Substance abuse, behavioral disorder, and mental health counselors advise people on a range of issues, such as those relating to alcoholism, addictions, or depression.
Substance abuse, behavioral disorder, and mental health counselors advise people on a range of issues, such as those relating to alcoholism, addictions, or depression. They provide support, including for prevention, to help clients recover from addiction, modify problem behaviors, or improve mental health.
Substance abuse, behavioral disorder, and mental health counselors typically do the following:
Substance abuse counselors and behavioral disorder counselors, also called addiction counselors, work with clients individually and in group sessions. They teach clients how to cope with stress and life’s problems in ways that help them recover. Furthermore, they help clients rebuild professional relationships and, if necessary, reestablish their career. They also help clients improve their personal relationships and find ways to discuss their addiction or other problems with family and friends.
Some addiction counselors work in facilities that employ many types of healthcare and mental health professionals. Addiction counselors may work with psychologists, psychiatrists, social workers, physicians, and registered nurses to develop treatment plans and coordinate care for patients.
Some counselors work with clients who have been ordered by a judge or referred by other people, such as a parole officer, to receive treatment for addiction. Others work with specific populations, such as teenagers, veterans, or people with disabilities. Counselors may have to intervene in crises by stepping in when someone is endangering his or her own life or the lives of others. They also intervene in noncrisis situations by encouraging a person with addictions or other issues, such as difficulty processing emotions, to get help. Noncrisis interventions often are requested by friends and family.
Mental health counselors advise individuals, families, couples, and groups. Some work with specific populations, such as children or older adults. Mental health counselors treat clients who have a variety of conditions, including anxiety, depression, grief, and stress. They also help with emotional health and relationship problems.
Substance abuse, behavioral disorder, and mental health counselors held about 449,800 jobs in 2023. The largest employers of substance abuse, behavioral disorder, and mental health counselors were as follows:
| Outpatient mental health and substance abuse centers | 17% |
| Individual and family services | 16 |
| Offices of other health practitioners | 14 |
| Residential mental health and substance abuse facilities | 9 |
| Hospitals; state, local, and private | 9 |
Substance abuse, behavioral disorder, and mental health counselors work in a variety of settings, including inpatient and outpatient treatment centers, correctional facilities, and hospitals. Some addiction counselors work in residential treatment centers, where clients live in the facility during their recovery.
Although rewarding, the work of substance abuse, behavioral disorder, and mental health counselors is often stressful. Many counselors have large workloads and do not always have enough resources to meet the demand for their services. In addition, counselors may have to intervene in crisis situations or work with agitated clients.
Most substance abuse, behavioral disorder, and mental health counselors work full time, although part-time work is common. In some settings, such as inpatient or residential facilities, they may need to work evenings, nights, or weekends.
Education and training requirements vary for entering these occupations. Substance abuse and behavioral disorder counselors typically need at least a bachelor’s degree, although some positions require a high school diploma and others require a master’s degree. Mental health counselors typically need a master’s degree and an internship. In addition, some counselors must be licensed.
Substance abuse, behavioral disorder, and mental health counselors typically need at least a bachelor’s degree, although the education required or preferred may vary by position, state, or employer. For example, substance abuse and behavioral disorder counselors typically need a bachelor’s degree to enter the occupation, but requirements may vary from a high school diploma to a master’s degree.
Mental health counselors typically need a master's degree. Common fields of undergraduate study include psychology, public policy and social services, and social science. Master’s degree programs often include an internship that is clinically supervised.
Substance abuse and behavioral disorder counselors in private practice must be licensed. Licensing requirements vary by state, but all states require these counselors to have a master’s degree and complete a specified number of hours of supervised clinical experience. In addition, counselors must pass an examination and complete continuing education every year. Contact information for your state's regulating board is available through the National Board for Certified Counselors.
Licensure requirements for substance abuse and behavioral disorder counselors outside of private practice vary by state. For example, not all states require applicants to have a specific degree, but some require them to pass an exam. Contact information for individual states’ licensing boards is available through the Addiction Technology Transfer Center Network.
All states require mental health counselors to be licensed. Licensure requires successfully completing a national examination and supervised clinical work under the supervision of a licensed counselor.
Some jobs require counselors to have certification in basic life support (BLS) or cardiopulmonary resuscitation (CPR).
Substance abuse and behavioral disorder counselors who earn a master’s degree and complete a specified number of hours of supervised clinical experience are eligible to get a state license. This allows them to go into private practice or start their own business.
Counselors who have personal experience overcoming alcohol or drug addictions are sometimes viewed as especially helpful and insightful to those seeking treatment.
Communication skills. Substance abuse, behavioral disorder, and mental health counselors need to effectively convey ideas and information to clients. They must also write concise but detailed reports documenting clients' progress.
Compassion. Substance abuse, behavioral disorder, and mental health counselors often work with people who are dealing with stressful and difficult situations, so they must empathize with their clients.
Interpersonal skills. Substance abuse, behavioral disorder, and mental health counselors must be able to develop and nurture good relationships with different types of people.
Listening skills. Substance abuse, behavioral disorder, and mental health counselors must give clients their full attention to be able to understand each client’s problems and values.
Patience. Substance abuse, behavioral disorder, and mental health counselors must be able to remain calm when working with all types of clients, including those who may be distressed or angry.
Median annual wages, May 2023
The median annual wage for substance abuse, behavioral disorder, and mental health counselors was $53,710 in May 2023. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $36,700, and the highest 10 percent earned more than $89,920.
In May 2023, the median annual wages for substance abuse, behavioral disorder, and mental health counselors in the top industries in which they worked were as follows:
| Hospitals; state, local, and private | $59,090 |
| Offices of other health practitioners | 55,410 |
| Outpatient mental health and substance abuse centers | 51,130 |
| Individual and family services | 51,010 |
| Residential mental health and substance abuse facilities | 46,880 |
Most substance abuse, behavioral disorder, and mental health counselors work full time, although part-time work is common. In some settings, such as inpatient or residential facilities, they may need to work evenings, nights, or weekends.
Percent change in employment, projected 2023-33
Employment of substance abuse, behavioral disorder, and mental health counselors is projected to grow 19 percent from 2023 to 2033, much faster than the average for all occupations.
About 48,900 openings for substance abuse, behavioral disorder, and mental health counselors are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment growth is expected for substance abuse, behavioral disorder, and mental health counselors as people continue to seek treatment for addiction and mental health issues.
Increased demand for these workers is expected because of a growth in the number of people, including youths, who have mental health and behavioral disorders. Additionally, there will be a continued need for services to assist the large number of people with addictions, especially those who have opioid use disorder.
Demand for these workers will be further strengthened as more jurisdictions require offenders who have a substance abuse disorder to seek counseling as part of their sentences.
| Occupational Title | SOC Code | Employment, 2023 | Projected Employment, 2033 | Change, 2023-33 | Employment by Industry | ||
|---|---|---|---|---|---|---|---|
| Percent | Numeric | ||||||
SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program | |||||||
Substance abuse, behavioral disorder, and mental health counselors | 21-1018 | 449,800 | 534,300 | 19 | 84,500 | Get data | |
This table shows a list of occupations with job duties that are similar to those of substance abuse, behavioral disorder, and mental health counselors.
| Occupation | Job Duties | ENTRY-LEVEL EDUCATION  | 2023 MEDIAN PAY | |
|---|---|---|---|---|
 | Health Education Specialists | Health education specialists develop programs to teach people about conditions affecting well-being. | Bachelor's degree | $62,860 |
 | Marriage and Family Therapists | Marriage and family therapists diagnose and treat cognitive, behavioral, or similar disorders in the context of couples and other relationships. | Master's degree | $58,510 |
 | Physicians and Surgeons | Physicians and surgeons diagnose and treat injuries or illnesses and address health maintenance. | Doctoral or professional degree | This wage is equal to or greater than $239,200 per year. |
 | Probation Officers and Correctional Treatment Specialists | Probation officers and correctional treatment specialists assist in rehabilitating law offenders in custody or on probation or parole. | Bachelor's degree | $61,800 |
 | Psychologists | Psychologists study cognitive, emotional, and social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. | See How to Become One | $92,740 |
 | Registered Nurses | Registered nurses (RNs) provide and coordinate patient care and educate patients and the public about various health conditions. | Bachelor's degree | $86,070 |
 | Rehabilitation Counselors | Rehabilitation counselors help people with physical, mental, developmental, or emotional disabilities live independently. | Master's degree | $44,040 |
 | School and Career Counselors and Advisors | School counselors help students develop academic and social skills. Career counselors and advisors help people choose a path to employment. | Master's degree | $61,710 |
 | Social and Community Service Managers | Social and community service managers coordinate and supervise programs and organizations that support public well-being. | Bachelor's degree | $77,030 |
 | Social and Human Service Assistants | Social and human service assistants provide client services in a variety of fields, such as psychology, rehabilitation, and social work. | High school diploma or equivalent | $41,410 |
 | Social Workers | Social workers help people prevent and cope with problems in their everyday lives. | See How to Become One | $58,380 |
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