Substance Abuse Counseling 101

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Upon graduation from Rutgers University’s online Master of Social Work, you will find number of career opportunities. One field well suited to MSW graduates is substance abuse social work or substance abuse counseling.

How do I pursue a career in addiction counseling?

As U.S. News & World Report observed, while a master’s degree has not traditionally been a prerequisite for a career in substance abuse counseling and social work, this is beginning to alter. The shift can be attributed to changes in the medical community’s understanding of substance abuse treatment. Health professionals are now recognizing the relationship between substance abuse and other mental health disorders, such as depression and schizophrenia. Effective counseling necessitates a more nuanced understanding of how both issues can inform each other, while also acknowledging that they are not innately linked in every case. In other words, not every patient dealing with substance abuse will have a mental disorder.

Given the complexities, many employers looking to hire mental health social workers and counselors now prefer candidates with at least a bachelor’s degree and ideally, a master’s degree. In fact, in many areas of the country, certification is actually mandatory.

What do substance abuse social workers and substance abuse counselors do?

Substance abuse social workers
If you secure a position as a substance abuse social worker, you will likely be employed in an institution such as a prison, rehabilitation facility, or hospital. As outlined by the U.S. Department of Labor, typical duties include working with specific clients and managing individual cases. You may help clients or patients devise strategies for sobriety, campaign on their behalf for f educational and employment opportunities, and offer assistance during episodes of relapse or personal crisis. Many substance abuse social workers also conduct counseling sessions, either one-on-one or in a group.

Substance abuse counselors
This role is very similar to that of a substance abuse social worker. According to U.S. News & World Report, if you embark on a career as a substance abuse counselor, you will likely work with both clients struggling with addiction and any family members negatively impacted by their loved one’s condition. You will offer empathy, patience and support, and help both addicts and families decide on best courses of treatment. You will conduct counseling in both a one-on-one and group setting. There is also a didactic component to this role; many substance abuse counselors oversee educational seminars and workshops about substance abuse and addiction. Furthermore, as a substance abuse counselor, you will be required to maintain working relationships with healthcare professionals and licensed therapists, so you can refer clients to any additional resources t they need.

Understanding the complexities of addiction

If a career as a substance abuse counselor or social worker speaks to you, it is important to understand the complex factors that lead to the condition.

According to the American Counseling Association, substance abuse and addiction remains a pressing health concern nationwide. Statistics from the group reveal that at least six percent of the population report addiction to illegal drugs, such as cocaine, heroin and prohibited methamphetamines. Furthermore, a greater number of Americans report problems with legal substances such as alcohol and physician-prescribed medications. Alcohol abuse is the most common issue, with a notable 12 percent of Americans struggling with an addiction to the substance. Prescription medication abuse is also similarly common, with a troubling 10 percent of Americans abusing prescriptions. To put these numbers into a wider perspective, the Substance Abuse and Mental Health Services Administration reported that in 2014, over 21 million Americans were dealing with a substance abuse problem.

In terms of causation, the American Counseling Association explained that medical professionals have yet to single out any one cause, listing biological, social, and individual factors as potential catalysts for addiction. As discussed, a link with other mental disorders has also been observed in many cases of addiction.

The source elaborated that the American Psychiatric Association recognizes substance abuse as a mental health condition. The classification defines abuse as dependency on, addiction to, and continued used of substances that can impact mood. Additionally, the APA understands addiction in several ways: withdrawal symptoms upon cessation of taking the substance, an obsession with the substance, a refusal to give it up, increased toleration, and a continuation of substance abuse despite negative societal consequences, such as job loss, fractured relationships and so on.
The American Counseling Association also noted that no one case of addiction is the same, despite the fact that common behaviors can be observed in many cases.

Effective counseling approaches

With a solid understanding about the complexities of addiction, you will likely be more able to provide the best possible care to your clients. As outlined, while no one individual is the same, and each counseling strategy must be tailored to the individual in question, there are a number of effective approaches employed by substance abuse counselor or social worker.

  1. Acknowledgement of the problem
  2. Substance abuse counseling can only be effective if patients admit that they have a problem. If your patient exhibits a denial of their issues, it is important to help her reach a place where she can recognize the reality of the situation. The National Center for Biotechnology explained that denial is a common initial response among those with an addiction problem. It is important, however, that the patient in question does come to terms with his or her addiction. Continued resistance can preclude the implementation of strategies that can move the individual forward.

  3. Display empathy and compassion
  4. Each patient’s circumstances will be different, but his or her needs will remain the same. It is imperative that you establish a connection with your patient that is marked by empathy, compassion and unbiased understanding, the American Counseling Associated detailed. For example, you may be working in a prison with clients who have committed crimes, but such individuals are deserving of the same respect and help as other patients seeking counseling services Thre is no room from moralistic judgment.

  5. Identify problems and triggers
  6. Many clients dealing with substance abuse will also be facing other life struggles. In some instances, tragedy and trauma can lead to substance abuse, and in other cases, substance abuse can engender a client’s issues. For example, a client’s addiction may lead to job loss or the breakdown of a relationship. In any case, as a counselor, you should help the patient identify personal struggles and any triggers that may have been a cause or consequence of addiction.

  7. Work with the individual to develop strategies for change
  8. As outlined by the ACA, you must come to an agreement with your patient about the strategies and treatments that you both feel are appropriate for the individual.. The counseling relationship is a collaborative one, and the client should play an active role in the treatment he receives. After all, if a patient is uncomfortable with the style of care, the chances of success will be curtailed.

Counseling techniques

The above approaches should be incorporated into an overall counseling strategy. Additionally, it is important to have an understanding of counseling techniques that can be implemented. Each technique offers a different perspective or approach to counseling, and the techniques will have varying levels of efficacy, contingent on the patient and his or her individual needs. The following three techniques are some of the most effective for substance abuse counseling.

  1. Cognitive behavior therapy
  2. An umbrella term for several techniques, CBT is based on the notion that our mindset can be altered to think in a more positive way.. Put another way, our thoughts are directly related to how we feel. Consequently, therapists and counselors who implement CBT techniques believe that if patients can learn to think differently, the will improve their mental wellbeing. If you decide to employ CBT techniques while working as a substance abuse counselor, you will help clients identify negative thought patterns, devise strategies for improvement, and set new life goals.

  3. Mindfulness
  4. According to Harvard Business Review, this technique concerns helping a client feel actively present in a particular moment. Counselors who utilize mindfulness strategies encourage clients to try and disregard the myriad of thoughts that may be occupying their mind and focus instead on what is occurring in the present moment. The reasoning behind this technique is that it helps clients become more engaged with everyday life and less concerned with negative thoughts and feelings.

  5. Narrative therapy
  6. As outlined by the Narrative Therapy Center of Toronto, this technique involves encouraging clients to look at their issues with a critical eye. In this way, problems in this way, clients can begin to understand themselves as separate from their issues, and not innately tied to them. Indeed, a central tenant of narrative therapy is that the individuals possess multiple tools they can use to help themselves and that they are not solely defined by their problems. This is especially useful for substance abuse counseling, as you will be able to help clients understand that although they may have addiction problems, they themselves are not the sum total of their struggles.


Substance abuse social work and counseling is a challenging, yet rewarding career path. While no one individual is the same, there are a number of effective approaches and strategies that you can employ in your career to help patients tackle the complex problem of addiction.
Securing your Master of Social Work degree online from Rutgers University is the first step on the road to a successful career in this important area. For more information, review the admissions page.