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Colorado Counseling Association’s Guide to Becoming A Licensing Professional Counselor in Colorado

A Resource Manual


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Table of Contents Purpose…………………………………………………………………………………………….3 Reviewing the Requirements…………………………………………….…………………………4 Candidate Status…………………………………………………………………………….……..5 Registered Psychotherapist………………………………………………………………………...6 Jurisprudence Examination…………………………………………………………………….….7 Mandatory Disclosure Statement……………………………………………………………..……8 Education Requirements & Education Equivalency……………………………………………….9 Exam Approval……………………………………………………………………………...…….10 Post-Degree Experience and Supervision Requirements…………………………………………11 Healthcare Professions Profile……………..…………………………………………………….12 Continuing Professional Development……………………………………………………………13 Mental Health Professional Licensing Requirements……..………………….…………………..16 Closing Remarks…………………………………………………………………………………..18 Appendix…………………………………………………………………………………………..19 SB11-187………………………………………………………………………………………..19 DORA Approved Disclosure Statement Sample………………..………………………………21 CCA Governing Board Contact Information………………………………………………...…22

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This Licensing Guide is the property of Colorado Counseling Association and is made available to active student and professional members. We ask that you follow the honor system and not reproduce, distribute, or share this document. CCA is a non-profit and maintains very affordable annual membership fees of only $30 for students and $60 for members. Please encourage interested parties to join CCA for access to the document so we have the funds to continue excellent service to all Colorado’s counselors. Warmly, The CCA Governing Council Disclaimer This Licensing Guide is for purposes of information only and is intended to serve only as a general resource, not as a form or recommendation. It has not been approved, sanctioned, or officially promulgated by any attorney, nor is it intended to represent the standard of practice in Colorado or any other state. In making this Guide available, neither the Colorado Counseling Association, nor the persons who prepared the guide, are rendering any legal, ethical, counseling, or other professional services, or advice to the user, or making any representation regarding the content of the document. In addition, please note this document will not be updated to address changes in applicable law, or websites, or in any industry custom or practice. Each user of this document is solely responsible for the contents of such document and assumes all risks in connection with such use. Users are advised to engage their own legal advisors for assistance in a practice start-up or continuation.

Purpose In light of recent legislative and regulatory changes, the CCA Board created the following guide to assist members with the licensing process. The goal is to provide members with the resources and information needed to successfully navigate and comply with the Colorado Department of Regulatory Agency’s (DORA) requirements for licensure. Various links and contacts are provided throughout the manual. Should you have further questions or require

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clarification, feel free to contact your local CCA Member-at-Large or Student Representative, listed in Appendix. 

Colorado Counseling Association Website:

http://www.coloradocounselingassociation.org/

Reviewing the Requirements There are many steps involved in becoming a Licensed Professional Counselor in the state of Colorado. Initially, applicants should review all of the requirements listed in the Colorado Revised Statutes. 

Colorado Revised Mental Health Statutes:

http://www.sos.state.co.us/pubs/elections/statutes.html Additionally, applicants should download a copy of the LPC Application and thoroughly review it. A complete list of requirements is outlined on the first three pages of the LPC Application for Licensure. 

Licensed Professional Counselor Application:

http://cdn.colorado.gov/cs/Satellite/DORA-Reg/CBON/DORA/1251632266340 Once applicants have reviewed the aforementioned information, the next step is to register as a Registered Psychotherapist, A Licensed Professional Counselor Candidate, or a Licensed Professional Counselor.

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Candidate Status Among other changes in the regulation of mental health professions, the SB11-187 bill continues the ability of the oversight boards to issue provisional licenses to candidates who meet the education requirements, but have not yet fulfilled the experience requirements. The bill also creates a registry for Licensed Professional Counselor Candidates who are working towards full licensure, effective November 1, 2011. This means that instead of registering with the Registered Psychotherapist database, applicants are eligible to register as a Licensed Professional Counselor Candidate while they are fulfilling their experience requirements. This allows the candidate to practice therapy under Board-approved supervision while completing the requirements for LPC licensure. This is a one-time registration that expires four years from the date of registration. In order to obtain LPC Candidate status, applicants must submit a completed exam application package, non-refundable application processing fee, and official transcript from an approved program. If the educational program is not approved by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), education equivalency forms must be completed and submitted to the Program/Board office for review with the completed application packet. Candidate status will NOT be approved until the LPC Program/Board evaluates and deems the education program equivalent. For more information, refer to the LPC application link below: LPC Application: http://cdn.colorado.gov/cs/Satellite/DORA-Reg/CBON/DORA/1251632266340

Note: Applicants may not begin accruing post-degree experience and supervision hours until they are granted candidate status, have registered in the Registered Psychotherapist database, OR possess a license in the State of Colorado in a related field. Essentially, the applicant must be registered in the DORA database in some form. Applicant checklists are provided in the LPC application on the DORA website. Part of the requirements includes completing the Colorado Jurisprudence Exam and submitting it with 2014 Colorado Counseling Association


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your application. For more details regarding the exam, refer to the Jurisprudence Exam section of this manual on page 7.

Registered Psychotherapist (Previously Unlicensed Psychotherapist) In order to apply for licensure or obtain clinical hours towards licensure, applicants must be registered in the DORA database. If an applicant does not already have a license in a related field in the state of Colorado or does not register as a Licensed Professional Counselor Candidate, they must register with the Registered Psychotherapist Board Database (C.R.S. 1243-702.5). If not registered in the database in some form, DORA will not accept the applicant’s post-degree, supervised experience hours for licensure. Meaning, any client contact hours accrued prior to being registered will NOT count towards licensure. Additionally, these hours may affect licensure and be the cause of further action to be taken by the board. The details of becoming registered are outlined in the Registered Psychotherapist Application. More information on becoming a Registered Psychotherapist is available on the DORA Mental Health homepage. Click on Registered Psychotherapist.

DORA Registered Psychotherapist Licensing Services:

http://cdn.colorado.gov/cs/Satellite?c=Page&childpagename=DORA-Reg %2FDORALayout&cid=1251632299711&pagename=CBONWrapper 

Registered Psychotherapist Application:

http://cdn.colorado.gov/cs/Satellite/DORA-Reg/CBON/DORA/1251632394750

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Jurisprudence Examination Included in the applications for all mental health professionals wishing to become registered, licensed, or certified is a Jurisprudence Examination. All applicants are required to pass this exam in order to become registered. This open book, online exam must be submitted with your completed application. The link to the exam is provided below. However, as stated on the DORA website, it is the applicant’s responsibility to make sure that he/she has the most recent version of the exam. Therefore, DORA provides links to the exam in both the LPC and the Registered Psychotherapist applications in the Applicant Checklist sections. Make sure to check those links for accuracy before taking the exam. Additionally, applicants should review the suggested exam resources available on DORA’s website. The application was recently revised to accommodate the changing legislation. Studying for the exam may require ethical code familiarity, state statues, LPC statues, and outside resources. On average, it takes applicants 8-30 hours to complete. Most resources can be found on the DORA website.

Note: Applicants are encouraged to check the website frequently for jurisprudence exam updates. Not only will the exam be updated in the near future, but it will also be available electronically to be taken entirely online. 

Jurisprudence Exam Resources:

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http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=ContentDisposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename %3D%22Jurisprudence+Examination+Overview.pdf%22&blobheadervalue2=application %2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251846112814&ssbinary=tr ue ď ś

Jurisprudence Exam:

http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=ContentDisposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename %3D%22Jurisprudence+Exam+IQT+Registration+User+Guide.pdf %22&blobheadervalue2=application %2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251834181423&ssbinary=tr ue

Mandatory Disclosure Statement According to C.R.S. 12-43-214, a mandatory disclosure of information to clients, has been required by law since July 1, 1988. This disclosure of information is viewed as significantly important in protecting the public from the unauthorized, unqualified, and improper application of psychotherapy. It is one of the few prohibited activities that is also an unlawful act (a class 3 misdemeanor offense). Listed below are the links to the model disclosure statement and the disclosure form checklist in order to assist psychotherapists in meeting this statutory requirement. Additionally, an example of the mandatory disclosure statement is also included in the Appendix section of this manual. All psychotherapists must include a copy of their mandatory disclosure statement with their registration application.

Note: Only those applying to register with DORA as a Registered Psychotherapist are required to submit their disclosure statement with their application. If you are applying for Candidate status, you do not need to include a disclosure statement. ď ś

Mandatory Disclosure Form Checklist/Sample:

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http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=ContentDisposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename %3D%22MH+Model+Disclosure+Statement.pdf%22&blobheadervalue2=application %2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251832452862&ssbinary=tr ue

Education Requirements & Education Equivalency Applicants must have completed a master’s or doctoral program with a major in Counseling or its equivalent in compliance. This means that the applicant obtained a master's or doctoral degree from a program that was approved by the Council for Accreditation for Counseling and Related Educational Programs (CACREP) at the time of graduation, or an equivalency program. Educational equivalency suggests that the applicant received a master's or doctoral degree from a graduate training program that, at the time s/he was enrolled and received her/his degree, fulfilled the Professional Counselor equivalency degree requirements. If this is the case, applicants must provide appropriate documentation from the institution in support of this education such as syllabi, dissertations, certifications, etc. If the applicant is using classes from more than one educational program or institution, s/he must provide separate equivalency sheets for each program. 2014 Colorado Counseling Association


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Applicant requirements and educational equivalency details outlined by the Board of Licensed Professional Counselor Examiners: for Licensure by Endorsement (out-of-state licenses) see Rule 12, p. 11; for Licensure Reinstatement (expired licenses) see Rule 13, p. 14; and for licensure by Examination (new licenses) see Rule 14 p. 15. Colorado State Board - Professional Counselor Rules & Regulations: http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=ContentDisposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename %3D %22Colorado+State+Board+of+Licensed+Professional+Counselor+Examiners+Rules %2C+effective+July+1%2C+2012+.pdf%22&blobheadervalue2=application %2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251832211402&ssbinary=tr ue Additionally, exact details about education equivalency courses and hours are listed in the LPC Application on the three-page Education Equivalency Worksheet.

Supervised Practicum/Internship Requirements In order to complete the final page of the education equivalency section, applicants must have completed a minimum of 700 hours of supervised practicum/internship during their graduate program. The applicant must provide proof of completion and should include a letter of completion written and signed by their practicum/internship supervisor. This letter should be written on either the internship site’s stationary or university stationary. Further details about practicum/internship requirements are listed in the Education Equivalency section of the LPC application.

Exam Approval All applicants must pass the National Counseling Examination. The NCE is provided to assist state boards of examiners in evaluating the knowledge of applicants for licensure or certification. The standardized examination, for use by its member boards, determines if applicants have attained the knowledge considered essential for entry-level professional practice. Therefore, in addition to submitting a completed LPC application, applicants are required to complete and Pass the NCE. Applicants can take the exam at any time within one semester of graduating, or before or after turning in an application to the licensing board. However, an applicant cannot become fully licensed until the exam is passed and results are turned in and verified by the licensing board. This includes the completed application, processing fees, name change documentation, an affidavit of eligibility, and official transcripts from degree2014 Colorado Counseling Association


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granting institutions or education equivalency worksheets. Details regarding each of these requirements are outlined in the application. Your school should have information regarding how to apply and sit for the exam, or exam details are provided below on the (NBCC) National Board of Certified Counselors listed below. Website: http://www.nbcc.org/

Post-Degree and Supervision Requirements In order to apply for permanent licensure as a Licensed Professional Counselor, applicants must complete a significant amount of post-degree experience. The requirements are listed below.

Post-Masters Experience: months

2000 overall clock hours of experience over a minimum of 24

1000 of those hours must be face-to-face direct client contact 1000 of those hours can be indirect for the purpose of diagnosis, assessment, and intervention Supervision:

100 hours over a period of 24 months

70 of those hours must be face-to-face, individual supervision for the remaining hours may be a combination of individual and group supervision

Post-Doctoral-Subject to Individual Doctoral Program Rules & Regulations ď ś Colorado State Board: Professional Counselor Rules & Regulations: http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=ContentDisposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D %22Colorado+State+Board+of+Licensed+Professional+Counselor+Examiners+Rules %2C+effective+July+1%2C+2012+.pdf%22&blobheadervalue2=application %2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1251832211402&ssbinary=true

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The Michael Skolnik Medical Transparency Act of 2010 mandates that specific healthcare professionals complete online healthcare profession profiles prior to renewal, certificate or registration. LPC applicants cannot start this profile until DORA has received your application and enters it into the database. According to the LPC Application, applicants should allow ten (10) days from the date their application was mailed before attempting to set up their profile. In order to set up your profile, go to the Healthcare Professions Profile webpage and click on the Create/Update Healthcare Professions Profile link on the left side of the page. You will then be asked to Log-on. If you have never accessed DORA before, then you will need to create a Login ID and a Password before proceeding to set up your profile. Once you have logged on, follow the prompts to complete your profile. ď ś

Healthcare Professions Profile:

http://cdn.colorado.gov/cs/Satellite?c=Page&childpagename=DORA-Reg %2FDORALayout&cid=1251632406854&pagename=CBONWrapper If you have questions or technical issues regarding your online profile, contact the Healthcare Professions Profiling Program at hppp@dora.state.co.us or (303) 894-5942.

Continuing Professional Development House Bill 09-1086 requires licensees in the list below to participate in Continuing Professional Development (CPD) in between license/certificate renewal periods. Licensees must complete 40 hours of planned Professional Development Activities (PDAs) prior to renewing your license in any odd year. This program was implemented on January 1, 2011. Licensees/certificants have from January 1, 2011 until August 31, 2013 to complete the CPD program. In order to renew, reinstate or reactivate your license or certificate, you must comply with and demonstrate that you have completed the CPD requirements. In order to practice in the State of Colorado, the follow mental health professionals must complete the CPD program: Licensed Social Workers Licensed Clinical Social Workers Licensed Professional Counselors Licensed Marriage and Family Therapists Licensed Addiction Counselors Certified Addiction Counselors (II and III)

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1. Download the Continuing Professional Development Portfolio from the DORA website. 

DORA Continuing Professional Development Webpage:

http://www.dora.state.co.us/mental-health/cc./ You can click on Marriage and Family Therapists under the Continuing Professional Development Resources on the left side of the screen or you can click on the link provided below to upload the CPD Portfolio for Marriage and Family Therapists. 

Marriage and Family Therapist CPD Portfolio:

http://www.dora.state.co.us/mental-health/cc./Portfolio_MFT_6.7.11.pdf It is extremely important to carefully review the portfolio. It provides extensive descriptions of the types of activities that can be used for CPD hours, CPD hour restrictions, how to document Professional Development Activities (PDAs), and what materials need to be submitted to DORA. For instance, no more than 20 hours can be accrued for a single Professional Development Activity (PDA) and those activities cannot be part of your full time job responsibilities. There is also a link to a Continuing Professional Development Workbook for Marriage and Family Therapists that includes Frequently Asked Questions pertaining to the CPD process as well as some assistance with how to develop your learning plan. 

Marriage and Family Therapist CPD Workbook:

http://www.dora.state.co.us/mental-health/cc./Workbook_MFT_6.7.11.pdf 2. Once you have reviewed the CPD Portfolio for MFTs, licensees should create a user account on the online CPD Portal. In order to do this click Create Login ID on the top left side of the screen on the link below. 

DORA Continuing Professional Development Portal Login:

https://www.dora.state.co.us/pls/cproweb/cpro.logon For step-by-step instructions on how to navigate the CPD Portal, follow the instructions in the CPD guide:

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CPD Guide to the Online Portal:

http://www.dora.state.co.us/mental-health/cc./PortalGuide.pdf 3. Once you have created your login ID and password, you will be directed to complete the Professional Practice Survey or Rubric. 4. Next you must draft your personal Learning Plan on the CPD Portal. Below is a link to a sample learning plan that can assist you with developing your own. ď ś

CPD Sample Learning Plan:

http://www.dora.state.co.us/mental-health/cc./Sample2011Learning%20Plan.pdf 5. Once you have set up your learning plan in the online portal, it is time to start implementing your Personal Learning Plan! 6. Make sure that you continue to update your plan online as you accrue your 40 CPD hrs. 7. It is also extremely important to retain documentation of your activities. Whether these are certificates, journals, syllabi or outlines, make sure to keep documentation of your activities. DORA does not require that you submit all of these materials, but occasionally they will ask for verification of your Professional Development Activities (PDAs). 8. Once you have completed your CPD requirements, you can renew your license from July-August 2013!

CPD Exemptions for Dual License and/or Certified Individuals Board Rule 19(h)(2) and Director Rule 3(h)(2) allows the Board/Director to grant an exemption from participation in the CPD program for a single license/certificate if the licensee has already complied with the program for a different license/certificate subject to the same program. Dually licensed/certified individuals must participate in a reflective assessment tool and maintain a learning plan for each license and/or certificate. However, they may double count their professional development activities by logging the same activities and hours on each learning plan.

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policy applies only to the following license types in the State of Colorado: CACII, CACIII, LAC, LMFT, LPC, LSW, and LCSW.  DORA Mental Health Programs Policy relating to CPD Exemptions: http://www.dora.state.co.us/mental-health/policies/20-1.pdf

Additional CPD Information and Resources: 

Continuing Professional Development FAQs:

http://www.dora.state.co.us/mental-health/cc/CPDProgramFAQs.pdf 

DORA Webinar on Continuing Professional Development:

www.dora.state.co.us/Registrations/LEGFAQs/MHWebinar.pptx  Mental Health Legislative Outreach Webinar, CPD Question & Answer Session: http://www.dora.state.co.us/mental-health/cc/WebinarQuestionsLog.pdf

Mental Health Professional Licensing Requirements

Licensure Type

Experience Hours: all licenses only allow 40 hours per week

Licensure Exam

LCSWLicensed Clinical Social Worker Master’s degree in Social Work3360 in Social Work related job signed-off by LCSW

LSWLicensed Social Worker

Yes – Can be taken

Yes- Can be taken

None

LMFTLicensed Marriage & Family Therapist 2000 experience hours, 1500 must be faceto-face therapy hours, with remaining 500 hours being case management. At least 1000 face-to-face hours must be relational Yes – Taken when all hour

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LPCLicensed Professional Counselor

LACLicensed Addiction Counselor

Registered Psychotherapist

Licensed Psychologis t

2000 experience hours (DORA is not clear if these need to be face-toface)

5000 (as part of CAC III) at an approved treatment facility ADAD or CDBH

None

1500 experience hours of post-degree internship (DORA is not clear on amount of face-to-face hours needed)

Yes – Can be taken before

Yes – Master’s

N/A

Yes


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Required

immediately after graduation

immediately after graduation

& supervision requirements are met or nearly met

graduation from an accredited Master’s/PhD program

Supervision Required

Yes – minimum 100 hours over a 2 year period. Up to 50 hours can be group supervision of up to 4 supervisees at one time

No

Yes – minimum of 100 hours over a 2-year period. Up to 50 hours can be group supervision of up to 4 supervisees at one time

Yes – minimum of 100 hours over a 2-year period. Up to 50 hours can be group supervision of up to 4 supervisees at one time

Time Period for Experience & Supervision

Minimum 24 months post graduation

N/A – done immediately after graduation from accredited CSWE program

Minimum 24 months post graduation

Minimum 24 months post graduation

Licensure Type

LCSWLicensed Clinical Social Worker LCSW

LSWLicensed Social Worker

LMFTLicensed Marriage & Family Therapist AAMFT Approved Supervisor or DORA approved professional

LPCLicensed Professional Counselor

Masters or Doctorate degree in Social Work from CSWE accredited program

Masters or Doctorate degree in Social Work from CSWE accredited program

Masters or Doctorate degree in Marriage & Family Therapy or equivalent from COMFTE accredited

Masters degree or higher in Counseling or equivalent

Who Can Supervise?

Education Required

N/A

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LPC, LCSW, LMFT, Licensed Psychologist, Licensed Psychiatrist

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No

Yes – minimum of 75 hours. Up to 25 hours can be group supervision

N/A

Minimum 12 months post graduations

Registered Psychotherapist

Licensed Psychologis t

N/A

Licensed Psychologist, Licensed Psychiatrist (up to 25% of hrs)

High School Diploma or GED

PsyD or PhD in a Psychology field from an APA accredited program


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Yes

Yes

17 program Yes

Yes

Yes

No

No

Closing Remarks The Colorado Association of Marriage and Family Therapy created this manual to assist members with the licensing process here in Colorado. For further assistance on navigating the Marriage and Family Therapist licensing process, contact your CAMFT Member-at-Large or Student Representative. 

Colorado Association for Marriage and Family Therapy Website:

http://www.coamft.org/ohana/website/index.cfm?p=95575656523  Colorado Association for Marriage and Family Therapy Board of Directors and Staff: http://www.coamft.org/ohana/website/?p=31027502   

Email: camftco@hotmail.com  Phone: 303-792-3966

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Appendix SB11-187 The exact language of the SB11-187 bill specific to MFTs and candidate status is as follows:

Note: The qualifications required to be a candidate are listed in all capital letters, which means it is a completely new addition to the statute, and not a change. 12-43-504. Qualifications - examination - licensure and registration. (1) The board shall issue a license as a marriage and family therapist to each applicant who files an application upon IN a form and in such manner as REQUIRED BY the board, prescribes, accompanied by a SUBMITS THE fee as is required by THE BOARD PURSUANT TO section 2014 Colorado Counseling Association


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12-43-204, and who furnishes evidence satisfactory to the board that he or she: (b) Is not in violation of any of the provisions PROVISION of this article or the ANY rule and regulations adopted under this article; (e) Has demonstrated DEMONSTRATES professional competence by passing an examination in marriage and family therapy prescribed by the board and a written, mail-in jurisprudence examination administered by the department of regulatory agencies DIVISION. (4) The board or its designated representatives shall administer and score DETERMINE THE PASS OR FAIL STATUS OF the examination and shall take any actions necessary to ensure impartiality. The BOARD SHALL DETERMINE THE passing score for the examination shall be determined by the board based upon a level of minimum competency to engage in marriage and family therapy practice. (5) (a) THE BOARD SHALL REGISTER AS A MARRIAGE AND FAMILY THERAPIST CANDIDATE A PERSON WHO: (I) FILES AN APPLICATION FOR REGISTRATION, ACCOMPANIED BY THE FEE AS REQUIRED BY SECTION 12-43-204; (II) SUBMITS EVIDENCE SATISFACTORY TO THE BOARD THAT HE OR SHE MEETS THE REQUIREMENTS OF PARAGRAPHS (a), (b), AND (c) OF SUBSECTION (1) OF THIS SECTION; AND (III) HAS NOT BEEN PREVIOUSLY REGISTERED AS A MARRIAGE AND FAMILY THERAPIST CANDIDATE BY THE BOARD. (b) A MARRIAGE AND FAMILY THERAPIST CANDIDATE WHO REGISTERS WITH THE BOARD PURSUANT TO THIS SUBSECTION (5) IS UNDER THE JURISDICTION OF THE BOARD AND IS NOT REQUIRED TO REGISTER WITH THE DATABASE OF REGISTERED PSYCHOTHERAPISTS PURSUANT TO SECTION 12-43-702.5. (c) IF A CANDIDATE DOES NOT MEET THE REQUIREMENTS OF PARAGRAPHS (d) AND (e) OF SUBSECTION (1) OF THIS SECTION WITHIN FOUR YEARS AFTER INITIAL REGISTRATION, THE CANDIDATE'S REGISTRATION EXPIRES AND IS NOT RENEWABLE, UNLESS THE BOARD, IN ITS DISCRETION, GRANTS THE CANDIDATE AN EXTENSION. A PERSON WHOSE MARRIAGE AND FAMILY THERAPIST CANDIDATE REGISTRATION EXPIRES IS NOT PRECLUDED 2014 Colorado Counseling Association


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FROM APPLYING TO THIS BOARD OR TO ANY OTHER BOARD FOR LICENSURE OR REGISTRATION IN A MENTAL HEALTH PROFESSION FOR WHICH THE PERSON IS QUALIFIED.

Mandatory Disclosure Statement Sample

DISCLOSURE STATEMENT 1. [Name, Business address, Business telephone number] 2. [List any degrees, credentials, certifications, registrations, and licenses held or obtained, including the education, experience, and training you were required to satisfy in order to obtain the degree, credentials, certifications, registrations, or 2014 Colorado Counseling Association


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licenses.] 3. The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Division of Registrations. The Board of _____________ __________________ Examiners can be reached at 1560 Broadway, Suite 1350, Denver, Colorado 80202, (303) 894-7800. As to the regulatory requirements applicable to mental health professionals: •

Registered psychotherapist is a psychotherapist listed in the State's database and is authorized by law to practice psychotherapy in Colorado but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain a registration from the state.

Certified Addiction Counselor I (CAC I) must be a high school graduate, complete required training hours and 1,000 hours of supervised experience.

Certified Addiction Counselor II (CAC II) must complete additional required training hours and 2,000 hours of supervised experience.

Certified Addiction Counselor III (CAC III) must have a bachelors degree in behavioral health, complete additional required training hours and 2,000 hours of supervised experience.

Licensed Addiction Counselor must have a clinical masters degree and meet the CAC III requirements.

Licensed Social Worker must hold a masters degree in social work.

Psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure.

Licensed Clinical Social Worker, a Licensed Marriage and Family Therapist, and a Licensed Professional Counselor must hold a masters degree in their profession and have two years of post-masters supervision.

A Licensed Psychologist must hold a doctorate degree in psychology and have one year of post-doctoral supervision. 4. You are entitled to receive information from your therapist about the methods of therapy, the techniques used, the duration of your therapy (if known), and the fee structure. You can seek a second opinion from another therapist or terminate therapy at any time. 5. In a professional relationship, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies the licensee, registrant or certificate holder. 6. Generally speaking, the information provided by 2014 Colorado Counseling Association


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and to the client during therapy sessions is legally confidential and cannot be released without the client’s consent. There are exceptions to this confidentiality, some of which are listed in section 12-43218 of the Colorado Revised Statutes, [If your practice is covered by HIPAA add this statement: “and the HIPAA Notice of Privacy Rights you were provided”] as well as other exceptions in Colorado and Federal law. For example, mental health professionals are required to report suspected child abuse to authorities. If a legal exception arises during therapy, if feasible, you will be informed accordingly. The Mental Health Practice Act (CRS 12-43-101, et seq.) is available at: http://www.dora.state.co.us/mental- health/Statute.pdf. I have read the preceding information, it has also been provided verbally, and I understand my rights as a client or as the client’s responsible party. _______________________________________________ Print Client’s name _____________________________________________ ________________________ Client’s or Responsible Party’s Signature

Date

If signed by Responsible Party, please state relationship to client and authority to consent: _________________________________________________________________ _______

2014 Colorado Counseling Association

Colorado Counseling Association Licensing Guide  

Resource Manual from Colorado Counseling Association Guide to Becoming an LPC in Colorado

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