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The construction of religious and cultural meaning in Egyptian psychiatric patient charts
- Author:
- COKER Elizabeth M.
- Journal article citation:
- Mental Health Religion and Culture, 7(4), December 2004, pp.323-347.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper explores the use of religious symbols and metaphors in Egyptian psychiatric inpatient charts to portray psychiatric pathology and, by extension, the role that religious symbols play in constructing psychiatric illnesses. This represents a deconstruction of patient charts, assuming that the psychiatrist chooses aspects of family and patient discourse which best represent unexamined cultural ideas of person and illness, normality and abnormality. All of the psychiatrists writing the charts were Egyptian and shared much of the same cultural background with their patients, excluding their medical training. Therefore, while chart discourse is used to justify a psychiatric diagnosis, it is also the product of a shared cultural history; a tacit agreement about what constitutes a meaningful story. This paper focuses mainly upon discourse that has religious connotations, for the reason that these seemed to be more invested with cultural meaning than other delusional themes. These religious symbols and metaphors are interpreted in light of their symbolic associations with certain existential states, the family unit and with society as a whole.
Assessing clinically significant religious impairment in clients: applications from measures in the psychology of religion and spirituality
- Authors:
- HILL Peter C., KILIAN Macus K.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.149-160.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews measures in the psychological study of religion and spirituality (RS) in terms of Hathaway’s conceptualisation of clinically significant religious impairment (CSRI). It is maintained that RS can be regarded as an endogenous variable impaired by psychopathology. Specific RS measures are discussed in terms of how they may be used to assess RS impairment in clients in terms of performing RS activities, achieving RS goals, and experiencing desired RS states.
Religious issues in diagnosis: the V-Code and beyond
- Authors:
- SCOTT Stacey, et al
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.161-173.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper addresses the issues around considering clients’ religious and spiritual functioning as a matter of client diversity. Such issues may be under appreciated by many clinicians. The introduction of a religious and spiritual problem V-Code (V62.89) into the DSM-IV provided a significant accommodation of client religious and spiritual functioning in contemporary psychodiagnostics. The V-Code allows for explicit identification of a nonpathological religious or spiritual focus in treatment. The nature of and history of the V-Code’s inclusion in DSM-IV is briefly reviewed. The strengths and limitations of the V-Code for raising clinician awareness of the religious and spiritual domain of client functioning is discussed and illustrated by a number of case examples. The V-Code approach is contrasted with Hathaway’s clinically significant religious impairment concept. Both are viewed as making complementary contributions to a religiously and spiritually sensitive clinical practice.
Ethical issues in considering ‘religious impairment’ in diagnosis
- Author:
- YARHOUSE Mark A.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.131-147.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There are several ethical implications of clinician assessment of clinically significant religious impairment (CSRI). This paper draws upon the American Psychological Association’s (APA’s) Code of Ethics (1992) to review relevant ethical principles and standards. It then presents a continuum of responses to the relationship between psychology and religion: religion as harmful, benign neglect of religion, formal: problem-focused, formal: domainfocused, and religion as paradigmatic alternative. This continuum is followed by a discussion of three clinical vignettes and an examination of the potential ethical tensions for each model. The conclusions drawn from this review are that the formal: domain-focused model presents a rationale for inclusion of CSRI in assessment and is the most promising among alternative models for avoiding professional obsolescence, expanding alternatives for clients and clinicians, and enhancing ethical practice and professionalism.
Development of a model for clinical assessment of religious coping: initial validation of the Process Evaluation Model
- Authors:
- BUTTER Eric M., PARGAMENT Kenneth L.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.175-194.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The relationship of religion to mental health has been widely researched in recent years, and has pointed to both positive and negative implications of religious coping. Traditionally, those interested in evaluating coping have looked at the efficacy of a particular coping activity. However, coping theory suggests that no one coping strategy is always effective or ineffective. Instead the efficacy of the coping process depends more on the flow, or process, of coping versus simply the outcomes of coping. This study proposes the Process Evaluation Model of religious coping, which defines well being as the degree to which the elements of the coping process are well integrated. Mental health practitioners and clergy (n¼166) completed a survey instrument developed for this study consisting of six vignettes. Each story reflected different degrees of integration in an individual coping with a personal crisis. Using a mixed design, we found support for the Process Evaluation Model. All participants were able to identify well integrated versus poorly integrated religious coping processes. Clinicians and clergy did not differ in their evaluation despite the historical rift between mental health and religion. Implications for clinical assessment and intervention are discussed as well as future directions for research using the Process Evaluation Model.
Clinically significant religious impairment
- Author:
- HATHAWAY William L.
- Journal article citation:
- Mental Health Religion and Culture, 6(2), July 2003, pp.113-129.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Recent psychodiagnostic practice, as embodied in the DSM IV, requires that psychopathological features result in a ‘‘clinically significant impairment’’ to qualify as a ‘‘mental disorder’’ in many cases. The impairment must be in social, occupational, or other important areas of functioning. The current proposal is that clinicians should consider the potential impairment in religious functioning arising from mental disorders in diagnostic process. It is suggested that psychopathology may result in a clinically significant religious impairment that is defined as a reduced ability to perform religious activities, achieve religious goals, or to experience religious states, due to a psychological disorder. Various existing approaches to studying the relationship between religious functioning and psychopathology are briefly reviewed and oughly categorized as either focused on ‘symptomatic religiosity’ or reflecting a ‘religiously sympathetic’ posture. Yet, in both of these approaches, religion has predominantly been construed as an exogenous variable contributing to mental health in some fashion (for good, for ill, or for both). The current proposal suggests that clinicians should also consider religion in endogenous perspective. So construed, religion is a significant domain of adaptive functioning, which may be adversely impacted by psychopathology. A discussion of various clinical, research and ethical issues involved in realizing the proposal is provided.
Social work and Koranic mental health healers
- Authors:
- AL-KRENAWI Alean, GRAHAM John R.
- Journal article citation:
- International Social Work, 42(12), January 1999, pp.53-65.
- Publisher:
- Sage
The healing activities of six Arab Muslim Koranic healers working in the Negev desert, West Bank and the Gaza Strip are analysed with respect to healer characteristics, the process of becoming a healer and the stages of treating mental illness, including pre-diagnosis, diagnosis, and treatment. Prospects are considered for mutual integration, observation, and dissemination between social work and Koranic healing.