Analysis of client deaths in California recommends tougher counselor standards.

A California nonprofit organization's finding that staff failures were present in 40 percent of the cases of client deaths it examined in residential treatment facilities has spurred an intense discussion and a call for tougher standards in a state with comparatively lenient requirements for credentialed counselors.

The nuances of the ongoing debate in California reflect the soul-searching of a profession that still lacks a widespread consensus on what its front-line workers' qualifications should be, as well as how and by whom their activities should be regulated.

Most of the individuals who have spoken out in California in response to last month's report from The Justin Foundation entitled The War on Addiction agree that California should beef up its education and training requirements for the certification of professional counselors. But some warn that with the addiction profession already experiencing a crisis in attracting and retaining front-line workers, too high a standard could make it impossible for some agencies to continue to perform needed services, especially at a time when Proposition 36 continues to drive up demand for treatment services.

"All of us agree that the requirements need to be more stringent, but you have to give people a reasonable career pathway as well," Joan E. Zweben, Ph.D., founder of The East Bay Community Recovery Project and The 14th Street Clinic & Medical Group in the Bay Area, …