The Process and Outcome of Spiritually Integrated Psychotherapies: A Cross-Cultural Study in Asia, Africa, Europe, and Latin America

• Published in: Psychotherapy (Chicago, Ill.) Ill.), 2022-09, Vol.59 (3), p.415-430
• Main Authors: Sim, Wonjin, Li, Xu, Hwang, Jeong Yeon, Hill, Clara E., An, Mira, Kim, Da Hwin
• Format: Article
• Language: English
• Subjects: Cross Cultural Psychology; Cross Cultural Treatment; Distress; Female; Foreign Language Translation; Human; Intervention; Male; Psychotherapeutic Outcomes; Psychotherapy; Religion; Spirituality
• ISSN: 0033-3204; 1939-1536
• DOI: 10.1037/pst0000409

We investigated the process and outcome of spiritually integrated psychotherapies (SIPs) with 34 Catholic therapists and 359 clients in Asia, Africa, Europe, and Latin America using a practice-based evidence design. The three most frequently used spiritual interventions across all therapists were: "encouraging personal prayer," "affirming trusting God," and "encouraging listening to the heart," but "discussing hope" was also one of the top three in Asia and Africa, "self-control" in Asia, "spiritual confrontation" and "self-disclosure" in Latin America, and "listening to spiritual issues" in Europe. In addition, using growth curve analyses, we found a significant decrease in both spiritual and nonspiritual distress over the course of SIPs; the levels of spiritual and nonspiritual concerns were highly correlated (but distinct) at any given time point. Also, the nonspiritual outcomes at one session significantly predicted the subsequent session's spiritual outcomes, but not the other way around. Finally, a moderate number of spiritual interventions were associated with a faster decline in nonspiritual distress than was a low number, although we found mixed results regarding whether a high number of spiritual interventions was associated with a faster decline of clients' nonspiritual distress than a moderate number. Results suggest that therapists should attend to spiritual concerns in psychotherapy. Clinical Impact Statement Question: What spiritual interventions are used and what are the spiritual and nonspiritual outcomes of spiritually integrated psychotherapies (SIPs) for Catholic therapists and clients in Asia, Africa, Latin America, and Europe? Findings: Different spiritual interventions were used with clients in different continents; clients reported reductions in spiritual and nonspiritual distress over the course of SIP sessions; spiritual intervention use was also found to correlate with client symptom reduction over time. Meaning: Therapists might consider using spiritual interventions with their clients, especially those whose cultures value spirituality and who are experiencing spiritual distress. Next Step: Future researchers could examine how therapists modify SIPs to fit the needs of clients from different cultures.