How does Drug and Alcohol Abuse Counseling Work?

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  • Written By: Donn Saylor
  • Edited By: Lauren Fritsky
  • Last Modified Date: 26 July 2018
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Drug and alcohol abuse counseling typically involves behavioral therapy, support groups, and, in some cases, admittance to addiction treatment programs. Substance abuse counselors work closely with clients to help them confront the reality of their alcohol or drug abuse and the reasons for this behavior. When an individual enters into drug and alcohol abuse counseling, he or she will be required to take a hard look at the past events, behavioral patterns, and personal choices that have played a role in shaping his or her current condition.

The recovery process works primarily by investigating the condition, usually conducted with a trained therapist in a psychoanalytic setting. Both therapists in private practice and those who work in substance abuse centers commonly provide this type of counseling. The approach entails a thorough examination of the psychological factors that gave rise to the addictive behavior. Most drug and alcohol abuse counseling takes the position that addiction is rooted in some sort of unresolved psychological issue, usually trauma experienced in childhood that has not been properly dealt with. The therapist will frequently employ various types of therapies to get to the root of the issue, most notably cognitive-behavioral therapy, a treatment process with a structured approach that aims to address problems and healthfully alter behaviors.


Drug and alcohol abuse counseling often involves a patient attending a support group. Most supports groups operate under the guidelines of The 12 Steps, an approach to recovery fashioned by Alcoholics Anonymous (AA). While many have achieved sobriety with the 12-step format, there are other group settings that can also provide valuable service, support, and the necessary skills to getting and staying sober. Rational Recovery®, Self Management and Recovery Training, or SMART Recovery®, Moderation Management, and Women for Sobriety all offer alternatives to the traditional 12-step format. AA and most other support groups typically provide a supportive atmosphere for participants to share their problems, work together to achieve goals and maintain sobriety, and support one another in dealing with the issues that have both caused and resulted from the addiction.

Some patients will require admittance to an addiction treatment program as a way to intensively confront drug and/or alcohol abuse. This type of drug and alcohol abuse counseling can either be inpatient, or residential, or outpatient. Many treatment or rehabilitation centers operate on a 12-step format and provide attendees with a safe, medically-sound, and supportive atmosphere in which to immerse themselves in their newfound sobriety.


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