Beginnings of the Minnesota Model
Hazelden was one of the three organizations that contributed to developing the Minnesota Model in the 1940’s. In 1949 it became one of the most internationally prestigious treatment and addiction research centres and continues to be seen this way..
Recently Hazelden and the Betty Ford Foundation merged, uniting their knowledge and expertise.
As a treatment centre, Hazelden helps people and their families who are affected by addictions to alcohol, drugs and compulsive behaviours, as well as other mental illnesses in the case of dual disorder patients. In addition, Hazelden is well known for excellence in providing continuing professional development and training for therapists who wish to specialise in addiction treatment, integrating the latest developments from the medical, psychological and psychiatric facets in the field of addiction.
In addition to the above, Hazelden also produces publications of resources on addiction including research and a range of studies by numerous well-respected authors and experts in the field of addictions.
THE PRINCIPLES THAT INSPIRE THE MINNESOTA MODEL:
- A comprehensive, personalised treatment of the addict.
- The dignified and respectful treatment of the patient.
- Regular attendance by the patient to Twelve Step groups as a key element to continue a life free from the use of addictive substances or behaviours.
- The vocation of service to the patient, family and society as a whole.
- Adopting an open stance and integrating all scientific advances and studies generated in the field of addictions.
This last principle is that which allows the Minnesota Model to constantly evolve and incorporate all medical, psychological and pharmaceutical advances, which have been demonstrated to be effective in addiction treatment and that are based on scientific evidence.
Basically this is the combined application of cognitive-behavioural and motivational therapies. In particular, Prochaska and Di Clemente’s Phases of Change and Miller and Rollnick’s Motivational Interviews are widely applied in the model.
Efficacy of the Minnesota Model
The reason for implementing this treatment model in our country is fundamentally based on a strict criteria for efficacy. With some variations, the Minnesota Model is a model which has been used with great success in the public and private health care systems of a range of countries such as the United States, Australia, the United Kingdom, Ireland, Portugal and Holland.
The efficacy of this model is supported by a range of studies carried out in the field of addiction. In particular, the model is endorsed by the MATCH Project (PDF), one of the largest studies ever conducted in the field over an eight-year period, which was supported by the North American National Institute of Alcohol Abuse and Alcoholism and various other institutions, including Hazelden, in the United States.
Over the eight-year period a large number of patients were assigned to one of three types of treatments used for addictions. These were cognitive behavioural therapies, motivational therapy and the Twelve Steps of Alcoholics Anonymous. All these treatments showed a similar efficacy during the first year, but in the long term the treatment centres that used the Twelve Step programme achieved a higher percentage of clean days in patients in recovery.
Previous studies have supported essential aspects of the MATCH Project, adding that the combination of a wide range of therapies can give more effective treatment results. The Hazelden Model is characterised by its inclusive nature with regard to different therapies, and has become one of the most effective addiction treatment models.
Several posterior studies confirm, build on and validate these results:
A follow up study of patients from the MATCH Project revealed that it is possible to predict the number of days a patient may take to relapse, taking two variables into account: temptation and self-efficacy.
Another model is the Social Identity Model Of Recovery (SIMOR), where recovery is addressed as a process of social identity transition.
The MAAEZ (Make AA Easier) programme measures the impact of recovery groups and their participants from the start of treatment until 12 months have gone by. The best results were seen in those individuals who consistently attended groups and found a sponsor (Read more about Sponsors→).
There have also been comparisons between recovery with and without a spiritual element.
Read more in the Journal of Substance Use & Misuse →
About the Minnesota Model
The focus of the Minnesota Model is characterised as being an integral and interdisciplinary approach to addiction and aims at complete abstinence from all substances which can affect the state of mind of the patient who wishes to recover. It is based on a combination of the Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Twelve Step programme, applied alongside the latest medical, psychological, psychiatric and pharmacological advances which develop in the field of addiction.
The so-called ‘Minnesota Experience’ was born from new and important concepts, creating a philosophy of intervention that was radical and controversial for that time. The treatment model is intensive and stands at the forefront of current knowledge for the treatment of all types of addictive diseases. It means the patient does not have to disconnect completely from their environment, and facilitates their early reintegration back into their normal activities in a relatively short timeframe. These characteristics in particular are extremely beneficial, both for the individual, their family and society.
One of the key ideas around which the model revolves is the concept of addiction as a disease – the so called ‘disease model’ – and not as a moral or personal deficiency in the addict. However, this concept of alcoholism as a disease is not new. At the end of the 18th century it was viewed as such by Benjamin Rush, the father of American psychiatry.
In this model the concept of disease can be defended both from a logical and therapeutic perspective, since the anatomy of the addict can be compared with that of other diseases in the classic sense of the word. In addition, dependence on chemical substances is seen as an illness and makes clinical sense: it supports humanitarian treatment for addicts, improves access to treatment and promotes complete abstinence from all chemical substances.
Although initially the model tried to treat the addiction and then address any additional mental illnesses the current treatment model simultaneously addresses these problems. On the other hand, the model recognises that the consequences associated with addiction affect all areas of the addict’s life, these being of a physical, mental, social and spiritual nature. With regard to the latter, the model focuses on spiritual growth, individual’s dignity and advocates the concept of a chronic illness, with no known cure, requiring continuous care in recovery.
The model aims to achieve objectives which include a comprehensive recovery of the addict and reintegration back into society through a dignified treatment that favours recovery. At the core of the treatment is the change in lifestyle. Recovery is facilitated with support from the addict’s natural environment, which is the family, friends and self help groups, which the addict should use permanently.
The model aims to achieve two long-term goals, on the one hand, complete abstinence from drugs, and on the other to achieve a better quality of life.
To achieve these long-term goals, short-term goals are used which are to help the addict and their family recognise the disease and the associated consequences.