Currently no minimum training required

By Rachel Fraser

The Province has recently concluded the first step in regulating psychotherapy in BC.  On June 24th, public consultation wrapped up on whether to designate the practice of psychotherapy as a Health Profession under the Health Professions Act, after which the government will decide on formal regulation.

Despite decades of lobbying by the profession, counsellors and mental health practitioners remain largely unregulated in BC. The exceptions are those registered with either the College of Psychologists, requiring a PhD in psychology, or the BC College of Social Workers, which are regulated outside of the Health Professions Act altogether.

Chantel Fewtrell, a counselling student offering online sessions to Valley residents from her home in Golden, said she supports the move.

“I think it will legitimize the profession, as well as make it safer for people. They know that they’ve got competent practitioners.”

Fewtrell is completing both a psychotherapy diploma and a PhD in Psychology but coming from a regulated background as a Registered Nurse, she found going into this profession there are so many grey areas, and the requirements are vague. Echoing advocacy groups, she expects that regulation will increase access to therapy by increasing the confidence of benefit providers and insurance programs that currently only cover Registered Psychologists or Social Workers.

“I think they’re more likely to endorse something that has tighter regulations around it,” she said.

The term “psychotherapy” is loosely defined, and generally used interchangeably with “clinical counselling” in BC as an umbrella term for a variety of modalities of talk therapy used to treat mental disorders and other mental health-related problems resulting in a patient’s psychological suffering, according to an explanatory note provided by the Ministry of Health.

Without regulation, there is no minimum training required to call oneself a psychotherapist or clinical counsellor and begin offering services, nor is there any binding disciplinary process for damage caused by incompetence or ethical breaches.

Professional member organizations such as the BC Association of Clinical Counsellors (BCACC) voluntarily self-regulate. In recognition of Masters-level education in a counselling program, ongoing professional development, and adherence to its standards of practice and code of ethics, the BCACC provides its members the designation of Registered Clinical Counsellor. The Association of Cooperative Counselling Therapists of Canada offers a competency-based Registered Therapeutic Counsellor  designation with different educational or experiential qualifications than a master’s degree.

These organizations have complaints processes and can discipline their members for breaches of ethics, but participation is voluntary. A counsellor facing a complaint or disciplinary process can simply quit the organization and continue offering services without a registered designation.

If approved, the rollout of regulation and how it will affect current practitioners is well in the future and no details are yet available, but other regulated provinces offer clues. According to the Canadian Counselling and Psychotherapy Association, though the others did not regulate around a single professional organization or exclusively admit one designation type, all new applicants registering to practice psychotherapy or clinical counselling require master’s degrees in counselling-related disciplines.

In the Robson Valley, local mental health supports are limited to those provided through the Northern Health Community Mental Health and Addictions programs, and Robson Valley Community Services (RVCS), though many private-practice counsellors, such as Fewtrell, based elsewhere in the province offer remote video or telephone sessions.

When asked what designations or education are required for counsellors serving the Valley as part of their mental health and addictions programming, Northern Health issued a statement confirming they employ a Mental Health and Addictions Clinician, and saying only that it is too early to say what effect regulation would have on the programs they offer here, and that they are committed to providing access to mental health and substance use services in Valemount and will work to ensure continuity of care through any regulatory changes. A job posting for that role in similar BC communities lists the qualifications required as a Bachelor’s Degree in an allied health, behavioural or social science or equivalent related knowledge, skills and experience.

Donalda Beeson, Co-Executive Director and Manager of Therapeutic Services for RVCS, said that Child and Youth Mental Health (CYMH) clinician is required to have a master’s degree, but not necessarily to have a Registered designation. Other roles that include counselling require a bachelor’s degree.

“As such, while working in counselling programs they cannot perform psychotherapy but rather are meant to provide psychoeducation,” she said.

Psychoeducation is another broadly defined term that can have some overlap with psychotherapy. According to the mandate for the The Prevention, Education, Advocacy, Counselling, and Empowerment Program for Children and Youth Experiencing Violence, a counselling program administered by RVCS, the focus of psychoeducation is on empowering the program participant through information and strategies, building coping skills and helping the participant explore their feelings and experiences.

The Ministry of Health said in an email that the decision to designate “psychotherapy” as a new health profession under the HPA is made by Cabinet, in regulation, and that feedback from the consultation will be used to inform that decision. No timeline on that process has been provided, and results of the public consultation are not yet available.