Talk:Better Access Scheme

Protection Request

I would like to request semi-protection on this page as it is subject to frequent vandalism. I have attempted to remove content that does not comply with Wikipedia standards on several occasions only to have the content reappear. Please remove content related to facebook. Facebook is not an appropriate source and the content is not objective or neutral.

Please remove this content as it is not acceptable:

"There is also considerable variability between provider disciplines and Medicare items within the scheme, leading some critics to cite quality control issues.[35][36] This is particularly the case with the psychologist service providers leading to much acrimony within the profession.[37] This acrimony was recently exacerbated when the Psychology Board of Australia formally announced plans to retire the 4+2 program stating that "The 4+2 internship is not comparable to international benchmarks for training and registration, and there are significant risks associated with the two-year unaccredited internship."[38]. This acrimony has manifested primarily in groups like the AAPi and RAPS publishing claims on social media that young female psychology students were offering sexual favours in exchange for votes supporting the APS College of Clinical Psychologists in APS elections, and statements of support for psychologists under investigation by AHPRA for publicly asserting that newly graduated clinical psychologists were "bumbling fools stumbling over their textbooks" [39]. In addition, these groups have initiated social media campaigns where experienced psychologists with decades of experience, several who had represented the APPi on the MBS Review Board, repeatedly attempt to aggressively debate policy issues relating to the field of psychology with undergraduate psychology students on online student forums. [40] To date, there is no evidence of similarly aggressive behavior on the part of the same AAPi representatives towards clinical psychologists with equivalent levels of experience as themselves, even when said clinical psychologists post on the same student forums. These groups also encourage mass letter writing campaigns to Public Health Networks, such as the National Disability Insurance Scheme, and community organisations like the Black Dog Institute [41] demanding that they stop advertising positions specifying a requirement for psychologists with clinical endorsement. The same campaign also targets individual clinical psychologists in psychological practice, in the form of communications from "Australian Psychologists" demanding the targeted sole practitioner psychologists stop advertising the fact that they have completed clinical training."

I have removed this content as it does not comply with Wikipedia standards. James Caulfield 777 (talk) 08:46, 9 June 2020 (UTC)

 Not done: requests for increases to the page protection level should be made at Wikipedia:Requests for page protection. ‑‑ElHef (Meep?) 12:12, 9 June 2020 (UTC)

A dispute

Hi Sarahbr1996 we're going to need to come to an agreement on this. I don't mind including some content that states things from the clinical viewpoint but I strongly object to material which denigrates registered psychologists and psychology institutions by using facebook as a reference source. The content of each paragraph must also relate to the topic at hand and not involve tangential issues.

James Caulfield 777 (talk)

According to Wikipedia facebook is not considered a reliable source Wikipedia:Reliable source examples

"Facebook is generally not acceptable as a reliable source, as anyone may create a page and add comments, and there is no stringent checking of a user's real name and age. On occasion, Facebook pages that are clearly marked as official pages for notable subjects, with direct link to those pages from official websites, in which case they may be used as primary sources. Note, however, that if a public figure says something noteworthy in an official Facebook account (or from another social media site, for that matter), it is likely that the media will report this anyway."

Please do not use facebook when sourcing.

James Caulfield 777 (talk) 02:28, 16 May 2019 (UTC)

I have reinstated information from the PBS, AHPRA and APS websites. Please stop deleting any mention of the details of the 4+2 pathway into psychology, or editorialising and adding additional qualifications apart from the actual requirements listed for 4+2's (4 years of undergraduate and 2 years of work experience, as defined on the APS website). Also please stop censoring the information regarding the Psychology Board of Australia's official announcement that the 4+2 pathway is being retired and it's reasons why. Reporting negative facts about something isn't denigrating it. I have also deleted your references from 2009 and 2010 which you used to claim that the decline in interest in programs like sports psychology in 2019 is solely due to the Better Access Initiative.

Hi Sarah,

Thank you for your more sensible edits of the Better Access page. Just a few clarifications; clients of clinical neuropsychologists are not eligible for the higher Medicare rebate, so I have updated the figures from the PsyBA and included them in the other grouping. Clinical Neuropsychology courses have actually flatlined over the last 5 years - they haven’t decreased but they haven’t increased either (I previously obtained figures from the APAC to determine this). I have also updated this in the relevant section.

I have also listed endorsed psychologists in the order of the percentage of endorsements currently held as indicated by the PsyBA to resolve the ordering issue.

A detailed inclusion of the requirements for registration I believe should be covered in another Wikipedia article. This info is already detailed in Psychologist or perhaps it could also be included on Australian Psychology Accreditation Council. It is also difficult to state the facts clearly as many registered psychologists that do not possess an endorsement similarly have Master and Doctoral degrees. Many have chosen not to pursue an endorsement because there is currently little incentive to do so as it does not lead to a higher rebate under the Better Access Scheme.

I never claim that the decline in interest in programs like sports psychology is solely due to the Better Access Initiative, but the references I site from the APS and a peer reviewed journal article do suggest that the Better Access Scheme has created a greater incentive for psychology students to pursue clinical psychology training. I believe this is very much relevant to the discussion.

Along with the 4+2 program the 5+1 program would also need to be discussed if the education and training of psychologists were included in the article. It is also worth noting that when the APS was responsible for the regulation of psychology courses they strongly supported the 4+2 pathway to registration. The change in stance is a relatively recent phenomenon. However, I have not removed your reference to the PsyBA thoughts on the matter, but could you please find another credible reference to support that this has lead to much acrimony within the profession. James Caulfield 777 (talk) 00:48, 17 May 2019 (UTC)

• I am going to have to ask both of you, James Caulfield 777 and especially you, Sarahbr1996, to adhere to talk page conventions: see Wikipedia:Talk_page_guidelines#Technical_and_format_standards. Sarah, you also need to sign your messages; James, you need to sign in the right place. And both of you need to have a long hard look at WP:SECONDARY and WP:RS. Drmies (talk) 01:04, 17 May 2019 (UTC)
• Both of you need to start paying attention to what others tell you, especially if some of those others are administrators who get irritated by edit warrions who don't listen. James Caulfield, you better not be logged out while editing again. What I think should happen here is someone else, someone who is not either of you, should have a look at this. User:Doc James, do you know who the psychologist on call is? Drmies (talk) 01:16, 17 May 2019 (UTC)
  • Apologies - I did not realise I should be signing. I should note that Doc James is Dr Clive Jones, who is a member and advocate for the AAPi/RAPS, and so is not an impartial representative. https://reformaps.org/dr-clive-jones-writes-to-the-aps-board/

    11:50, 4 April 2019‎ DrCMJ talk contribs‎ 23,479 bytes +874‎ Updating the details of the process undertaken by a committee I was directly involved in. I have also provided links to sources to confirm the accuracy of changes thank Tags: Mobile edit, Mobile web edit, Visual edit, references removed --Sarahbr1996 (talk) 01:32, 17 May 2019 (UTC)

Umm. Looking at this. Made a few minor changes. Appears we have a COI issue. Who I am in real life is fairly easy to figure out and it is not "Clive Jones". User:Markworthen this topic might be of more interest to you than me... Doc James (talk · contribs · email) 02:47, 17 May 2019 (UTC)

• • I am happy for the comments regarding the AAPi's activity on Facebook to be removed if the edits providing the full breakdown of the percentage of psychologists with and without endorsements, and the requirements for the different pathways to registration, taken directly from PSYBA and AHPRA websites are restored. All this information is public knowledge and verified, as well as central to the 2-Tier debate, so I am concerned about the ongoing attempts to remove this information from the Wikipedia article. Sarahbr1996 (talk) 01:24, 17 May 2019 (UTC)
    • My apologies Drmies. I would rather not have any content under impact to the psychology profession if we can't come to some agreement on this. As previously noted the requirements for registration are already detailed in Psychologist or perhaps it could also be included on Australian Psychology Accreditation Council. What I strongly object to is the second last paragraph on the page that is very vindictive, not appropriate, and uses facebook as a source. James Caulfield 777 (talk) 01:34, 17 May 2019 (UTC)
      • Again, I note that the information regarding the requirements for registration is central to the debate around Two Tier Structure of the Better Access Initiative, and so to omit is would be to provide a one-sided incomplete representation of the issue. Again, all this information is verified by the Psychology Board of Australia/Australian Health Practitioner Network.

        The information regarding the AAPi's activity on Social Media can be verified but I am happy to have it removed if the other information can be restored. I encourage the moderators to look at the initial version of this page created by James C, which contained very vindictive, not appropriate and completely unsourced claims about the APS and ACPA, organisations that the AAPi are opposed to. I also note that this page indicates James C made the initial comment about "acrimony within the profession", which he subsequently attempted to demand I provide evidence for after I attached the statement from the PSYBA which contributed to said acrimony for. Sarahbr1996 (talk) 01:47, 17 May 2019 (UTC)

        • Hmm. Thanks for at least starting to talk. I tried to clean it up a bit. Sarah, please note that I didn't ask Doc James to judge or whatever--I asked if he know a psychologist on call. That's quite a different thing. I don't know what y'all's dispute is about; I hope you understand that all this is rather uninteresting for an outsider. But some organization's activity on Facebook is typically not encyclopedic; footnotes 41 to 45, and the content it supposedly verifies, should be thrown out. Drmies (talk) 02:02, 17 May 2019 (UTC)
          • Support: footnotes 41 to 45, and the content it supposedly verifies, should be thrown out. Agree and I vote to remove the whole 3rd paragraph under 'Criticisms.' There is some factual information there around the plans to retire the one registration pathway, but I don't see how that's related to Better Access (at all) and might be better placed within a page "Psychology Board of Australia" who are the relevant authority who determine approved registration pathways. Citation 40 would sit better with the preceding paragraph, as it pertains to an association between socio-economic disadvantage/geographical region and access to primary health care/mental health services. The other reference regarding the acrimony refers to a newspaper article entitled "...psychologists derailed by professional stoush". Although this is related to Medicare, the professional stoush referred to (or acrimony) is unlikely to be able to be summarised in a balanced way from the newspaper article which provides a single perspective. I don't doubt that there is a 'professional stoush' but not sure it fits under 'Criticisms' in any case. I vote to remove the whole paragraph. Griffibo1 (talk) 14:59, 19 May 2019 (UTC)
        • I am happy for administrators to look into the original version of the page. I was at pains to provide an objective viewpoint and thoroughly source material according to Wikipedia guidelines. The debate has never been about training as all psychologists complete a minimum of 6 years of education and training to obtain registration. The source I used to support "acrimony within the profession" was a Sydney Morning Herald article , and I didn't explain it more than that as interested readers can do their own research. James Caulfield 777 (talk) 01:55, 17 May 2019 (UTC)
• I have been provided with a screenshot of James Caulfield posting on the official AAPi Facebook Group "Australian Psychologists" approximately ten minutes ago the following statement: "The Shitfuckery continues. I need some sensible psycholoigists to make rational suggestions on the Better Access Scheme talk page to resolve this Wikipedia edit war". Happy to forward the screenshot on upon request. I hope encouraging this type of brigading is not encouraged by Wikipedia. Sarahbr1996 (talk) 01:59, 17 May 2019 (UTC)
  • Shitfuckery? You young people, so obscene. James Caulfield, that's not cool. No, Sarah, I don't want you to send me any screenshots; let's hope that James realizes that this is not acceptable. James, look up WP:MEAT, for instance: ganging up on someone is not cool. If I were to see a whole bunch of new accounts swinging the article your way, you will be blocked. Drmies (talk) 02:05, 17 May 2019 (UTC)

Thanks Drmies for being fair in a debate that is probably quite uninteresting to you. Perhaps you could contact the Psychology Board of Australia or the Australian Psychological Society to ask for a psychologist to confirm information on the page? Sarahbr1996 (talk) 02:06, 17 May 2019 (UTC)

User:Sarahbr1996 we based Wikipedia content on reliable secondary sources not personal conversations. Doc James (talk · contribs · email) 02:47, 17 May 2019 (UTC)

• I apologize for swearing, but I am frustrated with this internal dispute. For the record, the "Australian Psychologists" facebook group is not an official AAPi facebook group as claimed, but a group that all registered psychologists can join. There are a diversity of opinions within that group as there are in many other psychology facebook groups. James Caulfield 777 (talk) 03:00, 17 May 2019 (UTC)

• Regarding the reduction in postgraduate programs I provided two good sources for this that directly link it to the introduction of the Medicare Better Access Scheme. My original paragraph was as follows: "Since the introduction of the Better Access Scheme in 2006 there has been a significant increase in student demand for places in clinical psychology postgraduate programs compared to other psychology postgraduate programs. With the exception of clinical psychology, postgraduate programs leading to an area of practice endorsement have dramatically declined including those in counselling, health, community, forensic, educational and developmental, organisational and sport and exercise psychology. In contrast, Master of Professional Psychology programs have increased over the same period." I don't see that there is anything inherently wrong with this. James Caulfield 777 (talk) 03:18, 17 May 2019 (UTC)

• This paragraph only references facebook and a tangential reference to the black dog institute website. It should be removed as it is slanderous and contains no credible information. "This acrimony has manifested primarily in groups like the AAPi and RAPS publishing claims on social media that young female psychology students were offering sexual favours in exchange for votes supporting the APS College of Clinical Psychologists in APS elections, and statements of support for psychologists under investigation by AHPRA for publicly asserting that newly graduated clinical psychologists were "bumbling fools stumbling over their textbooks" [43]. In addition, these groups have initiated social media campaigns where experienced psychologists with decades of experience, several who had represented the APPi on the MBS Review Board, repeatedly attempt to aggressively debate policy issues relating to the field of psychology with undergraduate psychology students on online student forums. [44] To date, there is no evidence of similarly aggressive behavior on the part of the same AAPi representatives towards clinical psychologists with equivalent levels of experience as themselves, even when said clinical psychologists post on the same student forums. These groups also encourage mass letter writing campaigns to Public Health Networks, such as the National Disability Insurance Scheme, and community organisations like the Black Dog Institute [45] demanding that they stop advertising positions specifying a requirement for psychologists with clinical endorsement. The same campaign also targets individual clinical psychologists in psychological practice, in the form of communications from "Australian Psychologists" demanding the targeted sole practitioner psychologists stop advertising the fact that they have completed clinical training." James Caulfield 777 (talk) 03:27, 17 May 2019 (UTC)

• I suggest that the following paragraph be used under the heading Impact to the Psychology Profession as it significantly clarifies the central dispute without exploring the minutia around pathways to registration and the previous regulatory requirements. “Under the Better Access Scheme clients of psychologists with an area of practice endorsement in clinical psychology are rebated $124.50 per 50-minute session. The clients of all other psychologists receive $84.80 rebate per 50-minute session, including those with an area of practice endorsement in counselling psychology, educational and developmental psychology, clinical neuropsychology, forensic psychology, organisational psychology, health psychology, sport and exercise psychology, and community psychology.” James Caulfield 777 (talk) 03:58, 17 May 2019 (UTC)

>I apologize for swearing

The issue isn't swearing, it is that you tried to brigade the Wikipedia page so that you could gang up on another contributor who has a different point of view.

>For the record, the "Australian Psychologists" facebook group is not an official AAPi facebook group as claimed, but a group that all registered psychologists can join. There are a diversity of opinions within that group as there are in many other psychology facebook groups.

That's not true, but that's ok.

>*Regarding the reduction in postgraduate programs I provided two good sources for this that directly link it to the introduction of the Medicare Better Access Scheme. My original paragraph was as follows: "Since the introduction of the Better Access Scheme in 2006 there has been a significant increase in student demand for places in clinical psychology postgraduate programs compared to other psychology postgraduate programs. With the exception of clinical psychology, postgraduate programs leading to an area of practice endorsement have dramatically declined including those in counselling, health, community, forensic, educational and developmental, organisational and sport and exercise psychology. In contrast, Master of Professional Psychology programs have increased over the same period." I don't see that there is anything inherently wrong with this. James Caulfield 777 (talk) 03:18, 17 May 2019 (UTC)

Except of course, both reference are from 2009-2010, so not really any proof that the decrease of interest in alternate programs in 2019 is solely because of the MBAS, and so this claim is unsubstantiated.

• • don't supportSecondary sources are the basis of all Wikipedia articles. If you have a secondary source that gainsays or elaborates on these references, please suggest it. We have to accept what's published. A brief look at the Crowe article suggests it was an acting President of the professional association of psychologists who authored it. It draws a causal conclusion that reduced diversity of special interest areas in psychology is a direct result of the introduction of the Better Access Scheme in 2009 (3 years in). It identifies the "two-tiered" Medicare rebate specifically. The publisher, Australian Psychological Society, and the author, make its a fairly quality source and could reasonably summarised. It would be difficult to find them partisan (in this direction) since they supported the two-tier approach from its inception. I also found a source which shows numbers and types of postgraduate courses from 2011 up to 2017 - shows clinical postgraduate courses (including neuropsychology) holding steady, while professional psychology courses saw a 350% increase (these were only introduced sometime around 2011 or 2012 so that stands to reason). Educational and developmental (down 56%), Community (down 67%), Forensic (down 86%), Health (down 50%) and Sport (down 50%). My own view is that Better Access is only one of the inputs to this phenomenon (expense of accreditation being another key driver) but until there's a secondary source that agrees with me, I'm not going to just go and write my opinion on the article. We have to use the available sources. Therefore - I do not support throwing out the summary by James Caulfield 777 on the basis of the source age. Griffibo1 (talk) 14:04, 21 May 2019 (UTC)

>*I suggest that the following paragraph be used under the heading Impact to the Psychology Profession as it significantly clarifies the central dispute without exploring the minutia around pathways to registration and the previous regulatory requirements. “Under the Better Access Scheme clients of psychologists with an area of practice endorsement in clinical psychology are rebated $124.50 per 50-minute session. The clients of all other psychologists receive $84.80 rebate per 50-minute session, including those with an area of practice endorsement in counselling psychology, educational and developmental psychology, clinical neuropsychology, forensic psychology, organisational psychology, health psychology, sport and exercise psychology, and community psychology.” James Caulfield 777 (talk) 03:58, 17 May 2019 (UTC)

• supportThis has direct relevance to the Better Access scheme, is brief, and articulates the two tiers, and which titles can offer which rebate. The source, again, is the professional association. I have no objection to the content of this suggested paragraph. It is neutral, factual, and blessedly brief, and aligns to the secondary source. Griffibo1 (talk) 14:04, 21 May 2019 (UTC)

This paragraph again completely avoids mentioning the existence of the 4+2 pathway, one of the more historically common pathways to registration. https://www.psychologyboard.gov.au/registration/provisional/4-2-internship-program.aspx It also intentionally creates a false impression that the majority of psychologists eligible for the lower rebate hold higher degrees and are endorsed. I suggest this paragraph which is based on information sourced from the Psychology Board of Australia and AHPRA's websites in 2018-2019, and which makes it clear that only a small percentage of psychologists who get the lower rebate have endorsements while the majority who do not qualify for the rebate are 4+2's or unendorsed psychologists. I note that that time and time again, there have been attempts to remove any reference to the 4+2 program.

• don't support I understand what you're trying to do in your edit below, but it doesn't really work imo. It reads as though you're introducing broad debate/granular levels of detail which go beyond the scope of the article. And as I know about the 'stoush' it's hard to miss the pedantic sort of commitment to communicating a message about the degree of training of non-endorsed psychologists. I also just don't think it's very interesting to the average reader. I understand that pathways to registration are relevant in general due to the fact they are in transition, with COAG focus, and there has been much change in the past decade, but as I've mentioned before I believe that is a matter for another page - perhaps the Australian Psychology Board. I don't object to the cut down neutral content suggested by the previous user above. If there is to be treatment of the fact of the structural changes to the profession(s) I have not found a secondary source which articulates them all; it would be great to distil out a consistent framework for summarising change impacts - so a table or small consistently structured section for each profession/stakeholders and clients/patients would be elegant (might be a project to suggest). Griffibo1 (talk) 14:04, 21 May 2019 (UTC)

How about this revision?

Under the Better Access Scheme clients of psychologists with an area of practice endorsement in clinical psychology are rebated $124.50 per 50-minute session. The clients of all other psychologists receive $84.80 rebate per 50-minute session. The latter includes those with an area of practice endorsement in other areas, 4+2 psychologists (with an article to be created later to link to the specific requirements of 4+2 registration) and all other psychologists who do not hold an endorsement.

This makes the article more succinct while not omitting the existence of the 4+2 pathway or suggesting that the only psychologists who receive the lower rebate are endorsed psychologists.Sarahbr1996 (talk) 01:46, 22 May 2019 (UTC) Sarahbr1996 (talk) 01:23, 22 May 2019 (UTC) Sarahbr1996 (talk) 01:46, 22 May 2019 (UTC)

Sarahbr1996 (talk) 13:55, 17 May 2019 (UTC) Sarahbr1996 (talk) 13:59, 17 May 2019 (UTC)

• Sorry to seem to be coming down a bit negative on your contribution, but I find it reads very heavy on detail and is not succinct. If there was a secondary source you found which could be summarised into an super brief treatment of the fact of diversity, without going heavy into the detail, I think it would be reasonable to include. But the only point of interest is diversity within the profession in my opinion - and by listing out who is and isn't able to provide the two services (by title) it's kind of already covered in my opinion. The thing you could include I guess is the bit about the fact that the two tier differentiation doesn't easily align with a profession with n endorsement types + x non-endorsed psychologists, and that it's stirred up some feeling. Do you have a source for that? Griffibo1 (talk) 14:04, 21 May 2019 (UTC)

Griffbo1, That is correct. To put it very briefly, psychologists with a clinical endorsement get a higher rebate from Medicare when other psychologists. The current requirement to get a clinical endorsement is a minimum of a Masters, and then completing a two year registrar program. In Australia, until recently psychologists could become registered without completing a Masters or PhD, but with two years of work experience after completing a 4 year college degree A group representing this pathway has advocated for the rebate to be made the same for all psychologists regardless of qualifications. I think it is misleading to only mention psychologists with endorsements as receiving the lower rebate, as this group is made up predominantly of psychologists who registered under the 4+2 program or are unendorsed. I hope the above edit captures this more succinctly. Sarahbr1996 (talk) 01:35, 22 May 2019 (UTC) Sarahbr1996 (talk) 01:46, 22 May 2019 (UTC)

Edit: I did a little numbercrunching and worked out that the percentage of endorsed psychologists who are not eligible for the higher rebate represent only 13% of all such psychologists. This means Jame's attempts to have only such endorsed psychologists mentioned as not being eligible for the high rebate is highly misleading, as it only reflects 13% of this group. I have amended my paragraph above accordingly.

Sarahbr1996 (talk) 00:37, 18 May 2019 (UTC)

Sarahbr1996 (talk) 11:05, 18 May 2019 (UTC)

Sarahbr1996 (talk) 11:46, 18 May 2019 (UTC)

As I've stated before clinical neuropsychologists are not eligible for the higher rebate, so your paragraph and numbercrunching are incorrect . If we cannot come to some agreement on this paragraph then I suggest the section 'Impact to the psychology profession' be completely removed. This content is not central to the article and I do not believe that the public or the psychology profession is served by discrediting the education and training of registered psychologists within a wikipedia article. James Caulfield 777 (talk) 10:45, 19 May 2019 (UTC)

>As I've stated before clinical neuropsychologists are not eligible for the higher rebate, so your paragraph and numbercrunching are incorrect

Well, that's not true but even if it were, the total number of Clinical Practice Endorsements as of Dec 2018 is 8,725 while the the total number of Clinical Neuropsychology Practice Endorsements is 677, so the paragraph is still correct in highlighting that endorsed psychologists form only a minor percentage of the total number of psychologists who do not qualify for the higher rebate.

Clinical Neuropsychologists can provide Medicare Services, but would offer the lower tier rebate amount. Only clinical psychologists can offer the higher rebate. They're totally different endorsements and there's no overlap through the term 'clinical' if that's the point of confusion? There are two tiers - (1) clinical endorsement, (2) and the rest. Griffibo1 (talk) 14:04, 21 May 2019 (UTC)

I also note that this is the original version of the section written by James Caulfield:

Clients of all other psychologists (including health psychologists, counselling psychologists and forensic psychologists) receive $84.80 rebate per 50-minute session. However, both registered and clinical psychologists see similar clients with similar presentations. Approximately 87% of Australian psychologists practice in clinical settings and often use the same psychological assessments, similar therapeutic approaches and work with the same or similar client populations in the assessment, diagnosis and treatment of mental health conditions. This has led the Australian Association of Psychologists and other mental health groups to call for a single Medicare rebate for the psychology profession, claiming that the current system disadvantages clients of registered psychologists and those in rural and remote communities.[25][26][27] The scheme has also rapidly increased student demand for places in clinical psychology postgraduate programs at the expense of other psychology postgraduate programs. With the exception of clinical psychology, all psychology postgraduate programs leading to an area of practice endorsement have declined since the inception of the Better Access initiative in 2006. Some programs such as counselling, community, health, forensic, educational and developmental and sport and exercise psychology are on the verge of extinction with only a handful of programs still operational.[28][29] Registered psychologists claim the higher Medicare rebate afforded to clinical psychologists has changed status perceptions within the industry.[30] The two-tiered model has set the precedent for many government programs to follow the Medicare system and pay registered psychologists significantly less than their clinical colleagues (e.g. Department of Veterans Affairs[31][32] and the NSW Government[33]). The issue has been exacerbated by the Australian Clinical Psychology Association (ACPA) spreading misinformation to government and professional bodies by claiming clinical psychologists are better equipped to treat complex mental health conditions.[34][35][36] However, many other psychologists have also completed advanced degree programs and have extensive training and experience in the assessment, diagnosis and treatment of complex mental health conditions.[37][38][39][40]

I note that as soon as the multiple unsourced claims about non-clinical psychologists and ACPA "spreading misinformation" were removed, and more accurate information, such as the existence of the 4+2 pathway and the fact that endorsed psychologists form only a small minority of psychologists who are not eligible for the higher rebate, James suddenly wishes for the entire section to be removed. Sarahbr1996 (talk) 15:42, 19 May 2019 (UTC)

The paragraph above is quite accurate and contains 16 credible references. It is hardly unsourced. James Caulfield 777 (talk) 12:52, 21 May 2019 (UTC)

>The paragraph above is quite accurate and contains 16 credible references. It is hardly unsourced.

Can you provide a source for the following? - "both registered and clinical psychologists see similar clients with similar presentations. Approximately 87% of Australian psychologists practice in clinical settings and often use the same psychological assessments, similar therapeutic approaches and work with the same or similar client populations in the assessment, diagnosis and treatment of mental health conditions" (Apart from citing a 47 page document, and claiming the source is somewhere in there). - the scheme has also rapidly increased student demand for places in clinical psychology postgraduate programs at the expense of other psychology postgraduate programs (preferably references dated after 2010, as your claims are regarding present day demand for programs) - The issue has been exacerbated by the Australian Clinical Psychology Association (ACPA) spreading misinformation to government and professional bodies by claiming clinical psychologists are better equipped to treat complex mental health conditions.

Also your comment "many other psychologists have also completed advanced degree programs and have extensive training and experience in the assessment, diagnosis and treatment of complex mental health condition" is a vague and meaningless statement - how many 4+2 psychologists have a Masters, Clinical PhD (The only PhD at present that is a qualification for practice) or Doctorate in the actual field of Psychology?

Sarahbr1996 (talk) 00:47, 22 May 2019 (UTC)

• I am not sure if my suggested edit was lost in all the discussion, so I am submitting it again here:

Under the Better Access Scheme clients of psychologists with an area of practice endorsement in clinical psychology are rebated $124.50 per 50-minute session. The clients of all other psychologists receive $84.80 rebate per 50-minute session. The latter includes those with an area of practice endorsement in other areas, 4+2 psychologists (with an article to be created later to link to the specific requirements of 4+2 registration) and all other psychologists who do not hold an endorsement.

This makes the article more succinct while not omitting the existence of the 4+2 pathway or suggesting that the only psychologists who receive the lower rebate are endorsed psychologists. Only mentioning endorsed psychologists who do not receive rebates is misleading, as they only present a small percentage of the total group of psychologists not eligible for the higher rebates.

Sarahbr1996 (talk) 00:48, 24 May 2019 (UTC)

I have removed the content that uses facebook as a source as this does not comply with wikipedia standards. James Caulfield 777 (talk) 06:47, 4 October 2019 (UTC)

References

Suggest removing Impact to the Psychology Profession

If I may wade in...I suggest removing this section entirely, at least for now. The impacts to the psychology profession in Australia since 2006 are broader than Better Access. While Better Access represents a major structural change in mental healthcare delivery in Australia, the differentiated rebate for clinically endorsed vs other psychologists (including other endorsed psychologists) has coincided with a heck of a lot of other structural changes in the field (and for a lot of other health professions). Unfortunately there are not a lot of high quality sources of secondary evidence dissecting these various changes and exploring them in relation to impacts on psychology or the other fields included in Better Access. There are a couple evaluating the effectiveness of the scheme itself, but none exploring the raft of knock on impacts to the professions specifically as a result of Better Access (that I could find). If a section is to be included here, I would suggest it could be broadened to cover the impacts across professions to provide balance. Broad analysis of the impacts specifically to the psychology profession of the array of regulatory/structural changes which have occurred, and continue to occur, in Australia over the past 13 years (since the 2006 Productivity Commission report on the health workforce) does seem a worthwhile inclusion, perhaps in another page Psychologist or Australian Health Practitioner Regulation Agency >Section e.g., Impacts on Professions of Transition to National Scheme., etc. But I think we'll have to wait for someone to publish such an analysis before we can summarise it. I couldn't find anything neutral.Griffibo1 (talk) 12:16, 19 May 2019 (UTC)

Thank you Griffbo1. I agree in principle, but the difficulty is that this entire article was originally written by the representative of an organisation that advocates for a particular position so it is important to review so that a lot of the structural bias in the article is removed. For example, I note these completely unsourced claims were made by the author in the original version of the article which suggests a specific agenda in the original :

"both registered and clinical psychologists see similar clients with similar presentations. Approximately 87% of Australian psychologists practice in clinical settings and often use the same psychological assessments, similar therapeutic approaches and work with the same or similar client populations in the assessment, diagnosis and treatment of mental health conditions."

As another example, the section headed "The 2018 Medicare Benefits Schedule Review" for example may appear impartial. However, it provides an unnecessary amount of focus and detail on recommendations from the the MBS Review Taskforce from only one particular year, despite the fact that this Taskforce has been in existence since 2015 and continues to operate in 2019. I note that the year that the article focuses on was the year that a large number of representatives from a particular lobby group were part of the review, while in 2019, an auxilary committee was required to be formed as these representatives could not reach agreement with the rest of the review. Given the unnecessarily detailed information on a committee whose suggestions were ultimately not accepted as of yet, I would request this section be removed as well.

Sarahbr1996 (talk) 15:29, 19 May 2019 (UTC)

I concede that the figure you mention in the first quote is incorrect. It should actually be 81.6% as indicated by the number of registered psychologists working as clinicians by Health Workforce Australia. There are quite a few articles to support the statement that registered psychologists work in a similar way to clinical psychologists. The 2018 Medicare Benefits Schedule Review is an important development in the Better Access Scheme and this section has been modified by others previously. As far as I am aware no lobby groups were invited to participate in the review. All members of the committee had to declare any conflicts of interest as detailed in the Mental Health Reference Group Report. James Caulfield 777 (talk) 10:41, 21 May 2019 (UTC)

"It should actually be 81.6% as indicated by the number of registered psychologists working as clinicians by Health Workforce Australia."

Being described as a clinician does not mean "both registered and clinical psychologists see similar clients with similar presentations. Approximately 87% of Australian psychologists practice in clinical settings and often use the same psychological assessments, similar therapeutic approaches and work with the same or similar client populations in the assessment, diagnosis and treatment of mental health conditions".Do you have an actual source comparing the work done by generalist and clinical psychologists for these claims apart from this?

"There are quite a few articles to support the statement that registered psychologists work in a similar way to clinical psychologists."

Nowhere in this link is a comparison made between the work done by registered and clinical psychologists. I note this is the second occasion you have intentionally misrepresented the contents of this link. You previously claimed the link stated "All registered psychologists complete a minimum of 6 years of education and training" when in fact the link states "Psychologists with general registration have a minimum of six years of university training and supervised (work) experience" and deleted all citations from the Australian Psychology Board clarifying the true nature of the 4+2 pathway, which requires a 4 year generalist undergraduate degree and 2 years work experience.

"As far as I am aware no lobby groups were invited to participate in the review. All members of the committee had to declare any conflicts of interest as detailed in the Mental Health Reference Group Report."

Yes, which is why if five members of the committee were all actively advocating for a particular lobby group, including on easily accessible social media, but forgot to mention this potential conflict of interest, an independent auxilary committee may have been required to be formed to take over part of the review, particularly if the five representatives were unable to not reach agreement with the rest of the review.

Do you have a credible source for this? James Caulfield 777 (talk) —Preceding undated comment added 06:20, 4 October 2019 (UTC)

Sarahbr1996 (talk) 01:10, 22 May 2019 (UTC)

Still getting used to using Wikipedia, so I am resubmitting this suggestion as I am not sure if I used the right format.

• I also would suggest the section "The 2018 Medicare Benefits Schedule Review" be removed entirely. It provides an unnecessary amount of focus and detail on recommendations from the the MBS Review Taskforce from only one particular year, despite the fact that this Taskforce has been in existence since 2015 and continues to operate in 2019. I note that the year that the article focuses on was the year that a large number of supporters from a particular lobby group were part of the review as part of the Mental Health Reference Group. I note that James Caufield, author of this article, is an advocate for this lobby group. I also note that this lobby group is currently publically lobbying to have the 2018 Taskforce reconvened - (See "Top priority 3. Ask the Medicare Benefits Schedule Review Taskforce to reconvene the old/existing Mental Health Reference Group") after it was placed on hold due to conflicts occurring within the group and an inability to reach agreement . As such, I suggest this section was created specifically to bolster these lobbying attempts.

Sarahbr1996 (talk) 01:16, 24 May 2019 (UTC) Sarahbr1996 (talk) 01:20, 24 May 2019 (UTC)

Sarahbr1996 (talk) 15:29, 19 May 2019 (UTC)

References