Addressing the existential dimension in treatment settings: Mental health professionals’ and healthcare chaplains’ attitudes,practices,understanding and perceptions of value
Restricted accessResearch articleFirst published online November, 2019
Addressing the existential dimension in treatment settings: Mental health professionals’ and healthcare chaplains’ attitudes,practices,understanding and perceptions of value
Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as an integrated part of specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders’ competence to address existential, religious and spiritual concerns; however, this should be further investigated.
BerthelsenE.Stifoss-HanssenH. (2014). Eksistensielle samtaler og religiøs betjening i helseinstitusjoner [Existential conversations and religious services in health institutions]. In DanboltL. J.HestadK. A.Stifoss-HanssenH.LienL. (Eds.), Religionspsykologi [Psychology of religion] (1st ed., pp. 383–387). Oslo, Norway: Gyldendal Akademisk.
2.
BonelliR. M.KoenigH. G. (2013). Mental disorders, religion and spirituality 1990 to 2010: A systematic evidence-based review. Journal of Religion and Health, 52, 657–673. doi:10.1007/s10943-013-9691-4
3.
BorgeL.MælandE. (2017). Er det rom for livssynstemaer i dagens psykisk helsearbeid? [Is there room for worldviews related issues in today’s mental health work?]. Klinisk Sygepleje / Clinical Nursing, 31(3), 165–177. doi:10.18261/issn.1903-2285-2017-03-02ER
4.
BroughamR. R.ZailC. M.MendozaC. M.MillerJ. R. (2009). Stress, sex differences, and coping strategies among college students. Current Psychology, 28(2), 85–97. doi:10.1007/s12144-009-9047-0
5.
BurkeM. T.HackneyH.HudsonP.MirantiJ.WattsG. A.EppL. (1999). Spirituality, religion, and CACREP curriculum standards. Journal of Counseling & Development, 77, 251–257. doi:10.1002/j.1556-6676.1999.tb02448.x
6.
CreswellJ. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Thousand Oaks, CA: SAGE.
7.
CurlinF. A.LawrenceR. E.OdellS.ChinM. H.LantosJ. D.KoenigH. G.MeadorK. G. (2007). Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. American Journal of Psychiatry, 164, 1825–1831. doi:10.1176/appi.ajp.2007.06122088
8.
DaileyS. F.RobertsonL. A.GillC. S. (2015). Spiritual competency scale: Further analysis. Measurement and Evaluation in Counseling and Development, 48, 15–29. doi:10.1177/0748175614544688
9.
DeinS.CookC. C.PowellA.EaggerS. (2010). Religion, spirituality and mental health. The Psychiatrist, 34, 63–64. doi:10.1192/pb.bp.109.025924
10.
DeMarinisV. (2003). Pastoral care, existential health, and existential epidemiology. Stockholm, Sweden: Verbum.
11.
DeMarinisV. (2008). The impact of postmodernization on existential health in Sweden: Psychology of religion’s function in existential public health analysis. Archive for the Psychology of Religion, 30(1), 57–74. doi:10.1163/157361208X316962
12.
DeMarinisV.UllandD.KarlsenK. E. (2011). Philosophy’s role for guiding theory and practice in clinical contexts grounded in a cultural psychiatry focus: A case study illustration from southern Norway. World Cultural Psychiatry Research Review, 6, 47–56.
13.
D’SouzaR. (2002). Do patients expect psychiatrists to be interested in spiritual issues?Australasian Psychiatry, 10(1), 44–47.
14.
D’SouzaR.GeorgeK. (2006). Spirituality, religion and psychiatry: Its application to clinical practice. Australasian Psychiatry, 14, 408–412. doi:10.1080/j.1440-1665.2006.02314.x
15.
EngelL.GeorgeE. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544. doi:10.1176/ajp.137.5.535
16.
ExlineJ. J.PargamentK. I.GrubbsJ. B.YaliA. M. (2014). The religious and spiritual struggles scale: Development and initial validation. Psychology of Religion and Spirituality, 6, 208–222. doi:10.1037/a0036465
17.
ExlineJ. J.RoseE. D. (2014). Religious and spiritual struggles. In PaloutzianR. F.ParkC. L. (Eds.), Handbook of the psychology of religion and spirituality (2nd ed., pp. 380–398). New York, NY: Guilford Press.
FoddyW. (1994). Constructing questions for interviews and questionnaires: Theory and practice in social research. Cambridge, UK: Cambridge University Press.
20.
FordT.TartagliaA. (2006). The development, status, and future of healthcare chaplaincy. Southern Medical Journal, 99, 675–680. doi:10.1097/01.smj.0000220893.37354.1e
21.
FrøkedalH.Stifoss-HanssenH.RuudT.DeMarinisV.GonzalezM. T. (2017). Existential group practice run by mental healthcare chaplains in Norway: A nationwide cross-sectional study. Mental Health, Religion & Culture, 20, 713–727. doi:10.1080/13674676.2017.1400528
22.
GeorgeL. S.ParkC. L. (2016). Meaning in life as comprehension, purpose, and mattering: Toward integration and new research questions. Review of General Psychology, 20, 205–220. doi:10.1037/gpr0000077
23.
GonçalvesJ. P. B.LucchettiG.MenezesP. R.ValladaH. (2015). Religious and spiritual interventions in mental health care: A systematic review and meta-analysis of randomized controlled clinical trials. Psychological Medicine, 45, 2937–2949. doi:org/10.1017/S0033291715001166
24.
GraneheimU. H.LundmanB. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112. doi:10.1016/j.nedt.2003.10.001
25.
HeffernanS.NeilS.WeatherheadS. (2014). Religion in inpatient mental health: A narrative review. Mental Health Review Journal, 19, 221–236. doi:org/10.1108/MHRJ-09-2014-0035
26.
HillP. C.PargamentK. I.HoodR. W.McCulloughM. E.Jr.SwyersJ. P.LarsonD. B.ZinnbauerB. (2000). Conceptualizing religion and spirituality: Points of commonality, points of departure. Journal for the Theory of Social Behaviour, 30, 51–77. doi:org/10.1111/1468-5914.00119
27.
JohnsonD. R. (1997). An existential model of group therapy for chronic mental conditions. International Journal of Group Psychotherapy, 47, 227–250. doi:10.1080/00207284.1997.11490819
28.
KaltonG. (1983). Introduction to survey sampling (Vol. 35). Newbury Park, CA: SAGE.
29.
KellyE. (2012). Competences in spiritual care education and training. In RumboldB. D.CobbM.PuchalskiC. M. (Eds.), Oxford textbook of spirituality in healthcare (pp. 435–442). Oxford, UK: Oxford University Press.
30.
KoenigH. G. (2004). Religion, spirituality, and medicine: Research findings and implications for clinical practice. Southern Medical Journal, 97, 1194–1200.
31.
KoenigH. G. (2009). Research on religion, spirituality, and mental health: A review. The Canadian Journal of Psychiatry, 54, 283–291. doi:org/10.1177/070674370905400502
32.
KoenigH. G.KingD.CarsonV. B. (2012). Handbook of religion and health. Oxford, UK: Oxford University Press.
33.
KoslanderT.ArvidssonB. (2005). How the spiritual dimension is addressed in psychiatric patient–nurse relationships. Journal of Advanced Nursing, 51, 558–566. doi:org/10.1111/j.1365-2648.2005.03540.x
34.
KoslanderT.ArvidssonB. (2007). Patients’ conceptions of how the spiritual dimension is addressed in mental health care: A qualitative study. Journal of Advanced Nursing, 57, 597–604. doi:org/10.1111/j.1365-2648.2006.04190.x
35.
KoslanderT.da SilvaA. B.RoxbergÅ. (2009). Existential and spiritual needs in mental health care: An ethical and holistic perspective. Journal of Holistic Nursing, 27, 34–42. doi:10.1177/0898010108323302
36.
KrejcieR. V.MorganD. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30, 607–610.
37.
KvaleS.BrinkmannS. (2009). Det kvalitative forskningsintervju [The qualitative research interview]. Oslo, Norway: Gyldedal Akademisk.
38.
la CourP.HvidtN. C. (2010). Research on meaning-making and health in secular society: Secular, spiritual and religious existential orientations. Social Science & Medicine, 71, 1292–1299. doi:10.1016/j.socscimed.2010.06.024
39.
LawrenceR. M.HeadJ.ChristodoulouG.AndonovskaB.KaramatS.DuggalA.. . . EaggerS. (2007). Clinicians’ attitudes to spirituality in old age psychiatry. International Psychogeriatrics, 19, 962–973. doi:org/10.1017/S1041610206004339
40.
LeeE.ZahnA.BaumannK. (2014). Religiosity/spirituality and mental health: Psychiatric staff’s attitudes and behaviors. Open Journal of Social Sciences, 2(11), 7. doi:org/10.4236/jss.2014.211002
41.
LeeE.ZahnA.BaumannK. (2015). How do psychiatric staffs approach religiosity/spirituality in clinical practice? Differing perceptions among psychiatric staff members and clinical chaplains. Religions, 6, 930–947. doi:10.3390/rel6030930
42.
LiljaA.DeMarinisV.LehtiA.ForssénA. (2016). Experiences and explanations of mental ill health in a group of devout Christians from the ethnic majority population in secular Sweden: A qualitative study. BMJ Open, 6(10), e011647. doi:10.1136/bmjopen-2016-011647
43.
LorentzenS.RuudT. (2014). Group therapy in public mental health services: Approaches, patients and group therapists. Journal of Psychiatric and Mental Health Nursing, 21, 219–225. doi:10.1111/jpm.12072
44.
LukoffD.LuF.TurnerR. (1992). Toward a more culturally sensitive DSM-IV: Psychoreligious and psychospiritual problems. Journal of Nervous and Mental Disease, 180, 673–682. doi:org/10.1097/00005053-199211000-00001
45.
MalterudK. (2017). Kvalitative forskningsmetoder for medisin og helsefag [Qualitative research methods for medicine and health sciences] (4th ed.). Oslo, Norway: Universitetsforlaget.
46.
Ministry of Social Affairs and Health. (1999–2006). Om opptrappingsplan for psykisk helse 1999–2006. Endringer i statsbudsjettet for 1998, 1997–1998 [Parliament. On an expansion plan for mental health 1999–2006. Changes in the national budget for 1998, 1997–1998] (St.prp.nr. 63). Retrieved from https://www.regjeringen.no/no/dokumenter/stprp-nr-63-1997-98-/id201915/sec1
Moreira-AlmeidaA.SharmaA.van RensburgB. J.VerhagenP. J.CookC. C. (2016). WPA position statement on spirituality and religion in psychiatry. World Psychiatry, 15, 87–88. doi:org/10.1002/wps.20304
49.
PaloutzianR. F.ParkC. L. (2014). Handbook of the psychology of religion and spirituality. New York, NY: Guilford Press.
50.
PargamentK. I. (2001). The psychology of religion and coping: Theory, research, practice. New York, NY: Guilford Press.
51.
ParkC. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136, 257–301. doi:10.1037/a0018301
52.
RejaU.ManfredaK. L.HlebecV.VehovarV. (2003). Open-ended vs. close-ended questions in web questionnaires. Developments in Applied Statistics, 19, 159–177.
53.
RobertsonL. A. (2010). The spiritual competency scale. Counseling and Values, 55, 6–24. doi:10.1002/j.2161-007X.2010.tb00019.x
RuelE.WagnerW. E. I.GillespieB. J. (2016). The practice of survey research: Theory and applications. Thousand Oaks, CA: SAGE.
56.
SchaeferD. R.DillmanD. A. (1998). Development of a standard e-mail methodology: Results of an experiment. Public Opinion Quarterly, 62, 378–397.
57.
SchnellT. (2009). The sources of meaning and meaning in life questionnaire (SoMe): Relations to demographics and well-being. The Journal of Positive Psychology, 4, 483–499. doi:10.1080/1743976090327107
58.
StålsettG.GudeT.RønnestadM. H.MonsenJ. T. (2012). Existential dynamic therapy (‘VITA’) for treatment-resistant depression with Cluster C disorder: Matched comparison to treatment as usual. Psychotherapy Research, 22, 579–591. doi:10.1080/10503307.2012.692214
59.
TimminsF.CaldeiraS.MurphyM.PujolN.SheafG.WeathersE., . . .FlanaganB. (2018). The role of the healthcare chaplain: A literature review. Journal of Health Care Chaplaincy, 24, 87–106. doi:org/10.1080/08854726.2017.1338048
60.
UllandD.DeMarinisV. (2014). Understanding and working with existential information in a Norwegian adolescent psychiatry context: A need and a challenge. Mental Health, Religion & Culture, 17, 582–593. doi:10.1080/13674676.2013.871241
61.
Van LeeuwenR. (2008). Towards nursing competencies in spiritual care (Unpublished doctoral dissertation). University of Groningen, Groningen, The Netherlands.
62.
Van LeeuwenR.TiesingaL. J.MiddelB.PostD.JochemsenH. (2009). The validity and reliability of an instrument to assess nursing competencies in spiritual care. Journal of Clinical Nursing, 18, 2857–2869. doi:10.1111/j.1365-2702.2008.02594.x
63.
Van UdenM.PieperJ. (2003). Clinical psychology of religion: A training model. Archive for the Psychology of Religion, 25, 155–164. doi:10.1163/157361203X00110
64.
Van UdenM. H.ZondagH. J. (2016). Religion as an existential resource: On meaning-making, religious coping and rituals. European Journal of Mental Health, 11(1–2), 3. doi:10.5708/EJMH.11.2016.1-2.1
65.
VerhagenP. J. (2017). Psychiatry and religion: Consensus reached!Mental Health, Religion & Culture, 20, 516–527. doi:org/10.1080/13674676.2017.1334195
66.
YalomI. D. (1980). Existential psychotherapy. New York, NY: Basic Books.
67.
YalomI. D. (1995). The theory and practice of group psychotherapy. New York, NY: Basic Books.
68.
Yangarber-HicksN. (2004). Religious coping styles and recovery from serious mental illness. Journal of Psychology & Theology, 32, 305–317. doi:org/10.1177/009164710403200403
