Application to Practice

Diagnostic Criteria

As substance abuse counselors, we must understand the established diagnostic criteria included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) standards and in the most current International Classification of Diseases (ICD) standards. This knowledge will help us establish client’s placement criteria, and will allow us to identify the strengths and limitations of both the diagnostic criteria and the placement criteria.

Note: I did not know what TAP 21 meant by placement criteria, so I went online and found this website American Society of Addiction Medicine (ASAM) and I read the table of contents of their placement criteria publication. Placement criteria refers to the type of treatment the client will be placed into, depending on the diagnosis. Types of treatment could be: early intervention, intensive outpatient (IOP), or Opiod Maintenance Therapy (OMT).

Supplemental readings about placement criteria and diagnosis:

Variety of Help

Because substance abuse treatment is not a one-size-fits-all, substance abuse counselor must be familiar with all the options out there in regards to helping strategies. The following list mentions some of them, just to give you an idea:

  • Methods and tools used to evaluate the substance abuse problem.
  • Interventions that match the client’s stage/level of dependence, change, and recovery.
  • The use of motivational interviewing (MI).
  • Ways to get the family and social network involved in the recovery process.
  • Support groups and self-help groups.
  • Court-ordered and voluntary care models.
  • Brief therapy interventions
  • Long-term therapy interventions.

Services Appropriate to Cultural Background

A competent substance abuse counselor must be aware of and respect the diversity within  and among cultures. For example:

  • Diverse cultural norms, values, beliefs, and behaviors.
  • Differences in verbal and nonverbal communication.

As substance abuse counselors dealing with clients from multicultural backgrounds, we need to find the resources to develop individualized treatment plans. We need to know the strengths and limitations of the available treatment options, how to have access to them and make referrals.

Medical and Pharmacological Resources

We must be familiar with:

  • Current literature related to medical and pharmacological interventions.
  • Potential risks and benefits of medical and pharmacological interventions.
  • Health practitioners in the community who have training in and knowledge about addiction and addiction treatment.

Service Coverage Options

Some substance abuse counselors might not like this part of the job, and even try to avoid it, but it is very important and necessary to do it and do it well. We must be familiar with:

  • The variety of public and private payment plans.
  • Methods of gaining access to available payment plans.
  • Policies and procedures used by available payment plans.

Our goal is to cooperate with payment providers in order to promote the most cost-effective, high-quality care for our clients.

Prepare for a Crisis

Features of crisis:

  • Family disruption
  • Social and legal problems
  • Physical and psychological
  • Panic states
  • Physical dysfunction

How to respond and follow through in crisis situations?

  • Perform substance use screening and assessment.
  • Use of prevention and intervention principles and methods.
  • Use of principles of crisis case management.
  • Be familiar with posttraumatic stress symptoms.
  • Methods of debriefing after critical events.
  • Know the available resources for assistance in the management of crisis situations.

TAP 21

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7 Comments

  1. yvette thomas says:

    I have a ASAM Dimensional Treatment Plan Categories tha I used to help formaulate treatment plans it also helped me learn the six dimensions which helped me pass the certification exam. I will be happy to share it with anyone that would like it. The Addiction Treatment Planner, Third Edition by Robert R. Perkinson, Arthur E. Jongsma, Jr is an excellent book it has Easy-to-use reference format helps locate treatment plan components by behavioral problem or DSM-IV-TR® diagnosis
    Includes a sample treatment plan that conforms to the requirements of most third-party payors and accrediting agencies (including HCFA, JCAHO, and NCQA)

    I hope this helps all that work in the field

    • Hi Yvette,

      That would be awesome! I learned what the ASAM was a few days ago, when I was writing one of my blogs. I needed an example for treatment plan placement criteria and found what you mentioned. They are pricey…I only had access to the table of contents.

      Thanks a lot.

      • I have a lot of info from working in the addiction field for 15+ yrs. I can post it on fb or email it to you. It is about 2 pages. I have some sample treatment plans as well. Let me know what you are looking for and I will see if I have it. The best way to get resource material is at conferences and other counselors who either are retiring or replace material. This is a field that is forever changing. Check out the ILL Certification board they have a list of books broken down into specific areas of specialities.

    • Tess York says:

      Thank you for all of your insight. I really enjoyed reading your post. I would appreciate being able to look over any additional information that you might be able to share, as I am new to the field. Thank you in advance.

      • Hello Tess,

        Visit the Downloads page. You can find more information there. When you go to the home page (click on the header image) you will find links to my other blogs where you can find more information. Visit also the Resources page, you will find suggestions for textbooks, websites, and videos that are great tools to learn more about this field. I hope this helps. Good luck!

  2. Aloha from Hawaii!

    I enjoyed reading your post! Necessary to the our scope of practice is the understanding of the ASAM criteria and dimensions as well as the upcoming revisions to the DSM-V. I find it important to understand not only the diagnostic material but also how our scope of practice converges with psychotherapy and social work. We are often called to clarify how we overlap and differ with regard to how others in the helping professions.

    Our Code of Ethics (NAADAC) informs us that we must constantly educate those in the public sector. There are many areas in which challenges in information and misinformation is disseminated. I find the work as a counselor / therapist in addictions challenging and rewarding and any opportunity to clarify how we approach treatment and share this information with others is an opportunity for growth.

    Mark Crumpton, CSAC, ICADC, SAP

    • Aloha Mark,

      I just found your comment on my “Spam” folder. I am still learning how this works; I don’t understand how you comment ended up as “spam.”

      I appreciate your response. I agree with you. This field is challenging but very rewarding.

      Thanks for sharing your thoughts!

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