Standards of Practice
CRPO registrants 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 registrant 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.
The standard of practice for registrants with regards to sexual abuse is informed by best practice in psychotherapy and the definition of sexual abuse under the RHPA (which is broader than in criminal law).
Misconduct Related to Sexual Abuse
Registered Psychotherapists must understand that there are no circumstances in which sexual activity between a registrant and current 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. Registrants are always responsible for their conduct. Even if the client makes sexual advances, the registrant is responsible for maintaining professional boundaries. Breaching boundaries is a betrayal of the therapeutic relationship and may result in disciplinary action, including revocation of registration.
Various kinds of behaviour, while not sexual abuse within the legal definition, raise similar concerns and are taken very seriously by CRPO. These include:
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.
Having Romantic/Sexual Contact with a Former Client
Sexual contact between an RP and a current or former client is strictly prohibited. CRPO registrants who attempt to engage in sexual contact with a client before five years have lapsed since the conclusion of therapy contravene CRPO policy and face serious consequences. All registrants should be familiar with the Sexual Contact with Former Clients within 5-Years Post Termination of Care policy.
CRPO has asked the provincial government to create a regulation regarding RPs and sexual abuse that would have a mandatory penalty of a reprimand and revocation of the registrant’s certificate of registration for five years, regardless of the circumstances. Until then, CRPO will rely on this policy in recommending revocation and a reprimand in discipline cases involving allegations of sexual misconduct by a registrant toward a former client.
Even beyond five years, psychotherapists should understand that it may never be appropriate to enter into a romantic or sexual relationship with a former client. In most cases, relationships with former clients are inappropriate, inadvisable and potentially damaging to the parties concerned.
Ultimately, a registrant may be called upon to defend their actions before a panel of peers and public members if a complaint or report is made against them.
Penalties for Sexual Abuse Under the RHPA
The RHPA requires that if a registrant is found to have committed any of the following acts of sexual abuse of a client, their 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.
- Touching of a sexual nature of the patient’s genitals, anus, breasts or buttocks.
If CRPO’s Discipline Committee finds that a member committed any other form of sexual abuse of a client, it must reprimand the member and suspend their Certificate of Registration for a period of time.
Mandatory Reporting of Sexual Abuse
Registered Psychotherapists and those who employ or have a business relationship with them are required to report if they have 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 immediately if it appears that the health professional will continue to sexually abuse the client or will sexually abuse other clients, or that they are 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 they cease 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 (Standard 1.3: Reporting Unsafe Practices), Professional Practice & Jurisprudence for Registered Psychotherapists (Section 3: Law (B. IV. Mandatory Reports), and sections 85.1-85.6 of the Health Professions Procedural Code, which is part of the RHPA.