Filing a Complaint About a Psychotherapist

Note: If you are in crisis, please contact your family doctor, go to your closest hospital, call the Ontario Mental Health Helpline at 1-866-531-2600, or call 911.

Introduction

If you have a concern or a complaint about the care you received from a Registered Psychotherapist, this is where you can find out more information about the process. The College of Registered Psychotherapists of Ontario is the organization that members of the public can make complaints to; our job is to ensure that Registered Psychotherapists are providing the care that they should to all Ontarians.

Before You Make a Complaint

The complaint process can be difficult for both complainants and psychotherapists. It will take several months until a decision is reached. CRPO will generally provide each party with the other’s comments, which may be difficult to read. While CRPO will always consider the information carefully, neutrally and in the public interest, the outcome may not be the one hoped for by the complainant or psychotherapist. It may be advisable to have personal supports in place during the complaint process.

You may wish to call CRPO and speak with a staff person about the process. The staff member will be able to provide you with important information. Contact information is available on the Contact Us page.

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How to File a Complaint

If you decide to submit a formal complaint, please use the Complaint Form (version française içi). You can submit the form by fax, email or surface mail. If you are unable to provide your complaint in writing, please contact CRPO and discuss the matter with a staff member.

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After You File a Complaint

Once you have submitted a complaint, a staff person will contact you to confirm receipt, obtain any clarification needed and offer to explain the complaint process. CRPO will then provide the psychotherapist you have complained about with notice of the complaint within 14 days from the time the complaint was received. In general, CRPO will provide the psychotherapist with a copy of the complaint and give them the opportunity respond.

Usually, the registrant’s letter of response is provided to the person making the complaint (called the complainant). However, if the complainant is not the client involved in the matter, or if the psychotherapist advises CRPO that release of the response may result in harm to the person making the complaint, CRPO may elect not to forward the response to the complainant, or to provide a summary or excerpts of the response.

In addition, an investigator may be selected to investigate the matter. If this occurs, the investigator may request to meet or speak with you in order to learn about the events and circumstances surrounding the complaint.

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What Will Happen to the Psychotherapist I Complained About?

Complaints about Registered Psychotherapists are reviewed by the Inquiries, Complaints and Reports Committee (ICRC). This committee is made up of members of the profession, as well as members of the public who sit on CRPO’s governing Council. The committee screens complaints and concerns about CRPO registrants and decides how they should be addressed. The following is a description of various outcomes the committee is able to order. They are sometimes used in combination with one another and are presented in order of increasing seriousness:

1. Take no action – The committee will not take any action where the information raised through the investigation process appears to include no risk or minimal risk to the public.
2. Issue written advice – Where an investigation has identified that there may be some room for improvement in a registrant’s professional practice or conduct, the committee can issue written advice, including recommendations. CRPO does not monitor or follow-up with the psychotherapist about whether they have followed the advice; however, non-cooperation could be considered in the future, e.g. if another complaint is made. This outcome reflects concerns that are of low risk to the public.
3. Remedial agreement – Where a concern about Registered Psychotherapist appears to present a low risk to the public, the psychotherapist and CRPO may enter into an agreement. The agreement generally includes self-directed learning and submission of an assignment for evaluation, such as a reflection paper.
4. Specified continuing education or remediation program (SCERP) – Where the committee identifies a practice deficiency that poses moderate risk to the public, it can order the registrant to complete a SCERP, which is a specific learning program meant to address the shortcoming.
5. In-person caution – If the committee identifies a serious concern that poses moderate risk to the public, it can order the psychotherapist to attend the CRPO office in person to receive a caution from the committee. A caution sends a strong message about the need for immediate improvement.
6. Undertakings – In situations involving a medium-to-high risk to the public, the psychotherapist, in consultation with CRPO, may voluntarily agree to restrict their practice or resign from CRPO and not reapply. A referral to a discipline hearing may also have been made. When a registrant resigns in such circumstances, a note to that effect will be posted to the Public Register and will remain there.
7. Referral to the Discipline Committee – Where investigation reveals a serious concern posing a high risk to the public, and where the evidence is sufficient to support a legal hearing, the Inquiries, Complaints and Reports Committee (ICRC) will refer specific allegations of professional misconduct or incompetence to the Discipline Committee. A discipline hearing is a formal legal process. Hearings are generally held in public. More information about the discipline process is available on the Discipline page of our website. Referrals to the Discipline Committee are relatively rare compared with other possible ICRC outcomes. Where a risk of harm to the public requires an immediate restriction on the registrant’s practice, the ICRC can make an “interim order” restricting the member’s ability to practise.

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What if I Disagree with the Decision?

Both you and the psychotherapist involved each have a right to request that an Inquiries, Complaints and Reports Committee (ICRC) decision be reviewed by the Health Professions Appeal and Review Board (HPARB). HPARB is a legal tribunal that is independent of CRPO. It reviews the ICRC’s decision in a complaint and determines whether the investigation was adequate and the decision was reasonable. Reviews by HPARB are usually open to the public. HPARB cannot review a decision to refer a complaint to the Discipline Committee or to incapacity proceedings, as the matter is still in progress at CRPO.

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How Long Will This Take?

The time it takes the College to make a decision on a complaint varies from case to case. The College will ensure that Complainants and Registrants are updated throughout this process. ICRC members and College staff work hard to avoid unnecessary delays in the complaints process—nevertheless, delays do occur. Currently the average time for receiving the ICRC’s written decision is around 316 days from receipt of the complaint. Timelines are affected by various factors including complexity of the issues and how quickly responses are provided when the College requests information.

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Confidentiality

CRPO takes the confidentiality of the complaints process seriously. Information about complaints is confidential to the complaints process. During an investigation, psychotherapists are generally asked to provide relevant documents from the client record. CRPO will make every effort to protect the confidentiality of client records. Complainants must keep in mind, however, that if a decision is reviewed by HPARB, or the matter is referred to the Discipline Committee, the information obtained through the complaints process may be presented at a review or hearing, which is open to the public.

Complainants who are concerned about the provision of their clinical file to CRPO, or have other questions about the confidentiality of the complaints process, are advised to contact us.

Feedback About the Complaints Process

Individuals involved in the complaints process are invited to write to CRPO with their comments or concerns about the process. The Registrar and/or Inquiries, Complaints and Reports Committee will review any such submission and determine what steps, if any, CRPO can take to address the concerns. CRPO uses the information received to improve the process.

Incapacity Inquiries

If a complaint investigation raises concerns about the psychotherapist’s mental and physical capacity to practise the profession safely and effectively, the ICRC follows a process to inquire into the registrant’s capacity. More information can be found on the Incapacity Proceedings page of our website.

Note: As of April 1, 2017, any ICRC decision involving an in-person caution, SCERP or undertaking, will result in a notation being made on the registrant’s Public Register profile. Please refer to CRPO’s By-law article 21.08 for more information.

Issues CRPO Cannot Address

There are various concerns about psychotherapists that are outside of CRPO’s jurisdiction. These include:

Members of Another Regulatory College

If a practitioner is a member of more than one college, you can make a complaint with any of the colleges where they are a member. Depending on the nature of the complaint, one or more of the colleges may play an active role in the investigation.

For example:

• Psychologists are regulated by the College of Psychologists of Ontario;
• Social workers are regulated by the Ontario College of Social Workers and Social Service Workers;
• Psychiatrists and GP psychotherapists are medical doctors who are regulated by the College of Physicians and Surgeons of Ontario; and
• Some nurses and occupational therapists may practise psychotherapy and are regulated by the College of Nurses of Ontario and the College of Occupational Therapists of Ontario, respectively.

Remedies Unavailable Through the College

The College’s complaints process cannot:

• Be used as evidence in civil proceedings such as family court, see Regulated Health Professions Act, 1991, s. 36 (3).
• Order the payment of funds by a registrant as a result of a financial loss suffered by the complainant. This is a matter for the courts.
• Resolve employment or labour relations difficulties that are not addressed by the professional standards governing the profession.
• Direct a member to change his or her professional opinion or a report.