Patients Pick Spiritual Treatment over Better Food, Survey Shows

Patients rate faith as most important factor in recovery, nursing staff rated it far lower

Successfully treating alcoholism and drug abuse poses challenges, but when the addicted patient also has a serious mental illness, treatment becomes even more complex. What do these "dual diagnosis" patients themselves see as what best helps them get well? A team of doctors decided to ask.

"The patients view spirituality as essential to their recovery and value spiritual programming in their treatment," these four doctors found when extensively interviewing 101 patients admitted to a "dual diagnosis" unit at Bellevue Hospital Center in New York City. The doctors also interviewed the 31 member nursing staff to see if the staff's perceptions of what helps best coincided with patients' views. They found a large gap.

"The nursing staff underestimated both the patients' level of spirituality and this importance placed on spiritual issues," the researchers noted.

The doctors developed a list of 11 items they believed "might be helpful in the promotion of recovery of addiction." These summarized their extensive 86-question survey of the patientsÌ psychiatric and drug use history, family background, age, income, education, and other factors, as well as a second questionnaire on the importance of their religious beliefs and practices.

When asked to rank these 11 items, patients listed "Inner peace" first, "Belief in God or a higher power" second, and attending Alcohol Anonymous (AA) meetings fourth. Staff had thought patients would rank belief in God much lower--ninth on the list--and thought "good stable housing" and "appropriate government benefits" would come first and second.

Such a wide gap between how patients and medical staff view the role of religious belief in treatment is all too common, noted Dr. David Larson, epidemiologist and president of the National Institute for Healthcare Research (NIHR).

In terms of nursing care, the patients listed the desire for "more groups focused on spirituality," and "more access to religious services," as second and third, behind "more access to doctors." By contrast, the staff surmised patients would prefer "better food," improved rooms," and "better movies." Clearly, the nursing staff did not fully understand the needs of the patient--particularly on the issue of spiritual care.

"The patients value things such as 'inner peace' and a 'belief in God' more highly than nurses who cared for them predicted," the doctors found.

"Perhaps spiritually based self-help groups can be introduced into a variety of treatment settings to provide a more supportive, non-intrusive, yet therapeutic atmosphere...given that patients...state they want this type of treatment," The researchers concluded. "It would not be difficult to provide and could become an important and sustaining form of treatment."

Reference: McDowell, D., Galanter, M., et al. (1996). "Spirituality and the Treatment of the Dually Diagnosed: An Investigation of Patient and Staff Attitudes." Journal of Addictive Diseases 15(2):55-68.