IC&RC Alcohol and Drug Counselor Examination Domains

I. UNDERSTANDING ADDICTION
The professional is able to:
1) Understand a variety of models and theories of addiction and other substance-related problems.
2) Recognize the social, political, economic, and cultural context within which addiction and substance abuse exist, including risk and resiliency factors that factors that characterize individuals and groups and their living environments.
3) Describe the behavioral, psychological, physical health, and social effects of psychoactive substances on the person using and significant others.
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.

II. TREATMENT KNOWLEDGE
The professional is able to:
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.
6) Recognize the importance of family, social networks, and community systems in the treatment and recovery process.
7) Understand the importance of research and outcome data, and their application in clinical practice.
8) Appreciate the value of an interdisciplinary approach to addiction treatment.

III. APPLICATION TO PRACTICE
The professional is able to:
9) Understand the established diagnostic criteria for substance use disorders, and describe treatment modalities and placement criteria within the continuum of care.
10) Describe a variety of helping strategies for reducing the negative effects of substance use, abuse, and dependency.
11) Tailor helping strategies and treatment modalities to the client’s stage of dependence, change, or recovery.
12) Provide treatment services appropriate to the personal and cultural identity and language of the client.
13) Adapt practice to the range of treatment settings and modalities.
14) Be familiar with medical and pharmaceutical resources in the treatment of substance use disorders.
15) Understand the variety of insurance and health maintenance options available, and appreciate the importance of helping clients access those benefits.
16) Recognize that crisis may indicate an underlying substance use disorder and may be a window of opportunity for change.
17) Understand the need for and the use of methods for measuring treatment outcome.

IV. PROFESSIONAL READINESS
The professional is able to:
18) Understand diverse cultures, and incorporate the relevant needs of culturally diverse groups, as well as people with disabilities, into clinical practice.
19) Understand the importance of self-awareness in one’s personal, professional, and cultural life.
20) Understand the addiction professional’s obligation to adhere to ethical and behavioral standards of conduct in the helping relationship.
21) Understand the importance of ongoing supervision and continuing education in the delivery of client services.
22) Understand the obligation of the addiction professional to participate in prevention and treatment activities.
23) Understand and apply setting-specific policies and procedures for handling crisis or dangerous situations, including safety measures for clients and staff.

The systematic approach to screening and assessment.

Ia. SCREENING
The process through which the counselor, client, and available significant others determine the most appropriate initial course of action, given the client’s needs, characteristics, and available resources within the community.
The counselor is able to:
24) Establish rapport, including management of a crisis situation and determination of need for additional professional assistance.
25) Gather data systematically from the client and other available collateral sources, using screening 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.
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.
27) Assist the client in identifying the role of substance use on his or her current life problems and the effects of continued harmful use or abuse.
28) Determine the client’s readiness for treatment and change as well as the needs of others involved in the current situation.
29) Review the treatment options that are appropriate for the client’s needs, characteristics, goals, and financial resources.
30) Apply accepted criteria for diagnosis of substance use disorders in making treatment recommendations.
31) Construct with the client and appropriate others an initial action plan based on client needs, client preferences, and resources available.
32) Based on the initial action plan, take specific steps to initiate an admission or referral and ensure follow-through.

Ib. ASSESSMENT
An ongoing process through which the counselor collaborates with the client, and others, to gather and interpret information necessary for planning treatment and evaluating client progress.
The counselor is able to:
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 other 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
●Socio-economic characteristics, lifestyle, and current legal status
●Use of community resources
●Treatment readiness
●Level of cognitive and behavioral functioning
34) Analyze and interpret the data to determine treatment recommendations.
35) Seek appropriate supervision and consultation.
36) Document assessment findings and treatment recommendations.

A collaborative process through which the counselor and client develop desired treatment outcomes, and identify the strategies to achieve them. At a minimum, the treatment plan addresses the identified substance related disorder(s), as well as issues related to treatment progress, including relationships with family/friends, employment, education, spirituality, health concerns, and legal needs.
The counselor is able to:
37) Use relevant assessment information to guide the treatment planning process.
38) Explain assessment findings to the client and significant others.
39) Provide the client and significant others with clarification and further information as needed.
40) Examine treatment implications in collaboration with the client and significant others.
41) Consider the readiness of the client and significant others to participate in treatment.
42) Prioritize the client’s needs in the order they will be addressed in treatment.
43) Formulate mutually agreed-on and measurable treatment goals and objectives.
44) Identify appropriate strategies for each treatment goal.
45) Coordinate treatment activities and community resources in a manner consistent with the client’s diagnosis and existing placement criteria.
46) Develop with the client a mutually acceptable plan of action, as well as methods for monitoring and evaluating progress.
47) Inform the client of confidentiality rights, program procedures that safeguard them, and the exceptions imposed by regulations.
48) Reassess the treatment plan at regular intervals or when indicated by changing circumstances

The process of facilitating the client’s utilization of available support systems and community resources to meet needs identified in clinical evaluation and/or treatment planning.
The counselor is able to:
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.
50) Continuously assess and evaluate referral resources to determine their appropriateness.
51) Differentiate between situations in which it is most appropriate for the client to self-refer to a resource and situations requiring counselor referral.
52) Arrange referrals to other professionals, agencies, community programs, or appropriate resources to meet the client’s needs.
53) Explain in clear and specific language the necessity for and process of referral to increase the likelihood of client understanding and follow-through.
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.
55) Evaluate the outcome of the referral.

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. Case management establishes a framework for action 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, and ongoing evaluation of treatment progress and client needs.

IVa. IMPLEMENTING THE TREATMENT PLAN
The counselor is able to:
56) Initiate collaboration with referral sources.
57) Obtain and interpret all relevant screening, assessment, and initial treatment planning information.
58) Confirm the client’s eligibility for admission and continued readiness for treatment and change.
59) Complete necessary administrative procedures for admission to treatment.
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
● Client rights and responsibilities
● The effect of treatment and recovery on significant others
61) Coordinate all treatment activities with services provided to the client by other resources.

IVb. CONSULTING
The counselor is able to:
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.
63) Understand the terminology, procedures, and roles of other disciplines related to the treatment of substance use disorders.
64) Contribute as a member of a multi-disciplinary treatment team.
65) Apply confidentiality rules and regulations appropriately.
66) Demonstrate respect and nonjudgmental attitudes toward clients in all contacts with community professionals and agencies.

IVc. CONTINUING ASSESSMENT AND TREATMENT PLANNING
The counselor is able to:
67) Maintain ongoing contact with the client and involved significant others to ensure adherence to the treatment plan.
68) Understand and recognize stages of change and other signs of treatment progress.
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.
70) Describe and document the treatment process, progress, and outcome.
71) Use accepted treatment outcome measures.
72) Conduct continuing care, relapse prevention, and discharge planning with the client and involved significant others.
73) Document service coordination activities throughout the continuum of care.
74) Apply placement, continued stay, and discharge criteria for each modality on the continuum of care.

A collaborative process that facilitates the client’s progress toward mutually determined treatment goals and objectives. Counseling includes individual, couple, family, and group methods that are sensitive to individual client characteristics and the influence of significant others, as well as the client’s cultural and social context. Competence in counseling is built upon an understanding and appreciation of, and the ability to use appropriately, the contributions of various addiction counseling models as they apply to modalities of care for individuals, groups, families, couples, and intimate dyads.

Va. INDIVIDUAL COUNSELING
The counselor is able to:
75) Establish a helping relationship with the client characterized by warmth, respect, genuineness, concreteness and empathy.
76) Facilitate the client’s engagement in the treatment and recovery process.
77) Work with the client to establish realistic, achievable goals consistent with achieving and maintaining recovery.
78) Promote client knowledge, skills, and attitudes that contribute to a positive change in substance use behaviors.
79) Encourage and reinforce client actions determined to be beneficial in progressing toward treatment goals.
80) Work appropriately with the client to recognize and discourage all behaviors inconsistent with progress toward treatment goals..
81) Recognize how, when, and why to involve the client’s significant others in enhancing or supporting the treatment plan.
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.
83) Facilitate the development of basic and life skills associated with recovery.
84) Adapt counseling strategies to the individual characteristics of the client, including but not limited to disability, gender, sexual orientation, develop-mental level, culture, ethnicity, age, and health status.
85) Make constructive therapeutic responses when the client’s behavior is inconsistent with stated recovery goals.
86) Make constructive therapeutic responses when the client’s behavior is inconsistent with stated recovery goals.
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.

Vb. GROUP COUNSELING
The counselor is able to:
88) Describe, select, and appropriately use strategies from accepted and culturally appropriate models for group counseling with clients with substance use disorders.
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.
90) Facilitate the entry of new members and the transition of exiting members.
91) Facilitate group growth within the established ground rules, and precipitate movement toward group and individual goals by using methods consistent with group type.
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.
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.

Vc. COUNSELING FOR FAMILIES, COUPLES, AND INTIMATE DYADS
The counselor is able to:
94) Understand the characteristics and dynamics of families, couples, and significant others affected by substance use.
96) Be familiar with and appropriately use models of diagnosis and intervention for families, couples, and intimate dyads, including extended, kinship, or tribal family structures.
97) Facilitate the engagement of selected members of the family, couple, or intimate dyed in the treatment and recovery process.
98) Help members of the family, couple, or intimate dyed understand the interaction between their system and addiction.
99) Help families, couples, and intimate dyads adopt strategies and behaviors that sustain recovery and maintain healthy relationships.

The process of providing clients, families, significant others, and community groups with information on risks related to alcohol and other drug use, as well as available prevention, treatment, and recovery resources.
The counselor is able to:
100) Design and provide culturally relevant formal and informal education programs that raise awareness and support substance abuse prevention and/or the recovery process.
101) Describe factors that increase the likelihood that an individual, community, or group will be at-risk for alcohol and other drug problems.
102) Sensitize others to issues of cultural identity, ethnic background, age, and gender role or identity in prevention, treatment, and recovery.
103) Describe warning signs, symptoms, and the course of addictions.
104) Describe how addiction affects families and significant/concerned others.
105) Describe continuum of care resources that are available to significant/concerned others.
106) Describe principles and philosophies of prevention, treatment, relapse, and recovery.
107) Understand the health and behavioral problems related to the treatment of addiction, including transmission and prevention of HIV/AIDS, TB, STDs, and other communicable diseases.
108) Teach basic life skills such as stress management, relaxation, communication, assertiveness, and refusal skills.

The recording of the screening and intake process, assessment, and treatment plan, as well as the preparation of written reports, clinical progress notes, discharge summaries and other client-related data.
The counselor is able to:
109) Demonstrate knowledge of accepted principles of client record management.
110) 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.
111) Prepare accurate and concise screening, intake, and assessment reports.
112) Prepare and record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.
113) Record progress of the client in relation to treatment goals and objectives.
114) Prepare an accurate, concise, informative, and current discharge summary.
115) Document the treatment outcome, using accepted methods and instruments.

116) Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the client.
117) Interpret and apply information from current counseling and addictions research literature in order to improve client care and enhance professional growth.
118) Adhere to federal and state laws, and agency regulations, regarding addictions treatment.
119) Recognize the importance of individual differences by gaining knowledge about personality, cultures, lifestyles, and other factors influencing client behavior, and applying this knowledge to practice.
120) Utilize a range of supervisory options to process personal feelings and concerns about clients.
121) Conduct culturally appropriate self-evaluations of professional performance, applying ethical, legal, and professional standards to enhance self-awareness and performance.
122) Obtain appropriate continuing professional education.
123) Assess and participate in regular supervision and consultation sessions.
124) Develop and utilize strategies to maintain physical and mental health.