Section 2 Practice Dimensions

PD 4 Service Coordination

Elements

Definition

The administrative, clinical, and evaluative activities that bring the client, treatment services, community agencies, and other resources together to focus on issues and needs identified in the treatment plan.

Service coordination, which includes case management and client advocacy, establishes a framework of action to enable the client to achieve specified goals. It involves collaboration with the client and significant others, coordination of treatment and referral services, liaison activities with community resources and managed care systems, client advocacy, and ongoing evaluation of treatment progress and client needs.

Element: Implementing the Treatment Plan

Competency 56

Initiate collaboration with the referral source.

Knowledge

  • How to access and transmit information necessary for referral.
  • Missions, functions, and resources of the community service network.
  • Managed care and other systems affecting the client.
  • Eligibility criteria for referral to community service providers.
  • Appropriate confidentiality rules and regulations.
  • Terminologies appropriate to the referral source.

Skills

  • Using appropriate technology to access, collect, summarize, and transmit referral data about the client.
  • Communicating respect and empathy for cultural and lifestyle differences.
  • Demonstrating appropriate oral and written communication.
  • Establishing trust and rapport with colleagues in the community.
  • Assessing the level and intensity of client care needed.
  • Being aware of the need to consult with professionals in other disciplines and specialties.

Attitudes

  • Respect for contributions and needs of multiple disciplines to the treatment process.
  • Confidence in using diverse systems and treatment approaches.
  • Openmindedness to a variety of treatment approaches.
  • Willingness to modify or adapt plans.

Competency 57

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

Knowledge

  • Methods for obtaining relevant screening, assessment, and initial treatment planning information.
  • How to interpret information for service coordination.
  • Theories, concepts, and philosophies of screening and assessment tools.
  • How to define long- and short-term goals of treatment.
  • Biopsychosocial assessment methods.

Skills

  • Using accurate, clear, and concise oral and written communication.
  • Interpreting, prioritizing, and using client information.
  • Soliciting comprehensive and accurate information from numerous sources, including the client.
  • Using appropriate technology to document appropriate information.

Attitudes

  • Appreciation for all sources and types of data and their possible treatment implications.
  • Awareness of personal biases that may affect work with the client.
  • Respect for the client’s self-assessment and reporting.

Competency 58

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

Knowledge

  • Philosophies, policies, procedures, and admission protocols for community agencies.
  • Eligibility criteria for referral to community service providers.
  • Principles for tailoring treatment to client needs.
  • Methods of assessing and documenting client change over time.
  • Federal and State confidentiality rules and regulations and clients’ privacy rights.

Skills

  • Working with the client to select the most appropriate treatment.
  • Accessing available funding resources.
  • Using effective communication styles.
  • Recognizing, documenting, and communi- cating client change.
  • Involving family and significant others in the treatment planning process.
  • Effectively interviewing and communicat- ing with clients who have cognitive or psychiatric impairments.
  • Accurately describing the client’s signs and symptoms of cognitive or psychiatric impairment when consulting with medical and mental health professionals.

Attitudes

  • Recognition of the importance of continued support, encouragement, and optimism.
  • Willingness to accept the limitations of treatment.
  • Appreciation for the goal of self- determination.
  • Recognition of the importance of family and significant others to treatment planning.
  • Appreciation for the need for continuing assessment and modifications to the treatment plan.

Competency 59

Complete necessary administrative procedures for admission to treatment.

Knowledge

  • Admission criteria and protocols.
  • Documentation requirements and confidentiality rules and regulations.
  • Appropriate Federal, State, and local regulations related to admission.
  • Funding mechanisms, reimbursement protocols, and required documentation.
  • Protocols required by managed care organizations.

Skills

  • Demonstrating accurate, clear, and concise oral and written communication.
  • Using language the client easily understands.
  • Negotiating with diverse treatment systems.
  • Advocating for services for the client.

Attitudes

  • Acceptance of the necessity to deal with bureaucratic systems.
  • Recognition of the importance of collaboration.
  • Appreciation of strengths-based principles that emphasize client autonomy and skills development.

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.

Knowledge

  • Functions and resources provided by treatment services and managed care systems.
  • Available community services.
  • Effective communication styles.
  • Clients’ rights and responsibilities.
  • Treatment schedule, timeframes, admission and discharge criteria, and costs.
  • Rules and regulations of the treatment program.
  • Roles and limitations of significant others in treatment.
  • How to apply confidentiality rules and regulations and clients’ privacy rights.

Skills

  • Demonstrating clear and concise oral and written communication.
  • Establishing appropriate boundaries with the client and significant others.

Attitudes

  • Respect for the input of the client and significant others.

Competency 61

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

Knowledge

  • Methods for determining the client’s progress in achieving treatment goals and objectives.
  • Documentation and reporting methods used by community agencies.
  • Service reimbursement issues and their effect on the treatment plan.
  • Case presentation techniques and protocols.
  • Applicable confidentiality rules and regulations.
  • Terminology and methods used by community agencies.

Skills

  • Delivering case presentations.
  • Using appropriate technology to collect and interpret client treatment information from diverse sources.
  • Demonstrating accurate, clear, and concise oral and written communication.
  • Participating in interdisciplinary team building.
  • Participating in negotiation, advocacy, conflict resolution, problemsolving, and mediation.

Attitudes

  • Willingness to collaborate with community agencies and service providers.

Uses of The Competencies

The Competencies is the foundation for addiction counseling coursework at the University of Nevada–Reno and the University of Nevada–Las Vegas. Both institutions offer an undergraduate minor and a graduate emphasis in addiction counseling with a number of courses developed directly from The Competencies. In addition, all instructors and students in these counseling programs are provided copies of the publication.

 

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.

Knowledge

  • Methods for assessing the client’s past and present biopsychosocial status.
  • Methods for assessing social systems that may affect the client’s progress in treatment.
  • Methods for continuous assessment and modification of the treatment plan.
  • Methods for assessing progress toward treatment goals.

Skills

  • Demonstrating clear and concise oral and written communication.
  • Synthesizing information and developing modified treatment goals and objectives.
  • Soliciting and interpreting feedback related to the treatment plan.
  • Prioritizing and documenting relevant client data.
  • Observing and identifying problems that might impede progress.
  • Soliciting client satisfaction feedback.

Attitudes

  • Respect for the personal nature of the information shared by the client and significant others.
  • Respect for interdisciplinary work.
  • Appreciation for incremental progress in completing treatment goals.
  • Recognition of relapse as an opportunity for positive change.

Competency 63

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

Knowledge

  • Functions and unique terminology of related disciplines.

Skills

  • Demonstrating accurate, clear, and concise oral and written communication.
  • Participating in interdisciplinary collaboration.
  • Interpreting oral and written data from various sources.

Attitudes

  • Confidence in asking questions and providing information across disciplines.

Competency 64

Contribute as part of a multidisciplinary treatment team.

Knowledge

  • Roles, responsibilities, and areas of expertise of other team members and professional disciplines.
  • Confidentiality rules and regulations.
  • Team dynamics and group process.

Skills

  • Demonstrating clear and concise oral and written communication.
  • Participating in problemsolving, decisionmaking, mediation, and advocacy.
  • Communicating about confidentiality issues.
  • Coordinating the client’s treatment with representatives of multiple disciplines and external systems.
  • Participating in team building and group process.

Attitudes

  • Interest in cooperation and collaboration with diverse service providers.
  • Respect and appreciation for other team members and their professional disciplines.
  • Recognition of the need to consult with professionals in other disciplines and specialties.

 

Uses of The Competencies

Kathryn Miller, Ph.D., associate professor at San Antonio College, used The Competencies as the basis for the article “A Resource for Addiction Counseling: LCDCs in Texas” published in the Texas Counseling Association Journal. The article explains to graduate-level counselors the scope of chemical dependency counseling practice and encourages cooperation between counseling generalists and specialists.

 

Competency 65

Apply confidentiality rules and regulations appropriately.

Knowledge

  • Federal, State, and local confidentiality rules and regulations, especially as they apply to substance abuse treatment, health care, mental health care, child welfare, and criminal justice.
  • How to apply confidentiality rules and regulations to documentation and sharing of client information.
  • Ethical standards related to confidentiality rules and regulations.
  • Clients’ rights and responsibilities.
  • How to apply confidentiality rules and regulations in emergency situations (medical/suicide prevention/mandatory reports of child abuse or neglect situations).

Skills

  • Explaining and applying confidentiality rules and regulations.
  • Obtaining informed consent.
  • Communicating with the client, family and significant others, and other service providers within the boundaries of existing confidentiality rules and regulations.
  • Communicating the need for client referral information in emergency situations and documenting these encounters.

Attitudes

  • Recognition of the importance of confidentiality rules and regulations.
  • Respect for a client’s right to privacy.
  • Recognition of the need to seek support or supervision in client health and safety emergency situations.

Competency 66

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

Knowledge

  • Behaviors appropriate to professional collaboration.
  • Clients’ rights and responsibilities.

Skills

  • Establishing and maintaining nonjudgmen- tal, respectful relationships with clients and service providers.
  • Demonstrating clear, concise, accurate communication with other professionals or agencies.
  • Applying confidentiality rules and regula- tions when communicating with agencies.
  • Transferring client information to other service providers in a professional manner.
  • Advocating with outside systems.

Attitudes

  • Willingness to advocate on behalf of the client.
  • Professional concern for the client.
  • Commitment to professionalism.

Uses of The Competencies

The Florida Certification Board (FCB) used the national standards for substance abuse counseling set forth in The Competencies to standardize the process of certification in the State of Florida and elevate the level of professionalism in the substance abuse treatment field. In 2003 FCB used this publication to develop Scopes of Professional Practice for three levels of addiction certification in Florida. To enhance the three Scopes of Practice, FCB expanded the educational requirements for certification. Using The Competencies to identify the specific educational content individuals would need to become certified according to the new Scopes of Practice, the educational compo- nents for certification were updated to include specific hours in each transdisciplinary foundation and practice dimension. Providers of continuing education for FCB are now required to detail the educational/training content on certificates to match the transdisciplinary foundations and  practice dimensions.

 

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.

Knowledge

  • Social, cultural, and family systems.
  • Techniques to engage the client in treatment process.
  • Outreach, followup, and continuing care techniques.
  • Methods for determining the client’s goals, treatment plan, and motivational level.
  • Assessment mechanisms to measure the client’s progress toward treatment objectives.

Skills

  • Engaging the client, family, and significant others in the ongoing treatment process.
  • Assessing client progress toward treatment goals.
  • Helping the client maintain motivation to change.
  • Assessing the comprehension level of the client, family, and significant others.
  • Documenting the client’s adherence to the treatment plan.
  • Recognizing and addressing ambivalence and resistance.
  • Implementing followup and continuing care protocols.

Attitudes

  • Respect for client’s efforts to achieve treatment goals.
  • Appreciation for incremental progress in completing treatment goals.
  • Respect for client’s choice of treatment goals.
  • Professional concern for the client, the family, and significant others.
  • Recognition of the importance of continued support, encouragement, and optimism.
  • Recognition of relapse as an opportunity for positive change.
  • Appreciation of strengths-based principles that emphasize client autonomy and skills development.

Competency 68

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

Knowledge

  • How to recognize incremental progress toward treatment goals.
  • The client’s cultural norms, biases, unique characteristics, and preferences for treatment.
  • Generally accepted treatment outcome measures.
  • Methods for evaluating treatment progress.
  • Methods for assessing the client’s motivation and adherence to treatment plans.
  • Theories and principles of the stages of change and recovery.

Skills

  • Identifying and documenting change.
  • Assessing adherence to treatment plans.
  • Applying treatment outcome measures.
  • Communicating with people of other cultures.
  • Reinforcing positive change.

Attitudes

  • Appreciation for cultural issues that affect treatment progress.
  • Respect for individual differences and readiness to change.
  • Recognition of the importance of continued support, encouragement, and optimism.

Uses of The Competencies

The Competencies has been used as a resource by instructors in developing online courses for Access ED, in presenting the Mid-Atlantic ATTC’s Center for Online Courses, and for traditional classroom delivery tailored to counselors, case managers, and supervisors. In Virginia specifically, The Competencies guided the design of the Virginia Institute for Professional Addictions Counselor Training (VIPACT) curriculum, which provides the didactic hours required for the Virginia Certified Substance Abuse Counselor credential. This program has been delivered to nondegreed, as well as B.S.- and M.S.-prepared, counselors and case managers over the past 3 years. VIPACT was developed and continues to be delivered under a cooperative agreement between the Mid-Atlantic ATTC and the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services.

 

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.

Knowledge

  • Continuum of care.
  • Interviewing techniques.
  • Stages in the treatment and recovery processes.
  • Individual differences in the recovery process.
  • Methods for evaluating treatment progress.
  • Methods for reinvolving the client in the treatment planning process.

Skills

  • Participating in conflict resolution, problemsolving, and mediation.
  • Observing, recognizing, assessing, and documenting client progress.
  • Eliciting the client’s perspectives on progress.
  • Demonstrating clear and concise oral and written communication.
  • Interviewing individuals, groups, and families.
  • Acquiring and prioritizing relevant treatment information.
  • Assisting the client in maintaining motivation.
  • Maintaining contact with the client, referral sources, and significant others.

Attitudes

  • Willingness to be flexible.
  • Respect for the client’s right to self-determination.
  • Appreciation of the role significant others play in the recovery process.
  • Appreciation of individual differences in the recovery process.

Competency 70

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

Knowledge

  • Treatment modalities.
  • Documentation of process, progress, and outcome.
  • Factors affecting the client’s success in treatment.
  • Generally accepted outcome measures.
  • Treatment planning.

Skills

  • Demonstrating clear and concise oral and written communication.
  • Observing and assessing client progress.
  • Engaging the client in the treatment process.
  • Applying progress and outcome measures.

Attitudes

  • Appreciation of the importance of accurate documentation.
  • Recognition of the importance of multidisciplinary treatment planning.

Competency 71

Use accepted treatment outcome measures.

Knowledge

  • Treatment outcome measures.
  • Concepts of validity and reliability of outcome measures.

Skills

  • Using outcome measures in the treatment planning process.

Attitudes

  • Appreciation of the need to measure outcomes.

Uses of The Competencies

The Northeast (Ne) ATTC instructs vendors and fellowship applicants to use The Competencies when designing and developing NeATTC-sponsored training curricula, educational products, and services. This activity helps agencies and individuals institutionalize the use of The Competencies as a tool in project planning and subsequent project activity.

 

Competency 72

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

Knowledge

  • Treatment planning process.
  • Continuum of care.
  • Social and family systems available for continuing care.
  • Community resources available for continuing care.
  • Signs and symptoms of relapse.
  • Relapse prevention strategies.
  • Family and social systems theories.
  • Discharge planning process.
  • Confidentiality rules and regulations.

Skills

  • Accessing information from referral sources.
  • Demonstrating clear and concise oral and written communication.
  • Assessing and documenting treatment progress.
  • Participating in confrontation, conflict resolution, and problemsolving.
  • Collaborating with referral sources.
  • Engaging the client and significant others in the treatment process and continuing care.
  • Assisting the client in developing a relapse prevention plan.

Attitudes

  • Recognition of the importance of continued support, encouragement, and optimism.
  • Appreciation of strengths-based principles that emphasize client autonomy and skills development.

Competency 73

Document service coordination activities throughout the continuum of care.

 

Knowledge

  • Documentation requirements, including but not limited to:
    • addiction counseling
    • other disciplines
    • funding sources
    • agencies and service
  • Service coordination role in the treatment process.

Skills

  • Demonstrating clear and concise written communication.
  • Using appropriate technology to report information in an accurate and timely manner within the bounds of confidentiality rules and regulations.

Attitudes

  • Acceptance of documentation as an integral part of the treatment process.
  • Willingness to use appropriate technology.

Competency 74

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

Knowledge

  • Treatment planning along the continuum of care.
  • Initial and ongoing placement criteria.
  • Methods to assess current and ongoing client status.
  • Stages of progress associated with treatment modalities.
  • Appropriate discharge indicators.
  • Managed care continuing care criteria and utilization review procedures.

Skills

  • Observing and assessing client progress.
  • Demonstrating clear and concise oral and written communication.
  • Participating in conflict resolution, problemsolving, mediation, and negotiation.
  • Tailoring treatment to meet client needs.
  • Applying placement, continued stay, and discharge criteria.

Attitudes

  • Confidence in the client’s ability to progress within a continuum of care.
  • Appreciation for the fair and objective use of placement, continued stay, and discharge criteria.

Bibliography

Bois, C., & Graham, K. (1997). Case management. In S. Harrison & V. Carver (Eds.) Alcohol and Drug Problems: A Practical Guide for Counsellors (2nd ed.). Toronto, Canada: Addiction Research Foundation, 61-76.

Bokos, P.J., Mejta, C.L., et al. (1993). A case management model for intravenous drug users. In J.A. Inciardi, R.M. Tims, & B.W. Fletcher (Eds.) Innovative Approaches in the Treatment of Drug Abuse—Program Models and Strategies. Westport, CT: Greenwood Press, 87-96.

Brindis, C., Pfeffer, R., & Wolfe, A. (1995). A case management program for chemically dependent clients with multiple needs. Journal of Case Management, 4:22-28.

Brindis, C.D., & Theidon, K.S. (1997). The role of case management in substance abuse treatment services for women and their children. Journal of Psychoactive Drugs, 29:79-88.

Brown, T.G., Seraganian, P., et al. (2002). Matching substance abuse aftercare treatment to client characteristics.  Addictive  Behavior, 27(4):585-604.

Center for Substance Abuse Treatment (1998). Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 27. DHHS Publication No. (SMA) 98-3222. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Drake, R.E., & Noordsy, D.L. (1994). Case management for people with coexisting severe mental disorder and substance use disorder. Psychiatric Annals,   24:427-431.

Erickson, J.R., Chong, J., et al. (1995). Service linkages: Understanding what fosters and what deters from service coordination for homeless adult drug users. Contemporary Drug Problems,  22:343-362.

Galanter, M. (2002). Healing through social and spiritual affiliation. Psychiatric Services, 53(9):1072-1074.

Godley, S.H., Godley, M.D., et al. (1994). Case management services for adolescent substance abusers: A program description. Journal of Substance Abuse Treatment,   11(4):309-317.

Graham, K., Timney, C.B., et al. (1995). Continuity of care in addictions treatment: The role of advocacy and coordination in case management. American Journal of Drug and Alcohol Abuse, 21:433-451.

Grant, R.M., Ernst, C.C., et al. (1996). When case management isn’t enough: A model of paraprofessional advocacy for drug- and alcohol-abusing mothers. Journal of Case Management,  5:3-11.

Grella, C.E., & Gilmore, J. (2002). Improving service delivery to the dually diagnosed in Los Angeles County.  Journal of Substance Abuse Treatment,   23(2):115-122.

Gruber, K.J., & Fleetwood, T.W. (2004). In-home continuing care services for substance use affected families. Substance Use & Misuse,   39(9):1379-1403.

Hser, Y.-I., & Anglin, M.D. (2005). Drug treatment and aftercare programs. In R.H. Coombs  (Ed.) Addiction Counseling Review. Mahwah, NJ: Lawrence Erlbaum Associates.

Legal Action Center (2003). Confidentiality and Communication: A Guide to the Federal Drug and Alcohol Confidentiality Law and HIPAA. New York: Legal Action Center.

Martin, S.S., & Inciardi, J.A. (1993). A case management treatment program for drug-involved prison  releases.  Prison  Journal, 73:319-331.

McKay, J.R., Lynch, K.G., et al. (2005). Do patient characteristics and initial progress in treatment moderate the effectiveness of telephone-based continuing care for substance use disorders? Addiction, 100(2):216-226.

McKay, J.R., Lynch, K.G., et al. (2005). The effectiveness of telephone-based continuing care for alcohol and cocaine dependence: 24-month outcomes. Archives of General Psychiatry, 62(2):199-207.

McLellan, A.T., Hagan, R.A., et al. (1999). Does clinical case management improve outpatient addiction treatment? Drug and Alcohol Dependence,   55:91-103.

Mejta, C.L., Bokos, P.J., et al. (1997). Improving substance abuse treatment access and retention using a case management approach. Journal of Drug Issues, 27:329-340.

Rapp, R.C., Siegal, H.A., & Fisher, J.H. (1992). A strengths-based model of case management/ advocacy: Adapting a mental health model to practice work with persons who have sub- stance abuse problems. In R.S. Ashery (Ed.) Progress and Issues in Case  Management.

NIDA Research Monograph No. 127. DHHS Publication No. (ADM) 92-19467. Rockville, MD: National Institute on Drug Abuse, 79-91.

Ridley, M.S. (1994). Practical issues in the application of case management to substance abuse treatment. Journal of Case Management, 3:132-138.

Siegal, H.A. (2005). Case management. In R.H. Coombs (Ed.) Addiction Counseling Review: Preparing for Comprehensive, Certification and Licensing Examinations. Mahwah, NJ: Lawrence Erlbaum Associates, 381-399.

Siegal, H.A., Rapp, R.C., et al. (1995). The strengths perspective of case management: A promising inpatient substance abuse treatment enhancement. Journal of Psychoactive Drugs, 27:67-72.

Siegal, H.A., Rapp, R.C., et al. (1997). The role of case management in retaining clients in substance abuse treatment: An exploratory analysis. Journal of Drug Issues, 27:821-832.

Snyder, C.M., Kaempfer, S.H., & Reis, K. (1996). An interdisciplinary, interagency, primary care approach to case management of the dually diagnosed patient with HIV disease. Journal of the Association of Nurses in AIDS Care, 7(5):72-82.

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