A. Application
Packet
Upon reading the requirements for professional credentialing
in Chapter 3, Section 4, pp. 11-12 and making a decision to upgrade to Licensed
Clinical Mental Health Therapist (LCMHT), an individual shall submit to the
Division an upgrade application packet containing the forms/materials listed
below. These forms verify the provisional certification requirements listed in
Chapter 3, Section 4, pp.11-12.
(1)
Application: A completed, notarized Upgrade Application Form;
(2) Employment: A completed Upgrade
Verification of Employment Form from the applicant's current place of
employment meeting the employment requirement listed in Chapter 3, Section 4,
B., (1), p. 11;
(3) Education: An
Official Transcript(s) meeting the educational requirements listed in Chapter
3, Section 4, B., (2), p.11.
However, if the educational requirement for LCMHT is met by
the Official Transcript already on file with the individual's initial
application for PCMHT or upgrade application for CMHT, then no further
documentation is necessary.
(4) Experience: A completed Upgrade
Verification of Experience Form(s) meeting the experience requirements listed
in Chapter 3, Section 4, B., (3), p. 11.
However, if any of the experience requirement for LCMHT is
met by the Verification of Experience Form(s) already submitted with the
individual's initial application for PCMHT or upgrade application for CMHT,
then only the balance necessary to meet LCMHT experience requirements should be
submitted.
(5) Ongoing
Inservice/Training:
If upgrading from PCMHT to LCMHT, a completed Verification of
Inservice/ Training Form(s) verifying required inservice/training obtained
during the individual's Provisional Certification Period as indicated in
Chapter 3, Section 2, E., (2), pp. 9-10; and,
If upgrading from CMHT to LCMHT, a completed Verification of
Inservice/ Training Form(s) verifying required inservice/training obtained
during the current two-year Certification/Licensure Period as indicated in
Chapter 3, Section 4, B., (4), pp. 11-12.
(6) MH-CTP: While successful completion of
the MH-CTP is required for a provisional certificant to upgrade, there is no
reporting requirement for the upgrade applicant. See Chapter 4, Section 1, I.,
p.23 for more information on documenting participation in the MH-CTP.
(7) Application Fee: A nonrefundable $75.00
check or money order made payable to the Mississippi Department of Mental
Health. See Chapter 6, Section 1, A., p. 36 for more information on the
Application Fee.
B.
Directions
(1) When preparing to submit an
upgrade application for clinical licensure (LCMHT), be sure to follow the
General Guidelines found in Chapter 4, Section 1, pp. 19-23 as well as the
directions found at the top of each form. Directions are also located in
Chapter 9 on p. 58 and in a checklist format found on pp. 59-60.
(2) If questions arise which are not
addressed in this document, please contact the Division for
assistance.
C.
Submission Timelines
When upgrading from PCMHT to LCMHT, individuals are expected
to follow these timelines:
(1) Upon
conclusion of the Provisional Certification Period (24 consecutive month
maximum), a provisional certificant is expected to submit an upgrade
application packet so that it is received by the Division no later than the
last working day of the 25th month (one month past the 24 consecutive month
maximum).
(2) Provisional
certificants who have completed all Provisional Certification Period
requirements prior to reaching the maximum number of months allowed (24 months)
and who wish to submit an upgrade application packet prior to the 25 month
deadline may do so.
(3) A
provisional certificant who has been unable to complete all requirements during
the Provisional Certification Period due to extenuating circumstances may
submit a written request to the Review Board for Extended status. This written
request must be received by the Division no later than the last working day of
the 25th month. See Chapter 3, Section 7, B., (2), p. 15 for more information
on Extended status.
(4) If neither
the upgrade application packet nor the written request for Extended status is
received by the last working day of the 25th month,
the provisional certificant is considered to have Defaulted. See Chapter 3,
Section 7, B., (3), pp. 15-16 for more information on Defaulted
status.
