"Grasping the Spirit": Factors Associated with Mental Health Rehabilitation Professionals` Perceived Preparedness to Incorporate Spiritual Aspects into Practice

Background and purpose: Spirituality has been identified as a core aspect in the rehabilitation and recovery process of many people coping with serious mental illness (SMI). Researchers indicate that people with SMI and professionals working with them find it important to deal with spiritual issues in the treatment process. Yet, mental health treatment policy and guidelines in Israel exclude spiritual aspects. While in other countries spiritual care is a requirement, many professionals feel insecure to effectively incorporate spirituality into their practice and do not do so. Feeling professionally prepared to perform an intervention is a key element in effectively incorporating new interventions into practice. With the aim to impact policy and practice change in Israel, this study examined mental health rehabilitation professionals' (mainly social workers) perceived preparedness to deal with clients’ spiritual issues in treatment and factors associated with such preparedness, namely, training (formal and informal), attitudes towards dealing with spirituality in practice, self-efficacy and spiritual well-being.

Methods: Partnering with community mental health rehabilitation organizations, 144 mental health rehabilitation professionals (65% of whom were social workers) who work in rehabilitation services in Israel were surveyed using a self- report questionnaire. Participants were recruited from mental health rehabilitation services via emails sent from the researcher and forwarded by the services’ managers. Filled-out surveys were sent directly to the researcher. This way managers could not know who participated in the study.

Results: Attitudes towards dealing with spirituality in practice, spiritual well- being and informal training were significantly associated with perceived preparedness to deal with clients’ spiritual issues in treatment (B=.60, p<.001; B=.21, p<.05; B =.21, p<.05, respectively). Moreover, attitudes mediated the association between perceived preparedness and informal training and spiritual well-being (B=.13 [CI 95% = .0035 - .0.2672]; B=.10 [CI 95%=.0036- .181], respectively).

Conclusions and implications: Results emphasize the major role of attitudes in feeling prepared to incorporate new intervention elements into treatment and the important role of the provider’s own spiritual well-being and training in this perceived preparedness. It is recommended that spirituality training, with emphasis on discussing participants’ attitudes towards incorporating spiritual aspects into practice, be incorporated into mental health rehabilitation and recovery training. It is also essential that such training and the incorporation of spiritual aspects into practice be anchored in mental health policy and guidelines. Special attention should be given to providers’ spiritual well-being which can be weakened as a result of intensive work in the mental health field. Further research should be done among providers from various religious and ethnic backgrounds and examine policy maker attitudes and practices regarding the incorporation of spirituality into mental health treatment.