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Addressing spirituality in CBT

Published online by Cambridge University Press:  27 July 2010

Rob Waller*
Affiliation:
NHS Lothian – Psychiatry, Livingston, UK
Chris Trepka
Affiliation:
Bradford District Care Trust – Psychology, Bradford, UK
Daniel Collerton
Affiliation:
Northumberland Tyne and Wear NHS Trust, Gateshead, UK
James Hawkins
Affiliation:
Edinburgh, UK
*
*Author for correspondence: Dr R. Waller, NHS Lothian, OPD5 Psychiatry, St John's Hospital, Howden Road, West Livingston, West Lothian EH54 6PP, UK. (email: rob.waller@nhslothian.scot.nhs.uk)

Abstract

Mental health policy places a requirement on clinicians to address matters of religion and belief, yet practice falls far behind. This paper summarizes a Panel Discussion at the 2008 BABCP Annual Conference attended by over 50 people. The five speakers each presented their experience of working with particular faith groups (Orthodox Jewish, Christian, Muslim) and from an agnostic viewpoint. Common themes are given, as well as practical advice to therapists who find themselves working with people who hold strong faith beliefs they may not share.

Type
Practice article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

Recommended follow-up reading

Mental Health Foundation (2007). Keeping the Faith. Spirituality and Recovery from Mental Health Problems. London: Mental Health Foundation.Google Scholar
Armstrong, K (2007). The Great Transformation: The World in the Time of Buddha, Socrates, Confucius and Jeremiah. London: Atlantic Books.Google Scholar
Campbell, J (1949). The Hero with a Thousand Faces. Novato, Canada: New World LibraryGoogle Scholar
Cook, CH, Powell, A, Sims, A (2009). Spirituality and Psychiatry. London: Gaskell.Google Scholar
Cutland, T (2005). Intrinsic Christianity, psychological distress and help seeking (http://www.psuche.co.uk/founder-of-psuche.htm). Accessed 30 April 2010.Google Scholar
Davie, G (1994). Religion in Britain since 1945: Believing without Belonging. Oxford: Wiley/Blackwell.Google Scholar
Department of Health (1990). Caring for People. The CPA for people with a mental illness referred to specialist mental health services. Joint Health/Social Services Circular C(90)23/LASSL(90)11.Google Scholar
Department of Health (2003 a). Inspiring hope: recognizing the importance of a whole person approach to mental health. London: HMSO.Google Scholar
Department of Health (2003 b). Delivering race equality: a framework for action. London: HMSO.Google Scholar
Department of Health (2007). Single equality scheme 2007–2010. London, Crown Copyright.Google Scholar
D'Souza, R, Rodrigo, A (2004). Spiritually augumented cognitive behavioural therapy. Australas Psychiatry 12: 148152.Google Scholar
Elders, A (2008). Is therapy paying enough attention to spirituality? CBT Today, December 2008.Google Scholar
Ellis, A (1980). The Case Against Religion: A Psychotherapists View and the Case Against Religiosity. Austin: American Atheist Press.Google Scholar
Enoch, D (2006). I Want a Christian Psychiatrist – Finding a Path Back to Mental and Spiritual Well-being. Oxford: Monarch Books.Google Scholar
General Medical Council (2008). Personal Beliefs and Medical Practice. London: General Medical Council.Google Scholar
Gilbert, P (2009). The Compassionate Mind. London: Constable.Google Scholar
Government Equalities Office (2009). Equality Bill. London: HMSO (http://services.parliament.uk/bills/2009-10/equality.html).Google Scholar
Haque, A (2004). Psychology from Islamic perspective: contributions of early Muslim scholars and challenges to contemporary Muslim psychologists. Journal of Religion and Health 43, 357377.Google Scholar
Hawkins, RS, Tan, RS, Tan, S, Turk, AA (1999). Secular versus Christian inpatient cognitive-behavioral therapy programs: impact on depression and spiritual well-being Journal of Psychology and Theology 27, 309319.Google Scholar
Hayes, SC (1984). Making sense of spirituality. Behaviorism 12, 99110.Google Scholar
Hayes, SC, Strosahl, KD (2005). A Practical Guide to Acceptance and Commitment Therapy. New York: Springer-Verlag.Google Scholar
Hebblethwaite, P (2005). Helping people change! Part 3 – a new Christian model for CBT. ACCORD 46, 46.Google Scholar
Hodge, D (2006). Spiritually modified cognitive behavioural therapy: a review of the literature. Social Work 51, 157166.Google Scholar
Hodge, D (2008). Constructing spiritually modified interventions. International Social Work 51, 178192.Google Scholar
Johnson, W, DeVries, R, Ridley, CR, Pettorini, D, Peterson, D (1994). The comparative efficacy of Christian and secular rational-emotive therapy with Christian clients. Journal of Psychology & Theology 22, 130140.Google Scholar
Johnson, W, Ridley, CR (1992). Brief Christian and non-Christian rational-emotive therapy with depressed Christian clients: an exploratory study. Counseling and Values 36, 220229.Google Scholar
Koenig, H (2004). Religion and mental health: what should psychiatrists do? Psychiatric Bulletin 34, 204.Google Scholar
Koenig, HG (2009). Research on religion, spirituality and mental health: a review. Canadian Journal of Psychiatry 54, 283291.Google Scholar
Meesam, M (2009). Spirituality and the NHS. Seminar delivered at the 2009 Mind and Soul Northern Conference.Google Scholar
Mental Health Foundation (2007). Keeping the Faith. Spirituality and Recovery from Mental Health Problems. London: Mental Health Foundation.Google Scholar
Murray, S, Boyd, K, Kendall, M, Worth, A, Benton, TF, Claus, H (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliative Medicine 18, 3945.Google Scholar
Neeleman, J, Persaud, R (1995). Why do psychiatrists neglect religion? British Journal of Medical Sociology 68, 169178.Google Scholar
Nelson, S, Hamson, S (2008). Yes, You Can! Working with Survivors of Childhood Sexual Trauma. Edinburgh: Scottish Government.Google Scholar
Office of National Statistics (ONS) (2001). Census 2001: Ethnicity and religion. London: HMSO.Google Scholar
Padesky, CA (1993). Socratic questioning: changing minds or guiding discovery? [Keynote Address]. European Congress of Behavioural and Cognitive Therapies. London, 24 September 1993.Google Scholar
Paradis, CM, Friedman, S, Lazar, RM, Grubea, J (1996). Cognitive behavioral treatment of anxiety disorders in Orthodox Jews. Cognitive and Behavioral Practice 3, 271288.Google Scholar
Pecheur, DR, Edwards, KJ (1984). A comparison of secular and religious versions of cognitive therapy with depressed Christian college students. Journal of Psychology & Theology 12, 4554.Google Scholar
Porterfield, A (2005). Healing in the History of Christianity. Oxford: Oxford University Press.Google Scholar
Propst, LR (1980). The comparative efficacy of religious and nonreligious imagery for the treatment of mild depression in religious individuals. Cognitive Therapy & Research 4, 167178.Google Scholar
Propst, LR, Ostrom, R, Watkins, E, Dean, T, Mashburn, D (1992). Comparative efficacy of religious and nonreligious cognitive-behavioral therapy for the treatment of clinical depression in religious individuals. Journal of Consulting and Clinical Psychology 60, 94103.Google Scholar
Puchalski, CM, Larson, DB (1998). Developing curricula in spirituality and medicine Academic Medicine 73, 1038.Google Scholar
Royal College of Psychiatrists (2002). Proposed amendments to the curriculum for basic specialist training and the MRCPsych examination. Prepared by the Spirituality Special Interest Group (http://www.rcpsych.ac.uk/pdf/nl10_five.pdf). Accessed 22 April 2009.Google Scholar
Scottish Government (2008). Spiritual care and chaplaincy in NHS Scotland – revised guidance. CEL (Chief Executive's Letter), 49.Google Scholar
Small, DK (2003). The development of Christian-oriented computer-assisted cognitive therapy: a pilot study. Dissertation Abstracts International: Section B: The Sciences and Engineering 63 (7-B).Google Scholar
Spiritual Care Committee of Bradford District Care Trust (2006). Model of spirituality [unpublished]. Available on request from Dr Rashid Skinner, Chair ().Google Scholar
Tan, SY, Johnson, WB (2005). Spiritually orientated cognitive behaviour therapy. In: Spiritually Orientated Psychotherapy (ed. Sperry, L. and Shafranske, E. P.), pp. 77103. Washington, DC: American Psychological Association.Google Scholar
Thwaites, R, Freeston, MH (2005). Safety-seeking behaviours: fact or function? How can we clinically differentiate between safety behaviours and adaptive coping strategies across anxiety disorders? Behavioural and Cognitive Psychotherapy 33, 177188.Google Scholar
Vaughan, K (2008). Christ in the Consultation. Triple Helix (Summer), pp. 12–13.Google Scholar
Williams, C, Richards, P, Whitton, I (2002). I'm Not Supposed to Feel Like This – A Christian Self-help Approach to Depression and Anxiety. London: Hodder & Stoughton.Google Scholar
Zhang, YD, Young, D, Lee, S, Li, L, Zhang, H, Xiao, Z, Wei, H, Feng, Y, Zhou, H, Chang, DF (2002). Chinese Taoist cognitive psychotherapy in the treatment of generalized anxiety disorder in contemporary China. Transcultural Psychiatry 39, 115129.Google Scholar
Armstrong, K (2007). The Great Transformation: The World in the Time of Buddha, Socrates, Confucius and Jeremiah. London: Atlantic Books.Google Scholar
Campbell, J (1949). The Hero with a Thousand Faces. Novato, Canada: New World LibraryGoogle Scholar
Cook, CH, Powell, A, Sims, A (2009). Spirituality and Psychiatry. London: Gaskell.Google Scholar
Cutland, T (2005). Intrinsic Christianity, psychological distress and help seeking (http://www.psuche.co.uk/founder-of-psuche.htm). Accessed 30 April 2010.Google Scholar
Davie, G (1994). Religion in Britain since 1945: Believing without Belonging. Oxford: Wiley/Blackwell.Google Scholar
Department of Health (1990). Caring for People. The CPA for people with a mental illness referred to specialist mental health services. Joint Health/Social Services Circular C(90)23/LASSL(90)11.Google Scholar
Department of Health (2003 a). Inspiring hope: recognizing the importance of a whole person approach to mental health. London: HMSO.Google Scholar
Department of Health (2003 b). Delivering race equality: a framework for action. London: HMSO.Google Scholar
Department of Health (2007). Single equality scheme 2007–2010. London, Crown Copyright.Google Scholar
D'Souza, R, Rodrigo, A (2004). Spiritually augumented cognitive behavioural therapy. Australas Psychiatry 12: 148152.Google Scholar
Elders, A (2008). Is therapy paying enough attention to spirituality? CBT Today, December 2008.Google Scholar
Ellis, A (1980). The Case Against Religion: A Psychotherapists View and the Case Against Religiosity. Austin: American Atheist Press.Google Scholar
Enoch, D (2006). I Want a Christian Psychiatrist – Finding a Path Back to Mental and Spiritual Well-being. Oxford: Monarch Books.Google Scholar
General Medical Council (2008). Personal Beliefs and Medical Practice. London: General Medical Council.Google Scholar
Gilbert, P (2009). The Compassionate Mind. London: Constable.Google Scholar
Government Equalities Office (2009). Equality Bill. London: HMSO (http://services.parliament.uk/bills/2009-10/equality.html).Google Scholar
Haque, A (2004). Psychology from Islamic perspective: contributions of early Muslim scholars and challenges to contemporary Muslim psychologists. Journal of Religion and Health 43, 357377.Google Scholar
Hawkins, RS, Tan, RS, Tan, S, Turk, AA (1999). Secular versus Christian inpatient cognitive-behavioral therapy programs: impact on depression and spiritual well-being Journal of Psychology and Theology 27, 309319.Google Scholar
Hayes, SC (1984). Making sense of spirituality. Behaviorism 12, 99110.Google Scholar
Hayes, SC, Strosahl, KD (2005). A Practical Guide to Acceptance and Commitment Therapy. New York: Springer-Verlag.Google Scholar
Hebblethwaite, P (2005). Helping people change! Part 3 – a new Christian model for CBT. ACCORD 46, 46.Google Scholar
Hodge, D (2006). Spiritually modified cognitive behavioural therapy: a review of the literature. Social Work 51, 157166.Google Scholar
Hodge, D (2008). Constructing spiritually modified interventions. International Social Work 51, 178192.Google Scholar
Johnson, W, DeVries, R, Ridley, CR, Pettorini, D, Peterson, D (1994). The comparative efficacy of Christian and secular rational-emotive therapy with Christian clients. Journal of Psychology & Theology 22, 130140.Google Scholar
Johnson, W, Ridley, CR (1992). Brief Christian and non-Christian rational-emotive therapy with depressed Christian clients: an exploratory study. Counseling and Values 36, 220229.Google Scholar
Koenig, H (2004). Religion and mental health: what should psychiatrists do? Psychiatric Bulletin 34, 204.Google Scholar
Koenig, HG (2009). Research on religion, spirituality and mental health: a review. Canadian Journal of Psychiatry 54, 283291.Google Scholar
Meesam, M (2009). Spirituality and the NHS. Seminar delivered at the 2009 Mind and Soul Northern Conference.Google Scholar
Mental Health Foundation (2007). Keeping the Faith. Spirituality and Recovery from Mental Health Problems. London: Mental Health Foundation.Google Scholar
Murray, S, Boyd, K, Kendall, M, Worth, A, Benton, TF, Claus, H (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliative Medicine 18, 3945.Google Scholar
Neeleman, J, Persaud, R (1995). Why do psychiatrists neglect religion? British Journal of Medical Sociology 68, 169178.Google Scholar
Nelson, S, Hamson, S (2008). Yes, You Can! Working with Survivors of Childhood Sexual Trauma. Edinburgh: Scottish Government.Google Scholar
Office of National Statistics (ONS) (2001). Census 2001: Ethnicity and religion. London: HMSO.Google Scholar
Padesky, CA (1993). Socratic questioning: changing minds or guiding discovery? [Keynote Address]. European Congress of Behavioural and Cognitive Therapies. London, 24 September 1993.Google Scholar
Paradis, CM, Friedman, S, Lazar, RM, Grubea, J (1996). Cognitive behavioral treatment of anxiety disorders in Orthodox Jews. Cognitive and Behavioral Practice 3, 271288.Google Scholar
Pecheur, DR, Edwards, KJ (1984). A comparison of secular and religious versions of cognitive therapy with depressed Christian college students. Journal of Psychology & Theology 12, 4554.Google Scholar
Porterfield, A (2005). Healing in the History of Christianity. Oxford: Oxford University Press.Google Scholar
Propst, LR (1980). The comparative efficacy of religious and nonreligious imagery for the treatment of mild depression in religious individuals. Cognitive Therapy & Research 4, 167178.Google Scholar
Propst, LR, Ostrom, R, Watkins, E, Dean, T, Mashburn, D (1992). Comparative efficacy of religious and nonreligious cognitive-behavioral therapy for the treatment of clinical depression in religious individuals. Journal of Consulting and Clinical Psychology 60, 94103.Google Scholar
Puchalski, CM, Larson, DB (1998). Developing curricula in spirituality and medicine Academic Medicine 73, 1038.Google Scholar
Royal College of Psychiatrists (2002). Proposed amendments to the curriculum for basic specialist training and the MRCPsych examination. Prepared by the Spirituality Special Interest Group (http://www.rcpsych.ac.uk/pdf/nl10_five.pdf). Accessed 22 April 2009.Google Scholar
Scottish Government (2008). Spiritual care and chaplaincy in NHS Scotland – revised guidance. CEL (Chief Executive's Letter), 49.Google Scholar
Small, DK (2003). The development of Christian-oriented computer-assisted cognitive therapy: a pilot study. Dissertation Abstracts International: Section B: The Sciences and Engineering 63 (7-B).Google Scholar
Spiritual Care Committee of Bradford District Care Trust (2006). Model of spirituality [unpublished]. Available on request from Dr Rashid Skinner, Chair ().Google Scholar
Tan, SY, Johnson, WB (2005). Spiritually orientated cognitive behaviour therapy. In: Spiritually Orientated Psychotherapy (ed. Sperry, L. and Shafranske, E. P.), pp. 77103. Washington, DC: American Psychological Association.Google Scholar
Thwaites, R, Freeston, MH (2005). Safety-seeking behaviours: fact or function? How can we clinically differentiate between safety behaviours and adaptive coping strategies across anxiety disorders? Behavioural and Cognitive Psychotherapy 33, 177188.Google Scholar
Vaughan, K (2008). Christ in the Consultation. Triple Helix (Summer), pp. 12–13.Google Scholar
Williams, C, Richards, P, Whitton, I (2002). I'm Not Supposed to Feel Like This – A Christian Self-help Approach to Depression and Anxiety. London: Hodder & Stoughton.Google Scholar
Zhang, YD, Young, D, Lee, S, Li, L, Zhang, H, Xiao, Z, Wei, H, Feng, Y, Zhou, H, Chang, DF (2002). Chinese Taoist cognitive psychotherapy in the treatment of generalized anxiety disorder in contemporary China. Transcultural Psychiatry 39, 115129.Google Scholar
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