(WITHDRAWN) A Practice-Based Evidence Study of the Use of Spiritually-Oriented Approaches in Mental Health Treatment

Background and Purpose: The importance of religion and spirituality (R/S) in human responses to adversity is well-known. Nonetheless, there has been a long-standing neglect of spirituality in therapeutic contexts. There is currently little insight into how R/S is being addressed in mental health treatment. Social work practitioners report that they lack education and training relevant to addressing R/S; consequently, despite being open to doing so, they address R/S in therapy at fairly low rates. This study was part of a big data project that used a practice-based evidence approach to generate insight into the use of spiritual approaches in mental health treatment. Data were collected in three mental health treatment settings over the course of 12 months. Two of the sites were community-based mental health treatment sites, and one was a private practice. All five sites were Christian-affiliated. By cataloguing the approaches that are being implemented in these settings, the study responds to a resounding demand for greater spiritual competence in mental health practice.

Methods: Practice-based evidence research involves the routine monitoring of therapeutic processes and outcomes. Data are collected by therapists in the context of treatment-as-usual. Therapists complete a checklist that documents their own use of therapeutic approaches in every session. They also facilitate clients’ completion of outcome measures. In the current study, data were collected using Amazon Fire tablets and a secure online survey data collection platform.

Five therapists collected data from 110 clients. Three of the therapists had MSW degrees, and four were licensed therapists. Client participants were majority female (54.6%) and ranged in age from 11 to 72 years, with a mean of 36.09. 28.5 percent of the sample was 25 or younger, and roughly 24.8 percent was 50 or older. Most clients were Christian (84.8%). The sample was racially diverse (46.1% Caucasian; 32.6% Latino/Hispanic; 20.2% African American; 0.9% Asian American). Participants were religious overall, with 91.7% reporting that religion was important to them, 86.4% reporting that they were open to discussing religion in therapy, and 88 percent reporting that they were open to trying religious suggestions.

Results: Given that this study sought to generate insight into the use of spiritual approaches in mental health treatment, analyses were descriptive. Findings focus on the frequency of use of different theoretical orientations and spiritual approaches. Five theoretical orientations and five spiritual approaches were used in at least 10 percent of sessions at Time 1 [Theoretical orientations: Client-centered (n=38), cognitive behavioral (n=37), solution-focused (n=33), narrative (n=17), and psychodynamic (n=11); Spiritual Interventions: encouraging listening to the heart (n=26), affirming trust in God (n=18), encouraging spiritual meditation (n=15), engaging in silent prayer (n=14); and discussing forgiveness (n=19)].

Conclusions and Implications: By providing a glimpse of what is being done in mental health treatment currently, findings clarify what is meant by “spiritually-integrated psychotherapies”. This is a vital step in developing the base of empirical literature that will be needed to advance the effective use of spiritual approaches in social work practice.