Careers in Substance Abuse Counseling

OnlinePsychologyDegrees.com interviewed Errol Rodriguez, Ph.D., assistant dean and program director for Adelphi University’s psychology and mental health counseling program.

Below he talks about a career in substance abuse counseling and what students should know as they enter the field.

Read a transcript of the interview

Q: How is alcohol/substance abuse counseling different than other types of psychology?

The alcohol and substance abuse specialty is quite different. It’s a much broader perspective in the field of psychology, and it has been around for many, many years. Specialization in this area requires a very broad, systemic perspective that involves medicine, legal, forensic and social work. Most of the other subspecialties of psychology don’t pull from that many disciplines for treatment.

Q: How did you get started in this field?

I would imagine that a lot of people got involved in this area almost out of necessity. So many of our patients who come in with depression, anxiety, or other psychological conditions may also substance abuse, but not report it. Sometimes – just by chance – you find out that a patient is abusing marijuana, or prescription painkillers.

As I started to read up on this area, I realized that this could be a potential area of interest, as well as a niche. And so I started to read, study and get involved in symposiums and colloquiums in the area of addiction.

Q: In your work, what is an average day like?

Typically, in an outpatient setting, an alcohol and substance abuse specialist will likely do an assessment first thing in the morning. He or she will see two or three individual patients, probably followed by a meeting of some sort. Then, he or she might do a couple of group [sessions] because in this area, group practice is incredibly important. A lot of people in the field believe that peer influence is very helpful in getting people to decide to make a change. That will probably be followed up with some consultation on the phone, either with an M.D., an employment assistance professional, or a legal professional if you’re working with someone involved in legal proceedings.

Q: In general, are there any specific traits that work well for someone in this career?

[You need to be] someone who isn’t judgmental. Alcohol and substance abuse still carry a strong social stigma. You have to be aware of your own involvement with drinking or using anything medicinally or recreationally. If you have a strong feeling about [substance abuse] one way or the other, make sure it doesn’t come with a set of judgments or biases that would predispose you to much greater challenges in working with these patients.

[You have to be patient]. There’s a huge amount of relapse in this area. Years ago, many therapists veered away from working in substance abuse; one reason is because of the high relapse rate. It feels like you haven’t done well enough, and that leads to a lot of burnout, a lot of frustration on the part of the therapists themselves. Know that there is a high rate of relapse – it doesn’t necessarily reflect whether the therapist is good or not; it’s the nature of the condition.

I also think that the therapist must be flexible. They have to be a good listener, and they need to be empathic.

Q: What do you wish someone had told you about the profession?

I would have loved for someone to tell me how wonderful the profession is. It really has a kind of gratification built into it. You really do get a chance to see a person turn his or her life around once he or she finally gets it. And, the change can be very dramatic. I would also have liked to get into [addiction counseling] earlier, to start training earlier. There are many ways to get the training, and it doesn’t necessarily have to be through university – but that would be a great way to get it. You can also get it by reading, going to symposiums and conferences. You can go to an Alcoholics Anonymous meeting and ask questions.

Q: What kind of changes have there been in your area of practice in the last few years?

Psychology has been involved in substance abuse probably about 100 years or so. Up until now, though, there’s been a fairly large gap in the training of psychologists going into the field of addiction, particularly alcohol and substance abuse. Over the last 15 years or so, there has been a resurgence of interest in this area, and more development of courses at the doctoral and master’s level.

Q: What do you see for the future of this field?

A lot is changing with some of the health care reform initiatives, but I think alcohol and substance abuse services will remain in-demand. [People don’t seem to be using substances less]. So I think in general, the field will only grow. The demand for specialists in this area is going to increase significantly.

Q: What should students ask themselves before entering the field?

I think that one of the things they should ask themselves is, “How much am I going to be affected working with someone with a substance abuse problem?” The question asks them – at least implicitly – if they have had any involvement in substances or if anyone from their family or friends had that involvement. [If so, would it] negatively affect their work with a substance-abusing patient?

Q: Any other recommendations for aspiring alcohol and substance abuse counselors?

If you specialize in this area, you can almost turn it into its own field and then have smaller specialties within it. It’s not as easy to do in some of the other areas of psychology, but in this area, because it’s so broad, you can do a variety of things.