Measurement of Religiosity/Spirituality in Adolescent Health Outcomes Research: Trends and Recommendations

The relationship between religious/spiritual (R/S) factors and adolescent health outcomes has been studied for decades; however, the R/S measurement tools used may not be developmentally relevant for adolescents. A systematic literature review was conducted to review and evaluate trends in measuring R/S in adolescent health outcomes research. In this review a total of 100 articles met criteria for inclusion. Relatively few (n = 15) included adolescent-specific R/S measures or items accounting for developmentally relevant issues such as parental religiosity or age-appropriate language. Future R/S and health research with adolescents would be strengthened by incorporating developmentally relevant R/S measurement tools, psychometrics, and multidimensional measures.     

Religious and spiritual struggle: prevalence and correlates among older adults with depression in the BRIGHTEN Program

Older adults (OA) are more religious and/or spiritual (R/S) than younger adults, but some experience R/S struggle which is associated with poorer quality of life. Little is known about R/S struggle in community dwelling OA. This study examines prevalence, correlates, the association with depression for R/S struggle, and a desire for spiritual care in community dwelling OA with depression. In a programme for integrating care for these OA, 188 participants provided demographic information along with the Geriatric Depression Scale and a tool screening for potential R/S struggle. Prevalence of potential R/S struggle was 50%. The younger OA and Caucasian individuals vs. Hispanic individuals were more likely to experience potential R/S struggle. A relationship of potential R/S struggle with depression persisted with the inclusion of controls. Of those with potential struggle, 52% wanted to see a chaplain. Screening for potential R/S struggle can play an important role in choosing specific interventions for OA with depression.     

Leadership and attachment theory

Comments on the six articles contained in the special issue of the American Psychologist (January 2007) devoted to leadership, written by W. Bennis; S. J. Zaccaro; V. H. Vroom and A. G. Yago; B. J. Avolio; R. J. Sternberg; and R. J. Hackman and R. Wageman. The current authors opine that the inclusion of attachment theory in the study of leadership could strengthen leadership theories as a whole.     

Kansas Physician Assistants’ Attitudes and Beliefs Regarding Spirituality and Religiosity in Patient Care

Research indicates patients want to discuss spirituality/religious (S/R) beliefs with their healthcare provider. This was a cross-sectional study of Kansas physician assistants (PA) regarding S/R in patient care. Surveys included questions about personal S/R beliefs and attitudes about S/R in patient care. Self-reported religious respondents agreed (92%) they should be aware of patient S/R; 82% agreed they should address it. Agreement with incorporating S/R increased significantly based on patient acuity. This research indicates Kansas PAs’ personal S/R beliefs influence their attitudes toward awareness and addressing patient S/R.     

A systematic review of religion/spirituality and sport: A psychological perspective

ObjectiveThe study aimed to review the existing literature on religion/spirituality (R/S) in sport from the psychological perspective.DesignA systematic review using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was employed.MethodThe literature search was completed in December 2018 using five different databases and Google Scholar. The titles and abstracts of the articles were reviewed for the selection process. The selected articles were classified into nine categories: the role of religion/spirituality, consultants, confidence, religious/spiritual faith, flow or being in the zone, identity, anxiety and depression, coping with adversity, and well-being and healing.ResultsA total of 56 studies met the criteria. The selected articles comprised various types of study design that were quantitative, qualitative, mixed-methods, as well as conceptual, review, theoretical, commentary, and perspective articles. The findings show that R/S can play a significant role among athletes in several ways (e.g., coping with uncertainties, building team cohesion, and alleviating anxiety). This study has also uncovered a few issues that should be emphasized for future research such as developing quantitative tools for R/S and sport-performance measurement and designing a religious/spiritual coping strategy that can be used among athletes from various cultures/religions.ConclusionAlthough R/S is often overlooked in sport psychology, the existing literature shows that it can have positive effects on mental health and contribute to achieving better sporting performance.     

The Influence of Spirituality and Religion on Coping for Combat‐Deployed Military Personnel

A paucity of research exists examining the role of spirituality/religion (S/R) as a protective factor for combat‐deployed military personnel. The purpose of this study is to (a) define the underlying structure of items from an author‐developed instrument measuring coping, beliefs, and support; and (b) examine how S/R affiliation, activities, and practices affect coping responses for 279 combat‐deployed military personnel. Significant predictors of coping included support, age, Christian affiliation, and frequency of S/R practices. The authors found that beliefs, S/R practices prior to deployment, previous combat deployments, and first deployment were not significant predictors of coping. Implications for counselors and future research are addressed.     

“Be Prepared if I Bring It Up:” Patients’ Perceptions of the Utility of Religious and Spiritual Discussion During Genetic Counseling

As debates continue about the relevance of religion to health care, research is needed to guide decisions about whether genetic counselors (GCs) should routinely address religious and/or spiritual (R/S) issues with their patients. We conducted an online survey to gauge patient perspectives on this issue. Among the 70 respondents, frequencies of closed-ended responses and thematic analyses of open-ended responses revealed multiple patient concerns related to R/S discussions with GCs. Although 60 respondents reported being R/S, only a small minority would want to discuss R/S issues if it meant less time discussing medical information. Most respondents also expressed opinions that: 1) genetic counseling should be about science; 2) GCs are not qualified to discuss R/S issues; 3) other outlets are available to meet the needs of patients who want R/S counseling; and/or 4) R/S discussions are more likely to be acceptable if patients broach the topic or in specific circumstances (e.g., when patients are facing end-of life issues). Overall, responses suggest routine or comprehensive R/S assessments or discussions are not necessary and that GCs would be best equipped to help all their patients if they were prepared to listen, be supportive, and make referrals when R/S issues arise in clinic.     

Diversity and leadership

Comments on the six articles contained in the special issue of the American Psychologist (January 2007) devoted to leadership, written by W. Bennis; S. J. Zaccaro; V. H. Vroom and A. G. Yago; B. J. Avolio; R. J. Sternberg; and R. J. Hackman and R. Wageman. The current authors express concern that the special issue failed to include attention to issues of diversity and intersecting identities as they pertain to leadership. A Special Issue Part II on Diversity and Leadership is being proposed to (a) advance new models of leadership, (b) expand on existing leadership theories, and (c) incorporate diversity and multiple identities in the formulation of more inclusive leadership research and theory. The goal of this special issue will be to revise our theories of leadership and our understanding of effective leadership to include gender, racial/ethnic minority status, sexual orientation, and disability status.     

An attentional learning account of the shape bias: reply to Cimpian and Markman (2005) and Booth, Waxman, and Huang (2005)

Recently, Developmental Psychology published 2 articles on the shape bias; both rejected the authors' previous proposals about the role of attentional learning in the development of a shape bias in object name learning. A. Cimpian and E. Markman (2005) did so by arguing that the shape bias does not exist but is an experimental artifact. A. E. Booth, S. R. Waxman, and Y. T. Huang (2005), in contrast, concluded that the shape bias (and its contextual link to artifact categories) does exist but that the mechanisms that underlie it are conceptual knowledge and not attentional learning. In response, in this article the authors clarify the claims of the Attentional Learning Account (ALA) and interpretations of the data under question. The authors also seek to make explicit the deeper theoretical divide: cognition as sequestered from processes of perceiving and acting versus as embedded in, and inseparable from, those very processes.     

Graded effects in hierarchical figure-ground organization: reply to Peterson (1999)

An important issue in vision research concerns the order of visual processing. S. P. Vecera and R. C. O'Reilly (1998) presented an interactive, hierarchical model that placed figure-ground segregation prior to object recognition. M. A. Peterson (1999) critiqued this model, arguing that because it used ambiguous stimulus displays, figure-ground processing did not precede object processing. In the current article, the authors respond to Peterson's (1999) interpretation of ambiguity in the model and her interpretation of what it means for figure-ground processing to come before object recognition. The authors argue that complete stimulus ambiguity is not critical to the model and that figure-ground precedes object recognition architecturally in the model. The arguments are supported with additional simulation results and an experiment, demonstrating that top-down inputs can influence figure-ground organization in displays that contain stimulus cues.     

Towards a multidisciplinary guideline religiousness,spirituality, and psychiatry: what do we need?

ABSTRACT

A multidisciplinary guideline on religion, spirituality (R/S), and psychiatry aims to address: (1) organising R/S consultation in mental health care, (2) categorising research findings, and (3) professionalism and education with respect to R/S. Contents are derived from brainstorm sessions with key participants in the field of R/S and psychiatry in the Netherlands, and from the position statements on R/S and psychiatry in the UK and by the World Psychiatric Association. The following chapters are proposed: (1) ethical and existential themes and R/S, (2) R/S in stages of mental health care practice, (3) R/S counselling, (4) collaboration, and (5) relationship to other guidelines. The core themes need verification by specialists in the field, nurses, therapists, counsellors, patient-practitioners, and psychiatrists. The author recommends to approach R/S in an easy way, to listen to matters of personal meaning, and to leave the task to others in case of a lack of affinity.     

Group intervention for medical patients—A treatment for damaged self-esteem

There is a need to integrate our knowledge of psychoanalytic theory, group therapy and medical care delivery systems. Understanding the importance of selfesteem, based upon the study of psychoanalytic theory, can help to determine appropriate technique in medical groups as well as to add to our understanding of the profound importance of such groups in the delivery of medical care. Groups in hospitals help patients to get in touch with their strengths, feel less isolated, and be more active—all of which enhance selfesteem. As patients participate in groups, narcissistic defenses can be enhanced and the quality of life improved. When interdisciplinary teams participate in patient groups, delivery of medical care can be more comprehensive: The totality of the patient emerges more clearly and staff becomes more aware and sensitive to his/her emotional and physical needs.This paper was presented at Thirty-Sixth Annual Conference, American Group Psychotherapy Association, 1978. The author would like to acknowledge Hazel M. Halloran and Susanne A. Kohut, Director and Associate Director, Department of Social Work, who conceived of and supported the expansion of the group work program in the General Hospital Division of St. Vincent's Hospital and Medical Center of New York. The following professionals contributed clinical material used in this paper: Sara Bookbinder, M.S.W., Carol Coven, M.S.W., Linda Haselman, R.N., Barbara Horn, M.S.W., Kathleen McQuade, R.N., Ellen McGuire, M.S.W., Sister Marita Rose O'Brien, R.N., and Emile Powe, M.D.     

An Evidence-Based Approach to Managing Suicidal Patients in the Patient-Centered Medical Home

Primary care is a critical setting for suicide prevention because it is often the first and only source of mental health care for the U.S. general population. It is also important because suicidal patients report a greater number of somatic complaints and make more frequent medical visits compared to nonsuicidal patients. Models for managing suicide within primary care have recently arisen, yet no models have been proposed for use within the patient-centered medical home (PCMH), a primary care model that integrates behavioral health into its practice. The authors suggest a chronic disease model for the management of suicide risk in the PCMH along with collaborative strategies that may include suicide screening and targeted assessment, warm hand-offs, cognitive-behavioral interventions, routine collaborative medication management, and means restriction counseling. The current paper advises how those within the PCMH can adapt and implement evidence-based practices to manage suicide. Finally, the authors discuss a case example illustrating these evidence-based and collaborative methods.     

Premarital counseling: Approaches,objectives, content,and evaluation—a bibliography

A major problem for the premarital counselor is that the literature in the field is scattered throughout numerous journals and books representing several disciplines. Since counselors tend to subscribe to and read the literature from their own academic discipline, they may be unaware of what is being written elsewhere. This article contains a bibliography of what the authors consider to be the most relevant books and articles on premarital counseling published by the various disciplines. For the convenience of the reader, each listing is also coded as to its content.The authors express their appreciation to Charles R. Figley, Ph.D., Douglas H. Sprenkle, Ph.D., and Diane Spencer, M.S., for their assistance in the preparation of this paper. The valuable assistance of those contributors who notified the authors of their publications is gratefully acknowledged.     

The dimensionality of coping among Chinese health care workers

The transactional model defines coping as a process that changes on the basis of the context of an environmental encounter. An instrument used to investigate coping in diverse person-environment interactions is the Ways of Coping Questionnaire (WOC; S. Folkman & R. S. Lazarus, 1988). Although evidence exists to support the basic underlying structure of the WOC in Western societies, no research has been conducted on the instrument's dimensionality in non-Western societies. The authors identified 14 factors for the WOC administered to a sample of health care workers in Beijing, China. The 14 factors identified in the present study were similar to the 8 factors identified in the original validation study (S. Folkman, R. S. Lazarus, C. Dunkel-Schetter, A. DeLongis, & R. J. Gruen, 1986), but they were more content specific.     

Loss of Religious or Spiritual Identities Among the LGBT Population

Lesbian, gay, bisexual, and transgender (LGBT) individuals are at risk of having negative experiences with religion because of mainstream religions’ non‐LGBT‐affirming stance. Negative religious experiences can lead to religious or spiritual (R/S) struggles and loss of R/S identity to maintain sexual identity. The authors describe R/S abuse, R/S struggle, and how these can result in loss of R/S identity in LGBT individuals. They provide a case study and discuss counseling implications and areas for future research.     

The Role of Religion in Therapy: Time for Psychologists to Have a Little Faith?

The argument has been made that religious and spiritual (R/S) forms of treatment, or R/S adaptations of existing treatments, are an appropriate, culturally sensitive, and potentially efficacious method of intervention when working clinically with religious patients experiencing psychological, behavioral, or physiological dysfunction. The previous articles in this special series describe four such interventions designed for use with patients with particular presenting problems including serious mental illness, cancer, eating disorders, and scrupulosity. This article offers a brief historical presentation on the growth of interest in R/S in clinical psychology and behavioral medicine, with particular attention to the general issue of the role of values in therapy, and includes criticisms of integrating R/S in treatment. The difficulty of appreciating unique R/S perspectives and their relevance for particular clients is emphasized and the question of whether a “true” understanding of R/S beliefs necessarily leads to better health is examined. Each of the four therapies presented in this special series is individually analyzed, and it is clear that they offer sensitive and culturally relevant approaches to treating the various disorders, though areas of potential improvement or possible confusion are highlighted. Finally, the following are deemed essential if R/S-informed therapies are to impact the field and be appropriately introduced with clients: (a) training of future and current practitioners; (b) longitudinal research on R/S; (c) outcome studies of R/S interventions; and (d) adequate funding for the achievement of these goals.     

Teachers’ and Parents’ Perspectives on a Curricular Subject of “Religion and Spirituality” for Indian Schools: A Pilot Study Toward School Mental Health Program

Religious–spiritual (R/S) education helps medical students cope with caregiving stress and gain skills in interpersonal empathy needed for clinical care. Such R/S education has been introduced into K-12 and college curricula in some developed nations and has been found to positively impact student’s mental health. Such a move has not yet been seen in the Indian education system. This paper aimed to examine perspectives of teachers and parents in India on appropriateness, benefits, and challenges of including R/S education into the school curriculum and also to gather their impressions on how a R/S curriculum might promote students’ health. A cross-sectional study of religiously stratified sample of teachers and parents was initiated in three preselected schools in India and the required sample size (N = 300) was reached through snowballing technique. A semi-structured questionnaire, with questions crafted from “Religion and Spirituality in Medicine, Physicians Perspective” (RSMPP) and “American Academy of Religion’s (AAR) Guidelines for Religious Literacy,” was used to determine participants’ perspectives. Findings revealed that teachers’ and parents’ “comfort in integrating R/S into school curriculum” was associated with their gender (OR 1.68), education status (OR 1.05), and intrinsic religiosity (OR 1.05). Intrinsic religiosity was significantly (p = 0.025) high among parents while “intrinsic spirituality” was high (p = 0.020) among teachers. How participants’ R/S characteristics influence their support of R/S education in school is discussed. In conclusion, participants believe R/S education will fosters students’ emotional health and interpersonal skills needed for social leadership. A curriculum that incorporates R/S education, which is based on AAR guidelines and clinically validated interpersonal spiritual care tools would be acceptable to both teachers and parents.     

Therapeutic Practices and Ethical Beliefs of Professionals Working With Adolescents in Residential Treatment

The authors investigated dual relationships between 2 groups of staff (direct care and professional) and adolescent clients in 2 residential treatment programs. Staff were surveyed on their behavior and corresponding ethical beliefs regarding interactions they believed to be acceptable with minor clients specifically at termination of the treatment program. Direct care staff were more likely than were professional staff to have inconsistencies in behaviors and ethical beliefs. The American Counseling Association's (1995) Code of Ethics would prohibit some of the staff beliefs regarding acceptable behavior. Both groups were uncertain about the ethical appropriateness of certain interactions with adolescent clients. Implications are discussed.     

Psychotherapy and survival in cancer: the conflict between hope and evidence

Despite contradictory findings, the belief that psychotherapy promotes survival in people who have been diagnosed with cancer has persisted since the seminal study by D. Spiegel, J. R. Bloom, H. C. Kramer, and E. Gottheil (1989). The current authors provide a systematic critical review of the relevant literature. In doing so, they introduce some considerations in the design, interpretation of results, and reporting of clinical trials that have not been sufficiently appreciated in the behavioral sciences. They note endemic problems in this literature. No randomized clinical trial designed with survival as a primary endpoint and in which psychotherapy was not confounded with medical care has yielded a positive effect. Among the implications of the review is that an adequately powered study examining effects of psychotherapy on survival after a diagnosis of cancer would require resources that are not justified by the strength of the available evidence.