ABSTRACT
This chapter focuses on some of the numerous controversies surrounding the Twelve Step phenomenon. Controversies include the debate about whether addiction or substance use disorder is a disease. A historically and cross-culturally informed account of medicine would properly highlight the fragility of constituting addiction entirely in secular terms, evacuated of all relationship with human knowledge structured by religious or spiritual epistemologies. Christine Le explores features of addictions counselling philosophy, drawing on person-centred, humanistic, analytical, neo-Freudian, existential, Gestalt, rational-emotive and cognitive approaches, and concluded that, despite differences, central to them all was the facilitation of change, growth and development of the individual, emphasising self-direction, self-efficacy and empowerment. Counselling is undertaken by trained professionals. Whilst contemporary counselling models commonly assign expertise, along with agency of change, to the client, a helper-helped differential inevitably still operates, and the counsellor is the 'professional' and sometimes even the 'expert' in the room.
