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The article presented here will discuss the basics of substance abuse counseling. This involves going over what exactly substance abuse counseling is, followed by what the role of the person aiding in the process is. The individual who assists an addict on his / her road to recovery and works closely with them is called a substance abuse counselor. Let’s begin talking about what is substance abuse counseling before diving into the role of a substance abuse counselor.

An intervention is an action that is taken with the aim of modifying the route of a disease process. The purpose of mentioning this was because substance abuse counseling is an intervention as well. It is an interruption in the ongoing course of addiction. More specifically, substance abuse counseling is the process the helps people get rid of their alcohol (or any other drug) addiction. During this process, the individual is guided in a way that drastically cuts down his / her use of the substance, whatever it may be; opiates, inhalants, depressants, etc. The goals of counseling differ according to the type of substance abuse that is in question. For example, to get rid of alcohol addiction, a process called Brief Alcohol Intervention (BAI) may be used.   

In general, substance abuse counseling makes use of some or all the following processes:

  1. Talk therapy sessions
  2. Communication regarding causes of addiction
  3. Positive and adaptive coping strategies
  4. Devising goals of treatment
  5. Devising plan / s of treatment
  6. Practicing skills and behaviors that are necessary for the treatment procedure
  7. Recommendations for a treatment program, for example, 12 step programs or support groups

A substance abuse counselor is also called an addiction counselor. As alluded to earlier in the introduction, a substance abuse counselor is a professional who is in charge of the substance abuse counseling process. These professionals are addiction counselors who are licensed and have vast knowledge in the field of psychology, chemical dependence, human behavior, therapeutic strategies, and mechanisms.

Although their titles may differ from one place to another, their basic goals of therapy and counseling remain the same. The counselors do not only deal with substance abuse recoveries and mental health problems, but their prowess extends to other behavioral problems such as eating disorders and gambling as well. These counselors may either be specialized in one field of work or type of patients (for example, only working with alcoholics), or they may have a more generalized circle of patients.

Crisis Intervention for Substance Abuse and Mental Health

Substance abuse counselors spend one on one time with each individual patient and come up with a unique path of treatment for each patient. They make sure confidentiality is maintained and the client’s information does not leave the counseling room or clinic. The counseling setting can also be a prison if need be. Thus, it is flexible according to the client’s needs. This entire job of substance abuse counseling requires immense patience and empathy. Other skills that are necessary for a good substance abuse counselor are good listening and communicating skills. It is essential for the counselor to be able to quietly listen to the patient, allowing trust to build amongst both parties. These counselors are the support system of an addict, someone with an eating disorder, or someone with a behavioral disorder (chronic gambler). Their role, in simplest terms, is to help the individuals recover through behavior modification and other treatment options. Some counselors may work with clients for a very long period of time to prevent relapse, which is fairly common among substance addicts.    

The first step that a substance abuse counselor takes is that he/she evaluates the patient’s psychological health before any treatment can begin. After the assessment of the client’s mental health condition, and once he/she is cleared and given the get-go, only then the professional asks the patient to go through medical detox. This is where the body that has previously been ingested drugs and/or alcohol frequently will now rid itself of all these toxins.

The counselor then goes on to ask about their social needs (which includes family and friends), making friendly conversation, and then moving on to the relevant treatment procedure. During this process, the counselor also goes over hindrances and potential impediments (called situational threats) that could set back the progress (such as some other underlying behavioral disorder or a learning disability). Such an in-depth treatment regimen can only be made by a licensed professional as they know exactly how to and which of the numerous aspects to consider while formulating a recovery plan.   

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A few other roles (some of which may overlap with what has already been discussed) of a substance abuse counselor include; meeting with clients regularly and evaluating their health issues, teaching coping mechanisms, providing updates to courts about their client’s journey to recovery, making aftercare plans post-treatment in order for the client to stay on track, holding meetings with family members to provide updates and support and also helping the patient find jobs and live a normal life once again.

Note that the below requirements are a general idea, and it could vary from state to state. For example, some states only require 150 hours of education. And some require as low as 2,000 clock hours of work. The below is to give you an idea of how it generally works in the States, and these numbers could change depending on the state you are in.

Educational Requirements:

350 hours of education are required by a candidate along with training that develops addiction counseling competencies;

  • At least 85 hours of the 350 needs to be committed towards substance abuse and alcohol knowledge. Of these 85 hours, tobacco usage and nicotine dependence need to have four hours committed to them.
  • A minimum of 150 hours should be committed towards alcohol and substance abuse counseling. Of the 150 hours, 15 must be put into cultural competence.
  • A minimum of 70 must be in the combined areas of assessment, evaluation, case management, treatment planning, and patient/ family/ community education.
  • Professional and ethical responsibilities should be given a minimum of 45 hours, and at least 15 of these hours must cover ethics related to addictions professionals. Also, at least 2 hours should be directed towards mandatory reporting of child abuse and maltreatment.

Education can be achieved through colleges or universities, government agencies, or other approved organizations. Distance learning is also an option if it is offered by an accredited college or through an approved provider. A CEU is awarded for ten clock hours of education; one semester hour is credited as 15 clock hours.

There is an educational package that candidates may go for which offers academic credit or one that does not. The same material is covered by all certified providers. It is still allowed to credit college coursework, provided the requirements are met. The agency notes that a bit of coursework taken as a portion of the qualifying degree program may be used in education and training necessities. Candidates will use the credentialing application to request that their transcripts be evaluated.

Exam Criteria:

Credentialed Alcoholism and Substance Abuse Counselor (CASAC) candidates have to take a written exam. The examination was developed by the IC&RC. Candidates will call the Credentialing Unit to request a registration form. A candidate can be approved any time after educational requirements have been met; it will be necessary to submit an application. The exam will cost $245, and the exam is offered via computer at ISO Quality Testing centers. A candidate who fails an examination attempt must wait 60 days before retesting. An unsuccessful candidate may continue to retest as long as the credentialing application remains active. However, each attempt entails a $245 fee.

Experience Needed:

6,000  hours of work experience are needed before credentialing by a person who has not got a college degree in a field related to human services. An associate’s degree (that is qualifying) may replace 1,000 experience hours. A qualifying bachelor’s degree can take place for 4,000 hours and a master’s degree for 6,000 experience hours. The credentialing agency has given a list of approved human service fields. The options among them are anthropology, audiology, community mental health, criminal justice, dance therapy, divinity, education, gerontology, music therapy, nursing, nutrition, occupational therapy, psychology, and rehabilitation and mental health counseling.

The work has to have taken place in an approved setting. Three hundred hours of supervised practical training has to be done. The trainee has to have at least ten hours of practical training in each of the main addiction counseling functions; this has to be done under direct supervision by a Qualified Health Professional (QHP). Volunteer work is creditable without limit if it is completed under a formal agreement and otherwise meets Credentialing Unit standards (including supervision requirements). A candidate can opt to credit a formal internship experience as education/ training or supervised experience but is not allowed to count it as both.

Additional Requirements:

Three professionals are required by the prospective CASAC to provide assessments of competency and ethical conduct. One has to come from the current or most recent clinical supervisor. One has to come from a CASAC or an addiction counselor who holds reciprocal-level credentialing through some IC&RC board. One has to come from a professional who is designated as a Qualified Health Professional. Substance abuse training and experience are necessary for the professional to have. He or she may hold credentialing as any of the following: counselor, family therapist, master or clinical social worker, registered nurse, occupational therapist, physician, physician’s assistant, psychologist, rehabilitation counselor, or therapeutic recreational therapist; a CASAC would also qualify. The Credentialing Unit requires fingerprint-based criminal background checks. Candidates have to use the approved vendor, MorphoTrust. It will be important to give the ORI and provider ID.

Application Process:

Candidates can apply before all the necessities have been met. Trainee status may be awarded when the substance abuse worker has completed the 350-hour education requirement or has accrued 4,000 work experience hours and completed 85 hours of applicable education; the 85 hours have to be dedicated towards alcoholism and substance abuse treatment. You cannot apply separately for the trainee status. The candidate shall file a CASAC application. The CASAC application will stay open for five years (based on the application postmark date). During this duration, the trainee is supposed to complete all the requirements for CASAC. There is an application fee of $100. The Credentialing Unit notes that you do not have to pay any additional fees to add materials to the file. You may extend the trainee status one time for three years. Ethical conduct evaluations will be required by the trainee to provide.

Long-Term Residential Program:

Twenty-four hours care is provided by long-term residential treatment, mostly outside of hospitals. The therapeutic community (TC) is the most well-known residential treatment model, with planned lengths of stay, which can last 6 to 12 months. TCs focus on the resocialization of the individual and use the entire community of the program, which includes other residents, staff, and the social context (as active components of treatment). Addiction is looked at as the context of an individual’s social and psychological deficits, and treatment looks into developing personal accountability and responsibility along with making the individual socially productive.

The treatment is highly structured and can be taken as confrontational at times, with certain activities made to help individuals examine damaging beliefs, self-concepts, and destructive patterns of behavior and embrace new, more productive, and constructive ways to interact with others. Many TCs offer comprehensive services, which may include training on how to get employed and other such services. Studies show that TCs can be changed to treat individuals with special needs, including adolescents, women, homeless individuals, people with severe mental disorders, and individuals in the criminal justice system.

Short-Term Residential Program:

Short-term residential programs provide a vigorous but comparably brief treatment that is based on a newer 12-step approach. These programs originally came into being to treat alcohol problems, but during the cocaine outburst of the mid-1980s, many firms began to treat other types of drug use disorders. The original residential treatment technique contains a 3 to 6-week hospital-based inpatient treatment phase, which follows an extended outpatient therapy and participation in a self-help group, such as AA. Following stays in residential treatment programs, it is necessary for individuals to remain engaged in outpatient treatment programs and/or aftercare programs. Once the patient leaves the residential setting, these programs will help to reduce the risk of deterioration and going back to substance use disorder or the specific substance.

Outpatient Treatment Program:

This type of treatment varies in the types and how intense the services offered are. The cost of outpatient treatment is lesser than residential or inpatient treatment and, more often than not, is suitable for people with jobs or excessive social supports. It should be known, however, that low-intensity programs could offer little more than substance education. Other outpatient programs, such as intensive day treatment, can be compared to residential programs in services and effectiveness, depending upon the individual patient’s characteristics and requirements. In many outpatient programs, a major component could be group counseling. Some outpatient models are also made to treat patients with medical or other mental health issues along with their drug addictions.

Group Counseling:

Many therapy settings like to use group therapy to make the most of the social reinforcement offered by peer discussion and to try and promote drug-free lifestyles. Research has shown that positive outcomes are achieved when group therapy is either offered in conjunction with individualized drug counseling or is changed to show the principles of cognitive-behavioral therapy or contingency management. Currently, researchers are testing ways in which group therapy can be standardized and changed to become more community-friendly.

Individualized Drug Counseling:

Individualized drug counseling does not only focus on reducing or stopping illicit drug or alcohol use, but it also looks into related areas of impaired functioning, such as an individual’s employment status, illegal activity, and his/her family/social relations, along with the content and structure of the individual’s recovery program. Through its importance and stress on short-term behavioral goals, individualized counseling assists the patient to develop coping strategies and techniques to resist drug use and continue abstaining. The addiction counselor recommends 12-step participation a minimum of 1 or 2 times a week and makes referrals for required supplemental medical, psychiatric, employment, and other services.

A Counselor works with those who struggle with addiction, listens carefully to their problems, and often tries to use methods like the 12-step program, as mentioned above, to help these people recover from their addiction. If the legal system is involved with any patient/client, the counselor may need to report on progress to a judge.

They also meet with families of individuals already recovering and try to help them restart their careers, find a job, improve their living situation, and refer them to some programs that could help them continue to excel. Along with the patient, family and friends may feel the effects of addiction as well. Substance abuse counselors could counsel the family and friends too.

A good amount of patience and compassion is needed to become a substance abuse counselor. Having good listening skills is very important, along with good communication skills. A counselor needs to be able to Give and receive trust, put a patient at ease and work hard to help a client find the right treatment plan that is of utmost importance. The job is quite difficult, but also very rewarding.

Setting at Work:

The US Bureau of Labor Statistics notes that 22 percent of substance abuse counselors work in outpatient facilities. The specialization of a counselor affects where he or she will work. For example, those who are specialized in working with kids and teens will most likely end up working in the school district. Some counselors work directly for hospitals, while some could choose to open a private practice. Counselors are also available to work in detention centers such as jails or prisons.

A good substance abuse counselor is invaluable to a patient suffering from addiction who wants to go into recovery. And with a wide range of specializations, such as gambling addiction, drug abuse, or kids and teens, there are lots of rewarding opportunities for counselors to help people that require it.


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