Showing papers by "Everett L. Worthington published in 2009"

Empirically supported religious and spiritual therapies.

Abstract: This article evaluated the efficacy status of religious and spiritual (R/S) therapies for mental health problems, including treatments for depression, anxiety, unforgiveness, eating disorders, schizophrenia, alcoholism, anger, and marital issues. Religions represented included Christianity, Islam, Taoism, and Buddhism. Some studies incorporated a generic spirituality. Several R/S therapies were found to be helpful for clients, supporting the further use and research on these therapies. There was limited evidence that R/S therapies outperformed established secular therapies, thus the decision to use an R/S therapy may be an issue of client preference and therapist comfort.

Collectivism, Forgiveness, and Social Harmony

Abstract: Existing models of forgiveness and the strategies to promote forgiveness that draw from them are predominantly individualistic. As the United States becomes more diverse and counseling psychology becomes a more global field, counseling psychologists are increasingly likely to encounter clients who have a collectivistic worldview. The authors propose a theoretical model that clarifies the relationship between collectivism and forgiveness. The importance of maintaining social harmony in collectivistic cultures is central to this relationship. The model has two propositions. First, collectivistic for- giveness occurs within the broad context of social harmony, reconciliation, and relational repair. Second, collectivistic forgiveness is understood as pri- marily a decision to forgive but is motivated largely to promote and maintain group harmony rather than inner peace (as is more often the case in individ- ualistically motivated forgiveness). Finally, the authors suggest a research agenda to study collectivi...

Psychotherapy with religious and spiritual clients: an introduction

Abstract: This invited issue of the Journal of Clinical Psychology: In Session is devoted to psychotherapy with religious and spiritual clients. After offering definitions of religion and spirituality, noting areas of potential convergence and differentiating nuances, the authors highlight the prevalence and types of spirituality among both clients and mental health professionals. They describe the historical and current context for examining approaches to psychotherapy with clients who endorse religion, experience spirituality within their religion, or define themselves as spiritual even if not religious. They then summarize the subsequent articles in this issue, which offer practical guidance for practitioners.

Comparison of Explicit Forgiveness Interventions With an Alternative Treatment: A Randomized Clinical Trial

Abstract: A new and sometimes controversial topic, forgiveness, has emerged from the psychological literature in counseling and psychotherapy. Many have claimed that forgiveness is a reasonable and worthwhile goal when attempting to help people deal with difficult experiences (e.g., Enright & Fitzgibbons, 2000; Ferch, 1998). These clinicians and researchers state that helping clients to forgive, rather than just cope with, the consequences of hurts can be useful for ameliorating multiple difficulties and promoting general well-being. Fitzgibbons (1986), for example, theorized that forgiveness can help clients to escape the control that past events have exerted over them and to limit the tendency to project the effects of past hurts into future relationships. Based on the theory that explicitly promoting forgiveness can be especially useful for some clients, interventions have been developed to help clients achieve forgiveness and have proven effective in clinical trials (Wade, Worthington, & Meyer, 2005). However, many of these interventions have not been directly compared with standard psychotherapeutic treatments, and so the question of whether explicit forgiveness treatments are more effective than current methods of treatment is still unanswered. * Definitions of Forgiveness There appears to be consensus in the psychological literature that forgiving is not condoning, pardoning, reconciling, excusing, justifying, forbearing, or just moving on with one's life (Wade & Worthington, 2005). But what is forgiveness? On this topic, researchers and clinicians often disagree. Worthington (2005) has suggested that greater consensus exists when one considers two basic types of relationships in which forgiveness can occur. In the case of a transgression by a stranger, forgiveness is defined as reducing one's grudge and giving up negative thoughts, emotions, and motivations. Hence, when dealing with strangers with whom the victim has not had nor desires to have an ongoing relationship, forgiveness is synonymous with the reduction in unforgiveness (defined as a complex of negative emotions, such as bitterness, that develops after ruminating on an offense; Worthington & Wade, 1999). In contrast, in ongoing valued relationships, forgiveness is understood to include both the reduction of vengeful, avoidant, and bitter feelings, thoughts, and behaviors (i.e., unforgiveness) and the increase or promotion of more positive feelings, thoughts, and behaviors. Theoretically, this occurs through replacing negative emotions with more positive, other-oriented emotions such as pity, sympathy, compassion, or even love (Worthington & Wade, 1999). Moreover, forgiveness is distinct from reconciliation (e.g., one may forgive and still decide to end a relationship). Victims who experience forgiveness defined in this way can still hold an offender accountable for the consequences of the offense and can think carefully about whether trust can be restored and the relationship renewed. * Outcome Research on Specific Forgiveness Interventions The first outcome study of an intervention designed explicitly to promote forgiveness was published in 1993 by Hebl and Enright, based on Enright's (Enright & the Human Development Study Group, 1991) process model of forgiveness. Since that time, numerous intervention studies have been conducted, primarily from two research laboratories, Enright's and Worthington's, although others have made significant contributions as well (in particular, Rye & Pargament, 2002; Rye et al., 2005). Most of the outcome research has been conducted in a group, psycho-educational format (for a review, see Wade & Worthington, 2005). However, several studies have been conducted to examine the efficacy of forgiveness interventions in individual counseling (e.g., Freedman & Enright, 1996) and groups of couples (e.g., Ripley & Worthington, 2002). The body of forgiveness intervention research has grown large enough that several meta-analyses have been published summarizing the results. …

Relational spirituality and the development of the Similarity of the Offender’s Spirituality Scale.

Abstract: We present a model of relational spirituality and forgiveness that considers how a victim’s spirituality affects his or her experience of and response to a transgression. In 2 studies, we investigate the psychometric properties of the Similarity of the Offender’s Spirituality Scale (SOS), which assesses the extent to which the victim sees the offender as spiritually similar. Results suggest the SOS has 2 factors that assess the offender’s spiritual and human similarity. The SOS showed initial evidence of construct validity, being related to other measures of spirituality and to measures of the victim’s response to a transgression. The overall model was found to offer incremental validity beyond known predictors of forgiveness. We suggest directions for future research.

Next steps for clinicians in religious and spiritual therapy: an endpiece.

Abstract: To conclude this issue of the Journal of Clinical Psychology: In Session, the authors identify several next steps for clinicians interested in religious and spiritual therapy. They call for more clinically useful definitions of religion and spirituality and suggest that new methods of clinical practice that employ both Western and Eastern religion and spirituality need to be developed and tested. The need for more clinically focused religious and spiritual assessments is highlighted. They recommend greater clergy-psychotherapist collaboration and propose that clinicians lead and collaborate with researchers to further meaningful research on religion and spirituality. Finally, the authors identify areas of graduate training that require strengthening and provide corresponding guidelines.

The dedication to the sacred (ds) scale: adapting a marriage measure to study relational spirituality

Abstract: We describe the development of the Dedication to the Sacred Scale (DS). The measure was created to test a model of relational spirituality and forgiveness. Items from a measure of commitment in couples (Stanley & Markman, 1992) were adapted to assess a victim's dedication to a relationship with the Sacred. In Study 1 (N = 171), confirmatory factor analysis revealed good fit to a single-factor model. We removed poor items and replicated the factor structure on an independent sample in Study 2 (N = 201). In Study 3 (N = 134), the five-item DS showed evidence of construct validity. It was positively related to religious commitment and uncorrelated with social desirability. The DS predicted forgiveness after the variance from religious commitment, desecration, and offender's spiritual and human similarity were removed. Those who viewed the Sacred as a personal being had higher scores than those who viewed the Sacred as impersonal. The current article is based on a new strategy of exploring the relationship between spirituality and forgiveness. Previous research has focused on the question, are people who are more religious more forgiving than people who are less religious (McCullough & Worthington, 1999). Instead, we ask the question, what ways of relating to the Sacred promote or inhibit forgiveness? To help answer this question, we use a model of relational spirituality and forgiveness that describes several ways a victim may perceive that a transgression has spiritual significance (Davis, Hook, & Worthington, 2008; Worthington, 2009). For one of the constructs in our model, we do not have a good measure. Thus, the current article reports on the development of the Dedication Sacred Scale (DS). For both psychological and theological reasons, we adapted a measure of marriage commitment to assess someone's relationship with the Sacred. A New Strategy to Study Spirituality and Forgiveness Most research on spirituality and forgiveness has focused on whether people who are more religious are more forgiving than people who are less religious (Worthington, in press). That is, most studies have treated spirituality as a personality-like trait that is relatively stable across situations and relationships. Such an approach has several drawbacks. First, by treating religiosity as a personality-like trait, researchers are not able to use causal designs. They cannot use experimental or longitudinal designs that investigate changes in spirituality if constructs are not expected to change much. Although religious beliefs, values, and practices are relatively stable, spiritual experiences fluctuate over time. Feelings of closeness, connection, intimacy, and dedication toward the Sacred (i.e., God in our context, though people may sacralize other objects; Pargament & Mahoney, 2005) may vary. Second, if researchers want to study actual offenses, using a trait-like measure of spirituality strains a measurement principle. Measures tend to correlate most strongly when they are measured at the same level-of-specificity (Tsang, McCullough, & Hoyt, 2005). Measuring trait religiosity or trait spirituality to predict forgiveness of specific offenses measures the two constructs at different levels-of-specificity. For this reason alone, one may not find a relationship between religiosity (or trait spirituality) and forgiveness. Third, after over 15 years of using the strategy, research has not authoritatively informed how clinicians help religious clients forgive. Researchers know that religion tends to promote forgiveness; however, little is known about when and why it promotes forgiveness, how people draw on religion to forgive, or how therapists can focus clients' attention to aspects of their religion or spiritual life that will help them achieve forgiveness when they want to forgive someone. For example, are those who are able to remain involved with the same church able to forgive better than those who change churches regularly? …

Lay Christian Counseling and Client Expectations for Integration in Therapy

Abstract: As lay approaches to Christian counseling have multiplied and become increasingly sophisticated, we hypothesize that these might affect expectations of conservative Christian clients for professional integrative psychotherapy. Accordingly, we review several models of lay counseling, broadly categorizing them into active listening, cognitive & solution-focused approaches, inner healing, and mixed models. We consider how client expectations for psychotherapy may be altered through their experiences with these approaches. Subsequently, we make recommendations for clinicians who deal with lay-counseling-experienced clients. These include doing a more detailed assessment of client lay counseling experiences and considering ethical aspects of treatment (informed consent and competency to treat). The integration of psychology and theology has matured since early writings of the 1960s (e.g., Tournier, 1962). It has become a movement with journals, professional organizations, and written ethical guidelines. Those practicing from an integration paradigm are also likely familiar with three other movements exploring the relationship between psychology and theology. These include Nouthetic biblical counseling (Adams, 1970), Christian psychology (Johnson, 2007), and historic Christian soul care (Moon & Benner, 2004). Besides these four approaches to Christian counseling and informal helping, however, a grass roots movement of lay Christian counseling has proliferated throughout church congregations in the United States and beyond (see Tan, 1991, 2002). These lay model developers have influenced tens of thousands of lay counselors and perhaps millions of congregants through their writings and seminars. Yet professional psychologists and counselors often are not familiar with them unless their particular congregation uses one of these approaches. This lay counseling movement has many potentially positive aspects. For example, it may serve people who might not get help otherwise, cannot afford professional therapy, do not wish to use insurance, or have access to counseling limited by managed care. Others belong to churches in which the pastor is either not trained, not interested, or not available (due to having too many other pastoral duties) to meet the needs for pastoral counseling. Still others simply may trust lay people, whom they know, more than a therapist, whom they do not know. In addition, the training itself may benefit the lay counselors spiritually and emotionally. As lay counseling has proliferated, many have attended lay counseling training seminars in their own or neighboring churches. Even people who do not intend to do supervised lay counseling may attend out of a desire to benefit personally. Exposure to lay counseling appears widespread. Hence we suggest a working hypothesis. When many Christians do attend therapy, they might not enter as naive participants. Instead, they might have received lay counseling training themselves or have been in congregations where such training has been offered. To the extent that this may occur, they might bring strong beliefs about what proper, true, Christian, or biblical therapy should consist of. As a result, a curious paradox can emerge. For Christian mental health professionals, surprisingly, the lay counseling movement can create resistance to the extent that the professional therapy differs from the person's implicit theory of Christian counseling. This hypothesis has not been scientifically investigated, but we believe it is reasonable and deserves empirical scrutiny. While such empirical studies might develop (which can require years of effort until publication), we believe it is prudent for professional therapists to consider how lay counseling might be affecting their practice. The present essay and review is offered with the intent of helping therapists understand lay counseling approaches with which they might not be familiar. Among the four of us authors, we represent considerable exposure to various substrates of Christian professional and lay counseling. …

Christian Couple Counseling by Professional, Pastoral, and Lay Counselors from a Protestant Perspective: A Nationwide Survey

Abstract: Couple counseling is widely practiced by Christian counselors, but there are almost no empirical data investigating it. The present study presents data from a national web-based survey of counselors from the American Association of Christian Counselors (AACC). We describe the nature of Christian couple counseling, as well as counselors' religiousness and their attitudes toward integrating religion and spirituality into couple counseling. Christian couple counselors were highly religious and their personal religiosity affected their attitude toward incorporating religion in counseling. There were differences between professional, pastoral, and lay counselors suggesting that each be treated separately rather than be lumped generically as Christian couple counseling.