Entry to Practice Competencies and Standards of Practice for Certified Nurse Psychotherapist (CNP)
Canadian Nurse Psychotherapist Association (CNPA)
Entry to Practice Competencies and Standards of Practice for
CNP – Certified Nurse Psychotherapist.
Competencies and Standards of Practice established minimum requirement and
create a solid foundation upon which to build for qualified nurses wanting to
practice counselling and psychotherapy as a CNP- Certified Nurse Psychotherapist
in any clinical settings.
The CNP competency profile below informs the minimum requirements for registered
nurses, registered practical nurses, registered psychiatric nurses, nurse
practitioners, nurses in Quebec, and license practical nurses who wish to become
certified as a CNP – Certified Nurse Psychotherapist..
Details of the CNP certification entry to practice competencies standard are noted
below and may be amended from time to time.
Define CNP standards
Services are provided by nurses properly registered to practice as a nurse with
the appropriate governing regulatory body of a province or territory in
Canada who meets the following criteria as may be amended from time to
time.
- Are in good standing with each Canadian nursing regulatory body with
which they are currently registered to practice in Canada. - Have obtained a certificate of completion in nurse psychotherapy
offered by the College of Health Studies, or obtained a certificate of
completion in a counselling and psychotherapy program offered at the
post-secondary level from a post-secondary learning institution. The
post-secondary program must integrate information from the CNP
entry to practice competencies and standards of practice from the
Nurse Psychotherapist Association. This consist of a minimum of 750
theory hours in counselling and psychotherapy skills, 450 hours of hands
on practical experience performing counselling and psychotherapy to clients
in a health care or mental health setting, 100 hours of clinical supervision in
counselling and psychotherapy provided by an experienced nurse
psychotherapist. - Nurses must have malpractice insurance with their respective nursing
association in which they are currently registered to practice in Canada.
Competencies and Standards of Practice for the CNP.
At entry-to-practice the CNP is able to:
1.1 Integrate a theory of psychological functioning when working with clients in all age group
a Integrate knowledge of human growth and development across the lifespan
b Integrate knowledge of systemic factors that facilitate or impair human functioning
with respect to psychological and mental illnesses
c Integrate knowledge of the psychological significance of spiritual, moral, social,
emotional, cognitive, behavioral, sexual, gender, and biological development.
1.2 Work within a framework based upon established counselling and psychotherapeutic theory.
a Integrate the theories upon which the certified nurse psychotherapist CNP is trained in
evidence based practice.
b Integrate knowledge of how human problems develop, from the viewpoint of the therapist’s
theoretical orientation.
c Identify circumstances where therapy is conflicted
d Recognize the benefits, limitations, and contraindications of differing
counselling and psychotherapeutic approaches.
e Establish a therapeutic relationship informed by the theoretical framework.
f Integrate theory of change consistent with the therapist’s theoretical orientation.
g Integrate knowledge of the impact of trauma on psychological functioning.
Certified Nurse Psychotherapist CNP is able to:
1.3 Integrate knowledge of comparative psychotherapy relevant to practice.
a Integrate knowledge of key concepts common to all psychotherapy practice
b Recognize the range of psychotherapy practiced within the province of Ontario or in the
Province where the CNP is practicing
c Integrate knowledge of psychopathology and mental illness
d Recognize the major diagnostic categories in current use.
e Recognize the major classes of psychoactive drugs and their effects as per the nurse training
1.4 Integrate awareness of self in relation to professional role as a Certified Nurse
Psychotherapist CNP.
a Integrate knowledge of the impact of the Certified Nurse Psychotherapist’s self on the
therapeutic process.
b Recognize how the Certified Nurse Psychotherapist CNP values and attitudes, both
in and out of awareness, may impact diverse clients.
c Recognize the cognitive, emotional and behavioral patterns of the therapist that may
influence therapeutic relationship.
d Recognize instances where the Certified Nurse Psychotherapist CNP life experiences may
enhance or compromise therapeutic effectiveness.
1.5 Integrate knowledge of human and cultural diversity.
a Integrate knowledge of human diversity.
b Recognize how oppression, power and social injustice may affect the client and also the
therapeutic process.
c Adapt the therapist’s approach when working with culturally diverse clients.
d Recognize barriers that may affect access to therapeutic services.
e Identify culturally-relevant resources. - Collegial and Interprofessional Relationships
2.1 Use effective professional communication.
a Use clear and concise written communication.
b Use clear and concise oral communication.
c Use clear and concise electronic communication.
d Communicate in a manner appropriate to the recipient.
e Use effective listening skills.
f Differentiate fact from opinion.
g Recognize and respond appropriately to non-verbal communication.
2.2 Maintain effective relationships.
a Show respect to others.
b Maintain appropriate professional boundaries.
c Recognize and address conflict in a constructive manner.
d Demonstrate personal and professional integrity.
2.3 Contribute to a collaborative and productive atmosphere.
a Create and sustain working relationships with other professionals encountered in practice.
b Create and sustain working relationships with colleagues of diverse socio- cultural
identities.
c Initiate inter-professional collaborative practice. - Professional Responsibilities
3.1 Comply with legal and professional obligations.
a Comply with applicable federal and provincial legislation.
b Comply with College of Nurses standards in addition to the CNP competencies and standards
c Address organizational policies and practices that are inconsistent with legislation
and professional standards.
d Comply with relevant municipal and local bylaws related to private practice
3.2 Apply an ethical decision making process.
a Recognize ethical issues encountered in practice.
b Resolve ethical dilemmas in a manner consistent with legislation and professional
standards.
c Accept responsibility for course of action taken.
3.3 Maintain self-care and level of health necessary for responsible therapy.
a Maintain personal physical, psychological, cognitive and emotional fitness to practice.
b Build and use a personal and professional support network.
c Maintain personal hygiene and appropriate professional presentation.
3.4 Evaluate and enhance professional practice.
a Undertake critical self-reflection and evaluation
b Solicit client feedback throughout the therapeutic process.
c Plan and implement methods to assess effectiveness of interventions.
d Obtain feedback from peers and supervisors to assist in practice review.
e Identify strengths as a therapist, and areas for development.
f Set goals for improvement.
g Modify practice to enhance effectiveness.
h Participate in relevant professional development activities.to enhance practice
i Maintain awareness of resources and sources of support relevant to practice.
3.5 Obtain clinical supervision or consultation.
a Initiate clinical supervision or consultation when appropriate or required.
b Articulate parameters of supervision or consultation.
c Protect client privacy and confidentiality, making disclosure only where permitted or required.
d Initiate a legal consultation when necessary.
3.6 Provide education and training consistent with the therapist’s practice.
a Recognize when to provide education and training to clients and others.
b Recognize therapist’s limits of professional expertise as a trainer / educator.
c Plan and implement effective instructional activities.
3.7 Maintain client records.
a Comply with the requirements of Certified Nurse Psychotherapist CNP Competencies and
Standards of practice and the nurse relevant professional nursing standard.
3.8 Assist client with needs for advocacy and support.
a Identify when advocacy or third-party support may be of value to the client, and advise client
accordingly.
b Support client to overcome barriers.
3.9 Provide detail reports to third parties.
a Prepare clear, concise, accurate and timely reports for third parties, appropriate to the needs of
the recipient.
b Recognize ethical and legal implications when preparing third-party reports.
3.10 Establish business practices relevant to professional role.
a Comply with the requirements of Certified Nurse Psychotherapist CNP competencies and standards of
practice, and relevant professional standards as per the nurse college of nurses, working in
independent practice.
b Explain limitations of service availability. - Therapeutic Process
4.1 Orient client to therapist’s practice.
a Describe therapist’s education, qualifications and role.
b Differentiate the role of the therapist in relation to other health professionals.
c Explain the responsibilities of the client and the therapist in a therapeutic relationship.
d Explain the advantages and disadvantages of participating in counselling psychotherapy.
e Explain client rights to privacy and confidentiality, and the limitations imposed upon it by law.
f Explain relevant rules and policies.
g Respond to client questions appropriately
h Explain and obtain informed consent in accordance with legal requirements.
4.2 Establish and maintain core conditions for therapy.
a Employ empathy, respect, and authenticity.
b Establish rapport
c Demonstrate awareness of the impact of the client’s context on the therapeutic process.
d Demonstrate sensitivity to the setting in which therapy takes place.
e Assume non-judgmental stance.
f Explain theoretical concepts in terms the client can understand.
g Foster client autonomy at all times
h Maintain appropriate therapeutic boundaries.at all times
i Define clear boundaries of response to client’s requests or demands.
j Take all reasonable measures to safeguard physical and emotional safety of client during
clinical work.
k Employ effective skills in observation of self, the client and the therapeutic process.
l Demonstrate dependability.
7. Ensure safe and effective use of self in the therapeutic relationship.
a Demonstrate awareness of the impact of the therapist’s subjective context on the therapeutic
process.
b Recognize the impact of power dynamics within the therapeutic relationship.
c Protect client from imposition of the therapist’s personal issues.
d Employ effective and congruent verbal and non-verbal communication.
e Use self-disclosure appropriately.
8. Conduct an appropriate risk assessment.
a Assess for specific risks as indicated.
b Develop safety plans with clients at risk.
c Refer to specific professional services where appropriate.
d Report to authorities as required by law.
e Follow up to monitor risk over time.
9. Structure and facilitate the therapeutic process.
a Communicate in a manner appropriate to client’s developmental level and socio- cultural
identity.
b Identify and respond appropriately to client’s strengths, vulnerabilities, resilience and resources.
c Respond non-reactively to anger, hostility and criticism from the client.
d Respond professionally to expressions of inappropriate attachment from the client.
e Anticipate and respond appropriately to the expression of intense emotions and help the client
to understanding and management.
f Recognize a variety of assessment approaches.
g Formulate an assessment.
h Develop individualized goals and objectives with the client.
i Formulate a direction for treatment or therapy.
j Practice therapy that is within therapist’s level of skill, knowledge and judgement.
k Focus and guide sessions.
l Engage client according to their demonstrated level of commitment to therapy.
m Facilitate client exploration of issues and patterns of behaviour.
n Support client to explore a range of emotions.
o Employ a variety of helping strategies.
p Ensure timeliness of interventions.
q Recognize the significance of both action and inaction.
r Identify contextual influences.
s Review therapeutic process and progress with client periodically, and make appropriate
adjustments.
t Recognize when to discontinue or conclude therapy.
10. Refer client.
a Develop and maintain a referral network.
b Identify situations in which referral or specialized treatment may benefit the client, or be required.
c Refer client, where indicated, in a reasonable time.
11. Conduct an effective closure process.
a Prepare client in a timely manner for the ending of a course of therapy.
b Outline follow-up options, support systems and resources.