Advances in Addiction & Recovery (Spring 2019) by NAADAC, the Association for Addiction Professionals

SPRING 2019 Vol. 7, No. 2

ADVANCES in Understanding and Addressing Underage Drinking

By the National Institute on Alcohol Abuse and Alcoholism (NIAAA)

PLUS: • Removing the Stigma and Barriers Against Medications for Opioid Addiction • Navigating Client Death in Addictions Counseling • 2019 Annual Conference Preliminary Schedule Navigating the Addiction Profession

NAADAC 2019 Annual Conference September 28 - Oc tober 3 | Orlando

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Preliminary Schedule Inside! SPRING 2019 Vol. 7 No. 2 Advances in Addiction & Recovery, the official publication of NAADAC, is focused on providing useful, innovative, and timely information on trends and best practices in the addiction profession that are beneficial for practitioners.

www.naadac.org/annualconference

NAADAC, the Association for Addiction Professionals, represents the professional interests of more than 100,000 addiction counselors, educators, and other addictionfocused health care professionals in the United States, Canada, and abroad. NAADAC’s members are addiction counselors, educators, and other addiction-focused health care professionals, who specialize in addiction prevention, treatment, recovery support, and education. Mailing Address 44 Canal Center Plaza, Suite 301 Alexandria, VA 22314 Telephone 703.741.7686 Email naadac@naadac.org Fax 703.741.7698

■ FEAT UR ES 24 National Academies Report Calls for Removing the Stigma and Barriers

Against Medications for Opiod Addiction By Jack B. Stein, PhD, Chief of Staff & Director, Office of Science Policy and Communications, National Institute on Drug Abuse

26 Advances in Understanding and Addressing Underage Drinking By National Institute on Alcohol Abuse and Alcoholism

28 Good Grief: A Counselor’s Thoughts on Navigating Client Death in Addications Counseling By Jessica Jordan-Banks, BA

■ DEPA R T M EN TS 4

President’s Corner: The Governance of NAADAC By Diane Sevening, EdD, LAC, MAC, NAADAC President

From The Executive Director: NAADAC, State Affiliate, and You! By Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP, NAADAC Executive Director

Certification: NCC AP Update: Meeting Challenges in Credentialing By Jerry Jenkins, MEd, MAC, NCC AP Chair

10 Ethics: Professional Transgressions in the Workplace

By Mita Johnson, EdD, LAC, MAC, SAP, NAADAC Ethic Committee Chair

Managing Editor

Jessica Gleason, JD

Associate Editor

Kristin Hamilton, JD

Graphic Designer

Julie Bedford, Jules Creative, LLC

Editorial Advisory Committee

Kirk Bowden, PhD, MAC, NCC, LPC Rio Salado College EAC Chair

Kansas Cafferty, LMFT, MCA, CATC, NCAAC True North Recovery Services National Certification Commission for Addiction Professionals (NCC AP)

Deann Jepson, MS Advocates for Human Potential, Inc.

Roy Kammer, EdD, LADC, ADCR-MN, CPPR, LPC (CD), NCC Hazelden Betty Ford Graduate School of Addiction Studies

James McKenna, MEd, LADC I McKenna Recovery Associates

Donald P. Osborn, PhD, LCSW, LMFT, LCAC, MAC Indiana Wesleyan University

Joseph Rosenfeld, PsyD, CRADC, HS-BCP Elgin Community College

Samson Teklemariam, MA, LPC, CPTM NAADAC, the Association for Addiction Professionals

Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP NAADAC, the Association for Addiction Professionals

Margaret Smith, EdD, MLADC Ottawa University & Keene State University

Article Submission Guidelines We are interested in accepting any interesting and topical articles that address issues of interest to addiction-focused professionals. Please submit story ideas and/or articles to Features Editor, Samson Teklemariam at steklemariam@naadac.org. For more information on submitting articles for inclusion in Advances in A ddiction & Recovery, please visit www.naadac.org/advances-in-addiction-recovery. Disclaimer It is expressly understood that articles published in Advances in Addiction & Recovery do not necessarily represent the view of NAADAC. The views expressed and the accuracy of t h e i n fo r m a t i o n o n w h i c h t h e y a r e b a s e d a r e t h e r e s p o n s i b i l i t y o f the author(s) and represent the wide diversity of thought and opinion within the addiction profession.

11 Membership: NAADAC Annual Awards & Nomination Process

Advertise With Us For more information on advertising, please contact Irina Vayner, NAADAC Exhibits & Ad Sales Manager, at ivayner@naadac.org.

12 Advocacy: Your Advocacy - Your NAADAC

Advances in Addiction & Recovery The Official Publication of NAADAC, the Association for Addiction Professionals ISBN: 978-0-9885247-0-5

14 Membership: Meet Your New 2019-2021 Regional Vice Presidents for the

This publication was prepared by NAADAC, the Association for Addiction Professionals. Reproduction without written permission is prohibited. For more information on obtaining additional copies of this publication, call 703.741.7686 or visit www. naadac.org.

By Jessica Gleason, JD, Deputy Director

By Tim Casey, Policy Advisor, Polsinelli

Mid-Central, North Central, Southeast and Southwest Regions By Kristin Hamilton, JD, NAADAC Sr. Communications Manager

Printed May 2019

20 2019 Annual Conference Preliminary Schedule 30 NAADAC CE Quiz

STAY CONNECTED

31 NAADAC Leadership ALL IMAGES FROM SHUTTERSTOCK UNLESS OTHERWISE NOTED

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■ P R ESID ENT ’S CORN E R

The Governance of NAADAC By Diane Sevening, EdD, LAC, MAC, NAADAC President

NAADAC’s governing body, the body that deter mine the direction of NAADAC and how N A A DA C c a n b e s t s e r v e i t s constituents, is the NAADAC Board of Directors. The NAADAC Board of Directors is made up of the State Affiliate Presidents, the Executive Committee, and an Organizational Delegate. The State Affiliate Presidents are elected by their respective State Af filiate associations, and the Executive Committee is comprised of NAADAC’s directly elected officers: the President, Immediate Past President, President-Elect, Secretary, Treasurer, and eight Regional Vice Presidents (RVPs). NAADAC’s Board of Directors meets in-person once a year at the NAADAC Annual Conference. The Executive Committee, joined by the non-voting NAADAC Executive Director and National Certification Commission for Addiction Professionals (NCC AP) Chair, meets on a monthly basis. State affiliates, by and through their respective presidents, provide the framework for NAADAC. State affiliates are run by professionals with their feet on the ground who represent national and state initiatives. Each state’s addiction professionals have specific needs, wants, and goals regarding credentialing standards, reimbursement challenges, workforce needs, and other issues. They are the voice that guides NAADAC in guaranteeing membership needs are being met for the addiction profession and professionals, along with advocating at their state and national levels for legislative changes. The president of each of the affiliates is the official representative to the NAADAC Board of Directors and these presidents have the opportunity to express their state concerns and have a vote in determining what is needed in the best interest of NAADAC. Each NAADAC board member has a fiduciary, legal, and ethical responsibility to act in a way which ensures that NAADAC operates in the best interest of its membership. By including Affiliate Presidents on the Board of Directors, each member is directly represented on the board. Members of the Board of Directors bring to the attention of NAADAC the recommendations, ideas, suggestions, and concerns of the persons they represent and in turn bring to the attention of all the members they represent to NAADAC’s policies, decisions, and opportunities available through membership. Each Affiliate President attends the annual Board of Directors meeting at the NAADAC Annual Conference and votes on various matters affecting NAADAC and its members. All NAADAC State Affiliates require their members to also 4

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be NAADAC members, and when anyone joins NAADAC, he or she automatically becomes a member of his or her State Affiliate. Each State Affiliate has a board of directors that is required to meet regularly and to submit an affiliate contract and associated materials to NAADAC. Once a state becomes an affiliate of NAADAC, the benefits are numerous. Each State Affiliates provides an annual submission of its organizational bylaws that coincide with the NAADAC bylaws, applicable policies and procedures, a copy of the latest audit report, and a list of the affiliates officers and committee chairs. This helps to guarantee consistency on the national and state levels and ensures the affiliated associations are operating within the rules and overall goals and objectives of NAADAC. Some State Affiliates hold annual state conferences and/or periodic trainings. As a recognized NAADAC affiliate, they often receive discounts for speakers, some that are nationally renowned, and a “care box” from the NAADAC office that includes all updated promotional materials about membership and programs, flyers, the latest NAADAC magazine, Advances in Addiction & Recovery, and NAADAC goodies to giveaway or auction off. NAADAC’s eight Regional Vice Presidents (RVPs) are elected by members within their respective regions: Northwest, North Central, Mid-Central, Mid-Atlantic, Northeast, Southeast, Mid-South, and Southwest. RVPs serve on the Executive Committee to represent the State Affiliates and members with their region. They are responsible for communicating any concerns or recommendations from their region to the Executive Committee and vice versa. RVPs are required to hold monthly regional calls with the State Affiliate Presidents in their region to discuss national happenings and connect with each state for updates about conferences, trainings, and legislative issues. RVPs offer assistance with trainings and conferences in their states as a speaker, mentor, and facilitator while making suggestions or recommendations for membership recruitment and retention. They are also required to submit a quarterly report of the progress in their regions to the Executive Committee and an annual report at the NAADAC Annual Conference for the Executive Committee and the Board of Directors. Quarterly calls are scheduled with the NAADAC President, President Elect, and the Executive Director, during which all RVPs get the opportunity to discuss what is happening in their regions, address areas of concerns, and seek guidance and support.

Some regions have “quiet” states, which are states that have NAADAC members but no organized or active State Affiliate. RVPs encourage chartering of local, state, and regional chapters and affiliates, and assist new chapters and affiliates during their formation. NAADAC assists these states and the RVPs in those regions by suggesting and supporting the development of an advisory council. Members within the quiet states are periodically contacted by the RVP to see if anyone is interested in taking a leadership role in developing an advisory council and offering a training or “lunch and learn” for the members and assist with creating better understanding of the benefits of a NAADAC affiliation. Regional conferences are also scheduled with the assistance of NAADAC and the RVP to assist with notifications, registration, conference materials, and speakers. Often times people are unable to attend the NAADAC Annual Conference and find the regional conferences informative and beneficial. It has been my honor and privilege to serve as a NAADAC State Affiliate President in South Dakota, where NAADAC was very supportive in assisting with the state corporation, state conferences, and licensure successes. I was also honored and privileged to be elected the NAADAC North Central RVP and became more knowledgeable about the concerns of other states and all the great benefits NAADAC provides with their support from staff, caring about the needs of each state, and

maintaining standards for the addiction professional and profession. As Abraham Lincoln said, “Commitment is what transforms a promise into reality,” and that is exactly what we do as addiction professionals and NAADAC does as an association that meets our needs. Diane Sevening, EdD, LAC, MAC, is an Assistant Professor at the University of South Dakota (USD) School of Health Sciences Addiction Counseling and Prevention Department (ACP), has over 35 years of teaching experience, and is a faculty advisor to CASPPA. In addition to serving as NAADAC President, Sevening is also a member of the SD Board of Addiction and Prevention Professionals (BAPP) and Treasurer of the International Coalition for Addiction Studies Education (INCASE). Her clinical experience involves seven years as the Prevention and Treatment Coordinator Student Health Services at USD, Family Therapist at St. Luke’s Addiction Center in Sioux City, IA for one year, and two years as clinical supervisor for the USD Counseling Center. Sevening has been the NAADAC Regional Vice President for the North Central Region, the NAADAC Student Committee Chair, a National Addiction Studies Accreditation Commission (NASAC) Evaluator, and is currently on the NASAC Board of Commissioners.

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■ F R O M T H E E X E C U T I VE DI RE C TOR

NAADAC, State Affiliates, and You! By Cynthia Moreno Tuohy, NCAC II, CDC III, SAP, NAADAC Executive Director

Advocacy is in the addiction professionals blood; as addiction professionals, we know that our clients are the most vulnerable, least protected, and most discriminated against due to their disease, and that many other community leaders, legislators and public do not want to recognize substance use disorders as a disease. We see this stigma evidenced every day in one form or another, from lack of insurance coverage for substance use disorder treatment, to the difficulties clients face gaining employment or re-employment, to child protective services lack of evidence-based supports to parents suffering from the disease, and to the criminal justice system’s untherapeutic regard for 85% of the incarcerated population having substance use-related issues. NAADAC’s Code of Ethics (Principle III, Sections 29 – 32) addresses advocacy directly, stating, “Providers shall be advocates for their clients in those settings where the client is unable to advocate for themselves. Addiction Professionals are aware of society’s prejudice and stigma towards people with substance use disorders, and willingly engage in the legislative process, educational institutions, and public forums to educate people about addictive disorders and advocate for opportunities and choices for our clients. Addiction Professionals shall advocate for changes in public policy and legislation to improve opportunities and choices for all persons whose lives are impaired by substance use disorders. Addiction Professionals shall inform the public of the impact of substance use disorders through active participation in civic affairs and community organizations. Providers shall act to guarantee that all persons, especially the disadvantaged, have access to the opportunities, resources, and services required to treat and manage their disorders. Providers shall educate the public about substance use disorders, while working to dispel negative myths, stereotypes, and misconceptions about substance use disorders and the people who have them.” On April 10-11, 2019, NAADAC Leadership, lead by our President, Diane Sevening, and our NCC AP Chair, Jerry Jenkins, worked with other NAADAC national and state leaders and other members and constituents of NAADAC to communicate NAADAC’s priorities and concerns to legislators and their staffs on Capitol Hill in Washington, D.C., to bring awareness of persons with substance use disorders and their specific needs, as well as NAADAC’s efforts to address those needs and the needs of the professionals who serve them! We advocated for public policy change in insurance reimbursement and protections with the enforcement of parity, for the increase of the Substance Abuse and Mental Health Block Grant and the allocation of funds to the SUPPORT for Patients and Communities Act, tuition support for addiction professionals, and funding of the Minority Fellowship Program. Without our leaders from their various states educating their specific legislators, the power in the message is lost. It is vital that your legislators hear from you personally, with your stories of client successes and the reasons why some of your clients are unable to achieve recovery, and that in the absence of enough treatment services, more people will die. Your work at the state level, fueled by NAADAC support when helpful, can push a bill or funding request to the finish line! NAADAC has partnered with many of our states this year to support credentialing protection from other disciplines working to get their foot in the door of addiction practice without 6

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any training in addiction-specific pharmacology, counseling skills, and practice. We have worked with our state affiliates to squash those bills or change them to be less harmful to our addiction specific practice. States such as Washington, Wyoming, California, North Dakota, and others have felt the “heat” of other disciplines pushing for the ability to administer addiction treatment with less education and training or no education and training. Your voice telling how your addiction specific training, education and practice makes a difference to the clients you serve and the efficacy of services rendered due to these disciplinespecific competencies is what is needed in those state and national legislative rooms. Several of these state bills came up with little warning, but NAADAC was able to be responsive and send letters of support with supporting documents to articulate the national addiction scopes of practice, the specific training needed, and education, levels required to provide appropriate evidence-based and effective treatment. Together, NAADAC and the state leadership presented persuasive materials, evidence, and arguments to that allowed us to prevent what could have been a disastrous law for our addiction counselors and the clients they serve. NAADAC is working with Polsinelli, our government relations firm, and our public policy advisors, Tim Casey and Julie Shroyer, to develop strategies to take to the Hill and language to create and place in legislation that will articulate in legislative language our initiatives and cause change that acknowledges the needs of our clients and our counselors/professionals. Part of the education we promote is the SAMHSA-NAADAC Addiction Professional Education & Career Ladder developed by NAADAC, accepted by partner national addiction organizations, and adopted by and promoted through SAMHSA. NAADAC is working to promote portable national credentials for the benefit of our clients, who move from state to state, and for our counselors, who to move across state lines and find themselves no longer to practice in the new state due to draconian laws or rules that prohibit the recognition of other state addiction credentials. With the advent and growth of telehealth, it will become more imperative that states adopt and accept portable credentials based on the SAMHSA-NAADAC Addiction Professional Education & Career Ladder. Together, we can build a unified state and national voice that builds on the principles of our Code of Ethics and NAADAC legislative initiatives and that works consistently and tenaciously to support our clients and professionals, as well as the health and wellness of individuals, families, and communities across the nation! Please join NAADAC and NCC AP and make a difference in your community, state, nation and around the world! Blessings, Cynthia REFERENCES SAMHSA-NAADAC Addiction Professional Education & Career Ladder, Updated September 2018. Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP, is the Executive Director of NAADAC, the Association for Addiction Professionals, and has worked as an addiction professional for over 35 years. She has been a trainer in Domestic Violence/Anger Management and Conflict Resolution for over 25 years as well as an international, national and state trainer in a variety of topics. Moreno Tuohy is also a curriculum writer in addiction screening and evaluation, counseling methods, conflict resolution, co-occurring disorders, and medicated assisted treatment and recovery, and has written articles published in national and other trade magazines. She holds a Bachelor’s Degree in Social Work and is certified both nationally and in Washington State.

SAMHSA-NAADAC Addiction Professional Education & Career Ladder

Education

High School or G.E.D.

Certificate Program, Training Series, Some College

Associate’s Degree

Bachelor’s Degree

SAMHSA Career Ladder Level

Career Opportunities • Peer Recovery Support Specialist or similar title • Court Diversion Support Specialist • Peer Navigator • Peer Advocate • Peer Educator • Recovery Coach

1. Offers support and encouragement 2. Navigation/referral to other support services in the community 3. Motivation and guidance to seek support in auxiliary services or mutual aid groups 4. Client, family, and/or community education 5. Documentation 6. Ethical responsibilities

Entry Level SUD Technician

• SUD Counselor in Training • Outreach Worker • Detox Tech • Intern • Community Educator • Residential Support Staff

1. Diagnostic impression, and Screening, Brief Intervention, Referral to Treatment (SBIRT) 2. Monitor treatment plan/compliance 3. Referral 4. Service coordination and case management for SUDs 5. Psycho-educational counseling of individuals and groups 6. Client, family, and/or community education 7. Documentation 8. Professional & ethical responsibilities

Associate SUD Counselor

• SUD Counselor in Training • Outreach • Recovery House • Detox Tech • Intern • Community Education • Group, Ind and Assessment support

Entry Level SUD Technician OR Peer Specialist

SUD Counselor

• • • • •

SUD Counselor Clinical Supervisor Manager Administrator Trainer

Master’s Degree

Clinical SUD Counselor OR Independent Clinical SUD Counselor/ Supervisor

Doctorate

Scope of Practice

• • • • • •

SUD Counselor Clinical Supervisor Manager Administrator Educator Private Practitioner

1. Clinical evaluation, including diagnostic impression or Screening, Brief Intervention, Referral to Treatment (SBIRT) 2. Treatment planning for SUDs and CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention 3. Referral 4. Service coordination and case management for SUDs and CODs 5. Counseling, therapy, trauma-informed care, and psycho-education with individuals and groups 6. Client, family, and/or community education 7. Documentation 8. Professional & ethical responsibilities 9. Clinical supervisory responsibilities for all categories of SUD counselors. Practitioner Under Clinical Supervision 1. Clinical evaluation, including screening, assessment, and diagnosis of SUDs and CODs 2. Treatment planning for SUDs & CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention 3. Referral 4. Service coordination and case management for SUDs & CODs 5. Counseling, therapy, trauma-informed care, and psycho-education with individuals and groups 6. Client, family, and/or community education 7. Documentation 8. Professional & ethical responsibilities 9. Clinical supervisory responsibilities for all categories of SUD counselors. Independent Practitioner 1. Clinical evaluation, including screening, assessment, and diagnosis of SUDs and CODs 2. Treatment planning for SUDs & CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention 3. Referral 4. Service coordination and case management for SUDs & CODs 5. Counseling, therapy, trauma-informed care, and psycho-education with individuals and groups 6. Client, family, and/or community education 7. Documentation 8. Professional & ethical responsibilities 9. Clinical supervisory responsibilities for all categories of SUD counselors.

Required State Credential or License

NCC AP National Certification

Dependent on state regulations

National Certified Peer Recovery Support Specialist (NCPRSS)

Dependent on state regulations

National Certified Addiction Counselor Level I (NCAC I)

Dependent on state regulations. Most states require license or certification.

National Certified Addiction Counselor Level I (NCAC I)

Dependent on state regulations. Most states require license or certification.

National Certified Addiction Counselor Level II (NCAC II)

Dependent on state regulations. Most states require license or certification.

Masters Addiction Counselor (MAC)

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■ CER T IF IC AT I ON

NCC AP Update: Meeting Challenges in Credentialing By Jerry Jenkins, MEd, MAC, NCC AP Chair In the article I wrote for the last issue of Advances in Addiction & Recovery, I focused on why substance use disorder professionals need to be pursing national credentials. As noted, the U.S. Department of Labor projects employment of addiction counselors to grow by 23% in the next seven years. The demand for qualified professionals is increasing at a pace exceeding most other professions. This is one reason for advocating for accessible training and education to enable people entering the field to learn the basics of substance use disorder treatment and to continue to advance their counseling skills and work toward earning credentials. With that background, the following is a “look behind the curtain” of the National Certification Commission for Addiction Professionals (NCC AP). It is imperative that we, as a profession, adapt to and take advantage of innovations in our field. NAADAC and NCC AP have long advocated for training and education that facilitates learning the basics of substance use disorder treatment and then continuing to learn updated information or technologies as it become available. In fact, it was because of the need for a consistent and concise requirement of specialized and continued training and experience that NCC AP was founded.

A Look Back The recognition of the need in the 1980’s for national credentialing was a strategic initiative by NAADAC, resulting the sponsoring of NCC AP. The impetus was the various credentialing criteria and titles being used by states. “Alphabet soup” was often used to describe the various combinations of letters for identifying addiction professionals. Further complicating professional recognition was the approach by some states to separately credential alcoholism counselors from other psychoactive substances (White, 1998). Since 1990, NCC AP has been developing standards for national credentials. Commissioners are experienced state licensed or certified SUD professionals responsible for “developing and keeping current national standards of requisite knowledge in substance use disorder counseling and providing evaluation mechanisms for measuring and monitoring the level of knowledge required for national credentialing. . .” NCC AP recognizes that the addiction profession is in constant development, which requires reassessing the tenets underlying credentialing. In 1998, the Substance Abuse and Mental Health Ser vices Administration (SAMSA) and the Center for Substance Abuse Treatment (CSAT) published Addiction Counseling Competencies – The Knowledge, Skills, and Attitudes of Professional Practice (The Competencies) as Technical Assistance Publication (TAP) 21. TAP 21 identifies 123 competencies that are essential to the effective practice of counseling for psychoactive substance use disorders. TAP 21 presents the knowledge, skills, and attitudes (KSAs) counselors need to become fully proficient in each competency (CSAT, 2005). Today, TAP 21 is considered the source document defining addiction counseling and the technical aspects of the profession. It was last formally updated in 2005.

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NCC AP recognizes the need for developing and maintaining current national standards of requisite knowledge in substance use disorder counseling and monitoring the level of knowledge required for national credentialing.

A Look Behind the Curtain NCC AP uses a combination of requirements to determine eligibility for national certification, including having a state credential as a SUD/ addiction counselor, supervised work experience, requisite SUD/addiction related training, and passing a comprehensive exam (NAADAC, n.d.). NCC AP, as part of its strategic plan, is doing quality assurance activities related to the examination process to ensure our credential exams for our three main credentials (National Certified Addiction Counselor Level I (NCAC I), National Certified Addiction Counselor Level II (NCAC II), and Master Addiction Counselor (MAC) reflect the current state of the profession. Information, technology, and best practices from ten years ago may be outdated. For example, we need to consider advances in understanding the impacts of adverse childhood events and other traumatic events on assessment techniques and counseling strategies, as well as advances in medication assisted treatment (MAT). Other examples include

the expanding use of electronic clinical records, as well as increased use of electronic technologies to connect with clients through everything from texting to remote monitoring and tele-behavioral health. Further, competencies may remain the same but the tools needed may change. The quality assurance process for the NCAC I, NCAC II, and MAC started from the ground up. First, NCC AP worked to answer the question,

“Why is the exam being created?” Short answers included: • To establish national professional standards for addiction professionals based on training, education, experience, and demonstrated knowledge. Credentials are part of a career ladder tied to a scope of practice, and are available for professionals to advance through the profession of addiction/SUD counseling. • To ensure professionals receiving credentials agree to a national code of ethics. • To position candidates for career advancement and increased salary potential. • To distinguish candidates as practitioners who have specialized addiction/SUD training and experience in assessment, treatment, and counseling.

Next, NCC AP underwent a critical reviewing of and ultimate reaffirming of the major topics constituting critical areas to be addressed by exams. The topics are: • Clinical evaluation, including screening, assessment and diagnosis of substance use/addiction and screening for CODs • Treatment planning for SUDs, including initial, ongoing, continuity of care, and discharge and planning for relapse prevention • Referral • Service coordination/case management in the areas of SUDs and CODs • Counseling skills and theories of counseling – therapy and psychoeducation with individuals, families, and groups in the area of SUDs • Client, family, and community education • Documentation and compliance • Professional and ethical responsibilities • Clinical supervisory responsibilities for all categories of SUD counselors • Pharmacology and physiology of SUD/addictive and COD • Code of ethics & professional development The NCC AP then underwent a review of the 123 competencies outlined in TAP 21 and determined the minimally acceptable knowledge and skills to be assessed by the examination process. In the fall of 2018, NCC AP credentialed professionals were surveyed regarding job roles in terms of the job functions (i.e., responsibilities/duties) and tasks performed on a job as well as the knowledge and/or skills (i.e., competencies) required to perform those tasks. The results of the job analysis will provide evidence to the breadth and depth of knowledge and skills substance use disorder counselors should possess in 2018. In turn, NCC AP will ensure that the exams accurately reflect the updated information. This is key to insuring a quality national credentialing process reflecting what the profession considers to be the minimum standards for identifying SUD professionals. In closing, NCC AP recognizes the need for developing and maintaining current national standards of requisite knowledge in substance use disorder counseling and monitoring the level of knowledge required for national credentialing. As described above, that process is currently underway in a robust manner. All of this is in support of insuring our national credentials for recognizing SUD counseling professionals are up to date and reflective of our critical task in effectively addressing substance use disorders. REFERENCES CSAT (Center for Substance Abuse Treatment). Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice—An Update to TAP 21. Technical Assistance Publication (TAP) Series 28. DHHS Publication No. (SMA) 06 4171. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2006a. NAADAC, the Association for Addiction Professionals (n.d). About the NCC AP. Retrieved from https://www.naadac.org/about-the-ncc-ap. White, W. L. (1998). Slaying the Dragon. Bloomington, IL: Chestnut Health System/ Lighthouse Institute, 275. Jerry A. Jenkins, MEd, LADAC, MAC, currently chairs the National Certification Commission for Addiction Professionals. He has over 35 years of experience in treating substance use disorders and mental illness and has been a member of NAADAC since the late 1980’s. He has worked in and managed community based, outpatient, halfway and residential treatment services where he has regularly hired people in recovery. He is an advocate for recovery as the expectation for behavioral health care with an emphasis on being trauma informed and substance use disorder treatment counselors having credentials to demonstrate having specialized training, experience and skills.

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■ E T H ICS

Professional Transgressions in the Workplace By Mita Johnson, EdD, LAC, MAC, SAP, NAADAC Ethics Committee Chair Most clinicians and allied providers who work with clients struggling with substance use and addictive behavior disorders chose our profession because they have a strong desire to help others work through the challenges and difficulties of use, dependence, and recovery. Our work is an inspiring and humbling opportunity to help fellow humans improve their lives while working towards wellness and functionality. We can all agree that our first priority is to do no harm to the client. Our second priority, albeit often not discussed, is to do no harm to the profession and/or organization. There are personal and corporate responsibilities that come with being part of helping and counseling professions. One of the most challenging ethical and potentially legal responsibilities we face is having to respond to a potential or actual transgression by a colleague or organization. We may have either first-hand or second-hand knowledge that a colleague or organization has done something that has the potential or the actuality of hurting the client, organization, or profession. The initial reaction may be to ignore the situation or hope someone else discovers it and handles the issue. Other reactions include fear, avoidance, assumption-building, and irritability. When you find yourself in such situations, there are steps to follow in handling these transgressions. When a clinician or allied provider discovers there may have been an ethical violation by a peer, colleague, or supervisor, he or she can first attempt to resolve the issue by bringing the issue to the attention of the colleague. When pursuing an informal resolution, the clinician has to ensure that internal biases, judgments, and assumptions are not clouding his or her understanding of the concerns. The clinician needs to be clear that the ethical and/or legal violation is not harming a client directly or violating ethical rules around privacy and confidentiality. If an informal resolution was not achieved or the ethical and/or legal violation has substantially harmed or is likely to harm a client, the organization, and/or the profession, the clinician has an obligation to take this situation to his or her clinical supervisor for direction and guidance. The clinician could also seek consultation to determine the best course of action from an industry expert, ethics committee, or licensing board, as long as he or she is protecting the confidentiality of clients at all times. When filing a formal complaint, the clinician can refer his or her complaints to the state licensing board, single state authority, professional organization’s ethics committees, or other appropriate institutional authorities. Often, clinicians do not want to report their colleagues to clinical supervisors or legal/professional entities. Understandably, no one wants to be a “snitch.” Ethical/legal dilemmas can be a cause for concern and are an expected byproduct of the work we do. So, how do you know when it is time to speak up? Can you protect yourself from negative consequences or retaliatory actions by the colleague or organization that result from attempting to reach an informal or formal resolution? If you do decide to say something, what do you say and to whom do you say it? There is no one strategy or answer for all situations, unfortunately. However, your North Star – your reason for wanting to bring the transgressions to light – is protecting the client, the organization-at-large, and our profession. Protecting the client from direct or indirect harm is always the right thing to do. When it comes to ethics, we may believe that a colleague’s transgressions are a test of our moral and professional identity, which can make us more emotional and vulnerable and less effective as clinicians and professionals. We can start rationalizing the situation, which only feeds our self-delusions. One thing to remember is that we tend to overestimate how awful the informal conversation may be, how terrible the retaliation may be, and how long the retaliation may

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last. Rationalizations that we get caught up in can include: it’s not a big deal, I don’t have all the information, the client overexaggerated, this is someone else’s problem, this transgression must be accepted as the norm, and the client will eventually stop seeing the colleague. In these situations, we often recognize the problem but are rationalizing the problem down to something not quite as big of a deal. When you find yourself rationalizing, it is important to question your underlying assumptions, fears of retaliation, and thoughts about what it means to “do no harm.” Ultimately, each one of us has to determine what constitutes unethical behavior. Once we come across professionally unethical and/or illegal behavior, we have to determine when and how to address it. We may begin by talking privately with the colleague to discuss the concern, best courses of action, and positive reasons for making changes before the client, organization, or profession is harmed. We must choose our battles carefully – everything that we don’t like is not necessarily an ethical breach. We should not share our concern with others until we have all the facts in hand. Our work must go on as usual – we have an ethical obligation to continue to do the best work we can – regardless of the actions of others. Supervisors should be alerted when unethical behavior crosses the line leading to harm to the client, organization, or profession. Alleged transgressions should be documented with supporting facts to support the assertions being made. Details, including dates, times, and summaries of what happened, are needed to support the case. When we believe that the transgressions are continuing and the organization is not addressing the concerns, clinicians have an obligation to report the incidents to their licensing and credentialing authorities and NAADAC’s/NCC AP’s ethics committees for further review. We have to choose which we are most afraid of – harm to the client or harm to oneself as a result of telling others about what is going on. As counselors, we have responsibilities to the profession and other professionals to create a safe treatment and recovery environment. We have a responsibility not only for our own ethical and legal practice, but also for the ethical and legal or unethical or illegal practice of our colleagues. Knowing and not acting can make us an accessory to the transgression. We are part of a greater profession that sincerely wants to be accepted as professional, ethical, and effective. The desire to do the right thing in circumstances of a colleague’s transgressions reveals a commitment to protect the public from harm while maintaining the ethical standards of our profession. Often, the right thing to do is not the easiest thing to do – and yet it is still the right thing to do. The question is not only who are we when no one is watching, but also, who are we when the profession and public are watching? Mita M. Johnson, EdD, LAC, MAC, SAP, has a Doctorate Degree in Counselor Education and Supervision, a Master’s Degree in Counseling, and a Bachelor’s Degree in Biology. She is a licensed professional counselor, licensed marriage and family therapist, and licensed addiction counselor, along with earning the national Master Addiction Counselor (MAC) and Department of Transportation Substance Abuse Professional (SAP) certifications. Johnson has two supervisory credentials (ACS and AAMFT) and is a NCC. She is a core faculty member at Walden University, and she maintains a private practice where she works with supervisees who are working on credentialing. Johnson is the NAADAC President-Elect and Ethics Chair, and a Board Member of the Colorado Association of Addiction Professionals (CAAP). She previously served as NAADAC’s Treasurer and Southwest Regional Vice-President, and CAAP President. In Colorado, Johnson is involved in regulatory and credentialing activities as well as workforce recruitment and retention initiatives. She speaks and trains regionally and nationally on a variety of topics. Her passions beyond workforce retention include pharmacology of drugs of addiction, infectious diseases, ethics, motivational interviewing, and clinical supervision.

■ M EM B ER S HI P

NAADAC Annual Awards & Nomination Process By Jessica Gleason, JD, Deputy Director Each year, NAADAC and its members celebrate and honor people and organizations that have achieved excellence in the treatment, recovery, prevention, medical, and educational sectors of our addiction profession over the past year. Awards are given in seven categories and will be presented during NAADAC’s Annual Conference in Orlando, Florida, at the President’s Awards Luncheon. It is important to recognize and honor the distinguished services, accomplishments, and contributions of individuals and organizations to continue to elevate and motivate the profession. Make sure to get your nominations in by May 31st! Award Categories The Addiction Educator of the Year Award recognizes an adjunct or full-time college/university professor who has contributed through academia to the addiction profession through mentoring students/ student chapters, colleagues or addiction professionals and/or by providing ongoing research or other contributions that grow, enhance, advocate and educate for the addiction profession. The Lifetime Honorary Membership Award recognizes an individual or entity who/that has worked in the addiction profession for at least 25 years, has established through research, publications, presentations or by other means the significance of the addiction profession and its professionals, had demonstrated leadership, service, and contributions to addiction profession, and has supported NAADAC’s mission, vision and Code of Ethics. The Lora Roe Memorial Addiction Counselor of the Year recognizes a counselor who has made an outstanding contribution to the profession of addiction counseling. To be eligible for this award, nominees must: be currently employed as an addiction counseling professional, and actively working as a counselor for not less than three years prior to receiving the award; be an active NAADAC member in good standing (the individual must be a voting member as opposed to an honorary or nonvoting member); have worked with clients (patients) for a sustained period with individual or group contact that fosters recovery from addiction disorders; preferably, be certified, registered or licensed as an addiction professional, although these qualifications are not mandatory; and have demonstrated to the satisfaction of one’s peers full compliance and support of NAADAC’s Code of Ethics. The Davida Coady Gorham Medical Professional of the Year recognizes medical professional who has made an outstanding contribution to the addiction profession. To be eligible for this award, nominees must: be currently employed in the addiction profession and actively working as such for a minimum of three years prior to receiving this award; hold licensure as a Medical Doctor, Registered Nurse, Licensed Practical/Vocational Nurse in their respective state; be an active NAADAC member in good standing (i.e., the individual must

be a voting member as opposed to an honorary member or nonvoting member); be working with clients/patients for a sustained period with individual or group contact that fosters recovery from addiction disorders; and have demonstrated to the satisfaction of one’s peers full compliance and support of NAADAC’s Code of Ethics. The Mel Schulstad Professional of the Year Award recognizes an individual who has made outstanding and sustained contributions to the advancement of the addiction counseling profession. The Organizational Achievement Award recognizes an organization that has demonstrated a strong commitment to the addiction profession and particularly strong support for the individual addiction professional. To be eligible for this award, nominees must have been in existence for at least five years and cannot be affiliated with any other organization or company that sells, distributes or supports the consumption of alcoholic spirits or illicit substances. The William F. “Bill” Callahan Award recognizes sustained and meritorious service at the national level to the profession of addiction counseling. To be eligible for this award, nominees must have a minimum of fifteen years in the addiction counseling profession or related administration, and possess a strong dedication to the addiction profession as demonstrated by involvement in and commitment to a variety of key organizations. Nominating Information Any NAADAC member in good standing may nominate any eligible individual NAADAC member for any of the above individual awards. Current members of the NAADAC Executive Committee are ineligible for all awards. To nominate an eligible addiction professional for a NAADAC award, please submit (1) a letter of recommendation stating how the nominee fulfills the award criteria; (2) at least three letters of support from three different sources (individuals, organizations, or agencies); (3) the nominee’s resume; and (4) a comp l e t e d N A A DA C R e c o g n i t i o n a n d A w a r d s N o m i n a t i o n Acknoweldgement Form.

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■ A D V O C AC Y

Your Advocacy - Your NAADAC By Tim Casey, Policy Advisor, Polsinelli

NAADAC’s Advocacy in Action Conference in April brought addiction professionals from across the country together in our nation’s capital. Over the course of two days, participants heard from key Administration officials, Congressional staff, and thought leaders in the field. Attendees capped their visit to Washington with a NAADAC briefing & full day of meetings on Capitol Hill. White House Office of National Drug Control Policy (ONDCP) Associate Director June S. Sivilli kicked off the conference with an overview of the Administration’s efforts to prevent illicit drug use and prescription drug misuse, as well as a discussion of the importance of improving access to substance use disorder treatment and recovery services. Sivilli went on to discuss the Administration’s efforts to build medication-assisted treatment (MAT) capacity and the importance of investing in the addiction workforce and promoting evidence-based practice. Rob Morrison, the Executive Director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), provided

an update on federal funding for substance use disorder treatment and recovery programs in FY2020. Israil Ali and Patsy Cunningham from the Health Resources and Services Administration (HRSA)’s Bureau of Health Workforce gave an overview of HRSA’s current and upcoming workforce initiatives, and presenter Garth Van Meter, Vice President of Government Affairs for Smart Approaches to Marijuana (SAM), discussed the debate surrounding the legalization of marijuana. NAADAC Public Policy Committee Co-Chairs Sherri Layton and Michael Kemp and Polsinelli Public Policy Advisors Julie Shroyer and Tim Casey delivered an overview on NAADAC priorities and shared key insights on how to build lasting relationships with lawmakers on issues that matter to the addiction profession. Finally, Gary Tennis, President of the National Alliance for Model State Drug Laws (NAMSDL), explained how NAMSDL’s model drug and alcohol laws, 12

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policies, and regulations are created and how they can serve as a catalyst for advancing lifesaving drug and alcohol policies. The Capitol dome served as the backdrop for the second day of the conference. Participants started their morning with a Congressional briefing in the House Cannon Building before meeting with members of the House and Senate and their staffers to discuss NAADAC’s policy priorities, including increased funding for treatment and recovery services, increased funding to the SAPT Block Grant, recognition of standardized credentials, and protecting the privacy of individuals with substance use disorders. The NAADAC Congressional briefing featured Gary Tennis, President of the National Alliance for Model State Drug Laws and Mar vin Ventrell, Executive Director of the National Association of Addiction Treatment Providers (NAATP), two prominent figures on the topic of ethics and marketing practices. Tennis spoke about NAMSDL’s Model Patient Protection and Treatment Ethics Act, designed to put a stop to predatory practices designed to exploit the resources while neglecting the safety and welfare of those who need real treatment. Ventrell then explained NAATP’s Quality Assurance Initiative (QAI) and its Ethics Code 2.5 for treatment providers. The QAI is a comprehensive program designed to deter problematic practices, promote best practices, protect the consumer, and inform the payer and policy-maker. The QAI Practice Guidebook, scheduled to be published this summer, will identify the core competencies of treatment center operation and provide guidelines for operation. Following Tennis and Ventrell’s remarks, Congressional staffers from the of fices of Representatives Katherine Clark (MA-05), Hal

Rogers (KY-05), and David Joyce (OH-14) provided critical insights on the 116th Congress and its commitment to issues impacting substance use disorders. After the briefing, conference goers made their way through the halls of the Capitol to visit their respective House and Senate lawmakers. Attendees emphasized the importance of supporting the addiction workforce, including the need to secure funding for the Substance Use Disorder Workforce Loan Repayment program established by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271). The program incentivizes students to pursue substance use disorder treatment professions by providing student loan relief. Without full funding for the new program, championed by Representatives Katherine Clark (D-MA-05), Hal Rogers (R-KY05), the addiction workforce and the individuals we serve will never see the benefits of this i m p o r t a n t p o l i c y v i c t o r y. NAADAC advocates urged Congress to allocate $25 million in federal funding for the program in Fiscal Year (FY) 2020. Conference attendees also encouraged lawmakers to support allocating federal funds for other important programs, including $14.7 million in funding for the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Minority Fellowship Program (MFP), which supports

diversity in the behavioral health workforce, and $8.6 billion in funding for the Health Resources and Services Administration (HRSA) to assist with the administration of the National Health Service Corps (NHSC) loan repayment program to improve access to addiction treatment in rural communities. Addiction professionals on the Hill also cautioned lawmakers against eroding important privacy protections for individuals with substance use disorder history. Attempts to align 42 CFR Part 2 and HIPAA regulations were hotly debated in the 115th Congress and attempts to revisit the issue ar e under way in the new Congress as similar legislation has been introduced in the House (H.R. 2062). NAADAC took this opportunity to educate congressional staff on the unintended consequences of such a law, including that it discourages individuals with substance use disorders from seeking treatment out of concern that their history may be shared without their permission. NAADAC also emphasized the importance of recognized credentials for the addiction workforce that recognizes standards of education, training, and practice that are addiction-specific. Advocacy in Action participants gained valuable skills and moved the needle on key policy items that will inevitably be debated this year on Capitol Hill. NAADAC plans to harness the energy and momentum from the conference to affect positive gains for the addiction workforce and for those living with substance use disorders. For more information on the 2019 Advocacy in Action Conference, please visit www.naadac.org/advocacy-conference. We hope to see you at the 2020 Advocacy in Action Conference next Spring!

Tim Casey is a policy advisor at Polsinelli. He has a proven record of leadership in advancing the federal priorities of national associations, corporations, consumer organizations, and nonprofits. On Capitol Hill, Casey is a trusted resource to Members of Congress and their staff. Casey’s experience in the House and Senate combined with his time as a senior lobbyist for prominent health care organizations offers clients sound policy advice, strategic political counsel, and a keen instinct for delivering on key priorities before Congress and the Administration. S P R I N G 2 019 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 13

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Meet Your New 2019 – 2021 Regional VicePresidents for the Mid-Central, North Central, Southeast, and Southwest Regions By Kristin Hamilton, JD, NAADAC Sr. Communications Manager Every two years, NAADAC members have the opportunity to select a Regional Vice-President who will represent his or her state affiliate on the NAADAC Executive Committee, with four of NAADAC’s eight regional positions being up for election each year. All 2019-2021 terms will begin on October 4, 2019, immediately after the NAADAC 2019 Annual Conference in Orlando, FL. This year, the Mid-Central, North Central, Southeast, and Southwest Regional Vice President positions came up for election. NAADAC only received one nomination for each of the open Regional Vice President positions. Accordingly, each of the nominated individuals will take office as the Regional Vice President of his or her respective region without an election. Please find each individual’s statements below.

tential clients of our many, varied services as well as indicate to governing and legislating bodies our professionalism. Our field has come a long way in promoting best practices, integrating medical advances, and promoting psychological well-being in every sense of the word. The coming years will challenge us through the current opiate epidemic and through the coming challenge to our authority under the guise of cooccurring disorders. Legislative funds are no longer guaranteed, and insurance funds are also a thing of the past. Therefore, it behooves us to look for alternate funding streams and to share this knowledge across the many states and municipalities represented under NAADAC’s umbrella. These are the many challenges we face, and if we face them together, we will all be stronger and our clients healthier!

Mid-Central Regional Vice-President Candidate & Uncontested Winner Representing Illinois, Indiana, Kentucky, Ohio, & Wisconsin.

Other qualifications:

Gisela Berger, PhD, MAC, LPC, NCC Mequon, WI Summary of NAADAC activities: Having been an active member for many years and in several states, I have been honored to have been chosen as Vice-President and then President of RAP-WI (Recovery and Addiction Professionals of Wisconsin). During this time, I revived (and, renamed) a dying organization. Today, though small, it is a vibrant part of the addictions treatment community in Wisconsin. Currently, it is the only organization representing treatment providers. RAP-WI advocates for our interests in the state legislature, holds twiceyearly conferences, is active in providing networking opportunities for professionals in the field, and allows members the opportunity to gain leadership experience. This revived, energetic association is the result of many years’ hard work, including empowering motivated people toward making RAP-WI the premier organization for addiction treatment providers in the state. On another note, I have been privileged to be a presenter at several local and state-wide conferences as well as for several NAADAC webinars. These presentations are an honor as I enjoy connecting with many, varied addiction treatment professionals. Philosophy statement on the future of NAADAC: I believe that NAADAC has positioned itself as the premier provider of educational resources, specialty credentialing, and advocacy efforts from the local to the national level. NAADAC stands alone in providing these many benefits in a cost-effective way to everyone working as an addiction professional. I believe that the current challenge is in crafting an identity that serves to both inform the public and po14

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I have served clients in many stages of recovery, have supervised clinicians in many stages of development, and have taught both undergraduate and graduate level students across many disciplines. I still believe that addiction professionals are experts and better trained than any other profession to work with substance use disorders. Our competency and our knowledge far surpass that of any other profession. It is through this diverse experience that I come to you asking for the opportunity to both build my region’s identity and to represent us to the national governing body. North Central Regional Vice-President Candidate & Uncontested Winner Representing Iowa, Kansas, Minnesota, Missouri, Nebraska, N. Dakota & S. Dakota. James ”JJ” Johnson, Jr., BS, LADC, NCAC II, SAP, ICS West St. Paul, MN Summary of NAADAC activities: A Midwesterner by heart, James “JJ” Johnson, Jr., BS, LADC, NCAC III, SAP started his career in addiction treatment and recover y in 1990 with Franciscan Skemp Healthcare in LaCrosse, WI, during which time he had the privilege of working with a Sister City project that took him to Russia to help develop Outpatient Treatment programs in cities outside of Moscow. In 2001, he accepted a position as Coordinator of Substance Abuse Services for New Ulm Medical Center; he remained at New Ulm Medical Center until accepting a position in St. Paul for HealthEast-Addiction Care. He is now Director of Residential Programs for NorthStar Regional in Chaska, MN. My involvement with NAADAC started in Wisconsin over 20 years ago and has never wavered since. The value I see in being involved with

NAADAC is unparalleled. I served as President of the Minnesota affiliate for ten years until 2014, stepping back as Minnesota Addiction Professionals (MNAP) continues to work. In 2016, when NAADAC was in Minneapolis, I was elected as NAADAC Regional Vice-President for the North Central Region to fill the vacancy left by now president Diane Sevening. Philosophy statement on the future of NAADAC: NAADAC is the premiere Association for Addiction Professionals and serves its members in multiple unprecedented ways. NAADAC has a mission and vision that continues to relevant in these times of division. The future is bright and exiting seeing take on more a global identity. I believe that this association needs to be at the forefront of all issues addiction treatment and recovery related. We welcome all addiction professional and that in and of itself makes us leaders in our own right. Other qualifications:

Other qualifications for Southeast RVP: I have been a member of the professional SUD profession in North Carolina for 26 years. During this time, I have worked in publicly and privately funded institutions and have first-hand experience with the challenges and strengths of these different funding environments. In response to the opiate crisis, I initiated the formation of a community coalition of public and private providers, with public health and safety, along with public education whose mission is to reduce provider fragmentation and to reduce barriers to treatment access. This coalition was named CURE Triad in 2017. Since its development began, CURE Triad has contributed to the creation of GC STOP. GC Stop is a public, private partnership to respond to opiate overdoses with follow-up… [ cut off of form ] Southwest Regional Vice-President Candidate & Uncontested Winner Representing Arizona, California, Colorado, Hawaii, New Mexico, Nevada, & Utah Thomas P. Gorham, LMFT, CADC II Berkeley, CA

Global voice in the recovering community. Successfully motivated the Nebraska Chapter to unify. Recognized as a leader in Minnesota Treatment Courts. Understands the issues facing the North Central Region and has a plan to address those needs long into the future.

Summary of NAADAC activities:

Marvin M. Sandifer, LCSW, LCAS Greensboro, NC

I have been a member of NAADAC since 2001. I have attended both the Advocacy and Annual Conferenced during most of those years. I was the founding President of the “Addiction Professionals for California” in 2019 and have continued in that position up to this time.

Summary of NAADAC activities:

Philosophy statement on the future of NAADAC:

Southeast Regional Vice-President Candidate & Uncontested Winner Representing Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, & Tennessee

I have been a member of the North Carolina State af filiate of NAADAC, Addiction Professionals of North Carolina (APNC), for a number of years. I was first elected to a APNC Regional Vice President position in 2016 and am currently serving my second term as a Regional Vice President, ending December 2019. While on the board of APNC, the association has grown substantially in membership, revenue, scope, and advocacy. My direct responsibilities are to facilitate regional training opportunities to provide licensure credits and to expose professionals to the growing science of substance use disorder treatment. Within North Carolina, there remains confusion among professionals between the licensure board’s and the professional association’s purpose. Philosophy statement on the future of NAADAC: NAADAC is an essential voice of reason and science to cut through the emotional issues of SUD and its effect on individuals, families, and communities. The stigma informed narrative around SUD, among the general population, policymakers and SUD providers, fuels irrational decisions that continue to punish and not support with evidenced-based accountability those individuals, families, and communities suffering from SUD. Prevention is ineffective; treatment is believed to be a waste of resources and recovery community development is rejected as undesirable. NAADAC and its state affiliates play a vital role in creating a narrative promoting current science on brain disorder and its effective treatment and management. The new narrative can influence policy development and resource acquisition that is effective in treating SUD.

I believe NAADAC needs to continue to lead the way in the prevention and treatment of Substance Use Disorders. We need to support, expand and train our workforce to meet the demands of the “Affordable Care Act.” Other qualifications: I have a rich personal history of homelessness and incarceration that allows me to clearly see the needs of specialized populations. I have been the Clinical Director and am now the Executive Director of a large non-profit treatment facility, which qualifies me both in the business and treatment aspects of our field. Kristin Hamilton, JD, is the Senior Communications Manager for NAADAC, the Association for Addiction Professionals. She works on NAADAC public relations, communications, and digital media, including the NAADAC website and social media, is editor of NAADAC’s two ePublications, the bi-weekly Addiction & Recovery eNews and weekly Professional eUpdate, and is associate editor for NAADAC’s magazine, Advances in Addiction and Recovery. She also contributes to the planning, organization, and administration of communication campaigns, administers the PhD Candidate Survey Program, nd serves as the affiliate liaison for the Communications Department. Hamilton holds a Juris Doctorate from Northeastern University School of Law in Boston, MA and a Bachelor of Science degree in Biology and Chemistry from Roger Williams University in Bristol, RI.

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To nominate an eligible organization for the NAADAC Organizational Achievement Award, please submit (1) a letter of recommendation including a detailed description of the nominated organization and how the organization has supported the addiction profession; (2) at least three letters of support from three different sources (individuals, organizations, or agencies); and (3) a completed NAADAC Recognition and Awards Nomination Acknowledgement Form. The NAADAC Recognition and Awards Nomination Acknolwedgment Form requires the nominee to sign a statement acknowledging that he/she meets all of the eligibility criteria for the particular award and has “demonstrated to the satisfaction of one’s peers full compliance and support of NAADAC’s Code of Ethics throughout [his/her] professional career.” For access to the NAADAC Recognition and Awards Nomination Acknowledgement Form and the specific eligibility criteria for each award, please visit: www.naadac.org/awards. All award nomination packets must be received by May 31, 2019 for consideration by the NAADAC Awards Committee. To nominate an individual or organization, please send the required documentation to: NAADAC, the Association for Addiction Professionals Attn: Awards Committee Chair 44 Canal Center Plaza, Ste 301 Alexandria, VA 22314

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Materials may also be faxed to the NAADAC Awards Committee (Attn: Jessica Gleason) at 800.377.1136 or sent by e-mail to naadac@naadac.org (please put “NAADAC Awards” in the subject line). NAADAC does not pay for travel to the venue of acceptance. If the award winner cannot attend the presentation, the award will be sent to the recipient. Questions? For more information, please visit www.naadac.org/recognition-and-awards. For further questions, please email NAADAC at naadac@naadac.org or call 703.741.7686. Jessica Gleason, JD, is the Deputy Director of NAADAC, the Association for Addiction Professionals. In this role, she assists the Executive Director in managing and leading the association and oversees the day to day operations and activities of the communications, marketing, public relations, exhibits and ad sales, training, and professional development departments. In addition, she assists the Executive Director in managing NAADAC’s government relations activities, sponsor recruitment and coordination, grant writing and programming, and other special projects. Gleason also serves as Managing Editor of NAADAC’s quarterly magazine, Advances in Addiction & Recovery. She joined NAADAC in October 2013 and was Director of Communications from January 2014 to November 2018.

Navigating the Addiction Profession

NAADAC 2019 Annual Conference September 28 - Oc tober 3 | Orlando

NAVIGATING THE ADDICTION PROFESSION

Early Bi ds Rate En th! 5 August 1

Join NAADAC for its 2019 Annual Conference: Navigating the Addiction Profession at the Renaissance Orlando at SeaWorld in Orlando, Florida, from September 28-October 3, 2019. Learn about the latest trends and issues that impact all addiction-focused professionals, connect and network, and build your business against the backdrop of vibrant Orlando.

Earn up to 43 CEs! The three-day Annual Conference will take place on September 29-October 1 and feature daily keynote speakers in plenary sessions, breakout workshops, and unique addiction-specific educational experiences within the following ten tracks: ■ Pharmacotherapy ■ Clinical Skills ■ Practice Management ■ Cultural Humility ■ Education/INCASE

■ Recovery Support ■ Co-occurring Disorders ■ Process Addictions ■ Peer Recovery ■ Professional Development

The main conference will also include an Awards Luncheon to honor outstanding addiction-focused professionals from around the nation, an exhibit hall with over 100 exhibitors, and special evening events, including an opening reception, a town hall, and an auction with entertainment to support the NAADAC Education & Research Foundation (NERF). In addition, attendees may register to attend one of seven full-day pre-conference sessions on September 28, one of two full-day postconference sessions on October 2, and/or one of two two-day postconference sessions on October 2 and 3.

www.naadac.org/annualconference

10 Reasons

Preliminary

Here’s why YOU should attend NAADAC’s 2019 Annual Conference: Navigating the Addiction Profession:

Up to 7 CEs Available

TO ATTEND 1. Earn up to 43 CEs. Six days of education, training, networking, and capacity building. Get the full schedule online!

2. Ten Tracks & Over 60 Breakout Sessions. This year’s conference features over 60 breakout sessions in ten different subject tracks.

3. Seven Pre-Conference Sessions & Four

SCHEDULE* SATURDAY (SEPTEMBER 28)

7:30 am – 7:00 pm Registration 7:30 am – 8:30 am Continental Breakfast (for Pre-Conference attendees only) 8:30 am – 5:00 pm PRE-CONFERENCE SESSIONS Basics of Addiction Counseling: Pharmacology of Psychoactive Substance Use Disorders Deborah Fenton-Nichols, EdD, LPC, LAC, NCC Clinical Supervision: A Relational and Individualized Approach Thomas Durham, PhD

Post-Conference Sessions. Dive deeper into subjects during full-day pre-conference and post-conference sessions, including a pre-conference session entirely in Spanish.

Being Your Most Ethical Self Kathryn Benson, NCAC II, LADAC II, QCS Telebehavioral Health Legal & Ethical Best Practices: Dos and Don’ts Marlene Maheu, PhD

4. Network, Connect, and Reconnect. Make

professional relationships and long-lasting friendships.

The Opioid Epidemic: A 360 View Darryl Inaba, PharmD, CATC V, CADC III, Richard Paul “Rick” Green, III, BSBA, LCDC, Cardwell “C.C.” Nuckols, PhD, and Peter D. Mott, MA, ICPS, LCDX

5. Learn from Industry Leaders. Experts and leading trainers, academics, practitioners, and clinicians are on the stage and in the audience.

6. Get Inspired. Our speakers and attendees are not only brilliant professionals, but are inspirational in their passion to make long-term positive impacts.

7. Celebrate Your Peers. Join NAADAC in

honoring outstanding addiction professionals and organizations from across the United States.

8. Two-day SAP Course. Get your U.S.

Department of Transportation Substance Abuse Professional (SAP) Qualification/ Requalification.

SCHEDULE

Los Opioides y La Comunidad Hispana Pierluigi Mancini, PhD, MAC, NCAC II, Glory McDaniel, MA, LPCC, NCC, CAC I, and Carlos D. Costa, MHS, LCSC, MAC, SAP 10:00 am – 10:15 am Morning Break 12:00 pm – 1:00 pm Lunch (for Pre-Conference attendees only) 3:30 pm – 3:45 pm Afternoon Break 5:00 pm – 8:00 pm Welcome Reception in Exhibit Hall 5:00 pm - 8:00 pm NAADAC Bookstore Open 9:00 pm – 10:00 pm Mutual Support Meeting

9. Professional Development. Experts and

leading trainers, academics, practitioners, and clinicians are on the stage and in the audience.

10. Have Fun! Attend receptions, meet new

friends, play in the pools, and be a kid in Orlando’s theme parks.

* Schedule subject to change without notice. For the most up-to-date schedule, please visit www.naadac. org/annualconference.

Endorsing and

COLLABORATING PARTNERS Part of what makes the 2019 Annual Conference unique is the depth and breadth of NAADAC’s partnerships. NAADAC is proud to have 14 national and local partners joining us, including:: • • • • • • • • • • • • • •

American Society of Addiction Medicine (ASAM) Association for the Treatment of Tobacco Use and Dependence (ATTUD) Council for Tobacco Treatment Training Programs (CTTTP) Faces & Voices of Recovery (FAVOR) Florida NAADAC International Coalition for Addiction Studies Education (INCASE) National Addiction Studies Accreditation Commission (NASAC) National Addiction Technology Transfer Network (ATTC) National Association for Children of Alcoholics (NACoA) National Association of Addiction Treatment Providers (NAATP) National Center for Responsible Gaming (NCRG) National Council for Behavioral Health National Hispanic and Latino Addiction Technology Transfer Center (NHLATTC) NIATx Learning Collaborative

SCHEDULE SUNDAY (SEPTEMBER 29)

Up to 7.5 CEs Available

6:30 am – 7:00 am Sunday Religious Services 7:00 am – 4:15 pm Registration 7:30 am – 4:15 pm NAADAC Bookstore Open 7:00 am – 8:00 am Continental Breakfast in Exhibit Hall 7:00 am - 4:15 pm Poster Presentations & Exhibit Hall Open 8:00 am – 9:45 am MORNING KEYNOTE Welcome and State of NAADAC Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP, Bobbie Hayes, MS, LMHC, CAP, and Diane Sevening, EdD, LAC, MAC The Brain and Recovery: An Updated on Neuroscience of Addiction Kevin McCauley, MD 9:45 am – 10:00 am Morning Break in Exhibit Hall 10:00 am – 11:30 am BREAKOUT SESSIONS TRACK: PHARMACOTHERAPY

Marijuana: Cannabis Use Disorder and Its Treatment Darryl Inaba, PharmD, CATC V, CADC III TRACK: CLINICAL SKILLS

TRACK: PEER RECOVERY

TRACK: CULTURAL HUMILITY

TRACK: EDUCATION/INCASE

TRACK: PEER RECOVERY

TRACK: PROFESSIONAL DEVELOPMENT

TRACK: EDUCTION/INCASE

Mapping Recovery Support Doreen O’Connor-Nash, CDP and Aylene Zeiger, CDP, NCAC I Training Graduate Students to Treat Addictive Behaviors: The Importance of Reflective Supervision Jennifer Tippett, PsyD Affiliate Leadership Training Diana Kamp, HeidiAnne Werner, CAE, & Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP 11:30 am – 12:30 pm NAADAC REGIONAL CAUCUS MEETINGS Mid-Atlantic Regional Caucus Mid-Central Regional Caucus Mid-South Regional Caucus North Central Regional Caucus Northeast Regional Caucus Northwest Regional Caucus Southeast Regional Caucus Southwest Regional Caucus International Caucus 12:30 pm – 2:30 pm Lunch in the Exhibit Hall 1:00 pm – 2:00 pm Military Regional Caucus & Military and Veteran Advisory Committee (MVAC) Meeting 2:30 pm – 4:00 pm BREAKOUT SESSIONS

Beyond Acronyms: Clinical Coaching on Motivational Interviewing to Improve Outcomes Casey Jackson, MSW, LICSW, MAC, CDP

TRACK: PHARMACOTHERAPY

TRACK: RECOVERY SUPPORT

TRACK: CLINICAL SKILLS

Incorporating Grief & Trauma Therapy into Substance Use Disorder Groups Aimee Hicks, MS, MAC, APC, NCC and Caroline Fernandes, MS, CCHT, CHWLC, CCEP TRACK: CO-OCCURRING DISORDERS

Co-occurring Disorders – Psychiatry and Substance Use Abid Nazeer, MD TRACK: PRACTICE MANAGEMENT

Technology and Clinical Supervision: The New Frontier Rachel McCrickard, LMFT, AAMFT Approved Supervisor TRACK: PROCESS ADDICTIONS

Deconstructing Infidelity: Beyond the Lens of Addiction Talal Alsaleem, PsyD, LMFT TRACK: CULTURAL HUMILITY Coming Soon

Methamphetamine: Addiction and Recovery Cardwell “C.C.” Nuckols, PhD The Intersection of Anger and Trauma: Understanding and Implementing Therapeutic Approaches Osvaldo Cabral, MA, LPC, LAC TRACK: RECOVERY SUPPORT

Guiding Healthy Identity Formation as a Mechanism of Recovery Support Karyl Sabbath, PhD, LICDC, LAC, ICCS TRACK: CO-OCCURRING DISORDERS

Diagnóstico Dual: Trastorno de Estrés Postraumático y Adicción Glory McDaniel, MA, LPCC, CACI, NCC TRACK: PRACTICE MANAGEMENT

How to Engage Alumni and Collect Outcomes Data Eva Hibnick, JD TRACK: PROCESS ADDICTIONS

Rethinking the Role of Shame Abi Jaffe, PhD

The Impact of Adverse Childhood Experiences and Trauma on Black Fathers Eddie McCaskill, LPC, LCSW, MAT, NBCC Using Sports as a Psycho-therapeutic Intervention: Designing and Developing an Intervention Program Jerry Joseph C. Valderrama, ICAP II, RC The Gamification of Addiction Studies Course: Using Games to Enhance Student Learning Outcomes Jennifer Londgren, EdD, LMFT, NCC, LADC-S TRACK: PROFESSIONAL DEVELOPMENT

Affiliate Leadership Training Diana Kamp, HeidiAnne Werner, CAE, & Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP

Ready to be

SEEN?

Showcase your institution, product, or organization at this prestigious event by exhibiting, sponsoring, or advertising at our 2019 Annual Conference. Access not only over 1,000 conference attendees, but NAADAC’s membership of over 10,500, its mailing list of over 48,000, and its website with over 220,000 monthly visits. To explore the many promotional opportunities available, download the 2019 Annual Conference Prospectus at https://www.naadac.org/ac19-exhibitsponsor-or-advertise or contact Irina Vayner, Exhibit and Ad Sales Manager, at ivayner@naadac.org or 703.741.7686 x140. We will sell out! Hurry and book your booth today!

SCHEDULE About the

CITY

Orlando, the “Theme Park Capital of the World,” is home to over a dozen theme parks, world-class golf courses, art galleries, shopping centers, major league sports teams, and a vibrant night life. About the

HOTEL The Renaissance Orlando at SeaWorld 6677 Sea Harbor Drive Orlando, FL 32821 407.351.5555 http://renaissance-hotels.marriott.com/ renaissance-orlando-at-seaworld The Renaissance Orlando at SeaWorld is offering rooms for a discounted rate of $139 a night (plus applicable taxes) for reservations made by September 6, 2019. Attendees may book their rooms online at https://book.passkey.com/ event/49596202/owner/210/home or by calling 407.351.5555. Please make reference to the “NAADAC Conference” to receive our special group rate. Reservations are available on a first-come, first-served basis for the limited number of rooms being held at the discounted rate. Please book your room early as space is limited and will sell out! Room Reservation Deadline: September 6, 2019. Visit the

EXHIBIT HALL On September 28-30, please be sure to visit and support the companies that are showcasing their institution, product, or organization in our Exhibit Hall this year. Exclusive time to interact with the exhibitors in the Exhibit Hall has been set aside during the Welcome Reception on Saturday evening, and during the breakfasts, lunches, and morning and afternoon coffee breaks on Sunday and Monday.

TRACK: CO-OCCURRING DISORDERS

4:00 pm - 4:15 pm Afternoon Break in Exhibit Hall 4:15 pm - 5:30 pm AFTERNOON KEYNOTE PANEL The Opioid Epidemic: A 360 View Darryl Inaba, PharmD, CATC V, CADC III, Richard Paul “Rick” Green III, BSBA, LCDC, Cardwell “C.C.” Nuckols, PhD, and Peter D. Mott, MA, ICPS, LCDX 6:00 pm – 7:30 pm NAADAC Town Hall Diane Sevening, EdD, LAC, Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP, Jack Stein, PhD (NIDA) 7:30 pm – 8:30 pm International Coalition for Addiction Studies Educators (INCASE) Membership Meeting 8:30 pm – 10:00 pm International Coalition for Addiction Studies Educators (INCASE) Reception 9:00 pm – 10:00 pm Mutual Support Meeting

MONDAY (SEPTEMBER 30)

Up to 6 CEs Available 7:30 am – 4:30 pm Registration

The Lone Wolf Joins the Pack: Developing & Maintaining Effective Multidisciplinary Team Cohesion James Gamache, MSW, LICSW, MLADC and Gordon Woods TRACK: PRACTICE MANAGEMENT

Telehealth 101 Malcolm Horn, PhD, LCSW, MAC, LAC TRACK: PROCESS ADDICTIONS

The Role of Addictions in the Lives of Women Who Have Overcome an Experience with Human Trafficking Michelle Harrison, LPCC, NCC TRACK: CULTURAL HUMILITY

La Humildad Cultural (Latinos-Hispanos en EE. UU.) Carlos D. Costa, MHS, LCSC, MAC, SAP TRACK: PEER RECOVERY

Effectiveness of Community Involvement Melissa Enoch, LPC, LCAS, CCS, MAC TRACK: EDUCATION/INCASE

Rubrics as a Tool for Managing Suitability for Practice Concerns Kathryn J. Miller, PhD, LPC, LCDC, ACS TRACK: PROFESSIONAL DEVELOPMENT

NAADAC Accomplishments in Addiction & Recovery Related Policy & Legislation – Keep the Momentum Going Sherri Layton, MBA, LCDC, CCS & Michael Kemp, NCAC I, ICS, CSAC, CSW

7:30 am – 5:00 pm NAADAC Bookstore Open

11:45 am – 1:45 pm Lunch in Exhibit Hall

7:30 am – 2:00 pm Poster Presentations & Exhibit Hall Open

2:00 pm – 3:30 pm BREAKOUT SESSIONS

7:30 am – 8:30 am Continental Breakfast in Foyer 8:30 am – 10:00 am MORNING KEYNOTE SESSION When the Titanic Meets the Iceberg: Addressing Trauma Beneath Addiction Mark Sanders, LCSW, CADC 10:00 am – 10:15 am Morning Break in Exhibit Hall 10:15 am – 11:45 am BREAKOUT SESSIONS TRACK: PHARMACOTHERAPY

Medications and Recovery James M. Wilson, MRC, LAC TRACK: CLINICAL SKILLS

A Family System’s Approach to Treating Trauma and Addiction Trish Caldwell, MFT, LPC, CCDP-D, CCTP TRACK: RECOVERY SUPPORT

Self-Care Strategies For Support Persons Caring For a Loved One Struggling with Substance Use Disorder Patricia Singh, PhD, LPCC

TRACK: PHARMACOTHERAPY

Medication-Assisted Treatment: Raising Hope and Controversy Mita Johnson, EdD, LPC, LMFT, MAC, SAP TRACK: CLINICAL SKILLS

A Journey Into Creativity Carmine Pecoraro, PsyD, CAP, ICADC, SAP TRACK: RECOVERY SUPPORT

I Am More Than Enough: Lessons of Transformation from Adult Children of Alcoholics Daniella Jackson, PhD, LMHC, Certified Health Coach TRACK: CO-OCCURRING DISORDERS

Therapeutic Cannabis: Helping or Harming the Recovery of Co-occurring Disorders Thad Shunkwiler, LMFT, LPCC, ACS, CCMHC TRACK: PRACTICE MANAGEMENT

E.T.H.I.C.S. of Self Care Tara Matthews, PhD, LPC, MAC TRACK: PROCESS ADDICTIONS

Eating Disorders: Process Addiction or Substance Use Disorder? Marty Lerner, PhD

SCHEDULE TRACK: CULTURAL HUMILITY

Latino-Informed Therapy Across the SUD and Addiction Continuum of Care Using the SANITY Model Frank Lemus, PhD, MFT TRACK: PEER RECOVERY

Peer Recovery in African American Communities: Lessons Learned from Federally Funded Projects Masica Jordan, EdD, LCPC TRACK: EDUCATION/INCASE

The Therapeutic Process in On-line Fieldwork Supervision of Master’s Students Eileen O’Mara, EdD, LADC, NCC and Ann Melvin, PhD, CRC, CADC, LCPC TRACK: PRACTICE MANAGEMENT

Clocktree Telehealth Platform Demonstration & Training 3:30 pm – 3:45 pm Afternoon Break in Foyer 3:45 pm - 5:15 pm AFTERNOON KEYNOTE SESSION Cultural Humility in Practice: Where Our Personal and Public Lives Intersect Miguel E. Gallardo, PsyD 6:30 pm - 8:30 pm NAADAC Education & Research Foundation (NERF) Auction Hosted by Gerard Schmidt, MA, LPC, MAC 9:00 pm – 10:00 pm Mutual Support Meeting

TUESDAY (OCTOBER 1)

Up to 6.5 CEs Available

8:00 am – 5:00 pm NAADAC Bookstore Open 8:00 am – 4:30 pm Registration 8:00 am – 9:00 am Continental Breakfast in Foyer 8:00 am – 5:00 pm National Certification Commission for Addiction Professionals (NCC AP) Meeting 8:30 am – 9:00 am Q&A with NAADAC President & Executive Director Diane Sevening, EdD, LAC, MAC and Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP 9:00 am - 10:30 am MORNING KEYNOTE SESSION The Changing Face of Healing Trauma Gary Ferguson, BS, ND 10:30 am -10:45 am Morning Break

10:45 am - 12:15 pm BREAKOUT SESSIONS TRACK: PHARMACOTHERAPY

Therapeutic Effect of IV NAD on Opiate and Alcohol Withdrawal: Implications for Clinical Populations Susan Broom-Gibson, PhD TRACK: CLINICAL SKILLS

Reality Therapy Demonstrations: Helping Clients Navigate Their Way Through Stages of Recovery Robert Wubbolding, EdD, LPCC TRACK: RECOVERY SUPPORT

Addiction and Family Law: Maximizing Parenting Access While Protecting Children From Harm Jennifer Keilin, MSW, LICSW TRACK: CO-OCCURRING DISORDERS

Counseling Those with Dual Diagnosis: Integrating 12 Step Recovery with Counseling Theories Blanca Sanchez-Navarro, LPC-S, LCDC

TRACK: RECOVERY SUPPORT

It’s Not Just Semantics: Examining the Language of Addiction Treatment and Recovery E. Vaughan Gilmore, LCSW, LCDC TRACK: CO-OCCURRING DISORDERS

Merging Highways - Integrated Treatment Approach to Co-occurring Disorders Nicole Akindoyo, LPC, MAC, CSAC, CCTP TRACK: PRACTICE MANAGEMENT

Parity Act Enforcement: How Providers Can Improve Access to Care Ellen Weber, JD and Sherri Layton, MBA, LCDC, CCS TRACK: PROCESS ADDICTIONS

Behavioral Addictions: Substantial Clinical Implications for Recovery Brian Lengfelder, LCPC, CAADC, MAC, CSAT-S TRACK: CULTURAL HUMILITY

How the ADA Addresses Addiction and Recovery Oce Harrison, EdD

Substance Use Disorder: Military Veterans and LGBTQ Populations Ami Crowley, EdD, NCC, ICADC, MCAP, ACS, LPC, LMHC, Justina Wong, BA, and John “JJ” Jackson, BA

TRACK: PROCESS ADDICTIONS

TRACK: PEER RECOVERY

TRACK: PRACTICE MANAGEMENT

Gambling Disorder in Addiction Counselors: Risk Factors and Prevalence Laura Lamb Atchley, PhD, LPC, LADC/MH, ICGC-II TRACK: CULTURAL HUMILITY

Recovery First, Family Second, Work Third: Incorporating Peer Services into Your Continuum of Care! Linda May Wacker, MEd, QMHP, Leah Hall, and Brittany Kintigh, MA

Examination of Ethics and Treatment Outcomes for Military and Veteran Populations David Daugherty, PhD

TRACK: EDUCATION/INCASE

TRACK: PEER RECOVERY

TRACK: PROFESSIONAL DEVELOPMENT

Ethical Considerations for Recovery Coaches Stacy Charpentier, RCP, CPRS TRACK: EDUCATION/INCASE

Now That You Know It....How Do You Do It? Kathy Elson, LPCC-S, LICDC-CS, MAC, SAP 12:30 pm – 2:15 pm President’s Awards Luncheon 2:30 pm - 4:00 pm BREAKOUT SESSIONS TRACK: PHARMACOTHERAPY

Los Opioides y La Comunidad Hispana Pierluigi Mancini, PhD, MAC, NCAC II TRACK: CLINICAL SKILLS

Incorporating Wellness to Optimize Relapse Prevention Dilani Perera-Diltz, PhD, LPCC-S, LCDC, MAC

Building Clinical Skills: Bring Case Studies to Life Beth Donnellan, MEd, ABD, CCTP, CATP National Credentialing Update – Defining Professional Practice in 2019 NCC AP Commissioners 4:00 pm - 4:15 pm Afternoon Break 4:15 pm - 5:45 pm AFTERNOON KEYNOTE & CLOSING CEREMONY Closing Ceremony Diane Sevening, EdD, LAC and Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP 9:00 pm – 10:00 pm Mutual Support Meeting

WEDNESDAY (OCTOBER 2)

Up to 7 CEs Available 7:00 am – 11:00 pm Registration

7:00 am – 8:00 am Continental Breakfast (for Post-Conference attendees only)

SCHEDULE 8:00 am - 4:30 pm POST-CONFERENCE SESSIONS Integrating Treatment for Co-occurring Disorders: An Introduction to What Every Addiction Counselor Needs to Know Thomas Durham, PhD Evidence-Based Practices for Treating GamblingRelated Problems & More Jon Grant, JD, MD, MPH, Joshua Grubbs, PhD, Shane Kraus, PhD and Iris Balodis, PhD Conflict Resolution Recovery - Day 1 Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP U.S. Department of Transportation’s Substance Abuse Professional Qualification/Requalification Course - Day 1 Mita Johnson, EdD, LPC, LMFT, MAC, SAP 12:00 pm – 1:00 pm Lunch (for Post-Conference attendees only)

THURSDAY (OCTOBER 3)

Up to 7 CEs Available

7:00 am – 8:00 am Continental Breakfast (for CRR and SAP course attendees only) 8:00 am - 4:30 pm POST-CONFERENCE SESSIONS Conflict Resolution Recovery - Day 1 Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP U.S. Department of Transportation’s Substance Abuse Professional Qualification/Requalification Course - Day 1 Mita Johnson, EdD, LPC, LMFT, MAC, SAP 12:00 pm – 1:00 pm Lunch (for CRR and SAP course attendees only)

Registration Form Fee Schedule

(please check category fee box)

Early Bird (ends 8/15)

Standard (ends 9/23)

Late/On-Site (starts 9/24)

$175

Non-Member Organizational Member Staff*

YES, I want to join NAADAC! Please visit www.naadac.org/join or call 703.741.7686 to enroll. Please send me additional information about membership.

PRE-CONFERENCE: SEPTEMBER 28 Member

Attendee Information (please print clearly)

$225

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$350

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$300

Student/Military Member

$150

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$250

Student/Military Non-Member

$225

$275

$325

THREE-DAY CONFERENCE: SEPTEMBER 29 - OCTOBER 1

This is my first NAADAC Training/Conference.

NAADAC or INCASE Member #: NAADAC Organizational Member Name: Name: Address: City:

State:

Phone: (

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Fax: (

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Email:

Zip: )

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If you require special accommodations to fully participate, please describe your needs:

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POST-CONFERENCE: OCTOBER 2 $175

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$225

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TWO-DAY SAP OR CRR TRAINING: OCTOBER 2-3 Member

$425

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$550

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$500

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ONE DAY ONLY Please check day you will attend: Sept. 29 Sept. 30 Oct. 1 (Only good for one day. To attend two or more days, full conference registration is needed.) Member

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SPECIAL EVENT: SEPTEMBER 30 Space is limited; sign up early. $15

Updates on Treating Tobacco Dependence Basics of Addiction Counseling: Pharmacology of Psychoactive Substance Use Disorders Clinical Supervision: A Relational and Individualized Approach Telebehavioral Health Legal & Ethical Best Practices: Dos and Donâ&#x20AC;&#x2122;ts Los Opioides y La Comunidad Hispana (Opioids and the Hispanic Community) Being Your Most Ethical Self The Opioid Epidemic: A 360 View

POST-CONFERENCE/TWO-DAY SAP OR CRR TRAINING: OCTOBER 2 - 3

Materials included in price

$15

PRE-CONFERENCE: SEPTEMBER 28

For Pre-Conference registration, please check one session to attend:

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NERF Auction

Pre- and Post-Conference Sessions

$15

*For a complete list of NAADAC Organizational Members, visit www.naadac.org/orgmembersdirectory

44 Canal Center Plaza, Suite 301 Alexandria, VA 22314 P: 703.741.7686 F: 703.741.7698 E: naadac@naadac.org

For Post-Conference registration, please check one session to attend:

Integrating Treatment for Co-occurring Disorders: Myths, Realities and Effective Approaches to Care Evidence-Based Practices for Treating Gambling-Related Problems & More DOT SAP Qualification/Requalification Training (2-day training) Conflict Resolution for Recovery (CRR) Training (2-day training)

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Signature Prices determined by date of payment. Please send payment and form together. Email form to naadac@naadac.org, fax to NAADAC at 703.741.7698, or mail to 44 Canal Center Plaza, Suite 301, Alexandria, VA 22314. Keep a copy for your records. Conference refund policy: All cancellations received prior to August 16, 2019 will receive a 75% refund. Thereafter, no refunds are given.

Questions? Visit www.naadac.org/annualconference or call 703.741.7686.

Pre-register now for best rates!

National Academies Report Calls for Removing the Stigma and Barriers Against Medications for Opiod Addiction

By Jack B. Stein, PhD, Chief of Staff & Director, Office of Science Policy and Communications, National Institute on Drug Abuse

n September 2018, the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Ser vices Administration (SAMHSA) asked the National Academies of Science, Engineering, and Medicine (NASEM) to develop an independent report on medications for opioid use disorder (OUD). NASEM’s mission is to provide objective, authoritative answers to

pressing scientific questions affecting the nation. They convened an expert committee to review all of the existing scientific evidence on the efficacy and utilization of medications and gaps where further research is needed, and the committee presented their consensus report in March of this year (National Academies of Sciences, Engineering, and Medicine, 2019). The report is a timely and unambiguous statement of how crucial medications are in the treatment of a life-threatening condition that now afflicts 2.1 million people in the United States (Center for Behavioral Health Statistics and Quality, 2018). OUD is a treatable chronic brain disease. This is the first conclusion of the NASEM report, and it is one that NIDA has also advanced for many years (see Box for a list of the report’s seven conclusions). Yet deeply entrenched mindsets—about addiction as a moral failing or about willpower as the sole basis for recovery—are hard to change among the wider public and even in many sectors of healthcare or the justice system that have less experience in addressing substance use disorders. These lingering prejudices, along with abstinence-only attitudes inherited from old recovery models, have impeded the uptake of effective FDA-approved medications—methadone, buprenorphine, and extended-release naltrexone. The second—and really, bottom line—conclusion of the NASEM report is that these medications are effective and that they save lives. A large evidence base shows that these medications reduce the risk of death from overdose, improve treatment retention, improve social functioning, and reduce the transmission of infectious disease, along with other positive outcomes. Evidence also shows that improved outcomes are associated with long-term retention in medication treatment (Conclusion #3). The distrust of medications seen in some treatment and justice settings translates not only to nonuse but also use for inadequate lengths of time, which may lead to treatment failure. The NASEM report should be helpful in demonstrating the value of medications for OUD to stakeholders, including insurers as they make coverage decisions. The NASEM report also concludes that medications should not be withheld or delayed just because behavioral interventions cannot be provided along with them (Conclusion #4). Behavioral treatments can be an important part of treatment, but NASEM’s review of the evidence suggests that some patients do well solely with medication and medical management. This conclusion reflects a shift in the field, away from viewing medications as “assisting” other forms of therapy toward viewing them as the standard of

It is necessary that we confront the barriers to medication utilization across healthcare settings and the justice system.

A d va n c e s i n A d d i c t i o n & R e c o v e r y | S P R I N G 2 019

medical care for OUD. At NIDA, we have stressed for years that medications for OUD are grossly underutilized. Data reviewed by the NASEM committee show that only a fifth of those who could benefit from these medications receive them and that there are gross disparities in access to this standard-of-care treatment (Conclusion #5). Yet medications are effective across all populations and treatment settings, and thus withholding them in any setting is to deny appropriate medical treatment (Conclusion #6). The wording of the NASEM report is direct: “Given that these medications are known to save lives, it is arguable that withholding them from persons with OUD is unethical, as withholding insulin or blood pressure medications would be” (National Academies of Sciences, Engineering, and Medicine, 2019). It is necessary that we confront the barriers to medication utilization across healthcare settings and the justice system (Conclusion #7). Research in recent years has shown the importance of initiating buprenorphine in emergency rooms rather than simply referring patients who have overdosed to treatment, for example (D’Onofrio G, O’Connor PG, Pantalon MV, et al., 2015). And several studies have shown the benefits of providing medication treatment for OUD in prison or initiating such treatment prior to release (Moore KE, Roberts W, Reid HH, et al., 2018). The high fatality rate from overdoses in the period following release into the community makes wider adoption of medications in these settings crucial. As part of removing barriers, the writers of the NASEM report recommend re-evaluating the utility of regulations around agonist medications that are unnecessary or not supported by evidence, as well as addressing the fragmentation of current addiction treatment in the U.S. It also recommends working to remove the difficulties associated with being reimbursed for these treatments. There are still gaps in our knowledge base. The report stresses the need for more research, for instance to widen the range of available formulations and medications, as well as understand how to choose the right medication for an individual patient. We also need research to determine appropriate lengths of treatment for different severities of opioid use disorder and whether medications differ in how long they should be given. Some of these urgent questions are the focus of research that will be funded by the NIH HEAL (Helping to End Addiction Long-termSM) Initiative, which expanded the budgets of NIDA and other NIH Institutes whose work is relevant to the entwined crises of opioid addiction and pain (National Institutes of Health, 2019). Addiction counselors have an important role to play, by working to overcome the stigma and misunderstanding about addiction and people with addiction, as well as helping educate the public and policymakers about the reality of addiction as a brain disease and the efficacy of medications in treating it. They can also encourage their patients to participate in the many research studies for new treatments being funded by NIH. As an independent assessment of the current state of the research from a major authority in health, the NASEM report now provides added weight when trying to change hearts and minds of those holding outmoded attitudes against use of medication in treating opioid addiction. It cannot be stressed enough: withholding life-saving medications for OUD is unethical. Given the dangers of untreated OUD, lack of access to medications for opioid use disorders puts lives at risk, and clinics currently reluctant or unable to provide medication are likely to find themselves “peer pressured” to update their treatment philosophy and protocols to meet what is now the accepted standard of care for opioid addiction.

REFERENCES Center for Behavioral Health Statistics and Quality. 2017 National Survey on Drug Use and Health: Detailed Tables. (2018). Retrieved from https://www.samhsa.gov/data/ report/2017-nsduh-detailed-tables D’Onofrio G, O’Connor PG, Pantalon MV, et al. Emergency department-initiated buprenor phine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015;313(16):1636–1644. doi:10.1001/jama.2015.3474 Moore KE, Roberts W, Reid HH, Smith KMZ, Oberleitner LMS, McKee SA. Effectiveness of medication assisted treatment for opioid use in prison and jail settings: A meta-anal ysis and systematic review. Journal of Substance Abuse Treatment. 2019;99:32-43. doi:10.1016/j.jsat.2018.12.003. National Academies of Sciences, Engineering, and Medicine. Medications for Opioid Use Disorder Save Lives. (2019). Washington, DC: The National Academies Press. Doi: https://doi.org/10.17226/25310 National Institutes of Health. NIH HEAL Initiative. (2019). https://www.nih.gov/research- training/medical-research-initiatives/heal-initiative Jack Stein, PhD, MSW, joined the National Institute on Drug Abuse (NIDA) in August 2012 as the Director of the Office of Science Policy and Communications (OSPC). In addition to this position, Stein was appointed the NIDA Chief of Staff in March 2019. He has over two decades of professional experience in leading national drug and HIV-related research, practice, and policy initiatives for NIDA, The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of National Drug Control Policy (ONDCP) where, before coming back to NIDA, he served as the Chief of the Prevention Branch.

Conclusions of the NASEM Consenus Study Report: Medications for Opiod Use Disorder Save Lives 1. Opioid use disorder is a treatable chronic brain disease. 2. U.S. Food and Drug Administration (FDA)-approved medications to treat opioid use disorder are effective and save lives. 3. Long-term retention on medications to treat opioid use disorder is associated with improved outcomes. 4. A lack of availability of behavioral interventions is not a sufficient justification to withhold medications to treat opioid use disorder. 5. Most people who could benefit from medication-based treatment for opioid use disorder do not receive it, and access is inequitable across subgroups of the population. 6. Medication-based treatment is effective across all treatment settings studied to date. Withholding or failing to have available all classes of FDA-approved medication for the treatment of opioid use disorder in any care or criminal justice setting is denying appropriate medical treatment. 7. Confronting the major barriers to the use of medications to treat opioid use disorder is critical to addressing the opioid crisis.

S P R I N G 2 019 | A d va n ce s i n A d d i c t i o n & R e c o v e r y 2 5

Advances in Understanding and Addressing Underage Drinking

By National Institute on Alcohol Abuse and Alcoholism (NIAAA)

ombating underage drinking is a major public health priority, as alcohol use by young people increases the likelihood of short- and long-term consequences, including altered brain development, academic problems, sexually transmitted infections, physical and sexual assault, traffic crashes, injuries, overdoses, and alcohol use disorder (AUD).

Epidemiological data from the 2018 Monitoring the Future (MTF) sur vey, funded by the National Institute on Drug Abuse, indicate that underage drinking among 8th, 10th, and 12th graders has declined by half, on average, over the past 2 decades (see graph). Although these declines are encouraging, alcohol remains the most widely used substance among U.S. youth. In 2018, about 8 percent of 8th graders, 19 percent of 10th graders, and 30 percent of 12th graders drank alcohol in the past month. According to the National Survey on Drug Use and Health, nearly 443,000 adolescents ages 12-17 had AUD in 2017. Underage binge drinking and high-intensity drinking in college settings are also a concern.

In 2011, NIAAA created “Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide,” a 2-item screening guide that helps clinicians quickly identify 9- to 18-year-olds who are at risk for alcohol use, are using alcohol, or have AUD—and to intervene as appropriate. Previous studies have shown that the NIAAA youth screening guide is an effective tool in a variety of settings, including in primary care and pediatric emergency departments, among youth who have a chronic health condition, and in schools. Most recently, a new study in primary care clinics serving racially and ethnically diverse patients validated the Guide’s utility in appropriately identifying youth ages 12–17 who are at risk for AUD.

So, what can be done to prevent or reduce underage drinking or catch problem drinking early on? And what have we learned about how alcohol use impacts the developing brain?

Through effective alcohol SBI, healthcare providers can detect and treat alcohol problems early. This is an important step, because heavy alcohol use during adolescence may result in long-lasting functional and structural changes in the brain. Recent findings from NIAAA’s National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), a longitudinal study of brain structure and function in approximately 800 youth, show that adolescents who initiated heavy alcohol use during the study experienced faster declines in brain gray matter volume and slower expansion of brain white matter relative to those who initiated no or low alcohol consumption during the same time. These changes may reflect irregularities in the developing brain’s normal processes of “pruning” infrequently used synapses and enhancing brain connectivity, respectively. NCANDA researchers also found that youth with a history of alcohol use exhibited weakened connections between brain networks involved in the regulation of emotional and cognitive functioning.

Advancing research on the development, evaluation, and implementation of underage drinking interventions and translating the findings into resources to prevent and reduce underage alcohol use have long been NIAAA priorities. A number of evidence-based interventions that target underage drinking are available but are underutilized. Such interventions can be delivered at the individual, family, school, community, and policy levels. For example, a recent NIAAA-supported study demonstrated that a combined individual- and community-level intervention effectively reduced underage drinking among Native American youth ages 13–20 living on rural California reservations. It is important to note that not all available underage drinking interventions are effective for all populations of youth or in all environmental contexts, emphasizing the need for a greater repertoire of developmentally and culturally appropriate preventive interventions. A current NIAAA-supported study is evaluating the efficacy of a “toolbox” of interventions, which are based on local cultural practices, in reducing AUD and related suicide among rural Yup’ik Alaska Native youth. NIAAA also supports research to encourage the implementation and uptake of alcohol screening and brief intervention (SBI) among youth. A growing body of evidence shows that alcohol SBI in primary care can effectively identify youth who have or are at risk for alcohol problems, as has been demonstrated for adults.

Learning more about the health effects of underage drinking and understanding how to effectively deter adolescents from alcohol use, as well as how to treat those who have already developed alcohol-related problems, continue to be key NIAAA research priorities. Note: NIAAA defines binge drinking as a pattern of drinking that increases a person’s blood alcohol concentration (BAC) to .08 g/dL (the legal driving limit for adults) or higher. This typically occurs after 4 drinks for women or 5 drinks for men in about 2 hours. Research suggests that youth reach this BAC with fewer drinks than adults.

For more information about underage drinking, please access the following NIAAA resources: Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide: https:// www.niaaa.nih.gov/publications/clinicalguides-and-manuals/alcohol-screeningand-brief-intervention-youth Factsheet: Underage Drinking: https:// pubs.niaaa.nih.gov/publications/ UnderageDrinking/UnderageFact.htm College Drinking website: https://www. collegedrinkingprevention.gov

REFERENCES Miech, R.A.; Schulenberg, J.E.; Johnston, L.D.; Bachman, J.G.; O’Malley, P.M.; and Patrick, M.E. National Adolescent Drug Trends in 2018. Ann Arbor, MI: University of Michigan Institute for Social Research, Monitoring the Future, December 17, 2018. http:// monitoringthefuture.org/data/18data.html#2018data- drugs. Accessed January 11, 2019. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Results From the 2017 National Survey on Drug Use and Health: Detailed Tables. Table 5.5A— Alcohol Use Disorder in Past Year among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Numbers in Thousands, 2016 and 2017. https://www.samhsa.gov/data/sites/default/ files/cbhsq-reports/NSDUHDetailedTabs2017/ NSDUHDetailedTabs2017.htm#tab5-5A. Accessed January 11, 2019. Moore, R.S.; Gilder, D.A.; Grube, J.W.; Lee, J.P.; Geisler, J.A.; Friese, B.; Calac, D.J.; Finan, L.J.; and Ehlers, C.L. Prevention of underage drinking on California Indian reservations using individual- and community-level approaches. American Journal of Public Health 108(8):1035–1041, 2018. PMID: 29927644 Allen, J.; Rasmus, S.M.; Fok, C.C.T.; Charles, B.; Henry, D.; and Qungasvik Team. Multi-level cultural intervention for the prevention of suicide and alcohol use risk with Alaska Native youth: A nonrandomized comparison of treatment intensity. Prevention Science 19(2):174–185, 2018. PMID: 28786044 Parast, L.; Meredith, L.S.; Stein, B.D.; Shadel, W.D.; and D’Amico, E.J. Identifying adolescents with alcohol use disorder: Optimal screening using the National Institute on Alcohol Abuse and Alcoholism screening guide. Psychology of Addictive Behaviors 32(5):508–516, 2018. PMID: 29975071 Müller-Oehring, E.M.; Kwon, D.; Nagel, B.J.; Sullivan, E.V.; Chu, W.; Rohlfing, T.; Prouty, D.; Nichols, B.N.; Poline, J.B.; Tapert, S.F.; Brown, S.A.; Cummins, K.; Brumback, T.; Colrain, I.M.; Baker, F.C.; De Bellis, M.D.; Voyvodic, J.T.; Clark, D.B.; Pfefferbaum, A.; and Pohl, K.M. Influences of age, sex, and moderate alcohol drinking on the intrinsic functional architecture of adolescent brains. Cerebral Cortex 28(3):1049–1063, 2018. PMID: 28168274 Pfefferbaum, A.; Kwon, D.; Brumback, T.; Thompson, W.K.; Cummins, K.; Tapert, S.F.; Brown, S.A.; Colrain, I.M.; Baker, F.C.; Prouty, D.; De Bellis, M.D.; Clark, D.B.; Nagel, B.J.; Chu, W.; Park, S.H.; Pohl, K.M.; and Sullivan, E.V. Altered brain developmental trajectories in adolescents after initiating drinking. The American Journal of Psychiatry 175(4):370–380, 2018. PMID: 29084454

Good Grief: A Counselor’s Thoughts on Navigating Client Death in Addictions Counseling

Jessica Love Jordan-Banks, BA

ealing with the death of a client can be challenging. As helping professionals, a significant part of what we do is build rapport and show genuine concern for our clients. Within that, I think it is safe to say

that we grow to care about and even develop an appropriate level of “therapist love” for some of our clients. We want to see them be successful in treatment and happy in their lives. When a client dies a premature death from causes related to the exact issues they are seeking our care, it can leave us feeling defeated. However, amidst the melancholy that accompanied this experience when I lost a client to an accidental overdose, I was able to learn a few valuable lessons. First, I learned the importance of acknowledging and non-judgmentally accepting my feelings. As students, we’re taught about maintaining appropriate boundaries as a means of safeguarding our clients and ourselves. While there is no disputing the importance of keeping healthy boundaries in a helping relationship; to a point, this message can be easily misconstrued as “not being allowed to care.” I remember initially being surprised by how emotionally affected I was by the news of the client’s death. In the moments following the call, I attempted to debrief and process the news with another member of the clinical team and found myself further surprised and frustrated by their perceived aloofness – “I mean, it’s sad, but I don’t let things like that get to me”. Was I overreacting? Had I failed to maintain “strong enough” boundaries? I went looking for answers. What I found was that “therapist grief” is just as real as “non-therapist grief.” There are dozens of articles and online forums dedicated to discussing the process of grieving the death of a client as a helping

professional. Just learning that I was not an unethical anomaly provided a lot of relief. From that, I gained more of a sense of freedom to feel how I was feeling and then discuss those feelings, which ultimately initiated the healing/rebalancing process. The second lesson that I learned was the importance of “knowing my role.” Three days prior to receiving the news that he had passed away, I facilitated a group in which the client had taken part. He reported a craving score of “0” and a feeling word of “happy.” He was, from what I could tell, his normal, quiet, intently observant self. He had successfully completed inpatient treatment, returned to work, and showed up for outpatient groups faithfully. He never once had a positive screening, and was preparing to be stepped down from IOP to Continuing Care. One could reasonably assume he was doing well in his recovery. What went wrong? What did I miss? How did I miss it? What could I have done differently? Would the outcome had been different if I dug a little deeper? Or if I had talked with the group about that dangers of using alone? Or the increased risk for overdose post-detox? He was so young. He was doing so well. Or was he? It is likely that I will never

“…My son won’t be coming back to IOP anymore. He overdosed last night.”

know for sure. And in the moments following that call, that particular thought haunted me. The pain in his mother’s voice left me shook. I felt like I had, in some way, failed him and his family. I held myself together enough to comfort the client’s primary counselor, who had taken the news understandably hard – “You did your best,” I whispered to her with a hug. I quietly ruminated for the remainder of my shift, then at my scheduled time, issued my usual “good nights” to the patients on the unit, and left to cry in my car. Later that day, I called one of my mentors and cried some more. She was gracious enough to let me feel how I felt in the moment, without judging or invalidating. And when I was done, she gently grounded me. “You did your part.” And before I could say my “buts,” she continued “You had a role in helping him achieve a period of sobriety where he could be proud of himself. His family was able to enjoy him being home and sober for the holidays.” She later sent me a note mentioning how the clinical team impacted him enough that he talked with his family about treatment, so much so his mother called, when she really did not have to.

I think it is not uncommon, as helping professionals, to judge our effectiveness or ineffectiveness as clinicians by the success of our clients. And while we make significant contributions toward helping clients discover and develop the tools or skills that they need to be successful, we cannot make them successful. We can model hope, build motivation for, and help clients move toward and through change, but we cannot make them change. What we can do, however, is be committed to creating an environment where our clients feel safe in exploring the idea of change. We accomplish this by being present, accountable, congruent, and nonjudgmental, and, showing unconditional positive regard to our clients. I firmly believe that if we approach each client with whom we work with at least the aforementioned five criteria, it would be difficult to “fail” them as a counselor. That realization led me to the third lesson I learned: appreciate the small victories. There is no happy ending when a client dies from an accidental overdose. An unfortunate reality in addiction counseling is that, even after we have given what feels to be 110% effort and used every evidence-based intervention in our wheelhouse, some clients may relapse, or worse. With all the “life lemons” in the addiction profession, learning to make lemonade, or find a silver lining, can help us avoid compassion-fatigue and burnout. The ‘silver lining’ that I have personally adopted is that, despite the challenges that overcoming addiction can present, millions of people still can and do recover. I continue to witness it firsthand, and it is nothing short of awe-inspiring. And that – the hope/possibility in it all – is enough to keep going. In looking for the ‘lemonade’ in this particular case, I am often drawn to a memory that captures the epitome of my “why.” About a month into the deceased’s outpatient treatment, I facilitated a Process Therapy group that he attended. During check-in, we talked about the weekend, and he shared with the group that he had recently attended a wedding. He reflected on how much he enjoyed himself and how different of an experience it was being at a wedding and in recovery. As he retold the story, he had the most infectious glow on his face, laughing about being a poor dancer when he is sober. That day he exuded a happiness that felt real, and the balance of the group seemed a little happier, and even more optimistic in the moments after. Even if it was only a momentary reprieve; prior to his untimely passing he had at least one moment of clarity in which he could fully experience happiness. And that is a victory worth celebrating. Truth be told, writing this has been a part of my grieving process. While our responsibilities as professionals may urge us to, in order to be of support to other clients, push through our own grieving process (or sometimes ignore the need to grieve all together), to do so would be unethical. We cannot take our clients any further than we have gone or been willing to go ourselves. It is imperative that we allow ourselves the space to grieve and mourn. Seek consultation or supervision. Take time off. See your own therapist. Take a walk. Meditate. Feed yourself spiritually. Ramp up your self-care. Whatever it is that you need to do to be healthy – do it. Jessica A. Love Jordan-Banks is a final year Master of Health Science Candidate in the Addictions Studies: Addictions Counseling Concentration graduate program at Governors State University in University Park, Illinois. As an emerging addictions therapist, author, researcher, educator and advocate, Jessica enjoys fostering a better understanding of addiction on both a micro level (counseling & education) and macro level (outreach, training, prevention & advocacy). Her professional interests include treatment & prevention program facilitation; community outreach & education; addictions professional development and training; treatment and prevention research; and improving client relations within the addiction & behavioral health treatment field. Her current research interest areas include issues in addictions counselor professional development and

Earn 1 CE by Taking an Online Multiple Choice Quiz Earn one Continuing Education hour by taking a multiple choice quiz on this article now at www.naadac.org/magazine-ce-articles. $15 for NAADAC members and non-members.

1. In each affiliate, who is the official representative to the NAADAC Board of Directors? a. The affiliate board b. The affiliate president c. The NAADAC Executive Director d. The national board director 2. What issues did NAADAC representatives and leadership advocate for during the Advocacy in Action Conference? a. Protections with the enforcement of parity b. Allocation of funds to the SUPPORT for Patients and Communities Act c. Tuition support for addiction professionals d. All of the above 3.

Which credentials were studied during the NCC AP job analysis? a. CRSW, MAC, CASAC b. MAC, CPRP, LADC c. NCAC I, NCAC II, MAC d. AODC, ASAM, MAC

4. Often, clinicians want to report their colleagues to legal/professional entities. a. True b. False 5. What are good reasons to report professional transgressions in the workplace? a. If you disagree with someone’s clinical approach and philosophy. b. To protect the client, protect the organization-at-large, and protect our profession. c. To ensure fidelity and compliance with an evidence-based practice. d. To protect one’s perspective on a conflict. 6. Alleged transgressions should be____________________________ to support the assertions being made. a. … documented with supporting facts … b. … brought first to the accused before going to a supervisor … c. … taken with a grain of salt … d. … written in a report only after a clear ethical violation is crossed

7. What was the conclusion of the NASEM report? a. That medications can only assist other forms of therapy, but cannot be viewed as the standard of medical care for Opioid Use Disorder. b. Results were inconclusive. c. That there is valid reason to distrust medications for Opioid Use Disorder. d. That medications used to treat Opioid Use Disorder are effective and save lives. 8. What can addiction professionals do to overcome the stigma about addiction and people with addiction? a. Educate the public and policymakers about the reality of addic tion as a brain disease and the efficacy of medications in treating it. b. Remind patients to be fearful of medical care providers. c. Clarify that there is only one path to recovery from addiction. d. Prescribe more medications to treat OUD. 9. A number of evidence-based interventions that target underage drinking are… a. …not effective for the majority of youth. b. …available but are underutilized. c. …enough, and no more research or curriculum development is needed. d. …used frequently but not many options are available. 10. When it comes to grieving the death of a patient, a young counselor will most likely find that… a. … there are few healthy ways to cope such a tragedy. b. … you may face judgement amongst your peers if you share your honest feelings. c. … there are dozens of articles and online forums dedicated to discussing this process, you are not alone. d. … this experience is rare, and it’s difficult to find information online or community support.

■ NA A DAC L E ADE RS H I P NAADAC EXECUTIVE COMMITTEE

NAADAC COMMITTEES

Updated 4/25/2019

North Central

STANDING COMMITTEE CHAIRS

AD HOC COMMITTEE CHAIRS

President Diane Sevening, EdD, LAC, MAC

(Represents Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota)

Awards Committee Chair Mary Woods, RN-BC, LADC, MSHS Bylaws Committee Chair Ronald A. Chupp, LCSW, LCAC, NCAC II, ICAC II

Adolescent Specialty Committee Co-Chairs Chris Bowers, CSAC, NCAAC Steven Durkee, NCAAC

Clinical Issues Committee Chair Mark Sanders, LCSW, CADC

International Committee Chair Elda Chan, PhD, MAC

Ethics Committee Chairs Mita Johnson, EdD, LPC, LAC, MAC, SAP Rose Marie, MAC, LCADC, CCS

PAST PRESIDENTS

President-Elect Mita Johnson, EdD, LPC, LAC, MAC, SAP Secretary Susan Coyer, MA, AADC-S, MAC, CCJP Treasurer Gregory J. Bennett, LAT, MAC Immediate Past President Gerard J. “Gerry” Schmidt, MA, LPC, MAC, LPC, CAC National Certification Commission for Addiction Professionals (NCC AP) Chair Jerry A. Jenkins, MEd, MAC Executive Director Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP REGIONAL VICE-PRESIDENTS Mid-Atlantic (Represents Delaware, the District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia and West Virginia)

Ron Pritchard, CSAC, CAS, NCAC II Mid-Central

James “JJ” Johnson Jr., BS, LADC, ICS Northeast (Represents Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont)

William Keithcart, MA, LADC Northwest

(Represents Alaska, Idaho, Montana, Oregon, Washington and Wyoming)

Finance & Audit Committee Chairs Mita Johnson, EdD, LPC, LAC, MAC, SAP Gregory J. Bennett, LAT, MAC

Malcolm Horn Southeast

(Represents Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina and Tennessee)

Angela Maxwell, MS, CSAPC Southwest

(Represents Arizona, California, Colorado, Hawaii, Nevada, New Mexico and Utah)

Julio Landero, PhD, MAC, MSW, LADC, LASAC Organizational Member Delegate Jim Gamache, MSW, MLADC, IAADC

(Represents Kentucky, Illinois, Indiana, Michigan, Ohio and Wisconsin)

Membership Committee Chair John Korkow, PhD, LAC, SAP Military & Veterans Advisory Committee Chair Ron Pritchard, CSAC, CAS, NCAC II Nominations and Elections Chair Kirk Bowden, PhD, MAC, NCC, LPC Personnel Committee Chair Diane Sevening, EdD, LAC, MAC Professional Practices and Standards Committee Chair Kirk Bowden, PhD, MAC, NCC, LPC Public Policy Committee Co-Chairs Michael Kemp, ICS, CSAC, CSW Sherri Layton, MBA, LCDC, CCS

Gisela Berger, PhD, MAC, LPC, NCC Mid-South

NERF President Diane Sevening, EdD, LAC, MAC

(Represents Arkansas, Louisiana, Oklahoma and Texas)

Matthew Feehery, MBA, LCDC, IAADC

Student Committee Chair Deborah Fenton-Nichols, EdD, LPC, LAC, NCC

NAADAC REGIONAL BOARD REPRESENTATIVES

NATIONAL CERTIFICATION COMMISSION FOR ADDICTION PROFESSIONALS (NCC AP) Jerry A. Jenkins, MEd, MAC NCC AP Chair Alaska James “Kansas” Cafferty, MA, LMFT, MCA, CATC, NCAAC NCC AP Chair-Elect California

1974-1977 Robert Dorris 1977-1979 Col. Mel Schulstad, CCDC, NCAC II (ret’d) 1979-1981 Jack Hamlin 1981-1982 John Brumbaugh, MA, LSW, CADAC IV, NCAC II 1982-1986 Tom Claunch, CAC 1986-1988 Franklin D. Lisnow, MEd, CAC, MAC 1988-1990 Paul Lubben, NCAC II 1990-1992 Kay Mattingly-Langlois, MA, NCAC II, MAC 1992-1994 Larry Osmonson, CAP, CTRT, NCAC II 1994-1996 Cynthia Moreno NCAC I, CCDC II 1996-1998 Roxanne Kibben, MA, NCAC II 1998-2000 T. Mark Gallagher, NCAC II 2000-2002 Bill B. Burnett, LPC, MAC 2002-2004 Roger A. Curtiss, LAC, NCAC II 2004-2006 Mary Ryan Woods, RNC, LADC, MSHS 2006-2007 Sharon Morgillo Freeman, PhD, APRN-CS, MAC 2007-2010 Patricia M. Greer, BA, LCDC, AAC 2010-2012 Donald P. Osborn, PhD (c), LCAC 2012-2014 Robert C. Richards, MA, NCAC II, CADC III 2014-2016 Kirk Bowden, PhD, MAC, NCC, LPC 2016-2018 Gerard J. Schmidt, MA, LPC, MAC

Rose Maire, MAC, LCADC, CCS Secretary New Jersey Kirk Bowden, PhD, MAC, LPC, SAP Treasurer Arizona Elda Chan, PhD, MAC, Grad. Dip. Family Therapy Hong Kong, China Christina Migliara, PhD, LMFT, MAC, CAP, CASAC Florida Diane Sevening, EdD, LAC, MAC (ex-officio) South Dakota

NAADAC EDUCATION & RESEARCH FOUNDATION (NERF) NERF President Diane Sevening, EdD, LAC, MAC NERF Events Fundraising Chair Nancy Deming, LCSW, MAC, AADC-S

NORTHEAST NORTH CENTRAL

MID-CENTRAL

Gloria Nepote, NCAC II, Kansas/Missouri Therissa Libby, PhD, Minnesota Tom Barr, LIMHP, LADC, Nebraska Megan Busch, LAC, LPCC, North Dakota Mark Young, South Dakota

Renee Lee, MSW, CADC, Illinois Stewart Ball, MAC, LCAC, LMFT, LCSW, Indiana Michael Townsend, NSSW, Kentucky Deborah Garrett, BS, CPRM, CPS, Michigan Dorothy Hillaire, LSW, LCDC II, Ohio Daniel Bizjak, MSW, ICS, CSAC, Wisconsin

Susan Campion, LADC, LMFT, Connecticut Ruth A. Johnson, LADC, SAP, CCS, Maine Joe Kelleher, LADC-1, Massachusetts Alexandra Hamel, MLAC, MAC, New Hampshire Christopher Taylor, CASAC, LMHC, MAC, SAP, New York John Mann, LADC, Vermont

NORTHWEST Diane C. Ogilvie, MAEd, Alaska Coralee Goni, MS, MBA, MAC, Montana Kerry Speed, MA, Oregon Terri Roper, MS, NCAC II, Washington

SOUTHWEST

MID-ATLANTIC

Yvonne Fortier, MA, LPC, LISAC, Arizona Thomas Gorham, MA, CADC II, California Agnieszka Baklazec, MA, LPC, LAC, MAC, Colorado David Marlon, MBA, MS, LADC, CAd, Nevada Shawn McMillen, Utah

Jevon Hicks Sr., BS, ICADC, Delaware Johnny Allem, MA, District of Columbia David Semanco, MAC, CAADC, CSAC, CACAD, Virginia Mary Aldrich-Crouch, MSW, MPH, LICSW, MAC, AADC, West Virginia SOUTHEAST MID-SOUTH Scott Kelley, LCDC, Texas

Sam Long IV, NCAC I, Alabama Bobbie Hayes, LMHC, CAP, Florida Donna Ritter, BT, CAC II, CCS, Georgia Tony Beatty, MA, LCAS, CCS, North Carolina James E. Campbell, LPC, CAC II, MAC, South Carolina Michele Squires, MS, LADAC II, MAC, QCS, Tennessee

NAADAC’s celebrated three-module Basics of Addiction Counseling Desk Reference has been updated! The Basics of Addiction Counseling Desk Reference, 11th Edition – Buy all Three! • Module I: Pharmacology of Psychoactive Substance Use Disorders • Module II: Addiction Counseling Theories, Practice and Skills • Module III: Ethical and Professional Issues in Addiction Counseling

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