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Certified Co-Occurring Disorders Professional Application

Certified Co-Occurring Disorders Professional Application Form

Requirements for the

Requirements for the CCDP – Certified Co-Occurring Disorders Professional Minimum Standards College Degree Supervised Work Experience (Co-Occurring-specific) Training and Education Requirements Distance Learning Supervised Practicum Professional References Sent directly to the CCB Exam (IC&RC COD Exam) IC&RC Reciprocal credential Initial certification is issued for two-years A minimum of a Bachelor’s degree (CCDP) or Master’s Degree (CCDP-D) in cooccurring disorders (COD) or behavioral science with a clinical application from a college or university that is accredited by the U.S. Department of Education or the Council on Higher Education Accreditation or an international equivalent if degree is from an international institution. 6,000 (CCDP) or 4000 (CCDP-D) hours specific to co-occurring disorders treatment within the last ten years 140 total hours (CCDP-D) or 200 total hours (CCDP): 140 Co-Occurring Disorders specific (with identified domain requirements) 30 Addiction-specific (CCDP Only) 30 Mental Health-specific (CCDP Only) Up to 150 hours of CCB-approved distance learning can be applied Up to 50 hours of distance learning can be applied if not CCB-approved 200 hours with no less than 20 hours in each of the 7 IC&RC CCDP performance domains 3 positive professional references with 1 from current or most recent clinical supervisor and two from professional colleagues (preferably CCB credentialed) Passing score on the IC&RC COD exam Annual Recertification Standards Must be completed per year to maintain credential Performance Domains 20 hours of co-occurring-specific training CCDP (Bachelor’s Degree Req’d) or CCDP- D (Master’s Req’d) Minimum Training Hours Screening & Assessment 24 Crisis Prevention & Management 18 Treatment & Recovery Planning 24 Counseling & Interventions 24 Recovery Supports & Coordination of Care 18 Psychopathology & Etiology 12 Psychopharmacology 12 CCB Approved Ethics 8 Minimum Addiction Specific Training Hours (CCDP Only) 30 Minimum Mental Health Specific Training Hours (CCDP Only) 30 Minimum Training Hours TOTAL 200 (CCDP)/140 (CCDP-D) I have read the above Standards and understand that I must meet ALL CURRENT STANDARDS in order to become certified as a CCDP or CCDP-D. Candidate’s Signature: Date: Connecticut Certification Board, Inc. CCDP Application 2 March 2013

CCDP/CCDP-D Application Submission Requirements Please make sure you complete all of the following items in order to ensure timely processing of your application. Your application will not be processed until you submit the filing fees and all of the following items have been met: Live or work in Connecticut full-time in order to apply for CCDP certification Have a Bachelor’s Degree (CCDP) or Master’s Degree (CCDP-D) in COD or a related field Enclose the application filing fee of $175.00 (check or money order payable to CCB) OR Pay online at www.ctcertboard.org Date of online payment: Request copies of your academic transcripts be sent directly to the CCB Complete the entire CCDP Application; submit, fill-out, sign, and submit all 10 pages of this packet Work Experience and Supervised Practicum Form (s) completed Request one reference form be completed by your current or most recent clinical supervisor (CCDP-D preferred) and mailed directly to the CCB using the forms provided Request two reference forms be completed by professional colleagues and mailed directly to the CCB using the form provided (make copies as needed) Read, sign, and initial pages of the CCB Code of Ethical Conduct & Auth. to Obtain Information Submit a CCDP Training Documentation Form which lists all education and training events you wish to apply towards the CCDP that includes at minimum all the following information: Training Date, Title of Training Event and Location of Event Trainer/instructor and Host Organization Length of event (i.e., 6 hours, etc.) Type of event: addiction-specific or elective with addiction content To download the training documentation form, visit the CCB website www.ctcertboard.org Attach a copy of certificates of attendance or transcripts for all training/educational events included on the CCDP Training Documentation Form Request copies of your academic transcripts be sent directly to the CCB (if needed) Make a copy of the entire packet for your records prior to submitting to the CCB I have completed all of the above items and submitted them according to the CCB submission requirement and current CCDP standards. Candidate’s Signature: Date: Connecticut Certification Board, Inc. CCDP Application 3 March 2013

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