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Regulating the profession of psychology: some reflections on the past and future
After nearly 10 years as Foundation Chair of the Psychology Board of Australia my term is concluding so this is my final message. It has been remarked that 'the only reason psychology is regulated is because psychologists are dangerous’. Indeed, Parliament first passed laws to regulate psychology in Australia over 50 years ago, in 1965 in Victoria, one year before the Australian Psychological Society was founded. These laws serve to protect the title 'psychologist' and restrict its use to those who are registered and thus meet and maintain the standards of the profession.
Psychology regulation became national in 2010, with the formation of the Psychology Board of Australia (the Board), supported by AHPRA, with powers to protect the public by setting national standards for the profession, and taking action in response to complaints about professional misconduct. A good way to learn about what the Board does is to read our annual report:
I was first introduced to the work of psychology regulation in 2002 when a colleague told me ‘there is a vacancy on the NSW Psychologists Registration Board and you should apply’. The application process was very much like any other role – a form was completed, referees nominated and a CV attached, with appointment by the Minister for Health. Working over the past 16 years for the Board within the National Registration and Accreditation Scheme (the National Scheme) has been at times stressful, but also enormously satisfying, and it has been a privilege to work alongside you as a professional colleague.
I strongly encourage you to consider the future of psychology and contribute to work of the Board and National Scheme. There are 48 Psychology Board of Australia members – 12 on the National Board and nine each across four state and territory regional boards. There are many other roles, for example on the National Psychology Examination Committee, the NSW Psychology Council, in AHPRA, on the Australian Psychology Accreditation Council, as a member of panels or tribunals, or as a peer reviewer. There are supervisor trainers, and many thousands of Board-approved supervisors, who every day are ensuring standards are upheld and the public has access to quality psychology services.
I would personally like to thank all my colleagues on the Board and AHPRA and everyone who has contributed to the National Scheme, and also to those in government, universities, employers, professional societies and associations, individual psychologists, consumer representatives and other interested people who have worked together to ensure the public has access to safe, high quality and effective psychology services.
Professor Brin Grenyer Chair, Psychology Board of Australia
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The Board has a current vacancy for a practitioner member on the Queensland Regional Board of the Psychology Board of Australia. Please visit the Board member recruitment page for further information on the position and details on how to apply.
Board-approved supervisors (BAS) must complete refresher training every five years to maintain their BAS status. Supervisors approved before the national supervisor training requirements took effect in July 2013 were given till 30 June 2018 to complete refresher training and supply evidence to the Board.
The Board was pleased to see that most of the 2013 cohort of supervisors attended a one-day master class or two-day full training workshop and sought BAS renewal in time, with 2,890 supervisors removed from the list of approved supervisors (28 per cent of all supervisors).
The Board had anticipated that many of the 2013 cohort of supervisors would not renew their BAS status after a 2016 survey revealed that two-thirds of Board-approved supervisors were not currently supervising someone in an internship, higher degree or registrar program. The higher than expected renewal rate shows many experienced psychologists are engaged in strengthening the profession through the effective supervision of new and developing psychologists. In addition, the number of psychologists becoming a Board-approved supervisor is growing at a faster rate than the number of psychologists entering the profession (5.5 per cent versus 4.3 per cent).
Supervisors who have allowed their Board approval to lapse can continue to provide supervision; however, that supervision will not count toward supervised practice requirements in Board-approved programs (including internships, higher degrees, registrar programs, transitional programs, and re-entry programs). BAS status can be reinstated by applying to the Board after completing a full supervisor training program.
It is not necessary to hold BAS status to provide peer supervision (such as for CPD purposes), supervision as a line manager, or supervision of a research dissertation.
Advice for provisional registrants and registrars
Your supervisor is responsible for notifying you of any changes to their BAS status. You can confirm your supervisor’s BAS status by searching for their name on the Board’s list of approved supervisors. If your supervisor’s name does not appear on the list of supervisors, you should discuss your arrangements with your supervisor.
Supervisors who are no longer Board-approved can continue to supervise your practice, but that supervision will not count toward your supervised practice requirements in your internship, higher degree or registrar program.
The Board’s new Guidelines for supervisors and Guidelines for supervisor training providers took effect on 1 August 2018. Supervisors should familiarise themselves with the new guidelines.
The Board has refreshed and simplified the guidelines, including reducing the number of supervisor approval categories to just ‘Board-approved supervisor’ and ‘Registrar program principal supervisor’. Approval in the first category will allow you to supervise all Board-approved programs, including 4+2 and 5+1 internships, higher degrees, transitional programs, re-entry programs, and registrar programs as a secondary supervisor. The new guidelines will now require all new supervisors to hold general registration for three years before seeking Board approval as a supervisor.
The Board has published a fact sheet which summarises and explains the changes and how they will affect current supervisors. Higher degree supervisors should review the fact sheet for more information on area of practice endorsement requirements under the new guidelines.
Psychologists currently completing supervisor training
If you started a full training program before 1 August 2018 (under the old supervisor guidelines), transition arrangements apply. Under these arrangements you can apply to become a supervisor once you have completed the training, provided you have held general registration for at least two years at the time you submit your application. The fact sheet has more information on these transition arrangements.
In May 2018 the Board hosted a webinar and public forum for psychologists and interns to hear more and ask questions about the proposal to retire the 4+2 internship to registration. The Board was pleased to have 470 participants log in to the webinar and 71 attend the forum in Sydney.
Participants raised many important questions about the proposed future date for transition, about how many 4+2 interns work in regional and rural areas, about the availability of fifth year courses, and about how supervisors can prepare to supervise 5+1 interns. Participants submitted over 150 questions during the webinar and presenters sought to address key themes in the time available. The Board collated frequently asked questions from the events and published its responses along with a copy of the presentation on its Professional practice issues webpage.
The public consultation on the Board’s proposal was open for nine weeks between 29 May and 1 June 2018. The Board is carefully considering the feedback received during the consultation process. The next steps are to finalise the proposal so that it can be presented to Health Ministers.
The new national psychology exam curriculum came into effect on 1 August 2018. The Board released an advance copy of the curriculum in January 2018, allowing a six-month transition for exam candidates and their supervisors to become familiar with the new requirements. The first national psychology exam that will be based on the new requirements will be the August sitting of the exam (3-24 August 2018).
Why is there a new curriculum?
The Board reviewed the national psychology exam curriculum between 2015 and 2017 to align the curriculum with changes in the profession since 2012, including the new APAC standards and the new International declaration of core competencies in professional psychology (the declaration).
Submissions to the Board’s Public consultation paper 28: National psychology examination curriculum review (CP28) are published on the Board’s website. The national psychology exam curriculum was first approved by the Board in March 2012. This was the first review of the curriculum.
What’s changed?
The main changes as a result of the consultation include the following:
The new curriculum is available at the National psychology exam section on the Board’s website.
The Board will soon invite applications from experienced psychologists seeking appointment to the National Psychology Examination Committee (the NPE Committee). The term of office of the current committee will end in December 2018, with new appointments expected to start in January 2019.
The functions of the NPE Committee are to develop the national psychology examination multiple-choice questions and to contribute to policy and curriculum frameworks and the development of resources (such as the reading list).
Committee appointments are made by the Board, under the National Law. The committee consists of nine senior members of the psychology profession and includes both members of the Board and members appointed through an expression of interest process. Committee members are psychologists with different areas of practice, including practitioners, academics and private and public sector psychologists.
The Board will soon be seeking applications to join the committee from members of the psychology profession who have experience and knowledge in the core competencies required for general registration in the profession, including experience in training, teaching, and assessment of professional competencies.
Expertise is required in the following areas:
The expression of interest process will be advertised on the Board’s vacancies webpage in the last quarter of 2018. Please email [email protected] if you would like to be notified when the expression of interest process opens.
This article was our most read item in the March 2018 edition of Connections – and one of our most popular articles to date. We have included it again for those who missed it previously. You may also like to share it with colleagues.
As a registered psychologist it is important that you accurately describe your registration status, and the entity you are registered with, to ensure the information you provide to the public is accurate and not misleading.
As a psychologist, you are registered with the Psychology Board of Australia; therefore if you are describing your registration status, you can refer to being ‘registered with the Psychology Board of Australia’.
The Australian Health Practitioner Regulation Agency (AHPRA) provides support and administrative functions to enable psychologists to register with the Psychology Board. It is therefore not correct to refer to your registration as being ‘registered with AHPRA’.
Remember that since the National Law was established in 2009, the state-based boards ceased to exist and were replaced by the National Board. Therefore, it is important that you no longer refer to your registration with a state-based board. For example you should not make reference to being ‘registered with the Victorian Psychologists Board’.
The Board is the entity that regulates the profession and so it is not accurate to refer to your registration as membership. Registration is different to belonging to a professional association or group. For example, you can refer to being a member of the Australian Psychological Society or the Australian Clinical Psychology Association.
The Australian Department of Health is a department of the Australian Government and is charged with responsibility for delivering a range of welfare, public aid and other health services to the people of Australia – but it does not regulate the profession – so you should not claim that you are registered by the Department of Health.
Here is a quick reference guide (not exhaustive):
We encourage you to regularly review your advertising materials and other documents such as email signatures and resumés to ensure these documents and materials accurately reflect your registration status and memberships.
AHPRA has issued more guidance for advertisers to make it clearer that selectively editing reviews is not acceptable.
Under the National Law1, testimonials about clinical care are not permitted, but reviews about non-clinical aspects of care are allowed.
In a recent case, an advertiser removed all negative comments from patients’ reviews. This selective editing changed the meaning of the reviews and had the potential to mislead the public. AHPRA’s new guidance makes it clear this is not acceptable and outlines the rules about editing or moderating reviews. It is misleading to:
Reviews influence consumers healthcare choices so advertisers must make sure reviews are genuine and not misleading.
The way advertisers moderate and publish reviews must comply with the National Law and the Australian Consumer Law.
The updated testimonial tool is available in the Advertising resources section on the AHPRA website.
For more information, access the Advertising resources on the AHPRA website.
1The Health Practitioner Regulation National Law, as in force in each state and territory.
A landmark commitment was launched recently to help achieve equity in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians to close the gap by 2031.
Launched on Thursday 5 July, the National Registration and Accreditation Scheme Statement of Intent is signed by 37 health organisations, including leading Aboriginal and Torres Strait Islander health organisations and entities working to implement Australia’s regulation scheme for health practitioners; AHPRA, all National Boards and all accreditation authorities.
The work to develop the Statement of Intent and its associated work is being led by the National Scheme Aboriginal and Torres Strait Islander Health Strategy Group and coordinated by AHPRA on behalf of the National Scheme. It has been developed in close partnership with a range of Aboriginal and Torres Strait Islander organisations and experts.
The group shares a commitment to ensuring that Aboriginal and Torres Strait Islander Peoples have access to health services that are culturally safe and free from racism so that they can enjoy a healthy life, equal to that of other Australians, enriched by a strong living culture, dignity and justice.
To help achieve this, the group is focusing on:
AHPRA and the National Boards also launched our first Reconciliation Action Plan (RAP). The RAP is an important formal statement of our commitment to work in partnership with Aboriginal and Torres Strait Islander Peoples to achieve patient safety for all Australians.
Patient safety for Aboriginal and Torres Strait Islander Peoples is the norm. We recognise that:
The National Scheme is uniquely placed in being able to directly contribute to, and significantly influence, real change to improve patient safety for Aboriginal and Torres Strait Islander Peoples in Australia’s health system. This is also true for all of us working within the Scheme, including AHPRA, the 15 National Boards and accreditation authorities.
This RAP outlines what AHPRA will do to start addressing the imbalance in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians.
You can read more about the Statement of Intent and the RAP on the AHPRA website.
In January, National Boards and AHPRA published a research framework to help transform health practitioner regulation to improve patient safety.
A research framework for the National Scheme: Optimising our investment in research sets out the research priorities and principles for National Boards and AHPRA to focus their research efforts.
The framework includes the priority research areas of: defining harms and risks related to the practice of regulated health professions, regulatory taxonomy or classification scheme, risk factors for complaints and/or poor practitioner performance, evidence for standards, codes and/or guidelines, evaluating regulatory interventions, stakeholder satisfaction and engagement, work readiness and workforce capacity and distribution.
It has been published to provide a solid base to facilitate risk-based research and evaluation activities, with a clear focus on translating the outcomes of research into initiatives that will inform regulatory policy development and decision-making to maximise the public benefit.
New independent research commissioned by AHPRA has looked internationally at vexatious complaints, finding these are very rare and that there is
The report found that the number of vexatious complaints dealt with in Australia and internationally is very small, less than one per cent, but they have a big effect on everyone involved. The research also confirms that the risk of someone not reporting their concerns is greater than if the complaint turns out to be vexatious.
Most of Australia’s 700,000 registered health practitioners provide great care, but patients also have the right to make a complaint when things don’t go so well.
The best available evidence suggests that truly vexatious complaints are very rare, and that under-reporting of well-founded concerns is likely a far greater problem.
There is a common misconception that a complaint must have been vexatious if it resulted in no regulatory action. However, a decision by a National Board not to take regulatory action does not mean that the complaint was unfounded or made in bad faith. For example, a risk to the public may have been adequately addressed between the time the complaint was made and when the investigation concluded.
The report will be used to inform best practice for reducing, identifying, and managing vexatious complaints and helps to identify opportunities to work with others to help reduce their frequency and adverse consequences.
The report is available on the AHPRA website under Published research.
AHPRA and the National Boards have welcomed the 700,000th health practitioner to be registered in Australia since the start of national regulation in 2010, Victoria-based enrolled nurse Alison Tregeagle.
Ms Tregeagle graduated in March 2018 as a mature-aged nursing graduate. Her registration with the Nursing and Midwifery Board of Australia was confirmed and published this month on the national Register of practitioners. While Alison was studying for her Diploma in Nursing, she was working in part-time and casual jobs at an aged care facility, a hospital and a pharmacy and is excited about embarking on her new career as an enrolled nurse.
Reaching the 700,000th registered practitioner milestone comes almost eight years after the launch of the National Scheme on 1 July 2010, when AHPRA and the National Boards for 10 health professions began their regulatory partnership governed by a nationally consistent National Law.
In 2010, the registration of over half a million health practitioners transferred to the new National Scheme, with a further four health professions joining in 2012 and growing the number of registered health practitioners to more than 590,000 for the year to 30 June 2013. This year the number will grow further as paramedics join the National Scheme in late 2018.
AHPRA’s first annual report showed there were slightly more than 530,000 registered health practitioners across Australia as at 30 June 2011 so hitting 700,000 represents significant growth over that time. It demonstrates that regulation is enabling the growth and mobility of a registered health workforce to support the delivery of health services to Australians.
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