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Spirituality & Recovery: Using Spiritual Interventions in the Process of Transforming Persons in Christ

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Title: Spirituality & Recovery: Using Spiritual Interventions in the Process of Transforming Persons in Christ


1
Spirituality RecoveryUsing Spiritual
Interventions in the Process of Transforming
Persons in Christ
  • Ana Wong-McDonald, Ph.D.
  • The Salvation Army Haven
  • 11301 Wilshire Blvd., Bldg. 212, 3rd Fl.
  • Los Angeles, CA 90073
  • (310) 478-3711, x43653
  • ana.wong-mcdonald_at_usw.salvationarmy.org

2
Presentation Outline
  • Introduction Research on spirituality and
    mental health
  • Example Results of a 3-year spirituality group
  • Application Spirituality interventions for
    transformation into Christ-likeness
  • Questions Discussions

3
Important Notice
  • Spiritual interventions do NOT replace
    professional treatment for people with severe
    mental illness.
  • Mental illness is a brain disorder (see handout
    posted on conference website from last year).
  • Effective treatment medication therapy
  • Best treatment medication therapy spiritual
    interventions

4
Introduction
  • What do research studies show about the
    relationship between spirituality and mental
    health?

5
Beneficial Effects of Spirituality/Religion
  • Research in the last 2 decades have evidenced
    that spiritual and religious practices contribute
    to better physical health, psychological
    adjustment, and lower rates of problematic
    behavior (Miller Thoresen, 1999 Mulligan
    Mulligan, 1999 Richards Bergin, 2000 Seybold
    _at_ Hill, 2001).

6
Beneficial Effects of Spirituality/Religion
  • Many people with mental illness see spiritual
    activities as an important part of their recovery
    processes.
  • They believe that spiritual concerns should be
    discussed with their counselors and mental health
    providers (Mulligan Mulligan, 1999 Quackenbos,
    Privette, Klentz, 1985 Rose, Westefeld,
    Ansley, 2001 Tepper, Rogers, Coleman, Malony,
    2001 Worthington, Jurusu, McCullough, Sanders,
    1996).

7
Beneficial Effects of Spirituality/Religion
  • On individuals with
  • Depression
  • Anxiety
  • Substance addictions
  • Schizophrenia

8
Impact of Spirituality on Persons with Major
Depression
  • Religiosity is associated with decreasing levels
    of depression (Catipovic, Ilakovac, Durjancek,
    Amidzc, 1995 Cosar, Kocal, Arikan, Isil, 1997
    Plante Boccaccini, 1997), especially for people
    with intrinsic religiosity or faith based on
    internal beliefs (Mickley, Carson, Soeken,
    1995 Watson, Milliron, Morris, Hood, 1994).

9
Impact of Spirituality onMajor Depression
  • Lower levels of depression among those who held a
    belief in an afterlife (Alvarado, Emper, Bresler,
    Dobson, 1995).
  • Depression less likely among religious
    individuals with medical illness or religious
    surgical patients as compared with their less
    religious peers (Richard Bergin, 2000).

10
Impact of Spirituality on Major Depression
  • Church attenders are half as likely to be
    depressed as non-attenders (Koenig et al., 1997
    Thearle, Vance, Najman, Embelton, Foster,
    1995).
  • In a 10-year longitudinal study, maternal
    religiosity and maternal-offspring concordance of
    religiosity were found to be protective agents
    against depression for offspring (Miller, Warner,
    Wickramaratne, Weissman, 1997).

11
Impact of Spirituality on Persons with Anxiety
Disorders
  • Positive mental outcomes noted for people with
    anxiety disorders who are intrinsically religious
    and among those who use religious and spiritual
    coping mechanisms (Jahangir, 1995).

12
Impact of Spirituality on Anxiety Disorders
  • A normal healthy religious life is a protective
    agent against anxiety disorders. Intrinsic
    religiosity is associated with lower levels of
    general anxiety (Lotufo-Neto, 1996 Mickley et
    al., 1995 Richards Bergin, 2000).
  • Death-anxiety among terminally ill patients with
    HIV/AIDS was decreased with use of religious and
    spiritual coping (Woods et al., 1999),
    specifically with the use of prayer (Kaplan et
    al., 1997).

13
Impact of Spirituality on Substance Addictions
  • Intrinsic religiosity is related to low levels of
    substance use (Fischer Richards, 1998), while
    the likelihood of using or relapse include a
    feeling of disconnectedness with ones religion
    (Gills Mubhashar, 1995).
  • Higher levels of religiosity or spirituality
    among individuals recovering from substance abuse
    are associated with enhanced coping, greater
    resilience to stress, an optimistic life
    orientation, greater perceived social support,
    and lower levels of anxiety among inpatient and
    halfway house substance abusers (Pardini, Plante,
    Sherman, 2001).

14
Impact of Spirituality on People with
Schizophrenia
  • Religious coping methods have positive effects on
    persons with schizophrenia and with their
    families (Wahass Kent, 1995).
  • For the individual with schizophrenia, religious
    worship with the family or with a congregation
    may integrate the person into a greater community
    when s/he feels isolated. For the family,
    religious worship with the individual with
    schizophrenia serves as a means of feeling
    connected with the individual who has lost touch
    with reality (MacGreen, 1997).

15
Example
  • Results of a 3-year spirituality group
    (Wong-McDonald, 2007)
  • Article is posted on conference website.

16
Group Description
  • The spirituality group (SG) was an optional group
    at a psychosocial rehabilitation program (psych
    rehab) at a community mental health center.
  • 48 persons with severe mental illness
    participated in psych rehab 20 chose to
    participate in SG (with signed informed consent),
    28 did not.
  • Of the 20 clients in SG, 18 professed to some
    type of Judeo-Christian faith while 2 were open
    to all faiths.

17
Group Description
  • The recovery process based on treatment goal
    attainment is compared between those in SG and
    those not in SG.
  • Examples of treatment goals include
  • Wellness (e.g., lowering frequency of panic
    attacks, losing weight, decreasing
    hospitalizations, overcoming agoraphobia)
  • Socialization (e.g., making a new friend, going
    out on a date, saving money to go on a vacation
    with friends)
  • Vocational/education (e.g., obtaining a drivers
    license, earning a high school diploma, returning
    to college, transitioning from volunteer to paid
    employment)

18
Outcome
  • For a 3-year period (April 2003-April 2006)
  • All 20 clients (100) in SG achieved their
    treatment goals, as compared to 16 out of 28
    (57) clients not in SG who attained the goals.
    Result is significant (p lt .0001).
  • Chi square tests were used to determine if the
    difference was due to ethnicity, attendance, yrs
    of education, diagnosis, type of goal, history of
    substance abuse, age, and housing arrangement.
    Results were all not significant.

19
Reports from Clients in SG
  • Spirituality is very important in their recovery.
  • Sensing Gods presence lessens feelings of
    sadness.
  • Their faith helps them to feel calmer from
    fears/anxieties.
  • Their faith helps them to forgive.
  • They feel more confident to pray.
  • They are more able to resolve things from a
    spiritual perspective.
  • They believe that there is always hope because
    God is always there.

20
Application Use of Spiritual Interventions to
Transform Persons into Christ-Likeness
  • What?
  • Who?
  • How?

21
What?
  • Spirituality refers to the lived experience of
    God in all aspects of life, that is rooted in the
    revealed word of God and grounded in the
    community of faith (Stevens, 2004).
  • Intervention refers to any action a counselor
    takes to move the counselee toward health,
    well-being, and Christ-likeness.

22
Scriptural Basis
  • Colossians 128-29
  • We proclaim Him, admonishing and teaching
    everyone with all wisdom, so that we may present
    everyone perfect in Christ. To this end I labor,
    struggling with all His energy, which so
    powerfully works in me.
  • Galatians 419
  • My children, with whom I am again in labor until
    Christ is formed in you.

23
Spiritual Formation
Christlikeness
Non-Christlikeness
  • Every intervention (e.g., becoming clean sober,
    forgiveness reconciliation, taking
    responsibility, seeking God, prayer) should move
    counselee toward Christlikeness.

24
Purpose of Spiritual Interventions
  • Affirm spiritual identity divine worth
  • Many do not know who they are in Christ
  • Understand problems from an eternal spiritual
    perspective
  • Give biblical teachings on trials suffering

25
Purpose of Spiritual Interventions
  • Modify erroneous spiritual beliefs
  • Many have false notions about what the bible says
  • Seek guidance and strength from God to cope and
    heal
  • Sometimes just a reminder that God is present in
    their troubles will help them to go on.

26
Purpose of Spiritual Interventions
  • Emotionally forgive heal from past
  • Some are stuck in the past and ruminate about
    wrongs done to them.
  • Accept responsibility
  • Taking responsibility for ones life is the first
    step. They may not be responsible for the past
    (i.e., abuse that was done to them) but they are
    responsible for their present future.

27
Purpose of Spiritual Interventions
  • Obtain (and offer) support from (and to) their
    religious community
  • Being a contributing member gives a sense of
    well-being and belonging
  • Grown in faith commitment to God
  • All spiritual interventions should point the way
    to Jesus.
  • (Richards Bergin, 1997)

28
What?
  • Two types of spiritual interventions (Tan, 1996)
  • Implicit
  • Explicit

29
Implicit Interventions
  • They are covert.
  • Counselor does NOT openly or directly use
    spiritual resources like prayer or Scripture.
  • Example Counselor praying silently for the
    counselee.
  • Example Counselor becomes Christs presence for
    the counselee by modeling the love of God in a
    way that can be experienced interpersonally.

30
Explicit Interventions
  • They are more overt.
  • Counselor directly and systematically deal with
    spiritual issues.
  • Counselor uses spiritual interventions like
    prayer, scripture, spiritual writings and music,
    and may refer/help counselee connect with a
    church.
  • Example Counselor gives counselee a list of
    biblical passages to read/study that are
    applicable to the counselees situation.
  • Example Counselor opens the session with prayer
    and may include prayer during the session at
    specific moments.

31
Who?
  • Implicit Can be used with anyone
  • Explicit For counselees who agrees to accept
    spiritual interventions and who can benefit from
    them. (For psychotherapists, this involves
    obtaining informed consents from clients.)

32
Who?
  • Explicit interventions are contraindicated for
    the following counselees (Richards Bergin,
    1997)
  • Those who make it clear that they do not want
    such interventions.
  • Those who are psychotic (i.e., out of touch to
    reality) or delusional (e.g., believe that God
    gave them powers to control the weather).

33
Implicit/Explicit Interventions Used in
Spirituality Group
  • SPIRITUALITY GROUP
  • Psychosocial rehabilitation (e.g., skills
    training, CBT)
  • Implicit interventions (e.g., silent prayers,
    counselor as presence of Christ)
  • Explicit interventions (e.g., open prayer
    inviting Spirit of God, reading Scripture,
    listening to spiritual music)
  • RESULT 100 attained treatment goal change in
    relationship with God with neighbor.
  • NO SPIR GROUP
  • Psych rehab
  • Implicit interventions used
  • Explicit interventions not used
  • RESULT 57 attained txt goal some change in
    relationship w/others from learning social skills
    and appropriate boundaries.

34
What?
  • Spiritual formation sits on 3 legs as its
    foundation these 3 legs also form the basis for
    the spiritual interventions
  • Spirit of God
  • Word of God
  • People of God
  • (See separate table posted on conference website
    for definitions and examples of spiritual
    interventions.)

35
Spirit of God
  • Psalm 1271
  • Unless the Lord builds the house, its builders
    labor in vain.

36
Spirit of God
  • Spiritual assessment/discernment
  • Continuous (overlap with counselor prayer)
  • Sometimes the Holy Spirit will direct counselor
    to a specific group topic (like a pastor is led
    to a sermon topic)
  • Listening (one ear is listening to the people,
    the other is attuned to God)
  • Counselor prayer
  • Before (to prepare both counselor and counselee,
    ask for Holy Spirit to lead session), during (can
    be silent to seek guidance from Holy Spirit or
    vocal to model for counselee), and after session
    (release counselee to God)
  • Counselee prayer
  • Encourage counselee to seek help from God

37
Spirit of God
  • Joint counselor counselee vocal prayer
  • Particularly useful for counselees who are unsure
    about how to pray
  • Spiritual relaxation imagery
  • Ask counselee to picture in their mind a soothing
    situation (such as them resting in the arms of
    Jesus)
  • Spiritual meditation
  • Ask counselee to ponder on a scriptural passage
    or biblical story that relates to their situation

38
Word of God
  • Hebrews 412
  • For the Word of the Lord is living and active,
    sharper than any double-edged sword. It
    penetrates even to dividing soul and spirit,
    joints and marrow it judges the thoughts and
    attitudes of the heart.
  • Isaiah 5511
  • My Word that goes out from My mouth It will not
    return to me empty, but will accomplish what I
    desire.

39
Word of God
  • Reference to Scripture
  • Many are ignorant of what the bible says
  • Teaching spiritual concepts
  • Need to explain certain passages/concepts (e.g.,
    what does being salt light mean?)
  • Spiritual confrontation
  • Point out incongruence between counselees
    beliefs/behavior and what the bible teaches

40
Word of God
  • Religious bibliotherapy
  • Giving counselees spiritual literature to read
    that relates to their problem
  • Memorization of Scripture
  • Encourage counselees to memorize scriptures
    relevant to their situations. Have them memorize
    a few life verses (i.e., promises that they
    can cling to during difficult times). May use
    hymns to aid memorization.

41
People of God
  • 1 Corinthians 1227,26
  • Now you are the body of Christ, and each one of
    you is a part of it. If one part suffers, every
    part suffers with it if one part is honored,
    every part rejoices with it.
  • Galatians 61-2
  • ...if someone is caught in a sin, you who are
    spiritual should restore him gently...Carry each
    others burdens, and in this way you will fulfill
    the law of Christ.

42
People of God
  • Use biblical community
  • Encourage counselees to connect with other
    believers. May start by creating a loving
    community in the group.
  • Pray support one another
  • Encourage outside meetings mutual support
    without counselor. May end session by asking
    Who will pray for Mary this week?
  • Spiritual self-disclosure
  • Counselor shares what God taught them in a
    relevant situation to model and encourage.

43
People of God
  • Encouraging forgiveness
  • Need to define and help counselees understand
    what forgiveness means share/model how to do
    this
  • Spiritual confrontation
  • There are times when a caring community will
    loving confront a member.
  • Service to others
  • Encourage (may create) loving acts to others in
    group and in community (e.g., volunteering at a
    board care home)

44
How?
  • The following approach was used in the
    Spirituality Group with people who have mental
    illness, but can be adapted into other settings.
  • Start from ground zero
  • Use material that is fairly easy to read (no
    higher than high school level)
  • Go slower. Use repetition. Some have cognitive
    deficits. Use handouts and visual aids.

45
How?
  • The following approach was used in the
    Spirituality Group with people who have mental
    illness, but can be adapted into other settings.
  • Watch attention spans. Vary modality with music,
    lecture, reading aloud, discussion, and video.
  • Do NOT dumb down the content
  • Do NOT accept less accountability than normal
    people

46
Process of Transformation
  • Knowing
  • Faith comes by hearing, and hearing by the Word
    of God (Romans 1017).
  • Being
  • I desire to do Your will, O my God Your law is
    within my heart (Psalm 408). The fruit of the
    Spirit is love, joy, peace, patience, kindness,
    goodness, faithfulness, gentleness and
    self-control (Galatians 522-23).
  • Doing
  • Faith by itself, if it is not accompanied by
    action, is dead (James 217).

47
Case Examples
  • Sharon History of domestic violence and
    involvement w/aggressive impulsive males
  • Knowing Learned biblical principles, healthy
    boundaries, job skills
  • Being Doing Took responsibility to grow
    returned to church and saw pastor regularly
    started leading group on boundaries in domestic
    violence shelter graduated from DV program,
    moved into own apartment stopped dating
    aggressive male when she noticed warning signs
    today she is employed by the Dept. of Mental
    Health as a peer counselor helping other clients

48
Case Examples
  • Ricky Bipolar Disorder, history of risky sexual
    behaviors
  • Knowing Learned what the Bible says about
    appropriate and healthy sex
  • Being Doing Stopped these behaviors for over
    a year donated money that he would have used on
    prostitutes to charity channeled energies into
    returning to school

49
Goal of Spiritual Interventions
  • Ephesians 414-16
  • Then we will no longer be infants, tossed back
    and forth by the waves, and blown here and there
    by every wind of teaching and by the cunning and
    craftiness of men in their deceitful scheming.
    Instead, speaking the truth in love, we will in
    all things grow up into Him who is the Head, that
    is Christ. From Him the whole body, joined and
    held together by every supporting ligament, grows
    and builds itself up in love, as each part does
    its work.

50
  • Questions Discussions

51
  • Thank you!
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