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Professional Readiness
Professional readiness is an ongoing process. It should not be understood as something you get done one time and you don’t look at it again. Professional readiness is directly linked to continuing education.
Understanding Diverse Cultures
A competent substance abuse counselor is constantly learning about:
- Information and resources in regards to diverse cultures, lifestyles, gender and age.
- Information and resources to provide quality care to people with special needs and disabilities.
- How culture, lifestyle, gender, etc. influence behavior.
- How culture, lifestyle, and values influence substance use.
- Assessment and intervention methods that are appropriate to culture and gender.
- Counseling methods that match the needs of people from multicultural backgrounds, and people with disabilities.
- Legislation related to human, civil, and client’s rights.
Self-awareness is Important
If we want to become competent substance abuse counselors, we must be open to evaluation, supervision, and change. In order to grow both personally and professionally, we need to:
- Be aware of our personal and professional strengths and limitations.
- Be aware of cultural, ethnic, and gender biases.
- Look for resources available for continuing education.
- Make a commitment to continuing professional education.
- Know the benefits of self-assessment, clinical supervision, and consultation with other professionals.
- Find ways to enhance our personal and professional growth.
Substance Abuse Prevention
Addictions professionals are not only involved with treatment and recovery. We also have the obligation to participate in prevention programs.
Substance abuse treatment and substance abuse prevention are two different fields. Research shows that for every dollar spent on prevention, 7 to 18 dollars are saved on treatment and recovery.
What we need to learn about substance abuse prevention includes:
- Research-based prevention models and strategies.
- The relationship between prevention and treatment.
- Environmental strategies and prevention campaigns.
- Benefits of working with community coalitions.
I recommend this book Substance Abuse Prevention: The Intersection of Science and Practice, by Julie Hogan et al. I am currently reading this book for my class on substance abuse prevention.
Setting-specific Policies and Procedures
It is our responsibility to learn, understand, and apply our agency’s (the place in which we are currently working) policies and procedures to handle crisis and dangerous situations, such as safety measures for clients and self.
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:
- ASAM Dimension 1
- ASAM Dimension 2
- ASAM Dimension 3
- ASAM Dimension 4
- Assessment
- 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.
Treatment Knowledge
Models of Treatment
The substance abuse counselor must be familiar with the most accepted and scientifically supported models of substance abuse prevention, treatment, recovery, relapse prevention, and continuing care. Knowledge in this area also includes:
- Philosophies, practices, policies, and outcomes of the most accepted therapeutic models.
- Pharmacotherapy
- Support groups and self-help groups
- Behavioral self-control training
- Mental health
- Psychotherapy
A competent substance abuse counselor must be open to new, evidence-based treatment approaches, including pharmacological interventions.
Family, Friends, and Community
Substance abuse counselors must also recognize the importance of family, social networks, and community systems in the client’s environment, since they could be either sources of strength or obstacles during treatment and recovery processes.
It is important to learn ways to incorporate family and social networks in treatment and recovery, and appreciate the many ways in which they could enhance these processes.
Research, Outcomes, and Applications
Knowledge in the following areas is necessary:
- Research methods in the behavioral and social sciences.
- Research literature related to the prevention and treatment of addiction.
- Research on epidemiology, etiology, and treatment efficacy.
- Benefits and limitations of research.
Interdisciplinary Approach
Knowledge in this area includes:
- How multiple disciplines contribute to treatment efficacy.
- Familiarity with terminology and concepts in order to communicate effectively across disciplines.
The substance abuse counselor must show a desire to collaborate with others, respect for the contributions of multiple disciplines, and commitment to professionalism.
Understanding Addiction
A competent substance abuse counselor must have a basic understanding of addiction. She/he must have knowledge about:
- the terms and concepts related to theory, etiology, research, and practice,
- criteria and methods used to evaluate models and theories (we should always question what we learn),
- how to apply those theories and models appropriately,
- how to access literature on addiction-related topics, i.e, research skills.
While doing this, the substance abuse counselor must possess certain attitudes, such as:
- being open to information that may differ from personal beliefs,
- appreciate the complexity in understanding addiction,
- value diverse ways of thinking expressed in theories and models,
- flexibility to form personal concepts through critical thinking.
The substance abuse counselor must be able to recognize the social, political, economic, and cultural context surrounding addiction and substance abuse. This is important because different living environments create the conditions for people to have both risk and protective factors that may lead to or prevent substance abuse and addiction. Knowledge in this area includes:
- Concepts of social, political, economic, and cultural systems and their impact on drug use/abuse.
- The history of licit and illicit drugs.
- Risk and protective factors for substance use/abuse.
- Statistical information about substance abuse disorders in the general population.
Substance abuse counselors must be able to describe the behavioral, psychological, physiological, and social effects of all psychoactive drugs on the person using and significant others. Knowledge in the following areas is necessary:
- Pharmacology of addiction.
- Initiation, intoxication, harmful use, abuse, dependence, withdrawal, craving, relapse, and recovery.
- The relationship of substance use and infectious diseases.
- The relationship between substance use and mental disorders.
Substance abuse counselors must be able to recognize overlapping symptoms for substance abuse, medical conditions, and mental disorders, also known as co-occurring/comorbid disorders, or dual diagnosis. Knowledge is required in:
- Normal and abnormal human growth and development.
- Methods from differentiating substance use disorders from medical conditions or mental disorders.
It is important that the substance abuse counselor does not jump into conclusions before all the assessments and clinical evaluations are completed. Whenever a client’s case is outside of the counselor’s expertise, she/he must be willing to refer the client to the most appropriate care.
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