SUD Workforce Enhancement for Longitudinal Learning (SWELL) Initiative
As specialty substance use disorder (SUD) systems evolve throughout California, particularly as a result of the changes resulting from the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver, there is a need to support and enhance the workforce throughout these systems.
While the continued professionalization of specialty SUD systems will result in the diversification of its workforce by discipline (SUD counselors, MFTs, LCSWs, clinical psychologists, nurses, nurse practitioners, physician assistants, physicians, etc), SUD counselors comprise between 70 – 90% of the workforce of publicly funded specialty SUD systems across the state. As a result, investing in the quality of the SUD workforce will be particularly important in order to ensure robust, high integrity, and quality-focused specialty SUD systems in the future.
Through collaborative discussions between Los Angeles County leadership and leadership from the SUD counselor certifying bodies (CAADE, CADTP, and CCAPP), there has been a recognition of the need to continue to enhance the SUD counselor workforce, particularly with regard to ensuring that counselors have the training and skillset necessary to excel in the work environment they often enter when they are hired by community-based SUD treatment programs. CCAPP will take this initiative state wide to enhance the workforce through California.
The SUD Workforce Enhancement for Longitudinal Learning (SWELL) Initiative is the product of these discussions, and is intended to serve as a blueprint for how the SUD counselor certifying bodies can structure the SUD counselor training curriculum and refine a unified vision for preparing the SUD counselor workforce of the future.
The goal of the SWELL Initiative is to enhance the SUD workforce to ensure counselors are prepared for the work environment they will be entering in publicly funded specialty SUD systems across California.
Workforce Development Through Strategic Partnerships Between Leadership from Los Angeles County and the SUD Counselor Certifying Bodies.
Through strategic partnerships focusing on workforce and curriculum development, the SWELL Initiative will cultivate a specialty SUD workforce throughout California that is robust, sustainable, and work-ready upon completion of training. This SUD workforce will possess the knowledge, competency, and skills to provide comprehensive, patient-centered, and effective SUD treatment that will improve the health and well-being of the patient populations they serve.
CURRICULUM DEVELOPMENT – GUIDING PRINCIPLES
SKILLS- and COMPETENCY-BASED FOCUS At its most fundamental level, SUD counselor training curriculums and evaluation need to be skills- and competency-based to ensure counselors are employment-ready upon graduation.
COMPREHENSIVE The SUD counselor training curriculum needs to prepare counselors to deliver services that reflect the biopsychosocial needs of their patients, including treatment options such as MAT and the importance of ensuring access to physical/mental health services.
PRACTICAL The SUD counselor training curriculum needs to prepare counselors to be work-ready, with a focus on the practical application of skills and principles learned throughout the curriculum.
INTEGRATED Core curriculum topics need to be integrated across the curriculum experience longitudinally so that counselors are exposed a number of different training topics in different context and can apply their learning to practice (e.g., documentation should be covered not just in a siloed course on documentation, but should also be incorporated into other areas of the training curriculum such as during courses on ASAM assessments, diagnostic criteria, case management, etc).
PROMOTE FLEXIBILITY IN PRACTICE The SUD counselor training curriculum needs to cultivate flexibility in service delivery so that counselors are competent in a variety of techniques and approaches so they can better tailor their approaches to the individual needs of their patients and apply them in a variety of clinical settings.
LONGITUDINAL The SUD counselor training curriculum needs to prepare counselors for lifelong learning as well as instill the expectation for lifelong learning among counselors already in practice (e.g., continuing education).
QUALITY-FOCUSED The SUD counselor training curriculum and the delivery of that curriculum needs to establish a quality-focused and high integrity culture among the SUD workforce.
CULTURALLY MINDFUL The SUD counselor training curriculum needs to promote cultural humility within the SUD workforce, not just in terms of delivering culturally and developmentally competent services to the patients it serves, but also in terms of reflecting upon itself to recognize and reduce innate provider biases that may exist. Cultural humility includes the treatment of vulnerable populations such as individuals that are homeless, criminal justice involved, LGBTQ, veterans, perinatal, and those with co-occurring mental and physical health conditions, including HIV/AIDS.
CORE CURRICULUM TOPICS
Conceptual overview of the ASAM Criteria
Conceptual, practical, and skills-based curriculum focused on the practical application of the ASAM Criteria through ASAM assessments
ASAM Continuum of Care
Conceptual, practical, and skills-based curriculum focused on familiarity with and how the SUD continuum of care (OTP, withdrawal management, residential, intensive outpatient, outpatient, recovery support services, etc) allows counselors to treat SUDs as a chronic condition
Conceptual, practical, and skills-based curriculum focused on the practical application of the diagnostic criteria for substance use disorders
Conceptual, practical, and skills-based curriculum focused on individualized documentation practices such as developing Treatment Plans, individual progress notes, group progress notes, and case management notes
Conceptual, practical, and skills-based curriculum focused on delivering case management services and the practical application of this service
Motivational Interviewing (MI)
Conceptual, practical, and skills-based curriculum focused developing a comprehensive understanding of MI, and the practical application of this approach
Cognitive Behavioral Therapy (CBT)
Conceptual, practical, and skills-based curriculum focused on developing a comprehensive understanding of CBT, and the practical application of this intervention
Medications for Addiction Treatment (MAT)
Conceptual, practical, and skills-based curriculum focused on developing an understanding of the role of MAT in SUD treatment, and the role of the SUD counselor in ensuring access to this treatment intervention
Conceptual, practical, and skills-based curriculum focused on cultivating cultural humility, both from the perspective of the patient and the counselor
Conceptual, practical, and skills-based curriculum focusing on a basic overview of both physical and mental health conditions, and their interaction with SUD treatment
Law / Ethics / Boundaries
Conceptual, practical, and skills-based curriculum focused on the practical application of law, ethics, and boundaries in the work environment
IMPLEMENTATION OBJECTIVES & TIMELINES
Targeting counselors already registered/certified with continuing education trainings and consideration of expanding the number and topics of mandatory continuing education required for recertification of SUD counselors currently in practice.
Launch Goal: July 2018
Targeting future trainees with curriculum modernization at the level of the SUD counselor certifying bodies.
Develop a plan to establish expected practices and professional developmental milestones for the entry of registered SUD counselors into the workforce and their expected progression to certification status.
Launch Goal: July 2019