issue 1: july 2011 - acpaissue 1: july 2011 acparian issue 1 july 2011 12 from the president t hese...

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CONTENTS

Presidents AddressEditors ReportBoard ReportFeature ArticleResearch Article ReviewClinican Perspective

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910111112 Editorial Guidelines

AcparianA PACTHE AUSTRALIANCLINICAL PSYCHOLOGYASSOCIATION THE OFFICIAL NEWSLETTER OF THE AUSTRALIAN CLINICAL PSYCHOLOGY ASSOCIATION

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Issue 1:A NEW START

In this issue

Exciting changes for ACPA

Clinical psychologists �ghtfor recognition

Review of clinical psychologists’ perceptions of the mentally ill

Working as a clinical psychologist in rural Tasmania

The Australian Quali�cations Framework (AQF) Revised

Immunity of court experts: “Safe no more?”

www.acpa.org.au

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Editor

Assoc. Editors

Copyeditor

Design

ACPARIAN Editorial Board

Kaye Horley, PhD

Giles Burch, PhDMcLytton Clever, DPsych (Clin)

Bronwyn Williams, MPsych (Clin)

Ben Callegari, MPsych (Clin)

CONTENTS

EditorialFrom the PresidentBoard ReportFeature Article: Clinical Psychology: The Fight for RecognitionClinical Psychology Research

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Clinical Perspectives: A Client’s PerspectiveClinical Perspectives: A Clinician’s PerspectiveEthics and the LawStudent and Training Matters Clinical Perspectives: A Student’s PerspectiveEditorial Guidelines

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CONGRATULATIONS!To Cathy Jhetam, who cleverly came up with ACPARIAN as the name for our newsletter. Cathy has won vouchers to the Melbourne conference. Thank you to everyone who took the time to contribute their creativity!

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Kaye Horley, PhDEditord

Welcome to the �rst edition of ACPARIAN. As a forum for the dissemination of knowledge on topics of interest, we trust you will �nd it professionally informative, interesting and relevant to your clinical needs. We hope it will serve to provide a medium for best practice in advancing the specialty of clinical psychology, the focus of ACPA. Our President’s address will resonate with members who will identify with the sentiments expressed.

The dedicated editorial board includes Giles Burch, responsible for the ethics and legal section, McLytton Clever, responsible for student and training matters, reviews of the latest research is my �eld. Bronwyn Williams will edit contributions and Ben Callegari will design and format the newsletter. Feature articles will be a collaborative e�ort.

Content re�ects topical issues shaping the profession of clinical psychology, providing a catalyst for re�ection and discussion amongst members. From time to time there will be a focus upon special areas of interest. The focus of this edition is upon the personal and professional re�ections of clinicians at various stages of their career. Our distinguished guest, Malcolm Macmillan, describes the emergence of clinical psychology in Australia and the continuing struggle for recognition. Sandy Kastner describes her fascinating and demanding clinical experiences, initially in Western Australia and subsequently in south-west Tasmania. We can probably all identify with Richard Syrkiewicz, the rushed student, whose goal will always be furthering knowledge. It appears apposite to also have the eloquent re�ections of a client that makes for humbling reading. Thank you to all our contributors and a special thank you to the client.

Many Australians consider mental health to be a signi�cant issue, however, stigma and discrimination is widespread, adversely a�ecting those who most need care. But what is known about the attitudes of clinical psychologists? Are we aware of our own attitudes? Do we distance ourselves from the mentally ill and how may that a�ect our practice? Read the research article to �nd some answers. The legal article informs us of changes in the responsibilities of an expert witness in the United Kingdom, and the possibility, though considered unlikely, that this precedence may be cited in Australia courts. Information regarding revision to professional doctorates along with psychology and cognitive science output details is provided in the students’ section.

We seek to bene�t from your ongoing contributions, comments and suggestions. Letters to the Editor will commence in the subsequent newsletter and I invite comments on any issues.

Please write ([email protected]) and let us know what you think of our first publication, and what you would like to see in ensuing issues.

Editorial


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From the President

These are tumultuous times. Everything in the psychology profession in Australia is changing. National registration has seen a single set of standards applied for all Australian psychologists. These national standards have put a desperately needed foundation under the previously rapidly declining value of accredited post-graduate quali�cations in clinical psychology across most of Australia. However, while these new standards do, in e�ect, mirror the standards previously in place in Western Australia, they have also led to great distress and loss in that State. The abandonment of specialist title and a period of grandparenting, in which the new standards are not yet fully applied, has seen the serious downgrading of the speciality of clinical psychology in Western Australia. Furthermore, the meaning of ‘endorsement’ nationally has been left undermined by the inclusion of those with quali�cations in other specialities and many without any accredited post-graduate training. The inclusion of these psychologists, previously ‘endorsed’ by the Australian Psychological Society in the interests of enabling unquali�ed psychologists to obtain access to clinical psychology rebates under the Better Access scheme, undermines the right of other health professionals and the public to di�erentiate quali�ed clinical psychologists from those without accredited quali�cations and training. Overall, this has led to the diminution of the value of professional training. It was out of this distress and anger over these losses that the Australian Clinical Psychology Association grew and �ourished, and has found its voice on the national stage. The removal of the Australian Psychological Society as the gatekeeper to the Better Access program and Medicare funding for psychologists has been an enormous step forward for the profession.

ACPA is founded on the principles of equality, a valuing of our members, and a voice for all. As one of these members has poetically declared, the listserve is the heart of ACPA, the membership its lifeblood, and the Board its head and backbone.

Sometimes our heart beats with calm regularity, sharing -information, ideas and resources; sometimes it beats furiously over issues arising in the professional landscape.

Many voices on the listserve have become familiar as they share, participate in vigorous debate, and raise concerns. It is important, however, not to forget that behind these voices is also a large membership of people quietly listening, considering and responding when needed directly to requests from the Board. These quieter members, along with their more vocal colleagues, make up the lifeblood of ACPA, supplying the vital organs of the profession: the public, private and academic sectors.

At the head of ACPA, the Board works with dedication to provide strategic and well-considered approaches to the concerns of members and to formulate longer-term strategic plans to realise the vision of ACPA and advance our mission, while also developing services for the membership. These activities develop ACPA’s strength and support.

ACPA is young; it is new and fresh. As this young organisation grows and matures, unhampered by the weight of vastly diverse interests and with no opulent executive salaries or o�ce rental to support, ACPA is free to respond to the needs of its members as a true professional organisation.

As President, it is a privilege and a pleasure to serve this cause and the members of ACPA. This would not be possible without the assistance and support of a dedicated and committed Board, each member of which works endlessly, in time voluntarily carved from busy and demanding professional and personal lives, to build ACPA and increase its e�cacy and impact. As we move into a new phase of gaining a wider and stronger voice with government bodies, I know that, with the help of our membership, we will be able to meet the challenges that arise for and within the profession and realise our mission.

I commend the Editorial Board on their hard work and warmly welcome you to the inaugural issue of ACPARIAN.

Judy Hyde, PhDACPA Presidentde

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The Advisory Council is envisaged to operate under the authority of the Board. The Council is therefore of considerable importance as it is a working body which will receive input and will consider, research, report on and make recommendations on issues so that the Board may more e�ectively exercise its management role.

Sections will be recognised by the Board to represent ACPA in the local area, and each section will have a representative who is a member of the Advisory Council. Insofar as the Council will be dealing with member issues, members will be encouraged to bring problems/issues/suggestions to the attention of their section having multiple lines of communication, this will not limit individual members from being able to approach the Board directly. We will propose that Sections will also be active in the provision of CPD, facilitating networking of members, and representing ACPA at the local level.

The Board is waiting for �nal feedback from our lawyers, and we expect that a draft will be put to the membership for comment sometime in July.

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From left to right: Alice Shires, MSc (Company Secretary), Dr Judy Hyde, PhD (ACPA President), Assoc. Prof. Caroline Hunt, PhD (ACPA Vice

President/Treasurer), Samantha May, MPsych (Clin) (Educational Commitee), Leanna Clarke, MPsych (Clin) (ACPA Public Officer)

BOARDacpaAcparianA PACTHE AUSTRALIANCLINICAL PSYCHOLOGY

ASSOCIATION THE OFFICIAL NEWSLETTER OF THE AUSTRALIAN CLINICAL PSYCHOLOGY ASSOCIATION

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GROWING ACPA: A PRELIMINARY LOOK AT A PROPOSED NEW STRUCTURE

Caroline Hunt, PhDACPA Vice President

Members may be aware that the Board of ACPA has been working on a new constitution on which members will vote during our AGM in October 2011. We recently called for members who might be interested in helping with this development, and now have a small working party who, over the coming months, will be working on this task. While the �rst draft of the Constitution in full, and explanatory notes, will be put to the membership for feedback shortly, our �rst newsletter allows us to �ag the way in which our thinking on this issue is progressing (with advice along the way from our lawyers).

The philosophy behind the development of the Constitution is that ACPA is a national body representing clinical psychologists across all sectors, with each member having an equal say and equal voting rights. In this sense, ACPA will certainly be “grass roots” based, and democratic in nature. An example of this approach is the recent call for involvement in various committees (mentoring, membership, CPD), which was put to the whole membership of ACPA via the list-serve.

To a great extent, the structure of an organisation is governed by the type of organisation it is. ACPA is a company limited by guarantee. As such, it has (a) members, and (b) directors. The Board of Directors is elected by the members. The management of the company is vested in the Board. If the members are dissatis�ed at the way in which the Board is managing the company, the members may and almost certainly will elect a new Board.

As ACPA has members throughout Australia, one would expect that the geographical distribution of the directors will, broadly speaking, re�ect the geographical distribution of the members. If the members are principally in New South Wales, Western Australia and Victoria, then we would aim for the directors to come from New South Wales, Western Australia and Victoria. This should mean that the Board will not only be generally representative of its members but also that individual members will be likely to have an appreciation of issues of relevance to their own states/territories.

Together with the Board of Directors, we will propose two additional aspects to the organisation: a “Council” that is advisory to the Board and will, among other things, deal with “member issues”, and local groups (“Sections”), based on various geographical regions within Australia.

Board Report

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Malcolm Macmillan holds the degrees of DSc (Monash), MSc (Melbourne, 1964), and BSc (Western Australia, 1950). Since 2005 he has been a Fellow of

the Academy of the Social Sciences in Australia, and during 2004-2005 was President of the International Society for the History of the Neurosciences. He

has held visiting Fellowships at Oxford University and the University of Pittsburgh. Malcolm was a Founding Member, then a Fellow (1988), and then a

Life Member of the Australian Psychological Society (APS). He is a past President of the APS and founding member of the APS College of Clinical

Psychologists. He is a Fellow of the American Psychological Society (now the Association for Psychological Science). He is a co-editor of the Journal of the

History of the Neurosciences, and is presently on the Editorial Board of History of Psychology. Malcolm has authored over 90 papers and book chapters.

His authored books An Odd Kind of Fame: Stories of Phineas Gage (MIT Press) and Freud Evaluated: The Completed Arc (MIT Press) have received

widespread critical success, including awards.

Professor Henry James, University of Melbourne

and in administering and interpreting di�erent kinds of psychological tests, including the (false) gods of projective tests worshipped by the clinically-oriented of that time. Given that our role was still predominately that of a diagnostic handmaiden to the all-powerful psychiatrist, our practice was not going to do much damage.

When proper training in clinical psychology began it was at the state level. Beginning in Western Australia as an addition to the Honours year, and taught from the perspective of Rogers’ non-directive (now client-centred) therapy by Pat Pentony and Elwyn Morey, it expanded through the phases of Diploma, Master and Doctor. Ross Smith and Nancy Stewart worked hard and successfully with the Department of Psychology at the University to get state funding for clinical training and an ‘exclusive’ clinical employment and promotional pathway in the public service. Concurrently, it was in WA that the �rst signi�cant group of private clinical practitioners emerged. Developments in Sydney under Gordon Hammer were similar, although there was no alliance with the public service. Victoria was left behind: no clinical course, no state subsidy, relatively many dinosaurs in state-owned zoos, and a very small number (4-5) surviving on the edges of private parks.

All this is by way of a preliminary to the problem that has so dogged us in Australia: the lack of recognition of clinical psychology as a specialist discipline and practice. Put another way, what hinders us is the positive answer many non-clinical psychologists give to these questions: “If dinosaurs could do it, why can’t I? Hasn’t my training given me the same abilities as they had (or have)? Don’t I have the same personal qualities to be as good a clinical psychologist as they?” The inevitable conclusion that follows from positive answers is that there is nothing special about clinical psychology. To be a good clinical psychologist requires only warmth, empathy, and honesty. And who will deny they have those qualities?

CLINICAL PSYCHOLOGY:THE FIGHT FOR RECOGNITION

Malcolm MacmillanProfessorial Fellow, Psychological Sciences, University of Melbourne.

On a pictorial scale showing the evolution of clinical psychology, I emerged at the Dinosaur Stage. When I began my course in 1946, psychology itself had barely been recognised as a discipline and had hardly been recognised as a profession although some psychologists had always been employed in educational occupational settings. Few worked in clinics, and when they did, it was as diagnostic testers. Not that there was no interest in clinical topics. At all three of the universities then o�ering courses in psychology—Sydney, Western Australia, and the newcomer, Melbourne—there was psychoanalytically-oriented interest in clinical questions. Nowhere was there speci�c training in clinical psychology.

Psychological facilities expanded enormously post WWII. Post-war reconstruction policies o�ered ex-service men and women scholarships for education and training (Commonwealth Reconstruction Training Scheme, CRTS), free vocational counselling (Department of Labour and National Service, LNS), free remediation of hearing problems (Commonwealth Acoustic Laboratories, CAL), and free help with psychiatric disorders (Repatriation Department)1. These services were gradually expanded into civilian life, and when they did, the growth was in keeping with the socialist policies and atmosphere of the time: almost all were located in government agencies and their services were free.

Clinical psychological services were virtually state government matters. The Commonwealth provided moneys to the states for mental health facilities, mainly clinic and hospital buildings, and through them (and on its own part to some extent) to the universities for training. Until about the late 1950s, that training only went as far as bachelor’s degrees. Dinosaurs learned on the job. This was not quite a disaster. Undergraduate training was then very much oriented toward practice and we had intensive training in observation, in interviewing, in constructing and analysing questionnaires,

Feature Article


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Of course all the empirical evidence is against the personal-quality view. But suppose it were true. How far do those qualities take one in assessing the severity of a post-traumatic-stress disorder? Planning a treatment program for anorexia? Evaluating research on the best ways to deal with episodes of early psychosis? Establishing the likelihood of suicide in someone with depression? Suppose, against the odds, I had only those personal qualities and did not want to be a clinician. How far would they take me in developing an e�ective ‘Quit’ campaign? Estimating the possibility that a violent o�ender would re-o�end? Devising an employment program to maximise employee satisfaction? There is a single reason why all those questions have to be answered in the negative: undertaking those tasks requires the speci�c skills appropriate to the speci�c area of psychology involved clinical, health, forensic, and occupational. Psychological practice may draw on generic skills but each specialist �eld demands the special skills for which the generic are only a foundation.

What clinical psychologists have always had to �ght for, tooth and nail, is simply the recognition, especially by other psychologists, that specialist training is absolutely necessary for clinical practice. Although it has always struck me as odd that this principle is not held strongly by many of my colleagues in other areas of specialist practice, it does not strike me as odd that it is not held by most graduates in psychology. They su�er from an old disease: ACBP [‘Anyone Can Be a Psychologist’]. It is they who provide, as they have always done, the main basis for the opposition of the Australian Psychological Society to the various manifestations of its College of Clinical Psychologists. Being able to qualify for registration and practice with (in most cases) desultory supervision after completing a pretty basic degree—one lacking the skills training endured by the dinosaurs—why should they not think themselves as good as those with specialist training?

Opposition to the College and its standards has emerged twice: once in the 1970s and again more recently. The 1970s battle was in a context in which ‘Colleges’ generally were to be abolished. It was launched by those opposed to the emergence of any specialised branches of psychology including members of the APS Council, the precursor to the present Board of Directors. Some of you may dimly recall the climax of the battle at the 1977 AGM of the APS in Sydney, where we won a decisive victory. A consequence was Peter Sheehan’s recommendation for a new APS structure having two Divisions and specialist Boards–the latter the precursors of the present Colleges. Not only had we retained our autonomy, we seemed to have ensured the future of a high standard of clinical practice.

However, the move from public to private practice with its related considerations of the two levels of Medicare rebates led to a new attack. The battle was now �ercer. Although Lyn Little�eld, Executive Director of the APS, said that in the original negotiations, the Commonwealth Government wanted specialist clinical services to be provided only by members of

the Clinical College, or those with equivalent quali�cations for membership, it was not long before APS lowered the standards for recognising equivalence. At the March 2006 meeting of the Victorian Section of the College, and in the presence of Lyn Little�eld, that fact was �nally admitted by Lyn Casey of the Medicare Team (but only after repeated questioning by Nick Allen). Since then, things have got worse. In quite unprincipled ways, APS prevented motions being put or manipulated proceedings at its AGM such that they weren’t discussed properly; restricted discussion of the issues at College meetings (including College committee meetings!); it took over processing applications for College membership; and it lowered entrance standards even further.

ACBP has now become institutionalised in the APS hierarchy, some members of whom have been able to sell the disease to the Commonwealth Government as a signi�cant part of the remedy for the country’s mental health needs! A turning of Oscar Wilde’s famous phrase pretty well sums up the present situation: the unwell being pursued by the unquali�ed. My experience2 was of a di�erent model of professional practice, one aimed directly at those whose needs are greatest but whose pockets are smallest: state mental health services. With political parties on the left and the right having successfully displaced socialist thinking by a capitalist mind-set, reviving a state system is now an impossible dream. But those changes should not allow victory to those opposed to the standard ACPA sets for specialist training in clinical psychology.

REFERENCES:

1 http://en.wikipedia.org/wiki/Department_of_Post- War_Reconstruction_(Australia) [A reasonably trustworthy Wiki account]

2 http://www.psychology.org.au/Assets/Files/Malcolm- Macmillan-APS-journey.pdf

Feature Article

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Call for contributions for

November 2011 Issue featuring:

DEPRESSIONACPARIAN invites members to contact the Editor, Kaye Horley [email protected] regarding contributions for the next edition. Contributions may be from clients and members or others with research, psychotherapeutic or other clinical expertise in this area. Final articles should observe the word limit detailed in the Editorial Guidelines and should be submitted by 3rd October 2011.


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Clinical Psychology ResearchKaye Horley, PhDEditor

Kaye has over forty years experience in health care settings including teaching, research and as clinician. She has always been interested in the “why?” of behaviour, and has a continued fascination with the mind, particularly the cognitive and emotional processes underlying mental illness, the focus of her PhD.

The focus of the research section of ACPARIAN is to provide clinical psychologists with reviews of innovative, relevant research informative to practice. Witmer, considered the founder of clinical psychology, de�ned it as “the study of individuals, by observation or experimentation, with the intention of promoting change” and opened the �rst clinic and training program in 1896 (see Thomas1 for an interesting review of this forgotten man). Since Witmer, clinical psychology as a discipline has emphasised its scienti�c framework, its rigorous research methodology and its application towards understanding and improving the human condition2. As Bray3 points out, what di�erentiates the practice of clinical psychologists from other practitioners is our strong scienti�c basis.

Historically, there has often appeared a dichotomy between the practitioner and the scientist (see Poortinga & Lunt4). Many would argue that clinical psychologists should be trained as both clinician and researcher, as science and clinical practice are closely integrated and inform the other. This is exempli�ed in evidence-based practice, as opposed to “trial-and error eclecticism”5. Clinical psychologists need to be able to critically evaluate research literature, engage in informed practice, and ensure recency of their professional knowledge.

Research o�ers growth as well as constraint, with evident di�culties exempli�ed in the complexity of distress or relationship, though one can point to Harlow6 investigating love in the nineteen-�fties. The challenges of clinical psychology research include the need for more sophisticated models of human behaviour, the development of valid and reliable assessment methods, and the need to evaluate disparate therapeutic approaches and outcomes2. In essence, systematic research is necessary to provide an empirical basis for the professional advancement of clinical psychology.

In 1907 Witmer1 established and edited the �rst scienti�c-based journal, The Psychological Clinic, for the �edgling area of clinical psychology. Subsequent literature has continued the dissemination of knowledge and promotion of clinical psychology as a science. ACPARIAN hopes to continue this tradition.

Please send research-oriented items of interest or reviews relevant to current practice. Comments and suggestions regarding this research section are most welcome. As the �rst edition of ACPARIAN pertains to the clinician, the �rst review is pertinent in highlighting potential biases inherent in our practice. REFERENCES

1. Thomas, H. (2009). Discovering Lightner Witmer: A Forgotten Hero of Psychology. Journal of Scienti�c Psychology, April, 3-13.

2. Roberts, M.C. & Ilardi, S.S. (2005). Research Methodology and Clinical Psychology: An Overview. New York: John Wiley & Sons.

3. Bray, J.H. (2010). The Future of Psychology Practice and Science. American Psychologist, 65 (5), p 355–369.

4. Poortinga, Y. H. & Lunt, I. (2011). Psychology as a Profession and a Science: The Change From EFPPA to EFPA. European Psychologist, 16 (2), 111–117.

5. Barlow, D. H. (1981). On the relation of clinical research to clinical practice: Current issues, new directions. Journal of Consult-ing and Clinical Psychology, 49 (2), 147-155.

6. Harlow, H.F. (1958). The nature of love. American Psychologist, 13, 573-685.

FEATURED RESEARCH ARTICLE REVIEW:

Servais, L. M. & Saunders, S. M. (2007). Clinical psychologists' perceptions of persons with mental illness. Professional Psychology: Research and Practice, 38(2), 214–219.

This study surveyed the perceptions of three hundred and six randomly selected clinical psychologists and the degree of their disidenti�cation towards those with a mental illness. Unjusti�ed biases may appear as the result of in�uencing interpersonal factors such as “likeability, similarity, attraction and disidenti�cation.” Disidenti�cation was de�ned as distancing oneself from the mentally ill by perceiving them as easily recognisable and di�erent in comparison to the self, perceived as “normal” and not disposed to a mental disorder. Disidenti�cation may be evident in the tendency of clinicians to group people into categories, for example, ‘alcoholics’, and then ascribe all with having similar negative qualities, for example, the belief that all alcoholics are in denial. It may also be evident when clinicians, rather than referring to a person, refers to them by their disorder (e.g. ‘borderlines’). Importantly, the role of furthering the public’s understanding and acceptance of the mentally ill by clinical psychologists necessitates an awareness of their own prejudices.

Participants and method

Participants worked in a variety of settings, with two thirds mostly in private or group practice, treating mild (39%), moderate (44%) and severe (17%) clients. Average completion of training was 14.5 years with average clinical experience 16.5 years. Six semantic


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The authors stress the importance of clinical psychologists’ awareness and redressing of negative attitudes, on both an individual and professional level, so that they do not re�ect the often negative and stereotypic attitudes and biases of the general public, for example, that those with a mental illness are unsafe. They emphasise the necessity for psychologists to examine the nature of their biases.

Professional training is considered one inadvertent likely source of attitudinal bias, for example, the distinctions between the expert clinician and client is highlighted, along with a focus upon dysfunction or abnormality. The authors suggest that curricula designed to counter bias with focus on particular disorders and stereotyping. In addition, there should be engendering of positive attitudes towards recovery and societal contribution. Supervisors of students should also monitor attitudes. Another suggestion is the use of mental health consumers as trainers, as they have been in�uential in positively a�ecting attitudes of professionals. The authors concluded that clinical psychologists are motivated by caring attitudes, but are a�ected by external in�uences that may result in negative perceptions and biases towards those with a mental illness.

Correspondence and contributions to: [email protected]

di�erential scales were used to examine positive and negative attitudes (e�ective-ine�ective; understandable incomprehen-sible; safe-dangerous; worthy-unworthy; desirable to be with-undesirable to be with; similar to me–dissimilar to self ) towards the following: self, member of public (non-clinical), and three clinical targets with either moderate depression, borderline features or schizophrenia.

Findings indicated signi�cant negativity of clinical psychologists towards all the clinical targets, but particularly towards those with a personality or psychotic disorder. They considered all clinical targets signi�cantly less e�ective and desirable than themselves, however, the target schizophrenia person was considered the most ine�ective person, and the target person with borderline features was considered the least desirable (42% clinicians). The latter was also perceived as the least worthy and more dangerous. The target person with schizophrenia was also perceived by the clinical psychologists as the least understandable and most di�erent (69% clinicians) to themselves than the other targets. The borderline feature target person was considered the next most dissimilar (60% clinicians), followed by the moderate depression target (24% clinicians).

The authors pointed out that their results were likely to under-estimate bias in the profession for three reasons. They assumed that the participants who responded would be more likely to have favourable attitudes and would have endeavoured to appear unbiased There was also an under-representation of those working in public social service agencies and those working with severe or chronic conditions, both areas associated with increased negativity in professionals.

The authors proposed that their results implied that disidenti�cation is a ‘dynamic’ process between the clinical psychologist and client and posited several reasons for its occurrence. Perceived di�erences were attributed to the possible need to augment self-esteem and decrease self-vulnerability. Another consideration was maintenance of professionalism with consequent elevated factors of ‘e�ectiveness’, ‘desirability’ and ‘safety’. They additionally pointed out that the e�ect is also one of emotional and cognitive distancing of the self from those with mental disorders. Attitudinal factors were considered to be mediated by both training and personal bias, with consequent e�ects upon professional behaviour.

Implications for Practice

It was considered that such negative perceptions are likely to contribute to pessimism regarding treatment outcome, negatively a�ect the provision of treatment and notably constrain therapist empathy and engagement with clients. In e�ect, if clinical psychologists are no di�erent in their attitudes towards the mentally ill from the general public they are serving to perpetuate stereotypes of the mentally ill.


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Above: Coastal cli�s of the Tasman Peninsula, Tasmania, Australia. Taken from near the “Devil’s Kitchen.” Photo by Felix Andrews

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A CLINICIAN’S PERSPECTIVE:WORKING AS A CLINICAL PSYCHOLOGIST IN RURAL TASMANIA.

Sandy Kastner, MPsychClinical Psychologist, Tasman Psychological Services.

Sandy is in private practice in Tasmania. In this article, she shares the unique journey of her career and the complexities of working as a clinical psychologist in some of Australia’s remotest areas.

When I was asked to write a short article for the inaugural ACPA newsletter re�ecting on my work as an ‘experienced’ practitioner my �rst response was “but I’m not experienced”! I completed my Master’s in Western Australia in 2004 and �nished my supervised practice in 2006, so I’ve been ‘fully-�edged’ for a mere �ve years! I therefore see myself as a developing rather than experienced, clinical psychologist. The “getting of wisdom” takes time, after all. Much has been crammed into those �ve years, however.

I started work as a clinical psychologist registrar in the Department for Child Protection in Karratha in the mining North West of WA, and feel that was absolutely the best learning experience that any psychologist can have. It should be compulsory: child abuse and neglect is the nursery of adult mental illness. As John Briere stated when he was the President of the International Society of Traumatic Stress Studies, “If we could eliminate child abuse and neglect tomorrow, the DSM would shrink to the size of a pamphlet”1.

There was so much to learn about such an important area that I wonder why it was barely mentioned in either undergraduate or post-graduate study? So much serious mental illness develops when children experience chaotic attachment relationships early in life. Why is so little time devoted to this in university psychology programs? You really get your hands dirty working in child protection, but the experience is priceless.

From the rugged, remote north-west I transferred down to bucolic Northam in the Wheatbelt of WA, around 100 kilometres east of Perth. From both these communities I learned some important ‘truths’. In spite of all the problems associated with the Aboriginal community, they have the capacity to sel�essly take on and care for the children of their relatives and do the best they can. I witnessed women giving up the chance of having their own families to care for the children of their sisters; I don’t think I could do this with the same grace. I gained profound respect for their sense of kinship that is so often lacking in mainstream Australia. I also learned that Northam was a ‘mecca’ for newly released sexual o�enders from the justice system!

Then came a major lifestyle change (which had absolutely nothing to do with the last sentence!), a move right across the mainland and down to the Tasman Peninsula in Tasmania and private practice in early 2008.This was a di�cult transition, moving from the ‘safety’ of working in a government department to the uncertainty of private practice, with no collegial support, in what seemed like a foreign country at times. It took exactly two years to become ‘accepted’ by the local community; this had been predicted by Alison, the practice nurse at the medical centre, when I �rst introduced myself to them o�ering psychological services, but foolish me thought she was joking!

As most people know, attracting GPs to work in rural medical centres is a problem. Interestingly, the local medical centre was owned by a WA company and the �rst GP I encountered here was a Russian doctor.

His wife and children remained in Melbourne whilst he “did his time” in rural Tasmania; he wasn’t the happiest of souls! He did refer one or two people to me, however, for which I was grateful. He was shipped o� to Newman in WA when he �nished his three years in Tasmania at the end of 2008.

The medical centre was then taken over by a local Tasmanian group of doctors, but they had as much trouble recruiting GPs to the Tasman Peninsula. 2009 was very unstable and it wasn’t until early in 2010 that things �nally settled down, when two retired GPs, both well into their 70’s, worked a commute system of three weeks on and three weeks o�. They had worked together as young GPs in Launceston years ago. Now one commuted from Adelaide, South Australia and the other from Hobart. That’s how hard it is to get GPs into rural medical centres, even scenically spectacular ones. So just as practice nurse Alison predicted, after two years, I was �nally accepted as someone who was reliable and staying around and referrals started coming in. I actually think that Alison was satis�ed that I was reliable and she encouraged the referrals! She is an important person in the local community after all, winning an Australia Day award for service to the community this year.

I work in closely with the school psychologist who visits the Peninsula weekly, so I still see children. In addition, there is a nursing home attached to Health and Community services complex and I’ve been asked to provide services there in the near future. I’ve had to hone skills across the full spectrum of mental health problems being the sole provider of mental health services, therefore continuing professional development is a constant companion. In addition, I also provide services to another lovely rural town an hour and a quarter drive away one day a week.

Although the Port Arthur massacre took place over 15 years ago, the aftermath is still evident in current referrals. Such is the nature of trauma – it has a triggering e�ect. Of course the most valuable resource I bring to my work is the initial child protection experience, the quality of early attach-ment relationships and how this impacts on personality development and the individual in their current life circumstances. It saddens me to say that child protection services in Tasmania leaves a lot to be desired and it amazes me that they don’t employ clinical psychologists.

So although the idea of coming to Tasmania was to ‘slow down’ and work part-time, I �nd myself very busy keeping up with everything that’s happening in our clinical psychology world and with our evolving knowledge base across the life-span. The hardest thing of all is the loneliness of individual practice. That is why I value ACPA so much; it has provided me with the collegial support of so many other wonderful, and far more experienced clinical psychologists than I. The generous sharing of information is inspirational and I thank you all for maintaining my sanity! Bless you.

REFERENCES:

1 Stein, P.T. & Kendall, J. (2004). Psychological trauma and the developing brain: Neurologically based interventions for troubled children. Birmingham, NY. The Haworth Maltreatment and Trauma Press, p. 214.

Clinical Perspectives


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A CLIENT’S PERSPECTIVE

Dante1 is a 39 year old male diagnosed with PTSD, Chronic, Major Depressive Disorder, Chronic, Agoraphobia Without History of Panic Disorder, and Irritable Bowel Syndrome, Chronic. He is in psychotherapy and o�ers clinical psychologists some perspectives on his experiences of therapy.

A core and formidable obstacle to my need for professional care, was the terrifying realisation that for me to receive accurate assistance, another human being would have to bear witness to the true details of my most daunting personal problems. My walking through the door that very �rst time created for me the very intimidating concept of making a “true witness” to my trials as a man and the abject shame that such confessions would trigger in me.

Although for me this very private relationship with my psychologist has now been safely created, the feelings I still experience of “exposure” when I speak of these matters, no matter how professionally or gently I am tended, still remain a consistently di�cult element in my preparation, and then attendance of each session. More than just a feeling of nervous anticipation or trepidation, each appointment I make with my psychologist exists for me long before the hour it occurs and lingers long after it is past, as my mind �rstly prepares and marshals itself for allowing another human being access to the private wounds of my life, and then secondly as my mind attempts to comfort itself after the intrusion of the session no matter how carefully the topics were imparted.

Synergy between the doctors and psychologists assisting me with my day to day troubles is also very important. From one school I currently receive treatment for PTSD and its multiple satellite phobias stemming from a violent sexual assault I endured as boy and have regrettably been unable to reconcile. From another group of professionals I also receive treatment for an acute intestinal disorder that is both chronic and severely disabling.

For me, what clearly de�nes my ability to e�ectively interact with these two groups of professionals is their ability to subtly adapt to my needs. Elements, both mind and body, that are often very much out my hands, create very real obstacles that I myself must adapt to before I can even receive care. Continuously adaptive and compassionate understanding of these daily elements from the professionals I trust remains one of the most helpful and important elements of my ongoing relationship with the medical community.

Though safely in a routine of care now, I was very nearly left by the wayside as my own passage into regular and competent care was, from a patient’s point of view, ridiculously di�cult and arbitrary when it came to the vast di�erences in the even the most basic professionalism of the persons I encountered.

Professional detachment and objectiveness from these people aside, many of those I spoke to had little or sometimes no ability to engage with me on anywhere close to a meaningful level; their clinical syntax and “one size �ts all” medicine so heavily entrenched around them that the experience was more like trying to interact with an answering machine than an actual person.

Though I do very much understand the need for personal boundaries to be in place between a psychologist and patient as it is core to establishing the “roles” of each within the context of therapy, I do believe this “emotional �rewall” in some psychologists can be so overdeveloped that, as care givers, they are rendered almost completely moot in regard to their ability to actually make the patient “feel better” each time they interact.

Another problem encountered that only serves to add to the clinical divide between patient and psychologist is the “do your own assessment” paperwork often handed out to patients to complete and then be “emotionally graded” based solely on the boxes ticked. I cannot stress how impersonal these devices make an appointment feel. Considered by some a valuable tool in patient assessment this collection of clumsy generalisa-tions, from a patient’s point of view, is completely inorganic to the real communication required when two human beings come together to speak of troubles.

This brings me again to the concept of the psychologist being the true witness of the patient’s pure and unexpurgated situation and the much needed professional acumen that should be applied while in that position.

This is not a radical concept or a fanciful notion forwarded by a patient with a “wish list”; it is a genuine requirement of the accurate execution of detailed and e�ective care. If the patient becomes aware that the psychologist can, in fact, see their situation but still cannot seem to express sincere compassion or original thought towards them, then this failure within the therapeutic process can only serve to compound, or even worse con�rm, a more fragile patient’s own feeling that their problems are in fact of little or no consequence to the world outside their own. This results in further isolation and a magni�cation of the feelings of futility and hopelessness indigenous to conditions like anxiety and depression.

I can guarantee you a distressed patient in full crisis only cares about one thing... “Did coming to you make them feel better?” If it did not, then you have to put ego and education aside and ask yourself as a professional “why not?”

In speaking of the problems faced when actually already in the care, perhaps I have been remiss in failing to mention some of the obstacles encountered long before a face to face session even occurs, these being ‘�nding and �nancing’ the care a patient requires.

These two subjects may, at �rst glance, seem dissimilar, but to the patient, how much it will cost is often more important than where it is. I am a disability pensioner (queue stigma) my �rst enquiries as to possible concessions to cost with professionals were met with a series of short, terse, negative answers, with one doctor actually laughing at the sugges-tion. Compounding this attitude was the fact that none of those I asked would in fact tell me where to �nd care that took into account my limited �nance, instructing me ultimately to just “go to your local hospital and ask there”.

Ultimately the beyondblue website provided more help than all my phone enquiries combined. It provided an area map of all professionals identi�ed within and most importantly displayed an icon system clearly marking those psychologists willing to bulk bill patients like myself.

Given the latest focus of both sides of government in regards to what is politely termed “welfare reform”, it has never been more important that patients in situations similar to my own are in the care of a professional able to o�cially de�ne the patient’s genuine need of continued assistance.

The stark irony of the moments of clarity and lucidity that I used to form these thoughts is that there exists in my mind the polar opposite to their productivity and while trapped by them again I will likely not even remember what I have attempted to achieve here.

Highlighting my �nal message to you, we (the patients) need you so much; any barriers you could reduce or remove to help us more easily get the help we need is beyond value.

I'm crying again now... I don't why yet, just that is going to be another hard day, I hope these words were worth it...

1 Reference to the long imprisoned character who reclaims the world in the story of the Count of Monte Cristo and also to Dante's famous inferno and the descent through the layers of hell; seen personally on a daily basis.



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ETHICS AND LEGAL DILEMMAS

Giles Burch, PhDAssociate Editor

Giles originally quali�ed as a Chartered Occupational Psychologist in the UK and has worked in the UK, New Zealand and Australia as both an academic and organisational consultant. He has a particular interest in work-related personality, psychological-well being, productivity and performance. Giles received his PhD from the Institute of Psychiatry, King's College London, and is currently completing the Doctor of Clinical Psychology at the University of Sydney.

Firstly, it is my great pleasure to welcome you to the Ethics and Legal Dilemmas section of ACPARIAN, which falls under my remit as Associate Editor. I envisage this section will provide a forum that explores ethical and legal matters that impact all of us working as clinical psychologists. In doing so, I hope that lively debate will ensue around the critical issues that we face, and are indeed challenged by, daily in our role.

The debate of ethical and legal issues in practice and research has a central role in the profession of clinical psychology, and thus has a critically important place in specialist clinical psychology training. From an early stage in our careers, we are philosophically challenged in our thinking with reference to a wide range of issues, such as: con�dentiality, boundary violations, guardianship, treatment orders and the treatment of suicidal patients, to name but a few (see Chiles & Strosahl, 20051, and Bloch & Green, 20092, for discussion on these and other issues).

Whilst a sound knowledge and understanding of the ethical dilemmas and legal issues in clinical practice and research will provide a basis for informing practice, it is the ongoing process of philosophical inquiry and challenging of assumptions of such complex clinically-related issues that helps maintain the professional standing and uniqueness of specialist clinical psychologists, and determine professional codes of ethics and standards, such as those espoused by ACPA3. The understanding of these issues within our clinical practice and research, and our preparedness to face and challenge these on an on-going basis, is core to clinical psychology practice, and thus, we feel, warrants special attention in ACPARIAN.

In order to facilitate discussion amongst ACPA members, we are seeking contributions that raise/discuss ethical and legal issues germane to clinical psychology practice or research. Such contributions may take the form of articles or case-studies and should be between 750 and 1000 words. Additionally, if you would like advice or answers regarding an ethical or legal dilemma you face, please tell us about this, and we will endeavor to �nd an ‘expert’ to respond to your challenges for publication in a subsequent edition. Finally, any items of news that you may come across that you believe are relevant and may be of interest to the readership; please send them through for inclusion in this section.

Ethics and the Law

For example, news from the United Kingdom of the recent court ruling that expert witnesses can now be sued for negligence (Jones v Kaney, 2011; UKSC 13), thereby over-turning a 400-year-old principle in the UK that experts who give evidence in the courts have immunity, is not only of interest, but may have implications for those ACPA members who provide expert witness testimony. This case is the feature for the current Ethics and Legal Dilemmas. In an article written by Lees, Whitely and Panos of Blake Dawson, a leading Australian law �rm, the case, involving a clinical psychologist, is outlined and implications of which are considered within the Australian context. I hope you enjoy this article and re�ect on the ethical and legal issues this case raises.

FURTHER READING

1 Chiles, J.A., & Strosahl, K.D. (2005). Clinical Manual for Assessment and Treatment of Suicidal Patients. Washington, DC: American Psychiatric Publishing, Inc.

2 Bloch, S., & Green, S.A. (2009). Psychiatric Ethics. Oxford: Oxford University Press.

3 ACPA Code of Ethics available: http://www.acpa.org.au/ACPA_-_Australian_Clinical_Psychology_Association/Code_of_Ethics.html


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IMMUNITY OF COURT EXPERTS: SAFE NO MORE?

Amanda Lees, Amanda Whitely, & Maria PanosBlake Dawson

Amanda Lees is a Senior Associate and Amanda Whitely and Maria Panos are lawyers with Blake Dawson, an Australian legal �rm.

In Brief

After con�ning the scope of advocates' immunity in 2002, the UK Supreme Court has now similarly restricted expert witnesses' immunity in Jones v Kaney [2011] UKSC 13. Expert witnesses in the United Kingdom are no longer immune from suit for breach of contract or negligence owed to their clients in relation to the evidence they give in court or the views they express in anticipa-tion of court proceedings.

Given the reluctance of Australian courts to diminish advocates' immunity, expert witnesses in Australian courts should not be immediately concerned. Nonetheless, it would be prudent to review contractual retainers and professional indemnity insurance policies to ensure that they provide protection if such a claim were made.

Background

Mr Jones engaged Ms Kaney, a consultant clinical psychologist, to provide an expert report in personal injury proceedings arising from a tra�c accident.

Ms Kaney prepared two reports, and signed a joint report drafted by the motor insurer's expert. The three reports all gave di�erent opinions on Mr Jones' medical state, with the joint report stating that Ms Kaney found Mr Jones to be deceptive and deceitful in his reporting.

On this basis, the majority held that the immunity ought not to apply in this case for the following reasons:

there is no conflict between an expert witness's duty to the court and their duty to their client to provide their services with reasonable skill and care;

there was no evidence to support the idea that the removal of the immunity would be a "chilling factor" which would reduce the availability of expert witnesses and make them reluctant to give evidence contrary to their client's interests; and

the abolition of advocates' immunity has not opened the floodgates of vexatious claims or affected advocates' practice or performance of their duties.

Importantly, the majority emphasised that insurance was available to protect experts against the risk of claims, and noted that it would be di�cult to mount a credible case that an expert witness has been negligent. Lord Brown expressed the view that courts should protect expert witnesses against specious claims from disgruntled litigants.

Lord Collins noted that expert witnesses are not protected from disciplinary proceedings for unprofessional conduct in the preparation for, or giving of, expert evidence and this would have far more serious consequences for an expert's livelihood and reputation.

The majority noted that the exception to the blanket immunity would assist courts by encouraging experts to give careful and reliable evaluations of the merits of a claim, and discouraging them from pitching the merits of a claim too high.

The minority decision

Lord Hope and Lady Hale held that the rule ought to be maintained given:

the lack of clarity of the scope of the proposed exception to the general immunity;

the uncertainty as to its effects; and

the absence of a principled basis for abolishing immunity for expert witnesses.

They expressed the view that it was more appropriate that the status quo be maintained and the Law Reform Commission or Parliament consider the issue.

The Australian position

The High Court of Australia considered advocates' immunity in 2005, in D'Orta-Ekenaike v Victoria Legal Aid (2005) 223 CLR 1. The majority declined to follow the House of Lords in restricting the immunity, and held that it should be maintained. Their Honours stated that the justi�cation for that immunity was the principle that controversies, once resolved, are not to be reopened except in narrowly de�ned circumstances.

The UK Supreme Court's decision in Jones may encourage claims against expert witnesses, although the majority of the UK Supreme Court considered that their decision would not have that e�ect. We consider that only in an exceptional case would an Australian court decline to uphold the immunity of expert witnesses, particularly in light of the High Court's emphasis on the need to preserve the certainty and �nality which underpin the judicial system.

© Blake Dawson 2011. Reproduced with permission. This article was first published in Blake Dawson's Litigation Update on the Blake Dawson Website at www.blakedawson.com.

The editors of ACPARIAN would like to thank Blake Dawson for permis-sion to reproduce this article in its entirety.

Correspondence and contributions to: [email protected]


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STUDENTS AND TRAINING MATTERS

McLytton Clever, DPsych (Clin)Associate Editor

McLytton emigrated from Zimbabwe to Australia in 2002 and has recently completed a doctorate in clinical psychology at Victoria University in Melbourne. His areas of speci�c interest include training, personality disorders, multicultural assessments and interventions, as well as sleep.

Welcome to the Students and Training Matters section of this �rst edition of ACPARIAN. This section will be a vehicle through which dissemination of information about student and training issues in clinical psychology in Australia will be covered.

Students and Training Matters will be a regular feature in the newsletter. Its principle objective is to provide students with a forum to share their experiences and learn from each other during their training.

Contributions by students to this newsletter �ts with ACPA’s stated recognition of a strong students’ voice in the psychological community. In short, student participation will o�er many bene�ts including:

Bene�ting from and contributing to their area of professional speciality through expressing their point of view;

Connecting with senior practitioners and potential mentors who can o�er advice to students on current issues in the profession including professional development opportunities;

Opportunities to collaborate on writing and research projects with senior clinicians;

Access to a variety of resources including community of like-minded students and experts; the chance to develop leadership skills in clinical psychology.

In addition, contributions in this section will cover issues on training of clinical psychologists in Australia. Some of the issues that we hope to cover include (but obviously not limited to) placements, career opportunities, quality of training programs, supervision, registration, as well as licensing issues in psychology. Where possible comparative articles on education and training of clinical psychologists in the Asia-Paci�c region or elsewhere in the world will be covered.

Invitations for contributions in this section will be open to students, clinical supervisors, and experts in the education and training of clinical psychologists. We will also strive to highlight success stories of students and educators in the specialty of clinical psychology in Australia.

Policy issues in training such as the ACPA Board’s position on quality and training, continuing professional development (CPD), and accreditation issues will be covered. In addition, we will cover controversies in training, reforms and changes in the profession. ACPA members and students alike will be given the platform to share their views through publication of their contributions in this newsletter.

We invite contributions from students and trainers regarding student and training issues in clinical psychology (or psychology in general) for publication in the next edition of ACPARIAN. Article length should be between 750 and 1000 words.

Send contributions to McLytton Clever: [email protected].

IN THE NEWS

Australian Quali�cations Framework (AQF) Revised

The Ministerial Council for Tertiary Education and Employment (MCTEE) approved revisions to the Australian Quali�cation Framework’s (AQF) 10 levels of quali�cation descriptors, associated policies and implementation arrangements on 18 March 2011. The report notes that these changes will a�ect the descriptor for professional coursework doctorates. In addition to the already existing course load, students undertaking the professional doctorates in psychology will be required to complete two years of full time research. Implementation of the new AQF will commence on 1 July 2011 with all AQF requirements required to be met by higher education providers from 1 January 2015. Further information on the new AQF speci�cations and a communiqué by Ministers of Education is available on the Australian Quali�cations Framework Council website at www.aqf.edu.au. Tell us what you think about these changes.

Psychology and Cognitive Sciences increase research output

The Excellence in Research Australia (ERA) report published by the Australian research Council (ARC) reports that Psychology and Cognitive Sciences contributed about 3% of the national research output . According to the ERA report there has been a 52% increase in research output in psychology and cognitive sciences over the reference period. Table 1 shows the distribution of research output according to Field of Research Code (FoR). ARC reports that the majority of these outputs were journal articles. According to the disciplinary pro�le presented in the report, Psychology and Cognitive Sciences shared a signi�cant proportion of research outputs with Medical and Health Sciences. The report also noted that �fty-one per cent (51%) of assessed Units of Evaluation (UoE) in Psychology and Cognitive Sciences received a rating at or above world standard. The complete report can be accessed from: http://www.arc.gov.au/era/outcomes_2010.htm.

Results by FoR Code

Grp Book Book Jour. Conf. NTRO TOTALCode Chap. Article Paper

1701 94 1,124 5,879 1,089 - 8,1861702 7 113 1,755 105 - 1,9811799 3 34 30 28 - 94Total 104 1,271 7,664 1,222 0 10,261

Note: Group codes - 1701 Psychology; 1702 Cognitive Sciences; 1799 Other Psychology and Cognitive Sciences. (Australian Research Council, 2010, section 2 p. 170).

REFERENCE

Australian Research Council (2010). Excellence in research for Australia 2010: National report. Retrieved from http://www.arc.gov.au/pdf/ERA_report.pdf on 26 May 2011.


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'surplus/negative' and 'de�cit/positive' forms of emptiness within my PhD research, there's a richness of perspectives being integrated that informs my roles as a PhD Candidate, practicing psychologist, clinical hypnotherapist, and self.

Actually, I can't foresee a day when I won't be a 'student clinician' in the sense that after the PhD is completed (or relinquished into an examiner's embrace), I'll still retain the �rm conviction that the research focus as well as a ‘work-in-progress’ sense of my own approach to clinicianship will remain a �rm philosophy of practice. Certainly can be more than a career.

ACPARIAN EDITORIAL GUIDELINES

ACPARIAN is the o�cial quarterly publication of the Australian Clinical Psychology Association.

Editorial Board

Editor Kaye Horley, PhD

Associate Editors Giles Burch, PhDMcLytton Clever, DPsych (Clin)

Copyeditor Bronwyn Williams, MPsych (Clin)

Design Ben Callegari, MPsych (Clin)

Aim ACPARIAN provides for the dissemination of knowledge on topics of interest informative to clinical psychologists. Its focus is on the latest clinical theory and research relevant to clinical practice including assessment and intervention, training and professional issues.

ContentSubmissions to ACPARIAN may include:Letters to the EditorGeneral articles, viewpoints, opinions and commentsArticles of particular ethical and/or legal interest to the professionResearch reviewsTheoretical perspectivesTechnology updatesStudents’ news and viewpoints Book reviewsGeneral Information and announcements.

From time to time, ACPARIAN will focus upon topics or issues of interest and call for submissions accordingly.

The ACPA Editorial Board welcomes contributions and suggestions for topics from the membership.

A STUDENT’S PERSPECTIVE

Richard Syrkiewicz, BPsych(Hons), Dip Clin Hyp PhD Candidate.

Richard is the current director of the Hypnotherapy Centre of Western Australia. He is currently completing his PhD thesis on depression, long-term patterns of emotional di�culties, and existential concerns.

Having just been asked to comment upon what it's like to be a student clinician for the ACPA Newsletter (read: about �ve minutes ago actually), I thought that some unrehearsed 'o� the cu�' views might be the best approach whilst I wait for my next patient and contemplate my motivation to read another article. I'd probably be relatively accurate in stating that it will be a di�erent experience for each student clinician, as each student will be at di�erent stages in di�erent post-graduate courses (though in my biased view, such a course would be clinically focussed and have a clear clinically focussed research component).

My own course is a PhD in clinical psychology (by coursework, practica and research), the long title probably being relatively indicative of the considerable duration such courses can take. Now at the tail-end of the course (in terms of years of enrolment at least), it's a pathway that has had its merits and will continue to 'set the tone' as my clinicianship develops; I can't see that development ever ending (in a positive sense). As 'fellow travellers' in many ways the formal and informal training path (however active) we each take will share some con�uence, yet also di�er markedly.

My PhD thesis focuses on informing clinicians of how 'inner-emptiness' has been re�ected upon across practitioners and writers within psychology and psychiatry (e.g. within Borderline Personality Disorder and Major Depression diagnostic categories of the DSM-IV-TR, and a couple of Personality Disorder areas within the ICD-10 [i.e. F62.0 & F60.3]), as well as considering theological and philosophcal aspects of the human experience of emptiness within the psyche.

A clinical indicator, the Inner-Emptiness Index, will then be formed and tested for various types of reliability and levels of internal and external validity.

Not only are aspects of psychopathology being considered, but also the concept of emptiness from arguably the earliest forms of 'positive psychology' from various eastern traditions across India, China, Tibet and Japan. This has been most concisely addressed as Sunyatta (also known as emptiness within the Zen tradition), or more broadly across various Buddhist traditions as realisation, liberation, or nirvana). Thus, emptiness may be spoken of as both a pathological experience within the psyche to be alleviated (from the perspective of Western psychology), as well as a non-dualistic liberation from conditioned su�ering to be realised (from earlier theosophical perspectives). Via the integration of both the


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ContributionsSubmissions should be made electronically, in a Word document, to the editor responsible for that section:

Student and Training Matters: McLytton Clever [email protected]

Ethics and Legal Matters: Giles Burch [email protected]

Perspectives, Research and Feature articles: Kaye Horley [email protected]

Please observe the following word limits: Letters to the Editor: 200 words.Perspectives, Research Articles, Student Matters and Ethics and Legal Matters: 750 to 1000 wordsFeature articles: 1000 - 1500 words.

References should be in APA style, using endnotes to mark in-text referencing.

Please ensure that submissions are made by the stated deadline. Late submissions may not be accepted.

Authors can expect the Editorial Board to review and change content for clarity and style. The Editorial Board will endeavour to make any signi�cant revisions in consultation with the author. The Editor reserves the right to include or reject written works at any point in the publication process.

The views expressed by authors in ACPARIAN do not necessarily re�ect those of the ACPA Editorial Board.

SubscriptionThree issues of ACPARIAN are produced each year in March, July and November and delivered electronically to ACPA members via the listserve.

© The Australian Clinical Psychology Association 2011

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