Transcript 12-EMCAPP-research

EMCAPP Symposium, Warsaw, 3-6.09.2012.
Scientific Researches
on Christian Psychotherapy
Anna Ostaszewska
Association of Christian Psychologists, Poland
[email protected]
„It is absurd to assume that a psychotherapist
can suspend her values ,which may
sometimes be explicit but always implicit
in her behaviour and attitudes.”
K. Evans, M. Gilbert: An Introduction to Integrative Psychotherapy, 2005
Kenneth R. Evans – President of the European Association for
Integrative Psychotherapy, Past president of the European
Association for Psychotherapy.
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I will present results of researches published in 13 articles in:
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Psychotherapy Research
Professional Psychology: Research and Practice
Psychological Bulletin
Journal of Clinical Psychology
Journal of Consulting & Clinical Psychology
Journal of Psychology & Theology
Mental Health, Religion & Culture
The Canadian Journal of Psychiatry
Norcross J. C. (Ed.), Psychotherapy relationships that
work (2011).
Articles were published in 1992-2011.
Evidence based practice.
Research on the effectiveness of
Christian Psychotherapy.
Worthington, E.L, Kurusu T.A., McCullough M.E., Sandage
S.J. (1996) Empirical Research on Religion and
Psychotherapeutic Processes and Outcomes - A 10-Year
Review and Research Prospectus.
Psychological Bulletin, Vol. 119, No. 3, 448-487, © by the American
Psychological Association.
Review of 148 articles on including religiosity into
psychotherapy
- Better methodological quality
-Religious people cannot be treated as mentally ill
-Religiosity does not give negative effects for mental health
Wade N.G., Worthington E.W., Vogel J. and D. (2007)
Effectiveness of religiously tailored interventions in Christian
therapy.
Psychotherapy Research, 17(1): 91-105.
Integrated religious therapy has the same effectiveness as traditional
therapy.
Religious interventions have especial meaning for religious
patients.
Religious interventions help in improving mental health by religious
clients but is not depended on real religious engage of a therapist.
Religious and nonreligious therapist agree that talking about client’s
spiritual experiences can be useful in psychotherapy.
They agree that some interventions should not be used in
psychotherapy – like praying loudly with a client.
Propst, L. R, Ostrom, R., Watkins, P., & Dean, T. (1992).
Comparative efficacy of religious and nonreligious
cognitive-behavioural therapy for the treatment of clinical
depression in religious individuals.
Journal of Consulting & Clinical Psychology, 60, 94-103.
Conclusions:
Religious people in depression attended cognitive-behavioural
therapy in which religious interventions were included.
They achieve better results in treatment than patients attended
traditional cognitive-behavioural therapy.
Hawkins, R. S., Tan, S., & Turk, A. A. (1999) Secular versus
Christian inpatient cognitive - behavioural therapy
programs: Impact on depression and spiritual well-being.
Journal of Psychology & Theology, 27, 309-18.
Therapy taking account religious values of patients (CCBT)
can be more effective than traditional cognitive-behavioural
therapy (CBT).
Reduction of depression symptoms was connected with
improving of spiritual well being of the all participants of this
research .
Smith, T. B., Bartz J. i Richards, S. (2007). Outcomes of
religious and spiritual adaptations to psychotherapy: A
meta-analytic review.
Psychotherapy Research, 17(6), 643-655.
This article reports a meta-analysis of 31 outcome studies of spiritual
therapies conducted from 1984 to 2005 with clients suffering from a variety of
psychological problems. Across the 31 studies, the random-effects weighted
average effect size was 0.56.
This finding provides some empirical evidence that spiritually oriented
psychotherapy approaches may be beneficial to individuals with certain
psychological problems (e.g., depression, anxiety, stress, eating disorders).
Spiritual interventions are being used with increasing frequency across all
types of treatment, including individual therapy, group therapy, marriage and
family therapy, and child and adolescent therapy.
Spiritual perspectives and interventions have now been incorporated into
most mainstream theoretical orientations.
Smith, Bartz, Richards, 2007. Cont.
The term spirituality refers to transcendent experiences with
and understandings about God or other forces in the universe,
whereas the term religious refers to an institutionalized
system of beliefs, values, and activities based on spiritual
creeds .
Both concepts have consistently been found to be relevant to
mental health.
Religious/ spiritual approaches to psychotherapy have the
potential to address clients’ religious/ spiritual concerns
when relevant and to involve language and interventions
that demonstrate respect for clients’ religious/
spiritual contexts.
In addition, religious/ spiritual treatment approaches have the
potential of being more congruent with client values and of
working with the methods of religious and spiritual coping
already present in clients’ religious and spiritual worldviews.
Nichole, A., Murray-Swank, N. A. i Pargament, K. I. (2005).
God, where are you?: Evaluating a spiritually-integrated
intervention for sexual abuse.
Mental Health, Religion & Culture, 8(3), 191–203.
Clients attended spiritually-integrated programs increased in
positive religious coping, spiritual well-being, and positive
images of God.
In general, many survivors of traumatic events rely on
spirituality as a valuable coping resource, turning to God and
faith communities in difficult times.
Researchers have demonstrated that survivors of sexual abuse
frequently use spirituality as an important coping resource.
Spirituality may prove helpful in the recovery process, as positive
forms of religious coping (e.g., developing a collaborative
partnership with God, seeking spiritual connection and
support) have been related to improved mental health and
increased stress-related growth.
Post, B. C. i Wade N. G. (2009). Religion and Spirituality in
Psychotherapy: A Practice-Friendly Review of Research.
Journal of Clinical Psychology, 65, 131-146.
Research indicates that therapists are open to religious/spiritual
issues, that clients want to discuss these matters in therapy,
and that the use of religious/spiritual interventions for some
clients can be an effective adjunct to traditional therapy
interventions.
A movement within the mental health professions to understand
and address the sacred has surfaced in recent years.
The practical question for clinicians is no longer whether to
address the sacred in psychotherapy with religious and spiritual
clients, but rather, the questions are when and how to address
the sacred.
Pargament, K. I., Murray-Swank, N. A., Tarakeshwar, N. (2005).
An empirically-based rationale for a spiritually-integrated
psychotherapy.
Mental Health, Religion & Culture, 8(3), 155-165.
An empirical justification of spiritually integrated psychotherapy:
Drawing on several lines of research we note that: (1) spirituality can
be a part of the solution to psychological problems; (2) spirituality
can be a source of problems in and of itself; (3) people want
spiritually sensitive help; and (4) spirituality cannot be separated
from psychotherapy.
Spiritually integrated psychotherapy is:
- based on a theory of spirituality,
- empirically oriented,
- ecumenical and
- possible to use in any form of psychotherapy.
Pargament, Murray-Swank, Tarakeshwar, 2005. Cont.
The risks of taking up this topic in psychotherapy:
- the risks of trivializing spirituality as simply a tool for
mental health,
- reducing spirituality to presumably more basic motivations
and drives,
- imposing spiritual values on clients
- and overestimating the importance of spirituality.
“Perhaps the greatest danger, however, is to neglect the
spiritual dimension in psychotherapy."
Frazier, R. C. i Hansen, N. D. (2009). Religious/Spiritual
Psychotherapy Behaviors: Do We Do What We Believe To Be
Important?
Professional Psychology: Research and Practice, 40(1), 81-87.
Research on using spiritual or religious techniques by psychotherapist.
The greater the practitioners’ religious/spiritual self-identification, the
more likely they were to report using these behaviors in
psychotherapy.
However, overall, and for 90% of the individual items, clinicians
engaged in these religious/spiritual psychotherapy behaviors less
frequently than their importance ratings suggested they should.
Martinez, J. S., Smith, T. B., Barlow i S. H. (2007). Spiritual
Interventions in Psychotherapy: Evaluations by Highly
Religious Clients.
Journal of Clinical Psychology, 63, 943–960.
„Existing psychotherapy outcome studies suggest that religious
interventions are indeed more effective with religious
clients compared to secular treatments”.
„However, there are some important qualifications that therapists
must consider.
When implemented, any religious intervention should clearly
match client values, readiness, and reason for seeking therapy.
Clients want to be supported and not manipulated.
As with every other type of therapeutic intervention, therapists
should carefully assess and be guided by client perspectives and
preferences.”
Norcross, J. C. (Ed.). (2011). Evidence-based therapy
relationships. Module on SAMHSA’s website:
http://www.nrepp.samhsa.gov/Norcross.aspx
What works in psychotherapy? (meta-analysis)
How to adapt methods to an individual patient ?
Demonstrably Effective Means:
1. Reactance / resistance level
2. Stages of change
3. Patient’s coping styles
4. Patient’s preferences
5. Culture
6. Religion, spirituality
Probably Effective Means:
1. Patient’s expectations
2. Attachment styles
John Norcross, cont.
Evidence based practice. What works in psychotherapy?
Demonstrably Effective Means - Religion/Spirituality
„Some patients enter psychotherapy with a definite interest
in incorporating their religious beliefs or spiritual values
into the work.
Many research studies have investigated whether these
religious-accommodative therapies work as well as, or
better than, their secular counterparts.
A meta-analysis of 46 studies, involving 3,290 clients, found
that patients receiving such therapies experienced
equivalent if not superior progress.”
Koenig, H, G, (2009) Research on Religion, Spirituality, and
Mental Health: A Review.
The Canadian Journal of Psychiatry; 54: 283-291
Religious and spiritual factors are increasingly being examined in
psychiatric research.
Recent studies have identified another side of religion that may
serve as a psychological and social resource for coping with stress.
After defining the terms religion and spirituality, this paper
reviews research on the relation between religion and
(or) spirituality, and mental health, focusing on depression,
suicide, anxiety, psychosis, and substance abuse.
Studies find that religious involvement is related to better coping
with stress and less depression, suicide, anxiety, and substance
abuse.
Koenig, H, G, (2009) cont.
While religious delusions may be common among people with
psychotic disorders, healthy normative religious beliefs and practices
appear to be stabilizing and may reduce the tremendous isolation,
fear, and loss of control that those with psychosis experience.
Clinicians need to be aware of the religious and spiritual activities of
their patients, appreciate their value as a resource for healthy mental
and social functioning, and recognize when those beliefs are
distorted, limiting, and contribute to pathology rather than alleviate
it.
REFERENCES
1. Frazier, R. C. i Hansen, N. D. (2009). Religious/Spiritual Psychotherapy
Behaviors: Do We Do What We Believe To Be Important? Professional
Psychology: Research and Practice, 40(1), 81-87.
2. Hawkins, R. S., Tan, S., i Turk, A. A. (1999). Secular versus Christian
inpatient cognitive- behavioral therapy programs: Impact on depression and
spiritual well-being. Journal of Psychology & Theology, 27, 309-18.
3. Koenig, H, G, (2009) Research on Religion, Spirituality, and Mental Health:
A Review. The Canadian Journal of Psychiatry; 54: 283-291
4. Martinez, J. S., Smith, T. B., Barlow i S. H. (2007). Spiritual Interventions in
Psychotherapy: Evaluations by Highly Religious Clients. Journal of Clinical
Psychology, 63, 943–960.
5. Nichole, A., Murray-Swank, N. A. i Pargament, K. I. (2005). God, where are
you?: Evaluating a spiritually-integrated intervention for sexual abuse.
Mental Health, Religion & Culture, 8(3), 191–203.
6. Norcross, J. C. (Ed.). (2011). Evidence-based therapy relationships. Module
on SAMHSA’s website: ttp://www.nrepp.samhsa.gov/Norcross.aspx
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REFERENCES cont.
7. Pargament, K. I., Murray-Swank, N. A., Tarakeshwar, N. (2005). An
empirically-based rationale for a spiritually-integrated psychotherapy.
Mental Health, Religion & Culture, 8(3), 155-165.
8. Post, B. C. i Wade N. G. (2009). Religion and Spirituality in Psychotherapy:
A Practice-Friendly Review of Research. Journal of Clinical Psychology, 65,
131-146.
9. Propst, L. R, Ostrom, R., Watkins, P. i Dean, T. (1992). Comparative efficacy
of religious and nonreligious cognitive-behavioral therapy for the treatment
of clinical depression in religious individuals. Journal of Consulting & Clinical
Psychology, 60, 94-103.
10. Prochaska, J. O., Norcross J. C. (2003). Systems of Psychotherapy. A
Transtheoretical Analysis. Thomson Learning, Inc.
11. Smith, T. B., Bartz J. i Richards, S. (2007). Outcomes of religious and
spiritual adaptations to psychotherapy: A meta-analytic review.
Psychotherapy Research, 17(6), 643-655.
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REFERENCES cont.
12. Wade, N. G., Worthington, E. W. i Vogel, I. J. (2007). Effectiveness of
religiously tailored interventions in Christian therapy. Psychotherapy
Research, 17(1), 91-105.
13. Worthington, E. L, Kurusu T. A., McCullough, M. E. i Sandage S. J.
(1996). Empirical Research on Religion and Psychotherapeutic Processes
and Outcomes. Review and Research Prospectus. Psychological Bulletin,
119(3), 448-487.
14. Worthington, E. L. Jr., Hook, J. N., Davis, D. E., & McDaniel, M. A.
(2011). Religion and spirituality. In J. C. Norcross (Ed.), Psychotherapy
relationships that work (2nd ed.). New York: Oxford University Press.
15. Worthington, E. L. Jr., Sandage, S. J. (2002). Religion and spirituality. W:
J. C. Norcross (red.), Psychotherapy relationships that work. New York:
Oxford University Press.
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THANK YOU !
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