NNAPF and Workforce Development

Overview of NNAPF's Workforce Development Mandate

Note to readers : The everview presented in this text is an extract from NNAPF's document: NNAPF Aboriginal Workforce Strategy.

During the mid 1990’s, the National Native Alcohol and Drug Abuse Program (NNADAP) served as a national, federally-funded wellness/addictions program for First Nations and Inuit in Canada, designed to provide treatment, prevention, training and research services as a comprehensive federal strategy. Specific to workforce development, the aim was to allow for culturally appropriate training programs, to support prevention, maintenance and treatment in First Nations and Inuit treatment centres and communities, through a cadre of para-professionals and professionals, comprised of advanced and basic level Counsellors.

Independent evaluation and intensive internal review processes were conducted locally, regionally and nationally, culminating in the NNADAP General Review 1998. The Review included 37 recommendations, one of which was the creation of National Native Addictions Partnership Foundation (NNAPF), a not-for-profit, non-governmental national Aboriginal organization, to implement all of the strategic recommendations of the NNADAP General Review.

Our stakeholders include First Nations, Métis and Inuit Addictions and Wellness Counsellors working in over 800 communities and more than 60 Treatment Centres. It is composed of a multi-sector network of Regional Working Groups, a Youth Services Addiction Committee (YSAC), and other Aboriginal partners with significant expertise in the field of addictions and its related health and social issues. One of the roles of the NNAPF is the renewal of the Aboriginal addictions system, in order to assist its evolution into a more efficient, culturally-appropriate and relevant program, administered and delivered by a trained and experienced Aboriginal Wellness and Addictions Counsellor workforce. These specialists represent the front-line staffs that address the mental wellness and addictions counseling requirements of First Nations, Métis and Inuit nationwide.

Over the years, the Foundation has worked tirelessly to address workforce development issues, to ensure that Wellness/Addictions workers nation-wide maintain standards that are comparable to that of mental health workers and other paraprofessionals working in Canada’s health care system. Of late, the Foundation’s efforts have included proposals to the Federal government to implement a National Certification of Aboriginal Addictions Counsellors, through a First Nations Wellness/Addictions Counsellor Certification Board (FNWACCB).

As well, the NNAPF has also sought support for a national workforce development survey of all Treatment Centre and community-based First Nations and Inuit Wellness/Addictions Counsellors. Hence, workforce development has been ongoing, and a more detailed overview of the Foundation’s efforts are summarized in one of NNAPF's core documents, the Position Paper on NNAPF's National Training and the new Aboriginal Health Human Resources Strategy (Appendix A). Lastly, a national workforce development strategy would not be complete without including the remarkable efforts of the Regional Working Groups of the Foundation. The national certification proposal for example, largely originated from the pilot project spearheaded by the B.C. Regional Working Group. Likewise, the work of the YSAC in the development of core competency curriculum modules for youth addictions training, as well as a standard salary reporting framework, exemplify the dynamism of the Foundation’s workforce development activities – with end products that are developed, designed and implemented by and for Aboriginal Peoples!

Workforce Development – A Backgrounder

Workforce development embraces the idea that all parts be considered when developing a workforce strategy, from recruitment to retention. There are five elements which typically make up a workforce development strategy, and all are equally important in advancing the professional development interests of a workforce (see figure below).

Five Elements of NNAPF's Workforce Development Strategy

Five Elements of Workforce Development Strategy Diagram

What’s included under the five elements of Workforce Development?

Structural supports for example, includes such features as addictions program accreditation, as well as national standardized policy in the areas of client consent, treatment planning, cultural competency and reporting. Education/training considers post-secondary policies and programs, to promote education, professional development, and ultimately certification. Recruitment includes fair consideration in health human services research, planning and promotion, with scholarships and mentorship projects to encourage retention. Information supports the technology needed to address the professional development interests of the workforce, and research and outcome measures are vital to ensure workforce development initiatives are best informed by research that takes into consideration the gaps and challenges faced by the Aboriginal addictions treatment and counsellor workforce.

What we Know and Don’t Know about the Aboriginal Wellness/Addictions Workforce – A Recap since RCAP

Note to readers : The rationale presented in this text is an extract from NNAPF's document: Proposal to implement a National “Certification of Aboriginal Addictions Counsellors, through a First Nations and Inuit Wellness/Addictions Counsellor Certification Board (FNIWACCB)

The Foundation knows that it takes tremendous commitment, dedication and personal growth to work in Aboriginal communities. The Foundation also knows that its Counsellors in both the Treatment Centres and First Nation and Inuit communities have taken a multitude of practical training, workshops and have gained tremendous experience that currently is not being acknowledged. Some of their more formal credentials range from post graduate degrees to limited high school, but never the less, the NNAPF also knows that the Wellness/Addiction workforce strength lies in its cultural/traditionally based knowledge and First Nations and Inuit healing philosophy.

Recommendations dating back to RCAP speak to the challenge of addressing gaps in information regarding the Aboriginal health workforce. The 1996 Report of the Royal Commission on Aboriginal Peoples (RCAP) identified the development of Aboriginal health and human resources, as essential to ensure the success of new approaches to health and healing. The RCAP further states that “more services if imposed by outside agencies will not lead to the desired outcomes.

A new approach to improving Aboriginal health was articulated, that identified equity, holism, Aboriginal control and diversity as desirable traits. This approach was espoused as having the power to do what the present system could not: to focus on healing. In addition, recommendations for an Aboriginal health and healing strategy calling for the mobilization and training of Aboriginal personnel are supported by the logic that “Aboriginal control of human services is necessary because control over one’s situation is a major determinant of health.” To that end, the Report recommended that governments and educational institutions undertake to train 10,000 Aboriginal people in health, including professional and managerial roles over the next decade. Most important in achieving this goal was the need to undertake the collection of data, which will support the development of Aboriginal health human resources, since the Report acknowledged that the absence of this vital information is an obstacle to planning.

Two years later, the NNADAP General Review 1998 identified 37 recommendations, of which three in particular speak to the accreditation arrangements with institutions in support of the certification of Wellness and Addictions Counsellors:

  • To develop revised scope of duties for the community Counsellors, which should take into consideration advanced and basic counselling. There should also be recognition and a training strategy developed to assure that NNADAP Counsellors have skills in areas of grief and loss, family violence, sexual abuse, tobacco, gambling, and other areas. Sample protocols should be developed to assist communities in dealing with 24-hour requirements and means for handling on-call within communities. (This should be related to the recommendations on a national accreditation process.)
  • As part of an overall accreditation process, a group of stakeholders should be involved in developing a code of conduct for NNADAP Counsellors which could be posted in First Nations’ buildings and in NNADAP offices. This would outline expectations relating to confidentiality, obligations, possible remedies and penalties where there are violations. (See recommendations on training.)
  • Health Canada, First Nations and Inuit organizations should negotiate accreditation with groups such as Ontario Interventionist Association to utilize certified alcoholism Counsellor title or develop a similar accreditation process. The program could also consider granting parallel privileges to individuals with certain educational qualifications as well such as Bachelor of Social Work (BSW), Master of Social Work (MSW), psychology, or other fields which would be considered as equivalent.

Unfortunately, very little information has been collected systematically about the number of Aboriginal Counsellors, their professional titles and roles. For the majority, an assessment of their salary levels relative to pay equity, and information regarding their practical skills relative to certification are unknown. From the field, the Foundation does know that Aboriginal Wellness/Addiction Counsellors tend to obtain specific skills that are related to the tasks of their positions. They tend to prefer practical learning situations, best provided by semi-formal or informal training such as workshops, seminars, training conferences, ad-hoc courses, etc., offered externally or internally. As well, attention must be paid to the recognition of Aboriginal Wellness/Addiction Counsellors’ informal but usually comprehensive training portfolio, coupled by real-life professional experience acquired through this training and through their work. As noted by the Foundation more recently:

The field of addictions services...is challenged to sustain a workforce that can meet the demands and needs presented by clients seeking treatment as well as the prevention needs faced by First Nations and Inuit communities. The NNAPF is committed to strengthening the addictions services continuum by supporting coordinated and meaningful workforce development strategies. (NNAPF National Strategy 2004)

Even more recently, the need for certification is further articulated by in the Assembly of First Nations draft report of the public health system relevant to First Nations. Specific to skills and knowledge enhancements to current health care providers, the report notes:

Increased skills and knowledge are recognized as necessary for the improvement of health promotion/prevention efforts at the national, provincial, territorial, regional and community levels. First Nations as well as non-First Nations nurses, physicians, CHRs, Addictions Counsellors, Counsellors and others would benefit from a better understanding of cultural knowledge of health and wellness, etc.

Hence, a recommendation that speaks directly to the need for a First Nations and Inuit designed and implemented wellness/addiction Counsellors certification process, specifically:

Recommendation #79: Certification and standards for innovative public health para-professionals should be considered to support public health activities that currently demand irrelevant qualifications.

Of late (2005), Canada equally recognizes and supports the need for culturally relevant training and certification. As noted in its National Framework for Action to Reduce the Harms associated with Alcohol and Other Drugs and Substances, the Federal government recognizes that “a significant influx of resources is needed to deal with outreach, treatment and aftercare to cover expenses related to the remoteness of northern communities. The need to recruit and retain care Counsellors and to support their professional development is crucial, especially if holistic and culturally relevant programs are to be designed and delivered effectively.

As noted in the framework, “[n]ecessary) actions identified to date include: establishing national standards and competencies to enhance knowledge and skills.” Hence, why “[t]raining and capacity building within First Nations, Inuit and Métis communities and empowering Aboriginal peoples to develop and implement their own culturally sensitive strategies are important to achieving long-term sustainable progress.

Most telling is the support for national certification as reflected in the Strategic Action Plan for First Nations and Inuit Mental Wellness. Developed by the First Nations & Inuit Mental Wellness Advisory Committee in June 2006, the final draft reflects a goal that identifies as one of the activities, the need to “ensure that competency development on the job continues to be available until the pool of qualified First Nations and Inuit is sufficient.” With FNIHB, Communities and Service providers identified as the lead, the overarching Goal #4 reads: “To enhance the knowledge, skills, recruitment and retention of a mental wellness and allied workforce, able to provide effective and culturally safe services and supports for First Nations and Inuit.

Lastly, an example from south of the border, speaks to the importance of grassroots direction in the design, development and implementation of a First Nations and Inuit Board and Certification Process. When examining the factors for success relative to the certification and training of Community Health Workers (CHWs) across the U.S.A., the varied training and certification programs merited a policy recommendation that drew attention to the importance of local design:

Advocacy and development of policies and programs for training and certification programs within states should include attention to the breadth and/or range of substantive and practice skills specializations sufficient to meet the primary expectations and obligations they are intended to fulfill.

This is especially important relative to certifying First Nations and Inuit Wellness/Addictions Counsellors, given that a strategy be developed for evaluating prior education and experience, to ensure that the applicant has the relevant alcohol and addictions-specific knowledge and skills.

Highlights of NNAPF's Workforce Development Activities

Note to readers: The everview presented in this text is an extract from NNAPF's document: NNAPF Aboriginal Workforce Strategy.

The success of both the program (NNADAP) and the subsequent establishment of the Foundation (NNAPF) are well documented. Since its incorporation, the Foundation has steadily advanced various workforce development activities, aimed at the promotion and advancement of the accreditation of programs/Treatment Centres, as well as the certification of Wellness and Addictions Counsellors in Treatment Centres and communities, nation-wide. An overview of the Foundation’s workforce development activities since 2000 is presented below:

National Workforce Development Activities 2000-2006

  • Directory of Addictions Specific Training in Canada 2001
    • Lists current educational institutions that provide addictions training – certificates, diplomas and degrees
  • HR Consultation – Edmonton NNAPF Gathering 2002
    • Consultation with Workers on issues, barriers, solutions and NNAPF's role

2001-2002
  • National Training Edmonton
  • National Salary Survey – key Treatment Centre personnel
  • Re-Profiling Initiative

2002-2003
  • National Training Saskatoon
  • Developed Community Risk Assessment Manual for front line workers
  • Community Worker Training Needs Survey (Competency Survey)
    • Based on 12 International Core Competencies
    • Results summarized
  • National Human Resource Development Strategy – Draft
  • Re-profiling Initiative – funded two models for training of treatment centre staff
    • Training to degree level in psychology
    • Specialized Crisis Training

2003-2004
  • Directory of Addictions Specific Training in Canada revised 2004
  • National Training Ottawa
  • First National Training Institutes Adhoc Meeting

2004-2005
  • National Training Vancouver – Partnership with CHABC and CAAN
  • National Training Institutes Meeting to begin development of Addictions Training Network

2005-2006
  • National Training Edmonton – Partnership with HOSW
  • Promotion of BC Certification Process – FNWACCB
  • Development of Clinical Supervision through Video Conferencing Proposal
  • Finalize National Workforce Development Strategy (draft HR Strategy)
  • Host proposed Aboriginal Workforce Development Symposium
  • National Ethics Guidelines, Counselling Guidelines, Prevention Report Guide

2006-2007

Worthy of note is the Foundation’s National Human Resource Development Strategy, which identifies that a “certification process for both Prevention Counsellors and Counsellors should be established by the Foundation, as part of the larger accreditation process.” The NNAPF strategy further notes that “Addictions Counsellor Certification should include a core of general counselling skills, supplemented by specialization in substance abuse and addictions Counsellor training. Current training must also be supplemented by programs to enhance knowledge/skills in the following:

  • Understanding/counselling re: drug abuse
  • Intervening with populations with special needs
  • Cultural heritage training and Traditional Healing Approaches
  • Broad spectrum skills training, e.g., the Community Reinforcement Approach (CRA).”

The NNAPF Regional Working Groups activities have achieved equally amazing results supporting workforce development, such as, but not limited to for example:

  • In Alberta region, the development of Prevention Manual for Addictions Counsellors, and where training is provided in required competencies for certification, with funding support for the certification for wellness/addiction Counsellors. Subsequently, more that 80% of Alberta’s front line workforce has been certified through CCPC;
  • In Manitoba region, the development of Orientation Manual for Addictions Counsellors;
  • All regions have supported formal and informal training for addictions Counsellors;
  • In British Columbia, the training of treatment Counsellors to a degree entry level; and the implementation of a First Nations Wellness/Addictions Counsellor Certification Board, and many other examples of regional innovation, and last but not least;
  • Specific to workforce development, the Youth Solvent Addiction Committee activities “include everything that is meant to improve staffing, staff training, and credentialing or staff management.” As noted earlier, the YSAC can boast of the development of core competency curriculum modules for youth addictions training that have been CCPC certified, in Research Methods and Client Follow-Up, Clinical Supervision, as well as Resiliency and Client Care, Emotional Intelligence and Addictions.

These and many more examples of regional innovation are what make the Foundation’s workforce development activities both validated and field-tested by front-line experience.