D.C. Mun. Regs. tit. 22, r. 22-A3430

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 22-A3430 - TRAUMA SYSTEMS THERAPY
3430.1

TST is a comprehensive, phase-based model for treating traumatic stress in children and adolescents that adds to individually-based approaches by specifically addressing the child's social environment and/or system of care. TST is designed to provide an integrated highly coordinated system of services guided by the specific understanding of the nature of child traumatic stress. TST focuses on the interaction between the child's difficulties regulating their emotions and the deficits within the child's social environment. The three phases of the model are Safety-Focused, Regulation-Focused, and Beyond Trauma.

3430.2

On average, individual TST sessions are one (1) to three (3) sessions per week, depending on the phase of treatment. Sessions are on average forty- five (45) to sixty (60) minutes in duration.

3430.3

TST is intended for children and youth six (6) through eighteen (18) years of age, who have:

(a) Been exposed to trauma;
(b) Plausible trauma histories;
(c) Difficulty regulating emotional and behavioral states;
(d) Dysregulation that is plausibly related to the trauma history; and
(e) Stable housing or a plan to achieve stable housing in the community.
3430.4

At a minimum, the TST team shall include:

(a) A TST-trained supervisor who provides the clinical and administrative supervision of the TST team. The supervisor shall be an independently licensed qualified practitioner experienced in providing individual, group, marital, or family counseling or psychotherapy;
(b) Access to a psychiatrist to monitor each youth's clinical status and response to treatment, and to direct psychopharmacologic treatment or consult with the consumer's psychopharmacologic treatment team. The psychiatrist shall be knowledgeable in TST ("be TST- informed");
(c) TST-trained therapists who provide individual therapy. Therapists shall hold a Master's degree in psychology, social work, counseling, or other related field and shall be appropriately licensed by the jurisdiction where services are delivered and practice within the scope of their license.
(d) TST-trained individuals who are qualified practitioners of Community-Based Intervention or who are credentialed to provide Community Support to provide crisis support, care coordination, skills building, and TST treatment plan support; and
(e) Individuals who provide Legal Advocacy Support and who are knowledgeable in TST ("are TST- informed").
3430.5

All TST supervisors and therapists shall have completed DBH-approved TST training.

3430.6

Providers of TST services shall maintain certification as a TST provider from a DBH-approved training entity.

3430.7

TST may be provided without prior authorization from the Department.

3430.8

TST shall not be billed on the same day as:

(a) Counseling;
(b) Rehabilitation Day Services;
(c) IDT;
(d) FFT;
(e) ACT;
(f) CPP; or
(g) TF-CBT.
3430.9

TST shall be provided:

(a) At the MHRS provider's service site; or
(b) In natural settings, including the consumer's home or community settings;
3430.10

Qualified Practitioners of TST are:

(a) Psychiatrists;
(b) Psychologists;
(c) LICSWs;
(d) APRNs with psychiatry as a specialty area of practice;
(e) LMFTs;
(f) LPCs;
(g) LGSWs;
(h) LGPCs;
(i) LISWs; and
(j) Psychology Associates.
3430.11

Services provided by qualified practitioners who are subject to supervision requirements, per applicable licensing and registration laws and regulations, shall be supervised by a qualified practitioner who is:

(a) Licensed to practice independently, and
(b) Trained in TST, as required by this chapter's TST requirements.

D.C. Mun. Regs. tit. 22, r. 22-A3430

Final Rulemaking published at 67 DCR 10674 (9/4/2020); amended by Final Rulemaking published at 70 DCR 3050 (3/10/2023), effective date corrected to 4/7/2023, by Errata Notice published at 71 DCR 4474 (4/19/2024).