Some physiotherapists may have heard that the controlled act of psychotherapy recently came into effect and that as a result, only certain professions, not including physiotherapists, are now allowed to perform the act. These professions include: psychotherapists, psychologists, physicians, social workers and social service workers, occupational therapists and nurses.
This is true, but it is not the full story.
The way that the controlled act of psychotherapy is defined in the Regulated Health Professions Act still permits health professionals to use psychotherapy techniques in their practices in some circumstances.
The controlled act is defined in the RHPA 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 judgment, insight, behaviour, communication or social functioning.”
Based on this definition, the controlled act has five components. All of them must be present to make performing a psychotherapy activity a controlled act:
- You are treating a patient
- You are applying a psychotherapy technique
- You have a therapeutic relationship with the patient
- The patient has a serious disorder of thought, cognition, mood, emotional regulation, perception or memory
- This disorder may seriously impair the patient’s judgment, insight, behaviour, communication or social functioning
Since all these condition must be present, it is possible for you to use psychotherapy techniques without performing the controlled act of psychotherapy. For example, if only four of these components apply, you are not performing the controlled act.
You are in the best position to determine whether performance of psychotherapy techniques falls within the definition of the controlled act by using these criteria to assess what you are doing, and the circumstances in which you are doing it.
As a practical example, if you are a physiotherapist who uses a psychotherapy technique (e.g. Cognitive-Behavioral Therapy) to treat patients, you might conduct an analysis as follows to determine if you can continue to provide this therapy:
- Am I are treating a patient?
- Am I applying a psychotherapy technique?
- Do I have a therapeutic relationship with the patient?
- Does my patient have a serious disorder of thought, cognition, mood, emotional regulation, perception or memory?
- Does my patient’s disorder have the potential to seriously impair the patient’s judgment, insight, behaviour, communication or social functioning?
If the answer to one or more of the questions in the analysis is no, you are not performing the controlled act of psychotherapy.
If you'd like more information be sure to review this article further outlining the Psychotherapy Act, 2007.