A One-Year longitudinal study on Surrender to God assessed during addiction treatment

• Treatment outcomes are examined using both explicit and implicit measures. • The study addresses patients experience of surrender to God (StG). • StG predicted lower relapse risk, even after controlling for meaning in life. • Abstinence was linked with explicit StG (short-term) and implicit StG (long-term) This study tested whether Surrender to God (StG), assessed explicitly (self-report) and implicitly (implicit association task), was a predictor of recovery characterized by reduced risk of relapse, reduced Substance Use Disorder (SUD) symptoms, and increased meaning in life. Longitudinal data ( N = 177) were collected during treatment at a Christian inpatient SUD treatment facility, with follow-ups at one, six, and twelve months after treatment discharge. We used generalized estimating equations (GEE) analyses with the binary outcome relapse to estimate predictive relationships of explicit and implicit StG after treatment. Additionally, linear mixed model analyses (LMM) were conducted concerning SUD symptoms and meaning in life, with either implicit or explicit StG scores as predictors. The analyses were controlled for baseline scores of SUD symptoms and meaning in life including Bonferroni-Holm correction. Implicit StG predicted decreased odds of relapse (Odds ratio = 0.371, p = 0.001) over the course of one year but not at the one-month follow-up assessment. The reversed pattern was found for explicit StG, which predicted lower chances of relapse up to one month after treatment (Odds ratio = 0.962, p = 0.011) but not at 6 or 12-months assessments. Neither implicit nor explicit StG predicted follow-up SUD symptoms or meaning in life. These results suggest that explicit StG may be useful in predicting short-term relapse, and implicit StG may be useful in predicting longer-term relapse. In the context of religion-based recovery, theory and clinical practice may benefit from including explicit and implicit measures concerning religion and spirituality, such as StG.