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Substance Use Disorders and Addictions

2
To my parents and Viv, for supporting me throughout my education and career.

To Melissa, for always knowing when I need to work and when I need to take a break. She always seems to magically
know what I need to get things done and makes everything about me better.

To Margaret, Charlie, and Nicholas, for the well-needed breaks of Monopoly, Star Wars, Arthur, Thomas, Minecraft,
Wii, trains, the park, the pool, hiking, and other distractions while writing this book.

3
Substance Use Disorders and Addictions

Keith Morgen
Centenary University Discovery Psychotherapy & Wellness Centers

Los Angeles
London
New Delhi
Singapore
Washington DC
Melbourne

4
 Copyright © 2017 by SAGE Publications, Inc.

All rights reserved. No part of this book may be reproduced or utilized in any form or by any means,
electronic or mechanical, including photocopying, recording, or by any information storage and retrieval
system, without permission in writing from the publisher.

FOR INFORMATION:

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Library of Congress Cataloging-in-Publication Data

Names: Morgen, Keith, (Keith J.), author.

Title: Substance use disorders and addictions / Keith Morgen.

Description: Thousand Oaks : SAGE Publications, [2017] | Includes bibliographical references and index.

Identifiers: LCCN 2016013694 | ISBN 9781483370569 (pbk. : alk. paper)

Subjects: | MESH: Substance-Related Disorders—therapy | Behavior, Addictive—therapy

Classification: LCC RC564 | NLM WM 270 | DDC 362.29—dc23 LC record available at https://lccn.loc.gov/2016013694

This book is printed on acid-free paper.

16 17 18 19 20 10 9 8 7 6 5 4 3 2 1

6
Contents
Editors’ Preface
Author’s Preface
Acknowledgments
About the Author
Section I. Addiction and the Brain, and the Introduction to the Case of Samantha
Chapter 1. Substance Use Disorder and Addiction: Basic and Brief Psychopharmacological and
Neuropsychological Review
Section II. Components of Clinical Treatment Planning
Chapter 2. Interview, Screening, and Assessment
Chapter 3. Diagnostic Issues: DSM-5 Overview for Substance-Related Disorders
Chapter 4. Treatment Modalities and Client Placement
Section III. Common Counseling Theories Applied to Substance Use Disorders and Addictions
Chapter 5. Motivational Interviewing
Chapter 6. Cognitive-Behavioral Therapy
Chapter 7. Family Counseling Interventions
Chapter 8. Existential Counseling
Section IV. Recovery Support and Counselor Supervision
Chapter 9. 12-Step Philosophy
Chapter 10. Relapse Prevention Theories
Chapter 11. Substance Use Disorders and Addiction Counseling Supervision
Closing Thoughts
References
Index

7
8
Editors’ Preface

9
Introduction to the Series Counseling and Professional Identity in the 21st
Century
While time, energy, and money have been poured into programs that target borders and drug trafficking,
ignorance and naiveté, and even skill development in learning how to “just say no,” the reality is that substance
use remains a major concern for all in this 21st century. Advances in our understanding of the psychosocial,
biological, and neurological contributors to the development and maintenance of substance disorders and
addiction have led to innovation in our approaches to both prevention and intervention. While much of what
we have done in the past took on a “one size fits all” mentality, this research has helped us understand the
highly unique and individualized nature of substance abuse and addiction. The text that you currently hold in
your hands, Substance Use Disorders and Addictions by Keith Morgen, reflects the latest in what we know of the
etiology, the prevention, and the intervention of substance abuse and addiction.

In an area with many more questions than answers, Substance Use Disorders and Addictions provides clear
direction in assessment, diagnosis, treatment, and prevention programming of substance use disorders and
additions. Dr. Morgen demonstrates his gift in being able to take difficult concepts and constructs tied to
things such as the psychoneurology of substance abuse and addiction and present them in easy-to-grasp
language, supported by an ample array of rich case illustrations. Substance Use Disorders and Addictions is an
essential reading for students and clinicians, regardless of their professional specialty or treatment focus.

While we are proud of the content and topics covered within this text, we are more than aware that one text,
one learning experience, will not be sufficient for the development of a counselor’s professional competency.
The formation of both your professional identity and practice will be a lifelong process. It is a process that we
hope to facilitate through the presentation of this text and the creation of our series Counseling and
Professional Identity in the 21st Century.

Counseling and Professional Identity in the 21st Century is a new, fresh, pedagogically sound series of texts
targeting counselors in training. This series is NOT simply a compilation of isolated books matching that
which is already in the market. Rather, each book, with its targeted knowledge and skills, will be presented as
but one part of a larger whole. The focus and content of each text serve as a single lens through which a
counselor can view his or her clients, engage in his or her practice, and articulate his or her own professional
identity.

Counseling and Professional Identity in the 21st Century is unique not just in the fact that it “packages” a series
of traditional texts but that it provides an integrated curriculum targeting the formation of the readers’
professional identity and efficient, ethical practice. Each book within the series is structured to facilitate the
ongoing professional formation of the reader. The materials found within each text are organized in order to
move the reader to higher levels of cognitive, affective, and psychomotor functioning, resulting in his or her
assimilation of the materials presented into both his or her professional identity and approach to professional
practice. While each text targets a specific set of core competencies (cognates and skills), competencies
identified by the professional organizations and accreditation bodies, each book in the series will emphasize

10
each of the following:

1. The assimilation of concepts and constructs provided across the text found within the series, thus
fostering the reader’s ongoing development as a competent professional;
2. The blending of contemporary theory with current research and empirical support;
3. A focus on the development of procedural knowledge with each text employing case illustrations and
guided practice exercises to facilitate the reader’s ability to translate the theory and research discussed
into professional decision making and application;
4. The emphasis on the need for and means of demonstrating accountability; and
5. The fostering of the reader’s professional identity and with it the assimilation of the ethics and standards
of practice guiding the counseling profession.

We are proud to have served as co-editors of this series, feeling sure that all the texts included, just like
Substance Use Disorders and Addictions, will serve as a significant resource to you and your development as a
professional counselor.

Richard Parsons, PhD

Naijian Zhang, PhD

11
Author’s Preface

12
Perspectives on the Current State of the Counseling Profession: How It
Pertains to This Book
I read a number of excellent books while writing this text. In the course of reading these other works, I began
to see a common theme that substance use disorder and addiction counseling is defined as a practice that is
based on the following criteria: (1) Substance use disorder and addiction counseling is evidence-based (e.g.,
motivational interviewing or brief structural family therapy—both of which will be discussed in this text); (2)
Substance use disorder and addiction counseling should approach clients from a positive perspective; (3) The
practice of substance use disorder and addiction counseling is complicated but relies on a collaborative stance
between counselor and client, as well as between counselor and the other areas of influence in the treatment
process (e.g., family, courts, or medical services); and (4) Substance use disorder and addiction counseling is
built on solid ethical principles and emphasizes social justice and multicultural considerations for the best
treatment and welfare of the client. These books all had titles such as Substance Abuse Counseling or Addiction
Counseling. However, the four components listed above can also be used to describe the core components of
the counseling profession for all disorders. That is why I chose to open this book with a discussion on what
exactly the profession of “substance use disorders and addiction counseling” is, is not, and perhaps can one day
be, at least how I see it.

One unique aspect of the addiction field is that those providing treatment for individuals with substance use
and addictive disorders can be physicians, psychologists, psychiatrists, licensed professional counselors
(LPCs), social workers, or addiction counselors. But concerns remain about how adequately trained these
professionals treating addiction are in providing such services (Miller, Scarborough, Clark, Leonard, &
Keziah, 2010). In addition, concerns remain regarding the curricular and clinical practice content of the
training (Morgen & Miller, 2013). Historically, these concerns arose because addiction counselors could
receive certification without formal training in addiction or counseling (Miller et al., 2010). However, recent
advances are strengthening the training process. For example, in 2009, the Council for Accreditation of
Counseling and Related Programs (CACREP) finalized guidelines for addiction counseling education in
relationship to knowledge, skills, and practices. CACREP also contains curricular mandates for the inclusion
of addictions material into the core of professional counseling training. Other guidelines for training and
competencies in addiction counseling were produced by the Center for Substance Abuse Treatment (CSAT)
and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition, the National
Addiction Studies Accreditation Commission (NASAC) was established to standardize addiction training.
Finally, there is also an increased emphasis of the master’s degree as an entry-level requirement for practice,
but in some states only a high school diploma or general equivalency diploma is required for credentialing in
the addiction profession (Miller et al., 2010).

Certification
Certification provides a professional standard that is governed by an organization, thus establishing a common
minimum competency for professionals. While there are state requirements for substance abuse counseling

13
licensure and certification guidelines, there is a lack of nationwide continuity. This lack of congruence of
standards between states produces a confused profession, even more confused trainees and students looking to
enter the profession, and clients who do not understand the differences. For example, a client once asked me,
“What is the difference if I receive addiction treatment from an addiction counselor or a psychologist or a
counselor or a social worker?”

I did not have an answer the client could understand. The real answer is just too confusing and basically is
summed up in the remainder of my Preface.

There are different certifications offered by various agencies both domestically and internationally (el-Guebaly
& Violato, 2011). For example, the International Association of Addictions and Offender Counselors
(IAAOC), which is a division of the American Counseling Association (ACA) working in conjunction with
the National Board of Certified Counselors (NBCC), has developed standards and a program for the
certification of master’s-level addiction counselors. One requirement for the master addiction counselor
(MAC) credential is a passing score on the Examination for Master Addiction Counselors (www.nbcc.org).
As of the writing of this book, the MAC application requirements are under review.

According to the National Association of Alcoholism and Drug Abuse Counselors (NAADAC), the National
Certification Commission for Addiction Professionals recognizes three levels of substance abuse certifications:
the national certified addiction counselor level I (NCAC I), the national certified addiction counselor level II
(NCAC II), and the MAC. The NAADAC also acknowledges additional specialties, such as the national
certified adolescent addiction counselor (see Table 1 for a review of several of the certification exams and their
associated applicant criteria and content). However, counselors’ level of certification or licensure will dictate
their scope of practice in regard to their state regulations.

Table 1 NAADAC Certifications and Associated Eligibility

Table 1 NAADAC Certifications and Associated Eligibility

Certification
Eligibility
Type

GED, High School Diploma, or higher.

Current credential or license as a Substance Use Disorder/Addiction counselor issued

by a state or credentialing authority.
National
At least three years full-time or 6,000 hours of supervised experience as a Substance
Certified
Use Disorder/Addiction counselor.
Addiction
Counselor – At least 270 contact hours of education and training in Substance Use
Level I Disorders/Addiction or related counseling subjects. Must include six hours of ethics
training and six hours of HIV/AIDS-specific training within the last six years. At least
50% of training hours must be face-to-face.

14
 Passing score on the NCAC I examination within four years of the application.

Bachelor’s degree or higher in Substance Use Disorder/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license as a Substance Use Disorder/Addiction counselor issued

National by a state or credentialing authority.
Certified
At least five years full-time or 10,000 hours of supervised experience as a Substance
Addiction
Use Disorder/Addiction counselor.
Counselor –
Level II At least 450 contact hours of education and training in Substance Use
Disorder/Addiction. Must include six hours of ethics training and six hours of
HIV/AIDS-specific training within the last six years. At least 50% of training hours
must be face-to-face.

Passing score on the NCAC II examination within four years of the application.

Master’s degree or higher in Substance Use Disorders/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license as a Substance Use Disorder/Addiction counselor or

professional counselor (social worker, mental health, marriage and family, professional
counselor, psychologist, psychiatrist, medical doctor) issued by a state or credentialing
Master authority.
Addiction
At least three years full-time or 6,000 hours of supervised experience as a Substance
Counselor
Use Disorder/Addiction counselor.

At least 500 contact hours of education and training in Substance Use

Disorder/Addiction. Must include six hours of ethics training and six hours of
HIV/AIDS-specific training within the last six years. At least 50% of training hours
must be face-to-face.

Passing score on the MAC examination within four years of the application.

Bachelor’s degree or higher in a healing art (i.e., substance use or mental health
disorders, nursing, respiratory therapy, or pharmacology etc.) from a regionally
accredited institution of higher learning.

Current credential or license in a healing art (i.e., substance use disorders, nursing,
respiratory therapy, or pharmacology, etc.) issued by a state or credentialing authority.

15
National At least three years full-time or 6,000 hours of employment in a health care profession
Dependence (i.e., substance use disorders, nursing, respiratory therapy, or pharmacology, etc.).
Specialist
At least 270 contact hours of education and training in healing art. Must include at
least 40 hours of nicotine-specific education, six hours of ethics training, and six hours
of HIV/AIDS-specific training within the last six years. At least 50% of training hours
must be face-to-face.

Passing score on NDS examination within four years of the application.

Bachelor’s degree or higher in Substance Use Disorders/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license as a Substance Use Disorder/Addiction counselor issued

by a state or credentialing authority.
National
At least five years full-time or 10,000 hours of supervised experience working in
Certified
Substance Use Disorder/Addiction and/or related counseling subjects. Must include
Adolescent
two and a half years or 5,000 hours of supervised experience working with adolescents.
Addictions
Counselor At least 270 contact hours of education and training in Substance Use
Disorder/Addiction and/or related counseling subjects. Must include at least 70
contact hours of training related to adolescent treatment, six hours of ethics training,
and six hours of HIV/AIDS-specific training within the last six years. At least 50% of
training hours must be face-to-face.

Passing score on the NCAAC examination within four years of the application.

GED, High School Diploma, or higher.

Minimum of one year full-time of direct practice (volunteer or paid) in a peer recovery
support environment.

At least 125 contact hours of peer recovery focused education and training to include
education in documentation, community/family education, case management, crisis
National
management, Recovery-Oriented Systems of Care (ROSC), screening and intake,
Certified
Identification of Indicators of substance use and/or co-occurring disorders for referral,
Peer
service coordination, service.
Recovery
Support planning, cultural awareness and/or humility, and basic pharmacology. Must include a
Specialist minimum of six hours of ethics and six hours of HIV/AIDS-specific training within
the last six years. At least 50% of training hours must be face-to-face.

16
 Minimum one year of recovery from Substance Use/Co-Occurring Mental Health
Disorders (self-attestation).

Passing score on the NCPRSS examination within four years of the application.

Bachelor’s degree or higher in Substance Use Disorder/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license as a Substance Use Disorder/Addiction counselor issued

by a state or credentialing authority.
National
At least 4,500 hours of supervised experience (volunteer or paid) in Substance Use
Endorsed
Disorder/Addiction, to include at least 3,000 hours of direct service delivering student
Student
assistance services.
Assistance
Professional At least 100 contact hours of education and training in Substance Use
Disorder/Addiction and/or related counseling subjects including six hours of ethics
training and six hours of HIV/AIDS-specific training within the last six years. At least
70 hours must be related to student assistance services. At least 50% of the 70 hours
must be face-to-face training.

Passing score on the NESAP examination within four years of the application.

Bachelor’s degree or higher in Substance Use Disorder/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license in Substance Use Disorder/Addiction and/or related

counseling subjects (social work, mental health counseling, psychology) issued by a
state or credentialing authority for the past five years.
National
At least five years full-time or 10,000 hours overall of employment as a Substance Use
Clinical
Disorder/Addiction counselor. This must include a minimum of two years full-time or
Supervision
4,000 hours performing direct clinical supervision, and 200 hours of received
Endorsement
supervision as a clinical supervisor.

At least of 30 contact hours of education and training specific to Substance Use

Disorder/Addiction clinical supervision. In addition, must include six hours of ethics
training and six hours of HIV/AIDS-specific training within the last six years. At least
50% of training hours must be face-to-face.

A passing score on the NCSE examination within four years of the application.

17
 Bachelor’s degree or higher in Substance Use Disorder/Addiction and/or related
counseling subjects (social work, mental health counseling, psychology) from a
regionally accredited institution of higher learning.

Current credential or license in Substance Use Disorder/Addiction and/or related

National counseling subjects (social work, mental health counseling, psychology) issued by a
Endorsed state or credentialing authority for the past five years.
Co-
Occurring At least five years full-time or 10,000 hours of supervised experience in Substance Use

Disorders and Mental Health Disorders treatment, to include two and a half years full-time or

Professional 5,000 hours of supervised experience working with co-occurring persons.

At least 70 contact hours of education and training in co-occurring disorders. Must

include six hours of ethics training and six hours of HIV/AIDS-specific training
within the last six years. At least 50% of training hours must be face-to-face.

Passing score on the NECODP examination within four years of the application.
Source: www.naadac.org.

The confusion—in part—is that each credentialing body has different requirements for certification. And
many of these requirements vary across agency and state. Morgen and Miller (2013) attempted to summarize
the overall mission of these varied bodies and concluded that they all share three general goals: (1) Each
defines a core set of counselor roles, (2) each addresses a set of expected addiction counseling competencies,
and (3) each makes use of assessment measures and exams to evaluate these competencies in those seeking
credentialing. But Morgen (2011) noted that many credentialing bodies and states differ in opinion regarding
the content and quantity of competencies required for addiction counseling credentialing.

To add another layer of confusion, some credentialing organizations actually have different levels of
certification. For example, the International Certification and Reciprocity Consortium (IC&RC), a national
organization of certifying boards providing national reciprocity of certification, has three levels of certification:
(1) certified addiction counselor, (2) certified drug counselor, and (3) alcohol and drug counselor. Each level
has different training, education, and supervision requirements experience (the higher the certification level,
the greater degree of requirements exist; http://www.internationalcredentialing.org/).

Licensure
Licensure is the most rigorous form of professional regulation (Morgen & Miller, 2013). Unlike certification,
which can be granted nationally (e.g., the NBCC national certified counselor status), state law establishes
licensure; thus, each state determines the requirements for licensure. Licensure eligibility typically consists of
two criteria: (1) a graduate degree (master’s or higher) in the addiction counseling, counseling, or (in some
states) psychology professions; and (2) postgraduate supervised hours of clinical work in the counseling or
addiction counseling profession. However, different states have different requirements for licensure in regard
to the degree type eligibility, graduate course work required, the professional identity and training of the

18
clinical supervisor, and the number of clinical hours performing professional or addiction counseling (and
related) services (Morgen, Miller, & Stretch, 2012).

Accreditation
Accreditation applies to the graduate counselor education or counseling psychology training program within a
college or university that educates and trains students in the addiction counseling or counseling discipline.
Accreditation procedures are designed to verify the quality and standardization of the graduate education. In
the accreditation process, standards are clearly specified for the training of addiction or counseling
practitioners, for instance, the mandated academic course content or the expected experiential practicum or
internship components of the graduate program. Programs that meet or exceed the specified standards are
then accredited. In 2009, CACREP recognized addiction counseling as a counseling specialty and thus
outlined the accreditation requirements for any addiction counselor graduate program. Table 2 shows these
requirements.

Table 2 CACREP (2015) Addiction Counseling Standards

Table 2 CACREP (2015) Addiction Counseling Standards

1. FOUNDATIONS
a. history and development of addiction counseling
b. theories and models of addiction related to substance use as well as behavioral and process
addictions
c. principles and philosophies of addiction-related self-help
d. principles, models, and documentation formats of biopsychosocial case conceptualization
and treatment planning
e. neurological, behavioral, psychological, physical, and social effects of psychoactive
substances and addictive disorders on the user and significant others
f. psychological tests and assessments specific to addiction counseling
2. CONTEXTUAL DIMENSIONS
a. roles and settings of addiction counselors
b. potential for addictive and substance use disorders to mimic and/or co-occur with a variety
of medical and psychological disorders
c. factors that increase the likelihood for a person, community, or group to be at risk for or
resilient to psychoactive substance use disorders
d. regulatory processes and substance abuse policy relative to service delivery opportunities in
addiction counseling
e. importance of vocation, family, social networks, and community systems in the addiction
treatment and recovery process
f. role of wellness and spirituality in the addiction recovery process
g. culturally and developmentally relevant education programs that raise awareness and
support addiction and substance abuse prevention and the recovery process

19
 h. classifications, indications, and contraindications of commonly prescribed
psychopharmacological medications for appropriate medical referral and consultation
i. diagnostic process, including differential diagnosis and the use of current diagnostic
classification systems, including the Diagnostic and Statistical Manual of Mental Disorders
(DSM) and the International Classification of Diseases (ICD)
j. cultural factors relevant to addiction and addictive behavior
k. professional organizations, preparation standards, and credentials relevant to the practice of
addiction counseling
l. legal and ethical considerations specific to addiction counseling
m. record keeping, third party reimbursement, and other practice and management
considerations in addiction counseling
3. PRACTICE
a. screening, assessment, and testing for addiction, including diagnostic interviews, mental
status examination, symptom inventories, and psychoeducational and personality
assessments
b. assessment of biopsychosocial and spiritual history relevant to addiction
c. assessment for symptoms of psychoactive substance toxicity, intoxication, and withdrawal
d. techniques and interventions related to substance abuse and other addictions
e. strategies for reducing the persisting negative effects of substance use, abuse, dependence,
and addictive disorders
f. strategies for helping clients identify the effects of addiction on life problems and the
effects of continued harmful use or abuse, and the benefits of a life without addiction
g. evaluating and identifying individualized strategies and treatment modalities relative to
clients’ stage of dependence, change, or recovery
h. strategies for interfacing with the legal system and working with court referred clients

Source: CACREP (2015, pp. 18–19).

In addition, CACREP (2015) also embeds required addictions training within the core professional
counseling curriculum. Thus, a graduate master’s program (e.g., clinical-counseling) leading to eligibility as a
licensed professional counselor must integrate addictions content into the curriculum. For example, CACREP
stipulates that theories and etiology of addictions and addictive behaviors be included in the content covered
within the course(s) meeting the human growth and development domain of the graduate counseling
curriculum. Some studies have shown that CACREP counseling programs currently satisfy these standards,
meaning that addictions content is currently being covered (Iarussi, Perjessy, & Reed, 2013). However,
though there has been some discussion in the literature regarding the nuts and bolts of how to integrate
addiction counseling content into the general professional counseling standards (e.g., Lee, Craig, Fetherson,
& Simpson, 2013), there are still unanswered questions regarding the degree and quality of the addiction
content integration into the counseling curriculum (Morgen, Miller, Chasek, DePue, & Ivers, 2015a, 2015b).
For instance, if you consider the topic of addiction etiology and addiction behaviors, that seems to be a very
expansive topic to try and integrate into even one or two full class sessions. Or if there is an addiction course,

20
what is the quality of that course, and how do the students integrate this content into their broader counseling
training?

CACREP program accreditation is defined as designating the “acceptable” degree of training. So a graduate
from a CACREP addiction counseling program could be seen as “more of an addiction counselor” than a
graduate from a non-CACREP program. In essence, counselor or addiction counselor identity (as defined by
CACREP and accepted by ACA and numerous states) is being shaped by program accreditation status (i.e.,
CACREP or other). If you consider this paradigm against the broader backdrop of all the different addiction
certifications and academic/professional eligibility requirements, you begin to see how the CACREP issue is
just one more component of a long national dialogue regarding the issue of counselor identity.

If CACREP is playing a role in establishing the credentialing of an addiction counselor (or professional
counselor), then perhaps more discussion regarding what exactly constitutes addiction counseling (or
professional counseling) training seems warranted. That is why some other accrediting and professional
counseling organizations are developing and growing in response to the CACREP standards. The alternate
movement is not anti-accreditation or anti-CACREP. Any counselor would agree in a split second about how
critical curricular oversight and accreditation are to the practice of training counselors. Training must be
rigorous with a core of standard content and skills instilled in all counselors via the classroom and field
experiences. The reasons for these new bodies seem more aligned with a desire for a clearer, and more unified,
definition of what it means to be a counselor or addiction counselor. Some of these new or growing groups are
the Alliance for Professional Counselors and the Master’s in Psychology and Counseling Accreditation
Council (MPCAC). In the future, some of these (or other) organizations could also take a role in organizing
the accreditation process focused on acceptable training and experience for qualification for licensure as an
addiction counselor. For example, Table 3 reviews the accreditation for counseling programs within MPCAC.
The reader can see where there is room for the inclusion of addiction counseling curricular and training
matters within the existing standards (or where standards can expand to include addiction counseling
content).

Table 3 Master’s in Psychology and Counseling Accreditation Standards

Table 3 Master’s in Psychology and Counseling Accreditation Standards

Professional counselor identity, ethical behavior, and social justice practices. Including but not limited
to: assisting students to acquire knowledge related to the history of the helping profession; professional
counseling roles and functions; ethical standards related to professional organizations in the field of
counseling; and public policy processes including system advocacy strategies on behalf of the
profession, clients, and the communities that counselors serve.

Human development and wellness across the life span. Including but not limited to: the study of life
span development; maturational and structural theories of human development; wellness counseling
theories; strategies to deal with developmental processes and transitions; human behavior; disabilities;
environmental, contextual and multicultural factors that contribute to healthy human development and
relevant culturally competent counseling practices; and the promotion of social justice in society.

21
Neuroscientific, physical, and biological foundations of human development and wellness. Including
but not limited to: facilitating students’ acquisition of new knowledge related to neuroscience, health
and wellness; addictions; and the use of neuroscientific research findings for culturally competent
counseling practices and social justice advocacy interventions.

Ecological, contextual, multicultural, social justice foundations of human development. Including but
not limited to: the study of culture from ecological, contextual, multicultural, and social justice
perspectives; evidence-based strategies for working with diverse groups (related to but not limited to
age, race, culture, ethnicity, disability, sexual orientation, gender, class, religion/spirituality); the
impact of power, privilege, and oppression and micro/macro aggressions on human development; and
culturally competent counseling and social justice advocacy interventions.

Counseling, consultation, and social justice advocacy theories and skills. Including but not limited to:
training in preventive counseling; consultation; individual, group, couples, marriage, family and
addictions counseling; systems change intervention strategies and skills; and social justice advocacy
interventions.

Group theory, practice, and social justice advocacy. Including but not limited to: principles of group
dynamics, group process, and group leadership; theories and methods of group counseling; and the
application of group work theory and practice to organizational dynamics and social justice advocacy in
different environmental settings (e.g., family, school, university, workplace, and community settings).

Career and life development. Including but not limited to: the study of vocational/career development
theories and decision-making models; career assessment instruments and techniques; occupational and
related educational systems; career development applications; career counseling processes/techniques;
and the application of social justice theories to people’s vocational/career development.

Assessment of human behavior and organizational/community/institutional systems. Including but

not limited to: assessment and diagnosis of individual psychiatric disorders as defined by classification
systems such as the Diagnostic Statistical Manual (DSM) and the International Classification of
Diseases (ICD); understanding of defined diagnostic disorders relative to the helping context;
knowledge of cultural biases associated with classification systems; assessment strategies designed to
promote healthy human functioning; and assessment strategies that focus on
organizational/community/social justice advocacy dynamics as they impact human development,
wellness, and the perpetuation of psychiatric disorders as listed in various classification systems.

Tests and measurements. Including but not limited to promoting an understanding of the theoretical
and historical basis for, as well as knowledge of cultural biases associated with: assessment techniques;
testing methods; knowledge of various types of tests and evaluation strategies that result in
knowledgeable selection, administration, interpretation; and use of assessment/evaluation instruments
and techniques that foster social justice among diverse client populations.

Traditional and social justice-oriented research and evaluations. Including but not limited to:

22
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