Apps AODA Counselor Application Instructions
- June 13, 2024
- APPs
Table of Contents
- Apps AODA Counselor Application
- Product Information
- Product Usage Instructions
- APPLICATION INSTRUCTIONS
- APPLICATION FOR CRSS
- WORK EXPERIENCE FORM
- SUPERVISED PRACTICAL EXPERIENCE
- ASSURANCE AND RELEASE
- CODE OF ETHICS FOR CERTIFIED RECOVERY SUPPORT SPECIALIST
- CRSS Application Checklist
- Read User Manual Online (PDF format)
- Download This Manual (PDF format)
Apps AODA Counselor Application
Product Information
The product in question is a Certified Recovery Support Specialist (CRSS) application manual. It is designed to guide professionals through the process of applying for CRSS certification. The manual provides instructions on how to complete the application form, as well as important information regarding fees, documentation requirements, and the review process. The manual emphasizes the need for accurate and neatly printed or typewritten application forms. It also highlights the importance of submitting all required documents, including validation from employers, supervisors, and trainers. Successful completion of the application process makes an applicant eligible to sit for the CRSS examination.
Product Usage Instructions
- Print or type your application forms neatly.
- Staple or paperclip all materials together, avoiding binders, folders, report covers, etc.
- Make a photocopy of the entire completed application, including attachments, for your records.
- Send the original copy of the application and copies of all other documents.
- Ensure all sections of the application are completed and signed where required.
- Notify ICB in writing of any changes to your name, work/home address, and work/home telephone numbers.
- Applications in process will be held by ICB for one year. If not completed within that time, reapplication will be required.
- ICB may request further information from employers and other persons listed on the application forms.
- Send the completed application to the following address: ICB 401 East Sangamon Avenue Springfield, IL 62702
APPLICATION INSTRUCTIONS
The initial application is a brief sketch of the professional’s qualifications that is meant to be an assessment for review purposes. The manual is a recording and compilation of documents demonstrating competency in the knowledge and skills specifically related to the functions of a Certified Recovery Support Specialist. This process includes validation from employers, supervisors, and trainers. An approved application means an applicant is eligible to sit for the CRSS examination.
- Application forms must be neatly printed or typewritten.
- Staple or paperclip your materials to keep them together. Do not place your application materials in binders, folders, report covers, etc.
- Checks and money orders for $75.00 should be made payable to ICB. All fees are non-refundable. No refunds will be given.
- Make a photocopy of the entire completed application including all attachments for your records. Send the original copy of the application and copies of all other documents.
- Applications will not be reviewed until all sections are completed and signed where required. Applicants will receive email notification of any deficiencies with the application.
- It is the applicant’s responsibility to notify ICB in writing of any changes to name, work/home address and work/home telephone numbers
- Applications in process will be held by ICB for one year and then destroyed if not completed, requiring reapplication
- ICB reserves the right to request further information from employers and other persons listed on the application forms.
- Send completed application to: ICB 401 East Sangamon Avenue Springfield, IL 62702
APPLICATION FOR CRSS
PLEASE PRINT OR TYPE
PLEASE NOTE: ICB, INC., RESERVES THE RIGHT TO REQUEST FURTHER INFORMATION FROM ALL EMPLOYERS AND OTHER PERSONS LISTED ON THE APPLICATION FORM. ICB, INC., AND ITS REVIEW COMMITTEES RESERVE THE OPTION TO REQUEST AN ORAL INTERVIEW WITH THE APPLICANT. THIS INFORMATION WILL BE USED STRICTLY TO EVALUATE THE PROFESSIONAL COMPETENCE OF THE CRSS AND WILL BE KEPT CONFIDENTIAL BY ICB, INC. FURTHER INFORMATION MAY BE REQUESTED IN ORDER TO VERIFY TRAINING, EMPLOYMENT, ETC. THIS INFORMATION IS NOT AVAILABLE TO OTHER PERSONS WITHOUT THE WRITTEN CONSENT OF THE APPLICANT.
WORK EXPERIENCE FORM
I hereby attest that the applicant is working/volunteering in a position where a minimum of 51% of his/her time is spent providing mental health recovery support services. The applicant minimally has primary responsibility for providing recovery support services to an individual and/or group, preparing recovery plans, documenting client’s progress and is supervised by an individual who is knowledgeable in the Recovery Support Performance Domains.
To determine eligibility of current and previous employment/volunteer work,
the following must apply to and be clearly documented by applicant: You must
be currently employed or volunteer in a recovery support specialist position
to be eligible for CRSS Certification;
Acceptable employment is one in which the applicant is working in a position
where a minimum of 51% of his/her time is spent providing mental health
recovery support services. The applicant minimally has primary responsibility
for providing recovery support services to an individual and/or group,
preparing recovery plans, documenting client’s progress and is clinically
supervised by an individual who is knowledgeable in the Recovery Support
Performance Domains.
BE SURE TO ATTACH A JOB DESCRIPTION FOR YOUR CURRENT POSITION. Job
descriptions must be on agency letterhead and dated and signed by applicant
and supervisor. All relevant former employment must be verified by job
descriptions from employers. Please reproduce this form as needed to record
work experience.
OTHER CERTIFICATIONS/LICENSES: List any other certifications or licenses you hold, and the state in which the credential is issued; if credential is national, please note.
All answers are correct to the best of my knowledge. I authorize any
educational institution or, other body having knowledge of my academic status,
to release information to the ICB regarding my status.
Signature of Applicant
Date
SUPERVISED PRACTICAL EXPERIENCE
To Supervisor: Please complete this form indicating applicant’s supervised practical training. This form is not intended to document applicant’s total number of hours worked, but rather the hours of supervision you have provided the applicant directly or indirectly. PLEASE RETURN THIS FORM DIRECTLY TO ICB, 401 East Sangamon Avenue, Springfield, IL 62702.
I hereby attest to the fact that I have provided the applicant supervision for
the number of hours noted below.
Realizing that supervision may take place in a variety of settings and have
many faces, ICB determined not to place limiting criteria on qualifications of
a supervisor. Rather, it was determined that supervision should be as broadly
defined as in the Center for Substance Abuse Treatment/Substance Abuse and
Mental Health Services Administration’s Technical Assistance Publication
Number 21. TAP 21 defines supervision/clinical supervision as: the
administrative, clinical, and evaluative process of monitoring, assessing, and
enhancing performance.
EDUCATION FORM
Please reproduce this form as needed to record all RELEVANT education. Be sure to attach documentation (i.e. transcripts, certificates) that supports participation. Lack of documentation will result in the inability to apply these hours towards certification.
STATEMENT OF SELF-DISCLOSURE
A Certified Recovery Support Specialist (CRSS) is a mental health consumer
who has been trained and certified to help other consumers identify and
achieve specific life goals. The CRSS cultivates the consumer’s ability to
make informed, independent choices, and assists consumers in gaining
information and support from the community to make their goals a reality. As a
CRSS, an individual accepts and agrees that his or her experience as a mental
health consumer will be known by their colleagues, consumers and others with
whom s/he may share that s/he has achieved this certification. Additionally, a
CRSS will follow the “Model Code of Ethics” outlined in the Illinois Certified
Recovery Support Specialist Model. “I understand the terms stated above, and I
accept and agree to these terms. I understand that, upon successful completion
of the application and examination, I will be issued a certificate as a
Certified Recovery Support Specialist (CRSS) under the terms stated above.”
Signature
Date
ASSURANCE AND RELEASE
The Illinois Certification Board (ICB) may request further information from
all persons listed on the application form, in order to verify training,
employment, etc. This information is not available to others outside the
certification process without the written consent of the applicant. “I give my
permission for the ICB Board and staff to investigate my background as it
relates to information contained in this application for certification as a
Certified Recovery Support Specialist. I understand that intentionally false
or misleading statements, or intentional omissions, shall result in denial or
revocation of certification.” “I consent to the release of information
contained in my application file, and other pertinent data submitted to, or
collected by the ICB, to officers, members, and staff of the afore mentioned
board.” “I further agree to hold the ICB, it’s officers, board members,
employees, and examiners free from civil liability for damages or complaints
by reason of any action that is within the scope of the performance of their
duties which they may take in connection with this application and subsequent
examinations, and/or the failure of ICB to issue certification.” “I certify
that I have read and subscribe to ICB, Inc.’s Code of Ethics for Certified
Recovery Support Specialists. “I further certify that my CRSS classification
and status is public knowledge.” “I hereby affirm that the information
provided on this form is correct and that I believe I am qualified for the
certification for which I am applying.”
Signature of Applicant
Date
CODE OF ETHICS FOR CERTIFIED RECOVERY SUPPORT SPECIALIST
CODE OF ETHICS FOR CRSS PROFESSIONALS
A code of ethics is a set of guidelines which are designed to set out
acceptable behaviors for members of a particular group, association, or
profession. The CRSS code of ethics serves to:
- Protect consumers of recovery support services
- Set a professional standard
- Increase confidence in the profession
- Identify core values which underlie the work performed
- Create accountability among CRSS professionals
- Establish occupational identity and maturity
ETHIC | IMPORTANCE |
---|
CRSS professionals will, when appropriate, openly share their stories of hope
and recovery and will likewise be able to identify and describe the supports
that promote their recovery and resilience.| Science has shown that having
hope is integral to an individual’s ability to recover. Hearing stories of
recovery helps people develop hope, particularly when those stories are
relevant to others’ lives and helps them to identify supports for their own
recovery.
CRSS professionals will practice safe and healthy disclosure about their own
experience through general sharing focused on providing hope and direction
toward recovery.| The experience of recovery and what is helpful is different
for each person. Sharing one’s recovery story can promote hope, but must not
be prescriptive.
CRSS professionals will maintain high standards of personal conduct and will
also conduct self- care in a manner that fosters their own recovery.| As a
role model, a CRSS professional’s integrity and health choices influence the
practices of persons served.
CRSS professionals will fairly and accurately represent themselves and their
capabilities to individuals they serve and to the community.| The goal is to
get a person to the right source of support for their current need. Damage
occurs when a professional misrepresents what services they are qualified to
provide.
CRSS professionals will keep current with emerging knowledge relevant to
recovery and openly share their knowledge.| Persons served deserve to make
choices based on the best information possible. Information and understanding
regarding mental health recovery is ever evolving and expanding.
CRSS professionals will not abuse substances under any circumstances.| As a
role model, a CRSS professional’s integrity and health choices influence the
practices of persons served.
CRSS professionals will provide services to meet the identified needs of the
individuals they serve as indicated within their service plan. They will avoid
providing services that are unnecessary or not capable of producing the
desired effect.| Persons served deserve individualized services with
demonstrated effectiveness.
---|---
CRSS professionals shall only provide service and support within work hours
and locations approved by the agency.| Persons must be afforded protection
from abuse, misconduct and conflicts of interest which are more likely to
occur outside the scope of professionally sanctioned hours and settings.
CRSS professionals will be guided by the principle of consumer self-
determination while also considering the needs of others and society. The
primary responsibility of CRSS Professionals is to help individuals they serve
achieve their goals, based upon their needs and wants.| While personal
responsibility and individual choice are cornerstones of recovery, these are
balanced by the need for support and safety not only of the individual, but of
others and the greater society.
CRSS professionals will advocate for the full involvement of individuals they
serve in communities of their choice with services in safe and least
restrictive environments possible.| Recovery is the process by which persons
with mental illnesses live, work, learn and participate fully in their
communities. All individuals have the right to live in a safe and least
restrictive environment.
CRSS professionals must not discriminate against individuals based on race,
religion, age, sex, disability, ethnicity, national ancestry, sexual
orientation or economic condition.| Individuals have the right to be treated
with equality and esteem.
CRSS professionals will never intimidate, threaten, harass, financially
exploit, use undue influence, physical force or verbal abuse, or make
unwarranted promises of benefits to the individuals they serve.| Even when
providing peer support services, the CRSS professional is at least implicitly
in a position of power as a staff person and must be careful how that
influence or perceived authority might place pressure upon individuals.
CRSS professionals will avoid relationships or commitments that conflict with
the interests of individuals they serve, impair professional judgment, imply a
conflict of interest, or create risk of harm to individuals they serve. When
dual relationships are unavoidable, it is the responsibility of the
professional to seek supervisory consultation to conduct him/herself in a way
that does not jeopardize the integrity of the helping relationship.| Even when
providing peer support services, the CRSS professional is at least implicitly
in a position of power as a staff person and must be careful how that
influence or perceived authority might place pressure upon individuals.
CRSS professionals will never engage in romantic or sexual/intimate activities
with the| The real and perceived power between a human service professional
and the persons they
individuals they serve. They will not provide services to individuals with
whom they have had a prior romantic or sexual relationship.| serve creates an
imbalance of power that is advantageous to the professional and
disenfranchising to the person served. This removes the possibility for a
genuine consensual relationship. Relationships of this type also cloud the
professional’s needed objective judgment, which reduces the quality of
services the person deserves.
---|---
CRSS professionals will not accept gifts of significant value from individuals
they serve. They do not loan, give, or receive money or payment for any
services to, or from, individuals they serve.| Even when providing peer
support services, the CRSS professional is at least implicitly in a position
of power as a staff person and must be careful how that influence or perceived
authority might place pressure upon individuals to give. A gift of significant
value from a consumer is essentially payment for a service that is already
being paid for by other means. Receiving a gift from an individual may also
unintentionally impact the treatment of that individual and other persons
served in an unfair manner.
CRSS professionals will, at all times, respect the rights, dignity, privacy
and confidentiality of those they support. CRSS Professionals will respect
confidential information shared by colleagues in the course of their
professional relationships and interactions.| Individuals have rights,
including the right to privacy, and CRSS professionals should not only honor,
but advocate for the necessity and enforcement of such rights.
CRSS professionals have a duty to inform appropriate persons when disclosure
is necessary to prevent serious, foreseeable, and imminent harm to an
individual they are serving or other identifiable person. CRSS Professionals
working in the human services field are mandated reporters of abuse, neglect
and exploitation.| The professional has a duty not only to protect persons
served, but also other individuals and society at large.
CRSS professionals will avoid negative criticism of colleagues in
communicating with individuals they serve and other professionals.| CRSS
professionals must use their influence for constructive purposes and not
engage in activities that detract from the recovery support of persons with
mental health challenges. Persons served benefit from a thoughtful, team based
approach where their welfare is the primary concern.
Adapted from the Peer Specialist Code of Ethics and Professional Standards by Colorado’s Northeast Behavioral Health Partnership (2011)
PERSONAL STATEMENT
As a Certified Recovery and Support Specialist, I shall strive at all times to
maintain the highest standards in all services I provide, valuing competency
and integrity over expediency or ability, providing services only in those
areas where my training and experience meet established standards. I shall
always recognize that I have assumed a heavy social and vocational
responsibility due to the intimate nature of my work, which touches the lives
of other human beings. My signature below indicates my agreement with and
willingness to abide by this Code of Ethics.
NAME
DATE
NOTARY SIGNATURE
DATE
NOTARY STAMP
CRSS Application Checklist
The following should be included in your CRSS Application:
When application is complete, send all materials to ICB, 401 East Sangamon Avenue, Springfield, IL 62702.
Read User Manual Online (PDF format)
Read User Manual Online (PDF format) >>