4579678 This rulemaking will update and revise experiential requirements, continuing education requirements, and provisions governing practice of marriage and family therapy under supervision by students, graduates, and applicants for licensure.
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DEPARTMENT OF HEALTH
NOTICE OF PROPOSED RULEMAKING
The Director of the Department of Health, pursuant to the authority set forth in Sections 302(14) and 831 of the District of Columbia Health Occupations Revision Act of 1985 (“Act”), effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code §§ 3-1203.02(14) and 3-1208.31 (2012 Repl.)), and Mayor’s Order 98-140, dated August 20, 1998, hereby gives notice of his intent to adopt the following amendments to Chapter 77 (Marriage and Family Therapy), Title 17 (Business, Occupations, and Professions), of the District of Columbia Municipal Regulations (DCMR), in not less than thirty (30) days after the date of publication of this notice in the D.C. Register.
This rulemaking will update and revise the provisions regulating marriage and family therapy by updating experiential requirements, continuing education requirements, and provisions governing practice of marriage and family therapy under supervision by students, graduates, and applicants for licensure.
CHAPTER 77, MARRIAGE AND FAMILY THERAPY, of TITLE 17, BUSINESS, OCCUPATIONS, AND PROFESSIONS, OF THE DCMR is amended as follows:
Section 7703 is amended to read as follows:
7703 EXPERIENTIAL REQUIREMENTS
7703.1 An applicant shall furnish proof satisfactory to the Board that the applicant has completed a minimum of two (2) years of full-time post-graduate supervised clinical experience, within five (5) years of graduation, consisting of supervised clinical work experience in marriage and family therapy following completion of the first qualifying graduate degree and practicum required as part of the course of study.
7703.2 Unless good cause is shown, the post-graduate supervised clinical experience shall be completed within five (5) years after the day the first qualifying degree was conferred and the practicum completed.
7703.3 The two (2)-year post-graduate supervised clinical experience required pursuant to § 7703.1 shall meet the following requirements:
(a) The experience shall be obtained under the supervision of a supervisor approved by the American Association for Marriage and Family Therapy (AAMFT) or a supervisor approved by the Board;
(b) The experience shall include a minimum of two thousand (2,000) hours of supervised practice in marriage and family therapy;
(c) The experience shall include a minimum of one thousand (1,000) hours of face-to-face direct client contact hours;
(d) The supervisee shall not receive compensation of any nature as a marriage and family therapist, either directly or indirectly, from a client, except for salary from an employer based on hours worked under supervision;
(e) The supervisor shall bear all responsibility for the practice by the supervisee and shall countersign all notes, documents, and correspondence;
(f) The client shall be informed of and consent to the services being performed under supervision;
(g) Prior to the initiation of the supervised clinical experience, the supervisor and the supervisee shall discuss and agree upon the scope of supervision, the scope of the supervised clinical experience, and the respective rights and responsibilities of the supervisor, the supervisee, and the clients;
(h) The supervision shall be provided in the following manner:
(1) The supervisor and the supervisee shall conduct at minimum monthly face-to-face discussions of the practice and all related matters; and
(2) One (1) hour of direct supervisory contact shall be provided for every twenty (20) hours of direct client contact; and
(3) The supervisee’s performance shall have been rated at least satisfactory by each supervisor.
7703.4 The Board may approve a supervisor who is not an AAMFT-approved supervisor provided that the intending supervisor meets the following requirements:
(a) Possesses a license, in good standing, to practice marriage and family therapy, professional counseling, counseling psychology, psychiatry, or independent clinical social work in the jurisdiction in which the supervised clinical experience shall occur;
(b) Possesses a minimum of five (5) years of clinical experience working with couples and families;
(c) Possesses sufficient experience and/or training in supervision;
(d) Shall not supervise more than five (5) individuals at any given time; and
(e) If not a licensed marriage and family therapist, agrees to comply with all the statutory and regulatory requirements of marriage and family therapy practice and to ensure that the supervisee receive adequate education, training, and mentoring to understand the legal and ethical obligations in the practice of marriage and family therapy.
7703.5 An applicant for licensure who has practiced marriage and family therapy, in a jurisdiction that does not require licensure, for a period of at least five (5) years prior to the date of submission of the application shall not be required to meet the supervised clinical experience requirements under this section.
7703.6 The Board may waive any requirements of § 7703.3 and § 7703.4 where an applicant started his or her supervised clinical experience prior to April 15, 2014.
Section 7707 is amended to read as follows:
7707 CONTINUING EDUCATION REQUIREMENTS
7707.1 This section shall apply to applicants for the renewal, reactivation, and reinstatement of a license.
7707.2 This section shall not apply to applicants for an initial license by reciprocity or endorsement.
7707.3 Continuing education credit shall be granted only for programs or activities approved by the Board in accordance with Section 7708.
7707.4 An applicant for renewal, reactivation, or reinstatement of a license to practice marriage and family therapy, shall submit proof of having completed thirty (30) hours of approved continuing education during the two-year (2) period preceding the date the license expires or preceding the date of the application for reactivation or reinstatement. The thirty (30) hours of approved continuing education shall include:
(a) A minimum of fifteen (15) of the thirty (30) hours shall be completed in a live, face-to-face setting that provides for direct, real-time interaction between presenter(s) and participants;
(b) Six (6) hours of the thirty (30) hours shall be in ethics;
(c) The remaining twenty-four (24) hours of continuing education may consist of current and emerging issues in marriage and family therapy such as the study of:
(1) Non-traditional families;
(2) Domestic violence;
(3) HIV;
(4) Aging;
(5) End-of-life issues;
(6) Addiction and psychopharmacology; and
(7) Trauma.
7707.5 To qualify for a license, a person in inactive status within the meaning of Section 511 of the Act (D.C. Official Code § 3-1205.11) who submits an application to reactivate a license shall submit proof of having met the continuing education requirements for each licensing period that the license was in inactive status.
7707.6 To qualify for a license, an applicant for reinstatement of a license to practice marriage and family therapy pursuant to Section 512 of the Act (D.C. Official Code § 3-1205.12) shall submit proof of having completed fifteen (15) hours of credit in an approved continuing education program for each year after March 31, 2006 that the applicant was not licensed, up to a maximum of seventy-five (75) hours.
7707.7 An applicant for license renewal, reactivation, or reinstatement under this section shall prove completion of required continuing education credits by submitting with the application the following information with respect to each program:
(a) The name and address of the sponsor of the program;
(b) The name of the program, its location, a description of the subject matter covered, and the names of the instructors;
(c) The dates on which the applicant attended the program;
(d) The hours of credit claimed; and
(e) Verification by the sponsor of completion, by signature or stamp.
7707.8 The Board shall accept for continuing education credit any credits or courses approved or accredited by the following organizations:
(a) The American Association for Marriage and Family Therapy (AAMFT);
(b) The National Association of Social Workers (NASW);
(c) The American Psychological Association (APA);
(d) The National Board for Certified Counselors (NBCC);
(e) The American Counseling Association (ACA); or
(f) Other state Marriage and Family Therapy boards.
7707.9 The Board may require proof of a licensee's completion of continuing education at the completion of a renewal period. A licensee shall:
(a) Maintain the required proof of completion for each continuing competence activity as specified in these regulations; and
(b) Retain documentation of a continuing competence activity for a minimum of two (2) years following the last day of the license renewal period for which the continuing competence activity was completed.
7707.10 The Board may audit up to twenty percent (20%) of the number of licensees to determine compliance with the continuing education contact hour requirements.
7707.11 Upon notification by the Board that a licensee has been selected for an audit, the licensee shall submit the required documentation within thirty (30) days of receipt of the notice.
7707.12 Licensees who fail to provide proof of continuing education compliance during an audit may be subject to an audit in the subsequent renewal cycle.
Section 7712 is amended to read as follows:
7712 PRACTICE OF MARRIAGE AND FAMILY THERAPY BY STUDENT, GRADUATES, AND FIRST-TIME APPLICANTS
7712.1 This section shall apply to the following:
(a) Students enrolled in recognized schools or colleges as candidates for a degree in marriage and family therapy, or enrolled in a college course pertaining to marriage and family therapy;
(b) Applicants for a license whose application for a license in the District of Columbia is pending; and
(c) Graduates of a master or doctoral program meeting the requirement of § 7702.1 who are meeting the supervised clinical experience requirements of Section 7703.
7712.2 A student, graduate, or applicant described in § 7712.1 may perform actions which require a license as a marriage and family therapist only in accordance with the Act and this section.
7712.3 A student, graduate, or applicant described in § 7712.1 may practice marriage and family therapy in the District under supervision of a marriage and family therapist licensed in the District who is an AAMFT-approved supervisor or a marriage and family therapist, a professional counselor, a clinical psychologist, a psychiatrist, or an independent clinical social worker licensed in the District of Columbia, provided that a supervisor who is not an AAMFT-approved supervisor shall first obtain the Board’s approval for supervision.
7712.4 A first-time applicant practicing marriage and family therapy pursuant to Section 7712.1 (b) who fails the national examination administered by the Association of Marital and Family Therapy Regulatory Boards shall cease practicing marriage and family therapy under supervision until such time as a marriage and family therapy license is duly issued to that individual.
7712.5 A supervisor of a student, graduate, or applicant practicing under this section shall be responsible for the actions performed or care provided by the supervisee during the time of the supervision and is subject to disciplinary action for any violation of the Act or this chapter by the supervisee.
7712.6 A supervisor shall review and co-sign any documentation relating to the cases and the practice written or produced by the supervisee.
7712.7 The Board may deny an application for a license from an applicant who is found to have violated the Act or this chapter.
7712.8 An unlicensed marriage and family therapist shall identify himself or herself as such at all times when practicing marriage and family therapy and shall provide a professional disclosure statement, as determined by the Board, to all clients and other individuals involved in such practice.
7712.9 An unlicensed marriage and family therapist shall not receive compensation of any nature as a marriage and family therapist, either directly or indirectly from a client, except for a salary from an employer based on hours worked under supervision.
7712.10 A licensed marriage and family therapist, a licensed professional counselor, a licensed clinical psychologist, a licensed psychiatrist, or a licensed independent clinical social worker may be approved to provide supervision only under these terms:
(a) The supervisor shall have been licensed in good standing in the District of Columbia and shall have a minimum of five (5) years of clinical experience providing services to couples and families;
(b) The supervisor shall not have been subject to a disciplinary action in any jurisdiction within the 5 years prior to the initiation of the supervision;
(c) Except as provided in § 7712.12 and § 7712.13, prior to the initiation of the supervision, the supervisor shall have completed a minimum of 6 hours of board-approved supervision course(s), a minimum of three (3) hours of which shall be obtained in a live, interactive, in-person, face-to-face setting;
(d) Once approved to provide supervision, a supervisor may continue to be approved as a supervisor in subsequent licensure period(s) if, during each renewal period, he or she completes a minimum of 6 hours of board-approved supervision course(s), at least three (3) hours of which shall be obtained in a live, interactive, in-person, face-to-face setting;
(e) The supervisor shall not supervise more than five (5) individuals at any given time;
(f) If not a licensed marriage and family therapist, the supervisor shall agree to comply with all the statutory and regulatory requirements governing the practice of marriage and family therapy and ensure that the supervisee receive adequate education, training, and mentoring to understand the legal and ethical obligations in the practice of marriage and family therapy; and
7712.11 A supervisor for supervised clinical experience shall provide supervision in accordance with § 7703.3 and shall comply with all supervision documentation as required by the Board.
7712.12 A supervisor who has been approved by the Board during any licensure period may supervise additional students, graduates, or applicants under this section without having to submit a new request for approval, provided that he or she continues to meet the requirements of § 7712.10.
7712.13 A supervisor approved by the Board during any licensure period may continue to be approved as supervisor for the next licensure period by submitting a request with an attestation or documentation as required by the Board.
7712.14 A supervisor may not supervise an individual with whom he or she has a familial, social, or financial relationship that may create a conflict of interests.
7712.15 A supervisor shall provide supervision, training, and mentoring as appropriate to the supervisee’s level of competence and ability and shall periodically observe the supervisee’s performance providing services to clients.
7712.16 A supervisor shall:
(a) Establish a written contract for supervision initiated before beginning supervision;
(b) Determine the skill level at which the supervisee may practice;
(c) Focus on raw data from the supervisee’s practice;
(d) Maintain documentation of supervisory sessions for at least three (3) years, including dates, duration, and focus of the supervisory sessions;
(e) Ensure that a supervisee has read and is knowledgeable about the District’s laws and regulations governing the practice of marriage and family therapy;
(f) Be responsible for the clinical professional practices of supervisees;
(g) Provide for emergency supervision and direction to a supervisee by a Board-approved supervisor;
(h) Provide a written evaluation of the supervisee’s progress to the supervisee every 3 months;
(i) Inform the Board in writing when there is any material change in the supervision or the supervisory relationship no later than ten (10) days following such a change; and
(j) Provide a copy of the documentation of supervision:
(1) On request by the supervisee; or
(2) On request by the Board or its authorized agent.
7712.17 A supervisee shall:
(a) Verify, through the exercise of due diligence prior to the initiation of the supervision, that:
(1) The supervisee’s supervisor has been approved by the Board; and
(2) There is a written contract for supervision;
(b) Attend and participate in supervision as agreed in the written contract for supervision;
(c) Prepare for supervision using case materials related to the supervisee’s marriage and family therapy practice; and
(d) Maintain documentation of supervisory sessions for at least three (3) years, including dates, duration, and focus of the supervision, to be available for verification to the Board, on request by the Board or its authorized agent.
(e) Not engage in the practice of marriage and family therapy independent of supervision.
(f) Provide the client with a copy of a professional disclosure statement that:
(1) Clearly states the marriage and family therapy services are provided under clinical supervision; and
(2) Provides the name of the supervisor with address and contact information;
(g) Inform the Board in writing when there is any material change in the supervision or the supervisory relationship no later than ten (10) days following such a change; and
(h) Obtain a signed release of information and informed consent for treatment form from the client which indicates that the client:
(1) Is aware that marriage and family therapy services are being provided under clinical supervision;
(2) Consents to the recording of marriage and family therapy sessions with the knowledge that the recording may be shared with and be limited to the supervisor; and
(3) Consents to the sharing of client information between the unlicensed marriage and family therapist and the named clinical supervisor.
7712.18 The Board may, at its discretion, waive certain requirements of § 7703.3 and § 7712.11 where an applicant started his or her supervised clinical practice prior to April 15, 2014.
Section 7799 is amended to read as follows:
7799 DEFINITIONS
7799.1 As used in this chapter, the following terms shall have the meanings ascribed:
AAMFT-approved supervisor – a marriage and family therapist who holds a designation of Approved Supervisor from the American Association for Marriage and Family Therapy.
Allied Field - academic study in, or performing the professional functions associated with, psychology, social work, psychiatry, professional counseling, or other comparable mental health profession.
Applicant - a person applying for a license to practice marriage and family therapy or applying for renewal of a license under this chapter.
Board - the Board of Marriage and Family Therapy, established by Section 217 of the Act, as amended by the Marriage and Family Therapy Amendment Act of 2003, effective March 10, 2004 (D.C. Law 15-88; D.C. Official Code § 3-1202.17).
Direct supervisory contact – in-person, face-to-face meeting between a supervisor and a supervisee for the purposes of discussing cases and the practice as well as providing guidance, review, instructions, and all aspects of supervision.
Face-to-face direct client contact – provision of direct marriage and family therapy services to clients in a live, in-person, face-to-face setting.
Immediate supervision – face-to-face supervision in which an approved marriage and family therapist, psychologist, psychiatrist, licensed independent clinical social worker, licensed professional counselor, or advance practice nurse is either discussing or observing the supervisee’s practice.
Instructional hours - the amount of time spent in actual presentation excluding preparation hours.
Marriage and family therapist - a person licensed to practice marriage and family therapy under the Act.
Professional disclosure statement – a statement stating that the marriage and family therapy services will be or are being provided by an unlicensed marriage and family therapist under supervision.
Supervised clinical experience – practice of marriage and family therapy by a graduate or first-time applicant for a license, performed without a license and under supervision of an AAMFT-approved supervisor or a supervisor approved by the Board in order to meet the experiential requirements pursuant to § 7703.
Unlicensed marriage and family therapist - a person who has completed the educational requirements for a degree in marriage and family therapy but has not met the clinical requirements for licensure and is engaged in the practice of marriage and family therapy pursuant to § 7712.
All persons desiring to comment on the subject matter of this proposed rulemaking action shall submit written comments, not later than thirty (30) days after the date of publication of this notice in the D.C. Register, to Department of Health, Office of the General Counsel, 899 North Capitol Street, N.E., 5th Floor, Washington, D.C. 20002. Copies of the proposed rules may be obtained between the hours of 8:00 a.m. and 4:00 p.m., Monday through Friday, excluding holidays, at the address listed above, or by contacting Angli Black, Administrative Assistant, at Angli.Black@dc.gov, (202) 442-5977.
