What Does a Substance Abuse Counselor Do?

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Substance abuse counselors help people experiencing substance use and drug addiction problems. They provide treatment and support for people trying to overcome substance use disorders or addictions.

Substance abuse counselors typically work in substance abuse treatment facilities, such as outpatient clinics and residential treatment centers. They may also work in hospitals, mental health clinics, or private practice.

History of Substance Abuse Counseling

Approaches to treating substance misuse and addiction have undergone many changes over time. In the past, addiction was often regarded as a character flaw or moral failure.

This perspective has shifted significantly in recent decades. Rather than seeing addiction as a personal failing, experts now view addiction as a brain-based condition that involves a complex interaction between genetics, brain circuits, the environment, and individual experiences.

Today, substance abuse counselors utilize various techniques to help address the many factors contributing to and maintaining substance abuse problems.

What Does a Substance Abuse Counselor Do?

Substance abuse counselors work with individuals and groups to provide counseling, education, and support to those struggling with substance use disorders. They may also provide case management services and refer clients to other resources, such as support groups or 12-step programs.

Specific job duties often vary depending on where professionals work and the type of support they offer. They often counsel individuals or groups to help people understand the factors contributing to addiction. Helping people develop new coping skills and ways of thinking is another important part of what substance abuse counselors do.

These professionals work with individuals who experience a range of substance use issues. This may involve working with people with alcohol use disorders, but they may also work with clients with substance use disorders involving drugs such as cocaine, heroin, marijuana, and prescription medications.

In addition to working with the individual with a substance use problem, counselors also work with couples, families, and others who may be affected by an individual's substance use.

Techniques Used by Substance Use Counselors

Substance abuse counselors use various techniques to help clients overcome substance use disorders and maintain sobriety. These techniques may include:

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a treatment approach that focuses on changing thoughts and behavior patterns. Substance abuse counselors often use CBT techniques to help clients recognize the inaccurate thoughts and feelings that help maintain addiction. They also use CBT to teach new coping skills that help people find new ways to deal with cravings, relapses, and stress.

Motivational Interviewing

Substance abuse counselors may also utilize an approach known as motivational interviewing to help people with addictions find the motivation to make changes in their lives. Using this strategy, counselors offer empathy and support while encouraging clients to see the discrepancy between where they are now and where they want to be.

The goal is to support each person's self-efficacy so that they feel motivated and capable of achieving their goals.

Substance Abuse Education

Professionals who work in substance abuse counseling also work to educate people about the effects and risks of drug and alcohol misuse. Psychoeducation is often conducted in a group therapy setting and helps participants learn more about the effects that substances have, the related behaviors that often contribute to drug use, and the potential consequences.

The goal is to help people gain greater self-awareness and an understanding of the community resources and treatments available to help them recover. Through education, people are often inspired to enter treatment on their own.

Important Skills for Substance Abuse Counselors

Substance abuse counseling can be a challenging field that requires patience and compassion. Some important qualities that a substance abuse counselor should have include:

  • Listening skills: Active listening is an important ability for anyone in the mental health field. People may not always be forthcoming, so knowing how to listen and put yourself in their position can be helpful. Listening without judgment can help clients feel heard, understood, and supported.
  • Empathy: Those struggling with addiction often cope with a lack of social support, particularly if their substance use has played a role in alienating friends and family. Empathizing and offering support can play an important part in addiction recovery.
  • Patience: Recovery from substance use rarely follows a straight path, so counselors must be ready to support clients as they deal with setbacks, obstacles, and relapses.

All of these qualities play a role in developing what is known as the therapeutic relationship or the working alliance between a mental health professional and a client. This relationship, which involves a bond of respect, trust, and mutual collaboration, can play an important part in successful substance use disorder treatment.

Where Do Substance Abuse Counselors Work?

Substance abuse counselors typically work in substance abuse treatment facilities, such as:

  • Outpatient clinics
  • Residential treatment centers
  • General hospitals
  • Mental hospitals
  • Mental health clinics
  • Government agencies
  • Private practice
  • Prisons
  • Probation and parole agencies
  • Juveline detention facilities
  • Halfway houses
  • Detox centers
  • Employee assistance programs

The work substance abuse counselors perform may vary. They may provide individual counseling, lead group therapy sessions, and intervene during crises. Sometimes this may involve being on-call and working weekends, evenings, and nights.

Education Requirements for Substance Abuse Counselors

Substance abuse counselors typically need at least a bachelor's degree in substance abuse counseling or a related field. One survey found that 71% of professionals employed in the addictions workforce held a bachelor's degree or higher.

Substance abuse counselors may have a master's degree or doctorate degree.  Around 48% of people working in the addictions field hold a master's or doctorate.

However, individual requirements can vary depending on the state and the employer. An individual's specific educational background and experience will determine the type of services they can provide.

Those with master's-level degrees in fields such as psychology, social work, counseling, and related fields can provide individual counseling or may work in private practice.

Professionals in private practice must be licensed by the state where they work. Such requirements vary from one state to the next, but most require between 2,000 and 4,000 hours of supervised clinical experience, the passage of a state licensing exam, and the completion of continuing education credits every year.

One study found that people employed as supervisors were more likely to be certified or licensed and hold a masters-level degree. Those with a higher educational status had greater familiarity and acceptance of evidence-based therapies. Counselors working in residential settings tended to have fewer years of experience.

Job Outlook and Salary for Substance Abuse Counselors

The job outlook for substance abuse counselors is expected to grow 23% from 2020 to 2030, which is faster than the average for other occupations. The demand for substance abuse counseling services is expected to increase as more states legalize marijuana, and the opioid epidemic continues.

The median annual salary for substance abuse counselors was $48,520 in May 2021. According to the U.S. Bureau of Labor Statistics, the lowest 10% of wage earners make less than $30,870, while the highest 10% earn more than $77,980.

The employment sector also plays an important role in determining salary. The median yearly earning for those employed in residential substance abuse facilities was $42,900, while the median for those in government settings was $60,450. 

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

8 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kendra Cherry, MSEd
Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."