Minnesota Model (12 Step ) vs Biopsychosocial Model (Our Treatment Approach.)



Talking about 12 Step Programs and 12 step treatment centers. How our approach at the The Foundation Clinic is different.


Here is the Transcript.


About our programme at the

Foundation Clinic and what our


how our programme is structured

and why why we've done it the


way that we have. Because We

sometimes receive a lot of


criticism that we're not a

twelve-step programme. So so in


the treatment world there are

two our programme which is the


biopsy social model versus the

Minnesota model the Minnesota


model is underpinned by the 12

step fellowships and what


happens is when people go into

a treatment facility the


treatment facility works with

the clients through the steps


and and it's been the the form

of treatment that's been around

since since the 60s when the

disease model was recognised

when alcoholism was recognized

as a disease as a result of the

success of AA and so they they

they took the twelve steps. The


spiritual principles of the

twelve steps and medicalised it

and this is where the Minnesota

model started and 12 step

treatment models being exported

around the world and many many

people have found recovery as a

result of the 12 step model.

However, science and and

addiction treatment has

progressed as we've moved away

from at the moral lens of

people that take drugs is

something there's something

morally wrong with them to the

medical model where people who

take drink and drugs that

there's something medically

wrong with them we've got a

model which is sitting in the

wellness model yes and the way

that we get people well is

through the biopsy social model

so what that means is the the

the biology of the person so

people come in and they get

detox so their body gets gets

detoxed and they get medically

cleaned out for what of a

better word. Then there's the

psychology that the people get

taught stuff while they're in

clinic and then there's a

social stuff where we create a

social environment for our

clients which we call the

therapeutic environment. And

what separates us out from the

rest of the the world I I would

say because I'm I'm I haven't

come across a programme like

ours which is continuously

changing and developing over

time. So Marilyn a clinical

psychologist in 2005 came and

spoke to us about trauma. So we

incorporated trauma into the

programme and we started to

understand the importance of

dealing with people's trauma.

Yep. So so we address that in

the programme. But our

framework, our structure is the

foundation is spiritual

principles. So if you like if

if you look at the NA

literature there's a preamble

that goes our programme is a

set of principles written so

simply we can follow them in

our daily lives and what we've

done with that is from the

twelve steps we've taken those

spiritual principles and we put

them in a framework around

people's emotions yes so the

the emotions are guilt and

shame angus atmosphere and joy

and and so the a three week

rolling programme is the first

week is spiritual principles

which is comes from twelve step

thinking and 12 step work and

we encourage our clients to go

to 12 step meetings but we have

the 12 step meetings run the

twelve step meetings by the

fellowships we don't think

philosophically we don't think

it's right to be selling

something that is is freely

given in a fellowship our

clinic. We've we've just it

feels ethically wrong to to me

personally and to to a lot of

people. Um because of the way

12 step treatment facilities

treat their clients at times.

Yep. It can be and I'm not

saying it is in every facility

but it can be quite shame

based. Or faith based in a way

that's doesn't resonate with

our philosophy. What we want is

our clients to decide works for

them. So in our treatment

facility we have fellowship

meetings that are run by the

various fellowships AANACA and

and and that should be governed

by the fellowships, hospitals

and institutions. So they

should have a a committee that

works with institutions to to

introduce the step programme as

a solution for people if they

wanted. What we do inside the

clinic is we have the twelve

steps stuck up on the on on the

walls and the reason that we do

that is people that do identify

with 12 step programmes. They

get that kind of similar

feeling should they go to

meetings anywhere in the world.

So the residents themselves in

the morning they'll have a

morning reading or something

which will be a reading from

one of the fellowship's daily

daily meditations or readings

or something and they're

encouraged to go to meetings

and to to to interact with

people in recovery. However,

there's a lot of shortcomings

that happen with within

meetings where people where

there's can be a lack of

boundaries, there can be sexual

predation, there can be all

sorts of challenges when

interacting with with mutual

aid or peer support groups. So

out there in the world it's

important that people

understand what our programme

is. We are not opposed to the

twelve step programme we

believe that the spiritual

principles are great and we

build on top of it with the the

the brain and the mind, our

thinking, metacognition,

behavioral therapy as a lot of

what are people talk about it's

about thinking about your

thinking about what's going on

so so so we integrate that into

people and what we want people

to do is when they come to the

clinic is to recognize what

their trauma was in the past

that they've been medicating to

to to over the years and to

have a look at that with sober

eye in a contained environment

just so that they can then

learn to stop using that trauma

as a justification for their

continued descent into

addiction yeah it's not our

role to kind of process all

that trauma and and to to to go

and dig dig dig there we just

want the person to kind of

recognise it and to for the

story to come out so that they

can look at it in a deeply

compassionate environment and

then the week of the programme

is community and growth and

this is what we've got here

we've got we've got a community

here we've got a community of

coaches we have the support

groups here we have the

systemic wellness practitioners

running various groups we've

got the pocket rehab meetings

we've got a whole lot of

recovery capital that can be

added to other people's

whatever works for them so some

people like to go to church.

Some people like to go to to

the mosque here. Some people

like to go to various

fellowship meetings. And we

welcome that and we encourage

that. But the boundary we have

as a clinic is we are a clinic.

And the the the word clinic

comes from French. It means

place of bedside learning. And

we have a whole lot of

professionals that are

supporting our patients and

their families. Why they are

going through the recovery

process. So we look at a

addiction as a systemic illness

which means one person's

behavior can impact a whole lot

of people so the family gets

impacted society gets impacted

so when people come to the

clinic they're taken out of

that environment and they do

pretty well in the clinic but

they then go back to those

environments that haven't

changed so part of our job is

to work with those

organizations and families to

just bring awareness and to

kind of challenge the stigma

that still sits around mental

health. So I personally get

very triggered when people

criticise our programme and say

that we're not a twelve step

programme. We're not our clinic

is **** because we don't follow

the Minnesota model. The the

and that's just not true and

and the reason I get angry is

one because it's not true. It

not there's no evidence around

supporting that and that

programmes continuously need to

adjust to the needs of the

client and their families as

opposed to so a recovery is an

emergent an emergent thing and

mental illness is something

that's that can comes and goes

so I feel very passionate about

this because families when

they're in a crisis yeah and

they don't know and somebody

talk them about recovery.

They're really open and

susceptible and they'll do

anything that anyone tells

them. Um in fact one of our

students Toby Solheim he did a

a research piece on it and and

the the the summary of his

research was that people will

do whatever they they kind of

told to do because they're

desperate. So I really wanted

to just kind of get this out to

everyone today and I hope you

watch this and understand what

our programme is about, why we

structure it the way it is and

what the recovery process is.

Our goal in treatment is to

make our clients aware of the

recovery capital that surround

them when they leave treatment

and why they're in treatment.

We're trying to enhance the

recovery capital internally for

that individual to go and

change their life. Um because

treatment believe it or not is

very traumatic for the

individuals there's a complete

break of the persona the

identity so so when people

start to to the recovery

process they start to feel

feelings that they haven't felt

for years the the the feelings

can be very high and low it's

it's it's very it's a very

tight container that we need to

contain people in that are that

are going through a traumatic

process. Trauma's like too

much, too soon, too quick,

there's a real overwhelm and

and when our clients start to

get angry, we know the process,

they're starting to get well.

They're moving out of denial.

And then we need to teach them

how to manage that anger, how

to get healthy boundaries

around it. And if you want to

relate that back to 12 steps

stuff, that would be steps one,

two and three. Yep, and which

in the spiritual principles

around that are honesty, minus

unwillingness. So do you think

you've got a a problem? Do you

want to do something about it?

And are you willing to do what

it takes? And and and that's

how we reference the twelve

step lens to our patients while

they're in treatment. So they

have the the the programme to

follow. They have the lectures

to follow. They have

therapeutic duties. They have

and that therapeutic

environment that guys start to

relate and talk to each other

around what recovery is for

them and our job as therapists

or as coaches or as

professionals is to maintain

that culture of recovery within

the clinic and within this

online community here so yeah

if you ever want to trigger me

criticize our program what

we've done we've been doing

this for like twenty 26 years

now. Just thinking and trying

to work out how best we can

support individuals and their

families. Oh hello Rasada. Wish

I could join. Look forward to

hearing this. Ah great. Well I

wish you could too Rasada. See

Rasada comes does does the

trauma stuff with our clients.

He runs groups where

constellations and trauma stuff

where he's helping the clients

look at traumatic events and to

build resilience for the

individuals. So they go out

into the outside world they can

start the process of healing

their trauma in a way that

suits them when they've got

some more resilience we just

want the person to look at it

and say oh **** okay well I was

molested as a child but I gotta

stop use stop using that as an

excuse to carry on my using to

justify my using yeah. So I'm

going to end that now. Thank

you very much. I'd love to

debate this sort of stuff. Um

I'd love to evidence it. Um and

we as an organisation or a

lived experience recovery

organisations and and what

we're trying to do here is take

people's lived experience and

to teach them how they can show

up in a professional role. And

whether that's a peer support

specialist, whether that's a

certified professional recovery

co, whether it's a systemic

wellness practitioner that's

what we're trying to do and

then we have the business

coaching which is which is

about getting relationships

right within organisations. Um

so yeah that that's my that's

my my my my rant or my

education or whatever and and

finally we have a

multidisciplinary team. So so

each person brings their

personal expertise to case

management. So doctors, medical

doctors, psychiatrists, social

worker, coaches, psychologists,

traumatologists, and and and

the the the multidisciplinary

team makes a decision around

what's going to be beneficial

for the client and what the

client is resisting and what

the family is how the family's

doing and yeah so that's what

we that's that that's our

approach and our philosophy and

our ethos. And and as community

members this is a sort of thing

that we need to maintain. Thank

you.

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