Drug and Alcohol Counseling: Developing Professional Practice

Introduction: Why Drug and Alcohol Counseling Matters

I believe that addiction to illicit drugs and alcohol is one of the most important areas of focus in contemporary counseling. That is largely because addictions are so disruptive to the entire nuclear family — and often to the extended family — of virtually every person who suffers from them. Addictions are also particularly tragic because they have the capacity to destroy lives that hold tremendous promise. The fact that excessive alcohol consumption is routinely encouraged in many social environments, and that highly addictive prescription drugs are prescribed at a higher rate now than ever before, adds to the urgency of addressing drug and alcohol abuse.

What truly distinguishes drug and alcohol addiction as such an important issue in counseling is the potential for the behaviors associated with it to intersect so tragically with the lives of random strangers — for example, in connection with violent crime and, especially, impaired driving. Unfortunately, I have witnessed both the tragic deterioration of lives that previously held tremendous potential in my community and the sudden and unexpected loss of life attributable to alcohol-impaired driving. Those experiences undoubtedly helped steer me toward my current educational and professional interest in counseling.

In the last several years, I have also become acutely aware of the increasing problem of drug and alcohol abuse among members of the U.S. armed forces following their return from long-term or repeated combat deployments. In many cases, soldiers who experienced significant trauma in the field have never fully acknowledged their reactions or their sense of loss (Frain, Bishop, & Bethel, 2010). This is especially significant with respect to military servicemen and servicewomen because the military social culture rewards and promotes stoicism while strongly discouraging outward displays of emotion as "weakness" (Frain, Bishop, & Bethel, 2010). Resources such as those provided by the U.S. Department of Veterans Affairs highlight just how prevalent this challenge has become for returning service members.

Helpful Personal Values and Attributes

I anticipate that some of the key skills and areas of knowledge that will enable me to succeed as a placement counselor will be my active listening skills, my ability to reflect meaningful conversational content back to clients, and my ability to establish and maintain rapport with clients and other stakeholders. I believe that I have begun to develop the ability to listen actively while guiding conversations passively (Cleak & Wilson, 2007). That skill will allow me to help narrow the focus of clinical conversations to clinically relevant issues in a manner that does not challenge the client's perceived autonomy or create conflict and, therefore, resistance (Cleak & Wilson, 2007).

These approaches to counseling are more conducive to eliciting information that is meaningful to placement recommendations and decisions than approaches that unnecessarily challenge clients or put them on the defensive in clinical interactions (Cleak & Wilson, 2007). Similarly, I believe I have developed the ability to recognize issues that have potential clinical significance and to pursue conversations and lines of questioning in a logical manner. Those skills allow me to make productive inferential use of background information and to build constructively upon interpersonal exchanges within conversations, as well as across multiple sessions (Cleak & Wilson, 2007).

Addressing Gaps in Substantive Knowledge and Clinical Experience

On one hand, I am fairly confident that I have developed several essential skills and accumulated substantive knowledge that is relevant and useful to placement counseling services. On the other hand, I recognize that I am still inexperienced and that I must continue my formal studies to become a qualified professional placement counselor. Toward that end, I have already begun reading extensively in the field, particularly in connection with my main area of interest in drug and alcohol addiction counseling.

More specifically, I have sought out literature covering a broad range of counseling issues — including behaviors, contributing factors, and potential barriers — applicable to many different client populations. For example, I have read about gender-based differences in the ways men and women experience and process negative emotions in relation to precipitating substance abuse, especially alcohol (Allen, 1994; Beckman & Amaro, 1986). That material is directly relevant to understanding the different gender-based connections between internalized negative emotions and addictive behaviors.

I have also explored literature detailing the ways in which social roles and expectations in typical male-dominated business cultures actually enable alcohol abusers, making it even more difficult for so-called "social drinkers" with addiction issues to acknowledge their problem, seek treatment, and return to the workplace without relapse (Cunningham, Sobell, Sobell, et al., 1993; Hajema, Knobbed, & Drop, 1999). Similarly, I have sought out material on the factors associated with the decision of street drug abusers to seek treatment (Siegal, Falck, Wang, et al., 2002), as well as literature pertaining to differences in addictive behavior associated with racial disparities (Lundgren, Amodeo, Ferguson, et al., 2002). Research published in sources such as the National Library of Medicine has been particularly useful in this regard. To supplement my reading and eliminate remaining gaps in my knowledge base, I plan to attend professional workshops on a continual basis and to participate in career development seminars and other practical clinical training opportunities.