Religion and Spirituality in Psychiatry

258 René Heftibenefits of forgiveness. Then members reflectedon incidents in their lives when they were hurt byanother person or institution. Finally, the stepstoward forgiveness were briefly outlined. (72)Week Six: Hope. The primary goal was toexplore spiritual strategies that could be usedto hold on to hope. Facilitating questions weretaken from readings on integrating hope andspirituality into treatment. (73) Group membersfirst talked about the meaning of hope and reasonsto retain hope. They then divided into pairsand discussed their personal hopes. The majorpathways to keeping hope alive were throughspiritual rituals (for example, hymns, reading theBible), trusting that God has a greater purpose,and through supporting each other.Week Seven: Wrap-up. In the final session,the two permanent facilitators reviewed thetopics covered by the group, solicited feedbackfrom group members, and shared their personalreactions. Emphasis was placed on maintainingconfidentiality even after the group ended. Asurvey was also distributed to gather feedback.Participants were asked what they learned fromthe group, what they found most helpful andleast helpful, and what suggestions they had forfuture groups. Most members spontaneouslyexpressed that they wanted the group to continue.Although most members felt they did notnecessarily learn new information, they enjoyedand appreciated the unique forum in which theycould explore an area that is often neglected inthe mental health services setting. Participantsfurther reported that they liked hearing others’spiritual beliefs and interests.In conclusion, this intervention appeared toreach many of its original objectives. It provideda safe environment for those with SMI to discussspiritual concerns. This unique topic of interventionappeared to be highly valued by participants.Community mental health professionals mayfeel that it is not their place to employ a spiritualissues group in a publicly funded agency. YetRichards and Bergin (74) (p. 159) note that there“are no professional ethical guidelines that prohibittherapists in civic settings from discussingreligious issues or using spiritual interventionswith clients.” In fact, they assert, it is unethical toderogate or overlook this dimension.Overall, this intervention holds promise asa useful addition to current community mentalhealth practice. Such groups have been run bylicensed nurse practitioners,( 62) social workers,(75) and clinical/community psychologists. (15)With some training in the area of serious mentalillness and spiritual concerns, professionalsfrom diverse areas of training (for example, psychiatristsand hospital chaplains) could also leadgroups or supervise the intervention.4.5. The Integrative Concept of theSGM-Clinic Langenthal (Switzerland)Th e scientific framework for our integrativeconcept is the extended bio-psycho-socialmodel (28) as described earlier in the chapter.We believe that in mental as well as in physicalillness there is always an existential and thereforea spiritual dimension that will influencetherapy in an explicit or more implicit way. Forthis reason, we take a spiritual history fromevery patient. We want to know whether andhow religiousness or spirituality determines thepatient’s understanding of his illness. Does thepatient have spiritual resources in coping withhis mental condition, or are his religious beliefsa burden and an obstacle in the therapeuticprocess?If a patient doesn’t consider himself religiousor spiritual, he will get a state-of-the-art-treatmentfor his mental illness focusing on his or herpersonal treatment goals. If a patient is religiousor spiritual, we try to understand how he wantsto integrate these aspects into his treatment program.Spiritual treatment goals can be:■■■■■Regaining hope and meaningStrengthen the relationship with God to bettercope with mental illnessPersevere in difficult circumstancesResolving anger, frustration, or disappointmenttoward GodUnderstanding why God allows bad things tohappen in patients’ lives