TPC-Journal-V2-Issue2

The Professional Counselor \Volume 2, Issue 2 126 sophisticated and in-depth education and clinical training is needed to insure that addicted clients receive the most efficacious treatment possible—hence the purpose for the creation of addiction counseling accreditation standards. On the road toward the creation of such educational standards, the helping professions began seeking standardization through the establishment of formal credentials and licensing. History of Addictions Credentialing As noted earlier, addiction counselors traditionally entered the field from a great diversity of backgrounds. As a result, debates ensued as to what best qualified one to be an addiction counselor. White (1999) stated: “Because so many of the grass roots treatment models utilized people in recovery who often had more prior contact with penal institutions than educational institutions, the challenge was how to prepare and professionalize this indigenous workforce while blending it with a growing array of other professionals entering the field…” (p. 25). At that point in time, many addiction counselors had only their own sobriety as a qualification to provide treatment. Unfortunately, the term “counselor” often was used to refer to these paraprofessionals to distinguish them from trained and licensed mental health professionals (i.e., psychiatrists, psychologists, and social workers). It was in this historical context that a small group founded the National Association of Alcoholism Counselors and Trainers (NAACT) in 1972. This group later evolved into the National Association of Alcoholism and Drug Abuse Counselors (NAADAC) (White, 2005). NAADAC enhanced the professionalism of addiction counselors by establishing ethical standards for addiction counselors, disseminating information via professional publications, and providing ongoing training and credentialing activities (White, 1999). At about the same time that NAADAC was moving forward, two events were unfolding that would further shape credentialing and training efforts. First, the Association for Counselor Education and Supervision introduced the first set of counselor preparation standards (Association for Counselor Education and Supervision, 1973). Ultimately, this led to the establishment of CACREP in 1981 to promote quality counselor preparation at the graduate level. Second, privatized certification boards began emerging at the state level (Mustaine, West, & Wyrick, 2003). A dynamic tension manifested within these state certification boards in regards to reluctance among some within the field to require formal graduate training. Into this mix, the National Board for Certified Counselors (NBCC), NAADAC, and the Commission for Rehabilitation Counselor Certification (CRCC) worked together to establish the Master Addictions Counselor (MAC) credential, a credential that provided addiction counselors with a uniform credential regardless of their original discipline (Juhnke, 2000). Several rationales exist for the continued shift toward credentialing graduate-level clinicians. First, and most pointedly, researchers have found that effective counseling with addicted clients requires specialized training and that professional counselors trained in academic graduate programs are more effective than their less educated counterparts (Carroll, 2000). Whereas many clinicians have sought to fulfill state certification requirements through workshops or seminars, the certification requirements offered therein are typically based on the number of attendance hours and have little to no assessment of content knowledge or mastery (Mustaine, West, & Myrick, 2003). Another reason for credentialing master’s-level clinicians is that they are better prepared than their lay counterparts to meet the multiple needs of addicted clients (Sias, 2002). Lay practitioners are often solely trained to address issues of chemical abuse and dependence (Banken & McGovern, 1992; Taleff & Martin, 1996), and thus lack the fundamental knowledge and skills required of professional counselors to address concomitant needs beyond chemical abuse. With the growing recognition of the prevalence of co-occurring disorders among clients with addictive disorders, as well as the familial impacts of addiction, the need for trained mental health professionals to treat these concerns has become increasingly important (Merta, 2001; Schulte, Meier, Sterling, & Berry, 2010). Third-party reimbursement requirements add a third reason for the lean toward graduate-level addiction counselors. Whereas state-based addiction counseling certification boards do not require a graduate degree, insurance companies have moved to such a requirement in order to receive reimbursement (Mustaine et al., 2003). A final reason for graduate- level counselors is provided by Mustaine et al., who noted that state-based addiction counseling certification boards have traditionally required no direct observation of addiction counselors by their supervisors (e.g,, through audiotape, videotape, transcript, or live observation). Accordingly, it is possible that all supervision can, in theory, be based upon supervisee self-report, a process known to be particularly problematic with novice supervisees (Campbell, 1994;