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.     

Psychotherapy and Religion: Rapprochement or Antithesis?

Religion and psychotherapy have long maintained separate directions, currently manifested in four viewpoints: orthodox, atheistic, neutralist, and moderate. Although each therapeutic viewpoint is distinct, each contains the seed for rapprochement. The need for a rapprochement that provides professional psychotherapy capable of addressing religious issues is clearly voiced by laypersons, who are clients or potential clients, and by members of the clergy and psychotherapeutic professions. Increasing numbers of ministers now receive professional preparation for pastoral counseling. It is timely for those in the counseling professions to consider seriously specialized education and certification in religious counseling for secular psychotherapists.     

Experiences of psychotherapists transitioning to private practice during COVID-19

The purpose of this qualitative phenomenological study was to gain insight into the lived experiences of psychotherapists transitioning to private practice during the COVID-19 pandemic. With an ever-expanding need for targeted and accessible mental health care, it is vital to understand this phenomenon and how it impacted patient access and care, and the providers themselves. Eighteen licensed psychotherapists were interviewed and their responses highlighted meaningful professional and clinical implications. As a result of the participant interviews, three major themes were identified: (1) the unknown related to COVID-19, (2) ease of transition and (3) work–life balance. Eleven additional subthemes emerged. Results suggested that psychotherapists had various personal and professional stressors exacerbated by the pandemic, along with a desire to balance work and life, manage the changes brought on by the pandemic, and gain or retain autonomy in their professional careers. Ultimately, the results of the study point to some shared experiences among psychotherapists, potential issues of access to psychotherapy, issues related to career satisfaction among psychotherapists, as well as some important areas for future research.     

Therapist attitudes and countertransference as predictors of professional quality of life and burnout among psychotherapists

This study aimed to examine the role of attitudes towards psychotherapy and countertransference dimensions as predictors of professional quality of life and burnout among psychotherapists in Iran. Participants were 259 psychotherapists who worked in mental health centres in Tehran (Iran), and they completed the Professional Quality of Life questionnaire, the Therapist Response Questionnaire and the Therapist Attitudes Scale. Professional quality of life was associated with countertransference dimensions and attitude towards psychotherapy. This study concludes that psychotherapists can benefit from working on their specific countertransference issues and re-evaluating their basic attitudes towards psychotherapy to achieve the highest levels of professional satisfaction. Culture may play a role in a specific therapist's attitude and difficulties in addressing certain aspects of countertransference.     

Youth Suicide: The Knowledge and Attitudes of Australian Teachers and Clergy

This is the first study of the suicide-related knowledge and attitudes of teachers and clergy in Australia. These professional groups have been identified as “gatekeepers” who might serve as a first line of assistance for distressed young people. Such gatekeepers, along with medical and mental health professionals, have a vital role to play in the prevention of youth suicide, of which Australia has the highest rates in the world. This research confirmed that high numbers of teachers and clergy have been approached by suicidal young persons. However, their gatekeeping role may be compromised by a low level of knowledge about signs of suicide risk, which was found even among those who had taken courses in suicide or death and dying or who had personally known someone who suicided. Suicidal behavior was found to be generally regarded as unacceptable, especially by those with a high religious commitment. Further educational efforts about suicide risk identification and prevention seem to be needed for both teachers and clergy; it will be important for such education to take into account attitudinal issues and how these might affect communication with young suicidal people.     

Mirror mirror on the ward: who is the unfairest of them all? Reflections on reflective practice groups in acute psychiatric settings

Consultant psychiatrists in medical psychotherapy, adult psychotherapists, child and adolescent psychotherapists and clinical psychologists increasingly complement their direct therapeutic activity with applications of their psychotherapeutic thinking in acute mental health work through facilitating reflective practice groups for staff working in mental health teams. The authors offer their reflections on facilitating National Health Service reflective practice groups using the metaphor of a mirrored dialogue between patient and professional, and professional and institution as a basis for informing the development of reflective practice for colleagues. Their reflections are based on working on three acute in-patient wards, in a crisis resolution team and in community mental health teams. They describe the practicalities of setting up and facilitating reflective practice groups, and offer insights into some of the issues that arise in reflective practice groups. They conclude that these groups are mutually beneficial in forging links between psychotherapy professionals and professionals working in other disciplines and areas of mental health. Facilitating these groups often requires a challenging adaptation of technique, which will not suit all psychotherapists, as well as a wider understanding of organisational dynamics and the interplay between clinicians and management.     

A qualitative analysis of contemporary ultra-orthodox rabbinical perspectives on scrupulosity

Scrupulosity is a religiously themed sub-type of obsessive-compulsive disorder. Religious individuals with scrupulosity tend to first turn to clergy for assistance rather than to mental health professionals. This is particularly relevant for Ultra-Orthodox Jewish patients, whose rabbis arbitrate a wide variety of life issues. In the current qualitative study, 15 Ultra-Orthodox rabbis were interviewed regarding their views on scrupulosity and their responses were analysed via grounded theory and thematic networks theory. All rabbis were familiar with scrupulosity and distinguished it from normative behaviors. Their conceptualizations regarding etiology were mostly psychological in nature, as opposed to religious or spiritual. Rabbis were generally supportive of psychology as a professional field and open to collaborating with therapists, although some controversies were raised. Given their isolated lifestyle, these findings are somewhat surprising and encouraging. Results suggest collaboration with Ultra-Orthodox rabbis can be fruitful and at times essential when dealing with scrupulosity.     

Training Community Clergy in Serious Illness: Balancing Faith and Medicine

Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious–medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.     

Online disinhibition: heightened potential for professional conduct issues among clergy in the Church of England?

This article identifies the potential of online social networking encounters to heighten the risk of professional conduct issues among clergy in the Church of England. It first considers the difficulties in establishing what constitutes inappropriate conduct for clergy working in complex twenty-first century contexts, and then goes on to suggest that the online disinhibition effect might form a significant factor in problematic online encounters, drawing on the work of psychologist John Suler, and other previous research. It then considers the question of how online identity might mesh or jar with embodied identity for clergy, and concludes that awareness of the online disinhibition effect coupled with conscious integration of online involvements into their broader support networks, rather than compartmentalising them, form useful ways for clergy to undermine toxic online disinhibition.     

Recognizing Anxiety Disorders in the Aftermath of the World Trade Center Crisis

This article seeks to educate the reader on how to recognize the presence of anxiety disorders as they occur in the church community. The author uses medical information, Scriptural wisdom and a case illustration to help concerned Christians to assist sufferers in getting appropriate care. Anxiety disorders in the aftermath of the World Trade Center trajedy will be on the rise and the paper addresses this matter particularly for clergy, caregivers and professional counselors.     

“I Didn’t Know It Existed Before You Called”: Protestant Clergy Experience, Education and Perceptions Regarding Genetics

Despite the intrinsic role religious/spiritual (hereafter, R/S) beliefs have in patient clinical decision-making and crisis coping, there is little research exploring the relationship that exists between clergy (professionals who provide R/S counsel and guidance) and genetic counseling patients. This qualitative, exploratory study was designed to explore Protestant clergy (N?=?8) perceptions of and experience with genetics-related issues. Data analysis revealed that a wide range of R/S perceptions regarding genetics-related issues exist within Protestantism, Protestant clergy have a basic understanding of genetic testing and conditions, and while directive counseling is inherent to Protestant clergy counseling, there appears to exist two opposing styles: unbiased and biased. Based on this information, there are two main implications for genetic counseling clinical practice. First, R/S assessments need to be increasingly implemented into genetic counseling sessions, so that the psychosocial needs of patients with specific R/S beliefs can be identified and addressed. An increase in R/S assessments may be accomplished by increased exposure in genetic counselor training, continuing education opportunities, and by establishing relationships with board-certified, professional chaplains. Second, genetic counselors can influence the genetic education and experience of clergy by raising awareness within their own R/S assemblies. Doing so can also serve to further educate genetic counselors in the R/S beliefs of their own traditions, thus increasing sensitivity, empathy and the quality of care provided.     

Calvary and the church broken for the world

The film Calvary raises a host of issues around how the movie‐going public understands clergy. Perceptions of clergy are often caught between expectations of hypocrisy and accusations of naivety. By subverting any sharp distinctions between that which is “holy” and that which is fully human in the calling of the priest, the movie demonstrates a kind of cinematic Christology that is also instructive for ecclesiological purposes, particularly when put in dialogue with the theology of Dietrich Bonhoeffer on the same subject.     

Integration sozialarbeiterischer Kompetenz in die psychotherapeutische Versorgung

Social and socioeconomic issues are a risk factor for the development of mental health problems and have the potential to negatively impact the psychotherapeutic treatment process. In addition, mental disorders can also result in socioeconomic stress. Neither professional training nor parameters of everyday practice of medical or psychological psychotherapists are geared towards acquiring sufficient competence to adequately handle complex social problems of highly impaired patients. Especially in times of social crises, three interrelated strategies may be helpful: to enhance psychotherapists’ sensibility and competence to recognize and deal with severe social crises, to promote cooperation with clinical social workers and to incorporate sociotherapeutic elements in the overall treatment planning. Using an approach of integrated care at a university medical department as an example, this article presents examples of how to implement these strategies into everyday therapeutic practice.     

A spectrum of belief: a qualitative exploration of candid discussions of clergy on mental health and healing

Since clergy are often first responders to mental health issues, it is important to understand clergy views on handling such issues. A discussion occurred in 2012 amongst clergy involved in a popular social utility network clergy’s group. One clergyperson asked peers: “If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?” Over 140 comments were made during 13 days, and 35 clergy from the United States, Africa, and India contributed to the discussion. Data from this conversation were examined via classic grounded theory. Analysis revealed a spectrum of beliefs that clergy hold regarding the causes and best treatments for emotional issues. Findings shed light on the candid thoughts clergy have about mental health care. The findings provide greater understanding for mental health practitioners with clients who rely on their church for emotional support.     

Transference and countertransference in an applied setting — education

This paper offers an overview of current clinical approaches to psychoanalytically informed work with parents by child psychotherapists. The analysis is based on practice at the Tavistock Clinic and on broader knowledge of trends in work with children and families within the National Health Service. A brief history sets the scene. Four varieties of approach are described, with clinical examples. The particular sensitivity of child psychotherapists to infantile features in the personality is highlighted, and it is argued that this, together with their broad clinical experience, provides a proper basis for psychoanalytic psychotherapy with parents. Such work significantly extends and enriches the clinical contribution of child psychotherapists and has involved a shift in professional identity. It also raises ethical issues which are discussed.     

Influence of personal therapy on learning and development of psychotherapeutic skills

The aim of the present study was to investigate psychodynamic psychotherapists’ experience of the influence of personal therapy on professional growth during training with a focus on the acquisition of knowledge and the development of psychotherapeutic skills. Thematic analysis was conducted on interviews with former students (N=10) at two training institutes for psychoanalytic psychotherapy. The resulting theme “professional subjectivity” indicated that personal therapy was experienced as having a positive effect on learning and growth of professional skill by facilitating the development of a theory- and knowledge-based professional subjectivity, a personally founded, professional attitude. Important elements of this development are “shared experience,” “personal influence,” and “knowledge integration.” The emergence of professional subjectivity proved to be an important factor in terms of professional advancement for future psychotherapists. Finding and relating to their own subjectivity was crucial in the process of developing a personally founded, professional attitude in the clinical work.     

The Relationship Between Recalled Self-esteem as a Child and Current Levels of Professional Burnout among Anglican Clergy in England

This study links and tests three strands of theory concerned with explaining individual differences in levels of professional burnout in general and among religious professionals in particular. These three strands concern the significance of current self-esteem, recalled self-esteem as a child, and personality. Data were provided by a sample of 1,278 male stipendiary parochial clergy working in the Church of England who completed the modified Maslach Burnout Inventory (specially designed for use among clergy), and the short-form Revised Eysenck Personality Questionnaire (designed to measure the personality dimensions of extraversion, neuroticism and psychoticism), together with a semantic differential index of recalled self-esteem as a child. The bivariate correlation coefficients demonstrated significant associations between more positive self-esteem as a child and lower levels of professional burnout (higher personal accomplishment, lower emotional exhaustion and lower depersonalisation). The bivariate correlation coefficients also demonstrated significant associations between personality and professional burnout. Multiple regression analyses, however, demonstrated that the association between recalled self-esteem as a child and professional burnout largely disappeared after controlling for the personality variables. The conclusion is drawn that knowledge about the personality profile of clergy functions as a more secure predictor of susceptibility to professional burnout than knowledge about recalled self-esteem as a child.     

Protestant Clergy and the Culture Wars: An Empirical Test of Hunter's Thesis

Examinations of culture wars typically assess the attitudes of the American public. This study instead focuses on culture wars among religious elites—clergy—and tests three aspects of the culture wars thesis: (1) whether religious elites are engaged in culture wars, (2) whether clergy attitudes are polarized on these issues, and (3) whether religious authority or religious affiliation is more salient in creating culture wars cleavages. Using data from a large random sample of Protestant clergy, we find a substantial amount of engagement in culture wars by all types of Protestant clergy. The amount of polarization is more attributable to views of religious authority (i.e., biblical inerrancy) than to religious tradition. Moreover, polarization among clergy is somewhat more evident on culture wars issues than on other social and political issues. These findings are generally supportive of the culture wars thesis and should help return examinations of culture wars back to where they were originally theorized to be waged: among elites.     

Therapeutische Arbeit und berufliche Entwicklung

The authors Orlinsky and Rønnestad present as a preview for their book titled How psychotherapists develop (2005) a short selective review of the main findings of their comprehensive international study about how psychotherapists experience their work with patients, what impacts therapists’ work experiences have on their professional development and which other factors influence their therapeutic work and their professional development, including the interactions of those factors. Briefly they discuss the main practical implications of these findings, e.g. for the training of psychotherapists.