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AAPi is deeply disappointed by the Therapeutic Goods Administration’s (TGA) updated guidance on psychedelic-assisted therapy (PAT), released this week, which continues to restrict the lead therapist role within the therapy dyad to psychologists with clinical endorsement only.
Despite years of advocacy, consultation, evidence, and expert feedback calling for a broader, more evidence-based approach, the TGA has chosen to maintain a divisive, unsupported two-tier system in psychology.
This decision is profoundly concerning both professionally and from a patient safety perspective.
What the New Guidance Says
Under the updated guidance, the psychedelic-assisted psychotherapy dyad must include at least one therapist who is:
- a clinical psychologist with endorsement in clinical psychology, OR
- a medical practitioner, OR
- certain other Ahpra-registered health practitioners,
With the AP psychiatrist determining the suitability of additional practitioners.
While the TGA has broadened the list of professions that may participate in psychedelic-assisted therapy, it has simultaneously retained the requirement that psychologists must hold clinical endorsement to act in the primary therapist role.
This means that the overwhelming majority of registered psychologists in Australia remain excluded from lead therapist roles in PAT, despite being regulated by the same National Law, governed by the same Psychology Board standards, and often possessing extensive psychotherapy, trauma, neuropsychology, counselling, health, or culturally informed practice expertise.
AAPi has consistently advocated against this endorsement restriction since psychedelic-assisted therapy was first legalised in Australia in 2023.
In 2023, AAPi formally wrote to the TGA and RANZCP outlining concerns that the requirement for “clinical psychologists” was not evidence-based and did not reflect international practice standards.
At that time, AAPi highlighted that:
- PAT-specific training is not part of Australian clinical psychology endorsement pathways;
- Australian and international PAT trials have included a diverse range of psychologists,
- international protocols focus on PAT-specific competency and psychotherapy experience, not endorsement status; and
- restricting PAT to clinical psychologists would reduce access, increase costs, and worsen workforce shortages.
AAPi again publicly raised concerns in 2025, urging the TGA to amend the wording so that all registered psychologists with appropriate PAT training and relevant clinical experience could participate as supporting or lead therapists.
In AAPi’s 2025 targeted consultation submission, we explicitly recommended that all psychologists registered with the Psychology Board of Australia should be eligible for lead therapist roles within therapy dyads.
Importantly, during the 2025 targeted consultation process, the removal of the “clinical psychology endorsement” requirement was openly discussed. AAPi’s understanding from those discussions was that there was broad recognition that PAT competency is not determined by endorsement alone, and there was no significant pushback against broadening eligibility.
For this reason, the TGA’s decision to retain endorsement-based restrictions has come as a shock.
This Is Not Supported by the Evidence. AAPi remains firmly of the view that PAT competency should be based on:
- specific PAT training,
- psychotherapy skills,
- trauma-informed experience,
- ethical competence,
- relational capacity, and
- ongoing supervision and governance,
Clinical psychology endorsement alone does not include dedicated psychedelic-assisted therapy training.
AAPi remains extremely concerned about the ongoing use of endorsement status to divide psychologists into “tiers” of legitimacy across healthcare systems.
All psychologists registered under the National Law:
- are regulated by Ahpra,
- are bound by the same Psychology Board Code of Conduct,
- undertake continuing professional development,
- maintain professional indemnity insurance,
- and are subject to the same complaints and disciplinary framework.
Yet once again, psychologists without clinical endorsement are being excluded. AAPi has repeatedly raised concerns that these endorsement-based restrictions are not evidence-based and are contributing to unnecessary workforce shortages, increased costs, and reduced access to care.
AAPi is seeking further clarification regarding:
- how this decision was ultimately made,
- what advice informed the retention of endorsement-based restrictions,
- who contributed to that advice,
- and why extensive consultation feedback supporting broader psychologist inclusion appears not to have been reflected in the final position.
AAPi is also investigating potential legal and advocacy options regarding the continuation of this two-tier approach.
We remain committed to advocating for:
- evidence-based workforce policy,
- equitable recognition of psychologists,
- patient safety,
- culturally safe and accessible care,
- and competency-based approaches to psychedelic-assisted therapy.
This issue is far from over.
Further information can be found here.