Religion and Spirituality in Psychiatry

254 René HeftiTable 17.1: Overview of Four Programs Integrating Religious and Spiritual Issues.Therapy Group onSpiritual IssuesSpirituality Group (SG) Spirituality MattersGroup (SMG)Spiritual IssuesPsychoeducational GroupAuthor(s) Kehoe NC Wong-McDonald A Revheim N,Greenberg WMCenter Day treatment center Hollywood Mental Nathan Kline Institute,Health Center Clinical ResearchEvaluation FacilitySettingFormat of the SGPurposeSpiritual key elements,interventionsEvaluationResultPersonal statements ofgroup membersConclusionOutpatient setting,chronically illpsychiatric patients,22 to 60 years old45 minutes weekly,ongoing, typically 10to 12 clients, attendingfor 2 to 3 yearsFoster tolerance,self-awareness, andnonpathogenictherapeuticexploration of valuesystemsExploring waysin which beliefsand practices helpor hinder copingwith mental illness.Consideringquestions, problems,and feelings aboutreligious belief. Strictgroup rules: toleranceand respectFeedback of the groupand co-workersTranscripts ofgroup meetings:exemplification ofgroup interactions“Group interactionsreveal that individualsare more than theirmental illness”A group focusingon religious issuescan provide anopportunity to exploretopics usually ignoredby mental healthpracticeCommunity-basedpsychosocial rehabprogram, psychiatricoutpatients, 2 days aweek1 hour per week, 20participants, openended,focusing ontopics of interestEnhance recovery,support treatmentgoals, helpparticipants gain aspiritual perspectiveDiscussing spiritualconcepts, encouragingforgiveness,referring to spiritualwritings, listeningto spiritual music,encouraging spiritualand emotionalsupport amonggroup membersand with their faithcommunitiesDegree of goalattainment100% goal attainmentin the SG vs. 57% inthe non-SG“By remembering thatJesus suffered morethan I ever did keptme from self-pity”Spirituality asa therapeuticcomponent canenhance recovery ofpersons with severemental illness24-bed state-hospitalinpatient unitfor persons withpersistent psychiatricdisabilitiesContinuousenrollment, typically12 to 40 sessions,multi- disciplinaryconceptPromote spiritualand social supportand improve copingresources, emotionfocusedcopingStructured grouptreatment approachaddressing spirituality,promote usingspiritual beliefs forcoping, shiftingperspective fromvictimization toresilience. Readingpsalms and spiritualstories, recitingprayersEvaluation period inthe second yearMore qualitative,e.g., new insights:medication as a giftof GodAs an outcome of agroup discussion: “OhLord, your medicationhas brought me asense of peace”Reviewing activityplans and group notesidentified themesconsistent with an“emotion-focusedcoping” modelPhillips RE, Laking R,Pargament KILocal communitymental health centerOutpatient setting,people with seriousmental illness (SMI),referred by mentalhealth workersSeven weeks, 1.5hrs/week, psychoeducationalprogram,10 participantsProvide newinformation aboutspirituality and allowparticipants to shareexperiencesPresenting aninclusive set ofspiritual topics:spiritual resources,spiritual strivings,spiritual struggles,forgiveness of others,and spiritual strategiesto promote hopeSurvey for feedback ofthe groupAppreciation of thegroup, the uniqueopportunity to discussspiritual issues“I liked hearing fromother spiritual beliefsand interests”The interventionappeared to reach itsoriginal objectivesand provided asafe environmentto discuss spiritualconcerns