Computers & Electronics

Spirituality, forgiveness and purpose in life in faithbased substance abuse treatment programs

Published
of 40
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Related Documents
Share
Description
University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 2012 Spirituality, forgiveness and purpose in life in faithbased substance
Transcript
University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 2012 Spirituality, forgiveness and purpose in life in faithbased substance abuse treatment programs Geoffrey C. B Lyons University of Wollongong Recommended Citation Lyons, Geoffrey C. B, Spirituality, forgiveness and purpose in life in faith-based substance abuse treatment programs, Doctor of Philosophy (Clincal Psychology) thesis, School of Psychology, University of Wollongong, Research Online is the open access institutional repository for the University of Wollongong. For further information contact Manager Repository Services: Spirituality, Forgiveness and Purpose in Life in Faith-Based Substance Abuse Treatment Programs A thesis submitted in fulfilment of the requirement for the degree of Doctor of Philosophy (Clinical Psychology) from University of Wollongong by Geoffrey C. B. Lyons, BSc (Hons) School of Psychology CERTIFICATION I, Geoffrey Charles Brecht Lyons, certify that this thesis, submitted in fulfilment of the requirements for the award of Doctor of Philosophy (Clinical Psychology) in the department of Psychology, University of Wollongong, does not incorporate without acknowledgement any material previously submitted for a degree or diploma in any university; and that to the best of my knowledge and belief does not contain any material previously published or written by another person where due reference is not made in the text. The document has not been submitted for qualification at any other academic institution. Geoffrey C. B. Lyons 13 April 2012 i TABLE OF CONTENTS Certification... i Table of Contents... ii List of Tables... ix List of Figures... xi List of Appendices... xii List of Publications from this Thesis... xiv Abstract... xv Acknowledgments... xvii CHAPTER ONE INTRODUCTION Substance Use Disorders Defining Recovery from Substance Abuse Spirituality and Substance Use Disorders Defining Spirituality and Religion Thesis Purpose and Outline... 9 CHAPTER TWO FAITH-BASED SUBSTANCE ABUSE TREATMENT PROGRAMS Faith-Based Substance Abuse Programs The Structure of Faith-Based Treatment Programs The Twelve Steps and Faith-Based Programs Twelve Steps and Spirituality The Twelve Steps and Defects of Character ii 2.2.3 The Twelve Steps and Faith-Based Organisations Summary of Twelve Step and Christian Faith-Based Treatment.Programs Empirical Research and Faith-Based Substance Abuse Programs Spirituality as a Buffer Against Substance Abuse The Effectiveness of Faith-Based Programs Empirical Research on Spirituality and Recovery from Substance.Abuse Spiritual Development in Substance Abuse Treatment Spiritual Experiences in Substance Abuse Treatment Spirituality, Psychological Wellbeing and Coping in...substance Abuse Treatment Spiritually Derived Support and Comfort in Substance...Abuse Treatment Spirituality and Self-Efficacy in Substance Abuse Treatment A Summary of the Empirical Literature on Faith-Based Programs and.spirituality CHAPTER THREE SPIRITUALITY, FORGIVENESS AND PURPOSE IN LIFE IN FAITH-BASED SUBSTANCE ABUSE TREATMENT Forgiveness and Faith-Based Treatment Programs Forgiveness, the Twelve Steps and Christian Faith-Based Programs Empirical Research on Forgiveness and Substance Abuse Purpose in Life and its Relationship with Faith-Based Recovery Empirical Research on Purpose in Life and Recovery from Substance Abuse The Spirituality/Forgiveness/Purpose Model of Recovery iii CHAPTER FOUR STUDY ONE: SALVATION ARMY TREATMENT PROVIDERS' ATTITUDES TOWARD SPIRITUALITY AND FORGIVENESS Introduction Method Participants Measures Procedure Results Factor Structure of the SFTS Differences in Attitudes towards Spiritual and Secular Factors of the.sfts The Influence of Religious Orientation, Age and Gender on Attitudes.toward Forgiveness Discussion Limitations Conclusions CHAPTER FIVE STUDY TWO: A CROSS-SECTIONAL INVESTIGATION OF SPIRITUALITY, FORGIVENESS AND PURPOSE IN LIFE IN RESIDENTIAL FAITH-BASED SUBSTANCE ABUSERS Introduction Method Participants iv 5.2.2 Measures Resentment Purpose in Life Private Spiritual Practices Spiritual Experiences and Feelings Spiritual Beliefs Dispositional Forgiveness of Self and Others Receiving Forgiveness from Others and God Procedure Results Testing Forgiveness Types as Predictors of Resentment Forgiveness Types as Mediators between Spirituality and Purpose in.life Post-Hoc Analyses: Testing Spiritual Beliefs and Practices as...predictors of Daily Spiritual Experiences Discussion Shame and Substance Abuse Treatment Spirituality, Forgiveness, and Purpose in Life Limitations Conclusion CHAPTER 6 STUDY THREE: A LONGITUDINAL STUDY OF SPIRITUALITY, FORGIVENESS, AND PURPOSE IN LIFE IN CLIENTS OF RESIDENTIAL FAITH-BASED SUBSTANCE ABUSE TREATMENT PROGRAMS Introduction Method v 6.2.1 Participants Measures Addiction Severity Index Purpose in Life Spiritual Experiences and Feelings Forgiveness of Self and Others Procedure Data Analysis Multi-Step Multiple Mediation Analyses Longitudinal and Cross-Sectional Multi-Step Multiple...Mediation Models Analysed Results The Influence of Participant Demographics on Post-Treatment.Abstinence Correlations at Intake, Follow-Up and between Intake and.follow-up Cross-sectional Differences in Spirituality, Forgiveness, and Purpose in Life as a Function of Post-Treatment Abstinence Change over Time in Spirituality, Forgiveness, and Purpose in Life Differences in Change in Spirituality, Forgiveness, and Purpose in Life as a Function of Abstinence Intake Multi-Step Multiple Mediation Models Follow-Up Multi-Step Multiple Mediation Models Longitudinal Multi-Step Multiple Mediation Models Post-hoc Muiltiple Mediation Analyses: Determining Whether the Indirect Effect of Purpose in Life is Greater vi than the Indirect Effect of Forgiveness Constructs Discussion Multi-Step Multiple Mediation Results: Daily Spiritual Experiences.and Forgiveness Multi-Step Multiple Mediation Results Purpose in Life and.substance Use Limitations Conclusions CHAPTER 7 THESIS CONCLUSION Thesis Aims and Research Empirical Findings of the Thesis Study 1: Survey of Faith-Based Treatment Providers Attitudes..toward Spirituality and Forgiveness Study 2: Cross-Sectional Client Survey Study 3: Longitudinal Client Survey Future Directions Interventions to Cultivate Daily Spiritual Experiences Spiritual Development and Causation among Spiritual Constructs Long-Term Stability in the Multi-Step Multiple Mediation..Relationships Shame and Resentment Forgiveness Constructs Forgiveness Interventions vii 7.3.7 Interventions to Cultivate Purpose in Life Dispositional and Functional Spirituality in Faith-Based Substance Abuse Treatment Measurement Issues in Spirituality and Psychological Wellbeing Conclusion REFERENCES APPENDICES viii LIST OF TABLES Table 1: The Twelve Steps of Alcoholics Anonymous Table 2: Treatment Providers' Demographics Table 3: Measures of Central Tendency and Factor Loadings for Treatment Provider's Importance Ratings Table 4: Participants Demographical Data Table 5: Means, Cronbach s Alphas and Correlations between Variables Table 6: Multiple Regression Results Testing Forgiveness Types as Predictors of Resentment Table 7: Multiple Mediation Analyses Testing Forgiveness as a Mediator of Spirituality and Purpose in Life Table 8: Multiple Regression Results Testing Twelve Step Spiritual Beliefs and Private Spiritual Practices as Predictors of Daily Spiritual Experiences Table 9: Participant Demographics and Substance Use Information Table 10: Correlations at Intake Table 11: Correlations at Follow-Up Table 12: Correlations between Intake and Follow-Up Table 13: Mean Differences from Intake to Follow-Up Table 14: Mean Scores at Intake and Follow-Up in Daily Spiritual Experiences, Forgiveness Constructs, and Purpose in Life as a Function of Post-Discharge Abstinence Table 15: Multi-Step Multiple Mediation Pathway Estimates at Intake Table 16: Multi-Step Multiple Mediation Bootstrapped Indirect Effects at Intake Table 17: Multi-Step Multiple Mediation Pathway Estimates at Follow-Up ix Table 18: Multi-Step Multiple Mediation Bootstrapped Indirect Effects at Follow-Up Table 19: Longitudinal Multi-Step Multiple Mediation Pathway Estimates Table 20: Longitudinal Multi-Step Multiple Mediation Bootstrapped Indirect Effects Table 21: Post-hoc multiple mediation analyses contrasting the indirect effects of change in purpose in life, change in forgiveness of self and change in forgiveness of others on change in alcohol use Table 22: Post-hoc multiple mediation analyses contrasting the indirect effects of change in purpose in life, change in forgiveness of self and change in forgiveness of others on change in drug use Table 23: A Summary of the Empirical Research on Spirituality in Substance Abuse Treatment x LIST OF FIGURES Figure 1: The Spirituality/Forgiveness/Purpose Model of Recovery Figure 2: A Visual Representation of the Elements of a Multi-Step Mediation Analyses Figure 3a: The Multiple Mediation Model Testing Forgiveness as a Mediator between Twelve Step Spiritual Beliefs and Purpose in Life Figure 3b: The Multiple Mediation Model Testing Forgiveness as a Mediator between Private Spiritual Practices and Purpose in Life Figure 3c: The Multiple Mediation Model Testing Forgiveness as a Mediator between Daily Spiritual Experiences and Purpose in Life Figure 4: Theoretical Relationships between Daily Spiritual Experiences, Forgiveness constructs and Purpose in Life Figure 5: Participation and Exclusion Criteria for Study Figure 6: Multi-step mediation modeling Figure 7: A Visual Representation of the Multi-Step Mulitple Mediation Anlayses Conducted in Study Figure 8: Cross-Sectional Multi-Step Multiple Mediation Results Testing the Indirect Effects of Spiritual Experiences on Alcohol and Drug Use at Intake Figure 9: Cross-Sectional Multi-Step Multiple Mediation Results Testing the Indirect Effects of Spiritual Experiences on Alcohol and Drug Use at Follow-Up Figure 10: Longitudinal Multi-Step Multiple Mediation Results Demonstrating the Indirect Effects of Change in Spiritual Experiences on Change in Alcohol and Drug use xi LIST OF APPENDICES Appendix A: A SUMMARY OF THE EMPIRICAL RESEARCH ON...SPIRITUALITY IN SUBSTANCE ABUSE TREATMENT Appendix B: STUDY a. Participant Demographic Survey b. The Spirituality and Forgiveness in Treatment Scale (SFTS) c. Participant Information Sheet d. Ethics Approval Appendix C: STUDY a. Forgiveness and Spiritual Development Questionnaires i. The Aggression Questionnaire: Resentment Subscale (RS) ii. The Life Engagement Test (LET) iii. Religious Background and Behaviours (RBB) iv. Daily Spiritual Experiences Scale (DSES) v. Spiritual Beliefs Scale (SBS) vi. Heartland Forgiveness Scale (HFS) vii. Receiving Forgiveness From others (RFO) viii. Receiving Forgiveness From God (RFG) b. Client Participant Information Sheet c. Ethics Approval Appendix D: STUDY a. Addiction Severity Index: Intake Version b. Addiction Severity Index: Follow-Up Version c. Intake and Follow-Up Measures i. The Life Engagement Test (LET) xii ii. Daily Spiritual Experiences Scale (DSES) iii. Heartland Forgiveness Scale (HFS) d. Participant Information Sheet and Consent Form e. Ethics Correspondence xiii List of Publications from this Thesis Lyons, G. C. B., Deane, F. P., & Kelly, P. J. (in press). Chapter 289: Faith-based substance abuse programs. In P. Miller (Ed.), Encyclopedia of Addictive Behaviors, Oxford: Elsevier. Lyons, G. C. B., Deane, F. P., & Kelly, P. J. (2011). Faith-based substance abuse treatment: Is it just about God? Exploring treatment providers attitudes toward spirituality, forgiveness and secular components of treatment. Counselling & Spirituality, 30, Lyons, G. C. B., Deane, F. P., Caputi, P., & Kelly, P. J. (2011). Spirituality and the treatment of substance use disorders: An exploration of forgiveness, resentment and purpose in life. Addiction, Research & Theory, 19, Lyons, G. C. B., Deane, F. P., & Kelly, P. J. (2010). Forgiveness and purpose in life as spiritual mechanisms of recovery from substance use disorders. Addiction, Research & Theory, 18, xiv ABSTRACT Substance use disorders are a significant international health problem. Faithbased organisations are one of the primary treatment options for individuals with substance use problems. Many of these faith-based organisations either incorporate Christian theology into treatment or utilise the spiritually-based Twelve Step philosophy of Alcoholics Anonymous. Empirical research has shown low to moderate associations between spirituality and recovery from substance use disorders; however, the exact mechanisms by which spirituality operates on recovery are unclear. Forgiveness and purpose in life are central to all major world religions; hence, this thesis explores the relationship between spirituality, forgiveness and purpose in life in the faith-based treatment of substance use disorders. Study 1 evaluated the perceived importance that faith-based treatment providers place on spiritual and forgiveness-based treatment components in comparison to other secular treatment components of substance abuse. A brief survey was completed by 99 Salvation Army drug and alcohol treatment providers employed within Australian residential rehabilitation programs. Attitudes towards spiritual components of treatment such as Christian education and spiritual development were positive; however, treatment providers rated secular interventions such as relapse prevention and anger management as more important than spiritual components. Treatment providers also conceptualized forgiveness to primarily be a spiritual construct that was as important to treatment as other secular based components. This study provided support for further investigations of forgiveness in the faith-based treatment of substance abuse. Study 2 is a cross-sectional investigation of spirituality, forgiveness and purpose in life among 277 substance abusers in residential faith-based treatment xv programs. Several different dimensions of spirituality and forgiveness were assessed. The results found that the daily spiritual experiences (e.g. feeling connected with God) associated with a person s spirituality predict forgiveness constructs. In turn these forgiveness types negatively predict resentment and positively predict purpose in life. The results emphasise the potential of forgiveness of self and receiving forgiveness from God and from others in the recovery process. Study 3 is a longitudinal investigation of spirituality, forgiveness and purpose in life among 242 residential faith-based substance abusers. It extends on the results of Study 2 by exploring the relationship between changes in spirituality, forgiveness and purpose in life on substance use. Results found that the development of daily spiritual experiences operated indirectly on substance use via forgiveness of self, forgiveness of others, and purpose in life; however, purpose in life emerged as being more influential than forgiveness of self or others. The results provide preliminary support for the central theory of this thesis: the cultivation of spirituality can operate on recovery from substance abuse by increasing forgiveness and purpose in life. The final chapter emphasises the need for ongoing longitudinal research on daily spiritual experiences, self-forgiveness and purpose in life in faith-based substance abuse treatments. The finding that daily spiritual experiences indirectly influence recovery suggests that faith-based treatment providers may maximise the spirituality-recovery relationship by developing interventions that cultivate daily spiritual experiences. xvi ACKNOWLEDGMENTS As a child my career aspirations consisted of being either a cowboy or a Jedi Knight; not a Doctor of Clinical Psychology. Embarrassingly, at age twenty-one not much had changed; not because of a lack of interest in academia or education but rather a lack of confidence. Now, in my mid-thirties, as I reflect on nearly a decade of tertiary education I find myself amazed by three things. Firstly, that I have been able to transform myself so completely and achieve something as hard as writing a doctoral thesis. Secondly, how relieved I feel now that it is over. Thirdly, how indebted I am to so many people. This third point cannot be over emphasised. Writing this thesis has been challenging; however, the personal growth that I have experienced has been immense. For me, this growth is the reward. Many people have helped me achieve this and I will forever be indebted to them. Firstly, I would like to thank my supervisor Professor Frank P. Deane. His hard work, attention to detail and scholarship have set an example that I hope one day to match. I would also like to thank my secondary supervisor Doctor Peter J. Kelly. His energetic approach to clinical psychology has been refreshing and inspiring. I must also express my gratitude to the clients and staff of The Australian Salvation Army Eastern Territories Division. In particular, Major David Pullen and Mr. Gerard Byrne have always been enthusiastic, appreciative and genuinely interested in my research topic. Their enthusiasm has been infectious. Importantly, I must thank my family: my mother Diana, father Keith, brother Stephen and sister Jenni. Each one has provided me with immense love and support. They have always been there for me, no matter what. Thank you also to Karen and Nigel, who have loved me as a son and come to my rescue more times than I can count. xvii My deepest gratitude, love and admiration go to my wife, Renee and our beautiful daughter, Ivy. Renee has journeyed with me from undergraduate to postgraduate and now beyond. This journey has been as demanding on her as me. She has tolerated my many mood swings, financial poverty, career instability, and general absences. She has shown me more patience than I deserve and more love than I could have hoped for. Our beautiful daughter Ivy has given me more joy than I ever thought possible and transformed my life in the most wonderful way. Her innocence has motivated me more than anything else. Finally, a thesis on spirituality would not be complete without thanking my Higher Power God the Father. Words cannot express how grateful I am for the blessings and guidance I have been given. xviii Chapter One Introduction 1 1.1 SUBSTANCE USE DISORDERS Substance use disorders represent a significant international health problem. Epidemiological research estimates that as many as 22.5 million people worldwide suffer from substance use disorders each year, with approximately 3.8 million receiving treatment (Hersen, Turner & Beidel, 2007). Worldwide, the cost of substance-related problems is estimated to be in excess of US$200 billion per annum (Fabricius, Langa & Wilson, 2008). The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR; APA, 2000) categorizes substance use disorders as either substance dependence or substance abuse. Substance dependence is defined as a maladaptive pattern of substance use that leads to significant impairment or distress, as manifested by three (or more) problems in a 12-month period (APA, 2000). Symptoms indicative of substance dependence include: a tolerance to the substance; withdrawal symptoms; constant thoughts or cravings for substance use; neglecting social, family, occupational, recreational activities in order to use substance(s); and an excessive amount of time spent in pursuit of/or taking substance(s) (APA, 2000). Substance abuse is defined as a maladaptive pattern of substance use leading to clinically significant levels of impairment or distress (APA, 2000, p. 199). This clinically significant impairment must manifest in one or more areas of life over a 12-month period. Essentially, the difference between substance dependence and abuse is a matter of severity. Symptoms of withdrawal or tolerance are characterist
Search
Related Search
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks