Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice

Book reviewed in this article: Craig S. Cashwell and J. Scott Young, Eds. (2005). Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice.     

Incorporating Religion/Spirituality Into Treatment for Serious Mental Illness

This paper examines whether religion and spirituality (R/S) should be incorporated into treatment for patients with serious mental illness. This question merits attention, especially in light of the strong presence of R/S in the United States and, in particular, among members of ethnic minorities. While the literature is somewhat mixed, prior research supports the view that incorporating adaptive R/S elements into treatment for patients with serious mental illness is beneficial, particularly for patients who do not exhibit severe psychotic symptoms. Drawing from our experiences in developing a family-focused Culturally-Informed Therapy for Schizophrenia (CIT-S), we will also highlight the importance of addressing spiritual issues within minority populations. In the second half of this paper, we will present several case illustrations of how R/S issues were used in CIT-S to help patients make sense of adverse situations and obtain much-needed support and coping resources outside the treatment room. Findings from this study indicate that religion and spirituality can often be incorporated into treatment in a way that coalesces with patients’ values and enhances treatment gains. Future research should investigate how therapists’ own R/S values interact with those of their clients, and whether congruency in R/S values has any impact on treatment efficacy.     

A Review of Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice

Book reviewed in this article: Craig S. Cashwell and J. Scott Young, Eds. (2005). Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

Integrating Religion and Spirituality in Marriage and Family Counseling

In the fields of counseling and psychology, interest in religious and spiritual issues is expanding. The authors examined integrating religion and spirituality with marriage and family counseling. They explored potential obstacles and negative consequences for this integration, as well as clinical implications. The positive impact of incorporating a religious or spiritual perspective into clinical practice is discussed. Ethical considerations, techniques, and strategies are presented.     

The Ways Paradigm: A Transtheoretical Model for Integrating Spirituality Into Counseling

Research suggests that an emphasis on spirituality and religion in counseling has increased awareness but not translated into changes in practice. The authors contend that part of this challenge is the lack of a broad, heuristic model for integration that seeks to embrace the complex, fluid, and negotiated nature of spirituality and religion. Cheston's ( 2000a ) Ways Paradigm for teaching counseling theory provides such a model, leading to new perspectives on counselor education, research, and practice.     

Acceptance and Commitment Therapy for Anxiety Disorders: Three Case Studies Exemplifying a Unified Treatment Protocol

Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance––attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre- and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre- to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.     

Integrating Spirituality and Domestic Violence Treatment

Summary

This article provides a brief reflection on how the Change of Seasons treatment model developed and the reasons for its success with Aboriginal men. Parallels between Aboriginal perspectives, or worldviews, and Ken Wilber's transpersonal psychology, Rupert Sheldrake's fields theory, and Peter Senge's systems thinking are also discussed. Practical rituals and ceremonies that have been successfully integrated into psychoeducational group counselling as practiced in the Change of Seasons model are explained. These musings are included to initiate further dialogue on holistic approaches to counselling and other community initiatives.     

Integrating Spirituality Into Counselor Preparation: A Developmental,Wellness Approach

Recent surveys of the general public and of counseling professionals suggest the pervasive importance of spirituality in the lives of all individuals. Yet, the infusion of spirituality in counselor preparation programs continues to be a concern. Incorporating spirituality within a wellness paradigm can help counselors and counselor educators value and address spirituality as an integral component of optimum human functioning. By distinguishing between religiosity and spirituality and operationally conceptualizing spirituality as a life span developmental phenomenon that is essential for achieving wellness, counselor educators can more readily incorporate spiritual issues within the philosophy of the counseling profession.     

The Relationship between Medicine,Spirituality and Religion: Three Models for Integration

The integration of medicine and religion is challenging for historical, ethical, practical and conceptual reasons. In order to make more explicit the bases and goals of relating spirituality and medicine, we distinguish here three complementary perspectives: a whole-person care model that emphasizes teamwork among generalists and spiritual professionals; an existential functioning view that identifies a role for the clinician in promoting full health, including spiritual well-being; and an open pluralism view, which highlights the importance of differing spiritual and cultural traditions in shaping the relationship.     

Spirituality and Religion: Implications for Counselors

In recent years, the topics of spirituality and religion have become more evident in the counseling literature. It seems logical that these areas could be of great interest to those in the counseling profession. This article summarizes W. R. Miller and C. E. Thoresen's (2003) overview of the field of research dealing with spirituality, religion, and health. Possible roles for spirituality and religion in counselor education and school counseling are highlighted.     

Religion and Spirituality in Quality of Life Studies

The authors present their views on the current state of the art for research focused upon religion/spirituality and quality of life. Because of the undeniable influence of religion and spirituality at the macro-level of cultures, the internal and external worlds of individuals embedded in any culture are touched by religion and spirituality – even for individuals who deny any religious affiliation or beliefs. Religion and spirituality has already attracted attention from QOL researchers across a wide set of disciplines and should continue to do so in the future. The authors discuss approaches, topics and methodological issues that should be considered when researching religion/spirituality and QOL. Recommendations for future research are set in italics.     

Examining College Counselors' Integration of Religion and Spirituality Into Substance Abuse Counseling

The authors explored college counselors' (N = 77) integration of religion and spirituality into substance abuse counseling. Results indicated a discrepancy between the importance ratings of religion and spirituality and the frequency of using such elements in counseling practice.     

Religion, Spirituality and Therapy: Implications for Training

Religion and spirituality are recognized coping resources but are neglected in psychological training and practice. However, religion and spirituality can be successfully used to cope with psychological disorders, prevent unhealthy behaviors and promote resilience. This study explored and described two questions regarding the concepts of the terminology religion and spirituality, and the perceptions of the use of religion and spirituality in therapy. Purposive sampling was utilized in a qualitative study of 15 registered psychologists, and data were analyzed using Tesch’s model of qualitative content analysis. The concepts religion and spirituality appear difficult to define but the importance of their use as coping mechanisms in their own and their clients’ lives was recognized. These findings have implications for professional training.     

Application of Problem Solving Therapy for Late-Life Anxiety

Cognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.     

Cognitive-Behavioral Treatment of Men and Anger: Three Single Case Studies

The treatment of men with anger problems presents significant challenges for practitioners. This article discusses a cognitive-behavioral, individual therapy, approach within the framework of three single case studies involving men. Treatment challenges and methodology are presented. Key treatment issues included: establishing a therapeutic relationship; facilitating understanding of the cognitive basis of anger; and addressing male-role socialization messages and male-identity schema that contributed to the experience and expression of anger in these men. Limitations relative to the small sample (n = 3) and the lack of a randomized control group preclude any definitive statements regarding the effectiveness or generalizability of the intervention. Nevertheless, the study highlights important theoretical and practical concerns for practitioners and future researchers to consider when working with men and anger.     

Spirituality and Well-Being in Old Age: Exploring the Dimensions of Spirituality in Relation to Late-Life Functioning

A growing body of research connects spirituality with positive late-life functioning. In this research, spirituality is often approached as a single measure in relation to well-being, neglecting its complex nature. Therefore, this study explores whether different dimensions of spirituality contribute uniquely to psychological well-being in advanced age. Results indicated that well-being was positively predicted by spirituality experienced through connectedness with the transcendent and through connectedness with others. Spirituality experienced through connectedness with nature did not predict well-being. These findings highlight the unique influence of each spirituality dimension on well-being as well as the need for a multidimensional approach.