3.1 LPC Scope of Practice, Authorized Activities, and Diagnosis Authority

LPC Scope of Practice, Authorized Activities, and Diagnosis Authority

In Oklahoma, Licensed Professional Counselors (LPCs) operate under a strict legal framework designed to protect the public and define the boundaries of the profession. This scope is established by the Oklahoma Licensed Professional Counselors Act (Title 59 O.S. § 1901 et seq.) and the administrative rules promulgated by the State Board of Behavioral Health Licensure (BBHL) under Oklahoma Administrative Code (OAC) Title 86, Chapter 10.

1. Statutory Definition and Authorized Activities

Under Title 59 O.S. § 1902(3), the practice of professional counseling is defined as the application of mental health, psychotherapeutic, and human development principles. These principles are applied to facilitate professional growth, career development, and personal adjustment, as well as to prevent, diagnose, and treat mental, emotional, or behavioral disorders. The law lists specific counseling services that an LPC is authorized to perform:

• Counseling: Rendering psychotherapeutic and counseling interventions to address emotional and behavioral distress.
• Appraisal: Administering and interpreting instruments to assess aptitudes, interests, abilities, and personal characteristics.
• Consulting: Applying professional principles to assist organizations or groups in solving human behavior problems.
• Referral: Evaluating client needs to identify resources and execute professional transfers to specialized providers.
• Research: Systematically investigating counseling processes to improve clinical practice and outcomes.

2. Diagnosis Authority and the ACA E.5 Ethical Framework

A key component of clinical counseling practice in Oklahoma is diagnostic authority. Under OAC 86:10-3-2(c), LPCs are explicitly authorized to diagnose emotional and mental disorders. However, the rule requires that if a diagnosis is made, it must be properly documented and aligned with the professional standards.

Specifically, OAC 86:10-3-2(c) mandates that LPCs perform proper diagnosis using standard classification manuals, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) or the International Classification of Diseases (ICD). Additionally, the rule integrates the American Counseling Association (ACA) Code of Ethics Section E.5 (Proper Diagnosis) framework. Under Section E.5, counselors must:

1. E.5.a. Proper Diagnosis: Carefully select and appropriately use assessment techniques (including personal interviews) to determine client mental status and render diagnostic decisions.
2. E.5.b. Cultural Sensitivity: Recognize that culture affects how client problems are defined. Counselors must evaluate the client’s cultural background, socioeconomic status, and language proficiency before rendering a formal diagnosis.
3. E.5.c. Historical and Social Prejudices: Counselors must be cognizant of the historical misdiagnosis and pathologizing of marginalized groups and actively work to mitigate these biases in their diagnostic formulations.
4. E.5.d. Refraining from Diagnosis: Counselors may refrain from making or reporting a diagnosis if they determine that doing so would cause clinical harm to the client or is otherwise countertherapeutic.

3. Explicit Prohibitions: Prescription Limitations

LPCs in Oklahoma do not have prescription privileges. Under Title 59 O.S. § 1902(3) and OAC 86:10-3-2, LPCs are strictly prohibited from prescribing, administering, or recommending medication or drugs.

LPCs must never advise clients to alter, discontinue, or initiate doses of medications prescribed by medical professionals. Doing so constitutes practicing medicine without a license under Oklahoma law, which is a criminal offense and a major violation of professional conduct. If a client requires pharmacotherapy, the LPC has a legal duty to refer them to a licensed medical practitioner. Practicing medicine without a license is subject to BBHL disciplinary actions, including administrative fines up to $10,000, license suspension, or revocation.

4. Record-Keeping and Clinical Retention

Documentation standards are heavily scrutinized during board investigations. Under OAC 86:10-3-3(b)(1), Licensed Professional Counselors must maintain and retain complete clinical records for a minimum period of five (5) years following the date of the last client contact.

A legally compliant clinical record in Oklahoma must contain:

1. Intake and Assessment Documentation: The client’s presenting problem, psychosocial history, and clinical baseline.
2. Signed Disclosure Statement: The professional disclosure statement must be signed and dated by the client prior to rendering services.
3. Treatment Plan: A collaborative plan detailing measurable goals, therapeutic modalities, and estimated timelines.
4. Progress Notes: Clear, chronological records of each session using standard templates (e.g., SOAP or BIRP) showing clinical progress.
5. Termination Summary: A final clinical note outlining the reasons for termination, overall progress, and recommendations.

5. Adding Competencies and Board Procedures

LPCs must limit their practice to areas in which they have established competence. Under OAC 86:10-3-2(a), LPCs must not offer services in specialties or modalities where they lack formal education, training, or supervised experience.

If an LPC wishes to add a new specialty or clinical service to their practice (e.g., EMDR or biofeedback), they must:

• Complete graduate-level coursework or board-approved continuing education units (CEUs) in the specialty area.
• Secure direct supervision or consultation from a qualified professional experienced in that modality.
• Update their official Professional Disclosure Statement on file with the BBHL and provide the revised statement to clients before using the new modality.

Summary of Scope Restrictions