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Therapist's Blog

Necessary Distinctions

12/21/2017

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I would like to take this moment to thank the Ontario Association of Social Workers for completing their 10 year goal of making it EVEN HARDER TO DISTINGUISH BETWEEN OUR PROFESSIONS.

I do not enjoy using my blog as a platform to complain; in fact, I recently started my old blog back up for that reason, but this is a HUGE issue that the general public has an incredibly difficult time understanding as it is and all for - what I can only assume anyway - to be able to garner more billing and/or reimbursement from insurance companies.

So, to provide context: Starting back in 2007-ish the OASW embarked on their mission to grant Social Workers who have completed the "proper" education and training - specifically in mental health counselling - the title of "Psychotherapist". At the time this was a venture worth pursuing. At the time, social workers were heavily involved in assisting with the treatment of mental illness and there were hundreds of opportunities for education specifically to become a therapist: A person capable of not just assisting in the treatment plan but also formulating - with their clients - treatment plans, identifying and assessing specific symptoms (still without diagnosis), and other activities that folks like myself do on a regular basis.

The necessity for the OASW's work was extinguished when the College of Registered Psychotherapists of Ontario stepped into the picture. This new governing body was established for the specific purpose of identifying, regulating, and accrediting educational programs that were producing practitioners in the then-unregulated profession of psychotherapy. The College has the legislative power to entrust the title of Psychotherapist (Registered or otherwise) onto its members in practice according to their training either in formal education (Master's degree programs) or informal education (non-diploma trainings).

Apparently the OASW didn't get the memo.

I want to draw a few necessary distinctions here and now:

Psychiatrist: A medical doctor who has completed their residency training in psychiatry - the medical field of psychology - and who is capable of diagnosing mental illness and prescribing medication. Psychiatrists often inform treatment planning and assist psychologists and psychotherapists in their practice depending on their practice area (many work in hospitals). 

Psychologist: An individual who has completed their Doctorate - either a Doctor of Philosophy (Ph. D) or Doctor of Psychology (Psy. D) - in Psychology or Psychology-related fields (ie. Counselling Psychology). Psychologists can assess and diagnose mental illness but generally practice psychotherapy at the highest level.

Psychotherapist: An individual who has completed their Master's Degree (or higher) in a mental health counselling-related field. Psychotherapists perform assessments and treat cognitive, emotional, or behavioural disturbances through a combination of specialized techniques in conjunction with the building therapeutic relationship. No diagnosis or prescriptions can be provided by a psychotherapist. Psychotherapists employ various techniques in order to freely engage exploration and expression of presenting problems. (Definitions provided by College of Registered Psychotherapists of Ontario and Ontario Association of Consultants, Counsellors, Psychometrists, and Psychotherapists)

Social Worker: An individual who collaborates with their clients and those within the client's circle of care to address challenges through the process of assessment, diagnosis, treatment, and evaluation as social support in order to help clients achieve psychosocial functioning. With various specific training a Social Worker can do many of the activities of a Psychotherapist however the title is (or was) reserved for those with formal education in counselling and/or psychology fields. Social Workers hold either a Baccalaureate or Master's Degree in Social Work. (Definition provided by the Ontario College of Social Workers and Social Service Workers (OCSWSSW))

Social Service Worker: An individual who assists clients in dealing with personal and social problems by delivering counselling, community services, and social support programs. These professionals hold a specialized post-secondary diploma or degree (depending on region where education was completed). (Definition provided by OCSWSSW)

Counsellor: An individual whose practice involves informing, advising, guiding and educating clients in various settings and in concordance to their training. There is currently a series of task forces studying the specific role and education of the profession and practice of Counsellor in order to improve the regulated title.

I completed my Master's program with many Social Workers (those who had completed their BSW programs and/or were members of the OCSWSSW) who then carried that title into their practice as Registered Social Worker (RSW) and Registered Psychotherapist (RP) as they were qualified members of both. However, the landmark conclusion made on the behalf of the OASW reopens the debate into the use and scope of these regulated titles in a way that is bothersome, if not insulting, to those of us currently in the field AND carries the added bonus of making things difficult for consumers.
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Investing in Mental Health

12/4/2017

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The provinces of Ontario (Oct 2017) and Quebec (Dec 2017) have made their opening pledges to invest in their respective province's mental health infrastructure. Ontario pledged about $73 million over 3 years and Quebec has started the ball rolling with $35 million but what does that mean for you?

At this point the short answer is: Not a whole lot - as many of my readers may suspect right off the bat. The $73 million in Ontario has already been earmarked for use in the province's 4 largest community-based mental health providers - Centre for Addiction and Mental Health (CAMH), Waypoint Centre for Mental Health Care, Ontario Shores Centre for Mental Health Sciences, and the Royal Ottawa Health Care Group. CAMH will also be receiving almost $633 million as part of an expansion to their campus which is basically a nearly-self-sustaining village designed to promote mental wellness.

As for the Quebec government, they have some work to do yet. As of right now there is no governing body for psychotherapists (Ontario has the College of Registered Psychotherapists) which means practicing psychotherapy in the province is (potentially dangerously) unregulated. To that end, Quebec is planning on building a governing body and then forming policies and procedures around the prospect of government-billing for practitioners. The statement was brief so I have no intentions pf extrapolating beyond that point.

My light-hearted pessimism aside this is a great time to be in need of mental health services. The pushes being made by the government highlight a very real need across the country even if they continue to show a lack of understanding of need on their part.

While we wait for something tangible to happen on the part of the regional governments here's what I am asking you - as a current or potential consumer of mental health services - to do:
Check your insurance coverage (if you have any) and see if Registered Psychotherapists (RPs) are covered. If so, ask for a receipt from your therapist and process your reimbursement accordingly.
If you do not have coverage:​​​
  1. ​Go to rptherapybenefits.ca and check out the information they are presenting. If this is something you want to advocate for then you can go under the "Resources" tab and hit "Resource List". You can then edit the template from there to tailor it to the Human Resources Benefits area of your employer requesting that they add RPs to their benefit plan.
  2. If you work in a unionized setting ask your union representative to add RPs to the list of professional services included in the group benefits plan during the next set of contract negotiations. In the same Resource List as above you can also find a template to write a letter to your union rep.
  3. Check to see if you have a Health Spending Account and see if you can use the funds in this account to cover services by an RP until you are covered directly in your benefit plan.
Another option that you can get your employer to access is an Employee (and Family) Assistance Plan (EAP or EFAP). The flip-side to this option is that there are usually significant limitations to the number of sessions you can access through that program before having to request more sessions (typically between 4 and 5 sessions are covered). To that end, I would really, REALLY recommend that if your employer is located in Renfrew County that they check out Valley Employee and Family Assistance Program because there is 
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