South African Society of Psychiatrists Guidelines for the Integration of Spirituality in the Approach to Psychiatric Practice

By van Rensburg, A. B. R. Janse | South African Journal of Psychiatry, November 2014 | Go to article overview

South African Society of Psychiatrists Guidelines for the Integration of Spirituality in the Approach to Psychiatric Practice


van Rensburg, A. B. R. Janse, South African Journal of Psychiatry


As a result of the fact that human consciousness transcends materialistic explanations, psychiatry now finds itself at an important crossroad. The fostering of spirituality and well-being is crucial for psychiatry to achieve its meaning and purpose, but spirituality and well-being have been neglected because of the tendency toward materialistic reductionism. (C R Cloninger) [1]

Neeleman and King [2] noted in 1993 that psychiatrists often ignore spirituality because: (i) it is considered unimportant; (ii) it is considered important but irrelevant to psychiatry; (iii) they may feel they know too little about it themselves to comment, or even to ask questions; (iv) the very terminology is confusing and hence embarrassing; and (v) there may also be an element of denial in which it is easier to ignore this area than to explore it as it is too personally challenging. Some years later, in terms of psychiatrists' own religious affiliation, Sims[3] referred to a study of psychiatrists working in London teaching hospitals. Although only 27% reported religious affiliation and 23% a belief in God, 92% felt that psychiatrists should be aware of the religious concerns of their patients.

Since then, it has become important to establish how, within accepted professional boundaries, the role of spirituality should be incorporated appropriately into the current model for practice and training. Curlin et al. [4] found that psychiatrists are more likely (82% v. 44%) to note that religion/spirituality sometimes causes negative emotions and also more likely (92% v. 74%) to encounter religious/ spiritual issues in a clinical setting). They also found that psychiatrists were less religious than other specialists, and that religious physicians were less willing to refer patients to psychiatrists. [5] According to them, this suggests that the historic tension between religion and psychiatry continues to shape the care that patients receive'.

A number of South African (SA) inquiries on spirituality, psychiatry and mental health have been published since 2011, including an explorative qualitative inquiry on the views and experiences of some local academic psychiatrists on the role of spirituality in SA specialist psychiatric practice and training, [6] interviews with a sample of Muslim psychiatrists in Johannesburg, [7] and an investigation of SA Hindu psychologists' perceptions of metal illness. [8]

During the 17th National SASOP Congress in September 2012, a decision was taken by the SASOP Spirituality and Psychiatry Special Interest Group (S&PSIG) (available from author), that some guidelines should be developed on how to include the role of spirituality in local specialist psychiatric practice and training appropriately. During August/September 2013, a draft document, 'Proposed Framework for Guidelines on the Role of Spirituality in Psychiatry Practice and Training', was submitted to the SASOP National Council for consideration, and subsequently circulated for comments to members of the SASOP, including the SASOP S&PSIG. After incorporating these comments from members, a final draft document was resubmitted to, and approved by, the SASOP Board of Directors in March 2014.

1. Reasons and context for guidelines

These guidelines were developed in view of the following:

1.1 World-wide religious affiliation

The Pew Research Centre's Forum on Religion and Public Life[9] recently published a review on the world's major religious groups in 2010. The study assembled data on the size and geographical distribution of eight major religious groups, including the religiously unaffiliated, and estimated that there are 5.8 billion religiously affiliated adults and children around the globe, representing 84% of the 2010 world population of 6.9 billion. The demographic study, based on an analysis of more than 2 500 censuses, surveys and population registers, found that worldwide, there were 2. …

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