Addiction counseling is a communications business. We as educators and clinical supervisors train new counselors to pay attention to spoken words, tone of voice, and body language; to notice subtle shifts in a client’s mood, thinking, and behavior; and to evaluate closely their own style of interacting. However, we often ignore or minimize the importance of high-quality written communication for counselors.
In addiction counseling, we do a great deal of writing. We write papers for publication and presentations; send e-mail messages containing critical information to colleagues and supervisors; prepare cover letters and résumés for potential jobs; and craft clinical notes that help steer a client’s treatment and could end up in court someday. Strong writing skills create better continuity of treatment, improved measurement of outcomes, and greater client advocacy.
Possessing such skills might also increase the opportunity for counselors to earn positions in management or administration, which typically come with higher pay and greater input into treatment content and structure. On the other hand, a lack of writing ability consistently holds counselors back from jobs in which they might otherwise excel.
Reports and record-keeping, or documentation, constitutes one of the 12 core functions identified for addiction counselors as part of our global criteria. It is listed right alongside counseling, case management and crisis intervention. Yet this function is often given only cursory attention, except when we have interns and new counselors crank out piles of generic progress notes. We consider documentation to be a necessary burden in order to meet accreditation standards and ensure reimbursement for services.
Instead, I want to encourage all those who run training programs and provide supervision of counselors to reconceptualize the role of writing in our field. We need to create a culture in our profession that prizes clear communication on all fronts, including and especially the written word.
Furthermore, as part of the shifting climate in behavioral healthcare, agencies are being held accountable for implementing evidence-based practices that demonstrate results with their clients. Auditors and managed care representatives spend at most a few hours per year seeing the actual work an agency does, so it is left up to the documentation to paint the rest of the clinical picture. We must ask what kind of picture our writing paints, and whether it is worthy of the great work being done.
Emphasis in training
Some students entering training programs to become addiction counselors assume that they will not need a well-rounded set of academic skills. They count on their interpersonal strengths to carry them in their careers. While these are important abilities, they are not enough. Graduates of training programs also need to be able to locate academic resources, cite them appropriately, and communicate their findings through both written and spoken words.
Along the way, a percentage of students may find this too arduous. Although we may lose some gifted people, I believe that ultimately we help groom better professionals this way.
A degree alone does not make someone a great employee or a good clinician. Nor does being able to write a solid research paper prepare someone to deal with a client in crisis or a family struggling with a substance-abusing teenager. As a supervisor in residential treatment I often said, “Give me someone who cares, and I can teach them the rest.” I still believe the trait of empathy is foremost in what makes a good professional. However, if our future counselors are going to take the next step and help create the environment of respect that the field of addiction counseling deserves, then they must also carry with them the skills that allow them to stand above professionals in other fields.