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

Oxhandler studies how to ethically & effectively assess and discuss clients’ religion/spirituality within health and mental health treatment

Religion and Social WorkReligion and Spirituality in Clinical PracticeEvidence-Based Practice ProcessScale DevelopmentMental Health (primarily Anxiety and Depression)

You might also like...

Check out some other posts from Baylor University

3 min

Can the Olympics Help Americans Forget Politics (at Least for 16 Days)?

Americans are divided on a multitude of different issues, but could the Olympic Games unite the country – at least for the duration of an Olympiad? A Baylor University sports marketing and branding expert says yes, the Olympics can help bring people together even when it’s hard for them to agree about anything else. In his latest Forbes Sports Money column, Baylor University sports marketing and branding expert Kirk Wakefield, Ph.D., executive director of the Curb Center for Sales Strategy in Sports and Entertainment (S3E) program at Baylor’s Hankamer School of Business, analyzed a July 8 national population poll that asked Americans questions about politics but also included the Steen Happiness Index (SHI). The 20-item happiness index provides a series of statements for participants to read and choose the one from each group that describes their state at that moment. Happiness items focus on three types of happy lives: the pleasant life (experiencing and savoring pleasures), the engaged life (losing the self in engaging activities) and the meaningful life (participating in meaningful activities). Are people happier when watching the Olympics? “Happy people follow the Olympics and people who follow the Olympics are happy people,” Wakefield wrote. The higher people scored on the happiness index, the more likely they are to: Watch at least some of the Olympics (49.75%) Root for the U.S. to win (31.8%) Follow the results of the Olympics (28.1%) Read stories about athletes in the Olympics (19.6%) Will talk with others about the Olympics events (18.7%) “Controlling for age, gender, income, education, race and marital status, Americans who follow the Olympics in one, two, or three of these ways are somewhat more happy people (+4% on the SHI). But those who follow the Olympics in four or all five of these ways are significantly happier people (+10% on the SHI),” Wakefield wrote. Who is happiest when the Olympics are on? The happiest? Those would be the Americans who love to talk about the Olympics with others while also cheering for U.S. athletes to win. In fact, they are about 14% happier than those who don’t follow the Olympics, according to the SHI. “Perhaps best of all, people of all political leaning and presidential preferences are equally likely to follow the Olympics. No matter the party, people can party together in unity following the Olympics,” Wakefield wrote. “Maybe we can’t forget politics. But we can give it a break to watch the Olympics.” ABOUT KIRK WAKEFIELD, PH.D. Kirk Wakefield, Ph.D., is The Edwin W. Streetman Professor of Retail Marketing at Baylor University, where he is the Executive Director of the Curb Center for Sales Strategy in Sports and Entertainment (S3E) program in the Hankamer School of Business. The author of Team Sports Marketing and founder of Wakefield Research Partners, Wakefield has conducted fan research on partnerships, pricing, promotions, sportscape, service, and anything else that explains why fans do what they do in nearly every venue in sports, including the NBA, NFL, MLB, MLS, NHL and NASCAR. His scholarly works appear in a breadth of journals: Journal of Marketing, Journal of Consumer Research, Journal of the Academy of Marketing Science, Journal of Service Research, Journal of Retailing, Journal of Advertising, Journal of Advertising Research and Journal of Sport Management, among others. Wakefield is a regular contributor to Sports Money on Forbes.com. ABOUT THE CURB CENTER FOR SALES STRATEGY IN SPORTS AND ENTERTAINMENT (S3E) The Center for Sales Strategy in Sports and Entertainment (S3E) at Baylor University is the only program in the U.S. focused on generating revenue for sports. S3E graduates have career opportunities in sales, digital marketing or business analytics for major league teams, university athletics, corporations and agencies. Baylor is the only university combining learning with practice in partnership with the Athletics Department to prepare graduates for careers in the business of sports. The S3E program is unique in vision, values, mission and culture to transform the business of sports and entertainment. Consistent with the Christian mission and purpose of Baylor University, we prepare passionate servant leaders to positively influence lives in places people go to play or watch others play.

4 min

It Has to Matter Who Wins: Futurecasting the MLB All-Star Game

Globe Life Field in Arlington, home of the 2023 World Series champion Texas Rangers, will play host to the 94th edition of the Major League Baseball All-Star Game on July 16, marking the second time in franchise history the Rangers will host the Midsummer Classic. MLB’s All-Star game – which matches up the best players from the American League and National League as selected by fans, managers and players – is considered one of best all-star contests among professional sports, said Kirk Wakefield, Ph.D., executive director of the Curb Center for Sales Strategy in Sports and Entertainment (S3E) program at Baylor University’s Hankamer School of Business. However, the game faces continued headwinds, Wakefield said, ranging from lagging viewership to fan voting to a game that is more an exhibition than a meaningful game. Wakefield Weighs In: Five Thoughts on MLB's All-Star Game Is the MLB All-Star game the best All-Star contest of all major leagues? Wakefield: Yes, it’s the only one where players seem to try their best. The NBA and NFL – who have practically given up – have declining viewership since 2011. Unfortunately, MLB All-Star game is on the same downhill skid. (According to Statista, viewership has declined from 22 million in 1993 to seven million in 2023.) The reason why is it doesn’t really matter who wins. If the players don’t care who wins, neither will fans. Further, fans aren’t particularly a fan of only one league so that it really matters if one league has bragging rights. That was less the case years ago before interleague play. How could viewership improve in any of the All-Star games? Wakefield: It has to matter who wins. MLB tried this with home field advantage for the World Series. They gave that up. The current approach in baseball is truly an exhibition because every player gets to play, so it’s like three players at every position playing three innings. That’s not how a manager would play it if trying to win. And it’s not like it used to be when the starters (who were more likely to be the best at their positions) played longer. One suggestion I’ve heard is to make the payoff big enough for the winners so that the players gave it their best. Get a sponsor to put up the money so the winners each make seven figures and could be the players and managers will play more like a team trying to win. Does Monday’s prelude, the hugely popular Homerun Derby, enhance Tuesday’s game? Wakefield: The Homerun Derby is popular because fans do follow individual players. It matters more who wins. That said, the HR derby’s viewership has still lagged. Bottom line: Fans are loyal to teams more than to leagues or individual players. Fan voting… Need we say more? Wakefield: Major market teams with huge fan bases will dominate, but what about the Kansas City Royals, who at one point in the season were on pace for the biggest year-over-year improvement in wins and losses? Given the way fan voting has become essentially a promotion game to get more fans to vote more often, it’s hardly representative of anything other than largest markets with the best promoters. The good news is that the MLB All-Star game will be quite the occasion in Arlington, Texas, with a bevy of game-related activities and events July 13-16. Wakefield: Arlington is an optimal location central to the U.S. with plenty of space to blow out the occasion. It’s like the Texas State Fair came to baseball, where all the rides and attractions are baseball-happy. ABOUT KIRK WAKEFIELD, PH.D. Kirk Wakefield, Ph.D., is The Edwin W. Streetman Professor of Retail Marketing at Baylor University, where he is the Executive Director of the Curb Center for Sales Strategy in Sports and Entertainment (S3E) program in the Hankamer School of Business at Baylor University. The author of Team Sports Marketing and founder of Wakefield Research Partners, Wakefield has conducted fan research on partnerships, pricing, promotions, sportscape, service, and anything else that explains why fans do what they do in nearly every venue in sports, including the NBA, NFL, MLB, MLS, NHL and NASCAR. His scholarly works appear in a breadth of journals: Journal of Marketing, Journal of Consumer Research, Journal of the Academy of Marketing Science, Journal of Service Research, Journal of Retailing, Journal of Advertising, Journal of Advertising Research and Journal of Sport Management, among others. Wakefield is a regular contributor to Sports Money on Forbes.com. ABOUT THE CURB CENTER FOR SALES STRATEGY IN SPORTS AND ENTERTAINMENT (S3E) The Center for Sales Strategy in Sports and Entertainment (S3E) at Baylor University is the only program in the U.S. focused on generating revenue for sports. S3E graduates have career opportunities in sales, digital marketing or business analytics for major league teams, university athletics, corporations and agencies. Baylor is the only university combining learning with practice in partnership with the Athletics Department to prepare graduates for careers in the business of sports. The S3E program is unique in vision, values, mission and culture to transform the business of sports and entertainment. Consistent with the Christian mission and purpose of Baylor University, we prepare passionate servant leaders to positively influence lives in places people go to play or watch others play.

4 min

Sleep Better, Live Better: Improving Sleep Quality Can Lead to Less Stress and Improved Cognition

Research has demonstrated that increased stress and all-night study sessions can lead to lower cognitive functioning and test scores, adding even more pressure on college students. Baylor sleep expert Michael K. Scullin, Ph.D., director of Baylor University’s Sleep Neuroscience and Cognition Laboratory and associate professor of psychology and neuroscience, studies how cognitive and behavioral processes are affected by sleep. “Sleep deprivation makes life worse. And it makes the person not getting enough sleep worse at life,” Scullin said. “However, if we focus on improving our sleep, life will get better, and we will get better at life.” Poor sleep is particularly common when students are studying for exams or working on major projects for classes. The combination of staying up late, cramming for tests, increased stress and bright light exposure late at night can lead to variable sleep durations and higher stress levels. “We know that as you accumulate sleep debt, whether it's from a single all-nighter or from weeks of variable sleep durations, it can exacerbate any pre-existing vulnerability a person may have to stress,” Scullin said. “For instance, if someone has a predisposition to panic attack disorder, sleep deprivation can increase panic attacks by about 40%. This applies to virtually any clinical or subclinical condition, whether it’s stress-related or not – sleep deprivation makes it worse.” Scullin added that even with a slight sleep deficit, any sort of negative event, such as a bad grade on a test, will feel much worse than it would for someone who is well-rested. “It becomes a cycle, and the individual begins to focus on what is worse instead of calming down at night and getting ready to fall asleep,” Scullin said. So how can a student – or any individual – break this cycle? It all starts with developing healthy sleep habits, which reduce stress and improve academic performance. Scullin suggests students try three Challenges to improve their sleep, mood and stress regulation. 1. Illuminate! Challenge One class activity that Scullin has used with students for years is called the Illuminate! Challenge, which focuses on students adding more natural sunlight to their lives in the morning hours. “About 90% of students do not know that we need natural sunlight daily in the morning to tell our internal biological clock when to start ticking. When our biological clock knows it's time to start ticking, it will make us feel more alert, which helps improve our mood,” Scullin said. Specifically, he suggests: Spending 20 minutes daily outdoors in natural daylight during the morning hours. Be intentional with this time as something aside from walking to class or other daily routines. Take the time when you would normally be inside studying or eating breakfast to go outside instead. “Almost every one of my students who has taken this challenge has said their mood and alertness improved,” Scullin said. 2. Deluminator Challenge The Deluminator Challenge eliminates light in your bedroom for a night of better sleep. Scullin said this challenge works by: Turning off all the lights and counting the number of artificial lights that exist in your environment. How many of your plugs have lights? How much light is coming in through your curtains? Cover up every light source (except fire alarms and other safety devices), including any light coming through windows. Blackout curtains are a good investment, or even using blankets to cover windows will help reduce light at night. It’s easy to adopt this challenge as it is sustainable once it is set. You will find that you can fall asleep easier and enjoy sleeping later in the morning because of the darker environment. “What normally happens is students see their devices are emitting unnatural light, and it is not nearly as dark as it should be,” Scullin said. “A lot of students in my classes report that this is their favorite challenge because it led to the biggest impact on sleep quality.” 3. Anti-Rumination Challenge Lying in bed thinking about everything you need to do the next day can increase stress levels and interrupt sleep. In a recent study, Scullin found that taking five minutes to write a “to-do” list at bedtime helped student participants fall asleep about 10 minutes faster than others who used that time to chronicle completed activities: Take five minutes to write down a to-do list of everything that needs to be done the next day. The to-do list offloads stress, gives you a good action plan for the next day and helps you feel accomplished as you check off the goals. When people get more sleep – even just one more hour of sleep per night – “they literally become happier,” Scullin said. That extra hour of sleep can improve social relationships, emotional reactions and cognitive functioning. With improved cognitive functioning comes improved academic performance. “Adding more sleep to your life makes life better, and it's going to make you better at life. It's going to resolve some of the stress, and you're going to better handle events that are inherently stressful. You're going to enjoy life while you're also taking classes. And you know what? Your grades are probably going to improve.”

View all posts