Why Ontario Must Uphold High Standards for Psychologists: A Call to Protect the Integrity of Our Profession

by | Jul 7, 2025 | Advocacy, Therapy, Training | 0 comments

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As a clinical psychologist, clinic director, and lifelong advocate for evidence-based care, I want to sound the alarm on a concerning development in our profession. The Ontario Psychological Association (OPA) recently sent out a message to its members about proposed changes by our regulatory college that could profoundly reshape what it means to be a psychologist in this province.

Below is the full message from the OPA Board of Directors:

IMPORTANT MESSAGE TO MEMBERS FROM THE OPA BOARD OF DIRECTORS


We are writing to inform members about a proposal we recently became aware of under consideration by the College of Psychologists and Behaviour Analysts of Ontario (CPBAO). This proposal, which was brought to our attention in May, has reportedly been passed by the CBPAO council and recommends a revision of the educational and training standards required for registration as psychologists and psychological associates in Ontario.

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By way of background, the Office of the Fairness Commissioner (OFC), which oversees registration practices for regulated professions in Ontario, rated the CPBAO as ‘medium to high risk’ in its 2022 and 2024 assessments. The most recent report cited concerns related to frequent appeals to the Health Professions Appeal and Review Board (HPARB), labour market shortages, and the under-representation of racialized individuals among PhD registrants. Recommendations included more flexible pathways for internationally trained psychologists and regular review of HPARB outcomes.

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We understand that the CPBAO proposal outlines several potential changes aimed at addressing the concerns raised by the Office of the Fairness Commissioner (OFC), which may include:

  1. Changes to program accreditation standards,
  2. The removal of the doctoral standard for psychology,
  3. The removal of the 4-year period of supervision required for registration among psychological associates.

We acknowledge the OFC’s concerns and understand the government’s emphasis on improving interprovincial mobility. Differences in registration requirements across provinces, coupled with Canada’s Free Trade Agreement, have created challenges including a rise in professionals with varied titles, training, and qualifications. This variation has led to public confusion and underscores the need for greater consistency and alignment across the profession.

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The OPA is committed to discussing the identified issues with key stakeholders to further understand and advance appropriate alternatives. We recognize the need to expand the psychological workforce and address the Fairness Commissioner’s concerns, however we believe there are more thoughtful and effective ways to do so, without increasing confusion or compromising the safety of psychological services to Ontario residents. We are also committed to fair and inclusive access to psychology training and are proud of the progress underway.  We believe there is a path forward for retaining standards, addressing OFC’s concerns and maintaining the integrity of the profession.  

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Simply revising or removing standards will not appropriately address challenges related to diversity, access, or the costs associated with mental health care; rather, it risks eliminating safeguards that protect Ontarians, while significantly eroding our professional reputation as experts in the field of mental health assessment and treatment. Like physicians and nurse practitioners, psychologists and psychological associates hold the protected act of diagnosis and require training that reflects this responsibility. 

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Since becoming aware of this proposal, we have been actively engaged in clarifying the facts, conducting outreach with key stakeholders, and developing materials to support the maintenance of the current appropriate registration standards. We are pleased to share that our advocacy efforts have facilitated meaningful connections and dialogue with stakeholders similarly devoted to upholding the overarching registration standards for psychology in Ontario. At the same time, we recognize that continued vigilance and advocacy will be necessary. We remain committed to promoting adherence to best practices in training, education, and supervision to ensure that psychologists in Ontario continue to be recognized for their high standards of competence and professionalism. As discussions around mobility and regulatory modernization continue, it is essential that any changes occur in partnership with key stakeholders, including the OPA. We look forward to continuing this important work.

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Please be assured that we will continue to update the membership.

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The Ontario Psychological Association and the Board of Directors

This proposal passed by the College of Psychologists and Behaviour Analysts of Ontario (CPBAO) has sparked serious concern among Ontario psychologists. As outlined by the Ontario Psychological Association (OPA), the proposed changes could significantly lower the educational and training requirements for registration as a psychologist or psychological associate. These changes may include:

  • Removing the doctoral degree requirement for psychologists;
  • Eliminating the four-year supervision requirement for psychological associates;
  • Altering accreditation standards for training programs.

These proposals appear to be a response to pressure from the Office of the Fairness Commissioner (OFC), which is advocating for increased access to the profession and improved interprovincial mobility. While access and fairness are essential goals, this approach is fundamentally flawed.

There Is No Shortage of Therapists

Let me be blunt: there is no shortage of therapists in Ontario. Since the creation of the College of Registered Psychotherapists in 2015, the mental health landscape has been flooded with competent, hardworking professionals, adding many psychotherapists to the existing field of social workers and nurse psychotherapists. These individuals provide the bulk of mental health services, and they are doing valuable, often life-changing work.

But here’s the reality: none of these professions are authorized to perform the controlled act of diagnosis. Nor do they receive the advanced, in-depth training required to manage complex clinical presentations, supervise other clinicians, or lead interdisciplinary treatment planning. That is the role of the psychologist.

If the goal is to allow easier movement across provinces or create faster pathways to practice, then aspiring professionals already have options. One can obtain a master’s degree and become a psychotherapist with far fewer barriers. The suggestion to dismantle the rigorous standards of psychology in the name of mobility is not only short-sighted—it’s dangerous.

Psychologists Are the Dentists of Mental Health

Think of it like this: in a dental office, you have dental assistants (technicians), dental hygienists (primary care providers), and dentists (diagnostic and treatment leaders). Dental hygienists provide most of the routine care, but it is the dentist who diagnoses, develops treatment plans, and supervises the entire process.

Psychologists play the same supervisory, diagnostic, and consultative role within the mental health system. Our training prepares us to assess the full clinical picture, understand differential diagnoses, supervise and support the work of others, and lead the system in evidence-based care.

To remove these responsibilities—or to water down the standards needed to attain them—is to risk collapsing this entire structure. We would no longer have a class of highly trained clinicians to lead the system forward. We would instead flatten the profession into a sea of generalists with minimal differentiation in training and expertise.

Prescription Rights: The Next Logical Step

Rather than weakening psychology’s entry requirements, we should be expanding our scope of practice to include prescription rights—a logical and evidence-based solution to our mental health crisis.

Research consistently shows that combined treatment using psychotherapy and medication is the most effective intervention for conditions such as depression and anxiety (e.g., Cuijpers et al., 2020; Thase, 2013). Psychologists are already experts in evidence-based psychotherapy. With additional training, they can—and should—become prescribers.

This model is already in place in several U.S. jurisdictions, including New Mexico, Louisiana, and the Department of Defense, where prescribing psychologists have been shown to provide safe, effective, and accessible care (DeNelsky & Garb, 2006).

Currently, however, medication for mental health conditions in Ontario is typically managed by:

  • Family physicians, who may lack the time, training, or continuity of care to prescribe appropriately.
  • Psychiatrists, who are in such short supply that waitlists can stretch for months or years. When accessed, these appointments often last just five to ten minutes.

In this climate, prescribing psychologists could dramatically improve access, continuity, and treatment quality—especially for patients with complex, treatment-resistant conditions. But this will never happen if we simultaneously reduce the educational requirements for entering the profession.

Granting prescribing rights demands high standards. It requires advanced diagnostic knowledge, pharmacological training, and strong clinical judgment. If we allow psychology to become a low-barrier profession, we are effectively disqualifying ourselves from the very future we should be moving toward.

What We Risk Losing

Lowering entry standards won’t make our system more equitable. It won’t address psychiatric shortages. It won’t improve patient care. Instead, it will:

  • Undermine public trust in the title of “psychologist.”
  • Confuse patients and referral sources.
  • Reduce the profession’s ability to lead, supervise, and innovate.
  • Widen the gap between our current scope and the future we should be fighting for.

Ontario needs more highly trained psychologists—not fewer. We need to invest in more doctoral-level training programs, create financial supports for students from underrepresented backgrounds, and expand the career opportunities of psychologists by evolving the scope of practice. That’s how we address workforce shortages without compromising care.

What I’m Doing—and What You Can Do

I’ve already written to my MPP to express my concerns. I urge all of my fellow psychologists, trainees, and clinic directors to do the same. Let your MPP know that these changes are a step in the wrong direction—and that Ontario deserves better.

In the meantime, I will continue to advocate for a system where psychologists are positioned as clinical leaders: experts in diagnosis, treatment, supervision, and—eventually—prescribing.

This is not the time to shrink our profession. This is the time to grow it into what Ontario’s mental health system truly needs.

References:

  • Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., van Straten, A. (2020). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. The Lancet Psychiatry, 7(6), 491–505.
  • Thase, M. E. (2013). Combining psychotherapy and pharmacotherapy for depression: Psychodynamics, cognitive-behavioral therapy, and the sequence of treatment. Biological Psychiatry, 73(1), 47–53.
  • DeNelsky, G. Y., & Garb, H. N. (2006). Prescription privileges for psychologists: A dangerous precedent. Professional Psychology: Research and Practice, 37(2), 219–227.

If you would like a template to email your MPP or help getting involved, don’t hesitate to reach out.

jennbossio

Dr. Jenn Bossio is a Clinical and Health Psychologist, the founder and director of the Tri Health Clinic—Ontario’s largest sex and couples therapy practice—and a passionate advocate for system-level change in mental health care. Based in Kingston, she was named Business Person of the Year (2025) and recognized as one of the Top 40 Under 40 (2024). Jenn is committed to redefining the role of psychologists in a rapidly evolving health care landscape.

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