“When one in four children under 18 — across all economic, social, religious and cultural groups — lives in a family with alcohol abuse and alcoholism, and countless others suffer because of parental drug use, it is crucial that clergy and other pastoral ministers have a clear understanding of addiction’s effect on the physical, emotional and spiritual well-being of their parish families.” (Latcovich and Wenger(2003)

Addiction counselors and clergy operate on parallel tracks as they work to help their clients or congregants achieve a fuller life by helping them overcome addiction and stay in recovery. Yet many addiction counselors and clergy may not understand how a collaboration of both professions could prove valuable as they work together toward the same goal. This article describes the Clergy Training Project, a joint venture between the National Association for Children of Alcoholics (NACoA) and the Johnson Institute (JI), and the development of core competencies for clergy and other pastoral ministers. It also illustrates collaborative efforts between addiction treatment centers and faith institutions and outlines specific strategies counselors can take to engage with their local faith community.

Background

The power of spirituality has played an important role in healing for many people. For example, the most widely recognized 12-step program, Alcoholics Anonymous, which has at its core an inherent reliance on a “higher power,” has successfully supported many people recovering from alcoholism and other addictions. There is a growing recognition that spirituality is an important aspect of recovery.

Though there is a difference between spirituality and religion, for many people the spiritual aspect of recovery may take on a religious aspect. Research sponsored by National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Fetzer Institute is focusing on the role of spirituality and faith in recovery. Results from one research project found that increases in several aspects of spirituality — forgiveness of others, formal religious practices, and life purpose — were correlated with abstinence (Connors, 2004). In another study, outpatient clients rated their current behavior with their ideal on spirituality, connectedness to God and others, and religious and spiritual behaviors. Over the course of treatment, participants moved closer to their ideal state on these variables (Saunders, 2004), demonstrating the importance of spiritual life in the recovery process. Woodruff (2003) also cites studies that illustrate the transformational character of spiritual conversion with respect to recovery.

Alcoholism and drug addiction are family diseases that cut across all segments of society. Children who grow up in homes with alcoholism are at risk for physical, emotional, and sexual abuse, as well as traumatic experiences, and suffer a higher incidence of depression and alcoholism (Anda et al., 2002). Families, especially children, suffer from the corrosive effects of alcoholism and they need to hear messages of hope from outside the family (Latcovich and Wenger, 2003). This is where the faith community can play a critical role by providing referrals, intervention, and ongoing support.

When individuals impacted by alcohol and other drug problems have sought guidance from faith communities, clergy within these communities often have not had the necessary training to recognize and respond to these problems. A 2001 study conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that 94 percent of clergy consider substance abuse and addiction an important problem in their congregations, yet only 12.5 percent of clergy received any training on dealing with substance abuse.
Likewise, those in the addiction treatment community, other than those steeped in 12-step traditions, may not recognize the healing power of faith for some clients and may not feel comfortable using spirituality as part of the treatment and recovery process (CASA, 2001).

The 2001 CASA study, which reviewed 300 publications and analyzed three national data sets, also found that religion and spirituality may be an important factor in a person’s recovery. Based on the findings in its study, CASA recommended the expansion of seminary training on addictions and, also, called for more collaboration between the faith community and the addiction treatment community to benefit the recipients of care.

The Clergy Training Project and Core Competencies

The Clergy Training Project partnership was formed by NACoA and JI in 2001 to address the clergy’s need for education on addiction and its effects on children and families. The project’s goal is to develop and support practical strategies for clergy and other pastoral ministers to learn how to minister effectively to those affected by alcoholism and addiction in their families.
In November 2001, the Clergy Training Project convened its first expert panel to explore developing and implementing seminary training on alcohol and drug addiction and its effects on the family. The group recommended that a second expert panel be convened to develop the minimum core competencies (knowledge and skills) that clergy need to assist families, children, and individuals affected by alcohol and drug abuse.

This second panel, comprised of a broad-based group of faith leaders from many denominations, drafted a report, Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and Its Impact on Family Members, outlining the basic knowledge and skills clergy and other pastoral ministers need to be effective in providing care to families and individuals who are troubled by alcohol or drug problems. The report was published in a monograph by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA), which provided support for the meetings in collaboration with the Clergy Training Project.

The core competencies are presented as essential components for clergy and pastoral ministers in meeting the needs of persons with alcohol or other drug dependencies, and their family members.

1. Be aware of the generally accepted definition of alcohol and other drug dependence and the societal stigma attached to alcohol and other drug dependence.
2. Be knowledgeable about the signs of alcohol and other drug dependence; characteristics of withdrawal; effects on the individual and the family; and characteristics of the stages of recovery.
3. Be aware that possible indicators of the disease may include, among others: marital conflict, family violence (physical, emotional, and verbal), suicide, hospitalization, or encounters with the criminal justice system.
4. Understand that addiction erodes and blocks religious and spiritual development; and be able to effectively communicate the importance of spirituality and the practice of religion in recovery, using the scripture, traditions, and rituals of the faith community.
5. Be aware of the potential benefits of early intervention for the addicted person, family system, and affected children.
6. Be aware of appropriate pastoral interactions with the addicted person, family system, and affected children.
7. Be able to communicate and sustain an appropriate level of concern, and messages of hope and caring.
8. Be familiar with and utilize available community resources to ensure a continuum of care for the addicted person, family system, and affected children.
9. Have a general knowledge of and, where possible, exposure to the 12-step programs — AA, NA, Al-Anon, Nar-Anon, Alateen, ACOA, and other groups. Be able to acknowledge and address values, issues, and attitudes regarding alcohol and other drug use and dependence in oneself and one’s own family.
10. Be able to acknowledge and address values, issues, and attitudes regarding alcohol and other drug use and dependence in oneself and one’s own family.
11. Be able to shape, form, and educate a caring congregation that welcomes and supports persons and families affected by alcohol and other drug dependence.
12. Be aware of how prevention strategies can benefit the larger community.

There is a significant need for training to help congregational ministers obtain this knowledge and integrate the skills into the daily practice of their ministry. At the same time, there is a tremendous unmet need for addiction treatment in this country (SAMHSA, 2004). SAMHSA estimates that of persons aged 12 or older, 7.7 million need treatment for an illicit drug problem and 18.6 million need treatment for an alcohol problem. Of the 7.7 million persons who need treatment for an illicit drug problem, only 1.4 million individuals have received treatment at a specialty substance abuse facility. Of those not getting needed treatment, an estimated 362,000 reported they knew they needed treatment, yet approximately 88,000 had sought help but were unable to obtain the necessary care (SAMHSA, 2003).

Clearly, we need a system that expands opportunities for support and care for those affected by addiction.

Training the faith community

There are a number of ongoing efforts in place to train clergy and pastoral counselors to: recognize addiction in their clients and congregants; to enable them to establish effective treatment referral networks; and to provide appropriate support to both addicted individuals and their children and families. The Core Competencies have been used as the blueprint for the following training initiatives:

• In November 2004, the Clergy Training Project, with funding from
SAMHSA, sponsored a 2 1/2 day training for 80 representatives of regional centers of the American Association of Pastoral Counselors (AAPC). This intense training focused on core knowledge that pastoral counselors need to help individuals and families affected by alcoholism and other addictions. The 80 AAPC members trained will, in turn, train pastoral counselors and clergy in their own centers and communities.
• In January 2005, the Certification Committee of AAPC added recommendations that grew out of this training to the AAPC Body of Knowledge on addiction. The Body of Knowledge outlines essential learning for AAPC certification as a pastoral counselor.
• Curriculum modules for seminary and post-seminary education currently are being developed by NIAAA in collaboration with the Clergy Training Project.
• Seminary and pastoral counseling journals across many religious denominations are publishing articles that address the prevalence of addiction in our society, its painful consequences for family members, and its role in blocking an effective spiritual life. These journals also have explored the knowledge and skills needed to address addiction issues in individuals and families, and the establishment of appropriate systems of education and support within congregations and counseling centers.

The role of pastoral counselors

Pastoral counselors have a significant capacity to enhance the health and well-being of individuals, families, and communities. As a result of training initiatives like the November 2004 training described above, pastoral counselors — working with local faith communities, behavioral health providers, and organizations like the Johnson Institute and NACoA — will be able to provide the necessary knowledge and skills to religious leaders in the areas of screening, referral, pastoral care, and community education to help those affected by alcoholism and addiction to find care, treatment, and effective recovery support.

Models of collaboration

Neither faith nor addiction treatment communities exist in isolation. Throughout the United States, there are a number of highly successful collaborations between the faith community and the treatment community. These models of collaboration between addiction services, congregations, and faith-based organizations are exemplified by some efforts in the Pittsburgh metropolitan area.

These collaborations include agencies working together to improve services, enhancing the capabilities of religious congregations, and training clergy and laity about addiction and mental health, as illustrated in the following examples:

• The Institute for Research, Education, and Training in Addiction (IRETA) worked with the White House Office of National Drug Control Policy’s 25 Cities Initiative to develop a “Caring Congregations” program that emphasizes
prevention in the schools, local treatment resources, and safety in the neighborhoods. Clergy in three communities are learning about addiction, prevention and treatment, as well as brief screening and intervention skills, as they serve on an informal care management group for individuals returning from treatment or incarceration. This project will begin operation during the summer of 2005.
• Rev. Dr. Jay Geisler is an Episcopal priest who has worked in addiction treatment. He coaches young clergy in addiction, mental health, and 12-step spirituality and serves as the president of the Episcopal Clergy Association, an organization formed to help clergy understand the basics of mental health and addiction. Working with local treatment programs, he and Karen A. Plavan, Ph.D., a social worker specializing in addiction, convene an annual conference to teach clergy and laity about addiction and mental health.
• Bethany Baptist Church, another example of cooperation between the faith community and addiction treatment specialists, has developed a lay counseling ministry to address counseling and addiction issues in the community. Addiction specialists provided training in screening and referral skills to lay counselors. The combination of acquired skills and the trustworthiness of the congregation has helped the church become a gateway for community residents to access and enter treatment; a source of support for families; and an important post-treatment recovery resource.

Another example of a clergy training project is the Rush Center of Johnson Institute, located in Austin, Texas, which offers materials, training, and technical assistance to congregations of any faith tradition who want to start a Faith Partners congregational team ministry or service. The team promotes prevention of alcohol, tobacco, and other drug abuse, early intervention methods, and addiction recovery support. For more information on the Rush Center or Faith Partners teams, see the website at www.rushcenter.org. or call toll-free at 1-888-451-9527.

Things addiction counselors can do

There are many things that those in the addiction treatment community can do to begin a dialogue and initiate collaboration with those in the faith community.

• Visit your local pastoral counseling center. You can locate one of the 100 pastoral counseling centers or a local pastoral counselor by visiting AAPC’s website at www.aapc.org. Get to know what they do and provide them with printed materials or brochures so that they can refer clients to you.
• Invite local pastoral counselors and clergy to come to your center. Help them to understand the range of services you can provide and the other types of resources that exist in the community for individuals, families, and children.
• Offer to provide training to clergy and other pastoral ministers on how to recognize and refer congregants with possible addictive disorders. You also can work with the pastoral counseling centers using the Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members as the basis for training.
• Look into doing cross-training with pastoral counselors and clergy. Cooperative training will expand knowledge and networking for treatment providers and those in the faith community.
• Consider partnerships with pastoral counselors and clergy when applying for grants.
• Rely on pastoral counselors for guidance when dealing with the role of spirituality in treatment and recovery. This may be particularly useful when a client needs help with one of the specific steps in a 12-step program that refers to reliance on God or a higher power.
• If you or someone in your center is trained in intervention, offer intervention services to the pastoral counseling center or clergy.

Working together

Addiction is a pervasive public health problem that destroys individuals, families, and communities. Recovery is a long-term process that for many people has a significant spiritual component. By combining forces, clergy and other pastoral ministers, and treatment professionals, can help address one of the most critical problems facing our nation. As clergy become more adept at recognizing signs of alcoholism and drug addiction — how to refer congregants, and how to support families and children — more people will access and engage in treatment. And, as treatment professionals reach out to the faith community to encourage early intervention and recovery support, more people will be helped.

Connecting the addiction treatment and prevention community with the faith community offers additional resources for both parties. There are many collaborative efforts already underway and there are many steps counselors can take to engage clergy and pastoral ministers. The resources available through the Clergy Training Project and through local pastoral counseling centers can help bridge the divide between the treatment services and the faith community.

Stephanie Abbott, MA, is an adjunct professor at Marymount University in Virginia, and Publications Director for the National Association for Children of Alcoholics with more than 30 years experience in the field of addiction and family.

Rev. Douglas M. Ronsheim, DMin, is a Presbyterian minister, a licensed Marriage and Family Therapist (PA), and the Executive Director of the American Association of Pastoral Counselors.

Donna Xander, MA, has a graduate degree in counseling and did her granduate internship in an addiction treatment program. She has written on several topics regarding substance abuse prevention and treatment.

References

Anda, R.R., Whitfield, C.I., Feletti, V.J., Chapman, D., Edwards, V., Dube, S.R., & Williamson, D.F. (2002). Adverse Childhood Experience, Alcoholic Parents and Later Risk of Alcoholism and Depression. Psychiatric Services. 53(8) 1001-1009.

Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (2004). Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members. DHHS Pub. No. (SMA) 04-3900 Rockville, MD: SAMHSA http://alt.samhsa.gov/grants/competency/css/menu.htm.

Connors, G. AA Participation, Spirituality and Alcohol Outcome. Presentation at the Research to Practice: Development of an Alcohol Curriculum for the Faith Community. Rockville, MD, July 15, 2004.

Latcovich, M.A. & Wenger, S. (2003). A Case Study Approach to Teaching Chemical Dependency in Seminary Formation: An Application of the Core Competencies. Seminary Journal, 9 (3) 20-25.

National Center on Addiction and Substance Abuse at Columbia University (2001, November). So Help Me God: Substance Abuse, Religion and Spirtuality. New York, NY.

Saunders, S. Spirituality and Alcohol Treatment. Presentation at the Research to Practice: Development of an Alcohol Curriculum for the Faith Community. Rockville, MD. July 15, 2004.

Woodruff, C.R. (2003). Role of Clergy: The Effects of Alcohol and Drugs on the Person and the Family. Seminary Journal. 9 (3) 14-18.

This article is published in Counselor,The Magazine for Addiction Professionals, June 2005, v.6, n.3, pp.32-37

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