MHRT/CSP Procedural Guidelines


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

(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

(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

(Non-Core Module)

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