Journal of Religion and Health

, Volume 57, Issue 4, pp 1330–1349 | Cite as

Teachers’ and Parents’ Perspectives on a Curricular Subject of “Religion and Spirituality” for Indian Schools: A Pilot Study Toward School Mental Health Program

  • Parameshwaran RamakrishnanEmail author
  • Andrew Baccari
  • Uma Ramachandran
  • Syed Faiz Ahmed
  • Harold G. Koenig
Original Paper


Religious–spiritual (R/S) education helps medical students cope with caregiving stress and gain skills in interpersonal empathy needed for clinical care. Such R/S education has been introduced into K-12 and college curricula in some developed nations and has been found to positively impact student’s mental health. Such a move has not yet been seen in the Indian education system. This paper aimed to examine perspectives of teachers and parents in India on appropriateness, benefits, and challenges of including R/S education into the school curriculum and also to gather their impressions on how a R/S curriculum might promote students’ health. A cross-sectional study of religiously stratified sample of teachers and parents was initiated in three preselected schools in India and the required sample size (N = 300) was reached through snowballing technique. A semi-structured questionnaire, with questions crafted from “Religion and Spirituality in Medicine, Physicians Perspective” (RSMPP) and “American Academy of Religion’s (AAR) Guidelines for Religious Literacy,” was used to determine participants’ perspectives. Findings revealed that teachers’ and parents’ “comfort in integrating R/S into school curriculum” was associated with their gender (OR 1.68), education status (OR 1.05), and intrinsic religiosity (OR 1.05). Intrinsic religiosity was significantly (p = 0.025) high among parents while “intrinsic spirituality” was high (p = 0.020) among teachers. How participants’ R/S characteristics influence their support of R/S education in school is discussed. In conclusion, participants believe R/S education will fosters students’ emotional health and interpersonal skills needed for social leadership. A curriculum that incorporates R/S education, which is based on AAR guidelines and clinically validated interpersonal spiritual care tools would be acceptable to both teachers and parents.


Religion-spirituality Mental and social health School education Curriculum development Parents–teachers–students 



This study was inspired by the experiences that I (first author in this paper) had as a visiting summer research intern at Gurgaon branch of Indus World School (IWS) in 2014. I am grateful to Harvard Divinity School’s “Center for Study of World Religion” that chose to award my project proposal, that aimed to understand “why and how to include religion/spirituality as a curricular subject in schools for promotion of interreligious understanding, peace, and social health among students.” This proposed internship project was supported by the Greeley scholarship award for which I am extremely grateful and feel blessed. Most importantly, I feel indebted to IWS administrative leadership of Mr. R. Satyanarayanan and Mr. Soumyo Dattagupta, and Principals of IWS Mrs. Kapila Sawhney Mrs. Archana Sharma and Mr. Ramanjit Ghuman for providing me the necessary infrastructure and personnel support to complete this study. Many thanks to members of the focus groups that helped to develop and pretest the questionnaire prior to our final study. Many thanks to our research-mentors Dr. B. K Ansari, and Mr. A. Abidi, for facilitating the "snowballing" process in Hyderabad, Telangana and, to Dr. A. Dias for the same in Bambolim, Goa. We greatly appreciate the Accendere Team for reviewing the manuscript, structuring, formatting, and preparing it for publication.


This study was not funded by any organization. However, I am extremely indebted to Harvard Divinity School's Greeley-CSWR scholarship (2014) for my 3-month summer international internship program at IWS. Experiences from that internship had inspired ideas, which went towards developing this research study, and it was completed in the summers of 2015-16. All the researchers and subjects (teachers and parents) of this study were voluntary participants. The AdiBhat Foundation of India, a nonprofit organization that is involved in the research on spirituality as health-related subject, supported the travel expenses of its principal investigator and overhead costs of the study.

Compliance with Ethical Standards

Ethical Approval

The ethics committee of Indus World School had approved this study which was in accordance with the ethical standards of the institutional (Indus World School) and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Aggarwal, J. C. (1966). Major recommendations of the Education Commission, 1964–66, including selected passages and comments. India Education Commission. New Delhi: Arya Book Depot.Google Scholar
  2. Allport, G. W., & Ross, J. M. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5(4), 432–443.CrossRefPubMedGoogle Scholar
  3. Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health and Mental Health Services Research, 37(1–2), 40–47.CrossRefPubMedGoogle Scholar
  4. Bang, H., & Zhou, Y. (2014). The function of wisdom dimensions in ego-identity development among Chinese university students. International Journal of Psychology, 49(6), 434–445.CrossRefPubMedGoogle Scholar
  5. Bostic, J. Q., Nevarez, M. D., Potter, M. P., Prince, J. B., Benningfield, M. M., & Aguirre, B. A. (2015). Being present at school: Implementing mindfulness in schools. Child & Adolescent Psychiatric Clinics of North America, 24(2), 245–259.CrossRefGoogle Scholar
  6. Chen, A. K., Kumar, A., & Haramati, A. (2016). The effect of mind body medicine course on medical student empathy: A pilot study. Medical Education Online, 21, 31196.CrossRefPubMedGoogle Scholar
  7. Crammer, C., Kaw, C., Gansler, T., & Stein, K. D. (2011). Cancer survivors’ spiritual well-being and use of complementary methods: A report from the American Cancer Society’s studies of cancer survivors. Journal of Religion and Health, 50(1), 92–107.CrossRefPubMedGoogle Scholar
  8. Curlin, F. A., Chin, M. H., Sellergren, S. A., Roach, C. J., & Lantos, J. D. (2006). The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Medical Care, 44(5), 446–453.CrossRefPubMedGoogle Scholar
  9. Curlin, F. A., Lantos, J. D., Roach, C. J., Sellergren, S. A., & Chin, M. H. (2005). Religious characteristics of U.S. physicians: A national survey. Journal of General Internal Medicine, 20(7), 629–634.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Curlin, F. A., Lawrence, R. E., Odell, S., Chin, M. H., Lantos, J. D., Koenig, H. G., et al. (2007). Religion, spirituality, and medicine: Psychiatrists’ and other physicians’ differing observations, interpretations, and clinical approaches. American Journal of Psychiatry, 164(12), 1825–1831.CrossRefPubMedGoogle Scholar
  11. Department of School Education and Literacy. (2017). Scheme for infrastructure development private aided/unaided minority institutes (IDMI)(Elementary, Secondary/senior secondary schools) Ministry of Human Resource Development, Government of India. New Delhi.
  12. Dobkin, P. L., & Hutchinson, T. A. (2013). Teaching mindfulness in medical school: Where are we now and where are we going? Medical Education, 47(8), 768–779.CrossRefPubMedGoogle Scholar
  13. Felver, J. C., Butzer, B., Olson, K. J., Smith, I. M., & Khalsa, S. B. (2015). Yoga in public school improves adolescent mood and affect. Contemporary School Psychology, 19(3), 184–192.CrossRefPubMedGoogle Scholar
  14. Gordon, J. S. (2014). Mind-body skills groups for medical students: Reducing stress, enhancing commitment, and promoting patient-centered care. BMC Medical Education, 14, 198.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Gulati, S., & Pant, D. (2008). Education for values in schoolA framework. Teaching of value education in schools. Government of India. Department of Educational Psychology and Foundations of Education. National Council of Educational Research and Training. New Delhi.
  16. Hall, P., Byszewski, A., Sutherland, S., & Stodel, E. J. (2012). Developing a sustainable electronic portfolio (ePortfolio) program that fosters reflective practice and incorporates CanMEDS competencies into the undergraduate medical curriculum. Academic Medicine, 87(6), 744–751.CrossRefPubMedGoogle Scholar
  17. Hoge, D. R. (1972). A validated intrinsic religious motivation scale. Journal for the Scientific Study of Religion, 11, 369–376.CrossRefGoogle Scholar
  18. Hojat, M., Michalec, B., Veloski, J. J., & Tykocinski, M. L. (2015). Can empathy, other personality attributes, and level of positive social influence in medical school identify potential leaders in medicine? Academic Medicine, 90(4), 505–510.CrossRefPubMedGoogle Scholar
  19. Hvidt, N. C., Kørup, A. K., Curlin, F. A., Baumann, K., Frick, E., Søndergaard, J., et al. (2016). The NERSH international collaboration on values, spirituality and religion in medicine: Development of questionnaire, description of data pool, and overview of pool publications. Religions, 7(8), 107.CrossRefGoogle Scholar
  20. Koenig, H. G. (1998). Religious attitudes and practices of hospitalized medically ill older adults. International Journal of Geriatric Psychiatry, 13(4), 213–224.CrossRefPubMedGoogle Scholar
  21. Koenig, H. G., & Büssing, A. (2010). The Duke University Religion Index (DUREL): A five-item measure for use in epidemiological studies. Religions, 1, 78–85.CrossRefGoogle Scholar
  22. Levin, J. S., Larson, D. B., & Puchalski, C. M. (1997). Religion and spirituality in medicine: Research and education. JAMA, 278(9), 792–793.CrossRefPubMedGoogle Scholar
  23. Li, S., Stampfer, M. J., Williams, D. R., & VanderWeele, T. J. (2016). Association of religious service attendance with mortality among women. JAMA Internal Medicine, 176(6), 777–785.CrossRefPubMedGoogle Scholar
  24. Lucchetti, G., de Oliveira, L. R., Koenig, H. G., Leite, J. R., Lucchetti, A. L., & Collaborators, S. B. R. A. M. E. (2013). Medical students, spirituality and religiosity–results from the multicenter study SBRAME. BMC Medical Education, 13, 162.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Lucchetti, G., Lucchetti, A. L., & Puchalski, C. M. (2012). Spirituality in medical education: Global reality? Journal of Religion and Health, 51(1), 3–19.CrossRefPubMedGoogle Scholar
  26. Menniti-Ippolito, F., & De Mei, B. (1999). The characteristics of the use and the levels of diffusion of nonconventional medicine [Article in Italian] (Abstract). Annali dell Istituto Superiore di Sanita, 35(4), 489–497.PubMedGoogle Scholar
  27. Moore, L. D. (2007). Overcoming religious illiteracy: A multicultural approach to teaching about religion in secondary schools. New York: Palgrave Macmillan (p. 4). Accessed 30 October 2016.
  28. Moore L. D. (2010). Guidelines for Teaching About Religion in K-12 Public Schools in the United States. American Academy of Religion’s “Religion in the Schools Task Force.” American Academy of Religion publication 2010. Accessed 30 Octber 2016.
  29. Neely, D., & Minford, E. J. (2008). Current status of teaching on spirituality in UK medical schools. Medical Education, 42(2), 176–182.CrossRefPubMedGoogle Scholar
  30. Noggle, J. J., Steiner, N. J., Minami, T., & Khalsa, S. B. (2012). Benefits of yoga for psychosocial well-being in a US high school curriculum: A preliminary randomized controlled trial. Journal of Developmental and Behavioral Pediatrics, 33(3), 193–201.CrossRefPubMedGoogle Scholar
  31. Penrod, J., Preston, D. B., Cain, R. E., & Starks, M. T. (2003). A discussion of chain referral as a method of sampling hard-to-reach populations. Journal of Transcultural Nursing, 14(2), 100–107.CrossRefPubMedGoogle Scholar
  32. Puchalski, C. M. (2006). Spirituality and medicine: Curricula in medical education. Journal of Cancer Education, 21(1), 14–18.CrossRefPubMedGoogle Scholar
  33. Puchalski, C. M., Blatt, B., Kogan, M., & Butler, A. (2014). Spirituality and health: The development of a field. Academic Medicine, 89(1), 10–16.CrossRefPubMedGoogle Scholar
  34. Puchalski, C. M., & Larson, D. B. (1998). Developing curricula in spirituality and medicine. Academic Medicine, 73(9), 970–974.CrossRefPubMedGoogle Scholar
  35. Ramakrishnan, P. (2015a). Theory and practice of chaplain’s spiritual care process: A psychiatrist’s experiences of chaplaincy and conceptualizing trans-personal model of mindfulness. Indian Journal of Psychiatry, 57(1), 21–29.CrossRefGoogle Scholar
  36. Ramakrishnan, P. (2015b). ‘You are here’: Locating ‘spirituality’ on the map of the current medical world. Current Opinion in Psychiatry, 28(5), 393–401.CrossRefPubMedGoogle Scholar
  37. Ramakrishnan, P., Dias, A., Rane, A., Shukla, A., Lakshmi, S., Ansari, B. K., et al. (2014a). Perspectives of Indian traditional and allopathic professionals on religion/spirituality and its role in medicine: Basis for developing an integrative medicine program. Journal of Religion and Health, 53(4), 1161–1175.CrossRefPubMedGoogle Scholar
  38. Ramakrishnan, P., Karimah, A., Kuntaman, K., Shukla, A., Ansari, B. K., Rao, P. H., et al. (2015). Religious/spiritual characteristics of Indian and Indonesian physicians and their acceptance of spirituality in health care: A cross-cultural comparison. Journal of Religion and Health, 54(2), 649–663.CrossRefPubMedGoogle Scholar
  39. Ramakrishnan, P., Rane, A., Dias, A., Bhat, J., Shukla, A., Lakshmi, S., et al. (2014b). Indian health care professionals’ attitude towards spiritual healing and its role in alleviating stigma of psychiatric services. Journal of Religion and Health, 53(6), 1800–1814.CrossRefPubMedGoogle Scholar
  40. Ring, M., Brodsky, M., Low Dog, T., Sierpina, V., Bailey, M., Locke, A., et al. (2014). Developing and implementing core competencies for integrative medicine fellowships. Academic Medicine, 89, 421–428.CrossRefPubMedGoogle Scholar
  41. Roeser, R. W., Ruhi Berry, R., Gonsalves, A., Hastak, Y., Shah, M., Rao, M., et al. (2006). Exploring the varieties of moral and spiritual education in India: Implications for adolescents’ spiritual development. Presentation at the American Educational Research Association, San Francisco 2006. Accessed 27 June 2017.
  42. Slavin, S. J., Schindler, D. L., & Chibnall, J. T. (2014). Medical student mental health 3.0: Improving student wellness through curricular changes. Academic Medicine, 89(4), 573–577.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Szumilas, M. (2010). Explaining odds ratios. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(3), 227–229.PubMedPubMedCentralGoogle Scholar
  44. Tan, J. Y., Lim, H. A., Kuek, N. M., Kua, E. H., & Mahendran, R. (2015). Caring for the caregiver while caring for the patient: Exploring the dyadic relationship between patient spirituality and caregiver quality of life. Supportive Care in Cancer, 23(12), 3403–3406.CrossRefPubMedGoogle Scholar
  45. Warnecke, E., Quinn, S., Ogden, K., Towle, N., & Nelson, M. R. (2011). A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Medical Education, 45(4), 381–388.CrossRefPubMedGoogle Scholar
  46. Willis, G. B., & Lessler, J. T. (1999). Question appraisal system: QAS 99. National Cancer Institute. Accessed 30 October 2016.
  47. Wu, C., Weber, W., Kozak, L., Standish, L. J., Ojemann, J. G., Ellenbogen, R. G., et al. (2009). A survey of complementary and alternative medicine (CAM) awareness among neurosurgeons in Washington State. Journal of Alternative and Complementary Medicine, 15(5), 551–555.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Parameshwaran Ramakrishnan
    • 1
    • 2
    Email author
  • Andrew Baccari
    • 2
  • Uma Ramachandran
    • 3
  • Syed Faiz Ahmed
    • 4
    • 5
  • Harold G. Koenig
    • 6
    • 7
  1. 1.AdiBhat FoundationNew DelhiIndia
  2. 2.Harvard Divinity SchoolHarvard UniversityCambridgeUSA
  3. 3.Indus World SchoolGurgaonIndia
  4. 4.Guidance High SchoolHyderabadIndia
  5. 5.Central Research Institute of Unani MedicineHyderabadIndia
  6. 6.Duke University Medical CenterDurhamUSA
  7. 7.King Abdulaziz UniversityJeddahSaudi Arabia

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