THE PATH TOWARD LICENSURE: WHAT I WISH I WOULD HAVE KNOWN Presented - - PowerPoint PPT Presentation

THE PATH TOWARD LICENSURE: WHAT I WISH I WOULD HAVE KNOWN

Presented By: Rachel McCrickard, LMFT

AAMFT Approved Supervisor rachel@wearemotivo.com

MY STORY

(but also a lot of people’s story)

For a therapist, getting your degree is 
 actually the easy part. It’s becoming 
 licensed that is so hard.

LICENSURE PAIN POINTS

SITE PLACEMENT LOCATING RULES CLINICAL SUPERVISION

DECIDING ON A SITE PLACEMENT

PRIVATE PRACTICE AGENCY SCHOOL/ UNIVERSITY GOVT SETTING

PRIVATE PRACTICE AGENCY/SCHOOL/GOVT

• Greater chance of working within

desired specialty

• Less detail needed in

documentation

• 1:1 Supervision
• Often more comfortable
• Determine own schedule
• Consistent access to client hours
• Typically free supervision
• Opportunity to develop skills
• Typically predictable paycheck
• Benefits/PTO
• Camaraderie with other

clinicians

PROS

PRIVATE PRACTICE AGENCY/SCHOOL/GOVT

• Client hours more difficult to

accumulate

• Sliding scale - pay unpredictable
• Not allowed in every state
• Often only working with those that

can easily access therapy

• Not much say over clients who

are assigned to you

• High rates of burnout
• Administrative supervision
• Lengthy documentation
• Can be isolating

CONS

WHAT HAS YOUR EXPERIENCE BEEN WITH VARIOUS SITE PLACEMENTS?

LOCATING THE RULES

2020 BBS RULES: https:/ /www.bbs.ca.gov/pdf/publications/lawsregs.pdf Chapter 16, Page 119: Licensed Professional Clinical Counselors

WHAT ARE THE RULES IN CALIFORNIA?

WHAT HAS YOUR EXPERIENCE BEEN WITH LOCATING LICENSURE RULES?

LOCATING QUALITY CLINICAL SUPERVISION

Clinical supervision supports trainee mental health professionals by offering

• versight and support from a more experienced provider.

To become licensed to practice, all mental health providers must complete a minimum number of therapy hours under clinical supervision. The specific requirements vary depending on the license a therapist seeks and the state in which they practice.

WHAT IS CLINICAL SUPERVISION?

• 1920: Psychologists decided that new professionals should participate in

their own therapy in order to become a therapist.

• As this happened, new clinicians would spend the therapy time talking

about their cases instead of their own “stuff.”

• 1923: Psychologists determined that a separate set of hours would be

required to focus on client work, called “clinical supervision.”

• They decided, after comparing themselves to other healthcare professional

tracks, to require two years of supervised practice in order to become

• licensed. This has been the standard for 100 years.
• Dr. Ben Caldwell, Saving Psychotherapy

HISTORY OF SUPERVISION

• The single biggest change agent in therapy lies in whether or not the

client feels liked and valued by the therapist - Unconditional Positive Regard

• The relationship between the therapist and the client is the greatest

therapeutic tool in the room.

• Strong therapeutic cohesion is only possible when the therapist has

developed his/her own sense of self.

Good supervision is important because it develops the therapist so that he/she can do effective work with clients.

WHY IS CLINICAL SUPERVISION IMPORTANT?

WHAT HAS YOUR EXPERIENCE BEEN WITH CLINICAL SUPERVISION?

SUPERVISION PAIN POINTS

• Hard to find in rural areas
• Often poor quality in agency setting; competing priorities
• Expensive – can range from $50-$150/hour ($10,000-$30,000)
• Take-what-you-can-get approach
• Fit is not the priority, price/accessibility is
• Just-get-through-it mentality
• Prolongs licensure process

SUPERVISION PAIN POINTS

Looks strikingly similar to good therapy:

• Strengths-based
• Built on trust
• Unconditional positive regard, “likeability”
• Focused on self-of-the-therapist and counter-transference
• Teaches tools and models clinical skills

WHAT DOES GOOD SUPERVISION LOOK LIKE?

Looks strikingly similar to poor therapy:

• “Here’s what you need to do.”
• “This reminds of when ___________ happened to me.”
• Focused on the client
• Ego-driven
• Disengaged
• Prioritizes administrative tasks over clinical development

WHAT DOES POOR SUPERVISION LOOK LIKE?

Rule Changes and COVID-19 Video Technology Advancements Connected
 Generation Rise in Online Education

THE CHANGING LANDSCAPE OF SUPERVISION

Clinical Supervision through live, two-way video conference, using a HIPAA-compliant medium.

Also called: 
 Tele-supervision, 
 Distance supervision, Remote supervision, 
 Virtual supervision

DEFINITION: ONLINE SUPERVISION

2020 BBS RULES: https:/ /www.bbs.ca.gov/pdf/publications/lawsregs.pdf

2020 BBS Statues and Regulations:

• Marriage & Family Therapists: page 37
• Social Workers: page 111
• Professional Counselors: page 137

“Notwithstanding subdivision an associate clinical social worker working in a governmental entity, school, college, university, or an institution that is nonprofit and charitable may obtain the required weekly direct supervisor contact via two-way, real-time videoconferencing. The supervisor shall be responsible for ensuring compliance with state and federal laws relating to confidentiality of patient health information.

TELE-SUPERVISION RULES IN CALIFORNIA

Go to: https:/ /bbs.ca.gov/pdf/temp_waiver_facetoface.pdf

The Director has granted the Board’s request to waive the following: • The component of BPC sections 4980.43.2(d), 4996.23.1(f), and 4999.46.2(d) that only permits Associate Marriage and Family Therapists (AMFTs), Associate Clinical Social Workers (ASWs), and Associate Professional Clinical Counselors (APCCs) to obtain their required weekly direct supervisor contact via videoconferencing if they are working in an exempt setting. Supervision via telephone is not permitted because it does not have a video component. Supervision must be via two-way, real-time videoconferencing. Effective till: July 5, 2020, unless extended

TEMPORARY WAIVER FOR PRIVATE PRACTICE SUPERVISION

https:/ /wearemotivo.com/online-clinical-supervision-rules/

MOTIVO’S RESEARCH

• Supervisor did not meet qualifications to supervise (most common)
• Unprofessional conduct
• Unethical conduct
• Not able to locate supervisor

CLINICAL SUPERVISION BOARD COMPLAINTS:

COVID-19 IMPACT ON TELE-SUPERVISION RULES

TELE-SUPERVISION RULE SHIFTS DUE TO COVID-19

6% 6% 12% 33% 43%

Allowed 100% due to COVID Allowed 100% prior to COVID Partially Allowed Not Allowed Unclear

SUPERVISION BEST PRACTICES

SUPERVISION BEST PRACTICES

• Vet Supervisor with questions (next slide)
• Come prepared with an agenda for the cases you would like to discuss
• Review the licensure rules together in the very first meeting and every

few months

• Ask for a contract
• Ask for help setting clinical goals for yourself
• Lean in, head nod, eye contact - same as therapy!
• Reserve the last 5-10 minutes for action items and wrap up

Contract Example:

https://docs.google.com/document/d/1dgCV1i1N7nLi51KD3AuZrmG3xNeDLMGoe2hvq_gm9I8/edit?usp=sharing

• What type of clients do you do your best work with?
• What modality(ies) do you use and how do you incorporate the modality into

your work?

• Why did you choose to become a supervisor?
• How many people have you supervised?
• How would your supervisees describe your approach to supervision?
• How will you challenge me to become a better therapist?
• How will we incorporate self-of-the-therapist work in our supervision?

QUESTIONS TO ASK POTENTIAL SUPERVISOR

• Logistically, what days/times are you available for supervision?
• How should I handle questions that come up between sessions, in both

emergency and non-emergency situations?

• How often will we review the licensure requirements in my state to ensure I am
• n track?
• Has your license ever been suspended or revoked by a state board?
• How many supervision hours can I anticipate collecting with you each month?

https:/ /wearemotivo.com/top-12-questions/

QUESTIONS TO ASK POTENTIAL SUPERVISOR

Motivo is a HIPAA-compliant virtual supervision platform for:

• Finding a Supervisor
• Secure Video Sessions
• Scheduling
• Billing
• Documentation
• Hour Tracking

WHAT IS MOTIVO?

• Supervisor matching
• Platform access for hour tracking

and documentation

• 20% off first three sessions
• Ongoing support

MOTIVO’S OFFERING TO CALPCC MEMBERS

Go to: https:/ /wearemotivo.com/california-calpcc-lpcc-supervision/

WHAT DID I MISS?

RACHEL MCCRICKARD, LMFT

FOUNDER / CEO, MOTIVO RACHEL@WEAREMOTIVO.COM WEAREMOTIVO.COM