CAC Clinical Training Program, Colorado Division of Behavioral Health Required classes for CAC I: Addiction Counseling Skills, Client Record Management, and Principles of Addiction Treatment are the three classes that make up the Core Curriculum and are basic to the foundational training of a beginning addiction counselor. The following summary is sourced by the Office of Behavior Health’s Addiction Counselor’s Handbook.
CAC I CLASSES:
∙ Addiction Counseling Skills (21 hour CAC I class) The purpose of this class is to provide a framework and counseling model for working with clients with substance use disorders. This class teaches a client-centered, counselor-directed model using a motivational style and spirit. The counselor will experience and learn the counseling skills to support the client to move through identifying and changing behaviors. Videotaping and feedback will assist the participants in developing a standard level of counseling skills proficiency.
∙ Client Record Management (14 hour CAC I class) This class is part designed to provide the counselor with an understanding of the clinical record and the continuum of client care that the record documents. This class will include an introduction to diagnosing substance abuse and dependence using the most current version of the Diagnostic and Statistical Manual (DSM). It will also include an introduction to the ASAM Patient Placement Criteria. Participants in this training will learn how to properly document for the clinical record including intake summaries, the use of screening and assessment instruments, treatment plans, progress notes, and discharge summaries. Confidentiality of the client record will be emphasized along with informed consent, releases of information and mandatory disclosure.
∙ Principles of Addiction Treatment (21 hour CAC I class) This class presents the models of addiction, defines and outlines various types of addiction treatment, presents the National Institute of Drug Abuse (NIDA) principles of effective treatment and reviews the use of evidence-based treatment approaches. The competencies required of an addiction counselor and scope of practice will be reviewed along with addiction counselor certification and licensure in Colorado, applicable rules and professional readiness.
∙ Infectious Diseases in Addiction Treatment (14 hour CAC I class) (formerly Infectious Diseases in the Alcohol & Drug Treatment Setting) Those who are abusing substances are at risk for contracting and spreading infectious diseases. Helping clients understand these risks is a cornerstone of addiction counseling. In this training, the focus will be on the complex relationship between the client’s use of drugs and alcohol, lifestyle choices, and physiological health. This class will prepare addiction professionals to screen for infectious diseases, determine client risk, educate clients about disease prevention and assist clients in obtaining appropriate treatment as needed. CAC Clinical Training Program Division of Behavioral Health Revised January 2012 17
∙ Culturally Informed Treatment (14 hour CAC I class) (formerly Diversity in Treatment Populations) This class will provide a basic foundation for understanding how cultural competence, awareness and sensitivity can improve quality of care and increase positive outcomes. The importance of cultural diversity as a factor in substance use disorder treatment will be discussed and cultural competency will be defined. This class provides an introduction to aid the counselor in working with culturally diverse individuals, explores barriers to treatment and recovery, and presents recommended treatment approaches for diverse populations. Exercises will involve self-examination and exploration of attitudes and beliefs regarding working with various cultural groups.
∙ Professional Ethics 1: Ethics and Jurisprudence (14 hour CAC I class) (Formerly Ethical Issues in the Alcohol & Drug Clinical Setting) Knowledge of ethics and the law related to the practice of psychotherapy is essential for safe practice. This class will present ethical issues specific to the practice of addiction counseling and an overview of Colorado laws that regulate the practice of psychotherapy. There will be an emphasis on developing ethical decision making skills, the NAADAC code of ethics and the federal confidentiality regulation. The Colorado Mental Health Practice Act will be reviewed to include disciplinary procedures, prohibited activities and the role of the Department of Regulatory Agencies.
∙ Pharmacology I (14 hour CAC I class) Training in pharmacology is a cornerstone of addiction counseling and a major part of what differentiates the professional field of addiction counseling from other mental health disciplines. This class will provide a solid base of knowledge about the drugs of abuse including alcohol, depressants, stimulants, cannabis, inhalants, designer drugs, hallucinogens, caffeine, nicotine and prescription drugs. It will identify physical effects of these drugs, withdrawal syndromes and process of detoxification. Various methods of drug testing and monitoring will be discussed. Required classes for CAC II:
CAC II CLASSES
∙ Clinical Assessment and Treatment Planning (14 hour CAC II class) (Prerequisite is Client Record Management) Client motivation and commitment to treatment begins with the assessment and diagnostic phase that occurs at intake. Participants in this class will learn the components of the clinical assessment including use of a biopsychosocial interview, use of screening and clinical assessment instruments, creation of a problem list, assessing risk of self-harm, identification of cultural needs and supports, trauma screening, determining state of readiness for change, client strengths and how this information translates to the treatment plan. Treatment planning and report writing will be emphasized along with determining appropriate level of care using the ASAM PPC-2.
∙ Motivational Interviewing (21 hour CAC II class) (Prerequisite is Addiction Counseling Skills) Motivational interviewing is an evidence-based practice with widespread use in the field of addiction counseling. MI is a client-centered collaborative counseling style based on client’s CAC Clinical Training Program Division of Behavioral Health Revised January 2012 18 level of motivation and ambivalence about changing behaviors. In this training, participants will learn the model of stages of change, motivational interviewing skills for creating an environment where positive change can occur, and how MI is effective at increasing client engagement, retention, compliance and improving treatment outcomes. Videotaping and feedback will assist the participants in developing a standard level of counseling skills proficiency in MI.
∙ Cognitive Behavioral Therapy (14 hour CAC II class) CBT has been shown to be a particularly useful treatment approach with substance use disorders. Participants will learn the theoretical foundations of CBT and how to incorporate CBT skills in a comprehensive treatment strategy that includes intake, assessment, case conceptualization, treatment planning, and therapy. Counselors will learn and practice effective ways to utilize the tools specific to CBT with their clients.
∙ Co-Occurring Disorders (14 hour CAC II class) For the purposes of this class, co-occurring disorders refers to co-occurring mental and substance use disorders existing at the same time. The class will focus on the interrelationship of these disorders and the differing needs of this population group focusing on the diagnostic criteria for mental disorders most often seen with substance use disorders. It will discuss three types of substance abuse programs: addiction only services, dual diagnosis capable, and dual diagnosis enhanced. Evidence-based treatment approaches with co-occurring disorders will be presented along with elements of treatment planning, importance of diagnosis and the use of medications to enhance treatment.
∙ Group Counseling Skills (21 hour CAC II class) This experiential training covers the process of change as it relates to the dynamics of an effective group experience and the qualities of group facilitation. Groups help draw clients into the culture of recovery Models of group therapy, the use of observation and feedback, group relational experience, group leadership and cultural diversity within groups will be discussed and experienced in classroom group exercises.
∙ Professional Ethics II (14 hour CAC II class) (Prerequisite is Professional Ethics I) This class will provide participants with a comprehensive introduction to ethical and risk management issues related to addiction treatment services with a special emphasis on professional boundaries and conduct. It will focus on three key topics: 1) ethical dilemmas encountered by addiction professionals with the use of case studies; 2) ethical decisionmaking strategies; and 3) risk management concepts designed to prevent ethics complaints and ethics-related lawsuits. Issues addressed will include professionals’ handling of confidential information, informed consent, conflicts of interest, the ethics of service delivery to culturally diverse groups, supervision, consultation, referral and termination of services.
∙ Pharmacology II (14 hour CAC II class) (Prerequisite is Pharmacology I) This class will present the neuroscience of addiction and research that is making a significant contribution to the understanding of addiction and addictive behaviors. Pharmacology II will explore the influence of contextual variables on addiction and recovery from a neuropsychological and cultural framework. Functional changes to the brain and the brain’s CAC Clinical Training Program Division of Behavioral Health Revised January 2012 19 ability to recover after exposure to drugs of abuse, medical problems associated with substance abuse, and the use of pharmacological assists in recovery will be discussed.
∙ Trauma Informed Care with Diverse Populations (14 hour CAC II class) This class will introduce the counselor to the concept of trauma-informed care, an approach that is being adopted more frequently within the human services fields based upon an increased awareness of the ways in which trauma impacts functioning. It will describe and define what trauma informed care is and ways in which a traditional treatment setting can be modified to increase the sense of safety experienced by clients. Participants will learn how to incorporate trauma-informed practices into treatment with diverse populations, such as military veterans, women, people with co-occurring disorders and other groups. Required Classes for CAC III
CAC III CLASSES
∙ Advanced Motivational Interviewing (14 hour CAC III class) (Prerequisite is Motivational Interviewing) This advanced training will serve as a booster session for Motivational Interviewing skills for the counselor as well as introducing advanced motivational interviewing skills including strategic use of MI, skills to respond to resistance from clients, basic coding skills, elicitation of change talk, developing change plans and deepening commitment language.
∙ Clinical Supervision I (21 hours CAC III class) This training is designed to help a counselor learn the models of supervision and tools necessary to use as a standard of supervision practice. In this course the counselor will be exposed to supervision that is tailored to the supervisee’s developmental level of experience. Ethical supervisory practices, including supervision contracts and work verification practices, will be discussed. Videotaping and feedback will assist the participant in developing a standard level of supervisory skills proficiency.
∙ Clinical Supervision II (14 hour CAC III class) (Prerequisites are both Advanced Motivational Interviewing and Clinical Supervision I) Clinical supervision II is designed to reinforce the motivational interviewing skills of the supervisor through the use of the MIA:STEP process. MIA:STEP (Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency) will be utilized as a format of supervision. Specialized techniques, coaching, coding, teaching, and use of video or audio taping in supervision will be discussed. Videotaping of practice sessions may be utilized.
∙ Professional Practice (7 hour CAC III class) This training will focus on administrative supervision, organizational issues, DBH-licensed treatment agency requirements including policies and procedures, challenges of the current treatment environment, confidentiality concerns in the electronic era, personnel and staff development, measuring performance treatment outcomes, and related topics. In addition, the implications of healthcare reform and the future of integrated care will be explored.