TECHNICAL COMPETENCIES - for Canada's Substance Use Workforce v. 3 - Canadian ...
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TECHNICAL COMPETENCIES for Canada’s Substance Use Workforce v. 3
All behavioural indicators across proficiency levels are examples
only and can be adapted or tailored to meet individual organizational
needs and mandates.
For CCSA’s competencies, substance use is inclusive of situations
where professionals are working with individuals who use or have
used substances, are diagnosed with a medically recognized
substance use disorder or are experiencing harms as a result of
using substances. For more information, please refer to the criteria
for substance use disorders in the Diagnostic and Statistical
Manual of Mental Disorders, 5th edition (DSM-5).
For more information on sex- and gender-based analysis (SGBA+),
please visit www.ccsa.ca/sex-and-gender-based-analysis
© Canadian Centre on Substance Use and Addiction, 2021
For additional copies, contact
CCSA, 75 Albert St., Suite 500
Ottawa, ON K1P 5E7
Tel.: 613-235-4048
Email: competencies@ccsa.ca
ISBN 978-1-77178-805-2TABLE OF CONTENTS Understanding Substance Use ............................................................................. 1 Understanding Concurrent Substance Use and Mental Health Conditions ............................................................................. 3 Collaborative Care Planning ....................................................................................... 5 Community Development ................................................................................................ 6 Counselling ................................................................................................................................................ 7 Crisis Intervention .......................................................................................................................... 9 Families, Caregivers* and Social Supports ..................................... 10 Group Facilitation ........................................................................................................................... 14 Medications .............................................................................................................................................. 15 Outreach ......................................................................................................................................................... 16 Prevention and Health Promotion .................................................................... 17 Program Development, Implementation and Evaluation .................................................................................................................................. 19 Record Keeping and Documentation ......................................................... 21 Referral .............................................................................................................................................................. 22 Screening and Assessment ......................................................................................... 23 Trauma- and Violence-Informed Care ....................................................... 25 Treatment Planning ..................................................................................................................... 28
UNDERSTANDING SUBSTANCE USE
Background or contextual knowledge of substances and substance use as defined in the Competencies, including the sex-specific neurological effects of
different substances and the impact of use on cognitive function, and as required to properly inform specific aspects of a professional’s work with people.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Explains what substance use is and: 1. Applies evidence-informed 1. Explains and applies an 1. Supervises or coaches others in
a. Its prevalence in Canada approaches to identify the severity understanding of the social developing their knowledge of
b. The neuroscientific basis of of the individual’s substance use and determinants of health that work causality, prevention, diagnosis and
substance use and how it can any other concurrent issues (e.g., alone or together to increase or treatment of substance use, and
impact cognitive function and physical, psychological, social and mitigate risk, and how these factors integrating this new knowledge into
development polysubstance use issues) may vary in different populations their work with people receiving
c. The neurological, physiological and cultures services
2. Explains the way that substances that
and behavioural impacts of alter mood, behaviour and cognitive 2. Accesses current research 2. Supervises or coaches colleagues
different substances processes are categorized or classed and integrates and applies this working with complex and sensitive
d. The bio-psycho-social-spiritual (e.g., stimulant, sedative) and cites knowledge when developing cases requiring a sophisticated
risk and protective factors for the proper and the street names, if and adapting evidence-informed understanding of all aspects of
development of substance use applicable, for key drugs within those approaches substance use and concurrent
concerns categories or classes conditions
3. Works with complex or sensitive
e. The various reasons for 3. Explains the range of factors that can cases requiring a sophisticated 3. Initiates, facilitates or participates in
substance use increase risk or protection against understanding of: collaborative research that:
EXAMPLES
developing substance use concerns, a. Most aspects of substance use a. Advances knowledge about
2. Describes the types of substances
and works with people to identify b. Substance-induced mental prevention, screening and
often used in the professional’s
such factors in their cases; for health issues (i.e., psychosis) assessment, and treatment of
locale
example: c. Various cultures and sub- substance use
3. Explains the social determinants a. Age, sex, gender identity, sexual b. Explores the range of sex and
populations
of health that have an impact on orientation and being racialized gender, social, political, economic,
people who use substances and d. The impact of adverse
b. Social support childhood experiences on the spiritual and cultural factors likely to
their families and communities, and have an impact on substance use
c. Biological markers and genetic brain
identifies some of those key factors,
vulnerability
for example, genetics, sex, gender, 4. Applies an understanding of 4. Contributes to professional
poverty, income, housing insecurity, d. Historical, social and cultural development, including training, skill
medications, side effects and
being racialized, etc. factors (colonialism) building, consultation, coaching and
contra-indications to provide
e. Trauma, violence and adverse mentoring, and exchanges of current
4. Explains key processes that adequate support (see Medications
childhood experiences knowledge on substance use
exacerbate substance use such as competency for additional details)
4. Explains the prevalence of concurrent 5. Develops new tools, techniques
stigma, racism, violence and trauma, 5. Participates in planning and
conditions and histories of trauma and support materials to assist the
and experiences of colonialism (e.g., conducting research on current
and violence that may be present substance use workforce
residential schools) trends in various aspects of the
for people who use substances, and
5. Explains exposure to substances applies this knowledge when working prevention, diagnosis and treatment 6. Advocates at the micro, meso and
in utero as a risk for fetal and child with them of substance use macro levels for developing and
development issues implementing public policy designed
5. Explains in general terms the impact to minimize risk while enhancing
6. Explains evidence-informed that stigma, trauma and violence, resiliency
approaches to managing substance and cultural and historical events
use (e.g., harm reduction or can have on people, and applies this 7. Advocates for funding of research
abstinence-based approaches) understanding in working with them and programs designed to improve
the lives of all people who use
substances
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 1UNDERSTANDING SUBSTANCE USE
Background or contextual knowledge of substances and substance use as defined in the Competencies, including the sex-specific neurological effects of
different substances and the impact of use on cognitive function, and as required to properly inform specific aspects of a professional’s work with people.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
7. Explains concurrent conditions and 6. Explains the concepts of the family
how they affect the prevalence, and social supports as systems with
prevention, diagnosis and treatment the potential to support or undermine
of substance use conditions the individual, and the type of impact
an individual’s substance use can
have on the family as a system
7. Explains the concept of recovery
capital and how it can contribute to
improved outcomes
8. Consults a wide range of evidence-
informed resources, including the
Diagnostic and Statistical Manual of
Mental Disorders, to develop and
apply an enhanced understanding of
people who use substances
EXAMPLES
9. Explains in general terms withdrawal
management, treatment and
recurrence prevention approaches,
and applies this knowledge in
working with people
10. Explains in general terms how and
why medications are used in the
treatment of substance use and
integrates a practical and level-
appropriate knowledge of medications
when working with people
11. Explains in general terms the
interactions that medications and
other drugs can have and applies this
understanding in working with people
(see Medications competency for
additional details)
12. Monitors current research to update
and enhance the knowledge base
applied when interacting with people
13. Explains evidence-informed
considerations when treating people
who are using different substances,
such as opioids, amphetamines,
alcohol and cannabis
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 2UNDERSTANDING CONCURRENT SUBSTANCE USE AND MENTAL HEALTH CONDITIONS
Knowledge and skills required to inform specific aspects of a professional’s work with people with concurrent substance use and mental health concerns. For
more information please refer to the criteria for concurrent disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Explains: 1. Explains the major categories, 1. Explains the impact of and 1. Supervises or coaches other
a. What is meant by concurrent signs and symptoms of mental relationship between intersectional professionals working with people
conditions (co-occurring health concerns and mental health factors and multiple layers of with concurrent substance use and
substance use and mental health diagnoses that can be concurrent stigma (e.g., culture, gender mental health conditions
concerns) and the importance of with substance use concerns identity, sexual orientation, 2. Collaborates and takes a leadership
treating both together being racialized, etc.) on people
2. Explains frequent causes of and role in developing and implementing
b. The impact that concurrent with concurrent conditions and
treatments for the categories cited a seamless, evidence-informed
conditions have on other co- collaborates with them to address approach to the delivery of services
occurring issues (e.g., behavioural 3. In transparent dialogue with people, these issues to people with concurrent conditions
or process addictions) provides objective descriptions of
2. Develops and implements across all sectors and disciplines
signs and symptoms of suspected
c. Factors that contribute to evidence-informed strategies that
concurrent substance use and mental 3. Collaborates and takes a leadership
concurrent conditions in general appropriately address:
health concerns when referring role initiating or facilitating cross-
and in specific populations and a. The relative severity of both
them to or consulting with specialist training opportunities with specialist
cultures (e.g., Indigenous or the person’s substance use and
practitioners practitioners in mental health and
racialized groups) mental health concerns substance use
4. Collaborates with people to integrate
EXAMPLES
d. The stigma associated with b. The specific needs related to
concurrent conditions, and how it results of consultations or referrals in the person’s cultural context 4. Advocates for, facilitates and
may vary in racialized populations their treatment plans contributes to collaborations among
c. The full range of the person’s
and marginalized cultures (e.g., the full range of professionals
5. Integrates trauma and violence- socioeconomic challenges
multi-layered stigma) involved in diagnosing and treating
informed approaches into treatment d. The need to collaborate with people with concurrent conditions
e. The relationship between strategies, supports and services others
mental health and substance use 5. Advocates for, initiates, facilitates
6. Integrates practical, level-appropriate
and the prevalence of concurrent 3. Collaborates with colleagues in or participates in research focused
knowledge of medications into
substance use and mental health integrating knowledge with practice on the appropriate integration of
treatment strategies, supports and
conditions 4. Collaborates with other agencies treatment for concurrent substance
services
f. The prevalence of trauma and and service providers to address use and mental health concerns
violence in the lives of people 7. Collaborates with people to challenges like employment,
who use substances or have understand the impact of stigma housing and other social
concurrent conditions, and and identifies evidence-informed determinants of health that
the impact it can have on their strategies to address different levels intersect with concurrent substance
substance use and treatment of stigma including, self, social, use and mental health conditions
organizational and structural stigma
g. Risks associated with 5. Demonstrates initiative in cross-
concurrent substance use 8. Collaborates with people to identify training opportunities with other
and mental health conditions, personal and systemic factors (e.g., professionals
including suicidality experiences of trauma and violence,
and social determinants of health)
that contribute to or protect against
developing concurrent substance use
and mental health conditions
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 3UNDERSTANDING CONCURRENT SUBSTANCE USE AND MENTAL HEALTH CONDITIONS
Knowledge and skills required to inform specific aspects of a professional’s work with people with concurrent substance use and mental health concerns. For
more information please refer to the criteria for concurrent disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
2. Explains that substance use 9. Monitors evidence-informed
professionals need to: knowledge about the best
a. Learn about concurrent approaches to treating concurrent
conditions substance use and mental health
b. Know the most important conditions and working with people
evidence-based references and living with these conditions
resources that should inform their
learning, including the Diagnostic
and Statistical Manual of Mental
Disorders, the Mental Health Act,
and mental health examinations
and assessments
c. Understand the interplay
between substance use and
mental health conditions
EXAMPLES
(specifically masking and
mimicking)
d. Understand that family,
caregiver and social support and a
host of other broad determinants
of health can contribute to or
protect against developing
concurrent conditions
e. Practice within the confines
of their knowledge and scope
of practice and consult and
collaborate with others, as
required
3. Engages with all individuals, their
families, caregivers and social
supports courteously, responsively
and non-judgmentally
4. Demonstrates the ability to support
or assist more senior professionals
working with people with concurrent
conditions of varying levels of
severity
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 4COLLABORATIVE CARE PLANNING
Meeting people who use substances where they are at and facilitating their movement within and between service providers. It includes providing information
on programs and services to people so they can make informed decisions about the services they receive; maintaining accurate documentation, sharing
information appropriately and with consent, and collaborating with other services providers.
*It is recommended that this competency be used in conjunction with the Behavioural Competency, Person-directed Care.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Demonstrates the ability to assist 1. Establishes and maintains 1. Establishes and maintains 1. Supervises or coaches others in:
colleagues who are in care planning collaborative working relationships treatment plans as part of a multi- a. Undertaking general care
in an administrative or support with people, and with internal and disciplinary team, as appropriate planning tasks
capacity to ensure care planning is external colleagues b. Evaluating complex treatment
2. Establishes and maintains
completed collaboratively within and plans and collaborating with
2. Monitors a range of resources to therapeutic rapport with people to
between services people and other resources to
become familiar with current service establish trust and support them in
2. Explains the importance of care options available to people and reducing barriers to achieve their make changes, as required
planning and how it is related to maintains up-to-date records of well-being goals c. Innovating solutions when
counselling, screening, assessment available services and resources conventional strategies have been
3. Conducts on-going assessments
and treatment planning unsuccessful
3. Consults with people to match them and evaluates treatment plans in
3. Explains the process of referral to with and refer them to the most collaboration with people, adjusting d. Ensuring compliance with care
and from other service providers, appropriate available services and plans, as appropriate planning protocols and changing
including protocols that determine supports, using information obtained protocols, when necessary
4. Establishes collaborative
how, when and with whom through dialogue with people and 2. Reviews counsellors’ care planning
EXAMPLES
relationships with a broad range of
information and documentation through screening and assessment documentation
internal and external services and
should be shared; explains services processes supports, using these relationships 3. Approves provision of case-
and programs to people so they can 4. Initiates and participates in case to facilitate referrals management documentation to
make informed decisions about the conferences and teleconferences, people using services and other
services they receive 5. Implements changes to service
and promptly conducts all necessary collaborators, on a case-by-case
delivery to improve peoples’
4. Explains the benefits of and follow-up basis
outcomes (e.g., increased
process for conducting case 5. Uses virtual, telehealth sites and engagement, efficiencies) 4. Initiates and facilitates case
conferences and teleconferences, online tools (e.g., video conferencing) conferences and teleconferences, as
and the situations in which each is 6. Collaborates with people to support
to facilitate care planning activities appropriate
appropriate them to make and follow through
6. Collaborates with people and their on decisions about treatment
5. Adheres to all legislation, guidelines, social supports on care planning planning
procedures and protocols about recommendations and activities
confidentiality and professional
ethics 7. Advocates for people when working
with related services and supports
6. Explains limits of confidentiality
in various situations and their
implications, as described in
applicable legislation and guidelines
7. Consults regularly with others,
internally and externally, to facilitate
coordinated and collaborative care
planning
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 5COMMUNITY DEVELOPMENT
Working together to identify community needs and resources, build capacity and plan, support or guide collective action.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Demonstrates an understanding 1. Establishes and maintains contacts 1. Collaborates with people most 1. Provides leadership in shaping an
of the needs of Indigenous and and networks to further community affected to: organizational vision and service
racialized communities (e.g., using involvement in developing and a. Leverage community capacity delivery system that reflects
the Truth and Reconciliation Calls to delivering services to enhance b. Ensure that programs and evidence-informed practices in
Action) community well-being services are culturally safe and community development
2. Accesses literature related to 2. Promotes fairness and good gender-sensitive 2. Provides leadership in developing
community development and judgment in planning and undertaking c. Generate solutions to complex and implementing evidence-
substance use service delivery community development activities community development issues informed, gender- and culturally
systems sensitive community health
3. Builds awareness in the community 2. Mobilizes and supports community
promotion practices and policies
3. Explains principles of community about the specific needs of people members to:
development (e.g., sustainable, affected by substance use, including a. Take a proactive role in 3. Communicates and collaborates
inclusive, equitable, etc.) the impact of stigma on their well- developing evidence-informed with key stakeholders and decision
being health promotion practices and makers (e.g., police services, school
4. Explains the role of community
policies tailored for specific boards, municipal, provincial,
members in initiating and supporting 4. Collaborates with people most
populations federal governments, subject-matter
community development activities affected to:
EXAMPLES
b. Reduce stigma associated with experts, etc.), within and outside
a. Assess and prioritize their needs,
5. Acts as first-line point of contact for the community, to obtain their input
issues and resources substance use
community members on and commitment to engage in
b. Generate collaborative solutions c. Promote a healthy lifestyle
6. Professionally engages with, relevant policy and program reform
to community challenges
encourages and responds to 3. Performs or participates in needs and development
c. Promote community ownership assessments by collecting,
all community members and 4. Incorporates relevant research
of constructive change analyzing and interpreting relevant
stakeholders findings and knowledge of gender,
d. Build tailored capacity within the community data, in partnership with
7. Maintains contact with community culture and other determinants of
community to achieve goals and other community members
resources and referral sources health into program planning
desired outcomes
8. Maintains list of gender- and 5. Assesses new community
5. Advocates for the inclusion of people initiatives and—if resources and
culturally sensitive specialist with lived and living experience circumstances permit—approves
community resources and their families and friends in those consistent with evidence-
9. Works collaboratively and develops community development activities informed practices in community
rapport with community members development
and groups
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 6COUNSELLING
Applying a comprehensive range of evidence-informed counselling styles, techniques and methodologies aimed at improving the overall well-being of people
affected by substance use.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Establishes and maintains therapeutic 1. Collaborates with people to: 1. Applies a broad range of gender- 1. Engages with people who present
relationships characterized by a. Understand the impact that the and culturally appropriate, with complex backgrounds and
courtesy, warmth, genuineness, family as a system can have on the evidence-informed counselling needs (e.g., traumatic brain injury)
empathy, trust and concreteness individual’s substance use approaches (e.g., land-based or 2. Applies mastery of substance use
b. Establish rapport and trust by Indigenous ways of healing) tailored
2. Explains: counselling theory and skills when
effectively applying skills such to the needs of individuals, groups,
a. Evidence-informed individual working with people
as understanding barriers to couples and families
and group counselling approaches
engagement, being empathetic and 3. Innovates counselling approaches
and techniques 2. Responds constructively and
supporting self-efficacy based on theory, research, trends,
b. The importance of building trust effectively to significant counselling promising practices and new
and rapport when working with c. Develop coping strategies and challenges like aggression, suicidal knowledge
people building on strengths to deal with ideation and substance-induced
challenging circumstances psychosis 4. Advocates for and integrates the use
c. Recurrence, risk and protective
of technology to provide counselling
factors 2. Matches people’s unique needs 3. Employs a neuroscientific services, especially to people living
d. The importance of collaborative and life challenges to appropriate understanding of substance use to in rural and remote locations
treatment, support and services treatment and support options (e.g., accurately assess an individual’s
EXAMPLES
harm-reduction services, outpatient developmental and cognitive 5. Collaborates with professionals
e. Life skills conducive to well-
or aftercare programs, abstinence- strengths in other fields of study to gather
being, like managing personal
based approaches, etc.) insight on alternative approaches to
finances 4. Engages people in discovering counselling
f. The range of approaches 3. Delivers brief interventions for people, the connection between
that can enhance counselling when and if required their substance use and their 6. Supervises or coaches colleagues
(e.g., mutual help, self-help, experiences and circumstances to promote evidence- and gender-
4. Integrates evidence-informed informed practices in all aspects of
psychotherapy, etc.)
counselling approaches based on 5. Collaborates with people to identify counselling and awareness of the
3. Describes the fundamentals of each individual’s comprehensive and address behaviours that are needs of specialized populations
trauma- and violence-informed assessment and treatment plans, inconsistent with well-being (e.g., through the Truth and
practice and interacts with people to when working with individuals and 6. Selects and adjusts approaches to Reconciliation Calls to Action)
facilitate their well-being and avoid with groups counselling based on the severity of
re-traumatization 7. Leads research to advance
5. Adapts counselling approaches substance use knowledge in the field and stays
4. Uses plain language in all to meet peoples’ specific needs 7. Prioritizes peoples’ access to current with emerging science and
communication with people (e.g., family counselling, vocational services and supports based on research findings
receiving services counselling, mother-child attachment signs and symptoms of recurrence
counselling) 8. Recognizes the value of a range of
5. Participates in creating a gender- lived and living expertise and seeks
sensitive and culturally safe 6. Collaborates with people to develop opportunities to incorporate this
environment, including screening for and implement evidence-informed expertise into research and practice
immediate safety concerns recurrence prevention plans
6. Provides virtual counselling services, 7. Monitors and identifies, symptoms
when required of recurrence and takes proactive
steps during counselling to prevent
7. Adheres to all legislation, guidelines,
recurrence for all people, especially
procedures and protocols about
those with a higher recurrence risk
confidentiality and professional
ethics
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 7COUNSELLING
Applying a comprehensive range of evidence-informed counselling styles, techniques and methodologies aimed at improving the overall well-being of people
affected by substance use.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
8. Collaborates with people to facilitate 8. Collaborates with people to identify
the development of strengths and life when existing services are no
skills associated with well-being longer needed; demonstrates
awareness and compassion during
9. Collaborates with other practitioners
transitions and, in collaboration
to provide integrated care for people
with people, develops plans that
10. Engages in self-analysis with clinical include long-term sustainable
supervisor and critical self-reflection supports and wrap around, follow-
to recognize personal or professional up services as needed (e.g., harm
limitations and biases that can reduction services, injectable opioid
impede ability to work constructively agonist therapy, abstinence-based
with people and works to mediate approaches, housing, mental health
and resolve those limitations and services, etc.)
biases
EXAMPLES
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 8CRISIS INTERVENTION
Recognizing and responding in a timely and evidence-informed manner when people affected by substance use are in a risky or dangerous situation,
such as a physical, sexual, emotional, psychosocial or financial crisis.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Defines “crisis” and explains the 1. Establishes a gender- and trauma- 1. Responds quickly to people in 1. Employs clinical expertise to work
principles of evidence-informed informed (physically and emotionally crisis, intervening as appropriate at with people to identify underlying
crisis intervention safe) environment for people in crisis, each stage of crisis factors that contribute to a crisis and
based on their unique needs to develop strategies to cope with
2. Develops and maintains a network 2. Monitors factors, such as
those factors
of resources and supports available 2. Discusses risks associated with medications, that might contribute
for people in crisis substance use with people and to individual crisis and takes 2. Employs a range of tailored
refers people in crisis to appropriate appropriate actions, such as intervention strategies and creative
3. Explains the risk factors and signs
resources and supports referring the individual to a solutions to stabilize complex crisis
and symptoms associated with
practitioner who is knowledgeable situations
various crises, such as suicidality, 3. Collaborates with people and their
in addictions and can prescribe
self-harm and harm to others, families to create plans for crisis 3. Demonstrates increased
medications, to attend to these
harms related to substance use prevention and intervention understanding of structural,
factors
(including drug poisoning or gendered factors contributing to
4. Collaborates with people and their
overdose), and psychosocial crises 3. Assesses and monitors people at crises, such as child apprehension,
families to assess and improve the
(e.g., loss of housing or income, risk of suicidality and other harms intimate partner violence or
skills they can use to cope during
child apprehension, intimate partner related to substance use, and homelessness
times of crisis
EXAMPLES
violence, etc.) initiates appropriate interventions or 4. Supervises or coaches other
5. Monitors peoples’ emotional state referral, as required
4. Identifies the essential components professionals to enhance their
and responds in a timely manner
of evidence-informed models of 4. Re-assesses and revises an gender- and trauma-informed
crisis prevention action plans 6. Calms escalating and potentially individual’s treatment plan, practice and crisis intervention skills
volatile situations, using a range of supports and services following a
5. Notifies more senior professionals 5. Monitors research and introduces
verbal and non-verbal communication crisis, as necessary
or relevant services and support new evidence-informed crisis
skills
systems if risk factors, signs or management approaches and
symptoms appear to be present 7. Supports people in crisis, promoting techniques, as appropriate
safety and stability for them, alone or
6. Describes the subtle and overt signs with their partners, children, families
of crisis or communities
7. Knows and applies safety screening, 8. Implements crisis prevention plans,
as appropriate where required
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 9FAMILIES, CAREGIVERS* AND SOCIAL SUPPORTS
Working collaboratively with individuals, families, caregivers, partners, Elders, groups and communities who are positioned to support the well-being goals of
people who use substances. It includes acknowledging families, caregivers and other people providing social support as partners in care and recognizing the
value of family-based interventions. Considers the role of other-than-human supports (e.g., companion and service animals, connections to nature, land-based
healing, etc.) in achieving well-being.
*Caregivers are often family members, but not always. They play a unique role that typically includes a variety of unpaid activities, from acting as informal case managers,
advocates and systems navigators, to monitoring symptoms and providing crisis intervention (Canadian Mental Health Association, 2006). Working collaboratively with
caregivers, when appropriate, can be a powerful resource for the service provider. See references to additional resources, below.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Engages with people and listens 1. Collaborates with people, their 1. Identifies and implements actions 1. Collaborates with people to develop
to gain insight into their lived and families, caregivers, partners and in collaboration with people that a deeper understanding of the
living experience of substance use, social support networks to: will lead to improved relationships family, caregiver, partner and social
challenges and goals for well-being a. Identify relevant power dynamics with family, caregivers, partners and support as a cohesive network, and
that help or hinder the development social supports to identify changes that could be
2. Engages people to identify
of healthy, supportive relationships made to improve the well-being of
resources, both internal and 2. Assesses the health of the family,
b. Assess the needs of all the people involved
external, that are shown to improve caregiver, partner and social
outcomes, which includes identifying and factor them into plans for support as a cohesive network 2. Conducts interventions in complex
meaningful sources of social support meaningful support of people and, and works with them to increase situations in which multiple
(e.g., family members, caregivers, when appropriate, their families, cohesion and build support for relationship, family, caregiver,
partners, Elders, friends, persons caregivers, partners and social the individual’s efforts to pursue partner or social support factors or
or groups within the individual’s support networks goals for well-being and develop risks are likely to have an impact on
community or network of social and implement an effective plan to one another
EXAMPLES
2. Facilitates dialogue with the
relationships) and resources such individual’s family, caregiver, partner achieve well-being 3. Supervises or coaches others
as access to safe and affordable and social support network to 3. Facilitates access to individual, developing and applying gender-
housing, income and employment improve: couples and family counselling and evidence-informed interventions
3. Engages with identified sources of a. Their understanding of the when such services are identified in their responses to complex
support to assess their willingness impact that substance use is likely as helpful in addressing relationship challenges impacting the family,
and suitability; collaboratively to have on them and their support concerns caregiver, partner and social support
develops a plan of engagement to for the individual network
4. Assists in rebuilding trust and
ensure that supportive relationships b. Their understanding of and ability stability in relationships affected by 4. Develops strategies to promote the
are not excluded for self-care the individual’s substance use value of well-being within the family,
4. Demonstrates an understanding c. Their ability to access services caregiver, partner and social support
5. Works with people and their
of the role and contribution of they need to support themselves network
families, caregivers, partners
caregivers, and recognizes the and their efforts, referring them to
and social support networks to 5. Develops and promotes anti-
value of engaging them in the other resources, as required
collaboratively develop support stigma initiatives and includes
development of person-directed plans for family members, family members, caregivers,
care plans that involve family, caregivers, partners and others partners and social supports in the
caregiver, partners and social supporting the individual, when design, delivery and evaluation of
support, where appropriate needed and identified, including these initiatives (e.g., Moms Stop
5. Collaboratively and regularly reviews consultations and referrals, when the Harm, Families for Addiction
the engagement of people involved appropriate Recovery)
in the individual’s support network to
respond to people’s changing needs
over time
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 10FAMILIES, CAREGIVERS* AND SOCIAL SUPPORTS
Working collaboratively with individuals, families, caregivers, partners, Elders, groups and communities who are positioned to support the well-being goals of
people who use substances. It includes acknowledging families, caregivers and other people providing social support as partners in care and recognizing the
value of family-based interventions. Considers the role of other-than-human supports (e.g., companion and service animals, connections to nature, land-based
healing, etc.) in achieving well-being.
*Caregivers are often family members, but not always. They play a unique role that typically includes a variety of unpaid activities, from acting as informal case managers,
advocates and systems navigators, to monitoring symptoms and providing crisis intervention (Canadian Mental Health Association, 2006). Working collaboratively with
caregivers, when appropriate, can be a powerful resource for the service provider. See references to additional resources, below.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
6. Obtains consent from people about 3. Assesses risks to safety and well- 6. Advocates at municipal, provincial
who, from their support network, being of children, dependents, and federal levels for recognizing
should be consulted and in what family members, caregivers, and respecting families, caregivers,
circumstances, except where duty partners and any other people in the partners and social supports as
to report requirements overrides individual’s network of social support central to an individual’s well-being
consent; ensures the people so relationships (e.g., risks of intimate in a way that is respectful to people
identified are kept informed of any partner violence; child abuse, etc.); experiencing substance use
developments in the individual’s and when assessed risks are high, 7. Educates individuals, families,
goals for well-being takes appropriate next steps (i.e., caregivers, partners and social
duty to report)
7. Where a decision to exclude certain supports about adverse childhood
family members, caregivers or 4. Advocates for unique and creative experiences and directs people
partners occurs, engages further supports in response to individualized and service providers towards
with people to gain insight and situations and needs evidence-informed approaches (e.g.,
EXAMPLES
listens to enhance understanding trauma- and violence-informed care
5. Recognizes that it is sometimes
about these relationships models; sex- and gender- informed
necessary and appropriate for the
approaches)
8. Initiates contact with family, individual to disengage from family,
caregivers, partners or social friends, caregivers, partners or 8. Explains and advocates for the
support network for input, where other social relationships, and the support of caregivers and their
appropriate challenges in doing so; facilitates and unique role as partners in care
supports a healthy transition from, or and their involvement in policy
9. Educates family, caregivers, partners
closure to, such relationships development
and social support network on
evidence-informed practices and 6. Recognizes when it is appropriate
services and necessary to respectfully bring
closure to the therapeutic relationship
10. Recognizes the significance of
with the individual, their family,
family, caregiver, partner and social
caregiver, partner or social support
support relationships, including
network
other-than-human supports (e.g.,
companion or service animals), to
achieving and managing well-being
and preventing recurrence; involves
these supports throughout the
process of prevention planning as
well as before and after access to
services
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 11FAMILIES, CAREGIVERS* AND SOCIAL SUPPORTS
Working collaboratively with individuals, families, caregivers, partners, Elders, groups and communities who are positioned to support the well-being goals of
people who use substances. It includes acknowledging families, caregivers and other people providing social support as partners in care and recognizing the
value of family-based interventions. Considers the role of other-than-human supports (e.g., companion and service animals, connections to nature, land-based
healing, etc.) in achieving well-being.
*Caregivers are often family members, but not always. They play a unique role that typically includes a variety of unpaid activities, from acting as informal case managers,
advocates and systems navigators, to monitoring symptoms and providing crisis intervention (Canadian Mental Health Association, 2006). Working collaboratively with
caregivers, when appropriate, can be a powerful resource for the service provider. See references to additional resources, below.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
11. Demonstrates an understanding
of the bi-directional impact of an
individual’s substance use on family,
caregiver, partner and social support
relationships, and how those
relationships impact an individual’s
substance use; engages the
individual’s family, caregiver, partner
and social support relationships in
supporting well-being
12. Describes the process of navigating
and accessing gender- and culturally
sensitive community resources that
EXAMPLES
are available to people and their
families, caregivers, partners and
social support networks
13. Engages with families, caregivers,
partners and social support
networks in a courteous, helpful and
professional manner, recognizing
them as partners in achieving
collaborative goals for well-being
14. Engages people in accessing family-
based interventions and resources
for well-being
15. Educates the individual and their
families, caregivers, partners or
social support networks about
evidence-informed practices,
services, approaches and
interventions
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 12FAMILIES, CAREGIVERS* AND SOCIAL SUPPORTS
Working collaboratively with individuals, families, caregivers, partners, Elders, groups and communities who are positioned to support the well-being goals of
people who use substances. It includes acknowledging families, caregivers and other people providing social support as partners in care and recognizing the
value of family-based interventions. Considers the role of other-than-human supports (e.g., companion and service animals, connections to nature, land-based
healing, etc.) in achieving well-being.
*Caregivers are often family members, but not always. They play a unique role that typically includes a variety of unpaid activities, from acting as informal case managers,
advocates and systems navigators, to monitoring symptoms and providing crisis intervention (Canadian Mental Health Association, 2006). Working collaboratively with
caregivers, when appropriate, can be a powerful resource for the service provider. See references to additional resources, below.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
16. Demonstrates an understanding of
the significance of non-judgmental,
gender- and culturally sensitive
and collaborative support for the
individual
17. Respects and recognizes people’s
autonomy in decision making around
EXAMPLES
goals for well-being
18. Demonstrates an understanding of
the indications and contraindications
for family-based interventions
19. Articulates the four types of family
work:
• family orientation
• family education
• family counselling
• family therapy
ADDITIONAL RESOURCES FOR FAMILY, CAREGIVERS AND SOCIAL SUPPORT COMPETENCY
Family Mental Health Alliance. (2006). Caring Together: Families as Partners in the Mental Health and Addiction System.
Ontario Caregiver Organization. (2020). Caregivers as Partners eLearning for Healthcare Providers (three 20-minute modules).
Mental Health Commission of Canada. (2013). National Guidelines for a Comprehensive Service System to Support Family Caregivers of Adults with Mental Health Problems and
Illnesses.
Mental Health Commission of Canada. (2020). Caregiver Mobilization Toolkit.
Ontario Centre of Excellence for Child and Youth Mental Health. (2019). Family Engagement (resource hub).
Vancouver Coastal Health. (2013). Family Involvement with Mental Health & Addiction Services.
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 13GROUP FACILITATION
Using evidence-informed approaches to work with people affected by substance use in group settings.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Explains the role of group 1. Explains the primary characteristics 1. Facilitates larger groups and groups 1. Demonstrates agility in facilitating a
approaches in working with people of a range of group facilitation with people with more complex variety of groups.
approaches needs using a range of proactive
2. Explains the differences between 2. Innovates, develops, adapts and
approaches and techniques to spur
group counselling, group therapy 2. Leads information sessions or applies group materials designed
and enhance group problem solving
and psycho-educational groups similar psycho-educational groups, to respond to a range of complex
and individual and group goal
consulting and debriefing with more situations, maintaining an evidence-
3. Supports more senior professionals achievement
senior colleagues informed approach
in facilitating group education, as
2. Designs and implements strategies
required 3. Screens and assesses group 3. Supervises or coaches other group
and techniques to meet group
members for suitability and facilitators to promote evidence-
4. Observes group sessions and needs
compatibility, consulting with more informed practices, gender- and
consults the lead about perceptions
senior colleagues 3. Continuously monitors and trauma-informed approaches,
of gendered and cultural group
assesses group dynamics to culturally responsive, high-quality
dynamics 4. Considers the need for groups that
maintain a safe, productive interventions, and adherence to
address gender, cultural, age and
5. Interacts with people in the group environment for all, intervening as service standards and program
racial discrimination; addresses
under close supervision by the lead necessary integrity
specific topics and advocates for
EXAMPLES
facilitator
such groups 4. Works to equalize power 4. Researches and promotes new
6. Explains behaviours that lead to and gendered imbalances in evidence-informed approaches
5. Encourages the development of
positive change and those that may relationships within the group to group facilitation by explaining
healthy social skills in all group
impede change and demonstrating techniques
members 5. Acquires expertise in the delivery
7. Ensures the group setup is and approaches and by sharing
of groups that meet the needs of
6. Engages with groups and develops resources with others
conducive to safety and promotes specific populations
rapport by using a range of facilitative
positive interactions for all 5. Leads in developing and
techniques 6. Intervenes appropriately and
8. Explains the principles of adult implementing groups that address
decisively if a crisis is developing
7. Encourages and models healthy specific needs and topics, such as
learning and education, and or escalating by being aware of
group dynamics groups for pregnant women at risk,
teaching theory and methods and attending to the group process
8. Adjusts facilitation style and women with a child with fetal alcohol
(e.g., by ending the session early or
approach to address individual syndrome disorder, women who
separating or temporarily removing
behaviours that pose challenges in have experienced violence, men with
members of the group)
promoting positive group interactions trauma histories, young gay men, etc.
7. Assesses and reconfigures groups,
9. Identifies and responds to gendered as required, to improve group
group dynamics that can result in functioning and address individual
silencing or unequal attention given needs
to group members
10. Facilitates manual-based groups with
fidelity to the manual; consults senior
staff or leadership if deviating from
the manual
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 14MEDICATIONS
Explains the use of medications in the treatment and management of substance use and mental health conditions and responds to ongoing needs related to
medication management and treatment.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Explains in general terms the type of 1. Explains the way that medications 1. Provides most current evidence 1. Applies comprehensive knowledge
medications that are the most prone that alter mood, behaviour and and information about available about the use of medications in
to producing dependency and those cognitive processes are: approaches (e.g., harm reduction; treating substance use in:
that are used: a. Administered sex specific) or practices for a. Working with people
a. To treat substance use b. Likely to interact with other the use of medication to treat b. Supervising or coaching others
b. To address mood, behaviour substances, including alcohol substance use or concurrent c. Overseeing or reviewing
and cognitive processes conditions treatment plans
And explains the impact:
c. To treat pain 2. Explains with accuracy and detail d. Collaborating and networking
c. When use of the drug is stopped
d. To treat co-related conditions, how medications that affect mood, e. Advocating for evidence-
d. When the drug is used
like organ failure, heart and lung behaviour and cognitive processes: informed practices
improperly
diseases, hepatitis, HIV and AIDS, a. Affect females and males
etc. 2. Reviews research about physiologically and neurologically 2. Builds and maintains a network
medications, such as methadone or b. Can have different impacts of resources skilled in the area
2. Explains the common side effects of medication management and
buprenorphine, that are used to treat depending on how they are
of medications used to treat interventions
substance use administered (e.g., dosages,
substance use and the potential
EXAMPLES
3. Consults with professionals forms of medication, etc.), and 3. Educates or arranges for
sex-differentiated impacts of using
prescribing medications, when their benefits and drawbacks professional development of others
them incorrectly
necessary c. Can have an impact on on the: types of medications that
3. Explains the signs and symptoms of people if taken alone or if taken mitigate or aggravate issues related
adverse drug reactions, and consults 4. Discusses with people their right to to substance use, and the sex and
in combination with other
with more senior professionals if use or not use medications gender factors affecting the use and
substances, including alcohol
adverse reactions are suspected 5. Supports individual access to prescription of medication
3. Identifies women, men and
4. Monitors people for signs of prescribed medications where 4. Initiates, facilitates or leads in
gender-diverse people who could
incorrect use of medication, barriers are present developing and implementing
potentially benefit from augmenting
and consults with more senior evidence-informed practices and
other treatment approaches with
professionals if incorrect usage is policies that support the innovative
medications
suspected use of medications in treating
4. Collaborates with people, teams substance use
5. Explains prescription take-back and medical professionals to:
initiatives a. Incorporate medications into
individual treatment plans, if
appropriate
b. Monitor the impact of
prescribed medications
5. Assesses people to identify
symptoms of adverse reactions for
overuse or misuse of medications
and initiates consultation
with medical professionals or
emergency medical services, as
required
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 15OUTREACH
Designing and delivering evidence-informed substance use services in the community to a broad range of people, including those who might otherwise not
seek or have access to those services.
1 = Foundational 2 = Developing 3 = Proficient 4 = Advanced
1. Explains in general terms: 1. Adheres to evidence-informed 1. Engages with others in the 1. Promotes, supports and enhances
a. What outreach is and the role practices in delivering or assisting in community: a variety of outreach services in the
it plays in expanding access the delivery of a range of substance a. To develop a thorough community, adhering to standards
to treatment and to primary, use services, often as part of a multi- understanding of local outreach and evidence-informed practices
secondary and tertiary prevention disciplinary team needs and gaps in services 2. Mobilizes multi-disciplinary
b. The type and range of outreach 2. Creates rapport with people by b. To develop and deliver teams composed of substance
activities interacting with them in their outreach activities aligned with use professionals, community-
c. What is meant by “marginalized preferred setting and acting in a evidence-informed practices and based resources and other related
populations,” and where those manner appropriate to that setting appropriate to target populations professionals, as required
populations are best reached and
3. Interacts with outreach contacts 2. Participates in evaluating outreach 3. Reviews evaluations of referral
served (e.g., Indigenous peoples,
using trauma-informed practice services, including those provided outcomes and, if appropriate,
racialized groups, etc.)
to avoid triggering negative or by the professional’s organization provides feedback to organizations
d. The type of substance use potentially dangerous responses and those provided by others in the or professionals
issues typically seen in various community
populations, including those 4. Collaborates with people to identify 4. Collaborates with and leads a
individual and overall needs of the 3. Evaluates the outcome of an range of community organizations
EXAMPLES
marginalized, stigmatized or
otherwise underserved outreach population with a gender individual referral to a community to develop outreach programs that
and cultural lens resource and brings related issues build on community strengths and
2. Provides support to outreach to the attention of more senior address community needs
5. Attends to the safety of all parties
workers and multi-disciplinary teams professionals, if appropriate
involved in outreach, including 5. Conducts research, applies sex-
3. Maintains contact with self, when planning and delivering 4. Applies a sex- and gender-based and gender-based analysis and
representatives from a wide range of outreach services analysis to identify barriers to collaborates with others to identify
community services accessing services and supports, outreach services with particular
6. Promotes health equity through
4. Recognizes and maintains personal and takes action to reduce those consideration for Indigenous and
assisting people to access
health and safety protocols when barriers racialized groups and ways of
appropriate services to improve their
working in the community bridging gaps to provide more
social determinants of health
comprehensive outreach services
7. Uses appropriate approaches
6. Prepares and delivers disaggregated
(e.g., gender- and trauma-informed
research findings and education to
approaches, brief intervention,
appropriate stakeholder groups (e.g.,
culturally responsive approaches,
community, funders, politicians,
etc.) when working with people who
peers at conferences, etc.) and,
experience barriers to engagement
when possible, contributes to peer
reviewed publications
© Canadian Centre on Substance Use and Addiction, 2021 Technical Competencies for Canada’s Substance Use Workforce 16You can also read
