Professional Disclosure for Supervision

The purpose of this disclosure statement is to provide you with the information you need to make an informed decision about working with me as your supervisor. I will provide you with an overview of my professional qualifications, theoretical frameworks, and values under which I practice and supervise. Additionally it will include limited personal information in support of informed consent and the agreements we are entering as a part of this process.

Nicholas Marzo, MS LPC, LMHC, CST-S, ACS, NCC, CCMHC

Practice Location: Modern Path, LLC 3720 Chamblee Dunwoody Rd, D2, Chamblee, GA 30341 Practice Phone: 678-802-9355                                                          

Practice Email: nmarzo@modernpath.net Emergency Phone: 404-313-9962

Qualifications

MS Counseling Psychology, Nova Southeastern University, April 2000

  • Licensed Mental Health Counselor, Florida, MH 7359, issued 2003, exp. 3/30/2027

    • Qualified Supervisor Endorsement

  • Licensed Professional Counselor, Georgia, LPC004808, is. 2/12/2007, exp. 9/30/2026

  • Licensed Mental Health Counselor New York, 013183, is. 1/25/23, exp. 12/31/25

  • Approved Clinical Supervisor, CCE ACS-4400

  • National Certified Counselor, 228288, is. 5/10/2007, exp. 8/31/2027

  • Certified Clinical Mental Health Counselor, 228288, is. 5/14/2018, exp. 8/31/2027

  • AASECT Certified Sex Therapist, 1303093, is. 9/5/2019, exp. 9/30/2028

  • AASECT CST Supervisor, is 9/2024, exp 9/2029

  • Georgia Certified Addiction Counselor II, Georgia Addictions Counselor Association, lapsed

Qualifying Training

Over 100 hours of continuing education in the area of Clinical Supervision between 2004 and 2022, this education continues with each licensing biennium

  • 50 hours of supervision specific to the practice of Sex Therapy Supervision

    • Supervised by Erika Pluhar, PhD and Nelly Cannon, PhD

  • Over 150 hours of continuing education in the area of sexual health and wellness and gender affirming care

    • Supervised by Erika Pluhar, PhD

    • Trained by Stephanie Buehler, PhD, Lexx James, PhD, Goody Howard PhD, and Bianca I Laureano, MS, PhD

  • Over 200 hours of continuing education hours in substance use disorders and behavioral health conditions and interventions

  • Completion of Emotionally Focused Therapy Externship and Core Skills and supervision requirements for Certification (did not opt to get certified)

    • Supervised by Yamonte Cooper, PhD

    • Trained and guided by Michael Barnett, PhD, Sylvina Irwin. PhD, and Robert Allan, PhD

    • Published: Edwards C, Allan R, Marzo N, Wynfield T, Hicks R. The use of emotionally focused therapy with polyamorous relationships. Fam Process. 2023 Dec;62(4):1362-1376. doi: 10.1111/famp.12934. Epub 2023 Sep 5. PMID: 37670416.

    • Have attended three additional externships as support staff including the first LGBTQ Specific Externship, London 2022

  • Additional areas of clinical training

    • REBT with Dr. Albert Ellis

    • Pathways to Integrative Care with Dr. Kenneth Minkoff

    • Motivational Interviewing, multiple trainers and exposures throughout career

    • Brief Solution Oriented Therapy with Insoo Kim Berg

    • Monteiro Method of Strength Based Sensory Assessment for diagnosing Autism

    • Trauma Focused CBT, multiple trainers and exposures throughout career

    • Psychopharmacology, multiple trainers and exposures throughout career

    • Additional areas clinical interest over the span of a 25 year career

    • Somatic Sex Education, The Amina Institute

    I have been leading and developing professionals in the public and private sector since 1999. I have supervised paraprofessionals, certified peer specialists, student interns, provisionally licensed clinicians psychologists, and licensed clinicians, psychologists, and healthcare professionals in community mental health centers, substance abuse programs ASAM Level .5, I, II and III.5, inpatient clinical teams, and private practice. I have also lead multidisciplinary teams administration oversight and utilization review and management environments. I became a Qualified Supervisor in the State of Florida in 2004. I became Certified Professional Counselor Supervisor in Georgia in 2017 (expired in 2023). I then became an ACS in 2022 and an AASECT CST-S in 2024. I adhere to the laws, rules, regulations, and codes of ethics for the states where I hold a license to practice, American Counseling Association, American Association of Sex Educators, Counselors and Therapists Code of Conduct, Center for Credentialling and Education Approved Clinical Supervisor Program and World Professional Association for Transgender Health.

 I currently serve as the Chairperson of the AASECT Ethics Advisory Committee and own a group psychotherapy and holistic wellness practice, Modern Path, LLC, in Chamblee, GA.

My direct experience is extensive and spans over 25 years as a professional and 5 additional years as a paraprofessional. I have worked in various aspects of behavioral healthcare including developmental disabilities, community mental health programs which included work with forensic, TANF, DFCS, houseless, and other complex severe and persistent mentally ill populations. From there I worked in the field of substance use disorders. There I developed my skills as an integrative care practitioner and an MI informed clinician within ASAM Level I, II and III. Following that work I engaged in Intensive Family Servies briefly before working at Georgia Regional Hospital Atlanta as Lead Social Worker. I then paused in my work in direct care and shifted to administrative oversight. I conducted PASSR Reviews for Skilled Nursing Facility Placement, conducted statewide utilization management and review, developed a statewide online learning management system to support the provider network, and was the ERO and ASO Lead on the Department of Justice Lawsuit against the State of Georgia related to the civil rights violations of those housed in the state hospital. In this position I was given the honor to re-work the DBHDD Provider Manual specifically related to Assertive Community Treatment, Community Support Team, and Psychiatric Residential Facilities. Additional responsibilities within the ERO and ASO included provider quality reviews, provider training, and other aspects state policy development, interpretation, and application. In private practice I have worked as a Certified Sex Therapist, using EFT and EFIT as well as eclectic models, serving individuals, groups, and relationships to clients age 13 to 75. My work centers the experience of queer, trans, and neurodivergent people and their loved ones. I am scheduled to begin training at the Somatic Experiencing Institute in November of 2025.

Specific exceptions to my work include: youth under the age of 13, victim advocacy, and eating disorders. Most other topic areas I have enough exposure and experience to engage in ethically sound supervisory discussions and am well resourced enough to make referrals to other professionals I know and trust who have expertise in these areas.

My areas of expertise in direct client work and program administration that support my current supervision capabilities include: 

  • Mental Health (both severe and general)

  • Substance Use Disorders

  • Autism, low and moderate support needs

  • ADHD

  • Developmental Disabilities

  • Sexual Health and Wellness

  • LGBTQIA2+

  • Relationship Counseling including Consensual Non-Monogamy, BDSM/Power Exchange, and other aspects of sex positivity that are relational in nature

  • Decolonizing the practice of therapy, Liberation Psychology, Feminist and Queer Theory

  • Complex Dual Relationships and Ethical Decision Making

  • Professional Development

  • Navigating insurance and other third-party funding constraints

 

Supervisees should also be aware that I am in the latter stages of my professional career. I no longer mask in ways that are a detriment to my health. I am a late diagnosed Autistic, with severe ADHD. I am a survivor of generational trauma, physical trauma, and gender trauma. I am a COVID long hauler experiencing significant physical impacts. I have resided solely in urban and suburban areas, New York City and Miami/Fort Lauderdale. I now live and work in the most diverse metro area of the deep south, Atlanta, GA. I am a consensually non-monogamous, trans masculine genderqueer Leatherman, who engages in body stress rituals. I have experienced marriage and divorce, birthed and raised a neurodivergent child who has opted to enter healthcare as her vocation and career. My spiritual beliefs are based in Existentialism, Taoism, and Animism. All of this informs my work as a clinician and I show up authentically and pridefully. I do my best to name transferance, countertransferance, and other self as therapist themes that arise in supervision and consultation. I welcome you to share your experiences that fall outside of the limitations of what you have been taught thus far. I invite open discussion using a humanistic lens as we are, first and foremost, humans with lived experiences that we cannot deny as we facilitate the wellness journeys of others.   

MODEL OF SUPERVISION AND SUPERVISION GOALS

Pre-licensed and Provisionally Licensed Supervisees

Supervision of pre – licensed and provisionally licensed supervisees will be provided using the Developmental Model of Supervision overlayed with queer theory, systemic theory, and an anti opression lens. This means that I am first and foremost going to make sure that you understand that counseling, as a profession, is integrated with the carceral mental health system and that as a profession we create dangerous situations for those who live in marginalized bodies. We will make all decisions through that lens while balancing the laws, rules and ethical codes that govern our license. The goals of our supervision are divided out into 3 stages:

Stage 1: Deconstructing the basic skills learned in graduate school, realigning them with your values and learning to apply them to your specific client base. The goals in this stage will be clinical interviewing and assessment, case conceptualization, choosing interventions, and ethical decision making. During this stage we will try on skills that you learned and find which ones feel the most comfortable for you and which ones bring out the most growth edges. Using this information, we will choose a theoretical framework for focused training and continued education.

Stage 2: Engage in continued education in the chosen theoretical framework and apply new skills. The goals for this stage are to develop your confidence and build on the foundation developed in Stage 1. We will also focus on continuing education. During this stage you will be asked to choose a theoretical framework within which to get additional training (EMDR, IFS, SE, EFT, etc) and begin that training with the goal of completion before or shortly after you qualify for independent licensure.

Stage 3: Preparation for independent practice. The goal for this stage is to use the skills gained in Stages 1 and 2 to demonstrate independent decision making and preparedness for independent licensure. Supervision will be less directive. Focus will be on your ability to provide support, guidance and feedback to peers, function as part of a multidisciplinary team, development of leadership skills and/or private practice skills, and community outreach and networking.

 

Independently Licensed Supervisees Seeking Professional Development

Supervision of independently licensed supervisees will be provided using the Developmental Model of Supervision overlayed with queer theory, systemic theory, and an anti-oppression lens. I will push you outside of your comfort zone to better understand the impact of systems of oppressions on the profession of counseling which then translates to your clients, supervisees and those wo work for or with you. We will make decisions through a balanced lens taking into consideration the laws, rules and ethical codes that govern our practice. The goals of our supervision are individualized and unique to each person I support.

Supervision may include a variety of topics from closing clinical gaps, processing issues related to transference and counter-transference/self as therapist and supervisee, resource development and more. You may also choose to bring in specific cases of your own or your supervisees to get an fresh set of eyes from your colleagues. Lastly, you may opt to bring in concerns related to business development and self-actualization as an entrepreneur. My goal is to help you help yourself and ensure that the next generation of counselors is not perpetuating the myths of the carceral mental health system, white supremacy, and the pathological world view of psychology as we currently know it.

 

Pre-Certified Sex Therapists

Supervision of pre- certified sex therapists will be provided using a unique combination of psychotherapy tools, somatic sex education, and spiritual growth and development. The goal for sex therapy supervision in my space is liberation from the messages placed upon our bodies in the ultimate pursuit of pleasure. Whatever that pleasure may be. This is achieved though a variety of techniques, including but not limited to: assessment, the PLISST Model, attachement theory, trauma informed interventions, narrative therapy, and triadic interventions with other sexual health and wellness professionals, sex educators, sexological body workers, somatic practitioners and spiritual guides and resources, when permitted by and appropriate for the client.  

My work is deeply grounded in the Code of Conduct and Guiding Principles of the American Association for Sex Educators, Counselors and Therapists, as well as the American Association of Somatic Sexologists. Interventions and resources will support the AASECT Core Knowledge Areas, Certified Therapist Skills, and Somatic Skills and Resources encouraged by the AASS. My goal in supervision is to support you using a Developmental Model of Supervision combined with the AASECT CKAs and Therapist Skills to ensure a sound foundation for Certification.

As stated previously, the foundation of my supervision will be based in liberation psychology, queer theory, systemic therapies, and uphold anti oppression lens. Additionally, I live in an oppressed body that is impacted by Autism, ADHD, Gender Trauma, and growing up undiagnosed thrice gifted in urban and suburban areas during the years of 1973-1999.

 

EVALUATION OF SUPERVISEE

Pre-Licensed Clinicians

The supervisee will be provided verbal feedback of their progress in supervision during each session. Written feedback is made available upon request. The supervisee will be evaluated based on video recording of sessions, medical record documentation, self-appraisal, and peer/colleague feedback (when appropriate). Competencies measured will include, but not be limited to: assessment techniques and case conceptualization, determining level of care, safety/WRAP planning, selection and application of clinically appropriate an theoretically sound interventions, engaging in collateral contact, review of external documentation and reports, functioning as a member of a multi-disciplinary treatment team, treatment planning and record keeping, case management and referral skills, discharge planning, professional ethics and application of state and federal laws, rules and regulations. A minimum of one time per year the supervisee will be asked to complete the Counselor Competency Scales (CCS-R) as a self-assessment and will be assessed by myself. The findings will be reported with skills and interventions identified to ensure a pathway to success.

Independently Licensed Clinicians

When engaged in supervision voluntarily the supervisee will be provided feedback related to their individual supervision goals in real time. The supervisee is invited to provide feedback throughout the process in an effort to realign supervision goals, fine tune the safety of the supervisory container, and engage in relational stregngthening along side a peer.

When engaged in supervision as a requirement of the supervisees licensing board or professional organization, feedback will be provided in regular increments based on the stated goals and requirements of the supervisee to maintain compliance with the requesting organization.

Pre-Certified Licensed Clinicians

Sex Therapy supervisees will be provided verbal feedback of their progress in supervision during each session. Written feedback is made available upon request. The supervisee will be evaluated based on video recording of sessions, medical record documentation, self-appraisal, and peer/colleague feedback (when appropriate). Competencies measured will include, but not be limited to: assessment techniques and case conceptualization, diagnostic skills when appropriate, implementation of referrals to medical professionals, pelvic floor physical therapy, somatic sex educators and sexological body workers if and when indicated by the clients goals and treatment plan. Additionally, we track selection and application of clinically appropriate and theoretically sound interventions, engaging in collateral contact and working within the triadic model, review of external documentation and reports, functioning as a member of a multi-disciplinary treatment team, treatment planning and record keeping, case management and referral skills, discharge planning, professional ethics and application of state and federal laws, rules, and regulations. A minimum of one time per year the supervisee will be asked to complete a written assessment of their skills and will be assessed by myself in writing. The findings will be reported with skills and interventions identified to ensure a pathway to success.

 

 FREQENCY AND DURATION

Pre-Licensed Clinicians

Georgia Specific: The State Composite Board of Georgia requires a minimum of 70 hours of supervision and 2000 hours of directed experience acquired in no less than a 24 months period and no more than a 60 month period beginning on the first day of your signed directed experience and supervision contracts (must have matching dates). The requirement for becoming independently licensed is outlined in GA Rule 135-5.02. The supervisee is responsible for documenting the total number of directed experience and supervision hours required to apply for independent license. The supervisee is required to maintain contemporaneous record of the supervision to support the records of the supervisor at all times.

Florida Specific: The parties recognize that the State of Florida Department of Health requires RIMHC to complete at least 100 hours of supervision in no less than 100 weeks. The supervisee must receive a minimum of one hour of supervision every two weeks. The supervisee must complete 1500 hours of direct clinical experience during the 100 week period. The requirement for becoming independently licensed is outlined in Florida 64B4. The supervisee is responsible for documenting the total number of direct clinical experience and supervision hours required to apply for an independent license. Please note, specific to the State of Florida I maintain  the right to relinquish my license for my own personal and professional safety and the personal and professional safety of my clients at any time. The war against transgender people has begun on Florida ground and I will not place myself or the clients of Modern Path, LLC at risk in support of your supervision. I will do my best to refer you to another competent supervisor but I can make no guarantee they are applying liberation psychology, queer theory, and anti-oppression values to their work. 

 

Independently Licensed Clinicians

When engaged in supervision voluntarily supervision will be provided consistent with the independently licensed clinicians stated goals and desires.

When engaged in supervision as a requirement of the supervisee's licensing board or professional organization, supervision will be provided consistent with the requirements outlined to remain in compliance.

Pre-Certified Sex Therapists and Sex Therapy Supervisors

Sex Therapy supervisees will be provided supervision consistent with the stated AASECT requirements at the time of the agreement and the individual needs of the supervisee.

SCHEDULING AND AVILABILITY

Generally speaking, supervision will occur on a set and agreed upon schedule. The supervisor may be available between scheduled sessions, as needed, for phone consultation Monday through Thursday from 9am until 6pm and on Friday or weekends via text. The supervisee understands that I am also engaged in clinical work and may not be able to respond until later in the day/evening. Supervisor will be available after hours for urgent or emergent situations only for those who in a directed experience placement at Modern Path. All others should use the policy and procedures outlined at their Directed Experience site for handling urgent and emergent situations and update me via email, phone or text during business hours unless you are truly unsupported at your site and you believe your client, your license, or mine may be at risk,

 EMERGENCY MANAGEMENT

The supervisee is encouraged to address emergencies consistent with the policies of their directed experience site. The supervisee should notify the supervisor of any urgent or emergent clinical needs within their practice as soon as the clinician’s safety has been established. Notification should occur via phone call and text at the numbers listed above. Should there be any doubt on the part of the supervisee as to what actions to take in a specific situation they should:

  1. Obtain consultation and guidance from their site director

  2. Obtain consultation and support from their state or regional crisis team/line

  3. Call 911 incase of a medical emergency or any situation that involves an imminent threat of harm to client or another individual

In a case where the supervisor is not going to be available for an extended period of time the supervisee will be notified and provided with the contact information of an independently licensed clinician who is capable of addressing the needs of the supervisees caseload.

 DISTANCE SUPERVISION

 Most of the supervision occurs via HIPAA compliant video conferencing. The supervisor agrees to maintain the training and credentials necessary to provide distance supervision.

LIABILITY

The supervisee agrees to obtain and maintain professional liability insurance. The supervisee will provide a copy of the policy to the supervisor annually to maintain in the supervision records. Failure to maintain liability insurance will result in termination of the contract.

The supervisor agrees to maintain professional liability insurance that includes a supervision rider. This policy is currently held by CPH and Associates, policy AR34219,

TRAINING EDUCATION AND PROFESSIONAL DEVELOPMENT

The supervisor requires tele-mental health training be completed within 90 days of entering a supervision contract if not already obtained. This training shoiuld be renewed a minimum of once every five years to reamin consistent with advances in technology.

The supervisor requires that pre-licensed and provisionally licensed supervisees engage in a continuing education series focused on a theoretical orientation during Stage 2 of the supervision process. All others may make choices based on their professional goals.

 The supervisee understands that they are responsible for obtaining the training, education and professional development needed to support their professional growth and to maintain compliance with their license requirements. The supervisor will assist to find resources that are accessible financially and that are developmentally appropriate, however the responsibility is on the supervisee to obtain training as recommended or risk termination of the contract if developmental goals cannot be met.

 

CONFIDENTIALITY

The supervisor and supervisee agree to comply with all aspects of HIPAA, CFR42 and state laws related to confidentiality for the state where they practice. Should the supervisee engage in any violations of confidentiality the supervisor will uphold necessary state and federal laws, rules an regulations and take action appropriate to the behavior of the supervisee. The supervisee will be informed in writing of any actions taken.

DISPLAY OF CREDENTIALS

Pre-licensed and provisionally licensed supervisees agree that they will clearly display the following on all print and electronic materials that they are under the supervision of the supervisor. This includes but is not limited to consents for treatment, service agreements, websites and other marketing materials, professional directories such as Therapy Den, etc. This should be documented as follows:

I am currently under the supervision of Nick Marzo, MS LPC, LMHC, CST, ACS, NCC, CCMHC consistent with GA Rule 135 and the Florida Board of Clinical Social Work, Marriage and Family Therapists and Mental Health Counselors. Nick can be reached at 678-802-9355 or nmarzo@modernpath.net to address any concerns about the care you receive.

Pre-certified sex therapists agree that they will not pre-maturely use language related to being an AASECT Certified Sex Therapist consistent with the AASECT Membership Agreement. The words sex therapist alone are not regulated in any state other than Florida. Those licensed in Florida may not use that term unless the conditions outlined in 64B4 have been met. All others may use the language sex therapist unless otherwise stated in your practice rules, laws or others codes.

DOCUMENTATION (Pre-Licensed, Provisionally Licensed and pre-certification Sex Therapists Only)

Supervisor agrees to provide supervisee an electronic copy of records created and maintained during supervision upon request. Supervisor does not agree to release the content of supervision notes. Supervisor logs all individual sessions within electronic medical record and treats

supervision documentation as they would treat a client’s clinical documentation. Group supervision logs are maintained by the supervisor as a separate document and include thematic summary of group presentations to protect the content and confidentiality of all clinical cases reviewed.

The supervisor does not maintain a record of direct experience or client psychotherapy hours. That responsibility falls solely on the supervisee.

Supervisee agrees to maintain their own record of supervision. It is recommended that supervisee review the processes recommended by their jurisdiction.

 

ATTESTATION FOR LICENSURE OR CERTIFICATION

Supervision does not guarantee that the supervisor will sign provide attestation for licensure or certification. The supervisor reserves the right to request additional time under supervision when clinically appropriate. Regardless of whether I believe you are prepared to become an independently licensed clinician at the time our relationship concludes. I will complete the necessary documentation, outline your strengths and all goals achieved, as well as your growth edges. I will include the number of hours of supervision provided and my recommendations related to continuing your path towards licensure or certification. This letter will be provided to you and to the governing body that has jurisdiction over our work.

 

DURATION AND TERMINATION

The period of this agreement shall begin on the date signed by both parties and end upon the supervisee being issued a license to practice independently within their jurisdiction. This agreement may be terminated by either party with a 30-day notice. If termination occurs prior to completion of licensure.

 

The agreement may be immediately terminated if:

  1. either party does not maintain necessary qualifications for supervision/licensure

  2. fails to follow the ACA Code of Ethics, Code of Ethics or Board Rules of the jurisdiction under which you practice in a way that is reckless and/or places a client in direct harm; all efforts will be made to support the supervisee throughout the supervision process to avoid this type of situation

  3. has a lapse in liability insurance

  4. Multiple absences that result in the inability to meet the standards required by the Board rules under which you practice

Should the agreement end prior to completion of licensure requirements both the supervisor and supervisee will be responsible to ensure all supervision logs and documentation are completed before termination of the agreement.