Podcasts about Black Dog Institute

Send Me a Message! In the next chapter of My Therapy Reflections, I share a very significant IFS (Internal Family Systems) breakthrough that has reframed how I view some of my darkest moments. When life feels too loud and too bright (which is most of the time), I tend to mentally retreat, like hiding in a tunnel—a cold, dark place that where I sometimes I can sleep for days. But this session revealed something surprising: my internal parts weren't trying to trap me there like I had thought. They were waiting at the top, encouraging me to come back.Even my inner critic—the voice I've long seen as cruel and as my enemy—was there trying to help. Not to tear me down, but to shield me from a world I'm not built for. This unexpected shift helped me see that every part of me, even the ones I've battled with, have been trying to protect me in their own, unique way.I also uncovered a younger part of myself, frozen at age 15, holding trauma I hadn't accessed in years. That story continues in Part B. But in this episode, it's all about beginning to see your inner system not as broken, but as misunderstood. Maybe, like me, you'll start to feel compassion for the parts of yourself you once feared.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! In this episode, Elliot records from inside his car as rain pours down outside, reflecting nicely the turbulence felt within all week. Battling extreme and rapid mood swings that have left him exhausted and overwhelmed, Elliot shares how poor sleep, stimulant medication, grey weather, and sensory sensitivities have compounded to intensify his struggles. As the rain falls mirroring his rapidly dropping mood, he offers listeners a genuine glimpse into the exhausting reality of managing emotional dysregulation and fatigue. --Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

This week, I chat with Josh Morrison, a psychologist, about the Netflix series Adolescence — and what it shows us about the wild ride our teens are on. We talk social media, tech use, mental health, and how we as dads can actually show up and support our kids through it all. If you've ever scratched your head wondering what's going on in your teen's world, this one's for you.Resources mentioned in episode: 1. Headspace (https://headspace.org.au/)2. Lifeline (https://www.lifeline.org.au/)3. Beyond Blue (https://www.beyondblue.org.au/)4. Kids Helpline (https://kidshelpline.com.au/)5. Black Dog Institute (https://www.blackdoginstitute.org.au/)

In this episode, our speakers discuss the use of psychedelic-assisted psychotherapy in the treatment for conditions such as depression and PTSD. This podcast is intended for individuals considering whether this approach could be helpful in treating their diagnosed psychiatric conditions. The conversation covers the role of psychotherapy in these treatments, the importance of ongoing research and the potential risks and contraindications involved. The discussion also explores how psychedelic agents uniquely impact brain function, contrasting this with standard treatments. Prof Mal Hopwood is the Ramsay Health Care Professor of Psychiatry at the University of Melbourne and the Director of the Professorial Psychiatry Unit at the Ramsay Clinic Albert Road (RCAR). A former President of the RANZCP, he is a dedicated researcher and clinician specialising in mood disorders and PTSD. He leads an active clinical trials group at RCAR, including in the area of psychedelic treatment.Dr Nigel Strauss has been a psychiatrist for 45 years and is currently a consultant at St Vincent's Hospital in Melbourne, as well as a psychedelic researcher at Swinburne University. He is a trained psychedelic psychotherapist and has written extensively on psychedelic medicine and psychology. He is currently sponsoring a trial on MDMA-assisted psychotherapy at Monash University.Dr Diana Korevaar is a psychiatrist with experience in private practice, where she integrates trauma-based methods with routine psychiatric care. Over the past five years, she has been actively involved in psychedelic-assisted therapy research trials across a wide variety of psychiatric conditions.Prof Colleen Loo is a psychiatrist, Australian National Health and Medical Research Council Leadership Fellow, and Professor of Psychiatry at the University of New South Wales and the Black Dog Institute in Sydney. She is a clinical and research expert in electroconvulsive therapy, transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and ketamine. She is now also researching psychedelic-assisted therapy.Prof David Castle; Department of Psychiatry, The University of Tasmania; and Co-Director, Tasmanian Centre for Mental Health Service Innovation. He has wide clinical and research interests and has published widely. He has a current particular interest in psychedelic assisted therapy.References and Resources:Professor Richard J Davidson on the neuroplasticity of emotional wellbeingWhite Paper on the science of awe, which describes the impact of training in competencies which overlap with psychedelic mystical experienceCompassion Focused therapy in psychedelic assisted thTopic suggestion:If you have a topic suggestion or would like to participate in a future episode of Psych Matters, we'd love to hear from you.Please contact us by email at: psychmatters.feedback@ranzcp.orgDisclaimer:This podcast is provided to you for information purposes only and to provide a broad public understanding of various mental health topics. The podcast may represent the views of the author and not necessarily the views of The Royal Australian and New Zealand College of Psychiatrists ('RANZCP'). The podcast is not to be relied upon as medical advice, or as a substitute for medical advice, does not establish a doctor-patient relationship and should not be a substitute for individual clinical judgement. By accessing The RANZCP's podcasts you also agree to the full terms and conditions of the RANZCP's Website. Expert mental health information and finding a psychiatrist in Australia or New Zealand is available on the RANZCP's Your Health In Mind Website.

In this episode, Harry opens up about where he's at and reflects on the importance of speaking up - whether it’s with friends, family, or a professional. If you find this chat helpful, please consider sharing it with someone who might benefit too. And if you or someone you know going through a tough time, here are some of the incredible support services available in Australia: Lifeline Australia

Send Me a Message! I'm back! It's been a little while between episodes, but in this check-in, I bring you along for the ride—literally. I talk about my recent solo road trip to the Gold Coast (via the very chill detour through Nimbin) to watch my beloved Newcastle Knights take on the Titans. The trip was meant to help me slow down and de-stress... but let's be real, it didn't quite go as planned.From battling anxiety on the open road to grappling with post-trip blues (and watching the Knights cop a flogging), this episode unpacks how even our best intentions to rest can get derailed by a dysregulated nervous system. I also touch on CBD oil, the struggle of feeling anxious before and after the trip, and how this lingering anxiety has been nudging me toward a depressive episode I'm now trying to fight off.This one's raw, reflective, and full of the honesty you've come to expect from The Dysregulated Podcast. If you've ever tried to give yourself a break and still ended up overwhelmed, this one's for you.--Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! Today has been one of those days—the kind where inspiring and motivated emotions go missing. Which is especially tough when you're in an interview trying to present the best version of yourself. That was today's challenge. But that's the thing with mental ill health—you don't always get to pick and choose the good days and the bad. And today was not a good one. Listen as I describe in real-time the feeling of "blergh", the state of being where inspiration, motivation and belief in oneself goes missing. --Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! In this episode of The Dysregulated Podcast, I dive into the power of anger—not the destructive kind, but the controlled, purposeful anger that drives action and transformation. After years of feeling stuck in a career dead-end, trapped by the grip of anxiety, I have used an old trick to shift my mindset. The key? Getting angry! Angry enough to demand more for myself.I explore how channelling anger can override fear and hesitation, offering the strength to push past self-doubt and take bold steps forward. This episode is about finding the fire within, using it to break free from stagnation, and turning frustration into the fuel needed to pursue something greater—like finally using that hard-earned degree!If you've ever felt stuck or powerless, this episode will challenge you to rethink anger as a tool for growth and change. It's time to stop simmering in frustration and start using it to fuel your next move.-Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Send Me a Message! In this episode of The Dysregulated Podcast, I dive into the must-dos to maintain positive mental health. Over the next two weeks, I'm committing to rediscovering and reinforcing the core habits and routines that keep me grounded, focused, and mentally clear. I'm talkin' the basics, but the basics that are so important. Although my fundamentals may seem trivial to some, for those with complex mental health disorders they can be a big challenge.Whether you're looking for inspiration to reset your own mental clarity or curious about what it takes to truly "lock in" your fundamentals, this episode offers insights into struggling with the business of life, my personal reflections, and a dose of realness. Pure insight!Let's explore how two weeks of intentional effort can spark positive change. Ready to take on the challenge with me? Let's get started! And thank you for keeping me accountable!Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

The increase in mental health and neurodivergent diagnoses in recent years indicates that we're more aware of our brains than ever before.   Does improved social awareness, self-identification, representation and access mean we've reached a turning point in the way we acknowledge and treat mental health and neurodivergence in society? Or are we at risk of over-pathologising ourselves and the world around us? Alice Dawkins is the Executive Director of Reset.Tech Australia, a policy organisation with a focus on regulating digital risks and online harms.  Sandersan Onie is an award-winning researcher at the Black Dog Institute and Harvard Medical School and is passionate about a mentally healthier world, especially how culture, AI, and tech can contribute to this vision.  Jean M. Twenge, Professor of Psychology at San Diego State University, is the author of more than 180 scientific publications and seven books, including Generations: The Real Differences between Gen Z, Millennials, Gen X, Boomers and Silents—and What They Mean for America's Future and iGen: Why Today's Super-Connected Kids Are Growing Up Less Rebellious. Sonny Jane Wise is an Autistic Bipolar ADHDer, who offers a powerful and relatable voice in the neurodiversity space. Their books resources, workshops and talks have led to organisations and services adopting a neurodiversity affirming framework and embedding inclusion within their policies.  Chaired by journalist, radio presenter, and podcaster Natasha Mitchell.

Despite decades of government investment, significant research endeavour, and a growing commitment to mental health training and response activities in schools and workplaces, rates of mental health in Australia are rising. The scale of this issue is staggering: a recent report shows that 494,000 Australians with moderate to severe mental health problems are not receiving the support they desperately need. Long wait times and a shortage of mental health professionals are leaving vulnerable Australians without access to timely and appropriate care, particularly those in rural and remote areas. When people finally get care, it doesn't always help. We know the current system is broken. We know what we need – a robust mental health system that is well-staffed, adequately funded and integrated across the country that will lay the foundations for a mentally healthier future. But how do we get there? How do we plan for a better future? And what is the role of Health Professionals? Listen to our Mental Health Month edition of Expert Insights were Black Dog Institute's Dr Peter Baldwin, Senior Research Fellow and Policy Research Manager, will share findings from BDI's recent mental health poll and discuss the key issues facing the health sector.   Panel Members: -Dr Peter Baldwin - Senior Research Fellow and Policy Research Manager, Black Dog InstituteDr Laura Kampel - Head of Clinical Services and Senior Clinical Psychologist, Black Dog InstituteMatt - Lived Experience Representative Facilitator: -Dr Sarah Barker - Clinical Psychologist

Send Me a Message! In this episode I detail my latest psychiatry appointment, with it being decided to raise my dosage of Vyvanse, with the hopes of further improving my ADHD symptoms. Slow and steady is the key, and I am now back on a dosage I have previously been prescribed after a gradual build up. There are two main issues to keep an eye out for other than effectiveness, that being an increase of anxiety and the potential for intense mood swings. So far, so good. But, I can't find myself falling into an old trap.... Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Screen-based devices play a central role in adolescents' daily lives, serving purposes such as education, entertainment, social interactions, and creativity. While public concern about the impact of screen use on adolescent mental health has grown, evidence of a direct link remains unclear. The association between screen use and mental health is complex, influenced by many factors. This webinar will report on new data about this association based on an analysis of the data provided by Australian adolescents currently enrolled in the Black Dog Institute's Future Proofing Study. These findings will be framed within the broader context of screen use research and offer recommendations for both societal and individual changes to help adolescents benefit from online experiences while reducing potential harms.Dr. Lyndsay Brown has worked for five years as a Research Officer on the Future Proofing Study, now the largest and most comprehensive longitudinal study of adolescent mental health in Australia. Between 2019 and 2021, thousands of Year 8 students across Australia were recruited for this six-year study and each year they complete confidential questionnaires about their mental health, identity, experiences, and well-being. The team analyses this data to identify the risk and protective factors associated with adolescent mental health and the early interventions that could help adolescents thrive. Lyndsay's work spans school engagement, data collection, research, public presentations, and community outreach.Hosted by Dr Kathy O'Grady.

In this inspiring episode, we sit down with Bailey Seamer, an extraordinary individual who undertook a 14-month, 5,000km hike along Australia's East Coast, from Wilsons Promontory to Cape York, all in the name of mental health advocacy. Bailey's story is one of resilience, determination, and hope, as she uses her journey to raise awareness and support for mental health issues. Diagnosed with a major depressive disorder at just 14, Bailey has faced significant challenges, including managing an all-consuming mental illness and dealing with the impact of bi-polar disorder. Despite these obstacles, she found solace and strength in walking, which became a crucial part of her healing journey. Her decision to embark on this monumental hike was driven by a desire to advocate for mental health, share her story, and demonstrate that even in the face of adversity, one can achieve incredible feats. Throughout her journey, Bailey encountered numerous challenges, from managing her mental health on the trail to dealing with the physical demands of such an extensive hike. She shares insights into her experiences, the support she received from family and strangers alike, and the lessons she learned along the way. Bailey's journey is a powerful reminder that no matter how difficult the path may seem, there is always hope, support, and the possibility of overcoming life's greatest challenges. Tune in to hear Bailey's incredible story, learn about her mental health advocacy efforts, and be inspired by her unwavering determination to make a difference. *** Don't miss out on the latest episodes of the Tough Girl Podcast, released every Tuesday at 7am UK time! Be sure to hit the subscribe button to stay updated on the incredible journeys and stories of strong women.  By supporting the Tough Girl Podcast on Patreon, you can make a difference in increasing the representation of female role models in the media, particularly in the world of adventure and physical challenges. Your contribution helps empower and inspire others. Visit www.patreon.com/toughgirlpodcast to be a part of this important movement.  Thank you for your invaluable support! *** Show notes Who is Bailey  Hiking the East Coast of Australia  Her mental health journey  Being diagnosed at 14 with a major depressive disorder  Being supported by her family Managing an all consuming mental illness  Having to leave university and move back home Bi-polar disorder?  Making the decision to go into a mental health hospital  Being in a really bad place  Walking home 30k from the hospital  Feeling proud of herself  Why walking became a really important part of her healing journey  ECT - Electric Convulsive Therapy  Having the idea to walk the East Coast Feeling a sadness and frustration and not knowing if she would be ok The Black Dog Institute  Sharing her ideas with people  Finding people's criticism, very helpful in her planning process. Not being taken seriously at first and doing something about it Why it was such an important leaning stage Being taken seriously and starting to take herself seriously as well Managing her bi-polar disorder while on the walk Why medication is an important part of her health care routine Having a bad day and what that can look like Wanting to be able to pinpoint the problem  Dealing with a spectrum of emotions  Understanding the difference between, ‘I can't' and ‘I don't want to' Tantrum Time Out for 7 mins Putting small rocks in her shoes…. A physical way of reframing the situation Creating a pocket of pleasure in her day Being alone while on the walk Making a decision by yourself  Reflecting back on previous situations Paying for the challenge The kindness of strangers Reflecting back on the journey and some of the main memories from the experience  Waking up with a fox in her tent! Adventure blues  Planning a trip to Rio to go to Carnival  Not walking a huge amount  What she wanted people to take away from her walk Why you are not alone if you are suffering from mental health Letting people know that there is support available and that there is no shame in asking for help Breaking things down and taking it one step at a time How to connect with Bailey online and find out more about her journey  Final words of advice Why everything will pass Nothing in this life is permanent    Social Media Website: wandering-minds.org  Instagram: @wandering_minds_walk  Facebook: @wanderingmindswalk   

Send Me a Message! ** Audio issues: some parts glichy **Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message!  In this episode of the My Therapy Reflections series, I dive into my latest telehealth therapy session—a format that has always left me feeling a bit uneasy. Despite the anxiety building up of the previous few days, I fought through and completed the session. The major focus of our discussion? My nagging belief that I'm somehow incompetent, particularly in the context of my ongoing struggle to land a new job. However, much of the session feels like a blur as I was dissociated for most of it. Grrr. Tune in as I reflect on the session and share my thoughts on working through anxiety and dissociation in therapy. Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

In this episode of Better Thinking, Nesh Nikolic speaks with Professor Jill Maree Newby about innovative technology-based interventions for depression and anxiety, highlighting the impact and effectiveness of internet and e-mental health approaches in modern mental health care. Jill Maree Newby is an Australian psychologist who is a professor and National Health and Medical Research Council Emerging Leader at the Black Dog Institute in the University of New South Wales. She has developed technology based interventions for depression and anxiety. Newby completed her master's degree and doctoral research at the University of New South Wales. Her doctoral research considered the role of autobiographical memories in depression. Newby studies anxiety disorders, phobias and depression. She has developed and investigated the effectiveness of technology-based interventions, including e-mental health and virtual reality interventions. Newby encourages people to seek help and gain practical advice on managing depression. Newby has argued that long wait times and high costs were a barrier to evidence-based treatment. She developed an online course that stopped people from worrying excessively. Newby investigated how the prevalence of mental health disorders increased during the COVID-19 pandemic. She found that almost 80% of Australians experienced worse mental health during the pandemic, and that women, young adults and caregivers were particularly vulnerable. She was named a 2020 Young Tall Poppy for her advocacy work in mental health. Episode link at https://neshnikolic.com/podcast/jill-maree-newbySee omnystudio.com/listener for privacy information.

The median age of onset for mental disorders is 14 years. This means, 50% of individuals who will develop mental illness will have already developed the disorder by the age of 14 years.Since children's diagnoses are missed, they do not receive the care that they need and are less likely to receive help, which has a flow-on effect to adolescence where more complicated conditions can present.In this episode, Professor Jennie Hudson from Black Dog Institute shares her findings on understanding the onset of anxiety and depression in children and teenagers, focusing on correcting the myth that mental health problems begin in adolescence.Joining her on the panel, is Psychiatrist Dr Brenda Heyworth who shares her insights from working with children and teenagers, and by Fiona, a lived experience representative who also discusses the topic from her perspective.Panel Members: -- Professor Jennie Hudson - Director of Research at Black Dog Institute- Dr Brenda Heyworth - Psychiatrist, Educator and Facilitator- Fiona - Lived Experience RepresentativeFacilitator: - - Dr Sarah Barker - Clinical Psychologist

Send Me a Message! *This episode contains coarse language*Stell returns to the show, this time showcasing her positive frame of mind. The interview contrasts sharply with Stell's previous appearance, highlighting how mood shifts can deeply influence our thoughts, words, and actions. With BPD and ADHD in particular, we find that there is this constant battle between emotional extremes. These two conversations with Stell when compared with each other, provide an insightful look into the contrasts that can occur within our minds, and how that can play out in the real world. This is as real, genuine, honest and vulnerable as it gets! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message! Medication changes can be tough, but often a revisit to a previous prescription is the best choice. Join me as I recount my latest psychiatrist appointment, where we decided that a stimulant medication, Vyvanse, could be the key to me regaining focus in life and unlocking my potential. I discuss the decision-making process, my history with Vyvanse, and what I'm hoping for this time around. 

My motivational quote for today is by – Joshua J. Marine, “Challenges are what make life interesting; overcoming them is what makes life meaningful” - Joshua J. Marine. I have learned that no one escapes tragedy or challenges in life.  There is no such thing as a perfect life or situation. That's life, filled with ups and downs!    Getting up, dusting off, and moving forward is the only control or approach we need to grow, learn, and, yes, even be happy.  Life can't be avoided unless you live in a cave, so how do we navigate difficult times? We need tools and strategies to help us get back up and move forward stronger, wiser, and more blessed.   YouTube: https://youtu.be/Er9SscxwNr8   About Julianne Mclean: Julianne is passionate about advocating for mental health and mental health research. She has completed courses in psychopathology and neuroscience at Harvard University and Developmental Psychology of the Lifespan at Sydney's Macquarie University. She has three counseling certificates from the Australian Institute of Professional Counsellors. She was the speaker for the world-renowned Black Dog Institute for Mental Health Research.   How to Get In Touch with Julianne Mclean: Email:  mcleanmktg@iprimus.com.au Website:  http://www.webtalkradio.net/Brainwaves   Stalk me online! LinkTree: https://linktr.ee/conniewhitman   Subscribe to the Enlightenment of Change podcast on your favorite podcast streaming service or YouTube.  New episodes are posted every week. Listen to Connie dive into new sales and business topics or problems you may have.  

In this episode of Better Thinking, Nesh Nikolic speaks with Dr Stevan Nikolin about understanding how depression affects brain activity and how this knowledge is being used to develop new treatments and improve existing ones. Dr Stevan Nikolin is a Neuroscience Fellow at the Black Dog Institute, specializing in the intersection of brain activity and depression. As both a neuroscientist and clinical researcher, his work focuses on developing and optimizing treatments for depression, including non-invasive brain stimulation, ketamine, and psilocybin. His research also explores the enhancement of cognitive functions through brain stimulation and cognitive electrophysiology (EEG). Additionally, Stevan applies EEG techniques to uncover deeper insights into the pathophysiology of clinical disorders like depression, aiming to drive innovation in mental health treatment. Episode link at https://neshnikolic.com/podcast/stevan-nikolinSee omnystudio.com/listener for privacy information.

Send Me a Message! In this instalment of My Therapy Reflections, I take listeners into the therapy room and uncover two powerful parts of myself: the Inner Critic and the Workaholic. These parts have been working tirelessly for years to protect me, but today I uncover just how much they've been influencing my life. It's a staggering realisation—understanding that while they were born out of a need to keep me protected, their methods are no longer serving my well-being. Join me as I explore how to acknowledge and appreciate their intentions, while convincing them to trust that the Self is ready to lead the way toward a healthier, more balanced life. This episode is all about introspection, healing, and the power of self-awareness. Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future. 

Send Me a Message! Welcome to The Dysregulated Podcast and the feature series, the Intake Interviews. In this introductory episode, host Elliot Waters sets the stage for a powerful journey into the world of mental health, through the voices of real people with lived and living experience.The Intake Interviews series dives deep into authentic stories of individuals navigating the challenges of mental illness, offering raw insights into their personal journeys, struggles, and triumphs. These conversations aim to spark open dialogue, reduce stigma, and encourage a greater understanding of the complexities of mental health.Join, as we introduce the incredible stories of resilience, hope, and healing that will be shared throughout this series. Whether you're looking for support, connection, or simply a better understanding of mental health, this series is for you.Trigger Warning: This episode and series may contain discussions of sensitive topics, including suicide, self-harm, substance use, sexual violence, domestic violence, trauma, and other mental health-related issues. Please take care of your well-being and seek support if needed.

Send Me a Message! In this episode, I share my first impressions of my new psychiatrist as part of my journey with ADHD. Join me as I discuss the insights I gained, the questions I had, and how this new perspective might shape my understanding of myself and how this developmental disorder affects me every day. Whether you're navigating your own mental health journey or just curious about the process, this episode offers an honest look at the experience of seeking help and the importance of finding the right fit in mental health care. Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message! In this episode, I reflect on my time in the psych ward, focusing on a morning meeting that moved me to tears. I've known for a while that this episode was coming, and now I'm grateful to share such an intimate and heartfelt experience with you. It was a profound moment of connection between myself and the other patients—one I'll never forget. Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

The term dMH (digital mental health) covers a wide range of online resources for mental health care.  This includes, but is not limited to, the CBT-based treatment programs that Australia has led the world in developing.   The scientific evidence is important for practitioner confidence but sometimes our patients and clients want to know about it too. This webinar will make it easier for you to explain why you are recommending an online treatment program. Please join Dr. Jan Orman and Prof Nick Titov, founder of the Mindspot Clinic at Macquarie University, who will discuss the evidence to support online CBT delivery.  They will talk about the evidence to support the use of online mental health treatment programs in general as well as the Mindspot Clinic specifically. Learning outcomes:By the end of the webinar participants will be able to:Describe some of the research that supports the use of online mental health treatment programsDescribe the situations in which they may consider recommending an online programExplain how they would talk to a patient about the evidence base for these programs and the best ways to get benefit from themNick Titov is a Professor of Psychology at Macquarie University.  He is also a Clinical Psychologist and Executive Director of the Australian MindSpot Clinic. MindSpot is a digital psychology service, which provides psychological assessments and treatments to adults across Australia. MindSpot employs mental health professionals to deliver care, it is accredited under the National Safety and Quality Digital Mental Health Standards, and it has been funded by the Australian Government since 2012.Nick has worked on >100 trials of psychological interventions and has published numerous reports of outcomes of digital psychology services in peer reviewed papers including in the Lancet Digital Health. Nick serves on multiple advisory groups to national and international organisations.Dr Jan Orman MBBS MPsychMed is a Sydney GP with a special interest in mental health and psychological medicine. She has a Masters in Psychological Medicine (CBT) from the University of NSW and has combined general practice and specialised work in mental health for over two decades.  Jan has also worked for more than 10 years as a facilitator in Black Dog Institute's Professional Education team. She is currently responsible for developing the content of, and delivering, the GP education programs for the Black Dog Institute's arm of the e-Mental Health in Practice Project.Click here to see the slides

Lucinda Price, AKA Frooomes, is an author, social media personality, broadcaster and comedian. She has cultivated a dedicated online audience and earned an AACTA nomination for Best Digital Creator in 2022. Lucinda has just released her debut book, All I Ever Wanted Was to Be Hot, which offers a refreshingly candid exploration of how pop culture, the internet, and contemporary beauty standards shape our perceptions of our bodies and self-image. You can find Lucinda here: https://www.instagram.com/frooomes/ If you or someone you know is struggling with any topics discussed in this episode please contact Lifeline on 13 11 14. Please see more support options below: Butterfly Foundation: ⁠https://butterfly.org.au/get-support/helpline/⁠ Beyond Blue: ⁠https://www.beyondblue.org.au/⁠ The Black Dog Institute: ⁠https://www.blackdoginstitute.org.au/ Produced by Head On Agency: ⁠https://www.headon.agency/⁠

Send Me a Message! In this episode, Elliot shares an update on his therapy journey so far. As anticipated, navigating a complex case takes considerable effort, but there's progress! With two therapies being utilised simultaneously, it's a challenging yet rewarding process—and you're invited to join the ride! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message! I did it! I (somehow) got Oasis tickets for the big reunion tour! But the whole process from announcement to purchase has been one big, imaginary catastrophe. Whether I was successful in getting a ticket or not felt like a life-or-death situation. And I could only see disappointment eventuating. My natural response. Thankfully the hopeful parts of me got me to the front of the queue, with a bit of good luck thrown in. One very significant victory, and we all need wins from time to time....Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.

Send Me a Message! In this episode, Elliot takes us through a deeply personal experience of battling depression, recounting four days spent bed-ridden and being unable to face the world. It's a raw and honest look at how mental illness can take over, even for someone who advocates for mental health awareness.Elliot shares some exciting news about the upcoming Intake Interview series, giving listeners a sneak peek into what's in store for the podcast. Tune in for an episode that's both introspective and forward-looking as we continue to navigate the complexities of mental health together.

Send Me a Message! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past, and continue to influence, my future.Please support me and the podcast: https://www.patreon.com/elliotwaters

With the plethora of digital CBT apps and programs available, how do you select one that's effective, safe, and engaging for teens? In this webinar Dr. Mirjana Subotic-Kerry, Senior Research Program Manager at Black Dog Institute delves into her research on digital cognitive behavioural therapy (CBT) and its impact on teen mental health.Mirjana shares the latest research findings and insights on navigating interventions to ensure they're evidence-based and prioritise the safety of teens' data and privacy, among other considerations.  She introduces the new app ClearlyMe.You can find the slides here.

Send Me a Message! Hear all about how white-hot emotion has driven me to hyper-fixation. 4.40am in the morning this episode was recorded, after hours of fighting my inner critic, pushing aside my imposter syndrome, stumbling into obsessive loops, a whole lot of catastrophising, freezing and not much sleep! This is pure, unfiltered insight into what my psyche pushes me to do. One helluva work ethic I'll say that! Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past, and continue to influence, my future.Please support me and the podcast: https://www.patreon.com/elliotwaters

Send Me a Message! In this episode I go back into the Psych ward and tell the story of the biggest turn-around of mental health I've ever seen. Unfortunately, no it didn't involve me, but a fellow patient who was suffering from Schizophrenia. From staying in his room and being mute to presenting and running the morning meetings, his response to medication was nothing short of a miracle!Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past, and continue to influence, my future.Please support me and the podcast: https://www.patreon.com/elliotwaters

Send Me a Message! Low mood and the physical toll it takes can be crippling, halting even the best-laid plans. Although I don't suffer from these attacks as frequently as I used to, when they strike, the combination of low mood and sweating can be overwhelming.  Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past, and continue to influence, my future.Please support me and the podcast: https://www.patreon.com/elliotwaters

In this episode of the Good Humans podcast, we are excited to welcome Josh Katz, an elite Australian Judo fighter currently training for the 2024 Paris Olympics. With an impressive career that showcases his dedication, skill, and passion for the sport, Josh represents the pinnacle of athletic excellence. He competed at the Rio Olympics but missed out on the Tokyo Games, making his journey to Paris even more significant. As he prepares to compete on the world stage once again, he continues to inspire others with his journey, determination, and resilience.Josh is also an ambassador for the Black Dog Institute and shares his story with students to help them build resilience and mental health. Through his advocacy, he profoundly impacts young people, teaching them the importance of mental well-being and perseverance.Join us as we explore Josh's life as a top-tier athlete, delving into the rigorous training, challenges, and triumphs that come with pursuing Olympic dreams. From his early days in Judo to his relentless preparation for Paris, Josh shares his story with honesty and insight. Discover the mindset and discipline required to excel at the highest level of competition.Josh's LinksINSTAGRAMWEBSITECooper's LinksINSTAGRAMTIK TOKThe Good Human Factory LinksINSTAGRAMWEBSITEMERCH - CODE - PODCAST 25% OFFWORKSHOP ENQUIRYTHE GOOD HUMAN FACTORY™️ 2020 Hosted on Acast. See acast.com/privacy for more information.

In this episode of the Good Humans podcast, we are excited to welcome Josh Katz, an elite Australian Judo fighter currently training for the 2024 Paris Olympics. With an impressive career that showcases his dedication, skill, and passion for the sport, Josh represents the pinnacle of athletic excellence. He competed at the Rio Olympics but missed out on the Tokyo Games, making his journey to Paris even more significant. As he prepares to compete on the world stage once again, he continues to inspire others with his journey, determination, and resilience.Josh is also an ambassador for the Black Dog Institute and shares his story with students to help them build resilience and mental health. Through his advocacy, he profoundly impacts young people, teaching them the importance of mental well-being and perseverance.Join us as we explore Josh's life as a top-tier athlete, delving into the rigorous training, challenges, and triumphs that come with pursuing Olympic dreams. From his early days in Judo to his relentless preparation for Paris, Josh shares his story with honesty and insight. Discover the mindset and discipline required to excel at the highest level of competition.Josh's LinksINSTAGRAMWEBSITECooper's LinksINSTAGRAMTIK TOKThe Good Human Factory LinksINSTAGRAMWEBSITEMERCH - CODE - PODCAST 25% OFFWORKSHOP ENQUIRYTHE GOOD HUMAN FACTORY™️ 2020 Hosted on Acast. See acast.com/privacy for more information.

Send Me a Message! In this episode together we walk through each step of the Beck Anxiety Inventory (BAI), reflecting on the questions, the scoring process, and the results. Discover how this inventory provides clarity and direction in managing anxiety and tailoring therapy. I offer practical advice on how you can use the BAI to better understand your own anxiety and take actionable steps toward improving your mental health.Whether you're struggling with anxiety yourself or simply interested in learning more about effective mental health tools, this episode provides valuable insights and encouragement. Tune in to learn how understanding your anxiety can be the first step toward managing it effectively.

Send Me a Message! In the "My Therapy Reflections" series, I take you into the world of psychotherapy and share my experiences using psychological interventions to create a life worth living. It is therapy and counselling that will enable me to form the framework needed to not only recover from mental illness but to thrive and grow beyond. Therapy is the setting in which this phoenix will rise again, and you're invited to come along on this journey with me!Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and it is through this lens that my stories are told. This is a raw, honest, and very real account of how various psychological disorders have shaped my past, and continue to influence my future.Support me and the podcast: https://www.patreon.com/elliotwaters

Send Me a Message! In this episode, join me as I navigate the whirlwind of my world, sharing insights and experiences from my ongoing mental health journey. From returning to therapy and ramping up my exercise routine to the fulfilling work I'm doing with the Black Dog Institute, including the webinars I've been presenting, there's a lot on my plate.Plus, I'm excited to announce the launch of a new series on the podcast: Intake Interviews! In these upcoming episodes, I'll be interviewing fascinating guests, diving deep into their stories and exploring their unique perspectives on mental health.Tune in for an honest, heartfelt, and inspiring look at how I'm managing the chaos of life and making strides in my mental health journey. 

Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past, and continue to influence, my future.Please support me and the podcast: https://www.patreon.com/elliotwaters

Sleep is vital to mental health, especially for adolescents who are in a critical stage of development and forming lifelong habits. However, 40% of young people face significant sleep problems which can put them at risk of developing anxiety or depression. There is extensive evidence for the benefits of Cognitive Behaviour for Insomnia (CBT-I), but an app delivering this gold standard treatment to adolescents was missing.In this webinar, Dr Sophie Li (Postdoctoral Research Fellow and clinical psychologist at Black Dog Institute) introduces Sleep Ninja®; a free, evidence-based smartphone app shown to be effective in helping young people with sleep problems.Hosted by Dr Sarah Barker

Research evidence clearly supports exposure as a key ingredient in first line treatment for anxiety, yet practitioners can be reluctant to use it with children and young people.In this episode, Professor Jennie Hudson from Black Dog Institute will share her research findings on exposure therapy for anxious children and adolescents as part of an app and programs she has developed for them and their caregivers. We will be joined by clinical psychologist, Anna McKinnon, who will share her clinical insights from extensive exposure therapy with children and families over the years about how we can use it effectively and by a lived experience panelist who will share their experience as a caregiver of an anxious young person.Listen to the conversation about the benefits of exposure therapy for anxious children, young people, and their caregivers and about approaches that practitioners can take to successfully introduce and effectively use exposure in order to have the best chance of children and their families achieving lasting, positive outcomes in anxiety management.Panel MembersJennie Hudson – Professor and Director of Research at Black Dog InstituteAnna McKinnon – Clinical PsychologistEmma – Lived Experience RepresentativeFacilitatorDr Sarah Barker, Clinical Psychologist

With the plethora of digital CBT apps and programs available, how do you select one that's effective, safe, and engaging for teens? In this episode, Dr. Aliza Werner-Seidler, Scientia Associate Professor and Head of Population Mental Health at Black Dog Institute, delves into her research on digital cognitive behavioural therapy (CBT) and its impact on teen mental health. Aliza shares the latest research findings and insights on navigating interventions to ensure they're evidence-based and prioritise the safety of teens' data and privacy, among other considerations. Joining her on the panel is Hazel McKenzie, a psychologist specialising in teen mental health, who discuss how clinicians currently integrate digital CBT into practice. Additionally, Ruby, a teenager serving as a lived experience representative, will offer invaluable perspectives on her firsthand experiences with digital CBT, shedding light on its impact and usability. Panel Members· Dr. Aliza Werner-Seidler - Scientia Associate Professor and Head of Population Mental Health at Black Dog Institute· Hazel McKenzie - Psychologist in private practice· Ruby - Lived Experience Representative Facilitator· Dr Sarah Barker, Clinical Psychologist

I know some days when your mental health is low, the last thing you want to do is get dressed and exercise, but I promise it actually can help.  Today Tiff talks you through, some little tips and facts as to how to exercise when you're feeling low and how it can help you.  Plus, we've got some mindfulness tips for you too! If you're struggling right now and need some help, please reach out to the services below: - Lifeline 13 11 14 or https://www.lifeline.org.au/- Beyond Blue https://www.beyondblue.org.au/ - HeadSpace  https://headspace.org.au/ - Black Dog Institute https://www.blackdoginstitute.org.au/  LINKS Follow Tiff Hall on Instagram @tiffhall_xo, Youtube, and Facebook Email Tiff at bounceforward@novaentertainment.com.au  Find out more about Tiff Hall and TXO https://mytxo.com/  Follow Nova Podcasts on Instagram for videos from the podcast and behind the scenes content – @novapodcastsofficial. CREDITSHost: Tiff HallExecutive Producer/ Editor: Rachael HartManaging Producer: Ricardo Bardon Find more great podcasts like this at novapodcasts.com.au Nova Entertainment acknowledges the traditional custodians of the land on which we produced this podcast, the Wurundjeri people of the Kulin Nation. We pay our respect to Elders past and present. See omnystudio.com/listener for privacy information.

  Show Notes - Episode Next STEPS: In conversation with Professor Ian Kneebone Welcome to the Aphasia Access Conversations Podcast. I'm Jerry Hoepner. I'm a professor at the University of Wisconsin – Eau Claire and co-facilitator of the Chippewa Valley Aphasia Camp, Blugold Brain Injury Group, Mayo Brain Injury Group, and Thursday Night Poets.  I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature Professor Ian Kneebone from the University of Sydney Technology.  Biosketch: Ian Kneebone Professor and Head of Discipline (Clinical Psychology) at the Graduate School of Health at the University of Technology Sydney. He is a chief investigator at the Aphasia CRE and has led and co-facilitated much of the work on optimizing mental health and wellbeing for individuals with aphasia. His work on illuminating the stepped care model as a guide for clinicians working with individuals with stroke has helped speech-language therapists and other rehabilitation disciplines to better understand their roles in psychological care after stroke and specifically aphasia. He previously joined the Aphasia Access Conversations Podcast with me for Episode #34. We're excited to have Ian joining us again, as so much work has taken place in the area of psychological and psychosocial interventions for individuals with aphasia in the past five years since that previous podcast conversation. Professor Kneebone and his colleagues have been at the center of that work, including developing and evaluating the ASK trial, the Kalmer relaxation program, collaborative goal setting, Reducing Emotional Distress in Stroke (REDS)and low intensity psychotherapeutic interventions, among others. In addition to Professor Kneebone's large-scale investigations about psychological interventions, Ian is a clinician at heart, also very engaged in hands-on clinical work, where he directly collaborates with speech-language pathologists and other disciplines. I'm privileged to discuss these topics with Ian today. Take aways: Need for psychological care for people with aphasia: People with aphasia have higher rates of depression, anxiety, and other psychological needs. People with aphasia are twice as likely to be anxious or depressed as someone with a stroke without aphasia. Stepped care model provides direction: The stepped care model helps us to define scope of practice and where we fit in, based upon our level of training. It also provides guidance for psychological care that all speech-language pathologists/speech-language therapists are trained to implement. Behavioral activation: This is a direct connection to the Life Participation Approach for Aphasia (LPAA). Increasing engagement in personally relevant activities is at the heart of both approaches. Ian discusses where solution-focused brief therapy and acceptance and commitment therapy fit into the stepped care levels: With additional training, good evidence is developing for these approaches. There is a need for ongoing psychological supports in the chronic phase of recovery: Increased mood state is associated with better physical and communication outcomes AND dealing with the physical and communication issues can improve mood state. Shifting to “compensation” can make people with aphasia feel like they're not going to recover further: We need to make sure that we have conversations about those shifts so that people don't misperceive that shift as the end of progress. SLPs/SLTs need to train mental health professionals to use supported communication techniques to support their interactions: SLPs/SLTs may need training on how to teach other disciplines to support communication. People with aphasia should be involved in co-design work to address psychological interventions. From a research perspective, we need to involve people with aphasia and from an intervention standpoint, we need to involve individuals with aphasia.   Interview Transcript: Jerry Hoepner: Today, it's my pleasure to introduce Professor Ian Kneebone. In Kneebone, is professor and head of discipline in clinical psychology at the Graduate School of Health at the University of Technology Sydney. He is a chief investigator at the Aphasia care and has led and co-facilitated much of the work on optimizing mental health and wellbeing for individuals with aphasia. His work on eliminating the step care model as a guide for clinicians working with individuals with stroke has helped speech language pathologist and speech language therapist and other rehabilitation disciplines to better understand their roles in psychological care after stroke, and specifically aphasia. He previously joined the Aphasia access conversations podcast with me for episode 34. We're excited to have Ian joining us again. As so much work has been done and taken place in the area of psychological and psychosocial interventions for individuals with aphasia. In the past five years since that previous podcast conversation, Professor Kneebone and his colleagues have been at the center of that work, including developing and evaluating the Ask trial, the calmer relaxation program, the collaborative goal setting, project and low intensity psychotherapeutic interventions among others. In addition to Professor knee bones, large scale in investigations about psychological interventions, Ian is a clinician at heart, also very engaged in hands on clinical work, where he directly collaborates with speech language pathologist and other disciplines. I'm privileged to discuss these topics with Ian today. I'm excited to dig into this conversation. And I'm really interested in talking a little bit about your perspectives about kind of the intersection of speech language pathology, and psycho psychotherapeutic interventions, psychological care, those big topics in general. And I know that in our past conversations, we've discussed a little bit about just the profound need for psychosocial psychological interventions for individuals with aphasia and the kind of the lack of access to care for mental health providers, to individuals with aphasia. So maybe we can start out a little bit by just sharing your thoughts on the role of speech language pathologists in addressing communication-based psychological supports for individuals with aphasia and their families.   Ian Kneebone: Well I think the first thing is to say that the whole stroke team should take responsibility for psychosocial issues and challenges, both from a prevention point of view, but also an intervention point of view. Where there's the potential to do so. Particularly with people with aphasia, the speech pathologist, or speech language therapist's role is a real standout one. And we know frequently that this work, because of the communication problems, often falls to Speech, Language Therapists to, you know, by their own admission, feeling unprepared to do it. So, I think there's certainly the will there from speech language therapists to be involved in this work, we just need to provide the right training the right scope of practice, and to get things going. So, this this gap in services is filled. You know, you were talking about the rates of psychosocial issues, but we do know that if you've got a stroke, and you've got a phase, you're afterwards, you're twice as likely as someone with without aphasia after a stroke to be anxious or depressed and have very, very high rates. Even clinical levels of depression are common. I guess it's not surprising anyone who works in the area will know that, but it's still very sobering to restate that statistic.   Jerry Hoepner: Yeah, it sure is. Just speaks to the tremendous amount of need and, and obviously, we know the tremendous amount of unmet needs for people with aphasia and their family members as well. Just because of how we're barely scraping the surface of this issue, I think, but making some good progress in those directions, you've done some really foundational work on the Stepped Care Model for stroke and even other populations as well. How can SLPs draw upon that model as a way to help them to understand scope of practice issues, to understand where they fit and kind of guide their interventions?   Ian Kneebone: Well, I think Stepped Care has been really useful. And I've gotten great feedback on this not that I invented step care by any means. But certainly, the improving access to psychological therapies model from the UK started this off in mental health. But the opportunity is to convey and allow people to know where they can work and what's appropriate, and when they might need to refer on or co-work with, with another profession. And the Stepped Care Model really does that. So, people are able to say, Well, I'm involved in this group, it's designed to prevent things like depression and anxiety, which are very common, as we just said, and I'm able to learn these skills or apply these practices to improve outcomes and prevent this. But you know, at some point, when these levels of symptoms of such and particularly questions of risk, risk of self-harm, risk of suicide, those sorts of things, when commonly people would refer on to mental health professionals. And I think the unique ability of speech language therapists to provide supportive communication training for mental health practitioners and so on, means that the role goes beyond just prevention, and to actually intervention. But also, to say that the model where people stepped and matched to the level of care they need, means that, you know, there is a scope of practice beyond prevention for speech language therapists, and that's those therapists who choose to train in psychological practices and psychotherapies. So, we do know, for instance, there's some strong work going on at the City University in London, where they're looking at training Speech, Language Therapists in a particular sort of Solution Focused therapy, which is very well regarded as an evidence base. And that's provided by speech language therapists, with the right training and the right background, to develop the competencies and know how to manage risks, and so on. So, the Step Care Model allows people to see where they're at in terms of their scope of practice, when they're on or when, if they want to, what skills they might need to practice at a at a high level.   Jerry Hoepner: Yeah, that's really well, well explained. And that's actually a really nice segue into my next question, because I know, the Step Care Model that you presented back in 2016 identifies some specific psychological interventions. So, you talk about motivational interviewing, cognitive behavioral therapy and a number of other approaches. I'm just interested is their kind of a plan in mind or a process in mind that will help to identify other interventions and kind of where they fall to give mental health professionals, speech language pathologists, and other disciplines, kind of a sense of where those other interventions fall. So, things like dialectical therapy and so forth?   Ian Kneebone: Well, there's a range of therapies that we've found useful for people with, with mental health problems, and obviously, it's the application of those to people with aphasia that's the point of interest. And we do now have very promising work going on cognitive behavior therapy for people with aphasia, we've just completed a case series, which is just been accepted by Neuropsychological Rehabilitation, looking at modified CBT for people with aphasia, which is really exciting. We're doing stuff on behavioral activation, which is very promising for people with aphasia and relaxation therapy, we've just completed some case series work, looking at that. And that's really exciting because that was co-designed by people with aphasia, and then then then launched based on that very solid foundation. The more interesting or the very interesting work is being done on some of these, what we call third wave Cognitive Behavior therapies, which are things like Dialectical Behavior Therapy and Acceptance and Commitment Therapy, for instance. And a lot of that's been leveraged off the brain, the general brain injury literature now where people like Dana Wong, who's from LaTrobe University here has done some seminal work looking at modifying for people with cognitive and communication problems, Acceptance and Commitment Therapy. Reg Morris from Plymouth University in the UK has done some great founding to work with some of his PhD students and looking at Acceptance and Commitment Therapy for both carers and people with aphasia after stroke, you did mention before, it's easy to focus on, of course, the client or the patient with aphasia, but you know, the need goes beyond that, because the ripple effect of the, of the impact of the communication and, you know, the disabilities that commonly come with stroke as well goes to a person's social circle and familial circle, and including those people in therapy is, is an important part of the investigation as well. Absolutely.   Jerry Hoepner: It's so common, we have partners who are socially isolated as well, just because they're the primary communication partner for that individual with aphasia, and whatever restrictions to participation, they feel, right, it's just all connected.   Ian Kneebone: When I teach my clinical students, I often say like, you no, you've got an identified person who's been referred to you, but you've got to realize that nearby, there's going to be someone who's just as anxious and depressed, if not more so. But at that point, and that we do know, there's a reciprocity between anxiety and depression, that person with aphasia, and, and a significant care person. So, it's really important to include those people in therapy if you can, but being mindful of not including it in a way that adds to the significant burden and challenges. So it's got to be done in a really appropriate way without asking people for things that they're not able to provide, because they're just coping with things like role changes, financial issues, and you know, the loss of the person as the relationship they had with them on account of communication.   Jerry Hoepner: Absolutely. And, as you were talking about that, it makes me think about how that changes over time as well. So those initial kind of burdens, that might be a tough time for them to engage in those kinds of conversations, because like you said, they're just trying to keep their head above water and trying to make it through everything else, all those other role changes and additional roles they've taken on. But I wonder about your thoughts in the chronic phase as, as both the individual with aphasia and their partners start to make those adjustments, if maybe that's an opportunity for some of those interventions.   Ian Kneebone: Those often talk about that that phase is life after stroke. And that's usually about 12 months later, when we know pretty much how people's rehabilitation has proceeded. And people are pretty much aware of how they will be functioning on into the future. And as you say, I think there's a there's a sort of a crisis point when someone's having their stroke. And there's that kind of acute phase where people are adjusting, but the important thing at that time, people think well, my personal, my personal looking after, or I'm going to get better and so on. But it's when that realization happens. So, we find these sorts of emotional difficulties can occur early or later after, after a stroke, with or without aphasia, of course, and that, you know, it's important that people's needs be met, on into the future, the recovery phase in life after stroke. Because many people when we've done this in our qualitative interviewing and surveys by places like the Stroke Association, UK, that people often the 12 months, a lot of the care, a lot of the treatment or drops away. And then as we were talking about the feeling isolated, and well, this is all I'm going to get, and so on, people are really challenged at that time, and we need to be able to provide, you know, supports and therapies on into the future for those individuals. You know, depression, anxiety content, you know, is pretty consistent at any time after a stroke. And when we're really bad at predicting, I think, you know, who's going to be affected at what state so we're going to be going to be vigilant, and we have to be, you know, particularly vigilant, I guess, I'm probably preaching to the converted with your audience here, but that we know that people are anxious and depressed out of stroke effects, their functional outcomes, and including the communication outcomes and so on, you know, if somewhere, you know, I remember seeing someone with a with a swallowing problem and the Speech Language Service was very concerned about this. And they had a day of good mood, and they came to a day hospital party, and now reading these party pies like there was no tomorrow's person's actual ability to swallow. Now I'm not saying it wasn't about risk was altered by their mood state and that that goes across the continuum of the areas which speech language therapists are involved with. So really important for outcomes and not just mood outcomes. You know, being depressed or anxious is distressing in itself. But you know, the ability to make a difference to people's physical and communicaiton outcomes of addressing psychological issues is considerable.   Jerry Hoepner: Yeah, I like the way that you describe that as being so intertwined and interconnected. So, you can't just separate those pieces out and say, I'm dealing with the physiological issues right now. Now I'm dealing with the psychological or the psychosocial and emotional issues, because there's so interconnected and, and I want to go back to a point you made earlier, which is, so often people early on have that sense of I'm going to be this, it's, I'm not going down the road a year, I'm not going to be one of those people who needs this. So, I'm just going to, you know, nose to the grindstone kind of work through this right now. But it can pop its head up anywhere in that recovery. And, and I think there's some reality that sets in once some of those initial supports are taken away.   Ian Kneebone: I mean, one of the biggest challenges I've faced when I've been in in stroke rehabilitation, and working with Speech, Language Therapists is around when people are using compensation, being asked to use compensation, as a strategy for communication and kind of dealing with all that mean, I'm not going to get any better with my speech. And, and, and, you know, people get really angry, and it's their frustration, and so on, and there's, you know, therapists going to be blamed for it. So, there's a real, real strategy there for dealing with that, and, you know, working with people to retain, retain hope. But you know, being pragmatic with well, you're leaving the hospital, now, you're going to have to communicate there in the community, you want to get out and do some of the things or at least some of the things you used to then how are we going to do this? And how are we going to approach it? But yeah, it can be quite a crisis point.   Jerry Hoepner: And I Yeah, and I think part of our role as a speech language therapist in that context, is to communicate that really well in a way that doesn't set them up for oh, you're switching over to compensatory approaches that you that means you think that I can no longer improve, in terms of my abilities, but rather to convey this is one of several things that we want you to do to be more successful, and to continue to engage. That's, I mean, that's kind of for speech language pathologists who are supposed to be good at communicating those things. We don't always do a very good job of communicating those things. I was thinking a little bit about Deborah Hersch's work on transitions and discharges and how poorly we do and saying, This is what's going to happen. We've got these limitations of the system. But this is the plan, this is not something that you did wrong, this is something that we just need to work through. And when we, I think when we feel discomfort about conveying things like it's time to transition home, or it's time to transition out of therapy, that we don't do a very good job of explaining those things.   Ian Kneebone: Well, I've certainly worked with a lot of members of stroke teams, allied health and speech pathologists, but one of the one of the difficulties, of course, is when we feel uncomfortable about doing it, and it's not the news, people want to hear we kind of beat around the bush. And then when people aren't clear, and you've got people with cognitive and communication problems, it's kind of a perfect storm for it to go amiss. Yeah. So, I think one of the messages I give out is people think if they just communicate it really well, it'll all be fine, and it'll go work fantastically, and people will transition really smoothly. But it's a bit of a wakeup call to realize, however well you put it, this is sometimes news people don't want to hear, and that there's going to be a reaction to that. And just to appreciate that it's not necessarily your fault. But there's the reaction that is it is people becoming aware of limitations going into the future, not the not the recovery they wanted, but the recovery they've got and supporting someone through that is a challenge when sometimes, you know, you're the target of dissatisfaction.   Jerry Hoepner: Right? No, that's such an important point. Just being cautious of that as well. Because certainly, certainly that's an important thing to consider. I'm interested in the process of interprofessional collaboration with mental health professionals with psychotherapists. What are your thoughts on the best way to approach a collaboration or setting up a collaboration with a mental health provider rather than an “oh, this person's got needs beyond what I can provide? Take them off my hands.”   Ian Kneebone: It's just so essential. One of the struggles we've had is that you know many people in my own profession, which is clinical psychology will say, well that this person can't communicate, I can't provide them with therapy. And that's so disappointing because we know if we modify them, we can do that. But certainly, my clinical experience in collaboration is that, you know, working closely with a speech language therapist about the best ways to communicate with someone they've, you know, very thoroughly assessed, is really useful in allowing me to learn and, you know, I work in session with, with therapists, as well as you know, gaining assessments and information and talking to them about that before it. And really importantly, there's a lot of in the research we're doing about collaborating, particularly with collaborating, particularly with speech language therapists, to be able to do those sorts of prevention work and, and therapies we've, we've discussed. And that's been such a joy working with Amanda Lakute, and some other people on that work, and Miranda Rose's team in looking at optimizing mental health and wellbeing in designing, for instance, Jas Sekhon's work, we know, on teaching Speech, Language Therapists, you know, counseling skills, so that they feel competent to support people that first step on the ladder, but also dealing with how speech language therapists can obtain the skills. And also really importantly, this is bringing onboard people with aphasia, to the co-design work, to design things that we know will be effective with them rather. So, we're not doing things to people, we're doing things with people and looking at the best way of designing our interventions. And not just our research, but our clinical interventions, so that they translate well into the different environments, healthcare environments that we work in.   Jerry Hoepner: Absolutely, and kind of three really important points for a speech language pathologist, one, having that training to feel more confident and comfortable with actually carrying out those level one, psychological interventions, but also having training on how to teach mental health professionals how to interact. So, training those communication support strategies is a big part of our role. And if there should be something that we're comfortable with, we should be comfortable as speech language pathologist with training others on how to use those communication supports and   Ian Kneebone: Jas of course is a speech language therapist, Jas and she has got such a great course and such a nice way of delivering that in the speech, language therapy world that it's, it's so nice, and then people say, well, Ian, can't you go and teach us in counseling and like, you know, I'm happy to provide counseling training and different psychotherapies. But, you know, the role model that people like Jas provides in saying, well, this leads, not only can Speech Language Therapists use these therapies I can try and others in them because, but you also know, it's a competency within, within the scope of, of every practitioner really. Yeah,   Jerry Hoepner: absolutely. And, and I think sometimes we forget about that piece, kind of think it's a given that we're going to be able to train other professionals, but I think, also, there's a little bit of that uncertainty, when you're working with someone else about expertise and roles and territory and all of those things you might kind of back off in terms of providing the thing that you are the very, you know, what is your kind of bread and butter, your biggest strength in terms of teaching those things. So, I agree, Jas is fantastic, and the work that she's done in that area has been just so helpful and moving us forward from an educational standpoint.   Ian Kneebone: I guess as a psychologist, I kind of assumed a lot of that work would be the net training was available in courses but as we know, from the surveys and so on, but it has been a bit hit and miss despite the demands and like guidelines, like the Royal College in, in the UK, for people to have those roles, and then it's kind of I know, it's hard to fit everything into the into courses, because there's so much new material on different ways of intervening and assessing, but it's such a core skill that it's good to see that those who may have missed it on the way through that they're released post, you know, these master courses that provide people with to fill in that gap.   Jerry Hoepner: Agreed. And again, there's a lot of a lot of training that still needs to happen yet and a lot more changes to happen in the graduate student training programs for speech language pathologists as well.   Ian Kneebone: When I'm talking to you from Australia, of course, and we're no exception here despite you know the leading lights that we have in this country for speech pathology and trading and communication and counseling skills for people with aphasia we're still working on it here and I know from your surveys, that's still a challenge in the US as well. So, it's a piece of work in progress.   Jerry Hoepner: Yeah, it definitely is. At least there's some awareness of it. And we're starting to make a little bit of ground, I think in terms of awareness. And definitely when we have international programs for training, speech language pathologists and speech language therapists from a counseling standpoint, but also for working together collaborating on research internationally, I think that bodes well, for our future, I think we're moving in the right direction. I want to return.. Oh, go ahead.   Ian Kneebone: No, no, I'm just agreeing with you. So Oh,   Jerry Hoepner: Oh gotcha. I want to return to the other point that you made about codesign, with individuals with aphasia, involved in that process. And I might have you talk a little bit about the relaxation program that you co designed the calmer program and kind of how that was set up. And what you've learned from that?   Ian Kneebone: Well, we pretty much it's run by Rebecca El-Helou, who's a PhD about the completed a PhD with me, and she's done a range of work, including the Kalmer project, which is part of what we call REDS, which was Reducing Emotional Distress in Stroke program. And we just thought, like, you know, relaxation, it's, it's one of these things that we know works with the general population really well. And, but it's not offered to people after stroke generally, or wouldn't necessarily people with aphasia after stroke. And so one of the things we wanted to do by that is, you know, start developing the evidence base, and we thought, you know, really, there are all these great relaxation programs out there, but will they work with people with aphasia, I mean, the advantages, of course, they can be very communication life, because of the nature of the interventions, you know, which is about, you know, focusing attention, reducing autonomic arousal, using breathing and so forth. So, they can be very nonverbal. So, with you, this is eminently suited, and it's also something that could be online, it can be on your phone, right. And it's such a great thing in terms of accessibility. So we work with people with aphasia, because we thought like a lot of, despite the low level of communication required, that it may not suit everybody, we weren't going to assume that people with aphasia would, would take to it necessarily, and we're so pleased that we got a group I think about 10 or 11, people who were involved with us in looking and going through the, the sort of standardized programs, and then looking at how we could reduce down the communication, and how we could also, you know, just make it user friendly, and whether people needed to care or not to support them in, in getting them online to do it. And just really tightening up something and tailoring it to people with aphasia. So, we've got about two levels of communication, for instance, which people can dial up depending on their needs. And, you know, and while I say we will talk with people with aphasia, we also of course, include speech language therapists and  uh Brooke Ryan, you may have heard her doing her work, she's out in western Australia at Curtin University now doing a great job in, in looking at psychosocial work with people with Aphasia out there. And, you know, certainly it was gone, guided by all the current guidelines on supporting people with aphasia, not only to do the relaxation training, but to communicate their views on the relaxation training and how we might modify it to be more appropriate. So that was great. And we also have recently done behavioral activation study, there's just been a publication in Aphasiology about behavioral activation, which is an intervention, which, at its simplest, is a getting people re engaged with their environment, doing things that they enjoy that they've got mastery over, and they value. And also looking at how it can produce an online program that would support people once again, with or without a carer, to undertake that in a really accessible way assessing accessible communicatively but also because it's online, it's available at the time of your own choosing. And we're really lucky we may not be known as well internationally is in Australia, but we had a lot of work from the Black Dog Institute here, which is developed a lot of online programs. So, we also benefited from their huge expertise in this area, in, in developing something that we hope is going to be really great for people with aphasia and, you know, just get the resource out there. I mean, some of the work we've done is trying to get, you know, health services to be out able to offer treatments but you know, getting clinicians with the time. And you know, getting resources to do that is a real challenge. So, you know, we've got to go with where people may be able to access things themselves through Stroke Association, stroke, foundations, those sorts of things, where possible, so that we can get things out there and kind of like, circumvent all the problems of resourcing in the health community, which, you know, we've got a very different approaches to healthcare in the US and Australia, but the same, the same struggle in trying to get resources to people. And so, we're just looking across the board and how we can do that in this online stuff, particularly with the assistance of real experts, like Black Dog has been a great opportunity here. And we're just like, inevitably looking for funding for the next stage where we can roll it out and provide an evidence base to how useful this might be to people with aphasia after stroke. Jerry Hoepner: I think that's so useful. And I want to kind of make the connection between behavioral activation and the Life Participation Approach to Aphasia interventions that Aphasia Access stands for. And that's just such an important part of everything that we do from a life participation approach is increasing that participation, finding ways to get people reengaged in authentic, meaningful things that they care about. So, I want to make that connection. And the way that that might look for individuals could be part of a community group, it could be an aphasia camp like we offer, and I know that Linda Worrall's group started at a camp in Australia a couple of years ago as well. So they've got a couple under their belt, or, and I think I like this extension into the accessible online format that can reach as many people as possible, even if that's like the way that gets them into the loop, because I think it's hard initially to, to invest in going someplace or becoming a part of a group, things like that. But certainly, there's something to be said about once you're in and once you have that success that comes with having the right supports and having peers who understand you, then it's a little bit easier to take that next step, I think,   Ian Kneebone: Oh, absolutely. And like the across this kind of leisure rehabilitation is something our occupational therapies, therapists colleagues talk about, and the behaviors talk about environment enrichment and so on. And, you know, battle activations, all in that ballpark, and really important for people, as you say, it's certainly part of, you know, Miranda Rose and her team are doing work on community aphasia groups, which are kind of exciting, because they're led by people with aphasia, once again, because of the resources, issues that happens with, you know, trying to fund these sorts of activities. And, you know, there's, that's certainly an important part, and also meeting in the group, as you know, is a valuable, enjoyable experience, both in terms of the support from right from people, you know, looking at what other people are doing, and getting engaged with that, but also, you know, being on a similar journey, and the support that that can give to other people's is, is really valuable, I think, is as part of the process that leads to the positive experiences from those groups. Jerry Hoepner: Absolutely. And I, and I hope our listeners I got pretty savvy listeners, I hope they pick up on that connection as an important way to return to those meaningful activities and to have a positive effect on mood and other psychological domains. Ian Knebone: Well, watch this space because the works, you know, the initial works being done, but they're rolling it out in Australia, where they've just got some, some country-type areas involved in offering this training to people. So they've developed some really comprehensive training things for the materials for the people, the professionals that support this program, but also for the people with aphasia who lead the groups. There's a PhD should Kathryn Pettigrove, who, who you should get a podcast on, she's just amazing and excited about this work, and you may have seen her in the US recently, but such talks with such enthusiasm about it. So, I would recommend that to you and your listeners. And as the evidence comes out, and it's going to be a great model, I think for helping people to help themselves. Really.   Jerry Hoepner: Absolutely. And you're right, we definitely need to get her on this podcast. I'll write that down as soon as we're done, make sure that we follow up with that terrific point. (See episode 86) Episode #86: Making Aphasia Groups Work   Ian Kneebone: And she's just so enthusiastic, new energy coming into the, into this area, not that there's a lack of energy, but it's just nice to see that, you know, a few people hanging on the baton.   Jerry Hoepner: Absolutely. Yeah. It's great to great to spread that out. Because there's so much to do. There's no no lack of things to do in this area, for sure. I'm interested in your thoughts. You talked a little bit about Jas Sekhon, but your perspectives on training, both future speech language pathologists who are in their training programs and existing speech language therapists pathologist who are already working clinically in seeking continuing education. Can you talk about some of the keys from your perspective to making that education successful?   Ian Kneebone: The first step is, you know, there's still a little bit of work in saying this, you know, convincing people this is part of their role, because some people will, will think, Well, no, I just hand this over to the psychologists that I you know, I don't think we can, we can accept that but, but moving forward. With that, it's really integrating, you know, the right, you know, say step one type interventions like problem solving, behavioral activation, relaxation therapies, and so on, right in into training courses, because these, these are things that, you know, people say, what's a psychological therapy? How am I going to do that? Well, it because it's psychological therapy, it doesn't have to be done by a psychologist is the first point. And a lot of it's kind of manualized and fairly intuitive to professionals. And many people come and say, you know, problem solving, and I've been dealing with all these challenges in my life already. And this just makes such sense. I wish I'd kind of it just, I should have known this already. Because, you know, I'm a slight person, I've got a master's degree in speech, and language therapy. But you know, it's so useful to me as well, and handing over to my clients is just really great. I mean, we do know, there's some work that's been done in the UK looking about Peter Knapp and his colleagues at looking at problem solving as a prevention and, you know, really good RCT results on how that prevents, you know, psychiatric psychological symptoms after stroke.   Jerry Hoepner: Absolutely.   Ian Kneebone: So, I think it's just rolling out and getting people to be to get over their concerns about and Jazz Jazz program. If you would, then that's, you know, specific counseling skills, but also then add some of these other strategies in. And we've got some experience in doing that recently. It's with step care, Carolyn Baker, who's at Monash University here in Melbourne, has been doing some work with with both online and offline online because of COVID in rolling out these therapies with allied health practitioners, including psychologists, but also Speech, Language Therapists, and being able to do that, and the main thing is just the kind of the structural issues in, you know, adding to people's workload, and allowing the system to support the investment that will, you know, lead, as we say, not just to people coping better with things but also improve, you know, the functional outcomes after stroke. So, while that's been a bit of a mixed feast, in terms of, you know, outcomes, because it's just been so hard to get these systems to take on board the training and get, get the people through these very straightforward psychological interventions that we know will almost certainly benefit people. But we're doing that, as I say, a two-pronged approach, we're looking at the self-help co-design work that can go online and so on and be accessible that way. And also trying to, you know, train every day, healthcare workers in being able to provide these to people with aphasia.   Jerry Hoepner: Absolutely, and when you say, fitting in to people's schedule, or their workload, I mean, I just think that goes both ways, because not addressing these things really limit your outcomes in terms of, kind of, like you said, the communication outcomes are going to improve as those psychosocial outcomes begin to improve.   Ian Kneebone: You know, it's short sighted not to make this investment. But you know, doesn't mean it'll net. And so, you know, the logic doesn't necessarily follow, right. In terms of what happens with healthcare resources. And the other thing is, I guess, we're talking about all what suspects with therapists, fleet Language Therapists role is really important that not to throw the baby out with the bathwater is that, you know, like, if someone's communication can improve their depression and anxiety will improve as well. So, you know, as I often say, when I'm talking to training other allied health people, you know, we've all you know, you've all abandoned the session because someone said or stressed or upset and so on. But if you keep on doing that, something's got to change. You can either refer them on or do some collaborative work with somebody, but not, you know, not stopped doing the OT or the physio or speech language therapy, because you know, those things have to come along with as you were saying earlier, they're all joined up.   Jerry Hoepner: Absolutely, no, that's a, that's a really great point. And they all have to happen simultaneously to be effective, for sure. Ian earlier, you were talking about Carolyn Baker's work, her recent work, and I'm really interested in the low intensity psychotherapeutic interventions from the eDelphi study. Just wondering about kind of your thoughts on what the place is for those you mentioned occupational therapist, physiotherapist, speech language therapist. Ian Kneebone: This is Carolyn's most recent work, which is the last data we kept it in the middle of this year has been rolling out training to people, you know medical nursing, speech language therapists and also psychologists in kind of first level step care for people with stroke. So, people were enrolled in the program, and some was telehealth some was not. And they would then choose one of three therapies that they thought might suit them best. And that would be problem solving behavioral activation or relaxation therapy, and then they'd have seven sessions of therapy with that. So these were people who weren't necessarily psychological therapists, although some were providing, providing these sessions within a current health system that's operating day to day with the practitioners from the current health system, rather than you know, someone coming in and doing a great RCT. But then the resources disappear, and you go away, no matter what you prove, one way or the other. And that's been a real eye opener, I mean, that there were major challenges when we started that because of COVID, because so many healthcare workers, as I'm sure there were in the, in the US were, were redirected to other tasks to do with the epidemic. But we've soldiered on, and got that it's a really great learning experience to see. See how that went, how it was rolled out. And we've got one at a time and qualitative evidence that we're going through, it's starting to sift through at the moment to look at what we can really learn from that project about how we do this going forward. I mean, I do not at the moment, it's just that that redirection of resources, particularly under COVID, was so difficult. And that was perhaps a unique time. But the resources, as I was saying earlier, are always under scrutiny and precious. So, right. It's about I think, partly getting the evidence base and so on. So we were talking about relaxation therapy recently. And I've got the irony of people saying, well, you know, you put it in a grant application to do to demonstrate the treatment efficacy, and people said, well, it's relaxation therapy, why wouldn't work? Of course it will work. And then, and then the people say, well, we can't put it in policy, because there's no evidence base. So you kind of you know, it even the same, the in the same grant round. Yeah. And so we're just doing it anyway, we're doing it with PhD students, we're doing it with, you know, startup resources that Miranda Rose in the Center of Research Excellence in Aphasia Rehabilitation in Melbourne have got hold of for us. And we're going to demonstrate the usefulness. So, people will put it in their guidelines and so on. And then the UK National Stroke guidelines, say all this great stuff about some relaxation training, we do the same, but there isn't sufficient, not sufficient numbers, significantly power to demonstrate efficacy and so on. I'm just really grateful they mentioned some of Vaour work. But then I kind of have well, yes, but and, you know, that means it's not rolled out. I used to work in a stroke rehabilitation word in Vatum, in the UK, and we had a number of Allied Health assistants, you know, physiotherapy assistants who've gone off and done all this training in how to do relaxation with people that didn't get any time to provide. So it's kind of like, oh, gosh, you know, it is hard to, sometimes to, to get this happening. But you know, I think there is saying that, but there is kind of a, it's a right time. And you were talking to me before about, you know, five, you know, psychosocial guidelines for people with aphasia, and so on that were being developed. And I think the more that we do that, the more the ability will be there to leverage those resources to people who need them.   Jerry Hoepner: Agreed. I think that is a really good place to start to wind down our conversation because I think we're moving in the right direction. Still, still plenty of work to do, but I'm wondering, kind of as a as a summary are there are two or three things that you think speech language therapist, working with people with aphasia should keep in mind from a psychological intervention standpoint, and what's a good starting point?   Ian Kneebone: Well, I think it's probably the three things I do is like, you know, take it on as part of your work to be aware of these, these these issues and try not to shy away from As tempting as that may be. So, the first thing is, you know, there are good instruments for now that we have screening for anxiety and depression so you can pick those up and they're well within your skill base to use. And then getting the skills and training and things like counseling if you don't have them already, or you don't feel confident in using them, and then getting access to some of these other things. So like Caroline's work, you know, we're hopefully the publish the manual shortly that can guide people, speech language therapists in using those treatments. So that will be something that's out there and a resource that people can use. And once again with it well within the competence of, you know, speech language therapists. And I think finally, you know, just using the great communication skills you've got, even when you're sort of giving people difficult news to receive that. And just being as clear as you can be, you know, how to do the communication. And, you know, kind of accepting people are going to be frustrated. But, but giving it the clarity and the justification in a way that retains people's hope for further recovery but it's pragmatic, to get them functioning as well as they can in the community, because that's so much of the key to people going forward.   Jerry Hoepner: Absolutely. And that's, that's our whole goal to get them reintegrated as much as possible.   Ian Kneebone: So, awareness, skills, communicating effectively regarding the difficulties and the challenges.   Jerry Hoepner: Excellent summary. Well, Ian, it's been fantastic having this conversation. Great to have it again, I don't remember exactly how many years ago we talked. But it's great to have that follow up conversation. And I know our listeners will really enjoy this conversation. So, thank you for being here today.   Ian Kneebone: I'm more than happy to help out and thanks for all the speech language therapists who have contributed to my work. I wouldn't be here without them. And it's great to see this interprofessional learning moving forward. If I hadn't missed out any of the great people I've worked with, I do apologize. But there's just too many of you now, which is part of the success story.   Jerry Hoepner: Yeah, that's a good problem to have. Well, thank you again. Goodbye.   Ian Kneebone: Thanks, Jerry.   Jerry Hoepner: On behalf of Aphasia Access, thank you for listening to this episode of the Aphasia Access Conversations Podcast. For more information on Aphasia Access and to access our growing library of materials go to www.aphasiaaccess.org. If you have an idea for a future podcast series or topic, email us at info@aphasiaaccess.org. Thanks again for your ongoing support of Aphasia Access.   Resources: El-Helou, R., Ryan, B., & Kneebone, I. (2023). Development of the “Kalmer” relaxation intervention: co-design with stroke survivors with aphasia. Disability and rehabilitation, 45(9), 1517-1529. Kneebone, I. I. (2016). Stepped psychological care after stroke. Disability and rehabilitation, 38(18), 1836-1843. Morris, R., Eccles, A., Ryan, B., & Kneebone, I. I. (2017). Prevalence of anxiety in people with aphasia after stroke. Aphasiology, 31(12), 1410-1415. Ryan, B., Bohan, J., & Kneebone, I. (2019). Help‐seeking and people with aphasia who have mood problems after stroke: perspectives of speech–language pathologists. International Journal of Language & Communication Disorders, 54(5), 779-793. Ryan, B., Kneebone, I., Rose, M. L., Togher, L., Power, E., Hoffmann, T., ... & Worrall, L. (2023). Preventing depression in aphasia: A cluster randomized control trial of the Aphasia Action Success Knowledge (ASK) program. International Journal of Stroke, 18(8), 996-1004. Sekhon, J. K., Oates, J., Kneebone, I., & Rose, M. (2019). Counselling training for speech–language therapists working with people affected by post‐stroke aphasia: a systematic review. International journal of language & communication disorders, 54(3), 321-346. Sekhon, J. K., Oates, J., Kneebone, I., & Rose, M. L. (2022). Counselling education for speech-language pathology students in Australia: A survey of education in post-stroke aphasia. Aphasiology, 36(12), 1417-1446. Sekhon, J. K., Oates, J., Kneebone, I., & Rose, M. L. (2023). A phase II randomised controlled trial evaluating the feasibility and preliminary efficacy of an education program on speech-language pathologist'self-efficacy, and self-rated competency for counselling to support psychological wellbeing in people with post-stroke aphasia. Topics in stroke rehabilitation, 30(8), 842-864.