Competency in Psychotherapy

BACKGROUND 

For nearly two years Priya has worked in an organization that offers mental health services.  Many of the clients have significant mental illness and are particularly vulnerable. Priya’s role in supporting clients began with the planning and running of functional based groups such as grocery shopping and meal preparation.  As she took on more training Priya introduced other group programming such as goal setting, communication skills and crisis prevention planning.

The pandemic has been particularly hard for this client population and the number of individuals using the centre, as well as the complexity of the needs, has increased. To meet this demand, the organization is expanding their mental health services. They have been talking about adding more individual psychotherapy sessions and specific psychotherapy groups. In a recent staff meeting Priya’s manager mentioned that she knows that OTs can “do psychotherapy” and is planning on having Priya develop and facilitate some of these groups in the upcoming year.

Initially Priya felt excited to be included in these new and exciting opportunities.  As she thought more about what this would involve, she started to consider if she is equipped to take on these new responsibilities. Over the past two years she has attended workshops that her organization has provided on topics such as motivational interviewing techniques. Has this on-the-job training and her two years of experience with this client group prepared her enough to take on these new psychotherapy roles? She knows the services are needed and doesn’t want to let her employer down. She’s feeling very conflicted and isn’t sure what to do next.

CONSIDERATIONS

Priya reviews the resources within the Standards for Psychotherapy and confirms that occupational therapists:

  • must have successfully completed training in psychotherapy and demonstrate competence prior to practising psychotherapy
  • will engage in regular supervision with a qualified practitioner of psychotherapy, appropriate to their level of experience to enhance psychotherapy skills

Priya begins to explore training options. She reviews the Association’s resources on training and supervision. She also speaks with her manager to find out more about what the psychotherapy groups would involve for example; the purpose, scope and modalities to incorporate. This helps her to decide on her specific training needs.

OUTCOME

After reviewing the expectations, Priya determines that although she has an interest in pursuing psychotherapy, she doesn’t currently have the required competency (knowledge, training, skills, and judgement) to perform psychotherapy interventions safely and effectively.

She has a discussion with her manager to explain that, yes, occupational therapists are one of the six professions that can provide psychotherapy services, however, only after gaining the competencies to do so. For Priya this means she will need to acquire additional training and appropriate supervision before providing psychotherapy services to clients. Priya is about to begin a training program that will align well with the needs of the clients and she is exploring different supervision options for the future.  To continue to grow her competence and to support her workplace, she offers to help with the development of one of the new communication modules and to sit in with the new psychotherapy group as a support to the facilitator. 

DISCUSSION

Occupational therapists have a broad range of skills to offer clients with mental health challenges. Working in the area of mental health is appropriate for occupational therapists, however, providing psychotherapy is not a competency that is solely obtained from on-the-job experience. Occupational therapists wanting to practice psychotherapy will need to expand their competence (knowledge, skill and judgment) through additional training and supervision as they transition into the field of psychotherapy.  

 

REFERENCES 

CONTACT

If you have any questions about this case, or have any ideas or requests for future cases, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or practice@coto.org.

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