Thousands of B.C. therapists and counsellors may soon find themselves held to minimum standards for education, training and public complaints, under a new regulatory regime proposed by the provincial government.
The move represents the start of a seismic shift in British Columbia’s mental health professions, which currently allow almost anyone to offer therapy or counselling services without any basic qualifications whatsoever, and almost no discipline or accountability.
“This is a significant profession, it involves a lot of people, the stakes are important, that means the risk is important, and we should do this,” Health Minister Adrian Dix said in an interview.
“That’s why we’re proceeding.”
The government announced Friday it would hold a 30-day public consultation with “psychotherapy” professions before designating them as a health profession.
The idea has long been advocated by professionals in the field, including the Federation of Associations for Counselling Therapists, as well as amongst political parties like the BC Greens.
“It’s long overdue,” said Green Leader Sonia Furstenau, who in 2021 introduced a private member’s bill on the issue.
“It’s essential for the public to be able to know whether they are accessing somebody who has proper training, and is expected to operate in an ethical and accountable way, or whether they are accessing somebody who has none of these things.”
B.C. already regulates psychologists (who possess a doctoral-level education) and psychiatrists (who are specialist medical doctors). It means the professions are part of regulatory colleges, set minimum educational standards for entry, run a public complaint process, administer an online registry to check credentials, and post disciplinary notices online so that the public is aware of who is violating the rules.
Outside of that, virtually anyone can call themselves a therapist, counsellor or mental health specialist, with wildly-varying degrees of education and competency. Any registration with an association, such as the BC Association of Clinical Counsellors, is voluntary, leaving patients nowhere to go if they have complaints or concerns.
“One of the challenges of counselling is how do you define it as a health profession – who is in and who is out,” said Dix.
“What we’re talking about here is approximately 4,600 people who practise psychotherapy. Who deal with mental health issues in a broad sense. They are not counselling on employment or other things, they have qualifications and they, I think, are a health profession.
“They are more and more important given the growing importance of mental health, so this provides the public protection and also establishes, and this is why they want it, education requirements, licensing and public professionalism.”
The move comes after high-profile cases of misconduct called into question the lack of regulation in the sector. The CBC’s Bethany Lindsay has reported extensively on the issue, highlighting, amongst others, the case of a a patient in a personal relationship without any accountability.
It would also bring B.C. into line with other provinces, like Ontario and Quebec, who have regulated the profession. Alberta is also moving to do so.
Still, the government move leaves a lot of questions unanswered. Its online consultation documents, and proposed regulatory change, do not define “psychotherapy” fully.
The Greens, for example, have called for government to close a loophole in social work regulations that allow the title to be used in some circumstances outside of the regulatory college. The proposed government changes do not appear to address that issue.
“There’s some people who would like to see it broader,” Dix said, of the changes. But, he said, this is an important first step.
Furstenau said she’d also like to see addictions treatment counsellors included, given their rising importance during the province’s ongoing toxic drug overdose crisis.
“Any company or body or organization that is doing addictions treatment needs to be regulated,” she said.
“Because I could put out a sign on my door and say I’m doing an addictions treatment program and there’s nobody doing oversight of that.”
The government proposal does not specifically mention addictions treatment, though it’s possible some counsellors may find themselves caught up in the regulation.
The changes would not happen immediately — cabinet would first have to declare the new health profession, then develop regulations, establish a college (or fold it into an existing health college) and set the rules.
It’s not clear how much of that could happen before the scheduled election date of Oct. 19.
Still, it’s a step in the right direction, which puts down a marker for future governments to follow through on, that is long overdue.
Rob Shaw has spent more than 16 years covering B.C. politics, now reporting for CHEK News and writing for Glacier Media. He is the co-author of the national bestselling book A Matter of Confidence, host of the weekly podcast Political Capital, and a regular guest on CBC Radio.
