“Out on the edge of my comfort”: Trainee counsellor/psychotherapists' experiences of spirituality in therapy—A qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered.     

Coping with major life events: the role of spirituality and self-transformation

The aim of the current study was to explore the process of self-transformation as a result of coping with a major life event, and to address the role, if any, that spirituality plays within the coping and transformational process. Using grounded theory methodology, six participants were interviewed over a period of 6 months. The findings, supportive of previous research, produced a preliminary model illustrating transformation as a gradual process. The core category was identified as “openness,” in that by being open to others or to the “Transcendent,” the participants were able to let go and transform. It was theorized that openness, in this sense, enables acceptance of material deriving from a realm of self beyond the everyday ego. Indeed, such a journey of transformation crucially seems to entail expanding the conception of self beyond customary limits. Understood in this way, transformation may be conceptualized as a process of continual movement into the unconscious, where the totality of the self is awakened, resulting in a reinterpretation of life purpose. The consequences of the transformation for participants were positive in nature. The role that spirituality plays within the coping and transformation process was seen to manifest as being subtle and unfolding and/or supportive.     

The Experience of Religion and Spirituality Among College Students Who Use Illicit Substances

Nine collegiate illicit substance users participated in a phenomenological study of their perceptions of religion, spirituality, and substance use. We identified three themes from the interviews: (a) development of substance-using behaviors, (b) journey with religion and spirituality, and (c) intersectionality of substance use and religious and spiritual journeys. The participants voiced a complex bidirectional relationship among use behaviors, religion, and spirituality that could be facilitative, adverse, or divergent. We provide implications and suggestions for future research.     

A Grounded Theory Study of Spirituality: Using Personal Narratives Suggested by Spiritual Images

This study expanded on traditional concepts of spirituality through an analysis of narratives derived from images with spiritual content. Twenty-five participants were selected based on their being actively involved in spiritual practices. They were requested to tell TAT-type stories to a series of twelve images that revolved around spiritual themes. The resulting 300 stories were coded according to Grounded Theory procedures. A theory of spirituality emerged that centered upon the expression of suffering and the expectation of it being relieved. Results suggest that the personal spiritual process is one that expects and seeks transformation of the suffering through a connection with another, a connection with the transcendent, acquiring wisdom, or transforming the internal state.     

“Sometimes cathartic. Sometimes quite raw”: Benefit and harm in an intimate partner violence trial

Research on intimate partner violence (IPV) has increased over the past two decades, however empirical research on potential harm to participants is limited. The aim of this study was to assess whether 272 women involved in a general practice based IPV intervention trial (weave) reported more benefit or harm, whether this differed by intervention or comparison group, and what types of benefit and harm were reported. Feedback was obtained via adapted Consequences of Screening Tool, visual analogue scale and open-ended question in baseline, 6-month, 12-month and 24-month surveys (all participants), and semi-structured interviews (subset of 28 participants). Participants in both the intervention and comparison groups tended to respond positively on all quantitative items, although on a number of items, the intervention group responded even more positively. At 6 and 12 months, 51.1% and 54.7% of all participants, respectively, reported their quality of life as becoming better and over 40% of women at each time-point, indicated they felt more positive about themselves as a result of some aspect of their involvement in weave. 42% of all participants reported their home lives becoming less difficult. In qualitative analyses, positive themes identified were altruism, value, evaluation of relationship, validation, self-awareness, empowerment, positive reinforcement, catharsis, motivation to seek help, and response to the research process. Negative themes identified were short-term emotional reactions, long-term emotional reactions, recall, retraumatization and minimization. Many participants indicated short-term negative emotions had been balanced by longer-term positive benefits. Further research is needed regarding characteristics and experiences of the small minority of participants who did not report positive benefit.     

Encountering the ‘unexpected’ in phenomenological research. Faith and belief as expressions of spirituality in a qualitative study

A study of 12 secondary schools students in Victoria, Australia explored the spirituality of young people in the context of their everyday lives through a hermeneutic phenomenological investigation. In developing an understanding of what spirituality meant to the participants in this study, it was apparent that spirituality was deeply abiding and embedded within the participants’ religious traditions. This was influenced by the exposure participants had to religious and spiritual teachings. Despite the fact that the participants expressed a range of religious beliefs about God, the afterlife and transcendence towards others as significant ways in which they understood spirituality, the findings were not generalisable across the Australian population. These themes will be explored throughout the paper proving implications for educators working with specific groups of students from faith backgrounds and the possibility of investigating what young people from non-religious backgrounds believe.     

Religion and Spirituality in Coping with Advanced Breast Cancer: Perspectives from Malaysian Muslim Women

This article is part of a larger study on the role of spirituality in coping with breast cancer among Malaysian Muslim women. The study seeks to reveal the meaning of the experience through the stories of three Muslim women surviving advanced breast cancer, to better understand the deep meanings that inform their experiences with spirituality and transformation as they cope with the challenges of breast cancer. Data were gathered using in-depth interview. Qualitative methods were used in identifying two themes—illness as an awakening and hope and freedom comes from surrendering to God. The themes were discussed in the context of two broad areas: (1) what are the new meanings these women discovered in their experiences with cancer; and (2) how did the new meanings change their lives? The study suggests that cancer survivors’ experiences with cancer and their learning processes must be understood within the appropriate cultural context. This is especially so for spirituality. The common emphasis of spirituality on relationship with God, self and others, may significantly influence how people learn to live with cancer.     

Protective Role of Spirituality from the Perspective of Indian College Students with Suicidal Ideation: “I am here Because God Exists”

Spiritual beliefs are found to be having a significant effect during times of struggles and trials in peoples’ lives. India being a multi-religious society, it is imperative to establish the relevance of spirituality in the lives of the college students with suicidal ideation. The current study therefore utilized focus group methodology to explore the Indian female college students’ perceptions on the protective role of spirituality as a factor contributing to their positive adaptation in times of adversity. Twenty students participated in the discussion. The results interestingly surfaced themes supporting the significance of them on how individuals rely on spiritual beliefs and the possible implications of the need to address it for positive adaptation. Most of the participants analogically stated the themes emerged as “something to stay afloat in the rough sea of life’s realities.”     

Women's Spirituality Across the Life Span: Implications for Counseling

Women's spirituality has unique characteristics that are often ignored within the spirituality literature. The authors review the literature on women's spirituality to reveal the major themes women have identified as relevant to their spiritual journeys across the life span. Implications for counseling and ideas for practice are included after major themes are examined.     

Intimate Partner Violence: The Recovery Experience

This qualitative study explored the recovery experience of six women who have survived intimate partner violence. Interviews were used as an instrument to elicit the individual stories of each of these women. Qualitative analysis revealed two types of themes: process and supports. The process themes include (a) spirituality, (b) facing death, (c) future relationships and (d) hope and encouragement. The support themes include (a) professional help (effective and ineffective) and (b) informal supports (family/friends/other survivors). Implications for helping professionals include the call for increased understanding of the recovery process and the need to abandon preset agendas when working with survivors.     

“The Lord is my Shepherd”: examining spirituality as a protection against mental health problems in youth exposed to violence in Brazil

Intrinsic and institutional spirituality or religiosity may each provide unique protective effects against the negative impacts of stress on mental health. Whether this extends to adolescents exposed to high levels of community violence is unknown. Three hundred twenty-five incarcerated adolescents from São Paulo City, Brazil responded to questions about spirituality and violence exposure drawn from the Social and Health Assessment, and mental health problems drawn from the Strengths and Difficulties Questionnaire. There was some evidence that intrinsic and institutional spirituality/religiosity may buffer the relation between violence exposure and certain mental health problems, and that intrinsic spirituality may mediate the relationship between institutional activities and certain mental well-being outcomes. These findings extend a degree of support to the multi-dimensional nature of spirituality to high-risk youth populations, suggesting a small differential and interactive role that intrinsic and institutional spirituality may play in protecting against some mental health problems.     

Spirituality: A Coping Mechanism in the Lives of Adults With Congenital Disabilities

The purpose of this study was to gain insight into the perspective of individuals with congenital disabilities about spirituality as a coping mechanism during crucial times in their lives. Qualitative analysis of interviews assessing turning points in the lives of 15 adults (6 women and 9 men; M = 37 years) with spina bifida, cerebral palsy, or attention deficit disorder was performed to determine how spirituality assisted them at these crucial times. Four recurring themes were identified: God as a guiding force, inner strength, meaning in life, and appropriateness of the use of spirituality in counseling. The authors discuss their findings and the use of spirituality in counseling adults with congenital disabilities.     

Spirituality as a 1‐Year Prospective Predictor of Violence Perpetration and Drug Use Among Youth at Continuation High Schools1

This paper presents the results of a 1‐year prospective study of violence perpetration, drug use, and spirituality among continuation high school youth. Spirituality was found to predict later violence perpetration and drug use as a single predictor. However, it failed to predict violence or drug use in models that also entered 6 other variables; particularly, baseline levels of violence and drug use, and morality of drug use. It is possible that current measures of spirituality predict later violence perpetration and drug use as a result of tapping attitudes about morality. Controlling for baseline spirituality, male gender, low morality of drug use, violence perpetration, and drug use predicted later spirituality. Spirituality appears to be affected by drug use and violence, but not the converse. The protective influence of spirituality is not supported, at least as currently measured.     

Spiritual resilience: Understanding the protection and promotion of well-being in the later life

Spirituality is important to a large percentage of the older adult population and serves as a key factor of resilience. Using qualitative research, we conducted and analyzed interviews with 64 participants willing to discuss their experiences with adversity. Participants ranged in age from 52 to 93 with a mean age of 74. For the purposes of this study, we analyzed 46 of the 64 interviews, selecting participants who indicated that spirituality was an important resource for managing hardship. The researchers examined the connections between spirituality and resilience. Using in-depth interviews, we explored the interplay between spirituality and resilience and the importance spirituality plays in dealing with adversity and hardship. A grounded theory analysis of the 46 interviews was performed. Major findings include participants’ use of spirituality as a tool to promote and maintain resilience in late life in five key domains: reliance on relationships, spiritual transformation, spiritual coping, power of belief, and commitment to spiritual values and practices. Results are presented as an interpretation of the participants’ perceptions of their spirituality, and indicate their reliance on spirituality to overcome hardship. In addition, we discuss the connections between spirituality and resilience and how these connections play out in the lives of older adults when considering their generational and cohort status. The roles these two constructs play in the lives of older adults are considered.     

The stage-specific role of spirituality among African American Christian women throughout the breast cancer experience

This study presents the results of semistructured interviews conducted with 18 African American Christian women regarding the role of spirituality throughout their breast cancer experiences. The spiritual themes relevant for phases of the breast cancer experience are identified. Analysis resulted in the identification of 11 codes and 5 subcodes that corresponded to the diagnosis, treatment, and posttreatment phases of the breast cancer experience. Most of the survivors indicated that their spirituality and faith assisted them throughout the breast cancer experience. Discussion focuses on the spiritual resources used by the participants at the different stages in the breast cancer experience. Attention is given to implications for how professionals can use these resources to assist African American women coping with breast cancer.     

Violence brief interventions: A rapid review

Provision of a Violence Brief Intervention (VBI) to young men undergoing treatment for a violent injury may represent a teachable moment for the prevention of future interpersonal violence in Scotland. Prior to intervention design, a rapid review of the research literature was necessary to examine existing programmes. After title and abstract screening, eight distinct VBIs were identified from full texts. Whilst none of the programmes were a perfect match for our intervention goals, they did demonstrate the potential effectiveness of brief interventions for violence prevention at both cognitive and behavioural levels. Key themes of successful interventions included brief motivational interviewing as an effective method of engaging with at-risk participants and encouraging change, the utility of social norms approaches for correcting peer norm misperceptions, the usefulness of working with victims of violence in medical settings (particularly oral and maxillofacial surgeries), the importance of addressing the role of alcohol after violent injury, the advantages of a computer-therapist hybrid model of delivery, and the need for adequate follow-up evaluation as part of a randomised control trial. This information has been used to design a VBI which is currently under evaluation.     

The Spiritual Dimension of Caring: Applying a Model for Spiritual Tasks of Ageing

SUMMARY

This chapter describes a spiritual dimension of ageing using themes and a model for spiritual tasks of ageing, developed as a part of doctoral studies that examined spirituality amongst a group of independent-living older adults in Canberra and NSW. This model has been tested further and the model was confirmed through in-depth interviews of residents of nursing homes in the ACT. The first study identified six major spiritual themes from participant interviews. These were: ultimate meaning in life for each person, the way they responded to meaning, self-sufficiency versus despair, moving from provisional to final life meanings, relationship versus isolation in ageing and hope versus despair.     

The Impact of Spirituality on Wellness for Appalachian Older Adults

The authors examined the role spirituality can play as a protective factor in the wellness of older adults residing in the Appalachian region of the United States. Analysis of participants' interviews identified 4 themes. These themes and implications for counselors working with Appalachian older adults are discussed.     

Disconnection, Depression, and Spirituality: A Study of the Role of Spirituality and Meaning in the Lives of Individuals with Severe Depression

This qualitative study explores the role of spirituality and meaning among 15 participants suffering from severe depression. During the time of this study, all the participants were in treatment at Loma Linda University Behavioral Medicine Center. The emerging themes are: (1) depression creates a sense of spiritual disconnection. Participants indicated feeling disconnected from God, the community, and oneself; (2) spirituality plays an important role in coping with the pain of depression; (3) there exists a deep yearning for a sense of meaning and a struggle to make sense of one’s pain; and (4) coming to terms with one’s circumstances and one’s depression at some level assists in the healing process.