in on-the-job training and related instruction.
Certified Drug and Alcohol Counselor
Work Process Content
On the Job Training
Demonstrate the ability to interview the client and peers to obtain an accurate history. Observe and document psychosocial, social and physiological signs and symptoms of alcohol and drug use. Create the diagnostic summary based on the assessment and interviews. Explain the difference tolerance and withdrawal. Describe the effects of various drugs of abuse on the physiological systems. Identify any Cooccurring disorders.
Identify Community resources to ensure quality of care and ensure the treatment plan. Follow documentation guidelines as per the IC&RC and complete the various types of documentation. Utilize HIV community Resources and Metal Health resources within the community. Utilize Disability services and employment services for clients.
Understand the four stages of group development and understand group process. Identify the processes individuals experience in group therapy. Learn Family counseling identify the roles family members play. Explain the difference between, interdependence, codependence and dependence.
Utilize the key concepts with counseling approaches. And understanding how to choose and change counseling approaches. Identify the six stages of counseling and identifying skills in each. Use Crisis intervention and understanding the causes of crisis intervention. Provide addiction focused counseling to identify the difference between each stage of recovery
Provide guidelines for ethical decision making and learn the importance of ethics in counseling. Understand the role of ethics in each stage of recovery and counseling. Following the proper procedures used to protect client rights during their treatment
Recovery and Education
The ability to relate to the client the main feature associated with SUD and understanding the client’s psychological and social strengths and weaknesses. Explain the physical side effects of various substances. Educate the family the benefits of counseling the barriers of recovery in each cultures.
Related Instruction Content
Domain 1: Interviewing, Assessment, & Diagnosis
• Initial Interviewing o Focuses of creating a therapeutic alliance with the client by incorporating listening skills, process skills and providing feedback. o Use role playing the demonstrate the following eight skills: A. Attending B. Paraphrasing C. Reflection of feeling D. Summarizing E. Probing F. Interpreting G. Providing information and feedback through motivation interviewing H. Appropriate use of self-disclosure. • Biopsychosocial Assessment o Focuses on gathering relevant information from the client in-order to obtain the client’s current status, history and using various interviewing techniques. o Evaluate information from sources other than the client, by gaining client consent interviews and written reports to provide a complete history. o Observe and document psychosocial, social and physiological signs and symptoms of alcohol and drug abuse. o Determine the client’s eligibility for referral to a variety of programs that will match the client’s needs and services. o Obtain signed releases from the client when sharing information to outside resources. o Identifying symptoms the show a need for additional services. o Become familiar to with pharmacology drugs of abuse. • Diagnostic Summaries o Create a diagnostic summary based on the assessments completed by other professionals. o Record continual treatment needs identified in regular assessment performed throughout the clients care and provide adjustments to the client’s treatment plan. o Develop a mutually agreed goals, objectives and treatment methods based on assessment findings on the client’s strengths, weakness, needs and problems. • Differential Diagnosis (DSM) o Understand the logic, purpose and functions of the DSM diagnostic system. o Describe the organizational scheme of the DSM, which includes the DSM axis, and the general diagnostic categories. o Identify the diagnostic criteria for substance abuse and dependence. o List frequently encountered differential diagnosis, such as substance induced syndromes, hypomania, and personality disorders. o Understand that only licensed counselor can diagnosis not certified counselors. • Pharmacology and Physiology o Define the meaning of psychopharmacology. o Understand and identify the major structural and functional units of the brain. o Identify the major neurotransmitters with CNS. o Understand the meaning of half-life, therapeutic dose, effective and lethal dose. o Know the difference between tolerance and withdrawal. o Know the difference between fat and water solubility. o Describe the effect and impacts of various drugs of abuse on the physiological body systems. • Prenatal Alcohol Use and Fetal Alcohol Spectrum Disorder: • Assessment and Intervention o Identify the appropriate screening tools on women of child bearing age regarding alcohol use while pregnant. o Assess appropriate referral and treatment options for women who drinking and pregnant. o Understand the salient Characteristics of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders. o Know the primary and secondary characteristics associated with Fetal Alcohol Spectrum Disorder (FASD). o Recognized the need for multidisciplinary assessment to determine appropriate services. o Identify proper treatment options for individuals with (FASD). • Compulsive Gambling o Understand what compulsive gambling is and the nature of addiction. o Identification and assessment of compulsive gamblers. o Identify the types of Gamblers and the different stages a gambler goes through. o Recognize vulnerable populations and at rick personality characteristics. o Design and gabling treatment plan, course of recovery and aftercare. • Co-Occurring Disorder Assessment o Describe the clinical presentations of co-occurring diagnosis that are encountered in substance abuse treatment settings. o Identify the ways in which substance abuse and mental health diagnosis can interact and influence a client’s clinical presentations. o Use SAMHSA’s four quadrant framework to judge clients according to the severity of the client’s substance abuse and mental health symptom. • Assessment Tools o Define Reliability, validity and sample population. o Become familiar with assessment instruments currently used with SUD’, addictive disorders and mental health disorders. Including the following: A. DSM – Diagnostic and Statistical Manual B. MAST- Michigan Alcoholism and Addicting screening test C. AUDIT- Alcohol use disorder identification test D. LOCI- Locus Control Inventory E. SASSI- Substance abuse Subtle Screening Inventory F. MAYSI- Massachusetts Youth Screening Inventory G. ASI- Addiction screening Index H. DAST- Drug Abuse Screening Test I. SOGS- South Oaks Gambling Screen J. MMPI- Minnesota Multiphasic Personality Inventory K. FTND- Fagerstrom Test for Nicotine Dependence L. BDI- Beck Depression Inventory M. MHSF-3 – Mental Health Screening Form N. SSI-SA- Simple Screening Instrument for substance Abuse. o Select Administer, score and interpret to clients the results of alcohol, tobacco and other drug assessment instruments in order to provide accurate, standardized measures clients problems. o Understand the purpose rationale and methods associated with the assessment process to the client to assure understanding and compliance.
Domain 2: Counseling, Crisis Interventions, and Therapy
• Introduction to Counseling o Define counseling and therapy as per the IC&RC. o Knowledge of the key concepts associated with the following counseling approaches: A. Reality Therapy B. Cognitive/ behavior Therapy C. Transitional Analysis D. Structural Family Therapy E. Psychodynamic Therapy F. Gestalt Therapy o Understanding the rationale for choosing and changing counseling approaches during the course of counseling. • Counseling Skills o Identify, demonstrate and explain the following counseling skills: A. Attending B. Paraphrasing C. Reflection of feeling D. Summarizing E. Probing F. Counselor self-disorders G. Interpreting H. Providing information and feedback as per MET o Add self-help group participation as an additional counseling process. o Knowledge of the six stages of counseling and identify the skills found in each stage. • Crisis Intervention o Understand Crisis Intervention within Alcohol and drug counseling per the IC & RC. o Understand the causes of Crises (The four types of trauma: situational, developmental, intrapsychic, and existential.) o Identify and give examples of the five psychological reactions to crisis. A. Shock B. Anxiety C. Depression D. Anger E. Intellectualization o The goals of crisis intervention: A. Stabilization B. Pressure relief C. Problem solving D. Return to pre-crisis function o Six stages of the compromising crisis intervention A. Establish rapport B. Gather data C. Reframe crisis D. Explore realistic options E. Contact supportive individuals F. Arrange for follow up o Risk factors and cues associated with suicide. o Demonstrate the appropriate set of responses to suicide crisis. o Explain the qualities of an effective crisis counselor. • Addiction Focused Counseling o Three modalities of A & D treatment: A. Pre- Treatment B. Rehabilitation C. Maintenance o Five goals of individual’s alcohol and drug counseling. A. Stop AOD use B. Relapse prevention C. Changing reinforcement contingencies D. Managing painful feelings appropriately E. Improving interpersonal functioning o Differentiate between early, middle and late stage recovery and provide examples of treatment issues in each stage. o Understand why termination of counseling is a process rather than an event. o Identify the various self-help groups and explain how these groups can enhance recovery for the client or significant other. • Group Counseling o Understand and learn the term universality. o Identify the four stages of group development and understand the features of each. A. Initial B. Transition C. Working D. Final o Group process. o Identify the three processes which individuals experience in order to benefit from groups. A. Compliance B. Identification C. internalization o Describe the counselors role in assisting clients in working thought he three process of group counseling. o Identify the three styles of leadership: A. Authoritarian B. Democratic C. Laissez-faire o Three leadership functions: A. Emotional stimulation B. Meaning attribution C. Executive function o Facilitation of techniques used by group leaders. o Leader interventions in response to urgent and critical group issues. o Develop skills when working with effectively with problematic group maters. • Family Counseling o How SUD affects the family together and independently. o Identify the rules in SUD affected by families per Black & Wegschider. o Identify the families’ roles and features by Wegscheider and the roles described by Black. o The difference between interdependence, co-dependence and dependence. o The difference between A & D counseling with families and family therapy. o Define Intervention and The Intervention process o Become familiar with family support groups and community based providers for families. • Cognitive Behavioral Therapy o Client’s Cognitions represents a synthesis of internal and external stimuli. o The role of cognitions in the client’s view of self, view of the world, and view of the past and future. o Alterations in client cognitions affect the client’s affective state and patterns of behavior. o CBT theory and techniques to the treatment of substance abuse disorders. • Motivational Interviewing/ Motivational Enhancement Therapy o Prochaska and Diclemente’s stages of changes and characteristics involved with each stage. o Assess client’s readiness to change using a client centered interview style and a questionnaire. o Counselor’s interventional style can impact a client’s level of Motivation, resistance and willingness to provide proper assessment information. o Open-ended questions and non-confrontational style to elicit the client’s perspective on presenting problems. o Understanding the spirit of Motivational enhancement Therapy (MET) and the importance of client center principals in substance abuse treatment. o Five micro skills of MET and their application within substance abuse program. o The principals for responding to resistance in non-confrontational style. o Enactment of basic empathetic listening, open ended questioning and reflective listening skills. • Pharmacological Approaches to Nicotine Dependencies o Approaching and assessing Nicotine dependence. o Identify various pharmacological interventions for nicotine dependence. o Evidence of supporting Pharmacological interventions for Nicotine dependence. o Relationship between tobacco dependence and mental and addictive disorders.
Domain 3: Community Resources, Services, and Documentation
• Community Resources o Identifying community resources and maintain relationships. o Match community resources to clients’ needs through cultural and lifestyle characteristics. o Explaining to the client the necessity for referral to facilitate the transition to other service providers. o Identify self-help groups pertinent to client’s needs. • Consultation o Consultation goals and benefits as per the IC&RC. o Consult with supervisors, counselors, professionals and other service providers to ensure quality care of the client. o Present cases to other treatment team members to facilitate comprehensive quality care. o Assist team members in providing input on their cases in order to develop a comprehensive care to the client. o Interact with Healthcare professionals by soliciting and providing information pertinent to the client Biopsychosocial status. • Documentation o What documentation is as per IC&RC? o Federal and state laws and regulations specific to the maintenance of the clients’ records. o Meaning of informed consent to the client. o Enter and utilize client notes. o Components required in a written case study. o The importance of documentation. o The difference among the following types of documentations A. Intake B. Assessment C. Treatment plan D. Treatment plan review E. Progress note F. Discharge plan G. Discharge summary • HIV & Resources o HIV community Resources o Up to date knowledge of HIV & AIDS that include: A. Symptoms B. Risk Factors C. Facts vs. Myths D. Current treatment approaches o Understanding of the basic confidentiality issues related to HIV & AIDS clients. • Mental Health Services o Understanding of the Mental Healthcare System in the State. o Co- occurring service eligibility criteria and how to access these services. o Identifying the levels of mental health care for clients with co-occurring disorders. o Psychiatric Emergency Screening System. o Utilizing effective supervision regarding client with co-occurring disorders. o Federal and (insert state) laws pertinent to co-occurring clients. • State Child and Family Services o Understanding the components of child and family care system in (insert state). o Child protection system and laws in (insert state). o Utilize appropriate supervision with cases having child protection issues relation SUD. • Criminal Justice System o Understanding the Criminal Justice system in the State. o Service eligibility criteria and how to access services for SUD within the CJ system. o Levels of involvement with the Criminal Justice system including drug court, legal restitution, etc. for clients. o Familiarize yourself with barriers that prohibit full reintegration back into the community. o Utilize appropriate supervision with SUD presenting cases loving Criminal Justice involvement. o Understanding of laws as they relate to SUD. • Disability Services o Understanding the disability service delivery system. o SUD service eligibility criteria and how to access services for clients with disabilities. o Identifying the type of disability services for a client with SUD. o Challenges and barriers of clients with a disability. o Reasonable accommodation laws and the barriers faced by the disabled community. • Employment services o Vocational issues clients face while in treatment. o Strategies promoting employment with client’s treatment. o Importance of employment in the recovery process. o Employment and vocational services. o Identify the indicators of the client’s readiness for employment. o Legal issues related to employment.
Domain 4: Addiction Recovery
• Addiction Recovery o Understanding the difference between substance abuse and substance dependence per the current DSM. o Basic knowledge of the various models of addiction. o Explaining the clients various stages of addictions and recovery. o Being able to define the following terms: A. Addiction B. Recovery C. Harm reduction D. Self Help groups E. Relapse ad relapse prevention F. Abstinence G. Sobriety H. Wellness (Biopsychosocial) • Psychological Client Education o Being able to relate to the client the main psychological features associated with SUD. o Assist the client in understanding how their psychological and social strength and weakness can be related to their recovery. o Communicate basic information about the following term: A. Mental Health B. Mental Illness C. Wellness o The role of psychiatric medications in recovery. • Biochemical/ Medical Client Education o Explain the physical side effects of various substances: A. Stimulants B. Depressants C. Analgesics D. THC etc. o The role of psychotherapeutic medications associated with drug use and withdrawal o Ability to explain the following terminologies: A. Therapeutic Medications B. Antipostropics C. Agonist D. Antagonist • Sociocultural Client Education o Understanding of the following characteristics of: A. Major cultural groups represented in client populations B. Special populations, such as disabilities, sexual orientation, female, youth and Gangs. • Addiction Recovery and Family Psychological Education o Co- dependency and the roles commonly assumed by families affected by SUD. o Education to the family about the benefit of self-help groups. o Education to the family about the rules of commonly found in the addictive family system. o Education to the family about their own personal recovery as well as the SUD family member. o Being able to describe to the family the features of co-dependency. o Help the family understand the recovery process. • Biochemical and Sociocultural Family Education o Cultural traditions of various subgroups o Barriers to recovery in various cultures o Identification of social institutions that can support the recovery process. o Specific behaviors that counselors should include or avoid when interacting with families. o Being able to describe to family members the basics of pharmacology of substance use disorders at a level that he family is able to understand. • Community and Professional Education o Current research based on ATOD educational resources. o Organization of materials for effective presentations. o Content that is specific to the participants. o Elements for making effective presentations. • Opiate and Stimulant Education o Understanding the history or opioid use. o Identify the types and effects of opiate replacement therapies. o The origin and use of opioid replacement therapies. o Understanding the interactions between opioids and other psychotropic substances. o The use of Methadone Maintenance in detoxification and in the recovery process. o Familiarity with new ORT’s o Acquiring the history of stimulant use. o Types of stimulant substances o Interactions between stimulants and other psychotropic substances. o Current status of pharmacological therapies available for stimulant abusers. • Alcohol, Sedative and hallucinogens o History of alcohol and sedative issues. o Types and effects of sedative substances. o The Detoxification process for alcohol and sedatives. o The interactions between alcohol and sedatives. o Impact of alcohol on physiological systems. o Understanding the history of hallucinations. o Types and effects of hallucination substances. o Interactions between hallucinations and other psychoactive substances.
Domain 5: Ethics, recovery, and growth
• Ethical Standards o Guidelines for ethical decision making. o Understanding the importance of ethics in SUD counseling. o NAADAC Code of ethics. o Understanding of ethics as related but not limited to the following: A. Patient Rights B. Confidentiality C. Privilege D. Exceptions to confidentiality E. Patient consent F. Internal communications G. Medical emergencies H. Court orders I. Duty to warn J. Danger to self and others K. Crimes at the program center or against the program staff L. Public presentation of client information M. Third party payers N. Research and audits O. Termination of counseling relationship P. Dual relationships Q. Professional competence and responsibilities R. Personal problems and professional effectiveness S. Use of self-help groups T. Counselor who is in recovery • Legal Aspects o Federal, state and agency regulations regarding alcohol and other drug abuse treatment by the following of proper procedures to protect client rights. o Regulations of State related to “Alcohol and Drug Counselor Licensing”. o Federal Confidentiality Regulations, 42CFR- Part 2. o HIPPA regulations as pertaining to SUD records. • Cultural Competency o The importance of individual differences by gaining knowledge about personality, cultures, lifestyles and other factors influencing client behavior in order to provide services that are sensitive to the uniqueness of the individual. o Attitudes and behaviors relative to the special populations and cultural groups with who they may become professionally involved. o Utilization of techniques pertinent to various groups and populations. • Professional Growth o Evidence based literature to foster professional development. o Utilization of self-assessment instruments to gain greater understanding of one’s strength and weakness. o Degree of competence relative to the 12 core functions of the ICRC. o Understanding the importance of professional and continuing education and develop their own professional improvement plan. o Utilizing clinical supervision as a way of identifying professional growth needs. • Personal Growth o Self-care activities which can foster personal growth: A. Accessing and managing emotions B. Exploring one’s belief systems C. Identifying and utilizing support systems D. Recognizing and addressing transference and counter transference issues. o Strategies used to maintain personal, physical, spiritual and mental health in order to ensure professional effectiveness. o The importance of personal growth and develop their own personal growth plan. • Dimensions of Recovery o Develop and operational understanding of wellness and recovery o Importance of wellness and recovery by developing an individualized wellness recovery action plan. o On-going Self-monitoring plans in order to periodically enhance their personal plan. • Supervision o Supervision within the State’s regulations. o Benefits of supervision, including the blending model. o The difference between supervision, consultation, and personal therapy. o The role of clinical supervision in helping the counselor identifies critical issues and appropriate responses in counseling relationships. o Necessary components to be incorporated when presenting a case in supervision. o Utilize a range of options to explore and discuss personal feelings and concerns about clients. o When to contact a supervisor regarding potential legal and ethical situations. o State regulations regarding requirements for giving and receiving clinical supervision as an intern as a CADC or if working in a licensed facility. • Community Involvement o Importance of professional Networking. o Develop skills in how to establish and maintain a professional network. o Importance of advocating for one’s clients as well as issues in the field. o Best practices to contribute to be-stigmatizing SUD related issues. o Cultural issues in the community and be able to incorporate relevant community information into their work. • Consultation o Consultation as per the IC&RC core Function. o Benefits of consultation. o Identify the tasks involved when seeking consultation. o Utilizing peers, clinical supervisors and a multi-disciplinary team to enhance the quality of care.