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Background: The rates of cigarette smoking among patients with schizophrenia are two to four times the rates observed in the community. Spirituality and religiousness have been shown to be associated with lower smoking rates in the general population. Aims: This study assessed the role of religion in cigarette smoking among patients with schizophrenia or schizo-affective disorder. Methods: Some 115 stabilized outpatients from Geneva's public psychiatric facilities were included. Interviews were conducted to investigate spiritual and religious beliefs, religious practices and religious coping. Cigarette smoking was assessed through interviews and medical records. Results: Some 58% of patients were smokers. Two-thirds of the total sample considered spirituality as very important or essential in their every day life. Religiosity was negatively associated with tobacco use: there were more current smokers without religious affiliation than non-smokers (p < 0.05). For non-smokers, the support of their faith community was significantly more important and they reported more frequent group religious practices than smokers (p < 0.05). This relation persisted after controlling for demographic confounders (gender, age, ethnicity, education, civil status). Conclusion: In patients with schizophrenia, religion and spirituality seem to be related to smoking behaviour. Similar results were previously found in the general population. These results underscore the need for a systematic exploration of religious issues in the care of smokers with schizophrenia. Key words: cigarette, psychosis, religion, schizophrenia, smoking, spirituality

Older adults may benefit from clinical conversations about the role of spirituality in their lives, but social workers and other helping professionals often do not have an understanding of where to proceed beyond initial questions of whether spirituality and/or religion are important and if so, what religious preference is held. Much has been written about definitions of spirituality and religion, but the literature has not yet provided a clear focus on ways to assess whether these are integrated positively or negatively in the lives of older adults. This article identifies eleven domains in spirituality that might be assessed. Within each domain an explanation is provided as well as a brief discussion of the rationale for including it in the classification. Sample interview questions and an illustrative vignette are included. Together these eleven domains build an important framework and resource for spiritual assessment with older adults. doi: 10.1300/J083v48n03_04 KEYWORDS. Spirituality, religion, aging, assessment, social work

African American elders are often acknowledged for their resilience in overcoming discrimination. Because of their unique historical experience, many have relied upon family support and spirituality to address mental health problems and have shunned professional mental health services. Despite the strengths of African American elders, there are mental health needs that require professional intervention. This article specifically discusses a mental health promotion program sponsored by the Mental Health Association of the District of Columbia. It provides a description of the program and an evaluation of its outcomes. An analysis of pre and post intervention evaluations (n = 228) shows success of the intervention in raising participant awareness of normal and abnormal mental health as well as resources available to them. doi: 10.1300/J083v48n03_09 KEYWORDS. African American elders, spirituality, mental health

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious /spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas. doi: 10.1300/J083v48n03_01 KEYWORDS. Spirituality/religiousness, social support, life satisfaction, depression, rural elderly, Brief Multidimensional Measures of Religiousness/Spirituality (BMMRS)

An innovative culturally centered group mentoring intervention is piloted with African-American boys in a relative caregiver program in Memphis. The integration of the Afrocentric conceptual framework is described. Its appropriateness for a group of at-risk urban youth is discussed. The implementation strategy includes promoting spirituality via a culturally centered mentoring approach. Spirituality is emphasized as a potential protective factor and is explored with a unique short questionnaire. The perceptions of the relative caregivers are also measured in an attempt to gauge influence of the intervention. Outcomes indicating a slight increase in spiritual orientation among the youth and improved school and home behavior are discussed, as are the limitations of this innovative culturally centered group mentoring effort. Strategies for further evaluation research are also provided. doi:10.1300/J009v30n01_06 [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: KEYWORDS, Culturally centered, African-American boys, relative care, spirituality, mentoring

Objective: The purpose of this study was to explore the role of spiritual coping in adult survivors' responses to current life stressors. Although there has been research on general coping and adult survivors of childhood sexual abuse (CSA), there has been no work done on spiritual coping behaviour and survivors' current adjustment. Method: One hundred and one adult survivors of childhood sexual abuse volunteered to participate in this study. Survivors were recruited through advertisements placed in various community venues. Survivors completed questionnaires on abuse descriptors, the coping resources of social support and general cognitive appraisal, spiritual coping and current distress. Spiritual coping was assessed in relation to a current negative life event. Results: In general, spiritual coping predicted the current distress of adult survivors beyond the contribution of demographics, severity of abuse, cognitive appraisal and support satisfaction. For example, self-directed ([beta] = .27), active surrender ([beta] = .32), and passive deferral ([beta] = -.35) significantly contributed to the prediction of anxious mood, [F(15, 60) = 3.31, p < .0001], while only spiritual discontent ([beta] = .26) predicted depressive mood, [F(15, 60) = 3.66, p < .0001] beyond the contribution of other factors. Negative forms of spiritual coping (e.g., spiritual discontent) tend to be related to greater distress, while more positive forms of spiritual coping (e.g., spiritual support) were related to less distress. For instance, spiritual discontent coping was related to greater depressive mood, while active surrender coping and religious forgiveness coping (i.e., seeking God's help to relinquish negative emotion) were associated with lower levels of depressive mood. Conclusions: The results highlight the importance of making a distinction between negative and positive forms of spiritual coping when investigating the role of spirituality in the current life functioning of adult survivors of childhood sexual abuse. Keywords: Spirituality; Coping; Stress

This study used an adaptation of the stress and appraisal model to examine the mediating effects of religiosity on caregiving strain and gain with an ethnically diverse sample of 384 Alzheimer's Disease (AD) caregivers. While the regression analysis indicated that religiosity did not mediate the stress of providing care for the entire sample, there were significant differences in the use of religiosity depending on the ethnicity (African American, Hispanic, and White non-Hispanic) of the caregiver, as well as significant differences between the three cohorts in the levels of caregiving strain (depression) and gain (sell-acceptance). Implications for the use of religiosity as a protective factor for AD caregivers are discussed. KEYWORDS. Alzheimer's Disease caregiving, religiosity and spirituality, African American and Hispanic caregivers

This paper discusses some important dimensions of faith and of the social contexts surrounding faith that are illustrative of continuity and growth in spirituality in the lives of older adults. Examples of an evolving spirituality emerge in the analysis of a recent qualitative research study that probed the nature of religious experience among thirty-one community-dwelling elders and fifteen elders residing in long-term care facilities. Face-to-face interviews with these forty-six older adults and with seven people who directed or assisted with formal and informal programs of faith comprise the empirical base for this paper. The seven people, I refer to them mnemonically as faithreps, worked in various ways in the long-term care settings to provide programs involving faith to older adults. The faithreps came from a range of educational and religious backgrounds and are not accurately or handily categorized. An evolving spirituality is shaped by the older person's links to the structural and the socio-relational contexts that have been created through interaction in the past as well as through interaction in the present. Moreover, the interaction of older adults and faithreps encourages spiritual growth because as social actors engaged with one another over a sustained period of time ill an institutional setting, questions and dialogue about life and its meaning are regularly evoked. The social interactions that foster spiritual evolution may be all admixture of the secular and the sacred. Such socio-relational contexts were once part of the naturalistic settings of daily life among the old, but now must emerge through the efforts and planning of others. The salience of faith among present cohorts of older adults sensitizes us to the necessity of devoting more consideration to optimal ways of strengthening and building contexts that are conducive to the evolution of spirituality. KEYWORDS. Religion in late life, religion and spirituality in old age, identity in late life, religion and identity among older adults, the social value of faith, religion in everyday life of tile old

Geriatric care managers face a complex task of helping families negotiate challenges of caring for frail elders and meeting everyday practical needs. At the same time care managers can respond to clients and families with acknowledgment of the spiritual dimension of caregiving. By being fully present to the suffering of families and elders, care managers can experience their own spiritual growth and can offer help to others at the same time. KEYWORDS. Spirituality, caregiving, dementia, geriatric care manager

This qualitative study examined ethical dilemmas faced by female caregivers of frail elders as well as the dominant role of caregivers' spirituality in addressing these dilemmas. Dilemmas are difficult decisions that involve conflicting values, e.g., freedom versus safety. In-depth interviews were conducted with thirteen ethnically diverse caregivers recruited from a home health agency and its parent hospital. Purposive sampiing was used to obtain variation among research participants. Focus group interviews of home health staff, key informant caregivers, and interviewees provided guidance for the research design, reflection on findings and development of implications. In order to deal with ethical dilemmas, all caregivers used spirituality as (1) a philosophy of life, e.g., 'This is what you do when you're family,' (2) an aid to decision-making, e.g., through the use of prayer; and/or, (3) a way to transcend dilemmas, e.g., 'no choice is hard.' Implications include the importance of care giver-driven assessment, professional self-reflection, and sustained formal services for caregivers. KEYWORDS. Ethics, caregiving, aging, religion, spiritual assessment

Postcards to God was a creative method to allow individuals to express their spirituality. The purpose of this study was to examine the validity of this innovative method. At a skilled nursing facility in a geriatric residence, 19 older disabled workshop participants created collage and message 'Postcards to God,' and completed a brief survey. Postcard content and construction were coded and analyzed using qualitative methods around self-reports along two attitudinal dimensions: (a) making a postcard to God, and (b) level of religiousness. Spiritual and religious dimensions were related to postcard thematic content. Postcards were used for expressions of spirituality and prayer across all levels of self-reported religiousness. The Postcards project seems like a useful way to facilitate spiritual expression. If validated in further study, this method may prove a useful way to promote spiritual expression in a variety of older and frail populations. KEYWORDS. Qualitative analysis, spirituality, spiritual expression

This article explores some likely characteristics of the particular and specific experiences of the relationship between religion and spirituality for cohorts born before 1935 by attending to three main points: (1) the word 'spirituality' came into common usage in the 1960s, well after people born before 1935; (2) for some in coh orts born before 1935, 'spirituality' had negative connotations; (3) a definition of 'spirituality' is possible that can express the experience of older adults and, at the same time, sharpen our current understanding of the term to include cognitive, experiential, and volitional elements. KEYWORDS. Religion, spirituality, cohort, cognition, experience, volition

Research on the concept of 'spirituality' demonstrates its overlap with 'religion,' so for many purposes they need to be considered together as 'spirituality/religion.' Investigations of age differences point to the likelihood that spirituality tends to increase during later adulthood. It has important positive relationships with various measures of life satisfaction, psychosocial well-being, and both physical and mental health. It benefits therapy for recovery from illness and is a source of meaning and purpose in life. Spiritual interventions help to relieve psychological distress and death anxiety, as well as the stresses of caregiving. Because of its therapeutic value, prayer is an important resource for coping with problems experienced during the life course. The Spiritual Well-Being Scale and many other instruments have been developed to measure spirituality and related concepts. As in all other domains of research on people, they all have limits and must be applied with caution for both technical and ethical reasons. Nevertheless, applications of the research findings, which overwhelmingly demonstrate the importance of spirituality to human well-being, already are improving the effectiveness of clinical work and social services in all of the health and human service professions. As scientific knowledge of spirituality expands, so does awareness of the need for further research, including the refinement of methodological procedures, expansion to new topics, and extension to international cultures and diverse religions. The outlook for research on spirituality and the consequent practical applications to benefit humanity is very promising. KEYWORDS. Spirituality, religion, aging, well-being, prayer, interventions, ethics

In stark contrast to Weber's warnings about bureaucracies parceling out the soul of workers, several popular and business writers claim that 'spirituality is exploding in the workplace.' Drawing on recent sociological research on spiritual practices, experiences, and discourse, we scrutinize this claim through a case study of a university hospital's nursing staff. We demonstrate that even in a workplace where a large majority of employees believe that their work practices are spiritual, they experience the sacred in a variety of ways, and are eager to talk about spirituality, many workers may still struggle to find opportunities to practice their spiritual beliefs, they may have other work experiences that cause them to doubt spirituality's relevance, and they may perceive talk about spirituality to be unwelcome. Implications of our findings for future sociological research on the sacred and the debate over secularization are discussed., SPIRITUALITY IN THE WORKPLACE: NEW EMPIRICAL DIRECTIONS IN THE STUDY OF THE SACRED It is horrible to think that the world could one day be filled with nothing but those [...]

There has been an increasing interest in spirituality among health care professionals over the last several decades. Specialists in the areas of trauma, grief, and death and dying have been among those who have shown particular interest in religious and spiritual issues. Recent efforts to distinguish religiosity from spirituality have stimulated inquiries into the changing meanings of these dimensions. Drawing on prior and parallel works, the authors created a questionnaire and asked for responses to it from convenience samples of experts in death studies (n = 22) and spiritual studies (n = 13). Our findings are suggestive of possible lines of convergence and divergence. Both groups considered themselves to be spiritual but not religious, and there was consensus that the meaning of the term spirituality is currently changing. There was also general agreement that spiritual experiences are meaningful learning opportunities and that spiritual individuals tend to be more hopeful and to experience more meaning or purpose in life than their nonspiritual peers. The themes most strongly associated with spirituality, in both groups were charity, community or connectedness, compassion, forgiveness, hope, meaning, and morality. Future research should be directed toward clarifying what people mean by 'spiritual' and how they experience and express this dimension of their lives.

This article explores the effects of child sexual abuse by priests and other perpetrators on victims' trust in the Catholic Church, priesthood, and in their relationship to God. Adult Catholics (1,810) in the United States and Canada were separated into three groups: those who reported no childhood sexual abuse (N = 1,376), those who had been sexually abused as children but not by a priest (N = 307), and those who had been sexually abused by priests (N = 40). Analyses of variances compared the level of trust in priesthood, Church, and God of these three groups and found a significant decline from those 'not abused' to those 'abused by a priest.' There was a slight decline in trust for those 'abused but not by a priest,' however, the results were statistically inconclusive. The 347 victims were then separated into two groups based upon their having received psychotherapy. The 'treatment' group (N = 152) reported significantly less trust in the priesthood, Church, and in their relationship to God than the 'no treatment' group (N = 194). This study highlighted the possible spiritual damage caused by child sexual abuse, particularly if the perpetrator was a religious leader, and supported the need to assess the religious impact of the victim's abuse and to include a process of spiritual healing. Key Words - Sexual abuse, Catholic Church, Priests, Spirituality, Trust.

This study of the restorative benefits of visiting a house of worship was based on questionnaire responses by 781 participants. Factor analysis of motivations for visiting yielded five factors, three of which matched those from a previous study (spirituality, beauty, and being away) and two new ones (contemplation and obligation). Factor analysis of activities at a house of worship yielded four factors along a gradient corresponding roughly to degree of organized religious practice: rituals, traditional activities, asking, and nonreligious activities. Spirituality and asking (for help or forgiveness) were the strongest predictors of positive outcomes, whereas nonreligious activities predicted negative outcomes. The results support and extend Attention Restoration Theory. They indicate that a house of worship can provide a compatible setting for satisfying a spirituality motive and for the cognitive activity of asking which can aid in conserving and restoring directed attention as well as fostering meditation and reflection.

A study reveals that women with abusive partners cope with the violence and the sense of betrayal in various ways, and most women turn to spirituality or God as a source of strength or comfort. Extent of religious involvement predicts increased psychological well-being and decreased depression, while greater religious involvement is also related to increased social support to colored women.

Tanice G. Foltz [*] I was first introduced to issues of gender, religion, and feminist research about 10 years ago, rather late in my career. Before that time I had [...]

Based in an unfortunate tradition that stretches back in time to Watson's behaviorism and Freud's psychoanalysis, psychology has tended to reject and to pathologize matters of the spirit. In the past 30 years, however, with the advent of what has been termed the cognitive revolution, psychology has greatly expanded the scope of its subject matter. Psychologists and thanatologists have begun to unravel the cognitive underpinnings of our assumptive world and the transformation of those underpinnings in times of crisis and stress. This article examines the cognitive basis of the spiritual experience and the use of cognitive assimilation, accommodation strategies during the process of mourning the death of a loved one, as well as during the process of living our own dying. Of special importance to mental health professionals and clergy, new research on dying, mourning, and spirituality suggests that the specific ways in which people rediscover meaning - such as belief in traditional religious doctrine, the afterlife, reincarnation, philanthropy, or a spiritual order to the universe - may be less important than the process itself. In other words, in the midst of dealing with profound loss in our lives, the ability to reascribe meaning to a changed world through spiritual transformation, religious conversion, or existential change may be more significant than the specific content by which that need is filled.

We examined the impact of personal spirituality and religious social activity on the life satisfaction of older widowed women. Fifty-one White, female retirement community residents completed measures of personal spirituality, religious social activities, and life satisfaction. Ten residents were also interviewed about their religious beliefs and activities. Although the interviews revealed both personal spirituality and religious social activity to be central to the life satisfaction of these women, quantitative results suggested only involvement with religious social activities was related to life satisfaction. Interviews revealed that church activities provided the women a loving family and a supportive community. Religious activities helped these older women overcome hardships, gave them a chance to sustain friendships, and provided a vehicle through which they could contribute to their community.