What You Need to Know as a Substance Abuse Counselor
FACT: The rate of illicit drug use among persons aged 12 or older was eight percent in 2008, according to the Substance Abuse and Mental Health Services Administration.
FACT: Substance abuse counselors made up 13 percent of the 665,500 counseling jobs in the 2008 workforce, according to the US Bureau of Labor Statistics.
Substance abuse (SA) counselors are in high demand due to the rates of drug and alcohol use in the U.S. Counselors work in rehabilitation facilities where the ultimate goal is to restore substance users/abusers to good health. This restoration process can include detox, outpatient, and residential treatment centers.
I am currently a counselor in a 6-month residential facility for men who abuse drugs and alcohol. Often, dealing with substance abuse can go hand-in-hand with dealing with mental health issues. Over the course of my work, I've helped clients with mood disorders, codependency and dysfunctional family systems. Below, I'll take you through understanding stages of recovery, setting boundaries and being self-aware as a counselor.
Be Patient
A high level of patience is a key value for a substance abuse counselor. In general, you might see clients that are in severe denial; in fact, some clients are at a facility by court order. Counselors must realize that they will be met with resistance from many, if not most, of their clients. The stages of change during treatment are important to know. They are:
- Precontemplation: denial
- Contemplation: accepting that something may be wrong
- Preparation: gaining the information to learn how to change
- Action: actively changing behaviors of the addictive lifestyle
- Maintenance: staying clean and sober
Different tactics are recommended for clients at different stages of change. Counselors should learn how to "roll with resistance" in order to achieve results and prevent a power struggle, particularly with clients in the precontemplation stage. For instance, you may ask someone who doesn't feel they have a SA problem to list 10 pros and 15 cons for using drugs. Obviously, in the client's perspective, the drugs have positive effects, or they wouldn't use them. It's important to acknowledge those positive aspects as you subtly challenge the resistant client by asking them to list the negative consequences of their drug use.
Another major concern for a substance abuse counselor is maintaining boundaries. Many who face substance abuse issues have backgrounds without fixed boundaries. Rules are unclear, inconsistent, confusing, unstructured, or unrealistic. It is critical that counselors enforce rules and boundaries with clients in order to provide the client with skills they may have never developed growing up.
Learn Self-Awareness
One of the most critical attributes a counselor should have is self-awareness. You should be able to evaluate your own thoughts, feelings, and behaviors and be open to challenging them. You must be able to "practice what you preach." Decisions might be made that you don't agree with. For example, a scenario arose in which I was the only one on my treatment team opposed to the early discharge of a client. It was difficult for me to accept this decision, but ultimately I had to let the client be responsible for his own actions. Being more self-aware as a counselor helps you to keep responsibility for actions on clients and work through your own feelings about cases.
As a counselor you will work with a variety of people and personalities and deal with many different issues. Ultimately, though, counseling starts with the self, and then works its way to the clients.
