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Religion, Spirituality and Faithin the Care of Torture Survivors
Part 2Webinar Presentation
Dr. Marcus M. McKinneySaint Francis Hospital and Medical Center
Hartford, Connecticut
June 17, 2009
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Introduction
• Thomas Moore Care of the Soul 1993.Harper• James Hillman Insearch 1994.Spring• Carl G. Jung Psychology and Religion:West and
East. 1969.Princeton University Press• Huguelet and Koenig Religion and Spirituality
in Psychiatry. 2009.Cambridge University Press
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Review
Spirituality: Meaning
Religion: System and Structure
Faith: Belief and Action
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Spirit & Soul
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Spiritual Assessment
Components
Process
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Why make an assessment?
• Swiss Study.2006 (Huguelet, Mohr)
– 1/3 of psychiatrists discussed spiritual issues– NONE of the MD’s initiated the discussion
– Canadian Study.2009 (same results)
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Why?
• “No time”• Concerned they would “offend”• Not Trained• Personally uncomfortable with topic• Concerned colleagues would disapprove• Not interested
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American Psychiatric Guidelines
• In the developmental, psychosocial and socio-cultural history domain
• Recommends considering “ What are the patient’s cultural, religious and spiritual beliefs, and how have these developed or changed over time? ”
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Typical Scale of Assessment
• F.I.C.A.– Faith “Is religious faith an important part of your
life”– Influence “How has faith influenced your life (past
and present)?”– Community “Are you currently a part of a religious
or spiritual community?”– Address Needs “Are there any spiritual needs that
you would like me to address?”
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Mohr and Huguelet*
• Religious/Spiritual History• Effect of illness upon spirituality/religiousness• Current Beliefs and Practices• Subjective importance of religion in life• Subjective importance of religion to cope
w/illness• Synergy of religion with psychiatric care
* Religion and Spirituality in Psychiatry. 2009 . Cambridge University Press page 236
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Component 1
Be Human(imperfect, flawed, etc)
Assess YOUR OWN spiritual and religious perspectives on humanity.
Assess the clients perspective on being human.
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Component 2
Help the person tell their story
In specifics
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Component 3
Assess symbolic aspects of spiritual life
After information gathering (FICA) explore the deeper themes in a persons story that give
meaning.
Example: worth/value, individuality, renewal, reflection, courage, allegiance
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Spiritually Implicating Ideas
Courage/FearIndependence/Community
Allegiance/BetrayalHonor/Dishonor
Dignity (worth)/Lack of Dignity (worthless)Valued and Affirmed/Humiliated
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Practical Example
It is not uncommon for a person to tell their trauma story and fear they
will “not be believed”
Clearly an opportunity for spiritual assessment:Belief; Testimony; Validation of things not
provable (faith)
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Component 4
Assess what (in the specfics) has touched them
Assess how hard it is for them to share these experiences
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Component 5
Assess how they relate-To You
-To Family & Friends
Assess How People relate to them
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Component 6
Assess any Rituals
Pilgrimage, Rebirth, BaptismConfession, Relics, Sacred Scripture
Holy Days, Saints, Prayers
Discover the meaning they find in ritual
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Dreams & Nightmares
Explore DreamsExplore Nightmares
(have them journal)
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Component 7
How do they cope with pain?
Is there a correlation between spiritual resources and ways to cope?
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Components
• Be Human• Invite story specifics• Reflect on Symbolic aspects of story• What touched them inside (about the experience)?• Relating• Rituals and Resources• Dreams & Nightmares• Coping
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Common Goals in Literaturefor Spiritual Assessment
• Reduce Stress• Offer Support
• Help a person cope
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Process
• Reflect on your own perspective regarding spirituality, religion and faith
• Get Basic Information (FICA)• Listen to stories carefully (for themes)• Become interested in having the person TEACH YOU.• Journaling• Invite stories about people they know or admire - see what
touches them.• Bring to awareness any insights they have for use in daily life
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Cross-Cultural Medicine- A Decade Later:Working with Refugee Survivors of Torture
Barbara Chester and Neal HoltonWest. J. Med. 1992
“Like torture survivors, the health professional assessing and treating these patients needs
the courage to imagine.”
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Web Resource
www.pastoralcounselingtraining.com860-714-4183