This guide provides practical advice on how to deal with the effects financial difficulties can have on your physical and mental health -- it covers:
•Possible health risks
•Warning signs
•Managing stress
•Getting help
•Suicide warning signs
•Other steps you can take
Possible Health Risks
Economic turmoil (e.g., increased unemployment, foreclosures, loss of investments and other financial distress) can result in a whole host of negative health effects - both physical and mental. It can be particularly devastating to your emotional and mental well-being. Although each of us is affected differently by economic troubles, these problems can add tremendous stress, which in turn can substantially increase the risk for developing such problems as:
•Depression
•Anxiety
•Compulsive Behaviors (over-eating, excessive gambling, spending, etc.)
•Substance Abuse
Warning Signs
It is important to be aware of signs that financial problems may be adversely affecting your emotional or mental well being --or that of someone you care about. These signs include:
•Persistent Sadness/Crying
•Excessive Anxiety
•Lack of Sleep/Constant Fatigue
•Excessive Irritability/Anger
•Increased drinking
•Illicit drug use, including misuse of medications
•Difficulty paying attention or staying focused
•Apathy - not caring about things that are usually important to you
•Not being able to function as well at work, school or home
Managing Stress
If you or someone you care about is experiencing these symptoms, you are not alone. These are common reactions to stress, and there are coping techniques that you can use to help manage it. They include:
•Trying to keep things in perspective - recognize the good aspects of life and retain hope for the future.
•Strengthening connections with family and friends who can provide important emotional support.
•Engaging in activities such as physical exercise, sports or hobbies that can relieve stress and anxiety.
•Developing new employment skills that can provide a practical and highly effective means of coping and directly address financial difficulties.
Getting Help
Even with these coping techniques, however, sometimes these problems can seem overwhelming and you may need additional help to get through "rough patches." Fortunately, there are many people and services that can provide help. These include your:
•Healthcare provider
•Spiritual leader
•School counselor
•Community health clinic
If you need help finding treatment services you can access our Mental Health Services Locator for information and mental health resources near you. Similarly, if you need help with a substance abuse problem you can use our Substance Abuse Treatment Facility Locator.
Specific help for financial hardship is also available, on issues such as:
•Making Home Affordable
•Foreclosure
•Reemployment
•Financial assistance
There are many other places where you can turn for guidance and support in dealing with the financial problems affecting you or someone you care about. These resources exist at the federal, state and community level and can be found through many sources such as:
•Federal and state government
•Civic associations
•Spiritual groups
•Other sources such as the government services section of a phone book
Suicide Warning Signs
Unemployment and other kinds of financial distress do not "cause" suicide directly, but they can be factors that interact dynamically within individuals and affect their risk for suicide. These financial factors can cause strong feelings such as humiliation and despair, which can precipitate suicidal thoughts or actions among those who may already be vulnerable to having these feelings because of life-experiences or underlying mental or emotional conditions (e.g., depression, bi-polar disorder) that place them at greater risk of suicide.
LCSW, MFT, LPC ceus suicide prevention
These are some of the signs you may want to be aware of in trying to determine whether you or someone you care about could be at risk for suicide:
•Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
•Looking for ways to kill oneself
•Thinking or fantasying about suicide
•Acting recklessly
•Seeing no reason for living or having no sense of purpose in life
If you or someone you care about are having suicidal thoughts or showing these symptoms SEEK IMMEDIATE HELP. Contact your healthcare provider, mental health crisis center, hospital emergency room or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for help.
Other Steps You Can Take
•Acknowledge that economic downturns can be frightening to everyone, but that there are ways of getting through them - from engaging in healthy activities, positive thinking, supportive relationships, to seeking help when needed from health professionals.
•Encourage community-based organizations and groups to provide increased levels of mental health treatment and support to those who are severely affected by the economy.
•Work together to help all members of the community build their resiliency and successfully return to healthy and productive lives.
For further information on mental health or substance abuse issues please visit The Substance Abuse and Mental Health Services Administration (SAMHSA).
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Special Note to Journalists
For ideas on how to best cover sensitive issues like suicide prevention in a thoughtful and constructive manner you can check out suggestions developed by the Annenberg Public Policy Center in conjunction with leading suicide prevention experts and journalists.
November 13, 2010
November 12, 2010
NIDA InfoFacts: Understanding Drug Abuse and Addiction
Many people do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. They mistakenly view drug abuse and addiction as strictly a social problem and may characterize those who take drugs as morally weak. One very common belief is that drug abusers should be able to just stop taking drugs if they are only willing to change their behavior. What people often underestimate is the complexity of drug addiction—that it is a disease that impacts the brain and because of that, stopping drug abuse is not simply a matter of willpower. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives.
Drug abuse and addiction are a major burden to society. Estimates of the total overall costs of substance abuse in the United States—including health- and crime-related costs as well as losses in productivity—exceed half a trillion dollars annually. This includes approximately $181 billion for illicit drugs,1 $168 billion for tobacco,2 and $185 billion for alcohol.3 Staggering as these numbers are, however, they do not fully describe the breadth of deleterious public health—and safety—implications, which include family disintegration, loss of employment, failure in school, domestic violence, child abuse, and other crimes.
What is drug addiction?
Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person’s self control and ability to make sound decisions, and at the same time send intense impulses to take drugs.
It is because of these changes in the brain that it is so challenging for a person who is addicted to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction’s powerful disruptive effects and regain control. Research shows that combining addiction treatment medications, if available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.
Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And, as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal failure—rather, it indicates that treatment should be reinstated, adjusted, or that alternate treatment is needed to help the individual regain control and recover.
What happens to your brain when you take drugs?
Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs are able to do this: (1) by imitating the brain’s natural chemical messengers, and/or (2) by overstimulating the “reward circuit” of the brain.
Some drugs, such as marijuana and heroin, have a similar structure to chemical messengers, called neurotransmitters, which are naturally produced by the brain. Because of this similarity, these drugs are able to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.
Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters, or prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message that ultimately disrupts normal communication patterns.
Nearly all drugs, directly or indirectly, target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that “teaches” people to repeat the behavior of abusing drugs.
As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. As a result, dopamine’s impact on the reward circuit is lessened, reducing the abuser’s ability to enjoy the drugs and the things that previously brought pleasure. This decrease compels those addicted to drugs to keep abusing drugs in order to attempt to bring their dopamine function back to normal. And, they may now require larger amounts of the drug than they first did to achieve the dopamine high—an effect known as tolerance.
Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Drugs of abuse facilitate nonconscious (conditioned) learning, which leads the user to experience uncontrollable cravings when they see a place or person they associate with the drug experience, even when the drug itself is not available. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decisionmaking, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse consequences—in other words, to become addicted to drugs.
mft continuing education, lcsw continuing education, ceus for mfts and lpcs
Why do some people become addicted, while others do not?
No single factor can predict whether or not a person will become addicted to drugs. Risk for addiction is influenced by a person’s biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:
Biology. The genes that people are born with––in combination with environmental influences––account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.
Environment. A person’s environment includes many different influences––from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and parental involvement can greatly influence the course of drug abuse and addiction in a person’s life.
Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability, and adolescents experience a double challenge. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it is to progress to more serious abuse. And because adolescents’ brains are still developing in the areas that govern decisionmaking, judgment, and self-control, they are especially prone to risk-taking behaviors, including trying drugs of abuse.
Prevention is the Key
Drug addiction is a preventable disease. Results from NIDA-funded research have shown that prevention programs that involve families, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. It is necessary, therefore, to help youth and the general public to understand the risks of drug abuse, and for teachers, parents, and healthcare professionals to keep sending the message that drug addiction can be prevented if a person never abuses drugs.
Drug abuse and addiction are a major burden to society. Estimates of the total overall costs of substance abuse in the United States—including health- and crime-related costs as well as losses in productivity—exceed half a trillion dollars annually. This includes approximately $181 billion for illicit drugs,1 $168 billion for tobacco,2 and $185 billion for alcohol.3 Staggering as these numbers are, however, they do not fully describe the breadth of deleterious public health—and safety—implications, which include family disintegration, loss of employment, failure in school, domestic violence, child abuse, and other crimes.
What is drug addiction?
Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person’s self control and ability to make sound decisions, and at the same time send intense impulses to take drugs.
It is because of these changes in the brain that it is so challenging for a person who is addicted to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction’s powerful disruptive effects and regain control. Research shows that combining addiction treatment medications, if available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.
Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And, as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal failure—rather, it indicates that treatment should be reinstated, adjusted, or that alternate treatment is needed to help the individual regain control and recover.
What happens to your brain when you take drugs?
Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs are able to do this: (1) by imitating the brain’s natural chemical messengers, and/or (2) by overstimulating the “reward circuit” of the brain.
Some drugs, such as marijuana and heroin, have a similar structure to chemical messengers, called neurotransmitters, which are naturally produced by the brain. Because of this similarity, these drugs are able to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.
Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters, or prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message that ultimately disrupts normal communication patterns.
Nearly all drugs, directly or indirectly, target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that “teaches” people to repeat the behavior of abusing drugs.
As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. As a result, dopamine’s impact on the reward circuit is lessened, reducing the abuser’s ability to enjoy the drugs and the things that previously brought pleasure. This decrease compels those addicted to drugs to keep abusing drugs in order to attempt to bring their dopamine function back to normal. And, they may now require larger amounts of the drug than they first did to achieve the dopamine high—an effect known as tolerance.
Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Drugs of abuse facilitate nonconscious (conditioned) learning, which leads the user to experience uncontrollable cravings when they see a place or person they associate with the drug experience, even when the drug itself is not available. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decisionmaking, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse consequences—in other words, to become addicted to drugs.
mft continuing education, lcsw continuing education, ceus for mfts and lpcs
Why do some people become addicted, while others do not?
No single factor can predict whether or not a person will become addicted to drugs. Risk for addiction is influenced by a person’s biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:
Biology. The genes that people are born with––in combination with environmental influences––account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.
Environment. A person’s environment includes many different influences––from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and parental involvement can greatly influence the course of drug abuse and addiction in a person’s life.
Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability, and adolescents experience a double challenge. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it is to progress to more serious abuse. And because adolescents’ brains are still developing in the areas that govern decisionmaking, judgment, and self-control, they are especially prone to risk-taking behaviors, including trying drugs of abuse.
Prevention is the Key
Drug addiction is a preventable disease. Results from NIDA-funded research have shown that prevention programs that involve families, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. It is necessary, therefore, to help youth and the general public to understand the risks of drug abuse, and for teachers, parents, and healthcare professionals to keep sending the message that drug addiction can be prevented if a person never abuses drugs.
November 11, 2010
Have you Thanked a Veteran Today?
Have you Thanked a Veteran Today?
Wednesday, November 10th, 2010
By Kathryn Power, Director CMHS and Military Families Strategic Initiative Lead
When SAMHSA employees and contractors reported for work on Tuesday, November 9, each person found a button on his or her chair asking, “Have you thanked a Veteran today?” Beneath the button was a flyer inviting them to attend a SAMHSA Veterans Day Observance, which featured Korean War Veterans discussing their experiences on the 60th anniversary of that conflict. And on the back of the flyer was a list of SAMHSA employees who responded to our invitation to be listed as U.S. military Veterans, so that we could all take the opportunity to thank them for their service to our country.
Veterans Day, November 11, is the day set aside to honor all men and women who have served honorably in the military during times of both war and peace. Veterans and their families all deserve our thanks, but we also have an obligation to be there to “serve those who served”.
SAMHSA’s third Strategic Initiative , Military Families, strives to facilitate innovative community-based solutions that foster access to evidence-based prevention, treatment, and recovery services for Service Members, Veterans, and their families who are at risk for or experiencing behavioral health problems.
We are proud of all of our initiatives and partnerships that serve these populations. SAMHSA has partnered with the Department of Veterans Affairs to run the Veterans Suicide Prevention Hotline (1-800-273-TALK/8255) and with the National Guard Bureau to pilot test programs in New Mexico and Kansas that expand opportunities in the community to serve National Guard members and their families. In addition to SAMHSA’s initiatives through partnerships, some of SAMHSA’s programs that serve current service members, veterans and their families, include SAMHSA’s Jail Diversion and Trauma Recovery program that prioritizes Veterans,the Access to Recovery program which serves to prevent substance abuse in National Guard communities, and SAMHSA’s new technical assistance center, with the goal of strengthening behavioral health care systems in States, Territories and Tribes. Serving our service members and their families is a top initiative for SAMHSA, so please join me this week in honoring all the men and women who have bravely and honorably served in the U.S. Military.
Have you thanked a Veteran today? And while you’re at it, please take a minute to thank their families, too.
MFT Continuing Education
Wednesday, November 10th, 2010
By Kathryn Power, Director CMHS and Military Families Strategic Initiative Lead
When SAMHSA employees and contractors reported for work on Tuesday, November 9, each person found a button on his or her chair asking, “Have you thanked a Veteran today?” Beneath the button was a flyer inviting them to attend a SAMHSA Veterans Day Observance, which featured Korean War Veterans discussing their experiences on the 60th anniversary of that conflict. And on the back of the flyer was a list of SAMHSA employees who responded to our invitation to be listed as U.S. military Veterans, so that we could all take the opportunity to thank them for their service to our country.
Veterans Day, November 11, is the day set aside to honor all men and women who have served honorably in the military during times of both war and peace. Veterans and their families all deserve our thanks, but we also have an obligation to be there to “serve those who served”.
SAMHSA’s third Strategic Initiative , Military Families, strives to facilitate innovative community-based solutions that foster access to evidence-based prevention, treatment, and recovery services for Service Members, Veterans, and their families who are at risk for or experiencing behavioral health problems.
We are proud of all of our initiatives and partnerships that serve these populations. SAMHSA has partnered with the Department of Veterans Affairs to run the Veterans Suicide Prevention Hotline (1-800-273-TALK/8255) and with the National Guard Bureau to pilot test programs in New Mexico and Kansas that expand opportunities in the community to serve National Guard members and their families. In addition to SAMHSA’s initiatives through partnerships, some of SAMHSA’s programs that serve current service members, veterans and their families, include SAMHSA’s Jail Diversion and Trauma Recovery program that prioritizes Veterans,the Access to Recovery program which serves to prevent substance abuse in National Guard communities, and SAMHSA’s new technical assistance center, with the goal of strengthening behavioral health care systems in States, Territories and Tribes. Serving our service members and their families is a top initiative for SAMHSA, so please join me this week in honoring all the men and women who have bravely and honorably served in the U.S. Military.
Have you thanked a Veteran today? And while you’re at it, please take a minute to thank their families, too.
MFT Continuing Education
November 10, 2010
Certification and Licensure Issues Related to the Treatment of Co-occurring Disorders
Certification and Licensure Issues Related to the Treatment of Co-occurring Disorders.SAMHSA’S Co-Occurring Center for Excellence (COCE)
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Overview• Purpose of licensure and certification for professionals is to protect the public and ensure that practitioners have meet standards for practice.• Purpose of licensure and accreditation of programs is to ensure that they meet state regulations and/or national operating standards and also protect the public.
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Licensure and Certification of Professionals – Key Definitions• Licensure: A license is a property right of an individual and as a property right a license is backed by the laws of the State in which it is granted. (Shimberg &Roederer, 1994) “…it is illegal for a person to practice a profession without meeting standards imposed by the State.” (Schoon & Smith, 2000)
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Licensure and Certification of Professionals - Key Definitions• Certification: A process established by a private sector body that defines standards for professional practice. It may prohibit the use of a title or designation but often does not restrict someone from practicing a profession. (Schoon & Smith 2000)
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Licensure and Certification of Professionals – Key Definitions• Difference between licensure and certification is that certification is voluntary, not overseen by a governmental body and usually does not prohibit someone from practicing• Some states use the term “certified to indicate a license-e.g. “certified independent social worker” instead of “licensed independent social worker
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Purpose of Licensure and Certification• Provides assurance that practitioners– have met standards of practice – Can perform scope of practice established for the profession– Have demonstrated knowledge and skill to practice• Provides protection from incompetent and unscrupulous professionals
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Current Scopes of Practice and Core Competencies• Scopes of Practice for social workers, psychologists and psychiatrists include assessment, diagnosis, treatment of mental, emotional and behavioral disorders • The scopes of practice for psychiatrists, psychologists, social workers, mental health counselors, and marriage and family therapists also include addiction treatment • However, pre-service education for these disciplines contains little content on addictions
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Specialty Credentials• Specialty credentials in addictions exist for psychiatrists, psychologists, social workers and licensed professional counselors• Fewer than 7 percent of practitioners hold these national credentials (Harwood, et al, in press)• Some States (e.g.CT, IL, PA) have developed or are in the process of developing specialty credentials in COD but they are generally for addiction counselors
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Specialty Credentials Requirements• Mental Health Practitioners need to know the Transdisciplinary Foundations as described in the Addiction Counseling Competencies (CSAT 1998)– Understanding Addictions (models & theories; behavioral, psychological, physical health and social effects of psychoactive substances)– Treatment knowledge (continuum of care; importance of social, family and other support systems; understanding and application of research; interdisciplinary approach to treatment– Application to Practice (Understanding of diagnostic and placement criteria; understanding of variety of helping strategies– Professional Readiness (Understanding of diverse cultures; disabilities
MFT and LCSW Continuing Education Requirements --------------------------------------------------------------------------------
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Specialty Credentials• For addiction counselors providing COD treatment the domains that have been identified include:– Assessment/evaluation/diagnosis– Clinical Competence– Case Management– Pharmacology and medical issues– Systems Integration– Professional Responsibility (IAODAPCA 2002)
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Benefits and Risks Related to Specialty Credentials• Enhance competencies of practitioners in providing services to clients with COD • Integrates COD services into practice• Specialty credentials are voluntary and not required for those providing COD services• Lack of pre-service education in COD may preclude effective screening, assessment, intervention and referrals for COD clients
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Elements of a COD Certification• Need comprehensive understanding of substance abuse & mental disorders– Remission– Recovery– Resilience• Competencies should include integrated assessment, engagement, integrated treatment planning and treatment, and long term integrated treatment methods (CSAT 2005)
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Benefits and Risks of a COD Credential• Currently a specialty credential for COD practice exists mainly for substance abuse professionals in several states• Other disciplines have an addiction certification• Advantage of developing a national COD credential is the creation of a scope of practice and competencies specifically designed for working with COD clients• Risk is further splintering of the field and concerns that all patients would be perceived as needing COD treatment
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Program Accreditation and Licensure• Accreditation is a voluntary performance-based process used to assess an organization or institution based on established quality and safety standards. Surveyors are carefully trained to conduct the evaluation; funders and third party payors usually require accreditation of institutions and agencies
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Program Accreditation and Licensure• Licensure is a right or permission granted by the state to engage in a business, perform an act or engage in a transaction that would be unlawful with such a right or permission (Merriam-Webster 1996) • States regulate the licensing of programs & hospitals; regulations may include policies, procedures, types of staff, facility safety standards and types of care specific programs can offer
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Core Capabilities for Programs Serving COD Clients• Following services are needed:– Integrated screening and assessment– Staged interventions– Assertive Outreach– Motivational interventions– Simultaneous Interventions– Risk Reduction– Tailored mental health and substance abuse treatment– Counseling– Social Support Interventions– Longitudinal view of remission and recovery– Cultural sensitivity and competence (CSAT 2005)
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Current Issues Regarding State Licensure of Programs• COD programs need to have appropriately trained & certified/licensed staff; comprehensive services including a full array of mental health and substance abuse treatment; supportive services; and implementation of evidence-based practices• Most programs are licensed by State mental health and substance abuse agencies respectively: funding streams are separate; different data collection systems; different staffing patterns; distinct service requirements
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Models of Licensure Standards for COD Programs • Comprehensive Continuous Integrated System of Care (CCISC) model is being implemented in several states (CSAT 2005)• CCISC integrates mental health and substance abuse systems to provide a comprehensive system of care including policies, financing, programs, clinical practices and basic clinician competencies (Minkoff 2003; CSAT 2005)
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Benefits of Licensure and Accreditation for COD Programs• Elimination of many obstacles that currently exist• Programs would be able to screen and assess for COD and some could be designated as programs to provide enhanced services• Programs that wish to specialize in COD treatment could be recognized• National accreditation would create consistent standards for programs including administrative, staffing and programmatic
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Issues and Future Direction• Little research exists on whether licensed/certified clinicians have better outcomes than those not certified• Though competencies in substance abuse are being added to practice standards few curricula provide adequate education or training• Evidence-based practices for COD treatment need to be incorporated into education and training standards• State program licensure practices still make programs providing COD treatment jump through a maze of regulations• JCAHO has not yet established national standards for dual diagnosis programs
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References• American Association for Marriage and Family Therapy Core Competency Taskforce. (2004) The MFT Core Competencies, Alexandria, VA: AAMFT• Association of Social Work Boards. Model social work practice act. www.aswb.org/Model_law.pdf• Association of State and Provincial Psychology Boards. The practice of psychology. www.asppb.org/exam/practice.asp• Center for Substance Abuse Treatment. 2005. Substance Abuse Treatment for Persons with Co- occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No (SMA) 05-3992. Rockville, MD: SAMHSA
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References• Center for Substance Abuse Treatment (1998). Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice. Technical Assistance Publication Series No. 21. DHHS Publication No. (SMA) 98-3171. Rockville, MD: SAMHSA• Harwood, H.J., Kowalski, J., and Ameen, A. (In press). Training on substance abuse of behavioral health professionals. Falls Church, VA: The Lewin Group• Illinois Alcohol and Other Drug Abuse Professional Certification Association. (2002). Mental Illness/Substance Abuse Professional Role Delineation Study. www.iaodapca.org.• Merriwam-Webster. (1996) Merriam-Webster’s Dictionary of Law. Springfield MA: Merriam-Webster.
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References• Minkoff, K. (2003). Comprehensive, continuous, integrated system of care model description. http://www.zialogic.org/CCISC.htm.• Schoon, C.G. & Smith, I.L. (2000). The licensure and certification mission. In C.G. Schoon and I.L. Smith (Eds.) The licensure and certification mission: Legal, social and political foundations (pp1-3). New York: Professional Examination Services.• Shimberg, B. & Roederer, (1994). Questions a legislator should ask. Lexington, KY: The Council on Licensure, Enforcement and Regulation.• Substance Abuse and Mental Health Services Administration (2003).Strategies for developing treatment programs for people with co- occurring substance abuse and mental disorders.DHHS Publication No. (SMA) 03-3782. Rockville, MD: SAMHSA• Substance Abuse and Mental Health Services Administration. (2002) Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. http://als.samshsa.gov/reports/congress2002/CoOccurringRPT.pdf.SAMHSA’S Co-Occurring Center for Excellence (COCE)
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Overview• Purpose of licensure and certification for professionals is to protect the public and ensure that practitioners have meet standards for practice.• Purpose of licensure and accreditation of programs is to ensure that they meet state regulations and/or national operating standards and also protect the public.
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Page 3
Licensure and Certification of Professionals – Key Definitions• Licensure: A license is a property right of an individual and as a property right a license is backed by the laws of the State in which it is granted. (Shimberg &Roederer, 1994) “…it is illegal for a person to practice a profession without meeting standards imposed by the State.” (Schoon & Smith, 2000)
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Page 4
Licensure and Certification of Professionals - Key Definitions• Certification: A process established by a private sector body that defines standards for professional practice. It may prohibit the use of a title or designation but often does not restrict someone from practicing a profession. (Schoon & Smith 2000)
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Page 5
Licensure and Certification of Professionals – Key Definitions• Difference between licensure and certification is that certification is voluntary, not overseen by a governmental body and usually does not prohibit someone from practicing• Some states use the term “certified to indicate a license-e.g. “certified independent social worker” instead of “licensed independent social worker
--------------------------------------------------------------------------------
Page 6
Purpose of Licensure and Certification• Provides assurance that practitioners– have met standards of practice – Can perform scope of practice established for the profession– Have demonstrated knowledge and skill to practice• Provides protection from incompetent and unscrupulous professionals
--------------------------------------------------------------------------------
Page 7
Current Scopes of Practice and Core Competencies• Scopes of Practice for social workers, psychologists and psychiatrists include assessment, diagnosis, treatment of mental, emotional and behavioral disorders • The scopes of practice for psychiatrists, psychologists, social workers, mental health counselors, and marriage and family therapists also include addiction treatment • However, pre-service education for these disciplines contains little content on addictions
--------------------------------------------------------------------------------
Page 8
Specialty Credentials• Specialty credentials in addictions exist for psychiatrists, psychologists, social workers and licensed professional counselors• Fewer than 7 percent of practitioners hold these national credentials (Harwood, et al, in press)• Some States (e.g.CT, IL, PA) have developed or are in the process of developing specialty credentials in COD but they are generally for addiction counselors
--------------------------------------------------------------------------------
Page 9
Specialty Credentials Requirements• Mental Health Practitioners need to know the Transdisciplinary Foundations as described in the Addiction Counseling Competencies (CSAT 1998)– Understanding Addictions (models & theories; behavioral, psychological, physical health and social effects of psychoactive substances)– Treatment knowledge (continuum of care; importance of social, family and other support systems; understanding and application of research; interdisciplinary approach to treatment– Application to Practice (Understanding of diagnostic and placement criteria; understanding of variety of helping strategies– Professional Readiness (Understanding of diverse cultures; disabilities
--------------------------------------------------------------------------------
Page 10
Specialty Credentials• For addiction counselors providing COD treatment the domains that have been identified include:– Assessment/evaluation/diagnosis– Clinical Competence– Case Management– Pharmacology and medical issues– Systems Integration– Professional Responsibility (IAODAPCA 2002)
--------------------------------------------------------------------------------
Page 11
Benefits and Risks Related to Specialty Credentials• Enhance competencies of practitioners in providing services to clients with COD • Integrates COD services into practice• Specialty credentials are voluntary and not required for those providing COD services• Lack of pre-service education in COD may preclude effective screening, assessment, intervention and referrals for COD clients
--------------------------------------------------------------------------------
Page 12
Elements of a COD Certification• Need comprehensive understanding of substance abuse & mental disorders– Remission– Recovery– Resilience• Competencies should include integrated assessment, engagement, integrated treatment planning and treatment, and long term integrated treatment methods (CSAT 2005)
--------------------------------------------------------------------------------
Page 13
Benefits and Risks of a COD Credential• Currently a specialty credential for COD practice exists mainly for substance abuse professionals in several states• Other disciplines have an addiction certification• Advantage of developing a national COD credential is the creation of a scope of practice and competencies specifically designed for working with COD clients• Risk is further splintering of the field and concerns that all patients would be perceived as needing COD treatment
--------------------------------------------------------------------------------
Page 14
Program Accreditation and Licensure• Accreditation is a voluntary performance-based process used to assess an organization or institution based on established quality and safety standards. Surveyors are carefully trained to conduct the evaluation; funders and third party payors usually require accreditation of institutions and agencies
--------------------------------------------------------------------------------
Page 15
Program Accreditation and Licensure• Licensure is a right or permission granted by the state to engage in a business, perform an act or engage in a transaction that would be unlawful with such a right or permission (Merriam-Webster 1996) • States regulate the licensing of programs & hospitals; regulations may include policies, procedures, types of staff, facility safety standards and types of care specific programs can offer
--------------------------------------------------------------------------------
Page 16
Core Capabilities for Programs Serving COD Clients• Following services are needed:– Integrated screening and assessment– Staged interventions– Assertive Outreach– Motivational interventions– Simultaneous Interventions– Risk Reduction– Tailored mental health and substance abuse treatment– Counseling– Social Support Interventions– Longitudinal view of remission and recovery– Cultural sensitivity and competence (CSAT 2005)
--------------------------------------------------------------------------------
Page 17
Current Issues Regarding State Licensure of Programs• COD programs need to have appropriately trained & certified/licensed staff; comprehensive services including a full array of mental health and substance abuse treatment; supportive services; and implementation of evidence-based practices• Most programs are licensed by State mental health and substance abuse agencies respectively: funding streams are separate; different data collection systems; different staffing patterns; distinct service requirements
--------------------------------------------------------------------------------
Page 18
Models of Licensure Standards for COD Programs • Comprehensive Continuous Integrated System of Care (CCISC) model is being implemented in several states (CSAT 2005)• CCISC integrates mental health and substance abuse systems to provide a comprehensive system of care including policies, financing, programs, clinical practices and basic clinician competencies (Minkoff 2003; CSAT 2005)
--------------------------------------------------------------------------------
Page 19
Benefits of Licensure and Accreditation for COD Programs• Elimination of many obstacles that currently exist• Programs would be able to screen and assess for COD and some could be designated as programs to provide enhanced services• Programs that wish to specialize in COD treatment could be recognized• National accreditation would create consistent standards for programs including administrative, staffing and programmatic
--------------------------------------------------------------------------------
Page 20
Issues and Future Direction• Little research exists on whether licensed/certified clinicians have better outcomes than those not certified• Though competencies in substance abuse are being added to practice standards few curricula provide adequate education or training• Evidence-based practices for COD treatment need to be incorporated into education and training standards• State program licensure practices still make programs providing COD treatment jump through a maze of regulations• JCAHO has not yet established national standards for dual diagnosis programs
--------------------------------------------------------------------------------
Page 21
References• American Association for Marriage and Family Therapy Core Competency Taskforce. (2004) The MFT Core Competencies, Alexandria, VA: AAMFT• Association of Social Work Boards. Model social work practice act. www.aswb.org/Model_law.pdf• Association of State and Provincial Psychology Boards. The practice of psychology. www.asppb.org/exam/practice.asp• Center for Substance Abuse Treatment. 2005. Substance Abuse Treatment for Persons with Co- occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No (SMA) 05-3992. Rockville, MD: SAMHSA
--------------------------------------------------------------------------------
Page 22
References• Center for Substance Abuse Treatment (1998). Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice. Technical Assistance Publication Series No. 21. DHHS Publication No. (SMA) 98-3171. Rockville, MD: SAMHSA• Harwood, H.J., Kowalski, J., and Ameen, A. (In press). Training on substance abuse of behavioral health professionals. Falls Church, VA: The Lewin Group• Illinois Alcohol and Other Drug Abuse Professional Certification Association. (2002). Mental Illness/Substance Abuse Professional Role Delineation Study. www.iaodapca.org.• Merriwam-Webster. (1996) Merriam-Webster’s Dictionary of Law. Springfield MA: Merriam-Webster.
--------------------------------------------------------------------------------
Page 23
References• Minkoff, K. (2003). Comprehensive, continuous, integrated system of care model description. http://www.zialogic.org/CCISC.htm.• Schoon, C.G. & Smith, I.L. (2000). The licensure and certification mission. In C.G. Schoon and I.L. Smith (Eds.) The licensure and certification mission: Legal, social and political foundations (pp1-3). New York: Professional Examination Services.• Shimberg, B. & Roederer, (1994). Questions a legislator should ask. Lexington, KY: The Council on Licensure, Enforcement and Regulation.• Substance Abuse and Mental Health Services Administration (2003).Strategies for developing treatment programs for people with co- occurring substance abuse and mental disorders.DHHS Publication No. (SMA) 03-3782. Rockville, MD: SAMHSA• Substance Abuse and Mental Health Services Administration. (2002) Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. http://als.samshsa.gov/reports/congress2002/CoOccurringRPT.pdf.
--------------------------------------------------------------------------------
Page 2
Overview• Purpose of licensure and certification for professionals is to protect the public and ensure that practitioners have meet standards for practice.• Purpose of licensure and accreditation of programs is to ensure that they meet state regulations and/or national operating standards and also protect the public.
--------------------------------------------------------------------------------
Page 3
Licensure and Certification of Professionals – Key Definitions• Licensure: A license is a property right of an individual and as a property right a license is backed by the laws of the State in which it is granted. (Shimberg &Roederer, 1994) “…it is illegal for a person to practice a profession without meeting standards imposed by the State.” (Schoon & Smith, 2000)
--------------------------------------------------------------------------------
Page 4
Licensure and Certification of Professionals - Key Definitions• Certification: A process established by a private sector body that defines standards for professional practice. It may prohibit the use of a title or designation but often does not restrict someone from practicing a profession. (Schoon & Smith 2000)
--------------------------------------------------------------------------------
Page 5
Licensure and Certification of Professionals – Key Definitions• Difference between licensure and certification is that certification is voluntary, not overseen by a governmental body and usually does not prohibit someone from practicing• Some states use the term “certified to indicate a license-e.g. “certified independent social worker” instead of “licensed independent social worker
--------------------------------------------------------------------------------
Page 6
Purpose of Licensure and Certification• Provides assurance that practitioners– have met standards of practice – Can perform scope of practice established for the profession– Have demonstrated knowledge and skill to practice• Provides protection from incompetent and unscrupulous professionals
--------------------------------------------------------------------------------
Page 7
Current Scopes of Practice and Core Competencies• Scopes of Practice for social workers, psychologists and psychiatrists include assessment, diagnosis, treatment of mental, emotional and behavioral disorders • The scopes of practice for psychiatrists, psychologists, social workers, mental health counselors, and marriage and family therapists also include addiction treatment • However, pre-service education for these disciplines contains little content on addictions
--------------------------------------------------------------------------------
Page 8
Specialty Credentials• Specialty credentials in addictions exist for psychiatrists, psychologists, social workers and licensed professional counselors• Fewer than 7 percent of practitioners hold these national credentials (Harwood, et al, in press)• Some States (e.g.CT, IL, PA) have developed or are in the process of developing specialty credentials in COD but they are generally for addiction counselors
--------------------------------------------------------------------------------
Page 9
Specialty Credentials Requirements• Mental Health Practitioners need to know the Transdisciplinary Foundations as described in the Addiction Counseling Competencies (CSAT 1998)– Understanding Addictions (models & theories; behavioral, psychological, physical health and social effects of psychoactive substances)– Treatment knowledge (continuum of care; importance of social, family and other support systems; understanding and application of research; interdisciplinary approach to treatment– Application to Practice (Understanding of diagnostic and placement criteria; understanding of variety of helping strategies– Professional Readiness (Understanding of diverse cultures; disabilities
MFT and LCSW Continuing Education Requirements --------------------------------------------------------------------------------
Page 10
Specialty Credentials• For addiction counselors providing COD treatment the domains that have been identified include:– Assessment/evaluation/diagnosis– Clinical Competence– Case Management– Pharmacology and medical issues– Systems Integration– Professional Responsibility (IAODAPCA 2002)
--------------------------------------------------------------------------------
Page 11
Benefits and Risks Related to Specialty Credentials• Enhance competencies of practitioners in providing services to clients with COD • Integrates COD services into practice• Specialty credentials are voluntary and not required for those providing COD services• Lack of pre-service education in COD may preclude effective screening, assessment, intervention and referrals for COD clients
--------------------------------------------------------------------------------
Page 12
Elements of a COD Certification• Need comprehensive understanding of substance abuse & mental disorders– Remission– Recovery– Resilience• Competencies should include integrated assessment, engagement, integrated treatment planning and treatment, and long term integrated treatment methods (CSAT 2005)
--------------------------------------------------------------------------------
Page 13
Benefits and Risks of a COD Credential• Currently a specialty credential for COD practice exists mainly for substance abuse professionals in several states• Other disciplines have an addiction certification• Advantage of developing a national COD credential is the creation of a scope of practice and competencies specifically designed for working with COD clients• Risk is further splintering of the field and concerns that all patients would be perceived as needing COD treatment
--------------------------------------------------------------------------------
Page 14
Program Accreditation and Licensure• Accreditation is a voluntary performance-based process used to assess an organization or institution based on established quality and safety standards. Surveyors are carefully trained to conduct the evaluation; funders and third party payors usually require accreditation of institutions and agencies
--------------------------------------------------------------------------------
Page 15
Program Accreditation and Licensure• Licensure is a right or permission granted by the state to engage in a business, perform an act or engage in a transaction that would be unlawful with such a right or permission (Merriam-Webster 1996) • States regulate the licensing of programs & hospitals; regulations may include policies, procedures, types of staff, facility safety standards and types of care specific programs can offer
--------------------------------------------------------------------------------
Page 16
Core Capabilities for Programs Serving COD Clients• Following services are needed:– Integrated screening and assessment– Staged interventions– Assertive Outreach– Motivational interventions– Simultaneous Interventions– Risk Reduction– Tailored mental health and substance abuse treatment– Counseling– Social Support Interventions– Longitudinal view of remission and recovery– Cultural sensitivity and competence (CSAT 2005)
--------------------------------------------------------------------------------
Page 17
Current Issues Regarding State Licensure of Programs• COD programs need to have appropriately trained & certified/licensed staff; comprehensive services including a full array of mental health and substance abuse treatment; supportive services; and implementation of evidence-based practices• Most programs are licensed by State mental health and substance abuse agencies respectively: funding streams are separate; different data collection systems; different staffing patterns; distinct service requirements
--------------------------------------------------------------------------------
Page 18
Models of Licensure Standards for COD Programs • Comprehensive Continuous Integrated System of Care (CCISC) model is being implemented in several states (CSAT 2005)• CCISC integrates mental health and substance abuse systems to provide a comprehensive system of care including policies, financing, programs, clinical practices and basic clinician competencies (Minkoff 2003; CSAT 2005)
--------------------------------------------------------------------------------
Page 19
Benefits of Licensure and Accreditation for COD Programs• Elimination of many obstacles that currently exist• Programs would be able to screen and assess for COD and some could be designated as programs to provide enhanced services• Programs that wish to specialize in COD treatment could be recognized• National accreditation would create consistent standards for programs including administrative, staffing and programmatic
--------------------------------------------------------------------------------
Page 20
Issues and Future Direction• Little research exists on whether licensed/certified clinicians have better outcomes than those not certified• Though competencies in substance abuse are being added to practice standards few curricula provide adequate education or training• Evidence-based practices for COD treatment need to be incorporated into education and training standards• State program licensure practices still make programs providing COD treatment jump through a maze of regulations• JCAHO has not yet established national standards for dual diagnosis programs
--------------------------------------------------------------------------------
Page 21
References• American Association for Marriage and Family Therapy Core Competency Taskforce. (2004) The MFT Core Competencies, Alexandria, VA: AAMFT• Association of Social Work Boards. Model social work practice act. www.aswb.org/Model_law.pdf• Association of State and Provincial Psychology Boards. The practice of psychology. www.asppb.org/exam/practice.asp• Center for Substance Abuse Treatment. 2005. Substance Abuse Treatment for Persons with Co- occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No (SMA) 05-3992. Rockville, MD: SAMHSA
--------------------------------------------------------------------------------
Page 22
References• Center for Substance Abuse Treatment (1998). Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice. Technical Assistance Publication Series No. 21. DHHS Publication No. (SMA) 98-3171. Rockville, MD: SAMHSA• Harwood, H.J., Kowalski, J., and Ameen, A. (In press). Training on substance abuse of behavioral health professionals. Falls Church, VA: The Lewin Group• Illinois Alcohol and Other Drug Abuse Professional Certification Association. (2002). Mental Illness/Substance Abuse Professional Role Delineation Study. www.iaodapca.org.• Merriwam-Webster. (1996) Merriam-Webster’s Dictionary of Law. Springfield MA: Merriam-Webster.
--------------------------------------------------------------------------------
Page 23
References• Minkoff, K. (2003). Comprehensive, continuous, integrated system of care model description. http://www.zialogic.org/CCISC.htm.• Schoon, C.G. & Smith, I.L. (2000). The licensure and certification mission. In C.G. Schoon and I.L. Smith (Eds.) The licensure and certification mission: Legal, social and political foundations (pp1-3). New York: Professional Examination Services.• Shimberg, B. & Roederer, (1994). Questions a legislator should ask. Lexington, KY: The Council on Licensure, Enforcement and Regulation.• Substance Abuse and Mental Health Services Administration (2003).Strategies for developing treatment programs for people with co- occurring substance abuse and mental disorders.DHHS Publication No. (SMA) 03-3782. Rockville, MD: SAMHSA• Substance Abuse and Mental Health Services Administration. (2002) Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. http://als.samshsa.gov/reports/congress2002/CoOccurringRPT.pdf.SAMHSA’S Co-Occurring Center for Excellence (COCE)
--------------------------------------------------------------------------------
Page 2
Overview• Purpose of licensure and certification for professionals is to protect the public and ensure that practitioners have meet standards for practice.• Purpose of licensure and accreditation of programs is to ensure that they meet state regulations and/or national operating standards and also protect the public.
--------------------------------------------------------------------------------
Page 3
Licensure and Certification of Professionals – Key Definitions• Licensure: A license is a property right of an individual and as a property right a license is backed by the laws of the State in which it is granted. (Shimberg &Roederer, 1994) “…it is illegal for a person to practice a profession without meeting standards imposed by the State.” (Schoon & Smith, 2000)
--------------------------------------------------------------------------------
Page 4
Licensure and Certification of Professionals - Key Definitions• Certification: A process established by a private sector body that defines standards for professional practice. It may prohibit the use of a title or designation but often does not restrict someone from practicing a profession. (Schoon & Smith 2000)
--------------------------------------------------------------------------------
Page 5
Licensure and Certification of Professionals – Key Definitions• Difference between licensure and certification is that certification is voluntary, not overseen by a governmental body and usually does not prohibit someone from practicing• Some states use the term “certified to indicate a license-e.g. “certified independent social worker” instead of “licensed independent social worker
--------------------------------------------------------------------------------
Page 6
Purpose of Licensure and Certification• Provides assurance that practitioners– have met standards of practice – Can perform scope of practice established for the profession– Have demonstrated knowledge and skill to practice• Provides protection from incompetent and unscrupulous professionals
--------------------------------------------------------------------------------
Page 7
Current Scopes of Practice and Core Competencies• Scopes of Practice for social workers, psychologists and psychiatrists include assessment, diagnosis, treatment of mental, emotional and behavioral disorders • The scopes of practice for psychiatrists, psychologists, social workers, mental health counselors, and marriage and family therapists also include addiction treatment • However, pre-service education for these disciplines contains little content on addictions
--------------------------------------------------------------------------------
Page 8
Specialty Credentials• Specialty credentials in addictions exist for psychiatrists, psychologists, social workers and licensed professional counselors• Fewer than 7 percent of practitioners hold these national credentials (Harwood, et al, in press)• Some States (e.g.CT, IL, PA) have developed or are in the process of developing specialty credentials in COD but they are generally for addiction counselors
--------------------------------------------------------------------------------
Page 9
Specialty Credentials Requirements• Mental Health Practitioners need to know the Transdisciplinary Foundations as described in the Addiction Counseling Competencies (CSAT 1998)– Understanding Addictions (models & theories; behavioral, psychological, physical health and social effects of psychoactive substances)– Treatment knowledge (continuum of care; importance of social, family and other support systems; understanding and application of research; interdisciplinary approach to treatment– Application to Practice (Understanding of diagnostic and placement criteria; understanding of variety of helping strategies– Professional Readiness (Understanding of diverse cultures; disabilities
--------------------------------------------------------------------------------
Page 10
Specialty Credentials• For addiction counselors providing COD treatment the domains that have been identified include:– Assessment/evaluation/diagnosis– Clinical Competence– Case Management– Pharmacology and medical issues– Systems Integration– Professional Responsibility (IAODAPCA 2002)
--------------------------------------------------------------------------------
Page 11
Benefits and Risks Related to Specialty Credentials• Enhance competencies of practitioners in providing services to clients with COD • Integrates COD services into practice• Specialty credentials are voluntary and not required for those providing COD services• Lack of pre-service education in COD may preclude effective screening, assessment, intervention and referrals for COD clients
--------------------------------------------------------------------------------
Page 12
Elements of a COD Certification• Need comprehensive understanding of substance abuse & mental disorders– Remission– Recovery– Resilience• Competencies should include integrated assessment, engagement, integrated treatment planning and treatment, and long term integrated treatment methods (CSAT 2005)
--------------------------------------------------------------------------------
Page 13
Benefits and Risks of a COD Credential• Currently a specialty credential for COD practice exists mainly for substance abuse professionals in several states• Other disciplines have an addiction certification• Advantage of developing a national COD credential is the creation of a scope of practice and competencies specifically designed for working with COD clients• Risk is further splintering of the field and concerns that all patients would be perceived as needing COD treatment
--------------------------------------------------------------------------------
Page 14
Program Accreditation and Licensure• Accreditation is a voluntary performance-based process used to assess an organization or institution based on established quality and safety standards. Surveyors are carefully trained to conduct the evaluation; funders and third party payors usually require accreditation of institutions and agencies
--------------------------------------------------------------------------------
Page 15
Program Accreditation and Licensure• Licensure is a right or permission granted by the state to engage in a business, perform an act or engage in a transaction that would be unlawful with such a right or permission (Merriam-Webster 1996) • States regulate the licensing of programs & hospitals; regulations may include policies, procedures, types of staff, facility safety standards and types of care specific programs can offer
--------------------------------------------------------------------------------
Page 16
Core Capabilities for Programs Serving COD Clients• Following services are needed:– Integrated screening and assessment– Staged interventions– Assertive Outreach– Motivational interventions– Simultaneous Interventions– Risk Reduction– Tailored mental health and substance abuse treatment– Counseling– Social Support Interventions– Longitudinal view of remission and recovery– Cultural sensitivity and competence (CSAT 2005)
--------------------------------------------------------------------------------
Page 17
Current Issues Regarding State Licensure of Programs• COD programs need to have appropriately trained & certified/licensed staff; comprehensive services including a full array of mental health and substance abuse treatment; supportive services; and implementation of evidence-based practices• Most programs are licensed by State mental health and substance abuse agencies respectively: funding streams are separate; different data collection systems; different staffing patterns; distinct service requirements
--------------------------------------------------------------------------------
Page 18
Models of Licensure Standards for COD Programs • Comprehensive Continuous Integrated System of Care (CCISC) model is being implemented in several states (CSAT 2005)• CCISC integrates mental health and substance abuse systems to provide a comprehensive system of care including policies, financing, programs, clinical practices and basic clinician competencies (Minkoff 2003; CSAT 2005)
--------------------------------------------------------------------------------
Page 19
Benefits of Licensure and Accreditation for COD Programs• Elimination of many obstacles that currently exist• Programs would be able to screen and assess for COD and some could be designated as programs to provide enhanced services• Programs that wish to specialize in COD treatment could be recognized• National accreditation would create consistent standards for programs including administrative, staffing and programmatic
--------------------------------------------------------------------------------
Page 20
Issues and Future Direction• Little research exists on whether licensed/certified clinicians have better outcomes than those not certified• Though competencies in substance abuse are being added to practice standards few curricula provide adequate education or training• Evidence-based practices for COD treatment need to be incorporated into education and training standards• State program licensure practices still make programs providing COD treatment jump through a maze of regulations• JCAHO has not yet established national standards for dual diagnosis programs
--------------------------------------------------------------------------------
Page 21
References• American Association for Marriage and Family Therapy Core Competency Taskforce. (2004) The MFT Core Competencies, Alexandria, VA: AAMFT• Association of Social Work Boards. Model social work practice act. www.aswb.org/Model_law.pdf• Association of State and Provincial Psychology Boards. The practice of psychology. www.asppb.org/exam/practice.asp• Center for Substance Abuse Treatment. 2005. Substance Abuse Treatment for Persons with Co- occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No (SMA) 05-3992. Rockville, MD: SAMHSA
--------------------------------------------------------------------------------
Page 22
References• Center for Substance Abuse Treatment (1998). Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice. Technical Assistance Publication Series No. 21. DHHS Publication No. (SMA) 98-3171. Rockville, MD: SAMHSA• Harwood, H.J., Kowalski, J., and Ameen, A. (In press). Training on substance abuse of behavioral health professionals. Falls Church, VA: The Lewin Group• Illinois Alcohol and Other Drug Abuse Professional Certification Association. (2002). Mental Illness/Substance Abuse Professional Role Delineation Study. www.iaodapca.org.• Merriwam-Webster. (1996) Merriam-Webster’s Dictionary of Law. Springfield MA: Merriam-Webster.
--------------------------------------------------------------------------------
Page 23
References• Minkoff, K. (2003). Comprehensive, continuous, integrated system of care model description. http://www.zialogic.org/CCISC.htm.• Schoon, C.G. & Smith, I.L. (2000). The licensure and certification mission. In C.G. Schoon and I.L. Smith (Eds.) The licensure and certification mission: Legal, social and political foundations (pp1-3). New York: Professional Examination Services.• Shimberg, B. & Roederer, (1994). Questions a legislator should ask. Lexington, KY: The Council on Licensure, Enforcement and Regulation.• Substance Abuse and Mental Health Services Administration (2003).Strategies for developing treatment programs for people with co- occurring substance abuse and mental disorders.DHHS Publication No. (SMA) 03-3782. Rockville, MD: SAMHSA• Substance Abuse and Mental Health Services Administration. (2002) Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. http://als.samshsa.gov/reports/congress2002/CoOccurringRPT.pdf.
November 09, 2010
MFT Continuing Education, LCSW Continuing Education, LPC Continuing Education
Alabama
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Alaska
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW) and Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Arizona
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Arkansas
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
California
Approved by the California Board of Behavioral Sciences for licensed Marriage and Family Therapists (MFT, LMFT), Marriage and Family Therapist Interns/Trainee (MFTI), Licensed Clinical Social Workers (LCSW) and Associate Clinical Social Workers (ASW).
Approved by the California Certification Board of Alcohol and Drug Counselors for licensed Drug and Alcohol Abuse Counselors (CADC I & II, CPS, CSS, CADCA)
Colorado
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Connecticut
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Delaware
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Meets qualifications in Rule 7.2.5 for licensed Social Workers (LCSW, LSW) (check with state board for further clarification)
Florida
Approved by the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Georgia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Hawaii
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Idaho
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for licensed Social Workers (LCSW, LSW)
Illinois
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Indiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Iowa
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in Rule 645-281.3 standards of the Iowa Administrative Rules (see state board for further clarification) for licensed Social Workers (LCSW, LSW)
Kansas
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW), Marriage and Family Therapist and Mental Health Counselors (MHC)
Kentucky
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Louisiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Maine
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)
Maryland
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)
Massachusetts
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Michigan
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
No continuing education requirements for license renewal for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Minnesota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
Check with board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Mississippi
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
Missouri
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Montana
Approved by the Montana Board of Social Work Examiners, Professional Counselors & Marriage and Family Therapists for licensed Social Workers (LCSW, LSW), Professional Counselors (LPC, LPCC), and licensed Marriage and Family Therapists (MFT, LMFT)
Nebraska
Meets criteria of an approved continuing education program provider for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Nevada
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)
New Hampshire
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
New Jersey
Accepts approval from the National Board for Certified Counselors (NBCC) for Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for Licensed Social Workers (LCSW, LSW)
New Mexico
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
New York
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
North Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapists (MFT, LMFT)
Not approved for licensed Social Workers (LCSW, LSW)
North Dakota
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)
Ohio
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Marriage and Family Therapists (MFT, LMFT)
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)
Oklahoma
Approved by the Oklahoma State Department of Health - Professional Counselor Licensing Board for licensed Marriage and Family Therapists (MFT, LMFT) and Licensed Professional Counselors (LPC)
Not approved for licensed Social Workers (LCSW, LSW)
Oregon
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Pennsylvania
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Rhode Island
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)
South Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
South Dakota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Tennessee
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Meets requirements stated in Rule 1365-01-.09 for CE credit for licensed Social Workers (LCSW, LSW) (see state board for further clarification)
Texas
Approved by the Texas Board of Examiners of Marriage and Family Therapists (MFT, LMFT) for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Utah
Meets requirements stated in rule R156-60b-304 for licensed Marriage and Family Therapists (MFT, LMFT) (see state board for further clarification on CE requirements)
Meets requirements stated in rule R156-60c-304 for licensed Professional Counselors (LPC, LPCC) (see state board for further clarification on CE requirements)
Not pre-approved for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)
Vermont
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in rule 3.3 Formal Activities (2), 3.4(2)(3) for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)
Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Washington
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
West Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) (check with state board for CE requirements)
No CE Provider status approval required for Category II (Individual Professional Activities) CE credit for licensed Social Workers (LCSW, LSW)
Wisconsin
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Wyoming
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
MFT Continuing Education
LCSW Continuing Education
LPC Continuing Education Units, Credits, Hours
Drug and Alchohol Counselor Continuing Education CEUs
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Alaska
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW) and Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Arizona
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Arkansas
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
California
Approved by the California Board of Behavioral Sciences for licensed Marriage and Family Therapists (MFT, LMFT), Marriage and Family Therapist Interns/Trainee (MFTI), Licensed Clinical Social Workers (LCSW) and Associate Clinical Social Workers (ASW).
Approved by the California Certification Board of Alcohol and Drug Counselors for licensed Drug and Alcohol Abuse Counselors (CADC I & II, CPS, CSS, CADCA)
Colorado
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Connecticut
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Delaware
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Meets qualifications in Rule 7.2.5 for licensed Social Workers (LCSW, LSW) (check with state board for further clarification)
Florida
Approved by the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Georgia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Hawaii
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Idaho
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for licensed Social Workers (LCSW, LSW)
Illinois
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Indiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Iowa
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in Rule 645-281.3 standards of the Iowa Administrative Rules (see state board for further clarification) for licensed Social Workers (LCSW, LSW)
Kansas
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW), Marriage and Family Therapist and Mental Health Counselors (MHC)
Kentucky
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Louisiana
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Maine
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)
Maryland
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Check state board for approval requirements for licensed Social Workers (LCSW, LSW)
Massachusetts
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Check state board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Michigan
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
No continuing education requirements for license renewal for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Minnesota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
Check with board for approval requirements for licensed Marriage and Family Therapists (MFT, LMFT)
Mississippi
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
Missouri
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Montana
Approved by the Montana Board of Social Work Examiners, Professional Counselors & Marriage and Family Therapists for licensed Social Workers (LCSW, LSW), Professional Counselors (LPC, LPCC), and licensed Marriage and Family Therapists (MFT, LMFT)
Nebraska
Meets criteria of an approved continuing education program provider for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Nevada
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)
New Hampshire
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
New Jersey
Accepts approval from the National Board for Certified Counselors (NBCC) for Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Not approved for Licensed Social Workers (LCSW, LSW)
New Mexico
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Social Workers (LCSW, LSW)
New York
No continuing education requirements for license renewal for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
North Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapists (MFT, LMFT)
Not approved for licensed Social Workers (LCSW, LSW)
North Dakota
No CE Provider status approval required for CE credit for licensed Marriage and Family Therapist and Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Social Workers (LCSW, LSW) (check with state board for CE requirements)
Ohio
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Marriage and Family Therapists (MFT, LMFT)
Approved by the Counselor, Social Worker and Marriage and Family Therapist Board of Ohio for licensed Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)
Oklahoma
Approved by the Oklahoma State Department of Health - Professional Counselor Licensing Board for licensed Marriage and Family Therapists (MFT, LMFT) and Licensed Professional Counselors (LPC)
Not approved for licensed Social Workers (LCSW, LSW)
Oregon
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Pennsylvania
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Rhode Island
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Not approved for licensed Social Workers (LCSW, LSW)
South Carolina
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
South Dakota
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Tennessee
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Meets requirements stated in Rule 1365-01-.09 for CE credit for licensed Social Workers (LCSW, LSW) (see state board for further clarification)
Texas
Approved by the Texas Board of Examiners of Marriage and Family Therapists (MFT, LMFT) for licensed Marriage and Family Therapists (MFT, LMFT)
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Utah
Meets requirements stated in rule R156-60b-304 for licensed Marriage and Family Therapists (MFT, LMFT) (see state board for further clarification on CE requirements)
Meets requirements stated in rule R156-60c-304 for licensed Professional Counselors (LPC, LPCC) (see state board for further clarification on CE requirements)
Not pre-approved for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)
Vermont
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
Meets requirements stated in rule 3.3 Formal Activities (2), 3.4(2)(3) for licensed Social Workers (LCSW, LSW) (see state board for further clarification on CE requirements)
Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Accepts approval from the California Board of Behavioral Sciences (CA BBS) for licensed Social Workers (LCSW, LSW)
Washington
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Mental Health Counselors (MHC)
West Virginia
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Professional Counselors (LPC, LPCC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) (check with state board for CE requirements)
No CE Provider status approval required for Category II (Individual Professional Activities) CE credit for licensed Social Workers (LCSW, LSW)
Wisconsin
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Social Workers (LCSW, LSW), Marriage and Family Therapists (MFT, LMFT) and Professional Counselors (LPC, LPCC)
Wyoming
Accepts approval from the National Board for Certified Counselors (NBCC) for licensed Mental Health Counselors (MHC)
Not pre-approved for licensed Marriage and Family Therapists (MFT, LMFT) and Social Workers (LCSW, LSW) (check with state board for CE requirements)
MFT Continuing Education
LCSW Continuing Education
LPC Continuing Education Units, Credits, Hours
Drug and Alchohol Counselor Continuing Education CEUs
How to Cheer Yourself Up When Youre Down
Got the colder weather, sour relationshops, no money, poor health, plain ol' down 'n dirty blues? Try some of these strategies to blow away those dark clouds and let the sunshine into your life again.
1) Dance! Put on your favourite music, turn it up loud and dance! This is guaranteed to make you feel good. If you are unable to dance, don't let that stop you having fun - sing at the top of your voice instead.
2) Smile! Force yourself to smile even if you don't feel like it. This tricks your brain into thinking that you are happy. You do want to be happy don't you? Okay then - a great big cheesy grin. After three, one, two, three, - smile :0)
3) Spend time with children. Their natural zest for life is infectious. As well as the pleasures of a spontaneous hug or a chubby little hand in yours, try to take away with you some of their joy in simple things, licking an ice cream, playing with water, tramping through fallen leaves or following a butterfly.
4) Reward yourself. If there is a job that you hate to do, household accounts, home repairs etc. don't keep putting it off so that it is constantly nagging at you. Just get it done. Then reward yourself with whatever you love, a shiny new magazine, a bunch of flowers, a long soak in an aromatic bath, two bars of chocolate or an evening in front of the tv doing absolutely nothing. Or even all of the above if you can afford it. The peace of mind that comes from having got the job done will be the greatest reward of all.
5) Clear out your clutter. The ancient art of Feng Shui believes that getting rid of clutter rids your home or work space of negative stuck energy and allows space for positive energy to surge into all aspects of your life. Whether or not this is correct, it is an undeniable fact that clearing out what you no longer want or need makes life easier. Your home is neater, looks more spacious and is easier to clean. There can also be a tremendous feeling of freedom as you let go of the past and trust in the future to bring you what you will need. Emotional clutter can be even more damaging. We've all said or done things we regret, the trick is to do anything you can to repair the damage and if that is not possible, forgive yourself and toss it out of your life.
6) Take action. If something is worrying you, be it a health problem, or debt or divorce, make that doctor's appointment, get some debt counselling, find out your rights. The reality is often less stressful than sitting alone worrying about it. Try to talk over your problems with a friend, or if that is impossible find a support group on the Internet by typing debt, divorce or whatever into a search engine.
7) Positive thoughts. When you leave the house each morning, say and mean, I'm going to have a great day, it's going to be lots of fun, rather than thinking Oh no, another dreary day at the office to get through. The first attitude will attract good vibrations and positive fun people to you, the second will ensure a depressing day.
8) Have more fun. Apparently children laugh approximately 400 times a day yet adults laugh only about 20 times a day. When do we lose our sense of fun? Claim it back. Play games, watch comedies, have daily jokes delivered to your mailbox or throw a fancy dress party.
9) Make something. Being creative gives you such a buzz you won't stay down in the dumps for long. Stencil a room, make a cake, plan a garden, sketch or paint a picture. Express yourself with a modern collage, change your rooms around, display your collections or start a patchwork quilt.
10) Keep a gratitude journal. Write down half a dozen things every day that you are grateful for, from waking up and seeing your children's beautiful little faces to the smell of the roses in the local park. This cannot fail to cheer you up if you do it regularly as it gives you a whole new way of experiencing your life.
11) Start a new project. Learn a language, trace your family history, redecorate your home, learn to ride a horse, gain a new qualification, take music lessons, learn to make your own soft furnishings or do your own auto repairs. Visualize yourself successfully completing the project and the benefits it will bring to your life. Then make a start and follow it through to the end. An added bonus will be the increased self esteem that comes from having planned, problem solved and perfected the whole project yourself.
12) See your old friends. It's easy to get into a work, family, housework, shopping, sleep and back to work again routine that leaves you no time at all to be the person you once were. The funny, up for a laugh, outgoing young woman you used to be. Spending time with friends who knew the old you seems to resurrect that side of your character. You will come away feeling younger, more positive and more excited by life than you were before you met up. Go on, invite them over to share a pizza and catch up on each other's lives.
13) Paint or accessorize a room that you spend a lot of time in a lovely bright yellow. The colour of sunshine will lift your spirit and bring positive vibrations. We subconciously know about the effects of colour on our emotions which is why we talk about the future looking rosy or having the blues.
14) Take the happiness option. You have the choice whether to spend this day, which you will never live through again, in a state of happiness or unhappiness. Choose to spend it as happily as you possibly can.
1) Dance! Put on your favourite music, turn it up loud and dance! This is guaranteed to make you feel good. If you are unable to dance, don't let that stop you having fun - sing at the top of your voice instead.
2) Smile! Force yourself to smile even if you don't feel like it. This tricks your brain into thinking that you are happy. You do want to be happy don't you? Okay then - a great big cheesy grin. After three, one, two, three, - smile :0)
3) Spend time with children. Their natural zest for life is infectious. As well as the pleasures of a spontaneous hug or a chubby little hand in yours, try to take away with you some of their joy in simple things, licking an ice cream, playing with water, tramping through fallen leaves or following a butterfly.
4) Reward yourself. If there is a job that you hate to do, household accounts, home repairs etc. don't keep putting it off so that it is constantly nagging at you. Just get it done. Then reward yourself with whatever you love, a shiny new magazine, a bunch of flowers, a long soak in an aromatic bath, two bars of chocolate or an evening in front of the tv doing absolutely nothing. Or even all of the above if you can afford it. The peace of mind that comes from having got the job done will be the greatest reward of all.
5) Clear out your clutter. The ancient art of Feng Shui believes that getting rid of clutter rids your home or work space of negative stuck energy and allows space for positive energy to surge into all aspects of your life. Whether or not this is correct, it is an undeniable fact that clearing out what you no longer want or need makes life easier. Your home is neater, looks more spacious and is easier to clean. There can also be a tremendous feeling of freedom as you let go of the past and trust in the future to bring you what you will need. Emotional clutter can be even more damaging. We've all said or done things we regret, the trick is to do anything you can to repair the damage and if that is not possible, forgive yourself and toss it out of your life.
6) Take action. If something is worrying you, be it a health problem, or debt or divorce, make that doctor's appointment, get some debt counselling, find out your rights. The reality is often less stressful than sitting alone worrying about it. Try to talk over your problems with a friend, or if that is impossible find a support group on the Internet by typing debt, divorce or whatever into a search engine.
7) Positive thoughts. When you leave the house each morning, say and mean, I'm going to have a great day, it's going to be lots of fun, rather than thinking Oh no, another dreary day at the office to get through. The first attitude will attract good vibrations and positive fun people to you, the second will ensure a depressing day.
8) Have more fun. Apparently children laugh approximately 400 times a day yet adults laugh only about 20 times a day. When do we lose our sense of fun? Claim it back. Play games, watch comedies, have daily jokes delivered to your mailbox or throw a fancy dress party.
9) Make something. Being creative gives you such a buzz you won't stay down in the dumps for long. Stencil a room, make a cake, plan a garden, sketch or paint a picture. Express yourself with a modern collage, change your rooms around, display your collections or start a patchwork quilt.
10) Keep a gratitude journal. Write down half a dozen things every day that you are grateful for, from waking up and seeing your children's beautiful little faces to the smell of the roses in the local park. This cannot fail to cheer you up if you do it regularly as it gives you a whole new way of experiencing your life.
11) Start a new project. Learn a language, trace your family history, redecorate your home, learn to ride a horse, gain a new qualification, take music lessons, learn to make your own soft furnishings or do your own auto repairs. Visualize yourself successfully completing the project and the benefits it will bring to your life. Then make a start and follow it through to the end. An added bonus will be the increased self esteem that comes from having planned, problem solved and perfected the whole project yourself.
12) See your old friends. It's easy to get into a work, family, housework, shopping, sleep and back to work again routine that leaves you no time at all to be the person you once were. The funny, up for a laugh, outgoing young woman you used to be. Spending time with friends who knew the old you seems to resurrect that side of your character. You will come away feeling younger, more positive and more excited by life than you were before you met up. Go on, invite them over to share a pizza and catch up on each other's lives.
13) Paint or accessorize a room that you spend a lot of time in a lovely bright yellow. The colour of sunshine will lift your spirit and bring positive vibrations. We subconciously know about the effects of colour on our emotions which is why we talk about the future looking rosy or having the blues.
14) Take the happiness option. You have the choice whether to spend this day, which you will never live through again, in a state of happiness or unhappiness. Choose to spend it as happily as you possibly can.
November 08, 2010
Substance Abuse and Inhalants CEUs
The percentage of adolescents (i.e., youths aged 12 to 17) who used inhalants in the past year was lower in 2007 (3.9 percent) than in 2003, 2004, and 2005 (4.5, 4.6, and 4.5 percent, respectively)
Among adolescents who used inhalants for the first time in the past year (i.e., past year initiates), the rate of use of nitrous oxide or "whippits" declined between 2002 and 2007 among both genders (males: 40.2 to 20.2 percent; females: 22.3 to 12.2 percent)
In 2007, 17.2 percent of adolescents who initiated illicit drug use during the past year indicated that inhalants were the first drug that they used; this rate remained relatively stable between 2002 and 2007
Adolescents have easy access to some dangerous substances—ordinary household products such as glue, shoe polish, and aerosol sprays. These products are safe when used as intended, but they can be dangerous and even deadly when sniffed or "huffed" to get high. Preventing and treating inhalant use problems, as well as raising awareness about the dangers of inhalant use, are important ongoing goals of the Substance Abuse and Mental Health Services Administration (SAMHSA). Monitoring trends in inhalant use is vital to assessing policies intended to reduce inhalant use.
This issue of The NSDUH Report examines trends in the use, dependence or abuse,1 and initiation of inhalants among adolescents (i.e., youths aged 12 to 17). The National Survey on Drug Use and Health (NSDUH) defines inhalants as "liquids, sprays, and gases that people sniff or inhale to get high or to make them feel good." NSDUH collects data not only about the use of any inhalant, but also about the use of specific types of inhalants. Respondents who used inhalants were asked when they first used them, and responses to this question were used to identify persons who had initiated use in the 12 months before the survey. This report uses data from the 2002 through 2007 NSDUHs.
--------------------------------------------------------------------------------
Use and Dependence or Abuse
--------------------------------------------------------------------------------
In 2007, almost 1.0 million adolescents used inhalants in the past year; this represents 3.9 percent of adolescents, which was lower than the rate in 2003, 2004, and 2005 (4.5, 4.6, and 4.5 percent, respectively) (Figure 1). Past year dependence on or abuse of inhalants remained relatively stable between 2002 and 2007, with 0.4 percent of adolescents (around 99,000 persons) meeting the criteria for dependence or abuse in 2007.
Figure 1. Trends in Past Year Inhalant Use and Dependence or Abuse among Adolescents: 2002 to 2007
Figure 1 Table. Trends in Past Year Inhalant Use and Dependence or Abuse among Adolescents: 2002 to 2007 Trend 2002 2003 2004 2005 2006 2007
Past Year Use 4.4% 4.5%* 4.6%* 4.5%* 4.4% 3.9%
Past Year Dependence or Abuse 0.4% 0.4% 0.5% 0.4% 0.4% 0.4%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Past Year Initiation of Inhalant Use
--------------------------------------------------------------------------------
In 2007, 2.1 percent of adolescents who had not previously used inhalants began using them during the 12 months prior to the survey (Figure 2). This rate was lower than the rates of initiation for 2002, 2003, 2004, and 2005.
Figure 2. Trends in Past Year Initiation of Inhalants among Adolescents Who Had Not Previously Used Inhalants: 2002 to 2007**
Figure 2 Table. Trends in Past Year Initiation of Inhalants among Adolescents Who Had Not Previously Used Inhalants: 2002 to 2007** Trend 2002 2003 2004 2005 2006 2007
Past Year Initiation of Inhalants 2.6%* 2.6%* 2.6%* 2.6%* 2.4% 2.1%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
NSDUH also provides data on the first illicit drug initiated among past year initiates.2 In 2007, 17.2 percent of past year illicit drug initiates indicated that inhalants were the first drug that they used (Table 1). Marijuana was the first drug used by 56.3 percent of past year illicit drug initiates; nonmedically used prescription-type drugs were the first type of drug used by 23.5 percent of past year illicit drug initiates. These rates remained relatively stable between 2002 and 2007.
Table 1. Trends for First Drug Initiated in the Past Year among Adolescents Who Initiated Illicit Drug Use in the Past Year: 2002 to 2007** First Drug Initiated*** 2002
(%) 2003
(%) 2004
(%) 2005
(%) 2006
(%) 2007
(%)
Marijuana and Hashish 59.9% 57.6% 57.3% 55.0% 57.1% 56.3%
Nonmedical Use of Prescription-Type Drugs 22.2% 20.4% 21.3% 22.0% 22.0% 23.5%
Inhalants 14.5% 19.4% 19.2% 19.6% 17.4% 17.2%
Hallucinogens 2.9% 2.3% 2.1% 2.5% 3.0% 2.3%
Cocaine 0.7% 0.4% 0.5% 1.0% 0.9% 0.8%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Use of Specific Inhalants among Past Year Inhalant Initiates
--------------------------------------------------------------------------------
Among past year inhalant initiates, the percentage using most specific types of inhalants in 2007 did not differ significantly from the percentage in 2002 (Table 2); however, there were a few exceptions. Among past year inhalant initiates, use of nitrous oxide or "whippits" was lower in 2007 than in 2002 (16.3 vs. 31.6 percent), and use of aerosol spray other than spray paint3 was higher in 2007 than 2002 (25.0 vs. 12.6 percent).
Table 2. Trends in Past Year Use of Specific Types of Inhalants among Past Year Inhalant Initiates Aged 12 to 17: 2002 to 2007** Type of Inhalant 2002
(%) 2003
(%) 2004
(%) 2005
(%) 2006
(%) 2007
(%)
Amyl Nitrite, "Poppers," Locker Room Odorizers,
or "Rush" 14.0% 17.0% 12.6% 16.4% 16.5% 19.3%
Correction Fluid, Degreaser, or Cleaning Fluid 15.7% 19.7% 19.6% 19.6% 22.5% 19.3%
Gasoline or Lighter Fluid 26.2% 23.2% 25.3% 26.7% 27.0% 28.1%
Glue, Shoe Polish, or Toluene 32.9% 30.2% 27.6% 31.3% 25.6% 28.8%
Halothane, Ether, or Other Anesthetics 2.9% 2.9% 4.5% 3.4% 4.5% 5.7%
Lacquer Thinner or Other Paint Solvents 13.9% 10.7% 10.8% 13.3% 14.2% 12.8%
Lighter Gases, Such as Butane or Propane 9.3% 9.7% 9.2% 8.1% 7.1% 9.9%
Nitrous Oxide or "Whippits" 31.6% 23.0% 20.1% 21.3% 17.7% 16.3%
Spray Paints 21.4% 23.3% 25.4% 23.9% 28.1% 25.1%
Aerosol Sprays Other than Spray Paints+ 12.6% 17.6% 23.6% 25.4% 23.5% 25.0%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Discussion
--------------------------------------------------------------------------------
Although the rates of inhalant use and inhalant initiation appeared to be on a downward trend, particularly since 2005, the rates of dependence on or abuse of these substances remained stable between 2002 and 2007. Rates of use of specific types of inhalants among past year initiates generally did not differ significantly from 2002 to 2007, although a few types showed significant changes. Use of nitrous oxide or "whippits" decreased by half, and use of aerosol sprays other than spray paints doubled. Over the period from 2002 to 2007, 15 to 20 percent of past year illicit drug initiates indicated that inhalants were the first illicit drug they had used.
These findings highlight the ongoing need for prevention and treatment of inhalant use and abuse. Continuing efforts are needed among adolescents and their parents, other family members, teachers, service providers, and policymakers to increase awareness of the dangers of inhalant use. Awareness campaigns and prevention efforts may need targeted messages about the use of specific inhalants, such as aerosol air fresheners, aerosol sprays, and aerosol cleaning products.
--------------------------------------------------------------------------------
End Notes
--------------------------------------------------------------------------------
1 Substance dependence or abuse is defined using criteria in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which includes symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year.
2 Illicit drugs refer to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.
3 Aerosol sprays other than spray paint include products such as aerosol air fresheners, aerosol spray, and aerosol cleaning products (e.g., dusting sprays, furniture polish). The aerosol propellants in these products are commonly chlorofluorocarbons. By contrast, nitrous oxide is used as a propellant for whipped cream and is available in 2-inch tapered cylinders called "whippits" that are used to pressurize home whipped-cream charging bottles.
--------------------------------------------------------------------------------
Figure and Table Notes
--------------------------------------------------------------------------------
* Difference between this estimate and 2007 estimate is statistically significant at the .05 level.
** Past year initiates are defined as adolescents who used a drug for the first time during the 12 months prior to the survey.
*** First drug initiated is based on the date of the first use for each drug, with imputation for the day of the month and for the month of the year, if not reported. Respondents may be counted in more than one drug category if they reported initiating multiple drugs on the same day the first time that they used drugs.
+ See End Note 3.
--------------------------------------------------------------------------------
Suggested Citation
--------------------------------------------------------------------------------
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (March 16, 2009). The NSDUH Report: Trends in Adolescent Inhalant Use: 2002 to 2007. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2002 to 2007 data used in this report are based on information obtained from 136,449 persons aged 12 to 17. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.
Among adolescents who used inhalants for the first time in the past year (i.e., past year initiates), the rate of use of nitrous oxide or "whippits" declined between 2002 and 2007 among both genders (males: 40.2 to 20.2 percent; females: 22.3 to 12.2 percent)
In 2007, 17.2 percent of adolescents who initiated illicit drug use during the past year indicated that inhalants were the first drug that they used; this rate remained relatively stable between 2002 and 2007
Adolescents have easy access to some dangerous substances—ordinary household products such as glue, shoe polish, and aerosol sprays. These products are safe when used as intended, but they can be dangerous and even deadly when sniffed or "huffed" to get high. Preventing and treating inhalant use problems, as well as raising awareness about the dangers of inhalant use, are important ongoing goals of the Substance Abuse and Mental Health Services Administration (SAMHSA). Monitoring trends in inhalant use is vital to assessing policies intended to reduce inhalant use.
This issue of The NSDUH Report examines trends in the use, dependence or abuse,1 and initiation of inhalants among adolescents (i.e., youths aged 12 to 17). The National Survey on Drug Use and Health (NSDUH) defines inhalants as "liquids, sprays, and gases that people sniff or inhale to get high or to make them feel good." NSDUH collects data not only about the use of any inhalant, but also about the use of specific types of inhalants. Respondents who used inhalants were asked when they first used them, and responses to this question were used to identify persons who had initiated use in the 12 months before the survey. This report uses data from the 2002 through 2007 NSDUHs.
--------------------------------------------------------------------------------
Use and Dependence or Abuse
--------------------------------------------------------------------------------
In 2007, almost 1.0 million adolescents used inhalants in the past year; this represents 3.9 percent of adolescents, which was lower than the rate in 2003, 2004, and 2005 (4.5, 4.6, and 4.5 percent, respectively) (Figure 1). Past year dependence on or abuse of inhalants remained relatively stable between 2002 and 2007, with 0.4 percent of adolescents (around 99,000 persons) meeting the criteria for dependence or abuse in 2007.
Figure 1. Trends in Past Year Inhalant Use and Dependence or Abuse among Adolescents: 2002 to 2007
Figure 1 Table. Trends in Past Year Inhalant Use and Dependence or Abuse among Adolescents: 2002 to 2007 Trend 2002 2003 2004 2005 2006 2007
Past Year Use 4.4% 4.5%* 4.6%* 4.5%* 4.4% 3.9%
Past Year Dependence or Abuse 0.4% 0.4% 0.5% 0.4% 0.4% 0.4%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Past Year Initiation of Inhalant Use
--------------------------------------------------------------------------------
In 2007, 2.1 percent of adolescents who had not previously used inhalants began using them during the 12 months prior to the survey (Figure 2). This rate was lower than the rates of initiation for 2002, 2003, 2004, and 2005.
Figure 2. Trends in Past Year Initiation of Inhalants among Adolescents Who Had Not Previously Used Inhalants: 2002 to 2007**
Figure 2 Table. Trends in Past Year Initiation of Inhalants among Adolescents Who Had Not Previously Used Inhalants: 2002 to 2007** Trend 2002 2003 2004 2005 2006 2007
Past Year Initiation of Inhalants 2.6%* 2.6%* 2.6%* 2.6%* 2.4% 2.1%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
NSDUH also provides data on the first illicit drug initiated among past year initiates.2 In 2007, 17.2 percent of past year illicit drug initiates indicated that inhalants were the first drug that they used (Table 1). Marijuana was the first drug used by 56.3 percent of past year illicit drug initiates; nonmedically used prescription-type drugs were the first type of drug used by 23.5 percent of past year illicit drug initiates. These rates remained relatively stable between 2002 and 2007.
Table 1. Trends for First Drug Initiated in the Past Year among Adolescents Who Initiated Illicit Drug Use in the Past Year: 2002 to 2007** First Drug Initiated*** 2002
(%) 2003
(%) 2004
(%) 2005
(%) 2006
(%) 2007
(%)
Marijuana and Hashish 59.9% 57.6% 57.3% 55.0% 57.1% 56.3%
Nonmedical Use of Prescription-Type Drugs 22.2% 20.4% 21.3% 22.0% 22.0% 23.5%
Inhalants 14.5% 19.4% 19.2% 19.6% 17.4% 17.2%
Hallucinogens 2.9% 2.3% 2.1% 2.5% 3.0% 2.3%
Cocaine 0.7% 0.4% 0.5% 1.0% 0.9% 0.8%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Use of Specific Inhalants among Past Year Inhalant Initiates
--------------------------------------------------------------------------------
Among past year inhalant initiates, the percentage using most specific types of inhalants in 2007 did not differ significantly from the percentage in 2002 (Table 2); however, there were a few exceptions. Among past year inhalant initiates, use of nitrous oxide or "whippits" was lower in 2007 than in 2002 (16.3 vs. 31.6 percent), and use of aerosol spray other than spray paint3 was higher in 2007 than 2002 (25.0 vs. 12.6 percent).
Table 2. Trends in Past Year Use of Specific Types of Inhalants among Past Year Inhalant Initiates Aged 12 to 17: 2002 to 2007** Type of Inhalant 2002
(%) 2003
(%) 2004
(%) 2005
(%) 2006
(%) 2007
(%)
Amyl Nitrite, "Poppers," Locker Room Odorizers,
or "Rush" 14.0% 17.0% 12.6% 16.4% 16.5% 19.3%
Correction Fluid, Degreaser, or Cleaning Fluid 15.7% 19.7% 19.6% 19.6% 22.5% 19.3%
Gasoline or Lighter Fluid 26.2% 23.2% 25.3% 26.7% 27.0% 28.1%
Glue, Shoe Polish, or Toluene 32.9% 30.2% 27.6% 31.3% 25.6% 28.8%
Halothane, Ether, or Other Anesthetics 2.9% 2.9% 4.5% 3.4% 4.5% 5.7%
Lacquer Thinner or Other Paint Solvents 13.9% 10.7% 10.8% 13.3% 14.2% 12.8%
Lighter Gases, Such as Butane or Propane 9.3% 9.7% 9.2% 8.1% 7.1% 9.9%
Nitrous Oxide or "Whippits" 31.6% 23.0% 20.1% 21.3% 17.7% 16.3%
Spray Paints 21.4% 23.3% 25.4% 23.9% 28.1% 25.1%
Aerosol Sprays Other than Spray Paints+ 12.6% 17.6% 23.6% 25.4% 23.5% 25.0%
Source: 2002 to 2007 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
--------------------------------------------------------------------------------
Discussion
--------------------------------------------------------------------------------
Although the rates of inhalant use and inhalant initiation appeared to be on a downward trend, particularly since 2005, the rates of dependence on or abuse of these substances remained stable between 2002 and 2007. Rates of use of specific types of inhalants among past year initiates generally did not differ significantly from 2002 to 2007, although a few types showed significant changes. Use of nitrous oxide or "whippits" decreased by half, and use of aerosol sprays other than spray paints doubled. Over the period from 2002 to 2007, 15 to 20 percent of past year illicit drug initiates indicated that inhalants were the first illicit drug they had used.
These findings highlight the ongoing need for prevention and treatment of inhalant use and abuse. Continuing efforts are needed among adolescents and their parents, other family members, teachers, service providers, and policymakers to increase awareness of the dangers of inhalant use. Awareness campaigns and prevention efforts may need targeted messages about the use of specific inhalants, such as aerosol air fresheners, aerosol sprays, and aerosol cleaning products.
--------------------------------------------------------------------------------
End Notes
--------------------------------------------------------------------------------
1 Substance dependence or abuse is defined using criteria in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which includes symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year.
2 Illicit drugs refer to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.
3 Aerosol sprays other than spray paint include products such as aerosol air fresheners, aerosol spray, and aerosol cleaning products (e.g., dusting sprays, furniture polish). The aerosol propellants in these products are commonly chlorofluorocarbons. By contrast, nitrous oxide is used as a propellant for whipped cream and is available in 2-inch tapered cylinders called "whippits" that are used to pressurize home whipped-cream charging bottles.
--------------------------------------------------------------------------------
Figure and Table Notes
--------------------------------------------------------------------------------
* Difference between this estimate and 2007 estimate is statistically significant at the .05 level.
** Past year initiates are defined as adolescents who used a drug for the first time during the 12 months prior to the survey.
*** First drug initiated is based on the date of the first use for each drug, with imputation for the day of the month and for the month of the year, if not reported. Respondents may be counted in more than one drug category if they reported initiating multiple drugs on the same day the first time that they used drugs.
+ See End Note 3.
--------------------------------------------------------------------------------
Suggested Citation
--------------------------------------------------------------------------------
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (March 16, 2009). The NSDUH Report: Trends in Adolescent Inhalant Use: 2002 to 2007. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2002 to 2007 data used in this report are based on information obtained from 136,449 persons aged 12 to 17. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.
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