How to become a dual diagnosis counselor

Is becoming a dual diagnosis counselor right for me?

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Overview
What do dual diagnosis counselors do?

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How to become a Dual Diagnosis Counselor

Becoming a dual diagnosis counselor typically involves a combination of education, clinical training, and licensure. Here’s an overview of the pathway to this career:

Bachelor’s Degree
Start by earning a bachelor’s degree in a relevant field, such as:

A bachelor's degree provides the foundational knowledge for understanding human behavior, mental health issues, and basic counseling techniques.

Master’s Degree
The vast majority of dual diagnosis counselors hold a master’s degree in one of the disciplines listed above in the Bachelor’s Degree section. Degrees in clinical psychology, social work, substance abuse counseling, mental health counseling, family psychology, and marriage and family therapy are particularly common choices.

Some institutions offer distinct graduate programs in dual diagnosis treatment. These programs are of course especially relevant and highly recommended. Key areas of study include:

  • Advanced counseling techniques
  • Co-occurring disorders and treatment modalities
  • Substance abuse counseling
  • Mental health assessment and diagnosis
  • Crisis intervention
  • Trauma-informed care

Accreditation
At both the undergraduate and graduate levels, it’s important to attend a program accredited by a recognized body, such as the Council for Accreditation of Counseling and Related Educational Programs (CACREP), the Commission on Accreditation of Rehabilitation Facilities (CARF), or the Council on Social Work Education (CSWE). Accreditation ensures that the program meets professional standards and prepares students for licensure.

Clinical Training and Internships
As part of their master’s program, aspiring dual diagnosis counselors will need to complete a supervised clinical internship or practicum comprised of a specific number of hours, typically 2,000 to 4.000 hours. This hands-on experience involves working directly with clients in settings like addiction treatment centers, mental health clinics, or hospitals.

Licensure
Following their clinical training, counselors need to obtain licensure in the state or country where they intend to practise. Requirements vary by location but generally involve completing the required education, clinical hours, and passing a licensing exam such as the National Counselor Examination (NCE) or the National Clinical Mental Health Counseling Examination (NCMHCE).

Depending on their degree and specialization, candidates may pursue different licenses, among them the Licensed Professional Counselor (LPC), the Licensed Clinical Social Worker (LCSW), or the Licensed Marriage and Family Therapist (LMFT).

Some states also offer specific licenses for addiction/substance abuse counselors or dual diagnosis specialists.

Continuing Education
Most states and organizations require counselors to earn continuing education (CE) credits focusing on best practices in dual diagnosis treatment to maintain their licensure and support professional growth.

It’s also important for those in the field to engage in ongoing supervision and peer support to help them manage the emotional demands of dual diagnosis counseling and prevent burnout.

Certifications
There are several certifications available for dual diagnosis counselors that can enhance their credentials and expertise in treating individuals with co-occurring mental health and substance use disorders. These are some prominent ones:

  • National Certified Counselor (NCC) – Offered by the National Board for Certified Counselors (NBCC), the NCC is a general certification for counselors who have earned an accredited Master’s Degree in Counseling or a related field, completed a certain number of supervised clinical hours, and passed the National Counselor Examination (NCE).
  • Certified Clinical Mental Health Counselor (CCMHC) – Also offered by the National Board for Certified Counselors (NBCC), this certification is specifically for counselors who wish to demonstrate their expertise in clinical mental health counseling. Requirements include an accredited Master’s Degree in Counseling, a minimum number of supervised clinical hours, and passing the National Clinical Mental Health Counseling Examination (NCMHCE).
  • National Certified Addiction Counselor, Level I (NCCAC I) / National Certified Addiction Counselor, Level II (NCCAC II) / Master Addiction Counselor (MAC) – These three foundational credentials for addiction counselors are offered by the National Certification Commission for Addiction Professionals (NCC AP). Respective minimum academic requirements at each level are a high school diploma, a bachelor’s degree, a master’s degree.
  • International Certification & Reciprocity Consortium (IC&RC) Prevention, Substance Use Disorder, and Recovery Credentialing – The IC&RC, in association with jurisdictionally specific Member Boards, offers the following credentials: Alcohol & Drug Counselor (ADC), Advanced Alcohol & Drug Counselor (AADC), Clinical Supervisor (CS), Prevention Specialist (PS), Certified Criminal Justice Addictions Professional (CCJP), Peer Recovery-Associate (PR-A), and Peer Recovery (PR). Requirements for each designation include a combination of education, supervised clinical hours, and passing an exam.
  • Certified Clinical Trauma Professional (CCTP) – Offered by the International Trauma Training Institute (ITTI), the CCTP signifies expertise in trauma recovery and can be beneficial for counselors who work with clients affected by abuse, violence, or other forms of trauma. Requirements include specialized training in trauma-informed care and trauma therapy, as well as a specified number of clinical hours working with trauma survivors and passing the CCTP exam.
  • American Association for Marriage and Family Therapy (AAMFT) Certifications – This association represents marriage and family therapists, including those working in behavioral health counseling who focus on family systems and relationship dynamics. AAMFT offers three different MFT certification badges: Clinical Fellow Designation, Approved Supervisor Designation, Certificate of Leadership.
  • Certified Family Recovery Specialist (CFRS) – This certification, offered by various organizations, is particularly relevant for counselors who specialize in family therapy and providing support for families of individuals dealing with dual diagnoses.
  • National Certified Peer Specialist (NCPS) – This certification, offered by the National Certification Board for Behavioral Health Professionals, is an advanced credential focused on the knowledge and skills peer specialists need when supporting others to achieve and maintain recovery from a mental health condition or other behavioral health challenge. Requirements include training, certification courses, and personal experience in recovery.

Professional Organizations
In addition to the certifying bodies referenced above in the Certifications section, the following organizations also support the dual diagnosis counseling community:

  • Substance Abuse and Mental Health Services Administration (SAMHSA) – SAMHSA is a key federal agency that offers research and treatment guidelines, evidence-based practices, grant opportunities, and resources for integrated mental health and substance use care.
  • National Alliance on Mental Illness (NAMI) – NAMI offers mental health advocacy, support groups and public education, and research and policy updates. While focused on mental illness, it supports professionals working with co-occurring disorders and offers insights on how mental illness and substance use intersect.
  • American Mental Health Counselors Association (AMHCA) – AMHCA focuses specifically on supporting mental health counselors, offering continuing education and conferences and advocating for policies that support the mental health counseling field.
  • National Association of Social Workers (NASW) – Many dual diagnosis counselors are licensed social workers. NASW is a large organization that provides support for integrated treatment of substance use and mental health disorders.
  • American Counseling Association (ACA) – The ACA is a broad professional association for counselors, including those in the dual diagnosis space. It offers educational resources, ethical guidelines, and networking opportunities for professionals in various counseling fields. ACA has divisions focusing on specific areas, such as mental health counseling, addiction counseling, marriage and family therapy, and school counseling.