Spiritual ity in Occupat ional Ther apy Pr act ice. Marissa Marchioni, MA, OTR/L & Rebecca Cunningham, OTD, OTR/L

Transcription

1 Spiritual ity in Occupat ional Ther apy Pr act ice Marissa Marchioni, MA, OTR/L & Rebecca Cunningham, OTD, OTR/L

2 What is Spiritual ity?

3 Occupat ional Ther apy Pr act ice Fr amewor k Definit ion Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred (Puchalski et al., 2009, p. 887)

4 Ot her Definit ions Meaning derived from or intrinsic to daily life occupations (Hammell, 2001)

5 Ot her Definit ions A pervasive life-force, manifestation of a higher self, source of will and self-determination, and a sense of meaning, purpose and connectedness that people experience in the context of their environment (Canadian Association of Occupational Therapists, 1997, p. 182).

6 Why Do es i t Matter?

7 Benefits of Spiritual ity Improves resilience (Rounding et al, 2011; Howell and Miller-Graff, 2014) Improves stress buffering(van Dyke, 2009) Post-traumatic growth (Currier et al, 2013) Decreases depression (Desrosierset al, 2007) Improves wellbeing (Ellison and Fan, 2008) Improves engagement in health management (Fitzgibbon et al, 2005; Park et al, 2009)

8 demogr aphics

9 PEW Research Center. (2012, December 18). The global religious landscape. Retrieved from:

10 PEW Research Center. (2012, December 18). The global religious landscape. Retrieved from:

11 Hackett, C. & Huynh, T. (2015, June 22). What is each country s second largest religious group? Retrieved from:

12 PEW Research Center. (2015, April 2). The future of world religions: Population growth projections Retrieved from:

13 PEW Research Center. (n.d.). Religious landscape study.

14 PEW Research Center. (n.d.). Religious landscape study.

15 PEW Research Center. (n.d.). Religious landscape study.

16 PEW Research Center. (n.d.). Religious landscape study.

17 PEW Research Center. (n.d.). Religious landscape study.

18 PEW Research Center. (n.d.). Religious landscape study.

19 Maj or Wor l d Rel igions

20 J udai sm One god Holy writings: Torah, Talmud, oral traditions Types: orthodox, conservative, reform House of worship: synagogue, temple

21 Christianity One god Holy writings: Bible Types: Baptist, Lutheran, Pentecostal, etc. House of Worship: church, cathedral, meeting house, temple, chapel, kingdom hall

22 I sl am One god Holy writings: Koran Types: Sunnis, Shiites, etc. House of worship: Mosque

23 Hinduism Many gods Holy writings: Many, including 4 vedas Types: No single belief system House of worship: temple

24 Buddhi sm No gods Holy writings: Many; Tripitaka, Mahyana Sutras, Tantra and Zen texts Types: Therevada and Mahayana House of worship: temple

25 I s spiritual ity being a ddr essed in o T Pr act ice?

26 Nope

27 No clear guidelines for teaching spirituality (Mthembu, Roman, & Wegner, 2016) 61.3 % of therapists never or rarely address spirituality in practice (Thompson et al., 2016) Confusion about implementation is ongoing (Morris et al, 2014) Practitioners still experince a t heory-practice gap (Collins, 2016) 85% of pract itioners are not assessing spirituality (Morris et al, 2014) 80 % of practitioners believe t hat assessments are not available for spirit ual assessment (Morris, 2013)

28 Assessment s

29 The Dail y Spir it ual Exper ience Scal e 16 quest ions, psychomet rically validat ed Translated into 40 languages Available free for non-profit use Useful for most religions and in secular settings

30 Wor l d Heal t h Or ganizat ion Qual it y of Life (WHOQOL- SRPB) 32 questions devoted to beliefs, spirituality, and religion Applicable cross-culturally Available in 20 languages Free for download from WHO website

31 Canadian occupat ional per f or mance measur e (COPM) Self-identified areas of occupational performance deficits Top 5 priorities scored on 10 point likert scale for performance and sat isfact ion Spirituality and faith based practices included

32 M odel s

33 Model of Human Occupat ion Does not explicitly address spirit ualit y Volition subsyst em includes: Personal causation Values Interests Choices Volit ional narrat ive (Kielhofner, 2008)

34 Canadian Model of Occupat ional Performance Spirituality is conceptualized as the central feature of a person (Law et al., 1997)

35 Occupat ional Per f or mance M odel Spirit is one of 3 core components of a person (Chappro & Ranka, 1997)

36 Per son- Envir onment - Occupat ion Per f or mance M odel Spirituality is an intrinsic factor of a person which impacts occupational performance (Bass, Baum, & Christiansen 2017)

37 Psychospir it ual Integration (Kang, 2003; Jones et al, 2016)

38 PSI Components and Dynamics

39 Six dimensions of Spiritual ity Becoming Meaning Being Centeredness Connectedness Transcendence

40 Becoming Volitionally directed growth of the self through active doing and consequent experience of flow

41 M eaning Involves the creation of life themes that forge a sense of purpose and resolution The sense of intrinsic purposefulness and vitality

42 Being Primordial presence Pervasive quality that forms the foundation of existence Who we really are

43 Cent er edness Within being but distinct from it Nucleus of one s being, the divine center of self from which all activities flow

44 Connect edness Seeing the self as a fluid process embedded within a larger interrelational context Universal love or compassion

45 Tr anscendence Innate drive to find ultimate meaning and happiness Freedom from all or in spite of all limitation

46 Spiritual Disorder Occupational/ Spiritual deprivation Community spiritual deprivation Occupational imbalance Spiritual latency

47 Appl icat ion t o Pr act ice

48 Becoming Promote autonomy, independence, and choice through occupations that promote self-healing Social skills Life skills Adaptation to disability Facilitate the just right challenge to improve flow

49 M eaning Exploring meaning of personal illness or disruption Focus on pursuit of goals Include occupations that enhance quality of life and wellbeing Facilitate culturally relevant occupations

50 Being Promote person-centered practice through active listening, valuing beliefs and experiences Allow time to discuss individuals values, desires, and dreams

51 Cent er edness Acknowledge an individual s spiritual or religious expression Engage in mindfulness, meditation, creative visualization, and connection to relationships that create a balance in their life

52 Connect edness Focus on creating connection with individuals to promote therapeutic process Facilitate connections with religious community Promote occupations that demonstrate care for others

53 Tr anscendence The aspirational outcome of integrating spirituality in practice

54 Responsibil ity of the practitioner

55 Addr ess Suf f er i ng

56 Check your Bias

57 Lear n about ot her Rel igions

58 Cr eat e a Habit t o Ask

59

60 Ref er ences American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. Am J Occup Ther, 56, Bass, J. D., Baum, C. M., & Christiansen, C. H. (2017). Person-Environment-Occupation-Performance Model. Perspectives on Human Occupations: Theories Underlying Practice, 161. Canadian Association of Occupational Therapists. (1997).Enabling occupation: An occupational therapy perspective. Ottawa: CAOT Publications ACE. Chapparo, C. & Ranka, J. (1997) Occupational Performance Model (Australia): Monograph 1. Retrieved 17 June, 2003, from Collins, M. (2016). Spirituality and Occupational Therapy: Reflections on Professional Practice and Future Possibilities. In Spirituality across Disciplines: Research and Practice: (pp ). Springer International Publishing. Currier, J. M., Mallot, J., Martinez, T. E., Sandy, C., & Neimeyer, R. A. (2013). Bereavement, religion, and posttraumatic growth: A matched control group investigation. Psychology of Religion and Spirituality, 5(2), 69. Desrosiers, A., & Miller, L. (2007). Relational spirituality and depression in adolescent girls. Journal of clinical psychology, 63(10), Ellison, C. G., & Fan, D. (2008). Daily spiritual experiences and psychological well-being among US adults. Social Indicators Research, 88(2), Farrar, J. E. (2001). Addressing spirituality and religious life in occupational therapy practice. Physical & Occupational Therapy in Geriatrics, 18(4), Fitzgibbon, M. L., Stolley, M. R., Ganschow, P., Schiffer, L., Wells, A., Simon, N., & Dyer, A. (2005). Results of a faith-based weight loss intervention for black women. Journal of the National Medical Association, 97(10), Gray, G. (2015). Spirituality and Occupational Therapy. Journal of the National Society of Allied Health, 12(1). Hammell, K. W. (2001). Intrinsicality: Reconsidering spirituality, meaning(s) and mandates. Canadian

61 Ref er ences Howell, K. H., & Miller-Graff, L. E. (2014). Protective factors associated with resilient functioning in young adulthood after childhood exposure to violence.child abuse & neglect, 38(12), Johnston, D., & Mayers, C. (2005). Spirituality: a review of how occupational therapists acknowledge, assess and meet spiritual needs. British Journal of Occupational Therapy, 68(9), Jones, J., Topping, A., Wattis, J., & Smith, J. (2016). A concept analysis of spirituality in occupational therapy practice. Journal for the Study of Spirituality, 6(1), Kang, C. (2003). A psychospiritual integration frame of reference for occupational therapy. Part 1: Conceptual foundations. Australian Occupational Therapy Journal, 50(2), Kielhofner, G. (Ed.). (2008). Model of human occupation: Theory and application. Lippincott Williams & Wilkins. Law, M., Cooper, B. A., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1997). Theoretical contexts for the practice of occupational therapy. Occupational therapy: Enabling function and well-being, Morris, D. N. (2013). Perceptions of spirituality and spiritual care in occupational therapy practice. Occupational Therapy in Mental Health, 29(1), Morris, D. N., Stecher, J., Briggs-Peppler, K. M., Chittenden, C. M., Rubira, J., & Wismer, L. K. (2014). Spirituality in occupational therapy: Do we practice what we teach?. Journal of religion and health, 53(1), Mthembu, T. G., Roman, N. V., & Wegner, L. (2016). A cross-sectional descriptive study of occupational therapy students perceptions and attitudes towards spirituality and spiritual care in occupational therapy education. Journal of religion and health, 55(5), Park, C. L., Edmondson, D., Hale-Smith, A., & Blank, T. O. (2009). Religiousness/spirituality and health behaviors in younger adult cancer survivors: does faith promote a healthier lifestyle?. Journal of Behavioral Medicine, 32(6), 582. PEW Research Center. (2015, April 2). The future of world religions: Population growth projections Retrieved from: PEW Research Center. (2012, December 18). The global religious landscape. Retrieved from:

62 Ref er ences Rounding, K., Hart, K. E., Hibbard, S., & Carroll, M. (2011). Emotional resilience in young adults who were reared by depressed parents: The moderating effects of offspring religiosity/spirituality. Journal of Spirituality in Mental Health, 13(4), Thompson, K., Cercle, W., Keele, L., Gaudet, S., Hanson, M., Sauer, W., & Gee, B. (2016). We ve Moved Past Sex: Can We Now Address Religion?. American Journal of Occupational Therapy, 70(4_Supplement_1), p p1. Van Dyke, C. J., Glenwick, D. S., Cecero, J. J., & Kim, S. K. (2009). The relationship of religious coping and spirituality to adjustment and psychological distress in urban early adolescents. Mental Health, Religion and Culture, 12(4),

63 Spirituality in Occupational Therapy Practice Marissa Marchioni, MA, OTR/L & Rebecca Cunningham, OTD, OTR/L Judaism Christianity Islam Hinduism Buddhism Founder Abraham, 2000 B.C. Jesus Christ, 30 A.D. Muhammad, 570 A.D. None Siddhartha Gautama 4th or 5th century B.C. How many Gods? Many None Holy Writings Torah, oral tradition, Talmud Bible Koran Many, including the 4 Vedas Many, including the Tripitaka, Mahyana Sutras, Tantra, and Zen texts Where do people practice? There are large Jewish populations in Israel and the U.S. Through its missionary activity Christianity has spread to most parts of the globe. Islam is the main religion of the Middle East, Asia, and the north of Africa. Hinduism is practiced by more than 80% of India's population. Buddhism is the main religion in many Asian countries. House of Worship Synagogue, temple Church, Cathedral, Meeting House, Temple, Chapel, Kingdom Hall Mosque Temple Temple The Big Religion Chart. (2016, November 21). Retrieved September 22, 2017, from 1 P age

64 Spirituality in Occupational Therapy Practice Marissa Marchioni, MA, OTR/L & Rebecca Cunningham, OTD, OTR/L The Psychospirtual Integration Model Kang, C. (2003). A psychospiritual integration frame of reference for occupational therapy. Part 1: Conceptual foundations. Australian Occupational Therapy Journal, 50(2), P age