1 Supervision Class 1 Professor Ian Chand Ph

1 Supervision Class 1 Professor: Ian Chand, Ph. D. : 1

2 Introduction 2

Introduction 3 Role in Supervision Client Trainee Intern Supervisor in Training CAMFT/AAMFT Approved Supervisor Myths in Supervision 3

4 Myths in Supervision A. Responsibilities of a Supervisor B. Myth 1 – “Working Under Someone’s License” C. Myth 2 – The Supervisor is “liable” for the Interns’ Actions D. Myth 3 – Patient records belong to the Intern 4

5 E. Myth 4 – Offsite supervision/Paying for Supervision is Unlawful (this myth has now been changed the client can pay the organization/agency and the organization can pay the supervisor). F. Myth 5 – The Supervisor Must Be Present 50% of the Time G. Myth 6 – Because the Supervisee is a Volunteer, Worker’s Comp Insurance is Unnecessary H. Myth 7 – The Patient “Belongs” to the Employer 5

6 Current BBS Laws MFT Licensure Supervision 6

7 Current BBS Laws n Any person supervising an intern or trainee within California shall comply with the requirements set forth below, and shall, prior to the commencement of such supervision, sign under penalty of perjury the “Responsibility Statement for Supervisors of a Marriage and Family Therapist Trainee or Intern” revised 2 -05 (10 requirements): 7

8 Current valid CA license MFT, LCSW, Psychologist, Psychiatrist n Provides supervision only to trainees at an academic institution that offers a qualifying degree program as specified in Section 4980. 40 (f) of the Code; and n Has been licensed in California as specified in Section 4980. 40 (f) of the Code, and in any other state, for a total of at least 2 years prior to commencing any supervision 8

9 n If not licensed as an MFT, a supervisor will have sufficient experience, training and education in marriage and family therapy. n Keeps self informed of developments in marriage and family therapy, and in CA law governing the practice of the same. n Has and maintains license in good standing – immediately informs intern or trainee of disciplinary action, lapse in licensure, etc. 9

10 n Has practiced psychotherapy for at least 2 years within the 5 year period immediately preceding any supervision, and has averaged at least 5 client contact hours per week. n Has had sufficient experience, training, and education in the area of clinical supervision to competently supervise interns or trainees. 10

11 n Completes minimum of 6 hours of supervision training and coursework every 2 years (4980. 54 and 4996. 22). You are also required to have 36 hours every 2 years and 12 hours have to be in Supervision + Law and Ethics n Supervisors who completed 6 hours of supervision training between 1/1/97 and 12/31/99 may apply towards CEU requirements. n Supervisors who commenced supervision after 1/1/2000, and have not taken 6 hours of supervision training may complete this training within 60 days of commencing supervision. n New supervisor is suppose to check with last supervisor 11

12 n Knows and understands laws and regulations pertaining to both the supervision of trainees and interns, and the experience required for licensure as an MFT. n Ensures that the extent, kind, and quality of counseling performed is consistent with the education, training, and experience of the intern or trainee. 12

13 n Monitors and evaluates the extent, kind, and quality of counseling perform by the intern or trainee – direct observation, audio or video tape, review of progress notes and treatment records, or other means deemed appropriate by supervisor. n Addresses manner in which emergencies will be handled. 13

14 n Provides intern or trainee with “Responsibility Statement for Supervisors of a Marriage and Family Therapist Intern or Trainee” prior to commencement of counseling or supervision n Trainee provides Board with his or her signed statements from each supervisor upon application to internship 14

15 n Gives at least 1 week notice of intent not to certify any further hours of experience for trainee or intern – if notice is not given, supervisor shall sign for hours in good faith where such supervisor provided the required supervision n Obtains from intern or trainee the name, address, and telephone number of intern or trainee’s most recent supervisor and employer 15

16 n When setting is not a private practice, supervisor shall ensure site provides experience which is within the scope of marriage and family therapy, and that the experience is in compliance with the requirements set forth within this section. n Shall provide any documentation which verifies supervisor’s compliance with the requirements herein, upon written request of the Board (random audit). 16

17 n Supervisors‘responsibility statement shall be used for supervisory relationships. n If supervisor fails to complete training or course requirement for supervision, the Board will accept hours of experience gained under that supervisor. 17

18 Hours of Supervision n During each week experience is claimed and for each work setting, applicant shall have: n 1 hour one-on-one supervision n 2 hours group supervision n These must be 60 minute hours, not 45 -50 minute therapy hours 18

19 n If less than 2 hours of group supervision are provided within the week, the supervision hours will not count and one’s hours of experience may be jeopardized. n The trainee/intern must receive at least 1 hour of one-on-one, individual supervision per week for a minimum of 52 weeks 19

20 n Not more than 5 hours of supervision shall be credited during any single week. n However, it may be necessary to gain and record more than 5 hours of supervision in a week to be able to count all hours of experience gained. 20

21 Supervision Reminders n Current valid license n Mandatory n Payment n Who for supervision may not supervise n Individual n Group n Other CEU’s supervision guidance 21

22 Current Valid License n Make sure your supervisor holds a current, valid license, which is not under suspension or probation by a licensing board n Be sure to check at the next renewal period that the supervisor has renewed their license n Be certain that the supervisor has been California licensed for 2 years prior to commencing supervision 22

23 n Professionals who may be supervisors include the following: n Physicians certified in psychiatry bye the American Board of Psychiatry and Neurology n Psychologists n Clinical Social Workers n Marriage and Family Therapists 23

24 Continuing Education Units (CEU’s) n Supervisors are required to complete a total of 6 CEU’s in supervision each license renewal period. n This coursework is to be taken either prior to or within 60 days after commencing the supervision of an intern or trainee. n Negligence on the part of the supervisor to take these hours will not result in the loss of hours for the intern or trainee. 24

25 CAMFT – Ethical Guidelines Professional Competence & Integrity n Marriage and family therapists are in violation of this Code and are subject to termination of membership, or other appropriate action, if they: 25

26 n a) are convicted of a crime substantially related to their professional qualifications or functions n b) are expelled from or disciplined by other professional organizations n c) have their licenses or certificates suspended or revoked or are otherwise disciplined by regulatory bodies 26

27 n d) they continue to practice when they are no longer competent to practice because they are impaired due to physical or mental causes or the abuse of alcohol or other substances n e) fail to cooperate with the Association or the Ethics Committee at any point from the inception of an ethical complaint through the completion of all proceedings regarding that complaint 27

28 MFT’s n Avoid contractual arrangements which provide financial incentives to withhold or limit medically/psychologically necessary care n Maintain patient records, written, taped, computerized, or stored in any other medium, consistent with sound clinical practice 28

29 n Seek appropriate professional assistance for their personal problems or conflicts that impair work performance or clinical judgment. n Actively strive to understand diverse cultural backgrounds of their clients by gaining knowledge, personal awareness, and developing sensitivity and skills pertinent to working with a diverse client population. 29

30 n MFT’s who provide therapy over the internet or by other electronic media take extra measures to identify and understand the diversity, ethnicity, and cultural sensitivity of such patients. n Are aware of how their cultural/racial/ethnic identity, values, and beliefs affect the process of therapy. 30

31 n Remain abreast of developments in their field through educational activities and clinical experiences n Do not engage in sexual or other harassment or exploitation of patients, students, interns, trainees, supervisees, employees, or colleagues 31

32 n Do not assess, diagnose, treat, or advise on problems beyond the level of their competence as determined by their education, training, and experience. n While developing new areas of practice, MFT’s take steps to ensure the competence of their work through education, training, consultation, and/or supervision. 32

33 n Do not provide professional services to a person receiving treatment or therapy from another psychotherapist, except by agreement with such other psychotherapist, or after termination of the patient’s relationship with the other psychotherapist. 33

34 n Initiate services by Internet or other electronic media to patients located only in jurisdictions where therapist may lawfully provide such service n Take reasonable steps to prevent the distortion or misuse of their clinical and research findings 34

35 n Because of their ability to influence and alter the lives of others, MFT’s exercise special care when making public their professional recommendations and opinions through testimony or other public statements. 35

36 Responsibility to Students and Supervisees n Supervisors and therapists are aware of their influential position with respect to students and supervisees, and they avoid exploiting the trust and dependency of such persons. n Avoid relationships that are reasonably likely to impair professional judgment or lead to exploitation. 36

37 n Provision of therapy to students or supervisees is unethical. n Sexual intercourse, sexual contact or sexual intimacy and/or harassment of any kind with students or supervisees is unethical. 37

38 n Do not permit students, employees, or supervisees to perform or to hold themselves out as competent to perform professional services beyond their training, level of experience, and competence. n Are responsible for maintaining the quality of supervision skills, and obtain consultation or supervision for their work whenever appropriate. 38

39 AAMFT – Standards & Ethics n Must not supervise his or her family members, former family members, clients in therapy, or any other person with whom the nature of the relationship prevents or makes difficult the establishment of a professional supervisory relationship. 39

40 n Are responsible for an initial screening to evaluate the MFT’s (trainee/intern) knowledge of systems theory, family development, special family issues, gender and cultural issues, systemic approaches and interventions, human development, human sexuality, and ethical responsibilities 40

41 n. A contract should be developed for the supervision, which delineates fees, hours, time and place of meetings, case responsibility, caseload review, handling of suicide threats, other dangerous clinical situations, and so forth. 41

42 n Supervision fee is a function of the contract between supervisors and MFT/trainees, including amounts and collection procedures. n Should be in keeping with the community standard n Approved Supervisors and supervisor candidates are encouraged to commit a portion of their supervision practice to providing pro-bono or reduced fee supervision to deserving MFT/trainees. 42

43 n The major emphasis on supervision should be on the MFT/trainee’s work with marriage/couple and family process, whether the MFT/trainee is working with individuals, couples or families. n During the supervision session, the MFT/trainee’s cases, not the supervisors’, are to be discussed. 43

44 n Individual supervision must be limited to one or two MFT/trainees in face-to-face sessions with the supervisor n Group supervision must be limited to six to ten supervisees n Trainees in group supervision sessions may not count the time as individual supervision even if they are presenting a case n They may count time as individual supervision when providing therapy while the supervisor and a group are observing therapy 44

45 n The progress of MFT/trainees should be periodically reviewed according to predetermined supervisory goals, and evaluations should be shared and discussed with trainees. n Should a supervisor develop significant concerns about the abilities, philosophical beliefs, or practices of a MFT/trainee, the concerns must be shared with the MFT/trainee and documented in writing as early as possible. 45

46 n Do not disclose MFT/trainee confidences except in limited circumstances (see AAMFT Code of Ethics) n Must have a clear understanding about responsibility for evaluations as well as specific details about how the evaluation will be shared 46

47 n Must provide supervision reports as needed by MFT/trainees, such as those required for AAMFT membership. n The supervisor’s signature on the forms verifies the accuracy of the information reported, so the supervisor is responsible for ensuring that the MFT/trainee has actually completed the clinical and supervision hours reported. 47

48 Supervision is expected to have the following characteristics: n Face-to-face conversation between MFT/MFT trainee and the supervisor - usually one hour each n Learning process should be sustained and intense 48

49 n Appointments customarily scheduled once a week, three times weekly is ordinarily the maximum and once every other week the minimum n It is a process clearly distinguishable from personal psychotherapy and is contracted in order to serve professional goal n It is normally completed over a period of one to three years 49

50 n AAMFT Approved supervisors may be asked to serve as the mentor for an MFT who wishes to become an approved supervisor n Before accepting responsibility of mentoring, the Approved Supervisor should be thoroughly familiar with the current requirements for becoming an Approved Supervisor 50

51 Requirements for AAMFT Approved Supervisor n Must have accumulated a total of 300 hours of MFT supervision experience before they can provide supervision mentoring to supervisor candidates n The 300 hours can include the 180 hours of supervision the Approved Supervisor provided during his/her own training for the designation 51

52 n The Supervisor mentor should maintain a strict log of supervision mentoring, and review the supervisor candidate’s log of supervision that the candidate is providing to MFT/trainees. n The Supervisor mentor must ensure that the hours counted by the supervisor candidate were actually spent in case discussion, and on the development of the candidate’s supervisory skills. n Hours spent discussing the requirements for the designation, or on completing the Approved Supervisor application packet, should not be counted as hours toward the supervision mentoring requirement 52

53 Becoming a CAMFT Approved Supervisor n Complete 21 -hours of courses n Provide supervision for 52 weeks – may be at one or more than one placement n Meet with CAMFT approved consultant/supervisor monthly, and get hours signed n Complete written supervision case summary 53

54 Supervision mentoring is expected to have the following characteristics: n It must focus primarily on live or audio taped/videotaped sessions of the supervision candidate’s work with a MFT/trainee. n It must include no more than two supervisor candidates at the same time. Supervision mentoring of a group of supervisor candidates does not count toward fulfilling the requirements. 54

55 n It must consist of face-to-face conversation between the Approved Supervisor mentor and the supervisor candidate, usually in periods of one hour each. n The major emphasis should be on the development of the supervisor candidate’s supervisory skills as opposed to an exclusive focus on clinical therapy skills. 55

56 n Work supervised is to be conducted in appropriate professional settings with adequate facilities. n The Approved Supervisor mentor must be available to the supervisor candidate in emergency situations or arrange in advance for a colleague to provide emergency consultation if needed by the supervisor candidate. 56

57 n The Supervisor mentor must evaluate and provide regular feedback to the supervisor candidate about progress, strengths, and areas in which professional development are needed. n It is recommended that after half of the required hours of supervision mentoring have been received, the Approved Supervisor conduct a mid-term evaluation. 57

58 Advertising n Approved Supervisors may advertise their designation in the yellow pages, and on business cards, stationery, etc. , provided these conform with the principles of the AAMFT Code of Ethics. n An example of an appropriate listing is “AAMFT Approved Supervisor. ” 58

59 n Approved Supervisors may also list the designation in programs, registers, professional journals, and newsletters. n The designation must not be represented as an advanced clinical status. 59

60 n AAMFT Clinical Members receive a listing on the AAMFT online referral service, n www. therapistlocator. net n Approved Supervisors who are Clinical Members are encouraged to update their Therapist. Locator profile to describe their supervision practice, and to attract potential supervisees. 60

61 Advertising by Supervisor Candidates n Supervisor candidates may not list their status in the yellow pages, on business cards, stationary, in programs, registers, journals, etc. n The term, “supervisor candidate” is used to describe persons who are actively training for the Approved Supervisor designation, but it is not a title or credential, and should not be used as such. 61

62 n Supervisor candidates should be careful that they do not imply that they have been awarded a designation, or that they will definitely receive the designation at some specified date. n Candidates may indicate on resumes that they are in training to become Approved Supervisor but is in training for the designation. n The term “Approved Supervisor” should not be used until the supervisor candidate officially receives the designation. 62

63 Contract Between Supervisor and Supervisee A. Responsibility Statement for Supervisors B. Four-Way Contract C. Supervisor-Supervisee Contract 63

Responsibility Statement for Supervisors 64 n This statement is to be signed by the supervisor prior to commencing supervision with an intern, trainee, or applicant n These forms are on the BBS website at www. bbs. ca. gov n Interns are to submit Supervisor Responsibility Statements to the Board for all supervisors upon application to take the examinations for licensure 64

65 Offsite Supervision or Supervision not Paid for by the Employer n It is not permissible to get offsite supervision in any work setting other than Private Practice. n It is also permissible for interns, trainees, and applicants to pay for supervision, but only where an appropriately executed letter of agreement exists. 65

66 n The original letter of agreement must be filed by the applicant with her/his application to take the examinations for licensure. n This letter of agreement should be typed onto the letterhead of the employer, as it is the employer who is permitting the “offsite supervision, ” or permitting the supervisee to get supervision not provided by the employer. 66

67 Notice of Change of Address n Licensees, registered interns, and applicants are required to notify the BBS within 30 days of a change of address. 67