January 2018

Part of psychotherapy is a controlled act. Now what?

On Dec. 30, 2017, government proclaimed one component of psychotherapy to be a controlled act.

The controlled act of psychotherapy is different from the other controlled acts because it does not include all psychotherapy practices. The controlled act is only the component of psychotherapy considered to be the highest risk to the client. It is not defined by a technique.

How will I determine if I’m performing the controlled act of psychotherapy?

There are five components in the controlled act. You must meet all of them to be performing the controlled act:

1. You are treating a client

2. You are applying a psychotherapy technique

3. You have a therapeutic relationship with the client

4. The client has a serious disorder of thought, cognition, mood, emotional regulation, perception or memory

5. This disorder may seriously impair the client’s judgment, insight, behaviour, communication or social functioning

It is possible you may be performing psychotherapy but not the controlled act of psychotherapy. For example, if only four of the above components apply, you are not performing the controlled act.

To better understand the components of the controlled act, read our psychotherapy FAQs at www.cno.org/psychotherapy-FAQs.

What does this mean for me?
Although the act has been proclaimed, for two years RNs and RPNs do not need an order to perform the controlled act of psychotherapy. This exemption period will end on Tuesday, Dec. 31, 2019.

To learn who can perform the controlled act and who can use the title “psychotherapist,” visit www.cno.org/psychotherapy-FAQs.

What happens after 2019?
When the exemption period ends on Tuesday, Dec. 31, 2019, RNs and RPNs will require an order to perform psychotherapy if it falls within the scope of the controlled act (meets all five criteria).

We are currently reviewing whether an order remains the best way to protect the public. If Council decides that an order is not needed, the College could create an initiation regulation. This would allow nurses to practise the controlled act without an order if specific conditions are met.

We will continue to keep you informed with updates on www.cno.org, The Standard and our Facebook page.

To learn more about initiation regulations, watch our webcast at www.cno.org/initiation-webcast.

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