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What Does a Substance Abuse Counselor Do in Treatment?

A substance abuse counselor specializes in providing support and treatment for people experiencing substance use and addiction problems.

What Is a Substance Abuse Counselor?

A substance abuse counselor is a mental health counselor who specializes in the treatment of chemical dependency and addiction. These counselors are also known as addiction counselors, and they provide support and services to assist with addiction treatment.1

Duties and Requirements of a Substance Abuse Counselor

The requirements for being this type of counselor may differ from state to state, so it is best to check with a local state board for the exact specifications. However, there are some general requirements that most all counselors must meet, which include:


  • Holding an advanced degree in an area such as psychology, sociology, or public health
  • Specialized training in drug and alcohol counseling
  • State certification

While most of these counselors are only required to have a Bachelor’s degree, a substance use therapist is required to hold a higher degree, such as a Master’s or doctorate degree. These counselors can work at treatment centers, hospitals, or public health centers.

What Does a Substance Abuse Counselor Do?

The specific job requirements of what each counselor does will vary depending on what facility they work in, along with the type of patients they help. Most often, however, addiction counselors who hold Bachelor’s degrees will be able to:

Perform Assessments

The role of a substance abuse counselor may include performing screening and assessments to determine the level of severity of the addiction and any other biopsychosocial information to help inform the individual treatment plan.

An example of a comprehensive assessment that a drug abuse counselor may use is the criteria from the American Society of Addiction Medicine (ASAM), which focuses on six dimensions including medical conditions, mental health complications, living environment, and others.2

Develop Individualized Treatment Plans

After completing any screenings or assessments, the role of this type of counselor is to work with the individual on creating a treatment plan catered specifically to their needs. Treatment plans should focus on the goals that the individual would like to achieve while in treatment.

Conduct Group and Individual Therapy

All forms of substance abuse counseling require some type of therapy. The alcohol and substance abuse counselor will be involved with conducting both group and individual therapy. However, depending on the place of work and state requirements, some counselors must hold a Master’s degree or higher to conduct individual therapy sessions.

Work With Patients to Avoid Relapse

Substance counseling also focuses on relapse prevention. This means working with individuals on understanding potential risks and building skills and resources to work to avoid relapse.

Refer Patients to Other Support Resources

If an individual is not appropriate for a certain level of services, requires a higher or lower level of care, or needs support services after treatment, it is the program’s responsibility to help support patients and clients with other resources as needed.

Keep Records

Addiction counselors are also required to keep records. These records may be required by insurance companies and the company the addiction counselor works for, but records are also important in keeping track of progress and informing the next steps of the individual’s treatment. All records should comply with Health Insurance Portability and Accountability Act (HIPAA) and other state privacy laws.

How Do I Become a Substance Abuse Counselor?

To become a substance abuse counselor, it is important to research the education requirements in your state. Those that attend these programs that are aimed at achieving a higher degree, such as a Master’s or doctorate, are more likely to be able to provide individual and family therapy than those with a Bachelor’s degree. A drug abuse counselor with a higher degree may also have the opportunity to work in private practices.

Factors and Considerations

If you’re looking to become this type of counselor, it’s important to think about:

  • Which degree you are interested in
  • Narrowing down which substance abuse counselor program fits your needs
  • Completing the program and becoming certified or licensed as a substance abuse counselor in the state you would like to work

Additionally, it’s important to note that if you’re planning to pursue a higher degree, you will be required to complete between 2,000 to 4,000 hours of supervised clinical experience and pass a state exam in order to become a licensed therapist.5 However, you can also become certified in counseling for drug abuse without a therapy license.6

Substance Abuse Counseling Techniques

There are many counseling theories for substance abuse that help to determine the most effective techniques for the treatment of addiction. Substance abuse counseling can be complicated and may utilize a variety of techniques to improve treatment outcomes.

Types of Therapy Utilized by Substance Abuse Counselors

Some of the counseling interventions for substance abuse include:

  • Behavioral Therapies: This can include cognitive behavior therapy (CBT) or dialectical behavior therapy (DBT).
  • EMDR (Eye Movement Desensitization and Reprocessing): This is often used to treat trauma. EMDR requires the addiction treatment counselor to be certified in EMDR treatment.
  • Motivational Therapies: These include motivational interviewing for substance abuse and motivational enhancement therapy, which are designed to assist individuals in finding their own motivations for treatment and making positive behavior change.3
  • Family Counseling and Therapies: This focuses on repairing, supporting, and improving family and relationship connections, which provides individuals with a healthy support system.
  • 12-Step Facilitation Therapy: Counseling for drug abuse also may include the facilitation of 12-step groups such as Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery.
  • Alternative & Holistic Therapies: Also called complementary and alternative medicine practices, these may include yoga, mindfulness and meditation, acupuncture, equine therapy, music and art therapies, or biofeedback.4

How Substance Abuse Counselors Contribute to Community

There are several benefits of being this type of counselor, including assisting individuals on their recovery journeys, being able to be a consultant and mentor, and helping to contribute to the community in varying ways.

Some of the other ways that social work for substance abuse helps to contribute to society and the community are:

  • Increasing community safety by helping addicts heal
  • Decreasing crime rates
  • Decreasing substance-related hospitalizations
  • Helping maintain safer roads
  • Decreasing domestic violence rates

Learn More About Addiction Counseling at San Diego Detox

San Diego Detox is a full-service detoxification center focused on holistic and individualized treatment for addiction and mental health concerns. Using evidence-based practices, our dedicated and compassionate team of mental health professionals work every day to help individuals overcome their substance abuse challenges.

To learn more about addiction counseling and find out the benefits of being a substance abuse counselor, contact us today.