The College of Occupational Therapists of Ontario has a zero tolerance policy toward sexual abuse of a client. This means that any form of sexual abuse, under any circumstance, is unacceptable.

If you have concerns or questions, please contact the College at 416.214.1177/1.800.890.6570 x234 or investigations@coto.org.

Please click on any of the questions below to display further information about sexual abuse and College processes.

What is sexual abuse?  

Sexual abuse is defined as:

Sexual relations, such as intercourse or other forms of physical sexual relations between the client and the occupational therapist.

Touching of a sexual nature of the client by the occupational therapist. In their work, occupational therapists may use their hands to touch various parts of your body. That’s part of many necessary exams and therapies. When that happens, you should expect the occupational therapist to tell you what he/she is going to do, to ask permission to touch you and to treat you with respect. Such physical contact is very different from touching you in a manner that’s not needed for treatment or assessment, such as in a sexual rather than a therapeutic way.

Behaviour or remarks of a sexual nature by the occupational therapist towards their client. That can include saying something sexually suggestive; asking you on a date; making sexual comments on your appearance or clothes; commenting about your sexual relationships; making sexually insulting or offensive comments; or giving unwanted attention (like kissing or hugging). It does not include behaviour or remarks that are necessary for the occupational therapist to do his or her work.


How do I know if I am an OT's client?  

In the context of sexual abuse, you are the client of an occupational therapist if any of the following conditions exist:

- the occupational therapist provided you with a health care service and charged or received from you, or from a third party on your behalf, payment for this service;
- the occupational therapist has contributed to your health record or file;
- you consented to a health care service recommended by the occupational therapist.

You will not be considered a client in the context of sexual abuse if all of the following conditions are satisfied:

- a sexual relationship already existed between you and the occupational therapist when the occupational therapist provided you with the health care service;
- the occupational therapist provided the health care service to you in an emergency circumstance or in circumstances where the service provided was minor in nature;
- the occupational therapist took reasonable steps to transfer your care to another health professional or there was no reasonable opportunity to transfer your care to another health professional.


I’m not sure if I was abused. What do I do?  

You are encouraged to contact the College. A staff member can help you understand the standards of practice that occupational therapists must follow, including their ethical, regulatory and clinical expectations.

You may also contact the College’s investigation staff to discuss the complaints process. If you wish, you do not have to identify yourself. You are only required to identify yourself if you choose to make a formal complaint.

To contact the College – if you are unsure or uncomfortable about occupational therapy treatment or services you have received, or to report sexual abuse – please call 416.214.1177/1.800.890.6570 x223 or email investigations@coto.org.


What if I didn’t object to what my OT was doing or if I was a willing participant?  

Sometimes, a client doesn’t object what the occupational therapist is doing, or may be the person who started the intimate/sexual relationship. In any of these instances, client consent is not relevant. It is the occupational therapist’s full responsibility to understand and maintain an appropriate relationship.


Why should I inform the College about suspected sexual abuse?  

The College may be unaware of the possible abuse. Often, incidents of sexual abuse are not isolated. By telling the College what happened, you may also be helping others who have been or may be abused. Reporting abuse protects the public. Anyone who brings forward a complaint about sexual abuse will be treated sensitively and compassionately.


Will the occupational therapist know I complained?  

Yes, if you decide to formally complain. The College must tell the occupational therapist your name so that he or she has a chance to respond to the allegations as part of the investigation. However, to protect your privacy, your personal information will not be made public.


Can occupational therapists practice when they’re accused of sexual abuse?  

Until there’s an actual decision regarding the sexual abuse (called a finding), they can. However, there are exceptions. The Inquiries, Complaints and Reports Committee (ICRC) investigates all complaints brought to the College’s attention, including those involving possible sexual abuse.

The ICRC may receive information that justifies a decision to suspend a registered occupational therapist. That’s called an “interim order”, and means the occupational therapist cannot practice while the investigation is ongoing. Through an interim order, the ICRC can also impose restrictions on the occupational therapist’s practice.


Does the College contact the police when there has been an allegation of sexual abuse?  

No. The College does not automatically report allegations of sexual abuse to the police. If you or someone you know feels they have been sexually abused by an OT, you have the right to report your concerns both to the College and to the police. A police investigation into allegations of sexual abuse is separate and distinct to any investigation carried out by the College and could result in a criminal conviction against the abusing OT. The College will only make a report to the police where the subject of the abuse consents to such a report being made.


How do I know if an occupational therapist has been accused of sexual abuse?  

Accusations are not publicly reported. All allegations are taken seriously and thoroughly investigated. Through an interim order, the College's Inquiries, Complaints & Reports Committee can impose restrictions on the occupational therapist’s practice during an investigation. Any restrictions placed on the OT's license (registration) will be made publicly available at Find an Occupational Therapist.


What happens to an occupational therapist who is found to have committed sexual abuse?  

If, following a hearing, a panel of the College’s Discipline Committee finds that an occupational therapist has sexually abused a client the Committee will impose the appropriate penalty, which may include revocation of the occupational therapist’s registration (license). A discipline hearing is the most serious proceeding that a regulated health professional can face.

Penalties can include reprimands and fines as well as the ability to limit, suspend or revoke the Occupational Therapist’s registration (license).


When must the College revoke an occupational therapist’s registration (licence) for committing sexual abuse?  

If, after a hearing before a panel of the College’s Discipline Committee, an occupational therapist is found to have committed professional misconduct by sexually abusing a client, the panel, in addition to any other action it might take, must reprimand the occupational therapist and revoke the occupational therapist’s registration (licence) if the sexual abuse consisted of any of the following acts:

Sexual intercourse;

Genital to genital, genital to anal, oral to genital or oral to anal contact;

Masturbation of the occupational therapist by, or in the presence of, the client;

Masturbation of the client by the occupational therapist;

Encouraging the client to masturbate in the presence of the occupational therapist; and/or,

Touching of a sexual nature of the client’s genitals, anus, breasts or buttocks.

Even if the sexual abuse did not involve any of these above-described acts, the Discipline Committee may still decide that the appropriate penalty is to revoke the occupational therapist’s registration.


How else can the College help if I’ve been sexually abused by an occupational therapist?  

The College provides funding to cover the costs of therapy or counselling for clients who’ve been sexually abused by their occupational therapist. You are eligible to receive funding if it is alleged in a complaint or report to the College, that you were sexually abused by an occupational therapist while you are or were the occupational therapist’s client.

If you have questions or would like more information, we can help. Please contact the Manager, Investigations & Resolutions at investigations@coto.org.


College Processes

How does the College work to address sexual abuse?  

The College defines appropriate conduct and unacceptable behavior for occupational therapists, with standards and guidelines, and enforces these expectations.

Through a Sexual Abuse Prevention Program, the College educates occupational therapists about their professional obligations, which include maintaining appropriate boundaries (the ethical lines around the relationship with clients). The College also trains its staff about what is considered sexual abuse, and provides information to the public about the expected behaviour by an occupational therapist.

The College takes all complaints seriously, about sexual abuse or any other issues. As part of its role to protect the public, the College investigates all complaints thoroughly.


If I make a complaint, how does the process work?
 

For information about the process, please view the Report Concerns or File a Complaint page. The page includes details about the steps in the process and also lists the answers to many questions about the process.


What happens if I mention the possible sexual abuse to a doctor or nurse or any other type of regulated health care professional?  

They are required by law to report it to the College. Learn more about regulated health professionals’ obligation to report this type of information on the Reporting Requirements and Processes page.


What are my responsibilities if I operate a facility where an occupational therapist works and suspect that he or she has engaged in sexual abuse? 

You have a legal obligation to make a mandatory report to the College. If you become aware that a client is being sexually abused by any regulated health care professional, you have the same obligation to report your suspicions to his or her regulator. For more information about sexual abuse mandatory reports, review the Reporting Requirements and Processes page.


As an occupational therapist, what do I do if I suspect that a fellow health care professional has sexually abused a client?  

You have a legal obligation to make a mandatory report to this College (if the instance involves an occupational therapist) or to the individual’s professional regulatory College. For more information about sexual abuse mandatory reports, review the Reporting Requirements and Processes page.

If the health care professional is not regulated, you should consider whether the client or anyone else is at risk of harm and assess the situation carefully. This assessment might include you consulting with the appropriate authority such as a supervisor, manager, risk manager, or even reporting your concerns directly to the police. 


Does the College contact the occupational therapist’s employer when there has been an allegation of sexual abuse?  

No. The College will contact the employer if there is a finding of sexual abuse against the OT or if the College's Inquiries, Complaints and Reports Committee makes a temporary order to suspend or place restrictions on the OT's license (registration).


What happens after the investigation?  

The merit or validity of a complaint is decided by the Inquiries, Complaints & Reports Committee (ICRC). The ICRC will decide if the complaint is supported based on the provided information. Following its investigation, if the ICRC has enough evidence to support a finding of professional misconduct or incompetence by reason of an occupational therapist sexually abusing a client, the Committee will refer the matter to the Discipline Committee.

A panel of the Discipline Committee will hold a hearing and impose the appropriate penalty. A discipline hearing is the most serious proceeding that a regulated health professional can face and carries with it the risk of loss of registration.


In sexual abuse cases, what will lead to an OT losing his or her license to practice? 

Occupational therapists face mandatory revocation of their Certificate of Registration (license), for a minimum of five years, if there is a finding of sexual abuse that includes any of the following involving a client:

sexual intercourse;
genital-to-genital, genital-to-anal, oral-to-genital, or oral-to-anal contact;
masturbation of the OT by or in the presence of the client;
masturbation of the client by the OT;
the occupational therapist encouraging the client to masturbate in his or her presence; or
sexual touching of genitals, anus, breasts or buttocks


Are discipline decisions about the conduct of an OT made public?  

Yes. All discipline decisions are made public. Anyone can call the College or check the list of OTs on our website at Find an Occupational Therapist. Information is also published on the Discipline page on our website.

To protect the privacy of the client, identifying information about the client is not published.