It's that time of the year again for New Year’s Resolutions. America starts 2009 with a new President, new elected officials and the new addiction parity law. There continue to be many changes and challenges in the addictions field. Another year has past, and some of my 2008 resolutions remain unresolved.

The field remains divided over credentialing and we lack a unified national voice. The field is one year closer to many of us retiring. A new Center for Substance Abuse Treatment, Treatment Improvement Protocol (TIP) on Clinical Supervision will be released in 2009. I was proud to have been the chair of that TIP, which is most likely my last publication on clinical supervision. In 2010, I will “hang up my PowerPoint” and stop doing most of the clinical supervision training I’ve done for 34 years. The field has yet to address the key issue of leadership succession as we face a major shortage in human resources and leadership succession over the next four years. So, the following are my top 10 resolutions for 2009.

1. Implement the Parity Bill. On October 3, 2009, the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008 takes effect, one year from the date it was signed. The bill is not a mandate requiring that coverage be provided for substance abuse treatment. Therefore, the next step will be to impact the procedure writing process so that the intent of the legislation is breathed into the procedures. It is imperative that every person reading this column be involved in implementing this key legislation.
2. Succession planning. We need to better prepare the next generation of leaders in the field. There will be an enormous brain-drain in the field as leaders retire. We need to invest heavily in training clinical supervisors and middle managers so they can soon ascend to the senior management positions that will be vacated by departing leaders. The North Carolina Fellows Program and the Addiction Technology Transfer Centers’ (ATTC) Leadership Development courses, and other initiatives can serve as national models for leadership development.
3. Recession proofing. Needless to say, we are in difficult financial times. Funds for training are limited. Staff is being cut back through attrition. Some organizations have relied on patient self-payment for services. We have been here before, in the 1990s, as managed care greatly impacted the field. Let’s not make again the mistakes of the 1990s when programs either went away or got into areas of treatment for which they were not qualified. Leaders need to find ways of “trimming the program fat” without “cutting the bone of quality care.” This is a critical time when leadership and vision is needed.
4. Remember. We have been here before. We must remember our founding “fathers and mothers” who got us here. When I present, I often mention names such as Marty Mann, Selden Bacon, Max Weisman or Senator Harold Hughes. Glazed eyes in the audience stare blankly back at me, unknowingly, unsure of whom I speak. What is frightening is not just that people do not know the names of our founders, they don’t seem to care about the past. Ernie Kurtz, one of the field’s greatest historians, said, “Without memory, there is no hope.” As the “new broom of the field sweeps clean,” we must retain the memory of our past so we can grow into the present and future.
5. Be creative. Training funds are scarce. We must find creative ways of training to maintain the clinical skills of our professionals. We need to explore alternative mechanisms, such as online courses (i.e., www.dlcas.com), synchronistic and asynchronistic training methods (as used for example by CARF), telemedicine and consulting (as the medical profession has embraced in recent decades). Although these mechanisms may be expensive, untrained and ill-equipped professionals are an even greater hazard to the field. Consider training as “the cost of doing business.”
6. Stress clinical supervision. Counselors learn by doing, with a master clinician looking over our shoulder, providing us counsel and support. The better the supervision, the greater staff retention. The better the supervision, the better staff morale. And, there is data to suggest, the better the supervision, the greater client satisfaction and retention. Now, there’s a bottom-line payback! Supervisors need further training and supervision of their supervision (SOS). For information on SOS systems, contact me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
7. Keep your eyes on the prize, the patients. In lean times, it is tempting to forget why we do what we do. Never forget that you are in the field to help the alcoholic and drug abuser. The minute you lose sight of that fact, you should be selling hamburgers. Keep your eyes always on the patients by going to alumni reunions, sobriety anniversaries, any gathering of people in recovery.
8. Remember what matters, our relationship with clients. Relationships heal, not techniques. Learn every evidence-based practice you can. However, never forget that techniques and skills are only tools in the hands of caring people who build a relationship first. Counsel from your heart, not your head.
9. Strengthen your own vessel first so you can carry more light. Self-care is oft spoken of and seldom practiced, especially by the leaders in the field. Remember, you can’t take a person to a place you haven’t been. Healers cannot heal from beyond whom they have become. We heal out of who we are. Take care of yourself, mentally, emotionally, physically, and most importantly, spiritually; always remember not just how to live but why you live.
10. And finally, my annual plea: Unify the field. Counselors should pressure their trade, credentialing and constituency organizations to finally merge the credentialing processes. I will likely retire long before the field is unified and the credentialing groups merge. But I will continue to advocate for such action.

I welcome your ideas, responses, and New Year’s resolutions for the field. Please write me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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Manabugsy2   |68.231.19.xxx |2009-02-10 21:28:08 go Reply 0   0

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