The Australian Psychology Workforce 3: A national profile of psychologists in salaried employment or in independent private practice

A detailed analysis of the different sectors of the psychology workforce was conducted as part of the National Psychology Workforce Survey: Independent Private Practice (IPP), Employed in Public Sector (EPuS) and Employed in Private Sector (EPrS). A total of 11,897 psychologists responded to the workforce survey, a response rate of 48%. Of these 8,086 were fully registered and currently working in a psychology role. Sectors were compared on a range of practice characteristics and differences were explored using a series of ANOVAs and post‐hoc analyses. Results of analyses revealed qualitative differences between the three sectors. Strategies for maintaining the employed workforce were also collected and are reported to be as much about increasing work satisfaction and support for professional and development opportunities as about salary.     

The Australian Psychology Workforce 1: A national profile of psychologists in practice

Existing workforce data on Australian psychologists are limited and data that exist are problematic. An online survey instrument was developed to profile psychologists including demographics and work characteristics including setting, role, service location and client type. A total of 11,897 completed the survey (response rate 48%) and a subset of these (N = 9,330) who held full registration were included in the current investigation. Participant demographics show a high (75%) proportion of females in the workforce which is particularly evident in the younger age range. Participation in the workforce was high (68%), with main psychology jobs spread relatively equally between the public and private sectors. Over a quarter of participants held a second psychology position, with the majority of second jobs being in private practice. For both first and second jobs the largest proportion spend their time providing counselling and mental health interventions one‐to‐one to adults. One quarter provide services in non‐metropolitan regions, a higher rate than previously reported. Specific population groups such as culturally and linguistically diverse and indigenous clients were prominent in workloads. This study provides a comprehensive profile and provides a rich data source for further exploration of the characteristics of specific groups within the workforce.     

Patient experiences with treatment in private practice compared with public mental health services

The study compared patient experiences with psychiatric treatment provided by private practitioners and public outpatient clinics. Questionnaires were completed by 642 outpatients in private practice and 6,677 outpatients in public clinics. The questionnaire included a measure of patient experiences comprising six items: treatment outcome, enough time for contact and dialogue with clinician, clinicians' understanding of patient's situation, suitability of therapy and treatment, clinician follow-up of planned actions, and influence on treatment. Patients in private practice had generally better experiences than patients in public outpatient treatment. The difference between private and public patients was largest for patients with poor self-evaluated mental health or those who had just one consultation in the previous three months. Private practitioners appear to have an important role in mental health services delivery, and patients have relatively good experiences with services. Further studies that assess the patient - clinician interaction in different mental health services may give further insights into potential service improvements.     

Using client feedback in training of future counseling psychologists: An evidence-based and social justice practice

Training in counseling psychology has evolved to emphasize both evidence-based practice (EBP) and social justice, though these two dimensions have often seemed disconnected, or even at odds in the practice of psychotherapy. The Partners for Change Outcome Management System (PCOMS), an EBP that monitors treatment outcomes and the therapeutic alliance across treatment (often called “client feedback”), may offer a means to connect evidence-based and socially just practices. The purpose of this article was to outline how the use of PCOMS in psychotherapy and supervision can serve as a useful training tool that is a form of EBP and also promotes a socially just paradigm in psychotherapy. We also offer an implementation example from a counseling psychology doctoral program to demonstrate how PCOMS can be used with clients in psychotherapy and included within the supervisory process.     

Toward the science‐informed practice of clinical supervision: The Australian context

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature and suggests steps to advance the development of a mature science of clinical supervision. The main areas requiring attention include the identification of the mechanisms by which supervision produces change in supervisees and their patients, the refinement of measurement methods and instrumentation, and the need to pursue collaborative research that maximises the generalisability of research findings.     

Working in Indigenous Contexts: Self‐Reported Experiences of Non‐Indigenous Australian Psychologists

Despite assertions in the literature that psychologists adopt culturally inappropriate strategies for working with Indigenous clients, there is little empirical evidence about this. The aim of this study was to document the self‐reported experiences of non‐Indigenous psychologists working with Indigenous clients, the factors that they felt constrain these interactions, and the clinical, assessment and communication strategies they perceived as effective in Indigenous contexts. Structured interviews were held with 23 psychologists, 18 females and five males, with age groups ranging from 20–30 to 50+. Thematic analysis of the data revealed that participants experienced contradictions between the typical Western white psychologists' ways of interacting with clients, which they had been taught and the typical ways in which relationships are structured in Indigenous communities. The results suggest that the Western model of psychological training does not work very well in Indigenous contexts, and that psychologists working in Indigenous contexts have to work out their own methods on a trial‐and‐error basis. This points to the need for more systematic cultural competence training. However, there is a lack of research into the effectiveness of psychological intervention from the viewpoints of Indigenous clients themselves.     

The Australian Psychology Workforce 2: A national profile of psychologists' education,training, specialist qualifications and continuous professional development

Objective data on the training profiles of Australian psychologists is scarce, despite important reforms across the higher education sector. This study aimed to profile Australian psychological training leading to registration. Universities, Registration Boards and registrants were profiled during 2008. Results revealed that there were 1063 postgraduate places a year across 34 university postgraduate training programs, with two thirds of places in clinical psychology. However, half of psychologists do not undertake postgraduate training, but undertake four years of university psychology followed by a 2 year internship (4+2) to make up the minimum standard for registration of 6 years training. Those with over 6 years of university training tended to work more in clinical, university or specialised areas of practice, whereas those with 4+2 were more likely to work in schools and general counselling. One quarter of psychologists are College members and 13% have doctoral qualifications. Analysis revealed a workforce that is actively engaged in ongoing professional development, supervision and further training. The profession has grown steadily in size by 6.24% per annum over the past 8 years and this presents a challenge for increasing the supply of postgraduate training places.     

The Future of Psychology in Family Medicine

Psychology has been integral to the field of family medicine since its inception as a medical specialty in the 1960s. Psychologists and other behavioral scientists contribute to family medicine in teaching clinical skills, in defining research questions, in developing research methodology, and in creating integrated physical/mental health care delivery systems. Future developments in the field of psychology in family medicine are likely to emphasize development and evaluation of screening measures which identify mental health problems in primary care, development of early intervention for those mental health problems, and more precise measurement of process and quality of care and health outcomes. Psychologists have an important role to fulfill in educating physicians on alternatives to pharmacologic and medical interventions for common presenting problems in primary care. However, current economic forces shaping the practice of medicine may work against further enhancing the efficacy of the physician in dealing with psychosocial issues. The future role of psychology in family medicine is not yet delineated, and while the move toward parity of reimbursement for mental and physical health care delivery may enhance this collaboration, there is a need to continue to evaluate how the psychological well-being of patients is influenced in the evolution of new models of care delivery.     

An Investigation of Psychology Staffing in Australian Metropolitan Acute Public Hospitals

Psychology is one component of the multidisciplinary services provided to patients in acute public hospitals, with research demonstrating that psychological intervention significantly enhances clinical outcomes for patients across a range of health issues. Despite the increasingly important role that psychologists play in Australian hospitals, there remains a lack of information available about staff levels, discipline structures, and clinical activity for psychological services within acute hospital settings. The most recent Australian data about hospital‐based psychology services was collected 20 years ago. The current study provides updated information from a survey of 15 Australian metropolitan, acute public hospitals: presenting and critically reviewing staffing configurations and models of service delivery. Results suggest that: (a) hospitals employ a highly skilled workforce at a rate of 0.16 full‐time equivalent psychology staff for every 10 hospital beds; (b) psychologists have a viable career pathway within the hospital‐based health sector; (c) role diversity is common, with the primary focus varying as a function of position level; (d) neuropsychology staffing requires urgent attention to address significant delays in access to services; and (e) public hospitals actively contribute to current and future workforce development through supervision, research, and training. The implications of these results for the future of psychological services in Australian healthcare are discussed.     

从跨文化心理学到文化建构主义心理学——心理学中文化意识的衍变

心理学中的文化意识在跨文化心理学、文化心理学、文化建构主义心理学中经历了3次重大衍变。跨文化心理学视文化为心理规律的干扰因素,认为理论研究应力求“去文化”;文化心理学认为心理是文化的“投射”,寻求理论的“文化敏感”;文化建构主义心理学则认为心理与文化是相互灌注、相互建构的关系,因而更加关注“心理”、“意义”与“现实”的双向建构过程。本文详细分析了上述几种不同的文化意识形态的主要特点,并结合历史背景,对其各自的意义、问题做了简要讨论。     

Community‐Based Learning and Critical Community Psychology Practice: Conducive and Corrosive Aspects

Community‐based learning (CBL) has been more recently introduced into some psychology programmes in the UK than in the USA, where it has existed for a number of decades in the form of ‘service learning’. CBL holds promise as a means of promoting and developing critical community psychology practice, but there are risks involved in its acritical adoption in the psychology curriculum. If associated power dynamics are not considered, CBL has the capacity to serve neoliberal interests and perpetuate, rather than challenge, oppressive social relations. This article examines ways in which CBL can be both conducive and corrosive to critical community psychology practice. Drawing on interdisciplinary literature, it explores ways in which students participating in CBL can be vulnerable to exploitation—both as victims and perpetrators—through collusion and cultural voyeurism. Consideration is given to ways of resisting institutional and other pressures to comply uncritically with the demands of the ‘employability agenda’. These include the importance of facilitated reflective processes in associated modules, to consider aspects of the interactions of people and systems. The article concludes that whilst CBL is inherently risky and involves discomfort for students, this enables development of a more informed consciousness where truly participatory work evolves towards greater social justice. Copyright © 2016 John Wiley & Sons, Ltd.     

Graduate attributes of the 4‐year Australian undergraduate psychology program

This paper outlines the background, process and outcomes for a project that delineated a set of graduate attributes of the 4‐year Australian undergraduate psychology program. The nature of the current undergraduate psychology program and its quality assurance system is described, followed by a consideration of current issues in psychology education and training. The processes involved in delineating the six graduate attributes (i.e., knowledge and understanding, research methods, critical thinking, values, communication, and application) are then described. Some issues and suggestions related to their implementation are then outlined. Finally, the authors summarise what has been accomplished in delineating the graduate attributes, and what still needs to be achieved.     

School Psychology: Training Individuals for One of the Best Kept Secrets in Professional Psychology

Abstract

School psychology training at the doctoral level is discussed. Given the increasing diversity in the schools as well as the varied education and mental health needs of the population, school psychology training is necessarily broad, involving traditional skills such as assessment, intervention, consultation, and counseling, all of which are taught within a context of a changing school population with changing needs. Because there is compulsory education, school psychologists’ interface with a broad cross-section of individual children, their parents, and their teachers. Moreover, school psychological practice is not limited to schools, as doctoral school psychologists are health service providers; many of these individuals work in other settings for which they are trained to provide services. The complexities and challenges of training school psychologists within this broad agenda effectively across domains are discussed.     

Professional education of psychologists using online problem‐based learning methods: Experience at Charles Sturt University

Abstract: Problem‐based learning (PBL) is a pedagogical approach to professional training that emphasises the development of clinical reasoning skills and self‐directed learning. In contrast to more traditional lecture‐based approaches that focus upon the linear acquisition of course content, PBL is undertaken in the context of actual case presentations. Although PBL has been adopted widely in the professional training of medical practitioners and nurses, it is only just beginning to be used in the professional education of psychologists. This paper examines the nature and benefits of PBL for education in clinical and forensic psychology by outlining its implementation and development at Charles Sturt University, located in a rural area of Australia. Although a full and independent evaluation of PBL for education in clinical or forensic psychology is yet to be undertaken, this paper argues that PBL can make a significant contribution to professional training in psychology.     

The Emphasis on Cognitive‐Behavioural Therapy within Clinical Psychology Training at Australian and New Zealand Universities: A Survey of Program Directors

Surveys of clinical psychologists' self‐reports of professional practice exist in Australia and New Zealand, but comparatively little data exist on the training available in universities. The present study was designed to gather data on the training and assessment of cognitive–behavioural therapy (CBT). A semi‐structured phone interview was designed for use with clinical psychology training directors, or equivalent, in Australia and New Zealand. Out of a total of 48 universities in the region, 40 clinical directors were successfully contacted: One declined involvement, and 39 agreed to participate, yielding a response rate of 81% (six in New Zealand and 33 in Australia). The data showed that it is common for clinical training programmes in our region to provide clinical trainees with foundational knowledge in CBT (i.e., 29 of the 39 surveyed). However, CBT is mainly incorporated into the auspices of clinical training programmes, there is a wide range of assessment methods to evaluate competence in providing therapy, and relatively few academic units exist that focus exclusively on CBT.     

The Future of Psychology in Medical Specialities: Introduction to the Special Issue

The continuing evolution of the health care delivery system in the United States presents threats and opportunities to psychologists in medical settings. This special issue explores the future of psychology in psychiatry, family medicine, rehabilitation, geriatric medicine, and pediatric medicine. The challenges facing neuropsychology and pain management are explored also. Finally, the professional issues of ethics in managed care, psychology in the public sector, and training future psychologists are addressed. Each paper summarizes concerns and provides recommendations for clinical practice, research, and training.     

应用心理学的学科性质——基于钱学森学科结构模型的分析

纯粹应用观和独立观是解释应用心理学学科性质的两个代表性理论。前者认为应用心理学仅是基础心理学知识和方法的直接应用;后者则认为应用心理学有独立的本质特征。钱学森学科结构模型赞同独立观,认为应用心理学有三个本质特征：1）研究旨趣面向心理工程技术中的重大问题,生产应用性理论;2）内容体系由社会需求决定,随着需求的变化而变化;3）研究方法的个人经验成分多于基础心理学,少于心理工程技术。在应用心理学建设中,1）要敏于实际需求;2）要大力发展、创立我国需要的应用心理学分支;3）要统一人才培养规制。     

Ethical practice from the perspective of the forensic psychologist: Commentary on the uses and value of the Australian Psychological Society (2007) Code of Ethics

Forensic practice in Australia and around the world attracts a high level of public and judicial scrutiny. The way in which the forensic psychologist conducts him or herself in ethically challenging situations is important not only to the reputation of the individual practitioner, but to the profession more widely. This paper outlines some of the ethical issues that commonly arise in forensic psychology practice and discusses these in relation to the recently published Australian Psychological Society (2007) Code of Ethics. Four ethically challenging scenarios are described and discussed in terms of how the Code might be used to offer guidance to psychologists about how they might best respond.     

'The power of being seen': an interpretative phenomenological analysis of how experienced counselling psychologists describe the meaning and significance of personal therapy in clinical practice

There is a widely acknowledged lack of clarity in psychotherapeutic training about the role of personal therapy in developing practitioner competence. This paper presents part of a wider ongoing qualitative study exploring the role that personal therapy plays in the clinical practice and training of experienced counselling psychologists. Results derived from an interpretative phenomenological analysis suggest that personal therapy is valued mainly as a means of enhancing reflectiveness within clinical work. Detailed examination of a subset of the data offers scope for exploring how this process may occur within therapy, and points to the potential significance of early attachment experiences in the development and amplification of participants' reflective capacities. A possible theoretical framework is proposed and implications for future research discussed.