LCSWA Six-Month Review: What the Form Asks and How to Prepare

What the LCSWA Six-Month Review Is

"All associate licensees shall submit reports of their clinical social work experience and supervision on a form prescribed by the Board ... every six months" (21 NCAC 63 .0210(e)). The prescribed form is titled "LCSWA SIX-MONTH REVIEW" (dated 2022.05.17). It runs a Review Period, mm/dd/yyyy to mm/dd/yyyy, across its own header, and it is the only form on the LCSWA track where clinical practice hours and supervision hours are entered for the Board to see.

The form opens with its own summary of the rule: "All LCSWA licensees are required to receive supervision of their clinical social work practice during their Associate status," provided, "unless otherwise pre-approved by the Board (in writing), ... by a North Carolina licensed LCSW in good standing with the Board, who has a MSW degree, and at least two years of post LCSW clinical practice experience" (LCSWA Six-Month Review, form header).

Section I: Completed by the LCSWA Licensee

Section I is printed "To be completed by the LCSWA licensee." It asks for the LCSWA's name, LCSWA number, address, and "Place of Employment (for this review period)." One line asks the LCSWA to check whether "Employment Verification with job description" "Is attached" or "has already been submitted," then closes with the LCSWA's daytime phone, signature and date (LCSWA Six-Month Review, Section I).

Sections II, III and IV that follow are not the LCSWA's to fill in. Section IV states it directly: "All portions of this section are to be completed ONLY BY LCSW CLINICAL SUPERVISOR. LCSWA licensees may NOT complete this section of the form" (LCSWA Six-Month Review, Section IV).

Section II: The Supervisor's Four Acknowledgments

Section II asks the LCSW clinical supervisor to acknowledge by checkmark or initials that each bulleted item has been completed (LCSWA Six-Month Review, Section II). The four items, printed exactly:

Each acknowledgment points to paperwork the associate's file already needs before practice starts: the Position Statement on Clinical Supervision and the emergency crisis plan are both required before an LCSWA practices at all, and the supervisory log is the log the supervisor maintains and makes available to the Board on request (21 NCAC 63 .0210(e)).

Section III: The 11 Rating Categories

Section III is marked "(Required)" and "to be completed ONLY BY LCSW CLINICAL SUPERVISOR," though the form adds, "You are encouraged to share your assessment with your supervisee as part of the supervision process" (LCSWA Six-Month Review, Section III). The supervisor rates the LCSWA across 11 categories using a five-point key: "Excellent (E), Very Good (VG), Good (G), Fair (F), Poor (P)," with the form noting to "Reference the Supervisor Manual for an explanation of key terms."

Section IV: The Narrative Summary and the Four Hour Counts

Section IV opens with a narrative field: "Provide a narrative summary regarding the LCSWA licensee's growth as a clinical practitioner and participation in clinical supervision" (LCSWA Six-Month Review, Section IV). Below that narrative, the form records a supervision period and four supervision hour counts and a clinical practice hour count, each marked "this review period only":

Below those counts, the supervisor signs an affirmation: "I affirm that the supervisee has practiced clinical social work and has demonstrated skill through practice experience as defined by statute [NCGS 90B-3] and Code [21 NCAC 63 .0102]; and that the above hours of supervision have occurred with the LCSWA as indicated. I certify that I am a current LCSW with a graduate degree in social work from a CSWE accredited program and that I am in good standing with the Board" (LCSWA Six-Month Review, Section IV), then prints the supervisor's LCSW number and license expiration date alongside the signature.

The Case Narrative: Clinical Case Summary Outline

The case narrative that Section II acknowledges is not written on the review form itself. It follows a separate document, the "LCSWA Clinical Case Summary OUTLINE" (2021-08), built around three headings: HISTORY, CLINICAL ASSESSMENT AND DIAGNOSIS, and TREATMENT. The outline instructs the LCSWA to "document when relevant in narrative form, using complete sentences," using "pseudo name or initials for client name and location," and never "in abbreviated or outline format" (Clinical Case Summary Outline).

The outline's instructions describe the case narrative as "a supervisory tool" that "should be reviewed in supervision, signed, and maintained by the clinical supervisor and LCSWA" (Clinical Case Summary Outline). The Board's FAQ adds the retention rule: case narratives "MUST be prepared, reviewed with your clinical supervisor and signed" each review period, "maintained on file with your clinical supervisor and immediately available to the Board upon request," for "a minimum of 3 years beyond the termination of services" (Board LCSWA FAQ).

The case narrative is not mailed in with the Six-Month Review. It stays in the supervisor's files and goes to the Board "only upon request" (Board LCSWA FAQ).

The 1:30 Ratio, Applied to This Period

Supervision has to be "conducted no less than once every two weeks, with at least one hour of supervision during every 30 hours of experience" (21 NCAC 63 .0211(a)(3)). The Board applies that rate to each six-month period, not only to the 3,000-hour career total. Its own worked example: "a person accruing 890 clinical practice hours during a six-month period must document at least 30 hours of clinical supervision" (Board LCSWA FAQ).

The form's own Board-use box states the same standard: approval is granted for "appropriately supervised clinical practice" and "at the required 1:30 supervision ratio" (LCSWA Six-Month Review, Board Use Only). When a period's supervision does not support its practice hours at that rate, the Board's FAQ describes the result directly: a notice comes back "stating that my employment hours have been reduced," because "the number of supervised clinical practice hours must be supported by the number of clinical supervision hours at the 1:30 ratio" (Board LCSWA FAQ). See North Carolina LCSWA supervision requirements for the full rate, the group cap and the technology cap this ratio sits inside.

One Review Per Employer, One Per Supervisor

"A separate Six-Month Review document must be submitted for each place of employment worked during the review period" (Board LCSWA FAQ). The rule runs the same way for supervision: "a separate Six-Month Review document must be completed by each supervisor that provided you clinical supervision during the review period" (Board LCSWA FAQ). An LCSWA with two jobs, or two supervisors inside one review period, files more than one form for that same six months.

Each version carries its own case narrative: "A comprehensive case narrative for each place of employment must also be prepared, reviewed and signed by you and your supervisor and maintained in the supervisor's files" (Board LCSWA FAQ).

Mailing, Confirmation and No Fax

The form itself sets the filing terms: "Please retain a copy of this document for your files," and by rule, "you are required to maintain records for a minimum of 3 years from the date services are terminated" (NCGS 90B-6(i)). It then sets the expectation for a reply: "You will not receive a response from the Board unless there is a concern or additional action is needed." A supervisee who wants proof of delivery has one option printed on the form: "If you wish to confirm receipt, please mail to the Board by traceable service" (LCSWA Six-Month Review, closing note).

The Running Totals a Six-Month Review Feeds Into

Because each form reports only "this review period," the totals that matter for licensure live outside any single form. The rule sets a 3,000 clock-hour work requirement (21 NCAC 63 .0211(a)(1)) and "a minimum of 100 hours of supervision" (21 NCAC 63 .0211(a)(3)), with "a maximum of 25 hours of group supervision" counted toward that 100 (21 NCAC 63 .0211(a)(3)) and "no more than 50 hours of supervision ... provided through the use of technology" unless the Board preapproves more (21 NCAC 63 .0211(a)(4)).

None of those numbers appear as a running total on the LCSWA Six-Month Review form. Adding a period's clinical practice hours, in-person hours, and technology hours to every prior period's figures, to see where the associate stands against 3,000, 100, 25 and 50, is arithmetic the associate and supervisor have to do themselves across every review filed.

The Final Six-Month Review and the LCSW Short Form

"You may submit the LCSW Short Form Application along with your final six-month review form once you have satisfied all requirements for LCSW license: two full years of supervised clinical practice [24 months] with no less than 3000 hours of documented practice and at least 100 hours of appropriate clinical supervision (no more than 25 hours of group supervision), and you have passed the ASWB Clinical Exam" (Board LCSWA FAQ). The last Six-Month Review is not a separate closing document; it is the same form, filed one more time alongside the application that moves the associate to North Carolina LCSW requirements.

The Board sets an expectation for how long that packet takes: "The review process may take a minimum of 30 days upon receipt of a completed Short Form application packet, including all required documents" (Board LCSWA FAQ).

Common Mistakes on the LCSWA Six-Month Review

Related North Carolina Social Work Guides

FAQ: LCSWA Six-Month Review