Dear Dick
articles about wide ranging psychological issues
from "The Local Bulletin" (Brisbane Australia)
by Dick Rigby
©all articles are copyright 2006

September 1999
About a month ago, I took my son to see a psychologist because he was having trouble coping at school.  The psychologist was able to help my son and we were pleased with the outcome.  However, I was surprised that the psychologist’s fees were so high.  Why do psychologists charge so much for their service?
Sam P
Dear Sam
In general, psychologists fees are in line with other professionals in the community who have done an equivalent amount of academic and post academic training.  In Queensland, the law stipulates that the title “Psychologist” can only be used by someone who is registered by The Psychologist Board of Queensland (or an equivalent interstate board).  In order to be registered by The Psychologist Board, a psychologist has to complete a four year university course and then complete a further two years of supervised post graduate training .   
On the other hand, anybody can call themselves a “counsellor” or a “psychotherapist”.  That title is not regulated by legislation.  A counsellor does not have to have any formal qualifications in Queensland. However, most counsellors that I know have done some formal training, and some are well qualified.  The fees charged by psychologists, reflect the level of training that psychologists have undergone.
It is a sore point with most psychologists, that psychiatrists (being doctors of medicine) are eligible to be part of the Commonwealth Government’s Medicare scheme.  This means that a psychiatric patient can have most, or all of their fee paid by Medicare.  However,  psychologist are not eligible for Medicare.  Most psychologists charge much less than psychiatrists, but it seems that they charge more because the government picks up the tab for the psychiatrists.
People who are covered by private medical insurance top cover are eligible to some rebate for psychological services.
I often say to my clients that good therapy is an investment in the future.  I know of so many cases where effective psychological intervention has saved a lot of money and heartache.  This is particularly true for marriage and couples counselling.

You’d have to be crazy

November 2001
My son has just turned 18.  He is having some difficulties at university and with his girl friend.  I have suggested that he see a psychologist to help.  I have even offered to pay.  He keeps saying to me that he is not crazy and he doesn’t have to see anyone.  What should I say to him?
Mrs. H
Dear Mrs. H
Many people, like your son, fear going to a psychologist.  Some fear that they will be found out to be crazy.  Others think that you have to be crazy to see a psychologist.  The truth is that most people who see psychologists do so just to get their life sorted out.  Some would call this “personal growth”.
You can reassure your son that psychologists see all sorts of people for all sorts of reasons.  Only a few of these people have any sort of clinical mental disorder.  A psychologist would help your son by encouraging him to start talking about the issues that are worrying him.  The psychologist would listen in a non judgemental way and look for ways of giving him support and encouragement.
The aim of this therapy would be to help your son feel better about himself.  When a person has low self esteem, they can often feel stuck and depressed.  In that state of mind, they find it very hard to find creative solutions to their problems.  They also find it very hard to put things in perspective.
A psychologist can help your son to stand back from his problems and look at things more objectively.  Your son may be having difficulties in his girl friend because of difficulties with communication.  Talking about different ways of communicating can be very helpful.  Sometimes it is useful to role play different ways of communication to find out which one is likely to work the best.
If your son is shy, there are many ways of learning how to be more self confident.  A psychologist would help him to listen more carefully to what he is saying to himself in social situations.  He can learn to change this self talk into being more supportive.
Sometimes young people will see is “woosey” to take personal problems to a psychologist.  They believe that they should be able to sort everything out for themselves.  My message is that you take a sports injury to a physiotherapist, an illness to a doctor and you take “feeling stuck and down” to a psychologist.
Good luck with your son.

Medicare for psychology

March 2008
In October 2006 the new federal Mental Health Care Plan came into effect.  Now, anyone who wishes to receive treatment from a registered psychologist (registered by the State psychologists Board) can claim a rebate from Medicare.  However, conditions apply!
It is a really good scheme allowing ordinary people to afford psychological treatment.  The present Federal Government is committed to keeping the service going.
One condition that applies is that a client must be referred by a GP, psychiatrist or peadiatrician.  The referring doctor would be required to do an assessment completing a “2710” online government form.  Any of the following conditions would be eligible for the rebate; Psychotic disorders, Schizophrenia, Bipolar disorder, Phobic disorders, Anxiety disorder, Adjustment disorder, Depression, Sexual disorders, Conduct disorders, Bereavement disorders, Post-traumatic stress disorder, Eating disorders, Panic disorder, Alcohol use disorders, Drug use disorders, Sleep problems, Attention deficit disorder, Obsessive Compulsive Disorder, Co-occurring anxiety and depression.
Quite an impressive list.  Most of the clients referred to me are suffering from depression and/or anxiety.  If you have a 2710 assessment in hand and trot along to your psychologist you will be eligible for six treatment sessions.  If at the end of six sessions, you require further treatment, your doctor can authorizes a further six sessions. 
You are entitled to 12 sessions in a calendar year.  (There are exceptional circumstances wither another six sessions can be authorized.)  The system renews itself on the 1st January each year.  Unused sessions from the previous year can be carried into the new year.
Medicare will rebate $75.00 for each session for the treatment “item 80110”.  A limited number of psychologist have been given authority to use a different item number and this attracts a higher rebate.  Unfortunately the authority for registering for this rebate has been placed in the exclusive hands of the Australian Psychological Society (APS).
The APS is a very narrow, academic and exclusive society.  They have eliminated many fully qualified clinical psychologists (such as myself) from this eligibility for the higher rebate.  I know of many Clinical Psychologist with over 20 years of clinical training and experience that the APS have found ineligible.   Strange behaviour indeed.  I hope that the government reviews this anomaly soon.
The good news is that the Mental Health Care scheme has been very popular and has shown us the huge community demand for psychological services.  Many of the private health insurance plans also give a reasonable rebate.  However, you cannot claim both rebates for the one session.
Take advantage of the scheme and get the help that you need when you need it.