Good evening everybody and welcome to tonight's webinar on supporting people with PTSD to participate in good work. We'll be using the term clients and patients interchangeably tonight and we'll also be sorting out exactly what we mean by good work. But before we start, MHBN would like to acknowledge the traditional custodians of the land, seas and waterways across Australia, upon which our webinar presenters and participants are located. We pay our respects to elders past and present for the memories, traditions, culture and hopes of Aboriginal and Torres Strait Islander Australia. So my name is Steve Trumbull and I'll be facilitating tonight's session. I'm a GP by background and professor of medical education at Melbourne Medical School. Tonight, Mental Health Professionals Network has partnered with ComCare to produce this webinar and just for background, ComCare is a government regulator, workers compensation insurer, claims manager and scheme administrator. It works with employees and employers, service providers and other stakeholders to minimise the impact of harm in the workplace, improve recovery and return to work and to promote the health benefits of good work. So we have disseminated the biographies of tonight's panelists with webinar information, an invitation. So the interests of ensuring we can cover as much content as possible will skip reading through the bios, but let's meet them one by one. Starting with Dr Tony McHugh, who's a psychologist based in Victoria. Hello, Tony, welcome. Thank you very much. Very glad to be here. Very important. We're very happy to be involved. Great. So what do then you find important particular area of work in your professional practice? I think this is one of the big issues that we don't work well enough at times. I think there's an emerging literature about how to work better with people to achieve functional outcomes and work as one of those things that we can see works incredibly important to humans. Fabulous. We'll definitely be talking about that tonight. So thanks for being with us. We're also joined by Dr Craig Barnett, who's from New South Wales and a general practitioner like myself. So Craig, what do you find important about this area of work? I very much enjoy this kind of area, Steve, because you get the opportunity to not only work with your diagnostic skills and your management skills and communication with the patient, but you also get to often work with a larger team of people. So I take sources of information from, say, my fellow psychologists and psychiatrists along with rehabilitation providers and hopefully with management within the workplace to try to foster optimal outcomes for these people who really struggle. I think one of the biggest challenges is there's a lack of common language and communication on some of this. So some people have very elegant communication about emotions and what's happening for them. Other people are really struggling to get that across and that may just proceed as behavioural change, whether that's anger or whatever. So that's one of the reasons I get involved in this. Great. Well, we're certainly going to touch on a lot of those issues tonight. So it's great to have you. Thanks very much. And last but definitely not least also in New South Wales, Christy Stonham, who's the manager of the shield strategy for Australian Federal Police. So welcome, Christy. And could you just tell us in a few words what the shield strategy actually is? Yeah, thanks, Steve. It's a pleasure to be with you all tonight representing the employer voice on this panel on behalf of the AFP. The shield service delivery model is transforming the way health and wellbeing is delivered within the AFP. And a key part of my role is to focus on the continuum of work health safety and rehabilitation services within the AFP. And it's a pleasure to be here with you tonight to provide some insight to what the AFP are doing in this space. Fabulous and always great to have the employer's perspective on these sorts of topics. So great to have you. Well, before we get started, just a few points to discuss about how the web player works. I'm sure many of you have been with us before, but I'll just run over these fairly quickly. To interact with the webinar platform to access the resources, you'll see you've got various options. There are the three dots in the lower right corner of your screen where you can access information. And under the information tab, you'll find the slides, the resources, including the case study that we're talking about tonight. There's a survey, a feedback survey to fill out for us. Come up more grand rules. Please be respectful of other participants and panellists, particularly in the chat box. It's a fabulous place there to chat with others. We can't see it, but the team in the back can keep an eye on it and let us know if topics are coming up and they'll let us know. But please do keep your comments on tonight's topic in the chat box rather than catching up with old friends as the main part of that. So what's going to happen now is each panelist will give a short discipline-specific presentation and then we'll go into a Q&A discussion between the panel. Our aim tonight is to discuss how practitioners and employers can work together to support patients with PTSD. And Craig said that working together is so important, but patients with PTSD are dissipating good work that supports their health and well-being. As Tony said, good work is so important for a healthy life. I'm not going to read those learning outcomes out loud because you can see them there and you can all create perfectly well, I'm sure. And you've also received the case, so hopefully you've been able to read that and aware of the sorts of issues that we'll be talking about. If you want to revisit the case, click on the three dots at the bottom right of the platform. So we're all set to go and we will start with Dr Tony McHugh, our psychologist colleague who's going to give us the psychologist perspective in just a few minutes. So over to you, Tony. Thanks very much, Steve. We should not make assumptions, I think, so it's important to define PTSD as the first thing we do. As you can see, it derives from the experience of threat of death, serious injury or sexual assault, or directly witnessing the same. That's according to DSM-5. It's important to note also that traumatisation is perceptual and no two people react to any given trauma in identical fashions. And we understand that PTSD cannot exist where an event has not been perceived as traumatic. That's referred to as the paradox of PTSD, and hence we talk about potentially traumatising events. DSM-5 relocated PTSD from anxiety to stress disorders. This was extremely contentious as the people who had in fact placed it there in the first place back in DSM-3 argued very strongly that this was not a sensible move. I think actually it is a stress disorder. I'm arguing against luminaries, but we're going to talk about PTSD tonight as per DSM-5 and ICD-11. We're overwhelmingly similar in definition. We won't be talking about complex PTSD and that might be the subject of another webinar in the future. Those classificatory changes however are very contentious as I've alluded to around the debates regarding criterion 8, the causal criterion, concept creep and expanding ideas of what harm might be to humans. Next slide please. This is the nature development and maintenance of PTSD. The onset of PTSD may occur after a potentially traumatising event from one month on. That is one month of symptoms, three months of chronicity. It means that you've got a chronic condition. Commonly comorbid with PTSD, anxiety, the most common comorbidity, mood and substance disorders. There are clear pre-peri and post-event risk factors for PTSD. Not all have the same predictive power. Gender and age for example are considered to be weak predictors. Peri traumatic reactions and post responses are perhaps the strongest indicator predictors and post trauma support is a particularly strong predictor. There are many, many theories of models of PTSD and many expert bodies offer information, describe research and offer clinical guidance such as the US PTSD Centre in Phoenix, Australia. I believe strongly that we are ethically obliged to know and implement such knowledge and treatment. Those graphs show that symptoms decline naturally for people over the first year post trauma. They also show that there are different trajectories and we need to be very, very mindful that I'll talk more about that later perhaps. Next slide please. All humans have latent vulnerabilities which are typically only expressed in the context of negative life events and potentially traumatising events. This is explainable in terms of a 1962 theory by a very important psychologist Paul Meale, the stress diathesis or diathesis stress construct. It's an explanatory model of stress responses that clients actually like and PTSD sufferers readily acknowledge. PTSD as that graph suggests is a disorder of recovery and most affected by it recover although different courses exist. Next slide please. How is PTSD best treated? One of the most important parts of tonight's presentation perhaps. The stage model of treatment is essential and many people have spoken about this Terry Keane is one who suggests six stages of treatment. John Brier suggests four and implicit in all of them are education and building a client personalised model of recovery and well-being. That is a term you may hear me refer to a number of times tonight. Also included are affect management, cognitive work, behavioural experiments and exposure like interventions. Early symptom reduction is important. That's what causes people to show up often but treatment is about more than symptoms. The meaning of what has occurred, current functioning and the meaning of that functioning to the self and to others are critical. Early treatment addressing the big three is critical. The big three emotions are anxiety and anxious avoidance is particularly important to address. Depression in the form of hopelessness, helplessness, awfulism and pointlessness is also important to address. But particularly important in my research and experience clinically is to address anger because it's a moral emotion and is connected to so many other emotions that appear post-traumatically. And it's an unrecognised until recently PTSD potentiator. Angry PTSD as I refer to is more than the very useful construct of post-traumatic embitterment disorder by Linden and I would encourage you all to go looking for that construct. It's readily available through Google searches for example. Both especially relevant when there is perceived or actual injustice nonetheless. Recovery hinges on the following new learning and adaptation to trauma focused CBT interventions. They include cognitive therapy, cognitive processing therapy, EMDR and above all prolonged exposure. They are the four evidence supported treatment interventions. This is best done in an envelope of slowness as suggested by Daniel Kahneman. And it's such an important book 2011 I would encourage you all again to go looking for it. And we need to emphasise mental toughness, hardiness, coping, self-agency and purpose. And Charles Bonanno and Lazarus are very important here and I encourage you all to remember your nature. The first quotes a bit tongue in cheek, but it is what he did say and everyone thinks it's the military but it was nature. Importantly he said if you have the why, the how will follow. It's very important for people to have a recovery ambition and to learn the treatment tactics and strategies that will help them. Next slide please. This is a fairly busy slide and other speakers particularly Christy are going to speak to elements of this. As you can see there are four stakeholder parties. There's the employer, the scheme, the worker and the trader. And I've underscored some things there that I think are important because time is precious. Mental health policies have to exist but they have to be enacted and leaders through to managers and all staff need to live and promote the truth of them. Also promoting diverse recovery stories is important by employers. Schemes need to act with dignity, empathy, wisdom and enabling client dignity rather. I need to really understand what mental health is and debunk myths. For the worker or the client to understand there are important health benefits of work. I won't talk much to that as Christy will talk to that. But again to develop a personal model of recovery and well-being by adopting tools, tactics and a sense of how they're going to recover. And for the trader it's our obligation to engage in efficient and effective treatment, debunk myths, implement and translate evidence-based practice, develop in conjunction with the client their personal model of recovery and well-being and to know our code in the sense that sometimes it's important to know when to conclude treatment sooner rather than later. That's what I've got to say for the present time. I will hand back to Steve. Thank you very much. Thanks so much Tony and I'm going to jump on an immediate question that's come up from Richard who hadn't come across the word awfulism before. I must say I've not either. Can you just tell us in a few words what awfulism is? It sounds appropriately awful. Awfulism is what angst-ridden people suffering from depression will talk about quite a bit. That things are awful. They are terrible. They are intolerable. It's a deep form of depression or depressive cognition where people are describing with great power how terrible things are for them. And sometimes it's important, not sometimes, it's frequently important to reality check, reframe, help people develop different takes on those ideas. Great. All right. Thanks so much and thank you also for giving us such a firm foundation to think further about the case on. You've already answered a number of the questions that have come up before the webinar. So let's now move on to Craig. So clearly Craig Tracey in the case here is spending time with her GP, but let's hear your take on what happens from the GP perspective when you're helping somebody like her. Thanks and thank you Tony because there's a lot of things in there that sort of reflect in what I do in day to day practice. I want the audience to first think about a psychologically injury as a wicked problem. We'll come back to what wicked means in a moment, but I want to really focus. It is a wicked problem. It's a very tricky one to solve. You need tailored management as we just heard from Tony the need to sort of personalize and understand what's going on for the individual. So unlike something like a shoulder injury where you can say, well, look, we're going to go through this sort of rehab process and we're going to lift a certain amount of weight. And then at 16 weeks, you should be right to get back to work. It's not quite so straightforward because it will depend on the exact circumstances, the resources the person has, the background, and of course what sort of work they're required to do and how the exposure has then affected that. Mental health situations as I'm sure all the psychologists in the room are well aware has a lack of visible features. So someone could present to work or present to the gym or wherever, and they may look fine, but it doesn't necessarily tell you what's going on under the skin there. And so they may actually be very scared, very vulnerable, rather confused and not sure what's actually going on for more why they're having these emotional responses. As I alluded to a little earlier, the communication in this space of mental health is incredibly difficult. And I think if you were to stand a small group of sort of claims managers and patients and perhaps GPs, perhaps psychologists, perhaps some psychiatrists and some social workers all in the one room, I'm sure that we would find very different approaches in the way language is used to communicate what's happening for the person. And with that becomes the other problem which is often misunderstanding both in communication but also in perceived ideas and beliefs. As a very clinical example, I have a lovely person who unfortunately has some fairly significant PTSD symptoms. And one of the relatives, one of the relatives constantly says to them, oh, you just need to pick yourself back up and get back and get back to what you were doing, you'll be fine. But of course that's not the position that the person is in. And simply that can happen in workplaces where people put their own speed or judgment on things. And finally, the risk if the person's mismanaged, and I can't emphasize this enough, if the psychologist, psychiatrist, the GP is on the phone to an insurer and says, look, there's a serious problem here. This person is actually deteriorating and becoming suicidal. There needs to be action on that and people need to be communicating. I recently unfortunately received a letter from a rehab provider in that exact circumstance. And the letter basically says, we tried to find the patient a couple of times and they did not answer. Period. No question as to whether they had suicided, whether they were dead on the floor or what, what further was to take place. And in fact, no contact with me except by snail mile. But look, so it's so important this is managed well because it is a risk, is a risk of a very negative outcomes. And I think sometimes workplaces don't necessarily understand the nuances of that. But nor are they exposed to just the same as I'd be a fairly hopeless accountant or a not so crash one engineer. But we do have success if we work on this. If we work as a team, our wicked problem can be reduced. I don't lay any great claims to academia with this diagram. But this is a diagram I use on a daily basis to think about where my patient is at and and how we might return them to work down the very bottom. So it's not the unusual and it was starting at the bottom of the diagram. It's where is the person themselves that can they actually get up out of bed in the morning? Can they actually get themselves dressed? Or do they to generate into tears and feel a need to return back into into hiding in their bed? Can they actually organize basic things like like remember to get their clothes on know where the car keys are remind the children perhaps to take their lunchboxes and so on. So down at that very basic level, you know, are they functioning as a person and can they care for themselves? If they're not, there's a lot of serious consequences that flow from that, both for the family and for the workplace that need to be considered. And then further up the scale is it's not like capable in a safe environment of having interactions. Can they, for example, go to a cafe with perhaps a trusted friend or significant others and have that cup of coffee? Or does things like their hyper vigilance, their anxiety prevent that? And on occasions, this is where rehab providers, if they're very attuned and also our psychologists, if they're attuned to the situation and given the latitude can actually make a big difference here. So sometimes meeting with an independent trusted person that actually knows what's going on for the person and monitoring what's happening to them can then perhaps take them to a quiet coffee shop and at the right time and see how they're responding, help talk them through how to manage that. And then at the higher end of the hierarchy, we have contributed to work. Work has some expectations. There's some rules. There's a cognitive load there and there's certain expectations and certain certain complex social leader actions. And under our workers' compensation schemes across the country, which we're very fortunate to have those in existence. We look to set aside the routine workload in such a way as to optimize an ability to come back into our workplace. Next slide.  I'll let you read that rather than be reading the whole thing out. But wicked problems are these complex things that have multiple elements involved. So sure as a general practitioner, I'm looking at my patient. But I'm also thinking about how we might integrate them back into their social fabric at home and then of course further into a workplace environment. And this requires really key things. There needs to be that communication. We need employer, significant others in the workplace to sort of understand a little about what the patient's going through and what's good or bad and a way of communicating that information. And one of the tips, for example, is in the case of people becoming anxious or feeling overwhelmed on a particularly bad day. One of the, I can't remember which one, whether it was Black Dog or it's the other one, had suggested that one of the things to do was just to have a little red card. And if there was a red card on the desk, don't talk to Bob or don't talk to Jenny today because they're only just managing to cope with what they've got in front of them. Understanding what's going on and we've mentioned there the communication difficulties around language. For example, perhaps a rigor back to a works on scaffolding and so forth is not going to have very erudite, often not going to have very erudite language about their emotions and what they're feeling. They're just going to experience some of the things that perhaps Tony's touched on such as that anger and a need to sort of blame somebody for what's taken place. And there needs to be this agreement. If we are to address this as a workplace and human concern, we need to reach a position where there's safety, think about those things like suicide, drug abuse or alcohol abuse. And the person needs to be capable of managing themselves, but also taking that a little further to actually be meaningful and manage their responses in the workplace. So what do you expect from this? And I was really heartened to hear Tony in Tony's talk there that he was mentioning that time slow being steady about this. People's emotional state does not change an alter very rapidly in the situation of significant mental health illness such as PTSD. So whereas something like a shoulder, you may be expecting to see an increase every every two or three weeks and you wonder why if you got to five weeks and there was no change. It may be quite normal to see four or five, six weeks before you see significant changes. But obviously there needs to be that kind of feedback loop of watching what's happening and understanding what's going on for the person at their individual and tailing in those treatments. And so in particularly at the time, if there's any insurance fund managers listening out there, you know, when a clinician, an experienced clinician says to you, look, I don't think this person is going to actually achieve any further upgrade for a period of time. That may be three months, it may be six months in the more extreme. It's important to recognise what that means. And just as Tony was saying, be prepared to actually say where we are and where we're going. And so acceptance of an outcome is important. If we were to move some of our mental health stuff in the more extreme PTSD into a physical arena, would we expect someone with quadriplegia to be out there running? And the answer is, don't be ridiculous, Dr. Bernanter. That's that's kind of being a little silly. But sometimes I find exactly the same situation in mental health where the expectation of an outcome is beyond what the person's managing to achieve and showing through their trajectory over time and showing in the information coming from multiple parties, not just myself. So understand what the outcome is to be for a person is really important. Thank you. Thanks so much, Craig, and both you and Tony now brought up the issue about time for treatment. How long and I might ask, I don't know, we'll get to the Q&A shortly, but I just might ask both of you how long you budget for sessions with somebody suffering from PTSD, both from the GP's perspective and the psychologist's perspective. I mean, how long is please a string, I guess, but what's your general experience? Would you like to go first? Again, it's always the based on degrees of what's actually happening and how people are responding. I certainly have ex police persons who we've worked with over two or three years and have achieved outcomes for them. Now, the outcome may not be going back to a very industrious taxing work environment, but I'm really pleased to say that in some of those cases we actually have people working two or three days a week and coming home enjoying that work, even though the work in some respects is very light on and I mean cognitive and physically compared to their past workload and abilities. But it's a very positive human outcome. Great. And Tony, what about in your experience? How long do you generally plan for? Well, it depends on many things. The intensity of the distress with which the person presents initially, the history of their traumatization, their personal characteristics and those human vulnerabilities. As I said, we all have them. But as a rule of thumb, that two year period that Craig referred to when I was at the Austin over a couple of decades, we ran a treatment program where we provided two years of treatment, both group and individual and psychiatry. In my own practice, I would average about 45 sessions across 18 months or so with seriously traumatized police. But there's a project in Victoria that I've been involved in called Blue Hub and the average number of sessions provided is 28. And that's to remission or termination of treatment and with most people returning to work where they have been working. So it varies, but we need to work actively and optimistically because there's a really negative thing that happens in more and more treatment, treatment, effectiveness, tails off. It becomes iatrogenic and people start thinking I must be really, really unwell and people aren't telling me. So I think the more effective and efficient we can be, the better. Right. Thank you so much for that. And both of you have mentioned the police force or different police forces. So now we go to Christy to hear your presentation. Thanks Christy from the AFP. Thank you, Steve. I'll start with some high level context from an AFP perspective. And as some of you would guess quite rightly assumed the high risk nature of work undertaken by the AFP provides an interesting picture in terms of injury and claims profile. So by way of example, mental stress is one of the highest mechanisms of injury in relation to accepted claims over the last four years. And psychological injury claims have recently overtaken the rate of physical injuries in the AFP and account for a significant part of our premium costs. Alongside the psychological injury obviously comes time off work, which directly links to a productivity cost as well given it often takes longer to recover from a psychological injury rather than a physical injury. A funding for shield was received in late 2020 and represents the single biggest wellbeing investment in AFP's history. From my perspective it recognises the unique stresses and inherent risks associated with policing along with community expectation that we do more to protect those who serve us. The slide on your screen visualises the six key components of our service delivery model and examples of what they include noting that we are still working towards formaturity. Through shield the AFP is transforming the way health and wellbeing services are delivered to all AFP employees by shifting the AFP's health model to be one focused on prevention and enhancing operational capability and member experience. However, we are realists and appreciate it will take a time for that cultural shift to be realised. Next slide please. To better support our diverse footprint we moved away from a centralised model with limited health and wellbeing services to establish multidisciplinary teams in each major geographical location with a strategic centre that develops the governance standards and quality assurance processes to promote a consistent service delivery around the country. Shield is considered a deployable capability which offers access to dedicated teams of clinicians and health professionals who understand the unique nature of work within the AFP. The multidisciplinary team model you can see on your screen is designed to provide holistic and connected care. However important to note that these locally based teams are complemented and supported by a nationally based team including an occupational hygienist, occupational therapist and dieticians. In context of the case study we have before us tonight, Shield may have been utilised to deploy early intervention from a psychological perspective immediately after the incident which may have minimised the ongoing impact to Tracy that we now see described. Another pathway would be the Early Access Programme. So in recognising that getting access to support as early as possible is critical to recovery and that support will look different for every person. The AFP have also invested in an Early Access Programme that works complementary to Shield and provides flexibility in terms of treating preferences and offers a pathway to be reimbursed for medical treatment, physio, imaging and limited periods of leave. Next slide please. In AFP we are investing in our safety culture at a strategic level and encouraging command or business to lean into their role of managing risk indicators as opposed to having the organisation, often in partnership with ComCare as our insurer, manage the realised risk. Knowing that it will take time to realise the full benefit of that ongoing cultural shift, we are concurrently working to enhance return to work outcomes and reduce the amount of time people are out of the workplace if an illness or injury should occur and this slide focuses on that. We are taking a multifaceted approach to uplifting the capability and awareness of key stakeholders in the return to work process and helping the AFP move beyond just their legislative requirements or obligations and really seeking to promote the concept of good work and how that can be achieved. The inner circle on this slide represents the model of shared responsibility required to enhance return to work outcomes but important to note that this slide represents the stakeholders we have the most direct relationship or influence over in the AFP. However a key group as being referenced by Craig and Tony before me also includes the treating team but I'll come back to that in my next slide. The outer circle reflects the integrated and holistic approach being taken across multiple pillars of effort to enable that capability uplift. Through the establishment of a working group across the organisation focused on return to work, we were able to get feedback from those within the business to understand what were considered barriers in regard to return to work. Some practical examples of what we're doing to enhance return to work outcomes in response to that information gathered includes leveraging off the semi embedded model of shield and developing strong relationships with commands so we can be considered a trusted partner with open lines of communication. The model also enhances the case manager's knowledge of the work environment so they can go and return to work conversations appropriately. We're empowering leaders and developing leaders to drive return to work outcomes by investing time and effort in tailoring training and education packages for different levels of our workforce to help them understand their legislative obligations, their role in influencing a positive safety culture and relevant to this topic. The practical steps to follow once someone becomes ill or injured, which has a primary focus on achieving good return to work outcomes and includes tools, templates, reference materials to make the process easy for them to follow. We're also being innovative with our governance. For example, with return to work processes or engagement in good work in general, it requires coordination and integration between the client, the supervisor and health services. We've recently introduced a piece of governance called the employee support board, which brings all relevant stakeholders together with a common goal of developing an employee support plan that has structured goals, activities and objectives. The people involved in that process is largely driven by the individual and may include the supervisor, the rehab case manager, clinicians, a workplace rehab provider, and any additional support that person would like to include, including family members if they so choose. We're also in the process of developing suitable duties register to ensure that there is always a pool of tasks and projects that can be undertaken by someone demonstrating capacity to return to work. However, may not be able to return to the pre-injury position just yet due to medical restrictions. Next slide, thank you. As mentioned earlier, the model of shared responsibility includes with treating teams as they play a key role in the promoting of both return to work with the employee and health benefits of good work. As we know, there is a limited window of time to influence positive incomes, positive outcomes. For example, the longer someone is off work, the less likely they are to return to work. It's evidence that if someone is off work for 20 days, the chance of ever getting them back to work is about 70%. And that percentage drops significantly as days out of the workplace increase. So from an employer's perspective, it is helpful if practitioners can be overt and provide advice on alternative duties, whether that be internal or external to the immediate workplace, including any modifications that may be required. There is also data that shows that if a healthcare provider contacted the patient's workplace, it was twice as likely that the injured worker would return to work. Sometimes it is important for a practitioner to understand if there are any non-medical factors delaying a return to work, and the best way to do that is to ask the relevant people. For example, the employee, the supervisor or the rehabilitation provider asks the question, what in your opinion are the barriers for returning to work? It is also great if practitioners can be available for and participate in case conferences when appropriate, including responding to requests for information or reports as it will help the employer meet their obligations and also assist your patient on their recovery journey. Next slide, please. Employers should strive to create a culture that promotes and celebrates good health and ensure everyone understands what they can do to contribute to that. However, when injury or illness does occur, employees obviously play a crucial role in realising return to work outcomes. Every workplace will experience challenges with return to work, and the answers to challenges you may experience likely sit within your business, so set up the right forums or avenues to enable that information to filter to the top so you can do something about it. It's never a case of one size fits all, as the needs of each agency differ, and in the AFP we have a very unique risk profile in operating environment. While we take as much guidance and advice that we can from ComCare and seek to deploy best practice case management, we have to be agile and ensure the frameworks, governance and training implemented suits our operating environment. And while it is recognised that recovery will take longer from a psychological injury, it doesn't mean you should take a passive approach. Ensure that you are empowering all the right people to play an active role in trying to achieve return to work outcomes and always remain in contact with the employee. I'm happy to leave that there for the moment, Steve. Thank you and hand back to you. Great. Thanks so much indeed. Chris, I'm very taken by the diagram you've got for SHIELD there. It surely requires somebody clever to get it that put on the SHIELD held by Chris Evans as Captain AFP. It's a compelling image of everything there. It's great. Definitely not my creative license. All right. I'll put my camera on so you can see me blushing at that pop culture reference. Thanks for that. It's so good to hear about the communication that's needed. People have been asking questions about what we can do to try to get more information from health care providers when you are putting together a program. Do you have any quick tips for the audience on how you can get information from health care providers like Craig and Tony that actually help you do work at your end at the employer's end? Yeah, absolutely. A good tip from our perspective is making sure we're very direct and targeted with the questions that we ask. Don't leave it to be ambiguous or misinterpreted by the person receiving the request. Be very clear with what you're asking and relate it as much as you can to the role requirements. What is the scope of the role? What is required of the individual and what is the specific question you are asking? The clearer your question is, the clearer the response can be. Great. Thanks so much. And we've now got a good half hour or so for group discussions. So thanks everybody for keeping your presentations concise and really what we need to focus on. Look, there are so many questions that have come in and that people have been asking during the webcast so far. But one that's cropped up a few times is when people are seeing that the workplace itself contributes to the cause of PTSD. There was one particular question about whether bullying in the workplace can meet the diagnostic requirements for the diagnosis of PTSD when there's not the major trauma and things that have been discussed by Tony. And then following on from that, what we can do to return a worker to a workplace that they're finding difficult, as in fact Tracy was. So who wants to pick up on that one to begin with? I guess the diagnostic issue might sit with you. Tony, if that's okay, about what happens if bullying is seen as the trigger for the person's distress. Very good question. Diagnosis is an art. If diagnoses become expanded to include things that weren't in the original diagnostic classifications, I think we run the risk of disorders becoming less meaningful. Bullying is something that is unacceptable, always has been, always will be. I don't think someone has to have PTSD when a clear-cut case of bullying is in place and the bullying needs to be treated for its effect on a person's psychology, particularly anxiety, depression, anger, those sorts of things. We're dealing with humans. We're not dealing with diagnostic concepts and I think distress is enough and I think assisting people to deal with improper workplace behaviour does not require a diagnosis of PTSD. I'd add one final thing if I may. I talked about predictors of recovery in PTSD and it's how a person is received after an event, how they are treated. I have had a complete conversion across my working life. I now agree with the luminaries who say that is the most important thing in predicting trajectory of recovery and Christie's touched on it, Craig's touched on it. I can't emphasise enough how an empathic response, sometimes a firm empathic response because there is a problem with increasing concepts of harm. I think the response of the workplace, the scheme, the people surrounding the client is so incredibly important. I'll leave it there. Thanks, Tony. Even in the instant before Tracy's car was struck by another car, the case tells us that she was finding her work difficult. She was going through a marriage or relationship breakup separation. I mean, these sorts of predisposings about concept that I gather, different people will receive that sort of impact differently depending on where they are in their life at that point in time. And I think you'd perceive that in general practice a lot, wouldn't you, Craig, that there are different people exposed to the same levels of trauma who come out of it completely differently. And some of those resilience issues that Tony mentioned, what are your thoughts on that? Yeah, look, absolutely. I couldn't agree more and hence part of the wicked problem is the very individually, individual nature of this sort of an injury. So in the case of our particular patient, who's name just escapes me, Tracy, you really want to just know a little bit about what was going on leading up to this. And we've got a little bit in the case there, but you know, how is that holdable situation going and what sorts of triggers that's caused for her? Has it dwelled up all sorts of issues around perhaps things like, you know, child support and living arrangements and the like. So that's going to come into the mix. Although I think I think for most we would see the fairly traumatic event of this accident. And certainly if we accept that the case is written almost as a storytelling from her viewpoint, the scene of a colleague with blood over their face and not moving. I think for many people, even with a fairly strong background, we'll find that really challenging. And this sort of sitting at exposure is one of the great problems that our emergency services such as the police that Christie has been talking about a face on a daily basis. So they not only have daily risks, they also have cumulative risks of this taking place. So Christie, the way the case is set up there was about four weeks between the incident and really Tracy coming to attention. Do you feel that there should have been more proactive strategies going on from the employer's side during the four weeks between the incident and the claim or the call cry for help? Yeah, absolutely. I also think there was a room for an opportunity for the employer to intervene even before the incident. I guess that the case study outlines some of the context there and it really describes some of the compounding psychosocial hazards that were developing for Tracy in terms of increased work demand. There are also personal stresses that she was experiencing that I guess contributed to her moving up that mental health continuum before the incident actually occurred. There's an obligation and an opportunity for the employer to identify those signs and symptoms in an employee and intervene early to provide support, show empathy and reduce some of the psychosocial hazards in place. From that perspective. But like you also mentioned, as soon as the incident occurred, there wasn't an opportunity for early intervention straight away. And from my perspective in AFP, we would have definitely recommended engagement with a psychologist sooner rather than later to undertake in a debriefing process. That's for example that may have given insight to some of the indicators that a more serious injury may develop and some psychoeducational targeted treatment could have been provided sooner rather than later. Thanks for that. I should have mentioned before that I'm a presiding member with medical panels for the work cover worksite side of the system. And I must say the number of times we sit on a panel with hundreds of thousands of dollars of legal fees and stomach linings being expended and you think why do people feel obliged to throw petrol on a small fire after an incident. But it does seem to be that we're not as good at managing these emerging problems, these wicked problems before they become too wicked. Anyway, does any, do anybody, does any other panelists have any comments about it before we move on to the next question?  Yes look I'm just to be curious Christy and forgive me because it's a bit of a devil's advocate question. Certainly for many of my people but working things like coal mines and all sorts of things. If they were to turn up to work and say oh boss I'm going through a bit of a breakup and yeah it's really getting on top of me and you want these extra reports done. I'm not sure what response they're likely to get from an employer. So how does the AFP are sure that that can happen because after all the workplace needs output. Yeah absolutely and that speaks to part of the wicked problem associated with the cultural shift required in organisations to reduce the stigma associated with having those open conversations and making sure people know that it is safer that they will be heard if they engage in those conversations because if people have a negative experience in trying to have that conversation chances are they're not going to have another one anytime soon. So it's going to take a lot of time to I guess across industries to reach that kind of maturity level but I think we will have to start somewhere and making it as I guess a cognizant effort in regards to our strategy our leadership frameworks and our general cultural aspirate aspirations will eventually have a force multiplier effect in that space but it will take time. Thanks Christy, thank you. Thanks and then to Tony. Tony someone's asked the question what is the status of early professional debriefing in PTSD events. I must say having worked as a GP in Mirrorsville after the fires in 2009. People didn't seem to be that ready for professional debriefing immediately after the fires but what are your thoughts about early intervention professional debriefing when there's been an obvious incident. A very good question and a very good observation to Steve. Often I think we're trying to apply things to people to clients that they're not actually seeking. I can remember when the Kosovars came to Australia in the mid 1990s. A lot of people went to bandana and places like that offering psychological interventions including debriefing. They pretty soon got the message we don't want that we want things that remind us of where we come from came from materials to make all kinds of clothes. They wanted practical assistance. To go to the question we really don't talk these days much about debriefing. I think debriefing done skillfully was probably a very useful thing but often it wasn't done as skillfully as it could be. We now tend to talk about developing skills. Psychological first aid and watchful waiting. And something that Christy referred to before is an obvious watching for when people are really having intense reactions because in most people their symptoms die down. But if someone's having nightmares or dreams as indeed I think Tracy was having these are signifiers for maybe we should be doing something more. But mandatory group based professional debriefing we don't really advocate for that anymore. Thanks for that. And while we've got to you did quote the famous philosopher. I thought it was Kelly Clarkson what doesn't kill you make you stronger but apparently it was me. That issue about I noted down mental toughness hardiness and coping. I've been seriously beaten up by medical students who are interpreting that sort of call out for resilience as being a way of putting responsibility on them for a damage traumatic health system that they're being dropped into. Any thoughts about that issue of who has sort of responsibility for hardiness. Look, I think it's like all things human. It's a shared responsibility. I can't insist on any client having what I call a personalized model of recovery. We've talked for decades about keeping clients at the center of our care. I don't know anyone who would say that we're trying to do that. But true effective fitness collaborative encouraging the individual system the employer the scheme and everyone to engage around how do we help this person understand that they are the most important. All the other parts are important. But they are the most important aspect of recovery that they are the agent of change. And it's not a critical thing. It's not a damning thing. It's when people finally have a plan for how they're going to get better because their treatment team has encouraged them to think optimistically about that. Then I think really good things can happen. I'll leave the dilemmas of the health system to others, but I don't think it's the responsibility of students. I worked in a public hospital for 20 years. Everyone's got a part to play in that. Absolutely. So what about you, Craig? I mean, we often find ourselves as GPs being almost recruited onto the patient side of the struggle with their employer that's going on. Do you find yourself in that situation? How do you balance your commitment to the patient while also doing what's in their best interest? Yeah, look, thanks. If I might just digress just a fraction on and pick up on Tony's comment and your comment about resilience. And I would love to say this is my thought, but it's not. It was a wonderful GP at a rural medicine conference in Port Macquarie this year.  And her reason for saying so was she said the reason is it's looking at one part of it. It's saying what the qualities are that the patient needs to have. She said, now think about like a soccer ball. If you bounce that on concrete or bounce that on a good playing field, it bounces really nicely. Now bounce it in a swamp and see what happens. It doesn't matter how good your resilience is, it won't bounce. And I thought that little description was actually very good because certainly as a GP I do encounter occasionally situations where workplaces are perhaps just not accepting of a mental health condition. And no matter what the determination and the residencies of the patient and the treating team, that can be very, very tricky. But thankfully they've not fallen, but it does happen. In terms of working with the workplace, look, most of the time if I'm dealing with something like PTSD, a significant mental health diagnosis, I'll have, I want the patient to be involved with the team. I'll want a psychologist and I usually want a rehabilitation provider. And I might, I might be a little cheeky if I may serve and say not just any rehabilitation provider. Many rehabilitation providers are physios or OTs and sure have some psychological knowledge. But I would really prefer someone that's got a psychology type background or has lots of experience in this area so that they know it's not just about the physical vulnerabilities and know how to communicate with the workplace about finding what that safe work is.  I think, I think unless Tony were to overrule me, I think for the moment we're not going to be very keen with her sort of driving too far or having anything that's particularly taxing. What we want to do is try to get her stable and have some sort of graded return to something that looks like a workplace progressively depending on how her self state is going. Yeah, and I mean, you know, having a really well trained experienced OTs is familiar with mental health issues can be a fabulous member of the team. That's for sure. So, Christy, is the AFP providing a swap or a plexipave court there for the boundary bounced on? Is that what your shield programs all about really is it making a firm foundation? Absolutely. There is a really key focus on prevention and that in embedded in that is the education component and focused on building resilience within AFP members across their career life cycle. Because we know the inherent risks that they're going to face in in the role that they are performing. So your 100% right shield is is focused on that, but not just focusing on building the resilience. It's how we adapt the leadership and the culture to be more accommodating and managing those risk indicators as opposed to allowing risk to be realized in the form of injury or illness. Yeah, and Craig mentioned some success he'd had with quite badly injured police officer who managed to get back to some sort of work within the environment. I still remember a surgeon saying after he slipped and cut his extensor off in his fingers, could no longer operate. And he said, I'm a surgeon. I search. It's what I do. How do you deal with this issue of AFP officers who are no longer able to do what attracted them to the job in the first place? I mean, they might they might have wanted to be sort of active policing officers rather than whatever work they might have. How do you show that to be good work for them? And that's a real challenging situation, Steve. And most people who join the AFP join it for a career that they're in it for the long haul and they strongly identify as a police officer. So that's often a barrier to achieving return to work outcomes because it's hard for them to adjust, I guess, the mental model of what I guess bringing value to the community means to them if they can't perform that role of a police officer anymore. So it often takes a little bit longer in those extreme circumstances. But we have, I guess, varying levels of success in regards to return to work outcomes in that situation. But we will always be guided by medical advice and very open to engaging or exploring opportunities outside the AFP as well. If it means getting people engaged in meaningful work. Okay, so you can have somebody deployed elsewhere within the Commonwealth Public Service system or finding other suitable work with an employer who has the need of those skills? Yeah, absolutely. We follow the return to work hierarchy as outlined by our insurer. But we definitely look external to the AFP within the broader Commonwealth when the medical advice supports us with that. Absolutely. Okay, thanks for that. So we'll be moving to the final phase of the webcast shortly. Maybe one final question and this is, I think, probably directed obviously best at Craig. It's about the use of mental health care plans and psychologists who are providing sessions, which are obviously strictly time limited, although there's a calendar year issue there. So you find that the mental health care plan system gives you enough referring capacity or is it really not enough when totally saying 45 sessions is about a starting point or a budget? Wow, that's a load and question, Steve. Thanks for that one. Okay, so we'll move on to the final question. Look, I think the mental health care plan is a very helpful fallback. I've had occasions where claims with workplaces are challenged and at least allows me to provide some additional care to keep the person in contact with their psychologist. And obviously, if it's a situation well outside of the workplace and the workplace doesn't have any funding arrangement in place, then certainly the mental health plan provides some benefit. Unfortunately, as I'm sure psychologists, GPs, I'm sure a number of health professionals watching this thing. There's a great gap has opened up over the last 30 years between what the Medicare system pays for all refunds to the patient as opposed to what the cost of delivering those services are. And that creates a great divinity. I now have very much, I see on a daily basis, a two tiered health system. People who have got money in their pocket and can get a mental health plan and afford the treatment and a very long line of people who fall by the wayside because they do not have access to financial resources. And so they're on very long waiting list with I'm going to say charity. That's not quite fair, but charity like situations where we're building is still occurring, often being propped up by the goodwill or some other some other financial process. Sure. So mental health practitioners in very short supply. We've got a full range of practitioners are kind of suited to social workers and all points in between, but they are a limited resource. Maybe we can just have a final comment from Tony before we move to the wrap up about the sort of words you might use when coming to the end of a therapeutic relationship with a client or when you've achieved the goals that you've sought. What sort of words do you use when helping a worker understand that their sessions have come to an end? To use the analogy, it's a bit like parenting. If you want to raise a good child, it starts from day one. And if I get my TARDIS and I go back long enough, I can remember that I was taught that from the point of assessment we're heading towards conclusion. So I'm saying those kinds of things to people early days. It's just like getting to having an adolescent child and starting to parent that it's too late. You parent from day one, you prepare people for release from day one. We really shouldn't be having unexpected conversations about conclusion. It should be planned all the way along, checking in and really making clear that more and more treatment is not necessarily better treatment. I have reviewed cases in some of my other roles where I won't tell people how much treatment, but if I said 45 was a ballpark, you can multiply it by a factor of five or six. And what message is that giving people when they have had that much treatment? Someone's not telling me the truth about how unwell I am. So I want people to think about assertive, active treatment and proper treatment planning. There are always going to be hiccups where the original estimate might have to go out by a few sessions to recover a situation. But right from day one, we should be talking about when we both know that the time has come. And I say to people, it will be a sad day, but it will be a great day when we have to part. Alright, thanks. So while you've got the speaking stick, maybe we can get you to sum up in just a couple of minutes your thoughts about this topic and we'll go around the room. Thank you. I said at the start that this is such an important topic. It's got so much meat to it. We can't do it justice. But my take home messages are around diagnosis and formulation. An accurate diagnosis and appropriate formulation is empowering of the individual through us explaining why it is so, what the symptoms mean, what recovery looks like, etc. Treating assertively, I've made that point a number of times. These schemes quite rightly don't want to see supportive psychotherapy. They're funded by the Australian public and they want to see effective and efficient treatment being delivered. And if we're not doing that, we're in violation of our various codes and we're not acting in the best interests of the client. The point is to attempt to, with their personal model of recovery at the heart of what we do, reestablish their functioning. So focusing on functioning is really, really important. Scores on metrics, unless we've done them multiple times, 9 million, 10, 15 times over the course of treatment, they are not objective. They vary at any point in time cross-sectionally. It's hard to interpret them. Working with optimism is the next one, showing people of the possible, demonstrating optimism and encouraging them to be optimists. And finally, a bit of a negative kind of thing to comment on that we must help people address their irritability where it is a problem. Irritability with the employer, irritability with the person who caused the accident or the event. Irritability with themselves. Sometimes there can be considerable shame about being on these schemes and where the shame and anger is only a hair spread for ways.  We talk a bit about moral injury these days. I think it's an okay enough concept. It's a bit pat at times, I think there are some things to be morally troubled about. Let's be realistic. I'm a much more helpful idea. I think it's traumatic embitterment disorder. That's Lyndon. It's a bit different to my idea of angry PTSD. But I think people are more often angry when having PTSD than classically anxious. And I think the move in DSM-5 was in my opinion, but I'm arguing against some giants, believe me. But in my opinion, I think it was the appropriate thing to do. Thank you. Thank you for that. And Craig, your final thoughts. Oh, look, I fully support the comments of Tony. This is a really massive topic. I want to return to the wicked problem. That communication is so important and it's communication at multiple levels across multiple people. So what's happening? What's happening to Tracy's partner? Obviously, there's stuff going on with the separation there. Had that not been the case, how is that functioning? And how is the mental health situation and the work of a claim affecting or con-care claim affecting the household? These are really very important things and it may have income implications as well. So as you're dealing with the psychological issues and the sort of medicine of the psychological situation as a GP, I'm also running parallel a whole lot of other things. What's going to happen if the income stays as it is? Have they got options to mitigate that? Are they far enough ahead on the mortgage? All that sort of thing comes into it and how are they socially functioning? I think the hierarchy that I use is a really nice little practical tool and harks back to some of its lovely to hear. Tony's very well founded, detailed knowledge pointing out that function is what we really want to look at and that the rating scales and stuff have some benefit but always look at what's in front of you. And for employers like Christie and others, making available the relevant people, the people that have the power to make decisions to share the information. And also those contact points, I had spoken for various reasons, had to contact con-care the other day to find the number that I've been provided with was just a general call centre and the person I was talking to had access to the case but had no knowledge of what was going on and particularly for psychological cases this can be a bit of a problem. Thank you. Well thanks Craig and the employer does have the final word. So Christie, what's your summer? Thank you. In summary, there's a couple of points I'll touch on and the first one is that employers obviously play a crucial role in realising return to work outcomes but ultimately they should have a strategic focus on preventing injury and illness and an abling early intervention that's reflected through their strategic documents, their cultural aspirations and leadership frameworks as that will all help to shape the culture and reduce the stigma associated with discussing and reporting mental health issues. Tony touched on it earlier as well but human-centred design is important in developing processes and focusing on the employee experience. It's incredibly important as an employer that you balance the experience of the person against the need to deliver on operational outcomes which I know can be a challenge. Lean into the problem. Don't do it alone. There's significant power in top-down leadership and using executive sponsors or champions can be incredibly powerful through being an influential communicator within the business, debunking myths associated with return to work processes and red manning of providing critical and user input to new initiatives and governance to ensure it is fit for purpose. And I guess my last point will be staying in contact with the employee. Don't let them be out of sight, out of mind. Keep their needs at the front and centre of your thoughts and make sure they feel valued and connected to the workplace still. Thanks. Thank you so much. Thank you to all our panellists. I'm just going to ask people not to leave us straight away. We've got a couple more things to do in this last minute. And the most important is to get you to give us some feedback on tonight's webcast. It's really important to us to know how it's gone and what we could do to improve these webinars and make sure that we're meeting your needs. So please do get on to the feedback links that you can do by that QR code there or to the survey monkey address, which will be there as well. So please give us feedback. For more information about Comqer, you can visit their website. The next webinars coming up for MHPN will be on emerging minds, practice skills to promote infant and parent mental health in the first 12 months, which is on Tuesday the 15th of August and another one in August on the 24th, which is looking at and relevant to tonight. Latest innovations to embed and sustain trauma-informed care on Thursday the 24th of August. Now, you might be aware that MHPN's networking programs supports practices to meet and network with others from their local community. And there are more than 350 of these networks across the country. So you can visit the MHPN website to find your nearest one and start one up. You can also send a message in offering to do that, start up a network around your area geographically and of expertise. Before I close, apart from thanking our panelists again and also for the very active discussions that were occurring amongst participants tonight, I would like to acknowledge the lived experience of people, carers, and colleagues who have lived with mental illness in the past and those who continue to live with mental illness in the present. So thank you to everyone for your participation this evening and I wish you good evening.


Okay, let's try this problem here. Calculate the number of moles and 3.0 grams of chlorine. So, moles, remember, and Cl2. So, 3.0 grams, and we need to figure out what the molecular weight of chlorine gas is. So guys, I'm going to form one chlorine atom, of course, that weighs 35.45 AMU. So, 2 chlorine atoms, you're going to weigh 2.7, right? So, 2 times that equals that. So, that's going to be 70.9 ohm Mu. And remember, you can approximate that to say that the molar mass of chlorine gas is going to be 70.90 grams per mole. So, now all you got to do is multiply it by the inverse or divide it by the molar mass. Cancel, and you get the number of moles. 3.0 divided by 70.9, 0.042 moles.


So, someone asked me why I use so many workspaces. So I thought I would actually make a video about why I like workspaces so much, because I wasn't always this way. In fact, there was a time when I was a KDE fanboy and I was fairly new to Linux and instead of using workspaces, I just had all my windows on my two monitors and they were piled on top of each other.  It was absolutely horrible. And I am so glad those days are behind me. Now I wouldn't be what you'd call the most organized of people, like I'm really not. Like I try to be, I try to be very organized, but I mostly fail. But in my attempts at trying to be organized, one of the things that I've come to realize is that I really like to have things in their place. At least on my computer, like I'm a very much, I would say I'm much more organized in my digital life than I am in other places in my life, that's for sure. On my computer, I enjoy having things in their place and I like to have a place for everything. So that's the reason why I like workspaces so much, because it allows me to assign actual dedicated screens. So in this case, I'm talking about virtual screens to a certain task. So for example, right now, if I showed you this, you could see that I'm recording my audio in audacity. This is audacity and there's nothing special about it, but I always, always whenever I have this application open, I have it on workspace six on this monitor. I know exactly where it's at. I can always go to it. Now, I also have OBS open on my other monitor on workspace 16. Those workspaces never change. I'm so used to having it in those two places, I know that's where they're at. I never have anything else on those two workspaces. And that's just the way it works best for me. Now, on the other workspaces, I'm not as rigid on what goes there, except for certain ones. So on workspace one, I always have an instance of Firefox. So in this case, I have Firefox open. And this is where an instance of Firefox always lives, right? I will sometimes have Firefox open on another workspace as well, if I have to have things side by side, but I always have one thing of Firefox here. So I know that that's the case. Workspace two, which I'm not going to show you because it probably has some of my actual work on there, I'm going to leave that kind of behind the veil if you will just be a little bit more mysterious. That's where I pretty much do all of my writing is workspace number two. Workspace three is usually a terminal of some kind. I'm either creating a video. In this case, it was for a video about the most important lakes commands you'll ever see. That video will be coming up soon. It's recorded. It's hilarious.  It's not even funny, but that's beside the point. Workspace three is almost always a terminal. Workspace seven is usually something where I'm reading something. So if I have a PDF open, in this case, I do, I have that open up on seven. Now, I'm only using on this workspace here, I have a total of nine workspaces. I'm only using five. OK, that's usually around average. I use between five and seven workspaces per monitor. That's usually where I'm at. I have a few extras that aren't usually used for anything, but I like having extras in case I want to put something there. I could probably be OK with 14 workspaces. That's usually about the absolute max I ever use at one time is 14. On this monitor here, I always use more workspaces than on this one because on workspace 19, I have discord on all the time. That's where discord lives. Workspace 18, I always have crusader. That's where crusader lives. It's always there. Workspace 10, which is the first workspace on this monitor, I have my to-do list and I have ZimWiki. Those things are always there. The other workspaces on this one usually are a combination between other instances of Firefox. I usually always have one or two because I'm working on a project or something and I need something on this screen that's not on this screen. I don't want to move this version of Firefox over somewhere else because I know that's where it's supposed to go. And so I have some of those here. Also, I have some other terminal things. If I'm ricing or something, chances are I'll have a terminal over here or if I'm creating notes for a video or whatever, those things go on other workspaces on this monitor over here. So as you can tell, my workflow is not a standard workflow by any means. I'm okay with that. I understand that most normal people don't have 20 workspaces. Good for those people. I'm happy for you. If you can live with just one or two or three workspaces, good for you. That's your workflow. That's what makes sense for you. But for me, I like workspaces a lot. And I like to have places for things. And I like to assign things to certain workspaces. That's the way I've been working now for two or three years. And it'd be really hard for me at this point. And it is actually, when I use a window manager that only has nine workspaces, like let's just say Qtile or Xmonad, those by default only come with nine workspaces. You can make them have more. But by default, you get nine. That's all you get. And it's shared between two monitors.  So you're golden there, or at least I'm golden there. But on the other ones, you only get nine total. And I find myself very constrained. Like I'm always running out of workspaces. Like even if, like almost instantaneously, I'll open up, I'll turn on the computer and get all my stuff set up. And all but one workspaces is full. Like it has stuff. Now, I know what you're thinking. Well, Matt, you could put more than one window on a workspace. That's true. And sometimes they do. So sometimes I have a, like in this case, on the OBS screen, I have a terminal and OBS open up at the same time. If I'm making a video and I need the notes right there in front of me, I can do that. You know, sometimes I do that. Most of the time though, I just want one thing on a workspace. It's just easier. It's bigger. You know, my eyesight's not that great so I can zoom in all I want without having to deal with weird wrapping of text and stuff like that. So that's the reason why I prefer to just have one thing on a workspace. It just works better for me. So to the person who has asked me why I use some of my workspace, that's the reason why. Again, I don't probably need 19 or 20 workspaces. I could do with 14. The problem comes in with keybindings. So the way I have it worked right now and the reason why I like I3 so much is because with I3, you can set a dedicated keybinding to every single workspace you have no matter how many workspaces you've created. So you can create as many workspaces as you want. There's no limit, which is my kind of win a manager. But you can also create a keybinding for every single one that you create. So I have super one through nine will interact with the workspaces on this monitor. Alt one through nine or zero through nine does the workspaces on this monitor here. And because they're segmented into one through nine and zero through nine over here, they kind of line up with the number row. Like there's zero through nine and then one through nine are basically the same range of numbers and it just makes it easier. When I, for a little while, a few weeks ago, I tried to cut it down. I tried to tone down the addiction and I went to 14 workspaces. It was fine, but then I had one through seven over here and eight through 14 over there. And then assigning those two different keybindings messed with my brain because I had the windows key one through seven for over here and then I had the alt key one through seven over there. And those numbers didn't line up. So alt plus one was the eighth workspace and that messed with my head. Like I like the number on the keyboard to associate with the workspace that I'm changing to, if that makes sense. So in my case, alt zero goes to workspace 10. There's no 10 key. So zero is the closest I get to. Same thing for anything above that. It's alt one goes to 11, alt two, 12, so on and so forth. It still makes a little bit sense. When they don't match up, it kind of messed with my head. So I eventually went back to 19 workspaces. So that is why I use my workspaces and kind of how I manage them. If you're interested in seeing the config files, all of my dot files are on my GitHub. You can find that link in the video description. You can follow me on Twitter at the Linuxcast. You can follow me on Mastodon or any of the other social media networks. Those links will be in the video description. You can support me on Patreon at patreon.com slash the Linuxcast. I'd like to thank my current patrons, Robert, Sid, Devon, Patrick, Fred, Kramer, Tridevil, Maglin, Jackson, Nathan, Toul, Steve A, separate guy, Linux, Gary, CML, KB, TGB, Keith, Andy, Uncle Bonehead, Gary, Antoine, Mitchell, J-Doug, Carbon Data, Jeremy, Sean, Odin, Martin, Ross, Eduardo, Art Center, Elliot, Ms. LaMarrick, Cam, Specialty, Peter, A, Crucible, Dark Benefic, Primus, TM, RLAC One. And Phillip, thanks everybody for watching. I'll see you next time.


Hello, how are you doing? Very good. How's everything going? Where are you right now? I'm actually in Westford in the office. So Okay, and is that usually like your location you're like Like your home base No, not not so much. I'm actually If you want to talk about home base my home base is actually in IMEA in Europe. I live in the Netherlands But for this year, I brought my family over to the States. I was originally born in Oregon So giving my kids a little bit of an experience in the States and we're living out at the beach on an island in North Carolina That sounds really nice. So well that was going to be kind of like my first question Like why don't you introduce yourself until it's a little bit about your work with with redhead? Yeah So, you know, you heard a little bit about background about me, but I've been with red hat about seven going well, I think this month is seven years actually I Started out for three years in Europe as a solutions architect doing like the technical sales role moved over to the middleware BU have a pretty strong background in BPM rules processes things like that did this in the financial world before I joined red hat Continue to work on that in the middleware BU Most people know me from from a lot of stuff. I've done around the the JBoss BRMS product and later the JBoss BPM suite so big app development background and I've just recently transitioned into something called the integrated solutions business unit That's kind of a business unit on top of all the other ones We now look across the entire red hat portfolio for solutions that make sense for our customers Thank you for that really really cool. And I wanted to ask you like how is it to work with within red head? Like do you think it makes the difference that we're so close involved like with open source? Like because it's it's almost like you think about red hat and immediately you think about open source So, how is it? I that's something that I usually ask people that come to the show to the open ship profiles Because I think it's so important that people understand that side of red hat and open shift It's I think that's probably one of the the main reasons that I'm here I'm a big fan always have been since early days of my you know, IT career development career Like having access to everything and and not being stopped by proprietary stuff that doesn't let me dig deeper I find out why it's not working or why I can't do what I want to do I think having that kind of openness is has now been proven in the market with the company like red hat there's a lot of companies to see a lot of value in that and I think having that back on a being able to dig into what's going on and to assist and to help and to Provide feedback or or you know, whether that's documentation feedback or code feedback. That's up to you At the higher level. It's really fascinating to watch how customer feature requests Actually happen right and even in between major releases Special special patches are sent out with their fixes for that specific customer. This does happen I think that makes all the difference in the world and I really can't imagine, you know, not working a red hat It's it's kind of a one of the first companies. They're been out where you get that feeling, right? You really want to be part of what's going on. It's pretty magical Okay, well, that's that's great and So I saw that one of your blog posts you were talking about like a CDK So like I'm trying to bring the conversation a little bit towards like the open-shift side I know that you are not part of the opening open-shift team But I I've seen that you do like a lot of like blog posts and things like that and you were talking about the CDK So how does like the CDK help you in your day by day? How like if you are a developer using open-shift, how does that help you? Before I get too far into that, maybe I can add a little bit of background on How I got over into the open-shift stuff. So when when the open-shift got acquired way back when I was one of the first, you know, I saw value right right away You know, you go tinker with some of our new acquisitions and see what it is And I was completely fascinated with the with the whole platform as a service kind of idea that was very quickly Integrated into our own tooling and our own own stuff You pretty much find everything that I blogged and put out there and whether it had anything to do with Open-shift or not Presentations workshops I host everything on open-shift right absolutely everything I've done you can you can find online And it's it's running on an open-shift instance I Came off of close to becoming an evangelist the way back in those days for them that didn't work out I went into the role in the middle where be you instead But I've always kept close ties with what's going on and watching it very closely and doing pretty much everything I do in it or on it and and Watching the transformation between what was cartridges at the time now is going to be darker images or images containerized stuff It's it's really fascinating to see where it's going and to watch the adoption curve, you know going up so steeply And and that brings us around to things like you know the images that you have the all-in-one image on open-shift I also wrote about it was playing with and tinkering with In my current role one of the product solutions we have is it's called the red hat cloud suite Which will be coming soon? This is taking the product portfolio from the operating system virtualization and open-stack layers up through containerized atomic enterprise layers Including open-shift enterprise on top of that and and cloud forms for the management orchestration and monitoring right So what what is the interface for an application developer from my world to this stack or to a cloud suite like that and That's pretty much the the open-shift is going to be the the face of what we're working with and what we're looking at and So I started digging a little bit into that because part of my job and part of what I do is you know speak at conferences or large groups or Putting videos together or doing webinars, right? It's pretty hard to put a data center on your laptop That's basically what we're talking about.  It's just not the way it works So the interface is what you can talk to a stack like that and explain all that Maybe show a video of someone that's done something at data center with it But that's not really how you want to do it you want to do some live stuff and show what this means for your pre application delivery your application development and So my plan was to dig a little bit into what would be the best interface to do something like that So I played a little bit with the open-shift All in one image and then I stumbled upon a relatively new project. This is the CDK Container development kit that's been going on here at Red Hat and and they're doing a big push right now of and some of the beta releases of what you're seeing me write about are tying this into the to the IDE so the jboss developer studio and Giving us some kind of integrated experience where you can install it quickly get spun up quickly and have some some pre-canned Stuff ready to go one of them happens to be the open-shift the enterprise sort of all in one image then inside the JDK or that JDK the CDK So that's what I tied together. They're a little rough. Of course, they're not finished and not, you know, publicized the stuff as GA yet So the install process wasn't exactly Easy so I went around and you know, I put that into my demo template Which I've done for all my demos and I got a lot of attention and and you know It'll probably be a little bit different when they release it I don't expect it to continue to be you know my my little demo template But it's just something I don't want to have to repeat that install process So everything I do I put out there, you know, it's about teaching sharing and you know share we grow and Yeah, I think this is gonna be something that's gonna gonna get people spun up a lot quicker That that's the whole idea behind it Get you go and have some examples ready to go out of the box instead of having to put your whole container Processing your container installation layers and stuff like that together. Oh Whoa, thank you I appreciate that you gave us like all that background So quite likely a lot of people are going to be interested in dad Like that's the kind of thing that you don't really see like on the blog or like On the commutation that's kind of like the experience that you are living Working with with thin right hat I wanted to ask a little bit more about what you do like day by day like We have talked with a couple of evangelists We have talked with a couple of like people that are moving all around Does your like position your current position like take you different places? Do you just like do presentations in one area different countries? How does that work? Yeah? So basically the last Four years, I've been doing a role that's Internally recognized as a technical marketing manager But externally we we call these a JBOS technology evangelist or red hat technology evangelist So there's a deviation from just the pure community evangelist that you see Like I think your previous one of your previous interviews with mark Marcus easel. He is one of the developer evangelists, right? So that there's a very large focus more so on community projects open-source community stuff Kind of kind of generating interest and digging into those pieces What I tend to focus on or what I do focus on is Everything to do around the products. So once the over-source project has been turned into a product You're missing the kind of noise that you're seeing in the community with evangelism out there. So we use technical marketing managers for that So what does my day look like? Where do I go? That's a pretty tough question There's several things that we're focusing on is things that I've found that work Kind of can give a sketch around that I wrote some blog posts about that too some articles I Believe a huge part of it is teaching and sharing So I listen very acutely to what our field is doing with the products and what the customers are Asking of them and you try to support that so both internally and and you know out in the wild You you see responses to stuff and I talk to people and if somebody has a need to be able to demonstrate Something in a product, which is an awful lot of what the demo projects were that I did in JBOS BRMS and the BPM space Whether that is containerized in the cloud or locally on your machine. Those are the ways we try to offer it They're basically demonstrating features or something that's a little bit difficult for them to understand to do normally and So we'll put something like that together Put it in easily repeatable form so you can spin it up spin it down It's it's strongly assisting the solution architects who you know are told today tomorrow You're going to be talking to the customer about a certain product or a certain technology And they may not have a lot of time to get prepared for it. So it's really nice if you have some stuff in a can Have a little video explanation around it or a couple of steps and they can get spun up really quick No, yeah, that's how that works. You know, I've had the training a long time ago But I just haven't talked about it for six months. So it's it's kind of nice to support that That's one aspect number two is being vocal about it So you have to get out there and you have to own stuff in social media. You have to own like tags Categories topics or at least get your voice in the mix I Believe consistency and writing is really important. I usually write something two three times a week At the at the peak of my you know, BRMS BPM time. I've now transitioned to a new role So I'm building up a base on that and foundation where I'm comfortable with to talk about You move into a space where you're not an expert You're not you know, you're not gonna be an expert overnight and there's there's aspects that I'm an expert of that I bring into that area. That's what I want to focus on Another part of it is is Also being able to go out and talk about this stuff. So finding the right places It's a whole lot different than the developer evangelism and that I'm not looking just to talk at any developer conferences You tend to target a little bit more specifically based on the crowd You're trying to reach which often includes customers analysts that kind of thing That doesn't preclude me from showing up at like a job user group or something like that I tend to back load my visits that way So if I show up somewhere for example Something I'm working on right now is Code of Motion in Amsterdam Submitted a bunch of stuff If that works out, I'll probably do a couple of user groups around it And I'll also stop into the office and do some sales enablement such as talking to our colleagues and explaining some of the new stuff That's coming and what it looks like that. That's my life, right? That's really how it goes around Another large chunk of it is the enablement when new products come out For example, what I just described with that cloud suite We'll visit the regions and bring some training and get some hands-on stuff together So they can they can learn that same thing happened with the with the JBoss products It's getting to the point now where we're growing so large that we have enablement Parts of our organization that do that So then my role is then more assisting to make sure the content either is mine that they're using or what we're developing Right stuff, and they'll take that over Yeah, that's Yeah, well, yeah, it's a really good idea what you would you do and thank you for that So I don't take tons of your time I'm just going to ask you like one last question and obviously it has to do with open shift Like what do you think about the latest version? Have you been able to try it any features that you would like to see like in future updates and things like that? I'm not a big feature hounds. I of course have been playing with the stuff that's coming along shifting more and more to open shift on Enterprise I should say The one request that I've had internally and I think you hearing externally too is it would be often nice if they'd make open shift online the same Right now. It's it's still the version two. It's coming It's not going to be very much longer But it used to be the other way around where we released that first and then the rest and in this case the containerized stuff They did it first enterprise and then they're going to do it online. So maybe next time. Please don't I miss being able to just spin stuff up and share it with the world, you know Yeah Yeah, right now I know that the entire team is working hard on that and they just want to do it like the right way So everyone tries to be happy or as happy as we can make everyone which is almost impossible But like let's say that we try our best Any parting thoughts anything that you would like to share with it with the block community that we have at open shift Parting thoughts. Um, no, no, really. I'm just uh continue to coat on I guess, right? Yeah, so well, uh, here you're going to see on the screen all the links. I think you have been seeing them during the video To contact Eric his blog his twitter. Uh, like you mentioned, he's quite active So and I think in the following weeks, we're going to have at least one of or two of his articles In our blog. So, uh, well, thanks for that and apart from that. Well, thank you for your time and have a great day Well, thank you


When Will Levis was here with us, he told us his hidden talent is singing. What is LJS's singing? You can sing as well. Yes. You're not going to demonstrate for us, are you? I got a song I can demonstrate for y'all. Okay, go ahead. In my life, I can't get right. Trying to figure out what to do. Well done! And you're in Nashville too. I mean, you may be able to pick up some extra work on the side.


What's good boys? Yeah, it's a hat day today. I don't know why. I never wear hats. It's just a hat day today. Two pieces of incredible news. Number one, the Owen jokes are over. The Lions get their first ever win in season. Oh my God. I don't know if you guys knew this, but on MMG Live, my podcast channel, I bet Chase, if the Lions went winless, like didn't get a single win, I would get the word Owen tattooed on my thigh. If the Lions have zero wins at the end of the season, I will get a tattoo on my body that says Owen. Yes I will. And for the last five weeks, I have been mortified that we were actually gonna go winless. Either way, we clutched up, be the Vikings. Sorry Vikings fans, I know it's a tough week for you guys. Second piece of good news.  The funniest man alive, in my personal opinion. The only issue was his account was banned like two months ago when I was trying to do this. But guess what baby? His account is back. I noticed that when I would do videos like make me laugh to win Madden or whatever, everybody was really just stealing Ghetto Gronk's content because he's so funny that that's kind of where everybody was getting the good meme. So show this guy some love and if you wanna follow someone hilarious on Instagram, follow Ghetto Gronk dude. This guy is so funny. Where do we start? It's been a while since we've taken a peek here. We'll start with the Baker Mayfield cycle. We'll start by shooting on some Browns fans.  Oh my God, Lowkey. The Browns played so horrible against Alliance.  Bro, Lowkey, Baker Mayfield is galaxy bread. He is just like Juju. Juju, Lowkey might be the third best receiver on the Steelers right now and I don't mean that as hate. I like Juju a lot. But Juju is on every commercial known to man because like every company is like, oh, gamer football player. Juju secures the bag regardless of how well he plays. It's kind of what Baker Mayfield is doing. He's on all those commercials and he's Lowkey a pretty mediocre quarterback this year. Baker Mayfield. This is from last week's games. Caption is Lamar through four interceptions and still outplayed Baker. Oh, I like this one. Steelers fans, you're not safe. Unimpressive wins to start the season. Fans get delusional, can't beat good teams, get exposed as frauds, big bends to see how. Whoa, okay, whoa. Cam Newton, five for 21, two interceptions, five point hit ready, got betched.  Jalen Rager really dropped two potential game winning touchdowns. Hey, well if you guys watched Wheel of Mutt yesterday which you definitely should have, you will know that I also hate Jalen Rager. The Rams are owning three since acquiring OBJ and Vaughn Miller. Dude, I don't know.  Matt Nagy hanging out to a string to the Bears head coaching job. I think the two coaches who need to be fired, Pete Carroll, Matt Nagy, probably Mike Zimmer too. After losing to Lyons, he is up there. This is my favorite one. The Giants left tackle has more touchdowns this season than their 72 million wide receiver and first drone pick combined. The Giants have been superbly unspectacular. Brown's players, dad's getting ready to trash Baker may be up. Christian McCaffrey last year's bro. This is so sad. Christian McCaffrey was like an indestructible tank for his first like three years in the league, dude. And now he's just been so injury prone. It's so sad. Russell Wilson this season. Yeah, ratio plus you fell. Russell Wilson every single year convinces people he's the best quarterback in the league for like four weeks and then he just falls off cliff every single year. Ooh, it wasn't the first time Russell Wilson has thrown an Enza interception to end the Seahawks season. I was pissed off watching that Washington football Seahawks game bro because DK McCaffrey was wide open. DK McCaffrey's dad about to go crazy on Facebook tomorrow. Russell Wilson every season weeks one. This is exactly what I'm talking about. Oh, Jalen Hurts slander get a croc bro. We are really gonna slander the goat back there. Let's let Russ cook. Russell Wilson, I put this on my story. All they said was let Russ cook. They didn't say it would be good food. Seahawks really trade away their future to the Jets for Jamal Adam. They said the same record as them. You know, that might be super galaxy brain now because now the Seahawks will have a good draft pick and hold on to most of your team. Thank you for participating in no win November. It's pretty cool that we're in the same league as the Rams but we are undefeated in December. There's not a lot of teams that can say they're undefeated in December. The Detroit Lions are undefeated in December. Taysum Hill throws foreign receptions in prime time, Sean Payton. 19 for 41 foreign receptions, 40 mil stolen, not a QB. Okay, I love Taysum Hill. I cannot justify that contract.  How did Taysum Hill get paid 40 mil, bro? Taysum Hill throwing the ball. Oh no, dude, I know this clip. Ooh, yeah. Rookie of the year just getting beamed up and intercepted by Mack Jones. The Detroit Vikings. Imagine being a Vikings fan.  That is- Minnesota!   Oh my God. I cannot believe the Patriots are the first seed.  Juvante Williams on the Broncos. Dude, Juvante Williams went off. Tyreek Hill thinks we forgot. I have literally never seen these. The bottom left one's my favorite. Tyreek Hartsu. Antonio Brown showing the NFL his Vax card. I don't get how like in a professional league though, how do you guys get scammed by Antonio Brown providing a fake Vax card? This is the NFL. How did you all get scammed by Antonio Brown of all people? For those of you who don't know and need some context, basically the NFL asked Antonio Brown to show, like provide his vaccination card, and he had a fake one made. So he gives the NFL a fake Vax card.  And he just played. And then finally it came out. It was Antonio Brown's former chef. So he used to be a chef for Antonio Brown, but is no longer, he snitched to the NFL. He was like, yo, by the way, Antonio's Vax card is completely fake.  And they checked in and they were like, oh, it's fake. Antonio Brown's chef after he didn't get paid. Yeah. He's Takashi 69 up there, ratting on everybody. Jamal after beating the defensive end allegations. OBJ, PB and J. Von Miller, Miller Light don't matter. Niners are four.  I don't want to hear anything about the Niners. Dude, stop, stop doing Matthew Stafford slander.  I'm not allowed to laugh at this. I'm not allowed to laugh at this. I'm not allowed to laugh. I had to step out of the room. I had to use the bathroom. When you throw an interception to Blitz Boy and he actually catches it. John Gruden's fantasy football team. Gruden's grinders lineup. Kirk Cousins, Christian McCaffrey, Rex Pericott, Beasley, Cooper Cupp, half of Jimmy Graham. Anyone but Young Way Coo. Raiders minus Carl, oh my God. He has a guard at the flex. John Gruden looking for the person that ruined his career. I stand with John Gruden. The NFL is blackballing him. He put Drew Brees and Nick Bowsite in here. Dude, when the Dolphins beat the Ravens, I saw a stat. It was like they ran the same Blitz like 39 times. Like actually 39 times, the exact same Blitz in those mid Blitz. Every good man player would pick this defensive part. It's honestly true. Mid Blitz is so easy to pick apart now. You just lost to the Sheldon High School fishing club president. I love that this picture exists. As long as Justin and Herbert continues to be good, which he most likely will. We can use this photo for like 10 years. That's so exciting. Browse fans when someone calls Baker Mayfield average. This is literally how my comments are gonna look after this video. This is obvious, right? Ah, I don't know. That might be a stretch. This might be a stretch right here. The NFL when Clyde Edwards alert pointed at someone. My son saw this and now he's addicted to drugs, do better.   These guys are out there. Basically like gladiators fighting each other. Let them taunt a little bit. I hope you guys enjoyed a gigantic shout out to Ghetto Ground Girl. This guy is a God.  Go follow him. I'll definitely do another one of these this season. Probably as we get closer to Super Bowl playoffs just gonna have so many good ones, dude. I hope you guys enjoyed. I can't wait to make another and I will see you in the next video. Peace.