- Naloxone
- A pure opioid antagonist (Narcan) that rapidly reverses an opioid overdose; rescue medication, not maintenance.
- CNS depressants
- A drug class slowing CNS activity — alcohol, benzodiazepines, barbiturates; their withdrawal can be fatal.
- Opioids
- A drug class binding opioid receptors (heroin, fentanyl, oxycodone); overdose causes respiratory depression.
- Stimulants
- A drug class speeding CNS activity (cocaine, methamphetamine, amphetamines); withdrawal is a 'crash.'
- Cannabis
- A psychoactive drug (THC) that impairs memory and coordination; mild withdrawal (irritability, sleep, appetite).
- Hallucinogens
- A drug class altering perception and thought (LSD, psilocybin, PCP, ketamine); PCP/ketamine are dissociatives.
- Inhalants
- Volatile chemicals (solvents, aerosols, nitrites) inhaled for intoxication; risk of 'sudden sniffing death.'
- Opioid overdose signs
- Pinpoint (miotic) pupils, slowed or stopped breathing, and unresponsiveness.
- Delirium tremens (DTs)
- A severe, potentially fatal alcohol-withdrawal syndrome with confusion, agitation, and autonomic instability.
- CNS depressant withdrawal risk
- Alcohol, benzodiazepine, and barbiturate withdrawal can cause seizures and delirium — medical detox is often required.
- Methadone
- A full opioid agonist for opioid use disorder, dispensed through licensed opioid treatment programs.
- Buprenorphine
- A partial opioid agonist with a ceiling effect for opioid use disorder; often combined with naloxone (Suboxone).
- Naltrexone
- An opioid antagonist that blocks opioid effects and treats both opioid and alcohol use disorder; client must be opioid-free first.
- Disulfiram (Antabuse)
- An aversive medication for alcohol use disorder, causing flushing and nausea if the client drinks.
- Acamprosate
- An alcohol use disorder medication that reduces craving and supports continued abstinence.
- Medication-assisted treatment (MAT)
- FDA-approved medications combined with counseling/behavioral therapy to treat SUD; medication alone is not treatment.
- Agonist
- A drug that activates a receptor (e.g., methadone at opioid receptors).
- Antagonist
- A drug that blocks a receptor (e.g., naloxone and naltrexone at opioid receptors).
- Partial agonist
- A drug that partially activates a receptor with a ceiling effect (e.g., buprenorphine).
- Cross-tolerance
- Tolerance to one drug producing tolerance to another in the same class.
- Synergism (potentiation)
- Combining drugs to produce an effect greater than the sum of each — e.g., alcohol plus benzodiazepines.
- Half-life
- The time for the body to eliminate half of a drug; influences withdrawal timing and dosing.
- Pharmacokinetics
- How the body absorbs, distributes, metabolizes, and eliminates a drug.
- Pharmacodynamics
- How a drug acts on the body and its receptors to produce effects.
- Motivational interviewing (MI)
- A collaborative, client-centered style that resolves ambivalence and evokes change talk (Miller & Rollnick).
- OARS
- MI micro-skills: Open-ended questions, Affirmations, Reflective listening, and Summaries.
- Change talk
- The client's own statements favoring change, which MI works to elicit and strengthen.
- Rolling with resistance
- An MI principle: avoid arguing for change; reflect and redirect rather than confront.
- Cognitive behavioral therapy (CBT)
- A structured, present-focused approach that changes distorted thoughts and maladaptive behaviors driving use.
- Cognitive restructuring
- A CBT technique of identifying, challenging, and replacing distorted automatic thoughts.
- Contingency management
- A behavioral approach using tangible rewards to reinforce abstinence or attendance; strong for stimulants.
- 12-step facilitation
- A structured approach that actively promotes client engagement in 12-step mutual-help groups (AA, NA).
- Relapse prevention (Marlatt)
- A CBT-based approach identifying high-risk situations and triggers and building coping skills.
- Trigger
- A person, place, feeling, or cue that increases the urge to use; identified in relapse-prevention work.
- Lapse vs. relapse
- A lapse is a single slip; a relapse is a return to the prior pattern of use — a lapse is a chance to learn.
- Abstinence violation effect
- Guilt and loss of control after a lapse that can drive a full relapse; addressed in relapse prevention.
- Group counseling
- Treatment in a group that harnesses peer support, universality, and feedback; common in addiction settings.
- Harm reduction
- Strategies (naloxone, syringe services, fentanyl test strips) that reduce harms of use without requiring abstinence.
- Crisis intervention
- Immediate, short-term help to stabilize a client in acute crisis — assess safety first, then stabilize and connect to resources.
- Triage
- Prioritizing clients by urgency of need so the most acute risks are addressed first.
- Psychoeducation
- Teaching clients about addiction, treatment, and coping strategies as part of counseling.
- Family therapy
- Treating the family system and its interaction patterns, recognizing addiction's impact on the whole family.
- Codependency
- A relational pattern in which a person enables another's substance use, often at their own expense.
- Enabling
- Behavior by others that shields a person from the consequences of use and inadvertently sustains it.
- Benzodiazepines
- CNS depressants (e.g., diazepam, alprazolam) with high dependence and dangerous withdrawal risk.
- Barbiturates
- Older CNS depressant sedatives with a narrow safety margin and life-threatening withdrawal.
- Fentanyl
- A potent synthetic opioid driving overdose deaths; often mixed into other drugs, raising overdose risk.
- Cocaine
- A short-acting stimulant producing euphoria, followed by a crash; cardiovascular risk in intoxication.
- Methamphetamine
- A long-acting, highly addictive stimulant with severe physical and psychological effects.
- Nicotine
- A stimulant and the addictive component of tobacco; an important target of addiction treatment.
- Alcohol
- A CNS depressant; the most commonly used drug with potentially fatal withdrawal in dependence.
- MDMA (ecstasy)
- A stimulant-hallucinogen ('club drug') affecting serotonin; risks include hyperthermia and dehydration.
- PCP
- A dissociative hallucinogen that can cause agitation, dissociation, and dangerous behavior.
- Cannabis use disorder
- A SUD involving problematic cannabis use; withdrawal includes irritability, sleep and appetite changes.
- Opioid use disorder (OUD)
- A SUD involving opioids; treated with MAT (methadone, buprenorphine, naltrexone) plus counseling.
- Alcohol use disorder (AUD)
- A SUD involving alcohol; medications include naltrexone, acamprosate, and disulfiram.
- Tapering
- Gradually reducing a drug dose to manage withdrawal safely, often used in medically supervised detox.
- Detoxification (detox)
- Medically managed withdrawal to safely clear a substance; a precursor to, not a substitute for, treatment.
- Behavioral therapy
- Evidence-based talk therapies (CBT, MI, CM) that help clients change substance-related behaviors.
- Community reinforcement approach
- A behavioral treatment that reorganizes the client's environment to make a sober life more rewarding.
- Affirmation (MI)
- A genuine statement recognizing the client's strengths or efforts; the 'A' in OARS.
- Reflective listening (MI)
- Mirroring back the client's meaning and feeling so they feel heard; the 'R' in OARS.
- Summarizing (MI)
- Pulling together what the client has said to reinforce change talk; the 'S' in OARS.
- Ambivalence
- Holding mixed feelings about change at once; MI is designed to resolve it in the direction of change.
- Group facilitation
- Guiding a counseling group — managing dynamics, encouraging participation, ensuring safety.
- Stages of group development
- Forming, storming, norming, performing, and adjourning — the phases a counseling group moves through.
- Relapse triggers (HALT)
- Common relapse cues — Hungry, Angry, Lonely, Tired — clients learn to recognize and manage.
- Coping skills training
- Teaching clients concrete skills (refusal, stress management, problem-solving) to handle high-risk situations.
- Stimulant withdrawal
- A 'crash' of fatigue, hypersomnia, depression, and craving; uncomfortable but rarely medically dangerous.
- Opioid withdrawal
- Flu-like symptoms (sweating, nausea, aches, anxiety); severe and distressing but rarely fatal.
- Biopsychosocial assessment
- A comprehensive intake gathering biological, psychological, and social information to understand the whole client in context.
- Mental status exam (MSE)
- A structured snapshot of current functioning — appearance, behavior, mood, affect, thought, perception, cognition, insight, judgment.
- Substance use disorder (DSM-5-TR)
- A diagnosis based on a problematic pattern of use meeting 2 or more of 11 criteria within 12 months.
- DSM-5-TR SUD criteria groups
- Impaired control, social impairment, risky use, and pharmacological criteria (tolerance and withdrawal).
- SUD severity thresholds
- Mild = 2–3 criteria, moderate = 4–5, severe = 6 or more, within a 12-month period.
- Tolerance
- Needing markedly more of a substance to get the same effect, or a reduced effect from the same amount.
- Withdrawal
- A substance-specific syndrome appearing when a heavy, long-term user stops or cuts back; for alcohol/sedatives it can be fatal.
- Craving
- A strong urge or desire to use a substance; one of the 11 DSM-5-TR SUD criteria.
- CAGE questionnaire
- A 4-item alcohol screen — Cut down, Annoyed, Guilty, Eye-opener; 2+ 'yes' answers signal a likely problem.
- AUDIT
- The WHO's 10-item Alcohol Use Disorders Identification Test for hazardous and harmful drinking.
- AUDIT-C
- The 3-item short form of the AUDIT, screening on alcohol consumption alone.
- DAST
- Drug Abuse Screening Test — a self-report screen for drug use other than alcohol.
- MAST
- Michigan Alcoholism Screening Test — a longer screen for alcohol problems.
- Addiction Severity Index (ASI)
- A structured clinical interview rating problem severity across multiple life domains to guide planning.
- ASAM Criteria
- A standardized ASAM framework that assesses six dimensions to match a client to the right level of care.
- ASAM Dimension 1
- Acute intoxication and/or withdrawal potential.
- ASAM Dimension 2
- Biomedical conditions and complications.
- ASAM Dimension 3
- Emotional, behavioral, or cognitive conditions and complications (mental health / co-occurring).
- ASAM Dimension 4
- Readiness to change (motivation).
- ASAM Dimension 5
- Relapse, continued use, or continued problem potential.
- ASAM Dimension 6
- Recovery and living environment.
- ASAM Level 0.5
- Early intervention — services for those at risk but not yet meeting SUD criteria.
- ASAM Level 1
- Outpatient treatment — fewer than 9 hours of services per week for stable clients.
- ASAM Level 2
- Intensive outpatient (2.1, 9+ hrs/week) and partial hospitalization (2.5, 20+ hrs/week).
- ASAM Level 3
- Residential/inpatient — 24-hour structured care, from low-intensity to medically monitored intensive.
- ASAM Level 4
- Medically managed intensive inpatient — 24-hour medically directed care for acute, unstable conditions.
- Least restrictive environment
- The principle of placing a client in the least-intensive level of care that is still safe and effective.
- Differential diagnosis
- Distinguishing among disorders with overlapping symptoms; rule out medical and substance-induced causes first.
- Co-occurring disorder
- A mental health disorder and a substance use disorder present together (dual diagnosis).
- Collateral information
- Data from family, records, or other providers that corroborates and enriches the client's self-report.
- Genogram
- A diagram of family relationships and patterns across generations, used to understand context in assessment.
- Suicide risk assessment
- Directly assessing ideation, plan, means, and intent, plus history and protective factors; asking does not increase risk.
- Withdrawal scale (CIWA)
- The Clinical Institute Withdrawal Assessment for alcohol — rates the severity of alcohol withdrawal.
- Blood alcohol concentration
- The percentage of alcohol in the blood; used to gauge intoxication level.
- Strengths-based assessment
- Identifying a client's resources, supports, and capabilities, not just deficits and problems.
- Tolerance vs. dependence
- Tolerance is reduced effect over time; physical dependence is adaptation producing withdrawal on cessation.
- Physical dependence
- Physiological adaptation to a drug such that stopping or reducing produces a withdrawal syndrome.
- Psychological dependence
- Emotional or mental reliance on a substance, marked by craving and use to cope or feel normal.
- Intoxication
- A reversible, substance-specific syndrome of behavioral and physical changes from recent use.
- Polysubstance use
- Use of more than one substance, which complicates assessment, withdrawal risk, and treatment.
- Route of administration
- How a drug is taken (oral, inhaled, injected, smoked); affects onset, intensity, and risk.
- Risk and protective factors
- Influences that raise (e.g., trauma, family history) or lower (e.g., support, coping) the likelihood of a SUD.
- Functional analysis
- Examining the antecedents, behavior, and consequences of use to understand and change it.
- Readiness ruler
- A 0–10 scaling question assessing how ready, willing, or able a client is to change.
- Mental health screening
- Brief screening for co-occurring depression, anxiety, trauma, or psychosis during assessment.
- Trauma-informed care
- An approach that recognizes the prevalence and impact of trauma and avoids re-traumatizing clients.
- Presenting problem
- The concern or symptom the client identifies as the reason for seeking (or being sent to) treatment.
- Diagnosis vs. screening
- Screening flags likely problems; diagnosis applies DSM-5-TR criteria after a full assessment.
- Standardized instrument
- A validated, structured tool (e.g., AUDIT, ASI) administered consistently to support reliable assessment.
- Drug testing (toxicology)
- Laboratory analysis (urine, saliva, blood) used to detect substances and monitor treatment progress.
- Detection window
- The period after use during which a drug or its metabolites can be detected in a test sample.
- Acute vs. chronic risk
- Acute risk is immediate (overdose, suicide); chronic risk unfolds over time (relapse, health decline).
- Client self-report
- Information the client provides about their use and history; corroborated with collateral data when possible.
- Treatment plan
- A collaborative document linking measurable goals and objectives to the assessment, with interventions and progress criteria.
- Collaborative goal setting
- Writing goals with the client, not for them — improving engagement, adherence, and outcomes.
- Goal (treatment plan)
- The broad, longer-term outcome the client is working toward (e.g., maintain abstinence).
- Objective (treatment plan)
- A specific, measurable, time-bound step toward a goal (e.g., attend 3 groups/week for 30 days).
- SMART objectives
- Specific, Measurable, Achievable, Relevant, and Time-bound — the standard for good treatment objectives.
- Intervention (plan)
- What the counselor will do to help the client reach an objective (e.g., weekly CBT, peer-group referral).
- Documentation
- Accurate, timely, objective, secure clinical records; one of the eight TAP 21 practice dimensions.
- SOAP note
- A documentation format: Subjective, Objective, Assessment, Plan.
- SOAP — Subjective
- What the client reports — feelings, concerns, and self-reported symptoms.
- SOAP — Objective
- What the counselor observes or measures — behavior, screen results, attendance.
- SOAP — Assessment
- The counselor's clinical interpretation and the client's progress toward goals.
- SOAP — Plan
- The next steps, interventions, and any changes to the treatment plan.
- DAP note
- A documentation format: Data, Assessment, Plan — a common alternative to SOAP.
- Case management
- Linking the client to and coordinating services — medical, housing, vocational, legal, and mutual-help resources.
- Service coordination
- Organizing and monitoring the multiple services a client needs across providers and systems.
- Referral
- Directing a client to another provider or service when a need exceeds the counselor's competence, scope, or program.
- Integrated treatment
- Treating a co-occurring mental health disorder and SUD together, by one team, rather than separately or sequentially.
- Continuing care (aftercare)
- Ongoing support after primary treatment to sustain recovery; planned during treatment, not after discharge.
- Discharge planning
- Preparing the client's transition out of a level of care, including referrals, supports, and a relapse-prevention plan.
- Relapse prevention plan
- A plan identifying the client's high-risk situations and triggers and the coping strategies to manage them.
- Progress note
- A record of each clinical contact documenting the session, the client's status, and progress toward goals.
- Treatment plan review
- Periodically reassessing and revising the plan with the client as needs and progress change.
- Measurable objective
- An objective written so progress can be objectively verified (frequency, duration, or a specific behavior).
- Client-centered planning
- Planning that reflects the client's own goals, values, culture, and stage of readiness.
- Recovery support services
- Non-clinical services (peer support, housing, employment help) that bolster long-term recovery.
- Wraparound services
- A coordinated, individualized set of supports surrounding a client and family across systems.
- Step-down / step-up
- Moving a client to a less or more intensive level of care as their needs and risk change.
- Modality
- The format of treatment — individual, group, couple, or family — chosen to fit the client's needs and goals.
- Short-term goal
- An achievable objective for the near term that builds momentum toward longer-term recovery goals.
- Long-term goal
- A broad recovery outcome the client works toward over the course of treatment and beyond.
- Outcome measurement
- Tracking measurable indicators (abstinence, attendance, functioning) to gauge treatment effectiveness.
- Treatment compliance
- The extent to which a client follows the agreed plan; low compliance prompts re-engagement, not just discharge.
- Barriers to treatment
- Obstacles (transportation, childcare, stigma, cost) that the plan should anticipate and address.
- Recovery plan
- A forward-looking plan for sustaining recovery, including supports, coping skills, and relapse prevention.
- Coordination with MAT prescriber
- Collaborating with the medical provider managing a client's medication-assisted treatment.
- Stepped care
- Starting with the least-intensive effective intervention and intensifying only if needed.
- Crisis plan
- A written plan of warning signs, coping steps, and emergency contacts for use in a crisis.
- Family involvement
- Engaging family in treatment and education to strengthen support and address systemic patterns.
- Re-assessment
- Periodically re-evaluating the client so the plan stays matched to current needs and risks.
- Treatment objective tracking
- Documenting progress on each objective so the plan reflects what is and isn't working.
- Sober living / recovery housing
- Structured, substance-free housing that supports clients transitioning back to independent living.
- Peer recovery support specialist
- A person with lived recovery experience who provides nonclinical support and connection to services.
- Continuity of care
- Coordinated, uninterrupted care across providers and levels so a client doesn't fall through the cracks.
- Aftercare planning timing
- Begin aftercare and continuing-care planning during treatment, not at the moment of discharge.
- Relapse as a process
- Relapse usually unfolds emotionally and mentally before physical use; recognizing early signs allows intervention.
- Vocational services
- Job training and employment support coordinated as part of comprehensive treatment planning.
- Screening
- A brief, first-pass step to detect whether a substance problem is likely; it is not a diagnosis and leads to a full assessment.
- Intake
- The formal start of the counseling relationship — gathering identifying and presenting information, explaining services, and obtaining informed consent.
- Engagement
- Building rapport and a working relationship so the client returns; one of the strongest early predictors of treatment retention.
- Orientation (to treatment)
- Explaining the program to the client: what happens, the voluntary nature of treatment, rights and responsibilities, fees, and confidentiality rules.
- Transtheoretical model
- Prochaska & DiClemente's stages-of-change model describing how people change a behavior over time.
- Stages of change (order)
- Precontemplation, contemplation, preparation, action, maintenance — with relapse a recycling point, not a failure.
- Precontemplation
- Stage of change in which the person is not yet considering change and may not see the use as a problem.
- Contemplation
- Stage of change marked by ambivalence — aware of the problem and weighing change against staying the same.
- Preparation
- Stage of change in which the person intends to act soon and is making a concrete plan (e.g., a quit date).
- Action
- Stage of change in which the person is actively modifying behavior — abstaining or cutting back.
- Maintenance
- Stage of change focused on sustaining the change and preventing relapse, generally beyond six months.
- Matching intervention to stage
- Core skill: meet the client where they are — don't push action on a precontemplative or ambivalent client.
- Mandated client
- A client referred by a court, employer, or agency; often ambivalent, so engagement and MI matter even more.
- Rapport
- A trusting, collaborative connection between counselor and client that supports honest disclosure and retention.
- Decisional balance
- Weighing the pros and cons of changing vs. not changing; a focus of motivational work in contemplation.
- Recovery capital
- The internal and external resources (supports, skills, housing, motivation) a person can draw on to start and sustain recovery.
- Continuum of care
- The full range of treatment settings, from early intervention through outpatient, residential, and inpatient care.
- Voluntary treatment
- Treatment the client chooses to enter; the counselor explains that participation is voluntary during orientation.
- Brief intervention
- A short, focused counseling contact (often after a positive screen) aimed at motivating change.
- SBIRT
- Screening, Brief Intervention, and Referral to Treatment — an evidence-based public-health approach to risky substance use.
- Treatment readiness
- The client's motivation and willingness to engage in treatment; assessed early and matched to interventions.
- Universality (groups)
- The therapeutic factor of realizing one is not alone in one's struggles — a benefit of group counseling.
- Confrontation (caution)
- Direct, harsh confrontation increases resistance and drop-out; modern practice favors empathy and motivational approaches.
- Treatment matching
- Selecting the type and intensity of treatment that best fits the individual client's needs and stage.
- Self-help / mutual-help groups
- Peer-led recovery groups such as AA, NA, SMART Recovery; the counselor connects clients to them.
- AA (Alcoholics Anonymous)
- A 12-step mutual-help fellowship supporting recovery from alcohol use through peer support and the 12 steps.
- NA (Narcotics Anonymous)
- A 12-step mutual-help fellowship for recovery from drug use.
- SMART Recovery
- A secular, science-based mutual-help program using cognitive-behavioral and motivational tools.
- Empathy (engagement)
- Accurately sensing and reflecting the client's experience; central to building the alliance early.
- Open-ended question
- A question that invites elaboration ('Tell me about...') rather than a yes/no answer; key in engagement.
- Active listening
- Fully attending to, reflecting, and clarifying what the client communicates, verbally and nonverbally.
- Stages-of-change relapse
- In the TTM, relapse returns a person to an earlier stage; treated as part of the change process, not failure.
- Externally motivated client
- A client pushed into treatment by outside pressure (court, family, work); engage and build internal motivation.
- Abstinence goal
- A treatment goal of no use of the substance(s); contrasted with moderation or harm-reduction goals.
- Sympathy vs. empathy
- Empathy is understanding the client's experience from their frame; sympathy is feeling pity, which is less helpful.
- Hope / instillation of hope
- Conveying that change and recovery are possible; a key engagement and group therapeutic factor.
- Initial contact
- The first interaction with a client, where safety, urgency, and the need for further assessment are gauged.
- Warm handoff
- A direct, in-person introduction of a client to the next provider or service to improve follow-through.
- Drop-out risk
- The likelihood a client disengages early; reduced by strong engagement and stage-matched intervention.
- Recovery
- A process of change through which a person improves health and wellness and lives a self-directed life.
- NAADAC/NCC AP Code of Ethics
- The professional ethics code for addiction counselors, covering the counseling relationship, confidentiality, and responsibilities.
- Informed consent
- The client's voluntary agreement to treatment after being told its nature, goals, risks, confidentiality limits, and rights; ongoing.
- Confidentiality
- The counselor's duty to protect client information; its limits are disclosed at the start of treatment.
- 42 CFR Part 2
- The federal rule protecting confidentiality of SUD records held by federally assisted programs; stricter than HIPAA.
- Part 2 written consent
- Specific written consent generally required before SUD records — even attendance — may be disclosed or re-disclosed.
- HIPAA
- The federal health-information privacy rule that interacts with, but is less strict than, 42 CFR Part 2 for SUD records.
- Duty to warn (Tarasoff)
- The obligation to take reasonable steps to protect an identifiable victim from a client's serious, imminent threat.
- Mandated reporting
- The legal duty to report reasonable suspicion of child, elder, or dependent-adult abuse, overriding confidentiality.
- Medical emergency exception
- Under Part 2, information may be shared with medical personnel to treat a bona fide medical emergency.
- Scope of practice
- The services a counselor is competent and legally permitted to provide; practicing beyond it is unethical.
- Scope of competence
- Practicing only within the areas where one has adequate training, experience, and supervision.
- Dual relationship
- A second role (social, business, sexual) with a client that risks impaired judgment or exploitation; sexual relations with current clients are prohibited.
- Autonomy
- The bioethical principle of respecting a client's right to self-determination and informed choice.
- Beneficence
- The bioethical principle of acting in the client's best interest and promoting their welfare.
- Nonmaleficence
- The bioethical principle of doing no harm and avoiding actions that could injure the client.
- Justice (ethics)
- The bioethical principle of treating clients fairly and equitably, without discrimination.
- Fidelity
- The ethical duty of loyalty — keeping promises and honoring the trust of the counseling relationship.
- Clinical supervision
- Oversight and guidance of a counselor's work to support competence, ethics, and professional development.
- Cultural competence
- Awareness of one's biases, knowledge of clients' worldviews, and skills for culturally responsive counseling.
- Cultural humility
- An ongoing, learner stance toward each client's identity and experience, alongside competence.
- Burnout
- Emotional exhaustion and reduced effectiveness from chronic work stress; self-care and supervision are protective.
- Countertransference
- The counselor's emotional reactions to a client, managed through self-awareness and supervision.
- Continuing education
- Ongoing professional learning required to maintain certification and competent, current practice.
- Privileged communication
- A legal protection (held by the client) keeping confidential communications out of legal proceedings, with exceptions.
- Boundaries
- The professional limits that keep the counseling relationship safe, ethical, and focused on the client's needs.
- Records retention
- Keeping and securely storing/disposing of client records per legal and ethical requirements.
- Reporting impaired colleague
- An ethical duty to address a colleague whose impairment endangers clients, per the code and law.
- Self-care
- Maintaining the counselor's own wellbeing to practice competently and prevent burnout — a professional responsibility.
- TAP 21
- SAMHSA's Addiction Counseling Competencies — 4 Transdisciplinary Foundations and 8 Practice Dimensions.
- Transdisciplinary Foundations
- TAP 21's four foundations: understanding addiction, treatment knowledge, application to practice, professional readiness.
- Eight Practice Dimensions
- TAP 21 functions: clinical evaluation, treatment planning, referral, service coordination, counseling, education, documentation, ethics.
- Clinical evaluation (dimension)
- The TAP 21 practice dimension covering screening and assessment of the client.
- Professional readiness
- The TAP 21 foundation covering ethics, professional growth, and culturally competent practice.
- Re-disclosure prohibition
- Under 42 CFR Part 2, recipients of SUD records are barred from re-disclosing them without consent.
- Qualifying court order (Part 2)
- A court order meeting Part 2's specific requirements — not an ordinary subpoena alone — can authorize disclosure.
- Release of information (ROI)
- A signed, specific authorization allowing the program to disclose defined records to a named recipient.
- Minor / consent
- Who can legally consent for a minor varies by state; the counselor follows applicable law for SUD treatment of youth.
- Privacy vs. confidentiality
- Privacy is the client's right to control disclosure; confidentiality is the counselor's duty to protect what's shared.
- Ethical decision-making model
- A structured process to weigh principles, law, and code when facing an ethical dilemma; document the reasoning.
- Conflict of interest
- A situation where a counselor's personal interest could compromise their professional judgment; avoid or disclose it.
- Gifts / bartering (boundaries)
- Accepting gifts or trading services can blur boundaries; the code urges caution and a focus on client welfare.
- Telehealth / e-therapy ethics
- Delivering counseling electronically requires informed consent, security, competence, and jurisdiction awareness.
- Reporting elder abuse
- A mandated-reporting duty to notify authorities of reasonable suspicion of abuse or neglect of an elder.
- Reporting child abuse
- A mandated-reporting duty that overrides confidentiality, including under 42 CFR Part 2.
- Competence maintenance
- Keeping skills current through continuing education and supervision, per the ethics code.
- Documentation as protection
- Accurate records support continuity of care and protect both client and counselor in disputes or audits.
- Nondiscrimination
- Providing services without discrimination based on race, gender, religion, disability, orientation, or other status.
- Termination ethics
- Ending services appropriately when goals are met or services are no longer beneficial; avoid abandonment.
- Supervision vs. consultation
- Supervision is ongoing oversight of one's work; consultation is seeking expert advice on a specific case or issue.
- Vicarious trauma
- Cumulative emotional impact on a counselor from exposure to clients' trauma; managed via self-care and supervision.
- Professional disclosure statement
- A document given to clients describing the counselor's credentials, services, fees, and policies.
- Duty to protect (steps)
- Reasonable steps may include warning the victim, notifying police, or arranging hospitalization, per state law.
