PROMOTING RECOVERY FROM TRAUMA
Annual Report 2017 2018 Improving the wellbeing and quality of life for individuals and communitieS who experience trauma Contents
Chair’s Report 2 Board of Management 3 Director’s Report 6 Senior Leadership Team 8 About Phoenix Australia 10 Centenary of Anzac Centre 12 Research 16 Policy and Service Development 24 Education and Training 28 Highlight Events 32 Publications, Presentations and Dissemination 36 Our Staff 40 Governance and Management 41 Financial Statement 43 Abbreviations and acronyms 56
Mission Goals To be an international leader – Improve outcomes for the community – Improve outcomes for members of the Defence in building the capability of community individuals, organisations and – Advance scientific knowledge about the nature, the community to understand, development and impact of traumatic stress – Provide leadership and expertise in evidence- prevent and recover from the informed posttraumatic mental health policy, adverse mental health effects of service delivery and practice – Enhance the operational and business capabilities trauma. To be at the forefront of of the organisation world’s best practice in veteran and military mental health. Values
– We are passionate about making a real difference to the wellbeing of people impacted by trauma – We operate with integrity in our words and actions – We collaborate with our colleagues and partners to achieve the best possible results – We are responsive to the changing needs of the communities we serve – We strive for excellence
Annual Report 2017 / 2018 1 Chair’s Report
His Honour Michael Strong
I am delighted to be able to report another excellent year – operationally and financially. On the military and veteran front, the Centenary of Anzac Centre was launched in September last year. Our new research clinic in the Melbourne Health precinct in Royal Park is contributing to the work of the Centre. The Practitioner Support Service – the other limb of the Centre – is generating great interest among practitioners and relevant services across the country. Other significant projects for the Departments of Veterans’ Affairs and Defence were completed and new projects begun. The strength and depth of our unique relationship with the Department of Veterans’ Affairs in particular is at the heart of our operations.
In past reports I have spoken of the growth in the diversity of our work in the broader community – especially (but by no means exclusively) among first responder agencies. This trend has continued to the point where Phoenix Australia is now sought out to undertake research and provide guidance and training on a scale we could not have imagined a few years ago. This speaks to our growing reputation as a centre of excellence in high risk occupational mental health generally, and posttraumatic mental health in particular. Indeed, our reputation extends beyond our shores as a result of international collaborations and the appointment of our staff to senior international roles. Our Director, Professor David Forbes is Vice-Chair of the International PTSD Guidelines Committee. Our Head of Research, Professor Meaghan O’Donnell is Immediate Past President of the International Society for Traumatic Stress Studies. Our international collaborations extend across the USA, Canada, UK, Europe, Asia and Israel.
The growth of our work, and of our reputation, is the result of the skill and dedication of Professor Forbes and his team. It has been a busy and demanding time for our staff. I thank them for their effort and commitment.
Financially, we returned a healthy surplus. This is not, of course, our raison d’etre, but the growth of our organisation creates a need to build our reserves to ensure that, in unexpected contingencies, we can meet our obligations.
I thank my fellow board members for their enthusiasm and support. Our board meetings are no dull affairs – the quality of our board ensures contributions at the highest level.
I again thank directors Greg Ridder and Paul Dolan for their work on the Finance and Risk Committee. As Chair, it is always a great comfort to know that the finances are in good hands.
In September 2017 Sir Angus Houston AK AFC graciously agreed to be our national Patron. Recently, David Mann AM joined us as our Ambassador. We are indeed fortunate to have such support.
2 Annual Report 2017 / 2018 Board of Management
Chair: His Honour Michael Strong Professor David Forbes Ms Gayle Anderson Mr Paul Dolan Professor Ian Everall Ms Veronica Hancock Professor Malcolm Hopwood Major General Mark Kelly Mr Greg Ridder Air Vice-Marshal Tracy Smart
Michael Strong Mr Paul Dolan Michael is a former solicitor, barrister, Prosecutor for the Paul commenced as the Head of Strategy and Operations Queen, judge of the County Court of Victoria, Vice President at Phoenix Australia in May 2018, an executive position on of the Victorian Civil and Administrative Tribunal, Director of the Board of Management. Prior to this executive role, Paul the Office of Police Integrity (Victoria), and a former Australian held a non-executive position on the board and was Chair Criminal Intelligence Commission Examiner. Michael is a of the Finance and Risk committee for four years. Paul is long-serving former director and President of Berry Street, an experienced director across the public and commercial Victoria’s largest independent child and family welfare agency sectors and also runs a business – Tektology – focussed and has served on boards and committees of numerous on health and social systems. His previous roles include other organisations. Michael’s interest in posttraumatic Managing Director for Australia and New Zealand with mental health stems, in part, from the active military service of Lightfoot Solutions, an Applied Analytics and Advisory his forebears. business, as well as Director of System Intelligence and Analytics and then Priority Child and Family Projects with the Professor David Forbes Department of Health and Human Services in Victoria. Prior David is the Director of Phoenix Australia and a clinical to that he was lead Director in Ernst & Young’s Healthcare psychologist with many years’ experience in the assessment Practice in Oceania. Paul has over 18 years’ public sector and treatment of mental health problems following trauma. and management consulting experience in strategy, reform David was the Chair of the Working Party for the inaugural and operational improvement, with a predominant focus on NHMRC-approved Australian Guidelines for the Treatment health and human services. Paul holds a BA (Hons) degree of Acute Stress Disorder and Posttraumatic Stress Disorder in Business and German from the University of Hull, and and is the Vice-Chair of the PTSD Guidelines Committee has also studied International Business at the University of for the International Society for Traumatic Stress Studies. He Innsbruck in Austria. sits on the editorial boards of key international journals and publishes widely in the international literature. Professor Ian Everall Ian was the Cato Chair and Head of the University of Ms Gayle Anderson Melbourne’s Department of Psychiatry until August 2017. He Gayle joined the Department of Veterans’ Affairs (DVA) from is a prominent international psychiatrist and neuropathologist the Department of the Prime Minster and Cabinet in January who trained in the UK. His experience includes directing 2018 and is the First Assistant Secretary, Health & Community a large clinical service and establishing a leading research Services Division within DVA. Gayle has responsibility for training program for psychiatrists at early career stage. Ian health and aged care policy development and program is a member of the Australian Advisory Council for Asia- management for DVA, including in relation to mental and Australia Mental Health and the Advisory Committee for the social health. Gayle has spent the majority of her career Melbourne Neuroscience Institute. working in health policy design and program implementation and commenced her career as an allied health professional.
Annual Report 2017 / 2018 3 Ms Veronica Hancock Mr Greg Ridder Veronica is the First Assistant Secretary of the Veterans’ Greg joined the board as director in 2012 and was appointed Services Design Division in the Commonwealth to the role of Chair of the Finance and Risk Committee in May Department of Veterans’ Affairs. Veronica has worked in 2018. Greg is an experienced company director and business the Commonwealth public service for over 30 years and advisor, with a strong commercial background in strategy, prior to joining DVA in 2012 worked for 17 years in the finance, and general management, having previously been Commonwealth health department where she had a variety President of NYSE listed packaging company Owens Illinois’ of policy development and program management roles in Asia Pacific regional operations. Greg’s other board roles are areas such as population health, private health insurance, at Kogan.com Limited, Tibaldi Australasia, Oxfam Australia medical indemnity, and dental. Veronica has degrees in Arts and Oxfam Australia Trading, and he is a mentor at Kilfinan and Law from the University of Adelaide. Australia. Greg is a Graduated Member of the Australian Institute of Company Directors and is a CPA. Professor Malcolm Hopwood Malcolm is the Ramsay Health Care Professor of Psychiatry, Air Vice-Marshal Tracy Smart AM University of Melbourne, based at the Albert Road Clinic in Tracy is the Commander Joint Health and Surgeon General Melbourne. He specialises in clinical aspects of mood and Australian Defence Force. She completed her medical anxiety disorders, psychopharmacology, and psychiatric training at Flinders University (SA) and served as a Medical aspects of acquired brain injury. Previously he led the Officer/Senior MO at bases around Australia and overseas. Psychological Trauma Recovery Service, incorporating the Her career has included deployments to the United Nations Veterans Psychiatry Unit and the Victorian Brain Disorders Assistance Mission in Rwanda; to Timor Leste; and to the Program, at Austin Health. He has held senior positions Middle East Area of Operations. She is a Fellow of the Royal within the Royal Australian and New Zealand College of Australasian College of Medical Administrators, a member Psychiatrists including past Chairmanships of the Victorian of the Australasian College of Aerospace Medicine, the Branch and the Board of Research, and was President of Aerospace Medicine Association (US) and the Centre for the College from 2015-2017. In 2017 Malcolm was installed Defence and Strategic Studies, and an Academician of the as President-Elect of the Asian Federation of Psychiatric International Academy of Aviation and Space Medicine. Associations, and he commenced as Interim Head of the She is also an Honorary Fellow of the Australasian College Department of Psychiatry, University of Melbourne. of Health Service Management. Air Vice-Marshal Smart was made a Member of the Order of Australia in 2012. Major General Mark Kelly AO DSC Mark is the Repatriation Commissioner in the Department of Veterans’ Affairs. Mark served in a number of senior command appointments during an Army career spanning over 35 years, including Commanding Officer of the 1st Battalion, The Royal Australian Regiment, Commander 3rd Brigade, Commander 1st Division, Land Commander Australia and Commander Joint Task Force 633 (CJTF 633). His operational experience includes service with the Commonwealth Monitoring Force in Zimbabwe/Rhodesia (1979-1980), Chief of Staff of the International Force in East Timor (1999-2000), with US CENTCOM in the Middle East, Afghanistan, the Horn of Africa and Iraq (2003-2004), and as CJTF 633 commanding all ADF elements in the Middle East Area of Operations, Iraq and Afghanistan (2009-10).
4 Annual Report 2017 / 2018 Patron
Air Chief Marshal Sir Angus Houston AK, AFC (Ret’d)
Sir Angus was awarded the Knight of the Order of Australia in January 2015 for extraordinary and pre-eminent achievement and merit in service to Australia, through distinguished service in the Australian Defence Force, continued commitment to serve the nation in leadership roles, particularly the national responses to the MH370 and MH17 disasters, and in a variety of roles in the community. Sir Angus retired from the military in July 2011 after serving for 41 years. He was Chief of the Australian Defence Force from 2005-2011 and prior to that was Chief of Air Force for four years. He was Chair of the Anzac Centenary Advisory Board from 2011-2013 which provided strategic advice to the Australian Government in relation to the planning and implementation of the Anzac Centenary. Sir Angus chairs a number of boards and also serves as a board member for numerous organisations. He is a visiting fellow of the Australian National University National Security College and the South Australian Special Envoy for International Trade and Investment. In addition, he is the Ambassador/Patron of a number of charitable organisations. Sir Angus has been awarded four honorary doctorate degrees from the University of South Australia, the Australian National University, the University of New South Wales and Griffith University.
Ambassador David Mann AM
David was made a Member of the Order of Australia in June 2018 for significant service to the community of Victoria, particularly through emergency services, entertainment, education, heritage and charitable organisations. He has worked for more than thirty years in an operational capacity with emergency services including Victoria Police, Melbourne Metropolitan Fire Brigade, and Ambulance Victoria. David is a roving reporter for 3AW 693, promoting the successes and achievements of Victorian businesses and organisations. He runs a marketing and public relations company, and consults to many companies and not-for-profit organisations around Australia. He is Chairman of the Victoria Police Blue Ribbon Foundation and Entertainment Assist, and sits on a number of other boards including the Chisholm Institute and The Production Company.
Annual Report 2017 / 2018 5 Director’s Report
Professor David Forbes
This past year has been one of significant achievements and significant expansion for Phoenix Australia, with the launch of the Centenary of Anzac Centre and considerable growth in our work generally. Our work with high risk industries has expanded; our tailored training programs are sought by a growing number of organisations from a wide range of sectors; our research and policy advice work in the area of compensation support for mental health is growing; and collaborations at an international level with other trauma, military and disaster experts continue to be an important focus.
The Anzac Centre was conceived from our experience over many years and the identification of two major unmet needs in the field of military and veteran mental health: firstly, the need to continue to innovate and develop new and more effective treatments, and secondly, the need for an expert advisory service to assist practitioners treating often complex military and veteran mental health problems. We are grateful for the funding from the Department of Veterans’ Affairs (DVA) which provides an exceptional opportunity for Phoenix Australia to deepen our capacity to deliver improved mental health outcomes for the veteran community and fully utilise our experience in the field. The then Minister for Veterans’ Affairs, the Hon Dan Tehan MP launched the Anzac Centre in September 2017 (read more about the launch on pages 32-33).
Staff have been extremely busy creating the foundations for the two components of the Anzac Centre: the Treatment Research Collaboration will undertake pioneering research into military and posttraumatic mental health conditions, and the Practitioner Support Service will provide expert advice to practitioners and ex-service organisations around the country that support veterans with mental health problems. You can read a little more about the establishment activities on pages 14-15. These activities and services are now in full swing. In July, the Anzac Centre will hold a national practitioner forum, in collaboration with DVA, Defence, and the Veterans and Veterans Families Counselling Service (VVCS) for practitioners working in military and veteran mental health. This forum will highlight key innovations in the field internationally, promote innovative treatments being conducted around Australia, and establish a national community of practice in military and veteran mental health.
For many years, Phoenix Australia has assisted high risk organisations such as emergency services to implement best practice approaches to recognising trauma and minimising its impact on their workers, who are at risk of being exposed to potentially traumatic incidents as a part of their day-to-day duties. This year our work has expanded to new clients including state-based services such as Victoria Police and the Department of Health and Human Services, and national agencies under the umbrella of the Department of Home Affairs such as the Australian Federal Police.
6 Annual Report 2017 / 2018 Our expertise in training is increasingly being sought by tested in Queensland later in 2018. You can read about the diverse organisations. Working with a trauma informed roundtable on pages 34-35, and about the SOLAR programs approach is becoming a focus for many sectors, and on page 19. we have provided Trauma Informed Care training this We are privileged to have opportunities to contribute to the year to legal firms, the alcohol and drug sector, and international community of trauma experts at the highest the homelessness sector, among others. Our Viewing levels. This year Professor Meaghan O’Donnell completed Objectionable Materials training, which has been her two-year presidency of the premier international trauma recognised with an award within the Australian Border Force, society, the International Society for Traumatic Stress has been presented this year to Department of Foreign Studies (ISTSS), and I am the Vice-Chair of the ISTSS PTSD Affairs staff who can be exposed to potentially traumatic Guidelines Committee. events and objectionable materials as part of their duties in consular and humanitarian settings. I congratulate two of our senior leaders on recent promotions: Meaghan O’Donnell, Head of Research, is The past year has seen growth in our work in the area of now Professor O’Donnell, and Deputy Director Andrea compensation support for mental health. We have provided Phelps is now Associate Professor Phelps. These promotions training to frontline staff at the NSW state insurance acknowledge their outstanding achievements both within regulatory authority (SIRA); a review of the mental health academia and in their roles at Phoenix Australia. impacts of compensation claim assessment processes commenced; we trained New South Wales psychologists In reviewing such a milestone year, I acknowledge and thank in Prolonged Exposure therapy for their work treating the staff of Phoenix Australia. Both our newer staff and emergency service personnel with PTSD on behalf of those of long-standing, display on a daily basis their strong EML; and we commenced an evaluation of the approach commitment to the organisation and its mission. Their high to compensation claims by Victoria’s Transport Accident quality and hard work and creativity is the reason Phoenix Commission in response to the 2017 Bourke Street vehicle- Australia is increasing its impact on improving outcomes for ramming attack. the current and ex-serving Defence community, high risk organisations, and across the community. To achieve our mission of being an international leader in the mental health effects of trauma, it is important that at Finally, I thank the Board, and especially our Chair, His an international level we seek to develop and strengthen Honour Michael Strong, for their continued strong and wise partnerships with other experts in the field for the benefit of guidance of this organisation. the individuals and communities who experience trauma. One activity this year stands out in this area.
In October 2017, in collaboration with The Prince’s Trust Australia, we hosted an international roundtable on disaster recovery in children, with experts from Australia, Canada, UK, USA, Norway and Germany. A follow-up from the roundtable held in Sydney in 2015 to develop an evidence- based recovery program for adults impacted by disaster, this two-day event resulted in a framework for an equivalent brief early intervention for children and adolescents. The SOLAR (Skills fOr Life Adjustment and Resilience) program will be available for adolescents – SOLAR-Teens – and for younger children – SOLAR-Kids. The programs will be field
Annual Report 2017 / 2018 7 Back: Nicole Sadler, David Forbes, Darryl Wade, Paul Dolan, Richard Cash, Meaghan O’Donnell Front: Jane Nursey, Andrea Phelps, Mark Hinton Absent: Anne-Laure Couineau, John Cooper
Senior Leadership Team
Professor David Forbes Paul Dolan BA (Hons) MA (ClinPsych) PhD BA (Hons) Director Head of Strategy and Operations As Director, David provides specialist content leadership Paul leads strategic and operational areas at Phoenix to ensure that Phoenix Australia maintains its position Australia. This incorporates governance, strategic at the forefront of international expertise in the mental and operational planning, strategic initiatives, brand, health effects of trauma, and veteran and military mental marketing, communications, and partnerships as well as the health more broadly. He guides Phoenix Australia into professional services functions – HR, finance, IT and facilities. new partnerships and areas of endeavour in order to enhance its sphere of influence, and develops and oversees relationships with key stakeholders. Professor Meaghan O’Donnell BAppSci (Hons) MPsych (Clin) PhD Head of Research Associate Professor Andrea Phelps Meaghan leads the research portfolio at Phoenix Australia. BA (Hons) MPsych (Clin) PhD This includes research, evaluation, knowledge synthesis, and Deputy Director the Treatment Research Collaboration (Anzac Centre). She As Deputy Director, Andrea is responsible for the delivery also oversees supervision of higher degrees students (PhD of services to the Department of Veterans’ Affairs under our and Masters students) and international research visitors. core contract arrangement, and the Centenary of Anzac Centre Grant. She also leads the development of large projects such as the Australian trauma treatment guidelines.
8 Annual Report 2017 / 2018 Associate Professor Darryl Wade Anne-Laure Couineau BA (Hons) MA (ClinPsych) PhD BA (Psych) MA (Psych) Grad Dip (Psych) Head of Policy and Practice Director Policy and Service Development Darryl is Head of Policy and Practice which includes the Anne-Laure brings her extensive experience in the treatment areas of Policy and Service Development, Education of posttraumatic mental health problems, knowledge and Training, and the Anzac Centre Practitioner Support translation, and best practice implementation to her role Service. His portfolio responsibilities include strategic and as Director Policy and Service Development. She leads operational planning, partnerships, business development, projects that support the development of evidence-based client and project delivery, supervision, and recruitment. frameworks and policies in organisations to improve support for staff that are at risk of being exposed to trauma, as well as the development of and support for best practice Dr John Cooper implementation programs in treatment services. MBBS MPM FRANZCP Consultant Psychiatrist Dr Richard Cash John provides psychiatric input across all of the Phoenix BA (Hons) PsyD Australia and Anzac Centre domains. He is a member of the Director Education and Training management group and the Anzac Centre Expert Council. Richard is responsible for Phoenix Australia’s Education and Training services. Richard is committed to disseminating Jane Nursey effective treatment and support strategies to mitigate the BBSc Grad Dip Child & Adol Psych MPsych (Clin Neuro) impact of trauma, and assist with trauma recovery. Richard Director Centenary of Anzac Centre leads the development and delivery of high quality training Practitioner Support Service programs including traditional face-to-face skills-based workshops, as well as innovative digital training. Jane provides strategic and operational leadership to the Practitioner Support Service team. This includes ensuring that the service meets it strategic, budgetary, reporting, Nicole Sadler AM CSC and operational objectives in delivering a range of high MPsych (Clin) quality advice and support services on veteran mental Director Military and High Risk Organisations health to multi-disciplinary health practitioners and veteran support agencies; liaising with key stakeholders in Nicole applies her expertise in military and veteran mental government, industry, health professional associations and health to a range of projects across the policy, research and community support organisations, providing supervision training areas, and has worked closely with the Departments and mentorship of staff, and managing the day-to-day of Defence and Veterans’ Affairs as well as other high risk operational requirements. organisations, such as police and first responder agencies. In addition, Nicole is one of the senior clinicians contributing to the Anzac Centre Practitioner Support Service. Dr Mark Hinton BEd BA (Hons) MPsych (Clin) PhD Director Centenary of Anzac Centre Treatment Research Collaboration Mark leads the Treatment Research Collaboration component of the Anzac Centre. In line with its aims and objectives, Mark is committed to engaging services in relevant, high quality research designed to produce outcomes that will make a real difference to the mental health and wellbeing of veterans and their families.
Annual Report 2017 / 2018 9 Phoenix Australia Centre for Posttraumatic Mental Health
Phoenix Australia - Centre for Posttraumatic Mental Health is a not-for-profit organisation and national centre of excellence
Whether from natural disasters, transport accidents, sexual assault, or exposure through military or emergency services experiences, trauma can have lasting effects and impact people’s mental health, relationships, work, and study. Phoenix Australia is at the forefront of research, policy, and training into posttraumatic mental health, utilising the latest research to improve wellbeing and build stronger communities. Phoenix Australia’s breadth of work encompasses Research and Evaluation, Policy and Service Development, and Education and Training. It is our unique ability to integrate knowledge and skills from all of these activities into best practice and tailored implementation, offering clients end-to-end service.
10 Annual Report 2017 / 2018 Research and Evaluation Education and Training Our program of internationally Our aim is to create engaging and acclaimed research and evaluation evidence-based education and aims to advance the knowledge training programs that improve of posttraumatic mental health; the practice of those working with create real-world solutions through individuals, organisations and the application of diverse research communities affected by trauma. methodologies; and translate We provide tailored training, research findings into practical supervision, and consultation implications for governments, services that meet the specific organisations, and communities. needs of a diverse range of clients.
Policy and Service Promoting Understanding Development Phoenix Australia promotes an Our policy and service development understanding of posttraumatic work aims to establish the standards mental health through online of best practice for the management and print resources, videos, of trauma. We translate research journal articles, presentations at into best practice policies and conferences and other forums, and procedures for organisations, and via expert media commentary. work with organisations to build their capacity to minimise the impact of workplace trauma.
Annual Report 2017 / 2018 11 The Centenary of Anzac Centre
The Centenary of Anzac Centre has been established to ensure better mental health and improved lives for Australia’s veterans and military personnel and their families.
It will achieve this through pioneering research, expert guidance and support for practitioners around Australia, and national leadership by engaging researchers, practitioners, and the veteran community to create collaborative networks.
Why is it needed? Proven treatments for posttraumatic stress disorder have limited effectiveness - only one third of patients fully recover, and in veterans, the outcomes are less positive than for the wider community. Evidence-based treatments are not widely available, with less than half of people receiving best practice treatment. Practitioners working with veterans, particularly those in rural and remote Australia, need support to treat often complex mental health problems.
The Centenary of Anzac Centre will provide national leadership in improving mental health care for veterans. Through a collaborative approach, it will produce innovations in evidence-based treatments and will support practitioners to provide the best possible care. Veterans and their families will benefit enormously.”
Air Chief Marshal Sir Angus Houston AK, AFC (Ret’d) Patron of Phoenix Australia
12 Annual Report 2017 / 2018 Treatment research and practitioner support The two components of the Anzac Centre address these issues. The Treatment Research Collaboration systematically addresses gaps in knowledge, discovers new treatments, tests innovative treatments, enhances treatment effectiveness, and focusses on early intervention. The Practitioner Support Service supports practitioners and others working with veterans by providing free multi- disciplinary expert advice and guidance, online resources, and professional development and networking opportunities. Integration of the research program and the Practitioner Support Service will enable research to be responsive to the needs of practitioners in the field, and for research findings to be translated into advice on best practice approaches.
Collaboration Fundamental to the operations of the Anzac Centre are the collaborations with other research and clinical centres, expert clinicians, ex-service organisations, and professional organisations. These collaborative relationships help to inform the work of both the research program and the Practitioner Support Service. Key partners are Professors Richard Bryant (University of NSW), Alexander McFarlane (University of Adelaide), and Malcolm Hopwood (University of Melbourne).
Long-term benefits Far-reaching benefits flowing from the work of the Anzac Centre will be improved lives for veterans and their families, reduced suffering, reduced costs to both individuals and society, and increased knowledge of treatments which will benefit not only veterans, but the broader Australian community.
www.anzaccentre.org.au
Annual Report 2017 / 2018 13 Treatment Research Collaboration
The Treatment Research Collaboration aims to improve mental health outcomes for veterans by conducting and facilitating innovative research into PTSD and other military mental health issues and to engage with the broader research and clinical community in this endeavour.
2017 - 2018 Overview The Research Map The past year has been a period of establishing a The Research Map, to be located on the Treatment foundation, developing collaborative research partnerships, Research Collaboration website, is planned to be a key and investigating the current evidence base in Australia for tool in establishing a national research network. The map the treatment of former serving Defence members. This will offer an interactive, visual representation of all veteran preliminary work is a prelude to the rich research activity mental health treatment research in Australia since 2013. planned for the future. With a fundamental aim being to The intention is for the map to be a living, evolving tool, with engage and collaborate with others involved in clinical new research activities being added as the network grows, service delivery and research in veteran mental health, enabling researchers to identify and establish potential a major commitment this year has been to reach out to partnerships. researchers, clinicians and clinical services, and veteran communities. A plan to develop an understanding of who The research framework is currently engaged in treatment research and the areas The research framework is being developed utilising the in which future research should be focussed was drafted. feedback gained through our consultations. It will serve as a The plan includes: i) a program of consultation with key summary of the main gaps identified in the current research stakeholders involved in veteran mental health in order to and be used to set key priorities for future research. Like the identify current treatment research activity, to consider views research map, it is anticipated that the research framework on treatment research gaps, and to seek recommendations will be a living document, evolving over time with ongoing for relevant future research; ii) development of a research learning and collaboration. map outlining treatment research currently being undertaken with Australian veterans; and iii) agreement on a research In the year to come the focus of the Treatment Research framework to guide our treatment research endeavours. Collaboration will move beyond consultation and into implementing research plans with early partnerships while new initiatives and partners are sought for future projects. Consultations The first projects will include a novel treatment trial and a A systematic approach to consultation was undertaken mechanism study with collaborators in Queensland and to ensure input from numerous stakeholders from the Victoria and the University of Tel Aviv. veteran mental health field. This included scoping the Australian peer-reviewed literature for the previous three years, searching the national trials registry, searching the DVA and Defence websites, plus face-to-face and phone consultations, and online surveys with research and clinical teams nationally. Academics and treatment providers from around Australia with national and international reputations as experts in areas relevant to veterans’ mental health were also approached for their input and feedback which they gladly gave.
14 Annual Report 2017 / 2018 Practitioner Support Service
The Practitioner Support Service is a free, nation-wide service, providing expert multidisciplinary guidance and support to health practitioners, support organisations, and others working with Australian veterans with mental health problems.
2017 - 2018 Overview Expert advisors A great deal of planning has gone into setting up the We have recruited four expert multi-disciplinary advisors: Practitioner Support Service and the first twelve months two psychiatrists, a general practitioner, and a mental health were spent on establishing the infrastructure required to social worker. The expert advisors will provide specialist deliver an accessible and impactful national service. This consultation as required to practitioners contacting the included defining the service model through a process service, engage with their professional colleagues to of consultation and writing a project plan; meeting with promote the service and best practice in the field of stakeholders to identify their support needs and preferences military and veteran mental health, and assist in identifying for how they interact with the service to ensure that they practitioner needs and developing resources on veteran experience it as targeted and responsive to them; building mental health. client management software to ensure seamless operation for delivery of the service model; building a website with Services from July 2018 resources and useful links for clinicians; conducting a national • Case consultations via phone or email with veteran mental recruitment campaign to employ highly experienced health experts from a range of disciplines (psychology, clinicians as expert advisors; piloting the program and psychiatry, GP, social work, family therapy). system software over a period of three months with VVCS to identify and rectify any implementation issues; and • Online resources for practitioners on veteran general developing a marketing strategy to promote the service - all mental health topics including trauma, with links to fact in preparation for the launch of the service in July 2018. sheets, latest research, videos, podcasts, and interviews with experts in veteran mental health, as well as links to The Practitioner Support Service is designed to be a flexible DVA webinars and other clinical resources. and accessible service that will seek continuous feedback from users to ensure it remains relevant to their identified • Facilitation of professional development and networking needs. Multiple communication channels will ensure that opportunities for those supporting and treating veterans, the service is available to every practitioner who needs it including a range of short seminars on veteran-specific regardless of their location or available resources. topics that can be tailored to meet the needs of specific services. Consultations Consultations with key stakeholders have been conducted in order to ensure that we are identifying the needs of the potential users of the service and designing it to meet those needs. Amongst others, we have met with staff from the US National Centre for PTSD, which offers a similar program, senior mental health staff within VVCS and DVA, and the Mental Health Professionals Network. Throughout the period of consultation, there has been much enthusiasm expressed about the service. In rural and remote areas particularly, practitioners are excited about what the service could offer them.
Annual Report 2017 / 2018 15 research
Phoenix Australia’s internationally acclaimed program 2017 - 2018 Overview of research and evaluation aims to advance the This year we have worked with a diverse range of government scientific knowledge of trauma and posttraumatic departments, organisations and research funding bodies. We mental health. have worked with both state and Commonwealth government We benefit from our extensive national and departments including Defence, DVA, Commonwealth Department international collaborative research relationships, of Health, Foreign Affairs and Trade, Victorian Department of Health and Human Services, and Queensland Health. We have worked with integrating the findings from our research activities the Community Fire Authority, Transport Accident Commission, as and program evaluation with advances from around well as charities and research funders including NHMRC, Hallmark the world. Ageing Research Initiative, and The Prince’s Trust Australia. This Phoenix Australia is proud of its unparalleled diverse set of research funders speaks to the translational nature leadership in translating research into practical of our research and its utility for government and organisations. implications for governments, organisations and A large focus this year has been our veteran and military research. communities, thereby promoting the best possible Again we are working with a diverse range of methodologies outcomes for people affected by trauma. including a large scale cohort study (LASER), measurement development (Moral Injury Outcome Scale), and rigorous randomised controlled trials testing interventions (SOAR, Phoenix Australia’s research targets three RESTORE). The various studies and methodologies have required main populations of trauma survivors: a diverse set of research skills and our staff group has adapted well to the challenge. • Military and veteran • Community It is important to mention the Skills fOr Life Adjustment and • Industry and workplace Resilience (SOLAR) program. SOLAR is a brief intervention for people experiencing adjustment difficulties following disaster We have five main programs of research: and trauma, delivered by non-mental health experts. This year • Epidemiology we completed a pilot study of SOLAR after bushfires in South Australia, and commenced a study testing the program in Tuvalu. • Phenomenology We have also translated all materials into Japanese and have trained • Intervention Japanese mental health clinicians who will assist with piloting the • Knowledge translation program in Japan. We held a roundtable in Scotland with experts • Veteran and military mental health. from around the world to develop SOLAR-Kids and SOLAR-Teens programs. We commenced developing these materials with funding from the Queensland Health Department. All this activity speaks to how important this program is seen in filling the gap for a brief ram Preva rog n len P atio ce intervention to facilitate adjustment after disaster and trauma. alu Ev n a r V We have been expanding our evaluation team as we see it as an te u e ln V y h ary e r lt lit E r g a i pi a important growth area for Phoenix Australia. The organisations it a M h d in l e lt em b t i H & a i n e io li o M l H t a ra l lo y we work with see evaluation as a critical part of all policy and m & t e ta g o n t n y r e e e P V ce M program implementation and we have responded to this foresight M M la ili kp ta r ry o
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g I o s g n e t s designing the three-year evaluation of the Anzac Centre itself. e n r T r m e o t t a o a n n c s e L a Finally I’d like to congratulate our PhD students for another year of la Co ty h F L t mmuni P io it R e n fabulous work. Special mention goes to Dr Renee Armstrong who e r v a s i t e e u r w re a completed her PhD this year. On page 22 you can read about the s In n terventio tm h ig great work our PhD students are doing including, the impact of N trauma exposure on firefighters (Heather Bancroft), social support U d niv te ers ica al Ind after natural disaster (Fanhong Shang), healthy ageing in older Se d lecte veterans (Loretta Watson), and moral injury (Anne McDonald).
16 Annual Report 2017 / 2018 Case Study Research
Pathways to Care Report: How transitioned and current serving ADF members access, use, and value mental health services
The Pathways to Care report, released in February 2018, treatment, and treatment for the prescribed timeframe, is the second of eight reports to be produced from the were concerning, particularly for transitioned members. Transition and Wellbeing Research Programme. Funded Satisfaction with services in general was also lower in this by the Departments of Defence and Veterans’ Affairs, the group relative to currently serving members. research programme is the most comprehensive study The report identified a number of ways that mental health undertaken in Australia on the impact of military service on services could be enhanced to improve outcomes for the mental, physical and social health of serving and recently veterans. Firstly, strategies for improving delivery of best transitioned ADF members and their families. Involving practice care and rates of retention in treatment need to be a total of 4326 transitioned members and 8480 regular considered. Secondly, processes for enhancing coordination members, it is one of the largest studies of transitioning and integration of care across the service system are defence members in the world. The Pathways to Care report necessary. Finally, it is important to increase care providers’ was led by Phoenix Australia. understanding of military culture and other relevant Pathways to Care investigated how serving and transitioned contextual factors, as this may improve their provision of ADF members access, use, and value mental health care to the ex-serving population. services. Two main groups were studied: ADF members The report elicited areas for further research, including the who transitioned out of the ADF between 2010 and 2014 need to examine the particular barriers to care for particular (including into Reserve service), and a sample of full-time mental health disorders such as PTSD and depression, and ADF members serving in 2015. We studied patterns of to examine further the factors that increase perceptions of accessing mental health services within the two groups, and stigma within these groups. any comparisons between them. The Pathways to Care report provides critical information The fundamental finding from this research was that the to better understand the uptake and utilisation of services, majority of serving and transitioned ADF members with and the factors, strengths, gaps, and preferences that a mental health concern received professional help, and influence that utilisation. The report’s findings will provide most sought help within the first 12 months of the problem the Departments of Defence and Veterans’ Affairs with arising. This is despite the finding of high rates of negative the information they need to guide future service delivery beliefs about seeking treatment. and mental health initiatives in order to further improve While the rates of initial engagement and uptake of services outcomes for the serving and ex-serving ADF communities. were high, the rates of those receiving evidence-based
The Pathways to Care research team has delivered important information about how ADF members utilise mental health care. This will help the ADF improve access to care within the defence force. Ultimately this will assist members when they transition into the community.”
David Morton Director General Mental Health, Psychology and Rehabilitation, Joint Health Command
Annual Report 2017 / 2018 17 Research Projects
Evaluation of TAC Bourke Street claims Review of the mental health impacts of compensation management claim assessment processes for DVA Vehicle-ramming attacks on civilians have become more The processes through which individuals claim and are assessed frequent in recent years. The most notable in Australia for compensation have been the subject of much scrutiny. There occurred on 20 January 2017, when a car was deliberately is increasing concern that some claimants may have worse driven into pedestrians along Bourke Street in central long-term health outcomes compared to injury survivors who Melbourne. Six people were killed, 36 physically injured, do not seek compensation. This topic has been the focus of and over 100 claimed compensation for mental and/or considerable attention in Australia over recent years, with several physical injuries to the Transport Accident Commission high level inquiries proposing a link between the experience of (TAC). TAC was responsible for providing and coordinating submitting a compensation claim and adverse psychological and financial compensation for medical and psychological physical health outcomes. DVA has engaged Phoenix Australia treatment to individuals, and for the loss of employment to conduct a literature review and desktop study to examine capacity. This was a unique situation for the TAC due the mental health impacts of compensation claim assessment to the high number of mental injury claims submitted, processes on claimants and their partners and families. and also the way in which these claims were managed. The aim of the review is to collate evidence from the Specifically, the TAC accepted all mental injury claims international research literature as well as the personal without the need to provide evidence of a sustained experiences of claimants, family members, and DVA personnel, mental injury. to inform our understanding of the relationship between The TAC contracted Phoenix Australia to examine the applying for compensation and adverse mental health effectiveness of this approach to claims management, outcomes. including evaluation of client experience, client outcomes, claims manager outcomes, and scheme performance more broadly. To accomplish this, we will review policy documents and conduct interviews with TAC stakeholders and clients involved in the incident, allowing comparison of the Bourke Street claims approach to the standard claims process. Additionally, Phoenix Australia will survey international experts to gain consensus on best practice for claims management following large-scale incidents. The project will run until December 2019. The findings from this project will be used to inform ongoing DFAT pilot of SOLAR program in Tuvalu improvements to the TAC’s standard claims management Skills fOr Life Adjustment and Resilience (SOLAR) is a brief process as well as provide learning for future responses to intervention for psychosocial recovery following disaster, targeting large-scale traumatic events. emotional adjustment and aiming to improve quality of life. A unique feature of the program is that it is able to be delivered by non-mental health specialists who are trained as ‘coaches’. In 2017, the Department of Foreign Affairs and Trade (DFAT) commissioned the Australian Red Cross in partnership with Phoenix Australia to pilot a culturally adapted version of SOLAR in the Pacific island nation of Tuvalu which was significantly impacted by Tropical Cyclone Pam in 2015. The study aims to demonstrate the feasibility, effectiveness and value of the SOLAR program in a nation representative of Small Island Developing States within the Commonwealth. The study will test the efficacy of the intervention to improve psychosocial adjustment. It will also involve extensive collaboration and capacity building in Tuvalu to ensure that the specific needs of communities are met, and that the program will continue to serve Tuvalu in the future. Should the pilot prove to be effective, it is possible that the SOLAR program could be implemented elsewhere in the Pacific region.
18 Annual Report 2017 / 2018 Queensland Health development of SOLAR program VVCS trial of Attention Control Training for children Recent research indicates that transitioning out of the Building on the success of the SOLAR program, in October military represents a vulnerable time for military personnel. 2017 Phoenix Australia, in collaboration with The Prince’s In the course of military training personnel are trained to Trust Australia, convened a meeting of international experts attend to cues in their environment that may signal threat; to arrive at a consensus regarding the optimum disaster in deployment situations, this training can be life-saving. recovery program for children and adolescents with mild to Upon return to civilian life, however, constantly feeling alert moderate adjustment problems (read more about the event and attending to cues that seem threatening can become on pages 34-35). Agreement was reached on the content a problem, and it can be associated with the development of recovery programs for children and adolescents (SOLAR- of PTSD. Attention Control Training (ACT) is an intervention Kids and SOLAR-Teens). designed to modify the fluctuations in attention to threat In 2018 Queensland Health provided funding to Phoenix that underpins PTSD. ACT is like a simple computer game, Australia in collaboration with the University of Queensland and involves responding to threatening and neutral stimuli. to develop materials and field test the two programs Participants learn to balance their attention equally, instead in Mackay as part of the disaster response following of focussing too much or too little on threatening stimuli, Tropical Cyclone Debbie. The program materials include which in turn improves mental health symptoms and developmentally appropriate workbooks for children and wellbeing. adolescents, a workbook for parents, and a training manual SOAR (Stepping Out Attention Retraining) is a randomised for coaches. The materials will guide the delivery of the controlled trial testing whether ACT is effective in preventing program to facilitate quality and consistency. PTSD from developing following transition. This national trial Coaches will be trained in September 2018, with the will be conducted by Phoenix Australia in collaboration with program commencing in the field soon after. VVCS, and will involve 1800 transitioning ADF members. The results of the trial will inform the broader military community both in Australia and overseas by improving our understanding of effective preventions for the development of mental health symptoms after military service.
Annual Report 2017 / 2018 19 The RESTORE trial Literature scan of psychosocial needs of female The Rapid Exposure Supporting Trauma Recovery veterans for DVA (RESTORE) trial involves a partnership between Phoenix As more women serve in the military and there is a Australia, the Departments of Defence and Veterans’ corresponding increase in female veterans, it is essential Affairs, and VVCS. The trial will identify whether a modified that their unique physical and mental health needs are form of the gold standard treatment for PTSD - prolonged understood and appropriately met. The psychosocial needs exposure (PE) therapy - that delivers the treatment over 10 of female veterans literature scan, commissioned by DVA, days in a two-week period can obtain similar outcomes to summarised emerging evidence regarding the mental standard PE which requires weekly treatment for 10 weeks. health, psychosocial, and medical needs of female veterans. The trial is the first Australian randomised controlled trial to The literature scan found a number of studies highlighting compare both modalities of PE for the treatment of PTSD, important differences in the prevalence, phenomenology, and aims to improve access to effective evidence-based and risk factors associated with PTSD, depression, substance care for current and former ADF personnel, particularly in use, and suicidality. These differences were often observed the provision and uptake of PE. Current and ex-serving in comparison to male veterans. The findings of this review members are being recruited across mainland Australia. will be used by DVA to gain a greater understanding of the Findings from this trial will directly influence DVA and unique needs of female veterans. Defence policy and delivery of evidence-based treatment to current and ex-serving defence force members nationwide. Evaluation of The Way Back suicide prevention service for DVA REA of meditational practices and mindfulness In a commitment to develop initiatives to support former for DVA defence force members who could be at risk of suicide, There is increasing interest in treatments such as meditation, DVA contracted beyondblue to adapt and pilot a version yoga and mindfulness for mental health disorders. These of their existing community suicide prevention support therapies are potentially cost effective, can have physical service, The Way Back, for the needs of ex-serving Defence benefits, and may appeal to people who find other personnel. Phoenix Australia has been engaged by DVA to types of therapy too confronting or demanding. Phoenix independently evaluate the effectiveness of The Way Back Australia was contracted by DVA to conduct a rapid at reducing suicidal behaviours in ex-serving members and evidence assessment (REA) of high level scientific evidence to collect evidence to inform future policy implementation in to understand the role of meditational practices and this area. This will be an ongoing evaluation and monitoring mindfulness in improving mental health. Three questions project, with completion scheduled for 2020. were developed to guide the assessment of the evidence. Specifically, the literature was searched to determine the efficacy of: 1) meditational practices, and 2) mindfulness to Development of the Moral Injury Outcome treat mental health disorders. A third search was conducted Scale for DVA to investigate the efficacy of meditational practices or The development of the Moral Injury Outcome Scale for mindfulness as an adjunct to standard treatment. The currently serving members and veterans is a multi-phased evidence in relation to each question is being assessed and project funded by DVA. It aims to develop a gold standard will be ranked in terms of quality. The findings of this review measure of the psycho-social-spiritual outcomes of moral will help DVA to decide the importance of meditational injury for use by DVA and ADF as part of their routine practices and mindfulness in helping veterans to improve assessment and treatment planning processes. Phoenix their mental health. Australia is working as part of an international consortium of experts in the US, Canada, UK, New Zealand, and The Netherlands to develop and test the measure.
20 Annual Report 2017 / 2018 Investigating successful ageing in veterans reviewed and updated following consultations with teachers, An investigation of successful ageing among older principals, School Support Service Officers, wellbeing Australian military veterans was conducted with seed staff, and Department of Education and Training staff. The funding from the University of Melbourne’s Hallmark Ageing program will be piloted in selected primary and secondary Research Initiative (HARI). Interviews were conducted schools. The study is being funded by the Teachers Health with 74 veterans aged between 60 and 75 to obtain their Fund and coordinated by the Jack Brockhoff Child Health perceptions of the meaning of successful ageing. Findings and Wellbeing Program in the School of Population and will tell us what is important to veterans as they move into Global Health at the University of Melbourne in partnership older age. The results of this investigation will be used to with the Victorian Department of Education and Training inform a larger, quantitative study which will commence in and Phoenix Australia. late 2018. The aim of the quantitative study is to measure the important ageing areas identified in the qualitative Longitudinal ADF Study Evaluating Resilience study, such as cognitive, psychological, physical, social, (LASER-Resilience) and spiritual domains. Taken together, these two studies will inform the development of interventions that promote Phoenix Australia has been collaborating with the ADF since successful ageing in Australian veterans. 2010 on the LASER-Resilience research project which aims to provide the ADF with valuable information regarding the situational and individual factors that both erode and NHMRC Program Grant promote psychological resilience in ADF members during Our NHMRC Program Grant represents a collaboration with training and their first three years of service. To date, Professors Richard Bryant (University of NSW), Derrick Silove Phoenix Australia has delivered four reports, and the final (University of NSW), Alexander McFarlane (University of report is nearing completion and will be delivered later Adelaide), Gin Malhi (University of Sydney), Kim Felmingham in 2018. The final report will inform the ADF’s resilience (University of Tasmania), and Mark Creamer (University of program - BattleSMART, provide baseline mental health Melbourne). The Melbourne site of this program grant has data, and drive changes to policies to alter organisation- been leading a study in collaboration with the Australian related factors that impact mental health outcomes. Institute of Family Studies examining the post-migration adjustment of refugee children and adolescents in Australia, Early intervention review for DHHS utilising data from the Building a New Life in Australia study. It is the first rigorous investigation of the experiences of The Victorian Department of Health and Human Services young refugees adjusting to resettlement in Australia. The (DHHS) engaged Phoenix Australia to undertake two study findings indicate refugee children and adolescents projects related to early responses to community disaster. appear to be functioning soundly relative to Australian The first was to develop an evaluation framework for the peers. Early treatment of mental health problems is provision of psychological first aid following natural disaster, recommended as a priority in resettlement, and initiatives and the second was to identify or adapt a screening tool for to enhance parental capability, physical health, school children aged 6 to 12 years. achievement and participation could assist to improve For the first project, we provided a summary of the settlement outcomes for young refugees. published international guideline recommendations for Also as part of the Program Grant we are conducting a the provision of PFA and universal psychosocial responses randomised controlled trial of a transdiagnostic intervention following emergencies, and developed a preliminary best for anxiety and depressive disorders that develop following practice framework to guide the evaluation and continual severe injury. We have been recruiting injury survivors from improvement of PFA services. the Alfred and Royal Melbourne Trauma Services and using For the second project, our objective was to identify or a stepped screening process identifying those who develop adapt a screening tool to identify primary school-aged disorders. The study is due for completion in 2019. children who are experiencing elevated levels of distress following exposure to a disaster. This was based on a review of current best practice approaches together with advice Strengthening School Communities from international experts in the field. We identified one This project is exploring the feasibility and impact of a tool for children aged seven and above, the Children’s classroom-delivered recovery and resilience program Revised Impact of Event Scale (CRIES; Children and War for children exposed to or at risk of potentially traumatic Foundation, 2005) and an alternate tool for younger incidents, including disasters and school emergencies. children, the Pediatric Emotional Distress Scale (PEDS; Skills for Psychological Recovery for Teachers (SPR-T) is Saylor et al., 1999). an adaptation of an existing intervention designed to assist adults in the aftermath of a disaster. The package has been re-developed as an online training program to enable teachers to implement the skills-based training in the classroom. To date, the existing resources have been
Annual Report 2017 / 2018 21 PhD Research – Primary Supervision
To what extent are Australian Vietnam veterans Social support and wellbeing among survivors of ageing successfully? natural disaster
This research is investigating successful ageing in Australian This longitudinal study, a collaboration between the Vietnam veterans including important ageing areas such University of Melbourne and Peking University, explores the as cognitive, psychological, physical, social, and spiritual psychological impact of social support received following domains. The research will inform the development of the Lushan County earthquake in 2013. By interviewing interventions that promote successful ageing in veterans as earthquake survivors two and a half years following the they age. An initial qualitative study funded by the Hallmark disaster, the study seeks to understand the impact of Ageing Research Initiative has been conducted, see report received social support on longer-term mental health and on page 21. This PhD is due for completion in July 2020. wellbeing, and explore the features that determine the quality of help received. This PhD is due for completion in Exploring Complex PTSD in a sample of people 2019. experiencing homelessness Moral injury in military and emergency services This study of 206 of Melbourne’s most disadvantaged personnel homeless (the largest sample of this population in an Australian study) investigated clinical outcomes following This study on moral injury has three components: 1) a trauma. The findings are important for the scientific qualitative investigation of the link between types of community in terms of understanding the construct of potentially morally injurious events and psychological Complex PTSD and its phenomenology. This PhD was responses; 2) development of a measure to assess a range completed in December 2017. of responses, with a particular focus on shame; 3): an fMRI study to investigate whether there are differences at a Mental health and wellbeing in firefighters neurobiological level between subjects with moral injury and PTSD. This PhD is due for completion in 2021. This study aims to clarify the prevalence of the mental health disorders that are commonly associated with exposure to trauma and develop a greater understanding of the range of factors which contribute to better and worse mental health in an Australian sample of firefighters. This PhD is due for completion in December 2018.
22 Annual Report 2017 / 2018 75% of Australians are exposed to at least one traumatic event in their lifetime
Annual Report 2017 / 2018 23 Policy and Service Development
Phoenix Australia’s policy and service development work 2017 - 2018 Overview aims to get evidence-based interventions into practice Over the past year, we have continued to work extensively to improve outcomes for people affected by trauma. Our with organisations to improve outcomes for current and service development work is informed by international former Defence members and people working in high risk research as well as our own expertise across research, organisations. We have collaborated with police services at translation and training. We translate research into best a state and federal level to help improve their approaches practice policies and procedures for organisations, and work to the mental health needs of their workforces. This has with organisations to build their capacity to minimise the included conducting a comprehensive review of mental impact of workplace trauma. health services offered to Australian Federal Police staff and a review of critical incident management for the Victoria Police Special Operations Group. We have also engaged Phoenix Australia works with organisations that with the Country Fire Authority and Department of Foreign have responsibility for people affected by trauma, Affairs and Trade to provide policy advice and review their including: approach to improving their support of staff. We have increased our focus on developing accessible • organisations where exposure to trauma is a predictable resources for people affected by trauma, including apps, risk of employment (e.g., Defence, police, fire, information booklets, and intervention programs. To ambulance and rail services) support the increased focus on family wellbeing in Defence • organisations that provide health and welfare services and DVA, we have developed information booklets for to people affected by trauma (e.g., agencies working families affected by the mental health of current and former with people experiencing social disadvantage, and Defence members, and for the Defence Community Organisation we have commenced the review and government departments that provide mental health and redevelopment of their programs aimed at improving welfare services) children’s resilience (KidSMART and TeenSMART programs). • organisations that have responsibility for providing We have continued to support the development of trauma treatment (e.g., VVCS, and hospital-based PTSD digital public resources through providing clinical advice, treatment programs) content review, and evaluation support, contributing to the development and improvement of apps for the • organisations responsible for setting the standards Metropolitan Fire Brigade and the Department of of care for people affected by trauma (e.g., the General Practice. Departments of Veterans’ Affairs and Defence, and third Our ongoing engagement with the compensation and party insurers). insurance sector across research, training, and policy and service development has led to new collaborations, such as partnering with the NSW state insurance regulatory authority to develop a framework that promotes wellbeing and recovery in people affected by motor vehicle accidents. Our work with the compensation sector is informed by trauma informed care principles and our research on the impacts of the compensation process on people who have experienced trauma.
24 Annual Report 2017 / 2018 Case Study Policy and Service Development
Revitalising Group Programs for VVCS
The Veterans and Veterans Families Counselling Service The outcome of our collaboration with Flinders University (VVCS) provides group programs as an important and VVCS is a suite of four engaging, evidence-based group component of the services available to veterans and their treatment programs: Recovery from Trauma, Managing Your families. In keeping with their commitment to continuous Pain, Understanding Anxiety, and Doing Anger Differently. quality improvement, VVCS contracted Phoenix Australia The delivery framework allows for a flexible approach to and our partner the Flinders Human Behaviour and Health delivering the programs with options for standard weekly Research Unit at Flinders University to redevelop four group sessions, condensed/intensive delivery, and a mix of face-to- programs, and redesign how groups are delivered across face and digital components. The development of clinical the organisation. good practice principles guides the integration of groups with one-on-one counselling at VVCS. With a fundamental focus on improving engagement and treatment outcomes, we consulted with VVCS extensively, In completing this important work, Phoenix Australia drew and explored how the delivery of groups can best meet on our ability to form strong partnerships with stakeholders the needs of their varied client cohorts, maintaining and subject matter experts, and brought our familiarity with engagement with existing cohorts but increasing VVCS, our expertise in developing training based on adult engagement with other cohorts such as contemporary education and learning principles, our knowledge base of veterans. We advocated for a ‘future proof’ approach to research into military and veteran mental health and clinical group program delivery, by building in up-to-date best best practice, and our experience in developing multimedia practice treatment strategies, audio-visual content, making learning and self-help tools. use of e-learning technology, and by providing a flexible Evaluation of the programs will be undertaken over the next and modularised delivery framework. 18 months. Further work in enhancing the digital adjunctive content for groups is currently in development with VVCS.
These new-look group programs offer an innovative, flexible approach to group treatment. And together with the existing suite of services that VVCS offers, will give veterans and their families more options for improving mental health and wellbeing.”
Stephanie Hodson National Manager, Veterans and Veterans Families Counselling Service
Annual Report 2017 / 2018 25 Policy and Service Development Projects
child booklet provides helpful information and parenting strategies for parents to assist their children. The development of the booklets was a joint effort, and we thank DVA, VVCS, Defence Community Organisation, the ADF Mental Health Directorate, as well as members of the Defence and veteran communities, for their thoughtful and considered input.
Review of AFP mental health services Over the past two years the Australian Federal Police (AFP) has been implementing a series of initiatives aimed at improving mental health outcomes for staff. The AFP engaged Phoenix Australia to undertake a review of its mental health services to ensure that the AFP has in place a multi-faceted, evidence-based, and comprehensive mental health program tailored to the specific needs of AFP staff. The review was conducted in three phases: 1) a review of AFP Wellbeing and Recovery Framework for SIRA wellbeing policies and procedures; 2) consultations with staff The NSW state insurance regulatory authority (SIRA) including leaders, union and staff support services, and family approached Phoenix Australia to conduct workshops to assist members; and 3) conducting an online staff survey. a new team (CTP ASSIST) to support motor vehicle accident Phoenix Australia has developed a best practice framework (MVA) survivors as they navigate the insurance claims process. for managing mental health in high risk organisations on Based on the success of these workshops, SIRA requested the basis of the research literature and our own extensive our assistance in developing a wellbeing and recovery experience in working with high risk organisations. This framework. framework was used to benchmark the AFP’s mental health The project commenced by identifying best practice for services, and we made recommendations according to each promoting recovery and supporting the wellbeing of MVA element of the framework. survivors going through a claims process. We then consulted The review process was achieved with a high level of with SIRA managers in order to develop the framework. The collaboration and transparency. Phoenix Australia thanks resultant SIRA Wellbeing and Recovery Framework informs: the staff members who gave their time to contribute to the 1) the work of staff who provide advice and support to MVA review. We hope that our review and recommendations will survivors through the claims process; 2) information provided provide a roadmap for ongoing improvement within the AFP. on the SIRA website for the public, insurers and professionals; and 3) guidance provided to insurers regarding the emotional recovery needs of people involved in an MVA. The framework seeks to ensure that people who have experienced an MVA have a positive and empowering interaction with service providers to support their wellbeing. It is consistent with evidence-based and trauma-informed service delivery. The work done with SIRA built on the regulator’s strong focus on client-centred processes and Phoenix Australia’s expanding work and research in the area Information booklets about PTSD for Defence of compensation support. family members DVA engaged Phoenix Australia to develop information Clinical data collection for DVA Trauma Recovery booklets for family members of serving, transitioning or ex- Programs – PTSD serving members of the ADF who are experiencing mental Phoenix Australia continues to monitor and report on the health difficulties following trauma. treatment outcomes of DVA-funded Trauma Recovery We developed five booklets: Supporting your partner, Programs (TRP) for veterans and other ex-serving members of When your parent is having problems (for adolescents), the ADF which are currently delivered by 13 hospitals across What’s happening to my family? (for children aged 9-12 Australia. In June 2017, the clinical data collection project years), Helping your child (to assist with parenting of children expanded to include the collection and analysis of data from and adolescents), and Supporting your son or daughter ADF members who attend the TRPs. (for the parents of members and ex-serving members). In the 2017-18 year, a total of 42 cohorts commenced, Each booklet aims to provide engaging, practical and including 187 veterans and 46 ADF members. The data personalised information on PTSD and other trauma-related collected shows that the TRPs are achieving modest positive mental health problems. The booklets provide advice overall clinical outcomes. Veteran data indicated small to about helping yourself and others, effective treatments moderate improvements on most primary and secondary and support, and getting help. Two booklets provide outcome measures from intake to discharge, and these developmentally appropriate information and practical ideas changes appeared to be maintained across to the 3-month to help adolescents and younger children cope with a parent and 9-month follow-ups. The ADF data showed small suffering from a mental health problem, and the Helping your improvements from intake to discharge.
26 Annual Report 2017 / 2018 Review and redevelopment of DCO’s KidSMART and Improving access to care and increasing resilience TeenSMART programs in migrant and refugee populations Children in military families face unique challenges, including Phoenix Australia in partnership with the Australian Muslim periods of separation from parents, concern for parent Women’s Centre for Human Rights (AMWCHR) is investigating safety during deployment, and frequent relocation. The the barriers and facilitators to accessing psychological support Defence Community Organisation (DCO) offers programs to experienced by migrant and refugee women exposed to children and teenagers which aim to foster resilience. DCO family violence or sexual assault. Recommendations based approached Phoenix Australia to review the existing programs on research will be developed to help increase access to and develop new content and produce train-the-trainer trauma informed care and mental health support. This two- materials. Three sets of materials based on best practice year project has been funded by the Helen Macpherson resilience programs aimed at children will be developed: for Smith Trust. 6-8 year olds, 9-12 year olds, and 13-17 year olds. Participant To date, we have conducted a literature review and resources will be developmentally appropriate and engaging, consultations and prepared a draft framework for trauma and the program will be suitable to be delivered by people informed care guidelines around delivery of culturally who have no mental health or social work experience. appropriate services. In partnership with AMWCHR and with funding from the Review of CFA mental health and wellbeing support Victorian Department of Premier and Cabinet, we have The Country Fire Authority (CFA) engaged Phoenix Australia examined how to best promote resilience in Muslim families. to conduct a review of mental health and wellbeing support in We conducted a literature review to identify existing the CFA, including its peer support program. The review will approaches to fostering family resilience in vulnerable families lead to advice on the required elements of a comprehensive and migrant and refugee communities, and developed and integrated wellbeing framework that addresses the needs an intervention aimed at increasing resilience and social of CFA members across their work lifecycle. Phoenix Australia participation in Muslim families. will also provide recommendations for enhancing the peer support program. MFB Let Me Know app Phoenix Australia partnered with the Metropolitan Fire Review of DFAT critical incident policy Brigade (MFB) to develop a mental health app for Victorian Department of Foreign Affairs and Trade (DFAT) staff can be firefighters (MFB and CFA). Let Me Know is a confidential exposed to critical incidents when working in Australia and self-assessment and self-care resource that allows users to overseas. DFAT engaged Phoenix Australia to review their measure the impact of exposure to trauma on their mental Critical Incident Policy to identify gaps and provide written health, and receive information and strategies accordingly. recommendations about changes and improvements to Phoenix Australia provided mental health consultancy and this policy. contributed to the overall design and functionality of this resource. This work continues our work in digital mental health resources, and followed on from the rollout across Australia Review of trauma support for Victoria Police Special of Equipt – an app developed in collaboration with the Police Operations Group Association of Victoria and VICPOL. Phoenix Australia was contracted by the Victoria Police Special Operations Group (SOG) to conduct a review of their General Practice Driving to Health app for taxi drivers critical incident, trauma support, and trauma management procedures, and to develop a psychological wellbeing Phoenix Australia collaborated with the Department of framework to meet the specific needs of the SOG. We General Practice on a pilot study of a mobile app for reducing reviewed the Victoria Police mental health and wellbeing psychological distress among taxi drivers. The Driving to policies and consulted with Victoria Police stakeholders, Health app was designed to increase taxi drivers’ use of self- SOG members, former SOG members and SOG family help strategies for psychological wellbeing and to encourage members. The review considered both operational and help-seeking among drivers with high psychological distress. organisational stressors in the workplace, and the associated An evaluation of the app suggests that it is an acceptable mental health support requirements. We made a number and feasible mental health tool to improve mental health of recommendations, based on best practice in high risk awareness and help-seeking in a hard to reach population. industries with similar demands to the work of SOG, to enhance the existing approach to mental health in SOG: Assessment of mental health after concussion promoting psychological preparedness, improving staff The Australian Football League has contracted Phoenix wellbeing, encouraging appropriate help-seeking, and Australia to develop and implement a standardised ensuring delivery of consistent and tailored post-incident protocol for the comprehensive assessment of mental support. health functioning in retired players who had received multiple concussive injuries in the course of their career. The individual mental health assessment provides the player with personalised diagnostic information and recommendations for seeking support and/or treatment for any identified problems. It is hoped that the data collected will contribute to the longitudinal data set on retired players which explores the relationships between the physical, neuropsychological, and mental health domains of players, which in turn will assist the AFL in the development of a comprehensive biopsychosocial lifespan health management plan for players.
Annual Report 2017 / 2018 27 Education & Training
At Phoenix Australia, we believe that giving practitioners 2017 - 2018 Overview and other providers the skills and knowledge to provide In 2017-2018, Phoenix Australia’s education and training practical, effective support and treatment will enhance the programs continued to support the work of organisations quality of life of those affected by trauma. and practitioners engaged in the critical work of providing Phoenix Australia delivers engaging and effective education treatment and support services for those affected by trauma. and training programs, and provides supervision and Our evidence-based training, supervision, and consultation consultation services to meet the needs of a diverse range services were delivered to government departments, military of practitioners and organisations. We also develop and veteran support agencies, professional and community- and deliver digital, face-to-face or blended training and based services as well as to individual practitioners across implementation solutions. Australia. Phoenix Australia’s training is offered via our one and two-day public workshops, as well as our private training programs tailored for the needs of specific organisations or workforces. Our public and private training programs increasingly reached beyond capital cities into regional and remote regions during 2017-2018. Phoenix Australia partnered with agencies supporting some of Australia’s Formal mental 3 health interventions most vulnerable and disadvantaged populations, delivering high quality, tailored workforce development programs. Our tailored programs included not only evidence-based Simple psychological skills training, but in many cases we provided policy strategies 2 and implementation guidance, follow-up practitioner consultations, as well as leadership training to ensure that Early response trauma informed and trauma-focussed treatment capacities 1advice and support are maintained and developed. We also developed e-learning training allowing people to access critical knowledge and skills more flexibly online. We expanded our repertoire of training offerings this year. Typically, our education and training activities are guided We drew on our track record of work supporting high by a three-level framework to deliver the most appropriate risk industry workforces such as law enforcement workers support and mental health care. and staff engaged in viewing objectionable material, and developed tailored resilience programs. These programs Level 1 refers to advice and simple practical and emotional support that can be provided in the days and weeks have been provided to a range of workers engaged in legal, following a traumatic event, aimed at reducing distress and military, and judicial settings, in recognition that working with facilitating recovery. individuals affected by trauma can have a range of impacts on staff. These programs aim to increase awareness of Level 2 refers to recovery-oriented approaches to assist trauma and its impact on staff wellbeing, as well as enhance those with more persistent posttraumatic mental health workforce resilience. problems. These approaches are well suited to practitioners with basic counselling skills working in primary care, mental Our programs, delivered by highly experienced trauma health, and community-based settings. experts and facilitators continue to receive excellent Level 3 refers to more intensive evidence-based feedback. Participants and the organisations we partner with psychological and pharmacological interventions for people consistently rate our programs highly for quality of content with more chronic and severe distress, including those with and delivery. diagnosable posttraumatic mental health disorders. 98% 100% participants rated the participants would recommend quality of training as high the training to others
28 Annual Report 2017 / 2018 Case Study Education & Training
Improving practitioner competence in evidence-based therapy for emergency service workers with PTSD
EML is a respected provider of workers compensation Forty-five psychologists attended the PE training workshop claims management in Australia, providing services to a in Sydney and 33 of these practitioners went on to attend 10 number of emergency service organisations. Consistent consultations or more. Our evaluation of the efficacy of the with their support for best practice in the management of program found that its aims were largely met: practitioners posttraumatic mental health problems in emergency service who participated in the full program showed that their workers, EML engaged Phoenix Australia to train New competency in delivering PE improved, their expectations South Wales psychologists in Prolonged Exposure therapy of the therapy improved, and they used PE with a greater for their work treating emergency service personnel with proportion of clients than prior to the training. The posttraumatic stress disorder (PTSD). Prolonged Exposure workshop and consultations were also rated very positively therapy (PE) is one of the most effective psychological by practitioners. therapies for PTSD but is not widely used by practitioners. One implication of our evaluation is the need to investigate Phoenix Australia aimed to deliver a comprehensive and strategies to enable practitioners to deliver PE or other effective training program that would improve practitioners’: evidence-based psychological therapies to more clients with 1) competence in using PE; 2) expectations for positive PTSD. outcomes from treatment; and 3) actual use of PE with clients with PTSD. A senior Phoenix Australia trainer with PE training accreditation delivered a skills-based training workshop to the practitioners, followed by telephone- based group consultations over a six-month period to assist attendees in their use of PE with clients. The workshop included video demonstrations, skills practice, and discussions of problematic reactions and therapist self-care. The consultations provided an opportunity for case-based discussion and feedback.
The training and consultations were educational and facilitated learning. They scaffolded on the background I had providing therapy for PTSD. The consultations were valuable due to the presentations of other participants and an opportunity to gain feedback and suggestions regarding my own work.”
Training participant
Annual Report 2017 / 2018 29 Education and Training Projects
Queensland Health disaster response training Remote Trauma Informed Care training The Queensland Department of Health is building the Phoenix Australia partnered with alcohol and drug and capacity of local practitioners and communities to respond hospital services in Mount Isa, Queensland to provide to the mental health impact of natural disasters and an enhanced trauma informed capacity development emergency incidents. Phoenix Australia was commissioned program to this remote location. Mount Isa’s health services to deliver a suite of training programs to practitioners in engaged Phoenix Australia to address a significant local disaster-prone communities. The programs delivered were need for effective interventions in trauma recovery. We Skills for Psychological Recovery (including a train-the-trainer delivered a series of extended Trauma Informed Care (TIC) workshop) and Psychological Treatment following Trauma workshops, allowing the training to address complex trauma and Disaster. The aims of the training programs were to presentations and comorbid alcohol and drug and mental train local practitioners to be competent and confident health needs. Phoenix Australia also provided a trauma in delivery of the two programs, and to promote their informed supervision training to a group of local clinical uptake and delivery by practitioners. The evaluation of the leads. This approach aimed to ensure that the trauma five workshops conducted indicated that they were well informed services were supported by a knowledgeable, well received, and importantly, that practitioners’ confidence to equipped team of local TIC ‘champions’. Phoenix Australia deliver interventions significantly improved with training and will return to Mount Isa later in 2018 to provide a booster was high at the end of training. session for Mount Isa services. In addition, we presented two workshops in Trauma- Focussed Therapy to Queensland Health clinicians in Mackay and Rockhampton, including members of the specialist Disaster Response Team, as part of the Queensland Government’s response following Cyclone Debbie in 2017.
Trauma recovery website Phoenix Australia, with the support of the Perpetual Philanthropic trust and a range of public donors, has been developing an online resource to support the recovery of people affected by trauma. Recovery Online will be an information and support website for people who have Training for DFAT staff experienced all forms of trauma, and who are experiencing Staff within the Department of Foreign Affairs (DFAT) the full range of potential impacts. The website provides can be exposed to potentially traumatic events and simple, easily accessible information about recovery, help- objectionable materials as part of their work duties in seeking and self-care. Phoenix Australia has developed a consular and humanitarian settings. DFAT engaged range of audio-visual resources for the website, and has Phoenix Australia to develop train-the-trainer resources to expanded our digital capabilities by undertaking the design enable in-service training for DFAT staff on two programs, and development of the resource in-house. It is expected Psychological First Aid (PFA) and Managing Exposure to that Recovery Online will debut in November 2018. Objectionable Materials. The PFA training was based on a flexible, evidence-informed approach to assist individuals, workplaces, and communities in the immediate aftermath of potentially traumatic events. The Managing Exposure to Objectionable Materials training included adaptive work practices with a focus on prevention, preparation, minimisation of exposure, and post-exposure management strategies.
30 Annual Report 2017 / 2018 Phoenix Australia public training program Resilience training Phoenix Australia’s public training programs were delivered Supporting trauma-affected populations can have an impact around Australia, with 42 workshops scheduled in 2017, and 37 on worker health and wellbeing. Employees engaged in a in 2018. The programs are aimed at a range of personnel who range of occupations within health settings as well as legal, support and treat individuals who have experienced the impact forensic, and other social service settings can experience these of psychological trauma. impacts through exposure to the details of people’s trauma, Our flagship Trauma-Focussed Psychological Therapy training through involvement in critical incidents, or from having to programs (for therapists working with children, and with adults) view objectionable material. Phoenix Australia has developed provide mental health professionals with the necessary skills and is delivering a range of tailored trauma informed resilience in exposure and cognitive therapy to effectively treat PTSD workshops to organisations to support the mental health and related conditions. Our Cognitive Processing Therapy and wellbeing of staff. Our programs identify the sources of program provides an alternative approach for evidence-based potential harm, what the impacts can be, and importantly, therapy for PTSD. These training programs include small-group what organisations and individuals can do to actively support consultations following the workshop to support practitioners to resilience. implement new skills in their practice. Our Anger and Trauma program provides a model to Training for frontline staff better understand anger in the context of trauma exposure, Phoenix Australia is increasingly working with compensation and provides practitioners with a set of flexible, effective providers and other organisations where frontline staff interventions to address problematic anger. communicate with and assist people who have experienced The Neuropsychological Impact of Trauma workshop provides trauma. Workshops are tailored to the particular needs of the an overview of how trauma impacts the brain at different stages organisation, but common aspects of the training include of the lifespan, and how to identify cognitive deficits and understanding the difficulties experienced by people following consider the practical implications for treatment planning. exposure to trauma, principles for supporting recovery, communicating effectively with people who have experienced Trauma Informed Care training provides a framework for trauma, and strategies for maintaining one’s own wellbeing, and understanding, responding to, and aiding recovery from that of colleagues. trauma-related impacts. Psychological First Aid training is suited to those who provide support in the immediate aftermath of We provided tailored training to SIRA for its CTP Assist team potentially traumatic events in the field (e.g., natural disaster) or (call centre and complex care team staff) who assist people within organisational settings (e.g., schools). following a motor vehicle accident, and also to staff of the Office of the Commonwealth Ombudsman who provide support to ADF and ex-ADF members who report physical or sexual abuse. Trauma Informed Care training Phoenix Australia’s TIC training and supervision program reflects Child complex trauma training a demand for a flexible approach for supporting engagement, The South Eastern Centre Against Sexual Assault engaged stabilisation, and ultimately recovery. Our model is underpinned Phoenix Australia to provide training for its workers in treating by effective tools, and tailored to best fit the needs of both complex trauma in children, often the result of experiencing clinical and community sector services. Our program allows neglect, sexual abuse, and witnessing domestic violence. We workers to understand the biopsychosocial impacts of trauma, adapted our Trauma-Focussed Therapy – Working with Children and equips them to provide psychoeducation, manage trauma and Adolescents training to particularly address the treatment disclosure, and deliver recovery-oriented brief interventions. of complex presentations, and developed audio materials to This year, we delivered TIC training and consultation services to demonstrate specific skills for treating children who have been practitioners from sectors such as alcohol and drug treatment, sexually abused. adult and adolescent mental health, refugee and asylum seeker The NSW Department of Family and Community Services support, community health, youth-focussed services, and the engaged Phoenix Australia to provide training for their homelessness sector. community centre psychologists who work with children and adolescents who have experienced complex trauma. Psychological First Aid training We presented a tailored training program focussed on the PFA is a recommended, practical and flexible approach to use of exposure-based therapy complemented by cognitive helping people in the immediate aftermath of a traumatic event, interventions. such as a disaster, workplace accident, or assault. Increasingly, organisations want their staff and volunteers trained in post- Mental health training for IPAR rehabilitation staff incident response. Phoenix Australia has provided tailored PFA IPAR, a leading occupational rehabilitation services provider, training to a wide number of organisations, including DFAT, engaged Phoenix Australia to develop a train-the-trainer Queensland Health, ACT Health, Barwon Health, CatholicCare, program on posttraumatic mental health issues for delivery Office of the Public Advocate, William Angliss Institute, Victoria to IPAR rehabilitation staff. The workshop content included Police, and St John Ambulance New South Wales. responses to trauma, effective treatments, assessment and initial management of risks, and staff self-care.
Phoenix Australia supervision Phoenix Australia provides high quality supervision to a range of professionals and organisations. Of note, we provided VVCS staff across Australia with regular group-based supervision to help support their use of Cognitive Processing Therapy for clients with PTSD.
Annual Report 2017 / 2018 31 Highlight Event Launch of the Centenary of Anzac Centre
On Friday 15th September 2017, An initiative of Phoenix Australia, the Centenary of Anzac Centre will improve the mental health of current the Centenary of Anzac Centre was and former Defence personnel. The Anzac Centre launched at Melbourne’s Shrine of comprises a treatment research collaboration to discover new and more effective treatments for PTSD Remembrance by the then Minister for and other mental health problems, and a nationwide Veterans’ Affairs, the Hon Dan Tehan MP. support service for practitioners who treat veterans (read more about the Anzac Centre’s activities on pages 12-15).
Air Vice-Marshal Chris Spence AO, Chairman of Shrine Trustees, welcomed attendees and recited the Ode of Remembrance. His Honour Michael Strong, Chair of Phoenix Australia, spoke of the importance to Phoenix Australia of the Anzac Centre, and welcomed the Minister and other speakers: Professor David Forbes, Air Vice-Marshal Tracy Smart, Commander Joint Health, and Sir Angus Houston - the patron of Phoenix Australia and the Anzac Centre.
32 Annual Report 2017 / 2018 Almost 100 guests attended the launch, including The Anzac Centre will undertake members of the Prime Ministerial Advisory Council pioneering research and provide on Veterans’ Mental Health, Dr Walter Busuttil from expert advice to practitioners Combat Stress in the UK, representatives of ex-service organisations, representatives of emergency services, nationwide who are supporting as well as colleagues from The Prince’s Trust Australia, veterans with PTSD. The NHMRC, the University of Melbourne, the University of Government’s investment in the NSW, and practitioner organisations. Centenary of Anzac Centre will lead Following the official launch, guests enjoyed the to improved treatment of mental opportunity for a relaxed catch up with acquaintances health conditions, including PTSD.” and colleagues over refreshments.
Phoenix Australia sincerely thanks the Australian The Hon Dan Tehan MP Government for its generous foundation grant and support for the Centenary of Anzac Centre.
Annual Report 2017 / 2018 33 Highlight Event International Roundtable on Disaster Recovery in Children
Nineteen mental health experts from Australia, UK, US, Norway, Germany and Canada gathered in Scotland on 21-22 October 2017 for a roundtable aimed at developing a protocol to help children and adolescents recover from trauma and disaster. The roundtable, led by Phoenix Australia and in collaboration with The Prince’s Trust Australia, was supported by His Royal Highness The Prince of Wales.
This roundtable built on a previous meeting of international intervention that helps children and adolescents deal with experts in November 2015, at which an evidence-based their experiences will help facilitate their emotional recovery recovery program for adults impacted by disaster was and minimise the negative impact of the trauma. developed. That program, named SOLAR (Skills fOr Life During the two-day roundtable discussions, delegates Adjustment and Resilience, originally known as InterPAR), developed a framework for a brief early intervention for has now been successfully piloted in communities affected children (SOLAR Kids) and for adolescents (SOLAR Teens), by bushfire in South Australia. SOLAR is a unique program, based on the ‘coach’ model. This approach will allow designed to be delivered by trained non-mental health the intervention to be easily accessed by children and specialists such as disaster responders, Red Cross or adolescents in schools and other local community settings, community volunteers, and community nurses. These vastly increasing its reach. The next steps are to secure ‘coaches’ receive training and supervision to deliver SOLAR funding for the development of the program materials, and to survivors who experience mild to moderate distress for a pilot trial in a location affected by recent disaster (see following a disaster. Queensland Health project summary on page 19). Childhood and adolescence are critical developmental Phoenix Australia is immensely grateful to The Prince of stages and exposure to disaster and trauma has the Wales and all other supporters for making the roundtable potential to significantly impact a child’s development and such a success. long-term outcomes. The result may be ongoing emotional distress, poor relationships, poor school outcomes, and an increased risk of mental health problems. A post-disaster
34 Annual Report 2017 / 2018 Roundtable delegates
Lucy Berliner, Harborview Center for Sexual Assault and Traumatic Stress, US Kate Brady, Australian Red Cross, Australia Professor Richard Bryant, University of New South Wales, Australia Dr Vanessa Cobham, University of Queensland, Australia Professor Mark Creamer, University of Melbourne, Australia Professor Grete Dyb, University of Oslo, Norway Professor David Forbes, Phoenix Australia, University of Melbourne, Australia Associate Professor Lisa Gibbs, University of Melbourne, Australia Professor Lutz Goldbeck, University of Ulm, Germany Associate Professor Nancy Kassan-Adams, University of Pennsylvania, US Professor Justin Kenardy, University of Queensland, Australia Janine Kirk AM, The Prince’s Trust, Australia Professor Brett McDermott, University of Queensland, Australia Dr Richard Meiser-Stedman, University of East Anglia, UK Associate Professor Karen Milligan, Ryerson University, Canada Jane Nursey, Phoenix Australia, University of Melbourne, Australia Elizabeth O’Connell, SYC Ltd, Australia Professor Meaghan O’Donnell, Phoenix Australia, University of Melbourne, Australia Professor Richard Williams, University of South Wales, UK Professor William Yule, King’s College London, UK
Thanks to our partners for facilitating the roundtable: The Prince’s Trust Australia, Pratt Foundation, Attorney-General’s Department, Department of Veterans’ Affairs, and the University of Melbourne.
Annual Report 2017 / 2018 35 Publications, Presentations and Dissemination
Journal Articles Published Murphy, M., Hollinghurst, S., Cowlishaw, S., & Salisbury, Baker, F., Metcalf, O., Varker, T., & O’Donnell, M. (2018). A C. (2018). Primary care outcomes questionnaire: A new systematic review of the efficacy of creative arts therapies in instrument for primary care. British Journal of General the treatment of adults with PTSD. Psychological Trauma: Practice. doi: DOI:10.3399/bjgp18X695765 Theory, Research, Practice, and Policy. Advance online O’Donnell, M., Metcalf, O., Watson, L., Phelps, A., & Varker, publication. http://dx.doi.org/10.1037/tra0000353 T. (2018). A systematic review of the efficacy of psychological Baecher, K., Kangas, M., Taylor, A., O’Donnell, M.L., Bryant, and pharmacological treatments for adjustment disorder in R., Silove, D., … Wade, D. (2018). The role of site and severity adults. Journal of Traumatic Stress, 31, 321-331. doi: 10.1002/ of injury as predictors of mental health outcomes following jts.22295 traumatic injury. Stress and Health. doi/abs/10.1002/smi.2815 O’Donnell, M., Schaefer, I., Varker, T., Kartal, D., Forbes, D., Bryant, R., Creamer, M., O’Donnell, M., Forbes, D., Bryant, R., … Steel, Z. (2017). A systematic review of person- Felmingham, K., Silove, D., … Nickerson, A. (2017). centered approaches to investigating trauma exposure. Separation from parents during childhood trauma predicts Clinical Psychology Review, 57, 22. doi.org/10.1016/j. adult attachment security and post-traumatic stress disorder. cpr.2017.08.009 Psychological Medicine, 47(11), 2028-2035. doi: 10.1017/ Petrie, K., Milligan Saville., J., Gayed, A., Deady, M., Phelps, S0033291717000472 A., Dell, L., Forbes, D., … Harvey, S. (2018). Prevalence of Cash, R., Varker, T., McHugh, A., Metcalf, O., Howard, A., PTSD and common mental disorders amongst ambulance Lloyd, D., … Forbes, D. (2018). Effectiveness of an anger personnel: A systematic review and meta-analysis. Social intervention for military members with PTSD: A clinical case Psychiatry and Psychiatric Epidemiology, https://doi. series. Military Medicine. doi: 10.1093/milmed/usx115 org/10.1007/s00127-018-1539-5 Coffey, G., Nursey, J., & Steele, Z. (2017). Guidelines on the Phelps, A., Steel, A., Metcalf, O., Alkemade, N., Kerr, Psychologically Vulnerable Applicant in the Protection Visa K., O’Donnell, M., Nursey, J., Cooper, J., Howard, A., Assessment Process. United Nations High Commissioner for Armstrong, R., & Forbes, D. (2018). Key patterns and Refugees. predictors of response to treatment for military veterans with posttraumatic stress disorder: A growth mixture modelling Coffey, G., Nursey, J., & Steele, Z. (2017). Schedule of Mental approach. Psychological Medicine, 48(1), 13. doi:10.1017/ State for Refugee Status Determination. United Nations High S0033291717001404 Commissioner for Refugees. Phelps, A., Varker, T., Metcalf, O. & Dell, L. (2017). What Cowlishaw, S., McCambridge, J., & Kessler, D. (2018). are effective psychological interventions for veterans with Identification of gambling problems in primary care: sleep disturbances? A Rapid Evidence Assessment. Military Properties of the NODS-CLiP screening tool. Journal of Medicine, 182(1): e1541-e1550 Addiction Medicine. Epub ahead of print. doi: 10.1097/ ADM.0000000000000429 Roberts, A., Landon, J., Sharman, S., Hakes, J., Suomi, A., & Cowlishaw, S. (2018). Gambling and interpersonal violence: Forbes, D., Nickerson, A., Bryant, R., Creamer, M., Silove, Results from the National Epidemiologic Survey on Alcohol D., McFarlane, A., … O’Donnell, M. (2018). The impact of and Related Conditions (NESARC). The American Journal on post-traumatic stress disorder symptomatology on quality Addictions, 27, 13. doi:10.1111/ajad.12656. of life: The sentinel experience of anger, hypervigilance and restricted affect. Australian & New Zealand Journal of Rodda, S., Merkouris, S., Abraham, C., Hodgins, D., Psychiatry. doi: 10.1177/0004867418772917 Cowlishaw, S., & Dowling, N. (2018). Therapist-delivered and self-help interventions for gambling problems: A review of Gibbs, L., Block, K., MacDougall, C., Harms, L., Baker, contents. Journal of Behavioral Addictions, 7(2), 211-226. E., Richardson, J., … Forbes, D. (2018). Ethical use and impact of participatory approaches to research in post- Spittal, M., Grant, G., O’Donnell, M., McFarlane, A., & disaster environments: An Australian bushfire case Studdert, D. (2018). Development of prediction models of study. BioMed Research International, 12. https://doi. stress and long-term disability among claimants to injury org/10.1155/2018/5621609 compensation systems: A cohort study. BMJ Open, 8. doi:10.1136/bmjopen-2017-020803 Gibbs, L., Molyneaux, R., Whiteley, S., Block, K., Harms, L., Bryant, R., Forbes, D., … Ireton, G. (2018). Distress Tuppin, K., Sinclair, L., Sadler, N. (2017). The three pillars and satisfaction with research participation: Impact on of Australian Army psychology: To serve with a strong retention in longitudinal disaster research. International foundation. In S. Bowles, & P. Bartone (Eds.), Handbook of Journal of Disaster Risk Reduction, 27, 68-74. doi:10.1016/j. Military Psychology, (pp. 489-500). Cham: Springer. ijdrr.2017.09.038 Varker, T., Brand, R., Ward, J., Terhaag, S., & Phelps, A. (2018). King, K., Schlichthorst, M., Spittal, M.J., Phelps, A., & Efficacy of synchronous telepsychology interventions for Pirkis, J. (2018). Can a documentary increase help-seeking people with anxiety, depression, posttraumatic stress disorder intentions in men? A randomised controlled trial. Journal of and adjustment disorder: A rapid evidence assessment. Epidemiology and Community Health., 72(1), 7. doi:10.1136/ Psychological Services. doi:10.1037/ser0000239 jech-2017-209502 Varker, T., Metcalf, O., Forbes, D., Chisholm, K., Harvey, S., Lloyd, D., Varker, T., Pham, T., O’Connor, J., & Phelps, A. Van Hooff, M., … Phelps, A. (2017). Research into Australian (2017). Reach, accessibility and effectiveness of an online self- emergency service workers mental health and wellbeing: guided wellbeing website for the military community. Journal An evidence map. Australian and New Zealand Journal of of Military and Veterans’ Health, 25(2), 8. Psychiatry, 52, 129-148. doi: 10.1177/0004867417738054 Wade, D., Lau, W., Nixon, R. (2018). A clinician’s quick guide of evidence-based approaches: Post-traumatic stress disorder. Clinical Practice Guidelines, 22, 2. doi: 10.1111/cp.12142
36 Annual Report 2017 / 2018 Wade, D., Mewton, L., Varker, T., Phelps, A., & Forbes, D. Forbes, D. (2018, March). Substance use and mental health (2017). The impact of potentially traumatic events on the consequences of trauma and implications for assessment mental health of males who have served in the military: and treatment. Keynote presentation to the Western Findings from the Australian National Survey of Mental Australian Drug and Alcohol Conference, Perth. Health and Wellbeing. Australian & New Zealand Journal of Forbes, D. (2017, October). The Centenary of Anzac Centre. Psychiatry, 51(7), 10. doi:10.1177/0004867416671413 Invited presentation to the Department of Premier & Cabinet Whittle, S., Vijayakumar, N., Simmons, J.G., Dennison, Veterans Branch, Melbourne. M., Schwartz, O., Pantelis, C., … Allen, N.B. (2017). Forbes, D. (2017, December). The Centenary of Anzac Role of positive parenting in the association between Centre; RESTORE Trial; Broader Research Agenda. Invited neighborhood social disadvantage and brain development presentation to the Younger Veterans - Contemporary Needs across adolescence. JAMA Psychiatry. doi:10.1001/ Forum, Canberra. jamapsychiatry.2017.1558 Forbes, D. and Nursey, J. (2017, August). Trauma informed practice. Invited presentation to the conference of the Journal Articles In Press Judicial College, Melbourne. Bryant, R., Edwards, B., Creamer, M., O’Donnell, M., Forbes, D. (2018, May). Treatment of trauma-related Forbes, D., Felmingham, K., … Hadzi-Pavlovic, D. (in press). mental health problems in veterans. Invited presentation to The impact of posttraumatic stress disorder on refugees’ Melbourne Legacy, Melbourne. parenting and their children’s mental health. Lancet Public Forbes, D. (2017, September). What is needed to improve Health. mental health outcomes for military and veteran personnel Bryant, R., Gibbs, L., Gallagher, H., Lusher, D., Pattison, and first responders? Invited presentation to the PTS17 P., MacDougall, C., Harms, L., … Forbes, D. (in press). Forum – Transition & Recovery, Brisbane. Longitudinal study of changing psychological outcomes Nursey, J. (2017, November). PTSD: The Informed Health following the Victorian Black Saturday bushfires. Australian Consumer. Invited presentation to the Actuaries Institute and New Zealand Journal of Psychiatry. Injury and Disability Schemes Seminar, Brisbane. Choi, Y., Hwa-Bok Choi, H., & O’Donnell, M. (in press). O’Donnell, M. (2018, May). Early intervention and facilitating Disaster Reintegration Model: A qualitative analysis on adjustment after disaster. Presentation to disaster response developing Korean disaster mental health support model. work group. Sendai, Japan. International Journal of Environmental Research and Public Health. Phelps, A.J. (2017, August). Understanding Trauma and Recovery. Invited presentation to the TAL Mental Health Kuhn, E., van der Meer, C., Owen, J., Hoffman, J., Cash, R., Awareness Day, Sydney. Carrese, P., … Iversen, T. (in press). PTSD Coach around the world. mHealth. Sadler, N. (2017, November). Modern Warrior Live Music Drama. Panel Member at the 33rd Meeting of the McCarthy, S., Thomas, S., Randle, M., Bestman, A., Pitt, H., International Society for Traumatic Stress Studies, Chicago, Cowlishaw, S., & Daube, M. (in press). Women’s gambling USA. behaviour, product preferences, and perceptions of product harm: Differences by age and gambling status. Harm Sadler, N. (2017, November). Chair, The relationship between Reduction Journal. PTSD and anger: Theory, assessment, and maintaining factors. Symposium at the 33rd Meeting of the International Phelps, A., Kanaan, R., Worsnop, C., Redston, S., Ralph, Society for Traumatic Stress Studies, Chicago, USA. N., & Forbes, D. (in press). An ambulatory PSG study of the posttraumatic nightmares of posttraumatic stress disorder. Sleep. Project Reports Phelps, A., Steele, Z., Cowlishaw, S., Metcalf, O., Alkemade, Baker, D., Rice, S., Sadler, N., Cooper, J., & Wade, D. (2017). N., Elliot, P., … Forbes, D. (in press). Treatment outcomes The Next Post: Young people transitioning from military for military veterans with PTSD: Response trajectories by service and their mental health. Melbourne: Orygen, The symptom cluster. Journal of Traumatic Stress. National Centre of Excellence in Youth Mental Health. Reifels, L., Mills, K., Dückers, M., & O’Donnell, M. (in press). Bendall, S., Phelps, A., Browne, V., Metcalf, O., Cooper, J., Psychiatric epidemiology and disaster exposure in Australia. Rose, B., Nursey, J., & Fava, N. (2018). Trauma and young Epidemiology and Psychiatric Sciences. people. Moving toward trauma-informed services and Wade, D., Lau, L., & Nixon, R. (In press). A clinician’s quick systems. Melbourne: Orygen, The National Centre of guide of evidence-based approaches: Posttraumatic stress Excellence in Youth Mental Health. disorder. Clinical Psychologist. Conroy, R., Gong, J., Phelps, A., & Nursey, J. (2018). Psychological screening tools for identifying psychological distress in children after emergencies. Report developed for Conference Presentations – Invited the Victorian Department of Health and Human Services. Cooper, J. (2017, August). War and health. Invited Melbourne: Phoenix Australia - Centre for Posttraumatic presentation to Torque Global Health Monash, Melbourne. Mental Health. Forbes, D. (2017, July). Current and future directions in the Couineau, A-L., Sadler, N., Terhaag, S., & Nursey, J. (2017). treatment of PTSD. Invited presentation to The Melbourne Review of trauma support for Victoria Police Special Clinic Academic Forum, Melbourne. Operations Group. Report developed for Victoria Police. Melbourne: Phoenix Australia - Centre for Posttraumatic Mental Health.
Annual Report 2017 / 2018 37 Davidson, S., Wade, D., Wadley, G., Reavley, N., Gunn, J., & McGregor, K., Crozier, T., Conroy, R., Mech, P., Wade, Fletcher, S. (2017). Driving to Health: A mobile mental health D., Dennison, M., Johnson, L., & Humphries, M. (2018). intervention for taxi drivers. Interim report prepared for the Occupational violence and aggression post-incident Shepherd Foundation. support resources evaluation report. Report prepared for Dunt, D., Gong, J., Dell, L., Varker, T., & Phelps, A. (2018). the Department of Health and Human Services. Melbourne: Developing a best practice framework for evaluating Phoenix Australia – Centre for Posttraumatic Mental Health. Psychological First Aid in emergency situations. Report O’Donnell, M., Watson, L., Metcalf, O., Varker, T., Couineau, developed for the Victorian Department of Health and A-L., & Forbes, D. (2017). Military and veteran mental Human Services. Melbourne: Phoenix Australia - Centre for health literature scan: 2013-2016. Report prepared for the Posttraumatic Mental Health. Department of Veteran’s Affairs. Melbourne: Phoenix Australia Forbes, D., O’Donnell, M., Wade, D., Nursey, J., Sadler, N., - Centre for Posttraumatic Mental Health. Phelps, A. Ridder, G., & Humphries, M. (2017). Centenary of Phelps, A.P., Dennison, M., Creamer, M., Varker, T., Nursey, Anzac Centre Quarterly Report, August–October 2017. Report J., Sadler, N., Cooper, J. Khoo, A., & Forbes, D. (2018). AFP prepared for the Department of Veterans’ Affairs. Melbourne: structural review, report and policy development on mental Phoenix Australia – Centre for Posttraumatic Mental Health. health: Final report. Report prepared for the Australian Forbes, D., Van Hooff, M., Lawrence-Wood, E., Sadler, N., Federal Police. Melbourne: Phoenix Australia – Centre for Hodson, S., Benassi, H., ... McFarlane, A.C. (2018). The Posttraumatic Mental Health. Transition & Wellbeing Research Programme: Mental Health Phelps, A., Kartal, D., Dell, L. Nursey, J., Sadler, N., O’Donnell, and Wellbeing Transition Study. Report 2: Pathways to Care. M., & Forbes, D. (2018). Centenary of Anzac Centre Quarterly Report prepared for the Department of Veteran’s Affairs and Activity Report, February–April 2018. Report prepared for the the Department of Defence. Department of Veterans’ Affairs. Melbourne: Phoenix Australia Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. – Centre for Posttraumatic Mental Health. (2018). Trauma Recovery Programs (PTSD) – Clinical data Phelps, A., Nursey, J., O’Donnell, M., Wade, D., Ridder, G., collection: Final report. Report prepared for the Department & Forbes, D. (2018). Centenary of Anzac Centre Quarterly of Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for Activity Report, November-January 2018. Report prepared Posttraumatic Mental Health. for the Department of Veterans’ Affairs. Melbourne: Phoenix Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Australia – Centre for Posttraumatic Mental Health. Trauma Recovery Programs - PTSD – Outcome report: Sbisa, A., Knight, H., Dell, L., & Forbes, D. (2018). Rapid Townsville Private Clinic. Report prepared for the Department Exposure Supporting Trauma Recover – The RESTORE trial of Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for progress report 10. Report prepared for the Department of Posttraumatic Mental Health. Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. Posttraumatic Mental Health. (2018). Trauma Recovery Programs - PTSD – Outcome Varker, T., Cole, R., Watson, L., Forbes, D., & O’Donnell, M. report: Toowong Private Hospital. Report prepared for the (2017). Hallucinogens as treatments for PTSD: A pipeline Department of Veterans’ Affairs. Melbourne: Phoenix Australia search. Report prepared for the Department of Veterans’ – Centre for Posttraumatic Mental Health. Affairs. Melbourne: Phoenix Australia Centre for Posttraumatic Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Mental Health. Trauma Recovery Programs - PTSD – Outcome report: The Varker, T., Gibson, K., Watson, L., Metcalf, O., & O’Donnell, Hollywood Clinic. Report prepared for the Department of M. (2018). What is the effectiveness of outreach services for Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for improvement mental health? A Rapid Evidence Assessment. Posttraumatic Mental Health. Report prepared for the Department of Veterans’ Affairs. Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). Melbourne: Phoenix Australia Centre for Posttraumatic Mental Trauma Recovery Programs - PTSD – Outcome report: St Health. John of God Richmond Hospital. Report prepared for the Varker, T., Metcalf, O., Khatri, J., Couineau, A-L., Phelps, Department of Veterans’ Affairs. Melbourne: Phoenix Australia A., & O’Donnell, M.L. (2018). Military and veteran mental – Centre for Posttraumatic Mental Health. health literature scan 2013-2017: Psychosocial need of Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). female veterans. Melbourne: Phoenix Australia – Centre for Trauma Recovery Programs - PTSD – Outcome report: Mater Posttraumatic Mental Health. Health Services North Queensland. Report prepared for the Varker, T., Watson, L., Gibson, K., Knight, H., & O’Donnell, M. Department of Veterans’ Affairs. Melbourne: Phoenix Australia (2017). Hallucinogens as treatments for PTSD, anxiety and – Centre for Posttraumatic Mental Health. depression: A Rapid Evidence Assessment. Report prepared Howard, A., Armstrong, R., Cowlishaw, S., & Phelps, A. (2018). for the Department of Veterans’ Affairs. Melbourne: Phoenix Trauma Recovery Programs - PTSD – Outcome report: Jamie Australia Centre for Posttraumatic Mental Health. Larcombe Centre. Report prepared for the Department of Wade, D., Metcalf, O., Terhaag, S., & Putica, A. (2018) Final Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for report for EML Insurance: Prolonged Exposure therapy Posttraumatic Mental Health. training and consultation program for PTSD among Kartal, D., O’Donnell, M., Hinton, M., Lau, W., Wade, D., emergency service personnel. Melbourne: Phoenix Australia – Nursey, J., Sadler, N., Johnson, L., Dolan, P., Humphries, M., Centre for Posttraumatic Mental Health. & Phelps, A. (2018). Centenary of Anzac Centre - Quarterly activity report. Report prepared for the Department of Veterans’ Affairs. Melbourne: Phoenix Australia – Centre for Posttraumatic Mental Health.
38 Annual Report 2017 / 2018 Improving outcomes for past and present members of the Defence community
Annual Report 2017 / 2018 39 Our Staff
During the 2017-2018 financial year, we welcomed:
Dr Andrea Putica Research Fellow I Juhi Khatri Research Assistant Lilian Ferguson Receptionist/ Belinda Pacella Research Assistant Office Administrator Kari McGregor Research Fellow I Dr Sean Cowlishaw Senior Research Fellow Dr David Pedder Research Fellow I Tilly Crozier Senior Clinical Specialist Dr Ellie Brown Research Fellow I Dr Alyssa Sbisa Research Fellow I Dr Rowena Conroy Senior Clinical Specialist Dr Paulina Mech Research Fellow I Dr Ros Lethbridge Clinical Specialist
This year we farewelled Dr Megan Dennison, Research Fellow I. We thank her for her hard work and commitment over the period she was employed with Phoenix Australia.
Phoenix Australia Employees as at 30 June 2018
Management Group Leadership Team Professor David Forbes Director Dr Richard Cash Director Education Associate Professor and Training Andrea Phelps Deputy Director Anne-Laure Couineau Director Policy and Professor Service Development Meaghan O’Donnell Head of Research Jane Nursey Director Centenary Associate Professor of Anzac Centre Darryl Wade Head of Policy and Practice Practitioner Support Service Dr John Cooper Consultant Psychiatrist Nicole Sadler Director Military and Paul Dolan Head of Strategy High Risk Organisations and Operations
Our People Dr Renee Armstrong Research Fellow I Dr Olivia Metcalf Clinical Research Specialist Dr Ellie Brown Research Fellow I Dr Kim Murray Clinical Research Specialist Dr Katherine Chisholm Research Fellow I Belinda Pacella Research Assistant Dr Rowena Conroy Senior Clinical Specialist Amanda Pearce Research Assistant Dr Sean Cowlishaw Senior Research Fellow Dr David Pedder Research Fellow I Tilly Crozier Senior Clinical Specialist Dr Andrea Putica Research Fellow I Dr Lisa Dell Senior Research Fellow Dr Naomi Ralph Research Fellow I Lilian Ferguson Receptionist/Office Daniel Redman IT Officer Administrator Dr Alyssa Sbisa Research Fellow I Suzie Firth Centre Manager Rebecca Sheehan Business Services Officer Dr Julia Fredrickson Clinical Research Specialist Dr Sonia Terhaag Research Fellow I Kari Gibson Research Assistant Dr Tracey Varker Senior Research Fellow Jaiganesh Govinda Swamy Financial Accountant Loretta Watson Research Assistant Alexandra Howard Senior Clinical Specialist Maria Humphries Communications Manager Dr Dzenana Kartal Research Specialist Honorary Staff Members Juhi Khatri Research Assistant Professor Richard Bryant Professorial Fellow Dr Holly Knight Clinical Research Specialist Professor Mark Creamer Professorial Fellow Dr Winnie Lau Senior Clinical Research Specialist Dr Peter Elliott Senior Fellow Dr Ros Lethbridge Clinical Specialist Associate Professor Virginia Lewis Principal Fellow Kari McGregor Research Fellow I Dr Lynda Matthews Senior Fellow Dr Paulina Mech Research Fellow I Professor Reg Nixon Principal Fellow Lee Merzel Executive Assistant
40 Annual Report 2017 / 2018 Governance and Management
Board of Management Membership and Meetings
The Phoenix Australia Board of Management is led by an independent chair and includes representatives from the Department of Veterans’ Affairs, the Australian Defence Force and the University of Melbourne. It also includes an independent secretary, one further independent director and the executive positions of Director of Phoenix Australia and Executive Manager Business Planning & Strategy.
Board members as at 30 June 2018
His Honour Michael Strong Professor David Forbes Ms Gayle Anderson Mr Paul Dolan Professor Malcolm Hopwood Major General Mark Kelly AO DSC Mr Greg Ridder Air Vice-Marshal Tracy Smart AM
Board meetings and attendance
30/08/17 08/11/17 06/12/17 21/02/18 09/05/18
His Honour Michael Strong • • • •
Professor David Forbes • • • •
Mr Paul Dolan • • •
Ms Veronica Hancock • •
Professor Malcom Hopwood • • •
Major General Mark Kelly • • • •
Mr Greg Ridder • • • •
Air Vice-Marshal Tracy Smart • •
Ms Gayle Anderson •
AGM attendance • Attendance Non-appointment at time of meeting
Annual Report 2017 / 2018 41
Significant Events
Board Appointments, Cessations, Resignations and Re-appointments
The following movements relating to the Board of Management occurred during the 2017-18 year:
• Ms Sue Campion resigned from the Board on 5 July 2017.
• Ms Veronica Hancock was appointed to the Board on 30 August 2017, and resigned from the Board on 6 December 2017.
• Professor Ian Everall resigned from the Board on 30 August 2017.
• Professor Malcolm Hopwood was appointed to the Board on 30 August 2017.
• Ms Gayle Anderson was appointed to the Board on 21 February 2018.
• Mr Paul Dolan was appointed to the Board as Executive Manager Business Planning and Strategy, with effect from 7 May 2018 for the remainder of current term to 30 April 2020.
• Mr Paul Dolan relinquished the role of Chair of the Finance and Risk Committee, with effect from 7 May 2018.
• Mr Greg Ridder was appointed Chair of the Finance and Risk Committee, with effect from 7 May 2018 for the remainder of current term to 14 April 2020.
Senior Staff Appointments
Mr Greg Ridder was appointed on a contractual basis as Senior Corporate Services Manager, for the period August 2017 to 7 May 2018.
Mr Paul Dolan was appointed as Head of Strategy and Operations, with effect from 7 May 2018.
42 Annual Report 2017 / 2018 Board of Management Report For the year ended 30 June 2018
The Board of Management submit the financial accounts of Phoenix Australia Centre for Posttraumatic Mental Health Inc for the financial year ended 30 June 2018.
Board Members The Board of Management in office at any time during or since the end of the year are: His Honour Michael Strong (Chair) Professor Ian Everall (Resigned 30-08-2017) Ms Gayle Anderson (Appointed 21-02-2018) Professor David Forbes Professor Malcolm Hopwood (Appointed 30-08-2017) Major General Mark Kelly AO DSC Air Vice-Marshal Tracy Smart AM Mr Greg Ridder Ms Sue Campion (Resigned 05-07-2017) Mr Paul Dolan Ms Veronica Hancock (Appointed 30-08-2017, resigned 06-12-2017)
Board members have been in office since the start of the financial year to the date of this report unless otherwise noted.
Principal Activities The principal activities of the Association during the year were to build the capability of individuals, communities and organisations to prevent, recognise and reduce the adverse mental health effects of trauma. The Association achieves this through world class research, policy and service development, and education and training.
Operating Results The operating result for the year was a surplus of $323,389 (2017: $77,493). The Association is exempt from income tax.
Significant Changes in State of Affairs In the opinion of the Board of Management, there were no significant changes in the state of affairs the Association that occurred during the financial year under review not otherwise disclosed in this report.
After Balance Date Events There has not arisen in the interval between the end of the financial year and the date of the report any item, transaction or event of a material and unusual nature that in the opinion of the Board is likely to substantially affect the operations of the Association, the results of those operations or the Association’s state of affairs in future financial years.
Future Developments The Association will continue to carry on the principal activities noted above. There are no likely developments in the activities in future years which will affect the results and therefore require disclosure.
Indemnification and Insurance of Board During the year, the Association paid insurance premiums to Comcover to indemnify its current Board of Directors and officers for the professional risks associated with their responsibilities and roles as Board of Directors and officers of the Association.
Signed in accordance with a resolution of the Board of Management on 26th September 2018.
His Honor Michael Strong Professor David Forbes Chair Director
Annual Report 2017 / 2018 43 Statement of Profit Or Loss and Other Comprehensive Income For the year ended 30 June 2018
Notes 2018 2017 $ $ Income DVA Core Funding 13 1,346,697 1,318,997 Centenary of Anzac Centre 16 (a) & (b) 1,067,904 - Policy and Service Improvement and Advice Income 1,473,127 717,980 Research Income 1,620,977 1,824,516 Training and Education Income 860,155 728,798 Publications and Audio Visual Sales 8,353 7,620 Donations 2,642 2,362 Income from other activities 14 44,915 53,474
Total income 6,424,770 4,653,747
Expenditure Consultants Fees 12 (a) 23,707 1,222 Contractors Fees 12 (b) & (c) 546,008 494,278 Employment Expense 4,299,205 3,291,619 Depreciation and Amortisation 50,822 60,843 Independent Board Member Fees 42,000 44,000 Printing and Production 94,368 36,600 Travel and Accommodation 220,573 154,914 Rent of Premises 207,378 177,255 Royal Park Site Establishment Expenses 17 206,128 - General Expenses 458,086 348,272
Total Expenditure 6,148,274 4,609,003
Operating profit / (loss) 276,496 44,744
Other Income Interest Received 46,892 30,218 Premises Sublease - 2,531
Net surplus / (deficit) for the year 323,389 77,493
STATEMENT OF CHANGES IN EQUITY
Accumulated surplus at the beginning of the financial year 1,251,955 1,174,462
Net surplus / (deficit) for the year 323,389 77,493
Accumulated surplus at the end of the financial year 1,575,344 1,251,955
The Statements should be read in conjunction with the notes to the accounts.
44 Annual Report 2017 / 2018 Statement of Financial Position As at 30 June 2018
Notes 2018 2017 $ $ Current Assets Cash and Cash Equivalents 2 3,132,669 1,410,795 Trade and Other Receivables 3 1,667,969 1,122,386 Other Assets 4 111,879 295,458 Work in Progress / Advance 1(b) 1,217,066 414,573
Total Current Assets 6,129,583 3,243,212
Non-Current Assets Property, Plant & Equipment 5 49,382 46,301 Intangible Assets 6 54,014 79,313
Total Non-Current Assets 103,396 125,614
Total Assets 6,232,979 3,368,826
Current Liabilities Trade and Other Payables 7 1,765,440 1,527,677 Borrowings 8 30,201 4,622 Other Liabilities 9 2,861,995 584,572
Total Current Liabilities 4,657,635 2,116,871
Net Assets 1,575,344 1,251,955
Funds Accumulated Surplus 1,575,344 1,251,955
Total Funds 1,575,344 1,251,955
The Statement of Financial Position should be read in conjunction with the notes to the accounts.
Annual Report 2017 / 2018 45 Statement of Cash Flows For the year ended 30 June 2018
Notes 2018 2017 $ $ Cash flows from operating activities Receipts from sales and activities 53,268 61,094 Operating income received 8,103,341 3,876,988 Payments to suppliers and employees (6,453,021) (3,903,644)
Net cash provided / (used in) operating activities 10 (b) 1,703,588 34,438
Cash flows from investing activities Interest received 46,892 30,218 Payments for furniture and equipment (28,606) (3,985) Payments for website development - (12,260)
Net cash provided by / (used in) investing activities 18,286 13,973
Net increase / (decrease) in cash held 1,721,874 48,411
Cash and cash equivalents at the beginning of the financial year 1,410,795 1,362,384
Cash and cash equivalents at the end of the financial year 10 (a) 3,132,669 1,410,795
The Cash Flow Statement should be read in conjunction with the notes to the accounts.
46 Annual Report 2017 / 2018 Notes to the Financial Statements For the year ended 30 June 2018
Note 1: Statement of Significant Accounting Policies
This financial report is a special purpose report prepared for use by the Board of Management to satisfy the financial reporting requirements of the Associations Incorporation Reform Act 2012. The Board of Management have determined that the Association is not a reporting entity. The financial report covers Phoenix Australia Centre for Posttraumatic Mental Health Inc as an individual entity and as an association incorporated in Victoria under the Associations Incorporation Reform Act 2012. The report has been prepared in accordance with the requirements of the Associations Incorporation Reform Act 2012 and the following Australian Accounting Standards:
AASB 101: Presentation of Financial Statements AASB 107: Statement of Cash Flows AASB 108: Accounting Policies, Changes in Accounting Estimates and Errors AASB 110: Events after the Reporting Period AASB 116: Property, Plant and Equipment AASB 117: Leases AASB 118: Revenue AASB 138: Intangible Assets
No other Australian Accounting Standards, Australian Accounting Interpretations or other authoritative pronouncements of the Australian Accounting Standards Board have been applied in the preparation of this financial report.
The financial report is prepared on an accrual basis and is based on historical costs and does not take into account changing money values or, except where specifically stated, current valuations of non-current assets.
The following is a summary of the material accounting policies adopted by the Association in the preparation of the financial report. The accounting policies have been consistently applied, unless otherwise stated.
(a) Property, Plant & Equipment Each class of plant and equipment is carried at cost, less, where applicable, any accumulated depreciation.
Furniture and Office Equipment Furniture and office equipment is measured on a cost basis.
Depreciation All fixed assets are depreciated on a diminishing value basis over their useful lives to the Association.
Intangible Assets Assets related to systems and software are carried out at cost, less accumulated amortisation. Systems and software costs are amortised on a straight line basis over 5 years.
Impairment of Assets Assets are assessed for impairment annually. Any excess of an asset’s carrying amount over its recoverable value is recognised immediately as an expense in profit or loss.
Annual Report 2017 / 2018 47 (b) Unearned Income
The liability for unearned income is the unutilised amount of grants received on the condition that specified services are delivered or conditions are fulfilled. Whilst agreed services are usually provided or the conditions usually fulfilled within 12 months of receipt of the grant, where some portion of the agreed services is yet to be provided as at the end of the financial year, a provision is recognised based on the estimated amount of services that will be provided after year end.
Work in Progress / Advance
Represents any preliminary work undertaken for a project where the contract is yet to be signed or when work under contract is in progress but not yet billed.
(c) Taxation Income Tax
The Association is a tax concession charity for the purposes of Australian taxation legislation and is therefore exempt from income tax. This exemption has been confirmed by the Australian Taxation Office.
Goods and Services Tax (GST)
Revenues, expenses and assets are recognised net of the amount of GST except where the amount of GST incurred is not recoverable from the Australian Taxation Office, in which case it is recognised as part of the cost of acquisition of an asset or as part of an item of expense.
(d) Operating Leases
Lease payments for operating leases, where substantially all the risks and benefits remain with the lessor, are recognised as expenses on a straight-line basis over the lease term.
Note 2: Cash and Cash Equivalents 2018 2017 $ $ Petty Cash 297 157 Cash at Bank - NAB Public Fund Account 44,683 42,159 Cash at Bank - NAB Cheque Account 2,166,222 765,617 Term Deposit - NAB (Bank Guarantee) 90,289 88,173 Term Deposit - NAB (Investment 1) 831,178 514,689 3,132,669 1,410,795
48 Annual Report 2017 / 2018 Note 3: Trade and Other Receivables Notes 2018 2017 $ $ Current Trade Debtors 1,652,628 1,117,719 Security Deposit 15,341 4,667 1,667,969 1,122,386
Note 4: Other Assets Current Interest Accrued 8,824 9,751 Prepayments 52,976 31,751 Other Current Assets 15 50,079 253,956
111,879 295,458
Note 5: Property, Plant and Equipment Furniture & Office Equipment 539,434 510,828 Less: Accumulated Depreciation (490,052) (464,527) 49,382 46,301
Note 6: Intangible Assets Project Management System 59,125 59,125 Less: Accumulated Amortisation (59,125) (59,114) Website Development 111,759 111,759 Less: Accumulated Amortisation (63,125) (40,773) Toolbox Database and Report System 37,501 37,501 Less: Accumulated Amortisation (32,120) (29,185) 54,014 79,313
Note 7: Trade and Other Payables Current Trade Creditors 77,773 47,192 Accruals 1,588,601 1,364,229 GST Owing 99,066 116,256 1,765,440 1,527,677
Note 8: Borrowings Current Credit Cards 30,201 4,622 30,201 4,622
Annual Report 2017 / 2018 49 Note 9: Other Liabilities 2018 2017 $ $ Current Unearned Income 2,861,995 584,572
2,861,995 584,572
Note 10: Notes to the Cash Flow Statement
(a) Reconciliation of cash and cash equivalents For the purposes of the Cash Flow Statement, cash and cash equivalents includes cash on hand and in banks and investments in money market instruments, net of outstanding bank overdrafts. Cash and cash equivalents at the end of the financial year as shown in the Cash Flow Statement is reconciled to the related items in the Statement of Financial Position as follows:
Petty Cash 297 157 Cash at Bank - NAB Public Fund Account 44,683 42,159 Cash at Bank - NAB Cheque Account 2,166,222 765,617 Term deposit - NAB (Bank Guarantee) 90,289 88,173 Term deposit - NAB (Investment I) 831,178 514,689
3,132,669 1,410,795
(b) Reconciliation of surplus / (deficit) for the year to net cash flows from operating activities Net surplus / (deficit) for the year 323,389 77,493 Depreciation 25,525 26,028 Amortisation of intangibles 25,299 34,813 Net finance income (46,892) (30,218)
Changes in assets and liabilities, net of effects from acquisitions and disposals of business: (Increase) / decrease in assets
Trade and other receivables (545,583) (704,966) Other assets (618,913) (98,548)
Increase / (decrease) in liabilities Trade and other payables 237,763 741,696 Borrowings 25,579 (1,161) Provisions 2,277,423 (10,699)
Net cash from operating activities 1,703,588 34,438
50 Annual Report 2017 / 2018 Note 11: Lease Commitments and Bank Guarantee 2018 2017 $ $ (a) Lease Commitments Current (less than 12 months) 60,536 182,328 Non Current (more than 12 months) - 64,121
60,536 246,449
The operating lease exists in relation to office rent. The lease is for a term of 5 years ending on 1 November 2018. Renewal negotiations are currently in progress.
Note 12: Contractors and Consultants (a) Consultants Person or company who undertakes a contract to provide specialised advice and/or labour to Phoenix Australia. Consultants usually perform work outside of the skillsets available across Phoenix Australia staff.
(b) Contractors Person or company who undertakes a contract to provide labour and/or materials to perform a service for and/or on behalf of Phoenix Australia. Contractors usually perform overflow work that Phoenix Australia would otherwise be able to perform itself given greater availability of internal resources.
(c) Contractors include Co-partners A Co-partner is a person or company who undertakes a large portion of the work in a particular project, perhaps even a larger portion than that undertaken by Phoenix Australia. Co-partners are hence project-specific. Co-partners usually perform major functions in a project that fall outside of the skillsets of Phoenix Australia staff, although, Phoenix Australia has been determined “lead” partner in these projects.
Note 13: DVA Core Funding DVA provides financial assistance to Phoenix Australia to provide a national base of expertise in veteran and military mental health to improve and maintain the health care and wellbeing of the veteran and defence force communities and provide support to DVA in respect of mental health policy, program development and service. The funding is acquitted similarly to other Phoenix Australia projects, with its own budget and control measures to demonstrate fulfilment of funding purposes and objectives.
Note 14: Income from Other Activities This includes income from donations, attendance at various meetings and other sundry income.
Note 15: Other Current Assets This includes reimburseable expenses for project related activities and a security deposit held in respect of the office leased in Canberra.
Annual Report 2017 / 2018 51 Note 16: Centenary of Anzac Centre Represents a Commonwealth grant provided to Phoenix Australia to establish and operate the Centenary of Anzac Centre consisting of a Practitioner Support Service and Treatment Research Collaboration to improve the mental health outcomes of serving and former-serving Australian Defence Force members. The funding is provided as part of the Support to Veterans and Their Families Program. (a) This Statement of Income and Expenditure has been prepared to meet the requirements of the Commonwealth Grant Agreement to establish and operate the Centenary of Anzac Centre.
Statement of Income and Expenditure For the period 01/07/2017 -30/06/2018
2018 $ Income Grant Funding received during the year 3,000,000
Expenses Salaries acquitted 514,040 Advertisment 3,544 Contractors and Consultants 233,950 Design, Printing and Production 24,453 Domestic Travel and Accommodation 21,031 Venue Hire and Catering 5,613 Royal Park site establishment 227,163 General expenses 9,582 Furniture and equipment at cost 13,903 Rent 14,701 Outgoings 2,245
Total Expenses 1,070,226
Grant Funding to be carried forward 1,929,774
The expenses as reported in above Statement of Income and Expenditure have been spent in accordance with the grant agreement required to be incurred by Phoenix Australia on the agreed project as detailed in the funding agreement.
( b) For the purposes of Phoenix Australia’s financial statements, Centenary of Anzac Centre income is only brought to account to the extent of expenditure incurred on the project. Any remaining project funding received (that is yet to be spent) is carried as unearned income in accordance with the policy outlined at Note 1(b). Reconciliation from the Centenary of Anzac Centre Statement of Income and Expenditure to the Phoenix Australia Statement of Profit or Loss and Other Comprehensive Income
Expenditure incurred per the Centenary of Anzac Centre Statement of Income and Expenditure 16 (a) 1,070,226 Less: Minor timing differences (2,324) Income per the Phoenix Australia Statement of Profit or Loss and Other Comprehensive income 1,067,902
Note 17: Royal Park Site Establishment Expenses This includes cost for establishing & renovating the leased facility to standard required for Treatment Research Clinic operated, for the Centenary of Anzac Centre.
52 Annual Report 2017 / 2018 Board of Management Declaration
The Board of Management has determined that the Association is not a reporting entity.
The Board of Management has determined that this special purpose financial report should be prepared in accordance with the accounting policies described in Note 1 to these financial statements.
In the opinion of the Board of Management:
1 The financial statements and notes to the financial statements for the year ended 30 June 2018 present fairly the financial position of the Association at 30 June 2018 and the results of its operations for the year then ended in accordance with the accounting policies described in Note 1 to the financial statements.
2 There are reasonable grounds to believe the Association will be able to pay its debts as and when they become due and payable.
This declaration is made in accordance with a resolution of the Board and is signed for and on behalf of the Board on 26th September 2018.
His Honour Michael Strong Professor David Forbes Chair Director
Annual Report 2017 / 2018 53 Independent Auditor’s Report
To the Members of Phoenix Australia Centre for Posttraumatic Mental Health Inc.
Opinion We have audited the accompanying financial report, being a special purpose financial report, of Phoenix Australia Centre for Posttraumatic Mental Health Inc. (the Association), which comprises the statement of financial position as at 30 June 2018, statement of profit or loss and other comprehensive income, statement of changes in equity, cash flow statement, a summary of significant accounting policies, other explanatory notes and the statement by the Board of Management. In our opinion, the financial report of Phoenix Australia Centre for Posttraumatic Mental Health Inc. presents fairly, in all material respects the financial position of the Association as of 30 June 2018 and of its financial performance for the year then ended in accordance with the accounting policies described in Note 1 to the financial statements.
Basis of Opinion We conducted our audit in accordance with Australian Auditing Standards. Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Report section of our report. We are independent of the Association in accordance with the auditor independence requirements of the Corporations Act 2001 and the ethical requirements of the Accounting Professional and Ethical Standards Board’s APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to our audit of the financial report in Australia. We have also fulfilled our other ethical responsibilities in accordance with the Code. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. We confirm that the independence declaration required by the Corporations Act 2001, which has been given to the Board of Management of the Association, would be in the same terms if given to the Board of Management as at the time of this auditor’s report.
Basis of Accounting and Restriction on Distribution Without modifying our opinion, we draw attention to Note 1 to the financial report, which describes the basis of accounting. The financial report has been prepared to assist Phoenix Australia Centre for Posttraumatic Mental Health Inc. to meet the requirements of the Associations Incorporation Reform Act 2012. As a result, the financial report may not be suitable for another purpose.
Other Information The Board of Management is responsible for the other information. The other information comprises the information in the Association’s annual report for the year ended 30 June 2018, but does not include the financial report and the auditor’s report thereon. Our opinion on the financial report does not cover the other information and we do not express any form of assurance conclusion thereon. In connection with our audit of the financial report, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial report or our knowledge obtained in the audit or otherwise appears to be materially misstated. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.
54 Annual Report 2017 / 2018 Board of Management’s Responsibility for the Financial Report The Board of Management of the Association is responsible for the preparation and fair presentation of the financial report and have determined that the accounting policies described in Note 1 to the financial statements, which form part of the financial report, are consistent with the financial reporting requirements of the Associations Incorporation Reform Act 2012 and are appropriate to meet the needs of the members. The Board of Management’s responsibilities also include establishing and maintaining internal control relevant to the preparation and fair presentation of the financial report that is free from material misstatement, whether due to fraud or error; selecting and applying appropriate accounting policies; and making accounting estimates that are reasonable in the circumstances.
Auditor’s Responsibility Our objectives are to obtain reasonable assurance about whether the financial report as a whole is free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with the Australian Auditing Standards will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of this financial report. As part of an audit in accordance with the Australian Auditing Standards, we exercise professional judgment and maintain professional scepticism throughout the audit. A further description of our responsibilities for the audit of the financial report is located at the Auditing and Assurance Standards Board website at: www.auasb.gov.au/auditors_responsibilities/ar4.pdf. This description forms part of our auditor’s report. We communicate with the Board of Management of the Association regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.
CFMC Assurance Pty Ltd
Craig Silvester Director
Dated this 26th day of September 2018 at Melbourne.
Annual Report 2017 / 2018 55 Acronyms and Abbreviations
ACT Attention Control Training
ADF Australian Defence Force
AFL Australian Football League
AMWCHR Australian Muslim Women’s Centre for Human Rights
Anzac Centre The Centenary of Anzac Centre
CFA Country Fire Authority
DCO Defence Community Organisation
Defence Department of Defence
DFAT Department of Foreign Affairs and Trade
DVA Department of Veterans’ Affairs fMRI Functional magnetic resonance imaging
HARI University of Melbourne’s Hallmark Ageing Research Initiative
ISTSS International Society for Traumatic Stress Studies
LASER Longitudinal ADF Study Evaluating Resilience
MFB Metropolitan Fire Brigade
MVA Motor vehicle accident
NHMRC National Health and Medical Research Council
PE Prolonged exposure therapy
PFA Psychological First Aid
PTSD Posttraumatic stress disorder
REA Rapid evidence assessment
RESTORE Rapid Exposure Supporting Trauma Recovery trial
SIRA NSW state insurance regulatory authority
SOAR Stepping Out Attention Retraining trial
SOG Victoria Police Special Operations Group
SOLAR Skills fOr Life Adjustment and Resilience
SPR-T Skills for Psychological Recovery for Teachers
TAC Victorian Transport Accident Commission
TIC Trauma informed care
TRP Trauma Recovery Program
VVCS Veterans and Veterans Families Counselling Service
56 Annual Report 2017 / 2018 National Centre of Excellence in Posttraumatic Mental Health www.phoenixaustralia.org
Copyright © 2018. Phoenix Australia Centre for Posttraumatic Mental Health Inc. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or distributed, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission of the publisher.
Published by Phoenix Australia Centre for Posttraumatic Mental Health Inc. Phone: +61 3 9035 5599 [email protected] www.phoenixaustralia.org
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Level 3, Alan Gilbert Building 161 Barry Street, Carlton VIC 3053 Phone: 03 9035 5599