Revisiting the Work of William White: The Historical Essence of Addiction Counseling (2004)

“What the addiction counselor knows that other service professionals do not is the very soul of the addicted—their terrifying fear of insanity, the shame of their wretchedness, their guilt over drug-induced sins of omission and commission, their desperate struggle to sustain their personhood, their need to avoid the psychological and social taint of addiction, and their hypervigilant search for the slightest trace of condescension, contempt or hostility in the posture, eyes or voice of the professed helper.” – William White: The Historical Essence of Addiction Counseling

Historical Essence of Addiction Counseling was a nine-paper written by William White and published in Counselor magazine in 2004. A key point is the grounding of addiction counseling both within an awareness of self and also beyond self within the context of family, community and across other service professions. The paper is broken out into five sections following an opening paragraph, Theoretical Foundation, Use of Self, Relationship with Clients, Relationship with other Professionals, Relationship with Community and closing with a section titled Pace Yourself: It’s a Marathon.

For readers, it is important to understand the context of the era this paper was published in. It was written in a time when a much higher percentage of addictions counselors across the nation were in recovery. They frequently came into the field as lay professionals who then over time garnered academic education secondary to a credentialing processes developed by and for communities of recovery. Processes that were more open than our current era for people in recovery to get into the field beyond academic focused pathways. The era preceded the development of community-based recovery-oriented services in the peer support model. There were few recognized pathways of recovery beyond faith based, 12 step mutual aid and medication assisted treatment, which was limited to methadone.

Key Figures Referenced in William White’s Paper on the Essence of Addiction Counseling

White referenced Courtenay Baylor, the very first paid professional addiction counselor. Baylor wrote a book titled “Remaking A Man One Successful Method of Mental Refitting” in 1919 and the link is a full text PDF of his work. It is a fascinating examination of the complexity of addictions, its impact on volition and efforts to help people change through the establishment of a therapeutic alliance. Baylor’s book still seems quite relevant. The very first addiction counselor’s words ring true, at least for me over 100 years later when he writes:

“As I always explain to the patient, I want him to learn and to accept for himself and to be able to apply to himself all that this treatment teaches. I can help him while he is with me, but I can only see him in half-hour periods for a limited number of meetings. He is with himself twenty-four hours a day, and my aim is to help him to help himself that his reconstruction will be permanent.”

As White so eloquently describes in his recognition of Baylor as a pioneering healer grounded in lived experience, we are part of a long tradition. When we consider our origins, one can both appreciate the contributions of advocates long lost in time but also experience profound humility as we see that they grappled with the very same kinds of things that we do now in our own times. We cannot be separated from our own history, even when we fail to understand it.

White also referenced Matt Rose in the paper. Rose was a key figure in the origin story of National Association of Alcoholism and Drug Abuse Counselors (NAADAC). As described by a paper highlighting White’s writings by Jessica Gleason, NAADAC Director of Communications in 2014, Rose helped form the National Association of Alcoholism Counselors and Trainers (NAACT) in 1972. He was its first executive director. These were the seeds of the National Association of Alcoholism Counselors (NAAC), which over time became NAADAC. In the Essence paper, White notes that what Rose deeply understood was that recovery was primarily nestled in community. Rose knew that what needed to be built was not solely the institutions of addiction treatment or even a body of credentialing for counselors but more importantly on building and expanding cultures of recovery. Community with which the addiction counselor served more as a guide to connect people. A process unique to addiction counseling not present in other forms of clinical disciplines.

The two concepts White highlighted by elevating two key figures in our own history are first, that we have a great deal in common with those who walked our road ahead of us, and that we should be humble in respect to our efforts. We have much to learn from our own history, both in respect to our successes and our failures. Efforts to connect people to the healing processes within the community are central to our field in ways we can ill afford to forget.

Theoretical Foundations:

White lists four defining premises of addiction counseling which I have paraphrased for simplicity but are well worth reading from the original as he had written them:

1. Addiction is a primary condition and not a superficial symptom of some other condition or conditions.
2. Resolution of life problems associated with addiction can only be resolved within the framework of recovery initiation and maintenance. (the emphasis here is perhaps on addiction and not a less severe substance related condition which may be more responsive to non-recovery associated strategies).
3. Those with the most severe substance use conditions who have low recovery capital are most often not able to get better without professional assistance.
4. Our institutions are best served by having professionals who have deep knowledge and expertise in facilitating recovery from all physical, psychological, sociocultural and often spiritual components that accompany addiction.

Key Concepts with Roots in the Tradition of Addictions Counseling

Another thing that White does in this paper is to highlight the essence of addiction counseling and relation to broader efforts. I found several key points he made in this respect:

1. White noted that the very origin of the field rests on the historic failure of other fields of endeavor to effectively address addiction and both its consequences to our society and the value of a focus on recovery. Strategies focused on solving a parental complex or historic trauma that inevitably fail without a focus on healing from the addiction itself, a whole person process. This point may be best reflected in a quote on page two of the paper “All that you have been and will be flows from the problem of addiction and how you respond or fail to respond to it.”
2. Central to the paper is that our profession has risen out of widespread contempt for people with substance use conditions that exist across other helping professions. “(Persons with addiction) have not fared well in service relationships in which they sense an air of moral superiority. What the role of addiction counselor brought, at its best, was a capacity for acceptance and a willingness for being with, rather than doing to or for.” He holds up the capacity of the addiction counselor to see beyond the challenges and the armor that often accompanies addiction to see the inherent value of the human within.
3. The paper describes how the very origins of concepts of wounded healers came from addictions counseling and the traditions of the use of self in efforts to help another person. These practices go back farther than the foundation of our nation and came out of Native American communities. Helping another heal is also strongly associated with the profession in the context of a calling rather than a job and how this is grounded in shared experience as he highlighted through the writings of his mentor, historian Ernie Kurtz.
4. White described forces beyond the therapeutic relationship with greater impact on the outcome than the therapy itself. A recognition perhaps unique to addiction counseling grounded in humility. Transformative change associated with paradox such as surrendering to overcome, the formation of healing narratives and the role of external relationships in change as part of our essence. Perhaps best described as he wrote: “While seasoned addiction counselors muster the best science-based interventions, they do so with an awareness that recovery often comes from forces and relationships outside the client and outside the therapeutic relationship. It is in this perspective that the addiction counselor sees himself or herself as much a witness of this recovery process as its facilitator.”

Other Facets Important to Our Evolution:

• White wrote about the eras of our development initiating with a focus on our commonality and the sharing of information and processes that highlighted common ground in respect to addiction and recovery. As we matured as a field we then moved to the recognition of special populations and a focus on highly individualized interventional strategies and diverse pathways of recovery. Underpinning all the theory and technique is that addiction counseling remains a unique encounter.
• The importance of ethical grounding in our field from which we have borrowed heavily from other disciplines in order to prevent harm in the name of help.
• The recognition of the vital role of intergenerational mentoring has in the transmission of the requisite knowledge, skills and attitudes to be effective as a change agent within the role of addictions counseling. Mentoring of newer counselors has historically been viewed as an essential responsibility of our field in a paying it forward tradition.  

At the end of the paper, White described a generation ago the lost dimension of activism in the context of the criminalization of addiction and the need to consider and advocate for broader dimensions of healing with an emphasis on our most vulnerable populations, such as our youth. History since then has perhaps shown us that the kind of loss of connection of the addiction counseling field that was occurring in that era are important to heed. Activism to broaden healing efforts foundational to our future.

Our Field as a Marathon and Not a Sprint                

In several places in the paper but most fully at the very end, White recognizes that one of the inherent strengths that characterize the profession of addiction counseling is our capacity to absorb profound loss and sustain resiliency within ourselves and to model resiliency as foundational for those we serve. He listed four core rituals which also were highlighted in our piece, We Need More Recovery Custodians and Fewer Recovery Rock Stars which focused more on public personas with similar self-care needs. These are 1) centering rituals (acts of prayer, meditation, self-reflection) that help keep one’s “eyes on the prize,” 2) mirroring rituals (reaching out to kindred spirits for support and inspiration), 3) acts of selfcare (taking care of oneself and one’s intimate circle physically, emotionally and spiritually), and 4) unpaid acts of service (reaching out to others outside the context of our professional duties in ways that elevate our spirits). Rituals vital to our capacity to serve in ways in which we remain vital over the long term.

The paper ends with the recognition that there is inevitable homogenization in human service associated disciplines but consider the distinguishing essence of addiction counseling as worth guarding into the future. He wrote the paper 21 years ago. What has held true over that era, what have we lost or failed to recall or even that which as a result of improved insight that can be dispensed with as a result of time and deeper insight?

Questions to consider:

• Do we still see addiction as a primary condition requiring a specialized focus for healing?
• Do we consider addiction counseling as a discipline distinctly separate from other helping disciplines? If so, does his 2004 paper accurately describe our essence in our own era? If not, what do we see as that essence now?
• Do we still consider that addiction is not something that can be resolved by addressing underlying conditions? If so, why? If not, what has changed in our fundamental understanding of addiction and its resolution?
• How has the rise of peer services, which may now be seen as the domain for lived experience impacted the essence of the field? Has addiction counseling become more academic in scope? If so, is this a positive development?
• Do we see the role and function of addictions counselors as a guide and connector to recovery community in the same way that White described in 2004? If not, how has it changed?
• The notion that people we support can be highly sensitive to contempt from other helping disciplines, had this changed? If so, how so?
• If there is an essence to addiction counseling, how are we transmitting that knowledge intergenerationally? Are there things we should be doing that we are not doing as effectively as we should?

One additional note for readers, I would strongly encourage everyone to read William White’s original paper and not just what I have written about it here. It should be read in the context of his larger body of work, a contribution to what we now know about our own field that is immeasurable. Beyond that, papers such as the one I am revisiting here afford us the opportunity to consider our field in the context of our time and consider how it has changed and to allow us the capacity to better inform strategies moving forward. This final point is perhaps the most important of all.

Sources

Baylor, C. (2019). Remaking A Man One Successful Method of Mental Refitting. Retrieved February 21, 2025, from https://www.cmia32.org/archives/publications/books/Remaking-A-Man.pdf

“Bob K.” (2021, April 25). Courtenay Baylor | AA Agnostica. https://aaagnostica.org/2021/04/25/courtenay-baylor/

Coyhis, D., & White, W. (2002). Addiction and Recovery in Native America: Lost History. Enduring Lessons. Counselor, 3(5), 16–20. https://www.chestnut.org/resources/c046f0b2-ef0f-471d-b48e-13fe70d620cc/2002AddictionRecoveryinNativeAmerica.pdf

Gleason, J. (2014). NAADAC’s Critical Role in the Development of a Profession: 40 Years of Achievement A Compilation of Summaries and Excerpts from William White’s new book, The History of Addiction Counseling in the United States.  NAADAC. https://www.naadac.org/assets/2416/aa&r_fall2014_naadacs_critical_role_in_the_development_of_a_profession_40_years_of_achievement.pdf

White, W. (2004). The historical essence of addiction counseling. Counselor. 5(3), 43–48. https://www.chestnut.org/Resources/74e59619-87e3-4d78-a412-7e0e8f2fce8a/2004HistoricalEssenceofAddictionCounseling.pdf

White, W., Stauffer, W. (2020.). We Need More Recovery Custodians and Fewer Recovery Rock Stars. Chestnut Health Systems. https://www.chestnut.org/Blog/Posts/346/William-White/2020/5/We-Need-More-Recovery-Custodians-and-Fewer-Recovery-Rock-Stars-Bill-Stauffer-and-Bill-White/blog-post/