The Australian Association of Psychologists Inc (AAPi) is a values-driven national professional peak body for psychologists that aims to preserve the rich diversity of psychological practice in Australia.
The AAPi is a not-for-profit peak body started in 2010 by a group of passionate grassroots psychologists. The AAPi was borne out of their desire to offer a professional body that represents the interests of all psychologists and preserve the diversity of psychology in Australia. Our primary goal is to address inequality in the profession and represent all psychologists and their clients equally to government and funding bodies.
The core values of the AAPi are Democracy, Diversity and Unity.
Our primary mission is to lobby for equitable access for the Australian public to professional psychological services funded under the current Medicare Better Access Scheme. This will be achieved by eliminating the two-tiered Medicare rebate structure, in favour of one-tier. The AAPi recognises that the inequity of the two-tier system has also become apparent in other spheres (i.e. Centrelink, DVA, private health funds).
History of Psychology in Australia
According to the Australian Health Practitioner Regulation Agency (AHPRA) as of July 2018 there were 36 376 registered psychologists in Australia. Over the past ten years, there has been an increase in representative bodies distinguishing between psychologists with a ‘clinical’ endorsement and other psychologists. This has resulted in a now-commonly held misconception that one small group who make up only 24% of all psychologists, hold greater qualifications, expertise and competency than the remaining 76% of their colleagues.
The Psychology Board of Australia (PsyBA) requires all psychologists to meet strict qualifications, training competencies and professional development requirements to maintain registration. All psychologists in Australia must hold full registration. Once registered, some psychologists choose to apply to the PsyBA for endorsement in one or more of nine endorsement areas, one of which is 'clinical' endorsement. However, this endorsement does not equate to a medical specialisation.
Two-Tiers and Medicare
The two-tiered system was introduced by a well-intended Howard government that sought the advice of the Australian Psychological Society (APS). The APS ill-advised the government that psychologists could be distinguished by their membership of APS colleges, which until that time were viewed as interest groups.
The APS advocated to the government for the inclusion of their 'clinical' psychologists in the Better Access Scheme. Several Freedom of Information documents have confirmed what had been submitted to the government officials. In a Senate inquiry into psychology, the APS continued to advocate for the two-tiered system. The AAPi sees the two-tier system as fundamentally divisive. The bulk of the APS membership seem to have been disadvantaged and disenfranchised by this false dichotomy as most do not have a clinical endorsement. Furthermore, there is simply no research evidence in support of this differential pay and status.
The 2011 Better Access program review clearly demonstrated that there is no difference in outcomes for clients of registered psychologists when compared with clients of clinical psychologists. The AAPi believe that in the absence of any data supporting such a difference between psychologists, there is no justification for a pay or status differential.
The Issue of Endorsement
We reject the arbitrary notion of PsyBA specialisation in endorsed areas and seek its discontinuation. Psychology is the speciality, and historically, competent psychologists have been able to work across the various areas of applied psychology. The only health professions able to have specialist areas are medicine, dentistry and podiatry. PsyBA endorsement is simply an extension of the arbitrary notion of specialists which APS interest groups have granted themselves.
All registered psychologists must demonstrate competency in diagnosis, assessment, treatment and writing diagnostic reports, regardless of whether they hold a clinical endorsement or not. The quality, skills and knowledge of a psychologist cannot be determined by endorsement status. Yet, under the Medicare Better Access Scheme, psychologists with a clinical endorsement attract rebates of $126.50 per 50 minute session compared to all other psychologists whose rebate is 31% less ($86.15).
The current criterion for endorsement includes the completion of a coursework Masters/Doctorate degree and one to two years of supervised practice. However, when the registration system for psychologists moved from state-based systems to being federally managed by AHPRA, existing paid members of special interest ‘Colleges’ of the APS were ‘grandfathered’ into the new endorsement system. This process was entirely conducted by the APS and non-APS members were unable to apply to be considered for endorsement. Therefore, psychologists with a ‘clinical’ endorsement may not hold any postgraduate qualifications. This process was further discussed in an article in Australasian Psychiatry:
"Despite such concerns, with the advent of endorsement, a substantial number of psychologists who had gained or were working towards gaining entry to the College via the ‘alternate route’ were grandparented into endorsement as clinical psychologists, leaving the public, health practitioners, and employers unable to differentiate those psychologists who have undertaken accredited training in clinical psychology" (Hunt & Hyde, 2013).
Yet many psychologists who do not hold a clinical endorsement (76% of registered psychologists) have postgraduate qualifications such as master degrees, PhDs and/or have extensive training and ongoing professional development in particular techniques and therapies. We have concerns about the transparency and consistency of the ‘grandfathering’ process as there are several examples of very well-qualified psychologists (some with PhDs and master degrees) being rejected for endorsement. Similarly, some psychologists hold multiple areas of endorsements whilst only holding one postgraduate degree.
The AAPi wants to set the story straight and restore psychology to a diverse and unified profession.