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What is the Minnesota Model

What is the Minnesota Model?

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The Minnesota Model is a treatment method used in many rehabs around the world. It is based on the twelve-step program and philosophy of Alcoholics Anonymous (AA). The 12-Step Model is known as the Minnesota Model because its use originally took hold in Minnesota at the Hazelden Foundation, one of the most renowned addiction treatment pioneers. The twelve-step model is by far the most popular method used globally due to its over-riding success rates. This is beginning to change as a new updated form of treatment, CBT, or Cognitive Behavioral Therapy is now being added. (Note: not usually replaced) CBT is very similar to the 12-Step method addressing impaired thinking and behaviour change. Addicts can use CBT tools to change their self defeating thinking patterns.

The Minnesota model embraces the disease model of addiction

The Minnesota method adheres to the disease model of addiction. The disease model treats addiction as an illness, which is chronic and progressive, with alcohol or drugs as the causal and sometimes medication agent. The inability to control drinking or drug use is seen as a symptom, compulsive behaviour, and complete abstinence from alcohol or drug consumption is the long-term means of managing the illness.

It is worth mentioning at this point that The American Society of Addiction Medicine (ASAM) in 2011 released the new definition of addiction after a four year process involving more than 80 experts, defining addiction as a disease involving many brain functions, mainly an imbalance in the reward circuitry. This creates a problem experiencing pleasure and compels people to seek ways to boost their pleasure related brain chemistry, using substances and in some cases excessive behaviour like food and gambling. In other words they put an official stamp on what AA had been saying for decades.

Don’t let yourself be scared away by old-fashioned terminology

While the Minnesota model embraces the disease model, it also uses the AA old-fashioned terminology, e.g. ‘making amends’, ‘defects of character’, ‘personal inventory’, ‘confessing the nature of our wrongs’ that modern professionals don’t approve of. Additionally, it is thought that recovery only comes with a ‘spiritual awakening’ which is also outside the realms of the many professionals, especially modern psychologists or general counsellors.

The main principals of the 12-Step Program are quite scientific when translated

These recovery support groups were started by two Alcoholics desperate for help having exhausted every possible medical, psychiatric, charitable and religious support offered at the time in 1930’s USA and Europe. They formed what we now know as Alcoholics Anonymous (AA), and it quickly grew internationally, a non-professional self-help group, based on mutual support “one alcoholic can best understand and help another”.

The twelve-step program of AA seems old-fashioned compared to modern forms of psychological interventions. However, the main principals are quite scientific if you investigate them, such as “Powerless” meaning Compulsive or “Unmanageability” meaning Consequences. Even the so-called spiritual aspect can be translated into a form of positive psychology or adopt a spiritual problem-solving style:

This is why social interactions like AA/NA meetings increase the probability of success

Attending the meetings is a rapid way to build a support network, make new friends and deal with loneliness if an issue. Some feel this is a life-support network which is now spread across the globe helping hundreds of millions of people who are trying to break free of many types addictions – not just alcoholism. It is said that social interactions increase the probability of success due to collective emotions, energy and common aims releasing brain chemistry during active engagement meetings, producing feelings of contentment naturally. Analysis has found that by participating in groups, the individual members’ beliefs matched those of their support group possibly similar to a supporter attending his team’s football matches.

Knowledge about addiction is meaningless without the action

We use the term “In Recovery” to identify being abstinent as opposed to being in relapse or active addiction. Most addiction experts agree that it’s a disease of some sort, usually chronic and progressive, so abstinence is the safest way to manage. In 12-Step recovery we understand the paradox that “self-knowledge avails us nothing”. This means no matter how much we learn about addiction theory we still need to commit to treatment and practice basic recovery rituals to stay abstinent, knowledge is meaningless without the action.

Why does AA suggest 90 meetings in 90 days?

We use the term “In Recovery” to identify being abstinent as opposed to being in relapse or active addiction. Most addiction experts agree that it’s a disease of some sort, usually chronic and progressive, so abstinence is the safest way to manage. In 12-Step recovery we understand the paradox that “self-knowledge avails us nothing”. This means no matter how much we learn about addiction theory we still need to commit to treatment and practice basic recovery rituals to stay abstinent, knowledge is meaningless without the action.

Key elements of the 12-Step Program: Why it works

Early days:

You are most at risk of relapse as a newcomer.

Repetition:

Addiction is repeated self destructive behaviour so requires an opposing force.

Discipline:

Most addicts lack discipline and will learn valuable self managing techniques.

Structure:

The most difficult part of change is we tend to revert to what we’ve always done. “The familiar is seductive.” Changing habits is the toughest part of long-term behavioural change. AA is structured to be every bit as habit forming as alcohol.

Being committed:

Being committed a key to succeeding in recovery, “half measures avail us nothing”.

New environment:

To feel safe and confident to open up and share requires familiarity and consistency gained through regular attendance.

Build self-efficacy:

AA gives members constant mutual support to continue their change. In each meeting they get to hear from others who were in their situation and choose sobriety.

Form groups or relationships:

One of the keys behind long-term positive behavioural change is the power of the group. Whether through accountability, responsibility or support, individuals are more likely to continue change within a united context.

Making friends:

You are more likely to make friends and get over trust barriers by intensive participation and are prone to loneliness in early recovery.

Sudden change:

Most addicts and alcoholics have a lot of free time on their hands suddenly and are prone to boredom.

Learning the program:

To adopt a new belief system that will go against the addict’s nature it requires intensive reprogramming so as not to use again.

Helping others:

Even as relative newcomers can help new or old members by reminding them where they came from. We take pride in being able to help others.

It may seem like a lot of meetings and overwhelming to the beginner but think of it as medicine. If you are sick or have any other disease, you take your medication, exercise and eat well; it’s no different for alcoholism and addiction, it’s  a disease, and it’s only 7 hours per week, plus it’s a great time to decompress, think and reflect on what’s happened. One day at a time…and it’s free.

A brief summary of the AA Twelve-Step Program

The Twelve-Step Program: Spiritual but not religious

A spiritual program not religious: One of the biggest blocks for many is the use of the word God in the AA literature, although it’s always qualified with “as we understand him” more recently the word Higher Power (HP) is being used. Taken in its original context, written 80 years ago by recovering alcoholics in America they were only trying to convey the message that much of the solution is best described as spiritual. The reason being is to find and nurture hope, faith and optimism, or a sustainable belief in oneself and a willingness to persevere through uncertainty and setbacks to remain clean and sober. Many do this by accepting a form of what we now call spirituality or psychologists call positive psychology. Developing a sense of meaning and overall purpose is said to be equally important also.

Minnesota Model Principles and Buddhism

I found that the ideas behind the steps have parallels in the Buddhist tradition, and that using the two together brought a deeper experience to my Buddhist tradition, and a more satisfying, integrated understanding to the steps.

– Kevin Griffin (One Breath at a Time: Buddhism and the Twelve Steps)

The Minnesota Model Principles and the 12 Steps are heavily influenced by the Judeo-Christian worldview, but the wisdom of this path is not confined to one religious or philosophical system. The fact that there are so many similarities between Buddhism and the 12 Steps can be viewed as evidence for the universality of this wisdom. There is no conflict or contradiction between Buddhism and the 12 Steps. Instead, the systems complement each other.

12 Steps are an important piece of the jigsaw but not the only one

The founders of Alcoholics Anonymous broke away from the Oxford Group (an evangelical Christian sect) because they realised that their program did not require any specific religious beliefs. This approach to recovery can work for atheists, Muslims, Jews, Christians, Hindus, Jains, and Buddhists. Although it is not a religious program, it is open to people of all religions and non-religions.

Many people find that combining their 12-step work with their religious or philosophical beliefs strengthens their sobriety. This is a sensible approach. The 12 Steps are an important piece of the jigsaw, but it might be a mistake to treat them as the only piece. The Minnesota Model principles are not limited.

Buddhism and God

Buddhism is sometimes referred to as an atheistic religion because followers are not required to believe in a supreme deity. The Buddha did actually talk about gods, but he did not promote the idea of a single creator God. The fact that God is mentioned so often in the Big Book might make it seem as if the 12 Steps are incompatible with Buddhism, but this is not the case. The program only asks that people believe in a God ‘as we understood him’ and Buddhists have no real problem with the idea of a higher power.

Buddhism and the Four Noble Truths

The Buddhist four noble truths would be the equivalent to the 12 steps and these are:

  1. There is suffering

  2. Suffering happens because of craving/desire

  3. There is a way to stop being a slave to craving/desire

  4. The way to stop being a slave to craving/desire is to follow the eightfold path (right understanding, right concentration, right mindfulness, right intention, right action, right livelihood, right view, and right speech)

Buddhist Twelve Steps & Minnesota Model Principles

Step 1

1. We admitted we were powerless over our addiction and our lives had become unmanageable

Buddhism: We came to see how delusions of the mind and craving was the source of our suffering

Step 2

2. We came to believe that a power greater than ourselves could restore us to sanity

Buddhism: We came to see how much of our sense of self is a kind of delusion but that a power outside of this sense of self could end our suffering

Step 3

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

Buddhism: we took refuge in a power beyond the delusions of self

Step 4

4. Made a searching and fearless moral inventory of ourselves.

Buddhism: we gained a better understanding of how we suffer due to delusions of the mind and karma

Step 5

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs

Buddhism: we practiced right speech and committed to a more honest way of living

Step 6

6. Were entirely ready to have God remove all these defects of character

Buddhism: We committed to a practice that would allow us to develop insights and mindfulness

Step 7

7. Humbly asked Him to remove our shortcomings.

Buddhism: With the help of our teachers and peers, we began the work needed to end our suffering

Step 8

8. Made a list of all persons we had harmed, and became willing to make amends to them all

Buddhism: We experienced insights into how our past actions caused suffering for other people

Step 9

9. Made direct amends to such people wherever possible, except when to do so would injure them or others

Buddhism: We developed compassion for the people we had hurt and we made amends for past misdeeds where appropriate

Step 10

10. Continued to take personal inventory, and when we were wrong, promptly admitted it

Buddhism: We continued to be mindful of our thoughts, emotions, and behaviour and made a commitment to more skilful action in the future

Step 11

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

Buddhism: Continued our mindfulness practice to gain insights and escape suffering

Step 12

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Buddhism and Minnesota Model Principles: We used the spiritual insights gained from mindfulness to benefit our own lives and the lives of other people.

At Hope we combine different models of recovery to give a varied and effective treatment plan. To reach out for help with your addiction. Contact us now.

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