The Role of Religion and Spirituality in Medical Patients in Germany

Using the new developed SpREUK questionnaire (version 1.0b), we examined how German patients (n = 129) with cancer, multiple sclerosis and other diseases view the impact of spirituality and religiosity (SpR) on their health and how they cope with illness. Patients with both a religious and spiritual attitude (32%) had significantly higher values in the sub-scales dealing with the search for meaningful support, and the stabilizing effects of SpR than patients without such attitudes (20%), while patients with a non-spiritual religious attitude (35%) had lower perception of the beneficial effects of their SpR and had significantly lower scores in the search for meaningful support sub-scale. Just half of the non-spiritual religious group and 42% of religious patients are convinced that finding an access to a spiritual source has a positive influence on their illness.     

The development of beliefs and values in early adolescence: a case study through religious education pedagogy

Remarks on current educational language precede discussions of: pupils’ educational development; pupil voice; adolescence and action research. There follows a report of an innovation in religious education pedagogy, designed to address concerns that pupils should be helped to understand the emergence of their own beliefs and values over time. This report then prompts some reflections on religious education’s turn in the direction of hermeneutics. A form of religious education is sketched where pupils’ awareness of changes to their own beliefs and values over time is a key feature. Such awareness marks spiritual, moral, social and cultural development, an issue granted less than adequate coverage in the present UK education agenda.     

Development of a spiritual screening tool for children and adolescents

A chaplain's ability to provide care where it is most needed depends upon some method of pastoral triage. Screening for spiritual needs of children and adolescents has been a largely neglected area. A Delphi panel developed elements to be included in a tool to screen 10-18 year olds' spiritual needs and resources. The Delphi panelists were informed of survey results of school-aged children and adolescents' opinions on spiritual issues important to them if they were hospitalized. A case study of the tool's use was conducted with a convenient sample of children and adolescents. Subsequent pilot use of the tool by five pediatric chaplains demonstrated the tool's utility in identifying patients' spiritual issues, ability to serve as a springboard to deeper discussion, and as a basis for initiating discussion of spiritual concerns with other disciplines on the healthcare team. Feedback indicates the potential clinical usefulness of this tool for hospitalized children and adolescents.     

In Search of Serenity: Religious Struggle Among Patients Hospitalized for Suspected Acute Coronary Syndrome

Hospitalization for a sudden cardiac event is a frightening experience, one that is often marked by uncertainty about health status, fear of recurrent cardiac problems, and related existential, religious, and spiritual concerns. Religious struggle, reflecting tension and strain regarding religious and spiritual issues, may arise in response to symptoms of acute coronary syndrome (ACS). The present study examined the prevalence and types of religious struggle using the Brief RCOPE, as well as associations between religious struggle, psychological distress, and self-reported sleep habits among 62 patients hospitalized with suspected ACS. Fifty-eight percent of the sample reported some degree of religious struggle. Questioning the power of God was the most frequently endorsed struggle. Those struggling religiously reported significantly more symptoms of anxiety, depression, and sleep disturbance. Non-White participants endorsed greater use of positive religious coping strategies and religious struggle. Results suggest that patients hospitalized for suspected ACS experiencing even low levels of religious struggle might benefit from referral to a hospital chaplain or appropriately trained mental health professional for more detailed religious and spiritual assessment. Practical means of efficiently screening for religious struggle during the often brief hospitalization period for suspected ACS are discussed.     

Religious Characteristics,Spirituality, and Depressive Symptoms Among 10th- to 12th-Graders Living in a Buddhist or Daoist Culture: A Short-Term Longitudinal Study

This study examines changes in and the relationship among religiosity, spiritual well-being, and depressive symptoms in primarily Buddhist or Daoist Taiwanese adolescents. A total of 2,239 16- to 18-year-old adolescents from 4 high schools were randomly selected and completed a questionnaire at baseline and at 6-month follow-up. Half of the Taiwanese adolescents reported being religious (50%), with Buddhism or Daoism predominating in terms of religious affiliation. Around 80% of adolescents believed in a God, but less than 40% believed that religion is important. Mixed models found no significant relationships between religiosity and spirituality or between religiosity and depressive symptoms. Self-efficacy and life scheme are valid domains for the spirituality construct, and a reciprocal relationship was found between spiritual well-being and depressive symptoms. This reciprocal relationship in adolescents is discussed in terms of a Buddhist or Daoist cultural context.     

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.     

Religious Coping and Cancer: Proposing an Acceptance and Commitment Therapy Approach

A cancer diagnosis is one of the most difficult diagnoses for any person to receive and cope with. Numerous individuals turn to religion or their spiritual beliefs to find meaning through the process of coping with such a serious illness. Therefore, in recent years research on religious coping has received increased attention. The aim of the present paper is to examine the area of religious coping, along with its dimensions and ways to assess it, as it relates to cancer. Moreover, this paper presents a relatively new approach to the psychological treatment of individuals with cancer. Namely, Acceptance and Commitment Therapy (ACT) is a spiritually and religiously sensitive treatment. This approach aims to first explore a person's values (including spiritual and religious values), to subsequently help the person accept any experience that the person has no control over in light of these values, and to then commit and take actions consistent with these values. Recent evidence providing initial support for this approach is discussed. Finally, a case example is presented to illustrate how ACT may be carried out to address religious coping in outpatient clinical practice with cancer patients.     

Solution‐Focused Counseling for Clients With Religious and Spiritual Concerns

Solution‐focused counseling is presented as a framework for clients with religious and spiritual concerns. The theory of solution‐focused counseling is described. Implications for using this model with religious and spiritual clients are considered. A case example is provided to illustrate the application of solution‐focused counseling for a client dealing with religious and spiritual issues.     

California psychologists' religiosity and psychotherapy

Forty-seven randomly selected California clinical psychologists were surveyed to examine the effect religious or spiritual orientation has on the practice of psychotherapy. This included an assessment of ideology, attitudes toward religiosity, affiliation with organized religion, dimensions of religiousness, and use of clinical interventions of a religious nature. The majority of these psychologists were found to address religious and spiritual issues in their personal lives, to respect the function religion serves in peoples' lives, and to address religious and spiritual issues in professional practice. The majority of these psychologists use interventions of a religious nature. Very limited training occurs respective of religious and spiritual concerns; 81% reported that religious or spiritual issues were rarely or never discussed in the course of their graduate education and training.This paper was presented at the annual meeting of the American Psychological Association in Los Angeles in August 1985.     

An Initial Examination of Religious Coping in Children With Asthma

This study evaluated the relations between positive religious coping (PRC) and negative religious coping (NRC) strategies and adjustment in 87 children and adolescents (described as “children”) hospitalized for asthma. Children's adjustment during hospitalization and at follow-up was correlated with and regressed onto measures of PRC and NRC. After controlling for relevant variables, religious coping predicted up to 50% of the variance in adjustment measures. Religious coping also significantly predicted adjustment after controlling for established measures of secular coping. PRC did not predict adjustment as hypothesized, other than predicting spiritual growth. NRC predicted poorer adjustment during hospitalization and at follow-up, and an increase in anxiety over time suggesting potential risk to children's adjustment. Although methodological limitations are noted, these initial findings provide a foundation on which to further examine the palliative and potentially harmful effects of children's religious coping.     

Internal Diversity in Buddhism: Comparing the Values of Buddhist Teens Raised by Heritage and Convert Parents

Self-assigned religious affiliation has been linked to different extents with other aspects of religiosity in Christians, but this correlation has not previously been studied for Buddhists. In this study, relevant attitudes were examined through focus groups conducted with 75 heritage- and convert-raised Buddhist teenagers at seven British locations. Issues investigated included identity, spirituality, congregational participation, hopes, worries, fears, parents, friends, substance use, and right and wrong. Similarities between the two groups did not particularly show Buddhist content. Contrasts included values concerning life after death, Buddhist identifiers, place of congregation, hopes, parental formality, spiritual teachers, femininity, meditation and the Sangha, alcohol and marijuana. The recommendations arising from this study are that social policy-makers working with religious identifiers would benefit from having awareness of the complex dynamic of religious styles in respect of Buddhism, shown in this research, and that future research on Buddhist identity and values should be clearly qualified by considerations of religious style.     

The Spiritual Needs and Resources of Hospitalized Primary Care Patients

Previous studies have recognized the importance of hospitalized primary care patients’ spiritual issues and needs. The sources patients consult to address these spiritual issues, including the role of their attending physician, have been largely unstudied. We sought to study patients’ internal and external resources for addressing spiritual questions, while also exploring the physician’s role in providing spiritual care. Our multicenter observational study evaluated 326 inpatients admitted to primary care physicians in four midwestern hospitals. We assessed how frequently these patients identified spiritual concerns during their hospitalization, the manner in which spiritual questions were addressed, patients’ desires for spiritual interaction, and patient outcome measures associated with spiritual care. Nearly 30% of respondents (referred to as “R/S respondents”) reported religious struggle or spiritual issues associated specifically with their hospitalization. Eight-three percent utilized internal religious coping for dealing with spiritual issues. Chaplains, clergy, or church members visited 54% of R/S respondents; 94% found those visits helpful. Family provided spiritual support to 45% of R/S respondents. Eight percent of R/S respondents desired, but only one patient actually received, spiritual interaction with their physician, even though 64% of these patients’ physicians agreed that doctors should address spiritual issues with their patients. We conclude that inpatients quite commonly utilize internal resources and quite rarely utilize physicians for addressing their spiritual issues. Spiritual caregiving is well received and is primarily accomplished by professionals, dedicated laypersons, or family members. A significantly higher percentage of R/S patients desire spiritual interaction with their physician than those who actually receive it.     

Therapist Spiritual and Religious Values in Psychotherapy

In training and in supervision, counselors learn to be cognizant of personal values (e.g., spirituality, religiosity), yet they are enjoined to except them from practice. This article examines the nature of therapist spiritual and religious values and the impact of these values on the practice of psychotherapy. A goal of effective treatment should be the integration of therapist spiritual and religious values with therapist epistemic values in order to accommodate the spiritual and religious needs of both client and counselor. Counselor spiritual and religious values can contribute to therapy, even when the therapist is engaged in a dialectic involving personal and epistemic values.     

Transmission of values from adolescents to their parents: the role of value content and authoritative parenting

The intergenerational transmission of values is a bidirectional process. To date, however, adolescents' influence on parental values has rarely been investigated. In the present study, we analyzed the transmission of values from adolescents (aged 11 to 17 years) to their mothers and fathers across a one-year interval in 431 mother-child dyads and 346 father-child dyads. Transmission of values from adolescents to parents was observed regarding topics that are salient in adolescence (the usefulness of new technology, beliefs concerning the traditional way of life, the importance of religion) but not regarding topics that become salient later. In addition, the transmission of adolescents' values to their parents was mainly observed in families with above-average levels of authoritative parenting (i.e., parents are receptive and supportive). However, adolescents' religious values were also transmitted to their parents in families with below-average levels of authoritative parenting. Transmission of values from parents to adolescents was also investigated.     

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.     

Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution

One key focus of a meaning reconstruction model of bereavement concerns spiritual meanings attributed to the death, whether consoling or troubling. Specifically, previous studies in our research program suggest that religiously inclined violent death survivors are at risk for elevated levels of both bereavement distress and complicated spiritual grief, a crisis of faith following loss that refers to the erosion of the mourner’s relationship to God and/or the religious community. However, more research is needed to understand the convergence of depression and spiritual struggle in the context of violent and natural loss. In this study of a diverse sample of 59 American Christians bereaved less than 5 years, we sought to: (1) determine if individuals bereaved by homicide, suicide or fatal accident differed from those bereaved by natural causes in their levels of depression and spiritual coping; (2) investigate the relation between the latter constructs; and (3) ascertain if cause of death mediates the effect of religious coping on depression. We found that: (a) violently bereaved individuals endorsed more negative religious coping, and (b) depression was associated with greater spiritual struggle, particularly a sense of disrupted relationship with God. Contrary to expectations, positive religious coping was unrelated to post-loss depression, and cause of death did not mediate the relationship between spiritual coping and depressive symptomatology. A clinical case study concludes the article, illustrating the interweaving of spiritual and psychological distress in tragic bereavement, and their implications for a meaning-oriented grief therapy.     

Other than “the set pattern”: Developing one’s own thoughts about spirituality and religion

In qualitative research, psychoanalysts and psychoanalytic psychotherapists who had continued to have a personal interest in religion or spirituality reflected on their religious upbringing. The 25 participants interviewed often gave their responses in what can be identified as narrative form. These narratives articulated participants’ often poignant and distinctive, sometimes humorous, experiences. They relate how and why accepted teaching regarding religious and spiritual issues was challenged, usually in adolescence, but for several participants much earlier. Important aspects included differing responses of significant others to the participants’ independent thinking, the beginnings of subsequent religious and spiritual questing, and, for some, the decision to become a psychotherapist.     

A review of online social networking profiles by adolescents: implications for future research and intervention

This study explored content posted and interactions taking place on adolescent online social networking profiles. Although "blogging" continues to soar in popularity, with over half of teenagers online participating in some form, little research has comprehensively explored blog communication within the context of adolescent development. Content was qualitatively coded from 100 randomly selected profiles authored by adolescents between the ages of 16 and 18. Rich thematic elements were identified including family and social issues, risk behaviors, disclosure of personally identifiable information, and frequent peer interaction. Results indicate adolescent blogs frequently contain appropriate images, positive comments about parents and peers, athletics, a variety of risk behaviors, and sexual and profane language. In addition, school type was examined (public versus private, religious) as a potential factor in understanding the differences in content posted by adolescents; however, no significant differences were found. Implications for parental monitoring and intervention are discussed as well as direction for future research. Adolescents' online profiles contain a wealth of intimate, candid, and publicly available information on a wide range of social issues pertinent to adolescence that contribute to the understanding of adolescent development and well-being.     

Bipolar depression (manic-depressive disease) in early adolescence

Bipolar Depression is rare in early adolescence. Since only rare cases were described in the literature, every case is important. In this article we described three cases of Bipolar Depression who were hospitalized in our Adolescent Unit during the past three years. All of them started at age 13--14. It is important to diagnose this illness in order to administer the required treatment in the acute phase and preventive treatment afterwards. Our experience indicates that treatment for early adolescents is identical with treatment for adults and calls for the same dosage.