the controlled act of psychotherapy providing clarity...the controlled act of psychotherapy...
TRANSCRIPT
The Controlled Act of
Psychotherapy –
Providing Clarity
Deborah AdamsRegistrar
Tuesday, May 29, 2018
Tav KanwarActing Manager, Registration
Sarah FraserActing Manager, Registration
Presentation Outline
1. Update on CRPO’s work regarding the Controlled
Act of Psychotherapy
2. Entry-to-practice requirements
3. Q&A
Controlled Act of Psychotherapy
1) Treating,
2) by means of psychotherapy technique,
3) delivered through a therapeutic relationship,
4) an individual’s serious disorder of thought, cognition,
mood, emotional regulation, perception or memory
that,
5) may seriously impair the individual’s judgement,
insight, behaviour, communication or social
functioning (RHPA 1991).
Proclamation of the Controlled Act
Proclamation of the Controlled Act
Psychotherapy with a Registered Psychotherapist
Draft regulation: Categories of Prescribed Therapies Involving
the Practice of Psychotherapy
Draft policy: Activities that are not Part of the Controlled Act of
Psychotherapy
Companion Document for Registered Psychotherapists
Self-assessment tool for unregulated practitioners
Registered Psychotherapists: Information for Ontarians
Self-Assessment Tool
Components assessed by this tool:
• the scope of psychotherapy
• the controlled act of psychotherapy
• the psychotherapeutic relationship
• entry-to-practice requirements
Self-Assessment Tool
• most likely not working within the scope of practice of
psychotherapy
• most likely working within the scope of practice of
psychotherapy
• most likely performing the controlled act of psychotherapy
• cannot answer “yes” to question related to entry-to-
practice requirements
1) Does your work primarily involve one or more of the
following in isolation or in the absence of a
psychotherapeutic relationship?
Self-Assessment Tool
• Advocating
• Applied behavior analysis
• Case management
• Clinical follow-up/care and
discharge planning
• Coordinating services
• Counselling & support
• Crisis
intervention/management
• Hypnotherapy
• Information/advice & KT
• Intake & referral
• Mediating
• Millieu therapy
• Monitoring
• Problem solving
• Psychometric testing &
assessment
• Rehabilitation
• Spiritual or faith
guidance/counselling
• Teaching
2) Are you establishing and maintaining an ongoing
psychotherapeutic relationship with your clients as indicated
by all of the following:
You are responsible for having a conversation with clients about the benefits, risks and expected outcome(s) of the psychotherapy.
You are responsible for gaining the client’s informed consent.
You are responsible for developing, with the client, a mutually agreed upon goal or plan for the psychotherapy.
You ensure that each therapy session has a clear beginning and a clear end where problems or concerns are presented and discussed and outcomes are explored.
You demonstrate the appropriate use of boundaries to create a safe and confidential environment.
You are responsible for ensuring that the client’s well-being is at the forefront of the relationship.
You work with the client to gather relevant information that will support the formulation of a plan for psychotherapy.
You continuously evaluate outcomes of each session and the impact on overall treatment goal(s).
Self-Assessment Tool
3) Are you providing treatment to clients for cognitive,
emotional or behavioural disturbances to improve their
mental health and wellbeing?
Self-Assessment Tool
4) Are you trained in, competent with and using
psychotherapy modalities from one or more of the following
five categories of prescribed therapies described in
Regulation or policy?
• Cognitive and Behavioural therapies
• Experiential and Humanistic therapies
• Psychodynamic therapies
• Somatic therapies
• Systemic and Collaborative therapies
Self-Assessment Tool
5) Are you using psychotherapy to treat a client’s serious
disorder of thought, cognition, mood, emotional regulation,
perception or memory?
Self-Assessment Tool
6) Could your client’s judgment, insight, behaviour,
communication or social functioning be seriously impaired
by the disorder referred to in question 5?
Self-Assessment Tool
7) Would you meet all of CRPO’s entry-to-practice
requirements including:
• Master’s degree in approved educational program or
substantial equivalent
• 125 direct client contact hours
• 30 hours of clinical supervision with a supervisor who satisfies
CRPO’s criteria
Self-Assessment Tool
Psychotherapy Counseling Coaching
aims at healing of
distressing disorders
aims at solution of
troubling problems
aims at optimization of
unrealized potential
through restoration of
morale, resolution of
conflicts, & amelioration
of maladaptive attitudes
and habits
through resolution of
dilemmas & improvement
in coping strategies
through development of
talent & refinement of
instrumental,
interpersonal & creative
skills
leading from painful,
symptomatic (‘abnormal’)
dysfunction
leading from frustrating,
impaired (‘inadequate’)
adaptation
leading from unsatisfying,
limited (‘average’)
performance
to asymptomatic or
‘adequate’ functionality
to competent or ‘normal’
adaptation
to enhanced or
‘outstanding’
effectiveness
Orlinsky Model
Registration Routes
Registration Requirements
Education and Training
To satisfy the education and training requirement, applicants must
have:
a) successfully completed a program recognized by the
Registration Committee; or
b) successfully completed education and training that is deemed
substantially equivalent to a recognized program.
Registration Requirements
a) Recognized Education and Training Programs
Currently there are 11 programs that are recognized by
CRPO
• Master’s and private training programs
• Two to five years in length
• Online and in person
List of recognized programs found on CRPO’s website:
https://www.crpo.ca/education-programs/
Registration Requirements
b) Substantially Equivalent Education and Training
To be considered substantially equivalent to a recognized program,
and applicant’s education and training must have:
1. included at least 360 hours of education and training central to
the practise of psychotherapy; and
2. enabled the applicant to develop required entry-to-practice
competencies.
Applicants provide detailed information to CRPO about their
education and training in psychotherapy by completing the
Competencies Mapping Tool.
Registration Requirements
Currency
Applicants must be current in the practice of the profession. There
are four ways an applicant can demonstrate currency.
1. Completed education and training within the past 12 months of
application;
2. Substantially completed education and traininga) Final semester; or
b) Completed 90% of the program; or
c) Completed program with exception of a thesis.
3. Completed clinical experience (450 DCC and 100 CS) within the
past 12 months before application; or
4. Completed 750 Currency hours in immediate previous 3 years.
Currency Hours
Currency hours include a broad range of professional activities
related to the practise of psychotherapy, such as:
• direct client work
• record-keeping and preparation in relation to direct client work
• professional development in psychotherapy
• engaging in clinical supervision as a supervisee
• conducting research or writing in the field of psychotherapy
• supervising
• teaching
• managing
• consulting
• other professional activities that impact the practice of
psychotherapy
Registration Requirements
Clinical Experience
To be eligible for registration in the Qualifying category, applicants
must have completed at least:
• 125 direct client contact hours; and
• 30 hours of clinical supervision.
Only direct client contact or clinical supervision hours completed
after the start of education can be counted.
Direct Client Contact (DCC)Any activity in which the client and therapist are directly and formally
engaged in the psychotherapeutic process.
Face to face
Phone
Skype
Individual
Couple
Family
Group
Interviewing for
intake
Interviewing,
test admin,
formal
assessment
fa
Facilitating
therapeutic
sessions
Case
conferences
Direct Client Contact (DCC)
The following are not considered DCC:
• Observing therapy session(s)
• Record-keeping.
• Administrative activities (e.g. report-writing).
• Psychometric assessment with little client interaction.
• Providing or receiving clinical or other forms of supervision.
Clinical Supervision
Clinical supervision is a contractual relationship to:
• Discuss the direction of therapy and the therapeutic relationship.
• Promote the professional growth of the supervisee.
• Enhance the supervisee’s safe and effective use of self in the
therapeutic relationship.
• Safeguard the well-being of the client.
Clinical SupervisionClinical supervision can be individual, dyadic or group. Group supervision may
include structured peer group supervision if the supervision is formal and structured,
and includes at least one group member who meets CRPO’s definition of a clinical
supervisor.
Structured peer group supervision differs from group clinical supervision, in that
the latter is led by a clinical supervisor, whereas the former includes at least one
member who would qualify as a clinical supervisor but is an equal participant (not
the leader). Structured peer group supervision often occurs in an institutional setting
but may be formalized outside such settings.
Informal “peer supervision” i.e. unstructured discussion of clients with
colleagues, is not considered an acceptable form of supervision for registration
purposes.
Clinical SupervisorPrior to proclamation, a “clinical supervisor” is a practitioner who has extensive
clinical experience, generally five years or more, in the practice of psychotherapy.
In the first three years following proclamation, a “clinical supervisor” is a
regulated practitioner in good standing (authorized by his or her College perform the
controlled act of psychotherapy), who has extensive clinical experience, generally
five years or more, in the practice of psychotherapy.
Note: one-year ‘grace’ period for supervisors to become registered
Three years after proclamation, a “clinical supervisor” is a regulated practitioner in
good standing authorized by his or her College to perform the controlled act of
psychotherapy, who has extensive clinical experience, generally five years or more,
in the practice of psychotherapy, and who has successfully demonstrated
competence in providing clinical supervision.
Outside Ontario, a clinical supervisor is an experienced practitioner of
psychotherapy qualified to provide clinical supervision in her or his jurisdiction.
Membership Categories
• Regular route applicants Registered Psychotherapist
(Qualifying) or RP (Qualifying)
• Ongoing clinical supervision
• Pursuing completion of requirements to become a full RP:• Remaining education and training (if any);
• Additional clinical experience (direct client contact and clinical
supervision); and
• Completion of the Registration Exam.
• Clinical experience requirement & Registration Exam within 5
years of applying
Membership Categories (cont’d)
• Full RPs must practise with ongoing clinical supervision until they have
1000 DCC and 150 CS hours total.
• RP (Qualifying) members must practise with ongoing supervision even
if they have 1000 DCC and 150 CS hours total.
*DCC = direct client contact; CS = clinical supervision
Registration Exam
• Canadian Professional Standard for Counselling and
Psychotherapy (CPSCP): Entry to Practice Competency
Assessment (commonly referred to as the “Registration Exam”).
• Offered by the COMPASS Centre for Examination Development
• Currently offered twice a year.
• Max of 3 attempts at the exam (first attempt must be taken
within first 2 years of applying to CRPO).
