My passion has been (and probably always will be) with substance use and addictions counseling. This is why I got my counseling degree. It was my speciality the first several years of my practice.
But ever since I went into private practice, I felt a sharp separation from addictions work. In part, this is because I believe that substance use and addictions treatment typically requires more than what can be accomplished in a private practice setting (e.g. groups, case staffings, medical support). But admittedly, part of it is because I felt lost and anxious about how I could effectively and ethically work with addictions in this setting.
I’ve been torn for years about wanting to stay connected to my passion while also being too anxious to make any meaningful connection with it in a private practice setting, beyond the occassional client who comes in with a mild substance use disorder. Then I had an idea: addiction-informed care.
In addictions treatment, we talk a lot about trauma-informed care: this notion of being educated on the impact of trauma on addiction, treatment, and recovery. It doesn’t imply doing direct trauma treatment, but it does imply that clinicians are informed enough about trauma to understand the nauances of how it interacts with every other area of a client’s life.
Addiction-informed care is the same concept, but kind of like a role reversal. While I typically will refer to a specialized program for addiction and substance use disorders, something unique I can offer is an addiction-informed approach. I understand the nuances of how addiction, like trauma, impacts every other area of a client’s life. And not just the client, but their loved ones, too.
I think it’s important to acknowledge that, despite the advocacy efforts of many professionals for many years, addiction and substance use both continue to be viewed as seperate from other mental health issues. This is evident even in addiction treatment, where the term “mental health” is used to describe any clinical concern that isn’t addiction or substance use. Even though substance use disorder is a clear category in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM), professionals still use language that suggests we don’t see it as a type of mental health issue. Counselors are often afraid to touch it (in many ironic ways, I’ve been one of them). The newest iteration of the CACREP standards, the accrediting body for counselor education program, has even reduced its already minimal references to substance use and addiction (and completely eliminated all references to behavioral addictions).
Addiction and substance use are mental health, just like depression, anxiety, and trauma. This belief is at the core of addiction-informed care.
This idea is still in its infancy, but I hope to refine it into a guiding principle for my practice. I want to say with confidence that my clinicians and I are informed enough about addiction to offer something special. While we don’t offer specialized addiction treatment, we absolutely offer something that can compliment that.
This isn’t meant to be a new style of therapy, a new modality, a structured 12-week program, etc. It’s a philosophy. I want it to speak to our unique identity as a practice. I want us to always be prepared to step back and ask: how is addiction, whether its theirs or their loved ones, affecting the picture here? How should I adjust my counseling accordingly?
I posted a page about addiction-informed care for the general public. I hope my words adequately express my ideas; this is something that’s hard to translate from a brain child to actual written text.
I was so thrilled to hear my supervisee’s excitement about this endeavor, too. We’ve started engaging in regular, targeted training and supervision efforts (on top of what they already do) to up our game and stay true to the notion of addiction-informed care. I’m so proud of their willingness to take on this extra work simply because they share a similar passion.
My hope is that this simple idea sparks a larger conversation. If this ressonates with anyone, please reach out to me at frankie@mindful-counseling.org. I would love to start some real dialogues about this concept and how we can expand on it to provide something meaningful to our community.
Supporting Articles
Addiction is a mental disorder within the mental health spectrum, and it matters
Counselors’ stigma toward addictions: Increasing awareness and decreasing stigma
Dual disorders: addiction and other mental disorders. Integrating mental health
Language, substance use disorders, and policy: the need to reach consensus on an “addiction-ary”