If you are looking for a therapist in Ontario, you may have come across occupational therapists who provide psychotherapy and wondered: Can an occupational therapist actually provide psychotherapy?
The short answer is yes.
In Ontario, occupational therapists (OTs) are regulated health professionals who can be authorized to provide the controlled act of psychotherapy. The College of Occupational Therapists of Ontario (COTO) specifically states that occupational therapists have direct authority to perform the controlled act of psychotherapy, provided they have the required knowledge, skills and judgment to do so.
This can be confusing because many people associate occupational therapy primarily with physical rehabilitation, assistive equipment or helping people return to work after an injury.
However, occupational therapy is a much broader profession. Occupational therapists can work in mental health and provide psychotherapy as part of their professional practice.
What is an occupational therapist?
Occupational therapists are regulated health professionals who help people participate in the activities and roles that are meaningful and important to them.
In occupational therapy, the word “occupation” does not simply mean employment. Occupations are the everyday activities that make up our lives, including:
Taking care of ourselves
Working or attending school
Maintaining relationships
Sleeping
Eating
Managing a household
Participating in hobbies
Socializing
Caring for others
Managing responsibilities
Participating in the community
Many of these daily activities become very difficult or impossible with mental illness. Because mental health can have a profound impact on all of these areas, occupational therapy has a long history of working with people experiencing mental health challenges.
Can occupational therapists provide psychotherapy in Ontario?
Yes.
Psychotherapy is one of the controlled acts that occupational therapists in Ontario have direct authority to perform.
COTO identifies psychotherapy as the one controlled act for which occupational therapists have direct authority. An OT does not need to receive delegation from a physician, psychologist, social worker or Registered Psychotherapist in order to perform the controlled act of psychotherapy.
COTO's guidance explains that OTs who are competent to provide psychotherapy are authorized to perform the controlled act and are expected to practise according to the College's Standards for Psychotherapy.
An occupational therapist providing psychotherapy is practising as a regulated health professional and is accountable to the regulatory requirements that apply to occupational therapy practice.
What is the controlled act of psychotherapy?
Ontario law defines psychotherapy as treating, by means of a psychotherapy technique delivered through a therapeutic relationship, an individual's serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair their judgment, insight, behaviour, communication or social functioning.
The fact that psychotherapy is a controlled act is important.
Controlled acts are health-care activities that are considered to carry a higher level of risk and therefore can only be performed by health professionals who have the appropriate legal authority and competence.
In Ontario, several regulated health professions can have authority to perform the controlled act of psychotherapy, including:
Occupational Therapists
Registered Psychotherapists
Registered Social Workers
Psychologists
Physicians
Nurses
Each profession is regulated by its own legislation and regulatory college, and professionals must practise within their scope of practice and competence.
Does an occupational therapist need to be a Registered Psychotherapist to provide psychotherapy?
No.
This is one of the most common points of confusion.
An occupational therapist does not need to be registered with the College of Registered Psychotherapists of Ontario (CRPO) in order to provide the controlled act of psychotherapy.
Occupational therapists have their own regulatory college: the College of Occupational Therapists of Ontario (COTO).
COTO specifically states that occupational therapists have direct authority to perform the controlled act of psychotherapy and that OTs performing psychotherapy are expected to follow the College's Standards for Psychotherapy.
There is also an important distinction between the terms “psychotherapist” and “Registered Psychotherapist.”
“Registered Psychotherapist” is a specific professional title associated with registration with the College of Registered Psychotherapists of Ontario.
An occupational therapist who meets the applicable requirements may provide psychotherapy without being a Registered Psychotherapist.
In other words:
An OT can be a psychotherapist without being a Registered Psychotherapist.
Is psychotherapy provided by an OT different from psychotherapy provided by an RP?
No.
Both occupational therapists and Registered Psychotherapists can provide psychotherapy, and both are regulated health professionals.
The difference is often the professional lens through which the therapist understands your concerns.
An occupational therapist may bring additional attention to how mental health affects your everyday functioning and participation.
For example, therapy might explore not only:
“How are you feeling?”
but also:
How is anxiety affecting your ability to attend school?
How is OCD interfering with your relationships?
How is trauma affecting your ability to work?
How is an eating disorder affecting your daily routines?
What happens when emotional distress makes it difficult to care for yourself?
How are your symptoms affecting sleep, eating, social participation or meaningful activities?
What changes would help you participate more fully in your life?
This doesn't mean that OT psychotherapy is simply “therapy plus occupational therapy.”
Rather, an occupational therapist may naturally consider the relationship between mental health, daily functioning and participation as part of their clinical perspective.
What kinds of mental health concerns can an OT treat with psychotherapy?
An occupational therapist's scope of practice does not mean that every OT provides psychotherapy or treats every mental health concern.
Like any regulated professional, an OT must practise within their education, training, competence and professional scope.
An OT who has additional training and experience in psychotherapy may work with concerns such as:
Anxiety
Depression
OCD
Trauma
Eating disorders
Emotional regulation difficulties
Relationship difficulties
Life transitions
Perfectionism
Stress
Difficulties with self-esteem
Behavioural patterns that interfere with daily life
The specific concerns an OT treats will depend on their individual education, training, experience and area of practice.
For example, at Cedar Tree Therapy, psychotherapy is provided to adults experiencing concerns including anxiety, OCD, eating disorders and trauma.
Why might someone choose an OT for psychotherapy?
There is no single “right” profession to choose when looking for a therapist.
The most important considerations are usually whether the therapist has appropriate training and experience with the concerns you want to address and whether you feel comfortable working with them.
However, an OT may be a particularly good fit for someone who wants therapy to connect closely with their everyday life.
For example, you may want to work on:
Mental health + daily functioning
Rather than focusing exclusively on symptoms, therapy can also consider how those symptoms affect your ability to live the life you want.
For someone with OCD, that might mean addressing intrusive thoughts and compulsions while also working toward being able to attend university, maintain relationships, travel or participate in activities that have become restricted by OCD.
For someone recovering from trauma, it might mean addressing trauma-related symptoms while also rebuilding routines, relationships, confidence and participation in meaningful activities.
For someone experiencing an eating disorder, treatment may involve both psychological recovery and the impact that the eating disorder has had on daily routines, social activities, relationships and participation.
What should I look for when choosing an OT who provides psychotherapy?
Not every occupational therapist provides psychotherapy.
If you are considering an OT for psychotherapy, ask about:
1. Their psychotherapy training
Ask what formal psychotherapy education and additional training they have completed.
2. Their clinical experience
Ask whether they regularly work with the specific concern you want help with.
For example, if you are looking for OCD treatment, you may want to ask specifically about experience with Exposure and Response Prevention (ERP).
If you are looking for trauma therapy, ask about the therapist's training and approach to trauma treatment.
3. Their regulatory status
You can verify that an occupational therapist is registered with the College of Occupational Therapists of Ontario. You want to make sure your insurance will cover psychotherapy with a therapist that holds this license type.
4. Their approach to treatment
Ask what types of therapy they use and what treatment might look like.
5. Insurance coverage
Insurance coverage can be particularly confusing when psychotherapy is provided by an occupational therapist.
Some benefit plans distinguish between occupational therapy and psychotherapy, and coverage depends on the specific wording of your plan.
Before beginning therapy, it is a good idea to contact your insurance provider and ask specifically whether psychotherapy provided by an occupational therapist is covered under your plan.
You may also want to ask whether the therapist must be listed under a particular provider category and whether there are limits on the amount of coverage available.
What is the difference between an OT psychotherapist and a Registered Psychotherapist?
Both are regulated professionals who may provide psychotherapy in Ontario.
The primary difference is their professional regulatory college and professional background.
An OT is regulated by the College of Occupational Therapists of Ontario, while a Registered Psychotherapist is regulated by the College of Registered Psychotherapists of Ontario.
Both professions have regulatory standards governing their practice.
The therapist's individual education, training, experience and clinical approach may be more important to your treatment than the professional title alone.
When choosing a therapist, look beyond the letters after their name and consider:
Do they have the training and experience to help me with the problem I'm experiencing?
So, can an occupational therapist provide psychotherapy in Ontario?
Yes.
Occupational therapists in Ontario have direct authority to perform the controlled act of psychotherapy. COTO specifically identifies psychotherapy as a controlled act that OTs are authorized to perform, provided they have the appropriate competence and practise within their professional requirements.
You do not need to be a Registered Psychotherapist to provide psychotherapy as an occupational therapist.
What matters is that the OT is appropriately registered, competent and trained to provide the services they offer and follows the professional and regulatory standards that apply to their practice.
Looking for psychotherapy with an occupational therapist in Ontario?
At Cedar Tree Therapy, psychotherapy is provided by an occupational therapist who also practises the controlled act of psychotherapy.
Therapy can also help you understand how anxiety, OCD, trauma or eating concerns are affecting your relationships, routines, work, school and ability to participate in the parts of life that matter to you.
If you're considering therapy and want to know whether an OT psychotherapist may be a good fit for you, you can learn more about psychotherapy services at Cedar Tree Therapy or reach out to discuss whether the practice is appropriate for your needs.
Frequently Asked Questions
Can an occupational therapist be a psychotherapist in Ontario?
Yes. Occupational therapists in Ontario have direct authority to perform the controlled act of psychotherapy when they have the appropriate competence and practise according to the requirements of their regulatory college.
Does an OT need to be registered with CRPO to provide psychotherapy?
No. An occupational therapist does not need to be a Registered Psychotherapist or registered with CRPO to provide psychotherapy. OTs are regulated by the College of Occupational Therapists of Ontario and have direct authority to perform the controlled act of psychotherapy.
Can an OT call themselves a psychotherapist?
COTO states that OTs may use the protected title “Psychotherapist” when identifying themselves as an OT, subject to the requirements of the Regulated Health Professions Act and applicable standards.
Is psychotherapy from an OT covered by insurance?
It depends on your individual insurance plan. Coverage varies between insurers and benefit plans, so clients should confirm directly with their provider whether psychotherapy provided by an occupational therapist is covered.
Is an occupational therapist the same as a Registered Psychotherapist?
No. They are different regulated professions. Occupational therapists are regulated by COTO, while Registered Psychotherapists are regulated by CRPO. Both may be authorized to provide psychotherapy in Ontario.
Can an OT treat OCD?
An OT who has appropriate training and competence in OCD treatment can provide psychotherapy for OCD. When choosing an OCD therapist, ask about their specific training and experience with evidence-based OCD treatment, including Exposure and Response Prevention (ERP).
Can an OT provide trauma therapy?
An OT with appropriate training and competence can provide psychotherapy for trauma-related concerns. The specific approaches used will depend on the therapist's education, training and clinical experience.
A note about this information: This article is intended for general educational purposes and is not legal, regulatory or insurance advice. Professional requirements and insurance policies can change. For questions about an occupational therapist's scope of practice, consult the College of Occupational Therapists of Ontario. For questions about your insurance coverage, contact your insurer directly.