Religion and Spirituality in Psychiatry

Integrating Spiritual Issues into Therapy 249Physicians,psychiatristaPsychiatricnursesPastoralcounselorsPsychologists,PsychotherapistsMentally illPatientSocial workersArt and musictherapistsPhysiotherapistsFigure 17.3. Model of an interdisciplinary team (inpatient setting).beliefs or activities to cope with daily difficultiesor frustrations. A majority of participantsdevoted as much as half of their total coping timeto religious practices, with prayer being the mostfrequent activity. Specific religious coping strategies,such as prayer or reading the Bible, wereassociated with higher SCL-90 scores (indicatingmore severe symptoms), more reported frustration,and a lower GAF score (indicating greaterimpairment). The amount of time that participantsdevoted to religious coping was negativelyrelated to reported levels of frustration and scoreson the SCL-90 symptom subscales. The resultsof the study suggest that religious activities andbeliefs may be particularly important for personswho are experiencing more severe symptoms,and increased religious activity may be associatedwith reduced symptoms over time.This is not only true in the United Statesbut also in Europe. The findings of Tepperet al. have been replicated by Mohr et al. inGeneva, Switzerland. (49) Semistructured interviewsfocused on religious coping were conductedwith a sample of 115 outpatients with psychoticillness at one of Geneva’s four psychiatric outpatientfacilities. For a majority of patients, religioninstilled hope, purpose, and meaning in their lives(71 percent), whereas for some, it induced spiritualdespair (14 percent). Patients also reportedthat religion lessened (54 percent) or increased(10 percent) psychotic and general symptoms.Religion was also found to increase social integration(28 percent) or social isolation (3 percent). Itreduced (33 percent) or increased (10 percent) therisk of suicide attempts, reduced (14 percent) orincreased (3 percent) substance use, and fosteredadherence to (16 percent) or was in oppositionto (15 percent) psychiatric treatment. The resultshighlight the clinical significance of religion andreligious coping in the care of patients with schizophrenia.Thus, spirituality should be integratedinto the psychosocial dimension of care.Huguelet et al. from the same public psychiatricoutpatient department in Geneva investigatedspirituality and religious practices of outpatients(N = 100) with schizophrenia and comparedthem with their clinician’s knowledge of patients’religious involvement. (50) Audiotaped interviewswere conducted about spirituality and religiouscoping. The patients’ clinicians (N = 34) wereasked about their own beliefs and religious activitiesas well as their patients’ religious and clinical