The Ontario College of Registered Psychotherapists
Spring 2013 Report, by Bob Bond
The “College of Registered Psychotherapists” [which is now an acceptable short form for the full title “College of Registered Psychotherapists and Registered Mental Health Therapists”] is hopefully on track to open, with its members both registered and fully functioning, on April 1, 2014. We still mustsay “hopefully” because there yet are legislative hoops to jump through; for example, the Ministry of Health and Long Term Care has yet to approve the Registration Regulation, upon which anyone’s entry to the College depends; and the Provincial Government must, in the final analysis, proclaim the fully developed form and content of the College in order to open its doors.
That being said, however, much has been approved, and much is being ‘knit together’, towards the College’s “birthing”. CASC-Ontario members are wise to keep checking the College website, in order to stay abreast of developments. Formal means of application are expected to be posted and used-by-us for preregistration starting this autumn, both for those entering by the ‘standard route’ and for those being “grandparented” into the College. All registrants will have to complete the Professional Practice and Jurisprudence e-Learning Module (still under development) [ All will have to provide a certificate showing Professional Liability Insurance coverage, according to the specifications required by the College [ For now, the preparatory work that can be done by those of us intending to be “grandparented” into the College is for each of us more-or-less independently to do our version of the Portfolio Scoring [ and then take advantage of information in the upcoming June/July CASC-Ontario “Communiqué” plus any regional/provincialworkshops and or tele-conferences the CASC-Ontario Council will sponsor.
An important question that many people are asking is about the use of volunteers (e.g. On-Call Community Clergy). A definitive answer must wait until the MOHLTC creates its “exclusionary clause” so we can see how people outside the College, whose activity ‘brushes against’ the controlled act of psychotherapy, are to be viewed and ‘managed’ (or ‘freed up’?!?). It might become necessary to stipulate limitations for these people’s scope of practice. For now, we have heard repeated assurances from folk such as Joyce Rowlands, Registrar, that volunteers will be able to continue their work. [We must simply wait and see “How?”.]
Across the province, if you put your ear to the ground, you will hear ongoing debate aboutneeding, or not, to join this College.
There are two points where confusion reigns, one of which is both born and resolved within the 1991 Regulated Health Professions Act (RHPA), the second of which is resolved by being clear about the conflicting definitions of “counselling” at play within the province.
First, the RHPA [1991]: At several points exemption is declared for faith-based practitioners counselling/ministering according to the tenets of their faith. By this exemption, the Act simply ensures the separation of church and state. It assures that what the pastor rightly does for members of St. John By The Gas Bar church is a matter for the church to decide and regulate. However, it does not mean this same pastor can “do his/her church’s thing” on everyone / anyone else. For instance, the Scientologist cannot walk into the hospital and start instructing patients to stop their medical treatments; the Jehovah’s Witness cannot come into the hospital and outlaw the blood bank; the Southern Baptist cannot insist palliative patients recite “the sinner’s prayer”; and so on. Once we’re in the realm of a chaplain / ‘spiritual practitioner’ / CASC “pastoral counsellor” plying her or his trade on the general population (e.g. upon the patients at a public hospital or the clients of a counselling centre), we find ourselves far beyond practice “according to the tenets of <the practitioner’s> faith.” In other words, the RHPA’s exemption clauses cannot be applied to interfaith chaplains / “pastoral counsellors” (whose practice must not be based dogmatically on the tenets of their personal faith in any case!), though these exemption clauses would apply to chaplains / “pastoral counsellors” exclusively ministering to members of their own faith-and-denomination.
Second, the matter of avoiding the RHPA and Psychotherapy Act by claiming chaplains or “pastoral counsellors” are “only doing counselling”, i.e. “we are not doing psychotherapy”.
In Ontario, the legislative framework understands “counselling” as providing information, advice, instruction, direction. [I.e. the Ontario understanding is in conflict with the CASC definition behind our title “pastoral counsellor”.]
Charged, as the pastor of St. John By The Gas Bar church is, with ‘keeping the faith’ so that the “flock’s” beliefs and practices, values and conduct are all “orthodox”, that pastor can be expected to counsel … a whole lot! The pastor’s “effective use of self” will be to be as persuasive, charismatic and inviting as can be mustered. “Safe use of self” means adamantly sticking to orthodoxy.
People outside the pastor’s flock can see and appreciate the pastor’s efforts at maintaining – indeed, “building up” – his/her church. If people outside the pastor’s flock want this insistence / counsel within their lives, they are welcome to “go join”. But people outside the flock not intent on it must be free of it. [So, for example, it is standard Policy and Procedure in Ontario Hospitals that the Visitors (including Clergy) from a given faith community are given access to see their own people, and them alone.]
For any random patient in an Ontario hospital or client in a counselling centre, to attend to their spiritual care is to be with them – in the terms of Cultural Anthropology – as a Healer. Their Curers (doctors, nurses, PTs, OTs) are all busily prescribing treatment and giving counsel as they declare a diagnosis, its effects, its required interventions and its outcomes. Meanwhile the Healer is prescribing and counsellingnot-one-bit-at-all. The Healer is asking, inviting, reflecting, and altogether accompanying the patient and the patient’s intimates through their confrontation, negotiation and change in a process of attending to the meanings of the illness. The one thing which must not be done by a healer / spiritual care provider / interfaith chaplain / CASC “pastoral counsellor” is to “counsel”. What’s more, to take a clergyperson and evolve him/her into a healer / spiritual care provider / chaplain / CASC “pastoral counsellor”, his/her knowledge and skillset must evolve, but most particularly his/her whole equipment around “the safe and effective use of self” must be done completely over.
Which, historically, was the impetus to begin Clinical Pastoral Education (and then Pastoral Counselling Education) back in the 1930’s … it was evident that what the seminary produced was a practitioner full of what Ontario calls ‘counsel’ and pretty much void of ‘healing’.
So we have, in North America and globally, our accredited centres with certified supervisors running approved programs that ‘produce’ certified practitioners. By the standards of our professional associations(internationally), until fully certified there is to be no independent / unsupervised practice. Which means that, in CASC’s professional view (i.e. according to CASC Standards, regulating CASC members), the pastor of St. John By The Gas Bar church has to restrict her/his caregiving to her/his own flock unless (a) she/he is in a CPE or PCE program giving care under Supervision, or (b) she/he is Certified in Pastoral Care or Pastoral Counselling, or conceivably (c) she/he is working under clinical supervision.
All of which is to say that chaplains and pastoral counsellors are not “out there counselling” according to the definition used by the Ontario government. What we are “out there doing”, instead, is held up within the scope of practice (and, in particular, the regulated act) of the College of Registered Psychotherapists. So, as long as we are giving direct care (as opposed to non-patient/client care roles like administration), we chaplains and pastoral counsellors need to belong to this College.
Clarity on these matters is essential. And clarity about our professional role and work cannot be sought from outside our profession … for example, by asking people within the MOHLTC, the Transitional Council or even the College Registrar, operating as they do on past experiences and caricatures (of ‘nice chaplains’ and ‘traditional pastoral counsellors’) more-so than from complete familiarity with CASC Standards.
Finally, a spotlight needs to be shone on a large piece of work being undertaken across the province of Ontario to explore and potentially move CASC training into full alignment with the College’s requirements. Marvin Shank, Neil Elford and Cindy Elkerton are the ‘prime movers’ of this work, but two broadly-based working groups have met under their direction, and two permanent provincial committees (Education and Practice) are in process of formation, all of it designed to address CASC competencies alongside those of the College. It is exciting work! Another independent aspect of this whole area of development is that two CASC teaching centres are among the ten (across all the modalities of psychotherapy training) piloting the College’s process for a training modalilty/centre to be fully recognized by the College (i.e. recognized as producing graduates who directly qualify as members).
So then, in summary, the CASC-Ontario membershipis not quite yet queuing, butnow we can start preparing in earnest to queue,for membership within the Ontario College of Psychotherapists. And increasingly Ontario CASCers are recognizing this College as a place we can feel ‘at home’ (which is pretty much ‘icing on the cake’ of being required by law, as we are, to belong!). “Stay tuned” both to the College website and to communications from the CASC-Ontario Council regarding this entry-to-College phase of CASC life in Ontario.