Ethical Concerns Raised Over Marketing of Independent Certificates, Credentials

During the past several years, the addiction field has been plagued by unscrupulous individuals and agencies doing anything from brokering patients, and padding billing and drug screens to unethical treatment practices solely for greed and money. While most providers and agencies are ethical and passionate in their work, it does put the addiction treatment profession under continued scrutiny.

Unfortunately, one of the emerging practices that is growing rapidly is the selling and marketing of certifications, certificates and credentials. Individuals, agencies or even some boards develop a “credential,” “certificate” or certification” that has not met any recognized criteria or completed any standardized process.

The International Certification and Reciprocity Consortium and the National Certification for Addiction Professionals have long been the national standard in the development of addiction related certifications and credentials. These organizations develop testing processes and standards to promote public protection for addiction treatment.

For instance, IC&RC products use the latest research on evidence-based practices and are updated every five years. Credentialing facilitates standardized practices and most importantly ensures trained ethical professionals are available to clients, families and communities. The development of credentials starts with subject matter experts from around the country to provide knowledge and skills. The foundation of a credential is a job task analysis, a methodical process of determining elements of practice, and knowledge to assess as part of a certification examination. This process utilizes a psychometrician to further develop the credential. There are also very clear candidate guides for the examinations. Individuals who receive certifications from these national organizations meet national standards in education, supervision and experience, and must pass a national examination issued by each jurisdiction. The credentials from these organizations are recognized nationally and, in some jurisdictions, listed in state statute.

Most of these independent certifications have not been reviewed, developed or formulated with any reliable standards and certainly not the standards required by IC&RC or NAADAC, the Association for Addiction Professionals’ National Certification Commission for Addiction Professionals; or compliant with the National Commission for Certifying Agencies (NCCA). It seems there is a certification for just about anything. Several of these new credentials are directly marketed to individuals and organizations. “Certified Addiction Feelings Resolution Specialist,” “Certified Addiction Activity Specialist" and “Certified Trauma Addiction Counselor” are just a few of the many independent credentials being direct marketed. Some of these certifications allow those going through the “trainings” to place credentials behind their name. These individuals and organizations market the credential or certificate, but the actual information regarding the designation is in some cases very elusive. Frequently, they require the completion of an application simply to obtain more detailed information about their certification programs.

Pitfalls of pop-up certifications

The opioid crisis has certainly changed how we treat individuals with opiate use disorders. These individuals can be very complex and should have qualified, experienced professionals with significant training in the field of addiction providing services. One of the more prevalent independent “certifications” to be marketed and sold is that of a “Medication Assisted Treatment Specialist.”

Many organizations require minimum standards for experience and education in treating this specialized population and meet developed standardized criteria. Many also require an existing practice certification or license and use MATS as a specialization. Others however are marketing this as a training certificate that requires no minimum supervision, education or experience. The only requirement is they attend a short, in-person training or online course and complete an online test where there is opportunity to search the Internet answers. Applicants are then given a certificate indicating they are a Medication Assisted Treatment Specialist. In this scenario, a deli person at your local grocery store who does not have any experience, training or education with this complex population can in fact become a Medication Assisted Treatment Specialist.

While I applaud and support specialized training of all kinds and personally provide trainings in many areas, I certainly do not authorize any credentials to be placed behind trainees’ names for the mere fact of taking a course. These pop-up certifications or certificates are concerning in that new professionals wanting to get into the field see them as an opportunity to get credentials behind their name without having to put in the work, education, training, supervision and testing of competency. Because credentialing is so confusing, many authorities or agencies do not understand these new pop-up credentials. As a result, agencies hiring professionals could assume these are recognized credentials. Individuals who are seeking services would interpret someone having the designation of a Medication Assisted Treatment Specialist as having specialized skills and competence. That may not be the case.

For the many addiction professionals who have worked hard through education, experience, supervision, passing national testing standards and demonstrating competence, these pop-up credentials discredit their hard work and diminish the accomplishment of holding nationally recognized credentials.

The profession of addiction treatment and those needing services deserve better than these new pop-up certifications and credentials. It is unfortunate that this practice is now becoming similar to the unethical practices to make money that historically have plagued the addiction field. Why work hard to get credentials when you can just buy them for less than $1,000?

Understanding nationally recognized training

NCCA sets standards for credentialing organizations, with very clear distinctions for certification and training certificates.

Certificate programs provide instruction and training to aid participants in achieving specific learning outcomes. A certificate program is complete once the certificate is awarded; whereas, certification is an ongoing process. Certified individuals are required to engage in specified activities, such as continuing education or re-examination, on a routine basis in order to maintain their certification.

No designation is awarded for a certificate. Although some certificate programs award designations or acronyms or letters for certificate recipients to use after their names to reference the certificate they hold, this practice has been criticized as contributing to the considerable confusion about the distinction between certificate and certification programs. Consequently, the practice of awarding designations, acronyms or letters for use after one’s name has been prohibited by a published standard for certificate programs.

NCCA defines certification as:

1. Certification confirms, through a rigorous examination process, that you have mastered the knowledge required for your professional role. A certificate program may or may not include an assessment to confirm that you have acquired the knowledge or skills that are the focus of program. If it does, the assessment is generally narrower in scope than certification, covering only a subset of the knowledge and skills needed to carry out your professional responsibilities. Certification assesses not what you learned in a single course or series of courses, but rather what you need to know to perform your job competently.
2. Certification is a comprehensive verification of your qualifications. Certification confirms not only that you mastered essential knowledge, but also that you have the academic background and work experience that experts have identified as being necessary for competent performance in your professional role.
3. Certification requires that you remain current in the field. A certificate program helps you to acquire knowledge and skills at a single point in time; it has no mechanism for ensuring that your knowledge and skills will remain current. By contrast, participation in the Certification Renewal process ensures that your knowledge base continues to evolve as the field changes. Your knowledge is up to date and consistent with today’s requirements for competent performance.
4. NCCA stipulates that holders of assessment-based certificates may not use letters or acronyms behind their names, nor may they use the word “certified” in describing their credentials. The use of letters, acronyms and the word “certified” are reserved to holders of professional certifications. Some organizations who offer pop-ups are merging training certificates and certification together. They identify it as a training certificate but then require they re-certify every two years. That practice is not in line with NCCA.

Validate your training

If you have concerns about the validity of a training certificate or certification, ask questions and become informed. You may be paying for something that is not a valid credential and even incur significant liability.

Some questions to ask:

• Is this certification or certificate recognized, required or accepted by state authorities, agencies or reimbursors of services?
• What standards were used in the development of the certification or training certificate?
• Who developed it? (Is it just an individual or individuals?)
• What is its history?
• When was the certificate or credential updated or developed? Was it developed more than years ago?
• Was a national organization involved in development?
• How does the training certificate or certification benefit me?
• Are their other training alternatives that will provide the same education?
• Did the individual or organization who developed the certification/certificate require the training be completed by them, and then provide the certification/certificate only through them?
• How does the cost compare to other recognized national credentials?

Individuals and agencies need to be aware of the seriousness of this current trend. It is also time for individuals and organizations to follow NCCA national standards when offering certification and certificate programs. All professionals providing substance use disorder treatment should be able to demonstrate the necessary skills and competency through recognized credentialing processes. Most importantly, those seeking services deserve care that is provided by skilled—and appropriately credentialed—professionals.

Donna Johnson, JD, ICADC II, ICCJP, ICCDP-D, is CEO of Addiction Solutions of Georgia, Inc.