ACA meet with the Department of Health and Aged Care

Last Thursday, ACA visited the Department of Health and Aged Care for a special ARCAP (Australian Register of Counsellors and Psychotherapists) meeting to discuss our recent submission to grant eligibility to Counsellors and Psychotherapists to provide Medicare Benefits Schedule (MBS) mental health services. Members can read the submission on the ACA website (or click here).

As part of the ARCAP delegation, we met with Mr Mark Roddam, First Assistant Secretary, Mental Health Division, Ms Anthea Raven, Assistant Secretary, Mental Health Access Branch, and Dr Ruth Vine, Deputy Chief Medical Officer.

We discussed a simple and effective proposal to improve access to affordable mental health care and how a cohort of highly skilled Counsellors and Psychotherapists stand underutilised. We also discussed in detail the extent of industry self-regulation necessary to ensure that MBS services are delivered safely and effectively, including: (1) the requirements that MBS Registered Counsellors and Psychotherapists would need to meet to be recognised as allied health professionals who are eligible to deliver MBS services and (2) the necessary regulatory oversight that the Australian Register of Counsellors and Psychotherapists would provide.

This is just one of many meetings we have planned with the Department of Health and Aged Care to discuss granting MBS eligibility to Counsellors and Psychotherapists. We are proud to advocate on behalf of the profession and we look forward to the next meeting to continue this important work with the Albanese government.

About ARCAP

ARCAP is an independent, national Register of Counsellors and Psychotherapists established by the Australian Counselling Association and the Psychotherapy and Counselling Federation of Australia.

All practitioners listed on the ARCAP Register have:

  • Completed professional qualifications in counselling or psychotherapy
  • Meet ongoing professional development requirements including clinical supervision of their practice
  • Abide by the ethical guidelines of the profession

Note-taking: the ins and outs

Article from: Counselling Australia Journal: Volume 23: Number 1 – Autumn 2022 

It is extremely important that professional supervisors have a good knowledge of what is appropriate and what is not with regard to note-taking. Not only do professional supervisors need to be aware of their own notes, but they also need to ensure their supervisees are keeping appropriate notes. Notes can be subpoenaed and, therefore, if they are not correctly written, the conduct of the supervisee and their professional supervisor will be brought into contention. Notes need to be legible, concise and accurate (Despenser, 2004; Presser & Pfrost, 1985).

For the supervisee, accurate notes are useful when debriefing with your professional supervisor, particularly if a difficult case was experienced several weeks before your professional supervision. Reading your notes the day after seeing a client can also be enlightening – you may find you have been judgmental, or your own belief system is interfering with your objectivity. Read notes critically, but do not change them; learn from them (Despenser, 2004; Presser & Pfost, 1985).

Taking notes is a contentious issue. Should you take notes, and if so, how much should you document and how should you reflect statements? What words are appropriate and what words will leave us professionally vulnerable? There is no real answer; but consider: will your notes be adequate and not incriminating if you are called upon by a court to divulge them, and will your client sue you after reading them? It is a good idea for professional supervisors to critique their supervisees’ notes, particularly those of new supervisees.

Clarity in documentation

The following is an excerpt taken from the American Counseling Association and written by Robert W Mitchell, ACSW. This document, entitled Documentation in Counseling Records, is relevant for any professional who is required to take notes (Mitchell, 2000; see also Armstrong, 2006).

Mark Twain once said to would-be writers, “As to the adjective, leave it out.” His words have meaning to us today. He meant that when you write an adjective, for better or for worse, you give an opinion. Adjectives must be carefully chosen, or even replaced, if language is to be clear and precise.

Examples of the need for clarity and precision are the focus of this article. Your written words are the only record of a session you have with a client, and those will count for nothing, for your agency’s purposes or in a courtroom, if you have not written them down accurately.

Let’s take an example: The sky is blue … no, the sky is generally blue … no, the sky generally appears to be blue… no, in some parts of the world, what is generally thought of as the sky sometimes appears to be blue. We sometimes make things harder on ourselves when we go to extremes. All we need to say is the sky is blue. In many instances, the work we do is simple and very straightforward; we don’t need to mystify it with complicated or confusing words.

Here’s another example: Jerry is exhibiting signs of depression … Jerry is depressed. These sentences are grammatically correct, yet I am unsure what exactly is meant. An attorney would have a great time with either of those statements, saying the writer was judgmental, prejudiced. The client was simply a quiet, unassuming person whose behaviour produced unwarranted and false conclusions. To eliminate that possibility, all you need to do is add a simple clarifying phrase. If Jerry is depressed or showing depression, add something like ‘because he lost his job’. If Jerry is repressing his emotions, add ‘by not answering questions and by changing the subject’. What clues tell you Jerry is depressed? Add ‘he said he has not been able to eat or sleep and is concerned about the crying spells’. Now your conclusions are supported with specifics.

Let’s consider more examples:

  • A favourite but inadequate phrase in records involves ‘negative attitude’. Again, that is too vague and too judgmental. To make it clear, write something like: ‘learn to discuss problems instead of throwing things’.
  • A frequent goal is ‘improve hygiene’. That’s too vague because it doesn’t tell you enough of a story. You must be specific. How about: ‘brush teeth and shower each day’?
  • Don’t write: ‘learn to become more independent’. What does that mean? Set up a business? Leave a husband? The specific goal could be: ‘get up in the morning and report to job on time’.
  • ‘Increase self-esteem’ is another favourite goal, but it’s difficult to really sink one’s teeth into such a phrase. How about: ‘will not be critical of self or personal decisions about disciplining children’. See the difference?
  • The record may read: ‘client participated in chalk talk’. What does ‘participated’ mean? Will every reader understand that a ‘chalk talk’ in this instance is a chemical dependency lecture? Did the client talk? Cry? Take a swing at another client? Or at you? Someone can participate in an active or a passive way. So one word doesn’t tell much. To clarify ‘participate’, add for example, ‘client revealed examples of how he had fooled himself about the increasing use of drugs. He reported denying the importance of wife’s complaints. The group encouraged his willingness to open up.’
  • Since part of our topic concerns communication, let’s take the phrase ‘communication problem’. Again, what does this mean? Why not list the exact problem; for example, ‘stuttering’, ‘speaking too fast’ or ‘talking around the subject’.
  • Is your client withdrawn? How do you know that? Write instead, ‘Suzanne is withdrawn as evidenced by the fact that she spends all her time in her room and refuses to even eat meals with her family.’
  • To characterise someone as ‘aggressive’ is not enough. Does the client fight? Push? Scream? Kick? Do not leave room for interpretation. If the client described eventually takes you to court, the term ‘aggressive’ used alone could be interpreted by the attorney as a positive characteristic, not a negative one.
  • If a client is unemployed, there may be more to the situation. Clarify your entry by adding something like ‘has been fired from last three jobs for drinking and excessive absences’.
  • You can define the term ‘nervous’ by writing something like ‘not eating; sleep is not restful; screams at children’.
  • Instead of ‘feels bad’, write ‘history of high blood pressure and heart condition’. Remember: one can feel bad physically and/or emotionally. That holds true for another one-word problem: health. Enter something like ‘asthmatic condition requires expensive medication, so the client does without’.
  • When the client is ambivalent, you need to know why. So does a record user. Enter something like ‘She cannot make a decision about continuing in a marriage with an abusive spouse’.
  • We often think we are describing a behaviour when we say, ‘Henry is lazy’, or ‘Laura is aggressive’, or ‘Karen is withdrawn’. These statements do not describe behaviours; they make undefined judgmental observations. That could be disastrous for a supervisee and the agency. What characteristics or symptoms give you cause to think the way you do? Write them down!

As you are choosing words, remember, it is a complex task. Your choice could convey, deliberately or not, a view that tends to be too negative. Consider these examples and decide which is better: dumb or limited intelligence; cheap or economical. It is vital that your words be clear and precise to satisfy your profession, external auditors, your client and attorneys, should the need arise. It is necessary to substantiate your observations and give them authority. Remember: good entries are precise and current.

There is also the matter of timeliness. The word ‘current’ is a directive to record information immediately. Waiting even one day can blur accuracy. Those who wait until the last minute to write their entries often suffer from fainting spells, anxiety attacks and acute writer’s elbow – a heavy price to pay.

Your client should be an active participant in setting goals, writing staff notes and plans and document client participation, perhaps including the client signature. Set goals the client will understand, agree with and accept. Objectives must be specific, measurable and meaningful to the client. Set a date for achievement of those goals. Define the methodology to be used in goal achievement. Do not create a reasonable doubt – that’s a lawyer’s job! Using words that are not specific or that create vague impressions could equate to an opinion, leaving room for reasonable doubt and the possible destruction of your credibility.

The writer’s reasonableness and credibility can be assumed not only from the words but also from the readability and appearance of the record. Did you ever stop to think that a record’s appearance affects a reader just as the appearance of a speaker affects a listener? There are several major factors that will influence the written word’s credibility and clarity:

  • Scrawled, scratchy or sloppy handwriting, which is difficult or impossible to read, may make the writer appear irresponsible, fairly or unfairly.
  • Small writing that is crammed into a small space not only says something about the writer’s concept of what is important but also frustrates the reader, who may already be looking for a way to use the record against you.
  • Disorganised filing, half-completed forms and a rambling assortment of ideas leave too much room for doubt.

Not taking care of the appearance of a document may be construed as an indication of disregard for the client and a lapse in professional accountability.

Excerpted from: ACA Legal Series: Volume 2: Documentation in Counselling Records Author: Robert W Mitchell, ACSW Series Editor: Theodore P Remley, Jr, JD, PhD

Reprinted kindly with permission for educational purposes, in gratitude to the authors and American Counselling Association.

For more information, see www.counseling.org/Publications/FrontMatter/72851-FM.pdf.

 

Advocacy Win: ACA Registered Counsellors recognised as Mental Health Practitioners in Victoria!

You may have seen late last year, ACA worked with the Opposition in Victoria on a Bill to get Registered Counsellors and Psychotherapists added to the list of Mental Health Practitioners, which was then lost by one vote.

Today, with big thanks to the tireless support from Emma Kealy MP, a new Mental Health and Wellbeing Bill was announced, which will finally see the definition of a Mental Health Practitioner expanded to include Registered Counsellors!

This will mean that ACA Registered Counsellors enjoy the same level of access and recognition as the other disciplines and can transition into areas such as schools – unlocking an additional 2,000 qualified professionals for the mental health workforce. It will go a long way to relieving desperate workforce shortages and for existing staff that are fatigued from the extra demand on the sector as a result of the pandemic.

Although the changes won’t come into affect until September next year, this is a long overdue win for the better mental health of Victorians and sets a precedent for other States and Territories to follow suit.

In a media release Ms Kealy said “the Australian Counselling Association and their members should be proud of their tireless efforts to fight to be recognised for the positive contribution they can make for Victorian’s mental health”.

Click here if you would like to read more of Ms Kealy’s media release.

ACA is proud to advocate on behalf of the counselling and psychotherapy workforce, and does not rely on third party groups for advocacy. We look forward to sharing more good news with members.

ACA Sign Partnership Agreement with Australia’s Leading Government Relations Firm Hawker Britton

As of July 2022, the Australian Counselling Association entered an exclusive partnership with Hawker Britton, Australia’s leading government relations firm.

Hawker Britton offers unrivalled expertise in government lobbying and strategic counsel for organisations looking to work with Labor Governments and is ideally placed to assist ACA.

The partnership will assist ACA to work with the Federal Government to advocate and advance the profession of Counselling and Psychotherapy across several areas such as:

  • To develop and maintain relationships with relevant policymakers such as Ministers, Advisers, other Parliamentarians, and officials in the relevant Departments and Agencies
  • To provide strategic advice regarding the most effective mode of engagement
  • To organise and host meetings with relevant stakeholders at political and official levels
  • To alert ACA to policy/political developments relevant to your concerns
  • To build the profile and understanding of ACA among policymakers
  • To provide feedback regarding progress or otherwise towards agreed objectives
  • To assist with any additional projects that may arise moving forward
  • Assist in developing effective communications strategies tailored to the Federal Labor Government
  • Provide high level strategic counsel regarding the Federal Labor Government and relevant stakeholders
  • Facilitate appropriate discussions with relevant government stakeholders
  • Outline strategies for ACA to engage with of key decision makers and influencers

ACA will be working directly with Directors Simon Banks (Managing Director) and Emma Webster. Simon is one of Australia’s most highly respected government relations, campaigning, and strategic communications professionals. Since 2007, Simon has advised some of Australia’s and the world’s largest companies on significant commercial transactions requiring Commonwealth Government approvals.

Prior to joining Hawker Britton, Simon served as Chief of Staff and Deputy Chief of Staff to three Federal Labor Leaders and has been Federal Labor’s Director of Policy and a Senior Policy and Media Adviser to several Labor Ministers.

Emma Webster is a Director at Hawker Britton’s Victorian office. Emma has been a trusted Senior Adviser at the highest levels of Government, working for Government leaders at a State, Territory, and Federal level including for Premier Daniel Andrews and former Prime Minister Julia Gillard.

“ACA is proud to advocate on behalf of members and the profession, and we are excited for this partnership with Hawker Britton to open many more doors for us to continue this crucial work,” says Philip Armstrong ACA CEO.

“Advocacy is too important to leave up to third parties and other peak bodies. They simply do not have the same investment on outcomes and cannot directly influence change, particularly if they also advocate for competing disciplines.”

With over 11,000 members, ACA is the leading and largest peak body for Counsellors and Psychotherapists in Australia.