Standards for public agencies

2020 Edition

Mental Health and/or Substance Use Services (PA-MHSU) 5: Clinical Counseling

The agency provides trauma-informed clinical counseling services that: 
  1. provide an appropriate level and intensity of support and treatment;
  2. recognize individual and family values and goals;
  3. accommodate variations in lifestyle; 
  4. emphasize personal growth, development, and situational change; and
  5. promote recovery, resilience, and wellness.


Ambulatory detoxification treatment programs include a range of therapies (e.g., cognitive, behavioral, medical, and mental health therapies), provided to persons served on an individual or group basis. Services aim to enhance the service recipient's understanding of addiction, completion of withdrawal management, and referral to an appropriate level of care for substance use treatment. The delivery of services will vary and depends on the assessed needs of the service recipient and his or her treatment progress. 
NA The agency provides Diagnosis, Assessment, and Referral Services only.
2020 Edition




Individuals and families who receive Mental Health and/or Substance Use Services improve social, emotional, psychological, cognitive, and family functioning and attain recovery and wellness.
Examples: Agency self-assessments can help evaluate the extent to which agencies’ policies and practices are trauma-informed, as well as identify strengths and barriers in regards to trauma-informed service delivery and provision. For example, agencies can evaluate staff training and professional development opportunities and review supervision ratios to assess whether personnel are trained and supported on trauma-informed care practices.
Note: Recovery is a holistic process of change where individuals learn to overcome or manage their diagnosed symptoms and conditions in order to improve overall well-being and achieve optimal health.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for evaluating level/intensity of care and follow-up
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

PA-MHSU 5.01

Clinical counseling services promote whole-person wellness and help the individual to develop the knowledge, skills, and supports necessary to:  
  1. manage mental health and/or substance use disorders; 
  2. cultivate and sustain positive, meaningful relationships with peers, family members, and the community; and 
  3. develop self-efficacy.

PA-MHSU 5.02

Personnel assist persons served to: 
  1. explore and clarify the concern or issue;
  2. voice the goals she or he wishes to achieve;
  3. identify successful coping or problem-solving strategies based on the individual’s strengths, formal and informal supports, and preferred solutions; and
  4. realize ways of maintaining and generalizing the individual’s gains.
Examples: Personnel can help to engage and motivate persons served in this process by demonstrating, for example: 
  1. sensitivity to the needs and personal goals of the service recipient;
  2. a non-threatening manner;
  3. respect for the person’s autonomy, confidentiality, sociocultural values, personal goals, lifestyle choices, and complex family interactions;
  4. flexibility; and
  5. appropriate boundaries.

PA-MHSU 5.03

Clinical personnel: 
  1. determine the optimal level and intensity of care, including clinical and community support services;
  2. follow up when an evaluation for psychotropic medications and medication-assisted treatment is recommended; and
  3. use written criteria to determine when the involvement of a psychiatrist is indicated.


Element (c) does not apply to detoxification treatment programs.