Religion and Spirituality in Psychiatry

Teaching Religious and Spiritual Issues 339on religious or spiritual issues. Brawer et al. (45)noted psychology’s “general negative stance” onreligion and spirituality. Despite this, they notedthat psychology is following the U.S. trend towardaddressing religion- spirituality in medical training,but not to the degree seen in medical schoolsand psychiatry residencies. Brawer and colleaguesnote more journals and more research devotedto psychology and religion-spirituality and thecreation of Division 36 of the APA (psychology)devoted to religion-spirituality in psychology.The latter development indicates a considerablenumber of psychologists with a primary interestin religion-spirituality. But does this translate intoattention to this topic in training?Brawer and colleagues (45) investigated thisquestion with a survey of education in religionspiritualityin the APA-accredited clinical psychologyprograms in the United States andCanada. They considered course work, research,and clinical supervision in a survey of directorsof training of the 197 programs accredited as of1998. Among ninety-eight respondents, theyfound that 13 percent of programs offered a specificcourse on religion-spirituality in psychology.Twenty-four more programs were consideringadding such a course. In the 77 percent of programsthat addressed religion-spirituality in clinicalsupervision, coverage was often inconsistentlyincorporated into the usual supervisory process.In 61 percent of programs, religion-spiritualitywas covered as part of another course not devotedspecifically to religion or spirituality: in culturaldiversity courses (57 percent), ethics courses(41 percent), psychotherapy courses (32 percent),psychopathology courses (19 percent), andcourses on psychology history, family, and assessment.Brawer and colleagues concluded that psychologytraining programs tended to incorporatereligion-spirituality into multiple course offerings.More than 30 percent of the training programshad a faculty member who had published scholarlywork on religion-spirituality, and 22 percenthad a faculty member who identified this fieldas a major area of interest. Forty-three percentof programs had a student whose major area ofinterest was religion- spirituality. This study didnot specify if programs were masters or doctoratelevel. Data collection methods for Brawer et al.’sstudy and for research on psychiatry residenciesare too different for meaningful comparison ofreligious-spiritual education of psychiatrists andpsychologists in North America.Th e data of Brawer and colleagues’ studyneed replication, but indicate that religionspiritualitytraining, while infrequent, is becomingmore available to Canadian and Americanpsychologists. Systematic training in this fieldstill occurs only in a minority of psychologicalprograms ( systematic in 17 percent),( 45) butinterest appears to be rising, and a corps of facultymembers is forming to mentor research inreligion-spirituality for future generations ofpsychologists. Still, the majority of programs donot offer much education in this area. Furtherevidence that North American psychology ismore interested in religion-spirituality comesfrom the APA’s (psychology) recent publicationof several books dealing with religion in therapy:Shafranske’s Religion and the Clinical Practiceof Psychology (46) and Richards and Bergin’sHandbook of Psychotherapy and ReligiousDiversity . (47) Like our polar ice caps, thefrostiness of psychology to religion-spiritualityappears to be melting somewhat.3.2.4. European Psychiatry Training:United KingdomLittle information is available on whetherreligion-spirituality courses are actually taughtin U.K. psychiatry residencies. As in the UnitedStates, U.K. psychiatrists are considerably less personallyreligious than the general population: 27percent of 231 London teaching hospital psychiatristsand psychiatric residents reported areligious affiliation (versus two-thirds of the residents’parents) and 23 percent (versus 70 percentof the U.K. population) endorsed a belief inGod.(48 , 49 ) Among respondent psychiatrists,87 percent attended religious services once a yearor not at all. Psychiatrists who trained outsideEurope tended to report a belief in God morethan those who trained in Europe (35 percentversus 20 percent, p = NS). In practice, about half