Clients' Perceptions of Marriage and Family Therapists Addressing the Religious and Spiritual Aspects of Clients' Lives

Abstract

As marriage and family therapists are emphasizing the actual contexts of clients' lives, religion and spirituality are being addressed as important aspects of culture. This pilot study investigated whether clients felt their therapist adequately addressed the religious and spiritual aspects of their lives according to their desires for such. Thirty-eight clients who attended therapy at university clinics were surveyed using a questionnaire about their own religiosity and spirituality, about their preferences to have religion and spirituality addressed, and whether they perceived their therapist addressed religion and spirituality in the therapy process according to their desires. Results show these family therapists did rather well at addressing the religious and spiritual aspects of their clients' lives. Demographic correlations showed that the gender of the client and whether the university clinic they attended was affiliated with a religious denomination were each positively correlated to whether the clients wanted religion and spirituality addressed and whether their therapist adequately addressed these issues. Detailed limitations are noted.     

Religion and Spirituality as a Resource in Marital and Family Therapy

ABSTRACT

Today's therapists are faced with a myriad of challenges in their quest to provide the best and most appropriate care for each of their clients. In our training, for the most part, religion and spirituality are left out of the equation. Knowing that many individuals are searching for some type of meaning in their lives and that religion and spirituality are important issues to a large number of people, it follows that to become a truly effective therapist one needs to become more knowledgeable and comfortable in dealing with religious and spiritual issues. This article explores various aspects of religion and spirituality as a part of marital and family therapy including definitions, attitudes and beliefs, ethical issues, culture, and training.     

Recognizing and Raising Spiritual and Religious Issues in Therapy

Abstract

Religious and spiritual experiences and practices comprise some of the most important aspects of many people's lives. Yet, for various reasons, mental health practitioners have been hesitant to bring these issues into overt discussions in therapy. This article proposes a four-part framework to assist therapists in addressing religion and spirituality in therapy. The four areas include spiritual issues raised by either the client or therapist, and religious issues raised by either the client or therapist. Guidelines for therapeutic conversation and clinical examples are offered for each of the four areas.     

Fundamentalism and the Search for Divinity: The Varied Role of Religion in Interfaith Couples

Religion has long been considered a crucial variable in marriage and family therapy research. Until recently, however, research on religious differences has not been specifically applied to clinical practice with interfaith couples. The importance of the rise in Fundamentalist values and their effects on interfaith couples has received far less attention. The purpose of this article is to describe how religious differences may be understood and experienced in a contemporary interfaith marriage. The ideas presented here aim to provide a glimpse into contemporary interfaith couples and a platform from which to explore broader themes of longing, surrender, and religious faith as they manifest in the couple dyad. Family clinicians are advised to carefully explore how religion operates in the lives of couples referred for treatment in relation to notions of romantic love, social support, and what is held sacred in the marriage. Clinical implications are provided for working with interfaith couples.     

A valuable burden? The impact of children with profound intellectual and multiple disabilities on family life

Background: This study analysed parents’ positive and negative appraisals of the impact of raising children with profound intellectual and multiple disabilities (PIMD) on family life.

Method: Mothers (n?=?52) and fathers (n?=?27) of 56 children with PIMD completed a questionnaire focused on their positive and negative appraisals of the impact of childhood disability on family life. Scale means (ranging from 10 to 40) were calculated, as was the relationship between the two subscales.

Results: Mothers and fathers indicated that their children affect family life both positively (M?=?31.4 and 32.8, respectively) and negatively (M?=?31.3 and 28.5, respectively). Only fathers showed a positive significant relationship between the positive and negative subscales.

Conclusions: Parents’ positive and negative appraisals co-occur. Although parents positively appraise the impact on family life, their substantial negative appraisals demand tailored support for families raising children with PIMD with a strong focus on practical support.     

Older adults' preferences for religion/spirituality in treatment for anxiety and depression

Objectives: To examine patient preferences for incorporating religion and/or spirituality into therapy for anxiety or depression and examine the relations between patient preferences and religious and spiritual coping styles, beliefs and behaviors.

Method: Participants (66 adults, 55 years or older, from earlier studies of cognitive-behavioral therapy for late-life anxiety and/or depression in primary care) completed these measures by telephone or in-person: Geriatric Anxiety Inventory, Client Attitudes Toward Spirituality in Therapy, Patient Interview, Brief Religious Coping, Religious Problem Solving Scale, Santa Clara Strength of Religious Faith, and Brief Multidimensional Measure of Religiousness and Spirituality. Spearman's rank-order correlations and ordinal logistic regression examined religious/spiritual variables as predictors of preferences for inclusion of religion or spirituality into counseling.

Results: Most participants (77–83%) preferred including religion and/or spirituality in therapy for anxiety and depression. Participants who thought it was important to include religion or spirituality in therapy reported more positive religious-based coping, greater strength of religious faith, and greater collaborative and less self-directed problem-solving styles than participants who did not think it was important.

Conclusion: For individuals like most participants in this study (Christians), incorporating spirituality/religion into counseling for anxiety and depression was desirable.     

Recognising the “forgotten man”: Fathers’ experiences in caring for a young child with autism spectrum disorder

ABSTRACT

Background Despite decades of research on family adaptation in relation to caring for a child with an autism spectrum disorder (ASD), the wellbeing of fathers remains poorly understood.

Method The present study sought to investigate experiences of fathers of young children with ASD aged between 2½ and 6 years attending an ASD-specific early intervention centre. Eighteen fathers initially completed a mailed questionnaire and 8 of these fathers were then interviewed by telephone. The questionnaire included standardised measures assessing constructs of the double ABCX model of family adaptation. The interview used open-ended questions to understand the experiences of fathers’ involvement in caring, sources of support, and coping strategies.

Results Fathers experienced elevated levels of parental stress and elevated depressive symptoms. Interviews deepened understanding of fathers’ personal experiences of each component of the double ABCX model.

Conclusions Findings from this study provide further insight into the fathering role and demonstrate the utility of the double ABCX model as a framework for exploring their experiences. The need for further research to explore practical implications to better support fathers is discussed.     

Suffering and the Relationship with the Problem in Postmodern Therapies: A Buddhist Re-Visioning

ABSTRACT

This article explores ways that Buddhist psychology can enrich postmodern family therapy practice. The discussion focuses in particular on Buddhist ideas regarding suffering and the relationship with suffering. We propose that Buddhist practices of accommodation to suffering offer an alternative orientation to problems that in various ways can be incorporated into postmodern therapeutic practice—specifically solution-focused brief therapy, narrative therapy, and collaborative language systems. The article compares and contrasts Buddhist and postmodern therapy ideas about relating to problems before providing examples of postmodern practice informed by Buddhist psychology.     

Religious orientation, aging, and blood pressure reactivity to interpersonal and cognitive stressors

Background: Research on religion and health suggests general health benefits for those who are more religiously involved. Particular aspects of religiosity that may influence this finding, however, have not been sufficiently investigated.Purpose: This study was designed to explore the relationship between religious orientation (intrinsic, extrinsic) and blood pressure reactivity among older (over 60 years) and younger (18–24 years) adults exposed to two qualitatively different laboratory stressors (cognitive, interpersonal).Methods:Participants were categorized as exhibiting either a predominately intrinsic or extrinsic religious orientation based on scores on the Religious Orientation Scale. They were subsequently exposed (in counterbalanced order) to two laboratory stressors that varied in terms of whether an interpersonal confrontation was involved. Measures of blood pressure were obtained at baseline and during stressor presentation.Results: Analyses indicated that older extrinsically religious individuals demonstrated exaggerated reactivity compared to younger participants and older intrinsically religious individuals. Older intrinsically religious participants did not differ from younger persons. Similar results were found for analysis of baseline data. Extrinsic participants had greater reactivity during the interpersonal confrontation condition than did intrinsic individuals.Conclusions: These findings suggest that religious orientation may be an important variable to study regarding cardiovascular reactivity in, particularly, older adults. This research was supported in part by National Institute on Aging Grant 1 R03 AG 18554-01. A previous version of this article was presented in August 2002 as a Citation Paper at the 110th Annual Convention of the American Psychological Association, Chicago. We thank Timothy W. Smith, James A. Blumenthal, Carl E. Thoresen, and Edward M. Heath for their assistance throughout this project. We also thank Llewellyn Jones and Jodi Hildabrandt for their efforts in collecting data.     

Mothers and fathers of young Dutch adolescents with Down syndrome: Health related quality of life and family functioning

BackgroundLike any child, children with Down syndrome (DS) affect the lives of their families. Most studies focus on the adaptation of parents and families of young children with DS, while relatively few studies include the perspective of fathers.AimsTo determine 1) whether mothers and fathers of 11 to 13-year-olds with DS differ from reference parents in health related quality of life (HRQoL) and family functioning, and 2) whether HRQoL in parents of children with DS changes over time, from when the child was 6–8 years old to when the child was 11–13 years old.Methods80 mothers and 44 fathers completed HRQoL and family functioning questionnaires. 58 parents (53 mothers) had completed the HRQoL-questionnaire in a previous study.ResultsMothers differed from reference mothers in one HRQoL-domain (Sexuality), while fathers’ HRQoL did not significantly differ from reference fathers. Both mothers and fathers scored in the (sub)clinical range more frequently than reference parents in Total family functioning, and in the domains Partner relation and Social network. Furthermore, fathers scored in the (sub)clinical range more frequently than reference parents in Responsiveness and Organization. HRQoL showed no significant change over time.Conclusions and implicationsOur findings indicate frequent family functioning problems but few HRQoL problems in parents and families of children with DS. In offering care, a family based approach with special attention for partner relation and social functioning is needed.     

Parental,child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0–7 years old: the CIKEO study

Background

A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE.

Objective

To investigate factors associated with PSE in parents of children aged 0–7 years old, and to explore whether the associations were different between mothers and fathers.

Methods

We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE.

Results

Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (− 2.05, 0.87), and 0.23 (− 0.46, 3.29), respectively.

Conclusions

A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care.

Trial registration

Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

     

Maternal Mentoring

Abstract

As more and more women enter family businesses, or begin their own, the pool of talent available from “Moms” to mentor their adult children increases. This article discusses this relatively new phenomena and comments on the general differences noted between the mentoring styles of mothers and fathers of their own progeny. There is almost no literature about this, so the references are sparse. Relevant family dynamics in the context of family businesses are also discussed.     

Pourquoi et comment aborder la spiritualité et la religiosité des patients souffrant de troubles mentaux sévères : une étude de terrain

ObjectivesThere is evidence that psychiatrists are rarely aware of how religion may intervene in their patient's life. That is particularly obvious concerning patients with psychosis. Yet, even for patients featuring delusions with religious content, religious activities and spiritual coping may have a favourable influence. Indeed, patients with psychosis can use religion to cope with life difficulties related to their psychotic condition, in a social perspective but also in order to gain meaning in their lives. Also, religion may be part of explanatory models about their disorder with, in some cases, a significant influence on treatment adhesion.Patients and methodsThis paper describes a prospective randomized study about a spiritual assessment performed by the psychiatrists of patients with schizophrenia. The outpatient clinics in which the sample was collected are affiliated with the department of psychiatry at the university hospitals of Geneva. Eighty-four outpatients with psychosis were randomized into two groups: an experimental group receiving both traditional treatment and spiritual assessment with their psychiatrist and a control group of patients receiving only their usual treatment. Psychiatrists were supervised by a clinician (PH) and a psychologist of religions (PYB) for each patient in the spiritual assessment group. Data were collected from both groups before and after 3 months of clinical follow-up.ResultsSpiritual assessment was well-tolerated by all patients. Moreover, their wish to discuss religious matters with their psychiatrist persisted following the spiritual assessment. Even though clinicians acknowledged the usefulness of the supervision for some patients, especially when religion was of importance for clinical care, they reported being moderately interested in applying spiritual assessments in clinical settings. Compared to the control group, there were no differences observed in the 3 months’ outcome in terms of primary outcome measures for satisfaction with care, yet the attendance at the appointments was significantly increased in the group with spiritual assessment. The same result was found when restricting analyses to patients for whom an intervention was suggested or patients who invested more in religion. Areas of potential intervention were frequent both in a psychiatric and psychotherapeutical perspective.ConclusionsSpiritual assessment appears to be useful for patients with psychosis. This is in accordance with the recommendations of the World Psychiatric Association which promotes considering the whole person in clinical care. Spiritual assessment is quite simple to perform, providing that clinicians do not prescribe or promote religion, and that no critical comments are made concerning religious issues. Clinicians do not need to know in depth the religious domains of each of their patients, as it appears that each patient accommodates his/her religious background his/her own way.     

Liminality,art therapy and childhood sexual abuse

Abstract

This article discusses the relevance of liminality for art therapy and childhood sexual abuse. ‘Liminality’ comes from the Latin word limen and refers to our encounters with, and experiences of, thresholds. Social anthropologists have studied liminality in the context of rite-of-passage rituals that commonly mark social and personal transitions, for example at puberty, marriage and death. I make two claims for the relevance of liminality in thinking about childhood sexual abuse. The first is that abused children become liminal personae (threshold-people) through their premature sexual knowledge and experiences. As we will see, in the anthropological literature liminal personae are considered to be anxiety-provoking. I believe that anthropological ideas can help us to make sense of public, media and government responses to the anxiety provoked by childhood sexual abuse. My second claim makes a link between liminality and trauma and brings together ideas about the breaching of thresholds, annihilation anxiety and experiences of the sublime. We will see that liminality is intimately linked with trauma and is therefore relevant for many art therapy clients. Images allow unspeakable traumatic experiences to be acknowledged and explored, which makes art therapy a particularly effective intervention for children traumatised by sexual abuse.     

ANT-Attachment Narrative Therapy

Abstract

The paper proposes that recent developments in attachment theory, especially the move to the study of representations, offer some helpful new directions for systemic family therapy. Some of the findings of a close association between early attachment experiences and the coherence of the narratives are reviewed. It is suggested that this offers a useful link for systemic approaches in showing how early interactions in families not only promote particular emotional attachment patterns, but also shape the content and style of the narratives that are formed. These implications are then explored in the context of work with anorexia nervosa. It is suggested that commonly observed patterns, such as avoidance of conflict and apparent difficulties in discussing relationships and feelings, are consistent with trans-generational experiences of insecure/avoidant attachments. Some implications for systemic therapy with families are outlined and illustrative case study is offered.     

Chaotic family environments and depressive symptoms in parents of autistic children: The protective role of optimism

BackgroundRaising an autistic child is associated with increased parenting stress and higher rates of depression for both mothers and fathers. While most research has focused on the challenges related to having an autistic child, such as higher rates of chaotic family environments, an emerging body of research has begun to examine the protective effects of optimism to reduce the negative impact on parent mental health.MethodA total of 133 mothers and 78 fathers of autistic children between the ages of 2–10 years participated in the study. Parents answered questionnaires related to their family functioning, dispositional optimism, and depressive symptoms.ResultsResults found a significant family chaotic environment X optimism X parent gender interaction. For mothers and fathers, higher levels of chaotic family environment were associated with increased depressive symptoms whereas increased levels of optimism were associated with lower levels of depressive symptoms. However, optimism was only protective for mothers and not for fathers.ConclusionsThe results highlight the need for the inclusion of optimism in parent-focused interventions.     

Father participation with mothers in the Signposts program: An initial investigation

Abstract

Background The Signposts program is an evidence-based intervention system for parents of children with intellectual disability and problem behaviours. This study provided an initial investigation of the outcomes for mothers associated with father participation in Signposts, using data collected from the Signposts Statewide project, conducted in Victoria, Australia.

Method Data from Signposts Statewide were analysed, with the effect size Cohen’s d and 95% confidence interval around d calculated for pre- to post-program changes for 134 mothers who participated in Signposts with fathers and 483 mothers who participated without fathers.

Results Although mothers in both groups benefitted from the program, as evidenced by pre- to post-program improvements across all measures, the mean effect size was notably larger for mothers who participated in Signposts with fathers.

Conclusions These results highlight possible further program benefits for mothers who participate in Signposts with fathers, and are of particular significance in light of research describing the increased stress experienced by mothers of children with a disability.     

Spirituality, psychiatry and participation: a cultural analysis

This article begins by asking whether religion and spirituality are useful terms for cross-cultural comparisons. After discussing the increasing distinction between religion and spirituality in Western cultures, it points out how the terms religion and spirituality are used in divergent ways in the literature and the need for conceptual clarification in this area. Broadly, spirituality relates to interconnectedness, ultimate meaning or life force itself. The current use of the term spirituality in Western cultures derives both from Christian spirituality and 'New Age' thinking, which often appropriates ideas from Eastern religious traditions. The sociocultural roots of this division are complex, involving both growth of individualism, the pursuit of meaning and discontent with materialism and scientific rationalism. This situation is contrasted with other monotheistic religions where there is no distinction between religion and spirituality. This turn to spirituality has influenced health care professionals' conceptualizations of health and healing. The implications for psychiatry are discussed. I conclude that spirituality is a way of 'being in the world' and shares affinities with Tambiah's notion of a participatory mode of thinking.