Becoming a Clinical Supervisor in Nevada: New Information You Need to Know

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Becoming a Clinical Supervisor in Nevada: New Information You Need to Know

Newly Revised Content!

If you are a behavioral health provider who has ever thought about becoming a clinical supervisor for substance abuse counselors, this post should have some great information about what clinical supervision is, the purpose of clinical supervision, some of the goals of clinical supervision, and some of the roles and responsibilities of a clinical supervisor. In addition, you will learn about recent changes in Nevada laws, changes to the Licensed Alcohol and Drug Certification (LADC) Board website and regulations, and several resources and training opportunities for becoming a clinical supervisor.

New Requirements in Nevada for Becoming a Clinical Supervisor

To become certified as an Alcohol & Drug Counselor Internship Supervisor, the following requirements must be met:

    • An LADC/LCADC must be licensed for two years and a CADC must be licensed for three years prior to applying to become a clinical supervisor.
    • Complete both classes in the following Clinical Supervision training series:
      1. 14-hour online Clinical Supervision Foundations Course hosted on the Healthy Knowledge Website.
        Note: this course is not hosted by CASAT. Questions about this course can be directed to 1-844-284-9616.
      2. Complete the Clinical Supervision for Alcohol and Drug Counselors 12 hour course with CASAT Learning. This course is offered twice per year alternating between online and in-person.
    • Submit your application for Supervisor Certification, along with you certificates of completion from the above trainings, to the Board of Examiners for Alcohol, Drug and Gambling Counselors office via your LICENSEE portal. There is a $60.00 processing fee for the application.

Requirements in Nevada for Renewing a Clinical Supervisor Certification

For existing Clinical Supervisors seeking to renew your certification with Board of Examiners for Alcohol, Drug and Gambling Counselors, the following requirements must be met:

    • Complete the Clinical Supervision Refresher 6 hour course with CASAT Learning. This course is offered twice per year alternating between live webinar and in-person. CASAT Learning now offers a self-paced, online Clinical Supervision Refresher course.
    • Submit your renewal application, along with your certificate of completion from the above training, to the Board of Examiners for Alcohol, Drug and Gambling Counselors office via your LICENSEE portal.

New Information For Alcohol and Drug Counselors

Last year, the Board of Examiners for Alcohol, Drug, and Gambling Counselors moved to a new online portal for all business related to applications and licensing and you should have received an email from nvadg@thentiacloud.net with instructions to activate your account. For current licensees and interns, the LICENSEE portal will allow you to update your contact information, place of practice, supervision agreements, as well as renewals. If you have not done so already, please click ‘activate now’ using the email address on file with the Board. Note: If you are unsure which email address is on file, please email Paula at licensingspecialist@adgc.nv.gov for assistance as you will not be able to login with any other email address.

  • For those wishing to test for certification/licensure, please navigate to the APPLICATION portal and login with the same login information you use for the Licensee Portal as they care separate, but connected.
  • For prospective interns or licensees, please create an account in the Application portal in order to begin the application process. Also note the flowcharts here to better understand the requirements for each credential.

Pathways to Licensure and Certification

In the Catalyst blog post from November 18, 2020: Choose Your Pathway To An LADC, LCADC, CADC, or CADC-I in Nevada: Featuring Brand-New Flowcharts for Each! The pathways are clearly outlined in flowcharts that were developed by CASAT for  LADCLCADCCADCCADC-I, and Nevada Certified Problem Gambling Counselor. Alcohol & Drug General Information and all of the flowcharts may also be downloaded from the State of Nevada Alcohol & Drug Abuse Counselors website.

To learn about obtaining a Certified Prevention Specialist (CPS) certification in Nevada, first read the Catalyst blog post Prevention Specialist Certification: What Is It and Why Do I Need It? 10 Reasons to Become a Certified Prevention Specialist

A Great Resource for Additional Information

One excellent way to find out more about clinical supervision is to access the National Frontier and Rural Telehealth Education Center (NFARtec). The NFARtec techies people how to use telehealth technologies to deliver addiction treatment and recovery services, and that includes clinical supervision. The Technology-Based Clinical Supervision Guidelines are downloadable from the NFARtec website or by using this link (Barton et al., 2016). The document provides background and history of technology-based clinical supervision, the many benefits of using technology to deliver it, and clearly outlines the support and infrastructure needed to deliver clinical supervision through the use of technology.

Applicable Board Meetings and Regulations

All Nevada Board meeting scan be found on the Board Meetings page of the Nevada State Board of Examiners for Alcohol, Drug and Gambling Counselors website.

Applicable regulations can also be found on the Regulations page of the Nevada State Board of Examiners for Alcohol, Drug and Gambling Counselors website. Please note that the Board voted to adopt a temporary regulation allowing clinical supervisors to electronically supervise their interns due to the pandemic. The Board voted to make the temporary regulation permanent on August 31, 2021. Please be aware that follow-up workshops will be coordinated by the Board prior to November 2021, so watch for notice of those tentative workshops. The temporary regulation can be viewed on the Nevada State legislature Register. Note that since the new telehealth regulation does not currently include being able to use telehealth supervision for employees who are not employed at the same agency as the supervisor, there is some confusion and clarification should be forthcoming in announcements of upcoming Clinical Supervision trainings sponsored by CASAT Learning.

Training Opportunities

CASAT Learning is offering a Clinical Supervision webinar series starting on March 2, 2022.  Clinical Supervision for Alcohol and Drug Counselors will be a 6-week live webinar series from March 2 – April 6, 2022, every Wednesday from 10:00 am – 11:30 am PST. This 12 CEU course will be presented by Amanda Hankins, CADC-S and Nick Tangeman, MSW LADC-S. The objectives of the training are to facilitate development of a personal model of supervision and practice skills to deliver high quality, effective clinical services to those seeking assistance for substance use disorders. This training prepares clinical supervisors to observe job performance, provide feedback and coaching, prioritize learning needs, develop achievable learning objectives, and continue monitoring performance to assess effectiveness. For more information about key topics/concepts and to register, please visit the CASAT Learning Website.

For existing Clinical Supervisors in Nevada seeking to renew their license, checkout CASAT Learning’s 6 CEU, self-paced online course, Clinical Supervision Refresher.

Clinical Supervision Resources and References

TAP 21-A: Competencies for Substance Abuse Treatment Clinical Supervisors lists competencies for effective supervision in substance use disorder treatment programs. It provides step-by-step guidance for implementing comprehensive supervisory training and workforce development.

Performance Assessment Rubrics Developed as a companion product to TAP 21. It describes counselor/clinician proficiency along a continuum marked by four distinct benchmark descriptions of counselor ability for each of the competencies. Such a continuum is referred to as a rubric. More will be said about the continuum later.

TIP 52: Clinical Supervision and Professional Development of the Substance Abuse Counselor offers tips for clinical supervisors in the substance use disorder treatment field. It covers functions of a clinical supervisor, and highlights stages of professional development for counselors and clinical supervisors.

TIP 61: Behavioral Health Services for American Indians and Alaska Natives provides behavioral health professionals with practical guidance about Native American history, historical trauma, and critical cultural perspectives in their work with American Indian and Alaska Native clients. The TIP discusses the demographics, social challenges, and behavioral health concerns of Native Americans. It highlights the importance of providers’ cultural awareness, cultural competence, and culture-specific knowledge. The TIP also helps administrators, program managers, and clinical supervisors foster a culturally responsive environment for American Indian and Alaska Native clients. Specific topic areas include workforce development strategies, program and professional development considerations, and culturally responsive policies and procedures.

ATTC Products

Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA:STEP) (Developed by Global ATTC) The MIA:STEP Blending Team designed empirically supported mentoring products to enhance the MI skills of treatment providers, as well as supervisory tools to fortify a supervisor’s ability to provide structured, focused, and effective clinical supervision. MIA:STEP introduces an effective strategy for observation-based clinical supervision, the use of which has potential to improve counselor skills beyond MI.

Clinical Supervision Foundations This course consists of two interconnected components: an online course and a face-to-face training and is intended for supervisors in substance use disorder (SUD) treatment and recovery settings. The course totals 30 contact hours and introduces clinical supervisors, along with persons preparing to become supervisors, to the knowledge and skills essential to the practice of supervision. The Clinical Supervision Foundations course is especially suited for: Beginning clinical supervisors; Clinical Supervisors who would like to enhance or review the fundamental skills needed to be a successful clinical supervisor; Counselors who are being groomed to become clinical supervisors; and Behavioral healthcare professionals who want to learn more about clinical supervision.

Additional ATTC products can be found in the Products & Resources Catalog.

Books and articles for Further Reading on Clinical Supervision:

Barton, T., Roget, N. A., & Hartje, J. (2016). Technology-Based Clinical Supervision: Guidelines for Licensing and Certification Boards. Reno, Nevada: National Frontier and Rural Addiction Technology Transfer Center, University of Nevada, Reno.

Bernard & Goodyear, B. (1998). Fundamentals of Clinical Supervision. (2nd ed.). Boston: Allyn & Bacon.

Gallon, S. (2002) Clinical Supervision: Building Chemical Dependency Counselor Skills. Portland, OR: Northwest Frontier

Powell, D. & Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods. San Francisco: Jossey-Bass.

Stoltenberg, C. D., & Delworth, U. (1987) Supervising Counselors and Therapists. San Francisco, CA: Jossey-Bass.

Stoltenberg, C. D., McNeil, B., & Delworth, U. (1998). IDM Supervision: An Integrated Developmental Model for Supervising

Counselors and Therapists. Jossey-Bass Publishers, San Francisco, CA.

Models of Supervision. Retrieved from the World Wide Web on September 22, 2005: http://soeweb.syr.edu/chs/OnlineField.supervision/models.htm

Links to New Nevada Legislation

SB 181 – Senate Bill No. 181 and Guide to Changes for SB 181

Your turn!:

For those who are already clinical supervisors, what are some of the rewards of being a clinical supervisor? What are some of the challenges? Please post your answers in our comments section

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Five Facts About the Brain and Addiction

Five Facts About the Brain and Addiction

The brain is a fascinating organ that governs many bodily functions. Thirty years ago, when brain  imaging studies compared the brains of those with addiction to drugs with those without an addiction, the changes made on the brain by drugs became evident and changed the course of research and the definition of substance use disorders (SUDs). While addiction was formerly thought of as a moral failing, the Brain Disease Model of SUDs has emerged due to further advances in imaging technologies and research  about the brain/addiction connection. As the research evolves to inform the field, greater awareness of brain function, genetic, and environmental factors is resulting in new insights, concepts for prevention, and treatment modalities for this complex, chronic – yet treatable – medical disorder  (Volkow et al., 2016).

Fact #1: Seeking and consuming intoxicating substances is not unique to humans. In the book Intoxication: The Universal Drive for Mind-Altering Substances, R.K. Siegel relates the results of 20 years of scientific and cultural research into the quest by animals for mind-altering substances (Siegel, R. K. (2005). The author declares that “We’re neither the first nor the most experienced species to develop a passion for drugs, yet, in mimicking the behavior of other animals through the millennia, we have become the most eager and reckless explorers of intoxication.” (Siegel, R. K., 2005, p. 10). From insects to rodents to primates and all species in between, “Seeking intoxication is the fourth drive” after hunger, thirst, and sex (Siegel, R. K., 2005, p. 10). The basis of this is that both animals and humans do things that give them pleasure. This is the body’s way of rewarding us for doing things that are good for us, such as eating, exercising, and sex. Drugs disrupt this natural system of positively reinforcing activities that are good for us. This system is illustrated below in the image from the National Institute on Drug Abuse (NIDA):

A picture containing diagram of the brain/dopamine reward system that is important for natural rewards such as food, music, and sex.

Fact #2: Using drugs can change the structure of your brain. Normal pleasurable activities cause the brain to release small amounts of the neurotransmitter dopamine. Because drugs, such as nicotine, cocaine, or marijuana, cause the brain to release larger amounts of dopamine than is normal, the brain adjusts to the higher levels of dopamine, requiring increasingly higher amounts of drugs to achieve the same pleasurable effect. When drug use becomes long-term, the number of dopamine receptors is reduced, or they make less dopamine. With toxic drugs, some neurons may die. The result is a reduced ability to feel pleasure through typically pleasurable activities, and needing drugs just to feel normal (NIDA: Brain and Addiction, 2020). Below is a series of brain scans from the NIDA website in which these brain changes can be very clearly seen:

A picture of a brain scan showing low dopamine D2 receptors during cocaine use, the same brain 1 month after cocaine use with partial recovery, and the same brain 4 months after cocaine use showing additional recovery.

A more detailed explanation of how the chronic disease of addiction physically changes the brain can be found in Inside the Addicted Human Brain, a presentation by Dr. Nora Volkow, Director of the National Institute on Drug Abuse at the National Institutes of Health. Dr. Volkow delivered the presentation at the USA Science & Engineering Festival on March 26, 2020.

Fact #3: Brain Changes caused by addiction make it more difficult for people to stop using addictive substances. While deciding to take drugs is a choice the first time, when a person continues to use drugs the changes that occur in the brain not only result in the SUD, but also affect that person’s ability to exert self-control. Changes in areas of the brain called the prefrontal cortex, which governs judgment, decision-making, learning, memory, and behavior control, can result in impulsivity, poor decision-making, and impaired self-control that make seeking treatment and maintaining recovery more difficult (Volkow et al., 2016; Siddiqui et al., 2008).

Fact #4: The brain is not the only factor that influences the development of a substance use disorder (SUD). In fact, there are many factors that influence the development of SUDs in addition to the response of the brain. Some of the biological factors that increase the risk of SUDs include:

  • Genetic makeup – genes are responsible for 40%-60% of the total risk for developing a SUD;
  • Developmental stage – development of the human brain is not complete until about age 25;
  • Gender – differences in epidemiology, biology, and treatment approach are significantly different for men and women, although more males than females develop SUDs;
  • Ethnicity – differences in metabolism and other physiological responses to substances.

Research has also identified environmental factors in the family, school, and community where a person lives that increase the risk of developing a SUD. Having family members with favorable attitudes towards alcohol or drugs or who use them problematically puts the children in the family at increased risk. Youth whose “peers use alcohol or other drugs (ATOD)” is also associated with great risk. A community where ATOD is – or is even simply perceived as – readily available puts children and youth in the community at increased risk. The NIDA graphic below provides a visual image of the interaction between biology, the environment, and the brain in the development of a SUD:

A diagram showing how the interaction between biology/genes, the environment, and drugs changes brain mechanisms to contribute to addiction.

Fact #5: Medication-Assisted Treatment (MAT) is the most effective treatment for SUDs. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment (MAT) is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. SAMHSA continues that “these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body” and when provided in the proper dose, “have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.” In the earlier blog post of October 8, 2020 New Research May Show Why Medication-Assisted Treatment (MAT) Is Not Catching On, this space described MAT and its benefits:

“Medication-assisted treatment (MAT) combined with counseling has been shown by research to be an effective treatment approach for people diagnosed with Opioid use disorder (OUD) (Sofuoglu, DeVito, & Carroll, 2018). As the Catalyst blog post Overcoming Barriers to MAT: Bridging the Gap Between Research and Treatment in Nevada described, the benefits of MAT include:

  • Improved survival
  • Increased retention in treatment
  • Decreased illicit opiate use
  • Decreased hepatitis and HIV seroconversion
  • Decreased criminal activities
  • Increased employment
  • Improved birth outcomes with perinatal drug users (The Connecticut Certification Board, 2018)

Three medications approved for use for opioid use disorder (OUD) are Buprenorphine, which works for medically supervised withdrawal and for maintenance, Naltrexone, which assists with preventing opioid dependence after medically supervised opioid withdrawal by blocking the effects of opioid agonists, and Methadone, which reduces opioid craving and withdrawal and blocks the effects of opioids.”

Yet an earlier Catalyst blog post from December 28, 2018 Overcoming Barriers to MAT: Bridging the Gap Between Research and Treatment in Nevada, barriers and solutions for implementing MAT were described. Additional information about MAT for Opioid Use Disorder (OUD) and Alcohol Use Disorder (AUD) can be found on the Substance Abuse and Mental Health Services (SAMHSA) Medication-Assisted Treatment (MAT) website.

For additional resources, visit the Resources & Downloads section of our website.

For professional development on addiction and the brain, resources are available through SAMHSA’s Technology Transfer Centers (TTC) Program:

Addiction Technology Transfer Centers (ATTC): The ATTCs support national and regional activities focused on preparing tools needed by practitioners to improve the quality of service delivery and to providing intensive technical assistance to provider organizations to improve their processes and practices in the delivery of effective SUD treatment and recovery services.

Mental Health Technology Transfer Centers (MHTTC): The MHTTCs work with organizations and treatment practitioners involved in the delivery of mental health services to strengthen their capacity to deliver effective evidence-based practices to individuals, including the full continuum of services spanning mental illness prevention, treatment, and recovery support.

Prevention Technology Transfer Centers (PTTC): The PTTCs develop and disseminate tools and strategies needed to improve the quality of substance abuse prevention efforts; provide intensive technical assistance and learning resources to prevention professionals in order to improve their understanding of prevention science, how to use epidemiological data to guide prevention planning, and selection and implementation of evidence-based and promising prevention practices; and develop tools and resources to engage the next generation of prevention professionals.

Ready to Learn More?

The Neuroscience of Addiction and Prevention LIVE WEBINAR

March 8, 2023 from 9:00 am – 10:00 am PST

The growing gap between biological and environmental evolution presents a unique opportunity for exploring the human brain, its strengths, and vulnerabilities in an interactive and stimulating way. To really understand substance use disorders (and use that understanding to increase resiliency) we must first understand the brain, especially the evolutionary constraints that have shaped its fundamental structures and functions. This presentation has been developed and repeatedly tested with different audiences by the presenter as a friendly yet rigorous science-based universal education and prevention tool. The presentation builds on the growing neuroscientific understanding of human behavior to explain the intrinsic vulnerabilities that emerge from the interaction between biological and environmental factors and the impact that drugs of abuse have on brain circuitry and behavior.

Presented by: Ruben Baler, Ph.D.

Dr. Ruben Baler joined the Science Policy Branch in NIDA’s Office of Science Policy and Communications in October 2004 as a Health Science Administrator. His early publications focused on gene promoter architecture and gene expression in the brain’s clock. At NIDA, he writes and lectures about the neurobiology of drug abuse and addiction for a range of audiences. Dr. Baler has gathered critical insight from diverse disciplines, which he combines to advance NIDA’s scientific mission as it intersects with cellular and molecular biology, genetics, immunology, bioinformatics, neuroscience, and neuroethics. Dr. Baler’s many contributions to other dissemination efforts include scientific writing (English and Spanish), teaching, public speaking to lay audiences, and fielding interview requests for a variety of print, radio, and broadcast media outlets. Prior to coming to NIDA, Dr. Baler worked at the National Institute of Mental Health, where he conducted basic research on the molecular basis of circadian gene expression in vertebrates. He received his Ph.D. in Microbiology and Molecular Biology from the University of Miami in 1993 and completed his postdoctoral training at the National Institute of Child Health and Human Development, specializing in Molecular Chronobiology.

Registration required: https://www.casatlearning.org/all/neuro-addiction

What facts can you share about the brain and its connection to substance use disorders? Please share in the comments below.

References

Goldstein, R. Z., & Volkow, N. D. (2011). Dysfunction of the prefrontal cortex in addiction: Neuroimaging findings and clinical implications. Nature Reviews. Neuroscience, 12(11), 652-669. https://doi.org/10.1038/nrn3119

Hall, W., Prof, Carter, A., PhD, & Forlini, C., PhD. (2015). The brain disease model of addiction: Is it supported by the evidence and has it delivered on its promises? The Lancet. Psychiatry, 2(1), 105-110. https://doi.org/10.1016/S2215-0366(14)00126-6

NIDA. 2020, February 25. The Neurobiology of Drug Addiction. Retrieved from https://www.drugabuse.gov/publications/teaching-addiction-science/neurobiology-drug-addiction on 2021, February 22 ……. https://www.drugabuse.gov/publications/teaching-addiction-science/neurobiology-drug-addiction

NIDA. 2020, October 7. Brain and Addiction. Retrieved from https://teens.drugabuse.gov/drug-facts/brain-and-addiction on 2021, February 24.

NIDA. 2020, July 10. Drugs and the Brain. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain on 2021, February 25.

Neurotransmitters and SUDS – Collaborating TTC: Southeast ATTC  Publication Date: May 24, 2019

Siddiqui, S. V., Chatterjee, U., Kumar, D., Siddiqui, A., & Goyal, N. (2008). Neuropsychology of prefrontal cortex. Indian journal of psychiatry50(3), 202–208. https://doi.org/10.4103/0019-5545.43634

Siegel, R. K. (2005). Intoxication: The universal drive for mind-altering substances. Inner Traditions/Bear & Co.

Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. The New England Journal of Medicine, 374(4), 363–371. – Download the Brain Disease Model of Addiction Research Update. Hazelden Betty Ford Foundation

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Showing 2 comments
  • Keith Drew
    Reply

    Nice post! Clinical Supervision training in Baltimore, MD, focuses on improving clinical skills and helps identify and improve problem areas.

    • Stephanie Pyle
      Reply

      Thank you! Glad you found the article useful.

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