July 2025
Since the Dame Carol Black Review in 2021, we’ve witnessed a long-overdue shift in how residential rehabilitation is perceived and funded. For the first time in years, rehab is being recognised as a vital component in the journey to recovery, especially for those facing the most complex and enduring challenges.
At Kenward Trust, where I’ve had the privilege of leading our transformation from financial uncertainty to award-winning recognition, we know just how life-changing residential recovery can be. Now, through my work as Chair of Choices Rehabs, I’m focused on ensuring that this progress isn’t temporary. It’s important our sector continues to have a strong, unified voice to also advocate, residential rehab as part of a wider continuum of care and part of a broader treatment system, all of which deserves funding and adequate support.
The Role of Rehab in Today’s Recovery Landscape.
Residential rehab is far more than a last resort. For many, it is the critical turning point that enables long-term, sustainable recovery. It offers:
- A structured, safe space away from environmental triggers
- 24/7 support from skilled professionals and a recovery community
- Time to address the underlying causes of addiction, including trauma
- A holistic path to rebuilding lives, not just stopping substance use
Responding to a More Complex Referral Landscape.
Today, we’re seeing increasingly complex referrals across our services. Many individuals arrive at rehab not only with substance dependency, but with:
- Significant mental health needs
- Housing instability
- Serious physical health complications
A particular concern is the growing number of under-30s presenting with ketamine addiction, which carries serious long-term risks, particularly to the bladder and kidneys. These cases require close, multi-disciplinary care that residential rehab is uniquely positioned to deliver.
Don’t Let This Progress Stall.
While the funding uplift following the review was welcome, it must not be viewed as a one-time solution. The road ahead requires:
- Sustained investment in residential treatment
- Clear recognition of rehab’s integral role within the wider system
- Commissioning decisions that prioritise complexity, outcomes, and ethics, not just cost
- A continued focus on trauma-informed, person-centred care
A Call to Stay Focused.
There is a real opportunity to reshape how we understand, and deliver, addiction recovery in the UK. But this depends on our continued collaboration, advocacy, and commitment to ethical, evidence-led support.
At Choices Rehabs, we are committed to being a strong voice for residential services, working alongside commissioners, providers, and policymakers to ensure rehab remains a valued, accessible part of the national response.
Let’s keep the momentum going. Lives depend on it.
Warm regards,
Penny Williams CEO, Kenward Trust, & Chair, Choices Rehabs.
July 2025
How to Become an Addiction Counsellor
The field of addiction counselling in the UK currently lacks a singular educational framework, presenting both challenges and opportunities for those seeking to enter this vital profession. With the recent closure of specialist addiction counselling
training courses, aspiring practitioners must navigate a fragmented landscape to build credible pathways towards accreditation and clinical practice.
The Foundation of Effective Practice
Effective addiction counselling demands high-level competence across multiple therapeutic models that address the complex psychological, emotional, and social factors influencing addiction. While addiction treatment represents a unique subset of mental healthcare, successful counselling remains rooted in a person-centred approach that prioritises empathy, unconditional positive regard, and genuine therapeutic connection as the foundation for fostering recovery.
Modern practitioners must master various therapeutic approaches, including 12-Step facilitation, cognitive behavioural therapy (CBT), and dialectical behavioural therapy (DBT), whilst understanding diverse modalities such as group psychotherapy, family therapy, and psychoeducation. However, true competence lies not merely in
understanding these models but in integrating and adapting them to meet each client’s unique and often complex needs.
Addiction rarely exists in isolation. It frequently interlinks with other mental health issues, emotional challenges, and behavioural patterns, including trauma, family dynamics, and psychiatric co-morbidities. Whilst integrated care for co-occurring disorders has long been considered best practice, this approach only succeeds when practitioners possess genuine expertise in both addiction and mental health.
Personal Readiness and Professional Qualities
Becoming an addiction therapist requires more than academic qualifications – it
demands deep commitment and specific personal qualities. Self-awareness is
paramount, as understanding one’s own thoughts, values, and interpersonal dynamics is crucial for effective practice. Engaging in personal therapy can greatly enhance this self-reflection, providing valuable insight into motivations and readiness to support others.
William White’s seminal paper; The Historical Essence of Addiction Counselling; offers invaluable guidance for aspiring counsellors. White describes the degree of presence, honesty, and emotional availability that informs addiction counselling work – qualities not always expected in other therapeutic fields. There exists something of
a vocation to this work, as White notes: ‘What the addiction counselor brings in addition to their skills is their whole person – their life.’
Clients engaging with addiction counsellors are often exquisitely attuned to inauthenticity; they respond to genuineness. This doesn’t mean over-disclosing or abandoning boundaries, but rather being human and willing to meet others in the
most challenging parts of their lives.
Professional Standards and Regulatory Framework
The UK counselling and psychotherapy field operates without compulsory regulatory standards for most practitioners, instead relying on voluntary standards established by various professional therapy associations. Exceptions include drama therapists, art therapists, and occupational therapists, which are regulated professions overseen by the Health and Care Professions Council (HCPC).
Addiction counsellors fall outside regulated professions and sit somewhat apart within mainstream counselling bodies. While addiction counsellors may register with organisations such as the BACP, many hours spent in addiction treatment facilities don’t count towards accreditation requirements. However, Addiction Professionals (AP) provides dedicated professional recognition, offering high-standard NCAC accreditation tailored specifically to addiction practice.
The BACP has recently launched an addictions competence framework after years of advocacy and development. This framework provides much-needed structure to guide practitioners in achieving necessary skills and standards, marking a significant step in establishing professional standards for addiction therapy.
The Loss of Specialist Degree Courses
For many years, the University of Bath, collaborating with Action on Addiction, offered a degree course in addiction counselling. This programme provided options for completing either a 2-year Foundation Degree or 3-year Honours Degree, suitable for those with only A-level qualifications and no prior field experience. It combined academic study with work-based learning, and graduates could achieve NCAC accreditation upon completing the course and accruing sufficient work
experience.
London South Bank University offered a Master’s degree in Addiction Psychology and Counselling, also providing direct routes to NCAC accreditation for honours degree holders. Unfortunately, both programmes have been discontinued, reflecting
broader trends as UK universities face increasing financial and operational pressure, with specialist programmes requiring clinical supervision often among the first to be cut.
This closure has deprived aspiring addiction counsellors of clear pathways into the field, forcing individuals to first train as general counsellors or psychotherapists before undertaking work-based learning, postgraduate studies, and CPD training to
gain addiction treatment competencies and accreditation.
Alternative Pathways
Undergraduate Foundation: For those enrolling in undergraduate studies, degrees in counselling or counselling and psychology provide suitable first steps. These three-year programmes offer well-rounded preparation, though additional training remains necessary for professional practice.
Postgraduate Studies: Those with counselling degrees can specialise through postgraduate programmes, choosing therapeutic schools that align with their values and intended practice. Entry requirements vary – some programmes accept
graduates from any 2:1 honours degree, while others require relevant degrees or
counselling skills certificates.
Professional Registration: Joining professional bodies as student members early provides access to resources, networking opportunities, and professional development events. Membership can progress from student to practitioner levels as
experience develops.
Addiction-Specific Training: While no dedicated postgraduate addiction counselling courses exist, relevant programmes include CBT diplomas and Master’s degrees, Leeds Beckett University’s Applied Motivational Interviewing Skills course, and DBT diplomas. The University of West London offers individual modules from their BSc in Addiction Studies as CPD courses.
International Options: Given UK limitations, studying abroad presents viable alternatives. The USA offers specialised programmes like those at Hazelden Betty Ford Graduate School, while Ireland’s PCI College provides Master’s courses in
addiction counselling and psychotherapy.
Professional Experience and Accreditation
Working in addiction treatment settings as soon as ready provides invaluable experience and supervision opportunities. Employers in this sector typically understand the limited availability of addiction-specific qualifications and often provide on-the-job training. Access to in-service training and workshops offers addiction-specific CPD opportunities.
NCAC accreditation requires 400 hours of supervised practice, including at least 250 hours working directly with addiction populations. Unlike broader counselling bodies, Addiction Professionals fully recognises practice hours gained in addiction-specific settings, making NCAC accreditation practical for specialists. Full-time addiction counsellors can often achieve accreditation faster than the typical two-year timeframe required by general bodies.
Sustaining Professional Practice
Supervision and Continuing Professional Development form the cornerstones of ethical practice and professional growth. For addiction counsellors, CPD offers pathways to developing vital mental health competencies for truly integrated care. This includes expanding expertise into dual diagnosis, trauma therapy, bereavement counselling, or family interventions. White identifies four essential pillars for sustaining addiction counselling practice: centerung rituals (meditation, reflection, mindfulness), mirroring rituals (peer support and inspiration), acts of self-care (nurturing physical, emotional, and spiritual well- being), and unpaid acts of service (giving back beyond professional duties).
Looking Forward
Despite current challenges, the unique ethos of addiction counselling – rooted in lived experience and informed by deep compassion needed to meet clients in vulnerable moments – remains its defining strength. As the field evolves through this challenging period, preserving that core identity proves essential. The path forward requires patience and purpose: pursuing the highest professional standards whilst nurturing what draws practitioners to this work initially. Ultimately, it’s the whole-self investment-personal as much as professional – that honours the integrity of this vital vocation.
Press Release
CHOICES REHABS SENDS OPEN LETTER TO CHANCELLOR CALLING FOR FAIR TREATMENT UNDER NATIONAL INSURANCE CHANGES
Choices Rehabs, a coalition of independent residential addiction rehabilitation providers across the UK, has written an open letter to the Chancellor in response to the recent National Insurance increase. The letter expresses concern about how the new policy will impact the sustainability of addiction treatment services, many of which are already operating with tight margins.
The letter, sent on behalf of Choices Group, commends the government’s funding commitments to social care and healthcare but requests that addiction rehabilitation providers be treated the same as the NHS and other public sector bodies when it comes to the National Insurance increase.
“While we fully understand the need for fiscal changes, we want to ensure that our ability to provide essential services is not compromised by this policy,” said a spokesperson for Choices Rehabs. “Our services support over 2,300 people each year, and without our intervention, many individuals would likely rely on the already overburdened NHS and public sector.”
As a group of real living wage employers, many of whom are charitable organisations, Choices Rehabs plays a critical role in helping people across the UK recover from addiction and rebuild their lives. However, the financial pressures caused by the National Insurance increase threaten the continuation of vital services.
“Addiction rehabilitation is already a sector that operates on very tight margins, and the new National Insurance changes place significant strain on what we can offer. We are asking the Chancellor to consider the essential role we play in the wider health and social care system and ensure that we are supported in the same way as public bodies,” the letter states.
Choices Rehabs hopes that the government will carefully consider this request and include addiction rehabilitation providers in discussions about the future of health and social care funding.
“We are eager to continue to be a part of the solution to the UK’s addiction crisis, and we hope that the government will recognise the valuable contribution we make,” the spokesperson added.
Choices Rehabs remains committed to supporting individuals on their recovery journeys and is urging the Chancellor to act to ensure these essential services are not lost due to financial constraints.
Press Release
CHOICES REHABS CALLS FOR GOVERNMENT ACTION TO FULFILL RECOMMENDATIONS OF DAME CAROL BLACK REVIEW ON ADDICTION TREATMENT
Choices Rehabs, a group of independent residential detox and rehabilitation centres across the UK, has written to the new Secretary of State for Health and Social Care, urging renewed government commitment to the recommendations of the Dame Carol Black Review. The group represents organisations that together provide treatment for over 2,500 individuals annually, offering over 200,000 bed nights for those in need of residential addiction treatment.
The open letter expresses concern that despite positive steps taken by the previous government, the residential treatment sector continues to face significant underfunding, preventing it from expanding its capacity to meet the growing demand for services. Choices Rehabs calls for increased investment and a more urgent pace in implementing the recommendations of the Dame Carol Black Review, particularly those related to residential rehabilitation and detoxification services.
“Our group plays a critical role in supporting individuals on their journey to recovery, but we are constrained by funding challenges and a lack of sufficient investment in residential treatment,” said a spokesperson for Choices Rehabs. “Despite the encouraging steps outlined in the government’s previous drug strategy, the residential sector remains significantly underfunded, and the targets set by the Dame Carol Black Review remain unmet.”
The letter highlights that, although some additional funding has been provided, it has not been enough to meet the 2% target of drug and alcohol treatment referrals to residential rehabilitation, as recommended by the Review. The Choices Group stresses the importance of residential addiction treatment as a vital part of a blended approach to recovery, which also includes community-based programs.
“We see firsthand the transformative power of residential treatment, not only in helping individuals break free from addiction but also in reducing the burden on other sectors such as the criminal justice system and emergency healthcare services,” the letter states.
The group also emphasises the strain that inflation and the legacy of COVID-19 have placed on the sector, with many residential providers operating on minimal reserves while still delivering life-changing care.
As part of their continued efforts to engage with the government, Choices Rehabs has invited a representative from the Department of Health and Social Care to meet with them, discuss the implementation of the Dame Carol Black Review, and consider further support for the residential treatment sector.
“We would be happy to host a visit to one of our centres, where you can see firsthand the positive impact our work has on the lives of those in recovery,” the letter concludes.