Policy and Political Action

Policy & Political Action

Support independent initiation of RN psychotherapy

The College of Nurses of Ontario (CNO) is seeking feedback on whether nurses should be permitted to initiate psychotherapy without an order from a physician (MD) or nurse practitioner (NP).

There are RNs who have been practising psychotherapy, including psychotherapy that would meet the threshold of the controlled act, for many years. Qualified RNs who are currently practising psychotherapy may continue to independently initiate psychotherapy until an exemption period ends on Dec. 31, 2019.

The proposed regulation would allow RNs to continue to initiate and perform the controlled act of psychotherapy without the need for an order from a MD or NP after Dec. 31, 2019.

Since 2014, to better protect the public and increase access to essential health services, Registered Nurses' Association of Ontario (RNAO) has been urging CNO to draft a regulation that would enable qualified RNs to independently initiate of psychotherapy. Like other disciples that already have the authority to perform psychotherapy, qualified RNs are best situated to assess their own knowledge, skill and judgment, a particular client's condition, appropriateness of intervention, and accept sole accountability for initiation. That is why then-Minister of Health and Long-Term Care, Dr. Eric Hoskins, asked CNO to revisit their 2014 decision requiring an order by a MD or NP as he had "full confidence in a RN's ability to make an appropriate assessment to initiate the act."

RNAO has written to CNO supporting the proposed regulation that would enable independent initiation of RN psychotherapy. In addition, RNAO urges CNO to provide practice standards, guidelines, and tools equivalent to the other regulatory colleges who members practice psychotherapy. This would provide clarity to novice nurse who are seeking direction in pathways to provide psychotherapy services, enhance public safety, and provide a common, congruent approach for this vital service.

Here are two things that you can do:

1. Sign the action alert below and share it with your networks. You can edit the email message and the subject line to add your own comments.
2. Indicate your support for the proposed regulation that would enable RNs to independently initiate the controlled act of psychotherapy on the CNO website.

Deadline: Monday, Feb. 18, 2019

The action alert will be sent to Minister of Health and Long-Term Care, Hon. Christine Elliott.

Copies will be sent to:

  • Hon. Doug Ford, Premier of Ontario
  • Andrea Horwath, Leader of the Official Opposition
  • France Gélinas, Critic, Health Care
  • John Fraser, Interim Leader of the Ontario Liberal Party
  • Michael Schreiner, Leader of the Green Party of Ontario
  • Anne Coghlan, Executive Director & Chief Executive Officer
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