Substance Abuse Research Development Program
for Underserved Populations

Methods to Study Ethnicity and Faith-Based Treatment

Investigators: James Alan Neff, Ph.D., Clayton T. Shorkey, Ph.D., Christopher Ellison, Ph.D.

Current Project Status and Findings

Despite increasing interest in “faith-based” substance abuse treatment and in the role of “spirituality” in substance abuse recovery, there is little systematic evidence regarding the efficacy of explicitly spiritual interventions (Miller, 1997). The Faith-Based Treatment pilot study was originated to develop quantitative and qualitative methodologies to support the development of a NIDA R01 to conduct a large scale prospective study of spiritual change mechanisms taking place during alcoholism/substance abuse treatment in these faith-based programs. This prospective proposal would explore the linkages of faith-based program elements, mediating spiritual change dimensions, and substance abuse treatment outcomes, particularly in minority populations served by many of these programs. Key outcomes of interest include

engagement and retention in the programs,
spiritual change, and
alcoholism/substance abuse recovery.

faith based graph

This pilot project involves building collaborative research partnerships with seven faith-based programs selected to represent a range of spiritual orientations, including licensed and unlicensed programs. Specific pilot project aims include:

Using Concept Mapping Methodology to develop measures of individual spirituality dimensions and program elements
Pilot testing newly constructed instruments in baseline interviews with 250 new admissions to the programs.

The project, funded in September of 2002 is currently involved in organizing and conducting preliminary focus groups for the Concept Mapping study.

Preliminary focus groups with social work educators who have site-visited local faith-based programs indicate that key elements of faith-based treatment programs are readily identifiable and that observers can differentiate programs on the basis of those dimensions. Specifically, ten “dimensions” were generated.

Rating data on the presence or absence of each of the 10 dimensions for 4 of the faith-based programs providing residential treatment services were subjected to a Cluster analysis as a preliminary test of whether programs could be empirically sorted into a typology. The clustering procedure yielded 2 clusters, basically contrasting the two non-traditional fundamentalist programs (Victory Outreach and ReMar) against the two more traditional, licensed programs (Salvation Army and Christian Farms).

The Clustering algorithm correctly classified 89% of ratings for the Victory Outreach/ReMar (VO/RM) cluster and 71% of ratings for the Salvation Army/Christian Farms (SA/CF) cluster (c2_1df = 21.32, p < .001), thus supporting the accuracy of the procedure. Finally, mean ratings on each dimension (reflecting the proportion of raters citing the presence of a particular dimension for that cluster) were compared for each cluster by means of a series of independent groups t-tests (“*” denotes significant mean differences at p < .05).

Cluster	Bible	Basic Needs	Con-version	Social-ization	Struc- ture	Wor- ship	Com-munity	Work Ethic	Local / Global Outreach
VO/RM	.71*	.82	.89*	.71	.75	.75*	.57	.68	.51*
SA/CF	.32	.79	.18	.54	.71	.39	.43	.43	.42

Notably, while program clusters did not differ on provision of basic needs, socialization, structure/discipline, or emphasis upon a sense of community, clusters did differ in terms of bible teachings, conversion experiences, communal worship, and outreach.

Ongoing Concept Mapping will seek to replicate and extend the current findings and lead to the development of measures of spirituality at the individual and program levels for use in a prospective study. An application to the Metanexus Institute (Templeton Foundation) has been submitted for funds to pilot 6 month follow-up interviews.

Funded by: NIDA Health Disparities Supplement grant # R24-DA13579-02S1

Publications and Presentations:

Neff, J.A., MacMaster, S.A, and Shorkey, C. “Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment.” Journal of Social Work Practice in the Addictions (Accepted for Publication).
Neff, J.A. “Exploring the Dimensionality of “Spirituality”: Confirmatory Factor Analyses of the Fetzer/NIA Multidimensional Measure of Spirituality for Use in Health Research in a National Sample”. 6^th Annual Conference of the Society for Social Work and Research, San Diego, CA, January, 2002.
Neff, J.A. and Shorkey, C. “Methods to Study Faith-Based Substance Abuse Treatment.” 2002 Health Services Research Among Hard to Reach Populations Conference, Key Largo, FL, October, 2002.
Neff, J.A. and Shorkey, C. “A Preliminary Focus Group Investigation to Identify Dimensions of “Spirituality” in Faith-Based Substance Abuse Treatment Programs.” Annual Meeting of the American Public Health Association, Philadelphia, November, 2002.

Abstract available here

Addiction Research Institute