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Britton EM, Taisir R, Cooper A, Remers S, Chorny Y, LaBelle O, Rush B, MacKillop J, Costello MJ. Psychometric Evaluation of an Adapted Short-Form Spirituality Scale in a Sample of Predominantly White Adults in an Inpatient Substance Use Disorder Treatment Program. Assessment 2024; 31:1309-1323. [PMID: 38160429 DOI: 10.1177/10731911231217478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Spirituality is an important aspect of treatment and recovery for substance use disorders (SUDs), but ambiguities in measurement can make it difficult to incorporate as part of routine care. We evaluated the psychometric properties of an adapted short-form version of the Spirituality Scale (the Spirituality Scale-Short-Form; SS-SF) for use in SUD treatment settings. Participants were adult patients (N = 1,388; Mage = 41.23 years, SDage = 11.55; 68% male; 86% White) who entered a large, clinically mixed inpatient SUD treatment program. Factor analysis supported the two-dimensional structure, with factors representing Self-Discovery and Transcendent Connection. Tests of measurement invariance demonstrated that the scale was invariant across age and gender subgroups. The SS-SF exhibited convergent and concurrent validity via associations with participation in spiritual activities, hopefulness, life satisfaction, 12-step participation, and depressive symptoms. Finally, scores on the SS-SF were significantly higher at discharge compared to admission, demonstrating short-term sensitivity to change. These findings support use of the SS-SF as a concise, psychometrically sound measure of spirituality in the context of substance use treatment.
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Affiliation(s)
| | - Radia Taisir
- Homewood Research Institute, Guelph, Ontario, Canada
| | - Alysha Cooper
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Yelena Chorny
- Homewood Health Centre, Guelph, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
| | - Onawa LaBelle
- Homewood Research Institute, Guelph, Ontario, Canada
- University of Windsor, Ontario, Canada
| | - Brian Rush
- Homewood Research Institute, Guelph, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Ontario, Canada
| | - James MacKillop
- Homewood Research Institute, Guelph, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Ontario, Canada
| | - Mary Jean Costello
- Homewood Research Institute, Guelph, Ontario, Canada
- University of Waterloo, Ontario, Canada
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Egan R, Gross J, Cameron C, Hobbs L, Patterson T. Spirituality: A Key Component of the Salvation Army's Bridge Programme Model of Treatment in Aotearoa New Zealand. JOURNAL OF RELIGION AND HEALTH 2022:10.1007/s10943-022-01674-7. [PMID: 36175736 PMCID: PMC10366305 DOI: 10.1007/s10943-022-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Spirituality is vital to The Salvation Army's Bridge model of treatment for alcohol and drug addiction. Spirituality is expressed through Recovery Church, prayer, spirituality lifters, the 12-step programme, and focuses on meaning and purpose. We recruited participants from several regional centers throughout Aotearoa New Zealand and evaluated spirituality using the WHOQol-SRPB and open-ended questions. Most participants held broad understandings of spirituality, only a minority equating it with religion. Participants who completed the Programme had statistically significant increases in spiritual wellbeing at end-of-treatment. These increases were maintained at a 3-month follow-up. Increases in spiritual wellbeing were associated with decreases in severity of alcohol and drug use.
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Affiliation(s)
- Richard Egan
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Julien Gross
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Claire Cameron
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Linda Hobbs
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Tess Patterson
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
- Opentia Research Focus Area, North-West University, Potchefstroom, South Africa
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Foulis SJ, Rigby K, Loftus A, Satchidanand N, Holmes D. Patient-centered addiction medicine: What patients say helps them the most in their recovery - the role of whole-person Healthcare and prayer in opioid addiction recovery. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Current Mental Health Clients’ Attitudes Regarding Religion and Spirituality in Treatment: A National Survey. RELIGIONS 2021. [DOI: 10.3390/rel12060371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the last several years, there has been a growing interest in clients’ views toward integrating their religion and spirituality (RS) into mental health treatment. However, most of these studies have been limited to small samples and specific populations, regions, and/or clinical issues. This article describes the first national survey of current mental health clients across the US regarding their attitudes towards integrating their RS in treatment using a revised version of the Religious/Spiritually Integrated Practice Assessment Scale-Client Attitudes, version 2 (RSIPAS-CAv2) with a sample of 989 clients. Our findings indicate mental health clients have overwhelmingly positive attitudes regarding integrating their RS into mental health treatment. Additionally, we explored what background characteristics predict clients’ attitudes toward this area of practice and found the top predictor was their intrinsic religiosity, followed by whether they had previously discussed RS with their current provider, age, gender, organized and non-organized religious activities, belief in God/Higher Power, and frequency of seeing their mental health provider. The reliability and validity of the RSIPAS-CAv2 was also explored and this scale is recommended for future use. Implications and recommendations for practice, research, and future training efforts are discussed.
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Farnia V, Abdoli N, Radmehr F, Alikhani M, Moradinazar M, Rezaei M, Behrooz B, Davarinejad O. Validation of the Persian version of the AWAER questionnaire (preventive warning of relapse – revised form) in methamphetamine users. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1838633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farnaz Radmehr
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Behrooz
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Omron Davarinejad
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Mallik D, Bowen S, Yang Y, Perkins R, Sandoz EK. Raja yoga meditation and medication-assisted treatment for relapse prevention: A pilot study. J Subst Abuse Treat 2018; 96:58-64. [PMID: 30466550 DOI: 10.1016/j.jsat.2018.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 01/27/2023]
Abstract
The continued need for advancement in evidence-based SUD treatment, as well as increases in treatment expense and decline in support from insurance providers, suggest that brief, innovative, and affordable treatments are needed. Meditation, spirituality, and adherence to medication-assisted treatments have all been shown to support abstinence. The current trial assessed effects of spiritually-based meditation, versus relaxation or standard treatment, on substance abstinence and psychological distress and dysfunction in a partially buprenorphine-supported (41.5%) treatment sample. Participants (N = 40) were recruited from an intensive outpatient treatment program, in which three treatment locations acted as separate experimental conditions. Abstinence was measured through urinalyses at baseline and weekly thereafter for the duration of the intervention. Psychological distress and dysfunction were assessed with a Likert-scaled questionnaire measuring symptoms typically associated with SUD. Co-varying for buprenorphine use, participants in the Meditation condition had better odds of remaining abstinent than participants in the Treatment-as-Usual (TAU) and Relaxation conditions. There were no significant differences in substance abstinence between the Relaxation and TAU conditions. Further, co-varying out baseline there were no significant differences at post-course in psychological distress and dysfunction between the three conditions. Results from this pilot trial suggest that this spiritually-informed approach may offer additive support to individuals in SUD treatment, as an aid to the meditative aspect of the 12 steps, or a non-12-step alternative spiritual supplement to standard SUD treatment.
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Affiliation(s)
- Debesh Mallik
- University of Louisiana at Lafayette, P.O. Box 43644, Lafayette, LA 70504, United States of America.
| | - Sarah Bowen
- Pacific University, United States of America
| | - Yang Yang
- University of Louisiana at Lafayette, United States of America
| | - Richard Perkins
- University of Louisiana at Lafayette, United States of America
| | - Emily K Sandoz
- University of Louisiana at Lafayette, United States of America
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Braid R. Our Healing: An Empirical Study of the Interrelationship Between Therapeutic Intervention and Spiritual Intervention in a Social Work Private Practice. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2017. [DOI: 10.1080/19349637.2017.1361255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Religious Beliefs and Their Relevance for Treatment Adherence in Mental Illness: A Review. RELIGIONS 2017. [DOI: 10.3390/rel8080150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gonçalves AMDS, Santos MAD, Chaves EDCL, Pillon SC. Transcultural adaptation and validation of the Brazilian version of Treatment Spirituality/Religiosity Scale. Rev Bras Enferm 2016; 69:235-41. [PMID: 27280558 DOI: 10.1590/0034-7167.2016690205i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 09/29/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: realizar a tradução e adaptação transcultural, bem como analisar as propriedades psicométricas do instrumento Treatment Spirituality / Religiosity Scale (TSRS) para a língua portuguesa do Brasil. Método: a amostra foi composta por 188 estudantes de Enfermagem de níveis técnico e superior. A análise da confiabilidade por teste-reteste foi realizada um mês após a primeira aplicação do instrumento. Para mensurar a validação de constructo procedeu-se a análise fatorial. Resultados: a versão brasileira da TSRS manteve-se com 10 itens, com dois fatores. A confiabilidade por teste-reteste apresentou coeficiente Kappa variando de 0,22 a 0,47, consistência interna global alfa de Cronbach de 0,85. Conclusão: a versão brasileira do TSRS apresentou valores de validade e de consistência interna satisfatórios, mostrando-se adequada para uso no contexto nacional.
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Affiliation(s)
- Angélica Martins de Souza Gonçalves
- Universidade Federal de São Carlos, Departamento de Enfermagem, São Carlos SP , Brazil, Universidade Federal de São Carlos, Departamento de Enfermagem. São Carlos-SP, Brasil., Universidade Federal de São Carlos
| | - Manoel Antônio Dos Santos
- Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Ribeirão Preto SP , Brazil, Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto. Ribeirão Preto-SP, Brasil., Universidade de São Paulo
| | - Erika de Cássia Lopes Chaves
- Universidade Federal de Alfenas, Departamento de Enfermagem, Alfenas MG , Brazil, Universidade Federal de Alfenas, Departamento de Enfermagem. Alfenas-MG, Brasil., Universidade Federal de Alfenas
| | - Sandra Cristina Pillon
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Ribeirão Preto SP , Brazil, Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Psiquiátrica e Ciências Humanas. Ribeirão Preto-SP, Brasil., Universidade de São Paulo
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Rosmarin DH, Forester BP, Shassian DM, Webb CA, Björgvinsson T. Interest in spiritually integrated psychotherapy among acute psychiatric patients. J Consult Clin Psychol 2015; 83:1149-53. [PMID: 26280491 DOI: 10.1037/ccp0000046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Spiritually integrated psychotherapy (SIP) is increasingly common, though systematic assessment of interest in such treatments, and predictors of such interest, has not yet been conducted among acute psychiatric patients. METHODS We conducted a survey with 253 acute psychiatric patients (95-99% response rate) at a private psychiatric hospital in Eastern Massachusetts to assess for interest in SIP, religious affiliation, and general spiritual or religious involvement alongside clinical and demographic factors. RESULTS More than half (58.2%) of patients reported "fairly" or greater interest in SIP, and 17.4% reported "very much" interest. Demographic and clinical factors were not significant predictors except that current depression predicted greater interest. Religious affiliation and general spiritual or religious involvement were associated with more interest; however, many affiliated patients reported low or no interest (42%), and conversely many unaffiliated patients reported "fairly" or greater interest (37%). CONCLUSIONS Many acute psychiatric patients, particularly individuals with major depression, report interest in integrating spirituality into their mental health care. Assessment of interest in SIP should be considered in the context of clinical care.
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Affiliation(s)
- David H Rosmarin
- Department of Psychiatry, McLean Hospital, Harvard Medical School
| | - Brent P Forester
- Department of Psychiatry, McLean Hospital, Harvard Medical School
| | | | - Christian A Webb
- Department of Psychiatry, McLean Hospital, Harvard Medical School
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Ghani MA, Brown SE, Khan F, Wickersham JA, Lim SH, Dhaliwal SK, Kamarulzaman A, Altice FL. An exploratory qualitative assessment of self-reported treatment outcomes and satisfaction among patients accessing an innovative voluntary drug treatment centre in Malaysia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:175-82. [PMID: 25577322 PMCID: PMC4291539 DOI: 10.1016/j.drugpo.2014.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 08/29/2014] [Accepted: 10/19/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND In Malaysia, compulsory drug detention centres (CDDCs) hold suspected drug users for two years without adjudication. Acute detoxification without healthcare access has been documented. CDDCs are criticized globally due to ineffectiveness in treating addiction and human rights violations. In response, the Malaysian government began transitioning these facilities into voluntary drug treatment centres known as "Cure and Care" (C&C) centres that embrace a holistic treatment-based approach to drug addiction rehabilitation. METHODS An explorative qualitative study was undertaken to explore patient perspectives and satisfaction regarding treatment and services at the new Cure and Care centre in Kota Bharu, Malaysia. A convenience sample of 20 patients was recruited to participate in semi-structured in-depth interviews. Content analysis was used to identify the salient themes. RESULTS Patients identified methadone treatment, psychosocial programs, religious instruction, and recreational activities as important factors contributing to treatment success for addressing both health and addiction needs. Though many had previously been in a CDDC, adherence to treatment in the C&C centre was perceived to be facilitated by the degree of social support, the voluntary nature and the array of new programs available for selection. CONCLUSION C&Cs represents a dramatic shift in the Malaysian government's approach to drug addiction. Our findings demonstrate positive patient experiences associated with the holistic treatment-based approach of these centres. This exploratory study provides additional evidence to document this ongoing policy transition and may guide continued expansion of new holistic drug treatment programs across the country.
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Affiliation(s)
- Mansur A Ghani
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA
| | - Shan-Estelle Brown
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA
| | - Farrah Khan
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA
| | - Jeffrey A Wickersham
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA
| | - Sin How Lim
- Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Adeeba Kamarulzaman
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA; Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Frederick L Altice
- Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, USA; Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Hodge DR, Lietz CA. Using spiritually modified cognitive-behavioral therapy in substance dependence treatment: therapists' and clients' perceptions of the presumed benefits and limitations. HEALTH & SOCIAL WORK 2014; 39:200-10. [PMID: 25369720 DOI: 10.1093/hsw/hlu022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Cognitive-behavioral therapy (CBT) that has been modified to incorporate clients' spiritual beliefs and practices has been used to treat a variety of problems. This study examines the utility of this modality with the treatment of alcohol dependence and other forms of substance abuse. Toward this end, six focus groups (three therapist groups and three client groups) were conducted to identify the presumed benefits and limitations of using spiritually modified CBT in substance dependence treatment. In terms of benefits, spiritually modified CBT was perceived to enhance outcomes through operationalizing horizontal and vertical sources of social support, divine coping resources, and spiritual motivation. Potential challenges include the risk of therapists inadvertently imposing their own beliefs during the modification process and the possibility of offending clients when conflicts in belief systems emerge, particularly in group setting. The article concludes by providing suggestions for incorporating spiritually modified CBT into treatment and develops a number of illustrative examples of spiritually modified CBT self-statements.
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White R, Jain S, Giurgi-Oncu C. Counterflows for mental well-being: what high-income countries can learn from low and middle-income countries. Int Rev Psychiatry 2014; 26:602-6. [PMID: 25343638 DOI: 10.3109/09540261.2014.939578] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Global mental health is a comparatively new area of study and research that is concerned with addressing inequities and inequalities in mental health provision across the globe. In recent years concerted efforts have been made to scale up mental health services in low- and middle-income countries (LMIC). As such, there has been tendency to view LMIC as recipients of mental health-related knowledge, rather than providers of knowledge. Critics have referred to the prevailing flow of information from high-income countries (HIC) to LMIC as a form of medical imperialism. To redress the apparent imbalance in knowledge exchange, this paper reflects on valuable lessons that HIC can potentially learn from LMIC in terms of supporting mental well-being. Specifically, the paper reflects on how a greater willingness to embrace pluralism in HIC may facilitate people to engage with forms of support that they believe to be appropriate for them. The paper also explores examples of what are termed 'counterflows' of knowledge; ideas that have originated from LMIC that are influencing mental health-related practice in HIC. Barriers to potential counterflows are discussed.
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Affiliation(s)
- Ross White
- Mental Health and Well-Being, University of Glasgow , Glasgow , UK
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Torchalla I, Li K, Strehlau V, Linden IA, Krausz M. Religious participation and substance use behaviors in a Canadian sample of homeless people. Community Ment Health J 2014; 50:862-9. [PMID: 24504535 DOI: 10.1007/s10597-014-9705-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 01/30/2014] [Indexed: 11/29/2022]
Abstract
This study examined religious behaviors in 380 homeless individuals. We hypothesized that higher frequency of religious attendance is associated with lower rates of use of all substances, lower rates of drug and alcohol dependence, and lower psychological distress. Individuals attending religious ceremonies at least weekly ("frequent attendees") were compared to infrequent attendees. Participants also provided qualitative information about their faith. In univariate analyses, frequent attendees had significantly lower rates of alcohol, cocaine, and opioid use than infrequent attendees. They also had lower rates of alcohol and drug dependence, lifetime suicide attempts, and psychological distress, but these differences were not significant. In multivariate analyses, religious attendance remained significantly associated with alcohol use and opioid use. Researchers need to examine how spiritual and religious practices can be effectively incorporated as a part of substance abuse treatment.
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Affiliation(s)
- Iris Torchalla
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, 620B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada,
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Tang WM. Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong. Subst Abuse Rehabil 2014; 5:53-62. [PMID: 25114609 PMCID: PMC4074179 DOI: 10.2147/sar.s61885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed.
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Affiliation(s)
- Wai-Man Tang
- Anthropology Department, The Chinese University of Hong Kong, Hong Kong
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Corry DAS, Lewis CA, Mallett J. Harnessing the Mental Health Benefits of the Creativity–Spirituality Construct: Introducing the Theory of Transformative Coping. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2014. [DOI: 10.1080/19349637.2014.896854] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hodge DR. Implicit spiritual assessment: an alternative approach for assessing client spirituality. SOCIAL WORK 2013; 58:223-230. [PMID: 24032303 DOI: 10.1093/sw/swt019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
To provide optimal services, a spiritual assessment is often administered to understand the intersection between clients' spirituality and service provision. Traditional assessment approaches, however, may be ineffective with clients who are uncomfortable with spiritual language or who are otherwise hesitant to discuss spirituality overtly. This article orients readers to an implicit spiritual assessment, an alternative approach that may be more valid with such clients. The process of administering an implicit assessment is discussed, sample questions are provided to help operationalize this approach, and suggestions are offered to integrate an implicit assessment with more traditional assessment approaches. By using terminology that is implicitly spiritual in nature, an implicit assessment enables practitioners to identify and operationalize dimensions of clients' experience that may be critical to effective service provision but would otherwise be overlooked.
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Abstract
Religious conversion has been the core of religion-based treatment models (e.g., Teen Challenge programs in the United States and Operation Dawn in Taiwan). This study aims to assess the impact of religious conversion on treatment retention and completion and to identify correlates of treatment retention and completion. In-take data and administrative records from 708 substance abusers who participated in an Evangelical faith-based recovery program in Taiwan between January 2001 and March 2009 were used to analyze the effect of religious conversion on treatment retention and completion. It was found that religious conversion is a strong predictor of length of stay in treatment and completion of treatment. Findings shed light on the empirical adequacy of the religious model of recovery and the profile of substance abusers likely to respond to faith-based interventions.
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Affiliation(s)
| | - Hung-En Sung
- John Jay College of Criminal Justice, New York, NY, USA
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Dalmida SG, Holstad MM, DiIorio C, Laderman G. The meaning and use of spirituality among African American women living with HIV/AIDS. West J Nurs Res 2012; 34:736-65. [PMID: 22566288 DOI: 10.1177/0193945912443740] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The purpose of this qualitative study was to explore the meaning and use of spirituality among African American (AA), predominantly Christian women with HIV. A nonrandom sample of 20 AA women from a large infectious disease clinic in Metro-Atlanta participated in the study. The study used focus groups and individual interviews to interview women about their lived spiritual experience. Content analysis and NUDIST software were used to analyze transcripts. The findings revealed the spiritual views and practices of AA women with HIV. The following themes (and subthemes) emerged: Spirituality is a process/journey or connection (connection to God, higher power, or spirit and HIV brought me closer to God), spiritual expression (religion/church attendance, prayer, helping others, having faith), and spiritual benefits (health/healing, spiritual support, inner peace/strength/ability to keep going, and here for a reason or purpose/a second chance). Findings highlight the importance of spirituality in health and well-being among AA women with HIV/AIDS.
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Lee EKO. Mind—Body—Spirit Practice and Perceived Self-Efficacy for Mental Health Promotion: An Exploratory Study. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2007.9721841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wachholtz A, Gonzalez G, Boyer E, Naqvi ZN, Rosenbaum C, Ziedonis D. Intersection of chronic pain treatment and opioid analgesic misuse: causes, treatments, and policy strategies. Subst Abuse Rehabil 2011; 2:145-62. [PMID: 24474854 PMCID: PMC3846312 DOI: 10.2147/sar.s12944] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Treating chronic pain in the context of opioid misuse can be very challenging. This paper explores the epidemiology and potential treatments for chronic pain and opioid misuse and identifies educational and regulation changes that may reduce diversion of opioid analgesics. We cover the epidemiology of chronic pain and aberrant opioid behaviors, psychosocial influences on pain, pharmacological treatments, psychological treatments, and social treatments, as well as educational and regulatory efforts being made to reduce the diversion of prescription opioids. There are a number of ongoing challenges in treating chronic pain and opioid misuse, and more research is needed to provide strong, integrated, and empirically validated treatments to reduce opioid misuse in the context of chronic pain.
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Affiliation(s)
- Amy Wachholtz
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Gerardo Gonzalez
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Edward Boyer
- Department of emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Zafar N Naqvi
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christopher Rosenbaum
- Department of emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Douglas Ziedonis
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Wachholtz A, Ziedonis D, Gonzalez G. Comorbid pain and opioid addiction: psychosocial and pharmacological treatments. Subst Use Misuse 2011; 46:1536-52. [PMID: 21756033 DOI: 10.3109/10826084.2011.559606] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Treating comorbid pain (nonmalignant) and opioid addiction is a complex endeavor that requires cooperation of multi-modal treatment teams incorporating pharmacological, psychological, and social components. There are multiple barriers for patients, mental health practitioners, and physical health practitioners to provide complete treatment for this difficult treatment population. In this article, we will review which treatments have been empirically validated in this treatment population, where further research is required, and considerations for potential "best approaches" to use for patient treatment while waiting for empirically validated treatment data. We will also discuss some complementary and alternative medicine approaches that have empirical validity in treating either pain or addiction individually, though empirical validity for the treatment of comorbid pain and addiction has not been established.
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Affiliation(s)
- Amy Wachholtz
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
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24
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Hagedorn WB, Moorhead HJH. The God-Shaped Hole: Addictive Disorders and the Search for Perfection. COUNSELING AND VALUES 2010. [DOI: 10.1002/j.2161-007x.2010.tb00022.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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25
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Krentzman AR, Farkas KJ, Townsend AL. Spirituality, Religiousness, and Alcoholism Treatment Outcomes: A Comparison between Black and White Participants. ALCOHOLISM TREATMENT QUARTERLY 2010; 28:128-150. [PMID: 22707846 DOI: 10.1080/07347321003648661] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study addresses an unexplained finding in the alcoholism treatment field: despite the health and socioeconomic disparities that exist between blacks and whites at intake, blacks and whites achieve equivalent treatment outcomes. Using Project MATCH data, this study explores religiousness and spirituality as strengths in the African American community that may account in part for equivalent outcomes. Using binary logistic regression, this study found that as purpose in life increased, blacks were more likely to achieve sobriety than whites. This study provides evidence that purpose in life is a cultural strength and an advantage among blacks in achieving sobriety.
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Affiliation(s)
- Amy R Krentzman
- University of Michigan Addiction Research Center, Ann Arbor, MI, and The Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
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26
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Heinz AJ, Disney ER, Epstein DH, Glezen LA, Clark PI, Preston KL. A focus-group study on spirituality and substance-user treatment. Subst Use Misuse 2010; 45:134-53. [PMID: 20025443 PMCID: PMC2943841 DOI: 10.3109/10826080903035130] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Focus groups were conducted in 2005-2006 with 25 urban methadone-maintained outpatients to examine beliefs about the role of spirituality in addiction and its appropriateness in formal treatment. Thematic analyses suggested that spirituality and religious practices suffered in complex ways during active addiction, but went "hand in hand" with recovery. Participants agreed that integration of a voluntary spiritual discussion group into formal treatment would be preferable to currently available alternatives. One limitation was that all participants identified as strongly spiritual. Studies of more diverse samples will help guide the development and evaluation of spiritually based interventions in formal treatment.
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Affiliation(s)
- Adrienne J Heinz
- Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland 21224, USA
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27
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Lillis J, Gifford E, Humphreys K, Moos R. Assessing spirituality/religiosity in the treatment environment: the Treatment Spirituality/Religiosity Scale. J Subst Abuse Treat 2009; 35:427-33. [PMID: 18424049 DOI: 10.1016/j.jsat.2008.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Revised: 01/30/2008] [Accepted: 02/18/2008] [Indexed: 11/25/2022]
Abstract
There has been much interest in measuring and evaluating the role of spirituality/religiosity (S/R) in substance use disorder (SUD) treatment. This study presents the initial evaluation of a new measure of S/R in the treatment environment: the Treatment Spirituality/Religiosity Scale (TSRS). The TSRS has 10 items and can be completed by both patient and staff to measure the emphasis on S/R in a given treatment program, which may have important implications for patient-program fit. Data on the TSRS were gathered from 3,018 patients and 329 staff members from 15 residential SUD treatment programs within the Department of Veterans Affairs Health Care System. The TSRS showed good internal consistency (alpha = .77), a single-factor structure, close agreement between patients and staff members (r = .93), and good discriminant validity. The TSRS appears to be a brief, easily administered, and potentially useful measure of the emphasis on S/R in residential SUD treatment programs.
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Affiliation(s)
- Jason Lillis
- VA Palo Alto Health Care System, Stanford University Medical School, Menlo Park, CA 94025, USA.
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28
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Mason SJ, Deane FP, Kelly PJ, Crowe TP. Do spirituality and religiosity help in the management of cravings in substance abuse treatment? Subst Use Misuse 2009; 44:1926-40. [PMID: 20001289 DOI: 10.3109/10826080802486723] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to examine the relationship of spirituality, religiosity and self-efficacy with drug and/or alcohol cravings. A cross-sectional survey was completed by 77 male participants at an Australian Salvation Army residential rehabilitation service in 2007. The survey included questions relating to the participants' drug and/or alcohol use and also measures for spirituality, religiosity, cravings, and self-efficacy. The sample included participants aged between 19 and 74 years, with more than 57% reporting a diagnosis for a mental disorder and 78% reporting polysubstance misuse with alcohol most frequently endorsed as the primary drug of concern (71%). Seventy-five percent of the clients reported that spirituality and religious faith were useful components of the treatment program. A multivariate multiple regression analysis identified that spirituality and self-efficacy have significant relationships with cravings. Self-efficacy mediated the relationship between spirituality and drug and/or alcohol cravings. The limitations of this study included its cross-sectional design and a sample that was drawn from a faith-based program. Future research would benefit from the longitudinal examination of the relationship between spirituality, self-efficacy, and cravings; the exploration of a broader range of client-specific and interpersonal variables; and the inclusion of a control group from a secular treatment facility.
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Affiliation(s)
- Sarah J Mason
- Illawarra Institute for Mental Health and School of Psychology, University of Wollongong, Wollongong, Australia
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29
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Philbin MM, Lozada R, Zúñiga ML, Mantsios A, Case P, Magis-Rodriguez C, Latkin CA, Strathdee SA. A qualitative assessment of stakeholder perceptions and socio-cultural influences on the acceptability of harm reduction programs in Tijuana, Mexico. Harm Reduct J 2008; 5:36. [PMID: 19021899 PMCID: PMC2613137 DOI: 10.1186/1477-7517-5-36] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 11/20/2008] [Indexed: 11/26/2022] Open
Abstract
Background The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. Methods We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions – Needle exchange programs (NEPs), syringe vending machines, and safer injection facilities (SIFs) – in Tijuana, Mexico. In-depth qualitative interviews were conducted with 40 community stakeholders to explore cultural and societal-related themes. Results Themes that emerged included Tijuana's location as a border city, family values, and culture as a mediator of social stigma and empathy towards IDUs. Perception of low levels of both awareness and socio-cultural readiness for harm reduction interventions was noted. Religious culture emerged as a theme, highlighting the important role religious leaders play in determining community responses to harm reduction and rehabilitation strategies for IDUs. The influence of religious culture on stakeholders' opinions concerning harm reduction interventions was evidenced by discussions of family and social values, stigma, and resulting policies. Conclusion Religion and politics were described as both a perceived benefit and deterrent, highlighting the need to further explore the overall influences of culture on the acceptability and implementation of harm reduction programs for drug users.
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Affiliation(s)
- Morgan M Philbin
- Division of International Health, School of Medicine, University of California San Diego, La Jolla, California, USA.
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30
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Shrikhande A, Dermatis H, Galanter M. The Need for Understanding the Role of Spirituality in Twelve-Step Programs. Subst Abus 2008. [DOI: 10.1080/08897070802418436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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White WL. Spiritual guidance, addiction treatment, and long-term recovery. J Subst Abuse Treat 2008; 35:443-4. [PMID: 18657939 DOI: 10.1016/j.jsat.2008.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 05/22/2008] [Indexed: 10/21/2022]
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32
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Dale H, Hunt N. Perceived Need for Spiritual and Religious Treatment Options in Chronically Ill Individuals. J Health Psychol 2008; 13:712-8. [DOI: 10.1177/1359105308094589] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to examine the desire for spiritual and religious treatment options in chronically ill adults. Email interview data ( N = 12) generated themes for religion, spirituality, and desired treatments. The resultant questionnaire data ( N = 83) analysed the popularity of treatments. Thirty-five wide-ranging spiritual and religious treatment options were identified for use in the questionnaire; 47 per cent of the sample was interested in spiritual or religious treatments. There is a need for spiritual and religious treatment options, and translation of treatments into practice would assist coping for many people.
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33
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Van der Meer Sanchez Z, De Oliveira LG, Nappo SA. Religiosity as a protective factor against the use of drugs. Subst Use Misuse 2008; 43:1476-86. [PMID: 18615320 DOI: 10.1080/10826080802183288] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although many studies have suggested that risk and protective factors are related to the use of drugs, their role has not been given due importance. More attention to protective factors could make them a fundamental tool in prevention programs. Since low socioeconomic level and adolescence are known as risk factors, the aim of this study was to identify which factors would prevent Brazilian adolescents from low-income families from using drugs. A qualitative method and an intentional sample selected by criteria were adopted for this investigation. During 2003, sixty-two youngsters, ages 16 to 24 years old, 30 drug users, and 32 nonusers were administered a semistructured interview. The subjects perceived family and religiosity as important protective factors in their lives. With regard to religiosity, 81% of nonusers believed in and practiced a religion, whereas only 13% of users considered themselves as being religious. The belief in and practice of a religion were also more evident among family members of nonusers (74%) than those of users (33%). These results indicated that religion may be a relevant protective factor for the sample studied, helping the family unit in keeping youth away from drugs. The study's limitations were noted.
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Affiliation(s)
- Zila Van der Meer Sanchez
- CEBRID-Brazilian Center of Information on Psychoactive Drugs/Department of Psychobiology of the Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
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34
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dos Santos M, van Staden F. Heroin Dependence Recovery. JOURNAL OF PSYCHOLOGY IN AFRICA 2008. [DOI: 10.1080/14330237.2008.10820206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Heinz A, Epstein DH, Preston KL. Spiritual/Religious experiences and in-treatment outcome in an inner-city program for heroin and cocaine dependence. J Psychoactive Drugs 2007; 39:41-9. [PMID: 17523584 DOI: 10.1080/02791072.2007.10399863] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although spirituality is an integral component of some of the most popular approaches to substance abuse treatment, there is little empirical evidence for a causal relationship between spirituality and treatment success. In the present study, 169 (121 male) opiate- or cocaine-abusing treatment seekers completed the Index of Spiritual Experience (INSPIRIT), a questionnaire that assesses both spirituality and religiosity. Responses were analyzed in terms of demographic variables and in-treatment outcome, which was determined by treatment retention and drug screens from observed biweekly urine collections. Religious/spiritual beliefs were common in these participants and were associated with in-treatment outcome: total INSPIRIT score was weakly correlated (r = .16, p < .04) with number of subsequent cocaine-negative urines, and participants reporting that they frequently spent time on religious/spiritual activities showed significantly better outcomes in terms of subsequent drug use and treatment retention. Women and African Americans were more likely than men and non-African Americans to report religious and spiritual beliefs or experiences on several individual items, and African Americans had higher INSPIRIT scores than Caucasians. The results suggest that spiritual and religious experience plays a role in substance abuse recovery and that demographic characteristics should be considered in the design of spiritually oriented behavioral interventions for addiction.
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Affiliation(s)
- Adrienne Heinz
- Clinical Pharmacology and Treatment Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, USA.
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36
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Abstract
This paper addresses current perspectives on the roles of spirituality and religion in recovery from serious mental health problems. Drawing on a variety of discussion groups and consultations in addition to the published literature, consumer perceptions as well as those of mental health and religious professionals are reviewed. Consumers note both potentially supportive and burdensome roles of religion and spirituality in recovery. Professionals report both hope for, and discomfort with, these domains in the context of mental health services. From each perspective emerge key recommendations regarding the appropriate place of spirituality and religion in psychiatric rehabilitation and related supports.
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37
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Loue S, Sajatovic M. Spirituality, coping, and HIV risk and prevention in a sample of severely mentally ill Puerto Rican women. J Urban Health 2006; 83:1168-82. [PMID: 17131192 PMCID: PMC3261281 DOI: 10.1007/s11524-006-9130-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hispanics have been disproportionately impacted by HIV/AIDS. Although HIV risk is significantly elevated among severely mentally ill persons (SMI), the risk of infection appears to be even greater among those SMI who are Hispanic, reflecting the increased risk of HIV among Hispanics. We report on findings from the first 41 participants in a qualitative study examining the context of HIV risk and risk reduction strategies among severely mentally ill Puerto Rican women residents in northeastern Ohio. Individuals participated in a baseline interview, two follow-up interviews, and up to 100 hours of shadowing. Interviews and shadowing activities were recorded and analyzed using a grounded theory. The majority of individuals reported using identification with a religious faith. A large proportion of the participants reported that their religious or spiritual beliefs were critical to their coping, had influenced them to reduce risk, and/or provided them with needed social support. Several participants also reported having experienced rejection from their faith communities. The emphasis on spirituality among Puerto Rican SMI is consistent with previous research demonstrating the importance of spirituality in the Hispanic culture and reliance on spiritual beliefs as a mean of coping among SMI. Our results support the incorporation of spiritual beliefs into secular HIV prevention efforts.
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Affiliation(s)
- Sana Loue
- Department of Epidemiology and Biostatistics, Center for Minority Public Health, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA.
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38
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39
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Margolin A, Beitel M, Schuman-Olivier Z, Avants SK. A controlled study of a spirituality-focused intervention for increasing motivation for HIV prevention among drug users. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2006; 18:311-22. [PMID: 16961448 DOI: 10.1521/aeap.2006.18.4.311] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Spiritual Self-Schema (3-S) therapy is a manual-guided intervention for increasing motivation for HIV prevention that integrates a cognitive model of self within a Buddhist framework suitable for people of all faiths. In this controlled study, 72 methadone-maintained clients received either standard care and 8 weeks of 3-S therapy, or standard care alone. At treatment completion, 3-S clients reported significantly greater increases in spiritual practices, expression of spiritual qualities, and motivation for HIV prevention. They were also less likely to have engaged in HIV risk behavior. Correlational analyses showed that attendance at 3-S therapy sessions was significantly positively related to spiritual practice at treatment completion and to motivation for HIV prevention, and that both attendance at 3-S sessions and motivation for HIV preventive behavior were significantly negatively related to HIV risk behavior. Completion of 3-S therapy predicted posttreatment HIV preventive behavior, controlling for pretreatment behavior, demographics, and addiction severity measures (odds ratio = 8.89; 95% confidence interval = 1.62-48.93).
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Affiliation(s)
- Arthur Margolin
- Yale University School of Medicine, New Haven, CT 06519, USA.
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40
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Day E, Gaston RL, Furlong E, Murali V, Copello A. United Kingdom substance misuse treatment workers' attitudes toward 12-step self-help groups. J Subst Abuse Treat 2006; 29:321-7. [PMID: 16311185 DOI: 10.1016/j.jsat.2005.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2004] [Revised: 03/05/2005] [Accepted: 08/23/2005] [Indexed: 11/19/2022]
Abstract
Research has highlighted the benefits of professional substance misuse treatment workers facilitating their clients' involvement in 12-step self-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). This study used a cross-sectional survey design to explore the attitudes of substance misuse treatment staff working in the English West Midlands region toward AA and NA and the 12-step philosophy. A total of 346 treatment workers responded (71%). Fewer than 10% used the 12-step model in their treatment work, and only a third felt that their clients were generally suited to AA or NA. Fewer than half (46%) said that they were likely to recommend that their clients attend a self-help group meeting. Staff with nursing qualifications were more likely to have a positive attitude toward AA/NA than their non-nursing colleagues, and there was a statistically significant association between the level of reported spirituality of the workers and the likelihood of them recommending to clients that they attend AA or NA meetings. These results highlight differences in the role of AA/NA within the substance misuse treatment system in the United Kingdom and that in the United States; possible explanations are discussed.
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Affiliation(s)
- Ed Day
- Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2QZ, UK.
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41
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Abstract
There is a pressing need in the substance abuse field for more comprehensive models of etiology and treatment that address the complex issues of addiction, including the biological, social, cultural, spiritual and developmental needs of individuals and groups. This article presents a theoretical framework for an integral approach to substance abuse that expands on the existing biopsychosocial model. One contribution of the model is an integrated approach to spirituality from a cross-cultural perspective. This integral approach examines substance abuse etiology and treatment from a four-quadrant perspective adapted from the work of Ken Wilber, and incorporates concepts from integrative medicine and transpersonal psychology/psychiatry. Implications of the model are explored.
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Affiliation(s)
- Diana S Amodia
- State of California Office of Alcohol and Drug Programs, USA
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42
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Tarakeshwar N, Khan N, Sikkema KJ. A relationship-based framework of spirituality for individuals with HIV. AIDS Behav 2006; 10:59-70. [PMID: 16489416 DOI: 10.1007/s10461-005-9052-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Twenty HIV-positive individuals (10 male, 10 female) participated in interviews on their spiritual life. Interview themes suggest that the HIV diagnosis facilitated a relationship-based framework of spirituality. Relationships that formed this framework were: relationship with God/Higher Power, renewed engagement with life, and relationship with family. Within ''relationship with God/Higher Power,'' subthemes included gratitude for God's benevolent influence, spiritual struggles, and building connections with their Higher Power. Self care, transformation of life goals, and accepting mortality were subthemes for ''renewed engagement with life.'' Subthemes within ''relationship with family'' included finding a sense of purpose, finding support through families, and families as a source of strain. Overall, results suggest that interventions that integrate spirituality need to consider a notion of spirituality that goes beyond church attendance, prayer, and Bible reading. These interventions must include the positive aspects of spirituality and spiritual struggles that individuals with HIV may experience.
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Affiliation(s)
- Nalini Tarakeshwar
- Department of Epidemiology and Public Health, Yale University, New Haven, Connecticut 06510, USA.
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43
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Laudet AB, Morgen K, White WL. The Role of Social Supports, Spirituality, Religiousness, Life Meaning and Affiliation with 12-Step Fellowships in Quality of Life Satisfaction Among Individuals in Recovery from Alcohol and Drug Problems. ALCOHOLISM TREATMENT QUARTERLY 2006; 24:33-73. [PMID: 16892161 PMCID: PMC1526775 DOI: 10.1300/j020v24n01_04] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Many recovering substance users report quitting drugs because they wanted a better life. The road of recovery is the path to a better life but a challenging and stressful path for most. There has been little research among recovering persons in spite of the numbers involved, and most research has focused on substance use outcomes. This study examines stress and quality of life as a function of time in recovery, and uses structural equation modeling to test the hypothesis that social supports, spirituality, religiousness, life meaning, and 12-step affiliation buffer stress toward enhanced life satisfaction. Recovering persons (N = 353) recruited in New York City were mostly inner-city ethnic minority members whose primary substance had been crack or heroin. Longer recovery time was significantly associated with lower stress and with higher quality of life. Findings supported the study hypothesis; the 'buffer' constructs accounted for 22% of the variance in life satisfaction. Implications for research and clinical practice are discussed.
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Affiliation(s)
| | - Keith Morgen
- Keith Morgen is Senior Research Associate, C-STAR at NDRI (E-mail: )
| | - William L. White
- William L. White is Senior Research Consultant, Chestnut Health Systems/Lighthouse Institute, 720 West Chestnut Street, Bloomington, IL 61701 (E-mail: )
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44
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Margolin A, Avants SK, Arnold R. Acupuncture and Spirituality-Focused Group Therapy for the Treatment of HIV-Positive Drug Users: A Preliminary Study. J Psychoactive Drugs 2005; 37:385-90. [PMID: 16480165 DOI: 10.1080/02791072.2005.10399811] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this study, 40 HIV-seropositive, cocaine abusing, methadone maintained drug users were randomized to either the standard five-needle National Acupuncture Detoxification Association (NADA) protocol or to a reduced, escalating dose (one to three needle) protocol. In addition to receiving their assigned acupuncture treatments, the last 15 patients also received a spirituality-focused group therapy intervention. Acupuncture treatments were offered five days per week for eight weeks. Urine samples were collected twice weekly and were analyzed for the presence of cocaine and heroin. Depression and anxiety were assessed pre- and post-treatment. Results showed no difference between the two acupuncture conditions on the number of weeks in which urine samples tested negative for illicit opiate and cocaine use. However, patients who received the spirituality-focused group therapy in addition to their assigned acupuncture treatment were abstinent from heroin and cocaine for significantly longer, and had greater reductions in depression and anxiety than did those patients not receiving spirituality-focused psychotherapy. These preliminary findings suggest that acupuncture and a spirituality-focused psychotherapy may be a synergistic combination worthwhile investigating in larger scale, controlled studies.
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Affiliation(s)
- Arthur Margolin
- Yale University School of Medicine, New Haven, Connecticut 06519, USA.
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45
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Pargament KI, McCarthy S, Shah P, Ano G, Tarakeshwar N, Wachholtz A, Sirrine N, Vasconcelles E, Murray-Swank N, Locher A, Duggan J. Religion and HIV: a review of the literature and clinical implications. South Med J 2005; 97:1201-9. [PMID: 15646758 DOI: 10.1097/01.smj.0000146508.14898.e2] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kenneth I Pargament
- Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, USA.
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46
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Avants SK, Margolin A. Development of Spiritual Self-Schema (3-S) Therapy for the Treatment of Addictive and HIV Risk Behavior: A Convergence of Cognitive and Buddhist Psychology. JOURNAL OF PSYCHOTHERAPY INTEGRATION 2004. [DOI: 10.1037/1053-0479.14.3.253] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Introduction: Spiritual Assessment and Intervention: Current Directions and Applications. JOURNAL OF RELIGION SPIRITUALITY & AGING 2004. [DOI: 10.1300/j496v17n01_01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sanchez ZVDM, Oliveira LGD, Nappo SA. Fatores protetores de adolescentes contra o uso de drogas com ênfase na religiosidade. CIENCIA & SAUDE COLETIVA 2004. [DOI: 10.1590/s1413-81232004000100005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Embora muitos estudos tenham retratado os fatores de risco ao uso de drogas, não tem sido dada a devida importância aos fatores de proteção, fundamentais para prevenção. Como o baixo nível socioeconômico é considerado fator de risco, o objetivo deste estudo foi identificar, entre adolescentes de baixo poder aquisitivo, quais seriam os fatores que pudessem preveni-los do consumo de drogas. Para essa investigação, adotou-se metodologia qualitativa e amostra intencional selecionada por critérios. Sessenta e dois jovens, usuários e não-usuários de drogas, foram submetidos à entrevista semi-estruturada. Entre os fatores protetores, a estrutura familiar e a religiosidade foram os mais freqüentemente citados. Quanto à religiosidade, foram observados os seguintes resultados: 81% dos não-usuários acreditam e praticam uma religião; entre os usuários, apenas 13% encontram-se nessa condição, atribuindo à prática religiosa um meio de abandono às drogas. Conclui-se que a religião pode ser um fator protetor relevante na amostra estudada, atuando como apoio na estruturação familiar e como importante fonte de informações.
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Marcotte D, Margolin A, Avants SK. Addressing the spiritual needs of a drug user living with human immunodeficiency virus: a case study. J Altern Complement Med 2003; 9:169-75. [PMID: 12676045 DOI: 10.1089/107555303321223044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe an application of Spiritual Self-Schema Therapy (3-S) with a human immunodeficiency virus (HIV)-seropositive, injection drug-using individual. INTERVENTION 3-S is a structured and readily administered therapy for integrating a spiritual dimension into addiction treatments for HIV-positive drug users. It posits the existence of many potential "selves," salient among which are the "addict" self and the "spiritual" self. The central strategy of 3-S is to "deactivate" the addict self and "activate" the spiritual self. Techniques to achieve this shift are discussed. RESULTS Over the course of treatment, this patient was able to use 3-S therapy to shift her dominant sense of self from that of an addict to a spiritual person and reported that this increased feelings of hope and the sense of control. CONCLUSION A spiritually based therapy appears to help injection drug users with HIV infection and warrants further investigation.
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Affiliation(s)
- David Marcotte
- Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, CT 06519, USA.
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