How alcohol treatment centers have changed through the years

The Washingtonian Movement

The first major incarnation of what would now be called the Alcohol Treatment Center appeared as a result of the Washington Total Abstinence Movement of 1842. Known as the "Washingtonians," movement followers dedicated themselves to helping "inebriates" sober up. The Washingtonians believed in mutual aid and created "refuge houses for drunkards" where those struggling with addiction could stay for a short time while being introduced to the Washingtonian fellowship, which would help them find jobs and generally get back on their feet.

The Washingtonians were not, however, the only people trying to provide solutions to the problem of alcoholism. Another paradigm in use at the time was the Asylum model. The key belief of this system was that "drunkards" could not be effectively helped on a voluntary basis. Like the mentally ill, those struggling with alcohol dependance were often confined for long periods of time.

AA's contribution

The alcohol treatment center concept underwent a major change in the late 1930s and 1940s, with the advent of Alcoholics Anonymous and their trademark, spirituality-based 12-step program. AA introduced the "disease concept" of addiction and effectively changed the way the public viewed alcoholism and treatment. AA, combined with the expense of maintaining large institutions, helped put an end to the Asylum method of alcoholism treatment.

By the 1960s, some state hospitals, especially those located in the state of Minnesota, began incorporating AA's 12-step principles into treatment programs. The "Minnesota model" consisted of an intensive period of detoxification -- usually lasting about seven days -- followed be several weeks of rehabilitation. This came to be known as the "28 day" model, since it usually took about a month for the participant to complete the program.

Things continued to change in the late 1960s through the 1970s. Several government task forces and several new pieces of legislation were developed to address alcoholism, and as a result, health insurance companies began incorporating substance abuse programs into their coverage plans. The result was that the alcohol treatment center had to adapt to the desires of patients who had gained more control over their choice of programs.

Programs continued to evolve through 1980s, 1990s, and the first decade of the 21st century. Today, people who feel they would benefit from treatment at an alcohol treatment center have many different programs and models to choose from. Many are based on AA's 12-step programs, while others have different theoretical underpinnings and may or may not require belief in a higher power. This choice offers hope for those suffering from addiction, since finding the right fit for treatment is an important aspect of sustainable recovery.

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