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Course Content and Outcomes Guide for AD 255 Effective Fall 2021

Course Number:
AD 255
Course Title:
Multiple Diagnoses
Credit Hours:
Lecture Hours:
Lecture/Lab Hours:
Lab Hours:
Special Fee:

Course Description

Covers assessment of chemical dependency clients for communicable diseases and co-existing mental disorders, effective intervention, and referral of clients to optimum resources for resolving co-existing diagnoses. Develops clear ethical guidelines for alcohol and drug counselors practicing within an area of competence. Prerequisites: AD 101, AD 102, (AD 160 or AD 150), WR 121 and admission to the Addiction Counseling Program. Prerequisites/concurrent: PSY 239. Audit available.

Addendum to Course Description

The code of ethics of the National Association of Alcohol and Drug Abuse Counselors refers to alcohol and drug counselors practicing within their area of competency. A & D counselors need to have basic screening ability to uncover multiple diagnoses and need to be highly competent at researching resources and referring clients to those resources. Course covers mental status examination, suicide prevention, and risk for suicide and violence. Students are expected to enter the course with current knowledge of HIV/AIDS gained from AD102 as course activities will focus on client interviewing, assessment, and referral. The students will understand the Axis II of the DSMIVtr and dual-diagnosis assessment and treatment. The integrated treatment model will be analyzed and its real-life application evaluated.

Intended Outcomes for the course

Upon completion of the course students should be able to:

  1. Conduct a communicable disease and co-existing mental disorders assessment with clients from the addicted population.
  2. Follow ethical guidelines that focus on limits of competency and appropriateness of making referrals.
  3. Interact with mental health professionals as part of an integrated approach to treatment and contribute to the development of an appropriate and effective treatment plan for addicted clients who may have multiple disorders/issues.
  4. Meet the ACCBO requirement for HIV risk assessment/risk reduction training.

Outcome Assessment Strategies

  1. Role play a client with one or more DSMIVtr mental health diagnosis.
  2. Interview a client with one or more DSMIVtr diagnosis.
  3. Debrief of the mental health disorder that the student researched and played.
  4. Conduct an audio taped interview in which alcohol and drug counselor gathers data regarding sexual behavior and needle-use behavior, assesses the relative risks of that behavior, and teaches risk reduction techniques to the interviewee. Focus is on communicable disease transmission.
  5. Research mental health or dual-diagnosis client, and present orally and in writing.
  6. Show understanding of mental health disorders in quizzes.
  7. Show understanding of Axis II disorders in DSMIVtr in quizzes.
  8. Practice observation and reporting of mental states and write it up. Be able to articulate descriptions of behavior and functioning using structure of the mental status exam including practicing pure observation and assessment.
  9. Show understanding of suicide risk assessment, intervention, and documentation on quizzes.
  10. Show understanding of violence risk assessment, intervention and documentation on quizzes.
  11. Analyze the need for integrated addictions and mental health treatment and attitudes and skills needed to work in integrated treatment.

Course Content (Themes, Concepts, Issues and Skills)

1.0 A & D Counselor Role and Limits of Competence
1.1 Clearly articulate NADAAC and ACCBO ethical standards regarding limits of competence.

1.2 Clearly state responsibility to refer to or co-case manage dual-diagnosis cases with trained/experienced professionals.

1.3 Identify how clinical supervision can be used for multiple-diagnosis cases.

2.0 Communicable Disease Assessments
2.1 Conduct an interview in which they gather data regarding sexual behavior and needle-use behavior, assess the relative risks of that behavior, and teach risk reduction techniques to the interviewee – interview could be audio or videotaped.

2.2 Gather data regarding history and risk of contracting HIV, Hepatitis C, Tuberculosis; assess the relative risks of that behavior, and teach risk reduction techniques to the interviewee.

3.0 Client Services for Communicable Diseases
3.1 Interview and evaluate at least one community agency providing services to clients with HIV, persons with TB, and/or persons with Hepatitis C.

3.2 Effectively refer alcohol and drug clients to appropriate social services and medical services, and effectively follow up on clients' use of and satisfaction with the services.

  1. 3.3 Understand the role of advocacy for alcoholics/addicts and use the Recovery Association Project as an example of advocating for Hepatitis C services with Multnomah County.

4.0 Dual Diagnosis
4.1 Identify the proper use of the Diagnostic and Statistical Manual IVtr including classification system, especially Axis II.

4.2 Determine the presence of a clinical disorder by using the DSMIVtr.

4.3 Recognize the symptoms of the most common anxiety disorders, thought disorders, mood disorders, personality disorders, and neurological disorders found in chemically dependent clients.

4.4 Perform a mental status exam.

4.5 Interview clients and collateral contacts about mental health history and symptoms.

4.6 Analyze the impact of mental health issues on alcohol and drug treatment.

4.7 Present counselor's analysis of the client's co-existing disorder to a clinical supervisor, a primary health provider, and to a treatment team. (if student has access to clients)

4.8 Document mental health history and symptoms and counselor observations in an effective, commonly used format.

4.9 Understand principles of integrated treatment and work collaboratively with mental health professional.

5.0 Duty to Warn and Protect
5.1 Manage, report, refer and document crisis situations (such as suicidal client, client who intends to kill or gravely harm others, client who threatens physical harm, or client who disrupts treatment).
5.2 Conduct a suicide assessment and intervention, report to supervisor and document it in the client file.

5.3 Assess danger of a client harming others, report to supervisor, report to intended victim, and document effectively in the client file.

5.4 Intervene effectively with a client who threatens physical harm or disrupts treatment.

5.5 Intervene effectively within Federal confidentiality guidelines and Oregon State law to assess counselor responsibility with HIV positive alcohol and drug clients who are practicing unsafe sex.5.6 Understand case law and ethical codes governing duty to warn potential victims.