Verification of Supervised Experience

Directions: 

4757-17-01 Counseling supervision

Please submit supervision evaluations as soon as supervision is completed including both when the required hours are met, or when a supervision relationship is terminated,  to ensure licensure applications can be processed.

Under your Training Supervision the Applicant was engaged in the practice of counseling with the intention to apply for a license as a Licensed Professional Clinical Counselor.  This type of supervision requires extensive time and involvement on the part of the supervisor in order to help supervisees improve their skills and/or learn new skills, and promote the professional development as a counselor. The recommendation you provide should be based upon the work you have done with the applicant over the previous two or more years. The Board provides additional information regarding Training Supervision on its web site. 

Please note two important definitions when completing the verification:

a) Individual supervision means a case-related interactive face-to-face meeting between one supervisor and no more than two supervisees.

b) Group Supervision means a case-related interactive face-to-face meeting with one supervisor and three or more supervisees.

LPCC SUPERVISION FORM

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