Eye on Florida Laws and Rules
What Is Supposed to Happen in an Hour of Supervision?
© Catherine L. Waltz, PhD, LCSW

November 19, 2014

Registered interns and licensed mental health professionals often want to know just what constitutes supervision.  Questions about supervision are posted online on Facebook and LinkedIn, emailed to me and sometimes I get a call from someone who wants to talk about a particular situation.  This article will address some of the expectations made clear and or implied by Florida Statutes Chapter 491 and Florida Administrative Code 64B4 (our practice rules).

One question that lingers in a local group for registered interns is, “What exactly counts as an “hour” towards licensure?”  Rule 64B4- 2.001 says two years of clinical experience consisting of at least 1500 hours of providing psychotherapy face-to-face with clients with supervision occurring in 100 hours.

I think that there a couple of informative questions that can help focus the discussion.  First, what is psychotherapy?  Clinical or psychotherapy practice includes several tasks and skills which are seen to develop over a period of time.  A registered intern is expected to learn how to apply their book knowledge in real life situations with clients.  The knowledge gained in course work lays the foundation for “describing, preventing, evaluating and treating individual, couples, marital, family, or group behavior” (F.S.491.003(7)).  Registered interns and seasoned clinicians are expected to be able to work with people to prevent and or treat undesired behavior and enhance a client’s mental health.  Registered interns’ experience is supposed include “assessment, diagnosis, treatment and evaluation of clients; providing at least 50% of the hours work consist of providing psychotherapy and counseling services directly to clients”. (F.S.491.003(3)).  The statutes define “clinical social work experience”, “the practice of marriage and family therapy”, and the practice of mental health counseling with essentially the same language.  Generally our practice also includes methods to evaluate, assess, diagnose and treat emotional and mental dysfunctions or disorders (whether cognitive, affective, or behavioral), behavioral disorders, interpersonal relationships, sexual dysfunction, alcoholism, and substance abuse.  Our professional areas of practice (clinical social work services, marriage and family therapy and mental health counselling) include, but are not limited to, psychotherapy, hypnotherapy and sex therapy, counseling, behavior modification, consultation, client-centered advocacy, crisis intervention, and providing necessary information or education to clients (F.S.491.003(7); (F.S.491.003(8); (F.S.491.003(9)).  An implication of these sections of law is that registered interns who are working in non-clinically focused jobs would not be eligible for a clinical license.

Next, “What exactly is supervision?  Supervision occurs in face-to-face meetings between a registered intern and his or her qualified supervisor.”  The statutes and rules indicate that a minimum of 100 hours1 of supervision is required to supervise the registered intern as they accrue their 1500 hours of psychotherapy practice (also referred to as clinical practice or services) in order to qualify for licensure (Rule 64B4- 2.002).  During those meeting between registered intern and qualified supervisor a primary function of the supervision is to develop a  supervisory relationship that promotes the development of responsibility, skills, knowledge, attitudes and adherence to ethical, legal and regulatory standards in …practice (64B4-2.002).  During these face-to-face meetings the intern is expected to apprise the supervisor of the diagnosis and treatment of each client, client cases are discussed, the supervisor provides the intern with oversight and guidance in diagnosing, treating and dealing with clients, and the supervisor evaluates the intern’s performance.  Similar to psychotherapy, supervision also can be observed to be developmental.  Some academics and researchers have written about the “beginning, middle and end” stages of psychotherapy.  There is a comparable process that occurs in supervision.  The beginning anxiety and uncertain and sometime overconfidence morphs into more stability and confidence as the supervisory relationship develops and the new clinician gains strength and a balance of knowledge with intervention skills.

When I supervise, I tend to think of supervision as a process by which I am a collaborator with the intern in their development of a professional persona as well as deepening their understanding of human behavior while they work to master the skills it takes to “be present” with human beings who are hurting.  It is a special role and relationship and one that I treasure.

Notes:
1If the intern attends group supervision (only three to six registered interns) it must alternate with individual supervision (one or two registered interns meeting at the same time.).

– Catherine L. Waltz, PhD, is an adjunct professor in the graduate program of the School of Social Work, Barry University.  She is a continuing education provider in the state of Florida providing courses on professional ethics, laws and rules, supervision, mental health error prevention and a specialist in domestic violence.  http://drwaltz.corecommerce.com/Workshops-At-A-Glance-15.html  The educational commentaries provided by Dr. Waltz do not constitute a legal opinion.  If legal advice is needed, it is recommended that contact be made with an attorney qualified in the jurisdiction in which you practice or is applicable to your case.  We recommend that you use your knowledge of the law and your code of ethics in conjunction with this information (and any other) when deciding upon a course of action.

{ 0 comments }

© Catherine L. Waltz, PhD, LCSW
October 29, 2014

This post updates the information previously posted on October 19th based on statutes that are in the process of being changed.  Registered Interns should read this commentary thoroughly.  The prior post has been edited and out-dated information deleted.

I’m a Registered Intern; can I have a private practice?

This question and others have been posed to me over the years.  Let’s look at the Florida statute regarding Registered Interns and independent private practice.  The quote below is from the section of law for social work practice and we can substitute marriage and family therapy or mental health counselling as the wording is the same.

Chapter 491, our practice act states this:

491.005 Licensure by examination.
491.005(1)(c) . . . “The experience requirement may be met by work performed on or off the premises of the supervising clinical social worker or the equivalent, provided the off-premises work is not the independent private practice rendering of clinical social work that does not have a licensed mental health professional, as determined by the board, on the premises at the same time the intern is providing services.”

So, what are the ramifications of this statute?

The fact that a licensed professional must be on premises at all times that the intern is seeing a client automatically makes it quite impractical for an intern to own a practice.  They would have to pay a licensed individual to be present at all times they meet with clients or hope that the professional happens to have their own clients concurrently (private communication).

HOWEVER, don’t get too excited Interns.  This next part is also very important.

The Florida Administrative Code/Rule 64B4-2.003 now states,
“Supervision provided by the applicant’s therapist, parents, spouse, former spouses, siblings, children, employees[emphasis added], or anyone sharing the same household, or any romantic, domestic or familial relationship shall not be acceptable toward fulfillment of licensure requirements. For the purposes of this section, a supervisor shall not be considered an employee of the applicant if the only compensation received by the supervisor consists of payment for actual supervisory hours.

Hiring someone for you practice who can be present, see their own clients and/or otherwise participate in the functioning of the practice and then provide your supervision is prohibited as that represents a conflict of interest (private communication)”.

This current law is being revised and the proposed language is this:

“So in order to legally operate a private practice, one would need to hire a licensed professional to be present at all times that you are seeing clients and then you would need to have separate person serve as your qualified supervisor.  Of course, there are folks out there who defy these laws and rules. The state is well aware that this nonsense is happening regularly and so just this year, moved to clarify the law so that those who want to stick to technicalities and ignore the spirit of the laws and rules would be without excuse.  The text of the proposed 491.005 (4) (c) reads (copied directly from the bill):

111 A licensed

112 mental health professional must be on the premises when clinical

113 services are provided by a registered intern in a private

114 practice setting. A registered intern may not engage in his or

115 her own independent private practice The experience requirement

116 may be met by work performed on or off the premises of the

117 supervising clinical social worker or the equivalent, provided

118 the off-premises work is not the independent private practice

119 rendering of clinical social work that does not have a licensed

120 mental health professional, as determined by the board, on the

121 premises at the same time the intern is providing services.

Any Registered Intern who is contemplating even a “technically legal” arrangement for private practice will find themselves clearly on the wrong side of the law when this revision is passed (private communication)”.

- Catherine L. Waltz, PhD, LCSW is an adjunct professor in the graduate program of the School of Social Work, Barry University.  She has been a continuing education provider in the state of Florida for more than 10 years.  She provides courses on professional ethics, laws and rules, supervision, mental health error prevention among other topics:  http://drwaltz.corecommerce.com/Workshops-At-A-Glance-15.html 

The educational commentaries provided by Dr. Waltz do not constitute a legal opinion.  If legal advice is needed, it is recommended that contact be made with an attorney qualified in the jurisdiction in which you practice or is applicable to your case.  We recommend that you use your knowledge of the law and your code of ethics in conjunction with this information (and any other) when deciding upon any course of action.

{ 0 comments }

I want to start a private practice. What do I need to know?

October 21, 2014

© Catherine L. Waltz, PhD, LCSW October 19, 2014, revised October 29, 2014 I’ve been licensed and working for a while but I really want to be in private practice.  What do I need do first?  I’m a Registered Intern; can I have a private practice? These questions and others have been posed to me […]

Read the full article →

New Course in November – Grief and Mourning

September 29, 2014

Grief and Mourning: The Lessons and Gifts (c) Sherrill Valdes, LCSW New Workshop Offered  by New Trainer on: November 21st, 2014 – 8AM to 3:30PM – 6 CEUS No one is immune from loss. Everyone has experienced loss in their lives and most are aware of how it affected their feelings and behaviors as well […]

Read the full article →

Are you up-to-date with the current Florida Laws & Rules?

September 11, 2014

© Catherine L. Waltz, PhD, LCSW September 11, 2014 While preparing to provide the new Renewal Florida Laws & Rules course I found approximately 15 law changes since 2010.  I focus on those changes when providing the course.  But, I believe that I am going to have to change that process.  It may be necessary […]

Read the full article →

8-hour versus 3-hour Florida Laws and Rules Courses

August 11, 2014

August 11, 2014 Are you confused about the different Laws and Rules courses?  3-Hours versus 8-Hours?  Online versus Live? This commentary is intended to help clarify the current expectations associated with the relevant rules. Rule 64B4-3.0035 requires that applicants for licensure must demonstrate knowledge of the laws and rules for licensure by attending an eight […]

Read the full article →

What teaching means to me despite trials and tribulations. . .

June 23, 2014

I love teaching. I love the sharing of knowledge and challenges between the students and me. One of my strongest values which underlies all that I do is to promote a positive image for the profession and help new social workers develop professionally. Teaching social work courses is my newest way of doing that. Classroom […]

Read the full article →

Registered Intern’s Professional Identity and Compliance – A new twist!

May 13, 2014

Really! There is no legal acronym for registered interns use.  I swear it is true. Last month I wrote about the increasing use of an illegal acronym by registered interns which I had noticed in a group on LinkedIn.  Within two days of that article being published in a variety of settings I received a […]

Read the full article →

There is no such thing as RCSWI, RMHCI, RMFTI !

April 28, 2014

There is no legal acronym for Registered Interns under F. S. 491 in the State of Florida. Registered Interns must spell out their registration status as noted in our Rules Chapter 64B4 – 5.005(j) Failure of a registered intern to use the words “registered intern” on all promotional materials, including cards, brochures, stationery, advertisements, and […]

Read the full article →

President Obama Signs the Protecting Access to Medicare Act of 2014

April 3, 2014

On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on April 1, 2014. This new law maintains the 0.5 percent update for such services that applied from January 1, 2014 through March […]

Read the full article →