Client Attitudes toward Integrating Religion and Spirituality in Mental Health Treatment: Scale Development and Client Responses.

This article describes the development, validation, and responses to the first administration of the Religious/Spiritually Integrated Practice Assessment Scale-Client Attitudes (RSIPAS-CA). A total of 1,047 U.S. adults responded to an online survey administered by Qualtrics, which included the RSIPAS-CA for secondary analysis. Of those, 245 indicated they were either current or former mental health clients and thus were asked to complete a 10-item instrument assessing clients' attitudes toward integrating religion and spirituality (RS) in mental health treatment. A confirmatory factor analysis showed the current sample's data approached an adequate fit, and the instrument's reliability was considered very good (α = .89). Descriptive analyses indicated that clients have mixed views regarding who should initiate the discussion of RS, but a majority responded favorably toward integrating RS in practice. The article ends with a general comparison between client responses to the current survey and clinical social workers' responses to the practitioners' RSIPAS. It also discusses implications for research based on the scale development and implications for practice and education, based on client preferences.

Identifiable grief responses in persons with Alzheimer's disease.

Various dementias alter many aspects of the life and interactions between older adults and their families. This is particularly true even in a context in which the emotion is one that is expected. One such experience is the grief related to the loss of a family member. Physicians, nurses, and family members in long-term care report that they frequently have residents for whom a primary loved one, such as a spouse, has died. Questions quickly surface as to whether or not to tell the senior with dementia, how to tell the person, and how that person's response will impact the family. In two separate focus groups these questions were discussed with a group of family members and an interdisciplinary group of physicians, nurses, nurse aides, and social workers connected to long-term care facilities in one mid-sized community. Three patterns of resident response were identified. "Self-threat" describes situations in which the individual responds to the announcement of the death by questioning who will take care of them now; substitution refers to the individual's inability to remember who has died and substitution with a relative who died years ago; and metaphone, substitution of an object or unrelated item for the loss of a loved one. The authors suggest that persons with dementia should be told in most circumstances that their loved one has died, but that behavioral interventions need to be designed to address the confusion that this announcement can initiate. Families need to be prepared that the senior may not respond in the ways they once would have to this loss.