Substance Use Disorder Counseling For Mental Health
Substance-Related and Addictive Disorders is a category of mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that encompasses a number of different disorders, including alcohol use disorder (also known as alcohol addiction) and opioid use disorder. Substance use counseling (previously called substance abuse counseling) can help individuals with these mental health conditions address their symptoms and foster emotional wellness.
Substance use disorder counselors, addiction counselors, and mental health centers provide treatment for those experiencing substance use disorder. Professionals like substance use disorder counselors work to develop individualized treatment plans and treatment goals to address issues related to drugs and alcohol, address substance use disorder, and prevent relapse.
Understanding substance use disorder
Substance use disorders (SUDs) are not a choice, but recovery is possible, and various research-supported treatment options (including substance use disorder counseling, previously called substance abuse counseling) and treatment centers are available. Often, underlying concerns and comorbid conditions, like anxiety disorders, environment, family history, and trauma, play a role in developing or affecting a person living with a SUD. Licensed counselors and substance use disorder counseling centers can help people manage any comorbid mental health conditions in clinical settings with individualized treatment plans.
SUDs can affect all areas of a person’s life, including social relationships, family and love life, work, education, physical health, and mental health.
Substance use addiction treatment
Substance use disorder can escalate into dependence and addiction. These two words are often used interchangeably, but they both pertain to aspects of substance reliance. Substance use disorder counseling and related mental health counseling can address all aspects of substance use and related behavioral disorders, helping individuals overcome addiction and avoid relapse.
You’re also not alone. According to the Substance Abuse and Mental Health Services Administration, more than 40 million Americans lived with an SUD in 2020, including 14.5 million who lived with alcohol use disorders. While studies indicate that over 50% of those living with substance use disorder maintain full-time jobs, the U.S. Bureau of Labor Statistics reports that unintentional drug overdoses are steadily rising in the workplace.
The hopeful news is that recovery is possible, and there is help, including in-person and online therapy, for those living with substance-related and other addictive disorders. Substance use disorder counseling professionals work to provide support in all areas of a person’s life to assist in managing substance use disorder.
Potential symptoms
Everyone experiences symptoms differently. Understanding the possible symptoms of a substance use disorder may help you identify if you need care.
Here are some potential symptoms and signs of SUDs:
- Difficulty cutting down on or quitting a substance despite wanting to do so
- Changes in performance at work or school
- Withdrawal symptoms upon attempting to discontinue the use of a substance
- Personality changes, such as secretiveness, irritability, or agitation
- Changes in sleep patterns (IE, difficulty sleeping, or oversleeping)
- Mood swings
- Outwardly visible symptoms, such as trembling or shaking, bloodshot eyes, and difficulty with personal hygiene
- Slurred speech
- Unexplained financial problems or needs due to spending money on substances
- Legal problems related to the use of substances
- Social changes due to the use of substances (IE, social isolation, or changing friend groups and hangout spots based on to substances)
- Difficulty or problems in interpersonal relationships related to the use of substances
- Cravings for the substance
The truth is that it’s never too soon to ask for help or start the recovery process. If you notice these symptoms in yourself, it may be time to reach out and ask for help.
What are some addiction treatment options?
There are several different treatments available for SUDs, including substance use disorder counseling services, and combined approaches are used frequently. Some people go to detox first to prepare themselves for treatment. In detox, counselors work to help clients discontinue the use of substances safely. After detox, a person may enter residential or inpatient treatment, followed by outpatient treatment and ongoing support groups or therapy. Substance use disorder counseling and addiction counselors, often working in an independent practice, provide addiction counseling and additional resources and counseling services to ensure a comprehensive recovery process.
Some common complementary therapies to used effectively treat substance use disorder include:
Motivational interviewing (MI) — Also known as Motivational Enhancement Therapy, MI is a counseling approach that seeks to alleviate any doubts an addicted person may have about pursuing therapy. It’s listed as an evidence-based therapy by the National Institute on Drug Abuse.
- The Matrix Model —The Matrix Model combines the principles behind various therapeutic techniques, such as CBT, MI, and CM, implementing them in a mixture of individual and group therapy sessions. It’s especially useful for treatment of alcohol abuse.
Step Facilitation Therapy —STP is a type of behavioral therapy intended to promote engagement with 12-step programs.
Contingency Management — Contingency management is a type of cognitive-behavioral therapy. It involves using tangible rewards to incentivize treatment engagement on the part of the patient. These rewards may involve gift vouchers or small cash prizes in exchange for meeting small and achievable treatment milestones (ex: attending sessions every day for a month). It’s been successfully used to treat opioid use disorder.
Rational Emotive Behavior Therapy (REBT) — Another form of behavioral therapy, REBT aims to replace irrational or limiting beliefs with more positive thought patterns. It’s an effective treatment for a large variety of co-occurring disorders, such as depression, anxiety, as well as various phobias and sleep issues.
In treatment, you often learn about and create a plan for relapse prevention, work on problem-solving skills and interpersonal relationships, address any legal or social issues that may be prevalent, address comorbid or co-occurring concerns and conditions, such as gambling addiction), and more. Family therapy sessions and emotional support for families and family members may also be provided. There is no shame in seeking care, for problem behaviors associated with SUDs, and it is important to destigmatize these issues so that more people can get the life-saving support they need.
Addressing co-occurring concerns in treatment for SUDs
Addressing co-occurring or comorbid concerns is often a vital part of treatment for SUDs.
Common comorbidities seen in those living with SUDs may include:
- Post-traumatic stress disorder (PTSD). It said that roughly half of those living with a SUD meet post-traumatic stress disorder or PTSD criteria.
- Eating disorders*. People with eating disorders are five times more likely to live with a SUD when compared to the rest of the general population.
- Anxiety disorders. Anxiety disorders are a significant risk factor for the development of a SUD, especially alcohol abuse.
- Almost a third of those living with major depressive disorder or MDD meet the criteria for a SUD. Substance use can also pair with other types of depression, like persistent depressive disorder.
- Attention-deficit/hyperactivity disorder (ADHD). People with ADHD are more likely to live with a SUD when compared to those without ADHD.
Other conditions can play a role in the development of SUDs for some people. In cases like these, addressing other concerns is often highly beneficial and is an important part of treatment for SUDs. Other risk factors, like environment, may also be addressed in treatment. When a person receives care that acknowledges their needs as a whole person and does not shy away from the role the substance may play in a person’s life, it means that a person can speak openly about their experiences, find healthy coping mechanisms to use when triggers arise, learn how to advocate for themselves, and gain other skills that may be beneficial for them as a unique person in recovery.
How substance use disorder counseling and group therapy can help you recover
If you’re considering SUD counseling and recovery, you might wonder how it works, what it will be like, or what the benefits of treatment might be. Substance use disorder counseling can help you:
1. Name and navigate the triggers of your addiction
Learning to name and navigate triggers is often a crucial part of relapse prevention. Your triggers might be specific feelings, specific situations (such as situations where you may be in the same room as or get offered a particular substance), or something else. Once your name or identify your triggers, you will likely make a plan for how you can navigate them, helping you engage in more rational thinking. This might be turning to a support system, leaving the room or event, finding ways to cope after the fact, or something else.
2. Work on life goals
A big part of counseling or treatment for SUDs is thinking about what you want your future to look like. This could include learning skills that’ll help you build and maintain healthy friendships, job or work-related skills and goals, and implementing positive daily routines into your life.
3. Challenge negative thoughts
It’s very common to experience depression, negative thoughts, and other challenges when new to sobriety. Learning to challenge negative thoughts effectively is something that we can all benefit from, and in time, your general thought patterns can become more positive and balanced if this is something you’re working on.
4. Improve your overall mental health for recovery
Because mental illness often coincides with substance abuse, one of the key principles of substance use disorder counseling is addressing mental health holistically. In other words, most often, you will address everything – or most things – that is impacting your mental health rather than the SUD diagnosis and the behaviors that might come with it alone. Many patients learn coping skills, communication skills, and so on that positively impact their lives and well-being overall.
5. Find solidarity and fight stigma
You will likely come to find a sense of solidarity in SUD counseling or treatment. Whether that is from the healthcare professionals you work with, of a support group, a sponsor, or someone else, finding people who take away the stigma of SUDs and provide solidarity for your recovery is something everyone who gets care deserves.
That said, this is by no means an extensive list. Counseling for a SUD can help you in many different ways, and it is the start of what truly feels like a new life for many people.
Where to find treatment near you
Ask a professional. You can ask a general doctor or call area hospitals for treatment information, you can also ask a substance abuse counselor, therapist, social worker, or psychiatrist you already work with.
Use a treatment locator such as https://findtreatment.gov.
Call a resource hotline such as the 211 hotlines. 211 is available in most areas in the United States. Dial “211” using any landline or cell phone, and you’ll be connected with an operator.
If you have health insurance, you can also contact your health insurance company directly to see what treatment resources they cover.
Tips for supporting your loved ones in recovery
If you live with a SUD and want to show someone in your life how to support or better understand what you’re going through, you may send online resources and other sources of information their way. SUD treatment often encourages the involvement of loved ones.
Alternatively, if you’re the loved one of a person with a SUD, you may want to find support for yourself. There are many support groups for loved ones of those with SUDs, including family and romantic partners.
Therapy and additional support options
Individual therapy with a licensed mental health professional may also be advantageous if you are the loved one of someone living with a SUD. It can be challenging to watch someone you care about face a SUD or another similar condition. Among the many other reasons people might seek therapy, therapy is a safe space to talk about your feelings and help you cope with or manage stress when times are hard. In time, you can learn to replace the negative habits and thought patterns that lead to substance abuse with more positive behaviors.
Online therapy is a viable option if an individual doesn’t want to meet in person. Individuals can connect with a licensed professional from their home without a commute, often at a more affordable price than in-person treatment.
Many halfway houses and correctional facilities are willing to accept proof of substance use disorder counseling with an online provider who has a Master’s degree or Bachelor’s degree in their field.
Takeaway
To find a therapist, you can get in contact with your doctor or insurance company, search the web for someone in your area, or sign up for a platform that offers remote therapy. Make sure to find someone that is licensed, with relevant supervised clinical experience in their field. Beyond education, it is important to find someone with good listening skills and the ability to offer you a variety of treatment options.
Whether you have a loved one with a SUD or want to talk about something else that’s on your mind, seeing a mental health professional can support you in finding clarity and confidence as you move forward.
What type of therapy works best for substance use disorder?
No one therapy type can fit all situations, and the most effective approach may vary based on the individual and underlying causes, but one of the most respected evidence-based therapies used to treat substance use disorder is cognitive behavioral therapy (CBT). This therapy involves teaching patients to recognize the underlying self-destructive behaviors driving their substance use disorder. Individuals learn coping skills to avoid these behaviors, helping them in maintaining sobriety. CBT is listed by the National Institute on Drug Abuse as an evidenced-based therapy.
What is a treatment plan for substance use (previously “substance abuse”)?
Substance use disorder counseling is a multi-step strategy for treating substance abuse, now referred to as substance use disorder. The five stages of substance use disorder counseling are often the following:
Precontemplation — The addicted person at this stage typically has not yet acknowledged their need for therapy. Denial of the problem and excuse-making are not uncommon here.
Contemplation —At this stage, the person understands they have a problem, but may still not quite be ready for treatment.
Preparation — Now, the person is usually taking action, but generally on their own; they aren’t quite ready to go to a substance use disorder treatment center. They may instead try to join a gym or treat their substance use disorder on their own.
Action — In the action stage, the person has decided to receive treatment. They may also be committed to abstinence and making substantial, positive lifestyle changes.
Maintenance — After getting treatment, the person is now committed to maintaining sobriety through continuing to practice the valuable coping skills and lifestyle changes they’ve adopted.
What does CBT therapy do for substance use disorder?
CBT aims to treat alcohol or drug use by addressing a person’s mental health, which is often at the root of substance use disorder. The treatment process involves helping a patient build self-awareness of their thoughts and behaviors, and teaching them coping skills to help them avoid the negative consequences brought on by their negative thought patterns. It’s often considered the most effective of all behavioral therapies. Other therapies contained within CBT include Contingency Management and Rational Emotive Behavior Therapy.
What are three options for substance use disorder treatment?
Broadly speaking, the three options for treating substance use disorder with drugs or alcohol are as follows:
For serious addictions, a person may check in to inpatient rehab to undergo a full detox. Stays in an inpatient program are typically two weeks, minimum. During this time, a person may be prescribed medication for substance withdrawal (this is known as a medically-assisted detox).
After detoxing, therapy to address any underlying mental illness of negative thought patterns can begin. This can take multiple forms, including 1-on-1 mental health counseling, group therapy, or various behavioral therapies.
After detox and therapy, a patient may enter what’s called outpatient rehab. The treatment process for outpatient rehab usually entails the person attending sessions during the day and then returning to their homes in the evenings. Treatment modalities here typically involve continued behavioral therapy, as well as support groups like AA to support the person’s addiction recovery.
What are the four steps of treatment planning?
Substance use treatment plans typically involve the following four steps:
Identify the Problem — This involves the person working with a medical professional to identify the exact addiction issue. For example, the patient may write out a problem statement identifying the issue as “prescription drug addiction,” or, “opioid addiction.” This statement may also encompass any co-occurring disorders like generalized anxiety or clinical depression.
Create a Goal — Next, the patient and professional would work together to address these issues. This could involve addiction treatment, therapy, medication, and learning coping skills.
Define Objectives — After the overall goals are established, a strategy is devised to reach them. This typically involves establishing concrete, observable behaviors, like positive affirmations or keeping a journal.
Intervention — The final step in a substance use disorder treatment plan is doing an intervention. This may entail group therapy sessions in which a patient’s reactions and statements are observed and tracked.
How can group therapy provide mental health support during the recovery process?
Group therapy puts you in contact with many others having similar experiences. It is a platform for expression of what you have been through, a chance to learn from others, and a realization that you are not alone. The support and sense of community can help keep you focused and motivated during recovery.
What role does substance use disorder counseling play in the overall treatment process?
Counseling is often one of the most crucial aspects of understanding why one turns to substances, addressing those concerns, and finding healthier coping mechanisms. It can become an integral part of recovery toward healthier choices and a better mindset. Beyond helping addiction, counselors work with clients on a range of concerns and can be an important part of addressing other mental health conditions that may co-occur with the substance use.
How does group therapy contribute to the support system during substance use disorder recovery?
Personal therapy helps you deal with your personal issues and problems, while group support can provide a community that understands your struggles. Together, they help you stay on course by providing both personal guidance and group encouragement.
What is the most common therapy for substance use disorder?
Cognitive behavioral therapy (CBT) is one of the most common therapy approaches for treating substance use disorder, but individuals may benefit from a variety of different approaches and counseling methods. For individuals with cost concerns regarding therapy, you may consider looking into sliding-scale options or financial aid, and online therapy platforms may also be more affordable for some people.
How does counseling help individuals with substance use disorders?
A substance use counselor—sometimes called addiction counselor or formerly substance abuse counselor—can provide counseling and expert care to individuals experiencing a substance use disorder that is vital to their recovery.
Those who are interested in a career in substance use counseling typically need to obtain a Master’s degree, gain clinical experience, pass an exam (such as the Examination for Advanced Alcohol and Drug Counselors), obtain continuing education, and adhere to high ethical standards. Additional training in group facilitation, case management, or crisis management may also be beneficial. For some professionals with prior learning experience, a graduate school may offer credit transfer agreements to reduce some course requirements in the first semester, but be sure to contact the school to determine their requirements.
- Previous Article
- Next Article