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Working in clincal psychology

By Cindy Wall

As a keen sportsperson in my early teens I was fortunate to have contact with a sports psychologist and thought that it seemed like a cool job. I enjoyed science in high school and initially considered a human movement degree with the aim of becoming a sports psychologist but instead entered the workforce following Year 12. It was not long though before I crossed paths with an industrial psychologist and was once again drawn to the field.

For as long as I can recall, one thing that has remained constant in my thinking is a basic curiosity of why people do what they do. This was very much the case during my undergraduate years where ‘abnormal psychology', ‘psychopathology' and ‘personality' were a source of fascination for me. Not being able to let go of the sports side of things, ‘health psychology' and ‘motivation' also held intrinsic appeal.

It seemed to be a logical decision to apply for a combined Clinical and Health Masters and it has proved vastly satisfying. My Masters dissertation explored exercise and motivation, and my current PhD research is looking at the influence of personality on rehabilitation, so those early themes remain strong. (Editor's note: Cindy completed her PhD in 2010.)

I have worked in non-government organisations (as a family therapist, and relationship counsellor), for state government organisations (as a psychologist/community care worker and as a research assistant) and at federal government level (as a psychologist/rehabilitation consultant).

At one acute in-patient facility I saw clients with schizophrenia, bipolar disorder and other DSM-IV diagnoses. I had to recognise when clients' symptoms became elevated, and liaised closely with the psychiatric registrar in the treatment approach that was adopted.

Presently I am working in the private sector as a clinical and health psychologist for a vocational rehabilitation and injury management consultancy in Darwin, NT. I have a case mix of individual clinical clients, referred from GPs or insurers, and my day normally begins with the review of scheduled appointments. I hold individual therapy or assessment sessions, usually with a cognitive behaviour therapy (CBT) approach, and on certain days I am likely to facilitate a two-hour CBT group session with eight to ten participants, covering depression, anxiety, social phobia, pain or panic. As well as assessing and treating the high-prevalence mood and affective disorders, much of this work involves awareness of Axis II issues that negatively impact on an individual's capacity to effectively manage their present circumstances.

I was involved in stage two of a ‘Better Outcomes in Mental Health' pilot program. This was very exciting and involved service delivery as well as program evaluation - I reviewed and allocated the GP referrals for the Better Outcomes group programs. One valuable component was the process of partnership building with allied health professionals and GPs. I am also involved in a multidisciplinary pain management program that is achieving noticeable change in individuals grappling with persistent pain.

Other daily tasks might include a team planning meeting for our pain management program - for which I deliver the psychology sessions - report writing, and data collection and analysis.

These current projects provide great ways of applying the scientist/practitioner model and, when coupled with the approach involving strong patient collaboration, the theory starts to have ‘real world' results. This is very rewarding as well as being a strong motivator for continual professional development.

Although my area of interest is the domain of such intellectual giants as Beck, Freeman, Livesley, Prochaska and DiClemente - it is the words of past lecturers and supervisors that have been just as influential on my current practice.

Psychologists in this field face the challenge of selling ourselves effectively as the profession best qualified to deal with the issues covered in our training. Students of psychology should respect the profession by constantly striving to achieve a combination of technical competence and human artistry. It is important that psychologists reduce professional fears and jealousies so that we can continue to build effective partnerships with peers and other disciplines. This will allow consumers to view us as relevant, competent and collaborative.