What Does A Substance Abuse Counselor Do In Treatment?

This article will discuss the role of a substance abuse counselor, relapse prevention, signs of addictive behavior, and sober support groups.   

substance abuse counselor 

Table of Contents

What Does a Substance Abuse Counselor Do? 

A substance abuse counselor is a licensed professional who treats substance use disorders. Generally, counselors specialize in working with either youth or adults. Substance abuse counselors commonly go on to pursue a mental health degree or certificate to treat co-occurring substance use and mental health disorders. Counselors or therapists are passionate about helping others and are usually open to supporting the patient’s immediate family throughout the recovery process.

Substance abuse counselors treat addiction by listening, teaching skills, educating, and guiding patients through the process of recovery. Counselors and peer support specialists often work together to help with resources, including employment, housing, and sober social activities. They also generally complete progress reports for clients involved in legal systems. 


Substance abuse counselors support patients by working alongside them on topics such as self-esteem, stress management, codependency, relapse prevention, triggers, motivation to change, and their recovery environment. Unconditional positive regard is a humanist approach to therapy that many substance abuse counselors use.

Essentially, unconditional positive regard means the counselor will show acceptance and care for the patient no matter who the individual is or what they do. Substance abuse counselors support patients with evidence-based treatment practices and healthy boundaries.


Drug and alcohol addictions are chronic diseases that require medical treatment, just like any other medical diagnosis. With successful rehabilitation, patients can learn healthy coping skills, how to remain abstinent, and go on to live happy, healthy lives. In most cases, patients require long-term care or multiple treatment episodes to achieve lasting sobriety. Substance abuse counselors facilitate rehabilitation in residential, inpatient, and outpatient settings.


Behavioral counseling and talk therapy are invaluable tools for individuals receiving substance use disorder treatment. Many substance abuse counselors go into the field after overcoming addiction or watching a family member struggle with substance use. Counselors with lived experience, education, or a combination of the two offer expert guidance and advice to patients in treatment.

What Role Does A Substance Abuse Counselor Do In Recovery?

In drug addiction therapy, addiction counselors communicate, listen, and encourage patients. Building trust and developing rapport is key to a successful therapeutic relationship. Once a patient begins to trust their addiction counselor, they can start to communicate their needs honestly and openly.

It is essential to remember that individuals in early recovery are usually fighting one of the most challenging battles of their life. Patients may resist sobriety, compliance, and treatment in the beginning stages of recovery. Every patient has a unique recovery journey, and it is the addiction counselors’ job to take a patient-centered approach to each individual they encounter.


A substance use disorder professional does not just give advice and educate. Their job is also to listen and provide patients with a safe place to express their feelings. Trust and understanding help an addiction counselor understand the patient’s unique experience and how their experiences should dictate the treatment episode.


During recovery, the patient must focus on healing and treatment. It can be challenging at times for individuals to let go of using friends, toxic relationships, and not put themselves in environments that are not supportive of recovery. When beginning addiction treatment, individuals have to set boundaries and make their well-being the number one priority.

Substance abuse counselors support this by communicating openly, referring to support groups like Alcohol Anonymous (AA), and treatment planning. Counselors create relapse prevention, and individual service plans to map out attainable goals that patients can focus on during various stages of their treatment. Treatment plans should be patient-centered and driven by the patient.


What is the central tenet of addiction recovery? The patient must have hope to believe their future can get better. If a person lacks hope, they may not feel the desire for healing and recovery at that moment. Addiction counselors help patients perceive and achieve a better future for themselves.


Self-discovery is a critical component of the recovery journey. Depression, low self-esteem, and lost relationships are all long-term effects of addiction and substance use. Substance abuse counselors can help patients reflect on the physical and mental toll addiction has had on their inner being. Self-discovery must take place to begin completing the physical and emotional work necessary for recovery.


Recovery is a lifelong commitment and journey. For this reason, individuals in treatment may get discouraged from time to time or face barriers to sobriety. Substance abuse counselors are experts in the areas of recovery options, community resources, and helping people find solutions to everyday problems.

Help to Prevent Relapse

Relapse prevention operates around four main ideas. The first idea is that relapse is a step-by-step process that occurs in stages. Second, recovery from addiction is a challenging and rewarding process of individual growth, development, and healing.

Number three is that cognitive therapy and mind-body relaxation are the top two tools of relapse prevention. These tools are critical when a person is developing healthy coping skills. Fourth, the explanation for nearly every relapse can be found in one of the following five areas:

  • Recovery environment
  • Honesty
  • Ability to ask for help
  • Self-care
  • Bending of the rules 


Life stressors and tension are two of the leading triggers for relapse. Addiction counselors help patients let go of negativity to promote mind and body relaxation. Self-care is generally discussed quite often in therapeutic sessions. Counselors also work with patients on triggers such as people, places, and things that are triggering. By planning for these encounters and thoughts, patients can role play and avoid relapse.


Guilt, shame, and embarrassment are common feelings that individuals in recovery experience. When patients begin their recovery journey, they often tell their counselor that they never want to think about drugs or alcohol again. Unfortunately, cravings are a part of every addict’s recovery journey.

Substance abuse counselors understand the science behind cravings and help patients develop coping skills for when they occur. Cognitive Behavioral Therapy (CBT) is an evidence-based treatment modality that counselors use to alter a patient’s negative thinking and fill their toolbox with healthy coping skills.

Damage Control

To discuss damage control, we must first cover regression. What is a regression in addiction recovery? Regression is a commonly used term that is similar to relapse in the harm reduction model of change. Whether the patient’s plan is complete abstinence, moderate use, or minimized use, a negative change from the patient’s intended initial plan is a regression.

The concept of harm reduction is centered around the idea that all individuals have the right to choose what their recovery plan will look like. Whether the patient is following a traditional 12-Steps program or a harm reduction model, substance abuse counselors can address relapses or regressions with their patients.

Healthy Coping Mechanisms

Let’s dive a bit deeper into healthy coping mechanisms and how substance abuse counselors help clients develop these critical skills. Healthy coping skills can include simple activities like going for a walk, watching a movie, playing with your dog, listening to music, or taking a bath. Addiction counselors are trained to break down coping strategies into everyday support and crisis support. Coping skills can include diversions (activities or hobbies), social support groups, or calling a loved one you trust. 

Help Understand Signs and Symptoms of Addictive Behavior

Licensed substance abuse counselors are professionally trained to educate patients, families, and the public about the signs and symptoms of addiction. Addiction counselors also provide psychoeducation and complete assessments to diagnose substance use disorders.  

Provide Psychoeducation

Substance abuse counselors provide clients with psychoeducational individual sessions and groups. The term psychoeducation was initially introduced in 1980 to describe family-oriented treatment for individuals with schizophrenia. Throughout the year’s psychoeducation has evolved and breaks down into four essential parts.

First, the counselor educates the patient about their substance use disorder. Next, the substance abuse counselor incorporates problem-solving, communication, and self-assertiveness into the patient’s treatment plan. Psychoeducation also includes information about the disease progression model, the consequences of continued use, treatment recommendations, and alternatives.

General Assessments

Substance abuse counselors use general assessments and screenings to determine whether individuals meet clinical criteria for one or more substance use disorders. The assessment is also used to determine the level of care for the patient. For example, an assessment could recommend outpatient, intensive outpatient, detox, or inpatient. After the assessment, the counselor reviews the results with the patient to create a plan. 

Creates Awareness to Drug Problems

At times, patients are in denial about their substance use disorder or the severity of their use. Substance abuse counselors come alongside their patients and utilize open discussion to increase awareness. If a patient is in the pre-contemplation stage of change, the counselor may use motivational interviewing to move them into the contemplation or action stages.

Periodic Drug and Alcohol Tests

Addiction counselors periodically screen their patients for substance use to monitor their progress and care needs. If a patient is struggling, the counselor must know about it so they can help. 

Refer to Other Support Groups and Therapies

Substance abuse counselors often refer their patients to community support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Sober social support is an essential part of recovery and healing. Additionally, counselors can refer their patients to ancillary therapy for help with mental health, eating disorders, anger management, family challenges, and more. 


If you or a loved one needs help, please call us at
623-523-4748 and our team at Blueprints For Recovery in Arizona will help.

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