Spiritual coaching in cancer patients: treating the spirit as well as the disease

Interest in the exploration of spirituality in medical practice has been growing recently due to some studies suggesting its role in the improvement of patient well-being and quality of life. This project examined the feasibility of providing spiritual coaching with patients in an outpatient Radiation Oncology clinic setting. The purpose of spiritual coaching was to provide patients with opportunities to explore their current spiritual lives, increase their involvement in spiritually enhancing activities, and expand their spiritual opportunities. Quality-of-life measurements focused on feelings of hopefulness and distress were used in patients undergoing radiation treatment for cancer. This study suggests that there is a potential benefit for spiritual coaching in the care of cancer patients, and future studies will be done to further el ucidate the ationship of spirituality and quality of life in this population.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Early trauma and serious mental illness: what role does spirituality play?

For many who experience serious mental illness, spirituality and religion can be common vehicles that provide a sense of coherence and meaning to life. However, in the presence of early trauma, spiritual and religious beliefs may be enhanced or destroyed, or never develop. This paper explores the relationship between spirituality/religion, early trauma, and serious mental illness. Three case examples from a qualitative phenomenological study are presented to illustrate spiritual and religious struggles that can arise and how a person can work through these over time to use spirituality and religion as positive resources for recovery. Tentative implications for practice are offered.     

Spiritual Bypass: A Preliminary Investigation

The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to influence depression and anxiety among college students. Results suggested that mindfulness and alexithymia accounted for variance in depression beyond what is accounted for by spirituality and that all 3 factors (mindfulness, alexithymia, and narcissism) accounted for variance in anxiety beyond what is accounted for by spirituality. Implications for counselors are provided.     

The Impact of a Breast Cancer Diagnosis on Religious/Spiritual Beliefs and Practices in the UK

The use of religious/spiritual resources may increase when dealing with the stress of a cancer diagnosis. However, there has been very little research conducted into changes in religious/spiritual beliefs and practices as a result of a cancer diagnosis outside the USA. The aim of this study was to examine the impact of a breast cancer diagnosis on patients’ religious/spiritual beliefs and practices in the UK where religious practice is different. The study used two methods. One compared the religious/spiritual beliefs and practices of 202 patients newly diagnosed with breast cancer with those of a control group of healthy women (n = 110). The other examined patients’ perceived change in religious/spiritual beliefs and practices at the time of surgery with those in the year prior to surgery. The aspects of religiousness/spirituality assessed were: levels of religiosity/spirituality, strength of faith, belief in God as well as private and public practices. Patient’s perceived their belief in God, strength of faith and private religious/spiritual practices to have significantly increased shortly after surgery compared with the year prior to surgery. However, there were no significant differences in religious/spiritual beliefs and practices between patients and healthy participants. Change scores demonstrated both a reduction and an increase in religious/spiritual beliefs and practices. Although belief in God, strength of faith and private religious/spiritual practices were perceived by patients to be significantly higher after their cancer diagnosis, no significant differences in religious/spiritual beliefs and practices were found between the cancer group at the time of surgery and the control group. Different methodologies appear to produce different results and may explain contradictions in past US studies. Limitations of this study are discussed and suggestions for future research are made.     

Religious Practice and Spirituality in the Psychological Adjustment of Survivors of Breast Cancer

Religion and spirituality are resources regularly used by patients with cancer coping with diagnosis and treatment, yet there is little research that examines these factors separately. This study investigated the relationships between religious practice and spirituality and quality of life (QoL) and stress in survivors of breast cancer. The sample included 130 women assessed 2 years following diagnosis. Using hierarchical multiple regression analysis, the authors found that spiritual well‐being was significantly associated with QoL and traumatic stress, whereas religious practice was not significantly associated with these variables. The results suggest that it may be helpful for clinicians to address spirituality, in particular with survivors of breast cancer.     

Talking about Spirituality in the Clinical Setting: Can Being Professional Require Being Personal?

Spirituality or religion often presents as a foreign element to the clinical environment, and its language and reasoning can be a source of conflict there. As a result, the use of spirituality or religion by patients and families seems to be a solicitation that is destined to be unanswered and seems to open a distance between those who speak this language and those who do not. I argue that there are two promising approaches for engaging such language and helping patients and their families to productively engage in the decision-making process. First, patient-centered interviewing techniques can be employed to explore the patient's religious or spiritual beliefs and successfully translate them into choices. Second, and more radically, I suggest that in some more recalcitrant conflicts regarding treatment plans, resolution may require that clinicians become more involved, personally engaging in discussion and disclosure of religious and spiritual worldviews. I believe that both these approaches are supported by rich models of informed consent such as the transparency model and identify considerations and circumstances that can justify such personal disclosures. I conclude by offering some considerations for curbing potential unprofessional excesses or abuses in discussing spirituality and religion with patients.     

Talking about spirituality in the clinical setting: can being professional require being personal?

Spirituality or religion often presents as a foreign element to the clinical environment, and its language and reasoning can be a source of conflict there. As a result, the use of spirituality or religion by patients and families seems to be a solicitation that is destined to be unanswered and seems to open a distance between those who speak this language and those who do not. I argue that there are two promising approaches for engaging such language and helping patients and their families to productively engage in the decision-making process. First, patient-centered interviewing techniques can be employed to explore the patient's religious or spiritual beliefs and successfully translate them into choices. Second, and more radically, I suggest that in some more recalcitrant conflicts regarding treatment plans, resolution may require that clinicians become more involved, personally engaging in discussion and disclosure of religious and spiritual worldviews. I believe that both these approaches are supported by rich models of informed consent such as the transparency model and identify considerations and circumstances that can justify such personal disclosures. I conclude by offering some considerations for curbing potential unprofessional excesses or abuses in discussing spirituality and religion with patients.     

An Exploratory Study of HIV+ Adolescents’ Spirituality: Will You Pray with Me?

The aims of the study were (1) to determine whether adolescents find it acceptable to have physicians explore their spiritual beliefs as part of their medical care, (2) to characterize the role of spirituality and religious beliefs in adolescents with and without HIV, and (3) to examine associations between spirituality/religion and quality of life. Adolescents receiving their medical care at an urban Adolescent Health Clinic completed a study-specific questionnaire about spiritual inquiry by their physician, the Brief Multidimensional Measurement of Religiousness/Spirituality, and the Pediatric Quality of Life Inventory 4.0. Chi-squared analysis, Fischer’s exact test, and t tests were used to assess associations. A total of 45 participants enrolled: 19 HIV+ (53% vertical transmission) and 26 HIV?; mean age 17.2 years; 80% African American. Four out of 45 (9%) had ever been asked by their doctor about their spiritual/religious beliefs, and only 8 (18%) had ever shared these beliefs with their healthcare provider. Most teens wanted their provider to ask them about their spiritual beliefs during some visits, especially when dealing with death/dying or chronic illness (67%). Those with HIV were more likely to endorse wanting their doctors to pray with them (42% vs. 15%), feeling “God’s presence” (Mean = 3.95 vs. 2.83), being “part of a larger force” (Mean = 2.58 vs. 1.69), and feeling “God had abandoned them” (Mean = 1.63 vs. 1.15). There are certain circumstances in which healthcare providers should include a spiritual history with teenage patients. Few differences emerged in the teens studied with and without HIV.     

Introducing Spirituality into Psychiatric Care

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of teaching hospitals. In order to develop this potential area of improved care, we (1) evaluated the differential attitudes of patients and psychiatric trainees toward the value of spirituality in the recovery process, (2) established a program of group meetings conducted by psychiatric residents and staff where patients can discuss how to draw on their spirituality in coping with their problems, and (3) established related training experiences for psychiatric residents. The results and implications of these three initiatives are presented.     

Manic depression and religious experience: The use of religion in therapy

In the article, I explore the use of spiritual strategies in the treatment of manic depression in religiously oriented psychiatric inpatients. Manic depression, a disorder primarily of mood, is characterized by bouts of mania alternating with depression. Religious themes and mystical experiences pervade the language of manic depressive illness, e.g., sensing one is God, being given a divine mission, receiving divine messages, having ecstatic experiences, and so on. Debate exists concerning the effectiveness of spiritual interventions in manic patients. I suggest that a trained religious leader may be able to work therapeutically with such patients, provided that two goals are kept in mind: emphasizing beliefs that facilitate positive coping and challenging irrational religious beliefs (i.e., beliefs that lead to negative coping). When examined psychoanalytically, patients’ religious symbols and beliefs reveal deeply held beliefs about themselves. In particular, splitting and idealization and devaluation can be seen in their religious belief system. The role of culture in promoting maladaptive belief systems must not be overlooked. In employing spiritual interventions in patients diagnosed with manic depression, potential dangers are imposing one's values on patients and overstating the importance of spirituality.     

The Oneness Beliefs Scale: Connecting Spirituality with Pro‐Environmental Behavior

The inherent unity of all phenomena, or oneness, is a central concept of mysticism, but there have heretofore been no measures of oneness beliefs. We developed the Oneness Beliefs Scale, with spiritual and physical oneness subscales. The spiritual oneness subscale fills a need in the field for a short, reliable measure of spirituality not characterized by the language of traditional Western religiousness. The physical oneness subscale allows researchers to juxtapose spiritual beliefs with a nonspiritual, materialist counterpart. We found that spiritual oneness beliefs were more strongly related to mystic experiences and spirituality than to traditional religiousness. Physical oneness was not strongly associated with either religiousness or spirituality. Both spiritual and physical oneness were positively associated with pro‐environmental attitudes but not with depression, anxiety, or negative affect. Spiritual oneness was a better predictor of pro‐environmental attitudes than was religiousness. Spiritual oneness also predicted donating to a pro‐environmental group, making this to our knowledge the first empirical study to show a positive association between a religion or spirituality measure and observed, rather than self‐reported, pro‐environmental behavior.     

Law and grace in Saint Augustine: a fresh perspective on mindfulness and spirituality in behaviour therapy

The secular, acceptance-based philosophy of third wave behaviour therapy has easily absorbed the notion of mindfulness that originated in Eastern spirituality, entailing a secularised approach to transcendence. The present article seeks to connect mindfulness with existing efforts to integrate the Western client's spirituality into psychotherapy. For that purpose, we show how Christian grace theology and mindfulness theory overlap in the way they construe transcendence and self. Both approaches enhance openness to experience and deemphasise verbal control as a tool for personal progress. It is argued that awareness of this overlap can make it easier for the therapist to understand and appreciate the client's religious perspective. It can also help turn a client's spirituality into a relevant personal strength for therapy. Finally, explaining the overlap can enhance the credibility of mindfulness interventions with traditional Christian clients and make these interventions relevant to their spiritual concerns.     

The Relationship of Religiosity and Spirituality to Quality of Life Among Cancer Patients

Most quality of life (QOL) assessments measure patients’ emotional well-being, functional well-being, interpersonal/social well-being, and satisfaction with treatment. Little attention has been given to patients’ spirituality or religiosity. Further, studies that have examined the impact of spirituality or religiosity on QOL have not differentiated between the constructs. The purpose of this study was to examine religiosity and spirituality as separate variables, and to define their relationship to QOL for 61 persons with cancer. Regression analyses indicated that, while spirituality and religiosity are moderately intercorrelated, spirituality has a stronger relationship with QOL than religiosity. When attempting to understand a person's spiritual life and its impact on QOL, there is a need for clear distinction between and separate assessment of spirituality and religiosity.     

A Model of Spirituality for Ageing Muslims

Spirituality’s influence on general well-being and its association with healthy ageing has been studied extensively. However, a different perspective has to be brought in when dealing with spirituality issues of ageing Muslims. Central to this perspective is the intertwining of religion and spirituality in Islam. This article will contribute to the understanding of the nature of Islamic spirituality and its immense importance in the life of a practicing ageing Muslim. Consequently, it will help care providers to include appropriate spiritual care in the care repertoire of a Muslim care recipient. It is assumed that the framework for a model of spirituality based on Islamic religious beliefs would help contextualise the relationship between spirituality and ageing Muslims. Not only challenges, but also the opportunities that old age provides for charting the spiritual journey have underpinned this model.     

Spirituality and Dream Work in Counseling: Clients’ Experiences

The authors suggest that focusing on dreams in counseling may be a useful framework to explore clients’ spiritual values and beliefs. Because little is known about how spirituality and dream work are integrated in practice, the purpose of this article is to document how some counselors and clients work on spirituality and dreams. Responses of clients who focused on dreams from a spiritual perspective are described and discussed. Relevant clinical issues that counselors may encounter are identified. Recommendations are made for counselors who wish to integrate spirituality and dream work in counseling.An earlier version of this article was presented at the Semi-Annual Meeting of the Association of Mormon Counselors and Psychotherapists, Salt Lake City, Utah, April 2004.     

Transforming Spirituality in Artistic Leisure: How the Spiritual Meaning of Belly Dance Changes Over Time

Studies show that different dimensions of religiosity change throughout the life course. Yet, we have little information about how spirituality that some people experience outside of formal religious organizations may change. The purpose of this study is to examine how spirituality associated with artistic leisure may emerge or decline over time. Drawing from two waves of semistructured qualitative interviews conducted five years apart, I examine how the spirituality dancers associate with belly dance changes over time and factors associated with those transformations. Rather than emerging, findings show that whether dancers instill belly dance with spirituality remains stable or decreases. Furthermore, much of the decrease in the spiritual meaning that dancers link to belly dance can be understood in the context of their changing involvement in the dance, different meanings they attach to belly dance, revisiting their personal beliefs about spirituality, and expanding their spiritual outlets.     

State education,spirituality, and culture: teachers’ personal and professional stories of negotiating the nexus

This paper explores the implications of spirituality for teaching and learning in multicultural state schools through the examination of several teachers’ personal and professional narratives. In attempting to capture the intangible, these narratives provide insights into the possibilities, both conscious and unconscious, of creating a climate that fosters spirituality. The classroom stories of a spiritual nature that the teachers recounted (while many and varied) revealed some common themes that related to the climate of the classrooms. Sensitive issues of faith, beliefs, and culture emerged and the teachers’ narratives illustrate ways in which inclusive communities can be fostered. The paper provides examples of cultural and social inclusiveness with a focus on two major themes: the relationship between life and death, and fostering a sense of belonging.     

Spirituality and Its Relationship with Personality in Depressed People: Preliminary Findings

The relationship between spirituality and personality in patients with depression is complex and not much explored. The aim of our study is to examine the interconnection between the spiritual quality of life (QoL) and Cloninger’s psychobiological model of personality in patients with depression. The sample consisted of 85 consecutive outpatients treated for depression. The measurements used were: Beck Depression Inventory, WHO-Quality of Life-Spiritual, Religious, Personal Beliefs, and Temperament and Character Inventory. The results have shown that higher harm avoidance, lower self-directedness and lower cooperativeness are personality dimensions associated with depression. The spiritual QoL has showed to play a significant role in depression, just as it has proved to be a unique predictor of lower depressive symptoms, adjusted for personality dimensions. The spiritual QoL itself is predicted by personality dimensions, self-directedness and self-transcendence implying that spirituality is a broader construct than the character dimension. Our findings may contribute to a more comprehensive understanding of depression, spirituality and personality.