Certified Addiction Counselor Training Verification Form

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Training Verification Form Requirement: CAC applicants must complete and document a minimum of 270 hours of training, with a minimum number of training hours in each performance domain as follows: 1. Clinical Evaluation: 25 hours 2. Treatment Planning: 15 hours 3. Counseling: 30 hours 4. Case Management and Referral: 10 hours 5. Client, Family and Community Education: 10 hours 6. Documentation: 10 hours 7. Ethical and Professional Responsibilities: 30 hours (must include 6 hours of counselor-specific ethics) 8. Understanding Addiction/Treatment Knowledge: 70 hours 9. Application to Practice/Professional Readiness: 70 hours (must include at least 4 hours of HIV-AIDS and 2 hours of Domestic Violence) Training hours must be non-repetitive (i.e., the same course cannot be claimed more than one time even if the course was taken multiple times) and all training must have been completed with the last 10 years. Content-specific training for initial application purposes DOES NOT have to be delivered by an approved training provider. How to Document: Electronic Submission: The applicant completes all required fields of data on the form and uploads the completed form and copies of supporting documentation to the system. Hard-copy Submission: The applicant completes all required fields of data on the form, attaches copies of eligible training documentation (in the same order as listed on the form) and mails all documents to the. Training documentation must provide the following information: Applicant s Name Title of course/training/educational event* Event sponsor/provider Delivery date(s) Number of Contact Hours *If the event title does not clearly identify the instructional content, please attach an official description of the event, such as an agenda or syllabus. If training certificates do not include all required information, contact the training provider and request the additional information on their official letterhead: include these letters with your training documentation. If you use college coursework for training credit, you must provide documentation for each entry as follows: (1) Highlight the course on the transcript that you are claiming for training credit. (2) Print out the course description published by the educational institution. (3) Place the transcript copy and the course description in the same order as the courses are listed on your training verification forms. Florida Certification Board ()

TRAINING TOPICS BY DOMAIN DOMAIN TOPICS Clinical Evaluation (25 hour) Addiction & Human Growth/Development Addictive Process Assessment Instruments, Procedures and Techniques Client Engagement Client Matching to Service Array Detoxification DSM IV/Diagnosis Criteria / ASAM Motivational Interviewing Other Substance & Behavioral Addictions Gambling/Smoking/Food Readiness and Motivation for Treatment Risk Factors/Risk Assessment/Risk Management Screening Instruments, Procedures and Techniques Screening/Assessment for Dual Diagnosis/Co-Occurring Disorders Signs/Symptoms/Stages of SUD, Active and Withdrawal Urinalysis and Other Biological Assessments Treatment Planning (15 hours) Client Placement Criteria Developing Individualized Treatment Plans Drug Court/Correction-based Treatment/Policy/Theory Enhancing Client Choice/Client-Directed Care Evidence Based Practice (EBP) Treatment Protocols Intake/Orientation to Treatment Medication-assisted Treatment On-going Assessment Overcoming Barriers to Treatment Progress Special Population Needs Stages of Change and Treatment Goals/Interventions Treatment Goals and Measuring Success Treatment Planning/Models of Treatment Counseling (30 hours) Client Progress Assessment and Response Counseling Theories/Techniques Developing a Therapeutic Alliance Evidence-based Practices Individual/Group/Family Counseling Motivational Interviewing Types of Treatment Programs/Levels of Treatment Case Management and Referral (10 hours) Advocacy/Liaison Activities Case Management Community Resources/Services Confidentiality/HIPPA Issues with Referrals Consultation

DOMAIN TOPICS Continuum of Care/Placement Making Referrals Managed Care Systems Referral Outcome/Evaluation Self-help Groups Service/Care Coordination/Collaboration Special Population Needs Client, Family and Community Education (10 hours) Adult Learning Theory Anger Management Skills Changing Criminal Behavior/Criminal Thinking Errors/Offender Treatment Co-Dependency Cultural Diversity/Special Populations Domestic Violence Family Dynamics Group Facilitation/Styles of Presentation HIV/TB/Hepatitis C Life Skills Moral Development Theories of Counseling / Personality Toxicology Victim/Perpetrator Counseling Documentation (10 hours) Assessment, Treatment, Progress, Discharge or Transfer Summaries Clinical Documentation Electronic Health Records/Technology Privacy & Confidentiality Progress Notes Psychosocial Summaries Reports/Record Keeping/Records Management Ethical and Professional Responsibilities (30 hours) Boundaries / Transference Computer Ethics Cultural Competence Ethical Decision Making / Code of Ethics Laws / Rules & Regulations Organizational Ethics Policy in Human Services Privacy / Confidentiality / HIPPA Relationships / Dual Relationships Sexual Misconduct Understanding Addiction/Treatment Disease of Addiction Dual or Triple Diagnoses (mental illness, HIV, mental retardation) Etiology/Causation of Addiction

DOMAIN TOPICS Knowledge (70 hours) History of Addiction and/or Addiction Treatment Involvement and Treatment of Family in Recovery Models of Treatment Other Substances and Behavioral Addictions Pharmacology Physical Aspects of Addiction, Brain Science Relationship of Addiction to Health, Crime, and Other Social Problems Signs, Symptoms, Progression of Addiction Treatment Components Types of Service Modalities (residential, outpatient, etc) of Support Groups Application to Practice/Professional Readiness (70 hours)* * Must include 4 hours of HIV-AIDS and 2 hours of Domestic Violence training content. Care for the Caregiver Crisis Intervention/Verbal De-escalation Ethics and Ethical Decision-making Individual, Group and Family Counseling Techniques Laws Governing Privacy, Confidentiality and HIPAA Management and Leadership Skills Medication-Assisted Treatment Models of Treatment Observation and Communication Skills Rules and Regulations that Govern Full Continuum of Services and Referrals Special Population Needs/Cultural Competence Supervision Techniques Understanding Research/Translating Research to Practice Wellness, Alternative Therapies, Nutrition

Training Verification Form (1 of 9) Training Topic: Clinical Evaluation Training Requirement: Minimum of 25 hours of training in topics directly related to Clinical Evaluation. ASAM Placement Criteria Florida Council on Community Mental Health 4-16-13 16 Conference Brochure Florida Certification Board ()

Training Verification Form (2 of 9) Training Topic: Treatment Planning Training Requirement: Minimum of 15 hours of training in topics directly related to Treatment Planning. Stages of Change Community Connections, Inc. 8-8-13 6 Certificate of Completion Florida Certification Board ()

Training Verification Form (3 of 9) Training Topic: Counseling Training Requirement: Minimum of 30 hours of training in topics directly related to Counseling. Crisis Intervention Woodland Behavioral Health 3-3-12 6 Certificate of Completion Florida Certification Board ()

Training Verification Form (4 of 9) Training Topic: Case Management and Referral Training Requirement: Minimum of 10 hours of training in topics directly related to Case Management and Referral. Methods for Effective Referrals FADAA Annual Conference 8-15-11 2 Conference Certificate of Attendance and Conference Brochure Florida Certification Board ()

Training Verification Form (5 of 9) Training Topic: Client, Family and Community Education Training Requirement: Minimum of 10 hours of training in topics directly related to Client, Family and Community Education. Adult Learning Principles Florida State University Fall 2012 6 Transcript Florida Certification Board ()

Training Verification Form (6 of 9) Training Topic: Documentation Training Requirement: Minimum of 10 hours of training in topics directly related to Documentation. Clinical Documentation Addiction Training, Inc. 11-10-11 2 Certificate of Completion Florida Certification Board ()

Training Verification Form (7 of 9) Training Topic: Ethical and Professional Responsibilities Training Requirement: Minimum of 30* hours of training in topics directly related to Ethical and Professional Responsibilities. *must include at least 6 hours of counselor-specific ethics training HIPAA & Confidentiality CMS 11-10-11 4 Certificate of Completion Florida Certification Board ()

Training Verification Form (8 of 9) Training Topic: Understanding Addiction/Treatment Knowledge Training Requirement: Minimum of 70 hours of training in topics directly related to Understanding Addiction/Treatment Knowledge. History of Addiction Treatment Florida State University Spring 2012 45 Transcript Florida Certification Board ()

Training Verification Form (9 of 9) Training Topic: Application to Practice/Professional Readiness Training Requirement: Minimum of 70* hours of training in topics directly related to Application to Practice/Professional Readiness. *must include at least 4 hours of HIV-AIDS and 2 hours of Domestic Violence Care for the Caregiver Illuminate Consulting 11-10-11 4 Certificate of Completion Florida Certification Board ()