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Journey to a profession: Part II

September 7, 2011
by Donald P. Osborn
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NCAD will introduce a new path to professional licensure in addiction

Editor’s note: At the 2010 National Conference on Addiction Disorders (NCAD), attendees celebrated three years of work completed by the National Addiction Studies and Standards Collaborative Committee (NASSCC) that culminated in establishing the National Addiction Studies Accreditation Commission (NASAC).

At the 2011 NCAD conference, to be held Sept. 17-21 in San Diego, two workshops related to these developments will be held. One will roll out the national standardized addictions curriculum with the new scope of practice. The second will be related to changes coming in the move from certification toward professional licensure in addiction.

This article is the second in a three-part series (click here to read Part I) written by Donald P. Osborne, president of NADAAC, which attempts to put the path that the field has taken into a historical context, as well as present a template for a new era in the counseling profession.

Concern over certification and education

In the early 1990s, Indiana began the process of adopting the state’s first licensure bill in addiction counseling. Shortly after the death of the bill, I began to research addiction counseling programs in higher education in the U.S. I quickly found that field was lacking—a disparity in standards was evident.

Coming out of mental health and a marriage and family therapy graduate education, I was familiar with the history of both professions with regard to the connection of academics and a scope of practice. They had competencies; they had set a template for the addiction field to follow.

The field of addiction counseling was an area that “cared for its own.” Those who had experienced addiction themselves were called upon, or offered their help to those who wanted to overcome addiction. Experts, theories or treatment programs did not exist.

Over time the field moved toward providing a basic level of education with workshops, trainings and conferences. In time, “training institutes” were established as businesses to offer “courses.” The institutes provided a valuable opportunity to prepare for certification to enter the field. They also helped individuals to keep current in maintaining certification.

Yet critics of the field and this approach saw flaws. For one, there was concern over course composition, and questioning of the lack of validity in content and effectiveness. The background and credentials of those providing the training were also questioned. If states did require some form of education, content, learning objectives and hours, the requirements varied.

Addiction counseling remained counter to the allied professions in how one became a counselor. In the allied professions one went to school, graduated, sat for a certification (or, if needed, licensure) exam and went into practice. For addictions, one simply studied for a certification exam, and if passed went on to counsel. Only then, and if the person wanted to, would one go to higher education.

Some academic programs existed, mostly at community colleges in a certificate or associate’s degree program. There were a few bachelor’s programs. In reviewing higher education programs, inconsistencies were found.

Some states with more than one program had varying credit hours and course content. In one state with two colleges with addiction programs within a few miles of each other, the programs did not match in several respects.

In interviewing various state officials assigned to the creation of addictions standards, they admitted they did not have addictions expertise. They were given the task by the governor or a state agency, and due to a lack of resources they wrote very minimal standards.

Also of concern was the lack of graduate-level programs. Some graduate programs in addictions were available, yet accreditation was an issue. An interesting finding regarding some programs was that they were “accredited” but lacked the accepted “gold standard” of accreditation from the Higher Learning Commission (HLC).

What was evident in the addiction workforce was an increase in counselors holding graduate degrees in something other than addiction counseling. Many of these programs did not until very recently require graduates to take a course in addictions.

In essence, many graduates would enter practice unprepared to address the issue of addiction and could be found negligent. To the credit of those in the workforce, they did seek out addictions certification to address the need and to be ethical in practice.

For the addiction field to have viability, it needed its own addiction-specific graduate programs and a coordinated, standardized curriculum.

A pilot program

In 2006 the Substance Abuse and Mental Health Services Administration (SAMHSA) established an education grant to Indiana Wesleyan University (IWU). The grant was to assist in the development of the first pilot program addressing academic opportunities in addiction counseling and to increase the addictions workforce.