levels, beginning with the identification of the knowledge and attitudes "that underlie competent practice not just for counselors but for addiction specialists in other disciplines as well" (National, n. pag.). In part this reflects the umbrella-type structure of a professional group that has not yet settled on its own identity. But it also reflects changes in demands on counselors as client needs have evolved to raise new demands and evolving approaches to counseling require closer definition of the field. Clinical practitioners face increasing numbers of clients who have multiple needs, "often presenting with concurrent personality disorders, mental health issues, developmental impairments, polysubstance dependency, and often greater need for primary health care services" (Washousky & Thomas, 1996, p. 30).
In addition, the field faces a fragmented set of requirements for third party reimbursement for professional services; requirements that are not in synch with the traditional licensure division of alcohol abuse, substance abuse, and ment
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