Thank you to all members and stakeholders who provided CRPO with feedback on the draft regulation defining “client” for sexual abuse provisions. Although a wide range of opinions was gathered, a few misunderstandings about the nature of the draft regulation emerged and are worth clarifying.

­­­First, the feedback indicated there was some confusion about individual regulatory colleges’ authority in this matter. In 2017, the provincial government passed legislation that strengthened colleges’ ability to address sexual abuse among health care providers. The definition of “patient” was expanded to include an individual who was a member’s client within the last year. Thus, a psychotherapist who engages in a sexual relationship with a former client within one year of terminating the relationship will be considered to have engaged in sexual abuse and will be subject to mandatory revocation.

This same legislation expanded the grounds for mandatory revocation of the certificate of registration and provided Colleges with the ability to develop a regulation to address the period of time an individual will be deemed to be a client for the purposes of the relevant sexual abuse provisions. Soon after the legislation came into force, the Client Relations Committee (CRC) began work on the Sexual Contact with Former Clients Within Five Years Post-Termination of Care policy. This was an interim measure while the CRPO waited for the government to proclaim into force the ability of the Colleges to pass a regulation extending the mandatory waiting period required in the RHPA. This policy indicates that RPs who engage in sexual contact with former clients before five years has lapsed risk a revocation of their membership with CRPO for five years.

Second, some comments received indicated an uncertainty about the five-year period RPs would have to observe before engaging in sexual relationships with former clients were this regulation passed. It’s important to note that the decision to establish a five-year waiting period was the result of a thorough review of the scholarly literature into the nature and the impact of sexual contact between mental health care providers and their clients. Overall, the research indicated that a total ban on post-termination relationships is ineffective, yet the impact of a sexual relationship with a mental health practitioner can be much more severe than other health care providers. CRPO concluded that a five-year ban on sexual relationships would allow a significant amount of time to elapse following the termination of the psychotherapeutic relationship, during which the power imbalance between the psychotherapist and former client could resolve.

Finally, some commenters indicated they felt CRPO was being more rigid than other colleges, and that the penalty is too harsh. To be clear, the penalty is set by the Protecting Patients Act, passed by the provincial government in 2017. The regulation CRPO wrote was about the time frame in which the penalty would apply. In reviewing the response of the other regulatory colleges who are empowered to perform the controlled act of psychotherapy, CRPO’s response is quite measured.

  • The College of Physicians and Surgeons of Ontario have indicated alignment with CRPO, and that they, too, are developing a regulation to extend the provider-patient relationship for five years beyond termination when the physician-patient relationship involves psychotherapy that is “more than minor or insubstantial.”
  • The standards of the College of Social Workers and Social Services Workers indicates “Sexual relations between College members and clients to whom the members have provided psychotherapy and/or counselling services are prohibited at any time following termination of the professional relationship.”
  • The College of Occupational Therapists of Ontario revised their sexual abuse standard so that it now indicates that even after a year has elapsed since the termination of the client-therapist relationship, members are never to engage in sexual relations with a former client where the client’s occupational therapy involved psychotherapy.
  • The Standards of Professional Conduct of the College of Psychologists of Ontario prohibits sexual activity with a former client for a period of at least two years, “or longer if the member reasonably ought to know that the former client is vulnerable to exploitation or may require future services from them.”
  • The College of Nurses of Ontario appears to be maintaining the one-year time frame.

CRPO thanks everyone who provided input on this matter. Sexual abuse committed by health professionals is reckless, damaging and destructive. All health regulatory colleges in Ontario are working to end it.