Religion and Spirituality in Psychiatry

256 René Heftireadings, or other materials that are read aloud.Topics are selected by leaders on a rotating basisand carefully prepared so that both negative andpositive emotions are addressed. For example,individual members’ guilt, anxiety, and intoleranceor cognitive distortions resulting fromprevious religious/spiritual experiences areexplored. Group members are encouraged toshare how the topic has relevance to the perceptionof their illness, previous behavior patterns,treatment failures (for example, medicationnonadherence, rehospitalization), and futuregoals (for example, appropriate discharge planning,commitment to treatment recommendations).At least one group leader is familiar withthe individual treatment plans and offers suchinput into the group process when appropriateto ensure integration with other clinical programmingfor goal attainment.In the ending phase , group members summarizethe session’s emergent themes and new learningthat influences goals and future choices, followedby a formal closing with a prayer composed bygroup members : “Give me light and insight so thatI may trust. Let me learn the way of peace so thatI may grow…. May those who find themselves offtrack, be guided. May those who are afraid, findcomfort. And may we all find patience on ourpath.” Topics for subsequent groups emerge fromeach week’s discussion, which fosters continuity,repetition, and self-disclosure.Group activities and exercises highlight usingspirituality as a coping mechanism during recovery.The principal group activities are readingPsalms (consistent with most participants havingJudeo-Christian identification), reading prayers,writing prayers, and telling stories from a varietyof faith perspectives.■■■faith that maintain strength and perseveranceduring these difficulties.Reciting prayers together that are familiar andcommon (“St. Francis Prayer”) or those specificfor personal needs (for example “prayersto start the day”) reinforce individuals’ existingreligious/spiritual practices. Using congregateprayers with individuals with limited socialskills can enhance social support throughfocusing on a shared goal.Writing original prayers helps improve selfawarenessof one’s needs and allows articulationof one’s experiences in a setting thatbrings comfort and a sense of closure. The useof templates or prayer formats (praise, thanksgiving,and intercession) assists individuals inthis creative and empowering experience.Reading spiritual stories, fables, allegories andpersonal narratives of others allows groupmembers to identify personal needs and values,and through identification, offers opportunitiesto express difficult emotions.Reviewing activity plans and group notes identifiedthemes consistent with an “emotion-focusedcoping” model.( 70) Emotion-focused copingincludes cognitive reframing, social comparisons,minimization (“looking on the bright sideof things”), and behavioral efforts to feel better(exercise, relaxation, meditation, support, religion,humor, and talking). Emotion-focusedcoping is useful when a situation cannot bechanged, and only the emotional response canbe changed, which can be self-affirming andempowering. This coping style is congruent withboth recovery and SMG goals and can coexistwith problem-focused approaches.■Readings from the Book of Psalms (69) evokethe full range of human emotions from thanksgivingand praise to anger, fear, desperation,despair, abandonment, hope, and protection.Reading selected Psalms as a group, followedby personal sharing, emphasizes the universalnature of experiencing conflicts and strugglesin daily life, while focusing on elements of4.4. “Spiritual Issues PsychoeducationalGroup” at a Community CenterThis study describes an innovative program forpeople with serious mental illness (SMI) whoare dealing with spiritual/religious issues. (68)The program was a seven-week semistructured,psycho-educational intervention in which participantsdiscussed religious resources, spiritual