As the President and Administrative Director of the International Certification & Reciprocity Consortium/Alcohol and Other Drug Abuse (IC&RC/AODA), we are pleased to help with the inauguration of a new feature in Counselor Magazine — this regular column dedicated to topics related to the prevention of alcohol, tobacco and other drug use disorders. On behalf of the IC&RC, we say thank you.

How did we get here? More than a decade ago, IC&RC made a commitment to setting standards and developing an exam to ensure the competence of persons working in prevention. A brief perusal of our minutes will show that, as early as 1988, our Board was discussing the need for prevention certification. This is remarkable for several reasons. First, virtually no other organization was considering prevention credentialing at that time. Second, IC&RC was a very young organization in the 1980s and almost all of our Board members then were counselors.

By 1994, the IC&RC member board from Illinois had taken the initiative, developed a role delineation (or job analysis) for this emerging part of the alcohol and drug field and had provided this work to the IC&RC to offer as a reciprocal credential. So, to borrow a phrase from a popular movie some years back, “if you build it, they will come,” right?

Well, not exactly or certainly not at first. An element of challenge existed for IC&RC as it moved to promote these new standards: the first new reciprocal credential since the introduction of the AODA counselor standards a decade earlier. We sought, however, to develop standards for competent practitioners for holistic care for everyone.

Perhaps one of the striking elements about IC&RC is that our bottom line as an organization is not always our budget. As the premier organization for setting standards and developing exams in this field, IC&RC’s bottom line is two-pronged:

• How will the public be better protected by this credential; and
• How will people’s lives be improved?

That was certainly the organization’s task as it set out on this new part of the journey. Now, after almost a decade of prevention certification at IC&RC, where are we?

One of the most encouraging signs is that more and more of the state and jurisdictional boards offer a prevention certification using IC&RC standards and its exam. For those unaware of how IC&RC works, the organization itself actually certifies no one. IC&RC is an alliance not of individuals but of certifying agencies. Many of those agencies are state certification or licensing boards. Included in our organization now are territories such as Puerto Rico and Guam, U.S. government agencies such as all branches of the U.S. military, and other nations in North and Central America, Europe, the Middle East, and Asia. All of these boards are bound together by a commitment to IC&RC standards and public protection.

Having just completed the Fall 2003 IC&RC Annual Meeting in Toronto, we now have more than 40 boards that certify more than 3,000 prevention professionals. In 2004, IC&RC will begin the process of updating the Role Delineation Study for Prevention Specialists. A panel of subject matter experts from the field will be convened and initiate the revision work. This work is vitally important to ensure that prevention practitioners meet a set of nationally and internationally recognized minimum practice standards.

However, if we follow the recent changes in prevention service delivery, we will see new trends in the field that require an understanding that Prevention Practitioner credentialing is as necessary as Counselor credentialing. Further, we believe that federal, state, and community regulatory and funding agencies should require that prevention practitioners be certified to better ensure that prevention services are provided in an appropriate and ethical manner. Credentialing Prevention Practitioners enhances prevention services in at least three important ways:

1. Ensuring Public Safety. The most compelling reason to certify prevention practitioners is to ensure public safety. A look at current headlines or the evening television news reveals countless examples of young people — entrusted to adults or to adult-supervised institutions — who experience abuse, violence and unethical behavior. State agencies and community-based organizations that adopt prevention practice standards and enforce those standards through the requirement of credentialing significantly increase the opportunity to teach practitioners appropriate and effective service delivery of prevention services. Further, it is reasonable for consumers of prevention services to expect protection in other areas of public safety such as:

• misappropriation of funds
• misrepresentation of credentials
• conflicts of interest
• discrimination

Therefore, it is necessary for prevention professionals to adhere to a recognized code of ethics.

2. Enhancing Public Funds Accountability. We exist in an era of enhanced accountability for public expenditures. Accountability dictates that the states and jurisdictions and their programs utilize prevention staff who demonstrate proficiency with competency-based standards. This increases the likelihood that taxpayer funds spent in prevention service delivery will be used for research- and evidence-based programming that offers reasonable hope of impacting the populations being served in a positive way.

3. Providing Practitioner Benefits. Prevention Practitioners also gain significant benefits by achieving and maintaining a practice credential. Not only are they able to demonstrate practice competencies in their daily work, but they become part of a national cadre of advocates for quality prevention service delivery. Through the continuing education required for recertification, practitioners are able to maintain their prevention knowledge, skills, and attitudes and stay abreast of new and emerging trends in the field. The continued development of knowledge and skills increases practitioners’ likelihood of improving their career standing and their potential for income development.

For all of these reasons, the application of a set of minimum practice standards that demonstrate an individual prevention practitioner’s competence to practice in the substance abuse prevention discipline is both necessary and prudent.

Making prevention certification a requirement to practice
Prevention services are changing. Early prevention efforts were cast as everything from puppet shows to juvenile offender diversion programs. Today, more attention is being directed toward concerted efforts to affect the attitudes and values of communities. These efforts are designed to promote healthy behaviors and lifestyles to reduce risks contributing to alcohol and other drug abuse.

Additionally, there is an emerging focus on being able to demonstrate changes in specific participants in prevention programs. Information from research has fostered prevention programming that today encompasses not only community environmental strategies, but also individual- and family-focused services. Youth/adult leadership activities, tutoring services, parent and family management programs, and mentoring programs are but a few of the popular prevention services. These programs demand well-qualified, ethical, and competent staff.

Agencies are also under pressure to demonstrate that programs like these and others have an impact on the people they serve. Increasing concerns for accountability in the delivery of public prevention services has made it a necessity for states and their publicly funded prevention programs to better demonstrate the efficacy and cost effectiveness of publicly supported services. National outcome measures that demonstrate the efficacy of prevention services will track the performance of individuals, as well as community-wide attitudes. To effectively demonstrate results, state- and community-based prevention programs need competent and knowledgeable staff skilled in the use of the latest and most ethical approaches to community-based prevention service delivery.

As a consequence of the changing dynamics of prevention programming and the demand for accountability for public expenditures, there is an increasing need for states to require prevention practitioners to meet nationally accepted standards of prevention practice. As of 2003, more than 40 IC&RC member boards offer a prevention credential. However, in the majority of instances, certification is voluntary. Without the encouragement of a legislative or state policy requirement for certification, many states and jurisdictions and their practitioners may neither understand the need to be certified nor appreciate the risks of not having certification.

Who should be credentialed in prevention?
Given the status of prevention today, the IC&RC/AODA takes the position that, at a minimum, certification in prevention should be required for anyone who meets either or both of the following criteria:

1. Practitioners who work in community-based prevention programs that receive state and/or federal funds for alcohol and other drug abuse services;

2. Full or part-time paid coordinators of volunteer prevention services in programs that receive state and/or federal funds.

For the most part, these criteria will affect community-based prevention services that are funded with federal block grant and/or state general revenue funds managed through the Single State Agency for Alcohol and Drug Abuse. However, other state agencies such as departments of education, agencies for children, youth, and families, juvenile corrections and diversion services, and departments of aging services target services to youth and adult populations affected by substance abuse. IC&RC believes that personnel from these agencies may not necessarily be required to be certified but should have the opportunity and be encouraged to become credentialed in substance abuse prevention. At a minimum, they should have access to continuing education programs offering competency-based substance abuse prevention course work.

IC&RC’s competency-based prevention credential
In keeping with its tradition of establishing high quality practice standards for substance abuse Counselors and Clinical Supervisors, IC&RC also has provided leadership in developing professional practice standards for Prevention Specialists. In cooperation with state agencies, prevention provider agencies, other professional organizations and individual prevention specialists, IC&RC champions the increasing importance of assuring that Prevention Practitioners are able to demonstrate their abilities to stay abreast of the latest research findings, employ best practices, apply innovations in prevention methods, and follow industry trends to ensure the competency of the services they provide.

Fundamental to having an effective prevention system is an effective prevention workforce. Fundamental to equipping that workforce is an effective certification program based on demonstrated practice competencies reflecting a high quality, professional discipline. The demonstration of competency in prevention service delivery, through testing for certification and the continuing education required to maintain certification, enables providers to stay abreast of advances in the prevention field and provides assurances to the public that state-supported prevention services are offered in an ethical and technically sound manner.

Prevention Role Delineation Study
Working with a cross section of prevention administrators, providers, practitioners, researchers, and others, IC&RC uses a formal process to identify and gain consensus on the specific competencies needed to effectively practice substance abuse prevention services. An initial Role Delineation Study was developed and published in 1993. The study identified six specific practice domains and detailed the knowledge, skills, and attitudes appropriate for each domain. The use of a formally published Role Delineation Study ensures that test questions used as the basis for certification are founded in those tasks and activities determined by the field as appropriate and necessary for effective prevention service delivery.
In 1999, IC&RC again convened practitioners from the field to update the current Prevention Role Delineation Study. This revised version reflects the current emphasis on “science-based” prevention services and integrates both service delivery and service management domains. With the updated Role Delineation Study, IC&RC continues to assure its members and the prevention specialists that they certify that certification is based on the latest and best information about the practice requirements of the field of substance abuse prevention service delivery.

IC&RC prevention written examination
The development of a valid examination for the IC&RC Prevention Credential begins with a clear, concise definition of the knowledge, skills, and abilities needed for competent job performance. From working with experts in the field of alcohol, tobacco and other drug abuse prevention, the knowledge and skill bases for the exam questions are derived from the actual practice of the prevention specialist, as outlined in the current ATOD Prevention Specialist Role Delineation Study.

The Prevention Specialist Examination was one of the first examinations to test knowledge and skills about substance abuse prevention on an international level. The examination was developed by IC&RC through the cooperation of the member boards and their strong desire to have an international examination based on current practice.

Ensuring public safety
Given the changing dynamics of the substance abuse prevention field and the political realities regarding today’s publicly supported substance abuse services, the need to gain and maintain public confidence is critical. One of the most important obligations that the field has to the public is to offer them a prevention workforce that demonstrates competency in the practice of substance abuse prevention strategies, programs, and services.

No other effort relative to the quality of prevention service delivery is as important as having knowledgeable and well-qualified individuals practicing prevention in our communities. By utilizing IC&RC’s competency-based approach to prevention credentialing and adopting a consistent standard of operation that requires prevention credentialing, states and their publicly funded prevention providers will significantly increase their capability to ensure public safety.

Jim Scarborough, President of the International Certification & Reciprocity
Consortium/Alcohol and Other Drug Abuse (IC&RC/AODA), is from Raleigh, NC.

Angie Wainwright, Administrative Director of the IC&RC/AODA, works at the corporate office in Falls Church, VA. For more information on prevention, visit http://www.icrcaoda.org/.

This article is published in Counselor,The Magazine for Addiction Professionals, February 2004, v.5, n.1, pp. 40-42.

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