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Counting on U training to enhance trusting relationships and mental health literacy among business advisors: protocol for a randomised controlled trial


Saxon, L and Bromfield, S and Leow-Taylor, SH and Vega, CE and Berk, M and LaMontagne, AD and Martin, AJ and Mohebbi, M and Nielsen, K and Reavley, NJ and Walker, A and Conway, A and de Silva, A and Memish, K and Rossetto, A and Tanewski, G and Noblet, A, Counting on U training to enhance trusting relationships and mental health literacy among business advisors: protocol for a randomised controlled trial, BMC Psychiatry, 22 Article 400. ISSN 1471-244X (2022) [Refereed Article]

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DOI: doi:10.1186/s12888-022-04034-7



Financial distress is thought to be a key reason why small-medium enterprise (SME) owners experience higher levels of mental health conditions compared with the broader population. Business advisors who form trusting, high-quality relationships with their SME clients, are therefore well placed to: (1) help prevent/reduce key sources of financial distress, (2) better understand the business and personal needs of their clients and, (3) recognise the signs and symptoms of mental health conditions and encourage help-seeking where appropriate. The aim of this study is to compare the effectiveness of relationship building training (RBT) combined with mental health first aid (MHFA) training for business advisors with MHFA alone, on the financial and mental health of their SME-owner clients.


This is a single blind, two-arm randomised controlled trial. Participants will be business advisors who provide information, guidance and/or assistance to SME owner clients and are in contact with them at least 3 times a year. The business advisors will invite their SME-owner clients to complete 3 online surveys at baseline, 6- and 12-months. Business advisors will be randomised to one of two conditions, using a 1:1 allocation ratio: (1) MHFA with RBT; or (2) MHFA alone, and complete 3 online surveys at baseline, 2- and 6-months. Primary outcomes will be measured in the business advisors and consist of the quality of the relationship, stigmatizing attitude, confidence to offer mental health first aid, quality of life and provision of mental health first aid. Secondary outcomes will be measured in the SME owners and includes trust in their business advisors, the quality of this relationship, financial wellbeing, financial distress, psychological distress, help-seeking behaviour, and quality of life. To complement the quantitative data, we will include a qualitative process evaluation to examine what contextual factors impacted the reach, effectiveness, adoption, implementation, and maintenance of the training.


As there is evidence for the connections between client trust, quality of relationship and financial and mental wellbeing, we hypothesise that the combined RBT and MHFA training will lead to greater improvements in these outcomes in SME owners compared with MHFA alone.

Item Details

Item Type:Refereed Article
Keywords:Mental health first aid, depression, prevention, mental health conditions, relationships, business advisors, SMEs, mental health, small business, accountants
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Occupational epidemiology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Occupational health
UTAS Author:Martin, AJ (Professor Angela Martin)
ID Code:150460
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-06-16
Last Modified:2022-06-16

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