Policy Advisory

Policy Advisory Board Policies and Guidelines (Allied Mental Health)

Date: 12/06/2017
Referenced Sources: Division of Professional Licensure's Office

Advisory Regarding Practicing With Children and Families In Massachusetts Where Parents May Be Separated, Divorced, Or Never Married

Practice Advisory:
Practicing with Children and Families in Massachusetts where Parents may be Separated , Divorced or Never Married

Adopted July 20, 2012 at a regularly scheduled meeting of the Board of Allied Mental Health and Human Service Professionals

Due to the large number of telephone calls, complaints and other inquires from both licensees and parents in this area of practice, the Board of Registration of Allied Mental Health and Human Service Professionals wishes to advise licensees of the following information related to the practices of licensed mental health counselors, licensed marriage and family therapists, licensed educational psychologists, and licensed rehabilitation counselors (collectively “licensees”) with children and families in the process of separation-divorce, never married, or post-divorce. Given that this policy deals with issues of confidentiality and testimonial privilege, and potential exceptions thereto, licensees are strongly advised to seek consultation from knowledgeable persons, including legal counsel in an appropriate circumstance:

  1. It is very important for licensees engaged in treatment of a minor child whose parents are separated or divorced, or who were never married to each other, to understand the custodial rights that each parent has. Under the law, terms like “physical custody” and “legal custody” have specific meanings that are highly relevant to a professional treating a child.
  2. The child-client whose parents are divorced or in the process of divorce has his or her own confidentiality rights and evidentiary privilege with respect to his or her relationship with the therapist. In other words, a licensee may not divulge the substance of what the child client has discussed either orally or by release of written records just because a parent asks for this information. This information may only be released with a court order or with the signed, informed consent of a mature minor. As stated by the Massachusetts Supreme Judicial Court in the 1987 case Adoption of Diane, “[W]here the parent and child may well have conflicting interests, and where the nature of the proceeding itself implies uncertainty concerning the parent’s ability to further the child’s best interests, it would be anomalous to allow the parent to exercise the privilege on the child’s behalf.” This case law has been interpreted further to mean that confidential information provided by the child in a psychotherapy environment, including a copy of the child’s record, should not be released to either parent or to the court, even with a signed release from one or both parents. Only the court can waive the child’s privilege and/or make a determination as to the release of confidential psychotherapy records, and Probate courts can and do appoint special guardians ad litem to decide this question for a child.
  3. Child therapists should refrain from initiating therapy with a child without the consent of both parents, unless there are legitimate protective issues relating to the child or other mitigating circumstances. Reaching out to the parent who did not initiate treatment for the child is a best practice that can help the therapist understand all sides of the child’s family situation and protect against being perceived as biased or allied with one parent.
  4. Sole legal custody is rarely awarded in Massachusetts except in circumstances in which one parent has died, there are protective issues, or the parents were never married. In these cases, the licensee should inquire as to the circumstances of the family before deciding whether to reach out to the non-custodial parent for his/her consent and involvement in the treatment.
  5. Psychotherapy and child custody evaluation are two very distinct services with different roles and responsibilities. “[Licensees] conducting a child custody evaluation with their current or prior psychotherapy clients and [licensees] conducting psychotherapy with their current or prior child custody examinees are both examples of multiple relationships.” (Guidelines for Child Custody Evaluations in Family Law Proceedings, 2010). The same individual should not undertake both roles.
  6. A child therapist should not write evaluative reports to lawyers or the court. Factual reports (providing information regarding the existence of the therapeutic relationship) should be provided only in response to a court order and only after legal consultation.
  7. A child custody evaluation is a specialized area of practice. In general, such forensic evaluations are conducted by court order and are assigned to specialized practitioners who have been certified in this area and are on the court’s list of approved providers, known as “Category E Guardians ad Litem.” A comprehensive set of standards links to PDF file apply to evaluative child custody investigations.
  8. A therapist for a parent should not write evaluative reports or make custody-visitation recommendations for use in court. Additionally, therapists should never submit evaluative letters or reports regarding the spouse or partner of their patient.
  9. It is advisable for licensees to communicate to parents prior to initiating treatment with a child, preferably in an informed consent document signed by all parties, that confidential information will not be released to the parent.

Working therapeutically with children in separated, divorced, or unmarried families requires a higher level of expertise, training, and consultation than working with children in intact families. It is good practice, whenever one is in doubt about how to proceed, to seek consultation with experts or with an attorney familiar with this work.

Policy on Reciprocity Applications for Licensed Marriage and Family Therapists: Policy No. 09-03

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on May 15, 2009 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.Purpose:

Pursuant to 262 CMR 3.04, "The Board shall issue a license without examination to an applicant licensed as a professional in a comparable field in another state whose requirements for the license are determined by the Board to be equivalent to or exceed the requirements of the Commonwealth."

The purpose of this policy statement is to offer guidance to applicants seeking licensure in Massachusetts as a Marriage and Family Therapist, who are also licensed as a marriage and family therapist and/or licensed in a comparable field in another state, regarding the Board's requirements for reciprocal licensure.

Policy:

Effective June 1, 2009, the Board will evaluate each reciprocity application, individually, to determine whether the state, in which the applicant is licensed, has substantially equivalent or higher requirements as those required by the Regulations

Discussion:

After reviewing several recent applications, the Board determined that there are states that currently do not have substantially equivalent requirements for licensure as those required by 262 CMR 3.00. In order to ensure that the public's health, safety, and welfare are properly protected by licensing qualified Massachusetts marriage and family therapists, according to the standards established at 262 CMR 3.03, the Board voted to adopt this policy.

Authority:

M.G.L. Chapter 13, Section 90; and 262 CMR 3.00 et seq.

Policy on Procedure for Reinstatement of Licensure after the Expiration of a License

Procedure for Renewal of Lapsed/Expired Licenses

The Board of Allied Mental Health and Human Services Professions ("the Board") voted at its meeting May 19, 2017 to adopt the following Policy Guideline.  This policy guideline is intended as a recommended protocol for the profession and the Board to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice areas under the Board’s jurisdiction. 

Policy No. 17-001

Purpose:
The purpose of this policy statement is to offer guidance to Licensees regarding the procedures for the renewal of lapsed/expired licenses as set forth in 262 Code Mass. Regs. § 9.01.

Policy:
1.             If a person seeks to reinstate their license within two (2) years (one renewal cycle) of their expiration date, the applicant may, upon discretion of the Board, renew his/her license by completing a renewal application including attesting to completion of all appropriate continuing education activities (30 Contact Hours), paying the current renewal fee, and paying a late fee.

2.             If a person seeks to reinstate their license beyond two years and less than four (4) years of their expiration date, the applicant may, upon discretion of the Board, renew their license by completing of the following:

a.             submit a completed license renewal application, together with documentation of completion of thirty (30) contact Hours of continuing educations, and

b.             pay two current renewal fees and any late fee as may be established by the Secretary of Administration and Finance pursuant to G. L. c. 7, § 3B to the Board.

3.             If a person seeks to reinstate their license beyond four (4) years (two renewal cycles or more) of their expiration date, the applicant may, upon discretion of the Board, renew their license by completing all of the following:

  1. submit a completed license renewal application, together with documentation of completion of sixty (60) contact Hours of continuing education completed within the last four years; and
  2. completion of any other board requirements as determined by the Board, including re-examination: and
  3. pay two current renewal fees and any late fee as may be established by the Secretary of Administration and Finance pursuant to G. L. 7, § 3B to the Board.

Policy on Proration of Continuing Education Requirements: Policy No. 09-01

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on January 16, 2009 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.

Purpose :

Pursuant to 262 CMR 7.02 (1), " All licensees are required, as a condition of license renewal, to complete a minimum of 30 contact hours of continuing education activities per licensure/renewal period (every two years)."

The purpose of this policy statement is to offer guidance to new Licensees regarding the Board's guidelines for prorating the number of continuing education contact hours required for a Licensee's first renewal cycle.

Policy :

The number of continuing education hours required for license renewal shall be pro-rated for the licensure period in which a Licensee first obtains his or her license from the Board, as follows:

 

  1. A licensee who first receives his or her license during the first quarter of the licensure period of an even- numbered calendar year (i.e., between January and June of 2008, 2010, 2012, etc.) shall complete seventy-five percent (75%) of the continuing education hours normally required for his or her license;
  2. A licensee who first receives his or her license during the second quarter of the licensure period of an even- numbered calendar year (i.e., between July and December of 2008, 2010, 2012, etc.) shall complete fifty percent (50%) of the continuing education hours normally required for his or her license;
  3. A licensee who first receives his or her license during the first quarter of the licensure period of an odd- numbered calendar year (i.e., between January and June of 2009, 2011, 2013, etc.) shall complete twenty-five percent (25%) of the continuing education hours normally required for his or her license; and
  4. A licensee who first receives his or her license during the second quarter of the licensure period of an odd- numbered calendar year (i.e., between July and December of 2009, 2011, 2013, etc..) shall not be required to complete any continuing education hours for that licensure period.

 

Authority:

M.G.L. Chapter 13, Section 90; and 262 CMR 7.00 et seq.

Policy on Board Recognized Entities Designated to Approve Sponsors of Continuing Education Courses: Policy No. 08-01

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on July 18, 2008 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.

This policy was reviewed and updated at the Board’s meeting on November 20th, 2015

Purpose:

The purpose of this policy statement is to offer guidance to Licensees and Continuing Education Providers regarding the entities designated by the Board to approve sponsors of continuing education programs and courses as set forth in 262 C.M.R. 7.00, et seq.

Policy:

Pursuant to 262 CMR 7.02, “Board –recognized Entities’ is defined as “Entities that the Board has designated as appropriate to approve sponsors of continuing education activities. Entities may define continuing education content areas appropriate for the specific license. Designated entities may define procedures for the sponsors to follow in the delivery of continuing education activities.”

In accordance with the above definition, the Board will accept courses or programs approved by the following entities:

For Licensed Mental Health Counselors (LMHC): Courses approved under the standards of the Massachusetts Mental Health Counselors Association (MAMHCA) or the National Board of Certified Counselors

For Licensed Marriage and Family Therapists (LMFT): Courses approved under the standards of the Massachusetts Association for Marriage and Family Therapy (MAMFT), the American Association of Marriage and Family Therapy (AAMFT), and/or their appointed Continuing Education administrators approved by this Board.

For Licensed Rehabilitation Counselors (LRC): Courses approved by the Commission of Rehabilitation Counselors (CRC) or Massachusetts Rehabilitation Counselors Association (MRCA).

For Licensed Educational Psychologists (LEP): Courses approved by the MA Department of Education, the National Association of School Psychologists, the American Psychological Association and the Massachusetts School Psychologists Association.

For Licensed Applied Behavior Analysts and Licensed Assistant Applied Behavior Analysts (LABA and LAABA) Course approved by Behavioral Analysts Certification Board (BACB)

Authority: M.G.L. Chapter 13, Section 90; and 262 CMR 7.00 et seq.

Policy on Distance, Online, and Other Electronic-Assisted Counseling: Policy No. 07-03

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on November 16, 2007 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.

Purpose:

The Board acknowledges that therapy and counseling are increasingly being provided at a distance, making use of the internet, telephone and other electronic means of communication. The emergence of new clinical procedures is necessarily accompanied by uncertainty about legal and ethical obligations. The purpose of this policy statement is to offer guidance to Licensees regarding the ethical obligations and standards of conduct in the use of distance, on-line, and other electronic assisted counseling.

Policy:

The Board's policy with regard to all distance or electronic-assisted provision of clinical services is as follows:

1. The services offered by licensees of this Board across a distance by electronic means, fall within the jurisdiction of the Board just as traditional, face-to-face services do. Therefore all Board policies and regulations will apply to these services.

2. Distance delivery of counseling and therapy is considered to occur in two locations: where the client is located and where the clinician is located.

3. Therefore, the provision of counseling and/or therapy to individuals located within Massachusetts at the time services are occurring, are considered to fall under the jurisdiction of the Board, regardless of the location of the provider.

4. Mental health professionals licensed by any jurisdiction other than Massachusetts, and not licensed by any Massachusetts Board or not eligible for an exception to Massachusetts licensure, are considered unlicensed by this Board for practice in Massachusetts.

5. Mental health professionals licensed by other jurisdictions who wish to provide services to clients within Massachusetts, are encouraged to apply for Massachusetts licensure. Some, licensees may find the following helpful:

a. Mental Health Counselors: 262CMR 2.03, (1) Licensure for CCMHC's in good standing with NBCC

b. MFT's: 262 CMR 3.04 Licensure by Reciprocity for MFT's.

6. Board licensees who wish to provide services via electronic means to clients located outside of Massachusetts are urged to ensure that they meet the requirements for practice within the jurisdiction where the client is located.

7. Licensees are encouraged to carefully review the way in which the structure of their relationships with clients will be impacted by distance-therapy or counseling to ensure compliance with Board regulations and standards of practice.

8. The following are some areas of practice that licensees should carefully consider:

a. Informed consent
b. Confidentiality
c. Basis for making clinical judgments
d. Areas of competence
e. Avoiding harm
f. Fees and financial arrangements
g. Advertising
h. Abandonment of clients
i. Handling requests for obtaining clinical records

9. The Board expects licensees to understand and overcome the significant challenges inherent in providing counseling and therapy without face-to-face contact with the client.

10. Some of the challenges that licensees are expected to manage include,

Use of Home Study and On-Line Programs to meet the Continuing Education Requirements: Policy No.: 07-02

The Board of Registration of Allied Mental Health and Human Services Professionals ("the Board") voted at its meeting on September 21, 2007 to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of allied mental health and human services.

Adopted September 21, 2007

Updated December 16, 2011

Purpose:

The purpose of this policy statement is to offer guidance to Licensees regarding the use of home study and on-line programs to meet the Continuing Education Requirements set forth in 262 C.M.R.  7.03(1). 

Policy:

It is Board policy that no more than 50% of the required “30 contact hours of continuing education activities” may derive from home study or on-line programming.

The Board has determined that LIVE tele-seminars and LIVE webinars would be accepted by the Board as “live” CEUs.  Re-broadcasts are not be accepted as “live” CEUs.

The Board’s Regulations 262 CMR 7.00 state the requirements for continuing education.

Pursuant to 262 CMR  7.03(1),  “All licensees are required, as a condition of license renewal, to complete a minimum of 30 contact hours of continuing education activities per licensure/renewal period (every two years).  These contact hours must be in compliance with Board approved entities' requirements.”

 Authority: M.G.L. Chapter 13, Section 90; and 262 CMR 7.00 et seq.

LMHC Course Policy: Policy #07-01

LMHC Course Policy

Adopted May 18, 2007

Purpose:
To more clearly define content required within the ten Required Course Areas set out in 262 C.M.R. 2.05(2)(d).

It is expected that all courses taken to meet the required course areas of the educational requirements for licensure as a Mental Health Counselor will focus specifically on mental health counseling. The content of courses used to meet the ten required areas stipulated in the educational requirements must include a range of recognized Mental Health Counseling approaches and not be restricted to one specialty area.

For those applicants, matriculating prior to August 1 st 2008, whose syllabi does not set out these standards, the Board will accept a letter of clarification from the DEAN or Department Chair attesting that this course does in fact meet these policy standards. All applications will be evaluated on a case-by-case basis.

The following are more specific descriptions of the ten required content areas. It is expected that the course descriptions for courses used to meet the educational requirements will reflect this information.

 

  1. Counseling Theory:
    Examination of the major theories, principles and techniques of Mental Health Counseling and their application to professional counseling settings. Understanding and applying theoretical perspectives with clients.
  2. Human Growth and Development:
    Understanding the nature and needs of individuals at all developmental stages of life. Understanding major theories of physical, cognitive, affective and social development and their application to Mental Health Counseling practice.
  3. Psychopathology:
    Identification and diagnosis and mental health treatment planning for abnormal, deviant, or psychopathological behavior, includes assessments and treatment procedures.
  4. Social and Cultural Foundations:
    Theories of multicultural counseling, issues and trends of a multicultural and diverse society. Foundational knowledge and skills needed to provide mental health counseling services to diverse populations in a culturally competent manner.
  5. Helping Relationships: Understanding of the theoretical bases of the helping processes, mental health counseling techniques, and their applications. Understanding and practice of helping skills necessary for the Mental Health Counselor.
  6. Group Work:
    Theoretical and Experiential understandings of group development, purpose, dynamics, counseling theories, group counseling methods and skills, as well as leadership styles. Understanding of the dynamics and processes of Mental Health (therapeutic, psychosocial, psycho-educational) groups.
  7. Special Treatment Issues:
    Elective areas relevant to the practice of mental health counseling, i.e. psychopharmacology, substance abuse, school or career issues, marriage and family treatment, sexuality and lifestyle choices, treating special populations.
  8. Appraisal:
    Individual and group educational and psychometric theories and approaches to appraisal. Examination of the various instruments and methods of psychological appraisal and assessment utilized by the mental health counselor. The function of measurement and evaluation, purposes of testing, reliability and validity.
  9. Research and Evaluation:
    Understanding social science research and evaluative methodologies and strategies, types of research, program evaluation, needs assessments, ethical and legal considerations.
  10. Professional Orientation:
    Understanding of professional roles and functions of Mental Health Counselors, with particular emphasis on legal and ethical standards. Ethical case conceptualization, analysis and decision making as relates to clinical practice. Knowledge and understanding of the standards set by the code of ethics of the American Counseling Association and the American Mental Health Counselors Association. Understanding of licensure and regulatory practices
Referenced Sources:

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