Spiritual,Religious, Nonspiritual,and Nonreligious Narratives in Marginalized Older Adults: A Typology of Coping Styles

SUMMARY

Narrative therapy is an important tool in the phenomenological framing of life events with older clients. Seventy-nine older adults who lived independently in four subsidized high-rise housing facilities in Chicago were interviewed in a research project about managing life challenges. Cases represent four types in a spiritual-religious typology: religious and spiritual, religious only, spiritual only, and neither religious nor spiritual (Zinnbauer, 1997). This article explores how older adults managed adversity and maintained a sense of self-efficacy. Findings indicate that older adults use many references to religion and spirituality in their narratives, either embracing these domains or defining themselves in contrast to them. Narrative therapy suggests that the implications of religious and spiritual resources addressed in client stories may reinforce coping capacity and promote aging well.     

Research and Theory Religion and Spirituality in Coping With Stress

Relations among and between religion, spirituality, and the ability to cope with stress were examined using a sample of 115 graduate students in counseling. Religion and spirituality positively correlated with coping with stress. Counseling students who expressed spirituality through religious beliefs had greater spiritual health and immunity to stressful situations than counseling students who identified themselves as spiritual but not religious. Counseling students with a religious/spiritual affiliation indicated more discomfort counseling clients hostile to religion compared with counseling students with a spiritual‐only affiliation. The results have implications for preparing counseling students to work with clients with religious/spiritual issues.     

The Doubting Process: A Longitudinal Study of the Precipitants and Consequences of Religious Doubt in Older Adults

Religious doubt arises from a process in which there is a precipitant, the experience of doubt, a coping response, and a health-related outcome. We assess whether social factors precipitate doubt and the coping responses that are invoked to deal with doubt. We evaluate whether these coping responses are, in turn, associated with health. Over time, people who encounter more negative interaction with fellow congregants have more doubts about religion, whereas more spiritual support and greater involvement in prayer groups are associated with less religious doubt. People who encounter more negative interaction are more likely to suppress religious doubts, but people who attend Bible study groups are more likely to seek spiritual growth when faced with doubt. Suppressing religious doubt is associated with less favorable health, whereas seeking spiritual growth has no significant effect.     

Therapists' Use of Religious and Spiritual Interventions in Christian Counseling: A Preliminary Report

This study explored the use of religious and spiritual interventions in counseling by Christian therapists (N = 100). Use of religious and spiritual interventions correlated with personal religiousness and clinical training involving religious clients and religious and spiritual interventions. Course work involving either psychology or theology did not correlate with use of or self‐reported competency in using religious and spiritual interventions. Self‐reported competency was associated with personal religiousness; professional beliefs, attitudes, and values; personal experiences with counseling; and clinical training involving religious clients and religious and spiritual interventions. It is suggested that training programs incorporate clinical rotations, workshops, and supervision involving religious clients and religious and spiritual interventions to teach therapists to use religious and spiritual interventions in counseling.     

Spiritual pathology and religious coping as predictors of forgiveness

Spiritual pathology, religious coping, and dispositional forgiveness were investigated in two studies with graduate students at a Christian university-based seminary. Spiritual pathology was operationalised using measures of spiritual instability and spiritual grandiosity. Study 1 (N?=?194) examined patterns of correlation between positive and negative religious coping items, spiritual pathology, and dispositional forgiveness. Spiritual instability correlated with numerous positive and negative religious coping items while spiritual grandiosity did not. Dispositional forgiveness correlated with more positive than negative religious coping items. Study 2 (N?=?214) tested regression models with these variables. Spiritual grandiosity showed a significant quadratic (concave down) effect in predicting dispositional forgiveness while the linear effect was not significant. A hierarchical regression model showed positive religious coping, spiritual instability, and the quadratic effect for spiritual grandiosity each predicted unique variance in dispositional forgiveness after controlling for spiritual impression management. Negative religious coping was not related to dispositional forgiveness when included with these variables.     

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.     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

Spirituality and Substance Abuse Recovery

Researchers explored patient and staff perceptions of spiritual well-being and the spiritual needs of patients enrolled in a residential substance abuse treatment program. The Spiritual Well-Being Scale was used to gather quantitative data. Additionally, a brief questionnaire containing one qualitative and two quantitative questions was completed by both clients and staff. A statistically significant difference was found, indicating a more positive sense of spiritual well-being among patients upon discharge. Although the staff and clients of the residential program have similar perceptions regarding the concept of spiritual well-being, their definitions do not appear identical.     

Stress, Religious Coping Resources, and Depressive Symptoms in an Urban Adolescent Sample

We surveyed low-income urban adolescents about their total exposure to urban stressors and their use of religious coping resources, specifically in the areas of social support, spiritual support, and community service opportunities provided by their congregations. Additionally, we assessed their current levels of depressive symptomatology. Among females, the relationship between stress and depressive symptoms was moderated by the use of spiritual support and community service opportunities. The moderating relationship was such that at low levels of stress, high usage of these resources protected against the development of depressive symptoms. At high levels of stress, however, the protective relationship was lost. Lastly, when the social support aspects of religious coping were statistically controlled, the moderation effect disappeared, suggesting that within this sample, the social support seeking aspects of the resources, rather than their religious nature, was responsible for the effects.     

Religious Coping Style, Concept of God, and Personal Religious Variables in Threat, Loss, and Challenge Situations

This study explored the important mediating role of personal religious variables and God concept in the use of religious coping in threat, loss, and challenge situations. One hundred and twenty-nine undergraduates completed questionnaires which included a God concept adjective checklist (Schaefer and Gorsuch 1992), a stressor scenario (Bjorck and Cohen 1993), and a measure of religious coping adapted from the BAV model (Gorsuch 1988). Results suggest that personal variables such as God concept and perception of others' beliefs played important mediating roles in religious coping in stressor situations. The relationship between coping style and stressor scenario was not entirely state-dependent, but influenced by personal variables. Strong relationships existed among God concept, the importance individuals placed on their religious and spiritual lives, and participation in religious activities.     

When 2–3% really matters: The (un)importance of religiosity in psychotherapy

Previous research suggests that clients’ religious beliefs are commonly excluded from therapeutic practice. Often, this exclusion is attributed to practitioners’ lack of knowledge or appropriate skills. Such analyses, however, have little regard for the interactional aspects of the therapist/client encounter. Drawing upon work within discursive social psychology, we argue that the exclusion of religious beliefs does not reflect therapists’ lack of knowledge or awareness but can more usefully be seen as the discursive accomplishment of marginalizing clients’ beliefs. Six practising psychotherapists were interviewed about religious beliefs within the therapeutic process. Participants construct religious beliefs as important but relevant only to restricted categories of clients. They rework religious beliefs as compatible with accepted practice, or construct particular groups of clients as incompatible with the process. Training and other requirements are reformulated in terms of spiritual beliefs rather than religious beliefs. These constructions display awareness of religious beliefs while marginalizing their relevance in practice. Inclusion of clients’ religious beliefs to best effect will require more psychotherapy to engage more constructively with religion than it does at present.     

Religious Coping and Quality of Life Among Severely Ill Lung Patients in a Secular Society

This survey study investigated the prevalence of religious beliefs and religious coping and possible associations between religious factors and quality of life (QoL) among a group of severely ill lung patients (lung cancer and chronic obstructive pulmonary disease) in Denmark (N = 111). Almost two thirds (64.8%) reported having some belief in God and/or a spiritual power. Patients who reported believing in God and patients who believed in God and a spiritual power reported better QoL than patients who reported that they believed in a spiritual power only. Religious coping was prevalent; for positive religious coping strategies, those used from least to most often, respectively, were invoked 15% to 37% of the time; for negative religious coping strategies the percentages were 3% to 16%. Negative religious coping was associated with lower QoL (β = ?0.320, p < .006), whereas no associations were found between positive religious coping and QoL. Results are discussed in relation to the cultural context of secularized societies like the Scandinavian countries.     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

Caring for Aging Parents: The Influence of Family Coping,Spirituality/Religiosity,and Hope on the Marital Satisfaction of Family Caregivers

The goal of this study was to gain a more complete understanding of the marital satisfaction of family caregivers based on a strength-based framework of family resiliency. Previous research has identified a relationship between the caregiving experience and coping, spirituality/religiosity, and hope, but no study to date has investigated the effect of those three variables on the marital satisfaction of family caregivers. We hypothesized that family caregivers who are spiritual/religious, hopeful, and use effective family coping strategies would experience greater marital satisfaction. A hierarchical linear regression analyzing data from 191 family caregivers supported the hypotheses. Implications for clinicians are discussed.     

Influence of religiosity on self-reported response to psychological therapies

There is a lack of research exploring the influence of religious or spiritual beliefs on response to psychological therapies. Our aims were to confirm the positive relationship between religiosity and psychological wellbeing, and investigate the potential synergistic impact of religiosity on self-reported response to psychological therapies. Participants were 118 adults (33 male, 85 female) aged 18 to 78 (M?=?40.01, SD?=?15.41); data was collected via online survey. Religious and psychological variables were assessed using a range of standard measures including the Depression, Anxiety and Stress Scale, the Warwick-Edinburgh Mental Well-being Scale, and the Daily Spiritual Experiences Scale. Atheists reported less psychological distress and increased personal wellbeing; participants with higher levels of religiosity experienced greater ongoing benefits from therapy in domains of coping and social functioning. Results suggest that mental health practitioners should consider the religious/spiritual beliefs and behaviours of their clients in their interventions.     

Reconciling Spiritual Values Conflicts for Counselors and Lesbian and Gay Clients

Counselors and lesbian and gay clients experience parallel values conflicts between religious beliefs/spirituality and sexual orientation. This article uses critical thinking to assist counselors to integrate religious/spiritual beliefs with professional ethical codes. Clients are assisted to integrate religious/spiritual beliefs with sexual orientation.     

Social Factors in the Church and Positive Religious Coping Responses: Assessing Differences Among Older Whites, Older Blacks, and Older Mexican Americans

Findings from a growing number of studies point to the social basis of a wide range of religious beliefs and behaviors. This study has two main goals. The first is to see whether four social aspects of congregational life (church attendance, attendance at Bible study groups, attendance at prayer groups, and informal spiritual support) are associated with greater use of positive religious coping responses. The second goal is to determine if the relationships between these social aspects of the church and religious coping vary across older whites, older blacks, and older Mexican Americans. The data suggest that more frequent church attendance is associated with greater use of religious coping responses in all three groups. However, the findings further reveal that the relationship between informal spiritual support and religious coping is especially stronger among older whites. The theoretical implications of these findings are discussed.     

Religious coping in highly religious psychiatric inpatients

This study among highly religious psychiatric patients in a mental hospital in the Netherlands focused on the following issues: their religious and spiritual beliefs and activities; their religious coping activities, measured using Pargament's three coping styles and a positive religious coping scale; the influence of religious coping on psychological and existential well-being; and the predictive value of general religiousness, as compared with religious coping activities, regarding psychological and existential well-being.

For this population of inpatients, religion had a positive influence on their ways of dealing with mental problems; religious coping was positively correlated with existential and psychological well-being. General religiousness as well as religious coping were positively correlated with existential well-being, whereas psychological well-being primarily was predicted by positive religious coping.

Results are discussed in the context of theoretical notions of religious coping, addressing in particular the positive influence of religious beliefs, relying on God, religious activities and religious social support in psychological and existential times of crisis.