Section 440IAC10-4-6. Counseling services

   (a) The objective for opioid addiction treatment is to improve the overall functioning of patients through the provision of opioid treatment medication at medically appropriate levels. In addition, counseling services shall be provided to support the following:

(1) A patient's elimination of illicit drug use and other destructive behaviors.

(2) The elimination of a patient's opioid treatment medication as medically appropriate.

(3) Establishing a sound basis for a patient's ongoing recovery after treatment is concluded.

  (b) Key goals for the patient shall include, but not be limited to, the following as appropriate to the individual patient:

(1) The elimination of the following:

(A) The use of illicitly obtained prescription opioid drugs.

(B) The illicit use of nonprescription opioid drugs.

(C) The illicit use of drugs other than opioids.

(D) Criminal behavior.

(E) Behavior related to the spread of infectious diseases.

(F) Alcohol abuse.

(2) An improvement in the following:

(A) Education or vocational training.

(B) Employment status.

(C) Family and other social relationships.

  (c) An OTP shall use the following:

(1) A structured approach in providing treatment and recovery-oriented services.

(2) Established criteria for determining patient progress.

  (d) Factors relevant to a patient's progress in treatment shall include, but not be limited to, the following:

(1) Absence of the abuse of alcohol and the use of other drugs, except as medically prescribed.

(2) Stable:

(A) social;

(B) vocational;

(C) legal;

(D) family;

(E) emotional; and

(F) behavioral;

functioning.

(3) Program attendance as scheduled by the OTP in the individualized treatment plan.

(4) Other individual goals identified in the patient's individualized treatment plan.

  (e) An OTP shall provide counseling services, including individual, group, and family counseling.

  (f) Counseling topics shall include, but not be limited to, the following:

(1) Health education and stabilization on opioid treatment medication.

(2) The patient's need for mental health services and other social services, as well as referral resources for those services.

(3) Encouraging the involvement of:

(A) family members;

(B) significant others; and

(C) supportive persons;

in the patient's recovery process.

(4) Preventing exposure to, and transmission of, the following:

(A) Hepatitis C.

(B) Tuberculosis.

(C) HIV/AIDS.

(D) Other sexually transmitted and communicable diseases.

(5) Employment.

(6) Further education or vocational training.

(7) Family dynamics.

  (g) Counseling services shall include the provision of the following:

(1) A comprehensive substance abuse assessment using a standardized addiction assessment instrument.

(2) Individualized treatment planning.

(3) Periodic treatment plan review.

(4) Interactions with the patient to assist the patient in reaching the patient's goals for recovery.

(5) Case management.

(6) Aftercare planning including the following:

(A) Referrals to recovery support services for the patient.

(B) Postdischarge sessions with an OTP counselor in support of continued recovery.

  (h) Based on the patient's time in treatment, counseling shall be provided on the following schedule:

(1) During the first three (3) months of treatment, at least four (4) hours of counseling per month, of which at least two (2) hours shall be in individual counseling.

(2) From three (3) months to six (6) months in treatment, at least two (2) hours of counseling per month, including one (1) hour of individual counseling.

(3) From six (6) months to one (1) year in treatment, at least one (1) hour of counseling per month.

(4) After one (1) year in treatment, based on the results of drug testing and other relevant indicators, the counselor shall determine the following:

(A) The patient's need for counseling.

(B) The frequency of counseling.

(Division of Mental Health and Addiction; 440 IAC 10-4-6; filed Dec 30, 2009, 2:00 p.m.: 20100127-IR-440080412FRA; readopted filed May 10, 2016, 11:24 a.m.: 20160608-IR-440160134RFA)