Author name: Therapy Near Me Editorial Team

Energy drinks and mental health: what the science actually says Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 10/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. Why this topic matters Energy drinks sit at the intersection of stimulation, sleep, mood, and risk‑taking. They combine high doses of caffeine with sugar and other bioactives (for example, taurine, guarana, B‑vitamins). In Australia, these products are regulated as formulated caffeinated beverages and may contain up to 320 mg of caffeine per litre with mandatory advisory statements (FSANZ, 2023; FSANZ, 2025). A single 500 mL can can therefore deliver ~160 mg caffeine—roughly two cups of instant coffee—often alongside ~50–80 g of sugar (Nuss et al., 2021). This piece synthesises what peer‑reviewed research says about energy drinks and mental health, with practical guidance you can actually use. What’s in the can and why it matters to your brain Caffeine antagonises adenosine receptors (A1, A2A), reducing sleep drive and increasing alertness; downstream, it modulates dopamine and noradrenaline signalling (EFSA NDA Panel, 2015). Guarana adds extra, often undeclared caffeine. Taurine may alter calcium handling and neurotransmission but human neuropsychiatric effects at beverage doses are uncertain. Sugar produces rapid glycaemic swings and is independently linked with depressive symptoms in prospective cohorts (Knüppel et al., 2017; Chen et al., 2024). The evidence at a glance Bottom line: most studies are observational and cannot prove causation, but the pattern is consistent—more frequent energy‑drink use co‑occurs with poorer sleep, more anxiety and distress, and riskier substance use, especially in adolescents. Australia‑specific context Under Standard 2.6.4, energy drinks in Australia must contain 145–320 mg caffeine per litre and carry advisory labels stating they are not suitable for children, pregnant or lactating women, and individuals sensitive to caffeine(FSANZ, 2023; FSANZ, 2025). Retail sales to minors are not banned nationally, and marketing frequently targets youth‑oriented settings, which helps explain observed consumption clusters with other unhealthy dietary behaviours and short sleep (Nuss et al., 2021). How energy drinks can affect mental health 1) Sleep architecture and mood Reduced slow‑wave sleep and curtailed total sleep time impair next‑day mood regulation and cognitive control (Drake et al., 2013). Adolescents often use caffeinated drinks to counter sleepiness, creating a stimulate‑then‑compensate loop that sustains low mood and irritability (Chawla et al., 2024; Nuss et al., 2021). 2) Anxiety thresholds At higher doses (often >200 mg in a sitting for non‑habituated users), caffeine can induce jitteriness, restlessness, and panic‑like symptoms. Individuals with anxiety disorders or panic disorder are more sensitive to these effects (Richards & Smith, 2016; EFSA NDA Panel, 2015). 3) Depression and psychological distress Multiple studies show dose‑response associations between frequent energy‑drink use and psychological distress and depressive symptoms (Masengo et al., 2020; Ajibo et al., 2024). Mechanisms may include sleep loss, glycaemic volatility from sugar, and co‑occurring risk behaviours (Park et al., 2016; Knüppel et al., 2017). 4) Suicidality signals Population studies in adolescents link high intake with suicidal ideation and, in some datasets, suicide attempts (Kim et al., 2020; Masengo et al., 2020). A 2025 meta‑analysis spanning caffeine beverages suggests elevated risk at higher exposures, warranting precaution (Low et al., 2025). These findings do not show that energy drinks cause suicidality; they indicate a red‑flag association that should prompt assessment of sleep, mood, and substance use. 5) Drug interactions and special groups Practical guidelines you can use today Safer, workable alternatives If you are chasing focus or a pre‑workout lift: What parents and schools can do Nuance and limitations Most human data are observational. Confounding by lifestyle (screen time, diet, stress) is likely; reverse causation is plausible (for example, low mood → more caffeine/sugar). Nevertheless, converging evidence across countries and methods ties frequent energy‑drink use with sleep loss, higher psychological distress, and risk‑taking—enough to recommend precaution, especially for teens and people with existing mental‑health conditions. References Ajibo, C., et al. (2024) ‘Consumption of energy drinks by children and young people: associations with physical and mental health’, Public Health, 226, pp. 1–10. CDC (2024) ‘Effects of mixing alcohol and caffeine’. Available at: https://www.cdc.gov/alcohol/about-alcohol-use/alcohol-caffeine.html (Accessed 9 December 2025). Chen, Y., et al. (2024) ‘Consumption of sugary beverages and depression risk considering genetic predisposition’, General Psychiatry, 37(4), e101446. Chawla, J., et al. (2024) ‘Optimising sleep in adolescents: the challenges’, Australian Journal of General Practice, June issue. Culm‑Merdek, K.E., et al. (2005) ‘Fluvoxamine impairs single‑dose caffeine clearance without affecting caffeine disposition’, British Journal of Clinical Pharmacology, 60(5), pp. 486–493. Drake, C., Roehrs, T., Shambroom, J., and Roth, T. (2013) ‘Caffeine effects on sleep taken 0, 3, or 6 hours before bedtime’, Journal of Clinical Sleep Medicine, 9(11), pp. 1195–1200. EFSA NDA Panel (2015) ‘Scientific opinion on the safety of caffeine’, EFSA Journal, 13(5), 4102. FSANZ (Food Standards Australia New Zealand) (2023) ‘Caffeine’. Available at: https://www.foodstandards.gov.au/consumer/prevention-of-foodborne-illness/caffeine (Accessed 9 December 2025). FSANZ (2025) ‘Proposal P1056: Caffeine review—second call for submissions’. Canberra: FSANZ. Hernandez‑Huerta, D., et al. (2017) ‘Psychopathology related to energy drinks: a psychosis case report’, Case Reports in Psychiatry, Article ID 7923036. Kim, H., et al. (2020) ‘Association between energy drink consumption and depression and suicide ideation in adolescents’, International Journal of Social Psychiatry, 66(6), pp. 557–565. Knüppel, A., Shipley, M.J., Llewellyn, C.H., and Brunner, E.J. (2017) ‘Sugar intake from sweet food and beverages and common mental disorder and depression’, Scientific Reports, 7, 6287. Low, C.E., et al. (2025) ‘Association of coffee and energy drink intake with suicide attempts and suicide ideation: a systematic review and meta‑analysis’, Journal of Affective Disorders Reports. Lucas, C. (2013) ‘Smoking and drug interactions’, Australian Prescriber, 36(3), pp. 102–104. Marczinski, C.A. (2014) ‘Energy drinks mixed with alcohol: what are the risks?’, Nutrition Reviews, 72(S1), pp. 98–107. Mannix, D., Mulholland, K., and Byrne, F. (2024) ‘Caffeine‑induced psychosis: a case report and review of literature’, Cureus, 16(8), eXXXXX. NPS MedicineWise (2024) ‘Fluvoxamine—consumer medicine information’. Available at: https://www.nps.org.au/(Accessed 9 December 2025). Nuss, T., Morley, B., Scully, M., and Wakefield, M. (2021) ‘Energy drink consumption among Australian adolescents associated with unhealthy dietary behaviours and short sleep duration’, Nutrition Journal, 20, 64. Owens, J.A., Mindell, J., and Baylor, A. (2014) ‘Effect of energy drink and caffeinated beverage consumption on sleep, mood and performance in children and adolescents’, Nutrition Reviews, 72(S1), pp. 65–71. Park, S., Lee,

  Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 08/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. In Australia, most people access a psychologist via a GP referral and Mental Health Treatment Plan (MHTP) under Better Access. The GP assesses needs, creates a plan and refers you for an initial course of sessions, with a mid‑course GP review before further sessions. You pay the fee and claim a Medicare rebate (a portion of the fee); some clinics bulk‑bill or offer reduced fees. Alternatives include private/self‑referral, NDIS, WorkCover, DVA, EAP, and Victims of Crime pathways. Telehealth is widely available when clinically appropriate. Your progress should be tracked with brief outcome measures and a clear plan. Step‑by‑step: how a psychology referral usually works 1) Recognise a need and book your GP Typical signs include persistent low mood, anxiety, sleep problems, or functioning changes at work/study/relationships. Bring notes about symptoms, duration, impacts, medications, and any risk (e.g., thoughts of self‑harm). 2) The GP assessment and Mental Health Treatment Plan (MHTP) Your GP takes a history, rules out medical contributors (e.g., thyroid, sleep apnoea, medication side‑effects), discusses goals, and may use brief tools such as K10, PHQ‑9, or GAD‑7. With your consent, they create a care plan outlining presenting problems, goals, initial session allocation, and referral to a registered or clinical psychologist. What to check on the referral letter Your full name/DOB and address GP details and provider number Named psychologist/service (or open referral) Diagnosis or problem description, goals, and number of sessions in the first block Date and signatureBring a copy to your first session; clinics also accept secure e‑referrals. 3) Booking your first appointment Choose in‑person or Telehealth (video/phone), ensuring privacy. Ask about fees, gap, concession rates, and whether the clinic can process your Medicare claim on the day. If the psychologist is not a fit, you can change providers—you don’t need a new plan; ask the GP to re‑address the referral. 4) First three sessions: goals, plan and skills A good start includes: Collaborative goals linked to day‑to‑day functioning A treatment approach matched to your needs (e.g., CBT, ACT, exposure, CBT‑I, IPT, DBT skills) Measurement‑based care (brief questionnaires each 1–2 sessions) to track change Home practice between sessionsEarly improvement by sessions 3–6 is a positive prognostic sign. 5) Mid‑course GP review When you complete the first session block, your psychologist sends a brief progress report (goals, measures, response, risks, recommendations). The GP reviews and, if appropriate, continues the plan for the next block. 6) Aftercare and relapse‑prevention As symptoms improve, sessions taper. You consolidate skills, set relapse‑prevention plans, and agree on signs it’s time for a booster session. Paying for care: Medicare, private health, and other funders Medicare (Better Access) Available with an eligible GP, psychiatrist or paediatrician referral and a valid MHTP. Rebates differ for general vs clinical psychologists and may adjust over time. You may owe a gap if the clinic’s fee exceeds the rebate; ask for fee transparency, concession rates, or bulk‑billing policies. Telehealth video/phone is generally eligible when clinically appropriate and when Medicare criteria are met. Keep all invoices for tax and private insurance claims. Private/self‑referral You can see a psychologist without a referral and self‑fund. This suits those wanting greater privacy from GP records or seeking modalities/frequency outside Medicare parameters. NDIS If you (or your child) are an NDIS participant, therapy can be funded where goals and functional needs support it (e.g., psychology, behaviour support, social skills). Speak with your planner/support coordinator about capacity building budgets and whether you need a report from your psychologist. Workers’ compensation / WorkCover and DVA If your difficulties relate to work injury or service, referrals often come from your GP, insurer, employer, or DVA. Your psychologist will usually complete a treatment plan aligned with scheme requirements. EAP and Victims of Crime Employer Assistance Programs (EAP) offer short‑term counselling, usually pre‑authorised by your employer. Victims of Crime schemes (state‑based) may fund therapy following eligible incidents. Choosing the right psychologist (and getting a good fit) Registration & scope: All psychologists are AHPRA‑registered; clinical psychologists have additional endorsed training. Choose experience matching your presenting problems. Approach & methods: Ask how they treat your condition and how progress is measured. Accessibility: Telehealth or home visits (where available), language needs, disability access. Cultural safety: Preference for culturally informed, LGBTQIA+‑affirming, or neuro‑affirming practice. Allied care: Will they liaise (with your consent) with your GP/psychiatrist/school/NDIS team? What good therapy looks like (the science in brief) Evidence‑based methods (e.g., CBT/BA for depression, exposure for anxiety, CBT‑I for insomnia, IPT for interpersonal issues) are supported by multiple meta‑analyses. Working alliance—agreement on goals and tasks with a positive bond—predicts outcome across therapies. Measurement‑based care (routine outcome monitoring) improves outcomes and reduces drop‑out by prompting timely course‑corrections. Common measures: PHQ‑9 (depression), GAD‑7 (anxiety), K10 (general distress), CORE‑10 (broad symptoms). Bring graphs to your GP review—this speeds decisions about extending your plan. Telehealth and privacy Telehealth can be as effective as in‑person when sessions are structured and private. Use headphones, a quiet space, and stable internet. Your psychologist will explain informed consent, limits to confidentiality, secure record‑keeping, and what to do if technology fails mid‑session. Costs, rebates and the ‘gap’—how to plan Ask for a written quote: fee, expected rebate, out‑of‑pocket amount, cancellation policy, report fees, and letters/forms. If finances are tight, ask about bulk‑billing, concessions, payment plans, or fewer, longer sessions with between‑session check‑ins. Keep an expenses log for tax and safety‑net thresholds. Quick checklist before your first session  GP referral letter + MHTP (or self‑referral notes)  Medication list and relevant reports  Two goals linked to daily life (e.g.,return to full work days; sleep ≥7 hours 4 nights/week)  Outcome baseline: PHQ‑9, GAD‑7, K10 or CORE‑10  Logistics: Telehealth vs in‑person, fee, rebate, transport/parking  Questions for your psychologist (see below) Questions to ask “How will we measure whether therapy is working?” “What does a typical session look like after the first one?” “How many sessions do people like me usually need?” “What will I practise between sessions?” Frequently asked questions Do I always need a GP referral?No. You can self‑refer privately. A GP referral and plan are needed to claim Medicare rebates under Better Access. What if I don’t click with the psychologist?It’s fine to switch. Ask your GP to re‑address the referral; you don’t need a new plan unless it has expired. How many sessions will I need?Many people notice change by sessions 3–6; simple problems may resolve within 8–12. Complex or chronic concerns can take longer. Can I use Telehealth?In most cases yes, subject to clinical suitability and meeting Medicare criteria when claiming rebates. Can a psychologist write to my school or employer?Only with your consent (or as required by law for safety). Many clients benefit when clinicians liaise with schools/NDIS/GPs. How Therapy Near Me can help Telehealth psychology Australia‑wide and home visits in select locations. Support with anxiety, depression, trauma, insomnia,

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 07/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. Envy is a two‑person emotion (I want what you have). Jealousy is a three‑person emotion (I fear losing someone to a rival) (Parrott & Smith, 1993; Smith & Kim, 2007). Envy comes in two flavours: benign envy can motivate self‑improvement, while malicious envy fuels pull‑down behaviours (Van de Ven, Zeelenberg & Pieters, 2009; Lange & Crusius, 2015). Jealousy ranges from normal/episodic to problematic, shaped by attachment style, communication, and relationship norms (Pfeiffer & Wong, 1989; White & Mullen, 1989). Both emotions intensify with social comparison (especially online) and improve with reappraisal, skills practice, and clear conversations(Gross & John, 2003; Kross et al., 2013; Verduyn et al., 2015). Envy vs jealousy at a glance Feature Envy Jealousy Social structure Dyadic: me ↔️ other person Triadic: me ↔️ partner ↔️ rival Core appraisal Another has a desired advantage (status, looks, role, achievement) Threat of loss/exclusion from a valued relationship Typical feelings Pain at gap; resentment; admiration (benign envy) Anxiety, anger, sadness; vigilance; urge to protect Motivation Level up (benign) or pull down the other (malicious) Protect / regain attention, affection, status in the relationship Common triggers Promotions, awards, lifestyle posts, body image Flirting, secrecy, reduced responsiveness, boundary breaches Helpful response Goal focus, learning, gratitude, limit comparisons Clarify agreements, communicate needs, build security, repair (Smith & Kim, 2007; Parrott & Smith, 1993; Van de Ven et al., 2009; Pfeiffer & Wong, 1989.) The psychology in brief Social media, status and the comparison trap Frequent upward comparison online predicts lower subjective wellbeing, with envy mediating the effect in several studies (Kross et al., 2013; Verduyn et al., 2015). Curated feeds exaggerate other people’s wins, priming either benign envy (inspiration) or malicious envy (resentment). Reduce exposure to toxic comparison loops and follow accounts that spark learning, not longing. Is jealousy always bad? No. Mild, episodic jealousy can flag attachment needs and prompt boundary setting or reassurance. But chronic or controlling jealousy—surveillance, accusations, isolation—erodes trust and may indicate coercive control or past trauma that needs professional support (White & Mullen, 1989; Harris, 2003). If safety is a concern, seek specialised help. Self‑check: which emotion is this? Ask: Use brief measures to track patterns: the Dispositional Envy Scale (Smith et al., 1999) and Multidimensional Jealousy Scale (Pfeiffer & Wong, 1989) are commonly used in research. Evidence‑based ways to cope If it’s envy If it’s jealousy When envy turns toxic (malicious envy) Warning signs: schadenfreude, derogating rivals, sabotaging, or chronic bitterness. Countermoves: When jealousy needs more than self‑help Seek professional support if you notice: A 14‑day reset plan FAQs Is envy the same as admiration?No. Admiration lacks the pain of upward comparison. Benign envy includes discomfort but channels it into self‑improvement (Van de Ven et al., 2009). Is jealousy proof the relationship is wrong?Not necessarily. Occasional jealousy is common. It becomes a problem when it drives control, isolation or aggression. Why do I feel worse after scrolling?Curated feeds intensify upward comparisons; envy mediates drops in wellbeing (Kross et al., 2013; Verduyn et al., 2015). Trim triggers and add learning‑focused content. Do men and women get jealous about different things?There are mixed findings. Some evolutionary studies report sex‑linked patterns; other work suggests individual differences (attachment, norms) explain more variance (Buss, 2000; Harris, 2003). Getting help (Australia) TherapyNearMe.com.au offers Telehealth psychology nationwide and home visits in select areas. Ask your GP about a Mental Health Treatment Plan for Medicare rebates, or discuss NDIS where appropriate. Call 1800 NEAR ME. References Ben‑Ze’ev, A. (2000) The Subtlety of Emotions. Cambridge, MA: MIT Press. Buss, D.M. (2000) The Dangerous Passion: Why Jealousy Is as Necessary as Love and Sex. New York: Free Press. Cusack, K., Jonas, D.E., Forneris, C.A., Wines, C., Sonis, J., Middleton, J.C. et al. (2016) ‘Psychological treatments for adults with PTSD: a systematic review and meta‑analysis’, Annals of Internal Medicine, 165(12), pp. 757–767. Dweck, C.S. (2006) Mindset: The New Psychology of Success. New York: Random House. Gross, J.J. & John, O.P. (2003) ‘Individual differences in two emotion regulation processes: Implications for affect, relationships, and well‑being’, Journal of Personality and Social Psychology, 85(2), pp. 348–362. Harris, C.R. (2003) ‘A review of sex differences in sexual jealousy, including self‑report data, psychophysiological responses, interpersonal violence, and morbid jealousy’, Personality and Social Psychology Review, 7(2), pp. 102–128. Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T. & Fang, A. (2012) ‘The efficacy of cognitive behavioral therapy: a review of meta‑analyses’, Cognitive Therapy and Research, 36(5), pp. 427–440. Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D.S., Lin, N. et al. (2013) ‘Facebook use predicts declines in subjective wellbeing in young adults’, PLoS ONE, 8(8), e69841. Lange, J. & Crusius, J. (2015) ‘Dispositional envy revisited: Unraveling the subtypes of envy’, Personality and Social Psychology Bulletin, 41(2), pp. 284–294. Parrott, W.G. & Smith, R.H. (1993) ‘Distinguishing the experiences of envy and jealousy’, Journal of Personality and Social Psychology, 64(6), pp. 906–920. Pfeiffer, S.M. & Wong, P.T.P. (1989) ‘Multidimensional jealousy’, Journal of Social and Personal Relationships, 6(2), pp. 181–196. Salovey, P. (ed.) (1991) The Psychology of Jealousy and Envy. New York: Guilford. Smith, R.H., Kim, S.H. (2007) ‘Comprehending envy’, Psychological Bulletin, 133(1), pp. 46–64. Smith, R.H., Parrott, W.G., Diener, E.F., Hoyle, R.H. & Kim, S.H. (1999) ‘Dispositional envy’, Personality and Social Psychology Bulletin, 25(8), pp. 1007–1020. Takahashi, H., Kato, M., Matsuura, M., Mobbs, D., Suhara, T. & Okubo, Y. (2009) ‘When your gain is my pain and your pain is my gain: Neural correlates of envy and schadenfreude’, Science, 323(5916), pp. 937–939. Van de Ven, N., Zeelenberg, M. & Pieters, R. (2009) ‘Leveling up and down: The experiences of benign and malicious envy’, Emotion, 9(3), pp. 419–429. Verduyn, P., Ybarra, O., Résibois, M., Jonides, J. & Kross, E. (2015) ‘Do social network sites enhance or undermine subjective well‑being? A critical review’, Social Issues and Policy Review, 9(1), pp. 274–302. White, G.L. & Mullen, P.E. (1989) Jealousy: Theory, Research, and Clinical Strategies. New York: Guilford. For confidential appointments with a registered psychologist, visit TherapyNearMe.com.au or call 1800 NEAR ME. We provide individual and couples therapy via Telehealth Australia‑wide and home visits in select areas.

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 06/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. A WorkCover (workers’ compensation) psychology claim supports treatment and safe return‑to‑work (RTW) after a work‑related psychological injury such as adjustment disorder, PTSD, depression or anxiety. The usual pathway is: report the injury → see your GP for assessment and a certificate of capacity → lodge a claim with your employer/insurer → get referred to a registered psychologist (Telehealth or in‑person) → agree on functional goals, a treatment plan (e.g., CBT/trauma‑focused therapy), and measurement‑based care → coordinate with your employeron a graded RTW plan → review progress at set intervals (WorkSafe Victoria, 2012; Horvath & Greenberg, 1989; de Jong et al., 2014). Early, work‑focused therapy improves symptoms and speeds RTW (Lagerveld et al., 2012; Joyce et al., 2016). What counts as a psychological injury? Australian schemes recognise mental injuries arising out of or in the course of employment (jurisdictional wording varies). Common diagnoses include acute stress reaction, PTSD, adjustment disorder, depression, generalised anxiety, and panic (APA, 2013). Many laws exclude “reasonable management action carried out in a reasonable way” from compensable causes—seek jurisdiction‑specific advice (Safe Work Australia, 2023). Red flags requiring urgent help: escalating suicidal ideation, violence, severe substance use, or acute trauma reactions. Call 000 in emergencies. How the WorkCover psychology pathway usually unfolds 1) Report and document Tell your employer as soon as practicable and complete an incident report. Keep your own notes (dates, people involved, impacts on sleep/work). Early reporting helps with claim decisions (Safe Work Australia, 2023). 2) See your GP and obtain a certificate of capacity Your GP assesses symptoms, rules out medical contributors (e.g., thyroid, sleep apnoea, medications) and records capacity for work (full, modified, or none). The certificate accompanies your claim and guides RTW planning. Brief outcome tools such as K10, PHQ‑9 and GAD‑7 are often used at baseline (Kessler et al., 2002; Kroenke, Spitzer & Williams, 2001; Spitzer et al., 2006). 3) Lodge your claim Claims are made to the employer’s insurer (state/territory schemes differ: WorkSafe Victoria, icare/SIRA NSW, WorkCover Queensland, ReturnToWorkSA, WorkCover WA, Comcare for some Commonwealth workplaces, NT WorkSafe, WorkSafe ACT). An insurer case manager will contact you for details and may request information from your GP. 4) Triage and referral to a psychologist With claim acceptance (or pending approval if pre‑authorised), your GP or the insurer can refer you to a registered psychologist. Choose a provider with occupational mental health experience and evidence‑based methods (CBT, exposure, trauma‑focused CBT/EMDR, ACT, problem‑solving), and who practises measurement‑based care(Hofmann et al., 2012; Cusack et al., 2016; de Jong et al., 2014). 5) First 3–6 sessions: assessment, goals and treatment plan A strong start includes: 6) Coordination and case conferencing Your psychologist (with your consent) can case‑conference with your GP, employer and the insurer to align duties, hours and supports. A graded RTW plan uses principles of activity pacing, graded exposure to feared tasks/locations, and problem‑solving for barriers (Lagerveld et al., 2012; D’Zurilla & Goldfried, 1971). 7) Reviews and independent opinions Insurers may request progress reports or an Independent Medical Examination (IME) for an external opinion. Keep your treatment goals and measures up to date—clear evidence of change helps decision‑making (de Jong et al., 2014). What does therapy involve? (evidence in brief) Your rights and responsibilities (plain English) Funding, fees and practicalities A 6‑point checklist for a strong WorkCover psychology plan Frequently asked questions Do I need a GP referral?Yes—your GP certificate of capacity and referral typically initiate psychological treatment under WorkCover. Can I change psychologists?Usually yes. Ask your insurer to re‑address the approval if needed. What if work is the trigger—do I have to go back?The goal is safe, suitable duties aligned with your capacity. Graded exposure to the least triggering tasks/site may be used while protecting safety. Decisions are individual and clinician‑guided. Will Telehealth be approved?Often yes when clinically appropriate and in line with scheme rules. Outcomes are generally non‑inferior to in‑person care (Backhaus et al., 2012; Norwood et al., 2018). What if my claim is denied?You may access care privately (e.g., Medicare/Better Access) while you seek a review. Get advice on your jurisdiction’s dispute process. How Therapy Near Me can help Book online or call 1800 NEAR ME. References American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: APA. Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131. Barkham, M., Bewick, B.M., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor‑Clark, J., Richards, D. & Evans, C. (2013) ‘The CORE‑10: A short measure of psychological distress for routine use’, Psychological Assessment, 25(4), pp. 1243–1254. Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944. Cusack, K., Jonas, D.E., Forneris, C.A., Wines, C., Sonis, J., Middleton, J.C. et al. (2016) ‘Psychological treatments for adults with PTSD: a systematic review and meta‑analysis’, Annals of Internal Medicine, 165(12), pp. 757–767. de Jong, K., Conijn, J.M., Gallagher‑Thompson, D., Mackin, R.S. & Aartjan Beekman, A.T.F. (2014) ‘The effectiveness of routine outcome monitoring: A meta‑analysis of individual participant data’, Psychotherapy, 51(4), pp. 501–515. Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D. & Gilbody, S. (2014) ‘Behavioural activation for depression: an updated meta‑analysis of effectiveness’, PLoS ONE, 9(6), e100100. Flückiger, C., Del Re, A.C., Wampold, B.E. & Horvath, A.O. (2018) ‘The alliance in adult psychotherapy: A meta‑analytic synthesis’, Psychotherapy, 55(4), pp. 316–340. Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T. & Fang, A. (2012) ‘The efficacy of cognitive behavioral therapy: a review of meta‑analyses’, Cognitive Therapy and Research, 36(5), pp. 427–440. Horvath, A.O. & Greenberg, L.S. (1989) ‘Development and validation of the Working Alliance Inventory’, Journal of Counseling Psychology, 36(2), pp. 223–233. Joyce, S., Modini, M., Christensen, H., Mykletun, A., Bryant, R., Mitchell, P.B. & Harvey, S.B. (2016) ‘Work‑focused interventions for common mental disorders: A systematic review and meta‑analysis’, Journal of Occupational and Environmental Medicine, 58(2), pp. 115–126. Kessler, R.C., Andrews, G., Colpe, L.J., Hiripi, E., Mroczek, D.K., Normand, S.L. et al. (2002) ‘Short screening scales to monitor population prevalences and trends in non‑specific psychological distress’, Psychological Medicine, 32(6), pp. 959–976. Lagerveld, S.E., Blonk, R.W.B., Brenninkmeijer, V., Wijngaards‑de Meij, L.D.N. & Schaufeli, W.B. (2012) ‘Work‑focused cognitive‑behavioural therapy and return to work in common mental disorders: A randomised clinical trial’, Occupational and Environmental Medicine, 69(12), pp. 857–863. Norton, P.J. & Price, E.C. (2007) ‘A meta‑analytic review of adult CBT outcomes across the anxiety disorders’, Journal of Nervous and Mental Disease,

To keep up with demand across Australia, Therapy Near Me has welcomed two highly experienced psychologists to our team: Psychologist Alyson Dunn and Psychologist Dr Ross Leembruggen. Both are: • Registered with Medicare and able to offer Medicare rebates for eligible referrals• Experienced working with NDIS participants (psychosocial disability, functional impact, complex needs)• Available immediately for new clients via telehealth• Able to support GPs, psychiatrists, support coordinators and plan managers who are seeking reliable, evidence-based care for their clients In addition, Alyson is available for home visits around the Gold Coast region available in Newcastle and the Hunter region, alongside their national telehealth work. Why These Psychologists Strengthen Our Clinical Quality (E-E-A-T in Practice) People want mental health information and services provided by clinicians with clear Experience, Expertise, Authority and Trustworthiness (E-E-A-T). These two appointments directly support that: • Deep experience: Both psychologists have long histories in frontline roles dealing with complex presentations, risk and crisis work, and multidisciplinary teams.• Recognised expertise: They are AHPRA-registered, endorsed as Board-Approved Supervisors, and trained in multiple evidence-based modalities.• Authority: Both hold key provider registrations (Medicare, NDIS and other schemes), professional memberships and specialist training in trauma, EMDR, clinical hypnosis and advanced therapies.• Trust: Their careers show long-term work in education, Defence, corrections, multi-site practices and community settings where safety, ethics and confidentiality are non-negotiable. Psychologist Alyson Dunn – Gold Coast & Telehealth Psychologist, Medicare & NDIS Key Points at a Glance • Location: Based near the NSW/QLD border; available for home visits around the Gold Coast and telehealth Australia-wide• Experience: 15+ years in counselling and psychology roles in TAFE, headspace, private practice and community services• Registration & providers:◦ AHPRA general registration◦ Psychology Board-Approved Supervisor◦ Registered Medicare provider◦ Works with NDIS participants (self-managed and plan-managed)• Immediate availability: Accepting new Medicare and NDIS clients now• Supervision: Offers Board-approved supervision psychologists Clinical Expertise and Approach Alyson holds a Bachelor of Science (Psychology), Bachelor of Arts (Anthropology) and a Postgraduate Diploma in Psychology. She has developed a strong reputation as a trauma-informed, compassionate and organised clinician who can safely manage complex presentations in both education and private practice settings. Her practice is guided by modern, evidence-based therapies, including: • Cognitive Behaviour Therapy (CBT)• Acceptance and Commitment Therapy (ACT)• Dialectical Behaviour Therapy (DBT)• Schema Therapy• Attachment-informed approaches• Brief, solution-focused interventions She has completed specialist training in: • Intensive trauma and stabilisation• DBT and Schema Therapy• Compassion-focussed and mindful self-compassion approaches• Eating disorder identification and intervention• Mental Health First Aid, suicide risk assessment and safety planning This combination of training and experience means that Alyson is particularly well suited for clients who need structured therapy, but also want someone warm and down-to-earth who can adapt to real-world pressures (study, work, parenting, financial stress, carers’ responsibilities, etc.). Who Alyson Works With Alyson provides telehealth and home visit psychology for: • Adolescents and adults experiencing anxiety, depression, stress and burnout• People recovering from trauma and adverse childhood experiences• Clients dealing with substance use, self-harm and suicidality (with clear safety planning)• Individuals and carers seeking support with grief, loss and relationship issues• Students and workers navigating study stress, career changes and workplace conflict She also brings extensive experience in crisis intervention, risk assessment, incident management and postvention, which strengthens the safety and clinical governance of our team. Supervision for Provisional Psychologists For provisional psychologists and early-career clinicians, Alyson provides Board-approved supervision and mentoring, informed by years of leadership as a Senior Counsellor and crisis team lead. This makes her an excellent contact for: • 4+2 and 5+1 provisional psychologists seeking a primary or secondary supervisor• Early-career clinicians wanting regular case consultation and skills development• Organisations needing supervision for staff in education, community or youth mental health settings Psychologist Dr Ross Leembruggen – Newcastle & Telehealth Clinical Lead, Medicare & NDIS Key Points at a Glance • Location: Based in Newcastle / Hunter region, seeing clients locally and via telehealth Australia-wide• Experience: Over 25 years as a psychologist and executive leader in Defence, corrections, private practice and multi-site services• Qualifications:◦ Master of Clinical Psychology (Post-Registration) (Cairnmillar Institute)◦ Doctor of Business Administration, Master of Business, Master of Innovation Management and Entrepreneurship◦ Postgraduate Diploma in Clinical Hypnosis, BA (Psychology) (Hons)• Registrations & providers:◦ AHPRA psychologist◦ AHPRA Board-Approved Clinical Supervisor◦ Medicare and National Disability Insurance Scheme (NDIS) provider◦ DVA, WorkCover, Open Arms, NSW Victims Services, TAC and others• Immediate availability: Accepting new Medicare and NDIS referrals Clinical Expertise and Leadership Ross has held senior roles including: • Principal Psychologist at XR Health• Senior Psychologist with the Royal Australian Navy and Royal Australian Air Force• Principal Psychologist at Hunter Psychological Services• Managing Director of his own multi-site practice, AusPsych His work spans: • Telehealth and virtual reality / augmented reality (VR/AR) therapy through XR Health• Trauma, critical incident response and high-risk work contexts• Performance and executive coaching for leaders, aircrew and special forces personnel• System-level quality improvement, innovation and service development, including building a start-up practice into a multi-million-dollar organisation with ten locations and 35 staff. He is accredited in a wide range of specialist tools and modalities, including Who Ross Works With Ross is particularly suited to: • Veterans, serving members and first responders seeking a psychologist who understands Defence and high-risk roles• Adults experiencing PTSD, complex trauma, moral injury, anxiety and depression• Professionals and executives wanting performance enhancement, mindset coaching and leadership support• NDIS participants requiring structured assessment and therapy for psychosocial disability and functional impairment He provides care via telehealth (including VR/AR where clinically indicated) and can see local clients in Newcastle and the Hunter region. Supervision and Clinical Governance As a Board-Approved Clinical Supervisor, Ross offers: • Supervision for intern and registered psychologists• Support for clinicians working with trauma, Defence/veteran populations and complex mental health• Training, workshops and input into service-wide clinical governance and quality improvement His presence at Therapy Near Me enhances our clinical leadership, supervision structure and innovation in digital mental health. How to Book With Alyson or Ross If you’re searching for a Medicare or NDIS psychologist, a telehealth

  If you’re at risk of harm, call 000. 24/7 help: National Gambling Helpline 1800 858 858 and Gambling Help Online (chat). You can also contact Lifeline 13 11 14 or 13YARN (for Aboriginal and Torres Strait Islander peoples). This article is general information only. Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 04/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. Gambling addiction (DSM‑5 gambling disorder) develops when fast, continuous games (e.g., pokies/slots, in‑play bets) pair unpredictable rewards with powerful sensory cues, training the brain’s dopamine‑based reward system to over‑value betting and under‑value long‑term goals (Schultz, 1997; Linnet et al., 2012). Cognitive distortions (e.g., gambler’s fallacy, illusion of control, near‑miss effects and losses disguised as wins) keep people betting (Tversky & Kahneman, 1974; Langer, 1975; Clark et al., 2009; Dixon et al., 2010). Effective help includes CBT with exposure/response prevention for urges, motivational interviewing, financial safeguards, self‑exclusion, and in some cases medication such as naltrexone (Cowlishaw et al., 2012; Ladouceur et al., 2001; Grant et al., 2008). Recovery is realistic with structured support, skills practice, and harm‑minimisation. What is gambling disorder? Gambling disorder is a persistent, recurrent pattern of gambling leading to clinically significant impairment or distress. Criteria include preoccupation, tolerance, chasing losses, withdrawal‑like irritability, repeated failed cut‑downs, lying, jeopardised relationships/work, and reliance on others for money (American Psychiatric Association, 2013). ICD‑11 recognises disordered gambling with similar features, classed among addictive behaviours (WHO, 2019). Not just ‘poor willpower’: genetics, temperament (e.g., impulsivity), mental‑health comorbidities (depression, anxiety, ADHD, substance use), early wins, trauma, and easy access raise risk (Slutske et al., 2010; Lorains, Cowlishaw & Thomas, 2011). Why it hooks the brain: three interacting systems 1) Learning & dopamine (reward prediction error) Random‑ratio (variable‑ratio) reward schedules pay out unpredictably; this produces large reward‑prediction‑error signals in the striatum, strengthening “bet again” learning (Ferster & Skinner, 1957; Schultz, 1997). Over time, cues(lights, sounds, app notifications) themselves trigger dopamine spikes and craving‑like states (Potenza, 2008; Wölfling et al., 2011). 2) Cognitive distortions Humans are prone to gambler’s fallacy (believing a win is “due”), hot‑hand beliefs, and illusion of control—especially when games include choices/buttons that feel skill‑like (Tversky & Kahneman, 1974; Gilovich, Vallone & Tversky, 1985; Langer, 1975). Near‑misses activate reward circuits and feel like “almost winning”, increasing persistence (Clark et al., 2009). On pokies, losses disguised as wins (LDWs)—where a winning jingle plays although you lost overall—drive over‑estimation of success (Dixon et al., 2010). 3) Decision control & stress With repetition, prefrontal control weakens; stress, sleep loss and alcohol further shift choices toward short‑term rewards (Leeman & Potenza, 2012). Smartphone betting adds 24/7 availability, micro‑betting, and personalised prompts that compress the bet‑decision‑reward loop (Gainsbury, 2015). Design features that increase risk Who is most at risk? Harms to watch for (beyond money) Quick self‑check & screening tools If you endorse several features, consider self‑exclusion, blocking tools and a clinical assessment. What works in treatment (evidence in brief) Psychological therapies Medications (always via GP/psychiatrist) Digital & Telehealth Harm‑minimisation you can put in place today For partners and families Australia: getting help A 30‑day starter plan FAQs Do I need to quit completely?Many benefit from abstinence, especially with fast, continuous products. Some work toward controlled gambling with strict limits; decide with a clinician. Why do I relapse after big wins?Big wins spike reward salience and shape memory. Plan If‑Then rules for wins (e.g., withdraw 80% immediately; stop for 48 hours). Is online betting more addictive?Risk is higher when products are fast, continuous and always available (Gainsbury, 2015). Will medication ‘switch off’ urges?No single pill works for everyone. Opioid antagonists can help some; they work best combined with CBT and safeguards (Grant et al., 2008). References American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: APA. Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131. Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944. Clark, L., Lawrence, A.J., Astley‑Jones, F. & Gray, N. (2009) ‘Gambling near‑misses enhance motivation to gamble and recruit win‑related brain circuitry’, Neuron, 61(3), pp. 481–490. Cowlishaw, S., Merkouris, S., Chapman, A. & Radermacher, H. (2012) ‘Psychological therapies for pathological and problem gambling’, Cochrane Database of Systematic Reviews, (11), CD008937. de Lisle, S.M., Dowling, N.A. & Allen, J.S. (2012) ‘Mindfulness and problem gambling treatment’, Journal of Gambling Studies, 28(2), pp. 335–354. Dixon, M.J., Harrigan, K.A., Sandhu, R., Collins, K. & Fugelsang, J.A. (2010) ‘Losses disguised as wins in modern multi‑line video slot machines’, Addiction, 105(10), pp. 1819–1824. Ferris, J. & Wynne, H. (2001) The Canadian Problem Gambling Index: Final Report. Ottawa: Canadian Centre on Substance Abuse. Ferster, C.B. & Skinner, B.F. (1957) Schedules of Reinforcement. New York: Appleton‑Century‑Crofts. Gainsbury, S. (2015) ‘Online gambling addiction: the relationship between internet gambling and disordered gambling’, Current Addiction Reports, 2(2), pp. 185–193. Gainsbury, S. & Blaszczynski, A. (2011) ‘Online self‑help for problem gamblers: An overview of evidence and policy issues’, Journal of Gambling Studies, 27(4), pp. 545–559. Gilovich, T., Vallone, R. & Tversky, A. (1985) ‘The hot hand in basketball: On the misperception of random sequences’, Cognitive Psychology, 17(3), pp. 295–314. Gooding, P. & Tarrier, N. (2009) ‘A systematic review and meta‑analysis of cognitive‑behavioural interventions for problem gambling’, Clinical Psychology Review, 29(2), pp. 123–138. Grant, J.E., Kim, S.W., Odlaug, B.L., Buchanan, S.N. & Potenza, M.N. (2008) ‘Pharmacological management of pathological gambling: an evidence‑based review’, CNS Drugs, 22(1), pp. 123–138. Grant, J.E., Kim, S.W. & Odlaug, B.L. (2007) ‘N‑acetyl cysteine, a glutamate modulator, in the treatment of pathological gambling: A pilot study’, Biological Psychiatry, 62(6), pp. 652–657. Harrigan, K. (2009) ‘Slot machine structural characteristics: A review of the literature and empirical research’, International Journal of Mental Health and Addiction, 7(1), pp. 29–40. Hodgins, D.C. & El‑Guebaly, N. (2004) ‘Natural and treatment‑assisted recovery from gambling problems: A comparison of resolved and active gamblers’, Addiction, 99(9), pp. 1182–1191. Johnson, E.E., Hamer, R.M., Nora, R.M., Tan, B., Eisenstein, N. & Englehart, C. (1997) ‘The Lie/Bet Questionnaire for screening pathological gamblers’, Psychological Reports, 80(1), pp. 83–88. Leeman, R.F. & Potenza, M.N. (2012) ‘Similarities and differences between pathological gambling and substance use disorders: A focus on impulsivity and compulsivity’, Psychopharmacology, 219(2), pp. 469–490. Ladouceur, R., Sylvain, C., Boutin, C. & Doucet, C. (2001) ‘Understanding and treating the pathological gambler’, Wiley Series in Clinical Psychology. Chichester: Wiley. Linnet, J., Møller, A., Peterson, E., Gjedde, A. & Doudet, D.J. (2012) ‘Dopamine release in ventral striatum during Iowa Gambling Task performance is associated with increased excitement in pathological gambling’, Addiction Biology, 17(5), pp. 913–922. Lorains, F.K., Cowlishaw, S. & Thomas, S.A. (2011) ‘Prevalence of comorbid disorders in problem and pathological gambling: A

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 03/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. Therapy is working when you see meaningful change in one or more of these areas: symptoms (less anxiety/low mood), functioning (sleep, study/work, relationships), skills (you use new tools between sessions) and alliance (you feel understood and have a shared plan). Research shows that using measurement‑based care (brief questionnaires every 1–2 sessions) improves outcomes and cuts drop‑out (Lambert, 2010; de Jong et al., 2014). Expect some change by sessions 3–6; early gains predict final outcomes, while ongoing plateau or deterioration signals the need to adjust the plan (Howard et al., 1986; Delgadillo et al., 2018). Telehealth is generally non‑inferior to in‑person when sessions are structured and private (Backhaus et al., 2012; Batastini et al., 2021). The four pillars of progress Rule of thumb: small but reliable improvement across 2–3 pillars by session 4–6 suggests you’re on track. What should improvement look like? (examples) Make it visible: simple tools that work (5–10 minutes) Use one symptom and one functioning/alliance measure: Cadence: complete before each session or every 1–2 sessions; plot the scores. Bring the chart to session. What counts as “real change”? (RCI & MCID, plain English) Don’t chase perfect numbers—consistent trend + life change beats one‑off score dips. How fast should I feel better? (expectations by approach) Dose–response: many clients show early response; diminishing returns after 12–20 sessions if goals are met (Howard et al., 1986). Complex presentations may need longer. Feedback‑informed & measurement‑based care (why it helps) Routinely sharing questionnaires with your clinician enables course‑corrections before problems entrench. Meta‑analyses show that feedback to therapists about not‑on‑track clients improves outcomes and reduces deterioration (Lambert, 2010; de Jong et al., 2014). In youth/family work, parent‑ and youth‑rated measures help align perspectives. What to ask your clinician: Signs therapy may not be working (yet) What to do (decision tree) Script to raise it: “Could we review my scores and goals? I’m not seeing the change I hoped for. I’d like us to decide on a 4‑week plan and specific home practices.” Does Telehealth change progress? Outcomes and working alliance are generally comparable to in‑person care when privacy is adequate and sessions are structured (Backhaus et al., 2012; Berryhill et al., 2019; Batastini et al., 2021; Norwood et al., 2018). Exposures can be coached in real‑world settings (home/work), which can accelerate gains for OCD/anxiety. Australia: funding, reviews and practicalities TherapyNearMe.com.au offers therapy nationwide and home visits in select areas. Call 1800 NEAR ME. A 30‑day progress plan you can start now FAQs How much improvement is “enough”?Aim for a reliable score drop plus a life impact (e.g., back to class, fewer sick days) and a sense you can self‑managesetbacks. What if scores bounce up after a good run?Relapse‑prevention is part of therapy. Review triggers; return to a brief booster if needed. Should I switch therapists?First, try an open conversation about fit and method. If misfit persists after a time‑limited plan (e.g., 4 weeks), switching can help (Swift & Greenberg, 2012). Can I do this if I have ADHD/autism?Yes—adapt pace, visuals, interests, and session length; many clients benefit from concrete goals and environmental supports. References Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131. Barkham, M., Bewick, B.M., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor‑Clark, J., Richards, D. & Evans, C. (2013) ‘The CORE‑10: A short measure of psychological distress for routine use’, Psychological Assessment, 25(4), pp. 1243–1254. Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944. Berryhill, M.B., Culmer, N., Williams, N., Halli‑Tierney, A., Betancourt, A., King, M., et al. (2019) ‘Videoconferencing psychotherapy and depression: a systematic review’, Telemedicine and e‑Health, 25(6), pp. 435–446. Cusack, K., Jonas, D.E., Forneris, C.A., Wines, C., Sonis, J., Middleton, J.C. et al. (2016) ‘Psychological treatments for adults with PTSD: a systematic review and meta‑analysis’, Annals of Internal Medicine, 165(12), pp. 757–767. de Jong, K., Conijn, J.M., Gallagher‑Thompson, D., Mackin, R.S. & Aartjan Beekman, A.T.F. (2014) ‘The effectiveness of routine outcome monitoring: A meta‑analysis of individual participant data’, Psychotherapy, 51(4), pp. 501–515. Delgadillo, J., Huey, D., Bennett, H. & McMillan, D. (2018) ‘Targeting improved outcomes in depression: A pragmatic cohort study of early change and treatment‑staging in routine practice’, Journal of Affective Disorders, 236, pp. 7–14. Duncan, B.L., Miller, S.D. & Sparks, J.A. (2003) The Heroic Client: A Revolutionary Way to Improve Effectiveness Through Client‑Directed, Outcome‑Informed Therapy. San Francisco: Jossey‑Bass. [Includes ORS/SRS development]. Ekers, D., Webster, L., Van Straten, A., Cuijpers, P., Richards, D. & Gilbody, S. (2014) ‘Behavioural activation for depression: an updated meta‑analysis of effectiveness’, PLoS ONE, 9(6), e100100. Flückiger, C., Del Re, A.C., Wampold, B.E. & Horvath, A.O. (2018) ‘The alliance in adult psychotherapy: A meta‑analytic synthesis’, Psychotherapy, 55(4), pp. 316–340. Hofmann, S.G., Asnaani, A., Vonk, I.J.J., Sawyer, A.T. & Fang, A. (2012) ‘The efficacy of cognitive behavioral therapy: a review of meta‑analyses’, Cognitive Therapy and Research, 36(5), pp. 427–440. Horvath, A.O. & Greenberg, L.S. (1989) ‘Development and validation of the Working Alliance Inventory’, Journal of Counseling Psychology, 36(2), pp. 223–233. Howard, K.I., Kopta, S.M., Krause, M.S. & Orlinsky, D.E. (1986) ‘The dose‑effect relationship in psychotherapy’, American Psychologist, 41(2), pp. 159–164. Jacobson, N.S. & Truax, P. (1991) ‘Clinical significance: A statistical approach to defining meaningful change in psychotherapy research’, Journal of Consulting and Clinical Psychology, 59(1), pp. 12–19. Kessler, R.C., Andrews, G., Colpe, L.J., Hiripi, E., Mroczek, D.K., Normand, S.L. et al. (2002) ‘Short screening scales to monitor population prevalences and trends in non‑specific psychological distress’, Psychological Medicine, 32(6), pp. 959–976. Kroenke, K., Spitzer, R.L. & Williams, J.B.W. (2001) ‘The PHQ‑9: validity of a brief depression severity measure’, Journal of General Internal Medicine, 16(9), pp. 606–613. Norton, P.J. & Price, E.C. (2007) ‘A meta‑analytic review of adult CBT outcomes across the anxiety disorders’, Journal of Nervous and Mental Disease, 195(6), pp. 521–531. Norwood, C., Moghaddam, N.G., Malins, S. & Sabin‑Farrell, R. (2018) ‘Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and meta‑analysis’, Clinical Psychology & Psychotherapy, 25(6), pp. 797–816. Olatunji, B.O., Davis, M.L., Powers, M.B. & Smits, J.A.J. (2013) ‘Cognitive behavioral therapy for obsessive–compulsive disorder: a meta‑analysis of treatment outcome and moderators’, Journal of Psychiatric Research, 47(1), pp. 33–41. Shadish, W.R. & Baldwin, S.A. (2003) ‘Meta‑analysis of marital and family therapy: an updated review’, Journal of Marital and Family Therapy, 29(4), pp. 547–570. Spitzer, R.L., Kroenke, K., Williams, J.B.W. & Löwe, B. (2006) ‘A brief

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 02/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. “Polygamy” (multiple spouses) is distinct from consensual non‑monogamy (CNM) such as polyamory (multiple, consensual, ongoing relationships). Psychology research shows that relationship quality depends less on structure and more on consent, equity, communication and safety practices. In consensual contexts, mental‑health and relationship‑satisfaction outcomes are often similar to monogamy (Conley et al., 2017; Moors et al., 2017). In coercive or highly unequal polygyny, women and children can face poorer wellbeing (Al‑Krenawi & Graham, 2006; 2013). Jealousy and stigma are common challenges; clear agreements, skills for emotion regulation, and sexual‑health plans help (Balzarini et al., 2017; Lehmiller, 2015). In Australia, polygamy is not legally recognised, while consensual non‑monogamy among adults is not criminalised; seek legal advice for family‑law implications. Definitions and why they matter Terminology matters because many older studies of “polygamy” examined coercive polygyny in patriarchal settings, whereas much contemporary CNM research studies consenting adults in WEIRD countries. Findings are not interchangeable (Conley et al., 2012). How common is it? Cross‑cultural data show that polygyny is or has been permitted in a majority of traditional societies, though often limited to a small portion of men (Murdock, 1967; White, 1988). In contemporary Western samples, 4–5% of adults report current CNM, and one in five have tried CNM at some point (Haupert et al., 2017; Rubin et al., 2014). Prevalence varies by age, orientation, and urbanisation. Why people choose multi‑partner arrangements Sociocultural and evolutionary lenses offer partial explanations: Relationship processes: jealousy, compersion and communication Skills that help: emotion‑regulation (reappraisal, mindfulness), assertive scripts, and structured problem‑solving(Gross & John, 2003; D’Zurilla & Goldfried, 1971). Mental‑health outcomes: what we know Sexual health and safety Children and family life Evidence is limited and context‑dependent: Ethics, law and cultural competence (Australia) A practical guide: thriving in multi‑partner settings (or deciding against it) Working with a psychologist (what to expect) FAQs Is jealousy proof that CNM won’t work for me?No. Jealousy is common; it can be managed with communication, reassurance and skills practice. Chronic, unmanageable jealousy may be a sign the structure isn’t right now (Balzarini et al., 2017). Is CNM always riskier for STIs?Risk depends on behaviour (barriers, testing, concurrency), not the label. Some CNM groups report more proactivesafer‑sex practices than secretly non‑monogamous individuals (Conley et al., 2012). Can children thrive with multiple adults?Yes, when homes are stable, resourced, low‑conflict and adults cooperate. Stigma and unclear rules can be challenges (Sheff, 2014). Can therapy be biased against CNM?Historically, yes. Choose a clinician experienced in CNM‑affirming practice; good therapy is values‑aligned and non‑judgemental (Conley et al., 2017). References Al‑Krenawi, A. (2013) Psychosocial Impact of Polygamy in the Middle East. New York: Springer. Al‑Krenawi, A. & Graham, J.R. (2006) ‘A comparison of family functioning, life and marital satisfaction, and mental health of women in polygamous and monogamous marriages’, International Journal of Social Psychiatry, 52(1), pp. 5–17. Al‑Krenawi, A. & Lightman, E.S. (2000) ‘Learning achievement, social adjustment, and family conflict among Bedouin‑Arab children from polygamous and monogamous families’, The Journal of Social Psychology, 140(3), pp. 345–355. Balzarini, R.N., Campbell, L., Kohut, T., Holmes, B.M., Lehmiller, J.J. & Harman, J.J. (2017) ‘Attachment and jealousy in consensually non‑monogamous relationships’, Journal of Social and Personal Relationships, 34(6), pp. 977–1005. Balzarini, R.N., Dhindsa, M., Kohut, T. & Campbell, L. (2021) ‘Compersion: Understanding positive feelings about a partner’s other relationships’, Archives of Sexual Behavior, 50(2), pp. 695–711. Conley, T.D., Matsick, J.L., Moors, A.C. & Ziegler, A. (2012) ‘Re‑examining monotropy: The mismeasurement of monogamy and the overlooked complexity of relationships’, The Journal of Sex Research, 49(1), pp. 51–69. Conley, T.D., Ziegler, A., Moors, A.C., Matsick, J.L. & Valentine, B. (2017) ‘A critical examination of popular assumptions about the benefits and outcomes of monogamous relationships’, Personality and Social Psychology Review, 21(2), pp. 126–152. D’Zurilla, T.J. & Goldfried, M.R. (1971) ‘Problem solving and behavior modification’, Journal of Abnormal Psychology, 78(1), pp. 107–126. Gross, J.J. & John, O.P. (2003) ‘Individual differences in two emotion regulation processes: Implications for affect, relationships, and well‑being’, Journal of Personality and Social Psychology, 85(2), pp. 348–362. Haupert, M.L., Gesselman, A.N., Moors, A.C., Fisher, H.E. & Garcia, J.R. (2017) ‘Prevalence of experiences with consensual nonmonogamous relationships: Findings from two national samples of single adults in the United States’, Journal of Sex & Marital Therapy, 43(5), pp. 424–440. Henrich, J., Boyd, R. & Richerson, P.J. (2012) ‘The puzzle of monogamous marriage’, Philosophical Transactions of the Royal Society B, 367(1589), pp. 657–669. Lehmiller, J.J. (2015) The Psychology of Human Sexuality (2nd ed.). Hoboken, NJ: Wiley. [See chapter on consensual non‑monogamy]. Mitchell, M.E., Bartholomew, K. & Cobb, R.J. (2014) ‘Need fulfillment in polyamorous relationships’, Journal of Sex Research, 51(3), pp. 329–339. Moors, A.C., Matsick, J.L., Ziegler, A. & Conley, T.D. (2017) ‘Stigma toward individuals engaged in consensual nonmonogamy: Robust and worthy of additional research’, The Journal of Sex Research, 54(2), pp. 146–167. Morris, M. & Kretzschmar, M. (1997) ‘Concurrent partnerships and the spread of HIV’, AIDS, 11(5), pp. 641–648. Murdock, G.P. (1967) ‘Ethnographic Atlas: A summary’, Ethnology, 6(2), pp. 109–236. Rodrigues, D., Lopes, D. & Paiva, A. (2017) ‘Sociosexuality, commitment, sexual jealousy, and relationship quality across different types of romantic relationships’, Journal of Sex Research, 54(5), pp. 1–15. Rubel, A.N. & Bogaert, A.F. (2015) ‘Consensual nonmonogamy: Psychological well‑being and relationship quality correlates’, Journal of Sex Research, 52(9), pp. 961–982. Rubin, J.D., Moors, A.C., Matsick, J.L., Ziegler, A. & Conley, T.D. (2014) ‘On the margins: Considering diversity among consensually non‑monogamous relationships’, Journal für Psychologie, 22(1), pp. 1–23. Sheff, E. (2010) ‘Strategies in polyamorous parenting’, Journal of GLBT Family Studies, 6(2), pp. 205–216. Sheff, E. (2014) The Polyamorists Next Door: Inside Multiple‑Partner Relationships and Families. Lanham, MD: Rowman & Littlefield. White, D.R. (1988) ‘Rethinking polygyny: Co‑wives, codes, and cultural systems’, Current Anthropology, 29(4), pp. 529–572. Keskin, D. (2019) ‘The effects of polygyny on women and children: A case from sub‑Saharan Africa’, Journal of Family Studies, 25(1), pp. 1–16. Matsick, J.L. & Rubin, J.D. (2018) ‘Bisexual prejudice and consensual non‑monogamy stigma: Evidence for overlapping experiences’, Psychology of Sexual Orientation and Gender Diversity, 5(2), pp. 132–141. General information only—does not replace legal or medical advice. TherapyNearMe.com.au does not publish testimonials in line with AHPRA guidance. For Telehealth bookings with a registered psychologist, visit TherapyNearMe.com.au or call 1800 NEAR ME.

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 01/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. Kids learn coping when adults model, coach and reinforce a small set of repeatable skills across everyday situations. The strongest evidence supports: What do we mean by “coping”? Coping is how children manage stressors—internally (feelings, thoughts) and outwardly (actions). Classic theory distinguishes problem‑focused (change the situation) and emotion‑focused (change the response) strategies (Lazarus & Folkman, 1984). Over‑reliance on avoidance and rumination is linked to poorer outcomes; reappraisal, problem‑solving and acceptance relate to better wellbeing (Aldao, Nolen‑Hoeksema & Schweizer, 2010). Goal for parents: help kids build a balanced toolkit and practise matching the strategy to the situation. The developmental lens (what’s realistic by age) Children develop at different speeds—adapt to language, attention span, and sensory needs. Core coping skills to teach (and how to coach them) 1) Calm‑body basics (for all ages) What: slow exhale‑focused breathing (4–6 breaths/min), muscle relaxation, 5‑senses grounding.Why: direct down‑shift of arousal; supports attention and learning (Gross & John, 2003).Coach: practise out of crisis for 60–90 seconds, 2–3×/day; pair with a cue (hand on belly). 2) Name it to tame it (emotions & thoughts) What: expand feeling words; connect body ↔ feeling ↔ thought; introduce cognitive reappraisal (“Could there be another way to see this?”).Why: better emotion knowledge predicts regulation and social outcomes (Eisenberg, Spinrad & Eggum, 2010).Coach: use books, faces charts; model your own reappraisal aloud. 3) The 5‑step problem‑solver 4) Bravery ladders for anxiety What: graded exposures from easy → hard (e.g., saying hello to a classmate → giving a short talk).Why: avoidance keeps fear alive; approach + repetition rewires learning (Kendall, 2013; Rapee et al., 2006).Coach: build a 8–10‑step ladder; rate fear (0–10); practise 3–5 times before moving up; pair with specific praise. 5) Mindful attention (short & often) What: 1–5 minute practices: noticing breath, sounds, or one object.Why: school‑based mindfulness shows small‑to‑moderate benefits for attention and stress (Zenner, Herrnleben‑Kurz & Walach, 2014).Coach: after school, before bed, or pre‑homework; keep it playful. 6) Sleep, movement and fuel Why: physical activity and good sleep buffer stress and improve mood and attention (Rodríguez‑Ayllón et al., 2019; Mindell & Owens, 2015).Coach: consistent bed/wake times; screens off 60 min before bed; daily outdoor play; water + balanced snacks. 7) Ask‑for‑help & friend skills What: identify safe adults; practise I‑statements and specific requests.Why: social support predicts resilience; assertiveness reduces conflict cycles (Masten, 2014).Coach: role‑play 1‑minute scripts; build a support map. 8) Gratitude & values in action What: brief gratitude journalling and kind acts.Why: linked to improved mood and peer relationships in youth (Froh, Sefick & Emmons, 2008).Coach: 3‑good‑things at dinner; weekly help‑someone plan. Parent moves that make coping stick When emotions run hot: quick de‑escalation Tackling common scenarios (step‑by‑step) Morning meltdowns (ages 6–9) Homework avoidance (ages 10–12) Social worry (teens) Sleep struggles What schools can do (and how to ask) When to get extra help (and where to start) Seek professional input if distress persists > 4–6 weeks, school refusal emerges, social withdrawal intensifies, or there are safety concerns. TherapyNearMe.com.au offers child‑focussed psychology nationwide and home visits in select areas. Call 1800 NEAR ME. A 30‑day starter plan Frequently asked questions Is distraction bad?Short‑term distraction can reduce overwhelm; it becomes unhelpful when it blocks approach and problem‑solving. What if my child refuses coping practice?Shrink the task to the first inch, use choice, and reinforce effort. Consider parent coaching (Triple P, PMT) (Sanders, 2012; Kazdin, 2008). Do coping apps help?Apps are supplements, not replacements. Look for therapist‑guided plans and keep practice brief and regular. References Aldao, A., Nolen‑Hoeksema, S. & Schweizer, S. (2010) ‘Emotion‑regulation strategies across psychopathology: A meta‑analytic review’, Clinical Psychology Review, 30(2), pp. 217–237. Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131. Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944. Compas, B.E., Jaser, S.S., Bettis, A.H., Watson, K.H., Gruhn, M.A., Dunbar, J.P., Williams, E.K. & Thigpen, J.C. (2017) ‘Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta‑analysis and narrative review’, Psychological Bulletin, 143(9), pp. 939–991. Dweck, C.S. (2006) Mindset: The New Psychology of Success. New York: Random House. D’Zurilla, T.J. & Goldfried, M.R. (1971) ‘Problem solving and behavior modification’, Journal of Abnormal Psychology, 78(1), pp. 107–126. Eisenberg, N., Spinrad, T.L. & Eggum, N.D. (2010) ‘Emotion‑related self‑regulation and its relation to children’s maladjustment’, Annual Review of Clinical Psychology, 6, pp. 495–525. Froh, J.J., Sefick, W.J. & Emmons, R.A. (2008) ‘Counting blessings in early adolescents: An experimental study of gratitude and subjective well‑being’, Journal of School Psychology, 46(2), pp. 213–233. Kazdin, A.E. (2008) Parent Management Training: Treatment for Oppositional, Aggressive, and Antisocial Behavior in Children and Adolescents. New York: Oxford University Press. Kendall, P.C. (2013) Coping Cat Parent and Therapist Manuals (latest ed.). Ardmore, PA: Workbook Publishing. Kliem, S., Kröger, C. & Kosfelder, J. (2010) ‘Dialectical behavior therapy for borderline personality disorder: A meta‑analysis using mixed‑effects modeling’, Journal of Consulting and Clinical Psychology, 78(6), pp. 936–951. Lazarus, R.S. & Folkman, S. (1984) Stress, Appraisal, and Coping. New York: Springer. Lebowitz, E.R., Marin, C., Martino, A., Shimshoni, Y., Fisher, P.H., Sanchez, A., Silverman, W.K. & Carpenter, A.L. (2019) ‘Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority trial of Supportive Parenting for Anxious Childhood Emotions (SPACE)’, Journal of the American Academy of Child & Adolescent Psychiatry, 59(3), pp. 362–372. Mindell, J.A. & Owens, J.A. (2015) A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. Masten, A.S. (2014) Ordinary Magic: Resilience in Development. New York: Guilford Press. Nezu, A.M., Nezu, C.M. & D’Zurilla, T.J. (2013) Problem‑Solving Therapy: A Positive Approach to Clinical Intervention (3rd ed.). New York: Springer. Rapee, R.M., Wignall, A., Spence, S.H., Cobham, V. & Lyneham, H.J. (2006) Helping Your Anxious Child: A Step-by-Step Guide (2nd ed.). Oakland, CA: New Harbinger. Rodríguez‑Ayllón, M., Cadenas‑Sanchez, C., Estévez‑López, F., Muñoz, N.E., Mora‑González, J., Michels, N., … & Esteban‑Cornejo, I. (2019) ‘Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality’, International Journal of Environmental Research and Public Health, 16(21), 4159. Sanders, M.R. (2012) ‘Development, evaluation, and multinational dissemination of the Triple P‐Positive Parenting Program’, Annual Review of Clinical Psychology, 8, pp. 345–379. Vygotsky, L.S. (1978) Mind in Society: The Development of Higher Psychological Processes. Cambridge, MA: Harvard University Press. Zenner, C., Herrnleben‑Kurz, S. & Walach, H. (2014) ‘Mindfulness‑based interventions in schools—a systematic

 Written by: Therapy Near Me Editorial Team Clinically reviewed by: qualified members of the Therapy Near Me clinical team Last updated: 01/12/2025 This article is intended as general information only and does not replace personalised medical or mental health advice. Learn more about our Editorial Policy. “Difficult” is not a diagnosis—it’s a pattern of behaviours (e.g., criticism, control, boundary violations, triangulation, stonewalling) that repeatedly harms wellbeing or blocks healthy problem‑solving. Evidence‑based tools include clear boundaries, assertive scripts, emotion‑regulation skills (e.g., reappraisal, DBT skills), and structured problem‑solving (Gross & John, 2003; Kliem, Kröger & Kosfelder, 2010; D’Zurilla & Goldfried, 1971; Aldao, Nolen‑Hoeksema & Schweizer, 2010). When substance use or serious mental illness is involved, family interventions(e.g., CRAFT, family psychoeducation) improve outcomes and reduce relapse (Roozen et al., 2010; Pharoah et al., 2010). If patterns involve coercive control or violence, prioritise safety and specialised support. What counts as “difficult”? Behaviour, not labels Common patterns: Focus on specific behaviours and impacts, not armchair diagnoses. This keeps conversations fair—and actionable. Why family conflict hits so hard (the science in brief) 60‑second self‑check In the past month, how often (Never / Sometimes / Often / Most days)… If you marked Often/Most days on ≥3 items, consider a structured plan below and seek professional support. Safety first: red flags that need a different response The playbook: tools that work (with scripts) 1) Boundaries that hold A boundary is what you will do to protect your limits—not a demand that others change. Use the IF—THEN—BECAUSE frame: “If the conversation becomes insulting, then I’ll end the call and we can try again tomorrow, because I want respectful discussions even when we disagree.” Tips: write your top 3 non‑negotiables; communicate once, calmly; follow through every time (Linehan‑informed skills; Kliem, Kröger & Kosfelder, 2010). 2) Assertive communication (DBT + NVC blend) Try DEAR MAN (Describe, Express, Assert, Reinforce; Mindful, Appear confident, Negotiate) with nonviolent communication tone (Rosenberg, 2003; Linehan model): 3) Regulate in the moment 4) Problem‑solving therapy (PST) Five steps: Define one problem → Brainstorm options → Weigh pros/cons → Choose & plan → Review (D’Zurilla & Goldfried, 1971; Nezu, Nezu & D’Zurilla, 2013).Use PST for practical issues (holidays, childcare, money); don’t use it to change personalities. 5) Motivational conversations for change‑resistant relatives Avoid persuasion. Use open questions, affirmations, reflections, summaries to evoke their reasons for change (Miller & Rollnick, 2013). MI shows small‑to‑moderate effects across behaviours (Lundahl et al., 2010). “On a scale of 0–10, how important is cutting back your drinking?” … “Why a 4 and not a 2?” 6) When substance use is involved: CRAFT Community Reinforcement Approach & Family Training teaches carers to reinforce sobriety‑compatible behaviours, improve communication and reduce enabling; it increases treatment entry and reduces use (Meyers & Wolfe, 2003; Roozen et al., 2010). 7) For serious mental illness: family psychoeducation Multi‑family or single‑family psychoeducation reduces relapse and rehospitalisation (Pharoah et al., 2010). NICE recommends family intervention for psychosis/schizophrenia (NICE, 2014). Special situations (with quick plays) Fix, contain or exit? A decision map If you choose no contact, write a one‑time, respectful note describing your limit; then stop explaining. A 30‑day plan you can start this week Getting professional help (Australia) TherapyNearMe.com.au offers therapy Australia‑wide. Call 1800 NEAR ME. References Aldao, A., Nolen‑Hoeksema, S. & Schweizer, S. (2010) ‘Emotion‑regulation strategies across psychopathology: A meta‑analytic review’, Clinical Psychology Review, 30(2), pp. 217–237. Backhaus, A., Agha, Z., Maglione, M.L., Repp, A., Ross, B., Zuest, D., Rice‑Thorp, N.M., Lohr, J. & Thorp, S.R. (2012) ‘Videoconferencing psychotherapy: A systematic review’, Psychological Services, 9(2), pp. 111–131. Batastini, A.B., Paprzycki, P., Jones, A.C. & MacLean, N. (2021) ‘Are videoconferenced mental and behavioral health services just as good as in‑person? A meta‑analysis of a fast‑growing practice’, Clinical Psychology Review, 83, 101944. Boss, P. (2006) Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss. New York: W.W. Norton. Butzlaff, R.L. & Hooley, J.M. (1998) ‘Expressed emotion and psychiatric relapse: A meta‑analysis’, Archives of General Psychiatry, 55(6), pp. 547–552. D’Zurilla, T.J. & Goldfried, M.R. (1971) ‘Problem solving and behavior modification’, Journal of Abnormal Psychology, 78(1), pp. 107–126. Gross, J.J. & John, O.P. (2003) ‘Individual differences in two emotion regulation processes: Implications for affect, relationships, and well‑being’, Journal of Personality and Social Psychology, 85(2), pp. 348–362. Kliem, S., Kröger, C. & Kosfelder, J. (2010) ‘Dialectical behavior therapy for borderline personality disorder: a meta‑analysis using mixed‑effects modeling’, Journal of Consulting and Clinical Psychology, 78(6), pp. 936–951. Lundahl, B., Kunz, C., Brownell, C., Tollefson, D. & Burke, B.L. (2010) ‘A meta‑analysis of motivational interviewing: Twenty‑five years of empirical studies’, Research on Social Work Practice, 20(2), pp. 137–160. Meyers, R.J. & Wolfe, B.L. (2003) Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening (The CRAFT Program). Center City, MN: Hazelden. Miller, W.R. & Rollnick, S. (2013) Motivational Interviewing: Helping People Change (3rd ed.). New York: Guilford Press. Nezu, A.M., Nezu, C.M. & D’Zurilla, T.J. (2013) Problem‑Solving Therapy: A Positive Approach to Clinical Intervention (3rd ed.). New York: Springer. NICE (2014) Psychosis and schizophrenia in adults: prevention and management (CG178). London: National Institute for Health and Care Excellence. Nolen‑Hoeksema, S., Wisco, B.E. & Lyubomirsky, S. (2008) ‘Rethinking rumination’, Perspectives on Psychological Science, 3(5), pp. 400–424. Pharoah, F., Mari, J., Rathbone, J. & Wong, W. (2010) ‘Family intervention for schizophrenia’, Cochrane Database of Systematic Reviews, (12), CD000088. Repetti, R.L., Taylor, S.E. & Seeman, T.E. (2002) ‘Risky families: Family social environments and the mental and physical health of offspring’, Psychological Bulletin, 128(2), pp. 330–366. Roozen, H.G., de Waart, R. & van der Kroft, P. (2010) ‘Community reinforcement approach and family training (CRAFT): A meta‑analysis of randomized controlled trials’, Addiction, 105(10), pp. 1729–1738. Rosenberg, M.B. (2003) Nonviolent Communication: A Language of Life. Encinitas, CA: PuddleDancer Press. Shadish, W.R. & Baldwin, S.A. (2003) ‘Meta‑analysis of marital and family therapy: an updated review’, Journal of Marital and Family Therapy, 29(4), pp. 547–570. Wiebe, S.A. & Johnson, S.M. (2016) ‘A review of the research in emotionally focused therapy for couples’, Family Process, 55(3), pp. 390–407. For  bookings with a registered psychologist, visit TherapyNearMe.com.au or call 1800 NEAR ME. We provide confidential support, including family work, couples therapy, and behaviour support (NDIS).