Australian Association of Psychologists Inc

True Voice of Australian Psychology

News and Updates

Latest news and updates from AAPi

The Australian Association of Psychologists Inc (AAPi) would like to comment on Interim Report from the Royal Commission into the Victorian Mental Health System Released in November 2019.

 

AAPi acknowledges and thanks the Royal Commission for the opportunity to provide feedback on behalf of our membership base. 

 

The work of this landmark commission is vitally important and AAPi acknowledges and agrees with the failures of the current system in Victoria and nationally. We commend many elements of the interim report especially the need for transformational change throughout the entirety of the mental health system.

 

The core messages AAPi would like to convey are:

  • AAPi would like to assert that there is an immediate need to cease the two-tier Medicare Rebate for psychological services. There is no evidence of greater effectiveness associated with any particular subtype of psychologist or in relation to their endorsement status. The two-tier system disadvantages clients and reduces access to psychology services. Furthermore, the community should not be expected to pay higher rebates/loadings for the services of endorsed psychologists when there is no evidence of greater outcomes or effectiveness. All psychologists should be on the one, higher rate allowing for more sessions to be bulk billed or gap payments minimised. 
  • AAPi is supportive of a collaborative, multidisciplinary model of care and thank all those working tirelessly in the field.
  • AAPi applauds the Royal Commission and the Victorian Government for the increase in funding for mental health services in Victoria and would suggest that other states and territories follow their example.
  • AAPi appreciates the opportunity to be consulted and contribute to this important work.
  • AAPi would like the Royal Commission to acknowledge the large role of Psychologists in all levels of care and service delivery.
  • As part of the ongoing Royal Commission, AAPi advocates for further peer reviewed, high quality research into the question of whether outcomes between registered psychologists and endorsed clinical psychologists differ significantly in a direction that suggests tertiary masters or doctorates in clinical psychology are correlated with better outcomes. Our hypothesis is that there is no significant difference in outcomes. Only if ethical research supports that the null hypothesis is rejected, there may be an argument for additional funding and rebates for endorsed clinical psychologists. To date no such research exists. The little which has been done supports either no difference (Pirkis et al 2011 and Jorm) and in research conducted specifically about any differences due to clinical psychology training no evidence of outcomes for clients being different was provided[1]. AAPi is strongly opposed to the two-tier Medicare Rebate for psychology, especially without clear evidence to justify this additional expenditure. 
  • AAPi supports and values the input and contribution of psychologists across the spectrum from prevention, early intervention, treatment and continuing care and acknowledges the specialised skills that psychologists contribute.
  • AAPi agrees with the commissions findings that current funding is inadequate, especially the reactive nature of input-based funding, which misses the complex nature of mental health and unmet need/demand. 
  • AAPi acknowledges the high cost of poor mental health in Victoria, estimated in this report to be 14.2 billion annually and highlight the economic benefits to increased funding and a revolutionised mental health care system. 
  • AAPi agrees that the capped 10 sessions currently offered under the Commonwealths Better Access Scheme is grossly inadequate for Psychology Treatment. AAPi supports the Productivity Commissions recommendation that this be increased to up to 20 sessions and would like to suggest that this be increased further to up to 40 sessions, similar to the new Eating Disorder Medicare Items.
  • The establishment of the Victorian Collaborative Centre for Mental Health and Wellbeing is meet with praise and AAPi looks forward to working with the collaborative.
  • AAPi would like The Royal Commission to acknowledge the important part private practice psychologists play in the mental health care of Victorians, especially where publicly accessible services are lacking and urges the Royal Commission to investigate properly funded access to psychologists in private practice, through a one-tier Medicare rebate with little to no gap payments from those requiring this service.

 

In conclusion, AAPi thanks and acknowledges the work of the Royal Commission and reiterates our commitment to further contribution to the final report in 2020.

 


[1] O’Donovan, A., Bain, J., Dyck, J.  (2005)  Does clinical psychology education enhance the clinical competence of practitioners? Journal of Professional Psychology: Research and Practice,36 (1)  APA     

Two Day Training: 21-22 Mar 2020, 9:00 am – 5pm

Melbourne VIC, Australia

Member Price: $295.00 (Normally $350)

There is a re-emerging recognition that many mental illnesses have their origins in unresolved trauma, not just PTSD and adjustment disorders. Trauma competent clinicians treat these symptomatic conditions as adaptations to adverse events and unresolved trauma memories, and seek to resolve the underlying distress rather that just control the symptoms. This enables them to deliver effective short-term treatments that create significant positive change for their clients. If we resolve the cause, the symptoms cease, as they are no longer needed. The explosion in our understanding of trauma and its impact on the brain has also led to the development of treatments that minimise or completely avoid the need for painful re-exposure and re-experiencing, making treatment a lot easier and less aversive for our clients. In short - treatment that is effective, relatively easy and brief, even for complicated conditions.

This is our level 1 practitioner training that will equip you to safely and effectively deliver brief trauma interventions to most people who are suffering from simple trauma, acute trauma, developmental trauma and multiple traumas. This training does not fully equip you to work with some complex trauma presentations where there is significant personality distortion or dissociative symptoms (level 2 does) but it provides the foundations for complex trauma work.

https://www.good-psychology.com/events 

AAPi has participated in the consultation process currently being undertaken by the NSW Government State Insurance Regulatory Authority (SIRA). On behalf of our NSW-based psychologists, we thank SIRA for the opportunity to contribute to this consultation.  We understand the aim of this process is to improve the effectiveness, efficiency, affordability and sustainability of delivering medical and allied health services to injured workers and motorists.  The AAPi would like to thank SIRA for the current use of a one rate (one tier) schedule of psychology services related fees for all psychologists. It is the clear and unequivocal stance of AAPi that this one rate or one tier system for psychology services continue. During our submission, AAPi provided an evidence backed response why the schedule of fees should be consistent for all psychologists.

Interested AAPi members can request a full copy of the submission by emailing admin@aapi.org.au

The Psychology Board of Australia website contains codes, guidelines and policies to provide guidance to psychologists.

Please visit their website here for more information.

AAPi is expanding the services we offer to our members.

Please check back soon for more details.

 

AAPi wants to support and celebrate our members. Check back soon for some of the achievements and contributions our members are making to psychology and their communities.

AAPi supports the implementation of evidence-based practice and ensuring practitioners are adequality trained and qualified to deliver services. AAPi supports the increased number of sessions available to eligible patients. AAPi supports a multi-disciplinary team approach to patient care. What the AAPi does not support is the discrimination of registered psychologists that are providing the same service for less money. The AAPi does not support the restriction of service provision to such a vulnerable population based on this discriminatory pricing strategy and the reduced ability for eligible patients to see the psychologist of their choosing due to financial restrictions. There is no evidence that endorsed ‘clinical psychologists’ provide better outcomes or are better trained than registered psychologists to justify receiving approximately 30% higher fees from Medicare.  

The basics:

  • Starting 1 November, 2019 a group of 64 new Eating Disorder MBS items will commence. 
  • These include 16 new item numbers for Psychologists.
  • Sadly, the two-tier model has again been adapted with 8 separate item numbers for eligible ‘clinical psychologists’ and 8 item numbers for eligible registered psychologists. Clients of registered psychologists are set to receive approximately 30% less for providing the same service.
  • Up to 40 sessions in a 12-month period will be available for evidence-based eating disorder psychology treatment (EDPT). These 40 sessions can be claimed by suitable trained Registered Psychologists, ‘Clinical Psychologists’, Accredited Mental Health Social Workers, Accredited Mental Health Occupational Therapists or GP’s meeting Standards Collaboration requirements.  
  • The new item numbers are focused on anorexia nervosa or patients with severe presentations of other eating disorders including bulimia nervosa, binge eating disorder and other specified feed and eating disorders (OSFED). Further information on patient eligibility criteria can be found in the more information section.
  • There will be a review of the group of items after 12 months of implementation.

Summary of item numbers

Item number

Detail

Who

Fee

82360

 

EDPT Service

Location: Consult rooms

Duration: 20-50 minutes

Registered Psychologist

$71.80

 

82361

 

EDPT Service Video Conference

Duration: 20-50 minutes

Registered Psychologist

$71.80

 

82362

 

EDPT Service

Location: other than consult rooms but not inpatient hospital

Duration: 20-50 mins

Registered Psychologist

$97.70

 

82363

 

EDPT Service

Location: Consult Rooms

Duration: at least 50 minutes

Registered Psychologist

$101.35

 

82364

 

EDPT Service

Video Conference

Duration: at least 50 minutes

Registered Psychologist

$101.35

82365

 

EDPT Service

Location: other than consult rooms but not inpatient hospital

Duration: at least 50 minutes

Registered Psychologist

$127.30

 

82366

 

EDPT Group of 6-10 patients

Location: in person

Duration: at least 60 mins

Registered Psychologist

$25.85

 

82367

 

EDPT Group of 6-10 patients

Location: Video Conference

Duration: at least 60 mins

Registered Psychologist

$25.85

82352

EDPT Service

Location: Consult rooms

Duration: 30-50 minutes

Clinical Psychologist

$101.35

 

82353

 

EDPT Service Video Conference

Duration: 30-50 minutes

Clinical Psychologist

$101.35

 

82354

 

EDPT Service

Location: other than consult rooms but not inpatient hospital

Duration: 30-50 mins

Clinical Psychologist

$126.65

 

82355

 

EDPT Service

Location: Consult Rooms

Duration: at least 50 minutes

Clinical Psychologist

$148.80

 

82356

 

EDPT Service

Video Conference

Duration: at least 50 minutes

Clinical Psychologist

$148.80

 

82357

 

EDPT Service

Location: Other than consult rooms but not inpatient hospital

Duration: at least 50 minutes

Clinical Psychologist

$174.10

 

82358

 

EDPT Group of 6-10 patients

Location: in person

Duration: at least 60 mins

Clinical Psychologist

$37.80

 

82359

 

EDPT Group of 6-10 patients

Location: Video Conference

Duration: at least 60 mins

Clinical Psychologist

$37.80

 

What is the approved evidence-based treatments and am I an eligible service provider?

The evidence-based treatments that have been approved are:

    • Family Based Treatment (FBT) for Eating Disorders
    • Adolescent Focused Therapy for Eating Disorders
    • Cognitive Behaviour Therapy for Eating Disorders (CBT-E)
    • Cognitive Behaviour Therapy for Anorexia Nervosa (CBT-AN)
    • Cognitive Behaviour Therapy for Bulimia Nervosa and Binge Eating Disorder (CBT-BN or CBT-BED)
    • Specialist Supportive Clinical Management (SSCM) for Eating Disorders
    • Maudsley Model of Anorexia Treatment in Adults (MANTRA)
    • Interpersonal Therapy (IPT) for Bulimia Nervosa and Binge Eating Disorder
    • Dialectical Behaviour Therapy (DBT) for Bulimia Nervosa and Binge Eating Disorder
    • Focal Psychodynamic Therapy for Eating Disorders

The allied mental health provider must be recognised by the Department of Human Services (DHS) as eligible to provide focussed psychological strategies. For registered psychologists this as “The person is a psychologist who is registered without limitation as a person who may provide that kind of service under the applicable law in force in that State or Territory in which the service is provided”.

It is expected that professionals will have the relevant education and training to deliver these services and meet the national core competencies for the safe and effective identification, response and treatment of eating disorders. Ongoing professional development is required. 

Flow on effects to other areas of Mental Health funding:

If the discrimination between pay rates for registered psychologists for eating disorders is allowed to continue, this will no doubt also lead to the same discrimination for the upcoming Mental Health Medicare Taskforce Review due for release in the coming months. All those working in Mental Health, not just eating disorders, should be concerned.

What the AAPi is doing:

The AAPi has met with the head of the Mental Health and Eating Disorders Medicare Review Unit as well as the Health Minister and other influential parties to advocate for our members. 

The AAPi is currently doing everything possible to challenge and stop the pay disparity and discrimination. This includes:

  • Investigating all possible legal and other avenues
  • Employment of a lobbyist to further advocate and petition for our rights and the rights of our patients
  • Extensive media campaigns
  • Partnering with other organisations/associations to increase our reach and resources.

What you can do to ensure fair and equal pay for Psychologists:

  • Join AAPi today. Now is the time that we need as many members and voices as possible in order to make the biggest impact. This is time sensitive. We need to act now. If you are not a member, we need you to join today. www.aapi.org.au
  • Ask other psychologists to join AAPi- forward this on to all the psychologists you know. Students, provisional psychologists, retired psychologists, educators, researchers. Everyone.
  • Community stakeholders and other allied health professionals are welcome to join AAPi as community members.
  • If you are an AAPi member, please ensure you are paid up for 2019-2020.

More information:

MBS Online Eating Disorders Fact Sheets

MBS Book Category 8 (Full details- Eating Disorders M16)

Eating Disorders Working Group Report

Federal Register of Legislation Health Insurance (Allied Health Services) Amendment (Eating Disorders) Determination 2019

ANZAED Mental Health and Dietetic Clinical Practice and Training Standards for the Treatment of Eating Disorders 

National Practice Standards for Eating Disorders- National Eating Disorders Collaboration

In a recent online survey conducted by the Australian Association of Psychologists inc. (AAPi) 80% of respondents were opposed to the 2 tier Medicare system, and believed that equitable rebates should be available to clients of all registered Medicare providers. 

When asked about the new Psychology Board of Australia’s (PBA) intention to distinguish between “endorsed” and “non endorsed” psychologists 76.2% of respondents believed that this represented an erosion of their qualifications. 

“On 7th June the Association wrote to the PBA seeking clarification of the status of “endorsed” and “non endorsed” psychologists” Paul Stevenson, AAPi President said. “We particularly asked for details of the transition arrangements for non APS College practitioners, and if they will be “grandfathered” into “endorsed” status. Regrettably, in its first opportunity to display some leadership for the profession the PBA let down its constituents, and not only failed to respond to our inquiry but did not even pay the Association the courtesy of acknowledging receipt of our letter” 

In a stinging rebuke of the system that results in GP’s receiving more than 50% of the Better Access Scheme’s Medicare funding for referring patients to psychologists, 86.2% of respondents indicated that GP’s should be reimbursed for referrals under their consultations funding and not from the mental health funding. 

“This survey vindicates the position of AAPi in calling for the abolition of the 2 tier Medicare scheme, and for substantially more funding being made available on an equitable basis for the treatment of psychological conditions in the most vulnerable in our community” Paul Stevenson said. 

Further endorsement of the AAPi came in the form of 84.6% of respondents wanting AAPi to promote professional development training programs, and 76.2% wanting the Association to take on a social advocacy role. The majority of respondents wanting the Association to concentrate on social issues in general.  

Half of the respondents contributed comments on a variety of issues, many referring to the over prescribing of medication; however the majority of comments could be summarised by the following contribution:- 
“Work towards gaining the acknowledgement of relevant bodies (e.g., Medicare) that psychologists who do not have a 'clinical masters' have relevant experience, that the professional development they have completed over the years is relevant study, and that there is no evidence that the clinical masters programmes run by universities provide better skilled aspiring psychologists than other legitimate avenues. It could be that those with a 'clinical masters' are less competent at the completion of their masters than those who have taken the 4 + 2 route, currently we don't know. It is very doubtful that a recent clinical master's graduate is more competent than an experienced 'generalist' psychologist, whatever route they have taken to attain their registration.” 

Author Paul J Stevenson OAM, President AAPi
 

New Board Members to be announced soon.