10.58.07.02

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "A regionally accredited educational institution" means a college or university that is accredited through a regional accrediting body recognized by the U.S. Department of Education and approved by the Board.

(2) "Alcohol and drug counseling" means assisting an individual, a family, or a group through the client-counselor relationship to:

(a) Develop an understanding of intrapersonal and interpersonal substance abuse problems;

(b) Define goals relating to substance abuse;

(c) Make decisions relating to substance abuse;

(d) Plan a course of action reflecting the needs, interests, and abilities of the individual, family, or group relating to substance abuse; and

(e) Use informational and community substance abuse resources relating to personal, social, emotional, educational, and vocational development and adjustment.

(3) "Approved alcohol and drug counselor supervisor" means:

(a) A licensed clinical alcohol and drug counselor approved by the Board;

(b) A health-care provider:

(i) Licensed under the Health Occupations Article, Annotated Code of Maryland;

(ii) With 3 years of documented experience in alcohol and drug counseling; and

(iii) Approved by the Board;

(c) A certified professional counselor — alcohol and drug, approved by the Board; or

(d) A certified associate counselor — alcohol and drug with 3 years of documented experience in alcohol and drug counseling, and approved by the Board.

(4) "Biopsychosocial evaluation" means a comprehensive assessment of the patient addressing the following areas:

(a) Physical health;

(b) Employment or financial support;

(c) Drug and alcohol use;

(d) Treatment history;

(e) Legal history;

(f) Familial and social relationships;

(g) Educational background; and

(h) Mental health.

(5) "Case management" means the provision of services which assist participants in gaining access to:

(a) The full range of substance abuse services;

(b) Any additional needed medical, social, financial assistance, counseling, educational, housing; or

(c) Other support services, as defined in COMAR 10.09.45.

(6) "Clinical supervision" means that the supervisor:

(a) Controls the supervisees’ work, and provides face-to-face or immediately available supervision;

(b) Evaluates completed work for technical soundness, appropriateness, and conformity to policy and requirements; and

(c) Confirms that all diagnoses are clinically supported by appropriate criteria, as:

(i) Defined in the current editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases and Related Health Problems (ICD); and

(ii) Documented by signature and credentials.

(7) "Close supervision" means that the supervisor:

(a) Closely controls the supervisees’ work, and provides direct, face-to-face, or on-site supervision;

(b) Maintains control through review of case management and progress notes, treatment plan reviews, and other documentation as appropriate;

(c) Evaluates completed work for accuracy, detail, and adherence to instructions and established procedures; and

(d) Reviews and approves content for all diagnostic impressions and new treatment plans, as documented by signature and credentials.

(8) "Co-occurring disorders (CODs)" means the occurrence in any individual, simultaneously or sequentially, of two or more somatic or behavioral health disorders which may imply an interaction between the disorders that affect the course and prognosis of each diagnosis.

(9) "Diagnosis" means the identification of psychological problems, emotional, or mental disorders by a licensed clinician, using specified terms and criteria identified in the current editions of the:

(a) Diagnostic and Statistical Manual of Mental Disorders (DSM); or

(b) International Classification of Diseases and Related Health Problems (ICD).

(10) "Direct supervision" means supervision provided by a supervisor who is present on the premises where services are provided, and is available for consultation within the treatment area.

(11) Face-to-Face.

(a) "Face-to-face" means supervision provided by a supervisor in the physical presence of the individuals involved in the supervisory relationship during either:

(i) Individual or group supervision; or

(ii) Using video conferencing that allows individuals to hear and see each other in actual points of time.

(b) "Face-to-face" does not include:

(i) Telephone supervision;

(ii) Internet communication such as email and social networking websites; or

(iii) Instant messaging that does not involve real-time video conferencing.

(12) "Health and human services counseling field" means a specific degree program with a counseling emphasis, including but not limited to the following areas:

(a) Addictions counseling, including:

(i) Alcohol and drug counseling;

(ii) Substance abuse counseling; or

(iii) Chemical dependence counseling;

(b) Counseling practiced under Health Occupations Article, Title 17, Annotated Code of Maryland, including:

(i) Professional counseling;

(ii) Marriage and family therapy; or

(iii) Art therapy;

(c) Practice areas of other mental health care providers, including, but not limited to:

(i) Psychiatry;

(ii) Psychology;

(iii) Social work; or

(iv) Psychiatric nursing;

(d) Other academic concentrations in the health and human services field, including, but not limited to:

(i) Human services;

(ii) Behavioral health or behavioral sciences;

(iii) Rehabilitation counseling;

(iv) Counselor education;

(v) Counseling psychology; or

(vi) Human development.

(13) "Immediately available supervision" means supervision provided by a supervisor who is instantly available;

(a) In person;

(b) By telephone or other electronic means; or

(c) By designation of one or more supervisors in the absence of the supervisor of record.

(14) "Licensed graduate alcohol and drug counselor" means an individual approved by the Board to practice graduate alcohol and drug counseling under the supervision of an approved alcohol and drug counselor supervisor while fulfilling the supervised clinical experience for licensure under:

(a) Health Occupations Article, §17-302(e), Annotated Code of Maryland; and

(b) Regulation .03 of this chapter.

(15) "Moderate supervision" means that the supervisor:

(a) Controls the supervisee’s work and provides face-to-face or immediately available supervision;

(b) Ensures that completed work and methods used are technically accurate and in compliance with instructions or established procedures;

(c) Provides more intense review for difficult assignments, if the supervisee has not previously performed similar assignments; and

(d) Reviews and approves content for all diagnostic impressions and new treatment plans, as documented by signature and credentials.

(16) Ongoing Process of Supervision.

(a) "Ongoing process of supervision" means that the supervisor is available to provide support for the supervisee’s day-to-day practice of alcohol and drug counseling, throughout the course of the supervisee’s scheduled work hours;

(b) "Ongoing process of supervision" includes, but is not limited to, direct and face-to-face supervision of an individual or a group.

(17) "On-site supervision" means supervision provided by a supervisor who is:

(a) Physically present in the facility where patient or client services are rendered; and

(b) Able to respond in person without delay.

(18) Participating in the development of diagnostic impressions.

(a) “Participating in the development of diagnostic impressions” means gathering information to support a diagnosis through:

(i) Screening and assessment activities;

(ii) Observations of signs and symptoms;

(iii) Reports of behaviors;

(iv) Collateral information acquired with the appropriate release; and

(v) The identification of specific disorders to be ruled out by the diagnosing clinician.

(b) "Participating in the development of diagnostic impressions" does not include diagnosis.

(19) "Practice clinical alcohol and drug counseling" means to engage professionally and for compensation in alcohol and drug counseling and appraisal activities by providing services for individuals, couples, families and groups involving:

(a) The application of counseling principles; and

(b) Methods in the diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions.

(20) "SBIRT" means Screening, Brief Intervention, and Referral to Treatment, including the following practices:

(a) Screening which quickly assesses the severity of substance use and identifies the appropriate level of treatment;

(b) Brief intervention which focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change; and

(c) Referral to treatment which provides individuals identified as needing more extensive treatment with access to specialty care.

(21) "Substance use disorders (SUDs)" means any problematic pattern of substance use leading to clinically significant impairment or distress, which is diagnosed using specified terms and criteria identified in the current editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases and Related Health Problems (ICD).

(22) "Substantially equivalent" means a degree in a program of studies approved by the Board to include, but not be limited to, the following for:

(a) Licensure purposes:

(i) A doctoral degree with a minimum of 90 graduate semester credit hours or 135 graduate quarter hours or a master's degree with a minimum of 60 graduate semester credit hours or 90 graduate quarter credit hours; and

(ii) A minimum of 51 credits in counseling, containing the required alcohol and drug coursework for the license, as specified in Regulation .03B(4) and (6) of this chapter;

(b) Certification at the bachelor’s level:

(i) A bachelor’s degree from a regionally accredited educational institution; and

(ii) A minimum of 45 credits in counseling, including the required alcohol and drug coursework for the level of certification sought, as specified in Regulations .06C(4) and .07D(4), of this chapter;

(c) Certification at the associate’s level:

(i) An associate’s degree from a regionally accredited educational institution; and

(ii) A minimum of 30 credits in counseling, including the required alcohol and drug coursework for the level of certification sought, as specified in Regulations .06C(4) and .07D(4) of this chapter.

(23) "Supervised experience in alcohol and drug counseling" means alcohol and drug counseling services provided under the close or moderate supervision of an approved licensed or certified alcohol and drug counselor supervisor.

(24) Supervision.

(a) "Supervision" means a formalized professional relationship between a supervisor and supervisee that involves:

(i) Directing, guiding, monitoring, instructing, and evaluating the supervisee’s alcohol and drug counseling practice throughout an ongoing process of supervision; and

(ii) Utilizes close, moderate, or clinical levels of supervision.

(b) "Supervision" includes an acceptance of direct responsibility for the patient services rendered by the supervisee, including continuous availability to the supervisee:

(i) In person;

(ii) Through written instructions;

(iii) By telephone or other electronic means; or

(iv) By designation of one or more supervisors in the absence of the supervisor of record as defined in COMAR 10.58.13.

(25) "Trauma informed care" means including in treatment an approach that:

(a) Engages people with histories of physical, sexual, emotional, or mental trauma in a manner that recognizes the:

(i) Presence of a trauma history;

(ii) Consequences of the trauma; and

(iii) Neurological, biological, psychological, and social effects of trauma for the affected individual; and

(b) Addresses the vulnerabilities or triggers for these individuals without causing the trauma to re-occur.

(26) "Under the supervision of an approved alcohol and drug counselor supervisor" means:

(a) Engaging in an ongoing process that includes direct, on-site, face-to-face individual or group meetings focused on quality of delivery of alcohol and drug counseling services; and

(b) Improving counseling skills for a minimum of:

(i) 1 documented hour for each 40-hour work week; or

(ii) Not less than 2 documented hours per month for less than a 40-hour work week.

(27) "Workshop" means a meeting or meetings of general sessions and face-to-face groups with a leader who:

(a) Is an expert in the defined content area; and

(b) Imparts information to participants who have an ample opportunity to interact.