The HB model described here is the HB model, I have developed at the inpatient treatment center Alfa-Fredensborg.
In short, it is described as a compassionate and effective treatment model for the clarification, assessment and treatment of alcohol and drug addiction, as well as other closely related disorders caused or aggravated by the problematic use of alcohol and illegal drugs or prescription drugs.
Alfa-Fredensborg's new unique HB model is based on more than 20 years of experience in offering alcohol and drug treatment in Denmark.
Alfa-Fredensborg has gone from being hardcore traditional Minnesota treatment in 2002, with the 12 steps, prayer and God, blue book, sponsor and 12 step self-help meetings to being the most innovative and ground-breaking alcohol and drug treatment center in Denmark.
Due to a conflict-ridden treatment environment, lack of results and a poor working environment, director Jørgen Maltesen, decided to replace the Minnesota model. After a trip to the USA 18 years ago in 2004, Alfa-Fredensborg agreed a collaboration with Terry Gorski from USA, to offer cognitive relapse prevention treatment based on the CENAPS model.
Alfa-Fredensborg's last major development step started 3 years ago, when the organization hired me to implement the HB model. We started the process at Alfa-Fredensborg, because the director Jørgen Maltesen wanted a less conflicted treatment environment, a fundamentally better working environment and a treatment method, where there was more focus on client involvement, as well as a more holistic health and lifestyle-based treatment.
The HB model has an exciting story - a story of breaking norms, going against what we know, challenging habits and systems, as well as holding on to the belief in and a desire to offer better alcohol and drug treatment in the future.
The first version of the HB model was developed in my old company Motivationshuset at the beginning of 2009. At the time, I called the model the "Building Block Model", because the client then built or assembled their own health and treatment plan using small blocks (each block representing a treatment activity, that the client desired, as part of the treatment plan).
In Denmark around 2009, there was a large influx of especially young new clients, who wanted treatment because of their problems with the use of alcohol, illegal drugs or prescription drugs. A fairly large proportion of these clients had previously been in alcohol and drug treatment without, however, achieving the goal of sustained and stable recovery.
At the request of Esbjerg municipality - I investigated whether it was possible to develop new and more modern alcohol and drug treatment methods.
My task was to develop and deliver better alcohol and drug treatment, preferably with a holistic health approach - and this had to be achieved by spending less money.
The building block model (2009 to 2014) was developed in my old company Motivationshuset, with great help from the social workers Karina Rohr Sørensen and Ditte Brøgger Løjborg.
The model was based on observations of clients with alcohol and drug addiction, underlying disorders, mental health problems, depression, post-traumatic stress, dyssocial personality traits or devastating personal health and lifestyle problems. The aim was to develop a new ground-breaking alcohol and drug treatment concept, based on values such as kindness, love and compassion. Where there should be a large degree of client involvement, with extra focus on supporting the clients, to find their own way, to achieve a life of freedom, with balance and health.
In 2018, I was employed at treatment center Alfa-Fredensborg as a project manager, with the aim of further developing and adapting the Building Block Model into a treatment concept for use in inpatient treatment. To give the model a fresh start in its new reality, I chose to rename the model the HB model (Heart and Brain model).
The HB model, which today is used with great success at Alfa-Fredensborg, was developed on the basis of clinical experiences with clients, with a serious degree of alcohol and drug addiction at five different treatment facilities:
(1) - Crimestop in Taastrup, outpatient program
(2) - Motivationhuset in Esbjerg, outpatient program
(3) - Life style house in Sweden, inpatient program
(4) - Alfa-Fredensborg in Fredensborg, inpatient program
(5) - Alfa-Copenhagen, outpatient program
In a historical perspective, the HB model can be described as the latest wave in the treatment of clients with alcohol and drug addiction, or other closely related disorders caused or aggravated, by the use of alcohol, illegal drugs or medication.
The HB model is not based on the basic principles of the 12-step program such as: God, higher power, blue book or the 12 steps of Alcoholics Anonymous (AA-/NA-/CA). The HB model doesn't have an opinion on whether something is good or bad. But it is always up to the clients themselves, to decide and find out if something suits them.
In the HB model, clients are free to use the elements of the 12-step program or other self-help support groups (if it makes sense and is part of their treatment plan). In the HB model, it is a basic value - that it is the individual client, who decides for himself, what he or she wants to do, to achieve a good life in freedom, with balance and health. The HB model always recognizes what makes sense for the client. The client is considered to be "the master of his own house", and we believe that the power to change life, lies primarily with the client himself. Instead of traditional Minnesota treatment, the HB model is based on newer and more modern treatment principles, such as the social educational model, the eclectic model, empowerment and solution-focused therapy model.
In addition, the HB model uses eight manual-based workbooks, which make it possible to individualize the treatment course, to the client's special treatment needs.
In a historical perspective, the HB model can be described as the fourth wave in the treatment of alcohol and drug addiction both in Denmark and other countries.
First treatment wave:
Year 1935: The introduction of the twelve steps of Alcoholics Anonymous and the introduction of alcoholism as a fatal disease.
Second treatment wave:
Year 1950: A merger of AA (sober alcoholics) with professional treatment into one model - also known as the Minnesota model or 12-step alcohol treatment.
Third treatment wave:
Year 1970: The CENAPS-Gorski model, which integrated knowledge of chemical dependency into a bio-psycho-social model that is both compatible with the principles of the 12-step program and with the principles of biological, cognitive, behavioral and social forms of therapy.
Fourth treatment wave:
Year 2009: The HB model, which integrates a bio-psycho-social treatment model into a holistic system for clarifying, assessing and treating alcohol and drug addiction. The model focuses on client involvement and is both compatible with the principles of an eclectic model, the theory of empowerment and a solution-focused model of relapse prevention.
I am addiction counselor and project manager at Alfa-Fredensborg. In addition, I am the developer of the HB model, as well as the author of the model's manual-based workbooks. I am also certified: addiction counselor, psychotherapist (2 years), treatment specialist, recovery coach, life & business coach and mindfulness instructor.
For more than 23 years, I have contributed knowledge and experience to the area of alcohol and drug treatment in Denmark and abroad, both as a therapist, teacher, author and concept developer.
When I started the development process of the HB model at treatment center Alfa-Fredensborg, I had the following objective:
(1) - to create the best treatment experience.
(2) - to create an inspiring treatment environment.
(3) - to develop a holistic health and treatment model
(4) - to create a healthy working environment.
(5) - to reduce stress and conflict levels.
(6) - to put the clients in focus during the treatment.
(7) - to develop manual based workbooks.
(8) - to create heart space and perform intelligent treatment
The HB model:
"Heart and Brain model"
Where the HB model really stands out from other treatment models, is the high degree of client involvement during the treatment process.
The HB model is based on the fact, that "the clients are the experts in their own life's and they must only work therapeutically with what makes sense to them".
The HB model is based on the fact, that the best treatment results are achieved with a high degree of client involvement and when a health-oriented and solution-focused effort is offered. The treatment must be interdisciplinary and must be offered by both healthcare professionals, social workers and psychotherapeutic professionals.
The very special thing about the HB model is the high degree of client involvement. This means, that the clients, on a daily basis, must have the opportunity (at a morning meeting) to select the health and treatment activities they want, need, or have the resources to participate in. By offering treatment with the HB model, we can now proudly say that the model is effective and has already proven its worth.
The HB model is multi-flexible, so that it easily can be adapted to several different levels of care and to a wide range of clients, who are associated with either inpatient, outpatient or prison treatment.
The HB model is easily integrated into various cognitive, emotion-based, behavioral and social forms of therapy and treatment. One of the model's many strengths is the interdisciplinary approach and the holistic health and treatment focus.
The HB model I have developed at treatment center Alfa-Fredensborg uses a wide variety of effective health and health-promoting treatment activities such as:
(1) Trauma therapy with a psychologist
(2) Investigation by doctors and psychiatrists
(3) Social counseling (economics - legal - family)
(4) Nursing care and health guidance
(5) Yoga, meditation and mindfulness
(6) Problem-solving group therapy
(7) Psychoeducation and workshops
(8) Individual therapy with addiction counsellor
(9) Guidance on sleep and diet (based on body type)
(10) Personal development via manual based workbooks
The HB model has a vision and goal to create the world's best alcohol and drug treatment, so in addition to having a high degree of client involvement, you must also have some effective treatment components that are based on the fact that people are affected negatively bio-psycho-socially, when they use alcohol, illegal drugs or presciption drugs.
If we are to fulfill the ambition to offer good and effective treatment, we must take care of the negative consequences the drugs have created and work with the underlying challenges, that may be the reason why alcohol and drugs have become a solution model.
The HB model's high degree of client involvement is the framework that creates the opportunities to carry out effective treatment. The many different treatment components are the practical tools/techniques to create progression and development in the clients, during their treatment course.
The HB model I have developed at Alfa-Fredensborg is based on more than 22 years of experience in offering alcohol and drug treatment.
Based on these experiences, I have chosen the following effective treatment components. Each of these treatment components relates to a general problem that is often the central focus of alcohol and drug treatment.
Together, these components form effective guides that relate to approx. 75% of the problems presented by clients in an alcohol and drug treatment course in Denmark and other countries.
Effective start of the treatment process
This treatment component offers clients a master plan consisting of a manual-based workbook "Notebook", with methods to achieve a good and effective beginning to an alcohol and drug treatment course. The clients use a stress and function scale, after which, in collaboration with the therapist, they map their current state and then set a goal around their general stress, well-being and ability to function. Clients are encouraged to continuously take notes from the health and treatment activities they participate in and make weekly reflections on the level of participation and any health, personal and lifestyle progress.
Clarification and assessment of the client's treatment needs
This treatment component offers the clients a master plan consisting of a manual-based workbook "The Clarification Book", that contains useful knowledge, various tests and self-evaluation exercises to clarify and assess their current treatment needs. By going through the exercises, the clients are investigated for any underlying disorders that may cause or "trigger" the urge to use alcohol, illegal drugs or medicine. In addition, the clients must deal with their motivation, upbringing conditions, psychological problems, post-traumatic stress, dyssocial personality traits and any personality and lifestyle crises, that have arisen.
Effective health and treatment planning
This treatment component offers clients a master plan consisting of a manual-based workbook "The Health Plan", with knowledge and effective techniques for putting together a holistic health and treatment plan. Here S.M.A.R.T is used in each of the 10 life (re)building areas in the health model, and the goal is to put together a plan, with different health activities, all of which, support a life without alcohol and drugs, crime, stress and post-acute abstinence. There is motivation to build an exciting life with freedom, balance and health.
Dealing with alcohol or drug addiction
This treatment component offers users a master plan, consisting of a manual-based workbook "Management of alcohol or drug addiction". The clients receive knowledge about alcohol and drug addiction, as well as techniques for implementing health activities to be used, to prevent problematic use of alcohol and drugs in the future. The clients are motivated to build a stable life with freedom, balance and health. The book provides an understanding of the imbalances in the brain and nervous system, that can cause cravings, vulnerability to stress and post-acute withdrawals, which must also be learned to handle, for to avoid addictive behavior or relapse to alcohol and drugs.
Dealing with relapses and acute life crises
This treatment component offers users a master plan, consisting of a manual-based workbook "Management of relapses and acute life crises". The clients are given suggestions and techniques to put together an effective emergency preparedness - should a relapse occur - and to prepare a comprehensive list of acute crises, that can lead to new relapses. The goal is to develop an effective crisis plan in which friends, family and networks actively help to stop the relapse, should it happen. Then gain knowledge and techniques to manage cravings, stress, post-acute withdrawal and emerging crises, before these crises activate the urge to use alcohol and drugs.
Relapse prevention therapy
This treatment component offers users a master plan, consisting of a manual-based workbook "Relapse prevention therapy". The clients receive knowledge and techniques to get back into a stable health process, after a shorter or longer relapse. The goal is to teach the clients to track down and deal with acute crises, addictive thinking and the deeper personality and lifestyle problems, that can disrupt a health process and activate the urge for alcohol and drugs, with new relapses as a result. It is encouraged to use the 10 life (re)building areas in the health model, to create bio-psycho-social balance, prevent cravings for alcohol and drugs, stress, post-acute withdrawal and new relapses.
Dealing with antisocial personality traits
This treatment component offers a master plan consisting of a manual based workbook "Dealing with antisocial personality traits". The clients receive knowledge, tests and self-evaluation exercises for clarification, investigation and treatment of drug addiction and antisocial personality traits. Clients must learn about the connection between the two disorders and create an effective strategy for treating both disorders at the same time. The goal is to detect and deal with acute emerging crises, identify antisocial thought patterns, and compile a comprehensive list of situations, people, and places to avoid, in order to remain responsible in the health process. It is encouraged to use the health model's 10 life (re)building areas, to create bio-psycho-social balance, as well as to prevent cravings, stress, post-acute withdrawal and new relapses.
Dealing with gambling addiction
This treatment component offers a master plan, consisting of a manual based workbook "Dealing with gambling addiction". The clients receive knowledge about gambling addiction in the form of addiction to various forms of gambling or the urge to take risks. The clients receive instructions and techniques for implementing health activities, that are used to prevent the urge to gamble, as well as the urge to use risky behavior in the future. The goal is to learn how to build a life of freedom, balance and health, and to gain an understanding of imbalances in the brain and nervous system, that can lead to vulnerability to stress and acute life crises, which are most often the triggering factors for gambling or taking others risk.
Therapy for dual diagnoses
This treatment component offers individual therapy for various mental and personality disorders. Clients learn through therapy to integrate the treatment of alcohol and drug addiction and the related and deeper mental and personality disorders, that often lead to relapse, if left untreated. The therapy is both supportive and challenging on how to deal with psychological challenges. They will receive more self-knowledge and insight on their own resources and positive qualities.
Therapy for post-traumatic stress disorder
This treatment component offers trauma therapy with the use of e.g. EMDR therapy. It is often a long-term trauma therapy course for clients, with a history of trauma. There is a focus on processing traumatic events and debilitating symptoms, where alcohol and drugs may have been used for self-medication. In addition, clients learn to build a life of freedom, balance and health, and gain an understanding of imbalances in the brain and nervous system that can lead to vulnerability to stress and life crises, which are most often the triggering factors for self-medication or self-harm.