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Tag Archives: Alcohol and Drug Counseling
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.
Consultation with Other Professionals in Regard to Client Treatment Services
Consultation with other professionals such as in-house staff and outside professionals is important in order to assure a comprehensive, competent care for the 
client.
Global Criteria
- Recognize issues that are beyond the counselor’s knowledge and skills.
- Consult with appropriate resources in order to secure the provision of effective treatment services.
- Abide by applicable laws, regulations, and agency policies in regards to client’s confidentiality.
- Explain the rationale for the consultation to the client, if appropriate.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.
Report and Record Keeping
Report and record keeping involves charting the results of assessments, treatment plan, writing reports, progress notes, discharge summaries, and other client-related data.
Global Criteria
- Prepare reports and relevant records. Integrate available information.
- Chart ongoing information in regards to the client.
- Use relevant information from records to monitor client’s care.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.
Referral
Referral is the process of identifying the needs of the client that cannot be met by the counselor and the agency and therefore assisting the client in finding support systems and community resources that he/she can use.
Global Criteria
- Identify needs and problems that the counselor and agency cannot meet.
- Explain the rationale for the referral to the client.
- Match client needs and problems to appropriate resources.
- Protect client’s confidentiality by following laws, regulations, and agency policies.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.
Client Education
Client education includes the provision of information concerning alcohol and other drug abuse, its consequences, and available services and resources created to help people overcome their addictions.
Global Criteria
- Present relevant information about alcohol and other drug use and abuse to the client, through formal and informal processes.
- Present information about available support services and resources for the treatment of alcohol and other drug abuse.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.
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