Provides comprehensive, independent mental health assessment and treatment services and contributes to the growth and development of the program.

RESPONSIBILITIES

Completes assessments of new patients.

• Consistently provides intake slots for office staff to schedule new patients. Schedules additional intake slots during periods of high volume.
• Obtains and thoroughly documents information about presenting symptoms and problems, prior treatment, and other relevant history and background. With patient consent, communicates directly with other current or prior treatment providers, family members, schools, or agencies to obtain more complete background information.
• Assesses mental status, including presence of thoughts or impulses to harm self or others.
• Formulates complete 5 axis DSM-IV diagnosis that is supported by the clinical record. Uses structured assessment tools or protocols to elaborate on diagnostic issues and assist in treatment planning.
• Records final disposition and plan in the final section of the intake form by the end of the third screening visit.

Develops an individualized written treatment plans for each patient admitted to the clinic.

• The Current Assessment section of the plan includes a summary of the patient’s problems and needs as well as their strengths and resources. Plans reflect continuity between issues identified in the assessment section, the goals and objectives of treatment, and the discharge criteria.
• Plans contain specific, measurable, outcome-oriented goals, objectives, and discharge criteria related to patients’ mental health problems. Goals and objectives are identified in at least one area other than mental health (e.g. physical health, family/social, educational/vocational).
• Plans include a list of all services to be provided and the specific provider and frequency for each. Details are included in the Methods section describing specific treatment approaches and/or intervention strategies that are known to be effective for the patient’s diagnosis or condition.
• Consults with patients and/or parents in the development of treatment plans, and their participation is documented by their signature on the plans. Patients are encouraged to identify their own goals for treatment, as documented in one or more progress notes.
• Completes treatment plans within 30 days or prior to the fourth visit after patients’ admission to the clinic, whichever comes first.

Reviews, revises, and updates treatment plans with new goals and objectives every 3 months.

• Summarizes patient progress towards the goals and objectives specified in the most recent prior treatment plan in the Current Assessment section.
• Revises goals and objectives as needed.
• Completes the reviews collaboratively with the patient and/or collateral.
• Completes the reviews on time with all required signatures.

Provides treatment services, including individual, group, and/or family psychotherapy, as specified in patient treatment plans and reviews.

• Employs treatment interventions and techniques that are clinically appropriate and effective for patients’ disorders and conditions. Modifies treatment techniques or approaches in work with specific patients based on review of the clinical literature and/or attendance at professional training programs. Offers patients educational material or references, such as books, pamphlets, audio or videotapes, related to diagnosis, treatment issues, or therapeutic activities.
• Makes note of patient response to therapist behavior and varies approach to improve outcome. Elicits explicit verbal or written patient   feedback concerning satisfaction with the treatment process, documents patient’s response, and modifies treatment approach as needed
• Documents information about each service provided in Progress Notes section of patient record. Documented information includes date, type of service, duration, treatment plan goals and objectives addressed (by code), brief summary of patient mental status and/or functioning, primary focus of session, therapist interventions and patient response, and plan for next contact. All notes are signed.

Responds effectively to reduce the risk of harm and to strengthen patients’ coping skills when they experience mental health emergencies.

• Given available information, assesses relevant risk and protective factors.
• Time and opportunity permitting, consults with Mental Health Clinic or Brinn Center psychiatrist concerning appropriate level of intervention.
• When needed, makes use of community based emergency services and programs, including Dutchess County Helpline, Mobile Crisis Team, 911, and state and local police agencies.
• Informs immediate supervisor of all emergency interventions. At the first opportunity following the intervention, conducts a review of the situation directly with the patient.

Closes cases when discharge criteria are met or when patients are referred elsewhere and/or leave treatment for other reasons.

• In consultation with patients, establishes realistic, observable, and functionally based discharge criteria when the patients are admitted to the clinic and documents those discharge criteria in the first treatment plan.
• Reviews with patients and, as needed, revises discharge criteria each time the patients’ treatment plans are reviewed.
• Sets a date for last appointment and discusses need for referrals and/or follow-up services of any kind after discharge when discharge criteria have been or are expected to be met.
• Discusses plans with patients for referral elsewhere and/or other alternatives to continued treatment in the clinic when discharge criteria have not been met and further progress is not expected.
• Notifies patients verbally and/or in writing that their cases may be closed when they do not consistently keep appointments or otherwise maintain active involvement in their treatment.
• Completes the Termination Summary within 48 hours after closing cases and, if patients are being referred to other treatment providers and have provided consent, forwards a copy of the summary to the other provider prior to the patient’s first appointment there.

Contributes to efforts to improve and expand the scope of services in the Mental Health Clinic.

• Attends and actively participates in all department staff meetings, clinical team meetings, and in-service education programs. Participates in at least one community or hospital-wide event or project.
• Completes a presentation on a professional topic for clinic staff, other hospital staff, or the community. Supervises a graduate level intern assigned to the clinic.
• Participates in quality improvement projects and activities. Takes responsibility for planning or implementing a quality improvement project.

Completes all tasks needed for scheduling, billing, and reimbursement purposes, including submission of insurance authorization requests, and documents information as required in patient records.

Performs other related duties as assigned.

• Serves as brand ambassador by upholding the WMCHealth Mission, Vision, and CARE values and promoting excellence in the patient experience, during every encounter.

QUALIFICATIONS/REQUIREMENTS

EXPERIENCE

• Three (3) years post graduate clinical experience in a mental health setting.

EDUCATION

• Master of Social Work degree from an accredited institution and at least one field placement in a mental health setting.

LICENSES/CERTIFICATIONS

• Licensed as a Certified Social Worker (LCSW) or LMSW in New York State.

OTHER

• If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
• Good interpersonal and communication skills and an ability to function as an effective team member
• Must demonstrate ability to form effective working relationships with patients, families, and other staff.