The Minnesota model treatment for substance dependence: program evaluation in a Swedish setting

The Minnesota model treatment for substance dependence is a group-based psychosocial intervention program that rests on the principles and twelve-step program of Alcoholics Anonymous (AA). The model was introduced to Sweden in 1983-84, and is currently used as the main treatment method in twenty-five percent of the addiction treatment units in the country. This thesis describes the results of a program evaluation in one private Minnesota model setting, with the general aims of studying posttreatment substance use and functioning in important life domains, and factors enhancing respectively hampering favorable substance use outcomes. Two-hundred and forty-four individuals were interviewed during one of their first days of stay in treatment, and 188 (77.0%) respectively 148 (61 %) were re-interviewed after 1 and 2 years. Results from Paper I indicated that participant's baseline alcohol dependence severity and treatment goals, and the degree of AA affiliation, satisfaction with treatment, and completion of aftercare, differentiated between those who turned out as abstainers, nonproblem drinkers and problem drinkers during the first year after treatment. Paper II showed that participant's Ist year drinking outcomes, and also the degree of AA affiliation and satisfaction with treatment during the first year, predicted drinking outcomes during the subsequent second year. In Paper III, significant improvements were observed in family, psychiatric and legal life domains between the baseline assessment and 1 -year follow-up, while no change was found in the employment and medical areas. Those who experienced problem drinking reported significantly more employment, family and psychiatric problems than non-problern drinkers and abstainers; no differences were found between the two favorable outcome groups. Finally, Paper IV indicated that women were more likely to engage in AA after treatment than rnen, as were those with pre-treatment AA experience, and abstinence as their treatment goal. The I-year abstinence rates of the study sample resembled those obtained in previous larger single group evaluations of Minnesota model treatment in the U.S. Findings are discussed with reference to methodological concerns and previous research on the prediction of treatment outcomes