Ethically Navigating Client Requests for Letters in Ontario
Registered Psychotherapists in Ontario routinely field requests from clients to write letters. Some requests fall squarely within our scope (e.g., verifying attendance for insurance or confirming that a client needs a service animal). Others, such as emotional support animal certifications, immigration/LMIA letters or opinions in legal disputes, tread dangerously close to medical practice or forensic evaluation. Poorly considered letters risk role‑creep, breaches of confidentiality and disciplinary action. As clinical supervisors who support therapists, we encounter these questions regularly in group supervision, dyad supervision and trauma‑informed supervision sessions. This article synthesizes guidance from the College of Registered Psychotherapists of Ontario (CRPO), human‑rights legislation and professional ethics to help you respond confidently and ethically.
Jurisdiction disclaimer: Laws, professional scopes and human‑rights provisions related to letter writing vary by province and country. The information below applies specifically to Registered Psychotherapists in Ontario, Canada. Therapists practising elsewhere should consult their own regulatory college or legal counsel.
Why therapists are asked for letters so often
Clients ask us to prove they are ill or to justify accommodations. Common scenarios include:
Service animals and emotional support animals (ESAs). Clients may ask for documentation to bring an animal into housing or public spaces. Under the AODA’s Integrated Accessibility Standards, a dog or animal is considered a service animal if it is clearly identified as trained or if documentation is provided by a regulated health professional—including Registered Psychotherapists wellness.uoguelph.ca. By contrast, ESAs provide comfort but are not trained; they do not enjoy automatic public access cmpa-acpm.ca.
Housing accommodations. Tenants with disabilities sometimes need letters to request accommodations from landlords (e.g., to keep an animal despite a no‑pets policy or to modify payment dates). Accommodation letters must come from qualified health‑care providers and should confirm that the tenant has a disability and explain how it limits major activities; they should not reveal diagnostic details without consent housingrightscanada.com.
Insurance receipts and paperwork. Clients’ insurers often ask for receipts or letters to confirm therapy sessions. CRPO instructs RPs to issue accurate invoices that include the client’s full name, service date and description and to avoid misrepresenting who attended the session crpo.ca.
Legal proceedings. Parents in custody disputes, lawyers or courts may request evaluations or opinions. Standard 5.2 of the CRPO’s Professional Practice Standards warns registrants to distinguish between factual reporting and opinion, avoid assessing individuals they have not met, and maintain confidentiality crpo.ca.
Immigration/LMIA or disability benefits. Clients may ask therapists to write letters supporting their immigration applications, employment accommodations or disability benefits. Such letters often require a medical diagnosis or formal functional assessment that is outside an RP’s scope crpo.ca. If a letter requires diagnostic opinions, it should be completed by a physician or psychologist crpo.ca.
Understanding the purpose of the request helps determine whether you can respond within your scope of practice and competence.
Which letters fall within a Registered Psychotherapist’s scope?
According to CRPO, RPs can assess clients’ cognitive, emotional and behavioural disturbances but may not diagnose mental disorders crpo.ca. Therapists may provide letters that:
Verify attendance and treatment. A letter can confirm that a client is receiving psychotherapy, the dates of sessions and general treatment goals. It must not contain third‑party health information or details about others involved crpo.ca. Ensure your client’s informed consent is obtained before releasing any information to third parties crpo.ca.
Support accommodation requests under the AODA or Human Rights Code. When a client has a disability that limits their participation in major life activities, you may confirm this and describe limitations without naming the diagnosis housingrightscanada.com. For service animal letters, include your qualifications (Registered Psychotherapist), state that you are treating the client for a disability and explain how the animal assists them wellness.uoguelph.ca.
Provide factual information in collaboration with other professionals. If a physician or psychologist is completing a medical form (e.g., for disability benefits), you may supply information about the client’s treatment and symptoms to them. The diagnosing professional will interpret this information and provide the clinical opinion crpo.ca.
When writing any letter within your scope:
Clarify the intended use. Ask the client who will read the letter and why. The content may differ for a housing accommodation versus an insurance receipt.
Obtain informed consent in writing. Explain what information will be shared and that the client may review the letter crpo.ca.
Stick to facts. State what you have personally observed, the length of the therapeutic relationship and general treatment themes. Indicate whether statements are factual or your clinical opinion crpo.ca.
Keep it concise. Provide only information relevant to the request, avoid including third‑party details and maintain the client’s privacy crpo.ca.
Requests that require other professionals
Some letters are outside the scope of a Registered Psychotherapist:
Diagnostic letters or disability certificates. Only physicians, psychologists and nurse practitioners can diagnose medical conditions or prepare disability certificates required for insurance, Worker’s Compensation or government benefits crpo.ca. Clients seeking disability benefits should be referred to those professionals.
Letters for immigration or LMIA applications. Immigration forms often ask for medical opinions on how a condition affects employability or require a physician’s verification. Because RPs cannot diagnose and immigration proceedings may involve forensic assessment, refer the client to a family doctor, psychiatrist or immigration lawyer.
Court evaluations or custody opinions. Providing an opinion about a third party (e.g., a child’s other parent) or a client’s fitness to parent is forensic work. CRPO advises RPs to avoid assessing individuals they have not met and to distinguish clearly between fact and opinion crpo.ca. Recommending custody arrangements or character assessments can bias therapy and may result in your records being subpoenaed myprivatepracticebuilder.com.
Emotional support animal (ESA) certifications. ESAs differ from service animals and lack specific legal protections cmpa-acpm.ca. Evidence supporting ESA benefits is limited, and clinicians are advised to decline requests unless they have specialized training and are confident the animal is integral to treatment ccme.osu.edu. If the request relates to housing, treat it as an accommodation letter focusing on the client’s disability and functional limitations housingrightscanada.com.
Insurance coding beyond receipts. Some insurers ask therapists to assign diagnostic codes or sign off on extended health‑benefit forms. Because RPs cannot diagnose, this should be completed by a physician or psychologist.
When confronted with requests outside your scope, refer appropriately. Provide the client with information about professionals who can complete the form and, if appropriate, collaborate by supplying factual information to them crpo.ca.
How to decline a request ethically
Refusing a client’s request can strain the therapeutic alliance. Here are steps to decline while maintaining trust and professionalism:
Acknowledge the client’s needs and validate their feelings. Clients may feel anxious or frustrated; empathise with their situation.
Explain your professional obligations. Share that CRPO standards require you to practice within your scope and competence crpo.ca and not to provide opinions about individuals you have not assessed crpo.ca.
Identify potential risks. For example, writing a court opinion may draw you into legal proceedings and require disclosure of confidential notes myprivatepracticebuilder.com.
Offer alternatives. Suggest the appropriate professional (e.g., physician, psychologist, occupational therapist, social worker) and provide a letter summarizing treatment to support that professional’s assessment crpo.ca.
Document the discussion. Note in the client’s file that you received a request, explained the limitations, provided referrals and that the client understood.
Template wording for declining a request
Dear [Client Name],
Thank you for discussing your request for a [type of letter] with me. I understand that this matter is important to you. Under the guidelines of the College of Registered Psychotherapists of Ontario, Registered Psychotherapists may provide documentation about treatment progress and functional limitations but are not authorized to diagnose medical conditions or offer forensic opinions crpo.ca.
After reviewing your request, I have concluded that a [type of letter] would involve providing a medical diagnosis/forensic opinion, which is beyond my scope of practice. I am therefore unable to prepare the letter you have requested. I encourage you to consult with your family physician, psychiatrist or another appropriate regulated health professional. With your consent, I am happy to provide them with information about your treatment to support their assessment.
Please let me know how you wish to proceed, and we can discuss other ways to support your needs within our therapy.
This wording validates the client’s needs, cites regulatory obligations and offers a collaborative path forward.
High‑risk scenarios therapists should avoid
Becoming an advocate in legal disputes. When asked to write a letter for court or child custody, decline and refer to a forensic evaluator. Acting as both therapist and evaluator compromises neutrality and may lead to subpoena of your notes myprivatepracticebuilder.com.
Providing diagnostic or treatment recommendations for people you have never met. Standard 5.2 prohibits assessing or diagnosing someone you haven’t treated crpo.ca.
Writing letters for disability benefits or insurance codes without competence. RPs cannot verify disability status or assign diagnostic codes crpo.ca.
Endorsing specific animals or products. A service‑animal letter should confirm that the client benefits from the animal but not endorse a particular animal or company cmpa-acpm.ca.
Guaranteeing outcomes. Do not suggest that a letter will guarantee approval. Housing providers, insurers and tribunals make their own determinations.
Frequently asked questions (FAQs)
Can I write a letter for my client’s emotional support animal? You may verify that your client has a disability and that an animal assists them with daily functioning, but avoid calling it an “ESA” or endorsing a specific animal. Under the AODA, only service animals have guaranteed accesscmpa-acpm.ca; ESAs lack formal legal status. Where appropriate, treat the request as a housing accommodation letter housingrightscanada.com.
My client needs a letter for an LMIA or immigration application—can I help? Immigration forms typically require a physician or psychologist to provide medical opinions and diagnoses. Because RPs do not diagnose mental disorders crpo.ca, you should decline, explain your limits and refer the client to a qualified professional.
What if my client’s lawyer asks for my clinical notes? Obtain written consent from the client before sharing any information crpo.ca. Provide only the relevant information; summaries rather than share raw notes crpo.ca. When legal proceedings are involved, consider consulting with your supervisor or legal counsel.
How can I help when a client’s landlord wants a “doctor’s note” for their pet? If the client has a disability that requires accommodation, you can write a letter confirming that they have a disability and require support but should avoid naming the diagnosis without consent housingrightscanada.com. Include your qualifications and contact information housingrightscanada.com. Remind the client that you cannot guarantee the landlord will accept the letter.
Can I sign an insurance form that asks for diagnostic codes? No. Only physicians or psychologists can assign diagnostic codes crpo.ca. Offer to provide a receipt summarizing the sessions crpo.ca, or suggest that the insurer accept documentation from a medical professional.
Conclusion: set boundaries and seek supervision
Requests for letters can feel like routine administrative tasks, yet they carry significant ethical and legal implications. When in doubt, pause, consult CRPO standards and your supervisor, and reflect on whether the request falls within your scope. Staying within your competence protects you, preserves the therapeutic relationship and ensures clients receive appropriate support. Incorporate discussion of letter requests into clinical supervision—including therapy supervision, psychotherapy supervision and counselling supervision—to develop scripts and protocols. These topics are common in group supervision CRPO sessions because many therapists struggle with them. Using supervision to build your ethical muscle will also help you attract clients searching for psychotherapy supervisors near me and clinical supervision in the helping professions.
If you need guidance or want to role‑play difficult conversations about declining letters, consider working with an experienced supervisor through Ontario Supervision. Our team offers individual, dyadic and group supervision sessions tailored to the challenges faced by RPs and RPs (Qualifying) across Ontario. We provide clinical supervision for therapists, mental health supervision, couple, marriage and family therapy supervision, IFS supervision and gestalt supervision. Whether you are searching for clinical supervision near me, how to find a clinical supervisor, or a clinical supervisor directory, we have options that fit your needs. Book an appointment today through our main site or directly via our Jane App portal. Sessions are available virtually for therapists in Brockville, Kingston, Ottawa, Toronto and throughout Ontario. Together, we can help you navigate ethical dilemmas and advance your professional growth.
References
College of Registered Psychotherapists of Ontario. (n.d.). Can I write a letter for my client? Retrieved 22 Nov 2025 from CRPO websitecrpo.cacrpo.ca.
College of Registered Psychotherapists of Ontario. (n.d.). Standard 5.2: Requests for reports. In Professional practice standards for registered psychotherapists. Retrieved 22 Nov 2025crpo.ca.
College of Registered Psychotherapists of Ontario. (n.d.). Consent to release information. Retrieved 22 Nov 2025crpo.cacrpo.ca.
College of Registered Psychotherapists of Ontario. (n.d.). Invoices and receipts. Retrieved 22 Nov 2025crpo.ca.
University of Guelph. (n.d.). Service animals and support persons – Integrated Accessibility Standards. Retrieved 22 Nov 2025wellness.uoguelph.ca.
Canadian Medical Protective Association. (2022). When a patient asks for an emotional support animal letter. Retrieved 22 Nov 2025cmpa-acpm.ca.
Canadian Centre for Housing Rights. (2023). Writing disability accommodation letters for housing providers. Retrieved 22 Nov 2025housingrightscanada.com.
Ohio State University. (2024). Emotional support animals: Ethics and considerations. Slide deck. Retrieved 22 Nov 2025ccme.osu.edu.
My Private Practice Builder. (2023). How to ethically handle client requests for letters, evaluations, and court related activities. Retrieved 22 Nov 2025myprivatepracticebuilder.com.
Ontario Supervision. (n.d.). Clinical supervision for therapists and supervisors. Retrieved 22 Nov 2025, from https://ontariosupervision.ca/
Ontario Supervision. (n.d.). Book a session. Retrieved 22 Nov 2025, from https://ontariosupervision.janeapp.com/
