Practice (Reading, translation, speaking)
The Evolution of Addiction Counseling
In the early 1900s, Courtenay Baylor was the first lay ther-
apist hired at a treatment clinic (Hagedorn, Culbreth, &
Cashwell, 2012). A lay therapist was a volunteer not spe-
cifically trained in addiction psychology but willing to help
individuals who struggled with it. During the 1950s, these
lay therapists became known as paraprofessional helpers
because they were not licensed but still assisted those in
the community with addictions, actively participated with
groups such as Alcoholics Anonymous, and utilized cer-
tain therapeutic models (White, 1998). The 1950s also saw
the emergence of the Minnesota Model, now known as the
Hazelden model, which is a treatment model that includes
total abstinence from all substances, although it does mir-
ror the 12 steps of Alcoholics Anonymous (Smith & Gar-
cia, 2013). The Hazelden model emphasized surrounding
addicts with a community, thereby allowing them to help
one another, and treating addicts holistically and with dig-
nity. This was a departure from the view that addicts were
morally weak or mentally ill and could only be housed in
jails or mental wards.
The 1960s precipitated this medicalization of addiction. The American Medical Association (AMA) developed the definition of the disease concept of addiction, which rests on the idea that addiction resembles a medical illness that causes distress and discomfort to an individual and should be treated and monitored rather than behavior that one can control. E. M. Jellinek provided the first clear explanation of alcoholism and its five phases in his book The Disease Concept of Alcoholism (1960).
These phases were formulated in letters of the Greek alphabet—alpha, beta, gamma,
delta, and epsilon. He later organized the Greek letters into a cluster of three stages of alcoholism: early, middle, and late stages (Faulkner, 2013). The Jellinek Curve helps counselors anticipate changes in an individual’s use and recover.