The controlled act of psychotherapy was proclaimed in force on December 30, 2017. It was drafted into the Regulated Health Professions Act in 2007. Controlled acts are acts that are considered inherently dangerous and are restricted to those authorized to perform them by law, or their delegates.  In order to perform a controlled act, you must be a member of a regulatory college authorized to perform that Act, or be a delegate of an authorized professional.

In 2007, the Psychotherapy Act was enacted and it created the College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario.  Companion legislation was amended so that the controlled act of psychotherapy would be authorized to:

  • Nurses
  • Physicians
  • Psychologists
  • Occupational therapists
  • Registered psychotherapists
  • Social workers

However, these provisions were not proclaimed in force, nor was the definition of the controlled act of psychotherapy, until December 30, 2017.

During the intervening period, the College of Psychotherapists was directed to work with 5 other regulatory colleges whose members were to be authorized to provide psychotherapy, to define the meaning of the controlled act. These other colleges are the College of Nurses of Ontario, the College of Psychologists of Ontario, the College of Physicians and Surgeons of Ontario, the College of Occupational Therapists of Ontario and the Ontario College of Social Workers and Social Service Workers.  In June of 2016 the colleges[1] published a document entitled “Understanding the Controlled Act of Psychotherapy[2]”.

In the fall of 2017 the Minister of Health and Long-Term Care referred the matter to its advisory council. The Minister asked HPRAC to further clarify the meaning of the controlled act and to build on the clarification document published by the Colleges[3]. HPRAC submitted its report to the Ministry in November of 2017 but that report has not been released by the Ministry.

In December, the Ministry notified the sector (via Bulletin) that individuals who practise psychotherapy but are not registered with one of the authorized colleges have until December 31, 2019 to determine if they are practising psychotherapy. If so, they must apply for registration with one of the colleges whose members are authorized to perform the controlled act[4]. The Bulletin also notes that the College of Psychotherapists has been instructed by the Ministry to further define the controlled act of psychotherapy and to identify practices that may be exempt from the controlled act of psychotherapy.

Finally, the Bulletin notes that the proclamations align with the Ministry’s objectives to increase accessibility to structured psychotherapy services for individuals with anxiety and depression.  The proclamations are certainly consistent with Health Quality Ontario’s recent recommendation to increase the pool of providers of psychotherapy in order to address prevalent mental health issues such as anxiety and depression. The bulletin further indicates that the Ministry will work with Health Quality Ontario and other stakeholders to provide access to structured psychotherapy services.

 


[1] All colleges except the CPSO participated in the development of the guidance document.
[2] Available on line at https://www.crpo.ca/controlled-act-of-psychotherapy/.
[3] The Minister’s referral letter can be found on line at http://hprac.org/en/links/resources/Letter-to-HPRAC_Aug-4_17-1.pdf .
[4] See the MOHLTC Health Bulletin entitled “New Psychotherapy Requirements to Support Patient Care and Safety”  dated Dec 21, 2017, available on line at http://www.health.gov.on.ca/en/news/bulletin/2017/hb_20171221.aspx .