Spirituality and Religion
Bill Miller (1998) provides an excellent introduction to views of spirituality within the drug and alcohol research and treatment fields. He proposes that religion is a social institution with specific and often rigid beliefs, practices, and rituals that are shared by a group of people. Spirituality is a personal, individual phenomenon with no boundaries or rigid beliefs or practices. Spirituality can stem from religion, but often exists completely separate from religion. From the beginning of the substance abuse treatment movement, addiction has been considered a spiritual disorder. The treatment field recognizes this, even if the research field has neglected the study of spirituality.
Ken Wilber (2000) placed spirituality within the realm of human development, although he noted that there is no consensus in the world literature as to whether spirituality develops separately from other lines of development, such as moral or cognitive development, whether it proceeds in a separate stage-like fashion, or is more accurately characterized as attitudes or experiences that people can have at any stage or age.
Because clients in substance abuse treatment come from a diverse religious and cultural backgrounds and some may have rejected formal religion, there is great value in developing treatment interventions that are cross-cultural and separate from any specific religious world views.
Spirituality and Culture
Who drops out of treatment and why? In an ideal world, all people would be treated fairly and given equal access to tools for recovery. However, we are far from that ideal world and instead, there is considerable stigma attached to many personal identities and behaviors. Because of social stigma in the form of racism, classism, homophobia, sexism, anti-Semitism, negative attitudes about drug users, and other forms of bias, clients with these stigmatized identities are more likely to avoid substance abuse treatment, drop out treatment early, or not complete treatment successfully.
Culture influences how we think about spirituality. Powerful (and often overlapping) influences include: the religious or spiritual traditions in which we were raised; our racial/ethnic heritage; our national origin; our gender and sexuality; our age; our education; our amount of exposure to diverse ideas and cultures; and a host of others.
Some cultures have spiritual practices deeply imbedded into the daily living activities, while other cultures, such as western, European- American cultures often think of spirituality as something separate from everyday practices.
Cross-Cultural Bridging
Cross-cultural anthropologist Angeles Arrien, PhD (1993) offers her Four-Fold Way model that is drawn from extensive study of the indigenous peoples of the world. Inner Substance Intervention® draws from her model’s four universal principles of communication to form the foundations necessary for substance abuse treatment.
Inner Substance Intervention is a model that fosters transformative change through the four universal principles and eight pathways to reduce harm. We provide a group process that is called the way of the council, where we implement the Inner Substance Intervention® tools.
-A Inner Substance Intervention® book will be able soon.
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Models: What’s different about our approach?
The table below shows the differences between Twelve Step (AA/NA) models and Inner Substance®. Inner Substance can be used as a supplement to any other treatment approach such as Twelve Step models, cognitive behavioral treatments, motivational enhancement, and so on.
This diagram shows our adaptation of Ken Wilber's work to the field of substance abuse treatment:
An Integral Model of Substance Abuse Treatment: Inner Substance ®
INTERIOR: INDIVIDUAL
(Individual lines of development, such as cognitive, affective, moral, spiritual)
Etiological Factors:
Emotional distress
Individual experiences of trauma/abuse
Treatment Components:
Twelve-Step
Cognitive Behavioral
Psychodynamic
Religiously based treatments
Specific Treatment Methods:
Individual counseling
Group counseling/psychoeducational
Individual spiritual practices
|
EXTERIOR: INDIVIDUAL
(cells, matter, organs, hormones, neurotransmitters, body systems)
Etiological Factors:
Genetic predisposition
Biochemical factors
Psychiatric/Medical illnesses
Treatment Components:
Addiction Medicine (psychiatry, internal medicine, other)
Primary Care
Specific Treatment Methods:
Medications
Detoxification
Nutrition
Fitness |
INTERIOR: COLLECTIVE
(social and cultural factors)
Etiological Factors:
Poverty
Effects of Oppression
Cultural Attitudes about Substances
Role of drugs/alcohol in culture
Treatment Components:
Culturally competent services
Gender/age specific services
Broader social context
Attention to social/cultural norms
Specific Treatment Methods:
Culturally specific treatments
Family Therapies
Life skills training
Education |
EXTERIOR: COLLECTIVE
(geopolitical formations, material circumstances)
Etiological Factors:
Economic Circumstances
Drug Policies & Laws
Political Agendas
Treatment Components:
Third Party Payers
Reimbursement issues
Dominant Philosophies of Treatment
Specific Treatment Methods:
Access to treatment
Payment options/plans
Treatment on demand options
Incarceration |
© Amodia, Cano, & Eliason, 2003
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