CASAC key terms

A national framework that matches clients to the appropriate level of substance use and mental health care based on six dimensions, including withdrawal risk, medical conditions, readiness to change, and relapse potential.

A structured evaluation across several life areas such as substance use history, medical status, psychiatric symptoms, family and social supports, legal problems, and employment. It forms the basis for diagnosis and treatment planning.

An approach that explains health and behavior through the interaction of biological, psychological, and social factors. Counselors use it to understand addiction and mental illness as conditions shaped by many influences.

The current diagnostic category for problematic substance use, rated as mild, moderate, or severe based on how many of eleven criteria are met within a twelve-month period.

Needing larger amounts of a substance to achieve the same effect, or experiencing reduced effects from continued use of the same amount. It is one criterion used in diagnosing substance use disorder.

A cluster of physical and psychological symptoms that appears when a person reduces or stops a substance after heavy or prolonged use. Some withdrawals, such as from alcohol or benzodiazepines, can be medically dangerous.

A brief, standardized procedure used to identify clients who may have a substance use or mental health problem and need further evaluation. Screening does not by itself establish a diagnosis.

A public health approach meaning Screening, Brief Intervention, and Referral to Treatment. It identifies risky substance use early, offers short motivational conversations, and connects people needing more care to services.

A written, individualized document that states a client's identified problems, measurable goals, specific objectives, planned interventions, responsible staff, and target dates for review. It guides care and is updated as needs change.

A method for writing objectives that are Specific, Measurable, Achievable, Relevant, and Time-bound. Counselors use it to turn broad client needs into observable targets that can be tracked in progress notes.

Building the treatment plan collaboratively with the client, honoring the person's own priorities, culture, and preferences. It supports engagement and respects the client's right to participate in decisions about care.

The intensity and setting of services a client needs, ranging from outpatient counseling to residential or medically managed inpatient care. Placement is matched to assessed needs and reviewed as the client's condition changes.

The full range of linked services from prevention and early intervention through detoxification, treatment, and recovery support. It allows clients to move between levels of care without losing connection to services.

A direct, personal transfer of a client to another provider, often by phone or in person, so the receiving service knows the client's situation. It reduces the chance that a referral will be lost.

A written, time-limited authorization signed by the client that permits a program to share specified information with named parties. It must meet confidentiality rules and can be revoked by the client.

Coordinating services for a client across multiple systems, including scheduling, advocacy, monitoring, and linking to housing, medical care, and benefits. It helps clients with complex needs stay engaged in treatment.

Ongoing communication among providers, agencies, and community supports so that a client receives consistent, non-duplicated care. It includes sharing treatment information appropriately and tracking whether referrals were completed.

A collaborative, goal-oriented counseling style that helps clients explore and resolve ambivalence about change. It uses open questions, affirmations, reflective listening, and summaries while avoiding confrontation.

A model describing readiness to change in steps: precontemplation, contemplation, preparation, action, maintenance, and sometimes relapse. Interventions are matched to the client's current stage rather than pushed ahead of it.

Client statements that favor movement toward change, such as reasons, need, ability, or commitment. Counselors listen for it and reinforce it, since hearing oneself argue for change supports behavior change.

Restating the meaning or feeling the counselor hears in a client's statement, often as a guess rather than a question. It conveys understanding, slows the conversation, and encourages the client to elaborate.

The counselor's ability to understand the client's experience from the client's own perspective and to communicate that understanding. It is a core therapeutic condition linked to a strong working alliance.

The collaborative working relationship between counselor and client, built on agreed goals, agreed tasks, and an emotional bond. A strong alliance predicts better engagement and treatment outcomes.

A structured set of strategies that help clients identify high-risk situations, cope with cravings, manage lapses, and adjust lifestyle to sustain recovery. It treats a lapse as information rather than failure.

People, places, feelings, times, or events that set off cravings or increase the likelihood of substance use. Identifying personal triggers is a common step in building a relapse prevention plan.

A circumstance in which a client's coping skills are likely to be overwhelmed and use becomes more probable, such as conflict, celebration, or contact with using peers. Plans are rehearsed in advance.

A dated entry in the clinical record describing services delivered, the client's response, progress toward plan objectives, and the counselor's clinical impressions. It documents medical necessity and should be written promptly.

A common progress note format with four sections: Subjective (client report), Objective (observable data), Assessment (clinical interpretation), and Plan (next steps). It organizes information consistently across sessions.

Accepted rules for clinical records, including timeliness, accuracy, legibility, objectivity, and avoiding speculation or judgmental language. Records must be complete enough to justify services and support continuity of care.

Federal regulations that give extra protection to records of clients in federally assisted substance use disorder treatment. They generally require specific written consent before disclosing identifiable information, beyond HIPAA requirements.

The ethical and legal duty to protect client information from unauthorized disclosure. It has defined limits, such as suspected child abuse, imminent danger, or valid court orders.

A legal obligation, in many jurisdictions, to take reasonable steps to protect an identifiable person when a client poses a serious threat of violence. Actions may include warning the person or notifying authorities.

A legal requirement for counselors to report suspected child abuse or neglect, and in many states other forms of abuse, to designated authorities. It overrides ordinary confidentiality and does not require client consent.

The boundaries of what a counselor is trained, licensed, and legally permitted to do. Working outside those limits, such as prescribing medication, is unethical and may be illegal.

Oversight and guidance provided by a qualified supervisor to support a counselor's skill development, case review, and adherence to standards. It is a required part of training and ongoing professional practice.

Limits that protect the professional relationship, including avoiding dual relationships, sexual contact, exploitation, and excessive self-disclosure. Boundary crossings are examined for harm and discussed in supervision.

The presence of both a substance use disorder and one or more mental health conditions in the same person. Best practice is integrated treatment that addresses both conditions together rather than sequentially.

A service model in which substance use and mental health treatment are delivered by one coordinated team rather than separate programs. It improves engagement and outcomes for clients with co-occurring disorders.

The use of FDA-approved medications, such as buprenorphine, methadone, or naltrexone for opioid use disorder, combined with counseling and other supports. It is evidence-based and not a substitute for recovery.

A drug that binds to the same brain receptors as an addictive substance and produces a milder, longer-lasting effect, reducing cravings and withdrawal. Methadone and buprenorphine are examples used in opioid treatment.

Medically supervised management of withdrawal, including monitoring vital signs and providing medication when needed. Detoxification alone is not treatment and should be followed by ongoing care.

A structured inquiry into suicidal thoughts, plans, intent, means, prior attempts, and protective factors. It guides decisions about safety planning, level of care, and referral rather than predicting risk with certainty.

A written, personalized list of coping strategies, supportive contacts, and emergency resources a client agrees to use when distress or suicidal urges rise. It is developed collaboratively and reviewed regularly.

Short-term, immediate support aimed at stabilizing a person in acute distress, reducing danger, and connecting them to ongoing care. It prioritizes safety, de-escalation, and clear next steps.

Verbal and environmental techniques that reduce agitation and the risk of violence, such as speaking calmly, lowering stimulation, offering choices, and maintaining safe space. It is preferred over confrontation or restraint.