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‘The world is a book, and those who do not travel read only one page’: Augustine (354–430 AD). The written history of mental philosophy and psychology spans some 2,500 years but oral wisdom from the original inhabitants spans many more thousands of years. From the works and learning of those who have gone before us we derive the benefit of taking different perspectives on thoughts and feelings, understanding individual differences and diversity, and how our life experiences play such an important role in the creation of a secure and creative individual.
Travel and learning from different people and cultures deepens our understanding of not only what is different, but also what is the same. Shirley MacLaine wrote in her book Don't fall off the Mountain, ‘The more I travelled the more I realized that fear makes strangers of people who should be friends.’
Psychologists have a powerful role to play in communities. We use our learning to help others understand conflict and discord, use communication skills to heal wounds, and advocate for human rights and equality of political and civil standing.
One of the impediments to the internationalisation of psychology is the difficulty of ensuring mobility of qualifications across jurisdictions. Each country has different rules and regulations governing the practice of psychology, and as a consequence it is often difficult to move practice from one country to another.
A year ago, (Connections Issue 13, April 2015), I wrote about psychologist competence and training reform so as to internationalise Australian qualifications. In December 2015, the Psychology Board of Australia (the Board) worked with major psychology groups and leaders to host a national summit in Canberra, which focused on reviewing the psychology education and training model (Communiqué, 18 December 2015). In order to promote discussion at the summit the Board released a green paper on training reform.
In 2016 there will be an opportunity to examine the fruits of this work. In May we will have the opportunity to view and comment on new draft standards for accrediting university programs, which have been developed by the Australian Psychology Accreditation Council (APAC). In June the Board will be introducing a simpler one-stop shop process for assessing overseas qualified applicants for registration in Australia, and in July we will move closer to having international agreement on the core competencies for psychologists being considered at the International Congress of Psychology. The Board will also participate in an Asia-Pacific Leadership Forum with the International Union of Psychological Science while at the congress.
The Board recently signed a new three-year memorandum of understanding with the New Zealand Psychologists Board, underscoring the mutual recognition of registration and mobility between our two countries. The Board's new international qualifications assessment will create opportunities to forge mutual recognition agreements with regulators across the globe. The goal will be for Australian qualifications to be recognised so that travel might not only expand one's horizons as a tourist, but also provide the opportunity to practise psychology overseas.
Professor Brin Grenyer Chair, Psychology Board of Australia
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The South Australian Health Practitioners Tribunal (the Tribunal) has found a formerly registered psychologist, Mr Douglas Knuckey, guilty of professional misconduct and permanently prohibited him from practising as a psychologist.
The misconduct occurred during the course of Mr Knuckey’s employment as the Chief Psychologist at South Australian Police.
In October 2010 Mr Knuckey began treating a serving police officer. Between March 2011 and March 2012, he engaged in an intimate and personal relationship with his patient contrary to clause C.4.3 of the Australian Psychological Society Code of Ethics.
In October and December 2011, Mr Knuckey helped the patient deliver her two children into the custody of her violent, estranged ex-husband for his access to them when Mr Knuckey knew (or reasonably should have known) that doing so may not be safe and was against the best interests of his patient and her children.
In April 2012 the Psychology Board of Australia took immediate action by accepting an undertaking from Mr Knuckey that he would not practise as a psychologist. He subsequently surrendered his registration as a psychologist in February 2015.
The Tribunal found that Mr Knuckey’s behaviour constituted professional misconduct within the meaning of the Health Practitioner Regulation National Law (South Australia) Act 2010 and, accordingly, the Tribunal:
The orders are published on the Tribunal’s website.
This recent NSW decision concerning a pharmacist highlights issues in mandatory reporting that psychologists need to be aware of. The Tribunal set out their observations in relation to the mandatory reporting obligations. The matter concerned a pharmacist who was found to have a drug dependency impairment and the Tribunal considered that the failure of his treating practitioners to make a notification concerning his condition and conduct (although those practitioners were not singled out for criticism) was indicative of a failure to understand, or properly implement, the mandatory notification provisions in the National Law.
The Tribunal stated:
148. Some commentators have expressed concern about treating practitioners notifying their own patients on the basis that this may inhibit impaired health practitioners from seeking treatment. The very low proportion of mandatory notifications made by treating practitioners since the inception of the National Law suggests that many doctors may feel the same way. 149. However this case surely stands as proof of the reverse; in that a failure to notify actually inhibited this impaired practitioner from being provided the supervision, monitoring, and treatment that could have helped him, and may even have prevented the events that ultimately led to these disciplinary proceedings. 150. We suggest that the ‘code of silence’ prevailed in this instance, to the detriment of both the public’s safety and the practitioner’s health and professional standing.
148. Some commentators have expressed concern about treating practitioners notifying their own patients on the basis that this may inhibit impaired health practitioners from seeking treatment. The very low proportion of mandatory notifications made by treating practitioners since the inception of the National Law suggests that many doctors may feel the same way.
149. However this case surely stands as proof of the reverse; in that a failure to notify actually inhibited this impaired practitioner from being provided the supervision, monitoring, and treatment that could have helped him, and may even have prevented the events that ultimately led to these disciplinary proceedings.
150. We suggest that the ‘code of silence’ prevailed in this instance, to the detriment of both the public’s safety and the practitioner’s health and professional standing.
The importance of practitioners making mandatory notifications was also the subject of comment in Hocking v Medical Board of Australia & Anor [2014] ACTSC 48 in which the Court noted that the mandatory reporting provisions are in part designed:
‘to ensure that practitioners do not adhere to a code of silence in relation to significant misconduct by other practitioners. The provision gives effect to the s 3(2)(a) objective of protection of the public.’
From 1 June 2016 the Board will streamline the application process for overseas qualified applicants1 by overseeing the assessment of their knowledge and skills as part of their application for registration in Australia.
Since the start of the National Registration and Accreditation Scheme (the National Scheme), overseas qualification assessment has been a two-step process for psychology.
To date, the Board has asked overseas qualified applicants to have their qualifications assessed by the Australian Psychological Society (APS) – the national assessing authority for the purpose of migration – before applying for registration in Australia.
The Board then considered the APS qualification assessment outcome, along with other relevant evidence, to determine whether the qualifications and training are substantially equivalent to those required for registration in Australia.
This two-step process has helped to maintain standards of qualifications assessment during the first five years of national registration.
Over the past few years, the Board has been working towards streamlining the application process for overseas qualified applicants in line with its functions under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).
Since 2013, overseas qualified applicants have been required to pass the National Psychology Exam and complete at least three months of supervised practice in the transitional program.
On 1 June 2016, the final step towards a streamlined application process will come into effect. The assessment of the knowledge and skills of overseas qualified applicants will be carried out as part of an application for registration, administered by the Australia Health Practitioner Regulation Agency (AHPRA) with oversight by the Board.
See the Board’s website for further details on each component of the pathway.
To support the transition, the Board has established a new qualification assessment framework setting clear expectations about the educational standards to be met by all overseas applicants for registration, regardless of where the study was completed.
The framework is consistent with the requirements of the National Law and informs decisions about two parts of the overseas application:
This critical information helps the Board decide if an overseas qualified applicant is suitably qualified and competent to provide safe care to the public.
The Board will continue to benchmark its assessment framework against international best practice in recognition that assessment and comparison of overseas qualifications continues to evolve internationally.
The Board appreciates the work of the APS during the first five years of national registration in maintaining standards of qualifications assessments.
The APS has been assessing psychology applications for registration since the early 1990s, and in 1997 was appointed by the Commonwealth Government as the assessing authority for applications under the general skilled migration categories for psychology – see the APS website for further details.
The Board’s transition to overseeing the assessment of overseas qualifications for registration will not change the APS’s role in assessing qualifications in psychology for the purpose of migration.
The Policy for overseas qualified applicants for registration will be retired when the overseas qualifications assessment framework comes into effect on 1 June 2016.
The Board proposes that the information on the transitional program be presented as a guideline, and in accordance with its obligations under the National Law will carry out wide-ranging consultation, including public consultation, on this proposal during 2016.
In the meantime, information on the transitional program will be available on the Board website to supplement the main requirements included in the general registration standard.
There is no change to registration for psychologists with registration in New Zealand, who apply under the Trans-Tasman Mutual Recognition Arrangement.
1Function under s35(1)(e) of the Health Practitioner National Law Act 2009, as in force in each state and territory (the National Law) to oversee the assessment of the knowledge and skills of overseas qualified applicants.
The Guidelines for the National Psychology Exam (the Guidelines) have been updated and the new version is now available on the Board’s website.
The Guidelines were updated as a result of the Board’s recent Consultation on ending the higher degree exemption from sitting the National Psychology Exam (Consultation paper 25).
As announced in the December 2015 communiqué, the Board has agreed to keep the higher degree exemption in place for another three years – until 30 June 2019. The updates to the Guidelines reflect the decision that applicants for registration who have completed an APAC-accredited higher degree program will not be required to pass the National Psychology Exam for general registration over the next three years. The FAQ have also been updated to note this extension.
Affected psychologists are encouraged to review the changes on the National Psychology Exam section on the Board’s website.
The Board has published the Policy and procedure for candidates who fail the exam three times, and an associated Statement and plan for professional development (SPPD-76 form).
This policy will assist the small number of registrants who fail the exam three times to understand in more detail what options are available to them, the steps they should take, and the evidence required by the Board to progress their plan to successfully re-sit the exam beyond three attempts.
The Guidelines for the National Psychology Examination (the Guidelines) state that candidates who fail the exam are permitted to re-sit the examination after completing a further three months of supervised practice as a registered psychologist or provisional psychologist. If a registrant fails three times, they will not be able to sit another examination until their registration renewal or a new application for registration is approved by the Board.
The guidelines have been updated to include the addition of this new policy.
The Board’s revised General registration standard came into effect on 2 May 2016 and the current standard, which has been in place since 1 July 2010, has been retired.
The revised standard will apply to all applications for general registration from 2 May 2016.
The revisions primarily improve the structure and update the terminology to explain existing requirements more clearly, and align the standard more closely with the requirements under the National Law,
The revisions do not introduce any new requirements for general registration. All current pathways to general registration – including accredited higher degree programs, internships, and transitional programs for overseas-qualified applicants – will continue to be recognised and meet the standard.
Current provisional psychologists applying for general registration after 2 May 2016 are advised to review the revised standard to confirm that they will meet all the requirements before applying for registration. The Board has published information about the revised standard, an advance copy of the revised standard was published on 15 February 2016.
On 24 March 2016 further information was published, including FAQ and fact sheets on transition arrangements for 4+2 and 5+1 interns who will be applying for general registration after the revised standard comes into effect.
The Board has also published a revised version of its Policy for higher degree students applying for general registration. This policy allows doctoral candidates to apply for general registration when they have completed the equivalent of a fifth- and sixth-year qualification (e.g. a two-year Masters), before completing their doctoral thesis.
The updated version of the policy, which started on 2 May 2016, does not make any changes to the requirements or the process of applying for early general registration. The updates are to terminology and references to sections of the revised General registration standard to ensure continued alignment between the two documents when the revised standard comes into effect.
The Board completed public consultation on a review of the Provisional registration standard together with a review of the guidelines for the 4+2 internship program in February 2015.
As reported in previous editions of Connections, the project was delayed after public consultation to allow the Board to work through issues raised by government about the proposed revisions to the standard. The work to address government concerns continued throughout 2015. This work has now been completed and the Board is seeking ministerial approval of the proposed revised provisional registration standard.
If the proposed revised provisional registration standard is approved by health ministers, the Board will implement a revised guideline for the 4+2 internship program at the same time as the revised standard.
The Board will continue to publish updates as they become available. If a proposed revised standard is approved by ministers, the Board will publish the revised standard, revised 4+2 guidelines and other information, including transition arrangements, before the revised standard comes into effect.
Current interns are also reminded that there are transition provisions currently published on the website for 4+2 and 5+1 interns who will be applying for general registration after the revised general registration standard starts on 2 May 2016.
The Board is undertaking a scheduled review of the Area of practice endorsements registration standard and the supporting guidelines on area of practice endorsements.
Public consultation on the standard and guidelines has recently been completed and the Board thanks all registrants and stakeholders who took the time to provide a submission.
The submissions are being reviewed and will be published (except those made in confidence) under Past consultations on the website soon.
A new supervisor services portal is now available for Board-approved supervisors.
If you have general registration and Board approval to provide supervision you can now:
Supervisor services are available via the online practitioner login, which can be accessed by clicking the login button at the top of all pages on the AHPRA and Board websites. You will need your 10-digit ID number (this is different to your registration number) and password. If you don’t know your ID number or password you can get it by contacting the AHPRA customer service team.
When you log in, the new services appear under Supervisor services > Supervisor information in the menu on the left of the screen.
There are health practitioners with a history of substance misuse who have restrictions placed on their registration. These restrictions are generally designed to keep the public safe while the practitioner remains in practice.
When restrictions are placed on a health practitioner’s registration, AHPRA monitors the practitioner to make sure they are complying with the restrictions. This process is referred to as ‘monitoring and compliance’.
From November 2015, all health practitioners who have restrictions placed on their registration by their National Board as a result of past substance misuse will have routine quarterly hair testing, in addition to random urine testing. Routine hair testing provides additional information about the use of a wide range of drugs, over a longer time period. It therefore provides greater assurance to the Board that the practitioner is not impaired as a result of ongoing substance misuse.
The introduction of routine hair testing is based on expert advice about modern drug screening methods. Using contemporary scientific evidence and the advice of an expert panel, National Boards and AHPRA will manage the risk associated with practitioners with a history of substance misuse.
For more information, see the news item on AHPRA’s website.
AHPRA has recently launched a new video (with an accompanying infographic) explaining the Australia-wide scheme that is in place to protect members of the public.
Aimed mainly at the community, the video outlines how AHPRA, working in partnership with the 14 National Boards, helps regulate Australia’s 630,000-plus registered health practitioners through a national scheme.
The video explains how the National Scheme works and how patients are protected.
Both resources are available on the What we do page of the AHPRA website. The video can also be watched on AHPRA’s YouTube channel.
AHPRA has published a news item that outlines employers’ obligations.
The campaign will be rolled out in stages and has three target audiences and objectives:
More information is available in the AHPRA news item.
State and territory summaries of the annual report are now available on the AHPRA website. The summaries provide a view of national data about our work to keep the public safe through a state or territory lens. We provide national comparisons to show how the state or territory compares with the national average and where possible, we provide two years of data, to identify and track trends over time. More comprehensive data are in the 2014/15 annual report of AHPRA and the National Boards which was published in November 2015. The annual report also includes more detailed profession-specific information. The 14 National Boards have also published individual profession profiles. To read the psychology profession profile go to the Board’s website.
From time to time the National Boards are asked to publicise important public health messages for health practitioners. The Queensland Coroner’s recent report into the death of a four-year-old girl, who died after swallowing a two-centimetre button battery, has highlighted the need for health practitioners to be aware of the dangers these products present to patients if ingested, and to be better equipped to handle suspected cases.
When swallowed, lithium button batteries (also known as ‘disc batteries’) can become lodged in the oesophagus and the residual charge can cause electrolysis. This burns through tissue causing severe, irreversible damage.
Recognising battery ingestion can be difficult if the ingestion is not witnessed, as the child may present with non-specific symptoms such as poor feeding, irritability, fever, vomiting, drooling or cough. The ingestion of disc batteries requires urgent intervention.
Further information is available from the ACCC or advice can be obtained by ringing the Poisons Information Centre in Australia on 13 11 26.