Substance Abuse and Mental Health
RECOVERY FROM SUBSTANCE abuse is a recovery phenomenon that is of importance to nursing. Reports in the literature indicate that recovery from substance abuse is a complex multidimensional process that occurs both with and without expert assistance [Prochaska et al 1992]. Whereas a combination of human, social, and economic costs of substance abuse have led to a plethora of research on topics such as the epidemiology of substance abuse, treatment outcomes such as client functioning, relapse phenomena, and most recently matching individual and treatment characteristics [Murphy 1993], very little is known about recovery from substance abuse in African American women. Although studies conducted with women have increased within the last decade, those conducted may not be generalizable to African American women [Davis 1997, Jackson 1995 and Murphy 1993]. It is estimated that women represent at least one-quarter of all who are dependent on various substances [Davis 1997 and Greenfield and Rogers 1999]. The recidivism rate for substance abusers has been reported to be at 90% 12 months after treatment, with most relapse occurring after 3 months [Substance Abuse and Mental Health Services Administration 1996].
For many African American women recovering from substance abuse, current treatment modalities and self-help groups do not meet their needs [Hooks 1993 and Nelson-Zlupko et al 1996], because mainstream treatment of substance abuse has traditionally been developed and implemented by male providers for male clients [Abbott 1994 and Reed 1985]. Unlike treatment for men, which can be individualistic oriented, women’s treatment must be focused within the context of their relationship to others [Finkelstein 1994]. Research suggests that women may benefit from substance abuse programs that include a residential component, as well as gender-specific services [Dempsey and Wenner 1996 and Nelson-Zlupko et al 1996]. Spirituality has often been noted in the health care literature to affect recovery [Ellison and Levin 1998, McNichol 1996 and Sloan et al 1999].
Although there has been a proliferation of reports in the health care literature substantiating the ameliorating effects of spirituality with a broad range of positive outcomes, only a few have focused on specific spiritually derived strategies as an aid to recovery [Brome et al 2000, Ellison and George 1994, Green et al 1997 and McMillen et al 2001]. It has also become important to articulate the distinction between spirituality and religion. Although some may regard the two as indistinguishable, others believe religion has specific behavioral, social, doctrinal, and denominational characteristics, whereas spirituality is concerned with the transcendent, and addressing ultimate questions about life’s meaning [Carson 1989, McSherry and Draper 1998, Ngai-Jacobson and Burkhardt 1989 and Reed 1992]. These differences are acknowledged. Undoubtedly, this confusion between spirituality and religion has been a huge roadblock in the understanding of what it means to be human.
An individual’s unique spirituality or spiritual “style,” is the way he or she seeks to find or create, use, and expand personal meaning in the context of the universe [Thibault et al 1991]. Feminist researchers and theologians have suggested that spirituality may be expressed differently by women than by men [Anderson and Hopkins 1991 and Ruether 1992]. [Turner et al 1998] concluded that ethnic minority women returned to church after beginning recovery with greater regularity than Anglo women. It is, therefore, possible that the ethnic minority churches may be meeting the needs of recovering women. The need for an Afrocentric approach in the treatment and recovery of substance abuse that would facilitate the strengthening of identity, spirituality, and community has been articulated by several researchers interested in the Afrocentric worldview [Asante 1988, Belgrave et al 1994 and Brisbane and Womble 1985]. Spirituality is considered to be the cornerstone of activities within the African American community [Jackson 1995 and Scandrett 1994]. Most of these activities are centered around the Black Church. How spirituality might be used in recovery and healing needs to be explored and described in this population.
Since the conception of modern nursing by Nightingale, spirituality has been central to the essence of nursing. In providing holistic care, nursing now addresses spirituality. The concept that the provision for patients’ spiritual needs is encompassed within the nurse’s role is supported by prolific nursing writers such as [Carson 1989. V.B. Carson. Spiritual dimensions of nursing practice, W.B. Saunders, Philadelphia (1989).Carson 1989], some nurse theorists [Watson 1988, Roy 1984, Neuman 1982, 1989 and Reed 1992]. Nurses are obligated to care for the whole human being, presupposing that they understand and accept patients’ spiritual experiences irrespective of their ways of expressing them. Therefore, the first step is for nurses and other health care professionals to begin their own spiritual journeys. As nurses achieve awareness of their inner selves, they can more readily address the spiritual needs of others by looking beyond the physical and more deeply within, and become aware that there is something sacred that can be witnessed and shared in the midst of life’s illness and disease. A phenomenological understanding of all that spirituality may represent to African American women is relevant to the recovery process from substance abuse.
Purpose
A qualitative phenomenological research study was designed to explore the essential elements of the lived experience of spirituality among African American women recovering from substance abuse, and to describe the meanings made of this phenomenon by the person experiencing it.
Methods
Philosophical perspective
The perspectives of [Frankl 1965, 1984] provide the conceptual orientation for this study, whereas direction for data analyses was provided by the procedural steps of [Giorgi 1985] method. [Frankl 1965, 1984] states that the meaning of life differs from man to man, from day to day, and from hour to hour. [Frankl 1965, 1984] proposed that the chief dynamic behind the addictive behavior is “existential frustration” created by a vacuum of a perceived meaning in personal existence, and manifested by the symptom of boredom. The underpinnings of Frankl’s work stresses individual’s freedom to transcend suffering and find meaning in life regardless of his circumstances. The substance abuser often looks on his existence as meaningless and without purpose. [Frankl 1965, 1984] concept of how meaning in life differs from day to day correlates with the philosophies of Alcoholics Anonymous (AA) in their statement about staying sober “one day at a time.” [Frankl 1965, 1984] work is based on empirical or phenomenological analysis, which was described as the way in which, man understands himself, and how he interprets his own existence.
Tags: substance abuse