By: Christina Crowe, RP

Google “therapist” in your town, and your feed will be filled with all sorts of practitioners, ranging from mental health professionals to “aroma therapists”.  Narrow down your mental health query to “registered psychotherapist” and you will find a list of clinicians close to you who are registered with the College of Registered Psychotherapists in Ontario (CRPO), or “psychotherapist” to find social workers registered with the Ontario College of Social Workers and Social Service Workers (OCSWSSW).

Mental health has received increasing media coverage and awareness in the public sphere, thanks to many years of hard work from advocates who’ve worked on reducing the stigma associated with mental illness.  

More and more, we see people comfortable enough to come forward as they consider being more proactive about their own mental health, or continuing to seek treatment for existing disorders.  If we have collectively learned anything over the past decade, it’s that – let’s face it, in Ontario – we have to take our health care into our own hands. And when it comes to mental health care the Ontario system is, unfortunately, not universal. Besides Registered Psychotherapists – who are Members of the CRPO – the members of five other regulated professions can also practice psychotherapy: nurses, occupational therapists, physicians, psychologists, psychological associates, social workers and social service workers. 

Is there a difference between psychotherapy and counselling?

There is a technical one: the Health Professions Regulatory Advisory Council (HPRAC)[1] distinguishes between psychotherapy & counselling as follows:

“The practice of psychotherapy is distinct from both general counselling, where the focus is on the provision of information, advice-giving, encouragement and instruction, and spiritual counselling, which is counselling related to religion or faith-based beliefs.”

The Ministry of Health and Long Term Care further defines psychotherapy as,

The assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication…. to treat, 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 (2007, c. 10, Sched. R, s. 3). 

That’s a mouthful! 

In simpler terms, psychotherapy is a collaborative wellness and treatment strategy based on the relationship between an individual/couple/family and the therapist.  Based on this definition, highlighting the healing relationship, it might be easy to see how the qualifications and experience of your chosen therapist start to become really important. 

While regulations allow many clinicians (such as your cardiologist, your GP, local nurse) to practice ‘psychotherapy’, not all clinicians have been trained to practice psychotherapy. It could be important to ask your potential therapist if their academic or clinical training included training in individual psychotherapy, and to treat the specific issue you are bringing to them.

When you chose a Registered (licensed) Psychotherapist, you can be assured of a high standard of education (at least a masters degree and a psychotherapy practicum), training specifically in providing individual, family or couple psychotherapy; ongoing education and government regulation. 

As health care professionals, psychotherapists work in a wide range of settings. Settings include: private practice, hospitals, clinics, care facilities, rehabilitation centres/programs, employee assistance programs, universities, and more.

10 questions to consider asking during your initial consultation call:

1. What is your academic training in individual, couple or family psychotherapy? 
2. What specialized training and/or experience have you had in working with the issue I am dealing with? 
3. Which Regulatory College do you belong to? 
4. What are your fees? 
5. How will my insurance claim be handled? (preferably fees and potential insurance coverage should be discussed on the phone prior to making the first appointment) 
6. What type of therapy do you do? (for example, behaviour therapy like CBT, experiential therapy like EFT, or modern psychoanalysis).
7. What are your practice protocols? (booking appointments, policy on missed appointments, emergencies, building access after-hours, etc.)
8. Can you provide a brief explanation as to what I can expect to happen in my sessions?
9. How many sessions will it take to resolve my issue? What can I expect?
10. How will my confidentiality be assured and further, what are the risks and benefits of psychotherapy?

Is Psychotherapy covered by the Public system?

​In Ontario, psychotherapy can be accessed both publicly with your OHIP card, as well as privately, either through your third party insurance or by paying yourself. 

Publicly, you can start with your family doctor, and some family physicians are specially trained in providing psychotherapy, though all physicians can technically provide some form of it.  You might be further referred to a psychiatrist, a hospital out or in patient program or a local public agency.  

Some publicly funded agencies will provide free counselling or psychotherapy services, and most will provide some free short term (1 or 2 sessions) or up to 5 sessions on a sliding scale based on income.  You can also see your clergy for faith-based counselling (generally free of charge). You can find these services by searching through your local CMHA website, or even our own Resources page). 

Privately, you have more access, mostly due to not needing a referral, and not sitting on a wait list.  

• You can access your employers extended benefits program, but will be limited by practitioner and have an annual cap that seems to usually be only 1-3 sessions.
• You find a local Registered Psychotherapist, or as in the past, a psychologist or social worker.  Each of these other specialties has some training in how to best help you.
• Many private practitioners have sliding scale rates (as do we), and some offer low cost, more affordable counselling if they are partners with graduate programs offering services with Masters degree level psychotherapy interns.

You should also know Registered Psychotherapists qualify as medical professionals by the CRA, so you can save your receipts for your annual tax return, as medical expenses. 

Given all of this information, the great news is, the government of Ontario is recognizing the need for greater access to standardized and quality mental health care. They are paying attention to who is delivering care, and hopefully, this will lead to making access more universal. In fact, Health Quality Ontario specifically recommends the public funding of evidenced based psychotherapy. You can read more of its recommendation here, and also see if the therapy you are getting for anxiety or major depressive disorder meets the Ontario standard here. 

All the very best in your search for support! To set up a free consultation call with an available therapist on our team, start HERE.

Reference

[1]HPRAC advises the Minister on whether unregulated health professions should be regulated, whether regulated professions should no longer be regulated, amendments to the Regulated Health Professions Act, a health profession act or a regulation under those acts, quality assurance and patient relations programs of Ontario’s health regulatory Colleges, and on other matters referred to it by the Minister.