Representation of mental illness in Christian self-help bestsellers

The present study examined messages about mental illness in 14 contemporary Christian self-help bestsellers. Content analysis revealed that most texts focused upon depression. Categories of textual units included Underlying Assumptions Regarding Depression, Representations of Depression, Roots/Causes/Reasons for Depression, and Christian Responses to Depression. Demonic influence was the most frequently cited reason for depression. Other reasons included negative cognitions, failure as a Christian, and negative emotions. Christian responses to depression included trusting God, religious activity, and individual willpower. Discussion of these results focused upon the problematic impact of these messages upon individuals with depression, and upon suggestions for reducing mental illness stigma in religious communities.     

Brief Christian and Non-Christian Rational-Emotive Therapy With Depressed Christian Clients: An Exploratory Study

The current outcome study operationalized a brief “Christian” form of rational-emotive therapy (CRET) and compared the therapeutic efficacy of this treatment with a standard version of brief rational-emotive therapy (RET) with depressed Christian clients. Results indicated that both treatments were effective in reducing depression and automatic negative thoughts, while only the CRET reduced clients' irrational beliefs. No between-group differences were obtained for clients' perceptions of the counselor. Findings are discussed in terms of applied integration issues and the long-standing antagonism of rational-emotive philosophy toward religious beliefs.     

Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients

The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.     

Religious versus Conventional Internet-based Cognitive Behavioral Therapy for Depression

The accessibility and efficacy of two Internet-supported interventions for depression: conventional cognitive behavioral therapy (C-CBT) and religious CBT (R-CBT) were investigated. Depressed participants (N = 79) were randomly assigned to either active treatment or wait-listed control group. Self-report measures of depression, anxiety, and life quality were collected before, immediately after, and 6 months after the intervention. Significant differences among the three conditions emerged at post-intervention with medium to large effect sizes (Cohen’s d between 0.45 and 1.89), but no differences between the R-CBT and C-CBT were found. However, the addition of religious components to CBT contributed to the initial treatment appeal for religious participants, thus increasing the treatment accessibility.     

The common sense of counseling psychology: introducing the Common-Sense Model of self-regulation

Abstract

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving clients’ self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage physical health problems, we suggest it may also be useful to understand self-management of mental health problems. The Common-Sense Model’s strengths-based perspective is a natural fit for the work of counseling psychologists. The model has important practical implications for addressing how clients understand mental health problems over the course of treatment and self-manage these problems during and after treatment.     

The Effects of Religiosity on Preferences and Expectations for Marital Therapy Among Married Christians

Highly religious couples constitute a substantial portion of marital therapy clients in the U.S. Married Christian individuals ( N = 211) completed a survey of demographics and religiosity (religious values and Christian beliefs). They rated preferences and expectations for one of four marital therapy situations: Christian therapist using Christian practices (e.g., prayer or reference to Scripture), Christian therapist using psychological practices only, non-Christian therapist willing to use Christian practices, and non-Christian therapist using psychological practices only. High religious values and high Christian beliefs predicted ratings of marital therapy situations, where high was defined as one standard deviation above the mean of standardized norm groups. Low to moderate religious values or Christian beliefs did not predict ratings of marital therapy. It was concluded that highly religious couples present a special situation where the marketing, assessment, and practice of marital therapy might differ from therapy with other types of couples.     

Perceptions of mental healthcare consumers regarding their conditions

Distress is experienced, understood and communicated differently across various cultures. The aim of the study was to investigate the role of culture, religion and spirituality in patients’ understanding of and coping with mental problems. A quantitative survey was done at a psychiatric institution. A questionnaire was designed to explore patients’ cultural and religious beliefs about mental illness, and how these beliefs and perceptions influenced their actions in search for recovery. Questionnaires were completed by 94 patients. The majority of participants were Christian (79.8%), followed by African traditionalists (17.0%). Seventy-two per cent believed that faith in God, and 34.4% that help from religious leaders, could contribute to mental wellness. Approximately a third (29.0%) believed that by keeping their ancestors happy, they would be protected from sickness and bad luck. Mental healthcare providers’ sensitivity to cultural and religious beliefs will translate into a more comprehensive management plan, ensuring a satisfying therapeutic relationship.     

Spontaneous Reports of Religious Coping by Patients with Chronic Physical Illness

Individuals undergoing the stress of physical illness often report the use of religious coping activities. This study compared the frequency of spontaneous reports of religious coping in three groups of patients including those with cancer preparing for a bone marrow transplant (n = 22), chronic pain (n = 36), and cardiovascular disease (n = 53). Participants were asked to respond to a written, open-ended question asking how they were coping with the challenges involved in their medical condition. The question asked them to list the resources, strategies, strengths, or behaviors that they found most helpful. No mention of religion or religious coping was included with the question. Of the 111 participants surveyed, 26.1% included religious coping in their responses. The relative percentage of religious coping was calculated by dividing the total number of coping responses by number of religious responses. Mean percentage of religious coping was highest in participants preparing for a bone marrow transplant (22.9%), followed by the cardiac group (5.7%), and the chronic pain group (3.8%).     

Stigma of mental illness,religious change,and explanatory models of mental illness among Jewish patients at a mental-health clinic in North Jerusalem

During 3 months in 2004, 38 recent referrals to a Community Mental Health Clinic in North Jerusalem, a substantially Ultra-Orthodox Jewish neighborhood, were evaluated by the Explanatory Model Interview Catalogue. This questionnaire, which includes a 13-item scale measuring stigma towards mental illness, was adapted and translated into Hebrew. Patients with a more religious upbringing expressed a greater sense of stigma towards mental illness; however, patients who now had a more religious affiliation did not. The 14 patients who had experienced a religious change toward a more religious affiliation reported a lower level of stigma than the 24 non-returnees. Even when controlling for religious upbringing, the partial correlation between stigma score and religious change was significant. Stigma was lower among younger but not older returnees. Findings from this study support the hypothesis that a stigma of mental illness may be a deterrent to the use of a public mental-health clinic for religious Jews in Israel. Ultra-Orthodox Jewish patients (especially non-Hasidic) used a nonreligious explanatory model (perception and understanding) of mental illness more often than a religious explanatory model. This last finding could reflect a shift in the Ultra-Orthodox Jewish communities from a religious to a more medical and psychological explanatory model.     

The Efficacy of Adult Christian Support Groups in Coping with the Death of a Significant Loved One

Psychologists sometimes minimize important resources such as religion and spiritual beliefs for coping with bereavement. Alienation of therapeutic psychology from religious values contrasts to professional and public interest in religious experience and commitment. A supportive viewpoint has come about partially as a result of recognizing important values which clinicians have found absent in many of their clients. Until spiritual belief systems become integrated into the work of clinicians, clients may not be fully integrative in coping with loss. The key finding of this study was that individuals who participated in Christian and secular support groups showed no statistically significant difference in their mean endorsement of negative criteria on the BHS, and no statistically significant difference for their mean score endorsement of positive criteria on the RCOPE. However, a Christian-oriented approach was no less effective than a psychological-oriented one. In both groups, a spiritual connection to a specific or generalized higher power was frequently identified which clients ascribed to facilitating the management of their coping.     

Experiences of Christian clients in secular psychotherapy: a mixed-methods investigation

Eleven Christian former clients were sampled to uncover factors contributing to positive versus negative experiences in secular psychotherapy. The qualitative results indicated that although many participants felt hesitant to discuss their faith due to uncertainty about their therapists' reactions, positive experiences were reportedly facilitated by therapists' openness to understanding clients' faith and giving clients control over how much, when, and how to discuss their religious beliefs and practices. Dissatisfied clients reported that their therapists expressed opposing religious views or avoided discussing religious or spiritual issues. Participants' self-reports of the working alliance and of their therapists' expertness, attractiveness, and trustworthiness were largely consistent with the narrative data, but the alliance scores were somewhat more sensitive to participants' positive versus negative evaluations of their therapy experience. That is, several participants rated their therapists' personal characteristics quite favorably but indicated poor agreement with their therapists on the goals or tasks of treatment.     

Dimensions of Religion Associated with Suicide Attempt and Suicide Ideation in Depressed,Religiously Affiliated Patients

There is substantial evidence to support the claim that religion can protect against suicide ideation, suicide attempts, and completed suicide. There is also evidence that religion does not always protect against suicidality. More insight is needed into the relationship between suicidal parameters and dimensions of religion. A total of 155 in‐ and outpatients with major depression from a Christian Mental Health Care institution were included. The following religious factors were assessed: religious service attendance, frequency of prayer, religious salience, type of God representation, and moral objections to suicide (MOS). Multiple regression analyses were computed. MOS have a unique and prominent (negative) association with suicide ideation and the lifetime history of suicide attempts, even after controlling for demographic features and severity of depression. The type of God representation is an independent statistical predictor of the severity of suicide ideation. A positive‐supportive God representation is negatively correlated with suicide ideation. A passive‐distressing God representation has a positive correlation with suicide ideation. High MOS and a positive‐supportive God representation in Christian patients with depression are negatively correlated with suicide ideation. Both are likely to be important markers for assessment and further development of therapeutic strategies.     

“Heaven and Hell on Earth” A critical discourse analysis of religious terms in Norwegian autobiographies describing personal experience of mental health problems

This article explores the use of religious terms in six Norwegian autobiographies written between 1925 and 2005 by people who themselves have been patients in the mental health services. Through a critical discourse analysis, we discuss the functions of religious discourse in the texts and its position in contrast to the medical discourse predominant in today's mental health services. It was found that religious (predominantly Christian) terms were used to varying degrees in all autobiographies as a means to capture the immensity and inherent ambivalence characteristic of mental health problems. Despite the “medical turn” in professional mental health discourse, there is no clear evidence of a decrease in the use of religious terms from the oldest to the most recent text. We propose that professional mental health workers to a larger extent take into account the religious dimension in therapy, and reflect on its larger historical and sociocultural context.     

Utilizing Religious Schemas to Cope with Mental Illness

Recent Gallup Polls suggest that 96% of Americans polled believe in God or a universal supreme being (Gallup, 1995). In addition, large percentages of Americans polled report that they pray or believe in miracles. It appears then that religious belief might be a useful coping strategy for those experiencing significant distress or illness. Although much of the research regarding religious coping and illness has focused on physical illness, it seems likely that religious coping would also be useful to those who are experiencing a mental illness. Existing data regarding the use of religious coping and mental illness is discussed, and Daniel McIntosh's theory of religion as a cognitive schema is applied to those suffering severe mental illness.     

Mindfulness,Christian Devotion Meditation,surrender, and worry

This article will present an approach for accommodating the benefits of mindfulness into therapy with Christians struggling with worry. Given the psychological benefits of mindfulness and its connection to spirituality, it is not surprising that both therapists and Christian clients are attempting to incorporate it into counselling. Centering prayer, which is a form of Christian Devotion Meditation, provides an accommodative approach to managing worry for Christian clients. The results of this study indicate that surrender, a key component of centering prayer, provides an empirical link for incorporating the benefits of mindfulness for Christians.     

Centering prayer as an alternative to mindfulness-based cognitive therapy for depression relapse prevention

In the last two decades, mindfulness has made a significant impact on Western secular psychology, as evidenced by several new treatment approaches that utilize mindfulness practices to ameliorate mental illness. Based on Buddhist teachings, mindfulness offers individuals the ability to, among other things, decenter from their thoughts and live in the present moment. As an example, mindfulness-based cognitive therapy (MBCT) teaches decentering and mindfulness techniques to adults in an eight-session group therapy format so as to reduce the likelihood of depression relapse. Yet, some Christian adults may prefer to turn to their own religious heritage, rather than the Buddhist tradition, in order to stave off depression relapse. Thus, the purpose of this article is to present centering prayer, a form of Christian meditation that is rooted in Catholic mysticism, as an alternative treatment for preventing depression relapse in adults. I argue that centering prayer overlaps considerably with MBCT, which makes it a suitable treatment alternative for many Christians in remission from depressive episodes.     

Therapists' Use of Religious and Spiritual Interventions in Christian Counseling: A Preliminary Report

This study explored the use of religious and spiritual interventions in counseling by Christian therapists (N = 100). Use of religious and spiritual interventions correlated with personal religiousness and clinical training involving religious clients and religious and spiritual interventions. Course work involving either psychology or theology did not correlate with use of or self‐reported competency in using religious and spiritual interventions. Self‐reported competency was associated with personal religiousness; professional beliefs, attitudes, and values; personal experiences with counseling; and clinical training involving religious clients and religious and spiritual interventions. It is suggested that training programs incorporate clinical rotations, workshops, and supervision involving religious clients and religious and spiritual interventions to teach therapists to use religious and spiritual interventions in counseling.     

How to Talk to Christian Clients About Their Spiritual Lives: Insights From Postmodern Family Therapy

Responding to literature calling for the integration of Christian spirituality and postmodern thinking, this article presents a more specific discussion of how postmodern family therapy approaches can be used to open therapy to the spiritual lives of Christian clients. In this article, postmodern family therapy approaches are described and the compatibility of postmodern family therapies and Christian thinking are examined. Finally, we see how a clinical practice based upon postmodern ideas can provide pastoral counselors with useful tools for talking with Christian clients about their spiritual lives. P. Gregg Blanton is Professor of Human Services at Montreat College. He is affiliated with the Pastoral Counseling and Growth Center in Asheville, NC.     

A narrative of my passion: Discovering spiritual gifts through a journey of physical illness

This essay is a reflection on the various insights gleamed from a physical illness. The author reflects upon her experiences, in light of the religious, theological, and spiritual perspectives of her Christian faith.     

Social Mishap Exposures for Social Anxiety Disorder: An Important Treatment Ingredient

Conventional cognitive-behavioral therapy for social anxiety disorder, which is closely based on the treatment for depression, has been shown to be effective in numerous randomized placebo-controlled trials. Although this intervention is more effective than waitlist control group and placebo conditions, a considerable number of clients do not respond to this approach. Newer approaches include techniques specifically tailored to this particular population. One of these techniques, social mishap exposure practice, is associated with significant improvement in treatment gains. We will describe here the theoretical framework for social mishap exposures that addresses the client's exaggerated estimation of social cost. We will then present clinical observations and outcome data of a client who underwent treatment that included such social mishap exposures. Findings are discussed in the context of treatment implications and directions for future research.