The current study examined the relationships among attachment styles to parent, peer, and romantic partner, ability to regulate emotion, as well as engagement in sexual behaviors and substance use. Attachment theory and previous research suggests that an individual learns how to manage emotions through the modeling of appropriate techniques and a stable sense of self-worth. These two aspects develop through a secure attachment bond with an important figure. When an individual does not have a secure attachment bond in which to practice adaptive affect regulation strategies, he/she may attempt to manage emotions through external means, such as sexual behaviors or substance use. Overall, results supported these associations, with some notable exceptions. Across attachment sources a secure attachment style was related to lower levels of psychological distress and less engagement in substance use. In contrast to the findings from earlier studies, affect regulation did not mediate the relationship between attachment and substance use, and engagement in sexual behaviors was not significantly related to either attachment style or affect regulation.

No description available.

The purpose of this study is to examine more closely those program components which facilitate dissonance, disharmony, and ambiguity among the keygroups of a residential substance abuse treatment program.

Background: Given the increasing number of military deployments in modern forces and the high individual and social costs of substance use disorders, the risk of substance use (alcohol, nicotine, illegal drugs) and substance use disorders (abuse, dependence) associated with deployment and deployment-related stressful experiences is an important area of research. Main questions in this area are: Are deployment and deployment-related stressful experiences associated with problematic substance use patterns and substance use disorders? Are there high-risk groups for deploymentrelated increases in substance use and the occurrence of substance use disorders? Do other mental disorders such as posttraumatic stress disorder play a role for the risk of substance use disorders? This dissertation thesis aims to contribute to these questions. The thesis is based on a research program in German military personnel deployed to Afghanistan. The program includes a crosssectional and a prospective-longitudinal study component. In the cross-sectional component, a random, stratified sample of 1483 was assessed twelve months after return from deployment. As a control group, 889 never deployed soldiers were also assessed. In the prospective-longitudinal component, another sample of 358 male soldiers was assessed directly before and twelve months following deployment. Information about substance use and substance use disorders was obtained using a standardized diagnostic interview. Deployment-related stressful experiences and other relevant variables were assessed with additional scales and questionnaires. Based on this study program, the following research questions were addressed: (1) Do deployed and never deployed soldiers differ regarding the prevalence of problematic substance use patterns (alcohol, nicotine, illegal drugs) and substance use disorders (alcohol, nicotine)? (2) How are soldiers with deployment-related changes in alcohol use characterized? (3) Are posttraumatic stress disorder symptoms related to the risk for substance use disorders (alcohol, nicotine)? (4) Are soldiers with prior mood and anxiety disorders at higher risk for the onset of substance use disorders (alcohol, nicotine) following deployment-related stressful experiences? Main results: Regarding these research questions, the following main results were observed: (1) Deployed and never deployed do not differ considerably regarding the prevalence of substance use and substance use disorders. (2) There was evidence for both deployment-related increases and decreases in alcohol use in specific subgroups. Compared to soldiers with a stable consumption, soldiers with increased alcohol use were characterized by lower ranks, less acceptance, less social support, more sleeping problems after deployment and more deployment-related negative cognitions. Soldiers with deployment-related decreases in alcohol use were characterized by fewer posttraumatic stress disorders symptoms prior deployment and less childhood emotional neglect. (3) Posttraumatic stress disorder symptoms were related to the risk for substance use disorders. These associations were partially attributable to other comorbid mental disorders. However, several posttraumatic stress disorder symptoms were related to substance use disorders above the contribution of comorbidity. (4) Specific constellations of prior mood and anxiety disorders and high degrees of certain deploymentrelated stressful experiences predicted the onset of alcohol use disorders. Conclusions: Based on these findings it can be concluded that German soldiers deployed to Afghanistan do not have an overall elevated risk for substance use and substance use disorders. However, several subgroups with a deployment-related increase in substance use and substance use disorders could be identified for specific substances. These subgroups include soldiers with low ranks, low social support and other mental disorders, of which several posttraumatic stress disorder symptoms might be particularly relevant. In addition, soldiers who experience mood and anxiety disorders prior to deployment as well as high degrees of specific deployment-related stressful experiences might be at higher risk for the onset of alcohol use disorders. It is also noteworthy that some soldiers show a deployment-related decrease in alcohol consumption. These findings might contribute to an improved identification of high-risk groups and suggest targets for possible interventions and preventive efforts. Because of some limitations, mainly regarding crosssectional designs and limited statistical power, some observed associations have to be interpreted with caution. Further prospective studies in high-risk populations or larger samples are necessary to replicate and extend the suggested findings. Moreover, the generalizability of findings to non-military samples and other types of stressful experiences should be investigated. These investigations might help to further reduce the prevalence of excessive substance use and substance use disorders.:Content Zusammenfassung 10 Summary 13 0 Preface 15 1 General introduction 16 1.1 Substance use and substance use disorders 16 1.2 Stressful experiences 23 1.3 Stressful experiences and substance use in deployed military personnel 28 2 Aims 34 3 Methods 36 3.1 Design 36 3.2 Sampling 37 3.3 Study instruments 38 4 Substance use and substance use disorders in recently deployed and never deployed soldiers 40 4.1 Abstract 40 4.2 Introduction 41 4.3 Methods 43 4.4 Results 47 4.5 Discussion 52 5 Predictors of changes in daily alcohol consumption in the aftermath of military deployment 57 5.1 Abstract 57 5.2 Introduction 58 5.3 Methods 60 5.4 Results 64 5.5 Discussion 68 6 Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD 73 6.1 Abstract 73 6.2 Introduction 74 6.3 Methods 78 6.4 Results 80 6.5 Discussion 85 7 Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence: The role of prior internalizing disorders 89 7.1 Abstract 89 7.2 Introduction 90 7.3 Methods 92 7.4 Results 96 7.5 Discussion 103 7.6 Conclusions 105 8 General discussion 106 8.1 Summary of main findings 106 8.2 Discussion of main findings 109 8.3 Critical discussion of methodology 117 8.4 Practical implications 120 8.5 Directions for future research 122 9 Conclusion 125 10 References 126 11 Appendix 157 / Hintergrund: Das Risiko für den Konsum psychotroper Substanzen (Alkohol, Nikotin, illegale Drogen)und das Auftreten von Substanzstörungen (Missbrauch, Abhängigkeit) im Zusammenhang mit Belastungen in militärischen Einsätzen ist angesichts der Zunahme militärischer Einsätze sowie der hohen individuellen und sozialen Kosten von Substanzstörungen ein Forschungsthema von hoher Relevanz. Wichtige Fragen sind dabei: Stehen Auslandseinsätze generell im Zusammenhang mit problematischen Konsummustern und Substanzstörungen? Gibt es bestimmte Risikogruppen für Anstiege im Substanzkonsum und das Auftreten von Substanzstörungen? Welche Rolle spielen andere psychische Störungen, wie z.B. die posttraumatische Belastungsstörung (PTBS), für das Auftreten einer Substanzstörung? Diese Dissertationsschrift behandelt verschiedene Aspekte dieser Fragestellungen auf der Grundlage eines Forschungsprogramms zur psychischen Gesundheit bei in Afghanistan eingesetzten deutschen Soldaten. Das Programm umfasste eine querschnittliche und eine prospektiv-longitudinale Studie. In der Querschnittstudie wurde eine randomisierte, stratifizierte Stichprobe von 1483 Soldaten zwölf Monate nach Rückkehr aus einem Einsatz in Afghanistan untersucht. Als Kontrollgruppe wurden zudem 889 Soldaten untersucht, welche niemals im Einsatz waren. In der prospektiv-longitudinalen Studie wurde eine weitere Stichprobe von 358 männlichen Soldaten unmittelbar vor und zwölf Monate nach Einsatzrückkehr aus Afghanistan untersucht. Information zu Substanzkonsum und Substanzstörungen nach DSM-IV wurden mittels standardisierter diagnostischer Interviews erfasst. Einsatzbezogene belastende Ereignisse und andere relevante Variablen wurden mit zusätzlichen Skalen und Fragebögen erhoben. Auf Basis dieses Studienprogramms wurden unter anderem die folgenden Fragestellungen bearbeitet: (1) Unterscheiden sich Soldaten mit und ohne Auslandseinsatz hinsichtlich der Prävalenz von kritischen Konsummustern (Alkohol, Nikotin, illegale Drogen) und Substanzstörungen (Alkohol, Nikotin)? (2) Durch welche Merkmale sind Soldaten mit einsatzbezogenen Veränderungen im Alkoholkonsum gekennzeichnet? (3) Sind Symptome der PTBS mit dem Risiko für Substanzstörungen (Alkohol, Nikotin) assoziiert? (4) Haben Soldaten mit bereits vor dem Einsatz bestehenden Angst- und affektiven Störungen ein höheres Risiko für das Auftreten einer Substanzstörung (Alkohol, Nikotin) nach belastenden Einsatzereignissen? Hauptergebnisse: In Bezug auf diese Fragestellungen ergaben sich folgende Ergebnisse: (1) Soldaten mit und ohne Auslandseinsatz unterschieden sich kaum hinsichtlich der Prävalenz von Substanzkonsum und Substanzstörungen. (2) Allerdings ergaben sich Hinweise auf Zu-, wie auch Abnahmeeffekte im Alkoholkonsum in unterschiedlichen Subgruppen. Soldaten mit einem Anstieg im Alkoholkonsum waren im Vergleich zu Soldaten mit stabilem Konsum durch einen niedrigeren Dienstgrad, ein geringeres Ausmaß an Akzeptanz, weniger soziale Unterstützung, mehr Schlafprobleme nach Einsatzrückkehr sowie ein höheres Ausmaß an negativen einsatzbezogenen Bewertungen gekennzeichnet. Bei Soldaten mit einer einsatzbezogenen Reduktion im Alkoholkonsum fanden sich weniger PTBS-Symptome vor dem Einsatz sowie ein geringeres Ausmaß an emotionaler Vernachlässigung in der Kindheit. (3) Es gab Zusammenhänge zwischen PTBS-Symptomen und Substanzstörungen, die jedoch teilweise durch andere komorbide psychische Störungen erklärt werden konnten. Allerdings blieben einige PTBS-Symptome über andere komorbide Störungen hinaus mit Substanzstörungen assoziiert. (4) Bestimmte Konstellationen von bereits vor dem Einsatz bestehenden Angst- und affektiven Störungen sagten bei hohem Ausmaß an einigen einsatzbezogenen Belastungen das Auftreten einer Störung durch Alkoholkonsum vorher. Schlussfolgerungen: Auf Grundlage dieser Befunde lässt sich schlussfolgern, dass in Afghanistan eingesetzte Bundeswehrsoldaten kein generell erhöhtes Risiko für kritische Konsummuster und das Auftreten von Substanzstörungen aufweisen. Allerdings konnten Subgruppen identifiziert werden, die in Bezug auf bestimmte Substanzen ein erhöhtes Risiko für einen erheblichen Anstieg im Substanzkosum oder das Auftreten einer Substanzstörung haben. Dazu gehören unter anderem Soldaten mit niedrigen Dienstgrad, geringer sozialer Unterstützung und anderen psychischen Störungen, wobei bestimmte Symptome der posttraumatischen Belastungsstörung von besonderer Relevanz sein könnten. Zudem scheint das Risiko für Störungen durch Alkoholkonsum bei Soldaten erhöht, bei denen bereits vor dem Einsatz Angst- und affektive Störungen auftraten und die gleichzeitig ein hohes Ausmaß an bestimmten Einsatzbelastungen erleben. Bemerkenswert ist aber auch, dass einige Soldaten nach dem Einsatz eine erhebliche Reduktion des Alkoholkonsums aufweisen. Die Befunde könnten zu einer verbesserten Identifikation von Risikogruppen beitragen und Ansatzpunkte für mögliche Interventionen und präventive Maßnahmen liefern. Aufgrund einiger Limitationen, die vor allem querschnittliche Designs und eine eingeschränkte statistische Power betreffen, sollten einige der beobachteten Zusammenhänge vorsichtig interpretiert werden. Weitere prospektive Untersuchungen an größeren Stichproben sowie Hochrisikokohorten sind nötig, um die Befunde zu replizieren und zu erweitern. Weiter sollte die Übertragbarkeit der Befunde auf nichtmilitärische Stichproben unter Einbezug anderer Arten von belastenden Ereignissen untersucht werden. Diese Untersuchungen könnten langfristig zur Senkung von problematischen Substanzkonsum und Substanzstörungen beitragen.:Content Zusammenfassung 10 Summary 13 0 Preface 15 1 General introduction 16 1.1 Substance use and substance use disorders 16 1.2 Stressful experiences 23 1.3 Stressful experiences and substance use in deployed military personnel 28 2 Aims 34 3 Methods 36 3.1 Design 36 3.2 Sampling 37 3.3 Study instruments 38 4 Substance use and substance use disorders in recently deployed and never deployed soldiers 40 4.1 Abstract 40 4.2 Introduction 41 4.3 Methods 43 4.4 Results 47 4.5 Discussion 52 5 Predictors of changes in daily alcohol consumption in the aftermath of military deployment 57 5.1 Abstract 57 5.2 Introduction 58 5.3 Methods 60 5.4 Results 64 5.5 Discussion 68 6 Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD 73 6.1 Abstract 73 6.2 Introduction 74 6.3 Methods 78 6.4 Results 80 6.5 Discussion 85 7 Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence: The role of prior internalizing disorders 89 7.1 Abstract 89 7.2 Introduction 90 7.3 Methods 92 7.4 Results 96 7.5 Discussion 103 7.6 Conclusions 105 8 General discussion 106 8.1 Summary of main findings 106 8.2 Discussion of main findings 109 8.3 Critical discussion of methodology 117 8.4 Practical implications 120 8.5 Directions for future research 122 9 Conclusion 125 10 References 126 11 Appendix 157

Bakgrund: Antalet dödsfall relaterat till narkotikarelaterat substansbruk ökar. Personer med narkotikarelaterat substansbrukssyndrom utgör en marginaliserad och stigmatiserad grupp i samhället. Dessa personer löper förhöjd risk för ohälsa, inte minst till följd av deras substansbruk. Stigmatisering inom hälso- och sjukvården är särskilt allvarligt, då det drabbar människor i ett särdeles sårbart tillstånd. Mot bakgrund av detta föreligger ett behov av att sammanställa tidigare forskning som studerat erfarenheter hos personer med narkotikarelaterat substansbrukssyndrom av att vårdas på sjukhus.   Syfte: Syftet var att undersöka de erfarenheter personer med narkotikarelaterat substansbrukssyndrom har av att vårdas på sjukhus. Metod: En icke-systematisk litteraturöversikt med integrerad dataanalys genomfördes baserat på 16 vetenskapliga originalartiklar. Litteratursökningarna utfördes i databaserna PubMed och CINAHL utifrån MeSH-termer och CINAHL Subject Headings, samt ytterligare relevanta sökord. Samtliga artiklar som inkluderades i studien har genomgått en kvalitetsgranskning enligt Sophiahemmet Högskolas bedömningsmall.   Resultat: Tre huvudkategorier identifierades, vilka var Erfarenheter av ojämlik vård, Erfarenheter av bemötande och Erfarenheter av utebliven vård. Resultatet visade att personer med narkotikarelaterat substansbrukssyndrom hade erfarit bristande bemötande av vårdpersonal till följd av stigmatisering och diskriminering, vilket ledde till konsekvenser som fördröjd eller nekad vård. Det framkom att vårdpersonal saknade kunskap om substansbrukssyndrom och hur substansbruksrelaterade tillstånd behandlas. Vidare visade resultatet att substansbruk utgjorde ett hinder för att erhålla adekvat smärtlindring, då vårdpersonalen antog att denna patientgrupp enbart sökte vård för att få tillgång till narkotikaklassade substanser. Personer med substansbrukssyndrom avbröt inte sällan sin sjukhusvistelse mot medicinsk inrådan, främst till följd av abstinensbesvär och inadekvat smärtlindring. Slutsats: Denna litteraturöversikt kan bidra till att hos vårdpersonal medvetandegöra patientgruppens erfarenheter och användas till grund för vidareutbildning inom området. Då flera stigmatiserade grupper kan tänkas uppleva liknande bemötande när de söker vård, kan föreliggande litteraturöversikt också användas för att förstå de erfarenheter stigmatiserade grupper generellt kan antas ha av att söka vård. / Background: The number of deaths related to narcotics related substance use is increasing. People with narcotics related substance use syndrome constitute a marginalized and stigmatized group in society. These people run an increased risk of ill health, especially as a result of their substance use. Stigmatization in health care is particularly serious, as it affects people in a particularly vulnerable state. In light of this, there is a need to compile previous research that has studied experiences of people with narcotics related substance use disorder being cared for in hospital settings.   Aim: The aim of this study was to examine experiences of people with narcotics related substance use disorder who have received hospital care.   Method: A non-systematic literature review with integrated data analysis was conducted based on 16 original scientific articles. The literature searches were carried out in the databases PubMed and CINAHL based on MeSH terms and CINAHL Subject Headings as well as additional relevant keywords. All articles that were included in the study have undergone a quality review according to Sophiahemmet University's assessment template.  Results: Three main categories were identified, as follows: Experiences of unequal care, Experiences of encounters and Experiences of missed care. The results showed that people with narcotics related substance use disorder had experienced a lack of treatment by healthcare professionals as a result of stigmatization and discrimination, which led to consequences such as delayed or denied care. It emerged that healthcare staff lacked knowledge about substance use disorder and how substance use related conditions are treated. Furthermore, the results showed that substance use constituted an obstacle to obtaining adequate pain relief as the healthcare staff assumed that this patient group only sought care to gain access to narcotic-classified substances. People with substance use syndrome often terminated their hospital stay against medical advice, mainly as a result of withdrawal symptoms and inadequate pain relief.  Conclusions: This literature review can contribute to raising awareness of the patient group's experiences among health care professionals and be used as a basis for further education in the field. As several stigmatized groups can conceivably experience similar treatment when they seek care, the present literature review can also be used to understand the experiences stigmatized groups can generally be assumed to have from seeking care.

No description available.

The aim of this thesis is to explore how men in recovery from substance use conceptualize challenges and use their inherent strengths to navigate them. Estimates of substance use prevalence rates in Canada suggest that approximately one-in-five Canadians will meet the diagnostic criteria for substance use disorder throughout their lifetime (Pearson, Janz & Ali, 2013). These prevalence estimates represent a significant cause for concern as addiction is a significant phenomenon in contemporary Canadian society. A scoping literature review was conducted on nineteen research studies to investigate the state of current research. Although there is a wealth of studies on addiction, research frequently utilizes pathologizing approaches. These approaches are commonly focused on addiction in the context of a social or individual issue ripe with problematizing discourses. Six qualitative semi-structured interviews were conducted on men living in recovery-based supportive housing for this research to explore their experiences from the onset of substance use into substance use and recovery efforts. A strength-based perspective was adopted for analysis purposes in order to more accurately reflect on the inherent strengths of the participants. The men provided in-depth accounts of their experiences, conceptualized challenges to their recovery and contrary to many contemporary research discourses, demonstrated an affluence of strengths while articulating challenge navigation. The men were also proactive in their ability to anticipate future challenges and conceive methods of effective challenge navigation. Findings of this study are analyzed and discussed in the context of recognizing the magnitude of the challenges facing the men in recovery and the incredible strengths that they demonstrate in challenge navigation. The implications for current social work practice are outlined and several suggestions are tabled with the goal of improving current practice methods. Finally, suggestions for future strength-based addiction research are offered with the intention of seeking overall improvements to the research field and addressing existing gaps within the literature. / Thesis / Master of Social Work (MSW)

The study aims to uncover social workers understandings of substance use (SU) among people with intellectual disabilities (ID) and ways in which social work with this group should be carried out.  Previous research has asserted that people with ID use drugs to a lesser extent, and therefore experience less drug related issues in general compared to the general popuation. However, people with ID experience more severe consequences from SU than others. Evidence for specific methods for working with this group is scarce.  The theoretical framework for this thesis is first based in the social model of disability. This enables the use of Goffmans symbolic interactionism with an emphesis on his theories of social roles. The last piece to the theoretical framework is cooperation theory which assists in analysing the themes of issues in cooperation that professionals express.  The thesis is carried out through semi-structured interviews with 6 interviewees, chosen through a combination of strategic- and snowball selection methods. The results are analysed thematically. Three main themes emerge from the empirical data: social factors, matters of cooperation between professionals and their organizations and communication styles between professionals and people with ID.  The main findings of the thesis is first: that Swedish research on the topic is practically non-exictent. Second: that effective methods are developed by professionals such as writing and drawing to enhance communication and that this knowledge is not transferred and expanded upon. Third: that professionals view SU among people with ID as caused by a need for social inclusion which they get from SU. / Undersökningen syftar till att ådagalägga socialarbetares förståelse av drogbruk bland personer med intellektuellt funktionshinder (IF) och hur socialt arbete med denna målgrupp bör utföras.  Tidigare forskning har visat att personer med IF använder droger i lägre grad, och därför erfar mindre drogrelaterade problem än befolkningen i övrigt. Personer med IF erfar dock allvarligare konsekvenser av sitt drogbruk än andra. Forskningsunderlaget för behandlingsmetoder är tunnsått.  Uppsatsens teoretiska utgångspunkter börjar i det sociala funktionshinderbegreppet som möjliggör användandet av Goffmans symboliska interaktionism med fokus på hans teori om sociala roller och masker. Slutligen används samverkansteori för att analysera samverkansrelaterade problem som framkommer i socialarbetares utsagor.  Undersökningen utförs som semistrukturerade intervjuer med 6 intervjupersoner som valts i kombinerad strategisk urvalsprocess och snöbollsurval. Empirin analyseras sedan tematiskt.  Tre huvudsakliga teman framkommer i empirin: sociala faktorer, samverkan mellan organisationer och professionella och kommunikation mellan professionella och personer med IF. Uppsatsen kommer fram till tre slutsatser. 1: Att svesnk forskning på ämnet saknas. 2: Att effektiva metoder för att arbeta med målgruppen så som att ritprata utvecklas i verksamheter men att denna kunskap inte förs vidare i organisationer över tid eller mellan organisationer och att denna kunskap behöver tas till vara och vidareutvecklas till arbetsmetoder. 3: Att socialarbetare ser drogbruk bland personer med IF som en konsekevens av ett behov av social tillhörighet.

Doctor of Philosophy / School of Family Studies and Human Services / Jared Anderson / This meta-analysis used data from 285 studies (yielding 983 effect sizes and a combined sample size of 627,726) to quantitatively evaluate the link between substance use and physical intimate partner violence (IPV) perpetration and victimization. Results indicated that overall substance use, alcohol use, and drug use were significantly related to both IPV perpetration and victimization, with mean effect sizes ranging from r =.18 to .23. Moderator analyses also compared males and females for overall substance use, alcohol use, and drug use; subcategories of alcohol use and drug use; and different types of drugs, for males and females, and for IPV perpetration and for victimization. This is the first meta-analysis to compare alcohol versus drug use for IPV perpetration and IPV victimization. The analyses revealed drug use to be a significantly stronger risk marker for victimization, and a non-significantly stronger risk marker for perpetration, compared to alcohol use. Alcohol consequence measures (i.e., abuse and dependence) were significantly stronger risk markers than consumption measures for IPV victimization, but non-significantly different for IPV perpetration. Furthermore, more frequent alcohol use (few times a week, almost daily, and daily) was a significantly stronger risk marker for perpetration compared to other alcohol frequency measures. Drug consequence measures (abuse/dependence) were significantly stronger risk markers for perpetration than simply drug use measures. There were no significant differences between different drug types, and no significant difference between stimulants versus non-stimulants for IPV perpetration and victimization (though these smaller comparisons may have been underpowered, and thus unable to detect differences). The findings of this study are important because they provide the most comprehensive and detailed analysis of the link between substance use and IPV to date.

Thesis (MA)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The aim of this study was to explore the dynamics between spiritual fitness and women in recovery from substance-problems. The phenomenological method of enquiry, and within this context, the qualitative approach, was followed. Interviews with five women, four of whom received treatment at Stepping Stones Addiction Centre, constituted the empirical data on which this research was based. These interviews revealed remarkable experiences in the lives of these women. The findings of the research indicate that women in recovery with substanceproblems benefit tremendously from interaction with the dimension of spirituality. Spirituality was understood in terms of the experience of intervention or support by a power greater than themselves – an experience which gave meaning to the lives of these women, which is manifested in their way of being and way of acting. This includes a new sense of responsibility and self-respect which empower them to become co-creators of their lives, and to contribute compassionately to the well-being of others. The continuous and disciplined application of “spiritual tools”, practices and guidelines constitute a growing dynamics of spiritual fitness which forms part of a holistic approach to treatment and recovery. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die dinamiek tussen spirituele fiksheid en vroue met substansie-probleme in die herstelproses, te verken. Die fenomenologiese metode van ondersoek, en binne hierdie konteks die kwalitatiewe benadering, is gebruik. Onderhoude met vyf vroue, van wie vier behandeling ontvang het by Stepping Stones Addiction Centre, het die empiriese data waarop hierdie navorsing gebaseer is, gekonstitueer. Hierdie onderhoude het merkwaardige ondervindings in die lewens van die vroue blootgelê. Die bevindings van die navorsing toon dat vroue met substansie- probleme in die herstelproses geweldig by die interaksie met die spirituele dimensie gebaat het. Spiritualiteit is verstaan in terme van die belewenis van intervensie of ondersteuning deur ‘n mag groter as hulself – ‘n ervaring wat betekenis gegee het aan die lewens van hierdie vroue, wat gemanifesteer het in hul wyse van bestaan en wyse van handel. Dit sluit ‘n nuwe begrip van verantwoordelikheid en selfrespek in, wat hul bemagtig om mede-skeppers van hul lewens te word, en op ‘n deernisvolle en empatiese wyse tot die welsyn van ander by te dra. Die voortgaande en gedissiplineerde toepassing van spirituele toerusting, gebruike en riglyne lei tot ‘n toenemende dinamiek van spirituele fiksheid wat deel vorm van ‘n holistiese benadering tot behandeling en die herstelproses.