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Certified Addiction ProfessionalTraining Verification FormDIRECTIONSThis form allows for documenting training hours as required for the CAP credential. The applicant completes all requiredfields of data on the Training Verification Form and uploads the completed form and copies of supporting documentationto their online application prior to submitting.All information must be TYPED. Handwritten forms will be denied.If submitting by hard copy, please attach copies of the supporting documentation to the completed Training VerificationForm and send as instructed below. Supporting documentation must be attached in the same order listed on the form.Mail:Florida Certification BoardAttn: Certification Operations1715 South Gadsden StreetTallahassee FL 32301Email:Fax:Subject Line:Certification Specialist’s email oradmin g Verification (applicant name)REQUIREMENTCAP Content SpecificTraining Requirement350 total clock hours of training divided as follows:1.2.3.4.5.6.7.8.9.Clinical Evaluation: 35 hoursTreatment Planning: 30 hoursCounseling: 50 hoursCase Management and Referral: 15 hoursClient, Family and Community Education: 15 hoursDocumentation: 15 hoursEthical and Professional Responsibilities: 30 hoursUnderstanding Addiction/Treatment Knowledge: 80 hoursApplication to Practice/Professional Readiness: 80 hours**Must include at least 4 hours of HIV-AIDS and 2 hours of Domestic Violence.SupportingDocumentationTraining documentation must provide the following information: Applicant Name; Title ofCourse/Training/Educational Event; Event Sponsor/Provider; Delivery Date(s); and Numberof Contact Hours.If training certificates do not include all required information, contact the training providerand request additional information on their official letterhead to submit asdocumentation. If using college coursework for training credit, you must provide a copy ofyour transcript as well as a copy of the course description.Eligible training must be taken from an FCB Approved Education Provider within the last10 years (no time limit on college coursework taken as part of a degree program). EligibleTraining Providers are listed on FCB's website at www.flcertificationboard.org underEducation & Training.Florida Certification Board (FCB)Effective Date: February 2019CAP Training Verification Form
TRAINING TOPICS BY DOMAINDOMAINTOPICSClinical Evaluation(35 hours) Addiction & Human Growth/DevelopmentAddictive ProcessAssessment Instruments, Procedures and TechniquesClient EngagementClient Matching to Service ArrayDetoxificationDSM IV/Diagnosis Criteria / ASAMMotivational InterviewingOther Substance & Behavioral Addictions – Gambling/Smoking/FoodReadiness and Motivation for TreatmentRisk Factors/Risk Assessment/Risk ManagementScreening Instruments, Procedures and TechniquesScreening/Assessment for Dual Diagnosis/Co-Occurring DisordersSigns/Symptoms/Stages of SUD, Active Use and WithdrawalUrinalysis and Other Biological AssessmentsTreatment Planning(30 hours) Client Placement CriteriaDeveloping Individualized Treatment PlansDrug Court/Correction-based Treatment/Policy/TheoryEnhancing Client Choice/Client-Directed CareEvidence Based Practice (EBP) Treatment ProtocolsIntake/Orientation to TreatmentMedication-assisted TreatmentOn-going AssessmentOvercoming Barriers to Treatment ProgressSpecial Population NeedsStages of Change and Treatment Goals/InterventionsTreatment Goals and Measuring SuccessTreatment Planning/Models of TreatmentCounseling (50 hours) Client Progress Assessment and ResponseCounseling Theories/TechniquesDeveloping a Therapeutic AllianceEvidence-based PracticesIndividual/Group/Family CounselingMotivational InterviewingTypes of Treatment Programs/Levels of TreatmentCase Management andReferral (15 hours) Advocacy/Liaison ActivitiesCase ManagementCommunity Resources/ServicesConfidentiality/HIPPA Issues with ReferralsConsultationFlorida Certification Board (FCB)Effective Date: February 2019CAP Training Verification Form
DOMAINTOPICS Continuum of Care/PlacementMaking ReferralsManaged Care SystemsReferral Outcome/EvaluationSelf-help GroupsService/Care Coordination/CollaborationSpecial Population NeedsClient, Family andCommunity Education(15 hours) Adult Learning TheoryAnger Management SkillsChanging Criminal Behavior/Criminal Thinking Errors/Offender TreatmentCo-DependencyCultural Diversity/Special PopulationsDomestic ViolenceFamily DynamicsGroup Facilitation/Styles of PresentationHIV/TB/Hepatitis CLife SkillsMoral DevelopmentTheories of Counseling / PersonalityToxicologyVictim/Perpetrator CounselingDocumentation (15 hours) Assessment, Treatment, Progress, Discharge or Transfer SummariesClinical DocumentationElectronic Health Records/TechnologyPrivacy & ConfidentialityProgress NotesPsychosocial SummariesReports/Record Keeping/Records ManagementEthical and ProfessionalResponsibilities (30 hours) Boundaries / TransferenceComputer EthicsCultural CompetenceEthical Decision Making / Code of EthicsLaws / Rules & RegulationsOrganizational EthicsPolicy in Human ServicesPrivacy / Confidentiality / HIPPARelationships / Dual RelationshipsSexual MisconductFlorida Certification Board (FCB)Effective Date: February 2019CAP Training Verification Form
dge (80 hours) Disease of AddictionDual or Triple Diagnoses (mental illness, HIV, mental retardation)Etiology/Causation of AddictionHistory of Addiction and/or Addiction TreatmentInvolvement and Treatment of Family in RecoveryModels of TreatmentOther Substances and Behavioral AddictionsPharmacologyPhysical Aspects of Addiction, Brain ScienceRelationship of Addiction to Health, Crime, and Other Social ProblemsSigns, Symptoms, Progression of AddictionTreatment ComponentsTypes of Service Modalities (residential, outpatient, etc)Use of Support GroupsApplication toPractice/ProfessionalReadiness (80 hours)* Care for the CaregiverCrisis Intervention/Verbal De-escalationEthics and Ethical Decision-makingIndividual, Group and Family Counseling TechniquesLaws Governing Privacy, Confidentiality and HIPAAManagement and Leadership SkillsMedication-Assisted TreatmentModels of TreatmentObservation and Communication SkillsRules and Regulations that Govern Full Continuum of Services and ReferralsSpecial Population Needs/Cultural CompetenceSupervision TechniquesUnderstanding Research/Translating Research to PracticeWellness, Alternative Therapies, Nutrition* Must include 4 hours of HIV-AIDS and 2 hours of Domestic Violence training content.Florida Certification Board (FCB)Effective Date: February 2019CAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: CLINICAL EVALUATION (1 OF 9)Training Requirement: Minimum 35 hours of training in topics directly related to Clinical Evaluation.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: TREATMENT PLANNING (2 OF 9)Training Requirement: Minimum 30 hours of training in topics directly related to Treatment Planning.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: COUNSELING (3 OF 9)Training Requirement: Minimum 50 hours of training in topics directly related to Counseling.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: CASE MANAGEMENT AND REFERRAL (4 OF 9)Training Requirement: Minimum 15 hours of training in topics directly related to Case Management and Referral.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: CLIENT, FAMILY AND COMMUNITY EDUCATION (5 OF 9)Training Requirement: Minimum 15 hours of training in topics directly related to Client, Family and Community Education.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: DOCUMENTATION (6 OF 9)Training Requirement: Minimum 15 hours of training in topics directly related to Documentation.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: ETHICAL AND PROFESSIONAL RESPONSIBILITIES (7 OF 9)Training Requirement: Minimum 30 hours of training in topics directly related to Ethical & Professional Responsibilities.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: UNDERSTANDING ADDICTION/TREATMENT KNOWLEDGE (8 OF 9)Training Requirement: Minimum 80 hours of training in topics directly related to Understanding Addiction/Treatment Knowledge.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Certified Addiction ProfessionalTraining Verification FormAPPLICANT NAME:EMAIL ADDRESS:TRAINING TOPIC: APPLICATION TO PRACTICE/PROFESSIONAL READINESS (9 OF 9)Training Requirement: Minimum 80 hours of training in topics directly related to Application to Practice/Professional Readiness.Must include at least 4 hours of HIV/AIDS and 2 hours of Domestic Violence.Title of TrainingExample: Stages of RecoveryFlorida Certification Board (FCB)Effective Date: February 2019Training ProviderFlorida Peer NetworkDate of TrainingTrainingHoursAwardedType of DocumentationAttached7/19/20174Certificate of CompletionFCBUseOnlyCAP Training Verification Form
Training Verification Form and uploads the completed form and copies of supporting documentation to their online application prior to submitting. All information must be TYPED. Handwritten forms will be denied. If submitting by hard copy, please attach copies of the supporting documentation to the completed . Training Verification Form
