Licensed clinical alcohol and drug counselor (LCADC) practice: Professional challenges,changes, and adaptations

The licensed clinical alcohol and drug counselor (LCADC) is an important public servant who prepares for many years to treat mental health, addiction, and co-occurring disorders. The purpose of this study is to understand the experiences of Licensed Clinical Alcohol and Drug Counselors (LCADC) in the State of Maryland, to learn more about their challenges, and to learn about adaptations these clinical counselors have made in their areas of practice. This was done by interviewing 12 LCADCs. The interviews revealed that when counselors enter a particular area of the counseling field, they find a history or past, a set of players, and rules that may not be readily apparent. In addition, their field of practice is ever changing. These changes occur as a result of a variety of factors, discussed in detail in subsequent chapters and illustrated in the three tables in this study. The counselors who specialize in treating addictions and co-occurring disorders have a unique set of challenges that they must navigate to practice successfully. Their successes as LCADCs appear to coincide with characteristics that might be found among serial entrepreneurs such as positivity; flexibility, and adaptability within a rapidly changing field. The study identified two major thematic dimensions: how the practice of LCADCs is evolving and the clashing occupational cultures between certified addiction counselors and LCADCs. These two thematic dimensions have required the 12 LCADCs interviewed to make major changes and adaptations to practice successfully. This exploration of LCADC experiences revealed many insights that may prove to be useful in improving practice and standards for other LCADCs.