| The Minnesota Model is described by McElrath in | | | | pervasive pattern of instability of interpersonal |
| 1997 as being "inextricably interwoven with the | | | | relationships, self-image, and affect along with |
| program, practice and philosophy of Alcoholics | | | | impulsivity. About 40% of chemically dependent |
| Anonymous (AA)". The AA movement conferred | | | | subjects are also diagnosed with BPD. Those with |
| the belief that alcoholism is a physical, mental and | | | | BPD seem especially prone to the use of |
| spiritual illness and developed the Twelve Steps, | | | | substances in order to cope with unwanted |
| which outline a spiritual solution, and the concept | | | | affective states. |
| of a fellowship where recovery can take place. | | | | The frequent co-occurrence of addiction with |
| The Hazelden Foundation was established in 1949 | | | | other mental health problems is of relevance and |
| as an environment in which respect, understanding | | | | importance to chemical dependency (CD) |
| and acceptance of the dignity of each patient was | | | | counseling. For example, patients with BPD are |
| promoted. The belief developed that time spent in | | | | likely to evoke strong and often negative |
| association with other alcoholics, talking with one | | | | responses among CD professionals. There is a risk |
| another and sharing life experiences, was central | | | | that patients presenting with symptoms of BPD |
| to recovery. Alcoholism was conceptualized within | | | | may be negatively stereotyped and treated |
| the disease model as a complex, existential | | | | inappropriately. There may be the tendency for |
| condition of "dis-ease", which could be relieved by | | | | staff to describe the patient in vivid and dramatic |
| sharing experiences. Furthermore, there was a | | | | terms that can set negative expectations even |
| fundamental belief that addicts have an inherent | | | | before the patient arrives on the treatment unit. |
| ability to change their beliefs, attitudes and | | | | There may be a tendency to react to |
| behaviors to restore health. | | | | self-harming or suicidal acts with horror and/or |
| Two long-term treatment goals of the Minnesota | | | | anger. The CD counselor needs to understand this |
| Model are total abstinence from all mood-altering | | | | behavior in the context of the patient's underlying |
| substances and an improved quality of life. | | | | pain and distress and their inability to express or |
| Consistent with the philosophy of AA, the | | | | process those feelings. Counselors need to be |
| objectives for the individual are to grow in | | | | educated to understand the etiology and |
| transcendental, spiritual awareness, to recognize | | | | manifestations of disorders such as BPD in order |
| personal choice and responsibility, and to develop | | | | to appreciate the worldview of patients with dual |
| peer relationships. The resources for recovery, | | | | disorders and enhance empathy and respect |
| then, lie primarily within the addict with treatment | | | | shown all patients. |
| providing the opportunity to discover and use | | | | Thus, while the Minnesota model has become |
| those resources and the therapeutic atmosphere | | | | recognized as the gold standard of chemical |
| conducive to change. This approach is by nature | | | | dependency residential care across North |
| client-centered. | | | | America, it has some inherent limitations. The |
| Much of the work done by clients toward | | | | disease concept, while introducing scientific rigor |
| achieving those goals is done within the context | | | | and a conceptual framework for conducting |
| of group therapy. Engaging with counselors and | | | | research and assigning treatment, is limited by the |
| members of the peer group, the alcoholic / addict | | | | tendency to label clients as 'sick', risking breeding |
| is encouraged to develop meaningful relationship | | | | stereotypical views and treatment approaches by |
| experiences and clarify feelings and definitions of | | | | clinical staff. Viewing the problem as being the |
| reality. Success of the process is characterized by | | | | 'disease' tends to shift the focus from the |
| relief, peace, increased sense of self worth, | | | | individual, manifested within the model by the |
| acceptance by self and the group, and the | | | | tendancy to conduct group therapy to the |
| existential restoration of meaning to life. | | | | relative exclusion of individual attention and |
| The success of the Minnesota Model stems from | | | | therapy. |
| it addressing the fundamental existential issues of | | | | The next generation of addiction treatment must |
| addiction. Common to AA, it is rooted in existential | | | | be more holistic in nature, addressing the whole |
| philosophy and incorporates a treatment | | | | person as an individual with a problem, rather vice |
| philosophy and treatment approach that | | | | versa. The potential for sterile, text book |
| addresses the core issues of addiction. This | | | | approaches to diagnosis and treatment must be |
| existential philosophy allows for a caring, nurturing, | | | | tempered with compassion, accurate empathy, |
| client-centered environment where the Twelve | | | | behavioral modification, growth of interpersonal |
| Steps provide direction and patients suffering | | | | relationships, and spiritual development. It is time |
| from addiction can find healing. | | | | to accept the advances and learning of the |
| Patients with co-morbid mental health conditions | | | | Minnesota model with gratitude, and move |
| receive concomitant treatment for both conditions | | | | forward with a more humanistic and loving |
| within a co-therapy concept. A common mental | | | | approach in a less clinical setting, such as a home |
| health diagnosis among chemically dependent | | | | setting that is warmer, safer, and more client |
| patients is borderline personality disorder (BPD), a | | | | focused and outcome oriented. |