The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70420

Jessica Rodriguez, MPH¹, Helena Hansen, MD, PhD², Bendek Hansen, PhD³, Tony P. George, MD², and Nilde Joanna Defendini Cordoliani, BA⁴. (1) Academic Affairs, Ponce School of Medicine, Valle de Andalucia 3523, Ponce, PR 00728-3132, (787) 284-1427, adriana01@centennialpr.net, (2) School of Medicine and Department of Anthropology, Yale University, 175 Nicoll Street, New Haven, CT 06511, (3) Department of Statistics, University of Michigan, West Hall room 439, 550 East University, Ann Arbor, MI 48109-1092, (4) Psychology Department, Catholic University, Ponce, Urbanizacion Valle Real, Calle Zarina 1915, Ponce, PR 00728

Faith-based substance abuse treatment has received favorable attention from the highest levels of government, yet there are few published comparisons of it to secular alternatives. We compare faith-based and secular treatments by contrasting clinical outcomes at three residential programs in southwest Puerto Rico. In Puerto Rico, over 75% of all state-licensed residential substance abuse treatment programs identify themselves as Christ-centered. The justice system frequently mandates substance abuse treatment as a condition of parole, sending parolees to both faith-based and secular treatment programs. This method of assignment to treatment offers unique advantages from the point of view of selection bias. Accordingly, criteria for inclusion in our sample include recent use of cocaine or heroin and referral to treatment by the justice system. Sample selection is sequential: each client meeting our criteria is recruited upon arrival at the treatment program. To date, this process has yielded 38 clients in two faith-based residential programs employing religious services, Bible study, and pastoral counseling as their primary therapeutic techniques, and 30 clients in a public residential program employing traditional biomedical and psychodynamic therapies for detoxification and relapse prevention. Primary outcome measures include program attrition, intra-subject differences between pre-treatment scores and three-month scores on the Addiction Severity Index and the University of Rhode Island Change Assessment Scale (in translation), and urine toxicologies at three months. Our study also involves an intensive ethnographic examination of the evangelical programs, enabling us to report in detail on how their models of addiction and treatment differ from biomedical models.

Learning Objectives:

At the end of this session, the participant will be able to
• articulate major differences in cultural models of addiction and treatment utilized by evangelical versus biomedical residential rehabilitation programs in Puerto Rico
• describe the findings from a clinical outcome comparison between clients in programs adhering to both models of addiction and treatment, and
• discuss important clinical and policy implications of the findings in light of federal initiatives to fund faith based treatment services.

Keywords: Substance Abuse Treatment, Faith Community

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.