There are a lot of textbooks and study guides already available in the addictions treatment field. But Paula DeSanto’s book aims to stand out from those by establishing itself as part of an entirely new therapeutic model. The model is said to be based on a holistic, person-centered approach to treatment that draws heavily upon recent scientific advances, advances in neuroscience that allow for brain “opportunities” rather than brain “illness,” and a de-stigmatization of addiction itself.
It’s important to note that DeSanto’s text, Effective Addiction Treatment: The Minnesota Alternative, is written as a study resource, serving as a guide to best practices for those working in the addictions field. As such it may not be of much interest to non-professionals, although there is certainly a wealth of information here that could be of use to anyone dealing with addiction themselves or with a close friend or family member. The author has spent more than 25 years developing therapeutic programs for mental illness and addictions treatment, and is the current owner and director of the Minnesota Alternatives consultation, training, and outpatient program that gives this book its name.
DeSanto emphasizes the need for a “paradigm change.” After going over some aspects of the field that will already be familiar to most practitioners, such as Motivational Interviewing and the Stages of Change model, the author stresses that treatment should always be client-led. She also explains how neuroscience can be integrated into treatment, and includes annotated diagrams of the human nervous system, neurons, and the brain. The chapter on neuroscience ends with some recommendations on how to increase willpower and self-control, and also lists five simple steps toward increased happiness, taken from The Happiness Advantage by Shawn Achor.
These sorts of tools and techniques are provided throughout the book, and are by no means new or revolutionary. Still, this is perhaps the first treatment manual that does a good job of compiling all of these tips and approaches into one simple, user-friendly volume.
The author goes on to discuss the environmental and chemical aspects of addiction, and includes a useful section on the concept of attunement, as covered by Gabor Mate in In The Realm of Hungry Ghosts. Attunement “literally means being ‘in tune’ with someone else’s emotional states.” Again, this will be familiar to any practitioner who has studied attachment, or who has worked with clients who are struggling to develop a sense of secure attachment in their lives, but it is encouraging to see the concept covered here within the context of addiction treatment.
In chapter 5 we are finally introduced to the Minnesota Alternative model. DeSanto explains that it blends different techniques from a range of theoretical frameworks, including person-centered approaches such as psychiatric rehabilitation; motivational strategies; concepts from neuroscience; holistic and emotion-based interventions; and cultural humility.
We are then given a summary of each of the specific stages of the program (from assessment through completion), a program culture and philosophy, and the characteristics that would be required in staff members in order to successfully initiate this treatment model. The author also addresses those systemic challenges that might arise when this model is integrated within others.
There is a lot of useful information here, and DeSanto does an excellent job of pulling together tips and techniques from a variety of sources, shaping them into a new cohesive approach to treatment within the addictions field. I am not convinced that the Minnesota Alternative is quite the paradigm shift it claims to be — rather, it is a mix of several aspects from previous, existing models — but it certainly demonstrates a positive commitment to recovery from addiction, and places the client at the forefront of this recovery journey.
Effective Addiction Treatment: The Minnesota Alternative
CreateSpace Independent Publishing Platform, August, 2012
Paperback, 186 pages