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Texas Mental Health Crisis: Intern Supervision and Underserved Areas

Texas supervisor training program, speaking, consulting

Texas We Have a Problem

Here’s the thing. In light of recent events I want to speak to all of the problems Texas has when it comes to providing excellent, accessible, and affordable mental health care. I want to outline solutions, propose law changes, and rally the troops. Texas seems to enjoy competing for 49th or 50th place when it comes to quality mental health care in America and this little blog post probably won’t change that. So, as a counselor supervisor, counselor educator, and practicing clinician, I will talk about what I know. This post is about counselor intern supervision and supervisor training.

For those readers who aren’t familiar with Texas rules governing licensed professional counselors:

  • Every Licensed Professional Counselor (LPC) in Texas must spend 3000 hours as a Licensed Professional Counselor Intern under the supervision of a Licensed Professional Counselor Supervisor (LPC-S).
  • There are places in Texas where there are no licensed professional counselors or supervisors (see the white areas in the map below).
  • There are strict limits on the number of supervision hours interns can accrue using technology.

Training more supervisors in rural areas and lifting the restrictions on webcam supervision would be easy first steps to helping Texans gain access to quality mental health care.

Texas supervisor training program, speaking, consulting

 

Counselors and Webcams

Increasing allowable intern supervision hours via technology is a no-brainer. The Telemedicine Wellness, Intervention, Triage, and Referral Project at the Texas Tech University Health Sciences Center is pioneering the use of technology to screen junior high and high school students, identify those most at risk for committing violence in schools, and intervene before anything happens. Data are already showing that the screenings have helped avert violent incidents and provide students the help they need. Why can’t interns attend supervision using the same technology? Counseling graduates on the fence about where to practice might choose underserved areas if they did not have to travel long distances to receive face to face supervision. Arguments against using technology in mental health are archaic and have become a roadblock to care.

Counselor Supervision Training

Changing the rules about technology and supervision is only a start. Long story short, we need seasoned counselors and counselor supervisors in underserved areas. One LPC Supervisor Course attended by five participants who agree to take on just two interns can impact hundreds of people in need of quality mental health care. Recently I, along with Dr. Christopher Taylor offered a six hour course to twenty participants in El Paso interested in offering their own 40 hour training. How exciting is that? Twenty seasoned licensed professional counselor supervisors near one of the most underserved areas in the state are now trained and willing to provide their own courses. Their impact alone could be a game-changer for interns who feel called to work in underserved areas.

Texas supervisor training, speaking, consulting

Lifting limits on technology and increasing the number of supervisors won’t solve everything but it’s a start. We still need to give interns the ability to bill Medicaid. We still need to convince the military and Tricare to hire licensed professional counselors. And we need to help Medicare understand that refusing to allow counselors to be credentialed under their plans makes them part of the problem. Texas, we need counselors and supervisors more than ever before. And we need them now.

Edu-Preneur: Create Your Own Supervisor Training Course

Supervisor training, speaking, consultation

“What is holding you back from creating your own 40-hour supervisor training?”

This question was part of the presentation I was giving with Dr. Paul Carrola and Dr. Amy Wilson at the Texas Association for Counselor Education and Supervision Mid-Winter conference. I was speaking to a room of about fifteen people curious about how to pull off a forty-hour supervisor training in their community. The most common barrier? Time. Participants worried about the time they would need to divert from their practices to create content and manage participants. In my article “The Good, the Bad and the Ugly: Creating a Counselor Supervisor Course,” I described some key components to help potential course designers. After my TACES presentation, however, I realized I need to talk about content, systems, and tools.

Supervisor Training Content

Supervisor training course content is prescribed by state licensing boards, accrediting bodies, and universities. In many states this is spelled out explicitly. The Texas LPC code, for example, defines the topics that must be covered in a supervisor training course. Unfortunately, since most potential supervisor trainers are not professional educators they don’t have easy access to powerpoints and textbooks. In those instances the content must be generated the old fashioned way, outsourced to content developers for a fee, or borrowed from public domain sources.

Participant Management Systems

Potential supervisor training participants will go through three stages: pre-purchasers, participants, and course graduates. Supervisor trainers must be able to manage expectations at each stage. Good participant management systems, organizational systems, and financial systems can help. Pre-purchasers need information about eligibility and law. They need quick responses to email and phone queries.  Most will also need to know your refund policy before they decide to follow through with their purchase. Participants have assignments to complete and deadlines to meet. If your supervisor training course requires online or outside assignments, then you must have a system to keep track of successful completion. Course graduates will need support and access to replacement certificates. Remember graduation from your course doesn’t mean the course graduate is automatically granted supervisor status. There may be a waiting period to gather more experience.  In Texas the course is only good for two years and Texas LPCs only have ninety days to complete it. You must have a system to track and be able to prove when the course graduates officially began and successfully (or unsuccessfully) completed your course.

Practical Tools

Course graduates appreciate helpful tools to help them begin integrating supervision into their private practice. It’s great if you can offer them supervisor toolkits, helpful software ideas, and economical apps. Remember your course graduates are your best source of good reviews and new referrals so help them leave your course feeling fully equipped! Follow up with them through emails and social media and help them stay connected with state organizations and other course graduates.

Content, systems, and tools are just a few things that will really make your supervisor training stand out and benefit your participants. Keep checking this blog for more great ideas!

 

Take the Next Step in Your Counseling Career

Texas supervisor training speaking consulting private practice

When I am speaking at an event or consulting one-on-one with counselors, I find there is always some confusion about the next right steps to take in a counseling career. Most of us started out with a story of strength and a dream to help. We persevered over adversity or we encountered something that we thought would kill us and instead it made us stronger. Most of us leaned on the shoulder of a counselor or therapist and learned we really could be ok. For most of us, turning that story into a career was life changing. Whether we decided to work in an agency, school, or private practice, getting paid to do what we loved to do was living the dream. A few years down the road from that first client, lots of mental health professionals are ready for a new challenge, a change of client ‘scenery,’ and improved income. Private practice, supervising, and supervisor training are just a few things you can think about as you plan the rest of your counseling career.

Agency to Private Practice

For lots of mental health professionals just starting out private practice can seem scary. With a few tricks and systems however, private practice is very do-able. Part time practice can be ideal for full time parents. You can make your schedule as busy as you like. Set a higher rate for your services so you keep your practice low volume and still pay your rent and buy groceries. Those who want a lucrative, high volume, full time practice can also set a rate and a create a schedule that meets their goals. There are many affordable consultants, tools, and boot camps you can utilize to get started on the right foot, stay compliant, and stop wasting time.

Integrating Supervision Into Private Practice

Becoming a supervisor is a wonderful way to expand your skills, give back to the profession, and add another stream of income to your practice. In most states extra training is required. If your state doesn’t require extra training, I’d get some anyway. Most supervisor training programs will teach you what you’ll need to know to stay organized, stay compliant, and mentor your interns. Like private practice, supervision means taking a leap into the unknown, but the rewards are worth it. There are so many ways to integrate supervision into a practice! You can start a non-profit and allow your interns to see clients at a reduced rate. The Ann’s Place Business Model shows you how to barter supervision for interns who will see your self-pay clients who need a sliding fee-scale. This helps your interns, your community, and your bottom line. Or you can take the more traditional route and charge your interns for your supervision services.

Provide Your Own Supervisor Training

Probably the most lucrative of all of these streams of income, is offering your own supervisor training. Costs for these courses can run anywhere from $500 to $1000 dollars per person. With some concentrated effort on the front end, you can enjoy this income stream as often as you can fill the seats. Teaching will enhance your own clinical skills as well and take your practice to a whole new level

Private practice, supervision, and providing a supervisor training are just a few ways you can create a career that will keep growing and changing with you. After all, your story isn’t over. Check out my book on Amazon, “My Next Steps: Create a Counseling Career You’ll Love,” for more ideas, advice from experts in the field, and a step by step guide so you can create the career you fell in love with.

Take a Look at My Intake Paperwork

Check out KateWalkerTraining Paperwork

Happy 2018! Every January I edit and revise all of my paperwork. As promised, here is a fifteen minute video consultation. In it, I act as your supervisor and tell you exactly why I include the things I do.  As a speaker, this is a topic I get asked to present a lot. Let me know what you think in the comments below!