Appendix B The Competencies

This is a complete list of the competencies without the knowledge, skills, and attitudes.

Transdisciplinary Foundation 1: Understanding  Addiction

Competency 1

Understand a variety of models and theories of addiction and other problems related to substance use.

Competency 2

Recognize the social, political, economic, and cultural context within which addiction and substance abuse exist, including risk and resiliency factors that characterize individuals and groups and their living environments.

Competency 3

Describe the behavioral, psychological, physical health, and social effects of psychoactive substances on the person using and significant others.

Competency 4

Recognize the potential for substance use 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 substance abuse.

Transdisciplinary Foundation 2: Treatment Knowledge

Competency 5

Describe the philosophies, practices, policies, and outcomes of the most generally accepted and scientifically supported models of treatment, recovery, relapse prevention, and continuing care for addiction and other substance-related problems.

Competency 6

Recognize the importance of family, social networks, and community systems in the treatment and recovery process.

Competency 7

Understand the importance of research and outcome data and their application in clinical practice.

Competency 8

Understand the value of an interdisciplinary approach to addiction treatment.

Transdisciplinary Foundation 3: Application to Practice

Competency 9

Understand the established diagnostic criteria for substance use disorders, and describe treatment modalities and placement criteria within the continuum of care.

Competency 10

Describe a variety of helping strategies for reducing the negative effects of substance use, abuse, and dependence.

Competency 11

Tailor helping strategies and treatment modalities to the client’s stage of dependence, change, or recovery.

Competency 12

Provide treatment services appropriate to the personal and cultural identity and language of the client.

Competency 13

Adapt practice to the range of treatment settings and modalities.

Competency 14

Be familiar with medical and pharmacological resources in the treatment of substance use disorders.

Competency 15

Understand the variety of insurance and health maintenance options available and the importance of helping clients access those benefits.

Competency 16

Recognize that crisis may indicate an underlying substance use disorder and may be a window of opportunity for change.

Competency 17

Understand the need for and use of methods for measuring treatment outcome.

Transdisciplinary Foundation 4:  Professional Readiness

Competency 18

Understand diverse cultures, and incorporate the relevant needs of culturally diverse groups, as well as people with disabilities, into clinical practice.

Competency 19

Understand the importance of self-awareness in one’s personal, professional, and cultural life.

Competency 20

Understand the addiction professional’s obligations to adhere to ethical and behavioral standards of conduct in the helping relationship.

Competency 21

Understand the importance of ongoing supervision and continuing education in the delivery of client services.

Competency 22

Understand the obligation of the addiction professional to participate in prevention and treatment activities.

Competency 23

Understand and apply setting-specific policies and procedures for handling crisis or dangerous situations, including safety measures for clients and staff.

Practice  Dimension 1: Clinical Evaluation — Element: Screening

Competency 24

Establish rapport, including management of a crisis situation and determination of need for additional professional assistance.

Competency 25

Gather data systematically from the client and other available collateral sources, using screen- ing instruments and other methods that are sensitive to age, developmental level, culture, and gender. At a minimum, data should include current and historic substance use; health, mental health, and substance-related treatment histories; mental and functional statuses; and current social, environmental, and/or economic constraints.

Competency 26

Screen for psychoactive substance toxicity, intoxication, and withdrawal symptoms; aggression or danger to others; potential for self-inflicted harm or suicide; and co-occurring mental disorders.

Competency 27

Assist the client in identifying the effect of substance use on his or her current life problems and the effects of continued harmful use or abuse.

Competency 28

Determine the client’s readiness for treatment and change as well as the needs of others involved in the current situation.

Competency 29

Review the treatment options that are appropriate for the client’s needs, characteristics, goals, and financial resources.

Competency 30

Apply accepted criteria for diagnosis of substance use disorders in making treatment recommendations.

Competency 31

Construct with the client and appropriate others an initial action plan based on client needs, client preferences, and resources available.

Competency 32

Based on the initial action plan, take specific steps to initiate an admission or referral and ensure followthrough.

Practice  Dimension  1: Clinical Evaluation — Element: Assessment

Competency 33

Select and use a comprehensive assessment process that is sensitive to age, gender, racial and ethnic culture, and disabilities that includes but is not limited to:

  • History of alcohol and drug use
  • Physical health, mental health, and addiction treatment histories
  • Family issues
  • Work history and career issues
  • History of criminality
  • Psychological, emotional, and worldview concerns
  • Current status of physical health, mental health, and substance use
  • Spiritual concerns of the client
  • Education and basic life skills
  • Socioeconomic characteristics, lifestyle, and current legal status
  • Use of community resources
  • Treatment readiness
  • Level of cognitive and behavioral functioning.

Competency 34

Analyze and interpret the data to determine treatment recommendations.

Competency 35

Seek appropriate supervision and consultation.

Competency 36

Document assessment findings and treatment recommendations.

Practice Dimension 2: Treatment Planning

Competency 37

Use relevant assessment information to guide the treatment planning process.

Competency 38

Explain assessment findings to the client and significant others.

Competency 39

Provide the client and significant others with clarification and additional information as needed.

Competency 40

Examine treatment options in collaboration with the client and significant others.

Competency 41

Consider the readiness of the client and significant others to participate in treatment.

Competency 42

Prioritize the client’s needs in the order they will be addressed in treatment.

Competency 43

Formulate mutually agreed-on and measurable treatment goals and objectives.

Competency 44

Identify appropriate strategies for each treatment goal.

Competency 45

Coordinate treatment activities and community resources in a manner consistent with the client’s diagnosis and existing placement criteria.

Competency 46

Develop with the client a mutually acceptable treatment plan and method for monitoring and evaluating progress.

Competency 47

Inform the client of confidentiality rights, program procedures that safeguard them, and the exceptions imposed by regulations.

Competency 48

Reassess the treatment plan at regular intervals or when indicated by changing circumstances.

Practice Dimension 3: Referral

Competency 49

Establish and maintain relationships with civic groups, agencies, other professionals, governmental entities, and the community at large to ensure appropriate referrals, identify service gaps, expand community resources, and help address unmet needs.

Competency 50

Continuously assess and evaluate referral resources to determine their appropriateness.

Competency 51

Differentiate between situations in which it is most appropriate for the client to self-refer to a resource and situations requiring counselor referral.

Competency 52

Arrange referrals to other professionals, agencies, community programs, or appropriate resources to meet the client’s needs.

Competency 53

Explain in clear and specific language the necessity for and process of referral to increase the likelihood of client understanding and followthrough.

Competency 54

Exchange relevant information with the agency or professional to whom the referral is being made in a manner consistent with confidentiality rules and regulations and generally accepted professional standards of care.

Competency 55

Evaluate the outcome of the referral.

Practice Dimension 4: Service Coordination — Element: Implementing the Treatment Plan

Competency 56

Initiate collaboration with the referral source.

Competency 57

Obtain, review, and interpret all relevant screening, assessment, and initial treatment planning information.

Competency 58

Confirm the client’s eligibility for admission and continued readiness for treatment and change.

Competency 59

Complete necessary administrative procedures for admission to treatment.

Competency 60

Establish accurate treatment and recovery expectations with the client and involved significant others, including but not limited to:

  • The nature of services
  • Program goals
  • Program procedures
  • Rules regarding client conduct
  • The schedule of treatment activities
  • Costs of treatment
  • Factors affecting duration of care
  • Clients’ rights and responsibilities
  • The effect of treatment and recovery on significant others.

Competency 61

Coordinate all treatment activities with services provided to the client by other resources.

Practice Dimension 4: Service Coordination — Element: Consulting

Competency 62

Summarize the client’s personal and cultural background, treatment plan, recovery progress, and problems inhibiting progress to ensure quality of care, gain feedback, and plan changes in the course of treatment.

Competency 63

Understand the terminology, procedures, and roles of other disciplines related to the treatment of substance use disorders.

Competency 64

Contribute as part of a multidisciplinary treatment team.

Competency 65

Apply confidentiality rules and regulations appropriately.

Competency 66

Demonstrate respect and nonjudgmental attitudes toward clients in all contacts with community professionals and agencies.

Practice Dimension 4: Service Coordination — Element: Continuing Assessment and Treatment Planning

Competency 67

Maintain ongoing contact with the client and involved significant others to ensure adherence to the treatment plan.

Competency 68

Understand and recognize stages of change and other signs of treatment progress.

Competency 69

Assess treatment and recovery progress, and, in consultation with the client and significant others, make appropriate changes to the treatment plan to ensure progress toward treatment goals.

Competency 70

Describe and document the treatment process, progress, and outcome.

Competency 71

Use accepted treatment outcome measures.

Competency 72

Conduct continuing care, relapse prevention, and discharge planning with the client and involved significant others.

Competency 73

Document service coordination activities throughout the continuum of care.

Competency 74

Apply placement, continued stay, and discharge criteria for each modality on the continuum of care.

Practice Dimension 5: Counseling — Element: Individual Counseling

Competency 75

Establish a helping relationship with the client characterized by warmth, respect, genuineness, concreteness, and empathy.

Competency 76

Facilitate the client’s engagement in the treatment and recovery process.

Competency 77

Work with the client to establish realistic, achievable goals consistent with achieving and maintaining recovery.

Competency 78

Promote client knowledge, skills, and attitudes that contribute to a positive change in substance use behaviors.

Competency 79

Encourage and reinforce client actions determined to be beneficial in progressing toward treatment goals.

Competency 80

Work appropriately with the client to recognize and discourage all behaviors inconsistent with progress toward treatment goals.

Competency 81

Recognize how, when, and why to involve the client’s significant others in enhancing or supporting the treatment plan.

Competency 82

Promote client knowledge, skills, and attitudes consistent with the maintenance of health and prevention of HIV/AIDS, tuberculosis, sexually transmitted diseases, hepatitis C, and other infectious  diseases.

Competency 83

Facilitate the development of basic and life skills associated with recovery.

Competency 84

Adapt counseling strategies to the individual characteristics of the client, including but not limited to disability, gender, sexual orientation, developmental level, culture, ethnicity, age, and health status.

Competency 85

Make constructive therapeutic responses when the client’s behavior is inconsistent with stated recovery goals.

Competency 86

Apply crisis prevention and management skills.

Competency 87

Facilitate the client’s identification, selection, and practice of strategies that help sustain the knowledge, skills, and attitudes needed for maintaining treatment progress and preventing relapse.

Practice Dimension 5: Counseling — Element: Group Counseling

Competency 88

Describe, select, and appropriately use strategies from accepted and culturally appropriate models for group counseling with clients with substance use disorders.

Competency 89

Carry out the actions necessary to form a group, including but not limited to determining group type, purpose, size, and leadership; recruiting and selecting members; establishing group goals and clarifying behavioral ground rules for participating; identifying outcomes; and determining criteria and methods for termination or graduation from the group.

Competency 90

Facilitate the entry of new members and the transition of exiting members.

Competency 91

Facilitate group growth within the established ground rules and movement toward group and individual goals by using methods consistent with group type.

Competency 92

Understand the concepts of process and content, and shift the focus of the group when such a shift will help the group move toward its goals.

Competency 93

Describe and summarize the client’s behavior within the group to document the client’s progress and identify needs and issues that may require a modification in the treatment plan.

Practice Dimension 5: Counseling — Element: Counseling Families, Couples, and Significant  Others

Competency 94

Understand the characteristics and dynamics of families, couples, and significant others affected by substance use.

Competency 95

Be familiar with and appropriately use models of diagnosis and intervention for families, couples, and significant others, including extended, kinship, or tribal family structures.

Competency 96

Facilitate the engagement of selected members of the family or significant others in the treatment and recovery process.

Competency 97

Assist families, couples, and significant others in understanding the interaction between the family system and substance use behaviors.

Competency 98

Assist families, couples, and significant others in adopting strategies and behaviors that sustain recovery and maintain healthy relationships.

Practice Dimension 6: Client, Family, and Community Education

Competency 99

Provide culturally relevant formal and informal education programs that raise awareness and support substance abuse prevention and the recovery process.

Competency 100

Describe factors that increase the likelihood for an individual, community, or group to be at risk for, or resilient to, psychoactive substance use disorders.

Competency 101

Sensitize others to issues of cultural identity, ethnic background, age, and gender in preven- tion, treatment, and recovery.

Competency 102

Describe warning signs, symptoms, and the course of substance use disorders.

Competency 103

Describe how substance use disorders affect families and concerned others.

Competency 104

Describe the continuum of care and resources available to the family and concerned others.

Competency 105

Describe principles and philosophy of prevention, treatment, and recovery.

Competency 106

Understand and describe the health and behavior problems related to substance use, including transmission and prevention of HIV/AIDS, tuberculosis, sexually transmitted diseases, hepatitis C, and other infectious   diseases.

Competency 107

Teach life skills, including but not limited to stress management, relaxation, communication, assertiveness, and refusal skills.

Practice Dimension 7: Documentation

Competency 108

Demonstrate knowledge of accepted principles of client record management.

Competency 109

Protect client rights to privacy and confidentiality in the preparation and handling of records, especially in relation to the communication of client information with third parties.

Competency 110

Prepare accurate and concise screening, intake, and assessment reports.

Competency 111

Record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.

Competency 112

Record progress of client in relation to treatment goals and objectives.

Competency 113

Prepare accurate and concise discharge summaries.

Competency 114

Document treatment outcome, using accepted methods and instruments.

Practice Dimension 8: Professional and Ethical Responsibilities

Competency 115

Adhere to established professional codes of ethics that define the professional context within which the counselor works to maintain professional standards and safeguard the client.

Competency 116

Adhere to Federal and State laws and agency regulations regarding the treatment of substance use disorders.

Competency 117

Interpret and apply information from current counseling and psychoactive substance use research literature to improve client care and enhance professional growth.

Competency 118

Recognize the importance of individual differences that influence client behavior, and apply this understanding to clinical practice.

Competency 119

Use a range of supervisory options to process personal feelings and concerns about clients.

Competency 120

Conduct self-evaluations of professional performance applying ethical, legal, and professional standards to enhance self-awareness and performance.

Competency 121

Obtain appropriate continuing professional education.

Competency 122

Participate in ongoing supervision and consultation.

Competency 123

Develop and use strategies to maintain one’s physical and mental health.


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