Specialty clinicians in talks to regulate mental health workers
The regulatory college would establish a code of ethics and a minimal number of clinical supervision hours required for its members
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Anyone in Manitoba can call themselves a therapist and there are no repercussions if they prey on clients by providing costly mental health services with zero qualifications to do so.
The Federation of Associations for Counselling Therapists in Manitoba wants that to change.
The new alliance of specialty clinicians known as FACT-MB is seeking powers to self-regulate its workforce after decades of debate about whether mental health workers need a regulatory college.
“If you decided tomorrow you wanted to start a private practice and ‘I want to be a therapist,’ there’s nothing stopping you from doing that,” said Veronica Ruiz, a marriage and family therapist in Winnipeg who runs Stone Flake clinic.
Concerns about the unregulated status have heightened alongside surging demand for counselling throughout the COVID-19 pandemic, she said, noting different groups of therapists have struggled to gain momentum in the past due to the small size of their respective populations.
Ruiz is president of the Manitoba Association of Marriage and Family Therapy — one of nine local organizations that have partnered to advocate for a regulatory body.
In May 2021, FACT-MB submitted a more than 500-page application to the province to request it allocate funds to develop a governing body of “counselling therapists,” not unlike the College of Physicians and Surgeons of Manitoba.
The proposed college would regulate clinicians who work as: psychotherapists; relational or family therapists; marriage therapists; professional counsellors; spiritual care practitioners or psycho-spiritual therapists; and art, music or drama therapists.
It would establish a code of ethics, professional development standards and a minimal number of clinical supervision hours required for its members, according to the blueprint.
Applicants would be required to meet more than 100 different competencies – the equivalent of a master’s-level education – that range from a solid understanding of client boundaries to remote service delivery expertise.
The body would also allow members of the public to search a registry of clinicians that highlights each individual’s qualifications, as well as their status, and report any concerns about a therapist to spark an investigation.
While there are regulations for mental health practitioners’ approved titles and activities in New Brunswick, Nova Scotia, Prince Edward Island, Ontario, and Quebec, therapy is unregulated elsewhere in Canada.
It’s optional for Manitoba clinicians to apply to join professional associations and seek accreditation from national bodies, none of which have strong enforcement abilities.
FACT-MB chairwoman Melody Newcomb said the problem with existing entities, including the Music Therapy Association of Manitoba, of which she is a member, is that they have no teeth to penalize incompetent counsellors.
The music therapist indicated the province has raised questions about whether harm is being done at present, and her response is the extent of the issue remains unclear because there is no central place for reporting malpractice.
“Every single therapist has heard horror stories of what clients have gone through with previous therapists,” said Carl Heaman-Warne, an instructor who teaches ethics in the master of marriage and family therapy program at the University of Winnipeg.
The most common form of malpractice, Heaman-Warne said he hears about, is a therapist has overstepped boundaries by either oversharing with a client or ghosting them because a subject that arose in a session triggered their personal issues.
In the current context — what he likened to “the wild west, in terms of practicing,” the veteran therapist recommended people searching for a counsellor seek referrals in their personal network and look up a potential candidate’s qualifications and memberships.
At the same time, Heaman-Warne said therapy is all about relationship-building so clients should trust their gut when it comes to a clinician’s professionalism and ask themselves if they feel comfortable a counsellor in question will make room for questions and respect their boundaries.
There are almost 190 local clinicians, students and associate members registered with the national organization that oversees marriage and family therapy. Ruiz, Heaman-Warne and Sandra Scott are among them.
Scott, clinic director of Winnipeg’s Thrive Counselling, said a college would not only hold professionals accountable, but it would also allow clients to see scroll through experts with an array of specialties – from professionals versed in supporting people with eating disorders to those who excel in guiding couples.
“It’s very concerning (we do not have regulation) — especially because the majority of people who are seeking therapy are in a vulnerable place in their life,” she added.
Over the last year and a half, there have been public hearings and stakeholders consultations on FACT-MB’s proposal.
The review process is now in its final stages; the council tasked with evaluating all applications put forward by unregulated healthcare professions is drafting recommendations for the province.
A spokesperson for Mental Health Minister Sarah Guillemard indicated her office is awaiting advice on next steps from the health professions advisory council.
The department’s five-year action plan “underscores the need to develop quality standards for addictions treatment programs and to measure and track system performance,” the spokesperson wrote in an email.
“New professional regulations” is among the priorities listed in the February 2022 document.
Heaman-Warne said the establishment of a college could prompt the expansion of workplace health coverage to include therapy for more Manitobans because insurers often look for regulation.
“Everybody comes into this profession with their heart in the right place and everybody is aware of how when any therapist is acting unprofessionally, it undermines all of us collectively,” he said, noting he has yet to hear any therapist vocalize opposition to the creation of a college.
Harold Wallbridge, registrar of the college governing psychologists in Manitoba, indicated professionals in his field are broadly in support of their colleagues’ desire to self-regulate.
The Manitoba College of Social Workers has expressed concerns.
“Protection of the title ‘counselling therapist’ crosses over into the core functions of counselling and therapy — an act (rather than a distinct profession) practiced by other regulated professions,” executive director Barbara Temmerman said in an email.
A total of 41 individuals — about two per cent of members — are registered with the college despite not having a social work degree. These clinicians have a limited scope of practice that allows them to do assessments and counselling at present.
Maggie Macintosh reports on education for the Winnipeg Free Press. Funding for the Free Press education reporter comes from the Government of Canada through the Local Journalism Initiative.