Minnesota Model

What is the Minnesota Model of treatment?

Imagine for a moment that it is 1949 and you or someone you love is alcoholic. As you struggle with this fact, you quickly learn there are only three outcomes to this situation. One is commitment to a locked ward in a mental hospital, sharing facilities with people diagnosed as schizophrenic. Another is a life of crime, which could mean years in prison. And third is a slow sinking into poverty and helplessness—perhaps life on skid row. In all three cases, you or your loved one’s condition would be denied, ignored, or denounced as evidence of moral weakness.

The year 1949 is significant because it marked Hazelden’s beginning. What started then as a guesthouse for alcoholic men has flowered into the prevailing method of treating addiction: the Minnesota Model. More importantly, this historic innovation offered alcoholics a new alternative to mental wards, jail, or homelessness.

It’s easy to forget that the Minnesota Model represents a social reform movement. The model played a major role in transforming treatment wards from terrible, hopeless places into places where alcoholics and addicts could retain their dignity. Hazelden began with the idea of creating a humane, therapeutic community for alcoholics and addicts. Once this idea was ridiculed; today it is seen as commonplace. The story of how this change has evolved is in large part the story of the Minnesota Model.

The model began humbly. During Hazelden’s first year of operation in Center City, Minnesota, the average daily patient count was seven, and the staff numbered three. The treatment program was just as bare boned, resting on a few expectations of the patients: behave responsibly, attend lectures on the Twelve Steps of Alcoholics Anonymous (AA), talk with other patients, make your bed, and stay sober.

It would be easy to dismiss such a program. Yet behind these simple rules was a wealth of clinical wisdom. All five rules focused on overcoming a common trait of alcoholics—something the founders of AA described as “self-will run riot.” People addicted to alcohol can be secretive, self-centered, and filled with resentment. In response, Hazelden’s founders insisted that patients attend to the details of daily life, tell their stories, and listen to each other. The aim was to help alcoholics shift from a life of isolation to a life of dialogue. This led to a heartening discovery, one that’s become a cornerstone of the Minnesota Model: alcoholics and addicts can help each other.

Throughout the 1950s, Hazelden built on this foundation by adopting some working principles developed at another Minnesota institution, the Willmar State Hospital. Among these were the following:

Addiction exists

This condition is not merely a symptom of some other underlying disorder. It deserves to be treated as a primary condition.

Addiction is a disease

Attempts to chide, shame, or scold an alcoholic or addict into abstinence are essentially useless. Instead, we should view addiction as an involuntary disability— a disease—and treat it as such.

Addiction is a multiphasic illness

This statement echoes an idea from AA—that alcoholics and addicts suffer from a disease affecting them physically, mentally, and spiritually. Therefore treatment for alcoholism or other drug addiction will be more effective when it takes all three aspects into account.

These principles set the stage for a model that expanded greatly during the 1960s, one that has been emulated worldwide and has merged the talents of people in many disciplines, including addiction counselors, physicians, psychologists, social workers, clergy, and other therapists. These people found themselves working on teams, often for the first time. And what united them was the notion of treating the whole person—body, mind, and spirit.

Today, the Hazelden Betty Ford Foundation continues to explore the most cutting-edge research and practices in the addiction field, but still at its core is the Minnesota Model. Fifty years of service have not altered this foundation.