Qualifications:

Graduation from an accredited educational program with a Master’s Degree in an area of study that is recognized by one of the licensing boards in the state of Oklahoma. Candidate must either hold a license in the state of Oklahoma or be receiving board approved supervision to become licensed. The following are the approved licensing boards in the state of Oklahoma: (a) Psychology, (b) Social Work (clinical specialty only for LSW), (c) Professional Counselor (LPC), (d) Marriage and Family Therapist (LMFT), or (e) Behavioral Practitioner (LBP).

Reporting Supervisor:

The Integrated Behavioral Health Outpatient Counselor reports directly to the Clinical Coordinator or Executive Director.

Positions Supervised:

The Integrated Behavioral Health Outpatient Counselor does not regularly supervise any positions.

Job Expectations and Responsibilities:

1. Initiate services with five (5) working days from the receipt of the referral.

2. Provide initial assessments in a timely manner, which will include evaluation of client’s cognitive abilities, communication skills, and short-term memory to determine if he/she can benefit from services.

3. Complete the Client Assessment Record (CAR) as part of the assessment process. This assessment is obtained in a face to face interview and becomes part of the Comprehensive Treatment Plan.

4. Complete the Comprehensive Treatment Plan on or before the fifth (5th) visit. Comprehensive Treatment Plan needs to be complete with a DSM-5 (in ICD 9 format) Diagnosis.

5. Include the following in the Comprehensive Treatment Plan:

a) Client’s strengths/abilities recorded in his/her own words; defer to parent if child is unable or refuses to answer.

b) Client’s liabilities/needs recorded in his/her own words; defer to parent if child is unable or refuses to answer.

c) Client’s preferences regarding type of treatment services; defer to parent if child is unable or refuses to answer.

d) Problem – record the behavior/situation that is problematic to the client; should be in the client’s words.

e) Goal – record the client’s expected outcome; may be in the counselor’s words.

f) Current objectives – positively record the specific objectives that the client is working on and how it is behaviorally measureable.

g) Initiated date – record the date that each objective began.

h) Target date – record the date each objective is to be achieved.

i) Treatment interventions – record the theoretical approach that the counselor will use to help the client achieve the objective.

j) Treatment services – record each treatment service to be received by client.

k) Frequency – record the frequency of each service.

l) Staff/credentials – record the responsible person and his/her credentials for each service.

m) Collaboration with school system – record statement of collaboration with client’s school and identify by title/credentials the school person with whom you are collaborating. Record any referrals given to the client to services outside the provider agency.

n) Transition/Discharge criteria, date, and after care plan – record what the client will do to achieve discharge, planned (month/year) discharge date, and after care plan for client. The plan for transition to lower level of care and/or out of the system and awareness of the client’s on-going behavioral health needs must be included.

o) Client signatures – must be signed by client if over age 14, the parent/guardian if under age 18, and must include statement by the client regarding their involvement, understanding, and comments on the plan. If client does not complete the statement of involvement, the clinician must make a statement regarding the client’s involvement. All signatures must be dated at the time they are signed, by the person signing the official state document.

p) Treatment team signatures – must obtain all required signatures.

q) Interpretive Treatment Summary – record a narrative on initial request that includes a description of client’s pre-morbid state, the onset of current symptoms, history of previous treatment or other attempts to deal with the problem.

r) Appropriate CDC for service initiation and subsequent service changes must be completed within required timeframes as specified by the Oklahoma Health Care Authority.

6. Complete treatment plan reviews 5 days prior to the approved end date, when possible.

7. Complete treatment plan reviews in the same manner as the Comprehensive Treatment Plan with the following exceptions:

a) Update the Client Assessment Record (CAR) in a face to face interview without duplicating a previous CAR of client’s or duplicating a CAR of another client.

b) Previous objectives – record the objectives the client was working on during the last authorization period.

c) Specific progress on objectives – record the client’s specific progress toward each specific objective utilizing the unit of measure incorporated in the objective.

d) Record a descriptive narrative of the client’s overall treatment summary on the Interpretive Treatment Summary. Summary includes information related to client’s overall progress/lack of progress toward treatment goals, ability to meet/not meet objectives and compliance/non compliance with treatment services.

8. Progress notes are to be turned in weekly on Wednesdays by 4:00 p.m. of the week following service delivery.

9. Progress notes must include the following:

a) Date

b) Start and stop time for each session

c) Signature of counselor

d) Credentials of counselor

e) Specific problem(s) and objectives addressed – these problems and objectives must be identified on the client’s current Comprehensive Treatment Plan.

f) Methods used to address problem(s) and who present to address problem (s)

g) Progress made toward goals

h) Client’s response to the session or intervention

i) Family’s response to the session or intervention when applicable

j) Medication use education, if applicable

k) Columbia-Suicide Severity Rating Scale results, when applicable

l) Any new problem(s) identified during session

m) Plan for continued treatment

n) Next appointment date and time

10. Complete the transition plan/discharge plan at the time of case closure with the client and family, when possible.

11. All transition plan/discharge plan must be completed within ten (10) days of client’s service termination date and thirty (30) days without services.

12. Make timely necessary changes as requested by OHCA, Clinical Coordinator, and/or professional reviewer.

13. Maintain scheduled appointments and thorough documentation in client’s file.

14. Attend weekly Integrated Behavioral Health Outpatient staff meetings.

15. Attend monthly individual supervision session with Clinical Coordinator.

16. Work with other program staff to coordinate inter-office agency referrals.

17. Provide linkage services for clients to other service agencies in the community, when appropriate, and maintain a good working relationship with the staff of those agencies, school administrators, and juvenile justice personnel.

18. Participate in professional reviews of client files to check for accuracy and completeness while providing qualitative information.

19. Participate and/or provide training in monthly staffing as requested by Clinical Supervisor and/or Executive Director.