Over the last few decades, America has experienced an epidemic of drug and alcohol addiction. Millions of Americans struggle to overcome dependence on these substances and their own addictive behaviors. For many people, this process can be a long and arduous ordeal, and along the way they'll require the proper support both medical and emotional. Family is important, but those entering rehab programs often turn to the experts in their journey: substance abuse counselors. Part friend, mentor, advocate and support system, substance abuse counselors are an integral part of many people's recovery process. Understanding the work of these counselors offers keen insight into how people battle back against substance abuse and reclaim their lives.
Becoming a Substance Abuse Counselor
To properly comprehend what it means to be a substance abuse counselor, it's crucial to understand the exhaustive training these experts undertake.
Choosing the Right Path
As is the case with almost every academic program, substance abuse counseling programs vary between different institutions. According to bestcolleges.com, some of these variations may be slight, but they are still important when picking a school that matches your personalized worldview and meets your basic needs. For instance, there are schools that adhere to a predominantly Catholic worldview, which means their programs will have some religious content. There are some schools where students pursue a second degree, like social work and behavioral science, concurrent to the substance abuse counseling program. Others simply help you prepare for specific licensure exams. It's important to understand the depth of each program before you make your final decision.
Going to School
While each substance abuse program offers its own unique approach, there are several points of agreement between many of these systems. For one, most people who enter into a substance abuse counselor program first get a bachelor's degree, usually in a related field like social work or general counseling. Of course, that's not always the case. As geteducated.com pointed out, some states only require counselors to get an associate degree in a field like psychology. From there, many substance abuse counseling programs involve further study at either the master's or doctoral level.
Emphasizing the disciplines of medicine, counseling and general psychology, the curriculums of most substance abuse counselor programs prepare students to take a holistic approach to addiction. Psychology courses, especially those having to do with cognition and development, lay the foundation of many programs. Biology, especially human anatomy, is equally vital, as it informs the science behind addiction. Counselors may also learn about history and how addiction develops contextually. Finally, it's important students master group and individual counseling techniques.
Internships help train counselors to effectively work with patients.
Landing an Internship
Internships are a chance for counselors to get real-world experience while carefully monitoring the counselor's progress. Like school, different internships emphasize certain concepts; for instance, one might be geared toward working with a younger population or those of a certain socio-economic standing. Substance Abuse and Mental Health Services Administration (SAMHSA), a nationally-recognized organization, gears its internships toward several key goals. Chief among those is ongoing research, managing grants and program administration.
When it's time to begin a proper career, counselors will need to gain accreditation. For many in the U.S., that accreditation process is handled by the Association for Addiction Professionals, which offers three levels of accreditation for counselors. Each program helps counselors distinguish themselves from their colleagues and counterparts. The different levels have unique requirements, most of which are earned through a counselor's career. Level one, for instance, requires 270 hours of education, while level two calls for 450 hours overall. According to counselor-license.com, some programs offer multiple options for securing accreditation. Some schools have entry-level programs in which you gain a license in a year, but require continued education. There are also programs that offer general counseling training, at which time you can specialize in addiction studies and treatment.
Choosing a Job Title
In its 2016-2017 handbook for occupational outlooks, the U.S. Bureau of Labor Statistics noted there were a wide array of fields that substance abuse counselors could enter following school. Each one presents a unique set of challenges and opportunities alike. Hospitals, for instance, are a bit more fast-paced, and there generally isn't nearly as much one-on-one time with patients. It's worth noting that you are helping an often underserved segment of the population. Working for state and local governments offer a similar kind of dynamic as hospitals, as many agencies have to deal with a larger variety of individuals. However, you do get the support of the government and, in many cases, added resources over other outfits. You could also work for an outpatient or residential mental health center. These private locations offer more opportunity to connect and work alongside patients individually.
The Work of Substance Abuse Counselors
Once education, internships and accreditation requirements have all been met, substance abuse counselors take the knowledge and experience they've gained and began building a practice. The work of a counselor can vary greatly depending on clientele and institution, but most of it emphasizes the following pillars.
The first meeting between a counselor and a patient can be a tricky situation. Neither party knows the other well enough, and as a result, it's the counselor's job to both comfort and properly screen the patient. The evaluation process begins with gathering information on the patient's medical background and the specifics of his or her substance abuse problem. From there, the counselor and patient work together to discuss the basics of a program, including overall goals, the unique structure and any possible scheduling limitations or other obstacles. The evaluation period is meant to be very basic, and is necessary for the counselor to determine if he or she can work alongside the patient and meet that person's needs.
Counselors must understand the underlying issues behind substance abuse.
Identify Issues and Coping Mechanisms
No two people abuse drugs or alcohol for the same reason. While one person might be working out issues related to childhood, another may have simply begun using as a response to a life event like a traumatic injury or the death of a loved one. Counselors must be able to recognize the underlying issues of each patient. Without a proper understanding of why they abuse drugs or alcohol, a counselor cannot adequately help patients on their road to recovery. This part of the process can be especially complicated, as many people have problems facing the issues that inform their addiction. Counselors must find a way to not only be equally forceful and comforting, but also detect when a patient may be putting up emotional walls and thus concealing the truth.
Create Treatment Plans
Just as everyone has his or her own reasons for abusing drugs and alcohol in the first place, the resulting treatment plan should be suited to each individual. Treatment plans have different levels of focus; while overarching goals are important, these plans have to provide detail and structure if someone will ever adhere to the guidelines. That means creating specific tasks for a number of months and outlining the people - the patient and their inner circle - who will accomplish each job or responsibility. More than just goals, an effective treatment plan also includes key problem areas for the patient, which helps keep him or her aware of any triggers or coping mechanisms. A well-made treatment plan also evolves, changing to reflect adjustments in the patient's life and overall goals. The patient should be involved in the planning process, as they need to feel engaged and comfortable with what the regimen involves.
Lead Therapy Sessions
Treatment plans are great, as they offer a road map for patients to follow. But pieces of paper can only do so much, and ongoing counseling is a way to redefine treatment protocol and touch base with the client. Though not always the case, many substance abuse patients will undergo both individual and group counseling. The former is a way to give each patient's feelings an individual spotlight, while the latter lets people learn from and commiserate alongside others in a similar situation. Regardless of the setting, there are several key areas that counseling must focus on. Not only should patients continually reevaluate goals, but counselors have to find a way to help them adjust perceptions and understand their own behaviors and reactions. Therapy sessions can alter depending on the patient. While some are more somber and intense, others can offer a chance for patients to connect emotionally.
Maintain Proper Disclosure Regulations
Revelations of substance abuse issues can have different effects depending on the individual. For some people, it might not be a major concern. But for others, this information could implicitly impact their work or personal lives. That's why the SAMHSA mandates that all counselors take the proper steps to protecting a client's privacy and right to confidentiality. Similar to how most doctors operate, counselors have a very specific framework in which they work and are limited in what they can tell whom, how they can share this info and even when. Understanding and adhering to these specific guidelines isn't just about staying within the law. Ensuring the utmost level of privacy is a way to show patients your commitment and dedication.
Provide Crisis Intervention
In a perfect world, the path to recovery for every individual would be easy and stress-free. However, that's not the case, and that's why crisis intervention is one of the most important parts of being a substance abuse counselor. In almost every individual's recovery, there will be a time when he or she begins to backslide and doubt the program's effectiveness. In some cases, this person just may need a few minutes to vent or talk out their frustrations. In more extreme instances, the counselor may have to talk the person down from returning to drugs or alcohol. Knowing when someone may be in danger of slipping takes a special level of attention, and reinforces the importance of continued contact and openness between counselor and patient. Most crisis interventions will also require some level of interaction from the patient's family or friends.
Work Alongside the Court System
Depending on the clientele you counsel, you may have to correspond regularly with various law enforcement services. In these instances, the people you're working with may be ex-convicts or parolees who have entered a substance abuse program as part of a court-issued arrangement. While this doesn't alter the way in which you'd treat an individual, it would add some new tasks to your workload or simply more levels of paperwork. It might also mean that there is a great level of oversight from an agent of the courts. This might be distracting to some counselors, but it's a normal and important part of working with this very specific group of people.
Offer Family Counseling
Patients aren't the only ones who require some counseling. Friends and family can also thrive with these opportunities for analysis and interpersonal communication. In fact, the SAMHSA went as far as saying the family plays a central role in almost all treatment plans, including substance abuse therapy. Family can help address the issues that led to a person's substance abuse problems, as these individuals offer valuable insight into the patient's upbringing, beliefs and personality. Family members can also gain something from ongoing therapy. Substance abuse can affect a person's entire life, and parents and siblings and the like will benefit from expressing emotions and safely confronting the patient.
Establish an Aftercare Regimen
The road to recovery doesn't always have a final destination. Instead, most people will have to continue to work on their personal issues. That's why aftercare is so very important. Much like the initial treatment plan, the aftercare regimen will offer detailed instructions and rules to offer the individual structure and support. That could mean continued counseling, educational programs, medical checkups and, in some cases, access to a motivational speaker or life coach. Effective aftercare is about continuing the work from the earlier recovery program, but also offering patients a growing sense of freedom. If they can't begin to rely on themselves and see real life change, many people will quickly relapse.
Substance abuse counselors are the support system for people struggling with their addictive tendencies and behaviors. Counselors offer a kind word and sense of belonging that many of these individuals have rarely experienced. However, as the National Institutes of Health explained, counselors must also teach patients how to become self-directed. That means that people have to learn how to make the right decisions for themselves and not simply to please counselors, family, friends, etc. Those people in recovery need attention and nurturing, but they also must understand their actions and have some level of accountability. It's the role of a counselor to help strike that balance and give people the framework necessary to succeed on their own.