The Many and Varied Types of Substance Abuse Counselors

July 10, 2019

When the typical patient or their family thinks about drug treatment, they don’t often understand how varied and diverse substance abuse counseling can be. Many levels of care within treatment, and even medical conditions that have to be managed through either detox or medication, make treatment complex and multi-factorial. Further complicating the matter is that mental health (a common co-occurring disorder) often factors into the addiction treatment protocol.

The setting in which substance abuse treatment is performed can also vary widely. Almost everyone knows about the large inpatient facilities, typically in the news when the celebrity goes to rehab, but there are also outpatient facilities and even in-office treatment protocols for higher functioning substance abusers.

Beyond the substance abuse counselor themselves, there is also a team of support and admin specialists (certified or not) who play a significant role in the progress through treatment as well as eventual outcomes… not to mention safety of the client as they work their way through the recovery process.

Following is a list of the most common professionals that will be encountered during the substance abuse recovery process.

Psychiatrists are medical doctors that specialize in behavioral disorders including mental health and substance abuse. Much like other physicians, they are licensed to perform medical treatments, prescribe medication and more. Psychiatrists, however, do not solely rely on medical interventions to treat their patients. They also, much like other substance use counselors, may use talk therapy including Cognitive Behavioral Therapy to aid in the recovery process. As with many other medical specialties, psychiatrists may continue with specialized training in a particular facet of psychiatry. One such specialization is addiction psychiatry.

Psychologists are doctorate-level clinicians that help those with behavioral issues such as addiction and mental health disorders. Psychologists are not licensed to administer the range of medical treatments that a psychiatrist is; however some states allow psychologists to prescribe medication when appropriate. Any psychologist prescribing medication must have completed advanced training in psychopharmacology. When psychologists believe that medical intervention is necessary, they will refer to a medical doctor. Psychologists typically employ talk therapy and may work in private practice or as part of larger facility or institution. Much like psychiatrist, a psychologist may specialize in one particular area of behavioral health.

Licensed Professional Counselors (LPCs) and Licensed Mental Health Counselors (LMHCs) are very similar masters-level counseling professionals. The role that these mental health counselors will take in a client’s recovery depends largely on the client’s particular circumstance as well as the other professionals with which they interact. Many of these counselors will work at behavioral health facilities or hospitals and have defined roles. Those in private practice may have broader roles. As with other counselors, they may choose to specialize in one facet of mental health or substance abuse.

Licensed Clinical Social Workers or LCSWs are social workers that focus specifically on mental health and substance abuse disorders and depending on the facility, hospital or behavioral health program may play an active role in the client’s recovery. LCSWs are also postgraduate/masters level professionals.

Certificate level counselors have received their certificate in counseling from a state-level addiction board such as the Florida Certification Board. Titles for these certifications range from Alcohol and Drug Counselor (ADC) to Certified Addiction Professional (CAP) and Certified Addiction Counselor (CAC). Depending on the jurisdiction as well as the certificates being pursued, professionals may require a bachelor’s degree in a related field or a GED. Master’s level certifications are also available for those having completed postgraduate training in a related field. While certificate level counselors cannot prescribe medical interventions, they usually work with a medical director and nursing staff at an addiction treatment or mental health facility. They are well versed in addiction related disorders and may pursue other certifications and licenses to enhance their knowledge and practice in other areas of behavioral health. Certified professionals/counselors make up the backbone of clinicians involved in the recovery process and must adhere to the highest level of ethical standards. For any interventions beyond their purview, they will refer out to the appropriate professionals.

As an aspiring professional, which license or certification should I pursue?

It is impossible to offer a direct answer to this question. As professionals, we all have various life experiences and goals that make pursuing one certification over another a very personal decision. For some, life experiences and/or education level will prevent them from taking a certain path. For others, pursuing multiple certifications or licenses may be appropriate.

Of particular note, the addiction treatment industry has been foundational in offering those in recovery a second chance at building a meaningful career. Many industries may shun prior drug abuse and related issues. However a counselor’s experience with drugs and the ramifications thereof can actually be exceptionally beneficial to others experiencing the worst times of their lives.

No matter what career path you choose, we at The Academy for Addiction Professionals applaud you for taking a step to helping some of the millions of Americans that struggle with behavioral health disorders but many of who sadly never received the appropriate care.

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The Academy for Addiction Professionals is a leading addiction professional training center and an approved education provider for both the Florida Certification Board (FCB) and NAADAC. We offer interactive in-class (South Florida Location) and online training courses for the Certified Addiction Professional (CAP), Certified Addiction Counselor (CAC), Certified Behavioral Health Technician (CBHT) and Certified Recovery Support Specialist (CRSS) levels of certification as well as Continuing Education and Professional Development programs.