Many of the clergy who lead America’s 260,000 religious congregations turn to psychologists who share their religious values when they refer congregants to social workers. However, this approach could impede people from getting the care they need, maintains Dr. Glen Milstein, Professor of Psychology at The City College of New York (CCNY).
For the past decade, Professor Milstein has led a multidisciplinary team of researchers in developing a new model for relationships between clergy and clinicians that is religion inclusive rather than faith based. Known as C.O.P.E. (Clergy Outreach and Professional Engagement), the approach is design to reduce burdens on both professions. It was described in detail earlier this year in the American Psychological Association’s journal “Professional Psychology: Research and Practice.”
The key to the C.O.P.E. model is the recognition that mental illness is a chronic disease with which patients sometimes can function and other times can not, Professor Milstein explains. “Clinicians and clergy perform distinct, complementary functions in treating these syndromes. While clinicians provide professional treatment to relieve individuals of their pain and suffering and move them from dysfunction to their highest level of function, clergy and religious communities provide a sense of context, support and community before, during and after treatment.”
The program aims to improve care of individuals by facilitating reciprocal collaboration between clinicians and members of the clergy, regardless of either’s religious affiliations. It is based on two principal ideas: The first is that clergy and clinicians can better help a broader array of persons with emotional difficulties and disorders through professional collaboration than they can by working alone, and secondly, that the program’s success is predicated on collaboration easing the workload for both groups.
Professor Milstein describes the approach as “religion-inclusive” since it calls upon the therapist to both assess the role of religion in the patient’s life and to educate themselves about the patient’s religious tradition. Often that education includes contact with the patient’s clergy.
Faith-based approaches, which call for the individual to be referred to a clinician from his or her own faith, can restrict care by excluding access to professionals best able to treat the condition, he maintains. Professor Milstein cites a research study comparing the work of religious psychotherapists with the work of nonreligious psychotherapists in treating religious Christians. The study found that nonreligious therapists who provided religiously informed psychotherapy achieved the best clinical outcomes for this group.
Working from the National Institute of Mental Health’s four prevention categories, Professor Milstein and his team developed two handouts, one for mental health professionals and the other for clergy. They provide descriptions in a hierarchal format of the four care stages and illustrate when it would be appropriate for clergy to contact clinicians and for clinicians to contact clergy.
The goal of C.O.P.E., Professor Milstein explains, is for clergy and clinicians to provide a continuum of care, whether the person is fully functional, is under stress, requires treatment or is trying to avoid relapse. The approach has been used to facilitate collaboration between expert clinicians and clergy from a variety of faiths including: Armenian Orthodox; Roman Catholic; Ethical Culture; Hindu; Muslim; Judaism, as well as evangelical and mainline Protestant denominations.
Because clergy tend to see people throughout their lifetimes and in different circumstances, they often are in a better position to identify whether or not someone is functioning properly, Professor Milstein points out. For example, they are likely to distinguish between someone who has lost a loved one and is going through a normal bereavement process and someone who could be clinically depressed. “Recommending an intervention for someone who may be depressed relieves their (clergy) burden,” he adds.
Similarly, religious communities can relieve the burden on the clinician by helping people reenter everyday life, Professor Milstein adds. “Religious communities are primary areas of social support for most people. If religion is an important part of an individual’s life, the clinician needs to make that connection. They should contact the clergy and let them know to look out for and welcome the person back.”
Conversely, he points out that the approach would not be helpful for patients who have had negative associations with religion or religious leaders. “The model is not a panacea, but, rather, an option to engage the whole person. Patients need to be assessed and treated individually without judgments about whether religion is good or bad.”
Professor Milstein’s research collaborators were: Amy Manierre, an American Baptists minister currently pursuing as Master of Social Work Degree at University of Houston; Virginia L. Susman, M.D., Associate Medical Director and Site Director at New York Presbyterian Hospital and Associate Professor of Clinical Psychiatry at Weill Medical College, and Dr. Martha L. Bruce, Professor of Sociology in Psychology at Weill Medical College.
The research was supported by grants from: the DeWitt Wallace-Reader’s Digest Research Fellowship Program in Psychiatry; the National Institute of Mental Health; the American Psychological Association and the Professional Staff Congress – CUNY.
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