Commentary: Simple Change Will Reduce Sea of Credentialing Confusion in California

Join Together’s recent article “Report: Lax Rules Allow Felons to Serve as Drug and Alcohol Counselors in California” shed light on how California lags behind the rest of the country by having a sea of certifications for substance use disorder treatment. Confusion like this is detrimental to the health and safety of the public, as well as to the clinicians themselves, and all who support the integrity of our field must call for change.

A Problem of Proliferation

Prospective service providers often are unable to determine which certification is best or more widely recognized, but that is only one of the many related problems associated with California’s treatment climate. Consider this: If the counselors themselves cannot figure out which certification they need or which is most credible, how can the client population be assured of competent and ethical services?

For the record, most would agree that not all credentials are created equal. Some (like International Certification & Reciprocity Consortium’s (IC&RC)) have minimum standards, an active code of ethics and a psychometrically valid and reliable written exam. Others are granted under much less stringent educational requirements. What this means is that saying you are certified as a counselor in California can mean drastically different things, depending on what letters you have after your name.

And what about ethical violations? Unscrupulous counselors who are disciplined under one credential can simply drop it and apply for a different one. Problem solved!

Believe it or not, the situation in California is better now, with the number of available certifications reduced by about half, following a state mandate requiring that the credentials themselves be credentialed. An organization called the National Commission for Certifying Agencies, an arm of the Institute for Credentialing Excellence, accredits certification programs. Still the workforce confusion in California is unmatched anywhere in the nation.

A Simple Solution

The proliferation problem in California could be eliminated if the state would unite the workforce under one credentialing process with uniform standards and a single exam. While acknowledging my obvious bias, the IC&RC process makes the most sense for a couple of reasons:
• First, the workforce around the rest of the country is decidedly IC&RC, with almost every state in the nation having an IC&RC member board. IC&RC currently represents more than 45,000 certified professionals around the country. Coming into the state of California already meeting some minimum requirements and having passed a common exam makes it easier for a competent, ethical counselor to join the state’s workforce.
• Second, a single recognized credential would make it a lot easier for prospective clients to have some assurances that their service provider is both ethical and competent. Having one credential would eliminate confusion over what it means to be credentialed, and it would eliminate an avenue for a previously disciplined counselor to continue working and perhaps even exploiting clients.

The issue of background checks is more complex. The state apparently has some legal stipulations that do not allow just anybody to do criminal background checks. A certifying body cannot mandate it if it is against state law. Consequently, the IC&RC credential in California can only require sworn disclosure of offenses, which of course does not preclude lying. If we assume honest applicants, then the IC&RC credential standards provide a clear safeguard against violent offenders and sexual predators by excluding them from practice. However, simply having a criminal record does not – and should not – automatically exclude someone from practice. To say that a criminal record disqualifies someone from the profession is to assume the worst of human beings: that we are not capable of change.

National statistics continue to show that approximately 80 percent of incarcerated individuals in the U.S. have abused drugs or alcohol, and nearly one-half are clinically addicted. If we say that those with criminal histories cannot be counselors, then we may as well say that recovery is a myth. Accepting former offenders as counselors, like recovery itself, assumes that change IS possible and therefore a worthy pursuit.

I believe in change and so does the IC&RC affiliate in California, the California Association of Alcoholism and Drug Abuse Counselors. The organization has a beautifully conceived program for incarcerated men and women called the Offender Mentor Certification Program. This program allows individuals serving lengthy sentences to learn about addiction counseling while still in prison. Stringent guidelines still disqualify sex offenders, but even some violent criminals can enter the program if they meet certain additional requirements related to their records – both in and out of prison.

Recovery is about change. Criminal rehabilitation is about change. IC&RC is hopeful that California will adopt a credentialing system that will protect the public while invigorating the workforce. But that will require California to change.

Phyllis A. Gardner, PhD, is President of IC&RC, which is the global leader in the credentialing of prevention, addiction treatment, and recovery professionals. Organized in 1981, it provides standards and examinations to certification and licensing boards in 24 countries, 47 states and territories, five Native American regions, and all branches of the U.S. military. Gardner holds a doctoral degree in Sociology from Texas Woman’s University and is a Licensed Chemical Dependency Counselor, Certified Clinical Supervisor, and Certified Advanced Addictions Counselor. She has served the Texas Certification Board of Addiction Professionals in various capacities since 1990 and is a past president of the Texas Association of Addiction & Prevention Professionals.

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    Dr. Lori Phelps

    July 14, 2013 at 11:20 PM

    With all due respect to IC&RC’s long history of success in establishing a national standard of 270 hours of education for addiction counselors and member organizations in many states and countries, Dr. Gardner’s suggestion that the IC&RC level credential should be the one used in California is misguided, though understandable given her position as president of the organization. Full disclosure: I am the Executive Director of CAADE.

    If we are to believe the rhetoric coming from the federal government—most notably from SAMHSA and CSAT—then any discussion of addiction counselor education standards must begin with higher education. The 270-hour IC&RC standard was set in the mid-1980s when addiction counselors were still largely culled from the recovering community. Since then, the national trend has been moving slowly but surely toward college degrees and professional licensure for addiction counselors. To that end, the National Addiction Studies Accreditation Commission (NASAC) was established in 2010 with the sole purpose of developing a national, standardized addiction studies curriculum in regionally accredited colleges and universities.
    The California Association for Alcohol/Drug Educators (CAADE) college curriculum was the model for the curriculum being developed by NASAC. The new NASAC curriculum has already been implemented in institutions of higher education in many states. Some 40 colleges and universities in California, Arizona, and Nevada have CAADE accredited Addiction Studies programs. Students who complete the CAADE accredited Addiction Studies programs, pass the nationally accredited CAADE examination and complete the requisite supervised internship hours, can obtain the Certified Addictions Treatment Counselor (CATC) credential. The CATC has advancing tiers, from I-V (and a CATC N for nurses at all levels), that are earned as the student completes higher degrees ranging from the AA to the Ph.D.

    Healthcare reform will require the addiction counselor of the future to have an AA degree or higher from an accredited program that offers the nationally recognized curriculum. The license will require a Master’s degree or higher. CAADE accredited Addiction Studies programs are preparing students to earn the only credential which will guarantee that they can be part of that inevitable future. No other certifying organization in our state can make that claim.
    I certainly agree with Dr. Gardner that a single credential in California is essential. But the IC&RC level credential is not the one that is going to get California up to speed with the rest of the country.

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