Patterns of conversation between clergy and their parishioners and referral to other professionals

Clergy deal with mental and physical health care issues as well as spiritual concerns within their congregations. Collaboration with psychotherapists and physicians could be argued to be "best practice" by clergy, but little is known about how clergy collaborate, particularly in non-hospital settings. This study describes reported practice patterns of referral by clergy in the context of their conversations with parishioners. Clergy report that parishioners regularly express psychosocial and medical concerns to them, and clergy also initiate these conversations. Clergy refer to medical providers and psychotherapist 23% of the time, and these referrals are found to be helpful, even though the professionals rarely connect with each other. Physicians and psychotherapists report they refer to clergy 10% and 24% of the time, respectively, and often find these referrals helpful. Further research is needed to understand the barriers and bridges to collaboration between professionals in different domains of care.     

Intensive OutPatient Therapy for Clergy Burnout: How Much Difference Can a Week Make?

A pre-test and post-test quasi-experimental matched pairs design was used to assess the effectiveness of a week-long multi-therapist intensive outpatient intervention process with clergy suffering from depression and burnout. Participants (n = 23) in the “Clergy in Kairos” program of the Pastoral Institute (Muse in J Pastor Care Couns 61(3):183–195, 2007) constituted the experimental variable. Clergy surveyed from United Methodist and Presbyterian denominations (n = 121) provided a control group from which 23 respondents were selected whose pre-test scores in depression and burnout were statistically equivalent to those in the experimental group. The treatment group consisted of clergy from three denominations who self-selected (or in some cases were referred by denominational officials) into the program. At the outset, clergy in both groups reported equivalent levels of conflict, emotional exhaustion, depersonalization, and depression. At the 6-months follow-up, clergy in the experimental group showed significant improvement of depression, emotional exhaustion, and depersonalization scores. By contrast, there was no change in the burnout and depression scores in the control group at 6-months post-test. Findings suggest the usefulness of a week-long multi-therapist intensive outpatient intervention in reducing burnout and depression.     

Negotiating the Cultural Steps in Developing an Online Intervention for Korean American Intimate Partner Violence

Korean American (KA) immigrants experiencing intimate partner violence (IPV) underutilize existing services, but instead rely on KA clergy for assistance. However, there had not yet been an intervention curriculum developed for KA clergy to help them address IPV in their congregations. There was a lack of understanding regarding what needed to be included in an intervention curriculum for KA clergy, as well as the most effective form of curriculum design and delivery for such an intervention. This article discusses the process of developing an online IPV intervention curriculum for KA clergy to increase their capacity for IPV prevention and intervention within their congregations. Researchers developed Korean Clergy for Healthy Families by incorporating feedback from expert consultants and engaging study participants. The result is an IPV curriculum that speaks to participants’ cultural values and religious beliefs, and identifies barriers KA clergy experience when confronted with IPV. Specific steps to assist those who would want to develop culturally appropriate interventions are provided.     

Woman battering: The response of the clergy

This paper examines the response of the church and the clergy to the problem of woman battering. A critical review of the theological foundations which may or may not contribute to violence directed toward females is presented. The research examining the response of the clergy to battered women is reviewed. Clergy report being confronted with the problem of woman battering and experiencing much difficulty in handling situations of this nature. In a study conducted by the authors, traditional attitudes were reflected by some modern day clergy; several clerical responses included female-blaming statements. More progressive clergy in this and other studies recognized woman battering as unacceptable; some are even studying ways to more effectively handle woman battering situations. A series of recommendations are included.Summary of Master's Thesis, Indiana University of PA, Indiana, PA 15705.     

A Classroom-Based Physical Activity Intervention for Elementary Student On-Task Behavior

Few youths engage in the recommended amount of physical activity (PA). Many educators have concerns about increasing PA in schools, including taking time from academics, though studies show that school-based PA can be beneficial to academics. This study extends previous research on the relationship between school-based PA and time on task (TOT) by engaging students in teacher-led PA breaks in the classroom and observing students' on-task behavior for a longer period than previous studies. A third-grade class of 23 students from a rural New England public school was observed as part of a single-subject withdrawal design study. The class, therefore, served as its own control. Student on-task behavior was observed for 45 min following both inactive and active conditions using systematic direct observation procedures. The intervention consisted of 10 min of whole-body movement: 1–2 min of warm-ups, 6–8 min of moderate PA, and 1–2 min of cool-downs. Multiple measures of effect indicate that simple, 10-min, breaks for PA can improve TOT rates among elementary students. This study supports the use of brief breaks for PA to improve student TOT while also indicating that the effects persist for at least 45 min. This is valuable to educators who wish to increase TOT with a simple classroom intervention and for those who wish to help students meet the recommended amount of daily PA.     

The Clergy Occupational Distress Index (CODI): Background and Findings from Two Samples of Clergy

This study demonstrates the reliability and validity of the Clergy Occupational Distress Index (CODI). The five-item index allows researchers to measure the frequency that clergy, who traditionally have not been the subject of occupational health studies, experience occupational distress. We assess the reliability and validity of the index using two samples of clergy: a nationally representative sample of clergy and a sample of clergy from nine Protestant denominations. Exploratory factor analysis and Cronbach’s scores are generated. Construct validity is measured by examining the association between CODI scores and depressive symptoms while controlling for demographic, ministerial, and health variables. In both samples, the five items of the CODI load onto a single factor and the Cronbach’s alpha scores are robust. The regression model indicates that a high score on the CODI (i.e., more frequent occupational distress) is positively associated with having depressive symptoms within the last 4 weeks. The CODI can be used to identify clergy who frequently experience occupational distress and to understand how occupational distress affects clergy’s health, ministerial career, and the functioning of their congregation.     

Clergy Burnout: A Comparison Study with Other Helping Professions

Clergy experience a large number of stressors in their work, including role overload and emotional labor. Although studies have found high rates of depression in clergy, the degree of work-related burnout in clergy compared to other occupations is unknown. The widely used Maslach Burnout Inventory (MBI) measures three aspects of burnout: emotional exhaustion, depersonalization, and personal accomplishment. We sought studies using comparable versions of the MBI for clergy; for social workers, counselors, and teachers because of those occupations’ emotional intensity and labor; and for police and emergency personnel because of the unpredictability and stress-related physiological arousal in those occupations. We found a total of 84 studies and compared the ranges of burnout scores between the studies of clergy, each additional occupation, and MBI published mean norms. Compared to U.S. norms, clergy exhibited moderate rates of burnout. Across the three kinds of burnout, clergy scores were relatively better than those of police and emergency personnel, similar to those of social workers and teachers, and worse than those of counselors. Clergy may benefit from burnout prevention strategies used by counselors. The moderate levels of burnout found for clergy, despite the numerous stressors associated with their occupation, suggest that clergy generally cope well and may be models to study. Overall, there is room for improvement in burnout for all professions, especially police and emergency personnel. It is important to remember the variation within any profession, including clergy, and prevent and address burnout for those in need.     

Minnesota clergy’s attitudes on suicide prevention and likelihood to inquire about suicidal thoughts and intent

Clergy are a recognised profession for suicide prevention and intervention in the United States. The current objective was to determine if clergy’s suicide prevention training, perceived roles in suicide prevention, and suicide prevention self-efficacy predicted likelihood to inquire about suicidal thoughts and intent. Among 367 Minnesota clergy surveyed, 30% reported a suicide in their congregation in the past year, and about one-third reported adequate training in suicide intervention strategies. The majority (85%) reported it was their role to provide education on suicide and mental health to their congregations, although 32% reported no or low ability to do so. Most (70%) stated, if concerned about a parishioner’s mental health, they would inquire about suicidal thoughts, but fewer (59%) stated they would inquire about suicidal intent. Significant, but weak, predictors of likelihood to inquire about suicide included self-efficacy and perceived role. Clergy could benefit from suicide prevention education, training, and support.     

Professional boundary violations and mentalizing in the clergy

In a national study, 25% of help-seekers contacted clergy; suicidal behavior was one of the significant predictors for making contact. Clergy have been found to refer 10% of help-seekers to mental health providers. This qualitative study explored the referral practices of 15 northeastern Mainline and Evangelical Protestant clergy when contacted by suicidal individuals; all referred to mental health providers. Participants reported low confidence with risk identification and provided moving examples of pastoral care.     

Physical Health Functioning Among United Methodist Clergy

United Methodist clergy have been found to have higher than average self-reported rates of obesity, diabetes, asthma, arthritis, and high blood pressure. However, health diagnoses differ from physical health functioning, which indicates how much health problems interfere with activities of daily living. Ninety-five percent (n = 1726) of all actively serving United Methodist clergy in North Carolina completed the SF-12, a measure of physical health functioning that has US norms based on self-administered survey data. Sixty-two percent (n = 1074) of our sample completed the SF-12 by self-administered formats. We used mean difference tests among self-administered clergy surveys to compare the clergy SF-12 Physical Composite Scores to US-normed scores. Clergy reported significantly better physical health composite scores than their gender- and age-matched peers, despite above average disease burden in the same sample. Although health interventions tailored to clergy that address chronic disease are urgently needed, it may be difficult to elicit participation given pastors’ optimistic view of their physical health functioning.     

A brief intervention to increase physical activity behavior among adolescents using mental simulations and action planning

This study evaluated the effectiveness of a brief integrated theory-based intervention to increase physical activity (PA) among adolescents over a three-month follow-up period. A 2 (mental simulation: present vs. absent) × 2 (action planning: present vs. absent) × 4 (time: baseline vs. one-month vs. two-month vs. three-month follow-up) mixed-model randomized controlled design was adopted. Adolescents aged 14–15 years (N = 267) completed baseline psychological measures and self-reported PA followed by the relevant intervention manipulation, if appropriate, with follow-up measures collected one, two, and three months later. Results revealed no significant effects for the mental simulation and action planning strategies nor the interaction of the two strategies. However, among participants with low levels of baseline PA, participants in both mental simulation alone and action planning alone groups reported significantly higher levels of PA at one-month follow up than other groups, suggesting that individual intervention components may be effective in low-active adolescents.     

The Glory of God is a Human Being Fully Alive: Predictors of Positive Versus Negative Mental Health Among Clergy

Clergy fulfill vital societal functions as meaning makers and community builders. Partly because of their important roles, clergy frequently encounter stressful situations. Further, studies suggest that clergy experience high rates of depression. Despite this, few studies have examined protective factors for clergy that may increase their positive mental health. We invited all United Methodist clergy in North Carolina to participate in a survey. Of church‐serving clergy, 85 percent responded (n = 1,476). Hierarchical multiple regression was used to assess the predictors of three positive and four negative mental health outcomes. The three sets of predictors were: demographics, which explained 2–10 percent of the variances; variables typically related to mental health (social support, social isolation, and financial stress), which explained 14–41 percent of the variances; and clergy‐specific variables, which explained 14–20 percent of the variances, indicating the importance of measuring occupation‐specific variables. Some variables (e.g., congregation demands) significantly related to both positive and negative mental health, whereas others (e.g., positive congregations, congregation support) significantly related primarily to positive mental health. In addition to their intervention implications, these findings support separate consideration for negative versus positive mental health.     

Parent Programs for Reducing Adolescent’s Antisocial Behavior and Substance Use: A Randomized Controlled Trial

Two theoretically based parent training programs, delivered in real-world settings by the social services, were examined in this randomized controlled trial for effectiveness in reducing adolescents’ antisocial behavior and substance use. Two hundred and thirty-seven (237) adolescents in ages between 12 and 18 and their parents were assigned to one of two programs or to a wait-list control condition. The programs were the nine weekly group sessions program Comet 12–18 (Swedish Parent Management Training Program) and the six weekly ParentSteps (Swedish shortened version by Strengthening Families Program 10–14). Outcome measures were antisocial behavior, substance use, and delinquency, and psychosocial dysfunction. Data based on adolescents’ and parents’ ratings of the adolescents’ problem behavior at baseline and 6 months later were analyzed with repeated measures ANVOA, Logistic regression, and Kruskal–Wallis H test. The results showed that parents’ ratings of adolescents’ antisocial behaviors decreased significantly over time, but no time by group effect emerged. No program effects were found in the adolescents’ self-reported antisocial behavior, delinquency, or psychosocial functioning. A threefold risk of illicit drug use was found in both intervention groups. The results suggest that neither Comet nor ParentSteps had beneficial effects on adolescent’s antisocial or delinquent behavior, or on alcohol use. The only significant group difference found was a threefold risk of drug use in the intervention adolescents at follow-up, but for several reasons this finding should be interpreted with caution. Trial registration number: ISRCTN76141538.     

The Life of Leaders: An Intensive Health Program for Clergy

Clergy suffer from chronic disease rates that are higher than those of non-clergy. Health interventions for clergy are needed, and some exist, although none to date have been described in the literature. Life of Leaders is a clergy health intervention designed with particular attention to the lifestyle and beliefs of United Methodist clergy, directed by Methodist LeBonheur Healthcare Center of Excellence in Faith and Health. It consists of a two-day retreat of a comprehensive executive physical and leadership development process. Its guiding principles include a focus on personal assets, multi-disciplinary, integrated care, and an emphasis on the contexts of ministry for the poor and community leadership. Consistent with calls to intervene on clergy health across multiple ecological levels, Life of Leaders intervenes at the individual and interpersonal levels, with potential for congregational and religious denominational change. Persons wishing to improve the health of clergy may wish to implement Life of Leaders or borrow from its guiding principles.     

A self-regulation-based intervention to increase physical activity in cancer patients

The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ²(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise intervention emphasizing self-regulation, but also from stress management, regarding both reducing stress and increasing PA.     

Testing social-cognitive mediators for objective estimates of physical activity from the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study

Objective: More evidence from prospective studies is needed to determine ‘if’ and ‘how’ social cognitive constructs mediate behaviour change. In a longitudinal study, we aimed to examine potential social cognitive mediators of objectively measured physical activity (PA) behaviour among people with type 2 diabetes (T2D) who participated in a six-month PA intervention. Methods: All participants from the proven effective Healthy Eating and Active Living for Diabetes in Primary Care Networks trial were included for this secondary analysis. Change in pedometer-derived daily step counts (baseline to six months) was the outcome of interest. Primary constructs of interest were from Social Cognitive Theory, however constructs from and Theory of Planned Behaviour were also tested in a mediating variable framework using a product-of-coefficients test. Results: The sample (N = 198) had a mean age of 59.5 (SD 8.3) years, haemoglobin A1c 6.8% (SD 1.1), 50% women, BMI 33.6 kg/m² (SD 6.5), systolic pressure 125.6 mmHg (SD 16.2) and average daily steps were 5879 (SD 3130). Daily pedometer-determined steps increased for the intervention group compared to usual care control at six-months (1481 [SD 2631] vs. 336 [SD 2712]; adjusted p = .002). There was a significant action theory test effect for ‘planning’ (A = .21, SE = .10, p = .037), and significant conceptual theory test results for ‘subjective norms’ (B = 657, SE = 312, p = .037) and ‘cons’ (B = ?664, SE = 270, p = .015). None of the constructs satisfied the criteria for mediation. Conclusions: We were unable to account for the effect of a pedometer-based PA intervention for people with T2D through our examination of mediators. Our findings are inconsistent with some literature concerning PA interventions in diabetes; this may be due to variability in measures used or in study populations.     

The Church of Faith and Freedom: African–American Baptists and Social Action

Clergy have an undeniable ability to shape the political beliefs and attitudes of their congregations and thus revealing how the framing activities of clergy affect behavior and influence mobilization is vital for political sociology. This ethnographic work delineates how, in 1972, the Second Baptist Church of Evanston's new pastor initiated a rapid change from social conservatism to become one of the most politically and socially active African–American Baptist churches in the Midwest. Second Baptist's radical change confirms the power of religious elites in shaping politics in spiritual institutions, and also demonstrates the vital impact of professional socialization on the theological and political orientations of clergy.     

Clergy Who Experience Trauma as a Result of Forced Termination

Forced termination of clergy is a demeaning and psychologically distressing experience. Clergy who experience a forced termination are subjected to mobbing (psychological harassment) and other activities meant to publicly or privately demean a minister in such a way that they resign their ministry position. In a purposive convenience sample of 55 ministers who had been forcibly terminated, participants scored above the known cut-off score for post-traumatic stress disorder (PTSD) and scored high on a measure of burnout and generalized anxiety disorder (GAD). Forced termination has been anecdotally connected to PTSD and GAD, this project sought to empirically link PTSD and GAD to the forced termination of clergy. This study raises concern for the long-term mental health effects of ministers who have been forcibly terminated and provides implications for future clinical study on this group of clergy. Findings in this research indicate there may be a process to forced termination, which could be developed into a theory on forced termination of clergy.     

Relocation and Well-Being in United Methodist Clergy and Their Spouses: What Pastoral Counselors Need to Know

The well-being of relocated, male Florida Annual Conference United Methodist clergy and clergy spouses (N = 124) was compared with that of nonrelocated male United Methodist clergy and clergy spouses (N = 153). Results revealed no significant differences in well-being between relocators and nonrelocators. Clergy spouses exhibited significantly lower well-being than did clergy. Perceptions of relocation, stress level, and coping resources were significant predictors of clergy well-being. However, only stress level and coping resources predicted spouse well-being. Qualitative analysis of participants' responses revealed that pastoral counselors should address issues such as grief, powerlessness, loneliness, and clergy family reluctance to seek counseling services.     

Clergy Wellness: An Assessment of Perceived Barriers to Achieving Healthier Lifestyles

This study sought to obtain a better understanding of how clergy view their health and to investigate their self-reported health status. Additionally, this study sought to explore personal and professional barriers among clergy to living a healthier life. An electronic 32-item survey was sent to all practicing clergy in Kansas East and West conferences of United Methodist church by the Kansas Area Office of the United Methodist Church. Survey items included participants’ demographic information and health conditions (e.g., diabetes, heart disease, high blood pressure, high cholesterol). The self-reported general health, mental health, and physical health data were also collected to compare to the general population in Kansas. Clergy were also asked to identify perceived barriers to health. A total of 150 clergy participated in the survey. The majority (93.7 %) self-reported their health as good, very good, or excellent. Participating clergy self-reported a higher prevalence of chronic diseases (diabetes, heart disease, high blood pressure, and high cholesterol) than the Kansas general population, but those differences were not statistically significant. More than three-fourths (77.4 %) of the participating clergy reported weights and heights that classified them as either overweight or obese. Lack of family time was the most frequently reported personal barrier to achieving a healthier lifestyle. An unpredictable work schedule was reported as the most frequent professional barrier to achieving a healthier lifestyle. This study suggests that Kansas clergy generally view their overall health status favorably despite being overweight or obese. Clergy also self-reported higher prevalence of chronic diseases than the general Kansas population, though the prevalence was not statistically different. This study provides additional insight into clergy health and offers suggestions to address the barriers preventing clergy from working toward better health.