Chapter B5 – Article 10. Behavioral Health Aide and Practitioner Curricula

Sec. B5.10.010. Equivalent Courses.

The Behavioral Health Academic Review Committee (BHARC) shall maintain and provide to the Board a list of courses that the BHARC has determined to contain course content equivalent to that required under this Article 10 [BHA curricula]. Applicants who have satisfactorily completed such courses shall be deemed to have met the applicable curricula requirements.

Sec. B5.10.100. General Orientation.

1. Minimum Hours. This course shall be no fewer than 28 contact hours which must include 4 contact hours regarding communication skills identified in section B5.10.100(c) and may be provided as an in-service training program by the employer.
2. This course shall provide an introduction to:
   1. the Alaska Tribal Health System;
   2. the history, statutory authority for, and current status of the Community Health Aide Program;
   3. community health aide program certification and the Community Health Aide Program Certification Board;
   4. the Alaska Community Health Aide/Practitioner Manual (CHAM) and the Behavioral Health Aide Manual (BHAM) and their uses;
   5. the dental health aide component of the community health aide program;
   6. the behavioral healthcare system in Alaska and how individuals may access it; and
   7. how the Alaska Tribal Health System is structured and the relationship of behavioral health within the care system, including individual regional differences, as appropriate.
3. Communication Skills. During this general orientation, an evaluation of the trainee’s communication, including writing skills, shall be conducted. If the trainee’s communication skills are insufficient to allow the trainee to successfully complete the remainder of the training and perform the work of a behavioral health aide or practitioner, a plan for improvement must be developed, before the trainee may proceed with other courses. The plan must be monitored for successful achievement of skills sufficient for the trainee to successfully perform the requisite course work and, ultimately, the work required for certification at the level of certification sought by the trainee. The communication skills improvement plan and monitoring may be required and continued throughout training and certification for each level of behavioral health aide or practitioner certification. This requirement shall not preclude assisting the trainee to satisfy the minimum communication skills requirements through accommodations such as dictation; computer assisted spelling programs and other means to assist the trainee to adequately communicate necessary information.

Sec. B5.10.105. Orientation to Behavioral Health Services.

This course which shall be 8 contact hours, will provide:

1. an introduction to:
   1. village-based behavioral health services;
   2. the rationale and philosophy for providing prevention, early intervention and case management within the community of client residence;
   3. emergency behavioral health response protocols; and
   4. the use of clinical supervision to support quality of services.
2. The instructor will work with each student to create a strength-based professional development plan that identifies the student’s training and supervision needs and use the student’s test results to identify strengths and areas for development. The BHA/P must present this plan and receive approval and feedback from their supervisor.

Sec. B5.10.110. Ethics, Consent, Confidentiality, and Privacy.

This course, which shall be 16 contact hours, will provide:

1. foundational information regarding:
   1. the need for professional ethics;
   2. the difference among ethics, agency policies and procedures, and laws that govern practice;
   3. personal and professional boundaries in a village-based setting, including identification of personal relationships and conflicts and their effect on a professional relationship;
   4. client’s rights and the duty to protect and advocate for client rights;
   5. the code of ethics for Behavioral Health Aides, with discussion of using the code of ethics as guidance in providing client services;
   6. the duty to obtain informed consent, including its application to:
      1. adults, minors, individuals with limited or impaired capacity, and individuals subject to court order such as guardianship;
      2. disclosure of information and the limitations to authorizations; and
      3. providers who are delivering services through tele-health modalities;
   7. confidentiality and privacy requirements under applicable law and regulation, including the Federal Privacy Act and the Health Insurance Portability and Accountability Act (HIPAA), US Code of Federal Regulations (42 CFR part 2), and their application to delivery of behavioral health services;
   8. exceptions to confidentiality requirements that occur without client consent, including:
      1. a review of reporting requirements, including those arising from suspected child abuse, elder vulnerable adult abuse;
      2. risk of harm to self or others;
      3. others permitted by law; and
      4. distinguishing among types of court orders (e.g. subpoenas vs. direct judicial orders);
   9. protecting written and electronic records;
   10. protecting privacy in various situations, including crowded settings, and in family and group counseling; and
   11. special rules regarding information subject to special confidentiality or privacy rules; and
2. applied exercises to:
   1. identify and develop responses to common ethical, consent, confidentiality and privacy situations; and
   2. obtain appropriate authorizations for release of information and how to use and document such authorizations.

Sec. B5.10.115. Human Development.

This course, which shall be 8 contact hours, will provide:

1. an introduction to foundational and practice information regarding:
   1. the development of the individual through the lifespan, from conception through adulthood including common maladaptive behaviors and childhood behavioral health concerns;
   2. prevention and early intervention for childhood behaviors and behavioral health concerns;
   3. common theories of human development, ages and stages;
   4. processes, experiences and influences that affect a developing person;
   5. physical, intellectual, social, emotional, spiritual, environmental, sexual, and occupational components of a person;
   6. attachment theories and their impact on development, adulthood and potential behavioral health concerns
   7. life stages and their role in family dynamics;
   8. the interaction of home, school, and community settings on human development; and
   9. the interaction of nature and nurture in shaping human development with a focus on socioeconomic status, family background, culture, rural vs. urban settings, and traditional ways of living; and
2. applied exercises to help trainees recognize that the stages of development inform behavioral health interventions and treatment.

Sec. B5.10.120. Introduction to Behavioral Health Concerns.

This course, which shall be 24 contact hours (which shall include 8 contact hours regarding mental health, 8 contact hours regarding substance use disorders, and 8 contact hours regarding other behavioral health issues), will provide:

1. an introduction to:
   1. the range of behavioral health issues experienced by individuals, families, and communities;
   2. the comprehensive continuum of care that can address behavioral health issues of various degrees of seriousness;
   3. common mental health disorders and the associated risk factors and treatment options, including therapeutic medications;
   4. addictive substances, including alcohol, tobacco (cigarettes/cigars/pipe, commercial chew, Iqmik/Dedigus/Blackbull), psychoactive substances (stimulants, depressants, opioids and psychedelics), and other substances (e.g., inhalants, anabolic steroids, and prescription drugs) and the associated risk factors and treatment options;
   5. other addictive behaviors (e.g. gambling, pornography) and the associated risk factors and treatment options; and
   6. other behavioral health issues, including child abuse and neglect, domestic violence, elder abuse, fetal alcohol spectrum disorder (FASD), homicide, disaster events, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), developmental disabilities, co-occurring disorders, and other conditions and events that effect behavior and adjustment.

Sec. B5.10.125. Introduction to Counseling.

This course, which shall be 12 contact hours, will provide:

1. foundational information about:
   1. personal characteristics of an effective counselor (establishing personal counseling values and philosophy);
   2. interviewing and listening skills;
   3. defining counselor and client roles;
   4. how to establish a counseling relationship;
   5. problem identification, goal development, and action planning with a client; and
   6. the client’s responsibility in counseling and how to assist and motivate a client to discover and practice more appropriate and healthy behavior; and
2. applied exercises in which trainees can practice the client-centered approach, using communication skills such as listening, attending, and reflection.

Sec. B5.10.130. Introduction to Documentation.

This course, which shall be 12 contact hours, will provide:

1. foundational information regarding:
   1. the establishment and maintenance of a quality client record, including the essential components of clinical/counseling records, including screening tools, assessments, treatment plans, progress notes, discharge summaries, and authorizations for disclosure;
   2. the purpose and elements of case narrative recording, including using data, assessment, and plan (DAP); subjective, objective, assessment and plan (SOAP); data, intervention, response and plan (DIRP) and other formats for case narrative recording;
2. an introduction to:
   1. the use of standardized information management systems and screening tools widely used by Alaska behavioral health programs;
   2. using criteria contained in the Diagnostic and Statistical Manual and American Society of Addiction Medicine (ASAM) Patient Placement Criteria (PCC) to standardize documentation in relation to treatment and service planning (problem list, goals, objectives, and interventions);
   3. documentation requirements specific to prevalent payers and accrediting bodies, such as Medicaid, Medicare, Commission on the Accreditation of Rehabilitation Facilities (CARF), and The Joint Commission; and
   4. administrative record keeping; and
3. applied exercises in which trainees practice:
   1. documenting client related work and consider the effect of confidentiality rules on the application of documentation requirements.

Sec. B5.10.135. Introduction to Case Management.

This course, which shall be 8 contact hours, will provide:

1. an introduction to foundational and practice information about:
   1. the use of available community resources (locally, regionally and statewide) related to coordinating services and case management;
   2. identifying and evaluating the appropriateness of potential resources for the individual client and making referrals when necessary;
   3. an emphasis on the inventive use of agency-based and other community and family resources;
   4. an introduction to the role and delivery of case management services;
   5. an emphasis on finding resources for diverse populations and complex clients;
   6. roles related to assisting clients in medication management and medication education; and
   7. focus on evaluation of service usefulness and accessibility issues that need to be considered in village-based practice; and
2. applied exercises in recognizing the role and components of case management.

Sec. B5.10.140. Working with Diverse Populations.

This course, which shall be 12 contact hours, will provide:

1. foundational and information regarding:
   1. working with clients of different ethnic or racial heritage, age, gender, lifestyle, sexual orientation, spirituality, and socioeconomic status;
   2. an introduction to beliefs, attitudes, knowledge and skills generally maintained by an effective multi-culturally aware counselor; and
   3. barriers that clients of diverse populations may face when seeking or receiving treatment; and
2. applied exercises to develop skills associated with respectfully assessing client needs:
   1. strategies for working in Alaska Native communities with other prominent minority/cultural groups in rural Alaska; and
   2. regarding the implications of personal and cultural historical trauma.

Sec. B5.10.145. Introduction to Group Counseling.

This course, which shall be 8 contact hours, will provide:

1. an introduction to foundational and practice information about:
   1. types and uses of groups for education and treatment;
   2. how to encourage and support self-help groups, e.g. Alcoholics Anonymous and Adult Children of Alcoholics;
   3. how to assess the potential for establishing other groups;
   4. group counseling dynamics, including open ended and closed groups;
   5. determining the criteria for participation in groups of various types and how to screen appropriate candidates for participation;
   6. time-limited group process;
   7. privacy and documentation issues arising in various group models; and
   8. providing group resources to communities for the purpose of education, prevention, or team building; and
2. applied exercises that provide exposure to the therapeutic group process and focus on the purpose, planning and conducting of:
   1. educational/informational groups; and
   2. “talking circles” or traditional healing groups as a therapeutic group process.

Sec. B5.10.150. Crisis Intervention.

This course, which shall be 16 contact hours, will provide:

1. an introduction to foundational and practice information about:
   1. common crisis events (domestic violence, physical or sexual abuse or assault, other violence, depression, substance use relapse, psychosis, job loss/financial problems, death, onset of serious medical condition or injury, loss of a relationship, bullying);
   2. dynamics of crisis events and response, including:
      1. assessment and evaluation of immediate risks, including risk of harm to self or others, and protective factors;
      2. using crisis for positive change; and
      3. working with families and communities affected by crisis events;
   3. stages and course of response to crisis events, including continuum of care from least to most restrictive;
   4. applying dynamics of crisis to suicide, including:
      1. common misconceptions regarding suicide;
      2. age-related suicidal ideation;
      3. evaluation of risk of harm to self or others; and
      4. working with families and communities affected by suicide;
   5. recognition of and immediate response to risk to clients who pose a risk to themselves or others;
   6. working with clinical supervisor to respond to imminent crises;
   7. the “civil commitment” process under Alaska law;
   8. survivor (family, friends, and community) care; and
   9. how community-based suicide prevention may be started and supported.

Sec. B5.10.155. HIV/AIDS and Infectious Diseases.

This course, which shall be 8 contact hours, will provide:

1. practice information regarding universal precautions and risk reduction;
2. health status and risk information regarding hepatitis, sexually transmitted diseases, tuberculosis, HIV and other infectious diseases that pose common risks for individuals with substance use disorders;
3. information regarding availability of testing, counseling and treatment for sexually transmitted diseases;
4. practice information about how to approach lifestyle or risk issues with clients;
5. guidance in providing referral options for client pre-test/post-test counseling support for HIV testing;
6. foundational information about how behavioral health issues can increase risk of HIV and other infectious diseases; and
7. foundational information about how HIV and infectious diseases can increase risk of developing or worsening behavioral health issues.

Sec. B5.10.160. Community Approach to Prevention.

This course, which shall be 8 contact hours, will provide:

1. foundational philosophy and practice information related to:
   1. community readiness assessment, community based prevention activities, and community development;
   2. key features of prevention (universal, selective, and indicated);
   3. determine key stakeholders with whom to partner when addressing community issues; and
   4. community readiness and key issue evaluation for developing effective prevention plans; and
2. applied exercises for developing:
   1. community prevention strategies; and
   2. providing brief public presentations.

Sec. B5.10.165. Family Systems I.

This course, which shall be 16 contact hours, will provide, with an emphasis on Alaska Native family systems:

1. an introduction to foundational and practice information regarding:
   1. family systems theory, kinship patterns, and family dynamics;
   2. family roles and effect of behavioral health disorders on individuals within the family and on the family as a system;
   3. communication within families and assessment of barriers;
   4. common response to stresses such as inadequate housing or income, job loss, illness;
   5. recognition and assessment of family norms;
   6. understanding life stages and their role in family dynamics;
   7. role of extended family;
   8. recognition of harm or risk or harm occurring within a family;
   9. effects of separation and loss due to divorce, death, foster care, or adoption; and
   10. parenting and the importance of healthy parent-child dynamics; and
2. a focus on supporting healthy family by identifying strengths and working with families to develop strategies to promote health and healing; and
3. applied practice exercises associated with:
   1. assessing family functioning;
   2. supporting healthy family functioning;
   3. improving family communication and support;
   4. responding to risks and harm occurring within a family; and
   5. teaching clients healthy parenting skills.

Sec. B5.10.170. Maintaining Health, Wellness and Balance.

This course, which shall be 8 contact hours, will provide:

1. an introduction to foundational and practice information regarding:
   1. how personal health, wellness, and balance improved the ability to provide behavioral health services;
   2. strategies for coping with personal and work-related stress so it does not interfere with providing appropriate services;
   3. appropriate use of supervision to address issues that arise for behavioral health service providers in a rural or remote setting; and
   4. compassion fatigue and vicarious trauma; and
2. applied exercises help trainees practice skills associated with the maintenance of their own health and wellness:
   1. identification and recognition of personal stress levels and potential impairment; and
   2. skills for maintaining their own health and wellness.

Sec. B5.10.200. Psychophysiology and Behavioral Health.

This course, which shall be 16 contact hours, will provide:

1. foundational information about:
   1. the brain-body connection;
   2. nervous system structure;
   3. neuro-anatomy;
   4. neurotransmitter and receptor function; and
   5. drug class/medication effects, and working with medical providers regarding medication management; and
2. exercises to help the trainee:
   1. understand the impact and importance of psychoactive substances (legal and illicit), on the brain and body; and
   2. develop ability to discuss psychoactive effects/implications with clients.

Sec. B5.10.205. Introduction to Co-Occurring Disorders.

This course, which shall be 8 contact hours, will provide:

1. a basic understanding of how mental health, substance use disorders, and other conditions can exist in combination, and affect treatment services and process and therapeutic medication management;
2. information about potential cause and origin of mental health disorders, along with a client perspective of the symptoms and limitations;
3. applied exercises will help the trainees practice their developing skills associated with identifying and describing these disorders; and
4. an understanding of the process of recovery techniques for relapse prevention as they relate to both substance use and mental health disorders.

Sec. B5.10.210. Tobacco Use and Treatment.

This course, which shall be 8 contact hours, will provide information on:

1. the magnitude of tobacco use prevalence and morbidity/mortality in Alaska;
2. the implications of Alaska Native tobacco use patterns, methods, and products for client evaluation and treatment;
3. tobacco-specific biology and pharmacotherapy;
4. treating tobacco users with special medical conditions;
5. best practices for tobacco treatment: United States Public Health Service (USPHS) Treating Tobacco Use and Dependence Clinical Practice Guideline and the Fagerstrom Test for Nicotine Dependence; and
6. statewide and regional treatment options and resources.

Sec. B5.10.215. Diagnostic and Statistical Manual Practice Application.

This course, which shall be 12 contact hours, will provide:

1. foundational information about:
   1. the philosophical and practice basis of evaluating behavioral health disorders using criteria contained in the Diagnostic and Statistical Manual (DSM); and
   2. the use of DSM-derived screening tools to develop working impressions and contribute information to clinical diagnosis; and
2. application exercises for practicing use of the DSM in case samples; and
3. analyze and discuss the need for and appropriate use of clinical supervision and consultation related to client evaluation.

Sec. B5.10.220. Advanced Interviewing Skills.

This course, which shall be 16 contact hours, will provide:

1. applied information about:
   1. the theoretical, evidence-based, and practical bases of various therapeutic modalities, e.g. cognitive behavioral therapy and motivational enhancement therapy; and
   2. stages of change as pertinent to helping clients understand the counseling process, set and reach goals, and have realistic expectations; and
2. practice exercises using evidence-based interviewing practices to enhance client readiness for behavior change, screening, intake, plan development, and relapse prevention.

Sec. B5.10.225. American Society of Addiction Medicine Patient Placement Criteria Practice Application.

This course, which shall be 12 contact hours, will provide:

1. foundational information about:
   1. the philosophical and practice basis of evaluating behavioral health disorders; and
   2. using criteria contained within the American Society of Addiction Medicine (ASAM) Patient Placement Criteria (PCC); and
2. guidance in evaluation of client risk and/or severity associated with the six ASAM dimensions; and
3. exercises in which trainees can practice:
   1. developing client placement recommendations based on what is available within the continuum of care; and
   2. use of later changes in client risk and/or severity associated with the six ASAM dimensions to document treatment/services progress.

Sec. B5.10.230. Case Studies and Applied Case Management.

This course, which shall be 8 contact hours, will provide applied exercises to practice:

1. participation in discussion and analysis of case studies with different behavioral health issues (abuse, addiction, child abuse, co-occurring disorders, domestic violence, mental illness, etc.);
2. information on Alaska Native health care disparities and an evaluation of services available in communities, hub towns, and the state;
3. more in-depth understanding of the importance of referrals, steps for making an appropriate and effective referral, receiving referrals, and following-up on referrals; and
4. case presentation for treatment team review, including Multi-Disciplinary teams (MDTs), and treatment teams.

Sec. B5.10.235. Traditional Health Based Practices.

This course, which shall be 8 contact hours, will provide:

1. foundational information regarding traditional lifestyles and health practices of the Alaska Native people prior to Western contact;
2. an introduction to beliefs, attitudes, and knowledge of health promotion and maintenance that were practiced historically;
3. tools for seeking and employing traditional resources to promote individual and community health;
4. an examination of the major changes that have led to the current health status of Alaska Native communities; and
5. potential strategies for improving behavior-based health status.

Sec. B5.10.240. Intermediate Therapeutic Group Counseling.

This course, which shall be 16 contact hours, will provide information and practice related to:

1. therapeutic group process with a focus on:
   1. determining the criteria for participation in groups of various types and how to screen appropriate candidates for participation;
   2. managing dual relationship and boundary challenges in small town or village-based settings;
   3. role and function of therapeutic group leadership; and
   4. therapeutic outcomes and risks associated with group educational and treatment experiences; and
2. applied exercises in which trainees will practice skills associated with planning, facilitating, and leading groups.

Sec. B5.10.245. Applied Crisis Management.

This course, which shall be 8 contact hours, will provide:

1. information and discussion with a focus on:
   1. facilitation community debriefing related to crisis events such as natural disasters, homicide, and suicide that have impact on families and other community members; and
   2. encouraging and supporting posttraumatic growth following a crisis event; and
2. applied exercises focusing on:
   1. accessing additional resources necessary for effective response to a crisis event that occurs in a village-based or urban setting;
   2. short and long term intervention models for responding positively to crises;
   3. using cultural activities, self-care, and stress management techniques to manage personal, client, and community responses to crises; and
   4. providing and facilitating formal crisis response and stress management activities within the community.

Sec. B5.10.250. Community Needs and Action.

This course, which shall be 12 contact hours, will provide:

1. focus on in-depth prevention (universal, selective, and indicated) plan development strategies that are appropriate and compatible with individual village characteristics; and
2. applied exercises to help trainees practice:
   1. identification and evaluation of community needs;
   2. completing a community readiness assessment;
   3. evaluation and development of various intervention efforts targeting behavioral health issues; and
   4. writing a community development strategy to promote community involvement in accomplishment of specific goals based on the results of the community readiness assessment.

Sec. B5.10.255. Family Systems II.

This course, which shall be 16 contact hours, will provide:

1. review and more advanced foundational and practice information related to:
   1. family systems work;
   2. child development and parenting;
   3. couples issues and implications for behavioral health treatment; and
   4. teaching basic communication, parenting, and anger management skills on an individual and group basis;
2. information regarding special practice issues, such as reporting abuse or neglect, ethical and confidentiality issues associated with conducting couples or family counseling, domestic violence and compliance with the Indian Child Welfare Act;
3. strategies for working with disrupted families and other agencies that may be engaged with them; and
4. applied exercises in which trainees practice skills associated with:
   1. providing intervention and support to families experiencing dysfunction; and
   2. teaching and facilitating healthy family behavior and skills.

Sec. B5.10.260. Behavioral Health Documentation.

This course which shall be 8 contact hours, will provide:

1. in depth information regarding quality documentation of:
   1. assessments, treatment plans, progress notes and discharge summaries;
   2. risk levels, and safety planning;
   3. diagnosis and recommendations informed by the current version of the DSM and ASAM criteria; and
   4. treatment progress; and
2. applied exercises in which trainees:
   1. practice documenting the process from intake, screening, assessment, treatment planning to progress notes and how all of these connect and inform each of the next steps using provided case studies;
   2. provide samples of their documentation without identifying information to receive feedback; and
   3. practice documentation in special situations such as: group counseling and family sessions, and individualized education plan (IEP) consultations.

Sec. B5.10.300. Treatment of Co-Occurring Disorders.

This course, which shall be 12 contact hours, will provide:

1. more advanced information and guidance related to:
   1. services and treatment planning with clients experiencing co-occurring disorders including the process through screening, assessment, diagnosis, treatment planning and treatment services;
   2. limitations and considerations directly related to the existence of more than one diagnosed behavioral health disorder; and
   3. how environmental issues such as family dynamics, social support or isolation, and identification of meaningful community roles can influence the course of substance use and mental health disorders; and
2. application exercises to provide:
   1. experience in developing individualized treatment/services plans addressing multiple clinical issues requiring complex evaluation and planning.

Sec. B5.10.305. Advanced Behavioral Health Clinical Care.

This course, which shall be 20 contact hours, will provide, in a seminar format, an opportunity for trainees to participate in exercises to:

1. learn counseling approaches having value and application within village-based behavioral health services targeting individuals affected by multiple disorders and complex disorders;
2. participate in exercises to support applied use of “Best Practice” models;
3. identify ways to work with those who need or receive psychiatric care outside of the community including discharge care, referrals, and community support; and
4. increase familiarity with the eBHAM “overlapping issues” chapter and how it relates to providing advanced behavioral health clinical care.

Sec. B5.10.310. Documentation and Quality Assurance.

This course, which shall be 16 contact hours, will provide:

1. advanced information regarding clinical/counseling records;
2. an introduction to quality assurance and how to evaluate:
   1. the quality of clinical record documentation;
   2. documentation to determine compliance with payer requirements and grant conditions, including how to conduct chart audits and compile information necessary to respond to external reviews and audits; and
3. applied exercises in evaluating record documentation and potential remediation for record deficits.

Sec. B5.10.315. Applied Case Studies in Alaska Native Culture Based Issues.

This course, which shall be 8 contact hours, will provide, in the context of case studies and skill development:

1. how traditional lifestyles and health practices impact the Alaska Native community;
2. how Alaska Native beliefs, attitudes, and knowledge of health promotion can promote positive changes to the current health status;
3. emphasis on potential strategies for improving behavioral health services;
4. incorporating traditional ways of healing into treatment plans, as appropriate; and
5. improving recognition and acceptance of cultural differences that affect treatment planning among clinical team members.

Sec. B5.10.320. Behavioral Health Clinical Team Building.

This course, which shall be 12 contact hours, will provide:

1. practical approaches to:
   1. team building, facilitation of team meetings, and support of a team approach to providing integrated behavioral health services;
   2. collaboration and partnership among individuals with different training and work settings, especially with community health aides and practitioners and dental health aides;
   3. interaction among different teams that may be involved with a single client; and
2. applied exercises in which each trainee will develop a team building plan;
3. practice providing support and feedback to others regarding clinical interventions, including counseling; and
4. practice initiating, designing, and facilitating a Multi-Disciplinary Team (MDT) and/or clinical team including public speaking and lead roles.

Sec. B5.10.325. Introduction to Supervision.

This course, which shall be 16 contact hours, will provide:

1. an introduction to philosophy and practical application of functions of:
   1. supervision, including coach/mentor, tutor/teacher, consultant, role model, evaluator, and administrator;
   2. guidance in developing a vision for supervisory relationships and defining expectations;
   3. skill development in nurturing counselor development, promoting development of skills and competencies, and achieving accountability;
   4. an introduction to ethics of supervision;
   5. an introduction to administrative requirements and related supervision;
   6. guidance in managing conflicting functions expected of supervisors;
   7. introduction to dual roles of providers, including mentors, administrative supervisors, and clinical supervisor roles;
   8. encouraging the development and enhancement of community resources by the supervisee; and
   9. addressing complaints from referral agencies and other community resources to maintain relationships with community, sate, and tribal partners; and
2. application exercises to assist trainees to practice various functions of supervision and begin developing their own supervisory approaches.

Sec. B5.10.330. Child Development.

This course, which shall be 20 contact hours, will provide:

1. foundational information regarding:
   1. review of developmental needs of youth ages in utero/birth to 17;
   2. developmental screenings and how to participate in an integrated approach with community health aides who perform well child checks;
   3. overview of threats to development, including
      1. domestic violence, lack of social/family connection, neglect, and related biological, emotional and psychological distress; and
      2. role of parenting and social supports;
   4. cultural influences of development;
   5. adaptive and maladaptive behavior in the developing child;
   6. issues of development related to exposure to alcohol and other substances in utero to age 3; and
   7. the impact of trauma on child development, including:
      1. hyper and hypo physiological responses manifested in maladaptive behaviors, traumatic brain injury (TBI) and fetal alcohol spectrum disorder (FASD);
      2. preverbal versus verbal trauma and expression;
      3. brain and nervous system functioning;
      4. social functioning; and
      5. adverse childhood experiences.

Sec. B5.10.400. Village-Based Behavioral Health Services.

This course, which shall be 20 contact hours and be conducted in a seminar format, will require participants to:

1. analyze and discuss contemporary problems and issues associated with providing village-based behavioral health services, including emerging clinical issues, funding, billable services, staffing levels, manpower development, etc.;
2. analyze how to address practice challenges in a village-based setting, including ethical issues, dual relationships, lack of alternative services, isolation, compassion fatigue, counselor burnout, and lack of training and supervision support;
3. recognize the importance of cultural and professional humility; and
4. evaluate strengths and weaknesses of the BHA/P in the area of cultural and professional humility.

Sec. B5.10.405. Challenges in Behavioral Health Services.

This course, which shall be 16 contact hours, will provide an opportunity for trainees to participate in development of specialized service planning for:

1. evaluation, services, treatment, and case management needs of individuals affected by:
   1. experiences such as;
      1. child abuse, domestic violence, elder abuse, sexual assault, or other violence;
      2. alcohol related brain disorder and traumatic brain injury;
      3. disasters, fires, and other traumatic events; and
   2. conditions such as;
      1. fetal alcohol spectrum disorder (FASD;
      2. attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD);
      3. developmental disabilities;
      4. tobacco dependency, especially in patients with medical conditions, such as periodontal disease, pregnancy, diabetes, cardiovascular disease, and lung disease that are affected by tobacco use; and
      5. other health conditions that affect behavior or adjustment; and
   3. participate in the development of specialized service planning to address the needs of clients with these clinical issues; and
   4. using the eBHAM as a resource to work appropriately with clients with overlapping issues.

Sec. B5.10.410. Competencies for Village-Based Supervision.

This course, which shall be 6 contact hours, will provide:

1. information regarding specific cultural issues that affect supervision;
   1. models of culture-specific oral and written communication with supervisees regarding consultation, mentoring, support, and evaluation regarding competencies and administrative performance.

Sec. B5.10.415. Principles and Practice of Clinical Supervision.

This course, which shall be 40 contact hours, will provide:

1. philosophy and practical application approaches to clinical supervision;
2. strategies for facilitating effective participation by supervisees in individualized clinical supervision sessions;
3. information regarding the use of technology (telehealth, real-time interactive e-mail, and other developing capacities) and how it modifies the clinical supervision relationship;
4. guidance regarding how to delineate the difference between mentorship, clinical and administrative supervision, and to identify potential ethical “boundary” issues with supervisees;
5. strategies for providing expectations to the supervisee on how to present client cases to a supervisor in a way that is effective for case review, consultation, and supervision;
6. application exercises in which each trainee will develop a clinical supervision plan that can be used within their individual work environment;
7. evaluating work-related competencies, including;
   1. improving supervisees’ self-assessment skills; and
   2. practice providing feedback both informally, and formally for evaluation of supervisee work performance, and behavior; and
8. documentation of supervision to meet ethical, and credentialing requirements.

Sec. B5.10.420. Child Centered Interventions.

This course, which shall be 20 contact hours, will provide:

1. applied exercises to:
   1. define the counselor role in the playroom;
   2. practice therapeutic approaches to counseling children and interventions for preverbal trauma;
   3. conduct crisis intervention appropriate to children and youth;
   4. increase culturally competent skills;
   5. increase skills associated with assessment and diagnosis and consultation with a treatment team and the client’s family; and
   6. effectively engage and counsel children, youth, and their parents/legal guardians.