a) Prior to admission, patients shall be informed of the amount of group treatment that may be part of any level of care and shall be given the option to participate in any recommended group treatment. If the patient exercises the option to not participate in a level of care based on the amount of group treatment, the organization shall offer a less restrictive level of care. Counseling and didactic groups for substance use disorder treatment are as follows:

1. 1) Counseling groups are a therapeutic activity with the primary purpose of allowing patients or significant others an opportunity to process issues related to their treatment in a group setting. Counseling groups can have a specific focus but are generally process oriented and less educational. All counseling groups shall be facilitated by professional staff. Justification for any patient who participates in a counseling group shall be documented as an assessed need and relate to the treatment plan. Counseling groups shall at no time exceed 16 patients per group.
2. 2) Didactic groups are a therapeutic activity with the primary purpose of educating patients or significant others on a specific treatment-related topic in a group setting. All didactic groups shall be led or supervised by professional staff or by other professionals with credentials specific to the subject matter of the didactic group following a lesson plan or outline approved by the organization. For example, a licensed dietitian might lead a group on nutrition. Justification for any patient who participates in a didactic group shall be documented as an assessed need and relate to the treatment plan. Didactic groups shall generally not exceed 24 people.