A 1-year longitudinal study showed that adoption of the religious coping strategy “surrender to God” was associated with nearly three times lower odds of substance use relapse in Christian patients over a 1-year period, when use of this strategy was measured using an implicit association task. However, when adoption of this coping strategy was explicitly measured, the likelihood of relapse was only slightly reduced after 1 month, but not at 6 and 12 month assessments. The paper is addictive behavior report.
Surrender to God is a religious coping strategy in substance use disorder recovery in which people give up their desires and actions in order to follow what they believe to be God’s will. It may support recovery by helping people shift their attention away from substance-related reinforcers and toward future-oriented, transcendent sources of meaning and support. This process has been described as humble detachment. This means letting go of attachment to craving while prioritizing awareness of God’s active and loving presence.
In this way, surrendering to God can reduce worry, negative repetitive thoughts, tolerance for uncertainty, negative emotions, and cravings. Previous research has linked surrender to God with less substance use and cravings, less anxiety and depression, greater meaning in life, and a stronger sense of being supported by God. However, long-term evidence is still limited, and there is no fully developed comprehensive theory showing that surrender to God causally promotes recovery.
There are two common approaches to measuring the adoption of this coping strategy: explicit and implicit. Apparently, surrender to God is measured by a self-report questionnaire that indicates the extent to which participants consciously endorse surrendering their problems, choices, and recovery to God.
This can be measured with an implicit association task that assesses how strongly and automatically a person subconsciously associates the concept of “surrender to God” with themselves. This implicit measure may be useful because substance use may involve automated and difficult-to-control processes that are not fully captured by self-report.
Study author Henk-Jan Seesink and colleagues hypothesized that “surrender to God” measured during substance use disorder treatment would be associated with a lower likelihood of relapse, lower levels of substance use disorder symptoms, and greater meaning in life at follow-up. They conducted a longitudinal study that followed patients receiving treatment for substance use disorders for up to one year after treatment.
The study authors initially approached 462 patients with substance use disorders at a government-certified Christian addiction and mental health clinic in Dordrecht, the Netherlands. At this clinic, a multidisciplinary team of addiction experts provides cognitive behavioral therapy-based treatment for addictions and, when appropriate, schema therapy-based treatment for personality disorders. Patients were also free to participate in non-government-funded voluntary religious activities, such as prayer meetings, and could choose whether to connect their faith and spirituality to their treatment goals.
After excluding early dropouts and non-Christian patients, the final number of participants in the study was 177. However, only 101 (57%) of these participants provided data after 12 months. Christian patients were selected for the primary analysis of this study primarily because surrender to God was expected to be a valid predictor of outcome in these populations.
49% of participants received treatment for alcohol use disorder, 25% received treatment for cocaine, 11% received treatment for cannabis, and the remaining participants received treatment for other types of substances. The average age of participants was 40 years. Approximately 75% of them were men.
Surrender to God was measured both explicitly (using the Dutch Surrender to God Scale) and implicitly (the Implicit Association Test for Surrender) at the beginning of the study. Study authors tracked relapse (return to drug use) and assessed participants’ substance use disorder symptoms (using the Leeds Addiction Questionnaire) and meaning in life (Multidimensional Existential Meaning Scale).
The results showed that although the implicit measure of “surrender to God” predicted a significant reduction in the odds of relapse over a one-year period (the odds dropped by almost a third), this was not the case at a one-month follow-up assessment. In contrast, an explicit measure of “surrender to God” predicted a modest decrease in the likelihood of relapse up to 1 month after treatment, but not at 6 or 12 month assessments. Surrender to God was not associated with reduced daily substance use disorder symptoms or increased meaning in life.
“These results suggest that explicit StG (surrender to God) may be useful in predicting short-term relapse, while implicit StG may be useful in predicting long-term relapse,” the study authors concluded.
This study contributes to the scientific understanding of coping strategies that may help prevent relapse in substance use disorders. However, the design of this study does not allow us to infer causality from the results. Furthermore, the attrition rate in this study was very high, meaning that a large proportion of participants dropped out or could not be contacted by the end of the study. This nonresponse may have influenced the survey results.
The paper, “One-Year Longitudinal Study of Surrender to God Assessed During Addiction Treatment,” was authored by Henk-Jan Seesink, Sis Freimors, Brian D. Ostafin, Haneke Sharp-Jonker, and Rheinout W. Veers.
