Addiction Counseling Competencies

Glossary of terms

This glossary contains descriptions of key words used in this Technical Publication. The descriptions of the terms reflect the usage of the terms in this document. The descriptions are not intended as universal or complete definitions of the terms.

Active listening – a counseling skill that enhances rapport and demonstrates interest and understanding through the use of verbal and nonverbal acknowledgement of client statements.

Addiction – a chronic, relapsing disease of the brain with social and behavioral manifestations marked by continued alcohol or drug use despite negative consequences.

Addiction Counseling – professional and ethical application of specific competencies that constitute eight practice dimensions, including clinical evaluation; treatment planning; referral; service coordination; individual, group, and family counseling; client, family, and community education; and documentation.

Advocacy – (1) a social or political movement working for changes in legislation, policy, and funding to reflect clients’ concerns and protect their rights (i.e., advocacy for clients) (2) a philosophy of substance of substance abuse treatment practice maintaining that clients should be involved actively in their own treatment and have rights in its planning and implementation (i.e., advocacy by clients). Much of advocacy is about shifting is about shifting the system from the directive model to one in which the client is an empowered, involved participant in treatment decisions.

Biomedical – pertaining to the biological and physiological aspects of clinical medicine.

Biopsychosocial - the biological, psychosocial; and social influences in human development and behavior.

Case management – see “Service coordination.”

Client – individual, significant other, or community agent who presents for alcohol and drug abuse education, prevention, intervention, treatment, and consultation services.

Collateral Sources – persons or organizations providing pertinent information about a client (can include members and legal, educational, and medical personnel).

Competency – specific counselor functions compromising requisite knowledge, skills, and attitudes.

Confidentiality – a client’s right to privacy as defined by applicable Federal and State statutes.

Confidentiality rules and regulations – rules established by Federal and State agencies to limit disclosure of information a client’s substance use disorder and treatment (described in 42 CFR, Part 2B 16). Programs must notify clients of their to confidentiality, provide a written summary of these rights, and establish written procedures regulating access to and use of client records.

Confrontation – a form of interpersonal exchange in which individuals present to one another their observations of, and reactions to, behaviors and attitudes that are matters of concern. Feedback is provided on behavior, and an appeal is made to the client for personal honesty, truthfulness in dealing with others, and responsible behavior.

Content – the subjects discussed in the context of counseling.

Continuing care – care that supports a client’s progress, monitors his or her condition, and responds to a return to substance use or a return of mental disorder symptoms. It is both a process of post treatment monitoring and a form of treatment itself; sometimes referred to as aftercare.

Continuum of care – the array of services that differ in terms of unique needs of clients throughout the course of treatment and recovery.

Contracting – the process by which the client and the counselor enter into an agreement to address specific problems, issues, or behaviors.

Co-occurring disorder/coexisting disorder – the presence of concurrent psychiatric or medical disorders in combination with substance use disorder.

Counseling – a therapeutic process aimed at meeting specific identified needs of the client.

Counter transference – a counselor’s unresolved feelings for significant others that may be transferred to the client.

Craving – an urgent, seemingly overpowering desire to use a substance, which often is associated with tension, anxiety, or other dysphonic, depressive, or negative affective states.

Cultural competency – the capacity of a service or organization to understand and work effectively in accord with the beliefs and practices of persons from a given ethnic/racial/religious/social group or sexual orientation. It includes the holding of knowledge, skills, and attitudes that allow the treatment provider and program to understand the full context of a client’s current and past socio-environmental situation.

Cultural diversity – the vast array of cultural groups based on varying behaviors, attitudes, values, languages, celebrations, rituals, and histories.

Culture – the vast structure of behaviors, ideas, attitudes, habits, values, beliefs, customs, language, rituals, ceremonies, histories, and practices distinctive to a particular group of people.

Diagnosis - classification of the nature and severity of the substance use, medical, mental health, or other problems present. DSM-IV-TR and ICD-10 commonly are used to classify substance use and mental disorders.

Disorder – an affliction that affects the functions of the mind and/or body, disturbing physical and/or mental health.

Duty to warn – the legal obligations of a counselor (healthcare provider) to notify the appropriate authorities as defined by statute and/or the potential victim when there is serious danger of a client’s inflicting injury on an identified individual.

Efficacy – the power to produce a desired effect.

Elements – specific, definable areas found in three of the practice dimensions (clinical evaluation, service coordination, and counseling).

Empirical – relying on observation or rather than theoretical principles or theory.

Engagement – a client’s commitment to and maintenance of treatment in all of its forms. Successful engagement program helps clients view the treatment facility as an important source.

Epidemiology – the study of the incidence, distribution, and consequences of a particular problem in one or more populations.

Etiology – the study of origins (what causes a disorder).

Extrinsic motivator - o rationale for changing substance use that comes from outside the client. Examples include threat of losing job, legal charges, or a souse/significant other ending a relationship.

Harmful use – patterns of alcohol or drug use for non-medical reasons that result in negative health consequences and some degree of impairment, in social, psychological, and occupational functioning of the user.

Helping strategy – an activity employed by the counselor to help the client accomplish his or her therapeutic goals.

Hepatitis C – a viral disease of the liver that is major cause of liver damage and cirrhosis.

Incidence – the number of new cases of a disorder that occur in a population during a specific period.

Indicated preventive interventions – strategies designed for persons who are identified as having minimal but detectable signs or symptoms or precursors of illness or condition. But whose condition is below the threshold of a formal diagnosis of the condition.

Individualized treatment plan - a strategy that addresses the identified substance use disorder(s), as well as issues related to treatment progress, including relationships with family and significant others, employment, education, spirituality, health concerns, and legal needs. Plans are developed in collaboration with the client and significant others are tailored to fit the client’s unique biopsychosocial strengths and needs.

Infectious – a contagious illness or disease illness or disease transmitted by direct or indirect contact.

Initiation – the individual’s introduction to and onset of drug or alcohol use.

Intervention – the specific treatment strategies, therapies, or techniques that are used to treat one or more disorders.

Intoxication – an altered physical and mental state resulting from the overuse of alcohol of drugs.

Intrinsic motivator – an individual’s internal reason for changing substance use behaviors, such as poor health or low self-esteem, resulting from his or her substance use.

Life skills training – activities that include development of job, vocational, life (budgeting, leisure, etc.), anger management, general coping, communication, and social skills; literacy classes and GED preparation; parenting classes; and relationship building.

Managed care – an approach to delivery of health and mental health services that seeks to reduce the cost of care by monitoring the access to and use of medical services and supplies, as well as outcomes of that care.

Modality/treatment modality – any specific treatment method or procedure used to relieve symptoms or motivate behaviors that lead to recovery.