Substance Abuse, Behavioral Disorder, and Mental Health Counselors

Substance abuse, behavioral disorder, and mental health counselors advise people on a range of issues, such as those relating to alcoholism, addictions, or depression. They provide support, including for prevention, to help clients recover from addiction, modify problem behaviors, or improve mental health.

Duties

Substance abuse, behavioral disorder, and mental health counselors typically do the following:

• Evaluate clients’ mental and physical health, addiction, or problematic behavior and assess their readiness for treatment
• Develop, recommend, and review treatment goals and plans with clients and their families
• Assist clients in developing skills and behaviors necessary to recover from their addiction or modify their behavior
• Work with clients to identify behaviors or situations that interfere with their recovery
• Document and maintain records of clients' progress
• Teach clients’ family members about addiction or behavior disorders and help them develop strategies to support clients in recovery
• Refer clients to other resources and services, such as job placement services and support groups
• Prepare clients for transition out of counseling through discharge planning
• Conduct outreach programs to help people identify the signs of addiction and other destructive behavior, as well as steps to take to avoid such behavior

Substance abuse counselors and behavioral disorder counselors, also called addiction counselors, work with clients individually and in group sessions. They teach clients how to cope with stress and life’s problems in ways that help them recover. Furthermore, they help clients rebuild professional relationships and, if necessary, reestablish their career. They also help clients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.

Some addiction counselors work in facilities that employ many types of healthcare and mental health professionals. Addiction counselors may work with psychologists, psychiatrists, social workers, physicians, and registered nurses to develop treatment plans and coordinate care for patients.

Some counselors work with clients who have been ordered by a judge or referred by other people, such as a parole officer, to receive treatment for addiction. Others work with specific populations, such as teenagers, veterans, or people with disabilities. Counselors may have to intervene in crises by stepping in when someone is endangering his or her own life or the lives of others. They also intervene in noncrisis situations by encouraging a person with addictions or other issues, such as difficulty processing emotions, to get help. Noncrisis interventions often are requested by friends and family.

Mental health counselors advise individuals, families, couples, and groups. Some work with specific populations, such as children or older adults. Mental health counselors treat clients who have a variety of conditions, including anxiety, depression, grief, and stress. They also help with emotional health and relationship problems.

Substance abuse, behavioral disorder, and mental health counselors held about 483,500 jobs in 2024. The largest employers of substance abuse, behavioral disorder, and mental health counselors were as follows:

Substance abuse, behavioral disorder, and mental health counselors work in a variety of settings, including inpatient and outpatient treatment centers, correctional facilities, and hospitals. Some addiction counselors work in residential treatment centers, where clients live in the facility during their recovery.

Although rewarding, the work of substance abuse, behavioral disorder, and mental health counselors is often stressful. Many counselors have large workloads and do not always have enough resources to meet the demand for their services. In addition, counselors may have to intervene in crisis situations or work with agitated clients.

Work Schedules

Most substance abuse, behavioral disorder, and mental health counselors work full time, although part-time work is common. In some settings, such as inpatient or residential facilities, they may need to work evenings, nights, or weekends.

Education and training requirements vary for entering these occupations. Substance abuse and behavioral disorder counselors typically need at least a bachelor’s degree, whereas mental health counselors typically need a master’s degree and an internship. Some counselors need a state-issued license.

The median annual wage for substance abuse, behavioral disorder, and mental health counselors was $59,190 in May 2024.

Employment of substance abuse, behavioral disorder, and mental health counselors is projected to grow 17 percent from 2024 to 2034, much faster than the average for all occupations.

About 48,300 openings for substance abuse, behavioral disorder, and mental health counselors are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.