PERTANIKA JOURNAL OF SOCIAL SCIENCES AND HUMANITIES

This qualitative study aimed to understand the motivations of people recovering from substance use disorders (SUDs) to work in addiction treatment agencies as counselors. A purposive and snowball sampling technique was used to recruit 18 recovering counselors from Long Island, New York. Most of the participants self-identified as Caucasian, and a third identified as African American. All interviews were audio-recorded and transcribed verbatim. The results indicate that want to give back, perceived self-efficacy to work with SUD clients, and previous experiences with addiction treatment services motivated people in recovery from SUD to become counselors. The respondents also reported the role of intrinsic rewards, such as witnessing clients’ progress over time and the opportunity to sustain their recovery, which influenced their decision to continue working in the addiction treatment field. Understanding work motivations has significant implications for assessing the staffing needs and professional development of SUD treatment programs, including recruitment, retention, and the overall size and capacity of the addiction treatment workforce.

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

• Bathish, R., Best, D., Savic, M., Beckwith, M., Mackenzie, J., & Lubman, D. I. (2017). “Is it me or should my friends take the credit?” The role of social networks and social identity in recovery from addiction. Journal of Applied Social Psychology, 47(1), 35-46. https://doi.org/10.1111/jasp.12420

• Beraldo, L., Gil, F., Ventriglio, A., de Andrade, A. G., da Silva, A. G., Torales, J., Gonçalves, P. D., Bhugra, D., & Castaldelli-Maia, J. M. (2019). Spirituality, religiosity and addiction recovery: Current perspectives. Current Drug Research Reviews, 11(1), 26-32. https://doi.org/10.2174/1874473711666180612075954

• Best, D., Beckwith, M., Haslam, C., Haslam, S. A., Jetten, J., Mawson, E., & Lubman, D. I. (2016). Overcoming alcohol and other drug addiction as a process of social identity transition: The social identity model of recovery (SIMOR). Addiction Research & Theory, 24(2), 111-123. https://doi.org/10.3109/16066359.2015.1075980

• Best, D., Bliuc, A. M., Iqbal, M., Upton, K., & Hodgkins, S. (2018). Mapping social identity change in online networks of addiction recovery. Addiction Research & Theory, 26(3), 163-173. https://doi.org/10.1080/16066359.2017.1347258

• Bilgin, M. (2015). The investigation of work values on pyschological counseling and guidance students. International Journal of Eurasia Social Sciences, 6(21), 187-198.

• Bliuc, A. M., Best, D., Iqbal, M., & Upton, K. (2017). Building addiction recovery capital through online participation in a recovery community. Social Science & Medicine, 193, 110-117. https://doi.org/10.1016/j.socscimed.2017.09.050

• Bouchery, E., & Dey, J. (2018). Substance use disorder workforce [Data set]. Mathematica Policy Research.

• Braun, V., & Clarke, V. (2014). What can “thematic analysis” offer health and wellbeing researchers? International Journal of Qualitative Studies on Health and Well-Being, 9(1), Article 26152. https://doi.org/10.3402/qhw.v9.26152

• Brown, E. M. (2017). Cross-racial trust factors: Exploring the experiences of blacks who have had white mentors in the counseling profession, [Doctoral dissertation, Old Dominion University]. ProQuest Dissertations Publishing.

• Bunce, A. E. (2019). “What we’re saying makes sense so I’ve subscribed to it and I try to live by it”. A qualitative exploration of prisoners’ motivation to participate in an innovative rehabilitation programme through the lens of self-determination theory [Doctoral dissertation, University of Surrey]. ProQuest Dissertations Publishing. https://doi.org/10.15126/thesis.00852929

• Calcaterra, S. L., Bach, P., Chadi, A., Chadi, N., Kimmel, S. D., Morford, K. L., Roy, P., & Samet, J. H. (2019). Methadone matters: What the United States can learn from the global effort to treat opioid addiction. Journal of General Internal Medicine, 34(6), 1039-1042. https://doi.org/10.1007/s11606-018-4801-3

• Cheung, C. C. (2016). An exploration of why entering the profession of counseling: The personal choices of university counselors in mainland China [Doctoral dissertation, The Chinese University of Hong Kong]. ProQuest Dissertations Publishing.

• Chick, J. (2015). Recovery: Twelve simple steps to life beyond addiction. Alcohol and Alcoholism, 50(1), 103. https://doi.org/10.1093/alcalc/agu086

• Chien, E. (2020). Diversity in the genetic counseling profession: Perspectives on barriers and motivations [Master’s thesis, Rutgers, The State University of New Jersey]. ProQuest Dissertations Publishing.

• Clandinin, D. J., & Caine, V. (2013). Narrative inquiry. In reviewing qualitative research in the social sciences. Routledge.

• Corey, M. S., & Corey, G. (2020). Becoming a helper. Cengage Learning.

• Creswell. J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches. Sage Publications.

• Danes, L. (2016). Professional satisfaction and subjective perception of provided services quality in employment counselors. Romanian Journal of Experimental Applied Psychology, 7(2), 82-96.

• Deane, F. P., Goff, R. O., Pullman, J., Sommer, J., & Lim, P. (2019). Changes in mental health providers’ recovery attitudes and strengths model implementation following training and supervision. International Journal of Mental Health and Addiction, 17(6), 1417-1431. https://doi.org/10.1007/s11469-018-9885-9

• Deci, E. L., & Ryan, R. M. (2008). Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology/Psychologie Canadienne, 49(3), 182-185. https://doi.apa.org/doi/10.1037/a0012801

• DeLucia, C., Bergman, B. G., Formoso, D., & Weinberg, L. B. (2015). Recovery in Narcotics Anonymous from the perspectives of long-term members: A qualitative study. Journal of Groups in Addiction & Recovery, 10(1), 3-22. https://doi.org/10.1080/1556035X.2014.969064

• Dermatis, H., & Galanter, M. (2016). The role of twelve-step-related spirituality in addiction recovery. Journal of Religion and Health, 55(2), 510-521. https://doi.org/10.1007/s10943-015-0019-4

• Doukas, N. (2015). A contemporary new role for counselors in recovery: Recovery coaches in communities of recovery. Alcoholism Treatment Quarterly, 33(2), 244-247. https://doi.org/10.1080/07347324.2015.1018786

• Doukas, N., & Cullen, J. (2010). Recovered addicts working in the addiction field: Pitfalls to substance abuse relapse. Drugs: Education, Prevention & Policy, 17(3), 216-231. https://doi.org/10.3109/09687630802378864

• Dugdale, S., Elison, S., Davies, G., Ward, J., & Dalton, M. (2016). Using the transtheoretical model to explore the impact of peer mentoring on peer mentors’ own recovery from substance misuse. Journal of Groups in Addiction & Recovery, 11(3), 166-181. https://doi.org/10.1080/1556035X.2016.1177769

• DuPont, R. L., Compton, W. M., & McLellan, A. T. (2015). Five-year recovery: A new standard for assessing effectiveness of substance use disorder treatment. Journal of Substance Abuse Treatment, 58, 1-5. https://doi.org/10.1016/j.jsat.2015.06.024

• Farber, B. A., Manevich, I., Metzger, J., & Saypol, E. (2005). Choosing psychotherapy as a career: Why did we cross that road? Journal of Clinical Psychology, 61(8), 1009-1031. https://doi.org/10.1002/jclp.20174

• Fei, J. T. B., Yee, A., Habil, M. H. B., & Danaee, M. (2016). Effectiveness of methadone maintenance therapy and improvement in quality of life following a decade of implementation. Journal of Substance Abuse Treatment, 69, 50-56. https://doi.org/10.1016/j.jsat.2016.07.006

• Fialk, A. (2018). Wounded versus non-wounded healers and substance abuse treatment: Countertransference considerations. [Doctoral dissertation, Yeshiva University]. ProQuest Dissertations Publishing.

• Foss-Kelly, L., & Protivnak, J. J. (2017). Voices from the desks: Exploring student experiences in counselor education. Journal of Counselor Preparation and Supervision, 9(2), 233-263. http://dx.doi.org.libproxy.adelphi.edu/10.7729/92.1181

• Gaine, G., Dubue, J., Purdon, S., & Abba-Aji, A. (2021). The relation between psychological need satisfaction in acute psychiatric hospital and recovery among emerging adults: A self-determination theory approach. Psychiatric Rehabilitation Journal, 44(2), 186-196. https://doi.apa.org/doi/10.1037/prj0000459

• Goodman, D. J., Saunders, E. C., & Wolff, K. B. (2020). In their own words: A qualitative study of factors promoting resilience and recovery among postpartum women with opioid use disorders. BMC Pregnancy and Childbirth, 20(1), 1-10. https://doi.org/10.1186/s12884-020-02872-5

• Greene, D. S., Yaffe, J., & Kopak, A. M. (2019). Relapse among recovering addiction professionals: Prevalence and predictors. Journal of Social Work Practice in the Addictions, 19(4), 323-344. https://doi.org/10.1080/1533256X.2019.1653718

• Gueta, K., Chen, G., & Ronel, N. (2020). Maintenance of long-term recovery from substance use: A mixed methods study of self-and treatment-changers. Drugs: Education, Prevention and Policy, 28(5, Special issue), 1-12. https://doi.org/10.1080/09687637.2020.1800592

• Hatch-Maillette, M. A., Harwick, R., Baer, J. S., Masters, T., Cloud, K., Peavy, M., Wiest, K., Wright, L., Beadnell, B., & Wells, E. A. (2019). Counselor turnover in substance use disorder treatment research: Observations from one multisite trial. Substance Abuse, 40(2), 214-220. https://doi.org/10.1080/08897077.2019.1572051

• Hill, C. E., Lystrup, A., Kline, K., Gebru, N. M., Birchler, J., Palmer, G., Robinson, J., Um, M., Griffin, S., Lipsky, E., & Knox, S. (2013). Aspiring to become a therapist: Personal strengths and challenges, influences, motivations, and expectations of future psychotherapists. Counselling Psychology Quarterly, 26(3-4), 267-293. https://doi.org/10.1080/09515070.2013.825763

• Kaslow, F. W. (2005). Growing up everyone’s trusted confidante: Why I really became a psychotherapist. Journal of Clinical Psychology, 61(8), 965-972. https://doi.org/10.1002/jclp.20169

• Kelly, J. F., Greene, M. C., Bergman, B. G., White, W. L., & Hoeppner, B. B. (2019). How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering US adults. Alcoholism: Clinical and Experimental Research, 43(7), 1533-1544. https://doi.org/10.1111/acer.14067

• Kern, E. O. (2014). The pathologized counselor: Effectively integrating vulnerability and professional identity. Journal of Creativity in Mental Health, 9(2), 304-316. https://doi.org/10.1080/15401383.2013.854189

• Kiang, M. V., Basu, S., Chen, J., & Alexander, M. J. (2019). Assessment of changes in the geographical distribution of opioid-related mortality across the United States by opioid type, 1999-2016. JAMA Network Open, 2(2), Article e190040. https://doi.org/10.1001/jamanetworkopen.2019.0040

• Lietz, C. A., Langer, C. L., & Furman, R. (2006). Establishing trustworthiness in qualitative research in social work: Implications from a study regarding spirituality. Qualitative Social Work, 5(4), 441-458. https://doi.org/10.1177/1473325006070288

• Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69(2), 97-110. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97

• Linington, M. (2016). The psychotherapist’s own psychotherapy: Patient and clinician perspectives. In J. D. Geller & J. C. Norcross (Eds.), Attachment: New directions in relational psychoanalysis and psychotherapy (pp. 167-171). Oxford University Press

• Madras, B. K. (2017). The surge of opioid use, addiction, and overdoses: Responsibility and response of the US health care system. JAMA Psychiatry, 74(5), 441-442. https://doi.org/10.1001/jamapsychiatry.2017.0163

• Mahrer, A. R. (2005). What inspired me to become a psychotherapist? Journal of Clinical Psychology, 61(8), 957-964. https://doi.org/10.1002/jclp.20168

• McCullough, M. E. (2000). Forgiveness as human strength: Theory, measurement, and links to well-being. Journal of Social and Clinical Psychology, 19(1), 43-55. https://doi.org/10.1521/jscp.2000.19.1.43

• McMillan, D. J., McConnell, B., & O’Sullivan, H. (2016). Continuing professional development–why bother? Perceptions and motivations of teachers in Ireland. Professional Development in Education, 42(1), 150-167. https://doi.org/10.1080/19415257.2014.952044

• Monnat, S. M., Peters, D. J., Berg, M. T., & Hochstetler, A. (2019). Using census data to understand county-level differences in overall drug mortality and opioid-related mortality by opioid type. American Journal of Public Health, 109(8), 1084-1091. https://doi.org/10.2105/AJPH.2019.305136

• Nielson, E. M. (2016). Substance abuse counselors’ recovery status and self-schemas: Preliminary implications for empirically supported treatment implementation. Journal of Drug and Alcohol Research, 5, Article 235982. https://doi.org/10.4303/jdar/235982

• Norcross, J. C., & Farber, B. A. (2005). Choosing psychotherapy as a career: Beyond ‘I want to help people’. Journal of Clinical Psychology, 61(8), 939-943. https://doi.org/10.1002/jclp.20175

• Nowell, B., & Albrecht, K. (2019). A reviewer’s guide to qualitative rigor. Journal of Public Administration Research and Theory, 29(2), 348-363. https://doi.org/10.1093/jopart/muy052

• Nurse, R. A. (2020). Case study on perceptions of recovered licensed professional counselors (LPCS) and licensed certified alcohol and drug counselors (LCADC) who counsel co-occurring mentally ill chemical abuser (MICA) [Doctoral dissertation, Capella University]. ProQuest Dissertations Publishing.

• Orlinsky, D. E., & Rønnestad, M. H. (2005). How psychotherapists develop: A study of therapeutic work and professional growth. American Psychological Association.

• Ottenberg, D. (1977). Traditional and nontraditional credentials in addictive problems: A dispatch from the battlefield. The Addiction Therapist, 2(1), 56-63.

• Patsiopoulos, A. T., & Buchanan, M. J. (2011). The practice of self-compassion in counseling: A narrative inquiry. Professional Psychology: Research and Practice, 42(4), 301-307. https://doi.apa.org/doi/10.1037/a0024482

• Pietkiewicz, I., & Skowrońska-Włoch, K. (2017). Attitudes to professional boundaries among therapists with and without substance abuse history. Polish Psychological Bulletin, 48(3), 411-422. https://doi.org/10.1515/ppb-2017-0047

• Poon, D. B., Watt, H. M. G., & Stewart, S. E. (2020). Future counselors’ career motivations, perceptions, and aspirations. Higher Education, Skills and Work-Based Learning, 10(1), 155-170. https://doi.org/10.1108/HESWBL-02-2019-0031

• Prom-Wormley, E. C., Ebejer, J., Dick, D. M., & Bowers, M. S. (2017). The genetic epidemiology of substance use disorder: A review. Drug and Alcohol Dependence, 180(1), 241-259. https://doi.org/10.1016/j.drugalcdep.2017.06.040

• Raynor, P. A., Pope, C., York, J., Smith, G., & Mueller, M. (2017). Exploring self-care and preferred supports for adult parents in recovery from substance use disorders: Qualitative findings from a feasibility study. Issues in Mental Health Nursing, 38(11), 956-963. https://doi.org/10.1080/01612840.2017.1370520

• Reamer, F. G. (2020). Boundary issues and dual relationships in the human services. Columbia University Press.

• Renard, M., & Snelgar, R. J. (2016). How can work be designed to be intrinsically rewarding? Qualitative insights from South African non-profit employees. South African Journal of Industrial Psychology, 42(1), 1-12. https://doi.org/10.4102/sajip.v42i1.1346

• Robinson, S. R. (2018). Mora reasoning and authenticity in paraprofessional and professional and recovering and non-recovering addiction counselors [Doctoral dissertation, University of Holy Cross] ProQuest Dissertations Publishing.

• Rønnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist: Research findings and perspectives on professional development. Journal of Career Development, 30(1), 5-44. https://doi.org/10.1177/089484530303000102

• Ruhm, C. J. (2018). Corrected US opioid‐involved drug poisoning deaths and mortality rates, 1999–2015. Addiction, 113(7), 1339-1344. https://doi.org/10.1111/add.14144

• Shannon, M. K. (2017). A phenomenological study of female counselors recovering from a substance use disorder [Doctoral dissertation, Capella University]. ProQuest Dissertations Publishing.

• Simons, L., Haas, D., Massella, J., Young, J., & Toth, P. (2017). Exploring professional identity development in alcohol and drug counselors in the 21st century. Journal of Alcohol and Drug Education, 61(2), 40-61.

• Stevanovic, P., & Rupert, P. A. (2004). Career-sustaining behaviors, satisfactions, and stresses of professional psychologists. Psychotherapy: Theory, Research, Practice, Training, 41(3), 301-309. https://doi.org/10.1037/0033-3204.41.3.301

• Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health 2017 (No. SMA 17-5044). U.S. Department of Health and Human Services, Center for Behavioral Health Statistics and Quality. https://www.cdc.gov/rdc/data/b1/2018-FinalAnalytic-Codebook-RDC508.pdf

• Tiesman, H. M., Gwilliam, M., Rojek, J., Hendricks, S., Montgomery, B., & Alpert, G. (2019). The impact of a crash prevention program in a large law enforcement agency. American Journal of Industrial Medicine, 62(10), 847-858. https://doi.org/10.1002/ajim.23032

• Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. Substance Abuse and Rehabilitation, 7, 143-154. https://doi.org/10.2147/SAR.S81535

• Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371. https://doi.org/10.1056/nejmra1511480

• von Greiff, N., & Skogens, L. (2021). Recovery and identity: A five-year follow-up of persons treated in 12-step-related programs. Drugs: Education, Prevention and Policy, 28(5), 465-474. https://doi.org/10.1080/09687637.2021.1909535

• Vroom, V. H. (1964). Work and motivation. Wiley & Sons.

• Warren, L., Feit, M. D., & Wells, J. (2011). Substance abuse among professionals: Limited research on substance-abusing social workers. Journal of Human Behavior in the Social Environment, 21(7), 803-812. https://doi.org/10.1080/10911359.2011.616753

• White, W. (2006). Sponsor, recovery coach, addiction counselor: The importance of role clarity and role integrity. Philadelphia Department of Behavioral Health and Mental Retardation Services. http://m.www.williamwhitepapers.com/pr/dlm_uploads/2006-Sponsor-Recovery-Coach-Addiction-Counselor.pdf

• Wile, C., & Jenkins, K. (2013). The value of a support group for medical professionals with substance use disorders. Australasian Psychiatry, 21(5), 481-485. https://doi.org/10.1177/1039856213498289

• Yao, C. W., & Vital, L. M. (2018). Reflexivity in international contexts: Implications for U.S. doctoral students international research preparation. Faculty Publications in Educational Administration, 13, 193-210. https://doi.org/10.28945/4005

• Zosky, D. (2013). Wounded healers: Graduate students with histories of trauma in a family violence course. Journal of Teaching in Social Work, 33(3), 239-250. https://doi.org/10.1080/08841233.2013.795923