Mental Health Rehabilitation Technician/Crisis Service Provider (MHRT/CSP)


The MHRT/Crisis Service Provider (MHRT/CSP) certification is for individuals who provide Crisis Resolution Services to adults and/or children in Maine.

The MHRT/CSP certification meets the MaineCare requirements for providing specific Crisis Resolution Services. These services are outlined in the MaineCare Benefits Manual, Chapter II, Section 65-06-1 and include all components of the following considered appropriate to the provision of emergency and crisis mental health care, to include co-occurring mental health and substance abuse conditions on a twenty-four (24) hour, seven (7) day a week basis. Crisis workers provide the following services:

  • Screening
  • Assessment
  • Evaluation
  • Intervention
  • Disposition

There are a variety of ways to meet the requirements for MHRT/CSP certification, including reading, completing, and testing out on modules from the Crisis Training Curriculum. All individuals must have a degree in order to obtain MHRT/CSP certification. Authorized agencies work with their own employees to determine each applicant’s qualifications.

Certification Procedural Guidelines

You can download a printable copy of these Guidelines in the following formats:

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If you do not have Adobe Acrobat, you may download a copy from the Adobe Website.


A Letter from Former OAMHS Director, Ron Welch, and CBHS Director, Joan Smyrski

(Adobe Version also available)

June 30, 2011

Dear Colleagues:

Attached you will find the 2011 Procedural Guidelines for Mental Health Rehabilitation Technician/Crisis Service Provider (MHRT/CSP) Certification. We trust that these guidelines will be a very useful resource to crisis service providers. This comprehensive booklet offers a clear and detailed explanation of how one may earn the MHRT/CSP certification—the certification required for individuals providing Crisis Resolution Services for adults and/or children in Maine.

As you know, the transition to MHRT/CSP started on April 1, 2007, when all new hires were required to be certified as a MHRT/CSP prior to providing Crisis Resolution Services. This was followed by an April 1, 2008, deadline for all existing Crisis Resolution staff to become MHRT/CSP certified. The publication of this booklet reflects the final step in establishing the certification infrastructure for MHRT/CSP.

While you can read the history of the development of this certification in the introduction of this booklet, we would like to touch briefly on that topic and give credit where credit is due. The Maine Crisis Network, an organization of crisis service providers in Maine, worked for many years to develop the Crisis Training Curriculum, and continues to work in tandem with DHHS and the Muskie School to make the training available statewide. The Maine Crisis Network took on this task, and continues this work, because of their commitment to high quality, standardized training for Maine’s crisis workers. They are to be commended for their dedication to their profession and to the people of Maine.

Sincerely,

Ron Welch, Director
Office of Adult Mental Health Services 

Jan Smyrski, Director
Children’s Behavioral Health 

The Joint Hospital and Crisis Service Providers, a stakeholder group that started meeting in December 2000, examined the multi-faceted aspects of hospital and crisis services with a goal of increasing the effectiveness of services for individuals with psychiatric disabilities. These meetings became known as the “Initiative Meetings” and one of their priorities was identifying necessary training for Maine’s crisis workers.

Providers of crisis services then formed the Maine Crisis Network (MCN) that focused on the development of a standardized level of competency among crisis service providers working in the adult and/or children’s mental health system in the state. Since there was shared recognition that the required training for Mental Health Rehabilitation Technician/Community (MHRT/C) certification did not adequately address the competencies necessary for crisis workers to perform effectively in their roles, the MCN decided to collectively develop their own curriculum in collaboration with DHHS. In 2003, the Maine Crisis Network (MCN) completed the 13-module Crisis Training Curriculum (CTC) that was then reviewed and approved by the Department of Health and Human Services-Office of Substance Abuse and Mental Health Services (DHHS-SAMHS) and DHHS-Children’s Behavioral Health Services (DHHS-CBHS). This Crisis Training Curriculum was designed to provide high quality, standardized training and certification for crisis workers.

In April 2007 the Mental Health Rehabilitation Technician/Crisis Service Provider (MHRT/CSP) certification program replaced the MHRT/C certification requirement for individuals providing crisis resolution services for adults and/or children. These Procedural Guidelines for MHRT/CSP Certification reflect the standards established by the Maine Crisis Network, and approved by DHHS, for providers of crisis resolution services.

2003: The Maine Crisis Network developed a 13-module Crisis Training Curriculum in collaboration with DHHS.

February 2007: The DHHS-Office of Substance Abuse and Mental Health Services (SAMHS) and Office of Child and Family Services (OCFS) announced the establishment of the MHRT/Crisis Service Provider certification. The Maine Crisis Network and DHHS agreed that satisfactory completion of the Crisis Training Curriculum met and/or exceeded the requirements necessary for a trainee to become eligible for the MHRT/Crisis Service Provider credential, given that other requirements have been met. (Specific MHRT/CSP certification requirements will be described later in this manual.)

April 1, 2007: DHHS set forth requirements that all staff that were hired prior to April 1, 2007, providing Crisis Intervention and/or Crisis Resolution Services must demonstrate competency in crisis practice by successfully completing the Crisis Training Curriculum module tests and earning the MHRT/CSP certification.

DHHS set forth the following requirements: Starting April 1, 2007, all new hires providing crisis intervention and/or crisis resolution services to adults and children, must be certified as a Mental Health Rehabilitation Technician/Crisis Services Provider (MHRT/CSP) prior to providing crisis services in the state of Maine. The MHRT/C no longer meets the requirements for these crisis services.

August 2007: The Muskie School’s Center for Learning (CFL) compared the Crisis Training Curriculum to the MHRT/C competencies to determine reciprocity. Based on that analysis, individuals with Full MHRT/C Certification and a relevant degree must complete all core modules. Individuals who have a MHRT/C, and do not have a relevant degree, must complete all core modules and test out of non-core modules.

Those who earned MHRT/CSP certification before April 1, 2014 can qualify for a Provisional MHRT/C Level B certificate. Those with the MHRT/CSP may earn the Full MHRT/C by completing the Case Management and Vocational Aspects of Disability course requirements. These requirements cannot be waived.

NOTE: Effective April 1, 2014, individuals with MHRT/CSP certification no longer qualify for the Provisional MHRT/C, Level B certificate due to some changes in the Crisis Training Curriculum. However, the requirements remain the same for those with Full MHRT/C certification who wish to earn the MHRT/CSP certificate.

A. Maine DHHS Office of Substance Abuse and Mental Health Services (SAMHS) and Office of Child and Family Services (OCFS)

The SAMHS and OCFS have responsibility for ensuring that all crisis resolution workers possess the competencies necessary to provide quality services, and the MHRT/CSP certification program operates in a fair and equitable manner. The SAMHS and OCFS have assigned responsibility for administering the MHRT/CSP certification program to the Muskie School’s Center for Learning.

B. The Center for Learning (CFL)

The Muskie School’s Center for Learning serves as the SAMHS and OCFS designee to administer the MHRT/CSP certification program. This includes reviewing applications from authorized agencies, and approving or denying these requests. CFL issues certificates to authorized agencies so that they can be distributed to employees. CFL also maintains a database to track certification information.

Note: The Center for Learning distributes certificates to authorized agencies only, and not to individual applicants.

The Center for Learning will collaborate with SAMHS and OCFS to develop and implement a quality assurance plan. The MHRT/CSP quality assurance program may consist of visits to authorized agencies in order to ensure thoroughness and accuracy of record keeping for certification procedures.

C. Maine Crisis Network (MCN)

The Maine Crisis Network serves as the conduit of information for the crisis system of Maine. Each agency has representation as part of the Network. The Maine Crisis Network members have put forth great efforts to learn from consumer feedback and needs. Systemic trends, current research, and considerable experience of the Network members have assisted them to offer more supportive, efficient, and clinically targeted services to Maine’s communities. Much time and effort has been spent by members of the MCN to create the Crisis Training Curriculum for the betterment of the behavioral health community in the state of Maine. The role of the MCN includes: continually reviewing and refreshing the curriculum and the Train-the-Trainer’s manual, maintaining a group of certified crisis trainers, and working in conjunction with the Department of Health and Human Services, Office of Substance Abuse and Mental Health Services, Office of Child and Family Services, and the Muskie School’s Center for Learning (CFL.)

D. Authorized Agencies

Certain agencies that provide crisis services to children and adults have been authorized by DHHS to fulfill responsibilities related to MHRT/CSP training and certification. Authorized agencies maintain documentation that reflects the employee’s MHRT/CSP qualifications and certification. This documentation includes copies of the applicant’s clinical license or credentials (if relevant), degree and transcripts, descriptions of relevant work experience and copies of MHRT/C Certification (if relevant), MHRT/CSP test scores and test dates, dates of completed training, applications for MHRT/CSP certification, as well as copies of MHRT/CSP certificates.

Authorized agencies apply for MHRT/CSP certification by submitting a standard application to CFL. These authorized agencies apply on behalf of their employees who are seeking MHRT/CSP certification. Authorized agencies give the original MHRT/CSP certificate to the individual who has earned the certification. Individuals can then provide a copy of their certificate to any agency provider who hires them as a MHRT/CSP thereafter.

Agencies keep a copy of all MHRT/CSP certificates for their records. If individuals lose their MHRT/CSP certificate and need a copy for their new employer, they can approach the original agency provider who issued their MHRT/CSP certificate to request a copy. If the original agency provider no longer has access to the employee’s MHRT/CSP certificate, the individuals can request a copy of their MHRT/CSP certificate from CFL.

Authorized agencies will be involved with ongoing quality assurance processes. This may include preparing employee records of those who have been certified as a MHRT/CSP to be reviewed by a quality assurance team at the request of SAMHS and/or OCFS.

A. MHRT/Crisis Service Provider Defined

The Mental Health Rehabilitation Technician/Crisis Service Providers certification (MHRT/CSP) is designed for individuals in DHHS-funded positions who provide crisis resolution services in the state of Maine.

There are a variety of ways to meet the requirements for MHRT/CSP certification, including reading, completing, and testing out on modules from the Crisis Training Curriculum.  All individuals must have a degree in order to obtain MHRT/CSP certification. The ways of acquiring MHRT/CSP certification are based on whether applicants have a full or conditional clinical license, relevant degree, relevant experience, and/or MHRT/C certification. There are also ways to meet MHRT/CSP certification requirements by having a degree that is not relevant. Specific information related to how to qualify for MHRT/CSP certification can be found on pages 9-14.  Authorized agencies work with their own employees to determine each applicant’s qualifications.

B. Scope of Practice for MHRT/CSP: Crisis Resolution Services

The MHRT/CSP certificate meets the MaineCare requirement for providing specific Crisis Resolution Services. Those services include all components of screening, assessment, evaluation, intervention, and disposition commonly considered appropriate to the provision of emergency and crisis mental health care, to include co-occurring mental health and substance abuse conditions (as outlined in the MaineCare Benefits Manual, Chapter II, Section 65-06-1).

As of April 1, 2007, all new hires providing crisis resolution services to adults and/or children must be certified as a Mental Health Rehabilitation Technician/Crisis Services Provider (MHRT/CSP) prior to providing services. The MHRT/C no longer meets the requirements for this service.

Note: Any future changes in MaineCare regulations that are pertinent to Maine’s crisis service providers could influence MHRT/CSP certification requirements.

C. Modules

There are two different kinds of training modules for MHRT/CSP certification: core and non-core. The core modules are those elements of the curriculum that address competencies absolutely key to crisis work. The non-core modules are no less important, as these provide the crisis worker with the knowledge base and foundational knowledge necessary to effectively deliver crisis services.

The training modules required for MHRT/CSP certification are as follows:

Module 1: Values and Attitudes (Core)
Module 2: Theories of Human Development (Non-Core)
Module 3: Psychosocial Rehabilitation (Non-Core)
Module 4: Crisis Theory and Principles of Crisis Management (Core)
Module 5: Safety (Core)
Module 6: Crisis Assessment (Core)
Module 7: Crisis and Trauma (Core)
Module 8: Crisis & Co-Occurring Disorders (Non-Core)
Module 9: Crisis Intervention (Core)
Module 10: Consultation and Collaboration (Non-Core)
Module 11: Legal and Ethical Issues (Core)
Module 12: Hospitalization (Core)
Module 13: Documentation (Non-Core)

D. Knowledge Competencies

Each module for MHRT/CSP certification has its own set of specific competencies. The knowledge competencies are listed under each module. Maine’s crisis workers must master these competencies in order to obtain MHRT/CSP certification.

Values and Attitudes
(Core Module)

  • Ability to make non-judgmental assessments and interventions
  • Ability to accept differences in values and behaviors
  • Ability to recognize the dynamics of transference and counter-transference
  • Ability to seek supervision around transference and counter-transference
  • Ability to maintain clear and professional boundaries
  • Ability to understand the importance of self-awareness in the provision of clinical work
  • Ability to understand the need for good self-care practices
  • Ability to recognize how the stigma associated with mental illness impacts crisis work

Theories of Human Development 
(Non-Core Module)

  • Ability to recognize how theories of human behavior can help explain behavior
  • Ability to integrate various theories into a flexible but practical approach to intervention
  • Ability to understand the application of theoretical knowledge in everyday situations

Psychosocial Rehabilitation
(Non-Core Module)

  • Implement the three phrases of the Psychosocial Rehabilitation process
  • Understand the cultural diversity as part of the planned strategies for service intervention
  • Implement the individual support planning process.
  • Operationalize Psychosocial Rehabilitation Principles

Crisis Theory and Principles of Crisis Management
(Core Module)

  • Ability to deal with emotionally laden issues and situations, using a realistic and relational approach
  • Ability to comprehend and apply theoretical material in crisis situations
  • Ability to differentiate between the need for crisis intervention vs. the need for traditional therapeutic approaches
  • Effectively communicate with persons who are in distress
  • Ability to assess stress in self and others

Safety
(Core Module)

  • Knowing the agency’s protocols for safety
  • Being responsible for identifying risk factors and
  • potentially dangerous situations
  • Being familiar with emergency resources (such as police, ambulance, back-up personnel, and so forth) and how to access them when needed
  • Being aware of the effects and aftermath of dangerous and traumatic situations

Crisis Assessment
(Core Module)

  • Ability to effectively listen and communicate
  • Conduct an effective assessment interview
  • Complete the process of a mental status evaluation
  • Evaluate risk of harm to self and/or others
  • Evaluate co-morbidity
  • Evaluate treatment and recovery history
  • Evaluate the client’s recovery environment
  • Evaluate the client’s level of engagement
  • Make a preliminary diagnosis of clients in crisis
  • Offer an outcome recommendation
  • Complete a CALOCUS/LOCUS
  • Administer a Mental Status Examination

Crisis and Trauma
(Core Module)

  • Integrate their knowledge about the scope of traumatic experience in the general population to the crisis population
  • Work with clients from a Trauma Framework
  • Assist a client in grounding/orientation, emotional regulation from a trauma-informed viewpoint
  • Understand how a client’s historical traumatic experience may shape their current behavior and perceptions
  • Intervene with clients utilizing trauma-informed skills and interventions
  • Maintain appropriate boundaries and integrate purposeful self-care to prevent vicarious traumatization

Crisis and Co-Occurring Disorders
(Non-Core Module)

  • Ability to effectively assess for co-morbid substance use disorders
  • Ability to identify predominately substance use versus mental heath disorders
  • Ability to differentiate the stages of change and motivational coping skills to effectively assist dually diagnosed clients in crisis
  • Effective communication with intoxicated and resistant clients in crisis through the use of cognitive-behavioral and motivational interviewing strategies

Crisis Intervention
(Core Module)

  • Develop a Plan of Action utilizing assessment tools such as the LOCUS/CALOCUS
  • Explain the intervention plan to the client/ family/ significant others
  • Facilitate coordination of care and services across systems and follow up as deemed clinically appropriate

Consultation and Collaboration
(Non-Core Module)

  • Identify when to use a consultant
  • Demonstrate expertise in conducting and documenting collaborative communications as part of the assessment
  • Demonstrate expertise in conducting and documenting consultation communication and recommendations
  • Demonstrate knowledge and understanding of LOCUS and CALOCUS assessment of level of care system

Legal and Ethical Issues in Crisis Work
(Core Module)

  • Ability to comprehend and apply ethical decision making into the daily functions of a crisis worker
  • Ability to understand the requirements of 42 CFR, limits of confidentiality, and the necessity for appropriately signed releases
  • Ability to apply the Tarasoff rule and its connection to protective custody by law enforcement officers under title 34-B
  • Ability to comprehend and apply the concepts of dual relationships, self disclosure, and professional boundaries when working with clientele
  • Ability to understand the requirements set forth under the AMHI Consent Decree and to ensure client rights are not violated
  • Ability to comprehend the possible consequences of an ethical breech and possess the knowledge to avoid ethical pitfalls
  • Understanding of HIPAA federal confidentiality and security regulations

Hospitalization
(Core Module)

  • Gather information necessary for inpatient case presentation
  • Complete an accurate, comprehensive case presentation to intake staff
  • Demonstrate medical necessity for inpatient admission
  • Facilitate voluntary and involuntary inpatient admissions
  • Ensure that EIC or “Blue Papers” are completed appropriately
  • Follow state guidelines for referrals
  • Comply with EMTALA regulations
  • Complete accurate documentation related to inpatient admissions
  • Understand how to initiate a Rapid Response Team Notification

Documentation
(Non-Core Module)

  • Ability to document a clinical intervention in a clear, concise manner
  • Ability to document a clinical encounter within legal guidelines

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Appendices

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FAQS for Individuals

Authorized agency providers apply on behalf of individuals seeking MHRT/CSP certification. If you would like to pursue MHRT/CSP certification, please contact an authorized agency in your area to learn about upcoming training. A list of these authorized agencies can be found in Appendix C.

Read more…

Once MHRT/CSP certification is granted, it does not expire.

Train-the-Trainer for individuals pursuing certification as MHRT/CSP trainers is held approximately every 3 years. The most recent train-the-trainer was held in 2008. CFL will post the next training on their website.

FAQS for Authorized Agency Providers

The effective application date for MHRT/CSP certification is the date that the authorized agency provider signs the application form. The authorized agency provider signs the application form when an individual has met all MHRT/CSP requirements.

Relevant clinical licenses and degrees are listed in Appendices A and B. Possessing a clinical license or degree does not automatically qualify an individual for MHRT/CSP certification. Please see Section 5 of the MHRT/CSP Guidelines for more detail.

Relevant experience is described in Appendix B. Having relevant experience does not automatically qualify an individual for MHRT/CSP certification. Please see Section 5 of the MHRT/CSP Guidelines for more detail.

One year of full-time experience is equivalent to a minimum of 1200 hours. In order to determine how many years of relevant experience a part-time employee has, count the number of relevant hours worked to determine if the sum adds up to at least 1200 for one year, 2400 hours for two years, etc.

An individual successfully passes a module test when scoring at least 80%.

Only authorized agencies can submit applications for MHRT/CSP certification. For a list of authorized agencies, please see Appendix C of the MHRT/CSP Guidelines. Individuals who want to apply for the MHRT/CSP certification must have their employer submit the application on their behalf. The application form may be found in the Forms section of this website.

Authorized agencies may mail or fax the application to:

MHRT Request
The Center for Learning
12 East Chestnut Street
Augusta, ME 04330

FAX: (207) 626-5022

If you have any questions, email us.