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Faith Communities: Studies, Articles, and Reports September 1997

Table of Contents

• Prevention
• Prevalence and Patterns
• Religiosity
• Treatment
• Other Publications

Prevention

Six hundred and thirty-five Northern black churches were surveyed regarding the offering of youth support programs. Of these, 176 reported having at least 1 program directed at adolescent nonmembers of the church, primarily from low-income homes. The most common programs consisted of Christian fellowships, ministry, counseling, group discussions, rap sessions, seminars, and workshops. Sports activities were second in frequency. The least common programs were AIDS and youth health-related services. It appears the greatest interest in youth programs are in churches that are Methodist, older middle-class, large in membership, owned or mortgaged, and with more paid clergy and staff. Characteristics of youth-oriented pastors are discussed. Generally, it was found that some of the most prominent issues facing black adolescents were not being adequately addressed by black churches. Suggestions for improving this situation are made, as well as citations of promising programs.

The author examines two prevention models identified in Harvesting New Generations: The Positive Development of Black Youth, by Useni Eugene Perkins. The deficit model represents a total denial of the existence or value of African-American culture and implies that African Americans are worthless. The bicultural model creates self-diffusion and confusion by expressing the broad diversities in racial and ethnic groups and suggesting they can all survive in an integrated society. The bicultural model is characterized by slave culture, assimilation, subculture inferiority, and European domination and integration, says the author. These models have been developed by scholars who have no knowledge or understanding of black behavior. Afrocentric models of prevention must be based on African philosophy, religion, psychology, culture, and the integration of these areas into the issue of African-American survival in the 1990's. An Afrocentric approach has been instituted by the West Dallas Community Center Rite of Passage project. Youth in the project are taught African rituals and chants, learn Swahili, and are introduced to African styles and dress. Definite changes in the youths' attitudes, morals, and perceptions of self have been noticed.

The purpose of this chapter is to explore the influence of religious involvement on drug use and the role of religious organizations in drug abuse prevention and treatment. Studies on religion and drug use are reviewed and discussed under the following topic headings: (1) religion and drug use; (2) theoretical explanations; (3) religious positions toward alcohol and drug abuse; (4) religion, mental health, and drug use; (5) religion and the prevention and treatment of drug abuse; and (6) prevention possibilities. A variety of prevention and treatment programs have been implemented by religious organizations. Some of the ways in which religious organizations could improve efforts toward alcohol and drug abuse prevention are by networking among religious organizations to help disseminate and evaluate drug prevention information.

Jews have long been recognized for their moderate drinking practices and for their low rates of alcohol problems. It is the purpose of this article to review the body of literature on Jewish drinking, extract the factors that appear to provide Jews with their "immunity," and discuss how these factors may be applied to prevention programs.

The author examines the following issues: what the clergy need to know about alcoholics and their families; the most common misconceptions about alcoholism; how to distinguish between social drinking and problem drinking; alcoholism as a moral weakness versus alcoholism as a disease; and Alcoholics Anonymous -- its effectiveness and how it works. The author also discusses the key issues facing pastors and church members, including: identifying alcoholism's progressive symptoms, counseling for alcoholics and family members, treatment programs, intervention, and aftercare. He also introduces the idea of a Support Team Ministry within the congregation, a church-connected network that raises awareness through education and that can help provide vital information on treatment programs. Tips are offered on how to begin such a group locally, staffed with volunteers.

This study surveyed the seven Roman Catholic dioceses of Florida to find out the level of awareness of alcoholism as a disease, and the need for treatment as indicated by the existence of programs for education, intervention, and treatment for this disease. Four of the seven dioceses have some strategy in place. Of the three that do not, two said they saw such a need, while the remaining one said consciousness of the need was gradually emerging. A review of the relevant literature is also presented.

Data from a questionnaire sent to 704 male university students and nonacademic staff were reanalyzed to compare self-reports of drug and alcohol intake patterns and problems, as well as family histories of psychiatric disorders for Jewish (n = 110, Group 1) and Christian men (n = 594, Group 2). Although the two groups did not differ significantly on the quantity and frequency of alcohol intake, men in Group 2 were more likely to report at least one episode of heavy drinking and alcohol-related problems, and their responses indicated a higher rate of a family history of alcoholism. There were no differences across the groups on the proportion of lifetime drug use and related difficulties, or on the family histories of other psychiatric disorders. The results are consistent with previous studies demonstrating a lower prevalence of heavy drinking and related problems among Jews.

This study is a secondary analysis of data gathered under the sponsorship of the Utah State Division of Alcoholism and Drugs in 1989. The researchers concluded that there is a difference in frequency of alcohol use, source of alcohol, and age of first alcohol use among Mormons (LDS), other religions, and non-religion subgroups. There is no significant difference found among the various religious subgroups for age of first marijuana use or of quantity of alcohol use. For all religions except Jews, a lower percentage of Utahns used alcohol than their national counterparts. A theoretical model for LDS drug use is presented.

This study examines cross-sectional associations between alcohol disorders and religious variables in a sample of North Carolina residents (n=2,969) ages 18-97 years who participated in wave II (1983-1984) of the National Institute of Mental Health Epidemiologic Catchment Area survey at Piedmont. The study was based on three hypotheses: (1) Those who frequently read the Bible or prayed, attended church, watched religious television, or claimed that religion was very important to them would have lower recent and lifetime rates of alcohol abuse and dependence than those who did not. Recent, but not lifetime alcohol disorders were less common among respondents who frequently read the Bible or prayed privately. However, alcohol disorders were common among those who frequently watched or listened to religious television and radio. (2) Those who reported having been "born again" would have a lower recent rates of alcohol abuse or dependence but higher lifetime rates. Recent and lifetime alcohol disorders were less common among weekly churchgoers and those who considered themselves "born again." (3) Affiliates of conservative or fundamentalist religious denominations would have lower recent and lifetime rates of alcohol abuse and dependence than members of other denominations. Lifetime, but not recent alcohol disorders were more prevalent among members of Pentecostal denominations. It is concluded that longitudinal studies are necessary to further clarify and explain these relationships between religious practices and alcohol disorders.

This survey was designed to identify the relationship between changes in adolescents' use of alcohol, which may have occurred concurrently with social changes, religious affiliation, religiosity, and gender. The authors also examined the relationship between adolescent alcohol use and family adaptability. The sample for the survey consisted of all of the ninth graders in a high school in Austin, TX. A 60-item questionnaire was a composite of several instruments that had been tested for reliability and validity. It included nine alcohol behavior items. Responses concerned with four of the nine kinds of alcohol behavior differed according to religious affiliation. These were frequency of drinking, volume, type of beverage, and frequency of heavy drinking (five or more drinks on one occasion). The following results are reported: (1) Students affiliated with religions other than Catholicism or Protestantism (Others) and those who belonged to no religious group (Nones) were more likely to drink two or more times a week than Catholics or Protestants. (2) Nones were more likely to consume three or more drinks on a single occasion than were Protestants, Catholics, or Others. (3) Nones and Others were more likely to drink hard liquor than were Catholics or Protestents, and to have had five or more drinks on one occasion in the past month.

A sample of 264 men and women participating in adult education programs in England completed a short scale of drinking behavior alongside indices of church attendance and denominational affiliation. The data demonstrate that drinking behavior is unrelated to frequency of church attendance, but significantly related to denominational identity. Members of the Free Churches were less likely to engage in drinking behavior than Anglicans, Roman Catholics, or individuals who claimed no denominational affiliation. These findings are discussed against the background of contemporary sociological theories regarding the compartmentalization of religious beliefs.

Drinking patterns of black college students were studied. The research sample included 160 students at a predominantly black university in the deep South. The students were administered a questionnaire derived from Ronald Akers' Boys Town Study. The following results of the study were seen: (1) Greater tendency to drink more and to experience alcohol-related problems in college for those who have their first drink at a lower age; (2) Attenuation of the negative relationship between age at first drink and college drinking patterns for those who start drinking in the presence of adults, or with the knowledge of their parents; (3) An important role for religious affiliation in constraining problem drinking during college years. It is concluded that family religious affiliation and parental guidance serve as social control variables providing access to normative standards within a particular sociocultural context. These variables become internalized by the time a student reaches college age and they become a part of a personal control system.

Variables that predict use of alcohol by children in fundamentalist Protestant Christian families were studied. The research sample included 302 male and female students enrolled in a mandatory health course at a fundamentalist Protestant Christian university. The students responded to a questionnaire designed to identify risk factors for alcohol use. The following results of the study were seen: (1) 28 percent of the students currently drank alcohol; (2) 18 percent of nondrinkers were drinkers before the age of 15; (3) 38 percent of nondrinkers were drinkers at one time after the age of 15; (4) 61 percent of current drinkers were male; and (5) students were more prone to be users of alcohol if they were male, had displayed aggressive and hyperactive behavior as a child, had a rebellious attitude in high school, had good friends who used alcohol, and believed that alcohol was not harmful. Prevention strategies based on these findings should be developed for use by Christian young people.

The relationship between religious affiliation and psychiatric disorder was examined among Protestant members of the baby-boom generation who resided in the Piedmont area of North Carolina. Data were obtained on 6-month and lifetime rates of major psychiatric disorders among 853 Protestant baby boomers during wave II of the National Institute of Mental Health's Epidemiologic Catchment Area survey, conducted in 1983-1984. Participants were grouped into three categories based on religious affiliation: mainline Protestants, conservative Protestants, and Pentecostals. Rates of disorder were compared across denominational groups, controlling for sex, race, physical health status, and socioeconomic status and stratifying by frequency of church attendance. The analyses were repeated for 1,826 middle-aged and older Protestants born between 1889 and 1944, and the results were compared with the findings for baby boomers. Among the baby boomers, Pentecostals had significantly higher 6-month and lifetime rates of depressive disorder, anxiety disorder, and any DSM-III disorder. Mainline Protestants had the lowest 6-month and lifetime rates of anxiety disorder and the lowest 6-month rates of any DSM-III disorder, whereas conservative Protestants had the lowest 6-month and lifetime rates of depressive disorder and the lowest lifetime rates of any DSM-III disorder. These relationships among baby boomers were weaker among middle-aged and older Protestants, although a new association with alcohol abuse or dependence emerged among older Pentecostals. It is concluded that Pentecostals in the Piedmont area experienced high rates of psychiatric disorder more than middle aged or older Pentecostals. Infrequent churchgoers appeared to be at greatest risk, although they seldom sought professional help for their problems.

Religiosity

Family and religious influences on adolescent substance abuse are discussed. The research sample included 322 adolescents and their parents/guardians who were interviewed by a trained interviewer. The subjects were selected to be representative of the entire spectrum of drug use, from abstainers to those who are addicted. The results of the study indicated that level of peer drug use is associated with substance abuse; that parental monitoring and family drug use have no direct effect on adolescent drug use; and that after parental monitoring and family drug use were controlled, family cohesion and religious importance are not associated with peer drug use, substance abuse, or current use of marijuana and cocaine. It is concluded that the results of the study support social learning theory in that associating with peers who use drugs is the major influence on adolescent substance use and abuse. Section headings in a preliminary review of the literature include: (1) peers and adolescent drug use; (2) parent-child bonds and adolescent drug use; (3) religion and adolescent drug use; (4) theory development; (5) social control theory; (6) social learning theory; and (7) theoretical model.

The existence of qualitative differences among various categories of substance users is investigated. Employing three subsamples of college students, the author examined the statistically significant paths in three models of substance use. Religiosity was negatively related to minor delinquency and alcohol use in all three models and negatively related to marijuana and other illicit drug use in the model containing polydrug users. Religious conservatism had no significant effect on minor delinquency, marijuana use, or other illicit drug use. This variable was negatively related to alcohol use, however. Social class displayed a weak positive association with attachment to school. An inverse relationship between attachment to school and minor delinquency was observed, but this was unrelated to substance use. Commitment to school was negatively related to minor delinquency and exhibited weak negative relationships with less serious substance use. No relationship between the school bonds and serious delinquency or other illicit drug use was observed.

The relationships between perceived parental religiosity, friends' alcohol consumption, and "hellfire" are discussed. Section headings in this review include: (1) hellfire and delinquency; (2) parents' religiosity and adolescent religiosity; (3) preliminary models; (4) the data; (5) measurement; (6) procedures; (7) models for males; and (8) models for females. It is concluded that there is little support for the theory that parental religiosity plays a role in the relationships between adolescent religiosity and drinking behavior. The findings support the hypothesis that religious parents influence children's behavior and choice of friends indirectly through the level of religious commitment the children express, although this influence declines over time relative to direct pressures from friends. Parameter estimates for social selection, socialization and final models linking perceived parents' religiosity, respondent's religious commitment, belief that drinking is a sin, friends' drinking and drinking behavior over years 1, 2, and 3, are presented in table form.

This study tested the predictive validity of Concern for Appropriate Scale (CAS) in the prediction of alcohol and marijuana use and whether it interacted with gender and/or religiosity in 143 college students. The CAS is a self-report inventory that contains 20 items. The findings indicate a support of the predictive validity of the CAS in terms of marijuana consumption, but not in terms of alcohol consumption. The CAS interacted with gender and religiosity in the prediction of alcohol use, and with religiosity only in the prediction of marijuana use. Overall, the study results validate the CAS as a direct predictor of marijuana use and as an indirect predictor of alcohol use.

Homogeneous effects cumulative logistic regression is used to examine the effects of personal religiosity on adolescent self-reported frequency of drug and alcohol use. Survey data from a sample of 3,065 male and female adolescents in grades 7 through 12 in 3 Midwestern States are employed. While the existence of an inverse religiosity-substance use relationship is well documented, questions still exist concerning the nature of these relationships. A review of the literature reveals three rival hypothesis concerning variation in the strength of these relationships across drug types: the Anti-Asceticism hypothesis, which predicts stronger relationships among the "softer" drug types; the Moral Condemnation hypothesis, which predicts stronger relationships among the "harder" drugs; and the Hellfire hypothesis, which predicts stable effects across drug types. These data provide strong support for the more general Hellfire hypothesis, with equivalent parameter estimates for the effects of religiosity observed for each drug type. However, slightly weaker effects are observed for adolescent use of alcohol.

This study examines the impact of religiosity on alcohol use by looking at the joint influence of religious stability and homogamy among Protestants. The main research question is whether one's alcohol consumption is affected by the spouse's faith under circumstances of religious stability or change. The data for this study came from the 13 General Social Surveys (GSS) conducted between 1972 and 1989. The analysis was limited to white, married, Protestants. The findings reveal that a spouse's religious beliefs have a significant impact on a person' s behavior in everyday life. The findings also point to the enduring effect of childhood religion on adult behavior. Reference group and socialization theories were used to specify the conditions under which people act on their beliefs.

Homogeneous effects logistic regression is used to examine the effects of personal religiosity and denomination on adolescent self-reported frequency of alcohol use by beverage type. Survey data from a sample of 3,065 male and female adolescents in grades 7-12 in 3 Midwestern States are employed. The findings are somewhat consistent with a hypothesis generated from the different cultural images of alcoholic beverages. For adolescents, the use of beer and liquor are largely restricted to recreational purposes, while wine has both functional and recreational uses. Because purely recreational use of psychotropic substances violates religious standards of asceticism, the effects of religiosity on the use of beer and liquor should be stronger than on the use of wine. The results show that the effects of personal religiosity are weakest for use of wine, but are relatively identical for beer and liquor.

This paper describes the emergence of wine culture in America. The flourishing of wine culture during the last few decades bears the distinctive traits of a genuine spiritual movement within American culture. It does not compete or in any way replace "theological religion" with its important articulation of doctrinal and moral guides to life. The wine revolution has given a bold new expression to the long-neglected aesthetic side of American cultural life. The gradual mingling of religious and secular forces shaping American's attitudes toward wine drinking has given rise to a wine culture that has enabled many modern Americans to appreciate the exhilaration that comes from an enhanced openness to natural sensations, and from sharing these inner experiences in a communal context.

References to philosophical and religious factors in the causation of alcoholism exist in literature which are of significance in understanding alcoholism in both its etiological and treatment aspects. This paper explores these factors, and leads to a consideration of the ways in which an alcoholic handles his existential anxiety. A tentative theoretical structure is presented which may prove useful in understanding the role of existential anxiety and its relationship to neurotic anxiety in the alcoholic.

This study reviews the experiences of 18 recovering Jewish alcoholics who have attended Alcoholics Anonymous (AA) meetings. All the subjects reported positive experiences with AA, in contrast with the widely held belief that AA is a Christian-oriented organization that might alienate Jewish alcoholics. While the author recognizes the limited value of such a small sample and the fact that most reports were not documented in professional journals, she contends that such experiences are valuable for rabbis or mental health professionals faced with individual Jewish alcoholics. In addition, the author points out that, although the AA experience was positive for all subjects, the individuals varied in the nature of their struggles, their preferences, their interpretations, and their resolution of challenges.

This article discusses the role that the clergy can play in education and referral for their congregations. The spiritual aspects of chemical dependency have frequently been dismissed by the lay public as unimportant or even non-existent. However, the clergy have also faced the natural reluctance of parishioners to reveal the existence of substance abuse within their families. Therefore, clergy have been overlooked as a resource in the battle against alcohol and drug abuse. Currently perceptions are changing both inside and outside the church, and religious and civic leaders have begun to recognize the value of working together to seek solutions to this problem. In a survey of 101 clergy, they found that the majority agreed to help in this area; however, they all requested more information to help them recognize substance abuse problems. The clergy stated that they see the results of substance abuse when ministering to broken families, troubled youth, and the homeless. The responses of this study provided the framework for the Interfaith Council's first clergy outreach program, a day-long conference titled: "The Clergy and Substance Abuse: Ministering to Your Congregation and Community." The program was tailored to meet the needs expressed by the clergy in the study.

The example of the role of the African-American church in resolving problems related to poverty and crime in the community is provided. The church, unlike social service agencies, community action, or a host of other anti-poverty strategies, occupies a unique place in African American culture. There are two elements peculiar to the church that give it the best chance to prevent violence, discourage out-of-wedlock births, encourage the healthy upbringing of children, and imbue a sense of work and responsibility that would help end poverty. First, the church's existing community networks give it an advantage that no government program could begin to match. And second, there is the church's inherent faith in the possibilities of conversion and transformation. Examples are provided.

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol-related disorders. A community survey of random samples of 200 each of Sikh, Hindu, and Muslim men, and 200 white English-born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/temple attenders drank regularly.

The author interviews Monsignor Ignatius McDermott, who has spent his life developing help for homeless or disadvantaged people with alcohol or drug problems. Monsignor McDermott first became aware of alcoholism as a family sickness in the Skid Row area of Chicago in the 1920's. At that time, there was incarceration but no rehabilitation. In the 1970's, he began working to establish non-medical detoxification facilities. Today, Haymarket House helps about 16,000 people annually. Monsignor McDermott founded the McDermott Foundation in 1986. One facility is for women who are in the last 3 months of pregnancy.

The author, a liberation theologian, reflects on how to find what is authentic in the African-American community in order to deal with violence, unemployment, and public housing. Political, economic, social, psychological, spiritual, and religious issues are all addressed. The real issue of violence is that everybody wants a place in the sun. Glyde Church has 32 programs, with a budget of over $5 million. Its Afrocentric recovery program deals with racism, death, and anger.

Clear, distinct lines are drawn between frequently confusing and overlapping concepts--such as the difference between religion, which is full of flawed humanity, and God, who is not. Information is provided to soothe the burning anger, to help straighten twisted thinking, and to revive broken hope. It is suggested that God is never lost to anyone, that there is always a way back to God, and that it is never too late either to find God or to deepen the relationship that has been there all along. It is further suggested that recovery is healing and that healing is human growth. Without the discipline and joy of meditation, however, an extremely important method to quicken, enhance, and deepen that growth is lost.

The classic symptoms of dysfunctional families are examined. Ways in which dysfunction permeates a family, breaks down communication, and leaves family members feeling isolated and anxious are illustrated. Dysfunctional families are characterized by three rules of denial: don't talk, don't trust, and don't feel. This denial often fuels the problem and keeps the cycle going. Ironically, children who grow up in dysfunctional families often repeat the patterns they learned as children, creating an unhealthy cycle. Ways in which Christians can help to heal themselves, breaking free from past problems and finding their inner child, are outlined. Recovery groups and church-sponsored programs are advocated for fostering recovery. Guidelines are presented for starting a support group for adult children of dysfunctional families.

The purpose of this study was to investigate the extent to which values, purpose, meaning, and religious involvement influence attitudes toward drinking and alcoholism within the Jewish community. Research prior to the 1970's indicated that Jews had a low incidence of alcoholism; however, current literature suggested that alcoholism is on the rise among Jews and that denial of the presence of alcoholism persists. Holmes (1979) suggested that persons with feelings of meaninglessness tended to drink excessively to fill the internal emptiness, which refers to Frankl' s (1963) concept of "existential vacuum." Samples of Orthodox, Conservative, Reform, and recovering alcoholic Jews completed Allport, Vernon, and Lindzey's Study of Values (A-V-L); Crumbaugh' s Purpose in Life Test (PIL); and the Haines Values and Religious Involvement Inventory (HVRII). The results indicated that a relationship existed between religious items on the A-V-L and religious items on the HVRII. The results further indicate that Orthodox, Conservative, and Reform groups (nonalcoholic sample) could be differentiated by aesthetic and social values, and that the nonalcoholic and recovering alcoholic samples could be differentiated by religious values. The results indicated that observance is related to participation for all groups combined. Results suggested that the nonalcoholic group had greater religious involvement than the recovering alcoholic group. Members of the nonalcoholic sample stated that they rarely experienced feelings of emptiness and turned to their religion to fill spiritual needs. Recovering alcoholic respondents reported more frequent incidences of emptiness and stated they turned to 12-step spirituality rather than religion to fill spiritual needs.

A Delphi investigation sponsored by the Task Force on Addictive Behavior of Jewish Family Service of Southern Middlesex County, NJ, was carried out to solicit expert opinion regarding numerous aspects of alcohol and drug use among Jews. These aspects included estimates of current and future severity of abuse, risk factors, attitudes, help seeking behavior, and protective mechanisms. The Delphi Method is a reiterative polling procedure to elicit expert opinion and work toward group consensus. A panel of experts was solicited from among clinicians working with primarily Jewish populations, published authors in the area of addictions and Judaism, and Jewish community leaders. A written Delphi questionnaire was completed by a final expert panel of 12 members, who were exposed to feedback from the panel during 3 successive iterations toward the goal of reaching consensus. Results indicated that the panel saw the addictive behavior of Jews as highly similar to that of Gentiles, including their severity of addiction, which conflicts with previous research. The Delphi panel also minimized the importance of protective mechanisms, such as maintaining moderate alcohol use through religious ritual, which have been commonly cited in the literature as making alcohol problems among Jews a rarity. An important exception to the panel's minimization of the uniqueness of the Jewish population was that Jews were seen as having significant attitudinal and emotional blocks to seeking treatment, particularly within the Jewish community, due to denial of the problem and judgmental treatment by other Jews.

This bibliography was derived from a larger project investigating the relationship between spirituality and recovery from addiction. Citations are provided in the following categories: references to general studies of addiction with the Jewish community; scholarly studies containing empirical studies and theoretical essays; sociocultural studies, comparing the followers of Judaism with other religious traditions and with other cultural groups; first person stories and case studies of Jewish addicts and alcoholics; references to Alcoholics Anonymous (AA), and Jewish Alcoholics, Chemically Dependent Persons and Significant Others (JACS), two organizations that help Jewish alcoholics and other drug addicts; the rabbi's impact on the congregation; alcoholism in Israel; minorities within the Jewish community, namely, women, youth, lesbians, gay men, and blacks; and how Jewish alcoholics are portrayed in literature.

It is contended there is nothing holy or helpful about denying that some Jews are alcoholics, addicts, and engage in compulsive behaviors. Both individuals and Jewish institutions must discourage the mix of alcohol with religion, no longer providing opportunities for compulsive behaviors of any kind. It is time to begin by reducing consumption, re-evaluating the drinking customs and rituals, and removing programs that furnish sanctioned opportunities for compulsive behaviors. Models of spiritual counseling can help move people through recovery back into a convenant with God through prayer, study, and holy experiences.

This paper defines the nature of the problems of substance abuse in the Jewish population and its treatment. This issue has gained attention in recent years as more and more cases present for treatment, prompting inquiry about the incidence. Problems unique to this population became obstacles to successful treatment. The authors present theories about the differences between Jews as a group and the general population. They ask why Jews have succeeded in remaining free of addiction problems, and review the literature in search of an answer. The paper considers traditional treatment approaches, patterns of resistance unique to the Jewish alcoholic, and addressing or overcoming treatment resistance.