There are no options for 4+2’s

Please don’t assume that because non-clinical psychologists did not obtain the clinical psychology endorsement that we are lazy and not good enough.

Lets take a look at our options to do a clinical psychology bridging course in Australia.

ACT: None
NSW: None
NT: None
QLD: One – offered 2 years part time internally, open to those who have an endorsement in another specialty.
SA: None
TAS: None
VIC: None
WA: One, offered on campus part-time or full-time and only open to those who have an endorsement in clinical neuro-psychology.

Therefore, if someone already has an endorsement in clinical neuropsychology and can commute to the campus at St Lucia QLD or Crawley WA they may take a bridging course. For other endorsed psychologists the only available option is if they can commute to St Lucia QLD. For 4+2 psychologists there is no bridging option.

This information is from the APAC website and the websites of the two universities that actually offer the bridging programs.

It is only 11 years since the introduction of the Medicare rebates. Psychologists who completed their 4th year of training before this chose their pathways without the knowledge that they were choosing a pathway of higher or lower value. Some psychology students may still pursue a career in a specialty that interests them, despite the knowledge that the other 8 specialities are not as financially valuable. Some trainee psychologists probably still admire the hands on training of the 4+2 or 5+1 pathways.


262 thoughts on “There are no options for 4+2’s

    1. Hi Matt,

      I’m confused – I just read the article you enclosed and it seemed to me that Prof Littlefield was actively defending the standards of Registered Psychologists against the disparaging comments of the 6 Clinical Executives that resigned at the time.

      Not sure if you saw my other comment posted today regarding the role of ACPA’s President in driving the public campaign denigrating the rest of the non-clinical profession -but your article further supports what I commented on below – that the public perception of Registered Psychologists have been tainted by ACPA’s agenda, not the APS…

  1. So let’s extend this argument further. Should psychiatrists get more than psychologists, counsellors, etc for their counselling and psychotherapy services? Psychiatrists get 52 sessions a year which can be used for weekly exploratory therapy subsidised by medicare. If you have a close look at psychiatrist training they appear to receive certainly no more than psychologists in a masters program receive, even less for many. The focus is still largely on psychodynamic and while there is evidence, surely if we go by arguments here then we all achieve the same so pay us all the same and give us all 18 sessions – i can see psychiatrists taking a pay cut to enable increased sessions for psychologists.
    Yes many in mental health have additional masters and doctorates, but it still vomes back to what is the base level minimum training for psychologists enabling reliable, high level, expert practice? How do we diffetentiate ourselves from other professions? Are we the same as social workers as Mr Goodluck would have us? Completely different training. Are we the same as psychiatrists but without the prescriptions?

    1. In proclaiming to the public, the government and the health community that some of us are worth more than others; it opens the door for the value of all of us to be questioned.

      As a united profession we had a lot more chance of being able to successfully lobby for higher status as a discipline in its own right within the mental health landscape – but by stratifying us using artificial ‘expertise standards’, it not only dilutes what we have to offer as a professional group, but it has pitted us all against each other, instead of channeling all our efforts towards elevating our profession.

      As the old adage states – “united we stand, divided we fall”, and we all know ‘what’ tends to come before the fall….

      1. There are 30K psychologists and onlt 3-4K psychiatrists. There is no way the government will suddenly increase the rate for all to the higher tier.

        1. i think the suggestion is that those who are currently on the higher rate have their pay (and status) reduced to the same rate (and status) as all other psychologists, unless it can be demonstrated empirically that their services are worth the higher rate. The benefit for that would be many more services available to the public in need; and an end to the artificial and ethically corrupting two tier system which is damaging the credibility of our entire profession.

        2. Hi JHemsworth

          No-one I am aware of is requesting that all psychologists are suddenly placed on the top tier rate. Some are advocating that the top tier is reduced to the bottom tier rate. Other’s suggest one tier which is approximately halfway between the two claiming that such a single tier would still result in savings for the government – that may be true I don’t have access to the numbers to crunch them. However, if there is the change that many of us are advocating for i.e. one tier then I think it is likely to be a graduated introduction as there are entire businesses built on the two tier model (really on the higher rebate) and it would be an unpopular move by government to subject these businesses to too much change to quickly. So a stepped approach in which the higher tier is gradually reduced and the lower tier is gradually increased over a number of years until they meet would be a more likely introduction. But all this is just speculation.

    2. my view- no, psychiatrists should not get more than psychologists, either money or sessions. Most psychiatrists do very little training in psychology, psychodynamic or otherwise- most of their training is in DSM categories and which drugs to apply to which label. Personally, i think this is of very dubious value to both individuals or society (see Peter Kinderman’s recent book, A Prescription for Psychiatry, where he articulates the reasons well- as per Szasz and many others since). The contemporary focus of psychiatry is not psychodynamic, it is pharmacological. The research has already clearly resolved what is the base-line level of training required to get good results for clients- both 4+2 and 4+masters have displayed it (no differences in the client populations or outcomes). There are clear overlaps in the training of psychologists and social workers (they study psychology too)- the training is not ‘completely different’. Psychologists are not the same as psychiatrists, even minus the prescriptions. Psychology is a stand alone discipline which need not resort to a medical model in order to get positive results for clients. That GPs and psychiatrists do so well under mental health funding is a product of the power of the AMA, not a reflection of good practice. Ditto for ‘clinical’ psychologists. Its about time the mental health field as a whole began paying attention to the evidence rather than vested financial interests- the proposed changes to the APS (and changes within our own profession) are a good place to start; then we change the world.

      1. Hi James

        Yes agree with most things you say on this entire blog. Psychiatry does have some efficacy, when needed, as an early intervention in crisis situations, but low dose and withdrawal as soon as possible is the approach most successful models of intervention support. I know of just 1 psychiatrist in Brisbane who uses ACT and whose first priority is to get people off their meds.

        Regarding psychology being a stand alone discipline and the incongruity of psychologists getting into bed with the medical model, I made a very long post about that, and other things here ->

        Labels, technical language, DSM diagnoses etc are not tools for change and they tend to disempower the client while empowering the practitioner. There is very little that is collaborative or bilateral in such practices.

        Kind Regards


      2. Nice one James. Logic, Reason, Evidence based = Good Science. We, the scientist practitioner psychology profession, should be heralding the common-sense approach of rewarding the best outcomes, not the highest status. The notion of ‘God Doctors’ is so old-school and unscientific. It is time Health Funds including the Government got serious about better outcomes for mental health and put the money where the outcomes are, not just in the pockets of the self-proclaimed elites.

      3. James, i agree with much of what you say, the psychiatry model is flawed and psychology is very different. However psychology and social work are quite different in training….. there may be some similarities in philosophy, but ive never heard of the science of social work.

        1. Probably also worthehile saying that if you think psychology and social work are similar, you probably need to update yourself on current content in training in these professions.

          1. have you ever worked in the real world, along side both psychologists and social workers, and seen what they/we do on a daily basis? I must have been working with a very skewed sample for the last 30+ years.

        2. ironic- you seem to be insistent upon ignoring the science in psychology (which demonstrates no difference between types of psychologists).

        3. Hi JHemsworth,

          A very small/brief sample of references below on the Science of Social Work that was found after a very quick 2 minute literature search. A lack of personal knowledge on something is not evidence that it doesn’t exist.

          Starting with the National Association of Social Workers (Ohio Branch) Conference titled: The Science of Social Work

          Quick 2 minute literature search found the references below on the science of social work…

          Christian Ghanem, Thomas R. Lawson, Sabine Pankofer, Markos Maragkos, Ingo Kollar. (2017) The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries. Journal of Evidence-Informed Social Work 14:2, 86-118

          Sally Cornish. (2016) Social work and the two cultures: The art and science of practice. Journal of Social Work, 14

          Bruce A. Thyer. (2015) Preparing Current and Future Practitioners to Integrate Research in Real Practice Settings. Research on Social Work Practice 25:4, 463-472

          Diane DePanfilis. (2014) Back to the Future: Using Social Work Research to Improve Social Work Practice. Journal of the Society for Social Work and Research 5:1, 1-21

          Daniel Gredig. (2011) From research to practice: Research-based Intervention Development in social work: developing practice through cooperative knowledge production. European Journal of Social Work 14:1, 53-70

          Bruce A Thyer, Laura L Myers. (2011) The quest for evidence-based practice: A view from the United States. Journal of Social Work 11:1, 8-25.

          Lisa R. Baker, Frederick Stephens, Laurel Hitchcock. (2010) Social Work Practitioners and Practice Evaluation: How Are We Doing?. Journal of Human Behavior in the Social Environment 20:8, 963-973.

          Allen Rubin, Danielle E. Parrish. (2010) Development and Validation of the Evidence-Based Practice Process Assessment Scale: Preliminary Findings. Research on Social Work Practice20:6, 629-640.

          Bruce A. Thyer. (2008) Evidence-Based Macro Practice: Addressing the Challenges and Opportunities. Journal of Evidence-Based Social Work 5:3-4, 453-472.
          A few pre millennia references

          Benbenishty, R. (1996) ‘Integrating Research and Practice: Time for a New Agenda’, Research on Social Work Practice 6(1): 77-82. Google Scholar

          Bronson, D. E. (1994) ‘Is a Scientist-Practitioner Model Appropriate for Direct Social Work Practice? No’, in W. W. Hudson and P. S. Nurius (eds) Controversial Issues in Social Work Research, pp. 79-86. Boston, MA: Allyn & Bacon. Google Scholar

          A. Zeira, C. Canali, T. Vecchiato, U. Jergeby, J. Thoburn, E. Neve. (2008) Evidence-based social work practice with children and families: a cross national perspective. European Journal of Social Work 11:1, 57-72.

          Building Social Work Knowledge for Effective Services and Policies: A Plan for Research Development. A Report of the Task-force on Social Work Research (1991). Austin, TX: Capital Printing.

          Chandler, S. M. (1994) ‘Is There an Ethical Responsibility to Use Practice Methods with the Best Empirical Evidence of Effectiveness? No’, in W. W. Hudson and P. S. Nurius (eds) Controversial Issues in Social Work Research, pp. 105-111. Boston, MA: Allyn & Bacon. Google Scholar

          Corcoran, Jacqueline (2000) Evidence-based Social Work Practice with Families. New York: Springer. Google Scholar

          deSchmidt, A. and Gorey, K. M. (1997) ‘Unpublished Social Work Research: Systematic Replication of a Recent Meta-analysis of Published Intervention Effectiveness Research’, Social Work Research 21(1): 58-62.Google Scholar

          Dewees, M. (1999) ‘The Application of Social Constructionist Principles to Teaching in Social Work Practice in Mental Health’, Journal of Teaching in Social Work 19(1/2): 31-46. Google Scholar

          Faul, A. C., McMurtry, S. L. and Hudson, W. W. (2001) ‘Can Empirical Clinical Practice Techniques Improve Social Work Outcomes?’, Research on Social Work Practice 11: 277-299.

          Fortune, A. E. and Reid, W. J. (1999) Research in Social Work, 3rd edn. New York: Columbia University Press.

          Gambrill, E. (in press) ‘Evidence-based Practice: Implications for Knowledge Development and Use in Social Work’, in A. Rosen and E. K. Proctor (eds) Developing Practice Guidelines for Social Work Intervention: Issues, Methods, and Research Agenda. New York: Columbia University Press.

          Gorey, K. M. (1996) ‘Effectiveness of Social Work Intervention Research: Internal Versus External Evaluations,’ Social Work Research 20(2): 119-128. Google Scholar

          Gorey, K. M. and Thyer, B. A. (1998) ‘Differential Effectiveness of Prevalent Social Work Practice Models: A Meta-analysis’, Social Work 43(3): 269-279.

          Howard, M. O. and Jenson, J. M. (1999) ‘Barriers to Development, Utilization, and Evaluation of Social Work Practice Guidelines: Toward an Action Plan for Social Work’, Research on Social Work Practice 9(3): 347-364.

          Kazi, M. A. F. and Wilson, J. (1996a) ‘Applying Single-case Evaluation Methodology in a British Social Work Agency’, Research on Social Work Practice 6(1): 5-26.

          Kazi, M. A. F. and Wilson, J. (1996b) ‘Applying Single-case Evaluation in Social Work’, British Journal of Social Work 26: 699-717.

          Kazi, M. A. F., Mantysaari, M. and Rostila, I. (1997) ‘Promoting the Use of Single-case Designs: Social Work Experiences from England and Finland’, Research on Social Work Practice 7(3): 311-328.

          Kirk, S. A. (1990) ‘Research Utilization: The Substructure of Belief’, in L. Videka-Sherman and W. J. Reid (eds) Advances in Clinical Social Work Research, pp. 233-250. Washington, DC: NASW Press.

          Kirk, S. A. (1999) ‘Good Intentions Are not Enough: Practice Guidelines for Social Work’, Research on Social Work Practice 9: 302-310.

          Kirk, S. A. and Reid, W. J. (in press) Science and Social Work: A Critical Appraisal. New York: Columbia University Press.

          MacDonald, G. (1994) ‘Developing Empirically-based Practice in Probation’, British Journal of Social Work 24: 405-427. Google Scholar

          MacDonald, G., Sheldon, B. and Gillespie, J. (1992) ‘Contemporary Studies of the Effectiveness of Social Work’, British Journal of Social Work 22(6): 625-643. Google Scholar

          McQuaide, S. (1999) ‘A Social Worker’s Use of the Diagnostic and Statistical Manual’, Families in Society 80: 410-416.

          Marino, R., Green, G. R. and Young, E. (1998) ‘Beyond the Scientist-practitioners Model’s Failure to Thrive: Social Workers’ Participation in Agency-based Research Activities’, Social Work Research 22: 188-191.

          Mullen, E. J. and Bacon, W. F. (in press) ‘Practitioner Adoption and Implementation of Evidence-based Effective Treatments and Issues of Quality Control’, in A. Rosen and E. K. Proctor (eds) Developing Practice Guidelines for Social Work Intervention: Issues, Methods, and Research Agenda. New York: Columbia University Press.

          Mutschler, E. (1984) ‘Evaluating Practice: A Study of Research Utilization by Practitioners’, Social Work 29: 332-337.

          Mutschler, E. and Jayaratne, S. (1993) ‘Integration of Information Technology and Single-system Designs: Issues and Promises’, in M. Bloom (ed.) Single-system Designs in the Social Services: Issues and Options for the 1990s, pp. 121-145. New York: Haworth Press.

          Peile, C. (1988) ‘Research Paradigms in Social Work: From Stalemate to Creative Synthesis’, Social Service Review 62(1): 2-19.

          Reid, W. J. (1992) Task Strategies: An Empirical Approach to Social Work Practice. New York: Columbia University Press.

          Reid, W. J. (1997) ‘Research on Task-centered Practice’, Social Work Research 21(3): 132-137.

          Reid, W. J. and Fortune, A. E. (1992) ‘Research Utilization in Direct Social Work Practice’, in T. Grasso and E. Epstein (eds) Research Utilization in Social Work, pp. 97-116. New York: Haworth Press.

          Reid, W. J. and Fortune, A. E. (in press) ‘Empirical Foundations for Practice Guidelines in Current Social Work Knowledge’, in A. Rosen and E. K. Proctor (eds) Developing Practice Guidelines for Social Work Intervention: Issues, Methods, and Research Agenda. New York: Columbia University Press.

          Reid, W. J. and Hanrahan, P. (1982) ‘Recent Evaluations of Social Work: Grounds for Optimism’, Social Work 27: 328-340.

          Reid, W. J. and Zettergren, P. (1999) ‘Empirical Practice in Evaluation in Social Work Practice’, in I. Shaw and J. Lishman (eds) Evaluation in Social Work Practice. Thousand Oaks, CA: Sage.

          Richey, C. A. and Roffman, R.A. (1999) ‘On the Sidelines of Guidelines: Further Thoughts on the Fit Between Clinical Guidelines and Social Work Practice’, Research on Social Work Practice 9: 311-321.

          Rodwell, M. K. (1998) Social Work Constructivist Research. New York: Garland Publishing.

          Rosen, A., Proctor, E. K. and Staudt, M. M. (1999) ‘Social Work Research and the Quest for Effective Practice’, Social Work Research 23: 4-14.

          Rubin, A. (1985) ‘Practice Effectiveness: More Grounds for Optimism’, Social Work 30: 469-476.

          Rubin, A. and Knox, K. S. (1996) ‘Data Analysis Problems in Single-case Evaluation: Issues for Research on Social Work Practice’, Research on Social Work Practice 6(1): 40-65.

          Seale, C. (in press) ‘Quality Issues in Qualitative Inquiry’, Qualitative Social Work.

          Sheffield, A. E. (1937) Social Insight in Case Situations. New York: D. Appleton-Century.

          Sheldon, B. (1986) ‘Social Work Effectiveness Experiments: Review and Implications’, British Journal of Social Work 16: 233-242.

          Slonim-Nevo, V. and Anson, Y. (1998) ‘Evaluating Practice: Does It Improve Treatment Outcome?’, Social Work Research 22(2): 66-75.

          Thomas, E. J. (1978) ‘Generating Innovation in Social Work: The Paradigm of Developmental Research’, Journal of Social Service Research 2: 95-115.

          Thyer, B. A. and Wodarski, J. S., eds (1998) Handbook of Empirical Social Work Practice, Vol. I: Mental Disorders. New York: John Wiley & Sons.

          Tyson, K. B. (1992) ‘A New Approach to Relevant Scientific Research for Practitioners: The Heuristic Paradigm’, Social Work 37(6): 541-556.

          Videka-Sherman, L. (1988) ‘Meta-analysis of Research on Social Work Practice in Mental Health’, Social Work 33: 325-338.

          Wakefield, J. C. and Kirk, S. A. (1996) ‘Unscientific Thinking about Scientific Practice: Evaluating the Scientist-practitioner Model’, Social Work Research 20(2): 83-95.

          Witkin, S. L. (1991) ‘Empirical Clinical Practice: A Critical Analysis’, Social Work 36: 158-165.

          Witkin, S. L. (1996) ‘If Empirical Practice is the Answer, Then What Is the Question?’, Social Work Research 20(2): 69-75.

          Wodarski, J. S. and Thyer, B. A., eds (1998) Handbook of Empirical Social Work Practice, Vol. II: Social Problems and Practice Issues. New York: John Wiley & Sons.

          1. Well, that is a lot of references but not a single piece of evidence showing that the work undertaken by psychologists and social workers is virtually identical as implied. If I handed this in as an asssignment, I would have failed. Surely we can expect a slightly more evidenced argument from Associate Professor Dr Clive James PhD?

            1. As we’ve seen…. evidence can be used superficially and put forward without explanation or elsboration. But still the challenges re the 4+2:remain unacknowledged

              1. So what are your thoughts on this briefing paper from the APS to the NSW Mental Health Commissioner in 2014, where amongst several other points, they state the fact that the current 4+2 pathway requirements are so onerous, that several organisations, communities and emerging psychologists are being adversely impacted by it? Page 5, subsection 3.3


                And if your focus is on historical standards; what do you propose should be done with the tens of thousands of currently registered psychologists who emerged through that pathway – deregister them?

                1. Yes, the requirements have become onerous on an attempt to improve this pathway. The issue is with implementation snd assessment of this pathway. How could one psychologist teach everything there is to know about practice in psychology?? Jow can one psychologist comprehensively teach and assess this? No psychologist can, nor should they. Also, one could argue the requirements have been made so onerous so as to dissuade people from pursuing this path, and in preparation for its coming retirement .
                  And, no those that have gone through 4+2 should not be deregistered, i dont think thats ever been suggested. This is about the future of professional practice in psychology and modernising the professional training and specialisation payhways.

                  1. Hi JHemsworth,

                    Most provisional psychologists will have more than one supervisor. While some may keep the same principal supervisor throughout their +2 path (in the same way universities will have one academic as the program convener of the masters degree) the +2 provisional psych will also have a number of secondary supervisors in the context of various specialist disciplines they may focus on and the numerous work placements they incur throughout the journey.

                    Basically though, the +2 pathway is not the way you see it. The picture you paint of it, is not true.

                    The +2 pathway is a very constructive way to build practice expertise. Particularly in the context of the +2 pathway coming off the back of 4 years of intense university training in both subject material and research.

                    Many 4th year dissertations are of a publishable quality and thus suggest we have done well in the first 4 years to establish great practitioners of research. The final 2 years of training need to have our students fully immersed in the practice environment. The +2 pathway affords this opportunity through a robust teaching methodology clearly known for its capacity to develop professional practice proficiency.

                    And again, of course, both the +2 pathway and masters programs can and always will need ongoing review and refinement in the quality control of glitches. But ultimately, there comes a time when the student needs to leave the confines of the school and start learning from within the context of the practice environment. If this cannot occur after four years of intense university training then we have a far bigger problem in our training than any of us care to realise or address.

                    The +2 pathway should not be ‘retired’ as you think it should. Psychology training is currently out of balance; being outweighed by a focus on research skills over practice skills. Our students need the training pathway afforded to them through the +2 pathway far more than you realise.

                    The growing fall out from our lack of focus in building professional practice expertise in our students can be seen through some of the quotes below:

                    Two quotes below from the American Psychological Association (APA) 2013 Guidelines for the Undergraduate Psychology Major – Version 2 (p.41)

                    “In times of challenging economics and limited job growth, legislators, taxpayers and parents justifiably want to be assured that the choice of a major (in psychology) can lead to a viable position in the workforce”.

                    “Some current legislators have wondered whether pursuing a psychology degree is a waste of time and money”

                    And you argue we need to follow in the footsteps of these ‘international standards”?

                    Two more quotes below from news reports in Australia after research from McCrindle was released on undergraduate psychology programs in Australia in early 2014:

                    “SCHOOL-LEAVERS considering studying psychology should have their heads read – it is officially Australia’s most overrated degree…” ( January 2014)

                    It goes on to say… “Only 63 per cent of psychology graduates in Australia found full-time work in their chosen field and those lucky ones had a median starting salary, …” only slightly higher than (what is) earned by factory workers”.

                    Our training is not just under the scrutiny of the APS, APAC and APRHA. The whole community makes judgments too. And if they don’t trust the way we are trained they will not trust us as a profession. The simplistic notion of keeping our students in the confines of the university setting longer through a master’s degree is not the clear cut easy answer you might be led to believe.

                    Kind Regards

                  2. You keep stating this idea of ‘only one supervisor’, so just out of interest, do you happen to have any actual statistical information about how many general psychologists have only ever been supervised by a single supervisor? I know that I wasn’t!

                    But let’s assume you are right, and the only way to elevate the profession is to improve the overall training standards and require a Masters as a minimum – this refers solely to those yet to enter the profession, but doesn’t address the large number of practicing registered psychologists, who simply can’t go back and try to get into a Clinical program now. Several individuals on this forum have been quite vocal about their perception that we shouldn’t be given a ‘free ride’ or be granted the option to access bridging courses if they become available; so how else do you propose the entire existing workforce be elevated to this ‘ideal standard’ we need to be striving for?

                    I understand there has been no explicit suggestion to deregister existing general psychologists; however the current reality is we are slowly being edged out of the professional landscape by being denied the rights to exert the skills we have acquired and successfully applied over several years of practice. So perhaps we won’t be deregistered, but rather, we will slowly be made redundant so that we voluntarily move on to other areas?

                    You and others can argue all you want about the perceived lax standards of the 4+2 pathway as justification for the existing 2 tier system, but there is no neat and effective way to resolve the current fracture in our profession, without first addressing the obvious need to honour the majority of existing general psychologists and provide them with a pathway to reclaim their rightful place within the professional landscape moving forward.

                    Have you ever stopped to ask yourself what would happen to the Medical landscape, if overnight, the AMA and Government decided that only Specialist Doctors should be eligible to provide healthcare services to the community and all General Practitioners were deemed underqualified and obsolete?

                    Seems unthinkable, doesn’t it?

                2. My thoughts are that this document shows that the APS is directly advocating for generalist psychologists, directly disproving the assertions made by some on this website. My thoughts also are that it is quite telling that some generalists deliberately pretend this document did not exist whenever discussing the role of the APS in supporting generalists, but then miraculously discover its existence as soon as it serves to support their agenda.

                  1. Well, I wasn’t asking for your thoughts, but since you persist on sharing them anyway, why don’t you enlighten me with what you believe my ‘agenda’ to be, so we can both move on?

                    1. Oh, I see. Can you perhaps provide a list of posters whose opinions you are actually asking for when you say you say you want people’s opinions on a topic so no one wastes their time thinking you are requesting genuine discussion of a topic? And it is obvious that some posters are keen to portray the APS as not acting on behalf of generalists when the document you linked to shows that to be false. I think it is telling that one of the very few tangible documents anyone can produce supporting the competence of generalists comes from the APS, yet those who try to present the APS as not assisting their generalist managers do their best to conceal or ignore the existence of the document as it goes against their agenda.

                    2. JDwyer – I have asked for your opinion directly, TWICE, about the following:

                      Do you feel that Clinical Psychologists would have been disadvantaged if Medicare had introduced a single rebate for all psychologists from the beginning?
                      If the central goal behind the 2 tiers is elevating the standards of the profession, how would a single rebate from inception, have detracted/prevented this goal from being achieved?

                      I have repeatedly stated that I welcome an open discussion with you on the above, so if you are interested in engaging in a ‘genuine debate’, I am still waiting on an answer about that…

            2. J Dwyer- thank you for consistently demonstrating the gobsmacking disrespect which RAPS are trying to address.

              1. Dr James Alexander PhD:

                repeatedly accuses clinical psychologists of being cold, heartless, and driven solely by greed and status; describes all clinical psychology students of having a false sense of superiority over all others; states that psychiatrists have lower quality training in mental health then Generalist psychologists and deserve less pay as a result:
                accuses others of showing gobsmacking disrespect.

                I note you like Clive
                Jones also fail to provide any actual argument for your implication that social work and psychology are significantly the same.

              2. The evidence can be difficult to accept. Probsbly worthwhile reviewing your posts James and checking whether you hold yourself to the standards you expect, that we should all expect, of others.

              3. The Australian College of Clinical Psychologists – a good example of where people wanted a title without doing the training and without this training were of course unable to join the APS Clinical College. Self appointed ‘Fellows’ some of whom amazingly continue to use ‘FACCP’ after their name. The existence of this ‘College’ completely undermines the argument put forward regarding a lack of awareness over the past 20 years regarding the moves to masters training and to clinical psych as the primary area.

                1. There are 9 colleges. Why is the existence of the clinical college evidence that clinical psych was to be the primary area?

                  1. Because Melanie, all the other colleges have different specialisations. Clinical is the primary area for mental health and illness. Counselling is the primary area for relationships family therapy and minor elements. Forensics is for dealing with criminal populations. Organisational is for HR employment etc. Need I go on

                    1. I think it is more due to Clinical Hegemony. All psychologists are equally registered to practise, or are some more equal than others?

                    2. clearly, Harold, there is a belief amongst some ‘clin’ psychs that some psychologists (ie.them) are more equal than others- in this, they have simply followed the lead provided by the APS, which has argued for years with the Federal Gov’t that some psychologists (ie. them) are more equal than others. Change in APS leadership and direction is needed.

                    3. by what authority can you state that counselling psychology is for ‘minor ailments’, while clinical psychology is for mental health and illness? Apart from not being reflected by reality (see the research quoted often in this blog), you appear to be using an antiquated notion of ‘mental health/illness’- which clinical psychologists in the British P.S are enthusiastically trying to leave behind as being erroneous and dangerous (see Peter Kinderman’s articles and book). BTW- your notion of ‘mental illness’ (as per DSM categories) is the least predictive of the psychologist-responsible factors in therapeutic change for clients (it explains around .5% of the variance in outcomes for clients)- it is less predictive than the intervention used, and even less predictive than the psychologists beliefs in their favoured intervention approach. That is, psychiatric-type notions of ‘mental illness’, terminology and classification add nothing therapeutic to client outcomes (according to research cited by Miller & Duncan).

                    4. Hi Cate,

                      I need to flag that your definition of other specialities in psychology is not true. Please feel free to define your focus as a psychologist but do be careful how you stereotype your colleagues.

                      To clarify my point, here is an excerpt from the ‘about’ page of the APS College of Counselling Psychologists website;

                      “Counselling Psychologists use their knowledge and understanding of psychology, psychotherapy, and mental health to treat a wide range of psychological issues, problems, and mental health disorders. They provide assessment, diagnosis and psychotherapy for individuals, couples, families, and groups. They use evidence-based therapies and evidence-based therapy relationships to assist clients to resolve mental health disorders or psychological problems and move toward greater psychological health”

                      Here is another link below to a text titled ‘Clinical Sport Psychology’

                      Here is another link to The Journal of Clinical Sport Psychology

                      The complexities of our role in psychological practice is broad and deep. We should not fall in to the trap of ‘dumbing it down’ through simplistic stereotypes.

                      Re: my personal journey; I hold endorsements in sport psychology and counselling psychology. I work a balance of academia and private practice. My private practice involves a comprehensive caseload of diagnosis and treatment across the general population and athletes.

                      Kind Regards

                    5. And Psychology specialises in the Psyche and human behaviour which contain the sub-specialisations mentioned in the College titles and more. Mental Health expertise is not exclusively Clinical College Psychology alone and there is much overlap. In fact one member has already pointed out that when they did their Masters of Counselling Psychology the degree was identical to a Masters of Clinical Psychology except for covering one less Psychometric Test and instead covering more counselling skills. In my mind that makes a Masters of Counselling Psychology it more versatile and useful than a Masters of Clinical Psychology when used in a mental health setting. Too many Clinical Psychologists see themselves as technicians working with machines and lack the skills of counselling to engage with the human element and establish the rapport and the therapeutic alliance that is the stand out predictor of positive outcomes in psychotherapy. We are not Psychiatry’s poor cousins who can’t prescribe. We are a seperate discipline and it is time Psychology stopped trying to be a reductionistic science like Medicine is trying to escape from and embraced the subjective element that is the Human Psyche from which we draw our name and raison d’etre. Too many clinical psychologist think they are being smart by saying, “I can’t help this person but I can label them and name the drug I think their GP should prescribe them.” That represents a failure of the profession of Psychology and needs to be opposed as strongly as possible as ‘psychopathology’ as defined by the DSM 5 (of the American Psychiatric Association), and Psychophamocology grow in popularity as the esoteric mumbo jumbo of a self-aggrandising elite called ‘Clinical Psychology’ emerging from the so called ‘universities’ of the post-post modern ‘fees for degrees’ educational economy we now must live and work with. How many Clinical Psychology Academics have been schmoozed by big Pharma and their Psychiatric mates to push the drugs onto the ‘mental heath consumers’ that make the ‘through-put’ of ‘mental health services’ possible?
                      There is a much bigger picture and medicare is a cancer to Psychology in Australia as an intellectually independent discipline.
                      We are not medicine and we are not inferior to medicine and we are not inferior to the subspecialisation of clinical psychology for having a less narrow – pseudo-medical focus.

          2. This is amazing and concerning… do much effort put inbto challenging a comment regarding differences re training between social workers and psychologists, yet not one comment or acknowledgement regarding the challenges and inconsistencies with the 4+2 pathway. My comment was not to degrade social work in any way, each profession has a role. But the two are, as are other professions, different and serve different purposes in the system.

            1. Some are more highly trained at examinable level and therefore more accountable in their training than others

              1. so, its ‘examinable level’ which counts now? Where is the evidence that more and more academic training (examinable level) produces more effective psychologists? What makes practicing psychologists accountable is whether they do an effective job or not. In the private practice world, this is reflected in being able to remain in business. The fact that ‘gen’ psychs are still in private practice, despite being denigrated and hobbled by the APS-Medicare-PBA, is testimony to the high level of skill. Our skills are ‘examinable’ by our clients on an hourly basis. Being willing to undergo more years of exams may produce psychologists who are more able to undergo more exams- but so what? Take this to its logical conclusion- only autistic savants should become psychologists? That would be plausible if we were discussing theoretical physics or maths, but we arent- we are talking about a profession which for the most part is engaged in helping suffering human beings. Is left-brained intellectual hoop jumping really the relevant criteria?

                1. Well said James! Too many clinical clique psychologists think university studies is important in making competent psychologists. They are too full of themselves to accept the evidence that what makes a true psychologist is the compassion, empathy and honesty that RAPS members like yourself and Gregory Goodluck represent.

                    1. Do you concern psychologist,

                      I am not defaming you at all. The comment was made in regards to the all you need is love scenario of the working alliance as mentioned by numerous people on the site. So the comment was not defaming anybody personally but it was commenting that you need more than just the working alliance.

                  1. PS Cate- the only available evidence clearly shows that there is no difference in what ‘clin’ psychs and ‘gen’ psychs do in terms of interventions; nor is there any difference in the populations with which they work. It would be great if you could start basing some of your derisive comments on demonstrated facts instead of mere opinion- oh, wait- there arent actually any demonstrated facts which support your opinions. The ‘ologist’ part of psychologist is meant to refer to science, which is a methodology based on rigorous observations- not just mere opinion, which we all know can be skewed by a range of self-serving biases and vested interests.

                    1. So sorry James I thought this post was for comments! My mistake I didn’t realise I was on the debating team at Sydney University please forgive me .

                  2. Well Tanya, if this is all about bringing psychologists together you’re doing a good job with comments like that – not only do you alienate so called ‘clinical clique psychologists’ but all psychologists who pursued postgraduate training – counselling, forensic, health, neuro, etc etc. Your comment, and those of others, unfortunately shows a very poor understanding of the content of masters programs, with the remarkably incorrect perception that ‘academic’ training’ as you call it means little practical experience and a rather odd belief that those who pursue postgrad training don’t possess empathy, compassion, or honesty…… these comments are here for all to see. I’d suggest more thoughtful, conciliatory, respectful, and informed comments.

                    1. David- Tanya’s comments can only be viewed in the context of 10 (or more) years of ‘gen’ psychs being told we are sub-standard, inadequate, poorly training, un-trained, and even ‘dangerous’ (those comments from the clinical clique in the APS and ACPA are there for all to see as well). I may have missed it, but i cant remember seeing you objecting to these kind of statements- only to the statements of people who push back against the destructive rhetoric, which is very damaging and hurtful for those to whom it is applied. As Dr Clive Jones has pointed out, masters level training is an excellent option for some people- it provides the ‘training wheels’ that they need, in the learning context they need, in order to then go out into the real world of applied psychology. And 2 yrs internship is also an excellent training option for some people- again, providing them with the training wheels and learning environment they need. Only one group in this discussion (the ‘clin’ psychs) have denigrated one training option as inadequate and needing to be eradicated.
                      In regards to the value of additional (eg. masters level) academic training (yes, this is a reasonable thing to call training done in an academic context), please present some evidence that it produces better- more effective- psychologists. What the research evidence has repeatedly clearly shown, over many decades, is that the ‘common factors’ are the most powerful of all psychologist related factors in predicting positive outcomes for clients. That is, positive regard, empathy, genuiness, being there for the client, etc. Research shows that these qualities are not related to either intervention approach, or to training- they are independent, can occur in any particular model of training or intervention, and are thus ‘common’ factors. There is no research evidence which associates these common factors with either doing masters level (or PhD level) training, or not. There is no reason to assume that the factors most predictive of positive outcomes for clients are in any way relevant for 4+2 or masters level training. However, the rhetoric of the clinical clique is that only they have the X factor which results in effective psychologists (therefore, they are deserving of higher status and pay). They suggest that they have this X factor by virtue of doing a masters degree in a particular sub-field (expand this claim to anyone else who wants to claim superiority by virtue of doing any masters degree, not just clin psych). There is simply no evidence that doing an additional academic program can teach people how to have the personal qualities related to the common factors- different training options (4+2, masters) may both allow and encourage these personal qualities to emerge- but that is just conjecture. So, in order to counter claims of superiority of the clinical clique, it is reasonable to point out that academic training does not by necessity result in the only very powerful psychologist-related predictor of positive outcomes for clients. It is not ‘gen’ psychs who are claiming superiority and disparaging all other psychologists. The research evidence shows that ‘gen’ psychs and ‘clin’ psychs get the same results, with the same types of presenting problems, using the same types of interventions- it is reasonable to assume, therefore, that most psychologists possess the common factors to around the same degree, regardless of training option taken.

                    2. And those who do a 4+2 also do alot of hard science and heaps of practicum… So lets all just randomly give ourselves stars and other not and be satisfied with the highest specialisation in psychology which is being fully registered psychologists, by hook or by crook. Enough with the false airs and gracelessness. Let’s get on with helping clients. I feel so much better now I don’t have to fight a vexatious complaint to the board. I can actually excel again.

                    3. This is an address specifically to Dr James Alexander.

                      Would you please decease& desist in stating that there is evidence of no difference in outcomes between clinical psychologist and generalist psychologist. This is misleading and miss represents the research that you are quoting. The authors of the research specifically stated it is not to be used for that purpose because they did not evaluate using the correct methodology to evaluate differences between groups.

                      If you continue Чесать #С Evidence опте фэйс then this will be taken further.

                    4. Cate- threats mean nothing to me. You would do well to avail yourself to the article(s) which Dr Clive Jones has written in regards to the actual state of evidence, which i believe all of my statements are in accord with. I will continue to present the evidence, regardless of threats. In addition, the null hypothesis is that there is no difference between types of psychologists. Unless you are able to cite evidence to the contrary, this is the reality as currently known. The onus is really on you to disprove the null hypothesis- good luck!

                    5. actually cate, on second thoughts, your threats are not totally meaningless to me. in fact, they reveal an urge in elements of the clinical clique towards totalitarianism- the need to control information, facts and communication if it does not support your favoured narrative. the need to suppress dissent with threats of retribution. the need to be in total control of words, communication, beliefs, thoughts. what is behind such a need to control, if not fear? what is this element in the clinical clique so fearful of that they feel the need to control the narrative, with threats of retribution if one persists to defy their commands? read the code of ethics- it is a violation to make frivilous and vexatious complaints against another psychologist.

                    6. Dr James Alexander PhD, are you referring to the “study” by Dr Clive James that has only been published on his Linked-In page and only “peer-reviewed” through posting it on a Facebook group for high school students and undergraduate university students?

                    7. Correction – Dr James Alexander PhD, my previous comment was referring to the “study” by Dr Clive Jones (not James) that has only been published on his Linked-In page and “peer-reviewed” by posting it on a Facebook group for high school students and undergraduate university students.

                    8. well Cate et. al. the burden of proof is on you. Cite evidence to the contrary and we can have an intelligent discussion. Or should we just bow to the authoritarianism of the academic elites claiming superiority without following their own rules of evidence?

                    9. There is NO empirical evidence using the correct methodology supporting the claim that there is no difference in outcomes between the two groups. I do not need to prove anything as the two tiered system is NOT about any outcomes but about standards of training. You prove that the standards of training are equivalent!

                    10. the null hypothesis is that there is no difference in the standard of training. if you are asserting there is a difference, the onus is on you to prove it. note- ‘standard’ is the operative word. clearly, the two training paths differ- but where is the evidence that the differences constitute different standards? what is the criteria for standards? could it be the actual outcomes with clients? if so, the evidence is of no difference. what other criteria of ‘standard’ could you possibly have in mind? if there is no difference in the real world (as demonstrated by the research), then there is just no difference- proof otherwise? please present it, if there is any.

                  3. Gregory Goodluck, an interesting observation about the “thought police” given the number of times both yourself and Dr James PhD have threatened to sue other contributors for making verifiable observations, such as the fact that a PhD in Education is not a PhD in Clinical Health Psychology.

                    1. JD. Did I threaten to sue someone? Really?
                      When? It must have been for something defamatory. Like missrepresenting the facts. Not for holding a contrary opinion. By the way. I wont be suing you for misrroresenting me. Just get your facts straight. Do the words, “enough rope” mean anything to you? Ask Andrew Denton.

                2. Hi James,

                  I think Cate is just regurgitating ACPA’s mantra.
                  Have you ever read the President’s address on their website? Following a discussion with a colleague yesterday, I was pointed to some of the President’s more public comments about the profession and what I found disturbed me!

                  Not just because in her address she clearly details her intention to push for Specialist Registration for Clinical Psychologists and disparages the APS, but also because there are several public statements made by the President directly attacking and defaming other Psychologists to the media and to Government.

                  Have you seen these before?

                  Here’s a link of the address on the ACPA website:

                  Here are 2 news articles that quote said president:



                  And here is a response from a Counselling Psychologist, Dr Khong, who was publicly defamed in a letter from the President to Tanya Plibersek, who as the Health Minister at the time.


                  I find it shocking that Greg can be reported to the board for generalised statements he has made on this site, and yet these comments that are clearly defamatory and bringing the profession into disrepute have been allowed without any consequences, that I’m aware of.

                  The more I learn, the more it seems we are all caught in the middle of various turf wars and the way out of this mess seems even more complex…

                  1. My understanding is that someone needs to actually make a notification to AHPRA for “investigation” if in breach of National Law.
                    Correct me if I am wrong. So why are we not making such notifications???????

                    1. Hi Concerned,

                      As I mentioned to Greg below, these more public comments were made more than 3 years ago – I personally haven’t come across anything more recent yet; so it may well be the case that this was investigated and she has subsequently stopped making public statements. I for one hope that Dr Khong raised a complaint about the defamation she suffered, but there’s nothing to be found on public record, so who knows.

                      However, as you may have seen in another comment I made to Clive, these comments have continued in submissions directly to the Board, so it isn’t as though they are not aware of it.

                      Here’s a quote of relevance from her President’s address on the ACPA website:

                      “ACPA was established in response to controversy resulting from the largest professional body representing psychologists in Australia, the Australian Psychological Society (APS), allowing a large number of psychologists without accredited postgraduate qualifications in clinical psychology entry to the College of Clinical Psychologists in order to enable them to obtain a higher rebate under Medicare than those not recognised by the APS as clinical psychologists.

                      In December, 2009, the CEO of the APS, Professor Lyndel Littlefield, publicly reprimanded Dr Deborah Wilmoth, Chair of the College of Clinical Psychologists of the APS, for supporting specialist registration for clinical psychologists in response to the PsyBA Consultation Paper on Registration Standards and Other Matters, despite specialist registration having the support of College members. Subsequently, the APS did not put forward the submission of the College to the PsyBA in which specialist title was supported. It is the aim of ACPA to continue to fight for specialist recognition of clinical psychology as a highly trained differentiated speciality in mental health, as it is in the rest of the developed English speaking world.

                      It has become increasingly apparent that the APS is unwilling and unable to represent the interests of accredited clinical psychologists, because those who have undertaken accredited post-graduate training in clinical psychology remain undifferentiated from those without this training in the membership of the College of Clinical Psychologists. Qualified clinical psychologists were, and remain, unable to be heard or to speak effectively within the APS on their own behalf.”

                      ACPA was formed 7 years ago and the fact that she has been allowed to maintain this attack on the APS visible in her President’s address, tells me that she is more influential and protected than we know.

                      Most sane people would be afraid of a lawsuit in such circumstances, but evidently the President is not concerned….what does that tell you?

                  2. Hi Tia,

                    Thank you for sharing this info. It is really quite profound, shocking and dreadful that a colleague from the clinical ‘camp’ would go to such lengths in the fabrication of such an allegation.

                    Kind Regards

                  3. So make a complaint Tia. when people say, ” somebody should do something about XYZ”. I say, ” You are somebody. Why don’t you do something about it,”
                    Who said,” Evil prospers when good men stand by and do nothing”?

                    1. Hi Greg,

                      My point was more that this person must be quite influential and powerful if she has been allowed to make such moves without consequence. These comments were more than 3 years ago!

                      Indeed, the more I’ve been researching into this, the more it seems to me that she may be a major contributing factor for the mess we find ourselves in.

                      When you have some time; have a look at some of ACPA’s submissions to the Board – it’s very telling reading and echos many sentiments we have read here from Cate and others…

    3. JHemsworth you have misrepresented me when you say “…same as social workers as Mr Goodluck would have us?” There are obvious differences and I advocate respecting the contribution of all disciplines. Some Social workers are very fine mental health clinicians as are some Occupational Therapists, medical officers, nurses, GPs and Psychiatrists. I would like to ask you to confine your comments to the debate and not get personal.
      Furthermore, other commentators on this thread have pointed out that Social work training does involve a considerable component of psychological work but goes beyond that to a broader rubric. I have always said that I would rather get help from a good Social worker than a mediocre psychologist, because a Social worker takes into more central consideration the sociopolitical environment, family and cultural systems and organisational structures and social administration factors rather than confining their assessment and treatment understandings to individual and intrapsychic factors with cursory consideration of the above-mentioned factors. But a good psychologist will attempt to consider the social milieux in all it’s nuances as well.
      So you see there are some important similarities and some important differences between the disciplines.
      I reiterate what I have said in other responses, that what is most important is mental health assessment and treatment competency. And that can be a set of transdisciplinary skills. Ask a group of mental health clients/’consumers’ which mental health workers helped them best of all and I think the bigger the sample the greater the variance will be across all mental health disciplines. Ideally, our clients will have a multidisciplinary experience.
      It might also surprise you to realise that many mental health clients are not that concerned about what qualifications a mental health worker has if that mental health worker is able to help them improve their mental health or manage the issues surrounding serious mental health problems. They are not as hung up on status and discernment as the workers seem to be. That discrimination comes from within the health professions and health organizations. It is an artifact of self-interested professional lobby groups, spilling out into government organisations and NGOs and private providers now.
      You may already know that I have dual qualifications and professional membership as a Social Worker and Registered Psychologist and have worked in multidisciplinary teams. I appreciatyour attempt to hook me into a reaction and thanks for the opportunity to respond. As a Social worker and a Psychologist I feel that I am qualified to comment
      It is the quality of the care and treatment that matters most of all to our clients/patients and the people who love them and care for them. I frequently have to remind people not to refer to me as Doctor as many do. Especially those from NESB/CALD backgrounds. To them it is a sign of respect for my training and experience and acknowledgment of the care and concern they receive. It is also challenging to explain to people that I am not a clinical psychologist, but a registered psychologist when they can clearly see I am working as a psychology clinician, assessing and treating in my clinic. I can explain it as, I don’t have a masters degree in clinical Psychology and that I wasn’t ‘grandfathered’ during the ‘historical window’…. etc. etc… and that I am still qualified and fully registered to practice…. etc… while their eyes glaze over and they look at the clock. All they care about is getting good mental health assessment and treatment. Which they do.
      How tedious. How unhelpful. What a waste of qualified, competent and experienced mental health worker time.

      1. Tedious. … absolutely. There are the good and not so good in all professions. There are transdisciplinary skills, commonalities, and differences. How fo we advance psychology? Where do we want it to be in 10 or 20 years? How do we influence and ultimately change the mental health system? Higher base level minimum training is part of the answer. Consistent and reliable training that is not based on the pen strokes of a single psycholigist, a model that is not used anywhere else and in no other profession. And….as i have said repeatedly, while this has produced some good psychologists, the system is flawed overall and a new minimum system is needed.

        1. on the contrary, a flawed system does not produce excellent psychologists getting excellent results (see the research). Your assertions of it being a less than adequate training model is simply not supported by the evidence. Psychology in Australia will never have influence as long as it is trying to promote just one type of psychologist (while trashing the reputations of all others- in spite of the evidence). It will only progress to the extent that it pays attention to research results- you and the APS leadership are failing miserably in that regard- nothing other than your desire for higher pay and status (at the expense of all other psychologists) will harm our profession. We get excellent results; the public want to use our services and dont give a toss about 4+2 or 4+masters- they just want quality help, which is exactly what they are getting. And yet the APS leadership and their minions want to just trash the majority of psychologists who achieve these results? I think you should be thankful that the moderators of RAPS are still allowing you to air such disparaging and counterproductive views (although i do understand their reasons for doing so).

          1. Unfortunately James you are the one repeatedly taking the us v them approach. I am not making disparaging comments at all. On the contrary i have acknowledged some psychologists who have come through the 4+2 pathway, i have stated facts about the 4+2 and its challenges, something you ate either unwilling to discuss or are not aware of – problematic both ways and limits your capacity to have a sensible discussion. The APS clearly has issues, proportional representation is important, and the future os psychology needs to be formulated in light of changes to training in health professions here and internationally. Please re-read my posts.

        2. Hi JHemsworth. I am glad we can agree on something. That it is tedious to have to constantly validate ourselves. Respect what you don’t understand.
          You may enjoy reading this excerpt from the AASW. It has been a long time since I have heard much about Social Psychology, but when I did my honours degree in Psychology last century my supervisor was a Social Psychologist called Ed Paey at Flinders University in South Australia, and the focus was on intrapsychic conceptualisations of social phenomena (we used the theory of planned behaviour and the theory of reasoned action and incorporated values into the model to predict pro-environmental behaviours via correlations and multiple regressions …fun…).
          Social work does that too, (concerns itself with intrapsychic phenomenon like cognitive schemas)and also integrates what is actually happening in the social systems to which the individual belongs, thus creating a multidimensional paradigm of operation, which if done well requires a lot of information gathering and analysis and a penchant for analysing multiple variables. That is what makes Social Workers such excellent Health and Community Researchers and Policy Developers and the like.

          These links take you to:
          1) the mental health standards for Mental HealthSocial workers

          2) the Scope of Social Work Practice for Social Work in Mental Health

          “Scope of Social Work Practice Social Work in Mental Health
          Contribution of social work in mental health: Social workers provide a significant contribution to the field by maintaining a dual focus on both the individual and family/contextual domains, and it this understanding that distinguishes social work from other health professions in the sector. Social workers are regularly involved with individuals and families experiencing complex social, psychological, family and institutional dynamics. Social workers offer a unique and valuable contribution in providing appropriate and targeted services and therefore have a clear role in the provision of effective mental health services. Individuals and families have different reactions to mental health disorders, both in terms of conditions that are emerging and those resulting from a situational crisis. Social workers contribute greatly to their clients and organisations by undertaking evidence-informed assessments and interventions. The social work assessment process takes into account the impact of biomedical factors and the range of psychological, social and other needs of the individual experiencing mental health disorder. Within this framework social workers respect the primacy of the individual’s rights (within medico-legal requirements) and work towards developing skills and confidence to assist individuals and their families maintain control of their lives and take responsibility for recovery and wellbeing. Social workers recognise the individual’s role in treatment planning and the individual’s right to have a knowledgeable, skilled practitioner who is guided by ethical practice. Conclusion Social workers work in multi-disciplinary mental health teams and within these teams, social workers recognise and address the multiple factors contributing to the specific context of an individual, family or group within the community. In assessing and intervening in the psychosocial factors affecting the relationship between the people with a mental illness/disorder, their significant others and the wider community, they make a significant contribution to the field. Accordingly, the profession of social work has a clear role in the continuum of mental health services.

          It is time Psychology had such rigour in defining scope of practice and standards of competency that psychologists could be accredited by.
          It is also time to start a college of General Practicing Psychologist Clinicians (GPGC) or Mental Health General Practicing Psychologist Clinicians (MHGPC) to distinguish us from the great variant group of GPPs which might include advertising, environmental, and various other psychological consultants not interested in providing mental health assessment, diagnosis and treatment. The DGPP seems to struggle with giving as GPPCs fair validation as practitioners of valid mental health psychology on par with endorsed clinical psychologists, when we do the same work as effectively recognised by medicare, but paid roughly a third less… for no apparent reason.
          Yes, very tedious.

          1. Im all for supporting a college of general practice psychologists which is for those working in the mental health field, but two important things – 1) the college structure in the APS is now largely meaningless with some interest groups having more members compared to colleges. 2) as the 4+2 is retired there will be less non postgraduate psychologists over the next 2 decades with bolstering of standards in other countries. How do we prepare for that? And the 4+2 retirement is not my impression, it has been stated by the PsyBA! !

    4. I have spent quite a bit of time reading through the comments today and have been particularly interested in proposals for the future. I did see a page on the 4+2 but I can’t seem to find it, so I hope that this post is okay on this page.

      Whatever happens in the two/ one tier rebate argument, it would be fantastic to start having conversations about how we as a profession would like to see the future especially the entry point for registration as a psychologist.

      From the comments I have read, it seems that many people who have trained via the 4+2 pathway value it highly – is this because of the 2 years supervised practice ?

      Is the 5+1 seen as less desirable – if so why? Is it the additional year at Uni, and 1 year less in supervision?

      Should the first 3 -4 years be changed to be more practical? Or more focused on Mental health – or should we retain the more general scientific training?

      Also there seems to be some mixed views on bridging courses

      What would the ideal be going forward?

      Are there any points we can agree on and advocate for as a whole profession, while recognizing those areas in which there is disagreement?

      1. Hi Sasha,

        I agree that it is really important for us to start considering all the possibilities and agreeing on the best way forward.

        I think we can all agree that we would like Psychology to be recognised and respected as a discipline in its own right, the need for high standards and that the standards of our work must be measured in some part by the outcomes we achieve. I think we can all also agree that our profession must have cohesion to flourish.

        Personally, I would love to see a more applied element introduced in the undergraduate years. I found it utterly absurd that I had to wait until 5th year to even ‘observe’ a client, let alone work with one and I think in this regard, Social Workers far surpass us in terms of their foundations.

        I mentioned in another post that I would love to see a broader range of advanced training options to allow us to truly specialise in particular areas that should be considered niche, such as working with mental health issues in children, family therapy, etc. Some programs exist, but are not accredited by APAC, so don’t translate as recognised specialist qualifications in Psychology; which is a real shame. My personal view is that the available advanced degrees are too broad in their scope and don’t really facilitate true specialisation, with the exception of Forensic, Neuropsychology, Educational & Developmental and Sports.

        But perhaps the first place to start is to have a more clearly delineated high level view of psychology and all its vast expressions? From there it would be easier to carve out the sub-disciplines and specialisations within these discrete expressions, where needed and identify the training and monitoring needs of each?

        What are your thoughts?

        1. Agree with everything you say there Tia including high level base training, options for specialisation, and a change to undergrad training. One of the problems with undergrad is that it is a cash cow for universities, only a proportion of those doing undergrad osych want to become psychologists, so we need to either cut psychology back to those who want to become psychologists or have streams. I am in favour of postgrad professional training following a science or social science 3 year undergrad, drop honours, and then 3-4 years professional training through a DPsych in clinical with a further specialisation in the last year or so – eg forensic, neuro, etc.

          1. Hi Tia,

            yes I must say I agree totally with your view of undergraduate years although I do think it is important to keep enough of the broader stuff that we retain our scientific focus – in my experience in the field I think this is a fundamental orientation that psychs of various backgrounds share and makes our profession unique.

            I am also very interested in your idea about specialisations – would you see these as university based – ie more focused versions of postgrad professional training and/or combined uni/practical? Presumably something much more substantial than current CPD offerings? Or more like a 1-2 year therapy training course?

            I do also agree about needing the high level view – that’s absolutely what we need. Any thoughts on how we do that? There is so much emotion and hurt that divides us, but perhaps we could find a process ?

            This is surely the only way forward for us – at the moment we are like a family in a nasty divorce, very polarised, hurting and appealing to external parties to make huge decisions about our future. Surely the only way we can really thrive is by somehow working it out between ourselves then facing outwards in unity – but I must confess I can’t see what kind of process could help us get there!

            1. Interesting idea about the 3 year undergrad and dropping hons then a DPsych – this would be more consistent with overseas systems I think.

              So you are thinking that the entry level would be a DPsych in clinical then additional training ? Interesting.

              Personally I think this could be part of the solution, but I would be concerned that by itself, it could lead to the profession shrinking greatly and being a very small group of very expensive practitioners. The broader public would not be well served by this I think.

              I would like to also see a large group of psychology practitioners who didn’t perhaps want or need to stay at Uni for the DPsych and could provided high quality care- especially in primary care (this is the group now referred to as “generalists”) . Psychology-trained people have a lot to offer, though maybe the training needs some tweaking.

              Clearly this group would need to have a clear and positive identity and be respected within the profession.

  2. If we extend Harold’s argument then those that do 4+2:pathway in a prison should be entitled to become ‘ forensic’ psychologists? Those that train with those with chronic illnesses should be ‘health’ psychs? And those that do 4+2 working with those with head injuries and conducting psychometric tests should be entitled to become ‘neuropsychologists’? No doubt training in these or a ‘clinic’ context would allow for some good specific knowledge and skills to be developed, but as these examples show, 4+2 generally only gives one experience and an area of endorsement/ specialisation is more about systematic and multiple learning experiences across differing contexts, with multiple teachers/supervisors, and multiple forms of assessment. Clinical psychology is not just about doing work in a ‘clinic’, just as forensic is so much more than working in a prison. And dont forget the further 2 years of endorsement training and supervision.

    1. Perhaps JHemsworth, with due respect, you might care to explain in detail how the work a ” Masters Clinical” psychologist actually differs so significantly from the work a “Generalist” does in a clinical setting such as a Medical Centre? Also, I’d equally be interested to know in your answer how that could be justified to taxpayers who are paying 47% extra via Medicare Rebates for what amounts to essentially the same services and treatment outcomes?

      1. Hello Garold, see my response above for the answer to your question. Clinical and other endorsements are much more than only doing therapy in a clinic – as important as that is i might add.

        1. JHemsworth: Try telling any employer that “Clinical and Other Endorsements are much more than only doing therapy in a clinic” as you suggest; and I am certain you will find that in the real world beyond academia, they would only really be interested in real work, hands on experience and therapy outcomes anyway.

          1. Ah… the stock standard RAPS argument. … ‘it is only us in the real world’. Not very creative and factually wrong.

            1. Hi JHemsworth,

              I would encourage you to read my 2008 article in Australian Psychologist: From Novice to Exert: Issues of concern in the training of psychologists. I bring attention to this simply because it speaks very specifically on this whole issue around real world practice placements and internships for psychologists in training. Being over 12,000 words in length there is no hope of being able to share the perspective given from this article through posts and comments on this blog.

              In a nutshell, the article traces the evolution of psychology training starting from the Boulder, Colorado Conference in 1949 where the origins of the scientist-practitioner model was established. It traces the ongoing tension between the place for and space given to ‘student practitioner’ and ‘student researcher’ in psychology training in the context of critical educational strategies most appropriate for the training of clinical practice expertise.

              It also throws a red herring in to all arguments focused on issues around the +2 provisional internship and masters degree in suggesting that any problems found in either of these post 4th year pathways is in many instances a consequence of issues in our undergrad and 4th year training programs. So in that sense it also examines how educational models need to progress practice based learning sequentially from 1st year right through to the end game of graduation, registration and practice.

              Below are some quotes from the article to give an idea of where I think the real issues in our training stem from:

              (p.38) “Ultimately, this article proposes that a significant problem contributing to the need to raise minimum standards for registration as a psychologist in Australia is the lack of sound practical experience for the necessary development of professional expertise in both undergraduate and fourth year graduate programs. Its absence from the curriculum in the first 4 years of psychology training represents a significant flaw in the progressive development of professional competence that cannot be remedied simply by adding compulsory postgraduate years to the minimum requirements of registration. On the contrary, if the spotlight of raising standards is placed solely on 2 years of compulsory postgraduate study, undergraduate and fourth year graduate programs in psychology would become increasingly irrelevant in that the development of professional expertise, through sound practical experience, would continue to be neglected until the fifth year of training.”.

              (p.39) “Furthermore, by intentionally neglecting practical experiences in the first 4 years of university training, postgraduate programs become restricted in their scope through having to offer introductory experiences in practice for students rather than being able to offer placements that have built on past experiences from the preceding undergraduate years.”.

              (p.39) “Ultimately such neglect ignores the educational practice required to develop sound professional expertise. It leaves fourth year graduate psychology students quite inept in their capacity to practice in any aspect of the profession except under their own volition through relevant voluntary experiences while training at an undergraduate level. Two years of compulsory postgraduate training will not remedy this serious problem currently stemming from undergraduate and fourth year graduate programs and, as a result, will do very little in raising minimum standards of professional capacity prior to registration.”

              I’ve completed other writing and conference presentations on this same topic since 2008 and the fundamental issue remains the same. Ultimately, the key issues I see in all post 4th year pathways to registration have their remedy involving changes in our undergrad and 4th year programs.

              And yes, my concerns do relate most specifically to the very neglected role of situated learning, practice placements and internships from 1st year right through to registration and practice.

              Kind Regards

              1. Has the Practitioner-Scientist model swung too far to the right – its all science now and not enough support for the clinicians’ judgement? We all know that the evidence-based research is largely done on uni students (not a truly representative sample) and doesn’t sufficiently address the issues of co-morbidity.

              2. Hi Clive

                I haven’t read or encountered any of your stuff yet but certainly need to get around to that. We do seem to have similar views on the design of learning environments. I have just posted and it includes the same issue you refer to above, although using different language. Also I would like to express my appreciation for your prolific presence on this blog.

                Kind Regards


            2. JHemsworth: Are you seriously trying to suggest that it is not standard practice to measure outcomes for research, business or whatever to confirm the efficacy of any interventions etc? Where are YOUR facts? Perhaps for starters you could come up with some facts and figures that treatment outcomes are better and/or worse for Clinicals versus Non-Clinicals? It’s amazing how whenever this question is asked directly it is usually evaded and/or never answered. Until it is answered, then maybe you will have some insight into why non-clinicals are so annoyed they have been paid 47% less by Medicare for well over a decade for doing identical work. I suggest there should be one rebate for all Registered Psychologists and if anyone feels they provide superior service they can always charge a bigger gap, can they not?

              1. As usual, the conflation of issues. My comments have largely been regarding the ‘validity and reliability’ of the 4+2 pathway…. and my comments and concerns have nit been addressed, let alone even acknowleded by anyone supporting this pathway. Other professions are upgrading their training….. psychology, or at least thise on this website, want the lowest common denominator with a poorly standardised and minimally assessed training process.

                1. how on earth do very reliably good outcomes for clients constitute ‘the lowest common denominator’? perhaps the rest of the world need to be looking at our 4+2 pathway as an exemplary training model? (or perhaps it would be better to start with the self-appointed ‘elite’ in the aps to deal with reality)

              2. Actually Harold, every time any one trots out the “prove that treatment outcomes are better and/or worse for Clinicals versus Generalist” argument, someone always points out that:

                A) No one can seem to provide documentation from AHPRA stating the basis of the higher rebate is based on differential outcomes, rather then more extensive training. I know that holders of other endorsements do spend the same amount of time qualifying for their endorsements but that is why the APS is advocating for those other endorsements to also qualify for the other endorsements, and rightfully so.

                B) As there is more evidence demonstrating that counsellors with basic training also achieve similar results to generalist and endorsed psychologists, such arguments could equally be applied to show that psychologists should get the same Medicare rebates as counsellors I.e $0.

                And it is then that people go oddly silent and refuse to answer.

            3. A major issue with a two tier rebate is that by paying some psychologists more than others (via Medicare Rebates financed by Taxpayers) for doing the same work, implies and is misleading the public that some are more inferior than others and others more superior. What is the problem with having one Medicare Rebate for ALL psychologists and charging a higher gap if one deems their services are superior? The market will soon decide. This rationale applies to all other Allied Health Professionals except for psychologists and the question has to be asked, why? It would certainly make for a more unified profession and put us all in a better bargaining position if there was one rebate for all.

              1. TAC and Workcover fund Psychology providers the same fee and the number of sessions are determined by a comprehensive assessment amd treatment planning process and ongoing review processes! (I was also a DVA and Comcare provider a few years ago but these referrals have dropped off and Im wondering if only Clinical Psychologists are now recognised for this “work” hmmmm??)

                The TAC and Workcover framework translates well to Medicare. Why didnt the APS promote this model of service delivery when consulting with gov instead of promoting Clinical Psychologists and by default discriminating against other Psychologists engaged in “clinical” psychological practice?

                I am a TAC and Workcover provider, have been for many decades, and have great relationships with GPs, Psychiatrists, Physios and claims managers and achieve great outcomes for my clients so why am I not equally valued by Medicare? Why am I considered only qualified to provide “focussed psychological strategies” ie a sub optimal 2nd tier basic psychologist under Medicare but highly valued to provide assessment, treatment/therapy and psychological reports under TAC and Workcover???

                In my opinion, its not about “influencing” (manipulating?) clients to continue to attend sessions for the benefit of your business’s viability!, its about correcting the “misconceptions” that GPs and the public have regarding endorsement vs non endorsement and clinical vs non clinical and ones acquired professional expertise within the field of private “clinical” psychological practice and mental illness/health! and redressing the discriminatory and defamatory views held by some.

          2. Thats not my experience Harold…. which is clearly part of the issue. Higher minimum quals and better training allow us to further develop the scope, roles, and influence of psychology. Broader viewd of the possibilities are required.

            1. the influence of psychology will never be advanced as long as the APS leaders (and their minions) are actively disparaging most of Australia’s psychologists, who have been demonstrated to achieve excellent outcomes with clients (with their 4+2 training).

              1. JHemsworth: Even Professor Brin Grenyer, the current Chair of psychology from A.H.P.R.A. has stated in writing in a recent edition of Contact Mag that 4 + 2 has “…produced many fine psychologists…” So are you suggesting he is wrong too?

                1. Mr Hanlon, please go back and read my posts, you clearly haven’t read them. As i have repeatedly said, the 4+2 has produced some good psychologiststhis pathway is too inconsistent, poorly standardised, unreliably assessed, and prone to idiosyncratic experiences. How can one psychologist reliably and properly teach all there is to know about neing a psychologist? And this is not just my opinion? the APS changed membership requirements 17 years ago to masters training for full membership. 17 YEARS AGO. The 4+2 has been on the chopping block for years with recent attempts to strengthen requirements but ultimately to make it too hard so as to lessen the number doing it. A supervisor of mine in 2001 who was on a state eeg board said they (state boards) has been trying for years to move to masters minimum. No other profession has this for good reason, but then they also have a clearer and applied focus in their training degree. Situated learning? Yeah…. no, sorry, doesnt account for the unreliable and poor standardisation in training. This is all very well known, and im only repeating what is out there. In the words of Gregory Goodluck, a frequent poster on here…. ‘wakey wakey’ (apologies for this last bit….)

                  1. AHPRA assesses the competency of psychologists going through the 4+2. It is not uncommon for the +2 to become a +3 while the board directs a candidate to upskill in a particular area. If they have not reached competency they will not receive full registration until such time as they do achieve competency.

                  2. stating that the 4+2 pathway has produced “some” good psychologists strongly infers that ‘good psychologists’, in your opinion, are a minority via this pathway. The research evidence is clear- most clients acheived their desired outcomes and were entirely satisfied with services provided by ‘generalist’ psychologists. This is not a result which deserves a begrudging “some” reference. The research makes it clear that most of the time, psychological services provided by ‘generalist’ psychologists are of an excellent quality. perhaps you need to modify your language to reflect the reality that the 4+2 pathway has for the most part produced excellent psychologists.

                    1. Hello James, I was thinking about this line of discussion….. aren’t we talking about the structure of the 4+2 and the known challenges with this route to registration? I just read another post on the site and it talked about keeping up with what is happening in other health professions – isn’t that what we want?

                    2. see Clive Jones’ comments re what is happening in other professions. Do we need to keep up with anyone (here or o/s) when it is our system (mostly 4+2) which has produced such excellent outcomes for clients, not with “some” psychologists, but with most psychologists? Pheraps it is the rest of the world that needs to be emulating what we do? If it aint broke, dont fix it!

                    3. the PBA have almost strangled the plus 2 part out of the equation, making it nearly impossible for people to succeed in getting registration that way, with an extreme amount of hoop jumping. I have heard the opinion expressed that the PBA is just the political branch of the APS, its members being prominent members of the APS (primarily academic ‘clinical’ psychology teachers who have awarded themselves multiple areas of ‘practice’ endorsement- despite having spend most of their working lives in teaching). As such, it could appear that the PBA have simply been running the APS agenda of eliminating the 4+2 pathway (which evidence demonstrates, has produced generations of highly effective psychologists). Anyone succeeding in the 4+2 pathway now just about deserves a medal. The best way of changing the PBA is by changing the APS.

    2. Probably most RAPS supporters here would agree that it is not the endorsement that bothers them; it is primarily the unequal pay for equal work in the context of the Better Access program, generally delivered in private practice clinics.

    3. JHemsworth:
      To answer your questions in brief:
      1)Yes probably
      2)Yes probably
      What are the criteria? If they meet the criteria then yes.
      If it looks like a duck and quacks like a duck, it’s probably a duck.
      This whole argument can be reduced to Competency-based training vs Educationist Elitist type training. It is the same argument between Universities and the Vocational Educational and Training (VET) Sector. You have PhD’s in Education crying about not being recognised as Certificate IV in Training and Assessment and having to do RPL. Status vs Demonstrated competencies. Time to climb down from the ivory towers and into the trenches and test your metal.
      If we are not careful (read sensible evidence based training and accreditation) University based Psychology training will be eclipsed by the VET Sector training and new qualifications that demonstrate better outcomes measured and validated and linked to certain competencies. They may be called Mental Health Clinicians or Community Service Workers with Mental Health specialisations. The answer is not to cling to antiquated notions of superiority, but to move with the times and provide multiple methods of accreditation for competency. A forensic trained psychologist who does as well or better than a competent University trained forensic psychologist should be recognised as competent if they meet all the competencies.
      If the Professors would pay more attention to evidence and competency based training of practitioners and less attention to their research programs and status building, our profession would make much more sensible judgements about who gets the Sneetches star on their belly and who goes without. It will be governments and Health Funds that see the wisdom in rewarding better outcomes, rather than higher status.
      It’s the difference between rewarding Spin, smoke and mirrors on the one hand and actual real outcomes on the other hand.
      Which method should scientist practioners apply to deciding who is worthy of recognition? The glamour or the guts?
      Wakey Wakey.

      1. Wow…. ‘glamour or guts’, wakey wakey’, you sure know how to win over people gregory. Youre right…. a masters is just glamour and not hard work. To use your example, and to correct your misunderstanding, forensic psychology includes areas such as civil, criminal, mental health, and family… these are all covered in a ‘university’ based masters course, with supervised placements, research, etc; A ‘forensic’ trained 4+2, who receives all their training in a prison setting no doubt has good prison based and skills and other hopefully good general skills, but is lacking the broader forensic training required of forensic psychologists. So no, prison based does not equate to a ‘forensic’ psych, no more than a ‘clinic’ based psych equates to a clinical psychologist. Unfortunately many here are lacking the broader perspective of this training and roles.

        1. JH: Again with the personal stuff. You are missing the point and getting bogged down in the sophistry and imagined lack of detail.
          I wrote: ” If they meet the criteria then yes.
          If it looks like a duck and quacks like a duck, it’s probably a duck.
          This whole argument can be reduced to Competency-based training vs Educationist Elitist type training.”
          If psychology doesn’t wake up to the fact that the public are not interested in our squabbles over who has the gold star and where it is placed, we will be superceded by competency based VET sector type Mental Health workers. And as tedious as it is to have to point out the obvious several times I sometimes use short and colourful words to convey an obvious meaning. Wakey Wakey and the glamour or the guts, being cases in point.
          I am sorry if these truths are unpallatable but if you can step away perhaps from the vested interest you must certainly have to be persisting in your one-eyed defense of an indefensible apartheid, you might actually entertain the veracity our our case to the extent of the glamour dropping from your eyes and an awakening to the reality of the very real and present danger to the future of our profession of Psychology if it doesn’t get it’s collective public health head out of the morass of academic hair splitting and into the real world of mental health treatment outcomes. Academia is a tool a means to an end, not an end in itself. There are many non academic people who are excellent thinkers, researchers and practitioners and help a hell of a lot of people that get treated and paid as second rate and passed over for jobs and promotions. This is outrageous. In the name of truth and science and public good you should be standing up and joining our cause.

          1. And i have acknowledged many of these concerns. My comments have largely been in relation to the 4+2.

        2. JH you missrepresented me again when you wrote: “You’re right…. a masters is just glamour and not hard work.” I did not say that. I would thankyou to be less antagonistic I was saying that whether someone gets there by Masters or 4+2 it is the competencies or the outcomes that matter to the public and to health funds and governments. The guts is the outcomes.. The glamour is whatever spin anybody cares to weave regardless of pathway. If you persist in mis-attributing me I may take legal action as I have now drawn your attention to it twice. Oh by the way I have worked in the courts and studied some law at graduate entry level, done assessments with inmates and enjoy working in forensic matters quite heartily. I would consider doing reasonable competency based bridging processes into that field as the post graduate courses I was eyeing of now no longer exist due to the reification of Masters in Clinical Psychology courses which has starved out other courses such as Forensic Psychology at universities such as the University of South Australia.
          This really is a bigger picture than ‘us’ against ‘them’ JH and if you persist in this trolling type of approach to the debate I might take it to a higher authority or two.
          Kindly desist from deliberately or recklessly misrepresenting my position. That is my final warning.

          1. Having one’s comments held up to the light of day can be anxiety provoking and lead to defensive and threatening reactions, including of litigation. I dont think this is the first time legal action has been suggested or encouraged on this site including against members of the APS. These comments are a record for all to see. I wonder what the ‘bumbling fools’ would think? The newly graduated postgrad trained psychologists? Or maybe that comment was only in relation to those with clinical postgrad? I dont know which group so wont jump to conclusions, that could perhaps be clarified. I guess anyone can trip over their books if they have enough lying around from intense and comprehensive 2-3-4 years postgrad training.
            It seems hopeless trying to discuss the future of psychology, acknowledging the challenges of the 4+2 pathway, modernising the base level training, and recognising the needs of future psychologists in an increasingly complex and internationalised system.

          2. JH- i would also appreciate your cessation of deliberate and repeated miss-quoting of statements i have made, deliberately leaving out the nuances and qualifiers in order that you play the victim. As Gregory states, there is a cut off point to endless tolerance of trolling. I have done my best to ignore it as a distracting side issue, but that does not give you license to continue with it.

          3. I think it telling that the same person who thinks that having worked in a “clinical setting” gives him the same supervised training and expertise as an endorsed clinical psychologist believes that some vague experience “working in the courts” and having “studied some law at a graduate entry level” makes him a lawyer.

        1. Dr A ; The answer is – “6.x” (where x = 1/6 of the total number of nails one can hit on the head with one response)

  3. Dear “Concerned”, friends and colleagues, if you want justice get yourselves together and take out a class action against Littlefield and the other 2 authors (if they were directors) of the 2006 submission from the APS.

    1. Seriously? You and others paid membershop fees for years and now you complain? Sorry, the horse had bolted. ..

      1. Angelique I have been complaining for years and have been reassured every time by APS that APS is supporting all psychologists but alas now we know why things have not “changed”… hidden agendas uncovered by RAPS.

      2. Hi Angeligue,

        To offer another example, I personally wrote to the APS board, Lyn Littlefield and Tony Abbott back in I think around May 2006, prior to its introduction, with a lot of concern. There was nothing I could find and no response given to my direct correspondence from the APS Board to clarify what they were specifically advocating for, on behalf of the membership. I, along with I’d suspect hundreds if not thousands, have been asking for clarity from the APS Board on various occasions ever since. And still no clear and succinct answer.

        Open, honest and unambiguously clear communication is a basic fundamental for the health of any organisation. But for over 11 years now, members have continued to clearly and directly seek from the Board, through a range of different avenues, a clear statement on their position with the Medicare Two Tier Rebate System for Psychological Services. And still… no clear and succinct answer.

        While the Board communicates support for it’s members the question is about a policy position on a very specific initiative of the Australian Government. So great, lets keep ‘supporting’ each other, but what is our policy position on this Government Initiative? I consider this a fair question from members that requires an unambiguously clear answer from the Board.

        I encourage the APS Board to make a very clear statement to it’s members and then also publicly to the nation the policy position it has held leading up to the Medicare Better Access Scheme and what position it has held since it’s inception. Has there been any changes to the Board’s policy over the years? Or has it stayed the same?

        Once clarified, we will all know where we honestly stand as a Society on the matter and we are all then free as a membership to choose our personal and/or collective responses accordingly. Otherwise, it ends up being an ongoing game of charades with the added bonus of smokes and mirrors. Which, after 11 years, does become a tad tiresome.

        In terms of the horse bolted… ? I think this forum is more about lassoing the wild brumby 🙂

        Kind Regards
        Clive Jones PhD MAPS

  4. Having gone through a long chain of very politely expressed debates, it was a shame to come across ‘Rubbish!’. At the same time, Linda – you are arguing from a single case history (you) and making assertions, not providing us with any independent evaluation of effectiveness.

    1. Dear QueenMaeve, continuing in the model of the very polite comments and arguments you observed … I offer, we all might want to freshen up our understandings of the purpose and achievements of single case histories. To my recall they (case histories) can inform of the diverse and holistic features of lived human experience, perhaps beyond the factors / variables that were selected for investigation in a more structured and quantitative approach. Assertions and hypotheses predicting relationships of selected variables might be generated from such single case histories. In a search for independent evaluations of effectiveness of interventions by clinical and non-clinical psychologists in the context of Medicare Better Access clients, I suggest a consideration of Melbourne University’s Evaluation of the Effectiveness of Better Access. In general it fails to identify any statistically significant difference between outcomes between clinical and non-clinical psychologists. Nor any statistical difference in the severity of clients treated by these groups. Outcomes are slightly in favour of the conglomerate non-clinical group of therapists.
      I agree we should carefully connect the type of methods & data to the type of claims we make, and I have not returned to Linda’s original statement to review her claims. BUT we should be open to what we can learn from the data that is available … both single case histories and national independent studies evaluating effectiveness of programs.

      1. Thank you John. Linda’s experience that she is a more effective psychologist despite being a “mere” generalist then her friends with Clinical Masters because of her years of experience is evidence in itself that the 4+2 training is as good or better then a “clinical” masters. The fact that her friends with “clinical” masters agree is more evidence of this. The people trying to dismiss this by talking about anecdotes are only trying to confuse the issue to protect the falsehood of Clinical superiority.

        1. This is now what constitutes evidence? Personal and highly subjective anecdotes…. ? Sorry, doesnt work.

          1. well, just look at the empirical evidence then- you can only ignore it for so long (before losing all credibility).

            1. Dear JHemsworth, what constitutes what type of evidence for what purposes is addressed in my blog/comment above. Please read the latter section which cites the Melbourne University Evaluation of Medicares Better Access Program. This instance of an independent study surveying thousands of participant/providers is consistent with much of the reports of individual experience by Linda and Tanya.
              Although processes for discriminating levels of competence, other than by academic qualification, may be very complex and cumbersome, this should not justify a default to pragmatics, practicality and politics which is at odds with the much lauded empirically derived “evidence base” – which shows little difference between clinical and non-clinical competence/performance in the area of Medicare’s psychological services.
              Evidenced based policy and practice we are advised needs to be a hallmark of psychologists.
              What is guiding policy and decisions on the 2 Tier Medicare Program ?
              With all due respect,

  5. Are other 4+2s in private “clinical” practice experiencing the difficulties I am as a sole provider? I need to know how others in my position are surviving out there……

    In my opinion, If we are not APS College members and hold no PBA endorsement we dont stand a chance!

    In my opinion a “clinical” psychologist, if “trained” to work with the most complicated and severe. should be working in acute inpatient hospital/specialized clinic settings as a member of a multi disciplinary team….. under Medicare we are currently limited to 10 sessions … “do no harm”

    Im left wondering … Do clinicals continue to see such severe presentations, (the argument used to justify the higher rebate they attract), beyond the 10 Medicare rebatable sessions as private fee paying clients? Many of my clients are the most disadvantaged and cant pay….. Are there other funding streams available to clinicals which non clinicals cannot tap into? “do no harm”

    Gov needs to realize that clinical psychologists are not 2nd tier psychiatrists, they provide the same for the same…..”do no harm”

    In my opinion the target group/ criteria within which referrals are made by GPs to “clinicals” and other psychologists, under Medicare is the same as are the therapeutic frameworks we utilize. We all provide a level of assessment to inform the therapeutic process and a report to the referrer (ie GP, psychiatrist or pediatrician). To not provide such would be incompetent. So please enlighten me – where is the difference?

    In my opinion, as with TAC and WorkCover there must be only one fee for all Medicare “treating” Psychology Providers.

    In my opinion I believe the APS “Believe in Change” funded marketing campaign has restricted my practice not only within Medicare but also within TAC and Workcover. GPs and psychiatrists are now not referring to me as frequently as they once did.

    Are they now by default referring to clinicals following the APS media marketing campaign which discredits me as a 4 + 2 sub optimal “general” with no “real” psychology expertise because there is no long list outlining the therapeutic process within which I operate nor frameworks within which I deliver services nor guarantee regarding my competencies fulfilled under legislative requirements!

    The APS informs the public that I have no endorsement. So what could this mean to people seeking information regarding service options? If I was seeking support and this is the information I had about an allied health professional I would skip past “general” and seek out the best ie “specialist” ie endorsed. Human nature!

    As a 4+2 I have been told by the DGPP that I am a member of “a broad church” and thus difficult to represent and identify?? I know what I do. I maintain all registration requirements under law. I know where my practice boundaries lie. I refer on to colleagues as required! I uphold our Code of Ethics which is I believe is currently under review!

    Are any non clinicals informing this review process?

    If this continues for me I will need to close my private practice which I have operated successfully for a very long time! The only change has been the recent APS national marketing campaign and website disseminated information. How will the APS compensate me for what I believe, in my opinion, to be discriminatory and unethical advertising leading to the gradual destruction of my business and livelihood? I was not invited to contribute to this marketing campaign to ensure I am not misrepresented!

    Who were the architects of the content of this website?

    I refuse to market my service to GPs by “soliciting” referrals via gift baskets, lunches or other inducements NOR will I join any website where I can purchase referrals eg I believe as operated by “virtual briefcase” or join large psychology practices or clinics popping up everywhere now with limiting business structures, some focussed on the $ and some administered by non psychologists churning out Medicare rebated clients and by default squeezing out the independent provider.

    Please correct me if I am wrong.

    Are other 4+2s in private “clinical” practice experiencing the difficulties I am as a sole provider? I need to know how others in my position are surviving out there……

    1. It certainly seems the A.P.S. has no qualms whatsoever charging all non-clinicals the same membership fees and yet expects them to acquire the same number of P.D.P. points, effectively do the same work for less pay via a 47% lesser Medicare Rebate and basically treat us as inferior psychologists simply because we have trained via a different pathway to Clinical Masters. I share your frustration and am glad more and more people are starting to wake up to the A.P.S.

    2. I feel for you. Diversify to survive. overreliance on Medicare will destroy psychology. Stand on your own merits and market your excellent qualifications and unique attributes. I have asked the APS to correct the misleading information on the Believe in Change website and been ignored and had a complaint raised about me to the PBA when the letter was posted on this blog. it’s clear to me that the APS executive doesn’t respect 4 +2 registered psychologists enough to correct the website and to publish clear information stating we are adequate. Psychology is our specialisation! I chose to be a Generalist to be as versatile and holistic as possible. We deserve more respect as the majority of APS members.

      1. ‘Psychology’ is not a specialistion. Unfortunately this appears to showca lack of understanding of models of training and specialisation. Medicine, OT, physiotherapy et al are not specialisation, you specialise within a particular area within the broader domain.

          1. True… but there are endorsements, I think this was the point of the post. Comments about psychology being a specialisation do not make sense. Don’t you ‘specialise’ (ie endorsement in psychology terms) within your broader field?

            1. no, you dont specialise in psychology because in Australia, there is no such thing legally. As such, it is reasonable to say that psychology per se is the specialisation- 6 years of study and training, focusing on psychology, is in line with other health professions (here and abroad).

              1. But psychology isnt a specialisation, is it? Sorry im confuse, can someone explain. I did mainly vhild work during my 4+2 so does that mean i specialise in children?

                1. Hi JHemsworth

                  Psychology certainly is a specialisation. If, as you state, you did the 4+2 you may not have noticed the specialisation as it is not necessarily made “visible”. I wrote to the APS years ago pointing this out and asking that this component be given much more attention throughout the entire psychology pathway, including undergraduate curriculums, but did not ever receive a reply – not even an acknowledgement of receipt of my communication. I would hope that any future RAPS supported board members are somewhat more collaborative. This post is also applicable to much of what has been said in the other thread – “The 4 + 2 Pathway: A valid and reliable training option for psychologists”.

                  To help with what is essentially a process driven notion I will initially describe two different but overlapping domains of psychology.

                  Academics make valuable contributions to psychology – no one would dispute this. Practitioners also make valuable contributions, as indeed do practitioner-academics. Academics more usually engage in hypothetico-deductive research – the creation of a controlled ‘unreal’ environment in which to conduct experiments. Practitioners more usually engage in action research – working with the full complexity that exists within the ‘real’ environment. The findings of hypothetico-deductive research can suggest and inform the development of action research processes. The outcomes of working with action research processes can generate ideas for hypothetico-deductive research. Each adds value to the other, but the balance is important and if the balance is disturbed by agendas in either camp, psychology as a service to our community will suffer.

                  For mental health there are two broad preferences operating here which tend to place psychologists in separate spheres of operation.

                  The Academic Research Arena:

                  Here the orientation is to attempt to “Investigate and Describe the Status Quo but Not to Produce Change”. Theories based upon controlled experimental conditions can be an outcome. Such theories do not readily generalise to the real world of practice, however they can suggest potentials for practice design for the real world. The designing is done in the world of the other broad preference.

                  The Practitioner Arena:

                  In this sphere of operation the orientation is for “Processes that have potential to Produce Positive Change in Mental Health”. Theories based upon direct engagement with the rich complexity of the real world in action can be an outcome. Specific outcomes are difficult to replicate, as the real world does not allow a lot of control over the experimental design. The processes used, however, are somewhat easier to replicate and it is the application of these processes that produce change.

                  Both the above orientations have the potential to complement each other. Indeed these two spheres of operation can amplify each other’s effectiveness by mutual sharing of their efforts. When this occurs in a balanced and respectful way the overall discipline of psychology is greatly enhanced and our community benefits.

                  In summary one domain is about controlled research design to describe the status quo. This is not an approach directly targeted at producing change and it is more about the content. The other domain is about process (and processes) interacting directly with the complexity of reality. This is an approach directly targeted at producing change and it is more about the process, including meta-process.

                  The Specialisation That is Therapeutic Psychology

                  To add more specific focus and to contain this within the arena of Medicare I shall address the following to psychologists who offer services to our community using the Medicare Better Access Items. I shall, instead of the more compartmentalised generalist or clinical or even endorsed psychologists, call these individuals “Therapeutic Psychologists”.

                  What follows applies in lesser degree to a psychologist who works with individuals who have profound intellectual disabilities. Such individuals are better catered for by team based or multidisciplinary care.

                  Note: Even though I am containing this to the arena described above it can be applied to other areas of psychology.

                  The province of therapeutic psychology is to help individuals and groups produce a positive change in thoughts, feelings and behaviour. When this approach is used in clinical settings it is usually referred to as mental health.

                  There is, fundamentally, only one process that can produce a positive change in thoughts, feelings and behaviour. Due to this, psychologists can be described by the following statement:

                  “Psychologists are involved in helping individuals and groups debrief existing mental skill-sets while simultaneously helping them to re-skill with more helpful mental skill-sets.”

                  The statement captures what an effective practitioner must be doing in order to be practising therapeutic psychology —

                  DEBRIEFING Mental Skill Sets

                  RE-SKILLING in new Mental Skill Sets

                  Note: Mental Skill Sets operate within the entire mind-body connection.

                  Practising Therapeutic Psychology

                  For human beings mental debriefing and re-skilling can only occur through the process of experiential learning.

                  Psychologists practice in EXPERIENTIAL LEARNING

                  Many occupations are involved in experiential learning, for instance a tennis coach, however this coach is interested in helping with physical skills while a psychologist helps with mental skills.

                  Psychological Experiential Learning = MENTAL DEBRIEFING + MENTAL RE-SKILLING

                  So practising therapeutic psychology is a specialisation in debriefing and re-skilling in mental skill sets within experiential learning itself.

                  Some Things Naturally Follow:

                  Psychologists are not directly involved in medicine. They cannot prescribe medicine and they do not work directly with people’s physical bodies.

                  Because psychologists don’t work directly in the area of medicine they are not interacting with a disease, instead they are interacting with a person or group. The interaction targets the person’s mental skill sets.

                  Individuals are different. Two individuals with the same schizophrenia diagnosis are highly likely to present differently. Among other behaviours, one may have depression and the other may have anxiety. A psychologist will help the person with the anxiety or with the depression. There will be individual skill sets involved. The psychologist cannot medically help the person with the disease called schizophrenia. However the psychologist can interact with the individual’s learning systems to help them understand how they are currently responding (their current skill set) and to help them learn different and more helpful responses (re-skilling). The psychologist cannot help the person learn a new skill set by telling them the theory of schizophrenia or by giving them a book to read. The psychologist cannot help the person learn a new skill set by testing them diagnostically, or by giving them a self-report inventory to complete. “The only way the learning can occur is for both practitioner and client to engage in the process of experiential learning.”

                  Training in Therapeutic Psychology

                  Psychologists Vs Clinical Psychologists – What are The Differences?

                  Those who choose to work in therapeutic psychology eventually gain their registration and then are able to practise independently. The 4 of the 4+2 pathway is mainly an academically driven learning process. The +2 is an experientially driven learning process, although the academics have asserted more influence in this over recent years. Here the content is more about the process i.e. it directly targets process driven ways of producing helpful change in consumers of psychological services. The +2 of the masters also exposes students to processes for change. However it is true to say that the exposure is often to university clinics and consumers who use these clinics. Additionally there is more academic driven content. It also needs to be acknowledged that there is a further +2 in the clinical masters where more exposure occurs. Juxtaposed to that of course there is ongoing exposure beyond the +2 of the 4+2 via the professional learning environment itself i.e. learning occurs through the acquisition of ongoing experience and including continuing professional development activities where psychologists can be exposed to a whole range of processes they can learn and adapt for their own practice. This is actually true for all psychologists who decide upon a career in therapeutic psychology. Their effectiveness for change in their client population is acquired through their learning and experience with therapeutic processes. All the therapeutic processes have been designed using the principles of experiential learning. If they weren’t, they wouldn’t work.

                  The practice of therapeutic psychology is really an artistry in a specialisation within experiential learning. The artistry is acquired and continually refined through the exposure explained immediately above.

                  Beyond the artistry there are other aspects:

                  Report Writing
                  Expert Witnesses e.g. in legal courts
                  etc …

                  These activities are not the practice of therapeutic psychology for change. Instead they are more aligned with describing the status quo.

                  If there is a difference when we encounter clinical psychology it is that the training is somewhat more focused on learning descriptions of the status quo. Studying the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (The DSM) is an example. There are no therapeutic processes in the DSM, it is entirely descriptive. It is an odd or incongruent thing for a therapeutic psychologist to be studying. The DSM was designed to be descriptive for psychiatrists to align medical drug treatments with described symptom complexes. The manual may have some treatment efficacy for psychiatrists but as psychologists cannot prescribe medications it has no treatment efficacy for the discipline of psychology. As already explained above the treatment efficacy for psychology is in therapeutic processes that utilise the principles of experiential learning. This assertion may at first seem somewhat counter-intuitive. An example may serve to illustrate.

                  Agoraphobia is one of many described symptom complexes in the DSM.

                  What does this description mean for therapeutic psychology? The answer is – ‘very little’. Agoraphobia is one of a large collection of descriptions of anxiety based conditions. During an initial consultation with a therapeutic psychologist a client will describe their issues and it will become clear that they exhibit anxiety across a range of circumstances. Therapeutic psychologists have a large number of processes they can use by direct application or modification to meet the individual’s circumstances. The processes target the behaviours, which can be changed by cycling the client through the twin areas of debriefing and re-skilling in the mental skill sets involved. The processes themselves work with underlying anxieties not with the categorisation Agoraphobia per se.

                  There are many such described conditions in the DSM. However therapeutic psychology is all about addressing underlying skill sets. It isn’t a discipline of prescribing medications to alter neurotransmitter functioning. Instead altered neurotransmitter functioning can be an outcome of the processes used in therapeutic psychology.

                  As John Alexander has already pointed out on this blog, the research reveals that classifying individuals according to some nomenclature has little to no relationship with producing helpful changes in such individuals. Consumers of psychological services want to feel better and be better, that is why they come.

                  I would suggest that, due to all of the above, the outcome of training in the discipline of applications in therapeutic psychology for positive client change is essentially the same.

                  Some Implications For Learning

                  Near the beginning of this post I mentioned that you may not have noticed the specialisation of therapeutic psychology because it may not have been made visible in your +2. This does not mean that you didn’t learn it, although it may mean that you could have learned it better. In experiential learning a lot of the learning is invisible. In order to make it somewhat more visible and therefore more deeply understood experiential learning itself needs to be part of the curriculum. You can view the processes for change that aspiring therapeutic psychologists are exposed to as the content of their learning environment. You can view experiential learning as the meta-process of all those processes. So designing a reflective practicum as a learning environment can result in amplified learning if both situated learning combined with the meta-process of experiential learning are included in the design.

                  We may learn a lot more if experiential learning was a process content of undergraduate programs. I’m assuming, that because it isn’t, it may also not be a process content, or variable dependent upon supervisor, of the +2 of the 4+2 or the +2 of any masters program.

                  Now consider if psychologists were actually taught about the processes and the meta-process of experiential learning itself. Outcomes could be that such focus in learning allows psychologists to move across different client populations more easily – that is the portable skill set of experiential learning helps psychologists understand the processes used in different client populations more deeply. It then becomes possible to successfully modify and port processes across client populations. I really have some difficulty understanding why the APS and PsyBA introduced the notion of Areas of Endorsement. It is restrictive, compartmentalising and does not recognise the real skill base of therapeutic psychology. Prior to these “areas” we used to talk about streams and movement across streams. What makes this movement possible is the specialisation of therapeutic psychology itself. It may be somewhat more difficult to move across some streams than others, however a mentoring program can address this, instead of an academically focussed and evaluated course of study.

                  I mentioned in a post in the other thread “The 4 + 2 Pathway: A valid and reliable training option for psychologists” that there are different learning preferences involved in individuals who prefer the world of hypothetico-deductive research and those who prefer action research. Further I suggested that the two different worlds are best left to those who understand them most. I did not mean that there would be no collaborative effort – each arena would benefit from the others input. However one learning preference trying to have undue influence over the arena of the other’s expertise can only create a stifled learning environment.

                  It is true that we do have a problem of evaluating skilled learning and that currently the evaluation is being driven by undue academic influence. The important theories of Argyris and Schon tell us that it is often an invalid form of evaluation to ask someone about their knowledge when evaluating a skill set. The more valid answer is in behaviour not in the spoken word. Skilled practising therapeutic psychologists are actually better placed to evaluate others skilled behaviour than academically driven models of evaluation. It is always important to make distinctions between the content and the process – and indeed the meta-process.

                  Lastly I need to acknowledge that there are some practitioners who base their practice largely on content. I do not consider these psychologists to be in the business of producing helpful change in consumers of their services. Instead they are interacting more with the status quo. This does not mean that they don’t provide a service to our community as government bodies and other organisations often require a “description” in order to make decisions.

                  This has been somewhat of a brain dump – it could be presented more clearly and would be improved by the use of diagrams but this isn’t possible in WordPress. I could post a huge amount more … but please ask some questions if you wish and we can develop it from there.

                  Kind Regards


          2. James you are correct!

            Just as non endorsed psychologists are in breach of National Law if they describe themselves as “clinical” psychologists (with significant $ and conduct penalties) so too are psychologists who define and/ or describe themselves in any way, shape or form a “specialist” within any field of Psychology in Australia. There are huge fines imposed for advertising or describing oneself as such.

            We all acquire General Registration in Australia. Some collegues have “area of practice” endorsements but these collegues CANNOT state they are specialists or use specialist in their title or purport to provide a more competent service than other psychologists nor use testimonials for direct service delivery because to do so is a breach of our Code of Ethics and National Law.

            I know that some APS members have been lobbying gov for recognition of specialisat title which was possible under the former WA psychology registration board which on transition to PBA was phased out and ceased in 2013 (giving psychologists time to update marketing and advertising material etc).

            However, a few years ago the APS was promoting Specialist vs Generalist Divisions and the PBA had responded by sending out information via their newsletter informing all Psychologists about breaches of law regarding purporting or using specialist title or specialisation.

            I believe there is a review currently underway re our Code of Ethics and some psychologists in positions of influence within the APS are supporting specialist title recognition. Does anyone know the details?

            In my opinion Psychology does not translate to the medical model eg an ENT cannot work with cardiac issues whereas a non endorsed and endorsed psychologist across all areas of practice within psychology can provide the same service provided they have undertaken CPD and practice within their area of self assessed competencies. Our evidence based practice theoretical frameworks and principles are shared! We develop expertise via our experience.

            1. totally agree- and endorsements are nothing but ‘specialisation’ by stealth. Many endorsed psychologists behave as though and present themselves as if they are specialists (see the statements of many- not all- ‘clin’ psychs)- they just dont use the actual word. And many leaders of the APS and PBA have granted themselves multiple areas of endorsement (areas of practice endorsement), despite the fact that they have focused their careers on teaching and researching, not on practicing- they should be considered endorsed teachers- not the long list of endorsements they have given themselves. Such corruption erodes our entire profession and destroys all of our credibility- not the least, theirs.

    3. Thank you concerned psychologist for reminding us that it is clinical psychologists who are “soliciting” referrals via gift baskets, lunches or “other inducements” offered by Clinical Masters students (we all know what those are), without any action by the APS. Such corruption needs to be addressed. On with the Spill!

      1. Oh Tanya, I see you have reined yourself in but haven’t quite given up?!

        Why don’t you make a clear pronouncement about your true position, rather than trolling through the comments, trying to undermine this initiative and those that support it?

        1. What is tiring is troublemakers attacking people for supporting RAPS supporters like concerned psychologist. Maybe we need stricter control over what types of comments can be made so only useful positive ones are published?

          1. On the contrary, dear Tanya – there is no need for comments to be only positive, but they should at least contribute to the debate in a useful and meaningful manner!

            It is much more productive to openly express divergent opinions, than to bombard the debate with insidious dissimulation.

            1. i agree Tia- with each comment by the anti-RAPS mob, they further demonstrate how convoluted and anti-empirical their arguments are; they demonstrate very clearly that their motive is not the welfare of clients or society, but their own need for superior prestige and power. They are systematically revealing who they are, and where their ethics lay to an ever widening audience of more psychologists. The inertia of many ‘generalist’ psychologists is based on an unwillingness to believe that their ‘clinical’ colleagues could possibly have such a derogatory view of them- these discussions are giving them all a valuable education in the real views behind the vested interest and turf warfare launched by those who have assumed superiority (and those who have illegitimately and unethically assumed control over the APS). The AAPi have been advised by one of Australia’s most prominent class-action law firms that there is a case to answer for in terms of restriction of trade and anti-monopoly industrial laws. What has been done to the majority of Australia’s psychologists by the APS is ethically and legally questionable on many different levels. Their minions, who are laughing all the way to the bank, create more delusional and creative arguments out of sheer desperation to ward off an inevitable awakening of tens of thousands of psychologists who have been naively handing over their membership fees to a junta that have consistently cut their throats when no one was looking. Well, more are all looking now- our numbers are growing each day. The counter-RAPS arguments offered are merely adding to the momentum of change (which will come about either within the APS or in the courts). Those who have set themselves up against RAPS are doing us a favour.

              1. Yes James, I agree.

                I can only feel encouraged by the fact that these individuals are going to such lengths to undermine the efforts of RAPS and their supporters.

                The fact that they have entered this debate intent on objecting to any articulated argument for equality, not only clearly illustrates the presence of perceived superiority, but most encouragingly, it can only mean that they actually believe that there is a tangible possibility of RAPS succeeding in its push for change!

                1. it astonishes and appalls me that these ‘clinicals’ fail to recognise that if the gov’t reduced their medicare pay rate to that of all others psychs, our clients would be able to get 15 sessions of counselling instead of 10 for the same cost to the tax payers. Where is their interest in the benefit to the community via psychology? Can they really be so focused on their own wealth and status, when it comes at the expense of the community’s needs? Why did these people ever enter psychology?

                  1. Yes, Dr James Alexander PhD, and if the government slashed the Medicare rebate for all psychologists to $40, members of the community could enjoy 20 sessions with the psychologist of their choice. Why aren’t you lobbying for that if your interest in the benefit to the community via psychology is so great? Can it be that you really only want others to experience a reduction in their own wealth and status, but are utterly unwilling to make any sacrifice of your own even if it comes at the expense of the community’s needs? Indeed, surely given yiur repeated arguments that bookish clinical psychologists can’t hold a candle to the superior service that a 4+2 offers solely through having a number of years of experience in the field, surely it makes more sense using your argument to reduce the rebate provided to these 4+2’s to maximize the number of sessions they can offer to the public … unless of course your concern for the public good ends as soon as it is you who has to experience a reduction in the Medicare rebates you enjoy?

                    1. With all respect James Alexander and J Dwyer, perhaps you are both looking at this the wrong way. Surely the best option is for psychologists as a united profession to systematically collect solid and indisputable outcome data that shows our value so that we can lobby for both higher rebates AND more sessions. We need to be able to show that we are worth every cent (and more) in terms of reduced hospital admissions (acute and chronic), reduced police involvement, lower school funding etc etc etc. These arguments that are trying to drag clinicals down does the entire profession a disservice.

                    2. Curious- agreed, however there is only one group of psychologists arguing that we are all equal (and should therefore have equal pay and status); and one group arguing that they are superior- it the latter (well represented by the APS ‘leaders’) to whom you need to address this issue.

                  2. Dr James Alexander PhD, when you say “one group arguing that they are superior” are you referring to the group that refers to clinical psychologists as cold and heartless, and describes all clinical psychology students (none of whom played any role in the two-tier system but are apparently much safer to attack then registered psychologists) of having a false sense of superiority over all others? It is interesting how the group that likes to constantly portray itself as being the victim of attack and marginalization actually appear to be the party responsible for most of it.

                2. referring specifically to the type of ‘clinicals’ who want to defend the pay and status differential that the aps has created for them (well aware that not all ‘clins’ are so blinded by by their privileging- some are embarrassed by it)

                  1. To ‘Curious’ well said and totally agree but would add…..we should all be banding together to lobby the government to exclude GPs from being the gate keepers of writing the MHTPs! If we were allowed to write the MHTPs for better access then with the massive savings we could lobby for ALL psychologists to be on the higher rebate with extra sessions and the government would still be saving money.

                    1. Hi Cate. Yes I couldn’t agree more and have said this many times too! Given the stepped care model coming into line at the moment that doesn’t seem likely but it’s a great way to cut costs.

            2. So you think you are the person who decides what comments are useful and productive in this important crucial debate about our livelihoods, and RAPS protecting us from the Clinicals attempts to place themselves above us. Hardly anyone here has complained about my comments apart from you. However you have picked many fights with people here and tried to tell them they should not say anything, while pretending to care about how we are held down everyday and told we are lesser by clinicals and universities. Maybe it is you who is trying to bombard the debate and make generalists all look bad, when all we want is a fair go.

              1. Well, if it looks like a troll, and it sounds like a troll…perhaps you just drew too much attention to yourself with comments about ‘university lectures filled with chants of “two tier forever” and “down with generalist scum”‘.

                But I must admit I really like the way you’ve changed tack and constructed this particular post – hardly a derisive tone in sight!

        2. yes, such people already have a place where their views are respected, acted upon, and even used to influence government (determining our pay rates, and levels of status, even careers). Its called the APS. And yet they feel the need to try and undermine efforts to correct injustice- what does this say about them?

          1. Thank you James for bringing attention to the role of the APS in influencing government with our money to always undermine our pay rates, status and careers so clinicals can prosper. I know the only reason many of us “generalists” did not enjoy even more success in our careers was because of their sabotage. I hope after the spill you and the other RAPS leaders will step up and take board roles with the APS so we can have leaders with views that reflect RAPS.

  6. Colleagues your thoughts please on one of my earlier postings…,..

    “I also came across a document, a 2012 paper, formulating recommendations re changing the clinical psychology training programs in Australia to align with competencies…so once the clinicals achieved their desired goal of “specialist” title within Medicare and higher fees, it seems they needed to back pedal and make sure that the training supported their claims… so it makes interesting reading…..they talk about ‘curriculum re-imagining’

    [PDF] Taking clinical psychology postgraduate training into the next decade: Aligning competencies to the

    So if such significant reform was required in the training of future clinical psychologists, does this mean that APS Clinical College members grandfathered into AHPRA attaining an endorsement in the area of practice of clinical psychology did not meet competencies?

    Where was the SAME “investment” in the grandfathering of the 4 + 2 Psychologists into their areas of practice endorsement? We had evidence to support our “endorsements” as we were able to demonstrate competencies as obtained from “real” “industry based training” not “academic” exercises and time limited placements, and our multiple years of direct “clinical” practice, cpd and meeting legislated requirements, unlike the clinical psychology candidate whose entire training program of clinical psychologists was post “endorsement” phase needing reconstruction?”


  7. Any bridging course implies all other Registered Psychologists are somehow inferior to “clinicals.” The concept is great for University coffers though, despite there being no evidence that treatments and/or treatment outcomes differ.

  8. I’m wondering what the clinical hegemony in the APS mean when they use the term “bridging course”? Does it simply mean General Practice Psychologists do extra courses during the day – when we have to work to eat? Does it mean we’d have to do placements (likely in areas many may never wish to work in anyway) – during weeks when we have to work – to eat? Would the bridging course take years and years and years? To do a Masters in Clinical Psych nowadays costs a small fortune in fees and foregone income whilst doing placements. Would a bridging course be any different? Would it be via genuine “part-time” – ie evenings or external studies? Or, is it meant that the membership needs and lifestyles would be considered and realistic modern human resource development options could be applied – not to set up hurdles or barriers but to actually assist the members who are paying the clinical clique to run the APS – to supposedly meet the needs of ALL members?

    1. To date the A.P.S. has done an excellent job hindering rather than helping the majority of their members.

    2. You mean do subjects at university, undertake standardised assessments, engage in research, and be supervised by multiple supervisors like in a postgrad masters course?? Hmmm….

  9. The previous national clinical bridging program (which was far far less onerous than the Masters of Clinical Psychology) was only discontinued in 2013. Was there any reason why psychologists with 10+ years of experience chose not to undertake this program?

    1. Ohi, Ohi – do I detect self-righteous victim blaming in this comment? Oh, should I assume that my colleague sincerely expects a simple response for a question that involves thousands of individuals and individual circumstances?

      Anyway, my opinion is that how can any member anticipate that his/her Association would be punitive or divisive in its intent ? Only after time provides the evidence…..I say it is reasonable to expect to pay members to trust their Association with delivering ongoingly nothing but empowering and enabling programs aso that all paying members can achieve the best in all areas. When reality challenges such expectation trust is the greatest casualty. I am one member who needs my trust into the Association to be repaired. To me the time is here for a more democratic and fair conversation to take place over the two tiers issue.

      1. So asking why experienced and financially established psychologists did not undertake a bridging program far less financially onerous then the Masters program that young students had to do, when the same psychologists were fully aware that doing so would make them eligible for the higher rebate is “victim blaming”? Sounds like some psychologists want the same financial benefits that students who sacrificed to complete a Masters earned, but without making the same sacrifice themselves.

        1. you keep conveniently ignoring the reality that many ‘generalist’ psychs also have masters degrees, PhDs, and nearly all have engaged in extensive PD training (at considerable expense and time- not the unique domain of ‘clin’ psychs).

      1. A lot… it would bring you close to the level of a clinical psychologist… close to but not the same without a clinical masters.

        1. Hi Angelique and all other Clinical Psychs commenting that the Masters makes your training superior to the rest of us – here’s an anecdote that I think illustrates the dangers of instilling into graduates from a Clinical Masters that their training alone epitomises the height of psychological expertise:

          I have a good friend of mine who progressed to the Clinical Masters, whilst I completed the 4+2 pathway.

          Maybe 3-4 years after we had both fully registered (they had been working part time in a hospital and part time in private practice) and whilst out on a social event, this friend proceeded to tell the group about a new client they had recently seen whose presenting complaint was Anxiety. However, apparently in the course of the initial assessment, this client also disclosed that they had been having an affair.

          My friend proceeded to tell the rest of us, full of pride, that at that point they told this client that they would not be able to help them, because what they were feeling wasn’t anxiety; it was guilt and told them that they should feel guilty and sent them on their way.

          Another friend who is not a psychologist immediately expressed shock and exclaimed that she thought psychologists weren’t supposed to judge their clients and my Clinical friend cooly replied it wasn’t judgement, it was a clinical assessment.

          Now, even with my ‘apparently’ inferior 4+2 training, it was evident to me that this behaviour was highly inappropriate and unethical. Not only because they did in fact judge this client, but also because they failed to refer the client on to someone else who wouldn’t be prejudiced against this client, so that they could obtain the help they wanted.

          Having not completed a Masters, I can’t possibly know, but where is it taught that it is not possible for people to feel both anxiety and guilt? Does the Masters not explore the myriad of maladaptive coping strategies clients can engage in to manage more difficult emotions, such as using sex to distract from their anxiety? And even assuming the assessment was correct, and the client’s primary struggle was guilt about the affair, isn’t it our job to help clients navigate this? Afterall, the guilt and anxiety could also be indicative of Depression, can it not?

          Are there Generalists who may be capable of making similar blunders? Absolutely! But can we please stop pretending that a Clinical Masters automatically instils one with infallible expertise!

          Thinking in absolutes is dangerous to ourselves, to our clients and to our profession!

          1. this little anecdote expresses well the common meaning of the term ‘clinical’, ie. cold, heartless.

        2. OK- the onus is on you to show some evidence that i) clinical psychs get better results with clients; ii) a masters degree in clincial psych will result in more competent psychologists whose clients get better outcomes, and iii) a bridging course will result in better outcomes. Without any evidence, your beliefs are just that- beliefs. Why should your beliefs result in lower pay and status for all other psychologists (in the absence of any evidence)?? Are we an evidence based science, or just another self-interested belief system? The null hypothesis holds- there is no demonstrated difference.

        3. Dear Angelique, you blog above may suggest that there is a “higher” and currently exclusive (to Clinical Psychology) level of education in mental health assessment/treatment.
          My view is that there may be a standard of competence in various mental health interventions, which diverse pathways / methods of education might promote and help trainees attain.
          Various comments on this string suggest that “the level” of mental health competence occupied by clinical psychologists is not necessarily desired, except in current Medicare Tier recognition.
          Would you care to explain if it is your claim that clinical psychology masters training is the superior and exclusive pathway to working in mental health ?

    2. I asked but they said because I completed my fourth year in 1978, the degree was too old . They did not recognise the value of 30 years of clinical work or the 63 books I have had published.
      Uni of Canberra also said I would need to do fourth year again,and really I was too old.

  10. This is the issue myself and many othrs are facing. I was offered a job placement that inluded my 4th year and internship. I took it, not realising that it would then limit my options to specialise down the track.

    Ive since become a single mum with my own practice in rural nsw. I would love to specialise in developmental psych, however my only options would be to shut my practice and move my family interstate. All at the end of it, id be no better off financially than I am now. Clinical psych would at least allow me the higher rebate but options are limited, and there is minimal subjects based on child and adolescents, which is my prefered caseload.
    Hardly good options and I would not be the only one facing these difficulties.

    1. In reply to no options for 4+2 . When I completed my fourth year I then had to make the decision whether to spend $25,000 and two years of my life not working in order to complete a Masters degree or whether to leave at that point and do paid internships in order to complete the two years of supervision component and be a 4 +2 . I made the decision to go on and do the masters degree through one years treatment for cancer as I believed that the 4+2 back in 1999 was on its way out in terms of level of training. I don’t see why they’re should be a bridging course for 4+2’s to get an easy ticket into any college that cost me two years of my life and $25000. See if you can do a masters degree online or part time there are options out there you just have to choose the harder pathway.

      1. in terms of effectiveness as a psychologist, your $25K masters degree is redundant. If you were persuaded to part with the money and 2 years of your life, thats your issue. There is simply no evidence based reason why you should be paid more for having chosen that course of action over another. Stick to the evidence.

        1. James Alexander, I will not stick to a flawed self report with no longitudinal follow up as ‘evidence’. You would probably find that people who have done a 6month counselling course would get the same results as those of the survey! What does that say? Counsellors (non psychologists) should get a Medicare rebate as well! The rebate is more about TRAINING. A Masters is a Professional systematic regulated standard of training that the Government can count on as a set standard. That’s how I see the tiered system…..who has the highest possible specialised training at a University level. My Masters is not redundant thank you very much. Finally, if I don’t believe the ‘evidence’ is good science then I don’t have to include it in any debate!

          1. Cate- you will not stick to the only evidence available? There is your problem in a nutshell. You want to retain a system (2 tiered rebates) simply because it ascribes a higher status to you, as well as higher pay. Yes, the research for decades has clearly shown that beyond a basic level, more and more academic training does nothing to increase the effectiveness of psychologists- acquaint yourself with it. It is inconvenient for all psychologists, yet accurate, that ‘counsellors’ with basic training are just as likely to get positive outcomes with clients. We dont deal with that finding by simply ignoring it, or bolstering ourselves with smoke and mirrors (arguments which are simply contrary to the evidence). Denial is not a great option, even though it appears to be the preferred one of many Australian ‘clinical’ psychs. Many ‘generalists’ psychs have at least as extensive training as those with a clin psych masters- other masters degrees, PhDs; and extensive PD training (which Grenyer’s own research demonstrated was well accessed by most Aust psychs). I understand you have a need to attach a great deal of value to your masters degree (it cost you a lot of money), but really- should this lead you to disparage all of your ‘generalist’ colleagues in order to justify your expense and efforts? I chose to do a PhD (at expense and time)- i dont need to disparage all other psychs who havent chosen to do this- i’m just pleased with having followed my interests (not the $).

            1. Hello Dr Alexander,

              “It is inconvenient for all psychologists, yet accurate, that ‘counsellors’ with basic training are just as likely to get positive outcomes with clients”

              Does that mean that if the Australian government accepts the research you are citing as the basis for your position, this creates a strong argument for counsellors with basic training to also be granted access to Medicate rebates? Do you think that a realistic proposal for the inclusion for counsellors into the Better Access Iniative can be made?

              1. if we lived in a world with infinite financial resources (which we obviously dont), then ‘yes’ to your question- what possible basis would be have in saying ‘no’ to others who get just as good results? But given the reality of limited funds, the line has to be drawn somewhere, and i think it reasonable that it be drawn around psychology as a profession (self-interest declaration: i have a financial interest in the above view- but i will not disparage those who are disadvantaged by that view, or make up spurious arguments against them).

                1. Hello Dr Alexander PhD, Thank you for confirming that your cited research and the arguments against a two-tier system can equally be applied to advocate that counsellors with a modicum of training should receive the same Medicare benefits as generalist psychologists. So there is no evidence then that generalist psychologists consistently obtain better results then counsellors with only basic training? I am sure there must be; otherwise, how can we justify the continued payment of any Medicare levy to a generalist psychologist?

                  1. I agree J. Dwyer, if you follow Dr Alexanders argument then outcomes by psychologists of any learnings or pathways do no better than a counsellor who has learned the basic micro skills of empathy, non judgemental stance and validation. That is what I am saying is that you can’t base the argument for doing away with a hierarchy based on training and experience because of a survey or what Scott Miller says about outcomes!

                    If we do, then the Government is likely to say that if Psychologists have the same outcome as counsellors then let’s get rid of better outcomes and save the money or drop the rebate to reflect the lowest base level I.e. Counsellors.

                    1. Ok Cate- so where does truth get a look in here? You are engaged (as per the APS clinicals) in a massive marketing snow-job. It has little to do with reality, and a lot to do with vested financial interests. We dont need to bend truth in order to demonstrate that services provided by psychologists per se are effective- the evidence speaks for itself. But the evidence does not indicate a difference amongst psychologists in terms of effectiveness. Nor does the evidence support any notion that ‘clinical’ psychs have done more training than anyone else. Have you not heard the often repeated statements that many ‘generalist’ psychs also have masters degrees in psychology, some have PhDs, and Grenyer found that the vast majority are enthusiastic PD participants.

                    2. Hi Cate and J Dwyer, this definitely is the case. Counsellors with degrees, master’s degrees and doctorates in psychotherapy lobby governments too. This is very much the issues being raised by them.

                      ATAPS is a funding model that allows opportunities for other schools and models of training to get a foot in.

                      If we keep blinkers on thinking the clinical psych master’s is the only way to go there is a great risk that the rug will be pulled out from under the whole procession of psychology.

                      Mental health nurses, clinical social workers, post grad trained counsellors are all there and in the field of practice rhetoric doesn’t cut it. The bottom line is outcome. I.e, has the patient improved and who is the one treating the patient that contributed to the improvement.

                      We can debate over so many things but the bottom line of funding is outcome . I.E who gives the funding agent what they pay for.

                      The governemt pays for mental health outcomes. Who delivers those outcomes. They don’t care who does it or how they are trained to get to be able to do it. They just want ‘bang for buck’ in the bottom line outcome.

                      If we oversell the prospect of outcome and ask for more money in the promise of it, and it doesn’t eventuate, the funding body will eventually feel they’ve been scammed. There is so much at stake for our whole profession guys. Getting our training right to ensure optimum outcomes is critical and at this stage the +2 and master’s show equivalence. We should not scam funding agencies on a different sales pitch to that.

                      kind regards

                    3. excellent points again clive. it does appear that based on outcome data, the aps and ‘clin’ psychs have scammed the government- somehow promising more than what other psychologists can offer (in the total absence of evidence- in fact, contrary to the only available evidence.

                  2. J.Dwyer- try and bend it any way you can. The only research on the matter i am aware of does not distinguish between different types of psychologists- the results are as true for ‘clinical’ psych as they are for ‘generalists’. More and more academic training does not produce better psychologists (beyond a basic level of training- which many counsellors also receive). Masters and doctorate level training is irrelevant to a psychologist’s ability to help their clients achieve desired outcomes- it value adds nothing to the client (although it does add income and status to the psychologist, esp in this corrupted context with the APS has created). Do you seriously want to argue in favour of this??

                    1. Thank you again for confirming that the conclusions of your self-published research on your Linked-In profile support the proposition that as psychologists, including all generalists, do not produce better results then counsellors with a modicum of training. Do you feel that all psychologists, including generalists, should enjoy the same Medicare access as counsellors? Because that is what your non – peer reviewed conclusions will be used to justify by a Federal Government keen to cut costs.

                    2. JDwyer- alas, sadly my friend, the government is not in the habit of following my suggestions (if they were, our profession would not be in this mess). The research i have referred to is not mine- it can all be found in the peer reviewed literature, if you bother to look for it. I am merely bringing it to your attention.

                  3. Hi J Dwyer, just out of interest – why have you chosen to focus only on generalist psychologists versus all psychologists, when comparing with Counsellors – I didn’t see that distinction being made in Dr Alexanders comment?

                    What are your thoughts on the fact that Medicare has been available to Psychologists for 10 years now and Counsellors and Psychotherapists haven’t all closed up shop and changed careers? Couldn’t this suggest that their clients haven’t been deterred from seeing them despite the lack of this incentive, presumably because their work must have some quality to it?

                    I know for a fact that there are Counsellors/Psychotherapists, in Sydney at least, that charge well above or equal to what some Clinical Psychologists charge and have no difficulty securing clients; so that must say something about the quality of their work; don’t you think?

                    If all psychologists had been placed on a single rebate when Medicare was first introduced, do you think this would have had a detrimental effect to Clinical Psychologists? If so, how and why?

          1. why whinge? Is that what you learnt to ask clients in your masters program? We whinge simply because our profession has been hijacked and vandalised by a small self-appointed elite, which has resulted in unjustifiable pay inequities, in unjustifiable status differentials, and the tarnishing of the majority of Australia’s very capable psychologists (who, btw, are doing clinical psychology very effectively every day of their working lives). How do we know that? It is what the research evidence shows. Beyond the issue of cost, the biggest reason which stops people accessing psychologists is a perception that it will not be effective- this, in spite of the fact that 80% of people who do access psychologists do better than those with the same problems who do not. Our profession has a problem, not of failing our clients, but of informing the public of how effective we are. And what does our ‘peak’ professional body do? It relegates most of the country’s psychologists to a second rate status- reinforcing the faulty notion that seeing the majority of Australia’s psychologists wont help- our peak body perpetuates the faulty notion that most of our psychologists are not up to the job of helping sufferers. And they have been taking the funds each year of the very same psychologists they have been disparaging and advocating against. The statements of some vocal ‘clinical’ psychs are just an appalling lie perpetrated out of nothing more than self interests- the need to make themselves look good (solely) by making all others look bad. Shame

            1. Well said, James. At the end of the day, the greatest strength we “generalists” have (oh How I loath the patronizing term foisted upon us by the APS) is that by not denigrating the clinical clique the way they routinely attack us, we have the moral higher ground. Everyday I see the Clinical faction belittle and stereotype us online as collectively incompetent and inferior due to choosing a more grounded approach to becoming psychologists, And I am filled with more and more admiration for the RAPS members who are not so insecure as to have yo desperately insult those who chose the academic pathway to match the understanding of humanity that we acquired through decades of experience as psychologists while they pore over their textbooks.

            2. My sentiments exactly, James!

              It is truly frightening to see how some of these comments are so contemptuous and totally devoid of any empathy for the rest of us!

              Why don’t you all try for 1 minute to stop thinking of retorts to our comments and imagine how it would feel to you if all of a sudden all the work you had put into your career and all the great outcomes you’ve achieved with your clients was deemed not good enough and inferior to some arbitrary standard set by one or a handful of people, informed only with their opinions, not objective facts – because ultimately that is what this is!

              And then tell us, that you wouldn’t feel compelled to fight for your rights and those of your peers?!

              1. Imagine how you would feel as a Masters of Psychology (Clinical) student who worked hard to gain her place and excited to join the profession who stumbles onto this site, only to see the far more experienced peers she respected and looked up to sneeringly dismiss her as being “Cold Hearted” (as per Dr James Alexander) or an incompetent bumbler who stumbles over her textbooks (as per Gregory Goodluck) … or are only one particular group of psychologists worthy of empathy?

                1. Ivanka, are you serious? Please tell me where is this ‘respect’ you speak of, because it certainly hasn’t made itself apparent in the comments I am referring to?!

                  For the past 10 years (probably a bit longer), emerging Clinical Psychologists have been indoctrinated to believe that their skills are far superior to the rest of us, despite our years of experience (as several comments have pointed out) so I’m finding it a bit hard to connect with this vision of new graduates who look up to me.

                  I wholeheartedly agree that it is not right for each side to tear each other apart the way it has been happening and I do believe that we are all worthy of respect and empathy. I believe the greatest cost of this whole Medicare debacle has been the unity and integrity of our profession in this country!

                  But seriously, your comment sounds a little like the gas lighting one can expect from a narcissistic mother or friend, who when pulled up on how they are mistreating others, comes back with “how can you say that to me…now look how upset you are making me feel!”

                  1. Ha ha, well said Tia. How funny it is that the clinical clique try to point the finger when respected practitioners like Dr James Alexander and Gregory Goodluck call out the coddled Masters of “Clinical” Psychology as the Cold-Hearted Textbook Bumblers they are. Never forget that these Clinical Students are indoctrinated from the first day they start university that they are superior to all others; indeed I remember reading a terrifying report on this page about how at Clinical lectures, the attendees would scream out “Down with the generalist scum!” and “Two Tier forever!”. These “Clinical” students who are taught they are “born to rule” psychology from the Age of Eighteen cannot be reasoned with. Thank you RAPS for providing us with a forum for us to speak in our defense against such attackers – I know my donation will go a long way to keeping our profession safe.

                    1. Hi Tanya, Ivanka, J Dwyer, et al…

                      What’s funny is the extent you all (I suspect there is more than 1 person here) seem to be going, to undermine the credibility of the desire to redress the imbalance that has torn our profession in two.

                      The energy being expended in creating multiple profiles and the proliferation of ludicrous comments such as the one above, to further this agenda suggests that there are some tangible fears about the status quo being legitimately challenged.

                      How encouraging…

                    2. Hello “Tia”,

                      What is funny is that as soon as you get called out on your own repeated direct attack on Masters students “For the past 10 years (probably a bit longer), emerging Clinical Psychologists have been indoctrinated to believe that their skills are far superior to the rest of us” you desperately run around trying to point the finger, claiming no RAPS supporter would say anything so offensive and divisive and it is all the work of sabateours when both your own comment above and Dr James Alexander’s comment directly below yours (“masters in clinical psych students appear to be taught to have a sneering superior attitude to all other psychs”) proves that to be a gross misrepresentation. But yes, please keep attacking the psychology student for going along with Dr Alexander’s request to use real names below while remaining deferential to the actual clinical psychologists posting here.

                    3. Hi JD,

                      So please tell me, if I am mistaken about ‘Tanya’ being a troll and she isn’t actually in cahoots with your obvious agenda to discredit this initiative and its supporters; why have you not once said anything to ‘Tanya’ about her ridiculous comments directly aimed at Students, such as the ones above and directly below?

                      Why do you find my ONE comment about the professional landscape producing Clinical psychologists post Medicare so deeply offensive that you have to keep quoting it several times and yet you seem to take no offence to her far more offensive and persistently attacking commentary?

                    4. So “Tia”, your response to being called out for your repeated attacks on students … is to attack the same student again and ask why she is not doing more to defend herself and her fellow students. Classy. I also like how you try to brush over the fact that it was you who directed attacks against me personally by claiming I was indoctrinated into believing I was superior to all generalist psychs and claiming I was a narcissist, and are still continuing to play the victim by pretending it is students like myself who are attacking you. And to be honest, I think that the comments by Tanya, Dr James Alexander PhD, and Gregory Goodluck all fall under the same category; my question is why have you been so selectively in attacking the anti-student sentiments expressed by these posters? Is that some only have the courage to attack sock puppet accounts they themselves have created because they only have the confidence to go after students, rather then actual psychologists?

                    5. Dear JD,

                      My apologies for the gaslighting ANALOGY – didn’t mean to hit a nerve!

                    6. No offense taken “Tia”; I think everyone reading can see which psychologist with “three decades of experience” is actually using gaslighting techniques to avoid uncomfortable points raised by the students she ridiculed by claiming that they have “have been indoctrinated to believe that their skills are far superior to the rest of us…”

                2. Ivanka (how about putting your real name to your comments?)- masters in clinical psych students appear to be taught to have a sneering superior attitude to all other psychs. Just have a good look at which cohort of psychologists have been unjustly disparaged by the powers in our profession (closely mimicked by their protege) , and then offer your sympathies accordingly. It is the majority of Australia’s psychologists who have been denegrated as ‘generalists’, locked out of employment options (which they have successfully been in for years), and paid less than others- no sympathy for the genuinely downtrodden?

                  1. Well said James. The fact that every “clinical” student is indoctrinated from the first day of university thinking they are “born to rule”shows the innate insecurity of the clinical clique. That is why I make sure no “clinical” students are accepted for placements at my work, as they simply cannot be trusted not to make even simple errors and we cannot risk our clients.

                    1. With all due respect Tanya, I don’t think it is right to say that Clinical students can’t be trusted not to make simple errors or are a risk to clients. That is exceptionally inflammatory, totally counterproductive to the argument James and I have raised above, and ultimately it is simply not true!

                      We aren’t advocating that they are inferior, are are only arguing that their training ALONE does not make them superior! I am happy to acknowledge that there are several Clinicals who far surpass me in terms of knowledge and expertise, having only been registered for 10 years. But I also believe that there are Generalists who are equally worthy of professional respect and deference.

                      If you believe this movement is about denigrating our Clinical colleagues by virtue of their training, I’m afraid you’re as guilt as them of baseless discrimination.

                    2. Tia, thank you for expressing this very respectful message. It helps move the conversation away from denigrating comments which prompt strong defensive reactions and/or avoidance of major issues. Warm regards.

        2. James, im interested to know where you think minimum standards for registration should sit? Are we saying a masters is no better than supervision pathway? What about international training models of europsy, dpsych, and phd?

          1. i think minimal standards are arbitrary- if we were only informed by the research, we might suggest just basic training in counselling is going to yield similar results to training in psychology. As previously stated, i have a clear vested interest in suggesting that minimal standards should be the Australian requirements for registration as a psychologist- but it seems to me to be a reasonable boundary. Four years of academic study is more than sufficient time to learn more than the basics of human behaviour, and basic counselling skills. Two years of supervised training in the field on top of that is smart- there is nothing like hands on work in the field to sharpen up skills. The research is clear- more and more academic training at uni adds nothing to the outcomes for clients. What research over the last 50+ yrs shows does add to positive outcomes for clients are the common factors (the psychologist related factors), ie. positive regard for the client, empathy, therapeutic alliance- relationship factors; more important are the extra-therapy factors (ups and downs in the clients lives, what they choose to do out of therapy etc); our choice of approach (the research suggests) adds little to therapeutic outcomes; our belief in our approach adds more than the actual approach; and the psychologist’s ‘diagnostic’ assessment adds less than 1% of variance to the outcome. So, extensive academic training in DSM nomenclature adds almost nothing to outcomes; as does extensive academic training in CBT etc. The only factors which make a difference to clients (and which can be taught) are relatively basic- intro’s to models and ways of working. Can empathy and compassion be taught?
            Adding more years to academic repetition of the basics simply adds nothing to the outcomes for clients (which is what its all about, isnt it?). As such, i’d say the requirements for registration are more than sufficient- which is what the case was prior to endorsement areas, the elevation of ‘clinical’ psychs to Brahmin status, and the 2 tiered rebate system (and all other systems which have fallen in line). For how many years were Australian psychologists very successfully plying their trade before these great ‘innovations’? This is all about turf warfare- nothing else, and our profession has simply been hijacked by one cohort.

            1. OK- the onus is on you to show some evidence that i) psychs get better results with clients than counsellors; ii) a four year degree in psych will result in more competent therapists whose clients get better outcomes, and iii) a PhD of any kind will result in better outcomes. Without any evidence, your beliefs that psychologists should get a Medicare rebate over counsellors are just that- beliefs. Why should your beliefs result in lower pay and status for all other therapists (in the presence of the argument you yourself have handed to a Federal Government keen to slash Medicare expenses)?? Are we an evidence based science, or just another self-interested belief system? As you have argued repeatedly, we must apply the null hypothesis – there is no demonstrated difference between the efficacy of counsellors and psychologists so we must apply the same Medicare rebate to both according to your logic.

              1. yeah, so what? If the gov’t wants to fund counsellors as well, thats their business- if they dont, thats their business. If counsellors want to lodge a case, thats their business. You falsely claiming a higher status and expertise than me is my business. Those adversely affected by dishonest claims are going to take action- what do you expect? It appears that you have no argument other than raising another issue- that says a lot.

            2. Psychology is more than counselling…. This seems to have been missed by some here. Public health, mental health, forensic, neuro, etc are not well served within such a ‘minimal’ model of training ( your word not mine)

              1. yes, excellent point- quite correct. (the comment is made in the context of ‘clinical’ psych’s insistence that only they get good outcomes with clients in counselling). Thats why there is a need for diversity in training, instead of financially rewarding only 1 form of training and penalising all others with less pay and less status. We used to have diversity in post grad training- now, it has been reduced to (mostly) one form of training only which is still financially viable for unis, and for students to do. This has been inflicted by academic ‘clinical’ psychs- teachers in charge of our profession- who have gained the most by having their courses now viewed as the only ones worth doing. And Australian psychology has lost its highly competent diversity. All are now promoted and viewed as inferior, apart from the self-appointed elite.

                1. yeah, so what? If the gov’t wants to fund clinical psychologists at a higher rate as well, thats their business- if they dont, thats their business. If non-Clinicals want to lodge a case against AHPRA & the Federal Givernment thats their business. You falsely claiming that Clinical Psychologists are all cold-hearted incompetents is my business. Those adversely affected by dishonest claims are going to take action- what do you expect? It appears that you have no argument with the government that implemented these policies but prefer to attack young Masters students that have played no role in the two tier system – that says a lot.

                  1. nowhere have i made any negative comments about all ‘clin’ psychs, nor have i attacked masters students. In fact, it has only been ‘clin’ psychs who have made broad disparaging statements about all others, echoing what the APS leadership has set up.

                    1. “nowhere have i made any negative comments about all ‘clin’ psychs, nor have i attacked masters students. ”

                      “masters in clinical psych students appear to be taught to have a sneering superior attitude to all other psychs.”

                      “this little anecdote expresses well the common meaning of the term ‘clinical’, ie. cold, heartless.”

                      I think the above comments from Dr James Alexander PhD speak for themselves.

      2. My friend has a PhD in Forensic Psychology, but the APS will still not accept her as a Clinical psychologist.

          1. And it was a PhD, not a masters…. the two degrees are very different, unless it is a PhD incorporating a MPsych, there seems to be a lot of confusion amongst people about this. A PhD is a research degree, unless it incorporates professional masters training.

      3. Dear Cate,

        Just as it is dangerous for the non-clinicals to generalise about the behaviour/attitude of Clinicals, it is equally unhelpful to generalise the experiences of the other side.

        It sounds so easy when you say “choose the harder path and find a masters to do”, but I think a big factor that is being ignored and assuming we want to do that, is that generally there are just not enough places in Masters programs for the number of applicants each year. Even back when I completed my 4th year in 2002, already the demand was ridiculous and I can only imagine how much worse it has gotten since then! A maximum of 20 places for 200+ applicants means that the bulk of undergrads will be forced to choose alternate paths if they intend to pursue their chosen profession and at least for now, the 4+2 and 5+1 pathways provide this alternative.

        As far as your point about an easy ticket – I can tell you that I spent $14,000 at the time to complete my Intership. Since then I have spent an additional $18,000 in clinical supervision alone, plus ongoing professional development on top of that, which I can’t even quantify. If your argument is solely based on time and money investment, it would have been cheaper for me to complete a Masters, than to continue to invest as much as I have and continue to do, in order to ensure I am the best practitioner I can be – and sadly none of this is deemed enough. Whilst I respect my peers reluctance and valid objections to pursuing a bridging course, I personally would gladly do a bridging course, despite the fact it will still require more time and money invested, but rest assured there are definitely no free rides here!

        1. You have to earn a place in a Masters Program by getting at least a credit average in your 4th year so of course Universities are not going to let everyone in. university is based on a merit system and at post grad level, specialisations. As I have stressed before, since Universities divided Masters Programs into specialisations, Clinical is the professional program for the mentally ill, Counselling was more for general complaints, couple andfamily therapy, forensic.. judicial system etc…. but you had to get a good GPA in order to get in. This was and is the system and everyone worked within that system until Medicare was introduced. There is no way the Government is going to increase its budget to have all psychologists on the higher rebate so what will be achieved is that all psychologists will be on the lower rebate and then you will have equalisation. Is that what RAPS and AAPI want?

          1. Cate- your distinction between purposes of clinical training and counselling training is just pure nonsense. Stick with what the research evidence demonstrates. ‘Clinical’ psychs and all other actually work with the same populations, with the same problems, to the same severity, use the same interventions, and achieve the same outcomes. The only difference is the amount they are paid (it may come as a surprise to you that many ‘generalists’ also have masters degrees and PhDs- and those that dont have usually done many years of PD training- arguably, more relevant to the real world). In fact, not entirely true- the demonstrated differences between them include:- better outcomes for clients of ‘generalists’ (although not statistically significant), and the post codes of ‘clinicals’ (in the more affluent areas of Australia. If you want to utilise a medical model (DSM etc) then please confine yourselves to psychiatric settings, not private practice or counselling settings. Of course there is no way the govt will increase the pay rate; so the best option (the one that reflects both reality and justice) is to reduce ‘clinicals’ to the same rate as everyone else, and dispense with the non-sense, anti-evidence claims of superiority. Any ‘clinical’ who wants to argue their superiority is clearly delusional.

            1. Okay, it is good to have a rational debate about these issues. Obviously I am coming from the side that the Medicare rebate system and Medicare in general is based on the type of training that you’ve had Plus experience.. You are coming from the side that it’s about outcomes. I understand that and that’s where we will not be able to meet.

              I can see that the fundamental problems lay with the universities and the APS branching psychology into masters degree specialisations back before the turn of the century. If there had just been one masters degree that taught the basics for all specialisations then we would not be having this problem. Everyone who had done that masters degree would have been on the same level with Medicare.

              I did not do a masters in clinical but in counselling so when I speak of what counselling subjects contained in the areas that it prepared you for I am speaking from experience. I know what I am talking about. I then worked in psychiatric hospitals on a lower grade then clinical psychologists for many years before Medicare came into place. A couple of times before Medicare I had applied for the clinical college because I worked in a clinical setting equal to clinical psychologist. Eventually the clinical college gave me set criteria to meet in 2006 in order to become a member of that college. To which I then spent another year completing. Again before Medicare came into place and before the two tiered system. I understand that you do not know me or my background and that it is easy for you to judge me and make assumptions that I am just after a higher rebate. Medicare came in after I was accepted into the clinical college so my motives are not for financial gain. I am a very rule-based person and follow rules that is where I am coming from. The rules are you have to do a masters degree in clinical or equivalent be supervised for the next two years by a clinical psych work in a clinical related area and then you can try and apply for the college possibly having to do bridging work. I know you disagree with all of these hoops considering the level of education that you have in psychology and your experience. I just wanted to let you know that in terms of training I am speaking from experience when I tell you what the masters of counselling did and did not include or prepare me for to work in psychiatric hospitals .

              I do not believe that in stating that case, that I am not disparaging generalist psychologist ( having been one prior to Medicare ) at all but just speaking about what the rules require. I do believe the fault for all of this disparity lies with the specialisations at Masters level in the late 1990s .

              Maybe we should be agitating together in unity for one masters degree that incorporates training for every area of psychology that you want to work again.

              1. Cate- that would be a great idea, if there was any reason to believe that masters level training produces superior psychologists- but there isnt any. Academics will dispute this, simply because they have a vested interest in ensuring all psychologists do their courses. But, we again need to defer to what the research evidence shows (anything else is just pure speculation- and why should payment systems or different statuses be decided by mere speculation??). Scott Miller provides very good research based evidence on what does and what doesnt create better outcomes for clients (which is what its all about, isnt it?). More and more academic training does not improve client outcomes; model of choice does not dictate outcome (although therapist belief in their approach does have an influence); the diagnostic label applied by the psychologist does not influence outcomes. The ‘general factors’ are the most important psychologist characteristics influencing outcomes- think warmth, empathy, relationship, etc. The ironic thing is that none of that can actually be taught, either at the undergrad or masters level. Look into the research- the answers have been available for decades (why didnt they teach you that?).

              2. Hi Cate, Thankyou for your honesty when you wrote: “Obviously I am coming from the side that the Medicare rebate system and Medicare in general is based on the type of training that you’ve had Plus experience.. You are coming from the side that it’s about outcomes. I understand that and that’s where we will not be able to meet.”
                Public money should be spent on better outcomes, not self-aggrandisement of a self-branded elite. That is fact.

              1. you need to learn to cope with the facts Angelique- they may be uncomfortable for you, but they remain the facts nevertheless. Reality doesnt alter just because you may have a problem with it. If you want to refer to the highly effective work of the bulk of Australia’s psychologists as ‘the lowest common denominator’, then it appears that you have little respect for our therapeutic goal of helping those in distress. Thats what its all about. If the research showed that ‘generalist’ psychs got poorer results than ‘clin’ psychs, then sure- i’d agree with you. However, the research clearly shows the opposite (in fact, the differences in outcomes are in favour of ‘generalists’, but it isnt statistically significant). In fairness to your mob, we really must acknowledge that those with a clinical masters get as good results as those who chose 2 years of post-grad hands-on training rather than more academics (well, nearly).

          2. Wow Cate, just as John Alder mentioned below, you might want to tone down the judgements.

            Not that it matters, but if you must know, I applied for the Clinical Masters at the end of 4th year and I progressed to the Interview stage, so it’s fair to assume my GPA was not the factor. Additionally, my 4th year thesis has been published in 2 different journals, both in Australia and Overseas, so that couldn’t have hurt my chances either. The feedback the University gave me at the time was that I had been shortlisted for a place, should any of the successful applicants not take their spot and that only 16 applicants were accepted in that particular intake, of which 9 were already experienced Registered Psychologists.

            That was back in 2003, before Medicare, Endorsement and during a time when other Masters still existed – so can you imagine what the landscape looks like now; given graduates are told the only aspiration is to be a Clinical Psychologist and most non-clinical programs have disappeared, with the exception of Forensic and Organisational?

            This whole movement is about so much more than $40 per hour – it is about dismantling the growing campaign to discredit our skills and prevent the current agenda from eradicating the rest of us from the profession!

            1. Well there must have been a reason you didnt get in…. they teach about the importance of insight and self reflection in a clinical masters, but not in 4+2 by the looks of it.

              1. Well Angelique, of course there was a reason I didn’t get in, least of all which is the fact that no matter how brilliant the 50 candidates in front of you, if there are only 16 places, 34 will have to miss out and that is just the way it goes. If you took the time to read the whole thread you will notice that my reply above was to Cate’s assumption that my GPA held me back, after I pointed out that ultimately there aren’t enough places in Masters programs to accommodate the demand and it is too simplistic to tell us to ‘go do a Masters’.

                But I must say, the more I read your comments and their disparaging tone, I find myself questioning in what ways I have been disadvantaged by not having this coveted Masters? I’m pretty sure judgement and derision don’t make up our core therapeutic skills….but perhaps it’s taught alongside self-reflection skills and we’ve already established that I missed that in my training… 😉

    2. I think that some psychologists would do the clinical training purely for the extra rebate and then continue to provide the same service to their preferred sector. Which, I feel, is the basis of the problem behind the two tier system.

      1. Yes, this is the problem. Medicare rebates are for mild to moderate problems, and we only get 10 sessions to do our work. If a “generalist” psychologist does the additional training and gets the clinical endorsement they will still be seeing Medicare clients, who being Medicare clients should have mild to moderate problems. Even if we accept the premise that clinical psychologists are better trained for complex mental illness (and I understand that there is contention around this), these presentations are not supposed to be seen under Better Access, but in other settings. Rebating clinical psychologists more highly under the Better Access program lures them away from the settings that they have trained for. What will the end result be? Experienced clinical psychologists being paid highly to see mild to moderate cases in private practice, while the complex clients in psychiatric settings have their needs seen to by registrars?

  11. I dont accept the premise that we need to or should do bridging courses- to be taught what exactly? How to do what we have already been competently doing for years, by academics who have not done the work we have done? Research evidence has been clear for decades- beyond a basic level of training, more and more training does not result in more effective psychologists. (‘clinical’ psych may entail more training in psychiatric nomenclature- which research shows is completely irrelevant to therapy outcomes). The notion that 4+2 psychs need to do bridging programs is based on the non-sense that we are currently less effective than ‘clinicals’- again, an assertion not supported by the evidence.

    1. Dear Alexander,
      Why should I have to go back and do an honours degree if I want to then do a PhD as I already have a masters degree with a research component to it but that is not accepted to get into a PhD. Why do people with honours degrees have preferences to get into a PhD and I don’t? You knew that doing a PhD was a research degree and not a professional degree when you did it. You’ve made choices that haven’t worked out the way that you thought they would. For decades now a masters degree in clinical is the highest professional degree to practice in mental health. Not counselling, forensics, sport, or organisational. You could have undertaken a masters in clinical at any time. But now all you want to do is complain because clinicals get $40 an hour more than you for your clients rebate.

      Self report outcome measures done by clients who have grown attached to their therapist regardless of university training are of course going to rate the clinician favourably in terms of outcome. There is a vast difference between that type of self-report and a longitudinal study as to long-term effectiveness of treatment for clients with severe illnesses.

      1. who’s saying things havent worked out for me the way i wanted? I was interested in a research area, so did a PhD in it. The only way in which my career has not ‘worked out’ is in the fact that my profession has been hijacked by a self-appointed elite who have managed to lie their way into a financial advantage with a gullible government. That has nothing to do with my fields of study or work. Research clearly shows that beyond a basic level of training, more and more training adds nothing to client outcomes. Any assertion beyond that is in fantasy land.

      2. Dear Cate, I suggest you consider not demonstrating the prejudices to which many RAPS supporters are reacting …. ie: 1/. “For decades now a masters degree in clinical is the highest professional degree to practice in mental health. Not counselling ….” This claim is open to dispute, yet you make it without caution nor evidence. 2/. “But now all you want to do is complain because clinicals get $40 an hour more than you for your clients rebate”… Not ALL they want – nor simply because of $40 an hour greater rebate for clients. Please consider the effects of that $40 difference- on the significant reduction in diverse alternate post-graduate psychology education (of particular relevance – Counselling Psychology) AND the incentive for GPs to “host” clinical psychologists in their GP Clinics, rather than the equally (more) effective non-clinicals. Supporting this confronting claim is the Commonwealth Funded Evaluation of Medicare’s Psychological services conducted by the University of Melbourne. This respected Australia wide study included “self report outcome measures done by clients”. Further evidence of difficulties in claiming “better outcomes” of particular helping professionals or particular therapeutic techniques is presented in meta-analytic studies such as Elliott, R, & Freire, 2010, in Person-Centered and Experiential Therapies WORK.
        Cate, while I do feel for the costs, hardships and suffering YOU endured to achieve your particular qualifications, I also expect from a psychologist, more respect for your fellow professionals and the recognition of risks of making unsupported and provocative claims – which can disclose prejudice.

        1. John, what evidence could you show that disputes the claim that since Masters degrees were branched off in to specialisations that Clinical is the degree that trains you for mental illness. Counselling doesn’t in terms of subjects in pharmacology, DSM or ICD training and mental illnesses? The evidence for my claim is in the course subjects. Clinical focusses on mental illness assessment, diagnosis and treatment- prove otherwise and I’ll listen to your argument happily?

          1. Cate- where is the evidence that DSM nomenclature results in better outcomes for clients? I remember research which shows that the diagnostic system used by a psychologist has no relationship to positive outcomes (see Scot Miller). Your clinical colleagues in the UK are doing all they can to distance themselves from the medical model, DSM nomenclature, pseudo scientific psychiatric theories- and yet you and your cohort seem to be doing all you can in a desperate grasp for credibility to hang on to the medical model, presumably to increase your status? Australian ‘clinical’ psychs would do well to explore the intellectual honesty of their colleagues o/s and bring themselves up to international standards.

          2. Dear Cate, thank you for offering to consider my argument, on a proviso that I show that “Clinical Psychology [does not] focuses on mental illness assessment, diagnosis and treatment”. Similarly I expect you might want me to demonstrate that a clinical psychology masters program is NOT the highest qualification in mental illness – diagnosis and treatment. My view does not need me to contradict either of these claims for clinical psychology.
            Most importantly and sincerely, Cate, I hope that your cancer is now in remission and that you are strong and healthy. I was deeply touched by your disclosure of your cancer struggle, as my sister died last year of brain cancer. I sense that we need as many caring (mental) health professionals contributing to the challenges of living and dying as is possible.
            Returning to the main purpose of this message: Clinical psychology has a long and established history of dealing with mental illness in mental institutions. Counselling psychology’s history in USA was in Veterans rehabilitation hospitals and in Australia in schools, then community health centres dealing with mental health issues (thanks to Dr Jim Penney for documenting these histories in a volume of the Australian Psychologist).
            I am suggesting we need be cautious in slipping between “mental illness” and “mental health”. In your earlier message you (Cate) claimed that Clinical Psychology was the highest qualification in mental health, most recently you ask for a dispute about “mental illness”. There is considerable and deeply held arguments about the use and differences of these terms (indeed Dr James Alexander wrote a minor thesis on this topic more than 20 years ago). My view is that Counselling Psychology has as stronger historical roots in community based mental health practice as might Clinical Psychology (thanks to Prof James Cardno, UniTas for alerting me to the significance of the history of psychology).

            Your challenge, to me, is to Clinical Psychology training being the highest level of training for mental illness. There is no need for me to dispute this. I would dispute that Clinical Psychology training is the ONLY training at the high/est level in mental health. The APS Board has supported this in recognising that Counselling Psychologists are “experts in mental health”. Subsequently the APS Board approved Clinical Psychologists as “experts in complex mental health”. (I await the discrimination of and prominence of “complex” cases in community mental health practice – especially when Medicare’s Better Access is TREATING anxiety/depression). The argument here is that determining that a course is at the highest level does not evidence that OTHER courses or PATHWAYS are not also at the high/est level.
            This argument could now stray onto the useful distinction identified by Roger Peters in ” … Some inconvenient truths” (previously posted on RAPS website) concerning attention to Tiers based on competence compared with qualifications.

            I return to your (Cate’s) inferred claim that Clinical Psychology Masters is the highest and ONLY training in mental health/illness. The documentation and recognition of psychologists competencies by APS, APAC and PsyBA has been undertaken for more than 10 years. Approximately 12 years ago the National Executive of College of Counselling Psychologists (of which I was a member) submitted to the APS Board (standards review) their declaration of the competencies of counselling psychologists for use in university course approval and accreditation processes. BUT “many of the similarities that we do share with clinical psychology had been removed. There had been no consultation with the Counselling Psychology National Executive at the time” (correspondence from the Chair, National Executive, CCOUNP – June 2017). In view of the subsequent recognition by the APS Board of the mental health expertise of counselling psychologists, I strongly suggest that the course content of the (remaining) counselling psychology masters program does contain training at the high/est level in mental health, including assessments using DSM/ICD.

            The counselling psychology curriculum has also included the humanistic tradition. An article in press, by Dr George Wills and the work of Marsha Linehan (Dialectical Behaviour Therapy) indicates the confluence of CBT and person centered approaches to therapy. Such discovery of unity with diversity is something to aspire to.

            Cate, I consider what I have been writing is mainly a request for respect and consideration of peers, rather than an argument

            I trust the above information helps you consider the significant professional qualities of your colleagues, and you decide to remain open to their suggestions and arguments.

            1. Cate- Mullings (2010) points out “There are some good examples of research comparing clinical and counselling psychology. Brems and Johnson for instance have compared clinical and counselling psychology across a number of areas including training content (1991), publication productivity (Brems, Johnson, & Gallucci, 1996), job-related activity (Brems & Johnson, 1996) and theoretical orientation (Brems & Johnson, 1997) – finding very few practical differences. The Association of State and Provincial Psychology Boards in the US, which has overseen standards in specialist psychology since 1961 have conducted a wide-scale practice analysis in recent years, demonstrating that there are no differences between clinical and counselling psychology in terms of the settings they work, the clients they see or the psychological practices they employ.” As such, the research would appear to argue against a unique status of ‘clinical’ psychology- the majority of psychologists do the same activities in clinical settings, whether they be APS endorsed ‘clinical’ psychologists or not. Mullings, B (2010) Conscience: the critical issues in Australian Psychology.

              1. Thanks Dr Alexander, having trained in Counselling Psychology I agree there is not much difference in course I did compared to Clinical. Please do not assume that because I am explaining the specialisations at University level that I am disparaging my fellow colleagues. I have supervised generalists who were brilliant and Clinicals who were not as good. I know there are individual differences and Psychologists who have worked hard since graduating in undertaking professional development and upskilling. And, I know you will say that all that upskilling does not result in better outcomes but that is too simplistic a response. Yes, the Universities are to blame for changing the status from 4+2 model to 5th and 6 year training to be a Psychologist but once they did that it virtually tied the Governments hands in regards as to what they considered a more educated standard. This had legal implications for government agencies. That’s why the solution is not so simple.

                Counsellors have equal outcomes to generalists. generalist have equal outcomes to Clinicals. Clinicals have equal outcomes to psychiatrists. Well, the government should just keep psychiatrists under Medicare and get rid of everyone else and same millions. That’s where your rationale can head….quite a slippery slope. I respect all my colleagues … becoming a psychologists in this country is hard work with many hoops, very costly in time and money…but such a rewarding career. Enjoy your research and make a difference Doc.

                1. oh, to the contrary Cate- i think PD training in intervention approaches which are demonstrated effective is valuable, and generally results in beneficial outcomes for clients . Most PD training is offered by practitioners- those who are actually doing the work, as opposed to those who have chosen to focus their careers on teaching and research (which is what trainees usually get at uni). Grenyer’s own research clearly demonstrated that the vast majority of Aust psychs are enthusiastic and regular participants in PD training. Very few think their training is over upon graduation. Training in what works is good and useful; training in what isnt valid is useless. Useful training may or may not occur in an academic program. The only masters in clinical psych program i know in Aust that includes training in EMDR (an approach advocated by the WHO, based on its impressive evidence) is in WA (Curtain uni?). All other masters of clin psych programs are teaching CBT as the main intervention approach (which meta-analyses are demonstrating to have a decreasing rate of effectiveness as time goes on). The point of upset ‘generalists’ and the RAPS group is that there are many pathways to becoming an effective psychologist (not just one)- well, there used to be, until the vandals got hold of our profession.

    2. YEs I agree . As a general psychologist of 30 plus years experience, I am Moree effective than my friends who are qualified clinical psychologists but have only two years experience.

      1. Rubbish…..making outlandish unfounded and highly personalised claims like this does not help your argument

        1. Richard, I assume your harsh “Rubbish” is directed to Linda ….. do you believe that Cate’s claims “helped her argument” or is your outrage selective ?

          1. Richard, it is pretty obvious that a dedicated psychologist with 30 years experience and ongoing PD might be more skilled and get better outcomes (if only by better rapport building skills) than a recent graduate with 2 years experience. (on average and with large variance). Add to that that Linda is talking about her friends who probably admire her mentoring and agree with her comments and have the humility to listen to her hard won Wisdom; I contend that Linda’s contribution to the very important philosophical, ethical & theoretical debate we are engaged in is both welcome and valid. We do need more research to test these ideas and clarify the mechanisms of improved our come. we all know rapport shines strongly above other variables as a predictor of positive client outcomes. I think Linda duxs the rapport stakes and more. if we are to have meaningful conversations here I think it best not to “rubbish” people’s contributions because they don’t follow the strict code of academic research methodology . Good science allows for theory building phases and drawing on inspiration from many sources. even the “hard” sciences contribute many examples of intuitive leaps, dreams, flashes of insight as bases for theories later tested and strongly supported by other evidence gathered by tighter controlled methods.
            I am sure Linda can hold her own in an academic debate. Long Practising psychologists deal more with the real world than the academic ivory towers (both of which I love and respect) and use the knowledge paths available to them and the language and imagery that makes sense to the people they help while being informed by the data and methods of academic psychology. Linda is contributing gold in a human way which is also gold. Research should find its purpose in its relevance to lived experience. more research please.
            What say you Linda.

            1. Good luck to you Goodluck … your merger of science with lived human experience is a valuable quality in that search to understand human experience/behaviour that I favour. Thank you for expressing this re-search approach so clearly, and respectfully for Linda.

            2. Well said Gregory Goodluck. It is only the arrogance and ignorance that is taught to Clinical Masters Students that would cause them to reject the obvious truth that their two years of book learning and one day a week of observing real psychologists at a placement is naturally inferior to twenty years working “the coalface”. I can see what Linda’s friends would admire and respect her for being honest about that truth, rather then wrapping them up in the cotton wool that universities wrap their ill-prepared students in.

              1. It’s probably worthwhile for those making comments like this to update themselves on the content of all masters courses, not just clinical, as this comment disparages all postgrad training.

                1. really? Masters degrees are no longer academic, university based programs? Where is the evidence that more and more academic training produces better performing psychologists (worthy of higher pay and status)?

              2. Quick fact check re postgrad clinical training. There is little to no ‘observing’ on placements. All placements are done personally ‘at the coalface’ and usually involve a combination of practice within the university clinic (just like private practice) and 2+ external placements in settings such as inpatient / outpatient mental health or hospital settings, schools, drug and alcohol, forensic etc based on the students areas of interest. The ‘book learning’ involves attending lectures and workshops run by experts in their field (just like PD but more of it and with the added extra of having to prove that content and skill was learnt), as well as building on and putting the very basic research skills learnt in undergrad into practice within their own research project. They then move full-time into said ‘coalface’ in employment just like everyone else so I really don’t see why anyone continues this issue of clinicals being ‘bookish’ and sheltered.

                Anyone who continues with this argument is also putting down the counselling / forensic / ed & dev psychs among us which I think is a real shame.

                1. Dear Colleagues,
                  I’ve read all of these exchanges and am left reinforced in my view that psychologists are intelligent, thoughtful and sensitive. It’s just a pity that we are wasting these qualities in trying to convince each other of relative superiority. While we do it, we play into the hands of the leaders of our Society who have allowed Government financial intervention to stratify us. Of course some of us are more experienced, some more knowledgeable, some more empathic, some of us less so but we should be joining with each other in open exchanges that allow for greater development in each of us. Openness is compromised badly when we fight over relative power. I hope that we can agree that we are in a pretty dismal relational state at present and that this is a consequence of narrowness in our leadership more than anything else. It’s for these reasons that I hope we can give up arguing with each other and give our attention to ways of reconstructing our Executive so that it is a better reflection of who we are than of those good at power politics.
                  Best wishes to each of you,
                  George Wills

                  1. thank you George- well said; fully concur. However, there is only one group of psychologists who are claiming supremacy- against all the available evidence. I am well aware that not all ‘clin’ psychologists share this view, and there are many who are actually embarrassed by it. It is no doubt a cancer in our profession- the sooner it is over, the better for all of us. Thats why change in the APS leadership is desperately needed.

                    1. It’s paradoxical that the claim for supremacy in all things would define Clinical Psychologists as Generalist more than any of the rest of us. We need a differentiated system of specialisms and each to receive the same level of Medicare funding.


                    2. If one trained in a clinic via a 4 +2 Internship pathway and/or similar and works in a clinic, why aren’t we allowed to call ourselves Clinical Psychologists? Why is the term “Clinical” only the domain of those who have trained by a Clinical Masters pathway? Can anyone answer that? Could it just be something to do with Clinical Hegemony on all 3 fronts in the A.P.S, A.H.P.R.A. and University Academia? Little wonder the general public is confused between Clinical and Generalist. I see no difference, similar to the analogy: “If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.”

                    3. good question Harold- could it be that the APS and the PBA are run by academics who happen to be teaching psychology in clinical masters programs? Whose status and careers have escalated since the introduction of endorsements (note: most of these academics- who have spent most of their careers teaching and researching- have awarded themselves multiple areas of practice endorsements, often 4 or more endorsements- it is truly astonishing that they have had time, in their busy academic careers, to build expertise in clinical psych, counselling psych, forensic psych, neuro psych, etc); and the upper Medicare rebate for ‘clinicals’ (now, the bulk of post grad students want to do their programs only- very good strategy to ensure they- the clinical psych academics- are in high demand; only 1 counselling psych masters left in Australia now). And this would be fine if it was actually based on any evidence of superior outcomes for clients (which is what we are meant to be about, isnt it?)- but it clearly is not based on evidence. How long can vested interests be allowed to vandalise an entire profession? I also note, Harold, that the PBA annual survey which we are all required to fill in asks us how many ‘clinical hours’ we engage in each week. So, we can do the same work as ‘clin’ psych for many years, using the same approaches, getting slightly better outcomes (not statistically significant), with the same clinical populations, working on the same clinical problems, in the same clinics, and even have to report the amount of “clinical hours” we are engaged in to the regulating authority, but only a select few are able to refer to themselves as ‘clinical’ psychologists. It is the appropriation of a term for purely self interests (engineered by the clinical psych academics who run both the APS and the PBA). Not one client is better off for it, and the disrespect metered out to the many by the elite few demonstrates that our profession is not better off for it either. Thankfully, people like RAPS and the AAPi are trying to do something about it. Hopefully, its not too late.

                  2. yes, I am behind your statement. It is the only way to make PSYCHOLOGY grow in a worthwhile manner!

Leave a Reply