Religious coping

1. Religious coping

2. The religious dimension of coping • Crises can be viewed through a spiritual lens as threats, challenges, losses, or opportunities for the growth of whatever the individual may hold sacred • In a survey of a national sample of Americans shortly after the 9/11 attacks, Schuster et al. (2001) found that 90% reportedly turned to their religion for solace and support • Health practitioners have begun to draw upon religious coping resources in their efforts to ameliorate a variety of problems and conditions

3. What we know about religion and coping • Freud (1927) argued that religion is rooted in the child’s sense of helplessness in the face of a world filled with dangerous and uncontrollable forces • For Freud, religion was defensive in nature, designed to allay anxiety and avoid the confrontation with reality • This view oversimplifies religious life and is inconsistent with an emerging literature on religion and coping

4. Religion is more than a defence • Before surgery patients facing major surgery reported higher levels of anxiety and beliefs in God than minor surgery patients and a control group • After surgery the levels of anxiety and religious beliefs declined significantly among those experiencing the serious procedures, while the levels of anxiety and beliefs remained constant in the other two groups (Shrimali & Broota, 1987) • While there may be a grain of truth that religion can serve as a defence, there is little foundation to the idea that religion is merely defence

5. Religion is more than a defence • Part of the power of religion lies in its ability to serve a wide variety of needs among its adherents • Most religious traditions provide their members with rites of passage that encourage them to acknowledge and mark difficult life transitions rather than deny their reality • Rather than encourage denial religion promotes reinterpretations of negative events through the sacred lens • Parents, of infants who died of sudden infant death syndrome, who were more religious found greater meaning in their child’s death over time and, in turn, experienced less distress (McIntosh et al., 1993)

6. Religion is more than a defence • Pargament et al. (1988) distinguished among three ways in which religion can be involved in the search for control in the problems-solving process: • A deferring approach in which the individual relinquishes the responsibility for problem solving to God • A self-directing approach in which the individual perceives God giving him/her the skills and resources to solve problems independently • A collaborative approach in which the individual perceives God to be a partner who shares in the responsibility for problem solving • Collaborative problem solving was the most common

7. Religion expresses itself in many ways in coping • When religion has been measured within the general coping literature, it has usually been assessed by only one or two items • It is important to consider not only how much religion is involved in coping, but also how religion is involved in coping • Pargament et al. (2000) developed a measure of 21 types of religious coping • The religious coping activities represent five key religious functions • Search for meaning • Search for mastery and control • Search for comfort and closeness to God • Search for a life transformation

8. The many methods of religious coping • Religious methods of coping to find meaning • E.g., Benevolent religious reappraisal – redefining the stressor through religion as potentially beneficial • Religious methods of coping to gain mastery and control • E.g., Active religious surrender – active giving up of control to God in coping • Religious methods of coping to gain comfort and closeness to God • E.g., Religious focus – engaging in religious activities to shift focus from the stressor • Religious methods of coping to gain intimacy with others and closeness to God • E.g., Religious helping - attempting to provide spiritual support and comfort to others • Religious methods of coping to achieve a life transformation • E.g., Religious conversion – looking to religion for a radical change in life

9. Religious coping methods can be helpful or harmful • Religious coping methods can be grouped into two broad overarching categories: positive and negative religious coping (Pargament et al., 1998) • Positive religious coping strategies reflect a secure relationship with God and a sense of spiritual connectedness with others • Negative religious coping strategies reflect an insecure relationship with God and tension between congregation members • Positive religious coping was positively associated with positive outcomes such as greater life-satisfaction and was negatively associated with negative outcomes such as depression (Ano & Vasconcelles, 2005)

10. Religious coping methods can be helpful or harmful • Positive religious coping has also been associated with indices of better physical health (e.g., Koenig et al., 2001) • Negative religious coping was positively associated with negative psychological outcomes such as depression and anxiety (Ano & Vasconcelles, 2005) • Negative religious coping also has harmful implications for physical functioning (e.g., Pargament et al., 2001)

11. Religious coping methods can be helpful or harmful • The relationships between religious coping and adjustment have remained significant after adjusting for the effects of demographic variables and non-religious coping measures • Some studies of religious coping have reported contradictory or non-significant findings (e.g., Culver et al., 2002) • Differences in samples, stressors, and measures may partly account for these discrepencies

12. People draw on a general orienting system in religious coping • The orienting system is a general disposition to the world that involves beliefs, feelings, practices, and relationships from religious, personality, and social domains (Pargament, 1997) • In specific situations, people draw on religious coping methods that are a part of their general orienting system • Studies have shown that religious coping mediated the relationship between dispositional variables (e.g., religious orientation, attachment to God) and the outcome to stressful events (e.g., Roesch & Ano, 2003; Belavich & Pargament, 2002)

13. Effects of religious coping are moderated by different factors • Religious coping appears to be more helpful for those who are religious (e.g., Krause et al., 1998; Pargament et al., 2001) • Religious coping appears to be more helpful during more taxing situations that push people to the bounds of human limitations, when immediate personal and social resources are depleted (e.g., Maton, 1989) • Religious coping has differential effects for people from different religious affiliations • Dealing with the stress of a kidney transplant, religious coping was associated with greater life satisfaction for Protestants but not for Catholics (Tix & Frazier, 1998)

14. From research to practice • Spiritually integrated psychotherapeutic approaches are still in their infancy • However, promising models of treatment that build on religious coping methods are in the process of development (e.g., Avants & Margolin, 2004) • Spiritual meditation was associated with significantly greater anxiety reduction, and greater ability to withstand pain than secular meditation or a relaxation group (Wachholtz & Pargament, in press) • People who made use of a prayer wheel reported significant decreases in anxiety, and to a lesser degree, depression (Rajagopal et al., 2002)

15. From research to practice • Compared to secular confession and a control condition, spiritual confession was associated with greater reports of spiritual growth (Murray-Swank, 2003) • However, it was also linked to higher levels of guilt in comparison to the non-spiritual confession conditions (Murray-Swank, 2003) • Targ and Levine (2002) compared the effects of a mind-body-spirit group intervention for women with cancer with a support group • The spiritual group showed greater increases in spiritual integration and less avoidance, but the support group showed more declines in confusion and helplessness/hopelessness

16. From research to practice • A Christian-accomodative form of cognitive-behavioural therapy did not differ in efficacy from standard cognitive-behavioural therapy (McCullough, 1999) • Retention and rehabilitation rates were higher in a drug rehab programme that encouraged religious transformation than those reported by comparable secular programmes (Gruner, 1984)

17. From research to practice • Murray-Swank and Pargament (2003) evaluated an 8-week individual intervention that drew on spiritual resources to help women who had experienced childhood sexual abuse • 80% of the women reported reductions in psychological and spiritual distress • Spiritual intervention did not trigger any serious psychological disturbances among individuals experiencing serious mental illness (Phillips et al., 2002)

18. Future directions – research and practice • Research in the domain of religion and coping should be more fully integrated into mainstream research and practice within the applied health professions and the social and health sciences • Research should investigate religious coping in ethnically and religiously diverse samples • Drawing on research from multicultural psychology, it would be interesting to examine the nature and prevalence of specific religious coping strategies, such as interpersonal religious discontent and seeking support from clergy and members in diverse ethnic groups

19. Future directions – research and practice • There is a need for more longitudinal studies of religious coping • Longitudinal studies are also needed to examine fluctuations in religious coping over time and their implications for adjustment • Results from a diary study of religious coping among arthritis patients found significant variation in religious coping from day to day (Keefe et al., 2001)

20. Future directions – research and practice • Studies should investigate religious coping among relatively neglected groups, such as people with serious mental illness • 80% of people with mental illness used religion to cope with daily frustrations (Tepper et al., 2001) • Researchers should examine religious coping from a developmental perspective and investigate how it develops over the life-span • E.g., could spending more time in contemplative prayer improve abstract cognitive reasoning?

21. Future directions – research and practice • There is need for studies of specific religious coping methods e.g., confession • Rites of passage (e.g., confirmations, funerals) are often imbued with deep emotions and significance, and thus represent rich targets for studies of the affective basis of spirituality • Research should incorporate both quantitative and qualitative methods for studying religious coping

22. Future directions – research and practice • There is a need for studies that include multiple criteria of well-being • E.g., social, spiritual, and physical dimensions of well-being • Mahoney et al. (2002) found that college students who perceived 9/11 terrorist attacks as desecrations of something sacred adopted more severely retaliatory attitudes toward the terrorists responsible for these acts

23. Future directions – research and practice • Studies are needed to compare the efficacy of religiously oriented treatments with other traditional secular interventions through experimental designs • Most psychospiritual interventions augment traditional approaches to the treatment of psychological problems • Additional studies are needed to develop and evaluate spiritually based interventions that specifically address religious problems, such as spiritual struggles