The Delivery of Services in Substance Abuse Treatment Programs: Comparing Faith-Based and Secular Providers

Although faith-based organizations (FBOs) have a long history of providing services to people with substance abuse problems, in recent years their role in addictions health services has been enhanced with the passage of the “Charitable Choice” provision of the 1966 Personal Responsibility and Work Opportunity Reconciliation Act as well as the establishment of the White House Office on Faith-Based and Community Initiatives. Despite this interest there has been a paucity of systematic data on FBO addiction health services. Most of the research has focused on the role religion and/or spirituality plays as a protective factor in preventing substance abuse or as a personal resource in the treatment and recovery process. In this paper we explore how FBOs differ from their secular counterparts in the types of services provided in substance abuse treatment programs. Recent national studies have shown a significant decline in the types and numbers of ancillary or social support services offered by treatment programs despite the fact that these services have been shown to be highly predictive of retention and completion of treatment. In this study we use data from the National Survey of Substance Abuse Treatment Services (N-SSATS), 2005. N-SSATS is a national survey of all treatment facilities contained in the Substance Abuse Mental Health Services Administration's (SAMHSA) Substance Abuse Treatment Facility Locator. Of the 14,747 eligible facilities 13, 367 or 90.6% participated in the study. The survey asked the administrators of these facilities to report whether or not they offered a listing of 32 specific services. The listing of services was subjected to a varimax rotated factor analysis. The results showed the existence of four distinct factors: (1) social support services (e.g., housing, employment, social and, case management services; (2) medical testing services (e.g., screening for Hepatitis B and C, HIV testing and, STD testing); (3) core treatment services (e.g., relapse prevention, individual therapy, group therapy, aftercare counseling); and, (4) pharmacotherapies (e.g., Antabuse, Naltrexone and, Campral). Each of these factors was then transformed into summative scales. The sample was then divided between those who self-identified as a FBO (n=889) and those who did not (n=12,477). Utilizing analysis of variance (ANOVA) and ordinary least squares regression analysis (OLS) differences between the FOBs and the non-FOB while controlling for factors such as setting, modality, size and client characteristics on the four service measures were examined. The findings showed that FBO were significantly more likely to provide a greater number of social support and medical testing services. No differences were found on the core treatment and pharmacotherapy measures. The implication of these findings for addictions health services research as well as the further development of service models in FBOs as well as their secular counterparts will be discussed.