Don't mention the Minnesota Model

Chip Somers reviews
Chemical Dependency Counselling
A Practical Guide By Robert R.Perkinson

It is deeply ingrained in the British thinking to be extremely wary of anything that isn't British. This is never more so than in relation to America. It is almost de rigeur to diminish anything that comes from across the Atlantic. We have, over the years, even found it hard to be thankful for their help during the War. We certainly pay little respect to their film industry, claiming that it never quite has the "authenticity" of the British film business. Yet how many British films would ever feature on anyone's Top 10 Best films list? This prejudice about all things foreign, especially American, is also relevant to medicine and in particular to the treatment of drug and alcohol problems.

The British medical world and the statutory agencies that deliver drug and alcohol treatment have always displayed a special arrogance about interference with the way they do things. It is an absolute requirement to disrespect and put down anything that comes from America. This is a huge mistake because for those people that are prepared to take off their blinkers, there is a vast amount of information and knowledge available if only they would look. America is the birthplace of Alcoholics Anonymous, an organisation that has an unparalleled success rate for dealing with alcohol dependency. In the United Kingdom it is almost universally dismissed as being the province of extremists and Christians and ignored with contempt prior to investigation.

Just under 50 years ago the Americans began to adopt some interesting and effective ways of dealing with alcoholics. They started treating them as a whole person rather than merely focusing on the substance. This method of treatment for purely geographical reasons began to be known as the Minnesota Model. It has gone on to spawn thousands of treatment facilities that are turning out completion and outcome statistics absolutely on a par, if not slightly better, than any of the other forms of intervention. So, how many clinicians in the UK started saying to themselves, "That looks interesting, I wonder what they are doing and how we could adopt that style over here?" The answer is – hardly any. Trying to find anyone working in the statutory field that doesn't almost gag on the phrase "Minnesota model" is rare. Even those agencies that did develop this treatment intervention have learnt to call it something different just so that they can get people to listen.

So it is for that reason that I believe this book will fail to grab the attention of anyone working over here. Which is a shame because hidden within it are some sections and worksheets that would form the basis of some useful workshops and interventions. Unfortunately almost on the first page there are some crass Americanisms that will turn off most British readers and discourage them from delving further. An encouragement to hug your patients on greeting them as they enter treatment is in itself enough to produce howls of hilarious laughter and certainly provide proof, if it was needed, that Americans are all just too touchy feely for words. So I doubt whether anyone in England will read beyond that point.

However, the author has made a valiant attempt to write a manual for treatment and is to be commended for making his style of prose at all times readable and accessible. Most textbooks of this nature are not written for the grass roots practitioner and are as a result just as poorly read as this book might be. For those readers who feel able to persevere there are amongst the pages some good, simply written, guides and exercises that would be a useful addition to any treatment setting. It will, however, always be a book to cherry pick from and not the ultimate guide that I believe the author had in mind when he first stared writing it. Before dismissing it out of hand, people should be open minded enough to explore its contents and take from it information and detail that would perhaps really help the people they are dealing with.

Chip Somers is Director of Focus Counselling