Whilst Cognitive Behavioural Therapy for Psychosis (CBTp) has been found to reduce psychotic symptoms, most evidence supporting its implementation originates from studies in Western and high-income countries. Furthermore, questions remain regarding the efficacy of CBTp conducted via teleconsultation. Herein we report an ongoing case in Indonesia involving an individual with schizoaffective disorder, who received 60 sessions of CBTp over seven months. Sessions were delivered via a combination of voice and video calls. The patient, a 40-year-old male, was diagnosed with schizoaffective disorder at the age of 26. He exhibited symptoms of paranoid and religious delusions, hallucinations (auditory, visual, and somatic) and disorganised speech during our intake interview. Negative symptoms were not apparent. In the 14 years prior to our initial consultation, the patient was prescribed antipsychotics and demonstrated good adherence. He had no history of psychotherapy independent of our clinic. Treatment involved CBTp techniques, including psychoeducation, a symptom diary, relaxation, and behavioural experiments. Study outcome was assessed with Psychotic Symptom Rating Scales. Both hallucination and delusion subscale scores improved 53% from 53 at intake to 25 during an assessment administered 6 months later. Results from this study demonstrate that the CBTp is both feasible, and beneficial, when conducted via teleconsultation in Indonesia.

Half of the people who seek treatment for Obsessive–Compulsive Disorder (OCD) do not benefit from first-line interventions. A better understanding of the factors associated with obsessions and compulsions may inform the development of more effective treatments. This study aimed to examine whether a fear of guilt is associated with obsessive–compulsive symptoms. Fear of guilt incorporates two domains: punishment (the tendency to believe that guilt means one is bad and to punish oneself for feelings of guilt) and harm prevention (the tendency to believe that guilt implies failure to be one's ideal self and the drive to prevent feelings of guilt). Online questionnaires assessing OCD symptoms, fear of guilt, and other related factors were administered to 192 adults. In contrast to previous studies, key conceptually relevant constructs, such as shame, anxiety, and depression symptoms, were also assessed. The punishment dimension of fear of guilt subscale was positively associated with OCD symptoms controlling for age, sex, guilt, shame, responsibility for harm, generalised anxiety, and depression. The punishment domain of fear of guilt may therefore be an important factor to consider and potentially target in treatments for OCD. Future investigations with clinical populations may clarify the importance of fear of guilt in OCD.

Although irritability is common in youth, research on treatment is in its infancy. Threat biases are more pronounced in irritable compared to low irritable youth, similar to evidence found in anxious youth. Therefore, interventions targeting these biases may be promising for reducing irritability. This study utilised a multiple baseline case series design to determine the feasibility, acceptability, and efficacy of positive search training (PST) for irritable children. Three children were included who met criteria for a principal diagnosis of Disruptive Mood Dysregulation Disorder (DMDD), and a secondary diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or Major Depressive Disorder (MDD). PST was feasible with two of the three participants; one child refused to continue after one session. For the two participants who completed PST, acceptability was stable with moderate-to-high ratings of engagement and enjoyment, and high and stable treatment-relevant verbalisations of the key strategies. Both cases showed declines in DMDD severity across treatment and no longer met criteria at post-treatment. Both participants met criteria for Oppositional Defiant Disorder (ODD) at post-treatment (considered less severe for irritability than DMDD). Declines in parent-reported irritability occurred for both cases, however some returns to baseline were observed. Overall, PST for irritable youth shows promise as an acceptable and feasible intervention. Further studies are needed combining PST with strategies for secondary diagnoses, given its high comorbidity with disruptive behaviour disorders.

The COVID-19 pandemic presents challenges to the provision of community programs and access to mental health services for young people. We examined the feasibility, reach, and acceptability of multi-technology delivery of an integrated system that assesses and provides feedback on youth mental health and wellbeing and connects them to care within the context of a youth sports development program. The system was delivered via computer, telephone, and teleconference with 66 adolescent boys participating in a rugby league development program in three communities in Australia. Young people completed online wellbeing and mental health measures (Assess step), parents were provided with telephone feedback on results, support, and referral options (Reflect step), and youth received teleconferenced workshops and online resources (Connect step). The multi-technology delivery was feasible to implement, and reach was high, with barriers experienced at the Assess step but minimally experienced at the Reflect and Connect steps. Delivering the system via multiple forms of technology was rated as highly beneficial and enjoyable by young people. Players improved in self-reported prosocial behaviour, gratitude, and anxiety symptoms from pre- to post-program. Strong collaboration between researchers, organisational personnel, and community members is important for achieving these outcomes.

Animal phobia is common in children, but it is also frequent in adults who maintain the problem throughout their lives. Eleven cases of animal phobia that were treated with progressive multimedia exposure are presented. The participants were two men and nine women (aged 19–27 years), with anxiety and avoidance problems in relation to various animals. A single-case A-B-Follow-up design was carried out, with concurrent control of several baselines; and a systematic between-subjects replication, with the same treatment repeated across different participants and types of phobias. A behavioural interview, phobia questionnaires, and Multimedia Behavioural Avoidance Test (M-BAT) with pictures and videos of animals, as well as heart rate, were used for assessment purposes. The intervention was the progressive multimedia exposure in four phases (photographs, videos, simulated animals, and live exposure), in addition to diaphragmatic breathing, and homework assignments. The results replicate the same efficacy in each of the participants, with statistically significant and clinical changes in their daily lives. Also, the data as a group show this success with a high Cohen's d effect size (between −1.63 and −30.03). We conclude with an appraisal of the usefulness of the procedure for adults with phobias who do not tolerate direct exposure.

This study examined cannabis use motives in individuals with anxiety disorders and compared motives between infrequent and frequent cannabis users. It was hypothesised that coping motives would be endorsed at a significantly higher rate than other motives, and that frequent cannabis users would endorse coping motives significantly more than infrequent users. Participants were 144 adults seeking clinical services for anxiety disorders who reported using cannabis. Cannabis use was categorized by infrequent (n = 54) and frequent (n = 90) use. Anxiety symptoms were assessed and deemed clinically significant. Participants completed measures of cannabis use motives, cannabis use patterns, and cannabis use disorder symptoms, cross-sectionally. Cannabis use motives were examined for the entire sample and compared between frequent and infrequent users. In general, cannabis users endorsed coping (i.e., use for managing distress) and enhancement (i.e., use for fun, pleasant feeling, or the high) motives at equal rates (p = .265) and more than other motives (p < .001). Frequent users reported using cannabis for coping and expansion motives (i.e., use to change one's thinking) significantly more than infrequent users. These results indicate that individuals with anxiety disorders use cannabis for various reasons, some of which may not be directly related to their mental health symptoms. Future research is needed to compare motives for cannabis use in those with anxiety disorders, other mental health populations, and the general population, as well as examine motives for cannabis use within specific anxiety disorders.

Health anxiety (HA) is common in psychiatric and medical settings. Cognitive models of HA highlight the role of misinterpreting physical sensations as dangerous. This report presents the case of a 31-year-old man and the use of a cognitive-behavioural approach to treat his HA which also considers the role of misinterpreting intrusions as abnormal, by drawing on theoretical accounts of obsessive-compulsive disorder (OCD). A single-case experimental design demonstrated reliable improvements in symptom measures of HA and general distress. Distinguishing sensation-based versus intrusion-based appraisals in HA has implications for interventions in health settings and for refining cognitive theory.