Introduction

In 1998, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT) published Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice (The Competencies) as Technical Assistance Publication (TAP) 21. Developed by the National Curriculum Committee of the Addiction Technology Transfer Center (ATTC) Network, TAP 21 identifies 123 competencies that are essential to the effective practice of counseling for psychoactive substance use disorders. TAP 21 also presents the knowledge, skills, and attitudes (KSAs) counselors need to become fully proficient in each competency.

TAP 21 has been widely distributed by SAMHSA’s Public Engagement Platform (PEP) and the ATTC Network. It has become a benchmark by which curricula are developed and educational programs and professional standards are measured for the field of substance abuse treatment in the United States. In addition, it has been translated into several languages.

Because the ATTC Network is committed to technology transfer, after the initial publication of TAP 21, the National Curriculum Committee began exploring ways to enhance the docu-ment for future printings. Successful technology transfer requires more than presenting good information. It entails transmitting scientific knowledge in a way that makes it understandable, feasible to implement in a real-world setting, and supportable at a systematic level—in other words, getting the right information across in a way that makes it useable. The National Curriculum Committee examined how best to package and present TAP 21 to help people learn key elements and adopt new strategies. The result was a revision of TAP 21—a process that was begun in 2000, was completed in 2005, and resulted in the current publication.

History of The Competencies

In 1993 CSAT created a multidisciplinary network of 11 ATTC Regional Centers geographically dispersed across the United States and in Puerto Rico and the U.S. Virgin Islands. Since its inception, the ATTC Network has collaborated with diverse international, national, State, regional, and local partners from multiple disciplines to recruit qualified addiction treatment practitioners and enhance academic preparation and professional development opportunities in the substance abuse treatment field.

The National Curriculum Committee, composed of ATTC Directors, was established at the Network’s inaugural meeting. The committee’s initial charge was to collect and evaluate existing addiction educational and professional development curricula and establish future priorities for ATTC curriculum development. This effort led to researching existing practice and professional literature and defining an extensive list of addiction practice competencies determined to be essential to effective counseling for substance use disorders. These initial competencies would serve as benchmarks to guide future ATTC curriculum design, develop-ment, and evaluation.

In addition to its own work, the National Curriculum Committee reviewed and incorporated other publications on the work of addiction counselors.1 In 1995 the committee’s work resulted in the ATTC publication Addiction Counselor Competencies. Subsequent to this publication, the ATTCs conducted a national survey to validate the competencies (see appendix C). Results supported virtually all of the competencies as being essential to the professional practice of addiction counseling.

In 1996, the International Certification and Reciprocity Consortium (ICRC) convened a national leadership group to evaluate the need for model addiction counselor training. After careful deliberation, the group concluded that much of the work to define such a curriculum standard had already been accomplished by the ATTC National Curriculum Committee and the ICRC in the National Curriculum Committee’s Addiction Counselor Competencies and the ICRC’s 1996 Role Delineation Study,2 respectively.

Soon after, CSAT agreed to fund a collaborative effort to finalize a document that could be used as a national standard. CSAT convened a panel—The National Steering Committee for Addiction Counseling Standards (NSC)—that comprised representatives from five national educational, certification, and professional associations. The NSC was successful in achieving unanimous endorsement of the Addiction Counselor Competencies—a milestone in the addiction counseling field.

Based on this foundation, the National Curriculum Committee began to delineate the KSAs that undergird each competency statement. Input was solicited from a number of key national organizations and selected field reviewers. In 1998 CSAT published the results of this ground-breaking work as TAP 21 (The Competencies).

After TAP 21 was published, the National Curriculum Committee systematically conducted focus groups and a national survey to elicit feedback from the field about the impact of TAP 21. Although feedback was uniformly positive and thousands of copies of TAP 21 were disseminated through SAMHSA’s PEP and the ATTC Network, refinements were needed to improve the utility of the publication and enhance its effect in both the addiction practice and educational systems.

Feedback obtained from the survey and the focus groups indicated a need for additional informa-tion to help the field incorporate the competencies into daily practice. Feedback also suggested that there was no need to change the competencies. The most common suggestions were to refine the 1998 publication by presenting the content in a more user-friendly fashion and linking it to professional literature and specific applications. The National Curriculum Committee revised TAP 21 in 2000 based on the feedback of dedicated addiction practice and education professionals; however, this revision was never published.

A new Update Committee was convened in 2005 to update the revised 2000 edition with literature published between 2000 and 2005. The Update Committee consisted of some of the original mem-bers from the National Curriculum Committee; representatives from NAADAC—The Association for Addiction Professionals, CSAT, the Center for Mental Health Services, the Center for Substance Abuse Prevention, the National Association for Children of Alcoholics, and the Annapolis Coalition; treatment providers; and experts in addiction research. The current updated edition retains all of the feedback-based improvements of the 2000 revised version and adds relevant literature  published after 2000. In addition, the competencies and KSAs of several practice dimensions, in particular those that address clinical evaluation and treatment planning, were rewritten to reflect current best practices.

What You Will Find Inside

The Model

When creating The Competencies, the National Curriculum Committee recognized a need to emphasize three characteristics of competency: knowledge, skills, and attitudes. Many hours were spent conceptualizing a differentiated model when designing TAP 21—a model that could address general KSAs necessary for all practitioners dealing with substance use disorders while explaining the more specific needs of professional substance abuse treatment counselors.

The first section of the model addresses the generic KSAs. This section contains the trans- disciplinary foundations, comprising four discrete building blocks: understanding addiction, treatment knowledge, application to practice, and professional readiness. The term “trans- disciplinary” was selected to describe the knowledge and skills needed by all disciplines (e.g., medicine, social work, pastoral guidance, corrections, social welfare) that deal directly with individuals with substance use disorders.

The second section of the model specifically addresses the professional practice needs, or practice dimensions, of addiction counselors. Each practice dimension includes a set of com-petencies, and, within each competency, the KSAs necessary for effective addiction counseling are outlined. Many additional competencies may be desirable for counselors in specific settings. Education and experience affect the depth of the individual counselor’s knowledge and skills; not all counselors will be experienced and proficient in all the compe-tencies discussed. The National Curriculum Committee’s goal for the future is to help ensure that every addiction counselor possesses, to an appropriate degree, each competency listed, regardless of setting or treat-ment model.

The relationship of the compo-nents in the competencies model is conceptualized as a hub with eight spokes (see figure 1). The hub contains the four transdisciplinary foun-dations that are central to the work of all addiction profes-sionals. The eight spokes are the practice dimensions, each containing the competencies the addiction counselor should attain to master each practice dimension.

Recommended Readings

Journal articles, book chapters, and other critical literature for each transdisciplinary foundation and practice dimension have been reviewed and included in this document. Moreover, separate bibliographies on attitudes and recovery have been added, as have lists of Internet and cultural competency resources. These can be found in section 3.

Appendices

Appendices include a glossary (appendix A), a complete list of the competencies (appendix B), a summary of the results of the Committee’s National Validation Study of The Competencies (appendix C), a complete bibliography with a detailed overview of the methodology used for literature searches (appendix D), and a list of people who acted as field reviewers or provided research assistance (appendix E).

Companion Volume—TAP 21-A

As a companion to this volume on counselor competencies, CSAT is publishing TAP 21-A, Competencies for Substance Abuse Treatment Clinical Supervisors, which discusses the qualities and abilities integral to supervising substance abuse treatment clinicians.

Uses of The Competencies

Since its inception, The Competencies has been improving addiction counseling and addiction counselor education across the country in a number of ways. The most common reported applications have been in curriculum/course evaluation and design for higher education; personal professional development; student advising, supervision, and assessment; assessment of competent practices; design of professional development and continuing education programs; and certification standards/exams.