THE MINNESOTA MODEL OF TREATMENT & SOCIAL SUPPORT

“An Old School Approach supporting a client’s involvement in the 12 Step

Community; with New School Methods of parallel professional services.”
David Moore, Ph.D. CDP
Merrill Scott Symposium; August 26, 2010

AN ADDICTION SERVICES MODEL

The Three Foundations of Moore & Associates
 Our methods are the New School of Integrative Addiction Medicine. We combine the
knowledge of Addiction Professionals with an interdisciplinary team of [as needed] Psychologists,
Physicians, Attorneys, Nutritionists, and Exercise-Mindfulness facilitators. This method, called an
Integrated Medicine approach, is at the cutting edge of supporting clients in managing their own,
comprehensive, lifestyle change—at home, at work, during leisure-recreational time and when
connecting with the community of recovery.
 The most successful model of recovery is the 5-year model of the Physicians’ Assistance
Program. Five-year addiction treatment programs for physicians represent the most effective
treatment model for any professional. Recent national field research of these Physicians Health
Programs indicate that their 51-75% recovery rates, over five years, could serve as a model for any
professional treatment [N=904 physicians studied]. Moore & Associates believes that adding a
confidential client-centered team to balance any external monitoring team provides an improvement
to maintain, or exceed, a 75% rate. Moore & Associates’ Integrated Medicine approach has been
developed to advocate for the overall wellness and recovery [Wellbriety1] of recovering persons
who have re-entered their home and community after intensive addiction treatment. This builds on
their first stage of treatment, during structured residential care, where a treatment team at their
rehabilitation center utilized a multi-dimensional therapy plan to apply counseling strategies so that
the patient would accept their addiction and a lifetime of recovery.
 The four dimensions of holistic recovery, used by the Executive Health Team, is based on
the Medicine Wheel Model of Wellbriety—which embraces all the 12-Step Programs and can
best be addressed in a renewal setting conducive to evidence-based
lifestyle restructuring used by Integrative Medicine Programs2---housed
at the established Cedar Springs lifestyle renewal center:
 1-3: Joining the community of recovery,
 4-6: Taking personal responsibility for a recovering lifestyle,
 7-9: Restoring oneself with family and community,
 10-12: Committing to a lifestyle of growth, strengthening recovery and
giving back to the community.

1
Don Coyhis; www.whitebison.org. 2010.
2 Research into practice examples are the multi-site models of the Dean Ornish Cardiac Recovery
Program; or extensive individual programs, such as Scripps Health’s Integrative Medicine Center
founded by Dr. Mimi Guarneri, MD, FACC [Scripps Health serves 27% of San Diego’s health care.]
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The Minnesota Model & Integrative Medicine© David Moore, PhD CDP
 H ISTORY AND P RACTICE OF T HE M INNESOTA M ODEL

Historical Introduction
The Minnesota Model of support group therapy integrated with professional behavioral health
services is a term given to chemical dependency treatment strategies developed in the Minneapolis
St Paul area in the 1960s3. It reaches back into the roots of the first 12 Step program of Alcoholics
Anonymous to what emerged as a string of case studies emanating from the therapeutic work of
Carl Jung. Jungian Psychology, at that time, was a blend of indigenous symbolism integrated
around a relatively generic spiritual concept of synchronicity. Jung guided his clients to an inner
self-evaluation and reconstructing their life experiences around a sense of balance and insight.
Unsuccessful with individual therapy, he suggested that one of his alcoholic clients attempt to
practice his principles within a religious group experience of his choosing. This led to a series of
three prominent historical case studies that spanned the Atlantic, from Jung’s Europe to the
Alcoholic Sanitariums of New York: Rowland H, Edwin “Ebby” T and then Bill W. Bill Wilson [a
stockbroker] and Dr. Robert Smith [a physician] used the spiritual group principle to found
Alcoholics Anonymous which evolved around two separate groups in Ohio. The Cleveland Group,
led by Clarence Snyder and Attorney Abby Golrick, focused on developing a secular approach to
the 12 Steps of AA—where spirituality was left to the individual [“God as you understand him”].
The Akron Group, led by Bill Wilson and Dr. Robert Smith, maintained a strong religious focus
modeled after the Oxford Group. The integration of this history is seen in many ways:
 The self-reconstruction inventory steps [4-10] that come forward from Jungian Psychology;
 An eclectic spirituality from the Cleveland Group [Clarence Snyder was always known for
his avowed agnosticism];
 Methods of group spirituality found in many religions and brought forward by the Akron
Group, such as a search for spirituality as a foundation to recovery, a belief in the power of
verbally acknowledging and atoning for wrongs, and a community perspective and group
service which led to AA’s on unique traditions of doing things as a group; and
 A concept of Fellowship and need for ongoing self-reflection, meditation and life balance
which sustained the 12 Step Groups’ membership beyond simply achieving abstinence.
The Emergence of a Parallel Professional Health Care Model
The “Minnesota Model” was a name coined in the first articles in the Journal of the American
Medical Association that described the new health care field of addictions treatment pioneered by
the Johnson Institute in the Minneapolis—St. Paul MN. In the Minnesota Model, the 12 Steps of
social support were seen as so important to the ongoing recovery of chemically dependent
persons—that behavioral health professionals developed a series of parallel therapeutic approaches
that maintained a consistency with the steps themselves. This consistency allowed chemically
dependent persons to move from treatment to social support with a seamless “transfer of training.”
As the 12-Step social networks have broadened to include people who have different addictions or
are experiencing childhood risks [CODA, ACOA] or even non-chronic emotional disorders
[Emotions Anonymous], the Minnesota Model has gained a broadened applicability. Whether an
activity is counseling, dietary assistance, pastoral therapy, case management, recreational therapy or
3
The Origins and Evolution of the Disease Concept of Treatment; Journal article by Daniel Yalisove; Journal of
Studies on Alcohol, Vol. 59, 1998.

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The Minnesota Model & Integrative Medicine© David Moore, PhD CDP
a myriad of other professional and para-professional strategies—the Minnesota Model allows for a
consistent service model that offers a transfer of training to the national 12 Step programs , recovery
clubs and connected recreational or social events.
The Integrative Medicine Path of Moore & Associates’ Minnesota Model Paradigm
In the past 40 years, the numbers of clients treated by the addiction field has grown by ever-earlier
professional and non-professional interventions on the addict. This follows the classic use of
threatened painful consequences to get through the addict’s denial so they will enter treatment.
However, the unfortunate effect is that the treatment resources, family and community support has,
on an increasingly expanding basis, been linked to intervention monitoring processes that extend far
beyond the point where the addict’s denial and delusion have been largely or fully removed.
As the patient re-enters the community, the Minnesota Model is compromised by inserting
monitoring persons and institutions throughout addict’s recovery. Even such a simple act as the
traditional “signed” AA attendance slip indicates where the person was, if the meeting was a
specialty meeting such as one for the GLBT community, if it was a smoking meeting, if he has
changed meetings, what time of day he is in what part of town and the list goes on.
In order to maintain the integrity of the Minnesota Model, the M&A Team would never be part of a
monitoring system[ unless required by a Court Order]. To further avoid even that remote possibility,
and safeguard the addict’s disability rights, one of the first tasks, if the recovering person is on a
monitored treatment plan, will be to refer the person to a disability lawyer separate from M&A—
which does not provide any legal advice. The addict will also be encouraged to meet with that
lawyer to make final decisions on the restorative justice plan developed during therapy [see Step 9
in chart, below]. While M&A supports the need for the monitoring activities, which also safeguard
community safety, their Integrative Team model is committing to filling the separate role of a fully
confidential Minnesota Model support program to the addicts themselves.
The Minnesota Model of the Executive Health Team
Generic Step of 12-Step Professional Counterpart to the Step [“Minnesota Model”] Used
Group by the Executive Health Team of Moore & Associates
1 “We admitted we were Self-assessment tools, strategies and Motivational Interviewing
powerless over [ ] and our allow the person to evaluate the compulsive behavior and its
lives had become consequences. They arrive at their own understanding of the
unmanageable.” disease of abuse, dependency or addiction.
2 “Came to believe that a The client receives group therapy based on the Johnson Institute
Power greater than model of leveling and feedback by peers. A transfer-of-training
ourselves could restore us occurs where the client is coached into a homogenous community
to sanity” support group that represents interpersonal connections and
empathy to use the recovery skills [i.e. restore us to sanity=recover
from our behavioral health disease].
3 Made a decision to turn The client develops a personal recovery contract, with an abstinent
our will and our lives over base, that has enough empowerment for the person to make a
to the care of God as we personal commitment or pledge, in the most meaningful way to
understood God [original that person, to take actions to sustain abstinence as a lifestyle.
and most use the phrase
“.as we understood Him”]

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The Minnesota Model & Integrative Medicine© David Moore, PhD CDP
4 Made a searching and The client conducts a paper and pencil review of their entire life in
fearless moral inventory a manner where they can identify emotionally uncomfortable
of ourselves points--for them or another person[s] they interacted with. They
reconstruct this narrative with a recall of the event, specific actions,
the emotional content of the event and the sensory elaboration they
remember [e.g. sight, sound, smell, touch, hearing]. This is often
done in a simple 3 column format of: Event, Actions, and Feelings.
5 Admitted to God, to After the client conducts a thorough timeline, or portion of the
ourselves and to another timeline, that person then adds a fourth column to each event that
human being the exact states what they should have done instead, from a moral [Golden
nature of our wrongs Rule and empathy] perspective. In cases where any cause of their
pain is from another, the person would develop the most moral
avoidant/survival behavior based on what they know now. In order
for a cathartic effect, the counselor works with the client to identify
the most person-centered environment/person[s] to verbally share
their information. The written columns are then used by the
counselor and client, except for those parts that the client selects to
remain confidential, to create a relapse prevention plan parallel to
Steps 6 and 7.
6 Were entirely ready to The program helps the client identify common themes throughout
have God remove all the fourth column of the events timeline. This identification is
these defects of character often of two types: 1) A Cognitive Therapy approach for faulty
belief systems; and 2) the ABCs of ineffective social/life skill
responses to interpersonal situations that led to emotional stress.
[“defects of character”=behavioral traits and cognitive schemas]
7 Humbly asked God to The client develops a relapse prevention plan with professional
remove our shortcomings and/or community group support that targets a change in faulty
beliefs and learning new interpersonal behaviors. [“humility”=re-
affirming a need for support]
8 Made a list of all persons The client reviews interpersonal and social damages that have
we had harmed, and occurred within the timeline of events. This includes preparatory
became willing to make work to understand the behavioral impact on others and therapeutic
amends to them all work on interpersonal empathy [the emotional impact]. This
includes a community reconstruction plan based on the four
principles of Restorative Justice.
9 Made direct amends to The program assists the client to implement, evaluate, and revise
such people wherever the reconstruction plan:
possible, except when to Encounter: Create opportunities for victims, aggressors and
do so would injure them community members who want to do so to meet to discuss the
or others crime and its aftermath
Amends: Expect aggressors to take steps to repair the harm they
have caused with specific actions
Reintegration: Seek to restore victims and aggressors to whole,
contributing members of society
Inclusion: Provide opportunities for other parties with a stake in a
specific wrong to participate in its resolution [e.g. family]

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The Minnesota Model & Integrative Medicine© David Moore, PhD CDP
1 Continued to take A case manager assists the client navigate real-life learning
0 personal inventory and experiences over the next five years. Navigation includes use of
when we were wrong inventory skills in decision-making, use of self-monitoring skills
promptly admitted it from the relapse prevention plan and ongoing refinement of
community restoration--including volunteer work in the social
support network they used to learn their recovery skill].
[“wrong”=interpersonal conflict or an emotional imbalance;
“admit”=address others directly to restore relationship or consult
with empowerment network to identify and resolve the emotional
imbalance.]
1 Sought through prayer The client receives psycho-education and support in developing an
1 and meditation to improve internal and external balance. The internal balance uses the
our conscious contact principles of integrative medicine of nutrition, meditative
with God as we mindfulness and stress management. The external balance uses the
understood God, praying principles of Wellbriety to identify a personal spirituality with the
only for knowledge of goal of a sense of emotional harmony with the surrounding world,
God's will for us and the both seen and unseen, that is connected to our thoughts and beliefs,
power to carry that out both conscious and unconscious.
1 Having had a spiritual Through case management and use of the client’s empowerment
2 awakening as the result of network of professional and social support, a state of conditional*
these steps, we tried to recovery is achieved based on 3 outcomes: 1) integration of skills
carry this message to in Steps 10 and 11 to a holistic lifestyle, 2) an enduring
other addicts, and to commitment to community restoration through participatory
practice these principles volunteerism in the community of recovery, and 3) an ongoing
in all our affairs transfer of training from the world of professional services to the
empowered client world of self-monitored growth and
development. [*based on maintaining the 3 outcomes and
maintaining access to an effective medical plan that can be
immediately used if relapse occurs.]

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The Minnesota Model & Integrative Medicine© David Moore, PhD CDP