People often draw on their faith as a source of hope and strength in the face of life’s challenges. Yet providers are often wary of using spirituality in the treatment of serious mental health issues, fearing it violates the separation of church and state and will lead to proselytizing or alienate patients who are not religious. Others even regard spiritual beliefs as potential psychiatric symptoms.
New research, however, suggests an important role for nondenominational spirituality in mental health recovery. A study published in the Psychiatric Rehabilitation Journal highlighted the potential of using a spirituality-infused group to provide a unique opportunity for people in recovery to combine research-supported treatments with personal spiritual support.
“Stigma prevents many individuals experiencing schizophrenia or bipolar disorders from seeking spiritual or religious support from a faith-based community organization. It is difficult for some people to find a community where they feel comfortable and accepted,” said Ann Marie Yamada, coauthor of the study and associate professor at the USC Suzanne Dworak-Peck School of Social Work. “These concerns may not be shared with mental health providers as they may perceive spiritual needs are not appropriate to discuss.”
This stigma creates a gap when patients are unable to find spiritual support from either a healthcare provider or religious community.
To cultivate spiritual resources that might have therapeutic value, Yamada and Andrew Subica of the UC Riverside School of Medicine collaborated with the Los Angeles County Department of Mental Health (LACDMH), the largest and most diverse organization of its kind in the nation, to design and test a new spirituality-based treatment program.
“Within the urban community served by LACDMH, spirituality has been an underutilized resource. It is a great tool for addressing the health and recovery needs of the largely African American and Latino patients served by the participating LACDMH agency,” Yamada said, adding that it is essential for investigators to understand the significance of spirituality and religion in these cultures and respectfully acknowledge the philosophical differences in practices between both groups.
The program, Spiritual Strategies for Psychosocial Recovery, uses spirituality as a therapeutic tool to teach practical coping skills.
“After learning that there are few well-documented interventions that incorporate spirituality, Dr. Subica and I wanted to take the best practices already being used and add greater emphasis on coping skills that have been shown to be effective,” Yamada said.
Group therapy sessions include activities like breathing exercises, goal setting and group discussion to build social skills and coping skills.
“When people find the strength to improve their coping skills, they are more likely to adhere to their treatment plans and see themselves as active participants in their health and recovery,” she said.
Taking a leap of faith
Yamada hopes more innovative providers like LACDMH will explore the potential of spirituality-infused treatments. Many of the LACDMH-affiliated wellness and recovery centers already offer some type of spirituality-related activities that involve meditation, mindfulness or support groups.
It’s just a matter of time, given that 80 percent of the adults sampled across California community mental health centers support integration of spirituality into mental health services, she said.
The study included a small pool of participants, but early findings are promising, and participants were consistently satisfied with the therapy sessions. Many patients described mood improvements and a feeling of empowerment and control over their conditions.
“I like having these tools because it helps me feel less tense,” one woman in the program said, according to the research article. “During the week when we don’t have group, I can use them.”
The success of the program suggests that health care providers and spiritual leaders can work together to address the needs of their communities.
“Involvement of both clinicians and religious leaders is one way to reduce the stereotypes held by both professions,” Yamada said. “These stereotypes serve as barriers to developing mental health services that integrate spirituality effectively.”
By understanding that spirituality can be a resource for many individuals, she said mental health providers are better equipped to offer comprehensive treatment.
“Ultimately, this intervention is about strengthening coping skills,” she said. “Spirituality enhances personal hope through connection to a greater power that could be religious, but is fundamentally defined in whatever way has meaning to each participant.”
Yamada looks forward to continuing her research to better understand the nuances of spirituality-based treatment and plans to expand to more locations to offer the group intervention to more people.