General practice is not the only health profession worried about scope of practice expansion.
The Psychology Board of Australia looks set to cut a year off psychologist training by removing the requirement for post-graduate study – but instead of solving workforce shortages, advocates fear the move could make things worse.
This set of reforms also seeks to introduce the mysterious “psychologist assistant” role.
According to consultation documents released earlier this year, the psychology board – at the behest of the Department of Health, Disability and Ageing – is currently considering a complete redesign of the training pathway for the profession.
Under the current rules, psychologists can only gain AHPRA registration after spending a minimum of six years in tertiary education. Most do a four-year undergraduate degree (including an honours year) followed by either a two-year masters program or a one-year masters and a one-year internship.
These are both Australian Qualifications Framework (AQF) level 9 qualifications, making it a higher bar than most other health professions in Australia have.
“Feedback provided insights into the structural problems inherent in the current pathway including the length and cost of training, the lack of practical training offered in the early years, and equity and access challenges for students,” the board wrote in its consultation document.
The proposed redesign would collapse the six-year pre- and post-graduate requirements into one five-year Honours degree equivalent to an AQF level 8, after which the graduates enter the workforce with general registration.
Those who do three years of undergraduate study are eligible for a Bachelor of Psychological Assistance and could enter the workforce as a psychology assistant.
“Promotion of equitable access to psychology training is achieved [in the proposed redesign] by reducing barriers to completion such as cost, duration and multiple entry requirements,” the board wrote.
“The new pathway also provides an early exit option after three years for students who elect not to complete the full five-year degree.
“The Bachelor of Psychological Assistance (AQF 7) would expose students to foundational professional competencies to enable entry into the workforce under the supervision of a psychologist.”
Australian Association of Psychologists Inc CEO Tegan Carrison disagreed with the board’s assertion.
“We have concerns that the reforms aren’t addressing some of the known issues within psychology,” she told The Medical Republic.
“Nothing that we’ve seen in the reforms address rural and remote workforce. These are things that need to be intentionally considered and addressed – [we cannot] just hope that, by reducing the pathway by one year, it will magically get better.”
The considerable unpaid placement requirements and the in-person study requirements, Ms Carrison said, are the factors which pose the biggest equity barriers to students from regional Australia or from low-income families.
There are also differences in the supervision requirements and assessment levels for undergraduate degrees compared to masters-level degrees.
“The biggest concern that we have is that we feel that the proposed training reforms are really a step down from the current education and training of psychologists,” she said.
Then, there’s the mystery of the psychology assistant workforce.
Psychology assistants, as a concept, were first introduced in the 2024 federal budget papers. At the time, the Department of Health, Disability and Ageing confirmed that the role would be based on the NHS assistant psychologist model.
No further information has been forthcoming. Even the psychology board appears to be uncertain as to what this role will look like.
In one FAQ document, the board clarified that the department had specifically instructed it to “consider the level of competency attainment and workforce potential of psychology students who do not complete the full training pathway”.
“Based on feedback that Board received during the discovery phase of the project, we understand that there is need for more clarity about the potential scope, competencies and regulatory requirements of a psychology assistant role, and the extent to which it may address established workforce needs,” the Psychology Board of Australia wrote.
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Ms Carrison said the lack of detail around the role had made it difficult to consult on.
“I would agree with [the] assertion that it seems like this is something that the federal government is pretty keen on, and also the state jurisdictions too,” she said.
“At a conceptual level, I think they like the idea, particularly when they look at studies … that predict massive shortfalls in the psychology profession in the future.
“The psychology board’s current consultation for the education and training reforms really doesn’t define things like the scope, the supervision arrangements, what they’ll do on a day-to-day basis, insurance, and registration. It doesn’t really step out the model in any tangible detail at this stage.”
The Psychotherapy and Counselling Federation of Australia (PACFA), which represents non-psychologist counsellors, is also concerned by the potential psychology assistant role.
Counsellors and psychotherapists are not an AHPRA-registered profession, meaning that there is no title protection in place.
“A PACFA registered counsellor has a minimum of a three-year bachelor’s degree in counselling or a two-year post-graduate master’s degree in counselling and psychotherapy,” PACFA CEO Johanna de Wever told TMR.
“They have all the skills, competencies, and capacities to work as a registered clinical counsellor or a certified practising counsellor. Psychotherapists have specialised advanced training and another three years of modality training.
“It is a career choice to specialise in a way where you support people in a therapeutic environment with a humanistic person-centred approach, and it’s widely supported by evidence, and it’s in high demand from the community.
“It’s concerning that there appears to be this possibility that, because there has not been title protection for the work of counsellor or psychotherapist, there is this risk that people … in the psychology assistant position could just walk out and start working as a counsellor, where traditionally psychology training does not actually require any counselling training at all.”
