Covid-19 and Practice Across State Lines

COVID-19-Mental-Health-State-Policies

The Impact of COVID-19 on Telemental Health Across State Lines

We will always remember 2019 as the year that permanently changed our lives. Years from now the term “social distancing” may drift away, but human contact may never be the same. Maybe not in our lifetime.

2019 is the the year of the 2019 novel coronavirus or simply, COVID-19. Below is a picture of my old can of Lysol indicating it kills human coronavirus, but coronaviruses have existed for centuries–or more–COVID-19 is a highly transmissible and deadly strain of that virus.

Telemental Health Law and Out of State Mental Health Practice

First, many states have implemented policies allowing for out of state telemental health practitioners, but these policies can changes without notice. If these policies change, you can’t defend unlicensed practice because you didn’t get the memo.

Not all states have implemented COVID-19 policies for out of state licensed health practitioners. Many have not. Most of the state policy changes effect physicians and nurses, but some have implemented policy allowing clinical social workers, professional counselors, marriage and family therapist and psychologists to practice within their state. The policy changes have been executed mainly via:

1) Governor Executive Order

2) Boards of Health or Divisions of Professions and Businesses

3) Individual Licensing Boards

4) Other

+ MORE: Examples of State Rules, COVID-19 and Telemental Health

Changing law and passing legislation takes time. Therefore most states’ laws are permitted under law to implement licensing policy and rules exceptions during a state of emergency. So no law changes–out of state practice has been addressed through executive order or board emergency rule and policy changes.

Out Of State Licensees and Practice Within State Boundaries Prohibited

It is important to note that the emergency policies allow only telehealth. Licensees can only deliver telehealth services to individuals from within their home state. They cannot practice geographically within that state. There is one exception however. Through a Governor Cuomo executive order, New York State has implemented an emergency policy that allows health care professionals to come to New York to practice within the state provided they have an active unencumbered practice license in their home state. It is essentially, ‘if you’re licensed, come to New York because we have a severe shortage of healthcare providers. This policy could change without notice.

Great LPC supervision. Invest wisely.

great-lpc-supervision

LPC Supervision

Trying to find that elusive great clinical supervisor? Supervisor refuses to sign forms, APC who violates boundaries….good LPC supervision in Georgia defined. Here are answers to your burning questions and suggestions for avoiding unethical supervisors.

“Eric was a fantastic supervisor. He prioritized my own professional and clinical growth and agency throughout our relationship. I felt comfortable bringing up and receiving supervision on my thorniest and most difficult struggles and dilemmas feeling secure that he had both the knowledge of the ethical and legal obligations and also the mindset and professional skills to help me fulfill both my obligation to my clients and my own obligation to my professional growth without compromising either. I would easily recommend him to others who are seeking a supervisor skilled in helping them navigate the bureaucratic elements of the counseling profession AND figuring out the boundaries and clinical elements of the therapeutic relationship.” -Girish Kumar Krishan

Difference between your supervisor boss and clinical supervisor.

Director V. Supervisor

In most states, a distinction is made between your boss and clinical supervisor. Your boss enforces employer policies and disciplinary procedures and can hire and terminate employees. They might not involve themselves directly in your counseling skills development. Some states such as Georgia does not require they be licensed. In fact, no level of education is specified. Georgia views your supervisor boss as whoever that employer chooses to manage their employees.

As stated in Georgia Board Rule 135-5-0-.01(a) 4:

“Supervision means the direct clinical review, for the purpose of training or teaching, by a supervisor of a Professional Counselor’s interaction with their client(s). The purpose of supervision is to promote the development of the practitioner’s clinical skills.”…

On the other hand, it is the role of the clinical supervisor to develop and have direct oversight of your psychotherapy skills and management of ethical practice.

In Georgia, boss and clinical supervisor are defined as “Director” and “Supervisor” respectively– Director because they direct your work activities and Supervisor because they oversee your clinical work.

In some states, it is assumed that your clinical supervisor is the person who employs you.

Who cannot be your supervisor?

Conflicts of Interest/ Dual Relationships

There are important exceptions to who can be your supervisor. Most states including Georgia, prohibit certain dual relationships. The most common is that a supervisor cannot be a family member. Some boards for example the Missouri Committee for Professional Counselors has written into rules that LPC supervision by certain non blood extended family members is prohibited.

There are also supervision relationships while not prohibited, can devolve into legal catastrophy for both supervisor and supervisee.

Choosing an LPC supervisor that is right for you.

Your supervisor will interview you. You should also prepare questions for them. You might explain that you understand the six important 6 dimensions (below) are important for understanding how they will supervise you. Ask them which dimensions they place the most emphasis.

You can even ask them for a rough percentage breakdown of the 6 dimensions. They may describe their work in a different manner, but asking them these questions will invariably be a step further towards having a meeting of the minds.

Can your boss be your clinical supervisor?

Again, theoretically if your state accepts them as an approved supervisor the answer is yes.

Who Governs Supervision Requirements?

State Licensing Boards

Ultimately, state government. Specifically, subdivisions of state government that regulate businesses and professions. Issuing and determining these requirements may be regulated by the Board of Health, entities created solely for licensing purposes or other commissions. They are referred to as licensing boards. This can apply to all professions including medicine, nursing, massage therapy, dental hygienists and so on. And they also apply to all matters of maintaining your license including ethics and continuing education.

In addition, state licensing boards often involve independent professional associations in creating licensing requirements. An example is LPCAGA, the Licensed Professional Counselors Association of Georgia. These associations represent and serve their licensees and membership– you pay for annual membership, they provide you benefits and services. Other professional are NBCC, AAMFT, NASW, and APA.

Since psychotherapy is a specialized area of healthcare, licensing boards members are often licensed mental health professionals.

Definition of LPC supervision.

Supervision is defined by Powell, D. & Brodsky A. (2004) states as “Clinical supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical and supportive.”

In order to be licensed in most states to perform psychotherapy, state licensing boards require a minimum masters level education and additional supervised experience after all degree requirements have been completed.

(In some states there are broad exemptions under the law for faith-based counselors (see page 6). Whereas these counselors cannot imply or advertised they are licensed, they are permitted to perform psychotherapy.)

With the exception of these exemptions, since psychotherapy is a form of healthcare treatment, state boards and the mental health profession assume that a graduate school education is not sufficient to qualify one to provide psychotherapy.

This is not only true for licensed professional counselors, but social workers, psychologists and marriage and family therapists, and other mental health professionals.

Supervised experience essentially means, “Now that you have completed graduate school you need X number of years or hours of guidance and professional development by a more experienced fully licensed peer while you are practicing at your mental health job. This process then prepares you to practice independently.”

Methods of LPC Supervision

Theoretical Orientations To LPC Supervision

I will not elaborate on the numerous theoretical approaches to supervision as these are better described elsewhere. Instead, since professional and personal compatibility are critical, I present these orientations in a manner which will aid in knowing what to expect with various supervisors.

A clinical supervisor approaches reflect their:

• personal values and attitudes.

• beliefs about how to approach psychotherapy.

• preferred methods of education

• perception of roles of the supervisor and supervisee.

• beliefs about necessary level of oversight of the supervisee’s counseling work.

• beliefs about what their role should be in the professional community at large.

• beliefs about autonomy.

• beliefs about their use of power.

A supervisor’s approach also evolves from their level of confidence.

Supervisory Styles and Dimensions

First, whereas there are activities of clinical supervision that are administrative, in all 50 states a clinical supervisor is usually required to also focus on development of the supervisee’s clinical skills. The following are 6 dimensions of clinical supervision. Together, they provide an overall picture of interventions used by a given clinical supervisor.

Mentoring

In addition to teacher / student , the relationship between a supervisor and supervisee is a peer relationship. You are equals. For example, in Georgia an APC (associate professional counselor) is licensed and has the same scope of practice under the law including APCs in Georgia can diagnose with the exception they must work while under direction and clinical supervision.

You are two licensees who have each made a legal agreement with the board to abide by all applicable law and rules.

A mentoring relationship is a relationship of equals where one is an eager pupil who submits to an experienced and wiser therapist. Supevisees have clear responsibilities under board rules–know and understand them.

It is also understood that the mentor does not have all the answers or solutions to a student’s questions. Both understand and respect that the mentor also is in a constant state of learning.

Example: Supervisor A: Views their role as engaging your participation and involvement in decision making. Expects you to make most decisions. Is comfortable working with supervisee mistakes and blunders. Is comfortable helping a supervisee develop an area of expertise that may be beyond the supervisor’s expertise.

Supervisor B: Is comfortable with a more didactic instructional approach. Expectations are that the supervisee implements all recommendations. Supervisee prefers to defer to supervisor for most decisions and desires clear instructions.

Evaluation

Evaluation comes in many forms.

1) Formal written feedback on clinical work.2) Verbal feedback on clinical work.3) Feedback designed to propel and challenge the supervisee that is guided by evaluation.4) Other feedback based upon direct observation.

Supervisor A: Is also comfortable with informal and fluid verbal feedback which prompts the supervisee to reflect and discover solutions that work best.

Supervisor B: Prefers use of objective measures in evalution of LPC progress.

Use of Authority

Specifically, the use of sapiential authority. This type of authority differs in that it is not the use power in a non-consensual manner. It requires from the supervisor:

1) ability to work with decisively and with conviction.

2) wisdom both personal and professional.

3) confidence in their ability as a therapist and supervisor.

4) an awareness of their own strengths and weaknesses.

Supervisor A: Uses wisdom and experience in a manner that conveys confidence and uses a power of suggestion. 

Supervisor B: May be more inclined to active intervention and assuming control in challenging situations.

Psychotherapeutic Interventions

Research and conventional wisdom differ regarding the use of psychotherapy in supervision. Some believe it is a boundary crossing and personal therapy should be handled by the supervisee’s therapist. Others believe it is a tool for the supervisee’s personal and professional growth.

There is general agreement that supervision should not BE psychotherapy. Some view psychotherapeutic techniques as essential since they facilitate awareness transference and countertransference which is fundamentally related to managing boundaries with clients and that ultimately it helps the supervisee develop ethical practices.

Supervisor A: Explores intrapersonal supervisee issues in the same manner as they would with a client in therapy. 

Supervisor B: Errs on the side of referring the supervisor to their therapist for all personal issues.

Active Intervention and Decision Making for the Supervisee

There are times when a supervisor believes they need to exert power and require you take action in some instances. For example, dealing with an acutely suicidal client or terminating a client where there is a clear conflict or dual relationship.

Supervisor A: Is comfortable allowing supervisee to take more risks and make mistakes.

Supervisor B: Believes that learning can best be supported by taking proactive measures to prevent the supervisee from causing injury to the client.

Gatekeeping

Gatekeeping refers to a supervisor’s responsibility to the profession that may conflict with their responsibility to you. For example, an ethical dilemma in which the supervisor believes a licensing board should be notified of either your situation or an unethical situation of which you are aware.

Supervisor A: Views their role as providing a service to the supervisee and their primary obligation is to the supervisory relationship.

Supervisor B: Seeks to eradicate poor quality or incompetent supervisees from the profession and that serving the profession first and foremost serves the best interest of the public at large.

State to State Requirements.

This List of All 50 states licensing requirementswill be helpful.

In Georgia, an individual with a masters degree in professional counseling is required to obtain 3 years of post masters supervised experience. This includes 3000 hours of employment while simultaneously completing 105 supervision hours from a board eligible supervisor. Half of the license applicant’s supervised experience must be provided by a board eligible LPC supervisor. Detailed requirements can be found at the Georgia Composite Board of Professional Counselors, Social Workers and Marriage and Family Therapists web site.

To illustrate how much they vary, some states LPC supervision and licensing requirements range from:

1) The Nevada Board of Examiners for Marriage and Family Therapists and Clinical Professional Counselors requires a minimum number of hours delivering direct clinical care.2) The Iowa Board of Behavioral Sciences requires a specific maximum percentage of supervision hours that can be obtained, online or electronically.3) The majority of state boards including the Louisiana State Board of Professional Counselors set out in board rules all supervisor training requirements or have recommended or board approved private training organizations. 4) The Wisconsin Dept of Safety and Professional Services LPC license requires no specified number of years post masters–only required hours.

Requirements for becoming an approved LPC supervisor.

Again the requirements range widely and could be any of the following.

1) An approved supervisor only needs to demonstrate minimal clinical experience.2) An approved supervisor must hold a state issued credential.3) Of 50 states, only Georgia’s board requires a supervision credential issued and maintained by one of two professional associations, The Licensed Professional Counselors Association of Georgia (LPCA) and The National Board for Certified Counselors (NBCC).

Who can be your supervisor?

Theoretically, any board approved supervisor could provide your clinical supervision.

Finding an LPC Supervisor in Georgia

How do I find a LPC clinical supervisor in Georgia? How do I choose a supervisor that is a good match? How can I ensure I find the best supervisor for me?

These are questions every new therapist confronts in their mental health clinical work. I provide local and distance clinical supervision for LPC and consultation with fully licensed clinicians who are facing difficult ethical dilemmas.

Essential Supervision Skills

While on the Composite Board, for six months in addition to the LPC complaints, I handled all of the Social Worker and Marriage and Family Therapist consumer complaints. As an Atlanta CPCS and national ACS Supervisor I have been exposed to many clinical, legal, and ethics issues related to practicing psychotherapy.

Your supervisor should be able to help you work through ethical dilemmas. They should also know how to distinguish ethics from legal matters and refer you to an attorney when needed– ​learn how to avoid incompetent supervisors.

Even though you may not work in a psychiatric hospital or residential treatment program, your supervisor should have broad experience in clinical mental health including residential facilities.

Areas of competence include severe depression and suicide, addiction, traumatic stress–all of those areas that can be frightening for new therapists–your clinical supervisor should be able to work confidently and with conviction on complex clinical issues.

My Model of Supervision

Balancing Low Structure and High Structure in Supervision

There are many models of supervision. A key concept is high versus low structure. Each has their advantages. The advantages of high structure in supervision is that by erring on the side of caution, the supervisor has greater day to day control of the therapist’s activities. The advantages of moderate structure are ability to take risk and make decisions on their own.

This pie chart describes the role of structure in my supervision. Whereas there is a structure in evaluation and feedback, gatekeeping has a minor role. The struggle of most new therapists is problem solving and self confidence and moderate structure promotes development in those areas.

Combined Authority and Mentoring

My supervision is a hybrid of mentoring and authority. Authority doesn’t refer to claiming to know everything. In fact, expect that you will have knowledge in areas I do not. It is referred to as sapiential authority and involves asserting conviction in helping you because I am experienced in clinical aspects of psychotherapy and ethics.

Through experience, I can often provide clarity on clinical and ethical dilemmas efficiently. And quickly. I have managed many high risk clients and can make this much less overwhelming for you. I combine this with a mentoring and coaching approach. Directed experience under supervision need not be frightening.

Psychotherapeutic Intervention

All of us have “blind spots”. Whether in our personal lives or as professionals. Sometimes we struggle to find a solution to an ethical dilemma or a clinical intervention with a client. Often we learn it is because we have a blind spot. This partly owes to countertransference. As therapists, we are mindful of countertransference as an obstacle- or facilitator- of change with our clients. In a supervisory relationship, we apply the same principles to promote professional growth within our supervisees.

Psychotherapeutic techniques therefore are an important role in therapist’ development. Not psychotherapy per se, but applying the principles of it.

Evaluation

The manner of evaluation I employ is as much critique as a tool for helping you become a better and more confident therapist. I will provide you both formal written and real-time verbal evaluation. You will view and participate in all of my written documentation and evaluation of your work.

How much can I expect to pay for LPC supervision?

Or simply, how much is clinical supervision to get my LPC license. Fees for private individual supervision in the Atlanta area range from $100- $150 per supervision session. Some may charge more, some less but these are good approximations. My fees range from $90-$120. I also provide LPC telesupervision / LPC distance supervision.

Clinical Supervisor is Incompetent and Unethical

Ethics Demystified: Clinical Supervisor Incompetent Unethical

So you say your clinical supervisor is incompetent?

Let’s learn to distinguish when a clinical supervisor is incompetent versus poor quality versus unethical. They may be one or all three. Some supervisor relationships can turn catastrophic.

But for sure, let’s learn what you can do about it. But be sure to read Guidelines for APCs from the Supervisors’ Perspective.

The relationship between a psychotherapy clinical supervisor and their supervisee is complicated. Clinical supervisors who provide distance or telesupervision face other challenges. Supervision is not for the faint of heart. One needs to work fearlessly and with confidence and conviction.

It has similarities to a client and therapist relationship. You may be a student in a graduate program. Perhaps it is an employer and employee relationship. Each has specific responsibilities. Very importantly, it is a professional peer relationship.

In any case, if you think your clinical supervisor is incompetent you’re clearly frustrated with with them.

Poor Quality Supervision

We encounter poor quality in everything we buy. Whether it is goods or services. Poor quality at a restaurant or from an online marketplace. Low quality clinical supervision whether provided by a social worker, psychologist or professional counselor.

In some instances what we perceive as poor quality clinical supervision may not be to someone else. So poor quality may not mean your clinical supervisor is incompetent. In addition, high quality supervision can be subjective.

However, when there is consensus of poor quality it probably just is. But what determines quality clinical supervision?

Clinical Supervision Training

There is quality supervisor training and inferior training. If you provide clinical supervision you should be trained properly. Training includes supervision CE continuing education workshops, masters or doctorate supervision coursework, one on one and group training in supervision of supervision and other.

In all situations, the training should meet an industry standard and be practical, logical and empirical. In many cases, a clinical supervisor is incompetent based on poor training. In short, clinical supervision training should be high quality.

A Competent and Experienced Therapist

Assuming our clinical supervisor is well trained, they also need to be experienced as a behavioral health clinician They should be a seasoned therapist with broad skills in treatment of mental illness and addictions. You will need someone to teach you these skills whether you are doing art therapy or working in a psychiatric hospital.

In other words, your therapy may not be deeply clinical. In most work settings, you WILL encounter suicidal and severe psychological disturbance. You need a clinical supervisor who has skill working with those problems.

A Supervisor Should Be Emotionally Mature

A clinical supervisor is held to a higher standard than your boss. In fact, your boss may be held to no standard at all. Perhaps held to a standard as an employee, but not as a boss. Managers are often provided little to no training.

A clinical supervisor needs to be a mentor. They need to know how to promote professional and personal growth. They need to be instructors and critics when needed. These are all skills required to provide counseling and psychotherapy.

Lastly, they should be receiving personal psychotherapy.

Incompetent or Unethical?

In brief, shortcomings in the above areas may suggest incompetence. Whereas not necessarily unethical but at it’s worst incompetent, inept and poor quality. Tragically, there are unethical supervisors.

+ MORE: Which Code of Ethics Should You Follow

Acting on Behalf of Another Against Your Best Interests

One encounters this most often when the clinical supervisor is also the boss. There is an inherent conflict with this arrangement. Mainly, in order for the supervisor to keep their job they must act on behalf of the mutual employer.

For example, you disclose to your clinical supervisor you refuse to comply with an employer policy of billing for services not rendered. Your supervisor reports your refusal and you are then fired. Therefore, the only way for you to resolve this conflict is to quit that job.

This does not represent high quality supervisory skills. In fact, there is an ethical violation: your supervisor has violated a confidence that has no bearing on your professional development. In fact, they have attempted to force you to something unethical. Even worse, they have pressed you to do something illegal.

Inappropriate Involvement With Your Off-Site Employer

For example, you inadvertently breached confidentiality. You have inflicted no harm. You ask your supervisor “John” for guidance. The supervisor believes it is their ethical responsibility to report the breach to your employer. They report and you are fired.

Perhaps an argument can be made for reporting to your employer. However, all other matters equal it is a violation of confidence and probably unethical. At the least, it is easy to understand why you might feel betrayed. An alternative solution might be your supervisor using this as a teaching opportunity. The breach was an accident and likely due to your inexperience.

We assume new and experienced therapists all make mistakes. The goal is first ‘do no harm’ and learn from the mistake.

As a side note, John has also put himself in a precarious position– his actions have directly caused termination of your employment. It’s easy to see this clinical supervisor is incompetent and unethical.

Appropriate involvement with an off-site employer can include confirming the worksite is consistent with that filed with the APC application and related matters. As a supervisee, you should provide your LPC clinical supervisor with a copy of the Directed Experience form completed by the Director.

Not Recommending For Licensure

John has supervised you for 12 months. It is time for you to submit your application for LPC licensing. You submit your application and it is denied because the supervisor checked the box that says, “I do not recommend for licensure”.

What happened? Why didn’t John notify you sooner? He told you he was concerned about the frequency of corrective action. However, it would have been best for John to notify you sooner that he did not intend to recommend you. It is probably an ethics concern because John accepted payment for supervision services for 12 months and was possibly aware before then of his intentions to not recommend.

Refusal to Complete Supervision Forms

Sometimes a supervisor will refuse to complete supervision licensing forms. The reasoning may be that the supervisee has an unpaid account balance. Or they do not want to recommend for licensure and refuse to complete the forms. The reason may also be they have formed opinions in their role as boss about the supervisees clinical skills.

Yet another reason, is this same boss / clinical supervisee has opinions about your job performance. Perhaps there is conflict with co-workers or deficiencies in completing agency paperwork.

Regarding an account balance, your supervisor would be wise to address it as a collection matter similar to unpaid patient accounts. In other words, this is not a matter for supervision, it is a fee dispute.

The others above are employer disputes and issues for the employer’s HR department to address. They may not directly reflect a supervisee’s competent and ethical practice.

Rude or Aggressive Behavior

There is a power differential between a supervisor and supervisee. It is unethical to abuse that power through aggressive, forceful or otherwise abusive behavior.

What You Can Do About It

Are Clinical Supervision Services, Services?

Yes they are. Like any service, we can choose to get it elsewhere. Anything we buy is a service and we pay –in some form– for clinical supervision. There is a cost of clinical supervision. That cost can be that an employer provides the supervision. Or we pay cash money for it. Ranging from $50.00 to $150.00 per session and higher.

Your Options

First, if you have exhausted all efforts to resolve the problem to no avail you can seek supervision elsewhere. If your supervisor refuses to complete your forms, you have several choices: do nothing and accept the license denial, attempt to resolve it with the supervisor, or rebut the supervisor’s refusal with the licensing board. Like all therapists, supervisors are fallible. If you want to justify your clinical supervisor is incompetent or unethical, make note of:

  • Can you defend it was an employer/employee dispute unrelated to your clinical competency?
  • Did the supervisor violate your confidence?
  • Was the conflict a result of your supervisor engaging in a dual relationship with your employer or other?

The Two Most Important Questions

There are two important questions to ask a supervisor during your interview:

• Have they ever refused to recommend for LPC licensure and if so, why.

• Have they filed a board complaint against a supervisee and why.

Determine whether you believe the supervisor had just reasons.

Lastly, request your supervision forms be completed immediately after you terminate with them. You can avoid problems that can result from attempting to get them signed later.

Find a Clinical Supervisor in GA for LPC

great-lpc-supervision

Finding a Clinical Supervisor in GA

How do I find a LPC clinical supervisor in Georgia? How do I choose a supervisor that is a good match? How can I ensure I find the best supervisor for me?

These are questions every new therapist confronts in their mental health clinical work. I provide local and distance clinical supervision for LPC and consultation with fully licensed clinicians who are facing difficult ethical dilemmas.

Basic Essential Supervision Skills

While on the Composite Board, for six months in addition to the LPC complaints, I handled all of the Social Worker and Marriage and Family Therapist consumer complaints. As an Atlanta CPCS and national ACS Supervisor I have been exposed to many clinical, legal, and ethics issues related to practicing psychotherapy.

Your supervisor should be able to help you work through ethical dilemmas. They should also know how to distinguish ethics from legal matters and refer you to an attorney when needed. Learn to avoid incompetent supervisors.

Even though you may not work in a psychiatric hospital or residential treatment program, your supervisor should have broad experience in clinical mental health.

These areas of competence include severe depression and suicide, addiction, traumatic stress–all of those areas that can be frightening for new therapists.

Your clinical supervisor should be able to work confidently and with conviction on complex clinical issues.

Supervisors Legal/ Ethical Concerns

Supervision is defined in Georgia Composite Board rules as, ” to promote the growth and development of the practitioner’s clinical skills.” My LAPC supervision emphasizes mutual trust and confidence as the foundation of the supervisory relationship. But I also interview and screen LAPC supervisees carefully. In contrast, many supervisors are less able to act with support and conviction within the supervisory experience.

Fearful that the supervisee is going to harm a client. Fear that the supervisor is going to report perceived ethical misconduct. Many are reluctant to provide Georgia licensing supervision for the above reasons.

find a clinical supervisor in ga for lpc

It is important to know that as an APC / LAPC, you have been issued a license to practice psychotherapy. You are ultimately responsible for that license.

Be teachable, be willing to learn.

If you are willing to be mentored, your supervisor should serve as a mentor. Decisions by the Georgia composite licensing board are often predicated on unremorseful actions– if you don’t believe you did anything unethical how can you be remorseful?

Whereas therapist ethics is not simple, approaching ethics in supervision from this simple framework allows both parties to focus on what is most important: producing a competent therapist who is not a risk to the public or liability to the profession.

Supervisor Role

From the Composite Board Rules, definition of Supervision: “The purpose of supervision is to promote the development of the practitioner’s clinical skills.

Supervision may include, without being limited to, the review of case presentations, audiotapes, videotapes, and direct observation of the practitioner’s clinical skills. Supervision does not require the supervisor to be present at the work site with the supervisee.”

Your Role

From Composite Board rules, “The practice of professional counseling means practice in that specialty which utilizes counseling and psychotherapy to evaluate and treat emotional and mental problems and conditions, whether cognitive, behavioral, or affective.”

As a supervisee, since you are under directed experience (are under direction from a boss at a site that is your formal licensing work site.) it is your responsibility to work towards learning and being teachable and open to honest input.

I believe that with my guidance you have the ability to be a great therapist. Supervision should be enjoyable and rewarding. Counseling is hazardous and stressful–your supervision shouldn’t be. I employ a moderately structured approach that will allow you to grow, take risks, make mistakes yet also have the safety net I will provide as an experienced and authoritative therapist. A Good LPC supervisor should guide you with confidence and assist with making the difficult decisions that every new therapist faces.

Three Key Factors in Clinical Supervision

Professional Hazards

Ironically, the greatest hazards for therapists are connected with our urge to help others. Insufficient self-care, excessive empathy leading to boundary crossings. When the lines between help and rescue become blurred. Boundary crossings are on of the greatest hazards of doing this work.

It can blind-side even experienced therapists. When a therapist whose top priority is maintaining public trust connects with a supervisor who understands these hazards, you have a winning combination for creating a good therapist.

There are also external factors that impede the process of becoming a good therapist. Many new therapists are working in public settings. Working for mental health companies that are contracted by state entities. Or working for large healthcare companies. All are operating on tight budgets (I have worked in all of these settings prior to private practice). You may need help finding a job as a counselor.

This can result in:

  • Lack of employer support for therapist training.
  • List Element
  • The boss must report on their employee’s job performance and…
  • …”good job performance” is subjective.

Those are less than ideal circumstances for learning. An employer-appointed supervisor has responsibilities that WILL interfere with therapist development. A Director at your Directed Experience site is required to referee employer/employee and human resource issues. If they are also your clinical Supervisor you may be at risk of the supervisor declining to sign your licensing application Supervision paperwork.

It is important you have a clear written contract with your supervisor. Under Georgia board rules you may also obtain distance supervision.

Supervisor Bias

Most Georgia therapists practice ethically. But these inaccuracies can make the prospect of becoming a therapist discouraging when interviewing with a particular supervisor. Making mistakes is part of learning.

Those of us experienced as mental health practitioners had to start somewhere. We all had to encounter our first client with schizophrenia. Our first seductive client.

As long as you are capable of following the therapist oath: ‘first, do no harm’, your relationship with your supervisor should be one of mutual trust.

My Model of Supervision

Balancing Low Structure and High Structure in Supervision

There are many models of supervision. A key concept is high versus low structure. Each has their advantages. The advantages of high structure in supervision is that by erring on the side of caution, the supervisor has greater day to day control of the therapist’s activities. The advantages of low structure are ability to take risk and make decisions on their own.

find a clinical supervisor in georgia

This pie chart describes the role of structure in my supervision. Whereas there is a structure in evaluation and feedback, planned interventions and gatekeeping has a minor role. The struggle of most new therapists is problem solving and self confidence and moderate structure promotes development in those areas.

The Synthesis of Authority and Mentoring

My supervision is a hybrid of mentoring and authority. Authority doesn’t refer to claiming to know everything. In fact, expect that you will have knowledge in areas I do not. It is referred to as sapiential authority and involves asserting conviction in helping you because I am experienced in clinical aspects of psychotherapy and ethics.

Through experience, I can often provide clarity on clinical and ethical dilemmas efficiently. And quickly. I have managed many high risk clients and can make this much less overwhelming for you. I combine this with a mentoring and coaching approach. Directed experience under supervision need not be frightening.

Psychotherapeutic Intervention

All of us have “blind spots”. Whether in our personal lives or as professionals. Sometimes we struggle to find a solution to an ethical dilemma or a clinical intervention with a client. Often we learn it is because we have a blind spot. This partly owes to countertransference. As therapists, we are mindful of countertransference as an obstacle- or facilitator- of change with our clients. In a supervisory relationship, we apply the same principles to promote professional growth within our supervisees.

Psychotherapeutic techniques therefore are an important role in therapist’ development. Not psychotherapy per se, but applying the principles of it.

Evaluation

The manner of evaluation I employ is as much critique as a tool in itself for helping you become a better and more confident therapist. I will provide you both formal written and real-time verbal evaluation.

How much can I expect to pay for LPC supervision?

Or simply, how much is clinical supervision to get my LPC license. Fees for private individual supervision in the Atlanta area range from $100- $150 per supervision session.

Some may charge more, some less but these are good approximations. My fees range from $90-$120. I also provide LPC telesupervision / LPC distance supervision.

Summary

I have described my perspective on ethics and supervision and my approach to training and developing licensees. It is similar to how I work with clients: you have the capacity to develop professionally and solve problems with my assistance. Obtaining an independent private supervisor lays the groundwork for the trust that is necessary when learning to become a good therapist.

If you wish, you can view my available openings and call to schedule a consultation for Georgia LPC clinical supervision.

LPC Jobs in Georgia That Are Board Approved

Finding LPC Jobs in Georgia That Are Board Approved

Finding a counseling job that is acceptable for obtaining your license is becoming increasingly difficult. State licensing boards are getting more and more stringent in their acceptable psychotherapist practice settings. These efforts are a precaution for ensuring applicants are properly trained.

You can lose valuable time – sometimes years – if you don’t select a job that will be eligible for licensure in GA. You may have concluded there are no LPC jobs in Georgia that are board approved particularly if you do not have an associate license.

Whereas there are no guarantees your work setting will be approved, you can maximize your chances. Here are guidelines and job board for LPCs :

find lpc jobs georgia

Avoid Work Settings That Resemble Independent Practice 

You have been hired as an independent contractor at “We Are Great Counselors, LLC.” This LLC is owned and operated solely by Bobby Sue an LPC. There are three counselors including yourself – all APC (associate professional counselors). Bobby Sue provides Supervision to some of you. You each have an office and everyone does the same thing: sees their psychotherapy clients and leaves for the day.

There is no formal system in which Bobby Sue provides oversight to any of the APC’s either as a Director or Supervisor. ( Make sure you understand definitions of a Director, Supervisor, Directed Experience and so on.

This is a risky work setting. Work within this type of arrangement at your own peril. First, as a new counselor you will not receive high quality and affordable LPC supervision or telesupervision needed to develop competence. You may feel lost and lack confidence in your clinical practice.

Second, the Directed Experience could be determined as ineligible. “But that’s the only work I can find so…

“…it leaves me with few choices.”

You do not need to work in an unsupportive work setting. In fact, a site with too much structure can be hazardous. Some organizations that receive may require you to choose between employer policies and what you know to be ethical practice. Note the following middle ground: 

Solid Clinical Experience and Directed Experience Under Supervision

One of the most widely available opportunities are private psychiatric practices. These can be great opportunities. This work experience is often acceptable if it includes the following components:

System for emergency intervention because a psychiatrist or advanced practice nurse is on site.

Fully licensed counselors. social workers or marriage and family therapists and TRUE supervision.

Use of DSM V and gaining a working knowledge of diagnosis the spectrum of mental disorders.

Systematic oversight and a system that understands and supports professional practice issues.

Summary

Be sure your work setting has systems that provide strong and supportive structure. A full directed experience site with comprehensive and competent supervision. 

  • System for emergency intervention because a psychiatrist or advanced practice nurse is on site.
  • checkFully licensed counselors. social workers or marriage and family therapists and TRUE supervision.
  • Use of DSM V and gaining a working knowledge of diagnosis the spectrum of mental disorders.
  • Systematic oversight and a system that understands and supports professional practice issues.

Guidelines for APC Supervisees

What is my role as a supervisee? What should be my relationship with my supervisor?

1) Be teachable. 2) Seek personal psychotherapy. 3) Understand the rules. 4) Five areas of development. Proper assessment, asking your supervisor for help when you are stuck with a client, case management, thoroughly understanding board rules and developing a specialty.

If you follow these recommendations your supervision should be pleasurable and fulfilling. However, you also should know ​what you can do about a rude, aggressive or incompetent supervisor.

It’s important to obtain rewarding and flexible supervision.

Be Teachable

Supervisors may be reluctant to continue to supervise you if you don’t implement their recommendations. This is especially true when it involves risky situations such as suicidal clients or boundary issues. Be aware of improvements you want to make.

Your journey through your entire career should be evaluating shortcomings and improvements.

Personal Psychotherapy

Do not view personal therapy as optional. You are performing hazardous work. If you are reluctant to work through your issues, your ability to help clients will be limited. It is also frustrating for a supervisor to work with one who is incapable of addressing countertransference.

Much of the mentoring and development work of a supervisor is helping you manage boundaries.

Personal psychotherapy helps to address your blind spots.

Five Development Areas

Proper assessment, asking your supervisor for help when you are stuck with a client, case management, thoroughly understanding board rules and developing a specialty.

Know the Board Rules

The Most Important Concept

This information is accurate as of 8/2/18. It is subordinate to future rule changes. I make no warranty for this info implied or otherwise.

Find the Board Rules at the Secretary of State website. The page will open in a new browser window. Attest to the copyright notice. Navigate to chapter 135-5. Notice the chapter is introduced by all of the Licensing Definitions. Once you have fully read and understood those definitions, you should have no problem understanding licensing requirements.

Memorize the following most important concept for Georgia APC/LPC licensing:

“…year(s) of post masters directed experience under supervision in a work setting acceptable to the board”.

There are eight definitions contained in that sentence:

1) Year(s) 2) Post Masters 3) Directed Experience 4) Director5) Direction6) Supervision7) Supervisor 8) Work Setting Acceptable to the Board

For example, a “Year” can be 12 to 20 months or it can have no specified number of months as is the case with your internship. “Post Masters” can be months after your degree was conferred or in the case of practicum / internship, Post Masters can mean before you graduated. Get it?

Study those definitions.

Studying these 12 tips and tricks and the art to reading board rules will also be helpful.

Develop a Specialty

None of us can deliver all types of counseling. Develop a specialty because it is a wise business decision and also ensures you are not practicing beyond your area of competence. If you do not enjoy working with adolescents, it is wise to not specialize in that population. If you enjoy adolescent therapy, consider specializing in DBT (Dialectical Behavioral Therapy) or another specialized adolescent / child therapy.

Become known in the professional community as a go-to therapist. You will also develop competence in that therapy – an important factor for avoiding civil and licensing board complaints.

Sample Application Denials

Many in supervision are also dealing with a recently denied license application. There are many reasons counseling license applications are denied. Most often a result of incomplete reading of the board rules.

The GA composite board denies applications requiring additional months or even years of directed experience under supervision.

Here they are in no particular order.

“You must obtain an additional 8 months of directed experience under supervision in an acceptable work setting.”

What happened? Possibly several things including the board has deemed ineligible 8 months of your work because you were not under supervision during that period, or perhaps you applied work months that were not post-masters. There may be other reasons.

Remedy: be sure to read and understand the rule that describes that work without simultaneous supervision is not allowed.

“Directed experience form C is not acceptable to the board as you have not documented training in counseling and psychotherapy.”

It is important to note that a state issued LPC, SW or MFT practice license allows you to practice psychotherapy independently. For example, your work was primarily case management. This may not theoretically be a problem, but under the law you are allowed to practice independently.

Since you may decide you want to practice independently, it is important you have been properly trained to do that.

Locate the scope of practice definition, “The Practice of Professional Counseling” in the rules. Acceptable work is further described in that paragraph. If you are a social worker or marriage and family therapist note your scope of practice differs from LPCs.

Remedy: Ensure your work setting provides experience and training in performing psychotherapy. Also, confirm with your Director in advance that the work setting has been previously accepted by the board.

“Your forms were not notarized properly.”

A notary public swears that your signature and date are true and accurate. Forms that have been crossed out or altered are not acceptable. Ensure any form you are required to submit is clean and clear.

Remedy: the board will usually require you to resubmit properly notarized forms so it’s best to get it right first. When your application is pended or denied, this is costing you valuable time and money. 

Obtaining a psychotherapy license in GA is not easy.

Getting your LPC license is not an easy task. Don’t expect it to be.

State licensing boards’ primary role is protecting the public from harmful therapists whether psychologists, social workers, marriage and family therapists or professional counselors–not being charitable or empathetic to your pursuit of getting licensed.

Applicants who are in clinical supervision for LPC should know the rules thoroughly.

It is not relevant that you graduated with a PhD from UCLA and worked at the Betty Ford Clinic if you have not met licensing requirements. It’s that simple. Completion of a graduate degree in counseling is the easier goal.

Your years of learning applied psychotherapy on the job, being the type of supervisee that a supervisor wants to work with, following licensing requirements and submitting a meticulous application are the most challenging tasks.

This requires that you read and understand the board rules and the instructions for completing the application. When you submit your APC, LPC, LMSW, LCSW or other license application, you are making a legal oath with the State of Georgia that you will abide by those rules.

How can you abide by rules that you have not carefully studied?

Understanding how to read the GA composite board rules for PC, SW and MFT can prevent a costly license denial..

Summary

These guidelines for APC supervisees address three major components.

1) Reading and understanding the board rules,

2) reading and understanding how to complete the application and

3) adopting a proper role as a supervisee. If you follow these recommendations, you will find the entire application process to be less frustrating and help ensure that you will be issued that coveted practice license.

Areas Served

I provide services to many areas in Georgia. Stay tuned for more information.