MoredetailedinformationaboutthemethodologyusedtoproducethisreportisavailableinAppendices1and2.AllappendicesarelocatedintheTechnicalReportaccompanyingthisdocument.Stage 1: Identify relevant research
AcomprehensivesearchofMedline,PsycINFO,CINAHL,EMBASEandtheCochraneLibrarywasundertakeninJune2013toidentifyrelevantsynthesisedresearch(systematicreviews(SRs)),andanyrelevantprimarystudies(randomisedcontrolledtrials(RCTs)orcontrolledclinicaltrials(CCTs)).SearchesoftheMotorAccidentsAuthorityofNSW(www.maa.nsw.gov.au)andtheAccidentCompensationCorporation(ACC)ofNewZealand(www.acc.co.nz)websiteswerealsoundertaken.Referencelistsofincludedstudieswerealsoscannedtoidentifyrelevantreferences.Studiesidentifiedbythesearcheswerescreenedforinclusionusingspecificselectioncriteria(seeAppendix2,TableA2.1).InthisreviewstudieswereonlyincludediftheywereSRs,RCTsorCCTsthatinvestigatedtheeffectsofcounsellingdeliveredbyprofessionalcomparedwithcounsellingdeliveredbyparaprofessionalsinpeopleexperiencingmentalhealthissuesrelatedtotrauma.Systematicreviewsthatmettheselectioncriteriawerereviewedtoidentifythemostuptodateandcomprehensivesourceofevidenceandcriticallyappraisedtodeterminewhethertheywereofhighquality.Thisprocesswasrepeatedforadditionalsourcesofevidence,untilthemostrecent,comprehensiveandhighqualitysourceofevidencewasidentifiedforeachindication.Allscreeningandselectionwasconductedindependentlybytworeviewers,resultswerecomparedandanydiscrepanciesdiscussedandresolved.Stage 2: Address further actions identified
SeealgorithminTable1.Table 1. Further action required to answer clinical questions.
Is there any synthesised research available? (e.g. EBGs, HTAs, SRs)
Yes No
Is this good quality research? Are RCTs available?
Yes No Yes No
Is it current (within 2 years)?
Undertake new SR and/or metaanalysis
Undertake new SR and/or metaanalysis
Consider looking for lower levels of evidence
Yes No
No further action Update existing SR
-
7of14 Report#091322.34R1CounsellingEvidenceReview
Themostrecent,relevant,highqualitypieceofevidencewasusedtoaddressthequestionposedabove.
RESULTS
Databasesearchesyielded3,728articles,whichwerescreenedforpotentialrelevance.Ofthese,29articleswerereviewedinfulltext.Fromthisreviewtwoarticleswereidentified(seeAppendices3and4).Nofurtherstudieswereidentifiedfromtheresultsoftheinternetsearch.Intotal,2paperswereidentified,consistingof:
1synthesisedstudy(1SR)8 1primarystudy(1RCT),9whichwasincludedinthesystematicreviewabove
ThisreportisthereforebasedonthesystematicreviewbyBoer(2005).8Criticalappraisalofthereviewfoundittobeofhighquality(seeAppendix5).TheSRbyBoer(2005)8aimedtocriticallyexaminethecommonsensenotionthatprofessionaltraining/qualificationisnecessarytodelivereffectivepsychologicaltreatmentforanxietyanddepressivedisorders.ThereviewonlyincludedRCTsthatlookedat:
1. paraprofessionaldeliveryofpsychologicaltreatmentforanxietyanddepressionversusprofessionaldeliveryoftreatment,or
2. paraprofessionaldeliveryofpsychologicaltreatmentforanxietyanddepressionversusnotreatment
Thelattercomparisonhoweverwasnotthefocusofthisreportandthustheseresultswereonlydiscussedbriefly.Inthisreviewtheauthorsdefinedprofessionalsaspeoplewithspecialisedprofessionaltrainingforthetreatmentofanxietyanddepression,includingpsychiatristsandpsychologists.Nursesandcounsellorswerealsoincludedinthisgroupifspecialistmentalhealthtrainingwasacompulsorypartoftheirdegree.Paraprofessionalswerementalhealthcareworkers,paidorvoluntary,whowereunqualifiedwithrespecttopsychologicaltreatmentforanxietyanddepressivedisorders.StudiesinthisreviewwerescoredagainstaQualityRatingScale(QRS),developedbytheCochraneCollaborationDepression,AnxietyandNeurosisReviewGroups.TheQRSwasdevelopedinordertostandardisethequalityassessmentoftrials,assessing23itemsofqualityaccordingtothreedegreesofadequacy(0;1;2).Inthisreviewstudieswerescoredagainst21ofthe23qualityitems,excludingtheblindingandsideeffectsitems,whichwerenotrelevanttothesetrials.Themaximumscorethatcouldberetrievedwas42for21items. ThereviewanditsfiveincludedstudiesaresummarisedinTables2and3.
-
8of14 Report#091322.34R1CounsellingEvidenceReview
Study characteristics
ThestudiesincludedintheBoerSR8werepublishedbetween1976and2003.Thepopulationsoftheincludedstudiesvaried.Twostudieslookedatanxiety:anxiousfirsttimemothers,10andspeechanxiety.11Theotherthreestudieslookedatvarioustypesofdepression,9,12andwomenatriskofdevelopingpostpartumdepression.13Theinterventionsexaminedbythestudiesalsovariedandincluded:cognitivebehaviouraltherapy9;supportivegrouptherapy;9systematicdesensitisationrelaxationandcuecontrolledrelaxation;11socialworkersupport;10andpeersupport.12,13Threeofthestudiesexaminedinterventionsforindividuals,10,12,13andtwolookedatgrouptherapies.9,11Alloftheparaprofessionalinterventionsinvolvedtrainingofvaryingduration.Oneoftheincludedstudiescomparedthesameinterventiondeliveredbyprofessionalsandparaprofessionals,9onestudycomparedthesameinterventiondeliveredbyprofessionalsandparaprofessionalsandnotreatment,11onestudycompareddifferentinterventionsdeliveredbyprofessionalsandparaprofessionalsandnotreatment,10whiletheremainingtwostudiescomparedparaprofessionalinterventionswithacontrolcondition(usualcommunitycare,13andnotreatment12).Thedurationoftreatmentintheincludedstudieswassixweeksforonestudy,11tenweeksforanotherstudy,9andnotspecifiedfortheremainingthreestudies.10,12,13Theincludedstudiesalsovariedintheoutcomemeasuresusedandthelengthoffollowup:
SpielbergerStateAnxiety,CostelloComreyAnxietyandTraitDepressionScales,BeckDepressionInventory(measuredat12months)10
HamiltonRatingScaleforDepression;BeckDepressionInventory(measuredtenweeksposttreatment)9
EdinburghPostnatalDepressionScalescore>12(measuredateightweeks)13 PresentStateExamination(measuredafteroneyear)12 TaylorManifestAnxietyScale(measuredsixweeksposttreatment)11
Study quality
Fourofthefiveincludedstudieswereconsideredtobeofmoderatetohighquality,i.e.QRSscorebetween2142.9,10,12,13ThestudybyRussell(1976)11wasconsideredtobeoflowquality.Thesamplesizewassmallforalloftheincludedstudies,withlessthan50ineacharm.Allocationconcealmentwasadequatelyperformedinthreeofthestudies10,12,13anddetailedbaselinecharacteristicswereonlyreportedbyonestudy.13Furthermorepowercalculationswereonlyadequatelyperformedandreportedinonestudy.9Clearselectioncriteriawerereportedinfourofthestudies.9,10,12,13Blindingofparticipantsandoutcomeassessorswasnotperformedinanyofthestudies.
Study results
Theindividualstudiesandtheirpooledresultsfoundnosignificantdifferencebetween
-
9of14 Report#091322.34R1CounsellingEvidenceReview
paraprofessionalsandprofessionalswithregardstoreductioninsymptomseverityimmediatelyfollowingtreatment911(StandardMeanDifference(SMD)=0.09,95%CI0.23to0.40;p=0.58)oratthree,six,nineand12monthsfollowup.11Furthermorenoheterogeneitywasfoundbetweenstudies(I2=0.1%;Chi2=4.0;df=4;p=0.41).Inadditionnosignificantdifferencewasfoundbetweenprofessionalsandparaprofessionalsfollowingvarioussensitivityandsubgroupanalyses(e.g.,studyquality,outcomemeasures,inclusioncriteria;paraprofessionalbackground,indication(anxietyordepression),individualorgroupinterventionorwhetherprofessionalsandparaprofessionalsperformedthesameintervention).Asignificantdifferencewasfoundinfavourofparaprofessionalscomparedtoacontrolcondition;1013howeverthiswasnotthefocusofthisreport.
DISCUSSION
Theauthorsconcludethatthefindingsofthereviewareinconclusivewithregardstoparaprofessionalspartiallyreplacingprofessionalsinthetreatmentofanxietyanddepressivedisordersduetothesmallnumberofincludedstudies,theirsmallsamplesizes,variationsintreatmentduration,majorityfemalepopulation,andmethodologicallimitations(suchasthepotentialraterbiasarisingfromtheuseofselfratedmeasuresandlackofblindingforobserverratedmeasures).8Theauthorssuggestthatthelackofasignificantdifferencebetweenparaprofessionalsandprofessionalscouldbeduetotheincludedstudiesbeinginadequatelydesignedtodetectsignificantdifferences.8ItshouldalsobenotedthatthemajorityofthestudiesincludedintheSRareovertenyearsold,withtheoldestpublishedin1976andthemostrecentpublishedin2003.
CONCLUSION
Thesmallnumberofstudiesavailabledoesnotallowconclusionstobedrawnabouttheeffectsofprofessionalcounsellingproviderscomparedtoparaprofessionalcounsellingprovidersformentalhealthoutcomesforpeoplefollowingtrauma.
-
10of14 Report#091322.34R1CounsellingEvidenceReview
SUMMARY TABLES Table 2. Summary of Boer 2005.8 BoerPC,WiersmaD,RussoS,vandenBoschRJ.Paraprofessionalsforanxietyanddepressivedisorders.Cochranedatabaseofsystematicreviews(Online).2005(2):CD004688.Studytype Systematicreviewof5RCTsIndication AnxietyanddepressivedisordersOutcomes Depressionand/oranxietysymptomscalescores.Validatedobserverand
selfratedmeasurementscaleswereaccepted.Definitionofprofessionals Peoplewithspecialisedprofessionaltrainingforthetreatmentofanxiety
anddepression,includingpsychiatristsandpsychologists.Nursesandcounsellorswereonlyincludedinthisgroupifspecialisttrainingwasacompulsorypartoftheirdegree.
Definitionofparaprofessionals Mentalhealthcareworkers,paidorvoluntary,whowereunqualifiedwithrespecttopsychologicaltreatmentforanxietyanddepressivedisorders.
Typeofintervention AnykindofpsychologicaltreatmentforanxietyanddepressivedisordersComparisonsmade 1.Paraprofessionalsvs.professionals
2.Paraprofessionalsvs.controlIncludedstudies 5RCTs:Barnett1985,10 Bright1999,9 Dennis2003,13Harris1999,12Russell
197611Findings Main results
Fivestudiesreportedfivecomparisonsofparaprofessionalsversusprofessionals(n=106)andfivecomparisonsofparaprofessionalsversuscontrolcondition(n=220).Nodifferenceswerefoundbetweenparaprofessionalsandprofessionals(SMD=0.09,95%CI0.23to0.40,p=0.58),andnosignificantheterogeneity.Studiescomparingparaprofessionalsversuscontrol(mixedcontinuousanddichotomousdata)showedasignificanteffectinfavourofparaprofessionals(OR=0.34,95%CI0.13to0.88,p=0.03),butheterogeneitywasindicated(I=60.9%,Chi=10.24,df=4,p=0.04).Authors conclusions Thefewstudiesincludedinthereviewdidnotallowconclusionsabouttheeffectofparaprofessionalscomparedtoprofessionals,butthreestudies(womenonly)indicatedasignificanteffectforparaprofessionals(allvolunteers)comparedtonotreatment,however,thisfindingisnotspecifictocounsellingasanintervention.Theevidencetodatemayjustifythedevelopmentandevaluationofprogramsincorporatingparaprofessionalsintreatmentprogramsforanxietyanddepressivedisorders.
-
11of14 Report#091322.34R1CounsellingEvidenceReview
Table 3. Summary of studies included in Boer 2005.8 Barnett 198510(RCT) Population:89highlyanxiousfirsttimemothers,3or4dayspostpartumSetting:hospital,AustraliaProfessionalintervention:assistancefromsocialworkerParaprofessionalintervention:assistancefromvolunteerControlgroup:notreceivinganyintervention.Treatmentduration:notspecifiedFollowup:Assessmentsatthree,six,nineandtwelvemonths.Outcomes&measures:Primaryoutcomewasstateanxietylevelat12months.SpielbergerStateAnxiety;Costellocomreyanxietyandtraitdepressionscales;TheBeckDepressionInventory.Quality:Interviewerofinitialinterviewandassessmentwasblinded.Nobaselinedifferencesoftrialsubjectsbetweenallocatedgroups.Nocointerventionsorotherpotentialconfounders.Adequateallocationconcealment.Qualityratingsystemscore:23Bright 19999(RCT) Population:98peoplewithdepression(28male,70female)Setting:universitybasedclinic,USAProfessionalIntervention:cognitivebehaviouraltherapy(CBT)ormutualsupportivegrouptherapyprovidedbyprofessionals(mastersdegreeinclinicaltraininginclinicalorcounsellingpsychology)ParaprofessionalIntervention:CBTormutualsupportivegrouptherapyprovidedbyparaprofessionals(noformaltraining,recruitedfromcommunitybasedselfhelporganizations)Treatmentduration:10weektreatmentduration;weekly90minsessionsforbothtreatmentconditionsFollowup:10weeksposttreatmentassessmentOutcomes&measures:10weeksposttreatment,HamiltonRatingScaleforDepressionassessedbyanindependentclinician;BeckDepressionInventory.Quality:Patient,providerandoutcomeassessorblindingwerenotmentioned.Dropoutratebeforecompleting7sessions=30%,42completedtheposttreatmentassessment.Baselinecharacteristicsdifferencesbetweencomparisongroupsnotreported.Allocationconcealment?Unclear.Nocointerventionsorotherpotentialconfounders.Qualityratingsystemscore:30.Dennis 200313(RCT) Population:44mothersidentifiedashighriskforpostpartumdepression(812weekspostpartum)Setting:home(telephonebased),CanadaParaprofessionalintervention:telephonebasedpeersupport(mothertomother),fromamotherwhopreviouslyexperiencedpostpartumdepressionControlgroup:usualcare(bothgroupshadaccesstothestandardcommunitypostpartumservices)Treatmentduration:telephonesupportprovidedasoftenasthepatientdeemednecessary,durationnotspecifiedFollowup:Assessmentsat4and8weekspostrandomisation,nolongtermfollowupOutcomes&measures:primaryoutcomeat8weeksEdinburghPostnatalDepressionScalescore>12Quality:Onedropoutinthecontrolgroup.Nobaselinedemographicdifferencesbetweencomparisongroups.
-
12of14 Report#091322.34R1CounsellingEvidenceReview
Intentiontotreatanalysis.Communitypostpartumservicesarepotentiallybiasing;nootherpotentialconfounders.Allocationconcealmentadequate.Qualityratingsystemscore:27Harris 199912(RCT) Population:86womenwithchronicdepressionSetting:homebased,UKParaprofessionalintervention:Volunteerbefriendingmeetingandtalkingwiththedepressedwomanforaminimumofonehoureachweek,andactingasafriendtoher,listeningandbeingthereforher.Controlcondition:notreceivingintervention,onwaitlistTreatmentduration:notspecifiedFollowup:Onefinalassessmentafter1yearOutcomes&measures:Remissionoftwomonthsormoreafteroneyear;PresentStateExamination.Quality:Intentiontotreatdesign.Nowithdrawals.Nobaselinedemographicdifferencesbetweencomparisongroups.Cointerventions(professionalcontactorpsychotropicdrugs)butnoassociationwithoutcome;nootherpotentialconfounders.Allocationconcealmentadequate.QualityRatingSystemscore:31Russell 197611(RCT) Population:23males,27females,volunteerundergraduates,withspeechinganxietySetting:university,USAProfessionalIntervention:systematicdesensitisationrelaxationandcuecontrolledrelaxationingroupsof2to4,ledbyprofessionals(counsellorsPhDinpsychology,experiencedwithinterventions).ParaprofessionalIntervention:systematicdesensitisationrelaxationandcuecontrolledrelaxationingroupsof2to4,ledbyparaprofessionals(advancedundergraduatewhohadnoprevioustrainingininterventions).ControlGroup:notreatmentTreatmentduration:5treatmentsessionsover6weeksFollowup:notspecifiedOutcomes&measures:Posttreatmentassessmentof6weeks,TaylorManifestAnxietyScaleQuality:Nopatient,providerandoutcomeassessorblinding.Nobaselinedifferencesbetweenthegroupsonscalesbyanalysisofvariance.Nocointerventionsorotherpotentialconfounders.42completedtheposttreatmentassessment.Allocationconcealmentunclear.QualityRatingsystemscore:17
DISCLAIMER
Theinformationinthisreportisasummaryofthatavailableandisprimarilydesignedtogivereadersastartingpoint to consider currently available research evidence. Whilst appreciable care has been taken in thepreparation of the materials included in this publication, the authors and the National Trauma ResearchInstitutedonotwarrant theaccuracyof thisdocumentanddenyany representation, impliedorexpressed,concerningtheefficacy,appropriatenessorsuitabilityofanytreatmentorproduct.Inviewofthepossibilityofhuman error or advances of medical knowledge the authors and the National Trauma Research Institutecannot and do not warrant that the information contained in these pages is in every aspect accurate orcomplete.Accordingly,theyarenotandwillnotbeheldresponsibleorliableforanyerrorsoromissionsthatmaybefound inthispublication.Youarethereforeencouragedtoconsultothersources inordertoconfirm
-
13of14 Report#091322.34R1CounsellingEvidenceReview
the information contained in thispublication and, in theevent thatmedical treatment is required, to takeprofessionalexpertadvicefromalegallyqualifiedandappropriatelyexperiencedmedicalpractitioner.
CONFLICT OF INTEREST
The TAC/WSV Evidence Service is provided by theNational Trauma Research Institute. TheNTRI does notacceptfundingfrompharmaceuticalorbiotechnologycompaniesorothercommercialentitieswithpotentialvestedinterestintheoutcomesofsystematicreviews.The TAC/WSV Health Services Group has engaged the NTRI for their objectivity and independence andrecognises that anymaterialsdevelopedmustbe freeof influence frompartieswith vested interests. TheEvidenceServicehasfulleditorialcontrol.
-
14of14 Report#091322.34R1CounsellingEvidenceReview
REFERENCES 1. AustralianCentreforPosttraumaticMentalHealth.Australianguidelinesforthetreatment
ofadultswithacutestressdisorderandposttraumaticstressdisorder.Melbourne,Victoria:ACPMH,2007.
2. MayouR,BryantB,EhlersA.Predictionofpsychologicaloutcomesoneyearafteramotorvehicleaccident.AmJPsychiatry.2001;158(8):12318.Epub2001/08/02.
3. MasonS,WardropeJ,TurpinG,RowlandsA.Outcomesafterinjury:acomparisonofworkplaceandnonworkplaceinjury.TheJournaloftrauma.2002;53(1):98103.
4. AustralianInstituteofHealthandWelfare.Mentalhealthservicesinbrief2012.Cat.no.HSE125.Canberra:AIHW,2012.
5. BrittH,MillerGC,CharlesJ,HendersonJ,BayramC,ValentiL,etal.GeneralpracticeactivityinAustralia201011.Generalpracticeseriesno.29.Sydney:SydneyUniversityPress;2011.
6. BlackDogInstitute.Psychologists&counsellors.2013[July2013];Availablefrom:http://www.blackdoginstitute.org.au/.
7. RichardsonJ,SheeanL,BamblingM.Becomingapsychotherapistorcounsellor:Asurveyofpsychotherapyandcounsellingtrainers.PsychotherapyAust.2009;16(1):70.
8. BoerPCAM,WiersmaD,RussoS,vandenBoschRJ.Paraprofessionalsforanxietyanddepressivedisorders.Cochranedatabaseofsystematicreviews(Online).2005(2):CD004688.
9. BrightJI,BakerKD,NeimeyerRA.Professionalandparaprofessionalgrouptreatmentsfordepression:acomparisonofcognitivebehavioralandmutualsupportinterventions.JConsultClinPsychol.1999;67(4):491501.
10. BarnettB,ParkerG.Professionalandnonprofessionalinterventionforhighlyanxiousprimiparousmothers.BrJPsychiatry.1985;146:28793.
11. RussellRK,WiseF.Treatmentofspeechanxietybycuecontrolledrelaxationanddesensitizationwithprofessionalandparaprofessionalcounselers.JCounsellingPsychol.1976;23(6):5836.
12. HarrisT,BrownGW,RobinsonR.Befriendingasaninterventionforchronicdepressionamongwomeninaninnercity.1:Randomisedcontrolledtrial.BrJPsychiatry.1999;174:21924.
13. DennisCL.Theeffectofpeersupportonpostpartumdepression:apilotrandomizedcontrolledtrial.CanJPsychiatry.2003;48(2):11524.