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Addiction and Twelve-Step Spirituality

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Christianity and Psychiatry

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Abstract

Addictions are among the leading causes of preventable death worldwide and in the United States. Given the morbidity and mortality of alcohol and other substance use disorders, effective treatments are needed. A recent meta-analysis found participation in Alcoholics Anonymous (AA) to be as effective – if not more effective – than other forms of alcohol use disorder treatment. Moreover, the methods used by clinicians to facilitate active AA and other twelve-step (TS) engagement (e.g., twelve-step facilitation, TSF) have been shown to increase the likelihood that individuals struggling with addictions will actively participate in twelve-step groups.

The authors of this chapter are clinicians who treat patients who struggle with various addictions and co-occurring mental health disorders. We write this chapter to explain why twelve-step participation is a vital treatment component for many, but not all, who are seeking spiritual renewal and recovery. Our aim is to offer hope that recovery from addiction is possible and that patients with a Christian worldview can find a group that supports recovery and their Christian faith. We will briefly review the intersection of twelve-step spirituality and Christianity by examining the historical background and Christian origins of AA/TS/TSF, examine putative mechanisms that promote recovery from addictions, compare and contrast some twelve-step self-help recovery groups, provide a case example, examine the expansion of peer-led mutual help groups, and close with future directions.

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Notes

  1. 1.

    Source used throughout this section.

  2. 2.

    Reference used throughout this section.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    David B. Hathaway

  2. Department of Psychiatry, Boston Medical Center, Boston, MA, USA

    Michael Dawes

  3. Department of Veterans Administration, Boston University, Boston, MA, USA

    Michael Dawes

Authors
  1. David B. Hathaway
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  2. Michael Dawes
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Corresponding author

Correspondence to Michael Dawes .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    John R. Peteet

  2. Medical College of Wisconsin, Milwaukee, WI, USA

    H. Steven Moffic

  3. Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Strand, London, UK

    Ahmed Hankir

  4. Psychiatry and Behavioral Sciences, Duke Medical Center, Durham, NC, USA

    Harold G. Koenig

Appendix

Appendix

How to Do TSF?

Due to space limitations, we refer interested clinicians seeking practical guidance on how to do TSF to the Project COMBINE Cognitive Behavioral Therapy manual [28]. Briefly, the steps include:

  • Provide a rationale for mutual-support group involvement.

  • Ask your patient for the reasons why additional support could be helpful.

  • Explore said patients’ attitudes and beliefs about mutual support.

  • Give information about available groups.

  • Give practical information on what to expect in a recovery group.

  • Encourage sampling more than one group; provide referral information.

  • Make a specific action plan.

For more detailed information, please refer to the above-referenced CBT manual.

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Hathaway, D.B., Dawes, M. (2021). Addiction and Twelve-Step Spirituality. In: Peteet, J.R., Moffic, H.S., Hankir, A., Koenig, H.G. (eds) Christianity and Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-80854-9_11

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  • DOI: https://doi.org/10.1007/978-3-030-80854-9_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80853-2

  • Online ISBN: 978-3-030-80854-9

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