Date of Conferral

2022

Degree

Ph.D.

School

Psychology

Advisor

Tracy Marsh

Abstract

The Minnesota model is ubiquitous in the United States for the treatment of substance use disorder (SUD). The model uses 12 steps and is centered on a belief in god(s) or a higher power; however, it is anathema to an atheist worldview. Researchers have noted that atheists do not readily become involved with 12-step programs and tend to drop out; however, there had been no qualitative investigations of the lived experiences of atheists in 12-step SUD treatment. The purpose of this study was to determine whether 12-step SUD treatment was problematic for atheists. An integrated theoretical framework was used. Minority stress theory was combined stigmatized identity theory, cognitive dissonance theory, and social identity theory. The interpretative phenomenological analysis method was applied to data collected from a purposive sample of 13 atheists from across the United States who had voluntarily attended 12-step SUD treatment within the prior 3 years. Themes that emerged from the data included that the participants were cognizant of having a stigmatized identity and experienced discrimination because of their atheism. The majority of the participants were “out” as atheists, but some concealed their lack of belief due to fear of ostracism. Another finding in the data was the perception that treating staff held a bias towards 12-step SUD programs and did not refer clients to alternatives. Most of the participants were unable to reconcile their lack of belief with the 12-step programs and dropped out soon after discharge. Some participants found secular mutual aid groups more consonant and, in turn, more helpful. Atheists with SUDs may benefit from the results of this study with better treatment outcomes that may arise from increased awareness and understanding of their needs. Positive social change may result from the lower SUD burden afforded by better treatment outcomes.

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