Professional treatment plus AA...
the "Minnesota Model"

Dear Dr. Bill,
I am an alcoholic in outpatient treatment in the city. My therapist insists that I
go to AA meetings in addition to working with her. She says that's the best way
for me to get better and stay sober when my treatment is finished. Is there any
proof that the AA part is really necessary? I've been to a couple of meetings
and felt uncomfortable with the God stuff. Convince me.

Anonymous Doubter

Dear Anonymous Doubter,

You wouldn't be in treatment if there wasn't a darn good reason for you to be
there. As they say in AA: "Take the cotton out of your ears and put it in your
mouth; then listen and do what you re told." That is, if you care at all about
finding good sobriety.

A treatment model that combines the principles of twelve step programs with
professional counseling (the so-called "Minnesota Model") has been evaluated
in both inpatient and outpatient formats. Multiple controlled randomized studies
have compared the effectiveness of the multidisciplinary Minnesota Model
approach to treatment with alternative recovery options; the Minnesota Model
won hands down. Due to the anonymity requirement, it has been virtually
impossible to do controlled outcome studies of AA's results but clinical practice
and the explosive growth of AA indicate it is very effective indeed.

Why does AA work? To answer such a question, one has to take seriously the
spiritual basis of the AA program...to come face to face with what you have
labeled "God stuff". Most actively drinking alcoholics and many therapists (not
those at the Van Ost Institute!) are put off by the centrality of God to AA and
its Twelve Steps, and refer to understand participation in AA as the substitution
of one addiction to another, or as supportive group therapy, or as group
persuasion. When a skeptic like yourself initially encounters AA's talk of a
"Higher Power" or "God as we understand Him," almost inevitably there will be
conjured up images of the hypocrisy and smug piousiness that are associated
with some of organized religion.

AA early on made the distinction between religion and spirituality; a distinction
that is only now starting to be more widely understood. As David Berenson
explained it over a dozen years ago in Networker magazine, "Religion often
involves accepting a specific dogma about the attributes of what is called God,
understood as being separate from the universe and from human beings. In
religion, belief may be more highly valued than a direct experience of a Devine
Presence. With spirituality it is just the reverse. The direct experience and
relationship with a Higher Power are primary and belief systems are secondary
or might be considered an impediment to developing the relationship. The Big
Book, Alcoholics Anonymous, states that to make use of spiritual principles
one need accept nothing on faith but only ask, 'Do I now believe, or am I
willing to believe, that there is a Power greater than myself?' Only this
provisional belief is required to open the door to a radical shift in experience."

The attitude that "I am the master of my fate: I am the captain of my soul," is
simply not appropriate for the addicted person like yourself whose task must
be to stop attempting to control by exerting will-power and become open to
the discovery of a Higher Power. Another way to say it is that the alcoholic
has to give up willfulness in favor of willingness. Simply put, Anonymous,
do what you have been told to do...you will never regret it.