Religion and Spirituality in Psychiatry

Integrating Spiritual Issues into Therapy 253tolerance of diversity, respect of others’ beliefs,and a ban on proselytizing. Another factor is thatmembership is open to all, regardless of religiousbackground or diagnosis.At least three other programs integratingspiritual issues into mental health care originatefrom the United States. The main informationon these four spirituality groups is presentedin Table 17.1 . The programs will be describedin detail in the following paragraphs. In addition,the integrative concept of the SGM-Clinicas a European model will be discussed andillustrated.4.2. “Spirituality Group” at the HollywoodMental Health Center, Los AngelesThe study of Ana Wong-McDonald et al. (65)examines the results of a spirituality group thatwas offered at a psychosocial rehabilitation programat an inner-city community mental healthcenter in Los Angeles. It was anticipated that,along with proper medication and psychiatricrehabilitation, the inclusion of spirituality asa therapeutic component would enhance therecovery of persons who wish to incorporate it asa part of their treatment services.Of the forty-eight individuals included inthe study, twenty attended the spirituality group(SG). All of the participants in the SG indicatedthat spiritual issues are important in their livesand that they wish to discuss them in the group.Eighteen participants professed adherence tosome form of Judeo-Christian faith. The groupmembers indicated that the following issues werepertinent in their recovery: finding hope again;dealing with depression, fear and anxiety, negativethoughts, self-doubt, and self-worth; emotionalhealing; and forgiveness.The standard psychosocial rehabilitation programwas conducted two days per week, fivehours on each of the days, emphasizing skillstraining, psycho-education, community integration,and cognitive behavioral treatment. (66)In April 2003, however, a spirituality group wasoffered as a sixty-minute optional weekly sessionin the same time slot as the regular standardgroup. The spirituality group was open-ended.Each session focused on a topic of interest (forexample, forgiveness). Spiritual interventionsincluded discussing spiritual concepts (forexample, raising awareness of God’s promises ofpeace, love, and faith and helping participantsto see their self-worth based in God’s promises),encouraging forgiveness, referring to spiritualwritings (for example, encouraging participantsto read the story of the prodigal son to understandGod’s love and forgiveness), listening tospiritual music, and encouraging spiritual andemotional support among the SG members (forexample, praying for one another and telephoningeach other for support).The general purposes of the interventions wereto help participants understand their problemsfrom an eternal, spiritual perspective, to gain agreater sense of hope, to emotionally forgive andheal past pain, to accept responsibility for theirown actions, and to experience and affirm theirsense of identity and self-worth. Participantswere also encouraged to connect with their faithcommunities for social and spiritual support.At time of entry into the psych rehab groupand at six-month intervals thereafter, participantsset treatment goals for symptom management,community integration, and improvementin their overall quality of life. Examples of goalsincluded health-related wellness (such as loweringthe frequency of panic attacks, losing weight,decreasing cigarette smoking, and lowering thenumber of hospitalizations), socialization goals(such as making at least one new friend, goingout on a date, or saving money to go on vacationswith friends), and vocational and educationalgoals (such as obtaining a driver’s license, maintaininga car, earning a high school diploma, andobtaining a volunteer job).All twenty participants (100 percent) in thespirituality group (SG) achieved their treatmentgoals, compared to sixteen out of twenty-eightpeople (57 percent) in the nonspirituality group(non-SG). The difference in goal attainmentbetween the two groups was highly significant(p = .0001). Individual examples of how spiritualitymay enhance recovery give an idea of its