Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users’ global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions.

While dual-caring responsibilities have increased for some middle-aged adults, due to caring for parents and children, limited research exists on the effects on well-being of this dual care role on working carers, and specifically with respect to women. For this 'Sandwich Generation', especially for those who work outside the home, these increased demands may adversely affect their life and job satisfaction, and their well-being, inclusive of their general health. The present research explored the impact of care responsibilities on the overall self-reported quality of life of women dual carers who work. It explored the usefulness of resources for working dual carers, in supporting them in their distinct roles. Employed women (N = 433, aged 23-69, M = 51.27 years) mainly from the United Kingdom and Australia completed an online structured survey. Findings indicated that higher levels of personal and work resources, in particular optimism, self-efficacy, job autonomy, skill discretion, and social support, were able to buffer deleterious outcomes, such as poor well-being (depression, anxiety, stress, negative affect), while supporting well-being (positive affect, general health), increasing job satisfaction and life satisfaction. The dual carer role was not a significant predictor of the participants' well-being, with only the women's general health being slightly reduced.

This qualitative study explored the experiences of self-identified adult players to gain insights into the state of play in adulthood. Interviews were conducted with 26 participants representing different styles of play behaviour. Thematic analysis using Nvivo 12 Plus software revealed that adults play differently from children and have a broader definition of play behaviour. Play was found to be rewarding and provided relief from adult responsibilities. The most skilled players integrated play into their work-life seamlessly. The analysis also identified a typology of 8 player types, influenced by parental attitudes and behaviours during childhood. Participants emphasised the importance of play for promoting wellbeing, although there was a degree of play illiteracy evidenced. Further research is needed to investigate if the benefits of play can be extended to the general population through facilitated engagement with remedial play and the development of an adult play discourse.

BACKGROUND Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy-memory-behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery. AIMS To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history. METHODS An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent. RESULTS A total of 322 men completed the survey. Multiple Welch's t-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent. CONCLUSIONS Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.

Healthcare providers are at high risk of occupational burnout, which has negative implications on the individual, their profession, the organisation and their patients. Psychologists are particularly susceptible to the repercussions of burnout due to the emotionally draining nature and content of their work. However, research has failed to outline and evaluate effective interventions for burnout within the profession. This study aimed to investigate the treatment effectiveness of burnout through a systematic literature review. Systematic searches of four databases using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were conducted. A total of 4832 articles were identified, and 15 were included in the final analysis. The search was limited to scholarly and peer-reviewed journals published in the English language, which measured and utilised a form of intervention for the treatment of burnout or stress and included participants within the psychology profession. Interventions identified included mindfulness, training courses, self-care and other therapy-based forms of interventions. Approximately 60% of study participants reported moderate to high levels of stress. Interventions were largely variable in modality, frequency and duration of sessions and follow-up period. Of the 15 studies included within the review, only four measured burnout as an outcome variable, while the others measured stress. Findings of this systematic review indicate that mindfulness-based interventions may be a starting point for reducing stress; however, the most effective intervention for psychologists who have reached burnout is largely unclear. It is recommended that future studies focus on the identification and measurement of burnout, are more rigorously designed and reported and consider peer-based online support approaches.

Objective: Study 5, from a series of six, examines the influence of attendance rates and personal attendance preferences on the effectiveness of Reflective Practice Groups (RPGs). It also explores participant perceptions regarding benefits and barriers of RPG.This article presents the current study in context of associated research and attempts to synthesise the collective findings. Background: Nursing can be associated with burnout, secondary traumatic stress (STS) and compassion fatigue. RPGs might help mitigate these negative impacts.Study Design/Methods: This cross-sectional study surveyed a cohort of 190 nurses (88% female) using validated scales to assess professional quality of life (ProQOL), job satisfaction (JS) and psychological distress, alongside perceived effectiveness of RPG, attendance rates and preferences. Open-ended questions explored perceived barriers and benefits to attendance.Results: Nurses who attended less RPGs reported higher STS. Those who preferred to go more frequently also reported higher STS however level of attendance and personal preference did not affect each other. Nurses attending 'as often as groups are run' also rated the effectiveness of RPG more highly. Other outcome measures were not significant for either variable. Perceived benefits of RPG included sharing, support, cohesiveness, skills development and facilitatory alliance. Barriers included workloads, rostering, time constraints and discomfort in a group setting.Discussion: The majority of nurses reported higher STS, preferred to attend RPGs more frequently, and rated them as more effective. Nurses who attended more RPGs reported significantly lower STS, indicating a restorative benefit. The lack of significance for Compassion Satisfaction (CS) ratings contrasted with findings of earlier studies. Logistical issues and discomfort in groups were barriers to RPG attendance. Perceived benefits related to personal and workgroup development.Alongside findings from the overarching project, results indicate a positive correlation between effective RPGs, personal and job resources, and aspects of ProQOL.Conclusion: Nurses with higher STS find RPGs more useful and want to attend more often. Higher RPG attendance is associated with lower STS.Voluntary attendance, facilitatory alliance, promotion of psychological safety, and organisational support are key considerations.In context of the overarching project, RPG attendance has been positively correlated with various aspects of ProQOL, personal and job resources. Cause and effect are still not clear and further research is required.What is already known about the topic?center dot RPGs are positively correlated with personal and job resources and CS.center dot Barriers to reflecting in RPGs include workplace logistical issues.What this paper adds:center dot Greater RPG attendance is associated with lower STS.center dot Nurses with higher STS prefer to attend more often and find RPGs more useful.center dot Discomfort in a group setting is an important consideration and should be addressed through effective facilitation and management of group process to promote psychological safety.center dot RPGs have now been positively associated with a greater number of personal resources, job resources and aspects ProQOL.

Background and objectives: Sexual fantasies represent a common aspect of human sexuality that can support sexual well-being but also contribute to psychopathology. The latter warrants intervention and bilateral stimulation with eye movements (EMs) may be a suitable intervention for impairing mental imagery of sexual fantasies. This study aimed to evaluate the effect of multiple rounds of EMs on sexual fantasies, gauge the effect over time with a one-week follow-up, and assess how impaired sexual imagery may influence behaviour and behavioural intention.Methods: Twenty-eight participants (14 male, Mage = 44.10, SDage = 9.77) selected a favoured sexual fantasy and engaged in five repeated rounds of an EM task, either face-to-face or via telehealth. Baseline phenomeno-logical characteristics of sexual fantasies were compared against repeated measures after each round of EMs and at one-week follow-up, as well as hypothetical behavioural intention and frequency of fantasy masturbation.Results: All sexual fantasy characteristics (e.g., vividness, sensations, arousal, believability) diminished pro-gressively between each round of EMs. These characteristics increased from round five to follow-up. However, they remained significantly reduced compared to baseline. Participants' hypothetical behavioural intention and frequency of masturbation associated with their sexual fantasies also reduced post-EM task.Limitations: Use of self-report measures; participants' mental imagery could not be measured directly; and no comparison groups were included.Conclusions: As an imagery impairing task, bilateral stimulation with EMs is effective for diminishing the phenomenological properties of sexual fantasies, extending upon extant literature. Collectively, the progressive research regarding EMs and sexual fantasies encourages replication in specific populations (e.g., individuals with problematic or harmful sexual fantasies).

Blended Learning (BL) as a pedagogical approach has increased in significance during the COVID-19 pandemic, with blended and online learning environments becoming the new digital norm for higher educational institutions around the globe. While BL has been discussed in the literature for thirty years, a common approach has been to categorise learner cohorts to support educators in better understanding students’ relationships with learning technologies. This approach, largely unsupported by empirical evidence, has failed to adequately address the challenges of integrating learning technologies to fit with non-traditional students’ preferences, their BL self-efficacy and the associated pedagogical implications. Focusing on student preference, our study presents findings from a pre-COVID survey of undergraduate students across four campuses of an Australian regional university where students shared their learning technology preferences and the self-regulated learning that influenced their academic self-efficacy in a BL context. Findings show students want consistency, relevance, and effectiveness with the use of BL tools, with a preference for lecture recordings and video resources to support their learning, while email and Facebook Messenger were preferred for communicating with peers and academic staff. Our study suggests a quality BL environment facilitates self-regulated learning using fit-for-purpose technological applications. Academic self-efficacy for BL can increase when students perceive the educational technologies used by their institution are sufficient for their learning needs.

Background Symptom-based diagnostic formulations significantly influence psychological treatment; however, they are not without limitations. Employing a transdiagnostic approach may address these shortcomings. For transdiagnosis to gain wider acceptance, it is crucial to establish a meaningful connection between transdiagnostic measures and symptom expression. Two potential transdiagnostic measures, the Event Characteristics Questionnaire (ECQ) and the Basic Psychological Needs Satisfaction and Needs Frustration Scale (BPNSNFS), were identified based on theories of psychopathology. The present study investigated whether the unique within-person characteristics assessed by each scale could indicate symptom expression over time. Method Online questionnaires were completed by 290 international participants (86% female) who had experienced a significant event within the past 12 months. The measures included the ECQ, BPNSNFS, and clinical assessments of depression, anxiety, and anger. Results Results indicated that only the BPNSNFS demonstrated a meaningful connection with symptom expression. A cross-lagged structural analysis revealed that participants experiencing higher levels of needs frustration reported higher levels of depression and anger. Conversely, those reporting higher levels of needs satisfaction reported lower levels of depression and anxiety. Conclusions The findings suggest that the BPNSNFS can serve as a valuable transdiagnostic tool to enhance the delivery of measure-based care. Further research should continue to explore the clinical role of basic psychological needs.

The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 ( N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 ( N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.

OBJECTIVE:This scoping review will identify and map the literature on interventions to address impostor phenomenon. INTRODUCTION:Impostor phenomenon, also known as impostor syndrome, describes intense feelings of fraudulence and chronic self-doubt. The phenomenon has been associated with a range of psychological issues and has been linked to negative career outcomes. While research on the prevalence of impostor phenomenon and its associated comorbidities has been reported for over 40 years, there is a paucity of studies that describe interventions to address this phenomenon. INCLUSION CRITERIA:The review will consider any English-language study that describes or evaluates interventions to mitigate impostor phenomenon. Quantitative and qualitative studies will be sourced from published literature, gray literature, and the references of retrieved articles. Studies will not be limited by participant or setting. Authors of primary studies will be contacted to identify additional sources or for clarifications, where required. Conference abstracts, editorials, and opinion papers will be excluded. METHODS:Databases to be searched will include APA PsycNet, MEDLINE, Scopus, and Web of Science. All databases will be searched from inception till the present. Retrieved citations will be independently reviewed by the reviewers, and relevant studies will be extracted using a data extraction form developed for this review. The results will be presented in tabular format and accompanied by a narrative summary. The review will be conducted in accordance with the JBI guidelines for scoping reviews. DETAILS OF THIS REVIEW AVAILABLE AT:Open Science Framework osf.io/w7xg6.

The novel coronavirus SARS-CoV-2 (COVID-19) has accentuated the role and interplay of numerous educational factors, inviting pedagogical research concerning online education. Using self-determination theory’s basic psychological needs and fundamental learning theories, identified educational factors were integrated into three pathways: (1) autonomy, technology acceptance, and self-regulation of learning; (2) relatedness, authentic happiness, and a classroom community; and (3) competency, harmonious passion, and trait conscientiousness. This study extends educational research by elucidating the relationships between psychological need fulfilment, educational factors, and students’ expectations of their future grades during the impact of COVID-19. Australian university students ( N = 226, 77% female) completed questionnaires assessing their experience of home isolation, factors of each hypothesised pathway, and their expected grades. Structural equation modelling revealed that higher need fulfilment significantly predicted engagement in educational factors and that educational factors are complexly interrelated, providing resilience, motivation, and the mechanisms that facilitate learning. Most importantly, relatedness between academics and students positively influenced all learning pathways. Reciprocal determinism demonstrated the most substantial association with expected grades, and new insight was gained into the interrelationships of passion, trait conscientiousness, and self-regulation of learning.

Objective Socially anxious individuals may prefer social media platforms over in-person interactions. For those with high social anxiety (SA), Facebook-related tasks have been associated with anxiety, negative thoughts, and safety behaviours. However, Instagram-related research remains limited. The present study aimed to assess Instagram use alongside cognitive and behavioural processes among participants with low, medium, and high SA. We hypothesised that when using Instagram, individuals with higher SA would (1) experience more negative social cognitions, (2) report higher body image concerns, (3) endorse more safety behaviours when posting pictures, and (4) engage in more photo manipulation. Method A sample of 213 Instagram users completed an online survey and were divided into groups based on SA severity. Results The high SA group reported comparing themselves to others and being more anxious on Instagram than the low and medium SA groups. Four 3 (SA groups) x 2 (gender) ANOVAs revealed support for the first three hypotheses and that there was no interaction effect between SA and gender for all outcomes. Conclusions Results expand our understanding of how specific social media platforms may be aversive for individuals with high SA, which has important implications for conceptualising the role of safety behaviours in online interactions. What is already known on this topic: Individuals with high social anxiety may prefer online social interactions. Clark and Wells' cognitive model of social anxiety can be extended to the online social media platforms. Social anxiety may be underpinned by body image concerns. What this paper adds: Instagram users with social anxiety experienced more negative social media cognitions and reported more safety behaviours. Instagram users with social anxiety also experienced more body image concerns. Despite gender differences in photo manipulation, an associated relationship with social anxiety was not supported.

Immersion in nature provides various psychological benefits to well-being. Recent research examines whether these benefits can be replicated in virtual reality (VR). This study aimed to systematically review the literature on the psychological effects on well-being of virtual immersion in nature. Databases searched included Scopus, EBSCO, Web of Science, Psychnet, and Pubmed with inclusion of peer reviewed articles published in English, between 2015 and 2020 (inclusive to July 2020), in which the research design includes VR-based immersion in nature. A total of 21 quantitative studies were identified. Within these articles, most employed quantitative research methodologies within an experimental design. In regard to psychological well-being, some evidence suggests that virtual immersion in nature significantly decreases negative affect. Conversely, other research found no change or an increase in negative affect. Generally, no significant differences were noted for positive affect. Physiological indicators of stress responses to virtual immersion in nature varied. Overall, research exploring the use of virtual reality immersion in nature is limited and the replication of the potential benefits gained from real immersion in nature is poorly understood. Future research is required to advance understanding and knowledge of the outcomes of virtual immersion in nature on human well-being.

Sexual wellbeing is an integral part of human existence, characterised by physical, emotional, mental, and sociocultural factors. This study aimed to synthesise and evaluate psychometric measures of sexual wellbeing. Following systematic review methodology, searches were conducted in August 2020 and articles were screened by two independent reviewers. Studies regarding adult sexual wellbeing (>= 18 years old), that also met eligibility criteria, were identified and relevant psychometric measures were extracted. A total of 74 unique measures were extracted from 88 papers, representing varying aspects of sexual wellbeing. Sexual wellbeing instruments were categorised by domains (e.g., cognitive-affective) and dimensions (e.g., sexual function, sexual desire), and reliability was summarised. The overall psychometric properties demonstrate that current measures are acceptable, although no single measure captured all domains of sexual wellbeing reflected in the literature. Rather, many instruments measured a single dimension of the multifaceted construct with variation amongst what constituted "sexual wellbeing". A unified approach to sexual wellbeing is needed to ensure clear operational definitions and theoretical frameworks are used to support psychometric evaluation. Clinicians and researchers are urged to critically evaluate which instrument best captures the desired aspects of sexual wellbeing or whether a combination of measures would be more appropriate. Supplemental data for this article is available online at https://doi.org/10.1080/14681994.2022.2033967 .

Introduction: Intellectual disability (ID) and co-morbid mental health problems are more common in developing countries such as Bangladesh. However, little is known about how Bangladeshi health practitioners diagnose mental health disorders in people with an ID. Studies in developed countries have explored the impact of the diagnostic overshadowing bias (DOB): the tendency for health practitioners to misattribute mental health symptomology to a client's ID, rather than a separate mental health disorder. To date, no study has investigated the presence of the DOB in Bangladesh. Method: A range of Bangladeshi health practitioners (N = 243) were randomly assigned a clinical vignette describing a client displaying symptoms of a mental health disorder. Vignette 1 described a client with an IQ of 105 who graduated from secondary school. Vignette 2 described a client with an IQ of 55 who attended special education. All other details were identical. Participants rated the likelihood of seven mental health diagnoses on a 5-point Likert scale. Results: Practitioners were more likely to diagnose schizophrenia, drug problems and being bullied in people with a typical IQ compared to those with an ID. Doctors, psychiatrists, and psychologists appeared to be more affected by the DOB than community health workers, traditional healers, and allied health practitioners. Conclusion: Findings indicate that the bias may be present in Bangladesh healthcare professionals. The development and implementation of specific training programs to meet the differing needs of practitioners, across the health fields are recommended.

This article presents qualitative reflections and insights from an evaluative research project on an innovative Australian program for male and female perpetrators of family violence. The study was guided by the Effects, Mechanisms, Moderators, Implementation, and Economic value (EMMIE) framework, with thematic analysis undertaken on the interviews of male and female perpetrators (N = 7), program facilitators (N = 6), and family members (N = 3). Potential gendered differences identified in the lived experience of male and female perpetrators were, first, the level of emotional expression and communication and, second, the level of self-reflection and insight. Despite these potential differences, both male and female perpetrators experienced the implementation of change to attitudes, beliefs, and behaviors relating to family violence as challenging.

Background: Massively multiplayer online games (MMOs) evolve online, whilst engaging large numbers of participants who play concurrently. Their online socialization component is a primary reason for their high popularity. Interestingly, the adverse effects of MMOs have attracted significant attention compared to their potential benefits. Methods: To address this deficit, employing PRISMA guidelines, this systematic review aimed to summarize empirical evidence regarding a range of interpersonal and intrapersonal MMO well-being outcomes for those older than 13. Results: Three databases identified 18 relevant English language studies, 13 quantitative, 4 qualitative and 1 mixed method published between January 2012 and August 2020. A narrative synthesis methodology was employed, whilst validated tools appraised risk of bias and study quality. Conclusions: A significant positive relationship between playing MMOs and social well-being was concluded, irrespective of one's age and/or their casual or immersed gaming patterns. This finding should be considered in the light of the limited: (a) game platforms investigated; (b) well-being constructs identified; and (c) research quality (i.e., modest). Nonetheless, conclusions are of relevance for game developers and health professionals, who should be cognizant of the significant MMOs-well-being association(s). Future research should focus on broadening the well-being constructs investigated, whilst enhancing the applied methodologies.

Objective: This study aimed to examine the relationship between the quality of reflective practice groups and nurses' professional quality of life. Background: Previous nursing research has indicated that reflective practice groups are positively associated with personal resources, job resources, and professional quality of life for nurses. The specific impact of the groups however, has not been distinguished from the impact of personal and job resources, and the explanatory mechanisms for the associations are unclear. Design/Methods: This study utilised a cross-sectional, quantitative research methodology with 184 Australian nurses from a regional teaching hospital who attended reflective practice groups (88.5% female). Surveys captured demographics, personal resources (i.e. self-efficacy), job resources (i.e. job autonomy, skill discretion, job social support, and group cohesion) and perceived quality of reflective practice groups, as measured by the Clinical Supervision Evaluation Questionnaire, alongside professional quality of life outcomes. Results: Participants who rated reflective practice groups as 'high quality' or more effective were associated with significantly higher scores for personal and job resources of self-efficacy, autonomy, skill discretion, social support, and group cohesion. These resources, in turn, correlated with more positive professional quality of life scores; in particular compassion satisfaction and burnout. Discussion: While the study used cross-sectional data and causality cannot be inferred, the findings do indicate a clear association between attending effectively facilitated reflective practice groups and greater personal and job resources. This may indicate that the groups provide nurses with an opportunity to build or enhance these resources. Furthermore, it is proposed that this could explain a mechanism by which reflective practice groups can indirectly impact positively on professional quality of life for nurses by building resources. Future research should explore causality longitudinally. Conclusion: This study provides evidence that nurses who perceive the groups favorably have greater social support, enhanced self-efficacy, more autonomy, and increased skill discretion. These factors also align with the restorative and formative benefits of supervision. Greater personal and job resources, in turn, can enhance professional quality of life. Whilst mediating pathways have been identified, it is still not possible to definitively attribute the development of these resources to group participation. Implications for Research, Policy, and Practice: There is growing evidence to support reflective practice groups as a viable form of group clinical supervision for nurses. It is important to ensure reflective practice groups are effectively facilitated. What is already known about the topic? Correlational data indicates that high quality reflective practice groups may offer a cost-effective form of group clinical supervision, for nurses; providing support and helping them deal with what can be a challenging professional environment. Reflective practice groups have been linked to a range of benefits across individual and organisational levels, including; 1) increased job satisfaction, 2) higher quality of patient care, less critical incidents, 3) higher rates of staff retainment and reduced leave, and 4) enhancing the integrity of the nursing profession through accountability and skill development. What this paper adds Despite these claims, little is known regarding the mechanisms underpinning these documented benefits. This study provides a theoretically driven explanation; that reflective practice groups provide an opportunity for job crafting, in which nurses actively build resources (i.e. skills development critical thinking and social support), mitigating some of the negative psychological consequences associated with nursing. This information can help guide policy, practice, and the development of effective interventions to provide support and supervision for nurses.

Objective: This qualitative research project set out to explore how, and by what means, participation in group clinical supervision might impact nurses. It aimed to describe participant perceptions of the processes within a long running reflective practice group for intensive care nurses and explore these in relation to relevant theory. Background: Interpersonal aspects of care are central to the nursing role, however, the associated emotional labour can develop into moral distress, compassion fatigue and burnout. Australia's peak nursing and midwifery bodies have released a joint position statement on the importance of supervision for nurses. Group supervision interventions, such as reflective practice groups, mitigate stress, promote learning and support interpersonal aspects of nursing. Method: Twenty-two intensive care nurses from a reflective practice group that had been running for 10 years, participated in focus groups convened by an independent researcher. Thematic analysis identified key perceptions relating to process and outcomes. Results: Group identification, voluntary participation and skilled facilitation created an enabling environment for nurses to self-disclose. The sense of universality experienced by participants, along with increased empathy, enabled reflection and self-evaluation relevant to the group prototype of the ideal nurse. Authentic emotional expression was seen to provide respite from emotional labour, thereby regenerating resources for nurses to cope with job demands. Discussion: Key themes can be aligned to social psychology constructs of group identity, task interdependence and homogeneity, supporting earlier studies that suggest group cohesion is comprised of measurable factors. By developing and aligning with these constructs, the facilitator assists the group to establish a safe space whilst conceptualizing and aspiring to a model for the professional and compassionate nurse. Conclusion: Social psychology constructs can help develop practice and research of group supervision for nurses. In clinical nursing settings, group identity is particularly salient and facilitator interventions should aim to strengthen this. The development of a sense of universality, when combined with voluntary participation and a focus on intra-group process, can enhance cohesion and create a safe space for self-disclosure. This enables nurses to examine actions and responses to clinical situations and explore emotions incongruent with the ideal nurse prototype, thereby promoting restorative and formative benefits. Implications for research, policy, and practice: This study adds to our understanding of processes in group clinical supervision for nurses and suggests that it is appropriate to apply social identity theory to improve practice and research. It will be of interest to nurses and nursing leaders who wish to develop supervision programs. What is already known about this topic? Compassion fatigue, emotional labour and moral distress contribute to nurse burnout. Group Clinical Supervision can help mitigate stress, enhance learning and support interpersonal aspects of nursing care. The supervisory alliance is an important factor in effective clinical supervision whilst group cohesion is an important factor in the effectiveness of group work. What this paper adds: Reflective Practice Groups (RPG) are defined as a form of Group Clinical Supervision that utilize social support as a resource. RPG facilitation principles are aligned with social psychology constructs of group identity, task interdependence and homogeneity. Alliance with the facilitator and cohesion within the group, enhanced by voluntary participation and facilitation techniques, allow group members to access restorative and formative benefits whilst prompting self-evaluation against the group ideal nursing prototype.