The PSYCHOPRACTOR

In Ontario we are quickly approaching April 1, 2016, which marks the one-year anniversary of the Proclamation by the province’s Ministry of Health and Long-term Care of the College of Registered Psychotherapists and Mental Health Therapists of Ontario (CRPO). In arriving at its proclamation the Ministry reserved a set of titles and terms for use by the College’s practising Members to designate their privilege as Members of CRPO and to set them apart from non-members. These titles and terms include words such as Psychotherapist, Psychotherapy, and the like. Neither is the practice or carrying-on of the Act or Controlled Act of Psychotherapy, as set forth in the Psychotherapy Act permitted to non-members of the CRPO.

Now, this is not a particularly egregious thing to impose: if a professional college is to be established that will provide protections to the public against improper practices on the part of professional practitioners, then such steps and designations are necessary to separate those professionals who agree to the regulations and rigors of the College from those who are not willing to subject themselves to them in a statutory manner.

But what of we practitioners who choose not to become members of the CRPO? How do we set apart and practise what it is we do among the therapeutic arts that is different from those which are both restricted and permitted by the College? Is there a title I can use that would be permitted by the College by falling outside of its “restricted” terms?; Is there a way I can describe what it is I do in the course of my work that demonstrates how that work falls in its activities outside of the Act and Controlled act of Psychotherapy as set forth by the College?

I have decided to try out – play with – the term/title, “Psychopractor” – one who undertakes the practice of “Psychopractry”.

Psychopractry would refer to the application of skill-based, “data” driven “techniques”, in the context of specific methods that describe a specific form of relationship between a Client and a Psychopractor.

Of course, the term/title Psychopractor will quickly and freely call to mind the profession and practice of Chiropractor – a health care professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on the use of skill-based, data driven techniques which focus on manual adjustment and/or manipulation of the spinal column, from the pelvis to the neck, and including associated nervous system and joints. The Chiropractor, too, conducts her/his techniques – manual manipulations – in the context of method that describes and underlies a therapeutic relationship. A significant aspect of that method is a “Treatment Plan”, which is devised and followed on the basis of a recording of the personal history of the spinal column and a diagnosis for each Client.

Excepting that one deals with neurological, physical conditions while the other with conditions of the “mind”, the parallels between them are striking to the extent that both focus on disorder and dysfunction. In the case of Psychotherapy, and its controlled act as set forth in the Psychotherapy Act (2007, 2015):

In the course of engaging in the practice of psychotherapy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning.

And so it is with designations by professional associations and statutory regulation by professional colleges regarding those acts we call “Therapies” – they refer to the reparation of impairments, disorders and dysfunctions. My Mentor, the late, great Alvin R. Mahrer – decried this, looking for either an expansion of the definition for the term Psychotherapy, or for a term to replace it.

My response to this is that, unlike the term and profession of Chiropractor, a Psychopractor, as I conceive of it, does not focus on diagnosis, impairment, disorder and dysfunction. Rather, s/he attends to the Potential, resident within the Client – potential for taking on whole and completely new ways of being and behaving, even to the point of becoming a different person with respect to behaviours, attitudes and relationships. Essentially here I am referring to what have hitherto been known as Humanistic Psychotherapies – those which, like many holistic “therapies” from other fields do not, in acordance with the urging of the World Health Organization, limit their understanding of “wellness” to simply the absence of disorder or dysfunction. Rather, they promote WHO’s definition of health as being “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”

In the form of Psychopractry which I practise these potentials are uncovered, not through diagnostic measures such as the taking of a Client’s history or questioning as to symptoms; rather, they are accessed via specific techniques used by the Psychopractor which are in experiential response to verbal data – with its prosaic and nonprosaic expressions – in the context of the Client-Practitionner relationship and the methods which define that relationship.

It is my strong sense that the entire field of Psychotherapy can be understood – and even taught and researched – in terms of the Methods, Techniques and Data that may characterize each of its approaches, and that such an understanding would be more useful and malleable than an understanding limited to diagnosis, treatment, disorder and dysfunction, etc. In Ontario at least, however, including within the CRPO and other colleges of the province’s Ministry of Health and Longterm Care which regulate and authorize members in carrying out the Act of Psychotherapy, such is not the case. This leaves open the legitimate choice to practitioners who formerly called themselves Psychotherapists, for whatever reason they may hold out, to resist and avoid joining those colleges.

So, let we “Psychopractors” carry on, basing our work on our methods, techniques and data. In future blogs I intend to expand on the concepts of Method, Technique and Data, using the approach to Psychopractry which I principally follow – that initiated by Alvin R. Mahrer – to provide examples and illustrations of these concepts.

 

The CRPO and practitioners of Counselling/Therapy

The practice of psychotherapy is the assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication.

Those of you who have been involved with or following the proclamation of the College of Registered Psychotherapists and Mental Health Therapists of Ontario (CRPO) will likely be familiar with these words; they form the “Scope of Practice” of Psychotherapy, declared in 2007 by the Ontario Ministry of Health and Longterm Care. Woefully problematic, in my estimation. And so is the “Authorized Act” of Psychotherapy, which came into force on April 1 of 2015 – the date the CRPO was proclaimed into existence by Ontario’s Lieutenant Governor:

In the course of engaging in the practice of psychotherapy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to treat, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning.

(“Member” here means a Member of CRPO.)

The focus in both of these statements on the treatment of serious disorders … may be a cause of significant difficulty for the College, and for the public it is established to protect. There are many Practitioners who use techniques in their work, but do not target disorders of cognition, mood, etc. Many Strength-based therapies and Humanistic approaches would fall into this category, including the approach to Experiential therapy which I use myself. These look to identify the Strengths and Potentials of Clients, and work to develop and enhance the use of those, often without reference to specific or even vague labels of disorder. The difficulty is that such practitioners are very possibly not obligated to become Members of the College, and if not, would not be subject to the regulations that have been developed for CRPO in its work of protecting the public from malpractice and misbehaviour by Psychotherapists. A broader Authorized Act and Scope of Practice needs to be formulated, because all of us who are practitioners of therapies ought to be subject to the ethics and regulations put forth by CRPO. These re-statements, it seems to me, should move toward a view of wellbeing more in line with that put forth by the World Health Organization, which poses Wellbeing as not limited to the absence of disease or disorder.

This is why I have proposed a formulation in earlier posts that refer to Psychotherapeutic Method, Data and Technique, and which refers to the view of wellbeing proposed by WHO.

Psychotherapeutic Method, Data and Technique

A couple of weeks ago I delivered a post in an effort to conceptualize the field of Psychotherapy in a way that could apply to any approach for understanding, discussing, supervising and researching it. In honing that conceptualization I write the following:

Psychotherapy is the application by a Psychotherapist of Psychotherapeutic Technique to Data gathered and attended to through interaction between a Psychotherapist and Client, in the context of a Psychotherapeutic Mrethod, for the purpose of contributing to the improvement of mental well-being in the Client, in ways that may include but are not limited to a reduction in psychic discomfort due to disorders of cognition, thought, behaviour, relationship and/or mood.

In this conceptualization Psychotherapeutic Method refers to physical aspects of Therapy such as set-up and the therapeutic space, philosophical aspects such as what the particular therapeutic approach views as change or improvement, and conceptual aspects such as what the Therapist needs to know in order to conduct therapy according to the particular approach. Data refers to information – verbal, written, visual, etc. – which the Therapists acts upon in order to produce further data, or to move therapy along a process which will contribute to the Client’s well-being and to accomplishment of therapeutic goals.  Psychotherapeutic Technique refers to those actions taken by a Psychotherapist on the Data.  As well, the term Mental Well-being is intended to align with the definition of “Well-being” put forward by the Wourld Health Organization, which specifically states that it is not limited to the absence of disorder.

This, of course, is merely a start; it is my hope that some among you will criticize and contribute via discussion on this post. In a near-future offering I will propose this conceptualization – or some version of it – as wording for the Controlled Act of Psychotherapy, presently being sought by the College of Registered Psychotherapists of Ontario, along with those other Ontario Professional colleges which are authorized to provide registration for the practice of Psychotherapy. O!, What Fun!

The Election – A Week Later

A week ago I, like many, was struggling to digest the results of the Canadian Federal Election. The decisiveness of the outcome was a shock – overwhelming – to me. The Liberal Party, I thought and still believe, stood best for change from the years of governance by the Conservative Party of Canada, and I did vote for the local Liberal candidate. However, had the NDP candidate stood the best chance of winning the riding in which I live, I would have voted for her. I held a visceral need for an end to Conservative Party of Canada government!!!  I do believe that there is a place in Canadian governance for ”

conservative” values – a place and power for the private sector, and the opportunity for individual and corporate citizens to determine how the majority of their income is spent. However, the place in governance that holds that some one with a view to the larger picture than the individual citizen holds sway with me, too. Besides, As well, along with party policies, a party’s heart and spirit turns out to be massively important some times, and that, I believe, is what played the major part in the endorsement of the Liberal party, the overall rejection of the Conservative Party of Canada, and the minimization of the New Democratic Party. Thank God that the days of running our Government, our Parliament and our Canada by manipulation, secrecy, deceit and fear/division seem to be over, or at least diminished. Napulation? – omnibus bills, unprecedented in size and number, which force one to, if s/he votes against an item with which s/he disagrees, to also vote against an unrelated item with which s/he strongly agrees. Secrecy? – the muzzling of and reduction in the number of scientists, including social scientists, so that research and evidence based knowledge was inaccessible, and could not inform policy and action nearly to the extent that idialogism did.  Deceit? – the number of cases in which members and associates of the Conservative Party of Canada were charged with and/or linked with election fraud.  Fear/division? – we were permitted, esp. those of us who are “old stock” Canadians, to feel good about ourselves by being encouraged to feel better than others – better for example – than a couple of women who wanted to wear necabs during their Citizenship Swearing-in ceremony, because we did not want their identity hidden from us, when, in fact, their identities would have been well and legally verified during a just-previous portion of the Citizenship process, including exposure of their faces.  If, “A Canadian is a Canadian is a Canadian”, as Justin Troudeau proclaimed during his acceptance address, than we will be a better Canada; if Diiversity is permitted to make a greater mark on our national culture, so that we not only learn about other folks and cultures )some very recent, and some a part of this land for centuries or millennia), but that who we are and what we do is informed and strengthened by that diversity, then we will be a better Canada; If inter-community consultation and collaboration is allowed to influence government policy and action, then we will be a better Canada; if the compassion of an inquiry into murdered and missing indigenous women and girls is exemplary, then we will be a better Canada. Even if we can only stride a short way into these fields – truthfully not new or lost fields to government in Canada – we will be a better Canada and better Canadians.  God bless our land, and may the policies and actions of our governments be of benefit to all our citizens, and esp. to those who need benefits the most. The greatness of a country is shown in how it honours and treats the seeming least of its citizens.

Around the middle of last month – September – I attended the 37th Annual Conference of the Ontario Association of Consultants, Counselors, Psychometricians and Psychotherapists (OACCPP). I was asked by the OACCPP Education Committee to facilitate a half-day workshop on the approach to Experiential Therapy formulated by my Mentor, Dr. Alvin R. Mahrer. What a BLAST!! – the workshop was very well received, with high participant evaluation scores, and excellent participation. Perhaps I will write more about that workshop in a later post. For the purposes of this one, though, I am drawing attention to the part of the workshop that focussed on Psychotherapy as a Science, and my characterization – based on some of Mahrer’s writing and thinking – that Psychotherapy can be thought of as grounded in Psychotherapeutic Method, Psychotherapeutic Data and Psychotherapeutic Technique. In this characterization Method can be thought of as including the physical set-up of the therapeutic space, Philosophical aspects of the therapy such as the purpose of the therapy and of individual sessions, and conceptual aspects such as what the Therapist is required to have knowledge of in terms of theory. The term Psychotherapeutic Data refers to the nature of the information generated by interactions between the Psychotherapist and Client on which the Therapist acts. Psychotherapeutic Technique would refer to actions applied by the Psychotherapist to the Psychotherapeutic Data. Understanding Psychotherapy in these terms allows a framework for research, supervision and discussion about any particular approach to Psychotherapy. Psychotherapy, I hold, can be conceptualized as: The application by a Psychotherapist of specified Therapeutic Techniques to specified Therapeutic Data, in the context of specified aspects of a Therapeutic method. In future posts let’s explore this conceptualization as a framework for research, supervision and discussion, and even as a statement of a controlled Act of Psychotherapy, such as is currently being sought by the new College of Registered Psychotherapists of Ontario.

Well! – It is far too long since I have posted anything – Please Excuse me. A number of months ago I upgraded my Internet Explorer, but the Screen-reader software I use as a blind computer operator did not sync with the Internet Explorer on a number of sites, including this one and my admin site for this Blog site. I certainly hope to post regularly now, and have many thoughts and ideas I want to share. I’ll be back soon – PROMISE!!

CATCHING UP!

WOW! I notice it has been over 6 weeks since I last contributed a blog here! I wrote nothing about Mother’s Day, about Pentecost, nor about Father’s Day. Neither did I write a thing about the one-year anniversary of my Bone Marrow transplant/infusion, which came and went on June 4. What the hec happened!?
Actually, for a big part of the past 6 weeks almost nothing happened, and that was the problem. For most of May I experienced incredible tiredness and low energy; in fact, during some days I was in bed for 16 hours! Was this a flare-up of the Graft Versus Host Disease, or a return of the Leukemia?, I wondered.
As it turns out, it was neither. In fact it wasn’t really a health concern, and yet it seemed to be, for seeming days on end, one of the most impacting health events of this whole adventure. What it was is the effects of a drastic reduction in dosages of Prednisone – a steroidal medication I have been taking in large quantities since the Leukemia treatments began in October of 2012 – firstly as an important part of the Chemotherapy against the Leukemia, and then as a big part of the treatment to keep my system and old bone marrow from fighting against the new one as part of the battle against Graft Versus Host Disease following the Transplant/Infusion. Because I had been served up the Prednisone in such large doses and for such a long time, my own body had stopped producing its natural steroids – an important source of energy; as the medication was reduced it was not immediately replaced by the generation of the natural source of energy.
Since near the beginning of June things have made quite a remarkable turn-around for me: now at low dosages of the Prednisone, with reductions taking place slowly, my energy has begun to return. I still need daily naps, for sure, but I have been more active. We did squeeze a nice Mother’s Day meal for Lynda out of May 11, but I was much more energized for Father’s Day on June 15. My daughters, Michelle, Kathleen and Christina, and Grand-Daughter Makayla, came to visit me on June 2 to celebrate the one-year anniversary of the Bone Marrow transplant/infusion, along with Kathleen’s birthday, which is June 7. I have even been out to a couple of Softball games :).
As much fun as any of this is the Relay For Life Run for the Canadian Cancer Society, Which Lynda and I took part in on June 13 – actually, we only completed the “Survivors” lap and a few others, and between us we raised some $500. A great deal of joy and fun too is the Leukemia Awareness Fund (LAF) Golf Tournament, organized in Kitchener by my friend Wayne Ernst, who is himself a survivor of Leukemia and a Bone Marrow transplant/infusion. It took place on June 19, in its fifth incarnation, with over 130 Golfers, tons of sponsors, auction tables, and a great meal; the final count is yet to come in, but we think it will gross some $35 thousand. All of the proceeds go to support programs and equipment at the Cancer Centre and Oncology Ward at the Grand River Hospital in Kitchener. WAY TO GO, WAYNE!! 🙂
This Saturday I expect to go to my favourite Softball park – the Peter Hallman Ball Yard in Kitchener – to take in a day of Softball games – O, what fun!
As you can tell, including even the difficult month of May, I continue to be fortunate and blessed, and in more ways than I have related to you here.
And that, I guess, is, in the end, the point: I don’t think there is any way I can relate to you how fortunate and blessed I am, especially since I am likely unaware of some of it myself. But I hope you get a sense of it, and join with me in being thankful. Be assured: I am grateful to you for your kind thoughts and prayers.