Posted in Politics, Psychology

Australian Psychology: Expert Practice & ‘4+2’ Pathway

The 4+2 pathway is one of a few training pathways currently available in Australia for students who aim to register and practice as a psychologist. The +2 of the 4+2 pathway involves two years of intently focused supervised provisional practice, often taken up after completing a four-year degree in psychology instead of a two year post graduate master’s degree in psychology.

While there are very few formal restrictions of practice currently in place for the 4+2 trained psychologist within Australia, there is a growing stigma towards those who follow this training pathway that suggests to prospective employers, government agencies and the public that the 4+2 trained psychologist is less skilled with greater limits in capacity to practice when compared to their master’s degree trained colleagues.

Feeding in to this stigma of the 4+2 trained psychologist is how the Australian Psychological Society (APS) and the Psychology Board of Australia (PsyBA) defines the 4+2 trained psychologist as a ‘general practicing psychologist‘ while denying opportunity to have formal acknowledgement and recognition of expertise developed through the +2 provisional training pathway and/or through the many years of refined expertise that has developed through their chosen fields of specialised practice.

As a science, it’s important we do not fall in to the trap of ill-informed stereotypes and prejudice. Unfortunately, it seems we have done so in the growing stigma faced by psychologists following the 4+2 pathway to registration and expert practice.

In this brief article, I would like to redress two (2) presumptions that are often made in the argument against the 4+2 pathway with a focus on how we train practice expertise.

Presumption One: The +2-training pathway is not an effective training pathway to springboard in to expert practice as a psychologist.

Presumption Two: A master’s degree is the ‘gold pass’ standard approach for the training of practice expertise in psychology.

Ultimately, I would like to suggest that both presumptions are just not true.

IN REDRESS OF PRESUMPTION ONE (i.e., the +2 training pathway is not effective training); it is critically important to firstly understand the teaching model around situated learning and the underlying principles of approach that the +2 of the 4+2 training pathway is based.

Basically, situated learning is the teaching strategy of learning on the job in the context of a supervisor overseeing the student’s learning and development. Its primary aim, as an educational approach, is to facilitate very specifically within the learner successful mastery of the practice setting. It is ultimately the educational pathway of choice from which the novice develops in to an expert.

Specifically, regular exposure to the complexity and ambiguity of the real world of practice facilitates the development of complex cognition and associated action processes most typically used by experts (Lave and Wenger 1991).

Ultimately advocates of the situated learning process argue that any knowledge and skill required to practice effectively must be taught in context and not in the abstract. Learners must use associated skills and tools in the same way practitioners do and therefore need to become “cognitive apprentices” in that discipline’s community and its culture (Lave & Wenger, 2002).

Two key principles of situated learning required for the development of skilled professional practice includes: (1) knowledge being presented in an authentic context and (2) learning that includes social interaction and collaboration from within the authentic context. (Lave, 2002; p.151). Since authentic context and social interaction are critical components of situated learning, student psychologists need to be involved and regularly immersed in the relevant community of professional practice.

The social interaction and associated learning that occurs in communities of psychological practice between experts and novices is crucial and should begin with the student psychologist observing members of the psychology practice community and then slowly move the student psychologist from the periphery of that practice community in to being fully participating members, applying practice skills effectively and in context.

By it’s very nature, the +2 pathway or the 4+2 psychology training model is a highly valid and reliable situated learning approach offering student psychologists an excellent way to develop authentic, practice based expertise.

IN REDRESS OF PRESUMPTION TWO (master’s being the ‘gold standard’ of training as opposed to the situated learning process of the +2 pathway); I firstly need to flag that I am in a minority of academics teaching in psychology who have a master’s degree in education.

In this context, I am quite intrigued that while many see master’s training as the gold pass standard of training for specialist work as a psychologist, the specialist areas of teaching psychology and research supervision in psychology does not require, as a fundamental prerequisite, a master’s degree in education before the psychologist can practice in the specialised field of degree program development, subject teaching and research supervision.

Specifically, while students who choose to pursue formal endorsement in an area of psychology practice within Australia need to complete a specialist master’s degree as a compulsory ‘must have gold pass’ to formal recognition in that specialist field, psychologists with the very serious responsibility of training other psychologists through university degree programs, post graduate research projects and practice placements do not need a specialist master’s degree in education to be considered an expert in this field.

The reason post graduate training in education is not required of academic psychologists who write university programs, teach and supervise research projects & practice placements is because psychology academics learn how to teach on the job, through a situated learning approach.

The pathway to specialised practice as an academic in psychology within the university setting will often begin after the student psychologist completes their 4th year of psychology training whereby the novice academic will then take on a provisional practice approach to both teaching and research as a PhD student whereby they will pick up teaching some tutorials while doing their PhD and then move on to more responsibility in teaching and research supervision as their capabilities build while they continue learning through the situated learning approach on the job.

The situated learning approach in the teaching of academics is considered valid and reliable in the development of practice expertise in the crucial role of psychology teaching, degree program development, research and practice placement supervision.

The PhD as an example of a Situated Learning Model of Approach

To clarify further the quality of education within the +2-pathway, it’s important to understand that the highest degree anyone can obtain – a PhD – is based purely on the situated learning model of teaching and learning.

How do academics become expert researchers? Through being fully immersed in the practice environment of research via the situated learning process of the PhD project and being cognitively apprenticed by a principal supervisor through on the job training in research. That’s how a PhD works. Being fed knowledge in class room lectures is a very basic and limited form of education. Hence why the highest degree anyone can obtain from a University focuses more on a situated learning approach … because overall it is a higher form of learning that has a greater influence on the development of expertise. Ultimately the +2 path of the 4+2 applies the same learning model of approach as a PhD.

Equivalent Treatment Outcomes Across the +2 and Master’s Trained Psychologist Treating Under Medicare Better Access

Various forms of research over decades have done very little to support the simple notion of quality educational practice being most likely through a master’s degree program. Most specifically, those variables found to be most critical in the development of practice expertise can be applied through master’s programs and the +2 pathway equally.

Government Commissioned Research offers further clarity on the equivalence in treatment outcomes across all psychologists trained through different pathways. While the research was published in 2011 the findings have been met with some unusual resistance with the data being defined by some as ‘catnip‘ for those “professional groups who are sometimes more interested in protecting their members’ access to public funding of their work than they are in making an unbiased evaluation of what might be the best type of mental health system for the Australian community.”

Such criticism misses the important role outcome research has in assessing the quality of government health care initiatives.

The table below is an extract from the original research commissioned by the Australian Government (Pirkis, 2011; p. 734) and offers a very clear and comprehensive overview of the following:

  • Pre/post measures and mean group differences derived from the K-10 and the three (3) subscales of the DASS (i.e., Depression, Anxiety & Stress)
  • Comparisons across clinical, generalist and GP treatment groups, and
  • Comparisons between mild, moderate and severe pre-treatment client groups.

The 2011 research examined pre/post treatment measures using the K-10 and the three (3) subscales of the DASS (i.e. Depression, Anxiety & Stress). Results of the research showed a clear reduction in symptoms post treatment across all measures of the K-10 and DASS and across both groups of psychologists (i.e., both generalists and clinical).

It was noted in the pre/post scores of symptom reduction the ‘clinical’ and ‘generalist’ psychologist groups were equivalent in treatment outcomes across mild, moderate and severe cases while the GP group had a lower symptom reduction post treatment across all cases.

Ultimately the findings of this research showed that:

  • all groups (i.e., clinical psychologists, generalist psychologists and GP’s) showed symptom reduction (as measured by the K-10 & DASS) post treatment
  • The psychologist group combined (i.e., clinical and generalist) showed greater symptom reduction post treatment compared to the GP group
  • There was no difference in post treatment measures between the clinical and generalist groups of psychologists.

At the very least these findings offer further support to the notion that 4+2 trained psychologists hold their own in practice expertise.

CONCLUSION

The question needs to be asked… what drives the push of the compulsory master’s degree for specialist endorsement in psychology? And an additional sideline question… what has some academics compelled to use the derogatory term of ‘catnip’ to define the data from a very standard methodological research approach typically used by academics to determine, for Governments, the quality of treatment outcomes in health care initiatives?

Particularly when the 4+2 pathway is a high quality situated learning approach that is already effectively applied not only through the +2-pathway but also through its application in the training of academics (in their capacity to teach, research and develop psychology programs) and with the PhD student as a cognitive apprentice of research.

Ultimately the 4+2 pathway is a very legitimate and highly effective form of education that does develop practice expertise across all specialist fields of psychology and therefore should be upheld and promoted as such.

Processes should be established to ensure the 4+2 trained psychologist can gain specialist college membership and nationally endorsed registration in their specific area of practice. To do otherwise simply ignores the science of situated learning and the role such learning has in the development of expertise.

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Author:

Hi everyone! I'm a psychologist who is passionate about the broad contribution this field can make to society. Ultimately, psychology is about living life well; whether in personal relationships, friendships, work, politics, local communities, society more broadly or your own personal wellbeing. Psychology covers it all! As a psychologist I consult regularly through my private practice on the Gold Coast in Australia and also internationally via Skype.

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