Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study
Abstract
:1. Introduction
Aims
- To explore the acceptability and feasibility of a spiritual intervention for people with depression;
- To examine the effects of this intervention on depressive symptoms, hope, meaning in life, self-esteem and social support, anxiety levels, and daily spiritual experience;
- To explore the participants’ views on the healing mechanisms of the intervention.
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Ethical Considerations
2.4. Intervention
2.5. Measurement
2.5.1. Acceptability and Feasibility
2.5.2. Measurement of the Outcomes
2.5.3. Focus Group
2.6. Treatment Fidelity
2.7. Data Analysis
3. Results
3.1. Characteristics of the Participants
3.2. Quantitative Analysis
3.3. Qualitative Analysis
3.3.1. Meaning of the Spiritual Intervention
3.3.2. Effects of Involvement in the Spiritual Group
3.3.3. Therapeutic Factors/Components of the Spiritual Intervention
3.3.4. Participants’ Views on and Suggestions for the Program
4. Discussion
4.1. Limitations
4.2. Implications and Suggestions for the Main Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Discussion Questions for the Focus Group
- When I say the word “spirituality” or “spiritual intervention”, what do you see or what do you think of?How would you describe the “spiritual intervention”?
- What do you think what kinds of factors will lead to the effectiveness of the spiritual intervention?
- What do you expect of a person who has participated in the spiritual intervention?
- What goes on in your spiritual intervention group?
- How do you see therapeutic processes involved in the spiritual intervention?
- Is there any other experience that you would like to share that we have not yet touched upon?
Appendix B. Checklist for Self-Monitoring of the Treatment Sessions
Skills Competence of Interventionist | Always/ Almost Always | Sometimes | Missed Opportunity |
---|---|---|---|
1. Actively engages all participants in the discussion. | |||
2. Actively listens when a participant is talking. | |||
3. Communicates with all participants in a respectful, positive, and non-judgmental manner. | |||
4. Appropriately reinforces participants’ ideas and opinions. | |||
5. Correctly conveys/communicates the program’s principles. | |||
6. Communicates to participants that the participants are experts about their own problems. | |||
8. Facilitates sharing of ideas among the participants. | |||
9. Does not impose own ideas on the participants. | |||
10. Effectively responds when the participants are resistant to new strategies or ideas. | |||
11. Effectively manages challenging behavior from the participants in the group (e.g., monopolizing, anger, prolonged silence). | |||
12. Maintains a good pace for group discussions (not too fast, not too slow). | |||
13. Effectively uses role-play or group activities to teach a principle or strategy. | |||
14. Builds on the participants’ knowledge by incorporating the strategies discussed in previous sessions into this session. | |||
1 = skill rarely or never demonstrated (skill demonstrated < 25% of the time); 2 = skill sometimes/occasionally demonstrated (skill demonstrated 25–75% of the time); 3 = skill consistently demonstrated (skill demonstrated > 75% of the time); Modified from the Fidelity Checklist [68]. |
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Session | Content |
---|---|
1 | Spirituality, mental health, and depression |
2 | Connectedness |
3 | Forgiveness and freedom |
4 | Suffering and transcendence |
5 | Hope and gratitude |
6 | Relapse prevention, review of the materials, and celebration |
Characteristics | Number | % |
---|---|---|
Age | ||
46–55 | 3 | 42.9 |
56–64 | 4 | 57.1 |
Gender | ||
Male | 1 | 14.3 |
Female | 6 | 85.7 |
Marital status | ||
Single | 3 | 42.9 |
Married | 3 | 42.9 |
Divorced | 1 | 14.3 |
Religion | ||
Protestant Christianity | 7 | 100 |
Educational background | ||
Secondary | 6 | 85.7 |
Doctoral | 1 | 14.3 |
Occupational status | ||
Unemployed | 1 | 14.3 |
Retired | 4 | 57.1 |
Other | 2 | 28.6 |
Received treatment | ||
Yes | 7 | 100 |
Assessment Outcome | Pre-Intervention (T0) Mean (SD) | Post-Intervention (T1) Mean (SD) | 3-Month Follow-Up (T2) Mean (SD) | p-Value | Cohen’s d T0 vs. T1 | Cohen’s d T0 vs. T2 |
---|---|---|---|---|---|---|
PHQ-9 | 7.43 (3.409) | 5.14 (3.532) | 4.86 (4.598) | 0.094 * | −0.66 | −0.63 |
GAD-7 | 5.71 (4.751) | 4.14 (3.436) | 3.43 (3.867) | 0.264 | −0.39 | −0.53 |
DSES | 62.86 (21.075) | 65.57 (21.678) | 63.71 (20.131) | 0.580 | 0.13 | 0.04 |
SHS | 30.29 (9.196) | 26.71 (11.309) | 29.43 (9.744) | 0.834 | −0.34 | −0.09 |
MLQ-Presence | 26.14 (5.398) | 20.57 (9.071) | 22.86 (6.594) | 0.170 | −0.75 | −0.54 |
MLQ-Search | 25.57 (10.277) | 20.29 (8.499) | 21.00 (7.937) | 0.568 | −0.56 | −0.49 |
RSES | 30.00 (3.512) | 31.86 (5.956) | 32.14 (5.242) | 0.108 | 0.38 | 0.48 |
MSPSS | 4.89 (1.103) | 4.42 (0.715) | 4.39 (0.938) | 0.607 | −0.51 | −0.49 |
Words | Frequency |
---|---|
God | 86 |
Prayer/pray | 31 |
Bible | 18 |
Support | 17 |
Scripture | 17 |
Sharing/share | 14 |
Faith | 10 |
Theme 1: Meaning of the Spiritual Intervention | |
---|---|
Category 1: Faith | |
Category 2: Spiritual dimension | Subcategory 1: God’s almighty power |
Subcategory 2: Spiritual guidance | |
Subcategory 3: Spiritual inspiration | |
Subcategory 4: Words of God | |
Subcategory 5: Spiritual comfort | |
Subcategory 6: Spiritual experience | |
Subcategory 7: Prayer | |
Category 2: Spiritual transformation | Subcategory 1: Spiritual growth |
Subcategory 2: Centering | |
Subcategory 3: Compassion | |
Theme 2: Effect of the spiritual group | |
Category 1: Group experience | Subcategory 1: Acceptance |
Subcategory 2: Direction and focus | |
Subcategory 3: Peer support | |
Subcategory 4: Genuine sharing | |
Subcategory 5: Better relationship with God | |
Category 2: Increased understanding | Subcategory 1: Knowledge |
Subcategory 2: Coping with depression | |
Subcategory 3: Relapse prevention | |
Subcategory 2: Gratitude | |
Subcategory 3: Preparation in advance | |
Category 4: Spiritual life | Subcategory 1: Communication with God |
Subcategory 2: Devotion | |
Category 5: Improvement of symptoms | Subcategory 1: Improvement in general condition |
Subcategory 2: Coping | |
Subcategory 3: Increased self-esteem | |
Theme 3: Therapeutic factors/components of the spiritual intervention | |
Category 1: Belief | Subcategory 1: Power of God |
Subcategory 2: God’s omnipotence | |
Subcategory 3: Relationship with God | |
Subcategory 4: God is listening | |
Category 2: Spiritual practice | Subcategory 1: Use of scripture |
Subcategory 2: Prayer | |
Subcategory 3: Sharing | |
Subcategory 4: Testimonies | |
Category 3: Group factors | Subcategory 1: Similar background |
Subcategory 2: Emotional catharsis | |
Subcategory 3: Support | |
Category 4: Spiritual advancement | Subcategory 1: Forgiveness |
Subcategory 2: Obedience | |
Subcategory 3: Meaning in suffering | |
Subcategory 4: Experiencing God | |
Category 5: Inspiration | Subcategory 1: Self-understanding |
Subcategory 2: Increased insight | |
Theme 4: Participants’ views on and suggestions for the programme | |
Category 1: Suggestions for the programme | Subcategory 1: Logistics of the program |
Subcategory 2: Program’s content and duration | |
Subcategory 3: Future suggestion |
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Leung, J.; Li, K.-K. Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study. Healthcare 2023, 11, 2134. https://doi.org/10.3390/healthcare11152134
Leung J, Li K-K. Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study. Healthcare. 2023; 11(15):2134. https://doi.org/10.3390/healthcare11152134
Chicago/Turabian StyleLeung, Judy, and Kin-Kit Li. 2023. "Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study" Healthcare 11, no. 15: 2134. https://doi.org/10.3390/healthcare11152134
APA StyleLeung, J., & Li, K. -K. (2023). Faith-Based Spiritual Intervention for Persons with Depression: Preliminary Evidence from a Pilot Study. Healthcare, 11(15), 2134. https://doi.org/10.3390/healthcare11152134