Multidisciplinary perceptions and considerations for spiritual care and biblical framework counseling in mental health

Abstract

Background: Religious/Spiritual (R/S) care is often desirable by mental health clients for culturally sensitive, patient-focused treatment; yet providers may experience hesitancy or overlook this need and treatment guidelines are limited. The aim of this qualitative study was to explore existing R/S care, as well as perspectives on what support care would be considered for patients choosing BFC. This is part of a project to collaboratively extend population-based mental health care access in resource–constrained communities of both the US, a High-Income Country (HIC) and Low-to-Middle Income Countries (LMICs) in Africa. 
 
 Methods: A qualitative literature synthesis, then an online survey was conducted with 54 multidisciplinary participants recruited via snowballing. Survey participants were asked to review a case as described by a BFC provider and respond anonymously to an open-ended questionnaire. The data collected was distilled with qualitative coding and thematic analysis. 
 
 Results: Literature synthesis identified multidisciplinary health professional provision of R/S, medical and/or psychological interventions as monotherapy or integrated strategies. There was a paucity of medical education guidelines. Qualitative themes included willingness to coordinate care for BFC clients, to what capacity should care be provided, and perceptions of BFC efficacy. R/S care was often integrated as part of a holistic treatment approach. Scheduled BFC patient follow-ups, ethical hand-offs or referrals were considered important for majority of survey respondents based on comfort-level with biblical counseling and perceived relapse potential. Spiritual growth and maintenance, medication management, and individual psychotherapy were recommended by survey respondents. There were contrasts in BFC and non-R/S provider perspectives on pertinent mental health history and inferences from the case. Significant information for patient support included symptoms and confirmatory diagnosis, medical comorbidities, relevant childhood issues, faith-health beliefs, family history and genetics, medication and therapy adherence, and substance use. Faith-health belief congruence of providers with BFC patients and ethical decision-making should be considered. Graduate Medical Education (GME) and other health professional programs may incorporate these considerations, existing R/S interventions, and multidisciplinary provider scope of practice as options for clinician training. Future research steps should include growing the body of anecdotal case reports, evidence-based case series and implementation science studies across a broader range of mental disorders.