Historical Addiction Counseling

White, W. (2004). The historical essence of addiction counseling.
Counselor, 5(3), 43-48.
The Historical Essence of Addiction Counseling
William L. White, MA
What distinguishes the profession of addiction counseling from the array of helping roles that have preceded and have followed it? What would be lost if the specialized knowledge and functions performed by the addiction counselor disappeared? This essay will explore these questions by attempting to define the historical essence of addiction counseling. The distinctiveness of this role lies in the unique way alcohol and other drug
(AOD) problems and their solutions have been defined within the addictions field. It also lies in nuanced views of the addiction counselor’s relationship
If these core understandings are ever lost, the essence of addiction counseling will have died even if the title and its institutional trappings survive. We must be cautious in our emulation of other helping professions. We must not forget that the failure of these professions to adequately understand and treat addiction constituted the germinating soil of addiction counseling as a specialized profession.
Use of Self
Virtually all of the helping professions speak of the “use of self” in the helping process, but addiction counseling brought many unique dimensions to this process. First, the addictions field is the source of the very concept of “wounded healer”—the idea that experiencing and overcoming an affliction bestows certain powers to understand and heal others similarly afflicted (White, 2000). The wounded healer tradition in addiction counseling begins with the abstinence-based, Native American cultural
To witness (and be present within) that process of transformation is the most sacred thing in the field, and what would most need to be rediscovered if the field collapsed today. The history of addiction counseling can be divided into two eras: the discovery of commonalities and the discovery of differences. In the first era, the field catalogued what people with alcohol and drug problems shared in common and through that process defined addiction and its diagnostic criteria. The common needs and change processes of people seeking to resolve these problems further led to clinical protocol that addressed these common needs and facilitated those change processes. The second era was marked by the recognition of differences—different patterns of AOD use, different etiological pathways to problem development, differential responses to treatment interventions, and multiple long-term pathways and styles of recovery. We are today in transition from herding clients through
“programs” to the recognition of “special populations” (demographic, cultural, and clinical subpopulations) to the development of highly individualized approaches to clients within these subpopulations.