Addiction Counseling 

The Philosophy
Addictions have an effect on one’s mind, body, spirit and emotions. Although treatable, without intervention the problems of addiction become greater, chronic and may progress toward disability or death. Client centered, holistic approaches to addictions treatment integrate various disciplines that assist a person’s recovery. The use of professional support helps develop new cognitive and behavioral skills while facilitating healing in the other areas of one’s life.

Addictions counseling is a form of mental health counseling that specializes in understanding the addictive process and the impact of addiction on the client, family and society.  The addictions counseling professional recognizes the potential for substance use disorders and behavioral addictions to mimic a variety of medical and psychological disorders. In addition, the addictions counselor recognizes the potential for medical and psychological disorders to co-exist with addiction.

The Art
The process of addictions counseling not only addresses the identified addiction but the co-existing issues related to family, relationships, employment, education, spirituality, physical health, mental health and legal concerns. A variety of helping techniques are tailored to meet the needs of the individual client or family member and within the context of a counseling session, the counselor and client develop a desired treatment outcome and strategies for achieving them.

Addictions counseling is appropriate for children, adolescents and adults who are addicted or who are affected by another person’s addiction. Treatment may include individual or group counseling sessions in one or more sessions in a week, outpatient treatment, inpatient rehabilitation, hospitalization or rehabilitation programs.  Sessions are used for assessment, education, discussion about the addiction, planning strategies, support, evaluation of progress, recommendations and referrals. The length of treatment depends upon the specific substance or behavior, the client’s stage of readiness, environmental influence and co-existing complications.

The Science
A search of PubMed, a free library of life science journals, on 03/17/2005 for randomized controlled trials for addiction counseling found 45 studies.  The bulk of the relevant studies concern counseling for tobacco, cocaine or alcohol addiction.  The results for counseling were at least as good or exceeded the results from pharmaceutical intervention.  All studies comparing counseling to untreated control found the advantage to be with counseling.  Here is a representative sample of relevant studies:

1. Interventions for smokeless tobacco use cessation.
   Cochrane Database Syst Rev. 2004;(3):CD004306.
   Ebbert JO, Rowland LC, Montori V, Vickers KS, Erwin PC, Dale LC, Stead LF.
   
2. The relationship between cocaine craving, psychosocial treatment, and subsequent cocaine use.
   Am J Psychiatry. 2003 Jul;160(7):1320-5
   Weiss RD, Griffin ML, Mazurick C, Berkman B, Gastfriend DR, Frank A, Barber JP, Blaine J, Salloum I, Moras K.
   
3. Out-patient behaviour therapy in alcoholism: relapse rates after 6 months.
   Acta Psychiatr Scand. 2001 Jan;103(1):24-9.
   Burtscheidt W, Wolwer W, Schwarz R, Strauss W, Loll A, Luthcke H, Redner C, Gaebel W.

The Practitioner
In Ohio, addictions counseling is currently changing from a certification process to a process of licensure in one of four levels of licensure or certification with The Ohio Chemical Dependency Professionals Board.

Chemical Dependency Counselor Assistant (CDCA) must complete 40 hours of education in chemical dependency and clinical methods while volunteering or working in a supervised program for addictions.

Licensed Chemical Dependency Counselor II (LCDCII) requires that the counselor have an associate’s degree in behavioral science or a bachelor’s degree in any field and (6,000 hours) of volunteer or work in a supervised program for chemical dependency.

Licensed Chemical Dependency Counselor III (LCDC III) entails a bachelor's degree in a behavioral science. And two years (4,000 hours) of volunteer or work in a supervised program for chemical dependency.

Licensed Independent Chemical Dependency Counselor (LICDC) must have completed a master’s degree in a behavioral science with documentation of coursework in ten specific content areas and (6,000 hours) paid work experience in chemical dependency and addictions counseling of which two years (4,000 hours) are clinical supervisory experience.

Additionally, all LICDC and LCDC levels must have obtained 270 hours of education in the core functions of addiction counseling, demonstrated 330 supervised hours of practical experience in the application of the core functions, and passed the AODA written examination and the CPM oral examination.
Chemical dependency counselors are required to renew their credential every two years and verify 40 hours of continuing education.