نویسندگان

1 دکترای تخصصی روان‌شناسی سلامت دانشگاه تهران

2 دانشگاه خوارزمی

3 استاد روان‌شناسی دانشگاه تهران

4 استاد بیهوشی دانشگاه علوم پزشکی ایران

چکیده

هدف پژوهش حاضر مقایسه اثر­بخشی معنویت­درمانی مبتنی بر فرهنگ ایرانی با رویکرد شناختی-رفتاری با رویکرد ذهن­آگاهی مبتنی بر کاهش استرس در کاهش افسردگی،اضطرابواسترس در بیماران مبتلا به درد مزمن بود. جامعه آماری پژوهش کلیه بیماران مبتلا به درد مزمن عضلانی­-اسکلتی مراجعه­کننده به بیمارستان حضرت­رسول­اکرم (ص) در شهر تهران بود. روش پژوهش از نوع شبه­آزمایشی با پیش­آزمون-پس­آزمون، گروه کنترل و دوره پیگیری بود. در این پژوهش تعداد 45 نفر با استفاده از روش نمونه­گیری داوطلبانه در سه گروه 15 نفره (معنویت­درمانی، ذهن­آگاهی و کنترل) طی 8 جلسه­ی 90 دقیقه­ای تحت مداخله­ قرار گرفتند. برای جمع­آوری داده­ها از پرسشنامه اطلاعات جمعیت­شناختی و مقیاسافسردگی،اضطرابواسترس استفاده شد. داده‌ها با استفاده از تحلیل واریانس با اندازه­گیری مکرر تحلیل شد. نتایج پژوهش نشان داد که میانگین­ افسردگی، اضطراب و استرس در دو گروه معنویت­درمانی مبتنی بر فرهنگ ایرانی با رویکرد شناختی-رفتاری و ذهن­آگاهی مبتنی بر کاهش استرس با یکدیگر تفاوت معناداری ندارند. به عبارت دیگر اثربخشی مداخله های­ درمانی در هر دو گروه یکسان می­باشد. مقایسه­های زوجی نشان می­دهد که بین افسردگی، اضطراب و استرس در سه مرحله پیش­آزمون، پس­آزمون و پیگیری تفاوت معناداری وجود دارد. افزون بر این میانگین افسردگی، اضطراب و استرس در بین گروه­های معنویت­درمانی و ذهن­آگاهی با گروه کنترل تفاوت معناداری دارند. میانگین افسردگی، اضطراب و استرس در گروه­های معنویت­درمانی و ذهن‌آگاهی پایین­تر از گروه کنترل می­باشد. به عبارت دیگر اثربخشی معنویت­درمانی و ذهن­آگاهی در کاهش افسردگی، اضطراب و استرس بیشتر از گروه کنترل در بیماران مبتلا به درد مزمن می­باشد. نتایج پژوهش نشان داد که مداخله معنویت­درمانی مبتنی بر فرهنگ ایرانی با رویکرد شناختی-رفتاری و مداخله ذهن­آگاهی مبتنی بر کاهش استرس در کاهش افسردگی، اضطراب و استرس در بیماران مبتلا به درد مزمن اثربخش بودند.

کلیدواژه‌ها

عنوان مقاله [English]

Comparing the Effectiveness of Spiritual Therapy Based on Iranian Culture with Mindfulness Based on Reduction Stress (MBSR) in Reducing Depression, Anxiety and Stress in Patients with Chronic Pain

نویسندگان [English]

  • Ali Akbar Haddadi Kuhsar 1
  • alireza moradi 2
  • Bagher Ghobari Bonab 3
  • Farnad Imani 4

1 Ph.D. in Health Psychology, University of Tehran, Tehran

2 kharazmi university

3 Professor, Department of Psychology, University of Tehran,

4 Professor, Department of Anesthesiology and Pain, Iran University of Medical

چکیده [English]

The main aim of the current study was to compare the effectiveness of spiritual therapy based on Iranian culture with mindfulness based on reduction stress (MBSR) in reducing depression, anxiety and stress in patients with chronic pain. All subjects who are suffer from Muscular-Skeletal disease were recruited from Hazrat-e-Rassoul Hospital, (Iran University of Medical Sciences, Tehran, Iran). Design of the study was quasi experimental pretest-posttest-control group design with follow-up stage. 45 patients randomly were assigned in three groups: Spiritual therapy, mindfulness therapy and control group. Each group constituted of intervention comprised of eight 90-minutes-sessions. Demographic information’s and depression, anxiety and stress scale were used to gather data. Data were analyzed with analysis of variance with repeated measurement. Analysis of data revealed that spiritual therapy and mindfulness therapy were not significantly different in reduction depression, anxiety and stress in patients with chronic pain (These treatment were equally effective). More ever, comparing pairs in groups revealed that depression, anxiety and stress were different in treatment and follow up stages. Both spiritual therapy and mindfulness therapy were different from the control group. Spiritual therapy and mindfulness therapy were lower in depression, anxiety and stress in compare to control group. In other word effectiveness of spiritual therapy and mindfulness therapy were more than control group in patients with chronic pain. Results showed that spiritual therapy and mindfulness therapy were effective in reduction of depression, anxiety and stress in patients with chronic pain.   

کلیدواژه‌ها [English]

  • Keywords: Spiritual Therapy
  • Mindfulness
  • Depression
  • Anxiety
  • stress
  • Chronic Pain
  • Patients
پدرام، محمد؛ محمدی، مسعود؛ نظیری، قاسم؛ آیین پرست، ندا .­(1389). اثر بخشی گروه درمانی شناختی-رفتاری بر درمان اختلال اضطراب، افسردگی و ایجاد امیدواری در زنان مبتلا به سرطان سینه . فصلنامهیعلمی-پژوهشیزنو جامعه. 1، 4، 75-61.
حمید، نجمه.­(1388). بررسی رابطه نگرش مذهبی با سلامت روانی و عملکرد سیستم ایمنی بدن سلولهایT کمکی، سلول­های مهاری/انهدامی و سلول­های ضد سرطانی NK.مطالعاتروانشناختی. 5، 28-17.
حمید، نجمه؛ احمدیان، علی و اکبری­شایه، یحیی.­(1391). بررسی اثربخشی درمانگری مذهب­محور بر میزان امیدواری وکیفیت زندگی بیماران مبتلا به سرطان سینه. مجله پزشکی هرمزگان. 16، 3، 221-213.
درویشی، حشمت­الله. (1388). بررسی کاربرد تصویر­سازی ذهنی و ریلکسیشن برکاهش اضطراب، افسردگی بیمارستان و افزایش امید به زندگی در زنان مبتلا به سرطان سینه بیمارستان گلستان اهواز. پایاننامهکارشناسیارشد، دانشگاه آزاد اسلامی واحد اهواز.
کلینی، محمد­بن­یعقوب. (1379). اصول الکافی. ج 2و3، ص 239، حدیث 5. ترجمه محمد‌باقر کمره­ای، تهران، دفتر مطالعات تاریخ و معارف اسلامی.
لطفی­کاشانی، فرح؛ مفید، بهرام؛ و سرافراز­مهر، سعیده. (1392). اثر بخشی معنویت­درمانی بر کاهش اضطراب، افسردگی و پریشانی زنان مبتلا به سرطان پستان. اندیشهورفتار. 7، 27، 36-27.
محمدی، شهناز. (1392). اثر معنویت­درمانی بر افسردگی زنان سالمند ساکن آسایشگاه سالمندان.فصلنامهمطالعاتروان‌‍شناسیبالینی. 12، 3، 82-71.
یعقوبی، حسن؛ سهرابی، فرامرز و محمدزاده، علی. (1391). مقایسه تأثیر رفتار درمانی شناختی و روان درمانی معنوی-مذهبی برکاهش اضطراب پنهان. فصلنامهمطالعاتروان‌شناسیبالینی. 7، 2، 169-151.
Achour, M., Bensaid, B., & Mohd Nor, M. R. B. (2016). An Islamic Perspective on Coping with Life Stressors. Applied Research Quality Life. 11: 663–685. DOI 10.1007/s11482-015-9389-8
Aten, D.J., & Schenck, J. E. (2007). Reflections on religion and health research: An interview with Dr. Harold G. Koenig. Journal of Religion and Health. 46, 183–190.
Aten, D.J., & Worthington, E. L. (2009). Next Steps for Clinicians in Religious and Spiritual Therapy: An Endpiece. Journal of clinical psychology. 65, 224-229.
Avants, S. K., & Margolin. A. (2004). Development of spiritual self-schema (3-S) therapy for the treatment of addictive and HIV risk behavior: A convergence of cognitive and Buddhist psychology. Journal of Psychotherapy Integration. 14,253–289.10.1037/1053-0479.14.3.253
Azhar, M. Z., & Varma, S. L. (1995). Religious psychotherapy as management of bereavement. Acta Psychiatrica Scandinavica. 91, 233–235.10.1111/j.1600-0447.
Azhar, M. Z., Varma, S. L., & Dharap, A. S. (1994). Religious psychotherapy in anxiety disorder patients. Acta Psychiatrica Scandinavica. 90, 1–3.10.1111/j.1600-0447.1994.tb01545.x.
Baniasadi, H., Lotfi, F., & Jamshidifar, Z. (2014). Effectiveness of mindfulness training on reduction of distress of patients infected by breast cancer. Procedia - Social and Behavioral Sciences, 114, 944-948. Doi: 10.1016/j.sbspro.
Barrera, T. L., Zeno, D., Bush, A. L., Barber, C. R., Stanley, M. A. (2012). Integrating religion and spirituality into treatment for late-life anxiety: three case studies. Cognitive and Behavioral Practice. 19 (2): 346-58.
Berry, D. (2002). Does religious psychotherapy improve anxiety and depression in religious adults? A review of randomized controlled studies. International  Journal of Psychiatric Nursing Research. 8:875–890.
Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosom Med. 64: 71–83.
Bormann, J. E., Gifford, A. L., Shively M, Smith TL, Redwine L, Kelly A., & Belding, W. (2006). Effects of spiritual mantram repetition on HIV outcomes: A randomized controlled trial. Journal of Behavioral Medicine. 29:359–376. 10.1007/s10865-006-9063-6.
Bormann, J. E., Thorp, S. R., Wetherell, J. L., Golshan, S., & Lang, A. J. (2013). Meditation-based mantram intervention for veterans with postraumatic stress disorder: A randomized trial. Psychological Trauma, Theory, Research, Practice, and Policy. 5, 259–267. 10.1037/a0027522.
Borysenko, J., & Borysenko, M. (1994). The power of mind to heal: Renewing body, mind, and spirit. Carson, CA: Hay House.
Carlson LE, Speca M, Patel KD, Goodey E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic medicine. 65(4):571-81.
Carlson LE, Ursuliak Z, Goodey E, Angen M, Speca M. (2001). The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Supportive Care in Cancer. 9(2):112-23.
Carlson, L E, Speca M, Patel KD, Goodey E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 29(4):448-74.
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology. 52:685–716.10.1146/annurev.psych.52.1.685
Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry research. 187(3):441-53.
Cole, B., & Pargament, K. I. (1999). Re-creating your life: A spiritual/psychotherapeutic intervention for people diagnosed with cancer. Psycho-Oncology. 8:395–407.10.1002/ (SICI) 1099-1611.
Coruh, B., & et al. (2005). Does religious activity improve health outcomes? A critical review of the recent literature. Explore. 1, 186-191.
Covinsky, K. E., Kahana, E., Chin, M. H., Palmer, R. M., Fortinsky, R. H., & Landefeld, C. S. (1999). Depressive symptoms and 3-year mortality in older hospitalized medical patients. Annals of Internal Medicine. 130, 563–569. 10.7326/0003-4819-130-7.
Crawley, R. (2015). Trait mindfulness and autobiographical memory specificity. Cognitive processing, 16(1), 79–86.
Davidson R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003) Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570.
Davydow, D. S., Russo, J. E., Ludman, E., Ciechanowski, P., Lin, E.H.B., Korff, M. V., & Katon, W. J. (2011). The association of comorbid depression with intensive care unit admission in patients with diabetes: A prospective cohort study. Psychosomatics. 42:117–126. 10. 1016/j. psym. 2010. 12. 020.
Echstein, D., & Kern, R. (2002). Life style assessment and interventions, life style skills. Ed: Lowa: Kend/Hunt. 5, 238.
Epstein, M. (1995). Thoughts without a thinker: Psychotherapy from a Buddhist perspective. New York, NY: Basic Books.
Exline, J., (2008). Beliefs about God and forgiveness in a Baptist church sample. Journal of Psychologyand Christianity. 27, 131- 139.
Fabricatore, A. N., Handal, P. J., & Fenzel, L. M. (2000). Personal spirituality as a moderator of the relationship between stressors and subjective well-being. Journal of Psychology & Theology, 28, 221–228.
Ferriss, A. L. (2002). Religion and the quality of life. Journal of Happiness Studies. 3, 199-215.
Foureur, M., Besley, K., Burton, G., Yu, G., & Crisp, J. (2013). Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemporary Nurse. 45:1, 114-125.
Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., & Fawcett, J. (2010). Antidepressant drug effects and depression severity: A patient-level meta-analysis. Journal of the American Medical Association. 303, 47–53. 10.1001/jama.2009.1943 .
Gartlehner, G., Hansen, R. A., Morgan, L. C., Thaler, K., Lux, L. J., Van Noord, M., Mager, U., Gaynes, B. N., Thieda, P., Strobelberger, M., Lloyd, S., Reichenpfader, U.,  & Lohr, K. N. (2007). Comparative Effectiveness Reviews, No. 46. Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An Update of the 2007 Comparative Effectiveness Review. RTI–UNC Evidence-based Practice Center Research Triangle Park, NC. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK83442/ 
Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: evidence of post intervention and 3-year follow-up benefits in wellbeing. Psychotherapy and Psychosomatics. 76(4), 226–233.
Grossmana, P., Niemannb, L., Schmidtc, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research. 57, 35–43.
Hackney, C. H. & Sanders, G. S. (2003). Religiosity and mental health: A Meta analysis of recent studies. Journal for the Scientific Study of Religion. 42, 43-55.
Hebert, R., S. Weinstein, E., Martive, L., & Schuh. R. (2006). Religion, spirituality and the well being of in formal caregivers: A review, critique and research prospectus. Aging and mental health. 10, 496- 520.
Hills, P. & Francis, L. J. (2004). Primary Personality trait correlates religious practice and orientation. Journal of Personality and Individual Differences. 36, 61-73.
Hilton, L., Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco B., Maher, A. R., Shanman, R. M., Sorbero, M. E., Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.  ann. behav. med. 51: 199–213.
Hodge, D. R. (2006). Spiritually modified cognitive therapy: A review of the literature. Social Work. 51:157–166. 10.1093/sw/51.2.157.  
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology. 78 (2),169-83.
Hook, J. N., Worthington, E. L., Davis, D. E., Jennings, D. J., Gartner, A. L., & Hook, J. P., (2010). Empirically supported religious and spiritual therapies. Journal of Clinical Psychology. 66, 46–72.
Jastrowski Mano, K. E., Salamon, K. S., Hainsworth, K. R., Anderson Khan, K. J., Ladwig, R. J., Davies, W. H., & Weisman, S. J. (2013). A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Altern Ther Health Med, 19(6), 8–14.
Kabat-Zinn, J. (1990) Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress Pain and Illness. New York: Dell Publishing.
Kabat-Zinn J, Lipworth L, Burney R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 8: 163–190.
Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, et al. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry. 149(7):936-43.
Kabat-Zinn J. (2003). Mindfulness-based interventions in context: past, present, and future. Clin Psychol: Sci Pract. 10: 144-56.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psych. 4: 33- 47.  
Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev. 31(6):1041–56.
Kézdy, A. & et al. (2010). Religious doubts and mental health in adolescence and young adulthood: The association with religious attitudes. Journal of Adolescence. 11, 1-9.
Kingston, J., Chadwick, P., Meron, D., & Skinner, T. C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of psychosomatic research. 62(3):297-300.
Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health. 2. New York, NY: Oxford University Press.
Koenig, H. G., Shelp, F., Goli, V., Cohen, H. J., & Blazer, D. G. (1989). Survival and healthcare utilization in elderly medical inpatients with major depression. Journal of the American Geriatrics Society. 37:599–606.
Koenig, H. G. (2012). Religious versus conventional psychotherapy for major depression in patients with chronic medical illness: Rationale, methods, and preliminary results. Depression Research and Treatment. Online first. 10.1155/2012/460419
Koszycki, D., Bilodeau C., Raab-Mayo, K., & Bradwejn, J. (2014). A multifaith spiritually based intervention versus supportive therapy for generalized anxiety disorder: A pilot randomized controlled trial. Journal of Clinical Psychology. 10.1002/jclp.22052.
Koszycki, D., Raab, K., Aldosary, F., & Bradwein, J. (2010). A multifaith spiritually based intervention for generalized anxiety disorder: A pilot randomized trial. Journal of Clinical Psychology. 66, 4,  430–441.
Kyranou, M. et al., (2013). Differences in depression, anxiety, and quality of life between women with and without breast pain prior to breast cancer surgery. European Journal of Oncology Nursing. 17, 190-195.
Levin, J. S., & Chatters, L. M. (1998). Research on religion and mental health: An overview of empirical findings and theoretical issues. In H. G. Koenig (Ed.), Handbook of religion and mental health (pp. 70–84). San Diego, CA: Academic Press.
Lovibond, S. H., & Lovibond, P. E (1995). Manual for the Depression Anxiety Stress Scales, (2nd Ed.). Sydney, Australia: Psychology Foundation of Australia.
Lustman, P. J., Griffith, L. S., Freedland, K. E., Kissel, S. S., & Clouse, R. E. (1998). Cognitive behavioral therapy for depression in type 2 diabetes mellitus. A randomized controlled trial. Annals of Internal Medicine. 129:613–621. 
Lynn, B., Yoo, G. J., Levine, E. G. (2014). ‘‘Trust in the Lord’’: Religious and Spiritual Practices of African American Breast Cancer Survivors. J Relig Health. 53:1706–1716. DOI 10.1007/s10943-013-9750-x
Makros J, Maccabe M. (2003). The relationship between religion spirituality psychological adjustment and quality of life among people with multiple sclerosis. Journal of religion and health 42(2): 143-59.
McCauley, J., Tarpley, M. J., Haaz, S., & Bartlett, S. J. (2008). Daily spiritual experiences of order adults with and without arthritis and the relationship to health outcomes. Arthritis Rheum. 59(1): 122-8.
Monti, D., Peterson, C., Kunkel, E., Hauck, W., Pequignot, E., Rhodes, L., et al. (2006). A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psycho-oncology.15(5):363-73.
Murray-Swank, N. A., & Pargament, K. I. (2005). God, where are you? Evaluating a spiritually-integrated intervention for sexual abuse. Mental Health, Religion and Culture. 8, 191–203. 10. 1080/ 13694670500138866.
Ong, S. C., Mak, B., Aung, M. O., Li, S. C., & Lim, S. G. (2008). Health related quality of life in chronic hepatitis B patients. Hepatology. 47, 1108-17.
Pargament, K. I. (1990). God help me: Toward a theoretical framework of coping for the psychology of religion. Research in the Social Scientific Study of Religion. 2, 195–224.
Pargament, K. I. (1999). The psychology of religion and spirituality? Yes and no. The International Journal for the Psychology of Religion, 9, 3-16.
Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the Sacred. New York, NY: Guilford Press.
Paukert, A. L., Phillips, L., Cully, J. A., Loboprabhu, S. M., Lomax, J. W., Stanley, M.A. (2009). Integration of religion into cognitive-behavioral therapy for geriatric anxiety and depression. J Psychiatr Pract. 15 (2): 103-12.
Pearce, M. J., & Koenig, H. K. (2013). Cognitive behavioral therapy for the treatment of depression in Christian patients with medical illness. Mental Health, Religion, and Culture. 16:730–740. 10.1080/13674676.2012.718752
Petersen, T. J, Sprich, S. E., & Wilhelm, S. (2016). The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy. Humana press.
Picdmont, R. L. (2004). The logoplex as a paradigm understanding spiritual transcendcnce. Research in the Social Scientific study of Religion. 15, 262-284.
Propst, R., Robins, C., Pearce, M, G., Koenig, H. G. (2014). Conventional Cognitive Behavioral Therapy (Treatment Manual for Depression in Clients with Chronic Physical Illness).
Razali, S. M., Hasanah, C. I., Aminah, K., & Subramaniam, M. (1998). Religious–sociocultural psychotherapy in patients with anxiety and depression. Australian and New Zealand Journal of Psychiatry. 32, 867–872.10.3109/00048679809073877.
Richards, P. S., & Bergin, A. E. (2004). Casebook for a Spiritual Strategy in Counseling and Psychotherapy. American Psychological Association, 1nd ed. Washington, DC, US.
Richards, P. S., & Bergin, A. E. (2005). A spiritual strategy for counseling and psychotherapy. American Psychological Association. 2nd ed. Washington, DC, US:
Richard. J., Santen, M. D., & Sellin M. D. (2007). Breast cancer prevention. Journal of clinical Endocrinology and metabolism. 33-39.
Richards, P. S., & Bergin, A. E. (1997). A spiritual strategy for counseling and psychotherapy. Washington, DC: American Psychological Association.
Richards, P. S., & Potts, R. (1995a). Using spiritual interventions in psychotherapy: Practices, success, failure, and ethical concerns of Mormon psychotherapists. Professional Psychology: Research and Practice. 26, 163-170.
Richards, P. S., & Potts, R. (1995b). Spiritual interventions in psychotherapy: A survey of practices and beliefs of AMCAP members. Association of Mormon Counselors and Psychotherapists Journal. 21, 39-68.
Rose, E. M., Westefeld, J. S., & Ansely, T. N. (2001). Spiritual counseling: Clients’ beliefs and preferences. Journal of Counseling Psychology. 48, 61–71. 10.1037/0022-0167.48.1.61
Rosenzweig, S., Greeso, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: Variationin treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research. 68, 29- 36.
Rubin, J. B. (1996). Psychology and Buddhism. New York, NY: Plenum Press.
Sahebi, A., Salari, R., & Asgari, J. (2005). Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Developmental Pscychology. 1(4):299-312.
Sanders, P. W., et al., (2015). Intrinsic Religiousness and Spirituality as Predictors of Mental Health and Positive Psychological Functioning in Latter-Day Saint Adolescents and Young Adults. Journal of Religion Health. 54: 871–887.
Savard, J., Simard, S., Giguere, I., Ivers, H., Morin, C. M., Manusell, E., & Marceau, D. (2006). Randomized clinical trial on cognitive therapy for depression in women with metastic breast cancer: Psychological and immunological effects. Palliative Supportive Care. 4, 219–237.
Serpa, J. G., Taylor, S. L., & Tillisch, K. (2014). Mindfulness-based stress reduction (MBSR) reduces anxiety, depression, and suicidal ideation in veterans. Medical Care, 52, 19–24.
Sheeran, T., Byers, A. L., & Bruce, M. L. (2010). Depression and increased short-term hospitalization risk among geriatric patients receiving home healthcare services. Psychiatric Services. 61, 78–80. 10.1176/appi.ps.61.1.78.
Shonin, E., Van Gordon, W., & Griffi ths, M. D. (2014). The emerging role of Buddhism in clinical psychology: Toward effective integration. Psychology of Religion and Spirituality, 6, 123–137.
Shonin, E., Van Gordon, W., & Griffiths, M, D. (2016). Mindfulness and Buddhist-Derived Approaches in Mental Health and Addiction. Springer.
Shultz, Whitney & Zickar. (2014). Measurement theory in action: case studies and exercises. Taylor & Francis. Second Edition.
Sibinga, E. M., Perry-Parrish, C., Chung, S. E., Johnson, S. B., Smith, M., & Ellen, J. M. (2013). School-based mindfulness instruction for urban male youth: A small randomized controlled trial. Prev Med, 57(6), 799–801.  doi:10.1016/j.ypmed.2013.08.027
Siegle, G., Steinhauer, S., Friedman, E., Thompson, W., & Thase, M. (2011). Remission Prognosis for cognitive therapy for Recurrent Depression Using the Pupil: Utility and Neural Correlates. Biological Psychiatry. 69 (8): 726-733.
Simon, G. E., Von Korff, M., Lin, E. (2005). Clinical and functional outcomes of depression treatment in patients with and without chronic medical illness. Psychological Medicine. 35, 271–279. 10.1017/S0033291704003071.
Sinyor, M., Schaffer, A., Levitt, A. (2010). The sequenced treatment alternatives to relieve depression (STAR*D) Trial: A review. The Canadian Journal of Psychiatry. 55, 126–135.
Smith, T. B., Bartz, J., & Richards, P. S. (2007). Outcomes of religious and spiritual adaptations in psychotherapy: A meta-analytic review. Psychotherapy Research. 17, 643–655. 10.1080/10503300701250347.
Spilka, B.; Hood, R. W.; Hunsberger, B. Gorsuch, R. (2003). The psychology of religion. 3rd Edition. New York: Guilford.
Stanley, M. A., Bush, A. L., Camp, M. E., Jameson, J. P., Phillips, L. L., Barber, C. R., & Cully, J. A. (2011). Older adults’ preferences for religion/spirituality in treatment of anxiety and depression. Aging and Mental Health. 2011; 15:334–343. 10.1080/13607863.2010.519326.
Tan, L., & Martin, G. (2013). Taming the adolescent mind: Preliminary report of a mindfulnessbased psychological intervention for adolescents with clinical  heterogeneous mental health diagnoses. Clin Child Psychol Psychiatr, 18(2), 300–312.
Tan, S. Y., & Johnson, W. B. (2005). Spiritually-oriented cognitive-behavioral-therapy. In: Sperry, L.; Shafranske, EP., editors. Spiritually-oriented psychotherapy. Washington, DC: American Psychological Association. 77-103.
Tarakeshwar, N., Pearce, M. J., & Sikkema, K. J. (2005). Development and implementation of a spiritual coping group intervention for adults living with HIV/AIDS: A pilot study. Mental Health, Religion, and Culture. 8, 179–190. 10.1080/13694670500138908.
Taylor, E. (2009). Promoting spiritual health in home health care. Home health care. 26 (6), 367-374.
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: empirical evidence. J Consult Clin Psychol. 70: 275–287.
Triandis, H. C. & Suh, E. M. (2002). Culture influences on personality. Annual Review of Psychology. 53(1): 133- 160.
Van der Oord, S., Bogels, S. M., & Pejnenberg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies. 21(1), 139–147.
Van Straten, A., Geraedts, A., Verdonck-de Leew, I., Andersson, G., & Cuijpers, P. (2010). Psychological treatment of depressive symptoms in patients with medical disorders: A meta anaylsis. Journal of Psychosomatic Research. 69:23–32.
Van Straten, A., Geraedts, A., Verdonck-de Leew, I., Andersson, G., & Cuijpers, P. (2010). Psychological treatment of depressive symptoms in patients with medical disorders: A meta anaylsis. Journal of Psychosomatic Research. 69:23–32.
Wade, N. G., Worthington, E. L., Vogel, D. L. (2007). Effectiveness of religiously tailored interventions in Christian therapy. Psychotherapy Research. 17: 91–105.
Waelde, L. C. et al. (2017). A Pilot Study of Mindfulness Meditation for Pediatric Chronic Pain. Children. 4, 32. doi:10.3390/children4050032
Walsh, J. J., Balint, M. G., Smolira, S. J. D. R., Fredericksen, L. K., & Madsen, S. (2009). Predicting individual differences in mindfulness: The role of trait anxiety, attachment, anxiety and attentional control. Personality and Individual Differences. 46(2):94-9.
Wang, C.-W., Chan, C. L. W., Ng, S.-M., & Ho, A. H. Y. (2008). The impact of spirituality on health-related quality of life among Chinese older adults with vision impairment. Aging & Mental Health, 12(2), 267–75.
Weisman, D. E., Maman, A. G., Tuchman, N., Duarte, E. A. (2010). Incorporating religion/spirituality into treatment for serious mental illness. Cognitive and Behavioral Practice. 17 (4): 348-57.
Williams, & Penman, D. (2012). Mindfulness: A practical guide to finding peace in a frantic world.Piatkus. co. uk
World Health Organization. (2008). Global burden of disease summary tables. Geneva, Switzerland: Health statistics and informatics Department, World Health Organization.
Worthington, E. L Jr., Hook, J. N., Davis, D. E., McDaniel, M. A. (2011). Religion and spirituality. Journal of Clinical Psychology: In Session. 67, 204–214. 10.1002/jclp.20760.
Worthington, J. R., & Sandage, S. J. (2016). Forgiveness and spirituality in psychotherapy: a relational approach. 1ed. American Psychological Association.
Zulling, K. J., Ward, R. M. & Horn, T. (2006). The Association between Perceived Spirituality, Religiosity and Life Satisfaction: the Mediating Role of Self-Rated Health. Social Indicators Research. 79, 255-274.