Substance abuse is categorized as the change that take effect to one’s brain while under the influence of an addictive drug substance. Substance abuse counselors evaluate a client’s mental and physical state in order to best assess their readiness for treatment before working with them to develop skills and behaviors that are necessary to recover from their addiction or to modify their behavior. While some may believe that substance abuse and addiction occurs to people with low moral principles or lack of willpower, it is actually the effect that the chemical makeup of these substances has on the individual's body and mind.
The prevalence and wide-reaching impact of drug addiction are the source of ongoing concern for our government, health care industry, schools, and employers. According to the Substance Abuse and Mental Health Service’s Administration 2013 National Survey on Drug Use and Health, an estimated 21.6 million persons aged 12 or older were classified with substance dependence or abuse, including illicit drugs and/or alcohol. Substance abuse counseling is a need for this nation that is increasing with health care reforms and societal changes.
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What does a Substance Abuse Counselor do? What is the role of an Addiction Counselor?
A typical client who has been abusing substances may find their addiction to include alcohol, illegal drugs such as amphetamines, opiates, cocaine, or prescription medications. Substance abuse is a dependency on any mood-altering substance. As defined by the American Society of Addiction Medicine (ASAM) addiction is characterized by, “an inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response." As with other chronic diseases, addiction entails cycles of remission and relapse. Some substance abuse counselors will meet with individuals who have a dual diagnosis, such as obsessive compulsive disorder and addiction. Without treating the addiction or engaging in recovery activities, the addiction can progress, resulting in disability or premature death.
While there are similarities of behavior across all types of substance abuse, an experienced substance abuse/addiction counselor knows to carefully treat each client as an individual with a unique history, personality traits, and pattern of abuse. Treatment plans are personalized based on a range of factors and may include individual or group therapy, as part of a comprehensive inpatient or outpatient treatment plan.
Substance abuse counselors must skillfully forge a trusting therapeutic relationship with their client, while they continue to assess their needs and progress, as summarized by the National Institute on Drug Abuse. A skilled counselor will help their client to become invested in the process. According to Amos Sales, Ed.D., a substance abuse counselor is one part of a larger treatment plan that may also include a community support group such as Alcoholics Anonymous (AA), alcoholism education, halfway houses and/or medication as prescribed by a psychiatrist or other medical doctor. Successful outcomes have been attributed to intervention, aversion therapy, stress management, solution-focused brief therapy, and social skills training.
The substance abuse counselor must determine the optimal counseling modality (cognitive, experiential, behavioral, dynamic) at each progression. Successful counseling has process factors including the counselor's establishing an open and collaborative rapport, facilitating client cognitive learning through reframing, feedback, and insight, and assisting the client in behavior changes through behavioral regulation, reality testing, and successful experiences. A successful substance abuse/addiction counselor will establish trust, create structure, address problems, and incorporate various therapeutic techniques where appropriate.
The optimal outcome is for clients to be able to successfully utilize the tools you have given them to achieve and maintain abstinence, reestablish their lives, make amends, and continue on with their daily life confidently, healthily and carefully.
Steps to Become a Substance Abuse Counselor
Step 1: Complete a bachelor’s degree in addiction studies, behavioral, social science, or psychology field.
Because a master’s degree is a requirement for licensure counselor, pursuing a bachelor’s degree in substance abuse and/or addiction studies or a related fields sets the groundwork for rehabilitation counseling students. Coursework for undergraduate studies in these fields will typically include the evaluation of human development, counseling foundation, theories of personality, foundations of addictions, and introduction to psychology.
Step 2: Earn a master’s degree in substance abuse and/or addiction counseling.
Some substance abuse counselor positions require only a bachelor’s. However to be licensed and certified, you should earn your master’s degree. Obtaining your graduate degree in counseling is a requirement for for practice as a licensed drug and alcohol counselor and clinical substance abuse disorder counselor .
Step 3: Complete graduate and postgraduate internship experience for certification/licensure requirements.
As a crucial aspect of accredited counseling master’s programs, graduate supervised counseling experience provides students with insight into their future role as a substance abuse counselor, gaining hands-on experience under other professional counselors.
Step 4: Pass any required substance counseling exams for licensure and certification.
Some states and/or counseling programs require the passing of a recognized examination for gradation or licensure such as the National Counselor Examination (NCE) and/or the National Clinical Mental Health Counseling Examination (NCMHCE). Some organizations require an examination to receive certification or credentialing.
Step 5: Apply for and earn additional counseling certifications.
Licensed professional counselors can pursue a national certification through the National Board of Certified Counselors (NBCC). The National Certification Commission for Addiction Professionals (NCC AP) offers three different credentials with additional specializations.
Step 6: Continue your education and stay up to date on substance abuse and addiction counseling trends and changes.
Continuing education is imperative to maintaining professional counseling licensure/certification and keeping up-to-date with any updates to the substance abuse and addictions field.
There can be five levels of counseling staff for substance abuse:
Substance Abuse Technician - Entry level, no clinical experience necessary
Substance Use Disorder Counselor - Bachelor’s degree
Clinical Substance Abuse Disorder Counselor - Master’s degree, practice only within a licensed program
Independent Substance Use Disorder Counselor - Master’s degree, practice and bill independently.
Depending on the setting and state in which they practice, the educational requirements for a substance abuse/addiction counselor vary. However, as is the case with any counselor, a master’s degree in counseling or related field such as social work or psychology is highly recommended and often required.
Certification demonstrates your experience, education and level of counseling skills. The American Institute of Health Care Professionals (AIHCP) offers the Substance Abuse Practitioner Certification Program . The Association for Addiction Professionals (NAADAC) offers certification programs specific to addiction and recovery. Many counselors become credentialed after having worked with an institution for a period of time. Some employers will pay fees associated with attaining counseling credentials.
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What are the licensing or certification requirements?
Substance abuse counselors in private practice must be licensed. Licensing requirements vary by state, but all states require a master’s degree from an accredited university, at least 2,000 hours of supervised clinical work, and a passing score on a state-recognized exam. While some practice requires just a Bachelor’s degree (see above levels of substance abuse counselors), in order to practice clinically, a master’s degree and licensure is required. Practicing addiction/substance abuse counselors may also need to take continuing education courses to maintain licensure. Information about each state's regulatory board can be found through the National Board for Certified Counselors.
Those practicing addiction counseling outside of private practice face less stringent requirements, depending on the state in which you plan to practice. Not all states require a specific degree, but many require applicants to pass an exam. Contact information for your state’s licensing board can found through the Addiction Technology Transfer Center (ATTC). You will also find a comprehensive list of different titles and certifications through the ATTC as these vary state to state and setting to setting.
Career Outlook for Substance Abuse Counselors and Addiction Counselors
According to both the U.S. Bureau of Labor Statistics (BLS) he average annual salary for a substance abuse/addiction counselor in the U.S. is about $40,000. However, salaries vary depending on the industry, setting and experience. Despite the relatively low compensation awarded to those in this important field, there are very high rates of satisfaction reported among industry surveys. Perhaps because most people become addiction counselors so that they can make a profound difference in the lives of those who really need a helping hand.
Employment of substance abuse/addiction counselors is reported to increase 22% between 2014 and 2024 as mental health counseling is increasing being covered by health insurance programs. The BLS summarizes that states are seeking to provide treatment and counseling services to those with substance use disorders in an effort to decrease jail time.
The highest rate of employment is within outpatient care centers for substance abuse/addiction counselors. They are also employed in residential, mental health, and other substance abuse facilities across the nation. Contrary to the average earnings, substance abuse/addiction counselors have reportedly earnedup to $72,000 per year working within junior colleges and slightly less in scientific research and primary and secondary school settings.