News from the Psychology Council of NSW No images? Click here September 2023 NewsletterMessage from the PresidentThe Psychology Council has had a busy time over the last few years with complaints increasing each year and adapting to the impact of COVID-19 on the profession. We are pleased to issue our Spring 2023 newsletter which covers some common issues that can significantly impact practitioners. The topics we choose for our newsletters are issues that arise through complaints and that we think will be beneficial reminders for all practitioners. The topics chosen for this newsletter include a clinical records update and a discussion of what it means to practise psychology. We urge all practitioners to read the articles. We would also be happy to receive any suggestions of topics that practitioners would like us to cover in future newsletters. Gail Purkis - President Aboriginal Cultural Safety StrategyOn 7 June, the Councils and the HPCA launched their joint Aboriginal Cultural Safety Strategy 2023 – 2024. Attendees heard from several guest speakers including Ms Deb Willcox AM, NSW Health Deputy Secretary, Health System Strategy and Patient Experience. You can read more about the launch here. The Strategy aims to improve the experiences of Aboriginal people who interact with the NSW healthcare and regulatory system through:
The Strategy was developed by the Councils and HPCA Aboriginal Cultural Safety Working Group. The group is comprised of members of the Councils, community members, and representatives from the Ministry of Health's Centre for Aboriginal Health. The Group comprises 50% Aboriginal membership and the Strategy is informed by their generously shared expertise, lived experience and knowledge. Clinical records updateIn the June 2019 NSW Psychology Council Newsletter, Simon Milton, the Council’s Professional Officer, wrote an item titled Client records – why they matter. This article covered what a client file should include, what an initial client record following an assessment should include, and what each subsequent substantive contact with a client should include. When reviewing psychologist’s clinical files in the context of examining a complaint made against them we continue to find that files often do not meet the expected standard. The APS Code of Ethics (was adopted by the Psychology Board of Australia as its Code) is accompanied by ethical guidelines including Ethical guidelines on record keeping. As noted in the summary of the guidelines: “Psychologists ensure that their client records include notes which accurately reflect their professional practice, were created at the time of client contact, or immediately following contact, and give clear reasons for any interventions and decisions taken at that time. They ensure that the notes reflect client respect and dignity, and meet psychologists’ responsibilities for maintaining client confidentiality. Psychologists are aware that their record management systems incorporate all paper files, notes and documents as well as electronic records.” Client records should include in full or via reference each and very text message, email and letter between the client and any other communication between the psychologist and other health professionals, treating agencies, referrers, family members, etc., consistent with the Ethical guidelines for providing psychological services and products using the internet and telecommunications technologies – “8.1 Psychologists keep records of email, online, text messaging, telephone and other work using internet and telecommunication technologies as they do for face-to-face psychological work”. Increasingly psychologists are using electronic booking and electronic medical record systems. Thought needs to be given to who can access these systems including privacy considerations related to this. If working for a NSW government department this is governed by the NSW Privacy and Personal Information Protection Act 1998 If working in any other setting this is governed by the Commonwealth Privacy Act 1988 Depending on work setting the APS Position Statement Record Keeping in Organisations (December 2020) offers helpful guidance including on ‘critical principles for safeguarding client information in e-records’. When considering what electronic record keeping system to use the paramount importance is client confidentiality. It is also important to consider using software that allows you to enter the date on which the service occurred, that ‘date stamps’ when the record was written and that cannot be altered at a later date. This provides you with appropriate protection if you need to rely on your notes at some future date. As a psychologist you are required to keep all records related to client care for a minimum of seven years after you complete your final activity related to that client. In the case of seeing people under the age of 18, and where you cease their care before they turn 18, you are required to keep all material related to the person’s care until at least their 25th birthday. While there is no legislated requirement to keep materials beyond these times it can often be helpful to do so. Where you use electronic medical records it is your responsibility to ensure that the storage of the records is consistent with the time scales described above. If you change electronic medical record software systems it is important that your old records continue to remain available to you. This could, for instance, be done by downloading all your records and/or migrating your records to your new software. Where hybrid paper and electronic files are used it is important that the paper component only contains documentation such as letters received, test proforma’s, etc. All clinical notes should be written in the electronic file. It is permissible to scan all paper documents into the electronic system and subsequently destroy the originals. The scanned copies need to be of a high standard. “Psychologists establish whether the electronic storage systems they use, such as cloud storage systems, are compliant with Australian law.” (Ethical guidelines on record keeping). The use of artificial intelligence in psychology is in its infancy. If you do make use of AI it is important to note its use in your client files and to attribute any materials created to the source. The profession has for a number of years made of use of various report writers, e.g., for the WAIS and the PAI. It is important when writing reports where material is quoted from these computer-generated reports to attribute source. It is unprofessional and plagiarism to not do so. It is also important when using such systems, including AI, to only use this material as part of your professional decision-making. For example, the PAI report writing software states on the first page “The interpretive information contained in this report should be viewed as only one source of hypotheses about the individual being evaluated. No decisions should be based solely on the information contained in this report. This material should be integrated with all other sources of information in reaching professional decisions about this individual.” This is very sage advice when utilising any form of computerised aid. Psychologists whose records are consistent with above advice should be both in a position to rely on their notes if a complaint is made against them and to not have their notes become a further matter of concern in considering a complaint outcome. Professor Christopher Willcox Deputy President What is practice?Complaints referred to the Psychology Council of NSW can often include activities that the registered psychologist believes are not part of their psychology practice. This may include splitting up their week into conducting their psychology practice and at another time and/or setting conducting non-evidence based activities, sometimes being paid and sometimes not, sometimes calling themselves a psychologist and sometimes not. These non-evidence based activities may include those that are outside the main psychology professional literature that when provided by a psychologist would be considered credible and safe as a result by the general public. So, it would be beneficial if all practitioners were aware of the following. The Council’s position is that if a registered psychologist practises psychology, their behaviour will be assessed against the Health Practitioner Regulation National Law (NSW) and the registration standards and codes established by said Law. Therefore, a registered psychologist cannot use as a defence against any allegation of a breach of the National Law that that said Law does not apply if they do not refer to themselves as a psychologist while practising. Health Practitioner Regulation National Law (NSW) No 86a of 2009 (Section 132) The Psychology Board of Australia defines practice as follows: Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a registered psychologist in the profession. Practice in this context is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on the safe, effective delivery of services in the profession. Psychology Board of Australia - guidelines and policies Put in simple terms a registered psychologist cannot turn their skills and knowledge as a psychologist on and off depending on the activity they are engaged in. Rather than give specific examples which would be very extensive and may not capture all possibilities, the following is suggested. If in doubt as to whether you should be engaging in an activity outside your practice where you are using your skills and knowledge as a psychologist, you would be advised to confer with a senior colleague in the profession or your supervisor. It may also be useful to discuss with the provider of your professional indemnity insurance and/or professional body if you are a member. Gail Purkis President |