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.     

Narrative Therapy for Adoption Issues in Families,Couples, and Individuals: Rationale and Approach

This article explores the application of narrative therapy to clinical work with clients’ adoption-related issues. The importance of therapist competency in addressing adoption-related issues is the primary focus for exploring the application of narrative therapy with individual, couple, and family clients experiencing adoption issues. The narrative method can be effective in exploring and understanding the diversity of experience and meanings adoption triad members report in regard to their adoption experiences (Baden & Wiley, 2007; Daniluk & Hurtig-Mitchell, 2003). Multiple realities and meanings emerge as a theme in the adoption literature and as core concepts in the narrative framework.     

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.     

Attachment as a Base for Family and Couple Therapy

All families have attachments; some may be secure, others insecure, and family and marital therapists inevitably have to relate to these. This paper discusses ways in which the therapist can establish a temporary secure base within therapy, which helps families to feel safe enough to explore new ways of relating. The overall aim is to help them to create a more secure family or couple base at home, from which they can explore new solutions during and after therapy. A new school of therapy is not proposed as therapists can also use their own approaches when a secure therapeutic base is established.     

Religious beliefs in schizophrenia: their relevance for adherence to treatment

The study examined how religious beliefs and practices impact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva's outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and religious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a systematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral medication. Fifty-eight percent of patients were Christians, 2% Jewish, 3% Muslim, 4% Buddhist, 14% belonged to various minority or syncretic religious movements, and 19% had no religious affiliation. Two thirds of the total sample considered spirituality as very important or even essential in everyday life. Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31% and negatively in 26%). Religious representations of illness were prominent in nonadherent patients. Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medication, versus 8% of adherent patients. Religion and spirituality contribute to shaping representations of disease and attitudes toward medical treatment in patients with schizophrenia. This dimension should be on the agenda of psychiatrists working with patients with schizophrenia.     

Addressing Religious Differences in Couples: The Two Churches,One Marriage Program

Marriages where individuals come from different religious backgrounds are both common and at greater risk for divorce and lower marital satisfaction. To address this need, a free web-based program called Two Churches, One Marriage was developed. The program has 8 units that are devoted to common challenges that couples from different religious backgrounds can face. This article also summarizes 2 studies that provide a preliminary evaluation of the program. The results suggest that the Two Churches, One Marriage program can be a valuable resource for couples from different religious backgrounds.     

Religious coping and caregiver well-being in Mexican-American families

Objective: We sought to explore the association of religious and spiritual coping with multiple measures of well-being in Latinos caring for older relatives with long-term or permanent disability, either with or without dementia.

Methods: Using a multi-dimensional survey instrument, we conducted in-home interviews with 66 predominantly Mexican-American Catholic family caregivers near the US–Mexico border. We assessed caregivers’ intrinsic, organizational and non-organizational religiosity with the Duke Religiosity Index, as well as Pargament's brief positive and negative spiritual coping scale to determine the association of religiosity with caregivers’ mental and physical health, depressive symptomatology and perceived burden.

Results: Using regression analysis, we controlled for sociocultural factors (e.g. familism, acculturation), other forms of formal and informal support, care recipients’ functional status and characteristics of the caregiving dyad. Intrinsic and organizational religiosity was associated with lower perceived burden, while non-organizational religiosity was associated with poorer mental health. Negative religious coping (e.g. feelings that the caregiver burden is a punishment) predicted greater depression.

Conclusion: Measures of well-being should be evaluated in relation to specific styles of religious and spiritual coping, given our range of findings. Further investigation is warranted regarding how knowledge of the positive and negative associations between religiosity and caregiving may assist healthcare providers in supporting Latino caregivers.     

Santa Clara Strength of Religious Faith Questionnaire: psychometric analysis in older adults

Objectives: To assist researchers and clinicians considering using the Santa Clara Strength of Religious Faith Questionnaire (SCSRFQ) with older-adult samples, the current study analyzed the psychometrics of SCSRFQ scores in two older-adult samples.

Method: Adults of age 55 or older who had formerly participated in studies of cognitive-behavioral therapy for anxiety and/or depression were recruited to complete questionnaires. In Study 1 (N = 66), the authors assessed the relations between the SCSRFQ and other measures of religiousness/spirituality, mental health, and demographic variables, using bivariate correlations and nonparametric tests. In Study 2 (N = 223), the authors also conducted confirmatory and exploratory factor analyses of the SCSRFQ, as well as an item response theory analysis.

Results: The SCSRFQ was moderately to highly positively correlated with all measures of religiousness/spirituality. Relations with mental health were weak and differed across samples. Ethnic minorities scored higher than White participants on the SCSRFQ, but only in Study 2. Factor analyses showed that a single-factor model fit the SCSRFQ best. According to item response theory analysis, SCSRFQ items discriminated well between participants with low-to-moderate levels of the construct but provided little information at higher levels.

Conclusion: Although the SCSRFQ scores had adequate psychometric characteristics, the measure's usefulness may be limited in samples of older adults.     

Religious attitudes and practices of hospitalized medically ill older adults

Objectives. To examine the prevalence of religious beliefs and practices among medically ill hospitalized older adults and relate them to social, psychological and health characteristics. Methods and procedures. Consecutive patients age 60 or over admitted to the general medicine, cardiology and neurology services of Duke University Medical Center were evaluated for participation in a depression study. As part of the evaluation, information on religious affiliation, religious attendance, private religious activities, intrinsic religiosity and religious coping was collected. Demographic, social, psychological and physical health characteristics were also assessed. Bivariate and multivariate correlates of religious belief and activity were examined using Pearson correlation and linear regression. Results. Of the 542 patients evaluated, detailed information on religious beliefs and behaviors was collected on 455 cognitively unimpaired patients. Over one-half (53·4%) of the sample reported attending religious services once per week or more often; 58·7% prayed or studied the Bible daily or more often; over 85% of patients held intrinsic religious attitudes; and over 40% spontaneously reported that their religious faith was the most important factor that enabled them to cope. Religious variables were consistently and independently related to race (Black), lower education, higher social support and greater life stressors, and religious attendance was associated with less medical illness burden. Religious attendance was also related to lower depressive symptoms, although the association weakened when other covariates were controlled. Conclusions. Religious practices, attitudes and coping behaviors are prevalent among hospitalized medically ill older adults and are related to social, psychological and physical health outcomes. Implications for clinical practice are discussed. © 1998 John Wiley & Sons, Ltd.     

A Tactile Lifeline Applied to Couple Therapy

ABSTRACT

The Person-of-the-Therapist Training (POTT) has grown and been refined, from its origins in the 1980s to its more formal articulation and implementation in recent years. After this process of development, it makes sense to look at the current state of this training model, and ponder about the directions in which POTT can continue to grow. In this paper, we take a look at the different ways POTT is currently being implemented in various settings and modalities, a testament to the versatility of POTT’s philosophy and methods. We also present a summary of the available research on POTT’s effects on the clinical and personal development of trainees. We conclude this paper by offering suggestions for POTT’s growth and expansion, including recommendations for ways in which trainers, students, clinicians and supervisors who are interested in this model can remain connected, and exchange ideas and experiences.     

Integrative Practice: Presentation of an Inpatient Family Therapy Program

ABSTRACT

An inpatient family therapy program for treating complex combinations of individual, couple, and family problems is presented within a holistic treatment framework. The treatment context and scheduled program form treatment guidelines, yet the single case treatment approach may be tailored. A case vignette illustrates how theories and methods from both the individual and systemic therapy traditions are implemented as integrative practice, enabling synergistic effects. The treatment program is evaluated throughout the therapy and at follow-up. Consumer satisfaction results show that the clients were very pleased with the treatment at discharge, and this satisfaction was maintained at 1-year follow-up.     

Family Therapy as Initiation

The purpose of this paper is to provide a brief examination of the nature of family therapy as it reflects the structural components of the ritual of initiation. Terminology is defined in order to illustrate the connection between family therapy, anthropology, comparative religion, and depth psychology. Van Gennep's (1960) classical anthropological model of the "Rites of Passage" is explicated to demonstrate the affinity with the stages of family therapy. Finally, a case study is explored in the context of ritual theory to further illustrate the clinical usefullness of this approach towards family therapy.     

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.     

Religion and Spirituality in the Lives of People with Serious Mental Illness

Although there is a fair sized literature documenting the relationship of religiousness and spirituality with health and well-being, far fewer studies have examined this phenomenon for people with serious mental illness. In this research, religiousness is defined as participation in an institutionalized doctrine while spirituality is framed as an individual pursuit of meaning outside the world of immediate experience. In this study, 1,824 people with serious mental illness completed self-report measures of religiousness and spirituality. They also completed measures of three health outcome domains: self-perceived well-being, psychiatric symptoms, and life goal achievement. Results showed that both religiousness and spirituality were significantly associated with proxies of well being and symptoms, but not of goal achievement. Implications of these findings for enhancing the lives of people with psychiatric disability are discussed.     

Hegemonic Therapy,Not Recognizing the Symbol

In this paper, the case of a Russian family will be explored through the lenses provided by chaos theory. Specifically, the theory of self-organizing structures, created by Prigogine, will be discussed in terms of this family's attempts to self-organize in spite of the difficulties imposed upon it by culturally hegemonic therapeutic practices. The symbols offered by the family while they were in chaos will also be addressed in terms of their meaning to therapists, given the unique human capacity of representing experiences.     

Filial Therapy with Co-Therapists

Abstract

The purpose of this paper is to describe a case where two therapists worked with a five-year-old boy, presenting with anger issues, and his family. One therapist conducted play sessions with the boy while the other therapist worked with the parental dyad behind a one-way mirror. The latter therapist explained the tenets of play therapy, translating its function to actions that can be done by the parent outside the therapy room. Secondarily, the therapist working with the parents explored familial interactions that systemically contributed to the son's anger outbursts. Additionally, this paper explores using co-therapy as a treatment modality when working with families with young children.     

Community Family Therapy: A Model for Family and Community Problem Solving and Development in South America

This article has a twofold purpose. First, it discusses theoretical and practice developments in both family therapy that include community, and in social work that emphasize acceleration toward social and community developmental welfare, but which should include microsystemic interventions. The authors contend that ethical family therapy and social work practice should use multimodal strategies, and suggest that the community family therapy (CFT) model is useful in addressing gaps in theoretical developments. Second, because the CFT model has not yet been adopted in South Africa, this article discusses evaluations of the CFT model by 3 groups of students for the model to be adopted with full understanding. These student groups are the 2010 cohort of final-year social work undergraduate students and the 2010 and 2011 cohort of postgraduate social work students at the University of KwaZulu Natal, Durban, South Africa. The article presents readers with some understanding of the CFT model, how its teaching has evolved through a learner-centered pedagogy, the merits and demerits of the model, and preconditions that may facilitate adoption of the model.