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Creating Incentives to Promote Workforce Development

Incentives may encourage practitioners to enhance their knowledge and skills for working with individuals with co-occurring mental and substance use disorders. Examples of incentives that States, communities and organizations provide include:


Practitioners from different systems of care may be trained in different fields and use different terminology, approaches and interventions. In some cases, credentials may bridge the differences and move systems of care towards a common service model. Credentialing may take different forms, either as an independent certification in co-occurring disorders available to practitioners in either mental health or substance abuse services or as an add-on to a licensed professional's existing credential.

Two levels of co-occurring credentials are now offered by the International Certification and Reciprocity Consortium:

  • Certified Co-Occurring Disorders Professional (CCDP) for associate and bachelor's level practitioners, and
  • Certified Co-Occurring Disorders Professional Diplomate (CCDPD), for master's and doctoral level practitioners.

These credentials were developed in Pennsylvania and were accepted by the International Certification and Reciprocity Consortium. The credentials have now been adopted by at least fifteen other states.


Many states have developed certification for practitioners providing services to individuals with co-occurring disorders. For example:

  • Oklahoma and New Mexico have established statewide certifications for Licensed Alcohol and Drug Counselors that include some COD competencies, but that are not a specific COD credential.
  • The District of Columbia developed an Educational Certificate in Co-occurring Disorders, a local practitioner's credential, which is jointly sponsored by the local mental health agency and the substance abuse agency.
  • In Virginia, an independent board offers certification by a process similar to securing a license. However, it is not associated with the state licensing process.
  • Minnesota is working to develop a certificate program open to both addictions and mental health counselors.

In some states certification is required. For example,

  • In Illinois, certification is required for individuals who provide co-occurring disorders services.
  • In Missouri, all major treatment organizations are required to become certified in co-occurring disorders.
  • In Delaware, all programs that receive funding from the State Mental Health Department must be certified in co-occurring disorders, and all licensed mental health practitioners will be encouraged to be COD certified.


Another strategy is to offer financial incentives to practitioners or agencies. Incentives may be training grants, enhanced rates or enhanced pay. For example:

  • Minnesota offers grants to help agencies move toward enhanced capability.
  • Connecticut offers higher rates for new residential programs with enhanced capabilities. It also gives an enhanced rate to agencies in which a minimum percentage of practitioners has completed training on co-occurring disorders.
  • Arkansas, New Mexico, and Virginia offer financial support to agencies that want to increase their skills, such as training grants or funding for consultants.
  • Louisiana offers enhanced pay to practitioners who attain a credential in co-occurring disorders.

Incentives are not sufficient if practitioners cannot be paid for treating individuals in an integrated way. Many states involved in improving services for individuals with co-occurring disorders work with State Medicaid agencies and third-party payers to address barriers to integrated treatment posed by billing requirements.

States also have undertaken work with Professional Licensing Boards to address regulations that may pose barriers to integrated work. Training can also address practitioner concerns by providing clear examples of how practitioners can provide integrated services consistent with their licenses. For example, while substance abuse counselors may not be allowed to prescribe medications or treat mental disorders, they can engage, educate and monitor warning signs for individuals with co-occurring disorders.

Resources and Links

  • A description of the purposes and elements of different types of licensing or certifications. Also includes information about risks and benefits of implementing licensing or certifications.

  • The page contains information about the experience, education, and other requirements for becoming certified in co-occurring disorders by the International Certification and Reciprocity Consortium, at either the Certified Co-Occurring Disorders Professional (CCDP) level or the Certified Co-Occurring Disorders Professional Diplomate (CCDPD) level.

  • The Connecticut Certification Board is an independent, non-governmental, 501(c) 3 nonprofit organization that offers certification for addiction counselors, clinical supervisors, co-occurring disorders and prevention professionals in Connecticut. The Board has established specialty certificates in substance abuse, co-occurring disorders, and problem gambling for professionals licensed and credentialed in other behavioral healthcare domains.