THE COLLEGE OF PSYCHOLOGISTS OF ONTARIO
SELF ASSESSMENT GUIDE AND
PROFESSIONAL DEVELOPMENT PLAN
Instructions and Forms Booklet
Quality Assurance Program
February/March 2011
Name: ________________________________ Date Completed: ______________________
QUALITY ASSURANCE PROGRAM
SELF ASSESSMENT GUIDE AND
PROFESSIONAL DEVELOPMENT PLAN
Introduction
The Self Assessment Guide and Professional Development Plan is to be completed by all members
holding Certificates of Registration regardless of whether a member‟s status is Regular, Academic or
Inactive. It is expected that all members will be engage in activities directed toward maintaining and
enhancing their level of knowledge and skill in their field of work. Continuing education activities
should be documented in the Self Assessment Guide and Professional Development Plan.
The Self Assessment Guide and Professional Development Plan must be completed and the Declaration
of Completion, attesting to this, submitted to the College by the date indicated.
Members are required to undertake this self-review every other year, with half of the membership
completing the Self Assessment Guide and Professional Development Plan each year. Members with odd
numbered registration numbers will complete the forms in the odd numbered years and those with even
registration numbers, in the even numbered years. Members with Certificates Authorizing Supervised
Practice or Certificates Authorizing Interim Autonomous Practice must complete the Self Assessment
Guide and Professional Development Plan every year.
In reviewing the materials, members may find that some sections are not applicable to their work. These
sections may be noted as Not Applicable (N/A).
Note: A completed sample 2011 Self Assessment Guide form is available for reference on the College
website.
Self Assessment Guide
The Self Assessment Guide is designed to assist members in evaluating their current level of knowledge
and skill. The Guide provides separate sections for the following areas:
Legislation, Standards, Codes and Guidelines
Service to Clients
Teaching/Training and Research Activities
Supervisory Activities
Current Areas of Practice and/or Services Provided
Anticipated Areas of Future Practice
Professional Development Plan*
Reflection on Professional Development Plan
Reference List of Areas of Practice and Service Provided
*Professional Development Plan
Following the completion of the self assessment, members are expected to create a Professional
Development Plan to address items identified in the self-review. The plan may address both areas of
current practice where continued development of knowledge or skill is desired, as well as areas of future
practice a member may be considering.
College of Psychologists of Ontario - Self Assessment Guide and Professional Development Plan Page 1
February/March 2011: Instructions and Forms
The Professional Development Plan is a tool that individual members can use to plan, undertake and
evaluate their personal continuing education program. The Professional Development Plan requires each
member to design his or her own continuing education program, both in content and in methodology.
The content of the program is dependent upon the member‟s self-identified developmental objectives,
and each member will design the program to suit his or her individual needs and learning style.
Submission to College Not Required
The Self Assessment Guide and Professional Development Plan component of the Quality Assurance
Program is founded upon principles of self-evaluation and continuous improvement. It is a tool to be
completed and retained by each member and is not normally submitted to the College. A member will be
required to make the most recent Self Assessment Guide and Professional Development Plan available to
reviewers should the member be randomly selected to participate in the Peer Assisted Review component
of the Quality Assurance Program.
Included with the Self Assessment Guide and Professional Development Plan is a Declaration of
Completion. This is to be signed and returned to the College by Thursday, June 30, 2011. The
Declaration asserts that: I have reviewed my practice in psychology and documented this in the Self
Assessment Guide. I have created a Professional Development Plan to address the continued
professional developmental objectives I have identified. I understand that I must retain the completed
Self Assessment Guide and Professional Development Plan in my files.
This Declaration of Completion is the College‟s documentation that members are participating in the
Quality Assurance Program.
NOTE: Members who do not submit the Declaration of Completion may be required to send the full,
completed Self Assessment Guide and Professional Development Plan for review by the Quality
Assurance Committee of the College.
Confidentiality and Legislative Protection of Quality Assurance Material
The Regulated Health Professions Act (1991), the Personal Health Information Protection Act (2004) and
the Quality of Care Information Protection Act (2004) provide for the protection of Quality Assurance
information, held by a member that was completed for the purpose of complying with the requirements of
the College‟s Quality Assurance Program. A member‟s Self Assessment Guide and Professional
Development Plan is not admissible in evidence in a civil proceeding. This information could be
required by the College however, to the extent permitted by legislation.
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February/March 2011: Instructions and Forms
PART I LEGISLATION, STANDARDS OF PROFESSIONAL CONDUCT,
CODE OF ETHICS AND GUIDELINES
Many statutes and regulations, the revised Standards of Professional Conduct, the Canadian Code of
Ethics for Psychologists, as well as the child abuse reporting requirements under the Child and Family
Services Act and the mandatory reporting obligations under the Regulated Health Professions Act, apply
to all members. In the first section of Part I, please consider whether you are sufficiently familiar with
the content of these documents. Members are not required to own these materials but it is important that
members be familiar with, and have access to, them. This is also to be noted in this section. Most of
these documents are readily available online from the College, Canadian Psychological Association or
the provincial and federal government websites. Links are provided for those documents available
online, as well as a key to the contact information for the sources of the documents.
Dependent upon your area of practice, there are a number of other pieces of legislation or guidelines that
may impact on your work. Review the items in the second section of Part I and, if they apply to your
practice, indicate your level of familiarity and access. Please include on the „Other‟ line, any items
which are not indicated, but which you consider to be important to your practice. The College would
appreciate being notified of significant omissions so these can be considered in future editions of the Self
Assessment Guide.
If you identify a need for greater familiarity, the way in which this will be obtained should form part of
your Professional Development Plan. Any needs you may have with respect to reviewing these
materials, obtaining them or securing ready access to them should also form part of your Professional
Development Plan.
Sufficiently Have Access
Document and Source Familiar to a Copy
Yes/No Yes/No
Psychology Act, 1991
Regulations under the Psychology Act
Professional Misconduct
Registration
Quality Assurance and Advertising
Regulated Health Professions Act and Health Professions Procedural
Code, 1991 as amended
Standards of Professional Conduct and Supplementary Notes, College
of Psychologists of Ontario, September 2005
Canadian Code of Ethics for Psychologists, Third Edition, Canadian
Psychological Association, Revised 2000
Practice Guidelines for Providers of Psychological Services,
Canadian Psychological Association, Updated 2001
Health Care Consent Act, 1996 as amended
Personal Health Information Protection Act (PHIPA) (2004)
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Protection of Personal Information and Electronic Documents Act
(PIPEDA) (2000)
Mandatory obligation to report child abuse under the Child
and Family Services Act, 1990 (s.72) as amended
The following Acts and Guidelines may not apply to all providers of psychological services. Please
complete the following chart for those which apply to your practice, marking the others as Not Applicable
(N/A).
Sufficiently Have Access
Familiar to a Copy
Yes/No Yes/No/N/A
Automobile Insurance Rate Stability Act, 1996 & Statutory Accident
Benefit Schedule, under the Insurance Act, 1996 as amended
Child and Family Services Act, 1990 as amended
Children‟s Law Reform Act, 1990 as amended
Companion Manual to the Canadian Code of Ethics
For Psychologists, Canadian Psychological Association, 2001
Corrections and Conditional Release Act (Canada) 1992
Ethical Guidelines for Psychological Practice Related to Child
Custody and Access, Ontario Psychological Association, 1997
Guidelines for Child Custody Evaluation in Family Law
Proceedings, American Psychological Association, 2010
Education Act, 1990 as amended
Ethics in Research with Human Participants, American Psychological
Association, 2000
Freedom of Information and Protection of Privacy Act, 1990
as amended
Human Rights Code, 1990 as amended
Mental Health Act, 1990
Municipal Freedom of Information and Protection of Privacy Act, 1990
as amended
Public Hospitals Act, 1990 as amended
Services and Supports to Promote Inclusion of Persons with
Developmental Disabilities Act, 2008
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Standards for Education and Psychological Testing, American
Psychological Association, 1999
Substitute Decisions Act, 1992
Workplace Safety and Insurance Act , 1997 as amended
Youth Criminal Justice Act, 2002 as amended
Other:
RESOURCES
Publications Ontario, http://www.e-laws.gov.on.ca/navigation?file=home&lang=en (English) or
http://www.e-laws.gov.on.ca/navigation?file=home&lang=fr (French)
50 Grosvenor St. Toronto, Ontario M7A 1N8.
(416) 326-5300, Toll Free (800) 668-9938
College of Psychologists of Ontario, www.cpo.on.ca
110 Eglinton Avenue West, Suite 500, Toronto, Ontario, M4R 1A3.
(416) 961-8817, Toll Free (800) 489-8388
Ontario Psychological Association, www.psych.on.ca
703 Yonge St., Suite 221, Toronto, Ontario M4Y 2B7. (416) 961-5552
Canadian Psychological Association, www.cpa.ca
151 Laurier Avenue West, Suite 702, Ottawa, Ontario, K1P 5J3. (613) 237-2144
Federal Publications, http://laws.justice.gc.ca/en/index.html (English) or
http://laws.justice.gc.ca/fr/index.html (French)
425 University Avenue, Suite 401, Toronto, Ontario M5G 1T6. (416) 860-1611
American Psychologist, 1994, 49(7) 677-680. American Psychological Association, www.apa.org
(800) 374-2721
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February/March 2011: Instructions and Forms
PART II SERVICE TO CLIENTS
This section is applicable to practitioners in their work with clients. This section contains a variety of
items drawn from the Standards of Professional Conduct and the Professional Misconduct Regulation. It
will assist you in thinking about your work relative to these very important areas of professional practice.
You may find that some items do not apply to your practice and these can be marked as Not Applicable
(N/A). Items that require further review or some action should be carried forward to your Professional
Development Plan. Please note that this section does not list every Standard or every item included in the
Professional Misconduct Regulation to which members are responsible to adhere.
My records contain the following information as per sections 9.2 and 9.3 of the revised Standards of
Professional Conduct. (Dependent upon whether a member‟s practice is with individuals or
corporations, not all of these may apply)
Action Action Completed
Yes/No Required Enter Date
Yes/No
Identifying data (e.g., names, addresses, telephone numbers, dates of birth,
sex, and referral source)
Documentation of client consent regarding the collection, use and
disclosure of personal health information
Documentation of client consent to treatment in the record, as needed
Description of services provided and the date of every relevant and
material contact with the client or consultation about the client
Assessment procedures used
Summary of findings
Periodic description of client progress
A copy of any service contract between you and the
patient/client
A copy of all reports received or sent by you on behalf of
or for a patient/client
The name, address and telephone number of the organization, firm,
corporation, or community, and the name and position of the primary
contact person
The name(s), and title(s) of the person(s) who can release confidential
information about the organization, firm,
corporation, entity, or community
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Action Action Completed
Yes/No Required Enter Date
Yes/No
Documentation, in the record, that fees have been discussed
Documentation, in the record, that the limits of confidentiality have been
discussed
Note: Numbers at the end of the following statements refer to an applicable Standard Of
Professional Conduct) (SPC) or Professional Misconduct Regulation (PM)
I only provide services in my demonstrated areas of professional
competence. SPC 5.1
I engage in activities to remain current to the scientific and professional
developments in areas directly related to the services that I provide.
I work out the method of setting fees and other charges with my clients at
the earliest possible opportunity. SPC 10.1
I do not accept prepayment for services but, with my client‟s agreement, I
may accept a retainer to be held in trust and applied against services
rendered. SPC 10.4
I retain client files for a minimum of 10 years following the client‟s last
contact or, in the case of clients under 18 years of age, for at least 10 years
following the day they became or would have become 18. SPC 9.4
Upon the request of my client or their legal representative, I provide
another member of the College with original or raw results or data within a
reasonable period of time.
I refuse to accept gifts of more than token value from my clients. SPC
12.6
I participate fully in all mandatory aspects of the Quality Assurance
Program. SPC 1.4
I am aware of the harassment provisions of Principle 13 of the Standards.
SPC 13
I inform my client of the limits of confidentiality before or at the
commencement of my involvement with them. PM #11
I provide a truthful, understandable and appropriate explanation of the
nature of an assessment, intervention or other service in response to my
client‟s request for such an explanation. PM #13
I inform my client of the charges to be levied for my services before or at
the commencement of a service.
PM #22
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February/March 2011: Instructions and Forms
Action Action Completed
Yes/No Required Enter Date
Yes/No
I do not charge a fee above the fee set out in the schedule of fees currently
published for the profession without informing the client before or at the
commencement of service. PM #25
I do not offer a reduction in fee for prompt payment.
PM #28
I have not entered into any arrangements such as a lease for use of
premises or equipment; administrative services or the provision of
supervision which provides for a fee or income splitting based on a
percentage of fees invoiced or collected. SPC 10.5
I have made arrangements for safeguarding of patient/client records, in
the event of my disability or death and I have informed the College of
these arrangements. SPC 9.8.1
I have notified the College of any offenses of which I have been found
guilty as per the RHPA.
I have made provisions for:
- Storage of records in a secure place which guarantees privacy of
access to the record.
- Maintenance of psychological tests and supplies in a secure place.
- Maintenance of records of all bills presented to patients/ clients and
payments received.
- Continuing patient/client care in the event of my disability or death.
- Mandatory professional liability insurance.
- Office and personal injury liability, as appropriate.
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February/March 2011: Instructions and Forms
PART III TEACHING/TRAINING AND RESEARCH ACTIVITIES
Many members are involved in teaching or training activities and/or research. For some members, these
activities are carried out in formal settings such as universities or funded research facilities that have
formal written policies with respect to ethics and conduct in teaching/training and/or research. Other
members conduct these activities in their work settings within organizations that do not necessarily have
formal written policies or codes of ethics and conduct. If you are involved in teaching or training and/or
research activities, please complete these parts. Should you assess that further review or action is
required, this should be carried forward to your Professional Development Plan.
TEACHING/TRAINING ACTIVITIES
Yes/No Action Required
Yes/No
I teach or train in a setting which has formal written codes
of ethics and policies regarding professional behaviour to
which I must adhere and I am familiar with these.
OR
I teach or train in a setting that does not have formal written
codes of ethics and policies but I am familiar with codes of
ethics and policies regarding professional behaviour with
respect to teaching and training.
RESEARCH ACTIVITIES
Yes/No Action Required
Yes/No
I conduct research under the auspices of a fund granting
body or research facility that has formal written codes of
ethics and policies regarding professional behaviour to
which I must adhere and I am familiar with these.
OR
I conduct research at a setting which is not under the
auspices of a fund granting body or research facility but I
am familiar with codes of ethics and policies regarding
professional behaviour with respect to conducting research.
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February/March 2011: Instructions and Forms
PART IV SUPERVISORY ACTIVITY
Many members are involved in supervisory activities in a variety of academic, institutional or private
practice settings. If you are engaged in supervisory activities, please complete Part IV and carry forward
any items that require further review or action to your Professional Development Plan.
Yes/No Action Required
Yes/No
I am sufficiently familiar with the Supervision Resource
Manual, 2nd Edition, March 2009 published by the College.
I am familiar with the Ethical Guidelines for Supervision in
Psychology: Teaching, Research, Practice, and
Administration, Canadian Psychological Association, 2009
I take full professional responsibility for all clients seen by
my supervisee.
I have adequate training, knowledge and skill to render
competently all psychological services undertaken by my
supervisee.
I ensure my supervisees have the background, training and
experience to perform the work they do.
I have such face-to-face contact with the clients seen by my
supervisee to ensure adequate planning for effective delivery
of services.
Procedures carried out by my supervisee, under my
supervision are planned in consultation with me.
Users of my supervisee‟s services are informed of his/her
status and are given specific information as to his/her
qualifications.
Clients are informed of the possibility of periodic meetings
with me at their request or at the supervisee‟s or my request.
All billing for services and payments for services are in my
name
Public announcements of service are offered only by me or in
my name.
In all fee-for-service arrangements, setting and receipt of fees
remains my responsibility or that of the employing agency.
I countersign all written reports and communications
prepared by my supervisee, under my supervision.
I encourage my supervisee to engage in ongoing professional
development.
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PART V CURRENT AREAS OF PRACTICE AND/OR SERVICES PROVIDED
List your current areas of practice or the services you provide. At the back of this booklet is a Reference
List: Areas of Practice and Services Provided that might be helpful in fully describing the psychological
services you provide. This list is not intended to be all-inclusive.
Identify any differences between your current and desired levels of knowledge or skill. Having identified
a difference, you should begin to think about how this might be addressed through professional
development. Please describe these differences and carry them forward to be addressed in your
Professional Development Plan.
Areas of Practice/Services Provided Differences Between Current and Desired
Levels of Knowledge and Skill
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PART VI ANTICIPATED AREAS OF FUTURE PRACTICE
Members often consider expanding or changing areas of practice. The Anticipated Areas of Future
Practice page will allow you to identify future areas of practice you may be considering, and an
evaluation of your current status with respect to necessary knowledge, skill and experience. Identify any
differences between your current and desired levels of knowledge and experience, and begin to develop
your Professional Development Plan.
Changing Areas of Practice: Retraining Plans
According to the Registration Regulation (Ontario Regulation 533/98) members of the College, “shall
practise the profession only within those areas of the member‟s competency that are authorized by the
College or under the supervision of a member who has competency in those areas.” [10(2)1] If you are
considering a change in your practice that could include either a change in area of practice, in activity
and/or in clients served, a retraining plan, approved by the Registration Committee of the College, may
be required. If you are unsure if the changes you are contemplating constitute a change in your area of
practice, you are encouraged to contact the Registration Committee. Please refer to the Guidelines For
Change of Area of Competence for Autonomous Practice Members.
Areas of Future Practice or Differences Between Current and Desired Levels of
Services to be Provided Knowledge and Experience
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February/March 2011: Instructions and Forms
PART VII PROFESSIONAL DEVELOPMENT PLAN
A Professional Development Plan is created by each member to address any differences between your
current and desired levels of knowledge or skill identified through the self assessment process.
Differences Developmental Plan Time Line Course, Workshop,
Activity
In addition to addressing the identified differences, members should also list any other continuing
educational activities undertaken to enhance practice and professional development. You may wish to
begin to track the number of hours of each in anticipation of the mandatory continuing education hours
requirement that is expected to be in place within a few months.
Course, Workshop, Activity Date Hours
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February/March 2011: Instructions and Forms
PART VIII REFLECTIONS ON PROFESSIONAL DEVELOPMENT PLAN
During the two year life of the Self Assessment Guide and Professional Development Plan some items
may become less relevant and some of your plans may change. It is helpful to note this as a reminder to
yourself about why a particular aspect of your Professional Development Plan was not carried out at all
or in the manner expected, when the Self Assessment Guide and Professional Development Plan was
originally completed. This can provide an ongoing record of the status of your professional development
and will be very useful in two years time when completing your next Self Assessment Guide and
Professional Development Plan.
Comments on Professional Developmental Plan
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Reference List: Areas of Practice and Services Provided
Populations
Infants Seniors
Children Couples
Adolescents Families
Adults Organizations
Conditions Assessed And/Or Treated - Types Of Difficulties Or Issues
Abuse; sexual, physical, emotional Chronic Pain Medical; e.g., cancer, stroke
Addiction; e.g., alcohol, gambling, Cognitive issues; giftedness, Palliative care
drugs, etc. delays, limitations Physical disabilities
AIDS and HIV Death and dying Psychiatric disorders
Anxiety Depression Separation, Divorce
Attention deficit disorder Eating disorders Sexuality
Autism Brain injury Sexual dysfunction
Behaviour problems Learning disabilities/problems Sports and Performance
Capacity to make decisions Lifestyle issues Other
Services Provided
Assessment Diagnosis Treatment
Addiction Behavioural Disorders Biofeedback
Adoption Developmental Disabilities Cognitive Behavioural Therapy
Child Custody/Welfare Mental Health/Psychiatric Counselling
Corrections/Forensic Disorders Crisis Intervention
Designated Capacity Assessor (SDA) Personality Disorders Desensitization Training
Disability Group Therapy
Industrial/Organizational Other Hypnotherapy
Neuropsychology Research Individual Therapy
Mental Health and Well Being Supervision Psychotherapy
Parenting Capacity Teaching/Training
Educational/Learning
Vocational/Career
Rehabilitation/Insurance
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NOTES
College of Psychologists of Ontario - Self Assessment Guide and Professional Development Plan Page 16
February/March 2011: Instructions and Forms
The College of Psychologists of Ontario
110 Eglinton Ave W, Suite 500
Toronto, Ontario M4R 1A3
Tel: (416) 961-8817/(800) 489-8388 Fax: (416) 961-2635
e-mail: cpo@cpo.on.ca website: www.cpo.on.ca
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February/March 2011: Instructions and Forms