National Credentials:National Credentials:Why They Are ImportantWhy They Are Important

Kathryn Benson, NCAC II, SAPKathryn Benson, NCAC II, SAP

Chair, NCC APChair, NCC AP

What is an Addiction Professional What is an Addiction Professional Credentialing Program?Credentialing Program?

An addiction credentialing program is An addiction credentialing program is an organized system of baseline an organized system of baseline requirements that must be met in requirements that must be met in order for a professional to practice order for a professional to practice within a given fieldwithin a given field

Benefits of CertificationBenefits of Certification

Professionalization of the field of substance use Professionalization of the field of substance use disordersdisorders

Proven method by which addiction professionals are Proven method by which addiction professionals are recognized recognized

Constant actualization of skills and knowledge of Constant actualization of skills and knowledge of addiction professionalsaddiction professionals

Clients verification that persons offering treatment Clients verification that persons offering treatment services are competent, skilled and knowledgeableservices are competent, skilled and knowledgeable

It improves overall quality of servicesIt improves overall quality of services

What is an Addiction Licensing What is an Addiction Licensing BoardBoard

Established to:Established to: Enforce effective Substance Use Disorder Enforce effective Substance Use Disorder

practice practice Determine adequate practice standardsDetermine adequate practice standards Protect the publicProtect the public Develop and maintain performance Develop and maintain performance

standardsstandards Ensure safety of the publicEnsure safety of the public Act on ethical complaintsAct on ethical complaints

Licensure BoardsLicensure Boards

15 State - Licensing Board for Substance Use 15 State - Licensing Board for Substance Use DisordersDisorders

51 State – Substance Use Disorder 51 State – Substance Use Disorder Credentialing BoardsCredentialing Boards

Nine National Credentialing BoardsNine National Credentialing Boards

-Available to in every state and -Available to in every state and territoryterritory

-Similar criteria, requirements, -Similar criteria, requirements, standards standards

-State Boards recognized within each -State Boards recognized within each state state

Accepted Credential StandardsAccepted Credential Standards

Should meet national criteriaShould meet national criteria Should have specific educational Should have specific educational

requirementsrequirements Should have specific skills setShould have specific skills set Should require clinical supervisory Should require clinical supervisory

over siteover site Should require renewal at least every Should require renewal at least every

2 years2 years

Need and Demand for Behavioral Health Need and Demand for Behavioral Health ServicesServices

Integration of Substance Use Integration of Substance Use Disorders practitioners as a specialty Disorders practitioners as a specialty profession is essentialprofession is essential

Recognition that SUD Professionals Recognition that SUD Professionals have supported the medical, mental have supported the medical, mental health and other behavioral health health and other behavioral health professionals is paramount to professionals is paramount to integrated care.integrated care.

Need and Demand for Behavioral Health Need and Demand for Behavioral Health ServicesServices

Acceptance that the SUD Acceptance that the SUD Professional has emerged into a full Professional has emerged into a full fledged profession fledged profession

A Specialty ProfessionA Specialty Profession

Substance Use Disorders is a Substance Use Disorders is a specialty profession requiring:specialty profession requiring:

Specific training and educationSpecific training and education Specific skill setsSpecific skill sets Core competencies and knowledgeCore competencies and knowledge Practice experiencePractice experience

A Specialty ProfessionA Specialty Profession

This profession has its ownThis profession has its own Core competenciesCore competencies Scopes of practiceScopes of practice Career ladderCareer ladder Standard of EthicsStandard of Ethics

Scopes of PracticeScopes of PracticeThe activities of a counselor within the The activities of a counselor within the

Substance Use Disorder profession are Substance Use Disorder profession are based on the practice dimensions based on the practice dimensions outlined in TAP 21 and include the outlined in TAP 21 and include the following:following:

1. Clinical Evaluation1. Clinical Evaluation 2. Treatment Planning2. Treatment Planning 3. Referral3. Referral 4. Service Coordination4. Service Coordination 5. Counseling5. Counseling

Scopes of PracticeScopes of Practice

6. Client, Family, and Community 6. Client, Family, and Community EducationEducation

7. Documentation7. Documentation 8. Professional and Ethical 8. Professional and Ethical

ResponsibilityResponsibility

Scopes of PracticeScopes of Practice Category 4:Category 4: Independent Clinical Substance Use Independent Clinical Substance Use

Disorder Counselor/Supervisor Disorder Counselor/Supervisor

Category 3:Category 3: Clinical Substance Use Disorder Clinical Substance Use Disorder CounselorCounselor

Category 2:Category 2: Substance Use Disorder Counselor Substance Use Disorder Counselor

Category 1:Category 1: Associate Substance Use Disorder Associate Substance Use Disorder CounselorCounselor

Substance Use Disorder TechnicianSubstance Use Disorder Technician

The Substance Use DisorderThe Substance Use DisorderTreatment WorkforceTreatment Workforce

Work Force PlacementsWork Force Placements

Private and Public ( local, state, Private and Public ( local, state, federal and international)federal and international)

Prevention and TreatmentPrevention and Treatment Schools ( elementary, secondary and Schools ( elementary, secondary and

post secondary)post secondary) Higher Education(Professors, Higher Education(Professors,

ResearchersResearchers

Under Representation of Minorities Under Representation of Minorities in Behavioral Health Workforcein Behavioral Health Workforce

Although minorities make up Although minorities make up approximately 30% of the U.S. population, approximately 30% of the U.S. population, they currently account for onlythey currently account for only

– 24.3% of all psychiatrists, 24.3% of all psychiatrists,

– 5.3% of psychologists, 5.3% of psychologists,

– 20% of counselors, 20% of counselors,

– 8.5% of marriage and family therapists, 8.5% of marriage and family therapists,

– 4.9% of school psychologists, and 4.9% of school psychologists, and

– 9.8% of psychiatric nurses (Duffy et al., 2004). 9.8% of psychiatric nurses (Duffy et al., 2004).

Certificants by RaceCertificants by Race

Caucasian -85.1%African Am. -8.8%Asian/ PacificIs. - 0.6%Hispanic/ Latino - 2.6%Native Am. -1.5%Other - 1.3%

Eliminating DisparitiesEliminating Disparities

Although minorities are a growing Although minorities are a growing percentage of the nation’s percentage of the nation’s population, they continue to be population, they continue to be underrepresented in the behavioral underrepresented in the behavioral health field.health field.• We need to attract more minorities We need to attract more minorities

to the behavioral health workforceto the behavioral health workforce..

Eliminating Disparities, Cont.Eliminating Disparities, Cont.

Only 10.4% of those (12 and older) Only 10.4% of those (12 and older) who needed treatment for a drug or who needed treatment for a drug or alcohol use problem in 2007 received alcohol use problem in 2007 received it at a specialty facility.it at a specialty facility.• We need to expand access to We need to expand access to

underserved areas and populations underserved areas and populations with culturally appropriate services with culturally appropriate services and treatmentand treatment..

Certificants by AgeCertificants by Age

30 and below -1.8%31 to 40 - 7.3%

41 to 50 -21.7%51 to 60 -42.1%61 and above -27.0%

Certificants by Certification/LicensureCertificants by Certification/Licensure

Certificants by Work SettingCertificants by Work Setting

ChallengesChallenges Inadequate college/ university Inadequate college/ university

specific education/preparationspecific education/preparation Lack of ability to obtain student loan Lack of ability to obtain student loan

and loan forgivenessand loan forgiveness Inadequate supervisionInadequate supervision Licensing/credentialing requirements Licensing/credentialing requirements

vary from state to statevary from state to state Inadequate salariesInadequate salaries

Challenges ContinuedChallenges Continued1. Acceptance of career ladder that is tied to 1. Acceptance of career ladder that is tied to scopes of practice scopes of practice2. Reduce stigma for patients & professionals2. Reduce stigma for patients & professionals3. Minority recruitment3. Minority recruitment4. Adding addictions professionals to national 4. Adding addictions professionals to national Service Health CoreService Health Core5. Promotion & Recognition at the agency 5. Promotion & Recognition at the agency and state level to enhance recruitmentand state level to enhance recruitment6. Resources for one-stop treatment cent6. Resources for one-stop treatment cent

Challenges ContinuedChallenges Continued7. Training with technology transfer 7. Training with technology transfer

for Evidence Based Practicesfor Evidence Based Practices8. Salary & Benefit enhancement8. Salary & Benefit enhancement9. Outcome and monitoring systems 9. Outcome and monitoring systems

for agency Programs for agency Programs (computerized & software support)(computerized & software support)

10. Increase funding at the state level10. Increase funding at the state level11. Increase funding at the agency 11. Increase funding at the agency

levellevel

Overcoming ChallengesOvercoming Challenges

Building Capacity for HBCU, HIS, and Building Capacity for HBCU, HIS, and Tribal, PBS/PBI by providing technical Tribal, PBS/PBI by providing technical assistance in increasing degree assistance in increasing degree programsprograms

Offer both on-line and traditional Offer both on-line and traditional courses and degreescourses and degrees

Provide regional leadership conferences for faculty and students in the field.

Overcoming Challenges Cont.Overcoming Challenges Cont. Provide regional curriculum Provide regional curriculum

development workshops through the development workshops through the use of technology use of technology (webinars) in developing curricula, training workshops, etc.

Incorporation of Core Competencies in Incorporation of Core Competencies in current Syllabicurrent Syllabi

Incorporation of evidence-based and emerging best practices into course syllabi

Overcoming Challenges Cont.Overcoming Challenges Cont.

Incorporation of infusion into non-substance abuse /mental health offerings in all curricula

Integration of HIV/AIDS and substance abuse (relationship of alcohol and other drug use and mental health to HIV/AIDS) in curriculum development

Overcoming Challenges, Cont.Overcoming Challenges, Cont. Research and compilation of a

database on the licensure process for each State

Research and compilation of a database on the certification process for each State

Research and compilation of a database that matches national accreditation body requirements with State requirements

Overcoming Challenges, Cont.Overcoming Challenges, Cont.

Provide training assistance opportunities for faculty and practitioners ready to take licensure and/or certification examinations in substance abuse, including mock examinations, refresher courses, and assistance with completing applications

Overcoming Challenges, Cont.Overcoming Challenges, Cont.

Creation of a database of employment opportunities, cooperative agreement availability, and substance abuse internship opportunities at the national and State levels and with community- and faith-based organizations serving substance abuse and behavior health agencies

Overcoming Challenges, Cont.Overcoming Challenges, Cont.

Expose students to strong mentors and career opportunities in behavioral health.

SAMHSA Response:SAMHSA Response: Minority Fellowship Program Minority Fellowship Program

(MFP)(MFP) SAMHSA program supported by SAMHSA program supported by

all three centers, CSAT, CSAP, CMHS. all three centers, CSAT, CSAP, CMHS. Purpose: to facilitate the entry of Purpose: to facilitate the entry of

ethnic minority students into mental ethnic minority students into mental health careers and health careers and

increase the number of psychologists, increase the number of psychologists, psychiatric nurses, psychiatrists, and social psychiatric nurses, psychiatrists, and social workers trained to teach, administer, and workers trained to teach, administer, and provide direct mental health and substance provide direct mental health and substance abuse services to ethnic minority groups. abuse services to ethnic minority groups.

SAMHSA Response (CSAT)SAMHSA Response (CSAT)

207 grantees who target African 207 grantees who target African American/Black populations:American/Black populations:• Minority AIDS Initiative: Targeted Minority AIDS Initiative: Targeted

Capacity Expansion-Capacity Expansion-HIV/AIDS and HIV/AIDS and HIV/AIDS OutreachHIV/AIDS Outreach

• Addiction Treatment – Homeless (AT-Addiction Treatment – Homeless (AT-HM)HM)

• Young Offenders Reentry Program Young Offenders Reentry Program (YORP)(YORP)

SAMHSA Response, CSAT, SAMHSA Response, CSAT, Cont.Cont.

Access to Recovery (ATR)Access to Recovery (ATR)Treatment Drug Courts (TDC)Treatment Drug Courts (TDC)Pregnant & Postpartum Women (PPW)Pregnant & Postpartum Women (PPW)Recovery Community Support Recovery Community Support Program (RCSP)Program (RCSP)Screening, Brief Intervention & Screening, Brief Intervention & Referral to Treatment Referral to Treatment (SBIRT)(SBIRT)

HISTORY OF THE HISTORY OF THE CERTIFICATION CERTIFICATION

PROCESS IN THE PROCESS IN THE UNITED STATESUNITED STATES

History of CertificationHistory of Certification

People working in the addiction counseling People working in the addiction counseling profession wanted their skills and knowledge profession wanted their skills and knowledge to be acknowledged and obtain professional to be acknowledged and obtain professional recognition for their work. recognition for their work.

A voluntary certification process began in the A voluntary certification process began in the early 1970s. early 1970s.

Certification procedures and eligibility were Certification procedures and eligibility were established by independent professional established by independent professional boards.boards.

History of CertificationHistory of Certification

The US government began in the late 1970s to The US government began in the late 1970s to include requirements for persons to demonstrate include requirements for persons to demonstrate that they held and had obtained credentials to that they held and had obtained credentials to practice within the facilities receiving Federal practice within the facilities receiving Federal funds.funds.

Until the 1980s, this was a voluntary process, and Until the 1980s, this was a voluntary process, and presently in 5 states, the voluntary status presently in 5 states, the voluntary status remains. Nevertheless, treatment facilities within remains. Nevertheless, treatment facilities within those states require their personnel to be those states require their personnel to be licensed.licensed.

Different states establish different eligibility Different states establish different eligibility requirements for certification or licensing.requirements for certification or licensing.

THE NATIONAL THE NATIONAL CERTIFICATION CERTIFICATION

COMMISSION (NCC)COMMISSION (NCC)

National Certification Commission National Certification Commission for Addiction Professionals for Addiction Professionals

(NCC AP)(NCC AP)Under the banner of NAADAC, the Under the banner of NAADAC, the Association for Addiction Professionals, the Association for Addiction Professionals, the National Certification Commission for National Certification Commission for Addiction Professionals (NCC Ap) operates Addiction Professionals (NCC Ap) operates as an independent body for all matters as an independent body for all matters involving the Associationinvolving the Association’’s alcohol and s alcohol and drug abuse counselor certification and drug abuse counselor certification and specialty endorsement opportunities at specialty endorsement opportunities at the national/international level.the national/international level.

National Certification Commission National Certification Commission (NCC)(NCC)

The NAADAC/NCC AP is building the profession by ensuring high standards of excellence for certification/licensure

and by providing quality continuing education.

History of the NCC APHistory of the NCC AP

Established in 1990 under the auspices of Established in 1990 under the auspices of NAADAC, The Association for Addiction NAADAC, The Association for Addiction ProfessionalsProfessionals

The NCC AP has independent autonomy in the The NCC AP has independent autonomy in the development and promulgation of our development and promulgation of our standards for testing, including:standards for testing, including:

who qualifies for the exams who qualifies for the exams contentcontent administration administration scoringscoring AppealsAppeals Development of new Credential ProductsDevelopment of new Credential Products

Mission of the NCC APMission of the NCC AP

The purposes and benefits of the NCC APThe purposes and benefits of the NCC AP’’s s national certifications are:national certifications are:

to focus on the individual counselor and to to focus on the individual counselor and to provide a formal indicator of the current provide a formal indicator of the current knowledge and competence at the national knowledge and competence at the national level;level;

to provide a national standard that is generally to provide a national standard that is generally higher than the state requirements and higher than the state requirements and encourages professionals to continue to learn encourages professionals to continue to learn for the sake of their clients;for the sake of their clients;

Mission (cont.)Mission (cont.)

to afford a means of establishing, to afford a means of establishing, measuring, and monitoring the measuring, and monitoring the requirements for knowledge in the requirements for knowledge in the profession; andprofession; and

to provide assistance to employers, health to provide assistance to employers, health care providers, educators, government care providers, educators, government entities, labor unions, other practitioners, entities, labor unions, other practitioners, and the public in the identification of quality and the public in the identification of quality counselors who have met the national counselors who have met the national competency standards.competency standards.

Certification OpportunitiesCertification Opportunities

The NCC AP instituted three The NCC AP instituted three credentials for alcoholism and drug credentials for alcoholism and drug abuse counselors: abuse counselors:

National Certified Addiction Counselor (NCAC National Certified Addiction Counselor (NCAC I)I)

National Certified Addiction Counselor (NCAC National Certified Addiction Counselor (NCAC II)II)

Master Addiction Counselor (MAC)Master Addiction Counselor (MAC)

NCAC I RequirementsNCAC I Requirements

Current state certification/licensure as an alcohol and/or Current state certification/licensure as an alcohol and/or drug abuse counselor. drug abuse counselor.

Three years' full-time or 6,000 hours of supervised Three years' full-time or 6,000 hours of supervised experience as an alcohol and/or drug abuse counselor. experience as an alcohol and/or drug abuse counselor.

270 contact hours of education and training in 270 contact hours of education and training in alcoholism and drug abuse or related counseling alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training. hours of HIV/AIDS training.

Passing score on the NCAC I written examination within Passing score on the NCAC I written examination within 4 years of application.4 years of application.

NCAC II RequirementsNCAC II Requirements

A Bachelor's level college degree from a regionally A Bachelor's level college degree from a regionally accredited institution of higher learning. accredited institution of higher learning.

Current state certification/licensure as an alcohol and/or Current state certification/licensure as an alcohol and/or drug abuse counselor. drug abuse counselor.

Five years full-time or 10,000 hours of supervised Five years full-time or 10,000 hours of supervised experience as an alcohol and/or drug abuse counselor. experience as an alcohol and/or drug abuse counselor.

450 contact hours of education and training in 450 contact hours of education and training in alcoholism and drug abuse or related counseling alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training. of HIV/AIDS training.

Passing score on the NCAC II written examination within Passing score on the NCAC II written examination within 4 years of application.4 years of application.

MAC RequirementsMAC Requirements Master's Degree in the healing arts or related field with Master's Degree in the healing arts or related field with

in-depth subjects applicable to the alcohol and drug in-depth subjects applicable to the alcohol and drug abuse treatment arena, by a regionally accredited abuse treatment arena, by a regionally accredited institution of higher learning. institution of higher learning.

Current state certification/licensure in alcohol and/or Current state certification/licensure in alcohol and/or drug abuse counseling or a related healing art. drug abuse counseling or a related healing art.

500 contact hours of specific alcohol and drug abuse 500 contact hours of specific alcohol and drug abuse counseling training. counseling training.

Three years full-time or 6,000 hours of supervised Three years full-time or 6,000 hours of supervised experience, two years or 4,000 hours of which is post experience, two years or 4,000 hours of which is post master's degree. master's degree.

Passing score on the MAC written examination within 4 Passing score on the MAC written examination within 4 years of application.years of application.

NAADAC NCC Certificants-December 31, 2011TAS

0.4%

NCAC I27.4%

NCAC II34.4%

MAC37.8%

Specialty OpportunitiesSpecialty Opportunities

The NCC AP also offers two specialty The NCC AP also offers two specialty opportunities that allow nationally certified opportunities that allow nationally certified addiction counselors to demonstrate their addiction counselors to demonstrate their

knowledge base in a particular area of knowledge base in a particular area of expertise:expertise:

Tobacco Addiction Specialist (TAS)Tobacco Addiction Specialist (TAS)

Adolescent Specialist Credential(ASC)Adolescent Specialist Credential(ASC)

SpecialtiesSpecialties

Student Assistance Professional Student Assistance Professional EndorsementEndorsement

Peer Recovery Specialist CredentialPeer Recovery Specialist Credential Co-Occurring Proficiency Co-Occurring Proficiency

EndorsementEndorsement Clinical Supervision EndorsementClinical Supervision Endorsement

Other Opportunity

NAADAC offers the training and validated examination for the Department of Transportation’s Substance Abuse Professional Qualification. (SAP)

SAPs by Region - December 31, 2010Mid Altantic

10%

Mid Central12%

Mid South9%

North Central7%

North East12%

North West7%

South East23%

South West20%

At Large0%

Examination Skill GroupsExamination Skill Groups

1)1) treatment admission (screening, intake and treatment admission (screening, intake and orientation)orientation)

2)2) clinical assessmentclinical assessment

3)3) ongoing treatment planningongoing treatment planning

4)4) counseling services (individual, group, family, counseling services (individual, group, family, crisis intervention and client education)crisis intervention and client education)

5)5) documentationdocumentation

6)6) case managementcase management

7)7) discharge and continuing caredischarge and continuing care

8)8) legal, ethical and professional growth issueslegal, ethical and professional growth issues

Training GroupsTraining Groups

1)1) treatment admission (screening, intake and treatment admission (screening, intake and orientation)orientation)

2)2) clinical assessmentclinical assessment

3)3) ongoing treatment planningongoing treatment planning

4)4) counseling services (individual, group, family, counseling services (individual, group, family, crisis intervention and client education)crisis intervention and client education)

5)5) documentationdocumentation

6)6) case managementcase management

7)7) discharge and continuing caredischarge and continuing care

8)8) legal, ethical and professional growth issueslegal, ethical and professional growth issues

Examination DomainsExamination Domains

NCAC INCAC I NCAC IINCAC II MACMAC

# of questions# of questions 250250 250250 200200

PharmacologyPharmacology 30%30% 25%25% 35%35%

Counseling Counseling practicepractice 40%40% 25%25% 30%30%

Theoretical Theoretical base of base of

counselingcounseling15%15% 25%25% 0%0%

Professional Professional issuesissues 15%15% 25%25% 35%35%

Examination DevelopmentExamination Development

Contracted The Professional Testing Corporation Contracted The Professional Testing Corporation (PTC)(PTC)

Psychometric ExpertisePsychometric Expertise

Testing AdministrationTesting Administration

Test items developed by the iNCC CommissionersTest items developed by the iNCC Commissioners

Item writing programItem writing program

Each iteration is differentEach iteration is different

Results compiled and analyzedResults compiled and analyzed

Examination Security Examination Security

Secure area at The Professional Secure area at The Professional Testing Corporation (PTC)Testing Corporation (PTC)

Controlled access to computer exam sitesControlled access to computer exam sites Permission cardPermission card Photo IDPhoto ID General computer site proctoring General computer site proctoring

proceduresprocedures Signature comparisonSignature comparison Each examination iteration is differentEach examination iteration is different

Ethical Standards and PrinciplesEthical Standards and Principles

NCC AP offers Ethics Standards for the Profession NCC AP offers Ethics Standards for the Profession based on the following principles:based on the following principles:Non-DiscriminationNon-Discrimination ResponsibilityResponsibilityCompetenceCompetence Legal & Moral StandardsLegal & Moral Standards

Public StatementsPublic Statements Publication CreditPublication CreditClient WelfareClient Welfare ConfidentialityConfidentialityClient RelationshipsClient Relationships RemunerationRemunerationInter-professional RelationshipsInter-professional Relationships Societal ObligationsSocietal Obligations

These core standards are enforced by These core standards are enforced by credentialing bodies nationwide and abroad.credentialing bodies nationwide and abroad.

The Importance of The Importance of MaintainingMaintaining

Your Professional Your Professional Standing Standing

ImportanceImportance

Protection of the professionProtection of the profession Protection of your clients/patientsProtection of your clients/patients Protection of your colleaguesProtection of your colleagues Protection of your agency Protection of your agency Protection of your practiceProtection of your practice

Preparing for the Changing LandscapePreparing for the Changing Landscape Better information dissemination Better information dissemination

More clarity in public announcements More clarity in public announcements

concerning decisions made at the national levelconcerning decisions made at the national level Equal acceptance of ALL professionsEqual acceptance of ALL professions Equal engagement in the planning for the Equal engagement in the planning for the

futurefuture Use of curricula developed for higher Use of curricula developed for higher

educational programs (NASCC) – SAMHSA educational programs (NASCC) – SAMHSA sponsoredsponsored

Understanding the role certificants can play in Understanding the role certificants can play in Peer Recovery, Peer CoachingPeer Recovery, Peer Coaching

The FutureThe Future Integration of all servicesIntegration of all services TA Center TA Center Clear career paths in this new Clear career paths in this new

landscape for all professionslandscape for all professions Building of a collaborative, collegial Building of a collaborative, collegial

workforceworkforce

QuestionsQuestions

Thank you for your attention.Thank you for your attention.

For more information: For more information:

NCC APNCC APDonna Croy, Certification AdministratorDonna Croy, Certification Administrator

donna@naadac.orgdonna@naadac.org

800-548-0497 x 111800-548-0497 x 111