Religion and Spirituality in Psychiatry

224 Marcus M. McKinneychallenges like this. Initiating a nonjudgmentalrelationship with spiritual leaders will serve toclarify common ground.Referring to faith leaders can lighten thepressure clinicians and/or faith leaders may feelin caring for people. In our pastoral counselingtraining program (6) we have seen medical, psychiatric,and faith leaders benefit from the supportthey receive by a more collaborative style. Theysleep better at night. They feel less responsiblefor “ curing” the person and experience more of acaring role that has healing outcomes.The life of a client seen from the perspective ofa spiritual leader can fill in critical diagnostic andcompliance information. A common reason forpatients decompensating may be noncompliancewith a treatment plan. Typically a person mightstop taking a medication or going to therapy.Spiritual leaders may know well what is causingresistance with a patient. Sometimes a personmay use their religion as a reason to justify noncompliancewith a care plan.Clinicians can learn key spiritual resources thatmake a difference to client outcomes. Spiritualleaders might know some common practiceswithin their own traditions that help, for example,depression. Clinicians might be more limited toacademic studies on spiritual resources. Groupsthat can assist people with talking about their illness,or about navigating employment, or findinghousing can be initiated in the community.It is good practice to have readily available localcontact information outlining such resources forpatients. I suspect nothing is more valuable thanlocal understanding of what helps a communitywith their mental health.Aside from our propensity to think of “mentalhealth” as individual in nature, it is advisableto assess the community mental health. By that Imean that culture and regional norms influenceour individual mental health. Where do we learnabout this? Collaboration with faith leaders whothink in those terms can inform us better as weassess and treat mental illness. For example, acommunity might be very introverted. Not rightor wrong, just is. The person with socializationneeds might inappropriately seek to “cure” his orher introversion. A clinician might value weighingfrom different perspectives (spiritual, cultural,individual) insight that can shape assessment andcare. In short, clinicians can learn from spiritualproviders also.Clients coming for psychiatric care mightnot know of an option to see a pastoral counselor.(Pastoral Counselor – This term refers toa minister who practices pastoral counselingat an advanced level which integrates religiousresources with insights from the behavioral sciences.Pastoral Counseling – This term refers toa process in which a pastoral counselor utilizesinsights and principles derived from the disciplinesof theology and the behavioral sciencesin working with individuals, couples, families,groups and social systems toward the achievementof wholeness and health.) Their contactwith spiritual professionals may be limited to“official” clergy from their denomination or localplace of worship. Many people desire a personwho can preserve their spiritual life while notneeding to defend any particular dogma, religion,or clergyperson.A referral would also be recommended whena clinician feels very passionate about his or herown spiritual orientation (or, conversely, has beeninjured by a spiritual/religious experience) and aclient presents in a way that tests the transferencearound their own issues.Sometimes a client may simply ask about theclinician’s religious faith. One way to hear thisquestion is the desire of the client to feel safe orhave common ground with his or her belief system.In many cases, the issue is addressed andno longer needs attention. However, this can betricky, even if both clinician and the client are ofthe same religious tradition. If the client’s carecan be facilitated by having a faith-based counselorserve as his or her primary support person,this might be considered. If transference is anissue and it is not addressed, the alternative cansometimes be having this issue float around theroom behind the scenes, popping out unexpectedlyas topics are touched.A final reason to refer is a bit controversial.Psychiatry and religion both can have a tendency