Spiritually-based Interventions Research Articles

Spiritual Awakening in 12-Step Recovery: Impact Among Residential Aftercare Residents.

Spiritually-based interventions in the form of 12-step programs are frequently offered as a part of substance use treatment programs in the United States. Programs based in the 12 steps guarantee that by working their program, an individual will undergo a process of transformation labeled a spiritual awakening. However, the impact of this experience on recovery factors and treatment adherence is unclear. The current study investigated adult residents (n = 115) who experienced a spiritual awakening attributed to 12-step group affiliation during their stay at residential aftercare facilities for substance use disorder. Self-efficacy and hope were greater for individuals who experienced a spiritual awakening versus those persons who did not experience awakening. Awakening was associated with greater affiliation to AA and decreased negative exit from the facility. Results revealed the potential for an awakening to improve treatment behavior and outcomes in a residential environment, as well as benefit an individual's personal recovery resources. Further theoretical and clinical implications are discussed.

Integrative Body-Mind-Spirit (I-BMS) Interventions for Posttraumatic Stress Disorder (PTSD): A Review of the Outcome Literature

ABSTRACTBackground: A growing interest in integrative body-mind-spirit (I-BMS) approaches to treatment of PTSD has resulted in a significant increase in related research. Method: This study conducted a synthesized review of randomized controlled trials of I-BMS treatments for PTSD, yielding thirteen studies that included: mindfulness/meditation (7), yoga (3), acupuncture (1), spiritually-based intervention (1), and relaxation (1) from 2004–2015. The study used a modified Delphi List (mDL) and the California Evidence-Based Clearinghouse (CEBC) to evaluate study rigor and level of research support for each practice. Results: Overall, I-BMS interventions demonstrated positive outcomes. Based on an mDL range between 0 and 7, scores were: 6 for meditation/mindfulness, 5.67 for yoga, 7 for acupuncture, 3 for spiritually-based intervention, and 4.5 for relaxation training. All interventions were recommended as practices with Promising Research Evidence (Level 3). Effect sizes (d) ranged from .51 to 1.88 for relaxation, .38 to 1.02 for spiritual, .31 to 1.4 for acupuncture, .1 to 1.54 for yoga and .2 to 1.53 for mindfulness meditation. Discussion: This study identified acupuncture, meditation, and yoga as high-quality alternative therapeutic practices for PTSD with promising evidence as effective and safe approaches. Future studies should assess long-term effects to further elevate the level of research support.

Multi-site evaluation of a complementary, spiritually-based intervention for Veterans: The Mantram Repetition Program

BackgroundMental and physical symptoms affect Veterans' quality of life. Despite available conventional treatments, an increasing number of Veterans are seeking complementary approaches to symptom management. Research on the Mantram Repetition Program (MRP), a spiritually-based intervention, has shown significant improvements in psychological distress and spiritual well-being in randomized trials. However, these findings have not been replicated in real-world settings. MethodsIn this naturalistic study, we analyzed outcomes from 273 Veterans who participated in MRP at six sites and explored outcomes based on facilitator training methods. Measures included satisfaction and symptoms of anxiety, depression, and somatization using the Brief Symptom Inventory-18; Functional Assessment of Chronic Illness Therapy-Spiritual Well-being questionnaire; and the Mindfulness Attention Awareness Scale. ResultsThere were significant improvements in all outcomes (p's < .001) regardless of how facilitators were trained. Patient satisfaction was high. ConclusionThe MRP was disseminated successfully yielding improvements in psychological distress, spiritual well-being, and mindfulness.

You Say You Want a (Food) Revolution

Mental and physical symptoms affect Veterans' quality of life. Despite available conventional treatments, an increasing number of Veterans are seeking complementary approaches to symptom management. Research on the Mantram Repetition Program (MRP), a spiritually-based intervention, has shown significant improvements in psychological distress and spiritual well-being in randomized trials. However, these findings have not been replicated in real-world settings.In this naturalistic study, we analyzed outcomes from 273 Veterans who participated in MRP at six sites and explored outcomes based on facilitator training methods. Measures included satisfaction and symptoms of anxiety, depression, and somatization using the Brief Symptom Inventory-18; Functional Assessment of Chronic Illness Therapy-Spiritual Well-being questionnaire; and the Mindfulness Attention Awareness Scale.There were significant improvements in all outcomes (p's < .001) regardless of how facilitators were trained. Patient satisfaction was high.The MRP was disseminated successfully yielding improvements in psychological distress, spiritual well-being, and mindfulness.

A Multifaith Spiritually Based Intervention Versus Supportive Therapy for Generalized Anxiety Disorder: A Pilot Randomized Controlled Trial

ObjectivesWe have previously reported that a multifaith spiritually based intervention (SBI) may have efficacy in the treatment of generalized anxiety disorder (GAD). This randomized pilot trial tested whether the SBI had greater efficacy than a nonspecific control condition in GAD.MethodTwenty-three participants with GAD of at least moderate severity were randomized to 12 individual sessions of the SBI (n = 11) or supportive psychotherapy (SP)—our control condition (n = 12).ResultsIntent-to-treat analysis revealed the SBI fared better than SP in decreasing blind clinician ratings of anxiety and illness severity and self-report worry and intolerance of uncertainty, with large between-group effect sizes. The SBI also produced greater changes in spiritual well-being. Results remained the same when supplementary analyses were performed on the completer sample. Treatment gains were maintained at 3-months follow-up.ConclusionsThis small pilot trial demonstrates that a nondenominational SBI has greater efficacy than a rigorous control in improving symptoms of GAD and enhancing spiritual well-being. These results are encouraging and further research on the efficacy of the SBI and its underlying mechanisms is warranted.

Comforting children and families who grieve: Incorporating spiritual support

Based on specific school and community tragedies, this article reviews difficult situations and how students’ spiritual and religious beliefs were incorporated into school-based grief interventions. Suggestions are made to strengthen this often untapped resource, encouraging school-based mental health professionals to consult with community spiritual leaders and parents, exploring students’ spiritual resources and more effectively blending spiritually-based interventions across settings.

Pilot Study to Assess HIV Knowledge, Spirituality, and Risk Behaviors Among Older African Americans

A pilot study was conducted in anticipation of implementation of a larger project to assess human immunodeficiency virus (HIV) risk behaviors among older African Americans. A cross-sectional methodology was employed, including 33 African Americans aged more than 50 years in the metropolitan Washington, DC, area. The average age of the participants was 66 years old, with an age range from 51 to 86 years. Data were collected utilizing previously validated instruments that were administered using an audio computer-assisted survey instrument. There was relatively high knowledge regarding HIV, with female participants scoring significantly higher compared to male participants (p=.003). Another specific finding of the preliminary study was the association between higher levels of spirituality and lower levels of HIV sexual risk behaviors (Spearman's correlation=-0.369, p=.035). Results of this pilot study suggest that older African American females may be more knowledgeable regarding HIV than older African American males. This may suggest that educational and behavioral interventions developedfor this group may need to be structured based upon the targeted gender of the audience. The association between increased spirituality and decreased risk behaviors may suggest that spiritually-based interventions may provide some benefit regarding reduction of HIV risk behaviors in this population. However, the small sample size in this study warrants caution in the conclusions and highlights the need for further research in this population.

A Randomized Controlled Trial to Assess Effectiveness of a Spiritually-Based Intervention to Help Chronically Ill Adults

Creative, cost-effective ways are needed to help older adults deal effectively with chronic diseases. Spiritual beliefs and practices are often used to deal with health problems. We evaluated whether a minimal intervention, consisting of a video and workbook encouraging use of patient spiritual coping, would be inoffensive and improve perceived health status. A randomized clinical trial of 100 older, chronically ill adults were assigned to a Spiritual (SPIRIT) or Educational (EDUC--standard cardiac risk reduction) intervention. Individuals in each group were shown a 28-minute video and given a workbook to complete over 4 weeks. Selected psychosocial and health outcome measures were administered at baseline and 6 weeks later. Participants were mostly female (62%), with a mean age of 65.8 +/- 9.6 years and had an average of three chronic illnesses. More than 90% were Christian. At baseline, frequent daily spiritual experiences (DSE) were associated with being African American (p < .05) and increased pain (p < .01) and co-morbidities (p < or = .01). Energy increased significantly (p < .05) in the SPIRIT group and decreased in the EDUC group. Improvements in pain, mood, health perceptions, illness intrusiveness, and self-efficacy were not statistically significant. A minimal intervention encouraging spiritual coping was inoffensive to patients, associated with increased energy, and required no additional clinician time.

A multifaith spiritually based intervention for generalized anxiety disorder: a pilot randomized trial

This pilot trial evaluated the efficacy of a multifaith spiritually based intervention (SBI) for generalized anxiety disorder (GAD). Patients meeting DSM-IV criteria for GAD of at least moderate severity were randomized to either 12 sessions of the SBI (n=11) delivered by a spiritual care counselor or 12 sessions of psychologist-administered cognitive-behavioral therapy (CBT; n=11). Outcome measures were completed at baseline, post-treatment, and 3-month and 6-month follow-ups. Primary efficacy measures included the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, and Penn State Worry Questionnaire. Data analysis was performed on the intent-to-treat sample using the Last Observation Carried Forward method. Eighteen patients (82%) completed the study. The SBI produced robust and clinically significant reductions from baseline in psychic and somatic symptoms of GAD and was comparable in efficacy to CBT. A reduction in depressive symptoms and improvement in social adjustment was also observed. Treatment response occurred in 63.6% of SBI-treated and 72.3% of CBT-treated patients. Gains were maintained at 3-month and 6-month follow-ups. These preliminary findings are encouraging and suggest that a multifaith SBI may be an effective treatment option for GAD. Further randomized controlled trials are needed to establish the efficacy of this intervention.

The Role of Religion and Spirituality in Working with Children and Adolescents

This national study examined social workers' attitudes and behaviors about religion and spirituality in practice with children and adolescents. The majority of respondents regarded religion and spirituality as relevant to this population and used a wide variety of spiritually-based interventions. Respondents also reported a somewhat frequent identification of spiritual and religious abuse and neglect of youth. However, the vast majority reported that religious or spiritual issues were rarely, if ever, addressed in their social work education. Findings reveal the need to develop specific curricular content about the religious and spiritual lives of youth, including ethical guidelines for spiritually sensitive practice with this population. doi:10.1300/J377v26n03_01

Chapter 7. A Neuroscientific Approach and the God Image

SUMMARY Recent neuroscientific discoveries are refining our understanding of what makes therapy work and how God image difficulties can be addressed effectively in counseling. This article discusses neural networks, implicit and explicit memory systems, hemispheric specialization and neurological aspects of trauma in regards to how these impact our assumptions about traditional psychotherapy and God image transformation. Given the varying levels of neuroscientific training in the pastoral and mental health professions, this discussion is written in an introductory fashion. Implications are highlighted through a case study demonstrating spiritually-based intervention strategies.

A Qualitative Examination of a Spiritually-Based Intervention and Self-Management in the Workplace

This qualitative study assesses the experience of an intervention that provided spiritually based self-management tools to hospital-based nurses. Drawing on wisdom traditions of the major world religions, the eight point program can be practiced by adherents to any religious faith, or those outside of all traditions. Five of eight program points were perceived as directly useful in improving the nurses' workplace interactions and enhancing fulfillment of compassionate caregiving missions. The findings suggest that this program can be an effective intervention among nurses in dealing with the demands of the healthcare environment and may be a resource for continuing education curricula.

The Effectiveness of a Spiritually-Based Intervention to Alleviate Subsyndromal Anxiety and Minor Depression Among Older Adults

The purpose of this study was to test the effectiveness of a spiritually-based intervention in the alleviation of subsyndromal anxiety and minor depression in an elderly population. Twenty-two residents of six continuing care communities diagnosed with minor depression participated in this study. There was a significant decrease in anxiety and a trend toward decreased depression. In addition, participants who continued to use the Prayer Wheel had a decrease in depression scores, while those who did not had an increase in depression scores. These findings suggest that use of the Prayer Wheel may promote psychological well-being among older adults.

Spiritual Genograms: A Generational Approach to Assessing Spirituality

Clients' spiritual and religious beliefs are often significantly shaped by family influences, particularly among many minority populations. Spiritual genograms offer an assessment method that highlights the spiritual and religious strengths that may exist within clients' families and depicts how these multi-generational dynamics inform current spiritual functioning. Information is provided on how to construct a spiritual genogram, as well as how to conduct an assessment, elicit spiritual strengths, and shift toward planning interventions. A case study is delineated, a number of spiritually-based interventions that flow from the instrument are reviewed, and sample questions are provided. The paper concludes by offering a number of suggestions as to when spiritual genograms may be particularly applicable.