The Castle Craig and the Minnesota Model

The Minnesota Model in the UK

Our model of residential addiction treatment was developed according to the principles of the Minnesota Model.  This is a methodology of delivering treatment based upon the 12 Step programme of Alcoholics Anonymous. The treatment setting allows for separation and respite from the patient’s drug or alcohol-associated environment. It occurs ideally in a residential clinic, but can also be adapted to an outpatient setting.

As part of this model of treatment, addiction to drugs and alcohol is defined as an illness or a disease, which is considered to be primary and chronic in nature. There is no absolute ‘cure’ for the disease of addiction but it can be kept in remission through total abstinence.

The treatment environment is accepting, respectful and dignified. Patients are helped to participate in their treatment and to take responsibility for their recovery. Association amongst peers is encouraged as being central to recovery. Treatment is systematic, and patients engage in a daily programme of education, facilitated group therapy, individual counselling and other activities that progress individuals’ treatment plans and facilitate interaction among the community. Individual treatment plans and individual goals are established at the start of treatment and regularly reviewed.

The goal of Minnesota Model treatment is recovery and rehabilitation through means of abstinence from alcohol and mood altering substances, and behavioural change. Treatment duration is based on a patient’s individual needs, and can involve varying combinations of inpatient and outpatient treatment.

Other key features of the Minnesota Model:

  • A medical basis to treatment, including assessment and diagnosis, detoxification, medical records and medical services.
  • Multidisciplinary team of psychiatrists, doctors, nurses, psychologists and therapists – some of whom may have a history of substance dependency, but are now in long-term recovery.
  • All patients have a primary diagnosis of addiction.  Alcoholics and drug addicts treated together, and considered to have the same condition.
  • Use of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) group meetings whilst in treatment and for continuing care.
  • The involvement of family (or significant others) in treatment.

The Castle Craig Model

The Castle Craig Model incorporates the definition of the Minnesota Model as defined above. Furthermore, Castle Craig emphasises the treatment of the whole person, and incorporates treatment approaches for co-occuring disorders such as post-traumatic stress disorder (PTSD), eating disorders and gambling addiction. As such the role of the consultant psychiatrist is central at Castle Craig, and a team of consultant psychiatrists lead the treatment team.

Cognitive Behavoural Therapy and other evidence based therapies are incorporated into treatment and continuing care and qualified psychotherapists or psychologists are employed as counsellors.

Furthermore, under the Castle Craig model, exercise and well-being are emphasised as well as a range of complementary therapies.

The Castle Craig model recommends longer lengths of stay than the 28 day Minnesota Model programmes which are common in America, and this is based on evidence that longer lengths of stay improve patient outcomes, and because of the co-occurring disorders that present in many patients.

The Castle Craig model is divided into phases of treatment depending on the length of time that a patient remains in a residential setting, before returning home and beginning their continuing care.

In Holland, a version of the Castle Craig model has been adapted to an outpatient setting.

References:

Damian McElrath (1997) The Minnesota Model, Journal of Psychoactive Drugs, 29:2, 141-144

Christopher Cook (1988) The Minnesota Model, British Journal of Addiction, 83, 625-634, and 735-748

George Christo (2002) Abstinence Oriented Residential Rehabilitation.

Patricia Owen, Minnesota Model:  Description of Counseling Approach: National Institute of Drug Abuse. http://archives.drugabuse.gov/ADAC/ADAC11.html