Download ETHICS

Ethical, Legal &
Professional Issues
Linda R. Shaw, Ph.D,
Fall, 2006
[email protected]
Morality
Values
 Duties

Morality
Personal Morals
 Societal Morals
 Group Morals

Morals vs. Ethics
Ethics = systematic reflection on
morality
 Ethics = applied morals
 Ethical Decisions - most difficult
when ethical dilemmas exist

Ethics - Definition

“Do the right thing” (Spike Lee)
Categorization of Moral
Theories
Relativism vs. Absolutism
 Micro ethics vs. Macro ethics
 Deontological vs. Teleological

Relativism vs. Absolutism

Relativism
What is right and wrong varies from
person to person and culture to culture
 There are no absolute moral standards


Absolutism

There are absolute moral standards
that are both universal and objective
Micro ethics vs. Macro
ethics

Micro ethics
The happiness of the individual is the
highest good
 The good of the group = the good of
the individuals who comprise the group


Macro ethics

The happiness of the group itself (city,
state, nation or race) is the highest
good
Deontological vs.
Teleological Theories

Deontological Theories

The correct way to proceed is to learn
basic duties and rights of individuals or
groups and act accordingly
• e.g. Kant’s Categorical Imperative

Teleological Theories

Sometimes adherence to duty leads to
consequences contrary to well-being.
• E.g. Utilitarianism ( Bentham, Mill)
Ethical Principles
Beneficence
 Autonomy
 Nonmaleficence
 Justice
 Fidelity

Beneficence
Comes with risks
 General Societal Obligations?
 Strength of Duty Factors

Significant need
 Ability to assist
 probability of success
 Benefit outweighs risk


Role-related obligation
Risks of Beneficence:
Paternalism


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Undermines dignity
promotes dependence
conflicts with rights to autonomy
When is paternalism justified?

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Competency is seriously limited
C has ability to promote Cl’s best interests
Cl’s interests are considered primary
Risk for loss must be real & significant
Autonomy

3 conditions necessary for autonomy


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What & how much should one disclose?

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Voluntariness
Competence
Full Disclosure
The “reasonable person” standard
Individualized standard
Does client/patient truly understand?
Informed Consent
enables client to make autonomous
choices
 minimizes harm/risk by enabling cl
to protect self
 encourages c & cl to discuss issues
openly & plan together

Promoting Autonomy
Assess
 Teach
 Encourage choice wherever &
whenever possible

Nonmaleficence

Beneficence vs. Nonmaleficence


Beneficence: Doing Good
Nonmaleficence: Avoiding Harm to another by
• not directly causing harm
• avoiding placing others at risk for harm

“Above all, do no harm” - role obligations


Obligation to prevent harm is stronger than
obligation to do good
In rehab, must take some risks for later
benefit
Negligence: Failure to act
or to exercise due care

Failure to exercise due care toward
another



Due Care = Proper training + Proper skills +
Diligence
Includes both deliberately & carelessly
imposed risks
Types of Negligence



Culpable ignorance
Personal Incompetence
Environmental factors
Justice
Most problem in conditions of
scarcity and competition
 Actions based on justice (examples)

avoiding discrimination
 avoiding exploitation
 distributing resources fairly

Material principles of Justice



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Equal shares
need
motivation/effort
contribution
free market exchange
fair opportunity

FUNDAMENTAL NEED: person will be harmed
if need is not met - takes priority
Quantitative criteria of
Distributive Justice
Cost-effectiveness
 Limitations:

Quantity isn’t everything (can’t quantify
human dignity & worth
 Efficiency ignores common values e.g.
hospice, etc.

Fidelity
Focuses on relationships
 Caregivers make implicit promises of
trustworthiness
 Asymmetric relationship increases
duty to fidelity

Confidentiality


Assumed by your willingness to enter into
therapist-patient relationship
Circumstances under which confidentiality
can be broken




clear & imminent danger to self or others
others as determined by law (e.g. child abuse,
elder abuse)
court actions/subpoena
Importance of disclosure
Dual Relationships
Sexual, family, friend, business,
supervisor, etc.
 Pt. Needs to be free of your
problems
 may impair objectivity &
professional judgement

Fidelity in Professional
Relationships
Fidelity to employer
 Fidelity to profession
 Fidelity to colleagues/team

Principles vs. Standards
Principles: General Guidelines to
govern one’s actions
 Standards: Generally derived from
principles and prescribe appropriate
behavior in a given circumstance

Rules
 Laws
 Codes

Ethical Codes



Assist counselors in deciding what to do
when situations of conflict arise
Help clarify the counselor’s responsibility
to the client and protect the client from
the counselor’s failure to fulfill these
responsibilities
Give the profession a means of self
governance
Ethical Codes of Interest to
Rehabilitation Counselors
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Code of Professional Ethics for Rehabilitation
Counselors (CRCC)
American Counseling Association (ACA)
International Association of Rehabilitation
Professionals (IARP)
American Psychological Association (APA)
National Association of Social Workers (NASW)
American Association for Marriage & Family
Therapy (AAMFT)
Association for Specialists in Group Work
(ASGW)
Code of Professional Ethics for
Rehabilitation Counselors

CRCC Ethics Committee initiated

2001 update due to
• Changes in practice
• Changes in technology
• Experience of Ethics Committee
Code Structure
Table of Contents
 Preamble
 Enforceable Standards of Ethical
Practice

11 Sections (A-K)
 Rules within each Section

Sections of Code
A The Counseling Relationship
 B Confidentiality
 C Advocacy and Accessibility
 D Professional Responsibility
 E Relationships with Other
Professionals
 F Evaluation, Assessment and
Interpretation

Sections of Code continued
G Teaching, Training, and
Supervision
 H Research and Publication
 I Electronic Communication and
Emerging Applications
 J Business Practices
 K Resolving Ethical Issues

Consultation Model
Code of Ethics
 Supervisor
 Colleagues
 Experts
 Licensure &/or Certification Boards

Questions to Ask
Have I Consulted with the Code?
Others?
 Have I Documented Everything?
 What if this was the Newspaper
Headline?
 What if this was the one I most
love?

Ethical Dilemma


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
Choice must be made between two or
more courses of action
Significant consequences for any course
of action
Each action can be supported by ethical
principle(s)
Ethical principle supporting unchosen
course of action is compromised
Ethical Decision Making Model
for Rehabilitation Counselors

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Review the situation & determine the
possible courses of action
List the factually based reasons
supporting each course of action
Identify the ethical principles that support
each action
List the factually based reasons for not
supporting each course of action
Identify the ethical principles that would
be compromised if each action were
taken
Ethical Decision Making
Model continued

Formulate a justification

Rubin et al. (1990)
The Eclectic DecisionMaking Model of Ethical
Behavior
Tarvydas (1998)
Stage I: Interpreting the
Situation through Awareness
and Fact-Finding
>Enhance sensitivity and
awareness
>Dilemma vs. issue?
>Determine major stakeholders &
their ethical claims in the situation
>Engage in the fact-finding process
Stage II: Formulating an
Ethical Decision
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Review the dilemma
Determine what ethical codes, laws,
principles, and institutional policies and
procedures apply
Generate possible and probable courses
of action
Consider potential positive and negative
consequences
Select the best ethical course of action
Stage III: Selecting an
Action by Weighing
Competing, Nonmoral Values
>Engage in Reflective Recognition
and Analysis of Personal
Competing Values
>Consider Contextual Influences
on Values Selection at the
Collegial, Team, Institutional, and
Societal Levels
Stage IV: Planning and Executing
the Selected Course of Action
Figure out a reasonable sequence of
concrete actions to be taken
 Anticipate & work out personal &
contextual barriers to effective
execution of the plan, and effective
counter-measures for them
 Carry out and evaluate the course of
action as planned

Processing Ethical
Complaints
The CRCC Ethics
Committee Process
and Procedures for
Processing Ethical
Complaints
Commission on Rehabilitation
Counselor Certification (CRCC)
CRC Credential
 Assures certified RCs meet minimum
ed, experience and competency
standards
 Consumer protection
 Accountability

CRCC Ethics Committee
Promotes Ethical Practice among
Certified Rehabilitation Counselors
 CRCC Code of Ethics
 Education
 Advisory Opinions
 Self Governance/Judicial Function

Reporting Ethical Violations
Who Reports?
 The Ethics Complaint Form

Steps in the Process

The Ethical Complaint Process
Flowchart
Details actions of Ethics Committee and
Administrative Office
 Blueprint for processing complaints

Suggested Procedures for Initial
Case Review (Tarvydas)

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Summarize charge
If true, as alleged, would there be an
ethical violation?
Identify specific Ethical Canon(s) and
Rule(s)
Accept complaint if violation may have
occurred
What additional info/evidence is needed?
Ethics Committee Actions
Letter of Instruction
 Reprimand
 Probation
 Suspension
 Revocation

Legal/Ethical Interface
Understanding the
Legal Issues
impacting
Rehabilitation
Counselors
Types of Procedural Law
Civil Law
 Criminal Law
 Mental Health Law

Civil Law
Lawsuits brought by private parties
against each other
 Losing means financial loss
 Burden of Proof:

Fair preponderance of the evidence
 Burden is on Plaintiff

Criminal Law
Disputes between state & persons
 Losing means loss of liberty
 Burden of Proof:

Beyond a reasonable doubt
 Burden is on the State

Mental Health Law

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Regulates how state helps mentally ill
persons (commitment hearings)
Considered type of Civil Law
Conflict: right to freedom vs. state’s resp.
to protect those unable to protect selves
Burden of Proof


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Because psych is too inexact to meet
reasonable doubt, must meet level of
reasonable medical certainty test
Clear & convincing evidence
Burden is on those bringing the proceedings
Case Law

Tarasoff v. Regents of the University of
California


Wyatt v. Stickney, Donaldson v. O’Connor
& O’Connor v. Donaldson:


Requires therapists to protect foreseeable
victims of dangerous clients (Duty to Warn or
Duty to Protect).
Duty to treat involuntarily confined mental
patients or release them
Caesar v. Mountanos

The client is the sole holder of the
psychotherapist-client privilege
Therapists are regulated by
Laws at three levels:
Federal
 State
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Statute
 Regulations

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Local

County/City
Florida Law Themes
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Confidentiality
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Mandated Reporting
of Abuse or Neglect
of:
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Allowable Exceptions to
Confidentiality
Aged persons
Disabled adults
Children
Children & Families
(confidentiality,
custody,etc)

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PsychotherapistPatient Privilege
Involuntary
Admission (Baker
Act)
Guardians and
Substitute
decision-making
Ethics and The Law
Mandatory
Reporting
Discretionary
Reporting
Duty to Protect
Ethics and The Law



Linda R. Shaw, Ph.D., CRC, LMHC
Associate Professor & Graduate
Coordinator
University of Florida Dept. of
Rehabilitation Counseling

This presentation provides general guidance
only. All questions related to Florida Law
should be directed to an attorney specializing
in mental health law.
Presumption of
Confidentiality

Confidentiality is necessary to preserve:

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Client privacy, dignity & respect
A relationship characterized by trust
Client Autonomy (freedom to decide with
whom information will be shared)
Florida LMHCs are included in Testimonial
Privilege Law – Cl. has right to keep
confidential communications from being
disclosed in a legal proceeding (Fla
Statute 90.503).
Rationale for Exceptions to
Confidentiality


Must balance client’s right to privacy &
autonomy with competing societal
interests
Exceptions may be either
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Mandatory – Counselor shall report
Permissive – Counselor may report
Whether an exception is permissive or
mandatory depends on the importance of
the societal interest at stake
Mandated Exceptions to
Confidentiality Reporting
Generally referred to as “Mandated
Reporting”
 Requires that certain information
applying to particularly vulnerable
groups be disclosed to ensure their
safety & well-being

Mandated Reporting
Required of all persons who, in a
professional capacity, come into
contact with individuals comprising
three groups:
 Groups include:

Children
 Elderly
 Disabled Adults

Mandated Reporting

Children (Fla. Statutes 39.01 and 827.03)

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Must report any incident of known or
suspected abuse, abandonment or neglect
Definitions:
• Abuse: “any willful act or threatened act that
results in a physical, mental or sexual injury or harm
that causes or is likely to cause the child’s physical,
mental, or emotional health to be significantly
impaired” (Fla. Statute 39.01) Also includes the
active “encouragement of any person to commit an
act that results or could reasonably be expected to
result in physical of mental injury to a child” (Fla
Statute 827.03)
Mandated Reporting

Children (Fla. Statutes 39.01 and 827.03)

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Must report any incident of known or
suspected abuse, abandonment or neglect
Definitions:
• Neglect: a caregiver’s failure to (1) provide a child
with necessary care, supervision, and services and
(2) to make a reasonable effort to protect a child
from abuse, neglect or exploitation (Fla Statutes
39.01 and 827.03).
• Abandonment: when a parent sufficiently fails to
support and nurture a child so as to evince a willful
rejection of parental obligations (Fla. Statute
39.01[1]).
Mandated Reporting

Children

Fla. Statutes 39.01 and 827.03 list
specific examples of situations that
would constitute abuse and/or neglect
– e.g.
• Cuts, bites, burns, scalding
• Excessively harsh discipline likely to result
in physical injury
• Failure to provide child with adequate food
or clothing
Mandated Reporting


Elders and Disabled Adults (Fla. Statute 415)
Definitions:
 Abuse: the “nonaccidental infliction of
physical or psychological injury or sexual
abuse” (Fla Stat. Ch. 415.102[1])
 Neglect: “the failure or omission . . . To
provide care, supervision, and services
necessary to maintain the physical and mental
health of the disabled adult or elderly
person.”(Fla. Stat. Ch. 415.101[2]).
 Exploitation includes “financial exploitation
and misuse of funds” (Fla. Stat. Ch.
415.101[2]).
Mandated Reporting

Standard for reporting


Must report if the mandated reporter
“knows or has reasonable cause to
suspect” that harm is occurring or has
occurred.
Timing of report

As soon as mandated reporter has
reasonable cause to suspect
Florida Abuse Hotline
Department of Children and Famlies
 Contact Information:

ServicePhone: (850) 487-4332
 Suncom: 377-4332
 Toll Free: (800)962-2873

Liability

Failure to report (e.g. Fla. Statute 491)

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Possible criminal sanctions – “knowingly &
willfully”
Civil sanctions
Professional discipline
Release from liability (Fla. Statute
39.203, 415.111)

No civil or criminal sanctions attach when
report is made in good faith
Permissive Reporting
Allows counselor to exercise discretion
and to violate confidentiality under
certain conditions:
Permissive Exceptions to
Confidentiality
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Client consent
Treatment emergencies
Facilitation of Treatment
Provision of mental health services

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Peer & administrative review
The legal system
Research
Public safety
Exceptions to Confidentiality to
Protect the Public Safety
Florida and the Tarasoff Decision
 Tarasoff v. California Board of
Regents



Created a duty to protect identifiable
3rd party
Florida is not a Tarasoff state
Florida Laws related to
public safety

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Confidentiality may be waived when
“there is a clear and immediate
probability of physical harm to the patient
or to the society”(Fla. Statute 491.0147)”
Psychiatrists have the option to to
disclose when the patient has made an
“actual threat” to “physically harm” an
“identifiable victim” (Fla Statute 455.671)
Florida Laws related to
public safety

Mental health counselors may
disclose to a HIV positive patient’s
sexual or needle-sharing partner
when
Patient has disclosed the identity; and
 Patient has refused to notify the
partner nor will he/she refrain from
high-risk activity (Fla Statute 455.674)

Protections against
Malpractice

Abide by the Law of No Surprises
Informed Consent
 Professional Disclosure

Professional Disclosure
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The nature & purpose of the services provided
Risks and Benefits
Alternatives to service provision
Information about the procedures and
duration of counseling
Limitations on confidentiality
Client’s right to make complaints and/or
discontinue services
Logistics of counseling (Making & canceling
appointments, etc.)
What to do in an emergency
Policies and procedures regarding fees
Protections against
Malpractice

Know your legal and ethical
responsibilities
Codes of Ethics
 Statutes & Regulations

Consult
Allows for “reality testing”
 Establishes standard for
“reasonable” care
 Establishes evidence for reasonable
& prudent action

Document
If its not written down, it didn’t
happen
 Never alter documentation!

Insure against malpractice
Anyone can be sued at any time
 Institution liability insurance may
not be adequate
 Available through professional
associations

Professional Disclosure
Professional Disclosure:

The act of sharing the information
needed to understand the nature
and characteristics of the counseling
process, toward the goal of
furthering informed, autonomous
decision making
Professional Disclosure:

Informed Consent:


The obligation to ensure that the
consumer understands all information
pertinent to any choices he or she must
make throughout the course of
treatment
Counseling Guidelines

Describes the logistics of how the
rehabili5tation process works
How to approach Disclosure

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Individual vs. Group
Written vs. Oral or Both
Low Tech vs. High Tech
Information Imparting vs. Information
Sharing

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A one-way street or a two-way street?
When/how does the consumer orient you?
Ensuring understanding – short term and
long term
What to include?
Varies by agency, state law, needs
of consumer
 How much is enough? Too much?
 Accessibility of Information

What to include?
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Goals of the Agency
The Rehabilitation Process
Services available
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What the agency can do
What the agency can’t do
Eligibility Criteria & Process
Financial Obligations/Limitations
Timelines
General Logistics (Appointments, etc)
What to include?
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The role of the Counselor
Education – Credentials - Special Skills
Contact Information
Values – Approach - Philosophy
What your counselor expects from you
What you may expect from your
counselor
Right to ask about treatment/progress
Right to complain
What to include?
Benefits & Risks of Participation
 Alternatives
 Purposes & Uses of Testing
 Release of Information
Procedures
 Limitations on Confidentiality

Disclosure Checklist



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Non technical &
easily understood?
Length? Enough
info? Too much?
Personal? Too
personal?
General tone?
Does it convey
what you want to
convey?


Inclusive of critical
information?
Inviting format?
(white space, font
size, etc.)
Decisions at the End of
Life
Introduction



Increasingly, Americans die in medical
facilities
85% of Americans die in some kind of
healthcare facility (hospitals, nursing
homes, hospices, etc.)
Of this group, 70% (60% of the
population as a whole) choose to withhold
some kind of life-sustaining treatment
The Right to Die

Do we have a right to die?



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Negative right (others may not interfere
Positive right (others must help
Do we own our own bodies and our lives?
Do we have the right to do whatever we
want with them?
Isn’t it cruel to let people suffer
pointlessly?
The Sanctity of Life
Life is a “gift from God”
 Importance of ministering to the
sick and dying
 See life as “priceless” (Kant)

Compassion for Suffering

The larger
question in many
of these situations
is: how do we
respond to
suffering?



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Hospice and
palliative care
Aggressive painkilling medications
Sitting with the
dying
Euthanasia
What are we striving for?

Euthanasia
means “a good
death”, “dying
well”

What is a good
death?




Peaceful
Painless
Lucid
With loved ones
gathered around
Some Initial Distinctions
Active vs. Passive Euthanasia
 Voluntary, Non-voluntary, and
Involuntary Euthanasia
 Assisted vs. Unassisted Euthanasia

Assisted vs. Unassisted
Euthanasia
Many patients who want to die are
unable to do so without assistance
 Some who are able to assist
themselves commit suicide with
guns, etc. - - ways that are much
harder and difficult for those who
are left behind

Voluntary, Non-voluntary
and Involuntary Euthanasia
Voluntary: Patient chooses to be put
to death
 Non-voluntary: Patient is unable to
make a choice at all
 Involuntary: Patient chooses not to
be put to death, but is anyway

Active vs. Passive
Euthanasia

Active euthanasia

Occurs in those
instances in which
someone takes
active means, such
as a lethal
injection, to bring
about someone’s
death

Passive euthanasia

Occurs in those
instances in which
someone simply
refuses to
intervene in order
to prevent
someone’s death
Active Euthanasia

Typical case for active euthanasia
There is no doubt that the patient will
die soon
 Passive measures will not bring about
the death of the patient
 The option of passive euthanasia
causes significantly more pain for the
patient (and often the family as well)
than active

Criticisms of the Active/Passive
Distinction in Euthanasia
Conceptual Clarity – vague dividing
line between active and passive,
depending on notions of “normal
care”
 Moral Significance – does passive
euthanasia sometimes cause more
suffering?

Health Care Advance
Directives
Planning Ahead for
End of Life Decisions
Health Care Advance
Directive

A document in which you give instructions
about your health care if, in the future,
you cannot speak for yourself


Living Will: State wishes about life-sustaining
medical treatments
Health Care Power of Attorney: Appoint
another to make medical treatment decisions
for yo if you cannot make them for yourself
Health Care Advance
Directives

Should provide specific guidance
regarding your wishes about:
Artificial respiration
 Nutritional support & hydration
 Medication use for

• Pain relief
• Prolonging life

Organ Donation
Legally Binding?
Legal document in most states
 Medicaid requires discussion for
admission to healthcare facilities
 Durable Power of Attorney
 Most courts tend to honor wishes
expressed in living will

The Slippery Slope

Worrisome examples from history:
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Nazi eugenics program
Chinese orphanages
Special danger to undervalued groups in
our society

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The elderly
Minorities
Persons with disabilities
Groups that are typically discriminated against
Ethical Issues in
Supervision and Research
Linda R. Shaw, PhD
University of Florida
[email protected]
Supervision

Clinical Supervision

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Developing and enhancing the clinical
competencies of supervisees
Providing oversight/Protecting the safety and
well-being of clients
Administrative Supervision


Facilitating the activities of supervisees
Ensuring competent performance of job duties
and implementing corrective action, as
necessary
Complex Overlapping Roles
Teacher
 Counselor
 Consultant
 Evaluator

Conflicting Roles
Power differential/therapy-like
relationship
 Fidelity to client, employer and
supervisee, and protection of self

Dual Relationships

Danger of impaired judgment and
exploitation
Is a sexual relationship appropriate?
 A close friendship?

Competence

Supervisory Skills
Development of Counselor Skills
 Implementing Corrective Action
 Providing meaningful evaluation

Confidentiality
Client information/Informed Consent
 Supervisee information

Ethical Issues in Research
Themes
Honesty
 Integrity
 Objectivity

Protection of Human
Subjects
Historical Violations of Human Rights
 Need for Informed Consent
 Nonmaleficence

Informed Consent
Voluntariness
 Confidentiality
 Full disclosure

Multicultural Diversity
Implications for
Ethical Practice
Diversity Issues in Ethics


Discrimination/Bias
Multicultural
Competence

Sue & Sue (1990)
Counselors have a
responsibility to:
(1)Become aware of
biases, stereotypes &
assumptions based
on culture
(2)Become aware of
client values & world
view
(3)Develop culturally
appropriate
intervention
strategies

Misperceptions
Based on Different
Worldviews
• Non-verbal behavior
• Directness vs.
indirectness
• Individualism vs.
Collectivism
• Change vs.
acceptance
• Cultural mistrust
Diversity Issues in Ethics
(continued)

Sensitivity to Cultural Issues in

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Test Selection & Interpretation
Diagnosis
Treatment Planning
Service Provision/Counseling
Electronic Communication/Web Counseling
Advocacy
Recruitment & Retention in Education
Programs
Research
Purposes of Professional
Associations




Represent members in lobbying,
professional advocacy efforts
Provide networking opportunities
Provide opportunities for professional
development
Promote professional practice



Support accreditation, certification
Promote ethical practice & self-regulation
Advocate for PWD
Exercise
Name of Association
 Structure

Divisions
 State/Regional/Local
 Governance Structure
 Committee


Benefits to membership
Licensed Mental Health
Counselor (LMHC)

Administered by the Board of
Clinical Social Work, Marriage &
Family Therapy and Mental Health
Counseling

http://www.doh.state.fl.us/mqa/491
/soc_home.html
Mental Health Counseling:
Definition




Broad definition
Includes “methods of a psychological
nature used to evaluate, assess, diagnose
& treat
“Includes counseling, behavior
modification, consultation, advocacy,
crisis intervention, client education,
research . . .”
“individuals, couples, families, groups,
organizations, & communities”
Academic Preparation
Generally based upon CACREP
requirements
 Major revision, effective Jan 1, 2001
 Requires:
 60 hr. masters program
 1,000 hours of practicum &/or
internship
 Specified coursework

Required Coursework – 3
hrs of:







Counseling Theories & Practice
Human Growth & Development
Diagnosis & Treatment of
psychopathology
Human sexuality
Group theories & practice
Individual evaluation and assessment
Career and Lifestyle Assessment
Required Coursework – 3
hrs of:



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Research and program evaluation
Social & cultural foundations
Counseling in community settings
Substance abuse
Legal ethical and professional standards
IT IS ESSENTIAL THAT YOU KEEP
COURSE SYLLABI!!
Supervised Experience

A minimum of:
2 years =1500 face to face over at
least 100 weeks
 100 hrs. of supervision per 1500 hrs. of
face to face
 1 hr. of supervision q 2 wks.
 1 hr. of supervision per 15 hrs. of face
to face


Focus on raw data
Supervised Experience



No more than 50% group supervision (26 supervisees)
Post-masters experience can commence
when 7 of 11 required courses, including
diagnosis & treatment has been
completed.
IT IS ESSENTIAL THAT YOU
PROPERLY DOCUMENT
SUPERVISION!!
Supervisor Qualifications
LMHC,LMFT, LCSW or equivalent in
another state
 M.D. Psychiatrist, Board Certified
 Licensed Psychologist + 3 yrs. Of
experience providing psychotherapy
(incl. 750 hr. face to face)
 AAMFT-approved or NCC-ACS
supervisor

Supervisor Qualifications
cont.

Supervisors must have completed 5
years clinical experience & training
in supervision in one of the
following:
Graduate level supervision course
 Continuing Education course (16 hr)
 Meet AAMFT or SW supervision course
requirements

Registered Intern
Requirement
Before beginning supervised
experience, must apply for intern
registration
 Includes review of coursework and
I.d. of qualified supervisor


Title: Registered Mental Health
Counselor Intern
Provisional License
For individuals who have satisfied
clinical experience
 Allows individuals to work under
supervision while completing
additional coursework or exam
requirements.

Exam
Taken at conclusion of 2 years of
supervised experience
 National Clinical Mental Health
Counseling (NCMHC) Exam

Laws & Rules
HIV/AIDS

Laws & Rules

Must complete 8 hr. course covering
• Specified Fla. Laws & rules
• Integration with competencies required for clinical
practice & interactive discussion of case examples

HIV/AIDS

Must complete course by time of licensure (or
within 6 mos. In extenuating circumstances)
Additional Approved
Training
Domestic Battery
 Medical Errors
