Frequently Asked Questions

The Co-Occurring Disorder Specialist is an enhancement available to be added to the license of specific counselors under RCW 18.205.105 (1) which allows them to provide substance use disorder treatment with some limitations. It is not available as a stand-alone credential, applicants must already possess one of the qualified license types to be eligible to apply.

You must already be fully licensed with one of the qualified license types in RCW 18.205.105(1) to be eligible for the Co-Occurring Disorder Specialist Enhancement. Note that you must have the full license, Associates who are under supervision and gaining hours for licensure are not eligible for the enhancement.

License Type qualified for the Co-Occurring Enhancement

• Psychologist licensed under 18.83 RCW
• Independent Clinical Social Worker licensed under 18.225 RCW
• Marriage and Family Therapist licensed under 18.225 RCW
• Mental Health Counselor licensed under 18.225 RCW
• Agency Affiliated Counselor (AAC)* registered under 18.19 RCW
  *AACs must meet additional requirements of a Master's degree in a counseling related field and have 2 years of supervised experience. RCW 18.205.105 (1)(e)

No, the creation of the co-occurring disorder enhancement does not change or modify the scope of practice for licensed psychologists.

To obtain the co-occurring specialist applicants must complete a 60-hour training course specifically relating to substance use treatment and approved by the department. Other training courses and college courses do not count toward the requirements, it is the completion of a full course not an aggregate of courses.

The training course consists of 30 hours in understanding the disease pattern of addiction and the pharmacology of alcohol and other drugs; and 30 hours in understanding addiction placement, continuing care, and discharge criteria including the American Society of Addiction Medicine (ASAM) criteria; treatment planning specific to substance abuse; relapse prevention; and confidentiality issues specific to substance use disorder treatment.

• List of approved Co-Occurring Educational Providers

To meet the educational component of the co-occurring specialist, the applicant must obtain experience hours under a licensed Substance Use Disorder Professional or someone who meets the requirements to become an SUDP and would be eligible to take the exam required for certification.

The experience requirement for a Co-Occurring Disorder Specialist enhancement consists of:

• 80 hours of supervised experience for an applicant with fewer than 5 years of experience under their primary license; or
• 40 hours of supervised experience for an applicant with more than 5 years of experience under their primary license.

Yes, there is an exam that is specific to this enhancement. The department is currently working to develop and implement this exam. Testing will be guided through the education provider. More information to follow as it becomes available.

A person who has obtained a co-occurring disorder specialist enhancement may provide substance use disorder counseling services equal in scope with those provided by a Substance Use Disorder Professional with the following limitations:

• A Co-Occurring Disorder Specialist may only provide substance use disorder counseling if they are employed by:
  • An agency that provides counseling services;
  • A federally qualified health center; or
  • A hospital.
• Following intake and assessment, they may provide substance use disorder treatment only to clients diagnosed with a substance use disorder and a mental health disorder; and
• Prior to providing substance use disorder treatment to a client assessed to be in need of 2.1 or higher level care according to American Society of Addiction Medicine (ASAM) criteria, the co-occurring disorder specialist must make a reasonable effort to refer and connect the client to the appropriate care setting as indicated by their assessed ASAM level of care.
  • If an enhancement holder is unable to refer a client to the appropriate level of care based on ASAM criteria, then the enhancement holder must substantiate the level of care or type of service chosen in the clinical record. WAC 246-804-040.

The fee can be found here WAC 246-804-990 or on the fee page. The enhancement is not a license, so it does not need to be renewed, however individuals must maintain their primary qualifying license to be able to work as a Co-Occurring Disorder Specialist. There are no continuing education requirements for the co-occurring enhancement, but you must maintain the CE requirements of your qualifying license.