Licensing Mental Health Counselors and Marriage and Family Therapists (216-RICR-40-05-11)

This Part is promulgated pursuant to the authority conferred under R.I. Gen. Laws Chapter 5-63.2 for the purpose of adopting prevailing standards pertaining to the licensure of mental health counselors and marriage and family therapists in this state.

A.In addition to the definitions within R.I. Gen. Laws Chapter 5-63.2, the following terms shall be construed as follows:

1."Act" refers to R.I. Gen. Laws Chapter 5-63.2, entitled, "Mental Health Counselors and Marriage and Family Therapists."

2.“Allied field” means counselor education, psychology, marriage and family therapy, counseling psychology, community mental health, education with a concentration in counseling or psychology, or other field determined by the Board to be an allied field. Said allied field shall include all components of the core curriculum, as it appears in § 11.5.1 of this Part entitled “The Core Curriculum: Clinical Mental Health Counselors” or in 11.5.2 of this Part entitled “The Core Curriculum: Marriage and Family Therapists”.

3."Board" means the Board of Mental Health Counselors and Marriage and Family Therapists.

4.“CACREP” means Counsel for Accreditation of Counseling & Related Educational programs.

5."Clinical counselor in mental health" means a person who has been licensed pursuant to R.I. Gen. Laws Chapter 5-63.2, which license is in force and not suspended or revoked as of the particular time in question.

6.“Clinical instruction” means all supervised course work within which the student has the opportunity to engage in a broad range of clinical activities similar to those performed by a licensed counselor/therapist. This includes all practice and internships completed within a student’s program.

7."The practice of clinical mental health counseling,” in addition to the definition in R.I. Gen. Laws Chapter 5-63.2, includes the following professional services:

a.Promoting mental health and wellness, which includes the achievement of social, career, and emotional development across the lifespan, as well as preventing and treating mental disorders and providing crisis intervention.

b.Psychotherapy, diagnosis, evaluation, administration of assessments, tests, and appraisals, referral, and treatment of behavioral, emotional, addiction and mental disorders, and establishment of counseling treatment plans for individuals, couples, groups, and families with emotional, mental, addiction, and physical disorders.

c.Consultation and program evaluation, program administration within and to schools and organizations, and training and supervision of interns, trainees, and pre-licensed professional counselors through accepted and established principles, methods, procedures, and ethics of counselor supervision.

d.The practice of clinical mental health counseling does not include functions or practices that are not within the professional’s training or education.

8."Department" means the Rhode Island Department of Health.

9."Director" means the Director of the Rhode Island Department of Health.

10.“Individual (face-to-face) supervision” means a tutorial relationship between a member of the mental health counseling profession and a student trainee. The supervisor monitors the clinical work of the trainee in order to evaluate this work, monitor the quality of services being offered to clients, and enhance the professional growth of the trainee.

11."Internship" means a part of an organized graduate or post-graduate program in counseling therapy and shall constitute a supervised experience within a mental health and/or marriage and family setting.

12.“Marriage and family therapist” means a person who has been licensed pursuant to R.I. Gen. Laws § 5-63.2-10 which license is in force and not suspended or revoked as of the particular time in question.

13.“This Part” means Rules and Regulations for Licensing Mental Health Counselors and Marriage and Family Therapists.

14."Person" means any individual, firm, corporation, partnership, organization or body politic.

15."Practice of marriage and family therapy" means the rendering of professional services to individuals, family groups, couples or organizations for monetary compensation. These professional services would include applying principles, methods, and therapeutic techniques for the purpose of resolving emotional conflicts, modifying perceptions and behavior, enhancing communications and understanding among all family members and the prevention of family and individual crisis. Individual marriage and family therapists also engage in psychotherapy of a nonmedical and nonpsychotic nature with appropriate referrals to psychiatric resources.

16."Practicum" means a part of an organized graduate program or post-graduate program in counseling therapy and shall constitute a supervised experience within the graduate counseling program or post-graduate program.

17."Recognized educational institution" means any educational institution which grants a Bachelor's, Master's, or Doctoral degree, and which is recognized by the Board of Mental Health Counselors and Marriage and Family Therapy Examiners or a recognized post-graduate clinical training program as specified in R.I. Gen. Laws §§ 5-63.2-9(2) and 5-63.2-10(2).

18.“R.I. Gen. Laws” means Rhode Island General Laws, as amended.

19.To "use a title or description of" means to hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationery, announcements, calling cards or other instruments of professional identification.

11.3.1Qualifications for Licensure of Clinical Mental Health Counselors

A.In addition to the requirements of R.I. Gen. Laws § 5-63.2-9, an applicant for licensure shall submit to the Board written evidence on forms furnished by the Department that said applicant has followed an approved pathway for licensure:

1.Has completed the following degree requirements:

a.Has received a master’s or higher level degree from a program accredited by CACREP; or an equivalent accrediting agency approved by both the board and by the cognizable national or regional certifying authority OR

b.Has received a master’s degree or certificate in advanced graduate studies or a doctoral degree in mental health counseling from a recognized educational institution, or a graduate degree in an allied field from a recognized educational institution and a graduate level course work that is equivalent to a master’s degree in mental health counseling. Coursework must include the required components of the Core Curriculum as indicated in § 11.5.1 of this Part AND

c.Has completed sixty (60) semester credit hours within their graduate counseling/therapy program or post graduate program. The sixty (60) semester credit hours must be received prior to beginning post graduate experience and supervised case work hours.

2.Has completed the following educational practicum and internship requirements:

a.Completed requisite CACREP expectations for internship and practicum; OR

b.Twelve (12) semester credit hours of supervised practicum and a minimum of one (1) calendar year of supervised internship consisting of twenty (20) hours per week deemed equivalent by the Board

3.After completing the necessary degree and practicum and internship requirements the applicant must complete the following post-graduate supervised work experience requirements:

a.Has completed post graduate experience and supervised case work hours as required in R.I. Gen. Laws § 5-63.2-9 by a person who at the time of rendering the supervision is recognized by the Board as an approved supervisor under the following requirements:

(1)Must be a licensed clinical mental health counselor, a licensed psychiatrist, a licensed psychologist, a licensed marriage and family therapist, or a licensed independent clinical social worker, who has been licensed in good standing for at least five (5) years and has at least five (5) years of clinical experience as a licensee AND:

(2)Has successfully completed one graduate course in supervision in counseling, taken at an institution of higher learning OR

(3)Is approved by the National Clinical Mental Health Counselor Examination of the National Board of Certified Counselors (NBCC) as a certified supervisor; OR

(4)Has at least two (2) years experience supervising clinical staff in a mental health setting

4.Successfully completes the National Clinical Mental Health Counselor Examination of the National Board of Certified Counselors (NBCC) or other examination approved by the Board to determine the applicant's qualification for licensure as a clinical mental health counselor or is applying for licensure under the provisions of R.I. Gen. Laws § 5-63.2-15.

11.3.2Qualifications for Licensure of Marriage and Family Therapists

A.In addition to the requirements of R.I. Gen. Laws § 5-63.2-10, an applicant for licensure shall submit to the Board written evidence on forms furnished by the Department that said applicant:

1.Has completed the following degree requirements:

a.Has completed a master’s degree or certificate in advanced graduate studies or doctoral degree in marriage and family therapy from a recognized educational institution, or a graduate degree in an allied field from a recognized educational institution and graduate level course work that is equivalent to a master’s degree in marriage and family therapy and must include the required components of the Core Curriculum as indicated in § 11.5.2 of this Part AND

b.Has completed sixty (60) semester credit hours within their graduate degree or post-graduate degree program specializing in marital and family therapy.

2.Has completed the following educational practicum and internship requirements:

a.Has completed a minimum of twelve (12) semester credit hours of supervised practicum AND

b.Has completed a one (1) calendar year of supervised internship consisting of twenty (20) hours per week deemed equivalent by the Board

3.After completing the necessary degree and practicum and internship requirements the applicant must complete the following post-graduate supervised work experience requirements:

a.Has completed post graduate experience and supervised case work hours as required in R.I. Gen. Laws § 5-63.2-10 by a person who at the time of rendering the supervision is recognized by the Board as an approved supervisor under the following requirements:

(1)Is duly certified as a supervisor by the American Association for Marriage and Family Therapy (AAMFT); OR

(2)Is a licensed marriage and family therapist who has been licensed in good standing for at least five (5) years and has at least five (5) years of clinical experience as a licensee; AND

(3)Has successfully completed one graduate-level course in MFT supervision; OR

(4)Has successfully completed one MFT supervision course taken through the American Association for Marriage and Family Therapy (AAMFT)/Rhode Island Association for Marriage and Family Therapy (RIAMFT).

4.Successfully completes the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) or other examination approved by the Board to determine the applicant's qualification for licensure as a marriage and family therapist or is applying for licensure under the provisions of R.I. Gen. Laws § 5-63.2-15.

11.3.3Application for Licensure and Fees

A.Application for license to practice as a mental health counselor or a marriage and family therapist shall be made on forms provided by the Department, which shall be completed and submitted to the Board thirty (30) days prior to the scheduled date of the Board meeting at which they are to be reviewed.

B.Such application shall be accompanied by the following:

1.A non-refundable application fee as set forth in the rules and regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (216-RICR-10-05-2). In no case shall said fee be returned. Applicants requiring reexamination shall submit a fee as set forth in 216-RICR-10-05-2 for each reexamination.

11.3.4Examination of Applicants

Examination requirements are stated in R.I. Gen. Laws § 5-63.2-14.

11.3.5Endorsement for Licensure

In addition to the requirements in R.I. Gen. Laws § 5-63.2-15, an applicant who is a licensed mental health counselor in another state whose qualifying degree is awarded by a CACREP accredited program in mental health counseling totaling sixty (60) or more semester hours shall be considered equivalent to the requirement established pursuant to the Act.

11.3.6Expiration and Renewal of License

A.Licensed clinical mental health counselor or licensed marriage and family therapists shall abide by all expiration and renewal of licensure requirements in R.I. Gen. Laws § 5-63.2-17.

B.Every clinical mental health counselor and marriage and family therapist who desires to continue licensure as a licensed clinical mental health counselor or licensed marriage and family therapist shall attest to the Department that the licensed clinical mental health counselor or licensed marriage and family therapist has completed a prescribed course of continuing education in accordance with the requirements of § 11.3.9 of this Part.

11.3.7Transfer to Inactive Lists--Reinstatement

A licensed clinical mental health counselor and/or licensed marriage and family therapist whose name has been transferred to the inactive list pursuant to R.I. Gen. Laws § 5-63.2-19 who wishes to be reinstated must, in addition to the provisions of R.I. Gen. Laws § 5-63.2-19, submit an application and fees to the Department, attesting to the completion of the continuing education requirements in accordance with § 11.3.9 of this Part within the immediate two (2) years prior to the applicant’s request for licensure reactivation, unless the license has been suspended or revoked.

11.3.8Continuing Education Requirements

A.The application for license renewal shall include satisfactory evidence of completion of forty (40) credits of continuing education relevant to the practice of clinical mental health counseling or marriage and family therapy practice, completed over the two (2) year period preceding re-licensure. Furthermore, a minimum of twenty (20) of the forty (40) credits of continuing education shall be completed within Category 1 of § 11.3.8(C) of this Part.

B.Continuing education programs sponsored or approved by the following organizations are deemed to be approved by the Board: American Counseling Association (ACA), American Mental Health Counselors Association (AMHCA), National Board for Certified Counselors, Inc. (NBCC), American Association for Marriage and Family Therapy (AAMFT), Rhode Island Mental Health Counselors Association (RIMHCA), Rhode Island Counseling Association (RICA), Rhode Island Association for Marriage and Family Therapist (RIAMFT), National Association of Social Workers (NASW), American Psychological Association (APA), American Medical Association (AMA) or such other nationally-recognized organizations, as approved by the Board.

C.Categories of Continuing Education Programs and Credits:

1.The Board recognizes the following categories of continuing education programs and/or activities and established credit hours.

D.An extension of time to complete the continuing education requirements may be granted to a clinical mental health counselor or marriage and family therapist solely at the discretion of the Board for reasons of hardship or other extenuating circumstances.

E.It shall be the sole responsibility of the individual clinical mental health counselor or marriage and family therapist to obtain documentation from the approved sponsoring or co-sponsoring organization, agency, or institution of his/her participation in a continuing education program and/or activity that shall include no less than the date, time, subject matter, name of lecturer or teacher, or such other data, and the number of credits earned. Those documents shall be retained by each licensee for no less than four (4) years (i.e., from the date of license renewal) and are subject to random audit by the Department.

F.A license shall be denied to any applicant who fails to provide satisfactory evidence of continuing education relevant to counseling/family studies as required in this Part.

G.Clinical mental health counselors or marriage and family therapists initially licensed by examination after the July 1st renewal date shall be exempt from the continuing education requirements stated herein until the date of the next renewal cycle (i.e., June 30th of the next even-numbered year).

H.A clinical mental health counselor or marriage and family therapist whose license has been revoked for failing to satisfy the continuing education requirements of this Part shall be required to complete such additional continuing education credits as may be required by the Board for the preceding two (2) year cycle.

I.Failure to comply with any provisions of this section shall be subject to the sanctions set forth in the Act.

11.3.9Privileged Communications

The provisions of R.I. Gen. Laws Chapters 9-17 and 5-37.3, shall apply to persons licensed pursuant to the Act and the rules and regulations herein.

11.4.1Grounds for Discipline 

In addition to the grounds for discipline set forth in R.I. Gen. Laws § 5-63.2-21, the Board shall have the power to deny, revoke or suspend any registration applied for or issued by the Department or otherwise discipline a licensed clinical mental health counselor and/or a licensed marriage and family therapist upon proof that the person has departed from or has failed to conform to the minimal standards of acceptable and prevailing practice of mental health counseling and/or marriage and family therapy and adhere to the National Board of Certified Counselors (NBCC) Code of Ethics adopted by the Board.

11.4.2Criminal Penalties for Violations

Criminal penalties for violation of authorizing act are set forth in R.I. Gen. Laws § 5-63.2-23.

11.4.3Prohibited Acts

Except as specifically provided elsewhere in R.I. Gen. Laws Chapter 5-63.2, no person who is not licensed under this Part shall violate the provisions of R.I. Gen. Laws § 5-63.2-11.

11.4.4Exemptions

Exemptions to this Part and authorizing statute are stated in R.I. Gen. Laws § 5-63.2-12.

11.4.5Rules Governing Practices and Procedures

All hearing and reviews required under the provisions of R.I. Gen. Laws Chapter 5-63.2, shall be held in accordance with the provisions of the Act and the "Rules and Regulations Pertaining to Practices and Procedures Before the Rhode Island Department of Health".

11.5.1The Core Curriculum: Clinical Mental Health Counselors

A.An applicant needs to complete courses in each of the following eight (8) categories, in accordance with the minimum number of credits required in each category, for a total of thirty (30) credits:

1.Helping relationships and counseling theory (9 credits minimum) (i.e., counseling and consultation theories including both individual and systems perspectives as well as coverage of relevant research and factors considered in applications; basic interviewing, assessment, and counseling skills; counselor or consultant characteristics and behaviors that influence helping processes including age, gender, and ethnic differences, verbal and nonverbal behaviors and personal characteristics, orientation, and skills; client or consultee characteristics and behaviors that influence helping processes including age, gender and ethnic differences, verbal and non- verbal behaviors and personal characteristics, traits, capabilities, and life circumstances; and ethical considerations, counseling processes, counseling theories, marriage and family counseling, family counseling, systems concepts)

2.Human growth and development (3 credits minimum) (i.e., theories of individual and family development and transitions across the life-span; theories of learning and personality development; human behavior including an understanding of developmental crises, disability, addictive behavior, psychopathology, and environmental factors as they affect both normal and abnormal behavior; strategies for facilitating development over the life-span; ethical considerations)

3.Social and cultural foundations (3 credits minimum) (i.e., multicultural and pluralistic trends including characteristics and concerns of diverse groups; attitudes and behavior based on such factors as age, race, religious preference, physical disability, sexual orientation, ethnicity and culture, family patterns, gender, socioeconomic status, and intellectual ability; individual family, and group strategies with diverse populations; and ethical considerations)

4.Groups (3 credits minimum) (i.e., principles of group dynamics including group process components, developmental stage theories, group members’ roles and behaviors; group leadership styles and approaches including characteristics of various types of group leaders and leadership styles; theories of group counseling including commonalities, distinguishing characteristics, and pertinent research and literature; group counseling methods including group counselor orientations and behaviors, ethical standards, appropriate selection criteria and methods, and methods of evaluation of effectiveness; approaches used for other types of group work, including task groups, prevention groups, support groups, and therapy groups; and ethical considerations)

5.Lifestyle and career development (3 credits minimum) (i.e., career development theories and decision making models; career, avocational, educational and labor market information resources, visual and print media, computer based career information systems; career development program planning, organization, implementation, administration and evaluation; interrelationships among work, family, and other life roles and factors including multicultural and gender issues as related to career development; career and educational placement, follow-up and evaluation; assessment instruments and techniques relevant to career planning and decision making; computer based career development applications and strategies, including computer assisted career guidance systems; career counseling processes, techniques and resources including those applicable to specific populations; and ethical considerations)

6.Appraisal (3 credits minimum) (i.e., theoretical and historical bases for assessment techniques; validity including evidence for establishing content, construct and empirical validity; reliability including methods of establishing stability, internal and equivalence reliability; appraisal methods including environmental assessment, performance assessment, individual and group test and inventory methods; behavioral observations, and computer managed and computer assisted methods; psychometric statistics including types of assessment scores, measures of central tendency, indices of variability, standards errors, and correlations; age, gender, ethnicity, language, disability, and cultural factors related to the assessment and evaluation of individuals and groups; strategies for selecting, administering, interpreting, and using assessment and evaluation instruments and techniques in counseling; ethical considerations)

7.Research and program evaluation (3 credits minimum) (i.e., basic types of research methods to include qualitative and quantitative research designs; basic parametric and nonparametric statistics; principles, practices, and applications of needs assessment and program evaluation; uses of computer for data management and analysis; ethical and legal considerations in research)

8.Professional orientation (3 credits minimum) (i.e., history of the helping professions including significant factors and events; professional roles and functions including similarities and differences with other types of professionals; professional organizations; ethical standards; professional preparation standards, their evolution and current applications; professional credentialing including certification, licensure, and accreditation practices and standards, and the effects of public policy on these issues; and public policy processes including the role of the professional counselor in advocating on behalf of the profession and its clientele).

11.5.2The Core Curriculum: Marriage and Family Therapists

A.Minimum Requirements

B.The marriage and family therapy core curriculum is based upon a systems/interactional understanding of peoples’ lives. A total of nine courses (twenty-seven [27] semester or equivalent quarter hours) are to be obtained from Areas I, II, and III. A total of three [3] standard courses must be taken in areas IV, V and VI. You must have supervised clinical practice in Area VII. This may be done either on-site or off-site.

C.Area I: Theoretical Foundations of Marriage and Family Therapy

1.A minimum of two (2) courses (six [6] semester or equivalent hours) will be taken in Area I.

2.In Area I, students conceptualize and distinguish the critical epistemological issues in marriage and family therapy.

3.Students learn about the historical development, theoretical foundations, and contemporary conceptual directions of the field of marriage and family therapy.

4.Course content should not be isolated conceptually from clinical concerns; nor is it adequate for students to deal only with practical treatment issues without reference to theoretical literature.

D.Area II: Clinical Knowledge

1.A minimum of six (6) courses (eighteen [18] semester or equivalent quarter hours) will be taken in Area II.

2.Area II courses will provide students with a comprehensive survey and substantive understanding of the major models and clinical issues of marriage and family therapy.

3.Courses taught in Area II will address the applied aspects of marriage and family therapy practice.

4.Courses taught in Area II will focus on two (2) major interdependent components: diagnosis/assessment and treatment processes. Within the context of marital and family systems, students will learn to diagnose and treat both dysfunctional relationship patterns and nervous and mental disorders, whether cognitive, affective, or behavioral. Major marriage and family therapy assessment methods and instruments will be covered. Marriage and family therapy faculty will teach students to use appropriate major mental health assessment instruments within a systemic context.

5.Courses taught in Area II will emphasize the interface between the interpersonal and the intrapersonal. Courses will expose all students to issues of gender as they relate to marriage and family therapy theory and practice. Course content in this area will include sex discrimination and gender role stereotyping. Courses will also expose all students to issues of sexuality as they relate to marriage and family therapy theory and practice. Course content will include sexual orientation and sexual functioning.

6.Courses will expose all students to issues of ethnicity, race, socioeconomic status and culture as they relate to marriage and family therapy and practice. Course content will include social, educational, economic and behavioral factors.

7.Courses taught in Area II will educate students about a wide variety of presenting problems including, but not limited to, sexual abuse, intense stress, problems of life cycle transitions, sexual dysfunctions, substance abuse, suicide, and violence.

E.Area III: Human Development and Family Studies

1.A minimum of one (1) course (three [3] semester or equivalent quarter hours) will be taken in Area III.

2.In Area III, students learn about the developmental processes within the family context. Students will become conversant with the life cycle of the family and the process and modification of family structures over time (e.g., birth of the first child, adolescent sexual development, leaving home, etc.)

3.Courses taught in Area III will emphasize the interface between the interpersonal and the intrapersonal. Courses will expose all students to issues of gender as they relate to marriage and family therapy theory and practice. Course content in this area will include sex discrimination and gender role stereotyping. Courses will also expose all students to issues of sexuality as they relate to marriage and family therapy theory and practice. Course content will include sexual orientation and sexual functioning.

4.Courses will expose all students to issues of ethnicity, race, socioeconomic status and culture as they relate to marriage and family therapy and practice. Course content will include social, educational, economic and behavioral factors.

F.Area IV: Ethics and Professional Studies

1.A minimum of one (1) course (three [3] semester or equivalent quarter hours) will be taken in Area IV.

2.Area IV contributes to the development of a professional attitude and identity. Studies will include professional socialization and the role of professional organizations, licensure and certification, legal responsibilities and liabilities of clinical practice and research, family law, confidentiality issues, the AAMFT Code of Ethics, and interprofessional cooperation.

3.The content of course work will be specific to the practice and profession of marriage and family therapy. A generic course in ethics is inappropriate for Area IV.

G.Area V: Research

1.A minimum of one (1) course (three [3] semester or equivalent quarter hours) will be taken in Area V. In Area V, students gain an understanding of research methodology and data analysis, and learn to evaluate research in marriage and family therapy.

2.Course content will include both quantitative and qualitative research.

H.Area VI: Graduate Elective

1.A minimum of one (1) course (three [3] semester or equivalent quarter hours) will be taken in Area VI. Additional elective courses will augment students’ specialized interest and background in marriage and family therapy. Additional courses may be chosen from coursework offered in a variety of disciplines.

I.Area VII: Supervised Clinical Practice

1.Students are required to spend a minimum of five hundred (500) face-to-face hours with clients. Programs will document a student’s satisfactory completion of the five hundred (500) hour requirement before awarding a degree. A minimum of one hundred (100) hours of supervision is required in the supervised clinical practicum. A minimum twelve (12) successive months of supervised clinical practice is required.

2.Although students may treat individual clients, at least 250 hours (fifty percent [50%] of the 500 direct client contact hours) must be completed with couples or families physically present in the room.

3.Preparation for clinical practice includes any necessary remediation for previous clinical deficiencies.

4.Clinical training will integrate didactic with clinical material. A practicum is a part-time clinical experience completed concurrently with didactic coursework. A practicum typically results in 5-10 direct client hours per week. It also includes such activities as supervision, staff meetings, community relations, and record keeping.

5.Direct client contact is defined as face-to-face (therapist and client) therapeutic meetings. Activities such as brief telephone contact, case planning, observation of therapy, record keeping, travel, administrative activities, consultation with community members or professionals, or supervision, are not considered direct client contact.

6.Assessments may be counted as direct client contact if they are face-to-face processes that are more than clerical in nature and focus.

7.Both individual or dyadic and group supervision of the student’s clinical practice are required. Individual or dyadic supervision will occur at least once (1) per week over a period of one (1) or more years.