CORE FUNCTIONS OF THE
ALCOHOL AND OTHER DRUG ABUSE COUNSELOR
The Case Presentation Method is based on Twelve Core Functions.
Scores on the CPM are based on the Global Criteria for each Core
Function. The counselor must be
able to demonstrate competence by achieving a passing score on the Global
Criteria in order to be certified. Although
the Core functions may overlap, depending on the nature of the counselorís
practice, each represents a specific entity.
Give specifics throughout and do not supply original definitions.
The process by which the client is determined appropriate and eligible
for admission to a particular program.
psychological, social, and physiological signs and symptoms
of alcohol and other drug use and abuse.
2. Determine the clientís appropriateness
for admission or referral.
3. Determine the clientís eligibility
for admission or referral.
4. Identify any coexisting
conditions (medical, psychiatric, physical, etc.) that indicate need for additional
assessment and/or services.
to applicable laws, regulations and
agency policies governing alcohol and other drug abuse services.
This function requires that the counselor consider a variety of factors
before deciding whether or not to admit the potential client for treatment.
It is imperative that the counselor use appropriate diagnostic criteria
to determine whether the applicantís alcohol or other drug use constitutes
abuse. All counselors must be able
to describe the criteria they use and demonstrate their competence by presenting
specific examples of how the use of alcohol and other drugs has become
dysfunctional for a particular client.
The determination of a particular clientís appropriateness for a
program requires the counselorís judgment and skill and is influenced by the
programís environment and modality (i.e., inpatient, outpatient, residential,
pharmacotherepy, detoxification, or day care).
Important factors include the nature of the substance abuse, the physical
condition of the client, the psychological functioning of the client, outside
supports/resources, previous treatment efforts, motivation and philosophy of the
The eligibility criteria are generally determined by the focus, target
population and funding requirements of the counselorís program or agency.
Many of the criteria are easily ascertained.
These may include the clientís age, gender, place of residence, legal
status, veteran status, income level and the referral source.
Allusion to following agency policy is a minimally acceptable statement
the applicant is found ineligible or inappropriate for this program, the
counselor should be able to suggest an alternative
The administrative and initial assessment procedures for admission to a
required documents for admission
to the program.
required documents for program eligibility
appropriately signed consents when
soliciting from or providing information
to outside sources to protect client confidentiality and rights.
The intake usually becomes an extension of the screening, when the decision to
admit is formally made and documented. Much
of the intake process includes the completion of various forms.
Typically, the client and counselor fill out an admission or intake
sheet, document the initial assessment, complete appropriate releases of
information, collect financial data, sign a consent for treatment and assign the
Describing to the client the following:
general nature and goals of the program; rules governing client conduct
and infractions that can lead to disciplinary action or discharge from the
program; in a non-residential program, the hours during which services are
available; treatment costs to be borne by the client, if any; and client rights.
9. Provide an overview
to the client by describing program
goals and objectives for client
10. Provide an overview to
the client by describing program rules,
and client obligations and rights.
11. Provide an overview to
the client of program operations.
The orientation may be provided before, during and/or after the
clientís screening and intake. It
can be conducted in an individual, group, or family context.
Portions of the orientation may include other personnel for certain
specific aspects of the treatment, such as
The procedures by which a counselor/program identifies and
evaluates an individualís strengths, weaknesses, problems and needs for
the development of a treatment plan.
relevant history from client
including but not limited
to alcohol and other drug abuse using
appropriate interview techniques.
13. Identify methods
and procedures for obtaining corroborative
information from significant secondary sources regarding clientís
alcohol and other drug abuse and psycho-social history.
appropriate assessment tools.
to the client the rationale for the
use of assessment
techniques in order to
Develop a diagnostic evaluation
of the clientís substance abuse and any coexisting conditions based on the
results of all assessments in order to provide an integrated approach to
treatment planning based on the clientís strengths, weaknesses, and identified
problems and needs.
Although assessment is a continuing process, it is generally emphasized
early in treatment.
It usually results from a combination of focused interviews,
testing and/or record reviews.
The counselor evaluates major life area (i.e., physical health,
vocational development, social adaptation, legal involvement and psychological
functioning) and assesses the extent to which alcohol or drug use has interfered
with the clientís functioning in each of these areas.
The result of this assessment should suggest the focus of treatment.
by which the counselor and the client identify and rank problems needing
resolution; establish agreed upon immediate
and long-term goals; and decide upon a treatment process and the resources to be
assessment results to client in an
and rank problems based on
individual client needs in the written treatment plan.
Formulate agreed upon immediate
and long-term goals using behavioral
terms in the written treatment plan.
Identify the treatment methods
and resources to be utilized as
appropriate for the individual client.
The treatment contract is based on the assessment and is a product of a
negotiation between the client and the counselor to assure that the plan is
tailored to the individualís needs. The language of the problem, goal, and
strategy statements should be specific, intelligible to the client and expressed
in behavioral terms. The statement of the
problem concisely elaborates on a clientís need
identified previously. The goal
statements refer specifically to the identified problem and may include on
objective of a set of objectives ultimately intended to resolve or mitigate the
problem. The goals must be
expressed in behavioral terms in order for the counselor and client to determine
progress in treatment. Both
immediate and long-term goals should be established.
The plan or strategy is a specific activity that links the problem with
the goal. It describes the
services, who will perform them, when they will be provided, and at what
frequency. Treatment planning is a
dynamic process and the contracts must be regularly reviewed and modified as
(Individual, Group, and Significant Others):
The utilization of special skills to assist individuals, families or
groups in achieving objectives through exploration of a problem and its
ramifications; examination of attitudes and feelings; consideration of
alternative solutions; and
21. Select the counseling
theory(ies) that apply(ies).
22. Apply technique(s)
to assist the client, group, and/or family in exploring problems
23. Apply technique(s)
to assist the client, group, and/or family in examining the clientís behavior,
attitudes, and/or feelings if appropriate in the treatment setting.
counseling in accordance with cultural, gender, and lifestyle differences.
with the client in an appropriate therapeutic
26. Elicit solutions
and decisions from the client.
the treatment plan.
Counseling is basically a relationship in which the counselor helps the
client mobilize resources to resolve his or her problem and/or modify attitudes
and values. The counselor must be
able to demonstrate a working knowledge of various counseling approaches.
These methods may include Reality Therapy, Transactional Analysis,
Strategic Family Therapy, Client Centered Therapy, etc.
Further, the counselor must be able to explain the rationale for using a
specific approach for the particular client.
For example, a behavioral approach might be suggested for clients who are
resistant and manipulative or have difficulty anticipating
consequences and regulating impulses. On
the other hand, a cognitive approach may be appropriate for a client who is
depressed, yet insightful and articulate.
Also, the counselor should explain his or her rationale for choosing a
counseling approach in an individual, group or significant other context.
Finally, the counselor should be able to explain why a counseling
approach or context changed during treatment.
Activities which bring services, agencies, resource, or people together
within a planned framework of action toward the achievement of established
goals. It may
involve liaison activities and collateral contacts.
services for client care.
29. Explain the rationale
of case management activities to the client.
Case management is the coordination of a multiple services plan.
Case management decisions must be explained to the client.
By the time many alcohol and other drug abusers enter treatment they tend
to manifest dysfunction in a variety of areas.
For example, a heroin addict may have hepatitis, lack job skills and have
a pending criminal charge. In this
case, the counselor might monitor his medical treatment, make a referral to a
vocational rehabilitation program and communicate with representatives of the
criminal justice system.
client may also be receiving other treatment services such as family therapy and
pharmacotherapy, within the same agency. These
activities must be integrated into the treatment plan and communication must be
maintained with the appropriate personnel
Those services which respond to an alcohol and/or other drug abuserís
needs during acute emotional and/or physical distress.
the elements of the client crisis.
Implement an immediate course
of action appropriate to the
overall treatment by utilizing
A crisis is a decisive, crucial event in the course of treatment that
threatens to compromise or destroy the rehabilitation effort.
These crises may be directly related to alcohol or drug use (i.e.,
overdose or relapse) or indirectly related.
The latter might include the death of a significant other,
separation/divorce, arrest, suicide gestures, a psychotic episode or outside
pressure to terminate treatment. If
no specific crisis is presented in the Written Case, rely on and describe a past
experience with a client. Describe
the overall picture-before, during, and after the crisis.
is imperative that the counselor be able to identify the crises when they
surface, attempt to mitigate or resolve the immediate problem and use negative
events to enhance the treatment efforts, if possible.
Provision of information to individuals and groups concerning alcohol and
other drug abuse and the available services and resources.
33. Present relevant
alcohol and other drug use/abuse information to the client through formal
and/or informal processes.
34. Present information
about available alcohol and other drug services
Client education is provided in a variety of ways.
In certain inpatient and residential programs, for example, a sequence of
formal classes may be conducted using a didactic format with reading materials
and films. On the other hand, an
outpatient counselor may provide relevant information to the client individually
In addition to alcohol and drug information, client education may include
a description of self-help groups and other resources that are available to the
clients and their families. The
applicant must be competent in providing specific examples of the type of
education provided to the client and the relevance to the case.
Identifying the needs of a client that cannot be met by the counselor or
agency and assisting the client to utilize the support systems and community
35. Identify need(s)
and/or problem(s) that the agency
and/or counselor cannot
the rationale for the referral to
client needs and/or problems to
38. Adhere to
applicable laws, regulations and agency policies governing
procedures related to the protection of the clientís
39. Assist the client
in utilizing the support systems
and community resources available.
In order to be competent in this function, the counselor must be familiar with
community resources, both alcohol and drug and others, and should be aware of
the limitations of each service and if the limitations could adversely impact
the client. In addition, the
counselor must be able to demonstrate a working knowledge of the referral
process, including confidentiality requirements and outcomes of the referral.
is obviously closely related to case management when integrated into the initial
and on-going treatment plan. It
also includes, however, aftercare or discharge planning referrals that take into
account the continuum of care.
Report and Record Keeping:Charting
the results of the assessment and treatment plan, writing
reports, progress notes, discharge summaries and other client-related
reports and relevant records
integrating available information to
facilitate the continuum of care.
pertinent ongoing information
pertaining to the client.
relevant information from written
documents for client care.
The report and record keeping function is
important. It benefits the
counselor by documenting the clientís progress in achieving his or her goals.
It facilitates adequate communication between co-workers.
It assists the counselorís supervisor in providing timely feedback.
It is valuable to other programs that may provide services to the client
at a later date. It can enhance the
accountability of the program to its licensing/funding sources.
Ultimately, if performed properly, it enhances the clientís entire
treatment experience. The applicant
must prove personal action in regard to the report and record keeping function.
Consultation With Other Professionals in Regard to Client
Relating with in-house staff or outside professionals to assure
comprehensive, quality care for the client.
issues that are beyond the
counselorís base of knowledge
with appropriate resources to ensure
the provision of effective treatment services.
to applicable laws, regulations and
agency policies governing the disclosure
of client-identifying data.
Explain the rationale
for the consultation to the client,
Consultations are meetings for discussion, decision-making and planning.
The most common consultation is the regular in-house staffing in which
client cases are reviewed with other members of the treatment team.
Consultations may also be conducted in individual sessions with the
supervisor, other counselors, psychologists, physicians, probation officers, and
other service providers connected to the clientís case.