Regulation - LGIC

The performance of the controlled act of psychotherapy by occupational therapists

Regulation Number(s):
New Regulation
Instrument Type:
Regulation - LGIC
Bill or Act:
Occupational Therapy Act, 1991
Summary of Decision:
Made: November 29, 2019
Approved: December 12, 2019
Filed: December 23, 2019
Published on e-Laws: December 23, 2019
Printed in The Ontario Gazette: January 11, 2020
Analysis of Regulatory Impact:
The proposed regulation is not expected to have any new incremental costs to Ontario businesses. The proposed regulation is consistent with existing mechanisms for services provided by OTs and does not create any new regulatory compliance costs.
Further Information:
Proposal Number:
Posting Date:
November 12, 2019
Summary of Proposal:
College Introduction

In Ontario, the regulation of health professions is based on a self-governance model. There are 26 health regulatory colleges governing 28 health professions under the Regulated Health Professions Act, 1991 (RHPA) and their respective health profession Acts.

Under the RHPA and the Occupational Therapy Act, 1991, the College of Occupational Therapists of Ontario (COTO) is responsible for governing the profession of occupational therapy in Ontario. Under these Acts, the COTO has the authority to make regulations on a variety of subject matters, including regulations regarding the performance of controlled acts authorized to the profession. The proposed regulation is subject to prior review by the Minister of Health and the approval of the Lieutenant Governor in Council (LGIC).


As a core component of the RHPA, there are specified controlled acts which include procedures or services that are considered to represent the most significant, invasive and potentially harmful health care services. Under the RHPA, these activities may only be performed by individuals authorized by their health profession specific Act or through another identified mechanism in the legislation. All other individuals are prohibited from performing these activities unless they are being performed under certain, limited circumstances (i.e. in an emergency).

The controlled act of psychotherapy was proclaimed on December 30, 2017, adding it to the list of controlled acts in the RHPA. At the same time, a two-year transitional period, ending December 31, 2019, was established to allow providers and organizations to undertake the necessary work to prepare for the coming in to force of the controlled act of psychotherapy.

Beginning December 31, 2019, only physicians, nurses, occupational therapists, psychologists, psychotherapists and social workers and social service workers who are authorized by their respective regulatory college will be able to perform the controlled act of psychotherapy.

COTO is proposing a new regulation to be made under the Occupational Therapy Act, 1991. The regulation would allow OTs to perform the controlled act of psychotherapy after December 31, 2019, if they meet the conditions of the regulation.

These conditions include, but are not limited to, the OT having the knowledge, skill and judgement to safely perform the controlled act and that the OT has determined the individual's condition warrants performance of the controlled act. Additionally, OTs are responsible for adhering to the standards of the profession in all aspects of their practice; this expectation will continue to apply to OTs performing the controlled act of psychotherapy.

The proposed regulation is intended to ensure that patients receiving psychotherapeutic services from OTs have continued access to care.

Should you wish to provide feedback on this proposal, you may provide it by email to
Contact Address:
Health Workforce Regulatory Oversight Branch
Strategic Policy, Planning and French Language Services Division
438 University Avenue, 10th Floor
Toronto ON M5G 2K8
Effective Date:
January 1, 2020