Who benefits from Two Way Prayer Meditation? Treatment effect moderators in a pilot randomized controlled trial of a spiritual intervention for people with substance use disorders

Abstract

Background: Two Way Prayer Meditation (TWPM) is a spiritual intervention that holds promise for improving the psychospiritual well-being of individuals in recovery from substance use disorders (SUD). This study aimed to identify moderators of TWPM’s treatment effects. Moderators tested included gender, race/ethnicity, age, education, religious/spiritual affiliation, and most often used substance. 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 the TWPM group or the treatment as usual control group. Linear mixed modeling was used to assess the moderating effect of each hypothesized moderator in the form of interaction tests. Sensitivity analyses were conducted by excluding cases with more than a minimum number of missing items. Results: There were no significant moderators for psychological distress, self-esteem, and most of the spiritual well-being outcomes. Both the primary and sensitivity analyses showed education significantly moderated TWPM’s effect on overall spirituality self-ranking. Specifically, TWPM’s positive effect on overall spirituality self-ranking was greater in the master’s degree subgroup than in the less than high school subgroup. Conclusion: TWPM’s treatment effects on most outcomes were not found to vary by the tested participant characteristics. The only statistically significant finding suggests clinicians may need to adjust TWPM workshop/teaching content, delivery style, or language used to reach clients with lower levels of education. Future better-powered studies are recommended to continue exploring the potential moderating effects of race/ethnicity, education, spiritual/religious affiliation, and most often used substance.

Keywords:

• Prayer
• substance use disorders
• well-being
• RCT
• moderators

Authors’ contributions

AHH contributed to study design, literature review, data collection, analysis and interpretation of data, manuscript writing, and revising it critically for important intellectual content. BW contributed to study design and data collection. CF, CS, and KvS contributed to study design and revising the paper critically for important intellectual content. AHC and DMD contributed to revising the paper critically for important intellectual content.

Acknowledgements

The authors would like to thank the clients who participated in the study and the program staff who assisted in the study implementation.

Additional information

Funding

This study was supported by the award/fellowship awarded to Audrey Hang Hai by the Waggoner Center for Alcoholism and Addiction Research at The University of Texas at Austin (Bruce/Jones Graduate Fellowship) and the Hogg Foundation for Mental Health (Frances Fowler Wallace Fellowship Award). The content is solely the responsibility of the authors and does not necessarily represent the official views of these organizations. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.