The Controlled Act of Psychotherapy

On December 30, 2017, an amendment to the Regulated Health Professions Act came into force, introducing a new controlled act of “psychotherapy” into the regulatory scheme. Prior to this, the provision of the service of “psychotherapy” was not strictly regulated. 

The controlled act of “psychotherapy” has now been added to the list of other “controlled acts”, which appear in section 27(2) of the Regulated Health Professions Act. The legislation defines the act of “psychotherapy” as follows: 

27(2)

14. 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, behaviour, communication or social functioning.

Only members of the following six Colleges are now permitted to practice the controlled act of psychotherapy: 

  • College of Registered Psychotherapists of Ontario (CRPO), 
  • College of Psychologists of Ontario (CPO), 
  • Ontario College of Social Workers and Social Service Workers (OCSWSSW), 
  • College of Nurses of Ontario (CNO), 
  • College of Occupational Therapists of Ontario (COTO), and
  • College of Physicians and Surgeons of Ontario (CPSO). 

Amended Regulations under the Regulated Health Professions Act allow for a two-year grace period during which psychotherapy providers must become registered with one of the above six colleges (see s. 7.2 of O. Reg. 107/96). Any person providing psychotherapy in the province of Ontario must become registered with one of the above Colleges by December 29, 2019. 

In addition, the Ontario Government requested clarification from the College of Registered Psychotherapists of Ontario as to what activities come under the scope of practice of “psychotherapy.” Since then, the CRPO has provided a limited amount of guidance on this issue. So far, the College has put out a statement that “counselling,” including “spiritual counselling” would not be included in the controlled act of “psychotherapy”. According to the College’s website: 

The practice of psychotherapy is distinct from both counselling, where the focus is on the provision of information, advice-giving, encouragement and instruction, and spiritual counselling, which is counselling related to religion or faith-based beliefs

At the same time, the CRPO recognizes that there may be significant overlap between “counselling” and “psychotherapy”: 

CRPO does not regulate counsellors or counselling. However, psychotherapy and counselling can be highly interrelated.

All individuals providing mental health and/or talk therapy should be aware of the above changes in the legislation and of the new requirements. 

In addition, the legislation should be closely monitored as the above changes were instituted by a prior Ontario government.