ACT: Code of Conduct for Health Workers | January 2024

After a number of years of consultation, in July 2023 the ACT government passed legislation and a regulation (Human Rights Commission Regulation 2023) enacting the Code of Conduct for Health Workers in the ACT. The Code commences in the ACT on 7 January 2024. Members who provide health services in the ACT need to be familiar with the Code.

The Code provides for minimum standards of care in the provision of health services by health workers in the ACT.

This includes:

  • Providing safe and ethical care
  • Obtaining consent for treatment
  • Keeping appropriate records & protecting a patients privacy
  • Having appropriate insurance
  • Minimising harm and acting appropriately if something goes wrong

The Code also obliges health workers to NOT:

  • Mislead a patient about services, products or qualifications
  • Put a patient at risk due to a physical or mental health concern
  • Make false claims about curing serios illnesses such as cancer
  • Exploit patients financially
  • Discourage patients from seeking other health services or treatments
  • Have an inappropriate relationship or inappropriate boundaries with a patient

Health workers are any person providing a health service who is not a registered practitioner such as a doctor, nurse, dentist or one of the 15 registered practitioner groups regulated by the Australian health practitioner regulation Agency (Ahpra). This means health workers in the ACT from 7 January 2024 must comply with the Code when providing health services in the ACT.

A health service is a service provided in the ACT to someone (the service user) for any of the following purposes:

  • (a) assessing, recording, maintaining or improving the physical, mental or emotional health, comfort or wellbeing of the service user;
  • (b) diagnosing or treating an illness, disability, disorder or condition of the service user.

This includes massage therapists, laser therapy, counsellors and social workers, dieticians, nutritionists, doula’s, aged care & disability care workers, assistants in nursing and others. (This definition is provided for by section 7 of the ACT Human Rights Commission Act 2005.)

The introduction of the Code aligns the ACT with states that have already introduced the Code including NSW, Victoria, South Australia, Queensland and Western Australia. From January 2024 patients accessing health services will be able to make a complaint to the ACT Human Rights Commission if the code is not adhered to when a health service is provided. Information about the Code is available at here.

The Code also requires health workers to display the Code where they are providing a health service. The requirement to display the Code may apply differently in institutional settings such as hospitals. Copies of the Code can be downloaded from the website or health workers can request copies of the Code by emailing us at [email protected].

The Commission generally tries to resolve complaints about health services through a conciliation process. Where significant conduct issues are identified by a complaint or through other means the Commission can take more significant regulatory action such as placing conditions on a health workers practice or prohibiting a health worker from providing that service.

If you need further information you can call the Health Services Commissioner’s team on 02 6205 2222 or email us at [email protected]

Research opportunity: Counsellors experiences of uncertainty

The University of Tasmania is currently seeking therapists to participate in a short research survey that aims to gain valuable insights into therapists’ experiences of uncertainty in their practice. The survey will take approximately 15 minutes to complete and is anonymous.

Uncertainty is a pervasive aspect of therapeutic practice, and it can have a significant impact on both therapists and their clients. By participating in this research survey, you will be contributing to a better understanding of therapists’ experiences of uncertainty and, in turn, improving the quality of mental health services.

To participate in this survey, please follow this link: https://utas.qualtrics.com/jfe/form/SV_0NfU13JNZph0SnI. The survey will be available until January 2024.

This study is being conducted by Dr Elly Quinlan, Dr Catherine Deans, Lize Booy and Amanda Tan Jia Qi from the University of Tasmania and has been approved by the University of Tasmania Human Research Ethics Committee (HREC) H0029273.

If you have any questions or concerns about this survey or would like more information about the study, please do not hesitate to reach out to Catherine at [email protected] or Amanda at  [email protected].

ACA joins National Rural Health Alliance

In stride towards strengthening mental health support in rural regions, the Australian Counselling Association (ACA) is proud to announce its membership with the National Rural Health Alliance (NRHA). This is an important and strategic engagement to ensure inclusion of Counsellors in workforce planning for regional, rural, and remote communities in Australia.  ACA has a diverse network of Counsellors who live and work in these communities and we are committed to doing more to support.

Jodie McKenzie (CEO) was invited to attend a special event at Parliament House to relaunch Parliamentary Friends of Rural and Regional Health, followed by the Council Strategy Day and celebration of the NRHA’s 30th Anniversary.

Jodie McKenzie attends NRHA event

Emma McBride MP, the Assistant Minister for Rural and Regional Health, Mental Health, and Suicide Prevention, highlighted the shortage of healthcare workers and reiterated the government’s commitment to make healthcare more accessible. The day continued with engaging discussions about the current health situation in rural Australia and future focus.

Highlights from NRHA event

“I was filled with much inspiration being surrounded by so many NRHA members who are truly committed and passionate about making a difference to regional, rural and remote health and hearing their stories and continued efforts. We all need to do more to ensure everyone gets the support they need. We are proud to be a member of NRHA, working together with all members to make sure rural areas in Australia have a healthy and happy future.” – Jodie McKenzie, CEO of the Australian Counselling Association

Welcoming a new chapter | CEO Announcement 

After 25 years Philip Armstrong steps down as CEO of ACA, Jodie McKenzie steps in as new CEO 

On 3 October 2023, Philip Armstrong informed the Board of ACA of his intention to leave his position of CEO to pursue personal interests as ACA transitions into its next chapter under a new Board. “I know I am stepping away at the right time for ACA. I’m excited to see ACA grow during its next phase as an ongoing member,” said Philip. Incoming ACA President Dee Hardy thanked Philip for his leadership and contribution to ACA over many years. “Philip’s contribution to ACA is peerless. We wish him all the best as he moves forward into his next phase,” said Ms Hardy.

We are pleased to announce that the ACA Board has appointed Deputy CEO Jodie McKenzie as the new CEO of ACA, effective Monday 9 October 2023. 

Jodie brings experience in planning, stakeholder engagement, change management, and risk and issues management to her role as CEO, in addition to being an experienced counsellor. 
 
Jodie joined ACA in January 2023 as Deputy CEO following an extensive executive search. 

“This is an organic transition – Jodie has done an outstanding job shadowing Philip over the best part of this year as Deputy CEO, co-leading ACA’s advocacy efforts with various stakeholders, government, and importantly with our community of 14,000+ Members,” said Ms Hardy. 

Click here to read more about Jodie McKenzie

ACA looks forward to strengthening relationships, advocating for, and advancing the counselling and psychotherapy profession under this new leadership. 

Are my notes confidential?

As featured in the Counselling Australia Journal, Volume 24, Number 2. With thanks to Michael Lynch Lawyers.

 

Professionals are often engaged to assist a party in navigating issues arising from the breakdown of their relationship. Family lawyers are frequently asked by these treating professionals ‘Are my notes confidential?’.

The starting point is non-confidentiality. Everything said to a GP, paediatrician, therapist, counsellor, psychologist and other allied health practitioners can be disclosed and it can be subpoenaed.

Why? So courts can learn the truth.

In parenting matters, the question that the Court must determine is “What is in the best interests of the child?”. This is the paramount consideration and if there are documents that can assist the Court to understand what parenting arrangements may meet the child’s best interests, then the Court should have access to them.

Practitioners such as psychologists and doctors have a responsibility to maintain client confidentiality as part of their ethical standards, clinical practice, and professional licensing regulations.

It is understandable that clients may become incredibly distressed when a subpoena is issued to their treating practitioner for their notes in circumstances where they thought that their personal health records were confidential.

The subpoena recipient (for example the psychologist or medical practitioner) and the person affected by the issuing of the subpoena (the husband or wife in the Court proceedings) may object to the production of documents under a subpoena.

Some of the grounds for objection include but are not limited to:

  • That the subpoena lacks a legitimate forensic purpose
  • That the subpoena is an abuse of process or oppressive
  • That the subpoenaed material is not relevant to the issues presented before the Court
  • That the information being requested is privileged

 

In a recent decision of Vitalis & Kazan (No 2) [2022] FedCFamC1F 601 (19 August 2022), the Court was asked to determine parenting arrangements for two children aged 8 years and 4 years.

In the proceedings, Ms Kazan served a subpoena on Ms Vitalis’s gender reassignment surgeon (“Dr O”) and on her medical insurer. Ms Vitalis objected on the ground of relevance.

It was noted by the Judge that “in any parenting proceeding any parties’ mental health issue is potentially relevant to the extent that it may impact on parenting capacity”.

Ms Vitalis accepted that her mental health was a relevant fact potentially in issue and did not object to subpoenas that Ms Kazan had issued to her identified treating mental health practitioners. She did object to the subpoena issued to Dr O on the basis that “the biological surgical procedures Dr O was involved in will not illuminate any issue relevant to parenting capacity” and was a “fishing expedition”.

Ms Kazan submitted that Dr O may have engaged in an assessment of Ms Vitalis’ mental health which was relevant to the issue before the Court. It was noted by the Judge (at paragraphs 21 and 22) that “ [A]s part of gender reassignment, the nature of the surgery might reasonably require the surgeon to satisfy themselves that the patient meets the criteria under the World Professional Association of Transgender Health Standards of Care Guideline. That might reasonably require the surgeon to engage in their own assessment of the patient’s mental health status. In this case… it is at least possible that Dr O was required to and did undertake his own independent mental health assessment of Ms Vitalis, taking into account Ms Q’s [Ms Vitalis’ treating clinical psychologist] opinion but not merely relying upon it.”

Due to the intimate nature of the surgery, Ms Vitalis maintained an objection to the subpoena on privacy grounds. It was also submitted that the Court “should control the use of subpoena in pursuance of the overarching purpose, of the Federal Circuit and Family Court of Australia Act 2021 (Cth) (“the Rules”), being to facilitate the just resolution of disputes according to law and as quickly, inexpensively and efficiently as possible.

The Judge in this case noted that “whilst privacy grounds would be relevant if the information sought went only to the physical process, where it is conceded that there is a real possibility of a mental health assessment, and therefore a genuine forensic purpose, privacy is not a proper ground for objection. While Ms Vitalis’ position is understandable, given the sensitive nature of the procedures involved, the nature of the family law jurisdiction, in which the Court enquires into the welfare and best interests of children, means that the public interest and children’s interest in the Court having all available relevant evidence about a parent’s mental health outweighs the parent’s right to privacy.

The Judge went on to say “Whilst the Court should, and does, exercise close control over the issuing of subpoena as part of the application of the overarching purpose, I am not persuaded that in the context of these proceedings the subpoena to Dr O is inconsistent with the overarching purpose.”

It was submitted by Ms Kazan that the subpoena to Ms Vitalis’ medical insurance company was appropriate as it would give details of other medical practitioners who had treated Ms Vitalis that “were not disclosed, and who Ms Kazan says should have been”.

In many cases, the Judge said that the subpoena to the medical insurer “would be a step too far, but each matter requires consideration on its own facts.” Here he said (at paragraph 38) that “Where a party’s mental health is an issue in the proceedings, and where it appears that she has taken an approach to disclosure which raises issues about the selectivity and reliability of that disclosure, it may be appropriate to allow a subpoena… to ensure that the Court has the best available evidence when considering the best interests of the children.”

The Judge held in this case that there was a “genuine forensic purpose to each subpoena” in this matter and allowed access to the records produced by Dr O and the medical insurance company.

 

WHAT TO DO IF YOU GET A SUBPOENA
  1. Read the subpoena
  2. Write down your thoughts
  • What documents am I being asked to provide?
  • Do these documents exist?
  • Are the documents relevant to an issue in dispute?
  • Are the documents privileged?
  • Should I object to the subpoena?
  • Is the Subpoena being used for a proper purpose or is it too broad, oppressive, a mere ‘fishing expedition’?
  • What date do I have to comply by?
  • Have I received conduct money?
  • How much will it cost me to produce the documents (eg photocopying costs)?
  • Where do I send the documents?

3. Get legal advice, if required, and speak with your insurer.

COUNSELLING PERSPECTIVES | Sexology: A Personal, Professional Perspective

ACA Member, Karen Triggs, provides a detailed and firsthand account of sexology as a counselling profession. As featured in the Counselling Australia Journal Winter 2023, Volume 24 Number 3.

What is sexology?

Sexology is the scientific study of human sexuality from biological, psychological and social perspectives. This typically includes the study of anatomy, reproduction, sexual function, sexual health and the psychological and societal factors that influence sexual behaviour. Sexologists typically have undergraduate degrees in public health, medicine, social work, psychology or counselling, as well as other allied health professions.

In Australia, anyone can ‘set up shop’ as a sexologist and provide sex therapy, as there is no legal requirement for registration. The Society of Australian Sexologists (SAS – see societyaustraliansexologists.org.au) is the peak professional body representing formally qualified sexologists who practice either as psychosexual therapists or educators. Its members are required to follow a stringent code of ethics and professional standards. SAS also offers an accreditation pathway for those who meet the stipulated supervision, clinical experience and professional development requirements. ASSERT NSW (assertnsw.au) is a similar organisation.

 

What does a psychosexual therapist actually do?

Psychosexual therapists help people to resolve sexual issues and difficulties and have more satisfying sex lives, which in turn contributes positively to general quality of life.

Psychosexual therapists treat a wide range of issues, such as in desire discrepancy, painful sex, performance anxiety, gender identity and orientation concerns, arousal and orgasm challenges, sexual trauma, problematic compulsive sexual behaviour, infidelity, and erectile difficulties.

In addition to conventional counselling and psychotherapy modalities and interventions, most psychosexual therapists use PLISSIT (permission, limited information, specific suggestions and intense therapy) – a valuable framework that facilitates a sensitive, client-centred approach to case formulation and treatment. Tertiary-qualified therapists are also required to complete the Sexual Attitudes Reassessment (SARS), which goes a long way to ensuring sex positive and inclusive practice.

I completed my SARS as part of the Curtin University postgraduate program and found the unit absolutely riveting. I remember some very interesting and unexpected conversations I had with my grandmother about the topics we covered. In my own practice, I often integrate somatic art therapy and internal family systems in my sex therapy sessions, both with individuals and partnered clients. My current area of interest is in exploring the intersection of ADHD and sexuality further.

What does a sex therapy session look like?

There is a common misconception that psychosexual therapists use ‘hands-on’ techniques in sessions. This is not at all true. Formally qualified psychosexual therapists will not allow nudity, erotic touch or any other sexual activity during sessions. Sex therapy is, therefore, not that different from traditional talk-based counselling. Any practical exercises requiring touch that may be recommended are always completed by clients in the privacy of their own home.

Clients are often anxious or embarrassed when they arrive at the first session, so it is important for the therapist to help clients feel at ease when talking about sex. The therapist needs to have a clear and comprehensive understanding of all the bio/psycho/social factors contributing to the problem, and a detailed sexual history is usually completed with each client. An important part of our work is to help clients shift from a narrow ‘intercourse = sex’ focus to one in which pleasure, sensual touch and connection is the focus. It is quite common for clients to have false beliefs about sex, and it is our responsibility to provide clear and accurate information.

Is there much of a demand for sex therapy?

Yes, in the last few years there has been a rapidly increasing need for sex therapy and we simply cannot keep up with the current demand. I would encourage counsellors interested in sexuality to learn more, either through sexology-focused professional development, supervision with an accredited psychosexual therapist or postgraduate training.

Where to find courses and resources to develop your career in sexology?

In Australia, the University of Sydney offers a postgraduate program in sexual and reproductive health – the ‘Psychosexual Therapy Pathway’ – which is a specialist pathway for registered counsellors, social workers and psychologists. Curtin University in Perth provides several options for study, which include the Graduate Certificate in Sexology, Graduate Diploma in Sexology and Master of Sexology (Professional). Entry into these courses requires applicants to hold a recognised bachelor degree. Both universities work closely with the SAS to develop professional standards for Australian sexologists.

Some of my favourite go-to resources include:

■Sexual intelligence: what we really want from sex and how to get it by Marty Klein

■Come as you are by Emily Nagoski

■Sex made simple: clinical strategies for sexual issues in therapy by Barry McCarthy

■Good loving, great sex by Dr Rosie King

■LGBTQ clients in therapy: clinical issues and treatment strategies by Joe Kort

■EMDR therapy and sexual health: a clinician’s guide by Stephanie Baird

Join your peers at the ACA 2023 Conference!

Join your peers and sector professionals to explore resilience-building throughout the mental health sector!

ACA is excited to be bringing our Annual Conference to Sydney, New South Wales, in September of this year!
The Conference will be held over three days, continuing our tradition of delivering top-notch training, cutting edge workshops and invaluable opportunities to network and learn from industry experts.

Tickets are limited, don’t miss this opportunity!

PROGRAM OVERVIEW

The Conference offers a range of programs and packages to build the professional capacity of front-line mental health providers, academics, researchers, and private practitioners, by providing insight into the delivery of mental health services at all levels.

REGISTRATION OPTIONS

Take advantage of the early bird promotion running until Monday 17 July 2023, 12.00am. Don’t miss out!

For more information or to register, visit: https://www.theaca.net.au/conference.php.

Did you know you can now renew online?

ACA Members who have met the requirements for Supervision and Ongoing Professional Development can now renew online!

Online renewals can be completed during the final month of your current membership period.

5 Steps to Renew Online:

  1. Log into the ACA Membership Portal.
  2. You will be redirected to the your Account Page.
  3. Ensure you have completed the annual requirements for Supervision and Ongoing Professional Development.
  4. View the menu on the left-hand side and click on the green ‘Renew My Membership’ button.
  5. Follow the prompts to renew.

Below are online tutorials to assist members in uploading Supervision and OPD requirements online.

“How to upload your supervision hours” instructional video: https://www.youtube.com/watch?v=lKD7zxJ7i4E

“How to upload your OPD points” instructional video: https://www.youtube.com/watch?v=tUqth3b2IaE&t=2s

Professional Advice: So you want to be a Counsellor…. Part 3

So You Want To Be A Counsellor is a multi-part advice series where counsellors share with ACA their professional journeys and the things they have learnt along the way. As featured in the Counselling Australia Journal Spring 2022, Volume 23 Number 3.

Michelle Sparkes, Supervising Counsellor at the Butterfly Foundation, shares her professional journey and tips for new professionals.

Tell us about your work.

I work with individuals, 16 years and older (and their families, carers and partners, as appropriate), to help them recover from the grip of disordered eating and body image concerns. Ultimately, these issues reflect a way of coping with challenging self and life experiences. I love this work and have been helping individuals recover from disordered eating for over 25 years. I take a holistic, whole-person approach to these challenging health and life-consuming problems, drawing on my professional experience as a physical and mental health clinician, and my lived experience of anorexia, eating disorder not otherwise specified (EDNOS) (now called OSFED – other specified feeding and eating disorders) and binge eating in my teen and early adult years. I also work as a supervising counsellor for the Butterfly National Helpline (Australia’s national charity for  eating disorders), providing oversight, training and supervision to helpline counsellors and working directly with consumers to provide information, support, guidance and referrals.

Do you love your work? Why?

My work at Butterfly gives me the opportunity to provide in the moment support to consumers and to invest in the training, upskilling and supervising of new/ er counsellors. My private work gives me the opportunity to work with individuals in a deeper, more substantial way and to witness their transformation over time. It is a pleasure and a privilege to do this work.

Looking back to your final year as a student (before you started your counselling career), what are the top three pieces of advice you give?

1. There are no stupid questions. Glean as much as you can from the practitioners you are learning from – your questions and their answers will help everyone.

2. Value the relationships and the different perspectives and life experience of your teachers and colleagues. You are members of the counselling body, and we are all richer for our diversity of insight, understanding and experience.

3. Volunteer for role-plays – these are rich opportunities for learning. Hearing and feeling yourself respond to a counsellor’s presence, tone, attitude and questions are incredibly valuable and you may never have a better opportunity to do this.

Imagine yourself entering your first counselling session as a qualified counsellor. What is the knowledge or advice you wish you had had?

Relax, you don’t need to know everything. Put your training and expectations to one side and focus on the person in front of you. Your capacity to connect with this person, to understand their needs and concerns and their hopes and desires is the most important thing for you to focus on right now. Be present, be warm, be relaxed, listen, listen, listen, never assume, observe, reflect, respond and let this process gently unfold and guide you.

Would you change your decision to be a counsellor or psychotherapist? Why?

I love being a counsellor in the eating disorder space – it’s a bit of an umbrella term, but it allows me the opportunity to provide the support that is right for the person I’m working with. A frustration for me is that, despite being registered as a counsellor since 2006 and amassing a huge amount of clinical experience and further training, I can’t offer my clients the benefit of a Medicare rebate under the Eating Disorder Plan, while a psychologist with the eating disorder credential can. Nor can I (based on my current ACA level) offer my clients much in the way of health fund rebates. It’s a frustration for me and a disadvantage for my clients. I am a credentialed eating disorder clinician, I‘ve worked in the eating disorder recovery space for over 25 years, I’ve authored books and developed eating disorder recovery programs and training, I’ve supervised counsellors on the Butterfly Helpline for the past three years and I’ve helped hundreds of people recover from disordered eating in private practice. This Medicare rebate regulation doesn’t feel like a match or true reflection of my accumulated training, knowledge, skills and experience.

What is your definition of counselling?

I like this definition: Professional counselling is a safe and confidential collaboration between qualified counsellors and clients to promote mental health and wellbeing, enhance self-understanding and resolve identified concerns. Clients are active participants in the counselling process at every stage. ■

Changes to Provisional Membership July 2023

What is ACA Provisional Membership?

Provisional is an ACA Membership open to graduates who had completed a non-ACA accredited Australian Qualifications Framework (AQF) Level 5 Diploma of Counselling that is Nationally Accredited and listed under the National Training Package.

ACA has intentionally not included this membership level within the Scope of Practice as the Scope is defined against skill levels that ACA is aware of.

Due to Provisional Membership being open for graduates of non-ACA accredited diplomas (AQF Level 5) this scope is unable to define against the ACA accreditation process what skills these graduates have.

Provisional is a non-voting ACA member level.

Provisional Membership will no longer be available to new applicants as of 1 July 2023

Any Diploma of Counselling (CHC51015) that is not an ACA accredited course and not complete by 30 June 2023, will no longer be eligible for ACA Provisional Membership, as Provisional Membership will cease as of 1 July 2023.

If you have completed and graduated from a non- ACA accredited Diploma of Counselling by 30 June 2023, you can apply for Provisional Membership until 30 June 2023.

This will mean that new ACA Members applying from 1 July 2023 will be required to have completed an ACA-accredited course in Counselling. In instances where an applicant has used recognition of prior learning (RPL) to gain credit towards their qualification, ACA will accept a maximum of 40% RPL otherwise the qualification will not be recognised.

What does this mean for current Provisional Members?

As a current ACA Provisional Members, will have two years to upgrade to Level 1 Membership, which requires having completed 25 hours of documented Supervision and be more than 12 months post-qualification in supervised practice.

Why is Provisional Membership being ceased?

This category of membership enables graduates from Diploma of Counselling (CHC51015) from a non-ACA accredited provider to gain ACA Membership. ACA is closing this membership category to strengthen industry standards and ensure consistent ACA educational standards for practising levels.

ACA is the only Nationally recognised registration body that accepts and recognises the Diploma of Counselling for membership.

If my course is not listed as ACA-accredited, can I ask ACA to accredit it?

Any non-ACA accredited Diploma of Counselling will no longer be eligible for ACA membership unless the course provider chooses to have their course accredited with ACA. A student cannot have a course accredited only the training provider can apply for accreditation.

How do I know if my course is ACA-Accredited?

Click here to view ACA-accredited courses. You must apply by the 30 June 2023 deadline to ensure you obtain ACA Provisional Membership.

If my course is not listed as ACA-Approved, can I ask ACA to accredit it?

Only training providers can seek course accreditation with ACA. For example, training providers of the Diploma of Counselling (CHC51015) must apply for accreditation to ACA via our formal process. Students are not able to directly engage with ACA to seek course accreditation.

What happens if I graduate from a non-ACA accredited course after 1 July 2023?

ACA will only accept graduates from the Diploma of Counselling (CHC51015) courses that also meet industry standards, and ACA criteria for Level 1 Membership.

In instances where an applicant has used recognition of prior learning (RPL)to gain credit towards their qualification, ACA will accept a maximum of 40% RPL otherwise the qualification will not be recognised.