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* 1. Name First, MI, Last 

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* 2. Georgia License(s) #'s

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* 3. Your Email Address:  This is the email address that the committee will use to communicate with you. 

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* 4. How many days does an APC have to notify the Board in writing of any director, clinical supervision, /andor worksite changes?

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* 5. A strong working alliance in supervision is important because:

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* 6. Jody believes she is finally ready to submit her application for LPC. She submits her application to her current clinical supervisor to review. Her clinical supervisor notices that Jody’s first cycle began on March 1, 2014 and ended on February 20, 2015. Jody then took a break of several years from accruing hours to concentrate on raising her children. How should Jody’s clinical supervisor advise her about the 2014 break?

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* 7. All supervisor relationships are responsible for the following:

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* 8. Which of the following is true of clinical supervision?

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* 9. Ju Mei has completed three years/cycles of clinical supervision and believes she is ready to file for the LPC application. Her clinical supervisor is helping her to put together all the documents needed for submitting the application. The supervisor notices that Ju Mei first two years/cycles she was supervised by a Licensed Psychologist at a mental health residential facility. For her third cycle, she was supervised by an LPC who was also a CPCS. What should Ju Mei’s clinical supervisor advise in regards to her application?

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* 10. This type of liability occurs when the supervisor becomes liable by virtue of the relationship with the supervisee.

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* 11. A supervisor advises her supervisee to break confidentiality for the protection of an intended victim. Is the supervisor supported by law in GA?

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* 12. Which condition must be present in order for vicarious liability to be established?

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* 13. Which supervisor factor has been found to negatively affect the supervisory working alliance?

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* 14. Who needs to sign off on Form A, "Site Supervision form", for the LPC Application?

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* 15. Is an internship/ practicum site required for licensure?

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* 16. Can an Intern/practicum student work for pay at the supervision site counseling?

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* 17. The Composite Board considers a yearly cycle accruing directed work experience hours and clinical supervision hours as

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* 18. To be an LPC Clinical Supervisor, one must have

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* 19. Who is required to keep supervision session records or logs of all supervision sessions ACCORDING TO GA LAW and Rules?

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* 20. The Georgia Composite Board requires, prior to the delivery of clinical TELESUPERVISION, the supervisor must have obtained the minimum of how many hours in TELESUPERVISION continuing education?

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* 21. A Licensed Associate Professional Counselor, can engage in the practice of counseling under direction and supervision for only up to 3 years

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* 22. An acceptable work setting called Directed Work Experience (DWE) includes the following; a director, worksite that the supervisee is required to provide counseling, and maybe in rehabilitation, career development, mental health, and community agencies.

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* 23. As a CPCS, you must accrue at least 24 supervision CE hours in synchronous training for your Recertification?

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* 24. To be re-certified as a CPCS, you have to complete your biennial CE hours and pass an exam.

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* 25. Continuing Education Hours in Ethics must always be synchronous?

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* 26. As supervisees develop, supervisors can expect to see the following characteristic(s):

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* 27. Supervisees are required to notify clients in the informed consent statement that they are under supervision and are to provide clients with the name and credentials of their supervisor.

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* 28. Supervisors are to inform supervisees of remediation and due process policies in case of adverse issues involving the supervisory relationship.erson has been abused, it is often wise to ask:

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* 29. What type of evaluations are to be conducted within the supervisory relationship?

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* 30. Regularly scheduled FORMAL evaluations offer the supervisor awareness of the supervisees progress or lack thereof and provide the groundwork for implementation of possible improvement and/or remedial plans.

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* 31. Which is important to do as a part of the tele-supervision?

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* 32. Asynchronous means on demand or self-study at one’s own pace/leisure; synchronous means that all parties are present at the same time and real-time interaction is taking place

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* 33. 1.     It is the responsibility of ________________(fill in the blank) to ensure that multicultural matters are addressed as part of the supervisory process.

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* 34. It is REQUIRED that the initial tele-supervision session be held in person before subsequent tele-supervision sessions can be held virtually.

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* 35. The location of the client at the time of telemental health counseling is called the "originating site" and the location of the provider is called the "distant site".

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* 36. In telemental health counseling, it is vital to utilize code words, symbols, and/or numbers for all non-visual communication between therapist and client to ensure confidentiality.

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* 37. Development is facilitated when the supervisee engages in reflection on the counseling work and relationship

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* 38. Clinical supervisors working in the state of Georgia should be familiar with which code of ethics as required by LPCAGA?

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* 39. Patrick, LAPC, is working to earn licensure hours. Patrick works as a 1099 Independent Contractor at a local mental health service site. The site has provided a Director and a clinical supervisor.  They are the same person.

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* 40. Patrick, LAPC is working to earn licensure hours. He has a director of the agency where he provides counseling for clients.  He has an LPC, CPCS clinical supervisor. He is quite anxious to open his own practice and build his client caseload. Patrick is advertising his therapeutic services in a psychological magazine. He is very careful to show his credentials as NCC, LAPC. What else must he include as part of his advertisement?

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* 41. Who’s responsibility is it to sign off on Form C?

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* 42. Are LAPCs require CE hours?

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* 43. How many supervisors may an LAPC have at one time?

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* 44. As a supervisor, I am responsible for reviewing the supervisee’s licensure application?

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* 45. Are supervisors required per the board rules to sign off on the supervision form in the LPC application?

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* 46. Practicum/ Internship hours count toward licensure?

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* 47. Can a supervisor be a director?

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* 48. The exam passing score is 80%.  The system will give you the score once you complete the exam and click DONE.

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