Preventing dropout in spiritually integrated psychotherapies: What are the effective methods of attending to clients' spirituality?

The purpose of this study was to examine associations between clinicians' use of varying types of spiritual interventions in the first session of spiritually integrated psychotherapies (SIPs) and clients' likelihood of returning for a second session. In total, 154 practitioners of SIPs from 33 settings in a practice-research network reported on their implementation of different methods for addressing clients' religion/spirituality on an after-session summary checklist. Roughly 80% or more of the clinicians implemented at least one spiritual intervention in the first session; on average, clinicians used 3.26 (SD = 3.66) of the interventions on the checklist. Occurring with 20% or more of the 1,094 clients, the most commonly used spiritual interventions included listening to spiritual issues, discussing compassion and hope, affirming clients' divine worth and attempts to trust God. In total, nearly one in five clients did not return for a second session. Focusing on interventions that were empirically linked with clients' engagement in a second session in bivariate analyses, discussion of spiritual dimensions of clients' problems and solutions was associated with a 118% greater probability that clients engaged in SIPs; in contrast, discussion of hope was linked with a 40% decrease in treatment engagement. In conclusion, findings highlight the potential opportunities and risks for implementing interventions that attend to clients' spirituality and/or religious faith at the start of SIPs. Research is needed to understand factors associated with the effective use of spiritual interventions and methods of training clinicians accordingly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Practice-based evidence for spiritually integrated psychotherapies: Examining trajectories of psychological and spiritual distress.

The aims of this practice-based evidence study were to (a) examine clients' trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-research network administered the Clinically Adaptive Multidimensional Outcome Survey (Sanders et al., 2018) at each session with 1,227 clients and reported their use of theoretical orientations and spiritual interventions on an after-session summary checklist. Focusing on sessions over an initial 12-week period, latent growth curve modeling analyses revealed that clients, on average, experienced significant reduction of psychological distress during their engagement in SIPs with improvements occurring most sharply in the first month. Further, other findings revealed a salient reciprocal interplay with spiritual distress throughout treatment, such that clients who were struggling with their religious faith and/or spirituality were more psychologically distressed and displayed a more attenuated and gradual pattern of symptom reduction. In such cases, clinicians frequently utilized spiritual interventions involving basic skills (e.g., spiritual assessment), virtues (e.g., discuss self-control), and religious attachment (e.g., encourage acceptance of divine love) that were uniquely associated with clients' rate and duration of decline in psychological and spiritual distress. The present findings affirm the routine effectiveness of SIPs along with highlighting the potential value of certain spiritual interventions in supporting holistic recovery among clients who want clinicians to be culturally responsive to their spiritual and/or religious identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Enhancing the evidence base for spiritually integrated psychotherapies: Progressing the paradigm of practice-based evidence.

Spiritually integrated approaches to psychological therapies enable practitioners to be responsive to clients' religious and spiritual concerns and have been combined with most mainstream therapeutic approaches. As such, although evidence is required regarding their efficacy, with randomized controlled trials having a privileged status, a single research paradigm is unlikely to deliver both a robust and relevant evidence base for the psychological therapies, that is, embedded in routine practice. The research paradigm of practice-based evidence provides a complementary approach to trials methodology as carried out in routine practice via the application of a myriad of qualitative and quantitative research designs. Accordingly, this article provides the background to a special section comprising 12 articles within a practice-based evidence paradigm that captures a focus on the therapist, the content of sessions and therapist-patient interactions, applications to specific patient populations and therapy modality, and the outcomes of spiritually integrated psychological therapies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Religious Discrimination Scale: Development and Initial Psychometric Evaluation.

This study presents the development and initial psychometric evaluation of the Religious Discrimination Scale (RDS). This 11-item instrument identified three dimensions based on perceived discrimination experiences of members of The Church of Jesus Christ of Latter-day Saints (LDS): Perceived Prejudice, Closet Symptoms, and Negative Labels. The psychometric evaluations of the RDS indicated a strong and clear factor structure as well as good internal consistency reliability. The test of measurement and structural invariance across gender also suggested that the RDS scale is equally appropriate to be used with both men and women. Implications for practice and research as well as future directions are discussed.

Development of the clinically adaptive multidimensional outcome survey.

OBJECTIVE: Routine outcome monitoring (ROM) has been strongly endorsed by psychotherapy researchers, but has yet to achieve widespread implementation in clinical settings. This article describes the development of the Clinically Adaptive Multidimensional Outcome Survey (CAMOS), an innovative ROM system that allows for local adaptation while providing high quality data. METHOD: Three-hundred and four clients at a university counseling center and 211 female patients at an eating disorder treatment facility were administered the CAMOS at intake, and 118 took the CAMOS at both intake and discharge. Two models were developed and compared. Both models were developed using exploratory and confirmatory factor analysis. RESULTS: A five-factor model was found to have the best model fit, internal consistency, convergent validity, and discriminant validity. CONCLUSIONS: The CAMOS has evidence to support its reliability and validity as a measure of various dimensions of distress. Distinctive tailoring features of the CAMOS compared to other ROM measures are described.

Can patients with eating disorders learn to eat intuitively? A 2-year pilot study.

The present article reports on a 2-year pilot study that evaluated the effectiveness of an intuitive eating program for patients in an eating disorder treatment center. Standardized measures of intuitive eating and eating disorder and psychological symptoms were administered. Psychotherapists and dietitians rated patients on the healthiness of their eating attitudes and behaviors. Preliminary findings indicated that patients can develop the skills of intuitive eating, and that the ability to eat intuitively is associated with positive treatment outcomes for each diagnostic category (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). We conclude by offering recommendations about how to implement intuitive eating training safely and effectively in inpatient and residential treatment programs.

Intrinsic religiousness and spirituality as predictors of mental health and positive psychological functioning in Latter-Day Saint adolescents and young adults.

We investigated the relationships between religiousness and spirituality and various indicators of mental health and positive psychosocial functioning in three separate samples of college students. A total of 898 students at Brigham Young University participated in the three studies. The students ranged in age from 17 to 26 years old, with the average age of 20.9 across all three samples. Our results indicate that intrinsic religiousness, spiritual maturity, and self-transcendence were significantly predictive of better mental health and positive functioning, including lower levels of depression, anxiety, and obsessive-compulsiveness, and higher levels of global self-esteem, identity integration, moral self-approval, and meaning in life. Intrinsic religiousness was not predictive of shame, perfectionism, and eating disorder symptoms. These findings are consistent with many prior studies that have found religiousness and spirituality to be positively associated with better mental health and positive psychosocial functioning in adolescents and young adults.

The role of inspiration in scientific scholarship and discovery: views of theistic scientists.

This qualitative research study examined the ways those who identify themselves as theistic scientists and scholars experience inspiration, as defined as divine guidance or influence, in their scientific scholarship and discovery. It also explored participants' beliefs about how scientists and scholars can seek and prepare to receive inspiration in their work. Open-ended surveys of 450 participants from the behavioral and natural sciences and from a variety of religious backgrounds were analyzed for content themes in the areas of experiences with inspiration, preparing to receive inspiration, and further thoughts on inspiration in science. The themes extracted indicated that these scientists and scholars have experienced inspiration throughout all stages of the research process. They also believe that certain practices and virtues, such as openness to inspiration and nurturing a relationship with God, can help scientists and scholars be more prepared to receive inspiration in their work.

A theistic spiritual treatment for women with eating disorders.

The authors describe a psychological treatment for women with eating disorders who have theistic spiritual beliefs and illustrate its application with a case report. They begin by briefly summarizing a theistic view of eating disorders. Then they illustrate how a theistic approach can complement traditional treatment by describing the processes and outcomes of their work with a 23-year-old Christian woman receiving inpatient treatment for an eating disorder not otherwise specified and a major depressive disorder (recurrent severe).

The role of spirituality in the treatment of trauma and eating disorders: recommendations for clinical practice.

The relationships among trauma, eating disorders, and spirituality are complex. Both trauma and eating disorders can distance women from their own spirituality, which undermines a potentially important treatment resource. In this article, we offer suggestions based on our clinical experience for helping eating disorder patients who have suffered trauma to rediscover their faith and spirituality. We describe how spirituality can be used as a resource to assist women throughout treatment and in recovery.

Comparative efficacy of spirituality, cognitive, and emotional support groups for treating eating disorder inpatients.

Spiritual interventions are rarely used in contemporary treatment programs and little empirical evidence is available concerning their effectiveness. The purpose of the present study was to evaluate the effectiveness of a spiritual group intervention for eating disorder inpatients. We compared the effectiveness of a Spirituality group with Cognitive and Emotional Support groups using a randomized, control group design. Participants were 122 women receiving inpatient eating disorder treatment. Patients in the Spirituality group tended to score significantly lower on psychological disturbance and eating disorder symptoms at the conclusion of treatment compared to patients in the other groups, and higher on spiritual well-being. On weekly outcome measures, patients in the Spirituality group improved significantly more quickly during the first four weeks of treatment. This study provides preliminary evidence that attending to eating disorder patients' spiritual growth and well-being during inpatient treatment may help reduce depression and anxiety, relationship distress, social role conflict, and eating disorder symptoms.

Examining the relationship between religious orientation and eating disturbances.

The relationship between religion and eating concerns is receiving increasing empirical attention. The current investigation sought to examine the relationship between eating attitudes and religious orientation, utilizing the fourfold typology of religious orientation. A curvilinear relationship was found between religious orientation and eating attitudes among a subclinical college population and a clinical population of individuals receiving inpatient treatment for eating disorders, particularly among extrinsically orientated individuals with diagnosis of bulimia nervosa.

The impact of exposure to the thin-ideal media image on women.

The purpose of this study was to experimentally examine the effects of exposure to the thin-ideal body image on women's affect, self-esteem, body satisfaction, eating disorder symptoms, and level of internalization of the thin-ideal. College women (N=145) were randomly exposed to photographs from popular magazines containing either thin-ideal images or neutral images. Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, although it did not cause more internalization of the thin-ideal. Exposure to thin-ideal media images may contribute to the development of eating disorders by causing body dissatisfaction, negative moods, low self-esteem, and eating disorders symptoms among women.

Intrinsic religiousness and spiritual well-being as predictors of treatment outcome among women with eating disorders.

This study investigated the relationship of religious orientation, religious affiliation, and spiritual well-being with treatment outcomes in an eating disorder inpatient treatment program. Participants were 251 women diagnosed with an eating disorder. Gain scores on the Eating Attitudes Test, Body Shape Questionnaire, Outcome Questionnaire 45.2, and therapist improvement ratings were used as outcome measures. Multiple regression analyses revealed that neither intrinsic religiousness nor religious affiliation were associated with treatment outcomes. Pearson correlations revealed that improvements in spiritual well-being during treatment were significantly associated with positive gains in eating attitudes, less body shape concerns, and positive psychological and social functioning.

Binge and purge processes in bulimia nervosa: a qualitative investigation.

This study explored the nature and functions of the binge and purge processes of those who suffer from bulimia nervosa. Using a qualitative research design, the researchers conducted semi-structured interviews with eight affected women, asking them to discuss their bingeing and purging experiences. Use of an emergent data analysis method revealed participants behaviors as attempts to cope and control, to improve self-regard and social status, to regulate emotion, and to provide physiological reinforcement. Implications of the findings for clinical practice are discussed.