| dc.description.abstract | Systematic Literature Review Abstract
Background. There is consistency in the literature about clinical psychologists feeling unready in discussing spiritual issues with their clients when the topic is raised. The prevalence of mental health difficulties is similar in both religious people and those who are neither religious nor spiritual. A significant amount of people accessing health services have spirituality, religion or faith as an important part of their identity. It would be beneficial to explore the literature in order to understand the challenges that CPs experience, which may influence their ability to incorporate spirituality into psychological therapy. Method. This systematic review was conducted using the Sample, Phenomenon of Interest, Design, Evaluation, Research (SPIDER) reporting tool. The sample for this review were the psychological practitioners who deliver psychological interventions directly to clients, such as CPs, counsellors, psychotherapists, and psychologists, including trainee and qualified practitioners. The phenomenon of interest was the sample having provided interventions or therapy to clients with clearly defined religious, faith or spiritual needs. Literature of qualitative and mixed methods studies was included. The evaluation that was explored was the ‘challenges’ reported by the sample. Results. A total of 11 articles were included in this review. The four themes were outlined in the literature as challenges: medical model & theoretical framework challenges, organisational/ systemic barriers & clinical supervision barriers, professional challenges and cultural barriers. Conclusions implications of the findings highlight a critical issue that a significant amount of the literature on spirituality in the UK is unpublished. In addition to the limited research, there was an emphasis on the lack of evidence-based theoretical frameworks used in the UK indicates a professional issue that likely impacts the quality of care given to clients of spiritual orientation.
Empirical Project Abstract
Background: Spirituality is a common concept which many people’s lifestyles are centred around. Within the UK and many other parts of the world Christians are a large part of the group of people recognized as spiritual, religious or living by faith. There is evidence suggesting that Clinical Psychologists (CPs) do not feel comfortable with incorporating spirituality into therapy for their clients. However, incorporation of spirituality into therapy is associated with positive client outcomes, but there is limited research on its association with therapeutic engagement and therapeutic alliance.
Objectives: Using a mixed methods approach, the aim of the study was to examine quantitatively the relationship between spirituality and engagement in therapy, and to qualitatively explore what is important about spirituality and therapy for Christians in order to best engage with therapy.
Method: Participants (N = 133) completed an online survey examining their daily spiritual experiences at the time they received therapy, perceived incorporation of spirituality into therapy and retrospective perceived engagement and working alliance in therapy. Five participants were then randomly picked to participate in in-depth semi structured interviews.
Analyses: Two moderated multiple linear regression analyses were conducted to evaluate the prediction of the two outcomes: perceived retrospective engagement in therapy and perceived retrospective working alliance. The qualitative interviews were analysed using thematic analysis. The findings of the study quantitatively suggest that the incorporation of spirituality into therapy and daily spiritual experiences explain unique variance with a positive association for both predictors. Qualitatively the study found that clients valued authentic conversations about spirituality, and incorporation of this into therapy supported engagement and working alliance. However, there was a strong consensus that therapists often dismissed the topic and which some participants found harmful.
Conclusions: It is, therefore, crucial to consider how CPs can be supported to address this need. Firstly, doctoral training programmes should review the context of teaching offered to support clinical psychologists in learning how to incorporate spirituality into therapy. Secondly, CPs should ensure that there is an active reflective process in practice when working with Christians. | en_GB |
