This regulation defines the Adolescent Community Reinforcement Approach (ACRA) as a specialty service delivered alongside Level 1 or Level 2.1 (ASAM 2.1) outpatient treatment for youth and young adults ages 12–24 with co-occurring mental health and substance use disorders. Providers must field ACRA-certified teams consisting of a Master's-level clinical supervisor and one to four certified clinicians, and must comply with ACRA certification requirements for supervision, taping, feedback, and coaching. Services are delivered over approximately six months, transitioning from office-based to home/community settings based on client progress.
View official sourceSPECIALTY SERVICE: ADOLESCENT — COMMUNITY REINFORCEMENT APPROACH Adolescent – Community Reinforcement Approach (“ACRA”) is a specialty service that is provided in conjunction with Level 1 or Level 2.1 Outpatient treatment as a more targeted approach to treatment for youth and young adults, ages twelve (12) to twenty-four (24) years old with co-occurring mental health and SUD. ACRA services include approximately ten (10) individual sessions with the adolescent, two (2) individualized sessions with the caregiver and two (2) sessions with the adolescent and caregiver together in accordance with the procedures outlined in the ACRA evidence-based practice certification model. The provider must have the following ACRA-certified staff for each ACRA team: A clinical supervisor, with ACRA clinical supervisor certification, who is also a Master’s-level qualified practitioner; and One (1) to four (4) clinicians with ACRA clinician certification who are either Master’s-level qualified practitioners or Bachelor’s-level qualified practitioners with at least five (5) years’ experience working with behaviorally-challenged youth. ACRA practitioners must comply with the supervision, taping, feedback and coaching requirements of the ACRA certification. A minimum of four units of ACRA services should be provided once per week. Level 1 or 2.1 services shall be provided as clinically appropriate. ACRA generally lasts up to six (6) months with the first three (3) months of services provided in the office setting and the last three (3) months of service provided in the home or community setting, based on the client’s needs and progress. Qualified Practitioners of Adolescent Community Reinforcement Approach (ACRA) are: Physicians; Psychologists; LICSWs; LGSWs; APRNs; LMFTs; LISWs; LPCs; LGPCs; Psychology Associates; and CACs I and II. SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020); as amended by Final Rulemaking 68 DCR 012400 (November 26, 2021). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 6347