Proclamation of the Psychotherapy Act, 2007: Important update for OCSWSSW members who provide psychotherapy services and/or use the title “Psychotherapist”

The Ontario College of Social Workers and Social Service Workers (OCSWSSW) has learned that some of the long-awaited legislative changes concerning psychotherapy have been proclaimed in force as of April 1, 2015.

These developments affect members who practise psychotherapy and/or use the title “psychotherapist”, as well as those who wish to do so in future.

At this time, the government has decided to proclaim into force most of the balance of the provisions of the Psychotherapy Act. These provisions create the new College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario (CRPO). Among other things, these provisions also restrict the use of the titles “psychotherapist”, “registered psychotherapist” and “registered mental health therapist” to members of CRPO.

However, the government has not yet proclaimed into force certain other provisions related to psychotherapy. The provisions in the Regulated Health Professions Act, 1991 (the “RHPA”) setting out the controlled act of psychotherapy and authorizing members of OCSWSSW to perform the controlled act of psychotherapy in compliance with the Social Work and Social Service Work Act, 1998 (the “SWSSWA”), its regulations and bylaws have NOT been proclaimed into force at this time.

Similarly, the provision in the SWSSWA permitting OCSWSSW members who are authorized to perform the controlled act of psychotherapy to use the title “psychotherapist” has NOT been proclaimed in force.

The delay in proclamation of these provisions has important implications for members of OCSWSSW.

1. Provision of psychotherapy services:

The controlled act of psychotherapy has NOT been proclaimed in force. This means that the provision of psychotherapy services continues to be in the public domain and the RHPA does not restrict who can provide psychotherapy services. Therefore, members of OCSWSSW may continue to perform the functions in the Scope of Practice of the Profession of Social Work or the Scope of Practice of the Profession of Social Service Work, respectively, including the provision of psychotherapy services, in accordance with the Code of Ethics and Standards of Practice Handbook, Second Edition, 2008.

Members may use the title “social worker” or “registered social worker”, or “social service worker” or “registered social service worker”, in connection with their practice of social work or social service work, as the case may be, and may perform specific activities that are permitted by legislation to be performed by members of the OCSWSSW.

2. Use of the title “Psychotherapist”:

The Psychotherapy Act restricts the use of the title “psychotherapist”, “registered psychotherapist” and “registered mental health therapist” to members of CRPO. A provision of the SWSSWA (s. 47.2) would have permitted members of the College authorized to perform the controlled act of psychotherapy to use the title “psychotherapist”. However, since that provision of the SWSSWA has not yet been proclaimed in force, as of April 1, 2015, members of the OCSWSSW are NOT permitted to use the title “psychotherapist”.

OCSWSSW members should note that this development similarly impacts members of the other Colleges whose members have not yet been authorized to use the title “psychotherapist” because the relevant provisions of the RHPA have not yet been proclaimed: the College of Occupational Therapists of Ontario (COTO), the College of Physicians and Surgeons of Ontario (CPSO), the College of Nurses of Ontario (CNO), and the College of Psychologists of Ontario (CPO).

3. Practice Guidelines for Performing the Controlled Act of Psychotherapy:

The College developed Practice Guidelines for Performing the Controlled Act of Psychotherapy, which were approved by the OCSWSSW Council in December 2013. The Guidelines were intended to augment the existing standards of practice which set out the minimum standards for all members. Because the controlled act of psychotherapy has not yet been proclaimed, the Practice Guidelines are not yet in force.

Key Points:

At this time, OCSWSSW members should note the following:

  • OCSWSSW members may continue to provide psychotherapy services provided they are competent to do so.
  • In addition to ensuring that they are familiar with the Code of Ethics and Standards of Practice Handbook, Second Edition, 2008, members should review the Practice Notes “‘But How Do I Know if I’m Competent’ – Issues to Consider” to ensure that they have considered and assessed their competence to provide psychotherapy services.
  • Psychotherapy is not an entry-to-practice competency. Competent practice requires ongoing education and training, as well as regular supervision and consultation.
  • Only members of the College of Registered Psychotherapists of Ontario (CRPO) are permitted to use the title “psychotherapist”, “registered psychotherapist” or “registered mental health therapist”.

Update on Proclamation of the Controlled Act of Psychotherapy:

The College is currently working collaboratively with the five other colleges whose members will have access to the controlled act of psychotherapy (once it is proclaimed), and with representatives from the Ministry of Health and Long-Term Care (MOHLTC) to further clarify the definition of the controlled act.

At the request of the MOHLTC, the group produced a clarification document intended to ensure consistent understanding of the controlled act among practitioners and the public prior to proclamation. This document was approved in principle by the College Council at its September 2016 meeting. All of the colleges who worked on the clarification document, with the exception of the College of Physicians and Surgeons (CPSO), also sought and obtained approval in principle of the clarification document by their respective councils.

Early in 2017, members of the College (along with members of the other colleges whose members will also have access to the controlled act once it is proclaimed), the public and other stakeholders were asked to provide comments on the clarification document as part of a consultation requested by the MOHLTC. The MOHLTC has told the colleges involved that feedback from the consultation will assist the government in moving forward towards proclamation of the controlled act of psychotherapy.

Links to the clarification document and YouTube video produced for the consultation process are below. These resources provide guidance on when psychotherapy becomes the controlled act once proclaimed into force.  Please note that at this time the controlled act of psychotherapy has not been proclaimed into force.

The College has been working on this issue with the other colleges for several years. We will continue to communicate regularly with government about this important issue, and will provide updates to our members as they are available.

History and Context:

For several years now, the regulation of psychotherapy has been the focus of much attention and interest for members. The College has been involved in various aspects of this issue throughout this time. Activities intensified over the past couple of years, as changes to the regulatory framework became more imminent. The following sets out the history regarding the regulation of psychotherapy:

  1. In 2007, the Government of Ontario decided to regulate psychotherapy as a controlled act. It introduced legislation, the Health System Improvements Act, 2007 (the “HSIA”), to amend the Regulated Health Professions Act, 1991 (the “RHPA”). Once proclaimed into force, this legislation would make psychotherapy a controlled act under the RHPA. A controlled act is an activity thought to have the potential of posing a risk of serious harm to the client. Restricting the performance of controlled acts to certain regulated professionals who are legally authorized to perform them is one approach to protecting the public.
  2. When the HSIA was first introduced as a bill, it authorized only physicians, nurses, occupational therapists, psychologists and members of a new college (the College of Psychotherapists and Registered Mental Health Therapists of Ontario) to perform the controlled act of psychotherapy. After a great deal of work by the OCSWSSW, the Ontario Association of Social Workers and a number of College members, an amendment to the bill was made which authorized members of the OCSWSSW to perform the controlled act of psychotherapy in compliance with the Social Work and Social Service Work Act, 1998 (the “SWSSWA”), its regulations and bylaws. The inclusion of OCSWSSW members among those professions authorized to perform the controlled act of psychotherapy marked a significant milestone for the OCSWSSW and its members. This was the first controlled act that members of the OCSWSSW would have been authorized to perform.
  3. When the HSIA was passed, only members of the new College of Psychotherapists and Registered Mental Health Therapists were authorized to use the titles “psychotherapist” and “registered mental health therapists”. However, in 2009 the Regulated Health Professions Statute Law Amendment Act, 2009 was passed which included amendments to the SWSSWA and the RHPA regarding the use of the title “psychotherapist”. On proclamation of amendments to the SWSSWA, a member of the OCSWSSW authorized to perform the controlled act of psychotherapy would have been permitted to use the title “psychotherapist” if the member complied with certain conditions. Similarly, on proclamation of the amendments to the RHPA, members of the College of Nurses of Ontario, the College of Occupational Therapists of Ontario, the College of Physicians and Surgeons of Ontario and the College of Psychologists of Ontario would have been permitted to use the title “psychotherapist” if their members complied with certain conditions.
  4. As explained above, the provisions in the RHPA pertaining to the controlled act of psychotherapy were NOT proclaimed into force on April 1, 2015. In addition, the provisions in the SWSSWA and the RHPA relating to the use of the title “psychotherapist” were NOT proclaimed into force on April 1, 2015. It is not known at this time when these provisions will come into force.

For further information, please contact Christina Van Sickle, Director of Professional Practice at cvansickle@ocswssw.org.


Frequently Asked Questions

What is the definition of the controlled act of psychotherapy?

The Regulated Health Professions Act, 1991 (the “RHPA”) sets out the controlled act that relates to psychotherapy as follows:

Treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behavior, communication or social functioning.
At this time, the government has not proclaimed in force the provisions in the RHPA setting out the controlled act of psychotherapy and authorizing members of OCSWSSW to perform it, in compliance with the Social Work and Social Service Work Act, 1998 (the “SWSSWA”), its regulations and bylaws. Psychotherapy continues to be in the public domain, and the RHPA does not restrict who can provide psychotherapy services.

Can a registered social worker or registered social service worker perform the controlled act of psychotherapy?

The provision of the Regulated Health Professions Act, 1991 (the “RHPA”) setting out the controlled act of psychotherapy has NOT been proclaimed. This means that the provision of psychotherapy services continues to be in the public domain, and the RHPA does not restrict who can provide psychotherapy services. Members of OCSWSSW may continue to provide psychotherapy services, in accordance with the Code of Ethics and Standards of Practice Handbook, Second Edition, 2008.

Didn’t the College develop Practice Guidelines related to psychotherapy? Are they going to be released now that the Psychotherapy Act has been proclaimed?

The College Council decided to develop Practice Guidelines for Performing the Controlled Act of Psychotherapy because psychotherapy was to be the first controlled act authorized to members of the OCSWSSW. These Practice Guidelines were approved by the OCSWSSW Council in December of 2013 but do not come into effect until the relevant provisions of the RHPA and the SWSSWA come into force. The guidelines were intended to assist members in applying the standards of practice and to alert them to the issues to consider when assessing their competence to perform the controlled act of psychotherapy. They cover issues pertaining to the practice of the controlled act of psychotherapy, including the need for ongoing education and training to maintain competence, and the importance of supervision and consultation. They also emphasize that psychotherapy is not an entry-to-practice competency.

Because the guidelines relate to the controlled act of psychotherapy, they will only come into effect and be distributed to members once the above-mentioned provisions of the RHPA and the SWSSWA are proclaimed into force. Until the guidelines are released, members should ensure that they are familiar with the Code of Ethics and Standards of Practice Handbook, Second Edition, 2008 and review the Practice Notes ““But How Do I Know if I’m Competent” – Issues to Consider” to ensure that they have considered and assessed their competence to provide psychotherapy services.

I am a member of the OCSWSSW who provides psychotherapy services as part of my practice. Can I call myself a “psychotherapist”?

The Psychotherapy Act restricts the use of the title “psychotherapist”, “registered psychotherapist” and “registered mental health therapist” to members of the College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario (CRPO). A provision of the SWSSWA (s. 47.2) would have permitted members of the College authorized to perform the controlled act of psychotherapy to use the title “psychotherapist”. However, since that provision of the SWSSWA has not yet been proclaimed in force, as of April 1, 2015, members of the OCSWSSW are NOT permitted to use the title “psychotherapist”. Members of the OCSWSSW who wish to use the title “psychotherapist”, “registered psychotherapist” or “registered mental health therapist” would need to join CRPO in order to do so.

I’m a registered member of OCSWSSW and I practise psychotherapy. Do I need to become a member of the College of Registered Psychotherapists of Ontario in order to practise psychotherapy?

No. The Psychotherapy Act, 2007, most of which is now in force, was proclaimed in force on April 1, 2015, however, the provision of the Regulated Health Professions Act, 1991 (the “RHPA”) setting out the controlled act of psychotherapy has NOT been proclaimed into force. This means that the provision of psychotherapy services continues to be in the public domain, and the RHPA does not restrict who can provide psychotherapy services. Members of OCSWSSW may continue to provide psychotherapy services, in accordance with the Code of Ethics and Standards of Practice Handbook, Second Edition, 2008.