1. Workforce Assessment COPSD Specialists in Texas Dick Spence 1 Laurel Mangrum 1 A.J. Ernst 2 Presented at the NASMHPD Research Institute (NRI) Conference, February 6, 2005, Baltimore, MD. 1 Addiction Research Institute, School of Social Work, University of Texas at Austin 2 Texas Department of State Health Services, Austin, Texas

2. Workforce Characteristics & Competence Self-Ratings Mental Health Settings vs Substance Abuse Settings

3. Methods Instrument: Co-Occurring Disorders Educational Competency Assessment Tool © (CODECAT) Minkoff & Cline, 2001. Measures competencies associated with the nine principles developed by the SAMHSA Managed Care Initiative on Co-Occurring Disorders (Minkoff, 1998). Population: Clinical specialists funded throughout Texas to provide treatment services to clients with Co-Occurring Psychiatric and Substance Disorders. (COPSD) A total population of 144 COPSD specialists were identified and recruited to complete the instrument on-line. 96 (67%) respondents completed the survey.

4. Workforce Characteristics Race/Ethnicity Mental Health Substance Abuse (n=42)(n=54) Race American Indian0%2% Asian American0%4% Black or African Am.13%16% White or Caucasian77%66% Other10%12% Ethnicity Hispanic17%22% No Significant Differences

5. Professional Experience and Training Mental Health Substance Abuse Number of Years Providing Counseling Services 10.58.5 Number of Years Providing COPSD Services* 2.41.7 COPSD Training Hours Over Past 12 Months 15 * p <.04

6. Professional Credentials ** p <.01

7. Education Levels ** p <.04

8. Self-Ratings -- Summary * p <.05 ** p <.02

9. Self-Ratings by Degree Level * p <.02 ** p <.003

10. Competency Self-Ratings Areas of: Knowledge, Skills, Attitudes, Values 1.Dual Diagnosis as Expectation, not an Exception 2.Subtypes of Dual Diagnosis 3.Emphathetic, Hopeful, Integrated, Continuous Relationships 4.Balancing Case Management and Care with Empathic Detachment, Consequences, and Contingent Learning. 5.Integrated Dual Primary Treatment 6.Disease and Recovery Model with Parallel Phases of Recovery and Stages of Change/Stages of Treatment * 7.Individualization of Treatment ** 8.Flexible Outcomes 9.Comprehensive, Continuous Integrated Systems of Care Differences between MH & SA providers (MH was lower) * p <.02 ** p <.003

11. Correlations of Self-Ratings with Experience and Training Summary Scores: Yrs Counseling Experience Yrs COPSD Experience Hrs COPSD Training Past Yr Attitudes and Values Total Score.04.31*.06 Knowledge and Skills Total Score.09.32*.27* CODECAT Total Score.07.30*.16 *p =<.04

12. Next Steps 1. Training responses for identified needs. 2. Conduct Time 2 CODECAT measurements 3. Evaluate Other Sources of Variation: Organizational and Clinical Variables Organizational Functioning (SOF) Treatment Process (CEST) Client Variables  Diagnostic Categories (MINI)  Symptom Severity (BDPRS, BSI)  Addiction Severity (ASI)  Readiness for Substance Abuse Treatment (SATS)