Mental Health Practitioners

Creative Arts Therapy Case Narrative Examination

Instructions For Completion Of Case Narratives To Meet The Examination Requirement For Licensure In New York State

In addition to meeting requirements for the education and experience for licensure as a creative arts therapist in New York State, you must also pass an examination acceptable to the State Board for Mental Health Practitioners. The State Board has determined that two case narratives that describe the assessment and treatment of separate clients will allow you to demonstrate a basic level of competence in applying the knowledge and skills necessary to practice creative arts therapy in New York State. You will be able to select your own cases in advance, but you will write the case narratives in a supervised, secure test center. Each narrative will be reviewed and scored by two members of the State Board or its designees to determine the thoroughness and appropriateness of your interactions with and your therapeutic approach to the treatment of a client.

Approval for the Examination

To be approved for the examination, you must submit an Application for Licensure (Form 1), the licensure and first registration fee of $345, and a Certification of Professional Education (Form 2) verifying that you have a master's or higher degree from a program registered by the Department, or the equivalent to the New York State Education Department. Once it is determined that your education is acceptable, you will receive a letter with instructions on how to register for the examination. It is your responsibility to register with the examination administrator, pay the appropriate fees, and comply with the examination administrator's policies.

When you register with the examination administrator, you will be asked to schedule two testing appointments at a test center. During each three-hour appointment, you will complete one of the case narratives that is required to meet the examination requirement. You may choose to schedule these appointments on the same day, consecutive days, or different days, depending on your personal preference. You will not meet the examination requirement for licensure until you have successfully completed two case narratives.

The examination administrator for the creative arts therapy case narratives is CASTLE Worldwide, Inc. For information on the application process and to acquire the needed forms, you may contact CASTLE Worldwide, Inc. at:

CASTLE Worldwide, Inc.
Attn: NY Exams
P.O. Box 570
Morrisville, NC 27560
Phone: 800-655-4845 or 919-572-6880
E-mail: info@castleworldwide.com
Web: www.castleworldwide.com/nysed/

The Examination

You may not bring notes, case files, or any other materials into the examination site. Prior to the examination, you should have selected a case of sufficient duration and depth to allow you to complete the eight required examination sections. Select a case that involves the treatment of an individual (rather than a couple, family, or group), and that reflects standard theoretical orientations, rather than experimental or eclectic approaches to treatment.

Your case narrative should provide sufficient evidence of treatment planning and implementation appropriate to the patient, regardless of the number of sessions.

The narrative should clearly state your theoretical orientation. The reviewers will evaluate the narrative as to whether your assessment and treatment of the patient is appropriate to that theoretical orientation.

Your case narrative must be organized according to the format of the scoring sheet used by the reviewers. Following this format increases the likelihood that you address each area in your case narrative and receive maximum credit for your narrative. Although the use of titles can suggest that the case narrative is a collection of discrete subjects, the acceptable narrative will reflect the relationship between areas (e.g., presenting problem, assessment, and treatment) in the practice of creative arts therapy. Any narrative that is not in compliance with the required computerized format will not be scored and the candidate will be notified to that effect.

Format for the Narrative

Your case narrative must demonstrate the relationships among: the presenting problems, the background material, formulation of case dynamics, an assessment statement, the treatment process, application of creative arts theory appropriate to the case and the qualifications of the applicant, the treatment outcomes, and supervisory issues. You must write the case narrative in the order and format provided on the score sheet directly on the computer. You will have three hours to write, review, and complete the narrative. When you are finished, it will be submitted electronically to the State Board for Mental Health Practitioners for scoring.

Do not include your name or any other identifying information in the case narrative. Do not use actual names of clients, supervisors or agencies; use fictitious names or initials.

Scoring the Case Narrative

Each case narrative will be reviewed and scored by two licensed professionals selected by the Department who are competent in the practice of creative arts therapy. The Department will make every effort to assign the scoring of a case narrative to a licensed creative arts therapist with the same theoretical orientation as the applicant.

The reviewer provides a score for each of the sections on the scoring sheet; these are added to produce a total score for the case narrative. A reviewer may assign zero credit, partial credit or full credit for each item on the score sheet. A total score of 75 or higher from each reviewer is required for a case narrative to be acceptable. The criteria to be used by the reviewer is detailed on the next three pages.

If your case narrative is acceptable, you will be notified that it has met the requirement for one of the two case narratives necessary for licensure.

If a case narrative receives a failing score, the applicant will receive the reviewers' score sheets with point values assigned to the narrative. (Raters may also have written comments about narrative deficiencies in the "comments" area under each scoring section.) An applicant may choose to revise the case narrative to improve scores in the deficient areas, in which case the applicant must schedule a session with the test center; there is no additional charge for revision. A failing case narrative may only be revised one time. As the applicant may not bring materials into the test room, the applicant will be provided with a copy of the rating sheets at the test center so that s/he may again see how the narrative was rated. If an applicant wishes to submit a new case narrative, (s)he must contact the test center to schedule a session and pay the required examination fee for a single case narrative.

An applicant is limited to submitting and revising two case narratives per calendar year.

Credit for a passing score on the narrative is retained until the applicant meets the requirements for licensure or the applicant withdraws the application or after five consecutive years of inactivity.

Criteria For Rating The Case Narrative

For candidate use in organizing and writing the case narrative to satisfy the examination requirement for licensure as a creative arts therapist.

The passing score is 75. The point value of each numbered criterion in the sections below appears in parentheses at the end of each criterion. Structure your case narrative exactly as the sections appear below in order.

Section I: Identifying Data (5 points)

In this section, the applicant should:

1. Demonstrate general understanding of what constitutes identifying data for this client. (1)
2. Adequately describe the client including description of characteristics germane to the practice of the applicant's therapy. (1)
3. Clearly describe the nature and setting of his/her contact with this client. (1)
4. Clarify the length and frequency of contact with this client. (1)
5. Present the material with clarity, relevance and acceptable use of language. (1)

Section I maximum score = 5

Section II: Presenting Problem (10 points)

In this section, the applicant should:

1. Demonstrate general understanding of what constitutes a presenting problem. (2)
2. Adequately describe the presenting problem from the client's perception. (2)
3. Adequately describe the presenting problem from his/her own perception, including reference to the perspective of his/her specific form of therapy. (3)
4. Differentiate between his/her perceptions and those of the client. (2)
5. Present the material with clarity, relevance and acceptable use of language. (1)

Section II maximum score = 10

Section III: Background Material (10 points)

In this section, the applicant should:

1. Demonstrate general understanding of what constitutes background material. (2)
2. Present background material relevant to the presenting problem. (2)
3. Address the major areas of the client's life and situation. (2)
4. Present sufficient background material to formulate a diagnosis. (3)
5. Present the material with clarity, relevance and acceptable use of language. (1)

Section III maximum score = 10

Section IV: Diagnostic Formulation (20 points)

In this section, the applicant should:

1. Demonstrate general understanding of what constitutes a diagnostic formulation. (2)
2. Incorporate the presenting problem in the diagnostic formulation. (2)
3. Incorporate background material in the diagnostic formulation. (2)
4. Address intrapsychic factors satisfactorily. (2)
5. Address interpersonal factors satisfactorily. (2)
6. Address environmental factors satisfactorily. (2)
7. Address ethnic/racial factors satisfactorily. (2)
8. Address physiological factors satisfactorily. (2)
9. Characterize patient's performance in therapy as it relates to diagnostic formulation. (2)
10. Demonstrate an acceptable level of competence formulating a diagnosis. (1)
11. Present the material with clarity, relevance and acceptable use of language. (1)

Section IV maximum score = 20

Section V: Diagnostic Category (15 points)

In this section, the applicant should:

1. Demonstrate general understanding of the use of DSM codes. (2)
2. Address Axis I diagnosis and present cogent rationale for the selection. (3)
3. Address Axis II diagnosis and present cogent rationale for the selection. (3)
4. Address Axis III diagnosis and present cogent rationale for the selection. (3)
5. Formulate a diagnosis consistent with the support material and appropriate to this case. (3)
6. Present the material with clarity, relevance and acceptable use of language. (1)

Section V maximum score = 15

Section VI: Treatment Process (20 points)

In this section, the applicant should:

1. Demonstrate general understanding of intervention from own therapy's theoretical basis. (1)
2. Adequately present a treatment plan including clear goals from own therapy's perspective. (2)
3. Adequately present a treatment plan including clear goals from psychodynamic perspective. (2)
4. Present the rationale for selection of appropriate therapeutic intervention(s), given diagnosis. (2)
5. Present essential interaction with the client. (3)
6. Adequately demonstrate observation skills and skill particular to this therapy. (3)
7. Adequately describe therapeutic effects on relevant factors in Section IV. (2)
8. Describe the therapeutic process from the client's perspective. (2)
9. Provide rationale for the continuation or termination of therapy. (2)
10. Present the material with clarity, relevance and acceptable use of language. (1)

Section VI maximum score = 20

Section VII: Treatment Outcomes (10 points)

In this section, the applicant should:

1. Demonstrate general understanding of what constitutes treatment outcomes. (1)
2. Describe changes in patient's performance of therapeutic tasks. (2)
3. Describe behavioral outcomes. (2)
4. Describe the patient's intellectual understanding. (2)
5. Describe the patient's integration of behavior and intellect. (2)
6. Present the material with clarity, relevance and acceptable use of language. (1)

Section VII maximum score = 10

Section VIII: Supervisory Issues (10 points)

In this section, the applicant should:

1. Demonstrate general understanding of the use of clinical supervision. (2)
2. Clearly identify issues pertinent to this case. (2)
3. Convey the supervisor's guidance in handling those issues. (2)
4. Convey how supervision assisted in acquiring or refining knowledge/skills. (3)
5. Present the material with clarity, relevance and acceptable use of language. (1)

Section VIII maximum score = 10

Final Score

The pass point is 75. A score of 75 or higher is a passing score and shall be considered satisfaction of the examination requirement for licensure as a creative arts therapist in New York State.