Health Professions Regulatory Advisory Council to Advise on the Controlled Act of Psychotherapy

On August 4, 2017, Health Minister Eric Hoskins wrote a letter requesting that the Health Professions Regulatory and Advisory Council (“HPRAC”) review issues related to the proposed amendment to the Regulated Health Professions Act, 1991 (the “RHPA”) on the controlled act of psychotherapy (the “Proposed Amendment”). HPRAC is established under the Regulated Health Professions Act, with a statutory duty to advise the Minister on health professions regulatory matters in Ontario.

As we wrote about here and here, most of the provisions of the Psychotherapy Act, 2007 were proclaimed into law in April 2015, creating the College of Registered Psychotherapists of Ontario, which now registers and regulates members. The Proposed Amendment would recognize psychotherapy as a “controlled act,” meaning that it can only be performed by certain registered health professionals. Specifically, the controlled act of psychotherapy could be performed only by members of the College of Registered Psychotherapists of Ontario, the College of Nurses, the College of Occupational Therapists, the College of Psychologists of Ontario, the College of Physicians and Surgeons, and the Ontario College of Social Workers and Social Service Workers.

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.

As the Proposed Amendment was passed almost ten years ago, the government must proclaim the amendment in force before December 31, 2017, or it will expire. Delay in enacting the amendment is largely due to continued uncertainty about the meaning of the controlled act of psychotherapy and who may perform it, which has been expressed by regulated health professionals and others, including child and youth workers, peer support counselors, and sexual assault support workers.

The controlled act of psychotherapy is defined as “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.” Although the regulatory colleges whose members may be granted the controlled act have produced a collaborative guidance document attempting to clarify the meaning of the controlled act of psychotherapy, uncertainty has persisted.

The Minister has requested that HPRAC provide advice on two questions: (1) how to clarify the meaning of the controlled act of psychotherapy and (2) to recommend criteria for determining whether certain groups not members of any regulated health profession should be granted an exemption permitting them to perform the controlled act of psychotherapy.

The Minister requested that HPRAC provide its advice no later than November 1, 2017. HPRAC has announced that it will engage in a multistage consultation process where information and responses are requested from and shared with stakeholders. HPRAC is currently developing its consultation approach for this referral and will post a notice on its  website when the details are finalized.

For more information regarding the controlled act of psychotherapy, contact us.

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