The development of the Religious Health Interventions in Behavioural Science (RHIBS) Taxonomy: a scientific classification of religious practices in health.

The development and delivery of religiously integrated health interventions is increasing, however lack of nomenclature to specify the religious components presents barriers to replication, implementation, and evidence synthesis. We describe the development of the "Religious Health Interventions in Behavioural Sciences (RHIBS)" Taxonomy, the first scientific classification of religious intervention components to be used globally by chaplains, healthcare providers, and researchers interested in the scientific study of religion, spirituality, and health. We developed a taxonomy of empirically used religious intervention components in health, sought international cross-disciplinary consensus for definitions and tested its usability. Study 1: systematic review of intervention studies to identify religious components tested within healthcare; development of taxonomy nomenclature, definitions, and categories. Study 2: Delphi exercise with 19 international, cross-disciplinary experts from a variety of religions. Study 3: "think aloud" study and usability testing with 10 end-users. Study 1: 12,337 papers identified from search, 167 intervention studies included, plus an additional 74 from hand-searching 14 systematic reviews. A taxonomy of 191 religious components, grouped into 27 categories resulted. Study 2: two Delphi rounds resulted in international and cross-disciplinary consensus of a revised taxonomy of 81 religious components grouped into 23 categories. Study 3: usability testing by participants (range of disciplines, geography, and religions) led to a final taxonomy comprising 82 religious components grouped into 22 categories and supported by online training. The "RHIBS Taxonomy," is the first multidisciplinary, global shared language within religion, spirituality, and health, ushering in a new era for religious interventions to be precisely defined, developed, and tested; shaping the evidence-base for future healthcare research/practice.

Currently, religious health interventions are poorly defined and internationally we do not have a shared language that we can use when discussing religious practices. A shared language will help us to understand the different religious practices used. We need this, because we can then find out which religious practices are helpful and which are unhelpful in improving health outcomes. Our project answered the following questions: "Can religious practices within health interventions be scientifically classified? Can the classification gain international, cross-disciplinary agreement? Can the classification be reliably and easily used?" We found 82 religious practices that have been explored scientifically, we grouped these practices into 22 larger categories to organize and build a classification system that received agreement from international experts from a range of occupational backgrounds. The religious practices have been labeled and defined to make a common language that everyone internationally can share when talking about religious practices in relation to health. The classification system will help to identify and implement the most beneficial religious practices to health and will inform healthcare practice.

Spiritually incorporating couple therapy in practice: Christian-accommodated couple therapy as an illustration.

Spiritually incorporating couple therapy (SICT)-couple therapy that incorporates spiritual interventions-has a growing research base. Information is limited on how spiritual interventions are used in practice; thus we studied treatment-as-usual (TAU). SICT is treatment that, at a couple's request, sometimes draws upon spiritual resources when addressing relational issues. We tracked 65 couples from 29 couple therapists (who advertised as spiritually incorporating therapists) over 402 sessions of SICT. Couple spirituality predicted use of spiritual interventions more than did therapist spirituality. The most used spiritual interventions included silent prayer for the couple, discussions of hope and forgiveness, and encouragement to consult their heart. In SICT, therapists used evidence-based couple therapy approaches. SICT should (a) treat highly religious couples in high distress as being at risk for early drop out; (b) follow couples' leads in using spiritual methods; and (c) draw on evidence-based couple and spiritual practices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

National longitudinal evidence for growth in subjective well-being from spiritual beliefs.

Previous research finds an association between spirituality and subjective well-being. However, the widespread use of poorly defined concepts of spirituality, tautological spirituality scales, and heavy reliance on cross-sectional samples cast doubts on prior findings. Here, we leverage ten waves of panel data from a nationally diverse longitudinal study to systematically test whether having spiritual beliefs leads to growth in personal well-being and life satisfaction (N = 3257, New Zealand, 2010-2020). Contrary to previous research, we find that belief in a spirit or life force predicts lower personal well-being and life satisfaction. However, in support of previous speculation, belief (relative to disbelief) in a spirit or life force predicts increasing personal well-being and life satisfaction over time. These findings are robust even while accounting for known demographic influences; they even hold among those who believe in a God but disbelieve in a spirit or life force. The recent growth in spiritual beliefs and decline in traditional religion across many industrial societies motivates further causal investigations of the mechanisms by which spiritual beliefs lead to growth in subjective well-being.

Religious/spiritual struggles and psychological distress: A test of three models in a longitudinal study of adults with chronic health conditions.

OBJECTIVE: This study tested three conceptual explanatory models that have been theorized to account for the linkages between religious/spiritual (R/S) struggles and psychological distress: the primary model (i.e., R/S struggles lead to psychological distress), the secondary model (i.e., psychological distress leads to R/S struggles), and the complex model (i.e., R/S struggles and psychological distress reciprocally exacerbate each other). METHODS: Using prospective data from a sample of US adults living with chronic health conditions (n = 302), we performed a cross-lagged panel analysis with three timepoints to test for evidence of potential causal relations between R/S struggles and psychological distress. RESULTS: Consistent with the complex conceptual model of R/S struggles, we found evidence of positive reciprocal associations between R/S struggles and psychological distress. CONCLUSION: The findings highlight the importance of attending to the dynamic interplay between R/S struggles and psychological distress when working with adults who have chronic health conditions.

Psychological and spiritual outcomes during the COVID-19 pandemic: A prospective longitudinal study of adults with chronic disease.

OBJECTIVE: This prospective longitudinal study examined whether coronavirus disease 2019 (COVID-19) has led to changes in psychological and spiritual outcomes among adults with chronic disease. METHOD: Participants (N = 302) were a stratified, nonrandom sample of adults (Mage = 64.46, SD = 10.86, 45.7% female). The sample was representative of the chronically ill, U.S. adult population in gender, race/ethnicity, region, and religious affiliation but older in age and higher in socioeconomic status. Participants completed online-administered measures 1 month before the March 11 pandemic declaration (T1) and then 1 and 3 months after it (T2 and T3). At T1 through T3, they completed measures of depression, anxiety, personal suffering, psychological well-being, trait resilience, optimism, hope, grit, spiritual struggles, spiritual fortitude, and positive religious coping. At T2 and T3, they also completed measures of social support, physical health, resource loss, perceived stress, and COVID-19 fears and exposure. RESULTS: Overall, people did not change substantially in psychological or spiritual outcomes over time. However, trait resilience increased and personal suffering declined. People highest in prepandemic suffering increased in spiritual fortitude. Racial/ethnic minorities increased in religious importance. Roughly half (48.9%) of participants exhibited psychological resilience (no/minimal depression or anxiety symptoms) at both T2 and T3. Perceived stress and psychological resource loss were associated with adverse mental health outcomes, but social support and physical health were not. COVID-19 fears contributed more to mental health than COVID-19 exposure. CONCLUSIONS: Even among vulnerable populations such as adults with chronic disease, during pandemic conditions like COVID-19, many people may exhibit-or even increase slightly in-psychological and spiritual resilience. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Integrating clients' religion and spirituality within psychotherapy: A comprehensive meta-analysis.

Some religious or spiritual (R/S) clients seek psychotherapy that integrates R/S values, while others may be reticent to disclose R/S-related aspects of struggles in a presumably secular setting. We meta-analyzed 97 outcome studies (N = 7,181) examining the efficacy of tailoring treatment to patients' R/S beliefs and values. We compared the effectiveness of R/S-tailored psychotherapy with no-treatment controls, alternate secular treatments, and additive secular treatments. R/S-adapted psychotherapy resulted in greater improvement in clients' psychological (g = 0.74, p < 0.000) and spiritual (g = 0.74, p < 0.000) functioning compared with no treatment and non R/S psychotherapies (psychological: g = 0.33, p < 0.001; spiritual: g = 0.43, p < 0.001). In more rigorous additive studies, R/S-accommodated psychotherapies were equally effective to standard approaches in reducing psychological distress (g = 0.13, p = 0.258), but resulted in greater spiritual well-being (g = 0.34, p < 0.000). We feature several clinical examples and conclude with evidence-based therapeutic practices.

Development of the Sources of Spirituality Scale.

Most measures of spirituality privilege religious spirituality, but people may experience spirituality in a variety of ways, including a sense of closeness, oneness, or connection with a theistic being, the transcendent (i.e., something outside space and time), oneself, humanity, or nature. The overall purpose of the present 4 studies was to develop the Sources of Spirituality (SOS) Scale to measure these different elements of spirituality. In Study 1, we created items, had them reviewed by experts, and used data from a sample of undergraduates (N = 218) to evaluate factor structure and inform initial measurement revisions. The factor structure replicated well in another sample of undergraduates (N = 200; Study 2), and in a sample of community adults (N = 140; Study 3). In a sample of undergraduates (N = 200; Study 4), we then evaluated evidence of construct validity by examining associations between SOS Scale scores and religious commitment, positive attitudes toward the Sacred, and dispositional connection with nature. Moreover, based on latent profile analyses results, we found 5 distinct patterns of spirituality based on SOS subscales. We consider implications for therapy and relevance of the findings for models of spirituality and future research.

Adapting an evidence-based intervention to REACH Forgiveness for different religions and spiritualities.

The REACH Forgiveness intervention has been used in psychoeducational groups, couple and individual counseling and psychotherapy, and workbooks. It has been investigated in over 20 randomized clinical trials (RCTs) worldwide. It has been accommodated to treat Christians and shown to be effective in RCTs. But most research has established it to be effective when not accommodating it to religious or spiritual clientele. In this article, we will claim that it can be accommodated to a variety of religious clients. We describe guidelines about what is essential to the treatment and what might be effectively modified to be acceptable to religious and spiritual clients embracing a variety of beliefs and practices.

Religion and spirituality.

Many clients highly value religious and spiritual (R/S) commitments, and many psychotherapists have accommodated secular treatments to R/S perspectives. We meta-analyzed 51 samples from 46 studies (N = 3,290) that examined the outcomes of religious accommodative therapies and nonreligious spirituality therapies. Comparisons on psychological and spiritual outcomes were made to a control condition, an alternate treatment, or a subset of those studies that used a dismantling design (similar in theory and duration of treatment, but including religious contents). Patients in R/S psychotherapies showed greater improvement than those in alternate secular psychotherapies both on psychological (d =.26) and on spiritual (d = .41) outcomes. Religiously accommodated treatments outperformed dismantling-design alternative treatments on spiritual (d = .33) but not on psychological outcomes. Clinical examples are provided and therapeutic practices are recommended.

Empirically supported religious and spiritual therapies.

This article evaluated the efficacy status of religious and spiritual (R/S) therapies for mental health problems, including treatments for depression, anxiety, unforgiveness, eating disorders, schizophrenia, alcoholism, anger, and marital issues. Religions represented included Christianity, Islam, Taoism, and Buddhism. Some studies incorporated a generic spirituality. Several R/S therapies were found to be helpful for clients, supporting the further use and research on these therapies. There was limited evidence that R/S therapies outperformed established secular therapies, thus the decision to use an R/S therapy may be an issue of client preference and therapist comfort.

Next steps for clinicians in religious and spiritual therapy: an endpiece.

To conclude this issue of the Journal of Clinical Psychology: In Session, the authors identify several next steps for clinicians interested in religious and spiritual therapy. They call for more clinically useful definitions of religion and spirituality and suggest that new methods of clinical practice that employ both Western and Eastern religion and spirituality need to be developed and tested. The need for more clinically focused religious and spiritual assessments is highlighted. They recommend greater clergy-psychotherapist collaboration and propose that clinicians lead and collaborate with researchers to further meaningful research on religion and spirituality. Finally, the authors identify areas of graduate training that require strengthening and provide corresponding guidelines.

Psychotherapy with religious and spiritual clients: an introduction.

This invited issue of the Journal of Clinical Psychology: In Session is devoted to psychotherapy with religious and spiritual clients. After offering definitions of religion and spirituality, noting areas of potential convergence and differentiating nuances, the authors highlight the prevalence and types of spirituality among both clients and mental health professionals. They describe the historical and current context for examining approaches to psychotherapy with clients who endorse religion, experience spirituality within their religion, or define themselves as spiritual even if not religious. They then summarize the subsequent articles in this issue, which offer practical guidance for practitioners.

Forgiveness in health research and medical practice.

With the rising popularity of positive psychology, research on forgiveness has flourished. Forgiveness has been found to have application to the field of medicine. We review definitions and describe potential physical and mental benefits of forgiveness. We (1) address potential mechanisms by which forgiveness might affect physical health, (2) evaluate the research on forgiveness and mental health, (3) summarize research on interventions to promote forgiveness, (4) examine issues specifically related to medicine in which forgiveness might play an important role, and (5) discuss forgiveness of self and others and seeking forgiveness in light of those applications. We emphasize the importance of one's motive in forgiving, noting that altruistic motives hold greater benefits than do self-interested motives.