1. Spirituality and Healthcare
ONCE UPON A TIME I WAS GOING TO BE A PHYSICIAN. MY DAD WAS A PHYSICIAN IN LAKEVIEW, OREGON, AND THE ENTIRE COMMUNITY, MYSELF INCLUDED, BELIEVED I WAS GOING TO GO TO COLLEGE, THEN TO MEDICAL SCHOOL, AND THEN COME BACK AND JOIN MY DAD IN PRACTICE.
WELL I WENT TO COLLEGE, AND THERE I RAN IN DR. WOODWARD AND 8AM CHEMISTRY. ABOUT 10 MAJORS LATER I WAS A DOUBLE MAJOR IN ENGLISH LITERATURE AND PHILOSOPHY.
EVENTUALLY I DID BECOME A DR. A DOCTOR IN THEOLOGY, BUT I NEVER BECAME AN MD. RIGHT AFTER I GOT MY DEGREE SOMONE ASKED MY SON, ABOUT 5 AT THE TIME, HOW IT FEL TO HAVE A DAD WHO WAS A DR. BRYCE, THINKING ONLY MDS LIKE GRANDAD WERE REAL DRS SAID, “OH ITS OK, BUT HE’S NOT THE KIND WHO DOES ANYONE ANY GOOD.”
I HAVE TO ADMIT I’VE ENJOYED MY JOURNEY THROUGH LIFE. I SPENT 14 YEARS AS A PRESBYTERIAN MINISTER, WORKED WITH NW MEDICAL TEAMS AND WORKED WITH THE POOREST OF THE POOR IN PLACES LIKE SOUTHERN MEXICO, DOING MEDICAL/COMMUNITY DEVELOPMENT WORK. NOW I HAVE BEEN AT OHSU FOR ALMOST 7 YEARS.
THROUGH ALL OF THIS I HAVE LEARNED A LOT. AS I HAVE STUMBLED ALONG I HAVE DISCOVERED THAT OFTEN BIG THOUGHTS COME IN SMALL PACKAGES…… IN SENTENCES, PHRASES THAT CATCH ONES ATTENTION, AND PROPEL ONE ALONG NEW PATHS OF THOUGHT. I ALSO HAVE DEVELOPED A TENDENCY TO ENCAPSULATE MY LEARNINGS INTO SUCH PHRASES OR SENTENCES……..
NOW I WOULD LIKE TO SAY THAT THE MOST POWERFUL SAYINGS CAME THROUGH THE “GREAT THINKERS” SUCH AS NIETCHE, HEGEL, KANT, FOR FROM ANCIENT SAGES SUCH AS PLATO OR ARISTOTLE. ADMITTEDLY THESE WRITERS OFTEN COME UP WITH INTERESTING A STIMULATING IDEAS. WE ARE ALL FAMILIAR WITH THE EMPIRICIST’S CLASSIC POSER….”IF A TREE FALLS IN THE FOREST AND NO LIVING BEING IS THERE TO OBSERVE IT, DOES IT STILL FALL?” THIS QUESTION HAS BEEN ALTERED IN MORE MODERN TIMES TO READ, “IF A MAN SPEAKS IN THE FOREST AND THERE IS NO WOMAN THERE TO HEAR HIM, IS HE STILL WRONG?”
BUT IT HAS BEEN IN THE MIDDLE OF DAILY LIFE, AND FROM FRIENDS THAT I HAVE FOUND MUCH OF THE WISDOM THAT SHAPES MY THINKING AND HELPS M,E ORDER MY UNIVERSE. THINK ABOUT THESE STATEMENTS
MEN ARE FROM EARTH, WOMEN ARE FROM EARTH, DEAL WITH IT.
YOU CAN NEVER DO JUST ONE THING.
I MAY NOT BE TOTAL PERFECT, BUT PARTS OF ME ARE EXCELLENT
Just this week a wise family doctor gave me a phrase I will probably use a lot in the coming years.
¨     What you see is less than what you get.
 Some of those statements might be seen as humorous
be there is something in them that makes one pause and think
Stephen Kliewer, D.Min
Department of Family Medicine
Oregon Health Science University
Executive Director
Wallowa Valley Center for Wellness

2. Religion Has Been Labeled:
A universal obsessional neurosis infantile helplessness a regression to primary narcissism.
Freud, S. Civilizations and its Discontents, 1959.
Let me digress for a moment into the relational history of medicine and spirituality
In the beginning these two worlds were in fact united. Indeed at one time medicine and religion were so thoroughly entwined that the medicine man was a priest, and the priest was the healer. In fact religion and medicine continued to be closely linked until the end of the medieval period. The first hospitals were founded in monasteries, the earliest physicians were usually monks. Women in religious orders were often healers as well.
  Then came the advent of the Scientific Revolution. This revolution had its roots in the work of philosophers like Descartes, Hume, and Locke, who promoted a new method for seeking knowledge. Truth could be discerned, Descartes insisted, ONLY through the examination of empirical data and a rational, scientific method. Building upon this notion, remarkable people helped to create the Scientific Revolution, and generated an unprecedented rise in knowledge in all scientific fields.
  But since this new experimental method could not be readily or confidently applied to God, or to one’s experiences with God, religion was rooted out of science, and a chasm emerged between spirituality and religion and science and medicine. A chasm that was widened by the tendancy of religion to be a defender of the status quo, and to reject many of the new discoveries that emerged as a result of the scientific method.
  Indeed in the minds of many devotees of science, religion and spirituality became negatives, and this attitude carried forward into modern times.
Let us take the comments made by leading health professionals over the years as an example of this enmity.
·        Sigmund Freud: Religion would thus be the universal obsessional neurosis of humanity, ……Historical residues have helped us to view religious teaching, as it were, as neurotic relics…..
·        Albert Ellis (founder of the Rational Emotive Therapy Inst. In NY.) wrote:…. Devout orthodox or dogmatic religion is significantly correlated with emotional disturbance.
·        Wendell Watters, a physician and professor psychiatry at McMaster University in Ontario, Canada…. Christian indoctrination is a form of mental and emotional abuse that can adversely affect bodily health in the same way a drug can.
3rd Edition of the APAs Diagnostic and Statistical Manual of Mental Disorders (DMS – III – R) the only 12 references to religion in the Glossary of Technical Terms are used to illustrate psychopathology (this has now been changed)

3. Negative Views (cont.)
Mandel: Spirituality is a “temporal lobe dysfunction” (The Psychobiology of Consciousness, 1980.)
Wendell Watters: “Religion is not only irrelevant but actually harmful to human beings.” (Deadly Doctrine: Health, Illness and God-talk, 1992)
Albert Ellis: “Devout orthodox or dogmatic religion is significantly correlated with emotional disturbance.” (Journal of Consulting and Clinical Psychology, 48 [1980])

4. DSM-III-R Misrepresentation of Religion
Of 45 case examples used to illustrate psychopathology in the DSM-III-R Glossary of Technical Terms:
10 (22.2%) had religious content.
2 (4.4%) had occupational content.
1 (2.2%) had family content.
NONE had sexual, ethnic, racial, age, gender, educational, or cultural content.
Larson DB, et al. (1993). American Journal of Psychiatry 150:12.

5. A Changing Climate
A search of a large public library database of popular magazines using the key words “spirituality and health” had the following results
= 25 articles
= articles
A search of MedLine using the key word “spirituality”
= 52 articles
= 90 articles
= articles
THE IMPORTANT THING TO NOTE IS THAT THE CHASM IS BEGINNING CLOSE
A LOT OF PHYSICIANS ARE BEGINNING TO THINK ABOUT INTEGRATING MEDICINE AND SPIRITUALITY
AND THE INTEREST IN THIS INTEGRATION IS GROWING AMONG MEDICAL PROFESSIONALS AT A RAPID RATE
NATIONWIDE.

6. Why?
One major reason healthcare providers are beginning to integrate spirituality into their practices is the fact that most of their patients have a faith of some kind.

7. Patients Believe Faith is Important! U.S. Beliefs: Faith and Health
79% Believe spiritual faith can help one
recover from illness, injury, or disease
56% Believe their faith helped them recover
from illness, injury, or disease
63% Believe doctors should talk to patients
about their spiritual faith
Only 10% of doctors have done so
USA Weekend, April 5-7, 1996.
PEOPLE ARE NOT JUST SPIRITUAL
THEY ARE CONSCIOUS OF THIS SPIRITUAL DIMENSION
AND THEY UNDERSTAND IT TO BE IMPORTANT
FOR LIFE
AND FOR HEALING

8. Patients Have a Spiritual Dimension U. S
Patients Have a Spiritual Dimension U.S. Religious Beliefs and Attitudes
Item % U.S. Population
Feel God loves people 90%
Believe in power of prayer 88%
God performs miracles today 85%
Mind over matter -
God not involved 11%
Emerging Trends, Princeton Religious Research Center, 1996.
THE SPIRITUAL NATURE OF PEOPLE IS HARD TO DENY WHEN YOU LOOK AT STATISTICS SUCH AS THESE

9. Compassionate Care
Technological advances of the last century tended to change the focus of medicine from a caring, service-oriented focus, to a technological, cure-oriented focus.

10. The impetus from research. The impact of spiritual practices
Mortality: People who have regular spiritual practices tend to live longer.
Coping: Patients who are spiritual utilize their faith in coping with illness, pain, and life stresses.
Recovery: An active spirituality tends tends to enhance recovery from illness and surgery.
Prevention: Spirituality helps prevent negative behaviors such as abuse, smoking, addiction and self harm.

11. Coping Pain questionnaire to hospitalized patients
Most commonly used methods for pain management.
Pain Pills %
Pain IV Med %
Prayer %
Pain Injections %
Relaxation Techniques 33%
Touch %
Massage %
McNeill, JA, et. al., J of Pain and Symptom Management, 1998;16(1):29-40

12. Coping with impending death
According to a Gallup survey the key elements for finding comfort in the process of dying were:
Companionship
Spiritual Comfort

13. Issues addressed by dying patients
The importance of a patient’s relationship to God or a Higher Power and to other people is based in the key questions one asks when facing death.
Why is this happening to me?
What will happen to me after I die?
Has my life had meaning? Have I made my mark?
Will I be missed and remembered?
Is there a God? Will that God be there for me?

14. Research in Spirituality and Health Positive and Negative Religious Coping
Positive Coping: Patients showed less psychological distress:
- seeking control through a partnership with God or a Higher Power in problem solving
- asking God’s forgiveness and trying to forgive others
- finding strength and comfort from one’s spiritual beliefs
- finding support from spiritual/religious community

15. Research in Spirituality and Health Positive and Negative Religious Coping
Negative Coping: Patients have more depression, poorer quality of life and callousness towards others
- seeing the crisis as punishment from God
- excessive guilt
- absolute belief in prayer and cure; inability to
resolve anger when cure does not occur
- refusal of indicated medical treatment

16. Prevention: Religion and Depression in Hospitalized Patients
Percent
Depressed
SO, WHY MEDICINE AND SPIRITUALITY……
IT HONORS THE WHOLE PERSON
REASON TWO, IT SEEMS TO HELP. THOSE WHO HAVE STUDIED THE IMPACT OF RELIGION AND SPIRITUALITY ON HEALTH, PEOPLE SUCH AS DAVID LARSON, HAROLD KOENIG AND OTHERS,
SUGGEST THAT IT HAS A NUMBER OF POSITIVE VALUES
IT HELPS PEOPLE COPE
IT HELPS THEM AVOID ILLNESS
AND IT MAY ACTUALLY AFFECT THE PROGRESSION OF DISEASE.
TAKE A LOOK AT THIS STUDY……..THIS IS A STUDY ON BOTH COPING AND PREVENTION.
Degree of Religious Coping
Depression assessed by self-rated Geriatric Depression Scale; religious coping by Religious Coping Index.
Source: Information based on results from 991 consecutively admitted patients (differences significant at p<.0001). Koenig (1994). Aging and God. Binghamton, NY: The Haworth Press.

17. Prevention: Church Attendance and Suicide Rates17 12 7 2
Suicide
Rate
per
100,000/yr
Church Attendance (Mean)
WE HAVE A SIMILAR STUDY HERE
WE SEE THE PREVENTION OF SUICIDE
REFLECTING AN ENHANCED ABILITY TO COPE
AND A PREVENTION OF DEPRESSION.
Source: Martin, W.T. (1984). Religiosity and United States suicide rates. Journal of Clinical Psychology 40:

18. Outcomes: Effects of Religiousness on Diastolic Blood Pressure
THIS STUDY ACTUALLY ADDRESSES A PHYSICAL CONDITION
ACTUALLY A LOT OF WORK HAS BEEN DONE LOOKING AT THE IMPACT OF SPIRITUALITY AND SPIRITUAL PRACTICES SUCH AS CHURCH GOING AND MEDITATION, ON BLOOD PRESSURE
HERBERT BENSON AT HARVARD
JAMES GORDON IN WASHINTON DC ARE TWO OF THE LEADERS WHO SUGGEST THAT SPIRITUAL ACTIVITY CAN ACTUALLY BE USED, WITH OR EVEN INSTEAD OF MEDICATION, TO HELP PEOPLE WITH THIS PROBLEM.
THIS STUDY REFLECTS THE IMPACT SPIRITUALITY ON DIASTOLIC BP
High-High: high church attendance, high religion importance.
Low-Low: low church attendance, low religion importance.
Source: Data from 407 men in the Evans County Cardiovascular Epidemiologic Study (p<.005). Larson, D., H. Koenig, B. Kaplan et al. (1989). Journal of Religion and health 28:

19. Research in Spirituality and Health Immune System Functioning: Study of 1,700 older adults
Those with attending church were half as likely to have elevated levels of IL-6
Increased levels of IL-6 are associated with Increased incidence of disease
Hypothesis - religious commitment may improve stress control through:
- better coping mechanisms
- richer social support
- strength of personal values and world-view
Koenig, Cohen, George, (1997) International Journal of Psychiatry in Medicine 26, p. 242 (Study sponsored by the National Institute on Aging).

20. Positive Therapeutic Effects of Intercessory Prayer in a Coronary Care Unit Population
This study took 393 patients hospitalized in the coronary care unit of San Francisco General Hospital .
Byrd, a cardiologist, randomly split the patients into two groups.
192 patients received intercessory prayer by Christian prayer groups located outside the hospital.
201 patients (the control group) received no prayer by the groups.
This was a double blind study. Neither the patients nor their physicians knew that they were being prayed for.
IN TERMS OF OUTCOMES, THIS IS PROBABLY THE MOST FAMOUS STUDY.
IT IS UNIQUE BECAUSE IT ACTUALLY INTRODUCES A SPIRITUAL INTERVENTION
INTERCESSORY PRAYER……..
ALL THE STUDIES WE HAVE SEEN PREVIOUSLY SIMPLY NOTED AN TREND THAT SURFACED
WHILE SOMETHING ELSE WAS BEING STUDIED, AND AN IMPACT THAT RELATED TO A PREVIOUSLY
EXISTING RELIGIOUS CONVICTION.
THERE ARE PROBLEMS WITH THIS STUDY,
PATIENTS WERE SCREENED BECAUSE OF THE IRB RULES
WHO KNOWS WHO ELSE WAS PRAYING FOR THE CONTROL GROUP, OR WHAT THEY WERE PRAYING FOR….
BUT IT IS SUGGESTIVE AND INTERESTING.
A RECENT STUDY DONE IN THE MIDWEST BY HARRIS AND OTHERS ATTEMPTED TO REPLICATE THIS STUDY.
IT TOOK 1013 PATIENTS ADMITTED TO THE CCU OVER 12 MONTHS AND SPLIT THEM INTO TWO GROUPS
AGAIN THE NUMBER OF NEW DIAGNOSES, INTERVENTIONS, ETC WERE STUDIED THROUGH A RETROSPECTIVE CHART REVIEW. THE RESULTS WERE SIMILAR. THIS STUDY WAS PUBLISHED IN THE ARCHIVES OF INTERNAL MEDICINE IN 1999.
BUT LET ME BE HONEST HERE. ALTHOUGH THE RESEARCH IS INTERESTING, AND IT MAKES THE CME PEOPLE HAPPY, THE REALLY POWERFUL REASONS FOR THINKING ABOUT THE INTEGRATION AND MEDICINE PROBABLY COME OUT OF THE EXAM ROOM.
DAD’S STORY.
The Results
New Problems or Events Prayer Control
Congestive heart failure 4 10
Cardiopulmonary arrest 3 8
Pneumonia 2 7
Antibiotics needed 2 7
Diuretics needed 2 9
Good track (no new diagnosis/therapy) 85% 73%
Bad track (high morbidity risk/died) 14% 22%
Byrd RC, (1988). Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Medical Journal, 81:

21. Illness Prevention: Survival and Mortality
30-year follow-up of nearly 7,000 persons living in Alameda County, CA initially seen in 1965; comparing frequent church attendees to infrequent attendees:
I. Frequent attendees had lower mortality rates (Relative Hazard=0.65)
Strawbridge et al. (1997). American Journal of Public Health, 87:

22. Illness Prevention: Survival and Mortality
II. During follow-up frequent attendees were:
a. more likely to stop smoking
b. more likely to increase exercising
c. more likely to increase social contacts
d. more likely to stay married
III. Adjusting for the 4 health practices did not
change frequent attainder's mortality rates.
Strawbridge et al. (1997). American Journal of Public Health, 87:

23. Common Criticisms
1. Studies suggesting a relationship between spirituality and health are flawed
2. The unique nature of the patient/physician relationship causes physician assumptions and beliefs to have undue influence,
3. That physicians have no expertise in spiritual matters (this is a fascinating statement!)

24. Common Criticisms
Most patients do not truly want to discuss spiritual issues and interest does not necessarily justify the incorporation of religious matters, and
5. The integration of spirituality into practice is an attempt to use religion that trivializes a deep and complex reality.
Sloan RP, et al, “Should Physicians Prescribe Religious Activities?” NEJM, June 22, 2000, 342(25) Sounding Board.
Sloan RP, Bagiella E, Powell T, "Religion, spirituality, and medicine," Lancet, 1999;353:

25. PERSONHOOD
Body
Soul
Social Self
Spiritual Self

26. DIMENSIONS OF SPIRITUALITY
Dimensional Spirituality
Ideological (beliefs and values)
Intellectual (raw knowledge)
Ritualistic (not just religious ritual)
Experiential
Consequential (influence of spirituality on daily activities
Supportive (the community)

27. MODELS OF SPIRITUALITY
DOMAIN MODEL
Beliefs
Practice
Experience
Life Situation
Spiritual Thoughts
Outcomes
JOURNEY MODEL
RELATIONSHIP MODEL

28. THE IMPACT OF SPIRITUALITY
Spirituality can have, potentially, both a positive and a negative effect on us.
Remember, what happens in one facet of our being impacts all other facets, so what happens spiritually impacts us socially, emotionally, mentally, and physically.

29. THE DARK SIDE OF SPIRITUALITY
Hopelessness/helplessness
Anger: Unfairness, Abandonment
Guilt/Curse
Confusion and Doubt (Fear)
Fear and Vulnerability (Despair)
Isolated/Alone

30. Spiritual Distress Spiritual Alienation Spiritual anxiety
“Where is God when I need God most?”
“Why isn’t God listening?
Spiritual anxiety
“Will I ever be forgiven”
“Am I going to die a horrible death?”
Spiritual Guilt
“I deserve this.”
“I didn’t pray hard enough”
Plotnikoff, MD, MTS, “Should medicine reach out to the spirit?, Postgraduate Medicine, Nov. 2000, Vol 108:6;19-25

31. Spiritual Distress Spiritual Anger Spiritual Loss “I feel empty”
“I’m mad at God”
“I blame God for this”
Spiritual Loss
“I feel empty”
“I don’t care anymore”
Spiritual Despair
“There is no way God could ever care for me.
“I’m just a corpse waiting to happen.”
Plotnikoff, MD, MTS, “Should medicine reach out to the spirit?, Postgraduate Medicine, Nov. 2000, Vol 108:6;19-25

32. EXAMPLES OF SPIRITUAL STRENGTH
Spiritual Meaning
“I am amazed how much I have been learning”
Spiritual Blessing
Spiritual Hope
“I know I’ll be OK, no matter what!”
Spiritual Empowerment
“I am so thankful for being able to rebuild my relationship with my father”

33. EXAMPLES OF SPIRITUAL STRENGTH
Spiritual Blessing
“I am so thankful for my doctors, and family, and all that is being done for me. I know I haven’t lived a perfect life, but God is working through so many people to help me.”
Spiritual Courage
“I know I am not doing well, and frankly I am afraid of what will happen as the disease gets worse, but I am counting on the prayers of my friends, and God’s love to see me through

34. EXAMPLES OF SPIRITUAL STRENGTH
Spiritual Meaning
“I am amazed how much I have been learning”
Spiritual Blessing
Spiritual Hope
“I know I’ll be OK, no matter what!”
Spiritual Empowerment
“I am so thankful for being able to rebuild my relationship with my father”

35. Non-Verbal Clues Tone of Voice Body Language Behavior
You can think about these elements as you talk with others, but it is also helpful, at times, to do a “self scan.” To look at one’s self in the “mirror” as it were, and think about what one’s tone, body language, and behavior is saying.

36. SPIRITUAL POLARITIES Despair – Hope Helplessness – Empowerment
Anger – Forgiveness
Guilt – Restoration
Fear – Serenity
Isolated/Alienated – Connected
Lost/Confused - Purpose

37. SPIRITUAL SCREENING Despair Hope Dread Courage
Helplessness Empowerment
Curse Blessing
Meaninglessness Fullness
Hodges S, “Spiritual Screening: The Starting Place for Intentional Pastoral Care, Chaplaincy Today, 15:1 (1999)

38. UNIVERSAL FILTERS This comes out of neurolinguistic programming.
Distortion: (Interpreting based on belief system, or making a process into a completed event).
Generalization: (I’m scared…. Of people)
Deletion: (I’m struggling…. With what?)

39. REFLECTION Think of a time you deleted important information.
Think of a topic where you moved to the level of generalization.
Can you remember a time when you distorted information? What was the issue?

40. SPIRITUAL & RELIGIOUS CHANGES
Have you ever had a significant change in your spiritual affiliation or practice?
What was the event or situation that was the catalyst?
What were the feelings attached to the event?

41. TROUBLING BELIEFS Faith equals healing Faith as prophylactic
Illness equals sin
Faith equals passivity
Authority equals mandate
All is from God
Suffering servant

42. Outcomes Gave Client Something To Think About
Helped Identify Key Stressors
Restored Hope/Faith/Harmony
Helped Deal with Ambiguity
Renewed Purpose/Meaning
Provided Closure
Helped Resolve Issued Identified
Adapted from: Rodrigues B, Rodrigues D, Casey DL, “Spiritual Needs and Chaplaincy Services, A National Empirical Study on Chaplaincy Encounters in Health Care Settings”, Providence Health Systems, 2000

43. CATEGORIES OF INTERVENTIONS
Empathic Strategies
Information Gathering/Assessment Strategies
Reflecting/Challenging Strategies
Facilitative Strategies
Collaborative Strategies

44. Key Interventions Affirmation/Comfort/Gift of Presence
Sacrament/Prayer/Ritual/Meditation
Verbalize Meaning of Illness/Loss/Change
Name and Make Use of Spirituality/beliefs
Grief Facilitation
Move Toward Use of Appropriate Medical Care (including 12 Step Programs)
Adapted from: Rodrigues B, Rodrigues D, Casey DL, “Spiritual Needs and Chaplaincy Services, A National Empirical Study on Chaplaincy Encounters in Health Care Settings”, Providence Health Systems, 2000
Also
Fact Sheet, National Institute for Healthcare Research, November 1999

45. Key Interventions Counseling/Dialogue
Explore Perceptions/Images of God
Explore Relations-God and Others
Examine Faith-Health Relationship
Make Sense of Events
Crisis Intervention
Decision Support
Ethical Deliberations

46. Assessment Tool BATHE Background: What is going on in your life?
Affect: How do you feel about what is going on?
Trouble: What troubles you the most?
Handling: How are you handling that?
Empathy: After exploring these issues with clients it is important to let them know you heard them and that you empathize with what they are experiencing.
From - The Fifteen Minute Hour: by Marian R. Stuart and Joseph A. Lieberman.

47. BRIEF INTERVENTION
1. General Opening: Religious or spiritual issues often influence how patients deal or cope with ……... Some people find their spiritual beliefs to be very helpful, while others do not find them helpful or never real thing about these things at all. I would be interested to understand better how you feel about this.
Rhodes M, Kristeller JL, “The OASIS Project: Oncologist-Assisted Spirituality Intervention Study, American Psychological Association, 8/8/00

48. BRIEF INTERVENTION
2. Inquiry About Beliefs: What part if any, do your spiritual beliefs play in how you have been dealing with…………?
Rhodes M, Kristeller JL, “The OASIS Project: Oncologist-Assisted Spirituality Intervention Study, American Psychological Association, 8/8/00

49. BRIEF INTERVENTION 3. Exploring Beliefs
Supportive/Positive God
Positive/Non Specific
Spiritual Conflict/Anger or Guilt
Rejecting Spiritual/Religious beliefs
4. Exploring Sources of Meaning and Peace:
Are there ways in which you have/can find a sense of
meaning and peace through all of this?
Rhodes M, Kristeller JL, “The OASIS Project: Oncologist-Assisted Spirituality Intervention Study, American Psychological Association, 8/8/00

50. BRIEF INTERVENTION
5. Exploring Communication with others: Is there anyone else you can talk to?
6. Exploring Availability of other Resources:
7. Closure:
Rhodes M, Kristeller JL, “The OASIS Project: Oncologist-Assisted Spirituality Intervention Study, American Psychological Association, 8/8/00

51. OTHER INTERVENTIONS Use of the “spectrum” The A-B-C-D-E system
Self talk
Meditation
Relaxation Response
Prayer
There are many ways to use your spirituality to promote cure.

52. Thanks
I appreciate the time you have taken to participate in this workshop. The ideas presented have come from many sources. To get details on all of these materials I would refer you to the book put together by myself and Dr. John Saultz, Chair of Family Medicine at OHSU.
Kliewer, S. P., & Saultz, J (2006). Healthcare and Spirituality. Abingdon, UK: Radcliffe Medical Press.