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Tennessee Laws, Rules and Ethical Standards of Practice for Behavioral Health Back to Course Index

 

*This course reviews ethical and legal standards. 
It is not all-encompassing and is not intended to offer legal advice.

 

A thorough working knowledge and comprehension of laws and rules governing licensed professional practice is vital for practitioners of human service related professions. Ethical standards of a profession are critical in setting forth expected behaviors and actions in various scenarios. Likewise, rules and laws governing practice in the State of Tennessee are critical to the practitioner to engage in lawful, appropriate practice and to protect the populace from unqualified practitioners. Licensed practitioners have not only ethical, but legal, responsibility to practice according to the statutes set forth by the rule making body of the State of Tennessee.

Persons engaged in the practice of clinical social work, marriage and family therapy, or
mental health counseling in the State of Florida are subject to the laws and rules administered through the Board for Licensed Professional Counselors, Licensed Marital and Family Therapists, and Licensed Clinical Pastoral Therapists as well as the Tennessee Board of Social Works; both hereafter referred to as “the Board” in this course. The Board is charged through legislation with ensuring safe practice among clinical social workers, marriage and family therapists, and mental health counselors. The Board sets forth minimum requirements that must be adhered to by persons practicing these professions.  This is accomplished through licensing, monitoring, disciplinary actions, and education.

Professionals practicing in these areas risk the loss of licensure and professional reputation by failing to adhere to the rules and laws set forth by the State of Tennessee. It is highly advantageous to license holders practicing clinical social work, marriage and family therapy, or mental health counseling to maintain current knowledge of pertinent laws and rules, as well as changes to the laws and rules as they are amended.

In this course we will explore the dynamics and potential danger zones for the counseling relationship and in the mental health field as well as exploring the Tennesee laws and rules

sse statutes and rules that govern the industry. This text will explore:

  • Key Concepts Regarding Dual Relationships
  • Physical Contact and Sexual Relationships
  • Self-Disclosure
  • Sound Decision Making and Managing Boundaries 
  • Emotional and Dependency Needs
  • Professional Distance
  • Therapeutic Styles
  • Tennessee Code Title 33 Chapter 6 Mental Health Services
  • Tennessee Code Title 37 Chapter 3 Council on Children’s Mental Health Care
  • Rules of the Tennessee Board for PC, MFT and CPT 
  • Rules of the Tennessee Board of Social Workers
  • The AAMFT, NASW, AAPC and the ACA Codes of Ethics
  • Title 63 Professions Of The Healing Arts

 

Ethics

Caring for people living with mental illness is ethically complex. Because of this special nature of mental disorders mental health professionals, in their efforts to prevent and alleviate mental suffering, assume a role of unusual significance in their clients’ lives.  They learn intimate details that the client would likely not want the world to know.  They work as advocates for their clients.  Having a strong ethical code helps to define protections for the client in what can be a very vulnerable relationship. 

 

Chapter 0450-01-.13 General Rules Governing Professional Counselors

PROFESSIONAL ETHICS. All licensees and certificate holders shall comply with the 2014 American Counseling Association Code of Ethics, except to the extent that it conflicts with the laws of the state of Tennessee or the rules of the Board. If the code of ethics conflicts with state law or rules, the state law or rules govern the matter. Violation of the code of ethics or state law or rules may subject a licensee or certificate holder to disciplinary action.

(1) The certified professional counselor and licensed professional counselor and anyone under his supervision shall conduct their professional practice in conformity with the legal, ethical and professional standards promulgated by the Board under its current statutes and rules and regulations.

(2) Each applicant and certificate holder or licensee is responsible for being familiar with and following this code of ethics.

(3) A copy of the code of ethics may be obtained by writing the Board Administrator, 665 Mainstream Drive, 2nd Floor, Nashville, Tennessee 37243, or by visiting https://www.tn.gov/health/health-program-areas/health-professional boards/pcmftboard/pcmft-board/statutes-and-rules.html.

(4) In the event an applicant, certificate holder, licensee, or other individual has a question regarding legal, ethical, and professional standards neither the Board nor its administrative personnel shall consider such questions unless presented with a proper petition for a declaratory order, subject to the requirements set forth in T.C.A. § 4-5-223.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 4-5-210, 4-5-223, 63-22-102, 63-22-110, and 63-22-150.  Administrative History: Original rule filed April 29, 1992; effective June 13, 1992. Amendment filed
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
August, 2019 (Revised) 35
August 16, 2002; effective October 30, 2002. Amendment filed July 30, 2003; effective October 13, 2003.
Amendments filed May 14, 2019; effective August 12, 2019.

Chapter 0450-02-.13 General Rules Governing Marital and Family Therapists PROFESSIONAL ETHICS.

The AAMFT code of ethics shall govern the conduct of marital and family therapists registered with the board.

(1) The certified marital and family therapists and licensed marital and family therapists and anyone under their supervision shall conduct their professional practice in conformity with the legal, ethical and professional standards promulgated by the Board under its current statutes and rules and regulations.

(2) All licensees and certificate holders shall comply with the current code of ethics adopted by the American Association for Marriage and Family Therapy (AAMFT), except to the extent that it conflicts with the laws of the state of Tennessee or the rules of the Board. If the code of ethics conflicts with state law or rules, the state law or rules govern the matter. Violation of the codes of ethics or state law or rules may subject a licensee or certificate holder to disciplinary action.

(a) Each applicant, certificate holder, or licensee is responsible for being familiar with and following this code of ethics.      

(b) A copy of this code of ethics may be obtained by writing the American Association for Marriage and Family Therapy, 1133 15th Street NW, Suite 300, Washington, D.C. 20005-2710.

(3) In the event an applicant, certificate holder, licensee, or other individual has a question regarding legal, ethical, and professional standards neither the Board nor its administrative personnel shall consider such questions unless presented with a proper petition for a declaratory order, subject to the requirements set forth in T.C.A. § 4-5-223.

(4) In addition to the other requirements of this rule, all licensees and certificate holders who practice marital and family therapy electronically shall comply with the Online Ethical Advisory Opinions adopted by the AAMFT, www.aamft.org, except to the extent that they conflict with the laws of the state of Tennessee or the rules of the Board. If the standards for the ethical practice of marital and family therapy over the Internet conflict with state law or rules, the state law or rules govern the matter. Violation of the standards for the ethical practice of marital and family therapy over the Internet or state law or rules may subject a licensee or certificate holder to disciplinary action.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 4-5-210, 4-5-223, 63-22-102, 63-22-106, 63-22-110, and 63-22-
115. Administrative History: Original rule filed April 29, 1992; effective June 13, 1992. Amendment filed April 10, 2002; effective June 24, 2002. Amendment filed August 16, 2002; effective October 30, 2002.
Amendment filed July 30, 2003; effective October 13, 2003. Amendments filed May 14, 2019; effective August 12, 2019. Amendments expired pursuant to Chapter 653, § 1 of the 2020 Public Acts, effective April 2, 2020, and the rules reverted to their previous statuses.

1365-01-.10 STANDARDS OF CONDUCT. General Rules and Regulations for Social Worker Certifications

(1) Code of Ethics – All licensees shall comply with the code of ethics adopted by the National Association of Social Workers (NASW), approved by the 1996 NASW Delegate Assembly and revised by the 2017 NASW Delegate Assembly, except to the extent it conflicts with the laws of the State of Tennessee or the rules of the Board. If the code of ethics conflicts with state law or rules, the state law or rules govern the matter. Violation of the code of ethics or state law or rules may subject a licensee to disciplinary action. A copy of the Code of Ethics may be found here: https://www.tn.gov/health/health-program-areas/health-professionalboards/sw-board/sw-board/statutes-and-rules.html.

(2) Each applicant or licensee is responsible for being familiar with and following the code of ethics.

(3) Unethical conduct shall include, but not be limited to, the following:

(a) Knowingly circulating untrue, fraudulent, misleading, or deceptive advertising;

(b) Engaging in sexual activities with current or former clients;

(c) Becoming addicted to the habitual use of intoxicating liquors, narcotics, or other stimulants so as to incapacitate a licensee from the performance of his or her professional obligations and duties;

(d) Disclosing confidential information;

(e) Failing to inform clients about the limits of client-social worker confidentiality;

(f) Denying a client’s reasonable request for access to any social worker records concerning the client;

(g) Failing to obtain the informed consent of clients before taping, recording, or permitting third parties to observe their activities;

(h) Failing to inform clients when a conflict of interest exists between the licensee and the client as well as between the licensee’s employer and the client;

(i) Failing to inform clients as to the purpose and nature of an evaluation, research, treatment, educational, or training procedure and to inform the clients that they must participate freely and voluntarily;

(j) Failing to terminate a client relationship when services are no longer required or requested or when it is reasonably clear that the relationship is not benefiting the client;

(k) Failing to make every effort to avoid dual relationships with clients and/or relationships that might impair the licensee’s independent professional judgment and impair the quality of services provided to each client;

(l) Entering into a relationship with a client that increases the risk of exploitation for the client to the licensee’s advantage;

(m) Failing to assist clients in finding needed services;

(n) Providing unnecessary or unwanted services;

(o) Failing to notify clients when the licensee anticipates terminating services. The licensee shall notify the client promptly and accommodate the transfer, referral, or continuation of services relative to the client’s needs and preferences;

(p) Setting fees that are unreasonable and not commensurate with the service performed;
and

(q) Engaging in the division of fees or agreeing to split or divide the fee received for professional services with any person for bringing or referring a client.

(4) Release of Records – Upon receiving a written request from the client or the client’s authorized representative, a licensee shall provide the client or the client’s authorized representative a complete copy of the client’s record or summary of such records maintained by the licensee; it shall be the licensee’s option as to whether copies of the client records or a summary of the records will be given to the client or authorized representative.

 

Chapter 0450-03-.13 General Rules Governing Clinical Pastoral Therapists
PROFESSIONAL ETHICS.

(1) The certified clinical pastoral therapists and anyone under their supervision shall conduct their professional practice in conformity with the legal, ethical and professional standards established by the Board.

(2) All licensees shall comply with the current code of ethics adopted by the American Association of Pastoral Counselors (AAPC), except to the extent that it conflicts with the laws of the state of Tennessee or the rules of the Board. If the code of ethics conflicts with state law or rules, the state law or rules govern the matter. Violation of the codes of ethics or state law or rules may subject a licensee to disciplinary action.

(a) Each applicant or licensee is responsible for being familiar with and following this code of ethics.

(b) A copy of this code of ethics may be obtained by writing the American Association of Pastoral Counselors, 9504A Lee Highway, Fairfax, VA 22031-2303.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 4-5-210, 63-22-102, 63-22-110, 63-22-203, 63-22-205, 63-22-206, and 63-22-207. Administrative History: Original rule filed December 30, 1998; effective March 15, 1999. Amendment filed August 16, 2002; effective October 30, 2002. Amendment filed July 21, 2004; effective October 4, 2004. Amendments filed May 14, 2019; effective August 12, 2019. Amendments expired pursuant to Chapter 653, § 1 of the 2020 Public Acts, effective April 2, 2020, and the rules
reverted to their previous statuses.

 

Boundaries are the framework within which the counseling relationship occurs. Boundaries keep the relationship professional.  They set the parameters within which the client remains safe and the treatment can be effective.  They also help to protect the clinician both emotionally and legally.

Having a strong ethical compass it critical to being a good counselor. 

  • Are your boundaries consistent? 
  • Do they waiver based on how you feel about the client or the situation? 
  • Do they establish healthy relationships, enabling the client to experience personal growth?

Professional issues typically include personal disclosure, limits regarding the use of touch, the tone of the professional relationship both in treatment and with the chance meeting in public, fee setting, projected length of sessions, the limits of the relationship and ultimately end “all things ethical”. 

The primary concern in establishing and managing boundaries with each individual client must be the best interests of the client. Except for behaviors of a sexual nature or obvious conflict of interest activities, boundary considerations often are not clear-cut matters of right and wrong. Rather, they are dependent upon many factors and require careful thinking through of all the issues, always keeping in mind the best interests of the client.  

Many questions arise when navigating the counseling relationship.  Should a counselor date a former client?  If they can date, how long should they wait after counseling has been terminated to have a relationship?  Should the counselor terminate counseling if they begin to privately become interested in the client?  Should a therapist accept a client’s gift?

The relationship outside of counseling, the acceptance of gifts, and the recognition of a previous or current client in public are examples of areas that could pose problems for both the therapist and the client.

Boundary issues also involve counselors and supervisors, both during academic years and post graduation on into the work force, as well as colleague situations.  Should my aunt, as a licensed professional, be able to supervise my practicum as an intern?  If my husband is a psychologist speaking for an association offering continuing education should I be able to earn contact hours if I attend?

Most state boards and all national associations have bi-laws and regulations concerning the relationships between a counselor and a client, as well as a supervisor and a counselor. As noted above Tennessee relies on national codes of ethics with specific state stanards.  It is good counsel to make yourself aware of the regulations and then to steer clear of any inappropriate situations.  This course will assist with this, however it is advisted to read through all of the Tennessee statutes and rules regarding the mental health field.  It is also a best practice to make your clients aware of the general boundaries and why they exist such as, “please understand to protect your privacy, if I see you in public I will not acknowledge you in any way.  This is not intended to offend you, but only to protect you.”  This way the client will not feel slighted should the event occur.

 

Dual Relationships with Clients

In most friendships or marriages the relationship bears some resemblance to a seesaw.  I tell you my thoughts and in turn you tell me your thoughts. You know my faults and I learn yours. There is a give and take of information that creates a balance.  A therapist/client relationship is not balanced.  By the nature of the relationship, one person is telling intimate details, feelings and fears and the other is not. This intimate knowledge creates power that has to be handled professionally.

A dual relationship exists when a therapist serves in the capacity of both therapist and at least one other role with the same client. Most commonly the second relationship is social, financial, or professional and may be concurrent or subsequent to the therapeutic relationship. The American Psychological Association reports research citing that dilemmas arising from “blurred, dual, or conflicting relationships” were the second most frequent ethical dilemma noted.  Dual relationships can also be a major basis for licensing disciplinary actions and ethics complaints against mental health professionals.

The American Counseling Association’s (ACA) Standards of Practice provide that counselors must make every effort to avoid dual relationships with clients that could impair their professional judgment or increase the risk of harm to clients. One can therefore infer, as with AAMFT’s Code, that not all dual relationships are unethical. In fact, the ACA standards specifically recognize that dual relationships sometimes cannot be avoided. As with other standards that recognize that dual relationships cannot always be avoided, the standards require that counselors must take appropriate steps to make sure that judgment is not impaired and that no exploitation occurs when the counselor is in such a dual relationship.

Counselors are aware of their influential positions with respect to clients, and they avoid exploiting the trust and dependency of clients. Counselors make every effort to avoid dual relationships with clients that could impair professional judgment or increase the risk of harm to clients. When a dual relationship cannot be avoided, counselors take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no exploitation occurs. 

The NASW Code of Ethics 1.06 page 9 states: “Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client.”  The NASW’s Code of Ethics also recognizes that not all dual relationships are avoidable, and provides that when such an avoidable dual relationship occurs the social worker takes steps to protect clients and is responsible for setting clear, appropriate, and culturally sensitive boundaries. Thus it appears that if this is done, the unavoidable dual relationship is permissible – not unethical. 

The ethical standards of the American Association for Marriage and Family Therapy, the AAMFT, do not specifically state that not all dual relationships are unethical or unavoidable, but one may infer that such is the case. The standards state that marriage and family therapists make every effort to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Implicit in such a statement is the possibility that some multiple relationships may not reasonably be expected to impair professional judgment or increase the risk of exploitation.

A window into any relationship is only as clear as the participant’s insight.  Most people see things from their point of view.  Is it wise, with one participant in a more powerful position to enter into multiple types of relationships with someone?

Therapists can and should be concerned about any behavior on their part that may interfere with their ability to maintain a professional and therapeutic relationship with their clients. When roles get blurred as when the therapist and patient become personal friends, business partners, or become involved sexually it often becomes impossible for the therapist to maintain professional objectivity. Dual relationships can erode and distort the professional nature of the therapeutic relationship. They may create conflicts of interest that compromise professional judgment or create situations where the therapist is engaged in meeting his or her own social, financial, or personal needs, rather than putting the welfare of the client foremost. Dual relationships can affect the current and future benefits of therapy.

The reality of potentially overlapping relationships and the effects of overlapping relationships make for a complicated decision making process.To determine if a relationship outside of the therapeutic realm is hazardous a professional must explore several areas.

Circumstantial roles, those that occur by pure coincidence, such as running into a client at their sales job in the mall, are difficult to avoid. They are bound to occur and this potential and how it is to be handled should be discussed in advance.  As noted earlier:  “If I see you in public, please do not be offended, but I will not approach or acknowledge you in any way to protect your confidentiality.”

Shifts in professional roles include difficulties that arise when a teacher or supervisor counsels a student. There is a clear potential for difficulty with this type of dual relationship.  Personal and professional role conflicts include sexual or romantic, social, and peer-like relationships.These personal and professional situations are fraught with danger.


Some professionals use their own comfort level to gauge whether they could successfully manage the overlapping relationship. The type and severity of the clients’ presenting problems is also used as an indicator when deciding to enter a dual relationship. Therapists are more likely to enter a dual relationship if the client is seeking problem solving and would likely avoid a dual relationship with a client if they suspected a complex issue such as a personality disorder. Other therapists involve prospective clients in the decision-making process to decide if the benefits of entering into a dual relationship outweigh the risk. Keith Brownlee (1996) expresses that “Pivotal to any decision making based on the codes, are the two central principles, impaired objectivity, and risk of exploitation.

When a dual relationship exists it is important to minimize the risks by engaging in ongoing consultation, setting clear expectations and boundaries, informed consent, documentation.

Physical Contact and Sexual Relationships with Clients

The achievement of trust is possible in a therapeutic relationship because there is no fear of losing “self” in establishing a connection with a therapist.  Most clients come to the situation with a vulnerable self.  Intimacy for these individuals can easily lead to abuse if those with whom they relate prove untrustworthy.


Many therapeutic styles involve the healing touch.  Hugging a client when they enter the office, holding their hand through difficult sessions or placing a hand on their shoulder when they are crying can all be ways of expressing interest and concern.  They can connect and solidify the helping relationship.  They can also be abused, misunderstood and damaging.  This issue forces counselors to examine the heart of the therapeutic process: the counseling relationship.  As we have explored there is clear consensus among the professional associations that concurrent sexual and professional relationships are unethical and in many states also illegal. Many of the associations agree that a sexual relationship cannot later be converted into a therapeutic relationship.  However, it is less clear regarding touching in session.


It is doubtful that most therapists set out to exploit their clients.  This type of violation is more of a process than a single event.  Yet when professionals deny or remain unaware of their personal significance, power, or authority they will begin the process of boundary violation.  If a client feels uncomfortable they may not always have a voice to express this.  What they perceived may not be accurate, but any activity that can be construed as intimate is frought with danger. 

Any time a professional exploits a relationship to meet personal needs rather than the needs of the client, even if not consciously done, the boundaries have been crossed and the professional is responsible.

The American Counseling Association Code of Ethics states that sexual and/or romantic counselor–client interactions or relationships with current clients, their romantic partners, or their family members are prohibited.  This prohibition applies to both inperson and electronic interactions or relationships.

Counselors are prohibited from engaging in counseling relationships with persons with whom they have had a previous sexual and/or romantic relationship. 

Sexual and/or romantic counselor–client interactions or relationships with
former clients, their romantic partners, or their family members are prohibited
for a period of 5 years following the last professional contact. This prohibition
applies to both in-person and electronic interactions or relationships.


If a relationship does peak, before engaging in sexual and/or romantic interactions or relationships with former clients, their romantic partners, or their family members, counselors must demonstrate forethought and document (in written form) whether the interaction or relationship can be viewed as exploitive in any way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor avoids entering into such an interaction or relationship.


Counselors are prohibited from engaging in counseling relationships with friends or family members with whom they have an inability to remain objective.  As well as engaging in a personal virtual relationship with individuals with whom they have a current counseling
relationship (e.g., through social and other media).

The National Association of Social Workers code prohibits sex with former clients in section 1.09, but states that if a social worker claims an exception, the full burden is on them to demonstrate “…that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally.” The codes also ban sexual contact with clients’ relatives or close personal friends where there is a potential to harm the client, but it is not clear whether this extends to a former clients’ relatives and friends.

The American Association for Marriage & Family Therapy has forbidden sex for 2 years after termination. This applies to either spouse or any family member who is seen in even a single session of marital or family therapy.

The American. Association for Pastoral Counseling has a prohibition of no sex for two years following termination of the counseling.

 

Although sexual relationships are clearly defined there are many other forms of physical contact that many professionals utilize in their therapeutic modalities.Professionals have argued that the increased sensitivity to physical contact with clients inhibits counseling.In Neuro Linguistic Programming, anchoring is done by applying gentle pressure to a part of the client’s body, such as the top of the knee.Reaching out to touch someone on the hand is a common gesture showing concern and support.It is difficult and sad to think an innocent gesture of support could be misunderstood or potentially hazardous.

Transference and counter transference can lead to harmful situations.Intense friendships which confuse the counseling or make the client unnecessarily dependent on the helper can be very damaging to a client.  Even romantic “game playing” can be quite distracting and harmful. Even without overt sexual contact, boundary breakdowns can lead to damages similar to those seen when the relationship becomes sexual (Schoener et. al., 1989, pp. 133-147; Simon, 1991) These damages can include:

  • The failure to render needed therapy — undermining what good work may have been done;
  • Failure to refer for other services — the psychotherapist “hanging on” to the client and trying to provide for all of his or her needs;
  • Creation of unhealthy dependency which is difficult to resolve;
  • Confusing the client about what is therapy and what is personal;
  • Breach of trust — client distrusting professionals as a result of the corruption of the therapy;
  • In some instances, interference in family relationships, friendships, etc.
  • Anger, loss of self-esteem, depression, and other psychological distress.

 

To Prevent and Avoid Sexual Misconduct:

1. Respect cultural differences and be aware of the sensitivities of individual clients.

2. Do not use gestures, tone of voice, expressions, or any other behaviors which clients may interpret as seductive, sexually demeaning, or as sexually abusive.

3. Do not make sexualized comments about a client’s body or clothing.

4. Do not make sexualized or sexually demeaning comments to a client.

5. Do not criticize a client’s sexual preference.

6. Do not ask details of sexual history or sexual likes/dislikes unless directly related to the purpose of the consultation.

7. Do not request a date with a client.

8. Do not engage in inappropriate ‘affectionate’ behavior with a client such as hugging or kissing. Do offer appropriate supportive contact when warranted.

9. Do not engage in any contact that is sexual, from touching to intercourse.

10. Do not talk about your own sexual preferences, fantasies, problems, activities or performance.

11. Learn to detect and deflect seductive clients and to control the therapeutic setting.

12. Maintain good records that reflect any intimate questions of a sexual nature and document any and all comments or concerns made by a client relative to alleged sexual abuse, and any other unusual incident that may occur during the course of, or after an appointment.

 

Self-Disclosure 

How much of themselves, if anything, should effective counselors reveal to clients? Does self-disclosure by the therapist help the therapeutic process or interfere with clients’ needs? Self-Disclosure to some degree is an almost universal behavior for counselors to use with the clients.Up to 70% of therapists have used some degree of self-disclosure in their practice. 

Even therapists who are uncomfortable with the idea of talking about themselves during sessions often believe that it is impossible for a therapist to be completely anonymous to their clients. After all, everything the psychologist says or does is revealing in some way to the patient. Further, an over-emphasis on this can be troubling or even damaging to the client. The client may begin to feel self-conscious about his or her own revelations or feel judged or disliked by the therapist.

A research study reported in The Journal of Consulting and Clinical Psychology supports appropriate self-disclosure.Researchers from the University of Pennsylvania’s Center for Psychotherapy Research studied clients and therapists-in-training who had randomly been asked to make revelations about themselves during the course of therapy or not. The study authors found that the clients whose therapists were willing to talk about themselves or offer opinions felt more secure in the counseling process and liked their therapists better than participants whose therapists were not offering any information about themselves. The therapist’s use of self-disclosure demystifies both the therapist and the client. It allows more of the client’s essence to come out and allows the interaction to become more of a dialogue.

In a group setting, group leaders can use self-disclosure, just like other members of the group, to become part of the genuine flow of communication.They openly share their thoughts and feelings in a thoughtful and accountable manner, respond to others authentically, and acknowledge or refute motives and feelings attributed to them. They can demonstrate respect for the feedback group members offer them.

Appropriate Self-disclosure is done for the purpose of helping the client.  Some common situations in which a therapist would be justified in making a self-disclosure include:

  • The disclosure is made for the purposes of the patient not the therapist.
  • The disclosure is that type that should be made to a patient with a certain type of disorder.  For example, if a patient is suffering from depression, the disclosure that the therapist had suffered from depression in the past might help the patient by giving him insight into the fact that a person suffering from depression can get past it. 

Ultimately, the appropriateness of a therapist’s self-disclosure comes down to the question of whether it was made with the patient’s best interests at heart.

Excessive therapist self-disclosure, however, is the most common boundary violation.Although it does not always lead into, it is also a frequent precursor to sexual involvement with clients, as well as a number of other therapeutic mistakes. 

Disclosing personal information can seem very natural and as noted can be helpful to the client and the therapeutic process.It can be done with the intent to show that the client is not alone in their specific situation or to encourage positive behaviors.

Therapist self-disclosure is problematic when it involves:

  • Disclosing current personal needs or problems
  • Disclosure as a common, rather than rare event, during sessions
  • Disclosing things not clearly connected to client’s problems or experiences; or not clearly things which would be likely to encourage or support client
  • Self-disclosure is not only frequent, but uses up more than a few minutes in a session
  • Self-disclosure occurs despite apparent client confusion or romantization

 

Sound Decision Making

One of the easiest gauges to use to determine if you are making good boundary decisions is to ask yourself, how would I feel if I woke up tomorrow morning and this was broadcast on the front page of the Newspaper in my hometown?

 

David, A Therapist in Walnut Cove, Was Supervised During His Practicum For Licensure By His Aunt Who Is Also In The Industry.  If the thought of this headline being read by your colleagues, neighbors, friends and family doesn’t leave you with a confident feeling then it probably is not a secure boundary decision.Don’t do anything that you would not want to see on the front page of the newspaper.

A second way to explore the relationship is to look for ways that this could jeopardize the counseling and the client.  For example, you are seeing Jessica who is nine years old and very upset over her parents pending divorce.  Her mother has brought her in for regular sessions for 4 months.  On one afternoon, her father comes to pick her up after her session and sparks ignite between the two of you.  It is likely not in the best interest of Jessica for the counselor with whom she has been trusting with her broken family to begin dating her father who is divorcing her mother.  Ask yourself, can I potentially see how this could negatively affect my client? 

As seen the decision making process is at times set in place by associations and state laws, always should be in agreement with our morals and by who we want to be and be seen as, and many times a gray area that each professional must navigate by how they feel about the situation.  Many professionals feel differently based on the circumstances. An example of this is that some counselors accept gifts from their clients, some do not.

Beyond the specifics set forth in an association code or state licensing law, the counselor is left to navigate the waters.  Ultimately though, make no mistake; it is the counselor’s responsibility to cause no harm to the client.  The counselor is the sound, stable, professional in the scenario.

 

Emotional and Dependency Needs

It is crucial for a counselor to maintain good awareness of their own emotional and dependency needs so as to not reverse the therapeutic process for their own gain.

Using excessive self-disclosure, romantic encounters-whether brought to fruition or just perpetuating a clients flirtation out of your own desire to be flattered, or financial dealings that can be seen as an exploitive are in opposition to the true goals of therapy.

It is a very dangerous power position to be in if the therapist cannot see
how he is getting his own needs met by using his position. The use of ongoing supervision can be effective here. 

 

Professional Distance

To be a successful counselor an individual needs good personal boundaries, as well.This means allowing clients to be responsible for their own decisions and actions and allowing them to experience the consequences.Professional distance does not mean that a counselor should be cold and uninvolved, but it is important the client works as hard as the counselor and the client owns the issue.Burn out in the mental health field is a major issue.Over involvement on an emotional level can cause therapists to lose their objectivity.They cannot exercise proper judgment in their dealings with those with whom they are seeking to help.There are many steps in establishing health professional distance, to explore a few:

  • Allow clients to participate in identifying the goals of treatment.
  • Identify resources in the community that meet specific needs for the clients so that the client can benefit from several support systems such as community projects and church groups with similar interests.
  • Help clients to accurately evaluate their options and to see progress-establish benchmarks for measuring growth.
  • Help clients develop strategies for handling problems outside of and between sessions.

Therapeutic Styles 


People who grow up in dysfunctional families tend to believe they are not allowed to have personal boundaries. This personal boundary, essentially the line that divides me from you, has been debated for decades by the different treatment modalities.Freud, although he thought that a therapist should be a blank slate and should refrain from any self-disclosure, was known to take patients on vacation to analyze them.  D. W. Winnicott had patients living with him as part of their treatment.

Research has failed to show that practice style is the major issue in boundary breakdowns.Some who practice modalities that frown upon self-disclosure end up having sexual relations with their clients and some who use touch techniques never have issues.

Dynamics Which Make Psychotherapy a Potential Setting for Boundary Violations and Exploitation        

Many clients come into therapy vulnerable, confused and in need.Without clear boundaries I can’t tell what is your stuff and what is mine.Maintaining this line is essential to effective work.However, keeping a clear line between the client and the counselor is not easy.

Some of the reasons for the difficulty include:

  • Therapy involves a fiduciary relationship with unequal power, especially early in the relationship. The therapist sets all the rules and the therapy is conducted in private so there is little accountability.
  • Transference
  • Wishes for nurturing can emerge and be quite powerful
  • Rescue fantasies — the counter transference trap of doing a better job than someone’s parents or previous therapist/counselor;
  • Fantasy that love, or sex, are curative in and of themselves
  • Repression or disavowal of anger at client’s persistent thwarting of your therapeutic efforts
  • It is a fertile ground for acting out anger at organization, supervisor, etc.
  • Defense against grief and mourning at termination;
  • It is an unreal world — the “exception” fantasy
  • Cultural myth that the “right woman” can fix the most disordered man

 

 

Supervisory Oversight imgres-12

Some areas which require self-awareness and watchfulness by ones’ supervisors or consultants include:

  • Obvious therapist distress or upset
  • Therapeutic drift — shifting style and approach to a given client
  • Lack of goals and reflection on progress in therapy
  • Therapy which exceeds normal length for a client of that type in the particular therapist’s practice.
  • Exceeding areas of competence, reluctance or unwillingness to refer for other types of therapy, assessment, etc.
  • Unwise techniques:

oRoutine hugs

oFace to face, intimate hugs

oExcessive touch

oSessions in non-traditional setting when this isn’t necessary

oAdult clients on lap

oRoutine or common socializing with clients

oExcessive self-disclosure by therapist

oDirect intervention in client’s life

oAttraction

oOver-identification with client

oUniquely similar family dynamics

oDivorce or loss in therapist’s life

oIdentity disturbance in therapist


Tennessee

The Tennessee Title 63 Professions Of The Healing Arts sets out standards of practice.  Chapter 22 covers Professional Counselors, Marital and Family Therapists, and Clinical Pastoral  Therapists.  Chapter 23 covers Social Workers.

Among other things, this explores the members and powers of the boards.  It lays out educational requirements, examinations, fees, renewals and disciplinary proceses.  

The grounds upon which the Professional Counselors, Marital and Family Therapists, and Clinical Pastoral  Therapists Board would exercise such power includes, but is not limited to, the following:

  • Conviction of a felony;
  • Using fraud or deception in applying for a license or certificate or in taking an examination required by this part;
  • Violating the rules and regulations adopted by the board, except that a violation of A.11.b of the 2014 American Counseling Association Code of Ethics, or any similar or successor provision, shall not be grounds upon which the board shall exercise its powers pursuant to subsection (a); provided, however, that a violation of A.11.b shall be a ground for the board to exercise these powers in cases involving an individual seeking or undergoing counseling where the individual was in imminent danger of harming themselves or others; or
  • Engaging in professional misconduct, unethical or unprofessional conduct, including, but not limited to, willful acts, negligence and conduct likely to deceive, defraud or harm the public or engaged in such conduct.

The grounds upon which the Social Work Board would exercise such power includes, but is not limited to, the following:

  • Willful or repeated violation of any provisions of this chapter or any rules of the board;
  • Fraud or deceit in procuring or attempting to procure a license, presenting to the board dishonest or fraudulent evidence of qualification, or fraud or deception in the process of examination for the purpose of securing a license;
  • Willful failure to display a license;
  • Fraud, deception, misrepresentation, dishonest or illegal practices in or connected with the practice of social work;
  • Circulating knowingly untrue, fraudulent, misleading or deceptive advertising;
  • Gross health care liability, or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of practice;
  • Unprofessional or unethical conduct, or engaging in practices in connection with the practice of social work that are in violation of the standards of professional conduct, as defined in this section or prescribed by the rules of the board;
  • Incapacity or impairment that prevents a licensee from engaging in the practice of social work with reasonable skill, competence, and safety to the public;
  • Conduct reflecting unfavorably upon the profession of social work;
  • Willful making of any false statement as to material in any oath or affidavit that is required by this chapter;
  • Revocation by another state of a license or certificate to practice in that state in which case the record of the revocation shall be conclusive evidence;
  • Conviction of a felony under federal or state law involving use, misuse, possession or sale of any controlled substance or controlled substance analogue;
  • Conviction of a felony in the courts of this state or any other state, territory or country that, if committed in this state, would be a felony:
  • The record of conviction in a court of competent jurisdiction is sufficient evidence for disciplinary action to be taken as may be considered proper by the board. For the purpose of this chapter, a conviction is considered to be a conviction that has been upheld by the highest appellate court having jurisdiction, or a conviction upon which the time for filing an appeal has passed; and
  • A record of conviction upon charges that involve unlawful practice. Based upon the record of conviction, without any other testimony, the board may take temporary disciplinary action even though an appeal for review by a higher court may be pending;
  • Permitting or allowing another to use the license for the purpose of treating or offering to treat patients;
  • Engaging in practice under a false or assumed name, or the impersonation of another practitioner of a like, similar or different name;
  • Employing or permitting any person who does not hold a license to practice social work in this state to perform work that, under this chapter, can lawfully be done only by persons holding the license and permitted by law to practice social work in this state; or
  • Addiction to the habitual use of intoxicating liquors, narcotics or other stimulants to such an extent as to incapacitate the applicant or holder from the performance of the applicant’s or holder’s professional obligations and duties.
  • The board may on its own motion cause to be investigated any report indicating that a license holder is or may be in violation of this chapter. Any person who in good faith reports to the board any information that a license holder is or may be in violation of this chapter is not subject to suit for civil damages as a result of the good faith report.
  • All administrative proceedings for disciplinary action against a licensee undertaken pursuant to this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

 

Summation

Public opinion and courts have led the way. Therapists can and have been sued for malpractice when their treatment leads to harming their patients and one of the most common causes of malpractice is therapists having sexual relations with patients and former patients.

Nowadays, virtually every professional discipline has ethical codes, which cover boundary issues and most expressly prohibit sexual relations with patients.

In order to establish a helping relationship, the individual in need must relinquish some level of control to create trust.  The client or patient’s trust rests on the assumption that the professional will operate within the context of the client’s need.   When the client expects this and projects an aura of sanctity onto the professional, the client’s vulnerability becomes a key factor in the relationship.   This is the reason that a client (adult or teen, male or female) is not considered morally and legally culpable if an illicit relationship develops between the two.  It remains incumbent upon the professional to set the limits of the relationship.

The key to dealing with these issues? Know who you are; know your strengths and weaknesses, and commit to using your strengths (power) in service to others.  Find ways outside of the therapeutic process of having your personal needs for intimacy met appropriately.  No spouse or best friend can meet all your needs but perhaps a cluster of persons with whom you share a reciprocal relationship can.  No one seeking your help in a professional role should be meeting your needs for receiving care.

 

Please review the appropriate area pertaining to your license:

Professional Counselors:

ACA Code of Ethics

RULES OF TENNESSEE BOARD FOR PROFESSIONAL COUNSELORS, MARITAL AND FAMILY THERAPISTS, AND CLINICAL PASTORAL THERAPISTS
CHAPTER 0450-01
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS
TABLE OF CONTENTS
0450-01-.01 Definitions 0450-01-.12 Continuing Education
0450-01-.02 Scope of Practice 0450-01-.13 Professional Ethics
0450-01-.03 Necessity of Certification or Licensure 0450-01-.14 Evidence of Professional Experience
0450-01-.04 Qualifications for Licensure 0450-01-.15 Disciplinary Actions and Civil Penalties
0450-01-.05 Procedures for Licensure 0450-01-.16 Duplicate Certificate or License
0450-01-.06 Fees 0450-01-.17 Change of Address and/or Name
0450-01-.07 Application Review, Approval, Denial, Interviews 0450-01-.18 Mandatory Release of Client Records
0450-01-.08 Examinations 0450-01-.19 Board Meetings, Officers, Consultants, Records,
0450-01-.09 Renewal of Certificate or License Declaratory Orders, and Screening Panels
0450-01-.10 Supervision – Post-Masters 0450-01-.20 Consumer Right-To-Know Requirements
0450-01-.11 Retirement and Reactivation of Certificate or 0450-01-.21 Advertising


License
0450-01-.01 DEFINITIONS. As used in this rule, the terms and acronyms shall have the following meanings ascribed to them.
(1) Actively engaged – Engaged in the practice of professional counseling 10 clock or more faceto-face client contact hours per week.
(2) Advertise – Means, but is not limited to, the issuing or causing to be distributed any card, sign, or device to any person, or the causing, permitting or allowing any sign or marking on or in any building or structure, or in any newspaper, or magazine or in any directory, or on radio or television, or by advertising by any other means designed to secure public attention;
(3) Applicant – Any individual seeking licensure by the board who has submitted an official application and paid the application fee.
(4) Approved Supervisor – An approved supervisor for professional experience subsequent to the master’s degree must be a currently Licensed Professional Counselor, Licensed Marital and Family Therapist, Licensed Clinical Pastoral Therapist, Licensed Clinical Social Worker, Licensed Psychologist with Health Service Provider designation, Licensed Senior Psychological Examiner, or Licensed Psychiatrist, who has been licensed at least five (5) years and who takes responsibility for the practice of the supervisee during a specific time to enable the supervisee to meet the requirements of licensing. If the supervisor is a Licensed Professional Counselor who is supervising a candidate for Licensed Professional Counselor with Mental Health Service Provider designation, the supervisor must have the Mental Health Service Provider designation.
(5) Board – The Board for Professional Counselors, Marital and Family Therapists, Clinical Pastoral Therapists.
(6) Board administrative office – The office of the administrator assigned to the board located at 665 Mainstream Drive, Nashville, TN 37243.
(7) Board Designee – Any person who has received a written delegation of authority from the board to perform board functions subject to review and ratification by the full board where provided by these rules.

(8) Certified Associate Counselor – Any person who has met the qualifications for CAC and holds a current, unsuspended or unrevoked certificate which has lawfully been issued by the board.
(9) Certified Professional Counselor – Any person who has met the qualifications for CPC and holds a current, unsuspended or unrevoked certificate which has lawfully been issued by the board.
(10) Clinically-related activities – Clinically-related workshops, trainings and seminars, treatment teams, clinical supervision, and research and leadership preparation for individual and group counseling. Graduate coursework in pursuit of licensure and administrative supervision in the work setting are not clinically-related activities.
(11) Clinical setting – A place where the practice of professional counseling occurs. An appropriate setting for an applicant’s pre and post master’s professional experience must meet the following criteria:
(a) The place or practice shall be a public, private, or community agency/mental health setting and must have integrated programs for the delivery of clinical mental health counseling in accordance with these rules and defined by definition (29) for non-Mental
Health Service Provider designation and definition (30) for the Mental Health Service Provider designation.
(b) The place or practice shall offer adequate physical resources, such as a private space that meets HIPAA requirements, necessary to allow for supervision and appropriate service delivery.
(c) The place or practice shall have at least one licensed mental health professional on site for a cumulative minimum of 20 hours per week whose assigned job duties include being available to the applicant for supervision and/or consultation while the applicant
is engaging in the practice of counseling or counseling related services. In addition, the place or practice shall have a written emergency plan in place to include method(s) of contacting supervisor(s) or other consultant(s), alternative contacts when supervisor(s) is(are) unavailable, information regarding crisis services, and crisis decision-making.
The licensed mental health professional can serve as the applicant’s supervisor if he or she meets the supervisor requirements pursuant to 0450-01-.10. If the licensed mental health professional on staff at the place or practice is unable or unwilling to serve as the applicant’s supervisor, the applicant must secure a supervisor who meets the supervisor requirements pursuant to 0450-01-.10.
(d) For an applicant pursuing post-master’s professional experience, the place or practice shall not be owned, or independently operated by the applicant. An applicant shall not seek a clinical setting or supervision that is in conflict with the multiple relationships
addressed by the American Counseling Association’s Code of Ethics. Prior to choosing a clinical setting, if an applicant is uncertain, he or she shall seek advice about what is considered acceptable from the Board.
(e) In the case of pre-master’s professional experience, the place or practice shall have written provisions to provide supervision and training experience as defined by graduate counseling program expectations.
(f) The applicant shall be an employee of the place or practice, or shall be affiliated by agreement. All agreements shall include but not be limited to the following information: the name of the individual responsible for supervision, specific job duties/responsibilities, method for obtaining and scheduling clients, liability insurance information, payment arrangements, emergency plan, and facility and service logistics. 
(12) Client Contact Hour – A 50 minute period a counselor or therapist spends working with an
individual, family or group.
(13) Closed Files – An administrative action which renders an incomplete or denied file inactive.
(14) Clock hour – Sixty minutes in a continuing education activity. Providers who measure continuing education activities in “continuing education units” shall define CEU in clock hours.
(15) Continuing education – Education beyond the basic licensing educational requirement which is related to the practice of professional counseling.
(16) Department – Tennessee Department of Health.
(17) Division – The Division of Health Related Boards, Tennessee Department of Health, from which the board receives administrative support.
(18) Fee – Money, gift, services or anything of value offered or received as compensation in return for rendering services.
(19) Fee Splitting – The practice of paying commissions to colleagues out of fees received from clients who have been referred by the colleague for services.
(20) Good Moral Character – Any individual being highly regarded in personal behavior and professional ethics.
(21) He/she His/her – When he or his appears in the text of these rules the word represents both the feminine and masculine genders.
(22) HRB – When the acronym HRB appears in this rule, it is intended to mean Health Related
Boards.
(23) Internship – The supervised, planned, practical experience completed near the end of the education process and obtained in the clinical setting by observing and applying the principles, methods, and techniques learned in training and/or educational settings. The
internship involves a longer period of time than the practicum.
(24) License – Document issued to an applicant who successfully completes the licensure process. The license takes the form of an “artistically designed” license as well as other versions bearing an expiration date.
(25) Licensed Professional Counselor – Any person who has met the qualifications for professional counselor and holds a current, unsuspended, or unrevoked license which has been lawfully issued by the board.
(26) Mental health/community agency setting – For purposes of the supervision requirements of this chapter, a clinical setting as defined in paragraph (11).
(27) NBCC – When the acronym NBCC appears in this rule, it is intended to mean National Board for Certified Counselors and may be referred to in these rules as the “testing agency”.
(28) Person – Any individual, firm, corporation, partnership, organization, or body politic.
(29) Practice of Professional Counseling (without the designation as a mental health service
provider) – Rendering or offering to render to individuals, groups, organizations, or the general public any service involving the application of principles, techniques, methods, or procedures of the counseling profession, including appraisal activities, as defined by the law, counseling, consulting and referral activities. Nothing in this section shall be construed to permit the treatment of any mental, emotional or adjustment disorder other than marital problems, parent-child problems, child, and adolescent antisocial behavior, adult antisocial behavior, other specified family circumstances, other interpersonal problems, phase of life problems, other life circumstance problems, occupational problems, and uncomplicated bereavement.
(30) Practice of counseling as a mental health services provider – the application of mental health
and human development principles in order to:
(a) Facilitate human development and adjustment throughout the life span;
(b) Prevent, diagnose, and treat mental, emotional or behavioral disorders and associated disorders which interfere with mental health;
(c) Conduct assessments and diagnoses for the purpose of establishing treatment goals and objectives within the limitations prescribed in T.C.A. § 63-22-150(1); and
(d) Plan, implement, and evaluate treatment plans using counseling treatment interventions. Counseling treatment interventions shall mean the application of cognitive, affective, behavioral and systemic counseling strategies which include principles of development, wellness, and pathology that reflect a pluralistic society.
Nothing in this definition shall be construed to permit the performance of any act which licensed professional counselors designated as mental health service providers are not educated and trained to perform, nor shall it be construed to permit the designation of
testing reports as “psychological”.
(31) Practicum – The supervised, planned, practical experience occurring in a clinical setting, for an early introduction to subject matter. It is generally time-bound and for a shorter period of time than an internship, but it allows for demonstration and testing of information, knowledge, and skills acquired.
(32) Professional Counseling – Assisting an individual, through the counseling relationship, in a
manner intended to facilitate normal human growth and development, using a combination of
mental health and human development principles, methods and techniques, to achieve
mental, emotional, physical, social, moral, educational, spiritual, and/or career development
and adjustment through the lifespan.
(33) Professional Experience – A minimum of 10 client contact hours per week engaged in
activities as described in the definition of professional counseling, and practice of counseling
excluding volunteer hours.
(34) Private Practice – Practice of counseling or therapy other than in a public or nonprofit agency
or entity.
(35) Recognized educational institution – Any educational institution that is accredited by a
nationally or regionally recognized educational body.
(36) Registrant – Any person who has been lawfully issued a certificate or license.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.01, continued)
August, 2019 (Revised) 5
(37) Relative – Parent, spouse, former spouse, siblings, children, cousins, in-laws (present and
former), aunts, uncles, grandparents, grandchildren, step-children, employees, or anyone
sharing the same household.
(38) Supervisee – An individual who is engaged in post graduate or graduate, supervised
experience under the direction of a supervisor.
(39) Supervision – Ongoing, direct clinical oversight for the purpose of training or teaching.
Supervision may include, without being limited to, the review of case presentations, audio
tapes, video tapes, and direct observation.
(a) Supervision shall be by an approved supervisor.
(b) An approved supervisor shall monitor the performance of an applicant’s interaction with
a client and provide regular documented face-to-face or live video conferencing (with
prior board approval based on hardship), consultation, guidance, and instructions with
respect to the clinical skills and competencies of the applicant.
(c) Individual supervision is supervision as defined by models developed by the Council for
Accreditation of Counseling and Related Educational Programs (CACREP) for
individual (one supervisor to supervisee) or triadic supervision (one supervisor to two
supervisees).
(d) Group supervision is supervision by one supervisor of a minimum of three (3) and a
maximum of eight (8) supervisees. Of the 150 hours collected, no more than fifty (50)
hours may be group supervision.
(40) Use a title or description of – To hold oneself out to the public as having a particular status by
means of stating on signs, mailboxes, address plates, stationery, announcements, business
cards or other instruments of professional identification.
(41) Written evidence – Includes, but is not limited to, verification from supervisors or other
professional colleagues familiar with the applicant’s work.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-145, 63-22-102, 63-22-104, 63-22-117, and 63-22-120.
Administrative History: Original rule filed October 9, 1986; effective November 23, 1986. Repeal and
new rule filed April 29, 1992; effective June 13, 1992. Amendment filed April 16, 1996; effective June 30,
1996. Amendment filed June 18, 1996; effective September 4, 1996. Amendment filed December 13,
2000; effective February 26, 2001. Amendment filed November 21, 2001; effective February 4, 2002.
Amendment filed April 30, 2002; effective July 14, 2002. Amendment filed August 16, 2002; effective
October 30, 2002. Amendment filed October 30, 2002; effective January 13, 2003. Amendment filed July
21, 2004; effective October 4, 2004. Amendment filed April 17, 2007; effective July 1, 2007. Amendment
filed November 26, 2008; effective February 9, 2009. Amendment filed October 25, 2012; effective
January 23, 2013.
0450-01-.02 SCOPE OF PRACTICE.
(1) The following shall be considered necessary when addressing the scope of practice for
professional counselors:
(a) Assisting an individual, through the counseling relationship, in a manner intended to
facilitate normal human growth and development, using a combination of mental health
and human development principles, methods and techniques, to achieve mental,
emotional, physical, social, moral, educational, spiritual and/or career development and
adjustment through the lifespan.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.02, continued)
August, 2019 (Revised) 6
(b) Rendering or offering to render to individuals, groups, organizations, or the general
public any service involving the application of principles, techniques, methods or
procedures of the counseling profession, including appraisal activities, counseling,
consulting and referral activities. Nothing in this section shall be construed to permit the
treatment of any mental, emotional or adjustment disorder other than marital problems,
parent-child problems, child and adolescent antisocial behavior, adult antisocial
behavior, other specified family circumstances, other interpersonal problems, phase of
life problems, other life circumstance problems, occupational problems, and
uncomplicated bereavement.
(c) Selecting, administering, scoring, and interpreting instruments designed to assess an
individual’s aptitudes, achievements, or interests, which are used to understand,
measure or facilitate such individual’s normal human growth and development, but
shall not include the use of projective techniques in the assessment of personality, nor
the use of psychological or clinical tests designed to identify or classify abnormal or
pathological human behavior, nor the use of individually administered intelligence tests.
Consistent with each counselor’s formal education and training, licensed or certified
professional counselors may administer and utilize appropriate assessment
instruments which measure and/or diagnose problems and/or dysfunctions within the
context of human growth and development as part of the counseling process or in the
development of a treatment plan.
(2) In addition to the provisions of paragraph (1), the following shall be considered necessary
when addressing the scope of practice for professional counselors as a mental health service
provider:
(a) Facilitate human development and adjustment throughout the life span;
(b) Prevent, diagnose, and treat mental, emotional or behavioral disorders and associated
disorders which interfere with mental health;
(c) Conduct assessments and diagnoses for the purpose of establishing treatment goals
and objectives within the limitations prescribed in T.C.A. § 63-22-150(1); and
(d) Plan, implement, and evaluate treatment plans using counseling treatment
interventions. “Counseling treatment interventions” means the application of cognitive,
affective, behavioral and systemic counseling strategies which include principles of
development, wellness, and pathology that reflect a pluralistic society. Nothing in this
definition shall be construed to permit the performance of any act which licensed
professional counselors designated as mental health service providers are not
educated and trained to perform, nor shall it be construed to permit the designation of
testing reports as “psychological.”
(3) Any person who engages in any unlawful act enumerated in these rules and T.C.A. §§ 63-22-
101, et seq., is guilty of a Class B misdemeanor.
(4) Nothing in these rules shall be construed as permitting individuals registered with the board
to administer or prescribe drugs or in any manner engage in the practice of medicine as
defined by Tennessee law.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-120, 63-10-101, 63-22-102, 63-22-106, 63-22-113, 63-22-
115, and 63-22-150. Administrative History: Original rule filed October 9, 1986; effective November 23,
1986. Repeal and new rule filed April 29, 1992; effective June 13, 1992. Amendment filed July 21, 2004;
effective October 4, 2004.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
August, 2019 (Revised) 7
0450-01-.03 NECESSITY OF CERTIFICATION OR LICENSURE.
(1) It is unlawful for any person who is not certified or licensed in the manner prescribed in T.C.A.
§§ 63-22-101, et seq., to represent himself as a certified or licensed professional counselor
or to hold himself out to the public as being licensed by means of using a title on signs,
mailboxes, address plates, stationery, announcements, telephone listings, calling cards, or
other instruments of professional identification.
(2) Professional counseling is one of the healing arts and as such the practice of which is
restricted to those persons credentialed by the board. Persons engaging in the practice of
professional counseling without being credentialed or expressly exempted by the law are in
violation of division law T.C.A. § 63-1-123.
(3) Nothing in these rules shall be construed to constrict or limit the Medical Practice Act, the
Social Work Certification and Licensing Law, the Nursing Practice Act, or the Psychology
Licensing Act (T.C.A. § 63-22-113(a)).
(4) These rules shall not apply to any Christian Science practitioner or to any priest, rabbi, or
minister of the gospel of any religious denomination when performing counseling services as
part of his pastoral or professional duties, or to any person who is licensed to practice
medicine, when providing counseling services as part of his professional practice.
(5) No other person shall hold himself out to the public by a title or description of services
incorporating the words “certified professional counselor” (CPC) or “licensed professional
counselor” (LPC), and he shall not state or imply that he is certified or licensed. Nothing in
this rule shall prohibit a person from stating or using the educational degrees which he has
obtained.
(6) Use of Titles –
(a) Any person who possesses a valid, unsuspended and unrevoked certificate issued by
the Board has the right to use the title “Certified Professional Counselor” and to
practice professional counseling, as defined in Rule 0450-01-.01.
(b) Any person who possesses a valid, unsuspended and unrevoked license issued by the
Board has the right to use the title “Licensed Professional Counselor” and to practice
professional counseling, as defined in T.C.A. § 63-22-150.
(c) Any person licensed by the Board to whom this rule applies must use the titles
authorized by this rule whenever he or she is “advertising” [as that term is defined in
rule 0450-01-.01(2)] or the failure to do so will constitute an omission of a material fact
which makes the advertisement misleading and deceptive and subjects the
professional counselor to disciplinary action pursuant to T.C.A. §§ 63-22-110(b)(4) and
63-22-117(a)(1).
(7) These provisions do not apply to counselors working in a community/human services agency
nor to professional counselors whose work is directly being supervised by an approved
supervisor while obtaining the required years of work experience.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-145, 63-1-146, 63-22-102, 63-22-110, 63-22-117, and 63-
22-150. Administrative History: Original rule filed October 9, 1986; effective November 23, 1986.
Repeal and new rule filed April 29, 1992; effective June 13, 1992. Amendment filed April 10, 2002;
effective June 24, 2002. Amendment filed April 17, 2007; effective July 1, 2007. Amendment filed
November 26, 2008; effective February 9, 2009.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
August, 2019 (Revised) 8
0450-01-.04 QUALIFICATIONS FOR LICENSURE.
(1) Professional Counselor by Examination. To be eligible to submit an application, a candidate
must show completion of the following qualifications:
(a) Be at least 18 years of age.
(b) Must provide evidence that he is highly regarded in moral character and professional
ethics (rule 0450-01-.05).
(c) Education. The educational requirements must be completed prior to the date of
application.
1. Sixty (60) graduate semester hours, based upon a program of studies with a
major in counseling, completed from an institution accredited by the Southern
Association of Colleges and Schools, the Counsel for Accreditation of
Counseling and Related Educational Programs, or a comparable accrediting
body.
2. The graduate coursework should include, but is not limited to, core areas of (one
course may satisfy study in more than one of the study areas):
(i) Theories of human behavior, learning and personality;
(ii) Abnormal behavior;
(iii) Theories of counseling and psychotherapy;
(iv) Evaluation and appraisal procedures;
(v) Group dynamics, theories and techniques;
(vi) Counseling techniques;
(vii) Multicultural counseling;
(viii) Ethics;
(ix) Research;
(x) Clinical practicum or internship (pursuant to T.C.A. § 63-22-104)
(d) A minimum of two (2) years of supervised post master professional experience
consisting of not less than ten (10) hours per week and fifty (50) contact hours of
supervision per year as defined by Rule 0450-01-.10(1).
(e) Pass the examination pursuant to rule 0450-01-.08.
(f) Until receipt of a license to practice as a Professional Counselor, an applicant will be
required to practice under supervision, pursuant to Rule 0450-01-.10.
(2) Upgrading from Certified Professional Counselor Status to Licensed Professional Counselor
Status
(a) Individuals certified on July 1, 1991, as professional counselors may upgrade from
certification to licensure by any of the following methods:
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.04, continued)
August, 2019 (Revised) 9
1. Providing a copy of his current CPC renewal certificate and verification to the
board’s satisfaction, that he has had five years work experience, pursuant to rule
0450-01-.14, as a certified professional counselor.
2. Providing a copy of his current CPC renewal certificate and evidence that he has
been certified by the NBCC.
3. Providing a copy of his current CPC renewal certificate and complying with the
requirements pursuant to rule 0450-01-.04(1).
(b) Upgrading from Certified Associate Professional Counselor Status to Licensed
Professional Counselor Status
1. Any person certified as an Associate Counselor on July 1, 1991, shall be deemed
to be a Certified Professional Counselor, but only for the purpose of upgrading to
Licensed Professional Counselor.
2. For the purpose of upgrading to Licensed Professional Counselor from Certified
Associate Counselor, the board will accept a passing score on the PES
examination, which was previously required for Associate Professional
Counselors, as fulfilling the requirement of 0450-01-.08.
(3) Licensed Professional Counselor (LPC) by Reciprocity. Individuals seeking licensure by
reciprocity must meet the following qualifications:
(a) Hold a current, undisciplined, professional counselor or equivalent license from another
state of the United States which has entered into a mutual reciprocity agreement with
the Tennessee Board for Professional Counselors, Marital and Family Therapists, and
Clinical Pastoral Therapists.
(b) Provide evidence that he or she is highly regarded in moral character and professional
ethics.
(c) Pass the Tennessee Jurisprudence Examination pursuant to rule 0450-01-.08.
(4) Licensed Professional Counselor with Mental Health Services Provider designation
(LPC/MHSP). To be eligible to submit an application, a candidate must show completion of
the following qualifications:
(a) Be at least 18 years of age.
(b) Provide evidence that he or she is highly regarded in moral character and professional
ethics.
(c) Education. The educational requirements must be completed prior to the date of
application.
1. Sixty (60) graduate semester hours, based upon a program of studies with a
major in counseling, completed from an institution accredited by the Southern
Association of Colleges and Schools, the Council for the Accreditation of
Counseling and Related Educational Programs, or a comparable accrediting
body;
2. The graduate coursework should include, but is not limited to, the following core
areas (one course may satisfy study in more than one of the study areas):
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.04, continued)
August, 2019 (Revised) 10
(i) Theories of human behavior, learning and personality;
(ii) Abnormal behavior;
(iii) Theories of counseling and psychotherapy;
(iv) Evaluation and appraisal procedures;
(v) Group dynamics, theories and techniques;
(vi) Counseling techniques;
(vii) Multicultural counseling;
(viii) Ethics;
(ix) Research;
(x) Clinical practicum or internship (pursuant to T.C.A. § 63-22-104);
(xi) Use of the DSM;
(xii) Treatment and treatment planning
3. Pursuant to T.C.A. § 63-22-120, a minimum of nine (9) graduate semester hours
of coursework must be “specifically related to diagnosis, treatment, appraisal and
assessment of mental disorders.” This will be interpreted to mean passing nine
(9) semester hours, either during the course of a graduate degree or as postgraduate work, in courses in which diagnosis, treatment and treatment planning,
appraisal and assessment of mental disorders, psychopathology, and the use of
the DSM were the entire focus of the course or comprised a substantial portion of
the course work.
(d) Meet the following requirements for post-masters professional experience:
1. Complete three thousand (3000) hours of supervised post-masters professional
experience, including one hundred and fifty (150) contact hours of supervision
obtained pursuant to Rule 0450-01-.10(6).
(i) One thousand and five hundred (1500) of the three thousand (3000) hours
of supervised post-masters professional experience shall be face-to-face
client contact hours.
(ii) One thousand and five hundred (1500) of the three thousand (3000) hours
of supervised post-masters professional experience shall be clinicallyrelated activities;
(e) Pass the National Counselors Examination, the National Clinical Mental Health
Counseling Examination, and the Tennessee Jurisprudence Exam pursuant to Rule
0450-01-.08.
(5) Licensed Professional Counselor with Mental Health Service Provider designation
(LPC/MHSP), by reciprocity. Individuals seeking licensure by reciprocity as LPC/MHSPs
must meet the following qualifications.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.04, continued)
August, 2019 (Revised) 11
(a) Hold a current, undisciplined, professional counselor license with a Mental Health
Service Provider designation, or its equivalent, from another state of the United States
which has entered into a mutual reciprocity agreement with the Tennessee Board for
Professional Counselors, Marital and Family Therapists, and Clinical Pastoral
Therapists.
(b) Provide evidence that he or she is highly regarded in moral character and professional
ethics.
(c) Pass the Tennessee Jurisprudence Examination pursuant to rule 0450-01-.08.
(6) Temporarily Licensed Professional Counselor with Mental Health Service Provider
designation.
(a) A temporary license may be issued by the Board for an applicant for licensed
professional counselor designated as a mental health service provider who has:
1. Completed the academic course work and training (except for the required
supervised professional experience) required for the license; and
2. Successfully passed the National Counselor Examination.
(b) A temporary license obtained pursuant to this section authorizes an applicant to
perform the functions specified in T.C.A. § 63-22-150(5), while working under the
supervision of an approved supervisor.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-22-102, 63-22-104, 63-22-107, 63-22-116, 63-22-120, 63-
22,121, 63-22-150, and Public Chapter 318, Acts of 1995. Administrative History: Original rule filed
October 9, 1986; effective November 23, 1986. Repeal and new rule filed April 29, 1992; effective June
13, 1992. Amendment filed October 18, 1995; effective January 1, 1996. Amendment filed April 16, 1996;
effective June 30, 1996. Amendment filed June 18, 1996; effective September 4, 1996. Amendment filed
January 31, 2000; effective April 15, 2000. Amendment filed September 4, 2003; to have become
effective November 18, 2003. However, stay of effective date filed by the Board for Professional
Counselors, Marital and Family Therapists, and Clinical Pastoral Therapists on November 7, 2003; new
effective date January 17, 2004. Amendment filed November 26, 2008; effective February 9, 2009.
Amendments filed October 25, 2012; effective January 23, 2013. Amendments filed January 7, 2014;
effective April 7, 2014.
0450-01-.05 PROCEDURES FOR LICENSURE. To become licensed as a professional counselor in
Tennessee a person must comply with the following procedures and requirements.
(1) Professional Counselor by Examination
(a) An application shall be requested from the Board’s administrative office or shall be
downloaded from the Internet.
(b) An applicant shall respond truthfully and completely to every question or request for
information contained in the form, and submit it along with all documentation and fees
required by the form and this rule to the board’s administrative office. It is the intent of
this rule that all steps necessary to accomplish the filing of the required documentation
be completed prior to filing an application and that all documentation be filed
simultaneously.
(c) Applications for licensure will be accepted throughout the year and files which are
completed on or before the 30th day prior to the meeting will ordinarily be processed at
the next board meeting scheduled for the purpose of reviewing files. Supporting
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.05, continued)
August, 2019 (Revised) 12
documents requested in these instructions must be received in the board’s office within
60 days of receipt of your application or the file will be closed.
(d) An applicant shall pay, at the time of application, the nonrefundable application fee as
provided in rule 0450-01-.06.
(e) An applicant shall submit verification of having completed a supervised practicum or
internship pursuant to T.C.A. § 63-22-104.
(f) An applicant shall submit with his application, a certified copy of his birth certificate.
(g) An applicant shall submit a clear and recognizable recently taken, bust photograph
which shows the full head face forward from at least the top of the shoulders up.
(h) It is the applicant’s responsibility to request a graduate transcript from his degree
granting institution, pursuant to T.C.A. § 63-22-104, be submitted directly from the
school to the board’s administrative office. The institution granting the degree must be
accredited, pursuant to rule 0450-01-.04(1), at the time the degree was granted. The
transcript must show that the degree has been conferred and carry the official seal of
the institution and reference the name under which the applicant has applied for
licensure. The transcript must show at least 60 graduate semester hours, pursuant to
rule 0450-01-.04(1). The educational requirements contained in this rule must be
completed prior to the date of application for licensure.
(i) An applicant shall complete and submit the worksheet form for reporting course work.
(j) An applicant shall submit evidence of good moral character. Such evidence shall
include at least two recent, within the preceding 12 months, original letters from
professionals attesting to the applicant’s personal character and professional ethics
and typed on the signator’s letterhead.
(k) An applicant shall submit evidence of completing a minimum of two (2) years
supervised post-master’s experience under the direction of an approved supervisor,
pursuant to rule 0450-01-.04(1)(d).
(l) An applicant shall direct NBCC to submit directly to the Board’s office evidence that he
or she passed the National Counselor Examination pursuant to rule 0450-01-.08.
(m) An applicant shall disclose the circumstances surrounding any of the following:
1. Conviction of any criminal law violation of any country, state, or municipality,
except minor traffic violations.
2. The denial of certification or licensure application by any other state or the
discipline of certification or licensure in any state.
3. Loss or restriction of certification or licensure.
4. Any civil suit judgment or civil suit settlement in which the applicant was a party
defendant including, without limitation, actions involving malpractice, breach of
contract, antitrust activity, or any other civil action remedy recognized under any
country’s or state’s statutory, common, or case law.
5. If the applicant discloses any of the above, the Board may require the applicant
to appear before the Board to answer questions regarding the circumstances and
regarding the applicant’s fitness to practice in the State of Tennessee. The
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.05, continued)
August, 2019 (Revised) 13
burden is on the applicant to prove by a preponderance of the evidence the
circumstances of any of the above.
6. Any of the above may be grounds for denial or conditioning of the license if the
Board determines it to be unprofessional conduct or conduct that violates T.C.A.
§§ 63-22-101, et seq. or Board rules and regulations.
(n) An applicant shall cause to be submitted to the Board’s administrative office directly
from the vendor identified in the Board’s licensure application materials, the result of a
criminal background check.
(o) When necessary, all documents required to be submitted shall be translated into
English and such translation certified along with the original document as to
authenticity by the issuing source.
(p) Personal resumes are not acceptable and will not be reviewed.
(q) Application review and licensure decisions shall be governed by rule 0450-01-.07.
(r) The burden is on the applicant to prove by a preponderance of the evidence that his
course work, supervision, and experience are equivalent to the board’s requirements.
(2) Licensed Professional Counselor by Upgrade.
(a) An application shall be requested from the Board’s administrative office or shall be
downloaded from the Internet.
(b) Requests for upgrade will be accepted throughout the year and files which are
completed on or before the 30th day prior to the meeting will ordinarily be processed at
the next board meeting scheduled for the purpose of reviewing files. Supporting
documents requested in these instructions must be received in the board office within
60 days of receipt of your application or the file will be closed.
(c) An individual seeking to upgrade shall pay the nonrefundable upgrade review fee,
pursuant to rule 0450-01-.06, upon submission of the upgrade application.
(d) An applicant shall respond truthfully and completely to every question or request for
information contained in the form and submit it along with all documentation and fees
required by the form and this rule to the board administrative office. It is the intent of
this rule that steps necessary to accomplish the filing of the application and that all
documentation be filed simultaneously.
(e) An individual currently registered with the board may upgrade his certification to
licensure by providing a copy of his current CPC certificate and:
1. Submitting evidence that he holds a current certification from NBCC, or
2. Compliance with the requirements pursuant to rule 0450-01-.04(1), or
3. Providing verification to the Board’s satisfaction, that he has had five (5) years
professional experience as a certified professional counselor.
(f) An applicant shall disclose the circumstances surrounding any of the following:
1. Conviction of any criminal law violation of any country, state, or municipality,
except minor traffic violations.
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.05, continued)
August, 2019 (Revised) 14
2. The denial of certification or licensure application by any other state or the
discipline of certification or licensure in any state.
3. Loss or restriction of certification or licensure.
4. Any civil suit judgment or civil suit settlement in which the applicant was a party
defendant including, without limitation, actions involving malpractice, breach of
contract, antitrust activity, or any other civil action remedy recognized under any
country’s or state’s statutory, common, or case law.
5. If the applicant discloses any of the above, the Board may require the applicant
to appear before the Board to answer questions regarding the circumstances and
regarding the applicant’s fitness to practice in the State of Tennessee. The
burden is on the applicant to prove by a preponderance of the evidence the
circumstances of any of the above.
6. Any of the above may be grounds for denial or conditioning of the license if the
Board determines it to be unprofessional conduct or conduct that violates T.C.A.
§§ 63-22-101, et seq. or Board rules and regulations.
(g) An applicant shall cause to be submitted to the Board’s administrative office directly
from the vendor identified in the Board’s licensure application materials, the result of a
criminal background check.
(h) Where necessary, all documents required to be submitted shall be translated into
English and such translation certified along with the original document as to
authenticity by the issuing source.
(i) Upgrade review and licensure decisions shall be governed by rule 0450-01-.07.
(j) Personal resumes are not acceptable and will not be reviewed.
(k) The burden is on the applicant to prove by a preponderance of the evidence that he
possesses the qualifications to upgrade to licensure status.
(3) Licensed Professional Counselor (LPC) by Reciprocity
(a) The Board may issue a license to any individual who holds a current professional
counselor license from another state of the United States which has entered into a
mutual reciprocity agreement with the Tennessee Board for Professional Counselors,
Marital and Family Therapists, and Clinical Pastoral Therapists, and who meets the
qualifications stated in rule 0450-01-.04(3).
(b) An application shall be requested from the Board’s administrative office or shall be
downloaded from the Internet. An applicant shall pay, at the time of application, the
nonrefundable application fee as provided in rule 0450-01-.06.
(c) Applications for licensure will be accepted throughout the year and files which are
completed on or before the 30th day prior to the meeting will ordinarily be processed at
the next Board meeting scheduled for the purpose of reviewing files. Supporting
documents requested in these instructions must be received in the Board office within
sixty (60) days of receipt of the application or the file will be closed.
(d) An applicant shall respond truthfully and completely to every question or request for
information contained in the form and submit it along with all documentation and fees
GENERAL RULES GOVERNING PROFESSIONAL COUNSELORS CHAPTER 0450-01
(Rule 0450-01-.05, continued)
August, 2019 (Revised) 15
required by the form and this rule to the Board administrative office. It is the intent of
this rule that all steps necessary to accomplish the filing of the required documentation
be completed prior to filing an application and that all documentation be filed
simultaneously.
(e) An applicant shall submit a clear and recognizable, recently taken, bust photograph
which shows the full head face forward from at least the top of the shoulders up.
(f) An applicant shall submit a certified photocopy of his or her birth certificate.
(g) An applicant shall submit evidence of good moral character. Such evidence shall
include two recent, within the preceding twelve (12) months, original letters from
professionals attesting to the applicant’s personal character and professional ethics
and typed on the signator’s letterhead.
(h) An applicant shall submit a copy of his original certificate or license from the other state
along with an official statement or affidavit from the appropriate certification or licensing
agency in the other state which indicates that the certificate or license is in effect and in
good standing, as well as under what provision such certificate or license was issued
(i.e. grandfathering, examination, reciprocity, endorsement, etc.).
(i) An applicant must submit a copy of his renewal certificate with the number from the
other state and expiration date.
(j) The applicant shall provide the Board with a copy of his state’s certification or licensing
law and rules in effect at the time the applicant was credentialed.
(k) An applicant shall disclose the circumstances surrounding any of the following:
1. Conviction of any criminal law violation of any country, state, or municipality,
except minor traffic violations.
2. The denial of certification or licensure application by any other state or the
discipline of certification or licensure in any state.
3. Loss or restriction of certification or licensure.
4. Any civil suit judgment or civil suit settlement in which the applicant was a party
defendant including, without limitation, actions involving malpractice, breach of
contract, antitrust activity or any other civil action remedy recognized under any
country’s or state’s statutory, common, or case law.
5. If the applicant discloses any of the above, the Board has the right to require the
applicant to appear before the Board to answer questions regarding the
circumstances and regarding the applicant’s fitness to practice in the State of
Tennessee. The burden is on the applicant to prove by a preponderance of the
evidence the circumstances of any of the above.
6. Regardless of the terms of a reciprocal agreement with another state, any of the
above may be grounds for denial or conditioning of the license if the Board
determines it to be unprofessional conduct or conduct that violates T.C.A. §§ 63-
22-101, et seq. or Board rules and regulations.
(l) An applicant shall cause to be submitted to the Board’s administrative office directly
from the vendor identified in the Board’s licensure application materials, the result of a
criminal background check.

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