Questions and Answers about MTABC and Regulation

General questions about government regulation

What is government regulation?
Government regulation refers to the legislation and procedures that a provincial government sets out for a profession and its members to be registered as a health profession within a particular province, with the purpose of protecting the public from harm. Once a provincial government regulates a profession, the College of that profession becomes the regulatory body that oversees the following professional functions. A “College” is the legal term and entity regulating the profession:

• registration and licensure of professional members
• approval of training program curriculum and faculty qualifications, including internships
• handling of ethical complaints
• requiring appropriate liability insurance and membership in the College
• requiring College members to maintain minimum standards of professional development, continuing education and upgrades
• ensuring minimum standards of practice are adhered to as per the competency profile
• ensuring title protection for College members, in order that the public receives standardized services by a recognized professional

What is the purpose of government regulation?

The goal of regulation is to reduce the risk of harm to the public while maximizing the well-being of the client. Provincial or territorial governments grant professional self-regulation as a privilege that requires standards of practice. Under the Agreement on Internal Trade (AIT), these standards must be comparable across Canada. There are two types of regulatory statutes: “stand alone” and “umbrella”.

There are different ways to assess the status of individuals within a College – by credential or by competency. What are they and how do they apply to regulation?

Credential is evidence of a qualification, competence or authority issued to an individual or third party who is assumed by practice, by assumed competence or by law to have authority to do so. This is usually in the form of an educational achievement (degree, diploma) or a professional designation or license.

Competence refers to a required standard for an individual to properly perform a specific job. It reflects knowledge, skills and behaviour. More generally, competence is the state or quality of being adequately or well qualified, having the ability to perform a specific role. Competencies can be gained through formal and informal learning and are generally integrated, each competency informing the other.

Capability is the ability to perform actions. In terms of labour, capability is the sum of an individual’s expertise and capacity. Capability represents a mix of skills that are brought to the work place, a position, or task, and which speaks to potential.

What is “shared scope of practice”?

In the health care industry, there are many overlapping areas of practice (for example, assessment and treatment). These would be considered “shared scope of practice”. Other areas, such as diagnosis or surgery, have been the scope of Medical Doctors. The Health Professions Act reviews requests for “limited scope of practice” and this ultimately establishes the privied territories of a particular discipline, or in this case, professional groups with a shared area of practice, namely counselling therapy.

What is a “reserved act”?

A “reserved act” defines a particular professional intervention that is “reserved” exclusively to be performed by members of a particular College. An example might be that a particular College has identified the reserved act of diagnosing a mental health illness as only being carried out by members of a particular College. This ability or skill would then become part of the competency profile for that particular College, and other Colleges would not be able to perform this act. In other provinces, reserved act is sometimes called a “controlled act”. The terms are synonymous.

What is AIT?

Agreement on Internal Trade requires provincial regulators to use competencies as a means of comparing the requirements of other jurisdictions in order to make labour mobility decisions. This is to protect a worker’s right to move from province to province and transfer their regulated status without having to upgrade education or qualifications. In general, AIT requires a competency-based regulatory approach in order to assess workers across various provinces who have a variety of trainings within a particular profession. The Agreement on Internal Trade (AIT)

What is title protection?

After implementation of the regulatory College, a music therapist who decides to not belong to the college would not identify as a ‘music therapist’ as this would be a protected title under the regulation. The regulatory college would have legal powers to go after those using protected titles. Those music therapists not registered with the regulatory college may not be allowed to use the MTA designation. Only those belonging to the College would be able to use the MTA assuming that designation would be granted exemption in that province.

The College of Counselling Therapists in BC

Why is the proposed new college called the College of Counselling Therapists?

In the late 1990’s when individual association members (who would eventually become members of the Task Group for Counsellor Regulation) were submitting applications to the Health Professions Council, the Health Professions Council saw that many like-minded professions were requesting regulation. In consultation with the Task Group, they suggested the term “Counselling Therapy” to cover all the constituent professionals (Clinical Counsellors, Marriage and Family Therapists, Music Therapists, Art Therapists, Certified Counsellors, Pastoral Care Counsellors, etc.).

What do counselling and psychotherapy have to do with music therapy?

For many years music therapists have expressed a desire to branch out into mental health, wellness and depth therapeutic work. Graduates have sometimes expressed a need for more counselling skills. This is indicative of the cross-over between areas. From a broader perspective, counselling is sometimes thought of as giving advice and as verbal process work. But counselling is a therapeutic spectrum of interventions aimed at supporting and facilitating a client’s psychosocial process through intake, assessment and therapy. Much of the work music therapists are trained for could be described as facilitating psychosocial processes. Dr. Donald Michel, RMT, in his book Music Therapy, quotes Masserman defining psychotherapy as… “the science and art of influencing behaviors as to make it … more efficient and satisfactory to the individual.” It may also be noteworthy to know that BC Art Therapy Association is a member of the Task Group, as are individual dance and drama therapists.

Who sets the required competencies for membership in the College?

Once the ministry has approved the College of Counselling Therapists, the first board will be appointed, whose task it will be, among other things, to set the competencies. This board will be informed and advised and hope to be comprised of the current Task Group representative members, plus appointed members of the public, and various subcommittees. As the Task Group has already done the work of creating the Competency Profile (2007), this step in the regulation process should be fairly easy.

What exactly are the competencies?

The Competency Profile (2007) contains 6 domains with basic knowledge required in all but the Professional and Practice domains, where intermediate knowledge and skill level is required.

1. Human Development: e.g. normal, abnormal, life span development, emotions, perception, learning, psychopathology.
2. Theoretical Foundations: e.g. theories of counselling, interviewing, theories of the major therapeutic schools, risk management.
3. Clinical Practice: e.g. counselling techniques, the therapeutic relationship, conflict resolution.
4. Professional Issues: e.g. ethics, practice review, standards.
5. Research: e.g. understanding reading, design, limitations, methods, language.
6. Practice: e.g. practicum, supervision, reporting.

The entry-to-practice level competencies are broad based enough so that they are as inclusive as possible for all the member groups, but also sets a basic common standard. These competencies can still be altered and will not be finalized until after the cabinet approves the process and appoints the first board.

There may be a second set of competencies looked at by the first board, which the Task Group has termed “advanced competencies”. Advanced competencies are really specialty competencies and each group will hopefully have input for their own membership. i.e. music therapists will suggest the competencies for music therapists and the program at Capilano University would be geared to meet those competencies.

Music therapy and government regulation

Why regulate music therapy?

Historically, national and provincial professional associations have had a dual mandate: serving both a self-regulatory function (i.e. certification, standards of education, standards of practice, code of ethics and ethical complaints) and a member service function (i.e. promoting the profession, advertising and public relations, offering liability and benefits insurance, conferences, journals, newsletters, and continuing education). With the development of regulatory Colleges in BC, Ontario and Quebec, member professions will be regulated. Music therapists in each of these provinces are aligning with a variety of professions to achieve regulated status and title protection. As each province regulates with a regulatory college, the regulatory function of the professional associations will shift to the regulatory college.

Will the music therapy training provide these competencies?

At this point in time the majority of the listed competencies are covered in the training to a greater or lesser degree. Some items, (e.g. testing and measurement, psychometrics), we may seek to have removed from the current list. Other areas may require a little upgrading; however this all looks very feasible. Therefore, yes, by the time this is in place, we expect the Music Therapy training facility will provide these competencies.

How does this process affect Capilano University?

Capilano University will continue as a Music Therapy training program, abiding by the curriculum guidelines set by the Canadian Association for Music Therapy. A few areas of training (for example, clinical counselling skills) may have to be augmented to meet the competencies set by the College of Counselling Therapists. Capilano University will be an active partner with the College of Counselling Therapists, once it is active.

How will being regulated in BC affect music therapists who move into BC in the future? Is there inter-provincial transferability?

After we are regulated, the new Board will discuss this for each profession. There will be a process established which will enable music therapists from outside BC to be regulated in BC. The College of Counselling Therapists will be legally required to abide by the Agreement on Internal Trade, a federal law that ensures that inter-provincial mobility is in place.

Does regulation under the HPA have any impact on the use of the title “Music Therapist” or “Music Therapist Accredited”?

When a health profession is regulated under the HPA it also means that their designated title (or any key words or derivative thereof) is legally protected and may only be used by professionals who are members of that regulatory body (e.g. College of Physiotherapists, College of Massage Therapists, College of Physicians and Surgeons, etc.)

The Task Group is using the working title of “Counselling Therapist” for title designation as this was the title recommended by government. It is uncertain how our current professional titles such as Registered Clinical Counsellor, Music Therapist Accredited, Registered Art Therapist, Canadian Certified Counsellor, etc. will be when BC becomes regulated. People who choose not to join (or who do not meet admission criteria) would be required to use other descriptive titles to describe their practice once the designated title is legally mandated.

How does my joining this new College affect memberships in the professional associations (MTABC and CAMT)?

This new College would change the roles that the professional associations have and membership in your professional organizations will still be important for different reasons. The College would be responsible for professional tasks such as: registration of members for entry-to-practice, mandating continuing education and professional development requirements for members, approval of university/training programs and internships, ethics, mandating liability insurance, scope of practice and professional standards, MTABC would provide services and support for job creation and referral, continuing education, professional development, liaison with external associations such as the HSA union, government, and communication for music therapists within the province, consulting with the College about competence requirements for music therapy practice within the province, etc.

CAMT would provide services like access to liability insurance, the annual conference, consulting with the College for music therapy program approval and graduate program standards and approval, resources such as the journal and music therapy week information, web page, etc.

In 2007, CAMT appointed Susan Summers as Chairperson of the CAMT government regulations committee. Susan is overseeing the regulation issue in Canada, is in constant contact with provincial representatives, organizes the annual CAMT conference Government Regulation panel and moderates the googlegroups, with representatives from each province and the CAMT board.

Would I be excluded if I’ve been practicing music therapy for several years and instead of a degree I have a diploma but I don’t necessarily meet the entrance criteria for this new professional college?

Not necessarily. This situation occurs often when new regulatory bodies are starting. During the start-up period, it is common to use a system of “porting” (grandparenting) for inclusion of those who are recognized as being competent enough to fulfill the entrance requirements yet don’t exactly meet the newly outlined criteria (see “Core Competencies/ Advanced Competencies”).

A special set of criteria for the “porting” process would be established for about two years to ensure that the process is fair and inclusive yet maintains a certain standard of professionalism. The MTABC recognizes the importance of this porting process and is committed to creating the most inclusive system possible. Other professions that have used a porting process during start up include RNABC (Registered Nurses Association of British Columbia) and the BCTF (British Columbia Teachers’ Federation).

How much will membership in this College cost me?

This depends on the number of members in the College – a minimum of 3500 members are anticipated. The more members, the lower the costs. Expect an annual tax-deductible fee that could be between $400-800.

Why support regulation?

The MTABC board and membership have voted twice to fully support MTABC continuing with the Task Group in our bid for title protection and health profession status. This will be music therapy’s only opportunity to be regulated and to gain the benefits as outlined below. After careful consideration, the consensus was to recommend that music therapy align with this Task Group.

The following is what are the positives for music therapy to be regulated within the College of Counselling Therapists:

1. increased recognition for music therapy professionally
2. music therapy will be on par with other health professions as more and more professions are brought under the “umbrella” of the Health Professions Act
3. increased credibility for music therapy
4. potential for third party billing (WCB/Worksafe BC, ICBC, insurance companies, etc.)
5. potential that our clients could deduct music therapy fees from their taxes
6. title protection for “music therapy” (or its derivatives)
7. potential for increased employment opportunities with referrals from other counselling professionals within the Task Group (six other professional associations)
8. increased opportunities for music therapists to upgrade their skills and knowledge competencies through professional development and continuing education courses
9. improve and maintain professional standards for our field
10. Capilano University degree requirements will have to shift slightly to meet the counselling competencies; ultimately, this will mean that music therapist graduating will have improved counselling skills (i.e. family systems, counselling)
11. Music therapy gains from the legal expertise and extensive experience that the Task Group members have in the process of regulation and government legislation
12. Being one of the first groups within the Task Group to gain regulation will allow us to have input into the porting (grandparenting) structure and time allocations to gain the credentials; possible elimination of difficulties because we are in “on the ground floor”
13. This task group’s process is an inclusive one; each profession still maintains its own identity and diversity but is included in the structure; other groups can be added at a later date
14. Gains licensure for private practice

On the other side, there are some things that each music therapist needs to consider:

1. being regulated will include more demands such as having liability insurance, keeping up professional development to meet competencies and to maintain standards, and being accountable to the College (this is already happening with CAMT but with the College of Counselling Therapists, it will be required legally)
2. once a music therapist has been a College member, he/she will be accountable to the College for ethical standards of the profession on an ongoing basis, even if he/she does not remain a College member
3. there will be financial considerations in terms of fees payable to the College annually
4. being regulated will mean that music therapists are dealing with an additional bureaucracy and administrative organization
5. some music therapy jobs may not be perceived as involving counselling and therefore may question why they should have to join a College
6. there will be entrance requirements for admission to the College and to the potential advanced stream

To read about “Music Therapy in Canada”, check out the article written by Kevin Kirkland, PhD, MTA (2007) on www.voices.no. www.voices.no/?q=country-of-the-month/2007-music-therapy-canada

Sources for this information gratefully acknowledged:

• Lorna Martin, President of CCPA, presentation at the 2011 and 2012 CAMT conference
• Stephen Williams, November 18, 2006: document presented to the CAMT and MTABC board of directors
• Susan Summers, MTABC representative to the Task Group for Counsellor Regulation: files, notes and knowledge
• Task Group for Counsellor Regulation documents
• George Bryce, legal counsel: documents and submissions