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The NADD Competency-Based Clinical Certification Program

EXECUTIVE SUMMARY 

It is estimated that more than a million people in the US have a dual diagnosis of Intellectual or Development Disability (IDD) and Mental Illness (IDD/MI).  These individuals have complex needs and present clinical challenges to professionals, programs, and systems.  Clinicians face the challenge of diagnosing mental illness and providing appropriate mental health treatment for persons who have IDD/MI. 

NADD Competency-Based Clinical Certification Program

NADD, an association for persons with developmental disabilities and mental health needs, developed the NADD Competency-Based Clinical Certification Program  to improve the quality and effectiveness of services provided to individuals with a dual diagnosis through the development of competency-based professional standards and through promoting ongoing professional development. 

Advantages of Clinical Certification by NADD

Clinical certification through the NADD Competency-Based Certification Program validates and provides assurance to people receiving services, professional colleagues, employers, and third-party payers that a clinician has met the standards established by NADD for providing services to individuals with ID/MI.  Certification attests to the clinician’s competency in providing these services.  In addition to the prestige this Certification provides, it may benefit the clinician through greater employment opportunities, job security, and promotions.  The certification is portable; clinicians moving to a different region bring their certifications with them and do not have to demonstrate or re-document their competence simply because they have moved.

Competency Areas

The clinician seeking certification will be required to demonstrate mastery of the following five competency areas: 

• Positive Behavior Supports and Effective Environment

• Psychotherapy 

• Psychopharmacology 

• Assessment of Medical Conditions 

• Assessment 

Pre-Requisites for Certification: Training, Experience, References

To be considered for certification, clinicians must have one of the following licenses in the USA or Canada (equivalent accepted):  state/province license, i.e. Ph.D., Psy.D., or Ed.D. Psychologist; state/province license, BCBA, or governing body recognition as an Applied Behavior Analyst; State/province license as a Physician, M.D., D.O., MBBS, or equivalent; state/province license as a Master’s level:  Mental Health Counselor; Marriage & Family Counselor: Addictions Counselor; state/province license as a Licensed Clinical Social Worker; state/province license as a Physician’s Assistant, Advanced Practice RN, or Nurse Practitioner (or clinical equivalent); or other similar credentialing; equivalent determination resides with the NADD Competency-Based Certification Program.  Professionals with a Master’s level in a related field or RNs are eligible with additional experience and a through explanation of the experience base.

The applicant must have 5 years experience in support of persons with intellectual disabilities and mental health issues. This can include internships and externships. For applicants with a Master’s degree in a related field and for RNs, 7 years is required.

In addition to providing copies of the applicant’s curriculum vitae and professional license, the applicant must submit reference letters from three people able to provide a reference about the applicant’s clinical skills, knowledge and values and experience with persons who have a dual diagnosis. 

Work Sample

Once the application has been reviewed and the applicant has been found to meet the prerequisites, the applicant will receive instructions to submit one work sample of a case that demonstrates clinical work with an individual who has a dual diagnosis.  See Appendix C: Work Sample Guidelines.  The work sample should be no more than five pages in length and should include these five competency areas:

1. Formulation/conceptualization of clinical problem(s)

2. Format for therapy or intervention

   • What were the goals/expected outcomes for treatment or intervention?

   • Other treatments that were considered and rejected.

   • Why the selected treatment was chosen and why the rejected treatments were rejected.

   • Were there modifications or adaptations of standard treatment protocol in order to meet the unique treatment needs of this individual? If so, briefly describe these modifications/adaptations.

3. Landmark events or salient issues that arose during the course of treatment and how these were addressed within treatment.

4. Reflection on issues within therapy and/or ethical concerns and/or issues relevant to cultural competency.

5. How the clinical approach was informed by an understanding of intellectual disability or dual diagnosis.

Prior to submission of the work sample, the applicant should review the work sample to verify that the submitted content includes consideration of each of the targeted areas.

NADD will assign two examiners to review to work sample.  The work sample will be reviewed to determine whether the candidate demonstrates competency in the five competency areas.  If the work sample is found to be acceptable, the interview will be scheduled.

Interview

The final component of the certification process is an interview, which may occur in person, at a NADD conference, via web-based video conferencing, or by telephone.  The applicant shall be presented with a case vignette approximately 24-48 hours before the interview, about which he or she shall be asked to verbally offer their thoughts and reflections (i.e. provide a case formulation and treatment plan).  The applicant must bring a copy of the work sample submitted in support of the application for Certification and a copy of the vignette provided by NADD for the interview to the interview.  The same two examiners who reviewed the work sample will participate in the interview.  The interview shall also include resolution of any questions raised during other parts of the application process.  Interviews will generally follow the outline below. 

1. Discussion of applicant’s training and experience in dual diagnosis

2. Resolution of specific questions arising from application materials

3. Discussion of clinical case summary submitted with application.  This discussion can include all the elements of the outline in Appendix C as well as:

   • Diagnostic process including medical rule out

   • Assessment approach and considerations

   • Psychotherapy considerations, approach, complications, and response

   • Positive Environment. Role of environment in clinical considerations and recommendations for changes 

4. Discussion of case vignette presented just prior to interview

   • Applicant will be asked to present a case formulation

   • Applicant should be prepared to present a treatment plan 

   • Respond to questions about case formulation and treatment plan

     • These questions can cover any of the items in the outline in Appendix C

5. Candidates can expect the interview to include additional topics or areas that are consistent with current practice.  Some topics might include: self-determination, consumer decision-making/problem solving, person-centered planning, assessment, analog functional analysis of medication effects, etc.

6. Review expectations, procedure, and timetable for certification process

Credential

Clinicians who receive NADD clinical certification will be entitled to use “NADD-CC” as a credential. 

Cost

The cost of the NADD Competency-Based Certification is $375.00.  A non-refundable application/exam fee of $375.00 must accompany the application package.  The NADD Competency-Based Certification is good for two years.  The renewal cost is $100.00.  There is a continuing education requirement of 10 hours every 2 years in areas related to Mental Wellness and Mental Health for persons with IDD.