Tenn. Comp. R. & Regs. 0450-03-.05 - PROCEDURES FOR LICENSURE

To become licensed as a clinical pastoral therapist in Tennessee a person must comply with the following procedures and requirements.

(1) Clinical Pastoral Therapist by Examination.
(a) An application packet shall be requested from the Board Administrative Office. When submitted, the appropriate fees, as provided in Rule 0450-03-.06, shall be included.
(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 documents requested in these instructions must be received in the Board's Office within 60 days of receipt of the application or the file will be closed.
(d) An applicant shall submit verification of having completed a supervised practicum and/or internship pursuant to T.C.A. § 63-22-203.
(e) An applicant shall submit with his application a head and shoulders photograph taken within the preceding 12 months.
(f) It is the applicant's responsibility to request a graduate transcript from his degree granting institution, pursuant to T.C.A. § 63-22-203, be submitted directly from the school to the Board's Administrative Office. The institution granting the degree must be accredited, pursuant to T.C.A. § 63-22-201(9), 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 120 graduate semester hours, pursuant to T.C.A. § 63-22-203(3)(A). The educational requirements contained in this Rule must be completed prior to the date of application for licensure.
(g) An applicant shall complete and submit the worksheet form for reporting course work as a part of the application.
(h) An applicant shall submit evidence of good moral character. Such evidence shall include at least two original letters written within the preceding 12 months from professionals attesting to the applicant's personal character and professional ethics. The letters must be submitted on the signator's letterhead.
(i) An applicant shall submit evidence of a practicum consisting of at least one (1) unit of full-time clinical pastoral education in a program accredited by the Association for Clinical Pastoral Education.
(j) An applicant shall submit evidence of an internship consisting of at least two (2) years of clinical pastoral therapy training in an approved training program.
(k) An applicant shall submit evidence of a minimum of one thousand four hundred (1,400) hours of pastoral therapy with individuals, couples, families and/or group, while receiving a minimum of two hundred seventy (270) hours of supervision of such therapy with an approved supervisor.
(l) An applicant shall direct the examination service to submit directly to the Board's Administrative Office evidence that he passed the examination, pursuant to Rule 0450- 03-.08.
(m) An applicant, who has met all other requirements upon being deemed eligible by the Board, shall be required to pass the oral examination, pursuant to Rule 0450-03-.08.
(n) 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 application by any other state or the discipline of certification in any state.
3. Loss or restriction of certification or professional licensure.
4. Any civil suit judgment or civil 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.
(o) 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.
(p) 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.
(q) Personal resumes are not acceptable and will not be reviewed.
(r) Application review and licensure decisions shall be governed by Rule 0450-03-.07.
(2) Clinical Pastoral Therapist by Endorsement if Certified as a Clinical Member of AAPC.
(a) An application packet shall be requested from the Board's Administrative Officer. When submitted, the appropriate fees, as provided in Rule 0530-3-.06, shall be included.
(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 documents requested in these instructions must be received in the Board's Office within 60 days of receipt of the application or the file will be closed.
(d) An applicant shall submit with his application a head and shoulders photograph taken within the preceding 12 months.
(e) An applicant shall cause the AAPC to send documentation that he is certified as a clinical member of the AAPC and that his membership is in good standing.
(f) An applicant shall submit documentation that he has been engaged in the full-time practice of clinical pastoral therapy for at least five (5) years subsequent to that certification. Such documentation shall include two (2) affidavits signed by certified mental health professionals and notarized, attesting to the applicant's period of service in full-time practice of pastoral therapy.
(g) An applicant shall submit evidence of good moral character. Such evidence shall include at least two original letters written within the preceding 12 months from professionals attesting to the applicant's personal character and professional ethics. The letters must be submitted on the signator's letterhead.
(h) An applicant, who has met all other requirements upon being deemed eligible by the Board, shall be required to pass the written and oral examination, pursuant to Rule 0450-03-.08.
(i) 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 application by any other state or the discipline of certification in any state.
3. Loss or restriction of certification.
4. Any civil suit judgment or civil 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.
(j) 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.
(k) 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.
(l) Personal resumes are not acceptable and will not be reviewed.
(m) Application review and licensure decisions shall be governed by Rule 0450-03-.07.
(3) Clinical Pastoral Therapist by Endorsement if Fellow or Diplomate of AAPC.
(a) An application packet shall be requested from the Board's Administrative Officer. When submitted, the appropriate fees, as required by Rule 0450-03-.06, shall be included.
(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 documents requested in these instructions must be received in the Board's Office within 60 days of receipt of the application or the file will be closed.
(d) An applicant shall submit with his application a head and shoulders photograph taken within the preceding 12 months.
(e) It is the applicant's responsibility to request the American Association of Pastoral Counselors to send documentation that he is a fellow or diplomate in the association and that his membership is in good standing.
(f) An applicant shall submit evidence of good moral character. Such evidence shall include at least two original letters written within the preceding 12 months from professionals attesting to the applicant's personal character and professional ethics. The letters must be submitted on the signator's letterhead.
(g) An applicant, who has met all other requirements upon being deemed eligible by the Board, shall be required to pass the written and oral examination, pursuant to Rule 0450-03-.08.
(h) 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 application by any other state or the discipline of certification in any state.
3. Loss or restriction of certification.
4. Any civil suit judgment or civil 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.
(i) 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.
(j) 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.
(k) Personal resumes are not acceptable and will not be reviewed.
(l) Application review and licensure decisions shall be governed by Rule 0450-03-.07.
(4) Clinical Pastoral Therapist by certain professional experience or by certification in certain other professions
(a) An application packet shall be requested from the Board's Administrative Officer.
(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 documents requested in these instructions must be received in the Board's Office within 60 days of receipt of the application or the file will be closed.
(d) An applicant shall submit with his application a head and shoulders photograph taken within the preceding 12 months.
(e) An applicant shall submit documentation of at least one (1) of the following:
1. Completion of educational requirements and supervised counseling experience as required in subparagraph 0450-03-.04(3) (b).
(i) It is the applicant's responsibility to request a graduate transcript from his degree granting institution, pursuant to T.C.A. § 63-22-203, be submitted directly from the school to the Board's Administrative Office. The institution granting the degree must be accredited, pursuant to T.C.A. § 63-22-201(10), 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 one hundred twenty (120) graduate semester hours, pursuant to T.C.A. § 63-22-203(3)(A). The educational requirements contained in this rule must be completed prior to the date of application for licensure.
(ii) An applicant shall complete and submit the worksheet form for reporting course work.
(iii) An applicant shall submit evidence of a practicum consisting of at least one (1) unit of full-time clinical pastoral education in a program accredited by the Association for Clinical Pastoral Education.
(iv) An applicant shall submit evidence of an internship consisting of at least two (2) years of clinical pastoral therapy training in an approved training program.
(v) An applicant shall submit evidence of a minimum of one thousand four hundred (1,400) hours of pastoral therapy with individuals, couples, families and/or groups while receiving a minimum of two hundred seventy (270) hours of supervision of such therapy with an approved supervisor.
2. Active status as a fellow or diplomate of AAPC and actively engaged in the practice of pastoral psychotherapy for at least five (5) years prior to January 1, 2003 as required in subparagraph 0450-03-.04(3) (c) - Such documentation shall include two (2) affidavits signed by licensed or certified mental health professionals, attesting to the applicant's practice of pastoral psychotherapy.
3. Completion of educational requirements, licensure requirements, and clinical pastoral therapy experience as required in subparagraph 0450-03-.04(3) (d).
(i) Documentation of a graduate theological degree.
(ii) An applicant shall submit a copy of his original Tennessee certificate or license as a psychologist designated as a health service provider, a professional counselor designated as a mental health service provider, a marital and family therapist, a clinical social worker, or an alcohol and drug abuse counselor, or an applicant must submit a copy of his renewal certificate.
(iii) An applicant must submit documentation that he has been actively engaged in the practice of clinical pastoral therapy for at least five (5) years prior to January 1, 2003. Such documentation shall include two (2) affidavits signed by certified mental health professionals, attesting to the applicant's period of service as a clinical pastoral therapist or pastoral counselor.
(f) An applicant shall submit evidence of good moral character. Such evidence shall include at least two original letters within the preceding 12 months from professionals attesting to the applicant's personal character and professional ethics. The letters must be submitted on the signator's letterhead.
(g) 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 application by any other state or the discipline of certification in any state.
3. Loss or restriction of certification and/or licensure.
4. Any civil suit judgment or civil 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.
(h) 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.
(i) 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.
(j) Personal resumes are not acceptable and will not be reviewed.
(k) Application review and licensure decisions shall be governed by Rule 0450-03-.07.

Notes

Tenn. Comp. R. & Regs. 0450-03-.05
Original rule filed December 30,1998; effective March 15, 1999. Amendment filed July 21, 2004; effective October 4, 2004. Amendment filed March 17, 2006; effective May 31, 2006.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-22-102, 63-22-110, 63-22-201, 63-22-202, 63-22-203, 63-22205, and 63-22-206.

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