Geoffrey C. B. Lyons

Forgiveness and purpose in life as spiritual mechanisms of recovery from substance use disorders

Spirituality has often been associated with recovery from substance use disorders through its emphasis in faith-based rehabilitation programs. The purpose of this article is to describe some psychological dynamics that may explain how spirituality aids in the treatment of substance abuse and dependence. Forgiveness and purpose in life are proposed as “spiritual mechanisms” that partially mediate a spiritually directed recovery. Recent empirical studies on spirituality and recovery from substance use disorders are discussed in relation to 12-steps of Alcoholics Anonymous and Christian principles in order to describe how forgiveness and purpose in life interact with spiritual development in substance use disorder treatment programs. A theoretical model detailing the relationship between spirituality, forgiveness, purpose, and recovery is presented based on anecdotal and empirical literature.

Spirituality and the treatment of substance use disorders: An exploration of forgiveness, resentment and purpose in life

Faith-based treatment programs are a viable treatment option for many individuals with substance use disorders; however, the psychological mechanisms that explain the relationship between spirituality and a recovery from substance use disorders have not been established. The Spirituality, Forgiveness, and Purpose (SFP) model of recovery proposes that forgiveness and purpose in life may mediate the spirituality–recovery relationship. As a preliminary step in exploring this theory, a cross-sectional investigation of 277 clients of the Australian Salvation Army Rehabilitation Service Centres was performed. A multiple regression found that forgiveness of others, forgiveness of self, receiving forgiveness from others, and receiving forgiveness from God predicted resentment. Furthermore, multiple mediation analyses found that forgiveness of self and receiving forgiveness from others and God mediated the relationship between daily spiritual experiences and purpose and engagement in life.

Self-Forgiveness, Shame, and Guilt in Recovery from Drug and Alcohol Problems

ABSTRACT Background: People with drug and/or alcohol problems often experience feelings of shame and guilt, which have been associated with poorer recovery. Self-forgiveness has the potential to reduce these negative experiences. Methods: The current study tested theorized mediators (acceptance, conciliatory behavior, empathy) of the relationships between shame and guilt with self-forgiveness. A cross-sectional sample of 133 individuals (74.4% male) receiving residential treatment for substance abuse completed self-report measures of shame, guilt, self-forgiveness, and the mediators. Results: Consistent with previous research, guilt had a positive association with self-forgiveness, whereas shame was negatively associated with self-forgiveness. Acceptance mediated the guilt and self-forgiveness relationship and had an indirect effect on the shame and self-forgiveness relationship. Conclusions: These findings emphasize the importance of targeting acceptance when trying to reduce the effects of shame and guilt on self-forgiveness.

Clinical and reliable change in an Australian residential substance use program using the addiction severity index

Although the Addiction Severity Index (ASI) is one of the most frequently used measures in alcohol and other drug research, it has rarely been used to assess clinical and reliable change. This study assessed clients’ clinical and reliable change at The Salvation Army residential substance abuse treatment centers in Australia. A total of 296 clients completed ASI interviews on admission to treatment and 3 months after discharge from treatment. Clients demonstrated significant improvement on all seven ASI composites. The range of reliable change for each ASI composite varied from 30% to 70%. More than two-thirds of clients experienced clinically significant improvement for alcohol and drug problems. Psychiatric distress was clinically reduced in 44% of clients. This research indicates that residential substance abuse treatment can make important differences in clients lives at a clinical and functional level. However, the research highlights the challenge of effectively targeting psychiatric comorbidity within alcohol and other drug abuse populations.

The Feasibility of Telephone Follow-Up Interviews for Monitoring Treatment Outcomes of Australian Residential Drug and Alcohol Treatment Programs

BACKGROUND Telephone follow-up interviewing is one method of monitoring treatment outcomes of individuals involved in drug and alcohol treatment programs. The present study is the first to examine the feasibility and generalizability of data obtained from telephone follow-up interviews after drug and alcohol treatment in Australia. METHODS Participants attended 1 of 8 Salvation Army Recovery Service Centres where staff administered outcome measures at intake. Three-month postdischarge telephone follow-up interviews were conducted by researchers from the Illawarra Institute for Mental Health, University of Wollongong. RESULTS A sample of 700 clients was obtained for follow-up (582 males; 118 females). A 51% follow-up rate was achieved at a cost of US

Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions

82 per completed interview. No significant differences in baseline characteristics between responding and nonresponding participants were found. CONCLUSIONS Overall, the telephone methodology was shown to be feasible and relatively inexpensive. However, the introduction of outcome measures at the service level in parallel with follow-up data collection procedures complicated the collection of response data. The burden of introducing outcome measures in residential services may be reduced by utilizing a phased implementation strategy.

Prediction of individual differences in adjustment to loss: Acceptance and valued-living as critical appraisal and coping strengths

INTRODUCTION AND AIMS Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. DESIGN AND METHODS The sample consisted of 220 substance-dependent individuals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. RESULTS Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regression examined the predictors of further treatment attendance. The full model accounted for 21% of the variance in treatment attendance, with attitude and Implementation Intentions contributing significantly to the prediction. DISCUSSION AND CONCLUSIONS Findings from the present study would suggest that assisting clients to develop a specific treatment plan, as well as helping clients to build positive perceptions about subsequent treatment, will promote greater attendance at further treatment following detoxification. [Kelly PJ, Leung J, Deane FP, Lyons GCB. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions. Drug Alcohol Rev 2016;35:678-685].

Relative Importance of Abstinence in Clients’ and Clinicians’ Perspectives of Recovery from Drug and Alcohol Abuse

ABSTRACT Our strengths-based model of coping with death and dying proposes acceptance and valued-living as key coping and appraisal strengths for the bereaved. These are core components of Acceptance and Commitment Therapy (ACT). The aim of this study was to provide an initial exploration of the theorized relationships via a survey of 97 bereaved university students. Using hierarchical regression analysis it was found that acceptance and valued-living were significant predictors of grief, while controlling for other model variables and loss characteristics. Results have implications for ACT-based approaches in supporting those bereaved who are struggling with their grief.

An acceptance and commitment therapy self-help intervention for carers of patients in palliative care: Protocol of a feasibility randomised controlled trial

This study collected data on drug and alcohol workers’ (n = 55) and clients’ (n = 139) perspectives on what constitutes a “recovery” from substance use disorder. Data were collected during 2010 from four residential faith-based treatment programs across the east coast of Australia. Self-report surveys specifically designed for this study were administered. Responses were compared using nonparametric test. Abstinence was seen as an important component of recovery but nonabstinent factors were also seen as having an important role. Staff placed more emphasis on clients taking responsibility for their problems and on the role of spiritual development. The importance of nonabstinence components was positively associated with a persons time in treatment and recovery. Implications, limitations, and future directions are noted.

Psychometric properties of the Recovery Assessment Scale in a sample with substance use disorder

Undertaking a caregiving role at end of life can have enduring psychological consequences for carers, including poor adjustment in bereavement. Acceptance and commitment therapy–based interventions have demonstrated effectiveness in helping people cope with a range of life challenges. This article presents the protocol of a feasibility randomised controlled trial of an acceptance and commitment therapy self-help intervention for psychological distress and grief in carers of patients in palliative care. We will assess feasibility and acceptability of the trial procedures and intervention as well as preliminary effectiveness of the intervention on carer well-being outcomes.