Chapter 1: Program Description

Chapter Overview

This chapter serves as an overview for higher educational institutions considering integration of the BHSS Clinical Training Program developed by the BHSS Project Team. In this chapter, we describe the scope of practice, educational requirements, and educational pathways for a BHSS. Please note that the BHSS Clinical Training Program is funded by Ballmer Group to create curriculum focused on adult populations. Efforts to expand to adolescent and young adult populations are discussed in Chapter 11. Future Opportunities.

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Mission, Vision, and Goals
Definition of a Washington State BHSS
Scope of Practice
National/Regional Accreditation Standards
BHSS Preparation: Baccalaureate (Degree programs, Program type)
BHSS Preparation: Post-Baccalaureate
Out-of-state Licensed Providers: Post-Baccalaureate
Continuing Education
Workforce Diversity

Behavioral Health Support Specialist Clinical Training Program Overview

Mission

The mission of the BHSS Clinical Training Program is to increase access to evidence-based interventions for common mental and behavioral conditions through workforce development at the bachelor level.

Purpose

The purpose of the BHSS Clinical Training Program is to be a catalyst for statewide implementation of BHSS curriculum that prepares a bachelor level psychology, social work, behavioral healthcare, or related degree student for a Washington state BHSS credential.

Goals

Goal 1: Design competencies and learning objectives that define the role and scope of practice for a BHSS.

Goal 2: Scale the role for Washington state by creating processes for integrating the BHSS Clinical Training Program into existing four-year degree programs in the behavioral healthcare field.

Goal 3: Partner with Washington state higher education institutions to adopt the BHSS Clinical Training Program.

Goal 4: Collaborate with government agencies, employers, and policy groups to implement legislation establishing a BHSS credential in Washington state.

Definition of a Washington State BHSS

BHSSs have the equivalent of at least a four-year bachelor’s degree in the U.S.; they complete a supervised clinical practicum; and are credentialed to deliver brief, evidence-based interventions under supervision (SSB 1589, 2023). Due to variability in how behavioral health support specialists are defined in the literature, we believe it is important to note that a BHSS in Washington state is situated between a non-specialist and graduate level provider. An important distinction of the Washington state BHSS is the inclusion of education and training in brief, evidence-based treatment informed by cognitive behavioral strategies that have been identified as effective across diverse groups (Anik et al., 2021; Cuijpers et al., 2019; Rojas-García et al., 2015).

Scope of Practice

Per the language of Substitute Senate Bill 5189 (opens in a new tab) or SSB 5189, the BHSS has a scope of practice that includes behavioral healthcare under supervision. A BHSS does not have within their scope of practice the ability to make diagnoses but does track and monitor treatment response and outcomes using measurement-based care (SSB 5189, 2023).

Notes on Scope of Practice

At the bachelor level, we anticipate that the BHSS will be helpful as an initial resource for addressing symptoms associated with common mental and behavioral health conditions such as depression, anxiety, and substance use concerns. Following screening to identify elevated mental health and substance use concerns, the BHSS will deliver brief treatment to help alleviate presenting symptoms when appropriate. Numerous studies have demonstrated success in preparing bachelor level or non-specialist practitioners to deliver interventions with fidelity using evidence-based models (Raue et al., 2019, 2021, 2022; Renn et al., 2022; Steinman et al., 2023; Woodard et al., 2023). In collaboration with a supervisor, the BHSS will use outcome measures to monitor patient progress to verify the patient is receiving the right intensity of treatment for the reported severity and duration of symptoms. Such a process is consistent with stepped care. A sample job description (opens in a new tab) and employment case examples (opens in a new tab) help illustrate the BHSS role and scope of practice.

BHSS Clinical Training Program & National/Regional Accreditation Standards

The role of the BHSS Clinical Training Program Project Team is to lead the development of curriculum and program guidelines. The Washington State Department of Health (DOH), in collaboration with the BHSS Clinical Training Program, will adopt standards to approve programs. At the time of this publication, one higher education partner is nationally accredited by the Council on Social Work Education (CSWE). We understand the importance of national and regional accreditation for professions and do not expect accredited programs to change language in their existing course catalogues to the language in the BHSS Clinical Training Program when there is general agreement on the intent of a course description, course purpose, and learning objectives. Where gaps in learning objectives do exist, we recommend identifying strategies to bridge the gaps in a manner that fits the educational partner’s curriculum revision policies and procedures. For example, some gaps may be addressed through the addition of learning objectives to a specific course or the addition of elective courses for students enrolled in the BHSS certification or specialization.

BHSS Preparation: Baccalaureate

Prerequisites

Psychology, social work, and behavioral healthcare are highly compatible bachelor’s degree programs for integrating BHSS competencies into a curriculum. These programs share a mission to prepare students for mental and behavioral healthcare fields.

Consistent with the programs mentioned above are prerequisite learning objectives associated with course titles such as (a) theories of personality or human development, and (b) abnormal psychology or introduction to mental health. Ideally, we recommend that both (a) and (b) are met to provide a foundation for starting BHSS coursework. At minimum, either (a) or (b) should be successfully completed prior to starting BHSS studies at the undergraduate level.

Chapter 9. Planning for Implementation: Sample Syllabi provides examples of learning objectives associated with theories of personality, human development, abnormal psychology, and introduction to mental health.

Degree Programs

In Version 1 (V1) of the BHSS Implementation Guide, qualifying degree programs are Bachelor of Arts (BA) or Bachelor of Science (BS) in Psychology; Bachelor of Social Work (BSW) or Social Welfare; and Bachelor of Applied Science (BAS) in Behavioral Healthcare or Integrated Behavioral Healthcare.

Related Degree Programs

There will be opportunities for a related degree program in behavioral sciences to assess the program’s degree of alignment with the BHSS Clinical Training Program and potentially offer BHSS preparation as an alternative for enrolled students. Behavioral science is a course of study at an accredited school or university, which includes the study of human behavior or nursing as a focus (Ohio CDPB, 2023). The BHSS Project Team perceives compatibility with behavioral science studies often connected to the following undergraduate degree programs: psychology, counseling, social work, nursing, human services, addiction studies, criminal justice, public health, sociology, family sciences, and human development. Related degree programs ought to include prerequisite learning requirements in addition to a mission and purpose to teach applied behavioral health clinical skills.

Program Type

An approved program may choose to create an “opt-in” decision point within a degree program defined by a Certificate or Specialization within the bachelor’s program, for example, Eastern Washington University’s Behavioral Health Support Specialist Certificate Program or the University of Washington Tacoma Social Welfare BHSS Specialization. An “opt-in” program allows students to “opt-out” if the student meets graduation criteria for the academic degree but does not meet criteria for a BHSS credential or specialization.

An approved program may also choose to prepare all enrolled degree students for the BHSS credential. An example of this is Lake Washington Institute of Technology’s Bachelor of Applied Science (BAS) in Behavioral Healthcare degree program.

An approved program may also include a bachelor’s degree combined with a registered apprenticeship. One model of apprenticeship includes the accumulation of college credit during the apprenticeship experience. Information on this program type is further addressed in Chapter 11. Future Opportunities.

BHSS Preparation: Post-Baccalaureate

For persons who hold a bachelor’s degree in an approved degree program, SSB 5189 provides an option for students to enroll in post-baccalaureate education to become a credentialed BHSS. Typically, education in preparation for a state credential is offered as academic credit. Rules on post-baccalaureate education will need to be addressed by DOH. We recommend the following:

• Admissions screening for the post-baccalaureate certificate or specialization program.
• Identification of acceptable related bachelor’s degrees, or combination of degree and human services experience.
• Completion of prerequisite courses.
• Acceptance into a post-baccalaureate certificate or specialization program.

Out-of-State Licensed Providers: Post-Baccalaureate

DOH will guide rule making for out-of-state license holders in compliance with regulatory mandates. At this writing, there are no other known bachelor-level BHSS credentials in the US. One related credential is the bachelor-level licensed social worker. We expect graduates from Council on Social Work Education (CSWE) accredited programs to meet or exceed knowledge of health equity, cultural responsiveness, helping relationships, and team-based care. We recommend evaluating equivalency for a bachelor-licensed social worker’s competency in care planning and care coordination, screening and assessment, the delivery of brief evidence-based interventions for common behavioral health conditions, and Washington laws and rules governing mental and behavioral health practice. We recommend a course or courses that review BHSS competencies with a focus on missing topic areas in the applicant’s bachelor’s program.

Continuing Education

Per SSB 5189, after a BHSS has been credentialed by the Department of Health, the BHSS will be required to complete a minimum of 20 hours of continuing education units or CEU every two years. CEU providers must meet DOH guidelines as a continuing education provider. We recommend that sources of CEU represent the interprofessional nature of BHSS work including, but not limited to psychology, mental health counseling, social work, marriage and family therapy, addiction studies, and nursing.

Workforce Diversity

The Bree Collaborative, state workforce advisory groups, and policy makers in Washington state have emphasized the importance of diversifying the behavioral health workforce to improve representation and reduce racial and ethnic disparities in behavioral healthcare (Moore et al, 2023). Workforce diversification is complex and strategies that address multiple elements ought to be considered, for example, education accessibility, outreach to underrepresented persons or groups, an educational experience that addresses cross cultural care, an inclusive learning environment, tuition assistance, and reasonable compensation rates. The addition of a bachelor level workforce may help improve diversity by encouraging post-secondary students, mid-career adults, and older adults to pursue higher education in the behavioral healthcare field. The Washington State Board for Community and Technical Colleges reports 49% of the student population represent students of color. Half of the initial BHSS clinical training programs are community colleges. Additionally, there will be future efforts to support workforce development at the bachelor level through innovative programs mentioned in Chapter 11. Future Opportunities.

Summary

• The BHSS Clinical Training Program aims to increase access to evidence-informed interventions for common mental and behavioral conditions across multiple settings by preparing bachelor-level students for a BHSS credential in Washington state. The BHSS Project Team is working with DOH and Washington state higher education programs to scale and refine the BHSS role.
• The BHSS Project Team created the guidelines for a BHSS in collaboration with community and education partners.

Up Next

In the next chapter, you will meet the BHSS Project Team and learn how to contact and work with the team members.