Counseling students seek broader skill set

Students pursuing degrees in addiction counseling appear to be getting more strategic about positioning themselves for career success, but there remain many unknowns for them in what is still a relatively young healthcare field.

“There is not a definitive curriculum that can get them licensed in addiction and mental health in every state,” says Roy Kammer, dean of the Hazelden Betty Ford Graduate School of Addiction Studies. “Also, you can be pursuing a program, and the [credentialing] requirements in a state can suddenly change.”

Addiction Professional spoke with Kammer about general trends in higher education for clinicians. The pattern that he immediately cited is the tendency for students to want to become integrated care providers, ultimately looking to be dually credentialed in addictions and mental health.

“They have started to see the [community] need,” Kammer says. “The idea that co-occurring disorders are the expectation rather than the exception rings so true. … People hear the numbers, and know that there are jobs out there.”

More students, Kammer says, are wisely seeing that pursuing dual licensure will make them a more desirable candidate in the job hunting process. “They are also talking long-term,” he adds. “They think that later on they might want to go into private practice, and this will give them a better opportunity to shift around within the field.”

Eye on state requirements

A great deal of variation from state to state remains in educational requirements for licensure or certification, and in general the requirements are getting more stringent as states seek to improve the overall quality and professionalism of substance use treatment services. Navigating the various credentialing boards that have a role in the process becomes a significant challenge for most students.

“During the first semester in our online degree program, we have the students look at the licensure requirements in the state they intend to practice in,” says Kammer.

Given a trend toward increased credit requirements for professional credentialing in states, Kammer says his school advises students who are seeking licensure in mental health to pursue its 60-credit program rather than a standard 44-credit curriculum.

Further complicating the process, Kammer says, is the fact that students might only be able to receive answers to general questions posed to credentialing boards prior to their actually applying for certification or licensure.

The increasingly complex landscape also has some schools examining their accreditation options for their degree programs. The National Addiction Studies Accreditation Commission (NASAC) accredits academic programs in addiction counseling, while the Council for Accreditation of Counseling and Related Educational Programs (CACREP) accredits master's- and doctoral-level programs in both addiction and mental health counseling. Some educational institutions might want to consider the broader CACREP accreditation if their curricula cross over into mental health, although doing that might require them to beef up the expertise on their faculty and enact other changes. “Do the organizations have the necessary resources?” says Kammer.

Clarifying the career ladder

The existence of multiple credentialing authorities for addiction professionals in some states has led to moves to delineate the career ladder and scope of practice for counselors. California legislators are considering Assembly Bill 700, which would establish uniform educational and experience standards for substance use disorder counselors in the state.

Under the proposed legislation, credentialing authorities in California would require individuals seeking certification to complete at least 315 documented hours of formal substance use disorder education, with instruction in ethics, public health and service provision to special populations among the required components. The curriculum requirements in the legislation are guided in part by the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Technical Assistance Publication (TAP) 21, Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice.

The legislation also would establish a six-tier career ladder and scope of practice for certified addiction counselors (CACs). The CAC 3 level, for example, would require a bachelor's degree and would not be eligible to engage in private practice, while the CAC 4 would require a master's degree and would allow for the provision of services for patients with co-occurring disorders. The bill is one of two pieces of state legislation strongly supported this year by the California Association for Alcohol/Drug Educators (CAADE).

Kammer believes that in general, opportunities for clinicians have grown immensely. Under the Affordable Care Act, “We made a shift from the social services realm to the health care realm,” opening up possibilities in integrated-care settings working with primary care professionals.

In addition, he says, students now have other options for what to do with their degree, even outside of clinical care. Some are expressing interest in marketing, or research, early on in their pursuit of a career, he says.