Lifelong Challenges

It often feels like a lifelong battle…I arrived in the UK where my degree in psychology from Quebec was not recognised as a Honours degree, but contained enough psychology as required by the British Psychological Society. I had completed a full year of internship placement through a beginning of a Masters in Quebec, but this was not recognised as sufficient to be classified under the Honours degree system. The problem is that universities offering a Honours degree program are rare in Quebec and programs limited.

In the UK, to be able to access a professional course to train as a psychologist, I had to do a conversion or a Masters course from an accredited course provider. At the time, the system was changing from being able to train as an Educational Psychologist (EP) from a teacher qualified to other opened routes. Although I had been a teacher in independent schools, there seemed to be no need in completing my teaching qualification to follow an EP qualification route. I decided to go through the Masters route to top up my first degree. I completed my Masters and then entered a very competitive Doctorate route, whilst working and with young children. Yes, my choice, yes hard work.

Now, we have made a move to Australia. Being registered as psychologist, brings a full whole set of challenges. Although we recognised this move as full of opportunities, it is also full of challenges, mainly because it feels like I have had lifelong challenges in trying to have my qualifications recognised. It is not just from the UK to Australia, but it seemed like I have been doing that forever. Yes, my choice, yes hard work.

The thing is that I really like working with children, young people and families. I really feel in my element. I also feel I have lots to offer, some global migration experiences, international literature perspective, macro-systemic views of different policy making and development, knowledge of different health and education and support systems for children and families experiencing disadvantages, special and additional needs, fluency in more than one language. The thing is no-one asks you about your strengths when you fill in a recognition qualification form because you enter a world where you are asked to conform with a set of rules and regulations. For example, I was completing a form last week. I am being asked to tick a box that represents the most, my English language skills, amongst a series of choices:

• primary, secondary and tertiary studies in English
• secondary for 2 years and tertiary studies in English
• 6 years continuous tertiary studies in English
• examination results

The thing is that I no longer fit into a set of boxes. As a global migrant, I experienced different educational routes and job opportunities. Boxes do not seem to represent well my journey. I lived 18 years in the UK, worked, was part of the community, studied at tertiary levels, but this is not represented in any of the boxes. Does this mean that I should be required to do more studies? Yes, there may be subtleties I miss in my expression of language, and yes there is a need for me to continue editing my work. Will an exam change that?

Registration in Australia: A number of UK psychologists asked for advice

The process of registering as a psychologist in Australia has not been easy so far. I started the process back in December, we are now in August, following a lot of work in understanding the system, completing forms, talking to people, the process is still not complete and I am still waiting. I posted some questions and queries on a large psychologist mailing group. A number of psychologists have asked me for advice as they would also like to come to Australia too. It seems appealing as EPs are on the skilled workforce and can apply for a work visa based on their qualifications and experiences. Working in a beautiful country, in varied working environments, also seems appealing. I did not personally need a skilled workforce assessment as I came here on a 457 visa sponsored by my husband’s employer. However, I am finding the registration process very confusing, demanding a huge amount of research and determination. I understand there is a consultation currently taking place which aims to support changes in the system, mainly presenting more thorough information to applicants and employers.

As many asked for my help, I said that I would respond in a post, intending to support fellow colleagues. I write here some important points about the process. This post intends to be supportive, highlighting key points that are confusing and difficult to understand. This is based on my knowledge and research as per August 2016. The system may change and my knowledge expand (I sincerely hope so!). It is my perception of the process, it may be different for others.

What do Psychologists from the UK need to know?

Mainly, the APS is like the BPS, AHPRA like the HCPC. The Australian Psychology Board is a branch of AHPRA comprised of 14 National Boards supported by AHPRA in the framework of a Health Profession Agreement. (Aboriginal and Torres Strait Islander Health Practice Board of Australia, Chinese Medicine Board of Australia, Chiropractic Board of Australia, Dental Board of Australia, Medical Board of Australia, Medical Radiation Practice Board of Australia, Nursing and Midwifery Board of Australia, Occupational Therapy Board of Australia, Optometry Board of Australia, Osteopathy Board of Australia, Pharmacy Board of Australia, Physiotherapy Board of Australia, Podiatry Board of Australia, Psychology Board of Australia).

Psychologists are trained to work in a range of settings, such as hospitals, schools, clinics, forensic, adults, elderly. Psychologists develop their skills across the lifespan within the training and must demonstrate these skills. AHPRA mentions that general registration as a psychologist enables an individual to work in any area of psychology that is within their scope of competence and use the title ‘Psychologist’ and that all psychologists with general registration meet a minimum standard of education and training and have been assessed as a suitable person to hold general registration in the profession.

Registration as a psychologist can be obtained from different training routes: 4+2, 5+1, 6 years. For example, 4 years of psychology studies and a 2 years of internships/placements. AHPRA explains that to become eligible for general registration, an applicant is generally required to have completed a four year undergraduate sequence of study in psychology (such as a bachelor degree with honours) followed by at least two years of practical experience as a registered provisional psychologist. AHPRA also mentions that the necessary practical experience is usually obtained by undertaking an approved postgraduate degree accredited at fifth and sixth year level (such as a two year Masters) or higher (such as a three or four year Doctorate). Alternatively, practical experience can be obtained by completing a 4+2 or 5+1 internship program. Within the doctoral route, internships are included so this refers to the 6 years + of studies. This means that UK EPs trained prior to 2006 within a Masters route may have more difficulties in having their qualifications recognised as a 6 years + and may be required to complete a longer internship or to enter a tertiary educational program in psychology.

The Commonwealth political system means that a federal system applies which is also similar to the Canadian political system. It means that each state has delegated powers in deciding their own state affairs. The role of the Commonwealth being different from the states one. This means that the Commonwealth and the states have different roles and mixed roles in managing budgets, decisions and jurisdiction. Delegated powers are related to specific areas of jurisdiction such as education which means that each state may have different ways to determine the role of the psychologist. This is reflected in the literature written on the subject by Mike Faulkner in The Handbook of International School Psychology. Edited by Shane R. Jimerson, Thomas Oakland, and Peter Farrell. SAGE Publications: Thousand Oaks, California, USA – London, UK. This is a big difference to the educational system in England and Wales where education is a centralised jurisdiction, the local authorities have the powers to implement national policies, programs and laws. However, delegated powers are given to Scotland to manage their educational decisions. Local authorities/local councils in Australia do not have powers like local authorities. Powers are delegated to the states. There is a free education system funded by the states, with some parallel private systems funded by non-profit organisation, fees and Commonwealth funding such as Catholic education, independent schools, etc.

Similarly, health is a jurisdiction delegated to the state for hospitals, but the Commonwealth also has special federal programs such as Medicare. The Medicare system is similar to the NHS, but does not cover all services. In Australia, psychologists are included in the workforce of professionals who deliver services under the Medicare system. In discussion with a GP, under a health and care plan, a client could be given a ten week counselling plan for example. This includes ALL psychologists, not just the ones working in health related systems. Psychologists therefore deliver services to the population in private practice as well as the state sector. In private practice, a client pays a fee to receive a service and then claims back some of the fees to Medicare. Alternatively, bulk billing is where a professional accepts the 85% of the Medicare reimbursed fees and claim it directly to Medicare. To be entitled to deliver services, psychologists must have a Medicare provider number, only fully registered psychologists (and other professionals under AHPRA, see boards above) can deliver this service. This also means that there are number of psychologists working in private practice as there seems to be a variation in salary between different service delivery methods. My research shows that in the state sector, i.e. education department work, an annual salary would be around $60 000 000+, compared to other providers such as private practice, up to $100 000. There is also a significant different between Clinical and registered psychologists. Clinical Psychologists tend to earn a substantially higher salary and can also claim more hourly to the Medicare system.

Registration process

As per the 1^st June 2016, the registration process changed. I aim to explain the registration process here to the best of my ability.

1. Application to the Australian Psychological Society

In the first instance, an application to the APS needs to be completed for assessment of qualifications and visa purposes. As per the 1^st June 2016, the APS completes assessment of qualifications for visa purposes only, but if an applicant comes to Australia with no need to apply for a visa, the applicant must go directly to AHPRA.

Allow at least 12 weeks for this process. All certificates, transcripts and identity papers need to be certified by a psychologist or an approved profession member.

The APS will make an assessment of how many years of study qualifications are equivalent to in the Australian context. Years of study have a big impact as it determines the process for AHPRA (although I have been told that AHPRA also review years of study during the process). If your qualifications are recognised as 6 years + studies, the process is slightly shorter for registration, see flowchart below.

Flow diagram (AHPRA)

Following the APS assessment process, a certificate of years of study is issued. This process does not include registration as a Psychologist. A six years + of studies gives entitlement to becoming a member of the APS, MAPS (reduction of fees apply following assessment). Some employers request the membership. APS is responsible for CPD and professional development and have support networks in local areas.

The APS will then signpost the applicant to the next phase of the process, AHPRA registration.

2. Application to AHPRA/Psychology Board to register as a Psychologist.

Find below the ‘recommended pathway’ to registration which consists of an application to AHPRA through different forms (detailed below), a transitional program of supervised practice and the National Psychology Exam.

Recommended pathway to registration in Australia for overseas qualified psychologists (AHPRA)

Assess your ability to meet the registration requirements

Fill in application form APOS-76 and provide all required documents to AHPRA

The Board will assess whether you meet the registration requirements

Receive advice that you need to complete a specified period of supervised practice and the National Psychology Exam

Use relevant form to submit a plan for your specified period of supervised practice to the Board for approval

Receive approval of your supervised practice plan and granted provisional registration

Complete specified period of supervised practice in accordance with your approved plan

Pass the National Psychology Exam

Apply for general registration

Granted general registration

To be able to practise as a psychologist in Australia, an AHPRA registration is essential. For a provisional psychologist registration, allow 10 weeks + for the assessment process. The ‘general’ registration process takes a minimum of 3 months leading to the exam. Exams take place four times a year, check available dates on the website to avoid being out of sync and experience significant delays in obtaining general registration.

For the initial provisional psychologist registration process, there is quite a lot of work to do:

• complete the APOS-76 form
• an international police check
• proof of English language skill standard
• proof of identity (certified documents)
• contact ALL universities, where a qualification was completed, to send a transcript directly to AHPRA
• CV signed respecting the AHPRA format
• Submission of papers related to internships/placement such as reports, record of supervision, course handbook
• AATP-76 form completed

The transitional program

The transitional program as it stands requires an applicant to complete 210 hours of practice, minimum 17.5 hours/week for 3 months, with supervision 1 hour fortnightly, going through policies and documents related to the Australian context of practice in preparation for the National Psychology Exam. The supervisor must complete the ACTP-76 form at the end of the program. This form outlines skills and knowledge needed for general registration. The transitional program aims for the candidate to demonstrate, through supervision sessions and observations of practice, competencies in the following areas:

• Ethical, legal and professional matters as relevant to the Australia context;
• Working with people from diverse groups as relevant to the Australian context.

In the ACTP-76 form, there is requirement to be observed completing specific psychological tasks such as a psychological assessments.

For the transitional program to be agreed with AHPRA, the applicant must NOT work independently. following a number of clarifications with AHPRA, this seems to mean: NOT work as a sole trader or open a private practice. An applicant can work or volunteer in a private practice though. An applicant can have more than one concurrent volunteering or salaried opportunities. AHPRA refers to ‘the applicant must not work independently’. I think that is particularly confusing as this could be interpreted as ‘must be accompanied’, ‘must not see clients alone’. What does independently mean in this context? I was advised to refer to the 4+2 internship information, but it becomes very complicated to look at information that is meant to be relevant, but that most of it isn’t.

When completing the APOS-76/AATP-76 forms, transitional program information and arrangements are required such as the names of a board approved supervisor and employer. This is a tricky part and it needs a lot of work and determination. I explain experienced difficulties below in the respective sections.

The flowchart published on the AHPRA website (see above) says that a transitional plan must be submitted after the application process, but when submitting the APOS-76 form, requesting provisional psychologist registration, it is required to submit the AATP-76 form with supervisors and employer information.  I queried this on a number of occasions. Following many communications and phone calls with a number of employers and supervisors, I submitted my application to register as a provisional psychologist aiming to agree a transitional program at a later date. My understanding is that when someone applies from overseas, provisional psychologist registration can be granted until arrangements with a supervisor and employer are finalised in Australia. Although I had arrived in the country, I followed that route because I could not find employment. Whilst my application was being processed, it gave me time to continue making arrangements for  a supervisor and employment.

Although there are no set criteria for an exemption, the Board is working on this and on a consultation to improve their communication around the transitional program. Exemptions mainly apply for qualified psychologists who have worked in Australia before. I have been told that exemptions for UK psychologists are not granted. All applicants must do the National Exam anyway so the transitional program will support learning and skills development. The National Exam is a requirement for all Australian psychologists and will become a requirement for doctoral trained Australian psychologists in 2017.

Finding a supervisor

In the form AATP-76, the name of a board approved supervisor who has agreed to be a supervisor is required. Supervisors can be contacted directly through the AHPRA website via email. To find a supervisor, it requires preparation such as emails, meeting people and explaining the process. I collated all documents from the AHPRA website to share with supervisors and discuss supervision arrangements. I realised that not all supervisors are aware of the transitional program process, have experience of having supervising a transitional program applicant and not all can accept a request of supervision for many reasons. A number of reasons were given to me: lack of confidence in the requirements of the program, too many supervisees, no workplace to offer.  Only a few supervisors replied to my request. Supervision costs around $150-170 an hour, although according to AHPRA, there is no set guidance for fees and arrangements. If a supervisor is requested to travel to a place of work, expenses may also need to be paid by the supervisee. Some supervisors will have reduced fees if an applicant accepts a voluntarily position or may lift their fees completely if the applicant works voluntarily in their practice. A supervisor can be external to the workplace or internship, however, not all employers will accept an external supervisor. Employers are not necessarily inclined to pay for supervision, unless the supervisor is within the organisation. Employers explained that organisations cannot keep up with the costs of supervision training in terms of time, capacity, preparation, follow-up and training per se. This means that many organisations do not have board approved supervisors. Supervision needs to be in place until the general registration is granted.

Finding an employer

As part of this process, finding an employer is also required. However, in my contact with many employers, most employers are particularly reluctant to employ provisional psychologists until receipt of a general registration. This is because of the Medicare system explained above.

The problem with a provisional psychologist registration is that jobs are rare, unless you demonstrate your skills are outstanding, etc. I found the education department (equivalent to local authority work) very difficult to understand in terms of recruitment policies and I am still finding my way around that system. For example, I have had a number of refusal email, no invitation to interview, and the name of the person who was offered the post sent by email. I was told that the education department must advertise their posts externally so there is not always a guarantee that advertised posts are vacant as internal candidates may already have the post.

Other employers explained that they do not have the capacity to offer supervision within their service and would not necessarily accept supervision from an external supervisor. Employers are also looking for psychologists who are able to gain a Medicare provider number so provisional psychologists are out of the equation. Provisional psychologist posts are rarely advertised, and are often voluntary. I have been told to apply to posts that are not entitled ‘psychologist’, but counsellor, student well-being, student welfare, etc. These posts are equivalent in terms of the initial salary band, but are not restricted to a specific profession. However, I applied for a number of these posts and was not successful. With a doctoral qualification, I did not even get one interview! The transitional program also requires an applicant to be observed carrying out specific tasks such as psychological assessments, duties strictly protected for the psychologist. By working as a counsellor, an applicant would not be able to complete the transitional program and may have to arrange other opportunities too.

In Australia, any registered psychologists could work in schools so the specific work of the EP, as per in the UK, is not as well known. For some specific organisations, the school work is very important and EP skills sought after. When applying for posts, I found that I had more success in getting to an interview after writing a covering letter explaining my role in the UK against selection criteria for the job with a very detailed CV. Although in a UK context, one would know what an EP does, in Australia, not all employers may be aware of the specific duties and roles undertaken as an EP in the UK, so some detailed explanations are necessary.

In terms of seeking employment, another important point to remember is that a visa will determine longevity restrictions of employment. For example, an employer cannot give a permanent post to an applicant who has a 4 year visa. Some employers may be ready to employ a successful applicant, but will need to think about employment laws, which may be a deterrent to an application from someone with a visa. I have yet to find out whether a selection process favour Australian citizens. This is the case in Canada where government employment is reserved to Canadian citizens. It is also important to remember that the time left on the visa will also determine employment opportunities. For example, an employer could not offer a year contract to someone who must leave in 6 months.

Overall, psychologists seeking registration/employment in Australia should aim to be very creative with their job searches, send CVs to lots of different settings, and be prepared to accept some voluntarily experience until full registration. Internships and placements are often voluntarily for Australians so there is perhaps an assumption that the transitional program should be voluntarily. I was initially disheartened with this suggestion, but I have come around to the idea and have accepted a very creative transitional program, a mix of salaried and voluntarily positions.

I have been in touch with other doctorate trained psychologists from the UK and they told me that the process of registration for them was quite straightforward when they arrived in Australia. However, it looks like the system has changed and now a transitional program and exam are required for registration.

After gaining general registration, an endorsement in educational and developmental psychology can be requested which allows the psychologist to charge higher fees for consultation and be a recognised specialist in the field. Many employers talked about this fee discrepancy being an important factor in recruitment. Again there is a process of supervision with the endorsement process…it appears to be a good thing to become an approved board supervisor which also requires supervision and further studies!

Current and hidden costs

During this process, I came across many hurdles. I was getting through one bit of the process, felt I was getting there, and then another form cropped up or another payment needed to take place. I recorded the costs associated with the process so that there is transparency and knowledge about the costings. AHPRA publishes a list of prices for their specific assessments, but I found a number of hidden costs as the process evolved. When I applied for the APS assessment, I certainly did not realise that I had to go through the AHPRA process as well.

$1000 APS assessment of qualifications

$436 AHPRA provisional registration

$900-1020: $150-170 supervision x 6

transport to workplace for supervisor x 4 for observations unless videoed

$450 National exam

$300 international police check

$436 AHPRA general registration

$150-170/supervision following three months of practice whilst waiting for general registration

$70 fees related to transcript requests

$105 working with children card, Victoria

$650 APS membership (reduction of fees apply in the first year following assessment of qualifications)

$255 Professional indemnity insurance for one year

$45 National Police Check

N.B.The APS charged $1000 for assessment of qualifications and AHPRA charges $700.

Further thoughts!

With AHPRA, a main learning point has been that it is very complicated! The system has changed and some officers have said that they are still learning about the process themselves. AHPRA has one main phone line which will be answered by ‘customer officers’/’admin people’. I phoned the number on many occasions. I was given different advice and my queries were not always answered. Within the system, there are also ‘registration officers’ who are able to answer queries either by email or phone. I found that asking to speak to a registration officer was helpful as ‘admin people’ on the phone could not answer my questions, but again I had some confusing advice and not all my emails were responded to, unless I chased an answer. There are also ‘professional officers’ who are trained psychologists and answer queries/assess the application. I found conversations with this person/role to be the most helpful as answers were professionally based and not process based as with the other two roles. I was also advised by the APS to ask to speak to professional officers. Overall, I had varied experiences when talking to different people. Some more helpful and competent than others. Competent and accurate answers are very important as these could influence the application and employment processes and prolonging the registration process, particularly if mistakes are made or regulations not respected. I also found that phoning regularly, to ask where the application is at, is a must. My numerous questions and queries clearly highlight the need for better communication about the transitional program and I intend to contribute to the consultation process. I have already voiced the issues presented in this text to officers who have supported me through the process.

Many employers find it difficult to believe that UK trained psychologists have to go through all of this, so it is worth asking questions, etc. It says ‘recommended’ pathway and this is where I got completely puzzled and I am still finding it hard to understand. In some places there are also mention of exemption, but no set guidance as to who is entitled to an exemption. One could assume that it leaves some flexibility in determining outcomes?!

We arrived in Australia in February and I am still working on this registration, mid-August. One should plan to either be unemployed for a period of time, complete the registration work prior leaving the UK (but communication with AHPRA may be difficult due to time difference, and seeking supervisor and employment opportunities too) or accept non-psychology related jobs/jobs not requiring registration initially. One should allow time to complete forms, research and gather paperwork and ensure ALL certificates, transcripts and pieces of identity are not in boxes or in a container. This is also the case for important documents in placement files such as supervision reports, course handbook, etc. Saving files electronically could also help this process, although both organisations requested important documents to be original and/or certified.

And if I went back to my country of origin to practise as a psychologist, I would have to go through a similar process, paperwork, processes, proof of identity, evidence of practice and qualifications, exam, supervised professional practice…and it makes me think that perhaps there could be an agreement between similar education systems and schools of psychology as per other professions…maybe I will choose to only move again after retirement, but I am a long way from that!

Any tips?

Resilience, patience, humility and a huge amount of perseverance and determination…

Links

AHPRA https://www.ahpra.gov.au

APS http://www.psychology.org.au

Mike Faulkner in The Handbook of International School Psychology. Edited by Shane R. Jimerson, Thomas Oakland, and Peter Farrell. SAGE Publications: Thousand Oaks, California, USA – London, UK