Addiction Conseling Competencies The, Skills, and Attitdes of Professional Practice 21 TAP 21 Technical Assistance Pblication Series U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Sbstance Abse and Mental Health Services Administration Center for Sbstance Abse Treatment www.samhsa.gov
Other Technical Assistance Pblications (TAPs) inclde: TAP 2 Medicaid Financing for Mental Health and Sbstance Abse Services for Children and Adolescents PHD581 TAP 13 Confidentiality of Patient Records for Alcohol and Other Drg Treatment BKD156 TAP 14 Siting Drg and Alcohol Treatment Programs: Legal Challenges to the NIMBY Syndrome BKD175 TAP 17 Treating Alcohol and Other Drg Absers in Rral and Frontier Areas BKD174 TAP 19 Conselor s Manal for Relapse Prevention With Chemically Dependent Criminal Offenders (SMA) 06-4217 TAP 20 Bringing Excellence to Sbstance Abse Services in Rral and Frontier America BKD220 TAP 21 Addiction Conseling Competencies: The, Skills, and Attitdes of Professional Practice (SMA) 08-4171 TAP 21-A Competencies for Sbstance Abse Treatment Clinical Spervisors (SMA) 08-4243 TAP 22 Contracting for Managed Sbstance Abse and Mental Health Services: A Gide for Pblic Prchasers BKD252 TAP 23 Sbstance Abse Treatment for Women Offenders: Gide to Promising Practices (SMA) 08-3929 TAP 24 Welfare Reform and Sbstance Abse Treatment Confidentiality: General Gidance for Reconciling Need to Know and Privacy BKD336 TAP 26 Identifying Sbstance Abse Among TANF-Eligible Families (SMA) 05-4089 TAP 28 The National Rral Alcohol and Drg Abse Network Awards for Excellence 2004, Sbmitted and Award-Winning Papers (SMA) 10-4183 TAP 29 Integrating State Administrative Records To Manage Sbstance Abse Treatment System Performance (SMA) 09-4268 TAP 30 Bprenorphine: A Gide for Nrses (SMA) 09-4376 TAP 31 Implementing Change in Sbstance Abse Treatment Programs (SMA) 09-4377
ADDICTION COUNSELING COMPETENCIES The, Skills, and Attitdes of Professional Practice Technical Assistance Pblication (TAP) Series 21 U.S. Department of Health and Hman Services Sbstance Abse and Mental Health Services Administration Center for Sbstance Abse Treatment 1 Choke Cherry Road Rockville, MD 20857
Acknowledgments A nmber of people deserve recognition for their tireless and dedicated work on this docment. The pblication was originally conceived and written by the National Addiction Technology Transfer Center (ATTC) Crriclm Committee. The Committee, one of six national committees designed to serve the ATTC Network, comprises representatives from several ATTC Regional Centers and the ATTC National Office. This grop was responsible for the original 1998 pblication and for the 2000 draft on which this pdated edition is based (see page v). A second Committee convened in 2005 to pdate and finalize the crrent docment (see page vi). Karl D. White, Ed.D., and Catherine D. Ngent, M.S., served as the Center for Sbstance Abse Treatment (CSAT) ATTC Project Officers. Christina Crrier served as the CSAT Government Project Officer. This pblication was prodced by JBS International, Inc. (JBS), nder the Application Program (KAP) contract nmber 270-04-7049. Lynne MacArthr, M.A., A.M.L.S., served as the JBS KAP Exective Project Co-Director; Barbara Fink, RN, M.P.H., served as JBS KAP Managing Project Co-Director; Dennis Brke, M.S., M.A., served as KAP Depty Director for Prodct Development; and Jennifer Frey, Ph.D., served as the KAP Depty Director for Application. Other JBS KAP personnel inclded Elliott Vanskike, Ph.D., Senior Writer; Wendy Caron, Editorial Qality Assrance Manager; Frances Nebesky, M.A., Qality Control Editor; and Pamela Frazier, Docment Prodction Specialist. Disclaimer The views, opinions, and content expressed herein are those of the expert panel and do not necessarily reflect the views, opinions, or policies of CSAT, the Sbstance Abse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Hman Services (HHS). No official spport of or endorsement by CSAT, SAMHSA, or HHS for these opinions or for particlar instrments, software, or resorces is intended or shold be inferred. Pblic Domain Notice All materials appearing in this volme except those taken directly from copyrighted sorces are in the pblic domain and may be reprodced or copied withot permission from SAMHSA/CSAT or the athors. Citation of the sorce is appreciated. However, this docment may not be reprodced or distribted for a fee withot the specific, written athorization of the Office of Commnications, SAMHSA, HHS. Electronic Access and Printed Copies This pblication may be ordered from SAMHSA s Pblications Ordering Web page at http://www.store.samhsa. gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). The docment can be downloaded from the KAP Web site at http://www.kap.samhsa.gov. Recommended Citation Center for Sbstance Abse Treatment. Addiction Conseling Competencies: The, Skills, and Attitdes of Professional Practice. Technical Assistance Pblication (TAP) Series 21. HHS Pblication No. (SMA) 08-4171. Rockville, MD: Sbstance Abse and Mental Health Services Administration, 2006. Originating Office Qality Improvement and Workforce Development Branch, Division of Services Improvement, Center for Sbstance Abse Treatment, Sbstance Abse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857. HHS Pblication No. (SMA) 08-4171 First printed 2006 Revised 2007, 2008, 2009, and 2011 ii
contents Crriclm Committees... v 1998 National ATTC Crriclm Committee... v 2005 Update Committee... vi Foreword... vii Introdction... 1 Section 1: Transdisciplinary Fondations... 5 I. Understanding Addiction... 7 II. Treatment... 13 III. Application to Practice... 19 IV. Professional Readiness... 27 Section 2: Practice Dimensions... 35 I. Clinical Evalation... 37 II. Treatment Planning... 53 III. Referral... 67 IV. Service Coordination... 77 V. Conseling... 99 VI. Client, Family, and Commnity Edcation... 131 VII. Docmentation.................................................... 141 VIII. Professional and Ethical Responsibilities... 151 Section 3: Additional Resorces... 161 Cltral Competency... 162 Internet Resorces... 163 Attitdes Bibliography... 164 Recovery Bibliography... 166 Section 4: Appendices... 169 A. Glossary...170 B. The Competencies: A Complete List...176 C. National Validation Stdy: Defining and Measring the Competence of Addiction Conselors...188 D.Complete Bibliography....196 E. Other Contribtors....224 iii
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Crriclm Committees 1998 National ATTC Crriclm Committee Affiliations indicated below are those at the time of the work. David A. Deitch, Ph.D. (Chair) Pacific Sothwest ATTC University of California San Diego La Jolla, California G.E. Carrier, Ph.D. Representing the Texas ATTC Alvin Commnity College Alvin, Texas Steven L. Gallon, Ph.D. Northwest Frontier ATTC Oregon Health and Science University Salem, Oregon Pala K. Horvatich, Ph.D. Mid-Atlantic ATTC Virginia Commonwealth University Richmond, Virginia Mary Beth Johnson, M.S.W. ATTC National Office University of Missori Kansas City Kansas City, Missori Hendi Crosby Kowal, M.P.H. DC/Delaware ATTC Danya International, Inc. Silver Spring, Maryland Linda Nicholas Great Lakes ATTC University of Illinois Chicago Jane Addams School of Social Work Chicago, Illinois Alan M. Parsons, M.S.W., ACSW Northeastern States ATTC State University of New York at Albany Albany, New York Nancy Roget, M.S., MFT, LADC Montain West ATTC University of Nevada Reno Reno, Nevada Ssanne R. Rohrer, RN, M.B.A. Center for Sbstance Abse Treatment Sbstance Abse and Mental Health Services Administration Washington, D.C. Anne Helene Skinstad, Psy.D. Prairielands ATTC University of Iowa Iowa City, Iowa Patricia L. Stilen, LCSW, CADAC Mid-America ATTC University of Missori Kansas City Kansas City, Missori Ssan A. Storti, RN, M.A. ATTC of New England Brown University Providence, Rhode Island Elleen M. Yancey, Ph.D. Sotheast ATTC Morehose School of Medicine Atlanta, Georgia v
Addiction Conseling Competencies 2005 Update Committee Pala K. Horvatich, Ph.D. (Chair) Mid-Atlantic ATTC Virginia Commonwealth University Richmond, Virginia Carol Davidson, M.S.W., CDP Evergreen Treatment Services Seattle, Washington Steven L. Gallon, Ph.D. Northwest Frontier ATTC Office of Alcohol and Drg Abse Programs Salem, Oregon Michael Hoge, Ph.D. Annapolis Coalition Yale University New Haven, Connectict James Holder, M.A., LPC-S, MAC National Association for Alcohol and Drg Addiction Conselors McLeod Behavioral Health Florence, Soth Carolina Mary Beth Johnson, M.S.W. ATTC National Office University of Missori Kansas City Kansas City, Missori Linda Kaplan, M.A. National Association for Children of Alcoholics Rockville, Maryland Captain Florentino (Tino) Merced-Galindez, M.S.N., RN Center for Sbstance Abse Prevention Sbstance Abse and Mental Health Services Administration Rockville, Maryland Randolph Mck, M.Ed. Center for Sbstance Abse Treatment Sbstance Abse and Mental Health Services Administration Rockville, Maryland Pal D. Nagy, M.S., LCAS, LPC, CCS Dke Addictions Program Dke University Medical Center Drham, North Carolina Nancy Roget, M.S., MFT, LADC Montain West ATTC University of Nevada Reno Reno, Nevada Gerard J. Schmidt, M.A., LPC, MAC NAADAC The Association for Addiction Professionals Valley HealthCare System Morgantown, West Virginia Michael Shafer, Ph.D. Pacific Sothwest ATTC Tcson, Arizona James L. Sorensen, Ph.D. San Francisco General Hospital University of California San Francisco San Francisco, California Patricia L. Stilen, LCSW, CADAC Mid-America ATTC University of Missori Kansas City Kansas City, Missori Deborah Stone, Ph.D. Center for Mental Health Services Sbstance Abse and Mental Health Services Administration Rockville, Maryland Pamela Waters, M.Ed., CAPP Sothern Coast ATTC Florida Certification Board Tallahassee, Florida vi
Foreword Conselors who treat people with sbstance se disorders do life-changing work on a daily basis, amid difficlt circmstances that inclde staff shortages, high trnover, low salaries, and scant program fnding. Conselors come to this important work by varios paths and with vastly different skills and experience. The diversity of backgronds and types of preparation can be a strength, provided there is a common fondation from which conselors work. This pblication addresses the following qestions: What professional standards shold gide sbstance abse treatment conselors? What is an appropriate scope of practice for the field? Which competencies are associated with positive otcomes? What knowledge, skills, and attitdes (KSAs) shold all sbstance abse treatment professionals have in common? Workforce development is essential to the field of sbstance se disorder treatment. The Sbstance Abse and Mental Health Services Administration (SAMHSA) has inclded workforce development in its Matrix of Priority Programs. A major focs of this workforce development strategy is improving the competencies of professionals in the field. This pdated edition of Technical Assistance Pblication (TAP) 21: Addiction Conseling Competencies: The, Skills, and Attitdes of Professional Practice (The Competencies) is a key component of that strategy. In 1998, in cooperation with its Addiction Technology Transfer Center (ATTC) Network, SAMHSA pblished TAP 21, a comprehensive list of 123 competencies that sbstance abse treatment conselors shold master to do their work effectively. TAP 21 has been sed to develop and evalate addiction conseling crricla, advise stdents, and assess conseling proficiencies. The overarching competencies in this pdated version of TAP 21 remain largely nchanged from the original TAP 21. The KSAs have been changed from those in the 1998 edition when necessary, in light of new thinking in the field. The competencies and the KSAs in practice dimensions that address clinical evalation and treatment planning have been revised to reflect changes in the field. The competencies are defined by sblists of the KSAs needed to master each competency. Bibliographies have been spplemented with new pblications throgh 2005. The format has been improved to make the information more accessible and sefl. SAMHSA s TAP series provides a flexible format for the timely transfer of important technical information to the sbstance abse treatment field. This pdated version of TAP 21 exemplifies the flexibility of the TAP format. We are gratefl to the members of the ATTC Network and staff and to all those who participated in the validation and pdating of these competency lists. Pamela S. Hyde, J.D. Administrator Sbstance Abse and Mental Health Services Administration H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM Director Center for Sbstance Abse Treatment Sbstance Abse and Mental Health Services Administration vii
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Introdction In 1998, the Sbstance Abse and Mental Health Services Administration (SAMHSA) and the Center for Sbstance Abse Treatment (CSAT) pblished Addiction Conseling Competencies: The, Skills, and Attitdes of Professional Practice (The Competencies) as Technical Assistance Pblication (TAP) 21. Developed by the National Crriclm Committee of the Addiction Technology Transfer Center (ATTC) Network, TAP 21 identifies 123 competencies that are essential to the effective practice of conseling for psychoactive sbstance se disorders. TAP 21 also presents the knowledge, skills, and attitdes (KSAs) conselors need to become flly proficient in each competency. TAP 21 has been widely distribted by SAMHSA s National Clearinghose for Alcohol and Drg Information (NCADI) and the ATTC Network. It has become a benchmark by which crricla are developed and edcational programs and professional standards are measred for the field of sbstance abse treatment in the United States. In addition, it has been translated into several langages. Becase the ATTC Network is committed to technology transfer, after the initial pblication of TAP 21, the National Crriclm Committee began exploring ways to enhance the docment for ftre printings. Sccessfl technology transfer reqires more than presenting good information. It entails transmitting scientific knowledge in a way that makes it nderstandable, feasible to implement in a real-world setting, and spportable at a systematic level in other words, getting the right information across in a way that makes it seable. The National Crriclm Committee examined how best to package and present TAP 21 to help people learn key elements and adopt new strategies. The reslt was a revision of TAP 21 a process that was begn in 2000, was completed in 2005, and reslted in the crrent pblication. History of The Competencies In 1993 CSAT created a mltidisciplinary network of 11 ATTC Regional Centers geographically dispersed across the United States and in Perto Rico and the U.S. Virgin Islands. Since its inception, the ATTC Network has collaborated with diverse international, national, State, regional, and local partners from mltiple disciplines to recrit qalified addiction treatment practitioners and enhance academic preparation and professional development opportnities in the sbstance abse treatment field. The National Crriclm Committee, composed of ATTC Directors, was established at the Network s inagral meeting. The committee s initial charge was to collect and evalate existing addiction edcational and professional development crricla and establish ftre priorities for ATTC crriclm development. This effort led to researching existing practice and professional literatre and defining an extensive list of addiction practice competencies determined to be essential to effective conseling for sbstance se disorders. These initial competencies wold serve as benchmarks to gide ftre ATTC crriclm design, development, and evalation. 1
Addiction Conseling Competencies In addition to its own work, the National Crriclm Committee reviewed and incorporated other pblications on the work of addiction conselors. 1 In 1995 the committee s work reslted in the ATTC pblication Addiction Conselor Competencies. Sbseqent to this pblication, the ATTCs condcted a national srvey to validate the competencies (see appendix C). Reslts spported virtally all of the competencies as being essential to the professional practice of addiction conseling. In 1996, the International Certification and Reciprocity Consortim (ICRC) convened a national leadership grop to evalate the need for model addiction conselor training. After carefl deliberation, the grop conclded that mch of the work to define sch a crriclm standard had already been accomplished by the ATTC National Crriclm Committee and the ICRC in the National Crriclm Committee s Addiction Conselor Competencies and the ICRC s 1996 Role Delineation Stdy, 2 respectively. Soon after, CSAT agreed to fnd a collaborative effort to finalize a docment that cold be sed as a national standard. CSAT convened a panel The National Steering Committee for Addiction Conseling Standards (NSC) that comprised representatives from five national edcational, certification, and professional associations. The NSC was sccessfl in achieving nanimos endorsement of the Addiction Conselor Competencies a milestone in the addiction conseling field. Based on this fondation, the National Crriclm Committee began to delineate the KSAs that ndergird each competency statement. Inpt was solicited from a nmber of key national organizations and selected field reviewers. In 1998 CSAT pblished the reslts of this grondbreaking work as TAP 21 (The Competencies). After TAP 21 was pblished, the National Crriclm Committee systematically condcted focs grops and a national srvey to elicit feedback from the field abot the impact of TAP 21. Althogh feedback was niformly positive and thosands of copies of TAP 21 were disseminated throgh SAMHSA s NCADI and the ATTC Network, refinements were needed to improve the tility of the pblication and enhance its effect in both the addiction practice and edcational systems. Feedback obtained from the srvey and the focs grops indicated a need for additional information to help the field incorporate the competencies into daily practice. Feedback also sggested that there was no need to change the competencies. The most common sggestions were to refine the 1998 pblication by presenting the content in a more ser-friendly fashion and linking it to professional literatre and specific applications. The National Crriclm Committee revised TAP 21 in 2000 based on the feedback of dedicated addiction practice and edcation professionals; however, this revision was never pblished. A new Update Committee was convened in 2005 to pdate the revised 2000 edition with literatre pblished between 2000 and 2005. The Update Committee consisted of some of the original members from the National Crriclm Committee; representatives from NAADAC The Association for Addiction Professionals, CSAT, the Center for Mental Health Services, the Center for Sbstance Abse Prevention, the National Association for Children of Alcoholics, and the Annapolis Coalition; treatment providers; and experts in addiction research. The crrent pdated edition retains all of the feedback-based improvements of the 2000 revised version and adds relevant 2 1 Birch and Davis Corporation (1986). Development of Model Professional Standards for Conselor Credentialing. Dbqe, IA: Kendall/Hnt Pblishing. 2 International Certification and Reciprocity Consortim (ICRC)/Alcohol and Other Drg Abse (1991). Role Delineation Stdy for Alcohol and Other Drg Abse Conselors. Raleigh, NC: ICRC.
Introdction literatre pblished after 2000. In addition, the competencies and KSAs of several practice dimensions, in particlar those that address clinical evalation and treatment planning, were rewritten to reflect crrent best practices. What Yo Will Find Inside The Model When creating The Competencies, the National Crriclm Committee recognized a need to emphasize three characteristics of competency: knowledge, skills, and attitdes. Many hors were spent conceptalizing a differentiated model when designing TAP 21 a model that cold address general KSAs necessary for all practitioners dealing with sbstance se disorders while explaining the more specific needs of professional sbstance abse treatment conselors. The first section of the model addresses the generic KSAs. This section contains the transdisciplinary fondations, comprising for discrete bilding blocks: nderstanding addiction, treatment knowledge, application to practice, and professional readiness. The term transdisciplinary was selected to describe the knowledge and skills needed by all disciplines (e.g., medicine, social work, pastoral gidance, corrections, social welfare) that deal directly with individals with sbstance se disorders. The second section of the model specifically addresses the professional practice needs, or practice dimensions, of addiction conselors. Each practice dimension incldes a set of competencies, and, within each competency, the KSAs necessary for effective addiction conseling are otlined. Many additional competencies may be desirable for conselors in specific settings. Edcation and experience affect the depth of the individal conselor s knowledge and skills; not all conselors will be experienced and proficient in all the Figre 1. Components in the Competencies Model competencies discssed. The National Crriclm Committee s goal for the ftre is to help ensre that every addiction conselor possesses, to an appropriate degree, each competency listed, regardless of setting or treatment model. The relationship of the components in the competencies model is conceptalized as a hb with eight spokes (see figre 1). The hb contains the for transdisciplinary fondations that are central to the work of all addiction professionals. The eight spokes are the practice dimensions, each containing the competencies the addiction conselor shold attain to master each practice dimension. 3
Addiction Conseling Competencies Recommended Readings Jornal articles, book chapters, and other critical literatre for each transdisciplinary fondation and practice dimension have been reviewed and inclded in this docment. Moreover, separate bibliographies on attitdes and recovery have been added, as have lists of Internet and cltral competency resorces. These can be fond in section 3. Appendices Appendices inclde a glossary (appendix A), a complete list of the competencies (appendix B), a smmary of the reslts of the Committee s National Validation Stdy of The Competencies (appendix C), a complete bibliography with a detailed overview of the methodology sed for literatre searches (appendix D), and a list of people who acted as field reviewers or provided research assistance (appendix E). Companion Volme TAP 21-A As a companion to this volme on conselor competencies, CSAT is pblishing TAP 21-A, Competencies for Sbstance Abse Treatment Clinical Spervisors, which discsses the qalities and abilities integral to spervising sbstance abse treatment clinicians. Uses of The Competencies Since its inception, The Competencies has been improving addiction conseling and addiction conselor edcation across the contry in a nmber of ways. The most common reported applications have been in crriclm/corse evalation and design for higher edcation; personal professional development; stdent advising, spervision, and assessment; assessment of competent practices; design of professional development and contining edcation programs; and certification standards/exams. Examples of how The Competencies is being sed are given on the following pages: Montana...24 Illinois...31 Nebraska... 40 New York...44 Missori...45 Texas...48 Perto Rico...56 International Applications... 59 New England...72 Idaho, Oregon, and Washington... 74 Nevada...85 Texas...88 Florida...89 Virginia...91 Northeast...93 Idaho... 103 Washington...112 California...116 Oregon and Wisconsin...135 Iowa...137 Georgia...143 Alaska, Hawaii, Idaho, Oregon, and Washington... 155 4
Section 1: Introdction to the Transdisciplinary Fondations The Transdisciplinary Fondations Addiction professionals work in a broad variety of disciplines bt share an nderstanding of the addictive process that goes beyond the narrow confines of any one specialty. Specific proficiencies, skills, levels of involvement with clients, and scope of practice vary widely among specializations. At their base, however, all addiction-focsed disciplines are bilt on for common fondations. This section focses on for sets of competencies that are transdisciplinary in that they nderlie the work not jst of conselors bt of all addiction professionals. The for areas of knowledge identified here serve as prereqisites to the development of competency in any of the addiction-focsed disciplines. The For Transdisciplinary Fondations I. Understanding Addiction II. Treatment III. Application to Practice IV. Professional Readiness Regardless of professional identity or discipline, each treatment provider mst have a basic nderstanding of addiction that incldes knowledge of crrent models and theories, appreciation of the mltiple contexts within which sbstance se occrs, and awareness of the effects of psychoactive drg se. Each professional mst be knowledgeable abot the continm of care and the social contexts affecting the treatment and recovery process. Each addiction specialist mst be able to identify a variety of helping strategies that can be tailored to meet the needs of individal clients. Each professional mst be prepared to adapt to an ever-changing set of challenges and constraints. Althogh specific skills and applications vary across disciplines, the attitdinal components tend to remain constant. The development of effective practice in addiction conseling depends on the presence of attitdes reflecting openness to alternative approaches, appreciation of diversity, and willingness to change. The following knowledge and attitdes are prereqisite to the development of competency in the professional treatment of sbstance se disorders. Sch knowledge and attitdes form the basis of nderstanding on which discipline-specific proficiencies are bilt. 5
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Transdisciplinary Fondation I UNDERSTANDING ADDICTION 7
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TF I. Understanding Addiction Competency 1: Understand a variety of models and theories of addiction and other problems related to sbstance se. X Terms and concepts related to theory, etiology, research, and practice. Scientific and theoretical basis of model from medicine, psychology, sociology, religios stdies, and other disciplines. Criteria and methods for evalating models and theories. Appropriate applications of models. How to access addiction-related literatre from mltiple disciplines. Attitdes X Openness to information that may differ from personally held views. Appreciation of the complexity inherent in nderstanding addiction. Valing of diverse concepts, models, and theories. Willingness to form personal concepts throgh critical thinking. Competency 2: Recognize the social, political, economic, and cltral context within which addiction and sbstance abse exist, inclding risk and resiliency factors that characterize individals and grops and their living environments. X Basic concepts of social, political, economic, and cltral systems and their impact on drg-taking activity. The history of licit and illicit drg se. Research reports and other literatre identifying risk and resiliency factors for sbstance se. Statistical information regarding the incidence and prevalence of sbstance se disorders in the general poplation and major demographic grops. Attitdes Recognition of the importance of contextal variables. X Appreciation for differences between and within cltres. 9
Addiction Conseling Competencies Competency 3: Describe the behavioral, psychological, physical health, and social effects of psychoactive sbstances on the person sing and significant others. X X Fndamental concepts of pharmacological properties and effects of all psychoactive sbstances. X X The continm of drg se, sch as initiation, intoxication, harmfl se, abse, dependence, withdrawal, craving, relapse, and recovery. Behavioral, psychological, social, and health effects of psychoactive sbstances. The effects of chronic sbstance se on clients, significant others, and commnities within a social, political, cltral, and economic context. X X The varying corses of addiction. The relationship between infectios diseases and sbstance se. Attitdes Sensitivity to mltiple inflences in the developmental corse of addiction. Interest in scientific research findings. Competency 4: Recognize the potential for sbstance se disorders to mimic a variety of medical and mental health conditions and the potential for medical and mental health conditions to coexist with addiction and sbstance abse. Normal hman growth and development. Symptoms of sbstance se disorders that are similar to those of other medical and/ or mental health conditions and how these disorders interact. X X The medical and mental health conditions that most commonly exist with addiction and sbstance se disorders. X X Methods for differentiating sbstance se disorders from other medical or mental health conditions. Attitdes Willingness to reserve jdgment ntil completion of a thorogh clinical evalation. Willingness to work with people who might display and/or have mental health conditions. Willingness to refer for treating conditions otside one s expertise. Appreciation of the contribtion of mltiple disciplines to the evalation process. 10
TF 1. Understanding Addiction Bibliography Members of the National ATTC Crriclm Committee reviewed the bibliography from the first printing of The Competencies. Following previosly established gidelines, the Committee reviewed and linked each reference with a specific transdisciplinary fondation. Primarily textbooks are referenced in this section; however, sch texts are not mtally exclsive of the practice dimensions. TF I. Understanding Addiction Akers, R.L. (1992). Drgs, Alcohol, and Society: Social Strctre, Process, and Policy. Monterey, CA: Brooks/Cole. Baer, J.S., Marlatt, G.A., & McMahon, R.J. (Eds.) (1993). Addictive Behaviors Across the Life Span. Newbry Park, CA: Sage Pblications. Bennett, L.A., Reiss, D., et al. (1987). The Alcoholic Family. New York: Basic Books. Blevins, G.A., Dana, R.Q., & Lewis, J.A. (1994). Sbstance Abse Conseling: An Individal Approach (2nd ed.). Pacific Grove, CA: Brooks/Cole. Cohen, W.E., Holstein, M.E., & Inaba, D.S. (1997). Uppers, Downers, All Aronders: Physical and Mental Effects of Psychoactive Drgs (3rd ed.). Ashland, OR: CNS Pblications. Collins, R.L., Leonard, K.E., & Searles, J.S. (Eds.) (1990). Alcohol and the Family: Research and Clinical Perspectives. New York: Gilford Press. Crtis, O. (1998). Chemical Dependency: A Family Affair. Pacific Grove, CA: Brooks/Cole. Epstein, E.E., & McCrady, B.S. (Eds.) (1999). Addictions: A Comprehensive Gidebook. New York: Oxford University Press. Fisher, G.L., & Harrison, T.C. (2004). Sbstance Abse: Information for School Conselors, Social Workers, Therapists, and Conselors. Boston: Allyn & Bacon. Gllotta, T.P., Adams, G.R., & Montemayor, R. (Eds.) (1994). Sbstance Misse in Adolescence. Thosand Oaks, CA: Sage Pblications. Jaffe, J. (Ed.) (1995). Encyclopedia of Drgs and Alcohol. New York: Macmillan. Jonnes, J. (1999). Hep-Cats, Narcs, and Pipe Dreams: A History of America s Romance With Illegal Drgs. Baltimore: Johns Hopkins University Press. Kinney, J. (2003). Loosening the Grip: A Handbook of Alcohol Information (7th ed.). New York: McGraw-Hill. Lawson, A.W., Lawson, G.W., & Rivers, P.C. (1996). Essentials of Chemical Dependency Conseling (2nd ed.). Gaithersbrg, MD: Aspen Pblishers. Lawson, G.W., & Lawson, A.W. (1992). Adolescent Sbstance Abse: Etiology, Treatment, and Prevention. Gaithersbrg, MD: Aspen Pblishers. Lewis, J.A., Dana, R.Q., & Blevins, G.A. (2001). Sbstance Abse Conseling (3rd ed.). Pacific Grove, CA: Brooks/Cole. Lowinson, J.H., Riz, P., et al. (Eds.) (1997). Sbstance Abse: A Comprehensive Textbook (3rd ed.). Baltimore: Lippincott Williams & Wilkins. 11