Integrating spirituality into alcohol treatment

Spirituality is presumed by millions of Americans to be directly relevant to problems of alcohol abuse. We summarize findings regarding the role of religion and spirituality in the prevention and treatment of substance abuse and present a case illustration. We also consider mechanisms responsible for these effects. We offer advice about why, by whom, and how religion and spirituality should be discussed with clients with substance use disorders. In a recent clinical trial, therapists trained in a clientcentered approach to facilitate exploration of spirituality fostered clients use of spiritual practices. We suggest that the therapists ability to skillfully engage clients in a discussion of spirituality is largely determined by how the therapist balances the dual roles of authoritative expert and evocative facilitator. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:185–198, 2009.