British Columbia Association for Marriage and Family Therapy

FREQUENTLY ASKED QUESTIONS ABOUT REGULATION

[current to October, 2014]

Words in red are defined in the Glossary, below

 

For the most recent updates,  see point 7, below.

 

1. WHAT IS THE DIFFERENCE BETWEEN A REGULATORY BODY (A COLLEGE) AND A PROFESSIONAL ASSOCIATION LIKE BCAMFT? 

 

  • A regulatory body has legal responsibility for the conduct of its members, providing membership standards and accountability to the public. 
  • A professional association promotes the profession and advocates for its members. 

 

AAMFT currently serves both as our professional association and as our professional (self-) regulatory body.  As our professional organization, it provides packages of consumer education, prepares and distributes email and web-based advertising, lobbies governments, holds training workshops and conferences, etc.  As our (self-) regulatory body, it sets the standards for membership in the various categories, handles ethical complaints against members and so on.

 

When we seek regulation as a profession in B.C., we are asking to become part of a legal body (usually called a College) created by the provincial government.  That body takes on the legal responsibility for our public accountability, enforces our professional standards, monitors our ethical and professional conduct and so on. The Board of Directors of such a regulatory body is composed of elected members of the profession plus members of the public, in addition to support staff.  

 

The government’s rationale for creating such a regulatory body is always based on some aspect of public protection.  The regulation of a profession like ours primarily takes the form of “title protection” in which only members of a specified class of registrants may freely use a particular title (or titles) to describe their work.  Such titles are often identified via adjectives such as “Registered,” “Certified,” or “Licensed,” attached to the name of the regulated profession – e.g. “Registered Nurse.”  Having such a title allows potential clients to clearly identify practitioners who are trained and accountable.

 

When a profession is regulated in this way, the professional association (e.g., BCAMFT) passes control over standards for registration, the handling of ethical complaints, and legal accountability to the regulatory body.  The professional association then focuses on promoting the profession and its members through the provision of liability insurance, continuing education opportunities, advertising to and education of the public, lobbying government, etc.  

 

 

 

2. IS THE PROFESSION OF MARRIAGE AND FAMILY THERAPY REGULATED ANYWHERE ELSE?

 

  • The MFT profession is regulated in the province of Quebec, and in Ontario in the new College of Psychotherapists and Mental Health Therapists.
  • The MFT profession is regulated in all 50 of the United States and in the District of Columbia.

 

 

3. WHAT ARE THE LEGAL UNDERPINNINGS OF HEALTH PROFESSIONS REGULATION IN BC?

 

  • Health professions are regulated through title protection and access to restricted acts, primarily through the Health Professions Act (HPA)
  • Title protection means that a person must meet certain requirements in order to use a protected title.  
  • Restricted acts are ones that could cause harm if not done professionally.  Mental health professions do not currently have access to any restricted acts.  In particular, psychotherapy is not currently considered a restricted act in BC.

 

 

4. WHAT KINDS OF TITLE PROTECTION ARE THERE?

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  • If we are granted title protection under the founding regulation of a College, then use of the title will be strongly restricted to those persons to whom the College grants its use.
  • If we obtain title protection under the bylaws of a College, then use of the title by College registrants will be restricted to those members of the College to whom the College (or a designated proxy such as The Canadian Registry) grants its use. 

 

 

5. WHAT IS A PROFESSIONAL LICENSE?

 

  • A professional license provides a legal means for a practitioner to engage in the actions and activities which constitute the scope of practice of the profession.  It is the common regulatory model in the United States.
  • Canada does not license health practitioners in this way.  See item 3 (above) for how regulation works here.

 

 

 

6. WHY SHOULD I CARE ABOUT PROFESSIONAL REGULATION? 

 

  • Current provincial health policy seems to emphasize increasing regulation of the health professions, so this is the future of health care. 

 

The government’s vision of provincial health care includes higher levels of accountability and public protection.  These both may be understood as reactions to increasing health care costs, and are consistent with the general drift of health care policy developments in North America.  It can easily be argued that the profession is better off arranging to be regulated prior to the imposition of any governmental deadlines.

 

  • Being regulated provides a clear pattern of public accountability for the profession.

 

This speaks to government’s need to establish patterns of responsibility and control, not least for purposes of public safety but also because it provides the accountability which government expects of regulated professions.

 

  • Title protection allows the public to identify members of the profession when selecting a therapist with whom to work.

 

Our claim to professional uniqueness hinges in large part on our advanced levels of supervised clinical training and our specific preparation for relationship-based clinical work.  We recognize that other mental health professionals will continue to be allowed to provide services to couples and families, but we want the public to be able to make a more informed choice regarding the excellence of training of practitioners.

 

  • Regulation provides immediate professional differentiation from other professions.

 

A profession can be said to have “arrived” when it is granted legal recognition and become a regulated entity.  This is quite a step beyond self-regulation.   For instance, members of the public now become involved in the governance of the profession, there are explicit standards and procedures for governance to which the Board can be held and complaints are handled in an explicit and transparent manner.  

 

  • Regulation improves the profession’s access to preferred provider status and to third party insurance coverage.

 

Through the federal lobbying efforts by the Canadian Association of Marriage and Family Therapists, we know that access to some of the Federal insurance programs will become available to MFTs once we achieve regulated status.  Access to other third party payer resources will require effective lobbying at the provincial level, an undertaking made much more likely to succeed by the acquisition of regulated status in a large College.

  • Regulated status makes possible a claim to GST/HST exemption.

 

The process of acquiring GST/HST exemption status requires the addition of our profession’s name to the list for regulated health professions that is part of Bill C-40.  This requires lobbying efforts in Ottawa and we understand that having achieved regulated status can only help achieve this goal.

 

  • Being regulated necessitates additional registration fees.

 

There is a lot of expense involved in professional regulation and a College is required to be self-funded from registration fees paid to the College.  Since the primary function of health professions regulation is public protection, the investigation and handling of public complaints is a core responsibility of a College in addition to establishing membership criteria, developing ethical codes, etc.  The administrative procedures (particularly the contentious ones) often require the College to obtain legal advice and can thus be quite costly.    

 

 

7. WHERE IS BCAMFT TRYING TO ‘FIND A HOME?’ 

 

  • Federation of Associations for Counselling Therapists in B.C.(FACTBC).  

 

We are members of FACTBC, effective July, 2014.  The professional associations previously working together as the Task Group on Counsellor Regulation have been joined in this new organization by several other professional counselling associations.  We now represent over 4000 practitioners.  The goal of this federation is to accomplish the designation of Counselling Therapy as a health profession under the Health Professions Act, and the consequent establishment of a new College.  

 

Among the core principles which member associations of FACTBC have endorsed is the idea that specialist professional title designations (e.g. RMFT) should receive bylaw protection.  At the government’s urging, the regulatory model for the Counselling Therapist is based on a competency profile for entry to the profession.  This approach to professional standards is a replacement for credential based designations such as those requiring a post-graduate degree and is strongly mandated by such Federal-Provincial legislation as the Agreement on Internal Trade.

 

For more information, visit www.factbc.org

 

  • The College of Psychologists of British Columbia.

 

We have been in conversation with the College of Psychologists of British Columbia for many months.  At the beginning, it seemed that we would be able to strike an agreement under which we would have been a ‘limited class’ of registrant, meaning that our scope of practice would be a restricted sub-set of the psychologist scope of practice.  This turned out to be problematic when it became clear that they expected us to restrict our practice strictly to couples and families, a restriction to which we could not agree.  The conversation is currently on hold.

 

  • The British Columbia College of Social Workers

 

We have begun to explore regulation under the College of Social Workers.  Our initial conversation with their Board was encouraging but has not been followed up with a more detailed discussion as of this date.

 

 

8. IF WE ARE PART OF A COLLEGE, WHO WILL DEFINE OUR SCOPE OF PRACTICE, ENTRANCE AND MEMBERSHIP STANDARDS, ETHICAL CODE AND SO ON?

 

  • AAMFT’s view is that these essential elements of the MFT profession must remain in the oversight of members of the profession and we adhere to that principle in our conversations.  On the other hand, those of us who join a College will necessarily be governed by its bylaws.

 

 

9. HOW WOULD WE BE INTEGRATED INTO A NEW OR EXISTING COLLEGE?

 

  • Clinical Fellows would most likely be ‘ported’ into the new body during a specified, time-limited period.  Our expectation would be that there would be no other professional requirements, but this remains to be confirmed as it is not the case in Ontario.  In some circumstances, a Criminal Records check might be required under existing provincial statutes.
  • We would intend to have procedures by which we can accommodate our Pre-Clinical Fellows but these have not yet been specified.

 

 

10. WHAT HAPPENS IF I DON’T CHOOSE TO ADOPT THE NEW, REGULATED STATUS?

 

  • You can continue to belong to AAMFT/BCAMFT.
  • There will be no restriction on what services you actually offer to the public.
  • You may not be allowed to use the designation “RMFT” at some time in the future.  There is a provision in the Health Professions Act (section 52.1, not yet in force) which will eventually prevent anyone in a health profession from using the words "regulated", "registered", "licensed" or "certified” with their professional designation unless they are registrants belonging to a regulatory College.

 

 

 

11. WHAT IF I AM ALREADY REGULATED BY A COLLEGE SUCH AS PSYCHOLOGY OR NURSING?

 

  •   The more the specific scopes of practice of your current College and the new College overlap, the more likely you will have to choose regulation under only one college.  While membership in more than one College may be possible, it would create an administrative problem and would likely best be avoided.

 

 

12.  WILL I HAVE TO PAY DUES TO BOTH AAMFT/BCAMFT AND TO THE COLLEGE?

 

  •   If holding status as a Clinical Fellow in AAMFT is a requirement for registration with a College, then you would need to pay both sets of fees.  
  •   In the event that the new College does not require standing as a Clinical Fellow, then you would not be required to pay both.  On the other hand, if you forego your membership in AAMFT, the College will likely not permit you to use our professional title (RMFT) in your advertising.  

 

 

13.  WHAT IS AAMFT’S POSITION WITH REGARD TO BCAMFT’S ATTEMPT TO JOIN A COLLEGE?

 

  •   AAMFT is strongly in support of our efforts.  We communicate with them regularly and receive their advice.

 

 

Glossary on Regulation

compiled by Roger Wells

 

Titles, concepts and entities involved in our efforts to achieve regulation for Marriage and Family Therapy in British Columbia

 

BylawsA regulatory body is always responsible for developing its own implementations of the general principles set out in governing legislation.  These implementations and other policy considerations arising from them, are called the bylaws of the body.

 

Competency.  In this context, competency is an observable or inferable skill or ability which constitutes part of the specific components of a profession.  A competency-based assessment for membership thus requires a candidate to actually demonstrate an adequate knowledge of the core practices of the profession, rather being assumed to know them by virtue of possessing a credential.  

 

Credential – something (normally a document) that establishes that the possessor has successfully completed some designated set of training and/or other experiences which implies a type and amount of educational experience.  In itself, a credential may or may not specify particular skills or abilities.  It arises from a business relationship, in which one pays a person or organization to provide specific training.  The post-graduate degree is a common example of a credential.  Other common forms include certificates of completion, which assert that someone has been trained to offer a form of service (such as a mental status assessment) or treatment such as EMDR or Critical Incident Stress Reduction.

 

Founding Regulation – the piece of provincial legislation which defines a profession, providing definitions, specific reserved titles, access to restricted acts (if any).  It connects to another piece of legislation (such as the HPA) which establishes the administrative structure for the regulation of the professions.  

 

Health Professions Act (HPA) – legislation in British Columbia under which the Health Professions are to be regulated for the benefit of public safety.  The administrative structure governing a designated profession (or group of professions) is called a College and is composed of both professional and public members as well as an administrative staff.  Many of the specific functions and legal requirements for the Board and the staff are set out by the Act.  Each College also has a set of bylaws which enable it to administer entry to and membership in the College, to regulate the conduct of its members, to handle complaints, etc.  Each College is self-funded, and must operate within the financial limits set by dues collected from registrants.

 

License.  A license grants legal permission to do the work of a profession, which would otherwise be unlawful.  Thus, a licensed MFT is specifically permitted to do MFT work as defined in their scope of practice.  This is the common regulatory model in the U.S.

 

Registered.  Registration is a procedure under the Health Professions Act by which the members of a College gain legal access to a controlled title and possibly to one or more restricted activities.  In other jurisdictions, the more or less equivalent word may be Chartered, Certified, etc., but the key ingredient is legal language that limits the names which non-members may use to describe their profession and which may also permit specific actions.  The word “Registered” is usually added as part of protected titles in B.C.

 

Restricted activities, in the meaning of the Health Professions Act (and equivalent acts in other provinces), are procedures or activities that only specified professions can legally carry out.  

  • As an example, in BC, touching a partially undressed client is a restricted act (e.g., generally forbidden) but is specifically permitted for physicians, nurses, practitioners of Chinese medicine, midwives, massage therapists, and physiotherapists (there may be others).  That is to say that these professions have access to the restricted activity.  
  • Dispensing medications is an act which can be carried out by pharmacists, dentists and physicians and by nurses following orders of a physician (in other words, some restricted activities can be delegated).  

Behaviours usually occurring during Counselling and Psychotherapy are not restricted activities in BC at the current time although the government has circulated a consultation document, which suggests that psychological diagnosis may become restricted.

 

Scope of practice – the legislative definition of what a profession “does.”  This sets out the profession’s “territory” – indicating what a qualified practitioner can legitimately do, but does not limit access to these actions by others.  Closely allied professions typically have over-lapping scopes of practice.  We do not “own” the activities included in the scope of practice but we also do not do things outside our scope of practice.

 

Title protection.  Controlled or protected titles are professional names that can only be legally employed by persons legislatively entitled to their use.  Physician is a controlled title in B.C., whereas Doctor is not.  Similarly, Psychologist is a controlled title.  Thus, you cannot call yourself a Psychologist in BC unless you are a member of the College of Psychologists.  In contrast, anyone can legally call themselves a Marriage and Family Therapist at this time, as our title is not currently protected.   

 
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