Visioning Ontario's "Association Life" distinct from "College Life" for Spiritual Care Professionals Bob Bond April 2011

Subtitle: Professional Associations (‘ours’ for Spiritual Care, in particular) Alongside Ontario’s College of Psychotherapists and Registered Mental Health Therapists as per RHPA, 1991; the 2006 Health System Improvements Act; & the 2009 Regulated Health Professions Statute Law Amendment Act

Professionals create Associations  Required within a fully formed professional association are the following:  a specialized body of knowledge under a duty of service to the public to apply that knowledge  a unique service to the public that the public cannot otherwise provide for itself  a scope of practice  professional standards  a code of ethics  an education program  a certification process  continuing education  a complaints and discipline process  legislation providing for self-regulation  the exercise of independent professional judgment  errors and omissions insurance

Governments create Colleges  Where malpractice by a professional can cause harm, the government responds by holding the professional to account within a College.

Governments create Colleges - the MOHLTC …  Duty of Minister  3. It is the duty of the Minister to ensure that the health professions are regulated and co- ordinated in the public interest, that appropriate standards of practice are developed and maintained and that individuals have access to services provided by the health professions of their choice and that they are treated with sensitivity and respect in their dealings with health professionals, the Colleges and the Board. 1991, c. 18, s

Governments create Colleges - the MOHLTC …  Powers of Minister  5. (1) The Minister may, 5. (1)  (a) inquire into or require a Council to inquire into the state of practice of a health profession in a locality or institution;  (b) review a Council’s activities and require the Council to provide reports and information;  (c) require a Council to make, amend or revoke a regulation under a health profession Act or the Drug and Pharmacies Regulation Act;  (d) require a Council to do anything that, in the opinion of the Minister, is necessary or advisable to carry out the intent of this Act [RHPA, 1991], the health profession Acts or the Drug and Pharmacies Regulation Act.

Regulated Health Professions Act, 1991 Controlled acts 27. (2)27. (2) A “controlled act” is any one of the following done with respect to an individual: 1. [Communicating … a diagnosis] 2. [Performing a procedure … below the dermis]

RHPA, 1991 Controlled acts 3. [Setting … a fracture] 4. [Moving the joints of the spine] 5. Administering a substance by injection or inhalation. 6. [Putting an instrument, hand or finger in a body opening] 7. [Applying a form of energy]

RHPA, 1991 Controlled acts 8. [Giving a drug] 9. [Giving eye glasses] 10. Prescribing a hearing aid for a hearing impaired person. 11. [Giving a dental appliance] 12. Managing labour or conducting the delivery of a baby. 13. [Allergy testing]

RHPA, 1991 Controlled acts Note: On a day to be named by proclamation of the Lieutenant Governor, subsection (2) is amended by the Statutes of Ontario, 2007, chapter 10, Schedule R, subsection 19 (1) by adding the following paragraph: 14. 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 judgement, insight, behaviour, communication or social functioning.

Bill 171, Health System Improvements Act  An Act to improve health systems enacts, amends and repeals legislation  Schedule R, Psychotherapy Act, 2007 College established: The College of Psychotherapists and Registered Mental Health Therapists

Psychotherapy Act, 2007 Scope of practice 3. The practice of psychotherapy is 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.

Psychotherapy Act, 2007 Authorized Act 4. In the course of engaging in the practice of psychotherapy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, 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 judgement, insight, behaviour, communication or social functioning.

Psychotherapy Act, 2007 Restricted titles 8. (1) No person other than a member shall use the title "psychotherapist" or "registered mental health therapist", a variation or abbreviation or an equivalent in another language.

Government Activity Since Passage of Act …  Government call for applications to the Transitional Council Issued April 2008 Closed May 30, 2008 ‘successful’ applicants from across the OCMHP

Government Activity Since Passage of Act …  Government appointment of a College Registrar, Joyce Rowlands, in October 2008

Government Activity Since Passage of Act …  On May 11, 2009 the Ontario government introduced Bill 179: Regulated Health Professions Statute Law Amendment Act, 2009

Regulated Health Professions Statute Law Amendment Act, 2009 Specifically, the bill proposes that:  The Psychotherapy Act, 2007 be amended so that the protected title “psychotherapist” is replaced with the title “Registered Psychotherapist”. The new title “Registered Psychotherapist” would only be available to those practicing under the College of Psychotherapists and Registered Mental Health Therapists of Ontario.

Regulated Health Professions Statute Law Amendment Act, 2009  Members of the five other Colleges who share the controlled act of psychotherapy will be entitled to refer to themselves as psychotherapist; but only within the context of also communicating their own college or professional designation. For example, a nurse practicing psychotherapy could refer to himself on a business card or sign as John Smith, College of Nurses of Ontario, Psychotherapist (-or- “Nurse-Psychotherapist”).

Regulated Health Professions Statute Law Amendment Act, 2009  The mandate of the College of Psychotherapists and Registered Mental Health Therapists of Ontario is amended to include developing, “in collaboration and consultation with other Colleges, standards of knowledge, skill and judgment relating to the performance of controlled acts common among health professions to enhance inter-professional collaboration, while respecting the unique character of individual health professions and their members”.

Government Activity Since Passage of Act …  Government appointment of Transitional Council (with ~3 year mandate) Named in September 2009

Transitional Council Activity “Registration”, “Professional Misconduct”, and “Quality Assurance” Regulations must be approved …before Psychotherapy Act, 2007 can be proclaimed …before Psychotherapy Act, 2007 can be proclaimed

23 October 30, 2009 Draft transitional Council Work Plan (Overview) for discussion purposes (t imelines approx.)

Pending Government Activity …  The Legislature’s debate, alterations and acceptance of the Transitional Council’s drafted regulations  The Permanent Council of the College takes over

Pending Activity by Spiritual Care Professionals  Ontario Association(s) To do the non-statutory self-regulating of professional Scope of Practice beyond “psychotherapy” To ADVOCATE!

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Advocacy –towards the Transitional Council

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Advocacy –that takes ourselves seriously –towards Employers –towards Faith Groups –towards / with / for Clergy without Professional Association

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Advocacy –towards Universities and Seminaries –towards Provincial Government Ministry of Health Ministry of Community Safety & Correctional Services Ministry of Community and Social Services

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Advocacy –towards the Federal Government Federal Corrections Canadian Military Matters of transportability –towards other professions / disciplines Professional Associations Provincial Colleges (at the very least, via the inter- college / inter-professional initiatives)

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Advocacy –towards ‘foci of care’ institutions, associations and working groups E.g. CCAC; FACS; Child Development Centres; Palliative Care; Cancer Care; mental health care (“psychotherapy” as an example); addictions care; trauma care; women’s health; men’s health; … –towards the general public E.g. How to distinguish qualifications and scopes of practice in Spiritual Care?

Visioning Ontario's SPRC "Association Life" distinct from "College Life" InterProfessional Education –Q: Beyond Chaplains, Pastoral Counsellors and Faith Community Leaders, who all claims to provide “spiritual care”? educates its members in the realm of “spiritual care”? does research in “spiritual care”? –A: Physicians, Nurses, Social Workers, Rec Therapists, Psychologists … Should not we (in SPRC) be leading them?

Visioning Ontario's SPRC "Association Life" distinct from "College Life" How to relate to the SPRC providers outside our ranks? –In Ontario: Consider OCA, OMC, CSO, Police Chaplains, University + College + School + Military Chaplains, ‘Spiritual’ or ‘Religious’ Therapists or Counsellors –A Possibility: Embrace them! [since some of ‘them’ will be in provincial Colleges with us as well] … Then: How to ‘get them in’ [i.e. into CASC] in a way that respects them (their actual competency) as well as upholding / respecting ourselves? The 2004 proposal from the Designation Task Force, led by CASC’s vice president, considered and informed this.

Religious CareSpiritual Care “Associate Member, Religious Care” -or- if not in CASC, a “Religious Care Volunteer” - “entry level” - usually a congregational or faith specific volunteer with no or little specialized training, but has the approval of their faith community to ‘visit their own’ “Associate Member, Spiritual Care” -or- if not in CASC, a “Spiritual Care Volunteer” - “entry level” - one who has taken some minimal amount of training and is functioning as a non faith specific spiritual care visitor - works at active listening; providing information and supplying resources; helping with programs; making appropriate referrals - supervised / directed / managed

Religious CareSpiritual Care “Member, Religious Care” -or- if not in CASC, a “Religious Care Practitioner” - a person of recognized standing within, and accountability to, their congregational or faith community / denomination. (e.g. ordination) - exercises leadership and care for own faith community - may have some specialized training (CASC/ ACSS or other) “Member, Spiritual Care” - demonstrated-and-growing competence in a multi-faith context; ability to “journey with” others. - Advanced SPE ‘standing’ - Completed at least one year of Masters- level studies - Endorsed by own faith community for multi-faith care-giving OR is currently registered in a Basic-level SPE program within the institution where the care is being provided. - a “Member” of CASC/ACSS - compliance with CASC/ACSS Code of Ethics - Continuing Education Requirement - or- in an ongoing SPE training process - Mentorship and/or ongoing Performance Review by a “Clinical Member” -or- in an ongoing SPE evaluation process

Religious CareSpiritual Care “Clinical Member, Religious Care” -Certified by CASC/ACSS as a specialist but practicing within their denomination or faith group i) Compliance with CASC/ACSS Code of Ethics ii) Continuing Education Requirement iii) Peer Review every 5 years - professional autonomy - competent as per “Competencies” document “Clinical Member, Spiritual Care” -is a Certified Member of CASC/ACSS functioning at the level of Specialist i) Compliance with CASC/ACSS Code of Ethics ii) Continuing Education Requirement iii) Peer Review every 5 years -professional autonomy -competent in spiritual assessment and care, self-awareness, spiritual & personal development, multi- dimensional communication, documentation and charting, brokering diversity, ethical behaviour, collaboration & partnerships, leadership, and research (as per “Competencies” document)

Religious CareSpiritual Care “Advanced Practitioner, Spiritual Care” Is a Certified Member of CASC/ACSS with additional approved training in one or more of the following: Ethics; Teaching / Supervision (CPE or PCE); Research; Clinical Practice [Spiritual Direction, Clinical Specialties (e.g. palliative care, geriatrics, mental health, pediatrics, forensics)]; psychotherapeutic modality

Visioning Ontario's SPRC "Association Life" distinct from "College Life" Professional Leadership for an Ontario SPRC Association –By volunteers? We know, and understand, the limitations imposed when working above-and-beyond full time employment. There cannot be ‘fullness’ of energy, or scheduling flexibility / freedom. –By paid leaders? …A suggestion re: financing … Greatly increase membership by opening more-porous boundaries; establish a formulae whereby the Province (or Region) keeps ever-larger proportions of newly gained membership money as ‘base funding’.

Returning to “where we are at” … the Barriers:  4 Regions of CASC in Ontario  Ontario Chaplains and Pastoral Counsellors aligning with OMC, CSO, OCA (basically defunct), and now OACCPP and CCPA besides CASC Non-CASC-certified practitioners in jails, colleges and universities, the military, many hospitals, most of LTC, hospice / palliative care

Returning to “where we are at” … the Barriers:  Competency in the provision of Spiritual Care is not identifiable by Government Other Professions Employers Faith Communities (!!!) The Public

Conversation ? ? ? Comments ? ? ? Questions ? ? ?

Thanks ! ! !