Journal of Religion and Health

, Volume 58, Issue 6, pp 2065–2085 | Cite as

Feasibility and Acceptability of a Telephone-Based Chaplaincy Intervention to Decrease Parental Spiritual Struggle

  • John Betz
  • Rhonda Szczesniak
  • Katrina Lewis
  • Teresa Pestian
  • Amy Simpson Bennethum
  • Judith McBride
  • Daniel H. GrossoehmeEmail author
Original Paper


Spiritual struggles (SSs) are distressing spiritual thoughts associated with poorer health outcomes. This study’s purpose was to test feasibility, acceptability, and fidelity of an intervention to decrease SS of parents of children with CF. Parents screening positive for SS were enrolled and were randomized to intervention or attention-control condition. Intervention focused on intra-, inter-, and divine SS. Mixed linear modeling examined between-group differences. We present analyses of N = 23, and participants all showed decreased levels of SS. Acceptability was high; feasibility was higher in the intervention arm. GuideSS_CF is acceptable and feasible and warrants development as a potentially efficacious intervention.


Chaplaincy Intervention Adolescent Cystic fibrosis 



The authors gratefully acknowledge the partial funding from the institution’s Research Innovation and Progress Award, the Division of Pulmonary Medicine and the Department of Pastoral Care.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

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


  1. Dalmida, S. G., Holstad, M. M., Diiorio, C., & Laderman, G. (2009). Spiritual well-being, depressive symptoms, and immune status among women living with HIV/AIDS. Women and Health,49(2–3), 119–143. Scholar
  2. Ellenberg, J. H. (1996). Intent-to-treat analysis versus as-treated analysis. Drug Information Journal,30(2), 535–544.CrossRefGoogle Scholar
  3. Exline, J. J., Pargament, K. I., Grubbs, J. B., & Yali, A. M. (2014). The religious and spiritual struggles scale: Development and initial validation. Psychology of Religion and Spirituality,6(3), 208.CrossRefGoogle Scholar
  4. Fitchett, G., Meyer, P. M., & Burton, L. A. (2000). Spiritual care in the hospital: Who requests it? Who needs it? Journal of Pastoral Care,54(2), 173–186.CrossRefGoogle Scholar
  5. Fitchett, G., & Risk, J. L. (2009). Screening for spiritual struggle. Journal of Pastoral Care and Counseling,63(1–2), 1–12.Google Scholar
  6. Fitchett, G., Winter-Pfändler, U., & Pargament, K. I. (2014). Struggle with the divine in Swiss patients visited by chaplains: Prevalence and correlates. Journal of Health Psychology,19(8), 966–976.CrossRefGoogle Scholar
  7. Grossoehme, D. H., & Fitchett, G. (2013). Testing the validity of a protocol to screen for spiritual risk among parents of children with cystic fibrosis. Research in the Social Scientific Study of Religion,24, 281–308.CrossRefGoogle Scholar
  8. Grossoehme, D. H., Opipari-Arrigan, L., VanDyke, R., Thurmond, S., & Seid, M. (2012a). Relationship of adherence determinants and parental spirituality in cystic fibrosis. Pediatric Pulmonology,47, 558–566. Scholar
  9. Grossoehme, D. H., Ragsdale, J. R., Cotton, S., Meyers, M. A., Clancy, J. P., Seid, M., et al. (2012b). Using spirituality after an adult CF diagnosis: Cognitive reframing and adherence motivation. Journal of Health Care Chaplaincy,18(3–4), 110–120. Scholar
  10. Grossoehme, D. H., Szczesniak, R. D., Britton, L. L., Siracusa, C. M., Quittner, A. L., Chini, B. A., et al. (2015). Adherence determinants in CF: Cluster analysis of parental psychosocial and religious/spiritual factors. Annals of the American Thoracic Society,12(6), 838–846. Scholar
  11. Grossoehme, D. H., Szczesniak, R. D., Mrug, S., Dimitriou, S. M., Marshall, A., & McPhail, G. L. (2016a). Adolescents’ spirituality and cystic fibrosis airway clearance treatment adherence: Examining mediators. Journal of Pediatric Psychology,41(9), 1022–1032.CrossRefGoogle Scholar
  12. Grossoehme, D. H., Teeters, A., Jelinek, S., Dimitriou, S. M., & Conard, L. A. (2016b). Screening for spiritual struggle in an adolescent transgender clinic: Feasibility and acceptability. Journal of Health Care Chaplaincy,22(2), 54–66. Scholar
  13. IBM SPSS Statistics for Windows (Version 23.0). (2015). Armonk, NY: IBM Corporation.Google Scholar
  14. Jones, A., Cohen, D., Johnstone, B., Yoon, D. P., Schopp, L. H., McCormack, G., et al. (2015). Relationships between negative spiritual beliefs and health outcomes for individuals with heterogeneous medical conditions. Journal of Spirituality in Mental Health,17(2), 135–152.CrossRefGoogle Scholar
  15. Kremer, H., Ironson, G., Kaplan, L., Stuetzele, R., Baker, N., & Fletcher, M. A. (2015). Spiritual coping predicts CD4-cell preservation and undetectable viral load over 4 years. AIDS Care,27(1), 71–79.CrossRefGoogle Scholar
  16. Mahoney, A., Carels, R. A., Pargament, K. I., Wachholtz, A., Leeper, L. E., Kaplar, M., et al. (2005). The sanctification of the body and behavioral health patterns of college students. International Journal for the Psychology of Religion,15(3), 221–238.CrossRefGoogle Scholar
  17. McConnell, K. M., Pargament, K. I., Ellison, C. G., & Flannelly, K. J. (2006). Examining the links between spiritual struggles and symptoms of psychopathology in a national sample. Journal of Clinical Psychology,62(12), 1469–1484. Scholar
  18. Modi, A. C. (2009). The impact of a new pediatric epilepsy diagnosis on parents: Parenting stress and activity patterns. Epilepsy & Behavior,14(1), 237–242.CrossRefGoogle Scholar
  19. Modi, A. C., Lim, C. S., Yu, N., Geller, D., Wagner, M. H., & Quittner, A. L. (2006). A multi-method assessment of treatment adherence for children with cystic fibrosis. Journal of Cystic Fibrosis,5(3), 177–185. Scholar
  20. Modi, A. C., & Quittner, A. L. (2006). Utilizing computerized phone diary procedures to assess health behaviors in family and social contexts. Children’s Health Care,35(1), 29–45.CrossRefGoogle Scholar
  21. Murray-Swank, N. A., & Pargament, K. I. (2005). God, where are you? Evaluating a spiritually-integrated intervention for sexual abuse. Mental Health, Religion & Culture,8(3), 191–203.CrossRefGoogle Scholar
  22. Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Development and initial validation of the RCOPE. Journal of Clinical Psychology,56(4), 519–543. Scholar
  23. Powers, S. W., Stark, L. J., Chamberlin, L. A., Filigno, S. S., Sullivan, S. M., Lemanek, K. L., et al. (2015). Behavioral and nutritional treatment for preschool-aged children with cystic fibrosis: A randomized clinical trial. JAMA Pediatrics,169(5), e150636. Scholar
  24. Quittner, A. L., Espelage, D. L., Opipari, L. C., Carter, B. D., & Eigen, H. (1998). Role strain in couples with and without a chronically ill child: Associations with marital satisfaction, intimacy and daily mood. Health Psychology,17, 112–124. Scholar
  25. Quittner, A. L., & Opipari, L. C. (1994). Differential treatment of siblings: Interview and diary analyses comparing two family contexts. Child Development,65(3), 800–814. Scholar
  26. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement,1(3), 385–401. Scholar
  27. Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model for behavioral therapies research: Getting started and moving on from Stage 1. Clinical Psychology: Science and Practice,8(2), 133–142. Scholar
  28. Steinhauser, K. E., Olsen, A., Johnson, K. S., Sanders, L. L., Olsen, M., Ammarell, N., et al. (2016). The feasibility and acceptability of a chaplain-led intervention for caregivers of seriously ill patients: A Caregiver Outlook pilot study. Palliative & Supportive Care,14(5), 456–467. Scholar
  29. Thuné-Boyle, I. C. V., Stygall, J., Keshtgar, M. R. S., Davidson, T. I., & Newman, S. P. (2013). Religious/spiritual coping resources and their relationship with adjustment in patients newly diagnosed with breast cancer in the UK. Psycho-Oncology,22(3), 646–658. Scholar
  30. Wiener, L., Riekert, K., Ryder, C., & Wood, L. V. (2004). Assessing medication adherence in adolescents with HIV when electronic monitoring is not feasible. AIDS Patient Care & STDs,18(9), 527–538.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of Cincinnati, College of MedicineCincinnatiUSA
  2. 2.Division of Biostatistics and EpidemiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Division of Pulmonary MedicineCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Department of Pastoral CareCincinnati Children’s Hospital Medical CenterCincinnatiUSA

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