Songwriting to Target State Shame, Guilt, and Pride in Adults with Substance Use Disorder on a Detoxification Unit: A Cluster-Randomized Study

Background: Resultant of engaging in behaviors outside of their value systems to maintain addiction, many people with substance use disorder (SUD) feel shame and guilt. Although shame, guilt, and pride do not represent traditional dependent measures in SUD research, experimental studies targeting these constructs are warranted. Objective: The purpose of this study was to determine the effects of a single songwriting intervention on state shame, guilt, and pride with adults with SUD on a detoxification unit. Method: Participants (N = 118) were cluster-randomized to songwriting or control conditions. To avoid testing fatigue in this single-session study, experimental participants received a group-based blues songwriting protocol targeting state shame, guilt, and pride and then completed the questionnaire. Control participants completed the questionnaire before receiving an intervention. Results: While there was no significant between-group difference in state shame or guilt, there tended to be slightly lower mean scores in the experimental condition. There was a significant between-group difference in state pride (p =.012), with experimental participants having higher mean scores than control participants. Conclusion: Although only the state pride measure reached significance, shame, guilt, and pride represent consequential constructs for people with SUD. As addressing shame and guilt can be perceived as confrontational, group-based blues songwriting may represent a positive, engaging, and creative intervention to target these challenging but important topics. Implications for clinical practice, limitations, and suggestions for future research are provided.