technical competencies report

Competenciesfor Canada’s Substance Abuse Workforce

SECTION VIITECHNICAL COMPETENCIES REPORT

This package was published by the Canadian Centreon Substance Abuse (CCSA).

Suggested citation: Canadian Centre on Substance Abuse. (2014). Competencies for Canada’s substance abuse workforce.

Ottawa, ON: Canadian Centre on Substance Abuse.

This is a living document, which CCSA may revise and update to reflect the latest evidence and research.

© Canadian Centre on Substance Abuse, 2014

For additional copies, contactCCSA, 75 Albert St., Suite 500

Ottawa, ON K1P 5E7Tel.: 613-235-4048

Email: [email protected]

ISBN 978-1-77178-192-3

SECTION VII TECHNICAL COMPETENCIES REPORT

TABLE OF CONTENTS

INTRODUCTION

GLOSSARY OF KEY TERMS

TECHNICAL COMPETENCY DEFINITIONS

USING THE TECHNICAL COMPETENCIES

BEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCY

VII–1

VII–3

VII–4

VII–7

VII–8

The Canadian Centre on Substance Abuse (CCSA) gratefully acknowledges the significant contributions and support

received from people working in the field who participated in focus groups across Canada.

CCSA especially thanks all its partners who so graciously allowed and encouraged staff to participate in the focus

groups. The research means nothing if the end result is not meaningful to the people for whom it is intended and CCSA

could not produce a meaningful report without the input from the focus groups.

CCSA also thanks members of the National Advisory Group on Workforce Development (comprised of representatives

from key national organizations and provincial/territorial governments) and other experienced directors and managers

who participated in reviews of both sets of competencies.

These documents can also be downloaded as a PDF at www.ccsa.ca

Ce document est également disponible en français sous le titre :Compétences pour les intervenants canadiens en toxicomanie

ACKNOWLEDGEMENTS

VII–1

© Canadian Centre on Substance Abuse, 2014 Competencies for Canada’s Substance Abuse Workforce

• Treatment evolved to increase focus on clients’ strengths, capabilities and resources. It is generally accepted in the field that treatment must engage and be driven by clients and incorporate their goals and success measurements. This strength-based approach recognizes that relapse can occur, and is an opportunity to build toward success, not a failure.

Technical Competencies Compared with Behavioural CompetenciesOrganizations and individuals who use the Competencies for Canada’s Substance Abuse Workforce have told us that keeping the Technical and Behavioural Competencies separate is useful, so they remain distinct although linked categories. The two types of competencies are defined as follows:

Technical Competencies are the specific, measurable knowledge and skills required to apply technical principles and information in a job function. Technical Competencies are usually learned in an educational environment or on the job. They are the “what” of a job and sometimes are called “hard” skills. Counselling is one example of a Technical Competency.

Behavioural Competencies are the specific, measurable knowledge, skills and values required to perform effectively in a job function. Behavioural Competencies are typically learned and developed through life experiences. They are the “how” of performing a job and are sometimes called “soft” skills. Interpersonal rapport/savvy is one example of a Behavioural Competency.

INTRODUCTIONWhen work began on the Competencies for Canada’s Substance Abuse Workforce, the Canadian Centre on Substance Abuse (CCSA) committed to updating them as necessary because competencies are dynamic and the substance abuse field changes over time. The second version of the Technical Competencies fulfills this commitment and reflects developments over the past few years:

• CCSA’s review of recent literature revealed new or reinforcing evidence for successful substance use treatment.

• Through discussions with stakeholders, we gained a clearer understanding of the distinction between Technical Competencies and Behavioural Competencies. As a result, we moved three Technical Competencies to the Behavioural Competencies (Diversity and Cultural Responsiveness, Ethics and Professionalism, and Teamwork). Conflict Management, a Technical Competency in version one, was considered so integral to other competencies that it was removed as a specific competency and relevant behaviour indicators were incorporated into other competencies.

• Professionals in the substance abuse field began to change the language of engagement with clients to remove disempowering words. For example: “mental health problems” was replaced by “mental health issues,” which reflects a more neutral view that individuals can encounter stresses rendering them less able to cope for a period, but good mental health can return without being treated by medication.

Competencies for Canada’s Substance Abuse Workforce

TECHNICAL COMPETENCIES REPORT

VII–2


New Features in Version TwoFocus on Substance UseThe focus of the Technical Competencies, version two, is substance use, which encompasses abuse, dependency, disorder, misuse and addiction. In this version, efforts have been made to use terminology that is meaningful to treatment providers without emphasis on a clinical or disease model. Research from other countries and anecdotal information garnered from participants in the focus groups indicate that treating problematic gambling and smoking can be successful using similar approaches and strategies as for treating substance use. Substance-Related and Addictive Disorders, a factsheet from the American Psychiatric Association (2013), indicates that research on pathological gambling has led to gambling disorder being included in the Diagnostic and Statistical Manual of Mental Disorder (fifth edition) and states that “gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology, and treatment.”

Trauma-specific Care vs. Trauma-informed Care One of the Technical Competencies is titled Trauma-specific Care, chosen to indicate that treatment providers discuss with clients the cause or causes of their trauma and assist clients to identify and incorporate in their lives ways to cope effectively with the effects of trauma so that clients build a bank of coping mechanisms that increase the quality of their lives. In addition to this competency, behaviour indicators throughout a number of the Technical Competencies also reference Trauma-specific Care.

Trauma-informed Care1 is provided by the whole organization. It is a systematic approach to caring for clients, doing the right thing before a client is even in the room to increase the client’s feeling of safety, choice and control. Trauma-informed care does not include talking about the underlying trauma.2

Sequencing the CompetenciesUnderstanding Substance Use and Understanding Concurrent Disorders are two foundational Technical Competencies that underpin all the other competencies in this report. They are set out first and the remaining Technical Competencies are then listed in alphabetical order. The focus groups were clear that substantive knowledge in the two foundational Technical Competencies is essential for everyone working in this field, although the level of proficiency required differs depending on the work an individual performs.

That the Technical Competency of counselling is more effective when combined with the Behavioural Competency of interpersonal rapport/savvy demonstrates how the two sets of competencies complement each other. The Behavioural Competencies inform the Technical Competencies; one set should not be used in isolation from the other.

Development Process for the CompetenciesWhen CCSA started researching competencies for the substance abuse treatment field in 2006, we realized that extensive work was needed to define them. We began with Technical Competencies because they are easier to observe and measure, publishing the first version of them in 2007. We then turned to Behavioural Competencies and published a report on them in 2010, along with guides, interview forms and performance measurement tools to assist organizations in using them.

CCSA began research on the second version of the Technical Competencies in 2012. We had already transferred four Technical Competencies to the Behavioural Competencies. We refined and expanded the remaining 14 Technical Competencies with additional behaviour indicators and added three new competencies. As with the previous competencies work, after we completed research on a draft of the second version of the Technical Competencies, we asked focus groups across Canada to review them.

Most of the focus groups were composed of frontline treatment service and program delivery staff. However, because of the importance of including concurrent disorders, CCSA hosted focus groups of mental health workers and nurses. Further, recognizing that the Competencies for Canada’s Substance Abuse Workforce extends beyond organizations that provide treatment services, we convened a focus group of probation officers and another of people with lived experience. All the focus groups provided key feedback in shaping version two of the Technical Competencies to increase inclusivity, ensure consistent terminology, increase clarity and reflect treatment of concurrent disorders. In total, 12 focus groups were held, with over 110 participants.

1 For a comparison between trauma-informed services and trauma-specific services and an organizational checklist, see Trauma Informed Practice Guide. Victoria: BC Centre of Excellence for Women’s Health, 2013.2 For more information on trauma-informed care, see Nancy Poole and Lorraine Greaves, eds., Becoming Trauma Informed. Toronto: Centre for Addiction and Mental Health, 2012.

Technical Competencies ReportNEW FEATURES IN VERSION TWO

VII–3


Mental Health IssuesUndiagnosed imbalance in mental health resulting in reduced ability to deal with stress, difficulties and people, and often leading to inappropriate or unhelpful coping mechanisms. (Although sometimes called mental health problems, this phrase was discarded as pejorative by focus groups validating this version of the Technical Competencies.) Symptoms are likely discussed between a client and a treatment provider and coping mechanisms are encouraged to aid the client in moving toward better mental health.

Mental IllnessPsychiatric disorder or mental-health impairment, diagnosed by a specialist practitioner, that requires treatment, often including medication.

Screening (see also Assessment)Brief initial process to identify the risks associated with a client’s substance use and any related concerns.

Social Support (see also Family)Individuals or groups who constitute social networks, Elders, community systems and any configuration of significant others in the client’s past, present or future, and who can either support or undermine the client’s treatment goals.

Specialist PractitionerRefers to psychiatrists, psychologists and other regulated clinicians who can diagnose mental illness and are licensed to prescribe medications.

Substance UseThe self-administration of a psychoactive substance (WHO, 2006). For the Technical Competencies, substance use includes abuse, dependency, addiction and misuse of both licit and illicit substances, and some emphasis on substance use prevention and health promotion.

TraumaExperiences that overwhelm an individual’s capacity to cope. Such experiences include trauma early in life (e.g., child abuse and neglect, witnessing violence) and later traumatic experiences (e.g., accidents, war, natural disasters).

GLOSSARY OF KEY TERMSCertain words and phrases have a meaning specific in this report. Those words are defined below, reflecting the environment and context in which treatment providers deliver services and programs.

Assessment (see also Screening)In-depth, ongoing process to inform the therapeutic approach. The practitioner engages the client; gathers information; establishes the presence or absence of a problem; identifies strengths and problem areas; and monitors issues such as client readiness to change, the need for crisis intervention or specialist practitioner intervention, and family support.

ClientIndividual or family seeking assistance and support to eliminate substance use or to deal with substance use issues.

Concurrent DisordersA combination of substance use and a diagnosed mental health problem. Examples of concurrent disorders are:

• A drinking problem and an anxiety disorder

• Cannabis dependence and schizophrenia

• Heroin dependence and borderline personality disorder

Evidence-informedTreatment approaches guided by the best available research and practice-based knowledge. Evidence-informed treatment approaches allow for innovation while incorporating lessons learned from existing research literature and being responsive to cultural backgrounds, community values and individual preferences. Evidence-based practices are treatment approaches validated by some form of documented scientific evidence.

Family (see also Social Support)Individuals or groups who constitute family both in the traditional sense and in a broader sense that includes any configuration of significant others in the client’s past, present or future and who can either support or undermine the client’s treatment goals.

Mental HealthContinuum of psychological and emotional well-being along which an individual moves periodically without having a mental illness. The World Health Organization (WHO) defines mental health as a state of well-being in which an individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

Technical Competencies ReportGLOSSARY OF KEY TERMS

TECHNICAL COMPETENCY DEFINITIONS

Competency Title Definition Notes on the Competency

Understanding Substance Use

(in v. 1 was Understanding Use, Abuse, and Dependency)

Background or contextual knowledge of substance use, as defined in the Competencies, required to properly inform more specific aspects of a professional’s work with clients and their families.

The choice of “substance use” reflects a research perspective that this phrase encompasses use, misuse, abuse, dependency and addiction.

This is 1 of 2 foundational competencies.

Understanding Concurrent Disorders

(in v. 1 was Mental Health)

Knowledge and skills required to properly inform more specific aspects of a professional’s work with clients with co-occurring substance use and mental illness, or substance use and mental health issues.

This competency recognizes that many treatment providers are not licensed clinicians, but must be conversant with concurrent disorders so they can serve clients effectively.

This is 2 of 2 foundational competencies.

Case Management Facilitating a substance use client’s movement within and between service providers. It includes maintaining accurate documentation, sharing client information appropriately and collaborating with other services providers.

This competency is closely linked to the competencies Client Referral and Record Keeping and Documentation.

Client Referral

NEW

Collaborating with substance use clients, services and supports to identify and access the best available resources to meet clients’ needs.

This competency reflects increased recognition of the importance of being able to access a wide range of pertinent resources.

This competency is closely linked to Case Management and Treatment Planning.

Community Development Working together to identify community needs and resources, and to plan and support or guide collective action.

Community development is expected to be planned and implemented collaboratively with community leaders where possible and appropriate, although this is not clearly stated in the definition of the competency.

This competency is closely linked to Outreach.

Counselling Applying a comprehensive range of evidence-informed counselling styles, techniques and methodologies aimed at improving the overall well-being of substance use and concurrent disorders clients.

Treatment providers use a range of methods and adapt or revise them in keeping with new knowledge, promising or best practices, and learning from application in practice to ensure that the counselling is strength-based and always focused on the client and his or her needs.

This competency is closely linked to Family and Social Support, Trauma-specific Care and Treatment Planning.


The 17 Technical Competencies in version two are listed below, along with definitions and notes to help readers understand the changes made for this version. For all Technical Competencies, some behaviour indicators were refined and new ones added.

Technical Competencies ReportTECHNICAL COMPETENCY DEFINITIONS

VII–4



Crisis Intervention Recognizing and responding effectively when a substance use or concurrent disorders client or associated group or community is in an unstable, risky, dangerous or potentially dangerous situation.

This competency does not indicate a requirement for crisis intervention training; however, it could be worthwhile as a professional development opportunity for staff requiring this competency.

Family and Social Support Working with clients and individuals and groups most affected by the client’s substance use and most able to either support or undermine the client’s treatment goals.

Sometimes, the client is not the individual with a drug problem and might be a family member. Sometimes, the client is the individual with a drug problem and their family is not supportive of their attempts to stop using substances.

For a full explanation of family, see the Glossary of Key Terms.

This competency is closely linked to Counselling.

Group Facilitation Using evidence-informed approaches to work effectively with substance use and concurrent disorders clients in group settings.

Medications

(in v. 1 was Pharmacology)

The knowledge and skills required to understand and use medications in the treatment of clients with substance use or concurrent disorders and to understand and respond to the impact that medications could have on the client.

Originally, this competency was titled Pharmacology; however, the focus groups found that term was not helpful.

Most treatment providers are not licensed to prescribe or dispense medications. As a result, the emphasis in this competency is on knowledge. For example, recognizing when medication is having an adverse effect and knowing how best to respond to increase the client’s success.

In organizations where treatment providers are licensed, most behaviour indicators for this competency can be adjusted to reflect appropriate actions.

Outreach Designing and delivering substance use and concurrent disorders services in the community to a broad range of clients, including those who might otherwise not seek or have access to those services.

This competency is closely linked to Community Development.

Prevention and Health Promotion

(prevention of substance use)

Engaging with substance use and concurrent disorders clients, their families and their communities to encourage the adoption of knowledge, behaviours, values and attitudes that promote personal and community well-being.

This competency recognizes that many treatment providers also work in prevention.3

3 For more information on prevention and health promotion work, look for the prevention workforce competencies that will be available from CCSA in spring 2015. They will focus on working with youth.

Technical Competencies Report TECHNICAL COMPETENCY DEFINITIONS

VII–5



Program Development, Implementation and Evaluation

Developing and implementing new substance use programs, modifying existing programs to respond to identified needs and evaluating the outcomes of new or revised programs.

This competency helps to inform staff about the range of program-related activities they could be expected to participate in and to equip staff to participate more effectively in needs assessment as well as program development, implementation and evaluation.

Record Keeping and Documentation

NEW

Creating and maintaining accurate, up-to-date, comprehensive client records able to withstand legal scrutiny.

This competency reflects the increasing importance of robust record keeping.

This competency is closely linked to Case Management.

Screening and Assessment Selecting, administering and interpreting the results of evidence-informed tools and methods to measure a client’s substance use and related concerns, and inform the care and treatment plan.

This competency is closely linked to Case Management, Counselling and Treatment Planning.

Trauma-specific Care

NEW

Interacting with substance use clients to identify and consider the impact that overwhelmingly negative events have on functioning and the ability to cope, and then developing and delivering interventions that emphasize safety, choice and personal control.

As research on trauma has increased, so has the realization that substance use and mental health issues often develop or increase as a result of trauma.

This competency is closely linked to Counselling.

Treatment Planning Collaboratively developing a treatment plan based on screening and assessment findings, ensuring that activities and resources reflect the client’s needs, strengths and goals. The process also includes monitoring, evaluating, planning for discharge and updating the treatment plan so that it reflects the client’s evolving needs and goals.

This competency is closely linked to Counselling, Case Management and Client Referral.

VII–6

Technical Competencies ReportTECHNICAL COMPETENCY DEFINITIONS


USING THE TECHNICAL COMPETENCIESFor each Technical Competency, there is a definition and four levels of proficiency: Introductory, Developing, Intermediate and Advanced. A full explanation of the proficiency levels is found in the Overview of Competencies for Canada’s Substance Abuse Workforce.

The Technical Competencies can be used to create or refine job descriptions and profiles, interview candidates, assess candidate suitability and experience, set employee performance expectations, and evaluate employee performance. They are also useful to individuals who wish to self-assess their skills and determine how they can best further develop their skills.

Tools to Support Use of Technical Competencies4

To assist organizations using the second version of the Technical Competencies, CCSA has provided in a separate section a series of interview questions for each competency. There are four questions for each competency, one for each level of proficiency, and each question links to particular behaviour indicators for that level of proficiency. The questions are examples that can be used as is or adapted to reflect an organization’s specific needs. By providing these sample questions, CCSA anticipates that organizations can more easily create additional questions that reflect behaviour indicators for specific jobs or functions within a particular organization.

Readers wishing to consider what Competencies users have said about incorporating them into practices can view the seven related videos, which discuss ease of use, benefits of use, curriculum and other topics. CCSA will continue to develop other resources as requested by partners and users of the Competencies.

Technical Competencies Report USING THE TECHNICAL COMPETENCIES

VII–7

4 An additional resource, Guide to Culturally Relevant Behaviour Indicators for the Technical Competencies, produced jointly by CCSA and the National Native Addiction Partnership Foundation (NNAPF), will be available by spring 2015.


VII–8

Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYUNDERSTANDING SUBSTANCE USE

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or c

oach

es c

olle

ague

swo

rkin

g wi

th c

ompl

ex a

nd s

ensit

iveca

ses

requ

iring

a so

phist

icate

dun

ders

tand

ing

of a

ll asp

ects

of s

ubst

ance

use

and

conc

urre

nt d

isord

ers

•In

itiate

s, fa

cilita

tes

or p

artic

ipat

es in

colla

bora

tive

rese

arch

that

:•

Adva

nces

kno

wled

ge a

bout

prev

entio

n, s

cree

ning

and

asse

ssm

ent,

and

treat

men

t of

subs

tanc

e us

e•

Expl

ores

the

rang

e of

soc

ial,

politi

cal,

econ

omic,

spi

ritua

l and

cultu

ral f

acto

rs lik

ely

to h

ave

anim

pact

on

subs

tanc

e us

e

•Co

ntrib

utes

to p

rofe

ssio

nal d

evel

opm

ent

and

exch

ange

s of

cur

rent

kno

wled

ge o

nsu

bsta

nce

use

and

conc

urre

nt d

isord

ers

•De

velo

ps n

ew to

ols,

tech

niqu

es a

ndsu

ppor

t mat

erial

s th

at a

ssist

the

subs

tanc

e us

e wo

rkfo

rce

•Ad

voca

tes

for t

he d

evel

opm

ent a

ndim

plem

enta

tion

of p

ublic

pol

icy d

esig

ned

to m

inim

ize ri

sk w

hile

enh

ancin

gre

silie

ncy

•Ad

voca

tes

for f

undi

ng o

f res

earc

h an

dpr

ogra

ms

desig

ned

to im

prov

e th

e liv

esof

sub

stan

ce a

buse

clie

nts

EXAMPLES


UN

DE

RS

TAN

DIN

G S

UB

STA

NC

E U

SE

: Bac

kgro

und

or c

onte

xtua

l kno

wle

dge

of s

ubst

ance

use

, as

defin

ed in

the

Com

pete

ncie

s,re

quire

d to

pro

perly

info

rm m

ore

spec

ific

aspe

cts

of a

pro

fess

iona

l’s w

ork

with

clie

nts

and

thei

r fa

milie

s.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

•Ex

plain

s in

gen

eral

term

s th

e im

pact

that

med

icatio

ns a

nd o

ther

dru

gs c

an h

ave

onon

e an

othe

r, an

d ap

plie

s th

is un

ders

tand

ing

inwo

rkin

g wi

th c

lient

s

•M

onito

rs in

form

atio

n ab

out c

urre

nt re

sear

chto

upd

ate

and

enha

nce

the

know

ledg

e ba

seap

plie

d wh

en in

tera

ctin

g wi

th c

lient

s

EXAMPLES

Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCY

UNDERSTANDING SUBSTANCE USE

VII–9


VII–10

Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYUNDERSTANDING CONCURRENT DISORDERS

UN

DE

RS

TAN

DIN

G C

ON

CU

RR

EN

T D

ISO

RD

ER

S: K

now

ledg

e an

d sk

ills re

quire

d to

pro

perly

info

rm m

ore

spec

ific

aspe

cts

of a

prof

essi

onal

’s w

ork

with

clie

nts

with

co-

occu

rrin

g su

bsta

nce

use

and

men

tal i

llnes

s or

sub

stan

ce u

se a

nd m

enta

l hea

lth is

sues

.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s a

begi

nnin

g un

ders

tand

ing:

• W

hat i

s m

eant

by

men

tal h

ealth

an

d m

enta

l illn

ess

and

the

diffe

renc

e be

twee

n th

em•

Fact

ors

that

con

tribu

te to

thei

r pr

esen

ce in

the

gene

ral a

nd in

sp

ecific

pop

ulat

ions

and

cul

ture

s•

The

stig

ma

that

is o

ften

asso

ciate

d wi

th m

enta

l illn

ess

and

men

tal

healt

h iss

ues,

and

how

that

may

va

ry in

diff

eren

t pop

ulat

ions

and

cu

lture

s•

The

relat

ions

hip

betw

een

men

tal

illnes

s an

d m

enta

l hea

lth is

sues

an

d co

-occ

urrin

g su

bsta

nce

use

• Th

at m

any

subs

tanc

e us

e cli

ents

ha

ve c

o-oc

curri

ng m

enta

l illn

ess

or

men

tal h

ealth

issu

es•

That

man

y su

bsta

nce

use

clien

ts

have

hist

orie

s of

trau

ma,

whi

ch c

an

have

an

impa

ct o

n th

eir s

ubst

ance

us

e an

d tre

atm

ent

• De

scrib

es h

ow c

oncu

rrent

diso

rder

s im

pact

pro

blem

gam

blin

g, in

cludi

ng:

• Ou

tlinin

g ho

w su

bsta

nce

use

prob

lem

s, m

enta

l illn

ess

and

men

tal h

ealth

issu

es a

ffect

th

e pr

even

tion,

diag

nosis

and

tre

atm

ent o

f pro

blem

gam

blin

g•

List

ing

the

kind

of s

ubst

ance

us

e pr

oble

ms,

men

tal il

lnes

ses

or m

enta

l hea

lth is

sues

ofte

n ex

perie

nced

by

clien

ts w

ith

prob

lem

gam

blin

g

• Ex

plain

s th

e m

ajor c

ateg

orie

s of

men

tal

illnes

s an

d of

men

tal h

ealth

issu

es a

nd

the

signs

and

sym

ptom

s of

eac

h

• Ex

plain

s fre

quen

t cau

ses

of a

nd

treat

men

ts fo

r the

cat

egor

ies

cited

• Pr

ovid

es o

bjec

tive

desc

riptio

ns o

f the

be

havio

ur o

f clie

nts

show

ing

signs

and

sy

mpt

oms

of s

uspe

cted

men

tal il

lnes

s or

men

tal h

ealth

issu

es w

hen

refe

rring

th

em to

or c

onsu

lting

with

spe

cialis

t pr

actit

ione

rs

• Co

llabo

rate

s wi

th c

lient

s to

inte

grat

e re

sults

of c

onsu

ltatio

ns o

r ref

erra

ls in

cli

ents

’ tre

atm

ent p

lans

• In

tegr

ates

trau

ma-

info

rmed

app

roac

hes

into

trea

tmen

t stra

tegi

es

• In

tegr

ates

pra

ctica

l, le

vel-a

ppro

priat

e kn

owle

dge

of m

edica

tions

into

trea

tmen

t st

rate

gies

• Co

llabo

rate

s wi

th c

lient

s to

iden

tify

the

impa

ct o

f stig

ma

and

how

to a

ddre

ss it

an

d ad

dres

s th

e ho

st o

f oth

er p

erso

nal

and

syst

emic

fact

ors

that

eith

er

cont

ribut

e to

or p

rote

ct a

gain

st th

e de

velo

pmen

t of c

oncu

rrent

diso

rder

s

• M

onito

rs e

viden

ce-in

form

ed k

nowl

edge

ab

out t

he b

est a

ppro

ache

s to

trea

ting

conc

urre

nt d

isord

ers

and

work

ing

with

pe

ople

who

hav

e th

ese

diso

rder

s

• Ex

plain

s th

e im

pact

of a

nd re

latio

nshi

p be

twee

n di

ffere

nt c

ultu

ral v

alues

and

st

igm

a on

clie

nts

with

con

curre

nt

diso

rder

s an

d co

llabo

rate

s wi

th c

lient

to

addr

ess

thes

e iss

ues

• De

velo

ps a

nd im

plem

ents

evid

ence

-in

form

ed s

trate

gies

that

app

ropr

iatel

y ad

dres

s:•

The

relat

ive s

ever

ity o

f bot

h th

e cli

ent’s

sub

stan

ce u

se a

nd m

enta

l illn

ess

or m

enta

l hea

lth is

sues

• Th

e sp

ecific

nee

ds re

lated

to th

e cli

ent’s

cul

tura

l con

text

• Th

e fu

ll ran

ge o

f the

clie

nt’s

chall

enge

s (e

.g.,

phys

ical h

ealth

, ho

usin

g, fi

nanc

es)

• Th

e ne

ed to

col

labor

ate

with

a

varie

ty o

f oth

ers

• Co

llabo

rate

s wi

th c

olle

ague

s in

in

tegr

atin

g kn

owle

dge

with

pra

ctice

• Co

llabo

rate

s wi

th o

ther

age

ncie

s an

d se

rvice

pro

vider

s to

add

ress

cha

lleng

es

like

empl

oym

ent a

nd h

ousin

g

• En

gage

s in

cro

ss-tr

ainin

g op

portu

nitie

s wi

th o

ther

pro

fess

iona

ls

• Su

perv

ises

or c

oach

es o

ther

pr

ofes

siona

ls wo

rkin

g wi

th c

lient

s wi

th

conc

urre

nt d

isord

ers

• Co

llabo

rate

s an

d ta

kes

a le

ader

ship

ro

le in

dev

elop

ing

and

impl

emen

ting

a se

amle

ss, e

viden

ce-in

form

ed a

ppro

ach

acro

ss a

ll sec

tors

and

disc

iplin

es to

th

e de

liver

y of

ser

vices

to c

lient

s wi

th

conc

urre

nt d

isord

ers

• Co

llabo

rate

s an

d ta

kes

a le

ader

ship

ro

le in

itiatin

g or

facil

itatin

g cr

oss-

train

ing

oppo

rtuni

ties

with

spe

cialis

t pra

ctitio

ners

• Ad

voca

tes

for,

facil

itate

s an

d co

ntrib

utes

to

col

labor

atio

ns b

etwe

en th

e fu

ll ran

ge

of p

rofe

ssio

nals

invo

lved

in d

iagno

sing

and

treat

ing

clien

ts w

ith c

oncu

rrent

di

sord

ers

• Ad

voca

tes

for,

initia

tes,

facil

itate

s or

pa

rticip

ates

in re

sear

ch fo

cuse

d on

the

appr

opria

te in

tegr

atio

n of

trea

tmen

t for

co

-occ

urrin

g su

bsta

nce

use

and

men

tal

illnes

s or

men

tal h

ealth

issu

es

EXAMPLES


UN

DE

RS

TAN

DIN

G C

ON

CU

RR

EN

T D

ISO

RD

ER

S: K

now

ledg

e an

d sk

ills re

quire

d to

pro

perly

info

rm m

ore

spec

ific

aspe

cts

of a

prof

essi

onal

’s w

ork

with

clie

nts

with

co-

occu

rrin

g su

bsta

nce

use

and

men

tal i

llnes

s or

sub

stan

ce u

se a

nd m

enta

l hea

lth is

sues

.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s th

at s

ubst

ance

use

pro

fess

iona

ls ne

ed to

: •

Lear

n ab

out m

enta

l illn

ess

and

men

tal h

ealth

issu

es

• Kn

ow o

f and

use

the

mos

t im

porta

nt e

viden

ce-in

form

ed

refe

renc

es a

nd re

sour

ces

that

sh

ould

info

rm th

eir l

earn

ing,

in

cludi

ng fo

r exa

mpl

e, th

e Di

agno

stic

and

Stat

istica

l M

anua

l of M

enta

l Diso

rder

, the

M

enta

l Hea

lth A

ct, m

enta

l sta

tus

exam

inat

ions

• Un

ders

tand

that

fam

ily, s

ocial

su

ppor

t and

a h

ost o

f oth

er b

road

de

term

inan

ts o

f hea

lth c

an e

ither

co

ntrib

ute

to o

r pro

tect

aga

inst

th

e de

velo

pmen

t of c

oncu

rrent

di

sord

ers

• Pr

actic

e wi

thin

the

confi

nes

of

thei

r kno

wled

ge a

nd c

onsu

lt an

d co

llabo

rate

with

oth

ers

as re

quire

d

• En

gage

s wi

th a

ll clie

nts,

thei

r fam

ilies

and

socia

l sup

ports

cou

rteou

sly, r

espo

nsive

ly an

d no

n-ju

dgm

enta

lly.

• Su

ppor

ts o

r ass

ists

othe

r mor

e se

nior

in

tern

al pr

ofes

siona

ls wo

rkin

g wi

th c

lient

s wi

th c

oncu

rrent

diso

rder

s of

var

y-in

g le

vels

of s

ever

ity

EXAMPLES


UNDERSTANDING CONCURRENT DISORDERS

VII–11


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYCASE MANAGEMENT

CA

SE

MA

NA

GE

ME

NT:

Fac

ilitat

ing

subs

tanc

e us

e cl

ient

’s m

ovem

ent w

ithin

and

bet

wee

n se

rvic

e pr

ovid

ers.

It in

clud

esm

aint

aini

ng a

ccur

ate

docu

men

tatio

n, s

harin

g cl

ient

info

rmat

ion

appr

opria

tely

and

col

labo

ratin

g w

ith o

ther

ser

vice

s pr

ovid

ers.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• As

sists

cas

e m

anag

emen

t col

leag

ues

in

an a

dmin

istra

tive

or s

uppo

rt ca

pacit

y

• En

gage

s co

urte

ously

and

pro

fess

iona

lly

with

oth

ers

• Ex

plain

s ho

w ca

se m

anag

emen

t is

relat

ed to

scr

eeni

ng, a

sses

smen

t and

tre

atm

ent p

lanni

ng

• Ex

plain

s th

e pr

oces

s fo

r ref

erra

l to

and

from

oth

er s

ervic

e pr

ovid

ers,

inclu

ding

pro

toco

ls th

at d

eter

min

e ho

w,

when

and

with

who

m in

form

atio

n an

d do

cum

enta

tion

shou

ld b

e sh

ared

• Ex

plain

s th

e be

nefit

s of

and

pro

cess

fo

r con

duct

ing

case

con

fere

nces

and

te

leco

nfer

ence

s, an

d th

e sit

uatio

ns in

wh

ich e

ach

is ap

prop

riate

• Ad

here

s to

all l

egisl

atio

n, g

uide

lines

, pr

oced

ures

and

pro

toco

ls ab

out c

lient

co

nfide

ntial

ity a

nd p

rofe

ssio

nal e

thics

• Es

tabl

ishes

and

main

tain

s co

nstru

ctive

wo

rkin

g re

latio

nshi

ps w

ith c

lient

s an

d th

eir f

amilie

s, an

d wi

th b

oth

inte

rnal

and

exte

rnal

colle

ague

s

• M

onito

rs a

rang

e of

reso

urce

s to

be

com

e fa

milia

r with

cur

rent

ser

vice

optio

ns a

vaila

ble

to c

lient

s an

d m

ainta

ins

up-to

-dat

e re

cord

s of

ava

ilabl

e se

rvice

s an

d re

sour

ces

• Co

nsul

ts w

ith c

lient

s to

mat

ch th

em w

ith

and

refe

r the

m to

the

mos

t app

ropr

iate

avail

able

ser

vices

and

sup

ports

, usin

g in

form

atio

n ob

tain

ed th

roug

h th

e sc

reen

ing

and

asse

ssm

ent p

roce

sses

• In

itiate

s an

d pa

rticip

ates

in c

ase

conf

eren

ces

and

tele

conf

eren

ces,

and

prom

ptly

cond

ucts

all n

eces

sary

fo

llow-

up

• Us

es o

r con

sider

s us

ing

tele

-hea

lth

sites

and

onl

ine

tool

s (e

.g.,

video

co

nfer

encin

g) to

facil

itate

cas

e m

anag

emen

t act

ivitie

s

• Co

llabo

rate

s wi

th c

lient

s an

d th

eir

fam

ilies

and

socia

l sup

ports

on

case

m

anag

emen

t rec

omm

enda

tions

and

ac

tivitie

s

• Ad

voca

tes

for c

lient

s wh

en w

orkin

g wi

th

relat

ed s

ervic

es a

nd s

uppo

rts

• Es

tabl

ishes

and

main

tain

s th

erap

eutic

ra

ppor

t with

clie

nts

to h

elp

them

adh

ere

to tr

eatm

ent p

lans

• Es

tabl

ishes

and

main

tain

s tre

atm

ent

plan

s as

par

t of a

mul

ti-di

scip

linar

y te

am,

as a

ppro

priat

e

• Ev

aluat

es o

ngoi

ng tr

eatm

ent p

lans

with

cli

ents,

adj

ustin

g pl

ans

as a

ppro

priat

e

• Es

tabl

ishes

con

stru

ctive

relat

ions

hips

with

a

broa

d ra

nge

of in

tern

al an

d ex

tern

al se

rvice

s an

d su

ppor

ts, u

sing

thes

e re

latio

nshi

ps to

facil

itate

clie

nt re

ferra

ls

• W

orks

with

the

clien

ts to

mot

ivate

them

to

mak

e an

d fo

llow-

thro

ugh

on d

ecisi

ons

abou

t tre

atm

ent p

lanni

ng

• Co

nsul

ts re

gular

ly wi

th o

ther

s, in

tern

ally

and

exte

rnall

y, to

facil

itate

coo

rdin

ated

an

d co

llabo

rativ

e ca

se m

anag

emen

t

• Su

perv

ises

or c

oach

es o

ther

s in

: •

Unde

rtakin

g ge

nera

l cas

e m

anag

emen

t tas

ks•

Evalu

atin

g co

mpl

ex tr

eatm

ent p

lans

and

colla

bora

ting

with

clie

nts

and

othe

r res

ourc

e to

mak

e ch

ange

s as

requ

ired

• In

nova

ting

solu

tions

whe

n co

nven

tiona

l stra

tegi

es h

ave

been

un

succ

essf

ul•

Ensu

ring

com

plian

ce w

ith

case

man

agem

ent p

roto

cols

and

chan

ging

pro

toco

ls wh

en

nece

ssar

y

• Re

views

cou

nsel

lors

’ cas

e m

anag

emen

t do

cum

enta

tion

• Ap

prov

es p

rovis

ion

of c

ase-

man

agem

ent

docu

men

tatio

n to

the

clien

t and

oth

er

colla

bora

tors,

on

a ca

se-b

y-ca

se b

asis

• In

itiate

s an

d fa

cilita

tes

case

con

fere

nces

an

d te

leco

nfer

ence

s, as

app

ropr

iate

EXAMPLES

VII–12


CLI

EN

T R

EFE

RR

AL:

Col

labo

ratin

g w

ith s

ubst

ance

use

clie

nts,

ser

vice

s an

dsu

ppor

ts to

iden

tify

and

acce

ss th

e be

st a

vaila

ble

reso

urce

s to

mee

t clie

nts’

nee

ds.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• De

velo

ps k

nowl

edge

of a

nd m

ainta

ins

relat

ions

hips

with

refe

rral r

esou

rces

• Bu

ilds

and

main

tain

s a

netw

ork

of

reso

urce

s av

ailab

le fo

r mee

ting

clien

t ne

eds

• Co

llabo

rate

s wi

th th

e cli

ent a

bout

po

tent

ial re

ferra

l opt

ions

, disc

ussin

g pr

iorit

ies,

expe

ctat

ions

and

requ

ired

actio

ns

• He

lps

com

plet

e do

cum

ents

requ

ired

for

the

refe

rral p

roce

ss

• Ad

here

s to

all l

egisl

atio

n, g

uide

lines

, pr

oced

ures

and

pro

toco

ls ab

out c

lient

co

nfide

ntial

ity a

nd p

rofe

ssio

nal e

thics

• Bu

ilds

awar

enes

s of

role

and

or

gani

zatio

nal m

anda

te w

ith re

ferra

l so

urce

s

• Is

conv

ersa

nt w

ith p

oten

tial r

efer

ral r

esou

rces

th

roug

h su

ch a

ctivi

ties

as v

isitin

g sit

es,

netw

orkin

g an

d st

udyin

g we

bsite

s an

d pu

blica

tions

• As

sess

es th

e cli

ent’s

read

ines

s an

d m

otiva

tion

to p

artic

ipat

e in

refe

rral s

ervic

es a

nd w

orks

wi

th th

e cli

ent t

o en

hanc

e re

adin

ess

• In

itiate

s co

llabo

ratio

n wi

th re

ferra

l sou

rces

as

appr

opria

te

• Co

ordi

nate

s re

ferra

l ser

vices

and

sup

ports

to

prov

ide

seam

less

car

e fo

r clie

nts

• Ad

voca

tes

for c

lient

whe

n ne

cess

ary

• M

ainta

ins

a ne

twor

k of

refe

rral

sour

ces

appr

opria

te to

the

need

s of

cli

ents

with

com

plex

hist

orie

s

• Co

llabo

rate

s wi

th c

lient

s to

enh

ance

th

eir m

otiva

tion

to ta

ke re

spon

sibilit

y fo

r, en

gage

in a

nd fo

llow-

up o

n th

e re

ferra

l pro

cess

• M

ainta

ins

cont

act w

ith th

e cli

ents

and

re

ferra

l sou

rce

to fa

cilita

te s

ucce

ssfu

l tre

atm

ent a

nd e

valu

ate

the

outc

ome

of th

e re

ferra

l

• Ad

voca

tes

with

refe

rral a

genc

ies

on

beha

lf of

clie

nts

• Bu

ilds

and

enha

nces

refe

rral c

apac

ity

by n

etwo

rkin

g wi

th e

xter

nal s

enio

r-lev

el

colle

ague

s

• Es

tabl

ishes

pro

toco

l and

met

hod

for

colle

ctin

g cli

ent s

atisf

actio

n da

ta

• Ov

erse

es th

e re

ferra

l pro

cess

to e

nsur

e th

at m

utua

lly b

enefi

cial r

elat

ions

hips

are

es

tabl

ished

• Re

views

refe

rral r

ecor

ds fo

r acc

urac

y, co

mpl

eten

ess,

timel

ines

s an

d co

mpl

iance

with

lega

l and

clin

ical

requ

irem

ents

• In

vest

igat

es s

ituat

ions

in w

hich

clie

nts

or re

ferra

l sou

rces

repo

rt in

appr

opria

te,

unsa

tisfa

ctor

y or

inco

mpl

ete

refe

rrals

EXAMPLES


CLIENT REFERRAL

VII–13


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYCOMMUNITY DEVELOPMENT

CO

MM

UN

ITY

DE

VE

LOP

ME

NT:

Wor

king

toge

ther

to id

entif

y co

mm

unity

nee

ds a

nd re

sour

ces,

and

to p

lan

and

supp

ort o

r gu

ide

colle

ctiv

e ac

tion.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ac

cess

es lit

erat

ure

relat

ed to

com

mun

ity

deve

lopm

ent

and

subs

tanc

e us

e se

rvice

de

liver

y sy

stem

s

• Ex

plain

s pr

incip

les

of c

omm

unity

de

velo

pmen

t (e.

g., s

usta

inab

le, in

clusiv

e,

equi

tabl

e)

• Ex

plain

s th

e ro

le o

f com

mun

ity m

embe

rs

in in

itiatin

g an

d su

ppor

ting

com

mun

ity

deve

lopm

ent a

ctivi

ties

• Ac

ts a

s fir

st-li

ne p

oint

of c

onta

ct fo

r co

mm

unity

mem

bers

• Co

urte

ously

eng

ages

with

, enc

oura

ges

and

resp

onds

to a

ll com

mun

ity m

embe

rs

and

stak

ehol

ders

• M

ainta

ins

cont

act w

ith c

omm

unity

re

sour

ces

and

refe

rral s

ourc

es

• W

orks

col

labor

ative

ly an

d de

velo

ps

rapp

ort w

ith c

omm

unity

mem

bers

and

gr

oups

• Es

tabl

ishes

and

main

tain

s co

ntac

ts

and

netw

orks

to fu

rther

com

mun

ity

invo

lvem

ent i

n de

velo

ping

and

del

iverin

g se

rvice

s to

enh

ance

com

mun

ity w

ell-

bein

g

• Pr

omot

es fa

irnes

s an

d go

od ju

dgm

ent

in p

lanni

ng a

nd u

nder

takin

g co

mm

unity

de

velo

pmen

t act

ivitie

s

• Bu

ilds

awar

enes

s in

the

com

mun

ity

abou

t the

nee

ds o

f sub

stan

ce u

se a

nd

conc

urre

nt d

isord

er c

lient

s

• Co

llabo

rate

s wi

th c

lient

s an

d ot

hers

mos

t af

fect

ed to

: •

Asse

ss a

nd p

riorit

ize th

eir n

eeds

, iss

ues

and

reso

urce

s •

Gene

rate

col

labor

ative

sol

utio

ns to

co

mm

unity

cha

lleng

es•

Prom

ote

com

mun

ity o

wner

ship

of

cons

truct

ive c

hang

e

• En

cour

ages

com

mun

ity le

ader

s to

co

nsid

er th

e vo

ice o

f peo

ple

with

lived

ex

perie

nce

in c

omm

unity

dev

elop

men

t ac

tivitie

s

• Co

llabo

rate

s wi

th c

lient

s an

d th

ose

mos

t af

fect

ed to

:•

Leve

rage

com

mun

ity c

apac

ity•

Ensu

re th

at p

rogr

ams

and

serv

ices

are

cultu

rally

sen

sitive

• Ge

nera

te s

olut

ions

to c

ompl

ex

com

mun

ity d

evel

opm

ent i

ssue

s

• M

obiliz

es a

nd s

uppo

rts c

omm

unity

m

embe

rs to

:•

Take

a p

roac

tive

role

in d

evel

opin

g ev

iden

ce-in

form

ed h

ealth

pr

omot

ion

prac

tices

and

pol

icies

• Re

duce

stig

ma

asso

ciate

d wi

th

subs

tanc

e us

e•

Prom

ote

a he

althy

lifes

tyle

• Pe

rform

s or

par

ticip

ates

in n

eeds

as

sess

men

ts b

y co

llect

ing,

ana

lyzin

g an

d in

terp

retin

g re

leva

nt c

omm

unity

dat

a,

in p

artn

ersh

ip w

ith o

ther

com

mun

ity

mem

bers

• In

corp

orat

es re

leva

nt re

sear

ch fi

ndin

gs

and

know

ledg

e of

det

erm

inan

ts o

f hea

lth

into

pro

gram

plan

ning

• Pr

ovid

es le

ader

ship

in s

hapi

ng a

n or

gani

zatio

nal v

ision

and

ser

vice

deliv

ery

syst

em th

at re

flect

s be

st p

ract

ices

in

com

mun

ity d

evel

opm

ent

• Pr

ovid

es le

ader

ship

in d

evel

opin

g an

d im

plem

entin

g ev

iden

ce-in

form

ed

com

mun

ity h

ealth

pro

mot

ion

prac

tices

an

d po

licie

s

• Co

mm

unica

tes

and

colla

bora

tes

with

ke

y st

akeh

olde

rs, w

ithin

and

out

side

the

com

mun

ity, s

uch

as s

ubje

ct m

atte

r ex

perts

, to

obta

in th

eir i

nput

on

and

com

mitm

ent t

o en

gage

in re

leva

nt p

olicy

an

d pr

ogra

m d

evel

opm

ent

• In

corp

orat

es re

leva

nt re

sear

ch fi

ndin

gs

and

know

ledg

e of

det

erm

inan

ts o

f hea

lth

into

pro

gram

plan

ning

• As

sess

es n

ew c

omm

unity

initia

tives

an

d—if

reso

urce

s an

d cir

cum

stan

ces

perm

it—ap

prov

es th

ose

cons

isten

t wi

th b

est p

ract

ices

in c

omm

unity

de

velo

pmen

t

EXAMPLES

VII–14


CO

UN

SE

LLIN

G: A

pply

ing

a co

mpr

ehen

sive

ran

ge o

f evi

denc

e-in

form

ed c

ouns

ellin

g st

yles

, tec

hniq

ues

and

met

hodo

logi

es a

imed

at i

mpr

ovin

g th

e ov

eral

l wel

l-bei

ng o

f sub

stan

ce u

se a

nd c

oncu

rren

t dis

orde

rs c

lient

s.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• As

sists

cou

nsel

lors

in a

n ad

min

istra

tive

or s

uppo

rt ca

pacit

y

• Ob

serv

es e

xper

ienc

ed s

taff

prov

idin

g se

rvice

s an

d fa

cilita

ting

grou

ps

• Ex

plain

s:

• Ev

iden

ce-in

form

ed in

divid

ual a

nd

grou

p co

unse

lling

appr

oach

es a

nd

tech

niqu

es s

uch

as m

otiva

tiona

l in

terv

iewi

ng a

nd c

ogni

tive

beha

viour

al th

erap

y•

The

impo

rtanc

e of

bui

ldin

g ra

ppor

t wh

en w

orkin

g wi

th c

lient

s to

en

hanc

e th

eir m

otiva

tion

• Re

lapse

, risk

and

pro

tect

ive fa

ctor

s•

The

impo

rtanc

e of

col

labor

ative

tre

atm

ent

• Li

fe s

kills

cond

ucive

to re

cove

ry,

like

man

agin

g pe

rson

al fin

ance

s•

The

rang

e of

app

roac

hes

that

can

en

hanc

e co

unse

lling

(e.g

., m

utua

l he

lp, s

elf-h

elp

and

psyc

hoth

erap

y)

• In

tera

cts

with

eac

h cli

ent t

o fa

cilita

te

that

clie

nt’s

reco

very

and

avo

id re

-tra

umat

izatio

n

• Us

es p

lain

langu

age

in a

ll clie

nt

com

mun

icatio

n

• Pa

rticip

ates

in c

reat

ing

a sa

fe

envir

onm

ent

• Ad

here

s to

all l

egisl

atio

n, g

uide

lines

, pr

oced

ures

and

pro

toco

ls ab

out c

lient

co

nfide

ntial

ity a

nd p

rofe

ssio

nal e

thics

• De

scrib

es th

e sig

ns a

nd s

ympt

oms

of

prob

lem

gam

blin

g, in

cludi

ng c

omm

on

cogn

itive

dist

ortio

ns, fi

nanc

ial im

pact

s an

d le

gal is

sues

• Co

llabo

rate

s wi

th c

lient

s to

:•

Esta

blish

and

main

tain

cou

nsel

ling

relat

ions

hips

cha

ract

erize

d by

cou

rtesy

, wa

rmth

, gen

uine

ness

, em

path

y an

d co

ncre

tene

ss

• Un

ders

tand

the

impa

ct th

at th

e fa

mily

as

a s

yste

m c

an h

ave

on th

e cli

ent’s

su

bsta

nce

use

• En

hanc

e th

eir m

otiva

tion

and

read

ines

s to

cha

nge

by e

ffect

ively

appl

ying

skills

su

ch a

s ro

lling

with

resis

tanc

e, b

eing

em

path

etic

and

supp

ortin

g se

lf-ef

ficac

y•

Deve

lop

copi

ng s

trate

gies

to d

eal w

ith

chall

engi

ng c

ircum

stan

ces

• M

atch

es c

lient

’s un

ique

nee

ds a

nd lif

e ch

allen

ges

to a

ppro

priat

e tre

atm

ent a

nd

supp

ort o

ptio

ns (e

.g.,

harm

-red

uctio

n ap

proa

ches

, out

patie

nt o

r afte

rcar

e pr

ogra

ms)

• De

liver

s br

ief i

nter

vent

ions

for c

lient

s, wh

en

and

if re

quire

d

• In

tegr

ates

evid

ence

-info

rmed

cou

nsel

ling

appr

oach

es b

ased

on

each

clie

nt’s

com

preh

ensiv

e as

sess

men

t and

trea

tmen

t pl

ans,

when

wor

king

with

indi

vidua

ls an

d wi

th

grou

ps

• Ad

apts

cou

nsel

ling

appr

oach

to m

eet e

ach

clien

t’s u

niqu

e ne

eds

(e.g

., fa

mily

cou

nsel

ling,

vo

catio

nal c

ouns

ellin

g)

• Co

llabo

rate

s wi

th c

lient

s to

dev

elop

and

im

plem

ent e

viden

ce-in

form

ed re

lapse

pr

even

tion

plan

s

• M

onito

rs a

ll clie

nts,

espe

cially

thos

e wi

th a

hi

gher

relap

se ri

sk, t

o id

entif

y sy

mpt

oms

of re

lapse

and

take

pro

activ

e st

eps

durin

g co

unse

lling

to p

reve

nt re

lapse

• Co

llabo

rate

s wi

th th

e cli

ent t

o fa

cilita

te th

e de

velo

pmen

t of l

ife s

kills

asso

ciate

d wi

th th

e re

cove

ry p

roce

ss

• Co

llabo

rate

s wi

th o

ther

pra

ctitio

ners

to

prov

ide

inte

grat

ed c

are

for c

lient

s

• En

gage

s in

sel

f-ana

lysis

with

clin

ical

supe

rviso

r to

reco

gnize

per

sona

l or

prof

essio

nal li

mita

tions

that

can

impe

de

abilit

y to

wor

k co

nstru

ctive

ly wi

th c

lient

s an

d m

ediat

e an

d re

solve

thos

e lim

itatio

ns

• Ap

plie

s a

broa

der r

ange

of e

viden

ce-

info

rmed

cou

nsel

ling

appr

oach

es

appr

opria

te to

the

need

s of

not

just

in

divid

uals

and

grou

ps, b

ut a

lso

coup

les

and

fam

ilies

• Re

spon

ds c

onst

ruct

ively

and

effe

ctive

ly to

sig

nific

ant c

ouns

ellin

g ch

allen

ges

like

aggr

essio

n an

d th

ough

ts o

f sui

cide

• En

gage

s cli

ents

in d

iscov

erin

g th

e co

nnec

tion

betw

een

thei

r sub

stan

ce

use

and

thei

r exp

erie

nces

• Co

llabo

rate

s wi

th c

lient

to a

ddre

ss

beha

viour

s th

at a

re in

cons

isten

t with

re

cove

ry

• Se

lect

s an

d ad

just

s ap

proa

ches

to

coun

sellin

g ba

sed

on th

e se

verit

y of

bot

h su

bsta

nce

use

and

men

tal

illnes

s or

men

tal h

ealth

issu

es

• Pr

iorit

izes

clien

t acc

ess

to tr

eatm

ent

base

d on

sig

ns a

nd s

ympt

oms

of

relap

se

• De

scrib

es th

e sig

ns a

nd s

ympt

oms

of

prob

lem

gam

blin

g, in

cludi

ng c

omm

on

cogn

itive

dist

ortio

ns fi

nanc

ial im

pact

s an

d le

gal is

sues

• En

gage

s wi

th c

lient

s wh

o pr

esen

t with

co

mpl

ex b

ackg

roun

ds a

nd n

eeds

• Ap

plie

s m

aste

ry o

f sub

stan

ce u

se

coun

sellin

g th

eory

and

skil

ls wh

en

work

ing

with

clie

nts

• In

nova

tes

coun

sellin

g ap

proa

ches

bas

ed

on th

eory,

rese

arch

, tre

nds,

prom

ising

pr

actic

es a

nd n

ew k

nowl

edge

• Ad

voca

tes

for a

nd in

tegr

ates

the

use

of te

chno

logy

to p

rovid

e co

unse

lling

serv

ices,

espe

cially

to ru

ral a

nd re

mot

e cli

ents

• Co

llabo

rate

s wi

th p

rofe

ssio

nals

in o

ther

fie

lds

of s

tudy

to g

athe

r ins

ight

on

alter

nativ

e ap

proa

ches

to c

ouns

ellin

g

• Su

perv

ises

or c

oach

es c

olle

ague

s to

pr

omot

e be

st p

ract

ices

in a

ll asp

ects

of

coun

sellin

g an

d aw

aren

ess

of th

e ne

eds

of s

pecia

lized

pop

ulat

ions

EXAMPLES


COUNSELLING

VII–15


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYCRISIS INTERVENTION

CR

ISIS

INT

ER

VE

NT

ION

: Rec

ogni

zing

and

resp

ondi

ng e

ffect

ivel

y w

hen

a su

bsta

nce

use

or c

oncu

rren

tdi

sord

ers

clie

nt o

r as

soci

ated

gro

up o

r co

mm

unity

is in

an

unst

able

, ris

ky, d

ange

rous

or

pote

ntia

lly d

ange

rous

situ

atio

n.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• De

fines

“cris

is” a

nd e

xplai

ns th

e pr

incip

les

of e

viden

ce-in

form

ed c

risis

inte

rven

tion

• De

velo

ps a

nd m

ainta

ins

a ne

twor

k of

re

sour

ces

and

supp

orts

ava

ilabl

e fo

r cli

ents

in c

risis

• Ex

plain

s th

e ris

k fa

ctor

s an

d sig

ns a

nd

sym

ptom

s as

socia

ted

with

sui

cide

and

othe

r sub

stan

ce u

se-r

elat

ed h

arm

s

• If

risk

fact

ors,

signs

or s

ympt

oms

appe

ar

to b

e pr

esen

t in

a cli

ent,

notifi

es m

ore

seni

or p

rofe

ssio

nals

or re

leva

nt s

ervic

es

and

supp

ort s

yste

ms

• Id

entifi

es th

e es

sent

ial c

ompo

nent

s of

ev

iden

ce-in

form

ed m

odel

s of

cris

is pr

even

tion

actio

n pl

ans

• De

scrib

es th

e su

btle

and

ove

rt sig

ns o

f cr

isis

• Es

tabl

ishes

a p

hysic

ally

and

emot

iona

lly

safe

env

ironm

ent f

or e

ach

clien

t in

crisi

s ba

sed

on th

at c

lient

’s un

ique

nee

ds

• Di

scus

ses

risks

ass

ociat

ed w

ith

subs

tanc

e us

e wi

th c

lient

s, an

d re

fers

cli

ents

in c

risis

to a

ppro

priat

e re

sour

ces

and

supp

orts

• Co

llabo

rate

s wi

th c

lient

s an

d th

eir

fam

ilies

to c

reat

e pl

ans

for c

risis

prev

entio

n an

d in

terv

entio

n

• Co

llabo

rate

s wi

th c

lient

s an

d th

eir

fam

ilies

to a

sses

s an

d im

prov

e th

e sk

ills

they

can

use

to c

ope

durin

g tim

es o

f cr

isis

• M

onito

rs c

lient

’s em

otio

nal s

tate

and

re

spon

ds a

ppro

priat

ely

• Ca

lms

esca

latin

g an

d po

tent

ially

volat

ile

situa

tions

, usin

g a

rang

e of

ver

bal a

nd

non-

verb

al co

mm

unica

tion

skills

• Su

ppor

ts c

lient

s in

cris

is, p

rom

otin

g sa

fety

and

sta

bility

for t

hem

and

thei

r fa

milie

s

• Im

plem

ents

cris

is pr

even

tion

plan

s wh

ere

requ

ired

• Re

spon

ds q

uick

ly an

d ef

fect

ively

to

clien

ts in

cris

is, in

terv

enin

g as

app

ropr

iate

at e

ach

stag

e of

cris

is

• M

onito

rs fa

ctor

s, su

ch a

s m

edica

tions

, th

at m

ight

con

tribu

te to

a c

lient

cris

is an

d ta

kes

appr

opria

te a

ctio

ns, s

uch

as

refe

rring

the

clien

t to

a pr

actit

ione

r who

ca

n pr

escr

ibe

med

icatio

ns, t

o at

tend

to

thes

e fa

ctor

s

• As

sess

es a

nd m

onito

rs c

lient

s at

risk

of

sui

cide

and

othe

r sub

stan

ce u

se-

relat

ed h

arm

s, an

d in

itiate

s ap

prop

riate

in

terv

entio

ns o

r ref

erra

l, as

requ

ired

• Re

-ass

esse

s an

d re

vises

clie

nt’s

treat

men

t plan

follo

wing

a c

risis,

as

nece

ssar

y

• Em

ploy

s cli

nica

l exp

ertis

e to

wor

k wi

th

clien

ts to

iden

tify

unde

rlyin

g fa

ctor

s th

at

cont

ribut

e to

a c

risis

and

to d

evel

op

stra

tegi

es to

cop

e wi

th th

ose

fact

ors

• Em

ploy

s a

rang

e of

sop

hist

icate

d in

terv

entio

n st

rate

gies

and

cre

ative

so

lutio

ns to

sta

biliz

e co

mpl

ex c

risis

situa

tions

• Su

perv

ises

or c

oach

es o

ther

pr

ofes

siona

ls to

enh

ance

thei

r cris

is in

terv

entio

n sk

ills

• M

onito

rs re

sear

ch a

nd in

trodu

ces

new

evid

ence

-info

rmed

cris

is m

anag

emen

t ap

proa

ches

and

tech

niqu

es, a

s ap

prop

riate

EXAMPLES

VII–16


FAM

ILY

AN

D S

OC

IAL

SU

PP

OR

T: W

orki

ng w

ith c

lient

s an

d in

divi

dual

s an

d gr

oups

mos

t affe

cted

by th

e cl

ient

’s s

ubst

ance

use

and

who

are

mos

t abl

e to

eith

er s

uppo

rt o

r un

derm

ine

the

clie

nt’s

trea

tmen

t goa

ls.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s wh

y an

d ho

w fa

mily

and

soc

ial

supp

orts

are

impo

rtant

par

ts o

f effe

ctive

tre

atm

ent a

nd re

lapse

pre

vent

ion

plan

ning

• Ex

plain

s th

e im

pact

that

sub

stan

ce u

se

can

have

on

a cli

ent’s

fam

ily a

nd th

e im

pact

fam

ily c

an h

ave

on a

clie

nt’s

subs

tanc

e us

e

• Ex

plain

s co

mm

unity

reso

urce

s av

ailab

le

to th

e cli

ent a

nd th

e cli

ent’s

fam

ily

• En

gage

s wi

th th

e cli

ent t

o id

entif

y all

pa

rties

the

clien

t con

sider

s to

be

fam

ily

• En

gage

s wi

th th

e cli

ent’s

fam

ily in

a

cour

teou

s, he

lpfu

l and

pro

fess

iona

l m

anne

r

• Co

llabo

rate

s wi

th th

e cli

ent a

nd th

e cli

ent’s

fa

mily

mem

bers

to:

• Id

entif

y dy

nam

ics th

at h

elp

or h

inde

r th

e de

velo

pmen

t of b

alanc

ed, h

ealth

y re

latio

nshi

ps

• As

sess

the

need

s of

all a

nd fa

ctor

them

in

to tr

eatm

ent p

lans

for t

he c

lient

and

, wh

en a

ppro

priat

e, th

e cli

ent’s

fam

ily

• W

orks

with

the

clien

t’s fa

mily

mem

bers

to

facil

itate

:•

Thei

r und

erst

andi

ng o

f the

impa

cts

that

su

bsta

nce

use

or c

oncu

rrent

diso

rder

s ar

e lik

ely

to h

ave

on th

e cli

ent a

nd th

em•

Thei

r und

erst

andi

ng o

f the

nee

d to

take

ca

re o

f the

mse

lves

• Th

eir a

bility

to a

cces

s se

rvice

s th

ey

need

, ref

errin

g th

em to

oth

er re

sour

ces,

as re

quire

d

• As

sess

es c

lient

s wi

th c

hild

ren

or o

ther

de

pend

ents

to id

entif

y ris

ks to

the

safe

ty a

nd

well-

bein

g of

thos

e de

pend

ents,

and

whe

n as

sess

ed ri

sks

are

high

, tak

es a

ppro

priat

e ne

xt s

teps

, suc

h as

con

tact

ing

the

Child

ren’

s Ai

d So

ciety,

sub

ject

to p

roto

cols

that

gov

ern

confi

dent

iality

• W

orks

with

the

clien

t to

iden

tify

and

impl

emen

t act

ions

that

will

lead

to

impr

oved

fam

ily re

latio

nshi

ps

• As

sess

es th

e he

alth

of th

e fa

mily

as

a sy

stem

and

wor

ks w

ith th

e fa

mily

to

incr

ease

its

cohe

sion

and

build

su

ppor

t for

clie

nt e

fforts

to d

evel

op

and

impl

emen

t an

effe

ctive

trea

tmen

t pl

an

• Pr

ovid

es c

oupl

e an

d fa

mily

ther

apy

for t

hose

affe

cted

by

prob

lem

ga

mbl

ing

• As

sists

in s

tabi

lizin

g co

uple

s an

d fa

milie

s af

fect

ed b

y pr

oble

m

gam

blin

g, in

cludi

ng p

rovid

ing

prob

lem

gam

blin

g in

form

atio

n an

d he

lpin

g re

-est

ablis

h tru

st

• W

orks

with

the

clien

t and

the

clien

t’s

fam

ily to

:•

Scre

en a

nd a

sses

ses

the

clien

t’s fa

mily

to id

entif

y ris

ks

relat

ed to

sub

stan

ce u

se o

r co

ncur

rent

diso

rder

s•

Deve

lop

treat

men

t plan

s fo

r fa

mily

mem

bers

as

requ

ired,

in

cludi

ng c

onsu

ltatio

ns a

nd

refe

rrals

when

app

ropr

iate

• W

orks

with

clie

nts

to d

evel

op a

dee

per

unde

rsta

ndin

g of

the

fam

ily a

s a

syst

em,

and

to id

entif

y ch

ange

s th

at c

ould

be

mad

e to

impr

ove

the

well-

bein

g of

the

fam

ily a

nd e

ach

fam

ily m

embe

r

• Co

nduc

ts in

terv

entio

ns in

com

plex

sit

uatio

ns in

whi

ch m

ultip

le fa

ctor

s or

ris

ks a

re lik

ely

to h

ave

an im

pact

on

one

anot

her

• Su

perv

ises

or c

oach

es o

ther

s:•

In th

e de

velo

pmen

t and

app

licat

ion

of e

viden

ce-in

form

ed fa

mily

in

terv

entio

ns•

Wor

king

with

com

plex

cha

lleng

es

with

a c

lient

’s fa

mily

• Pr

omot

es th

e va

lue

of fa

mily

wel

lnes

s

EXAMPLES


FAMILY AND SOCIAL SUPPORT

VII–17


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYGROUP FACILITATION

GR

OU

P F

AC

ILIT

AT

ION

: Usi

ng e

vide

nce-

info

rmed

app

roac

hes

to w

ork

effe

ctiv

ely

with

sub

stan

ceus

e an

d co

ncur

rent

dis

orde

rs c

lient

s in

gro

up s

ettin

gs.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s th

e ro

le o

f gro

up in

terv

entio

n ap

proa

ches

in w

orkin

g wi

th c

lient

s

• Su

ppor

ts m

ore

seni

or p

rofe

ssio

nals,

as

requ

ired

• Ob

serv

es g

roup

s se

ssio

ns a

nd c

onsu

lts

the

lead

abo

ut p

erce

ptio

ns o

f gro

up

dyna

mics

• In

tera

cts

with

clie

nts

in th

e gr

oup

unde

r clo

se s

uper

visio

n by

the

lead

facil

itato

r

• Ex

plain

s be

havio

urs

that

lead

to p

ositiv

e ch

ange

and

thos

e th

at im

pede

cha

nge

• Ex

plain

s th

e pr

imar

y ch

arac

teris

tics

of a

ra

nge

of g

roup

facil

itatio

n ap

proa

ches

• Le

ads

info

rmat

ion

sess

ions

or s

imila

r ps

ycho

-edu

catio

nal g

roup

s, co

nsul

ting

and

debr

iefin

g wi

th m

ore

seni

or

colle

ague

s

• Sc

reen

s an

d as

sess

es g

roup

mem

bers

fo

r sui

tabi

lity a

nd c

ompa

tibilit

y, co

nsul

ting

with

mor

e se

nior

col

leag

ues

• Pl

ans

and

sets

up

grou

p ro

oms

and

seat

ing

arra

ngem

ents

that

enc

oura

ge

easy

acc

ess

and

posit

ive g

roup

in

tera

ctio

ns

• En

cour

ages

the

deve

lopm

ent o

f hea

lthy

socia

l skil

ls in

all g

roup

mem

bers

• En

gage

s wi

th g

roup

clie

nts

and

deve

lops

ra

ppor

t by

usin

g a

rang

e of

facil

itativ

e te

chni

ques

• En

cour

ages

and

mod

els

healt

hy g

roup

dy

nam

ics

• Ad

just

s fa

cilita

tion

style

and

app

roac

h to

add

ress

clie

nt b

ehav

iour

s lik

ely

to

impe

de g

roup

func

tion

• Fa

cilita

tes

large

r gro

ups

or g

roup

s wi

th

clien

ts w

ith m

ore

com

plex

nee

ds, u

sing

a wi

de ra

nge

of p

roac

tive

appr

oach

es a

nd

tech

niqu

es to

spu

r and

enh

ance

gro

up

prob

lem

sol

ving

and

indi

vidua

l and

gro

up

goal

achi

evem

ent

• De

signs

and

impl

emen

ts s

trate

gies

and

te

chni

ques

to m

eet g

roup

nee

ds

• Co

ntin

uous

ly m

onito

rs a

nd a

sses

ses

grou

p dy

nam

ics to

main

tain

a s

afe,

pr

oduc

tive

envir

onm

ent,

inte

rven

ing

as

nece

ssar

y

• In

terv

enes

dec

isive

ly if

a cr

isis

is de

velo

ping

or e

scala

ting

(e.g

., by

end

ing

the

sess

ion

early

or s

epar

atin

g or

te

mpo

rarily

rem

ovin

g m

embe

rs o

f the

gr

oup)

• As

sess

es a

nd re

confi

gure

s gr

oups

, as

requ

ired,

to im

prov

e gr

oup

func

tioni

ng

and

addr

ess

indi

vidua

l nee

ds

• Fa

cilita

tes

grou

ps u

suall

y fa

cilita

ted

by

anot

her p

erso

n, w

hen

that

facil

itato

r is

unav

ailab

le

• In

nova

tes,

deve

lops

, ada

pts

and

appl

ies

grou

p m

ater

ials

desig

ned

to d

eal w

ith a

ra

nge

of c

ompl

ex s

ituat

ions

, main

tain

ing

an e

viden

ce-in

form

ed a

ppro

ach

• Su

perv

ises

or c

oach

es o

ther

gro

up

facil

itato

rs to

pro

mot

e be

st p

ract

ices,

high

-qua

lity in

terv

entio

ns a

nd a

dher

ence

to

ser

vice

stan

dard

s an

d pr

ogra

m

inte

grity

• Re

sear

ches

and

pro

mot

es n

ew

evid

ence

-info

rmed

app

roac

hes

to g

roup

facil

itatio

n by

exp

laini

ng

and

dem

onst

ratin

g te

chni

ques

and

ap

proa

ches

and

by

shar

ing

reso

urce

s wi

th o

ther

s

EXAMPLES

VII–18


ME

DIC

AT

ION

S: T

he k

now

ledg

e an

d sk

ills re

quire

d to

und

erst

and

and

use

med

icat

ions

in th

e tr

eatm

ent o

f clie

nts

with

sub

stan

ceus

e or

con

curr

ent d

isor

ders

and

to u

nder

stan

d an

d re

spon

d to

the

impa

ct th

at m

edic

atio

ns c

ould

hav

e on

the

clie

nt.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s th

e ty

pe o

f m

edica

tions

that

are

:•

Usef

ul in

trea

ting

subs

tanc

e us

e or

co

ncur

rent

diso

rder

s•

Used

to a

ddre

ss m

ood,

beh

avio

ur

and

cogn

itive

proc

esse

s•

Freq

uent

ly us

ed to

trea

t pain

• M

ost p

rone

to o

veru

se o

r abu

se

• Us

ed to

trea

t rel

ated

con

ditio

ns,

like

hepa

titis

• Ex

plain

s th

e sig

ns a

nd s

ympt

oms

of

adve

rse

drug

reac

tions

, and

con

sults

wi

th m

ore

seni

or p

rofe

ssio

nals

if ad

vers

e re

actio

ns a

re s

uspe

cted

• Ex

plain

s th

e co

mm

on e

ffect

s of

ove

r-th

e-co

unte

r pro

duct

s an

d th

e po

tent

ial

impa

cts

of u

sing

them

inco

rrect

ly

• M

onito

rs c

lient

s fo

r sig

ns o

f inc

orre

ct u

se

of m

edica

tion,

and

con

sults

with

mor

e se

nior

pro

fess

iona

ls if

inco

rrect

usa

ge is

su

spec

ted

• Ex

plain

s pr

escr

iptio

n ta

ke-b

ack

initia

tives

• Ex

plain

s th

e wa

y th

at d

rugs

that

alte

r moo

d,

beha

viour

and

cog

nitiv

e pr

oces

ses

are:

• Ca

tego

rized

or c

lasse

d (e

.g.,

stim

ulan

t, se

dativ

e) a

nd c

ites

the

prop

er a

nd th

e st

reet

nam

es fo

r key

dru

gs w

ithin

thos

e ca

tego

ries

or c

lasse

s•

Adm

inist

ered

• Li

kely

to a

ffect

a c

lient

and

the

impa

ct

they

are

likel

y to

hav

e on

a c

lient

if

com

bine

d wi

th o

ther

sub

stan

ces,

inclu

ding

alco

hol,

or if

use

of t

he d

rug

is st

oppe

d•

Misu

sed

and

what

the

impa

ct o

f misu

se

is lik

ely

to b

e

• Re

views

rese

arch

info

rmat

ion

abou

t m

edica

tions

, suc

h as

met

hado

ne o

r bu

pren

orph

ine,

that

are

use

d in

trea

ting

subs

tanc

e us

e an

d co

ncur

rent

diso

rder

s

• Co

nsul

ts w

ith p

rofe

ssio

nals

pres

crib

ing

med

icatio

ns w

hen

nece

ssar

y

• Di

scus

ses

with

clie

nts

thei

r rig

ht to

use

or n

ot

use

med

icatio

ns

• Su

ppor

ts c

lient

acc

ess

to p

resc

ribed

m

edica

tions

whe

re b

arrie

rs a

re p

rese

nt

• Ex

plain

s wi

th a

ccur

acy

and

deta

il ho

w m

edica

tions

that

affe

ct m

ood,

be

havio

ur a

nd c

ogni

tive

proc

esse

s:•

Affe

ct th

e wa

y th

at c

lient

s, in

cludi

ng th

ose

in w

ithdr

awal,

fu

nctio

n•

Can

have

diff

eren

t im

pact

s de

pend

ing

on h

ow th

ey a

re

adm

inist

ered

• Ca

n ha

ve a

n im

pact

on

clien

ts,

if ta

ken

alone

or i

f tak

en

in c

ombi

natio

n wi

th o

ther

su

bsta

nces

, inc

ludi

ng a

lcoho

l

• Id

entifi

es c

lient

s wh

o co

uld

pote

ntial

ly be

nefit

from

aug

men

ting

othe

r tre

atm

ent a

ppro

ache

s wi

th

med

icatio

ns a

nd c

ollab

orat

es w

ith

clien

ts a

nd m

edica

l pro

fess

iona

ls to

:•

Inco

rpor

ate

med

icatio

ns in

to

clien

ts’ t

reat

men

t plan

s, if

appr

opria

te•

Mon

itor t

he im

pact

of

pres

crib

ed m

edica

tions

• As

sess

es c

lient

s, in

cludi

ng th

ose

refe

rred

by le

ss-e

xper

ienc

ed

prof

essio

nals,

to id

entif

y sy

mpt

oms

of a

dver

se re

actio

ns to

the

use

or a

buse

of m

edica

tions

and

in

itiate

s co

nsul

tatio

n wi

th m

edica

l pr

ofes

siona

ls or

em

erge

ncy

med

ical

serv

ices,

as re

quire

d

• Pr

ovid

es m

ost c

urre

nt e

viden

ce

and

info

rmat

ion

abou

t ava

ilabl

e ph

arm

acot

hera

py fo

r sm

okin

g ce

ssat

ion

in C

anad

a

• Ex

plain

s be

nefit

s of

usin

g ph

arm

acot

hera

py, i

ts s

ide

effe

cts

and

how

to m

anag

e th

em, c

ontra

-in

dica

tions

and

leng

th o

f use

• Ap

plie

s co

mpr

ehen

sive

know

ledg

e ab

out t

he u

se o

f med

icatio

ns in

tre

atin

g su

bsta

nce

use

and

conc

urre

nt

diso

rder

s in

:•

Wor

king

with

clie

nts

• Su

perv

ising

or c

oach

ing

othe

rs•

Over

seei

ng o

r rev

iewi

ng tr

eatm

ent

plan

s•

Colla

bora

ting

and

netw

orkin

g•

Advo

catin

g fo

r bes

t pra

ctice

s

• Bu

ilds

and

main

tain

s a

netw

ork

of

quali

fied

reso

urce

s sk

illed

in th

e ar

ea o

f ph

arm

acol

ogica

l inte

rven

tions

• Ed

ucat

es o

r arra

nges

for p

rofe

ssio

nal

deve

lopm

ent o

f oth

ers

on th

e ty

pes

of

med

icatio

ns th

at m

itigat

e or

agg

rava

te

prob

lem

s re

lated

to s

ubst

ance

use

• In

itiate

s, fa

cilita

tes

or le

ads

the

deve

lopm

ent a

nd im

plem

enta

tion

of e

viden

ce-in

form

ed p

ract

ices

and

polic

ies

that

sup

port

the

inno

vativ

e us

e of

med

icatio

ns in

trea

ting

subs

tanc

e us

e an

d co

ncur

rent

diso

rder

s

EXAMPLES


MEDICATIONS

VII–19


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYOUTREACH

OU

TR

EA

CH

: Des

igni

ng a

nd d

eliv

erin

g su

bsta

nce

use

and

conc

urre

nt d

isor

ders

ser

vice

s in

the

com

mun

ityto

a b

road

ran

ge o

f clie

nts,

incl

udin

g th

ose

who

mig

ht o

ther

wis

e no

t see

k or

hav

e ac

cess

to th

ose

serv

ices

.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s:

• W

hat o

utre

ach

is an

d th

e ro

le

it pl

ays

in p

reve

ntio

n, e

arly

inte

rven

tion

and

treat

men

t•

The

type

and

rang

e of

out

reac

h ac

tivitie

s•

Wha

t is

mea

nt b

y “m

argi

naliz

ed

popu

latio

ns,”

wher

e th

ose

popu

latio

ns a

re lik

ely

to b

e fo

und

loca

lly a

nd h

ow th

ey a

re s

erve

d•

The

type

of s

ubst

ance

use

iss

ues

typi

cally

see

n in

var

ious

po

pulat

ions

, inc

ludi

ng th

ose

mar

gina

lized

, stig

mat

ized

or

othe

rwise

und

erse

rved

• Pr

ovid

es a

dmin

istra

tive

or o

ther

sup

port

to o

utre

ach

work

ers

and

mul

ti-di

scip

linar

y te

ams

• M

ainta

ins

cont

act w

ith re

pres

enta

tives

fro

m c

omm

unity

ser

vices

• Ad

here

s to

evid

ence

-info

rmed

pra

ctice

s in

del

iverin

g or

ass

istin

g in

the

deliv

ery

of

a ra

nge

of s

ubst

ance

use

ser

vices

, ofte

n as

par

t of a

mul

ti-di

scip

linar

y te

am

• Cr

eate

s ra

ppor

t with

pot

entia

l and

ex

istin

g ou

treac

h cli

ents

by

inte

ract

ing

with

them

in th

eir p

refe

rred

setti

ng a

nd

actin

g in

a m

anne

r app

ropr

iate

to th

at

setti

ng

• In

tera

cts

with

out

reac

h co

ntac

ts w

ith

sens

itivity

to a

void

trig

gerin

g ne

gativ

e or

po

tent

ially

dang

erou

s re

spon

ses

• Co

llabo

rate

s wi

th e

ach

outre

ach

clien

t to

iden

tify

indi

vidua

l nee

ds a

nd a

sses

ses

the

outre

ach

popu

latio

n ov

erall

to h

elp

iden

tify

gene

ral n

eeds

• At

tend

s to

the

safe

ty o

f all p

artie

s in

volve

d in

out

reac

h, w

hen

plan

ning

and

de

liver

ing

outre

ach

serv

ices

• En

gage

s wi

th o

ther

s in

the

com

mun

ity to

:•

Deve

lop

a th

orou

gh u

nder

stan

ding

of

loca

l out

reac

h ne

eds

and

gaps

in

ser

vices

• De

velo

p an

d de

liver

out

reac

h ac

tivitie

s ali

gned

with

bes

t pr

actic

es a

nd a

ppro

priat

e to

targ

et

popu

latio

ns

• Pa

rticip

ates

in e

valu

atin

g ou

treac

h se

rvice

s, in

cludi

ng th

ose

prov

ided

by

the

prof

essio

nal’s

org

aniza

tion

and

thos

e pr

ovid

ed b

y ot

hers

in th

e co

mm

unity

• Ev

aluat

es th

e ou

tcom

e of

a c

lient

refe

rral

to a

com

mun

ity re

sour

ce a

nd b

rings

re

lated

issu

es to

the

atte

ntio

n of

mor

e se

nior

pro

fess

iona

ls, if

app

ropr

iate

• Id

entifi

es b

arrie

rs to

acc

essin

g cli

ent

serv

ices

and

supp

orts,

and

take

s ac

tion

to re

duce

thos

e ba

rrier

s

• Pr

omot

es, s

uppo

rts a

nd e

nhan

ces

a va

riety

of o

utre

ach

serv

ices

in th

e co

mm

unity

, adh

erin

g to

sta

ndar

ds a

nd

best

pra

ctice

s

• M

obiliz

es m

ulti-

disc

iplin

ary

team

s co

mpo

sed

of s

ubst

ance

use

pr

ofes

siona

ls, c

omm

unity

-bas

ed

reso

urce

s an

d ot

her r

elat

ed

prof

essio

nals,

as

requ

ired

• Re

views

eva

luat

ions

of r

efer

ral o

utco

mes

an

d, if

app

ropr

iate,

pro

vides

feed

back

to

orga

niza

tions

or p

rofe

ssio

nals

• Co

nduc

ts re

sear

ch a

nd c

ollab

orat

es

with

oth

ers

to id

entif

y ou

treac

h se

rvice

ga

ps a

nd w

ays

of b

ridgi

ng th

ose

gaps

to

prov

ide

mor

e co

mpr

ehen

sive

outre

ach

serv

ices

• Co

llabo

rate

s wi

th a

nd s

omet

imes

lead

s a

rang

e of

com

mun

ity o

rgan

izatio

ns to

de

velo

p ou

treac

h pr

ogra

ms

that

bui

ld

on c

omm

unity

stre

ngth

s an

d ad

dres

s co

mm

unity

nee

ds

EXAMPLES

VII–20


PR

EV

EN

TIO

N A

ND

HE

ALT

H P

RO

MO

TIO

N: E

ngag

ing

with

sub

stan

ce u

se a

nd c

oncu

rren

t dis

orde

rs c

lient

s, th

eir

fam

ilies

and

thei

r co

mm

uniti

es to

enc

oura

ge th

e ad

optio

n of

kno

wle

dge,

beh

avio

urs,

val

ues

and

attit

udes

that

pro

mot

e pe

rson

al a

nd c

omm

unity

wel

l-bei

ng.

Not

e th

at t

hro

ug

hou

t th

is c

omp

eten

cy t

he

term

pre

ven

tion

sh

ould

be

inte

rpre

ted

to

mea

n p

reve

nti

on o

f su

bst

ance

use

.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s im

porta

nt

conc

epts

in p

reve

ntio

n an

d he

alth

prom

otio

n, s

uch

as:

• Th

e ke

y so

cial d

eter

min

ants

of

healt

h•

The

cont

inuu

m o

f pre

vent

ion

inte

rven

tions

from

prim

ary

prev

entio

n to

har

m re

duct

ion

• Th

e fa

ctor

s th

at c

an e

ither

redu

ce

or in

crea

se th

e ris

k of

sub

stan

ce

use

or c

oncu

rrent

diso

rder

s•

The

role

of p

reve

ntio

n ou

treac

h se

rvice

s as

par

t of a

n ef

fect

ive

prev

entio

n an

d he

alth

prom

otio

n st

rate

gy•

That

pre

vent

ion

and

healt

h pr

omot

ion

effo

rts m

ust b

e ta

ilore

d to

the

cultu

re, c

onte

xt a

nd n

eeds

of

targ

et p

opul

atio

ns

• As

sists

in th

e de

liver

y of

a ra

nge

of

prev

entio

n pr

ogra

ms

and

in c

oord

inat

ing

com

mun

icatio

n be

twee

n all

invo

lved

parti

es

• Co

urte

ously

eng

ages

with

, enc

oura

ges

and

resp

onds

to c

lient

s an

d co

mm

unity

m

embe

rs

• En

gage

s wi

th c

lient

s an

d th

eir

fam

ilies

usin

g ve

rbal

and

non-

verb

al co

mm

unica

tion

to c

onve

y co

nfide

nce

in

thei

r abi

lities

to re

duce

or e

limin

ate

the

nega

tive

impa

ct o

f sub

stan

ce a

buse

or

conc

urre

nt d

isord

ers

• Ex

plain

s be

st p

ract

ices

in p

reve

ntio

n an

d he

alth

prom

otio

n, a

nd a

pplie

s th

at u

nder

stan

ding

wh

en e

ngag

ing

with

the

com

mun

ity, c

lient

s an

d

clien

ts’ f

amilie

s

• Pa

rticip

ates

in d

evel

opin

g an

d de

liver

ing

prev

entio

n an

d he

alth

prom

otio

n ac

tivitie

s, wo

rkin

g alo

ne, w

ith o

rgan

izatio

nal t

eam

s an

d in

co

llabo

ratio

n wi

th p

artn

ers

in th

e co

mm

unity

• De

liver

s or

ass

ists

in th

e de

liver

y of

sta

ndar

dize

d pu

blic

educ

atio

n pr

ogra

ms

to g

ener

al po

pulat

ions

like

scho

ols

and

com

mun

ity g

roup

s

• De

liver

s or

ass

ists

in th

e de

liver

y of

cus

tom

ized

prog

ram

s ta

ilore

d to

the

need

s of

spe

cific

targ

et

popu

latio

ns

• St

udie

s th

e ev

iden

ce o

n pr

even

tion

and

healt

h pr

omot

ion

and

enga

ges

with

clie

nts

and

subj

ect

mat

ter e

xper

ts to

bet

ter u

nder

stan

d th

e im

pact

pr

even

tion

and

healt

h pr

omot

ion

prog

ram

s ha

ve

on d

iffer

ent c

ultu

res

and

in d

iffer

ent c

onte

xts,

and

appl

ies

that

und

erst

andi

ng in

ser

vice

and

prod

uct d

evel

opm

ent a

nd d

elive

ry e

fforts

• Sh

ares

idea

s an

d in

form

atio

n an

d ex

plain

s ho

w an

d wh

y sp

ecific

task

s co

ntrib

ute

to th

e co

mm

unity

’s pr

even

tion

and

healt

h pr

omot

ion

capa

city

• Pr

omot

es a

ware

ness

of t

he lin

kage

bet

ween

so

me

recr

eatio

nal v

enue

s lik

e ca

sinos

or b

ars

and

subs

tanc

e us

e, d

urin

g in

tera

ctio

ns w

ith

clien

ts a

nd th

e co

mm

unity

• Pr

omot

es a

sen

se o

f com

mun

ity o

wner

ship

and

in

volve

men

t by:

• He

lpin

g to

bui

ld c

omm

unity

con

nect

ions

• He

lpin

g en

hanc

e th

e re

silie

nce

of a

ll co

mm

unity

mem

bers

• Ad

voca

ting

for a

nd e

duca

ting

othe

rs o

n he

althy

pub

lic p

olicy

• Co

llabo

rate

s wi

th a

rang

e of

sta

keho

lder

s to

id

entif

y an

d as

sign

prio

ritie

s to

com

mun

ity n

eeds

an

d re

quire

d re

sour

ces

relat

ed to

pre

vent

ion

and

healt

h pr

omot

ion

• M

onito

rs re

sear

ch re

lated

to p

reve

ntio

n an

d he

alth

prom

otio

n an

d ap

plie

s re

leva

nt fi

ndin

gs in

all

act

ivitie

s in

cludi

ng in

tera

ctio

ns w

ith c

lient

s an

d co

mm

unity

mem

bers

• De

velo

ps a

nd d

elive

rs a

rang

e of

co

mpl

ex in

terv

entio

ns, p

rogr

ams

and

serv

ices

info

rmed

by

an in

-dep

th

know

ledg

e of

rele

vant

pre

vent

ion

and

healt

h pr

omot

ion

tech

niqu

es a

nd

appr

oach

es

• M

anag

es u

nusu

al or

diffi

cult

situa

tions

whe

n de

liver

ing

prog

ram

s in

the

com

mun

ity w

ith a

t-risk

po

pulat

ions

• M

obiliz

es a

nd s

uppo

rts c

omm

unity

m

embe

r inv

olve

men

t in

prev

entio

n an

d he

alth

prom

otio

n ac

tivitie

s th

at

addr

ess

key

dete

rmin

ants

of h

ealth

, le

vera

ging

com

mun

ity s

treng

ths

and

reso

urce

s in

the

proc

ess

• Ga

uges

the

leve

l of c

omm

unity

co

mm

itmen

t and

abi

lity a

nd s

hifts

fro

m a

lead

ersh

ip to

a s

uppo

rt ro

le a

s ot

hers

ass

ume

mor

e re

spon

sibilit

y

• Pa

rticip

ates

with

com

mun

ity

mem

bers

in e

valu

atin

g pr

even

tion

and

healt

h pr

omot

ion

activ

ities

• Ad

voca

tes

on b

ehalf

of t

he

com

mun

ity, a

s a

whol

e, fo

r su

stain

able

pre

vent

ion

and

healt

h pr

omot

ion

serv

ices

tailo

red

to

com

mun

ity n

eeds

• Ad

voca

tes

for p

reve

ntio

n an

d he

alth

prom

otio

n se

rvice

s, us

ing

evalu

atio

n da

ta a

nd o

ther

evid

ence

-info

rmed

fin

ding

s

• Su

perv

ises

or c

oach

es o

ther

s in

de

velo

ping

, im

plem

entin

g an

d ev

aluat

ing

evid

ence

-info

rmed

pre

vent

ion

and

healt

h pr

omot

ion

initia

tives

• Ov

erse

es a

nd m

anag

es a

rang

e of

pr

even

tion

and

healt

h pr

omot

ion-

focu

sed

initia

tives

that

are

bas

ed o

n be

st

prac

tices

and

that

add

ress

sus

tain

abilit

y, an

d cu

ltura

l and

con

text

ual r

elev

ance

, an

d in

clude

ben

chm

arks

for e

valu

atio

n pu

rpos

es

• In

corp

orat

es re

leva

nt re

sear

ch fi

ndin

gs

and

know

ledg

e of

soc

ial d

eter

min

ants

of

healt

h an

d ris

k an

d pr

otec

tive

fact

ors

in

prog

ram

plan

ning

• In

itiate

s, fa

cilita

tes,

lead

s or

con

duct

s an

alysis

and

eva

luat

ion

of c

omm

unity

pr

ogra

ms

and

serv

ices

to m

easu

re

effe

ctive

ness

, ide

ntify

gap

s in

ser

vice

and

prio

ritize

nee

ds

• Fa

cilita

tes

the

deve

lopm

ent a

nd

main

tena

nce

of m

ulti-

disc

iplin

ary

colla

bora

tions

that

:•

Supp

ort h

ealth

y fa

milie

s an

d co

mm

unitie

s•

De-s

tigm

atize

mar

gina

lized

po

pulat

ions

• En

hanc

e pu

blic

polic

y an

d pr

ogra

m d

esig

n

• Co

llabo

rate

s on

, lea

ds o

r con

tribu

tes

to

the

desig

n an

d de

liver

y of

cus

tom

ized

prog

ram

s in

com

plex

, sen

sitive

situ

atio

ns

that

call

for a

hig

h de

gree

of m

ulti-

disc

iplin

ary

invo

lvem

ent

EXAMPLES


PREVENTION AND HEALTH PROMOTION

VII–21


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYPROGRAM DEVELOPMENT, IMPLEMENTATION AND EVALUATION

PR

OG

RA

M D

EV

ELO

PM

EN

T, IM

PLE

ME

NTA

TIO

N A

ND

EVA

LUA

TIO

N: D

evel

opin

g an

d im

plem

entin

g ne

w s

ubst

ance

use

pro

gram

s,

mod

ifyin

g ex

istin

g pr

ogra

ms

to re

spon

d to

iden

tified

nee

ds a

nd e

valu

atin

g th

e ou

tcom

es o

f new

or

revi

sed

prog

ram

s.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s wh

at is

m

eant

by

need

s as

sess

men

t, pr

ogra

m

deve

lopm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Ex

plain

s in

gen

eral

term

s th

e ra

tiona

le fo

r ea

ch o

f the

se fo

ur c

ompo

nent

s an

d th

e re

latio

nshi

p am

ong

them

• Su

ppor

ts o

ther

s in

thei

r nee

ds

asse

ssm

ent,

prog

ram

dev

elop

men

t, im

plem

enta

tion

and

evalu

atio

n ef

forts

• Ga

ther

s in

form

atio

n or

ass

ists

in

info

rmat

ion

gath

erin

g fo

r rep

orts

and

re

sear

ch, i

nclu

ding

eva

luat

ion,

by:

• Or

derin

g or

com

pilin

g da

ta b

ase

repo

rts•

Cond

uctin

g te

leph

one

surv

eys

• En

terin

g or

man

ipul

atin

g su

rvey

da

ta

• Ex

plain

s ho

w re

leva

nt p

olici

es, e

viden

ce,

fram

ewor

ks a

nd th

eorie

s ap

ply

to

prog

ram

dev

elop

men

t

• Ex

plain

s th

e ph

ases

or s

tage

s of

nee

ds

asse

ssm

ent,

prog

ram

dev

elop

men

t, im

plem

enta

tion

and

evalu

atio

n; th

e go

als

and

outp

uts

for e

ach

phas

e; a

nd th

e ac

tivitie

s lik

ely

to b

e co

nduc

ted

as p

art o

f ea

ch p

hase

• As

sists

sen

ior c

olle

ague

s in

dev

elop

ing

data

col

lect

ions

tool

s fo

r eva

luat

ion

and

othe

r res

earc

h pu

rpos

es

• Co

nduc

ts s

uper

vised

rese

arch

for

evalu

atio

n of

fund

ing

prop

osals

by:

• He

lpin

g to

dev

elop

logi

c m

odel

s or

do

cum

ent p

roce

dure

s •

Repo

rting

on

focu

s gr

oups

• Re

com

men

ding

how

to a

pply

rele

vant

pol

icies

(e.g

., on

co

nfide

ntial

ity) t

o re

sear

ch b

eing

co

nduc

ted

• As

sess

es th

e m

agni

tude

and

nat

ure

of th

e iss

ues,

inclu

ding

dist

ribut

ion

of

risk

fact

ors,

when

con

duct

ing

need

s as

sess

men

ts

• In

itiate

s ev

aluat

ion

plan

ning

ear

ly in

a

prog

ram

’s life

cyc

le, c

ontin

uous

ly m

onito

rs p

rogr

ess

and

mak

es n

otes

to

ensu

re th

ose

insig

hts

are

reta

ined

• Co

llabo

rate

s wi

th c

lient

s to

ens

ure

evalu

atio

n pl

ans

inclu

de is

sues

that

are

im

porta

nt to

them

• Pa

rticip

ates

in a

sses

smen

ts a

nd

deve

lopi

ng, i

mpl

emen

ting

or e

valu

atin

g lar

ge o

r com

plex

pro

gram

s, or

lead

s su

ch e

fforts

for s

mall

er o

r les

s co

mpl

ex

prog

ram

s

• Pl

ans

and

cond

ucts

eva

luat

ions

usin

g va

rious

met

hodo

logi

es (e

.g.,

inte

rvie

ws,

surv

eys

and

focu

s gr

oups

)

• Id

entifi

es th

e re

sour

ces

requ

ired

to

deve

lop,

impl

emen

t or e

valu

ate

a pr

ogra

m a

nd m

obiliz

es th

ose

reso

urce

s, as

app

ropr

iate

• De

velo

ps d

ata-

colle

ctio

n to

ols

like

inte

rvie

w gu

ides

and

sur

veys

, and

use

s th

ose

tool

s to

gat

her i

nfor

mat

ion

• Re

sear

ches

and

dev

elop

s sp

ecific

fu

ndin

g pr

opos

als

• Ap

plie

s re

leva

nt p

olici

es, s

uch

as th

ose

that

gov

ern

priva

cy a

nd c

onfid

entia

lity,

and

rele

vant

theo

ries

or re

sear

ch to

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

proj

ects

• An

alyze

s or

par

ticip

ates

in th

e an

alysis

of

prog

ram

eva

luat

ion

findi

ngs

• Sh

ares

eva

luat

ion

findi

ngs

with

oth

ers

and

prom

otes

on-

goin

g kn

owle

dge

exch

ange

abo

ut p

rogr

am d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Co

nduc

ts c

ompl

ex p

rogr

am

need

s as

sess

men

ts, d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

proj

ects

or

lead

s in

tern

al te

ams

char

ged

with

su

ch p

roje

cts

• Co

llabo

rate

s wi

th a

nd s

omet

imes

lead

s m

ulti-

disc

iplin

ary

team

s de

signi

ng,

impl

emen

ting

or e

valu

atin

g cu

stom

ized

prog

ram

s

• Su

perv

ises

or c

oach

es o

ther

s in

volve

d in

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• W

rites

fina

l rep

orts

in a

ccor

danc

e wi

th

evid

ence

-info

rmed

sta

ndar

ds

• Re

views

fund

ing

prop

osals

and

cle

arly

conv

eys

revie

w de

cisio

ns

• In

itiate

s or

con

duct

s re

sear

ch:

• On

tren

ds in

pro

gram

de

velo

pmen

t, im

plem

enta

tion

and

evalu

atio

n•

To s

uppo

rt th

e de

velo

pmen

t of

fund

ing

prop

osals

• Cr

eativ

ely

appl

ies

new

lear

ning

to re

flect

ev

iden

ce-in

form

ed a

ppro

ache

s to

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Es

tabl

ishes

and

main

tain

s po

sitive

an

d pr

ofes

siona

l com

mun

icatio

ns

with

fund

ing

orga

niza

tions

to m

ainta

in

awar

enes

s of

upc

omin

g in

itiativ

es

• In

itiate

s kn

owle

dge

exch

ange

op

portu

nitie

s to

leve

rage

and

roll-

up

mul

ti-di

scip

linar

y fin

ding

s

EXAMPLES

VII–22


EXAMPLES

PR

OG

RA

M D

EV

ELO

PM

EN

T, IM

PLE

ME

NTA

TIO

N A

ND

EVA

LUA

TIO

N: D

evel

opin

g an

d im

plem

entin

g ne

w s

ubst

ance

use

pro

gram

s,

mod

ifyin

g ex

istin

g pr

ogra

ms

to re

spon

d to

iden

tified

nee

ds a

nd e

valu

atin

g th

e ou

tcom

es o

f new

or

revi

sed

prog

ram

s.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s wh

at is

m

eant

by

need

s as

sess

men

t, pr

ogra

m

deve

lopm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Ex

plain

s in

gen

eral

term

s th

e ra

tiona

le fo

r ea

ch o

f the

se fo

ur c

ompo

nent

s an

d th

e re

latio

nshi

p am

ong

them

• Su

ppor

ts o

ther

s in

thei

r nee

ds

asse

ssm

ent,

prog

ram

dev

elop

men

t, im

plem

enta

tion

and

evalu

atio

n ef

forts

• Ga

ther

s in

form

atio

n or

ass

ists

in

info

rmat

ion

gath

erin

g fo

r rep

orts

and

re

sear

ch, i

nclu

ding

eva

luat

ion,

by:

• Or

derin

g or

com

pilin

g da

ta b

ase

repo

rts•

Cond

uctin

g te

leph

one

surv

eys

• En

terin

g or

man

ipul

atin

g su

rvey

da

ta

• Ex

plain

s ho

w re

leva

nt p

olici

es, e

viden

ce,

fram

ewor

ks a

nd th

eorie

s ap

ply

to

prog

ram

dev

elop

men

t

• Ex

plain

s th

e ph

ases

or s

tage

s of

nee

ds

asse

ssm

ent,

prog

ram

dev

elop

men

t, im

plem

enta

tion

and

evalu

atio

n; th

e go

als

and

outp

uts

for e

ach

phas

e; a

nd th

e ac

tivitie

s lik

ely

to b

e co

nduc

ted

as p

art o

f ea

ch p

hase

• As

sists

sen

ior c

olle

ague

s in

dev

elop

ing

data

col

lect

ions

tool

s fo

r eva

luat

ion

and

othe

r res

earc

h pu

rpos

es

• Co

nduc

ts s

uper

vised

rese

arch

for

evalu

atio

n of

fund

ing

prop

osals

by:

• He

lpin

g to

dev

elop

logi

c m

odel

s or

do

cum

ent p

roce

dure

s •

Repo

rting

on

focu

s gr

oups

• Re

com

men

ding

how

to a

pply

rele

vant

pol

icies

(e.g

., on

co

nfide

ntial

ity) t

o re

sear

ch b

eing

co

nduc

ted

• As

sess

es th

e m

agni

tude

and

nat

ure

of th

e iss

ues,

inclu

ding

dist

ribut

ion

of

risk

fact

ors,

when

con

duct

ing

need

s as

sess

men

ts

• In

itiate

s ev

aluat

ion

plan

ning

ear

ly in

a

prog

ram

’s life

cyc

le, c

ontin

uous

ly m

onito

rs p

rogr

ess

and

mak

es n

otes

to

ensu

re th

ose

insig

hts

are

reta

ined

• Co

llabo

rate

s wi

th c

lient

s to

ens

ure

evalu

atio

n pl

ans

inclu

de is

sues

that

are

im

porta

nt to

them

• Pa

rticip

ates

in a

sses

smen

ts a

nd

deve

lopi

ng, i

mpl

emen

ting

or e

valu

atin

g lar

ge o

r com

plex

pro

gram

s, or

lead

s su

ch e

fforts

for s

mall

er o

r les

s co

mpl

ex

prog

ram

s

• Pl

ans

and

cond

ucts

eva

luat

ions

usin

g va

rious

met

hodo

logi

es (e

.g.,

inte

rvie

ws,

surv

eys

and

focu

s gr

oups

)

• Id

entifi

es th

e re

sour

ces

requ

ired

to

deve

lop,

impl

emen

t or e

valu

ate

a pr

ogra

m a

nd m

obiliz

es th

ose

reso

urce

s, as

app

ropr

iate

• De

velo

ps d

ata-

colle

ctio

n to

ols

like

inte

rvie

w gu

ides

and

sur

veys

, and

use

s th

ose

tool

s to

gat

her i

nfor

mat

ion

• Re

sear

ches

and

dev

elop

s sp

ecific

fu

ndin

g pr

opos

als

• Ap

plie

s re

leva

nt p

olici

es, s

uch

as th

ose

that

gov

ern

priva

cy a

nd c

onfid

entia

lity,

and

rele

vant

theo

ries

or re

sear

ch to

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

proj

ects

• An

alyze

s or

par

ticip

ates

in th

e an

alysis

of

prog

ram

eva

luat

ion

findi

ngs

• Sh

ares

eva

luat

ion

findi

ngs

with

oth

ers

and

prom

otes

on-

goin

g kn

owle

dge

exch

ange

abo

ut p

rogr

am d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Co

nduc

ts c

ompl

ex p

rogr

am

need

s as

sess

men

ts, d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

proj

ects

or

lead

s in

tern

al te

ams

char

ged

with

su

ch p

roje

cts

• Co

llabo

rate

s wi

th a

nd s

omet

imes

lead

s m

ulti-

disc

iplin

ary

team

s de

signi

ng,

impl

emen

ting

or e

valu

atin

g cu

stom

ized

prog

ram

s

• Su

perv

ises

or c

oach

es o

ther

s in

volve

d in

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• W

rites

fina

l rep

orts

in a

ccor

danc

e wi

th

evid

ence

-info

rmed

sta

ndar

ds

• Re

views

fund

ing

prop

osals

and

cle

arly

conv

eys

revie

w de

cisio

ns

• In

itiate

s or

con

duct

s re

sear

ch:

• On

tren

ds in

pro

gram

de

velo

pmen

t, im

plem

enta

tion

and

evalu

atio

n•

To s

uppo

rt th

e de

velo

pmen

t of

fund

ing

prop

osals

• Cr

eativ

ely

appl

ies

new

lear

ning

to re

flect

ev

iden

ce-in

form

ed a

ppro

ache

s to

pr

ogra

m d

evel

opm

ent,

impl

emen

tatio

n an

d ev

aluat

ion

• Es

tabl

ishes

and

main

tain

s po

sitive

an

d pr

ofes

siona

l com

mun

icatio

ns

with

fund

ing

orga

niza

tions

to m

ainta

in

awar

enes

s of

upc

omin

g in

itiativ

es

• In

itiate

s kn

owle

dge

exch

ange

op

portu

nitie

s to

leve

rage

and

roll-

up

mul

ti-di

scip

linar

y fin

ding

s

RE

CO

RD

KE

EP

ING

AN

D D

OC

UM

EN

TAT

ION

: Cre

atin

g an

d m

aint

aini

ng a

ccur

ate,

up-

to-d

ate,

com

preh

ensi

ve c

lient

reco

rds

able

to w

ithst

and

lega

l scr

utin

y.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• As

sists

in u

pdat

ing

less

sen

sitive

clie

nt

reco

rds

(e.g

., in

take

repo

rts, r

elea

se

form

s, pr

ogre

ss n

otes

)

• Ad

here

s to

all r

equi

rem

ents

and

pr

otoc

ols

abou

t whe

re, w

hen

and

how

clien

t rec

ords

are

to b

e sa

fegu

arde

d

• En

ters,

acc

urat

ely

and

legi

bly,

all

requ

ired

elem

ents

of c

lient

reco

rds

into

in

form

atio

n sy

stem

s in

a ti

mel

y m

anne

r

• Ob

tain

s in

form

ed c

onse

nt fr

om c

lient

s an

d do

cum

enta

tion

requ

ired

for e

xcha

ngin

g in

form

atio

n (e

.g.,

durin

g th

e re

ferra

l pro

cess

)

• Di

scus

ses

the

boun

darie

s of

con

fiden

tiality

wi

th c

lient

s to

ens

ure

they

und

erst

and

the

circu

mst

ance

s in

whi

ch in

form

atio

n wi

ll or w

ill no

t be

shar

ed

• Up

date

s se

nsitiv

e cli

ent r

ecor

ds (e

.g.,

scre

enin

g an

d as

sess

men

t rep

orts,

cou

rt-m

anda

ted

repo

rts)

• Us

es a

ppro

priat

e te

rmin

olog

y an

d ap

prov

ed

abbr

eviat

ions

in c

lient

reco

rds

and

docu

men

tatio

n

• Re

cord

s all

clie

nt a

nd re

lated

pro

fess

iona

l in

tera

ctio

ns in

an

obje

ctive

and

acc

urat

e m

anne

r tha

t refl

ects

org

aniza

tiona

l pro

toco

ls,

esta

blish

ed re

gulat

ory

prac

tices

and

reco

rd

keep

ing

guid

elin

es

• Do

cum

ents

all s

tage

s of

the

treat

men

t pr

oces

s cle

arly,

acc

urat

ely

and

conc

isely,

en

surin

g th

at e

ntrie

s ar

e le

gibl

e if

hand

writt

en

or a

ccur

atel

y ty

ped

and

code

d fo

r ele

ctro

nic

syst

ems

• As

certa

ins

and

conv

eys

to o

ther

s th

e ap

prov

ed a

bbre

viatio

ns fo

r use

in

clien

t rec

ords

• Pr

epar

es d

ischa

rge

sum

mar

ies

• Re

spon

ds to

cas

e-se

nsitiv

e re

ques

ts fo

r rec

ords

from

ext

erna

l or

gani

zatio

ns (e

.g.,

cour

t sub

poen

as

or c

hild

wel

fare

inve

stig

atio

ns)

• M

onito

rs a

nd s

ampl

es a

ll typ

es o

f clie

nt

reco

rds

to e

nsur

e th

at p

ract

ices

adhe

re

to c

onfid

entia

lity, i

nfor

mat

ion-

shar

ing

and

data

pro

tect

ion

requ

irem

ents

and

pr

otoc

ols

• Su

perv

ises

or c

oach

es o

ther

s to

:•

Ensu

re a

dher

ence

to a

ll rel

evan

t re

quire

men

ts a

nd p

roto

cols

• Re

med

y an

y lap

ses

disc

over

ed

thro

ugh

file s

ampl

ing

and

mon

itorin

g

• M

onito

rs re

sear

ch, b

ulle

tins,

news

lette

rs,

jour

nals

and

webs

ites

to k

eep

up-to

-dat

e on

legi

slativ

e ch

ange

s lik

ely

to h

ave

an

impa

ct o

n cli

ent r

ecor

ds

• Re

views

disc

harg

e su

mm

arie

s, as

re

quire

d

• Su

perv

ises

or c

oach

es o

ther

s on

ca

se-s

ensit

ive re

ques

ts fo

r rec

ords

from

ex

tern

al or

gani

zatio

ns

• En

sure

s th

at e

lect

roni

c re

cord

kee

ping

sy

stem

s ar

e se

cure

ly pr

otec

ted

and

back

ed u

p so

that

reco

rds

are

retri

evab

le

in th

e ev

ent o

f com

pute

r cra

shes

, vira

l in

fect

ions

or o

ther

tech

nica

l pro

blem

s

EXAMPLES


RECORD KEEPING AND DOCUMENTATION

VII–23


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYSCREENING AND ASSESSMENT

SC

RE

EN

ING

AN

D A

SS

ES

SM

EN

T: S

elec

ting,

adm

inis

terin

g an

d in

terp

retin

g th

e re

sults

of e

vide

nce-

info

rmed

tool

s an

d m

etho

ds to

mea

sure

a c

lient

’s s

ubst

ance

use

and

rela

ted

conc

erns

, and

info

rm th

e ca

re a

nd tr

eatm

ent p

lan.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s in

gen

eral

term

s th

at:

• Sc

reen

ing

begi

ns th

e pr

oces

s of

id

entif

ying

and

addr

essin

g cli

ent

conc

erns

and

cou

ld le

ad to

furth

er

inve

stig

atio

n or

not

• In

form

atio

n ga

ther

ed d

urin

g sc

reen

ing

is a

“sna

psho

t” ra

ther

th

an a

com

plet

e cli

ent p

ortra

it•

Asse

ssm

ent i

s an

ong

oing

pro

cess

th

at e

valu

ates

clie

nt p

rogr

ess

and

prov

ides

a ra

tiona

le fo

r cha

ngin

g th

e tre

atm

ent p

lan, a

s ne

cess

ary

• Th

e re

latio

nshi

p of

scr

eeni

ng a

nd

asse

ssm

ent t

o on

e an

othe

r and

to

the

rang

e of

oth

er p

roce

sses

and

se

rvice

s pr

ovid

ed to

the

clien

t

• Ad

here

s to

all l

egisl

atio

n, g

uide

lines

, pr

oced

ures

, pro

toco

ls an

d pr

ofes

siona

l et

hics

abo

ut p

rivac

y, co

nfide

ntial

ity a

nd

hu

man

righ

ts

• Pr

ovid

es a

dmin

istra

tive

or o

ther

sup

port

to in

take

wor

kers

or c

linica

l sta

ff co

nduc

ting

asse

ssm

ents

• Ac

quire

s ba

sic c

lient

info

rmat

ion,

ad

herin

g to

all r

elev

ant t

empl

ates

or

guid

es to

ens

ure

com

plet

enes

s an

d ac

cura

cy

• Re

flect

s on

his

or h

er o

wn p

erso

nal a

nd

prof

essio

nal a

ttitu

des

and

cultu

ral b

iases

, an

d th

e im

pact

they

mig

ht h

ave

on th

e ab

ility

to in

tera

ct w

ith c

lient

s in

a n

on-

judg

men

tal w

ay, a

nd s

eeks

ass

istan

ce

and

supp

ort w

hen

requ

ired

• Pr

ovid

es e

ach

clien

t with

an

envir

onm

ent

that

feel

s sa

fe in

light

of t

hat c

lient

’s ne

eds,

back

grou

nd a

nd c

ultu

re

• Co

nduc

ts s

cree

ning

and

ass

essm

ent u

sing

evid

ence

-info

rmed

tool

s sh

own

to le

ad to

the

best

out

com

es a

nd v

alida

ted

for t

he c

lient

po

pulat

ion

bein

g se

rved

• Co

nduc

ts s

cree

ning

and

ass

essm

ent

inte

rvie

ws e

xplo

ring

the

clien

t’s u

nder

lying

th

ough

ts a

nd e

mot

ions

usin

g:•

A ra

nge

of q

uest

ioni

ng te

chni

ques

• No

n-ju

dgm

enta

l, op

en-e

nded

que

stio

ns•

Inco

nsist

encie

s (e

.g.,

betw

een

verb

al an

d no

n-ve

rbal

com

mun

icatio

n) to

elic

it ac

cura

te in

form

atio

n•

Lang

uage

app

ropr

iate

to th

e cli

ent’s

le

vel o

f und

erst

andi

ng

• De

liver

s br

ief i

nter

vent

ions

for c

lient

s du

ring

scre

enin

g or

ass

essm

ent s

ervic

es

• En

gage

s wi

th e

ach

clien

t to:

• Id

entif

y re

leva

nt c

ultu

ral a

nd h

istor

ical

influ

ence

s•

Resp

ond

to th

at c

lient

’s ne

eds

and

build

rapp

ort

• En

hanc

e m

otiva

tion

to a

cces

s re

leva

nt

prog

ram

s an

d se

rvice

s

• Se

lect

s an

d ap

plie

s sc

reen

ing

and

asse

ssm

ent t

ools

and

inte

rpre

ts d

ata

they

yie

ld to

prio

ritize

the

clien

t’s is

sues

and

info

rm

the

deve

lopm

ent o

f tre

atm

ent p

lans

• As

sess

es th

e cli

ent’s

read

ines

s to

cha

nge

on a

n on

-goi

ng b

asis,

not

ing

any

chan

ges

that

occ

ur a

nd a

dapt

ing

the

treat

men

t plan

ac

cord

ingl

y

• Em

ploy

s ev

iden

ce-in

form

ed h

ealth

sc

reen

ing

and

asse

ssm

ent t

ools

to

iden

tify

healt

h pr

oble

ms

that

mig

ht

influ

ence

the

clien

t’s tr

eatm

ent p

lan

• Id

entifi

es m

enta

l and

phy

sical

signs

an

d sy

mpt

oms

that

mim

ic su

bsta

nce

use

beha

viour

s (e

.g.,

into

xicat

ion

or w

ithdr

awal)

and

inte

rven

es

appr

opria

tely

• Id

entifi

es s

igns

of c

risis

durin

g sc

reen

ing

and

asse

ssm

ent a

nd

quick

ly in

terv

enes

to e

nsur

e sa

fety

• In

tegr

ates

evid

ence

-info

rmed

re

sear

ch o

n sc

reen

ing

and

asse

ssm

ent t

ools

and

tech

niqu

es in

to

prac

tice

• As

sess

es th

e ad

equa

cy o

f exis

ting

tool

s an

d pr

actic

es, a

nd in

nova

tes

enha

ncem

ents,

as

appr

opria

te

• Su

perv

ises

or c

oach

es o

ther

s to

:•

Ensu

re th

e qu

ality

and

inte

grity

of

scre

enin

g an

d as

sess

men

t too

ls an

d pr

actic

es•

Enric

h th

eir k

nowl

edge

and

refe

r th

em to

reso

urce

s ab

out t

he

impa

ct o

f diff

eren

t clie

nt c

ultu

res

• En

hanc

e in

terv

iewi

ng a

nd o

ther

cli

nica

l skil

ls

• In

itiate

s, co

llabo

rate

s on

or c

ondu

cts

rese

arch

on

vario

us a

spec

ts o

f sc

reen

ing

and

asse

ssm

ent

EXAMPLES

VII–24


SC

RE

EN

ING

AN

D A

SS

ES

SM

EN

T: S

elec

ting,

adm

inis

terin

g an

d in

terp

retin

g th

e re

sults

of e

vide

nce-

info

rmed

tool

s an

d m

etho

ds to

mea

sure

a

clie

nt’s

sub

stan

ce u

se a

nd re

late

d co

ncer

ns, a

nd in

form

the

care

and

trea

tmen

t pla

n.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Id

entifi

es c

lient

s wh

o m

ight

be

at ri

sk o

f su

icide

, sel

f-har

m o

r of h

arm

ing

othe

rs,

and

notifi

es m

ore

seni

or p

rofe

ssio

nals

or, i

f ap

prop

riate

, call

s fo

r em

erge

ncy

serv

ices

• Co

nsul

ts a

nd c

ollab

orat

es w

ith o

ther

pr

ofes

siona

ls to

clar

ify o

r enh

ance

clie

nt-

prov

ided

info

rmat

ion

and

iden

tify

risks

that

m

ight

not

oth

erwi

se h

ave

emer

ged

(e.g

., in

com

patib

le m

edica

tions

, dou

ble-

doct

orin

g)

• Re

fers

clie

nts

who

will n

ot b

e in

volve

d fu

rther

wi

th th

e pr

ofes

siona

l’s o

rgan

izatio

n to

oth

er

com

mun

ity re

sour

ces

that

cou

ld b

e he

lpfu

l

• M

onito

rs c

urre

nt tr

ends

and

info

rmat

ion

abou

t re

sear

ch re

lated

to s

cree

ning

and

ass

essm

ent

EXAMPLES EXAMPLES


SCREENING AND ASSESSMENT

VII–25

TR

AU

MA

-SP

EC

IFIC

CA

RE

: Int

erac

ting

with

sub

stan

ce u

se c

lient

s to

iden

tify

and

cons

ider

the

impa

ct th

at o

verw

helm

ingl

y ne

gativ

e ev

ents

hav

e on

fu

nctio

ning

and

the

abilit

y to

cop

e, a

nd th

en d

evel

opin

g an

d de

liver

ing

inte

rven

tions

that

em

phas

ize

safe

ty, c

hoic

e an

d pe

rson

al c

ontro

l.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s tra

uma

and

its p

reva

lenc

e,

how

it of

ten

man

ifest

s, an

d its

cau

ses,

inclu

ding

: •

Phys

ical,

emot

iona

l and

sex

ual

abus

e•

The

mul

ti-ge

nera

tiona

l impa

cts

of

resid

entia

l sch

ools

• Ac

ciden

ts a

nd n

atur

al di

sast

ers

• Re

spon

ds to

the

uniq

ue n

eeds

of e

ach

traum

a su

rvivo

r, th

us c

reat

ing

ther

apeu

tic

rapp

ort

• Ex

plain

s th

e po

tent

ial fo

r

re

-trau

mat

izatio

n an

d ho

w it

can

be

avoi

ded

or re

duce

d, p

rovid

ing

exam

ples

on

a c

ase-

by-c

ase

basis

• Ex

plain

s th

e di

ffere

nt w

ays

that

par

ticul

ar

popu

latio

ns c

an e

xper

ienc

e an

d m

anife

st

traum

a, a

nd in

tera

cts

with

clie

nts

info

rmed

by

this

know

ledg

e

• In

tera

cts

sens

itivel

y wi

th c

lient

s to

he

lp th

em m

anag

e th

e im

pact

that

tra

uma

has

on th

eir l

ives

and

prev

ent

re-tr

aum

atiza

tion

• Co

llabo

rate

s wi

th th

e cli

ent t

o bu

ild o

n st

reng

ths

that

enh

ance

resil

ienc

y an

d po

sitive

cop

ing

skills

• Bu

ilds

rapp

ort w

ith c

lient

s wh

o ha

ve

expe

rienc

ed tr

aum

a by

pro

vidin

g a

safe

en

viron

men

t dur

ing

ever

y in

tera

ctio

n, fo

r ex

ampl

e:•

Arra

ngin

g th

e m

eetin

g sp

ace

to

mee

t the

clie

nt’s

need

to fe

el s

afe

• Cr

eatin

g a

crisi

s pl

an•

Esta

blish

ing

pred

ictab

le

expe

ctat

ions

• Fa

cilita

tes

reco

very

from

trau

ma

by

refe

rring

clie

nt to

cou

nsel

ling,

oth

er

clini

cal in

terv

entio

ns o

r com

mun

ity

serv

ices

and

supp

orts,

as

appr

opria

te

• Co

nduc

ts s

cree

ning

and

ass

essm

ents

to

iden

tify

the

pres

ence

of t

raum

a-re

lated

sy

mpt

oms

• En

gage

s cli

ents

in e

xplo

ring

the

conn

ectio

n be

twee

n tra

uma,

sub

stan

ce

use

and

men

tal il

lnes

s or

men

tal h

ealth

iss

ues

and

• Cr

eate

s tre

atm

ent p

lans

that

inte

grat

e an

und

erst

andi

ng o

f the

relat

ions

hip

betw

een

traum

a, s

ubst

ance

use

and

m

enta

l illn

ess

or m

enta

l hea

lth is

sues

• Co

llabo

rate

s wi

th c

lient

s to

:•

Fost

er a

n un

ders

tand

ing

of

inte

grat

ed tr

eatm

ent f

or c

lient

s wi

th

hist

orie

s of

trau

ma

and

subs

tanc

e us

e or

con

curre

nt d

isord

ers

• He

lp th

em a

ckno

wled

ge tr

aum

a an

d he

al fro

m it

• He

lp th

em d

evel

op s

trate

gies

to

min

imize

the

impa

ct o

f trig

gers,

vu

lner

abilit

ies

or o

ther

fact

ors

that

co

ntrib

ute

to re

-trau

mat

izatio

n•

Supp

ort s

elf-e

ffica

cy, s

elf-

dete

rmin

atio

n, d

igni

ty a

nd p

erso

nal

cont

rol

• En

cour

age

the

choi

ce o

f tre

atm

ent

optio

ns th

at e

nsur

e ph

ysica

l, ps

ycho

logi

cal a

nd e

mot

iona

l saf

ety

• Ed

ucat

es a

nd a

dvoc

ates

for e

duca

ting

serv

ice p

rovid

ers

abou

t vica

rious

trau

ma

and

com

pass

ion

fatig

ue, a

nd c

onst

ruct

ive

ways

to d

eal w

ith th

ese

issue

s

• Cr

eate

s an

d pr

omot

es p

rogr

ams

that

pr

omot

e cli

ent a

nd s

taff

self-

care

• Cr

eate

s, pr

omot

es a

nd a

dvoc

ates

for

prog

ram

s, se

rvice

s an

d su

ppor

ts th

at

addr

ess

the

impa

ct o

f tra

uma

on c

lient

s

• M

ento

rs o

r coa

ches

oth

ers

to h

elp

them

de

velo

p an

d de

mon

stra

te e

mpa

thy

in

thei

r int

erac

tions

with

clie

nts

and

othe

rs

• Es

tabl

ishes

pro

toco

ls de

signe

d to

pr

omot

e fe

elin

gs o

f saf

ety

in a

ll clie

nts,

inclu

ding

thos

e wi

th h

istor

ies

of tr

aum

a

EXAMPLES


Technical Competencies ReportBEHAVIOUR INDICATORS BY LEVEL OF PROFICIENCYTRAUMA-SPECIFIC CARE

VII–26

EXAMPLES


TR

EA

TM

EN

T P

LAN

NIN

G: C

olla

bora

tivel

y de

velo

ping

a tr

eatm

ent p

lan

base

d on

scr

eeni

ng a

nd a

sses

smen

t find

ings

, ens

urin

g th

at a

ctiv

ities

an

d re

sour

ces

refle

ct th

e cl

ient

’s n

eeds

, str

engt

hs a

nd g

oals

. The

pro

cess

als

o in

clud

es m

onito

ring,

eva

luat

ing,

pla

nnin

g fo

r di

scha

rge

and

upda

ting

the

trea

tmen

t pla

n so

that

it re

flect

s th

e cl

ient

’s e

volv

ing

need

s an

d go

als.

1 =

Intr

od

ucto

ry2

= D

evel

op

ing

3 =

Inte

rmed

iate

4 =

Ad

vanc

ed

• Ex

plain

s th

e or

gani

zatio

n’s

treat

men

t pl

anni

ng p

roce

ss

• Pr

ovid

es b

asic

info

rmat

ion

abou

t av

ailab

le tr

eatm

ent p

rogr

ams

and

serv

ices

to c

lient

s an

d re

fers

them

to

prog

ram

s an

d se

rvice

s as

app

ropr

iate

• Id

entifi

es a

nd h

elps

add

ress

clie

nt

barri

ers

to tr

eatm

ent s

uch

as la

ck o

f tra

nspo

rtatio

n or

acc

ess

to d

ayca

re

serv

ices

• Ad

here

s to

all l

egisl

atio

n, g

uide

lines

, pr

oced

ures

and

pro

toco

ls re

gard

ing

clien

t con

fiden

tiality

and

pro

fess

iona

l et

hics

• As

sess

es th

e cli

ent’s

cur

rent

sta

ge o

f re

adin

ess

to c

omm

it to

and

eng

age

in

treat

men

t plan

act

ivitie

s

• Co

llabo

rate

s wi

th th

e cli

ent t

o:•

Esta

blish

a b

asic

unde

rsta

ndin

g of

tre

atm

ent p

lanni

ng

• Id

entif

y re

alist

ic an

d ac

hiev

able

sho

rt-

and

long

-term

goa

ls•

Iden

tify

cultu

ral,

cont

extu

al an

d pe

rson

al fa

ctor

s th

at s

houl

d be

con

sider

ed in

th

e pl

an•

Deve

lop

a tre

atm

ent p

lan b

ased

on

best

or p

rom

ising

pra

ctice

s an

d th

e cli

ent’s

goa

ls, a

ge, g

ende

r, cu

ltura

l and

co

ntex

tual

back

grou

nd, a

nd s

o on

• Ad

apt t

he p

lan o

ver t

ime,

so

it co

ntin

ues

to re

spon

d to

the

clien

t’s

mot

ivatio

n to

cha

nge

and

othe

r life

cir

cum

stan

ces

• Es

tabl

ishes

reali

stic

expe

ctat

ions

abo

ut th

e tre

atm

ent p

lan w

ith th

e cli

ent a

nd th

e cli

ent’s

fa

mily

, inc

ludi

ng c

lient

con

duct

, mee

ting

atte

ndan

ce a

nd e

ngag

emen

t in

treat

men

t ac

tivitie

s

• Ke

eps

clear

and

acc

urat

e re

cord

s of

all k

ey

info

rmat

ion

gath

ered

dur

ing

the

treat

men

t pl

anni

ng p

roce

ss

• As

sists

sen

ior s

taff

in e

valu

atin

g tre

atm

ent

plan

ning

act

ivitie

s

• As

sess

es th

e re

lative

sev

erity

of t

he

clien

t’s s

ubst

ance

use

and

men

tal

illnes

s or

men

tal h

ealth

issu

es, i

f pr

esen

t, an

d ad

just

s th

e tre

atm

ent

plan

to re

flect

the

relat

ive p

riorit

y of

ea

ch

• Ap

plie

s a

rang

e of

evid

ence

-info

rmed

an

d cli

ent-c

entre

d te

chni

ques

and

ap

proa

ches

to s

uppo

rt co

mm

itmen

t to

the

treat

men

t plan

and

relat

ed

activ

ities

• Cr

eativ

ely

enga

ges

with

clie

nts

with

co

mpl

ex o

r sen

sitive

bac

kgro

unds

to

help

enh

ance

the

clien

t’s m

otiva

tion

and

impr

ove

the

likel

ihoo

d of

ac

hiev

ing

treat

men

t goa

ls

• M

onito

rs c

lient

pro

gres

s th

roug

hout

th

e co

urse

of t

reat

men

t, ce

lebr

ates

su

cces

s, re

cogn

izes

the

oppo

rtuni

ties

prov

ided

by

setb

acks

or o

bsta

cles

and

supp

orts

the

clien

t in

resp

ondi

ng

to th

em

• M

onito

rs e

mer

ging

info

rmat

ion

abou

t ev

iden

ce-in

form

ed a

ppro

ache

s th

at

coul

d aid

in d

evel

opin

g ef

fect

ive

treat

men

t plan

s

• Co

llabo

rate

s wi

th a

bro

ad ra

nge

of m

ulti-

disc

iplin

ary

prof

essio

nals

to d

esig

n an

d im

plem

ent t

reat

men

t plan

s an

d ac

tivitie

s th

at a

ddre

ss c

ompl

ex c

lient

nee

ds,

popu

latio

n gr

oups

and

con

text

s

• Su

perv

ises

or c

oach

es o

ther

s in

the

desig

n an

d de

liver

y of

effe

ctive

trea

tmen

t pl

ans

• Le

ads

or c

ollab

orat

es w

ith o

ther

s in

pl

anni

ng a

nd c

ondu

ctin

g ev

aluat

ions

of

treat

men

t plan

ning

EXAMPLES


TREATMENT PLANNING

VII–27

technical competencies report

Documents