Professional Training and Development
“Spirituality is recognized as a factor that contributes to health in many persons.
The concept of spirituality is found in all cultures and societies. It is expressed in
an individual’s search for ultimate meaning through participation in religion
and/or belief in God, family, naturalism, rationalism, humanism, and the arts.
All of these factors can influence how patients and health care professionals
perceive health and illness and how they interact with one another.”
(Association of American Medical Colleges 1999:25)
Curricula in the fields of medicine, nursing, social work, and mental health are increasingly introducing courses that address spirituality and religion.
It is estimated that more than 85% of the 126 medical schools in the U.S. offer either an elective or required course on spirituality and religion and health (Weaver 2006). This is a significant increase over the 17% that did so in 1994 (Fortin and Barnett 2004). In some curricula, this material is included in courses on holistic medicine or complementary and alternative medicine (CAM), and may not be reflected in the above statistics. Brokaw et al. (2002) found the topics of faith, prayers, and/or spirituality to be included in 64% of the CAM courses at 53 medical schools they surveyed.
In a study of curricula conducted by Fortin and Barnett (2004), the most common objectives of courses on spirituality and religion in medical schools were:
- to understand the impact of spiritual beliefs on a patient’s health,
- to understand how the personal beliefs of the medical student can impact care, and
- to develop skills in completing a spiritual or religious assessment.
Nursing, with its holistic approach, has always included some element of the awareness of the importance of spirituality and religion to health and mental health, but to varying degrees through the years, as emphasis was placed on physical or psychosocial needs of the patient and technology. Spirituality and religion has become an increasing focus of research in nursing and is receiving more attention in nursing curricula. Spiritual distress is recognized as a nursing diagnosis by the North American Nursing Diagnosis Association and nursing literature contains frequent references to “spiritual needs,” “spiritual well-being,” and a “healing presence.”
A trend, similar to that noted for other fields, is apparent in the training of social workers where courses related to spirituality and religions are offered. Jack Wall, the Associate Dean of the School of Social Work at Loyola states, “Social work’s cardinal rule is ‘start where the clients are.’
For some clients, religion and spirituality of various kinds are central, for others very peripheral. The bottom line though is that social workers need to be prepared to deal with these concerns in interactions with their clients” (Heffern 2001).
As with the training of other providers, spirituality and religion are receiving increased awareness as they relate to mental health. The Corresponding Committee on Religion, Spirituality, and Psychiatry of the American Psychiatric Association (2006) has developed guidelines titled, “Religious/Spiritual Commitments and Psychiatric Practice.” These guidelines recommend that psychiatrists respect their patient’s religious/spiritual commitment, not impose their own beliefs, and include the “cultural, religious spiritual, and personal ideals” of the patient when making treatment decisions.
The American Psychiatric Association chose the theme of “Spirituality, Religion, and Psychiatry” for its annual meeting in May 2007. The Diagnostic and Statistical Manual-IV (DSM-IV) has a new category, “Religious or Spiritual Problem.” This is a divergent approach from prior thinking. Lukoff, a co-author of this new category who offers an online course on the topic sees this as a “significant breakthrough” because it is the first time that recognition is given to “distressing religious and spiritual experiences as nonpathological problems.”
Nevertheless, despite the recognition of religion and spirituality to health as mentioned above, research conducted by Curlin et al. (2007) demonstrates that the “historic tensions between psychiatry and religion” still exist and continue to influence the type of care a patient may receive for mental health conditions.