(The following is a continuation of Parts 1 and 2)
Hope for Change for the Addict
When a counselor approaches addiction as a part of the created order which has been corrupted by mankind’s sin, then that counselor can offer substantial hope for change to the addict. The redemptive narrative of Scripture teaches that God has worked and is continuing to work to restore and redeem all things to Himself for His glory. Negative addiction stems from a corrupted heart attempting to realize some need (Welch, 2003). God’s plan of redemption begins with a spiritually regenerated heart and works through the process of sanctification throughout life.
Though the above appears to be the approach of the nouthetic counselor, there are many in the counseling field that would not take such a strictly biblical spiritual view. How then is it that they might offer hope of change to the addict? A key seems to be how the counselor views the relationship between addiction and spirituality. As stated above there is growing acknowledgment of the importance of recognizing spirituality within the realm of clinical counseling (Frederick, 2014; Hodge, 2011; Hodge & Lietz, 2014; Rosmarin, Green, Pirutinsky, & McKay, 2013). In particular, practitioners using spiritually modified Cognitive-Behavioral Therapy have empirical data which supports the ethical and effective treatment of substance use disorders (Hodge & Lietz, 2014). This is hopeful.
How and Why Change Occurs for Addicted People
An addicted person can only change on the basis of his or her own desire. This is not to say that one’s desire is the guarantor of change The only guaranteed change is the change that happens by the work of God through sanctification of the Christian in this life and glorification of the Christian following death (Philippians 1:6). That said, there remains hope for change for all addicted people in this life who desire to change and are willing to allow others to help them through the change process.
Change Begins With a Desire
Alcoholics Anonymous (AA) is one of the prominent organizations in the realm of addiction treatment and its lone criterion for membership is that one desires to stop drinking (Lê, Ingvarson, & Page, 1995). In many situations where change happens in the life of an addicted person, the desire for change stems from the addict. In some situations however, it is the desire of people surrounding the addict who influence the addict to change. This is evidenced in the television show Intervention, which airs on the A&E network. To return to a spiritual perspective, it is ultimately God who desires change in the life of every man and woman.
Change Does Not Happen in a Vacuum
It was mentioned earlier that mankind has relational needs. People are inherently relational and dependent upon interaction with God and others (Balswick, King, & Reimer, 2005; May, 2009). This means that one cannot change without the interactions of others (Hodge & Lietz, 2014). A hallmark of the stated effectiveness of AA is the support group atmosphere provided to its members (Lê et al., 1995). Families, friends and healthcare professionals all play a part in the holistic approach to change and recovery for the addict. One study indicates that moving from a substance use social group to a new identity with a recovery social group resulted in better outcomes in regards to substance use (Dingle, Stark, Cruwys, & Best, 2015).
Effective Change is Holistic
Holistic change involves the spiritual biopsychosocial person. Psychotherapists have traditionally addressed the biopsychosocial aspects of change for clients. For holistic and effective changes however, spirituality must be addressed by psychotherapists. Frederick (2014) relates five potential relationships between psychology and spirituality as proposed by Len Sperry and his colleagues. Christian spirituality in particular is discussed by McMinn, Staley, Webb and Seegobin (2010) as they differentiate biblical counseling, pastoral counseling and Christian psychology. Rosmarin et al., (2013) note that attention to spirituality and religion has a “rightful place in clinical training” (p. 431). Nouthetic counselors would agree that effective change involves the spiritual and add that change requires one’s desires to be changed as a result of that person coming to a knowledge of God (Welch, 2003). Effective change in this case could also be called biblical change.
Effective Change is not Necessarily Biblical Change
This semantical issue, effective versus biblical change, is indicative of a potential danger of integrating the spiritual with traditional psychotherapies. This is the danger of imposing one’s own beliefs on the client (Hodge & Lietz, 2014). Therapists have an ethical obligation to yield to the clients’ desires in regards to spiritual discussion and treatment methods. Good (effective) change is not necessarily biblical change and the therapist must determine exactly the nature of the change desired by the client. The harm reduction model espoused by VanWormer and Davis (2013) promotes effective change without addressing fundamental spiritual issues which some would say underlie addiction.
For example, an alcoholic may quit drinking, but take up smoking or drinking coffee while at AA meetings. There is good change (abstinence from alcohol) but the alcohol addiction has simply been swapped for another substance or process. Another example would be the forced abstinence which happens when an addict is incarcerated. The substance use ends, but the addict has not addressed the issues that resulted in choices being made to use in the first place.
(References are listed at the end of the first post of this series.)
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