Different kinds of shrinks and quacks
By Sarah Walsh
I really wish the term “shrink” would catch on in Australia. I love it.
It feels less intimidating than psychologist or psychiatrist. Shrink is playful, a little cheeky, and hints at productivity too. I hope that my work assists in shrinking challenges, shrinking distress, shrinking what feels too overwhelming.
Or perhaps I have just been watching too much of the new season of "Shrinking". Thank you Jason Segel for showing us what not to do.
Despite how unintimidating and nerdy psychologists may feel as individuals, there’s often still a lot of misconceptions, stigma and fear around talking therapy, and the people who deliver it.
This theme has come up a lot in my recent conversations. In the last fortnight, I’ve had the privilege of chatting with some incredible business owners.I’ve caffeinated with a mental health OT, a women’s health GP, a pain physiotherapist, and an exercise physiologist, all at various stages of running their own brilliant businesses.
One thing that really stood out was how little is known about our psychology training pathways and areas of endorsement. And honestly? That’s completely understandable.
I have a theory that if people know more about the diversity of our profession it might help to break down the barriers to accessing care.
Even psychologists in training often don’t fully understand the options available to them. It’s a complicated (and currently heavily scrutinised) landscape undergoing multiple national reviews.
To confuse things further, we’re a profession that is regulated to the point that we can’t describe ourselves using everyday words like “specialty” or “specialist,” because those terms are protected for specific medical professionals.
Most people know that there are General Psychologists and Clinical Psychologists. These terms referring to different levels of training and registration with AHPRA (our governing body). Clinical Psychologists will have gained endorsement after completing a registrar program following their general registration.
But far fewer people realise that there are actually nine different areas of endorsement for psychologists.
So those of us in trained in the minority endorsement groups often find ourselves awkwardly trying to explain that we've also had a solid amount of learning and experience in our special interest areas.
Here are the current nine areas of practice endorsement:
Clinical Neuropsychology
Clinical Psychology
Community Psychology
Counselling Psychology
Educational and Developmental Psychology
Forensic Psychology
Health Psychology
Organisational Psychology
Sport and Exercise Psychology
Like much of our training, the pathways into these endorsement areas are intense. To be eligible, psychologists must complete advanced training in their specific area of practice. The registrar program then adds squillions (okay okay maybe only about 4x) more hours of supervision and CPD on top of what’s required for general registration.
The next hurdle is finding someone willing and able to support your registrar program. Offering registrar training for Health Psychologists has become one of the highlights of my career.
Delightfully, I have found myself competitively obsessed with growing our little minority (and supporting others career development of course).
In 2023, of the approximately 44,000 registered psychologists in Australia , around 26% were endorsed in Clinical Psychology, and less than 1% were endorsed in Health Psychology. With stats like these, no wonder people assume there’s a simple “general vs clinical” binary.
But like many vocations, our profession thrives with diversity. I believe we’re stronger with both breadth and depth of training.
Even if the additional training to gain endorsement isn’t widely understood or appreciated, our clients and our profession benefit enormously from practitioners who pursue it. (Cue overwhelming bias from me and my underdog group of healthies.)
Whether or not psychologists decide to take an endorsement pathway, they can still have specific training in the endorsement areas.
I’ve absolutely loved hosting placements from a variety of postgraduate programs (health, organisational, sport and exercise, counselling...), each group sees issues through a slightly different lens, and that diversity of thinking is genuinely valuable.
Just as you wouldn’t send someone with a broken leg directly to a radiologist, finding the right kind of therapist for mental health support matters.
Although it is important to note that at our core, we are all psychologists and many of us have overlapping areas that we work in.
I’m hoping this reflection helps increase awareness that there are more options and interest areas out there than people often realise. Finding the right fit can help destigmatise help‑seeking and can genuinely improve wellbeing.
Most psychologist databases allow you to search by area of interest, training, including the APS “Find a Psychologist” tool and the AAPi directory.
So tell me — what comes to mind when you think about the different kinds of shrinks (help me make it catch on!)?