OLERE Scope of Practice 2 — Questions and Answers
Question 1: An Oklahoma LPC's client mentions they have been experiencing physical symptoms that may be related to their mental health. The LPC's most appropriate response is to:
- Treat the physical symptoms as part of the counseling relationship
- Recommend the client see their primary care physician while continuing counseling for the psychological aspects (Correct answer)
- Diagnose the physical symptoms based on the client's description
- Refer the client to a psychiatrist for all future care
Correct answer: Recommend the client see their primary care physician while continuing counseling for the psychological aspects
Physical symptoms are outside an LPC's scope of practice. The counselor should recommend the client consult their physician for the physical symptoms while continuing to address the psychological components within the counseling relationship.
Oklahoma LPCs are licensed to provide mental health counseling and cannot diagnose or treat physical medical conditions. When a client presents physical symptoms, even those potentially related to mental health, the counselor should recommend evaluation by a physician. The counselor can continue providing counseling for the psychological aspects while coordinating with the medical provider.
Question 2: Can an Oklahoma LPC conduct psychological testing and provide psychological test interpretations?
- Yes, all mental health testing is within the LPC scope of practice
- Limited because LPCs may administer certain counseling assessments but comprehensive psychological testing is within the psychologist's scope (Correct answer)
- No because all assessment is prohibited for LPCs
- Yes, as long as the LPC has taken a graduate course in testing
Correct answer: Limited because LPCs may administer certain counseling assessments but comprehensive psychological testing is within the psychologist's scope
While Oklahoma LPCs can administer counseling-related assessments, formal psychological testing such as comprehensive neuropsychological assessments or IQ testing is primarily within the scope of practice of licensed psychologists.
Oklahoma LPCs are trained in assessment and may use various counseling-related tools such as intake interviews, standardized symptom checklists, and brief validated screening instruments. However, comprehensive psychological testing including cognitive assessment, neuropsychological evaluation, and formal personality testing with complex interpretation is within the specialized scope of practice of licensed psychologists. LPCs should understand the boundaries of assessment within their training and licensure.
Question 3: A client presents to an Oklahoma LPC with symptoms that suggest a psychotic disorder. The LPC's most appropriate action is to:
- Diagnose the disorder and develop a counseling treatment plan independently
- Conduct a thorough clinical assessment and coordinate with a psychiatrist for evaluation and potential medication management (Correct answer)
- Tell the client their symptoms are beyond the LPC's scope and terminate services
- Provide counseling only and avoid documenting the psychotic symptoms
Correct answer: Conduct a thorough clinical assessment and coordinate with a psychiatrist for evaluation and potential medication management
LPCs can assess and support clients with serious mental illness, but medication management for psychotic disorders requires coordination with a psychiatrist or prescribing provider. The LPC should collaborate with medical providers rather than manage such cases alone.
Oklahoma LPCs can assess, diagnose using DSM-5 diagnoses, and provide counseling for clients with serious mental illness. However, the biological aspects of psychotic disorders often require medication management outside the LPC's scope. The appropriate response is to conduct a thorough assessment, continue providing counseling support, and coordinate with a psychiatrist or prescribing provider. Abruptly terminating services with a client experiencing a psychotic episode would be abandonment.
Question 4: An Oklahoma LPC working in a school setting is asked to provide vocational rehabilitation assessments for students. This is:
- Within scope because school counselors provide comprehensive services to students
- Outside scope unless the LPC has specific training in vocational rehabilitation assessment (Correct answer)
- Always within scope because LPCs are licensed for all types of counseling
- Within scope only with a specific endorsement from the state board
Correct answer: Outside scope unless the LPC has specific training in vocational rehabilitation assessment
Vocational rehabilitation assessment is a specialized area requiring specific training. An LPC who lacks specific vocational rehabilitation training should not provide these assessments, regardless of their general licensure.
Vocational rehabilitation assessment involves specialized tools and methods for evaluating individuals' abilities, interests, and barriers to employment. This specialty area has its own training, credentialing such as the Certified Rehabilitation Counselor, and ethical standards. An LPC without specific training in vocational rehabilitation should not conduct these assessments and should facilitate a referral to a qualified vocational rehabilitation counselor. Competence is the limiting factor, not the license category.
Question 5: An Oklahoma LPC who is asked to provide testimony as an expert witness in a court proceeding should:
- Decline all forensic work because it is outside the LPC's scope of practice
- Only accept if they have specific training and supervised experience in forensic assessment (Correct answer)
- Accept because any licensed mental health professional can serve as an expert witness
- Accept only if the case involves their current or former client
Correct answer: Only accept if they have specific training and supervised experience in forensic assessment
Forensic work including serving as an expert witness requires specialized training. An LPC who lacks forensic training should not accept expert witness roles that exceed their competence.
Forensic mental health work including custody evaluations, competency assessments, and expert witness testimony is a specialized area with distinct ethical and professional standards. An LPC who lacks specific training and supervised experience in forensic work should not accept these roles. Competence in forensic contexts is different from competence in clinical treatment. LPCs interested in forensic work should obtain specialized training and supervision.
Question 6: An Oklahoma LPC is supervising an LPC-Candidate who requests guidance on prescribing medication for a client. The supervisor's response should be:
- Provide guidance because supervisors are responsible for all aspects of the supervisee's practice
- Clarify that prescribing medication is not within the LPC or LPC-Candidate scope of practice and address the client's needs through appropriate referral (Correct answer)
- Recommend the supervisee take a pharmacology course to expand their competence
- Advise the supervisee to consult with a psychiatrist informally rather than referring
Correct answer: Clarify that prescribing medication is not within the LPC or LPC-Candidate scope of practice and address the client's needs through appropriate referral
Prescribing medication is unambiguously outside the LPC scope of practice in Oklahoma. The supervisor must clarify this boundary and help the supervisee address the client's needs through an appropriate referral to a prescribing provider.
In Oklahoma, as in all states, prescribing medication is restricted to licensed medical professionals including physicians, advanced practice nurses with prescriptive authority, and physician assistants. No amount of training or continuing education makes prescription authority part of an LPC's scope of practice. The supervisor should clarify this boundary unambiguously and help the supervisee address the client's medication needs through referral to a prescribing provider.
OLERE Scope of Practice 2
An Oklahoma LPC's client mentions they have been experiencing physical symptoms that may be related to their mental health.
The LPC's most appropriate response is to: