Drug & alcohol counselors treat patients either one on one or in group settings. They educate and develop treatment plans for patients to help them better cope with their addictive personalities. Periodically, counselors will assess patients to determine how much progress has been made towards recovery. Typically, counselors work within a rigid program structure as determined by their employer. These programs are often implemented by facility managers and chiefs of staff. For example, the twelve step program may be used to treat alcohol addiction at a particular hospital or treatment facility where a counselor is employed.

Counselors seek to find what triggers a patient's behavior and to help them eliminate such triggers from their life. They take detailed notes, which helps them to form a better understanding of a patient's unique situation. They ask appropriate questions and offer advice as to which approach is best for treating a particular problem. Counselors are trained to recognize attitudinal barriers which may inhibit a person's ability to successfully overcome their addiction. They then work to help patients remove those barriers.

Drug & abuse counselors also teach patients how to best prevent a relapse. They do this by developing a strategy to help patients manage their problem in the best way possible. Helping them to understand the signs and symptoms of their addictive behavior can often prevent a patient from experiencing a total relapse. Ultimately, the goal is to find a course of treatment which will enable a person to finally break free of a destructive pattern and get on with their life.

Counselors also work to increase awareness of drug problems. This often involves writing articles for local newspapers, magazines or blogs, as well as speaking to community groups. Conducting drug education workshops and community outreach programs help to provide information to those who may be reluctant about seeking treatment.