A proposed overhaul of training for Australian psychologists is close to being finalised that would make this country among the least rigorous in the qualifications required to become a practitioner.
Currently the process for becoming a psychologist is not straightforward. It entails years of study that cost tens of thousands of dollars, including an honours year and a postgraduate program. The work-experience placements students depend on are hard to find. Following general registration, practitioners can seek endorsement in specialist areas, from clinical neuropsychology to forensic psychology, each with its own coursework and registrar program.
Last year , the Department of Health asked the Psychology Board of Australia to streamline training. The board has just issued a consultation report and redesign plan for a single five-year pathway that also lowers the required qualification from master’s to undergraduate level.
Mental Health Australia chief executive Carolyn Nikoloski says “increasing the supply of new psychology graduates is only one piece of the puzzle”.
Whereas most countries require doctoral or master’s level attainment, the proposal would have Australia join Brazil as being among the few jurisdictions across the globe where an undergraduate degree qualifies a person to practise. The change would put at risk graduates’ recognition and their ability to practise in Europe, Canada and the United States.
Leanne Clarke’s concern is that psychologists registered with less training and supervision will still carry the responsibility of diagnosis. “Diagnosis is one of the most consequential things we do,” says Clarke, who has run a clinical psychology practice in Sydney’s south for more than two decades. “Get it wrong and the person pays. A misdiagnosis follows them into their medical records, their treatment, their insurance, their sense of who they are. Sometimes for life.”
Clarke was a founding board member of the Australian Clinical Psychology Association, which does not support the redesign and will take its concerns – with other professional bodies, universities and lived experience advocates – to Parliament House on October 26.
The Psychology Board of Australia’s report runs to 41 pages and does not use the word “oppose”. It gives no figure for how many of the 2500 respondents rejected the model. The only statistic on sentiment is in the executive summary, where it says “almost half of all respondents express at least some level of support for the proposed model”. This suggests more than half expressed none.
This distortion is troubling, as it is the board’s evaluation that reaches health ministers. The board did not respond to questions from The Saturday Paper.
In responses to a public consultation conducted between April and June, the sector’s objections centre on what the change does to training quality, placement demand, research and the future of the discipline. The way the consultation was run, and what the case for reform rests on, are also disputed. Of the employers surveyed, 37 per cent said psychologists newly registered under the current system do not meet expectations for workforce readiness, and 57 per cent did not agree that a shorter pathway would help. The consultation paper states that “creating a shorter, more practical training pathway is not considered by the majority of employers to be a viable strategy to improve workforce readiness”.
The report says the changes “may have industrial implications and workforce planning implications that relevant employers will need to consider”. Employers, among them state and territory health services, regional providers and private practices, would be left to address what the lower qualification means in practice.
“Early career psychologists will end up in high-volume services that value throughput rather than quality training.”
UNSW Sydney told the board that representatives of local health authorities in NSW and Queensland have “indicated they would be unwilling to employ” less qualified graduates.
Dr Aaron Frost directs Benchmark Psychology in Brisbane and has trained more than 3000 psychologists as supervisors. Much of his work focuses on what gives a graduate the clinical judgement to treat a person in crisis independently. That takes years of supervised practice, he says, and without proper resourcing the quality of treatment varies enormously.
“Early-career psychologists will end up in high-volume services that value throughput rather than quality training,” Frost says.
Charlotte Bowyer, who oversees a specialised psychology practice at Mount Pleasant in Perth’s south, says the proposal does not adequately address one of the profession’s biggest workforce problems: remote services. Many rural and regional communities already struggle to attract and retain psychologists, regardless of endorsement.
The new pathway would require an approved training site and a supervisor who already holds endorsement. Rural communities rarely have either. “Has the board asked someone living in a rural community if they want the only psychologist in town to leave for further training?” Bowyer asks.
Advanced training must become more accessible outside the cities, she says, not less. If psychologists must relocate, cut their workload or lose local supervision, communities already short of services will lose out. This would replace the current registrar pathway featuring two years of supervised practice done on the job after a master’s.
Advanced postgraduate training and supervised practice matter most where similar symptoms have very different causes, Bowyer says. Memory problems may reflect depression or dementia. Cognitive difficulties after trauma may arise from post-traumatic stress, a brain injury or both.
The Australia & New Zealand Academy for Eating Disorders told the board that “lowering training standards introduces risks to treatment quality and patient safety”.
Dr Marjorie Collins, president of the Institute of Clinical Psychologists, is concerned that “in the current reform, no equivalent independent safety review, trial or economic modelling has been presented”. The risks are left to implementation instead. “For a once-in-a-generation massive change, that is the wrong sequence.”
Regarding the baseline demand for psychologists in health settings, the board expects the shortfall to rise from 57 per cent in 2025 to 97 per cent by 2038. Both these figures are based on questionable projections. The model draws its recent history from 2019 to 2023, a window spanning the pandemic that drove demand higher, according to the board’s own paper.
The forecasting also measures the number of psychologists Australia has against the number it would need if everyone with a mental health condition received a full course of care. Clarke calls that modelling “make-believe”.
More than 80 per cent of registered psychologists are women. The Health Services Union told the board that lowering the qualification level risks reinforcing the undervaluation of a predominantly female profession. It could also lead to cuts in public award wages, making psychologists harder to retain in the public system.
I have the privilege of supervising psychology master’s students. One student spent this year learning to assess children with severe epilepsy in a hospital while building the skills to evaluate published findings for her thesis. That ability to weigh evidence will matter the next time she meets a child who does not fit the pattern.
Lowering the qualification limits that training to only those who can afford more years of university. The Heads of Psychology Australia warned the board of “the unintended consequence of diminishing diversity in our training pool”, with cost deterring poorer and marginalised students.
The consultation offered one model and told stakeholders that “alternative training models will not be considered”. The board was asked to provide an impact analysis, covering cost, benefit and risk to the public. None has been published, and none appears to have been conducted. The board declined an interview, pointing to published material that does not mention an impact analysis.
Few responses came from the people the reform is intended to help. Of the 2500 participants, only 55 were from community members and consumers. Mental Health Carers Australia, a nationally funded mental health peak body, told the board that organisations representing families and carers did not appear to have been involved in the project reference groups – “a significant oversight”.
A spokesperson for the Department of Health, Disability and Ageing said the government “acknowledges the range of views and concerns raised by stakeholders” and that “the Board’s final recommendations will be considered by Health Ministers on whether to endorse the reforms”.
Marjorie Collins wants the redesign paused until there is an independent assessment of its implications for public safety, quality of care and cost. “We support reform. It is badly needed,” she says. “We do not support the model put forward.”
My fear is that with this reform, graduates will be less prepared and less grounded in science. An alternative pathway would bring practical training forward without removing master’s-level training. Supporting placements and reforming the clinical supervision system would do more for capacity than shortening degrees.
Without that support, we risk creating a system that “pumps out practitioners with nowhere to place them”, Frost says. “How on earth is creating a massive new wave of undergraduate placement demand going to fix the bottleneck?”