Place of Performance: Yokota AB, Japan
Licensed Clinical Social Worker, BHOP (Behavioral Health Optimization Program) may be required to function in a specialty mental health clinic or in a patient centered medical home (PCMH) location as a behavioral health consultant (BHC) and/or Behavioral Health Care Facilitator (BHCF).
• Attend and participate in meetings during normal duty hours, professional staff conferences and other appropriate professional activities such as: quality improvement meetings, professional staff meetings, commander's staff meetings, mental health flight meetings, and other meetings required by medical treatment facility (MTF) guidance, or as directed by the Government Representative (GR).
• Responsible for and applies psychological procedures and techniques, including interviewing, behavioral assessment, and evidenced-based therapies, in the evaluation, diagnosis, and treatment of psychological and neuropsychological disorders using the following skills:
a. Individual, family and group psychotherapy, and couples therapy, alcohol and drug treatment evaluations.
b. Maintain satisfactory customer service and patient care relationships as assessed in the Services Summary.
c. Consult with medical personnel, legal authorities, military commanders and school districts, as required.
d. Maintain accurate and current notes in the Mental Health records, inpatient medical records and electronic medical records of all patients seen, as appropriate, and produce reports of evaluation and/or treatment, as required.
a. Participate in military specific training (e.g., training to perform security clearances, use of the Air Force (AF) Guide to Managing Suicidal Behavior, pre-post deployment screening, Post Traumatic Stress Disorder (PTSD) and combat stress) and others as directed by the Functional Requirements Evaluator Designee FRED/GR or AF policy.
b. Participate in and successfully complete Air Force provided Phase I and Phase II BHC training.
c. Attend 5-day Phase I BHC training. This training will be conducted at a military facility within the continental U.S. Scheduling and location of this training will be coordinated by the FRED/GR. All course content will be provided by the Government upon arrival at the location of the training. Successful completion of Phase I BHC training is required before seeing patients in primary care.
d. Attend 2-day Phase II BHC training. Phase II training will require you to demonstrate core competency skills to an expert trainer. This training shall be completed within 90 days upon completion of Phase I training and will be conducted at a military facility within the continental U.S. Scheduling and location of this training will be coordinated by the FRED/GR. The location of this training may be different than the location of the Phase I Training. All course content will be provided by the Government upon arrival to the location of the training. The 90-day threshold for demonstration of core competency skills will be extended if the Air Force is unable to provide training opportunities within 90 days.
e. Phase I and Phase II training courses, along with any training materials associated with this course, will be provided by the Government.
f. Information on installation access will be provided by the FRED/GR or authorized Government representative.
g. Be aware and abide all policies, rules, and laws for the training location(s) to include, but not limited to, personnel and vehicle installation access, security, and safety.
• Provide brief (typically no more than four appointments) cognitive/behavioral interventions in primary care under the Air Force consultation model (i.e., per the Air Force Behavioral Health Optimization Program Practice Manual). Services will mimic the pace of primary care (i.e., patients seen for 15- to 30-minute appointments).
• Efficiently manage appointments (e.g. confirm and clarify consultation issue and obtain initial patient engagement in addressing consultation issue within 60 seconds after completing the introductory script (2 mins or less), complete focused assessment in 15 mins or less for intake appointments, summary and formulation takes 1-3 minutes and occur between the assessment and intervention phase of appointment).
• Use a biopsychosocial approach to assessment, intervention and primary care team feedback (e.g. how a patient’s physical condition, thoughts, emotions, behaviors, and environment are impacting or influencing the identified problem and functioning).
• Use evidence-based interventions appropriate for a primary care setting (e.g. self-management skills or home-based practice for relaxed breathing and eating behavior changes).
• Base interventions on measurable, functional outcomes and symptoms reduction (e.g. improved ability to work, improved performance on responsibilities at home, increased frequency or improved quality of social interactions) that are collaboratively developed with the patient.
• Teach patient self-management skills as a primary strategy to decrease symptoms and improve function (e.g. activity pacing to manage chronic pain exacerbation).
• Stay on time when conducting consecutive appointments (e.g. if one appointment runs 5 mins long, shorten future appointments in order to maintain schedule).
• Use follow-up intervals that are appropriate for a primary care setting (e.g. every 2-4 weeks).
• Provide interventions for most common mental health and medical conditions in primary care, recommending specialty mental health care only when indicated.
• Offer a minimum of one class per quarter with a format appropriate for primary care (e.g. sleep enhancement class, relaxation class, drop-in stress management class, group medical visit for chronic condition, classes consistent with any of the IBHC clinical pathways).
• Clearly and concisely provide assessment results and feedback to PCMs in 3 minutes or less and include specific recommendations for PCM’s course of action with a patient. Provide feedback to the PCM on same day as the patient visit for a majority of appointments when PCM is in the clinic on that day.
• Deliver brief presentations/trainings to primary care team members regarding behavioral health issues and BHC services.
• Participate in team efforts to develop, implement, evaluate, and revise clinical pathway programs needed in the clinic.
• Consult with medical personnel, legal authorities, and military commanders as required.
• Contact referred patients to assess treatment adherence.
• Use validated symptom inventories to assess current symptom severity. (e.g. Behavioral Health Measure -20).
• Assess barriers to treatment adherence and help patient problem-solve solutions to barriers.
• Provide patients with education regarding their mental health condition and treatment regimen.
• Maintain patient information in a patient registry through AHLTA (Armed Forces Health Longitudinal Technology Application).
• Maintain accurate and current notes in the electronic medical records of all patients contacted for review by the managing physician.
• Routinely staff difficult cases with the referring provider, behavioral health consultant and/or psychiatry consultant.
• Perform case management functions, staffing with other providers, medication referrals and other referrals as needed.
• Prepare all documentation to meet or exceed established standards of the MTF. Provide concise, clear notes in the EMR free of psychological or psychiatric jargon. Focus on referral problem, frequency, duration, functional impact and specific recommendations for change. Document the majority interactions with or about the patient in the EMR by the end of the clinic day on which the patient is seen or within 24 hours of patient’s appointment. If suicide risk becomes apparent (e.g. positive answer on screening questionnaires or verbal self-report) the IBHC must conduct risk assessment and crisis planning comparable to that which would be accomplished in the specialty mental health clinic and document the encounter on the same day. All notes must be completed, without exception, within 72 hours of the patient appointment in order to meet the established standards of the MTF.
• Guidelines are as outlined in the “Operating Instructions of the MTF” to include but not limited to: timeliness, legibility, accuracy, content and signature. Only MTF and Air Force approved abbreviations may be used to document care in the health care record. Ensure complete patient identifying information is on all documentation that is to become part of a health care record.
• The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment).
• Make every attempt to complete all reports for the day by Close of Business (COB). In case some reports are not able to be completed by COB, complete them as quickly as possible, to the maximum extent practicable, but shall not complete them later than 72 hours after each appointment/session. The Government will evaluate the quality and timeliness and notations as stated above.
• Must hold a Master of Social Work (M.S.W.) degree from a graduate school of social work fully accredited by the Council on Social Work Education (CSWE).
• Must have current, unrestricted clinical license to independently practice social work in any one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.
• Must maintain currency of continuing medical education, certification(s), health requirements, Basic Life Support (BLS)/Advanced Cardiac Life Support (ACLS) and initial/annual training completion records.
• Minimum of two (2) years within the past five (5) years in the independent practice of clinical social work in a mental health setting working with an adult population, or with children and teens if specifically working with that population.
• Should have experience and demonstrated competence with Electronic Medical Records and preferably have experience with Armed Forces Health Longitudinal Technology Application (AHLTA).
Skills and Knowledge:
• TOEIC score of at least 860 or equivalent certificate is required for non-native English speakers.
• Has basic knowledge of psychopharmacological agents (e.g. can name commonly used anxiety and antidepressant medication, appropriate dose and first line recommendations for a specific symptom presentation).