People with intellectual/developmental disabilities (IDD) in conjunction with mental illness (MI) are referred to as having a dual diagnosis. Individuals with an IDD are up to four times more likely to have some kind of psychiatric disorder than the general population, with as many as 40 percent experiencing symptoms associated with behavioral, mental and personality disorders. In the United States, more than one million people are considered to have both an IDD and mental illness.
Challenges Related to Delivering Service to Individuals With a Dual Diagnosis
Individuals with a dual diagnosis have multifaceted needs that present service challenges to the systems and professionals dedicated to providing them with support services and treatment. Even though an individual with IDD has an increased risk of having a psychiatric disorder, on many occasions, these disorders are not well supported or identified correctly. Behavioral problems often make providing the highest quality of care to an individual with a dual diagnosis extremely difficult. Therefore, providing adequate support for these individuals requires a specialist to understand and modify the existing support approaches and services to meet the specific needs of each person being served with a dual diagnosis. The National Association for the Dually Diagnosed (NADD) has created a certification review process to establish standards of practice for those serving individuals with a dual diagnosis.
The NADD’s Accreditation Dual Diagnosis Specialist Certification Program
The NADD Specialist Certification Program for Dual Diagnosis Specialists reviews and assesses the competence of professionals providing services to those who have an IDD in conjunction with mental illness. Professionals eligible for certification may train, manage, deliver and/or supervise the services delivered to individuals with these co-occurring conditions. Professionals include those who work in state, county or provincial government. These professionals include program directors, program supervisors and specialists, as well as care/case managers, peer specialists, support coordinators and trainers.
Benefits of Certification for the Specialist
Attaining NADD certification through the Dual Diagnosis Specialist Certification Program validates an individual’s expertise in providing care to those with IDD/MI, providing assurance to persons being served, employers and colleagues. Specialists who successfully attain their certification are recognized within the medical field by their ability to use the credential "NADD-DSS."
Benefits of Specialist Certification for Persons Being Served
- Ensure health care dollars are acquiring effective services.
- Improve the lives of individuals with IDD/MI.
- Provide the workforce with an established level of expertise related to serving those with a dual diagnosis.
- Assist support groups and families in making informed decisions about where to receive services.
Certification Is Awarded to Specialists Demonstrating Competency in Six Areas
Specialists seeking NADD certification must demonstrate mastery of the six competency areas listed below.
To attain NADD Dual Diagnosis Specialist Certification, an individual must demonstrate:
1. The Proper Use of Newly Emerging Best Practices
These practices include understanding when an assessment may be necessary, the reason for assessments and how to perform them. In addition, the specialist must recognize the connection between the assessment and service delivery.
2. The Multimodal Bio-Psycho-Social Approach
A specialist must demonstrate:
- Familiarity with the bio-psycho-social/multi-modal approach.
- The biopsychosocial approach methodically considers the complex interactions of psychological, biological and social factors as they relate to an individual’s health, illness and delivery of health care.
- The multi-modal approach is based on the notion that each human is a biological being that thinks, acts, feels, imagines and interacts. As such, psychological treatment must address each of these personalities (or modalities). When providing multimodal assessment and treatment, seven equally significant dimensions of modalities must be addressed. These seven dimensions are referred to by the acronym BASIC I.D.
- B for Behavior
- A for Affect
- S for Sensation
- I for Imagery
- C for Cognition
- I for Interpersonal Relationships
- D for Drugs/Biology
- Having knowledge of the bio-psycho-social/multi-modal approach allows the specialist to develop a service plan for the person being served that includes aspects of both recovery and resiliency.
- An understanding and appreciation for the holistic approach.
- The ability to identify inter-relationships among the individual’s social, biological and psychological domains.
- An appreciation for the environmental, individual and contextual learning styles.
- The ability to express information enabling the delivery of relevant/accurate psychiatric, psychological, medical and behavioral information to an individual’s other supporters/caregivers and/or specialists.
To attain NADD Dual Diagnosis Certification, a specialist must utilize all aspects of the bio-psycho-social/multi-modal approach as a guide for creating an individual’s service/treatment plan.
3. Build Rapport by Employing Respectful, Effective Communication
A specialist is required to demonstrate:
- An understanding of the importance of effective communication between supporters and stakeholders in relation to the care and well-being of the person being served.
- A realization that the person being served is ultimately in control.
4. Knowledge of Therapeutic Concepts
The specialist must establish that he/she has:
- An appreciation of neurosensory processing disorders.
- An understanding of how trauma affects the body and the brain.
- Useful knowledge related to psychotherapeutic skills.
- A grasp of genetic underpinning and the advances to guide an individual’s treatment.
5. The Capacity to Employ Administrative Critical Thinking
To attain certification, a specialist is required to:
- Identify when a treatment plan does not meet the needs of the person being served, as well as have the aptitude to assess and then resource effective strategies that do meet the needs and wants of the person being served.
- Recognize when a behavior plan is too complex to implement.
- Demonstrate an understanding related to the significance of the involvement of families/teams/direct support professionals (DSPs) to an individual’s support/treatment plan.
- Understand the need for families and staff to comprehend the multimodal treatment approach.
6. Exhibit Knowledge of Fiduciary Responsibilities and Dual Role Service Delivery
A specialist must:
- Identify the connection between good care and funding.
- Have the ability to provide reports related to the progress of the person being served in relation to his/her therapeutic goals and results.
- Work in conjunction with clinicians and/or other stakeholders in the event that anticipated outcomes are not being reached.
Besides providing the specialist with prestige, NADD certification may provide the specialist with employment opportunities, promotions and job security. Furthermore, NADD certification is portable; therefore, a specialist who moves to another region does not have to reapply for NADD certification. Unless requested otherwise, the NADD-Certified Dual Diagnosis Specialist’s name and contact information is posted on the NADD website. Individuals who are interested in learning more about attaining NADD Dual Diagnosis Certification for Specialists can find information by visiting the NADD website or by watching its online webinar.