This chapter: Establishes the requirements for an individual to practice professional art therapy; Establishes standards of supervision and the responsibilities of supervisors and supervisees in the practice of clinical professional art therapy; Applies to licensees who: Practice clinical professional art therapy; and Provide supervision for licensed graduate professional art therapists; Applies to licensed graduate professional art therapists who are in the process of obtaining the supervised clinical experience required by Health Occupations Article, §17-304.1, Annotated Code of Maryland; and Does not apply to personnel or management practices associated with contractual relationships or employment. On or after December 31, 2018, an approved art therapy supervisor shall follow the requirements set forth in Regulations .06—.08 of this chapter. In this chapter, the following terms have the meanings indicated. Terms Defined. “Accredited educational institution” means a college or university that is: Accredited through a recognized body endorsed by the U.S. Department of Education; and Approved by the Board. “Applicant” means an individual applying for licensure as a clinical or graduate professional art therapist. “Approved art therapy supervisor” means: An Art Therapy Credentials Board Certified Supervisor; An Art Therapy Credentials Board Registered Art Therapist or Board Certified Art Therapist; A licensed clinical professional art therapist; or Another mental health care provider approved by the Board and licensed under the Health Occupations Article, Title 17, Annotated Code of Maryland. “Equivalent” means a degree in a program of studies determined by the Board to have: Substantial art therapy emphasis in the subject matter; and The extent of training required for the specified level of licensure. Face-to-Face. “Face-to-face” means in the physical presence of the individuals involved in the supervisory relationship during either individual or group supervision or using video conferencing which allows individuals to hear and see each other in actual points of time. “Face-to-face” does not include: Telephone supervision; or Internet communication that does not involve actual or real time video conferencing, such as instant messaging services, emails, texting, and social networking sites. “Group supervision” means the provision of face-to-face supervision to more than one individual at a time. “Licensed graduate professional art therapist” means an individual approved by the Board to practice graduate professional art therapy under the supervision of an approved supervisor while fulfilling the supervised clinical experience for licensure under: Health Occupations Article, §§17-304.1 and 17-309, Annotated Code of Maryland; and Regulation .04 of this chapter. “Licensed mental health care provider” means: A licensed clinical professional art therapist; Another mental health care provider approved by the Board and licensed under Health Occupations Article, Title 17, Annotated Code of Maryland; or A licensed mental health care provider from a state, territory, or jurisdiction that authorizes the application of equivalent art therapy principles and methods as set forth in Health Occupations Article, §17-308, Annotated Code of Maryland. “Practice” means to engage professionally and for compensation in art therapy and appraisal activities by providing services for individuals, couples, families and groups involving: The application of therapy principles; and Methods in the diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions. “Relative” means: Spouse, or domestic partner; Parent, stepparent or legal guardian; Sibling or stepsibling; Child, stepchild, foster child, or ward; Mother-in-law or father-in-law; Son-in-law or daughter-in-law; Grandparent or grandchild; Aunt or uncle; or Cousin. “Supervised clinical experience in professional art therapy” means therapy services conducted under the supervision of an approved art therapy supervisor that includes: Monitoring the performance of a supervisee; and Providing, with respect to clinical skill and competencies: Documented and direct consultation; Guidance; and Instruction. “Supervision training” means a course or program designed to provide information regarding the supervision process utilized by: Licensed clinical professional art therapists; or Licensed mental health providers. To qualify for licensure as a clinical professional art therapist, an applicant shall have: Completed one of the following from an accredited educational institution: A master’s degree in an art therapy program approved by the Board with: A minimum of 60 graduate semester credit hours; or 90 graduate quarter credit hours; A doctoral degree in an art therapy program approved by the Board with: A minimum of 90 graduate semester credit hours; or 135 graduate quarter credit hours; or A graduate level degree which: Includes the coursework listed in §A(2) of this regulation; and Is approved by the Board; Completed a minimum of 3 graduate semester credit hours in each of the following course content areas: Human growth and personality development; Social and cultural foundations of counseling; Theories of art therapy; Art therapy techniques: Group dynamics, processing, and counseling; Lifestyle and career development; Appraisal; Research and evaluation; Professional, legal, and ethical responsibilities; Marriage and family therapy; Supervised field experience that includes: A supervised clinical internship, externship, field experience, or practicum placement; and Direct client contact in art therapy with a minimum of 125 hours of face-to-face client therapy; Alcohol and drug counseling; Psychopathology; and Diagnosis and treatment of mental and emotional disorders; For a master’s level applicant, completed supervised clinical experience in professional art therapy obtained under the supervision of an approved art therapy supervisor of not less than 3 years with a minimum of 3,000 hours, of which: 1,500 hours shall be face-to-face client contact hours, including 100 face-to-face clinical supervision hours obtained after the awarding of a master’s degree, of which: At least 50 hours shall be face-to-face individual clinical supervision; and 50 hours may be face-to-face group clinical supervision; A maximum of 1 year and 1,000 hours of clinical experience may be acquired before the awarding of the master's degree; and Not less than 2 years and 2,000 hours shall be acquired after the master's degree has been awarded; For a doctoral level applicant, completed supervised clinical experience in professional art therapy obtained under the supervision of an approved art therapy supervisor of not less than 2 years with a minimum of 2,000 hours, of which: 1,000 hours shall be face-to-face client contact hours, including 50 face-to-face clinical supervision hours obtained after the awarding of a doctoral degree, of which: At least 25 hours shall be face-to-face individual clinical supervision; and 25 hours may be face-to-face group clinical supervision; A maximum of 1 year and 1,000 hours of clinical experience may be acquired before the awarding of the doctoral degree; and Not less than 1 year and 1,000 hours shall be acquired after the doctoral degree has been awarded; Achieved a passing score on: A national certification exam approved by the Board; and An examination of: Health Occupations Article, Title 17, Annotated Code of Maryland; and COMAR 10.58; Submitted a completed Board-approved application; Provided an official transcript from the educational institution which awarded the master’s or doctoral degree; Paid all applicable fees set forth in COMAR 10.58.02; Submitted to a criminal background check; Good moral character; and Complied with: Health Occupations Article, Title 17, Annotated Code of Maryland; and The code of ethics as set forth in COMAR 10.58.03. An applicant who fails an examination for licensure may retake the exam. The Board shall act upon applications within a 6-month period as follows: Within 90 days after receipt of an application, the Board shall determine whether the application is complete; If the Board determines that the application is not complete, the Board or the Board’s designee shall send a notice of deficiency to the applicant; Upon receipt of a notice, the applicant shall correct the deficiency within 90 days, or another period specified in the notice; and If the applicant fails to correct the deficiency within the required period, the application shall lapse and the applicant shall be required to: Submit a new application; and Pay the required non-refundable fee set forth in COMAR 10.58.02. Renewal. To renew a clinical professional art therapist license, the applicant shall: Submit a completed Board-approved application; Pay the required application fee set forth in COMAR 10.58.02; and Attest to completion of continuing education activities as specified in COMAR 10.58.05.05 and .06. A licensed clinical professional art therapist shall comply with the renewal requirements as provided in Health Occupations Article, §17–504, Annotated Code of Maryland. An individual who fails to renew licensure is not authorized to and may not practice clinical professional art therapy. Reinstatement. Within 5 calendar years after the certificate renewal date, the Board may reinstate the license of a licensed clinical professional art therapist otherwise entitled to reinstatement under Health Occupations Article, §17-505(b), Annotated Code of Maryland, whose license was not renewed for any reason, if the licensee: Completes within that 5-year period the minimum of 20 CEUs required for each year; and Pays the reinstatement fee set by the Board in COMAR 10.58.02. CEUs which are acquired in order to reinstate under COMAR 10.58.05.05 and.06 may be credited only once and may not be credited for any future renewals. For any licensed clinical professional art therapist whose license has expired more than 5 calendar years before the request for reinstatement, a new application for licensure shall be completed and the current licensure requirements shall be met. An individual who fails to reinstate licensure is not authorized to and may not practice clinical professional art therapy. Inactive Status. In accordance with Health Occupations Article, §17-505, Annotated Code of Maryland, a request to transfer a license to inactive status shall be granted upon receipt of the: Completed Board-approved application; and Payment of the required, non-refundable, annual fee set forth in COMAR 10.58.02. An individual may apply for inactive status only if the individual’s license is still active at the time application for inactive status is made. An individual on inactive status is not authorized to and may not practice clinical professional art therapy. An individual on inactive status seeking to be reinstated to active status shall be required, as a condition of reinstatement, to submit proof of having completed 20 CEU’s for each year of inactive status, at least 40 of which shall have been obtained within the 2-year period immediately preceding the application for reinstatement. To qualify for licensure as a graduate professional art therapist, an applicant shall have: Completed one of the following from an accredited educational institution approved by the Board: A master’s degree in an art therapy program approved by the Board with: A minimum of 60 graduate semester credit hours; or 90 graduate quarter credit hours; A doctoral degree in an art therapy program approved by the Board with: A minimum of 90 graduate semester credit hours; or 135 graduate quarter credit hours; or A graduate level degree which: Includes the coursework listed in §A(2) of this regulation; and Is approved by the Board; Completed the graduate coursework required as set forth in Regulation .03A(2) of this chapter; Achieved a passing score on: A national certification exam approved by the Board; and An examination of: Health Occupations Article, Title 17, Annotated Code of Maryland; and COMAR 10.58; Submitted a completed Board-approved application; Provided an official transcript from the educational institution which awarded the master’s or doctoral degree; Paid all applicable fees set forth in COMAR 10.58.02; Submitted to a criminal background check; Good moral character; and Complied with: Health Occupations Article, Title 17, Annotated Code of Maryland; and The code of ethics as set forth in COMAR 10.58.03. An applicant who fails an examination for licensure may retake the exam. Composition of Supervised Clinical Experience. A licensed graduate professional art therapist shall complete at least half of the requisite supervised clinical experience in professional art therapy hours under the supervision of a licensed clinical professional art therapist who has been approved by the Board to provide art therapy supervision. A licensed graduate professional art therapist may complete the remainder of the supervised clinical experience in professional art therapy hours under the supervision of an approved art therapy supervisor as defined in Regulation .02 of this chapter. The Board shall act upon applications within a 6-month period as follows: Within 90 days after receipt of an application, the Board shall determine whether the application is complete; If the Board determines that the application is not complete, the Board or the Board’s designee shall send a notice of deficiency to the applicant; Upon receipt of a notice, the applicant shall correct the deficiency within 90 days, or other period specified in the notice; and If the applicant fails to correct the deficiency within the required period, the application shall lapse and the applicant shall be required to: Submit a new application; and Pay the required non-refundable fee set forth in COMAR 10.58.02. Expiration, Renewal, and Extension. The graduate professional art therapist license expires 2 years after the date issued. If a licensed graduate professional art therapist is unable to accumulate the required clinical hours of supervision for licensure within 2 years, the licensee may apply for a 2-year extension before the license expires, up to a maximum of 6 years. A licensed graduate professional art therapist who has applied for and received an extension as set forth in §D(2) of this regulation, shall comply with the renewal requirements as provided in Health Occupations Article, §17–504, Annotated Code of Maryland. If a licensed graduate professional art therapist notifies the Board in writing, the Board may consider a license extension beyond the 6-year maximum set forth in §D(2) of this regulation. An applicant licensed as an art therapist or its equivalent, as established by the Board, in another state, territory, or jurisdiction is eligible for licensure if the applicant: Provides: A completed Board-approved application; Verification that the applicant has: A copy of a current license from each state, territory, or jurisdiction in which the applicant has been licensed, registered, or otherwise authorized to practice art therapy; Documentation, satisfactory to the Board, that the applicant is currently licensed in good standing to practice art therapy in another state, territory, or jurisdiction; No history of disciplinary action, past or pending, in a state, territory, or jurisdiction in which the applicant holds a license to practice art therapy; and Not committed any act or omission that would be grounds for discipline or denial of licensure under Health Occupations Article, §17-509, Annotated Code of Maryland; An official transcript from the educational institution which awarded the master’s or doctoral degree; Verification from employers, supervisors, or colleagues after the awarding of the graduate degree, that the applicant has practiced clinical professional art therapy for: Not less than 2 years; and A minimum of 2,000 hours; and For an applicant with a master’s degree consisting of less than 60 graduate semester credit hours: Documentation, satisfactory to the Board, of not less than 2 years and minimum of 2,000 hours after the awarding of the graduate degree; and Documentation showing completion of a minimum of 3 graduate semester credit hours covering each of the following primary topics or content areas: Diagnosis and treatment of mental and emotional disorders; Appraisal; Professional, legal, and ethical responsibilities; and Current certification from a national accrediting body approved by the Board; Pays all applicable fees set forth in COMAR 10.58.02; Achieves a passing score on: A national certification exam approved by the Board; and An examination of: Health Occupations Article, Title 17, Annotated Code of Maryland; and COMAR 10.58; Submits to a criminal background check; Is of good moral character; and Complies with: Health Occupations Article, Title 17, Annotated Code of Maryland; and The code of ethics as set forth in COMAR 10.58.03. A supervisor shall: Supervise only in those areas within the supervisor’s competence as determined by education, training, and experience; Provide supervision appropriate to the particular level of licensure being applied for or maintained; Provide supervision in the general content areas established in Health Occupations Article, §17-304.1, Annotated Code of Maryland; and Ensure that a supervisee has read and is knowledgeable about: Health Occupations Article, Title 17, Annotated Code of Maryland; and COMAR 10.58, with special emphasis on the Code of Ethics, COMAR 10.58.03. In addition to the requirements of §A of this regulation, the supervisor shall specifically instruct and provide guidance: Relating to the supervisee’s scope of practice of clinical professional art therapy under Health Occupations Article, §17-101, Annotated Code of Maryland; To supervisees in appropriate billing practices if applicable to the practice site including: Providing services involving the application of therapy principles and methods in the diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions of individuals, families, couples or groups, as stated in Health Occupations Article, §17-308, Annotated Code of Maryland; Record keeping; Disclosure of fees and financial arrangements; and Appropriate maintenance and destruction of clinical and financial records. The following individuals may not provide clinical supervision for a licensed graduate professional art therapy supervisee: A relative; A licensed graduate professional art therapist; A licensed graduate alcohol and drug counselor; A licensed graduate professional counselor; A licensed graduate marriage and family therapist; A certified alcohol and drug counselor; An individual with whom there could be a conflict of interest, including, but not limited to: An employee supervising their own employer; or A student supervising their own teacher; or Any other graduate level health care provider licensed under Health Occupations Article, Title 17, Annotated Code of Maryland. Licensure. An individual providing supervision shall be approved by the Board and licensed by the Board as a Clinical professional art therapist; Clinical professional counselor; Clinical alcohol and drug counselor; Clinical marriage and family therapist; or Mental health care provider as defined in Regulation .02B of this chapter. Supervision Experience, Education and Training. A supervisor or any mental health care provider, licensed by the Board under Health Occupations Article, Title 17, Annotated Code of Maryland, who is approved by the Board and has completed 3 years of documented experience in clinical counseling or psychotherapy, shall complete by December 31, 2019: 2 years of documented experience providing art therapy supervision; At least 3 graduate semester credit hours or 5 quarter credit hours of academic coursework in art therapy supervision; At least 3 graduate semester credit hours or 5 quarter credit hours of academic coursework in counseling supervision; or A Board-approved continuing education program that includes a minimum of 18 continuing education units (CEUs) with a trainer or trainers in: Counseling; Art therapy; or Psychotherapy supervision. A licensed individual who applied for and was granted Board-approved supervisor status before December 31, 2019 based on 2 years of documented experience providing art therapy supervision, may continue to provide art therapy supervision after that date. After December 31, 2019, an applicant for Board-approved supervisor status shall have: 3 years documented experience in professional art therapy as approved by the Board; and Completed the requirements of §A or B of this regulation. Supervision training required by this section may be obtained in a graduate course that may include, but is not limited to: The role and responsibilities of the supervisor; The needs of the supervisee, supervisor, and the agency setting while maintaining a clear ethical perspective, including: The maintenance of appropriate boundaries; and Making clinically appropriate diagnoses; The role of the supervisor as gatekeeper to the profession; Methods for building effective and appropriate relationships with clients; Models for group supervision; and Models and modalities for practice intervention. Pre-Supervision Responsibilities of a Supervisor. In addition to meeting the requirements of this regulation, the supervisor shall: File the completed Board-approved licensed professional art therapy supervisor application form; Provide the supervisee with a copy of the Board’s licensed clinical professional art therapy supervisor letter; and Have an active license that is without restrictions or conditions due to disciplinary action for the 2 years preceding an application for licensed clinical professional art therapy-approved supervisor status. A supervisor shall: Agree to and sign a Board-approved contract before initiating supervision; Ensure that the supervisee is practicing within the scope of the supervisee’s license; Determine the skill level at which the supervisee may practice; Focus on primary data from the supervisee’s practice; Maintain documentation of supervisory sessions for at least 7 years, including: Dates; Duration; and Focus of the supervisory sessions; Ensure that a supervisee has read and is knowledgeable about: Health Occupations Article, Title 17, Annotated Code of Maryland; and COMAR 10.58 with special emphasis on the Code of Ethics, COMAR 10.58.03; Within a reasonable period of time before the conclusion of supervision, provide the supervisee and employer with a notice of termination to avoid or minimize any harmful effect on the supervisee’s clients or patients; Be responsible for the clinical professional practices of supervisees; Provide: For emergency supervision and direction to a supervisee by a Board-approved supervisor; A written evaluation of progress to the supervisee on a regular basis or as needed; and A copy of the documentation required by §E of this regulation on request by the: Supervisee; or Board or its authorized agent; and Comply with a Board audit of a supervisor’s compliance with regard to the supervisory requirements and responsibilities. A supervisee shall: Verify that the supervisor has been approved by the Board; Agree to and sign a Board-approved contract before initiating supervision; Attend and participate in supervision as agreed to in the supervision contract; Prepare for supervision using case materials related to the supervisee’s clinical professional art therapy practice; and Maintain documentation of supervisory sessions for at least 7 years, to be available for verification to the Board or its authorized agent, including: Dates; Duration; and Focus of the supervision. A supervisee may not engage in the practice of clinical professional art therapy independent of supervision. A supervisee shall give the client a copy of a professional disclosure statement as described in Health Occupations Article, §17-507, Annotated Code of Maryland, that: Clearly states the art therapy services are provided under clinical supervision; and Provides the name of the supervisor with address and contact information. A supervisee shall obtain from the client a signed: Release of information; and Informed consent for treatment which indicates that the client: Is aware that art therapy services are being provided under clinical supervision; Consents to the recording of art therapy sessions with the knowledge that the recording may only be shared with the supervisor; and Consents to the sharing of client information between the licensed graduate professional art therapist and the named clinical supervisor. Health Occupations Article, §§17-101, 17-205, 17-301, 17-304.1, 17-304.2, 17-307, 17-307.1, 17-309,17-501.1, 17-502—17-505, 17-507, and 17-509, Annotated Code of Maryland Effective date: December 31, 2018 (45:26 Md. R. 1246)