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 treatment and support.

Substance abuse, behavioral disorder, and mental health counselors advise people who suffer from alcoholism, drug addiction, eating disorders, mental health issues, or other mental or behavioral problems. They provide treatment and support to help clients recover from addiction or modify problem behaviors.

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
• Teach clients’ family members about addiction or behavior disorders and help them develop strategies to cope with those problems
• Refer clients to other resources and services, such as job placement services and support groups
• 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. Many incorporate the principles of 12-step programs, such as Alcoholics Anonymous (AA), to guide their practice. 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 to receive treatment for addiction. Others work with specific populations, such as teenagers, veterans, or people with disabilities. Some specialize in crisis intervention; these counselors step in when someone is endangering his or her own life or the lives of others. Other counselors specialize in noncrisis interventions, which encourage a person with addictions or other issues, such as difficulty managing anger, to get help. Noncrisis interventions often are performed at the request of friends and family.

Mental health counselors provide treatment to individuals, families, couples, and groups. Some work with specific populations, such as the elderly, college students, or children. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses. They also help with mental and emotional health issues 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 304,500 jobs in 2018. 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 wide variety of settings, including mental health centers, prisons, probation or parole agencies, and juvenile detention facilities. They also work in halfway houses, detox centers, or in employee assistance programs (EAPs). EAPs are mental health programs provided by some employers to help employees deal with personal problems.

Some addiction counselors work in residential treatment centers, where clients live in the facility for a fixed period of time. Others work with clients in outpatient treatment centers. Some counselors work in private practice, where they may work alone or with a group of counselors or other professionals.

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

Work Schedules

Most substance abuse, behavioral disorder, and mental health counselors work full time. In some settings, such as inpatient 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.

Most positions require at least a bachelor’s degree. Although educational requirements can vary from a high school diploma and certification to a master’s degree for substance abuse and behavioral disorder counselors, a master’s degree and an internship is typically required to become a mental health counselor.

Education

Most substance abuse, behavioral disorder, and mental health counselor positions require at least a bachelor’s degree. However, depending on the state and employer, educational requirements for substance abuse, behavioral disorder, and mental health counselors can vary from a high school diploma and certification to a master’s degree. Workers with psychology, clinical social work, mental health counseling, and similar master’s degrees can provide more services to their clients, such as private one-on-one counseling sessions, and they require less supervision than those with less education. Those interested should research their state’s educational requirements.

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 2,000 to 4,000 hours of supervised clinical experience. In addition, counselors must pass a state-issued exam and complete continuing education every year. Contact information for your state's regulating board can be found through the National Board for Certified Counselors.

The licensure criteria for substance abuse and behavioral disorder counselors outside of private practice vary from state to state. For example, not all states require applicants to have a specific degree, but many require them to pass an exam. Contact information for individual states’ licensing boards can be found through the Addiction Technology Transfer Center Network.

All states require mental health counselors to be licensed, after completing a period of postdegree supervised clinical work under the supervision of a licensed counselor. 

Other Experience

There is a long tradition of people who have overcome their own addictions to be involved in counseling others to overcome their addictions. Counselors with personal experience overcoming alcohol or drug addictions are sometimes viewed as especially helpful and insightful to those seeking treatment.

Important Qualities

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

Interpersonal skills. Substance abuse, behavioral disorder, and mental health counselors must be able to work with different types of people. They spend most of their time working directly with clients or other professionals and must be able to develop and nurture good relationships.

Listening skills. Substance abuse, behavioral disorder, and mental health counselors need good listening skills. They must give their full attention to a client to be able to understand that 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.

Speaking skills. Substance abuse, behavioral disorder, and mental health counselors need to be able to effectively communicate with clients. They must express ideas and information in a way that their clients easily understand.

Pay About this section

The median annual wage for substance abuse, behavioral disorder, and mental health counselors was $46,240 in May 2019. 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 $29,520, and the highest 10 percent earned more than $76,080.

In May 2019, 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. In some settings, such as inpatient 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 22 percent from 2018 to 2028, much faster than the average for all occupations. Employment growth is expected as people continue to seek addiction and mental health counseling services.

Demand for substance abuse, behavioral disorder, and mental health counselors is also expected to increase as states seek treatment and counseling services for drug offenders rather than jail time. In recent years, the criminal justice system has recognized that drug and other substance abuse addicts are less likely to offend again if they get treatment for their addiction. As a result, sentences often require drug offenders to attend treatment and counseling programs. In addition, some research suggests that these programs are more cost effective than incarceration and states may use them as a method to reduce recidivism rates.

In addition, there will be a continued need for counselors to work with military veterans to provide them the appropriate mental health or substance abuse counseling care.

Job Prospects

Job prospects are expected to be very good for substance abuse and behavioral disorder counselors, particularly for those with a bachelor’s or master’s degree. In addition, many workers leave the field after a few years and need to be replaced. As a result, those interested in entering this field should find favorable prospects.

Job prospects are also expected to be very good for mental health counselors, particularly in rural areas or other communities that are underserved by mental health practitioners.

State & Area Data About this section

Occupational Employment Statistics (OES)

The Occupational Employment Statistics (OES) 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 OES 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.com. 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

O*NET

Mental Health Counselors

Substance Abuse and Behavioral Disorder Counselors