Religion/spirituality and health outcomes
Traditional religious practices
The potential health benefits of R/S have been noted in many studies, including less prevalent drug and alcohol abuse (Gorsuch 1995); more effective coping with negative life events
(Pargament 1997; Polonia and Pendleton 1989); and higher resilience (Connor and Davidson 2003). In terms of physical health, one systematic review of 724 quantitative studies on the relationship between religion and health found that 66% of those studies noted a positive relationship between religion and health (Koenig et al. 2001). The specific practice of prayer has been positively associated with pain coping and post-traumatic growth, being linked to providing a sense of meaning/purpose, increasing a sense of control, fostering relaxation, and serving as a means of giving and receiving support (Harris et al. 2010; Wachholtz et al. 2007). Specific research on individuals undergoing rehabilitation for traumatic injuries or other physical medical conditions has found a positive relationship between positive spiritual experiences and better physical and mental health outcomes (Johnstone and Yoon 2009). These authors also note value in addressing R/S in those individuals with acquired disabilities (e.g., traumatic brain injury, stroke, spinal cord injury), who will probably live for a long time with their disability and may find R/S helpful in their adjustment and re-evaluation of life’s meaning over time.
Non-traditional religious practices
Specific less traditional spiritual practices, including yoga and meditation, have also found support in the healthcare literature. Most western yoga instruction is centred on physical postures, breathing, and meditation—and this type of yoga practice has received a great deal of research support for multiple health problems. Ross et al. (2013) note positive associations for individuals with cancer, diabetes, cardiovascular disease, and metabolic syndrome, as well as depression and anxiety. Others have offered personal narrative accounts detailing the use of yoga in their own lives as a path to healing. Sanford (2006) speaks about his journey after becoming paralysed at age 13, then discovering yoga as a young adult and finding a new mind-body connection that he went on to share as a yoga teacher and mentor for people with disabilities. Meditation has a rich tradition itself as a separate spiritual practice and, like yoga, is meant to be a system to alleviate suffering, with much empirical support suggesting its effectiveness in managing pain, depression, and anxiety (Bergemann et al. 2013). Mindfulnessbased meditation in particular has been studied quite extensively and is widely used in mental health settings (Davidson et al. 2003).
Cultural competence
Congruent with psychologists’ ethical responsibility to provide culturally competent and culturally informed care, addressing R/S is required. According to the American Psychological Association (APA), cultural differences include religion and are specifically mentioned in the code of ethics. Thus, not recognising this cultural lens within psychological practice would violate specific ethical standards (APA 2002; Plante 2016).This is similar to psychologists’ conceptualisation of disability as a cultural variable that must be recognised when working with people with disabilities (APA 2005; Hays 2009). Pargament and colleagues (2013) call it “more than good sense” (p. 6) to include R/S in clinical practice, given that such a large portion of the population sees the world though a “sacred lens” (p. 6). Johnstone (2007) also notes that ignoring these important cultural variables can negatively affect an individual’s experience in psychotherapy, such that they may be less open to certain interventions or even discontinue therapy prematurely, not having their “total being” understood. A report from the American Association of Pastoral Counselors (2000) found that this effect may be even more pronounced in individuals with more conservative or devout religious identities, who may be more concerned that clinicians won’t take their beliefs seriously. In fact, in this same report, 75% of respondents indicated that it was important to seek counselling from professionals who would integrate their religious beliefs and values into counselling.