ABSTRACT INCORPORATING CLIENTS' UNDERLYING RELIGIOUS AND SPIRITUAL BELIEFS IN THERAPY MAY IMPROVE SUBSTANCE ABUSE TREATMENT PRACTICES, ESPECIALLY FOR PERSONS OF COLOR Author: Marguerite E. Hendrickson Dissertation Chair: Ram Cnaan, Ph.D. Although pharmacological breakthroughs have improved treatment outcomes for alcohol and opioid dependence through decreased cravings and blocked reward effects, there are no FDA approved medications for the treatment of cocaine dependence. In addition, many routinely practiced psychotherapy models for addiction remain limited in their effects. As composite case studies will reveal, cravings and urges to use cocaine prevent clients from obtaining and sustaining abstinence. Multiple case studies will examine how clients use their underlying religious and spiritual beliefs to cope with cravings and urges. The first paper in this dissertation investigates how clients’ religious problem-solving styles can both positively and negatively affect the recovery process when viewed through the lens of a scientifically validated instrument, Religious Problem-Solving Scale. The second paper examines how addressing religious/spiritual issues in therapy may strengthen the therapeutic alliance with African Americans in outpatient treatment for cocaine dependence. Given the research evidence that African Americans and Hispanics actively engage their religious/spiritual beliefs during recovery, this multi- paper dissertation suggests that clinicians adapt evidence-based therapies by incorporating religious/spiritual content to meet the needs of the growing population of color in the United States.