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The consequences of alcohol and other drug abuse are enormous and costly. Although the costs can be evaluated in dollars, they are more readily understood in human terms: health and medical problems, personal and family discord, lower work productivity and job loss, legal problem including automobile accidents and other crime, and the list goes on.

Preventing and treating substance use problems have proven to be difficult indeed, but one of the best ways to address the problem is to provide effective counseling and treatment for substance abusers. The primary goal of substance abuse counseling is to assist clients in achieving and maintaining control of their substance abuse and related behaviors and to help clients recover from the damage the abuse has caused them and the people around them.

While the counselor takes an active role in the recovery process, it is the client who is the effective agent of change. The metaphor of the hiker and the guide is useful for conceptualizing the counselor-patient relationship. The counselor guides the client through at least the early stages of recovery, but the recovery process ultimately belongs to the client. It is the client who learns to take responsibility for working on, and succeeding with, a program of recovery. The counselor tries to create a sense of participating in a collaborative and a partnership relationship.

To be an effective substance abuse counselor you should first possess a thorough knowledge of AOD use and abuse and counseling and treatment approaches and techniques. Second, no matter how much knowledge you possess, including possibly your own experiences with overcoming substance abuse problems, you should let the clients be the experts in discussing their lives. This can be done by utilizing the strategies discussed in this course, including assessing where the clients are in the stages of change and through such techniques as motivational interviewing help them to meaningfully address their substance use and related problems.

Third, with the client, develop a counseling and treatment plan which is individually suited to each client’s needs both in terms of their substance abuse, but also the associated problems that caused, or were caused by, their substance abuse. This treatment plan should not only address each client’s immediate recovery needs, but one that also addresses their long-term recovery and maintenance needs.

Finally, no matter what counseling and treatment strategies you use, what you bring as the counselor to the therapy and treatment sessions significantly influence the outcome. More than anything else your clients need to feel you are competent to work with them and you care about their recovery. Working with clients who use and abuse alcohol and other drugs can be very difficult, but rewards can also be great.