Social Work

License Requirements

Licensed Clinical Social Worker "R" Psychotherapy Privilege

Introduction

What follows is information and the application forms for the psychotherapy privilege available to Licensed Clinical Social Workers (LCSWs) licensed in New York State. This information is based on applicable law and regulation and Department administrative policy and reflects the many inquiries received by the Office of the Professions regarding this credential. The format is designed to provide convenient and practical answers to the typical questions posed by applicants, their supervisors, employers, and consumers of social work psychotherapy services.

New York State Insurance Law authorizes a privilege to the LCSW license. This privilege requires the LCSW license and three years of supervised experience in psychotherapy obtained after receiving the LCSW. A separate application and fee are required for this privilege.

Definition of Terms

Licensed Clinical Social Worker: The practice of clinical social work encompasses the scope of practice of licensed master social work and, in addition, includes the diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities and of the psychosocial aspects of illness, injury, disability and impairment undertaken within a psychosocial framework; administration and interpretation of tests and measures of psychosocial functioning; development and implementation of appropriate assessment-based treatment plans; and the provision of crisis oriented psychotherapy and brief, short-term and long-term psychotherapy and psychotherapeutic treatment to individuals, couples, families and groups, habilitation, psychoanalysis and behavior therapy; all undertaken for the purpose of preventing, assessing, treating, ameliorating and resolving psychosocial dysfunction with the goal of maintaining and enhancing the mental, emotional, behavioral and social functioning and well-being of individuals, couples, families, small groups, organizations, communities and society.

Diagnosis: Diagnosis in the context of licensed clinical social work practice is the process of distinguishing, beyond general social work assessment, between similar mental, emotional, behavioral, developmental and addictive disorders, impairments and disabilities within a psychosocial framework on the basis of their similar and unique characteristics consistent with accepted classification systems.

Psychotherapy: Psychotherapy in the content of licensed clinical social work practice is the use of verbal methods in interpersonal relationships with the intent of assisting a person or persons to modify attitudes and behavior which are intellectually, socially, or emotionally maladaptive.

Assessment-based treatment plans: Development of assessment-based treatment plans in the context of licensed clinical social work practice refers to the development of an integrated plan of prioritized interventions, that is based on the diagnosis and psychosocial assessment of the client, to address mental, emotional, behavioral, developmental and addictive disorders, impairments and disabilities, reactions to illnesses, injuries, disabilities and impairments, and social problems.

LCSW Reimbursement: An LCSW is recognized in New York State as a reimbursable psychotherapist. The insurance law has been called "make available legislation," because an insurance company is required to provide reimbursement for social work services only at the request of the insured group (which is usually represented by a labor union). The LCSW's clients may receive reimbursement for mental health services under the regulation and limitations of the insurance law. Information on LCSWs is available here, listed by the name of the Licensed Clinical Social Worker.

Psychotherapy "R" Privilege: An LCSW who fulfills the requirements of the insurance law for supervised experience providing psychotherapy, is recognized in New York State as a reimbursable psychotherapist. The "R" privilege requires insurance carriers to provide reimbursement for psychotherapy services whenever a health insurance contract includes reimbursement of qualified psychologists and psychiatrists. The "R" statute has been called "mandatory legislation." This designation is added to one's license number (e.g., LCSW R123456) and the practitioner's clients must receive reimbursement for mental health services under the regulation and limitations of the insurance law. Information on LCSWs who have the "R" privilege is available here, listed by name of Licensed Clinical Social Worker.

Exclusions to Coverage Authorized by the Pysychotherapy Privilege

Licensed Clinical Social Workers in New York State who have received the psychotherapy privilege are recognized providers of psychotherapy services under New York State Insurance Law, Sections 3221 and 4303, EXCEPT under the following conditions:

1. The benefits are provided under an individual contract with an insurance company, not a group health plan.
2. The insurance plan is part of a managed care organization ( HMO, IPA, PPO, etc.), which may not recognize social workers.
3. The employer is self-insured, which means the employer has funded the benefit program rather than hiring an insurance company to take that financial risk. (Note: Some employers hire the insurance company only to administer the fund and are still regarded as self-insured.)
4. The contract between the employer and the insurance company was delivered out-of-state. Regardless of where the insurance company is located, when it negotiates a contract to cover the employees of any employer whose home office is not in New York State, the contract is delivered to that employer at the out-of-state address. Even if some employees work within New York State at a branch office or company plant, the Insurance Law of New York State has no jurisdiction.

All inquiries regarding the above conditions should be verified with the insurance company or employer. Further clarification cannot be provided by the State Board for Social Work. Complaints should be directed to the Consumer Services Bureau of the New York State Insurance Department at 1-800-342-3736.

General Requirements

To secure a licensed clinical social worker psychotherapy "R" privilege in New York State you must:

• be a licensed and currently registered New York State licensed clinical social worker;
• meet professional work experience for the privilege; and
• file an application for the privilege and the other forms indicated, along with the appropriate fee, to the Office of the Professions at the address specified on each form.

The specific requirements for the licensed clinical social worker psychotherapy "R" privilege are contained in Sections 3221(1)(4)(a) and (d) and Section 4303 (i) and (n) of New York's Insurance Law and Part 74.5 of the Regulations of the Commissioner of Education. Copies of the relevant sections of NYS Law and the Commissioner's Regulations are available upon request by e-mailing opforms@mail.nysed.gov or by calling 518-474-3817 ext. 320.

Fees

The fee for the licensed clinical social worker psychotherapy "R" privilege is $85.

Fees are subject to change. The fee due is the one in law when your application is received (unless fees are increased retroactively). You will be billed for the difference if fees have been increased.

• Do not send cash.
• Make your personal check or money order payable to the New York State Education Department. Your cancelled check is your receipt.
• Mail your application and fee to:

  NYS Education Department, Office of the Professions
  P.O. Box 22063
  Albany, NY 12201.

Requirements for the Privilege

To qualify for the licensed clinical social worker psychotherapy "R" privilege, you must be a licensed clinical social worker (LCSW).

You must have an additional 36 months of full-time, or the part-time equivalent, of LCSW experience in psychotherapy under the supervision of an LCSW, licensed psychologist or psychiatrist. The qualifications for the supervisor are listed in Appendix A

You and your supervisor must submit documentation using Form 4SWPR and the Psychotherapy Log that verifies the experience which meets the following conditions:

1. Only the practice of psychotherapy, as defined in the Education Law, is acceptable for the privilege.
2. The post-LCSW experience must be at least 36 subsequent calendar months of psychotherapy experience. You should provide no less than 400 client contact hours of psychotherapy in any 12-month period.
3. A total of 36 months and 2,400 hours of direct client contact beyond the LCSW are required. Every subsequent month and client contact hour will be counted.
4. The 36 months and 2,400 hours of direct client contact in psychotherapy may not be shortened by providing more than 20 client contact hours per week. Part-time experience will increase the time to complete the required hours.
5. A client contact hour is at least 45 minutes of psychotherapy with individuals, families or groups.
6. The supervised experience may be in a facility or non-facility setting, acceptable to the Department, or a combination of facility and non-facility practice.
7. All experience must be supervised by an LCSW, licensed psychologist, or psychiatrist as defined below;
8. Supervision for the licensed clinical social worker psychotherapy "R" privilege application must consist of individual supervision or consultation at least two hours per month which may be provided in-person, or by telephone, video conference or internet. During this period, supervision of at least four hours per month may be provided through group supervision or consultation, peer supervision or case seminars from a Regents chartered psychotherapy program.
9. You must submit two case summaries acceptable to the Department when any portion of the submitted experience was under peer supervision.

Requirements for Supervisors: Psychiatrists, Psychologists and Social Workers

Supervision of applicants for the licensed clinical social worker psychotherapy "R" privilege must be provided by either a:

1. Physician who, while supervising the applicant, was licensed by the state in which supervision occurred and had appropriate training and experience in psychiatry as determined by the Department, such as board certification or a psychiatric residency; or
2. Psychologist who, while supervising the applicant, was licensed as a psychologist in the state where supervision occurred and was qualified in psychotherapy as determined by the Department or is a graduate of an American Psychological Association approved program in psychology or an equivalent program as determined by the Department; or
3. A New York State LCSW or the equivalent who was licensed and registered while supervising the applicant, as determined by the Department.

The Department will review the qualifications of a prospective supervisor who submits a completed Form 4Q. Approval of the supervisor's qualifications does not guarantee approval of the applicant's experience which must be completed in accordance with Part 74.5 of the Commissioner's Regulations.

Types of Supervision

1. Individual, Facility-based: The facility assigns an appropriate qualified employee to supervise the applicant in one-to-one sessions. The supervisor should have more experience than the applicant, superior expertise or training in a relevant practice area, or both. Supervision must be at least two hours per month.
2. Individual, Consultant: The applicant (or facility) hires an appropriately qualified individual to supervise the applicant's clinical work in one-to-one sessions. If hired to supervise facility-based work, an appropriate agreement or contract should be reached between the facility, the consultant, and the applicant. If hired to supervise a private practice, the supervisor should have experience (a minimum of three years) or documentable clinical expertise superior to that of the applicant.
3. Individual, Peer: The applicant hires an individual of similar experience and/or expertise to supervise the applicant's private practice in one-to-one sessions. Note: This type of supervision requires applicants to submit case summaries.
4. Group, Facility-based: The facility schedules regular reviews of cases and/or skill and knowledge development sessions under the supervision of an appropriately qualified employee. Supervision must be at least four hours per month.
5. Group, Non facility-based: The applicant joins a group of private practitioners which hires a qualified supervisor. Supervision must be at least four hours per month.
6. Case Seminar: The applicant attends a formally structured program offered at a Regents chartered psychotherapy institute or other accredited educational institution for the supervision of cases and enhancement of skills and knowledge. The applicant must complete at least four hours per month of case seminars.

Informed Consent

It is the responsibility of the licensed clinical social worker (LCSW) to inform the client that the LCSW is supervised in the practice of psychotherapy. The client should understand that the LCSW is sharing with a qualified supervisor information about the diagnosis and treatment of each client and that the supervisor provides the LCSW with oversight and guidance in diagnosing and treating clients. The client should be provided with contact information for the supervisor to share any concerns or questions about the applicant's practice.

If an LCSW is employed in an agency or other setting and on-site supervision is not available, it is the responsibility of the LCSW, employer and supervisor to make arrangements for supervision. In addition to informed consent for the client, the arrangements should include access by the supervisor to client information and records to ensure appropriate supervision of the LCSW seeking the psychotherapy privilege.

Case Summaries

Overall Framework

Case summaries are required to demonstrate a basic level of competence for doing psychotherapy, which includes both diagnostic and treatment skills as demonstrated in the written material. The case summary informs the State Board about the quality of your supervised experience.

When the State Board has approved the experience completed under peer supervision, you will be provided with information on how to meet the requirement for submission of two case summaries. In general, the case summaries should present:

1. Satisfactory evidence of your ability to recognize, understand the meaning of, and treat interpersonal and/or intrapsychic conflicts.
2. Ability to clearly differentiate the patient's verbalization and conceptualization of the problem from your own verbalization and conceptualization.
3. Continuity within the case development with one category flowing from the other, especially showing a treatment plan flowing from diagnostic understanding which, in-turn, flows from relevant background material.
4. While one area of case presentation may be stronger than another, each case must be evaluated and scored area by area, the total score of which determines pass or fail.
5. Although you may practice from a variety of theoretical orientations, all presentations should demonstrate basic knowledge of the particular orientation as well as internal consistency and therapeutic ability. Each case will be reviewed by Board Members with appropriate expertise in the treatment modalities presented.
6. Your case summary should include a minimum of four sessions to ensure adequate time to demonstrate the requisite diagnostic and treatment skills. There should be sufficient evidence of treatment planning and implementation appropriate to the diagnosis whether four sessions or forty sessions.
7. Selection of cases should lend itself to fulfilling the requirement of this exercise; e.g. complicated cases with numerous factors affecting the client are more difficult to evaluate and score than a case with more straightforward dynamics.

Scoring

1. Case summaries will not be reviewed until all required experience has been approved.
2. Each case summary is reviewed and scored by members of the State Board for Social Work who have competency in providing and/or supervising the provision of psychotherapy.
3. Each element on the Case Summary Score Sheet will receive points, from zero to the assigned values. Partial credit may be awarded depending on how that element was addressed in the case summary.
4. A passing score is 75 points or higher.
5. A failed case summary may be revised and resubmitted one time only.
6. Your application remains "open" until all requirements have been met or you withdraw the application or after (5) consecutive years of inactivity.
7. Credit for a case summary that received a passing score is retained until a second case summary receives a passing score or you withdraw the application.
8. Feedback on failed case summaries is made available to you by providing the score sheet and point values awarded for that case summary.

Forms

Form 1SWPR - Application for Licensed Clinical Social Worker Psychotherapy "R" Privilege (swpr1.pdf; 17K; 2 pages)

All applicants for the licensed clinical social worker psychotherapy "R" privilege must complete this form and submit it with the $85 application fee directly to the Office of the Professions at the address at the end of Form 1SWPR. Make checks payable to the New York State Education Department. NOTE: Your cancelled check is your receipt.

You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the application will delay its review. Original signatures are required, therefore, we cannot accept faxes or copies. Your signature on Form 1SWPR must be notarized by a Notary Public.

Appendix A - Requirements for Supervised Experience for Licensed Clinical Social Worker Psychotherapy "R" Privilege - (HTML | PDF)

Send this document to the licensed professional(s) who supervised your experience or will supervise your practice along with the form you are asking them to complete.

Form 4SWPR - Certification of Experience for the Licensed Clinical Social Worker Psychotherapy "R" Privilege (swpr4.pdf; 22K; 4 pages)

This form must be submitted directly by your supervisor after you have completed the supervised experience. If you have completed the experience and your supervisor is not available, you must provide the supervisor's qualifications and your experience may be verified by a licensed colleague. The Office of the Professions will not accept this form if submitted by the applicant.

Section I: Complete this section of the form before sending the entire form and a copy of Appendix A to your supervisor to complete section II. Note: Only experience in psychotherapy is acceptable for the privilege. Be sure to sign and date item 7.

Section II: The supervisor verifying your psychotherapy experience must complete this section and provide information about his/her qualifications. The supervisor, or if the supervisor is not available a licensed colleague, must complete and sign the attestation, have the signature notarized by a Notary Public, and return the form directly to the Office of the Professions at the address at the end of the form. A copy of the supervisor's license or registration should be attached to the form.

Psychotherapy Log: Use the psychotherapy log to document your hours of practice and supervision. This log must be completed by you and your supervisor for all experience completed after October 1, 2007. All pages of the log must be submitted along with form 4SWPR.

A separate Form 4SWPR must be submitted for each supervised experience you list on the Application for Licensed Clinical Social Worker Psychotherapy "R" Privilege Experience Record (Form 1SWPR).

Please photocopy the form as needed but all forms submitted to the Department must bear original signatures.

Form 4Q - Licensed Psychologist Qualified to Supervise Psychotherapy (if applicable) (swpr4q.pdf; 20K; 3 pages)

This form must be submitted directly by your supervisor. The Office of the Professions will not accept this form if submitted by the applicant.

This form may be submitted if your supervisor has not already been approved by the State Education Department to supervise the provision of psychotherapy services by an LCSW. Approval of the supervisor does not guarantee approval of the applicant's experience which must be completed in accordance with the requirements in the Commissioner's Regulations.

Section I: Complete this section before giving the entire form and a copy of Appendix A to your prospective supervisor.

Section II: Your supervisor must complete this section, sign the attestation, have the signature notarized by a Notary Public, and return both pages of this form directly to the Office of the Professions at the address at the end of the form.

Please photocopy the form as needed but all forms submitted must bear original signatures and be notarized by a Notary Public.

Address/Name Change Form - Optional (anchange.pdf; 16K; 2 pages)

You are required to notify us within 30 days of any name or address changes. Please read the instructions and complete the appropriate sections of this form.