February 2019 - CRPO

1 1 Professional Practice & Jurisprudencefor Registered PsychotherapistsFebruary 20192 PROFESSIONAL PRACTICE & jurisprudence FOR REGISTERED PSYCHOTHERAPISTSP rofessional Practice & jurisprudence for Registered Psychotherapists February 2019 TABLE OF of Terms and Abbreviations ..7 Section 1: Professionalism and Self-Regulation .. Concept of Self-Regulation .. Self-Regulatory Framework ..8 Role of the College ..8 Role of the College Council .. , Professional Standards, Professional Misconduct, Incompetence & Incapacity .. of Ethics ..11 Practice Standards ..13 Misconduct ..14 IV. V. Incapacity.

2 15 Section 2: Client-Therapist Relationships ..17A. Introduction .. Consent ..17I. Consent ..17 Concept of Informed Consent ..19 of Receiving Consent ..20 Where the Client is Incapable ..20 Decision-Maker ..21 VI. Emergencies ..23C. Boundaries ..25I. Self-Disclosure ..25 or Receiving of 25 Relationships ..26 Established Customs ..26 3 PROFESSIONAL PRACTICE & jurisprudence FOR REGISTERED Opinions ..26 Friends ..27 VII. Touching .. Abuse .. of Sexual Abuse ..28 a Spouse or Partner ..29 Former Clients and Handling Sexual / Romantic Feelings for Clients ..29 of Allegations of Sexual Abuse by the College.

3 Collaboration .. Role of the Client ..31 for RPs to Consider ..31F. Billing .. a Client About Fees ..32 When No Service Is 33 Reductions and Free Consultations ..33 Section 3: Law .. of law .. Health Professions Act (RHPA) .. Acts and Delegation ..34 of Practice ..39 of Titles ..40 uThe Doctor Title ..40 uRP / Registered Psychotherapist and RMHT / Registered Mental Health Therapist titles ..40 41 uSexual Abuse Mandatory Report ..42 uIncompetence, Incapacity and Professional Misconduct Mandatory Report ..43 uOffences Mandatory Self-Report ..44 uProfessional Negligence Mandatory Self-Report.

4 44 uDuty to Warn & Mandatory Reporting ..45 Register ..47 Corporations ..474 PROFESSIONAL PRACTICE & jurisprudence FOR REGISTERED Act, Regulations, By-Laws .. Regulation ..48 Misconduct Regulation ..49 uConduct towards the College ..50 uCatch-all Provisions ..50 III. Record-keeping ..51 uHow records are kept ..51 uHow long to keep records ..52 uMaintaining or transferring records upon leaving a practice or retiring ..52 uConfidentiality and privacy issues ..52 uClient access to records .. of Interest ..54 V. Advertising .. College .. Process ..57 and Discipline Process ..58 uFormal Complaints.

5 58 uInvestigations of Registrar s Reports ..59 uPossible Outcomes of the ICRC Process ..59 uDiscipline Proceedings ..60 Process ..61 uHearings Before the Fitness to Practise Committee ..62 uAppeals ..62 Assurance Program ..63 uSelf-assessment and professional development ..64 uPeer and practice assessment and remediation ..64 uFollow up Actions .. laws .. Health Information Protection Act (PHIPA) ..66 uProtecting Personal Health Information ..67 uCollection, use and disclosure of personal health information ..67 uAccess to Personal Health Information ..68 uCorrection of Personal Health information.

6 69 uComplaints ..69 Information Protection and Electronic Documents Act (PIPEDA) ..70 Care Consent 71 5 PROFESSIONAL PRACTICE & jurisprudence FOR REGISTERED Health Act ..72 uTypes of Admission to a psychiatric facility ..72 uUse of restraints ..73 uApplication for Psychiatric Assessment (Form 1) ..73 uCommunity Treatment Plans ..75 and Family Services 77 Care Homes Act ..79 Rights and Accessibility Legislation ..80 uHuman Rights Code ..80 uDuty to Accommodate ..81 uAccessibility for Ontarians with Disabilities Act ..82 VIII. Municipal Licensing ..85 Conclusion ..856 PROFESSIONAL PRACTICE & jurisprudence FOR REGISTERED PSYCHOTHERAPISTSOVERVIEWThe purpose of this handbook is to provide information on the ethical and legal framework within which Registered Psychotherapists (RPs) practise in Ontario.

7 There are three main sections to this document. Section 1 discusses professionalism and self-regulation and how these concepts apply to therapists. It explains the regulatory framework that governs self-regulated health professions in Ontario, including setting out the role of the regulatory college. Section 2 looks at client-therapist relationships; how open communication with clients and colleagues is fundamental to professional practice; and how this fits within the self-regulatory framework. The third and final section reviews the various laws that RPs are most likely to deal with in their PRACTICE & jurisprudence FOR REGISTERED PSYCHOTHERAPISTSGLOSSARY OF TERMS AND ABBREVIATIONSIn this document a number of Acts are referred to by their abbreviations, including the following.

8 AODA - Accessibility for Ontarians with Disabilities Act, 2005 CFSA - Child and Family Services Act, 1990 HCCA - Health Care Consent Act, 1996 MHA Mental Health Act, 1990 PHIPA Personal Health Information Protection Act, 2004 PIPEDA Personal Information Protection and Electronic Documents Act, 2000 RHPA Regulated Health Professions Act, 1991 Other abbreviations include the following: CAS Children s Aid Society CCB Consent and Capacity Board CTO Community Treatment Orders HPARB Health Professions Appeal and Review Board HPRAC Health Professions Regulatory Advisory Council ICRC Inquiries, Complaints and Reports Committee QA Program - Quality Assurance Program RP Registered Psychotherapist SDM Substitute PRACTICE & jurisprudence FOR REGISTERED PSYCHOTHERAPISTSSECTION 1: PROFESSIONALISM AND SELF-REGULATIONA.

9 THE CONCEPT OF SELF-REGULATIONR egistered Psychotherapists (RPs) are Members of a self-regulated profession and as such have special duties and responsibilities to the clients they serve, to their coworkers and to their regulatory college, which is the College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario (the College), also known as the College of Registered Psychotherapists of Ontario. RPs are also subject to a number of laws and regulations. As part of the self-regulatory framework, the College sets out by-laws which apply to its Members and a code of ethics to provide guidance.

10 Members also work within a scope of practice and must follow specific standards of practice. In Ontario, many health professions are self-regulated under statute. In other jurisdictions, similar professions may be regulated directly by government or through general consumer protection laws. Ontario s regulatory model serves as the basis for professional regulation in several other jurisdictions, and is seen by many as a model of choice. I. The Self-Regulatory FrameworkSelf-regulation under statute is a relatively new concept for psychotherapists in Ontario. RPs will be regulated under the Regulated Health Professions Act (RHPA) and the Psychotherapy Act when the latter comes fully into force.