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:
- The best heart surgeon in the world
- The best heart surgeon in your area/state/country
- A fully qualified heart surgeon with lots of experience doing the procedure you need
- A registered heart surgeon with some experience doing the operation you need
- A fully qualified surgeon with lots of successful heart operations
- A fully trained surgeon with some successful heart operations
- A supervised heart surgeon intern with some successful heart operations
- A fully qualified surgeon who has performed successful surgeries
- A registered medical doctor (such as your General Practitioner) with some surgical experience
- 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:
- The best Sports Psychologist in the world
- One of the best Sports Psychologists in your area/state/country
- A fully qualified Sports Psychologist
- A recommended and fully qualified Psychiatrist with some experience successfully helping top athletes
- A recommended and fully qualified Psychologist with some experience successfully helping top athletes
- A fully supervised Sports Psychology intern with some experience helping top athletes
- A fully qualified Psychiatrist
- A fully qualified Psychologist
- A fully qualified Psychiatric or Mental Health Nurse
- A fully qualified Social Worker
- 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?
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
10 thoughts on “The Importance of Seeing Fully Qualified Professionals”
Interesting article. Nice analogy used. However, I think we are making assumptions that the more highly qualified (in terms of formal training) they are, the better the service they provide will be. I have found this to patently untrue in my own life experiences. My mother suffers from stage 4 colon cancer and I have had to deal with some very highly qualified but actually rather useless doctors who couldn’t be up front with my mother about the truth on her condition. They were not upfront about the truth and endorsed my family members in doing things that harmed her health. e.g needlessly delaying her operation when she was only at stage 2, and also endorsing her consumption of pumpkin and durian when the dietician had specifically recommended a low residue diet in the wake of repeated emergency hospitalizations due to intestinal blockage. She ended up getting hospitalized a few more times until I confronted the doctor in front of his while medical team.
I’ve also been misdiagnosed by highly qualified mental healthcare professionals and forced to take medication that had very harmful side effects and which dragged me down emotionally, mentally and spiritually and further traumatized me. These were all highly qualified doctors, very respected by their peers, but somehow they failed me and my mother abysmally.
Now, what are your thoughts on this?
Not every doctor or qualified mental health professional will be excellent. But it does help improve the quality of information that someone has and treatment that they can provide in comparison to someone with no formal qualifications or regulatory body that they need to be a part of.
But what if the regulatory and educational bodies themselves are full of the same wrong thinking and cultural norms that replicate the same kind of values and behavior?
Then seeking out alternative therapies sounds like another path in these circumstances. The more scientific support an intervention has, ideally with randomised controlled trials and meta-analyses backing up their hypotheses and findings, the more I would recommend it. But I do understand that there is bias even in Science. Based on how I have been educated, I still believe that there are ways to determine the quality of data that an idea has supporting it. But not everyone will think this way.
LikeLiked by 1 person
I’ve also been concerned about the proliferation of unregulated mental health service providers, and the line seems to have gotten blurred between what people expect mental health professionals to do and what they expect of unregulated providers. A specific evidence-based intervention may not work for a specific individual, but I’d still rather try an evidence-based intervention than one that’s popular but doesn’t have any scientific evidence to back it up.
LikeLiked by 1 person
Absolutely. And I worry that without any formal mental health training, someone will just try whatever they think is best rather than looking at what the science and evidence suggest.
Hope all is well with you.
My comment is on your article that we might have the qualifications but our skill set can vary on physical or mental aptitude.
It reminded me of a conversation with a highly regarded professor in gynaecology who demonstrated to me the manual skill of making a caesarean incision and how some of the students didn’t have the sense of finesse.
And of course this also applies to trades or other skills.
I have seen people in your profession before and one of them was beyond the pale ( details withheld)
You are the first one that really had impact on my outlooks and stimulated a positive outcome.
LikeLiked by 1 person
Thanks for the comment, Jim.
Yes, I agree that there is more to it than just qualifications. Someone can be fully qualified, but it doesn’t mean that they will be the best at helping someone with what they need. Or that they have the ideal skill set or aptitude.
Some fully qualified people may even cause harm or damage. But at least there are pathways that people can take to complain about the professional, and have their ability to practice cancelled or suspended if it is needed.
Conversely, I’m sure that there are people out there with no qualifications in the mental health space that are also making really positive changes in some of the people that they see. But if they are not, there are fewer options for redress. They can also make many claims and market in ways that professionals, especially psychologists, are not ethically allowed to. Which may lead to them looking like better options even if they are not.
I think it’s great that so many people want to help people to improve their mental health. I just worry about the potential dangers that it can have on the people who need this support if the person is not trained or guided by a specific set of ethics.
I hope that all is well with you too
Thank you for this post. I think you are right. Qualifications do matter in terms of how reliable a person is in the field. I gave up my wellbeing meditation project. Will go to do something else ☺️
LikeLiked by 1 person