Counseling & recovery supports

Substance use disorder counseling usually focuses on how to reduce and stop your substance use and address related harms. Most (but not all) substance use disorder counseling:

• Requires complete abstinence from alcohol and all drugs as the goal,
• Is delivered on an outpatient basis,
• Involves groups counseling.

This type of counseling also is available in residential treatment, but this may be harder to get into and/or be more expensive if not covered by insurance.

Substance use disorder counseling can be delivered by a substance use disorder professional or other specialized providers.

Things to consider when you think about counseling:

• What are your goals? Abstinence-only or moderation/reduction?
• Do you want residential (you live there, usually for 28+ days) or outpatient?
• How comfortable are you around other people? Do you want group counseling or individual or some combo of the two?

Many people with substance use disorders also want help for their mental health, for issues such as depression, anxiety, and trauma. Mental health counseling can help people improve their mood and resilience, and learn coping skills, and typically is done one-on-one.

Counseling for mental health can be provided by a licensed clinical social worker, mental health counselor, psychologist, or psychiatrist.

Things to consider:

• Mental health counseling can look very different across providers, some can be more structured than others.
• There are many helpful therapies that are based on research, such as cognitive behavioral therapy, but not all providers deliver these.
• Post-traumatic stress disorder can include experiences like nightmares, avoiding things that remind someone of past events, and always feeling on-guard. There are effective therapies for PTSD – people don’t have to live with these experiences.
• Think about what you want help with, and what approaches might work best for you.

Many people with a substance use disorder find it helpful to talk to someone in recovery. Peer counselors and recovery coaches have lived experience with substance use disorder (SUD) and can support you in your recovery. Their level of training and the type of supervision they receive varies widely.

Certified peer counselors

In WA State Certified Peer Counselors, or CPCs, have lived experience with SUD, and can work with you and/or your loved ones on your recovery path.

Certified Peer Counselors draw on their own experiences in recovery to:

• Support you in your recovery,
• Help you to determine your own goals,
• Learn how to access services and navigate systems,
• Plan for challenges and lapses,
• Develop healthy community networks,
• Navigate crises,
• Encourage hope.

They are trained and state certified to offer peer support services. CPCs are not licensed mental health or SUD professionals.

In Washington State, people in recovery from mental health and/or SUD can become CPCs through the WA Health Care Authority’s Division of Behavioral Health and Recovery.

Requirements to become a CPC:

• Complete an online course,
• Submit an application to WA HCA,
• Complete 36-40 hours of in person training,
• Pass oral and written exams and become credentialed with the WA Department of Health.

Learn more about Certified Peer Counselors in this factsheet from HCA.

Recovery coaches

Recovery coaches are trained to support people struggling with substance use disorder. Many recovery coaches have their own experience with substance use disorder.

Recovery coaches can help you:

• Identify barriers to your recovery,
• Make plans to overcome those barriers,
• Figure out what you want your treatment plan to look like and support you to follow it,
• Get and stay connected with others in recover,
• Inspire you to be hopeful no matter what is going on for you.

They will work with you at any and all stages of your recovery process.

Requirements to become a recovery coach:

• Recovery coaches may complete a multi-day training.

Learn more about recovery coaches here:

• Recovery Coaching (WA Recovery Alliance).
• Recovery Coach Academy (Center for Addiction Recovery Training).

A care navigator, or patient navigator, can help you access treatment and healthcare.

Peer counselors and recovery coaches can be care navigators. Nurses, social workers, or volunteers can be too.

In Washington, care navigators are funded to work in many different settings. You can find care navigators at a healthcare provider, syringe exchange, or when leaving jail or prison (Binswanger et al., 2015, and Banta-Green et al., 2019).

In the 2019 Washington State Syringe Exchange Survey conducted by the UW Addictions, Drug & Alcohol Institute (ADAI, formerly the Alcohol & Drug Abuse Institute), many exchange clients were interested in someone to help them navigate services.

A care navigator can help you:

• Learn about the medications for opioid use disorder,
• Sign up for insurance,
• Connect with other providers,
• Remove barriers to care.