What is Substance Abuse Counseling?

Substance abuse counselors help people to recover from drug and alcohol addiction. By using several behavioral therapy techniques, these counselors can help patients reclaim their lives.

In 1784, physician Benjamin Rush was the first in the United States to describe addiction as a public health problem. Early treatments included stays in expensive and often unethically run asylums, sometimes paired with mysterious injections and unproven therapies. Sigmund Freud even suggested cocaine as a cure for alcoholism and morphine addiction.

Today, substance abuse counselors understand that addiction is a disease that can affect the brain in complex ways. It cannot be solved with miracle cures, but through finding the right treatment combinations for each patient.

How Does Substance Abuse Counseling Work?

Substance abuse counseling focuses on behavioral therapies that teach clients to understand their addictions and manage situations that may trigger a craving. These behavioral therapies may include individual care, group counseling, or family behavior therapy.

Substance abuse is treatable, but no single treatment works for everyone. Given that substance abuse can stem from a combination of genetics, mental illness, situational distress, and other factors, substance abuse counseling alone has its limits. Some patients require medications to aid in their recovery, such as acamprosate, disulfiram, or naltrexone, and pre-existing mental illness must also be taken into account.

What Are the Goals of Substance Abuse Counseling?

Substance abuse counseling aims to teach coping and stress management strategies, address and treat underlying issues that prevent recovery (such as mental and emotional disorders), and offer support and resources to sustain a patient's ongoing recovery. Substance abuse counselors can also help patients to rebuild their lives, including repairing the damage done to personal and professional relationships.

By teaching patients to regain control over their lives and banishing self-defeating behaviors, substance abuse counselors can guide recovering addicts through coping and stress management techniques.

Substance abuse counselors help recovering addicts to build a network to support them through their recovery

Substance abuse counselors also ensure that those who need additional support with mental and emotional disorders, such as post-traumatic stress disorder (PTSD), receive therapy that will help them on the road to recovery, including medical assistance or medication.

Ongoing counseling is crucial in helping recovering addicts to prevent a relapse. Stress, environmental triggers, and personal problems can make it difficult for patients to maintain their sobriety. Substance abuse counselors provide ongoing support, teaching patients to recognize their triggers and build coping strategies for long-term recovery.

Recovery is a complex process, and it is different for each patient. Substance abuse counselors help recovering addicts to build a network to support them through their recovery. These counselors may help patients to repair relationships with family and friends or assist them in reestablishing interrupted careers.

Substance Abuse Counseling Techniques

Some of the main substance abuse counseling techniques include behavioral therapies, motivational therapies,12-step facilitation therapy, various counseling models, and alternative therapies (such as acupuncture, creative expression therapy, animal therapy, and meditation).

Proven as a method for treating alcohol, marijuana, cocaine, methamphetamine, and nicotine, cognitive behavioral therapy trains patients to understand their addictive behaviors. Cognitive therapy emphasizes the source of addictive behavior and equips people to cope with cravings and triggers through tactics such as self-monitoring and avoidance.

Cognitive therapy emphasizes the source of addictive behavior and equips people to cope with cravings and triggers

Another behavioral technique, the matrix model, is primarily used for people recovering from stimulant addictions. Substance abuse counselors provide each matrix-model patient with a detailed plan for sustaining their recovery, outlining specific goals for counseling sessions and drawing from other recovery techniques.

Motivational therapy incentivizes the patient to recover from their addiction. Motivational enhancement therapy encourages people to commit to their recovery by focusing on immediate change. Contingency management and motivational incentive programs offer rewards such as vouchers that might be exchanged for movie passes, food, and other items. Community reinforcement, often paired with vouchers, is a 24-week therapy that focuses on improving relationships.

Substance abuse counselors may encourage those in recovery to join a 12-step program such as Narcotics Anonymous or Alcoholics Anonymous, as a resource for long-term sobriety. Some substance abuse counselors may also introduce 12-step tenets such as acceptance and surrender, as well as encouraging attendance at 12-step meetings.

Substance abuse counselors may encourage those in recovery to join a 12-step program such as Narcotics Anonymous or Alcoholics Anonymous

Depending on each individual's needs, a substance abuse counselor might suggest a combination of individual, family, or group therapy. Individual counseling involves one-on-one sessions with a substance abuse counselor, while family therapy involves a significant other or parent involvement in the case of adolescents. In group therapy, the counselor leads a discussion among patients who are all in recovery.

Substance abuse counselors employ these techniques with patients in outpatient mental health and substance abuse centers, prisons, parole agencies, juvenile detention centers, and hospitals.

Substance Abuse Counseling Techniques

Issues Treated by Substance Abuse Counseling

Substance abuse counseling helps many types of people struggling with addictions to alcohol, marijuana, cocaine, methamphetamine, opioids, nicotine, and more. The repercussions of substance abuse extend beyond the bodily risks of compulsive drug use. Substance abuse can result in joblessness, homelessness, financial struggles, domestic issues, and crime.

Addiction is a complex disease in which genetics play a crucial role, along with one or several of the underlying issues listed below. Through a combination of therapies, substance abuse counselors can help patients to face these issues and work toward recovery.

Benefits of Substance Abuse Counseling

How to Become a Substance Abuse Counselor

Though specific requirements vary by location, most substance abuse counselors hold at least a bachelor's degree. According to the Bureau of Labor Statistics, all fifty states require counselors who are in private practice to hold a master's degree.

In some states, substance abuse counselors obtain licensure by completing a minimum number of internship hours, which may include attending Alcoholics Anonymous and Narcotics Anonymous meetings. State examinations, applications, and fees may also be required.

Substance abuse counseling requires compassion, patience, and strong interpersonal skills.

How to Find a Substance Abuse Counselor

To find a substance abuse counselor, a person might begin by contacting their doctor or local hospital. Alternatively, they might seek out options online through a medical database, such as Healthgrades, or the Substance Abuse and Mental Health Services Administration's (SAMHSA) behavioral health treatment services locator.

  • Behavioral Health Treatment Services Locator SAMHSA provides a confidential database where people can search for substance abuse and mental health facilities by address, city, or zip code. The site does not collect personal information, and searches are anonymous.
  • Find a Substance Abuse Counselor Healthgrades is a website with a searchable database of physicians and medical facilities, including substance abuse counselors and facilities. Visitors can search for a counselor by state, read reviews, and gather contact information.

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