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.     

Effects of religiosity and spirituality on the treatment response in patients with depressive disorders

BackgroundFew studies have investigated the roles of religiosity and spirituality in predicting treatment response among psychiatric patients with depressive disorders.MethodsIn total, 232 outpatients with depressive disorders completed measurements of psychological symptoms, religiosity, and spirituality at baseline. A response was defined as Clinical Global Impression—Improvement scale (CGI-I) score of 1 or 2 at the last visit during a 6-month treatment period. Univariate analyses and logistic regression analysis were used to identify predictors of treatment response.ResultsIn univariate analyses, treatment response was associated with marital status, longer treatment duration, less severe baseline symptoms, higher personal importance of religion, and higher spirituality. In logistic regression analysis, subjective important considerations for religion and spirituality were significantly related with treatment response after controlling for marital status, treatment duration, and baseline symptom severity. Of these variables, spirituality remained a significant predictor in the final model.ConclusionsThese findings suggest that higher spirituality may independently contribute to favorable treatment responses among depressed patients in addition to other demographic and clinical factors.     

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.     

Types of childhood trauma and spirituality in adult patients with depressive disorders

ObjectiveThe aim of this study was to investigate the differences in spirituality among adult patients with depressive disorders, who had suffered various types of abuse or neglect in childhood.MethodsA total of 305 outpatients diagnosed with depressive disorders completed questionnaires on socio-demographic variables, childhood trauma history, and spirituality. We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to measure five different types of childhood trauma (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) to assess spirituality.ResultsDepressive symptoms and total CTQ-SF scores showed a negative correlation with spirituality. In the regression model, being older and belonging to a religion significantly predicted greater spirituality. Depressive symptoms significantly predicted lower spirituality. From among the five types of childhood trauma assessed by the CTQ-SF, only emotional neglect significantly predicted lower spirituality.ConclusionA history of childhood emotional neglect was significantly related to lower spirituality, especially in the case of the Meaning aspect of spirituality. This finding suggests the potential harmful influence of childhood emotional neglect on the development of spirituality in psychiatric patients. Investigating different aspects of childhood trauma might be important in order to develop a more comprehensive psychiatric intervention that aids in the development of spirituality.     

Supervision of Cross-Cultural Couples Therapy

Abstract

This author discusses the importance of actively giving voice in clinical supervision and the therapy room to the code of silence around issues of ethnicity, gender, spirituality, and socioeconomic struggles that plague many cross-cultural couples. The author explores obstacles that collude with dominant oppressive discourses in supervision and therapy and provides suggestions for giving voice to issues of ethnicity, gender, spirituality, and socioeconomic status. The author offers strategies for entering a dialogue of cross-cultural exploration using narrative theory via a supervision case.     

‘Following the word of God’: Empirical insights into managerial perceptions on spirituality,culture and health

Abstract

This article focuses on managers in a selected South African organization and the connections they draw between mental health, culture and spirituality within the workplace. The aim is to gain a deeper understanding of the interrelationships in this complex and growing scientific discourse and to respond to the research question of how mental health, culture and spirituality are interrelated from a managerial perspective. The study follows an inductive single case study approach within the phenomenological paradigm. Qualitative research methods using in-depth interviews and observation were used. The sample comprised 27 managers within the international South African automotive organization. The findings show that not only culture, but also spirituality and religion in particular, influence mental health and well-being of managers at work. Conclusions are drawn and recommendations made.     

Religion/Spirituality and Adolescent Psychiatric Symptoms: A Review

The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of articles reviewed found at least one significant (p < .05) relationship between religiousness and better mental health. Evidence for relationships between greater religiousness and less psychopathology was strongest in the area of teenage substance use. Methods of measuring religion/spirituality were highly heterogeneous. Further research on the relationship of religion/spirituality to delinquency, depression, suicidality, and anxiety is warranted. Measurement recommendations, research priorities, and clinical implications are discussed.     

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.     

Investigating the interlinkages of alcohol use and misuse,spirituality and culture – Insights from a systematic review

Abstract

Religious values are part of cultures, but spirituality is an internal dimension which may be present in varying degrees across all nations. As both cultural and spiritual factors are important in determining the pattern of alcohol consumption by individuals, it is important to study the relationships between them. The present systematic review aims to summarize the knowledge on the relationship between alcohol use and misuse, religiousness/spirituality and culture drawn from medical studies. Data from the medical literature to date indicate that for some racial and ethnic minorities a return to the traditional culture linked with concepts of spiritual or religious factors can produce a major degree of support for people trying to maintain abstinence from alcohol. This can be seen even in the worst environments. On the other hand, among the general population, religion and/or spirituality can play a positive role in the maintenance of abstinence, but a local heavy drinking culture is a strong risk factor for relapse. These factors are important and can be used for interventions and prevention strategies. However, possible mediating effects need to be explored further. It is likely that both types of intervention (classical medical treatment plus spiritual-based treatment) may work in individuals.     

Religion,spirituality, and chaplains in the biomedical literature: 1965-2000

In recent years, several prominent medical journals have published articles addressing the relationship between religion/spirituality and medicine, and recognizing the importance of religion in the lives of most Americans, especially in times of illness. We hypothesized that the publication of these articles reflected a trend in the biomedical literature in which greater attention is being given to the role of religion and spirituality in health-care. A correlational design was used, based on an electronic survey of all articles in MEDLINE for the years 1965 through 2000. The search terms used were: 1) religion or religious; 2) spiritual; and 3) chaplain. The number of articles per 100,000 that mentioned religion (religion or religious), spirituality, or chaplains each year was determined. Statistically significant upward trends across years were found for the rates of articles addressing religion (r = .59, p < .001) and spirituality (r = .89, p < .001) and a non-significant trend was found for chaplains (r = .31). The rising rates of articles on religion and spirituality in biomedical journals suggest a growing recognition of the need to address spiritual and religious issues in health-care.     

Religion, spirituality, and medicine: psychiatrists' and other physicians' differing observations, interpretations, and clinical approaches

OBJECTIVE: This study compared the ways in which psychiatrists and nonpsychiatrists interpret the relationship between religion/spirituality and health and address religion/spirituality issues in the clinical encounter. METHOD: The authors mailed a survey to a stratified random sample of 2,000 practicing U.S. physicians, with an oversampling of psychiatrists. The authors asked the physicians about their beliefs and observations regarding the relationship between religion/spirituality and patient health and about the ways in which they address religion/spirituality in the clinical setting. RESULTS: A total of 1,144 physicians completed the survey. Psychiatrists generally endorse positive influences of religion/spirituality on health, but they are more likely than other physicians to note that religion/spirituality sometimes causes negative emotions that lead to increased patient suffering (82% versus 44%). Compared to other physicians, psychiatrists are more likely to encounter religion/spirituality issues in clinical settings (92% versus 74% report their patients sometimes or often mention religion/spirituality issues), and they are more open to addressing religion/spirituality issues with patients (93% versus 53% say that it is usually or always appropriate to inquire about religion/spirituality). CONCLUSIONS: This study suggests that the vast majority of psychiatrists appreciate the importance of religion and/or spirituality at least at a functional level. Compared to other physicians, psychiatrists also appear to be more comfortable, and have more experience, addressing religion/spirituality concerns in the clinical setting.     

Do spirituality and religiousness differ with regard to personality and recovery from depression? A follow-up study

BackgroundThe studies show that both spirituality and religiousness are protective for mental health. Personality is related with course and outcome of depression, as well as spirituality and religiousness, and their relations toward to recovery from depression are underresearched. This study followed influence of spirituality and religiousness on course and outcome of depression in patients with depressive episode, controlled for personality dimensions.MethodsThe patients were assessed with self-report measures of depression (Beck Depression Inventory), spirituality (WHO-Quality of Life-Spiritual, Religious, Personal Beliefs), religiousness (Duke University Religion Index) and personality (Temperament and Character Inventory). Ninety nine patients finished a year long follow up.ResultsHigher spirituality influenced recovery of depression in patients with depressive episode, but religiousness did not show to be significant predictor of recovery for depression. Dimension harm avoidance was significant predictor of improvement of depression in all points of measurement.LimitationsSome limitations of this research are small sample size, usage of the self-report measures of depression in follow-up period, and the predominantly Catholic affiliation of the participants that can impact the generalizability of our data to other denominations.ConclusionSpirituality and dimension harm avoidance are significant predictors of recovery from depression during a year long follow up.     

A critical view of transgender health care in Germany: Psychopathologizing gender identity – Symptom of ‘disordered’ psychiatric/psychological diagnostics?

Abstract

After explaining the essential trans* terminology, I offer a short historical overview of the way health care has dealt with the subject of gender, trans* and health in different times. In the third section, I compare the world's most important diagnostic manuals, namely the International statistical classification of diseases and related health problems (ICD) and the Diagnostic and statistical manual of mental disorders (DSM), i.e. their criteria for ‘gender identity disorders’ (ICD-10) and ‘gender dysphoria’ (DSM-5). The fourth section branch out the factors which influence every diagnostic conception – of no matter whom – in the health care system. The last section discusses the implications resulting from this diagnostic dilemma for the health situation of gender nonconforming people.     

Religion, spirituality and the well-being of informal caregivers: a review, critique, and research prospectus

The purpose of this article is to review and critique the published literature examining the relationships between religion/spirituality and caregiver well-being and to provide directions for future research. A systematic search was conducted using bibliographic databases, reference sections of articles, and by contacting experts in the field. Articles were reviewed for measurement, theoretical, and design limitations. Eighty-three studies were retrieved. Research on religion/spirituality and caregiver well-being is a burgeoning area of investigation; 37% of the articles were published in the last five years. Evidence for the effects of religion/spirituality were unclear; the preponderance (n = 71, 86%) of studies found no or a mixed association (i.e., a combination of positive, negative, or non-significant results) between religion/spirituality and well-being. These ambiguous results are a reflection of the multidimensionality of religion/spirituality and the diversity of well-being outcomes examined. They also partially reflect the frequent use of unrefined measures of religion/spirituality and of atheoretical approaches to studying this topic. Investigators have a fairly large number of studies on religion/spirituality and caregiver well-being on which to build. Future studies should be theory driven and utilize psychometrically sound measures of religion/spirituality. Suggestions are provided to help guide future work.     

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.     

Brain mechanisms in religion and spirituality: An integrative predictive processing framework

We present the theory of predictive processing as a unifying framework to account for the neurocognitive basis of religion and spirituality. Our model is substantiated by discussing four different brain mechanisms that play a key role in religion and spirituality: temporal brain areas are associated with religious visions and ecstatic experiences; multisensory brain areas and the default mode network are involved in self-transcendent experiences; the Theory of Mind-network is associated with prayer experiences and over attribution of intentionality; top-down mechanisms instantiated in the anterior cingulate cortex and the medial prefrontal cortex could be involved in acquiring and maintaining intuitive supernatural beliefs. We compare the predictive processing model with two-systems accounts of religion and spirituality, by highlighting the central role of prediction error monitoring. We conclude by presenting novel predictions for future research and by discussing the philosophical and theological implications of neuroscientific research on religion and spirituality.     

The gender difference in chinese suicide rates

Abstract

Chinese women have a higher rate of suicide than Chinese men in the regions of mainland China currently reporting mortality data to the World Health Organization. This gender difference is documented. and possible reasons for the gender differences are explored using data from a survey of female suicides in Chuanzhou County in the Guangxi region of China. A definitive explanation for the gender difference must await detailed psychological autopsy studies.     

L’influence de la dimension spirituelle comme dynamique thérapeutique complémentaire dans les pratiques de méditation et dans le champ de la santé mentale

ObjectivesThe purpose of this article is to reinstate the framework of the notion of spirituality in the therapeutic field and to underline the potential link between meditation and spirituality, in order to question the potential hindrance to therapeutic effects caused the dissociation of meditation and spirituality. We explore the possible spiritual dimensions of meditation, and, lastly, discuss whether a spiritual dimension is relevant to meditative practice.MethodWe carried out a literature review, selecting the main research dealing with the link between spirituality and meditation.ResultsIt appears that the spiritual dimension has not been taken into account in the therapeutic applications of mindfulness meditation; it would be beneficial for spirituality to be integrated into the meditative process as a complementary tool for the adaptation and the stimulation of practice.DiscussionThe question of the link between spirituality and meditation questions the fact of meditation's having been cut off from its cultural substratum. We suggest that it would be appropriate in certain cases to reactivate this tradition, as well as the role of the psychotherapist in this dynamic.ConclusionThe dimension of spirituality could be a fecund tool in therapeutic accompaniment; integrating spirituality into therapeutic meditation could have positive impacts in terms of patients’ well being and mental health.     

The influence of the spiritual dimension as a complementary therapeutic dynamic in meditation practices and in the field of mental health

ObjectivesThe purpose of this article is to reinstate the framework of the notion of spirituality in the therapeutic field and to underline the potential link between meditation and spirituality, in order to question the potential hindrance to therapeutic effects caused the dissociation of meditation and spirituality. We explore the possible spiritual dimensions of meditation, and, lastly, discuss whether a spiritual dimension is relevant to meditative practice.MethodWe carried out a literature review, selecting the main research dealing with the link between spirituality and meditation.ResultsIt appears that the spiritual dimension has not been taken into account in the therapeutic applications of mindfulness meditation; it would be beneficial for spirituality to be integrated into the meditative process as a complementary tool for the adaptation and the stimulation of practice.DiscussionThe question of the link between spirituality and meditation questions the fact of meditation's having been cut off from its cultural substratum. We suggest that it would be appropriate in certain cases to reactivate this tradition, as well as the role of the psychotherapist in this dynamic.ConclusionThe dimension of spirituality could be a fecund tool in therapeutic accompaniment; integrating spirituality into therapeutic meditation could have positive impacts in terms of patients’ wellbeing and mental health.