>Therefore individuals aren't responsible and should not be coached to make different choices.
No that's not the point either. Most people do make their own choices, but the ways in which they come to those choices are influenced by their past experiences. Past experience can have a drastic effect on the choices you make in the future. Abuse/neglect/malnourishment during childhood and/or traumatic brain injury can have profound effects on someone's decision-making abilities later in life.
People should be held accountable for their poor choices, but with the understanding that not all lives have had equal opportunity, and there needs to be actual coaching available, not a bunch of finger wagging. Simply telling someone what's wrong with their life is that they "buy too many lotto tickets" is likely ignorant of the actual underlying problems that person may be facing or had to deal with in the past.