My genuine apologies in advance: this is going to be looong. But it’s so important that you have all the knowledge necessary to make a fully informed decision about your practitioner. There’s a lot of (mis)information to wade through out there. I’ve summarised the most salient points here — with links to additional detail and supporting sources — to help facilitate your process!

Okay, here we go…

‘Psychotherapy’ is what’s known as a ‘controlled act’, and ‘psychotherapist’ is a ‘protected title’, in Ontario — meaning that only specific, regulated practitioners are legally allowed to call themselves psychotherapists and/or practice psychotherapy. These include members of The Ontario College of Social Workers and Social Service Workers (the OCSWSSW, of which I’m a member), The College of Nurses of Ontario, The College of Occupational Therapists of Ontario, The College of Physicians and Surgeons of Ontario, The College of Psychologists of Ontario, and The College of Registered Psychotherapists of Ontario.

Regulation is a means of reducing risk of harm to clients through education and training requirements, standards of practice, ethical obligations, and a formal complaints process for breaches of these standards and obligations. All currently regulated healing professions were once unregulated, and began with culturally embedded, community-based service, care, and expertise — built through the art, science, and politics of survival.

Many practices and modalities — particularly holistic interventions that engage body, mind, spirit, and system — are rooted in the attuned brilliance and exhaustive, loving labour of BIPOC communities across time, place, and intersections (notably within and between disability, queer, trans, womxn, femme, poor, working-class, spiritual, and faith-based communities) and have been extractively, aculturally, and/or acitationally co-opted for ownership, gatekeeping, power, and profit by western disciplines, white scholars and practitioners, and the colonial state. Many folx who devote their existence to radical care and healing — who are experts, scholars, practitioners, leaders, educators, facilitators, consultants, and specialists — can’t or don’t seek the institutional ‘education’ to ‘practice’ what they’re already living. Some of us bide our time, whittled away to the nub by glorious, arduous labour that’s sickeningly underpaid and even more that doesn’t count as ‘work’, perhaps finally securing the resources to credentialise our gifts and callings — only to have more of our commitment and skills stolen and undervalued through unpaid internships and low-wage positions that claim to ‘teach’ us without recognising what we’ve been embodying all our lives and across generations…we have much to learn and contribute, but fear and/or accept that little-to-none of it will be realised through these means. All of us collaborating in this transformative, relational changework know that to persist ethically and sustainably, we’ll have to be relentlessly, creatively resistant against burnout, scarcity, austerity, assimilation, erasure, division, cynicism, and denigration. Too many more of us to fathom would be wounded, ailing, abandoned, alienated, or dead without this strategising, exploitation, genius, sacrifice, and sustenance.

There are highly skilled and ethical practitioners working as part of currently unregulated care and healing professions — for example, peer workers, somatic coaches, meditation teachers, craniosacral therapists, manual osteopaths, and birth and end-of-life doulas — and practitioners who meet the standards for membership within a particular college but fail to provide skilled, ethical care. In other words, regulation shouldn’t — in and of itself — be seen as a guarantee of a given practitioner’s capacities to meet your specific needs and expectations, and there may be practitioners who are part of unregulated professions and the broader community who could better meet them.

Click here to read a Canadian Association of Social Workers (CASW) article that summarises the basic differences between how social workers, psychologists, psychiatrists, and GPs practice with regards to assessment and treatment in the context of mental health. Click here for an Ontario Association of Social Workers (OASW) FAQ that provides more rich and specific detail about how social workers practice in this context. The relationally supported, talk-based aspect of this change, growth, and wellness work may be referred to as either psychotherapy, therapy, or counselling — depending on practitioner, jurisdiction, discipline, and practice environment — but ‘counselling’ is not a regulated act in Ontario. Click here for a comprehensive (and accurate!) blog post written by a colleague at The Healing Collective, which digs a bit deeper into how members of each of the above Ontario colleges practice psychotherapy. A key consideration is the overlap and distinction between Registered Social Workers (RSWs) and Registered Psychotherapists (RPs) in this province, which include clear differences in educational backgrounds and nuanced variability in core disciplinary values, conceptualisations, and foci. At the practitioner level, differences between how an RSW psychotherapist and an RP approach this work come down to a unique and unfolding interplay of their chosen field, where they studied, lived experience, their philosophies of existence and care, continued learning and development, and spirituopolitical values (whether or not the therapist openly acknowledges this) — for clients, this is where research, consultation, and fit really come in to play.

In Ontario, social workers comprise the majority of practitioners offering mental health services and psychotherapy. Click here to read how the OCSWSSW outlines the scope of practice for RSWs (which includes me). Click here for the OCSWSSW’s specific guidelines for the practice of psychotherapy by RSWs. Realistically, our work could encompass modalities and processes that fall within the scope of the regulated act of psychotherapy, the also-regulated practice of social work, the unregulated acts of counselling and somatic guiding/coaching, and what the OCSWSSW defines as ‘psychotherapy services’ and ‘counselling services’ (you can read more about the murky distinctions between these services and the act of psychotherapy on page 5 of the linked guidelines). It would also, most importantly, include the deeply healing, living praxis of genuine, inquisitive, empathic, nurturing, embodied, and just human interconnecting — which cannot be regulated, possessed, or professionalised, but must be care-fully boundaried, continuously consensual, and radically ethical in the context of a therapeutic relationship.

As noted, members of each of the above Ontario colleges adhere to a specific code of ethics and standards of practice — click here for the OCSWSSW’s, to which I adhere as a foundational baseline. Click here for detailed information regarding filing a complaint or report about an RSW’s professional conduct. An important, often obscured caveat: because ethics and the realities of practice on the ground are inherently nuanced and unavoidably rife with dilemmas, all codes of ethics and standards of practice contain irreconcilable contradictions — and those of the OCSWSSW are no exception. For example, in community service and group practice settings, how do practitioners navigate conflicts between the College’s requirements, their own values, and the policies of the organisation they work for? In theory, members of the OCSWSSW are required to “maintai[n] the best interest of the client as the primary professional obligation”, “tak[e] an anti-racist and anti-oppressive stance in their work”, and “advocat[e] for social justice” (among many other ethical duties); in reality, agency and group practice policies often blatantly and oppressively contravene client and community rights to self-determination, dignity, justice, and holistic well-being — instead prioritising risk mitigation, financial gain, professional status, control over care, and other constraints of colonial and neoliberal bureaucracy. In these cases, highly committed, well‑intentioned practitioners have to make spirit‑wounding, values‑challenging, near‑impossible decisions that somehow work to reconcile their promised duty to “advocat[e] for workplace conditions and policies that are consistent with [the OCSWSSW’s] Code of Ethics and the Standards of Practice” and the undeniable threat of being disciplined or terminated by their employer (thus no longer being able to serve the very clients and communities to whom they were duty-bound!). Matters are further complicated for OCSWSSW members — myself included — who work with a serious commitment to anti‑carceral, anti‑coercive, anti‑colonial (i.e., justice‑oriented) practice, particularly around the intricacies of our duties to warn, protect, and report: we risk professional discipline and possible revocation of our registration to practice by adhering to the core, imperative values of social work and the College’s stated Code of Ethics (as we must…but, also, heart- and gut-wrenching).

Very (very!) broadly speaking, social workers providing mental health services and practicing psychotherapy engage a range of interventions that overlap with those employed by other practitioners, but necessarily underpinned with an ethical commitment to social justice — understanding and addressing the ways in which their clients’ experiences are dynamically embedded in systemic context. While social workers provide comprehensive, holistic assessment and intervention across biological, psychological, emotional, social, political, cultural, temporal, environmental, and spiritual domains, we cannot diagnose mental ‘disorder’ or ‘illness’ (as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders), nor can we prescribe medication of any kind — though we can and should connect you with practitioners who provide these services, when appropriate. Social workers who practice psychotherapy should have additional, specialised training beyond their Bachelor and/or Master of Social Work; are required to engage in ongoing learning and development; and should be supervised in their work, via mentor practitioners and peer colleagues, in independent, group, and organisational practice settings.

Given our systems-based, client-centred lens, most social worker psychotherapists (including me!) draw from a range of therapeutic modalities and associated interventions/techniques (e.g., Emotion/Emotionally Focused Therapy [separate modalities both known as EFT], Narrative Therapy, Relational Psychotherapy, Acceptance and Commitment Therapy [ACT], Cognitive Behavioural Therapy [CBT], Dialectical Behaviour Therapy [DBT], psychodynamic therapies, Gestalt Therapy, Internal Family Systems [IFS], Structural Family Therapy, Motivational Interviewing, somatic [i.e., body-mind] therapies, feminist therapies) to practice what’s known as ‘integratively’ — responsively adapting to each client’s specific, multifaceted experiences, sense(s) of self, and therapeutic needs.

Whether in work with individuals, couples, constellations/polycules, families, groups, communities, organisations, or institutions, many social workers (including me!) explicitly commit to anti-oppressive; anti-racist; anti-colonial; anti-ableist; anti-saneist; non-pathologising; sex, sex work, kink, and body positive; harm reduction-based; 2SLGBTQIA+-liberatory; culturally humble; trauma-informed; strength-affirming practice…but this does not necessarily mean that they will hold themselves accountable to these complex, intersecting, demanding praxes, and even when they do, they — meaning we, meaning all of us — will inevitably stumble. Ask a lot of questions when you’re seeking services; challenge practitioners when it feels important and safe to do so; trust your psychopoliticospiritual gut; and always feel free to discontinue service with any practitioner (social worker or not) who fails to accept feedback with open-hearted humility, engage in critically attuned repair work, and accountably (re)enact their espoused ethics.

…we made it :)!