Counselor / Clinician

There are many career paths for professional advancement by addictions counselors, and each workplace may have specific opportunities.

A national scope of practice and career ladder for Substance Use Disorder Counselors has been developed by NAADAC (The Association for Addiction Professionals) and is also a good reference for planning your next step.

A Counselor works directly with people in addiction treatment or recovery. Counselors may also work with families and friends of the client. The counselor must be able to:

  • Assess clients for clinical needs
  • Create individualized treatment plans
  • Provide service coordination and case management services
  • Make appropriate referrals
  • Use evidence-based or best practices
  • Document client interactions and activities
  • Stay up to date with, and carry out their legal, professional and ethical responsibilities
  • Maintain culturally responsive practice skills
  • Complete necessary administrative tasks

For more information on skills and knowledge needed by addiction counselors, see TAP 21 - Addiction Counseling Competencies from the Substance Abuse and Mental Health Services Administration.

The word "Counselor" is used in everyday speech to mean everything from a clinician with a PhD in psychology to an overnight counselor whose position does not require a degree. Different levels of positions for counselors have different responsibilities and requirements (see Licensure, below).

As he or she advances, a counselor may need to learn skills of supervision and/or administration.

A counselor may have a degree in social work, psychology, marriage and family therapy or any number of other disciplines related to health and behavior, each of which has particular academic and professional milestones (BA, MA/MSW, PhD/DSW; internship, counselor, supervisor, administrator, program director, CEO). Not every "Counselor" position requires a degree: the highest level of licensure requires a master's degree or a Ph.D; other levels require proof of a high school diploma or equivalent. See Licensure, below.

See Education Overview for an introduction and Counselor/Clinician Education Opportunities for a list of options in MA.

In Massachusetts, Licensure (LADC) and Certification (CADC) as an Alcohol and Drug Counselor are two distinct processes. This Comparison provides information about both.


The Code of Massachusetts Regulations CMR 105 168.000 provides the legal framework for licensure.

Massachusetts Licenses 3 Levels of addictions counselors: LADC I, II and III/Assistants (click here for full details of licensure):

  • LADC I may provide services as an independent clinician and may supervise LADC II and III
  • LADC II's and Assistants may provide services under supervision of an LADC I; or may work in a licensed substance abuse treatment facility under supervision as permitted by the regulations governing the facility.
  • LADC Assistants/III's may provide recovery support services with direct clinical and administrative supervision

Third party payers (health insurance) now reimburse for services delivered by some levels of Licensed Alcohol and Drug Counselors or Certified Alcohol and Drug Counselors.  Check with individual payers about their credentialing process to be eligible for reimbursement, specific services and reimbursement rates. Payers also sometimes reimburse for services by workers licensed in fields such as: social work, psychology, mental health counseling, marriage and family counseling. For information, see this link for the Board of Registration in Mental Health and Allied Health and Human Services Professionals (Mental Health Counselor, Marriage and Family Therapist, Rehabilitation Counselor, Educational Psychologist); this link for Psychologists; and this one for Social Workers.

Advocates are working to obtain wide reimbursement directly for MA Licensed Substance Abuse Counselors.

See Education and Licensure/Certification for an explanation of the roles each of these play in a career in addiction treatment and prevention.


National Certifications are available from:

Massachusetts counts some of these toward licensure requirements – see the full details and information on reciprocity at the MA DPH Bureau of Substance Addiction Services Licensure webpage.

In addition, there are specialty certifications.

Study Guides

  • IC&RC Study Guides
  • NAADAC provides information about testing for each of its certifications. Study Guides in various media are available for purchase.

Counselors are in high demand, and opportunities are projected to continue to grow. In certain jobs counselors may be eligible for tuition loan repayment by the federal government.

Counselors may grow to:

  • Supervise other counselors or case managers
  • Become an administrator (such as a Program Director or Executive Director)
  • Some Counselors become Case Managers.