Best Practice Self-Regulation Model for Psychotherapy and Counselling in Australia
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Best Practice Self-Regulation Model for Psychotherapy and Counselling in Australia: Final Report Prepared by Margot Schofield Submitted to The Department of Human Services, Victoria February, 2008 Copyright State of Victoria Department of Human Services, 2008 This publication is copyright. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. Authorized by the State Government of Victoria, 50 Lonsdale Street Melbourne. This document may be downloaded from the following websites: www.health.vic.gov.au/pracreg/psychotherapy.htm This research was undertaken by Margot Schofield, PhD, Professor of Counselling and Psychotherapy, La Trobe University, Melbourne Director of Research, Psychotherapy and Counselling Federation of Australia 290 Park Street, North Fitzroy VIC 3068. Telephone 03 9486 3077; Fax 03 9386 3933. Email: [email protected]; Web www.pacfa.org.au Acknowledgements The assistance of the following people and organisations is gratefully acknowledged: • Funding was provided by the Victorian Department of Human Services (DHS), • Leah Collins and Jon Kettle provided valuable research assistance, • Stephanie Exton and Samantha Noyes provided valued administrative assistance, • The PACFA Board and Council provided feedback and contributed to the policy debates, • The many professionals, associations and stakeholders who contributed to the ideas and information contained in the report. • The University of New England also made this project possible from 2003-2004 through their agreement with PACFA for Margot Schofield to undertake this research role with PACFA. • La Trobe University who provided practical support. CONTENTS EXECUTIVE SUMMARY 1 Aims of Project 1 Core Activities 1 Methodology and Key Results 1 Literature Review 1 Feasibility of a Joint Self-Regulation Model 3 Discussion Paper on Self-Regulatory Models for Counselling and Psychotherapy 3 National Consultation Process 4 41 PACFA Professional Associations 4 Non-PACFA Professional Associations 5 Consultation with Non-PACFA National Counselling and Psychotherapy Bodies 5 Consultation with Relevant Government Bodies, and Other Stakeholders 6 Preferred Model and Implementation Plan 6 Registration of Practitioners 7 Entry to Practice Standards 7 Specialist Counselling and Supervision Standards 8 Sections of the Register 8 Administration 8 Ethics and Complaints Procedures 8 Mapping The Profession 9 Survey of Professional Counselling Associations 9 Workforce Survey 10 Course Accreditation Model 10 Implementation of Priority Activities of Self-Regulation Model 10 Summary 11 CHAPTER 1: INTRODUCTION Background 13 Purpose of this Report 13 Context of the Self-Regulation Project for the Counselling and Psychotherapy Profession 14 DHS Service Aim 14 Specific Objectives of the Self-Regulation Project 14 Core Activities Defined for the Project 14 Key Activities Undertaken 14 Defining the Profession of Counselling and Psychotherapy 15 Defining Self Regulation 16 Overview of Final Report 17 CHAPTER 2: LITERATURE REVIEW 19 Why Regulate? 19 How to Regulate? 20 Principles 20 Statutory Regulation 20 Co-Regulation 21 Self-Regulation 21 Alternative Forms of Regulation 21 International Trends in Regulation of the Health Professions 22 United Kingdom - Health Professions Council (HPC) 22 Role of the HPC 22 Structure of the HPC 22 UK Review of Non-Medical Regulation 24 Canada - Health Professions Regulatory Advisory Council (HPRAC), Ontario 24 British Columbia 25 Scope of Practice 26 Reserved Acts 26 USA 26 New Zealand 27 Summary of International Trends 27 Current Trends in Regulation of the Health Professions in Australia 27 National Competition Policy Agreement of 1995 27 The AHMAC Criteria for Regulation 27 Productivity Commission Research Report: Australian Health Workforce 28 Implications of Productivity Commission Report 28 Victorian Review of the Regulation of the Health Professions 29 1998-1999 Review of the Health Services (Conciliation and Review) Act 30 Summary 30 Development of the Counselling and Psychotherapy Profession 30 International Trends in the Regulation of Psychotherapy and Counselling 31 United Kingdom (UK) 32 UK Department of Health Project on Regulation of Counselling and Psychotherapy 32 UK Project on Framework for Regulation of Psychotherapy 32 Proposal for a Psychological Professions Council 35 UK Skills for Health Project 35 Statutory Regulation of Counselling and Psychotherapy Profession 36 United States of America 36 Canada 36 Regulation of Psychotherapy in Canada 36 Ontario 36 HPRAC Recommendations 37 Regulation of Counselling in Canada 38 British Columbia 38 New Zealand 39 Alternative Forms of Regulating Counselling and Psychotherapy 39 Nebraska Model for Regulating Counselling 40 Licensure 40 Certification 40 Washington State's Approach to Regulating Counselling 40 Registration 40 Certification 40 Licensure 40 Summary 41 CHAPTER 3: JOINT SELF-REGULATORY MODELS FOR SELF-REGULATING HEALTH PROFESSIONS 43 BACKGROUND 43 PHASE 1: SURVEY OF PROFESSIONAL ASSOCIATIONS 44 Aim 44 Method 44 Sample 44 Procedure 45 Survey 45 Results 45 Characteristics of the Self-Regulating Bodies 45 Facilitators for Joint Self-Regulation 55 Professional Aim 55 CPD, Professional Conduct Standards, Ethics & Complaint Procedures 55 Barriers to Joint Self-Regulation 55 Australian Context: Regulated and Non-Regulated Allied and Complementary Health 55 Professionals Breadth of Professions Covered 55 Range of Membership Categories and Qualification Levels 55 Proposed Models 55 PHASE 2: CONSULTATION MEETINGS 56 Participants 56 Consultation Findings 56 Key Themes 56 Standards and Self-Regulation Already in Place 56 Incentives for Joint Self-Regulation 56 Challenging the AHMAC Criteria for Statutory Registration 57 Ideas Regarding Implementation 57 Roles of the Professions 57 Roles of the Registration Board 57 Areas of Agreement 57 Areas of Concern 58 Proposed Steering Committee 58 DISCUSSION 58 Summary 59 CHAPTER 4: DEVELOPING A BEST PRACTICE SELF-REGULATION MODEL FOR COUNSELLING AND 61 PSYCHOTHERAPY DISCUSSION PAPER ON BEST PRACTICE MODELS 61 Options for a Model of Self-Regulation 62 The Role of PACFA 62 Model One: The PACFA Self-Regulation Model 65 Model Two: Independent Registration Board 66 Features of a Best Practice Model for Registration 67 Membership of Board: Size and Composition 67 Meetings of the Board 69 Remuneration of Board Members 69 Registration Fee 69 Protection of the Board and its Members 69 Accountability to the Profession and the Public 70 Register Application Procedures 70 Minimum Qualification and Entry to Practice Standards 70 Level of Training for Registration 70 Curriculum and Course Contact Hours 70 Core Curriculum 71 Personal Therapy/Self Development 71 Client Contact Requirements for Registration 71 Post-Training Supervision Requirements for Registration 71 Ongoing Supervision Requirements for Renewal of Registration 71 Supervisor Requirements 71 Professional Development Requirements for Renewal of Registration 71 Professional Development Activities 76 Monitoring Professional Development for Renewal of Registration 76 Membership Terminology 76 Code of Good Governance 76 Ethics and Complaint Handling 77 Within Self-Regulating Professional Associations 77 Complaints Handling by Independent Registration Boards 77 The PACFA Complaints Handling Model 79 The Roles of Case Officer, Complaints Committee and Appeals Committee 84 Sanctions 84 A Complaints Committee for each Professional Association 85 Protocols with Government Health Service Commissioners 85 Negative Licensing 85 Summary 85 CHAPTER 5: METHODOLOGY AND CONSULTATION PROCESS 87 Consultation Methods for Counselling and Psychotherapy Professions 87 National and State Conferences 88 State Consultation Meetings with Profession on the Proposed Best Practice Models 88 Consultations with Indigenous Counsellors 90 Consultation with Educators and Trainers 90 Consultation Meetings Coordinated by DHS 90 Consultations with Health Services Commissioners 91 Consultations with Government Departments, Ministers and Senior Advisers 92 Responses to Discussion Paper on Best Practice Self-Regulatory Model 92 Models for a Registration Board 92 The Make-Up of the Board 93 Pathways to Register 93 Minimum Qualifications 94 Course Accreditation and Core Curriculum 94 Client Contact and Supervision Requirements 94 Training and Qualifications of Supervisors 94 Professional Development 95 Complaints 95 Register versus Directory 95 Membership Categories 95 Summary 96 Consumer Concerns 96 Summary 96 CHAPTER 6: PROFILE OF COUNSELLING AND PSYCHOTHERAPY PROFESSIONAL ASSOCIATIONS 97 Historical Overview of Psychotherapy and Counselling Professional Bodies in Australia 97 Psychotherapy and Counselling Federation of Australia (PACFA) 97 Study of Self-Regulatory Models for 6 Large National Associations 123 Methods 123 Sample 123 Procedures 123 Results 123 Structures and Governance 124 Training and Entry to Practice Standards 124 Course Accreditation 125 Ongoing Professional Development 125 Ethics and Complaints Handling 125 Registration or Directory of Members 125 Discussion 125 Summary 126 CHAPTER 7: MAPPING THE PSYCHOTHERAPY AND COUNSELLING PROFESSION WORKFORCE 127 Background 127 Aims 127 Methods 127 Participants 127 Design 127 Survey 127 Procedure 127 Statistical Analysis 128 Results 128 Sample Characteristics 128 Employment Titles 128 Qualifications 128 Professional History 128 Membership of Professional Bodies 128 Employment Positions and Sectors 128 Theoretical Orientation 128 Perceived