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Internship: Shadowing a Substance Abuse Counselor Essay


Overwhelming challenges of the 21st century force many people to use drugs, as they are unable to keep up with the pace of the contemporary life. Many people become addicts and they are unable to handle the issues associated with their addiction.

Therefore, counseling is coming to the fore, as counselors are able to assist drug addicts to quit their harmful habit and effectively integrate into the community. This paper dwells upon the internship at Legacy Services (New York). The intern shadowed a substance abuse counselor to gain the necessary experience for practice.

It is necessary to note that participation in sessions and multi-disciplinary staff meetings; observation and contribution to development of certain treatments strategies equipped the intern with the necessary skills and knowledge that will help him be an efficient drug abuse counselor.

Moreover, strong and weak sides of the Legacy Services are analyzed and conclusions are made. In the end of the work discussion of the main presented ideas is introduced. Recommendations and possible implications of the main ideas of the work are suggested.


Statement of the Problem

The issue of substance abuse counseling includes why people use drugs and to understand the effects on their health. It also considers the effects of drugs on one’s health as well as the resulting mental health issues because of substance abuse.

Substance abuse has been around for years,and individuals are not aware of how to identify and learn to cope with the challenges of addiction.

Additionally, behavioral assessments, intervention, multidisciplinary management, preparation, education, and program development and execution made huge changes in participants’ substance abuse behaviors (Babinski,Pelham, &Waxmonsky, 2013).

According to Babinski et al. (2013),counseling for people who depend on chemicals requires some skills for it to be effective. Also, most participants prefer counseling that is done by specialists(Babinski et al., 2013).

However, severalprograms of substance abuse were examined; all engaged moralistic group settings on various clinical issues, which showed the programscould affect participants’ treatment(Greenfield &Venner, 2012).

The programs should be equipped with the knowledge and skills necessary to guide the participants to their future endeavors or self-sufficiency(Dufour et al., 2014). Also, counselors’failure to keep up with modern information to encourage the participant’schange of behavior could lead to relapse.

Relapsing into drugs or alcohol abuse can occur even after long periods of sobriety (Greenfield &Venner, 2012).Therefore, the reason why it is critical for the counselors in this field to utilize the emerging knowledge to help participants who are drug addicts.

Purpose of the Internship

The internship period is to gain in-depth knowledge of mental health by acquiring new emerging information from the mentor,concerning people who have health impairments (Greenfield &Venner, 2012).

It will enable the intern to learn and take an active role in shaping individuals’ lives and assisting people and their families with mental problems. Emerging information is important in helping participants who have advanced mental problems to improve healthcare outcomes.

He will learn basic counseling skills from the mentor as well as knowledge about ethical issues to be considered during the helping process (Wallace, Brown, & Hilton, 2014).The learner wouldlearncurrent data to monitor the progress of a participant of the program using emerging methods of data collection.

In addition, he would learn to understand the needs of participants and the possible causes of mental disabilities (Greenfield &Venner, 2012).

Review of Literature

Risk for Substance Abuse

Over the past two decades, researchers have tried to reveal the factors behind the beginning of substance abuse and the progression to addiction (Corte &Szalacha, 2010). Main risk factors lead to the increase of a person’s chance to become abused. However, there are several protective factors that reduce personal risk.

Main risk factors for substance abuse are different for every person and affect people at different stages of lives. The substance abuse counselors focus on the risk factors before initiating the counseling approaches (Corte &Szalacha, 2010). In the case of children, risk factors include aggressive behavior, social difficulties, or academic failure.

The risks, such as aggressive behavior,can be controlled by helping children develop appropriate positive attitudes in life and prevent further risk. Other factors, such as poverty, peer influence, drug availability, and lack of parental supervision, mainly affect the youth.

The more a person is predisposed to the risks, the higher are the chances of substance abuse. Ineffective parenting and a guardian who is involved in substance abuse increase the risk of children and adolescents to substance abuse. According to Gallagher (2014), the highest risk of substance abuse are adolescents.

For this reason, the counselors focus on preventive interventions and support skills of enhancing protective factors of substance abuse (Gallagher, 2014).

Clinical level of evidence-based

There are several clinical evidence-based approaches applied to deal with substance abuse (Smith & Liu, 2014). Several statewide initiatives of substance abuse treatment systems have been growing in the past decade as a result of movements towards evidence-based practice in health care systems.

The importance of using the scientific clinical advances in intervention of clinical practices has been emphasized by many scholars. Several psychological evidence-based programs have been utilized in the approaches to substance abuse.

Clinical expertise is important in the translation of scientific evidence-based approaches into practice that include the behavioral approaches and Pharmacotherapies. The health care providers are supposed to develop statements that assist them in identifying the appropriate intervention for the clinical circumstances (Corte &Szalacha, 2010).

The pharmacotherapy approaches include nicotine replacement therapies: application of drugs, such as bupropion, methadone, and naltrexone: and combination of drugs with behavioral treatment. Behavioral approaches focus on abstinence and modification of peoples’ behaviors as well as their attitudes about substance abuse.

Additionally, they include cognitive behavior therapy, contingency management interventions, motivational enhancement, and community reinforcements (Gordon, 2013).

The Effects on the Body

Substance abuse has adverse effects on the body, such as mental health problems (Corte &Szalacha, 2010).For instance, continuous abuse of cannabis results in mental health problems, such as schizophrenia. Substance abuse predisposes a person to diseases, such as asthma, heart diseases, and lung cancer.

Cocaine is known to be over-stimulating, causing pregnancy complications, such as stillbirths and miscarriages. Also, substance abuse can expose a person to diseases, such as HIV, because of sharing of injecting devices.

According to Gallagher (2014), the substances weaken the immune system, cause memory problems, and excessive dehydration (Gallagher, 2014).

The Burden of Substance Abuse between Nations

Substance abuse poses a significant threat to the health, economic and social status of the affected families, communities, and the countries (Smith & Liu, 2014). In year 2000, substance abuse contributed to 12.4% of all deaths worldwide (Gallagher, 2014).

The calculation of adjusted life years in Mexico and the United States indicated that the life lost because of premature mortality related to substance abuse is on the rise. The burden of the disease in disability-adjusted life years is high in the United Kingdom and the United States as compared to African and Mediterranean countries.

Substance abuse has both economic and health effects on the nations affected. For instance, evidence-based prevention and treatment costs can save the U.S. government up to $10 in subsequent costs of every $1 spent (Gordon, 2013).

The ones involved in the abuse cannot unleash their full potential in economic growth as the productivity is reduced. Productivity losses estimated at $ 120 billion, calculated as labor and non-participation, are significant in the United States.

Similarly, studies have identified a 0.4 % loss in GDP in Canada as a result of non-labor participation because of substance abuse (Gordon, 2013). The situation is similar in Australia that experienced 0.3 % GDP loss (Gallagher, 2014).

The Determinants of Health and Health Inequity

The health of a person includes an individual’s well being physically, mentally, and emotionally (Regina & Valeria, 2014). Several factors determine the health of a person.

These include the genetics and physiology of a person, such as the sex and age. Individual behavior, such as substance abuse, plays a significant role in determining a person’s health.

The social and physical environment as well as the interaction determines the health status of an individual as he or she is expose to several diseases causing factors, such as stress, discrimination, and overcrowding. Health inequity is mainly determined by infrastructure, health services, and policy formulations (Gordon, 2013).

Discrimination in the access of health services affects the approaches to substance abuse because of health inequity. Access to quality health care minimizes the causes of health inequity in societies.

The health policies formulated should take into consideration the disparities and variations in achievement of quality health care (Regina & Valeria, 2014).

Social and economic factors

Social and economic factors have a significant influence on the substance abuse (Corte &Szalacha, 2010). For instance, poverty and socioeconomic status of a family can make a person turn to substance abuse to find solace.

It is a result of lack of basic human needs such, as food, shelter, education, and proper health care. The social structures and factors in the community play a significant role in substance abuse as they determine the peer influence. The familial and demographic factors are important predictors of substance abuse (Gordon, 2013).

Besides, research studies have established a relationship between the parent socioeconomic status and substance abuse. Parents have a tremendous influence on their children to desist or initiate substance abuse. Peer influence plays a great part as socialization can initiate substance abuse (Gordon, 2013).

Physical and environmental factors

Many people do not understand how others initiate substance abuse and addiction (Gordon, 2013). However, physical and environmental factors explain the situation. The environment in which a person lives has different influences on substance abuse.

These include the access to drugs such as those living in urban areas and the general quality of life. The socioeconomic status of friends and families can either increase or limit access to these substances. Peer influence, bad parenting, physical or sexual violence and high level of stress influence the escalation of substance abuse.

Similarly, the availability of drugs is the primary physical factor related to substance abuse. The development of the effective prevention strategies for the substance abuse counselors is based on the knowledge of the risk and protective factors (Corte &Szalacha, 2010).

Individual behaviors/characteristics

Individual behaviors and characteristics of substance abuse determine the type of approach chosen by the counselor (Gallagher, 2014). The characteristics indicate the level of addiction and dependence.

People who have already become addicted to different substances exhibit the characteristics of an overwhelming and repetitive urge to them. The substance abuse has become a part of their lives and a life’s priority. They experience problems in their wok or schools as their performances are low.

Besides, irritability and confusion are common among the addicts (Gordon, 2013). The victims of substance abuse experience changes in their attitude and behavior because of mood swings and reduced inhibitions. They include suicidal behaviors and self-imposed isolation (Gordon, 2013).


Prevention of substance abuse is dealt with by first recognizing the risk and protective factors. Counselors play a vital role in designing the strategies (Garner, 2009). The initial strategies are personal. They include helping the person deal with peer pressure. Teens and adolescents start substance abuse as a result of peer pressure.

They should find a plan for resisting the pressure. Dealing with life pressures such as stress is an effective prevention strategy that helps a person to cope with life rather than turning to substance abuse. The counselors should help those seeking help for the people with mental problems that result from substance abuse.

These include post-traumatic stress, Schizophrenia, anxiety, and depression. Before the initiation of behavioral or pharmacological therapies, it is necessary to the counselors to examine the risk factors.

They include the social, environmental, and economic factors to give an overview of the problem and identify the appropriate therapies. The strategies undertaken depend on the level of addiction.

There are several promising strategies to end substance abuse. These include: law enforcement, treatment, and prevention strategies. The prevention strategies comprise community-based processes, prevention education in learning institutions, as well as the environmental approaches that promote policies reducing the risk factors.

The preventive measures should start early in life and proceed to adolescence (Corte &Szalacha, 2010). Building of family bonds is essential in promoting responsible parenting. The treatment strategies include an emphasis on family-based treatment, rehabilitation of the addicts, and other programs according to the clinicians.

Law enforcement is a crucial strategy for dealing with substance abuse and reducing the number of such cases. Introduction of tough penalties can deter adolescents and teenagers from engaging in substance abuse. Additionally, law enforcement includes the community policing to give insights of drug availability in the societies.

Commitment and follow-up of the affected are essential to achieving the desired results of the programs (Garner, 2009).

Methods and Procedures


There is one method used in the writing of this paper. The method will be developmental.


Sites Specifics


The mentor is James Brown, MA, M.Ed, LCDC; he is an experienced Licensed Chemical Dependency Counselor who helps clients who are referred to his Behavioral and Public Health Department, which helps participants globally.

The mentor is also an instructor of a mental health program, and he utilizes effective skills to help people who are addicted and have become dependents.

The counselor has 15 years of experience and has a Bachelor of Science in Public Relations, Bachelor of Science in Government, Master of Arts in Counseling and a Master of Education Degree.

The mentor has good communication skills and creates a good rapport with clients. He dresses modestly, speaks fluently, and sits in an upright posture during counseling sessions.


The facility is named Legacy Services. The department has other workers who work in collaboration with the mentor, but in different departments.

Population served

Behavioral and Public Health Department serves people of different ages whose behaviors have been affected by drugs and have experienced difficulties in coping with the demands of life. It is notable that young adults and adults are the most affected.

With regard to the population that the intern would be handling in this department, he would be helping the trainer to offer services to about 200 persons in a day.

The participants would be alcoholics and persons who abuse other drugs and who would not able to cope without them (Carroll, De Leon, Joseph, & Winick, 2013). The intern would coordinate with his mentor to monitor the progress of participants.

Internship objectives

Specifically, the intern want to learn how to understand substance abuse group and individual sessions in a therapy and counseling setting or environment. The learning objectives include the following:

  1. The intern will learn to identify signs and symptoms that are associated with mental problems.
  2. The intern will learn to identify the challenges in participants’ daily lives, such as addressing boundaries, anger management, denial, minimization and blame.
  3. The intern will learn to identify the fourethical dilemmas related to substance abuse counselling, such as beneficence, do no harm; autonomy, independent living, give the participant the benefit of the doubt; justice, fair and equal treatment, and fidelity, keep promises to participants.
  4. The intern will learn how to identify participants’ detoxification needs such as signs and symptoms of withdrawal, screening and evaluation during intake process.
Schedule of activities

Internship activities are scheduled to take place from November 3, 2014 to January 7, 2015.Also, allactivities will be used to facilitate the learning of the objectives.

Table 1

Schedule of Activities

Week Activity Hours
1 The intern would participated in various group sessions as part of orientation to counseling. Introduction to basic emerging counseling skills was achieved during this period. 8
2 The intern shadowed the mentor on intensive outpatient sessions using 12-step and clinical modalities treatment to bring about a positive change in the participants life. 8
3 The intern shadowed the mentor and observe emerging individual counseling boundaries or taking notes of the daily sessions. 8
4 The intern shadowed the mentor on how to identify diagnosis classification and the type of mental issues a participant would report during intake process. 8
5 The intern participated in treatment preparation and conceptualization. 8
6 The intern shadowed the mentor on this day by carrying out research by utilizing modern methods of peer-reviewed research from the State website. This information was used to better educate the participants of new techniques. 8
7 The intern listened to the mentor educate him about the types of addictions, how addictions occur, and how to deal with addiction. The mentor educated two separate groups of participants. 8
8 The intern participated in crisis intervention and primary care integration. 8
9 The intern attended seminars learning about emerging issues in mental health. 8
10 The intern shadowed the mentor while he collaborated meetings with multi-disciplinary staff. 8
Total hours 80
Learning benefit

The learning benefit that the intern will be expected to receive during this mentor internship experience on addiction and substance abuse counseling was important because of the need to learn the challenging face-to-face counseling group’stechniques, crisis intervention supports and tools that would enable the intern to build on counseling skills.

The intern believe these skills would helpwith the progress from a simpler and immature phase to a more complex level of maturity about addiction.

Current employment

The intern is employed as a Health Crisis Coordinator and coordinates many programs, for example, behavioral and public health, injury and disability, vocational and employment services. Most of his assignments are conducted domestically; however, he does travel to London from time to time.

In addition to a Bachelor of Science in Education and Master of Arts in Education degree. Also, he holds a Post-Specialty Certificate in Emergency Management and Post-Master’s Certificate in Professional Counseling.

Search procedure

Libraries used

There was only one library used to search for sources for this project. The Counseling Professions Division Library at Southern Mills University and Google Scholarwas used for the project.

Search engines and databases used

The following databases were used to search for the sources for this project. The databases werePubMed and PsycINFO and MEDline (EBSCO) and Global Health and Alt Health Watch and MEDLINE (Ovid).

Search terms

Several search terms were used to identify sources for this project. The search terms included (a) Behavioral Health, (b) Substance Abuse,(c) Behavioral Therapy, (d) Public Health, (e) Behavioral Treatment, and (f) Alcoholism.

Boolean strings

Boolean strings were considered for the literature search. No Boolean strings were used in the literature search.

Age of the sources

The significant literature will be reviewed. Sources from the last 5 years will be considered for inclusion in the review of literature. No historical or seminal articles will be considered.

Inclusion criteria

There were four inclusion criteria. Inclusion criteria included (a) literature published since 2010, (b) English-language text, (c) peer-reviewed articles, and (d) Web sites relating to shadowing a substance abuse counselor.

Exclusion criteria

There were fourexclusion criteria.The exclusion criteria included (a) literature published before 2010,(b) text not published in English, (c) articles not peer reviewed, and (d) Web sites not relating to shadowing a substance abuse counselor.



The internship is a highly valuable experience for the intern who wants to improve his/her skills and knowledge in the sphere of drug abuse and mental health That is why, it is vital for him/her to choose the right institution which can guarantee his/her further development as a professional.

Resting on this fact, it can be recommended to draw an interns attention to the Legacy Services. The Legacy Services is a company which promotes development of knowledge and awareness of the issue of substance abuse among interns.

Being very efficient and credible company, it can guarantee high level of its services and professionalism of its workers. However, having its main strengths it also has its weak sides.

That is why, it is important to investigate the company precisely to determine the main aspects of its work to understand better the main regularities according to which it functions.

Analysis of Strengths, Weaknesses, opportunities, and Threats


The first strength of Legacy Services is a highly reputable company that provides quality services. Its reputation in terms of the provision of superior substance abuse counseling services elevates its credibility in enabling an intern to obtain the set of objectives.

The organization also has qualified staff members who act as its strength in the provision of services. Secondly, the organization upholds integrity at all its levels of operation. Thirdly, there are adequate resources that include training kits, office space, finance, working incentives among others that aid service delivery.


Although clear strengths of the organization have been identified, it is, however, difficult for identification of weaknesses to be indicated at this time.

The weaknesses are always identified when an experience has already been achieved either positive or negative. Therefore, it is prudent for the weaknesses to be enumerated later because of more time is needed.


The underlying opportunities why the intern selected the institution are based on its capacity to expand its customer base, counseling services and revenue base. The organization is promising based on its strategic plans that are formulated already.

In particular, the expected customer growth rate makes the organization so attractive for interns who expect to offer services to some of the customers. Increase revenue amounts or financial capacity of the company may also help in hiring some of the interns hence its preference.

Likewise, the advancement of counseling services indicates a wider knowledge on counseling matters that is noble for interns.


Probable threats the organization has the potential of facing that may impede the realization of the set objectives of an intern including high enrolment rate, lack of divergent funding sources and competition. In particular, people enroll for the internship position in the organization more than it can accommodate.

This makes it difficult for prospecting interns to be sure of getting the privilege of working there. Secondly, the company faces stiff competition from other rival institutions that focus on providing counselling services. The high rate of competition may affect its reputation and stature in the society.

The institution also has limited sources of funding that may affect its capacity of accommodating more interns who aspire to acquire experience.

Based on the institution’s SWOT analysis, it is evident that it holds the capacity of ensuring that the intern receives best results. The choice is good for intern in a broader perspective given that its strengths and opportunities outweigh its weaknesses and threats.


During the internship, interns are able to observe the way seasoned counselors work and the way clients respond to the treatment. This internship can be seen as one of such experiences.

The intern was fully integrated in the process. Thus, he participated in numerous sessions where he could note peculiarities of behavior of the mentor and clients, strategies employed during the sessions, the way clients respond to this or that strategy. The intern could also trace possible signs of clients’ potential relapse.

The intern took part in meetings with multi-disciplinary staff and this was a very important experience. Cooperation with different professionals enabled the counselor to provide high-quality services to clients and make sure their needs could be met.

Importantly, the intern had an opportunity to collaborate with mentor and develop some treatment strategies. This was a remarkable experience as the intern obtained many insights from his mentor during development of the strategies.

Admittedly, it is impossible to gain such experience through reading books and articles. The intern obtained an opportunity to observe quite conventional as well as extraordinary cases as all people are different and they often face quite different challenges.

The intern could feel the specific atmosphere, which is created during sessions. These observations and shadowing enabled the intern to get certain confidence, which will be crucial for his future career.


Having analyzed the data, it is possible to make certain conclusions. The issue of substance abuse counseling is very important nowadays within the framework of the increase of level of abuse among people. That is why, the need in professionals who can provide qualified advice for a person who suffers from the substance abuse is obvious.

With this in mind, some patterns for preparation of qualified interns should be suggested. Taking into account complexity and topicality of the issue, the analysis of the methodology and main objectives of internship was also provided.

Moreover, the importance of practice for internship should also be mentioned as it allows an intern to obtain knowledge which is not available in books or some other sources. Great significance of the process of teaching and preparation of interns should also be remembered.


It is obvious, that the main ideas presented in the work should be adopted as it can promote improvement of the situation connected with the issue of substance abuse. Implication of the main points mentioned in the work can guarantee further development of knowledge in this sphere.

Moreover, the issue of training of the professionals who are ready to consult people who suffer from substance abuse can become very helpful in terms of blistering growth of this kind of dependence.

Main methods outlined in the work can also be applied to the process of training of new interns as they will allow increase of the level of efficiency of interns and general improvement of the situation. With this in mind, the data presented should be studied and taken into account in order to provide better understanding of the issue.


Having analyzed the issue, it is possible to make several recommendations. First of all, it is necessary to say that the change of the existing system of internship is needed. The emphasis should be made on practice as only it can allow better knowledge and practical skills among interns.

Moreover, some new methods should be applied to existing system for it to be more modern. However, there is one more recommendation. It goes without saying, that the further investigation of this issue is necessary.

Within the framework of the increase of number of people who suffer from substance abuse, it is very important to investigate different methods to prevent it.

Taking this fact into account, it is possible to say that internship which allows students to obtain practical knowledge can serve as the first stage in better understanding of the problem of substance abuse.


Babinski, D. E., Pelham, W. E., &Waxmonsky, J. G. (2013). Cognitive-behavioral therapy for pediatric obsessive-compulsive disorder complicated by stigma: A case study. Clinical Case Studies, 15(34), 65-77.

Carroll, J. F., De Leon, G., Joseph, H., & Winick, C. (2013). Reflections on the past, present, and the future of the chemical dependency treatment field: Four unique perspectives. Alcoholism Treatment Quarterly, 31(1), 107-120.

Corte, C., &Szalacha, L. (2010). Self-cognitions, risk factors for alcohol problems, and drinking in preadolescent urban youths. Journal of Child & Adolescent Substance Abuse, 19(5), 406-423.

Dufour, S. P., Graham, S., Friesen, J., Rosenblat, M., Rous, C.,&Richardson, J. (2014). Physiotherapists supporting self-management through health coaching: A mixed methods program evaluation. Physiotherapy Theory and Practice, 10(1), 1-10.

Gallagher, S. (2014). Treatment strategies for forensic psychologists working with clients dealing with substance abuse, legal charges, and enabling parents. Journal of Forensic Psychology Practice, 14(2), 158-168.

Gordon, A. (2013). Substance abuse journal: New beginnings. Substance Abuse, 34(4), 339-341.

Regina, C., & Valeria, M. (2014). Social determinants of health and inequity among people with disabilities: A Brazilian experience. Journal of Public Health and Epidemiology, 6(11), 326-337.

Smith, B., & Liu, J. (2014). Latent practice profiles of substance abuse treatment counselors: Do evidence-based techniques displace traditional techniques? Journal of Substance Abuse Treatment, 46(4), 439-446.

Wallace, L. M., Brown, K. E., & Hilton, S. (2014). Planning for, implementing and assessing the impactof health promotion and behavior change interventions: Away forward for health psychologists. Health Psychology Review, 8(1), 8-33.

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