Rationale for Higher Education for Addiction Counselors/Therapists
The standard of “315 hours of education” for addiction counselors is obsolete. To speak of addiction counselor education in terms of “hours” today is outmoded and frankly, irrelevant. The national trend long ago began moving toward college degrees and professional licensure for addiction counselors, and such levels of education are measured in units, quarters and semesters, not in hours. The 315-hour “national” standard was set in the early 1980’s based on the so-called “Birch and Davis Study,” (National Institute on Alcohol Abuse and Alcoholism - Development of Model Professional Standards for Counselor Credentialing, 1984). The study was a preliminary attempt to identify addiction counselor competencies, and while it was a seminal study, it is still unclear how the study in any way suggests that 315 hours of education are sufficient to acquire the competencies it outlines. In any case, a quarter of a century has passed since that study was done. Neither the internet nor cell phones existed in 1984, and in addition to those and other extraordinary technological advances, there have been significant changes in our understanding of addiction and its treatment. Here are just a few developments that have occurred in the field that have impacted the competencies addiction counselors must develop:
- Research continues to improve our understanding of the neurological underpinnings of addiction as a chronic, relapsing disorder. Counselors/therapists must learn about the physiological effects of alcohol and other drugs as well as the properties of the medications used to treat addiction. And our knowledge base is constantly growing and changing—it is not static.
- HIV and HEP C are now common issues faced by those who access treatment.
- Addiction counselors must now learn about addiction and its relationship to other mental disorders, including the effects of a multitude of psychiatric medications and a host of cutting edge, nuanced, and sometimes controversial, evidence based treatment approaches.
- Ethnic, Gender and Cultural Diversity Competence is now considered to be an essential part of the education required for counselors to perform their duties in ethical and competent ways. Treatment centers want counselors to be trained in the treatment of “specific populations” including, among others:
o Multiple cultural groups
o Women with children
o LGBT (lesbian, gay, bisexual, transgender)
The concept of “tiers” or “career ladders” based on increasing levels of education serves as a perfect model for the evolution of our field into a recognized profession. But the tiers must be graduated in a way that makes advancing up the ladder both desirable and achievable, with career incentives in between. Recent legislative proposals do not offer tiers or a career ladder at all--they offer only two options at opposite extremes: either no degree with some “hours” of education, or a Master’s degree. Other states, Arizona for one, have real tiered systems with graduated levels ranging from the Associate degree to the Bachelor’s degree to the Master’s degree with appropriate changes in scope of practice at each degree level.
Finally, the Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional PracticeTechnical Assistance Publication (TAP) Series 21 (1996 and 2006) provided us with an evidence based justification for increasing the low educational standards once thought to be adequate for training addiction counselors. While there will always be a need for peer “coaches” and sponsors and peer helpers in social model settings, sober living environments and community based prevention and aftercare, the changes in science and practice demand that we bring professional addiction counselor/therapist education up to par with that of other healthcare professionals by requiring college degrees that include a broad social science foundation, and significant work experience under the direction of qualified, educated and trained supervisors. The time has come for us to insist upon nothing less.
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