Tania McMahon, Author at Benchmark Psychology

Using e-Mental Health to Help Our Clients

As part of the Australian Government’s recommended stepped care model of mental healthcare, ‘e-Mental Health’ services (low-intensity online mental health interventions and resources) are becoming a much more important part of our mental health system.

With 1 in 5 Australians experiencing mental health difficulties, low intensity interventions can provide an ideal option for individuals with mild-moderate mental health symptoms where other options (e.g. psychologist referral, medication) might not be suitable. However, e-Mental Health services need not be an either-or choice when compared with face-to-face treatment. In fact, e-Mental Health services can fill multiple roles in the space between an individual seeking help from their GP and accessing treatment with a Psychologist, from initial psychoeducation and increasing acceptability of face-to-face services for first-time help-seekers, to crisis support between appointments, to providing interim support and brief intervention for busy periods where they may be on a waitlist.

Below is a brief guide to the range of e-Mental Health services available (Table 1), as well as an outline of the various roles e-Mental Health can play, and which services are most appropriate.

All listed programs have been developed by credible sources, such as the Australian Government, universities, and national nongovernment organisations.

Table 1. e-Mental Health Service categoriesHere is an outline of some of the ways e-Mental Health can be used to help our clients:

Head to Health (https://headtohealth.gov.au/) Previously ‘mindhealthconnect’, this is the Australian Government’s portal to mental health information and e-Mental Health services. It enables consumers to search for information and receive advice about their mental health needs.
Telephone and Webchat	Telephone and online chat services, most often free and used for crisis support, information-seeking, or brief counselling.	Lifeline Kids Helpline eHeadspace Suicide Callback Service Beyond Blue Support Service
Psychoeducation Websites	Freely accessible websites providing mental health information, and often general tips and strategies for wellbeing.	Beyondblue - www.beyondblue.org.au Black Dog Institute - www.blackdoginstitute.org.au ReachOut - https://au.reachout.com/ Centre for Clinical Interventions - www.cci.health.wa.gov.au
Online programs	Online self-guided courses that are either transdiagnostic (i.e. targeting common core mental health symptoms), or address a specific problem (e.g. Social Anxiety, PTSD). Some programs offer limited guidance from a therapist via phone or email. The majority of programs are free, with a few being low-cost.	Mindspot - https://mindspot.org.au/ Moodgym - https://moodgym.com.au/home This Way Up - https://thiswayup.org.au/ myCompass - https://www.mycompass.org.au/ OnTrack - https://www.ontrack.org.au/ Mental Health Online - https://www.mentalhealthonline.org.au/
Apps	Easy and convenient to use (as they are mobile- or tablet-based). However, due to the number of apps available on the market and the relative ease in creating them (compared to the more comprehensive online programs), many do not have experimental validation. As such, it is important to thoroughly check the content and credentials of any app before referring to it.	BeyondNow Suicide Safety Planning app (developed by Beyondblue) MoodPrism and MoodMission (developed by Monash University) AIMhi Stay Strong App (developed by Menzies School of Health Research for practitioners developing a mental health plan with ATSI clients)

1. As crisis support:

Telephone and webchat services are a great option for clients to contact if they need immediate support out of hours or between appointments with their healthcare professional.
Apps such as the BeyondNow Suicide Safety Planning app can help clients and their healthcare professional create a strong, structured plan for dealing with ongoing crises and distress.

2. Psychoeducation for first-time or hesitant help-seekers:

Head to Health, the government’s mental health information portal, is a great place to direct clients to in the first instance.
Psychoeducation websites are fantastic tool for providing information about general stress and wellbeing, specific diagnoses (e.g. generalised anxiety, eating disorders), or specific problem areas (e.g. parenting, relationship issues, work stress) to first time help-seekers.
Online programs (particularly the transdiagnostic programs that don’t focus on a specific diagnosis, such as myCompass) are a great option for help-seekers who are hesitant or uncertain about face-to-face mental health intervention.

3. Interim support:

If clients are on a waitlist or aren’t able to access timely support due to situational circumstances, online programs and apps can provide a great option to help them start working on their wellbeing in the meantime (which also means they can hit the ground running when they are able to commence face-to-face intervention).

4. To complement face-to-face treatment:

Online programs and apps can help build on the skills being taught in therapy, such as CBT strategies, mindfulness and positive psychology. Whilst using these resources as a complementary tool can involve a little extra work on the part of the clinician (i.e. to be able to get to know the programs available and find ones that complement their work), it can really help to strengthen and reinforce the work done in session.

10 Signs That It’s Time For A Digital Detox

Do you find yourself constantly tethered to your devices? Compared to one or two decades ago, you’ve probably noticed that a large portion of your waking life is now spent connected to technology and the Internet. Whether you’re sifting tirelessly through work emails, Googling energetically for an assignment, slaying giant dragons in an online game, or endlessly scrolling through social media on the commute home, you feel continually connected.

The digital revolution has been incredibly beneficial for us; there is more entertainment, more ways to connect, more information and more ways to share it. However, for a growing number of people, use of this technology is becoming difficult to control - and you might be one of them. You might have told yourself “I can stop anytime I want”, or “it’s just something for me to do when I’m bored – at least I’m not drinking or taking drugs”, but then time after time find yourself absorbed in online activities for far longer than you intended.

Having said that, the amount of time you spend online, in and of itself, does not always indicate whether you have a problem or not. In fact, it can be quite difficult to determine whether your Internet use is problematic, given that so much of your daily life is likely dependent on the Internet; most of your work activities probably require email and Internet access; you might regularly do banking, insurance and other errands online; and social media and instant messaging are often the quickest ways to communicate with your family and friends. For most of us, ‘switching off’ completely would be simply impossible. With so much Internet use being ‘necessary’, how do you know when it’s time to make a focused effort to cut back? When is it time for a ‘digital detox’?

The most important warning sign that something needs to change is when your internet, technology or gaming use starts to interfere with your relationships, work or daily life; in short, when you start to experience negative consequences. Below are 10 signs that indicate that your use might be turning into a problem you can no longer control:

1. You often find yourself thinking about going online.

Whether you’re waking up in the morning, commuting home, watching TV, or at dinner with friends, you find your mind constantly switches to what you could be doing online. ‘What’s happening on Facebook?’ ‘Has that blog been updated yet?’ ‘What could I post next?’ ‘I wonder if any of my friends will be online to run that dungeon when I get home.’ Online activities start to take up all of your head space.

2. You find yourself spending longer and longer periods of time online.

A few years ago, you might have sat online or games for 30 minutes to 1 hour before you felt satisfied enough to do something else. Now, 3 hours seem to go by without you even noticing, and you still crave more. You might also notice impatience with Internet speed – anything even slightly slower than what you’re used to causes you the utmost frustration. Think of it in a similar way to the rewarding feeling of substances – if you were a smoker dependent on that instant ‘hit’ from your cigarette, you’d get pretty frustrated if it occasionally took ten times as long to kick in.

3. You go online to lift your mood or escape your problems.

You probably have a range of ‘coping strategies’ for when you’re feeling low or going through a tough time. However, if you find that you’re constantly turning to the Internet as your primary source of comfort, this may be a sign that you’re becoming reliant on it. Again, think of it in a similar way to substance use – you might pour yourself a stiff drink if you’ve had a pretty trying day, but if you find yourself having a drink every time you feel low, this might be a sign of dependence.

4. You feel cranky, sad, annoyed or irritable when you’re not online.

Try resisting the urge to go online or game for a day (or even a few hours!) and see how you feel. If you find yourself struggling with any of the emotions above, AND if going back online gets rid of those feelings, it might be a sign that your use is becoming a problem.

5. You’ve lost interest in activities and hobbies that you used to like.

What things did you used to do before you spent so much time on the Internet or gaming? How much do they feature in your life now? Has the Internet become your sole focus? If you were a bookworm who hasn’t read a book in a year, an avid guitar-player whose guitar is gathering dust, or a budding cook who now relies on microwave meals, this might mean that the Internet has slowly begun to take over.

6. You neglect your health and sleep because of your Internet or gaming use.

Unlike alcohol or other substance use, Internet and gaming use frequently involve extended sedentary sessions sitting down, often with poor posture. If you find yourself continuing to go online despite being sleep deprived, skipping meals, or suffering back, neck or other physical problems, this strongly suggests it’s time for you to cut back.

7. You’ve lost or jeopardised your relationship, job or studies because of your Internet or gaming use.

Whether you were given an ultimatum by your partner, you were fired or given a warning at work, or your university or school marks have dropped significantly, putting any of these important domains in your life at risk is a strong sign that it’s time to make some changes to your use.

8. You’ve covered up or lied about your Internet or gaming use.

You can’t bear the thought of disappointing your friends or family yet again, so you find yourself ‘minimising’ or flat-out deceiving them about how much you’re actually online. For example, you might come home and complain wretchedly about your busy day at work, when you know you spent most of the time browsing websites and YouTube clips. Or, you might say you only stayed up till 1am gaming the previous night, when you know full well you only finally crawled to bed at 4am.

9. You continue going online or gaming despite it causing problems in your relationships.

Your husband might have complained that he hardly sees you in the evenings anymore; your kids might constantly nag you for attention; or your friends might be fed up that you always turn down their social invitations; yet you still find yourself choosing to go online time and time again. You might find yourself constantly making excuses for your behaviour, e.g. “I’ll be down soon!”, “Everyone should be allowed time to themselves”, or “I’ll say yes next time”.

10. You desperately want to cut back your use, or you’ve already tried (and failed).

If you’re already at the point where you’ve tried (or frequently thought about) cutting back, this can be a pretty clear sign that your use is becoming difficult for you to control.

Similar to gambling and alcohol use, overuse of Internet, technology and gaming starts to become a serious issue when it interferes with other areas of your life. Whilst Internet use is simply a ‘hobby’ or 'interest' for many of us, a prominent researcher in the field once put it very succinctly saying:

"Hobbies add to your life, and addictions take away."

If you feel that your Internet, technology or gaming use is becoming (or already is) the latter, it’s important to seek help. Behaviour change can be difficult on your own, and a qualified psychologist can help you to build your motivation and give you practical strategies to change.