Who Works in Rehabs? Understanding Roles and Titles

Mental Health Experts

Talk therapy is a core component of most treatment programs. There are many different approaches, but a few are especially common during rehab:

• cognitive behavioral therapy (CBT)
• dialectical behavioral therapy (DBT)
• acceptance and commitment therapy (ACT)

These are examples of evidence-based treatment. In other words, data shows that they can help with addiction recovery. Your therapist may recommend these methods as part of your care plan.

Counselors

Counseling helps people work through acute issues⁵ and kickstart the healing process. A counselor is more like an ally than a guide. They’ll get to know you, learn about your goals for recovery, and help you decide what to do next.

Counseling is a broad field, so most counselors choose a specific focus. For instance, you might see someone who mainly treats gambling addiction, or helps patients heal from trauma. Substance abuse counselors concentrate on addiction treatment.

Licensed professional counselors (LPCs) can diagnose patients,⁶ unlike other types of counselors. LPCs can also create treatment plans and advise in their area of expertise.

Qualifications

“Counselor” is a job title. Most addiction counselors hold at least a bachelor’s degree, but that’s not always required. LPCs need a master’s degree⁶ (Psy.M. or M.Psych), and a state license.

Psychotherapists (M.S., M.A.)

A psychotherapist, or talk therapist, can provide longer-term treatment than a counselor. They serve as a guide during talk therapy, helping you explore your mental health. In many programs, they also take the lead on designing your treatment plan.

During rehab, you’ll likely attend both 1:1 and group therapy sessions. You may also receive talk therapy sessions from another type of expert, like a psychologist or psychiatrist.

Qualifications

Therapists need a master’s degree⁷ (M.S. or M.A.) in a mental health field and a state license.

Psychologists (Ph.D., PsyD)

Psychologists are licensed mental health professionals, much like therapists. However, they have more rigorous educational requirements.

Practicing psychologists need a doctoral degree. They are qualified to both treat patients and do clinical research. Because of their academic background, psychologists might use more specialized treatment techniques. It’s also more common for psychologists to treat patients with severe mental health symptoms.⁸

Qualifications

Practicing psychologists have a Ph.D. in a field of psychology or a doctorate of psychology (Psy.D.). They also adhere to state licensing laws.

Certified Addiction Specialists (CAS)

A certified addiction specialist (CAS) is a mental health professional with advanced training in addiction treatment. Usually, a CAS treats addictive disorders⁹ in 5 main areas:

• substance use disorders

• alcohol use disorder

• eating disorders

• gambling
• sex addiction

The responsibilities of a CAS depends on their background and specialization. For example, you could see a medical doctor certified to treat alcohol use disorder. They would take a different approach than a CAS whose background is in psychology.

Some states require that certain professionals have an addiction specialist certification.⁹ For example, all opioid medical directors in Ohio must be addiction specialists.

Qualifications

All certified addiction specialists must have a bachelor’s degree. To provide patient care, they also need a master’s degree and certification from an accredited organization.

Licensed Marriage and Family Therapists (LMFT)

Addiction can damage relationships. For the person with addiction, unhealthy relationships can trigger mental health symptoms. And those symptoms can lead to drug use, which can erode your loved ones’ trust. Without professional support, it’s easy to get stuck in this loop.

LMFTs provide family or couples counseling to help you heal interpersonal dynamics. Treatment can be transformative for your relationships and for each individual family member. For many people, this is an essential part of healing from addiction. A strong support network increases your chances of long-term recovery.¹⁰

Qualifications

LMFTs hold a master’s or doctoral degree. They also need a state license from the Association of Marital & Family Therapy Regulatory Boards.¹¹

Medical Professionals

Many rehabs also employ medical professionals. Depending on their licensure, they may treat physical issues, prescribe medication for mental health, or both.

Some facilities have a special focus on medical treatment. If you’re planning to go through medical detox, for example, it’s important to find a qualified provider. Unsupervised detox can be extremely dangerous. These professionals can help you manage the physical and emotional symptoms of recovery.

Psychiatrists (M.D., D.O.)

A psychiatrist is a medical doctor (an M.D. or D.O.)¹² who specializes in mental health. They can give you an official diagnosis and prescribe medication. For people in addiction recovery, this type of treatment usually requires close supervision, to make sure you only take your meds as directed.

Talk therapy almost always accompanies psychiatric treatment. Your psychiatrist may provide therapy, or they may work in tandem with another professional, like a psychologist. But even if you’re seeing some else for psychotherapy, you’ll have regular check-ins with your psychiatrist. They’ll ask you about your life, your symptoms, and whether you’re experiencing unwanted side effects. Over time, they may adjust your dosage to achieve the best results.

Some patients need ongoing medical treatment for mental health issues, even after finishing rehab. In rare situations, you may be able to keep seeing the same person when you return home. But most of the time, you’ll need to sign a release form so they can share your medical history with your new psychiatrist.

Qualifications

Psychiatrists may be medical doctors (M.D.s) or doctors of osteopathic medicine (D.O.s). They also need a state physician’s license.

Medical Doctors (M.D.)

Many rehabs have doctors on staff. In medical detox programs, they ensure patients’ safety throughout withdrawal.¹³ But they can also support other aspects of recovery. For example, some people develop addiction in the attempt to manage chronic pain. In that case, a doctor might help you find non-addictive medications to serve the same purpose.

Some diagnoses, like eating disorders, have both physical and psychological symptoms. Medical care can be a major component of treatment for these conditions.

Qualifications

M.D.s have doctorates. They may also need a certification in addiction medicine,¹⁴ or relevant state licensing.

Addiction Medicine Physicians (ADM)

Drug addiction can take a toll on your physical health.¹⁵ If that’s your experience, your provider may refer you to an addiction medicine physician (ADM).

ADMs specialize in addiction-related health issues. They can give you an official diagnosis, and treat both physical and emotional symptoms. ADMs may also treat the loved ones of a person in recovery.

Qualifications

ADMs need a doctorate and a certification in the ADM subspecialty from ABMS.¹⁶ This is a relatively new credential.

Nurses (LPN, LVN, RN, APRN, etc.)

There are numerous different types of nurses.¹⁷

• Licenced practical nurses (LPNs) and licensed vocational nurses (LVNs) can check your vital signs, update your records, and provide basic care.
• Registered nurses (RNs) have more responsibilities.¹⁸ For example, RNs can assess your symptoms and help coordinate your treatment plan.
• Advanced practice registered nurses (APRNs)¹⁹ are nurses with master’s degrees or higher. They can diagnose patients, prescribe medication, and design your plan of care.

Qualifications

LPNs and LVNs must complete a year-long program²⁰ and pass a state licensing exam.

RNs may have a bachelor of science in nursing (BSN), an associate’s degree in nursing (ADN), or an associate of science in nursing (ASN). All of these programs include supervised clinical training. RNs are also licensed by the state.²¹

There are several types of APRNs,¹⁹ which require various degrees and types of education. APRNs often have specific areas of focus, like chronic illness or counseling.

Holistic and Complementary Health Practitioners

Mental health and addiction can affect every aspect of your life, from relationships to nutrition.

In holistic treatment, you’ll approach recovery as an integrated, whole-self experience. Instead of just treating your symptoms, you’ll reconnect your mind, body, and spirit with each other.

Holistic addiction treatment is increasingly popular.²² As a result, it’s easier than ever to find a rehab that employs the following specialists:

• acupuncturists
• massage therapists
• mindfulness teachers
• naturopathic doctors and herbalists
• somatic therapists
• yoga instructors

Some rehabs also offer experiential therapies, like equine and adventure therapy. Qualified experts lead these sessions, sometimes with the help of a talk therapist.

Qualifications

Requirements for holistic practitioners vary widely. For example, massage therapy is regulated at the state level. And in most U.S. states massage therapists must pass the Massage and Bodywork Licensing Exam (MBLEx)²³ to get a license. But in some states, like Minnesota, there are no licensing regulations.

Other complementary treatments are relatively new to the U.S., even if they have a long history in other countries. As a result, not all of these professionals require licenses. But as researchers continue to study these therapies, those requirements may change.

Find Recovery With the Support of a Strong Treatment Team

Starting recovery is a major commitment—to yourself and to the program. You don’t need to spend your time in rehab wondering if you can trust your team. Look for a center that employs experienced professionals who work well together. With their support, you can focus on what really matters: your healing journey.

Review our list of rehabs to compare the essentials about each center, from treatment team information to pricing and insurance options.

Reviewed by Rajnandini Rathod

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