Once clinicians have identified the areas where addiction, mental health, and/or infectious disease services need to overlap, the next step is identifying the barriers that prevent it. Barriers can be individual services or systemic problems. Individual barriers result from:

• Lack of knowledge;
• Lack of skill;
• Professional belief; and
• Tradition.

Systemic barriers, which have the potential to threaten professional training, can result from:

• Program mission;
• Admission criteria;
• Program components;
• Professional standards;
• Agency regulations;
• Funding requirements; or
• Conflicting Federal, State, or local regulations.

Both individual and systemic barriers can be removed through carefully planned Cross-Training. Cross-Training can be successful where other efforts have failed because it focuses on the point of service and because both practitioners and systems have the goal of improving the services delivered by individual clinicians at the point of service.

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