Addiction Treatment Intervention: An Uncontrolled Prospective Pilot Study of Spiritual Self-Schema Therapy with Latina Women

Abstract

Spiritual Self-Schema (3-S) is a weekly 8-session, mindfulness-based, manual-guided, individual intervention targeting addiction and human immunodeficiency virus (HIV) risk behaviors that integrates cognitive behavioral strategies with Buddhist principles and clients’ religious/spiritual beliefs. 3-S is efficacious for reducing drug use and HIV risk behaviors among mixed-gender, methadone-maintained outpatients. The study goal was to conduct a preliminary evaluation of 3-S therapy among urban, low-income Latinas (n = 13) in residential addiction treatment. Data gathered via in-person interviews (baseline, 8 and 20 weeks postentry) showed high rates of 3-S acceptability and positive changes in a number of outcomes relevant to recovery from addiction and to HIV prevention, including impulsivity, spirituality, motivation for change, and HIV prevention knowledge. The study findings are promising; however, a controlled study with longer follow-up is needed to rigorously assess the efficacy of 3-S therapy with Latinas in substance abuse treatment.

Keywords

Addiction Hispanic HIV prevention Latino mindfulness women

Get full access to this article

View all access options for this article.

References

National Institute on Drug Abuse. 2002. Principles of HIV Prevention in Drug-Using Populations, Bethesda, MD: National Institute of Health.

Geppert

, Bogenschutz

M P

and Miller

W R

. 2007. Development of a bibliography on religion, spirituality and addictions. Drug Alcohol Rev., 26: 389–395.

Avants

S K

and Margolin

. 2004. Development of Spiritual Self-Schema (3-S) therapy for the treatment of addictive and HIV risk behavior: a convergence of cognitive and Buddhist psychology. J Psychother Integrat, 14: 253–289.

Margolin

, Beitel

, Schuman-Olivier

and Avants

S K

. 2006. A controlled study of a spirituality-focused intervention for increasing motivation for HIV prevention among drug users. AIDS Educ Prevent, 18: 311–322.

Avants

S K

and Margolin

. 2003. Spiritual Self Schema Therapy manual Retrieved August 5, 2007, from http://www.3-s.us/

Avants

S K

, Beitel

and Margolin

. 2005. Making the shift from ‘addict self to spiritual self.’ Results from a stage I study of Spiritual Self Schema (3-S) therapy for treatment of addiction and HIV risk behavior. Mental Health Religion Culture, 8: 167–177.

Margolin

, Schuman-Olivier

, Beitel

, Arnold

R M

, Fulwiler

C E

and Avants

S K

. 2007. A preliminary study of Spiritual Self-Schema (3-S+) therapy for reducing impulsivity in HIV-positive drug users. J Clin Psychol, 63: 979–999.

2006. Center for Disease Control and Prevention Available at: http://www.cdc.gov/hiv/topics/surveillance/resources/reportsHIV/AIDS Surveillance Report 18. Accessed September 19, 2008

Kottiri

B J

, Friedman

S R

, Neaigus

, Curtis

and Des Jarlais

D C

. 2002. Risk networks and racial/ethnic differences in the prevalence of HIV infection among injection drug users. J Acquir Immune Defic Syndr, 30: 95–104.

10.

National Institute on Drug Abuse. 2007. Hispanics and drug abuse Available at: http://www.drugabuse.gov/newsroom/07/NS-2.html NewsScan NIDA Addiction Research News (Feb). Accessed September 11, 2008

11.

Arévalo

, Prado

and Amaro

. 2008. Spirituality, sense of coherence, and coping responses in women receiving treatment for alcohol and drug addiction. Eval Program Plann, 31: 113–123.

12.

Amaro

, McGraw

, Larson

M J

, López

, Nieves

and Marshall

. 2005. Boston Consortium of Services for Families in Recovery: a trauma-informed intervention model for women's alcohol and drug addiction treatment. Alcohol Treat Q, 22: 95–119.

13.

McLellan

A T

, Kushner

Metzger

. 1992. The Fifth Edition of the Addiction Severity Index. J Subst Abuse Treat, 9: 199–213.

14.

McLellan

A T

, Luborsky

Cacciola

. 1985. New data from the Addiction Severity Index: reliability and validity in three centers. J Nerv Mental Dis, 173: 412–423.

15.

Argeriou

, McCarty

, Mulvey

and Daley

. 1994. Use of the Addiction Severity Index with homeless substance abusers. J Subst Abuse Treat, 11: 359–65.

16.

Hodgins

D C

and El-Guebaly

. 1992. More data on the Addiction Severity Index: reliability and validity with the mentally ill substance abuser. J Nerv Mental Dis, 180: 197–201.

17.

Leonhard

, Mulvey

, Gastfriend

D R

and Shwartz

. 2000. The Addiction Severity Index: a field study of internal consistency and validity. J Subst Abuse Treat, 18: 129–135.

18.

Foa

E B

, Cashman

, Jaycox

and Perry

. 1997. The validation of a self-report measure of posttraumatic stress disorder: the Posttraumatic Diagnostic Scale. Psychol Assess, 9: 445–451.

19.

Derogatis

. 1993. Brief Symptom Inventory (BSI): Administration, Scoring and Procedures Manual, 4th ed., Minneapolis: National Computer Systems.

20.

Vincent

. 1990. Credibility assessments in trials of acupuncture. Complement Med Res, 4: 8–11.

21.

Patton

J H

, Stanford

M S

and Barratt

E S

. 1995. Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol, 51: 768–74.

22.

National Institute on Drug Abuse. 1994. Outreach/Risk Reduction Strategies for Changing HIV-Related Risk Among Injection Drug Users, Rockville, MD: NIDA. NIH Publication No. 94-3726

23.

Simpson

T L

, Kaysen

Bowen

. 2007. PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals. J Trauma Stress, 20: 239–249.

24.

Beitel

, Genova

, Schuman-Olivier

, Arnold

, Avants

S K

and Margolin

. 2007. Reflections by inner-city drug users on a Buddhist-based spirituality focused therapy: a qualitative study. Am J Orthopsychiatry, 77: 1–9.

25.

Gómez

and Marín

. 1996. Gender, culture, and power: barriers to HIV-prevention strategies for women. J Sex Res, 33: 355–362.

26.

Nyamathi

, Bennett

, Leake

, Lewis

and Flaskerud

. 1993. AIDS-related knowledge, perceptions, and behaviors among impoverished minority women. Am J Public Health, 83: 65–71.

27.

Bernal

, Bonilla

and Bellido

. 1995. Ecological validity and cultural sensitivity for outcome research: issues for the cultural adaptation and development of psychosocial treatments with Hispanics. (Special Issue: Psychosocial Treatment Research.). J Abnorm Child Psychol, 23: 67–83.