Study: Discuss Religion, Spirituality When Treating Young Adults with Severe Mental Illness

Oct 22, 2018

5 min

Holly Oxhandler, Ph.D.

Baylor researcher and expert says it’s “critical” that mental health providers be equipped to assess clients’ religion/spirituality


A majority of young adults with severe mental illness – bipolar disorder, schizophrenia or major depression – consider religion and spirituality relevant to their mental health, according to a new study from Baylor University’s Diana R. Garland School of Social Work.


Holly Oxhandler, Ph.D., associate dean for research and faculty development in the Garland School of Social Work, served as lead author on the study, which was published in the journal Spirituality in Clinical Practice.


Researchers examined data from 55 young adults (ages 18-25) with serious mental illness who had used crisis emergency services. Of the 55 young adults interviewed, 34 “mentioned religion or spirituality in the context of talking about their mental health symptoms and service use with little-to-no prompting,” researchers wrote.


The sample for the study was racially diverse and gender-balanced. Not all of those interviewed considered themselves religious, as 41 percent answered “other,” “I don’t know” or “none” when asked their religious preference. However, researchers found that religion and spirituality emerged as a unique way in which this sample was able to make sense of their difficult life situations and mental health struggles.


“Not only did these young adults struggle with serious mental illness, but they had also experienced extreme adversity – including abuse, poverty, homelessness, addiction, near-death experiences, loss and an overwhelming lack of access to medical and mental health services,” researchers wrote. “Yet, many attempted to explain, make sense of or organize their circumstances through their religious/spiritual perspective and talked about God as a source of comfort and support.”


The young adults expressed both positive and negative views of God, prayer and support from religious and spiritual communities. Regardless of their views, the important thing to note, Oxhandler explained, is that they’re talking about these topics – something social workers and counselors traditionally are not often equipped or trained to assess or discuss.


“It’s the elephant in the room,” Oxhandler said of discussions of religion and spirituality. “If we continue to ignore it, we’re ignoring a huge component of peoples’ lives that may be tied to the clinical issue.”


Oxhandler, who has researched this area extensively, said such discussions can help drive subsequent treatment options.


“As mental health care providers discern what mental health services to provide or coping strategies to recommend, it’s especially important they understand the role of religion/spirituality in the lives of the vulnerable young adults they serve,” she said.


Researchers also found that those surveyed described using positive religious coping, negative religious coping or experiences, discussed their relationship with God/Higher Power and unpacked the role of their support systems and faith.


Positive religious coping included prayer, reading religious texts, support from their religious and spiritual communities and identifying religious and spiritual meaning in difficult situations.


Negative religious coping or experiences included having a negative experience with a religious organization not being supportive or receiving hurtful messages from the religious community.


“Those who discussed their relationship with God or a higher power discussed God providing a sense of comfort or protection, accepting them for who they are or positively intervening in their lives,” Oxhandler said. “Among those who unpacked the role of their support systems and faith, they often described family and friends referencing religion or God for support, and some even offered recommendations for others struggling with mental illness that involve religion and spirituality.”


Some of those interviewed shared that they found the mention of God or religion by family and friends less than helpful.


For example, a 22-year-old white female with no religious identification mentioned in her interview that a family member “tries to tell me that going to church will be better for me because it will help me find peace, and it really does quite the opposite.”


Interestingly, researchers noted that nearly all participants who reported negative experiences with religion and spirituality also reported utilizing positive religious and spiritual coping or having a positive relationship with God.


Oxhandler said such complexity highlights the importance of including religion and spirituality during the initial assessment with a client.


“It’s critical that mental health care providers be well equipped and trained to assess for the complex role of religion and spirituality in the lives of young adults with serious mental illness, recognizing that it could appear to be a tremendous source of support and resilience and/or a source of pain and discomfort, if even a part of their lives at all,” she said.


ABOUT THE STUDY

Religion and Spirituality Among Young Adults With Severe Mental Illness,” published in the journal Spirituality in Clinical Practice, is authored by Holly K. Oxhandler, Ph.D., L.M.S.W., assistant professor and associate dean for research and faculty development, Diana R. Garland School of Social Work, Baylor University; Sarah C. Narendorf, Ph.D., L.C.S.W., assistant professor, Graduate College of Social Work, University of Houston; and Kelsey M. Moffatt, M.S.W., Diana R. Garland School of Social Work, Baylor University.


ABOUT BAYLOR UNIVERSITY

Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions.


ABOUT DIANA R. GARLAND SCHOOL OF SOCIAL WORK

Baylor University’s Diana R. Garland School of Social Work is home to one of the leading graduate social work programs in the nation with a research agenda focused on the integration of faith and practice. Upholding its mission of preparing social workers in a Christian context for worldwide service and leadership, the School offers a baccalaureate degree (B.S.W.), a Master of Social Work (M.S.W.) degree and three joint-degree options, M.S.W./M.B.A., M.S.W./M.Div. and M.S.W./M.T.S., through a partnership with Baylor’s Hankamer School of Business and George W. Truett Theological Seminary, and a Ph.D. program. Visit www.baylor.edu/social_work to learn more.

Connect with:
Holly Oxhandler, Ph.D.

Holly Oxhandler, Ph.D.

Associate Dean for Research and Faculty Development, Associate Professor, Diana R. Garland School of Social Work

Social work expert in the ethical integration of clients' religion and spirituality in evidence-based mental and behavioral health treatment

Religion and Spirituality in Clinical PracticeMentoring and Professional DevelopmentMental Health

You might also like...

Check out some other posts from Baylor University

2 min

Historical Significance of the Papal Name

In the wake of the historic election of Pope Leo XIV, the first American to ascend to the papacy, scholars and observers alike are reflecting on the global, historical and theological implications of his early statements and symbolic choices. His decision to take the name Leo – a name not used for over a century – immediately evokes comparisons to both Leo XIII and Leo I (Leo the Great), popes known for their firm leadership and dynamic engagement with the world. Baylor University’s Elisabeth Rain Kincaid, J.D., Ph.D., director of the Institute for Faith and Learning and an expert on early modern theology and Catholic Social Thought, said choosing the name Leo is significant, especially in today’s world. Through his choice of name, rhetorical style and theological references, the new pope is signaling a clear vision for a Church that is simultaneously grounded in tradition and open to global dialogue, Kincaid said. Kincaid is currently at work on a monograph – “Business Ethics for a Flourishing Life: Catholic Social Thought in the Modern Workplace” – in which she argues for the continued importance of Leo XIII’s thought for modern life. If you're covering the news about Pope Leo XIV and are looking to know why Cardinal Robert Prevost chose that name - we can help. Elisabeth Rain Kincaid is an author, speaker, teacher, and theologian. She has published broadly in peer-reviewed journals and popular publications. She is a frequent speaker at conferences, churches, and professional events on topics including business ethics, virtue and character, Christian engagement with law and politics, and work and vocation. She is currently the Director for the Institute for Faith and Learning at Baylor University. In her teaching, she draws upon her years of experience as a white-collar criminal defense attorney and a private equity professional, along with her ministry experience. Elisabeth is available to speak with media about this topic - simply contact Shelby Cefaratti-Bertin, M.A., Assistant Director of Media and Public Relations at Baylor University, Shelby_Cefaratti@baylor.edu or 254-327-8012 to arrange an interview today.

5 min

Digital Dementia: Does Technology Use by ‘Digital Pioneers’ Correlate to Cognitive Decline?

As the first generation that interacted with digital technology reaches an age where dementia risks emerge, scientists have asked the question: Is there a correlation between digital technology use and an increased risk of dementia? With the phrases “brain rot” and “brain drain” circulating on social media, it would appear that most people would assume the answer is yes. However, a new study in Nature Human Behavior by neuroscientists at Baylor University and the University of Texas at Austin Dell Medical School reveals the opposite – digital technologies are actually associated with reduced cognitive decline. The study – A meta-analysis of technology use and cognitive aging – was sparked by the ongoing concern about the passive activity of digital technologies and their relation to accelerating risks of dementia. Study co-authors are Jared F. Benge, Ph.D., clinical neuropsychologist and associate professor of neurology at Dell Medical School and UT Health Austin’s Comprehensive Memory Center within the Mulva Clinic for the Neurosciences, and Michael K. Scullin, Ph.D., associate professor of psychology and neuroscience at Baylor. “You can flip on the news on just about any day and you’ll see people talking about how technologies are harming us,” Scullin said. “People often use the terms ‘brain drain’ and ‘brain rot,’ and now digital dementia is an emerging phrase. As researchers, we wanted to know if this was true.” The “digital dementia” hypothesis predicts that a lifetime of exposure to digital technology will worsen cognitive abilities. On the contrary, the study’s findings challenge this hypothesis, indicating instead that engagement with digital technology fosters cognitive resilience in these adults. Reviewing more than 136 studies with data that encompassed over 400,000 adults, and longitudinal studies with an average of 6 years of follow-up data, Scullin and Benge found compelling evidence that digital technology use is associated with better cognitive aging outcomes, rather than harm. The researchers’ study supported the “technological reserve” hypothesis, finding that digital technologies can promote behaviors that preserve cognition. In fact, their study revealed that digital technology use correlates with a 58% lower risk of cognitive impairment. This pattern of cognitive protection persisted when the researchers controlled for socioeconomic status, education, age, gender, baseline cognitive ability, social support, overall health, and engagement with mental activities like reading that might have explained the findings. Increase in problem-solving skills Scullin said that for some, these findings are surprising as technology use is often associated with being sedentary both physically and mentally. However, for the current generation of older adults who were introduced to the first technological advancements – computers, the Internet and smartphones – past their childhood, using technology is cognitively challenging because it is everchanging. “One of the first things that middle-age and older adults were saying is that ‘I’m so frustrated by this computer. This is hard to learn.’ That's actually a reflection of the cognitive challenge, which may be beneficial for the brain even if it doesn’t feel great in the moment.” Scullin said. Technology requires constant adaption, he said, such as understanding new software updates, troubleshooting Internet loss or filtering out website ads. “If you’re doing that for years and you’re really engaging with it, even though you might experience frustration, that may be a sign of you exercising your brain,” he said. Social connection Technology also enables communication and engagement like never before, which can expand opportunities for connectivity. Video calls, emails and messaging apps help maintain social networks, especially for people who would not otherwise regularly see their family members. “Now you can connect with families across generations,” Scullin said. “You not only can talk to them, you can see them. You can share pictures. You can exchange emails and it's all within a second or less. So that means there's a greater opportunity for decreasing loneliness.” Better social connectedness is a well-documented correlate of cognitive functioning in older adults, providing a link between decreased isolation from digital technologies and reduced risks of dementia. Impact of “digital scaffolding” A dementia diagnosis is indicated in part when cognitive changes lead to a loss of independence with daily tasks. Tools such as digital reminders, GPS navigation and online banking allow older adults to remain independent despite cognitive difficulties through digital scaffolding. According to the research article, this digital scaffold “facilitates better functional outcomes in older adults while general cognitive functioning declines.” Technologies can serve as a compensatory support system to maintain general independence and reduce the risk of a dementia diagnosis even with the presence of some cognitive decline. “As clinical practice continues to move toward an individualized, precision-medicine approach, it will be necessary for the field to identify for whom and for how long, such digital scaffolding is effective,” the researchers said. Promoting healthy technology use While Scullin recognizes the negative effects of technology, such as distracted driving or using technology over consistent face-to-face interaction, he also emphasizes how promoting a healthy use of digital tools in older adults is beneficial for their cognitive health. “If you have a parent or grandparent who’s just staying away from technology, maybe revisit that. Could they learn to use photo, messaging, or calendar apps on a smartphone or tablet? Start simple and be very patient while they learn,” he said. Social media use is another highly debated topic in terms of cognitive effects. While he says it’s hard to predict the cognitive effects of endlessly scrolling on TikTok, Scullin does argue that generating videos through creative cognition could be beneficial. In addition, he said that interacting with communities online can provide benefits by forming social connections. “We could spend a long time talking about all the specific ways in which technology use can be bad. However, the net effect since the 1990s has been positive for overall cognition in older adults,” he said. FUNDING The study was supported by funding from the National Institutes of Health (R01AG082783; M.K.S., J.F.B.). Michael Scullin was named Baylor’s inaugural Newsmaker of the Year in 2018, after his “to-do list” research was widely covered by media outlets, including ABC’s Good Morning America, TODAY.com, USA TODAY, Discover, LiveScience, HealthDay, BBC Radio and many more, reaching an international circulation and viewership of nearly 1 billion people. Looking to interview or chat with Michael Scullin? Simply click on his icon now to arrange an interview today.

2 min

Daylight Saving Time: Baylor Sleep Expert Offers Suggestions to Help Adjust to the Change

Daylight saving time, with its one-hour spring forward at 2 a.m. Sunday, March 12, may seem like a small shift of just a single hour, but on a societal level, it has startling effects, says Baylor University sleep researcher Michael Scullin, Ph.D., associate professor of psychology and neuroscience and director of the Sleep Neuroscience and Cognition Laboratory at Baylor. So what are the consequences of this one-hour time shift on our sleep quality and how can we quickly adjust when springing our clocks forward? "Many people not only lose that single hour of sleep," Scullin said, "but also have difficulty over several subsequent nights adjusting their circadian rhythms to the new bed-wake time schedules." For example, parents who have routine bedtimes for their children experience difficulty for the whole family because children will not want to (or be able to) go to bed one hour earlier than their body is used to. "When you couple this bedtime difficulty with the fact that most people have morning school and work schedules that require them to wake up at a set time," Scullin said, "it becomes clear that ‘springing forward’ has a larger consequence than skipping a single hour." The consequences of the spring daylight saving time shift are well documented. Researchers have observed changes in cognitive functioning, increased driving accidents, moodiness and willingness to punish others for mistakes. "Researchers have also documented that acute sleep loss and circadian dysregulation lead to an increase in cardiovascular events," Scullin said. "If someone's cardiovascular health is ‘borderline’ then the springtime shift can be the factor that precipitates a stroke or a myocardial infarction (heart attack)." Scullin offers some simple suggestions to anticipate and adapt to the spring forward shift: Adjust in advance. About a week before the "spring forward," go to bed 15 or 20 minutes earlier each day. Avoid long naps during the day. If you need a nap, take it earlier in the day and for no more than 20 minutes. Bring on the sunlight. Getting more natural sunlight in the morning hours is very beneficial in resetting our biological clock. In some cases, evening melatonin also can help people to adapt to the time change. Scullin has published numerous studies focusing on sleep and brain function, including the connection between sleep and creativity, musical “earworms” and their effect on sleep and how writing a to-do list before you turn in for the night can help you get better sleep. In fact, Scullin was named Baylor’s inaugural Newsmaker of the Year in 2018, after his “to-do list” research was widely covered by media outlets, including ABC’s Good Morning America, TODAY.com, USA TODAY, Discover, LiveScience, HealthDay, BBC Radio and many more, reaching an international circulation and viewership of nearly 1 billion people. Looking to interview or chat with Michael Scullin? Simply click on his icon now to arrange an interview today.

View all posts