Desistance is a criminological term referring to the cessation of offending and the causal process that underlies it. There has been a recent growth in research aiming to conceptualise the desistance process from men’s use of family and/or domestic violence (F/DV), however the concept of agency – and in particular, the subjective experience of agency as articulated by desisting men themselves – has not been examined specifically or systematically, despite its purported centrality as a mechanism of change in desistance. This thematic synthesis sought to identify and synthesise common themes across qualitative studies examining men’s subjective experience of agency in their change process away from their use of F/DV during and subsequent to attending a specialised F/DV intervention. Men’s experience of agency – that is, an individual’s sense of control over their life - was found to be relevant in all stages of desistance, and central in how they made sense of their change process. Men’s narratives depicted desistance as a process, with identifiable stages and processes which seem to occur in a non-linear manner, accumulating as men’s sense of agency in desistance expands. Themes and subthemes comprising the analysis culminated in a conceptual model of men’s agentic development in desistance from F/DV. Implications for theory and practice are discussed in light of the results, as well as limitations and future research directions.

Emerging research suggests that exposure to appearance-ideal images on Instagram can negatively affect users’ body satisfaction. The current study aimed to explore gender differences in males and females’ levels of body satisfaction, pre and post short exposure to appearance-ideal Instagram images. Additionally, it aimed to investigate gender differences in state appearance comparisons, and how these relate to decreases in body satisfaction. Participants, including 99 females and 103 males aged between 18-29 years of age, viewed ten sets of ten Instagram posts from public Instagram profiles on their smartphones. Both genders experienced a significant decrease in body satisfaction following exposure to Instagram images, with no significant gender differences in body satisfaction levels prior to exposure to images. Females reported significantly higher levels of state appearance comparisons compared to males, and state appearance comparisons were significantly correlated to decreases in body satisfaction for females, but not males. Despite this, gender did not significantly moderate this relationship. The findings from this study suggest that males and females have similar levels of body satisfaction, and that exposure to appearance-ideal Instagram images seem to have an equally detrimental effect on body satisfaction levels for both genders. Further research is required to understand emerging gender differences in appearance comparisons, and to explore the potential role of alternative mechanisms of influence. 

Lesbian, gay, and bisexual (LGB) adults report unique barriers to accessing mental health services and have more unmet mental health care needs than their heterosexual counterparts. There is widespread acknowledgment that clinical interventions need to be tailored and inclusive to effectively meet the needs of LGB adults, yet remarkably little research has examined this question empirically. The aim of the present research was to examine mental health service use in LGB adults, and whether psychotherapy inclusiveness was associated with client satisfaction and perceived outcome via the therapeutic alliance. A total of 464 LGB adults residing in Australia who had recently accessed psychotherapy completed an online questionnaire. Results revealed that higher inclusiveness of psychotherapy was associated with both improved client satisfaction and perceived outcome, and these relationships were mediated by the task component of the therapeutic alliance. Inclusiveness was also associated with client satisfaction via the bond component of the therapeutic alliance. The results are consistent with calls to tailor clinical interventions to be appropriate and inclusive of LGB clients and highlight that the therapeutic alliance may be one mechanism underlying the association between inclusive practice and better clinical outcomes. Future research is needed to develop and test the efficacy of tailored clinical interventions and to examine these research questions in gender minority adults.

Stereotypes surrounding the progressive invisibility and asexuality of older individuals remain dominant within society and serves to shape not only popular opinion and societal discourses, but also policy development and research. Whilst existing quantitative research has explored aspects such as changes in sexual activities and frequencies of sex within a biomedical model, few have provided a platform to investigate the beliefs and perspectives of older individuals with respect to not only their interpretation of these discourses, but also the meaning and significance of sex within their own lives. This qualitative study utilised a social constructivist framework to examine the self-perceived importance of active engagement in sexuality and sex in midlife, as well as women’s renegotiation and reconstruction of problematising discourses and assumptions. A sample of twenty-four women aged 56 to 70 years took part in one-to-one interviews utilising a flexible conversation structure, after which a thematic analysis was conducted to inductively evaluate the data. Findings demonstrated that the majority of participants experienced frustration and distress at present discourses regarding asexuality at midlife and older age. Participants voiced strong desires to not only maintain intimacy and relationships, but to additionally continue engaging in sexual activity. Such results stand in contrast to mainstream attitudes and demonstrate the need to reconceptualise sexuality in older adults. The findings have significant implications for broader policy, health campaigns, education and training for health professionals, as well as relevance regarding health and clinical psychology.

 Although anxiety is part of the human condition, anxiety disorders are distressing, functionally impairing and highly prevalent. Extensive research has demonstrated independent associations among anxiety symptoms, interpersonal sensitivity, social connectedness and attachment, however, how these variables co-relate remains poorly understood. In this study, 151 participants (75.5% female, Mage = 28.42) who believed they had experienced anxiety symptoms completed an online questionnaire examining their level of anxiety, interpersonal sensitivity, social connectedness and attachment. The questionnaire included the Beck Anxiety Inventory (BAI; Beck & Steer, 1990), the Interpersonal Sensitivity Measure (IPSM; Boyce & Parker, 1989), the Social Connectedness Scale- Revised (SCS-R; Lee et al., 2001), and the Revised Adult Attachment Scale - Close Relationships Version (RAAS-CRV; Collins & Read, 1996). Results reinforced previous findings of independent relationships among anxiety, interpersonal sensitivity, and social connectedness. However,  a hierarchical regression yielded a significant predictive model for anxiety symptoms, with interpersonal sensitivity and social connectedness emerging as significant predictors. By prioritising the clinical validation of these findings, future research could include further exploration of the model overall, as well as focus on interpersonal sensitivity and its role in the development and maintenance of anxiety disorders. These results suggest that interpersonal sensitivity may have a unique role in its relationship with anxiety.

Day patient (DP) programs represent a significant development in the treatment of eating disorders, however currently there is a dearth of literature evaluating the effectiveness of DP treatment based upon the targeted goals of treatment. This study aimed to explore the effectiveness and short-term stability of an Australian DP program by examining change across the seven key goals of treatment using a naturalistic pre-post-follow-up study design. The seven DP program goals were informed by the transdiagnostic cognitive behavioural theory of eating disorders (T-CBT; Fairburn, Cooper, & Shafran, 2003) and included reduced eating disordered cognitions, increased readiness to change, increased quality of life, reduced perpetuating factors, reduced co- morbid factors, weight stabilisation within the healthy weight range, and reduced eating disordered behaviours. The objectives of the study were to: (1) provide a thorough description of the treatment components of the DP program under investigation; (2) undertake a comprehensive evaluation of the DP program based on all seven treatment goals informed by the T-CBT model; (3) evaluate the short-term stability of any treatment effects three months after discharge; (4) identify characteristics of patients who drop-out of treatment and patients who complete the program with poor outcomes; (5) identify predictors of treatment completion and good outcome; and (6) explore the impact of treatment dose, admission length, and treatment intensity on patient outcomes. The sample included 75 participants meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) criteria for an eating disorder who were admitted to the eating disorders DP program at the Northside Clinic in Sydney. Participants completed measures assessing eating disordered cognitions, readiness to change, quality of life, perpetuating factors, co- morbid factors, body mass index (BMI), and eating disordered behaviours. Fifty-eight patients completed the DP program and 17 dropped-out of treatment. The results demonstrated that there were significant improvements between admission and discharge across all seven targeted areas of treatment, which were maintained at three month follow-up. As recommended in the DP treatment literature, three outcome groups (drop-out, good outcome, poor outcome) were determined according to definitions outlined by Mahon (2000). Identified predictors of program completion included independent living and attendance travel time of one hour or less. Good outcome was predicted by BMI at admission. Participants with good outcome attended an equivalent number of treatment days to participants with poor outcome, however they remained admitted to the DP program for a longer period of time and attended less intensively each week. The results are discussed in the context of other published studies, and potential directions for future research are suggested.

Technological Adjuncts to Increase Adherence to Therapy: The Role of Mobile Phones                       

Doctor of Psychology (Clinical Psychology)