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Why APHRA Is More Dangerous Than A Homicidal Client
On Friday 8th April 2016, the Health Professionals Australia Reform Association (HPARA) held its first conference at which they invited me as a keynote speaker. Herein follows the essence of my presentation, with slides below.
HPARA is dedicated to getting the government to initiate a Royal Commission into AHPRA's complaints process and how it is abused to target good, competent health practitioners by rivals who have opposing commercial or personal interests.
We heard harrowing stories of the grave harm inflicted on patient care as a result of AHPRA's ineffective complaints process, which is especially concerning, given their mandate to "protect the public." We heard how constant harassment by AHPRA has led to many suicides, financial and career ruination and PTSD of our best doctors and nurses.
If you are a health professional, or a consumer who doesn't want to risk being harmed by the sub-par medical system because great practitioners have been drummed out of town by their less competent rivals, please apply to join HPARA. The cost is only $25 per year and we urgently need as much support as we can get!
To join, click here.
Who Am I?
My name is Dr Sophie Henshaw and I am one of 32,766 registered psychologists in Australia (roughly equivalent to the number of registered GPs). I graduated as a Doctor of Psychology from Murdoch University in 2000 after 7 years’ full time study.
I am currently registered as a Clinical Psychologist. I have been a registered psychologist since 1999. I run a busy, full time private practice in the suburb of Munster in Perth, WA.
I treat adult clients who suffer from anxiety and depression, usually originating from difficult relationships at home or at work. I'm an expert in workplace bullying related issues. I have never had an official complaint from a client - ever. Some words to describe me are:
AHPRA: Fear-Mongering Tactics From The Top
As psychologists, we receive threats, threats and more threats from the Chair of the Psychology Board of Australia (PsyBA), a branch of AHPRA (Australian Health Practitioners Regulation Agency).
Our Chair believes that “psychologists are dangerous” because Scientology was closed down in the 1960s and because patients died as a result of the psychiatric deep sleep therapy in the 1970s.
His reasoning doesn’t quite make sense to me. See his public statement on the matter at: http://bit.ly/psychs-are-dangerous
The ironically-named “Connections” newsletter from the PsyBA contains a threat in each issue and here are some examples:
“Psychologists who abandon evidence-based interventions and use discredited treatments, or interventions that have no reputable evidence, put the public at risk of harm. …If practices are not represented in mainstream psychology textbooks and the associated specialist scientific literature, then a registration board will be concerned and may take action.” (Nov 2012).
So, we are not allowed to provide any therapies that haven't been written up in text books. Might that be undergraduate textbooks, by any chance? Or any old books? Are some allowed, while others are prohibited? Talk about threats to innovation! New therapies are being developed all the time and research has demonstrated the equivalence of therapeutic modalities.
The evidence for evidence-based therapies is an invention by the profession of psychology to obtain legitimacy (read: status) for psychology-as-science and funding from governments or insurance companies for CBT (Cognitive Behaviour Therapy). Newer evidence now shows that outcome-based therapy provides better data than evidence-based therapy to demonstrate the efficacy of psychotherapy.
In fact, Duncan, Miller, Wampold and Hubbard (2010) call the equivalence of effectiveness among psychotherapies the "Dodo verdict" after Lewis Carroll's "Alice In Wonderland," where the Dodo says: "Everybody has won and all must have prizes." They argue that if three factors of change are strongly met then even something such as religious healing can be as effective as a psychological therapy model. For more details about this fascinating topic, read my article entitled: Is CBT The Golden Standard For Psychological Therapy? It's Time To Stop Pretending And Get Real.
“There are penalties that can be applied to people who mislead the public to believe they are a psychologist when they are not registered, with fines of up to $30,000” (April 2014)
Additionally, when you receive a notification of complaint, attached to the letter are the following threats:
- Investigators Have Power to obtain information
- If you Fail to produce information or attend a meeting with an investigator
- Give False or misleading information or documents
- Obstruct investigators
- $5,000 fine for individual or $10,000 for a body corporate
“You have a mandatory obligation to report… Do not delay in acting on these beliefs…. Not making a complaint [about an inappropriate relationship between a colleague and a client] leaves you open to a finding of misconduct.” (Sept 2015).
On rare occasions, it may be necessary to report a colleague for boundary violations with a client. However, this "mandatory reporting" has huge scope to be abused by malfeasant practitioners with professional or personal vendettas against colleagues! Interesting how there's no mention of the potential for vexatious complaints or the damage they inflict here...
* Humiliation by peers:
“’Skeleton notes', which only record the date and that a session occurred, are likely to be severely criticised by peers as not giving a satisfactory account of the service. 'Process notes' that reveal deeply intimate but irrelevant information about a clients’ personal circumstances are also likely to be severely criticised for potentially harming the client by breaching their confidentiality, privacy and dignity.” (Nov 2015)
Damned if you do, and damned if you don't then? Way to go to make us all more hypervigilant and paranoid about note-taking, given that AHPRA are on a perpetual fault-finding mission (as demonstrated by AHPRA's nit-picking approach of my website, as per the 1st May notification in the complaint timeline below).
- AHPRA fees are due on 30th November.
- The reminders start on 29th September
- You get four reminders
- You get threatened with fines for not paying on time
This bullying attitude sets up a relationship based on FEAR and LACK OF TRUST
Anatomy Of A Complaint
In 2015, I was attacked by a Facebook bully who took exception to my anti Tony Abbott political stance on comments to posts. I had never actually met this person and had no contact with her until she targeted me.
This person has a reputation as a “troll” who has impugned the reputation of a number of small businesses, as you can see here:
As an aside, you will notice that nearly all these reviews have a one-star rating, except the Eagles Nest Bar and Grill, which has five stars.
How come they did so well? This establishment is located in the wilds of Queensland and therefore it's very unlikely this reviewer from Western Australia had ever been there. However, this eatery achieved media notoriety in December 2014 for having a sign outside its premises declaring "sorry, no Muslims" (and we have already established this reviewer's extreme right-wing views). Read more about it here.
She took her “trolling” one step further and used the AHPRA complaints process to attempt to destroy my reputation and career. I have written a full account of this harrowing six-month long experience. If you wish to read it, please contact me using this form:
In the meantime, here is the timeline of the 2015 complaint:
A Facebook troll attacks (I ask her to take down her comment, no response. Facebook says naaaah.)
Facebook bully puts in a complaint to AHPRA.
I get a call from AHPRA (10am), then receive an email notification about my conduct (2pm). I’m given 36 hours to respond to accusations of making an inappropriate comment on Facebook relevant to my fitness to practice as a psychologist as well as practicing outside my scope of competence in a therapy workshop which I purportedly fraudulently offered Medicare rebates for.
I work all day to produce a letter with three appendices, including 6 letters of endorsement from participants and assistant teachers.
(8am)- Deadline for my written response to be submitted to AHPRA.
My response is considered inadequate to demonstrate a vexatious complaint and I receive a notification of investigation. I invoke my professional indemnity insurance and I lawyer-up.
Deadline to respond to the notification. My lawyers do a great job of reiterating everything I already told AHPRA but couched in proper Legalese, with just the merest hint of a threat of legal action.
Second complaint from AHPRA, this time regarding “false, misleading or deceptive advertising” on my website. The phrases they object to indicate their desperation to find something that will stick.
As an example, they pick on my statement: “You will need to bring a MHCP (Mental Health Care Plan) referral from your GP who will give you an initial 6 sessions, after which you need a re-referral from your GP for a total of 10 sessions” because it “may be misleading because it could be read as suggesting that a patient will require 10 sessions, when the purpose of a re-referral is for an assessment of whether a patient requires further sessions. Entitlement to 10 sessions does not as a corollary mean a patient will require all 10 sessions.”
So, with guidance from my lawyer I write: “You will need to bring a MHCP referral from your GP who will give you an initial 6 sessions, after which you need a re-referral from your GP if you require a further four sessions, which you may not. It will be up to the discretion of your referring GP to decide how many sessions you will require.”
Spot the difference? This semantic nit-picking now makes the public A LOT safer from me, the dangerous psychologist, and yes, this is public money well spent (yes, I am being sarcastic here).
Taking it one step further than semantics, the following is also true:
1) I only have 12+ years training in mental health, so I’m not competent enough to decide whether my client needs more than six sessions. No, I need a GP who has had six weeks of training in mental health (if s/he's lucky) to do that for me (no disrespect to GPs who are relegated to the unenviable task of gatekeepers and bureaucrats of the Medicare system ... as if they didn't have enough paperwork to do already)
2) The literature clearly shows that an optimal treatment time for mood or anxiety disorders is 18 sessions.
Having a lawyer works and AHPRA back down. They write to me to say: “The board recognises that being the subject of a notification can be stressful. Thank you for your cooperation. This matter has now been closed.”
Why APHRA Is More Dangerous Than A Homicidal Client:
1. I’ve had stand-over tactics from raging male clients and threats to kill my dog
2. I set and reinforce boundaries (from session #1 onwards)
3. I stay calm
4. I validate their feelings and diffuse their rage
5. I give them options
6. I apply consequences
7. I write a follow up letter to the client, reiterating the boundaries I set in their final session
8. I write a letter to their referring GP
9. I have no further contact
1. Early threats set the tone
2. Guidelines are ambiguous and irrational
3. AHPRA “Not allowed” to advise on how to comply
4. Guilty until proven innocent
5. Protect the public, demonise the practitioners
6. Operate under a shroud of secrecy
7. Collude with bullies who have a professional or personal agenda
8. No penalties for vexatious complainants
9. Destroy careers with impunity
Some Important Questions
=> Has our money been well spent?
=> Has the public now been satisfactorily protected from me, a dangerous psychologist?
=> Who are these people? Background? Recent graduates?
=> What qualifies them to investigate and tear down health professionals?
=> What are their Key Performance Indicators (KPIs)?
=> What rewards are linked to the KPIs?
=> How about some empathy training?
1. A code of conduct that:
Recognises the rights of both the public and the health practitioners equally
Recognises the impact of vexatious complaints on health professionals
Penalises malicious and vexatious complainants (fines)
2. Investigation into how the complaints process is used as a bullying tactic
3. Set up independent body (really independent) to audit the auditors