Integrating Religion and Spirituality Into Treatment for Late-Life Anxiety: Three Case Studies

Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to incorporate religion/spirituality (R/S). The cases presented here illustrate the use of a 12-week modular CBT intervention for late-life anxiety, designed to allow incorporation of R/S elements in accordance with patient preferences. The three women treated using this protocol chose different levels and methods of R/S integration into therapy. All three women showed substantial improvement in worry symptoms, as well as a variety of secondary outcomes following treatment; these gains were maintained at 6-month follow-up. These preliminary results suggest that the incorporation of R/S into CBT might be beneficial for older adults with GAD. Strengths, limitations, and future directions are discussed.     

Incorporating Spirituality Into Core Counseling Courses: Ideas for Classroom Application

Recently, spirituality has received increased attention in the counseling field, and both spirituality and religion have been acknowledged as important aspects of multiculturalism. The role of spiritual and religious beliefs is mentioned throughout the Standards of the Council for Accreditation of Counseling and Related Educational Programs (CACREP), and guidelines for working with spiritual issues within various cultural paradigms are emerging. Nevertheless, many counselor educators seem unsure about how to infuse spiritual issues into courses. This article presents a rationale for inclusion of spiritual issues in counselor education curricula and provides activities to incorporate knowledge and skills for dealing with spiritual and religious diversity in CACREP core courses.     

Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice

Book reviewed in this article: Craig S. Cashwell and J. Scott Young, Eds. (2005). Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice.     

Examining College Counselors' Integration of Religion and Spirituality Into Substance Abuse Counseling

The authors explored college counselors' (N = 77) integration of religion and spirituality into substance abuse counseling. Results indicated a discrepancy between the importance ratings of religion and spirituality and the frequency of using such elements in counseling practice.     

Mental Health, Depression, and Dimensions of Spirituality and Religion

The author explores the relationship between spirituality and religion and human growth and development, specifically examining emotional well-being during adulthood. Dimensions of spirituality to be explored are meaning in life, a transcendent purpose, intrinsic values, and spiritual community. The argument is made that spirituality is related to emotional well-being during adulthood. Implications for further research and relevant information for counselors, psychologists, and educators are included.     

The Role of Religion and Spirituality in Mental and Physical Health

An increased interest in the effects of religion and spirituality on health is apparent in the psychological and medical literature. Although religion in particular was thought, in the past, to have a predominantly negative influence on health, recent research suggests this relationship is more complex. This article reviews the literature on the impact of religion and spirituality on physical and mental health, concluding that the influence is largely beneficial. Mechanisms for the positive effect of religion and spirituality are proposed.     

Religion and Suicide in Patients with Mental Illness or Cancer

In Switzerland, the highest rates of suicide are observed in persons without religious affiliation and the lowest in Catholics, with Protestants in an intermediate position. We examined whether this association was modified by concomitant psychiatric diagnoses or malignancies, based on 6,909 suicides (ICD‐10 codes X60‐X84) recorded in 3.69 million adult residents 2001–2008. Suicides were related to mental illness or cancer if codes F or C, respectively, were mentioned on the death certificate. The protective effect of religion was substantially stronger if a diagnosis of cancer was mentioned on the death certificate and weaker if a mental illness was mentioned.     

Changes in Attitudes Toward Religion Among Those with Mental Illness

Despite the increased attention given to the religious experiences of those with mental illness, the specific nature of the changes in religious attitudes that occur within this population remain yet unknown. In this study, 406 individuals with persistent mental illness who attended one of 13 Los Angeles County Mental Health facilities completed a demographic questionnaire, an adapted version of the Religious Coping Index, and the Symptom Checklist 90-R. Over 54% of the participants reported a change in their religious beliefs such that their faith became stronger or weaker as a result, and 66% perceived these changes to be positive in nature. Qualitative codings suggest that a constructive or destructive use of religion and the quality of one's self-image and relationship with God are the primary themes underlying these changes. Those changes that were predominantly positive were associated with less severe symptomatology and more religious coping when compared to predominantly negative changes. These findings suggest that religious attitudes may be an ongoing and dynamic part of the experience of mental illness that should be considered in the treatment and research afforded by mental health professionals.     

Applying a Transdiagnostic Cognitive-Behavioral Treatment to Adolescents at High Risk for Serious Mental Illness: Rationale and Preliminary Findings

Given the chronic and deleterious course of serious mental illness (SMI; schizophrenia and bipolar disorder), significant efforts have been undertaken to improve prediction of SMI and provide treatment for adolescents in the early, putatively prodromal stage of these illnesses. While risk assessments and disorder-specific treatments for adolescents at risk for SMI have shown some efficacy, significant issues remain around disorder-specific treatments for these youth. There is substantial heterogeneity of psychopathology within adolescents at high risk for SMI that leads to many false-positives and varying diagnostic outcomes. As a result, initial treatment focusing on broad symptoms and skills has been proposed in place of disorder-specific treatments. We discuss the rationale for providing an already-developed and empirically supported transdiagnostic treatment for emotional disorders (termed the Unified Protocol) as a first-line staging of treatment for adolescents experiencing early SMI symptoms. Additionally, we outline the open trial we are piloting using this transdiagnostic treatment in adolescents between the ages of 13 – 17 who have begun experiencing distressing yet subsyndromal psychosis or bipolar mood symptoms. Preliminary findings suggest feasibility and acceptability as well as initial efficacy in improving psychiatric symptoms, quality of life, and difficulties regulating emotions. We also present case studies from our open trial. A unified, cognitive-behavioral treatment for early presentations of SMI has important clinical and public health benefits, including streamlining treatment and providing broad skills that are applicable to a wide range of psychopathology.     

Rock: An Unlikely Metaphor for Spirituality,Family Therapy,Mental Health and Illness

This article brings together fragments of a conceptual scheme and a number of big ideas: religious faith, contexts of African American spirituality, mental health and illness; and family therapy and the extended metaphor of sedimentary rock formation. Religion and spirituality are used somewhat interchangeably in this essay to signify embodied spirituality and sacred unity. The rock metaphor captures the idea of multiple entities that, like layers of sedimentary rock, make up families and communities and provide cohesion and a connection with the past. The rock metaphor captures the quality of hardness that may have either a positive of negative meaning and that allows for resilience in the face of adversity. Both qualities can be found in African American spirituality and Black churches. Both qualities have a relationship with the numinous. The qualities of the rock and their relationship with the numinous offer family therapists’ new insights and ways to think about how to approach a clinical presentation.     

Housing for People with Serious Mental Illness: A Comparison of Values and Research

This article contrasts values associated with the delivery of housing programs for people with serious mental illness with the typical topics pertaining to housing that are studied by researchers. Six values were identified through a search and content analysis of the literature on housing for people with serious mental illness. A second review of the literature was conducted to identify research on housing for this population. A comparison of findings from the two reviews suggested that whereas values concerned with the therapeutic benefits of housing had received considerable research attention, those concerned with a citizenship dimension had received relatively little. The findings are discussed in terms of their implications for the delivery of housing services and for housing research.     

Spirituality,Culture and Mental Health: Prospects and Risks for Contemporary Psychology of Religion

This paper asks whether: (1) psychology of religion is doing what it is supposed to do, (2) the contemporary psychological attention to religion and spirituality is perhaps of a transgressive nature, and (3) conceptualizations of spirituality in psychological publications are biased. It makes a plea for phenomenologically well-informed research on real forms of religion and spirituality, from a perspective that is as broad as psychology at present has become, with due regard for both the cultural make-up of the phenomena and the unavoidable limits of psychologists' professional competence.     

A Holistic Client Functioning Profile Comparison of People With Serious Mental Illness

Among a sample of 196 participants, small differences in holistic client functioning, as measured by standardized Adult Needs and Strengths Assessment (Lyons & Walton, 1999) and symptom severity scores, emerged across 3 diagnostic categories of serious mental illness (SMI; i.e., depression, bipolar disorder, and schizophrenia). However, sizable variations in symptom severity were evident across diagnoses of SMI, despite study participants receiving a similar configuration and intensity of recovery-oriented usual-care services. These results may evidence previous concerns surrounding the transdiagnosis of SMI, overlapping criteria and symptomatology among disorders in the Diagnostic and Statistical Manual of Mental Disorders, and mental health treatment and service practices in the United States. Implications for counselor practice are discussed.     

Spirituality and Religion: Implications for Counselors

In recent years, the topics of spirituality and religion have become more evident in the counseling literature. It seems logical that these areas could be of great interest to those in the counseling profession. This article summarizes W. R. Miller and C. E. Thoresen's (2003) overview of the field of research dealing with spirituality, religion, and health. Possible roles for spirituality and religion in counselor education and school counseling are highlighted.     

A Review of Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice

Book reviewed in this article: Craig S. Cashwell and J. Scott Young, Eds. (2005). Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice     

Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals With Serious Mental Illness

Mental health professionals frequently work with family caregivers in the provision of psychotherapy services to individuals with serious mental illness. To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. When working with family caregivers, practitioners utilize the American Psychological Association’s Ethics Code (2010), legal codes, and a complex decision-making plan; identify and communicate ethical obligations to family caregivers; consider the unmet needs of this population; avoid harm resulting from multiple relationships; and balance ethical duties of beneficence and respect for autonomy.     

Mental Illness and Psychiatric Treatment Among Women

When mental illness is precisely defined as a functional disorder involving acute distress or disorganization (or both), women are consistently found to have higher rates of mental illness than men. This sex difference appears to be real and not an artifact of response bias, patient behavior, or clinician bias. The higher rates of mental illness among women can be linked to aspects of their societal role and particularly to aspects of the marital role. Therapists who treat women whose mental illness is in part a response to the characteristics of conventional sex roles have no treatment alternatives that are not in some way problematic. The treatment alternative chosen has, in the broadest sense, political implications for the society at large.