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Article Excerpt
Professional counselors and counselors-in-training continue to serve clients who have substance abuse issues, yet systematic training in substance abuse counseling is not available to many counselors. The authors investigated the extent to which students in programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2001) are exposed to clients presenting with substance abuse issues and the relationship between state licensure or certification in substance abuse and the resulting perception of the need for the inclusion of substance abuse training in these programs. Three methods are presented for possibly including substance abuse training in CACREP standards.
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Substance abuse continues to be a national problem, and there are no indications that it is decreasing in its level of severity or in the number of individuals dealing with this problem (Chappel & Lewis, 1997). According to the U.S. Department of Health and Human Services, SAMSHA, and the Office of Applied Studies (2001), an estimated 16.6 million Americans, ages 12 and older, were classified as having either substance abuse or dependence disorders. In addition, approximately one third of clients with psychiatric disorders have a history of alcohol or other drug abuse, and half of the clients with substance abuse or dependence disorders experience symptoms that are sufficient enough to warrant being diagnosed with another mental disorder (Regier et al., 1990). These numbers are indicative of an enormous need for the provision of services for persons in this population.
Professional counselors are frequently called on to provide services to persons with substance abuse issues. Nugent (2000) stated that "A dramatic increase in the need for counseling services has also occurred because of the growing numbers of reported cases of child neglect and abuse, domestic violence, and substance abuse" (p. 1). Therefore, it is necessary for counselors to take a leadership role, as they have in other areas, in the development of standards for the training of counselors in providing services for persons with substance abuse or dependence issues.
It is not clear, however, if professional licensed counselors are being adequately educated and trained to meet this leadership role. Recent research has suggested that the helping professions have been slow to respond with quality training in this area (Morgan & Toloczko, 1997) and that current training and education of helping professionals in the area of addictions may be inadequate (Chappel & Lewis, 1997; Deitch & Carleton, 1997; Glass, 1989; Montgomery, 1993). McDermott, Tricker, and Farha (1991) found that there was a need for focused and specialized training in substance-related issues. They indicated that the lack of such training for counselors was manifested in the reluctance of these professionals to identify, treat, or refer persons with substance abuse issues. McDermott et al. reported a "paucity of models for the training of counselors to work with these problems" (p. 87).
Chappel and Lewis (1997) argued that the clinical skills necessary for working with persons with substance abuse or dependence disorders were best acquired in supervised clinical settings with continuing supervision. An analysis of the Standards established by the Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2001) revealed, however, that the only reference to substance abuse in the Program Objectives and Curriculum Standards is Standard II.K.3.c., Human Growth and Development. This standard requires course work to provide an understanding of the nature and needs of individuals at all developmental levels, including all of the following: "an understanding of developmental crisis, disability, exceptional behavior, addictive behavior [italics added] psychopathology, and situational and environmental factors that affect both normal and abnormal behavior" (p. 61). The phrase "addictive behavior" or "substance abuse" is listed in the Program Area Standards for Marital, Couple, and Family Counseling/Therapy Programs, Mental Health Counseling Programs, Gerontology Counseling, College Counseling, Student Affairs, and School Counseling (CACREP, 2001). There is no mention of addictive behavior or substance abuse in the Community or Career Counseling Program Area standards.
Morgan and Toloczko (1997) surveyed the then existing 86 CACREP-approved programs to determine how substance abuse was included in the curriculum of those programs (e.g., course objectives, assignments, textbooks). Results revealed that 97% of the respondents indicated that there was a need for addiction-related training in counselor education. Morgan and Toloczko reported that the percentage of CACREP programs that had either required (30%) or elective (77%) addiction-related course offerings indicated a strong commitment to substance abuse and dependence training. In their study, "31% of respondents stated that they have current plans to provide systematic training or knowledge regarding substance abuse or dependency to all of their students regardless of specialty area" (p. 69). This finding might reflect the fact that 87% of the programs...
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