Drug & Alcohol Counselor

Drug Alcohol Counselor

The role of a drug alcohol counselor is to help people who have problems with alcohol, drugs, gambling, and eating disorders.

They counsel individuals who are addicted to drugs and alcohol,helping them to identify behaviors and problems related to their addiction.

Counseling can be done on an individual basis, but is frequently done in a group setting. These counselors will often work with family members who are affected by the addictions of their loved ones. Counselors also conduct programs aimed at preventing addictions.

Characteristics And Qualities

Excellent counselors have hope and optimism for their patient’s recovery with a high degree of empathy, patience, and tolerance.

They should have the flexibility and ability to enjoy working with difficult patients, have a realistic perspective on change and provide steps to invoke change. An excellent drug alcohol counselor has a low need to control the patient.

They also have the ability to engage the patient yet be able to detach. They have been educated on how to utilize a multiplicity of treatment interventions rather than relying on a single way of counseling.

Treatment Goals and Objectives

  1. Providing information and education.
  2. Challenging denial and self-destructive behaviors. (Confrontation is modified to take into account the patient’s ego strength and ability to tolerate confrontation.)
  3. Providing realistic feedback on problems and progress in treatment.
  4. Encouraging and monitoring abstinence.
  5. Helping the patient get involved in self-help groups.
  6. Helping the patient identify, prioritize, and work on problems and recovery issues.
  7. Monitoring addiction recovery issues.
  8. Monitoring symptoms such as; suicidal thoughts, mood disorders, and problem behaviors.
  9. Helping the patient develop specific skills, such as; coping with alcohol or other drug cravings, refusing offers to get high, challenging faulty thinking, coping with negative affects, improving interpersonal behaviors, managing relapse warning signs.
  10. Advocating on behalf of the patient and facilitating inpatient admission when needed.
  11. Facilitating the use of community resources or services.
  12. Developing therapeutic assignments aimed at helping the patient reach a goal or make a specific change.
  13. Following up when a patient fails to follow through with treatment.
  14. Offering support, encouragement, and outreach.

Patient Counselor Relationship

The counselor’s goal is seen as critical in helping patients become involved and stay involved in the recovery process. Community support systems, professional treatment groups, and self-help
programs also serve as possible agents of positive change.

Although patients have to work on a number of intrapersonal (occurring within the individual mind or self) and interpersonal (involving relations between persons) issues as part of long-term recovery, medications can facilitate this process by attenuating acute symptoms, improving mood, or improving cognitive abilities or impulse control.

Thus, medications may eliminate or reduce symptoms as well as help patients become more able to address problems during counseling sessions.

A severely depressed patient may be unable to focus on learning cognitive or behavioral interventions until he or she experiences a certain degree of remission from symptoms of depression. Some patients will not be able to focus on abstinence from drugs or alcohol until the psychotic symptoms are under control.

The goals of this counseling model are:

  1. Achieving and maintaining abstinence from alcohol or other drugs of abuse.
  2. Stabilizing acute psychiatric symptoms.
    (“Psychiatric” is defined as the branch of medicine that deals with the diagnosis, treatment, and prevention of mental and emotional disorders).
  3. Resolving or reducing problems and improving physical, emotional, social, family, interpersonal, occupational, academic, spiritual, financial, and legal functioning.
  4. Working toward positive lifestyle change.
  5. Early intervention in the process of addiction relapse or the psychiatric disorder.


  1. Motivating patients to seek detoxification orinpatient treatment if symptoms warrant, and sometimes facilitating an involuntary commitment for psychiatric care.
  2. Educating patients about psychiatric illness addictive illness, treatment, and the recovery process.
  3. Supporting patients’ efforts at recovery and providing a sense of hope regarding the positive change.
  4. Referring patients for other needed services (case management, medical, social, vocational, economic needs).
  5. Helping patients increase self-awareness so that information regarding dual disorders can be personalized.
  6. Helping patients identify problems and areas of change.
  7. Helping patients develop and improve problem-solving ability and develop recovery coping skills.
  8. Facilitating pharmacotherapy evaluation and compliance.
    (“Pharmacology” means the science of drugs, including their composition, uses, and effects). (This requires close collaboration with the team psychiatrist.

Role Of Self-Help Programs

All patients are educated regarding self-help programs and linked up to specific programs.

The self-help programs recommended may include any of the following for a given patient: Alcoholics Anonymous (AA) Narcotics Anonymous (NA) and other addiction support groups such as;

It is possible for patients to recover without involvement in a 12-step group. Failure to attend 12-step groups is not viewed as a sign of resistance.

However, active involvement in a 12 Step Program can provide a spiritual and social foundation that can contribute to long-term sobriety. Sponsorship, recovery literature, and recovery clubs are also very helpful aspects of recovery.

Family Treatment

Families are often adversely affected by a patient’s drug and alcohol abuse. Family members can have a significant impact on the patient’s recovery…good or bad.

They can be either an excellent source of support or add stress. Drug alcohol counselors are encouraged to include families in assessment and treatment sessions.

Patients in need of family therapy may be referred to a social worker or therapist who specializes in family therapy.

Particular attention is paid to children of patients so that assessments can be arranged if a counselor feels that a psychiatric evaluation is warranted for the child.

The counselor will encourage the family to attend support groups for mental health disorders or addictive disorders.

The drug alcohol counselor also works with the patient on strategies to improve communication and relationships with family members even when they are not directly involved in treatment sessions or recovery group meetings.

Strategies For Dealing With Denial, Resistance And Poor Motivation

Drug alcohol counselors can help deal with patients in denial. The counselor attempts to validate the denial in the context of addiction or psychiatric illness.

Education, therapeutic assignments and sessions involving family or significant others may be used to help deal with denial and resistance.

If there is any resistance, this can be an indicator that the patient is subconsciously admitting they have a problem and it is explored in treatment sessions.

Poor motivation is usually seen as a manifestation of an illness, particularly with more severely addicted or impaired patients. Personality issues also greatly contribute to resistance and poor motivation.

Counselor’s Response To Slips And Relapses

The drug alcohol counselor typically approaches slips and relapses as opportunities for the patient to learn about relapse prevention. All relapses to drug and alcohol use are explored in an attempt to identify triggers and warning signs.

Strategies are discussed to help the patient better prepare for recovery. Additional sessions or telephone contacts may be used to help the patient stabilize from some relapses. Inpatient detoxification or rehabilitation programs may be arranged in instances where the relapse is severe.

Relapse Prevention And Aftercare Planning

  1. Teach patients the importance of having a follow-up aftercare plan to facilitate ongoing recovery. This plan should involve professional treatment and participation in self-help support programs.
  2. Teach patients that failure to comply with ongoing treatment increases the chances of chemical use or psychiatric relapse.
  3. Help patients identify potential benefits of continued involvement in treatment and recovery.
  4. Teach patients the importance of being prepared to handle emergencies should they arise.

Putting The Puzzle Back Together Again

It is helpful if the counselor provides encouragement and positive feedback for the
work that the patient accomplished and for the effort put forth. Reading, writing, or behavioral assignments may be given at the end of the session.

The goal of these therapeutic assignments is to have the patient actively work on problems and issues between counseling sessions.

Recovery Assignments

  1. Understanding psychiatric and addiction (causes, symptoms, and treatment).
  2. Understanding relationships between drug use and psychiatric disorders.
  3. Denial of abuse or addiction and common roadblocks to recovery.
  4. Medical and psychiatric effects of drugs and alcohol.
  5. Psychosocial effects and recovery process for substance abuse.
  6. Medication education.
  7. Coping with cravings and desires to use alcohol or other drugs.
  8. Coping with anger, anxiety, and worry.
  9. Coping with boredom.
  10. Discovering ways to use leisure time.
  11. Coping with depression.
  12. Coping with guilt and shame.
  13. Family issues and treatment recovery resources.
  14. Developing a sober recovery support system.
  15. Coping with pressures to get high, drunk or to stop taking psychiatric medications.
  16. Changing negative or maladaptive thinking.
  17. Spirituality in recovery.
  18. Joining AA or NA, mental health, and dual recovery support groups and recovery clubs.
  19. Relapse prevention (warning signs, high-risk factors).
  20. Follow-up care.

Professional Counseling combines the latest in medical treatment, therapeutic counseling, family counseling, group therapy, relapse prevention and education.

If you or a loved one has a substance abuse problem or addiction, you could benefit greatly from a certified drug and alcohol counselor.

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