The APS Green paper has raised many concerns for members, especially General Psychologists, who make up 50% of the APS membership and almost 70% of Australia’s psychology work force. As such, it represents a betrayal by the organisation which has been largely funded by general psychologists to represent their interests.
The paper states that approximately 30,000 Australian General Psychologists after six years of rigorous training will only be able to treat clients with mild mental health symptoms.
The paper also proposes that General Psychologists might be allowed to treat moderate mental health problems, if they are prepared to complete a special pathway. This new pathway means that, depending on their level of Recognised Prior Leaning, General Psychologists will be required to complete 40-hours of certified training as well as an unknown amount of supervised practice. But they will never be allowed to treat severe clients.
The logistical problems and the costs associated with providing such training for many thousands of people will be enormous. It seems highly unlikely that this could be achieved in any reasonable time scale. How long can psychologists be expected to endure such limitations on their practice? We are offered no estimate of the practicalities of this so-called solution.
These proposed restrictions have the potential to further destroy the professional standing and livelihoods of General Psychologists. General Psychologists have been treating clients with moderate and severe disorders for the past 12 years, and there is no evidence of differences in treatment outcomes by General Psychologists compared to that of endorsed psychologists.
The paper also gives no indication of what the certified training will include. Given that general psychologists no longer are restricted to Focussed Psychological Strategies, CBT remains the obvious option. However, it is well recognised across the world that CBT is not appropriate for all patients (Wampold-et-al-2016).
The newly certified General Psychologists will also not be allowed to use evidence-based psychological therapies, as these are restricted to Clinical psychologists and possibly other endorsed psychologists. This means that the majority of Australian psychologists will not be able to use the best evidence-based therapeutic interventions for patients suffering moderate mental health issues.
The paper offers no data to support these proposals. Surely serious evidence and data have been collected in preparation for this onslaught on thousands of General Psychologists? The only rationale offered for this dramatic differentiation between psychologists is years of tertiary level training.
This is absolutely not supported by research across the world, which clearly states that years of training is not a significant factor in therapeutic outcomes for patients. On the contrary, the research shows that the therapeutic relationship and client factors account for as much as 70% of successful outcomes in therapy. (The Heart and Soul of Change, Second Edition: Delivering What Works in Therapy. (2015) Bruce E. Wampold & Barry L. Duncan & Scott D. Miller).
We understand time was pressing for the APS MBS Committee. But the proposals in the Green paper need a lot more thought and consultation if this is not to be seen as a cynical grab for ‘treatment territory’ by clinical and endorsed psychologists.
If the same recommendations for General Psychologists are reinstated in the White Paper later this month, General Psychologists will be better served by an organisation that will exclusively represent their interests – as the RACGP represents those of General Practitioners.
PS. Can we please drop the term ‘generalists’? It was first coined in the 2006 APS submission to government to describe all non-clinical psychologists. However we now have three distinct and separate groups – clinical, other endorsed and general psychologists.
PPS. We are running a poll (below) to explore reactions to the Green Paper. We would love it if you could participate in this important data gathering exercise 🙂