Ethical challenges and opportunities at the edge: Incorporating spirituality and religion into psychotherapy.

Incorporating spirituality and religion into psychotherapy has been controversial, but recent contributions have argued the importance and provided foundations for doing so. Discussions of ethical challenges in this process are emerging, and this contribution discusses several preliminary issues, relying on the Resolution on Religious, Religion-Based and/or Religion-Derived Prejudice adopted by the American Psychological Association in 2007, as guidance when used with the American Psychological Association’s (2002) Ethical Principles of Psychologists and Code of Conduct. Specifically, this discussion of preliminary challenges addresses competence, bias, maintaining traditions and standards of psychology, and integrity in labeling services for reimbursement. Commentators deepen the discussion, addressing what constitutes minimal competence in this area; effective and truly mutual collaboration with clergy; the high level of ethical complexity and “inherent messiness” of this domain of psychological practice; and the particular challenges of demarcating the boundaries of these domains for regulatory and billing purposes. This discussion offers decidedly preliminary ideas on managing the interface of these domains. Further development is needed before this nascent area approximates precise guidelines or standards. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identifying and integrating helpful and harmful religious beliefs into psychotherapy.

The 2 main roles of the psychotherapist involve identifying and understanding the client's problems/strengths and treating problems. Suggestions are offered to guide addressing or avoiding religious beliefs in both roles. Types of religious beliefs that contribute to distress, particularly for youth, are identified and treatment options are offered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reviews of The guide to pastoral counseling and care; Psychotherapy with priests, Protestant clergy, and Catholic religious: A practical guide; and Spirituality, ethics, and relationship in adulthood: Clinical and theoretical explorations.

Reviews the books, The guide to pastoral counseling and care by Gary Ahlskog and Harry Sands (see record 2000-00411-000); Psychotherapy with priests, Protestant clergy, and Catholic religious: A practical guide by Joseph W. Ciarrocchi and Robert J. Wicks (see record 2000-00453-000); and Spirituality, ethics, and relationship in adulthood: Clinical and theoretical explorations by Melvin E. Miller and Alan N. West (see record 2000-05026-000). Some 90 percent of the American public has at least a conventional affiliation with religion, according to national polls over the last 50 years, yet psychology is one of the professions with a level of religious affiliation variously estimated at 30 to 40 percent. So patients for whom religion is or was important in their lives are quite likely to appear in treatment, and most analysts or therapists are unprepared to understand and professionally respond to the issues these patients raise. Recently, the American Psychological Association (APA) has published three broad, well-structured volumes to fill this gap (Richards & Bergin, 1997, 2000; Shafranske, 1996). If you are interested in learning about the life of religious professionals and the communities with which they work, the three books reviewed here deal with areas that the APA publications do not, with varying degrees of effectiveness. They are all recently published by a division of International Universities Press and are a very diverse set. The Guide to Pastoral Counseling and Care and Spirituality, Ethics, and Relationship in Adulthood: Clinical and Theoretical Explorations are both edited collections, and they evince the characteristics of nearly all edited collections: variations in quality, tone, voice, and utility. Psychotherapy With Priests, Protestant Clergy, and Catholic Religious: A Practical Guide also varies in the theoretical stance it takes, shuttling between cognitive–behavioral, interpersonal, and psychoanalytic perspectives. These three books each have something to offer and their own sets of shortcomings. I do not think that they will substitute for the issues covered in the Shafranske (1996) or Richards and Bergin (1997, 2000) handbooks, but they do provide therapists and analysts with specific information that may be relevant to specific clients. Many analysts may have to grit their teeth at times over therapeutic recommendations, especially in the Ciarrocchi and Wicks book, but that is not what these books should be read for. The practicing clinician will find much of use in the first two books, but less in the Miller and West book. The Miller and West book may appeal to a reader interested in a more philosophical approach from a postmodern perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of training to address religion in clincal practice.

Psychologists routinely work with clients who hold religious beliefs and values, yet there is often the question of whether psychologists are trained and competent to address religion as an aspect of diversity. How do training programs prepare psychologists to address this specific diversity issue? Do training programs equip psychologists to work effectively with religious clients? It is useful for psychologists to consider a 3-tier training system in religion and religious diversity that reflects a commitment to seeing religion as a meaningful expression of diversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Varieties of religion–family linkages.

Comments on the articles by A. Mahoney et al (see record 2001-05578-002), B. H. Fiese and T. J. Tomcho (see record 2001-05578-003), K. T. Sullivan (see record 2001-05578-004), and D. L. Flor and N. Flanagan Knapp (see record 2001-05578-005). The 4 articles in this special issue make important contributions to both family and religious studies as well as to their interface. This commentary begins by considering 4 unifying themes present across all of the articles, including meaningful religion-family linkages, the importance of gender differences in the faith-family interface, the significance of intergenerational relationships, and the need for better theory. The authors then discuss the unique major strength and secondary limitations of each study. Finally, the commentary focuses on two challenges inhibiting the contemporary study of religion and the family--a relative lack of racial and religious diversity in samples and the lack of a unifying theory of religion--family linkages--and suggests how to adjust the trajectory of future theory and research to address these issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology, religion, and the family: It's time for a revival.

Comments on the articles by A. Mahoney et al (see record 2001-05578-002), B. H. Fiese and T. J. Tomcho (see record 2001-05578-003), K. T. Sullivan (see record 2001-05578-004), and D. L. Flor and N. Flanagan Knapp (see record 2001-05578-005). Despite some occasional efforts to link psychology, religion, and the family, psychological research has largely ignored the topic. Three fundamental psychological questions about the role of religion in the family are raised. The publication of the 4 studies in this issue represents a watershed in this area, and these articles provide a model for future research. However, several pitfalls in this area of research are identified. These pitfalls are primarily due to the complexity of religion and heterogeneity associated with it. Four research directions are then recommended. It is concluded that this area is ripe for a research revival. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation.

Treatment dropouts and high "no show" rates are vexing problems for practicing psychologists and the populations they serve. This article describes a one-session intervention based on principles derived from motivational interviewing and ethnographic interviewing designed to improve depressed patients' participation in subsequent psychiatric treatment. The authors explain the rationale for developing an engagement intervention, describe the intervention itself, and present case vignettes based on a pilot study evaluating the feasibility and acceptability of administering the intervention to depressed mothers whose children suffer from psychiatric illness. The article includes strategies that may be implemented in clinical practice to improve patients' participation in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical responses when patients' religious beliefs appear to harm their well-being.

Although religious affiliation is generally associated with good mental health, at times patients may present with religious beliefs that appear to harm their well-being or social functioning. On the one hand, it would appear that respect for the patient's religious traditions requires psychologists to refrain from challenging those problematic religious beliefs. On the other hand, the goal of promoting patient welfare requires psychologists to challenge those beliefs that appear to inhibit patient well-being. This article analyzes this apparent dichotomy and suggests ethically based responses consistent with good clinical care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal constructs and psychodynamic psychotherapy: A case study.

[Correction Notice: An erratum for this article was reported in Vol 24(1) of Psychoanalytic Psychology (see record 2007-00135-015). An error was made in the reproduction of figures 5 and 6. The corrected versions are provided with the erratum.] During a short term, psychoanalytically informed psychotherapy, a college student's salient constructs regarding her self and her object representations were elicited via the Role Construct Repertory Test. The course of this psychotherapy is traced and is examined with regard to the information provided by component analyses of these repertory grids. The aims of this article are to demonstrate the utility of an independent measure such as repertory grids for 1) additional understanding of the patient's modes of construing self and others; 2) establishing meaningful foci for a short-term treatment; 3) providing information for a more considered set of interpretive interventions regarding key conflicts; and 4) considering changes and outcome in light of the foci of the treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religiously integrated psychotherapy with Muslim clients: From research to practice.

In this paper, we attempt to translate empirical findings from a program of research that developed a Psychological Measure of Islamic Religiousness (PMIR) into practical clinical applications. The findings from this program of research are complemented and illuminated by findings from other empirical research and clinical work with Muslims. Our recommendations can be summarized as follows. First, clinicians should inquire directly about the place of religion in the lives of their Muslim clients. Second, mental health professionals should ask about what Islam means to their clients and educate themselves about basic Islamic beliefs and practices. Third, clinicians should help their Muslim clients draw on Islamic positive religious coping methods to deal with stressors. Fourth, we recommend that clinicians assess for religious struggles, normalize them, help clients find satisfying solutions to these struggles and, if appropriate, refer clients who struggle to a Muslim pastoral counselor or religious leader. Finally, in order to overcome stigma associated with mental health issues, mental health professionals should educate the Islamic public about psychology, psychopathology, and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A legal and ethical review of patient responsibilities and psychotherapist duties.

The ethics and standards of practice literature has long focused on the duties that psychotherapists owe their patients. While this has been valuable to the profession, it has created a circumstance in which psychotherapists have focused on their duties and responsibilities to their patients with little understanding or respect for how the conduct of a patient can impact those factors. These articles will review these factors from both an ethical and legal perspective. In addition, all of the articles discuss the premise that, while the psychotherapist has the primary responsibilities when rendering treatment to a patient, the treatment alliance is actually a dynamic that changes depending upon the conduct of both the psychotherapist and the patient. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Monetary incentives improve recall of research consent information: It pays to remember.

Research participants often fail to recall substantial amounts of informed consent information after delays of only a few days. Numerous interventions have proven effective at improving consent recall; however, virtually all have focused on compensating for potential cognitive deficits and have ignored motivational factors. In this pilot study, the authors randomly assigned 31 drug court clients participating in a clinical research trial to a control group that received a standard informed consent procedure or to a group that received the same procedure plus incentives for correctly recalling consent information. The incentive group was told they would receive $5 for each of the 15 consent items they could answer correctly 1 week later. At the follow-up, the incentive group recalled a significantly greater percentage of consent information overall than the control group (65% vs. 42%, p     

Religious commitment and expectations about psychotherapy among Christian clients.

To assist psychotherapists in understanding client religiousness, Richards and Bergin (2005) have suggested assessing clients' religiousness at a broad level initially, using ecumenical measures, followed by a more detailed assessment that uses measures particular to the client's religious affiliation. In this study, the utility of this approach was tested in predicting expectations about psychotherapy of Christian clients (N = 176). Their religious commitment was considered in comparison to religious beliefs, attitudes, values, and behaviors. Client religiousness was positively associated with ratings of therapist expertise and attractiveness, desire to discuss religious issues in psychotherapy, and desire to see a Christian therapist. This suggests that assessing religious commitment is important, and that measuring religious beliefs, attitudes, values, and behaviors add accuracy to assessment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Readability level of Health Insurance Portability and Accountability Act notices of privacy practices used by psychologists in clinical practice.

Obtaining informed consent from a client to participate in psychotherapy includes providing an understanding of what treatment or evaluation is going to take place with the psychologist, as well as what the psychologist may or may not do with the client's records. Psychologists have an obligation to communicate clearly with their clients regarding informed consent. In this investigation, 1 Health Insurance Portability and Accountability Act Notice of Privacy Practices was solicited from a practicing psychologist in each state plus the District of Columbia. The authors then analyzed these forms using 2 measures of readability. A large majority (82%) of these forms were written at the ceiling reading level (12th grade), and almost the entire sample (94%) fell into the difficult range of reading ease. On the basis of the data obtained in this investigation, it is recommended that psychologists move to improve the readability of these documents and should do so to improve clinical practice, reduce liability, and follow ethical standards. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symposium on relationships between religion and mental health: Introductory remarks.

"We are witnessing a conspicuous change in the climate between religion and science in recent years." In psychology this has been evidenced in seminars on religion and psychiatry, work shops on pastoral care and psychotherapy, grants to universities for developing mental health curricula for theological students, creation of an Academy of Religion and Mental Health, and the establishing of an APA committee to study relationships between religion and mental health. "The hitherto existing chasm between religion and psychology is somewhat unusual because… both concern themselves with human nature and behavior." This symposium spotlights: expanding links between psychology and religion, religious experience and psychological conflict, the nature of religious controls, and moral issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symposium on relationships between religion and mental health: Discussion.

"To prepare to serve the personal needs of those who come to the pastor, psychology and clinical training have come into the curriculum of theological education… . It may be noted… that the deeper the psychotherapy the more like a religious conversion it becomes." Ostow finds that the most effective psychological controls in animal and human behavior "are exactly those which religion has developed with conspicuous success." Goodwin Watson notes that amoral therapy is a contradiction in terms, for every personal choice is a moral one. "Mental health is everybody's business. Every profession and every discipline of knowledge is responsible to give from its wisdom to the cause of healthy living on this planet. Psychology and psychiatry are making notable contributions. Religion and ethics too are disciplines needed on this frontier. From the ultimate concern of ethical religion we may ask faithful devotion to the human quest for wholeness." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Leading researchers' consensus on psychotherapy research findings: Implications for the teaching and conduct of psychotherapy.

We examined leading international psychotherapy researchers' views on psychotherapy outcome research. Participants completed a questionnaire on which they rated level of research evidence for or against various assertions about psychotherapy processes and outcomes. Participants rated how confident they were that the assertions were supported by psychotherapy research. Strong, or relatively strong, consensus was achieved on several of the questionnaire items. Areas for which relative uniformity of opinion does or does not exist have potential implications for the teaching and conduct of psychotherapy and for the science-practice interface in psychotherapy. Additionally, consensus about psychotherapy findings can be used as a yardstick by which to measure practicing clinicians' knowledge of the research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The religious mind and the evolution of religion.

This article summarizes the literature on the religious mind and connects it to archeological and anthropological data on the evolution of religion. These connections suggest a three stage model in the evolution of religion: One, the earliest form of religion (pre-Upper Paleolithic [UP]) would have been restricted to ecstatic rituals used to facilitate social bonding; two, the transition to UP religion was marked by the emergence of shamanistic healing rituals; and, three, the cave art, elaborate burials, and other artifacts associated with the UP represent the first evidence of ancestor worship and the emergence of theological narratives of the supernatural. The emergence of UP religion was associated with the move from egalitarian to transegalitarian hunter-gatherers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)