Life stories used as evidence for the diagnosis of addiction in group therapy

Abstract

In this article I study how the life stories of patients are used as evidence in the diagnosis of addiction in Minnesota model group therapy. As part of this therapy, patients have to tell their life story, concentrating on their substance abuse. This story is used by the therapists as a means for getting patients to recognize and accept that they are addicts. For this purpose the therapists use intervening questions. This article concentrates on the placement and the structure of the patients’ responses to these interventions and the kinds of attitudes or standpoints the patients express. I will also discuss ways in which the theory of the Minnesota model informs the therapists’ actions by analysing the places within the patient's story where the therapists choose to intervene and the structure of their intervening turns. The data of the study consist of five 45-minute group therapy sessions and three multi-professional team meetings in a Finnish inpatient clinic. The therapists pose questions when the patient has said something that clearly hints at a symptom of addiction. The questions are designed as (disjunctive) yes/no questions which offer to the patient two alternative formulations of their talk to choose from. The first alternative hints at less problematic use of alcohol, and the latter, often an only implicit alternative, hints at more problematic consumption. This order offers to the patient an opportunity to choose the less problematic version in a preferred manner – if they are to display themselves as not having more problems with consumption than anyone else. The therapists can, then, use the patients’ responses to monitor how they have adopted the treatment and the diagnosis of addiction, that is, whether they are resistant or compliant.