It was quiet in the practice on Wednesday evening, some of my colleagues were away, and others were working behind closed doors. I finished my last session at 7 pm, closed my trusty laptop, picked up my raggedy pad with scrawled notes, untangled the cords to my old-fashioned earphones, and packed my bag. Took my favourite green teacup to the kitchen, said goodnight to Millie who was managing the reception desk and slid out the backdoor.
I left behind the psychologist’s chair, its contours will be warmed by someone else, but no longer by me.
Tears slid down my face as I drove the 10 minutes to my home. That was it, I’d retired. I’d finished my career as a psychologist. Who was I now?
I was only working two days a week but those last 20 sessions in the final fortnight were gruelling. Every session was a heartfelt goodbye. It was like putting unfinished books back on the shelf, but therapy is often like that. This time though I knew that the clients could not return. I would not witness chapters yet to be told or future chapters of their lives. I’d worked intensely with these wonderful people, some for many years and knew their hopes and dreams. I knew what held them back and I had to let them all go.
The tears that escaped only hinted at the turmoil within me. Grief, joy, fear, hope, regret, and relief whirled within me but were mostly contained during those last sessions. I hugged clients, shook hands, patted backs and, accepted gifts, letters and cards. “Goodbye, go well, take care” I whispered. I hoped I would bump into them in the street some time, but I have rarely seen clients outside the therapy room. Floundering for the final words, nothing I said felt enough.
I will miss the laughter
A friend asked what would I miss most when I stopped being a psychologist, and I surprised myself when I said “the laughter”. The laughter of therapy is like no other. We expect tears in therapy but not laughter and yet they come from the same deep well of emotions. I will miss those moments when a client suddenly laughs at what they are saying or thinking. It’s not a dismissive or condescending laugh, Nor is it an avoidant laugh. Rather it seems like a ray of sunshine, giggling with the delight of new knowledge. The joyful newness of discovering a new way of being.
How I will miss those clever, ironic and humorous comments made by clients when they suddenly understand a part of themself. I rarely laugh as deeply and with such compassion in my “real” life.
You’ll find me drinking Bloody Marys in my PJs
My son, daughter, and daughter-in-law celebrated my retirement by gifting me a bottle of vodka, Bloody Mary mix, lemon juice, a glass, and PJs. The Bloody Mary tradition was born while living in Papua New Guinea for eight years. I would board the plane to leave and order a Bloody Mary. It’s become our family marker of travel and transitions. Is this what they think I’ll be doing with the rest of my life?
Therapy is an act of love
While part of me still longs to do the therapeutic work I no longer want to sit inside a closed room for many hours of the day. I want to be free to create (perhaps to write another book), to enjoy the sun on my face. and perhaps to do nothing much at all.
I want to re-connect with the people I love but have not seen enough of.
For me, therapy has been an act of love. A love full of respect, safety, caring, boundaries, vulnerability, growth and hope. Therapy has often included raging against the injustices of the world. I will find ways to maintain both love and rage.
I have such gratitude for the wonderful, inspiring and insightful clients and colleagues with whom I have shared my therapeutic journey. Thank you.
I met June Stevens 35 years ago at the beginning of my journey to become a psychologist, and now I have four weeks until I retire. I was 30 years old, newly married, and had just moved from Sydney to Nowra on the South Coast of New South Wales. Nowra was the smallest community I had lived in and I felt uncomfortable with my newly discovered public visibility. People I met immediately placed me on the correct branch of the Moorhouse family tree – “Oh you’re Rhonda and Arthur’s youngest son’s wife! “Are you Owen or Arthurs’s new daughter-in-law?” “We heard Jenell had a new sister-in-law”.
I felt both welcomed and alienated by strangers deftly placing me in the family system. It was as if they knew something I wasn’t privy to. For the first time I understood why people dressed up to go to the supermarket as I would undoubtedly run into some matriarch of the community there. For a while, I felt unable to pop down to the shops in my favourite daggy t-shirt and shorts. I mourned my anonymity.
The move to Nowra was part of our plan to start a family. After we made the decision, I discovered that I was eligible to go to university – for free! As a teenager in New Zealand, I failed the equivalent of grade 12 and university was wiped as an option for me. In Sydney, I had just completed a Diploma in Personnel Management – 2 nights a week for 3 years through the TAFE system, while working full time. I was bursting with pride at this achievement.
Completing the course unexpectedly provided me with entry into university and 6 months off my degree. Even though I was a New Zealander I was still eligible for the free study, and I was even eligible for a student payment as I’d only gotten married that year. I would lose it the next year as a “wife”! The girl who failed school could go to university. So after we moved to Nowra I made the 160 km round train trip to Wollongong university, 3 times a week and began studying psychology. Thank you, Gough Whitlam
June, and the Lifeline Telephone Counselling course
I only knew my husband’s family in this small town and had limited time and opportunity to make friends. I was definitely lonely. I discovered the Lifeline Telephone Counselling course was offered in Nowra. The course lured me with the hope of real-world experience to accompany my academic studies and access to a community of like-minded people. I’m sure the confidentiality and secrecy surrounding being a Lifeline telephone counsellor was also part of the attraction.
June Stevens was the course facilitator. Even though she knew all the Moorhouses, I felt seen by June. It was June who taught me how to listen. It was June who introduced me to the unconditional positive regard of Carl Rogers. It was June who facilitated my unexpected self growth through the course. It was June who infused my heart with empathy and respect for others which I carried forward. My clients and I benefited from June’s work.
A bookend to my career as a psychologist
I left Nowra 30 years ago and have not seen June on my visits back. My parents-in-law see her regularly and I know I have been a topic of conversation. Last week, a month out from my retirement, my book Not Forgotten: they called me number 10 at Neerkol orphanagewas given to June, who is now 90 years old. The book is the culmination of my career as a psychologist and provides a wonderful bookend to my career. It gives me great pleasure to see the finale of my life as a psychologist held by June, who was present way back in the beginning. I hope she sees the ripple of her work through the pages.
An apology to Forgotten Australians was clearly needed
It’s been 12 years since 11 am on Monday, the 16th of November 2009, when Prime Minister Kevin Rudd apologised to the “Forgotten Australians” and to former child migrants.
As a Forgotten Australian, Samilya only has this one bedraggled photo of herself from her eight horrendous years at St Joseph’s Orphanage, Neerkol. Samilya had yearned for this apology and hoped that her life would be better once it was made. Surely the little girl in the photo deserved an apology, for all the abuse and neglect she had suffered.
The long term impact of a childhood spent in institutional care is complex and varied. However, a fundamental, ongoing issue is the lack of trust and security and lack of interpersonal and life skills that are acquired through a normal family upbringing, especially social and parenting skills. A lifelong inability to initiate and maintain stable, loving relationships was described by many care leavers who have undergone multiple relationships and failed marriages. Many cannot form trust in relationships and remain loners, never marrying or living an isolated existence.
The Senate Committee’s first recommendation was that a national apology be made to the children in institutional care who were its victims.
Sorry – that as children you were taken from your families and placed in institutions where so often you were abused.
Sorry – for the physical suffering, the emotional starvation and the cold absence of love, of tenderness, of care.
Sorry – for the tragedy, the absolute tragedy, of childhoods lost – childhoods spent instead in austere and authoritarian places, where names were replaced by numbers, spontaneous play by regimented routine, the joy of learning by the repetitive drudgery of menial work.
Sorry – for all these injustices to you, as children, who were placed in our care.
I hoped this apology would make a difference
Samilya hoped that this apology, unlike the two other formal apologies she had already received, would make a significant difference to her wellbeing. Samilya was clearly moved but the apology when she blogged the following in the lead up to the national apology:
Today is 4 November 2009. I have forgotten a day but today went well. I finally got out of bed after talking to myself and doing a workout before going to work. That is a choice. But 57 years ago the choices were taken away, and from many others, who were abandoned and put into orphanages. November 16 is sorry day for all of us. It was not about sorry or the money. It was and still is about the truth behind the disadvantaged kids, who are now adults and still misplaced.
A few days after the national apology Samilya wrote again:
Pain is cruel to live by. I lived with pain as a little girl from my abandoned past. Now I would like to die as it is lonely and I am in pain. No wonder the elderly don’t want to live, I have finally come to this point, body pain is horrible how does anyone want to live in a world without love and not knowing love from parents, or family. That was the hardest pain of all.
16th November 2009 was a great day it was the sorry day. It meant a lot as it all finally came out that we were telling the truth. Can anyone describe love and how to be loved by one self? How can you love yourself when you weren’t loved as a child?
I am still forgotten and misplaced
Not long after Prime Minister Kevin Rudd made the apology, Samilya’s view of it changed.
I am now living in the past since going to the third apology night at the state library and I couldn’t go to Kevin Rudd’s one yesterday, I watched it on youtube. It was very painful as I still can’t seem to understand, I have written and emailed before and have gotten no reply and this to me is very confusing, I have gone backward not forward, I missed my psychiatrist appointment due to this, not good. I have to wait now till I see my doctor. Having some kind of faith in any system is very hard for me and for my family to trust. It has affected my daughters in many ways and my sons, I also emailed the Sisters of Mercy about the Royal Commission and all they can say is that they hope this makes families understand, but what about making us understand and why wasn’t this done years ago? Unless you lived in the shoes of us you will never understand or be able to. I would like to add my name to the list for the Royal Commission as I wasn’t heard the last time. So much more needs to be said. I am the one who is still left in limbo and believes in hell and heaven and I will be struck by the devil if I am bad. I have emailed others in the government and no reply so I am still forgotten and misplaced.
Did “sorry” make 2021 better?
Many Forgotten Australians are still awaiting payments through the National Redress Scheme which was established after the Royal Commission into Institutional Sexual Abuse concluded in 2013. The Redress Scheme offers payments of up to $150,000 but the average payment is only $80,000 and the process is slow, arduous and for many who apply, re-triggering of their trauma. There has been no similar scheme for F0rgotten Australians who were not sexually abused, but who were violently abused and neglected.
Forgotten Australians have petitioned for a Health Care Card for medical and dental care for all Forgotten Australians. The card would provide ease of access to health care and government services similar to the Gold Card for Veterans. The petition seems to have lost impetus despite having almost 7,000 signatures and can be found here:
When I started talking with Samilya and playing with the idea of writing her story I envisaged a historical novel. My fantasy included crafting turbulently romantic scenes and bold acts of heroism. I soon realised that this was not the pathway for recounting the abuse and neglect that had been foisted on Samilya. I needed to place Samilya’s story in a historical context and provide a psychological overview of the impact of trauma on her life. The reality became hours of library and internet research and ploughing my way through tombs of government documents.
I had no idea how to write a novel and even less idea of how to write a biography. Yet still, I persisted. I needed to become a better writer.
I asked for feedback on my writing
I am blessed to be surrounded by a group of intelligent, educated, thoughtful readers in my life and so I reached out for help – I asked for feedback on my writing. Handing over my draft manuscript was terrifying. Here was my best – what if it wasn’t enough? I was tentatively stepping into the arena and asking for criticism. I could no longer see what needed work in the manuscript, I was drowning in it.
And so started a process where I would edit the manuscript, hand it to a carefully selected reviewer, listen to their feedback and make more changes – or not. Then I would repeat the process with the next reviewer. It was often hard to hear what my readers had to say. Sometimes it was excruciatingly painful. Always it was useful and they made me a better writer. The manuscript is far richer for their input.
I asked for a lot of feedback. By the time I finished 15 people had read and provided feedback on my writing – psychologists, social workers, academics, a well-known author, those with legal backgrounds, some who saw the bigger picture, some who were detail-focused, a few who loved me and one who didn’t know me.
During the feedback process, I became better at asking for what I needed my reviewers to look for. I learnt to listen without becoming defensive. I became adept at choosing which feedback was useful and which wasn’t. I was full of gratitude for the time and consideration they took to share their thoughts with me. I have since given feedback on another writers manuscript and it’s a tough job.
In 1954, two-year-old Samilya was abandoned by her migrant parents and placed in St Joseph’s Home, known as Neerkol Orphanage, outside of Rockhampton. After suffering years of insidious abuse at the hands of the Catholic nuns and priests, at age 10, Samilya is returned to her mother’s care where the trauma continued.
Not Forgotten: They called me Number 10 at Neerkol Orphanage, as told to Samilya’s friend, psychologist Anne Moorhouse, lays bare the lifelong effects of horrific childhood abuse and neglect. A psychological overview places Samilya’s trauma in developmental context, and explains Samilya’s mental health diagnosis, dissociative identity disorder.
Samilya is one of 500,000 so-called “Forgotten Australians” who were placed into childhood institutions from 1920–1970. Not Forgotten follows her marathon fight for elusive justice from the 1999 Forde Inquiry through to the 2013 Royal Commission into Institutional Responses to Child Sexual Abuse.
Each day Samilya fights to survive, to work, to have a home, to be a good partner and a loving mother. All Samilya has ever hoped for is an ordinary life.
Eight long, long years ago we started writingNot Forgotten: They called me Number 10 at Neerkol orphanage. Now I can reveal that Not Forgotten is the biography of Samilya Bjelic, who is referred to in past posts as Ms Forgotten Australian. We had to do this as there were current legal matters which meant we could not disclose her identity. We were silenced for two years. I swore and ranted against this suppression, yet the legal team assured me it was in Samilya’s best interest. For the first time, I felt my voice silenced by the Catholic church, for Samilya it was a repeat experience. Endured multiple times throughout her life.
Yet now here we are, free from legal constraints and tantalisingly close to having the book in our hands. This week, Covid-19 lockdowns permitting, Samilya and I will pick up our first copies.
So let me introduce you to Samilya Bjelic. She is an extraordinary woman who has endured more than most in her lifetime. She is a Forgotten Australian, volunteer, activist, mother, grandmother, friend. You will only really know and understand why she is my hero after you read Not Forgotten: They called me Number 10 at Neerkol Orphanage.
The end is tantalisingly near. I can almost feel the weight of the book in my hand and smell the print on the page. This eight-year journey of narrating Ms Forgotten Australian’s biography has been much longer than I expected. We’re not quite there yet and I feel so impatient! I’ve sat with frustration and a sense of injustice as we were delayed by legal matters. I’ve struggled to harness my patience while those who matter needed time to reflect on the impact the book would have on them. I’ve been exhausted and bored by the seemingly endless hours of work. Now, as we get much closer to having a book, alongside excitement I feel the bubbling cesspit of anxiety and fear.
Self-doubt makes an appearance
My mind wanders to thoughts like “What if people tell me the book is terrible?” “What if no one reads it” “Who am I to think I can write a book?” “What if my peers, or clients, think I’m an awful psychologist?” “What if there are mistakes I haven’t found?” “What if I’ve misrepresented Ms Forgotten Australian?” “Self-publishing is not the same as being a real author!”
We all experience self-doubt but I refuse to allow self-doubt to ruin this time for me. I was musing over how to manage these thoughts and feelings when a client mentioned the Man in the Arena quote by Theodore Rosevelt and a talk on the topic by Brene Brown.
The woman in the arena
It is not the critic who counts; not the woman who points out how the strong woman stumbles, or where the doer of deeds could have done them better. The credit belongs to the woman who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends herself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if she fails, at least fails while daring greatly, so that her place shall never be with those cold and timid souls who neither know victory nor defeat.
Theodore Roosevelt (of course he wrote it about a man… but I like it better about a woman)
Invite your critics into the arena
The quote resonated with me. I am about to step into the arena. I will be vulnerable and exposed as I present the best of me to the world in the form of a book. Why wouldn’t I feel some fear? There will always be critics in the audience, both real and imagined. Brene urges us to reserve a seat for the four critics who will undoubtedly turn up.
Shame – the universal feeling that we all experience. As a critic, it tells you you are not good enough.
Scarcity – This critic tells you that what you are doing is not original, that there are better educated, trained and articulate people than you. That what you are doing does not matter.
Comparison – it’s the death of joy. My comparison critic will undoubtedly tell me I should not even mention the name, Brene Brown alongside my own.
Yourself – the critical internal voice with its familiar messages, known only to you.
So come on in critics and take a seat up the front. You will not tell me anything I haven’t already thought of. You are so familiar. I will see you and I will hear you but I will continue. I am ready. I will dare greatly. I will step into the arena and if I falter, as I may…I can always watch Brene Brown again, pick myself up and continue.
“Did you push her?” has been the awful question frequently addressed to my husband, in my presence, after I broke my ankle 5 weeks ago. I fell down our stairs, he wasn’t home.
When I first heard people ask him “Did you push her?” I was shocked but assumed it was a one-off tasteless comment. Now I’ve heard it multiple times, from both genders. Often from strangers who know nothing about us, but sometimes from friends who should know better.
Even a health worker asked him “Did you push her?”
Yesterday I went for a blood test about an unrelated matter. The phlebotomist, a health worker, asked him “Did you push her?” She had just been alone in the room with me and certainly had not checked for domestic violence. That was the only time I’d been alone with a health worker, without my husband, who has been transporting and caring for me since my accident.
“Did you push her?” is not funny.
“Did you push her” is not a joke. I’m not laughing and neither is my husband. It minimises domestic violence and it’s silencing of victims. Imagine being a victim of domestic violence and someone jokingly asks the perpetrator (in your presence) if he pushed you. He’s certainly not going to admit it and she’s likely to be too fearful to say anything. The question itself may increase her danger by antagonising the perpetrator.
Don’t assume you can recognise a victim of domestic violence
Maybe you’re thinking they’re only asking my husband “Did you push her?” because its so obvious I am not a victim of domestic violence. That argument assumes a domestic violence victim can be identified at first glance by a stranger. None of my recent clients who had been attacked in their homes by their partners had a sign on their heads saying “victim of domestic violence”. They do not have downcast eyes. Their clothes aren’t torn and bedraggled. They do not have obvious bruises. They were all women – a busy, thoughtful mum of 4 children, a successful businesswoman and an older semi-retired woman (who looked a lot like me). All were in dangerous situations.
Don’t assume you can recognise a perpetrator of domestic violence
“Did you push her?” also assumes that a perpetrator can be identified easily. I have lost count of the times clients have told me that violent perpetrators in the home, were upstanding community citizens. You cannot recognise a perpetrator through a casual interaction.
“Did you push her?” belittles the high rate of domestic violence in Australia.
On average, one woman per week is killed by a current or former partner.
On average, one male per month is killed by a current or former partner.
Stop giving tacit approval for domestic violence
“Did you push her?” along with the nudge nudge, wink wink, that I’ve often seen accompanying the question, seems to carry with it tacit approval that it’s ok to push a woman down the stairs. Is this really 2021? Have we learnt nothing? The question disgusts and saddens me.
How you can help if you suspect an injury was caused by domestic violence?
First stop asking “Did you push her?”
Take the victim aside. Privately and quietly ask them what happened.
Wow, what a year! As a psychologist, the 2020 Covid-19 pandemic barrelled through my work, rest, and play, leaving me besieged with questions.
One week I was delivering face to face therapy, the next week I was huddled in my spare bedroom providing telehealth on the phone and through video for 8 weeks. Clients embraced the technology, and therapy continued much the same as it had before, or did it?
What happened to that space where clients travel to and from therapy?
The coming to and going from therapy is part of the reflective process. You make space and time for yourself, travel there, arrive, settle in, engage in therapy, and then travel away. What is the impact on the therapeutic process when you just move from the lounge to your bedroom, or when you continue doing chores or parenting while you talk?
How many times did I interrupt the process of therapy?
I would barge in asking “Can you still hear me”? Or ask clients to repeat themselves as I strained hearing only every fourth word on a video call because of that annoying delay. Those spaces of time where no one speaks have a multitude of meanings in therapy: “I don’t know what to say next”, “I’m overwhelmed”, “I’m angry or sad or tired”,” I’m reflecting and processing”, “It’s too much”, “Stop, “Go on”. The silences were much harder to navigate on the phone or even by video.
How many tears did I miss?
I learned that the glistening of teary eyes is impossible to see over the phone and difficult over video. How many times did I not pause to honour the tears? How many other emotions did I misinterpret or not notice?
How do I hold space for clients when I am navigating the same storm?
As therapists, we become adept at tracking and managing our own emotions during sessions so that the focus remains on the client. I’ve been aware of an increased need to do this as clients express their fears, grief and anger of living through a pandemic. I could so often say “me too”. I’m continually checking in and asking myself (and clients) “What do I need to do to care for myself today?”
What will work look like in the future?
Clients, friends and family have shared how they loathe or love working from home. Some feel released from the cacophony of noise, people and demands. Others are grieving the loss of human connection.
I cringe when I hear organisations stating how wonderfully productive working-from-home has been and how they will be implementing it for their employees in the future. I’ve heard too many stories of people overworking due to boredom during lockdown or fear of job losses. We are only at the beginning of this forced work-from-home pandemic experiment. What may have been expedient in the initial sprint of the pandemic may not be sustainable in what is turning out to be a marathon. How will friendships develop with reduced work socialisation? How do you build trust in a team when you are rarely in close contact? How many more lonely people will we have in Australia? Will employers make workplaces leaner and meaner and perhaps insist employees work predominantly from home as a cost-cutting move? How can we design better lives for ourselves as we come out of this pandemic?
About 30% of my work continues to be telehealth which is fantastic for clients who, for whatever reason, cannot come in for face-to-face sessions. I am grateful the intensity of delivering telehealth has eased for me and commiserate with colleagues delivering telehealth full time, even though I know some like it. After a day of telehealth, my body was stiff and ached with the increased concentration, my eyes were sore as if I was trying to use them to listen and I was emotionally spent. Do I need to upgrade my computer and earphones or source an ergonomic chair designed for telehealth? Would it make that much of a difference if I did?
How can we maintain the sanctuary of home?
I’ve vigilantly kept home separate from work, and I like it that way. During my work-from-home period, my haven was temporarily invaded, not just by my work but also by my noisy husband. After 35 years of marriage, I learnt my husband talks a lot at work, much more than I ever imagined! His voice echoed through the house until I banished him to a bedroom. What did others learn about their partners during this enforced episode of closeness? How did others maintain the sanctuary of the home, or was it not important to them? Is delineating between work and rest important? Are people now sleeping and being intimate in their workspaces?
Why didn’t I buy shares in home renovation and craft businesses?
Before we went into lockdown I encouraged my family to buy what they needed for those small home reno projects and to stock up on art and craft goods. I celebrated rooms painted, pots decorated, furniture made and first-time attempts at embroidery. I received the most beautiful hand made mothers day card. I feasted on new menus. I heard songs broadcast by those who had been too scared to perform. I learnt to crochet via youtube and created a Pandemic Christmas Wreath. Each year as I hang it I will remember 2020 as the year that was like no other.
As people experience the rhthym, creativity, passion, problem-solving, absorption and satisfaction that art and crafts bring will they be re-valued and retained in our post-pandemic world? Are art and craft the richest form of mindfulness?
How do I socialise?
For me, play is dominated by spending time with others, particularly those I love. I hold increased gratitude for those who live geographically close to me and to those who have continued to include me in the rhythm of their lives. Friends who meet me regularly for walks help provide a missing structure. I find it unexpectedly difficult to organise meeting up with others. It’s as if spontaneity has seeped out of me. How will I rekindle it? And what about the planners who love to see a full diary, how are they managing? What are people looking forward to? It’s as if I’m looking at the world through dirty glasses, something is not quite right yet I can’t wipe it away. How would others describe their experience?
Have communities changed?
My Tarragindi neighbours organised regular pandemic drinks in our cul de sac on Sunday afternoons. Initially, we social distanced, calling to each other from across the road. As the pandemic eased in Queensland we became closer.
On ANZAC Day my husband trumpeted The Last Post from our driveway, neighbours joining us from a distance, telling us it was the most moving ANZAC Day they’d attended.
I now know my neighbours far better than I did at the beginning of 2020. Will we continue with these new social traditions? Do communities feel closer now or more distant? Will the way we make and sustain relationships change?
When will I see my family and friends?
My arms ache to hug my daughter, brother, sister, parents-in-law, nephews, nieces and friends. No matter how many video calls we have my most pressing question remains “When will I see my daughter again?”.
Update: 2020. We have suffered through the Australian Bush Fires and now are in the midst of the Covid 19 pandemic. People have lost their jobs, their homes and their lives as they know it. There is an increased demand for bulk billed mental health services. After a week of providing bulk billed telehealth to clients it is clear, that despite our best intentions, the bulk billing rate is unsustainable. At this time telehealth can only be bulk billed. We are unable to charge a gap fee. Psychologists will be unable to pay their rent and put food on their table. It is devastating. We need an increase in the bulk billing rate. Please sign the petition Increase Access to Essential Psychology Services – End Two-Tier Medicare.
After a day working with vulnerable people, many of whom have been hurt at the hands of others, its no wonder that psychologists often have difficulty nodding off to sleep at night. Yet it’s not worrying about clients that keep many of us awake.
Midnight Worry No. 1 – Can I survive financially?
Psychologists, particularly if they are in private practice, worry about whether they can continue to make a living. We know that many vulnerable clients who require psychological treatment, often have difficulty paying for the service. You cannot sustain a psych0logy practice by bulk billing clients ($86.15 Medicare payment) and also pay rent, insurance, professional development, administration costs, superannuation, sick leave, and holiday leave. One restless night I calculated what my income would look like if I tried to bulk bill.
Bulk billing income $2,153.75 x 46 weeks (4 weeks holiday and 10 public holidays)$86.15 per hour x 25 hours = $2,153.75 per week
25 clinical hours is a full-time workload with time to do the myriad of other tasks including liaising with doctors, schools, and solicitors.
Superannuation As a predominantly female workforce let’s not join the growing ranks of women over the age of 55 who have no superannuation
Additional expenses – 20% of income Conservative estimate of small business operating expenses including admin support, accountants, legal advice, utilities etc.
I feel sick about this, but I have not calculated an allowance for sick leave. If you’re a bulk billing psychologist it’s unlikely you’ll be able to charge clients who don’t turn up. Most psychologists don’t have a full diary of 25 clients attending each and every week. Now I understand why psychologists need to charge at least twice the bulk-billing rate.
At the end of the year, the tension around the cost of psychological services is exacerbated as many clients have used up the 10 subsidised sessions provided by Medicare for a calendar year. All psychologists hate those days when clients ask us to reduce our fee, or even worse, provide a free session. It’s like choosing between providing the service to the client and paying your own bills.
How do you tell a mother, who’s recently left a DV relationship, that you won’t see her 13-year-old daughter who has started self-harming until January next year when Medicare kicks in again? Not much point in asking her RUOK if there is no alternative service to refer her to. That’s the stuff of our nightmares as I wrote in Dear Mental Health Client, please don’t be too unwell.
Midnight Worry No 2 – What to do about workplace discrimination?
Many psychologists know their employment choices have been unfairly reduced. Jobs for psychologists are sometimes advertised as only being available for those with clinical endorsements, without any rational reason. This unfairly disadvantages most psychologists (and clients), for no valid reason. Some of us toss and turn at night trying to make sense of an industry that eliminates highly qualified and experienced candidates from jobs. It’s hard to sleep when your enraged – Enraged psychologists fighting for an improved mental health system
Surely Australians that use government-funded mental health services have a right to expect that they will be seen by the most appropriately skilled psychologist available? There are 30,385 psychologists in Australia of which only 9,000 have a clinical endorsement. That’s a serious reduction in the pool of candidates.
Midnight Worry No 3 – Why is psychology a split profession?
Psychologists are anxiously waiting for the outcome of the Medicare Benefits Schedule Taskforce Review into Mental Health. If the recently released MBS Eating Disorders changes are indicative of what’s coming, the pay disparity between psychologists with clinical endorsement and those without will be magnified. A client who sees a psychologist without clinical endorsement will receive a Medicare rebate of $101.35 whereas a client who sees a psychologist with clinical endorsement will receive a rebate of $148.80. Both psychologists will be doing the same work. Holding a clinical endorsement does not mean the psychologist has a higher level of education, expertise or experience.
No wonder many of us can’t sleep when we find ourselves sitting next to another psychologist, equally experienced, educated, skilled and professional (and often our friend), yet for some unfathomable reason, they are being paid almost $50 per hour more, for providing exactly the same service. If psychologists who are not in private practice don’t think this affects them, watch what happens to even more job advertisements as this disparity continues and becomes embedded as the status quo.
Midnight Worry No 4 – Do psychologists really care?
There is an energetic Australian Psychologist’s Facebook Group, but we need thousands more members. Could our membership reach 20,000 and include most Australian psychologists? We need the power of numbers to allow the dissemination of information. This is a great use of social media. Do psychologists really care what’s happening in their profession? Do they care about how this disadvantages their clients? I’ve contemplated this before – Uniting Psychologists: Visionaries, Activists, Noisemakers… and Bystanders. In the midnight hours, I ponder whether psychologists are complacent, apathetic, overwhelmed or disbelieving, I haven’t yet come up with an answer.
The Australian Association of Psychologists Inc (AAPi) provides a viable and ethical alternative to the Australian Psychological Society (APS). The APS has to take responsibility for the mess the profession is in now. They have not been advocating for the majority of psychologists. AAPi needs the power of membership numbers to negotiate on our behalf, and on behalf of clients. Yet many psychologists remain members of the APS, which continually fails to represent them.
I recently bumped into a young ex-work colleague, she’s a psychologist establishing her practice. I explained what was happening and referred her to AAPi and the Australian Psychologists Facebook page, but sadly her response was that she didn’t want to be “political”. Similarly, another psychologist on maternity leave maintained her APS membership for fear of retribution, even though she was adamant that they’d done nothing to assist her career. It’s not a requirement that psychologists are members of any professional organisation but both these young women have the most to lose in the current situation, and would benefit from an organisation which represents them, and their clients.
Dreaming of a way forward
The way forward is for psychologists to actively engage in protecting and growing their profession. We must be proactive to ensure clients can access a diverse workforce of psychologists.
Join the Australian Association of Psychologists Inc – it’s only $250 per annum for a full-time psychologist and $100 if you’re part-time. If you are too fearful to leave the APS then at least be members of both! Follow them on Facebook, Linkedin and Twitter too. Students can join for free.
Join the Australian Psychologists Facebook Page– it’s a closed group and they’ll ask you some questions to check you’re not a robot, and that you are a psychologist. It’s an amazing community of psychologists.
Disseminate information. When you see an ad or article from AAPi share it on Linkedin, Twitter, and Facebook. Email information directly to psychologists who you know are out of the social media loop. Talk to your colleagues.
Unite. Share your concerns with your clinically endorsed colleagues. These may be difficult conversations but it may be the only way to dispel the myths surrounding the split and to unite the profession.
Sharethis article with every psychologist you know and ask them to share it with every psychologist they know. Share AAPi posts and information.