Current through Register Vol. XLI, No. 50, December 13, 2024
Section 69-7-31 - Counseling31.1. Each opioid treatment program shall provide substance abuse counseling to every patient as is clinically necessary. Counseling sessions should encourage and guide the patient to a lifestyle that that does not include abuse of prescribed or illicit medications, drugs or other substances.31.2. The counseling shall be provided by a counselor, qualified by education, training or experience to assess the psychological and sociological background of patients, to contribute to the appropriate individualized treatment plan for the patient, and to monitor patient progress. The primary counselor shall develop and implement the psychological and social portions of the patient's individualized treatment plan of care, in coordination with the medical staff. The individualized treatment plan of care shall address the social, environmental, psychological, social and familial issues relative to recognizing, correcting and eliminating the individual's maladaptive patterns of drug consumption and other high risk and/or destructive behaviors.31.3. The primary counselor is responsible for assisting the patient in altering life styles and patterns of behavior in order to improve the individual's ability to function adaptively in his or her family and community. Counseling shall address the social, environmental, psychological and familial issues that contribute to the individual's maladaptive patterns of drug consumption and other high risk and/or destructive behaviors.31.4. Each opioid treatment program shall provide counseling on matters indirectly related to substance addiction, including, but not limited to: 31.4.a. Preventing exposure to, and the transmission of, HIV disease and Hepatitis C disease for each patient admitted or readmitted to maintenance or detoxification treatment; and31.4.b. Domestic violence, sexual abuse and anger management.31.5. Each opioid treatment program shall develop and implement policies which ensure that single sex groups and/or same sex counselors will be available to all patients, as needed and clinically indicated.31.6. Each opioid treatment program must provide directly, or through referral to adequate and reasonably accessible community resources, vocational rehabilitation, education, and employment services for patients who either request such services or who have been determined by the program staff to be in need of such services.31.7. Ratios of primary counselor to persons served shall be adequate to allow sessions to occur as described in this subsection and to allow persons served access to their primary counselor if more frequent contact is merited by need or is requested by the patient. The ratio of individual and group therapy sessions must be individually determined by the specific needs of the patient. The clinical staff caseload ratio shall: 31.7.a. Reflect an appropriate clinical mix of sex, race and ethnicity representative of the population served;31.7.b. Allow the program to provide adequate psychosocial assessments, treatment planning and individualized counseling; and31.7.c. Allow for regularly scheduled, documented individual counseling sessions.31.8. Counseling sessions shall be provided according to generally accepted best practices and shall be offered: 31.8.a. At least weekly during the first ninety days of treatment;31.8.b. At least twice per month during the remainder of the first year of treatment; and31.8.c. At least monthly thereafter.31.9. The counseling program shall provide for mandatory and documented weekly counseling of any patient who has a positive drug test and is required by §41.3 of this rule to undergo additional counseling. The counseling sessions shall be no less than thirty minutes to a patient with a counselor who is licensed, certified or enrolled in the process of obtaining licensure or certification. The mandatory counseling sessions may consist of group counseling sessions. However, the patient must attend at least one individual, private session per month. 31.10. Exceptions to frequency of counselor to patient contact shall be clearly justified by program documentation. The program physician or prescribing professional evaluating the patient's eligibility for take-home doses shall carefully consider the patient's participation in the counseling sessions and the patient's current phase in treatment as factors in the decision. A justified lack of participation (such as for reasons of employment) shall not be held against the patient in the take-home decision.