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Course Description

Course: Ethics for Texas LCDCs (3 hours)

Course Description:The purpose of this course is to help Texas LCDCs review Sections 150.1 (Definitions), 150.12 (Scope of Practice), 150.42 (Ethical Standards), and 150.43 (Actions Against a License) of the LCDC Handbood. After reading these sections, participants will take a 30 item quiz made up of case vignettes illuminating ethical guidelines presented in the LCDC Handbook. This course attempts to meet the guidelines of the Center for Substance Abuse Treatment's (CSAT) Technical Assistance Publication (TAP) # 21 (Section 2, VIII, 1) by providing information regarding the Knowledge, Skills, and Attitudes (KSA's) needed by addiction counselors to meet professional ethical standards. Objectives:The course objectives coincide with the KSA's: Upon completion of course, participants will: 1) Recall the definition of abuse, neglect and exploitation, as well as the procedure for reporting such issues; 2) Explain professional standards and scope of practice; 3) Identify rules regarding sexual contact and other boundary issues; 4) Evaluate guidelines and limits regarding confidentiality; 5) Identify the difference between the role of professional counselor and that of a peer counselor or sponsor; 6) Recall means for addressing, and consequences of, alleged ethical violations.

Course Outline: I. Course Pre-Quiz II. (text) Definitions III. Scope of Practice IV. Ethical Standards V. Actions Against a License VI. Course Quiz VII. Course Evaluation

Course: HIV, Hepatitis C., and Sexually Transmitted Diseases (6 hours)

Course Description: This course attempts to meet the guidelines of the Center for Substance Abuse Treatment’s (CSAT) Technical Assistance Publication (TAP) #21 (Section 2, VI, 8), by providing information regarding the Knowledge, Skills, and Attitudes (KSA’s) needed by counselors to address the health and behavioral problems related to substance abuse and the transmission and prevention of HIV, Hepatitis C., and STDs. This course text involves information from four government sources including the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) Treatment Improvement Protocol (TIP) #37 (Chapters 1 and 5) and TIP #6 (Chapter 2), The National Institute on Drug Abuse (Volume 15, Number 1; Volume 16, Number 3; and Principles of HIV/AIDS and Other Infections Prevention in Drug-Using Populations), and the National Institute of Allergy and Infectious Diseases (An Introduction to Sexually Transmitted Diseases). In the first text, TIP #37, Chapters 1 and 5, participants are provided a basic overview of HIV, including epidemiological data from the CDC. Chapter 5 discusses the integration of treatment services, via collaboration, so that all needs of HIV infected clients with substance abuse disorders can be met. The information regarding Hepatitis C is from two NIDA articles that address the relationship and health risks regarding drug use and Hepatitis C. The information regarding sexually transmitted diseases is from the National Institute of Allergy and Infectious Diseases and provides an introduction to sexually transmitted diseases. The last section, Section D, text from NIDA and SAMHSA instruct on the strategies for the prevention and treatment of clients with and at risk for HIV, Hepatitis C., and STDs.

Course Outline: I.Course Pre-quiz; II. Introduction to HIV/AIDS; III. Overview of HIV - A. Origin of HIV/AIDS; B. HIV Transmission; C. Risks of Transmission: D. Life Cycle of HIV; 1. Infection; 2. Latency Period; 3. Early symptomatic infection; 4. AIDS; 5. End-stage disease; IV. Changes in Epidemiology of HIV/AIDS since 1995; A. Current Trends in the HIV/AIDS Pandemic; B. Regional HIV/AIDS Epidemiology; HIV Epidemiology among groups: 1. Homosexuals; 2. Incarcerated persons; 3. Sex workers; 4. Homeless or marginally housed; 5. Adolescents; V. Integrating Treatment Services; A. HIV/AIDS services in Substance Abuse Treatment; B. Issues of Integrated Care; 1. Early Intervention Settings; 2. Obstacles to Integrated Care; 3. Dealing with Ongoing Substance Abuse-abstinence model, public health model, differential standards of care; 4. Referral to and Coordination of Linkages; 5. Case Finding; 6. Home-based Services for Clients with End-stage HIV/AIDS; 7. Stressors in home-based caregiving; 8. Substance Abuse in the home; 9. Examples of Integrated Treatment; VI. Hepatitis C and Drug Abuse; A. Transmission of Hepatitis C; B. Prevention of HCV; C. HCV and Injection Drug Users (IDUs); VII. Introduction to Sexually Transmitted Diseases; A. HIV Infection and AIDS; B. Chlamydial Infection; C. Genital Herpes; D. Genital Warts; E. Gonorrhea; F. Syphilis; VIII. Prevention Strategies for STDs; IX. Treatment of Clients Diagnosed with STDs; X. Prevention of HIV, Hepatitis C., and STDs; A. Assessing Risk for Infection; B. Infectious Disease Testing; C. Preparation for Testing; XI. Counseling the Patient With Positive Test Results for Infectious Diseases; XII. Counseling the Patient With Negative Test Results; XIII. Principles of Risk Reduction; A. Principles of Risk Reduction; B. Retention In Treatment

Objectives:Upon completion of this course, participants will be able to: 1) Identify the routes of HIV transmission and the five stages of the HIV life-cycle; 2) Assess HIV epidemiology among groups; 3) Explain the elements of HIV/AIDS services in Substance Abuse Treatment; 4) Evaluate barriers to effective integration of HIV/AIDS and substance abuse services; 5) Review the transmission and prevention of Hepatitis C; 6) Identify the effects of injection drug use on HCV acquisition and persistence; 7) Understand the prevention and treatment options for those with and at risk for Hepatitis C; 8) Review the acquisition of the most prevalent sexually transmitted diseases; 9) Recall the prevention strategies for STDs; 9) Identify and explain the principles and strategies for counseling clients with HIV, Hepatitis C., and STDs.

Course: Professional Interventions That Facilitate 12-Step Help Group Involvement (3 hours)

Course Description: The course text is from an article found in Alcohol Research & Health and is written by Keith Humphreys, Ph.D. This article discusses the rationale for interventions that facilitate alcohol-dependent patients' affiliations with AA and related mutual-help oragnizations such as Narcotics Anonymous. The article also reviews recent research comparing those interventions with other methods. This course attempts to meet the Knowledge, Skills, and Attitudes (KSA's) of the CSAT's Technical Assistance Publication # 21 (Section 1, I., B, 1) by providing information describing the outcomes of self-help group invovlement and justification for validity of self-help approaches. Also, to adhere to the KSA's of TAP # 21, (Section 2, III) by providing information that endorses counselor referral self-help community resources.

Course Outline: I. Introduction; A. Facilitating involvement in 12-steps; B. Effectiveness of TSF; II. Importance of 12-step Group Affiliation in Alcohol Treatment; A. Overview of research regarding effectiveness of AA; B. Influence of Managed Care in enhancing interest in cost-effective care III. Evaluation of TSF; A. Project MATCH and VA study; 1. Comparison of TSF with CB therapy and MET; 2. Comparison of 12-step with CB therapy; IV. Conclusions from recent research; V. Directions for future research.

Objectives:Upon completion of this course, participants will: 1) Recall reasons for the importance of 12-step group affiliation in alcohol treatment; 2) Examine recent evaluations of TSF interventions; 3) Reveiw the major goals of 12-step facilitation in Project MATCH; and 4) Recall comparison of Twelve-step Facilitation interventions with Cognitive behaviorial therapy and Motivational Enhancement Therapy in Project MATCH.

Course: The Link Between Smoking and Drinking: Genetic and Behavioral Factors (6 hours)

Course Description: With smoking related illnesses being a top killer in the U.S., and data showing that a large percentage of heavy drinkers are smokers, counselors need to be informed about the data related to tobacco use and drinking, as well as strategies to address these problems. The text is from the government publication Alcohol Research & Health and involves two articles. This course discusses the genetic and behavioral risks of becoming a smoker as well as the risk of alcohol dependence and the connection between the two addictions. This information attempts to meet the guidelines of Technical Assistance Publication #21, Section 1, I., A., by facilitating counselor understanding of terms and concepts related to smoking and alcohol research, appropriate application of models, appreciation of the complexity inherent in understanding addiction, and the formation of personal concepts through critical thinking regarding the treatment of nicotine and alcohol abuse.

Course Outline: I. Introduction II. Australian Twin Panel III. Smoking and Reactions to Alcohol IV. Behavioral Mechanisms Involved in the Initiation of Drinking and Smoking V. Mechanisms of dependence A. Tolerance and Sensitization After Prolonged Use B. Withdrawal Symptoms C. The influence of stress

Objectives:Upon completion of this course, participants will: 1) Recall outcomes of smoking and alcohol dependence in the Australian Twin Panel; 2) Assess current data related to the comorbidity between smoking and drinking: 3) Identify behaviorial mechanisms involved in the initiation of drinking and smoking; 4) Evaluate the anxiety-reducing, antidepressant, aversive, and reinforcing effects of alcohol and nicotine; 5) Identify mechanisms of dependence; 6) Explain neuronal mechanisms involved in dependence; 7) Recall interdependent factors involved with smoking and drinking dependence.

Course: Substance Abuse Treatment for Persons With Co-Occurring Disorders (9 hours)

Course Description: Participants will read the text and then complete a 30 item true-false quiz. The text for this course is from the Substance Abuse and Mental Health Services Administration/Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocol (TIP) Number 42, titled: Substance Abuse Treatment for Persons With Co-Occurring Disorders. The TIP attempts to summarize for the clinician the state-of-the-art in the treatment of co-occurring disorder (COD) in the substance abuse and mental health fields. It contains chapters on terminology, assessment, and treatment strategies and models, as well as recommendations for treatment, research, and policy planning. The primary concern of this TIP is co-occurring substance use (abuse and dependence) and mental disorders, even though it is recognized that this same vulnerable population also is subject to many other physical and social ills. The TIP includes important work on nicotine dependence, a somewhat large and separate body of work that admittedly does need further integration into the general field of COD. Nicotine dependency is treated here as an important cross-cutting issue. Finally, although the TIP does address several specific populations (i.e., homeless, criminal justice, and women), it does this briefly and does not describe programs specifically for adolescents or for such specialized populations as new Asian and Hispanic/Latino immigrants. At the same time, the authors fully recognize, and the TIP states, that all COD treatment must be culturally relevant. : The text for this course is from SAMHSA/CSAT Treatment Improvement Protocol (TIP) Number 42, titled: Substance Abuse Treatment for Persons With Co-Occurring Disorders. Found online at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.74073 KSA Dimension and Sub Element: Section 1 (Transdisciplinary Foundations), A (Understanding Addiction), 4, Knowledge (a)(b)(c)(d), Attitudes (a)(b)(c)(d).

Objectives:Upon completion of this course, participants will be able to: 1) Identify the definitions, terms, and classification systems for co-occurring disorders; 2) Recall keys to successful co-occurring disorder programming; 3) Review the basic screening, assessment, and treatment strategies for clients with co-occurring disorders; 4) Understand the traditional and special settings, models, and specific populations of co-occurring disorders; 5) Describe elements of working with substance abuse treatment clients who also have the cross-cutting issues of suicidality and nicotine dependence; 6) Identify the ways that toxic effects of substances can mimic mental illness.

Course: Substance Abuse Treatment and Family Therapy (12 hours)

Course Description: Participants will read the text and then take an online quiz. This text, TIP #39, Substance Abuse Treatment and Family Therapy, addresses how substance abuse affects the entire family and how substance abuse treatment providers can use principles from family therapy to change the interactions among family members. The TIP provides basic information about family therapy for substance abuse treatment professionals and basic information about substance abuse treatment for family therapists. The TIP presents the models, techniques and principles of family therapy, with special attention to the stages of motivation as well as to treatment and recovery. Discussion also focuses on clinical decision making and training, supervision, cultural considerations, specific populations, funding and research. The TIP further identifies future directions for both research and clinical practice.

References: The text for this course is from SAMHSA/CSAT Treatment Improvement Protocol (TIP) Number 39, titled: Substance Abuse Treatment and Family Therapy. Found online at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.70382 KSA Dimension and Sub Element: Section 1 (Transdisciplinary Foundations), B (Treatment Knowledge), 2, Knowledge (a),(b), Attitudes(a).

Objectives:Upon course completion, participants will: 1) Review the evolution of family therapy as a component of substance abuse treatment; 2) Recall primary models of family therapy from a systems perspective; 3) Identify the stages of change and levels of recovery from substance abuse; 4) Understand treatment issues likely to arise in different family structures that include a person abusing substances such as the economic and psychological consequences that spouses, parents, and children experience; 5) Describe how substance abuse treatment and family therapy can be integrated to provide effective solutions to multiple problems; 6) Review the application of treatment with special populations; 7) Understand some of the policy implications for effectively joining family therapy and substance abuse treatment.

Course: Substance Abuse Treatment: Group Therapy (9 hours)

Course Description: This is an online course. Participants will read the text and then complete a quiz. The text is from SAMHSA/CSAT Treatment Improvement Protocol (TIP) Number 41, titled: Substance Abuse Treatment: Group Therapy. This text presents an overview of the role and efficacy of group therapy in substance abuse treatment planning. The goal of this TIP is to offer the latest research and clinical findings and to distill them into practical guidelines for practitioners of group therapy modalities in the field of substance abuse treatment. The TIP describes effective types of group therapy and offers a theoretical basis for group therapy's effectiveness in the treatment of substance use disorders. This work also will be a useful guide to supervisors and trainers of beginning counselors, as well as to experienced counselors. Finally, the TIP is meant to provide researchers and clinicians with a guide to sources of information and topics for further inquiry. Objectives: Upon successful completion of this course, participants will: 1) Identify the benefits of group therapy and the differences between group therapy and 12 Step Self Help Groups; 2) Understand the types of group therapy commonly used in substance abuse treatment; 3) Recall criteria for placement of clients in groups; 4) Describe fixed and revolving group membership and the phases of group therapy; 5) Review the characteristics of the early, middle, and late stages of treatment; 6) Describe desirable leader traits and behaviors, along with the concepts and techniques vital to process groups; 7) Understand the skills group therapy clinicians need, the purpose and value of clinical supervision, and how to get the training necessary to be a group clinician or supervisor of clinicians.

Course: Alcohol Abuse and Violence Against Women (4 hours)

Course Description: Each year, more than 500,000 non-fatal violent crimes are committed against women. These crimes include sexual assault, rape, intimate partner violence, and elder abuse. Many of these crimes involve the use of alcohol or other drugs. Addiction professionals are on the front lines in being able to help people affected by alcohol abuse and violence against women. Domestic violence and alcohol abuse are so widespread that nearly one-third of all Americans know a woman who has suffered violence from her partners, and an even higher number know someone affected by alcohol abuse. The course describes these "hidden problems" and identifies risk factors, screening and assessment tools, prevention and intervention strategies, tools for clients, and legal issues.

Objectives: Upon course completion, participants will: 1) Review addiction and alcoholism, the behaviors associated with it, as well as diagnostic criteria; 2) Clarify the definitions of the various types of violence against women (e.g., rape, domestic violence) and the types and methods of abuse, myths, medical and psychological effects of violence, and problems during pregnancy; 3) Understand the links between alcohol and domestic violence, theories regarding the intersection of alcohol and violence, and their effects on children and teenagers; 4) Recall terms relating to sexual assault and rape and prevention strategies; 5) Examine prevention and education techniques; 6) Review various screenings for domestic violence, sexual assault, battering, and alcohol abuse; 7) Understand the diagnosis and treatment for substance abuse, sexual assault, and domestic violence within the treatment fields of substance abuse and violence against women; 8) Review legal and ethical issues related to alcohol addiction, domestic violence and sexual assault.

Course: Uncovering Substance Use and Elder Abuse (6 hours)

Course Description: Every year, millions of older people are at risk of physical, psychological, or other forms of elder abuse and neglect. Yet, elder abuse remains a largely hidden problem. Contrary to popular belief, most elder abuse occurs within family settings. Elder abuse is preventable. Effective responses are needed to address the causes of the abuse, regardless of the setting and circumstance. As with other forms of violence, one of the most common factors that put older people at risk is the victim's or perpetrator's abuse of alcohol or other substances. This course examines substance abuse and other risk factors for elder abuse and identifies intervention techniques and effective prevention activities at the individual, family, and community level. This online course provides an introduction to elder abuse in the family and institutional settings. Although laws and responsibilities may vary among these settings, practitioners stress the importance of defining and addressing elder abuse across the spectrum -- whether at home or in a long-term care setting. (Research shows that although elder self-neglect shares common risk factors with other forms of elder abuse, additional complexities indicate an in-depth discussion of self-neglect requires separate study.) This online course uses definitions developed by the National Elder Abuse Incidence Study, the nation's first major report examining the extent of elder abuse. These definitions are applied to abuse within the family and institutional settings.

Objectives: Upon completing this course, participants will: Part I: 1) Understand the nature, scope, and severity of elder abuse; 2) Identify substance abuse as a major risk factor contributing to elder abuse. 3) Recognize the societal and cultural context of elder abuse; Part II: 4) Identify three types of abuse suffered by older adults; 5) Recognize the role of family in elder abuse trends; 6) List three consequences of abuse and neglect for the older adult, the abuser, and society; Part III: 7) Recognize substance abuse as a major risk factor associated with elder abuse and neglect; 8) Identify three substance abuse patterns that practitioners have observed in victims of elder abuse and their perpetrators; 9) List three barriers to intervention in substance abuse-related elder abuse. Part IV: 10) Identify three indicators that could signal elder abuse; 11) Identify two warning signs of problem alcohol use that mimic signs of aging; 12) List three barriers to identifying elder abuse. Part V: 13) Recognize the role that Adult Protective Services and the Long-Term Care Ombudsman Program play in intervention and treatment of elder abuse; 14) Identify a range of methods for intervention; 15) Identify health and mental health and other services to help victims of abuse. Part VI: 16) Identify two protective factors to help older people build resiliency and avoid abuse; 17) Identify two approaches to help prevent abuse among families and caregivers; 18) Define the multidisciplinary team approach toward elder abuse prevention and its benefits.

Course: The Link Between Substance Abuse and Suicide (6 hours)

Disclaimer : This text is taken from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, National Mental Health Information Center, Center for Mental Health Services.

Course Description: This course provides an introduction to help advance the goals and objectives of the National Strategy for Suicide Prevention (NSSP). The modules are designed to promote awareness of the link between substance abuse and suicide as well as other risk factors. The course includes information about tools and other resources to identify suicidal behaviors and to provide early intervention and prevention. The modules are designed to alert healthcare professionals to the latest research and strategies for effective responses.

Objectives: Upon course completion, participants will: 1) Understand the nature, scope, and severity of the problem and the connection between substance abuse and suicide; 2) Identify substance abuse as a major risk factor for those who attempt or complete suicide; 3) Recognize five suicide warning signs; 4) Differentiate between suicidal ideation, suicide planning, suicide attempt, and suicide; 5) List five examples of the biopsychosocial, environmental, and/or sociocultural dimensions of suicide; 6) Describe three protective factors; 7) Identify alcohol as the abused substance most often associated with the spectrum of suicidal behaviors and outcomes; 8) Recognize the importance of co-occurring disorders (co-existing substance abuse and mental health disorders); 9) Identify three common characteristics among people diagnosed with co-occurring disorders that increase the risk of suicide; 10) Identify the suicide risks and behaviors particular to youth, adults, and older adulthood; 11) Understand the multi-generational transmission of some suicide risk factors across the generations; 12) List common barriers or stigmas preventing individuals from seeking help for suicidal behaviors and/or substance abuse; 13) Recognize five of the special populations that have unique risks for suicide: 14) Understand that many cultural differences affect the risks for both suicide and substance abuse; 15) Identify some of the ways that members of special populations have needs that are unmet; 16) Recognize the continuum of care for prevention to early intervention and treatment; 17) Identify the key prevention and early intervention partners in the community; 18) Determine relevant prevention programs, along with private and public initiatives to prevent suicide.

Course: Detoxification and Substance Abuse Treatment (12 hours)

Course Description: This is from the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Improvement Protocol 45. Among the issues covered in this TIP is the importance of detoxification as one component in the continuum of healthcare services for substance-related disorders. The TIP reinforces the urgent need for nontraditional settings-emergency rooms, medical and surgical wards in hospitals, acute care clinics, and others-to be prepared to participate in the process of getting the patient who is in need of detoxification services into treatment as quickly as possible. Furthermore, it promotes the latest strategies for retaining individuals in detoxification while also encouraging the development of the therapeutic alliance to promote the patient's entrance into substance abuse treatment. The TIP also includes suggestions on addressing psychosocial issues that may impact detoxification treatment, such as providing culturally appropriate services to the patient population.

Objectives: Upon course completion, participants will: 1) Review essential concepts and definitions in detoxification; 2) Understand the settings, levels of care, and patient placement of individuals undergoing detoxification; 3) Review the psychosocial and biomedical issues during detoxification; 4) Recall the services available for withdrawal from specific substances; 5) Examine the co-occurring medical and psychiatric conditions involved with detoxification; 6) Review financing and organizational issues related to detoxification services.

Course: Clinical Issues in Intensive Outpatient Treatment (12 hours)

Course Description: This text is from the Substance Abuse and Mental Health Services Administration TIP #47. This Treatment Improvement Protocol, Substance Abuse: Clinical Issues in Intensive Outpatient Treatment, addresses the practical needs of treatment providers as they design and implement IOT programs. The TIP provides specific information on the principles of intensive outpatient treatment; services and treatment models; modifications for distinct population groups; culturally competent treatment; screening and patient placement criteria; counseling methods and techniques, including involvement of families; and the continuum of care. The TIP also covers such important issues as how to improve early retention, provide the appropriate length and intensity of services, provide the most promising mix of wrap-around services for positive client outcomes, and arrange ongoing care in the community.

Objectives: Participants in this course will: 1) Understand principles of Intensive Outpatient Treatment: 2) Review IOP and the Continuum of Care; 3) Recall elements of services in IOP programs; 4) Evaluate components of treatment entry and engagement; 5) Understand family based services in IOP programs; 6) Review clinical issues, challenges, and strategies in Intensive Outpatient Treatment; 7) Examine various IOP treatment approaches.