Assessing Practitioners and Organizations Competencies
Workforce development initiatives are more clearly defined when states and communities have information on how services are provided. Conducting organizational assessment provides this information. Organization assessments measure agency-wide operating procedures and components of the treatment process. Assessment information identifies strengths and weaknesses and informs training plans for providing evidence-based, integrated services for co-occurring disorders.
Examples of instruments can be used to assess organizations include:
- Integrated Treatment for Co-Occurring Disorders Fidelity Scale (IDDT) (PDF - 1.31MB)
- Co-morbidity Program Audit and Self-Survey (COMPASS)
- Dual Diagnosis in Addiction Treatment (DDCAT) (PDF - 370Kb)
- Dual Diagnosis in Mental Health Treatment (DDCMHT) (PDF - 373 Kb)
It may make sense to use more than one assessment tool; different tools may be most useful at different stages of organizational change. Some organizations suggest that the COMPASS is most useful early in the process of organizational change, while other tools such as the DDCAT are more useful at later stages of changes. The tools are largely compatible and complementary.
Some states have reviewed available tools and created an instrument specific to the individual needs in the state. For example, Maine developed its own tool, called the Maine Organizational Assessment Tool, and requires all agencies to use it to assess their competency level.
Results of organizational assessments can also be used to create action plans for supporting organizational changes. For example, in South Dakota, agencies are asked to develop a COMPASS-based Quality Improvement Action Plan as part of the accreditation process. Results are reported through an online survey. In South Carolina, state employees complete the DDCAT with each agency, pull together findings in a single report, and follow up with technical assistance to support organizational change.
It is important to assess competencies in a way that reduces anxiety and maximizes positive interest in the implications of the findings for quality improvement. Vocabulary and approach make a difference in working with organizations on assessment. One idea is to frame the assessment as a "consultation" rather than an audit and stress that the process is intended to reinforce agencies' own self-improvement initiatives.
In addition to organizational assessments, states assess practitioner performance using standardized instruments such as the Co-Occurring Disorders Educational Competency Assessment Tool [CODECAT™]. Others assess practitioner competencies more informally through supervision, learning communities, and routine interactive training. Some states and communities are actively exploring Web-based platforms for administering practitioner training and assessing knowledge gained. For example, New York State has developed a Web-based learning system.
Resources and Links
The CODECAT presents principles for the treatment for co-occurring disorders, identifies the expected clinician core competencies associated with each principle, and provides a format for either supervisory evaluation or clinician self-evaluation of these competencies.
This tool assesses attitudes, values, skills and knowledge of staff working with clients with co-occurring disorders. It was adapted from the CODECAT.
This document sets out practitioner competencies needed to deliver co-occurring disorder treatment in Minnesota. It was developed using criteria from the DDCAT and DDMHT.
Competencies for Providing Services to Individuals with Co-Occurring Mental Health and Substance Use Disorders Direct Care Staff Evaluation Tool
Connecticut's staff evaluation tool of basic, intermediate, and advanced competencies
Co-occurring mental and substance abuse disorders: a guide for mental health planning + advisory councils
A guide to help state mental health planning and advisory council members and others assess the programs and services in their state plans for people who have co-occurring mental and substance abuse disorders.
An essential planning tool for organizations considering integration
Tools for supporting integrated COD services