Few people sign up for a substance abuse counseling degree imagining they’ll be spending their days in front of a laptop screen.
Addiction counseling requires building strong interpersonal connections at the deepest levels. You have to be able to communicate clearly and compassionately with your clients to disrupt the negative cycles of addiction. It’s almost always something that everyone pictures happening in person, heart-to-heart—eye contact, expressions of concern, and an open back-and-forth conversation.
It’s not the sort of thing you imagine would go very well if it was mediated by a computer.
Just like other kinds of behavioral and mental health counseling, though, substance abuse counseling was thrown suddenly and almost entirely online during the COVID-19 pandemic.
To almost everyone’s surprise, online substance abuse counseling was a big hit.
In fact, for some populations, in some cases, remote intensive counseling services proved to work even better than traditional outpatient counseling services.
Today, that hard won experience has created a whole new category of position in substance abuse counseling: the remote addiction therapist.
Remote Substance Abuse Counseling is Here to Stay
With proof that it works well, it was clear after the pandemic that there was no going back for some patients. Those outside of major metros or in places with few counseling options had always been underserved; remote addiction counseling was a lifeline. For others, the convenience of getting their counseling over the internet simply made getting treatment more practical.
At the same time, like other kinds of work that has been shifting online, remote substance abuse counseling turned out to be better for both counselors and employers. The cost savings associated with reducing office space is a win for behavioral health services and nonprofits offering drug and alcohol treatment. The flexibility and reduction in commuting time is a clear victory for individual counselors.
And for patients, the broader menu of different individual counselors they can choose from when their services move online increases the odds of finding a great fit for their own personality and problems.
Online Substance Abuse Counseling Isn’t Without Its Limitations
Remote substance abuse counselor jobs come with the same scope of practice as any other kind of certified addiction counselor job. You might be surprised how flexible and effective video conferencing and app connectivity have become.
But there are still certain categories of addiction counseling that probably aren’t going to go online anytime soon. Anything dealing with patient populations who aren’t internet savvy and don’t have good connectivity isn’t going to work. Similarly, outreach programs, where you are part of the effort to make initial contacts instead of simply having patients come to you, isn’t something that can happen remotely.
There are also cases like criminal justice addiction counseling where other restrictions limit remote therapy… although when institutions and agencies get on board, the kind of accessibility and equipment they can put together in an effort to assure accessibility and bring costs down could make this a possibility in the not-too-distant future. Work-arounds that sprung up in the wake of COVID-19 proved that.
Of course, there are also simply cases and patients where remote counseling just can’t provide the necessary connection, whether that’s due to a dark episode in the throes of addiction or a co-occuring mental health condition. Not everyone does well without direct eye contact and a sympathetic voice in the same room. You have to make allowances for personal style and needs with remote therapy.
Remote Counseling Doesn’t Mean Less Professional Responsibility
Remote addiction counseling is a breakthrough, but it’s one that has to comply with all the existing rules and regulations for approved therapy practices. So it continues to include requirements for documentation and maintaining professional standards.
Online tools for substance abuse therapists need to be HIPAA-compliant.
That means that remote substance abuse counselors, apart from independent clinical SUD counselors, have to perform under appropriate supervision from a senior counselor.
This does’t work too differently from remote online therapy itself, however. It’s entirely possible to get all the feedback and mentoring needed through video and chat connections. And with the rise of fully electronic record-keeping systems, supervisors don’t have to visit your office and paw through a raggedy manila file folder anymore to check out your case notes.
Looking for Remote Substance Abuse Counselor and Remote Peer Support Specialist Jobs
With more and more popping up in the market, jobs for remote substance abuse counselors and remote peer support specialists aren’t tough to find. They show up right in the same search listings as other addiction counseling jobs.
The one catch to remote substance abuse counseling, though, is that it still has to be conducted only with patients in states where you are licensed to practice. So although jobs can be found all over the country, the easiest place to look will be for listings in your own state.
The same agencies, non-profits, and private behavioral health services that hire most SUD counselors are hiring remote counselors now. You may not even see any difference in the job titles… many are all but identical to regular addiction therapist job listings. The remote nature is in the description!
You will also find dedicated roles such as:
- Remote Outpatient Group Counselor
- Warmline Peer Support Specialist
- Remote Addictions Counselor
- Telehealth SUD Therapist
- Telehealth Addiction Counselor
Online substance abuse counseling often lends itself to specialization. For example, there are some roles that are dedicated entirely to intake. If you love evaluating and making an initial connection and assessment for new clients all the time, that will be right up your alley. And because specialization is often efficient, many remote therapy organizations are going in that direction.
It’s also the case that these positions are used to try and maximize rare skillsets some counselors posses… for example, many bilingual therapists can find remote work easily. The nature of the population might not support such a role in a single clinic, but with remote clients it’s easy to fill a roster.
Remote Peer Support Specialists in High Demand
Peer support specialists have a special niche to fill in substance abuse counseling. As recovered substance use disorder patients themselves, they have a unique ability to connect and communicate with people still on the road to recovery.
You might expect that peer specialists need that in-person connection even more than other counselors. But it turns out that’s not the case. There are plenty of ways they put their special talents to use that don’t involve being shoulder to shoulder with clients.
For starters, many peer support specialists have long been a lifeline on the other end of a phone call. When a patient is in crisis, it’s always been easier to call someone who has been there and gotten through it. So in some sense, peer support specialists already offered some level of remote services.
Now that role has been expanded. Working from anywhere, peer support counselors can handle phone, email, or chat help in near real-time. They can also handle other traditional roles in intake and assessment, client advocacy, and counseling coordination fully remotely. And they get all the same advantages as other counselors in terms of flexibility, availability, and focus.
Remote Addiction Therapy in Practice May Bring New and Innovative Tools To Substance Abuse Counseling
Some of the most interesting new roles popping up in remote substance abuse therapy, though, are those that are blending traditional treatment techniques with new technological approaches. Not only do these make use of remote communication technologies—they may also be integrated with websites and apps that serve as part of the treatment program.
These apps allow counseling to happen even when the counselor isn’t available. Incorporating best practices from common therapies like contingency management and cognitive behavioral therapy (CBT), apps use behavioral cues to intervene when patients need it the most.
These apps combine education, reflective therapy, and even gamified skill-building exercise to promote healthier behaviors. Even the VA has gotten on board with VetChange, an app that helps military veterans cope with drinking, smoking, and PTSD impacts.
Remote counseling is also making treatment more effective—and more convenient—for patients on medicated treatment programs, such as those using methadone to block other opioids. Part of the drill for those patients has long been a commute to a clinic, where they must be directly observed by a technician or therapist taking their dose.
Now, some treatment centers are allowing patients to take home their prescriptions and take them at their own convenience… so long as they take a video of themselves taking the dose, and forwarding it to their counselor for confirmation.
What Does the Future Hold for Remote Substance Abuse Counseling Jobs?
Considering that this is what the state of the art of today already offers in remote SUD counseling, what does the profession look like on the other side of new breakthroughs in areas like artificial intelligence and wearable devices?
Like most things to do with AI, it’s mostly speculation and imagination at this point. But the combination of connectivity and in-depth statistical analysis points to a revolution in the kind of information a remote addiction counselor might have to work with.
Artificial intelligence may take the path that remote app-based interventions have forged and take it to the next level.
AI can comb through everything from location data to medical records to personal shopping transactions to identify underlying patterns that even the best therapist might never detect. Combining all that information across millions of cases can provide predictive trends that can by applied to a single patient. AI might offer a running perspective on that patient’s recovery efforts, letting the therapist know remotely if they are experiencing a risky episode or if they are on the cusp of crisis.
Real-Time Monitoring Can Bring Massive Safety Benefits in Remote Substance Abuse Counseling
Putting those abilities together with the deep biometric data that comes with wearable devices, such as smart watches and internet-connected glucose monitors, and you get a better physiological picture of recovery, too. It’s hard to hide a high from a watch that is always keeping an eye on your pulse rate.
This has big safety implications for remote substance abuse counseling, too. Many of the newest devices can already automatically call 911 if they detect the wearer has fallen or has been in a crash of some sort. A new generation may do something similar for overdoses, sending Narcan-equipped responders immediately, even if the OD happens somewhere out of sight.
Substance abuse counselors who get started in the field today will be in the perfect position to take advantage of these technologies as they mature. They’ll also have a very 21st century position in terms of the flexibility and independence that comes with the job. It’s an exciting space in addiction counseling, and one to watch for future opportunities.