to which students and current members of the workforce possess or practice these competencies (Hoge et al., 2005a).

Leaders in M/SU education and clinical care also have called for certain knowledge, skills, and attitudes (i.e., core competencies) to be addressed by the education of all clinicians providing M/SU health care. Such competencies include, for example, detecting co-occurring mental and substance-use problems and illnesses, and avoiding the stigmatizing attitudes and practices of health care providers that obstruct patients’ self-management of their illness and recovery, as described in Chapter 3. Several initiatives have been undertaken to develop and implement core competencies, including two for those treating substance use and one for those treating mental conditions. But these initiatives (described below) have not yet fully taken hold.


Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice In 1995, the National Curriculum Committee of the Addiction Technology Transfer Center program, a nationwide training system supported by SAMHSA’s Center for Substance Abuse Treatment (CSAT), reached agreement on core competencies for addiction counseling across professional groups that may treat people with substance-use problems and illnesses. The resulting document, Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice, identifies the basic knowledge and attitudes required for all disciplines in the addiction field, as well as those necessary for the professional practice of addiction counseling (clinical evaluation; treatment planning; referral; service coordination; counseling; client, family, and community education; documentation; and professional and ethical responsibilities, each with its own set of competencies). The goal is for every addiction counselor and every specialty treatment facility to possess every competency, regardless of setting or treatment model (Addiction Technology Transfer Centers National Curriculum Committee, 1998; Hoge et al., 2005a).


Interdisciplinary Project to Improve Health Professional Education in Substance Abuse This 5-year cooperative project of the Health Resources and Services Administration (HRSA), the Association for Medical Education and Research in Substance Abuse (AMERSA), and CSAT produced (1) a strategic plan for interdisciplinary faculty development to prepare the general health professions workforce to provide care for substance-use problems and illnesses, (2) an interdisciplinary faculty development program to improve the educational curriculums for general health care professionals, and (3) an infrastructure to support faculty development in substance-use treatment. The initiative also produced a set of core and discipline-specific knowledge, attitudes, and competencies needed by health professionals to



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