CLINIC DIRECTOR'S REPORT (Dr Rosemary Webster)

In 2009 the Psychology Clinic experienced a 50% increase in clients, from 109 to 234; mainly due to the introduction of a new group program "Menopause Made Manageable" (MMM). One of the reasons for introducing this program was to provide more learning opportunities for interns due to recent reduced client intakes. The groups were facilitated by Dr Rosemary Webster with interns providing co-therapy.

With 'baby boomer' women reaching menopause age and approximately 20% of women aged 45-65 years of age experiencing distressing menopausal symptoms the Clinic Director perceived a need for a group treatment program to reduce menopause symptoms (hot flushes, night sweats and other physical symptoms, memory and concentration problems, anxiety, depression and relationship stress). The program was well received with 150 women enquiring about the program following media advertising.

Fluctuations in women's hormone levels during menopause affect the central nervous system, which contributes to physiological as well as psychological symptoms. The MMM program is based on cognitive behavioural therapy strategies and is one of the first such programs to evaluate improvements in menopausal symptoms including anxiety and depression. It is a broad based treatment designed to improve physical, psychological and interpersonal difficulties associated with menopausal symptoms.

The Clinic Director developed the treatment program with the assistance of ten postgraduate students (see clinical services section for interns' names) who were on placement in the Psychology Clinic in 2008. Twelve groups (providing treatment to 75 women) were conducted from May to December 2009 and treatment was provided by the clinic director with 11 postgraduate students as co-therapists (see clinical services section for interns' names). A therapist manual is being written for the MMM program and interns will continue to provide treatment on an ongoing basis.

The interns continued to receive excellent supervision experiences. Mick Hunter as Deputy Clinic Director provided guidance and backup supervision if needed. Kathy Dynon and Yasmina Nasstasia continued to provide exceptional clinical supervision. Due to competing commitments Kathy reduced her time in the clinic from two days to one day and Glen Wand commenced in July 2009. Karen Drysdale, lecturer in Psychology at the school of Psychology continued to provide excellent cognitive assessment supervision. Students are very fortunate to be guided by a specialist. Thank you to each supervisor for your time and effort in providing support for our training programs by educating, mentoring and inspiring our interns.

Emma Bence (clinic administrator) continued to provide excellent administration of the Psychology Clinic and has gained mastery of the new service management system which improves the efficiency of the clinic. Emma's friendly welcoming presence in the clinic is a great asset to making clients feel relaxed and comfortable attending the Clinic.

As well as providing placement opportunities for postgraduate clinical and health psychology students, the Clinic provided pre-clinical experience to undergraduate psychology students. During 2009 the clinic benefited from the services of 5 honours level students who volunteered their time as receptionists for the Clinic (see administration section for students' names). These students provided a wonderful service to the clinic and benefited from gaining valuable experience working in the Clinic and attending group supervision. This is an opportunity for honours students to gain experience that will assist them in gaining entry into the postgraduate programs in the future.

The Clinic continued to provide both individual and group therapy for adults and children for a range of clinical problems, in particular anxiety disorders. The Cool Kids group anxiety treatment program (developed at Macquarie University) for primary school-aged children and their families continued to be popular. Unfortunately there has been limited demand for the adolescent anxiety and depression group program "Chilled" apparently due to reluctance of young people to attend therapy.

An important role of the Clinic is to support clinical research. In 2009 Bonnie Ip and Cindy Buxton (professional doctoral students) continued to contribute to the MMM program and to evaluate its efficacy. The program was designed to be administered weekly for 10 weeks. Due to the large demand for treatment and limited availability of times during the week a condensed program was provided with sessions 1-5 on one day (Saturday) and sessions 6-10 on a Saturday 5 weeks later.

All of the recommendations in the 2008 external review of Clinic operations have been actioned. The clinic continues to have regular Clinic Team meetings and Clinic Management Board meetings with student representatives. The formalised weekly team meetings have resulted in improved communication and clinic operations. The minutes of board meetings are available on the intranet, on Blackboard, for students to access.

Dr Rosemary Webster (Clinic Director)

SUPERVISOR'S REPORTS

YASMINA NASSTASIA'S REPORT

I am pleased to be able to once again contribute to this report and share with you some of the highlights of my experience as a Supervisor in the Psychology Clinic; a role which I have now undertaken since June, 2008 and more importantly, a role which I find satisfying and rewarding. Being able to contribute to the knowledge and skills development of our postgraduate Psychology students, helping grow their confidence and observing the changes to their assessment, conceptualization and intervention skills as the placement progresses is part of what makes this role so rewarding.

Each new student brings with them a diverse range of skills and clinical experience. Some are already working as registered Psychologists in the Community and others are new to the profession. In my experience, effective supervision requires taking into consideration the developmental stage of each intern and putting into place supervisory practices which reflects this knowledge. At any one point in time, I may be acting as co therapist with my new interns, who initially require intensive supervision and at the other end of the spectrum, viewing taped therapy sessions with more experienced interns and facilitating a reflective approach to their clinical practice. Another highlight of my role is the opportunity to facilitate group supervision which is offered each placement day. Feedback from my interns suggests that students really value group supervision and see this as an opportunity to learn new skills that address key clinical and professional issues. This training is alternated with case discussions and student workshop presentations and provides a good mix of experiential and theoretical skills development. The most rewarding aspect of this process is when interns actively engage with the learning material, they read the assigned homework, complete the discussion questions, volunteer their thoughts, ask questions, participate in role plays, courageously share their taped therapy sessions and more importantly, feel safe enough to do so. I believe learning works best within a supportive group environment.

In addition to individual therapy and cognitive assessments, the Psychology Clinic offers a growing range of group therapy programs. As a team we continue to think through what will work best; how we can progress this and what do we leave behind. One of our more enduring and popular group programs is Cool Kids and I think part of the reason why this program is so successful is because it is an effective anxiety management program for children. Cool Kids is a well researched, evidence based treatment, but not only that, we also spend a lot of time planning and troubleshooting to ensure that the interns are providing a high quality service. The enthusiasm and energy of the interns is another key factor and feedback from participants is positive. Cool Kids, I expect, will continue to grow in the future and as part of that growth, modifying the program, to incorporate other aspects of anxiety management and bringing the information to life so that children more readily absorb and engage with the material has been another highlight of my role as Supervisor. As part of the work towards modifying our delivery of the program, I wish to take this opportunity to thank Waverney Innes for her invaluable suggestions. Waverney has an amazing capacity to engage young children and I am grateful for her contributions.

I also wish to thank a number of other people that have assisted me and supported me in my role as Supervisor in 2009. Rosemary Webster, our Clinic Director who I believe deserves a special mention. Rosie's commitment to the Clinic and her support of all staff is noteworthy. Emma Bence our Clinic Administrator; my fellow supervisors, Kathy Dynon, Glen Wand, and Karen Drysdale, without whom we couldn't offer the specialized, cognitive assessments. I would also like to thank Wayne Clarke, the group supervision with you in 2009 was a wonderful learning opportunity; Ingeborg Stiefal and Waverney Innes from the Child and Family Team in Gosford; your knowledge and skills in working with children is impressive, thank you for your generosity in sharing some of this with me. Last but not least, each and every one of my interns, as you learn from me, I also learn from you. Thank you all and I look forward to another busy year.

Yasmina Nasstasia
Placement Coordinator/Clinical Supervisor (Monday, Tuesday)

KATHY DYNON'S REPORT

I was again privileged to be part of the Psychology Clinic supervision team in 2009, two days per week in Semester 1 and one day per week in Semester 2. During the year I supervised fifteen postgraduate students at different stages of their professional development, and enjoyed watching their enthusiasm and commitment to the learning process. The clinic provides a unique opportunity for interns to address areas of professional and personal development in a safe and nurturing environment, allowing space for reflective practice and skill development.

Group supervision continued to be a highlight, with interns contributing their own resources and sharing knowledge with each other, as well as being very receptive to new skills and therapeutic techniques. During the year we were fortunate to receive a variety of new resources, particularly for our child and family work, which makes up the majority of our clinical case load.

It is with much sadness that I leave the clinic supervisor role in early 2010 to go on maternity leave. I am very grateful to be handing over to Tom Pepe from the Child and Family Health Service, who brings much knowledge and experience to share with our interns. I wish Tom well in the role, and also wish to pass on my sincere thanks to Rosie, Emma, Yasmina, and Glen for their ongoing professionalism and dedication to the Psychology Clinic and postgraduate students.

Kathy Dynon (Thursday's supervisor)
Clinic Supervisor

GLEN WAND'S REPORT

I had worked in the Psychology Clinic in 2005 and restarted part way through 2009. I would like to share some of my observations and experiences.

Supervision at the Clinic is unique for me in my professional work. It is very rewarding for me to see interns grow in their skills and confidence. Often interns have not seen clients before, or their experience is limited. The mentoring work that I do with interns is intensive. The structure of the clinic facilitates this and I believe this work is at a level that cannot be matched through supervision of placements at other agencies and services. The interns are often on such a steep learning curve, they have opportunities to prepare for sessions and to review each piece of work through case discussion at individual supervision and through observational learning (e.g. video recording and one-way screen). There is also group supervision, which is a great opportunity for focused tuition, mutual support and sharing of clinical experiences. It is indeed an enriching experience for interns and I am grateful to be part of this.

I was particularly pleased with the group supervision experiences. We had worked out a rough schedule of topics but combined this with flexibility and responsiveness, i.e. to particular requests that emerged in the course of recent work and clinical circumstances. I was able to prepare for topics in advance, including material on the use of reflecting teams as a way of working therapeutically with clients. Some sessions were used for tuition, others for case discussion and some for role plays. These role plays were to help with individual client work as well as to give interns an experience with the reflective team format.

Also, there is now a Clinic Administrator position, so competently filled by Emma Bence. Her role in maintaining continuity of administration over the four days of operation of the Clinic has been invaluable, particularly in providing information regarding allocation of referrals. This is a complex decision making process at times, balancing the needs of service provision for clients, timeliness of service delivery and the need to distribute the referrals as evenly as we can to interns who staff the Clinic on different days.

Glen Wand
Clinic Supervisor (Friday's supervisor)