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
Powered by

You might also like...

Check out some other posts from Baylor University

The ABCs of Joy: How Adversity, Belonging and Curiosity Lead to a Fuller Life featured image

5 min

The ABCs of Joy: How Adversity, Belonging and Curiosity Lead to a Fuller Life

Young people today have more technology, more convenience and more connectivity than any generation before them. Yet many are struggling with anxiety, loneliness and a growing sense of dissatisfaction in their lives. The problem may be that most people have confused happiness with something deeper, and that’s joy, said Baylor University education researcher Jon Eckert, Ed.D. Data published by the Centers for Disease Control and Prevention shows that approximately one in two 12th-grade girls is not satisfied with herself, and one in three 12th-grade boys is not satisfied with himself. "We are in a happiness crisis. Kids are pursuing what they think is happiness, but they're doing it through ways that don't actually lead to happiness. Joy is different. It's deeper. It's this sense of enduring love and gratitude for others that will emerge through struggle." - Jon Eckert, Ed.D. Through years of research, Eckert identified what he calls the ABCs of Joy – Adversity, Belonging and Curiosity – finding that adversity builds belonging, and belonging cultivates curiosity. These ABCs of Joy, he said, can help people move beyond circumstantial happiness toward a more meaningful and enduring life. “I work with school leaders from all over the world and find that when people believe joy is durable and grounded in lives lived for and with others, those same people often realize the depth of their struggle determines the peak of their joy,” Eckert said. Adversity In a culture that often treats struggle as something to avoid, Eckert argues that adversity is essential to joy. "A lot of times the most joyful people we know have had really hard lives because life can be hard and joyful," Eckert said. "Oftentimes, the depth of our struggle will determine the peak of our joy." Eckert believes that when parents, teachers and coaches remove every obstacle from a young person's path, they may unintentionally prevent them from experiencing the growth that comes from overcoming challenges. "If we rob kids of the chance to struggle, then we also rob them of the chance to experience that kind of joy," Eckert said. “And I'm very clear, it's not trauma that we want for kids; it's adversity. We want them to do hard things and grow from the experience.” Belonging If adversity is where joy begins, belonging is where it grows. Drawing on flourishing research, Eckert said people may succeed independently, but they cannot truly flourish alone. Belonging is rooted in relationships where people know they are valued and supported. “Belonging is the knowledge that we matter to others, and they matter to us, which is knowledge we gain by going through hard things together,” Eckert said. “We may enjoy the fun-loving, carefree friend, but we need the person who shows up when things are hard.” At a time when much of life has moved online, that truth has become increasingly important. Social media and digital platforms offer constant connectivity, but they often fail to provide the deeper relationships people need. The strongest relationships are often forged through shared challenges, and those relationships not only provide support during difficult times, Eckert said, but also create opportunities for joy. Curiosity Eckert believes belonging and curiosity are closely connected. When people feel secure in who they are and in their relationships, they are more willing to engage those whose experiences, beliefs and backgrounds differ from their own. Because of online algorithms and digital echo chambers, many people limit meaningful engagement with people who hold different perspectives and tend to automatically dismiss those who hold ideas or opinions they disagree with. "We've become incurious as a society,” Eckert said. “How do we allow our joy and our love for others to overcome that incuriosity and seek out others? Those are the people that we should want to engage because that's what makes life more interesting." Curiosity is also essential to learning. While grades, degrees and career goals can motivate behavior, genuine learning begins with a desire to know more. "The only real form of intrinsic motivation for learning is curiosity," Eckert said. “Everything else is just delayed gratification.” Joy is more than happiness Eckert challenges the way many people, especially young people, think about happiness. Social media has fundamentally changed the way many young people evaluate their own lives by encouraging constant comparison with curated versions of others’ experiences. "If your happiness is normative and it's compared to other people, you're always going to lose on this," he said. Ultimately, Eckert believes the path forward is not found in comfort or convenience but in embracing the ABCs of Joy. When adversity is met with belonging and curiosity, young people can discover something far more durable than happiness: a joyful life marked by resilience, meaningful relationships and a deeper understanding of themselves and others. "Joy is not freedom from struggle," he said. "Joy is the fuel that allows us to struggle well.” ABOUT JON ECKERT, ED.D. Jon Eckert, Ed.D., is professor of educational leadership and The Lynda and Robert Copple Endowed Chair for Christians in School Leadership in Baylor University’s Moody School of Education. He leads the Baylor Center for School Leadership, and serves as program director of Baylor’s M.A. in School Leadership and assistant chair of the Department of Educational Leadership. Eckert’s research interests include collective leadership, teaching effectiveness, evaluation and strategic compensation to enhance that effectiveness, and science education. He has conducted research for the U.S. Department of Education, the Carnegie Foundation, the National Network of State Teachers of the Year, the National Institute for Excellence in Teaching and the Center for Teaching Quality, which he has published in numerous peer-reviewed journals and presented around the world. Eckert is the author of several books, including “Just Teaching: Feedback, Engagement, and Well-being for Each Student,” “Leading Together: Teachers and Principals Improving Student Outcomes,” and the soon-to-be-released “The Happiness Crisis: How Adversity Can Build a Resilient and Joyful Next Generation.” More from Jon Eckert, Ed.D. WATCH/LISTEN: Baylor Connections Podcast: Leadership Catalysts: Baylor Center for School Leadership A New Chapter for Educators: Culture of Joy 2026 at Foster Pavilion Looking to know more or arrange an interview? Simply contact: Shelby Cefaratti-Bertin at Shelby_Cefaratti@baylor.edu today.

Go Outside and Play: The Benefits of Outdoor Play for All Ages featured image

4 min

Go Outside and Play: The Benefits of Outdoor Play for All Ages

The simple act of playing outside offers a multitude of interconnected benefits, profoundly enhancing physical, mental and cognitive well-being. Healthy living expert Renée Umstattd Meyer, Ph.D., professor of public health in Baylor University’s Robbins College of Health and Human Sciences, recommends making outdoor play a regular part of your family’s routine, especially during the summertime when kids are out of school and schedules are typically lighter. “Being outdoors is an equalizer, or at least it can be. Nature offers a lot of opportunities, and there are benefits to all types of being outside, whether it be yards, parks or driveways bordered by trees,” Umstattd Meyer said. “Going outdoors does not require a sign-up fee or certain types of equipment; it is just there waiting for visitors.” Umstattd Meyer’s research focuses on promoting health and access to opportunities for healthy living through an active living lens by collaborating to foster healthy and active opportunities and lifestyles for all people. The benefits of simply being outside, she says, increase through the combination of five factors: movement, connection with nature, connection with others, a reset from busy school schedules and a sense of community. Movement Outdoor play gets kids moving, which inspires creativity, critical thinking and exploration. And research bears that out, Umstattd Meyer said, showing that exercise and physical activity, even in relatively shorter bouts, help with concentration, problem-solving, learning and memory. “Being outdoors beckons us to move our bodies, for kids to run, cartwheel, spin and twirl, play chase, build pill-bug houses, chase lightning bugs, start a pick-up game, and for adults, to walk, exercise, play with our kids, pull a few weeds out of a flower bed, plant and tend to a vegetable, herb or flower garden,” she said. Summertime Safety While playing outside comes with numerous benefits, Umstattd Meyer says a few simple steps will help families safely manage higher temperatures, sun exposure and those pesky mosquitoes: Find time for outdoor play during the cooler times of day. Make sure to have plenty of water and shade available. It's okay to take a break! Use sunscreen and mosquito repellent – reapply as needed. Connection with nature Time outdoors offers well-documented physical and mental benefits, increases awareness and can evoke a sense of environmental stewardship, Umstattd Meyer said. “Just being in nature, whatever the nature might be, from a driveway with a little green around it to local parks, offers those same benefits and connection,” she said. Connection with others Spending time outside also helps people reconnect and step away from the number of devices and screens that contribute to feelings of loneliness and isolation. “Outdoor play also allows opportunities for connection with others, from family members and friends to neighbors,” Umstattd Meyer said. “It provides time and space for adults to connect with others as well, to build relationships, familiarity and trust.” Reset from the schedules Summer play can provide a break from the structured routines of the school year, but Umstattd Meyer said that it requires intentionality. “Taking a break from the planned and orchestrated schedules and demands of the school year and associated stressors, along with a break from screens and devices, will actually foster curiosity and creative thought, opportunities for critical analysis and awareness of caring for our natural surroundings and the environment,” she said. Fosters a sense of community Outdoor play not only benefits children’s health and development, but it also creates natural opportunities for families to build connections and strengthen neighborhood relationships, Umstattd Meyer said. “Being outside with our kids gives us the opportunity to say hello and get to know our neighbors,” she said. “It also allows for parents to become more comfortable with their kids being outside while becoming more acquainted with neighbors, to build confidence that their kids are capable of exploring their surroundings and the outdoors.” Umstattd Meyer encourages everyone to find outdoor spaces and engage in play, which can be planned or spontaneous and is freely chosen at any age. “Play is pursued for enjoyment and recreation rather than serving a serious or practical purpose and enhances health, happiness and quality of life,” Umstattd Meyer said. While technology has improved people’s daily lives, it also has contributed to reduced social connection and engagement with the natural world, she said. At the same time, Americans of all ages are experiencing higher levels of stress and anxiety over demands for higher productivity and achievement. “I encourage each of us to create the time to enjoy nature and plan for ways to regularly engage in outside play in a way that allows you to connect with others and physically move your body,” Umstattd Meyer said. National Play Outside Day The first Saturday of every month marks National Play Outside Day, when people of all ages are encouraged to set their screens and devices aside and head outdoors with friends and families to play together, enjoy nature and discover the multiple benefits of play. Looking to know more or arrange an interview? Simply contact: Shelby Cefaratti-Bertin at Shelby_Cefaratti@baylor.edu today.

Family Reunion Month: Seven Simple Tips to Begin Recording Your Family’s Oral History featured image

4 min

Family Reunion Month: Seven Simple Tips to Begin Recording Your Family’s Oral History

When families gather together for vacations and reunions, they are often regaled with tales about an older relative’s fascinating life story or firsthand experience as an eyewitness to history. So how do you capture and preserve those precious memories? Historians with Baylor University’s renowned Institute for Oral History, home of the national Oral History Association as well as its regional affiliate Texas Oral History Association, have recorded and preserved oral history memoirs of individuals since 1970. Stephen Sloan and Adrienne Cain Darough Stephen Sloan, Ph.D., IOH director, professor of history and executive director of the national OHA, and Adrienne Cain Darough, M.L.S., assistant director and clinical associate professor, share seven simple best practices to help family members begin oral history conversations that enrich recollections of the past. Seven best practices for family oral history conversations 1. Make sure your family member wants their story to be documented or recorded. That's a very important question to ask ahead of time, Cain said. “Many oral historians have run into the spot where, ‘Oh, my grandpa would be great,’ and you get there and it's like, ‘Grandpa does not want to talk to you.’ So first making sure that they want their story recorded.” 2. Determine the type of recording equipment you want to use. Decide if you want to record your interview with an audio recorder or using a video recording device. The Institute for Oral History offers a helpful resource on choosing the right digital recorder for your needs and comfort level. 3. Do some advance research about your family member’s life and their timeline to help you formulate your questions. You can't just put down a recorder in front of someone and say, "Talk." Are there specific things that you want to know? For example, would your family member recall a specific time in their life or a moment in history that affected them? What were they like in high school and what were things they enjoyed doing? Did they serve in the military? “Doing your research to try to form those questions will help you get around what I will say is the reluctance to talk sometimes,” Cain said. “The favorite thing that I love to hear is, ‘Oh, I don't have much to say,’ or ‘I'm not that important.’ And then you sit down with them, and you listen to their stories, and your mind is just blown by the things that they've seen and experienced.” 4. Ask open-ended questions without making any assumptions. With oral history, Sloan said it’s important not to go into the interview with a specific agenda and try to lead anyone to a certain conclusion. “We can do this very subtly by assuming information, but I can't assume that their experience with that topic is X. That could have been very far from how they encountered whatever event that may have been,” Sloan said. “I've got to allow them to relate to me the ways in which they lived these experiences.” 5. Start with the basics, such as “Where are you from?” When Sloan, Cain and their oral history colleagues conduct an interview on any given topic, they generally begin with some life history of the subject, providing important context for historians. “Ask questions early on that are easy for them to answer: a little bit of the backstory, a little bit of where they're from, where they grew up,” Sloan said. “I want to understand the lens through which they experienced events, and the only way I can do that is, who was this? What was formative in their life growing up? Who spoke into who they were? What did they learn? Where did they go? What did they do? Those are the sorts of things that I would be exploring early in the interview.” One of the questions Cain enjoys asking is, “What did you want to be when you grew up?” There is the standard answer, but she notes that there’s often something that happened that may have changed that trajectory. “You want to give them something that's very easy and comfortable to talk about,” Cain said. “What was your favorite subject, just to see if that was something that continued on in their life. If there's a certain hobby or something that you know they're affiliated with, when did you learn about that? Tell me more. What's your interest in this? And then they'll get to talking.” 6. Make sure you are listening, an important facet of gathering oral history. When conducting an oral history interview, you are not only listening for what they're saying, you're also listening for what they're not saying, Cain said. “Are there things that are being skipped around?” Cain said. “For example, sometimes when you're talking to veterans about their combat experience, they need time. There may be some things they have seen and that may be the first time they're reliving or retelling these stories. And you just have to be prepared for that.” 7. Be patient. It might take your subject some time to warm up to the conversation. Patience is a virtue in oral history interviewing. “If you're talking to someone who is 80, 90 or even 100, that's a lot of memories that they have to go through, so patience is important,” Cain said. Oral History Resources LISTEN: Dr. Stephen Sloan and Adrienne Cain Darough join the Baylor Connections Podcast to share more about preserving oral histories while offering tips for individuals seeking to preserve the stories of family or friends. FREE RESOURCES: Baylor’s Institute for Oral History provides free oral history resources on the IOH website. Get best practices on oral history interviewing, project planning and organization, transcribing interviews, protecting and preserving recordings and conducting phone or Zoom oral history interviews. Looking to know more or arrange an interview with the experts? Simply contact: Shelby Cefaratti-Bertin at Shelby_Cefaratti@baylor.edu today.

View all posts