North Carolina LCMHCA Supervision Requirements

What LCMHCA Supervision Requires

An LCMHCA (Licensed Clinical Mental Health Counselor Associate) accrues clinical supervision under a set rate: "a minimum of one hour of individual or two hours of group clinical supervision per 40 hours of supervised professional counseling practice" (21 NCAC 53 .0208). That supervision sits outside the practice hours it covers: "Individual clinical supervision hours do not count towards the 40 hours of supervised professional practice" (21 NCAC 53 .0208).

Across the full 3,000-hour LCMHCA track, the rule also sets a floor: at least 100 hours of clinical supervision documented during the 3,000 hours, with no less than three-quarters of it individual (21 NCAC 53 .0205(a)). The rate and the 100-hour floor are two separate requirements, and both apply.

The Rate: One Individual Hour or Two Group Hours per 40

Supervised professional practice is defined as "counseling experience under the supervision of a qualified clinical supervisor ... and includes a minimum of one hour of individual or two hours of group clinical supervision per 40 hours of supervised professional counseling practice" (21 NCAC 53 .0208). The Board's own page restates the exclusion in both directions: "Individual and group clinical supervision hours do not count towards the 40 hours" (Board LCMHCA page).

The rate is a ratio, not a fixed weekly schedule. An LCMHCA who logs 40 hours of practice in a given stretch owes at least one hour of individual supervision or two hours of group supervision for that stretch, and the two forms of supervision can be mixed across the track as long as the three-quarters individual share, covered next, is met.

The 100-Hour Minimum and the Three-Quarters Individual Rule

"At least 100 hours of clinical supervision ... shall be documented during the 3000 hours of supervised clinical mental health practice" (21 NCAC 53 .0205(a)). Inside that 100-hour floor, "No less than three-quarters of the hours of clinical supervision shall be individual clinical supervision" (21 NCAC 53 .0205(a); .0208). The Board's page states the resulting figure directly: "At least 75 hours must be individual supervision" (Board LCMHCA page).

Individual and Group Sessions Defined

Individual clinical supervision is "face-to-face supervision ... of one or two supervisees and a qualified clinical supervisor, for a period not less than one hour of clinical supervision per session ... per 40 hours of supervised professional practice" (21 NCAC 53 .0210). A single individual session can therefore include one or two supervisees at a time with the same supervisor.

Group clinical supervision is "face-to-face supervision ... between groups of supervisees, not to exceed 12 supervisees per group, and a qualified clinical supervisor, for a period not less than two hours of clinical supervision per session, per 40 hours of supervised professional practice" (21 NCAC 53 .0211). A group session runs at least two hours and holds no more than 12 supervisees.

Face-to-Face Supervision, Synchronous Video and What a Session Must Cover

Every individual and group session must be face-to-face, defined as "supervision that is live, interactive, and visual. Video supervision is permitted as long as the session is synchronous and involves verbal and visual interaction during the supervision" (21 NCAC 53 .0212). A recorded video message reviewed later does not meet that definition; the session has to happen live.

What happens inside the session is also defined: "The focus of a supervision session shall be on raw data from clinical work that is made available to the supervisor through such means as live observation, co-therapy, audio and video recordings, and live supervision. Written materials and self-reports by the supervised counselor may supplement the supervision process but shall not be the sole basis of any supervision session" (21 NCAC 53 .0208).

The Final Supervision Report lists the modalities a supervisor can point to for that raw data: Live Observation/Supervision, Co-therapy, Audio Recording, and Video Recording (Final Supervision Report).

Who Can Supervise an LCMHCA

A "qualified clinical supervisor" is an LCMHC with a master's degree, an independent license not currently under supervision, three semester graduate credits or 45 contact hours of continuing education in clinical supervision, and "a minimum of five years of post-graduate counseling experience with a minimum of two years of post licensure experience" (21 NCAC 53 .0209(a)). The rule also recognizes an "equivalently and actively licensed mental health professional" meeting paragraph (c), which adds "a minimum of 10 contact hours of continuing education in professional knowledge and competency in the field of counseling supervision completed every two years" (21 NCAC 53 .0209(c)).

As of July 1, 2017, "all qualified clinical supervisors shall hold the credential of licensed clinical mental health counselor supervisor or be a licensed clinical mental health counselor or an equivalently and actively licensed mental health professional, as defined in Paragraph (c)" (21 NCAC 53 .0209(b)). The statute frames the same requirement from the supervisor-credential side: "Supervisor" means "any licensed clinical mental health counselor supervisor or, when one is inaccessible, a licensed clinical mental health counselor or an equivalently and actively licensed mental health professional, as determined by the Board, who meets the qualifications established by the Board" (G.S. 90-330(a)(4)). The supervisor credential itself, LCMHCS in North Carolina, covers the LCMHCS application in full.

The rule's list of mental health professionals names: LCMHC; LMFT; LCSW holding a CSWE-accredited MSW; licensed psychologists; psychiatrists; and certain psychiatric nurse practitioners and clinical nurse specialists (21 NCAC 53 .0213).

21 NCAC 53 does not list barred relationships for LCMHCA supervision.

The Supervision Contract

An LCMHCA "shall not practice unless" a supervision contract has been submitted to the Board (21 NCAC 53 .0702(1)). The Supervision Contract form itself (Revised 12/18/2025) is direct about the sequence: it "must be received and approved by the NCBLCMHC prior to initiation of supervision," and "Hours accrued without a Board-approved contract on file will not be accepted" (Supervision Contract form).

"A separate supervision contract form shall be filed for each separate work setting," and if the LCMHCA receives supervision from more than one supervisor, "a separate supervision contract form shall be filed for each individual qualified clinical supervisor" (21 NCAC 53 .0702(1), (2)). Each contract records the supervisor's name and contact information, the supervision modality and frequency, and the name and physical location of the site where supervision will take place (21 NCAC 53 .0702(1)(a)-(e)).

The Supervisor's Log and the Reports

The supervisor, "in collaboration with the supervisee, shall maintain a log of clinical supervision hours" recording the date, start and stop times, modality, and notes for each session, kept "for a minimum of seven years beyond termination or completion of supervision" (21 NCAC 53 .0801(e)).

The supervisor also files a Quarterly Supervision Report each quarter that supervision has occurred (21 NCAC 53 .0702(3); .0801(c)), due April 30, July 31, October 31, and January 31 (Board LCMHCA page). That report carries no hours: "The Board does not require the submission of hours on Quarterly Supervision Reports. All hours are to be reported to the Board on Final Supervision reports" (Board LCMHCA page). The full breakdown of each report's fields lives at North Carolina LCMHCA supervision reports.

Hours are recorded only on the Final Supervision Report, filed by the supervisor "upon termination or completion of supervision" (21 NCAC 53 .0702(3); .0801(c)). The Quarterly Supervision Report form adds: "A Final Supervision Report form must be submitted to the Board within two (2) weeks of termination of supervision" (Quarterly Supervision Report, Revised 8/06/2025). The form (Revised 8/06/2025) itself is explicit that the supervisor, not the associate, submits it: "Self-reporting of hours from the LCMHCA will not be accepted" (Final Supervision Report). It carries the total indirect and direct counseling hours, the individual clinical supervision hours "no less than 1hr per 40 hrs worked," and the group clinical supervision hours "no less than 2hrs per 40 hrs worked" (Final Supervision Report). An associate supervised by more than one supervisor needs a Final Report from each one: "If you have multiple supervisors, a Final Report is required from each supervisor" (Board LCMHCA page).

A Worked Example: Rate, Floor and the Same 75 Hours

Consider an LCMHCA who gains experience at the rule's weekly cap of no more than 40 hours a week (21 NCAC 53 .0205(a)) and takes every hour of clinical supervision individually. Over the full 3,000 hours of supervised clinical mental health practice, that is 3,000 divided by 40, or 75 blocks of 40 hours. At the rate of one individual hour per 40-hour block (21 NCAC 53 .0208), 75 blocks produce 75 hours of individual supervision. That total is arithmetic that follows from the rate; the rule itself never states "75 hours" as a rate-based figure.

Separately, the rule sets its own floor for the track as a whole: at least 100 hours of clinical supervision, with no less than three-quarters of it individual (21 NCAC 53 .0205(a)). Three-quarters of that 100-hour floor is also 75 hours, again arithmetic, and it matches the Board's page: "At least 75 hours must be individual supervision" (Board LCMHCA page). The two calculations land on the same number in this example because the pace matched the minimum rate exactly. An LCMHCA who takes some hours in group sessions instead still owes at least 75 individual hours out of the 100-hour floor, however the remaining hours are split.

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FAQ: North Carolina LCMHCA Supervision Requirements