Stages of Substance Abuse Counseling

The website About Recovery estimates that 25 million Americans struggle with substance abuse problems. Many of these individuals need help overcoming their addiction. Substance abuse counseling and a step-by-step process address these issues methodically. Some counselors and facilities combine one or more of these stages.

Screening/Intake

• The facility first screens the client to determine his eligibility for their program. He may be ineligible if he has other mental health issues or if the facility does not accept his insurance. During intake, the patient usually fills out an extensive questionnaire providing background information. This further assesses the client's appropriateness for the program. Some facilities separate these steps.

Orientation

• Once the patient has been accepted into the program, a staff member reviews the expectations of the patient while enrolled in the program. A patient is briefed on program rules, what the program offers, program length and counselor information.

Assessment

• During assessment, the counselor reviews the scope of the client's substance abuse problem. She addresses the number of substances the patient uses, the duration, amount and severity of drug use and any related issues such as mental illness or homelessness.

Treatment Planning

• The counselor explains the assessment results to the client. The patient and counselor develop a treatment plan to address the addiction issues, identifying what methods and resources they will use. They also set immediate and long-range goals.

Counseling/Education

• While these are normally two separate stages, counseling involves developing specific strategies to address the client's substance abuse issues. The patient must participate in the process as he works toward the treatment goals. The counselor will tailor counseling to a patient's needs. Education about addiction issues can be done in a group setting, one on one or in a combination of settings.

Case Management

• This stage applies only to patients who need other services such as social workers or mental health services. The counselor coordinates these services for the client.

Crisis Intervention

• All patients may not go through this stage. However, if there is a crisis, the counselor will relate appropriate strategies to address the crisis and avert problems.

Referral

• Substance abuse counselors may not be able to meet all the needs of the client. In these situations, the counselor must identify the patient's need, explain the reason for referral, find an appropriate agency, work within the guidelines of confidentiality laws and support the patient through the transition.

Documentation

• Sometimes called report and record keeping, documentation tracks client conversations and progress toward immediate and long-term goals. This can include court reports, daily chronological notes, charts and reports to other agencies.

Consultations

• Similar to referrals, consultations may be done at the end of treatment with other in-house personnel or outside professionals. Again, the counselor needs to adhere to confidentiality rules and explain the rationale for the consultation to the client.