The Importance of Seeing Fully Qualified Professionals

Please consider the following scenario:

You require open-heart surgery to fix something that could otherwise severely impact your quality of life or kill you prematurely.

I’m guessing that you would have a pretty similar hierarchy to most people of who you would try to book for the surgery:

1. The best heart surgeon in the world
2. The best heart surgeon in your area/state/country
3. A fully qualified heart surgeon with lots of experience doing the procedure you need
4. A registered heart surgeon with some experience doing the operation you need
5. A fully qualified surgeon with lots of successful heart operations
6. A fully trained surgeon with some successful heart operations
7. A supervised heart surgeon intern with some successful heart operations
8. A fully qualified surgeon who has performed successful surgeries
9. A registered medical doctor (such as your General Practitioner) with some surgical experience
10. A fully qualified nurse with some surgical experience

Notice that everyone else who is unqualified to perform surgeries is not on the list, regardless of how highly they think of themselves or how much they care about hearts or surgery. Suppose an unqualified person has some experience completing surgeries or comes highly recommended by someone. Even in that case, there is still no way I would risk myself or someone that I love going under the knife with them.

Now let’s compare this to if you have a mental health issue and want additional support:

Imagine that you are a top athlete and want to improve the mental side of your game.

What would your hierarchy look like for who you’d see to help improve your psychological health and overall performance?

For me, it would look like this:

1. The best Sports Psychologist in the world
2. One of the best Sports Psychologists in your area/state/country
3. A fully qualified Sports Psychologist
4. A recommended and fully qualified Psychiatrist with some experience successfully helping top athletes
5. A recommended and fully qualified Psychologist with some experience successfully helping top athletes
6. A fully supervised Sports Psychology intern with some experience helping top athletes
7. A fully qualified Psychiatrist
8. A fully qualified Psychologist
9. A fully qualified Psychiatric or Mental Health Nurse
10. A fully qualified Social Worker
11. Someone who has completed a Master’s Program in Counselling at an accredited university

Notice again that I do not put anyone on my list who is not a fully qualified and registered mental health professional, regardless of how much they love sports or mental health. Like surgery, I believe that if you are going to pay for mental health support, try to obtain it from fully qualified people.

A fully qualified Psychiatrist has studied at University for at least 12 years, including a complete medical degree and then a four-year residency in Psychiatry. A Psychologist has completed at least a Doctorate or a PhD in the USA. In Australia, they need to study mental health for at least six years before becoming a Psychologist. Both Psychiatrists and Psychologists must also be registered each year with a regulatory body, have professional indemnity insurance, continue to abide by their respective code of ethics and provide empirically supported treatment. They must also continue their professional development and keep a logbook of everything they have learned and the supervision they have sought.

As a Psychologist, if treatment is not effectively helping someone, you cannot continue treating them indefinitely. Because of our ethical code of practice, if someone is not getting any better, we need to refer them to another mental health professional who can hopefully help them more. We’re also not allowed to use testimonials or make unsubstantiated claims about how much we can help you. If these marketing strategies are not banned, someone can use them to persuade you unfairly.

A person working in the mental health field without any qualifications or protected titles does not have these limitations. They can practice unscientifically and unethically. They can continue charging you to see them regardless of the harm they are causing you. They can breach your confidentiality and tell others that they see you. They don’t have to get any professional supervision or do any continued professional development. They also don’t have to keep any notes or records of your sessions together or keep them in a secure and locked place for the next seven years. And they can make up fake testimonials saying how exceptional their services are and how much they help people just like you.

A Difficult Lesson to Learn

In 2017, the Adelaide Crows Football Club was one of the strongest teams in the AFL. They were hoping to win the club’s first premiership in 19 years. But, unfortunately, they lost to Richmond by 48 points in the Grand Final.

After their loss, the football department questioned the players’ mental fortitude. The department told them that they must improve the mental aspect of their game and build resilience to win it all in 2018.

Hoping to gain a mental edge over the rest of the league in preparation for the 2018 season, they decided to head off on an experimental preseason camp involving knives, blindfolds, army gear and the removal of personal phones for the duration of the four-day camp. Run by Collective Mind, a consultancy group of two people who are self-proclaimed Executive Coaches and Trainers.

Since this camp, things have only gone downhill for Adelaide. As of July 4th, 2020, head coach Don Pyke, head of football Brett Burton, senior assistant coach Scott Camporeale and eight of the best 22 players from 2017 left the club.

Eddie Betts left Adelaide to head back to Carlton in 2019 and said in February 2020, “that (camp) was one of the main reasons it was so hard to enjoy footy.”

Mitch McGovern was another player who left the crows. Furthermore, his manager said, “the reasons Mitch left the Crows was because of the camp and the Adelaide football department, and that’s it.”

After finishing minor premiers in 2017, Adelaide dropped to 12th in 2018. In 2019, they won fewer games but finished 11th. They then lost 13 games to start the season and finished last in 2020. This year they improved slightly again and finished 15th out of 18. Collective Minds do not blame themselves for this decline, even though they credit themselves for Adelaide’s first place at the end of the regular season in 2017. Perhaps this drop from first to last in three years was just a coincidence.

I first wrote this Facebook post back on June 26th 2018:

Dear Adelaide Crows,

If you want to get the mental edge over other AFL teams, why would you choose a company run by two individuals who do not even have an undergraduate degree in psychology?

There are 92 endorsed sport and exercise psychologists in Australia, 322 health psychologists, 513 organisational psychologists, 615 clinical neuropsychologists and over 8,000 clinical psychologists. Generally speaking, there are over 29,000 registered psychologists in Australia in 2018, and 1,469 psychologists in South Australia alone.

Psychologists… are held accountable by the Australian Health Practitioners Regulation Agency. Not all psychologists are amazing, but it is a nice way to monitor psychologists’ behaviours and ensure a certain level of quality control.

Let’s hope that other professional teams, sporting clubs, organisations, businesses and individuals learn from this experience and try to seek support from people that are adequately qualified in whatever services they are offering.”

More than three years later, I still think that hiring people without even a Bachelor’s degree in a mental health field can be pretty dangerous if you want them to improve the mental side of your game.

But Have we Learnt Our Lesson?

It sure doesn’t look like it.

I enjoyed reading ‘The Resilience Project: Finding Happiness through Gratitude, Empathy and Mindfulness’ by Hugh van Cuylenberg. My brother first read it and said he loved it and found it an emotional read. He recommended that I check it out.

The author was a great storyteller, and it was nice to see someone talk about the benefits of gratitude, empathy and mindfulness. Van Cuylenberg calls these three components GEM and says that they are the key to resilience and finding happiness.

I’ve never seen him run a presentation to a group before, but Hugh is a compelling public speaker. He is a qualified teacher who has previously worked in schools as a teacher and has a Master’s degree in education. Hugh has some skills in how to craft and portray an engaging message. 

His Resilience Project website says that he has worked with the Australian Cricket Team, Australian Netball Team, Australian Women’s Soccer and Rugby teams, National Rugby League, and ten Australian Football League teams. He highlights that he works closely with the Port Adelaide Football team and has worked individually with Steve Smith and Dustin Martin.

He is not working with these teams or individuals on how to best teach others. Or how to give effective presentations.

He is talking to them about improving their mental health or ‘resilience’. And he has zero mental health degrees, as far as I can see.

He has mentioned reading some of the work by Dr Martin Seligman on Positive Psychology and the benefits of GEM. But doing some personal reading on topics is not the same as passing examinations and observations year after year and meeting all of the requirements to be fully qualified and endorsed as a practising mental health specialist.

Remember, there are over 100 specialised sports psychiatrists and sports psychologists in Australia and 29,000 psychologists. They are all much more qualified to provide practical mental health support to these teams and athletes. Yet, these athletes and teams overlook this expertise and go with someone with no formal training in mental health. And they are not alone.

The resilience project claims that they have worked with 500 workplaces, 1000 schools, and over one million Australians. Yet, interestingly, none of the 14 Resilience Project employees indicates that they have an undergraduate or postgraduate degree in mental health.

The #1 player in the world

Ben Crowe calls himself the Director of Mojo Crowe and a Mindset Coach. He has a Bachelor of Arts degree majoring in Creative Writing and has studied sports management for three years. He convinced Ash Barty, the current #1 female tennis player globally, to be her mindset coach. She seems happy with their working relationship so far.

With his previous experience as a director of sports marketing at NIKE in the Asia Pacific, Ben is well experienced and suited to working with athletes as the co-founder of his company Unscriptd.com. He says that he helps athletes share and market themselves to the world.

If Barty were working with him in this regard, that would be entirely appropriate and possibly very helpful. Regarding her mental health or ‘mindset’, I don’t see how his education or qualifications relate to this. But he does say that he works with Dylan Alcott, Stephanie Gilmore, the Australian Cricket Team, Richmond Football Club, leaders at Macquarie Bank, and the World Health Organisation. So again, she’s not alone. These individuals and companies have enough money to hire the best professionals in an area. How do people think that the best person to teach about mindset is someone without mental health training?

Conclusion

There is a need for more mental health funding and education to increase access. 75–95% of people in lower to middle-income countries cannot access specialised mental health services.

Until we can have more qualified mental health specialists, there will be a role for life coaches, counsellors, and psychotherapists.

However, the public needs to be well informed about the differences between the education and regulations required to work in each profession. Twelve years of study after high school for Psychiatry. At least six years for Psychology. A personal coach, counsellor, or psychotherapist may have no formal mental health education or qualifications at all.

As ‘life coach’, ‘counsellor’ and ‘therapist’ are unprotected titles in Australia, you could open up your own business or practice tomorrow and start treating and managing mental health or ‘mindset’ or ‘resilience’ problems. You could also start working with some top athletes and teams if you are a great self-promoter and they are uninformed enough to hire you.

I know it seems like an extreme comparison, but would you allow yourself to be operated on by someone who wasn’t qualified or didn’t go through a long and formal education process to develop and maintain their skills? If not, why should your mental health treatment and support be taken any less seriously?

If there are no psychiatrists, psychologists, mental health nurses or social workers available in your area, see if you can access any of these individuals online. If you still can’t and need mental health support, unregulated professions like life coaches, therapists, or counsellors might help. I would make sure you know how long they have studied first and hope they practice ethically and scientifically.

Dr Damon Ashworth

Clinical Psychologist