UNIVERSITY OF NORTH GEORGIA CLINICAL MENTAL HEALTH COUNSELING CLINIC STUDENT HANDBOOK For COMMUNITY COUNSELING CLINIC HANDBOOK If you need this document in another format, please email Shanta Ghimire at shanta.ghimire@ung.edu or call 706-867-2791
TABLE OF CONTENTS Content Page Introduction..2 Mission Statement..2 General Information..3 Hours of Operation 3 Staff.3 Ethical Guidelines..3 Student Requirements.....5 Pre- Requisites 5 Practicum.. 5 Internship.5 Student Responsibilities..6 Counselor Trainee Responsibilities..6 Intake Procedures..6 Client Files...7 Termination Procedures.8 Request for Records..9 Returning Clients 9 Administrative Responsibilities....9 Counseling Rooms &Equipment.11 Telephone Communication 12 Counselor Trainee Illness or Emergencies...13 Missed or Cancelled Appointments...13 Miscellaneous..13 2
INTRODUCTION Welcome to the Clinical Mental Health Counseling Clinic (CHMHCC) The practicum/internship experience will provide counselor trainees with the unique opportunity to serve as a practitioner in the community while receiving intensive supervision from the Clinical Mental Health Faculty at the University of North Georgia (UNG). Counselor trainees will have an assigned faculty supervisor who will provide instruction, guidance, and feedback. This manual is designed to assist counselor trainees in understanding their role as counselors in a mental health agency. The CHMCC procedures in this manual have been written to provide counselor trainees with a brief review of the legal and ethical standards used in a mental health practice and for the smooth operation of the clinic. Please note that enrollment in this course is contingent upon counselor trainees obtaining and providing proof of professional liability (malpractice) insurance. MISSION STATEMENT The Clinical Mental Health Counseling Clinic s mission is to provide students with the most comprehensive and up- to- date knowledge and skills in the field of counseling and to expose students to practical experiences in a supervised counseling setting while providing counseling to the general community. 3
GENERAL INFORMATION The clinic is located at: 199 Choice Avenue Dahlonega, GA 30597 Phone: 796-867- 2588 Hours of Operation The hours of operation may very slightly from semester to semester and therefore will be posted at the beginning of each semester on the front door of the clinic. Faculty/Staff are on duty the established hours of operation. The clinic is closed during all university semester breaks and holidays. Staff As part of the day- to- day operations of the clinic, the director may coordinate all functions of the clinic with the university faculty and community agencies. The clinic director may also serve as an instructor, provide consultation to faculty and counseling trainees, hire and supervise student assistants, provide backup for scheduling appointments, and managing phones. Counselor trainees will also serve as staff and will answer phones, gather intake information, and schedule new appointments. This time will count toward the total number of required practicum and internship hours. Ethical Guidelines and Standards of Practice The clinic follows all of the ethical standards as set out by the American Counseling Association (ACA) Please refer to these standards to guide behavior and decision making as a counselor. When in doubt, always consult with the assigned faculty supervisor or the Clinic Director. The ACA guidelines may be found at http://www.counseling.org/resources/aca- code- of- ethics.pdf. When seeing clients at the CMHC clinic, counselor trainees are acting under the supervision of a licensed faculty supervisor. The Clinic Director is responsible for all client and student records and therefore, is also responsible for counselor trainee compliance with professional standards of practice at the CHMCC. If for any reason the client submits a lawsuit, the University, the department, faculty supervisor, clinic director and the counselor trainee could be named in a suit and held responsible. 4
STUDENT REQUIREMENTS Pre- Requisites Counselor Trainees complete their program of study by applying their traditional classroom experience and training as a clinical mental health counselor to the required practicum and internship training. Students enrolling in Practicum/Internship must have first successfully completed all pre- requisite courses. The pre- requisite courses for enrolling in Practicum (COUN 7550) are: COUN 7400: Advanced Clinical Mental Health Counseling COUN 6010: Psychological Helping Skills COUN 6200: Counseling Theories COUN 6300: Group Counseling COUN 7100: Psychopathological Diagnosis Counselor trainees must apply for practicum the semester prior to enrollment in the course. Practicum In counseling practicum, the primary focus is to become integrated into a clinical placement and demonstrate individual counseling skills. Counselor trainees complete a supervised practicum that totals a minimum of 100 clock hours. The experience provides students with the opportunity to develop counseling skills under the supervision of a faculty supervisor who is also a Georgia Licensed Professional Counselor. Practicum students will complete hours at the CMHC Clinic and at another community agency of their choosing. Placement within a community agency should be determined by the student and their faculty supervisor. Internship During the counseling internship process, the focus shifts to the role of an entry level practicing counselor. Counselor trainees complete two semesters of internship for a total of 600 clock hours, which are required by the State of Georgia for licensure, after successfully completing practicum. Interns have the option to complete more than 600 hours if they are interested in licensure in other states. Interns are responsible for identifying the required number of internship hours based on the state for which the intend to request licensure. Interns will be expected to complete the majority of their clinic hours at a local community agency and to supplement their clinical hours at the CMHCC. Practicum/Internship provides each student: The opportunity to perform all the duties normally required of staff members in a counseling setting 5
Student Responsibilities To become familiar with professional activities other than direct service work; and Supervised experience in the use of professional resources (assessment instruments, print and non- print media, profession literature, and research) After being granted permission to enroll in Practicum, but before beginning to work directly with clients, students must: 1. Obtain professional liability insurance. Counselor Trainees are not exempt from malpractice suits or the ethical requirements of the professional association, and therefore are required to purchase and maintain liability insurance. The student must submit a copy of the declaration of insurance page to the clinic director. Liability insurance is available from a variety of companies Students can choose the company they prefer after comparing rates. It is strongly recommended that student apply for the 1,000,000/#3,000,000 annual aggregate. If students continue their internship activities for longer than 12 months they must renew their professional liability insurance for an additional year and submit proof of this coverage to the Clinic Director. 2. Students must complete a Semester Availability Form indicating the days and times they are available to see clients at the CMHC Clinic. Students will also provide the clinic with personal contact information. It is recommended for practicum that each student be available at least two days per week for 2-6 hours per week in order to maximize available time and space to see clients. 3. Student should read and follow the procedures laid out in the CHMCC Procedures Manual and Student Practicum/Internship handbook. 4. Students are require to maintain professional and ethical conduct with their clients, colleagues, and faculty at all times throughout their training in the program in order to maintain their enrollment in the program. Unprofessional conduct may cause a student to be dismissed from the program. Intake Procedures COUNSELOR/TRAINEE RESPONSIBILITIES Clinic staff and counselor trainees may perform and telephone intake using the appropriate form, and schedule the initial client appointment. New clients will be informed that the first session will be used to gather information regarding the client s history and may last approximately one hour and thirty minutes. They will 6
also be advised that if the first appointment is missed, it will be the client s responsibility to call and reschedule with the next available counselor- trainee. Every effort will be made the match client needs with a counselor- trainee s particular skills or area of interest (i.e., children, geriatrics, career counseling, etc.) Once the counselor- trainee has seen the client for the first time, it is up to the counselor trainee to establish an appointment time with the client for the future clinic visits. Review the scheduling calendar and make sure that the time offered will coincide with an available lab and during the posted hours of operation for the semester. Client Files Information will be taken by front desk personal at the time of the initial phone contact. An effort will be made to identify the presenting problem and place clients with Counselor Trainees based on area of interest. Counselor Trainees are responsible for building and maintaining a file on each client that is assigned to them at the clinic. Client charts will be prepared in advance. New clients will have a file marked with their name and all the necessary forms will be in the file. Each Counselor Trainee is responsible for reviewing, and having clients sign the appropriate forms. Several forms will be in each client file. Counselor Trainees are responsible for filling out all appropriate forms after or during each counseling session with the client. Form included in the file include: Client Attendance Record To document client attendance, absences or termination of treatment. Informed Consent This form is to be completed during the first session with each client. It covers all the necessary legal issues regarding the counseling process. Counseling cannot be provided without the client signing this document. Counselor Trainees also sign this form indicating that they have reviewed the form with the client, answered all questions the client may have, and that they have witnessed the client sign the form. Emergency Contact Information for Minors: It is preferred that a parent or guardian be available while a minor is in the counseling session. They may wait in the lobby until the end of the minor s session. If for any reason the parent or guardian is unable to wait or leaves the clinic this emergency form allows the CMHCC to take any necessary medical action that is required on behalf of the minor. Assessment and Treatment Plan: These forms are designed to assess any possible critical issues that might require immediate attention. An assessment of the problem helps to better understand what the client wants or needs to address during their time in 7
treatment. It also helps to identify the goals of treatment and writing of the treatment plan. A treatment plan consistent with any and all issues to be addressed is important in order to avoid malpractice and to make sure the client s needs are being met. Treatment plans reflect relevant responses to critical issues. Progress Notes: Progress or case notes are written have each clinical Session with the client. It is a brief note regarding the clients progress, or lack of progress, homework assignments, direction for future sessions, or change of goals. These notes should be reviewed by the counselor trainee prior to the next counselor session to remind them where the specific client is at with the treatment process. Discharge Summary: When a client is terminated from treatment, and/or at the completion of each semester, the counselor trainee will write a discharge summary. The summary will include information regarding the client s initial reason for treatment, progress in treatment, and reason for discharge. At semester end, if the counselor trainee and supervising faculty believe the client could benefit from future appointments, a note should be made in the discharge summary so that the client could benefit from future appointments, a note should be made in the discharge summary so that the client can be placed on the list for the next semester. To ensure confidentiality, all client charts must remain at the CHMCC and be returned to the file room at the end of each day. Termination Procedures The client director and the counselor trainee s faculty supervisor should be notified if a client completes counseling before the end of the semester or for any reason terminates counseling so that the counselor trainee can be provided with a new client. When a client completes or chooses to leave treatment, the counselor trainee is responsible for closing the file. Make sure that as much of the paperwork in the file is filled out as is possible. In the discharge summary provide as much information as is available regarding the reason for the client leaving treatment. This information will be helpful when subsequent counselors contact the CMHCC for information on the former client. The information will also help to protect the CMHCC from claims of negligence/malpractice should unforeseeable events follow termination of counseling. A case summary may be requested by the faculty supervisor for class requirements but should not be part of the client file. Counselor trainees and faculty supervisor must sign and/or initial all forms in the client file. 8
All discharged client files will be stored in the inactive files for seven years. To ensure client confidentiality, all client files must remain at the CMHCC and be returned to the file room a the end of each day. Request for Records All requests for records or reports by the client or outside resources require that: Returning Clients Signed authorization for release of information by the client is on file in the clinic. All information released is co- signed by faculty supervisor and copies placed in the client file. Counselor trainees subpoenaed or contacted for information should immediately contact their faculty supervisor or the clinic director. Do not attempt to provide information directly to the requesting source. Copying and mailing are the responsibility of the counselor trainee during the semester the client is seen. Clients will generally only be seen for one semester. If it is necessary for the client to continue in treatment, it is the counselor trainee s responsibility to find an appropriate referral source. Exceptions to the one- semester limit is granted to clients who began late in the semester and wish to continue treatment the following semester or in certain circumstances when the counselor trainee, faculty supervisor, and/or clinic director determine a referral for a second semester at CMHCC is clinically appropriate. All client information in the file must be completed and signed by both the counselor trainee and faculty supervisor. In addition, the following steps need to be taken: Indicate under the comment section of the Client Attendance Sheet: recommended for return. The faculty supervisor must initial this recommendation. Have the client sign a release of information so that the new counselor can contact the previous counselor Complete new intake information form, updating any changed information Administrative Responsibilities In order to better understand the day- to- day operations of a mental health clinic, students will be assigned on a rotating basis to administrative responsibilities at the clinic. Responsibilities may include but are not limited to manning the front desk, answering the telephone, preparing files, shredding documents, completing 9
clinical audits of client files, copying forms, marketing services, and other tasks as assigned. These duties will count as indirect hours in the practicum/internship hours. A semester schedule will be posted at the receptionist s desk. Students should check with the Clinic Director for additional tasks outside of those listed as routine for the week. If an assigned student must change clinic responsibility hours, it is that student s responsibility to switch hours with another student and report the change to the clinic director. Counselor- Trainee s should arrive at the clinic at least 15 minutes before their first schedule appointment to log into the video equipment and prepare the assigned lab for the counseling session. All sessions should begin on the hour and last 50 minutes, unless it is an initial intake appointment, which may last approximately one hour and thirty minutes. It is possible that clients may be booked back- to- back, so it is important that counselor trainees do not go over the scheduled amount of time. It is typical to need to remaining 10 minutes of the hour to take a moment for yourself, write a counseling note, or to reset the taping equipment for your next client. Client Attendance Each time the client is seen in the counseling center the counselor- trainee will: Complete the attendance record in the chart Enter a progress note or summary of the session Present the file to the Clinic Director or faculty supervisor for review and signature Set the next appointment for the client Excluding extraordinary circumstances, if a client misses two appointments, even if the call to cancel, they will be dropped from the schedule and put back on the waiting list. Counselor trainees must have a discussion with their faculty supervisor and let the office staff know that they expect the client to continue after two failed appointments. The Informed Consent form which clients sign at the first session contains a clause regarding attendance. The form should be reviewed in the first session with the client. The client attendance policy will be strictly enforced for the following reasons: 1. We are a professional training program and counselor trainees do not benefit from the experience if they cannot depend on the client to attend the session. 2. For counseling to be beneficial, regular attendance is necessary. 3. Experience has shown that clients who miss the first sessions or two later sessions general miss several more sessions and terminate counseling prematurely. 10
Counseling Rooms and Equipment There are four (4) counseling labs located in the CMHC Clinic. They are equipped with a couch and two or three chairs. Each of the rooms is big enough to host a small family for a therapy session. Each room has video taping equipment and a computer trainee for to use. Do not allow clients to use the computers. Toys, games and art supplies are stored in room 101. Art supplies can be taken to other labs for appointments. Return any unused supplies to room 101 at the end of each client session. Supervise clients using art supplies that can damage walls or floors. The counselor trainee is responsible for cleaning up after their clients. Is specific supplies are used up or low, please advise the clinic director immediately so that replacements can be ordered. Counseling rooms are assigned based on specific requests made by the counselor trainee, (i.e., need for art materials, or toys, group or family therapy). Specific requests must be noted on the scheduling calendar a week in advance. Counselor trainees are responsible for checking the assigned room prior to an appointment in order to assure the room is set up appropriately, has enough chairs, etc. Place client chairs so they are facing away from the two way mirror, as it can be a distracting reminder to the client that someone may be observing them on the other side of the mirror. At the end of the day, return any furnishings that were borrowed from other rooms to the appropriate places. Any art supplies should be cleaned up and caps should be tightly closed on all paint or liquid items. Place all unused materials back into the appropriate bins and shelves so the room is in order for the next counselor trainee to use. If the client used the last of the tissues, replace the box for the next counselor trainee. Turn off the lights in the room at the end of the last appointment. Students are required to record every session. If the client refuses to sign a consent form, they cannot be seen at the CMHCC. Recording sessions are controlled by the computer located in the room. Due to identifiability of clients of the video, it is important that confidentiality is maintained while viewing the tapes. Tapes may be viewed in the CHMC computer lab located in room 107. The computer room will be open during the hours of operation of the clinic. If a counselor trainee intends to run a group and the classroom is available, the room can be rearranged to suit the groups needs. The tables fold down and are on wheels so they may be moved to one side of the room. The chairs are on wheels and can be moved however needed. They are also stackable if there are more chairs than needed for the group. The group/classroom is located in Room 103. Please report any missing or malfunctioning equipment to the clinic director, front desk staff or faculty supervisor. 11
If the counselor trainee or client has food or beverages during the counseling session, please remove empty wrappers and opened containers from the counseling office at the session. Avoid using the waiting area to talk and socialize on heavy clinic days. Use an empty room for consultation or studying. Sound proofing is minimal, so keep voices down outside the counseling labs, in hallways, and in the observation rooms. Telephone Communication On occasion a client may need to contact the counselor trainee or the reverse. Clients should only try to reach their counselor- trainee through the clinic main phone number. Clients may leave a message for the counselor- trainee at the clinic. Messages will provided to the counselor- trainee then next time they are in the clinic. If it is an emergency, cancelled or changed appointment, the clinic staff will make every effort to contact the counselor- trainee with the information. To avoid unsupervised contact with a client, counselor trainees should make every effort to return client calls during the clinic hours. If there are requests for phone calls, letters, and other agency collaboration, in relationship to a client, the counselor trainee should consult with their faculty supervisor. When calling clients for any reason these rules must be followed in order to protect the client and the counselor- trainee s confidentiality: 1. Use the clinic phones whenever possible to contact clients. Never give personal contact information to a client. In certain situations when telephone contact with a client is absolutely necessary outside of clinic hours, always use the privacy or block settings (*67) on a personal phone. 2. If a counselor trainee needs to call their client, speak only to the client. If a message must be left either on voicemail or with another party, simply state that the call is from the University of North Georgia CHMC Clinic and leave a return phone number. 3. As part of the intake packet make sure the client provides a phone number where they may be reached and make sure it is okay to leave a message on that phone. 4. Counselor- trainees must provide their personal contact information at the beginning of each semester to ensure the proper relay of messages, appointments and information. 12
Counselor Trainee Illness or Emergencies In case of illness or emergency that would prevent the counselor- trainee from being at the clinic for their appointment, a message should be left with the staff or the faculty supervisor at least 24 hours in advance. Only extreme emergencies should prevent counselor trainees from performing their assigned client duties. Counselor trainees are responsible for contacting any clients they have seen more than once to cancel and reschedule the appointment for that day. Any new clients will be contacted by the staff, or reassigned to available students. Missed or cancelled appointments If a client calls to cancel an appointment a note will be placed in the file. If the client no shows for the first appointment then the counselor trainee should return the file to staff for processing. Please note on the client attendance record a NS meaning the client failed to come to the appointment. It is not the responsibility of the counselor trainee to follow up with the client if this was a first visit. Staff will follow up with the client. If a counselor- trainee has seen the client for at least one session then it becomes the counselor trainee s responsibility to contact the client and make a decision about rescheduling the appointment. MISCELLANEOUS Lending Library The counseling lab has a small library of helpful treatment planners, books, video tapes, and other resources available for counselor trainees. Any books must be checked out with the staff before removing from the building. Do not keep the materials for longer than three weeks, as other counselor trainees may be interested in the same materials. 13