Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

ABSTRACT

Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.     

Testing Faith

Abstract

The U.S. federal government, through Charitable Choice, has opened public funding for the delivery of social services to faith-based organizations (FBOs) more than ever before. This increased access to governmental funding at all levels has led to a closer examination of the evidence base on the effectiveness of the services provided by FBOs, and the capacity of FBOs to respond to data needs for accountability and program improvement efforts. This paper discusses the current status of evaluation research on FBO services and the emerging data needs among faith-based providers. Promising avenues for enhancing the current understanding of outcomes of FBO services are explored such as (1) adopting outcome measurement practices in use within the current nonprofit sector, and (2) developing more rigorous research designs tailored to the special contexts of faith-based services. The paper suggests an agenda in which FBO operators, funders, and evaluators work together to move forward in improving the evidence base on faith-based services.     

Belief Systems in Faith-Based Human Service Programs

Abstract

Using a grounded theory design and methods, 65 key informants in 15 faith-based organizations having promising programs in four urban areas were interviewed. Respondents were asked what makes their direct service programs faith-based. A story emerges, motivated by mission-driven visions tied to forces beyond local programs and steeped in deep traditions. A major implication of the findings is that in teaching people about the various practices of diverse religious groups, we are only giving them the visible elements. While the expressed values of acts and faith are integral in the faith-based discussion, they do not tell the full story. The deep drivers of human behavior and practice are found in the specific beliefs and interpretations of individuals who are involved either as leaders or participants in faith-based organizations. For many of these individuals in faith-based organizations, mission and accountability to God trumps secular or professional expectations.     

Finding Congregations

Abstract

The need to assess the effectiveness of faith-based social interventions is pressing. On the one hand, politicians and pundits claim that faith-based organizations are impressively successful and inexpensive. On the other hand, critics claim that faith-based organizations lack the capacity to carry out social services. However, rigorously-collected empirical data is just beginning to appear and is still in short supply, particularly congregations. In this paper, we discuss some critical methodological and conceptual problems that arise from years of academic neglect of faith-based social service provision. We demonstrate how our attempt to create a comprehensive account of congregation-based social services in Philadelphia necessitated defining even such basic terms as “congregation” and devising novel methods for identifying and gathering information from congregations.     

Faith-Based and Community Initiative

Abstract

President Bush's Executive Orders to establish Centers of Faith-Based and Community Initiatives have encouraged the use of faith-based organizations (FBOs) as service providers in a range of federally funded programs. New federal rules and regulations are removing barriers so that FBOs can participate in these programs. Yet, there is no centralized information system that accumulates data related to performance standards or outcome measures. This article analyzes the scope and scale of services provided by FBOs and the diverse approaches to studying the outcomes from these services.     

Evaluating the Effectiveness of Faith-Based Welfare Agencies

Abstract

This study examines the methodological challenges associated with conducting research on faith-based organizations. The arguments advanced are based on a group of comparative case studies conducted by the authors on secular and faith-based providers in three different social service domains: (1) transitional housing, (2) parent education, and (3) residential substance abuse treatment programs. All case studies utilized the same research protocol. The study identifies the lessons learned from comparative case study research on faith-based organizations when a similar protocol is implemented to examine a variety of social service domains and provider types.     

Faith-Based Programs and the Role of Empirical Research

Abstract

After some decades of being subject to neglect or contempt, faith-based social care programs are receiving increased attention and resources enabling them to undertake a greater role in the national network of human services. Faith-based programs receiving public support can expect to be rightly scrutinized by the public, in terms of their ability to attain professed program goals. The tools of conventional empirically-oriented program evaluation research have tremendous potential to help demonstrate the effectiveness of faith-based programs, which will justify their receipt of ongoing support from public funds. Negative research findings can be properly scrutinized by the faith-based community of service providers to help make tough, data-based, decisions on funding priorities. Several examples are described, illustrating how various types of faith-based programs have profitably participated in program evaluation studies.     

How Do They Fit?

Abstract

Despite public policies that promote an increased role for faith-based organizations in the delivery of publicly supported services, insufficient attention has been paid to assessing how service delivery by faith-based and secular providers might differ. This study considers the issues involved in evaluating the role of faith-based organizations within the broad context of a community's social service offerings. Criteria are developed for assessing role differences by comparing the types of services, delivery approaches, and service locations offered by different types of providers. The approach is then illustrated using a large sample of social service providers in Los Angeles County. Important role differences are revealed. Faith-based organizations offer fewer and different types of services than their secular counterparts. The results suggest a modest and focused role for faith-based organizations in social service delivery, but one that is complementary to the efforts of secular providers. The methodological issues raised by such analyses are highlighted.     

Looking Inside the “Black Box”

Abstract

The continued devolution of social welfare systems and services in the U.S. resultsin high stakes program evaluations in the field of family support and early intervention. Programs are expected to utilize evidence-based interventions and to demonstrate effectiveness. A look at implementation helps to differentiate between theories that do not work and programs that are not effective. Methods for identifying program implementation are needed. In a 17-site program evaluation, the author and her colleagues developed a methodology for measuring implementation and demonstrated the effects of differential implementation in understanding program outcomes.     

Executive Orders for the Faith-Based and Community Initiatives

Abstract

Debate surrounding the Faith-Based and Community Initiatives draws both fire and praise as the Bush Administration continues to promote the federal funding of partnerships among state and local government and faith-based service providers. President Bush has endorsed religious groups as valuable partners in delivering services that address social problems through a series of Executive Orders. The intent of this article is to further our understanding of the history related to these executive decisions, the different conceptualizations for defining and classifying faith-based organizations, the issues surrounding faith-based organizations, and the legislative effort to make the faith-based initiative a permanent statutory feature.     

The Effectiveness of Faith-Based Welfare-to-Work Programs

Abstract

This essay first highlights three major challenges of measuring program effectiveness. It concludes effectiveness can best be conceptualized in terms of program outcomes and that such outcomes-while difficult to measure-can be measured with sufficient accuracy to justify the effort. These considerations are then illustrated by data gathered from 17 Los Angeles welfare-to-work programs and their clients in order to assess the comparative effectiveness of faith-based and secular programs. The essay concludes that no one type of welfare-to-work program was more effective across the board than any other type of program. Instead, the different types of programs seemed to be especially effective in certain specialized areas. The faith-based programs were especially effective in providing welfare recipients with emotional support and a sense of having a sympathetic, understanding base of support. The for-profit providers were especially effective in providing needed training in marketable job skills and help in finding employment. The essay concludes by discussing two public policy implications that flow from this type of program specialization.     

Spirituality and Faith-Based Social Services

Abstract

Spiritual aspects of faith-based social services are rarely addressed in discussions of policy initiatives encouraging greater involvement of faith-based providers in service delivery. This article reports findings of a qualitative study of the values, beliefs, and practices of non-congregational faith-based service providers. Twenty-two providers in Midwestern and northwestern regions of the U.S. were asked about the spiritual bases of their programs, spiritual dimensions of service relationships, distinctions between service communities and programs, and distinctions between service ministries and social work. Implications for collaborations among providers with different beliefs are discussed.     

Building a Faith-Based Human Service Agency

Abstract

Interest in faith-based organizations has increased substantially since the Bush administration made them a priority in the presidential campaign of 2000 and established a special office in the White House to promote their involvement in government supported human services. The primary goal of this initiative is to encourage faith-based organizations, usually understood to mean congregations, to engage their members in supporting services to those most in need. While most research on faith-based organizations is limited to the past decade or two, very little is known about how they operate. This case study of Community Ministries of Rockville, Maryland (CMR) is designed to address this issue. CMR differs from most faith-based organizations in that it neither represents a single congregation nor the traditional faith-related social service agency like Catholic, Jewish, or Lutheran Social Services. The case study features the twenty-five year history of the Executive Director of a faith-based human service organization supported by twenty congregations. It concludes with the identification of major challenges and lessons learned.     

Social Accountability as an Innovative Frame in Civic Action: The Case of Rede Nossa São Paulo

In the past three decades, Brazil’s state and civil society have undergone a transformation. Non-profit organizations have proliferated, revealing new opportunities for participation, while sustainability and corporate social responsibility have produced new agendas for corporations. Against this background, accountability has emerged within the debate, particularly with regard to governmental transparency and efficiency. This paper examines the Rede Nossa São Paulo movement, which pledges social justice and sustainability and promotes social accountability as its main strategy to achieve its mission. Thus, the main objective of this study is to understand social accountability; more broadly, the goal is to examine governmental accountability in the mobilization process developed by Rede Nossa São Paulo by referring to the framing perspective as a core aspect in the understanding of social movements. Social accountability is presented as a frame that is composed of the union between movements that are historically bonded by the motto of social justice and other groups that are related to urban development and social and environmental responsibility.     

A Joint University—Field Agency: Toward the Integration of Classroom and Practicum

Abstract

The authors describe an innovative program designed to create a joint university and local municipality agency in Israel. The agency was structured to be a teaching laboratory that would offer innovative services for social work clients and a unique field placement for students. Four major goals involved joint outcomes for both university and municipality. These included (a) demonstrating evaluation research as a means of accountability and as a tool for practice; (b) using generic social work methods for work with families; (c) reaching out to difficult and high-risk clients with innovative programs; and (d) using the laboratory as a training center for welfare workers, agency supervisors, and students from all levels of the social work programs. The authors describe and evaluate each of the goals, discussing the implications for teaching and for social work practice.     

A Faith-Based Alternative Youth Education Program

Abstract

Community-based and faith-based programs are on-going partners in the social welfare mix which characterizes U.S. welfare provision. In the face of calls for more rigorous research on the capacity and impact of faith-based and community-based programs which use public funds, the research community must gain sophistication in addressing methodological issues inherent in participatory designs for the study of such programs. This article describes concerns which arose while implementing participatory research during a federally-funded, intensive 10-month long case study of a faith-based alternative education program for at risk youth. The project was funded through the Department of Health and Humans Services, Administration for Children and Family. The challenges to data collection are presented and suggestions for doing participatory research in similar settings are discussed.     

Integrating Pharmacotherapy and Psychosocial Interventions in the Treatment of Individuals with Alcohol Problems

Abstract

Both research and clinical experiences suggest that there are separate and overlapping benefits of medications and psychosocial treatments for alcohol problems. Evidence has shown that medication(s) combined with a moderate intensity psychosocial therapy can produce outcomes beyond what each of these approaches can produce alone. Taking medication can be helpful in facilitating longer periods of abstinence that in turn affords practitioners a greater opportunity to enhance patients' individual and social coping resources and to increase their motivation to change. Combining effective pharmacological and psychosocial interventions may provide the impetus to integrate alcoholism treatment into the general health care delivery system, thereby helping to increase the accessibility of care and well-being for individuals seeking or needing help with alcohol problems.     

Examining the Underlying Values of Food Security Programming: Implications for the Social Work Profession

Incongruities between social work’s professional values and dominant public and private responses to food insecurity are discussed. Empowerment theory is positioned as an evaluative lens to examine food assistance. Summaries of dominant forms of food assistance are provided and scrutinized using basic tenets of empowerment theory. Contrasting examples of innovative programs are also discussed in terms of their potential for empowering outcomes. Highlighted programs, including community gardens, community kitchens, and the food rescue and redistribution program D.C. Central Kitchen, demonstrate the evaluative potential of empowerment theory. Implications for social work research and practice are explored.