PREFACE  

This document presents the knowledge, skills, and attitudes that are needed for achieving and practicing the competencies listed in Addiction Counseling Competencies (included as Appendix C). The document is intended to provide guidance for the professional treatment of substance use disorders which has become recognized as a complex multidisciplinary practice supported by a large and rapidly expanding body of theoretical and scientific literature. Both public and private research initiatives have repeatedly demonstrated the cost effectiveness of well designed strategies for intervening with people suffering from the adverse consequences of both substance abuse and dependence.  

As our understanding for how best to interrupt the destructive course of substance abuse problems has grown, the parallel process of preparing treatment professionals has also been developing. Addiction specialties have recently emerged in medicine, nursing, and other allied health and human service professions. The primary care givers, however, have traditionally been counselors who specialize in chemical dependency treatment. Historically, those counselors have been trained in specialty training programs often developed by treatment agencies rather than in academic institutions. Today, due to a variety of policy and economic factors, the preparation of substance abuse counselors is being undertaken by colleges in cooperation with treatment agencies, where classroom and field training experiences are being integrated into competency-based instructional programs.  

In 1993 the Center for Substance Abuse Treatment (CSAT) created the Addiction Technology Transfer Center (ATTC) Program, comprised of eleven geographically dispersed centers covering twenty-four states and Puerto Rico, to foster improvements in the preparation of addiction treatment professionals. As part of that program the ATTC National Curriculum Committee (the Committee) was established to evaluate existing curricula and establish priorities for curriculum development. The Committeeís first activity was to define the competencies essential to the effective practice of counseling for psychoactive substance use disorders. Those competencies could then be used as criteria for evaluating curriculum materials.  

In addition to its own original contribution, the Committee reviewed and incorporated existing literature related to the work of the addiction counselor (Birch & Davis, 1986; ICRC, 1991). The result of the Committeeís effort was the 1995 publication of Addiction Counselor Competencies. Subsequently, the ATTCs conducted a national survey to validate the competencies. Results indicated broad support for virtually all of the competencies as essential to the practice of addiction counseling.  

The Committee then began the process of delineating the knowledge, skills, and attitudes (KSAs) that make up each of the 121 competencies listed in the Addiction Counselor Competencies. During the development of the KSAs, the Committee elicited input from professional organizations including the International Certification Reciprocity Consortium (ICRC), the National Association of Alcoholism and Drug Abuse Counselors (NAADAC), the American Psychological Association, the National Association of State Alcohol & Drug Abuse Directors, and the International Coalition of Addiction Studies Educators (INCASE). Field reviewers also made significant contributions to the final product that appears here.

 
Collaborative Effort   

In November 1996, ICRC convened a meeting of representatives from a number of national organizations, which represent the professional addiction counseling field, to deliberate the need for model counselor training curricula. The group concluded that much of the work to define such a curriculum standard had been completed by the ATTC National Curriculum Committee and the ICRC. The work included a draft of Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice and the 1996 Role Delineation Study, respectively. Only a modest amount of work remained to finalize a document that could be used as a national standard. CSAT agreed to support an expanded collaborative effort and convened a panel representing key educational, certification, and professional associations to complete the work. This group is the National Steering Committee on Addiction Counseling Standards. It is comprised of representatives from CSAT, the ATTC National Curriculum Committee, ICRC, NAADAC, INCASE, and the American Academy of Health Care Providers in the Addictive Disorders.  

The National Steering Committee reviewed the 1996 ICRC Role Delineation Study and a draft of the Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice (1997). It determined that with minor modifications, the Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice document includes the essential knowledge, skills, and attitudes requisite to effective addiction counseling practice. The National Steering Committee endorses and promotes the Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice document as a vehicle for counselor development and curriculum planning for both pre-service and continuing education. It is a dynamic document that will continue to evolve as addiction science and technology progress.

 
INTRODUCTION   

Every day, countless lives are enriched or saved because of the work carried out by addiction counselors. In a myriad of settings, competent, well-trained counselors form the relationships and carry out the strategies that help their clients move from life-threatening addiction to life-affirming recovery. Although the field of addictions can be very broad in scope, we have chosen to focus on the work of counselors who deal with psychoactive substance use, abuse, and dependence among their clients.  

We can state with certainty that thousands of addiction counselors accomplish their missions with distinction. We also know, however, that even specialists in the addictions field have not traditionally been able to define with clarity the professional standards that should guide their work. What is the scope of practice that is appropriate for an addiction counselor? What are the competencies that are most likely to be associated with positive outcomes? What knowledge, skills, and attitudes should be shared by all members of the addiction counseling profession? The central purpose of this publication is to address those questions.
 

Transdisciplinary Foundations   

The first section, Transdisciplinary Foundations for Addiction Professionals, identifies the knowledge and attitudes that underlie competent practice not just for counselors but for addiction specialists in other disciplines as well. Functional skills may vary across disciplines, but the knowledge and attitudes highlighted here provide a basis of understanding that should be common to all addictions professionals and that serves as a prerequisite to the development of competency in each discipline. These foundations, as articulated in Addiction Counseling Competencies (Appendix C), include:  

The Professional Practice of Addiction Counseling   

The second section of the publication addresses the professional practice of addiction counseling. The National Curriculum Committee of the Addiction Technology Transfer Center program, which is supported by the Center for Substance Abuse Treatment, developed this section over a three-year period. Using reviews of current research, input from key experts, and feedback from experienced trainers and practitioners, the Committee sought to define the professional practice that would be appropriate for the addiction counselor of the 21st century. Eight Practice Dimensions were identified, with the Committee recognizing that the counselorís effectiveness would depend on his or her ability to develop expertise in each. These dimensions include the following:  

Several of these dimensions encompass specific Elements. Clinical evaluation, for instance, includes both screening and assessment. Service coordination includes three definable elements: implementing the treatment plan, consulting, and carrying on the process of ongoing assessment and treatment planning. Counseling, of course, includes the elements of individual, group, and family counseling.  

The Committeeís delineation of the addiction counselorís scope of practice provided it with a context for identifying the competencies that are necessary for effective functioning in the addiction counselor role. Each dimension carries its own set of Competencies. Many additional competencies may be desirable for counselors in specific settings. In addition, education and experience will affect the depth of the individual counselorís knowledge and skills. Our goal for the future, however, is that every addiction counselor possess every competency listed on these pages, regardless of setting or treatment model.  

The competencies underlying effective practice of addiction counseling were introduced in a 1995 publication (see Appendix C for a revised edition, entitled Addiction Counseling Competencies). The Committee members recognized that greater detail is needed to make this schema useful for program development, evaluation, and training. Thus, the current full document lists the Knowledge, Skills, and Attitudes that combine to ensure attainment of each of the competencies listed in the document presented in Appendix C.

 
Using This Document   

This document is not intended to be a curriculum that must be followed in a specific sequence. Instead, it identifies the knowledge, skills, and attitudes that could serve as outcomes toward which curricula might aim. Settings, time constraints, and levels of counselor training diverge widely. For this reason, we provide a set of outcome guidelines that may be used to meet varying needs. Educators and curriculum developers can build courses, curricula, and training packages oriented toward these outcomes. Counseling practitioners can assess their own progress toward achieving the competencies. Supervisory and administrative personnel can use the materials to identify in-service training and continuing education needs within their agencies.  

As the Committee stated in our first publication, we know that the field of addiction counseling will be characterized by significant change in the coming decades. No one can predict in great detail the specifics of each counselorís setting, clientele, and practice. Nevertheless, we can predict with certainty that addiction counselors of the future will be individuals who are comfortable with the process of lifelong learning, who are able to apply their skills in a variety of settings, and who welcome the opportunity to develop new strategies in response to the changing needs of their clients and communities.  

Inquiries may be directed to the Committee chair: David A. Deitch, Ph.D., California Addiction Technology Transfer Center, UCSD School of Medicine, 565 Pearl St., Suite 360, La Jolla, California 92037.
 

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Email: no@nattc.org | Revised March 1998