Abstract
It is observed that there is a significant increase in scientific publications on the subject of spirituality and religiosity in the health area. Such studies show that patients would like this topic to be addressed in their psychotherapy care, but it is identified that there is a lack of adequate training to carry out these issues for psychologists. So, this article aims to verify the effectiveness of an online training on the clinical management of religiosity, spirituality, secularity, and unusual experiences in psychotherapy for 46 Brazilian psychotherapist psychologists. As a result, we were able to observe the statistically significant increase in the total CRESEAP score, indicating that the competencies measured were satisfactorily developed. The P-DUREL (IR) scale was positively correlated in the pre-test with the CRESEAP subscale “Therapist’s Spirituality in the Therapeutic Relationship” before training and after, ceased to exist, demonstrating that the participants’ spiritual and religious beliefs were no longer interfering in the clinical practice. The ARES scale was positively related to the “Differential Diagnosis” subscale in the pre-test, and in the post-test, this association ceased to exist, indicating that all psychotherapists can perform the differential diagnosis, regardless of their faith. Therefore, the online training proved to be effective for developing spiritual and religious competencies in Brazilian psychotherapists, offering evidence-based resources to support professional performance on this topic. It is suggested that other studies be carried out with a larger number of participants and with comparative groups of therapists (working with different clinical approaches of psychotherapy, clinical experiences, and atheists).
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Notes
The clinical managements of spirituality and of religiosity are general issues in common, such as the ethics necessary when approaching such topics. However, there are specificities. Therefore, in the training, firstly, the concepts were clarified and, throughout the classes, some clinical situations were presented that illustrated the management of religious issues and others on spiritual issues, even to highlight such differences in practice.
References
Allmon AL (2011) Religion and the DSM: From pathology to possibilities. J Relig Health 52:538–549. https://doi.org/10.1007/s10943-011-9505-5
Almeida AM, Sharma A, Van Rensburg BJ, Verhagen PJ, Christopher CC (2018) Posicionamento da Associação Mundial de Psiquiatria sobre espiritualidade e religiosidade em psiquiatria. Debates Psiquiatr 8(2):6–8. https://doi.org/10.25118/2236-918X-8-2-1
Bairrão JF (2004) Espiritualidade brasileira e clínica psicológica. In: Angerami-Camon VA (Org.), Espiritualidade e Prática Clínica. Thomson, São Paulo, pp 193–214
Balboni TA, VanderWeele TJ, Doan-Soares SD, Long KNG, Ferrell BR, Fitchett G, Koenig HG, Bain PA, Puchalski C, Steinhauser KE, Sulmasy DP, Koh HK (2022) Spirituality in serious illness and health. JAMA 328(2):184–197. https://doi.org/10.1001/jama.2022.11086. Erratum in: JAMA. 2022 Aug 23;328(8):780
Barrera TL, Zeno D, Bush AL, Barber CR, Stanley MA (2012) Integrating religion and spirituality into treatment for late-life anxiety: three case studies. Cogn Behav Pract 19(2):346–358. https://doi.org/10.1016/j.cbpra.2011.05.007
Belz-Merk M (2000) Counseling and therapy for people who claim exceptional experiences. J Parapsychol 64:238–239
Braghetta CC (2017) Desenvolvimento e validação de um instrumento para avaliar espiritualidade: Escala de Atitudes Relacionadas à Espiritualidade (ARES) (Master’s thesis, Universidade de São Paulo). Recuperado de https://www.teses.usp.br/teses/disponiveis/5/5142/tde-05102017-112819/pt-br.php
Brasil (2023) Conselho Federal de Psicologia. 7ª Resolução do Conselho Federal de Psicologia publicada em 06 de abril de 2023. Atos Oficiais do Conselho Federal de Psicologia. Disponível em: https://atosoficiais.com.br/cfp/resolucao-do-exercicio-profissional-n-7-2023-estabelece-normas-para-o-exercicio-profissional-em-relacao-ao-carater-laico-da-pratica-psicologica?origin=instituicao
Brasil (2012) Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Diário Oficial [da] República Federativa do Brasil, Brasília, DF. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html
Brasil (2013) Ministério da Saúde. Conselho Nacional de Saúde. Norma Operacional nº 001/2013. Brasília, p.1–14. Disponível em http://conselho.saude.gov.br/web_comissoes/conep/aquivos/CNS%20%20Norma%20Operacional%20001%20-%20conep%20finalizada%2030-09.pdf
Brasil (2016) Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 510, de 7 de abril de 2016. Diário Oficial [da] República Federativa do Brasil, Brasília, DF. Seção 1. p. 44–46. Disponível em: http://conselho.saude.gov.br/resolucoes/2016/Reso510.pdf
Campbell M (2022) When faith hurts: clients’ experience of the therapeutic relationship and a counselor’s way of being on the resolution of religious and spiritual struggles. J Pastoral Care Counsel 76(4):234–244. https://doi.org/10.1177/15423050221116542
Cardeña E, Lynn SJ, Krippner S (2013) Variedades da experiência anômala: análise das evidências científicas. Atheneu, São Paulo
Cohen J (1988) Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Lawrence Erlbaum
Crabtree SA, Bell CA, Rupert DA, Sandage SJ, Devor NG, Stavros G (2021) Humility, differentiation of self, and clinical training in spiritual and religious competence. J Spiritual Mental Health 23(4):342–362. https://doi.org/10.1080/19349637.2020.1737627
Cunha VFD, Scorsolini-Comin F (2019) A dimensão religiosidade/espiritualidade na Prática Clínica: revisão Integrativa da literatura científica. Psic: Teor Pesq 35. https://doi.org/10.1590/0102.3772e35419
Cunha VF, Scorsolini-Comin F (2021) Brazilian psychotherapists and the dimension of religiosity/spirituality. Couns Psychother Res 21(2):281–289. https://doi.org/10.1002/capr.12357
Currier JM, Fox J, Vieten C, Pearce M, Oxhandler HK (2023) Enhancing competencies for the ethical integration of religion and spirituality in psychological services. Psychol Serv 20(1):40. https://doi.org/10.1037/ser0000678
Esperandio MRG, Machado GAS (2018) Brazilian physicians’ beliefs and attitudes toward patients’ spirituality: implications for clinical practice. J Relig Health 58(4):1172–1187. https://doi.org/10.1007/s10943-018-0707-y
Ferreira AL, Silva LACD, Silva SCRD, Bezerra MA (2020) As espiritualidades em psicoterapeutas junguianos e transpessoais: um breve estudo fenomenológico. Rev Abordagem Gestáltica 26(2):135–146. https://doi.org/10.18065/2020v26n2.2
Fontes F (2017) Religiosidade e prática psicoterapêutica clínica: contribuições à Psicologia da Religião. Rev Estud Religião (REVER) 17(2):37–49. https://doi.org/10.23925/1677-1222.2017vol17i2a3
Garssen B, Visser A, Pool G (2021) Does spirituality or religion positively affect mental health? Meta-analysis of longitudinal studies. Int J Psychol Relig 31(1):4–20. https://doi.org/10.1080/10508619.2020.1729570
Koenig HG, Büssing A (2010) The Duke University Religion Index (DUREL): a five-item measure for use in epidemiological studies. Religions 1(1):78–85. https://doi.org/10.3390/rel1010078
Lucchetti G, Granero Lucchetti AL, Peres MF, Leão FC, Moreira-Almeida A, Koenig HG (2012) Validation of the duke religion index: DUREL (Portuguese version). J Relig Health 51(2):579–586. https://doi.org/10.1007/s10943-010-9429-5
Miller GE (1990) The assessment of clinical skills/competence/performance. Acad Med 65(9):S63–S67
Moreira-Almeida A, Cardeña E (2011) Differential diagnosis between non-pathological psychotic and spiritual experiences and mental disorders: a contribution from Latin American studies to the ICD-11. Braz J Psychiatry 33:s21–s28. https://doi.org/10.1590/S1516-44462011000500004
Moukaddam N, Andry T, Cao J, Moon YM, Tucci V, Shah A, Lomax JW (2019) Instant countertransference affects assessment and treatment recommendations for depression in patients openly professing religious faith. Spiritual Clin Pract 6(2):100–109. https://doi.org/10.1037/scp0000182
Murray RP, Dunn KS (2017) Assessing nurses’ knowledge of spiritual care practices before and after an educational workshop. J Contin Educ Nurs 48(3):115–122. https://doi.org/10.3928/00220124-20170220-07
Nardini-Bubols M (2022) Clinical management of issues about spirituality, religiosity and anomalous experiences in psychotherapy: identification, training and evaluation. Doctoral Thesis in Clinical Psychology. Pontifical Catholic University of Rio Grande do Sul
Osório IHS, Gonçalves LM, Pozzobon PM, Gaspar Júnior JJ, Miranda FM, Lucchetti AL, Lucchetti G (2017) Effect of an educational intervention in “spirituality and health” on knowledge, attitudes, and skills of students in health-related areas: A controlled randomized trial. Med Teach 39(10):1057–1064. https://doi.org/10.1080/0142159X.2017.1337878
Oxhandler HK, Canda ER, Polson EC, Husain A, Parrish DE (2024) Promoting religious and spiritual competencies in clinical social work: Considerations, potential barriers, and supports. Spiritual Clin Pract. Advance online publication. https://doi.org/10.1037/scp0000364
Oxhandler HK, Parrish DE, Torres LR, Achenbaum WA (2015) The integration of clients’ religion/spirituality in social work practice: a national survey. Soc Work 60:228–237. https://doi.org/10.1093/sw/swv018
Pargament KI (2011) Spiritually integrated psychotherapy: Understanding and addressing the sacred. Guilford Press
Pasquali L, Colaboradores (2009) Instrumentação Psicológica: fundamentos e práticas, 1st edn. Artmed
Pearce M (2016) Cognitive behavioral therapy for Christians with depression: A practical tool-based primer. Templeton Press, West Conshohocken, PA
Pearce MJ, Pargament KI, Oxhandler HK, Vieten C, Wong S (2020) Novel online training program improves spiritual competencies in mental health care. Spiritual Clin Pract 7(3):145. https://doi.org/10.1037/scp0000208
Rabeyron T, Loose T (2015) Anomalous experiences, trauma, and symbolization processes at the frontiers between psychoanalysis and cognitive neurosciences. Front Psychol 6:1926. https://doi.org/10.3389/fpsyg.2015.01926
Raddatz JS, Motta RF, Alminhana LO (2019) Religiosidade/Espiritualidade na Prática Clínica: Círculo vicioso entre demanda e ausência de treinamento. Psico-USF 24:699–709. https://doi.org/10.1590/1413-82712019240408
Rathore LN, Kriplani V (2023) Integrating spirituality into psychotherapy practice in mental health: ethical issues, challenges and possible way out. Int J Health Sci Res 13(3):167–173. https://doi.org/10.52403/ijhsr.20230316
Rossato L, Benfato JC, Ullán AM, Scorsolini-Comin F (2022) Religious-spiritual experiences of family members and caregivers of children and adolescents with cancer. Palliat Support Care 20(5):711–719. https://doi.org/10.1017/S1478951521001590
Roxburgh EC, Evenden RE (2016) ‘It’s about having exposure to this’: investigating the training needs of therapists in relation to the issue of anomalous experiences. Br J Guid Couns 44(5):540–549. https://doi.org/10.1080/03069885.2016.1213375
Rupert D, Moon SH, Sandage SJ (2019) Clinical training groups for spirituality and religion in psychotherapy. J Spiritual Mental Health 21(3):163–177. https://doi.org/10.1080/19349637.2018.1465879
Silva AA, De La Longuiniere ACF, Souza IA, Cafezeiro AS, de Oliveira Cunha ALG, Yarid SD (2020) A espiritualidade no processo de formação dos profissionais de saúde. Rev Pró-univerSUS 11(2):158–163. https://doi.org/10.21727/rpu.v11i2.2369
Sperry L, Shafranske EP (eds) (2005) Spiritually oriented psychotherapy. American Psychological Association, Washington, DC
Strelhow, M. R. W., & Sarriera, J. C. (2018). Evidências de validade do Índice de Religiosidade de Duke (P-DUREL) entre adolescentes. Aval Psicol 17(3). https://doi.org/10.15689/ap.2018.1703.14630.06
Vandenberghe L, Prado FC, de Camargo EA (2012) Spirituality and religion in psychotherapy: Views of Brazilian psychotherapists. Int Perspect Psychol: Res, Pract, Consult 1(2):79. https://doi.org/10.1037/a0028656
Vieten C, Scammell S, Pierce A, Pilato R, Ammondson I, Pargament KI, Lukoff D (2016) Competencies for psychologists in the domains of religion and spirituality. Spiritual Clin Pract 3(2):92. https://doi.org/10.1037/scp0000078
Vieten C, Scammell S, Pilato R, Ammondson I, Pargament KI, Lukoff D (2013) Spiritual and religious competencies for psychologists. Psychol Relig Spiritual 5(3):129. https://doi.org/10.1037/a0032699
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The authors received partial financial support from the Coordination for the Improvement of Higher Education Personnel (CAPES) during all the PhD course of Milena Nardini Bubols, which makes this study possible.
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We certify that all authors participated sufficiently in the work to make public their responsibility for the content. The contribution of each author can be attributed as follows:
- Milena Nardini Bubols: project administration; formal data analysis; conceptualization; investigation; methodology; essay; data tabulation; validation; formatting.
- Dalton Breno Costa: formal data analysis; essay; data tabulation; validation; formatting.
- Carmen Morte-Taty: writing and final validation.
- Tatiana Quarti Irigaray. methodology; essay; supervision; validation.
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This study was submitted to the Research Ethics Committee of the Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil, and approved under protocol number 3,746,885 and CAAE 23918919.4.0000.5336. This study followed the Regulatory Guidelines and Norms involving research with human subjects provided for in Resolution 466/2012 (Brazil 2012), Resolution 510/2016 (Brazil 2016), and Operational Norm 001 of the National Health Council (Brazil 2013). In addition, the necessary ethical precautions were taken to guarantee anonymity regarding data treatment and dissemination of the study findings, with the aim of not causing harm to the participants. All participants had access to the written informed consent form, compliance with which was mandatory for participation in the study.
This study is part of a PhD Research of the main author Milena Nardini Bubols and was partially funding by Coordination for the Improvement of Higher Education Personnel (Capes/Taxas).
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Nardini-Bubols, M., Costa, D.B., Moret-Tatay, C. et al. Effects of the Religious and Spiritual Competencies Training in Brazilian Psychologists: A Pilot Study. Int J Lat Am Relig (2024). https://doi.org/10.1007/s41603-024-00234-z
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DOI: https://doi.org/10.1007/s41603-024-00234-z