Author ORCID Identifier

Date of Award

Summer 8-8-2023

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Counseling and Psychological Services

First Advisor

Dr. Brian Dew

Second Advisor

Dr. Catharina Chang

Third Advisor

Dr. Franco Dispenza

Fourth Advisor

Dr. Saundra Tabet


With over 40 million Americans aged 12 and older meeting the criteria for a Substance Use Disorder (SUD) in 2020, and drug overdose deaths reaching record highs that same year, the treatment of persons with SUDs has become a focal point of the counseling profession (CDC, 2021; SAMHSA, 2021). There is a growing need for clinical mental health counselors (CMHC) trained to treat SUDs (The United States Bureau of Labor Statistics, 2022). However, negative attitudes and stigma toward substance-related addiction serve as a deterrent for counselors working in substance-treatment settings (Murphy, 2022). Addressing substance-related attitudes in counseling students is critical as they may harm the client and the therapeutic relationship (Boysen, 2010; SAMHSA, 2017; Van Boekel et al., 2013). The need for addiction-related training standards in CACREP-accredited CMHC programs to address the knowledge, skills, and attitudes components of addiction counseling competency is reviewed in Chapter 1. In Chapter 2, the attitudes of 210 masters-level counseling students enrolled in CACREP-accredited CMHC programs toward working with clients with SUDs were assessed. Exposure to persons with substance addiction was found to predict students’ attitudes toward working with clients with SUDs. Two facets of addiction attitudes were observed: how favorably students viewed working with clients with SUDs and students’ desire to work with clients with SUDs. Several factors that facilitate more favorable perceptions of working with clients with SUDs and greater desire to treat this population were identified; these factors include exposure to persons with substance addiction and completion of addiction-related coursework and trainings. Implications for how CACREP-accredited CMHC programs may enrich addiction counseling curriculum to facilitate more positive addiction-related attitudes among students are presented. Implications for future research are provided.


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