Fill Out Your Supervision Hours Form

What is the Supervision Hours form?

The Supervision Hours form is a required document for individuals pursuing licensure as a Licensed Master Social Worker (LMSW) in New York State. It outlines the supervision experience that an LMSW must complete under a qualified supervisor while providing clinical social work services. This form needs to be submitted before the supervised experience begins.

Who can supervise my clinical social work practice?

Your supervisor must be licensed and registered in New York State as either a Licensed Clinical Social Worker (LCSW), a licensed psychologist, or a board-certified physician in psychiatry. The supervisor must not have a familial relationship with you, as this could lead to unprofessional conduct charges.

How many hours of supervised experience do I need to complete?

You are required to complete a total of 2,000 client contact hours over a minimum of three years and no more than six years. This experience needs to involve diagnosis, psychotherapy, and treatment planning. It's crucial to track these hours accurately using the provided psychotherapy log.

What happens if I submit the form after completing my supervised experience?

If you submit the Supervision Hours form after the supervised experience has ended, it will not be reviewed. This requirement emphasizes the importance of submitting the form beforehand to ensure proper oversight and compliance with regulations.

Can I employ my own supervisor?

No, as an LMSW, you cannot employ or contract with your supervisor. The supervisor must be provided by the setting where you work or receive clinical training. This arrangement ensures that the supervision is structured appropriately within an authorized setting.

What if my proposed supervisor is not licensed in New York State?

If your proposed supervisor is not licensed in New York State, they must submit an Approval of Qualifications to Supervise Psychotherapy (Form 4Q). This allows the Department to review whether the supervisor meets the necessary qualifications in diagnosis, psychotherapy, and treatment planning.

How should I document my supervision hours?

You must use the psychotherapy log provided to document both your client contact hours and supervision hours. This log should be maintained by your supervisor and submitted upon request by the Department of Education to verify that all requirements are met.

What types of settings are acceptable for my supervised experience?

Your supervised experience must occur in a setting legally authorized to provide psychotherapy services. Acceptable settings include professional corporations, programs approved by various New York State Offices, and other entities that comply with specific regulations. Make sure to review the qualifications before starting your position.

What should I do if my contact information changes while completing my supervised experience?

As an applicant, you must notify the Department of any address or name changes within 30 days. Keeping your information current is vital to ensure that all communications regarding your licensure are sent to the right place.

Completing the Supervision Hours form is a critical step on the path to becoming a Licensed Master Social Worker (LMSW) in New York. However, many applicants make mistakes that can cause delays in processing their application or lead to outright denial. Understanding these common mistakes can help ensure a smoother experience.

One common error is the failure to accurately fill in personal information, particularly in Section I. For instance, an applicant might enter their name differently from how it appears on the Application for Licensure (Form 1). This inconsistency can create confusion and may require additional clarification, slowing down the approval process. Make sure your details are consistent across all documents.

In addition, some applicants neglect to sign and date item 9, which is a crucial step in validating the application. Failing to sign the form means it cannot be processed, requiring the applicant to start over. Always remember to check that all required signatures are included before submitting the form.

Another mistake is submitting the form after the supervised experience has already been completed. The guidelines clearly state that the form must be submitted prior to beginning supervision. Submitting the form late leads to automatic non-review and can extend the path to licensure unnecessarily.

Many also do not take enough care when documenting their hours in the psychotherapy log. Whether using individual or group supervision, applicants sometimes miscalculate the total number of hours or forget to get their supervisor's initials. Ensure all entries are accurate and that your supervisor verifies them to avoid discrepancies.

Additionally, to maximize your chances of success, applicants should verify that their supervisor holds the appropriate qualifications ahead of time. Some applicants mistakenly assume that any licensed social worker can supervise them. The requirements specify that the supervisor must hold certain licenses and meet additional criteria. Confirming these details in advance can prevent future complications.

Lastly, neglecting to attach any necessary supplemental documents, such as the operating certificate or waivers, can halt the review process. Ensure all required documents accompany your application to avoid any delays or rejections. Checking the requirements carefully before submitting your application can pay significant dividends down the line.

The Supervision Hours form plays a crucial role in the licensing process for aspiring Licensed Master Social Workers (LMSWs) in New York. Alongside this form, there are several other documents essential for a complete application. Each of these documents serves a specific purpose in documenting the supervised experience required for licensure. Here’s a brief overview of additional forms you may encounter.

• Application for Licensed Master Social Worker: This application is a formal request for licensure. It requires personal information, educational background, and verification of the MSW degree. A fee must accompany this application.
• Psychotherapy Log: This log is used to record the hours spent providing psychotherapy services. It tracks client contact hours and supervision received, ensuring compliance with the requirement of 2,000 hours.
• Appendix A - Requirements for Supervised Experience: This document outlines the necessary qualifications and standards for supervised experience. It details the regulations that both supervisors and LMSWs must adhere to throughout their training.
• Approval of Qualifications to Supervise Psychotherapy (Form 4Q): When a supervisor is not licensed in New York State, they must submit this form for approval. This ensures that the supervisor meets the competency requirements necessary for effective guidance.
• Verification of Employment Setting: This is a statement confirming that the LMSW is employed at an authorized setting. It may require documentation like an operating certificate or waiver from the New York State Education Department.
• Supervisor’s Affidavit: The supervisor must sign an affidavit verifying that they have read and agree to the terms outlined in the associated documents. This adds an additional layer of accountability.
• Supervision Agreement: This agreement, between the LMSW and the supervisor, specifies details about the supervision process, including frequency and format. It helps to formalize the supervisor-learner relationship.
• Client Consent Forms: These forms ensure that clients are informed about the LMSW's supervisory status and the nature of their treatment. Client consent is critical to maintaining transparency and trust.
• Exit Interview Documentation: If applicable, this may capture the final assessment of the supervised experience. It can serve as a reflection on the LMSW's growth and readiness for independent practice.
• Payment Receipt for Fees: Proof of payment for application and licensing fees is often required. This documentation verifies that all financial obligations to the licensing authority have been met.

Gathering and submitting these documents properly can significantly impact the licensing process for aspiring LMSWs. Each piece of paperwork is designed to maintain standards in social work practice, ensuring competency and ethical treatment of clients. Proper attention to detail in completing these forms can facilitate a smoother path to licensure.

• Plan for Supervised Experience: This document outlines the necessary steps and requirements for gaining supervised experience as a Licensed Master Social Worker (LMSW). Similar to the Supervision Hours form, it provides a framework for documenting required hours and obtaining necessary signatures to validate the supervisory relationship.

• Application for Licensed Master Social Worker: This application collects personal and educational information to permit licensure as an LMSW. Like the Supervision Hours form, it requires accurate documentation and verification of qualifications, ensuring that applicants meet the state standards for licensure.

• Psychotherapy Log: This log serves as a record for the hours spent in client contact and supervision. It is similar to the Supervision Hours form because it requires both the applicant and supervisor to document and confirm the hours completed during the supervised experience.

• Supervisor's Affidavit Form: This form captures the supervisor's agreement to oversee an LMSW. Similar to the Supervision Hours form, it includes a verification process, where the supervisor must attest to their qualifications and the suitability of the supervision arrangement.

• Appendix A for Supervised Experience: This document specifies the requirements for supervised experience needed for licensure. Like the Supervision Hours form, it reinforces the structure of the supervisory experience and ensures compliance with the regulations set by the state.

• Do ensure that your name is exactly as it appears on your Application for Licensure. Accuracy is critical.
• Do communicate clearly with your supervisor about the requirements and expectations before starting your supervised experience.
• Do submit the Supervision Hours form and the accompanying fee before beginning your employment. Late submissions will not be reviewed.
• Do keep thorough documentation of your client contact hours and supervision sessions in the provided psychotherapy log.
• Don’t forget to sign and date the form where indicated. Failure to do so can delay your application process.
• Don’t attempt to submit the form if you’ve already completed your supervised experience, as it will be rejected.

Misconceptions about the Supervision Hours form can lead to confusion for applicants. Understanding these misconceptions is crucial for a smooth application process. Here are four common misunderstandings explained.

• The form can be submitted after the supervision is complete. Many believe they can send in the Supervision Hours form after finishing their supervised experience. However, this is incorrect. The form must be submitted before beginning the supervised experience to be eligible for review.
• Any supervisor can sign off on the form. It is often assumed that any licensed professional can supervise an LMSW. In reality, the supervisor must meet specific criteria, such as being a Licensed Clinical Social Worker, licensed psychologist, or a board-certified physician in psychiatry. The qualifications are strictly outlined in the regulations.
• Completing the form is a one-time task. Some applicants think filling out the Supervision Hours form is a one-and-done activity. This is misleading. The form requires ongoing documentation throughout the experience. It's important to regularly track hours of practice and supervision.
• The setting is not important as long as supervision occurs. There is a misconception that any setting is suitable for obtaining supervision hours. This is not the case. The supervised experience must occur in an authorized setting that complies with New York State regulations, ensuring the legitimacy of the practice and supervision provided.

Filling out the Supervision Hours form is a critical step for Licensed Master Social Workers (LMSWs) in New York. Here are some key takeaways to consider:

• Ensure that you complete Section I accurately. The name provided should match exactly with your Application for Licensure.
• A supervisor must possess the appropriate licensure and cannot have any familial ties to the LMSW.
• You are required to document a total of 2,000 client contact hours within a timeframe ranging from 36 months to 6 years.
• The entire form, along with Appendix A, should be submitted before starting any supervised experience. Late submissions will not be reviewed.
• Prior to beginning supervised experience, verify the license status of your proposed supervisor through the Office of the Professions' website.
• Include the necessary fee of $10 when submitting the form to avoid delays in processing.
• Both the LMSW and the supervisor must evidence that they meet all requirements established in the Education Law and Commissioner's Regulations.