Key Responsibilities and Required Skills for Drug and Alcohol Counselor

🎯 Role Definition

This role requires an experienced, compassionate Drug and Alcohol Counselor to deliver evidence-based treatment and recovery services to individuals with substance use disorders (SUD). The ideal candidate conducts clinical assessments, develops individualized treatment plans, facilitates individual and group counseling, coordinates care with medical and behavioral health providers (including MAT programs), documents progress in the electronic health record (EHR), and supports clients through crisis intervention, discharge planning, and long-term relapse prevention. This role requires strong clinical judgment, cultural humility, knowledge of ASAM criteria and trauma-informed care, and the ability to work collaboratively with multidisciplinary teams and community partners to achieve measurable client outcomes.

📈 Career Progression

Typical Career Path

Entry Point From:

Peer Support Specialist or Recovery Coach transitioning to clinical roles
Behavioral Health Technician or Residential Counselor seeking clinical advancement
Case Manager with experience in SUD programs

Advancement To:

Senior Drug and Alcohol Counselor / Lead Clinician
Clinical Supervisor or Program Manager for Addiction Services
Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Substance Use Disorder Program Director

Lateral Moves:

Case Manager (complex care coordination)
Community Outreach Coordinator / Prevention Specialist
Co-occurring Disorders Specialist or Dual-Diagnosis Clinician

Core Responsibilities

Primary Functions

Conduct comprehensive intake assessments using standardized tools (e.g., ASAM criteria, DSM-5 symptom checklists, addiction severity indices) to determine level of care, risk factors, co-occurring mental health conditions, and appropriate treatment modalities.
Develop individualized, measurable treatment plans in collaboration with clients that specify short- and long-term recovery goals, evidence-based interventions, frequency of services, discharge criteria, and aftercare supports.
Provide individual counseling sessions using evidence-based approaches such as motivational interviewing (MI), cognitive-behavioral therapy (CBT), relapse prevention, and trauma-informed practices tailored to each client’s stage of change.
Facilitate structured group therapy sessions (e.g., relapse prevention, coping skills, 12-step integration, family education, process groups) that promote peer support, skill-building, and accountability.
Coordinate medication-assisted treatment (MAT) services by collaborating with prescribing providers, monitoring medication adherence, educating clients about MAT options (buprenorphine, methadone, naltrexone), and integrating pharmacotherapy into recovery planning.
Perform crisis intervention and safety planning for clients experiencing acute intoxication, withdrawal, suicidal ideation, domestic violence exposure, or other high-risk events; arrange emergency referrals and collaborate with medical providers as needed.
Conduct and interpret urine drug screens, breathalyzer results, and other toxicology testing, documenting results, discussing findings with clients, and integrating outcomes into treatment adjustments.
Provide case management and care coordination: link clients to housing, employment, legal resources, primary care, psychiatric services, and community supports; advocate on behalf of clients with payers and external agencies.
Maintain timely, accurate clinical documentation in the electronic health record (EHR), including intake summaries, treatment plans, progress notes, discharge summaries, and billing codes in compliance with agency policies, HIPAA, and payer requirements.
Complete discharge planning and aftercare coordination that includes relapse prevention strategies, referrals to outpatient or stepped-down services, sober living options, and ongoing recovery supports.
Screen for and document co-occurring mental health disorders (depression, PTSD, bipolar disorder) and coordinate integrated treatment with behavioral health clinicians or refer for psychiatric evaluation and medication management.
Deliver family and significant-other counseling and psychoeducation to increase family support, improve communication, and reduce enabling behaviors that undermine recovery.
Monitor clinical outcomes and client progress using quantitative measures (e.g., validated assessment scales, attendance, toxicology results) and adjust care plans accordingly to meet recovery goals.
Provide overdose prevention education, including naloxone training and distribution, safe use guidance, and linkage to harm reduction programs for clients at high risk of opioid-related harm.
Participate in multidisciplinary team meetings, treatment planning conferences, and case reviews to ensure continuity of care, shared clinical decision-making, and coordinated discharge transitions.
Supervise and mentor junior counselors, practicum students, or interns; provide clinical feedback, shadowing opportunities, and support ongoing professional development.
Ensure program compliance with state regulations, licensing requirements, accreditation standards, and funder/grant reporting obligations; assist with quality improvement and audits.
Design and deliver community outreach, prevention education, and referral development activities with hospitals, courts, schools, or shelters to expand access to SUD treatment services.
Develop and update clinic policies, clinical protocols, and evidence-based workflows for screening, brief intervention, and referral to treatment (SBIRT) and stepped care models.
Maintain professional knowledge of current best practices, SAMHSA guidelines, and research in addiction treatment through continuing education, supervision, and professional networking.
Manage caseload effectively to balance active clinical hours with administrative duties, documentation, and scheduled outreach, ensuring timely client contact and follow-up.
Provide culturally competent care that respects diverse backgrounds, addresses language needs, and tailors interventions for special populations (youth, LGBTQIA+, veterans, pregnant/postpartum clients).

Secondary Functions

Assist program leadership with grant writing, data collection, and reporting for funding compliance and outcome measurement.
Participate in agency-wide quality improvement initiatives, performance metric reviews, and development of clinical key performance indicators (KPIs).
Deliver training sessions for staff on trauma-informed care, motivational interviewing, cultural humility, and risk management best practices.
Support the intake team by providing triage decisions during high-demand periods and assist with waitlist management and triage protocols.
Represent the clinic at community coalitions, referral network meetings, and professional conferences to maintain referral pipelines and professional relationships.
Perform limited administrative tasks such as scheduling, billing review, authorization coordination, and documentation audits to facilitate smooth program operations.
Contribute to protocol development for infection control, client confidentiality, and workplace safety, including response plans for client behavioral escalations.
Participate in contingency management and outcome-driven programming design, including the delivery of incentives and monitoring of program fidelity.

Required Skills & Competencies

Hard Skills (Technical)

Proficient use of electronic health record (EHR) systems for clinical documentation, billing, and reporting (experience with Credible, Epic, Cerner, or similar platforms preferred).
Clinical assessment expertise: ASAM level-of-care criteria, DSM-5 diagnostic interviewing, biopsychosocial assessment.
Evidence-based clinical interventions: Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Relapse Prevention, Contingency Management.
Knowledge and coordination of Medication-Assisted Treatment (MAT) and working knowledge of opioid use disorder pharmacotherapies (buprenorphine, methadone, naltrexone).
Competence in performing and documenting urine drug screens and interpreting toxicology results within clinical context.
Case management and care coordination skills: referral processes, resource navigation, housing and benefits linkage, and utilization management.
Familiarity with HIPAA privacy standards, clinical ethics, mandatory reporting, and confidentiality in behavioral health settings.
Outcome measurement and progress monitoring skills, including use of validated tools (AUDIT, DAST, PHQ-9, GAD-7) and KPI tracking.
Crisis intervention and de-escalation techniques, safety planning, and ability to coordinate with emergency services and inpatient units.
Documentation and billing proficiency: accurate treatment plans, progress notes, CPT coding basics for behavioral health services, and authorization management.
Trauma-informed care and cultural competency skills for working with marginalized and diverse populations.
Experience facilitating group therapy, psychoeducation workshops, and family counseling sessions.

Soft Skills

Strong verbal and written communication skills for client engagement, interdisciplinary collaboration, and clear documentation.
High level of empathy, patience, and nonjudgmental approach to build therapeutic rapport with clients in early recovery.
Excellent active listening and motivational skills to move clients through stages of change and enhance treatment engagement.
Resilience, emotional self-regulation, and ability to manage vicarious trauma and stressful clinical situations.
Critical thinking and clinical decision-making to prioritize high-risk cases and adjust treatment plans responsively.
Cultural humility and adaptability to serve clients from diverse socioeconomic, cultural, and linguistic backgrounds.
Time management and organizational skills to balance caseload, documentation deadlines, and community outreach responsibilities.
Conflict resolution and boundary-setting skills to maintain therapeutic relationships and professional standards.
Collaborative team orientation to work effectively with medical providers, peer specialists, social workers, and external agencies.
Initiative and continuous-learning mindset to adopt new evidence-based practices, workflows, and regulatory requirements.

Education & Experience

Educational Background

Minimum Education:

Associate degree in human services, counseling, psychology, or related field plus state-required substance use disorder certification (e.g., CADC, CAADC, LADC) and 1–2 years of direct SUD experience.
OR High school diploma/GED with significant experience (2–4 years) in addiction services and completion of recognized addiction counseling certification pathway where permitted by state regulations.

Preferred Education:

Bachelor’s degree in Social Work (BSW), Psychology, Counseling, or a related behavioral health field.
Master’s degree (MSW, MEd Counseling, LPC) preferred for advanced clinical roles; state licensure (LCSW, LPC, LCPC) or advanced substance use certification (ICADC, MAC) strongly preferred.

Relevant Fields of Study:

Social Work
Counseling / Clinical Mental Health Counseling
Psychology
Human Services
Addiction Studies / Substance Use Disorders

Experience Requirements

Typical Experience Range: 1–5 years of direct clinical experience in substance use disorder treatment, outpatient or residential settings; experience may vary by level (entry vs. senior roles).

Preferred:

2–5+ years providing assessment, individual and group counseling, and case management in SUD programs.
Prior experience with MAT programs, working with co-occurring disorders, and supervising trainees or peer staff.
Demonstrated experience using EHRs, documenting to compliance standards, and achieving measurable client outcomes.

Certifications (preferred/required depending on jurisdiction): Certified/Licensed Alcohol and Drug Counselor (CADC/LADC/ICADC), CPR/First Aid, naloxone administration training, and state-specific licensing as required.