TPC-Journal-V2-Issue2

The Professional Counselor \Volume 2, Issue 2 125 National Opinion Research Council [NORC], 1999; Young, 1999). In fact, when one tallies the estimated costs and losses attributed to addictive disorders in the form of health care costs, job productivity losses, crime and punishment, mental health care, impacts on the children and partners of addicts, and monies spent on the pursuit of drugs, alcohol, and other behaviors, one conservative estimate puts the annual total at $1.1 trillion dollars (Juhnke & Hagedorn, 2006). Without a group of specially trained counselors, untreated addictive disorders will continue to perpetuate costs that many are unable to pay. Those individuals who emerged to address the aforementioned concerns did not initially matriculate from graduate programs in the helping professions. In fact, no other counseling specialty has been more closely associated with its “recovering” clients than has the addiction field. The origins of addiction treatment come straight from what is referred to as the “lay therapy” movement of the early 1900s (White, 1999). Courtenay Baylor is considered by many to be the first lay therapist to be hired at the treatment clinic in which he was originally a client. His approach to developing a cadre of addiction treatment providers from individuals who had participated in the treatment process became the norm well into the 20 th century and laid the groundwork for the concept of wounded healers (Jung, 1993; White 2000b). The wounded healer approach became a much stronger influence with the development of Alcoholics Anonymous in the 1930s. Many members of AA began developing clubhouses, “retreats” (known as halfway houses today), and treatment centers (White & Kurtz, 2008). Much of the motivation of AA members providing such services for alcoholics resulted from a general negligence toward these individuals by the medical and mental health communities (AA, 1976). By 1950, paraprofessional helpers/lay therapists were firmly entrenched in the community of addiction treatment, with the pre-eminent model of treatment, the Minnesota Model, drawing heavily on professionals with no formal training in the helping professions (Fisher & Harrison, 2009; Libretto, Weil, Nemes, Copland-Linger, & Johansson, 2004). Following the adoption of the American Medical Association’s disease concept of addiction in 1967 (Merta, 2001), the latter half of the 20 th century produced several additional steps in the treatment process for addicted clients. Formalized training programs were created by both the National Institute for Alcoholism and Alcohol Abuse (NIAAA) and the National Institute for Drug Abuse (NIDA) in the 1970s to create a group of professionals to work with addicted clients using the disease concept, in conjunction with the Minnesota Model, as the primary treatment approach (White, 2000a). Then, during the 1980s, a shift occurred where formally educated and trained professionals began entering the treatment realm, especially from the field of counseling. These individuals stood by their education and training, rather than their recovery status, as the basis for legitimately providing treatment (Hosie, West, & Mackey, 1988). What emerged was a blending of three distinct groups: minimally-educated paraprofessional helpers (with recovery as their entry point into the treatment community), master’s level counselors (without recovery status as their entry point), and a hybrid of the two: master’s level recovering counselors (Culbreth, 2000). The intersection of helpers entering the treatment arena from these three different perspectives, each with varying levels of experiences related to addiction, led to debates regarding what type of helper was best suited to work effectively with addicted clients—lay or professional helpers. More recently, important developments in addiction treatment have evolved. For example, new treatment paradigms such as harm reduction and relapse prevention examine addiction from perspectives different from those perpetuated by earlier models (e.g., reducing negative impacts rather than solely focusing on abstinence) (Fisher & Harrison, 2009). Similarly, considering the challenges involved with the change process, Prochaska, DiClemente, and Norcross (1992) developed a stage model (the transtheoretical model of change) to examine the processes that occur in clients’ behaviors as they enter recovery while offering suggested strategies aimed at counseling them within and through each stage. Then, motivational interviewing was developed to help explore and resolve the ambivalence and resistance experienced by those entering recovery (Miller & Rollnick, 2002). Another major development, that of viewing addiction through the lens of dual diagnosis (or co-occurring disorders) has been a significant step in addressing clients with multiple mental health issues and needs. More recently, the recognition of a variety of process addictions (addictions to such things as sex, gambling, the Internet and gaming) has taken the concept of addiction to a different level, beyond the traditional scope of chemicals. Finally, there have been significant advances in psychopharmacological approaches to addiction, along with manualized treatment approaches from specific theoretical perspectives, such as Project MATCH (Merta, 2001). All of the aforementioned developments have led to the need for a much higher level of training and education for professionals intent on working with addicted individuals. Relying solely on one’s recovery status can no longer adequately prepare a counselor to address the myriad of complex issues brought forward by today’s clients. 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