Mental Health Clinician

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Working with Others

Engages in Active and Reflective Listening *

Speaks Clearly and at a Pace That Ensures Understanding *

Uses Non-Judgmental Language and Behaviors *

Communicates Directly with the Client’s Family and Significant Others (with Client Consent) *

Employs “Person-Centered/Person-First” Language *

Utilizes Technical Language Accurately, Including Clinical Terminology *

Demonstrates Warmth, Empathy, and Genuineness *

Shows Respect and Concern for Others Through Words and Actions *

Focuses on and Respects the Concerns and Preferences of the Client and Family *

Provides Support and Encouragement to Clients *

Collaborates with Providers and Clients to Complete Tasks and Solve Problems *

Maintains Appropriate Boundaries in All Relationships *

Screening & Assessment

Obtains Information from Providers Knowledgeable of the Client and Family *

Collects Demographic, Psychological, Social, and Medical Information Through Interviews of the Client and Family *

Summarizes All Information Verbally or in Writing *

Demonstrates Sound Judgment in Evaluating and Using the Information Collected *

Assists Clients in Completing Screening Tools on Substance Use and Mental Health Conditions *

Scores and Interprets the Results of Screening Tools Correctly *

Assesses Clients’ Preferred Method of Communication and Language Barriers *

Identifies Client and Family Strengths and Resources *

Identifies Client and Family Goals *

Assesses Clients’ Motivation and Readiness to Participate in Services *

Identifies Client Problems, Mental Health and Substance Use Conditions, and Stressors *

Identifies Signs of Abuse and Neglect *

Assesses Level of Risk for Harm to Self or Others *

Determines Whether Additional Assessment is Required and Arranges if Necessary *

Assesses Physical and Psychological Risk Associated with Acute Intoxication, Overdose, Withdrawal, Detoxification, and Co-occurring Mental Health and Substance Use Disorders *

Applies the Criteria in the Current Version of the Diagnostic and Statistical Manual for Mental Disorders (DSM) in Assessing Clients’ Behavioral Health Conditions *

Applies the ASAM Criteria to Guide Treatment Planning and Recommend a Level of Care *

Planning Services

Identifies Recommended Short-term and Longer-term Service Goals *

Identifies Service Options Based on Experience & Research *

Evaluates Eligibility and Insurance Coverage or Ability to Pay for Recommended Services *

Communicates Outcome of the Screening & Assessment to the Client & Family *

Assists the Client & Family in Understanding the Client’s Conditions and Effects *

Discusses Recommended Goals and Services with Client & Family & Alternate Options *

Assists Client in Communicating His or Her Needs to Others *

Negotiates and Finalizes a Plan of Care with the Client & Family Based on Their Preferences *

Assists the Client in Developing a Crisis Plan for Future Episodes of Illness *

Supports the Client in Developing Wellness & Recovery Plans *

Providing Services

Arranges for Assistance, if Needed, with Language Translation or Literacy *

Implements the Plan of Care (e.g., Begins Services, Makes Referrals) *

Monitors Client’s Condition, Behavior, and Progress on a Continuous Basis *

Recognizes When Progress Has Slowed, Addresses Barriers, and Works to Motivate the Client *

Evaluates Progress and Reviews and Revises the Plan of Care on a Regular Basis *

Encourages Client Participation in Services and Reaches Out When the Client is Not Engaged *

Participates in Developing, Coordinating, and Monitoring a Discharge Plan *

Establishes Working Relationships & Coordinates Care with Other Providers and Teams in the Agency *

Establishes Working Relationships & Coordinates Care with Other Providers in Other Agencies *

Assists in Establishing Routine and Formal Working Relationships with Other Agencies *

Reviews the List of the Client’s Medications and Their Effects and Side Effects *

Supports Client and Family Education about Medication Effects and Side Effects *

Coaches the Client on Strategies for Taking Medications as Prescribed *

Coaches the Family on Strategies for Supporting the Client in Taking Medications *

Supports the Client’s Participation in Medical Appointments, Medical Monitoring, and Lab Testing *

Assists the Client in Monitoring and Reporting Medication Effects and Side Effects to the Medical Prescriber *

Provides Emotional Support, Encouragement, and Reassurance *

Helps the Client Define the Problem by Telling Their Story, Discussing Their Situation, and Challenging His or Her Current Perspective, When Warranted *

Helps the Client Set Goals by Discussing the Possibilities and Assisting the Client to Select and Commit to New Goals *

Helps the Client Take Action through Problem-Solving, Education and Training, Reflecting on Past Experiences and Patterns, Creating an Action Plan, Contracting, and Providing Feedback *

Recognizes Behavioral Health Crises and Early Warning Signs of Crises *

Assists in Deescalating Problems in Their Early Phase *

Reports Crises and Seeks Assistance from a Supervisor or Licensed Behavioral Health Professional *

Seeks Assistance, as Needed, from Village Public Safety Officers, Other First Responders, or Community Members *

Assists in Implementing the Response to an Individual, Family, and Community Crises *

Communicates with the Family and Others about the Crisis and the Response *

Assists with Notifications and Investigations of Reportable Events (e.g., Abuse, Domestic Violence, Assaults, Neglect, Deaths) *

Provides Support to Those Affected by the Crisis and Assists Them in Accessing Supportive Services *

Assists the Client and Family in Obtaining Services Related to the Crisis (e.g., Domestic Violence Shelter; Emergency Foster Care) *

Participates in Debriefing Meetings to Discuss the Crisis and the Response *

Assesses Family Norms and Roles (in Nuclear and Extended Families, Clans, Biological and Nonbiological Families) *

Uses Genograms and Sociograms to Assess and Work with Families *

Identifies Family Dynamics, Functional and Dysfunctional Units, and Barriers to Communication *

Identifies the Impact within the Family of an Individual with a Mental Health or Substance Use Condition and Accommodations Made by the Family for the Individual *

Identifies the Impact on Family Functioning of Stressors (e.g., Medical Illness, Separation, Divorce, Abuse, Financial Concerns, Housing Issues, Legal Trouble) *

Engages Members of the Family in Constructive Problem-Solving *

Assists the Family in Improving Its Functioning *

Identifies the Functions, Limitations, and Risks of Different Types of Groups (Educational, Psychoeducational, Self-Help, Support, Activity, Skill Development, Therapeutic) *

Identifies Appropriate Members for the Different Types of Groups *

Orients New Members to Groups Addressing the Purpose, Rules, Boundaries, Levels of Self-Disclosure *

Runs Groups Effectively, Providing Adequate Structure, Encouraging Member Interaction, and Maintaining Safety *

Assists Clients in Ending Participation in a Group or Transitioning to Another Group *

Manages the Ending of Groups *

Linking to Community Resources

Maintains Information on a Range of Community Resources (e.g., Service, Medical, Financial, Housing, Spiritual, Volunteer) *

Maintains Information on Traditional Support & Intervention Resources (Elders, Traditional Healers) *

Identifies Recommended Resources and Traditional Supports for the Client and Family Based on Need and Eligibility *

Identifies Resources Outside of the Community That May Need to Be Brought into the Community *

Discusses Resource Recommendations & Options with the Client & Family *

Motivates the Client & Family to Access and Use Resources *

Negotiates a Plan with the Client & Family About Accessing Resources Based on Their Preferences *

Makes a Referral and Actively Connects the Client or Family to Selected Resources *

Ensures That the Referral Was Accepted and Client or Family is Receiving Services *

Makes an Alternate Referral if the Initial Referral Was Unsuccessful *

Draws on Individuals in the Community to Offer Support to the Client & Family *

Educates Clients, Families, and the Community About Behavioral Health Conditions and Their Prevention and Treatment *

Provides Information to Destigmatize People with Mental Health and Substance Use Conditions *

Uses Community Gatherings to Encourage Healthy Behaviors *

Serves in Community Workgroups Focused on Prevention and Early Intervention with Behavioral Health Conditions *

Works with Community Leaders to Develop Supports for Individuals and Families at Risk *

Engages and Provides Support to Individuals and Families at Risk *

Educates Clients and Families About Strategies for Improving Physical and Mental Health *

Assists in Assessing Community Needs and Readiness for Prevention and Early Interventions Activities *

Provides Information to Clients and Families About Their Rights and Responsibilities *

Supports Individual and Family Goals and Wishes Within the Agency and with Other Organizations *

Helps Clients and Families to Participate in Service Planning Meetings *

Refers Clients and Families to Peer and Family Support Activities and Advocacy Organizations *

Cultural Competency & Individualizing Care

Recognizes and Adapts to Different Cultures, Including the Varied Alaska Native Tribes and Communities *

Recognizes and Respects Diversity, Differences, and Cultural Traditions, Including Among Different Alaska Native Tribes and Communities *

Assesses and Manages One’s Own Personal Biases *

Is Aware of the Traditions of the Community *

Demonstrates Awareness of and Sensitivity to the Client Degree of Involvement in Their Traditions, Values, and Community *

Adapts Services to the Unique Characteristics and Preferences of the Client and Family *

Applies Knowledge of Gender, Sexual Orientation, Life Span Development, Financial Status, Religion, Disability, and Intergenerational Differences in Delivering Services *

Promotes Empowerment as a Goal and Desirable Treatment Outcome for Alaska Native/American Indian People by Fostering Client and Family Decision-Making, Problem-Solving, and Self-Determination *

Effectively Discusses Cultural Issues and Differences with Clients *

Uses Cultural Views of Health and Family When Assisting in Providing Services *

Utilizes Cultural Resources and Traditional Practices When Providing Services (e.g., Storytelling, Talking Circles, and Deferring to Elders) *

Identifies and Addresses Issues of Difference to Reduce Conflict Between Individuals and Groups *

Routinely Considers and Discusses Cultural Issues in Supervision and Team Meetings *

Consults with Elders or Traditional Healers in the Community *

Documenting

Completes All Required Documentation (e.g., Screening & Assessment, Intake, Service Plans, Progress Notes, Discharge Summaries) *

Produces Documentation That Is Objective, Accurate, and Legible with Correct Language, Grammar, and Spelling *

Completes Documentation in a Timely Manner *

Reviews Client Documentation with Clients When They Request to Do So and When Approved by the Agency *

Demonstrates Sensitivity When Assisting Clients in Understanding Their Documentation During a Records Review *

Professional & Ethical Practice

Minimizes Absences, Arrives on Time, and Completes a Full Work Day *

Completes Assigned Duties in a Timely Way and Follows Through on Instructions Received, Reasonable Requests, and Promises Made *

Acts Professional in Interactions with the Client, Family, Community, and Other Professionals *

Works Within the Limits of Assigned Duties and Role *

Recognizes Personal Limits of Knowledge and Skills *

Seeks Additional Supervision or Consultation When Uncertain About What to Do or Concerned About the Performance of Others *

Complies with the Code of Ethics *

Complies with Laws, Regulations, and Agency Policies *

Manages Effectively Personal and Professional Boundaries with Clients, Families, and the Community *

Models Appropriate Personal and Professional Behavior *

Respects Client and Family Rights *

Provides Information and Obtains Informed Consent *

Complies with Special Rules and Procedures Related to Consent for: Involuntary Commitment; Mandated Reporting; Minors; or Individuals Unable to Consent, Under Guardianship, or Subject to a Court Order *

Complies with Laws, Regulations, and Agency Policies Regarding Confidentiality and Privacy (e.g., HIPAA, Federal Privacy Act, 42 C.F.R, Part 2) *

Complies with the Procedures Regarding Disclosure of Confidential Information (e.g., Mandated Reporting, Duty to Warn, Client Authorized Releases of Information) *

Maintains the Physical Security of Confidential Information (Electronic and Hard Copy) *

Educates Clients and Families About Confidentiality, Privacy, and Their Limits *

Assists Clients with Decisions and Process to Release Confidential Information *

Maintains the Confidences and Privacy of Clients and Families, Even When Not Required by Law, Regulation or Policy *

Protects Client and Family Anonymity When Providing Information for Statistical Information and Research *

Assists in Ensuring That Other Individuals Providing Services Comply with the Laws, Regulations, and Policy on Confidentiality and Privacy *

Recognizes Signs of Personal Stress *

Uses Self-Care Strategies to Manage Stress, Maintain Health, and Prevent Burnout *

Professional Development

Sets Personal Goals for Professional Development *

Participates in Employer Sponsored Training and Other Continuing Education Activities *

Adopts Best Practices Learned Through Continuing Education *

Participates Routinely and Constructively in Supervision *

Uses Supervision, Peer Consultation, and Self-Evaluation to Enhance Self-Awareness and Improve Professional Performance *

Uses Formal Evaluations to Improve Professional Performance and the Quality of Services Provided *

Provides Guidance and Mentoring to Others *

Mental Health Clinician

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