Substance Abuse, Behavioral Disorder, and Mental Health Counselors

Summary

What Substance Abuse, Behavioral Disorder, and Mental Health Counselors Do About this section

Substance abuse, behavioral disorder, and mental health counselors provide advice and support.

Substance abuse, behavioral disorder, and mental health counselors advise people on a range of issues, such as those relating to alcoholism, addictions, or depression. They provide support, including for prevention, to help clients recover from addiction, modify problem behaviors, or improve mental health.

Duties

Substance abuse, behavioral disorder, and mental health counselors typically do the following:

• Evaluate clients’ mental and physical health, addiction, or problematic behavior and assess their readiness for treatment
• Develop, recommend, and review treatment goals and plans with clients and their families
• Assist clients in developing skills and behaviors necessary to recover from their addiction or modify their behavior
• Work with clients to identify behaviors or situations that interfere with their recovery
• Document and maintain records of clients' progress
• Teach clients’ family members about addiction or behavior disorders and help them develop strategies to support clients in recovery
• Refer clients to other resources and services, such as job placement services and support groups
• Prepare clients for transition out of counseling through discharge planning
• Conduct outreach programs to help people identify the signs of addiction and other destructive behavior, as well as steps to take to avoid such behavior

Substance abuse counselors and behavioral disorder counselors, also called addiction counselors, work with clients individually and in group sessions. They teach clients how to cope with stress and life’s problems in ways that help them recover. Furthermore, they help clients rebuild professional relationships and, if necessary, reestablish their career. They also help clients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.

Some addiction counselors work in facilities that employ many types of healthcare and mental health professionals. Addiction counselors may work with psychologists, psychiatrists, social workers, physicians, and registered nurses to develop treatment plans and coordinate care for patients.

Some counselors work with clients who have been ordered by a judge or referred by other people, such as a parole officer, to receive treatment for addiction. Others work with specific populations, such as teenagers, veterans, or people with disabilities. Counselors may have to intervene in crises by stepping in when someone is endangering his or her own life or the lives of others. They also intervene in noncrisis situations by encouraging a person with addictions or other issues, such as difficulty processing emotions, to get help. Noncrisis interventions often are requested by friends and family.

Mental health counselors advise individuals, families, couples, and groups. Some work with specific populations, such as children or older adults. Mental health counselors treat clients who have a variety of conditions, including anxiety, depression, grief, and stress. They also help with emotional health and relationship problems.

Work Environment About this section

Substance abuse, behavioral disorder, and mental health counselors work in a wide variety of settings, including mental health centers, prisons, probation or parole agencies, and juvenile detention facilities.

Substance abuse, behavioral disorder, and mental health counselors held about 449,800 jobs in 2023. The largest employers of substance abuse, behavioral disorder, and mental health counselors were as follows:

Substance abuse, behavioral disorder, and mental health counselors work in a variety of settings, including inpatient and outpatient treatment centers, correctional facilities, and hospitals. Some addiction counselors work in residential treatment centers, where clients live in the facility during their recovery.

Although rewarding, the work of substance abuse, behavioral disorder, and mental health counselors is often stressful. Many counselors have large workloads and do not always have enough resources to meet the demand for their services. In addition, counselors may have to intervene in crisis situations or work with agitated clients.

Work Schedules

Most substance abuse, behavioral disorder, and mental health counselors work full time, although part-time work is common. In some settings, such as inpatient or residential facilities, they may need to work evenings, nights, or weekends.

How to Become a Substance Abuse, Behavioral Disorder, or Mental Health Counselor About this section

Substance abuse, behavioral disorder, and mental health counselors need a license in private practice.

Education and training requirements vary for entering these occupations. Substance abuse and behavioral disorder counselors typically need at least a bachelor’s degree, although some positions require a high school diploma and others require a master’s degree. Mental health counselors typically need a master’s degree and an internship. In addition, some counselors must be licensed.

Education

Substance abuse, behavioral disorder, and mental health counselors typically need at least a bachelor’s degree, although the education required or preferred may vary by position, state, or employer. For example, substance abuse and behavioral disorder counselors typically need a bachelor’s degree to enter the occupation, but requirements may vary from a high school diploma to a master’s degree.

Mental health counselors typically need a master's degree. Common fields of undergraduate study include psychology, public policy and social services, and social science. Master’s degree programs often include an internship that is clinically supervised.

Licenses, Certifications, and Registrations

Substance abuse and behavioral disorder counselors in private practice must be licensed. Licensing requirements vary by state, but all states require these counselors to have a master’s degree and complete a specified number of hours of supervised clinical experience. In addition, counselors must pass an examination and complete continuing education every year. Contact information for your state's regulating board is available through the National Board for Certified Counselors.

Licensure requirements for substance abuse and behavioral disorder counselors outside of private practice vary by state. For example, not all states require applicants to have a specific degree, but some require them to pass an exam. Contact information for individual states’ licensing boards is available through the Addiction Technology Transfer Center Network.

All states require mental health counselors to be licensed. Licensure requires successfully completing a national examination and supervised clinical work under the supervision of a licensed counselor. 

Some jobs require counselors to have certification in basic life support (BLS) or cardiopulmonary resuscitation (CPR).

Advancement

Substance abuse and behavioral disorder counselors who earn a master’s degree and complete a specified number of hours of supervised clinical experience are eligible to get a state license. This allows them to go into private practice or start their own business.

Other Experience

Counselors who have personal experience overcoming alcohol or drug addictions are sometimes viewed as especially helpful and insightful to those seeking treatment.

Important Qualities

Communication skills. Substance abuse, behavioral disorder, and mental health counselors need to effectively convey ideas and information to clients. They must also write concise but detailed reports documenting clients' progress.

Compassion. Substance abuse, behavioral disorder, and mental health counselors often work with people who are dealing with stressful and difficult situations, so they must empathize with their clients.

Interpersonal skills. Substance abuse, behavioral disorder, and mental health counselors must be able to develop and nurture good relationships with different types of people.

Listening skills. Substance abuse, behavioral disorder, and mental health counselors must give clients their full attention to be able to understand each client’s problems and values.

Patience. Substance abuse, behavioral disorder, and mental health counselors must be able to remain calm when working with all types of clients, including those who may be distressed or angry.

Pay About this section

The median annual wage for substance abuse, behavioral disorder, and mental health counselors was $53,710 in May 2023. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $36,700, and the highest 10 percent earned more than $89,920.

In May 2023, the median annual wages for substance abuse, behavioral disorder, and mental health counselors in the top industries in which they worked were as follows:

Most substance abuse, behavioral disorder, and mental health counselors work full time, although part-time work is common. In some settings, such as inpatient or residential facilities, they may need to work evenings, nights, or weekends.

Job Outlook About this section

Employment of substance abuse, behavioral disorder, and mental health counselors is projected to grow 19 percent from 2023 to 2033, much faster than the average for all occupations.

About 48,900 openings for substance abuse, behavioral disorder, and mental health counselors are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.

Employment

Employment growth is expected for substance abuse, behavioral disorder, and mental health counselors as people continue to seek treatment for addiction and mental health issues.

Increased demand for these workers is expected because of a growth in the number of people, including youths, who have mental health and behavioral disorders. Additionally, there will be a continued need for services to assist the large number of people with addictions, especially those who have opioid use disorder.

Demand for these workers will be further strengthened as more jurisdictions require offenders who have a substance abuse disorder to seek counseling as part of their sentences.

State & Area Data About this section

Occupational Employment and Wage Statistics (OEWS)

The Occupational Employment and Wage Statistics (OEWS) program produces employment and wage estimates annually for over 800 occupations. These estimates are available for the nation as a whole, for individual states, and for metropolitan and nonmetropolitan areas. The link(s) below go to OEWS data maps for employment and wages by state and area.

• Substance abuse, behavioral disorder, and mental health counselors

Projections Central

Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www.projectionscentral.org. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.

CareerOneStop

CareerOneStop includes hundreds of occupational profiles with data available by state and metro area. There are links in the left-hand side menu to compare occupational employment by state and occupational wages by local area or metro area. There is also a salary info tool to search for wages by zip code.

Contacts for More Information About this section

For more information about addiction counselors, visit

Addiction Technology Transfer Center Network

NAADAC, The Association for Addiction Professionals

For more information about counseling and counseling specialties, visit

American Counseling Association

For contact information for state regulating boards, visit

National Board for Certified Counselors

Occupational Requirements Survey

For a profile highlighting selected BLS data on occupational requirements, see

Mental health counselors (PDF)

O*NET

Mental Health Counselors

Substance Abuse and Behavioral Disorder Counselors