2015 Samaritan Institute 1

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1 A Curriculum for Mental Health Providers Kelly Arora, PhD Rationale Key theory and components Sample: Interspiritual dialogue & listening skills Challenges to measuring outcomes Subject Matter Experts Kenneth I. Pargament, PhD Bowling Green State University Institute for ity & Health, Texas Medical Center Carrie Doehring, PhD Iliff School of Theology Kelly Arora, PhD Samaritan Institute Samaritan Institute COMMUNITY 1-day workshop OR 9 minute in-service Curriculum Components INTRODUCTION TO SIT ROOTS OF SPIRITUALITY SIT Competencies: Attitude Demonstrate empathy, respect and appreciation for clients from diverse spiritual backgrounds MIND BODY SPIRIT 1-week SPIRIT Academy SM Denver CO EVALUATING SPIRITUALITY ASSESSING SPIRITUALITY SPIRITUALITY OF THE THERAPIST ADDRESSING SPIRITUALITY View spirituality and religion as important aspects of human diversity Be aware of how our own spiritual background and beliefs may influence client relations Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (13). and religious competencies for psychologists. Psychology of Religion and ity. SIT Competencies: Knowledge SIT Competencies: Knowledge SIT Competencies: Skills Know that diverse forms of spirituality exist; explore spiritual beliefs, communities and practices that are important to clients Describe how spirituality and religion can be overlapping, yet distinct, constructs Understand that clients spiritual experiences may be difficult to differentiate from psychopathological symptoms Recognize that spiritual beliefs, practices and experiences develop and change Be aware of spiritual resources that may support well-being and recovery from psychological disorders Identify spiritual experiences, practices and beliefs that have the potential to negatively impact psychological health Identify legal and ethical issues related to spirituality in psychotherapy Communicate empathically and effectively with clients who have diverse spiritual backgrounds Inquire about spiritual background, experience, practices, attitudes and beliefs as part of a client s history Help clients explore and access their spiritual strengths and resources Samaritan Institute 1

2 SIT Competencies: Skills ity Identify and address spiritual problems, and make referrals as needed Search for the sacred Transcendence Stay abreast of research and professional developments regarding spirituality as it relates to clinical practice, and engage in ongoing assessment of one s own spiritual competence Recognize the limits of one s qualifications and competence in the spiritual domain, and make referrals as needed Ultimacy Boundlessness Virtue Meaning God Time CONNECTION ity Search for the sacred Meaning making Nature Transcendent Reality Ultimate Truth Relationship Divine ALLAH Marriage Soul Values Beliefs Practices Relationships Religion Values, beliefs, practices & relationships shared within institutions designed to facilitate spirituality ity: A Way of Seeing G O D I S N O W H E R E God is now here God is nowhere Samaritan Institute 2

3 Sensitivity We can be spiritually sensitive without spiritual expertise Immersion in a spiritual tradition does not make us spiritually sensitive Diversity Christian Denominations Non-Denominational Independent Churches Catholic Episcopal United Methodist Unitarian Universalist Hindu Buddhist seeker Presbyterian Lutheran Buddhism in the U.S. Zen leanings Simple & accessible Sympathizers JewBu + Religious Fluidity New York Times 8 / General Social Survey 14 44% of Americans have switched religious affiliations as adults 16% of American adults are unaffiliated; Nones are now the 4 th largest 21% religious group in the US History of Tension [Religion works] by distorting the picture of the real world in a delusional manner... by forcibly fixing [adherents] in a state of psychical infantilism and by drawing them into a mass delusion. Sigmund Freud 19 Civilization and Its Discontents Samaritan Institute 3

4 all-about-psychology.com Secular Privilege in Psychology Shafranske and Cummings 13 1 General Population Psychologists Religion important Believe in God Pray daily History of Tension Religion: Missing or symptomatic of psychopathology Fear of Psychology Psychological systems of counseling may lead a person along the broad way which leads to destruction... The entrance into new life through faith in Jesus is the small gate. Bobgan & Bobgan 1987 Reasons for Tension? Jesus as pharmacist Germany c M.D. Medical Deity? Healing rituals Purification to enter the Holy of Holies Membership for full services Sacred texts Vestments Healers see into mystery Pilgrimages to healing sites Confession & penance Ψ Values Systems Empiricism Mystery Individualism Community Skepticism Faith Autonomy Surrender Pragmatism Transformation Samaritan Institute 4

5 Doctoral Programs % Examples: Baylor University Bowling Green State University Boston University Brigham Young University Columbia University Fuller Theological Seminary Loma Linda University Loyola University of Maryland Regent University Seattle Pacific University University of Denver/Iliff School of Theology Religion is a Cultural Fact 14 General Social Survey Christian Unaffiliated Other World Rlgn % Americans Who Believe 14 General Social Survey 8 5 God exists Life after death People Want ly-sensitive Care MacLean, Phifer, et al % of Patients who Agree or Strongly Agree Routine office visit People Want ly-sensitive Care Rose, Westefeld & Ansley 8 9 diverse counseling centers 74 patients 72% want to discuss spiritual issues in counseling 1992/ Samaritan-AAPC Polls N= / N=58 If you had a serious problem in your life that required counseling, would you prefer to see a professional counselor who represents spiritual and beliefs? Ask about my religious beliefs Say silent prayer for me Pray with me Hospitalized Dying YES NO Don't Know / Samaritan-AAPC Polls N= / N=58 would you prefer to see a professional counselor who integrates your and beliefs into the counseling process? ity is a Resource Pargament YES NO Don't know/refused 1992 Public Religion Research Institute Religion & Politics Tracking Survey 14 Pray in crisis Pray for health Ask others to pray Samaritan Institute 5

6 ity & Health Koenig, McCullough, and Larson 11 Lower rates of suicide Less anxiety Greater well-being, happiness & life satisfaction Lower rates of depression & faster recovery Lower rates of alcohol & drug use Less delinquency & criminal activity Greater marital stability & satisfaction growth struggles Negative health effects Moral: Illness reflects a spiritual reality Biomedical: Illness is a malfunction in the body-machine Social: Each body is a variation of normal; Illness and disability are socially-constructed limitations Energy Body: Illness is imbalanced or blocked energy What does this mean for my life? MORAL Did I do something to deserve this? ENERGY BODY I wondered if my tendency to criticize my body and to stuff my unfeminine emotions like anger and frustration deep into the caverns of myself made me more likely to become ill. BIOMEDICAL Autoimmunity is known to be influenced by genetics and jumpstarted by an environmental trigger OK, OK, it s not like you re not dying. Still want to go grab that beer? SOCIAL Wick, E. (). How I kept living when my body turned on me: I was diagnosed with rheumatoid arthritis when I was 24. Now every day is a battle with myself. Buzzfeed. Retrieved from buzzfeed.com website: How a person views illness may play a bigger role in determining health outcomes than the actual severity of the disease. Petrie & Weinman 12 A treatment that does not consider the patient s view [of the illness] is likely to fail. 85%: Depression is a loss of faith Search for the sacred ity Embedded in Treatment Rye and Pargament 2 Prayer Beliefs forgiveness intervention Going to church Talking to pastor Medicine and faith work together, but faith is the indispensable element for healing Wittink, Joo, Lewis, & Barg 9 Relationships Meaning making Practices Values I asked God for help/support as I was trying to forgive Secular forgiveness intervention I prayed for the person who wronged me as I was trying to forgive Samaritan Institute 6

7 Promising Treatments Meditation for Vascular Headaches Wachholtz & Pargament 5 God is peace. God is joy Headache Occurrence 1 1 Pain Tolerance I am content. I am joyful. Meditation Internally-Focused Secular Meditation GROUP Meditation 9 8 GROUP Progressive Muscle Relaxation Grass is green. Sand is soft Internal Secular External Meditation 5 Meditation Internal Secular Externally-Focused Secular Meditation.6 Day 1-5 Day 6- Day 26- Day Day 16- Day Time Period Relaxation 1 TIME 2 External Meditation Relaxation Theory Kenneth I. Pargament, PhD Clinical Psychologist/Educator Psychology and Religion Religious Coping Carrie Doehring, PhD Clergy/Educator Values and Intersectionality Multicultural Care Kelly Arora, PhD Director/Educator Interspiritual Dialogue Chronic Illness & Meaning Making Foundations for ly- Sensitive Dialogue Know yourself Listen compassionately Notice differences Follow the client s lead Values in Clinical Practice Balmer et al. 12 Therapists adapt, compare, and reflect upon their own spiritual/religious when preparing to engage the spiritual resources of clients. Recommendations for practice and training call for therapists to be self-aware and to critically examine their own spirituality. Keeling, Dolbin-MacNab, Ford & Perkins YOUNG ADULTHOOD ADULTHOOD CHILDHOOD Beliefs & principles of ultimate importance that guide our decisions & behavior Personal Values Lived Embedded Values Relationships Social justice Sanctity of life Interconnection Ethical behavior Creativity Integrity Family Tradition Monogamy Serenity Health Surrender Marriage Helping others Stewardship Honesty Reason Interdependence Samaritan Institute 7

8 Values Well-being Lived = Embedded Distress Lived Embedded I can attest that nothing wracks the conscience of someone raised Protestant like failing to carry out one s occupational duties in a timely and efficient manner. Steve Chapman, Chicago Tribune on missing work because he had the flu Distress My Your Know Yourself Wellbeing Distress Clinicians, being human, have personal feelings and judgments about their patients and are influenced by the degree of value congruence between themselves and patients. What s your approach to spiritual dialogue? Rejectionist Exclusivist Inclusivist Respectful Gartner et al. 199 Rejectionist Exclusivist Inclusivist No sacred reality Fix the problem vs. dialogue beliefs & practices are signs of psychopathology One understanding of and way to connect with the sacred Reject scientific/medical expertise Agreement & conversion vs. dialogue Connectedness & unity Dialogue affirms unity of views Focus on commonalities diminishes differences Samaritan Institute 8

9 Diana Nyad & Oprah 13 Diana Oprah ly-sensitive Dialogue I m not a God person I am an atheist But you re in the awe Respectful My definition of God is humanity and is the love of humanity There is an inference with God that there is a presence, a creator or an overseer I don t call you an atheist then If you believe in the awe, and the wonder and the mystery, that IS what God is Respect the irreducible differences that make the other person unique Respect our common humanity (1:41) We will never know Until that last breath. And maybe it s an Oh, wow! one, as it was for Steve Jobs Respect ourselves as we share authentically, without imposing our beliefs & Diana I m not a God person I am an atheist My definition of God is humanity and the love of humanity There is an inference with God that there is a presence, a creator or an overseer Oprah Tell me what being an atheist means to you I also embrace love of humanity. How is that different from an atheist s perspective? God is often understood in these ways Listen Compassionately Listening and being present are acts of compassion We will never know I appreciate your willingness to share your spiritual beliefs with us today PHOTO BY MARCO ANELLI Marina Abramovic: Art is Present Authenticity Detection National Academy of Sciences 11; Ellis & Campbell 4 seconds Foundations for Dialogue Notice Differences and Follow the Client s Lead (3:25) Samaritan Institute 9

10 I know what God is like for you because I know what God is like Helmeke & Bischof 2 I know about your religious tradition I know what your language about God means Fate Mystical Ultimate God Truth Serenity Centered Spirit Use the Patient s Language Universal consciousness Faith Miracle I just read a book about I prayed about it I feel lost. I don t know why this is happening to me. Responses that shut down dialogue It s good to send positive affirmations into the universe. Please fill out these forms. I started that book, but I couldn t finish it. I had a dream and when I woke up, I called and made this appointment to talk about it. It sounds like the dream was meaningful to you. I feel lost. I don t know why this is happening. I m sorry. The Universe sent me a sign to come here today. I m glad you didn t ignore a sign from the Universe. Would you say more about this sign? Challenges to Measuring Training Outcomes No widespread systematic training for entry levels of spiritual and religious KSA competence No formal agreement on KSA competencies Need to differentiate between training for generalists vs. specialists Questions & Comments x19 Samaritan Institute