Key findings
• There are 135 faith-based alcohol treatment service providers representing over 300 groups/projects/initiatives/courses in England and Wales. There is clustering of organisations in larger urban areas and small towns, with rural services tending to be dominated by residential rehabilitation programmes. 76% of organisations define themselves as ‘Christian – other’ (non-Catholic), with 52% of those being ‘Evangelical’. The majority of faith-based organisations rely on funding from ‘umbrella’ religious organisations, partner churches and charitable donations. Only a small minority of organisations are registered with regulatory bodies such as the National Drug Treatment Monitoring or Care Quality Commission.
• 34% of all faith-based alcohol treatment providers make religious participation mandatory for service users, a figure that rises to 52% when residential faith-based alcohol treatment providers are considered. Alongside these 66 residential alcohol treatment centres provided by faith-based organisations, there has been a notable growth in church-based franchises running twelve step recovery courses.
• Against a backdrop of the combined impact of austerity, long standing restructuring including marketisation of health services in England, and changes in UK government policy, faith-based alcohol treatment is ‘filling the gaps’ not covered by national charities, private sector companies, or statutory funding. Despite the stated desire for secular and faith-based alcohol treatment service providers to work together, there remains significant suspicion with regards to evidence-based policy and the transparency of theology and practice, which is exacerbated by the competitive nature of funding opportunities. More specifically, key stakeholders and some faith-based alcohol treatment providers expressed concern about moral and judgmental views on alcohol; lack of expert knowledge and experience; lack of registration with regulatory bodies; clarity over ethics, theology and practice; and lack of safeguarding and equality and diversity knowledges and training.
• Service user accounts of faith-based recovery are diverse, with significant positive and negative experiences. Singing, prayer, faith and spirituality featured heavily in service user positive accounts of recovery. ‘Faking it’ and ‘playing the game’ were also seen as a widespread and pragmatic engagement with group practices of prayer and worship. Our research suggests the need for a more effective assessment of the function and impact of both conscious and implied proselytisation that takes into account power dynamics within faith-based alcohol treatment.
• Service users often have sophisticated knowledge regarding pathways to treatment and provision and services in both secular and faith-based alcohol treatment and their voices should be foregrounded in reviews of practice and policy.