The Historical Essence of Addiction Counseling

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The Historical Essence of Addiction Counseling

• William L. White
• Chestnut Health Systems

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Presentation Goals

• What distinguishes the profession of addiction
  counseling from other helping professions?
• Kinetic ideas regarding AOD problems
• Use of Self
• Relationships with Clients
• Professional Peer Relationships
• Relationships to Community

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Theoretical Foundation

• Five kinetic ideas
• 1. Severe and Persistent AOD problems constitute
  a PRIMARY disorder
• 2. The multiple problems experienced by those
  with this disorder are best resolved through a
  framework of recovery initiation and maintenance

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Kinetic Ideas

• 3. Addiction counseling for individuals with high
  problem severity/complexity and low recovery
  capital increases the prognosis for long-term
  recovery.
• 4. That treatment is best provided by individuals
  with knowledge expertise in facilitating the
  physical, psychological, cultural and spiritual
  journey from addiction to recovery.

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Kinetic Ideas

• 5. Is the addicted person viewed as Dr. Jekyll or
  Mr. Hyde?
• --Mr. Hyde Real person revealed by
  intoxication and disinhibition addiction is the
  revelation of badness
• --Dr. Jekyll Real person is the sober self
  addiction is about goodness corrupted by sickness
  

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Use of Self

• Wounded Healer Tradition
• They were not alcoholic, but they did have
  something in common each in his or her own
  way...had been emptied out.Each had encountered
  and survived tragedy. --Kurtz, 1996
• Openness to calling

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Use of Self

• Use of our Whole Person
• --greater appreciation of mutual vulnerability
• --greater use of self-disclosure, e.g., Baylors
  reciprocal confidentiality
• --combined with expectation for detachment
  objectivity

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Use of Self

• Hope
• --a dimension of all helping professions
• --Addiction counseling unique in use of self as
  living proof of such hope and/or ability to
  link clients to communities of recovering
  people.

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Use of Self

• Capacity to absorb loss
• --Use of losses to heighten understanding of
  addiction
• --Use of losses as opportunities for
  re-commitment
• --Awareness of the high stakes involved in our
  work brings unique rewards and burdens

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Relationship with Clients

• A history of contempt from other professions
• Empathic identification alliance
• --Being with rather than doing to or for
• Moral equality emotional authenticity

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Relationships with Clients

• Respect for Transformative Change
• Respect for the power of catalytic metaphors
• Teaching recovery self-management
• --students versus patients

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Professional Peer Relationships

• Inter-professional Collaboration
• --Francis Chambers (1935) Dr. Edward Strecker
• --Principles of collaboration
• --Boundaries of competence
• --Mutual respect
• Intra-professional Collaboration
• --Baylors model of mentoring

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Relationship to Community

• Matt Rose
• --OEO National Association of Alcoholism
  Counselors and Trainers (1972)
• Recovery and Community
• Lost Rediscovered Activism

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Future of Addiction Counseling

• Threats to Addiction Treatment Field to Role of
  Addiction Counselor
• --restigmatization, demedicalization,
  recriminalization
• --Colonization and loss of core values core
  clinical technology
• --New role of recovery coach

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Future of Addiction Counseling

• Aging of Field
• Age as vulnerability (problems of leadership
  development/succession
• Age is opportunity (power of a volunteer force)
• In search of a new generation of addiction
  counselors

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The Future of Addiction Counseling

• Opportunities
• --Renewal movement
• --New breakthroughs in knowledge technology
• Sacredness of our role
• Essence worth cherishing protecting

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Closing

• What we are responsible for is creating a milieu
  of opportunity, choice and hope. What happens
  with that opportunity is up to those we serve.
  We can own neither the addiction nor the
  recovery, only the clarity of the presented
  choice, the best clinical technology we can
  muster, and our faith in the potential for human
  rebirth. White, 1998