Minnesota model

DEFINITION: The Minnesota model is a multiprofessional model of drug treatment based on the principles of Alcoholics Anonymous and cognitive-behavioral therapy.

Background and Treatment Philosophy

The Minnesota model (MM) was established in 1948 as a new form of drug treatment. The first MM residential program, known as Pioneer House, was established in an old warehouse in Minnesota and was modeled after the principles of Alcoholics Anonymous (AA). The treatment centers Hazelden and Willmar State Hospital, both in Minnesota, adopted a similar model in 1949 and 1950, respectively. Collectively, these three programs constitute the origins of MM. Pioneer House is now Hazelden Betty Ford. MM was initially designed as a residential treatment program, although outpatient variants of the model exist today, and the model itself is amenable to various delivery settings.

The principles and philosophy of AA and the disease concept of addiction, a central element of AA, are essential parts of the MM treatment philosophy. The disease concept of addiction views people with substance abuse disorder as having an incurable or chronic disease. Individuals with addictions are believed to be biologically different from those who do not struggle with similar issues. They are not blamed for their addiction, but they are considered responsible for facing their disease. The program emphasizes that those with substance abuse disorder can change their beliefs, behaviors, and lifestyles and can become well, but only through complete abstinence from all chemical substances.

The typical residential stay ranges from three to six weeks, with a common twenty-eight-day program of inpatient treatment and lifelong aftercare, primarily through AA, to manage the disease. Aftercare may also include family counseling and extended care. The residential treatment program comprises many dimensions of care, including individual counseling, group therapy, family counseling, working the AA twelve-step program, attendance at AA or Narcotics Anonymous meetings, daily reflection and readings (usually of AA’s “big book”), and lectures.

MM-based programs are staffed by different professionals, a central feature of the model’s multiprofessional and comprehensive approach to treatment, and include nurses, clergy, professional social workers, psychologists, and counselors. Counselors are often recovering from addictions themselves and have trained through the residential program.

The client is treated as a whole person with professional attention devoted to the mind, body, and spirit, a focus sometimes referred to as the physical-psychological-spiritual model of treatment. Clients are treated with dignity by staff and other residents. Although there are no standard guidelines as to what a treatment center must do to officially claim the MM concept, the common elements discussed here make up a typical treatment program. The Betty Ford Center and Hazelden were among the larger and more recognizable residential treatment programs based on MM. In 2013, these two programs merged to form the Hazelden Betty Ford Center, creating the largest nonprofit addiction treatment organization in the United States.

MM is similar to concept houses and therapeutic communities in its emphasis on mutual aid, the peer community, and treating the whole person. The heavy emphasis on AA philosophy—the belief in the disease model of addiction instead of the moral shortcomings of individuals with substance abuse disorder—and shorter durations of residency are two of the primary differences between MM and other therapeutic communities. Some clients of MM may participate in a therapeutic community or extended care after completing a program of inpatient care.

Criticisms and Successes

Criticisms of MM often focus on aspects of the treatment philosophy instead of on the whole model itself. A common basis for criticism is found in the tenets of AA, such as the insistence on complete abstinence over controlled drinking; the emphasis on spirituality and a higher power, which may not resonate with all individuals with substance abuse disorder; and the rigidness of the AA philosophy, resulting in an inflexible program. People with addictions who do not wish to seek help from AA have few helpful exit strategies because of the intolerance of AA members to treatment alternatives.

Other criticisms are directed toward the disease concept of addiction, which some argue relieves the person with an addiction of too much responsibility for their addiction and which can reinforce self-indulgent behavior and undermine treatment. Despite criticisms, research suggests that the multiprofessional approach to treatment grounded in the principles of AA is a successful form of treatment for many people with a substance abuse disorder.

Although there are challenges in studying the success of treatment programs, and although many studies have methodological flaws, evidence shows that MM graduates do as well as, and possibly better than, graduates of other treatment programs. Completion of the program results in long-term abstinence for many people with an addiction and shortens periods of repeated drug use for persons who may fail to maintain abstinence. There are documented improvements in graduates' psychosocial well-being, self-esteem, family relationships, employment, and overall physical health.

In a move that acknowledges the need to change treatment tactics as new research emerges, Hazelden began incorporating the use of anti-addiction drugs, such as Suboxone, into its program in 2013. Professionals at the facility hoped that this move—which mainly targeted those suffering from opioid addictions—away from the program's foundation in abstinence would help patients having difficulty adhering to the MM. As the twenty-first century progressed, Hazelden Betty Ford continued to expand its medication-assisted treatment (MAT) options by also providing Buprenorphine, Naltrexone, and Methadone. However, although willing to adapt to proven addiction treatment strategies, the center also remained faithful to the MM. 

Bibliography

Cook, Christopher. "The Minnesota Model in the Management of Drug and Alcohol Dependency: Miracle, Method, or Myth? Part II. Evidence and Conclusions." British Journal of Addiction, vol. 83, 1988, pp. 735–48.

“Inpatient Behavioral Health Center.” Hazelden Betty Ford, www.hazeldenbettyford.org/locations/plymouth. Accessed 9 Oct. 2025.

“Minnesota Model.” Hazelton Betty Ford, learn.hazeldenbettyford.org/learn/article/minnesota-model. Accessed 9 Oct. 2025.

Montague, Hollie, and Ian Fairholm. "The Minnesota Model: A Clinical Assessment of Its Effectiveness in Treating Anxiety and Depression Compared to Addiction." International Journal of Mental Health and Addiction, vol. 18, pp. 1422-36, 2020, psycnet.apa.org/doi/10.1007/s11469-019-00168-0. Accessed 9 Oct. 2025.

Spicer, Jerry. The Minnesota Model: The Evolution of the Multidisciplinary Approach to Addiction Recovery. Hazelden, 1993.

Szalavitz, Maia. “Hazelden Introduces Antiaddiction Medications into Recovery for First Time.” Time, 5 Nov. 2012, healthland.time.com/2012/11/05/hazelden-introduces-antiaddiction-medications-in-recovery-for-first-time. Accessed 9 Oct. 2025.

Willyard, Cassandra. "Pharmacotherapy: Quest for the Quitting Pill." Nature, vol. 522, no. 7557, 2015, pp. S53-S55, doi.org/10.1038/522S53a. Accessed 9 Oct. 2025.