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.