The Regulation of Counsellors across Canada OVERVIEW AND POLICY QUESTIONS for the National Symposium on Counsellor Regulation November 21 and 22, 2005 Vancouver, British Columbia OVERVIEW The following general comments and observations can be drawn from the information in the November 10, 2005 Summary Report on the Regulation of Counsellors Across Canada: A) Statutory regulation 1. Counsellors are a regulated profession only in Quebec, albeit focused on specific types: guidance counsellors, psychoeducators, and marital and family therapists.1 Nothing like “controlled acts” (Ontario) or “reserved actions” (BC) have been granted to the estimated 5,700 Quebec counsellors. There are now discussions on whether psychotherapists should also become regulated. 2. In many if not all provinces, many practitioners who provide counselling services may also be registrants of an existing health, social service or education profession; e.g. psychologists, registered or psychiatric nurses, clinical social workers, or school counsellors. B) Voluntary regulation 3. In some provinces, only a few persons who advertise that they are providing counselling services are not regulated through an existing college; in other provinces, there are many persons who provide counselling but are not regulated, except possibly through voluntary self-regulation. 4. There does not appear to be a single, over-arching or widely accepted definition of counselling, at least not as a health profession. Some definitions focus on mental health and personal growth, while others extend beyond “health” and include camp, financial, religious, real estate and other forms of “counselling”. Ontario is looking at a definition of psychotherapy rather than counselling. 5. Counsellors refer to themselves by a number of titles or provide services to the public in different of forums, ranging from addictions through to pastoral counselling. Some counsellors focus on specific populations (e.g. youth, elderly, couples, families), while others focus on specific types of counselling therapies (e.g. art therapy, music therapy, psychotherapy or marriage and family therapy). 6. Therefore, it is not surprising that there is no available or reliable data on the total number of persons who provide counselling to the public. Based on projections from those provinces that have some data, a rough estimate is that there are about 40,000 persons across Canada who provide “health” counselling (i.e. counselling that is directed at mental health and personal growth). 1 Persons who provide family mediation (“family mediators”) are usually also members of another professional body, such as law, social working, psychology, etc. 7. The most common entry standard for being registered a counsellor (regulated or non- regulated) is a master’s degree in counselling or some related field. 8. The Agreement on Internal Trade requires that a college’s entry standards be competency-based so that, regardless of what academic standard it may impose, the college must be able to prove that that requirement relates principally to competence. BC Task Group and the Ontario Coalition have agreed that a competency profile analysis should be used to inform the entry standards that would be set within their proposed regulatory models. 9. Most of the professional associations have bylaws in place that allow them to investigate and resolve public complaints against their members, but very few receive many if any complaints and most lack the resources to actively promote this aspect of their bylaws. 10. Only four provinces have an umbrella health professions governance statute that could be used as a framework for having counselling regulated: Quebec, Ontario, Alberta and British Columbia. For the other provinces, it would appear that a dedicated and separate counselling regulation statute would have to be approved by the Legislature. 11. Some of the national associations provide a basis to regulate members of their provincial bodies by way of occupational titles granted under the federal Trade-Mark Act; e.g. the Canadian Counselling Association and the Canadian Association for Music Therapy.2 However, this is a limited form of title protection that still relies on member cooperation and goodwill to succeed. 12. There is some movement toward the regulation of counselling in British Columbia and Ontario, as those governments are pursuing legislative options. While BC is not actively looking at regulating psychotherapy/psychotherapists, the Ontario Regulated Health Professions Advisory Council is studying that issue. 13. In the other provinces, the professional associations are still in the preliminary stages of having governments consider the possibility of regulating counselling. Many governments in the “smaller” provinces appear to be content to wait to see what happens in British Columbia and Ontario. Some also believe that most of the practitioners who provide counselling are currently members of existing professions. 14. In general terms, the major issues that are holding back the regulation of counselling in any jurisdiction appear to be: (a) the need to prove a case for regulation by a thorough risks of harm analysis, and by that analysis - to define the most appropriate model for regulation; (b) the need to define what constitutes counselling for the purposes of regulation (either as a broad scope of practice definition, or if it – or some subset of counselling -is to become a controlled/reserved action); (c) the need to define what the competencies (e.g. education/training and experience) should be for entry into the profession; and It is now no longer possible for a professional association to obtained occupational title protection under the federal Trade-Mark Act. Only BC has the capacity through its Society Act to grant title protection for other professions, but this option is also no longer available. (d)the need for the different counselling associations whose various members would be regulated by a single college to demonstrate cooperation and agreement on the major issues, including a commitment to fund the start-up phase of the college. POLICY QUESTIONS The following are offered as questions to help stimulate a discussion on the regulation of counsellors across Canada during the roundtable. These are not necessarily all the questions that will be discussed, nor will they be considered in this order. 1. What does it take to move governments to agree to regulate counselling as a health or helping profession? For example: Before they will move forward with approving new legislation, do governments have to complete a social policy and risks of harm analysis that clearly demonstrates that regulation is needed and identifies the specific model that should be employed? 2. With or without that analysis, do the associations have to engage in government lobbying and public relations campaigns to move the issue of professional regulation forward? If so, how should such a program be organized, and what should be the message(s)? 3. What type of regulatory model would work best for regulating counsellors or psychotherapists? A title protection (“certification”) model? Or a controlled acts / reserved actions (“licensing”) model? And why? (See also the following question.) 4. If one or more controlled/reserved acts are to be employed within the regulatory model, how should those acts be defined? And how would it relate to the broader definition of counselling practice? In other words, what aspects of counselling practice should become controlled/reserved acts? In particular, should “psychotherapy” or “psychological diagnosis” become controlled/reserved acts? And why or why not? 5. If only a title protection model should be used for regulating counsellors, what professional title(s) would best identify the members of a statutorily regulated counselling profession composed of practitioners with diverse backgrounds and orientations? 6. Should counsellors join together to create their own college? Or should they join with professions in another existing college, such as social workers or psychologists? What are the advantages and disadvantages of these governance options? 7. Should a “uniform” or “model” Regulation of Counsellors Act be prepared that could then be adopted by those provinces which do not currently have an umbrella health professions statute? (This would include model college bylaws, a uniform set of entry-level competences, a common code of ethics, universal practice standards, etc.) Or should some sort of social policy discussion paper be prepared before a model act is drafted? Or should the model act be part of the discussion paper? 8. How long should the various professional associations continue to regulate their members in the public interest if there is no indication that their provincial government is going to move forward with regulation? Or should the associations continue with voluntary, self-regulation even if a government decides not to regulate counselling, because that activity still provides benefits to their members?