UTAH STATE STANDARDS FOR BATTERER INTERVENTION PROGRAMS
OUTPATIENT TREATMENT SERVICES

Policy #603

1. Victim/Children Treatment:

Individual and/or group counseling services shall be made available to assist a victim whether sheltered or not. Appropriate counseling services shall be provided to dependent children while in the shelter. Domestic violence victims and their dependent children are eligible for outpatient treatment services whether sheltered or not.

a. Programs providing victim or children treatment services shall comply with the Department of Human Services Licensing Manual Standards Section C-IV, Outpatient Treatment Standards.

b. Individuals providing victim or children treatment services shall be licensed in accordance with the Mental Health Professional Practice Act (UCA 58-60).

c. Treatment is not time limited, however, cases shall be reviewed and need for continued service documented in six month periods of service.

d. Client needs for psychiatric consultation, or treatment for substance abuse or other co-occurring diagnoses, when indicated and documented in the case file, shall be addressed by the treatment provider through appropriate referral or by limited integration of such condition(s) into the domestic violence treatment process, in compliance with the provisions of Policy #603, item 3.a. of this manual.

e. Couple counseling shall not be utilized until an assessment has been conducted which indicates the victim is at low risk for endangerment of further abuse due to the counseling. The assessment shall, at a minimum, document that the abuser is taking responsibility for his behavior and that all forms of physical abusive behavior have stopped. In addition, it shall document that the victim is not taking responsibility for the abuser's behavior, and has acquired sufficient assertiveness skills to state her needs in the relationship. This section does not preclude brief meetings conducted jointly with the victim and the perpetrator for the purpose of explaining or informing the parties about such matters as program procedures, behavioral contract provisions or anger management techniques.



2. Perpetrator Treatment:

Domestic violence perpetrator treatment shall be made available to court ordered and voluntarily participating perpetrators of domestic violence defined in Policy #601, item 3 of this manual.

a. Providers of domestic violence perpetrator treatment shall comply with the Department of Human Services Licensing Standards, Section C-IV, Outpatient Treatment Standards.

b. Individuals providing domestic violence perpetrator outpatient treatment services shall be licensed in accordance with the Mental Health Professional Practice Act (UCA 58-60).

c. Programs shall not provide couple counseling, nor include a perpetrator and victim in the same therapy group until an assessment has been conducted which indicates the victim is at low risk for endangerment of further abuse due to the counseling. The assessment shall utilize, at a minimum, the same criteria as of this manual.

d. Client needs for psychiatric consultation, or treatment for substance abuse or other co-occurring diagnoses, when indicated and documented in the case file, shall be addressed by the treatment provider through appropriate referral or by limited integration of such condition(s) into the domestic violence treatment process, in compliance with the provisions of of this manual.

e. Department of Human Services contract providers or DFS treatment staff shall additionally:

1) Maintain in individual client files assessments and individual treatment plans that comply with Section C-IV-E (2) of the Department of Human Services Licensing Standards.

2) Perpetrator treatment cases shall be reviewed and renewed in three month periods of service. Documentation of the three month review of progress and renewed treatment goals and methods shall be written at the three month service review.



3. Division of Family Services Contract Billing:

a. It is intended that domestic violence contract funds be used to pay for treatment services in which the primary focus is the treatment of domestic violence. However, it is acknowledged that many domestic violence perpetrators and victims have co-occurring psychiatric diagnoses which may be appropriately addressed, by limited integration into the treatment plan by the provider, or by referral. If these issues are integrated into the treatment plan, they may not dominate treatment. Additionally, they must be consistent with the assessment and the diagnosis.

b. Domestic violence contract funds are not to be billed for alcohol/drug abuse treatment, general counseling or marriage counseling.

c. Treatment providers shall conduct a client income verification and document that an appropriate sliding fee schedule was utilized to bill 1st and 3rd party payments prior to billing the balance to the DFS Domestic Violence Fund. Only first party fees may be waived for victims whose cohabiting partner is also undergoing treatment in the same program.


SECTION C: CATEGORICAL STANDARDS

4. Out Patient Treatment Programs:

A. Definition: Outpatient Treatment Program means individual, family, or group therapy or counseling designed to improve and ' enhance social or psychological functioning for those consumers whose physical and emotional status allows them to continue functioning in their usual living environment. (62A-101-12 U.C.A.)

B. Purpose: Outpatient Treatment shall serve consumers who need a less structured program than do consumers in Day Treatment or Residential programs. Consumers live independently, but are provided c ounseling at least one hour per month not to exceed two hours per session.

C. Program:

1. All outpatient treatment programs shall comply with the Office of Licensing general provisions and core standards.

2. Outpatient treatment plans are developed based on assessment and evaluation of individual needs. The treatment is consultative and may include medication management.

3. Treatment plans shall be reviewed and signed by the clinical supervisor quarterly at a minimum.

D. Staffing: Professional staff shall include:

1. Mental Health:

a. a licensed physician, or a consulting licensed physician,

b. a licensed psychologist, or a consulting licensed psychologist,

c. a certified or clinical social worker,

d. a registered nurse with advanced training or experience in psychiatric nursing,

e. a licensed social service worker, or licensed practical nurse, and

f. a person with a graduate degree in counseling or psychology with the appropriate training and experience.

g. Unlicensed staff trained to work with psychiatric consumers shall be supervised by a licensed professional.

2. Substance Abuse:

a. a licensed physician or consulting licensed physician,

b. a certified or licensed clinical social worker, or, consulting certified or licensed clinical social worker,

c. a licensed or consulting licensed psychologist, and
d. other licensed professionals or consultants with training to work with substance abusers.

e. Unlicensed staff trained to work with substance abusers shall be supervised by a licensed professional.

3. Domestic Violence outpatient Perpetrator Treatment (see glossary for definition):

a. a licensed physician or a consulting licensed physician; or

b. a licensed psychologist, or a consulting licensed psychologist;. or

c. a' licensed clinical social worker, or a consulting licensee. clinical social worker; or

d. a licensed psychiatric nurse or a consulting licensed psychiatric nurse; or

e. a licensed marriage and family ..therapist or a consulting marriage and family therapist.

f. Also, a person with a graduate degree in counseling, psychiatric nursing, marriage and family therapy, social work or psychology and at least one year of continual, full time related experience, or a graduate student training for one of the above degrees who is engaging in said work to satisfy placement requirements. Both of the above shall practice under the direction and supervision of a licensed clinical professional qualified as per paragraphs a. through e. above.

g. A licensed social services worker with at least three years of continual, full time, related experience, when practicing under the direction and supervision of a licensed clinical professional may Co facilitate a group or -individual therapy session with a person qualified as per paragraphs a. through e. above.

h.- The clinical supervisor of a domestic violence treatment program shall meet requirements listed in one of the paragraphs a. through e. above.

Direct Service:
1. Mental Health and Substance Abuse Programs;

An individual, a group, a couple, or a family counseling session shall be provided to the consumer at least monthly. This service shall coincide with the personalized treatment plan. A consumer's record file shall document, in progress notes, the date of session and signature of counselor.

The program may allow the counselor/therapist to provide a treatment session less frequently than once a month, however, this action shall be justified in the consumer's record and cleared by the clinical supervisor.

2. Domestic violence perpetrator treatment programs shall comply with the following requirements:

a. Maintain and document cooperative working relationships with domestic violence shelters, victims and/or current partners, and victim treatment programs, referring courts and local domestic violence coordinating councils (if available).

b. Treatment sessions for each perpetrator will be provided for at least one hour per week for a minimum of twelve weeks. Treatment shall comply with generally accepted practices in the current domestic violence literature.

c. Conduct at intake an in-depth, face to face client -interview and assessment to determine the perpetrator's clinical profile and treatment needs. Additional assessment information shall be obtained from the police incident report perpetrator's criminal history, prior treatment providers, and/.or the victim, when available. Information from the victim shall be obtained and used in such a way that does not blame or endanger the victim. In addition to the intake guidelines listed in the Core Standards (section VI. C.) the assessment will include the following:,

a profile of the frequency, severity and duration of the domestic violence behavior,

2) an evaluation of the perpetrator's potential for further violence toward self or others, ' including risk factors for homicide, suicide and/or child abuse, and

3) a mental status assessment and clinical impressions, a psychiatric evaluation, if indicated.

d. Assessment information shall be used to compile an individualized treatment plan for remediating the abusive behavior and related problems. Perpetrators who are not deemed appropriate for domestic violence treatment, due to a primary problem of substance abuse, severe psychiatric dysfunction, language barriers or other reasons, shall be referred back tothe court for alternative disposition.

e. Couple or family therapy shall not be provided until a risk assessment has been conducted to determine that the therapy will not expose the victim or dependent children to risk of intimidation or further abuse.

f-.-Have written procedures for notifying referring courts to facilitate timely court sanctions for perpetrators who fail to contact the treatment program, drbp out prematurely, fail to comply with attendance or other treatment program requirements, or engage in further domestic violence behaviors.

g. Comply with the Utah :Duty to Warn" statute in order to protect domestic violence victims from further violent acts.

h. Document specialized training in domestic violence assessment and treatment practices for all individuals providing treatment services, including 24 hours of pre-service training and 16 hours of training annually thereafter.

i. clinical supervision for treatment staff shall consist of a minimum of weekly face to face contacts with the clinical supervisor to discuss clinical dynamics of cases. The clinical supervisor shall be available for case consultation when requested by treatment staff.