Judy Hyde: More than 50% of Clinical Psychologists are Unqualified in Clinical Psychology!

Left to right: Caroline Hunt, Anthony Cichello, Judy Hyde

Celebrating the ACPA’s move to George Street, Sydney

You can download the above photo from the ACPA Facebook page here.

Judy Hyde, President of the Australian Clinical Psychology Association (ACPA) made a submission to the Federal Department of Industry in 2016 stating the following:

“There is an over supply of generalist psychologists (ANZSCO, 2723, 2014; Hyde, 2014; Grenyer, 2013).
There is an under supply of qualified clinical psychologists. More than half of those clinical psychologists currently endorsed by the Psychology Board of Australia do not have qualifications in clinical psychology, although these are now required for endorsement going forward.”

In response to this, and no matter which way you look at it, by the ACPA President’s own admission more than half of the psychologists with ‘Clinical’ endorsement (who attract 47% higher Medicare rebates) are less qualified than ‘Generalist’ psychologists who hold higher degrees (Masters and Doctorate). Of note there are a significant number of ‘generalist’ psychologists who hold multiple postgraduate advanced degrees across various areas of psychology.

According to data from the Psychology Board of Australia (as at 31 March 2018), there are 29,213 registered psychologists in Australia with 8,298 of these holding endorsement as clinical psychologists (28%). Of this 28% more than half “do not have qualifications in clinical psychology”. So if we do the maths Judy Hyde is actually implying over 85% of registered psychologists in Australia are not qualified to provide Psychological Therapy Services under Tier One of the Better Access to Mental Health scheme.

A bigger mystery is how Judy Hyde has arrived at this figure given that the Psychology Board of Australia has advised that due to the variations in the way the data was presented and transferred from state and territory jurisdictions the data cannot be presented in a meaningful format. A letter from Senator the Hon Bridget McKenzie confirms this, download the letter here.

In her submission Judy Hyde also claimed:

“Non-metropolitan areas frequently struggle to obtain qualified clinical psychologists. On occasion they are forced to employ generalist psychologists who do not have the training to work at the level required in mental health.”

All psychologists are educated and trained in the main therapeutic approaches of psychology. Many have also completed further non-university based study in areas such as Acceptance and Commitment Therapy, Schema Therapy, Trauma-Focussed Therapies, Narrative Therapy, etc.

Research shows that all psychologists produce comparable treatment outcomes across the spectrum of mild, moderate and severe mental illness. In addition, the theoretical basis of experiential learning itself tells us that any psychologist who claims expertise, advanced knowledge and skills in specific areas who hasn’t had some measure of exposure in those areas relative to their peers is making a false claim. The same applies, across all areas of practice, to any newly graduated clinical psychologist who has only had initial minimal exposure and to others, regardless of years of practice, who haven’t experienced a good measure of exposure within particular areas.  Again, this strongly suggests that having an endorsement as a ‘clinical’ psychologist does not automatically make oneself superior in skills to generalist psychologists.

So what is the answer to Judy Hyde’s inference?

generalist psychologists who do not have the training to work at the level required in mental health”

When the registration system for psychologists moved from the state-based systems to being federally managed by AHPRA, many members of the APS were automatically endorsed in areas of their choosing. Therefore, many clinical psychologists hold the same level of training and qualifications as ‘generalist’ or ‘registered’ psychologists.  In fact, a large portion of ‘generalist‘ psychologists hold postgraduate qualifications such as masters, PhDs or specific training in particular techniques such as EMDR. Psychologists cannot be considered better trained or skilled by virtue of holding the title ‘clinical psychologist’. The knowledge, skills and ability of a psychologist cannot be deemed by endorsement status alone. Nor can years of academic study be seen as an accurate measure of any psychologist’s ability or experience in treating Mental Health Disorders. A graduate from the Master of Clinical Psychology with 2 years of supervised experience cannot be compared to a psychologist who has 4 years undergraduate study, postgraduate training and qualifications, and decades of documented experience providing assessment, diagnosis and treatment of mental health disorders with measured positive outcomes.

There are three key reasons why all psychologists have equivalence in practice expertise:

  • All psychology pathways to registration and practice are subjected to rigorous development and stringent monitoring to ensure the same baseline competencies are upheld.
  • Expert clinical practice involves a complex mix of practice experience, supervision and professional development as key variables in treatment outcomes – beyond academic qualifications.
  • Yearly registration ensures all psychologists have extensive formal requirements across practice experience, supervision and professional development to ensure practice expertise continues to build post-graduation.

Unlike specialities in medicine, the notion of clinical practice in psychology is not unique to clinical psychologists. Generalist Psychologists are treating people across a very broad range of conditions and levels of severity in their daily practice. The skills to diagnose, treat mental illness therapeutically, and produce effective outcomes are not unique to one advanced area of psychology. Once again, this is highlighted by the scientific evidence.

Importantly, there are a number of different pathways to registration to practice as a psychologist in Australia.  Psychologists, participating in and completing these pathways, ALL experience advanced levels of training and supervised practice. All psychologists are required to complete Continuous Professional Development that is relevant to the scope of their practice and interests.

You can download the Hyde submission here.

ACPA have also made a submission to the Medicare Benefits Schedule Review Task-force in September 2017.

In their submission ACPA claimed the following:

“Qualified clinical psychologists hold a four-year accredited undergraduate degree majoring in the science of psychology, plus at least a two-year Master’s, or three- year Doctoral degree in clinical psychology, plus a registrar program to bring post- graduate training in mental health to four years”

This is contradictory to Judy Hyde’s admission that over half of endorsed clinical psychologists have no qualifications in clinical psychology.

The ACPA submission also states:

“the majority of generalist psychologists and other allied health providers able to access MBS items have undertaken no accredited training in professional psychology, including assessment, diagnosis, formulation or treatment of mental health disorders”

The sweeping statement that ‘generalist’ psychologists have “undertaken no accredited training in professional psychology, including assessment, diagnosis, formulation or treatment of mental health disorders” is inaccurate and verging on defamatory. It is statements such as these that lead to the public being misinformed and referring medical practitioners being misled to believe ‘generalist’ psychologists are inferior to their ‘clinically’ endorsed colleagues.

The statement completely disregards the fact that in Australia, there are indeed 8 other endorsed areas of psychology (clinical neuropsychology, community psychology, counselling psychology, educational and developmental psychology, forensic psychology, health psychology, organisational psychology, and sport and exercise psychology). It is common knowledge that to obtain each area of endorsement the psychologist must have

(a) an accredited doctorate in one of the approved areas of practice, and a minimum one year of approved supervised full-time equivalent practice with a Board- approved supervisor or

(b)  an accredited Masters in one of the approved areas of practice, and a minimum of two years of approved supervised full-time equivalent practice with a Board- approved supervisor or

c)  another qualification that, in the Board’s opinion, is substantially equivalent to (a) or (b).

Each endorsement area is relevant to servicing a wide range of mental health consumers. Unfortunately registered psychologists, who have been practicing for more than 10 years, were unable to become endorsed through lack of available pathways. Ironically, a significant number of psychologists with the same qualifications were “grandfathered” into the clinical college and received clinical endorsement despite the fact that they do not have a Master or Doctoral degree in clinical psychology.

ACPA also stated:

“We support the Mental Health Commission’s (2014) recommendation for cashing out of MBS services provided by registered psychologists without accredited professional qualifications in mental health to fund psychological services on a salaried or, when necessary, sessional basis.”

Psychologists who have gained general registration from many different pathways are engaged in clinical practice on a daily basis in Australia. These psychologists are assessing and treating people across a broad range of conditions from mild to severe presentations. The skills required to assess, diagnose, and treat mental illness therapeutically and achieve effective outcomes are not unique to clinical psychology. To suggest any registered psychologist is not worthy of MBS services is defamatory to all psychologists without clinical endorsement and claims elitism in a profession where the code of ethics prohibits such behaviour.

You can download the submission here, or directly from the ACPA web site here.

A question all psychologists can submit to the new APS Advisory Council:

What is the APS doing about the continual denigration of generalist psychologists by the ACPA; Will the Board release a public statement correcting the inaccuracies in the ACPA submission?

There is more about the ACPA submissions and ‘activities’ in the RAPS Community Forum:

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