McLean successfully integrates spirituality and religion with mental health treatment

September 19, 2019

In a paper published in the latest issue of the American Journal of Psychotherapy, McLean Hospital clinicians describe the success of the hospital's Spiritual Psychotherapy for Inpatient, Residential & Intensive Treatment (SPIRIT) program. The clinicians drew their conclusions from a sample of nearly 1,500 patients.

SPIRIT is an optional program that is available to all patients who come to McLean each year for mental health care. It integrates religion and spirituality with mental health treatment. According to the paper, many patients have cited the program as a major factor in their successful treatment.

The paper's author, David H. Rosmarin, PhD, ABPP, said that "the statistical majority of our patients want to address spirituality in their mental health care, but few clinicians have any training in this area." To address this need, Rosmarin and his colleagues developed SPIRIT. Its creation was aided by funding from the John Templeton Foundation's Bridges Consortium.

Rosmarin, director of McLean's Spirituality and Mental Health Program, reported that SPIRIT offers "a flexible protocol that gives clinicians the tools they need to address a fair amount of spiritual needs." The protocol, he said, "can be used with any kind of patient, including those with anxiety, mood, substance use, or psychotic disorders; those in inpatient, residential, and intensive programs; and with patients who do or do not have religious backgrounds."

Paper co-author Brent P. Forester, MD, MSc, said that integrating religion and spirituality with mental health is gaining acceptance among clinicians. "Historically, there has been an unease and tension in the field of psychiatry when it comes to the topic of religion," he said. "But we have come a long way towards an understanding that spirituality and religion are distinct and that there may be benefits towards asking about the role that spirituality plays in one's mental health."

This study, Forester stated, "provides evidence that integrating spiritually informed interventions into standard psychiatric care is well accepted and greatly helps individuals who are struggling with various forms of psychiatric illness."

Central to the program are group sessions to help patients explore how their spirituality or religion can be incorporated into their treatment plan and help bring about emotional change. SPIRIT participants also receive handouts about a variety of topics, including ways that prayer, meditation, and sacred verses can work with mental health treatment plans.

McLean's Hilary S. Connery, MD, PhD, believes that SPIRIT can be particularly helpful for people with highly stigmatized illnesses. Often, she said, these illnesses "place sick persons in circumstances that cause them--and their families and sometimes even health care providers--to question whether or not they have done something 'wrong' or 'evil' that has directly resulted in their illness. Their recovery is fraught with shame and guilt, often disproportionate to their actual illness onset and development. This shame and guilt fosters treatment avoidance."

However, Connery asserted that "spiritual interventions can be lifesaving for such individuals in correcting inappropriately personalized experiences of ill health, thus allowing them to greatly improve treatment engagement, adherence, and positive outcomes, and to reduce risk for suicide and other stress-related self-harm behaviors."

Forester, chief of McLean's Division of Geriatric Psychiatry, believes that seniors may benefit from programs like SPIRIT. "Older adults, in particular, suffer from loneliness, anxiety, and depression and face significant medical challenges," he said. "This population, therefore, may greatly benefit from assessing attitudes about spirituality and the role of spirituality in one's life."

Regardless of age or specific mental health issue, the SPIRIT program has proved to be popular with patients. Rosmarin cited recent studies in which more than 80% of McLean patients report using religion to cope with stress, and 58.2% say they want spirituality as part of their care.

In addition, interviews with patients after treatment have revealed their positive feelings about SPIRIT. "We've never had an adverse event or received negative feedback," Rosmarin said.

SPIRIT is not only popular. It is also effective. "One of the biggest issues in psychiatry is that people don't complete their treatment or don't come in the first place," Rosmarin said. "SPIRIT has helped people stay on track."

Moreover, he said, "There is a lot of evidence that many people utilize spirituality to cope with stress and other issues." For example, he stated, "Spiritually based 12-step programs for substance use disorders are by far the most common pathway to recovery in this country."

Rosmarin hopes the paper will lead to more institutions adopting programs like McLean's. "SPIRIT could be syndicated regionally or nationally," he said. "I see no reason why SPIRIT can't be running at other hospitals. It's easy to train clinicians, patients want this, and the program works. The proof is in the pudding."

McLean Hospital

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