Practice Notes is an educational tool designed to help Ontario social workers, social service workers, employers and members of the public gain a better understanding of recurring issues dealt with by the College’s Professional Practice Department and Complaints Committee that may affect everyday practice. The notes offer general guidance only and College registrants1 with specific practice inquiries should consult the College, since the relevant standards and appropriate course of action will vary depending on the situation.
The Professional Practice Department regularly speaks to registrants interested in pursuing private practice as their primary employment or as a part-time supplement to their full-time role. This trend is growing, partly due to the increasing need for mental health services, the familiarity and availability of online service platforms, and the flexibility private practice provides. Additionally, the Scopes of Practice for Social Work and Social Service Work are broad, allowing registrants to work with diverse client groups and practice modalities.
However, in addition to having the requisite competence2 to work in private practice3, registrants must determine whether their chosen modality is within their professional scope and based on a credible body of professional knowledge. The Scopes of Practice describe the proper scope of professional activities for social workers and social service workers, and provide some examples of workplace settings in which those professional activities may take place. Statements found in the Scopes of Practice provide three types of information: what each profession does, the methods it uses, and the purpose of its activities.4 Registrants must refer to this information to guide their work and ensure they are practising within the scope outlined by the College.
At times, Professional Practice staff speak with registrants who spend time and money training in an area outside their profession’s scope of practice. They are disappointed to learn they cannot use this modality in their social work or social service work practice.
Similarly, Professional Practice staff hear from health benefit insurance providers who seek to determine whether a claim for services is fraudulent because a practice is not considered within the scope of practice.
Examples of practices the Professional Practice staff have been consulted on include the following:
- Christian counselling (as a standalone practice)
- Harmonic egg counselling
- Life/career/executive coaching
- Career counselling
- Financial social work/social service work
- Meditation (as a standalone practice)
- Cuddle therapy
- Infant sleep training and lactation consultant
- Therapeutic touch
- Placement of ear seeds
- Hypnotherapy/hypnosis
- Health and fitness coaching
- Trauma-sensitive or informed yoga (as a standalone practice)
- Reiki
- Tarot cards
- Supervising lactation and sleep consultants
- Pet therapy
Aspects of some of the above modalities might be able to be integrated into a registrant’s social work or social service work practice, provided that the registrant has the necessary competence to do so and provided that the modality is used appropriately as a technique within the registrant’s professional practice (rather than as a standalone practice). For example, in the context of a social work or social service work practice, it may be appropriate at times to use meditation exercises, discuss career and financial goals or discuss a client’s spiritual practices and support. However, registrants are “responsible for being aware of the extent and parameters of their competence and their professional scope of practice and limit their practice accordingly.”5
It may be entirely inappropriate to incorporate certain modalities into social work or social service practice, for example modalities involving physical touch and/or where a client may be fully or partially undressed (for example, cuddle therapy, therapeutic touch, and massage). In such instances, clear and appropriate boundaries necessary for the provision of social work services and social service work services are inherently blurred. Registrants should ensure clients in these other modalities are not also social work or social service work clients.
In addition to the Scopes of Practice, registrants must also review the Standards of Practice, which state:
College registrants shall ensure that any professional recommendations or opinions they provide are supported by evidence and a credible body of professional social work or social service work knowledge.
Evidence can include information gathered from:
- direct observation;
- clinical sessions;
- professional meetings;
- indigenous worldviews and ways of knowing;
- collateral sources;
- documents and correspondence;
- clinical tools (e.g. diagnostic assessment measures, rating scales);
- research;
- training and continuing education;
- supervision; and/or
- relevant and reputable professional journals/literature.6
The Standards of Practice explain that a “body of professional social work knowledge and body of professional social service work knowledge relates to both theoretical and practical understanding. A body of knowledge can be attained through education, clinical experience, consultation and supervision, professional development and a review of relevant research and literature. Professional social work knowledge and professional social service work knowledge draw upon the knowledge base of other professions including sociology, psychology, anthropology, medicine, law and economics as well as their own respective distinct bodies of knowledge.”7
Registrants must always be prepared to explain the evidence and credible body of professional knowledge utilized in client care. This includes justifying why they select specific practice modalities and how the approach is appropriate for the client and their presenting issues and goals. “College registrants shall not offer a service and/or product that the registrant knows or ought reasonably to know is not likely to benefit the client and/or that is not relevant to the client’s needs.”8 Additionally, registrants must remember that all services provided must conform to College standards. 9
Ensuring that a practice modality or approach benefits clients and meets their needs is of utmost importance. During Professional Practice consultations, it can be apparent that registrants have aligned with or are passionate about a specific modality. This could be problematic if a registrant wanted to use a particular modality when it was not indicated for a client. In practice, registrants must “distinguish their own needs and interests from those of their clients to ensure that, within professional relationships, clients’ needs and interests remain paramount.”10
Practising Outside the Scope of Practice
When registrants practise and provide social work and social service work services, they must use their professional designation and/or title in communications with clients and/or the public.11 Conversely, if registrants are practising using a modality that is outside the scope of practice, they must clearly identify that it is not part of their social work or social service work practice.
Registrants should be aware that it may not be appropriate to use their social work/ social service work protected titles in advertising non-social work/social service work services, like life coaching services, or on their life coaching (or other non-professional) website. Advertising for non-social work services/social service work services that relies on the use of title may be misleading to members of the public, and may create the impression that those other services fall within the practice of social work or social service work.
Consider the following scenario:
A registrant scheduled a Professional Practice consultation to discuss the launch of their life coaching practice. Professional Practice staff and the registrant reviewed how aspects of life coaching may overlap with social work and social service work practice; however, life coaching is not referenced in the Scopes of Practice for either profession.12 ,13
Professional Practice staff stated that training for life coaching is not standardized. The registrant also identified that evidence for life coaching was emergent. Professional Practice staff suggested the registrant consider developing a different website from their social work or social service work website to advertise their life coaching business. They must also ensure separate billing for life coaching services from their social work or social service work services. The registrant was also informed that it could be a conflict of interest14 to refer clients from their life coaching practice to their social work or social service work practice. Instead, if appropriate and indicated, the registrant should refer clients from their life coaching practice to another registrant for social work or social service work services. In a similar instance, clients from their social work or social service work practice should be referred to another life coach.
It was also discussed that registrants should still provide clients with information about the body of knowledge on which modalities are based when practising outside the scope of practice. This includes training the registrant has undertaken, the accepted approach or program for the modality, and any information regarding an oversight body or accepted standards for the modality.15
Conclusion
If a registrant embarks on private practice, they must have the requisite competence and use approaches based on evidence and a credible body of professional knowledge. These approaches must be in the client’s best interest and within the registrant’s scope of practice. The College of Regulated Psychotherapists of Ontario has a list on its website that provides five categories of psychotherapy and non-exhaustive examples of each modality, which may be helpful to registrants when considering these issues. Registrants should also reflect on the questions below:
- Is this modality supported by evidence from a credible body of knowledge?
- Is this approach indicated for the client and their presenting issues?
- If called into question, would I be able to defend my decision-making process and clearly explain why I used the modality I did?
If registrants want to utilize a modality that is outside the scope of practice, they must ensure they:
- Do not use it in their social work or social service work practice;
- Have clear boundaries between their practices, which may include in some cases ensuring they do not use that modality on social work or social service work clients;
- Provide clear information to clients about the proposed modality; and
- Invoice appropriately.
If you have questions about this issue or want to discuss further, please contact the Professional Practice Department at practice@ocswssw.org or book a professional practice consult.
- Disclaimer: the term “member” and “registrant” are used interchangeably and synonymously as equivalent to the term “member” as used in the Social Work and Social Service Work Act, 1998, and the Regulations. ↩︎
- Betteridge, Lise. “Practice Notes: “But How Do I Know If I’m Competent?” – Issue to Consider.” Perspective, Fall 2013. https://www.ocswssw.org/wp-content/uploads/PN-How_Do_I_Know.pdf ↩︎
- “Practice Notes: Why You Need to Put the Time In Before Private Practice.” Perspective, Fall 2023. https://www.ocswssw.org/2023/10/14/why-you-need-to-put-in-the-time-before-private-practice/ ↩︎
- Ontario College of Social Workers and Social Service Workers (OCSWSSW), Position Paper on Scopes of Practice, October 2008.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle II: Competence and Integrity, interpretation 2.1.1.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle II: Competence and Integrity, interpretation 2.1.7.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Glossary.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle III: Responsibility to Clients, interpretation 3.8.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle III: Responsibility to Clients, interpretation 3.9.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle I: Relationship with Clients, interpretation 1.8. ↩︎
- OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Principle VII: Advertising and Communications, interpretation 7.2.1.
↩︎ - OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Scope of Practice for Social Work. ↩︎
- OCSWSSW, The Code of Ethics and Standards of Practice, Third Edition, 2023, Scope of Practice for Social Service Work. ↩︎
- A College registrant is in a “conflict of interest” when they have a personal, financial or professional interest or obligation that may influence how they carry out their professional responsibilities. A conflict of interest may be actual or perceived, the latter meaning that a reasonable person, informed of all the circumstances, would have concerns that the interest or obligation may influence the registrant in the exercise of their professional responsibilities. A mere possibility or suspicion of influence does not in itself create a conflict of interest.
↩︎ - Blake, Pamela. “Practice Notes: Incorporating Adjunct Techniques – What Are The Considerations?” Perspective, Fall 2009. https://www.ocswssw.org/wp-content/uploads/PN-Incorporating_Adjunct_Techniques.pdf
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