titles, licenses and who can do what to whom under Bill 21

A psychologist teaching at a major Canadian University who prefers to remain anonymous wrote to me because she was concerned that I was claiming that psychologists were “unlicensed and untrained”.

As I explained to her, nobody is disputing that psychologists are licensed and trained as psychologists.  What I am claiming is that psychologists do not always have specialized training or licenses in the specialized areas searched for by the public.

Most psychologists offering couple or family interventions, for example, are not licensed couple and family therapists.  So, when a person searches for a couple or family therapist using the Order of Psychologists' search engine and naïvely chooses "psychologist" as the first search criterion, this filters out all non-psychologist licensed couple and family therapists while leaving in psychologists without a license in couple/family therapy.

I explained to her that, when I said that psychologists were unlicensed in the specialties searched under, this was what I meant.  In the case of couple and family therapy, sex therapy, psychoanalysis, occupational therapy, art therapy and other specialized forms of therapy, professionals earn at least a master’s degree or have another equivalently high level of specialized training, and in many cases also a specialized license in these disciplines, which most psychologists lack. 

She made the interesting comment that, for psychologists, there was no "value added" by getting a couple and family therapy license since it was “covered” by their psychology license.

I reminded her that, although it may be legal for a psychologist to see couples, a psychologist needs to have a couple and family therapy license if she intends to treat them as a "couple and family therapist" or leads her clients in other ways to believe that she is a couple and family therapist when she is not.  So at least the title has some value under the law:

36.  No person shall in any way whatsoever:
(d) use the title “Marriage and Family Therapist”, “Marriage Therapist”, “Family Therapist”, or a title or abbreviation which may lead to the belief that he is such a therapist, or use the initials “M.F.T.”, “T.C.F.”, “M.T.”, “T.C.”, “F.T.” or “T.F.”, unless he holds a valid permit for that purpose and is entered on the roll of the Ordre professionnel des travailleurs sociaux et des thérapeutes conjugaux et familiaux du Québec
[my bold, Professional Code of Quebec; article 36]

Interestingly, my correspondent is not herself licensed to use the title of marital/family therapist but is currently training students to become licensed marital and family therapists in Quebec.  Whether that makes sense, whether it is even legal, is a question I ask myself.  It would be interesting to know how many couple and family therapists are training students to become licensed psychologists.

Finally, I said to my correspondent that, if she meant by "no value added" she meant no economic value, then I completely agreed: there is now *zero* economic value to being a licensed marital/family therapist.  That has been my main point from the beginning: those who have been trained and licensed as couple/family therapists (it used to take three years of post-graduate training and supervision of real clinical value to obtain this license), and who now pay their fees as psychotherapists to the Order of Psychologists and who also pay a fee to be included in the Order of Psychologists' referral system, can yet be excluded by the Order of Psychologists' search engine when the public is searching for a couple/family therapist.

Likewise insurance companies do not cover couple and family therapy offered by licensed couple and family therapists unless they are psychologists, while psychologists (and doctors!) who have no training, expertise or license as a marital/family therapist will be reimbursed for sessions of couple and family therapy.  This is not to say that all those who are reimbursed as psychologists or doctors have no training in this field...  But I never claimed that.

My main point has always been that none of this protects the public from those not qualified to practice, whereas public protection was the very raison d'être of Bill 21, and is now the Order of Psychologists' mandate.

I will end with a quote from my correspondent who said it better than I could:

for many of us, we have spent thousands of hours and thousands of dollars in training, supervision and supervised practice and the thought of getting yet one more license to do something we are already doing seems torturous.

This is exactly how all non-psychologist psychotherapists feel now that Bill 21 has been put into effect.

Bill 21 could have forced psychologists who are qualified to practice couple and family therapy to go to the Order of Social Workers and Couple and Family Therapists to apply for a permit, the way it is now forcing psychotherapists qualified to practice psychotherapy to go to the Order of Psychologists for a permit.  But it didn't.

Please sign my petition.