Spirituality in the treatment of substance use disorders: Proposing the Three-legged Stool as a model for intervention

Spirituality is a multidimensional construct that is considered to be a protective factor in the treatment of addictions. However, because there has been little agreement regarding the conceptualization of this complex construct, it has been difficult to operationalize spirituality in clinical settings so that its protective value can be maximized. This article presents a preliminary framework-the Three-legged Stool-to help therapists structure their spiritual interventions. The three "legs" of the spiritual "stool" consist of service (helping others), solitude (contemplative prayer and meditation) and creativity (creative arts and play therapy techniques). The authors begin by explaining the origin of the framework as it arose from their research and practice experiences. They conceptualize the different components of the framework and present support for the inclusion of each leg with a review of the theoretical and empirical literature. Because this framework has not been tested empirically, the addictions research and treatment communities are asked to explore its strengths, limitations, and usefulness and to engage in conversations about how to utilize and improve the framework.