PCB CCS Application | www.pacertboard.org | email@example.com | Revised January 2021
supervision of said counseling. Applicant must have primary responsibility for providing substance use disorder
counseling in an individual and/or group setting, preparing treatment plans, documenting client progress and is
clinically supervised. No other work experience in the drug and alcohol field can be used for counselor
certification other than what is stated above.
Qualifying clinical supervision work experience is based on a specific aspect of staff development dealing with
the clinical skills and competencies for persons providing counseling. The format for supervision is commonly
one-to-one and/or small groups on a regular basis. Methods for review often include case review and
discussion, utilizing direct and indirect observation of a counselor(s) clinical work.
Qualifying work experience can be from multiple employers to accumulate the required years/hours.
If the applicant’s work experience requirement is not fulfilled from their current employer, they must include
documentation from previous employer(s) verifying their title, duties and dates employed with their
application. DO NOT submit a resume as proof of previous work experience. Applicant must contact previous
employers and request detailed documentation of their employment from them.
The applicant must be currently employed as a clinical supervisor at the time of application.
All work experience must have occurred within the last seven (7) years. Volunteer work is not acceptable. Time
spent participating in or facilitating mutual support groups is not acceptable.
Clinical internships completed as part of a college degree program may be eligible to use toward the required
work experience. Internships must be ones in which the student was providing drug and alcohol counseling as
described on page 10 of this application under Work Experience; internships must be well documented by the
agency in which the internship occurred; internships must have been supervised; internships must appear on
the official college transcript.
CURRENT JOB DESCRIPTION
REQUIRED: Copy of current clinical supervisor job description, obtained from current
employer, and which must be signed by both the applicant and their immediate clinical
All applicants must include a copy of their current clinical supervisor job description. This document is provided
by your employer and must be signed and dated by the applicant and their immediate supervisor.
Job descriptions determine and verify eligible current work experience. Job description must clearly delineate
clinical supervision as a primary function of the position.
If you have held different counselor and/or clinical supervisor positions with your current employer, please
provide all relevant job descriptions with the application. For instance, if you started as a counselor assistant,
then you were promoted to a Counselor I and then a Counselor II and then to a Clinical Supervisor, include all
In lieu of job description(s), employer may provide an official position description on agency letterhead. This
required documentation must include the applicants’ dates of employment (to/from) employment status (full-
time or part-time), title of position, a detailed description of the duties and responsibilities for the position, and
the average number of hours per week the applicant worked.