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Welcome to the addiction counselor exam review. This presentation is part of the addiction counselor certification training. Go to https//www.ALLCEUs.com/certificate – tracks/ to learn more about our specialty certificates starting at 149 dollars. Alrighty everybody welcome to today’s presentation of the addiction counselor exam review. This is the final installment on our addiction counselor exam review series that is based on the addiction counselor exam review text. I’m really encouraging y’all to submit questions and I will create a few additional presentations to answer any questions that you know I may not have answered or I didn’t answer the way in as much depth as you wanted in order to help you prepare for your addiction counselor exam so again please below you can submit questions and I will put all those together and next week I will do a user input presentation so on we go with case management service coordination so today we’re going to define referral and service coordination within the context of case management we’ll explore why case management is necessary and I know at a lot of agencies you work at or you will work at you’re not gonna have case managers so you need need to know how to do case management because it just it has to be done we’re gonna identify the different approaches to case management will identify the case managers role in service coordination will define service planning and identify challenges and solutions to collaboration so service coordination that’s really you know the crux of case management case managers are there to work with clients in a collaborative process to help them access needed services and this is not just counseling this can be medical housing transportation you name it anything a client needs in order to achieve his or her highest quality of life we’re going to try to connect them with we’re not necessarily and a lot of times not able to provide it but there are providers in the community most likely who already do provide that service so we are the ones that serve as the the linkage we’re gonna help connect those two people together we’ll help them select the most appropriate services because you know it’s not one size fits all a lot of times how do you choose the right doctor how do you choose the right treatment program you know what services do you really need will facilitate the linkages with those services and promote continued retention in those services by monitoring participation so we don’t just link them and go okay toodles been real you know we want to link them then we want to follow up and go how’s it going is this meeting your needs if not what else do we need to do or do we need to look elsewhere we want to make sure that we don’t just you know give them a number and send them out the door because that’s not case management we want to coordinate multiple services when necessary such as addiction counseling mental health counseling psychiatry and primary care you know i I’ve worked with all four of those on many many cases and advocate with the client for continued participation the case manager has even more contact in many cases than the clinician with the client and we have way more contact with the client then maybe the psychiatrist or the primary care physician so it’s really important for the case manager to be alert to waning motivation and advocate for their continued participation it’s also important for the case manager to advocate for continued participation if a program is saying you know what I think I think it’s time to discharge the case manager might be able to point out a few reasons why this client is not ready for discharge yet or not ready for step down so case managers are in large part advocates for clients objectives of case management are to ensure continuity of care we want to make sure that everybody on the team is on the same page and we want to make sure that you know the client is accessing and able to access all the services that he or she needs we provide accessibility and by establishing relationships with gatekeepers and this can include insurance companies this can include you know if you’re making a referral to maybe a teaching hospital you know who is the gatekeeper there who decides when the appointments are and who gets accepted and all that kind of thing you

want to develop contracts or memorandums of understanding abbreviated mo use which specify available slots so for example the detox unit that I used to run we had 16 beds but we always had 4 slots for adolescents so you know we knew that we had to make sure that we could accommodate at any particular time up to 4 adolescents and we need to identify in those Memorandum of Understanding consequences for failure to implement specified activities or procedures so if we fail to maintain those 4 beds and those 4 beds were needed you know we could potentially lose our contract with the state so you know it was big bad mojo but in other memorandum memoranda of understanding between agencies it could just hurt the working relationship you may start getting stopped getting referrals from them they may stop taking referrals from you you know it could close a door on to it on an avenue of treatment that your clients may need so memoranda of understanding really spell out this is what we as an agency do this is what we as an agency are willing to commit to do to your refer for your clients for your referrals and this is what you as the other agency are going to do in return this is how it’s you know we’re going to cooperate accountability and you do want to be careful when you write those because there’s a lot of patient brokering issues that can come out of that if it’s not done correctly you know you don’t want to guarantee that you’re gonna send all your referrals somewhere but that’s a whole different course that’s ethics so make sure that the memoranda of understanding is very clear and there’s no exclusive benefit so anyway accountability is another thing that case managers do we follow up with referrals both with the client and with the referral source you know if I refer John over to primary care or pain management I’m going to follow up with John when he comes back to see me or when I go to see him to see how it went but I’m also gonna follow up with the referral source to say you know did Sean Don show that did John show up on time was this an appropriate referral was this useful yada yada because I don’t want to send them in appropriate referrals so I want to make sure that both the referral source and the client are happy we I want to measure outcomes with client satisfaction client outcomes and service system outcomes such as a reduction in the cost to treat so if normally it costs $15,000 to treat this client for a month but we decide to start referring out for certain other services so we don’t have to provide them that will lower the cost to treat potentially for us but are we still getting the same client outcomes and client satisfaction and case managers help with efficiency because it’s the case manager’s job to know the system and to make it work so you’re the one out there just really making sure that everything’s you know flowing smoothly case management is necessary because of poor Gordon poor service coordination lack of service continuity and the difficulty clients have negotiating the gap between services we had a lot of struggles referring to certain agencies where I came from and those agencies I won’t name hopefully things have improved but there were a cup agencies we knew that if a client had to interact with them it was going to be a big headache so it wasn’t important for us to establish a contact person over there that we could call thankfully our attending physician was married to their attending physician so it was a little easier but it was important for us to have a contact person over there in order to cut through all the red tape we need to provide structure where the case manager acts as the human link between the client and service providers and we also are potentially the core agency that develops contracts with providers for identified services so we’re kind of figuring out who offers what and then we’ve got a menu of options before us and and that’s what we’re doing we’re kind of brokering out sometimes the core agency that’s providing the case management make control case management funds so you know they may be the ones that are deciding who is eligible for case management and who isn’t they act as a single point of entry for clients

so if somebody needs case management they will come in this way or you know ideally this is the place that people enter the system now this doesn’t happen a lot especially in a recovery-oriented system of care where we adhere to that no wrong door philosophy that means people can come in from anywhere from the jail from social services wherever we do want to make sure that they get funneled you know wherever they come in from initially they get funneled to a single place if you will that you know can help disseminate things so we don’t have repetition of you know somebody went to a mental health counselor did an assessment now they need to go to a substance abuse counselor and do an assessment and all these other things so we want to act as a single point of contact if you will and we can help develop missing service elements because we can look at all of the services that are available on that menu and say oh transportation is missing and that’s a big issue for our clients so case managers are on the ground and we’re able to identify service needs that can facilitate client success so there are multiple different approaches to case management the brokerage approach which I already kind of mentioned they coordinate services and provide few if any services themselves they’re the ones that are just kind of sitting there like the cashier at McDonald’s going ok what do you want to order from the menu they can provide some stabilization and empowerment they’re going to you know help the client potentially connect with those resources you know do a warm handoff but they’re not going to provide the services themselves then you have integrated case management this is family focused and strengths based and uses an independent facilitator to coordinate all relevant people including providers family and natural supports this team then works in partnership with the family with the family to create safety based comprehensive treatment plans addressing the needs of all family members ok so this is a very family based system because guess what your person probably doesn’t live alone so we need to integrate everybody that’s in that person’s immediate household and anybody they consider you know their family or immediate supports so we can make sure that those people are getting their needs met because caregivers have needs to case management offers a single point of contact for clients is client driven strength based involves advocacy both between services with seemingly contradictory requirements to serve the best interest of the client so if you’ve got a perfect example we used to have clients who would need mental health services you know crisis stabilization and they’d also need detoxification and it was a hot potato because the CSU did not want to handle a client who was under the influence and the detox unit wasn’t able to handle client who was potentially a threat to himself or someone else so there was generally a back and forth and it required a lot of advocacy from the program director between the two of them to decide what was in the best interest of the client where did this client need to be it involves advocacy with agencies you know workforce development law enforcement you know the whole kit and kaboodle families legal systems and legislative bodies it may involve the recommendation of sanctions to encourage client compliance and motivation so sometimes especially in your problem solving courts like drug court and mental health court you may have a case manager who is assigned to each client who makes recommendations to the court based on the clients progress in treatment case management is community-based and pragmatic that means it meets the client literally and figuratively where the client is if they are ready for treatment or if they’re not quite ready for treatment or if they’re in aftercare and they need you know to maintain their relapse prevention plan but we go into the community they’re not coming into the clinic we’re going into the community to see how they’re doing it’s anticipate ori based on the natural course of the clients presenting issues so if you know that you’re working with a client who it has bipolar disorder you know isn’t anticipating that there may be another resurgence of symptoms at some point so we want to make sure that the client has the ability to access

services should they start to decompensate it’s flexible to individual needs and culturally sensitive so the case managers role and I said this when I was doing tip 42 yesterday we use very specific language when we’re writing case management notes because there are certain agencies reimbursement providers whatever you want to call them who are very specific about what they will reimburse for case management so we’re going to use words like linkages advocacy and management not other words because we want to help clients manage Linc advocate and get support in order to maximize their quality of life and achieve as much independence as possible so a case manager has certain certain basic competencies that they need to have you need to be able to establish rapport just like a counselor you need to have an awareness of how to maintain boundaries and be non-judgmental just like a counselor you need to recognize the importance of family social networks and the community in the whole process of recovery you know yes the person has to be willing to do the next right thing but they also need support from whatever they define as family as well as the community in which they choose to reside case managers need to understand a variety of insurance and payment options available and that includes things like patient assistance programs to help clients access medication when they can’t afford it they need to understand culture and respond in a culturally recent sensitive manner understand the value of an interdisciplinary approach to treatment so the case manager is not you know sometimes is not necessarily a clinician so but even if they are you know we need to respect this interdisciplinary approach recognizing that most clients have physical health needs they may have pain needs they may have mental health needs they may have addiction needs and they may also have social environmental needs so we need to think of Maslow’s hierarchy and make sure that we’ve got providers that can help clients meet all of their basic Maslow V&E and case managers can serve both as a facilitator for referrals and an advocate like I talked about earlier as a facilitator the case manager composes the team you know we help the client figure out what things they need what services they need and then we may reach out to those agencies and say I have a referral for you and this composes the team we notify participants of team meetings now thankfully with you know a lot of HIPAA compliant chat available now it’s easier to do these meetings you don’t have to find a room and everybody travels there and everything so these meetings are a lot easier everybody just logs on to VC or something like that in order to participate the facilitator the case manager will often chair the meeting to make sure that everything is getting said and everybody has a chance to speak they maintain team focus on the client not on what this agency needs or you know the funding priorities of this agency we need to focus on the client what does the client need and if you don’t have money to do it how can we help get it paid for and we want to ensure clients desires and needs are adequately represented and considered referral you know we’ve been talking about service coordination and I keep talking about referrals and that’s something that a case manager does and referral is the process of facilitating the clients use of available services and support systems to meet the needs identified in their assessment or treatment planning any referral you make you’re going to need to link back to a treatment plan goal or the assessment in some way to identify why does this person need this service at this time it involves identifying needs of the clients which cannot be met by a particular agency and this is true regardless of whether the client is receiving case management services even if you don’t have a case manager on staff and there’s not no hope of one as counselors a lot of times we have to do case management services because that’s necessary to help clients you know start on this forward path so we need to be willing and aware of services and providers that are in the community that we can make referrals to in appropriate referrals may lead to drop out if clients hopes get up then they’re denied access to services so if you refer somebody over to the housing department to get section 8 housing and they’re told there’s a six-month waitlist they may just kind of throw their hands

up and get frustrated so you need to be contacting those agencies and talking before you send somebody over on a wild goose chase an inadequate followup with the client as well as the referral source often leads to premature dropout so we need to make sure that the referral source is keeping tabs on the client and we need to make sure that the client is getting their needs met and if not figure out how to help them do that counselors and case managers must know resources in their community including the processes for getting enrolled in whatever services are offered any limitations such as diagnostic limitations or insurance limitations requirements to get in the program you know if you’re trying to get somebody in a day treatment program or in a clubhouse type program you need to know what the requirements are to be admitted to that program and you need to be aware of confidentiality and talking to those referral sources you know you can’t be without a release of information you know you really don’t want to be disclosing client information to referral sources now there are some very very very limited caveats in HIPAA for coordination of care but it’s always best to get a signed release of information before you start contacting referral sources counselors and case managers should visit referral agencies initially to find out what they do and what the agencies like so you know what you’re sending your client to and also semi-annually after that and you may be laughing going here right yeah it doesn’t happen like that this is the ideal world you should even if you don’t visit the referral agency semi-annually you should at least call your contact person and touch base and go our service is still available have you added any programs and remind them of your program and make sure they’re still good to go potential problems and referrals include differences in agency funding so if one agency only takes Medicaid and your agency is state-funded and you have a client that doesn’t have Medicaid then you’re not going to be able to refer a bunch of clients to them there may be differences in eligibility so an agency whose eligibility is pregnant and postpartum women is not going to be able to serve your twenty three or twenty three-year-old male client so we need to make sure that you know the population I serve the referrals I make are appropriate to that agency for example in a place where I came from right now currently the only sober living houses are available to male veterans that’s it so you know in terms of eligibility if you’re not a male veteran you can’t get into those places so don’t even refer somebody they’re inadequate data sharing is another potential problem in referrals because you know you refer somebody over and they get to that referral source and the referral sources like I’ve never heard of you before you know or they try to make the person go through an entire assessment over again so they’re having to redo that two-hour process conflicting treatment plans can be another problem which is where the case manager really needs to step in and advocate to make sure we can cooperate and coordinate the treatment plans ensure that moving between agencies doesn’t interrupt the continuity of care you don’t want somebody to you know not be doing well in IOP get referred to residential discharged from IOP and not able to get into residential for three weeks that’s not going to that’s not going to be really helpful so we need to make sure that there’s continuity of care in these handoffs potential referral sources include marriage and family and mental health counselors abuse and trauma counseling resources and this includes your rape crisis center and in those types of places primary care women’s health nutritional referrals holistic practitioners pain management legal services financial counseling you know some clients will need to declare bankruptcy or maybe they’re going through a divorce and they need to figure out their finances housing career counseling and educational planning and religious spiritual and faith support and there are other things that will come up I had a client recently who was trying to get out of a very violent domestic relationship and needed to come up with money for first last and

security so she could leave and didn’t know where to come up with that so we called information and referral United Way information and referral and found out some resources and you can also go online and find out some resources that would meet that clients particular need so sometimes you got to be creative in trying to figure out where you can get the resources your client needs potential referral sources and this is refer out and referrals from career counseling and educational planning make sure to be have a relationship with your Workforce Development Board religious spiritual and faith support a lot of churches not only provide faith-based support but they also have food pantries clothing closets and and other things so you want to find out what’s out there LGBTQ support what kind of support groups are out there 12-step meetings there are tons of different types of 12-step meetings from schizophrenic synonymous to Alcoholics Anonymous their meetings are listed online know what’s available in your area and their locations also know about smart recovery meetings and celebrate recovery meetings and any other type of support group meetings that are out there including mental health support and grief support be aware of what your Veterans Administration offers in your area you may have a VA hospital or you may not so you need to know what kind of services are there for veterans and who takes TRICARE you need to be aware of child care resources not only for parents to have their kids in child care after school while they’re working but what resources are there so the parent doesn’t have to bring the child to their counseling appointments or their doctor’s appointments or whatever and we also need to know what transportation options are out there to help people get to their appointments is there a Medicare van again some churches will do transportation especially for homebound elderly that type of thing to help them get to their doctor’s appointments so know what services can be provided in your community potential reasons you may need to make a referral if your agency does not provide that service if you don’t provide transportation or childcare or primary care you need to know who does the counselor may not be the best person to provide the service such as you know if the client is struggling with sexual identity issues and that is not something that you have enough confidence in where you feel like you can be ethical in treating that client you may need to refer you may be able to not refer and just consult but you know be aware that there are some issues that you just may not be trained in if your if your counselor has or you know your your client has PTSD and wants to try EMDR if you’re not trained in EMDR obviously you can’t do it so you need to know who to refer to if the counselor believes there might be a conflict of interest so you know and it happens in big towns and small towns where occasionally there’s a conflict of interest and you may need to refer out or the counselor may recognize the need for a different level of care so if the client and when I say counselor here it can be counselor or case manager if the client is struggling at their current level of err to have a rich and meaningful life they’re struggling with their depression or their schizophrenia or their addiction they may need a more intensive level likewise if the client is has been doing an intensive level and they’re ready to step down you may need need to know what agencies are your step down options the counselor or case manager should explain the rationale for any referrals to facilitate participation don’t just hand your client a list of people to contact and go contact these people and they can help you let’s talk about why how is it related to the treatment plan and the assessment familiarize the client with the agency to quell any anxiety so what is it like when you go in there who are you gonna meet with what can i what can the client expect that first meeting so they’re not going do I plan for three hours or 30 minutes or you know what am I supposed to be doing contact the referral source in the clients presence you know this helps and sometimes if the client can make the contact themselves that’s even better but contact the referral source in the clients present so the client knows you made the contact and they feel confident that that agency knows to expect them have the clients schedule the actual appointment so you may call pain

management and say you know I’ve got this client Sally Jo who I’m going who I’m referring over to you she’s going to call you this week to set up an appointment and you know ideally you have a contact person there where you can communicate with and get all the pertinent information to that person and then have Sally Jo call and make make his or her own appointment give the client the contact name and number and the agency address so they don’t have to go on Google they don’t have to go to Yelp they can just look at the card and go okay I’m supposed to call this person and set an appointment document the referral and follow-up with the client and the provider and put it in the client record when you followup note that you made the referral 11:2 you followed up on eleven nine with the client who said she had an appointment on eleven fourteen and you followed up with a provider on eleven fourteen or whatever but you want to document the dates and times that you follow up with those people to demonstrate continuity of care it doesn’t have to be a super detailed note but you do need the dates and times dual diagnosis or co-occurring disorders indicates the presence of both mental health and addiction issues people with co-occurring issues often experience more severe emotional social and physical problems than someone with only one issue and it’s important for everybody to remember that medical mental health and addictive disorders all influence each other so let’s think about it if somebody has you know a chronic illness that causes them pain that could contribute to guilt anxiety frustration depression they may try to self-medicate with addictive behaviors or addictive substances so I mean there’s the addiction in the mental health there if they’re engaging in addictive behaviors or using addictive substances it can impact them medically but it can also contribute to depression and anxiety if they’ve got a mental health disorder like schizophrenia they may not take care of themselves physically so they may have some medical issues and the medications they’re on they’re on for the schizophrenia may need to be monitored to prevent any medical problems and they may be more likely to develop addictive disorders so we do want to recognize that all of these things interact and when one thing gets exacerbated it’s probably going to make the other two worse use and withdrawal can both can cause both mood social and physical conditions so we need to pay attention whether you’re again whether you’re a counselor or a case manager disorders vary in terms of severity it can be mild you know not a huge problem too severe where the person needs to be hospitalized it can be chronic like all the time every day or it can be sporadic episodes every six to nine months or it can be a sporadic like every once a month this happens for every weekend the person is binging and disorders vary in terms of their disability and degree of impairment in functioning so some people can drink a fifth of alcohol and have a pretty severe alcohol problem but they’re still going to work whereas other people are barely functioning so we need to understand you know how severe is the problem how much is it impairing the person’s ability to function and what does the course look like are they using all the time some of the time or are they depressed all the time or intermittently because that’s going to change the types of services that this person probably needs now service planning is the word we use basically for treatment planning and case management service plans are designed with the provider to identify the treatment objectives or treatment plans are designed with the provider to identify treatment objectives necessary to achieve goals service plans are umbrella documents which tie together all of the treatment plans from various providers so you may have a mental health treatment plan a substance abuse treatment plan a pain management treatment plan and a treatment plan for diabetes so the service plan will tie all those together to make sure there’s no conflicting goals and the case manager will help the team define short-term goals and objectives that help the person move forward in each area the structure of the comprehensive service plan identifies long-term goals you know we’re going to identify what we hope this client will get out of being involved in case management and all these services provide a current status narrative you know your comprehensive

assessment whatever you want to call it and then identify required services supports and resources to help the client meet those long term goals given their current status linking monitoring and advocacy are those three things that a case management case manager does and linkages goes beyond just providing a list of resources remember I said you’re the human contact that connects those two people so you need to make sure that you develop a network of known resources and contacts so you can basically help them shake hands you know you don’t want to just say here’s a list that’s not a linkage a linkage is actually connecting the client with a person the foundation for successful implementation is based on interdisciplinary team planning effort and this team includes the client we’re not just doing all these things behind the scenes and telling the client what to do next we’re involving the client in this process to decide their goals and priorities to assign responsibilities for each goal and to reach consensus in the overall approaches so for example you know if you’ve got this team going and but for substance the client is addicted to opiates and you’ve got a pain management physician on there and a mental health clinician on there and not everybody is good with a methadone program you know we need to reach consensus and the overall approach for how we’re going to address the pain as well as the opiate addiction service coordination encompasses administrative clinical and evaluative activities that bring the client treatment services community agencies and other resources together to focus on the needs identified in the recovery plan so this service plan provides service coordination service coordination includes case management and collaboration with the client and significant others coordination of treatment and referral services to address issues contributing to and caused by their addictive or mental health behaviors liaison activities with community resources you know going out touching base every six months an ongoing evaluation of treatment progress and client needs so that’s the case management part client advocacy is another part in service coordination where sometimes case managers have to advocate with one agency or the other to make sure that service plan comes to fruition tasks of service coordination include initiating and collaborating with referral sources providing a warm referral and what that means is you’re not just calling up and saying Jim Bob will be at your facility on Tuesday you’re calling up the agency and saying I’ve got this client his name’s Jim Bob he’s got these presenting issues 36 year old white male yada yada yada so when Jim Bob arrives they have the basic information they need to get him started instead of having to start from from jump in service coordination you also obtain review and interpret all relevant screening assessment and treatment planning information so it’s important for case managers to understand the lingo and the basic issues from a bunch of different disciplines so you may have to in that team meeting have a session where each provider is explaining exactly what they need to have happen you want to confirm client eligibility for admission and continued readiness for change no sense sending them somewhere if they’re not motivated to do anything complete necessary administrative procedures for admission and coordinate all treatment activities with services provided to the client by other resources so again if the client is going to pain management and then has to go for an MRI you want to make sure that your court helping to coordinate all those treatment activities you also want to establish realistic recovery expectations including the nature of services be very upfront this is that informed consent what kind of services are you going into what are the program goals what are the program procedures the set the schedule you know when does it meet what services are offered what are the rules regarding client contact the client rights and responsibilities the schedule of treatment activities the costs of treatment this is very important to tell them upfront and facts that impact the duration of treatment so you know maybe it’s a 28-day program but what might constitute an extension or what might get the client to be discharged sooner so they’re aware of

what they’re walking into types of services that are going to be coordinated physical health physical mental health physical health including you know any issues related to liver function hepatitis brain functioning HIV tuberculosis STDs any of that needs to be addressed job skills employment opportunities interpersonal skills like communication training and education needs legal services housing services food you know remember Maslow you got to have that bottom level before you can focus on anything else so food childcare and transportation service coordination is essential to prevent clients from falling through the cracks and foster a more holistic view of the client it’s not just a person with an addiction so you may be in a team meeting and somebody’s complaining that the client was a no-show because they couldn’t find a sitter and you know that they were being non-compliant they should have found a sitter ahead of time and had a back-up plan and yada yada yada well there are two ways to look at it you can look at it as non-compliance or you can look at it as the person being a responsible parent they had a sitter and the sitter backed out at the last minute or they weren’t able to find a sitter and they knew they couldn’t leave the kid home alone you know there are two ways to look at it so we want to foster a holistic view of the client and recognize that they’ve got multiple demands they’re probably an employee they’re probably you know they could be a parent they you know they may have a lot of different roles when something happens when a client does something that we don’t like you know just for lack of a better word we need to step back and go what was the function of that behavior why did that client choose that behavior as being more important or more rewarding than what I wanted him to do and in this case maybe the person you know truly needed to take care of their kid we also need to look at you know if it’s habitual no-shows we need to look at other reasons why this client may be no showing for that service and it could be poor rapport and engagement there’s a lot of reasons but we do need to step back and go the client is doing the best they can with the tools they have at this point in time so why did they make this choice why was this current choice more rewarding than what I wanted them to do challenges in service coordination a lot of agencies use different assessment tools I know the assessment tool we used was created by our chief operating officer so nobody else used it and so when people went to different agencies they had to go through the same basic information with each provider over and and over again we couldn’t just send them a packet and they copy it so these different assessment tools produced a fragmented picture of the client unless these different tools are integrated which ideally the case manager can do but it’s better if you just have a uniform assessment that everybody uses for general intake and you know this often obviously creates frustration for the client if they’re like didn’t I just answer these questions with that provider over there other challenges include agreeing which agency or clinician is lead or the primary contact for the client and other agencies the lead agency uses a holistic assessment that meets the needs of all associated agencies when possible so if you are the lead agency and you’re doing this assessment you need to make sure that you’re asking the questions that the mental health provider needs asked and that the medical provider needs asked etc other challenges include funding and eligibility barriers such as there are a lot of places that won’t provide services to people with a felony difficult to treat clients and differing staff credentials challenges to collaboration and service coordination can occur at three levels one is personal so attitudes and attributes of the people working there toward the clients that you’re referring professional differing theoretical beliefs are approaches to treatment of addiction and mental health issues and the use of jargon so you know professionally you may a physician may see treatment of addiction very differently than a addictions counselor who also may see treatment of addiction very differently

than a mental health counselor or a social worker so we need to understand our professional attitudinal differences or our professional worldview and organizational challenges could include not recognizing the need for a partnership just saying you know we don’t need all this formal stuff just call us no a lot of times you do need a formal partnership a lack of a shared mission lack of ownership by senior management lack of trust between agencies if you’ve worked in an agency you know this exists a lot of times because we’re competing for the same dollars unclear guidelines for collaboration and a lack of a process from monitoring and managing collaborative processes so you have you know an informal agreement because there wasn’t a recognized need for a partnership senior management’s really divorced from it and a couple of referrals go south and then there starts to be hard feelings on in both agencies which leads to a breakdown in the system because there was no monitoring no collaboration and no leadership involvement all righty like I said before this concludes our series for the addiction counselor exam review in depth podcasts and videos of all the topics we reviewed can be found on our YouTube channel at all CEUs comm slash YouTube or as episodes in the counselor toolbox podcast if there are areas you would like additional information on and please I’m encouraging you please do please send a support ticket to support at all CEUs comm or note it in the comments below and I will create future podcasts for this series based on viewer questions alrighty everybody have a great day all of us at all CEUs wish you great success on your exam once you’re certified or licensed please remember to visit all CEUs for all of your continuing education needs we offer unlimited CEUs for $59 for addiction and mental health counselors social workers and marriage and family therapists if you’re still thinking about becoming an addiction counselor all CEUs offers the training you need in three formats online multimedia self-study self-study + live webinars or face-to-face weekend intensives which meet one weekend per month for 12 months we can even present a training series at your facility just email support at all CEUs dot-com go to all CEUs dot-com / a sir that’s all CEUs dot-com / AC er to learn more

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