The Development and Feasibility of a Novel Group Intervention to Support Helping Professionals in Metabolizing Suffering and Engaging Strengths: The CHRYSALIS Program.

This feasibility study reports on the development and initial evaluation of a novel online intervention for helping professionals (HPs; i.e. mental health professionals, chaplains, clergy) designed to (a) address occupational hazards, such as burnout and vicarious traumatization, and (b) promote well-being and flourishing at work. In contrast with competency and self-care focused models, the CHRYSALIS (Catalyzing Helping Professionals' Resilience, VitalitY, Spirituality, Authentic Living, and Inner Strength) intervention centers the self of the provider, explores cultural and spiritual contexts, and attends to systemic challenges. As part of a larger randomized controlled trial evaluating two program formats, the group format entails eight online sessions exploring strengths that can promote well-being, including processing, relational, vitalizing, orienting, and agentic capacities. To pilot test this framework and establish proof of concept, this study analyzed data from 41 HPs who had been randomly assigned to the group condition and completed surveys at four time points. Quantitative results indicated significant reductions in vicarious traumatization and burnout as well as increased well-being and meaning in work. Qualitative results suggest the intervention fostered relational support, cultivated new perspectives, and increased engagement with strengths, positively impacting participants' work and navigation of caregiving systems. Feedback about cohesion and group dynamic challenges in an online format informed further program development. This study provides initial support for the feasibility and efficacy of the group format of the CHRYSALIS intervention as a creative means to address HPs' risk for occupational hazards and promote holistic formation in a relational context.

A practice-based study of relational virtues and alliance correspondence in psychodynamic psychotherapy.

OBJECTIVE: Treatment outcome monitoring typically emphasizes pathology. In contrast, we responded to the need to establish psychodynamic psychotherapy as evidence-based by modeling changes in gratitude and forgiveness. METHOD: We utilized a practice-based research design involving non-manualized outpatient treatment. We employed a longitudinal mixture modeling approach to evaluate treatment effectiveness. We did so by testing the theorized role for relational virtues (i.e., gratitude, forgiveness) as signs of progress in psychodynamic treatment, with relational virtues referring to the application of character strengths to specific situations. We modeled clients' self-reported level on the virtues as a joint process over five time points, and examined the influence of early treatment alliance correspondence on patterns of change using a sample of outpatient clients (N = 185; Mage = 40.12; 60% female; 74.1% White). RESULTS: A 3-class solution best fit the data, with one class exhibiting growth in gratitude and forgiveness, improved symptoms, and a greater likelihood of symptom improvement relative to well-being gains. Alliance correspondence predicted the classes of change patterns, with greater similarity between clinicians' and clients' perceptions about the alliance predicting greater likelihood of belonging to the subgroup showing highest levels of virtues and well-being, lowest symptoms, and improved well-being. CONCLUSION: Clinical implications involve monitoring gratitude and forgiveness as signs of progress and navigating the dialectic between implicit alliance processes and explicit virtue interventions. The former involves nurturing a strong alliance and repairing ruptures, whereas the latter involves direct in-session conversation and/or the practice of virtue interventions in and/or outside of session.

"God wastes nothing": A consensual qualitative study of coping among Catholic individuals with cancer diagnoses.

While religious meaning-making has been extensively studied, emic religious coping remains largely unexplored. This consensual qualitative research study explored Catholic cancer survivors' (N = 22) descriptions of drawing on their religious framework throughout their cancer journeys. Findings revealed distinctive Catholic resources such as the power of blessings, drawing comfort from the saints and sacraments, and "offering up" suffering as a form of spiritual surrender, suggesting the existence of underlying theodicies of divine purpose as well as potential clinical resources. While many participants described spiritual struggles and questions, most found meaning through deepening their faith, helping others, and re-examining their priorities. Exploratory mixed-method analyses suggest that questioning God may promote turning toward faith, while being angry at God is associated with difficulty in doing so. The findings have implications for research, pointing to emic practices that merit further study.

Supporting chaplains on the frontlines of the COVID-19 pandemic: A mixed-method practice-based pilot intervention study.

During the coronavirus disease 2019 (COVID-19) pandemic, chaplains have played a pivotal role in patient, family member, and staff care. However, little empirical attention has been given to (a) the potential toll of frontline spiritual care on chaplains' mental health and occupational functioning as well as (b) the development of interventions that can help ameliorate these risks and promote resilience. Using a mixed-method practice-based design, we conducted a pilot study (n = 77) to evaluate a novel spiritually integrated support group intervention for chaplains across multiple industries, which consisted of five Zoom-based sessions cofacilitated by psychotherapists. Participants completed pre- and postintervention measures of traumatic stress, burnout, spiritual/moral struggles, flourishing, resilience, and overall experience in the group. Qualitative findings elucidated the salience of peer support, therapeutic group processes, and key intervention components that warrant further study. Quantitative results indicated significant (a) decreases in burnout and spiritual/moral struggles from pre- to postintervention as well as (b) increases in sense of resilience and flourishing. Findings of this pilot study offer preliminary evidence for the use of a spiritually integrated group model to decrease isolation, address moral and spiritual distress, and promote resilience among chaplains. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Coping Resources among Forced Migrants in South Africa: Exploring the Role of Character Strengths in Coping, Adjustment, and Flourishing.

This phenomenological qualitative study explored how forced migrants in South Africa cope with violent, traumatic experiences and precarious resettlement conditions. Data came from a larger empirical project examining migration, psychological distress, and coping. In-depth interviews were conducted with 14 refugees and asylum seekers (Mage = 30.27, SDage = 9.27; male = 71.43%) who migrated from five African countries to Durban, South Africa. Despite overwhelming stressors, participants described pathways to transcend victimhood and hardship through engaging character strengths in ways that promote post-traumatic growth. Qualitative analysis revealed five overarching domains: spirituality and religiousness, love and kindness, hope and optimism, persistence and fortitude, and gratitude and thankfulness. Findings are framed within positive existential psychology and dual-factor understandings of mental health, which attend to both human suffering and flourishing. Limitations, future research directions, and clinical and community implications are discussed, with attention to the role of character strengths in adaptive coping and psychological well-being. The intergenerational transmission of strengths is explored as one potential means of buffering intergenerational trauma impacts and promoting family post-traumatic growth.

New horizons in group psychotherapy research and practice from third wave positive psychology: a practice-friendly review.

Group psychotherapy has been shown to be equivalent to individual therapy for many disorders, including anxiety, depression, grief, eating disorders, and schizophrenia (Burlingame & Strauss, 2021). In addition to effectiveness in reducing symptoms, group offers members a sense of belonging, purpose, hope, altruism, and meaning throughout treatment (Yalom & Leszcz, 2020). These additional outcomes are especially important considering the COVID-19 pandemic and national/international conflicts, given the trauma, disruptions, and losses people have experienced. Applying recent developments in positive psychology to group therapy can enhance treatment. A practice-friendly review examined recent advances in the positive psychology literature, demonstrating how group therapy offers members unique growth opportunities in addition to reducing symptoms. Key findings from studies applying positive psychological constructs to group therapy outcomes are synthesized. Our review sheds light on the relevance of third wave positive psychology to enrich group therapy (Lomas et al., 2021). Specifically, group therapy can facilitate the development of vitalizing psychological virtues, and these can be used to assess treatment outcome: humanity, wisdom, transcendence, courage, temperance, and justice. Interrelatedly, we present support for including attachment theory and mentalization within a positive psychological group framework. Implications are explored for group therapy research, clinical work, and training.

Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions.

A comprehensive review of the practice-based evidence for spiritually integrated psychotherapy (SIP) is necessary in order to catalyze research and training in this important diversity area. In this article, we identify and synthesize key findings from 35 studies in six key areas: (a) SIPs in trauma treatment, (b) SIPs in treating eating disorders, (c) SIPs in general psychotherapy, (d) existential concerns as part of SIPs, (e) patients and therapist attitudes about SIPs, and (f) SIP supervision and training models. Building on this, we propose a culturally contextual understanding of this diversity area, drawing from the Relational Spirituality Model (RSM). Finally, we discuss best practices for spiritually responsive clinical care and offer a research prospectus to strengthen the evidence base for real-world effectiveness. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Attachment processes following traumatic loss: A mediation model examining identity distress, shattered assumptions, prolonged grief, and posttraumatic growth.

OBJECTIVE: Sudden or violent death of a loved one poses unique challenges for the bereaved. Research has found such losses to be associated with higher levels of chronic psychological distress. The present study explored underlying mechanisms and risk and protective factors for both prolonged grief and posttraumatic growth, considering both human and divine attachment. METHOD: In a mixed college and community sample of 374 traumatically bereaved adults, we examined associations between adult attachment to close others, adult attachment to God, identity distress, and shattered assumptions with the outcome variables of prolonged grief and posttraumatic growth. RESULTS: Correlations indicate that religious individuals' attachment patterns in close adult relationships were partially mirrored in their relationship with God. Regression analyses indicate a curvilinear relationship between prolonged grief and posttraumatic growth. Path analyses indicate significant associations between insecure attachment strategies and prolonged grief symptoms through the mediators of identity distress and shattered assumptions. Specifically, attachment anxiety in relation to close others and God, and attachment avoidance in relation to close others, were indirectly associated with prolonged grief. Attachment avoidance in relation to God was negatively associated with prolonged grief and posttraumatic growth, but there was no evidence for mediation. CONCLUSION: Faced with the traumatic loss of a loved one, the ability and desire to effectively access relationships facilitating emotional processing and cognitive reorganization is predicated on survivors' internal working model of attachment. These results inform the assessment and treatment of individuals bereaved through sudden or violent means. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Attachment, coping, and psychological symptoms among military veterans and active duty personnel.

Background and Objectives: Military service is a stressful occupation, including increased risk for psychological distress. In order to provide the best care for service members and veterans (SMVs), it is important to understand personality and behavioral patterns associated with negative outcomes. This study examined links between attachment processes, coping styles, problematic alcohol use and psychological distress.Design: Using a cross-sectional, correlational design, a multi-instrument survey was administered to participants either online or in-person.Methods: Veterans and active duty service members (N = 268) completed measures of adult attachment, coping styles, alcohol use, and psychological symptoms.Results: Attachment avoidance was positively associated with avoidant coping, alcohol use, depression, and PTSD symptoms, but negatively related to problem-focused coping. Attachment anxiety was associated with avoidant coping, depression, GAD, and PTSD symptoms. Avoidant coping, but not problem-focused coping, was associated with psychological symptoms, and significant indirect relationships were noted between insecure attachment processes, avoidant coping, and psychological symptoms.Conclusion: Findings highlight personality and behavioral factors that may be important treatment foci when working with SMVs. Future studies should evaluate this model using longitudinal designs.

Religious support buffers the indirect negative psychological effects of mass shooting in church-affiliated individuals.

OBJECTIVE: Religion has been shown to protect against the negative effects of traumatic events. The current pilot study explored the extent to which religious support (i.e., sense of comfort and support from the Sacred, religious leaders, and fellow faith participants) buffered against the indirect negative psychological symptoms (i.e., religious/spiritual struggle, depression, anxiety, posttraumatic stress disorder [PTSD]) following the 2015 mass shooting on the campus of Umpqua Community College in Roseburg, Oregon. METHOD: The study examined 34 individuals (12 male, 22 female) that were indirectly affected by the mass shooting (i.e., did not directly witness the shooting and were not physically harmed by the shooting), recruited from the surrounding religious community. Participants completed measures of resource loss, religious support, religious and spiritual struggle, depression, anxiety, and PTSD symptoms. RESULTS: Religious support buffered the relationship between resource loss and negative psychological symptoms for religious and spiritual struggle, depression, and PTSD symptoms but not anxiety. CONCLUSIONS: Religious and spiritual support may be an important factor for helping church-affiliated individuals cope with the negative effects of resource loss that occur when a community is affected by a mass shooting. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Integrating clients' religion and spirituality within psychotherapy: A comprehensive meta-analysis.

Some religious or spiritual (R/S) clients seek psychotherapy that integrates R/S values, while others may be reticent to disclose R/S-related aspects of struggles in a presumably secular setting. We meta-analyzed 97 outcome studies (N = 7,181) examining the efficacy of tailoring treatment to patients' R/S beliefs and values. We compared the effectiveness of R/S-tailored psychotherapy with no-treatment controls, alternate secular treatments, and additive secular treatments. R/S-adapted psychotherapy resulted in greater improvement in clients' psychological (g = 0.74, p < 0.000) and spiritual (g = 0.74, p < 0.000) functioning compared with no treatment and non R/S psychotherapies (psychological: g = 0.33, p < 0.001; spiritual: g = 0.43, p < 0.001). In more rigorous additive studies, R/S-accommodated psychotherapies were equally effective to standard approaches in reducing psychological distress (g = 0.13, p = 0.258), but resulted in greater spiritual well-being (g = 0.34, p < 0.000). We feature several clinical examples and conclude with evidence-based therapeutic practices.