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The Role of the Counselor in Addiction Recovery

Substance abuse counselors provide a necessary support system for individuals recovering from eating disorders, drug and alcohol issues, gambling addictions, and other behavioral issues. By forming a relationship built on trust with their patients, counselors provide the support, resources, and judgement-free guidance that patients can utilize on their road to addiction recovery.

Counselors in this field help addicts with both crisis and long-term addiction management issues, which can range from immediate medical intervention, to supporting them manage their recovery long term.

Create a Therapeutic Alliance with Patients

The decision to seek treatment for addiction is no easy one, and requires a great deal of trust between patients and their counselors. As such, counselors should take care to create a strong bond with their patients, known as a therapeutic alliance.

A therapeutic alliance is the trust patients feel with their counselors, allowing them to feel vulnerable sorting out their problems and work together effectively. Strong alliances like this ensure that patients view their counselors as trustworthy, and know that their best interests are on the forefront. This allows counselors and patients to work together even during tribulation.1

While this trust takes time to develop, patients should eventually feel comfortable speaking freely during sessions, feel relief after an appointment, and feel a desire to go back.

Strong therapeutic alliances can be made by

  • Ensuring patients know you are interested in their well being

  • Attentiveness during sessions

  • Letting patients know you can empathize with their problems

  • Understanding and communicating the foundational issues at play in recovery

Therapeutic alliances are a key factor to addiction recovery. By creating an environment where patients feel comfortable and welcome discussing their hardships, counselors can better help their clients on the road to recovery.

Encourage Patient Recovery

Recovering from addiction is difficult, as many individuals with alcohol or drug dependency fail to recognize their own patterns of abuse, or have ambivalent feelings about seeking treatment. In substance abuse treatment, the patient’s motivation to change has often been a source of frustration, since counselors have little control over a patient’s desire to change.

The counseling community is rethinking current approaches to motivation, by empowering the counselor to elicit and enhance motivation, and to find a style that will best meet the needs of the client.2

“The most desirable attributes for the counselor mirror those recommended in the general psychological literature and include non-possessive warmth, friendliness, genuineness, respect, affirmation, and empathy,” according to findings by the NCBI. In comparison, confrontational counseling which included challenging the client, disputing, and refuting led to opposite results. “In this study the more a client was confronted, the more alcohol the client drank.”

Although change is ultimately the in the hands of the patient, counselors can adapt their style to help enhance client motivation throughout each stage of their recovery. The counselor’s role goes far beyond simply listening, teaching, and offering advice.

Instead, the responsibility of the counselor to help patients recognize problematic behaviors and help guide them into recovery, and empower them to take action and change these behaviors.

Help Patients Develop a Relapse Prevention Plan

The chronic nature of addiction ensures that a large percentage of those diagnosed will relapse at some point during their recovery. Some studies indicate that an estimated 40-60 percent of addicts will relapse at some point during their life, which is on par with many well understood illnesses such as diabetes, asthma, and hypertension.3 But relapse doesn’t mean treatment has failed, rather, it serves as an indicator that treatments need to be adjusted to best help the patient.

Once the decision to seek treatment for addiction has been made, it’s important that patients are well equipped to avoid relapse in the future. Preventing relapse requires more than just the willpower to say “no” when temptation arises, and prevention needs to start early in the recovery process. Developing a comprehensive relapse prevention plan is an essential function of the counselor’s role in addiction recovery.4

Plans will be tailored to the needs of each individual patient, but essential elements include:

  • A detailed account of the patient’s experience with substance abuse including previous relapses

  • Warning signs and ways patients can best manage them

  • A detailed list of family, friends, and counselors that can be used as a support network

  • An emergency relapse plan

  • Specific lifestyle changes that patients can do to prioritize their well being

Meet With Family Members to Provide Guidance

For family and friends of patients in recovery, addressing the addiction is one of the most difficult aspects of helping loved ones recover. Inadvertently, daily interactions with loved ones can enable the addict, and many family members choose to ignore the problem out of fear that their loved ones will be pushed away by the confrontation.

As such, during addiction therapy treatment, it’s important that family be well informed of how to handle their family member’s addiction moving forward. Counselors can help patients families in a variety of ways, from mediating family therapy sessions, to helping them locate a support group.5

The support of friends and family plays an integral role in recovering from addiction. Since recovery is a lifelong journey, having supportive family members who understand the process is of profound importance. Family members who are informed about addiction recovery can greatly increase chances of success throughout the recovery process, and in some cases can help keep addicts accountable. Substance abuse counselors can help families understand the complex road to recovery, and offer support for the difficult journey ahead.

Refer Patients to Outside Support Groups

There are a variety of outside resources available to those recovering from addiction that are beneficial when combined with counseling treatment. As a counselor, referring patients to programs such as Alcoholics Anonymous and Narcotics Anonymous can add another level of outside support.

These community based programs provide an additional layer of accountability to those seeking rehabilitation, and by attending meetings, patients will be surrounded by individuals with similar backgrounds, and can further share their stories, wisdom, and struggles in a non-judgmental environment.

The role of the counselor in addiction treatment involves far more than just talking an addict through treatment. Counselors have to be highly empathetic people, who have a passion for building relationships with their patients. From providing a safe space for patients to openly talk about their struggles with addiction, to guiding family members through the recovery process, to addressing plans to avoid relapse, counselors play an important role in addiction recovery.


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