Psychotherapy in the Private Sector: A Survey of Licensed Psychologists and Psychotherapists in Quebec

By Bradley, Stacy; Roberge, Pasquale et al. | Canadian Journal of Counselling and Psychotherapy (Online), January 1, 2019 | Go to article overview

Psychotherapy in the Private Sector: A Survey of Licensed Psychologists and Psychotherapists in Quebec


Bradley, Stacy, Roberge, Pasquale, Service, John, Vasiliadis, Helen-Maria, Drapeau, Martin, Canadian Journal of Counselling and Psychotherapy (Online)


The mental health care needs of Canadians, and the failure of our health system to meet these needs, has become an important topic of discussion among practitioners, researchers, mental health care organizations, the media, governments, and the public (e.g., Cavaliere, 2014; Peachey, Hicks, & Adams, 2013). The need for appropriate mental health treatment has never been greater: As of 2011, 1 in 5 Canadians suffer from a mental health problem (Mental Health Commission of Canada, 2012). Mental health problems are also one of the primary causes of disability in Canada and worldwide (Centre for Addiction and Mental Health, 2012).

The recent Mental Health Care System survey conducted through The Mood Disorders Society of Canada (2015) reported that 38% of Canadians had to wait more than a year to receive an initial mental health diagnosis. Furthermore, the 2014 Survey on Living with Chronic Diseases in Canada (Public Health Agency of Canada, 2014) showed that approximately 12% of Canadians have a mood or anxiety disorder, with 93% being prescribed medication and only 20% receiving a psychological intervention. This is troubling given the well-documented efficacy and cost-effectiveness of psychotherapy (American Psychological Association, 2013; Fansi, Jehanno, Lapalme, Drapeau, & Bouchard, 2016; Hunsley, Elliott, 6 Therrien, 2014; Vasiliadis, Dezetter, Latimer, Drapeau, & Lesage, 2017).

With this increased focus on mental health care needs, the Canadian Psychological Association (CPA) has called for documentation of the roles, practice characteristics, and service demands of Canadian psychologists (Ronson, Cohen, & Hunsley, 2011). Indeed, the field of psychology in Canada has lagged regarding documenting the characteristics and practices of its professionals. Until Hunsley, Ronson, and Cohen's (2013) recent survey on the practice of psychology in Canada, these general characteristics had not been investigated in over two decades (Hunsley & Lefebvre, 1990; Warner, 1991). In comparison, the American Psychological Association (APA) has been surveying its members concerning practice activities and characteristics for over four decades (Garfield & Kurtz, 1976; Norcross & Karpiak, 2012; Norcross, Karpiak, & Santoro, 2005; Prochaska & Norcross, 1983).

According to the most recent data available for Canada, the dominant activity of licensed psychologists is psychotherapy, particularly individual therapy with the adult population, followed by assessment activities (Hunsley et al., 2013; Ionita & Fitzpatrick, 2014). Hunsley and colleagues' (2013) study (N = 538) also showed that the most prevalent presenting problems treated by most psychologists include anxiety disorders, mood disorders, and interpersonal difficulties. Regarding theoretical orientation, cognitive-behavioural was reported as the most frequently endorsed among Canadian practitioners, followed by an integrative/eclectic orientation.

However, a factor to consider in understanding these practices is the increase of practitioners working in the private sector (for Canada, see Peachey et al., 2013; for the United States, see Norcross & Karpiak, 2012; for Australia, see Byrne & Davenport, 2005). In Quebec alone, 4,842 members of the Ordre des Psychologues du Québec (OPQ), the regulatory body for psychologists in Quebec, work either part-time or full-time in the private sector (Ordre des Psychologues du Québec, 2015, 2010). In Ionita and Fitzpatrick's (2014) survey of psychologists in Canada (N = 1,668), approximately 63% of their sample received payment for services directly from the client. According to an Institut National d'Excellence en Santé et en Services Sociaux report (INESSS, 2015) on the inequality of access to psychotherapy services, only a third of the professionals licensed to offer psychotherapy services in Quebec work in a public setting with the majority working privately.

Unfortunately, little is known about psychologists in the private sector. …

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