ACT Counselor

Purpose: Collaborate with client and family to identify goals and potential solutions to problems which cause emotional turmoil. Mental Health Professionals seek to; improve communication and coping skills; strengthen self-esteem; promote behavior change; and provide accurate documentation of efforts.  

Department: TACT (Tueller Assertive Community Treatment)

Supervised by: TACT Team Lead

Positions supervised: None

Location: Idaho Falls office, Rigby office, Rexburg office, client home (as assigned or agreed upon at time of hire)

Role Overview

Working as a Therapist (often titled "Mental Health Clinician" or "ACT Clinician") on an Assertive Community Treatment team is a radical departure from traditional outpatient therapy. You will not sit in a quiet office doing 50-minute sessions while waiting for clients to come to you.

Under the Tool for Measurement of Assertive Community Treatment (TMACT), you are a mobile, in-vivo clinical specialist. You bring the therapy directly into the client’s environment—whether that is a living room, a park bench, or a homeless shelter.

Here is a breakdown of your core responsibilities, daily tasks, and what to expect as a Therapist on an Idaho-based ACT team under TMACT fidelity standards.

Core TMACT Expectations for the Therapist

While the TMACT doesn't have a single line item simply called "Therapist," your role is the driving force behind several critical subscales, particularly the Evidence-Based Practices (EP) and Core Practices (CP) items:

• EP6: Empirically Supported Psychotherapies: The TMACT explicitly measures how well the team delivers high-level, evidence-based therapies. It is your job to provide modalities like Cognitive Behavioral Therapy for Psychosis (CBTp), Dialectical Behavior Therapy (DBT) skills, and trauma-informed care.
• CP4: Community-Based Services (In-Vivo): To achieve high fidelity, the team must provide at least 80% of its services in the      community. You are expected to be in the field for the vast majority of your day, providing therapy where the client's triggers and daily life actually happen.
• Shared Caseload (The Generalist Crossover): You do not have "your own" 30 clients. The team shares a caseload of 100. While you might be the primary therapist for a specific subset of clients who need intense trauma processing, you are also expected to help with generalist duties—like prompting a client to do their laundry while you teach them distress tolerance skills.
• Family Psychoeducation: The TMACT expects the team to engage with a client’s "natural supports." You will lead the charge in meeting with parents, siblings, or landlords to teach them about the neurobiology of severe mental illness, how to      communicate with someone experiencing delusions, and how to set healthy boundaries.

Daily and Weekly Tasks Checklist

• The Morning Huddle: Attend the daily organizational meeting. You will provide the clinical "lens" for the day. If a client is highly paranoid, you will advise the nurses or peer specialists on exactly which DBT or de-escalation skills to prompt when they go deliver the client's medication.
• In-Vivo Psychotherapy: Drive out into the community to deliver therapy in short, frequent bursts. Instead of one 60-minute session a week, you might see a highly symptomatic client three times a week for 20 minutes each time.
• Functional Assessments: Conduct thorough clinical assessments to evaluate a client’s coping mechanisms, trauma history, and cognitive functioning.
• Co-Responding to Crises: If a client is actively hallucinating or suicidal in the community, you will often co-respond with the Team Leader or Psychiatric Provider to conduct a risk assessment and attempt to de-escalate the situation to avoid a hospital      admission.
• Cross-Training the Team: You are the team's psychotherapy expert. You will spend time informally training the bachelor's-level generalists and peer specialists on how to use basic cognitive reframing or validation techniques during their routine visits.

The Reality Check (Idaho Context)

Being an ACT Therapist in Idaho—especially in vast catchment areas like Region 7—is an exercise in clinical creativity and grit.

You are treating the highest-acuity individuals in the state. Many of your clients have profound, untreated trauma that is masked by severe persistent mental illness (SPMI) and chronic substance use. Because you are doing therapy in their actual environment, you have to be highly adaptable. You might plan to do a CBT worksheet on cognitive distortions, but when you arrive at the client's apartment, they are facing an eviction notice and are in a panic. You have to immediately pivot, using that real-life crisis to practice distress tolerance skills in real-time.

Furthermore, you will regularly interact with Idaho's crisis systems. You will likely work closely with local Designated Examiners (DEs) when navigating involuntary mental health holds, and you will coordinate closely with the state psychiatric hospitals (like State Hospital South in Blackfoot) to ensure a warm hand-off when your clients are discharged back into the community.

You trade the predictability of a quiet office for the profound reward of keeping someone safe, housed, and moving toward recovery in the real world. 

Qualifications:

• Must hold a master’s degree and hold one of the following licensures: 

1. LCSW (Licensed Clinical Social Worker)
2. LMSW (Licensed Master Social Worker)
3. LCPC (Licensed Clinical Professional Counselor)
4. LPC (Licensed Professional Counselor)
5. LMFT (Licensed Marriage and Family Therapist)
6. LAMFT (Licensed Associate Marriage and Family Therapist)

• LP (Licensed Psychologist)
• Experience providing mental health services for clients with serious persistent mental illness (SPMI)
• Strong knowledge of chemical dependency and mental health diagnosis treatment
• Must be proficient in using empirically supported psychotherapies such as CBT (especially CBT for psychosis), Acceptance and Commitment Therapy (ACT), and Motivational Interviewing (MI)
• Preferred experience with skills training/psychiatric rehabilitation approaches
• Understand and accept the use of harm reduction vs. abstinence-based interventions for co-occurring substance use disorders
• Be able to pass an enhanced background check