Abstract
This paper reviews empirical studies conducted on the role of spirituality and religiosity (S/R) characteristics in 12-step recovery among program members followed up after substance abuse treatment and those assessed independent of formal treatment. Aspects of spiritual functioning that change in relation to program participation and those S/R characteristics that were found to mediate the association between program involvement and drinking-related outcomes are discussed. In addition, a review is provided of 12-step program studies investigating S/R-related predictors of clinical outcomes relevant to risk of relapse among members in long-term recovery. To further examine the role of S/R characteristics in recovery, a study was conducted on long-term AA members to assess the relationship of S/R characteristics and AA program involvement to craving for alcohol and emotional distress after controlling for relevant demographic variables. Feeling God’s presence daily, believing in a higher power as a universal spirit, and serving as an AA sponsor were all predictive of positive outcomes.
Similar content being viewed by others
References
Alcoholics Anonymous World Services. (1957). Alcoholics Anonymous comes of age: A brief history of A.A. New York, NY: Alcoholism Anonymous World Services.
Alcoholics Anonymous World Services. (2015). A. A. Fact File. New York, NY: Alcoholics Anonymous World Services. Accessed February 5, 2015, http://www.aa.org/assets/en_US/aa-literature/m-24-aa-fact-file.
Alcoholics Anonymous (AA). (2003). Spiritual awakening: Journeys of the spirit from the pages of the AA Grapevine. New York, NY: AA Grapevine.
Benson, P., & Spilka, B. (1973). God image as a function of self-esteem and locus of control. Journal for the Scientific Study of Religion, 12, 297–310.
Caldwell, P. E., & Cutter, H. S. (1998). Alcoholics Anonymous affiliation during early recovery. Journal of Substance Abuse Treatment, 15(3), 221–228.
Carroll, S. (1993). Spirituality and purpose in life in alcoholism recovery. Journal of Studies on Alcohol, 54(3), 297–301.
Connors, G. J., Walitzer, K. S., & Tonigan, J. S. (2008). Spiritual change in recovery. In M. Galanter & L. A. Kaskutas (Eds.), Recent developments in alcoholism (pp. 209–227). Totowa, NJ: Humana Press.
Crumbaugh, J. C., & Maholick, L. T. (1964). An experimental study in existentialism: The psychometric approach to Frankl’s concept of noogenic neurosis. Journal of Clinical Psychology, 20, 200–207.
Dahlsgaard, K., Peterson, C., & Seligman, M. E. P. (2005). Shared virtue: The convergence of valued human strengths across culture and history. Review of General Psychology, 9(3), 203–213.
Detar, D. T. (2011). Alcoholics Anonymous and other twelve-step programs in recovery. Primary Care Clinical Office Practice, 38(1), 143–148.
Emrick, C. D., Tonigan, J. S., Montgomery, H. A., & Little, L. (1993). Alcoholics Anonymous: What is currently known? In B. S. McCrady & W. R. Miller (Eds.), Research on Alcoholics Anonymous: Opportunities and alternatives (pp. 41–76). Piscataway, NJ: Rutgers Center for Alcohol Studies.
Fetzer Institute/National Institute on Aging. (1999). Multidimensional measurement of religiousness/spirituality for use in health research: A report of the Fetzer Institute/National Institute on Aging Working Group, with additional psychometric data. Kalamazoo, MI: Fetzer Institute.
Galanter, M. (2005). Spirituality and the healthy mind. Science, therapy, and the need for personal meaning. New York, NY: Oxford University Press.
Galanter, M., Dermatis, H., Post, S., & Sampson, C. (2013a). Spirituality-based recovery from drug addiction in the twelve-step fellowship of Narcotics Anonymous. Journal of Addiction Medicine, 7(3), 189–195.
Galanter, M., Dermatis, H., & Sampson, C. (2014a). Spiritual awakening in Alcoholics Anonymous: Empirical findings. Alcoholism Treatment Quarterly, 32(2–3), 319–334.
Galanter, M., Dermatis, H., & Sampson, C. (2014b). Narcotics Anonymous: A comparison of military veterans and non-veterans. Journal of Addictive Diseases, 33, 187–195.
Galanter, M., Dermatis, H., & Santucci, C. (2012). Young people in Alcoholics Anonymous: The role of spiritual orientation and AA member affiliation. Journal of Addictive Diseases, 31(2), 173–182.
Galanter, M., Dermatis, H., Stanievich, J., & Santucci, C. (2013b). Physicians in long-term recovery who are members of Alcoholics Anonymous. The American Journal on Addiction, 22(4), 323–328.
Galanter, M., Dermatis, H., Talbot, N., McMahon, C., & Alexander, M. J. (2011). Introducing spirituality into psychiatric care. Journal of Religion and Health, 50, 81–91.
Gilbert, F. S. (1991). Development of a “Steps Questionnaire”. Journal of Studies on Alcohol and Drugs, 52(4), 353–360.
Hart, K. E. (1999). A spiritual interpretation of the 12-steps of Alcoholics Anonymous: From resentment to forgiveness to love. Journal of Ministry in Addiction & Recovery, 6(2), 25–39.
Horstmann, M. J., & Tonigan, J. S. (2000). Faith development in Alcoholics Anonymous (AA): A study of two AA groups. Alcoholism Treatment Quarterly, 18(4), 75–84.
Humphreys, K., Kaskutas, L. A., & Weisner, C. (1998). The Alcoholics Anonymous Affiliation Scale: Development, reliability, and norms for diverse treated and untreated populations. Alcoholism: Clinical and Experiential Research, 22, 974–978.
Kaskutas, L. A., Turk, N., Bond, J., & Weisner, C. (2003). The role of religion, spirituality and Alcoholics Anonymous in sustained sobriety. Alcoholism Treatment Quarterly, 21(1), 1–16.
Kelly, J. F., & Moos, R. (2003). Dropout from 12-step self-help groups: Prevalence, predictors, and counteracting treatment influences. Journal of Substance Abuse Treatment, 24(3), 241–250.
Kelly, J. F., Stout, R. L., Magill, M., Tonigan, J. S., & Pagano, M. E. (2011). Spirituality in recovery: A lagged mediational analysis of Alcoholics Anonymous’ principal theoretical mechanism of behavior change. Alcoholism: Clinical and Experimental Research, 35(3), 454–463.
Krentzman, A. R., Cranford, J. A., & Robinson, E. A. (2013). Multiple dimensions of spirituality in recovery: A lagged meditational analysis of Alcoholics Anonymous’ principal theoretical mechanism of behavior change. Substance Abuse, 34(1), 20–32.
Mathew, R. J., Georgi, J., Wilson, W. H., & Mathew, V. G. (1996). A retrospective study of the concept of spirituality as understood by recovering individuals. Journal of Substance Abuse Treatment, 13(1), 67–73.
Mauger, P. A., Perry, J. E., Freeman, T., & Grove, D. C. (1992). The measurement of forgiveness: Preliminary research. Journal of Psychology and Christianity, 11, 170–180.
Oakes, K. E. (2008). Purpose in life: A mediating variable between involvement in Alcoholics Anonymous and long-term recovery. Alcoholism Treatment Quarterly, 26(4), 450–463.
Pargament, K. I., Kennell, J., Hathaway, W., Grevengoed, N., Newman, J., & Jones, W. (1988). Religion and the problem-solving process: Three styles of coping. Journal for the Scientific Study of Religion, 27(1), 90–104.
Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37, 710–724.
Peterson, C., & Seligman, M. E. (2004). Character strengths and virtues: A classification and handbook. Washington, DC: American Psychological Association.
Puchalski, C. M. (2003). The spiritual dimension: The healing force for body and mind. In C. M. Puchalski (Ed.), Caregiving book series (pp. 174–195). Americus, GA: Rosalyn Carter Institute for Human Development, Georgia Southwestern State University.
Puchalski, C., & Ferrell, B. (2010). Making health care whole: Integrating spirituality into patient care. West Conshohocken: Templeton Press.
Reinert, D. F. (1997). The Surrender Scale: Reliability, factor structure, and validity. Alcoholism Treatment Quarterly, 15(3), 15–32.
Robinson, E. A., Cranford, J. A., Webb, J. R., & Brower, K. J. (2007). Six-month changes in spirituality, religiousness, and heavy drinking in a treatment-seeking sample. Journal of Studies on Alcohol and Drugs, 68(2), 282–290.
Salsman, J. M., Brown, T. L., Brechting, E. H., & Carlson, C. R. (2005). The link between religion and spirituality and psychological adjustment: The mediating role of optimism and social support. Personality and Social Psychology Bulletin, 31, 522–535.
Tonigan, J. S. (2003). Changing AA practices and outcomes: Project MATCH three-year follow-up. Alcoholism: Clinical and Experimental Research, 27(3), 526–528.
Tonigan, J. S., Connors, G. J., & Miller, W. R. (1996a). Alcoholics Anonymous involvement (AAI) scale: Reliability and norms. Psychology of Addictive Behaviors, 10(2), 75–80.
Tonigan, J. S., Miller, W. R., & Schermer, C. (2002). Atheists, agnostics and Alcoholics Anonymous. Journal on Studies of Alcohol and Drugs, 63(5), 534–541.
Tonigan, J. S., Rynes, K. N., & McCrady, B. S. (2013). Spirituality as a change mechanism in 12-step programs: A replication, extension, and refinement. Substance Use and Misuse, 48(12), 1161–1173.
Tonigan, J. S., Toscova, R., & Miller, W. R. (1996b). Meta-analysis of the literature on Alcoholics Anonymous: Sample and study characteristics moderate findings. Journal of Studies on Alcohol, 57(1), 65–72.
Underwood, L. G. (1999). Daily spiritual experiences: Multidimensional measurement of religiousness/spirituality for use in health research. A report of the Fetzer Institute/National Institute on Aging Working Group (pp. 11–18). Kalamazoo, MI: Fetzer Institute.
Underwood, L. G., & Teresi, J. A. (2002). The Daily Spirituality Experience Scale: Development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data. Annuals of Behavioral Medicine, 24, 22–33.
Young, L. B. (2013). Characteristics and practices of sponsored members of Alcoholics Anonymous. Journal of Groups in Addiction & Recovery, 8(2), 149–164.
Zemore, S. E. (2007). A role for spiritual change in the benefits of 12-step involvement. Alcoholism: Clinical and Experiential Research, 31(S3), 76S–79S.
Zemore, S. E., & Kaskutas, L. A. (2004). Helping, spirituality and Alcoholics Anonymous in recovery. Journal on Studies of Alcohol and Drugs, 65(3), 383–391.
Acknowledgments
This study was undertaken with support from The John Templeton Foundation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dermatis, H., Galanter, M. The Role of Twelve-Step-Related Spirituality in Addiction Recovery. J Relig Health 55, 510–521 (2016). https://doi.org/10.1007/s10943-015-0019-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-015-0019-4