CSARS: Chester Studies of Addiction, Recovery and Spirituality Group
The Higher Power Project
The Chester Study of Addiction, Recovery & Spirituality (CSARS) Group is based at the University of Chester and aims to:
- To undertake qualitative research with people in recovery from addiction, with a focus on spirituality, broadly defined.
- To develop projects in the community to ensure this research, and other evidence-based research work, can be utilized by the professions involved in the treatment of addiction and by people suffering with substance use problems themselves.
- To disseminate the outcomes and findings of its activities through publications, presentations, conferences and training.
Over the past five years CSARS Group has been engaged in the following activities:
The Higher Power Project is a research project in addiction, recovery and spirituality funded by a grant from the Sir Halley Stewart Trust to explore the experiences and stories of people in recovery from addictions.
The Higher Power Project recorded and mapped the range of understandings of ‘Higher Power’ or ‘power greater than ourselves’ used by people in recovery from addiction to alcohol and/or drugs. Those in recovery through Twelve Step Programmes, or treatment centres which use the Twelve Steps, are likely to have some concept of Higher Power.
The comprehensive Higher Power Project questionnaire was completed by 107 respondents in 12-Step recovery (AA, NA, Al Anon, OA, CA, GA, ACoA, Co-DA, SAA) and 50 of them participated in detailed follow-up interviews. Their length of abstinent-time ranged between 6 months and 48.6 years, 58 identified as male and 49 female.
Descriptions of Higher Power were diverse. 90% considered Higher Power as “essential” to their recovery, while a further 9% thought it was “quite important”. 22% of participants identified as religious, whilst 78% identified as spiritual (including 5 atheists).
The findings of the project will help to inform a more accurate understanding of what is sometimes described as the spirituality of Twelve Step and other recovery programmes. Our analysed data is of value to treatment providers, the medical profession, social workers and anyone interested in ways in which people with Substance Use Disorders in sustained recovery mitigate the risk of resuming use. The CSARS group was established as a vehicle to ensure the research outputs of the Higher Power Project reached the relevant populations.
- Dossett, W. (2020) ‘Spiritus contra spiritum’: Spirituality, belief and discipline in Alcoholics Anonymous. in Schmidt, B and Leonardi, J. Spirituality and Wellbeing: Interdisciplinary Approaches to the Study of Religious Experience and Health. Sheffield, Equinox.
- Dossett, W. (2019) Kleśas and Pretas: Therapy and Liberation in Buddhist Recovery from Addiction. Implicit Religion: Religion, Spirituality and Addiction Recovery, 22(2), 215–242. http://dx.doi.org/10.1558/imre.40694
- Dossett, W., & Metcalf-White, L. (2019). Religion, Spirituality and Addiction Recovery: Introduction. Implicit Religion: Religion, Spirituality and Addiction Recovery, 22(2), 95–100. http://dx.doi.org/10.1558/imre.40695
- Cook, C. C. H., & Dossett, W. (2018). Addiction and Forgiveness. In S. Hance (Ed.), Forgiveness in Practice. London: Jessica Kingsley Publishers.
- Dossett, W., (2018) Twelve Step Mutual Aid: Spirituality, Vulnerability and Recovery. in Beckford, J., Harvey, S. & Steidinger, S. (Eds.). New Religious Movements and Counselling: Academic, Professional and Personal Perspectives. Routledge Inform Series on Minority Religions and Spiritual Movements New York; London: Routledge.
- Dossett, W., (2017). ‘A daily reprieve contingent on the maintenance of our spiritual condition.’ A commentary on Kelly, J. F. (2016). Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research: How AA works. Addiction. https://doi.org/10.1111/add.13731
- Dossett, W., (2015). ‘Reflections on the language of salvation in twelve step recovery’ in Bacon, H., Dossett, W., & Knowles, S. Alternative Salvations: Engaging the sacred and secular. London: Bloomsbury
- Cook, C. C. H., & Dossett, W., Religion and Addiction. Special Issue. Religions. MDPI Open Access http://www.mdpi.com/journal/religions/special_issues/religion-addiction
- Dossett, W., (2013). Addiction, Spirituality and the Twelve Steps. International Social Work. May, Vol. 56, No.2. (article selected by Psychology Progress, (http://psychologyprogress.com/), as a ‘Key Research Article’, September 2013: ‘selected from a wide variety of peer-reviewed journals and … judged to be of major importance in their respective fields’.)
- BBC Radio 4 2nd Sept 2018: Package on Spiritual Anonymity and Recovery Walks
- Cork 96FM Opinion Line. Guest speaker on programme “AA: Why does it Work?” 20th October 2017
- Religious Studies Project. 23rd Jan 2017: Religion, Spirituality and Addiction
- BBC Radio 4 30th Oct 2016: Package on Church of the Ragamuffins
- Things Unseen: 20th Mar 2015 Addiction and Faith – the Twelve Step programmes
- Religious Studies Project. 12th Nov 2014: Narrative and Reflexivity in the Study of Religion – roundtable.
- Beyond Belief. BBC Radio Four. 8th Mar 2013: Religion and Addiction
- William Temple Foundation: 7th Oct 2015 Is Spiritual Anonymity Depriving Us of Addiction Recovery Role Models?
- TRS Chester: 2nd May 2014: Reflections: The Morning After (on the death of Peaches Geldof)
Selected invited keynotes/conference papers
- ‘Non-religion & spirituality in Wales: some perspectives from the Addiction Recovery Movement and beyond’ Lampeter Interfaith Conference: Spirituality: Multifaith and Interfaith Perspectives. 17-19 July 2018
- ‘Spirituality: A floating signifier in recovery experiences.’ NDSAG New Directions in the Study of Alcohol Group Annual Conference University of Sheffield, June 7th 2018.
- Celebration of Women’s Research: University of Chester: Faculty of Arts and Humanities ‘Power and powerlessness: Women in AA.’ March 7th 2018
- Invited presentation on the Higher Power Project to the Welsh Assembly Government at the Senedd. Nov 14th 2017
- Faces and Voices of Recovery Annual Conference: ‘Narratives of recovery from North Wales.’ 8th Sept 2017.
- Sir Alister Hardy Lampeter Lecture. July 16th 2017. ‘Spiritus contra spiritum’: Spirituality and recovery from alcohol use disorder.’Excessive Appetites Conference, St Mary’s University, 21 April 2017 ‘Creativity, autonomy and the self-narrative in Alcoholics Anonymous.’
- Chester Theological Society. Feb 7th 2017. ‘‘In return for a bottle and a hangover we have been given the Keys of the Kingdom’: Reflections on the Language of Salvation in Twelve Step Recovery.’
- University of Edinburgh School of Divinity Departmental Seminar 9th Nov 2016 ‘Twelve-step addiction recovery: troubling the redemptive metanarrative.’
- BASR (British Association for the Study of Religions) 5-7 Sept 2016 ‘Alcoholics Anonymous: On the limits of ‘Spiritual But Not Religious’. University of Wolverhampton
- CSARS 4th Annual Conference 2nd -3rd Nov 2015 ‘On the contribution of Theology and Religious Studies to an Understanding of Addiction and Recovery.’ (jointly with Prof Christopher C H Cook)
- NGG Conference (29th-30th Oct 2015) ‘‘Spiritus contra spiritum’: reflections on the implications of the correspondence of C.G. Jung and Bill W for an understanding of spiritual awakening in alcohol use disorder recovery.’ Radboud University, Nijmegen.
- Faces and Voices of Recovery Annual Conference (11th Sept 2015). ‘Recovery Spirituality: On the Diversity of Higher Power language.’ Durham Cathedral.
- UK Recovery Federation Conference at Manchester Metropolitan University (1st Sept 2015) – jointly with Dr Stephanie Sinclair ‘Recovery Spirituality Workshop.’
- Cathedrals Group Symposium (2nd-3rd July 2015) ‘On the correspondence of C.G. Jung with Bill W: Wellbeing and spiritual awakening in alcohol use disorder recovery.’ Liverpool Hope University.
- Chester Literature Festival (21 Oct 2014) ’‘May the Force be with you’: Using Popular Culture in Addiction Recovery.’ Town Hall, Chester
- The Living Room Annual Lecture: Welsh Government, Cardiff. (24 June 2014)‘….but I don’t do religion!’ A study of contemporary spirituality in twelve step recovery. ‘
- UK Recovery Federation Conference at the Athena Conference Centre in Leicester, Opening Keynote. (26 Sept 2014). ‘Creating Narratives for the Recovery Movement: the Good, the True and the Beautiful.’
- Recovery from Addiction: Bridging the Gap between Policy and Practice Conference (April 29-30 2014) University of Chester. ‘How Religious are Alcoholics Anonymous and Narcotics Anonymous?’
- Project for Spirituality, Theology and Health Seminar, University of Durham, 20 Feb 2014 ‘Beyond Cult or Cure: The negotiated language of ‘higher power’ in contemporary twelve-step programmes.’
- INFORM 25th Anniversary Conference: ‘Minority religions: Contemplating the Past and Anticipating the Future’ (31 Jan – 2 Feb 2014): ‘Secularisation and the past, present and future of Alcoholics Anonymous.’
- Contemporary religion in historical perspective: engaging outside Academia. The Open University, (15-16 May 2013) ‘I don’t do God’ : The potential contribution of Religious Studies to addictions recovery .’
- London Buddhist Vihara. Women’s Day Celebrations Dec 16th 2012 invited public lecture entitled ‘Women, Addiction and Recovery: Some stories of hope and lovingkindness.’
- Emerging challenges in addiction psychiatry; Alcohol: harm, interventions and policy; The research base for Policy; Recovery. Society for the Study of Addictions Annual Symposium (York, 8th & 9th November 2012): ‘A consideration of the language of Higher Power as “post-modern negotiated spirituality.”
- Religion and (In)Equalities. British Sociological Association’s Sociology of Religion Study Group (University of Chester, 28th-30th March 2012): ‘A consideration of the language of “Higher Power” in recovery’
Community Recovery Projects
Mutual Aid Facilitation
In recent years Government policy on substance misuse in the UK has focused increasingly on recovery and has emphasised the need for service providers to ensure that they and their clients engage with Mutual Aid groups. Mutual Aid is typically available in communities through by Twelve-Step Fellowships or SMART Recovery. Twelve-Step Facilitation (TSF) has been shown to impact positively on the probability of long-term recovery (Humphreys and Moos, 2001: Humphreys et al, 2004: Laudet, 2010: Kelly & White, 2012, Kelly, 2017) and the intervention is used widely in the US in various forms.
CSARS Group is committed to applying its research findings and experience to provide Mutual Aid Facilitation recovery projects for the benefit of individuals, families and communities in the UK. To date, fourteen community recovery projects have been delivered in and these projects have been supported by Welsh Government (North Wales Area Planning Board) and Shropshire Council and North Wales Recovery Community (Penrhyn House) in partnership with local agencies and with the cooperation of Alcoholics Anonymous, Narcotics Anonymous and SMART Recovery.
The projects provide a framework, support and knowledge to volunteer participants wanting to try to achieve abstinence-based recovery through 13 weekly group sessions by providing:
- An understanding of Substance Use Disorder and its associated problems.
- A safe group environment for participants in early recovery whilst they establish themselves in local recovery communities. Group sessions include:
- Changing thinking and behaviour
- Accepting the need for help and understanding what mutual aid offers
- Living in the day (or the present)
- Living abstinent – tips and techniques
- The relapse process and guidance on prevention
- Managing emotions and living with others
- Developing individual recovery plans
- Support while recovery is established through engagement with mutual-aid groups and other local recovery groups and initiatives.
- Accompanied attendance at AA/NA/SMART Recovery meetings.
Outcomes from 14 Recovery Projects*
Summary Recruitment & Retention Data
|Participants Engaged||Assessed||Accepted||Attended Sessions (%)||Regular Attenders (>50% attendance)||Sporadic attenders (25-49% attendance)||Participant Retention (Regular + Sporadic)(%)|
|380||273||262||262 (66%)||104 (40%)||61 (23%)||165 (63%)|
* Bangor (3), Colwyn Bay, Rhyl (2), Shotton (2), Wrexham (3), Llandudno, Shrewsbury, Oswestry,
Recruitment to recovery projects has required significant effort because of disappointing referral rates from many local service providers. Overall 35% of potential participants were engaged through word of mouth or local networking.
There were 262 participants across all projects who attended group sessions, which represented 69% of the total number of people referred or otherwise engaged with. Of these, 104 (40%) attended the weekly sessions regularly and 61 (23%) sporadically. All attendees developed personal recovery plans and the majority regularly attended local Mutual Aid meetings and/or other recovery groups and activities of their choice. The outcomes from individual projects varied but there was no statistically significant pattern.
Feedback from participants is very positive and indicates the importance of the recovery capital, culture, hubs and activities available in Bangor, Shrewsbury and Wrexham as foundations for their sustainable recoveries (see below).
Recovery Outcomes Data for Members of the Penrhyn Recovery Community
Obtaining long-term outcomes data for participants with Substance Use Disorder (SUD) is difficult and resource-intensive because of the fluid nature of the population. In collaboration with staff and participants at Penrhyn House in Bangor, supported by questionnaires and interviews, we have gathered data on relapse frequency and severity, and personal and lifestyle changes for 75 participants for the period 2015-2018.
At Penrhyn House, participant attendance at Mutual Aid recovery groups shows a striking correlation with a reduction in the frequency and severity of relapse, and an increase in the extent of positive personal and lifestyle change. Feedback from the questionnaires and interviews shows that there is a widespread understanding that participation in recovery groups is an invaluable component of achieving sustainable recovery, and that there is strong support for the continuation these groups. In view of the positive outcomes from this study, NWRC will continue to offer as many MA recovery groups as possible to participants at Penrhyn House.
Feedback from participants on the pilot MAF recovery project in Wrexham (WRAPP):
- WRAPP is a great support group that also gives you a foot into AA and after-support, which I feel I lacked the last time I attempted to stay sober.
- I love the talking, sharing and debating in the group, it helps you to understand your own feelings.
- IT’S NOT JUST YOU!
- WRAPP is good and I have seen a difference in myself. Going to AA as part of WRAPP is good.
- I have been sober for a while now and being in group has done me good – I think it would help other people too.
- It gave me a massive head-start. I got things quickly in the rooms once I found them. I probably wouldn’t have found the rooms by myself anyway
- I realise that I can have a happy, honest and good life without alcohol.
- Two choices exist (for me):
- A life of carnage, no family, no business, no friends, no future
- A fulfilling life with people I love and the possibility of a good future
- AA and other support will help me keep sober
The projects have encouraged local links to Mutual Aid and other recovery groups and also helped to build Community Recovery Capital. The project helped to stimulate the formation of new Mutual Aid groups in some communities and also two “legacy” Recovery Group meetings supported by ex-participants from the CSARS Mutual Aid Facilitation programmes continue to meet in Bangor and Wrexham.
The reluctance of some professionals to refer their clients to mutual aid facilitation based recovery projects has been indicated (Day et al; 2005, 2015) and unfortunately this has been the experience of CSARS Group. Despite holding numerous training events and meetings with local teams and individuals (since 2013) to explain the potential benefits for their clients, professional reluctance has continued to be an issue in some areas. It has hindered recruitment to several of the projects.
In view of the positive outcomes from the Penrhyn House study, Penrhyn House will continue to offer as many Mutual Aid recovery groups as possible to participants and we suggest that other treatment providers review the extent to which they refer, encourage and facilitate their clients to attend Mutual Aid groups
Feedback from Substance Misuse professionals attending mutual aid meetings
Our experience is that some substance misuse professionals benefit from training sessions in which preconceived ideas and concerns about Mutual Aid can be addressed. We also offer to arrange for staff to be accompanied to attend local mutual aid meetings and, although take-up was low, feedback from those attending was very positive, for example:
- It gave me a huge insight into people’s experiences and the difficulties alcoholics have to overcome everyday which we would take for granted. I will try and persuade people who I come across that there is hope and spread the word of AA and the other fellowships out there. I was impressed by the support you all give each other and “got it” If you know what I mean!
- I found it hugely uplifting and the experience was one of warmth, acceptance and support that is unrivalled by anything that I have been involved with before.
- The people were so open, honest and accepting of everybody. From a commissioning perspective it made me realise that we need to think carefully about how and by whom services are best delivered. It also made me think about how we get more people to engage with groups like this.
The Higher Power Project and CSARS Group have hosted four sector-leading conferences at the University of Chester, each drawing audiences of more than 100 delegates, including professionals, academics, service-users and fellowship members. The conferences are considered significant by the University for their value in terms of impact beyond as well as within academia. The first conference was held prior to the beginning of the SHST project funding.
- March 14th 2012: ‘Addiction: A spiritual illness with a spiritual solution?.’
- February 20th and 21st 2013: Two day conference: “Recovery from addiction: Faith-based and spiritual solutions.”
- Day 1 – “Faith-based solutions to addiction”
Evening Public Lecture – Mark Gilman and Prof Keith Humphreys “Recovery from addiction: Transatlantic interperspectives.”
- Day 2 – Practitioners’ workshop – “Twelve step programmes and spirituality.”
- Day 1 – “Faith-based solutions to addiction”
- April 29th & 30th 2014: Two Day Conference: “Recovery from Addiction: Bridging the Gap between Policy and Practice”.
- Day 1 – “Recovery Policy and Practice Options”
Evening Public Lecture – Prof David Best “Recovery – “What do we know and where might we go?”
- Day 2- : Workshop – “Facilitating Recovery Policy Delivery”
- Day 1 – “Recovery Policy and Practice Options”
- 2nd &3rd November 2015: CSARS Group 4th Annual Recovery from Addiction Conference.
Day 1- ‘Religion, Addiction and Recovery’
Evening Public Lecture – Prof John F. Kelly – “Scientific & Social Aspects of Recovery – the role of Mutual Aid and Community Initiatives.”
Day 2 – “Understanding and Responding to the Characteristics and Challenges of Recovery”
- September 9th 2016: Faces and Voices of Recovery UK annual conference 2016, Widnes: “Addiction, Recovery and Families.”
(In partnership with CSARS Group, University of Chester and Halton Borough Council)
The CSARS Group Team
- Dr Wendy Dossett: Director (Projects)
- Prof John Stoner: Director (Research)
- Liam Metcalf-White: Projects Officer & Research Assistant
- Tim Roberts: Research Assistant
We are extremely grateful to the many individuals, organisations and institutions that have supported our work in many different ways. We now have a database of more than 500 email contacts interested in following our work. We have 200 followers on Facebook and more than 2000 followers on Twitter.
We would also like to thank the organisations below for their financial support:
Sir Halley Stewart Trust (SHST), Alcohol Research UK (ARUK), Centre for Research into Environment & Health (CREH), Society for the Study of Addiction (SSA), Shropshire Council, University of Chester (UoC), Welsh Government