1. Dr David Cane Catalysis Consulting www.catalysisconsulting.net
Statutory Regulation and Practice Competencies for Spiritual Care Professionals
Presentation to:
Canadian Association for Pastoral Practice and Education
British Columbia
Dr David Cane
Catalysis Consulting
Vancouver BC
Nov

2. Topics Statutory regulation in Canada
Canadian approach, mandates, mechanisms
Developments in regulation for counselling and mental health professions
Best Practices - Competencies and Credentials
CAPPE competencies for spiritual care professionals
National validation survey

3. Canadian approach, mandate, mechanisms
Statutory Regulation
Canadian approach, mandate, mechanisms

4. Regulation in Canada
Regulating professional practice is a provincial government responsibility
Different legislative approaches exist
Umbrella acts
Occupation-specific acts
Extent of delegation by government varies
Gov’t dept / “College” / Professional Assn
“Self-regulation” concept

5. Regulatory Mandate
The only reason governments regulate is to protect the public
The regulator's mandate is to ensure safe, effective and ethical practice
Control of entry to practice
Control of practice standards
Control of conditions for ongoing registration
Handling of public complaints

6. So is it in the profession’s interest to achieve statutory regulation?
Possible Pros
Increased recognition and “credibility”
Enhanced public awareness
Increased public protection
Allows professional association to focus on member services and back away from “regulation”
Access to third party billing
Possible Cons
Increased costs to individuals
Loss of control over standards

7. Mechanisms of Regulation
Title protection
Restricted / protected / controlled title(s)
No restriction on activities
Restricted / controlled activities
Specific reserved activities established
Often granted to several professions
Restricted scope of practice
Broad-based protection of the profession’s work

8. Ontario: Regulation of Psychotherapists and Registered Mental Health Therapists
Practice of Psychotherapy defined:
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
Authorized Act of Psychotherapy defined:
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 judgment, insight, behaviour, communication or social functioning

9. Terminology Confusing! Regulation Licensure Registration Certification
statutory… voluntary…
Licensure
license to practice… goes with restricted activity?
Registration
with whom?
Certification
by whom?… for what purpose?
Accreditation
of educational programs… of health care facilities

10. Coordinating Regulation Nationally: The Agreement on Internal Trade:
Federal-provincial agreement, 1994
Broad scope (trade, investment, employment)
Labour Mobility Chapter seeks to facilitate cross-jurisdictional mobility of workers

11. Current AIT Requirements
Regulators must collaborate when establishing or changing standards, and in general work together to enhance Labour Mobility
Regulators must compare standards and identify “competency gaps” between jurisdictions
Regulators must accommodate differences by enabling transferring workers to address competency gaps

12. Major AIT changes are coming as of April 1 2009!
As of Apr 2009 Full Labour Mobility (FLM) will exist in all professions across all jurisdictions unless government has approved an exception
“Declared full mobility” replaces “accommodation of differences”
Exceptions will be limited, and based upon major scope of practice differences

13. Current Status of Regulation for Counselling & Mental Health Professionals

14. Quebec has statutory regulation in effect
Career counsellor; psychoeducator
Competencies are in place
Ontario has initiated regulation
Psychotherapist; registered mental health therapist
Designations yet to be defined; “authorized act” established
BC’s Task Group for Counsellor Regulation active since mid 1990s
Group is advocating a broad generalist designation (“Counselling Therapist”) with specialties (tiered approach)
Competencies developed for Counselling Therapist
Gov’t has recently indicated that regulation is not on their “immediate agenda”
Regulation may take place this year in Nova Scotia
NSACT is advocating a model based upon the Counselling Therapist with a minimum Masters degree requirement
Numerous processes of voluntary self-regulation exist
BCACC, CCA, CAPPE

15. BC’s Proposed Multi-Tier Model
Counsellor
Pastoral
Counsellor
Career
Therapist
Music
Family Therapist
Marriage &
Designation 5
Specialty
Tier 2
Counselling Therapist
Entry-to-Practice level
Generic Counselling Skills
Tier 1
Specialty Designations:
Reflect more complex skill sets
Recognize specialist credentials
Generalist Entry-Level Designation:
Broad, inclusive scope of practice with generic skill set
Maximizes public protection

16. Best Practices in Regulation
Occupational Competencies and Credentials

17. Professional Regulation Involves Accountability
Professionals are accountable for the quality of their services (their job skills)
The regulator is accountable (to government and to the public) to set and enforce standards for these services
Standards must be defensible based upon the mandate of public protection
Accountability is an ongoing expectation

18. Best regulatory practice means…
…regulating on-the-job activity (not prior education)
Registrants are accountable for their job skills
on a daily basis, in real-time
they are not accountable for their credentials; credentials are historical

19. Defining and measuring job skills is the key
Measurable job skills are called Occupational Competencies
An Occupational Competency is a statement describing a job task that a person can perform to a specified level of proficiency

20. Competencies can serve different purposes
Occupational Competencies
Describe job tasks
Used by employers and by regulators to define job requirements
Assessment Competencies
Break job tasks into components for assessment purposes
Used by regulators to blueprint a registration exam
Used by employers to assess worker performance
Educational Competencies
Break components into smaller steps to facilitate student learning
Used by educators to develop curriculum and assess student learning
Hierarchy of Competencies

21. CAPPE Practice Competencies for Spiritual Care Professionals
National Validation Survey

22. Why did CAPPE undertake a validation process?
Involved with national initiatives to establish regulation for counselling and mental health professionals
Substantial common ground exists across the counselling / mental health field
Developed Practice Competencies to guide its Certification Programs
Opportunity to integrate and validate competencies
Competencies can distinguish common ground from specialties
Help prepare for an effective regulatory process

23. Integrated Competency Model for Spiritual Care
“Specialist Competencies”
Spiritual
Care
Professional
Generic Competencies
(applicable to a broad range
of counsellors and therapists)

24. The validation process
On-line survey made available to CAPPE membership nationally (March-April 2008)
Listings of competencies (generic & specialist)
For each competency, respondents to rate:
How important you consider this competency to be for safe and effective practice
How frequently you use this competency in your own practice
Demographic questions included to help analyze data

25. Summary of demographics
198 respondents nationally (~20% of membership)
59% of respondents from ON
14% of respondents from BC
74% of respondents in Clinical Pastoral Education stream
16% of respondents in Pastoral Counselling Education stream

30. Competency rankings – what constitutes “validation”?
Importance scale:
Critically important
Important
Somewhat important
Not important
Cannot rate
Frequency scale:
Very frequently
Frequently
Occasionally
Seldom
Not used

31. Margins of Error
Margin of error on 150 responses (for respondents nationally)
+- 6% on a cumulative % value ( 90% conf)
ON respondents (N = 70)
+- 9%
BC respondents (N = 25)
+-16%
Retired members (N = 5)
too high to estimate

32. Are the competencies “Validated”?
Broadly speaking yes, very strongly for both generic and spiritual care
Examples of exceptions: 5.3.a and H.3
Are there significant differences between the BC survey results and Canada-wide? No
Bear in mind the larger margin of error on the BC data

33. What next?
Will the competency validation data impact CAPPE’s certification program?
Will the counselling-related professions be able to move ahead on a consistent basis nationally?
There are different approaches emerging x-Canada
Will the new AIT help promote a common approach?
Can CAPPE find a way to have Spiritual Care practice recognized within the broader context of regulation in counselling and mental health?

34. Thank You!