Profile - Substance Abuse Treatment and Rehabilitation in Canada

Professional development

Counsellor standards of practice and codes of ethics are reported to be generally prevalent and well communicated across the country, although it was noted that this extends only to those counsellors with a professional designation or those certified as counsellors by the national certifying body, the Addiction Intervention Association, with under 1000 counsellors currently certified.

Minimum qualification for substance abuse counsellors in government-funded agencies varies from none to a graduate university degree. The most stringent minimum requirements for counsellors in government-funded services are Nova Scotia's (Master's-level counselling degree), Newfoundland's (counselling degree with a professional designation) and New Brunswick's (Bachelor of Social Work). Minimum requirements for counsellors in other agencies were reported to be highly variable. The situation in Quebec is likely typical, where it is reported that better budgets assured for government-funded agencies allow them to recruit, train and retain more qualified staff than most private agencies can.

The formal certification of addictions counsellors was reported as an ongoing issue for staff of addiction treatment services except in Newfoundland, New Brunswick, Nova Scotia and British Columbia. A survey in Ontario found that 50% of the counsellors in specialized addiction treatment services were considering certification, although only 12% were certified at the time of the survey. However, most managers of addiction services did not require staff to be certified (Ogborne, Braun & Schmidt, 1996). Certification is an issue for governments or their agencies in Manitoba, Saskatchewan and the Northwest Territories. In Quebec, counsellors in the private sector view certification as an issue, as do a number of the government regional services organizations.

Entry-level training opportunities and resources were considered to be available in most regions except Newfoundland, New Brunswick, Nova Scotia, Saskatchewan and Yukon. As addiction services in most jurisdictions were folded into their associated ministries through the 1990s, centralized training that previously existed through these agencies dissipated. A portion of the need for basic and more advanced substance abuse counsellor training is being met by the 67 community colleges and universities across the country which sponsor course work in this area (CCSA, 1996). However, uneven access to training is noted in a number of recent investigations (Ogborne, Braun & Schmidt, 1996; Corbett, 1994; CCSA, 1997). McMaster University, in separate projects with the Canadian Centre on Substance Abuse and the ARF, has used Internet delivery for several of its courses as a way to increase professional development in this area. Currently McMaster is working with the ARF to compare different modes of course delivery including through the Internet.

In recent years, efforts have been made to advance the professional development of physicians on addictions issues. A 1989 meeting of Canadian medical educators contributed to increased attention to alcohol and drug problems in undergraduate medical school training - from approximately three hours of education to about eight hours - in subsequent years. The Canadian Society of Addiction Medicine, which represents 200 physicians identifying Addiction Medicine as their specialty, is promoting standards development in this area of practice. More recently, Health Canada has sponsored and coordinated a project to develop an interfaculty training plan for physicians, nurses and pharmacists. In Ontario, Project CREATE involves the development and evaluation of a common curriculum for medical students in the five Ontario medical schools.