The Alberta Therapeutic Recreation Association(ATRA) is the provincial body representing the profession since its inception in 1985. It is a voluntary association that in the absence of regulation has provided governance to its members through establishing standards of practice, a code of ethics, entry to practice requirements and a continuing competence program. ATRA is registered under the Societies Act and is currently pursuing regulation under the Health Professions Act (HPA).
The fundamental concerns and inadequacies of recreation therapy being an unregulated profession and not being able to ensure public protection and safety in Alberta include:
- No mandatory registration
- No title protection
- No authority to register or investigate complaints from employers regarding unprofessional conduct of individual recreation therapists, which poses a potential risk to clients and employers
- Recreation therapists not being subject to the same discipline that those under the HPA are held accountable to
- Patients assuming that recreation therapists are regulated and as such are potentially vulnerable due to the lack of regulatory safeguards in place to ensure that all recreation therapists in the province are registered, meet standards of practice, code of ethics, education and continuing competence requirements
- Recreation therapists who are unaware of the boundaries between psychosocial intervention and the restricted activity of psychosocial intervention which requires supervision by an authorized regulated health professional, specialized training, and meeting defined competencies
Recreation Therapists work with vulnerable patients who are frail, palliative, lonely, isolated and depressed, experience loss of control and independence, lack support systems, have inadequate boundaries and are therefore vulnerable to abuse (e.g., physical, sexual, financial, emotional) from others, including health care professionals that they trust. Furthermore, risk may be amplified for patients receiving services in one-to-one situations and alone in their homes.
Regulation of recreation therapists would provide additional protection to patients from abuse and misconduct; and heighten the awareness, confidence and expectations of the public, patients, health employers and other health professionals. It would provide a clear public interest mandate, and would enable education of the public as to the role of a recreation therapist in a collaborative health care team. The public would be able to access the appropriate services that they require, as there would be clear expectations of the service provided and clinical outcomes to be obtained by a recreation therapist.
ATRA’S HISTORY OF REGULATION
Our original HPA application for regulation of recreation therapists in Alberta was submitted to Alberta Health in 2010. As our profession has continued to evolve and grow, we have gained traction and have been able to develop a good working relationship with Alberta Health, specifically with the Director of Health Professions Policy & Partnerships who continues to support our application.
Although we were initially seeking to have an independent regulatory college, Alberta Health has advised ATRA to pursue regulation of recreation therapists via a partnership model due to our relatively small profession and the benefits of greater sustainability, shared infrastructure and potential for guidance from an existing regulatory college. In 2015, we began discussions with the Alberta College of Occupational Therapists (ACOT) about a potential partnership; however this partnership exploration ended in February 2017.
In spring 2017, in discussion with our Alberta Health liaison, we asked if there was a possibility of requesting a meeting with the Minister of Health with the aim of gaining approval to elevate our application to the more intensive government and external stakeholder review/research phase, but conditional upon finding a viable regulated college partner if regulation was mandated.
In June 2017, this course of action was endorsed and we were advised to update our 2010 HPA Application. From July to December of 2017, we put our efforts into revising our 2010 HPA Application to reflect our current status. This comprised of removing content that was no longer applicable, and adding new content to capture the evolution of our Professional Association and its many changes, advancements and accomplishments. Included, were several excellent letters of support from employers, managers, Post-Secondary Institutions and from our national association.
We have spent the first half of 2018, working with our Alberta Health liaison to ensure that we have everything in order to request a meeting with the Minister of Health. In addition, the Alberta Health liaison will be developing a short summary of key information from our HPA Application to share with other regulated colleges in our quest to find a partner.
We acknowledge that this is a political process and we are reliant on the support from Alberta Health to move our application forward. We also recognize that our members will need fortitude and patience as ATRA continues its journey towards regulation.
1. What is regulation?
Regulation is a set of requirements or consistent rules that define how health professions provide ethical and competent service to the public. Legislation is passed by a vote of members of the Alberta Legislative Assembly, and is called the Health Professions Act (HPA). All regulatory bodies under the HPA are called colleges.
Each self-governing health profession must apply to Alberta’s Health Minister to become regulated. If the application is approved, the minister takes a motion to members of the Alberta Legislative Assembly to include the profession under the Health Professions Act within a college.
Health Professions Act, A new law for regulated health professionals.
Alberta Health Services (2012), Overview of the Health Professions Act of Alberta: Implications for clinical practice. HPA (2004) Employers Handbook.
2. Why is regulation so important to Albertans?
Regulation ensures that Albertans are receiving competent and ethical services through:
● Protection of the public through mandatory registration with the college
● Mandatory continuing competence requirements
● Enforcement of standards of practice and codes of ethics
● Fair and consistent regulatory processes for registration and disciplinary procedures for all professions
● Practice statements and protected titles identifying uniqueness for each profession.
3. Why should Recreation Therapists pursue regulation?
Our therapeutic recreation profession should be accountable for its practice, the same way our colleagues are. Albertans should know that they are receiving competent and ethical health services from Recreation Therapists through mandatory registration that ensures standards of practice, entry to practice, continuing competence criteria and code of ethics are met.
(Reference: ATRA, (2013) Risk to the Public for Recreation Therapists in Alberta). ATRA members can locate this document in the Members section of the ATRA web site in the ATRA Guiding Documents section of the Documents & Forms page.)
4. How does the role of a regulatory college differ from the role of a professional association at both the provincial and national levels?
A college is a regulatory body (defined by provincial law) that protects and serves the public interest by ensuring all practitioners are registered and that they provide competent and ethical services to Albertans. To do this, the college will investigate concerns or complaints about registered members.
ATRA and the Canadian Therapeutic Recreation Association (CTRA) are voluntary, non-regulated bodies that assist Recreation Therapists in achieving excellence in their professional practice. They offer educational and networking opportunities for its members, promote Therapeutic Recreation (TR) and advocate for TR services to the public and external stakeholders. ATRA performs these roles provincially and CTRA, nationally.
5. Why partner with an existing Regulated College rather than pursue our own regulatory college?
The Alberta government is directing small professions seeking regulation to partner with existing regulated colleges because it’s more fiscally responsible and sustainable. Regulated colleges have had years to develop infrastructure and expertise that can guide and benefit ATRA’s transition to regulation. A combined college creates sustainability for membership numbers and enables funds to support the college and protect the membership.
Examples of combined regulatory colleges in Alberta include:
- The Alberta College of Speech-Language Pathologists (SLP) and Audiologists
- The Alberta College of Medical Diagnostic and Therapeutic Technologists
- The College of Physicians and Surgeons of Alberta.
6. Who decides if the therapeutic recreation profession becomes regulated?
The Alberta government ultimately decides whether or not to move forward with our application for regulation after it assesses risk to the public and the need for regulation of our profession. At this time ongoing discussions continue to reflect progress towards regulation however the government has the ability to stop, delay, or accelerate the process at any time. If Alberta Health supports our HPA Application to become regulated, it would be conditional on securing a partnership with an established regulated college.