health counselor and master addictions
counselor.* 100 The National Counselor
Examination for Licensure and Certification
(NCE), administered by NBCC, is required for
those seeking certification. The NCE exam does
not appear to contain substance use/addiction-
related content;^101 however, the specialty
certification exam administered by the NBCC
for the master addictions counselor exam
focuses on addiction.^102 The master addictions
counselor certification requires (1) a minimum
of 12 semester hours of graduate coursework in
addiction content or 500 continuing education
hours in addiction content; (2) three years of
supervised experience as an addiction counselor
at a minimum of 20 hours per week (two of the
three years must have been completed after
obtaining the master’s degree in counseling);
and (3) a passing score on the examination for
master addictions counselor.^103 National
certification is voluntary; however, in some
states, counselors are exempt from taking a state
certification exam if they pass the national
exam.^104
Professional counselors are trained to provide
treatment for mental, emotional and behavioral
disorders and tend to encounter in their practice
individuals who engage in risky substance use or
have addiction.^105 Although risky substance use
and addiction may be addressed under broad
course content areas, CASA Columbia’s review
found few explicit state licensing requirements
that mandate a specific number of addiction-
related education hours in their curriculum
guidelines.†
The Council for Accreditation of Counseling
and Related Educational Programs (CACREP),
which accredits master’s programs in numerous
counseling specialties,^ requires all programs to
provide students with an understanding of
“theories and etiology of addictions and
addictive behaviors, including strategies for
- The NCC is a pre- or co-requisite for the specialty
credentials.
† More frequently, states mention substance use and
addiction as topics that may be addressed under
content areas such as human growth and development
or that may be taken as electives or continuing
education courses.
prevention, intervention and treatment.” The
CACREP specifically includes additional
substance-related content in the curricular
requirements for clinical mental health
counseling; marriage, couple and family
counseling; school counseling; and student
affairs and college counseling programs.^106
Surveys of these programs reveal, however, that
the majority of CACREP-accredited master’s
programs in counseling offer elective courses
but do not require substance use/addiction-
related course work. When asked to identify
which courses teach addiction-related content,
CACREP programs typically cite supervised
clinical settings (practicums and internships),
where students encounter patients who engage in
risky substance use or have addiction, rather
than classroom-based courses. Most counseling
degree programs do not provide any addiction
education prior to the clinical experience.^107Marriage and Family Therapists. Marriage and
family therapists either must have a master’s
degree, a doctoral degree or three to four years
of post-graduate clinical training for licensure.^108
According to CASA Columbia’s review, few
states have explicit addiction-related education
requirements (such as minimum number of
hours of addiction content); most states that
mention addiction include it as an optional or
suggested topic or as a topic eligible for
continuing education credit. The national
licensing exam in Marital and Family Therapy is
administered by the Association of Marital and
Family Therapy Regulatory Boards (AMFTRB).
In drafting the Examination in Marital and
Family Therapy, the Examination Advisory
Committee draws from a list of the 56
knowledge areas required for entry-level
practice in marital and family therapy, which
includes two areas related to substance use and
addiction.‡ 109Social Workers. Some social workers function
as mental health professionals, providing
counseling services. Social workers must earn,‡ The substance-related areas in the AMFTRB are
“effect of substance abuse and dependence on
individual and family functioning” and “addiction
treatment modalities.”