Religion and Spirituality in Psychiatry

366 Philippe Huguelet and Harold G. Koenighave implemented a holistic and interdisciplinarymodel for therapy based on an “extended”bio-psycho- social model. In such settings, thepastoral/spiritual counselor may be involvedin the interdisciplinary team, with rightsand responsibilities similar to that of othertherapists.The chapter on integrating spirituality intotherapy includes detailed information aboutone such program in Langenthal, Switzerland.Patients who request such treatment are providedwith both state-of-the-art psychiatric andpsychological treatment plus spiritual treatment,where the goals of therapy focus on regaininghope and meaning, strengthening the relationshipwith God, or working toward forgiveness inbroken relationships. Psycho-educational groupmeetings are offered that focus on the integrationof therapeutic and spiritual aspects of care,emphasizing the benefit and importance of religiousand spiritual coping. There are also spiritualsinging and music groups, art therapy, anddiscussion groups, often led by a pastoral counselor.Spiritual issues such as unhealthy beliefsare also challenged from both a spiritual and apsychotherapeutic view in counseling.Families taking care of patients with mentaldisorders often face a heavy burden. Research hasgenerally found that religiosity among caregiversis linked to enhanced adjustment. Family membersoften turn to religion to cope with the stressof caring for an ill family member. The authoremphasizes how religiosity may contribute tothe well-being of caregivers by expanding theircapacity and motivation for self-care.18. EXPLANATORY MODELS MENTALILLNESS AND ITS TREATMENTOver the course of history, a number of theoreticalissues concerning the causes of mental disorders(or explanatory models) have preoccupiedthe mental health field. People who are sufferingtend to explain their disease according to collectivelyelaborated social constructions, which cannotbe reduced to mere institutional or medicaldefinitions. These explanations include severaldimensions of a religious, collective, existential,emotional, and sentimental nature.When clinicians meet with their patients,there are actually two different cultural and spiritualperspectives to reconcile through communication,confrontation, and sometimes evennegotiation. Furthermore, as compared withWestern societies, people in developing countries(and minority groups living within developedcountries) seem to attach more importanceto the symbolic and spiritual side of the disease.The different understandings of the disease mayinfluence treatment choices as they are developedby patients. Chronic mental disorders area major reason why patients seek out alternativetherapies.Clinicians can deal with this issue by carefullyconsidering patients’ explanatory modelsfor their psychiatric disorders. Religious beliefscan have either a positive or negative impact onadherence to the treatment. Sometimes, medicaltreatment may enter into conflict with the teachingsof religious groups.Even if the patient’s account of the situationmay be perceived as irrational or inconsistent,clinicians should try to build bridges betweentheir own explanatory models and those ofpatients. Even neuropharmacology can be presentedas related to God’s creation. Nobody canprove it, but nobody can disprove it either! Inthis way, an explanatory model that takes bothpositions into account can be “negotiated” withthe patient. This is especially important becauseevidence suggests that patients are more satisfiedwhen their psychiatrist shares their modelof understanding distress and treatment.19. PSYCHOTHERAPY FROM ACHRISTIAN PERSPECTIVEChristian forms of psychotherapy seek to transformthe mind of the believer so that they can findmeaning and purpose in their relationship withGod. They use the teachings found in the Bibleand integrate them with current secular concepts.Christian psychotherapy involves belief ina cosmology (an explanation as to why things are