Job Description
Job Summary: The community embedded social worker provides clinical services/counseling, screening, and case management services to patients/clients/participants in one or more specific embedded community setting (distinct jobs in which services are provided at primary care or specialty medical practice offices; or working with persons who are unhoused; or working to provide team-based care to a specific population or setting) as an independently licensed practitioner. This work is typically as a part of an interdisciplinary team that could include medical providers (doctors, nurses, etc.), case managers, peer support services, housing advocates, and/or others. The work is often fast paced, and involves on-the-fly pivots according to the needs of the team, and the clients served.
QUALIFICATIONS:
Core Competencies
Engagement, Screening, and Assessment
Assesses patients comprehensively, according to needs of embedded team and agency needs; Clinicians should be proficient in diagnosis, formulation, risk assessment, level of care assessment, identifying strengths and areas of ongoing challenges, etc.
Assesses patient/client/participant ’s social and family structure in context of patient/client/participant ’s presenting problems
Assesses and plans for the patient/client/participant ’s aftercare needs
Conceptualizes patients and systems in their social context, taking into account systems stressors as well as intra- and interpersonal problems and strengths
Demonstrates understanding of addiction and recovery, including as it relates to screening, assessment, engagement, clinical interventions and approaches, and ASAM criteria for referrals and placement
Synthesizes and conveys relevant information, include clinical and case formulations, orally and in writing.
Formulates understandings of case material, using all data available as well as understanding of interplay
between stressors and vulnerabilities and presenting problems.
Understands best practices for assessment and treatment of clients with diverse backgrounds and cultural experiences, including intersectionality and the impacts of systemic oppression and marginalization
Assesses and diagnoses patients, using DSM 5 criteria, consulting with team members as necessary
Demonstrates the ability to form a therapeutic relationship with the patient/client/participant and families.
Contacts the patient/client/participant ’s providers and referral sources to obtain collateral information for assessment, and to coordinate treatment
Uses standardized assessment and screening tools as necessary, including for depression, anxiety, substance use, and suicide and violence risk
Must be able to use in-person, telephonic, and two-way video telehealth to engage client as needed
Treatment
Demonstrates the ability to provide direct clinical care to patients in order to promote change according to
the patient/client/participant ’s treatment plan.
Individual Psychotherapy: In a manner appropriate to the setting and frame, meets with patient/client/participant in a therapeutic relationship to address clinical and psychosocial issues relevant to the patient/client/participant ’s diagnosis and presenting problems, and promotes change according to treatment goals.
Family work/family therapy: Engages therapeutically with client family and systems to further client’s treatment and progress toward goals, indicated
Supportive therapy: Meets with patient/client/participant as necessary to provide support and resolve specific task-oriented problems that may have an impact on treatment.
Group therapy: Meets with patients in psychoeducational or psychotherapeutic group sessions to promote,
through the group process, individual growth according to treatment goals.
Demonstrates the ability to integrate theoretical knowledge of clinical practice, group dynamics and individualized biopsychosocial assessment effectively and ethically in treatment.
Attends and participates in treatment planning/ team planning sessions of assigned patients on a regular basis. Reports
consistently to the treatment team with regard to assessments and the content and focus of therapy.
Documents all interactions with patient/client/participant(s) in progress notes in the electronic medical record.
Documentation will adhere to any policies of embedded agency, as well as Retreat policies where appropriate.
Maintains contact with referral sources and involved community agencies according to the aftercare needs of the patient/client/participant, using professional judgement and according to the patient/client/participant ’s treatment plan, as coordinated with other treatment team members.
Demonstrates an understanding of evidence-based practices for the populations served, and maintains competency in these areas.
Engages actively with community support systems, health care and human service resources, courts and
police, etc., to coordinate care and treatment, when appropriate
Professionalism and Team Engagement
Demonstrates strong interpersonal skills and the ability to work within a multidisciplinary team.
Maintains effective working relationships with program staff as indicated by direct observation of
supervisor
Supports program policies and priorities relating to patient/client/participant care, workflow, and productivity
Demonstrates good organizational and time management skills and ability to work in a fast-paced setting.
Adheres to the Brattleboro Retreat’s code of ethics, standards for service delivery, policies and procedures
as well as the State of Vermont mental health code.
Demonstrates adherence to professional standards and values according to NASW Code of Ethics or other applicable professional Codes of Ethics to assure the provision of ethical care.
Represents the Retreat professionally in all interactions will providers and community members
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