Psychology - Information for clients

Mental Health services provided by a Medical Practitioner (including General Practitioners and Psychiatrists) are funded in accordance with the Medical Practitioners policy.

Please refer to the Family Counselling policy for information about providing Family Counselling services to the immediate family members of a person who dies or is severely injured in a transport accident.  

Policy

The TAC can pay the reasonable costs of psychology services when required as a result of a transport accident injury under section 60 of the Transport Accident Act 1986 (the Act), on referral from a medical practitioner.

The TAC will periodically review a client's entitlement to psychology services to ensure that the treatment and services remain reasonable for the transport accident injury and are payable under the Act.

Background

The TAC has developed the Clinical Framework for the Delivery of Health Services (Clinical Framework) to set out key principles for delivery of services to clients.

The Clinical Framework is based on the following principles:

• Measurement and demonstration of the effectiveness of treatment
• Adoption of a biopsychosocial approach
• Empowering the client to manage their injury
• Implementing goals focused on optimising function, participation and/or return to work/health
• Base treatment on best available research evidence.

The TAC expects that all health professionals providing services to clients integrate the principles of the Clinical Framework into their daily practice.

Further information about the Clinical Framework can be found at www.tac.vic.gov.au.

Definitions

In this policy, mental health is considered a state of emotional and social wellbeing in which the individual can cope with the normal stresses of life and achieve their potential. It includes being able to work productively and contribute to community life. Mental health is not simply the absence of mental illness

Guidelines

What can the TAC pay for in relation to psychology services?

The TAC can pay the reasonable costs of psychology services for a client who has been referred by a medical practitioner:

• required as a result of the transport accident injury
• that are clinically justified, safe and effective
• that promotes progress towards functional independence, participation and self-management.

Please note that the TAC will not pay for more than one initial consultation by the same provider or clinic unless there are exceptional circumstances, for example where a significant period of time has elapsed since the client last received psychology treatment.

The TAC can pay for consultations to a maximum time-limit of 60 minutes per consultation. For any consultations greater than this period a treater must provide clinical justification for an extended session and prior approval must be given by the TAC. This includes:

• the administration of psychometric tests that take longer than 60 minutes - any test results must be sent to the TAC
• where the trauma focused intervention (i.e. trauma focused cognitive behavioural therapy or eye movement desensitisation and reprocessing) being delivered requires a discrete number of extended sessions*
• where it has been agreed that it is more appropriate for the client to undertake longer but less frequent sessions, e.g. for a client who travels excessive distances for treatment
• services provided by a neuropsychologist.

^{* The Australian Guidelines for the Treatment of Acute Stress Disorder & Posttraumatic Stress Disorder (Australian Centre for Posttraumatic Mental Health, 2013) state that in most cases 8-12 sessions of trauma focused treatment is usually sufficient.}

To expedite payment of accounts, the TAC encourages treating psychologists to seek prior approval for extended consultations.

Group consultations

The TAC can pay the reasonable costs of group consultations provided by a psychologist. Group consultations must consist of a minimum of four and a maximum of 10 clients in a group receiving continual overall supervision and treatment.

Family counselling

The TAC can pay the reasonable costs of family counselling for the immediate family of a client who dies or sustains a severe injury as a result of a transport accident. Refer to the Family Counselling policy.

E-therapy services

The Australian Government's mindhealthconnect website provides up to date information and resources to assist with mental health issues. The site provides a list of endorsed online e-therapy services as well as other information about anxiety, stress and depression.

E-therapy programs are generally free web-based support programs where people can access information and counselling, and undertake cognitive behavioural therapy modules to assist them in managing persistent pain or mental health issues such as anxiety and depression.

The TAC can reimburse the reasonable costs of e-therapy services where:

• there is a cost associated with accessing the service, and
• the e-therapy program is registered as a content partner with the mindhealthconnect website and;
• the client has been referred by a medical practitioner or psychologist.

For more information refer to the TAC factsheet e-therapy – online mental health and persistent pain resources. 

Meeting attendance

The TAC can pay the reasonable costs for a psychologist to attend a meeting where:

• attendance at the meeting has been requested by the TAC as part of the independence planning process, or
• prior written approval has been provided by the TAC, and
• the need for attendance is clinically justified.

Travel

The TAC can pay the reasonable costs of travel time for psychologists where:

• prior written approval has been provided by the TAC
• a request has been provided by a treating practitioner confirming that the client is medically unfit to travel, or clinical justification has been provided by the treating therapist that the treatment should be delivered in a community setting, for example home, work or school
• the psychologist providing treatment is the most appropriate according to the geographic location of the client and the therapy specialty required
• travel time is separately billed and is reimbursed on a time only basis at a pro rata rate.

Refer to the Psychology Fee Schedule for information about how to invoice travel. 

Who can provide psychology services?

Psychology services can be provided by a psychologist who is registered under the Health Practitioner Regulation National Law to practice in the psychology profession (other than as a student).

Neuropsychology services can be provided by a psychologist whose registration is endorsed under section 98 of the Health Practitioner Regulation National Law Act as being qualified to practise as a clinical neuropsychologist.

The TAC prefers that the treating psychologist has knowledge and skills in the assessment and treatment of people with problems relating to post-traumatic mental health.

What information does the TAC need?

For clients with a 'severe injury' treatment will be approved as part of the independence planning process. The psychologist will be required to submit initial baseline measures within 10 working days of approval of treatment from the TAC. Outcome measures are to be maintained and recorded throughout the treatment and provided to the TAC upon request.

For all other clients the TAC does not require any information from the psychologist before commencement of initial treatment for a client's transport accident injury.

After initial treatment has commenced, the psychologist must submit to the TAC a Mental Health Treatment Plan (psychology or neuropsychology), which includes baseline measures, where the psychologist expects to provide more than five sessions of treatment. This also applies to clients who have:

• been previously treated at another psychology clinic 
• received psychology treatment and it is more than 12 months since the last treatment session.

For all clients, the TAC may contact the client or psychologist for further information if required. In some circumstances a Mental Health Treatment Review (MHTR) (psychology or neuropsychology) may be requested by the TAC. Psychologists should not submit a MHTR or written reports unless specifically requested by the TAC.

In relation to psychology services, what will the TAC not pay for?

The TAC will not pay for:

• treatment or services that are not in line with the Clinical Framework
• treatment or services for a person other than the client
• treatment or services provided by probationary psychologists
• neurotherapy treatment
• E-therapy services that are not endorsed by Mindhealthconnect, or are free to the public
• E-therapy services that are not referred by a medical practitioner or psychologist 
• fees associated with cancellation or non attendance
• treatment or services provided outside the Commonwealth of Australia 
• treatment or services provided by telephone or other non face to face mediums 
• telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
• non-hospital services provided more than once on the same day to the same client
• treatment or services where the cost is included in the hospital bed fee. Refer to the Public Hospitals policy and the Private Hospitals policy
• treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.