ACA Strengthens International Partnerships

This week ACA CEO Philip Armstrong and ILO Elliott Ainley visited our counterparts at the British Association for Counselling & Psychotherapy. During our visit, we discussed our similar domestic challenges and how ACA and BACP can collaborate on developing joint strategies for addressing issues such as stigma, professional recognition, training standards and accreditation frameworks.

We discovered a significant amount of synergy between our organisations, both being the leading entities for the profession in our respective countries. ACA would like to sincerely thank the team at the BACP, particularly Fiona & Caroline from the Senior Professional Standards team, for their hospitality during our strategic outreach program.

We look forward to sharing more about this visit with members.

World Mental Health Day: 10 Helpful Habits

World Mental Health Day – 10 October – is a day for global mental health education, awareness and advocacy. It is an initiative of the World Federation for Mental Health to raise public awareness of mental health issues worldwide.

The Australian Counselling Association is a proud partner of Mental Health Australia, who are leading the World Mental Health Day campaign in Australia.

This World Mental Health Day – Monday 10 October – the message is simple: “Look after your mental health, Australia.”

1 in 5 Australians are affected by mental illness annually, yet many don’t seek help because of stigma. During the COVID-19 pandemic, prioritising mental health and wellbeing has been more important than ever.

We encourage all Australians to make mindful habits for mental health, not just this October, but always. Here are 10 tips that may help you or someone you know.

Stay active

Exercise increases wellbeing and helps reduce symptoms of common mental health concerns. Your gym may have closed or your fitness groups may be cancelled, but that doesn’t mean you can’t exercise! Yoga, Pilates, HI IT routines – all can be done in a relatively small space and with no equipment. Have a search on the internet for free workout videos and guides.

Eat well

Eating a nutritious diet is great for both your physical and mental health. As much as possible, try and stick to a healthy diet even as your activities and environment change.

Connect with others

COVID-19 may have made connecting with others trickier, but social connection is more important than ever. When many of us faced lockdown, physical distancing, and travel restrictions, we relied on technology to talk to our friends and family. Where possible, try to connect with others by going out for a coffee or meal together, seeing a film, or going to an event. Reach out to your neighbours and community. Share how you’re feeling and invite others to share with you.

world mental health day helpful habits

Do something you enjoy each day

Do things that make you feel physically and emotionally comfortable, engaging in activities that make you feel safe and calm. Continue to do the things you enjoy as much as possible.

Limit media consumption (and choose trusted sources)

Choose how often you engage with news and social media and be sure to find news sources that are trustworthy and factual. Add in some content that makes you laugh and feel comfortable wherever possible.

Keep to a routine

Keep to your regular routine as much as possible, including exercise, sleep, daily chores, work, recreational activities and connecting with others.

world mental health day helpful habits

Get an early night

Prioritise getting enough sleep each night to help you feel more energised and focused during the day. Getting enough rest is the foundation to protecting your mental health.

Be kind to yourself

Remind yourself that there is no right or wrong reaction to the uncertainties of the pandemic, or to worrying events. Allow yourself extra grace if your productivity and motivation have been impacted by the changing environment.

Maintain perspective

While this is an uncertain time, try and view these changes with openness and acceptance. Remind yourself of things you’re grateful for and things you’ve learned.

world mental health day helpful habits

Seek help

It’s normal to experience anxiety and stress resulting from the pandemic. Talking to a Registered Counsellor or Psychotherapist can help you through it. With ACA’s Find a Counsellor tool you can search for a practitioner in your region.


Australia’s Mental Health Crisis: Unlocking a qualified and ready workforce

By Philip Armstrong

I recently read an article from The Conversation (click here to read) about Australia’s mental health crisis, titled: We can’t solve Australia’s mental health emergency if we don’t train enough psychologists.

While I certainly agree there is a severe shortage of mental health practitioners in Australia, I must disagree that training more psychologists is the only solution to this crisis.

None of the measures put forward in The Conversation article address the most urgent issue facing the mental health sector today: how can we provide access to mental health services for Australians who need immediate support?

Currently the challenge for mental health providers is how to cope with this surge in demand and ensure that support is provided when and where it is most urgently needed.

So what does this mean in real terms for everyday Australians? And what options are available to help alleviate the pressure?

Unlocking an overlooked workforce

One potential and swift solution to our mental health crisis involves making better use of the thousands of Registered Counsellors and Psychotherapists employed right across Australia today.

Registered Counsellors and Psychotherapists are a qualified, highly trained sector of the mental health workforce, but are currently under-utilised. As counselling specialists, Registered Counsellors and Psychotherapists could significantly reduce the burden on the system, freeing up psychologists to focus on more advanced cases and lowering wait times across the board.

As expert communicators and relational practitioners, Registered Counsellors and Psychotherapists are strong compliments to multidisciplinary teams and should be utilised broadly throughout the workforce.

What’s more, this is a workforce that can be accessed immediately: right now, the Australian Counselling Association has a membership of over 11,500 Registered Counsellors and Psychotherapists that can make a difference.

Safeguarding Australian’s mental health

While there are multiple external factors contributing to Australia’s current mental health crisis, many of which are outside of our control, right now there is an opportunity to alleviate and potentially even reverse the declining mental health of our nation.

It is the strong recommendation of the Australian Counselling Association that Registered Counsellors and Psychotherapists are added to the list of allied health professions in the Health Insurance (Allied Health Services) Determination 2014, which provide Focussed Psychological Strategies under the Medicare Benefits Schedule (MBS) Better Access Initiative (BAI).

There are at least 4,000 Registered Counsellors and Psychotherapists who meet the current criteria for the Medicare Benefits Schedule (MBS), while a further 1,000 could be eligible to register within six months.

Including Registered Counsellors and Psychotherapists into the MBS will significantly increase access to bulk billing services, especially for our nation’s most vulnerable. In the absence of a viable solution from the Government, it presents an appropriate, cost-effective and immediate solution that would ultimately help save lives.

Reframing Autism and Understanding the Female Autism Phenotype

Article from: Counselling Australia Journal: Volume 22: Number 3 – Spring 2021

By Dr Jillian Stansfield

The Diagnostic and statistical manual of mental disorders (DSM-5), published in 2013, refers to autism spectrum disorder (ASD) as an umbrella term and is based on a deficit medical model. The DSM-5 diagnosis of ASD includes the previously separated diagnoses Asperger’s syndrome, Rhett syndrome, pervasive developmental disorder and pervasive developmental disorder not otherwise specified (PDD-NOS), and focuses on traits most often associated with males. The criteria to be met for an ASD diagnosis under the DSM-5 are persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following: socialemotional reciprocity; non-verbal communicative behaviours; and developing, maintaining and understanding relationships (APA, 2013). These symptoms are present from early childhood and limit or impair everyday functioning (APA, 2013). A diagnosis of ASD is also assigned a severity specifier of level 1, 2 or 3, depending on the support required. Therefore, the terms ‘high-functioning’ and ‘lowfunctioning’ are redundant and are not included in either of the diagnostic manuals DSM-5 or International Classification of Diseases (ICD-11) (World Health Organization, 2018). As there is no definitive biological test for determining autism, a process is followed that relies on multiple sources of information, including tests and observations to assist medical professionals with making a diagnosis (APA, 2013).

Diagnoses of females are predicated on the same narrow ASD criteria, which is geared towards the male presentation of autism and is one reason why girls may not receive an autism diagnosis, also referred to as a ‘missed diagnosis’ (Fields, 2020; Stansfield, 2020). A ‘misdiagnosis’ can occur when someone is diagnosed with a mental disorder based on a cluster of traits that overlap with autism. The lack of understanding and research about the female-typical presentation or female autism phenotype is reflected in the disparity of diagnoses between males and females, a ratio of 4:1 (Hull et al., 2020).

However, the use of one term, ‘autism’, has resulted in confusion about where people diagnosed under the range of autistic-like conditions should be placed along the autism spectrum (Bennett & Goodall, 2016). This is particularly problematic when individuals are overlooked or misdiagnosed, particularly females, or when the preconceived view is that the overarching diagnostic term is ‘Kanner-type’ or ‘classic’ autism traits. The words ‘disability’ and ‘disorder’, both of which are used in social discourse, indicate a deficit in ability or that something is wrong. However, some autism deficits could be viewed as strengths or advantages (Goodall, 2015). There is an inconsistency in language about and definitions of autism (Cleaton & Kirby, 2018).

Instead of being considered a disability or disorder, as the formal terms suggest, autism is regarded by some as more of a neurological difference (Goodall, 2015). Throughout this paper, the terms ‘autistic’ and ‘on the autism spectrum’ are preferred when referring to a person diagnosed with an autism spectrum disorder. Neither a ‘person-first’ nor an ‘autism-first’ approach is used because some people in the autism community prefer one term over the other and it is essential for the terms adopted to respect the autistic community (Kenny et al., 2015).

History of autism

The history of autism is confronting, with an evolving line of thought that includes many misconceptions and perspectives: from perceptions that people on the autism spectrum have ‘refrigerator mothers’, to people being labelled as ‘rain man’ or as having an ‘extreme male brain’ (Silberman, 2015). Due to the pathologising of traits and to stigma, today’s knowledge and understanding of autism is still in its infancy and it appears people are some way off from understanding and accepting this different way of thinking (Stansfield, 2020).

Child psychiatrist Leo Kanner identified the ‘classic’ model of autism towards the middle half of the last century (Kanner, 1943, 1944; Silberman, 2015; Singer, 2017). Kanner used the term ‘autism’ from the Greek word for self (autos) to describe this cluster of traits, as these children “seemed happiest in isolation” (Silberman, 2015, p. 5).

At the same time, Asperger’s syndrome, commonly known as Asperger’s, was first identified by Dr Hans Asperger, who noted some similar characteristics among children in his paediatric practice (Attwood, 2004; Silberman, 2015). Although Asperger referred to his patients as “little professors” due to their abilities in math and science (Silberman, 2015, p. 6), this more positive aspect of his work is tainted by his link to the Nazi era: he is said to have been among the doctors who had the power to decide the fate of children who did not meet certain physical and mental abilities (Sheffer, 2018; Szalai, 2018). Although the origin of autism and the term ‘Asperger’s syndrome’ are tainted by this unsavoury narrative, Asperger’s work was the starting point for discourse on autism (Stansfield, 2020).

When Lorna Wing, a psychiatrist, had a daughter who was diagnosed with Kanner’s classic autism in the 1960s, it was almost unheard of for a female to receive an autism diagnosis. Following the realisation that her daughter had autism, Wing made it her quest to seek out the supports available to families of children like her own (Silberman, 2015). Wing (1981) found that many children did not fit the mould of Kanner’s rigid traits and set out to expand the definition of autism, proposing that it was a ‘continuum’ and later adopting the term ‘spectrum’ (Silberman, 2015, p. 353). Despite Wing’s work, several decades later the connection between autism and girls remains relatively undiscovered and far more is known about autism in males (Tomlinson et al., 2020).

Background of autism spectrum disorder

The DSM-5 is becoming a somewhat outdated source for determining a diagnosis, and controversy surrounds the umbrella term ‘autism spectrum disorder’ in the last update. One point of contention is the use of the word ‘disorder’, because autism is becoming more accepted, particularly in the autistic community, as a neurotype or condition rather than as a mental disorder (Stansfield, 2020). The view that autism is a disorder that can be cured is reflective of the medical model approach, and lags behind anecdotal and clinical observations of the female autism phenotype (Marshall, 2014). No specific changes appear to have been made to DSM-5 diagnostic criteria to reflect this in the foreseeable future.

Silberman (2015) posed the question, “[A]fter 70 years of research on autism, why do we still seem to know so little about it?” (p. 15). People on the autism spectrum are beginning to demonstrate that ‘‘‘neurotypical’ is not the only way to be, or even the best way to be” (Singer, 2017, p. 1195). Over time, autism has become recognised more as a neurotype (neurological type) that differs from a ‘neurotypical’ brain, which is a dominant neurotype, and which Singer observes is “a term coined to sideline [people, like] the word ‘normal’” (2017, p. 404). Neither one is better or worse than the other; the neurotypical brain is “designed to facilitate socialisation” and the autistic brain is designed “to focus on understanding the world around us” (Castellon, 2020, p. 31).

The cluster of deficit-based traits for ASD identified in the DSM-5 are oriented toward males (Ranson & Byrne, 2014), leaving girls undiagnosed or misdiagnosed when their collective autistic traits are misinterpreted and categorised as a mental illness rather than as autism (Carpenter et al., 2019). According to the traditional definition of autism, identified as a male syndrome, the number of children diagnosed with ASD has risen over the last decade (Sproston et al., 2017). The higher rate of diagnoses does not mean the number of people who have been born with the condition has risen; rather, it is illustrative of a better understanding of autism due to ongoing research, education and awareness (Carpenter, 2017). Further research on girls and autism is likely to see the number of female diagnoses increase, shrinking the gap between males and females.

The lack of knowledge about girls and autism due to a dearth of research leaves many girls unsupported, misdiagnosed and misunderstood, even though they may receive a diagnosis as an adult (Carpenter et al., 2019; Cook et al., 2017; Mademtzi et al., 2017). The later diagnoses of women may be one reason why ASD is, according to statistics, diagnosed four times more often in males than in females. Other reasons include ASD presenting differently in males (APA, 2013; Mademtzi et al., 2017; Moyse & Porter, 2015) and diagnostic tools derived from the DSM-5 being skewed towards male traits and characteristics of autism (Ranson & Byrne, 2014). A further reason frequently cited for missed or late diagnoses in females is their ability to mask traits associated with autism (Cook et al., 2017; Ranson & Byrne, 2014). Females are better at masking or camouflaging their symptoms through strategies such as mimicking and scripting (Myles et al., 2019). Due to being able to mask their inadequacies and mimic others, females on the autism spectrum are perceived as ‘normal’, with the result that many autistic girls ‘fly under the radar’ and suffer in silence during their primary years (Attwood, 2006).

Social model and medical model of disability

The medical model versus social model debate is frequently highlighted in the literature on autism (Alsharif, 2019; Liu et al., 2018; Manago et al., 2017; Pickard, 2019; Singer, 2017) and is included in this overview to acknowledge how far our thinking has come in terms of what autism is or is not and how it presents in everyday life. The medical model, with a deficit focus on ASD according to the DSM-5, insinuates a stigma associated with the term ‘disorder’: that it is something ‘wrong’ that requires ‘fixing’, even when the perceived negatives could be strengths or unique abilities (Angulo-Jiménez & DeThorne, 2019).

The social model proposes more than one perspective, but essentially asserts that autism is a social construct whereby society determines what is a disability and ability and how they are approached (Mitra, 2006).

The social and medical models are in opposition to one another – the latter focuses purely on disability, whereas the social model draws attention to autism as a spectrum and showcases abilities. Although the social model exposes the social inequalities encountered by people on the autism spectrum, it acknowledges that it is not the person with the disability who needs to change, but society that needs to change its perspectives on autism (Shakespeare & Watson, 2002).

The neurodiversity paradigm for understanding autism is sometimes considered an ‘outgrowth’ of the social model in that it acknowledges the need for support (Angulo-Jiménez & DeThorne, 2019, p. 570).

Disassociating autism from the notion of being a mental disorder and moving towards a more holistic view of how it manifests in the real world means that the strengths inherent in this different way of thinking are not ignored. A different way of thinking simply means autistic people will learn about the world in a different way (Sherratt, 2005).

What the medical model identifies as deficits, the social model may identify as strengths. Focusing on a social model, whereby autism is identified as a neurology, will enable a better understanding of autism in females, not only in a schooling context, but also in the medical milieu where diagnosis takes place. This holistic view of autistic strengths and challenges, rather than just deficits, will allow for better understanding and earlier identification of females on the autism spectrum.

Mediation is needed between the social and medical models to reframe how society views disability, reduce stigma and promote acceptance. One model that is emerging from this binary view is the neurodiversity paradigm, which stems from the social model (den Houting, 2019). Singer (2017) is credited with coining the term ‘neurodiversity’, and did so in the belief that “we need to go beyond the dichotomy of the medical model vs. social model” (p. 615).

Given the history of autism, the medical and social models, people’s lived experiences and the adoption of the term ‘neurodiversity’ within autism discourse, Silberman’s (2015) modern view of autism as a “different operating system” is a favourable one (p. 471). The neurodiversity paradigm began to emerge in the late 1990s (Angulo-Jiménez & Dethorne, 2019; Silberman, 2015) to explain the concept that there is not just one type of ‘normal’ brain.

Identifying the female autism phenotype

As girls on the autism spectrum grow older, they are more likely to be misdiagnosed with mental health issues (Myles et al., 2019). Misdiagnosis can have devastating long-term effects, as undiagnosed females may be medicated, develop limited survival strategies and are often left to navigate a challenging world as ‘misunderstood’ individuals, leading to a plethora of problems in their adulthood (Holliday Willey, 2012). Teachers are often the first to recognise when a student may need a referral to a specialist health professional so that these students receive the appropriate support and intervention in the early years.

As autistic females are underrepresented in the research, ‘female stories’ are often shared to gain insights (Jarman & Rayner, 2015). Jarman and Rayner presented themselves as case studies and shared their personal stories and knowledge of being on the autism spectrum. Temple Grandin’s Asperger’s and girls (2006) and Wenn Lawson’s Girls and autism: Educational, family and personal perspectives (2019) are examples of the autistic voice. They highlight the importance of listening to the voices of autistic females by adding an element of authenticity to the academic discourse. There are also well-known autistic women presented in the media, Greta Thunberg (Swedish environmental activist), Susan Boyle (Scottish singer) and Hannah Gadsby (Australian comedian) who openly share their diagnosis and talents, and challenge ideas of what autism ‘looks like’. Jarman (2013) proposed further case studies on school-aged females on the autism spectrum to enhance understanding and recognise their unique challenges and characteristics. As research often lags behind clinical and anecdotal observations (Marshall, 2015), Jarman’s (2013) work was important for advancing our understanding of the relatively new medical term ASD.

There are many anecdotal and clinical observations on the female profile of autism in the form of checklists and online stories about ‘lived experiences’. These can be a resource for females who have been misdiagnosed, have a missed diagnosis or are seeking answers to explain their differences (Craft, 2016; Marshall, 2016; Starlight and Stories, 2018; The Little Black Duck, 2018). Tania Marshall is an Australian psychologist, specialist and prolific writer on autistic girls and women, who has published numerous books and blogs on the female presentation of autism, including I am Aspien Girl and I am Aspien Woman. Marshall (2019) explored the many traits of girls on the autism spectrum, as well as themes such as masking, anxiety, perfectionism, emotion and high achievement, acknowledging that many of these traits make it difficult to identify and support autistic females.

A communication tool, CASSIE, was recently developed from evidence-based research, and focused on the female autism phenotype in the early years of schooling (5–8 years of age). The CASSIE tool, which is presented in the form of a wheel, can assist with identifying autistic girls in the early years’ classroom and help teachers to better manage girls’ learning and social experiences (Stansfield, 2020). The CASSIE tool further informs the literature about the traits and characteristics that pertain to the female autism phenotype. There is no single way to categorise the traits and characteristics of girls on the autism spectrum, and CASSIE incorporates communication, academic, sensory, social and identity aspects (Stansfield, 2020). Stansfield (2020) found several reasons why girls are ‘invisible’, meaning fewer girls are diagnosed than boys: they have masking traits; they are social, but more so with adults; traits vary between males and females; they are capable but this is not always shown in their work; there are misconceptions that autism is a ‘boy’ condition; and deficits are seen as strengths and vice versa. These reasons support the DSM-5 (2013), which states that females go unrecognised due to “subtler manifestations of social and communication difficulties” (APA, 2013, p. 57).

The development of the CASSIE tool is beneficial not only to teachers and parents, but also to the wider support network. It can help identify autistic females and support them, regardless of whether they are diagnosed (Stansfield, 2020). Ongoing research on the female autism phenotype, such as the contributions of Jarman (2013) and Stansfield (2020), may assist in reducing the number of missed diagnoses or misdiagnoses of autistic females.


There is a continuing need for acceptance of autism in the general community. Sharing knowledge brings about greater understanding, and highlighting the female autism phenotype with a focus on strengths is a positive way of reducing stigma and increasing acceptance. Over time, education will change community perspectives on autism and how it presents in females. People on the autism spectrum are beginning to demonstrate that “‘neurotypical’ is not the only way to be, or even the best way to be” (Singer, 2017, p. 1195). Over time, autism has become more recognised as a neurotype that differs from a neurotypical brain, a dominant neurotype (Singer, 2017). Neither one is better or worse than the other.



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Alsharif, H. N. (2019). The model of disability in Saudi Arabia [Article]. Indonesian Journal of International and Comparative Law, 6(1), 3-23. 

Angulo-Jiménez, H., & DeThorne, L. (2019). Narratives About Autism: An Analysis of YouTube Videos by Individuals Who Self-Identify as Autistic. American Journal of Speech-language pathology, 28(2), 569-590. https://doi:10.1044/2018_AJSLP-18-0045 

Attwood, T. (2004). Strategies to reduce the bullying of young children with Asperger’s syndrome. Australian Journal of Early Childhood, 29(3), 15-23. 

Attwood, T. (2006). The Pattern of Abilities and Development of Girls with Asperger’s Syndrome. In T. Attwood., T. Grandin., T. Bolick., C. Faherty., L. Iland., J. McIlwee Myers., R. Snyder., S. Wagner, & M. Wrobel (Eds.) Asperger’s and girls, (pp.82-172). Future Horizons. 

Bennett, M., & Goodall, E. (2016). A Meta-analysis of DSM-5 Autism Diagnoses in Relation to DSM-IV and DSM-IV-TR [journal article]. Review Journal of Autism and Developmental Disorders, 3(2), 119-124. 

Carpenter, L. (2017). Supporting students with Autism Spectrum Disorder. In M. Hyde., L. Carpenter., & S. Dole (Eds.) Diversity, inclusion and engagement. (3rd ed., pp.284-307). Oxford University Press. 

Carpenter, B., Happé, F., & Egerton, J. (2019). Where are all the autistic girls? In Carpenter, B., Happé, F., & Egerton, J. (Eds) Girls and autism. Educational, family and personal perspectives. (p.3-9). Routledge. 

Castellon, S. (2020). The spectrum girls’ survival guide. Jessica Kingsley Publishers. 

Cleaton, M., & Kirby, A. (2018). Why Do We Find it so Hard to Calculate the Burden of Neurodevelopmental Disorders? Journal of Childhood and Developmental Disorders, 4(3:10), 1-20. 

Cook, A., Ogden, J., & Winstone, N. (2017). Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings. European Journal of Special Needs Education, 33(3), 302-315. 

Craft, S. (2016). Females with Asperger’s Syndrome Checklist by Samantha Craft. 

den Houting, J. (2019). Neurodiversity: An insider’s perspective. Autism, 23(2), 271–273. 61318 82076 2. 

Fields, L. (2020). Adult autism: hidden in plain sight. Readers Digest Magazine, April 2020, 46-49 

Goodall, C. (2015). How do we create ASD‐friendly schools? A dilemma of placement. Support for Learning, 30(4), 305-326. https://doi:10.1111/1467-9604.12104 

Holliday Willey, L. (2012). Safety skills for Asperger women: How to save a perfectly good female life. Jessica Kingsley Publishers.  

Hull, L., Petrides, K. V., & Mandy, W. (2020). The Female Autism Phenotype and Camouflaging: a Narrative Review. Review Journal of Autism and Developmental Disorders. doi:10.1007/s40489-020-00197-9 

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Jarman, B., & Rayner, C. (2015). Asperger’s and Girls: What Teachers Need to Know. Australian Journal of Teacher Education, 39(2), 128 -142. https://doi:10.1017/jse.2015.7 

Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be used to describe autism? Perspectives from the UK autism community. Autism, 20(4), 1-21. 

Liu, M. J., Ma, L. Y., Chou, W. J., Chen, Y. M., Liu, T. L., Hsiao, R. C., Hu, H.F., Yen, C. F. (2018). Effects of theory of mind performance training on reducing bullying involvement in children and adolescents with high-functioning autism spectrum disorder. PLoS ONE, 13(1). https://doi:10.1371/journal.pone.0191271 

Mademtzi, M., Singh, P., Shic, F., & Koenig, K. (2017). Challenges of Females with Autism: A Parental Perspective. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3341-8 

Manago, B., Davis, J. L., & Goar, C. (2017). Discourse in Action: Parents’ use of medical and social models to resist disability stigma [Article]. Social Science and Medicine, 184, 169-177.  

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Marshall, T. (2013, 2016). First Signs of Aspergers in Bright Young Girls Pre-School. 

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Moyse, R., & Porter, J. (2015). The experience of the hidden curriculum for autistic girls at mainstream primary schools. European Journal of Special Needs Education, 30(2), 187-201. https://doi:10.1080/08856257.2014.986915 

Myles, O., Boyle, C., & Richards, A. (2019) The social experiences and sense of belonging in adolescent females with autism in mainstream school. Educational and Child Psychology, 36, 8-21 

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Suicide Prevention: Lessons for Counsellors

Article from: Counselling Australia Journal: Volume 23: Number 2 – Winter 2022

By Melissa Marino

Counsellors are critical gatekeepers in the prevention of suicide, says Dr Nicole Hill, a leader in youth suicide prevention research in Australia.

It is, therefore, integral they and other health professionals receive suicide-specific training and operate as part of a healthcare network with families, educators, community organisations and social systems to identify risk and respond in a timely manner.

Dr Hill says her work shows that one in two young people who die by suicide had a suspected or known mental health diagnosis at their time of death. This is important for counsellors to know as it indicates there are opportunities within the health system to make a difference.

The initial response someone receives when reaching out for help can determine how likely they will be to seek future support, she says. With often weeks-long waiting lists for therapy, it is critical that adequate interim support and information is provided to keep people engaged.

“There’s a duty of care to inform young people of strategies or resources they can use to help bridge that waiting period,” she says.

Crisis helplines, such as Lifeline, “can really help during the fleeting suicidal crisis”, she says. And new peer support programs such as one being trialled by SANE Australia could be valuable.

For young people who have disclosed suicide ideation and have a specific plan, best-practice strategies such as means-restriction counselling and safety planning can be very effective. “The research shows that in the general population, safety planning can reduce the risk of suicidal behaviour by up to 50 per cent – so that’s a really important one,” she says.

Culturally informed care is also critical to ensure LGBTIQA+ young people and others who are marginalised have a safe space to go, she says. “It’s as much about addressing the mental health concerns of young people as the social and cultural contexts and stresses that they face.”

Training more counsellors would help address the issue of mental health in young people but, in the long term, changes to the system to ensure young people could access coordinated, ongoing support are required,  she said.

As a keynote speaker at the International Association for Suicide Prevention conference, Dr Hill says such events are important for upskilling, exchanging ideas and learning about evidence-based best practice. On a personal level, it is also invaluable to meet others working in the “significantly underfunded” yet critical field,  she says.

“The work is hard. We’re dealing with suicide, which is a very difficult topic and has a personal cost. But being able to connect with others who are dealing with the same challenges is really good for our own wellbeing as well.”

Your Guide to the ACA Careers Centre

Matching job seekers to employment opportunities

The ACA Careers Centre is a central hub where employers can advertise current job vacancies to the right candidates and job seeker can find suitable employment opportunities within the counselling industry. In August 2022, over 200 jobs were posted in to the ACA Careers Centre! These jobs spanned all Australian States and Territories with a range suitable for new graduates to experienced practitioners, and across all levels of membership.

The ACA Careers Centre is an information service, not a recruitment service.

How does the ACA Careers Centre work?

What are the benefits to the ACA Careers Centre?

As a job seeker:

Members can quickly and easily find jobs in their area and desired field, that are specific to Counselling and Psychotherapy.

  • Only accessible to ACA members.
  • Ability to filter searches by state, city, speciality and work type.
  • All job listings are linked to the advertiser’s original ad, so there’s no need to manage any additional accounts.
  • Setup email notifications to advise you of any new job listings.

As an employer:

Job vacancies that are listed on the ACA Career Centre provide increased opportunities for suitable candidates to find your job listings.

  • Get your ad in-front of the largest network of Counsellors and Psychotherapists in the country.
  • Easy to use process that links your ACA Career Centre job listings to your current Seek ad so there’s no double handling.
  • Free to post as many ads as you like!


What are the most frequently posted jobs on the ACA Careers Centre?

Often, the positions available to Counsellors and Psychotherapists will not be titled “Counsellor” or “Psychotherapist”. The Counselling industry is wide-reaching and diverse. There are more opportunities out there for counsellors than we realise. Here are some of the common terms and positions advertised:

  • Counsellor or Psychotherapist
  • Drug & Alcohol Intake Officer
  • Counsellor Educator
  • Community Mental Health Worker
  • Disability Liaison Officer
  • Clinical Manager
  • Therapeutic Specialist
  • Mental Health Worker
  • Integrated Therapy Team Leader
  • Case Manager
  • Women’s Wellness Advocate
  • Health and Wellbeing Consultant
  • Early Intervention Mental Health Clinician
  • Behaviour Support Practitioner
  • Multicultural Services
  • Community Worker
  • Helpline Advisor
  • First Responder
  • Support Worker
  • Family Support Officer
  • Refugee Services Officer
  • EAP Clinician/Counsellor
  • CBT Consultant
  • Group Facilitator
  • Crisis Counsellor Advocate

Member information regarding the Allied Health Professions Association

What is AHPA?

The Allied Health Professions Australia (AHPA) was founded and run by the Australian Psychological Society for many years. It is a collegiate body consisting of 25 national allied health association members and a further 13 affiliate members. AHPA collectively represents some 150,000+ allied health professionals who provide services across a range of health settings, as well as disability, aged care, education, justice, community services and more in Australia.

Membership to AHPA does not formally define Allied Health status, ACA has successfully advocated for our members to be formally listed as Allied Health professionals in the majority of States of Australia, without support from AHPA.


Is ACA a member of AHPA?

Yes, in 2020, ACA became an affiliate member, albeit becoming a member did not influence AHPA members (the APS or AASW) in continuing to not support advocacy for Counselling and Psychotherapy to move into the Medicare Benefits Schedule (MBS) space.


What’s the difference between an Affiliate member and a Full Member?

Full members must pay an annual fee of $2 per member to AHPA in exchange for full voting rights.

AHPA has been clear and concise in formally stating it advocates equally for both ordinary and affiliate members irrespective of membership status. AHPA is unable to specifically support advocacy for individual members in areas where other members do not, for example APS and AASW do no support advocacy for Counsellors to move into MBS and many other areas. This means AHPA are unable to specifically support the advocacy work of ACA, regardless of membership status.


Why isn’t ACA an ordinary member?

ACA has decided, for the time being, to remain an affiliate member based on numerous factors:

APS and AASW do not support Counsellors and Psychotherapists moving into MBS. As a result the AHPA has stated on several occasions it can only advocate for the broadening of access to Medicare for all its members however, it cannot advocate for Counsellors and Psychotherapists specifically.  This means the economic and human resource burden of front-line advocacy for our members is borne by ACA regardless of membership status.

There is no correlation between greater employment opportunities for AHPA full members as opposed to affiliate members. In fact, employers by and large insist on registration with ACA as their primary benchmark. The cost to the association for membership has to be passed back to ACA members, the return on investment does not meet the pub test.

ACA would never rely on third parties to do our advocacy work for us particularly when large numbers within that group worked in opposition to our advocacy.

AHPA has to date not formally supported Counsellors or Psychotherapists in terms of advocacy for entry into MBS.

In regard to return on investment for ACA members, outcomes have to date been 100% due to our solo Federal/State/Territory and industry advocacy efforts.

We have achieved far more through our solo advocacy efforts in three years of affiliate membership.

ACA cannot justify becoming a full member at this time as the return on investment reflects there will be little to no direct benefit for ACA members.


Did I hear that being a full member of AHPA means we can get Medicare, GST exemption etc.?

No, AHPA has clearly stated they cannot advocate for Counsellors and Psychotherapists to move into the MBS space as not all their full members support this.

There is no correlation between full membership to AHPA and inclusion in MBS or receiving GST exemption. A single association cannot achieve MBS or GST exemption; the individual providing the service has a GST exemption on the provisor they deliver through the Better Access Initiative using an MBS item number.

GST exemption legislation clearly indicates that membership to any association is not a primary factor in being eligible for exemption status. For Counsellors and Psychotherapists, the primary obstacle is not being able to access provider numbers for MBS services and item numbers.

AHPA advocates for their members equally; we must remember that their members include many other disciplines that actively work against Counsellors and Psychotherapists becoming part of the MBS.


Do ACA plan to become a full member?

Full membership to AHPA will not fundamentally change anything for Counsellors and Psychotherapists in relation to creditability, access, advocacy, registration or employment opportunities. AHPA do have a strong record of advocacy in relation to issues that collectively impact on Allied Health Professions as a whole, such as advocating for consistency in policy during the height of the COVID-19 crisis.

ACA will consider full membership once it has successfully advocated for its members for inclusion into MBS or AHPA formally agree to openly support our members moving into the MBS space.

ACA has achieved so much over the last 12 months regarding advocacy, including significant milestones such as:

First Peak Body to be given a place on the MSB review Committee (SEG)

Counsellors and Psychotherapists wrote into legislation in Victoria to come under the definition of Mental Health Practitioner, in conjunction with Emma Keely MP.

Recommendation from the Queensland State Government to the Federal Government for Counsellors to come into the MBS.

These significant milestones have been achieved without relying on third parties to do our advocacy work for us, or at an unnecessary extra cost to our members.



Mental wellness in a time of crisis recovery

Article from: Counselling Australia Journal: Volume 23: Number 2 – Winter 2022

By Melissa Marino 

Professor Sam Harvey

Over the past 20 years in Australia, great gains have been made in public health outcomes; however, mental wellbeing is a notable exception. As the COVID-19 pandemic shines a spotlight on mental health, Black Dog Institute executive director Professor Sam Harvey shares his insights on how we can start to rectify this – and the critical role counsellors will play.

As the executive director of Black Dog Institute, Professor Sam Harvey leads research and on-the-ground programs to understand, treat and prevent mental illness. On a personal level, he keeps on top of his own mental health through a few simple activities. “Spending time with my kids, going out for a walk – they are really important to me so I make sure they’re prioritised,” he says.

His advice to others seeking to maintain their own wellbeing is to recognise the specific activities that matter to them – and to take the time out to do them. “As individuals, taking action is how we can help our own mental health,” he says.

For Professor Harvey, the COVID-19 pandemic and the lockdowns that came with it provided a better balance between work and home life and more time for the activities he enjoys.

But for many others, the experience was the opposite. Home schooling was much harder in smaller dwellings with fewer computers. And many people in the lowest-paid, least-secure jobs either lost employment or were unable to work from home.

The effect of changed working conditions under COVID-19 on people’s mental health was so significant, Black Dog Institute produced a white paper on the issue. “COVID disproportionately affected those who were least able to take another hit,” says Professor Harvey. “And it’s something we really need to keep an eye on because we know the mental health consequences of insecure work are very substantial.”

Shadow pandemic

Increased reports of depression, anxiety and eating disorders are all symptoms of what has been coined a ‘shadow pandemic’ of mental ill-heath playing out in the wake of COVID-19.

By amplifying social disadvantage, the pandemic has propelled trends that have been a long time building, making mental ill-health one of the dominant health problems in society today.

In Australia, mental health symptoms are now the number one cause for people consulting with their GP, Professor Harvey says. And suicide has overtaken motor vehicle accidents as the leading cause of death among young people.

Unlike other major public health issues that have trended down over time, rates of mental health symptoms, particularly among young people, are increasing year on year, he says.

“This is particularly damning because since the industrial revolution, by and large, we have handed over better health outcomes to future generations – for example in cardiovascular disease and lung health,” he says. “The two areas in which we’ve failed are obesity and mental health. They’re the two that are getting worse in the next generation, and we don’t understand why.”

As the relatively new executive director of Black Dog Institute (since November 2021) this is an issue Professor Harvey wants to understand and reverse. “It’s a huge unanswered question,” he says.

Golden opportunity

What is known is that increased rates of mental ill-health have corresponded with increased awareness of the issue – with both peaking in the pandemic.

If there is any silver lining, this heightened awareness opens a window of opportunity to address mental health meaningfully, says Professor Harvey, who is also the Institute’s chief scientist.

“As a community and at policymaker level, there’s an understanding of just what a big issue mental health is, and my key concern is that we don’t miss that opportunity with small-scale, ineffective interventions,” he says. “We have to use this moment to do things properly.”

For Professor Harvey, the right approach starts with increased funding. “We’ve underinvested in the past. And given that mental health is one of the most pressing health issues for society, an inadequate proportion of the budget at all levels of government goes towards it.”

Secondly, the funding must back evidence-based, coordinated programs and services around prevention, early intervention and treatment, he says. And COVID-19 has provided a blueprint for how science can guide such a response to a widespread, urgent public health issue.

“We mobilised the scientific community to answer the big questions and the people making decisions were guided by that science,” he says. “We need exactly that to happen with mental health. And the solution doesn’t lie just within the health settings. We have to do the right things in schools, in workplaces and in communities.”

Support structures

Schools and workplaces across Australia are full of good intentions to raise awareness around mental health, he says. But without adequate, science-backed resources to support them, they could be doing more harm than good.

“By just telling people about symptoms [of depression or anxiety] without giving them any practical skills to deal with them, without making sure there are services that can actually help, you risk at best wasting a lot of money and good intentions on something that’s not helpful,” he says. “And at worst, without offering any practical assistance, you may cause people to be more distressed than they would have been otherwise.”

Instead, he says, if programs such as those based around cognitive behavioural therapy, for example, were used in schools, initial distress could be prevented from developing into a more severe mental health problem.

To investigate the impact of adequate support structures, Black Dog Institute is embarking on research with a group of workers identified at increased risk of mental ill-health. It is screening emergency service workers to identify those who are at risk or unwell, and test whether their outcomes can be improved by having a range of health professionals, including counsellors, on hand.

“The reality is we’ve never been able to show the benefit of that support before, so this is a big step for us,” he says.

Coordinated workforce

Professor Harvey says a larger, better-funded and more coordinated mental health workforce is critical to ensure people get assistance when they need it. “There’s a lot of promotion encouraging people to get help when they have symptoms – which is fantastic – but let’s make sure when they see a doctor or counsellor or psychiatrist, they’re not left on a 12-month waiting list,” he says.

Wait times of this length are ludicrous, he says, and ultimately Australia needs to train a bigger workforce to meet demand. In the interim, in a lesson learnt through the rise in telehealth consultations over lockdowns, the existing workforce could be used more efficiently by blending online and face-to-face care.

Technology could also help address the fragmentation of mental health care that Professor Harvey says has become more pronounced over the past decade. If people could access their information, for example, they could share it between counsellors and other health professionals and “move more seamlessly between services to receive the support they need depending on how their symptoms are progressing”.

Counsellors, he says, will play a critical role in a better coordinated pool of mental health professionals supporting people’s changing needs.

“We need more counsellors, but we also need them to be properly integrated into the other parts of the health service, such as general practice,” he says. “There needs to be more of a focus funding collaborative care that brings everybody together rather than individuals operating in isolation.”

Evidence from Europe and the US shows that when you do collaborative care well, clients have improved outcomes and, overall, the costs are less. In Australia, coordination is challenging because of its mix of state and federal government and public and private sector providers. But it’s a challenge that must be tackled, he says. “Given the size of the problem, I just don’t think it’s optional anymore.”

Holistic support

Not a week goes by at Black Dog Institute without a parent or individual seeking help to navigate the system, he says. And there has also been a surge in schools and workplaces asking for advice around how to manage the distress and mental health challenges presenting in students and staff.

Leading Australia’s mental health response through schools, workplaces and communities is one of four key priorities in Black Dog Institute’s new five-year strategy. Another is developing new models of blended care to get optimal, tailored treatment to individuals.

“We want to make sure that mental health and wellbeing is front and centre when we think about what a post-COVID recovery looks like, making sure that as we return to some form of normality, we prioritise mental health in the way we set up our workplaces, schools and clinical settings.”

In workplaces, training for managers to spot when someone may be struggling is showing a way forward. “We’ve done large, controlled studies demonstrating that this type of intervention has a return on investment of A$10 saved for every dollar spent on the training because of the reduction in sickness absence among workers,” he says.

The wellbeing of those working in the sector is also a focus, with the Institute researching why health professionals have elevated rates of mental health symptoms and an increased risk of suicide.

The Institute also provides a national clinical service for health professionals, as well as training programs, resources and networks to manage burnout and promote mental health and wellbeing.

Prevention frontier

In schools, Institute research is underway with primary-aged children on how to reliably identify those who may be struggling and help alter their trajectory. “We now know you can see clear signs of anxiety when children are in primary school. And that’s important because it’s much easier to treat the problems when their minds are more flexible,” Professor Harvey says. “If you leave it until they’re older, it becomes harder to shift.”

There are also promising developments in early intervention for adults, he says. Institute research from 2021 shows that the number of stressed workers who went on to develop depression was reduced through the use of a smartphone app featuring activities to develop mental fitness and resilience.

“There’s a range of exciting opportunities around prevention that we’re now trying to demonstrate can work broadly,” he says.

Prevention is a long-term goal, but – like most public health research – a focus on the cure usually comes first.

“If we look at other areas of health like cardiovascular disease, the first wave of progress was in having effective treatments. The next wave was working out how you can prevent people becoming unwell through changing diets, increasing exercise and stopping smoking,” he says.

“We now have good treatments for mental health, so one of the next frontiers is prevention – and there’s early signs we can do that at scale.”

And while an increased attention on mental health in light of COVID-19 is welcome, there now needs to be action, he says. “I think the next year or so will really determine whether improved mental health and wellbeing is a lasting legacy of what’s happened as a result of COVID or whether it’s just another false dawn.”


Important Update: ACA Office Operating Hours

Dear members,

We would like to inform you of a change to ACA’s operating hours. ACA HQ will now be operating from 8am to 4.30pm (AEST), Monday to Thursday.

This change will take effect starting Monday, 22 August 2022.

We hope the new time will be more convenient for members. This change is also on account of training purposes to better service our members.

Members, you can contact us via email outside of these operating hours, and our dedicated staff will get back to you as soon as possible.

We greatly appreciate your kind cooperation and understanding.

ACA Contact Information

Address: Unit 2/42 Finsbury Street Yuggera Country Newmarket Qld 4051

Postal Address: P.O.Box Yuggera Country 88 Grange Qld 4051

Telephone: 07 3356 4255 or 1300 784 333

For all registration, eligibility, renewal & upgrade enquiries please email

For all invoice, advertising & receipt enquiries please email


ACA Live Q&A!

ACA will once again be hosting a virtual Q&A session from ACA headquarters this Tuesday 23rd August, 6.30pm AEST via Zoom.

Join CEO Philip Armstrong live as he answers member questions about the industry, upcoming AGM and proposed structural change. We will also take a look at what the rest of 2022 has instore for ACA and its members.

The event will be held via Zoom and will also be made available to watch afterwards for ACA members.

Click here to register via Eventbrite.

Please note, there is a maximum capacity on this Q&A – first in, best dressed. Only registered participants will receive the Zoom link to the session.

Event details:
Tuesday, 23rd August 2022, 6.30pm AEST via Zoom
Please check your local time.

Do you have a question? Members, don’t miss this opportunity to ask Philip your questions. Members can submit questions live on Zoom during the session. Alternatively, email your questions ahead of time to, to ensure your question is not missed.

We hope you can tune in!