Alcohol and drug abuse counselors' main goal is to help patients stop their destructive behaviors. Counselors may also work with the families of clients to give them support and guidance in dealing with the problem.
Counselors begin by trying to learn about a patient's general background and history of drug or alcohol use. They may review patient records, including police reports, employment records, medical records, or reports from other counselors.
Counselors also interview the patient to determine the nature and extent of substance abuse. During an interview, the counselor asks questions about what types of substances the patient uses, how often, and for how long. The counselor may also ask patients about previous attempts to stop using the substance and about how the problem has affected their lives in various respects.
Using the information they obtain from the patient and their knowledge of substance abuse patterns, counselors formulate a program for treatment and rehabilitation. A substantial part of the rehabilitation process involves individual, group, or family counseling sessions. During individual sessions, counselors do a great deal of listening, perhaps asking appropriate questions to guide patients to insights about themselves. In group therapy sessions, counselors supervise groups of several patients, helping move their discussion in positive ways. In counseling sessions, counselors also teach patients methods of overcoming their dependencies. For example, they might help a patient develop a series of goals for behavioral change.
Counselors monitor and assess the progress of their patients. In most cases, counselors deal with several different patients in various stages of recovery—some may need help breaking the pattern of substance abuse; some may already have stopped using, but still need support; others may be recovered users who have suffered a relapse. Counselors maintain ongoing relationships with patients to help them adapt to the different recovery stages.
Working with families is another aspect of many alcohol and drug abuse counselors' jobs. They may ask a patient's family for insight into the patient's behavior. They may also teach the patient's family members how to deal with and support the patient through the recovery process.
Counselors may work with other health professionals and social agencies, including physicians, psychiatrists, psychologists, employment services, and court systems. In some cases, the counselor, with the patient's permission, may serve as a spokesperson for the patient, working with corrections officers, social workers, or employers. In other cases, a patient's needs might exceed the counselor's abilities; when this is the case, the counselor refers the patient to an appropriate medical expert, agency, or social program.
There is a substantial amount of paperwork involved in counseling alcohol and drug abusers. Detailed records must be kept on patients in order to follow their progress. For example, a report must be written after each counseling session. Counselors who work in residential treatment settings are required to participate in regular staff meetings to develop treatment plans and review patient progress. They may also meet periodically with family members or social service agency representatives to discuss patient progress and needs.
In some cases, alcohol and drug abuse counselors specialize in working with certain groups of people. Some work only with children or teenagers; others work with businesses to counsel employees who may have problems related to drugs and alcohol. In still other cases, counselors specialize in treating people who are addicted to specific drugs, such as cocaine, heroin, or alcohol. Counselors may need special training in order to work with specific groups.
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