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Counseling

Counseling can help you develop skills to recover from alcohol and drug misuse. 

What is counseling? Counseling provides guidance from a licensed professional for reducing alcohol or drug use and staying sober. Using various evidence-based treatment approaches, a counselor or therapist can help you to understand factors that contribute to your substance use, to identify and avoid triggers, to cope with cravings, and to strengthen your motivation. Counseling can also help you discover ways to cope with other life challenges.

Counseling is usually provided in an outpatient setting, but it also can be provided as part of an inpatient or residential program. And because counselors work directly with you to determine your needs, they can be good guides for determining whether treatment options, like support groups or rehab, are right for you.

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Choosing a counselor

You should always work with a licensed counselor

States have their own requirements for getting a counseling license, and they fall under different names. Look for counselor designations like:

  • Addiction counselor (this particular certification varies widely by state)
  • Licensed clinical social worker (LCSW)
  • Marriage and family therapist (LMFT)
  • Mental health counselor (LMHC, LPC, or LCMHC)
  • Licensed psychologist

A more comprehensive overview is provided by Mental Health America.

Don’t be afraid to ask if a provider is licensed. You can also go to your state’s accreditation website to determine what the right license is, as well as check if a particular provider’s license is current. 

Your relationship with a counselor or therapist is key

Don’t discount the importance of feeling comfortable with the person guiding your care. While it’s important that your counselor or therapist is licensed and uses evidence-based treatments, it’s also critical that you feel respected and heard. Beyond finding the treatment methodology that will work for you, focus on finding someone you can trust, with whom you can build a productive relationship.

You may have financial support options

Before you see a counselor, it’s a good idea to call your insurance company and find out which providers and types of care are covered. If you don’t have commercial insurance, you may still have options that can support your care, such as:

  • Medicare and Medicaid. If you have Medicare or Medicaid, check your policy to see if counseling for mental health and substance use disorders is covered and whether there are limitations or out-of-pocket costs.
  • Employer assistance programs. Some employers have employee assistance programs that offer financial or other support for mental health and substance misuse disorders. Be sure to review your employer’s benefits information or talk to someone in your human resources department.
  • Payment assistance or free treatment. Some community organizations and providers offer a sliding fee scale, which means they lower the price of their services if your financial situation warrants it. Others even provide free services based on your ability to pay. Low-cost options may also be available through your state. You can call SAMHSA’s National Helpline at 1-800-622-HELP (4357) for a referral to the state office that’s responsible for these programs.

Other considerations

  • Treatment can be different from person to person. Counseling is based on your individual needs and circumstances. It can address things that may be driving substance misuse, such as past trauma. Or, it can help you manage aspects of your life that are affected by or contribute to your substance use, such as your family, relationships, and employment. Counseling also can vary in length — people might regularly see their counselor for anywhere from a few months to years.
  • Counselors can help you overcome mental health challenges. Mental health conditions often co-occur with substance use disorders and can make recovery more difficult. Because of this, it’s important to treat these co-occurring disorders together.
  • Counseling is an important part of medication assisted treatment (MAT). MAT is a treatment approach that uses a combination of medicine, counseling, and therapy to treat alcohol, opioid, and tobacco use disorders. MAT has been shown to be effective — and for those with opioid use disorder specifically, to reduce the need for inpatient detoxification. Counselors who are not also doctors cannot prescribe medication themselves, but they can likely guide you toward a medical professional who can.

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