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Addiction and spirituality. Addiction 99:539--551
Abstract
Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction.
To clarify the way(s) in which the concept of spirituality is understood and employed in practice by clinicians and researchers who publish papers on addiction and spirituality, and to develop a definition or description of spirituality which might receive widespread assent within the field.
A descriptive study of 265 published books and papers on spirituality and addiction.
The study revealed a diversity and lack of clarity of understanding of the concept of spirituality. However, it was possible to identify 13 conceptual components of spirituality which recurred within the literature. Among these conceptual components of spirituality, 'relatedness' and 'transcendence' were encountered most frequently. 'Meaning/purpose', 'wholeness (non-)religiousness' and 'consciousness' were encountered less frequently in the papers on addiction and spirituality than in an unsystematically ascertained sample of papers concerned with spirituality in relation to other areas of psychology and medicine. However, biases in the literature are notable. For example, the great majority of publications are from North America and the field is dominated by interest in Twelve-Step and Christian spirituality.
Spirituality, as understood within the addiction field, is currently poorly defined. Thirteen conceptual components of spirituality which are employed in this field are identified provisionally and a working definition is proposed as a basis for future research.
... It will affects inter and personal relation with other coworkers in the every working days [12]. Cook (2004) the study found that most workers of illicit drugs and heavy drinkers are working adults, many of whom were not substance to addiction in adolescence. The study revealed that ample evidence that substance to addiction among workers is associated with a variety of negative outcomes, including accidents, absenteeism, turnover and other sources of performance and productivity losses [13]. ...
... Cook (2004) the study found that most workers of illicit drugs and heavy drinkers are working adults, many of whom were not substance to addiction in adolescence. The study revealed that ample evidence that substance to addiction among workers is associated with a variety of negative outcomes, including accidents, absenteeism, turnover and other sources of performance and productivity losses [13]. ...
... 1. Workers assistance programs, designed to identify workers with substance addiction (and other) problems and provide them with appropriate treatment. 2. To ensure to designed to identified the substance to addiction workers and-depending on the program provided them with treatment [13]. ...
... A non-theistic approach to spirituality enables the research to focus on spirituality from a connectedness perspective (Chiu, Emblen, Van Hofwegen, Sawatzky, & Meyerhoff, 2004;Cook, 2004;Dyson, Cobb & Forman, 1997). Hence, spirituality is defined as "a human belief in, movement toward, and relationship with a higher purpose or power, self, and others from which a sense of purpose, consciousness, interconnectedness, and destiny may be derived" (Swift, 2003, p. 5). ...
... Researchers often reinforce a search for meaning when defining spirituality (Anderson, Krajewski, Goffin, & Jackson, 2008;Tisdell, 2003;Woods & Woods, 2008). For the purpose of this study, a non-theistic approach to spirituality enables the research to focus on spirituality from a connectedness perspective (Chiu, Emblen, Van Hofwegen, Sawatzky, & Meyerhoff, 2004;Cook, 2004;Dyson et. al, 1997). ...
... Spirituality can exist inclusively or exclusively of religion. A non-theistic approach to spirituality enables the research to focus on spirituality from a connectedness perspective (Chiu, Emblen, Van Hofwegen, Sawatzky, & Meyerhoff, 2004;Cook, 2004;Dyson, Cobb & Forman, 1997). ...
The goal of this study was to explore the connection between authentic leadership, spirituality, and human development theory to determine if spirituality contributes to the emergence or formation of an authentic leadership identity. An interdisciplinary research approach was conducted by reviewing literature on authentic leadership, spirituality, and human development. A sequential explanatory mixed method design was used to collect and analyze the personal beliefs and life experiences of individuals who were nominated as authentic leaders. Sixty-one participants completed a questionnaire and a subset of eleven participants completed semi-structured interviews. Quantitative findings identified that nearly 94% of participants considered themselves to be spiritual (n = 57). Most participants (90%) believe that spirituality influences their beliefs about leadership and their behaviors as leaders (n =55). Similarly, most participants (90%) affirmed that their spirituality influences their authenticity and self-awareness as a leader (n =55). Qualitative findings from semi-structured interviews identified that spirituality, or spiritual influences, experienced during the formative years, influenced participants’ values and beliefs, defined their principles and ethics, and provided a framework for how to live and behave. For most participants, these values and beliefs were informed by religious parents and/or a religious upbringing. When a participant did not reference a religious parent or religious upbringing, a sense of God, or higher power, or a strong sense of service was acknowledged instead. Findings also credit spirituality, or the belief in a higher power or God with having encouraged a participants’ journey or purpose. Participants acknowledged that spirituality has helped and continues to help define who they are, who they want to be, and how they want to live and work. Based on these findings, this study offers evidence that values and beliefs link spirituality to the emergence of an authentic leadership identity. While an individual's identity continues to be shaped and influenced across a person's lifespan, core values which influenced their emergence as an authentic leader were established during the early formative years, informed by parental and spiritual (religious) influences. As such, spirituality may be a mediating variable which influences the emergence of authentic leadership identity, as well as, encourages a sense of purpose, life-direction, and/or self-actualization.
... As an abstract concept, spirituality has been used interchangeably with religion in the literature (Yeşilçınar et al., 2018). Cook (2004) defines spirituality as relatedness, recognition of a transcendent dimension to life, the distinctiveness of humanity, the inner 'core', 'force' or 'soul' of a person, meaning and purpose in life, authenticity and truth, values, importance and worth, non-materiality non-religiousness, holistic wellness, wholeness or health, self-knowledge and self-actualisation, creativity, and consciousness. ...
... The above excerpts were in line with Cook's (2004) suggestion on the definitions of spirituality which include relatedness, that is, relationship with other individuals. Additionally, spirituality as an inner component of individuals is related closely to their outward behaviours. ...
... Many publications offer reviews especially in healthcare and education. A paper by Cook (2004) provides an overview of 265 associated papers and books, with the outcome being a compromised combination of humanistic, with some reflections on genuine, spirituality. A so-called 'Critical literature review' by Victor et al. (2015) would be more correctly labelled 'A comparative review', since it described, but did not clearly differentiate between, religion and spirituality. ...
... as leading to union with God. 4 The fact or condition of being immaterial. 5 Med. ...
From history, we find too many examples of leaders attempting, and too often succeeding, in oppressing their people, instead of leading positively and encouraging each of them to optimize their individual potential, which can help build constructive and productive communities, with people living with positive outlooks on life, resulting from wholesome mental attitude. When oppressed, people often lose hope, which can lead to them becoming depressed, even to the point of being suicidal. It takes effort for people to encourage and build others up, rather than impose their own ideas on them, but it is worth the effort. People are the product of their worldview in action. There are two prominent, contrasting worldviews, namely humanistic and theistic. The critical foundation for well-being among people is their spiritual well-being, which has potential to enhance their own mental, psychological and social well-being, as well as enable them to be positive contributors to the quality of life of their community. From a theistic perspective, a personal relationship with God, through Christ, liberates a person from the tyranny that can be imposed by political and/or religious oppressors and provides wisdom, plus mental and emotional strength, through the indwelling power of Holy Spirit-God. God has the power, ability and desire to save all who acknowledge Jesus as their personal savior and make Him Lord of their life. In fact, this is the prime message that is revealed in the life-giving words of the Bible. Living in a right relationship with God provides hope and help for each person to overcome the many trials and tribulations that they face on Earth, whether that be at the end of a long, productive life, or cut short by unforeseen tragedy, such as that resulting from political and/or religious oppression.
... The Latin word 'spiritus' is the foundation of the word 'spiritual', meaning 'to blow or breathe', and 'to give life to the soul' (13). It also means a journey, or pursuit for truth (14), A study reported that the theory of spirituality had 13 conceptual components; among which, divine existence and connection were the furthermost referenced conceptual components (15). The eight steps concept analysis conducted by another study built-in immateriality as one of the terms associated with spirituality (16). ...
... The eight steps concept analysis conducted by another study built-in immateriality as one of the terms associated with spirituality (16). The literature revealed different synonyms for this concept such as personal meaning, purpose, values, beliefs, and personal connectedness, connectedness to others, connectedness to the surrounding, and connectedness to God, or a Supreme Being (15)(16)(17). Spirituality is psychological with numerous expectations. It is an interconnection of something beyond and connecting something within ourselves (17)(18) and individuals understand their spirituality in different ways through the practice of a certain religion (16 17, 19 20). ...
Objective: Adolescence is a transition period where drug experimentation is common. Spirituality and religiosity have been recognized by literature as having a possible role in stabilizing good physical and mental health. To compare the religiosity and spirituality among adolescents abusing a psychoactive substance and those not abusing psychoactive substances in a Nigerian hospital
Methods: This was a cross-sectional descriptive study conducted among adolescent patients admitted to the drug rehabilitation unit and adolescents attending the General Outpatient Department of the ABUAD Multisystem Hospital, Ado-Ekiti. The Daily Spiritual Experience Scale and Centrality of Religiosity Scale were used
Results: The prevalence of high religiosity and spirituality among the respondents was 57.9% and 56.1%. The prevalence of high religiosity and spirituality among respondents not abusing psychoactive substances was 62.9% and 62.6% respectively, while the level of high spirituality and religiosity among respondents abusing psychoactive substances was 53.0% and 49.1% respectively. A significant proportion of the respondents who had a low level of religiosity (55.9%) abused psychoactive substances than respondents who do not abuse psychoactive substances (45.7%) (X2=7.694 p=0.006). Similarly, more proportion of respondents who had a low level of spirituality (57.4%) abused psychoactive substances than respondents who do not abuse psychoactive substances (44.2%). The observation is statistically significant (X2=11.1, p
... For example, the definition of spirituality used earlier might be viewed and interpreted through a secular lens without resorting to any formal notions of spirituality. Also, a review of the body of research on addiction and spirituality (Cook, 2004), which analysed 263 publications, identified 13 common conceptual components that the authors had used to define spirituality: 1 relatedness 2 transcendence 3 humanity 4 core/force/soul 5 meaning/purpose 6 authenticity/truth 7 values 8 non-materiality 9 (non-) religiousness 10 wholeness 11 self-knowledge 12 creativity 13 consciousness. ...
... The findings reveal varying understandings of what spirituality is and how it can help. These understandings generally reflect different selections, emphases upon and combinations of the 13 component concepts of spirituality discussed earlier (and described in more detail in Cook, 2004). Future research needs to more clearly identify them and examine their interrelationships and interdependence. ...
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
... This result of our study supports other studies (11,52,54,55). Spirituality has become a common concept in contemporary addiction literature (56). Spirituality is defined as an inner resource that facilitates a sense of belonging with other people (56,57). ...
... Spirituality has become a common concept in contemporary addiction literature (56). Spirituality is defined as an inner resource that facilitates a sense of belonging with other people (56,57). If individuals need for belonging is met, they are likely to overcome their psychiatric problems and troubles as well as not rely on cyberspace (14,24,58). ...
... En addictologie, historiquement la dimension transcendantale a toujours eu une place par exemple avec le programme en 12 étapes [65]. De nombreuses études ont été faites dans ce domaine, mais il faut être prudent au regard de l'imprécision des définitions mêmes des termes comme spiritualité et religion [66]. Cependant, il semble qu'une sensibilisation à la dimension spirituelle puisse être aidante, en particulier dans certaines populations comme les Américains d'origine africaine [64] ou dans les addictions à internet en particulier chez les adolescents [67]. ...
Objectifs
Les comportements addictifs sont des comportements complexes, souvent rattachés à des plaisirs sociaux, tels que des usages de substances, des activités de jeu, ou encore des conduites sexuelles ou sportives. Ces comportements envahissent progressivement la vie des personnes concernées, ce qui mène à une atteinte parfois marquée des sphères de leur vie sociale. La réhabilitation de telles atteintes fait désormais partie intégrante de l’approche thérapeutique moderne des soins addictologiques.
Méthodes
À travers une revue narrative ciblée de la littérature, cet article a pour objectif d’expliciter en quoi la réhabilitation consiste et pourquoi elle est pertinente en addictologie.
Résultats
La réhabilitation psychosociale nécessite la réalisation d’un inventaire complet et très large de l’état clinique et du fonctionnement, qui permet l’élaboration d’un projet de soins individuel co-construit avec les personnes concernées. Les soins de réhabilitation psychosociale ont pour principal objectif de renforcer leurs capacités. Ils sont généralement associés à une prise en charge psychopharmacologique et psychothérapique, ainsi qu’à un accompagnement du rétablissement des fonctions de base que sont le sommeil, l’alimentation, l’activité physique et la spiritualité.
Conclusion
La réhabilitation psychosociale est particulièrement pertinente en addictologie. Elle nécessite une évaluation complète et structurée et l’élaboration d’un projet d’accompagnement personnalisé et co-construit avec les personnes concernées. Elle intègre de nombreuses dimensions psychosociales souvent négligées, dont le rétablissement va permettre une reprise d’activité fonctionnelle globale et une optimisation de la qualité de vie.
Abstract
Objectives
Addictive behaviors constitute complex behaviors that are usually related to social habits, such as substance use, gambling or gaming activities, or sexual or physical activity. They progressively overrun and stifle the routine habits of the concerned individuals, for example within their occupational or family spheres of life, as well as in their hobbies or in their main physiological functions, such as sleep or eating cycles. The rehabilitation approach of care integrates the objective of restoring the altered habits and functional rhythms, to optimize the clinical outcomes and improve quality of life of the concerned persons.
Methods
Using a focused and narrative literature review, we aimed to explain what psychosocial rehabilitation consists in, and why this approach is particularly relevant for the addiction care, although to date it has remained insufficiently developed in the routine practice of many facilities.
Results
The “rehab” approach, is first based on a structured and comprehensive assessment of the clinical and functional aspects of the patient, which secondarily allows to frame an individualized project of care that is closely built together with the patient. This project of care can integrate classical pharmacotherapeutic and psychotherapeutic tools, but it also emphasizes wider approaches for restoring some basic social and physiological functions of the concerned person, such as sleep, eating, social functioning, physical activity, or spiritual needs. Priorities among these different dimensions have to be defined by the concerned person.
Conclusions
The “rehab” approach is particularly relevant in addiction medicine. It represents a more global conception of care that conceives the recovery of social and physiological functioning as a core treatment objective for the concerned persons. The consequences for care organization are that many additional professionals should be integrated into the treatment schemes for addiction, including peer counselors, occupational therapists, physical activity coaches, or dieticians.
... Spirituality, as an inherent component of being human, is connected with the belief that there are aspects of human life that transcend physical reality and that there is more to life than what we see or fully understand (Underwood & Teresi, 2002). A spiritual person seeks answers to fundamental questions about life and looks for meaning and purpose in their lives in connectedness with others, oneself, nature, and the sacred or transcendent (Cook, 2004). ...
Despite the well-established role of mutual-aid groups in addiction treatment, no research has yet explored the role of the 12-step pathway in spiritual growth and gratitude, or its direct and indirect relationships with well-being among individuals with compulsive sexual behavior disorders (CSBD). The purpose of the current study was to examine the number of 12 steps completed as an antecedent of spiritual growth and gratitude and its relationship with well-being among members of Sexaholics Anonymous (SA). The sample consisted of 80 individuals (72 men and 8 women) attending SA meetings in Poland. The study variables were measured using the Daily Spiritual Experiences Scale, Gratitude Questionnaire, Satisfaction with Life Scale, Positive and Negative Affect Schedule, and a single question regarding the number of 12 steps completed. A path analysis showed that the number of 12 steps completed was negatively and directly related to negative affect. Moreover, the number of 12 steps completed was related to higher spiritual growth, which was directly related to higher levels of life satisfaction and lower levels of negative affect, and indirectly, through gratitude, to higher levels of life satisfaction and positive affect. The results suggest that spiritual growth, rooted in the 12-step program, and its ability to increase gratitude, may promote recovery from CSBD.
... Thus, spirituality is concerned with matters of meaning and purpose in life, truth, and values. 3 Older adults with cancer have strong spiritual needs, especially toward the end of their lives. 4,5 However, many caregivers have an incorrect understanding of the thoughts and behaviors of older adults and neglect their spiritual needs. ...
Objective
To clarify the concept of spiritual needs and explain its meaning to older adults with cancer.
Methods
Electronic databases (Web of Science, PubMed, EBSCOASU, CNKI, Wanfang, and VIP) were systematically searched and analyzed using “spiritual needs” as keywords. Rodgers' evolutionary method guided the concept analysis to identify attributes, antecedents, and consequences. Two rounds of Delphi expert consultations ensured accuracy, reliability, and feasibility for implementation.
Results
Spiritual needs express an individual's expectations of comfort and inner peace that satisfy his or her perception of the meaning and purpose of life, the ability to love and be loved, feelings of peace and gratitude, and a sense of belonging and hope. Spiritual needs have four dimensions: personal, communal, environmental, and transcendence or supreme. The attributes of spiritual needs include meaning and purpose of life, love and being loved, peace and gratitude, belonging, and hope. The antecedents include spiritual recognition and events that trigger spiritual needs and spiritual need thresholds. The outcomes of addressing and meeting the spiritual needs of older adults with cancer include promoting their spiritual health and enhancing their quality of life. After two rounds of Delphi experts' consultation, the expert authority coefficients (Cr) were 0.83 and 0.88, respectively. Experts agreed on the concept of spiritual needs.
Conclusions
Exploring antecedents of spiritual needs in older adults with cancer clarifies obstacles to spiritual practice, offering intervention strategies for spiritual care and well-being. Meeting their spiritual needs enhances spiritual health and quality of life, essential in humanistic nursing care.
... The word religion on the other hand has the same root as ligament, ligature, and oblige. It is that grounding of faith and basis of life to which people might regard themself as being bound for their survival, a rope that ties them to God and to other believers (Cook 2004). Spirituality is increasingly being included as a component of psychiatric treatment and as an independent and dependent variable in treatment research. ...
Objectives:
Pancreatic cancer is a major site of gastrointestinal tumors and remains a leading cause of cancer death in adults in the United States. There is also a strong association between pancreatic cancer and depression. When struggling with cancer, along the different phases of illness, a human being is confronted with manifold issues, which might profoundly interfere with their sense of meaning and purpose.
Methods:
From this standpoint, several different therapeutic techniques have been designed to manage the psychological needs of the patients. Here we provide 2 clinical scenarios, where there was a strong religious correlation to the therapeutic techniques employed with patients suffering from pancreatic cancer.
Results:
The 2 cases described showed some improvement in their overall life view and could recalibrate their expectations based on a strong religious foundation.
Significance of results:
The role of religion and spirituality in health has also received increasing attention in literature. Religion and spirituality can help patients with cancer find meaning in their illness, provide comfort in the face of existential fears, and receive support from a community of like-minded individuals. In effect, they also provide evidence toward the scope of and integrating the domain of spirituality into holistic cancer care.
... Spirituality comes from the term spirit, and has been described as a vital essence and a powerful source to meaning and purpose in life, which is closely connected to the body, expressed through emotions, feelings, behavior, and relationships (Benner, 2011;Cook, 2020;Koenig, 2009;Miller & Thoresen, 2003). Spirituality is usually defined as a meaningful system which helps a person to find values, aims and connections in life (Cook, 2004(Cook, , 2020Koenig, 2009;Swinton, 2020a). ...
... Benliğin içindeki, 'içsel', içkin ve kişisel olanla bir ilişki olarak veya tamamen 'öteki', aşkın ve benliğin ötesinde olanla bir ilişki olarak deneyimlenebilir. Buradaki deneyim temel ve nihai öneme sahiptir ve bu nedenle yaşamdaki anlam, amaç, hakikat, değerler gibi konularla ilgilenir (Cook, 2004;İşbilen, 2022). ...
... In which these symptoms and impact made the addicts expected to experience the withdrawal of drug consumption. According to Cook (2004) spirituality is a key variable in the etiology and treatment of addictive disorders. Spirituality should be seen from a multidimensional perspective and not only on the meaning of life. ...
... Here, we shall address these aspects related to R/S, but we must always keep in mind the fundamental importance of the other aspects for effective treatment and prevention (3) . This is because there has been a growing recognition that aspects of R/S are important variables in the understanding of the etiology and in the treatment of these disorders (4) . Recently, the International Society of Addiction Medicine published a guideline reviewing the evidence and introducing recommendations on how spirituality can be incorporated into the study and clinical practice of substance-use disorders (5) . ...
Alcohol and other substance use disorders are complex problems with multiple variables and determinants, requiring a multidimensional approach to prevention and treatment. A robust research body shows that Religiosity and Spirituality (R/S) have a prominent role in these disorders; however, a current gap is how to apply this knowledge. We present practical guidelines on how to integrate R/S to substance use prevention and treatment in an ethical and evidence-based way. These guidelines have been endorsed by many academic leaders in these topics and by health associations related to the three major Brazilian religions. The integration of R/S is part of a respectful person-centered interdisciplinary approach, that do not to impose religious beliefs or secular worldviews. The most critical interventions include collecting the history of spiritual and religious beliefs, practices and experiences and how these may be used positively in treatment. It is also essential that health professionals are encouraged to value and respect the R/S of patients, as well as that religious groups recognize that professional and technical interventions can make a valuable contribution to preventing and treating these disorders.
... Meaning has been classified as comprising needs of purpose (goals and fulfilment), value or significance, efficacy (control over one's life) and selfworth [62,63]. The related concept of a spiritual void underpins spiritual approaches to addiction, including the 12-step programs [71,72]. We posit that meaning can be used as a rubric that clients use to assess the meaningfulness to them of the treatment intervention, particularly the various activities included. ...
Issues:
Completion of residential treatment for substance use disorder (SUD) relates to improvements in substance use and mental health. Findings from systematic reviews have been equivocal about which interventions work best for clients. There has been limited attention to the theories that explain the effectiveness of residential treatment.
Approach:
We conducted a realist review of the literature to identify program theories that would explain successful and unsuccessful outcomes from residential treatment for SUD. The unit of analysis was context-mechanism-outcome (CMO). Inclusion criteria were studies of residential treatment of more than 30 days for adults with SUD. Pharmacological studies were excluded.
Key findings:
We identified 24 studies from 5748 screened. The studies were from settings comprising Indigenous programs, faith-based programs, psycho-social interventions and therapeutic communities and were conducted in North America, Scandinavia, Continental Europe and Australasia. We chose six CMO configurations as the best explanations for outcomes from residential treatment. Theories that best explained the mechanisms of change were the need to belong, meaning in life, and self-determination theory.
Implications:
Previous research has noted similar outcomes from different residential treatment interventions, but has not been able to explain these similarities. In contrast, our findings suggest that the outcomes can be explained by causal mechanisms that apply across all programs, regardless of the philosophy of treatment.
Conclusion:
We identified six CMO configurations whose mechanisms of change could be explained by three overarching theories-the need to belong, meaning in life and self-determination theory. The findings apply across ethnicities and genders.
... A religious or spiritual sense of belonging in the traditional sense might discourage individuals from excessive substance use, particularly based on their beliefs or principles (c.f. Cook, 2004;Geppert et al., 2007). As noted earlier, RSWB (especially Hope) can activate healthy coping mechanisms in challenging situations. ...
Background: It is becoming increasingly apparent that the COVID-19
pandemic not only poses risks to physical health, but that it also might lead
to a global mental health crisis, making the exploration of protective factors
for mental well-being highly relevant. The present study seeks to investigate
religious/spiritual well-being (RSWB) as a potential protective factor with
regard to psychiatric symptom burden and addictive behavior.
Materials and Methods: The data was collected by conducting an online
survey in the interim period between two national lockdowns with young
adults (N = 306; age: 18–35) in Austria. The primary study variables were
assessed through the Brief Symptom Inventory 18 (BSI-18; psychiatric
symptom load), the Alcohol, Smoking and Substance Involvement Screening
Test (ASSIST; addictive behavior/addiction risk) and the Multidimensional
Inventory for Religious/Spiritual Well-Being short version (MI-RSWB 12), with
its sub-dimensions Hope (HO), Forgiveness (FO), General Religiosity (GR), and
Connectedness (CO).
Results: We observed HO and FO as substantial negative predictors of
psychiatric symptom burden. With regard to addictive behavior, HO in
particular but also GR seem to have a protective function. Furthermore,
we found positive connections between CO, psychiatric symptom burden,
and addictive behavior.
Conclusion: In line with our assumptions, HO, FO and to a minor extent GR
were confirmed as negative predictors regarding psychiatric symptom burden
or addictive behavior in young adults, coping with the psychological threat
of COVID-19 pandemic. These dimensions might be further considered as
potential resources in clinical treatment. However, the positive prediction of
mental illness parameters by increased feelings of CO could also be interpreted
as an expression of exhaustion and alienation from the real world.
... Through a critical lens, it's perceived by some as exploitative and used by organisations for instrumental gain (Cook 2004). Alternatively, it's framed as "psychological coercion." ...
... The search for purpose, or meaning in life, has been characterised as central to coping with distress and a navigating a pathway towards well-being (Frankl 2008) and subjective well-being (Schueller and Seligman, 2010). Authors have described meaning and purpose as central components of spirituality in addiction studies (Cook 2004;Gutierrez 2019), in 12-step programmes and in recovery (Galanter 2007;Laudet et al. 2006). Life meaning has also featured as a key ingredient of human capital in recovery capital models (Hennessy 2017), both separate from spirituality (Cano et al. 2017;Groshkova et al. 2013) and connected to spirituality (Laudet et al. 2006;Sterling et al. 2008). ...
Residential treatment of addiction remains a key element in addictions management, though high rates of attrition and relapse are reported, and underlying mechanisms of change remain unclear. This study aimed to complete the first stage of a realist evaluation—to develop an initial programme theory that would explain possible contexts and mechanisms of change leading to outcomes from a residential treatment programme for substance use disorders. Realist evaluation using key informant interviews and document review. Residential treatment centre in New Zealand. Four key informants (managers and caseworkers). Retroductive analysis (inductive and deductive) of semi-structured interviews and content analysis of documents. We identified one intermediate outcome of identity change that contributed to successful completion of residential treatment. The mechanisms leading to these outcomes were the development of a sense of belonging to the recovery community and a sense of hope and purpose. These mechanisms were activated in contexts including supportive and structured culture (staff and peers) and the absence of chaos. We developed an initial programme theory to explain successful completion of a residential treatment for SUD. Theories like this are important because practitioners can use them to increase the likelihood of replication of successful treatment. We found that realist evaluation provides researchers with appropriate philosophy and methods with which to explore and start to unravel some of the complexity within residential treatment for addictions.
... A systematic review of studies on substance use disorder and spirituality found that 32 of 50 studies that used validated instruments to measure spirituality had a mismatch between the definition of spirituality adopted and what the instruments can really assess. 83 This is another problem that is due to the coexistence of different definitions of spirituality, as each definition proposed or assumed in the construction of an instrument for measuring spirituality may not be compatible with the one assumed by the authors of subsequent studies. Therefore, it is essential that this expanding field of investigation develops its conceptual framework so that it includes different forms of connections, meaning making, and subjectivities when studying spirituality. ...
The importance of spirituality as a research topic has been increasingly recognized, which has led to several studies on the topic. Areas including psychology, medicine, and nursing have produced studies on spirituality under a plurality of definitions and methods, which reveals the complexity of the theme. However, this has resulted in a range of potential problems, including: (1) the use of overlapping and contradictory terms between studies, or even within the same study, (2) research methodologies that do not fit the definitions (sometimes unreflectively) assumed by the authors, (3) difficulties, or even the impossibility, of comparing the results of studies, (4) controversies in respect of the inclusion/exclusion of secular groups in research on spirituality, and (5) ambiguous measurements, often being exclusively dependent on each participant's individual interpretation of what spirituality means. This article discusses these problems, recommends theoretical and methodological alternatives and presents a taxonomy of definitions of spirituality.
... The research study propounds that factors underlying each variable share a significant relationship with spirituality and their crucial role in the maintenance of sound psychological health cannot be overlooked. Spirituality is understood as a complex phenomenon as inferred by Cook in 2004 which can hold different meanings for people across different age spans, cultures and religions. It is mostly understood as closely related to religion and more commonly investigated in the older generations. ...
Abstract
Context: Growing understanding around spirituality as a constantly evolving construct has led to a wide number of researches attempting to understand the multiplicity of the dimensions it encases. With such advancements, the spiritual framework as different from religion has proved to play a role in alleviation of mental distress and restoration of mental equilibrium.
Objective: The objective was to study the relationship between spirituality, psychological capital and psychological well-being among emerging adults in India. The study also explores the role of psychological capital and psychological well-being in predicting experience of spirituality by emerging adults residing in India.
Design: This study has a non-experimental, correlational research design.
Participants: Two hundred young adults falling in the age range of 18-25 participated in the study.
Results: The results indicate a significant positive correlation between the two variables namely psychological capital (r(200)=.644, p<.01) and psychological well-being (r (200) = .555, p < .01) with spirituality. psychological capital and psychological well-being predicted spirituality. F (2,197) = 111.92, p < .001, R2=0.532) which could be used to sensitize the population towards the construct having a separate entity from religion and integrate it within the field of mental health to promote a positive notion of psychological well-being and psychological capital amongst the chosen population of emerging young adults.
Keywords: spirituality, psychological well-being, psychological capital, emerging adults
... Spirituality may take a humanistic (secular) form orrelating to a transcendent higher powera religious form. Chris Cook (2004), psychiatrist, ordained Anglican priest and Professor of Spirituality, Theology & Health at Durham University, comments: Spirituality is a distinctive, potentially creative and universal dimension of human experience arising both within the inner subjective awareness of individuals and within communities, social groups and traditions. It may be experienced as relationship with that which is intimately 'inner', immanent and personal, within the self and others, and/or as relationship with that which is wholly 'other', transcendent and beyond the self. ...
... Bağımlılık yaşantısı aktif olarak devam eden bireylerin psikolojik açıdan iyi oluş düzeyleri ve başa çıkma tarzları, bağımlılıktan arınmada oldukça önemli hususlardır. Günümüzde din veya maneviyatla bütünleşik çalışmalar özellikle bağımlılık tedavisinde önemli bir konu haline gelmiştir (Cook, 2004;Galanter ve ark., 2007;Kelly ve ark., 2011). Dinden/maneviyattan destek almak, iyileşme sürecinin niteliğinin artırılmasına katkı sunacağı düşünülmektedir. ...
Manevi danışmanlık ve rehberlik • Sosyal hizmet • Bağımlılık • Bağlanma • Din • Maneviyat
Spiritual counseling and care • Social work • Addiction • Attachment • Religion • Spirituality
... Spirituality is a common human orientation, and its meaning is broad and varied (Cook, 2004). Religious spirituality is its traditional form, and religious institutes (e.g. ...
This study addresses the potential role of spirituality in promoting mental health and wellbeing and argues for its utility in the helping professions. Spirituality, as a common human orientation, has long been a central notion in recovery movements. In the first part of the paper the author discusses the differences and overlaps between spirituality and its traditional form, religion. In the second part a questionnaire was used to study laypersons’, and professional helpers’ views on spirituality. The convenience sample comprised 137 persons. Professionals could find spirituality an important resource in their practice and included it in their interventions mainly when their clients had introduced the theme first. Most of the laypersons in the sample were concerned with spiritual issues and regularly practiced meditation or prayer. They conceived spirituality to cope with mental or physical illnesses.
... This agrees with Liu et al. (2020a) who found that self-compassion and social connectedness worked together to buffer the impact of racial discrimination on mental health among college students. As Cook (2004) previously stated, this association leads us to consider that peace and meaning cannot be restricted to the individual sphere, but rather that it implies a connective and interrelated dimension. ...
The COVID-19 lockdown has had a massive psychological impact on mental health in the
general population, with increases in anxiety, depression, and post-traumatic stress disorder. Spiritual well-being, specifically peace and meaning, has already been identified as one of the main protective factors for these disorders in the COVID-19 context. The aim of the present study is to identify facilitating elements for peace and meaning during the COVID-19 lockdown in Spain. Online surveys were used to obtain data from a sample of 3480 Spanish people. Self-compassion and social support were positively related with peace and meaning, while loneliness and perceived discrimination were negatively related. The model for peace and meaning was statistically significant, explaining 47% of
the variance. The significant variables were self-kindness, family support, mindfulness, and sense of belonging having a positive association and loneliness a negative one.
... These experiences are therefore considered deeply healing. Some of the cognitive and behavioural shifts linked to these experiences include: increased empathy, compassion, gratitude, openness, trust, altruism, curiosity, awareness, creativity, authenticity, integrity, a sense of higher purpose and meaning in life, a sense of virtuous mission or selfless service towards humanity, a sense of being reborn and liberated from past attitudes and beliefs, a sense of devotion to love-based values, and a rejection of "religiousness" and materialistic lifestyles (Cook, 2004;McClintock et al., 2016;Taylor and Egeto-Szabo, 2017;McGee, 2020). These deep shifts may lead to radical changes in religious and philosophical views, relationships, and career paths (Taylor and Egeto-Szabo, 2017). ...
Spontaneous Spiritual Awakenings (SSAs) are subjective experiences characterised by a sudden sense of direct contact, union, or complete nondual merging (experience of oneness) with a perceived ultimate reality, the universe, “God,” or the divine. These profound transformative experiences have scarcely been researched, despite extensive anecdotal evidence suggesting their potential to catalyse drastic, long-term, and often positive shifts in perception, world-view, and well-being. The aims of this study were to investigate the phenomenological variances of these experiences, including the potential differences between SSAs and Spontaneous Kundalini Awakenings (SKAs), a subset of awakening experiences that the authors postulate may produce a higher likelihood of both physical and negative effects; to explore how these experiences compare to other altered states of consciousness (ASCs), including those mediated by certain psychedelic substances; and understand their impact on well-being. Personality trait absorption and temporal lobe lability (TLL) were assessed as predictors of Spontaneous Spiritual and Kundalini Awakenings (SSA/SKAs). A mixed within and between-participants self-report survey design was adopted. A total of 152 participants reporting their most powerful SSA/SKAs completed questionnaires measuring nondual, kundalini, and mystical experience, as well as depth of ASC, and trait absorption and TLL. Spontaneous Kundalini Awakenings were found to be significantly more physical, but not significantly more negative than SSAs, and overall, both sets of experiences were perceived to be overwhelmingly more positive than negative, even in cases where the experience was initially challenging. The phenomenological distribution of SSA/SKAs was similar to other measured ASCs although greater in magnitude, and appeared most similar in distribution and in magnitude to drug-induced ASCs, particularly classic psychedelics DMT and psilocybin. Temporal lobe lability and trait absorption were found to predict the SSA/SKA experience. The limitations and implications of these findings are discussed.
... Maneviyat kavramının İngilizce karşılığı olarak alanyazında sıkça kullanılan "spirituality" kelimesi, Latince kökenli olup "nefes, buhar, hava, rüzgar" anlamına gelen spiritus sözcüğünden türemiştir (Cook, 2004;Marques, Dhiman ve King, 2005). Maneviyat ise Türkçe alanyazında tercih edilen bir terimdir. ...
Örgütler, varlıklarını devam ettirebilme sürecinde pek çok yapıcı veya yıkıcı potansiyeli olan durumla karşı karşıya kalabilmektedir. Eğitim örgütlerinden olan okullar da bu tür durumlardan etkilenebilmektedir. Bu araştırma, ilköğretim okullarında görev yapan öğretmenlerin örgütsel sinisizm ve örgütsel maneviyat algılarının örgütsel bağlılık düzeyleri üzerindeki rolünü belirlemek amacıyla yapılmıştır. Rize ilindeki devlet okullarında görev yapan 417 öğretmen, araştırmanın örneklemini oluşturmaktadır. Araştırmada ilişkisel tarama modeli kullanılmıştır. Araştırmanın sonucunda ilköğretim okullarında görev yapan öğretmenlerin örgütsel bağlılık düzeylerinde gerçekleşen değişimin %55’i, örgütsel sinisizm ve örgütsel maneviyat ile açıklanabilmektedir. Örgütsel sinisizm ile örgütsel bağlılık arasında orta düzeyde negatif; örgütsel maneviyat ile örgütsel bağlılık arasında ise orta düzeyde, pozitif ve anlamlı bir ilişki bulunmaktadır.
... Specifically, previous evidence pointed out that considering the role of spirituality during the recovery helps to improve positive coping skills in rehab patients (Arévalo et al., 2008;Currier, 2020;Kondo et al., 2000). Although spirituality and self-transcendence values are different constructs, these are strongly related (Cook, 2004;Hyland et al., 2010). Spirituality is often considered as the value that reflects the one's desire to go beyond the self, exploring transcendence without any specific religious were at risk are more likely to experience the so-called "mortality salience" (Greenberg et al., 1992) that consists of increasing awareness of the fragility of the human existence and death (Bassett & Going, 2012). ...
Background: Substance addiction is a psychosocial problem facing many people today. While the previous trend in addiction treatment was the harm reduction approach, nowadays it is fully recognized the importance of promoting human resources in order to help people to face the rehabilitation process, to prevent the risk of treatment dropout and future relapses, and to positively re-integrate them into the society. During the process of recovery from substance addiction, resilience is one of the most important protective factors against both dropouts and relapses. This study analyzed for the first time whether and the extent to which self-transcendence values (i.e., benevolence and universalism) promote resilience, considering the mediating role of hope, among patients in residential substance abuse treatment.
Method: Seventy-six Italian patients in residential treatment for substance addiction (86.5% males and 13.5% females; Mage = 40.23, SD = 10.88) participated to the study. Participants were asked to complete the Self-transcendence subscale from the Portrait Values Questionnaire, the Hope Scale, and the Connor Davidson Resilience Scale.
Results: Findings showed that self-transcendence values were positively related to resilience and that hope fully mediated (in a positive direction) this relationship. Self-transcendence values promoted resilience through the mediating role of hope.
Conclusions: This complex relationship suggests a holistic model of resilience during the process of recovery from substance addiction. Limitations of the study, practical implications, and future research developments are discussed.
... b. Religiosity: Religiosity and spirituality are multidimensional concepts ( George et al., 2000 ;Miller and Thoresen, 2003 ;Cook, 2004 ;Hill, 2005 ). Numerous explanations of religiosity have been offered from diverse disciplines and perspectives. ...
Religion is a powerful institution that models human behaviors at all levels. In a time of proven environmental crisis, it is useful to think about how this institution can improve conservation efforts and nature care through promoting sustainable and prosocial behaviors. Although some research argues that the effect of political ideology and economic status is by far a stronger predictor than religiosity per se, this varies across cultures. We develop a first research strategy, based on two sources: 1) The World Values Survey, between 1997 and 2018, to identify trends regarding the importance of religion in Colombians’ life. 2) Self-administered survey (a total of 450 surveys applied to Colombians, under snowball sampling in 2020) the sample size is adjusted to the data analysis technique, which was Structural Equation Modeling (SEM), to understand the potential relationship between religiosity, environmental perception, prosocial, and sustainable behaviors in a megadiverse country, and highly religious such as Colombia. The results of this first research, in the Colombian case, reiterate and provide empirical support to earlier theoretical studies that have pointed out the contribution of religiosity and spirituality to sustainability and prosocial behaviors. This case shows that acting sustainably is not just a matter of belief or unbelief, nor of being spiritual or atheist. Prosocial behaviors, in combination with environmental perception and knowledge, have a major influence on sustainable behaviors for the Colombian case.
Afin d’examiner ce qui pousse les individus à développer certaines croyances sur l’homéopathie et à utiliser cette médecine alternative et complémentaire (MAC), cette étude se concentre sur la spiritualité explicite et la préférence pour le naturel. Elle a été conduite auprès de 367 participants, 207 de sexe féminin et 160 de sexe masculin. Les résultats de cette étude montrent que la spiritualité explicite et la préférence pour le naturel des individus sont significativement liées à leurs croyances selon lesquelles l’homéopathie soulage les symptômes et améliore le bien-être. Ceux-ci expliquent également de manière significative l’utilisation de cette médecine alternative et complémentaire.
This study aims to determine the effect of religious accommodation on psychotherapy in anxiety and depression disorders. This review systematically examines clinical trials of the integration of religion and psychotherapy for treating patients with depression or anxiety. The results of the studies review shown that psychotherapy using religious alternatives effective for treating depression and anxiety as other types of psychotherapy. Integrating religion into psychotherapy has shown a variety of results. But some studies shown that religious can support mental illness, and prayer can be alternative to meditation in psychotherapy. Religion and psychotherapy can affect anxiety, depression, suicide, and bipolar in the psychotherapy practice. Religion and psychotherapy can build self-control in people, and religion and psychotherapy can drive people to their well-being. But in the studies shown that in the practice of psychotherapy, the use of religion and spirituality as alternatives to meditation is still separated. This results in many variations of results in studies of religion and spirituality in psychotherapy practice.
The Aim of this study was to examine the attitudes of mental health service users towards spirituality and spiritually competent practice. A validated quantitative questionnaire was designed to elicit the perceptions of spirituality and spiritually competent practice. Participants were invited to participate in the study via social media. Standard statistical procedures, including reliability analyses, were applied. Respondents who viewed spirituality as distinct from religion were likely to place a higher value on Spirituality in Everyday Life. Those who had experienced the integration of spirituality within services they had received also placed a higher value on the place of Spirituality in Practice. The relationship between these measures and the distinction between religion and spirituality and how far spirituality had been integrated in services received and reasons for these associations are discussed in the light of the importance of spiritual care as a part of person-centred care. The evaluation by service users, of the concept of spiritually competent practice and the need for spiritual competencies in mental health staff were the most positive of all the findings.
Background: Research has suggested that religiosity is a protective factor in alcohol use, but this is an area that could be further explored. Objective: To undertake a systematic review of the literature on drinking patterns and their relationship with religiosity and non-religiosity in adult populations. Methods: We searched for relevant studies using the PubMed, LILACS, Web of Science, Scopus, and Psych-INFO databases. This review included only studies of people aged 18 and over which had a non-religious group as a comparison measure. Results: Fifty-one studies met the inclusion criteria. The present review showed that religious people tend to have lower alcohol consumption compared to those with no religion. However, this difference appears only when religions are analyzed together without differentiating between religious affiliations (Catholicism, Buddhism, Evangelicalism, etc.). Some religious affiliations, such as Buddhism, Catholicism and Lutheranism, appear to be risk factors for alcohol consumption. Definitions of risk consumption showed high heterogeneity, ranging from eight to 21 or more doses per week, a difference of 13 doses of alcohol between studies. Conclusions: The present review showed that religious people tend to have lower alcohol consumption compared to non-religious people. However, the results are contradictory when religious affiliations are analyzed separately and compared with non-religious participants. Adequately understanding which dimensions of religiosity and non-religiosity (e.g., group processes, engagement, meaning, rules of behavior) are protective in adulthood is fundamental to the construction of more effective interventions in this age group.
The following research focused on psycho-social determinants of health perception from the perspective of patient self-analysis underlying aspects of diagnostics and therapy directly linked to the patient's personal experience, for Quality Improvement Purposes. In particular, the study analyzed the importance of factors such as environment, personal belief and perspective on life, as a way to relate the patient's viewpoint within the specific structure of therapeutic groups led by the University of Vermont Medical Center (UVMMC, former Fletcher Allen Health Care) Inpatient Psychiatry Activities Therapists on the units Shepardson 3 and 6. Methods: The research is comprised of two parts: Part 1 has been represented by the Focus Group Questionnaire (FGQ), as previously approved by UVMMC Quality Council Meeting, and administered verbally (through printed handouts) on both units by UVMMC Activities therapists. Part 2, the Health Perception Survey, has been presented as printed attachment to the FGQ and followed the same structure, rules, and requirements of the FGQ. The data collected have been part of a retrospective cohort study in the case of the FGQ and have been implemented by the HPS, an empirical research questionnaire conducted over a period of six months, as approved by the Institutional Review Boards (IRBs). Patients have been able to choose to participate in the therapeutic focus group and not allow their responses to be used for research. Furthermore, patients have been able to decide to only answer the questions in the FGQ and not take part in the HPS. In the case of patients changing their mind after the focus group interview has been completed and wishing to withdraw from the study, the information collected has been used as part of the research study because the information was recorded with no identifiers, and with no link to patients' name.
This study discusses the spiritual well-being of 8–11 year-old children and its determinants. The aim of the study was to examine differences in terms of gender and age in selected variables and verify the relationship between spiritual well-being and selected variables: the religiosity of children, parental support; peer support, as well as explaining to extent to which the stated variables predict individual domains of spiritual well-being. In order to measure the selected variables, a test battery consisting of theFGLL, PSSS and FSSS questionnaires were used in addition to the author’s Family Religious Activities Scale and the Religious Activities with Friends Scale. . . The sample consisted of 444 respondents (49% boys). The age of the respondents ranged from 8 to 11 (M = 9.69). The results were analysed by several statistical procedures. The results of the study confirm the importance of the support of parents and peers in the development of spiritual well-being in children aged 8to11.
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.
This study investigated the relationship between lifestyle choices and substance addiction in young adults by applying the Relapse Prevention model of addiction. Data were obtained from a cross-sectional online survey of 926 young adults aged 18∼24 residing in 24 countries. Of these, 17.6% reported that they had serious substance addiction, with alcohol addiction being the highest (11.2%), followed by nicotine (10.3%) and illicit drug (8.7%) addiction. Results of chi-square test and logistic regression analysis revealed a significant association between all lifestyle factors (spirituality, regular exercise, intake of nutrients like tryptophan, folic acid, omega-3 fatty acids, and micronutrients) and substance addiction (illicit drugs, alcohol, nicotine). And depression was also found to be a significant factor influencing substance addiction. In particular, the risk of alcohol addiction was the highest at 9.870 (95% CI: 4.525-21.525) times among those who said they did not read the spiritual content than those who did. And the risk of nicotine and illicit drug addiction was the highest among those who said their intake of micronutrients was ‘less than 1 serving’ per day compared to ‘more than 5 servings,’ with odds ratios of 9.606(95% CI: 2.726-30.111) and 8.642(95% CI: 2.022-37.378) respectively. These findings suggest that holistic lifestyle interventions may help prevent and reduce substance addiction in young adults.
Insights from the field of cemetery research demonstrate that urban cemeteries have a variety of functions, not limited to their primary purpose of providing space for interment of human remains and commemoration of loved ones. This multiplicity of functions and meanings shapes cemeteries’ special place in contemporary cities and calls for a sensitive framework for their planning and management. This thesis sets out to explore the role of cemeteries with two foci: densification processes, which can reconfigure functions of urban green spaces, and postsecular debates, which highlight the relationships between the secular and the spiritual/religious. In many cities, cemeteries indeed function as publicly accessible green spaces and accommodate intrinsic spiritual aspects, yet it remains unclear how their role might be reshaped in dense postsecular cities.
This research is situated within the interdisciplinary field of urban studies and employs the concept of public space as the main theoretical lens. I also draw on the idea of municipal spirituality — a discursive tool intended to integrate the spiritual aspects of places into planning. The aim of this thesis is to contribute to existing research with new knowledge and understanding of the role of urban cemeteries as public spaces with an empirical focus on the policy context. The thesis consists of three scientific papers and an introductory essay.
Inspired by a recent call for more global urban studies, this thesis employs a comparative methodology and uses three cities (Oslo, Copenhagen and Moscow) as case studies in a multiple-case research design. The empirical material (policy documents and interviews with experts) is analysed qualitatively, in both inductive and deductive manners, and supplemented with field observations.
This thesis contributes to the existing body of literature in three ways. First, it establishes a multidimensional framework for the analysis of cemeteries as public spaces and demonstrates how different dimensions are manifested in the three case study cities. The framework illuminates both dimensions inherent to cemeteries (liminal and spiritual) and dimensions common to public spaces in general (multifunctional, multicultural and commercial). Second, the thesis outlines a comparative methodology that enables an assessment of the role of cemeteries in different contexts, as understood by planners and policymakers. While in Oslo and Copenhagen cemeteries are seen as multifunctional green spaces, Moscow cemeteries are viewed predominantly as burial spaces and places for commemoration and their other functions are overlooked. Third, this thesis extends an invitation to revisit debates around the notion of public space. The conceptualisation of urban cemeteries as a special type of public space emphasises the importance of the spiritual aspects — often forgotten in these debates — and points to the demand for a greater diversity of public spaces to fulfil citizen’s varied needs.
Zusammenfassung
Der Beitrag beschreibt, wie Psychodrama als Verfahren innerhalb der religionspsychologischen Praxis empirisch eingesetzt werden kann, um religiöse/spirituelle Strukturen sichtbar bzw. religiöse/spirituelle Phänomene begreifbar zu machen. Hierbei gilt es, Religiosität bzw. Spiritualität als therapeutische Ressource herauszuarbeiten. Im Artikel werden zudem die religionspsychologischen Anteile des Psychodramas skizziert, die schließlich in Überlegungen zum Ritual und zur Katharsis münden. Die psychodramatische Lesung des ‚Zauberbergs‘ von vier Freimaurern dient hierbei als Fallbeispiel für die praktische Anwendung.
Despite more than the 80-year history of the AA movement, there is a gap in academic knowledge about the essence of AA spiritual concepts. One particularly important lacuna about AA practice is weakness of theoretical frame for the often-used measuring tools of spiritual variables in quantitative studies. This article argues that theological analysis of AA practice can be a very useful part of empirical studies if the researcher’s theological commitments favor studying nonconfessional groups. A promising possible vein for future research is proposed.
Özet: Son yıllarda maneviyatın sosyal hizmet bilimi ve uygulamalarına dahil edilmesinin önemi anlaşılmaya başlanmıştır. Bu açıdan sosyal hizmette bireyi bütüncül/holistik perspektifle değerlendirmede onun manevi boyutunun da ele alınması tam iyilik halini sağlamada doğru bir yaklaşım olacaktır. Ülkemizde sosyal hizmet biliminde manevi değerlendirme yöntemleri ve uygulamalarına dair yeterli bilgiye ve kaynağa ulaşılmamış olması, bireyi bütüncül değerlendirmede önemli bir rolü olan manevi değerlendirme yöntemlerine dair yeterli bilgiye ulusal yazında ulaşılmaması bu araştırmanın yürütülmesindeki temel gayedir. Araştırmanın problemi; dünyada manevi sosyal hizmet uygulamalarında manevi değerlendirmenin nasıl yapılacağı ve hangi değerlendirme yöntemlerinin kullanıldığını incelemek ve sosyal hizmet müdahale ve uygulamalarında en yaygın kullanılan manevi değerlendirme yöntemlerini ve araçlarını ortaya koymaktır. Türkiye’de, sosyal hizmet alanında manevi ihtiyaçlara yönelik uygulamaların yetersiz olması nedeniyle dünyada öne çıkan sosyal hizmet uygulama örneklerini incelemek önem arz etmektedir. Dolayısıyla bu çalışma, sosyal hizmet alanında önemli bir boşluğu dolduracak ve literatüre katkı sağlayacaktır.Araştırmanın amacı; sosyal hizmet müdahalelerinde kullanılacak olan manevi değerlendirme yöntemlerinin incelenmesidir. Bu çalışmada uluslararası literatür taranarak manevi değerlendirme yöntem ve araç önerilerinin getirilmiş olması, araştırmanın özgünlüğünü ortaya koymaktadır.Araştırmada nitel araştırma yöntemlerinden durum çalışması kullanılmış ve nitel veri toplama araçlarından döküman analizi kullanılarak gerçekleştirilmiştir. Bu kapsamda manevi değerlendirme yöntemlerine dair uluslararası literatür taranmıştır. Elde edilen bulgulara göre dünyada en çok kullanılan manevi değerlendirme yöntemleri; açık/kısa değerlendirme, örtük değerlendirme, kapsamlı değerlendirme ve endirekt/dolaylı değerlendirme olarak belirlenmiştir. Ayrıca manevi değerlendirme ölçekleri olarak da Maneviyat ve Manevi Bakım Ölçeği, Manevi Bakım Yeterlilik Ölçeği, Manevi Bakım Verme Ölçeği, Hastaların Manevi İhtiyaçlarını Değerlendirme Ölçeği, Manevi Bakım Algıları ve Uygulamaları Ölçeği uluslararası yayınlanan ve Türkçe’ye uyarlanan ölçekler olarak tespit edilmiştir. Manevi değerlendirmede kullanılan yerli ölçekler ise, Manevi Destek Algısı Ölçeği, Manevi Yönelim Ölçeği, Manevi Bakım Gereksinim Ölçeği, SHUMDR Ölçeği ve Maneviyat Ölçekleridir.
Anahtar kelimeler: Manevi sosyal hizmet, Manevi müdahale, Manevi değerlendirme
Abstract: In recent years, the importance of incorporating spirituality into social work science and social work practice has begun to be understood. In this respect, it would be a correct approach to evaluate the individual with a holistic perspective in social work, and to consider his spiritual dimension as well. The main purpose of this research is that there is not sufficient information and resources about spiritual assessment methods and practices in social work science in our country, and that there is not sufficient information about spiritual assessment methods, which have an important role in the holistic assessment of the individual in the national literature.The problem of the research is to examine which assessment methods are used in spiritual assessment in social work in the world and to reveal the most widely used spiritual assessment methods and tools in social work interventions and practices. It is important to examine the examples of social work practices that come to the fore in the world due to the inadequacy of practices for spiritual needs in the field of social work in Turkey. Therefore, the study will fill an important gap in the field of social work and contribute to the literature. Purpose of the research is the examination of spiritual assessment methods to be used in social work interventions. In the study, the fact that spiritual assessment method and tool suggestions were brought by scanning the international literature reveals the originality of the research. Case study, one of the qualitative research methods was used in the research and it was carried out using document analysis, one of the qualitative data collection tools. In this context, the international literature on spiritual evaluation practices was reviewed. According to the findings, the most used spiritual assessment methods in the world were found as; explicit/short assessment, implicit assessment, comprehensive assessment and indirect assessment. In addition, Spirituality and Spiritual Care Rating Scale, Spiritual Care-Competence Scale, Spiritual Care- Giving Scale, Patients’ Spiritual Needs Assessment Scale, Spiritual Care Perceptions and Practices Scale were found as international published scales adapted into Turkish. National scales used in spiritual assessment were found as Spiritual Support Perception Scale, Spiritual Orientation Scale, Spiritual Care Needs Scale, SHUMDR Scale and Spirituality Scales.
Keywords: Spiritual social work, Spiritualintervention, Spiritual assessment
Bu araştırma, sosyal hizmette maneviyata niçin ihtiyaç duyulduğu sorusuna cevap aramaktadır. İnsanın karşılaştığı sorunları aşmada, bu sorunlarla başa çıkmada, bunları anlamlandırmada ve manevi huzura erişmede manevi destek kaynaklarının danışana sunulmasına maneviyata duyarlı sosyal hizmet denir. Sosyal hizmetin tarihinin insanlık tarihiyle eş değer olduğunu söyleyebiliriz. Dolayısıyla özellikle Batı’da modernleşme sürecinde yaşanan sorunlar ya da dönemin hâkim paradigması (bilim-kilise çatışması, rasyonelleşme ve pozitivist bilgi yaklaşımı) bir dönem, maneviyattan uzak sosyal hizmet disiplini ve müdahalesini de beraberinde getirmiştir. Batı’da 20. yy.ın son çeyreğinde, bu yaklaşımın eksikliğinin hissedildiğini ve günümüzde bu alanla ilgili çalışmaların yoğunlaştığını söyleyebiliriz. Türkiye’de ise bu konudaki çalışmaların yetersizliği açıktır. Çalışmanın problemi, maneviyata duyarlı sosyal hizmete niçin ihtiyaç vardır? Ülkemizde konu ile ilgili literatürün yetersizliği çalışmanın önemini ortaya koymaktadır. Çalışmanın yöntemi ise literatür taramasına dayalı betimsel bir çalışmadır. Sosyal hizmet mikro, mezzo ve makro düzeyde bireylerin, ailelerin, grupların ve toplumların işlevselliğini artırmayı, sorunlarını aşmada onları güçlendirmeyi kendisine hedef edinen bir meslektir. Dolayısıyla sosyal hizmet, bireylerin kendilerinden ve kendileri dışından kaynaklanan sorunları aşmada, kaynaklarla fırsatları buluşturma noktasında yardımcı olur. Manevi değerlere mesafeli olan sosyal hizmet anlayışının bireylerin karşılaştıkları bazı sorulara ve sorunlara tatmin edici cevap bulmasının zorluğu aşikârdır. Maneviyata duyarlı sosyal hizmet anlayışı ve uygulamalarının danışanlara sorunları aşmada, bunları anlamlandırmada ve bireyi güçlendirmede önemli rol oynayacağı da açıktır. Bu çalışma maneviyata duyarlı sosyal hizmetin gerekliliğini dört maddede ele almaktadır: Birincisi, modern toplumlar geçmişe nazaran daha fazla tehdit ve korku altındadır. Dolayısıyla daha fazla kaygı, stres ve güvensizlik yaşamaktadırlar. Teknoloji ve bilimdeki gelişmeler insana büyük imkân ve kolaylıklar sunarken diğer taraftan onları bugüne kadar yaşanmayan bazı problemlerle de karşı karşıya bırakmıştır. Maneviyata duyarlı sosyal hizmet bireylerin, grupların ve toplulukların yaşamış olduğu korku ikliminden onların mevcut kültürel yapısını ve inanç dünyasını harekete geçirerek uzaklaşmalarına katkı sağlayacaktır. İkincisi, modern yaşam tarzı ve bireyselleşme insanın sosyal destek sistemlerini zayıflatarak yalnızlaştırmıştır. Modern yaşam tarzı insanı yalnızlığa itmektedir. Bireyci ve ben merkezli yaşam tarzı bireyi toplumsal bağlardan uzaklaştırarak yalnızlaştırmış ve başkasına ihtiyaç duymayan bir algı oluşturmuştur. Maneviyata duyarlı sosyal hizmet bireyin yalnızlığını gidererek yaşam kalitesini ve sevincini artıracak, geleceğe ümitle bakmasında ve yalnızlığını aşmada kendisine yardım sağlayacaktır. Üçüncüsü, insanoğlu karşılaştığı olayları ve sorunları anlamlandırmak ister. Modern çağa “anlamlandırma krizi çağı” desek yanlış olmaz. Günümüz insanı karşılaştığı sorunları anlamlandırma noktasında ciddi krizler yaşamaktadır. Özellikle de ağır hastalık, engellilik ve ölüm gibi varoluşsal yaşamı tehdit eden unsurlarla karşılaştığında bu sorunları aşmada ve yaşamının anlamlandırılmasında maneviyatın etkisi büyüktür. Bireylerin kaybettikleri anlamı yeniden inşa etme çabaları ancak maneviyata duyarlı sosyal hizmet sunumu ile mümkün olabilmektedir. Dördüncüsü, modern sosyal hizmet anlayışının insan merkezli, bütüncül, hak temelli olması nedeniyle insanın bütüncül değerlendirilmesi gerektiği düşüncesi maneviyata duyarlı sosyal hizmetin gerekliliğini ön plana çıkarmaktadır. Baş döndüren, çok çeşitli ve hızlı bir değişim yaşayan günümüz insanı karmaşık ilişkiler ağı içerisinde yaşamaktadır. İnsan davranışlarının tek boyutlu değerlendirilmesinin yanlışlığı günümüzde daha iyi anlaşılmaktadır. Müracaatçıların bireysel farklılıkları ve sorunlara yaklaşımları bunlara yönelik uygulamaların da bütüncül ve kuşatıcı bir bakış açısı ile değerlendirilmesini zorunlu hale getirmektedir. Dolayısıyla insanın bütüncül değerlendirilmesi, manevi sosyal hizmetin bireylere sunulan bir ikram değil insan olmasından kaynaklı hak çerçevesinde değerlendirilmesi gerekliliğini de ortaya koymaktadır.
This chapter presents spirituality in advanced practice nursing within the African context. Because the Advanced Practice Nurse (APN) role has only been recently formalised in a few countries in Africa, it is difficult to find a system-wide case study of the integration of spiritual aspects of care into APN consultation. As a result, the author explored individual patient encounters by APNs that involved issues of spirituality in some countries where APNs are formalised. Spirituality is part of everyday life of an African. Illness is often perceived as a form of suffering or punishment in a typical African society and is often attributed to a supernatural source. Africans are highly religious and associates spirituality with a deity (spirit). APN programmes are being established on the continent through the advocacy of various leaders and academics. It is essential that spirituality, as a component of holistic care, is built into curricula to ensure that future APNs are competent in spirituality and the provision of spiritual.
This chapter introduces Rogers’ Availability and Vulnerability framework which has been developed to help APNs operationalise spirituality. Spirituality is innately human and is influenced by the context we work in and how we emotionally engage with those in our care. Spirituality can be simply integrated into APN practice and operationalised through availability and vulnerability. Working in this way enables spirituality to be addressed on a practical level. Several examples from practice illustrate aspects of the framework.
Critical pastoral theology has no doubt come to recognize the significance of social formations in the crisis of addiction as a symptom of suffering. This article suggests that how we understand and describe these social formations matters. It argues that our most common approaches to addiction risk reproducing forms of domination via an incomplete notion of freedom in their attempt to clarify the exceptional status of addiction. This can function to obscure the capitalist nature of addiction and the addictive nature of capitalism undergirding our everyday lives. The author argues that addiction is itself a symptomatic expression of capitalist social formations; not merely an individual pathology, addiction names the way our social attachments to objects and to one another become compulsive despite their negative consequences. This critical concept of addiction allows us to see, name, and negate the false promises on which the endurance of capitalism depends. The ultimate aim of this critical approach is to consider how we as caregivers might reflect on and transform these dominating social divisions.
Although spirituality has been considered a protective factor against shopping addiction, the mechanisms involved in this relationship are still poorly recognized. The present study aims to test the association of daily spiritual experiences, self-efficacy, and gender with shopping addiction. The sample consisted of 430 young adults (275 women and 155 men), with a mean age of 20.44 (SD = 1.70). The Daily Spiritual Experiences Scale, the General Self-Efficacy Scale, and the Bergen Shopping Addiction Scale were used to measure the study variables. The results showed that: (1) Daily spiritual experiences had a direct negative effect on shopping addiction; (2) daily spiritual experiences were positively related to self-efficacy, thought the effect was moderated by gender; (3) self-efficacy negatively correlated with a shopping addiction; and (4) the indirect effect of daily spiritual experiences on shopping addiction through self-efficacy was significant for women but insignificant for men. The findings confirm that spirituality protects young adults against developing a shopping addiction. They also suggest that when introducing spiritual issues into shopping addiction prevention or treatment programs, the gender-specific effects of spirituality on shopping addiction via self-efficacy should be considered to adequately utilize young women’s and men’s spiritual resources.
Explores ways in which Alcoholic Anonymous's (AA's) spirituality can be understood. Topics explored range from Jungian and Jamesian psychology, to Stoicism, the work of G. Bateson (1971), and transpersonal psychology and therapy. It is speculated that the difficulty some mental health counselors have in accepting AA as a viable form of therapeutic change could be due to unsophisticated terminology and counselors' lack of familiarity with relevant literature. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Buddhist doctrines deal in detail with craving and attachment, how they arise, the forms they take, their results, and also how they can be managed. This and Buddhist emphasis on impermanence makes these doctrines pertinent to theories of the causation and mechanisms of addictions and to possible therapies. Certain Buddhist teachings relevant to addictions are presented within the context of the Four Noble Truths and similarities are drawn to contemporary approaches. As well as being helpful for treating Buddhist clients such a framework may provide a spiritual but non-theistic alternative for those who reject the theism implicit in the twelve-step philosophy. Directions for research include exploring changing ethical behaviour and the use of meditation both as an adjunct to orthodox treatment and as a means of self-change within this framework.
Cluster analyzed four variables: school attendance, employment, church attendance, and delinquency, to develop life-style profiles. Data from 218 African-American urban adolescents were used in the study. Five meaningful clusters were retained and subjected to criterion validity analyses using measures of spirituality, participation in a voluntary organization, self-esteem, and friend's substance use. The five clusters were then compared on cigarette, alcohol, marijuana, and hard drug use. The results suggest that a life-style that includes an adaptive compensatory behavior component may be more adaptive than a life-style that does not include compensatory behavior. For example, youths who left high school before graduation but were involved in church reported less alcohol and substance use than youths who left school and were not involved in any meaningful instrumental activity. Implications for intervention and future research on high-risk behaviors are discussed.
Identifying relevant studies is “the most fundamental challenge” when compiling a systematic review.1 Electronic databases, such as Medline, may detect only about half of papers identified by the gold standard of hand searching journals.1 Hand searching requires a focus, usually the specialist literature,2 which may not exist for newly developed fields or those that cross boundaries with other areas. We examined the usefulness of contacting other experts when searching for relevant references for a systematic review of a field where such a specialist focus does not exist.
View this table:
Results of various types of search
As part of a systematic review undertaken in 1996, all published literature relating to “near patient testing” (any investigation performed in a clinical setting where the result is available without a sample being sent to a laboratory for analysis) in primary care was identified for 1986-95.3 Electronic databases were searched and secondary citations were collected from identified publications (see table). The search strategy is reported elsewhere.3 Indexes of abstracts from major international …
Art therapy is a fascinating and powerful tool found helpful in the treatment of alcoholism and other forms of chemical dependency. After defining what art therapy is, the author discusses the value of art therapy for the chemically dependent client. Finally, the author discusses how art therapy is used in the Chemical Dependency Center at The University of Iowa Hospitals and Clinics to help clients explore their spirituality.
BACKGROUND: The social support network and spiritual orientation of Alcoholics Anonymous were significant predictors of the choice of this study's sample of 125 sober alcoholic women to actively participate in Alcoholics Anonymous for at least 1 year. Religious affiliation is another choice that a woman may make in seeking to know herself in sobriety.
OBJECTIVE: The first objective of these ancillary analyses was to determine whether either length of sobriety or number of weekly meetings attended was correlated to power as knowing participation in change, perceived social support, and spirituality. The second objective was to determine whether there was a difference in spirituality between women who actively participated in their religion and those who did not.
DESIGN: This correlational study was designed to explore relations among power as knowing participation in change, social support, spirituality, length of sobriety, and number of weekly meetings attended. These research questions were answered by using hierarchical multiple regressions and a t test.
RESULTS: The number of Alcoholics Anonymous meetings attended weekly contributed significantly to power and to spirituality. Length of sobriety was not correlated with any of the three major variables. Spirituality scores were also significantly higher for those who were actively involved in their religion than for those who were not.
CONCLUSIONS: The significant difference among the findings in the conceptualization of time emphasizes the needfor a continuing connection with a group ofpeers. Also, the role of organized religion in spiritual orientation was demonstrated.
This study deals with environmental and behavioural factors that play a role in the recovery from addictive behaviours. Two primary questions are asked: To what extent the factors influential in resolving addictive behaviours and the means of maintaining the change differ by addictions, and to what extent the former factors predict the latter? Subjects (n=76, 38 women) who had managed to resolve their addiction and maintain the change for more than three years were recruited by newspaper ads. The sample included addictions to alcohol (26), multiple substances (16), nicotine (15), binge eating (11), and other (8), which included sex, gambling and benzodiazepine. The mean time of recovery was 9.3 years. Two types of factor analyses were used to define factors that played a role in resolving the problem and in maintaining the change. Seven change factors and four maintenance factors were supported by both methods. The change factors were: Tiring Out, Love, 12 Steps, Revival, Family, Social Consequences, and Peer Group change. The maintenance factors were: Self-Control, Professional Treatment, 12 Steps and Spirituality, as well as Social and Cognitive Coping. Significant (p
Since 1959 Wat Thamkrabok, a Buddhist monastery in Thailand, has been conducting a drug addiction rehabilitation program which claims a 70% success rate. The program is known for its use of unconventional methods, such as inducing vomiting to relieve ‘cravings’ for drugs, herbal saunas, strict discipline, an emphasis on Buddhism, and a sacred vow to never again use drugs. This is a descriptive study based on observations and interviews (mostly with foreigners) made at the monastery. While it was not possible to evaluate claims of success, there were several interesting aspects of the program which emerged. Vomiting was reported to be effective in reducing “craving,” and participants seemed to have a positive regard for the program, but there were some serious concerns raised about health risks and the coercive nature of the program.
“Sarah's” story is a true account of one individual's healing from the trauma of childhood sexual abuse through counseling, spiritual growth, and the use of therapeutic ritual. The article explores the relationship between the psychospiritual issues associated with childhood sexual abuse and commonly designated treatment goals. Addressing psychospiritual issues is shown to be the key to achieving assimilation and healing. Ritual therapy is suggested as a method for helping clients accomplish this task through the discovery of metameaning. A description of Sarah's therapeutic ritual is offered as a model for treatment design, and its efficacy in Sarah's case is evaluated.
Using the principle of metacommunication, the evolution of humanity's relationship with God is described as a process of 8 stages, culminating in a systemic view of God as the "between" or relatedness. It is noted that family therapists are in a position to use God as a resource in their work. Alcoholics Anonymous (AA) was one of the first self-help groups to distinguish between spirituality and religion, and AA exemplifies how a self-help group can catalyze changes not usually accessible in therapy. This process is a function of AA's theology and the specific manner in which members relate to each other. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Contends that spirituality and self-esteem are often neglected or misunderstood concepts in the treatment of alcoholics. One's spirit can either be malevolent or vital, and alcoholics typically feel either cynical or lifeless. Self-esteem can also be positive or negative, and alcoholics have generally abdicated their responsibility for this choice. It is suggested that the process of reestablishing a positive spirituality and a healthy self-esteem involves separating spirituality from concepts of formal religion; having alcoholics recognize their negative, caustic views of themselves and the world; identifying the regulating mechanism of self-esteem; removing blocks to healthy psychological functioning; instilling hope and developing positive processes for controlling one's view of self and the world; and accepting the choice and responsibility to live with reality on a daily, creative basis. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Codependent persons are individuals who, through learned behavior, become so inordinately focused upon or preoccupied with living for the significant people in their lives that they neglect the constant unfolding of their own unique lives. Codependent persons typically direct themselves to become what their significant others want them to be and then strive to conform to that image. To overcome the obstacles of codependency is an interdisciplinary task. The most effective treatment for this disease rests in a balanced program of psychotherapy, group support, and spiritual direction. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
David M. Wulff deftly integrates world-wide theoretical, empirical, and clinical literatures into a thorough examination of the world's major religious traditions. Bridging the gulf between empirical and interpretive approaches, this finely crafted text presents a balanced assessment of all major perspectives and encourages critical thinking. Dr. Wulff not only cites the most important German and French studies, but includes significant contributions from many other parts of the world—including material virtually unknown in the United States.
This genuinely comprehensive introduction to the field is organized according to two basic trends: the objective viewpoint, which approaches religion with the tools of experimental and correlational psychology, and the subjective perspective which applies the viewpoints of the depth, existential-phenomenological, and humanistic psychologies. Throughout, Dr. Wulff includes material from diverse religious traditions which provide a more inclusive and balanced view of religion while promoting a more comprehensive psychology. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The purpose of this article is to give a full and detailed exposition of the fourth and fifth steps of the 12 Steps of Alcoholics Anonymous (AA), stressing their special application to the treatment modality. Alcoholism is a disease that affects the whole human being - physical, mental and emotional (i.e., the spiritual self). Although alcoholism is being addressed in this article, the treatment and recovery discovered in the 12 Steps is applicable to other compulsive and obsessive addictions, such as other drug dependencies, eating disorders, gambling and sex. Because of the social, religious and environmental misunderstandings that surround this disease, the guilt, shame and acute feelings of isolation need to be recognized and dealt with during the patient's stay at a treatment center. It is essential for recovery and long-term sobriety that the patient learn to 'dump' his/her guilt and express feelings of anger, resentment, embarrassment and despair.
This study examines the relationship between spirituality and recovery from alcoholism. Spirituality was defined as the extent of practice of Alcoholics Anonymous Steps 11 and 12 and was measured by a Step Questionnaire developed by the researcher. Step 11 suggests prayer and meditation and Step 12 suggests assistance of other alcoholics. Expressed degree of purpose in life was also seen as a reflection of spirituality. It was postulated that the extent to which Steps 11 and 12 were practiced would be positively correlated with the extent of purpose in life reported by 100 Alcoholics Anonymous members. The major findings of this study are significant positive correlations between practice of Step 11 and purpose in life scores (r = .59, p < .001) and between Step 11 and length of sobriety (r = .25, p < .01). Number of Alcoholics Anonymous meetings attended was significantly correlated with purpose in life scores (r = .24, p < .01) and length of sobriety (r = .25, p < .01). These findings suggest that a sense of purpose in life increases with continuing sobriety and practice of the spiritual principles of Alcoholics Anonymous.
An experience in developing a treatment program of addiction in an Arabic Muslim Society. The three major waves of knowledge and methodology are reviewed in historical perspective. General description of Al Amal Hospital, Dammam, K.S.A, and the three phases which the hospital treatment program underwent. Drug therapy was the main line of treatment in the first phase, which resulted in a massive consumption of controlled drugs exposing patients to iatrogenic dependence. The second phase introduced a wider concept of treatment using a bio-psycho-social model in the context of the 12 steps program of the AA. This approach did not reflect positively on patients' care due to the resistance of both patients and staff. The third phase addressed the causes of this resistance and formulated the basis for a comprehensive treatment program for addiction that relies on a clear philosophy and defined treatment stages. A multitude of treatment components were introduced and monitored by a daily clinical program audit. During the three phases, hospital records showed a progressive decrease in the amount of medications consumed (> 90%) and dropouts (24%-2.8%). The overall number of patients completing the treatment program markedly increased and although the average daily census dropped, there was, in fact, an increase in the number of voluntary patients.
This study describes the development and outcome of a new treatment programme for the management of heroin addiction in Bahrain. The problem reached its peak in the early 1980s with several reported deaths and with the involvement of many disciplines in the overall response. In 1983, treatment of all addicts was restricted by law to the government psychiatric hospital. The newly established specialized drug unit was overwhelmed by the number of patients seeking treatment. The lack of sufficient resources and suitably trained staff forced the unit to adopt an outpatient maintenance therapy approach for most of its clients. In 1987, a new comprehensive treatment programme was introduced that relies on a clear philosophy, safe detoxification (using objective scales for withdrawal manifestations) rather than maintenance therapy, followed by psychological and social rehabilitation. A national committee for drug addiction was formed and an intensive programme of education was started at all levels. The results indicate an initial increase at inpatient level but a marked drop of outpatient attendance. The use of the Opioid Objective Withdrawal Manifestations Scale (OOWMS) revealed that only a small number of our patients developed moderate or severe signs of withdrawal that required detoxification, and the rate of dispensed controlled medication was reduced by 99%. The effect of this approach is discussed, with special reference to the need for a collaborative effort from all disciplines in planning, implementing, continuously evaluating and modifying the national programmes for handling the serious problem of addiction.
Since 1959 Wat Thamkrabok, a Buddhist monastery in Thailand, has been conducting a drug addiction rehabilitation program which claims a 70% success rate. The program is known for its use of unconventional methods, such as inducing vomiting to relieve "cravings" for drugs, herbal saunas, strict discipline, an emphasis on Buddhism, and a sacred vow to never again use drugs. This is a descriptive study based on observations and interviews (mostly with foreigners) made at the monastery. While it was not possible to evaluate claims of success, there were several interesting aspects of the program which emerged. Vomiting was reported to be effective in reducing "craving," and participants seemed to have a positive regard for the program, but there were some serious concerns raised about health risks and the coercive nature of the program.
Twelve-step programs have stressed the importance of spiritual practices for over four decades. The spiritual principles embodied in the twelve-step programs may be key in their success of recovering addicts/alcoholics with an overall recovery rate of 34%. A literature search revealed little available data on spiritual principles and practices and their effects on long-term recovery from substance abuse. This study compared two groups of recovering addicts, those with one year of recovery and those with less than one year and a history of relapse. Spiritual practices were measured using a five-point Likert scale questionnaire. The results of the study indicated a relationship between spiritual practices and long-term recovery from substance abuse.
Editor—I agree with Culliford that knowing your patients better makes for a better therapeutic relationship.1 Often—for example, in terminal care or when physical measures do not have an impact on any disease—being able to relate in “wider” terms can increase the potential for healing. But I disagree with Culliford on the question of methodology.
Most religions and other arenas of spirituality use ritualised gestures, incantations, prayers, symbolism, and rites. Unless you believe that these processes have effects through a perceived extracorporeal being, power, or energy, the effect is presumed to come from within patients themselves. But the placebo effect is inherently based on its own camouflage. Once you know you're taking placebo then the magic is lost.
The entire effect is dependent on your “faith” in the procedure. Although I might deliberately use the placebo effect in my pharmacological treatment of patients, is it not an unethical deceit for me to portray a facade of spirituality for their benefit when I don't believe it myself? If that is true then what is Culliford suggesting? Might it be that my deficiencies as a non-believer translate into deficiencies as a doctor? Perhaps I don't really want an answer to that.
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