Processes and outcomes of theistic spiritually oriented psychotherapy: A practice-based evidence investigation.

Abstract

Various approaches for incorporating spirituality into psychotherapy have been developed, but few have been submitted to empirical scrutiny. The present article reports the results of a practice-based evidence (PBE) study, and demonstrates the value of PBE as a research strategy for the empirical evaluation of spiritually oriented psychotherapies (SOPs). This approach involves examining the effectiveness of SOPs in routine settings, providing more externally valid results than randomized controlled trials. Outcome and process data for 304 clients at a private, religious, university counseling center were examined using a PBE methodology. Clinicians integrated a wide variety of spiritual interventions with various secular treatments. The therapist, low initial spiritual distress, and client desire to discuss spirituality in session predicted the frequency with which spiritual interventions were used. The results of multiple hierarchical linear models suggested that clients improved substantially in multiple domains of functioning. The frequency of use of spiritual interventions was not a significant predictor of differential growth trajectories for clients. This study provides an example of how PBE can be used to explore and evaluate the effectiveness of the types of spiritual interventions practitioners employ in their practices.

A practice‐based evidence investigation of God representations in spiritually integrated psychotherapies

“…Although the absence of a comparison group and manualized approach limits the ability to gauge whether these improvements can be attributed to specific therapeutic activities, this finding aligns with outcomes of controlled trials of SIPs (Anderson et al, 2015; Captari et al, 2018; Gonçalves et al, 2015). In addition, Sanders et al (2015) found the same pattern in a PBE study of SIPs conducted in a religiously affiliated university counseling center. On the other hand, we did not find corresponding improvements in representations of God.…”

“…In tandem, these findings perhaps suggest clinicians did not affirm trusting God with highly distressed clients in the initial alliance‐building phase but then implement this intervention more often when addressing more severe problems that possibly were not improving over the course of treatment. However, in keeping with Sanders et al (2015), the size of the client sample likely limited the ability to detect unique effects for other spiritual interventions.…”

“…Other descriptive information collected from clinicians at the end of sessions revealed a range of strategies for R/S integration that were implemented in CBT, client‐centered, and other theoretical approaches. Focusing on a validated checklist of spiritual interventions (Richards et al, 2015; Sanders et al, 2015), the two most commonly used approaches entailed affirming clients' divine worth and trust in God. Clinicians also frequently encouraged clients to engage in specific practices (e.g., prayer, meditation, reading sacred texts, and journaling), listen to their own heart or spiritual center, and/or accept divine love.…”

“…After clients answered the CORE‐10 and LAMBI subscales, clinicians similarly utilized the online behavioral assessment system to complete the Clinically Adaptive Multidimensional Outcome Survey–Therapist Session Checklist (CAMOS‐TSC; Richards et al, 2015; Sanders et al, 2015) as a way of summarizing spiritual interventions that were implemented in the particular session. Namely, using a checklist approach in which only relevant response options for that session were endorsed, clinicians' responses on the CAMOS‐TSC could differ from session‐to‐session depending on which spiritual interventions were utilized.…”

The 4 Ds: Using Ignatian spirituality in secular psychotherapy and beyond.

“…In recent years, clinical psychology has rediscovered many of the helpful techniques and interventions that originated centuries ago from the great spiritual, religious, and wisdom traditions (e.g., Hood, Hill, & Spika, 2009;Pargament, 2007;Pargament, Exline, Jones, Mahoney, & Shafranske, 2013;Plante, 2009Plante, , 2016Sanders et al, 2015). Much has already been written about spirituality in clinical practice in recent years.…”