Repository logo

Implementing evidence-based practice for dual diagnosis: what education do addiction counseling credentials require?




Aponte, Rebecca A., author
Chavez, Ernest, advisor
Anderson, Sharon, committee member
Richards, Tracy, committee member
Rosén, Lee A., committee member

Journal Title

Journal ISSN

Volume Title


Substance misuse is a leading cause of death in the United States that disproportionately affects the mentally ill and receives inadequate resources for research and treatment. Prior studies have indicated the majority of individuals with serious mental illness also meet criteria for at least one substance use disorder, and individuals dually diagnosed with these conditions experience significantly poorer outcomes. Despite this, treatment facilities have generally failed to adopt Integrated Dual Diagnosis Treatment [IDDT], an evidence-based modality of treatment for the dually diagnosed population. Practitioners of addiction treatment are rarely required to be licensed health professionals, and the credentialing requirements for addiction counselors vary widely by state. This paper utilizes a mixed-method approach to examine the state-by-state variation in required formal education for addiction counselor credentials with particular focus on coursework related to treating the dual diagnosis population. A directed content analysis of the requirements by state was conducted, followed by a multiple linear regression comparing requirements of addiction counselor education and the ratio of substance use facilities providing a minimal interventions for dual diagnosis. The results indicated no connection between addiction counselor education and likelihood of availability of dual diagnosis treatment within a given state's treatment facilities. However, significant variation with regard to credentialing was found between states. These issues are presented within the context of the history of addiction treatment in the United States. Implications for policy are discussed, and recommendations for the evolution of the field are made.


Rights Access



Associated Publications