SPECIFIC REQUIREMENTS REGARDING
CERTIFICATION AS A LCSW SUPERVISOR
1. Hold a current (not- expired), LCSW license in good standing (no disciplinary actions).
2. Completion of a Board approved supervision course for a minimum of sixteen hours (16) hours and
submit your Certificate of Supervision Training Certificate with your application. All supervision training
meet be approved by the Board in order to be considered for this purpose. LCSW Supervisors must
receive two (2) hours of continuing education in supervision during each biennial renewal period. No
supervision continuing education is required for the first renewal period.
3. Submit notarized statements from current and previous employers verifying two years post clinical
practice in social work at the LCSW level.
4. Submit application and fees.
INSTRUCTIONS FOR COMPLETING A MINIMUM OF SIXTEEN (16)
HOURS OF LCSW SUPERVISION TRAINING THROUGH A COMBINATION
OF ONLINE COURSES AND THE WRITTEN LCSW SUPERVISOR TEST TO
BECOME A BOARD APPROVED LCSW SUPERVISOR
The rules and regulations require that certification as a Board approved LCSW Supervisor requires the
following: 1) LCSW with a minimum of two years of verifiable clinical practice at the LCSW level and;
2) completion of a Board approved supervision course for a minimum of sixteen (16) hours. After the
approval of LCSW Supervisor status, each supervisor must submit two hours of board approved
supervision continuing education with the renewal of their license.
Instructions
1. An LCSW can go to the following link: Courses By Subject – Zur Institute and purchase fifteen
(15) hours of LCSW supervision, listed under Supervision & E-Supervision, Supervision
Package #1 or #2. Upon completion of the courses, please maintain all certificates of
completion for documentation. You will mail copies of the certificates in with the LCSW
Application and Test.
2. Complete the LCSW Test and Application for Certification as a LCSW Supervisor, and mail all
documents together to the Board’s address with an $80.00 money order or cashier’s check. Be
sure to include a description of clinical work experience as required on the application.
RULES REGARDING SUPERVISION
1. Supervision must be provided by an LCSW holding Board certification.
2. Supervisor must maintain his/her license as a LCSW in accordance with licensure laws of the
State of Mississippi.
3. It shall be considered unethical for an LCSW without clinical expertise to supervise a LMSW
candidate seeking to become a clinician.
4. No plan of supervision will be approved if the contracted supervisor is supervising more than seven
(7) master social workers that are in pursuit of the LCSW.
5. Individual supervision shall mean a maximum of two (2) supervisees meeting with one supervisor and
group supervision shall mean a maximum of seven (7) supervisees with one supervisor.
6. The Supervision period must be for a minimum of twenty-four (24) months and may not exceed thirty-
six (36) months. Each six (6) month evaluation period begins the date of the approval letter the Social
Work Discipline Specific Committee (SWDSC) mails to the licensee. You will also receive a copy of
that letter.
7. Upon completion of their supervision, you as a “Supervisor” having been under contract with the
licensee cannot complete a “professional reference” on the same licensee. That would be considered
as overkill. Too much information from the one individual.
8. For supervisors and supervisees who are not employed within the same agency, there must be a written
plan approved by the Board to address how the LCSW Supervisor will insure that the face to face
supervision is observed or carried out. Such face to face supervision must include on-site visits to
the supervisee’s practice location at least once per six (6) month supervision period and
recorded on the evaluation form.
9. Supervision may include alternate means of supervision by audio or audiovisual electronic device
provided there is direct, interactive, live exchange between the supervisor and supervisee or provided
that communication is verbally or visually interactive between the supervisor and the supervisee. No
more than one-fourth (1/4) of the required hours may be by alternate means to direct face-to-face
contact for a total of twenty-five (25) hours.
Mississippi
State Board of Examiners for Social Workers and Marriage and Family Therapists
P.O. Box 4508, Jackson, MS 39296-4508
(601) 987-6806/ Fax: 601-987-6808
Application for Certification as a LCSW Supervisor
Please Type or Print
I. Personal Information LCSW License NO.___________ Last 4 SSN ____________
Name as appears on your LCSW license ___________________________________________
Name if different from above ___________________________ Date of Birth ______________
License expiration date: _____________________ Tel. ( )_____________________
Current Mailing Address ________________________________________________________
________________________________________________________
Current Employer ___________________________________ Tel. ( )__________________
Address _____________________________________________________________________
II. Board Approved LCSW Supervisor Training
Completion of a Board approved supervision course for a minimum of sixteen hours (16) hours is required.
All supervision training must be approved by the Board in order to be considered for this purpose.
Supervision trainers must be an approved LCSW supervisor.
Declaration of Applicant: I the undersigned do hereby apply for certification as a qualified supervisor for
applicants seeking the supervisory process leading to licensure as a Licensed Certified Social Worker. I
declare that I am willing to abide by the rules and regulations of a supervisor as defined in the book of Rules
and Regulations Regarding the Licensure of Social Workers and Marriage and Family Therapists and within
the boundaries of the laws of the State of Mississippi of the United States.
Signed____________________________________________ Date ____________________
Instructions: Complete the LCSW Test and Application for Certification as a LCSW Supervisor, and mail
everything in together to the Board’s address listed above with an $80.00 money order or cashier’s check.
___________________________________________________________________________________________________
FOR BOARD USE ONLY
APPROVE _____ NOT APPROVED ______ DATE: ____________
ASSIGNED SUPERVISOR ID No. __________________
MBOESWMFT – Form 390 – Effective Date 05/17/2022
Mississippi
State Board of Examiners for Social Workers and Marriage and Family Therapists
P.O. Box 4508, Jackson, MS 39296-4508
(601) 987-6806/ Fax: 601-987-6808
Verification of Post Clinical Practice in Social Work
(If applicant has had more than one employer, please submit a completed form for each employer.)
To be completed by applicant seeking LCSW Supervisor status:
Name_____________________________________________ License # ____________________
Address________________________________________________________________________
Street City State Zip Phone
Place of Employment ______________________________________________________________
Address_________________________________________________________________________
Street City State Zip Phone
Department_______________________________ Position/Title____________________________
Dates practiced ______________________ to ______________________
Please include a description of clinical work experience such as a job description or resume
illustrating clinical aspects of employment.
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
TO BE COMPLETED BY EMPLOYER
I the undersigned do affirm that the applicant
listed above has practiced as a clinical level (Seal)
social worker at this setting during the time
frame described above.
______________________________________
Print or type Employer’s Name Subscribed and sworn to me this
______________________________________
Employer’s Signature
________ day of _________________, 20_____.
________________________
Date
_____________________________________
(Notary Public)
Mississippi
Board of Examiners for Social Workers and Marriage and Family Therapists
P.O. Box 4508, Jackson, MS 39296-4508
(601) 987-6806/ Fax: 601-987-6808
LCSW Supervisor Test
INSTRUCTIONS: Complete the LCSW Test and Application for Certification as a LCSW Supervisor, and mail everything in
together to the Board’s address listed above. Do not forget to include the Application and Application Fee.
Include your name, address, telephone number & email address. The test will be scored & results will be mailed or emailed to you.
Keep your documentation to include with your continuing education report during license renewal years.
Name: _________________________________________________________ License Number: _______________
Mailing Address: ________________________________________________________________________________________
Email address: _____________________________________________________Phone #______________________________
Please read the guidelines and rules/regulations pertinent to performing the duties of a Licensed Certified Social Work
Supervisor. Then answer the following questions by selecting the best answer.
1. The supervision process may begin:
a. At any time decided upon by the supervisee & supervisor
b. Only after approval by the Social Work Discipline Specific Committee (SCDSC) of the Board of Examiners
c. Once a supervision plan is developed and mailed to the BOE
d. All of the above
2. It is the supervisee’s responsibility to:
a. Secure an approved LCSW supervisor
b. Complete an application to enter into supervision
c. Submit a processing fee ($80.00)
d. All of the above
3. A Licensed Master Social Worker who desires to enter into a supervisory relationship can do so with:
a. Any LCSW
b. A BOE approved LCSW supervisor
c. An LCSW who plans to take the supervision training
4. Once the supervision plan is submitted to the BOE, it is automatically approved by the SWDSC and the LMSW and
LCSW may begin the supervision process.
a. True
b. False
LCSW Supervisor Test – Page 2
5. At the end of the supervisory process, supervision sessions should total ___ hours of meeting time.
a. 36
b. 24
c. 100
d. 1,000
6. At the end of the supervisory process, face to face client contact hours should total____ hours.
a. 500
b. 1,000
c. 2,000
d. 3,000
7. Applicants for the LCSW exam are allowed to take the ASWB exam:
a. Only once
b. Every ninety days
c. Every 2 months
d. Anytime
8. The LCSW supervisor must have:
a. A valid license
b. 2 years of verifiable clinical practice at the LCSW level
c. Both of the above
9. LCSW supervisors may supervise no more than __ supervisee(s) at any given time.
a. 7
b. 10
c. 5
d. 1
10. Supervision must occur in which of the following?
a. must be employed in a social work setting (institution, agency, center that delivers social services, or a similar
entity)
b. can be employed anywhere (social work or non-social work setting)
c. can be unemployed
11. In order to change supervisors, the LMSW should:
a. Ensure that the current supervisor completes an evaluation and a termination form
b. Ensure that the documents are sent within 30 days of termination to the BOE
c. Submit a new application & supervisory contract (with revisions) to the BOE
d. All of the above
LCSW Supervisor Test – Page 3
12. Obligations of the supervisee during supervision include:
a. Seek critical professional feedback & evaluation from the supervisor
b. Maintain documentation of the supervision sessions
c. Prepare for sessions
d. Seek knowledge regarding resources & collegial contacts
e. All of the above
13. Obligations of the supervisor include:
a. Maintain documentation of the sessions
b. Provide evaluation of the supervisee at required time periods
c. Identify supervisee’s ability to practice without harm to the public
d. All of the above
14. Supervisors should avoid dual relationships in supervision including:
a. Their children or parents
b. Spouses or former spouses
c. Siblings
d. Anyone sharing the same household
e. All of the above
15. The BOE has a recommended fee schedule for supervision sessions:
a. True
b. False
16. The plan of supervision is designed to guide:
a. The LMSW’s work environment
b. The topics of discussion, study & consultation during supervisory sessions
c. The LMSW’s personal goals
17. The 3 main areas of the plan of supervision are orientation, professional development, practice context.
a. True
b. False
18. The minimum period of supervision is for 24 months, however, the supervision process exceeds the 24 month mark
because the Social Work Discipline Specific Committee must review the evaluations after each six month period.
a. True
b. False
19. Sections of the supervision plan are optional.
a. True
b. False
LCSW Supervisor Test – Page 4
20. The LMSW supervisee should have a continuous commitment to learning and service.
a. True
b. False
21. Face-to-face interaction is required for supervision.
a. True
b. False
22. Supervision via alternative means includes:
a. Direct, interactive exchange
b. Live exchange
c. Verbally & visually interactive
d. All of the above
23. No more than __ of the required hours of supervision may be by alternate means:
a. One-fourth
b. One-half
c. One-tenth
d. There is No limit
24. It is expected by the Board of Examiners, Social Work Discipline Specific Committee that supervisees receive scores of
all “10’s” on the first evaluation.
a. True
b. False
25. The Mississippi State Board of Examiners for Social Workers & Marriage & Family Therapists does not recommend,
endorse, prescribe, or promote the establishment of compensation agreements for supervision. However, which of the
following are true according to the BOE “Guide to Supervision”?
a. If fees are charged they are usually based on an hourly rate
b. The payment agreement is made between the supervisor & the supervisee
c. According to NASW, there seems to be no standard fee schedule for supervision
d. All of the above
26. Which of the following are mandatory on each six-month’s evaluation form?
a. Site visit notes recorded by the supervisor
b. Comments about supervisee’s progress
c. Signatures & dates of signatures by both the supervisor and supervisee
d. All of the above
Note: A review of regulations & guidelines combined with a passing score of 88% yields two hours (2) continuing education
credits specific to LCSW Supervisors.
MBOESWMFT – Form T393 – Effective Date 09/09/2021
