Licensed Psychological Examiner Independent Status

From the Arkansas Psychology Board Rules and Regulations

5.3.5. Requirements for Licensure As a Psychological Examiner With Independent Practice Privileges (LPE-I). At any point in their career, a person with an LPE license may apply for independent practice privileges.

5.3.5.A. An Individual must have an LPE license issued by this Board or meet all requirements for the LPE license with a master’s degree in Psychology.

5.3.5.B. An individual licensed as an LPE prior to 12/31/1997 shall write a letter to the Board requesting independent practice privileges and shall submit a revised Statement of Intent For Independent Practice. Independent practice must exclude Neuropsychological Assessment and Projective Personality Assessment.

5.3.5.C. An individual licensed as an LPE after 12/31/1997 must write a letter to the Board applying for independent practice privileges. This application must include:

5.3.5.C.(1) A revised Statement of Intent which excludes the independent practice of Neuropsychological Assessment and Projective Personality Assessment and provide documentation of having received appropriate training and experience in those areas requested for independent practice.

5.3.5.C.(2) A plan of supervision of 3000 hours of clinical training, defined as direct and indirect client service, by a Board approved supervisor. The plan of supervision must be approved by the Board prior to implementation of the plan.

5.3.5.D. After 12/31/2013, no new psychological examiner license shall be issued.

NOTE: Independent Practice requests are only considered by the Arkansas Psychology Board Members on a quarterly basis. The months are February, May, August, and November. In order to be included on the Agenda for that particular month, everything MUST be received in the Board office by the first of the month. If your information is NOT received by the first of the month, it will NOT be presented to the Board Members until Independent Practice requests are considered again. Please plan accordingly!

Licensed Psychological Examiner

Licensed BEFORE December 31, 1997

If you are a Licensed Psychological Examiner, and you were licensed before December 31, 1997, you can complete the Statement of Intent Pre-1997 form. You MUST include a cover letter requesting independent practice.

  1. The Statement of Intent Psychological Examiner Independent Practice—Pre-1997 MUST match with the current, most recent Board approved Statement of Intent on file. If you need a copy of your Statement of Intent, please contact the Board office. Copies are $1 per page, which MUST be paid in advance.

    a. If you would like to make changes to the Statement of Intent on file, you must complete a Statement of Intent to Practice as a Licensed Psychological Examiner and submit this form to the Board office for approval.

    i. You MUST include a cover letter with the Statement of Intent to Practice as a Licensed Psychological Examiner form.

    ii. You MUST sign and date this form.

    iii. This request must be approved by the Arkansas Psychology Board Members BEFORE you can submit the information related to Independent Status.

  2. If no changes are to made to your Statement of Intent—or—you received approval for the revisions on your Statement of Intent, then, you may complete the Statement of Intent—Psychological Examiner Independent Practice—Pre-1997 form.

    a. You MUST include a cover letter with the Statement of Intent—Psychological Examiner Independent Practice—Pre-1997 form

    b. You MUST sign and date this form.

    c. This request MUST be approved by the Arkansas Psychology Board Members before you will be granted Independent Status.

    d. Important, if, according to your Statement of Intent-Psychological Examiner Independent Practice-Pre 1997, you are still providing any services that require supervision, you MUST submit a Supervision Agreement and Plan to the Board for consideration. Otherwise, you shall not provide any of those specific services to clients.

    i. You and your Arkansas Psychology Board approved Supervising Psychologist MUST sign and date this form.

Licensed Psychological Examiner

Licensed AFTER December 31, 1997

If you are a Licensed Psychological Examiner, and you were licensed after December 31, 1997, you MUST complete the Statement of Intent-Psychological Examiner Independent Practice-Post 1997 and the Licensee Supervision Plan—PE Independent Practice forms. You MUST include a cover letter requesting independent practice.

  1. The Statement of Intent Psychological Examiner Independent Practice—Post-1997 MUST match with the current, most recent Board approved Statement of Intent on file. If you need a copy of your Statement of Intent, please contact the Board office. Copies are $1 per page, which must be paid in advance.

    a. If you would like to make changes to the Statement of Intent on file, you must complete a Statement of Intent to Practice as a Licensed Psychological Examiner and submit this form to the Board office for approval.

    i. You MUST include a cover letter with the Statement of Intent to Practice as a Licensed Psychological Examiner form.

    ii. You MUST sign and date this form.

    iii. This request MUST be approved by the Arkansas Psychology Board Members BEFORE you can submit the information related to Independent Status.

  2. If no changes are to made to your Statement of Intent—or—you received approval for the revisions on your Statement of Intent, then, you may complete the Statement of Intent—Psychological Examiner Independent Practice—Post-1997 form and the Licensee Supervision Plan—PE Independent Practice form.

    a. The Plan of Supervision Sessions on the Licensee Supervision Plan—PE Independent Practice form MUST be: Individual, one hour, face-to-face, weekly, supervision with the Arkansas Psychology Board approved Supervising Psychologist indicated on this form. This is the minimum standard!

    b. You and your Arkansas Psychology Board approved Supervising Psychologist MUST sign and date this form.

    c. You MUST include a cover letter with the above forms.

    d. This request MUST be approved by the Arkansas Psychology Board Members.

    e. You shall NOT begin accruing the 3000 hours of supervised experience towards Independent status until your request is approved by the Arkansas Psychology Board Members.

Licensee Supervision Completion

When you complete the 3000 hours of supervised experience for Independent status as a Licensed Psychological Examiner within the State of Arkansas, you MUST complete a Licensee Supervision Completion—PE Independent Practice form. This form requires approval from the Arkansas Psychology Board Members before you shall be considered an Independent practitioner. Important, if, according to your Statement of Intent-Psychological Examiner Independent Practice-Post 1997, you are still providing any services that require supervision, you MUST submit a Supervision Agreement and Plan to the Board for consideration. Otherwise, you shall not provide any of those specific services to clients.

  1. You MUST complete the Licensee Supervision Completion—PE Independent Practice form and submit it to the Board office for consideration.

    a. Important, if you had more than one (1) Arkansas Psychology Board approved Supervising Psychologist, while you were accruing the 3000 hours of supervised experience towards Independent status, then the Board requires each one to complete the Licensee Supervision Completion—PE Independent Practice form.

  2. You and your Arkansas Psychology Board approved Supervising Psychologist(s) MUST sign and date the form(s).

  3. If required, you MUST include a Supervision Agreement and Plan for any areas of practice that would still require supervision.

  4. You MUST include a cover letter with the above form(s).

    a. This request must be approved by the Arkansas Psychology Board Members before you will be granted Independent Status.

Forms

NOTE: Independent Practice requests are only considered by the Arkansas Psychology Board Members on a quarterly basis. The months are February, May, August, and November. In order to be included on the Agenda for that particular month, everything MUST be received in the Board office by the first of the month. If your information is NOT received by the first of the month, it will NOT be presented to the Board Members until Independent Practice requests are considered again. Please plan accordingly! All forms can be found in the Forms section of the website.

NOTE: If you are revising your current Statement of Intent, that must be approved before you may submit your request for Independent status.

NOTE: If you are granted Independent Status and you are still providing ANY services that require Supervision, then, you must submit the Supervision Agreement and Plan to the Board office.

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Arkansas Psychology Board
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Little Rock, AR 72201
(501) 682-6167
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