Methods: This study employed a randomized controlled trial design with pretest and posttest. In total, 134 adults in four residential recovery programs participated in the study and were randomly assigned to either the TWPM condition or the treatment-as-usual control condition. Psychological distress and self-esteem were measured with the Outcome Questionnaire-30 and the Rosenberg's Self-Esteem Scale respectively. Spiritual well-being outcomes were measured with the Brief Multidimensional Measure of Religiousness/Spirituality and Christian Inventory of Spirituality. Intent-to-treat analyses were conducted using linear mixed models with participants nested within recovery programs. Sensitivity analyses were conducted by excluding cases with more than minimum number of missing items. Treatment effect sizes were estimated using Hedges’ g.
Results: Both primary and sensitivity analyses found significant treatment effects on daily spiritual experiences (condition x time, b= 4.50, standard error [SE]= .74, t= 6.05, p<.001, Hedges’s g= .62), reliance on God (b= 5.00, SE= 1.52, t= 3.29, p<.010, g= .49), private religious practice (b= 3.65, SE= 1.11, t= 3.29, p<.010, g= .36), and positive religious/spiritual coping (b= 1.77, SE= .35, t= 5.07, p<.001, g= .68).Treatment effects on psychological distress (g= .33), self-esteem (g= .41), and overall spirituality self-ranking (g= .32) reached significance in the primary analysis but not in the sensitivity analysis.
Conclusions and Implications: This study found evidence of TWPM’s efficacy in improving some aspects of the spiritual well-being of adults with substance use disorders. TWPM was also found to be promising in decreasing psychological distress and increasing self-esteem. Future research should replicate this study with a larger and more broadly representative sample. Longer follow-up periods and comparing TWPM to active control conditions such as other psychospiritual interventions would also be useful.