Yes — LMSWs in Texas can participate in diagnosing, but only under clinical supervision.

To engage in clinical social work (including diagnosing), an LMSW must:

• work in a clinical setting

• be under the supervision of an LCSW-S

• follow an approved supervision plan

This is often referred to as LMSW-AP (Advanced Practice) status.

Under these conditions, LMSWs can:

• conduct assessments

• contribute to diagnoses

• provide psychotherapy

However, they cannot independently diagnose or practice clinically without supervision.

Missed supervision can create:

• gaps in compliance

• delays in approval

• potential rejection of hours

In practice:

• supervision must align with your clinical work

• extended gaps often require explanation or correction

The safest approach is to maintain a consistent supervision schedule throughout the required 24-month period.

You’ll need:

• a supervision plan/agreement

• documentation of clinical hours

• documentation of supervision hours

• final verification forms submitted to the board

In practice, keeping these updated in real time is far easier than reconstructing them later.

Supervision must be regular and ongoing throughout the 24-month supervision period.

Most supervisees:

• meet weekly or biweekly

• maintain consistent supervision aligned with their clinical work

In practice, irregular supervision can create compliance issues and delay approval.

The supervision phase requires at least 24 full months in Texas.

You must complete:

• 3,000 supervised clinical hours

• at least 100 hours of supervision

• over a period of no less than 24 months

Even if you reach the required hours sooner, supervision must continue for the full 24 months.

In practice, most people complete the process in about 24 months or slightly longer, depending on consistency and documentation.

The process typically follows these steps:

1. Earn a Master of Social Work (MSW)

2. Obtain LMSW licensure

3. Begin supervised clinical work

4. Complete:

   • 3,000 clinical hours

   • 100 supervision hours

   • over at least 24 full months

5. Submit documentation to the Texas board

6. Pass the clinical licensing exam

In practice, the supervision phase is the longest and most important part of the process.

Sometimes — but only if they meet Texas requirements.

The Texas board will evaluate:

• the supervisor’s credentials

• the structure of supervision

• documentation quality

In practice, out-of-state hours often require additional verification and may not fully transfer.

Clinical hours generally include:

• direct client interaction

• assessment and treatment planning

• psychotherapy

• clinical documentation

Non-clinical tasks (like administrative work) typically do not count.

In practice, if the work involves clinical judgment and client care, it likely qualifies — but it must be clearly documented.

Supervision hours do not “expire” in a strict sense, but they can become invalid if requirements are not consistently met.

For example:

• long gaps without supervision

• missing documentation

• changes in supervision without proper updates

In practice, consistency matters.
Irregular supervision is one of the biggest causes of delayed or rejected applications.

Yes — telehealth clinical hours can count, as long as:

• they are legitimate clinical services

• they are performed under appropriate supervision

• they meet all licensing board requirements

In practice, telehealth is now a standard part of clinical work and is widely accepted when properly documented.