BEHAVIORAL SCIENTISTS

chapter 31	licensure of marital and family therapists and
mental health counselors	
chapter 32	continuing education for marital and family
therapists and mental health counselors	
chapter 33	discipline for marital and family therapists and mental health counselors	
CHAPTER 31
LICENSURE OF MARITAL AND FAMILY THERAPISTS
AND MENTAL HEALTH COUNSELORS
[Prior to 1/30/02, see 645—Chapter 30]
645—31.1(154D) Definitions. For purposes of these rules, the following definitions shall apply:
“ACA” means the American Counseling Association.
“Active license” means a license that is current and has not expired.
“AMFTRB” means the Association of Marital and Family Therapy Regulatory Boards.
“Board” means the board of behavioral science.
“CCE” means the Center for Credentialing and Education, Inc.
“Course” means three graduate semester credit hours.
“CRCC” means the Commission on Rehabilitation Counselor Certification.
“Department” means the department of public health.
“Grace period” means the 30-day period following expiration of a license when the license is still considered to be active. In order to renew a license during the grace period, a licensee is required to pay a late fee.
“Inactive license” means a license that has expired because it was not renewed by the end of the grace period. The category of “inactive license” may include licenses formerly known as lapsed, inactive, delinquent, closed, or retired.
“Licensee” means any person licensed to practice as a marital and family therapist or mental health counselor in the state of Iowa.
“License expiration date” means September 30 of even-numbered years.
“Licensure by endorsement” means the issuance of an Iowa license to practice mental health counseling or marital and family therapy to an applicant who is or has been licensed in another state.
“Mandatory training” means training on identifying and reporting child abuse or dependent adult abuse required of marital and family therapists and mental health counselors who are mandatory reporters. The full requirements on mandatory reporting of child abuse and the training requirements are found in Iowa Code section 232.69. The full requirements on mandatory reporting of dependent adult abuse and the training requirements are found in Iowa Code section 235B.16.
“NBCC” means the National Board for Certified Counselors.
“Reactivate” or “reactivation” means the process as outlined in rule 31.16(17A,147,272C) by which an inactive license is restored to active status.
“Reciprocal license” means the issuance of an Iowa license to practice mental health counseling or marital and family therapy to an applicant who is currently licensed in another state which has a mutual agreement with the Iowa board of behavioral science to license persons who have the same or similar qualifications to those required in Iowa.
“Reinstatement” means the process as outlined in 645—11.31(272C) by which a licensee who has had a license suspended or revoked or who has voluntarily surrendered a license may apply to have the license reinstated, with or without conditions. Once the license is reinstated, the licensee may apply for active status.
“Temporary license” means a license to practice martial and family therapy or mental health counseling under direct supervision of a qualified supervisor as determined by the board by rule to fulfill the postgraduate supervised clinical experience requirement in accordance with this chapter.
645—31.2(154D) Requirements for licensure. The following criteria shall apply to licensure:
	31.2(1) The applicant shall complete a board-approved application packet. Application forms may be obtained from the board’s Web site (http://www.idph.state.ia.us/licensure) or directly from the board office. All applications shall be sent to the Board of Behavioral Science, Professional Licensure Division, Fifth Floor, Lucas State Office Building, Des Moines, Iowa 50319-0075.
	31.2(2) The applicant shall complete the application form according to the instructions contained in the application. If the application is not completed according to the instructions, the application will not be reviewed by the board.
	31.2(3) Each application shall be accompanied by the appropriate fees payable to the Board of Behavioral Science. The fees are nonrefundable.
	31.2(4) No application will be considered by the board until official copies of academic transcripts sent directly from the school to the board of behavioral science have been received by the board.
	31.2(5) The candidate shall have the examination score sent directly from the testing service to the board.
	31.2(6) The completed application form shall be filed with the board of behavioral science with all required supervision forms and fees at least 90 days before the date of the examination.
	31.2(7) A licensee who was issued an initial license within six months prior to the renewal shall not be required to renew the license until the renewal date two years later.
	31.2(8) Incomplete applications that have been on file in the board office for more than two years shall be:
	a. 	Considered invalid and shall be destroyed; or
	b. 	Maintained upon written request of the applicant. The applicant is responsible for requesting that the file be maintained.
	31.2(9) Notification of eligibility for examination shall be sent to the licensee by the board.
645—31.3(154D) Examination requirements. The following criteria shall apply to the written examination(s):
	31.3(1) In order to qualify for licensing, the applicant:
	a. 	For a marital and family therapist license shall take and pass the Association of Marital and Family Therapy Regulatory Board (AMFTRB) Examination in Marital and Family Therapy.
	b. 	For a mental health counselor license shall take and pass the National Counselor Examination of the NBCC, or the National Clinical Mental Health Counselor Examination of the NBCC, or the Certified Rehabilitation Counselor Examination of the CRCC.
	31.3(2) Examination information will be provided when the applicant has been approved to take the examination.
	31.3(3) The board will notify the applicant in writing of examination results.
	31.3(4) Persons determined by the board not to have performed satisfactorily may apply for reexamination.
	31.3(5) The passing score on the written examination shall be the passing point criterion established by the appropriate national testing authority at the time the test was administered.
645—31.4(154D) Educational qualifications for marital and family therapists. The applicant must present proof of meeting the following educational requirements for licensure as a marital and family therapist:
	31.4(1) Accredited program. Applicants must present with the application an official transcript verifying completion of a master’s degree of 60 semester hours (or 80 quarter hours or equivalent) or a doctoral degree in marital and family therapy from a program accredited by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) from a college or university accredited by an agency recognized by the United States Department of Education. Applicants who entered a program of study prior to July 1, 2008, must present with the application an official transcript verifying completion of a master’s degree of 45 semester hours or the equivalent; or
	31.4(2) Content-equivalent program. Applicants must present an official transcript verifying completion of a master’s degree of 60 semester hours (or 80 quarter hours or equivalent) or a doctoral degree in a mental health, behavioral science, or a counseling-related field from a college or university accredited by an agency recognized by the United States Department of Education, which is content-equivalent to a graduate degree in marital and family therapy. Applicants who entered a program of study prior to July 1, 2008, must present with the application an official transcript verifying completion of a master’s degree of 45 semester hours or the equivalent. After March 31, 2009, graduates from non-COAMFTE-accredited marital and family therapy programs shall provide an equivalency evaluation of their educational credentials by the Center for Credentialing and Education, Inc. (CCE), Web site http://cce-global.org. The professional curriculum must be equivalent to that stated in these rules. Applicants shall bear the expense of the curriculum evaluation. In order to qualify as a “content-equivalent” degree, a graduate transcript must document:
	a. 	At least 9 semester hours or the equivalent in each of the three areas listed below:
	(1)	Theoretical foundations of marital and family therapy systems. Any course which deals primarily in areas such as family life cycle; theories of family development; marriage or the family; sociology of the family; families under stress; the contemporary family; family in a social context; the cross-cultural family; youth/adult/aging and the family; family subsystems; individual, interpersonal relationships (marital, parental, sibling).
	(2)	Assessment and treatment in family and marital therapy. Any course which deals primarily in areas such as family therapy methodology; family assessment; treatment and intervention methods; overview of major clinical theories of marital and family therapy, such as communications, contextual, experiential, object relations, strategic, structural, systemic, transgenerational.
	(3)	Human development. Any course which deals primarily in areas such as human development; personality theory; human sexuality. One course must be psychopathology.
	b. 	At least 3 semester hours or the equivalent in each of the two areas listed below:
	(1)	Ethics and professional studies. Any course which deals primarily in areas such as professional socialization and the role of the professional organization; legal responsibilities and liabilities; independent practice and interprofessional cooperation; ethical issues in marital and family counseling; and family law.
	(2)	Research. Any course which deals primarily in areas such as research design, methods, statistics; research in marital and family studies and therapy.
If the applicant has taught a graduate-level course as outlined above at a college or university accredited by an agency recognized by the United States Department of Education or the Council on Professional Accreditation, that course will be credited toward the course requirements.
	c. 	A graduate-level clinical practicum in marital and family therapy of at least 300 clock hours is required for all applicants.
645—31.5(154D) Clinical experience requirements for marital and family therapists.
	31.5(1) The supervised clinical experience shall:
	a. 	Be a minimum of two years or the equivalent of full-time supervised clinical work experience in marital and family therapy;
	b. 	Be completed following the practicum and all graduate coursework, with the exception of the thesis;
	c. 	Include successful completion of at least 300 hours of clinical supervision concurrent with 2,000 hours of marital and family therapy conducted in person with couples, families, and individuals. Applicants who entered a program of study prior to July 1, 2008, shall include successful completion of 200 hours of clinical supervision concurrent with 1,000 hours of marital and family therapy conducted in person with couples, families, and individuals;
	d. 	Include at least 150 of the 300 hours of clinical supervision as individual supervision. Applicants who entered a program of study prior to July 1, 2008, shall include at least 100 of the 200 hours of clinical supervision as individual supervision;
	e. 	Have 50 percent (150 hours) of the clinical supervision conducted in person. Applicants who entered a program of study prior to July 1, 2008, shall have 100 hours of the clinical supervision conducted in person; and
	f. 	Have only supervised clinical contact credited for this requirement.
	31.5(2) To meet the requirements of the supervised clinical experience:
	a. 	The supervisee must:
	(1)	Meet with the supervisor for a minimum of four hours per month;
	(2)	Offer documentation of supervised hours signed by the supervisor;
	(3)	Compute part-time employment on a prorated basis for the supervised professional experience;
	(4)	Have the background, training, and experience that is appropriate to the functions performed;
	(5)	Have supervision that is clearly distinguishable from personal psychotherapy and is contracted in order to serve professional/vocational goals;
	(6)	Have individual supervision that shall be in person with no more than one supervisor to two supervisees;
	(7)	Have group supervision that may be completed with up to ten supervisees and a supervisor; and
	(8)	Not participate in the following activities which are deemed unacceptable for clinical supervision:
	1.	Peer supervision, i.e., supervision by a person of equivalent, but not superior, qualifications, status, and experience.
	2.	Supervision, by current or former family members, or any other person, in which the nature of the personal relationship prevents, or makes difficult, the establishment of a professional relationship.
	3.	Administrative supervision, e.g., clinical practice performed under administrative rather than clinical supervision of an institutional director or executive.
	4.	A primarily didactic process wherein techniques or procedures are taught in a group setting, classroom, workshop, or seminar.
	5.	Consultation, staff development, or orientation to a field or program, or role-playing of family interrelationships as a substitute for current clinical practice in an appropriate clinical situation.
	b. 	The supervisor shall:
	(1)	Be an Iowa-licensed marital and family therapist with a minimum of three years of clinical experience following licensure; or
	(2)	Be a supervisor or supervisor candidate approved by the American Association for Marriage and Family Therapy Commission on Supervision; or
	(3)	Be licensed under Iowa Code chapter 147 and have a minimum of three years of full-time professional work experience, including experience in marital and family therapy, as approved by the board; and
	(4)	Meet a minimum of four hours per month with the supervisee; and
	(5)	Provide training that is appropriate to the functions to be performed; and
	(6)	Ensure that therapeutic work is completed under the professional supervision of a supervisor; and
	(7)	Not supervise any marital and family therapy or permit the supervisee to engage in any therapy which the supervisor cannot perform competently.
	31.5(3) An applicant who has obtained American Association for Marriage and Family Therapy clinical membership and has provided a transcript sent directly from the school to the board is considered to have met the educational and clinical experience requirements of rules 31.4(154D) and 31.5(154D).
645—31.6(154D) Educational qualifications for mental health counselors. The applicant must present proof of meeting the following educational requirements for a mental health counselor:
	31.6(1) Accredited program. Applicants must present with the application an official transcript verifying completion of a master’s degree of 60 semester hours (or equivalent quarter hours) or a doctoral degree in counseling with emphasis in mental health counseling from a mental health counseling program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACREP) from a college or university accredited by an agency recognized by the United States Department of Education. Applicants who entered a program of study prior to July 1, 2008, must present with the application an official transcript verifying completion of a master's degree of 45 semester hours or the equivalent; or
	31.6(2) Content-equivalent program. Applicants must present an official transcript verifying completion of a master’s degree or a doctoral degree from a college or university accredited by an agency recognized by the United States Department of Education which is content-equivalent to a master’s degree in counseling with emphasis in mental health counseling. Applicants who entered a program of study prior to July 1, 2008, must present with the application an official transcript verifying completion of a master's degree of 45 semester hours or the equivalent. After March 31, 2009, graduates from non-CACREP-accredited mental health counseling programs shall provide an equivalency evaluation of their educational credentials by the Center for Credentialing and Education, Inc. (CCE), Web site http://cce-global.org. The professional curriculum must be equivalent to that stated in these rules. Applicants shall bear the expense of the curriculum evaluation. The degree will be considered as “content-equivalent” if it includes 60 semester hours (or equivalent quarter hours) and successful completion of graduate-level coursework in each of the following areas:
	a. 	Professional identity. Studies that provide an understanding of all of the following aspects of professional functioning:
	(1)	History and philosophy of the counseling profession, including significant factors and events;
	(2)	Professional roles, functions, and relationships with other providers of human services;
	(3)	Technological competence and computer literacy;
	(4)	Professional organizations, primarily ACA, its divisions, branches, and affiliates, including membership benefits, activities, services to members, and current emphases;
	(5)	Professional credentialing, including certification, licensure, and accreditation practices and standards, and the effects of public policy on these issues;
	(6)	Public and private policy processes, including the role of the professional counselor in advocating on behalf of the profession;
	(7)	Advocacy processes needed to address institutional and social barriers that impede access, equity, and success for clients; and
	(8)	Ethical standards of ACA and related entities, and applications of ethical and legal considerations in professional counseling.
	b. 	Social and cultural diversity. Studies that provide an understanding of the cultural context of relationships, issues, and trends in a multicultural and diverse society related to such factors as culture, ethnicity, nationality, age, gender, sexual orientation, mental and physical characteristics, education, family values, religious and spiritual values, socioeconomic status and unique characteristics of individuals, couples, families, ethnic groups, and communities including all of the following:
	(1)	Multicultural and pluralistic trends, including characteristics and concerns between and within diverse groups nationally and internationally;
	(2)	Attitudes, beliefs, understandings, and acculturative experiences, including specific experiential learning activities;
	(3)	Individual, couple, family, group, and community strategies for working with diverse populations and ethnic groups;
	(4)	Counselors’ roles in social justice, advocacy and conflict resolution, cultural self-awareness, the nature of biases, prejudices, processes of intentional and unintentional oppression and discrimination, and other culturally supported behaviors that are detrimental to the growth of the human spirit, mind or body;
	(5)	Theories of multicultural counseling, theories of identity development, and multicultural competencies; and
	(6)	Ethical and legal considerations.
	c. 	Human growth and development. Studies that provide an understanding of the nature and needs of individuals at all developmental levels, including all of the following:
	(1)	Theories of individual and family development and transitions across the life span;
	(2)	Theories of learning and personality development;
	(3)	Human behavior including an understanding of developmental crises, disability, exceptional behavior, addictive behavior, psychopathology, and situational and environmental factors that affect both normal and abnormal behavior;
	(4)	Strategies for facilitating optimum development over the life span; and
	(5)	Ethical and legal considerations.
	d. 	Career development. Studies that provide an understanding of career development and related life factors, including all of the following:
	(1)	Career development theories and decision-making models;
	(2)	Career, avocational, educational, occupational and labor market information resources, visual and print media, computer-based career information systems, and other electronic career information systems;
	(3)	Career development program planning, organization, implementation, administration, and evaluation;
	(4)	Interrelationships among and between work, family, and other life roles and factors including the role of diversity and gender in career development;
	(5)	Career and educational planning, placement, follow-up, and evaluation;
	(6)	Assessment instruments and techniques that are relevant to career planning and decision making;
	(7)	Technology-based career development applications and strategies, including computer-assisted career guidance and information systems and appropriate worldwide Web sites;
	(8)	Career counseling processes, techniques, and resources, including those applicable to specific populations; and
	(9)	Ethical and legal considerations.
	e. 	Helping relationships. Studies that provide an understanding of counseling and consultation processes, including all of the following:
	(1)	Counselor and consultant characteristics and behaviors that influence helping processes including age, gender, and ethnic differences, verbal and nonverbal behaviors and personal characteristics, orientations, and skills;
	(2)	An understanding of essential interviewing and counseling skills so that the student is able to develop a therapeutic relationship, establish appropriate counseling goals, design intervention strategies, evaluate client outcome, and successfully terminate the counselor-client relationship. Studies will also facilitate student self-awareness so that the counselor-client relationship is therapeutic and the counselor maintains appropriate professional boundaries;
	(3)	Counseling theories that provide the student with a consistent model(s) to conceptualize client presentation and select appropriate counseling interventions. Student experiences should include an examination of the historical development of counseling theories, an exploration of affective, behavioral, and cognitive theories, and an opportunity to apply the theoretical material to case studies. Students will also be exposed to models of counseling that are consistent with current professional research and practice in the field so that they can begin to develop a personal model of counseling;
	(4)	A systems perspective that provides an understanding of family and other systems theories and major models of family and related interventions. Students will be exposed to a rationale for selecting family and other systems theories as appropriate modalities for family assessment and counseling;
	(5)	A general framework for understanding and practicing. Student experiences should include an examination of the historical development of consultation, an exploration of the stages of consultation and the major models of consultation, and an opportunity to apply the theoretical material to case presentations. Students will begin to develop a personal model of consultation;
	(6)	Integration of technological strategies and applications within counseling and consultation processes; and
	(7)	Ethical and legal considerations.
	f. 	Group work. Studies that provide both theoretical and experiential understanding of group purpose, development, dynamics, counseling theories, group counseling methods and skills, and other group approaches, including all of the following:
	(1)	Principles of group dynamics, including group process components, developmental stage theories, group members’ roles and behaviors, and therapeutic factors of group work;
	(2)	Group leadership styles and approaches, including characteristics of various types of group leaders and leadership styles;
	(3)	Theories of group counseling, including commonalties, distinguishing characteristics, and pertinent research and literature;
	(4)	Group counseling methods, including group counselor orientations and behaviors, appropriate selection criteria and methods, and methods of evaluation of effectiveness;
	(5)	Approaches used for other types of group work, including task groups, psychoeducational groups, and therapy groups;
	(6)	Professional preparation standards for group leaders; and
	(7)	Ethical and legal considerations.
	g. 	Assessment. Studies that provide an understanding of individual and group approaches to assessment and evaluation, including the following:
	(1)	Historical perspectives concerning the nature and meaning of assessment;
	(2)	Basic concepts of standardized and nonstandardized testing and other assessment techniques including norm-referenced and criterion-referenced assessment, environmental assessment, performance assessment, individual and group test and inventory methods, behavioral observations, and computer-managed and computer-assisted methods;
	(3)	Statistical concepts, including scales of measurement, measures of central tendency, indices of variability, shapes and types of distributions, and correlations;
	(4)	Reliability (i.e., theory of measurement error, models of reliability, and the use of reliability information);
	(5)	Validity (i.e., evidence of validity, types of validity, and the relationship between reliability and validity);
	(6)	Age, gender, sexual orientation, ethnicity, language, disability, culture, spirituality, and other factors related to the assessment and evaluation of individuals, groups, and specific populations;
	(7)	Strategies for selecting, administering, and interpreting assessment and evaluation instruments and techniques in counseling;
	(8)	An understanding of general principles and methods of case conceptualization, assessment, or diagnoses of mental and emotional status; and
	(9)	Ethical and legal considerations.
	h. 	Research and program evaluation. Studies that provide an understanding of research methods, statistical analysis, needs assessment, and program evaluation, including all of the following:
	(1)	The importance of research and opportunities and difficulties in conducting research in the counseling profession;
	(2)	Research methods such as qualitative, quantitative, single-case designs, action research, and outcome-based research;
	(3)	Use of technology and statistical methods in conducting research and program evaluation, assuming basic computer literacy;
	(4)	Principles, models, and applications of needs assessment, program evaluation, and use of findings to effect program modifications;
	(5)	Use of research to improve counseling effectiveness; and
	(6)	Ethical and legal considerations.
	i. 	Diagnosis and treatment planning. Studies that provide an understanding of individual and group approaches to assessment and evaluation. Studies in this area include, but are not limited to, the following:
	(1)	The principles of the diagnostic process, including differential diagnosis, and the use of current diagnostic tools, such as the current edition of the Diagnostic and Statistical Manual;
	(2)	The established diagnostic criteria for mental or emotional disorders that describe treatment modalities and placement criteria within the continuum of care;
	(3)	The impact of co-occurring substance use disorders on medical and psychological disorders;
	(4)	The relevance and potential biases of commonly used diagnostic tools as related to multicultural populations;
	(5)	The appropriate use of diagnostic tools, including the current edition of the Diagnostic and Statistical Manual, to describe the symptoms and clinical presentation of clients with mental or emotional impairments; and
	(6)	The ability to conceptualize accurate multi-axial diagnoses of disorders presented by clients and how to communicate the differential diagnosis to clients’ managed care and insurance companies or other third-party payers.
	j. 	Psychopathology. Studies that provide an understanding of emotional and mental disorders experienced by persons of all ages, characteristics of disorders, and common nosologies of emotional and mental disorders utilized within the U.S. health care system for diagnosis and treatment planning. Studies in this area include, but are not limited to, the following:
	(1)	Study of cognitive, behavioral, physiological and interpersonal mechanisms for adapting to change and to stressors;
	(2)	Role of genetic, physiological, cognitive, environmental and interpersonal factors, and their interactions, on development of the form, severity, course and persistence of the various types of disorders and dysfunction;
	(3)	Research methods and findings pertinent to the description, classification, diagnosis, origin, and course of disorders and dysfunction;
	(4)	Theoretical perspectives relevant to the origin, development, and course and outcome for the forms of behavior disorders and dysfunction; and
	(5)	Methods of intervention or prevention used to minimize and modify maladaptive behaviors, disruptive and distressful cognition, or compromised interpersonal functioning associated with various forms of maladaptation.
	k. 	Practicum. A graduate-level clinical supervised counseling practicum in which students must complete supervised practicum experiences that total a minimum of 100 clock hours prior to receiving the master’s degree. The practicum provides for the development of counseling skills under supervision. The student’s practicum includes all of the following:
	(1)	Forty hours of direct service with clients, including experience in individual counseling and group work;
	(2)	Weekly interaction with an average of one hour per week of individual and triadic supervision which occurs regularly over a minimum of one academic term by a program faculty member or a supervisor working under the supervision of a program faculty member;
	(3)	An average of one and one-half hours per week of group supervision that is provided on a regular schedule over the course of the student’s practicum by a program faculty member or a supervisor under the supervision of a program faculty member; and
	(4)	Evaluation of the student’s performance throughout the practicum including a formal evaluation after the student completes the practicum.
	l. 	Internship. A graduate-level clinical supervised counseling internship that requires students to complete a supervised internship of 600 clock hours that is begun after successful completion of the student’s practicum and prior to receiving the master’s degree. The internship provides an opportunity for the student to perform, under supervision, a variety of counseling activities that a professional counselor is expected to perform. The student’s internship includes all of the following:
	(1)	A minimum of 240 hours of direct service with clientele appropriate to the program of study;
	(2)	A minimum of one hour per week of individual supervision and triadic supervision, throughout the internship, usually performed by the on-site supervisor;
	(3)	A minimum of one and one-half hours per week of group supervision, throughout the internship, usually performed by a program faculty member supervisor;
	(4)	The opportunity for the student to become familiar with a variety of professional activities in addition to direct service (e.g., record keeping, supervision, information and referral, in-service and staff meetings);
	(5)	The opportunity for the student to develop program-appropriate audiotapes or videotapes, or a combination of both, of the student’s interactions with clients for use in supervision;
	(6)	The opportunity for the student to gain supervised experience in the use of a variety of professional resources such as assessment instruments, technologies, print and nonprint media, professional literature, and research; and
	(7)	A formal evaluation of the student’s performance during the internship by a program faculty member in consultation with the site supervisor.
If the applicant has taught a graduate-level course as outlined above at a college or university accredited by an agency recognized by the United States Department of Education or the Council on Professional Accreditation, that course may be credited toward the course requirement.
	31.6(3) Foreign-trained marital and family therapists or mental health counselors. Foreign-trained marital and family therapists or mental health counselors shall:
	a. 	Provide an equivalency evaluation of their educational credentials by the following: International Educational Research Foundations, Inc., Credentials Evaluation Service, P.O. Box 3665, Culver City, CA 90231-3665; telephone (310)258-9451; Web site www.ierf.org or E-mail at info@ierf.org. The professional curriculum must be equivalent to that stated in these rules. A candidate shall bear the expense of the curriculum evaluation.
	b. 	Provide a notarized copy of the certificate or diploma awarded to the applicant from a mental health counselor program in the country in which the applicant was educated.
	c. 	Receive a final determination from the board regarding the application for licensure.
645—31.7(154D) Clinical experience requirements for mental health counselors.
	31.7(1) The supervised clinical experience shall:
	a. 	Be a minimum of two years or the equivalent of full-time supervised professional work experience in mental health counseling;
	b. 	Be completed following completion of the practicum and all graduate coursework, with exception of the thesis;
	c. 	Include successful completion of at least 300 hours of clinical supervision concurrent with 2,000 hours of mental health counseling conducted in person with individuals, couples or families. Applicants who entered a program of study prior to July 1, 2008, shall include successful completion of 200 hours of clinical supervision concurrent with 1,000 hours of mental health counseling conducted in person with couples, families and individuals;
	d. 	Include at least 150 of the 300 hours of supervision as individual supervision. Applicants who entered a program of study prior to July 1, 2008, shall include at least 100 of the 200 hours of clinical supervision as individual supervison;
	e. 	Include 50 percent (150 hours) of all clinical supervision in person. Applicants who entered a program of study prior to July 1, 2008, shall have 100 hours of the clinical supervision conducted in person; and
	f. 	Have only supervised clinical contact credited for this requirement.
	31.7(2) To meet the requirements of the supervised clinical experience:
	a. 	The supervisee must:
	(1)	Meet with the supervisor a minimum of four hours per month;
	(2)	Offer documentation of supervised hours signed by the supervisor;
	(3)	Compute part-time employment on a prorated basis for the supervised professional experience;
	(4)	Have the background, training, and experience that are appropriate to the functions performed;
	(5)	Have supervision that is clearly distinguishable from personal counseling and is contracted in order to serve professional/vocational goals;
	(6)	Have individual supervision that shall be in person with no more than one supervisor to two supervisees;
	(7)	Have group supervision that may be completed with up to ten supervisees and a supervisor; and
	(8)	Not participate in the following activities which are deemed unacceptable for clinical supervision:
	1.	Peer supervision, i.e., supervision by a person of equivalent, but not superior, qualifications, status, and experience.
	2.	Supervision, by current or former family members, or any other person, in which the nature of the personal relationship prevents, or makes difficult, the establishment of a professional relationship.
	3.	Administrative supervision, e.g., clinical practice performed under administrative rather than clinical supervision of an institutional director or executive.
	4.	A primarily didactic process wherein techniques or procedures are taught in a group setting, classroom, workshop, or seminar.
	5.	Consultation, staff development, or orientation to a field or program, or role-playing of family interrelationships as a substitute for current clinical practice in an appropriate clinical situation.
	b. 	The supervisor:
	(1)	May be a licensed mental health counselor in Iowa with at least three years of postlicensure clinical experience; or
	(2)	Shall be approved by the National Board for Certified Counselors (NBCC) as a supervisor; or
	(3)	May be an alternate supervisor who possesses qualifications equivalent to a licensed mental health counselor with at least three years of postlicensure clinical experience, including mental health professionals licensed pursuant to Iowa Code chapter 147; and
	(4)	Shall meet a minimum of four hours per month with the supervisee; and
	(5)	Shall provide training that is appropriate to the functions to be performed; and
	(6)	Shall ensure that therapeutic work is done under the professional supervision of a supervisor; and
	(7)	Shall not supervise any mental health counselor or permit the supervisee to engage in any therapy which the supervisor cannot perform competently.
	31.7(3) Rescinded IAB 7/6/05, effective 8/10/05.
	31.7(4) An applicant who has obtained Certified Clinical Mental Health Counselor status with the National Board for Certified Counselors (NBCC) and submits a transcript sent directly from the school to the board is considered to have met the educational and clinical experience requirements of rules 31.6(154D) and 31.7(154D).
645—31.8(154D) Licensure by endorsement. An applicant who has been a licensed marriage and family therapist or mental health counselor under the laws of another jurisdiction may file an application for licensure by endorsement with the board office. The board may receive by endorsement any applicant from the District of Columbia or another state, territory, province or foreign country who:
	1.	Submits to the board a completed application;
	2.	Pays the licensure fee;
	3.	Shows evidence of licensure requirements that are similar to those required in Iowa;
	4.	Provides official transcripts sent directly from the school to the board verifying completion of a master’s degree of 45 hours or equivalent if the applicant entered a program of study prior to July 1, 2008, or verifying completion of a master's degree of 60 hours or equivalent if the applicant entered a program of study on or after July 1, 2008, or the appropriate doctoral degree. After March 31, 2009, graduates from a non-CACREP-accredited mental health counselor program or a non-COAMFTE-accredited marital and family therapy program shall provide an equivalency evaluation of their educational credentials by the Center for Credentialing and Education, Inc. (CCE), Web site http://cce-global.org. The professional curriculum must be equivalent to that stated in these rules. Applicants shall bear the expense of the curriculum evaluation;
	5.	Supplies satisfactory evidence of the candidate’s qualifications in writing on the prescribed forms by the candidate’s supervisors. If verification of clinical experience is not available, the board may consider submission of documentation from the state in which the applicant is currently licensed or equivalent documentation of supervision; and
	6.	Provides verification(s) of license(s) from every jurisdiction in which the applicant has been licensed, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification direct from the jurisdiction’s board office if the verification provides:
	●	Licensee’s name;
	●	Date of initial licensure;
	●	Current licensure status; and
	●	Any disciplinary action taken against the license.
	7.	In lieu of the requirements listed in paragraphs “3” through “5” of this rule, a mental health counselor applicant may provide to the board evidence that the applicant has demonstrated appropriate qualifications at either tier 1 or tier 2 of the National Credentials Registry of the American Association of State Counseling Boards. The mental health counselor applicant shall have the National Credentials Registry of the American Association of State Counseling Boards send directly to the board official verification that the applicant has met the qualifications.
645—31.9(147) Licensure by reciprocal agreement. Rescinded IAB 1/14/09, effective 2/18/09.
645—31.10(147) License renewal.
	31.10(1) The biennial license renewal period for a license to practice marital and family therapy or mental health counseling shall begin on October 1 of an even-numbered year and end on September 30 of the next even-numbered year. The board shall send a renewal notice by regular mail to each licensee at the address on record at least 60 days prior to the expiration of the license. The licensee is responsible for renewing the license prior to its expiration. Failure of the licensee to receive the notice does not relieve the licensee of the responsibility for renewing the license.
	31.10(2) An individual who was issued an initial license within six months of the license renewal date will not be required to renew the license until the subsequent renewal two years later.
	31.10(3) A licensee seeking renewal shall:
	a. 	Meet the continuing education requirements of rule 645—32.2(272C) and the mandatory reporting requirements of subrule 31.10(4). A licensee whose license was reactivated during the current renewal compliance period may use continuing education credit earned during the compliance period for the first renewal following reactivation; and
	b. 	Submit the completed renewal application and renewal fee before the license expiration date.
	c. 	An individual who was issued a license within six months of the license renewal date will not be required to renew the license until the next renewal two years later.
	31.10(4) Mandatory reporter training requirements.
	a. 	A licensee who, in the scope of professional practice or in the licensee’s employment responsibilities, examines, attends, counsels or treats children in Iowa shall indicate on the renewal application completion of two hours of training in child abuse identification and reporting in the previous five years or condition(s) for waiver of this requirement as identified in paragraph “e.”
	b. 	A licensee who, in the course of employment, examines, attends, counsels or treats adults in Iowa shall indicate on the renewal application completion of two hours of training in dependent adult abuse identification and reporting in the previous five years or condition(s) for waiver of this requirement as identified in paragraph “e.”
	c. 	A licensee who, in the scope of professional practice or in the course of employment, examines, attends, counsels or treats both adults and children in Iowa shall indicate on the renewal application completion of training in abuse identification and reporting for dependent adults and children in the previous five years or condition(s) for waiver of this requirement as identified in paragraph “e.”
Training may be completed through separate courses as identified in paragraphs “a” and “b” or in one combined two-hour course that includes curricula for identifying and reporting child abuse and dependent adult abuse. The course shall be a curriculum approved by the Iowa department of public health abuse education review panel.
	d. 	The licensee shall maintain written documentation for five years after mandatory training as identified in paragraphs “a” to “c,” including program date(s), content, duration, and proof of participation.
	e. 	The requirement for mandatory training for identifying and reporting child and dependent adult abuse shall be suspended if the board determines that suspension is in the public interest or that a person at the time of license renewal:
	(1)	Is engaged in active duty in the military service of this state or the United States.
	(2)	Holds a current waiver by the board based on evidence of significant hardship in complying with training requirements, including an exemption of continuing education requirements or extension of time in which to fulfill requirements due to a physical or mental disability or illness as identified in 645—Chapter 4.
	f. 	The board may select licensees for audit of compliance with the requirements in paragraphs “a” to “e.”
	31.10(5) Upon receiving the information required by this rule and the required fee, board staff shall administratively issue a two-year license and shall send the licensee a wallet card by regular mail. In the event the board receives adverse information on the renewal application, the board shall issue the renewal license but may refer the adverse information for further consideration or disciplinary investigation.
	31.10(6) A person licensed to practice as a marital and family therapist or mental health counselor shall keep the person’s license certificate and wallet card displayed in a conspicuous public place at the primary site of practice.
	31.10(7) Late renewal. The license shall become late when the license has not been renewed by the expiration date on the wallet card. The licensee shall be assessed a late fee as specified in 645—subrule 5.3(3). To renew a late license, the licensee shall complete the renewal requirements and submit the late fee within the grace period.
	31.10(8) Inactive license. A licensee who fails to renew the license by the end of the grace period has an inactive license. A licensee whose license is inactive continues to hold the privilege of licensure in Iowa, but may not practice mental health counseling or marital and family therapy in Iowa until the license is reactivated. A licensee who practices mental health counseling or marital and family therapy in the state of Iowa with an inactive license may be subject to disciplinary action by the board, injunctive action pursuant to Iowa Code section 147.83, criminal sanctions pursuant to Iowa Code section 147.86, and other available legal remedies.
645—31.11(272C) Exemptions for inactive practitioners. Rescinded IAB 7/6/05, effective 8/10/05.
645—31.12(147) Licensee record keeping.
	31.12(1) A licensee shall maintain sufficient, timely, and accurate documentation in client records.
	31.12(2) For purposes of this rule, “client” means the individual, couple, family, or group to whom a licensee provides direct clinical services.
	31.12(3) A licensee’s records shall reflect the services provided, facilitate the delivery of services, and ensure continuity of services in the future.
	31.12(4) Clinical services. A licensee who provides clinical services in any employment setting, including private practice, shall:
	a. 	Store records in accordance with state and federal statutes and regulations governing record retention and with the guidelines of the licensee’s employer or agency, if applicable. If no other legal provisions govern record retention, a licensee shall store all client records for a minimum of seven years after the date of the client’s discharge or death, or, in the case of a minor, for three years after the client reaches the age of majority under state law or seven years after the date of the client’s discharge or death, whichever is longer.
	b. 	Maintain timely records that include subjective and objective data, an assessment, a treatment plan, and any revisions to the assessment or plan made during the course of treatment.
	c. 	Provide the client with reasonable access to records concerning the client. A licensee who is concerned that a client’s access to the client’s records could cause serious misunderstanding or harm to the client shall provide assistance in interpreting the records and consultation with the client regarding the records. A licensee may limit a client’s access to the client’s records, or portions of the records, only in exceptional circumstances when there is compelling evidence that such access would cause serious harm to the client. Both the client’s request for access and the licensee’s rationale for withholding some or all of a record shall be documented in the client’s records.
	d. 	Take steps to protect the confidentiality of other individuals identified or discussed in any records to which a client is provided access.
	31.12(5) Electronic record keeping. The requirements of this rule apply to electronic records as well as to records kept by any other means. When electronic records are kept, the licensee shall ensure that a duplicate hard-copy record or a backup, unalterable electronic record is maintained.
	31.12(6) Correction of records.
	a. 	Hard-copy records. Original notations shall be legible, written in ink, and contain no erasures or whiteouts. If incorrect information is placed in the original record, it must be crossed out with a single, nondeleting line and be initialed and dated by the licensee.
	b. 	Electronic records. If a record is stored in an electronic format, the record may be amended with a signed addendum attached to the record.
	31.12(7) Confidentiality and transfer of records. Marital and family therapists or mental health counselors shall preserve the confidentiality of client records in accordance with their respective rules of conduct and with federal and state law. Upon receipt of a written release or authorization signed by the client, the licensee shall furnish such therapy records, or copies of the records, as will be beneficial for the future treatment of that client. A fee may be charged for duplication of records, but a licensee may not refuse to transfer records for nonpayment of any fees. A written request may be required before transferring the record(s).
	31.12(8) Retirement, death or discontinuance of practice.
	a. 	If a licensee is retiring or discontinuing practice and is the owner of a practice, the licensee shall notify in writing all active clients and, upon knowledge and agreement of the clients, shall make reasonable arrangements with those clients to transfer client records, or copies of those records, to the succeeding licensee.
	b. 	Upon a licensee’s death:
	(1)	The licensee’s employer or representative must ensure that all client records are transferred to another licensee or entity that is held to the same standards of confidentiality and agrees to act as custodian of the records.
	(2)	The licensee’s employer or representative shall notify each active client that the client’s records will be transferred to another licensee or entity that will retain custody of the records and that, at the client’s written request, the records will be sent to the licensee or entity of the client’s choice.
	31.12(9) Nothing stated in this rule shall prohibit a licensee from conveying or transferring the licensee’s client records to another licensed individual who is assuming a practice, provided that written notice is furnished to all clients.
645—31.13(147) Duplicate certificate or wallet card. Rescinded IAB 1/14/09, effective 2/18/09.
645—31.14(147) Reissued certificate or wallet card. Rescinded IAB 1/14/09, effective 2/18/09.
645—31.15(17A,147,272C) License denial. Rescinded IAB 1/14/09, effective 2/18/09.
645—31.16(17A,147,272C) License reactivation. To apply for reactivation of an inactive license, a licensee shall:
	31.16(1) Submit a reactivation application on a form provided by the board.
	31.16(2) Pay the reactivation fee that is due as specified in 645—Chapter 5.
	31.16(3) Provide verification of current competence to practice mental health counseling or marital and family therapy by satisfying one of the following criteria:
	a. 	If the license has been on inactive status for five years or less, an applicant must provide the following:
	(1)	Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
	1.	Licensee’s name;
	2.	Date of initial licensure;
	3.	Current licensure status; and
	4.	Any disciplinary action taken against the license; and
	(2)	Verification of completion of 40 hours of continuing education within two years of the application for reactivation.
	b. 	If the license has been on inactive status for more than five years, an applicant must provide the following:
	(1)	Verification of the license(s) from every jurisdiction in which the applicant is or has been licensed and is or has been practicing during the time period the Iowa license was inactive, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification from a jurisdiction’s board office if the verification includes:
	1.	Licensee’s name;
	2.	Date of initial licensure;
	3.	Current licensure status; and
	4.	Any disciplinary action taken against the license; and
	(2)	Verification of completion of 80 hours of continuing education within two years of application for reactivation.
645—31.17(17A,147,272C) License reinstatement. A licensee whose license has been revoked, suspended, or voluntarily surrendered must apply for and receive reinstatement of the license in accordance with 645—11.31(272C) and must apply for and be granted reactivation of the license in accordance with 31.16(17A,147,272C) prior to practicing mental health counseling or marital and family therapy in this state.
645—31.18(154D) Marital and family therapy and mental health counselor services subject to regulation. Marital and family therapy and mental health counselor services provided to an individual in this state through telephonic, electronic or other means, regardless of the location of the marital and family therapy and mental health counselor, shall constitute the practice of marital and family therapy and mental health counseling and shall be subject to regulation in Iowa.
These rules are intended to implement Iowa Code chapters 17A, 147, 154D and 272C.
[Filed 6/5/92, Notice 4/15/92—published 6/24/92, effective 7/29/92]
[Filed emergency 7/31/92—published 8/19/92, effective 7/31/92]
[Filed 11/17/94, Notice 9/14/94—published 12/7/94, effective 1/11/95]
[Filed 5/2/97, Notice 3/12/97—published 5/21/97, effective 6/25/97]
[Filed 5/16/97, Notice 4/9/97—published 6/4/97, effective 7/9/97]
[Filed 8/21/98, Notice 7/15/98—published 9/9/98, effective 10/14/98]
[Filed 4/2/99, Notice 2/10/99—published 4/21/99, effective 5/26/99]
[Filed 2/1/01, Notice 10/18/00—published 2/21/01, effective 3/28/01]
[Filed 12/6/01, Notice 10/3/01—published 12/26/01, effective 1/30/02]
[Filed 3/29/02, Notice 2/20/02—published 4/17/02, effective 5/22/02]
[Filed 9/26/02, Notice 7/24/02—published 10/16/02, effective 11/20/02]
[Filed 12/12/03, Notice 10/15/03—published 1/7/04, effective 2/11/04]
[Filed 6/15/05, Notice 4/13/05—published 7/6/05, effective 8/10/05]◊
[Filed 12/9/05, Notice 10/12/05—published 1/4/06, effective 2/8/06]
[Filed 2/10/06, Notice 1/4/06—published 3/1/06, effective 4/5/06]
[Filed 2/15/07, Notice 12/6/06—published 3/14/07, effective 4/18/07]
[Filed 12/11/08, Notice 10/22/08—published 1/14/09, effective 2/18/09]1
[Editorial change: IAC Supplement 2/25/09]
◊	Two or more ARCs
1	February 18, 2009, effective date of amendments to 645—31.4(154D) to 645—31.8(154D), ARC 7476B, Items 5 to 9, delayed 70 days by the Administrative Rules Review Committee at its meeting held February 6, 2009.