Preventing and Addressing Sexual Abuse by Members
Client Relations Committee
Sexual Abuse Under the RHPA
Penalties for Sexual Abuse Under the RHPA
Misconduct Related to Sexual Abuse
Complaints and Reports of Sexual Abuse
Mandatory Reporting of Sexual Abuse
Therapy and Counselling Fund
Professional Practice and Jurisprudence e-Learning Module
Standards of Practice
Sexual abuse is an extremely serious form of professional misconduct that can result in loss of registration and/or other mandatory penalties. CRPO affirms a zero-tolerance approach to sexual abuse of clients by Members. This page contains information about CRPO’s role in preventing and responding to sexual abuse of clients by Members.
In December 2014, the Minister of Health and Long-Term Care, Dr. Eric Hoskins, established a Task Force to examine and provide recommendations on how to strengthen the Regulated Health Professions Act, 1991 (RHPA) regarding sexual abuse of clients by members. The recommendations were released in September 2016. Please see the news release and the appendix for recommendations.
The recommendations focus on client empowerment, strengthening requirements under the RHPA, strengthening leadership and accountability, increasing transparency, improving the complaints, investigation and discipline processes for sexual abuse cases, and enhancing overall knowledge and education.
The Federation of Health Regulatory Colleges of Ontario and the Ministry of Health and Long-Term Care met to discuss the recommendations. We will update CRPO stakeholders with further developments, including changes to CRPO policy and process, as they occur.
The role of the CRPO’s Client Relations Committee is to oversee the “Client Relations Program”, which is a program to enhance relations between Members and clients. The Client Relations Program includes measures for preventing and dealing with sexual abuse of clients by Members, including:
- Educational requirements for Members.
- Guidelines for the conduct of Members with their clients.
- Training for CRPO’s staff.
- The provision of information to the public.
The Committee will continue meeting to develop these elements.
The definition of sexual abuse under the RHPA is broader than in criminal law, and includes any sexual activity, including suggestive comments and ‘off-colour’ jokes, made by a Member in the presence of a client. Members must understand that there are no circumstances in which sexual activity between a Member and client is acceptable. In the context of a therapeutic relationship, there is a power imbalance between therapist and client. As a result, the client is never a mutual participant in any form of sexual contact, remark, or relationship. By definition, sexual abuse is detrimental to appropriate care and cannot be tolerated. Members are responsible for their conduct. Even if the client makes sexual advances, the Member is responsible for maintaining professional boundaries. Breaching boundaries is a betrayal of the therapeutic relationship and may result in disciplinary action, including revocation of membership.
The RHPA states that “sexual abuse” means:
- sexual intercourse or other forms of physical sexual relations between the Member and the client,
- touching, of a sexual nature, of the client by the Member, or
- behaviour or remarks of a sexual nature by the Member towards the client.
“Sexual nature” does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided.
The RHPA requires that if a Member is found to have committed any of the following acts of sexual abuse of a client, his/her registration must be revoked for a period of at least five years:
- Sexual intercourse.
- Genital to genital, genital to anal, oral to genital, or oral to anal contact.
- Masturbation of the Member by, or in the presence of, the client.
- Masturbation of the client by the Member.
- Encouragement of the client by the Member to masturbate in the presence of the Member.
If the College’s Discipline Committee finds that a Member committed any other form of sexual abuse of a client, it must reprimand the Member, and there will likely be additional penalties.
Various kinds of behaviour, while not sexual abuse within the legal definition, raise similar concerns and are taken very seriously by CRPO. These include:
Having a romantic/sexual relationship with a former client
The College urges Members in the strongest possible terms to avoid romantic or sexual relationships with former clients. In most cases, relationships with former clients are inappropriate, inadvisable, and potentially damaging to the parties concerned.
Despite this proscription, the experience of some regulatory colleges has been that an outright prohibition of such relationships is unworkable, especially where a relationship may develop many years later, and the original client-therapist relationship was relatively brief.
Members must, therefore, carefully consider the following factors before entering into such a relationship with a former client:
- the nature and length of the former client-therapist relationship;
- the issues presented by the client in therapy;
- the length of time since the client-therapist relationship ended; and
- the vulnerability of the client.
Members should understand that it may never be appropriate to enter into a romantic or sexual relationship with a former client, e.g. where the therapeutic relationship was long or intense, or where a power imbalance continues to exist between the Member and the former client. Ultimately, a Member may be called upon to defend his/her actions before a panel of peers, if a complaint is made against the Member.
Inappropriate conduct or relationships with psychotherapy students or supervisees
Due to the authority and trust that Members hold over their psychotherapy students and supervisees, inappropriate relationships in these situations will be approached in a manner similar to boundary violations or abuse of clients.
Any member of the public who has a question, concern or complaint about a Registered Psychotherapist (RP) can contact CPRO. To learn about the complaints process, click here. CRPO will make every effort to support individuals who come forward with information about sexual abuse by a Member. In particular:
- the individual’s privacy will be respected – only relevant staff, investigator(s) and committee members will have access to your information;
- wherever possible, CRPO will accommodate a request to speak with a staff-member of either gender;
- individuals can withdraw from the complaints process at any time;
- individuals can bring support persons with them, e.g. to an interview with College staff or an investigator, or to a hearing;
- College staff will be trained in sensitive, non-judgmental ways of collecting information;
- staff will explain the complaints/discipline process;
- if a matter is referred to a discipline hearing, such hearings are generally held in public; however, the identity of witnesses (such as the complainant) can be protected by a publication ban in cases involving sexual abuse.
Please note that it is very difficult for the College to investigate complaints of sexual abuse if the subject of the abuse is not willing to share their story with the College.
To speak with someone at the College about your concern, please contact:
|Tel:||(416) 862-4778 (Direct line to Director, Professional Conduct)
1 (888) 661-4801 (General toll-free line)
Attention: Director, Professional Conduct
163 Queen Street East, 4th floor
Toronto, ON M5A 1S1
Under the RHPA, a Member of any regulated health profession in Ontario is required to report if s/he has reasonable grounds, obtained while practising the profession, to believe that another regulated health professional has sexually abused a client.
The report must:
- be made in writing within 30 days of receiving the information;
- be made right away if it appears that the health professional will continue to sexually abuse the client or will sexually abuse other clients, or that s/he is likely to expose a client to harm or injury and there is urgent need for intervention;
- be directed to the Registrar of the college to which the alleged sexual abuser belongs;
- include the reporter’s name and the alleged grounds of the report; and
- to protect the privacy of potentially vulnerable clients, it must not include the client’s name unless the client has consented in writing.
There are additional reporting requirements if the person making the report, e.g. a CRPO Member, is providing psychotherapy to another regulated health professional who may have sexually abused a client. Specifically, the report must also include an opinion, if the reporter is able to form one, of whether the suspected abuser is likely to sexually abuse clients in the future. The reporter must file an additional report to the College if s/he ceases to provide psychotherapy to the Member who was the subject of the first report.
Additional mandatory reporting obligations exist for anyone who operates a facility where a Member practises (e.g. hospital, clinic). Similarly, there is a mandatory reporting obligation for anyone who terminates a business or employment relationship with a Member due to incompetence, incapacity or professional misconduct, including sexual abuse. These obligations apply whether the facility operator or employer/business associate is a regulated health professional or not.
For more information about mandatory reporting obligations, see CRPO’s Professional Practice Standards for Registered Psychotherapists (section 1.3, Reporting Unsafe Practices), Professional Practice and Jurisprudence for Registered Psychotherapists (page 51, Mandatory Reports), and sections 85.1-85.6 of the Health Professions Procedural Code, which is part of the RHPA.
Under the RHPA, every college is required to have a program to provide funding for therapy or counselling for persons who, while clients, were sexually abused by Members. If a CRPO Member has been found by the Discipline Committee to have committed sexual abuse, the client(s) who were sexually abused by the Member will be eligible for therapy/counselling paid for by the fund. Funding will not be provided if the counselling or therapy is covered by OHIP or a private health insurance plan.
With few restrictions, the individual concerned will be able to work with the counsellor or therapist of his/her choice. Funding is provided directly to the therapist or counsellor for therapy or counselling that was provided since the sexual abuse took place.
One of CRPO’s registration requirements for all applicants is successful completion of our Professional Practice and Jurisprudence (JRP) e-Learning Module. The JRP Module covers several topics related to the prevention of sexual abuse of clients by Members. These include: maintaining professional boundaries, definitions and examples of sexual abuse, and mandatory reporting of sexual abuse. The companion document to the JRP Module, Professional Practice and Jurisprudence for Registered Psychotherapists, is available to the public on CRPO’s website, and is free of charge.
CRPO Members are required to abide by the College’s Professional Practice Standards for Registered Psychotherapists. This comprehensive document is based on CRPO’s Professional Misconduct Regulation, and sets out minimum expectations for Member conduct. The Standards cover numerous topics related to preventing and dealing with sexual abuse. These include conflict of interest, dual or multiple relationships with clients, undue influence and abuse, and illegal conduct. Clients and members of the public are encouraged to familiarize themselves with this document in order to understand the obligations of RPs.
In the future, the College expects that it may develop additional resources and guidelines on preventing and responding to sexual abuse of clients by Members.