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Updated on April 26, 2021

Substance Abuse Counseling & Careers

What Do Substance Abuse and Behavioral Disorder Counselors Do?

Substance abuse and behavioral disorder counselors provide support and guidance for people and their family members who are dealing with alcohol addiction or drug addiction and co-occurring disorders. The goal is to uncover the cause of alcohol addiction or drug addiction and learn to cope with it.

Counselors also help people understand why treatment is important and recognize the effect their disorder has on their lives and others’ lives. This includes their health issues, such as:

  • Mental and emotional health
  • Physical health
  • Pregnancy
  • Chronic health issues

Counselors also act as a clearinghouse that collect and provide information about support groups and other resources. They also educate family and caregivers regarding the patient’s disorder and oversee family therapy sessions.

An addiction counselor plays an active role in a patient’s recovery. They work with doctors and other health professionals to create addiction treatment plans or action plans. They also evaluate the effectiveness of that plan and monitor progress and look for signs of relapse.

Throughout treatment, addiction professionals talk to patients and help them understand and manage their disorder(s). This is done through individual face-to-face counseling sessions, group therapy sessions, and more. Most play a role in all aspects of treatment, from detox to recovery support to long-term sober living.

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What Makes a Good Addiction Counselor?

An addiction counselor works with their patients to identify their needs and goals. They help develop a personalized treatment plan with their patients.

A good addiction counselor is compassionate and an excellent listener. The first counseling sessions help lay the foundation for mutual trust, which is essential for a successful outcome.

Many counselors are former addicts themselves, although this is not a requirement. As such, many counselors are empathetic and patient. A good addiction counselor can help create a safe environment for the user to communicate openly.

Good communication between the counselor and the user helps the therapist identify the underlying problems that may drive addictive tendencies. This part of therapy is crucial because without understanding the underlying issues, long-term recovery is more challenging.

A good counselor can also diagnose and treat any co-occurring mental health problems. Another essential quality in a good addiction counselor is a desire and commitment to help their patients work through the stages of change to reach long-term sobriety.

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Types of Therapies Offered

Counselors work in various settings, including long- and short-term residential, outpatient, individual, and group counseling programs. Many therapies are offered, including:

  • Cognitive Behavioral Therapy (CBT): Assists people with a substance use disorder to recognize and change their maladaptive behaviors. It also helps with the development of coping skills, identifying risky situations, learning what to do about them, and preventing relapse.
  • Contingency Management (CM): Treats several types of substance use disorders and encourages and reinforces sobriety.
  • Motivational Interviewing (MI): Assists in resolving ambivalence in recovering individuals so they can embrace their treatment efforts and develop their motivation.
  • Dialectical Behavioral Therapy (DBT): Focuses on treating severe personality disorders. It also assists with reducing cravings, avoiding situations, and learning healthy coping skills.
  • Rational Emotive Behavior Therapy (REBT): Assists with understanding one’s thoughts and developing better habits and positive thinking.
  • Matrix Model: Employs a combination of various therapeutic techniques, including rewarding good behaviors and teaching self-esteem, dignity, and self-worth.
  • Group counseling: Provides support and guidance in a group setting, such as 12-step programs.

Which of these therapies used is based on whether they are part of an organized recovery program or work in private practice. Those in private practice have autonomous control over case management and treating a patient.

How Does Someone Become a Substance Abuse Counselor?

The majority of jobs available for substance abuse counselors require at least a bachelor’s degree, but these requirements vary by state. One can be a certified counselor with a high school diploma, 6,000 hours of supervised work experience in addictions, and passing IC&RC or NAADAC test. 

There are also some instances in which people offer guidance to those with substance use disorders without any official education or requirements. An example of this is leading 12-step group counseling programs such as Alcoholics Anonymous.

The amount of education needed to work as a counselor and whether or not you need an advanced degree is often predicated on the environment in which you plan to work.

The average career of a path of a counselor includes the following:

Earn a Bachelor’s Degree

Though it is possible to work in the addiction counseling field without a Bachelor’s Degree, most counselors have at least this much education. The majority of them have degrees in counseling, social work, human services, behavioral health, or psychology, which are the types of degrees required for admission to a Masters-level program. Requirements vary from state-to-state, so make sure you know what is required in your state.

Earn a Master’s Counseling Degree

Many people who intend to pursue more than an entry-level position in substance abuse, behavioral disorder, and mental health counseling need an advanced degree.

Complete an Internship or Practicum

Most states require counselors to participate in a supervised internship or practicum as part of their coursework to receive their license in counseling. This is a great opportunity to gain hands-on clinical experience from or be able to observe experienced mental health counselors within the field of mental health. This is also a great opportunity to learn more about a more specific career path. You might find that you want to pursue further education or work with a specific type of patient.

Earn Professional Credentials

Substance abuse counselors are required to be licensed to practice legally. Standards vary from state-to-state, but most states require a certain amount of education, a certain amount of hands-on work, and a certain amount of ongoing training and education. There is also a licensure exam.

The next step once someone is working in the field of substance abuse counseling, should they choose to further their education, is to earn a Phd.

How to Find a Substance Abuse Counselor

Most people find a drug or alcohol counselor in one of two ways:

  • They research their options on their own
  • They are referred to a counselor from another healthcare professional or a friend or family member

It’s important to determine if a counselor is right for you before pursuing a long-term relationship. In addition to the counselor’s reputation, this also includes their work experience and credentials. 

However, just because someone is highly recommended and skilled at what they do does not mean they are the right fit for every patient. It’s important to check a counselor’s credentials and patient reviews. This information alone is not enough to make your decision. It’s the first step in the process.

You’ll want to schedule a consultation with one or more alcohol or drug abuse counselors either in person or by phone. This allows you to speak to the person and see if there is an initial connection.

Additionally, you’ll want to look at the counselor’s area of expertise and consider their therapeutic approach. You can learn this information from their website or by scheduling an initial meeting. Though some people will want to know the ins-and-outs of the various approaches, others just want to know if they like a counselor and if that counselor has experience treating similar substance abuse issues to their own. 

If you feel comfortable with a counselor and the methods you discuss in your initial meeting seem doable and give you hope, chances are you have found someone with whom you can work.

It is completely appropriate to not decide after an initial meeting with just one counselor. Some people must meet with two or three counselors before finding someone that works for them. 

You can let each potential counselor know that you are “shopping around.” The best counselors recognize that they are not selling you a product, but instead are looking to begin a therapeutic relationship.

Finally, remember that even if you thought you found a counselor, the relationship can change over time. After a few meetings, some people realize that what they thought was going to work doesn’t progress. Others work with a counselor and achieve progress but eventually need to work with someone else. All of these are acceptable and are expected parts of attending mental health counseling and working as a counselor.

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“Substance Abuse, Behavioral Disorder, and Mental Health Counselors: Occupational Outlook Handbook: U.S. Bureau of Labor Statistics.” Bls.Gov, 12 Apr. 2019,

National Institute on Drug Abuse. “Types of Treatment Programs.” Drugabuse.Gov, 2018,

Do You Have What It Takes to Become An Addiction Counselor? The Key Traits and Qualifications of a Successful Drug & Alcohol Counselor, InterCoast Colleges,

Rieckmann, Traci et al. “The substance abuse counseling workforce: education, preparation, and certification.” Substance abuse vol. 32,4 (2011): 180-90. doi:10.1080/08897077.2011.600122,

Vilardaga, Roger et al. “Burnout among the addiction counseling workforce: the differential roles of mindfulness and values-based processes and work-site factors.” Journal of substance abuse treatment vol. 40,4 (2011): 323-35. doi:10.1016/j.jsat.2010.11.015,

Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 41.) 7 Training and Supervision. Available from:,

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