The following document serves as an agreement between the above-named intern (supervisee) and Aaron Norton, PhD, LMHC, LMFT (supervisor).

 
My Professional Background, Qualifications, and Philosophy of Supervision:
 
I am a Licensed Mental Health Counselor and Licensed Marriage & Family Therapist with certifications in addictions, rehabilitation counseling, forensic evaluation, forensic psychometry, and trauma who works full-time the University of South Florida's Counselor Education program and part-time at Norton Consulting Services, LLC/Integrity Counseling, Inc., a group private practice in Largo, FL, where I provide professional consultation and training; clinical and forensic mental health and substance abuse evaluation; administrative services for the National Board of Forensic Evaluators; and individual, couples, and family psychotherapy and counseling with adolescents and adults. 

I am a Qualified Supervisor who provides clinical supervision to Registered Mental Health Counselor Interns and Registered Marriage & Family Therapy Interns who are pursuing licensure.  I value participation in professional associations and am very involved with the local, state, and national chapters of the American Mental Health Counselors Association (AMHCA).  

I earned a PhD in Counselor Education and Supervision, a MA in Rehabilitation & Mental Health Counseling, and a BA in Psychology from USF.  I have 20 years of experience as a case manager, clinician, and supervisor in the human services industry and have worked in a variety of residential and outpatient treatment settings in both the public and private sector. 
 
My counseling and supervision theory is best described as integrative cognitive-behavioral, integrating approaches and techniques from a range of counseling and supervision theories into a cognitive-behavioral model. I specialize in client issues such as anxiety, depression, addictions, and lesbian, gay, bisexual, and transgender (LGBT) issues. I also have specialized expertise in clinical and forensic evaluations. 

I am hopeful that you will experience me as warm, flexible, collaborative, and non-judgmental but also professional and relatively structured in my approach to supervision.  In many respects, I believe that interns are likely to experience the typical supervision session more like consultation with a peer specialist than supervision with an authority figure.  However, I am also expected to serve the role of “gate-keeper” in the event that there is evidence that you are an “impaired practitioner” or are unable to ethically and effectively practice.

 

Laws and Rules Governing Internship/Supervision:

The Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling (a.k.a. "the 491 Board") and state legislators have established the following laws and rules governing the sueprvision process for reigstered mental health counselor interns and registered mariage and family therapy interns:

• You must receive at least 100 hours of supervision completed in no less than 100 weeks (Rule 64B4-2.002 (1)(a)).
  • Supervision may be provided through "face-to-face electronic methods" so long as the supervisor deems it appropriate.
• You must provide at least 1,500 hours of face-to-face psychotherapy with clients Rule (Rule 64B4-2.002 (1)(b)).
  • Hours provided via an "electronic means" (i.e., telehealth) may be applied to this requirement, so long as a written telehealth protocol and safety plan is in place that includes the provision that the qualified supervisor is readily available during the electronic therapy session, telehealth is appropriate for the specific client, and laws and rules governing telehealth are honored (Rule 64B4-2.002 (6)).
• If you are working in a private practice setting, you must ensure that a licensed mental health professional (who does not necessarily need to be your qualified supervisor) is "on the premises" when you provide clinical services (F.S. 491.005(3)(c); F.S. 491.005(4)(c)). Neither the staute or the 491 Board define the term "private practice."  The Counseling Dictionary, published by the American Counseling Association, defines "private practice" as "a practice in which a clinician assumes total responsibility for the nature and quality of the treatment provided and collects fees directly or indirectly in return for such services."
  
  
  • A "mental health professional" is defined by the Board as "a psychotherapist licensed under Chapter 491, F.S., a psychologist licensed under Chapter 490, F.S., a psychiatrist licensed under Chapter 458 or 459, F.S., who is certified by the American Board of Psychiatry and Neurology; or an advanced registered nurse practitioner certified under Section 464.012, F.S., and who is certified by a board approved national certification organization pursuant to Rule 64B9-4.002, F.A.C." (Rule 64B4-2.006)
• Up to half of your supervision sessions may be "group" instead of "individual."  (Individual supervision sessions are defined as a qualified supervisor meeting with one or two interns, and group supervision sessions are defined as three to six interns meeting with the qualified supervisor.). However, each group supervision session must alternate with an individual supervision session (i.e., you cannot have two group sessions in a row) (Rule 64B4-2.002(4)). 
• I cannot supervise more than 25 interns simultaneously (Rule 64B4-2.002(7)).

 

My Responsibilities as a Supervisor:

The 491 Board has also established the following responsibilities for qualified supervisors per Rule 64B4-2.0025 and Rule 64B4-2.003:

• I will create a supervision contract with you (you are reading it right now) covering expectations, meetings, and associated costs.
• Once we have both signed this agreement, I will email to the 491 Board a signed and dated letter notifying the Board that I have agreed to provide you with supervision during your internship.
• I will not start your superivsion until after the Board has provided you with an approval letter attesting to your active status as a registered intern.  (In my experience, this typically takes about two weeks from the time you apply, but sometimes it takes longer.)
• I must ensure that at all times we are both acting within our scope of practice.
• I have to report any violations of the scope of practice, standard of care, or any laws or rules directly to the Board within seven (7) days of becoming knowledgeable of the violation.
• I will create and sign notes documenting each supervision session, including the date, time, duration, and participants within 24 hours of the session.
• I must ensure that both you and I are complying with all continuing education requirements established by the Board.
• If you or I terminate our supervision relationship, I will noify the Board and submit the "Verification of Clinical Experience" form to the Board within seven (7) days.
• If the Board requests that I (a) provide them with information about your supervision, or (b) appear before them to discuss your supervision, then I will do so.
• If I am unable to provide adequate supervision, I will terminate our supervisory relationship.
• I will provide you with training and feedback throughout the supervision process; educate and update you on the codes of ethics governing our professions; and decribe ethical, legal, and regulatory issues of supervision, including documentation of supervisory sessions.
  • (Please note that we will use the most current editions of the AAMFT, ACA, and AMHCA codes of ethics.)  
• I will emphasize the importance of providing assessments and using techniques that are sensitive to the individual client’s needs, including the client’s cultural background.
• I will serve as a mentor and role model for professional conduct, including self-care.
• I will educate you about ethical, legal, and regulatory issues related to telehealth.
• I will set clear preofessional and personal boundaries.
• I will educate you about "personal versus professional self."
• I will not provide you with supervision if I am (or used to be) your therapist, parent, spouse, sibling, child, employee, household member, family member, or romantic or domestic partner.

In addition to these responsibilities required by the Board, I will:

• Be available by cell phone at (727) 403-6208 and will respond within 24 hours to messages unless I inform you that I will be unavailable during a specified period of time.
• Give you access to an electronic folder that you can use to access signed logs documenting your supervision hours.
• Respect the differing clinical and administrative opinions and perspectives of supervisors and administrative staff working within your agency (unless doing so would violate laws and rules and/or constitute a clear ethical violation).

Use of Artificial Intelligence (AI) Tools for Supervision Sessions:

During electronic supervision sessions, I use a HIPAA-compliant AI technology (Zoom's AI Companion) to generate a summary for each supervision appointment.  This technology is a 1-way secure information exchange (i.e., the AI bot will use external data when organizing information but will not store or transmit any information from our appointments to an external source).  This summary can be made available to you upon request.

 

 

 

Supervision Fees

• The cost for supervision sessions is as follows: $80 for individual supervision (one-on-one), $45 for individual supervision (when two interns are present for the same session), and $30 for group supervision (three to six interns present for the same session).
• In the event that you are (a) are absent from a scheduled individual supervision appointment, or (b) cancel with less than 24 hours notice, you will still be charged for the appointment.

 

Your Responsibilities as a Supervisee:

• You agree to provide me with at least 24 hours’ notice in the event that the you need to cancel or reschedule an appointment.  In the event of a late cancellation or no show for individual sessions, you will be charged the full rate of the session.
• You attest that if working in a private practice setting, a licensed mental health professional (i.e., LMHC, LMFT, LCSW, licensed psychologist, psychiatric APRN, psychiatric DO/MD) will be available at your work site at all times in the event of a crisis or emergency.
• You attest that you will learn and abide by your agency’s/work site’s internal policies and procedures for managing acute crises and emergencies.
• You will not provide me with HIPAA-regulated protected health information (PHI) unless you have (a) obtained a signed HIPAA-compliant release of information from the client indicating the client’s consent to sharing such information; and (b) have utilized the appropriate administrative channels in your agency/practice setting to permit sharing such information with an external supervisor.  (Note that the sharing of PHI is not typical in my supervision practice.)
• You will keep a log of client contact hours that I will review weekly during face-to-face supervision appointments.  Per 64B4-2.0025(5)(e), we must use form DH-MQA 5078.  You can access and complete that form each week by clicking here. 
• You will provide me with verbal and/or written case presentations for client case conceptualization and discussion.
• You agree to provide me with video or audio recordings of sessions and to obtain your client's written consent for recording upon my request.  Note that in this scenario you will need to have also adhered to your agency/practice’s internal administrative procedures for such “raw data” to be shared.  If your agency, employer, etc. does not have an audio/video recording consent form, you can access one using this link: https://hipaa.jotform.com/aaroncap/Recording-Consent-Intern
• During each session, you will provide me with updates regarding cases discussed during each previous supervision session.
• In the event that I inform you that I will be unavailable by phone for a specified period of time, you will obtain back-up supervision for emergency cases.  You are permitted to have a "backup" qualified supervisor on file, though that QS will need to sigan an agreement with you and notify the board that they are also providing you with supervision.  Two qualified supervisors that many of my interns use in my absence include Taurean Wilson, LMHC and Rachel Gilmore, LMHC, but you can choose to identify a different QS.
• You agree to abide by the most current version of the AAMFT Code of Ethics (MFT interns) and/or the ACA and AMHCA codes (MHC interns).
• You agree to comply with federal, state, and local laws and rules governing our profession. 
  • Examples of federal laws pertainig to our profession include 42 CFR, Part 2 (for clients treated for substance use disorders); 45 CFR, Parts 160, 162, and and 164 (HIPAA and HITECH), and 45 CFR, Part 149 (the No Surprises Act). 
  • Most state laws governing our profession are housed in Chapters 491, 456, 120, 39, 90, 394, 397, and 415 in the Florida Statutes.
  • State statutes confer power to the 491 Board to create rules that also govern the profession.  Those rules are housed in the Florida Adminitstrative Code under Chapter 64B4.  
• If you have more than one Qualified Supervisor or clinical supervisor, either within your agency or outside of it, you agree that there may be scenarios in which I will need to communicate with your on-site supervisor(s).  This is particularly critical for scenarios involving clear and significant breeches of law and/or professional ethics.
• Per F.S. 491.0149(2)(b), any promotional materials, including cards, brochures, stationary, advertisements, and signs naming you must include the words "registered mental health counselor intern" or "registered marriage and family therapy intern" (depending on your licensure path). 

 

Either party may terminate this supervision agreement verballly or in writing at any time.