EMCAPP Symposium, Warsaw, 3-6.09.2012.

Scientific Researches on Christian Psychotherapy

Anna Ostaszewska

Association of Christian Psychologists, Polandspch@spch.pl

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„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.

I will present results of researches published in 13 articles in:

1.Psychotherapy Research2.Professional Psychology: Research and Practice3.Psychological Bulletin4.Journal of Clinical Psychology5.Journal of Consulting & Clinical Psychology6.Journal of Psychology & Theology7.Mental Health, Religion & Culture8.The Canadian Journal of Psychiatry9.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 clearlymatch client values, readiness, and reason for seeking therapy.Clients want to be supported and not manipulated. As with every other type of therapeutic intervention, therapistsshould 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.

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THANK YOU !

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