This study explores the impact of perceptions of shame on counseling in alcohol and other drug (AOD) settings. While some recent research points to the potential treatment barriers that result from discrimination against AOD clients by health care professionals, there is a dearth of research on the impact of shame and stigma on the work of allied health professionals. The qualitative data presented here are drawn from 17 in-depth interviews with counselors and AOD workers based in New South Wales, Australia. The article focuses on the professional tensions arising in managing stigma, alongside the alienating and isolating manifestations of shame, by exploring three themes: (a) the application of negative labels such as “addicts” and “junkies,” (b) the stigmatization of AOD settings, and (c) the impact of labeling and stigmatization on service provision. These findings point to the potential treatment barriers of stigma when counselling clients in AOD settings.
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