One of the most commonly used treatment models in addiction is the 12-step model developed in the 1930s and rooted in spirituality. Yet, surprisingly, there is no clear understanding about how to nurture spirituality among people struggling with addictions.

In a unique study titled “Attachment Style, Spirituality, and Depressive Symptoms Among Individuals in Substance Abuse Treatment,” published in the Journal of Social Service Research, Gail Horton, Ph.D., associate professor; Naelys Luna, Ph.D., associate professor, School of Social Work in the College for Design and Social Inquiry at Florida Atlantic University, and Tammy Malloy, LCSW, chief clinical officer, Behavioral Health of the Palm Beaches (BHOPB), demonstrate that the lack of ultimate meaning in life, an important dimension of spirituality, is associated with alcohol abuse and drug addiction, as well as other mental health problems including anxiety and depression.

Although adult attachment styles and spirituality have been shown to be protective factors against depressive symptoms among individuals in treatment for substance use disorders, no studies to date have examined how these two factors together are related to depressive symptoms in this population.

Horton, Luna and Malloy looked at how adult attachment styles (secure vs. insecure) and two distinct spirituality dimensions (existential purpose/meaning in life and religious well-being or the perceived relationship with God) are associated with depressive symptoms.

Working in collaboration with BHOPB, a substance abuse treatment center in Palm Beach County, Horton, Luna and Malloy developed a research model that looks at how creativity, service and solitude can be used in addiction treatment to foster purpose and meaning in life. They found that encouraging people’s creative talents (painting, writing), giving them opportunities to serve others, and helping them to connect to core values and their true self through prayer and meditation helped them to discover ultimate purpose and meaning as part of their recovery process.

A key finding of their research shows that having an insecure attachment style appears to be a risk factor for developing depressive symptoms. Another significant finding shows that the existential-purpose and meaning-in-life dimension of spirituality seems to be the most important factor related to depressive symptoms in this sample population.

Horton and Luna note that although their research results suggest that practitioners could consider focusing on promoting improved interpersonal relationships for individuals with insecure attachment styles, they may want to place fostering purpose and meaning in life as a higher priority for treatment planning.

“Programs such as the 12-step model might want to take into consideration the relative importance of the two spiritual dimensions and put into place programmatic support for the development of purpose and meaning in life rather than only stressing the perceived closeness to God,” said Malloy.

Addiction is one of the most damaging health problems in the U.S. today and the World Health Organization (WHO) reports that by 2020, mental health and substance use disorders will be a major cause of disability worldwide surpassing physical illness. In 2009, an estimated 23.5 million Americans ages 12 and older required addiction treatment. The societal cost of substance abuse problems is approximately $511 billion.

“The cutting-edge research conducted by Drs. Horton and Luna and Ms. Malloy is extremely important because it sheds light on different ways to help individuals in treatment addiction,” said John R. Graham, Ph.D., professor and director of FAU’s School of Social Work. “This in turn not only helps the clients receiving treatment, but also improves how addiction professionals do their work – contributing to the health and well-being of the broader community.”