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 SCHOOL/ GOVT AGENCY PRACTICE UNIVERSITY SETTING

PROS PRIVATE PRACTICE AGENCY/SCHOOL/GOVT • Greater chance of working within • Consistent access to client hours • Typically free supervision desired specialty • Less detail needed in • Opportunity to develop skills • Typically predictable paycheck documentation • 1:1 Supervision • Benefits/PTO • Often more comfortable • Camaraderie with other • Determine own schedule clinicians

CONS PRIVATE PRACTICE AGENCY/SCHOOL/GOVT • Client hours more di ff icult to • Not much say over clients who accumulate are assigned to you • Sliding scale - pay unpredictable • High rates of burnout • Not allowed in every state • Administrative supervision • Often only working with those that • Lengthy documentation • Can be isolating can easily access therapy

WHAT HAS YOUR EXPERIENCE BEEN WITH VARIOUS SITE PLACEMENTS?

LOCATING THE RULES

WHAT ARE THE RULES IN CALIFORNIA? 2020 BBS RULES: https:/ /www.bbs.ca.gov/pdf/publications/lawsregs.pdf Chapter 16, Page 119: Licensed Professional Clinical Counselors

WHAT HAS YOUR EXPERIENCE BEEN WITH LOCATING LICENSURE RULES?

LOCATING QUALITY CLINICAL SUPERVISION

WHAT IS CLINICAL SUPERVISION? Clinical supervision supports trainee mental health professionals by o ff ering oversight 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.

HISTORY OF 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 “stu ff .” • 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

WHY IS CLINICAL SUPERVISION IMPORTANT? • 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 e ff ective work with clients.

WHAT HAS YOUR EXPERIENCE BEEN WITH CLINICAL SUPERVISION?

SUPERVISION PAIN POINTS

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

WHAT DOES GOOD SUPERVISION LOOK LIKE? 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 POOR 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

THE CHANGING LANDSCAPE OF SUPERVISION Rule Changes Video Technology and COVID-19 Advancements Connected 
 Rise in Online Generation Education

DEFINITION: ONLINE SUPERVISION Clinical Supervision through live, two-way video conference, using a HIPAA-compliant medium. Also called: 
 Tele-supervision, 
 Distance supervision, Remote supervision, 
 Virtual supervision

TELE-SUPERVISION RULES IN CALIFORNIA 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. 2020 BBS RULES: https:/ /www.bbs.ca.gov/pdf/publications/lawsregs.pdf

TEMPORARY WAIVER FOR PRIVATE PRACTICE SUPERVISION 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. E ff ective till: July 5, 2020, unless extended Go to: https:/ /bbs.ca.gov/pdf/temp_waiver_facetoface.pdf

MOTIVO’S RESEARCH https:/ /wearemotivo.com/online-clinical-supervision-rules/

CLINICAL SUPERVISION BOARD COMPLAINTS: • Supervisor did not meet qualifications to supervise (most common) • Unprofessional conduct • Unethical conduct • Not able to locate supervisor

COVID-19 IMPACT ON TELE-SUPERVISION RULES

Unclear Not Allowed 6% Partially 6% Allowed Allowed 100% 12% due to COVID 43% 33% Allowed 100% prior to COVID TELE-SUPERVISION RULE SHIFTS DUE TO COVID-19

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

QUESTIONS TO ASK POTENTIAL SUPERVISOR • 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 on 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/

WHAT IS MOTIVO? Motivo is a HIPAA-compliant virtual supervision platform for: - Finding a Supervisor - Secure Video Sessions - Scheduling - Billing - Documentation - Hour Tracking

MOTIVO’S OFFERING TO CALPCC MEMBERS • Supervisor matching • Platform access for hour tracking and documentation • 20% o ff first three sessions • Ongoing support Go to: https:/ /wearemotivo.com/california-calpcc-lpcc-supervision/

WHAT DID I MISS?

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