Substance abuse counseling: what to know

What the job involves, what changes the price, and what to ask a pro.

What substance abuse counseling is

Substance abuse counseling is a set of confidential sessions with a counselor about alcohol or drug use, where you explore goals, challenges and support options. It can be one on one or in a group, and sometimes works alongside a doctor. If you or someone you know is in crisis or in danger, contact local emergency services instead of waiting for an appointment.

Signs you need it

  • Using more than you planned or finding it hard to cut back
  • Use is causing problems at work, home or with health
  • Friends or family have raised concerns
  • You want help setting goals about use and building support
  • A doctor, employer or court has suggested counseling

What the pro does

  • An intake on your use, health, history and goals
  • Talking through triggers, habits and what help you already have
  • Setting goals together and planning around risky situations
  • Connecting you to other support such as groups or your doctor
  • Reviewing progress and adjusting the plan

What changes the price

Every job is different, so we do not publish prices. These are the things that move the quote up or down.

  • The counselor's license or credential
  • Individual or group sessions
  • Session length and frequency
  • In person or video
  • Insurance or private pay
  • Cancellation terms

What a written quote should spell out

  • Session length, schedule and formats
  • Whether group sessions are included
  • Cancellation terms
  • Billing and insurance details
  • Privacy rules, including when information may be shared by law or with your consent

Questions to ask before you hire

  • What is your license or credential, and who can I verify it with?
  • How do you work with someone who wants to cut back but not stop?
  • When should I see a doctor about stopping?
  • How is my information kept private?
  • How do you work with family?
  • What if I relapse?

Red flags

  • Promises that you will stay sober
  • Shaming or lectures
  • Telling you to stop a substance suddenly without a doctor if it may be unsafe
  • Cannot name a license or credential
  • Sharing your information without clear consent

What you can do yourself

Telling a trusted person, removing triggers from home and tracking use can help, but stopping some substances suddenly can be unsafe. Talk with your doctor before changing use, especially if you take medication or have health conditions. If someone is in danger, call emergency services.

Licenses and permits

Therapy and counseling are licensed health professions. Ask for the license type and number, then check it with your state licensing board before the first session.

Substance abuse counseling questions

Is counseling confidential?

Generally yes, with limits the counselor must explain. Ask for the policy in writing.

Do I have to quit completely?

Goals are set with you. Ask how the counselor approaches this.

Can family join?

Often yes, with your consent. Ask the counselor whether family sessions are offered and how privacy is handled for them.

What if I have already tried and relapsed?

Counselors expect setbacks. A good one will adjust the plan with you.

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