What is unlawful practice and what is unauthorized use of a title ?
What is unlawful practice and what is unauthorized use of a title ?
There are two ways of breaking the law:
- Using a title that is reserved for professionals without being authorized to do so
- Engaging in reserved activities without being authorized to do so, pretending that one is authorized to do so, or acting in such a way as to make people believe that one is authorized to do so
Unauthorized use of the title
Under the Professional Code, the title “psychologist” is restricted to members of the Ordre des psychologues du Québec, and the title “psychotherapist” is restricted to physicians, psychologists, and holders of a psychotherapist’s permit issued by the Ordre des psychologues. Any other person who uses one of these titles may be sued for unauthorized use.
Regarding the title “psychologist,” the Professional Code says this:
"No person shall in any way whatsoever … use the title 'Psychologist' or any other title or abbreviation which may lead to the belief that he is a psychologist, or use initials which may lead to the belief that he is a psychologist, unless he holds a valid permit for that purpose and is entered on the role of the Ordre professionnel des psychologues du Québec." [Professional Code, section 36(e)]
Here are a few examples of what might be seen as unauthorized use of the title "psychologist":
- Calling oneself a psychologist or psychologue
- Calling oneself a soul psychologist
- Advertising under the heading "psychologist" or "psychologue"
- Using an abbreviation such as "psych."
The Professional Code says this about the title "psychotherapist":
"With the exception of physicians and psychologists, no person shall practice psychotherapy or use the title of 'Psychotherapist' or any other title or abbreviation which may lead to the belief that he is a psychotherapist, unless he holds a psychotherapist’s permit." (Professional Code, section 187.1)
Here are a few examples of what might be seen as unauthorized use of the title "psychotherapist":
- Calling oneself a psychotherapist or psychothérapeute
- Calling oneself a psychoanalyst or metapsychoanalyst
- Calling oneself a metapsychotherapist
- Advertising under the heading "psychotherapist" or "psychotherapy"
Activities reserved to psychologists
Some activities are reserved to psychologists and various other professionals. Here are some of the reserved activities that are often brought to the attention of the Ordre:
Assessment of mental disorders
"Assessing a mental disorder, in the context of reserved activities, means making a clinical judgment, on the basis of the information available to the professional, on the nature of ‘clinically significant conditions characterized by alterations in thinking, mood (emotions) or behaviour associated with personal distress and/or impaired functioning,’ and communicating the outcome of this judgment." (Office des professions du Québec, Guide explicatif, p. 34, in French)
Assessment of neuropsychological disorders
“ … assessment of neuropsychological disorders is designed to find links between a clinical condition and a possible change in cerebral or higher mental functions, to identify any impairment of these functions, and, if necessary, to establish a brain/behaviour link – a link which cannot be reduced to determining where the identified dysfunctions are ‘geographically’ located in the brain.” (Guide explicatif, p. 42, in French)
The practice of psychotherapy is an activity restricted to psychologists, physicians, and holders of a psychotherapist’s permit. The Ordre des psychologues is responsible for taking legal action against the unlawful practice of psychotherapy and the unauthorized use of the title "psychotherapist."
Psychotherapy is defined as follows by the Professional Code:
"Psychotherapy is psychological treatment for a mental disorder, behavioural disturbance or other problem resulting in psychological suffering or distress, and has as its purpose to foster significant changes in the client’s cognitive, emotional or behavioural functioning, his interpersonal relations, his personality or his health. Such treatment goes beyond help aimed at dealing with everyday difficulties and beyond a support or counselling role."
Interventions that are not psychotherapy
Some interventions are related to, but do not constitute, psychotherapy. The Regulation respecting the psychotherapist’s permit lists some of these interventions and provides the following definitions.
- Accompaniment and support of a person through regular or sporadic meetings, so that the person may express his difficulties. In such a context, the professional or intervener may give advice or make recommendations.
- Support intervention to support a person so that the person may maintain and consolidate acquired skills and adaptation strategies by targeting strengths and resources through regular or sporadic meetings or activities. The intervention includes reassuring, advising and providing information related to the person’s condition or the experienced situation.
- Conjugal and family intervention designed to promote and support the optimal functioning of the couple or family by means of interviews that often involve all the family members. Such intervention is intended to change the factors in the functioning of the family or couple that impede the couple’s or family members’ blossoming or to offer assistance and advice in the face of everyday life’s difficulties.
- Psychological education intended to teach skills through the information and education of the person. Such education may be used at every step of the care and service process. It consists in the teaching of specific knowledge and skills to maintain or improve the person’s autonomy or health, in particular to prevent the appearance of health or social problems, including mental problems or the deterioration of the person’s mental condition. Such teaching may pertain for instance to the nature of the physical or mental illness, its symptoms, its treatments including the role that may be played by the person in the maintenance or restoration of his health, as well as stress management techniques, relaxation techniques, or assertiveness techniques.
- Rehabilitation aiming at helping a person to deal with the symptoms of an illness or improving the person’s skills. Such rehabilitation is used, among other things, with persons suffering from significant mental health problems so that they may reach an optimal level of autonomy towards recovery. It may form part of meetings to accompany or support the person and include, for instance, the management of hallucinations and the practice of day-to-day and social skills.
- Clinical follow-up that consists in meetings to update a disciplinary intervention plan. It is intended for persons who display behaviour problems or any other problem causing suffering or psychological distress, or health problems, including mental problems. It may involve the contribution of various professionals or interveners grouped in interdisciplinary or multidisciplinary teams. Such follow-up may be part of an intervention plan within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Education Act (chapter I-13.3), take the form of meetings or interventions to accompany or support the person and also include psychological rehabilitation or education. It may also include the adjustment of pharmacotherapy.
- Coaching to update one’s potential by developing talents, resources or skills in a person neither in distress nor in pain, but who expresses particular needs in terms of personal or professional achievements.
- Crisis intervention consisting in an immediate, short and directing intervention adjusted to the type of crisis, the characteristics of the person and of the person’s surrounding. It is intended to stabilize the condition of the person or the person’s environment in connection with the crisis situation. That type of intervention may involve exploring the situation and assessing possible consequences, for instance, the danger potential, suicidal risk or risk of decompensation, defusing, support, the teaching of adaptation strategies to deal with the experienced situation and orientation towards services or care more adapted to the needs.
The following documents (in French) provide more information:
Office des professions du Québec (2013). Loi modifiant le Code des professions et d’autres dispositions législatives dans le domaine de la santé mentale et des relations humaines: Guide explicatif.
Lorquet, E. (2011). Le guide explicatif du projet de loi 21. Chronique Affaires juridiques, Psychologie Québec, Vol. 28, No. 3, p. 11-12.
Lorquet, E. (2012). Ce qui est ou ce qui n’est pas de la psychothérapie: les enjeux. Chronique Affaires juridiques, Psychologie Québec, Vol. 29, No. 2, p. 15-17.
Lorquet, E. (2012). Les avis du Conseil consultatif interdisciplinaire sur l’exercice de la psychothérapie. Chronique Affaires juridiques, Psychologie Québec, Vol. 29, No. 5, p. 18-20.
Lorquet, E. (2012). Exercez-vous la psychothérapie? Chronique Affaires juridiques, Psychologie Québec, Vol. 29, No 6, p. 15.
Lorquet, E., and Desjardins, P. (2013). Le mandat et le fonctionnement du réseau des répondants de la loi 21. Chronique Affaires juridiques, Psychologie Québec, Vol. 30, No. 1, p. 9-10.
Desjardins, P. (2013). Le départage nécessaire des pratiques en psychothérapie. Chronique Pratique professionnelle, Psychologie Québec, Vol. 30, No. 5, p. 13 -15.
Lorquet, E. (2013). L’Ordre informe les organismes concernés dans le dossier de la psychothérapie. Chronique Affaires juridiques, Psychologie Québec, Vol. 30, No. 5, p. 22-23 .
Lorquet, E. (2014). Bien informer et prévenir les poursuites pour pratique illégale de la psychothérapie. Chronique Affaires juridiques, Psychologie Québec, Vol. 31, No. 3, p. 13 .
Desjardins, P. (2015). L’encadrement de la psychothérapie: un défi de la loi 21. Chronique Pratique professionnelle, Psychologie Québec, Vol. 32, No. 5, p. 13 -15.
Lorquet, E. (2015). Une entente avec l’École de formation professionnelle en hypnothérapie. Chronique Affaires juridiques, Psychologie Québec, Vol. 32, No. 5, p. 17-18.