Intake – a core drug counselor function.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Intake involves a lot of paperwork.

Counseling

Counseling.
Photo courtesy of Pixabay.com

Getting a client signed up for a drug treatment program involves a lot of paperwork that needs to be completed before the counseling can begin. Drug counselors need to know how to do this function, although the exact paperwork they will have to do can vary a great deal from program to program. Many treatment agencies now use computerized systems. As the counseling field shifts towards more electronic records, more of the intake paperwork will end up on the computer. Some systems now include electronic signature pads that will capture the client signature onto the electronic file.

Some of this paperwork part can be done by office staff. Larger drug treatment programs may have one person assigned to do the intake paperwork. There are some advantages to having the primary counselor, the one the client will see the client throughout treatment, do the intake. When the client first comes into drug treatment, they are likely to be anxious and uncertain. Developing a relationship, establishing rapport, is an essential part of what staff at a drug treatment program must do. It’s easier to build up a rapport when the client sees the same person throughout treatment.

Informed consent is a required part of treatment.

Informed consent is not a separate specific drug counselor function, but it should be incorporated into all the intake paperwork as part of the legal and ethical responsibilities of a counselor. Fees need to be discussed during the first session the staff spends with the client.

Limits of confidentiality and the exceptions to them need to be explained to the client. What information will the program keep confidential and what information might be disclosed. Drug counseling has an extremely high requirement for confidentiality. Drug counselors should not even confirm or deny that someone is in their program.

Drug counselors are mandated reporters who must report clients who are a danger to themselves or others. They also are required to report abuse of the child, an elderly, or a disabled person. In some jurisdictions, they may be required to report clients who view child pornography. All these exceptions to confidentiality need to be explained to the client during the intake process.

Because so many clients are referred to drug treatment by the criminal justice system, parole probation, or the courts, more of the client’s information may be divulged than might happen in mental health counseling.

As part of the evidence that you did informed consent, the client will be required to sign a form called either a consent for treatment or a treatment agreement.

Consent to release information forms.

If any information about a client will be released to an outside party, a specific form called a consent for release of information should be filled out and signed by the client. These forms are often referred to by counselors as “releases.” Most releases can be revoked by the client, which must be done in writing if they decide they want the drug program stop releasing information. One exception to this right to revoke consent to release information is the “criminal justice consent form.”

If the criminal justice system has sent a client to your program, they will require information about that client. If the client does not wish to sign a release of information, you will not be able to admit that client to your program. Clients who attend a drug treatment program without signing a release for the criminal justice system will not have met their legal requirements for a court-mandated program.

Financial forms are part of drug counseling intakes.

For most programs, someone is paying for treatment. If it’s insurance, then there will be insurance forms to fill out. If the treatment is paid for by the criminal justice system or the child protective services, there will be other forms they will need to fill out. Clients who self-pay will still need to fill out a financial agreement.   Some programs have a sliding scale fee agreement for low-income clients. Providing financial information and filling out additional forms may be a part of qualifying for these reduced fees.

HIPPA notice of privacy practices.

Almost all programs nowadays are “covered entities” and must follow the HIPPA regulations. The counselor needs to give the client a notice of privacy practices and have the client sign a form saying they received this information.

Demographic information.

Clients need to provide the program with their demographic information. You need to know who it is you’re working with. It’s good practice to have an address and phone number for this client. This form might also next of kin.

Consent to follow-up.

Some programs do follow-up studies to see how effective their treatment is. Studying the results of treatment may be a condition of receiving funding from grants or contracts with governmental agencies. It’s a good practice to have written permission to follow-up, signed at the time of intake. You should also make sure you know how you are allowed to contact the client. If the phone number they gave you is a work phone, they may not want you calling there for follow-up.

Program rules or expectations.

During the intake, the counselor may give the client rules, a form about client rights and responsibilities and other information about the program. Some programs do this after the intake as part of a separate step referred to as the core function of orientation. More about orientation in an upcoming post.

There are a wide variety of other forms used by various treatment programs. Most of these forms have been created by the individual treatment program.

Assessment may take place during intake.

Assessment means different things in different contexts. Assessment is considered a separate drug counselor function and it’s a skill that counselors need to learn and to practice. Assessment may take place during the initial intake. Some programs will schedule a separate appointment for the assessment. Assessment functions as the bridge between the first domain which involves getting clients into treatment, and the second domain which is the work the counselor will do in creating a comprehensive recovery plan.

In our next installment of this “what do drug counselors do and how do they do it” series we will look at the core counselor function of assessment.

For more on the drug counselor domains and the core functions see John W. Herdman’s book Global Criteria; the 12 Core Functions of the Substance Abuse Counselor

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Advertisements

What do drug counselors do?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drug counselors have many job duties besides talking to clients.

Counseling

Counseling.
Photo courtesy of Pixabay.com

When you say counselor, most people envision a person who sits talking with the client. Many people who want to become counselors believe they would be good at it because friends have told them they’re good at giving advice. Professional counselors avoid giving advice. The stakes are just too high. It is the client’s life, and they need to make the decisions. What counselors may sometimes do is provide education, but that education needs to be objective not the counselor’s opinion.

Most drug counselors do not work in private practice but work for agencies. Because of this system, not every counselor does every one of these functions, but it is essential for them to know how to do each of these functions.

In the workplace, counselors perform many tasks other than counseling.

Peripheral tasks are probably true of all professions. There are lots of things that must be done by the professional beyond the function most people expect. One of those other things that the drug counselor needs to do is paperwork. The paperwork function, along with several other administrative tasks can take up a sizable chunk of the counselor’s day, but these other tasks need to be done to keep the program running so that it’s there when the client needs it.

There are different systems for classifying the drug counselor’s duties.

Defining what any profession does, and how they should do it, can be problematic. Many books have been written about how, in mental health counseling, the therapist or professional mental health counselor should do what they do. I have seen very few however which go into any detail about all the things they do each day other than counseling.

The what does the counselor do and how do they do it is especially problematic when it comes to drug counseling. Mental health counseling has its roots in medicine and psychology while substance use disorder counseling has its origins in self-help groups and recovery literature. As drug counseling has become more professional, it has become essential to define precisely what the job duties of the counselor may be or should be, in addition to the actual time spent “counseling” clients.

Here are the three primary sources in this area that I’m familiar with and have used in teaching substance abuse counseling classes. Along the way, there have been several workforce studies done which have informed these three sources.

John W. Herdman’s book Global Criteria; the 12 Core Functions of the Substance Abuse Counselor, first published in 1994 this book is now in its seventh edition just released in 2018. This book has been a standard text, especially among accredited programs, across the country as part of the introductory drug counseling training’s since it was first written.

Substance Abuse Mental Health Services Administration (SAMHSA) published TAP 21 Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice. This book was initially issued in 1998 and has been revised since. TAP21 has been incorporated into some of the tests used to license or certified drug counselors.

The International Certification and Reciprocity Consortium (ICRC.) The ICRC took all the various tasks a drug counselor might do and sorted them into four categories which they call performance domains.

While the three different systems use different labels, I see very little that is part of the tasks of the counselor that is not included in all three systems. So, what are the four domains that a drug counselor needs to know about to do their job?

Domain One: “Intake” or getting the client in the treatment.

This domain includes all the tasks that would be necessary to get the client to the point of the first counseling session. In Mental health treatment settings, some or all this work would be done by paraprofessionals or office staff. Some drug programs may have specialized intake counselors, but in many drug and alcohol counseling programs counselors would be doing this work themselves.

The intake domain would include such functions as screening, assessment, and engagement activities, as well as orienting the client to the program.

Domain Two: treatment planning, collaboration, and referral.

This domain includes developing a treatment plan, case management functions, referrals and linkages, and consultation.

Domain Three: counseling, both individual and group.

Most drug counseling is done in the group setting. These groups could include psychoeducational groups, “process” or discussion groups, feelings groups, or topical groups, often focused on the 12 steps or life skills.

There are many different theories and techniques for individual counseling.

Domain Four: professional, legal and ethical responsibilities.

This domain includes the requirement to complete paperwork, meeting your legal responsibilities and following the applicable code of ethics. Doing things professionally, legally, and ethically should be woven into everything the counselor does, but the counselor also needs to periodically review the decision-making model they’re using to be sure that they and the agency they work for are performing legally and ethically.

In future posts let’s look at the various tasks the drug counselor must do in each of these domains.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.