Job Overview

 

  1. Review assessments from referring facilities and note problems/issues that require further attention and integrate this information into client’s current course of treatment.
  2. Contact referral source and other key individuals no less than weekly to gather additional information as necessary and to update on progress.
  3. Complete LOCUS forms (admission, continued stay, transfers and Discharge) for each level of care. Documenting Criteria.
  4. Gather comprehensive diagnostic information through biopsychosocial assessment within 5 days of admission. (IL- 3 days)
  5. Complete initial Trac9 assessment upon intake, and weekly thereafter, to identify problem areas that may affect treatment and/or need to be addressed in treatment planning.
  6. Initiate collateral call to family and/or support system within 72 hours of admission.
  7. Follow-up on safe call, if contact was unavailable upon intake, within 24 hours of admission.
  8. Present Biopsychosocial and diagnostic information to treatment team in a clear, concise manner.
  9. During first session with client, review initial treatment plan, including case management issues and be sure that client and staff assignments and responsibilities are understood and in progress.
  10. Formulate a comprehensive treatment plan with client that effectively addresses client issues and is completed within established time frames.
  11. Develop clearly stated treatment goals and objectives that are measurable and that are client driven.
  12. Develop interventions that will accomplish goals and objectives and state the planned frequency of interventions.
  13. Facilitate daily process groups connecting treatment plan goals and objectives.
  14. Participate effectively in multidisciplinary treatment plan reviews, demonstrating adequate preparation and understanding of client issues, progress, areas of resistance, positive and negative strategies, etc.
  15. Document the client’s progress accurately as it relates to treatment goals and objectives.
  16. Continue treatment planning process throughout client’s stay in treatment, opening new problems and developing or revising treatment plans as necessary.
  17. Complete transfer summaries as clients move through appropriate levels of care.
  18. Assist clients in gaining group process skills.
  19. Track client’s clinical problems in group.
  20. Utilize experiential techniques effectively.
  21. Create atmosphere in which self-disclosure is facilitated.
  22. Conduct educational and process groups (lectures/videos/discussions) effectively.
  23. Adhere to time schedules.
  24. Provide individual counseling to clients at least one (1) time per week.
  25. Assist clients gain insight into problems.
  26. Give client a clear picture of where he/she stands regarding progress toward improvements as seen by the therapist and the multidisciplinary treatment team.
  27. Enforce program rules and regulations in a firm but fair and respectful manner.
  28. Confront counter-productive behavior appropriately and with respect.
  29. Bond with clients and elicit respect.
  30. Adapt to different types of clients.
  31. Identify client strengths and weaknesses and be able to document and work on them, per the treatment plan, throughout the course of treatment.
  32. Always maintain healthy boundaries with clients.
  33. Understand and apply the program’s clinical philosophy.
  34. Maintain regular contact and open communication with families consisting of one family session per week.
  35. Assist families in identifying the problems and issues they need to work on.
  36. Assist families in finding resources to help themselves including the family call line that takes place weekly.
  37. Link client with internal and external resources as needed to meet client needs.
  38. Assist client in managing outside stressors (legal, financial, vocational, etc.) according to the best interests of the client’s progress in recovery.
  39. Demonstrate good strategic and problem-solving skills and utilizing morning meeting and group supervision to staff a case, if needed.
  40. Be effective in finding needed resources and working in tandem with Case Management.
  41. Maintain clinical records according to program policies and those of licensing and accrediting agencies.
  42. Ensure that documentation is timely, consistent, clear, and articulate and never copy/pasted from another note or another chart.
  43. Keep clinical records always secure.
  44. Use good clinical judgment in moving client through treatment levels and ensuring there is supportive documentation in the Medical Record.
  45. Prepare client to maintain recovery post-discharge.
  46. Develop a continuing care plan that meets client needs for ongoing support following discharge.
  47. Complete discharge summary within 5 days of client discharge.
  48. Therapist is responsible for having client follow their treatment plan and transition to the next appropriate level of care as determined prior to admission.
  49. Demonstrates ability to work with clients with substance use disorders.
  50. Demonstrates knowledge of policies and procedures related to suicide, risk, and assessment and is observed assessing clients based on suicide safety and concerns.

 

REQUIRED EDUCATUION: Master’s Degree in Social Work, Mental Health Counseling, Marriage and Family Therapy or Healthcare related major, required.  Certified as DBT clinician.

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