Certificate of Proficiency in the Treatment of Alcohol and Other ... [PDF]

Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders

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C A N D I D AT E G U I D E

A P P L I C AT I O N M AT E R I A L S

COLLEGE OF PROFESSIONAL PSYCHOLOGY

A PA P R A C T I C E O R G A N I Z AT I O N

CANDIDATE GUIDE AND APPLICATION MATERIALS The College of Professional Psychology awards proficiency certification on behalf of the American Psychological Association Practice Organization, the world’s largest scientific and professional organization representing psychologists. This Candidate Guide and Application Materials booklet provides information about the College of Professional Psychology’s examination for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders, along with the forms needed to take the examination and receive certification.

The Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders is a uniform national credential offered exclusively to psychologists who treat alcohol and other psychoactive substance use disorders and who meet eligibility requirements, regardless of APA membership status. It provides an effective mechanism for informing consumers, referral sources, and third-party payers that you possess the knowledge and experience associated with competent practice in the treatment of alcohol and other psychoactive substance use disorders. 2014

© 2014 APA Practice Organization. All rights reserved.

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CONTENTS Candidate Guide Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The Examination General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 How the Examination was Developed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Establishing the Passing Score Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Examination Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Examination Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Computerized Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Your Score Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Follow-up Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Candidates with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Suggestions for Taking the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Sample Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Knowledge-Based Content Outline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Resources Articles and Chapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Books and Monographs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Application Materials Requirements for Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 The Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Renewal of Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Before You Proceed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Fees Fee Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Documenting Your Engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Work Setting Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Application Forms Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Waiver and Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Application Fee Payment Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Verification of the Provision of Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Reference Cover Letter Form (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Reference Cover Letter Form (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Application Checklist, Mailing Instructions, and Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inside Back Cover

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CANDIDATE GUIDE for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders INTRODUCTION This Candidate Guide will provide information about the College of Professional Psychology’s examination for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders. It contains a description of the examination, including what it measures, how it was developed, how it is administered, and how it is scored. General exam-taking strategies are provided along with sample examination questions. A list of suggested readings is also provided to assist in preparing for the examination. THE EXAMINATION 1. General Information The examination is administered by computer at more than 500 locations and can be scheduled at your convenience by appointment. It is practice-related, measuring knowledge that is associated with the treatment of alcohol and other psychoactive substance use disorders and is targeted to the level of expertise typically referred to as the entry- or journeyman level, rather than to the level typically associated with expert status. The examination consists of 150 multiple-choice items. Items call for analysis and judgment, as well as recall of facts. Many items present scenarios that are typical practice situations.

recognized as a leading research organization with more than 20 years of experience in exam development and validation. Members of the Expert Working Group were carefully selected to reflect the diversity of the profession in terms of practice setting, geographical location, gender, and ethnicity, as well as methodological approach to treatment. The Expert Working Group developed a content outline, or “blueprint” for the examination, that accurately reflects the practice of the profession and supports the examination’s content validity. It was produced through use of a carefully constructed, multi-step practice analysis that involved input from a larger sample of psychologists. Additionally, APA’s Division on Addictions (Division 50), in collaboration with the Division on Psychopharmacology and Substance Abuse (Division 28), played an important role in developing the knowledge base that ultimately contributed to the final content outline for the examination. Using the validated, practice-based content outline, approximately 35 psychologists with expertise in this treatment area wrote examination items. They were encouraged to draw upon actual treatment experience to ensure item relevance. All items were reviewed by colleagues to ensure validity, fairness, relevance and clarity. After revisions were complete, a smaller group of psychologists conducted a critical review of each item. This group also documented several important aspects of validity for each item. 3. Establishing the Passing Score Criteria

2. How the Examination Was Developed

The passing score was determined using a criterionreferenced methodology referred to as a modified Angoff approach to standard setting. This methodology permits candidates to compete against the standard, rather than each other. There is no pre-determined failure rate, as there is when using a norm-referenced methodology.

The examination was developed by the College of Professional Psychology’s 15-member Expert Working Group under the psychometric guidance of Personnel Decisions Research Institutes, Inc. (PDRI), of Minneapolis. PDRI is nationally

Using the modified Angoff approach, items are evaluated based on difficulty for the entry-level practitioner, as well as importance for safe and effective practice. Difficulty/importance ratings are then averaged across all items to set the

You will have 3 hours in which to complete the examination. This should be adequate time to comfortably read, consider, and mark each item.

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Examination Measurements Following a carefully constructed, multi-step practice analysis, a content outline was developed, and then validated. Items were written, reviewed, validated and documented to ensure fairness, relevance and clarity. As a result, each examination item meets the following criteria: • It measures knowledge that was identified in the practice analysis as important for psychologists who treat alcohol and other psychoactive substance use disorders. • It measures knowledge that is needed to perform at least one of the treatment tasks identified in the practice analysis as especially important in treatment settings. • It measures knowledge that, when not known, may reasonably be expected to lead to significant adverse consequences. • It measures knowledge needed by all psychologists treating psychoactive substance use disorders. • It has a difficulty level that is appropriate for entry-level psychologists practicing in the treatment of alcohol and other psychoactive substance use disorders. • It has only one clearly correct answer, on which there is expert agreement.

passing score. Two forms of the examination have been carefully equated for difficulty level and for content areas measured. The passing score, thus, represents the minimum level of knowledge that must be demonstrated by the psychologist practicing in this treatment area. A candidate’s score on the examination is simply the number of items answered correctly represented as a percentage. All items receive identical weight. Passing the examination requires a score at or above the set passing score, which is the same for all candidates.

In order to ensure exam security, there is no provision for failing or passing candidates to review their examination. However, comments about the examination may be addressed directly to the College of Professional Psychology. 4. Examination Administration The examination is computer-administered by Prometric, Inc., a part of the Thompson Corporation. Computer knowledge is not required in order to take the examination by computer. Before the examination begins, a simple tutorial will guide you through the process of selecting answers. The time you spend on the tutorial is not assessed against the time allotted for the examination. A HELP feature will be available during the examination. Additionally, you may mark questions and return to them later to review and/or change your answers. If you have any questions about how to work with the computer, the test center administrator will be available.

Computerized Administration Computerized administration affords candidates a number of advantages, including greater efficiency in test-taking. For example: • Candidates may mark items for later review. • The computer will give you a tally of items that you have and have not answered. • The computer will show you how much time is remaining so you may pace yourself through the examination. • The computer will prevent some common test-taking mistakes such as marking more than one answer for an item. • The computer will provide immediate feedback on your performance when you complete the examination.

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5. Your Score Report After you complete the examination, you will receive your overall percent-correct score. Information about your performance in each of 12 knowledge categories is also provided to assist you in selecting continuing education for renewal of your certification. Your overall percent-correct score will be forwarded to the College of Professional Psychology for comparison with the passing score. You will receive written confirmation of your exam results with information about certification or exam retake within approximately 4 weeks from the date of your exam. 6. Follow-up Survey After you receive information about your performance, you will be given the option of completing a short, follow-up survey. Your willingness to complete the survey will not affect your score on the examination. Answers to this survey will assist the College of Professional Psychology in keeping the exam content current with regard to the practice of psychology in this treatment area. We hope you will take the time to assist. 7. Candidates with Disabilities All Prometric Test Centers are accessible to candidates with disabilities and comply with the Americans with Disabilities Act (42 USG Section 12101 et. seq.). Most special needs can be accommodated by Prometric Test Centers; however, authorization from the College of Professional Psychology is necessary. The following guideline applies to candidates seeking special accommodations: Candidates requesting special testing accommodations due to impaired sensory, manual, or speaking skills, or other disability must submit, by mail or fax, a written request that includes name, address, social security number, and a description of the requested accommodation. The written request must be accompanied by supporting documentation from an appropriately qualified, licensed professional reflecting a diagnosis of the condition and an explanation of the need for the requested accommodation. Alternatively, documentation may be submitted from appropriate educational or regulatory officials

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indicating that special accommodation has been provided historically for the candidate’s condition that is prompting his or her present request. The written request for special accommodation must be submitted to the College of Professional Psychology at least 45 days in advance of the desired testing date. The College of Professional Psychology will evaluate each request on its own merit in accordance with the Americans with Disabilities Act. Suggestions for Taking the Examination • Read the instructions carefully and complete the tutorial. Make sure that you understand how to mark your responses before beginning. • Read each question and all the answers carefully and completely before selecting the most appropriate answer. • Remember that your task is to identify the best answer among those given. In some cases, more than one answer may be workable, but you must decide which is the best answer. • When you choose an answer, resist changing it unless you are absolutely certain that it is not the best answer. • Answer all questions on the examination, even those about which you are uncertain. • The 3-hour time limit should be more than sufficient to answer all questions. However, check your time periodically and budget your time carefully. • If you have time remaining when you reach the end of the examination, return to any items that you have skipped, or about which you were unsure. • If you have time, go through all of the items to make sure that your responses are recorded correctly.

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SAMPLE QUESTIONS Following are four sample test items that are illustrative of the types of items that comprise the examination. These sample items are not meant to illustrate the diversity of subject areas. The correct answer for each is indicated by an asterisk (*). Sample Item 1 illustrates the most common format used in the examination. 1. Among individual therapies, the modality that has been shown to yield the most consistent positive outcome is: a. b. c. d.

client-centered (“motivational”) therapy * confrontational therapy pschodynamic therapy relaxation therapy

Sample Item 2 illustrates a format used for some items. This format uses one alternative which may be an inclusive (All of the above), or exclusive (None of the above), or which may in some other way depart from the nature of the other three responses. Alternative d. is, in essence, None of the above.

a. b. c. d.

I, III, and IV * II, II, and IV I, III, and V II, III, and V

Sample Item 4 is illustrative of items that present realistic treatment situations. 4. When a 35-year-old male comes for a 5:00 pm outpatient evaluation you detect alcohol on his breath. His breath alcohol level is .17% with repeated readings over a 20-minute period. He acknowledges having two beers after work. His speech is not slurred, his gait is steady, and he is cooperative and articulate. The most likely explanation is: a. b. c. d.

error in breathalyzer reading liver damage from alcohol behavioral tolerance to alcohol * delayed first-pass metabolism

2. Which of the following is a potential symptom of cocaine withdrawal? a. b. c. d.

paranoia mania dysphoria * There is no clinically significant cocaine withdrawal symptom.

Sample Item 3 illustrates another format that is sometimes used. This format presents a group of potential answers and allows for the possibility that more than one answer may be correct. 3. Research shows which three of the following to be the most common proximal precursors to addiction relapse for adults? I. II. III. IV. V.

negative affective state positive emotional state social pressure interpersonal conflict flare-up of psychiatric symptoms

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KNOWLEDGE-BASED CONTENT OUTLINE The practice-related knowledge sampled by the examination is organized into 12 Knowledge Categories (A through L) and associated Knowledge Elements. All 12 categories are represented on each form of the examination according to the percentages indicated after the title for the category. For example, 11% of the items (16 items out of the 150) are drawn from Category A, 6% from Category B (9 items out of the 150), etc. Percentages were established as a result of the practice analysis and reflect the relative importance of each category for practice in the treatment area as well as the amount of knowledge each category contains. Please bear in mind that the examination samples from the knowledge elements associated with the 12 categories. Thus, not every knowledge element, nor all aspects of any specific knowledge element, may be represented in a given examination form. A. Clinical Pharmacology and Clinical Epidemiology of Psychoactive Substances (11%) Includes knowledge of classes, preparations, and routes of administration of psychoactive substances; major pharmacologic actions; psychological/behavioral effects; medical and psychosocial consequences of acute and chronic use; trends in availability and use in the general population and in defined specific populations such as ethnic minorities, adolescents, elderly, pregnant women, and persons with coexisting Axis I or Axis II disorders; pharmacological factors that underlie behavioral and psychological effects of psychoactive substances; role of user expectation in subjective and behavioral effects of use; adverse psychological, behavioral, physiological, interpersonal, and social effects of psychoactive substance use disorders (PSUDs). Knowledge Elements: 1. Knowledge of classes of psychoactive substances and specific substances within those classes, including: central nervous system (CNS) stimulants (e.g., cocaine, caffeine, amphetamine, and methamphetamine), CNS

APA Practice Organization College of Professional Psychology

depressants (e.g., alcohol, benzodiazepine/ anxiolitics, barbiturates), cannabinoids (e.g., marijuana and hashish), opioids (e.g., heroin, methadone, and prescription narcotics), hallucinogens (e.g., LSD, psylocibin, mescaline, and peyote), inhalants (e.g., amyl nitrate, butyl nitrate, and nitrous oxides; glues, solvents, and other volatile substances), nicotine, steroids, etc. 2. For the most commonly used psychoactive substances within each class specified in Element 1 (namely alcohol, marijuana, cocaine, heroin, benzodiazepines, LSD, inhalants, and nicotine): Knowledge of preparations, routes of administration, major pharmacologic actions; psychological/ behavioral effects, (including craving, drug-seeking behavior and motivation for use); reinforcing effects in animals and humans; medical and psychosocial consequences of acute and chronic use; and most clinically significant drug combinations (e.g., cocaine and alcohol; heroin and cocaine; alcohol and sedative-hypnotics). 3. For each of the psychoactive substances listed in Element 2: Knowledge of trends in availability and use in the general population and in defined specific populations such as ethnic and other minorities, adolescents, the elderly, pregnant women, and persons with coexisting Axis I or Axis II disorders. 4. For each of the psychoactive substances listed in Element 2: Knowledge of pharmacological factors that underlie behavioral and psychological effects of psychoactive substances, including: tolerance and cross tolerance; mechanisms underlying psychoactive effects, including drug-induced alterations in brain receptor and neurotransmitter systems; time course of effects and aftereffects; development of physical dependency, including acute and protracted withdrawal; half-life, metabolism and excretion; detectability in body fluids (urine and blood), including legal definitions of intoxication; and the most common drugdrug interactions as they affect each of the preceding.

C 8 5. Knowledge of user expectation as it influences subjective and behavioral effects of psychoactive substances (e.g., placebo effects and context effects; balanced placebo research). 6. Knowledge of adverse psychological and behavioral consequences of excessive/pathological use (both acute and chronic; e.g., induced distortions in personality, affect, perception, cognition, coping style and defenses, judgment, and other behavioral/cognitive processes). 7. Knowledge of adverse physiological consequences of excessive/pathological use (e.g., overdose, contribution to HIV and other STDs, tuberculosis, hepatitis and other liver disease, GI disorders, sexual functioning and fertility, fetal alcohol effects and transient neonatal impairments, brain dysfunction). 8. Knowledge of adverse interpersonal effects of psychoactive substance use disorders (PSUDs; e.g., impact on marriage and family, workplace colleagues, immediate social contacts; impact on interpersonal violence and abuse behavior). 9. Knowledge of adverse social effects of PSUDs (e.g., vocational, legal, and financial impact). B. Etiology of Psychoactive Substance Use Disorders (6%) Includes knowledge of genetic and other biological risk/vulnerability to PSUDs; psychological and sociocultural predisposing experiences; psychological, sociocultural, and biological concepts of etiology and integrative models. Knowledge Elements: 1. Knowledge of key findings pertaining to genetic and other biological risk/vulnerability to PSUDs (e.g., family transmission, brain neurochemical and other biological susceptibility). 2. Knowledge of psychosocial risk factors associated with etiology (e.g. family substance use and physical, sexual and psychological abuse; early

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conduct disorder and temperament traits (e.g., impulsivity); environmental, cultural/social factors including availability and peer influence; individual psychopathology; attention and learning deficits; impaired affect regulation (e.g., self-medication hypothesis); impaired behavioral self regulation. 3. Knowledge of major psychological perspectives regarding etiology of PSUDs (e.g., operant and classical conditioning models, social learning, psychoanalytic, family systems, cognitive behavioral, opponent process). 4. Knowledge of integrative models of etiology of PSUDs (e.g., biopsychosocial, community healing models). C. Initiation, Progression, and Maintenance of PSUDs (5%) Includes knowledge of factors that contribute to the use initiation of psychoactive substance use; psychological, biological, and social factors associated with the maintenance and progression of PSUDs. Knowledge Elements: 1. Knowledge of factors that contribute to initiation of psychoactive substance use (e.g., availability, exposure, peer influence, expectancy, and reinforcing drug effects). 2. Knowledge of psychological factors associated with the maintenance and progression of PSUDs (e.g., conditioning and reinforcement, cognitive factors, affective factors, personality and temperament). 3. Knowledge of biological factors associated with the maintenance and progression of PSUDs (e.g., tolerance, physical dependence, metabolic factors, and factors at the neurotransmitter level). 4. Knowledge of social factors associated with the maintenance and progression of PSUDs (e.g., familial factors, social/cultural environments that support substance use, intergenerational PTSDs, and societal attitudes and expectations toward certain specific populations).

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early intervention in health care settings, schools, workplaces, the community, and family.

D. Course/Natural History Of PSUDs (5%) Includes knowledge of long-term course of PSUDs in treated and untreated populations; heterogeneity in course and the role of problem severity; alternatives to formal treatment and circumstances under which they are sought and accepted by users; help-seeking and alternatives to formal treatment and circumstances under which they are sought and accepted by users; “natural recovery” rates and factors associated with natural recovery. Knowledge Elements:

3. Knowledge of techniques for prevention and early intervention, and their effectiveness. 4. Knowledge of harm reduction approaches aimed at preventing or reducing high risk behaviors and their negative consequences in the community, in clinical populations, and in users’ significant others (e.g., needle exchange programs, condom distribution programs, and community education programs).

1. Knowledge of long-term course of PSUDs in treated and untreated populations.

F.

2. Knowledge of heterogeneity in course of PSUDs, including the role of problem severity.

Includes screening for persons at risk for or experiencing PSUDs; approaches to assessment of substance use and substance dependence, including need for detoxification evaluation; principles for assessment of use history and current use patterns; effective interviewing strategies; timing issues involved with assessment and intervention techniques and their implications; collateral sources of assessment information; physical and sexual abuse and other trauma; assessment of the family system and its relationship to the PSUD of the client; use of assessment data to select initial level of care, develop an initial treatment plan, engage the client in treatment, and modify the plan during treatment.

3. Knowledge of alternatives to formal treatment that promote behavior change, and circumstances under which substance users will seek out or be receptive to such alternatives. 4. Knowledge of help-seeking for substance-related problems and the factors that promote or deter help-seeking and motivation for change. 5. Knowledge of “natural recovery” factors associated with untreated recovery from PSUDs. E. Prevention, Early Intervention, and Harm Reduction (6%) Includes knowledge of primary (universal) and secondary (targeted) methods of prevention; harm reduction methods; techniques of prevention, identification, and early intervention and their effectiveness. Knowledge Elements: 1. Knowledge of methods of prevention of PSUDs (including educational, skills-based, public health, community, regulatory and supply-side methods; as well as sociocultural, age-related, gender-based, and other variants of these approaches). 2. Knowledge of principles for identification and

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Screening and Assessment of Psychoactive Substance Use (11%)

Knowledge Elements: 1. Knowledge of screening instruments for individuals at risk for or experiencing PSUDs, regardless of presenting problem or complaint. 2. Knowledge of types of biological approaches to the assessment of substance use, including measures such as BAC, urine drug screens, liver assays, hair analysis; their proper use, and strengths and weaknesses. 3. Knowledge of psychological approaches to the assessment of current and past psychoactive substance use, including interviewing techniques, standardized interviews; standardized psychological measures, their proper use, and strengths and weaknesses.

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4. Knowledge of approaches to the assessment of current and past adverse psychosocial consequences (“abuse”).

16. Knowledge of principles for the utilization of ongoing assessment data to modify the treatment plan during treatment.

5. Knowledge of common cognitive deficits associated with psychoactive substance use and familiarity with common neuropsychological approaches to their assessment. (Note: “Familiarity with” implies basic knowledge.)

17. Knowledge of alternative levels and approaches used by medical professionals for detoxification and withdrawal management.

6. Knowledge of incidence, screening, and assessment issues related to physical and sexual abuse and other traumatic experiences in relation to substance use.

Includes DSM-IV criteria for diagnosis of substance related and induced disorders; differentiating substance-related disorders from other disorders; comorbidity of substance-related with psychological and behavioral problems; familiarity with medical conditions that are complicated or exacerbated by psychoactive substance use.

7. Knowledge of principles for assessment of degree of physical dependence and need for medically monitored withdrawal treatment.

G. Diagnosis and Comorbidity (9%)

Knowledge Elements: 8. Knowledge of interviewing strategies to reduce defensiveness and enhance cooperation and motivation. 9. Knowledge of appropriate timing of assessment and intervention techniques (e.g., the limited reliability and validity of tests given to persons in withdrawal and early stages of abstinence) and their implications for assessment. 10. Knowledge of types and uses of collateral sources of information in the assessment process (e.g., spouse, employer, teacher). 11. Knowledge of physical signs and symptoms of use, intoxication, and withdrawal (e.g., needle marks, pupillary dilation or constriction). 12. Knowledge of principles for assessment of the family system and its relationship to the PSUD of the identified family member. 13. Knowledge of principles for utilization of assessment data to select an initial level of care for a client. 14. Knowledge of principles for the utilization of assessment data to develop an initial treatment plan for a client. 15. Knowledge of principles for the utilization of assessment data to engage the client in treatment.

1. Knowledge of DSM-IV criteria for diagnoses of substance-related and substance-induced disorders, as well as the criteria for the several DSM-IV disorders frequently comorbid with the substance-related and substance-induced disorders. 2. Knowledge of principles for differentiating substance-related disorders from other Axis I and Axis II disorders, and the ability of psychoactive substance use to mimic and/or exacerbate these disorders. 3. Knowledge of comorbidity (including incidence) of PSUDs with psychological and behavioral problems, including Axis I and Axis II disorders. 4. Familiarity with common medical conditions (e.g., diabetes, hypertension) that are complicated or exacerbated by psychoactive substance use, and indications for referral for appropriate assessment and/or treatment. (Note: “Familiarity with” implies basic knowledge.) H. Treatment I: Models and Approaches (14%) Includes knowledge of alternative treatment modalities, settings, contexts and levels of care; major models of treatment; principles for selection

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and use of psychological therapies and 12-step facilitation; methods for delivering psychological interventions to substance abusers; evidence for the effectiveness of treatment methods; substancespecific treatments and their effectiveness; adjunctive pharmacotherapies; indications and contraindications for other pharmacological agents; familiarity with acupuncture and other alternative treatment approaches.

6. Knowledge of the appropriate role of pharmacotherapies in the overall treatment of addiction and evidence regarding their effectiveness; including opioid substitution (methadone, LAAM), opioid antagonists (naltrexone, including its use with alcohol dependence), alcohol sensitizing medications (disulfiram), and nicotine replacement (patch, gum, etc.).

Knowledge Elements:

7. Familiarity with pharmacologic agents that are contraindicated for individuals with substance use problems (e.g., long-term use of minor tranquilizers in the treatment of alcohol use), as well as those appropriate in the treatment of concomitant psychopathology. (Note: “Familiarity with” implies basic knowledge.)

1. Knowledge of clinical delivery systems, including treatment settings (e.g. in-hospital, nonmedical residential, outpatient), treatment services (individual, group, family therapy) and levels and modalities of care (e.g., brief interventions, intensive outpatient, partial hospitalization, therapeutic communities, and methadone maintenance) as related to client placement. 2. Knowledge of major theoretical models of treatment, including their basic assumptions about etiology and how people change, strengths and limitations, and empirical evidence (e.g., psychodynamic, behavioral, cognitive, family systems, traditional disease, spiritual, 12-step, biomedical, and integrated models such as biopsychosocial, public health, and therapeutic communities). 3. Knowledge of methods for delivering psycho logical interventions to substance abusers. 4. Knowledge of principles for selection and use of the various psychological therapies (including social skills training, contingency management, motivational enhancement therapy, aversion therapies, cognitive therapy, community reinforcement approach, relapse prevention, stress management, behavioral self-control training, cue exposure, client-centered therapy, supportive/expressive therapy, psychodynamically oriented therapy, cognitive-behavioral and structural-systems family therapy) and 12-step facilitation. 5. Knowledge of substance-specific (vs. generic) treatments (including treatments for nicotine dependence) and their effectiveness.

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8. Knowledge of evidence for the effectiveness of treatment methods (including combined behavioral-pharmacological treatments). I.

Treatment II: Planning, Implementing, and Managing Treatment and the Course of Recovery (16%)

Includes knowledge of the phases, courses, or stages of recovery and the treatments appropriate to each; issues pertaining to motivation and readiness to change; relevant research, theory, and practice pertaining to relapse; issues pertaining to treatment goals; the course of withdrawal and resources for detoxification; therapist behaviors facilitating treatment success; approaches for client-treatment matching; dealing with concomitant diagnosis of substance use and other psychological problems; dealing with severely mentally ill substance users; adjunctive use of self-help groups; treatment for family members; treatment interfaces with worksite and other aspects of the community; treatment of criminal offenders. Knowledge Elements: 1. Knowledge of phases/courses/stages of recovery and change, and the treatment goals, modalities, and techniques appropriate to each. 2. Knowledge of relevant issues and research related to motivation/readiness to change.

C 12 3. Knowledge of relevant research, theory, and practice on relapse (e.g., rates, temporal patterns, varieties, conditions associated with relapse, and prevention strategies). 4. Knowledge of appropriate and realistic treatment goals for individuals with PSUDs. 5. Knowledge of appropriate resources for detoxification and the usual course of withdrawal. 6. Knowledge of therapist behaviors that facilitate or hinder client engagement and retention in treatment (e.g., empathic style, telephone follow-up). 7. Knowledge of different approaches for clienttreatment matching (e.g., preference, clinician assignment, cultural competence, placement protocols and decision rules). 8. Knowledge of methods for the treatment of persons with concomitant diagnoses of a PSUD and other psychological problems. 9. Knowledge of issues in the treatment of severely mentally ill individuals who are substance abusers (includes sequencing of treatments, integration of treatment approaches, issues of continuity of care, attention to social and environmental needs of severely mentally ill individuals). 10. Knowledge of effective treatment models for family members (whether or not the substance abuser is seeking treatment). 11. Knowledge of principles for managing the interfaces between addiction treatment and the community (e.g., social service system, legal system, ethnic/culture-specific institutions such as mutual assistance societies, child protective services, correctional facilities, vocational rehabilitation, SSI, health care providers, health insurance companies, employers). 12. Knowledge of appropriate methods for treating criminal offenders (including DWI/DUI offenders).

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13. Knowledge of the following community selfhelp groups and groups available for significant others of substance abusers (e.g., Alcoholics Anonymous, Al-Anon, Narcotics Anonymous, Women for Sobriety, Rational Recovery, nicotine dependence support groups); including the basic philosophy and structure of each program, clinical procedures to facilitate involvement of clients and significant others, and empirical evidence for effectiveness. J.

Issues in Specific Populations (6%)

Includes knowledge of substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and treatments for children and adolescents, ethnic and cultural minority groups, women and men, gays and lesbians, older persons, persons with HIV, health care professionals, and the homeless. Knowledge Elements: 1. Knowledge of substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and treatments for children and adolescents. 2. Knowledge of substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and treatments appropriate for specific ethnic and cultural minority groups. 3. Knowledge of gender-specific substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and effective treatments (including issues related to perinatal substance use for women). 4. Knowledge of substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and treatments for gays and lesbians. 5. Knowledge of substance use patterns, risk factors, course, concomitant psychological and social functioning, access barriers, and treatments for older persons.

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6. Knowledge of special issues related to substance abuse and treatment of persons with HIV. K. Research Knowledge (6%) Includes knowledge of research principles appropriate for evaluating substance abuse treatments; key findings in the current literature relevant to the effectiveness of common forms of substance abuse treatment and prevention; knowledge of databases, journals, and central information sources for keeping abreast of new developments in the substance use field. Knowledge Elements: 1. Knowledge of research principles appropriate for evaluating substance abuse treatments (including appropriate follow-up intervals, outcome domains, comparison groups, outcome-oriented clinical record-keeping). 2. Knowledge of key findings in current literature pertaining to the effectiveness of common forms of substance abuse prevention and treatment (including overall patterns in reduction in substance use; improvement in personal and social function; reduction in public health and public safety concerns; and success for gender, age, and ethnic minority populations). 3. Knowledge of databases, journals, and central information sources useful for keeping abreast of new developments in the substance use field (e.g., NCADI, ETOH, DAWN, Journal of Substance Abuse Treatment, Journal of Consulting and Clinical Psychology). L.

Legal and Ethical Issues (5%)

Includes knowledge of laws relevant to substance abuse treatment (e.g., confidentiality, ADA); application of ethical principles for psychologists to specific dilemmas of the substance field. Knowledge Elements: 1. Knowledge of federal laws regulating confidentiality and disclosure of information for PSUDs, and conditions under which the general laws do not apply.

APA Practice Organization College of Professional Psychology

2. Knowledge of relevant issues and regulations related to the Americans with Disabilities Act (ADA; includes specialized treatment programs and practices such as methadone maintenance programs). 3. Knowledge of principles for dealing with dilemmas of contradictory legal and ethical demands that relate to confidentiality, authorization, treatment implementation, and other treatment management issues (e.g., adolescents’ confidentiality, pregnant addicts, reporting of crimes, coerced treatment).

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RESOURCES The Expert Working Group provides the following references in an attempt to assist candidates who wish to do some reading prior to taking the examination. However, these references should not be considered required readings. The Expert Working Group does not suggest that candidates attempt to obtain and study each and every reference. It is important to be aware of the fact that the examination is practice-based and does not sample from specific references. Thus, the references are presented to provide a broad representation of available literature for those unfamiliar with a portion of the information covered in the exam content outline. Articles and Chapters Abrams, R. C. (1987). Substance abuse in the elderly: Alcohol and prescription drugs. Hospital Community Psychiatry, 38, 1285-1287. Alcohol Alert, (1994, January). National Institute on Alcohol Abuse and Alcoholism, 23, 1-4. Bear, S., Marlatt, G. A., & McMahon, R. J. (Eds.). (1993). Addictive behaviors across the life span: Prevention, treatment, and policy issues. chaps. 2, 7, 11,12. Newbury Park, CA: Sage. Brown, S. A., Inaba, R. K., Gillin, J. C., Schuckit, M. A., Stewart, M. A., & Irwin, M. R. (1995). Alcoholism and effective disorder: Clinical course of depressive symptoms. The American Journal of Psychiatry, 152(1), 45-52. Brown, S. A., Vick, P. W., & Creamer, V. A. (1989). Characteristics of relapse following adolescent substance abuse treatment. Addictive Behaviors, 14, 291-300. Bukstein, O. G. (1995). Development, Risk, and Consequences. In Adolescent substance abuse: Assessment prevention and treatment, (pp. 5372). New York: Wiley. Bukstein, O. G. (1995). Co-existing Psychiatric Disorders. In Adolescent substance abuse: Assessment prevention and treatment, (pp. 7393). New York: Wiley.

De Leon, G. (1995). Therapeutic community treatment of substance abuse. In G.O. Gabbard (Ed.), Treatments of psychiatric disorders (2nd ed.) (Vol. 1, pp. 886-904). Washington, D.C.: American Psychiatric Press. De Leon, G. (1996). Integrative recovery: A stage paradigm. Substance Abuse,17, 51-63. De Leon, G., Melnick,G., & Tims, F.M. (2000). The role of motivation and readiness in treatment and recovery. In F.M.Tims, C.G. Leukfeld, & J.J. Platt (Eds.), Relapse and recovery in addictions (pp.143-171). New Haven, CT: Yale University Press. De Leon, G. (2003). Therapeutic communities: Research-practice reciprocity. In J. L. Sorensen, R.A. Rawson, J. Guydish, & J. E. Zweben (Eds.), Drug abuse treatment through collaboration: Practice and research partnerships that work (pp. 17-35). Washington, DC: American Psychological Association. Egelko, S., Galanter, M., Dermatis. H., Jurewicz, E., Jamison, A., Dingle S., & De Leon, G. (2002). Improved psychological status in a modified TC for homeless MICA men. Journal of Addictive Diseases, 21(2), 75-92. Eighth special report to the U.S. Congress on alcohol and health (1993). Rockville, MD: NIAAA. Emrick, C. D., Tonigan, J. S., Montgomery, H., & Little, L. (1993). Alcoholics anonymous: What is currently known? In B. S. McCrady & W. R. Miller (Eds.)., Research on alcoholics anonymous (pp. 41-76). New Brunswick, NJ: Alcohol Research Documentation, Inc. Finney, J.W. & Moos, R.H. (1998). Psychosocial treatments for alcohol use disorders. In P.E. Nathan & J.M. Gorman (Eds.), A guide to treatments that work (pp. 156-166). New York: Oxford University Press.

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Gabbard, G. O. (Ed.). (1995). Treatments of psychiatric disorders (2nd ed.) Vol. 1, Section 4: Substance abuse disorder. Washington, D.C.: American Psychiatric Press. Hawke, J. M., Jainchill, J., & De Leon, G. (2003, Feb.). Posttreatment victimization and violence among adolescents following residential drug treatment. Child Maltreatment, 8(1), 58-71. Kofoed, L. L. (1987). Treatment compliance of older alcoholics: An elder-specific approach is superior to “mainstreaming.” Journal of Studies on Alcohol, 48, 4751. Kressel, D., Zompa, D., & De Leon, G. (2002, July/August). A statewide integrated quality assurance model for correctional-based therapeutic community programs. Offender Substance Abuse Report [newsletter] Volume II, No. 4: 49-64. Levounis, P., Galanter, M., Dermatis, H., Hamowy, A., & De Leon, G. (2002). Correlates of HIV transmission risk factors and considerations for interventions in homeless, chemically addicted and mentally ill patients. Journal of Addictive Diseases, 21(3), 61-72. McGinnis, J. M., & Foege, W. H. (1993). Actual causes of death in the United States. Journal of the American Medical Association, 270(18), 2207-2212.

Miller, W. R., Walters, S. T., & Bennett, M. E. (2001). How effective is alcoholism treatment? Journal of Studies on Alcohol, 62, 211-220. Miller, W. R., & Wilbourne, P. L. (2002). Mesa Grande: A methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction, 97, 265-277.National Institutes on Alcohol Abuse and Alcoholism (1995). Alcohol and Tobacco: From Basic Science to Clinical Practice. (No. 95-3931) chaps. 1, 2, 10. Rockville, MD: National Institutes of Health. O’Brien, C.P. & McKay, J. (1998). Psychopharmacological treatments of substance use disorders. In P.E. Nathan & J.M. Gorman (Eds.), A guide to treatments that work (pp. 127155). New York: Oxford University Press. Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption — II. Addiction, 88, 791-804. Simpson, T. L., & Miller, W. R. (2002). Concomitance between childhood sexual and physical abuse and substance abuse: A review. Clinical Psychology Review, 22, 27-77. Skinner, H. A. & Allen, B. A. (1982). Alcohol dependence syndrome: Measurement and validation. Journal of Abnormal Psychology, 91(3), 199-209.

Meyer, R. E. (1986). How to understand the relationship between psychopathology and addictive disorders: Another example of the chicken and the egg. In R.E., Meyer (Ed.), Psychopathol-ogy and addictive disorders (pp. 3-16). New York: Guilford.

Sorensen, J. L., & Zweben, J. (Eds.), (1993). Special edition on recent developments in psychosocial treatment of addictions. Psychology of Addictive Behaviors, 7(2), 103-109.

Miller, W. R., & Brown, S. A. (1997). Why psychologists should treat alcohol and drug problems. American Psychologist, 52, 1269-1279.

Zweben, J., & Wallace, J. (Eds.) (1989). Dual Diagnosis: Clinical and Research Perspectives. Journal of Psychoactive Drugs, 21(2), 131-251.

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Books and Monographs Allen, J. P., & Columbus, M. (Eds.). (1995). Assessing Alcohol Problems: A Guide to Clinicians and Researchers. NIAAA Treatment Handbook Series 4: Bethesda, MD: NIAAA. Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse (1994). Rockville, MD: CSAT. Babor, T. F., & DelBoca, F. K. (Eds.) (2002). Treatment matching in alcoholism. Cambridge, UK: Cambridge University Press. Bryant, K. J., Windle, M., & West, S. G. (Eds.) (1997). The science of prevention: Methodological advances from alcohol and substance abuse research. Washington, DC: American Psychological Association. De Leon, G. (edit.) (1997). Community as method: Therapeutic communities for special populations and special settings. Westport, CT: Greenwood Press. De Leon, G. (2000). The therapeutic community: Theory, model and method. New York: Springer Publishing. Fiore, M.C., Bailey, W.C., Cohen, S.J., et al. (2000). Treating tobacco and dependence: A Clinical practice guideline. United States Department of Health & Human Services, Public Health Service. Rockville, MD. Frances, R. J., & Miller, S. I. (Eds.). (1991). Clinical textbook of addictive disorders. New York: Guilford. Frone, M. R. (2013). Alcohol and illicit drug use in the workforce and workplace. Washington, DC: American Psychological Association. Gerstein, D. R., & Harwood, H. J. (Eds.). (1990). Treating drug problems: A study of the evolution, effectiveness, and financing of public and private drug treatment systems. Report by the Committee for the Substance Abuse Coverage Study, Division of Health Care Services, Institute of Medicine. Washington, D.C.: National Academy Press.

Glantz, M. D. & Hartel, C. R. (Eds.) (1999). Drug abuse: Origins and Interventions. Washington, DC: American Psychological Association. Goldstein, A. (1994). Addiction from Biology to Drug Policy. New York: W. H. Freeman & Co. Halkitis, P. N. (2009). Methamphetamine addiction: Biological foundations, psychological factors, and social consequences. Washington, DC: American Psychological Association. Hester, R. K., & Miller, W. R. (Eds.). (1989). Handbook of Alcoholism Treatment Approaches: Effective Alternatives. New York: Pergamon Press.Higgins, S.T., & Silverman, K. (1999). Motivating behavior change among illicit drug abusers. Washington, DC: American Psychological Association. Hester, R. K., & Miller, W. R. (Eds.) (2003). Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed.). Boston, MA: Allyn & Bacon. Inciardi, J. A., (Ed.). (1990). Handbook on Drug Control. New York: Greenwood Press. Kaminer, Y. (1994). Adolescent substance abuse: A comprehensive guide to theory and practice. New York: Plenum. Karasu, T. B. (Ed.). (1989). Treatments of psychiatric disorders (Vol. 2). Washington, D.C: American Psychiatric Association Press. Leukefeld, C. G. & Tims, F. M. (Eds.) (1988). Compulsory treatment of drug abuse: Research and clinical practice. (NIDA Research Monograph #86, DHHS Publication No. [Adm]88-1578). Rockville, MD: National Institute on Drug Abuse. Lowinson, J. H., Ruiz, P., Millman, R. B., & Langrod, J. G., (Eds.). (1992). Substance abuse: A comprehensive textbook. (2nd ed.) Baltimore, MD: Williams & Wilkins.

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Mail, P. D., Heurtin-Roberts, S., Martin, S. E., & Howard, J., (2002), (Eds.). Alcohol use among American Indians and Alaska Natives: Multiple perspectives on a complex problem. National Institute on Alcohol Abuse and Alcoholism Research Monograph No. 37. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. Margolis, R. D., & Zweben, J. E. (1998). Treating patients with alcohol and other drug problems: An integrated approach. Washington, DC: American Psychological Association Margolis, R. D., & Zweben, J. E. (2011). Treating patients with alcohol and other drug problems: An integrated approach, second edition. Washington, DC: American Psychological Association. Marlatt, G. A., & Gordon, J. R. (Eds). (1995). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford. Marlatt, G. A., & Witkiewitz, K. (Eds.). (2009). Addictive behaviors: New readings on etiology, prevention, and treatment. Washington, DC: American Psychological Association. McCrady, B. S. & Miller, W. R. (Eds.). (1993). Research on Alcoholics Anonymous: Opportunities and Alternatives. New Brunswick, New Jersey: Rutgers Center of Alcohol Studies. McCrady, B. S., & Epstein, E. E. (1999). Addictions: A comprehensive guidebook. New York: Oxford University Press. McKay, J. R. (2010). Treating substance use disorders with adaptive continuing care. Washington, DC: American Psychological Association. Meyers, R. J., & Miller, W. R. (Eds.) (2001). A community reinforcement approach to addiction treatment. Cambridge, UK: Cambridge University Press. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.

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Rotgers, F., Keller, D. S., & Morgenstern, J. (Eds.). (1996). Treating substance abuse: Theory and techniques. New York: Guilford. Scheier, L. M. (2010). Handbook of drug use etiology: Theory, methods, and empirical findings. Washington, DC: American Psychological Association. Schuckit, M. A. (1995). Drug and alcohol abuse: A clinical guide to diagnosis and treatment (4th ed.). New York: Plenum. Shaffer, H. J. (2012). APA addiction syndrome handbook. Washington, DC: American Psychological Association. Sorenson, J. L., Rawson, R. A., Guydish, J., & Zweben, J. E. (Eds.). (2003). Drug abuse treatment through collaboration: Practice and research partnerships that work. Washington, DC: American Psychological Association. Strain, E.C., & Stitzer, M.L. (1999). Methadone treatment for opioid dependence. Baltimore, MD: Johns Hopkins University Press. Trimble, J. & Beauvais, F. (Eds.). (2001). Health promotion and substance abuse prevention among American Indians and Alaska Natives: Issues in cultural competence. (CSAP Cultural Competence Series 9). Special Collaborative Edition. United States Department of Health & Human Services, Substance Abuse & Mental Services Administration, Center for Substance Abuse Prevention, Office of Minority Health, Health Resources & Service Administration, Bureau of Primary Health. Rockville, MD. Tuten, M. L., Hendree, E. J., Schaeffer, C. M., & Stitzer, M. L. (Eds.). (2012). Reinforcementbased treatment for substance use disorders: A comprehensive behavioral approach. Washington, DC: American Psychological Association. Washton, A. M. & Zweben, J. E. (2006) Treating alcohol and drug problems in psychotherapy practice: Doing what works. New York: Guilford Publications, Inc.

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White, W. H. (1998). Slaying the dragon: The history of addiction treatment and recovery in America. Bloomington, IL: Chestnut Health Systems. Winger, G., Hofmann, F. G., & Woods, J. H. (1992). A Handbook on Drug and Alcohol Abuse, (3rd ed.). New York: Oxford University Press. Zimberg, S., Wallace, J., & Blume, S. (1985). Practical Approaches to Alcoholism Psychotherapy, (2nd ed.). New York: Plenum Press.

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APPLICATION MATERIALS For the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders

REQUIREMENTS FOR CERTIFICATION The requirements for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders include: • • •

•

current state or provincial license in good standing to engage in the independent practice of psychology; provision of health services in psychology; engagement as a licensed psychologist in the treatment of alcohol and other psychoactive substance use disorders for at least 1 year during the last 3 years; and successful completion of the College of Professional Psychology’s examination in the treatment of alcohol and other psychoactive substance use disorders.

The recertification program requires that you obtain a minimum of 18 hours of CE credit (contact hours) over the 3-year period of certification. Only continuing education that is provided by an APA-approved sponsor, a state or provincial psychological association, the American Society of Addictions Medicine (ASAM), Substance Abuse & Mental Health Services Administration (SAMHSA), or that is approved by a state or provincial psychology licensing board for renewal of state licensure will be accepted. You will also be asked to submit verification that your state or provincial license continues in good standing. BEFORE YOU PROCEED •

THE EXAMINATION As mentioned on page 4, the examination consists of 150 multiple-choice items. It is administered by computer at more than 500 locations and can be scheduled at your convenience by appointment. Results are transmitted to the College of Professional Psychology. Confirmation of certification is issued within several weeks. RENEWAL OF CERTIFICATION The APA Practice Organization, College of Professional Psychology’s Certificate of Proficiency provides certification for 3 years. Because of the importance of remaining current with regard to the treatment of alcohol and other psychoactive substance use disorders, certified psychologists will be required to renew certification every 3 years. This is accomplished through the College of Professional Psychology’s recertification program.

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• •

You must enclose all forms and letters to be submitted in application for the Certificate of Proficiency in one envelope. A pre-addressed envelope is provided for this purpose. Your application will not be processed without all forms and letters, including the appropriate payment. No staples or paper clips, please.

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FEES

WORK SETTING CODES

The fees for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders are listed below. Use the Application Fee Payment Form (page 25) to pay your application fee.

Non-Refundable Application Fee: Practice Assessment Payer (PA) . . . . .$325 APA Member . . . . . . . . . . . . . . . . . . $395 Non-Member . . . . . . . . . . . . . . . . . . . $425 Examination Fee . . . . . . . . . . . . . . . . $200 (paid at the time you schedule your testing session)

Annual Maintenance Fee . . . . . . . . . . $50 Renewal Fee . . . . . . . . . . . . . . . . . . . . $125 (paid at the time of three-year renewal; includes Maintenance Fee for the renewal year)

DOCUMENTING YOUR ENGAGEMENT in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders (Letters of Reference) Using the Reference Letter Cover Form (pages 29 and 31), submit two (2) letters of reference which specifically address your recent (1 year within the last 3 years) engagement in the treatment of alcohol and other psychoactive substance use disorders. Both theReference Letter Cover Form and the reference letter itself must be submitted. Letters of reference may be written only by the following licensed professionals: psychologists, physicians, social workers, or nurses. Licensed professionals who write letters of reference are not required to be supervisors or co-workers, but may be colleagues (psychologists, physicians, social workers, or nurses) who have knowledge of your recent practice in this treatment area.

Human Service Settings 31 32 33 34 36 35 37 41 42 43 44 45 46 47 40 48 38 39 70 49

Public general hospital Private general hospital City/county/state psychiatric hospital Not for profit private psychiatric hospital For profit, private psychiatric hospital Veterans Administration (VA) hospital Military hospital (e.g.Air Force) Individual private practice Group psychological practice Medical/psychological group practice Outpatient mental health clinic, freestanding Community mental health center or clinic (CMHC) Health Maintenance Organization (HMO) Counseling or guidance center (not school or college) Nursing home Special health services (e.g., substance abuse or mental retardation) Independent Practice Association (IPA) Preferred provider organization (PPO) Other managed care Other human service setting

Other Employment Settings 51 52 53 54 55 56 61 62 63 64 65 66 69 06

Self-employed (not private practice or independent consultant) Consulting firm Private research organization or lab Government research organization or lab Business or industry (excluding consulting firm or research organization) Independent consultant Criminal justice system Military service (other than above settings) Federal government agency (other than above settings) State govt. agency (other than above settings) Local govt. agency (other than above settings) Other non-profit organization Other non-educational or non-service setting not listed above Student counseling or services center (university)

To write to us, address your inquiries to: APA Practice Organization College of Professional Psychology 750 First Street, NE Washington, D.C. 20002-4242

APA Practice Organization College of Professional Psychology

C 21 APPLICATION Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders Please type or print

1. Name ______________________________________________ Degree ________________________ Mailing Address ______________________________________________________________________ _________________________________________________________________________ ________________________________________________________________________ Daytime Phone Number _________________________ Fax Number ________________________ Email Address _______________________________________________________________________ Social Security Number __ __ __ – __ __ – __ __ __ __ APA Member Number (if applicable) 0000 __ __ __ __ – __ __ __ __ 2. Will you require special accommodations?

❏ Yes ❏ No

3. I hereby declare that I have been engaged in the treatment of alcohol and other psychoactive substance use disorders as a licensed psychologist for at least 1 year during the last 3 years. Signature _____________________________________________ Date _______________________ 4A. Current Psychology License Licensing State or Province ______ License Number ___________ Expiration Date ___ /___ /___ Month

Day

Year

Be sure to enclose a photocopy of a document (or documents) that verifies your current licensure status including the date of expiration (i.e., wallet card, wall certificate, letter from the state or provincial licensing board). Is this state of provincial license to practice psychology current and in good standing? ❏ Yes ❏ No (If No, your licensure status does not meet the necessary eligibility requirements.) Does this license confer upon you the right to engage in the independent practice of psychology without limitations or restrictions, such as the need for supervision or limitations on the services you may provide? ❏ Yes ❏ No (If No, your licensure status does not meet the necessary eligibility requirements.) 4B. Original Psychology License I have been continuously licensed to engage in the independent practice of psychology without limitations or restrictions since ____ /____. State or province granting original license: _____ /____. Month

Year

Month

Year

4C. Have you, at any time, been the subject of a finding of unethical, unprofessional (including malpractice), or illegal conduct made as a part of a final decision by a regulatory body (i.e., licensing board, professional ethics body, or other regulatory body) or by a court (civil or criminal)? ❏ Yes ❏ No (If yes, attach an explanation and copies of official documents.)

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C 22 5.

Provision of Health Services In order to be eligible for the Certificate of Proficiency you must be a psychologist who provides health services. For the purpose of certification by the APA Practice Organization, College of Professional Psychology, health services is defined as follows: Health services include the delivery or supervision of prevention, assessment, consultation and/or therapeutic intervention services in psychology directly to individuals whose growth, adjustment, or functioning is actually impaired or is at risk for impairment. Select ONE of the following ways to document the fact that you are a psychologist who provides health services. Check ONLY One:

❏ Current Practice: I hereby declare that I have been legally engaged in the provision of health services in psychology for at least 2 years during the last 5 years. Enclose Verification of the Provision of Health Services form (see page 27) and sign below: Signature _______________________________________________________________

6.

❏

Listing in a Register: Current listing in a nationally recognized register of psychologists who provide health services. Enclose a photocopy of your current listing in the published register, the title page of the register, and the copyright page.

❏

State or Provincial Recognition as a Health Service Provider: Current recognition pursuant to state or provincial psychology licensing laws as a “Health Service Provider.” If your state or provincial licensing board grants a “Health Service Provider” title, it is typically reflected in the documentation submitted pursuant to Section 4 (above). If it is not, enclose additional appropriate documentation from the state or province.The following states grant a “Health Service Provider” designation: IA, IN, KY, MA, MO, NC, OK,TN, and TX

The following optional demographic information is requested to enable the APA Practice Organization College of Professional Psychology to know more about its certificants. Information provided will have no bearing on your application for certification. Where did you gain your knowledge of and experience in the treatment of alcohol and other psychoactive substance use disorders? Check ALL that apply:

❏ ❏ ❏ ❏

APA-approved continuing education ❏ Other coursework ❏ Other continuing education Training in the workplace after licensure ❏ Part of formal graduate training in psychology Part of formal post-doctoral training in psychology Other, specify: _____________________________________________________________________

What percent of your practice of psychology is devoted to the treatment of alcohol and other psychoactive substance use disorders?

❏ Less than 25% ❏ Between 26% and 50% ❏ Between 51% and 75% ❏ Between 76% and 100% Enter ONE code that reflects your primary work setting (see the Work Setting Codes table on page 18 for codes): _______ How did you become aware of this certification program? ❏ APA Monitor ❏ Workplace requirement or preference ❏ State association meeting or publication ❏ Colleague ❏ APA Practice Organization website ❏ Other, specify: ___________________ APA Practice Organization College of Professional Psychology

C 23 WAIVER AND ACKNOWLEDGMENT I have applied to the APA Practice Organization, College of Professional Psychology for the Certificate of Proficiency. I hereby certify that the information provided in this application and its enclosures is accurate and complete to the best of my knowledge and belief. I hereby attest to the fact that my state or provincial license is current and in good standing. I authorize the College of Professional Psychology to contact any or all of the references provided in my application and/or the state or provincial licensing agency through which I am licensed. I understand that the College of Professional Psychology has the right to refuse or revoke certification if my application contains fraudulent information. I understand that the certification program of the College of Professional Psychology is voluntary and I agree to be bound by its policies and procedures as they now exist or as they may be amended in the future. I understand that renewal of the College of Professional Psychology Certificate of Proficiency through its recertification program is required for continued certification. I acknowledge the authority of the College of Professional Psychology to establish and maintain standards for certification and to reject or accept applicants for certification. I agree to hold the American Psychological Association Practice Organization and the American Psychological Association free from any claim, damage, or complaint by reason of any action it may take in regard to this application, including, but not limited to, the establishment of certification criteria, including examination content and scoring, and the determination of whether I have met the requirements for certification. I understand that my Certificate of Proficiency may be revoked if I am the subject of a finding of unethical, unprofessional, or illegal conduct made as a part of a final decision by a court or regulatory body (administrative, civil or criminal), including the American Psychological Association’s Code of Ethics enforcement entity. If I am granted certification, I agree to notify the College of Professional Psychology of such a finding within 45 days of the final decision. I understand that my Certificate of Proficiency may be revoked if I fail to meet renewal criteria or to pay fees and that I may resign my certification at any time without refund of fees paid.

Signature _____________________________________________________ Date __________________________

NOTARY On this ________________ day of ______________________________________________, 20 _____________, (Applicant) ____________________________________________________ personally appeared before me and signed his or her signature above, having satisfactorily proven to be the person whose signature appears above. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Signature of Notary Public ______ __________________________________________________________________ My commission expires _________________________________________________________________________

APA Practice Organization College of Professional Psychology

C 25 APPLICATION FEE PAYMENT FORM Please type or print Name _________________________________________________________________________________ Address _______________________________________________________________________________ _______________________________________________________________________________ Daytime Phone Number _________________________________________________________________ APA Member Number (if applicable) 0000 __ __ __ __ – __ __ __ __

Please Note: Payment must be made in U.S. funds. Check the appropriate non-refundable application fee: ❏ $325 PA Payer*

❏ $395 APA Members

❏ $425 Non-Members * APA Practice Organization Practice Assessment (PA) Payer

Form of Payment

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Check (Make payable to: APA Practice Organization)

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VISA

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MasterCard

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American Express

Card Number __________________________________________________________ Expiration _____ /______ Name as it appears on credit card ________________________________________________________________ Signature _____________________________________________________________________________________ I understand that an additional examination fee of $200 must be paid at the time I schedule my examination.

FOR ACCOUNTING USE ONLY 41530-267810-MGRAD-APP

APA Practice Organization College of Professional Psychology

C 27 VERIFICATION OF THE PROVISION OF HEALTH SERVICES

Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders The same reference may be used to verify applicant’s engagement in the delivery of health services as is used to document engagement in the treatment of alcohol and other psychoactive substance use disorder. Applicant’s Name ____________________________________________________________________________ Applicant’s Address _________________________________________________________________________ _________________________________________________________________________ To the Psychologist, Physician, Social Worker or Nurse: The above-named individual is applying to the APA Practice Organization, College of Professional Psychology for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Use Disorders. The applicant is required to document that he or she has been engaged in the provision of health services in psychology for at least 2 years during the last 5 years. You have been identified by the applicant as a licensed professional who has knowledge of the applicant’s practice in psychology. In this capacity we ask you to read the statement below and determine whether, based on your own knowledge, it applies to the applicant. Return this completed form directly to the applicant who will submit it to the APA Practice Organization, College of Professional Psychology with his or her application.

Verification Statement Based on my own knowledge, I hereby verify that (the applicant) ___ ___________________________________ has been engaged for at least 2 of the last 5 years in the delivery or supervision of prevention, assessment, consultation and/or therapeutic intervention services in psychology directly to individuals whose growth, adjustment, or functioning is actually impaired or is at risk for impairment. Check the box that indicates your licensed profession (ONLY these four are accepted):

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Psychologist

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Physician

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Social Worker

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Nurse

Your Name ________________________________________________________________________________ Address ___________________________________________________________________________________ ____________________________________________________________________________________ Licensing State or Province ___________________________________________________________________ State or Provincial License Number _____________________ Expiration Date ________________________ Signature _______________________________________________ Date _______________ _______________

Please return this form directly to the applicant.

APA Practice Organization College of Professional Psychology

C 29 REFERENCE LETTER COVER FORM

Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders Applicant’s Name _________________________________________________________________________ Applicant’s Address ______________________________________________________________________ ______________________________________________________________________ To the Psychologist, Physician, Social Worker or Nurse: The above-named individual is applying to the APA Practice Organization College of Professional Psychology for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders. The applicant is required to document that he or she has been engaged in the treatment of alcohol and other psychoactive substance use disorders for at least 1 year during the last 3 years. You have been identified by the applicant as a licensed professional who has knowledge of his or her practice in psychology for at least 1 year of the last 3 years. In this capacity we ask you to write a letter of reference for the above-named applicant. You must describe your knowledge of his or her practice during the last 3 years in the treatment of alcohol and other psychoactive substance use disorders. Include information about how long you have known the applicant and specify your professional relationship. Return both this completed cover form and your letter directly to the applicant who will submit them to the APA Practice Organization, College of Professional Psychology with his or her application. Check the box that indicates your licensed profession (ONLY these four are accepted): ❏ Psychologist ❏ Physician ❏ Social Worker ❏ Nurse Your Name ______________________________________________________________________________ Address ________________________________________________________________________________ ____ _____________________________________________________________________________ Licensing State or Province _______________________________________________________________ State or Provincial License Number ______________________ Expiration Date ____________________ My knowledge of the applicant’s practice of psychology in the treatment alcohol and other psychoactive substance use disorders covers the following period of time: From ____ /____ To ____ /____ Month

Year

Month

Year

Signature ________________________________________________________ Date ___________________________

We appreciate your time and thoughtful assistance. Please return this cover form along with your letter of reference directly to the applicant. You may place your letter of reference in a sealed envelope if you wish.

APA Practice Organization College of Professional Psychology

C 31 REFERENCE LETTER COVER FORM

Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders Applicant’s Name _________________________________________________________________________ Applicant’s Address ______________________________________________________________________ ______________________________________________________________________ To the Psychologist, Physician, Social Worker or Nurse: The above-named individual is applying to the APA Practice Organization College of Professional Psychology for the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders. The applicant is required to document that he or she has been engaged in the treatment of alcohol and other psychoactive substance use disorders for at least 1 year during the last 3 years. You have been identified by the applicant as a licensed professional who has knowledge of his or her practice in psychology for at least 1 year of the last 3 years. In this capacity we ask you to write a letter of reference for the above-named applicant. You must describe your knowledge of his or her practice during the last 3 years in the treatment of alcohol and other psychoactive substance use disorders. Include information about how long you have known the applicant and specify your professional relationship. Return both this completed cover form and your letter directly to the applicant who will submit them to the APA Practice Organization, College of Professional Psychology with his or her application. Check the box that indicates your licensed profession (ONLY these four are accepted): ❏ Psychologist ❏ Social Worker ❏ Physician ❏ Nurse Your Name ______________________________________________________________________________ Address ________________________________________________________________________________ __________________________________________________________________________________ Licensing State or Province _______________________________________________________________ State or Provincial License Number ______________________ Expiration Date ____________________ My knowledge of the applicant’s practice of psychology in the treatment alcohol and other psychoactive substance use disorders covers the following period of time: From ____ /____ To ____ /____ Month

Year

Month

Year

Signature ________________________________________________________ Date ___________________________

We appreciate your time and thoughtful assistance. Please return this cover form along with your letter of reference directly to the applicant. You may place your letter of reference in a sealed envelope if you wish.

APA Practice Organization College of Professional Psychology

TO ENSURE YOUR APPLICATION IS COMPLETE Enclose in the pre-addressed envelope provided with this Application:

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Completed Certificate of Proficiency Application (pages 21-22)

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Signed and notarized Waiver and Acknowledgment (page 23)

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Photocopy of licensure documentation (see page 21 for details)

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Documentation of provision of health services (see page 27 for options)

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Two (2) letters of reference AND cover forms (see page 29 for information)

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Application Fee Payment Form (page 25) and check or credit card authorization

MAIL TO: APA Practice Organization College of Professional Psychology 750 First Street, NE Washington, D.C. 20002-4242 Telephone (202) 336-6100 Fax (202) 336-5797 Email [email protected]

AMERICAN PSYCHOLOGICAL ASSOCIATION PRACTICE ORGANIZATION

750 First Street, NE Washington, DC 20002-4242 (202) 336–6100 • (202) 336–5797 fax [email protected]