Research on Health & Spirituality
at Nyack College
Summary of Research Workshops in
August 2013 on Spirituality and Health
at Duke University Medical Center with
Dr. Harold G. Koenig, MD & Colleagues
Presenter: James Chin, Ph.D.
Spirituality In The USA
• Gallup Poll 92% Americans believe in God or a Higher Power
• 63% report membership-church, synagogue or mosque (2009)
• 43% attend religious services weekly or almost weekly (2009)
• 40 to 45% psychologists in survey report belief in a God
• 23 to 70% psychiatrists in survey report belief in a God
• APA requires all APA grad schools to teach multiculturalism &
spirituality & all have a course to address this yet survey
indicated poor grad school compliance (Cooke, et al., 2012)
• 90% medical schools have course spirituality and health yet
43% indicated more content/training necessary
• Physicians report 90% patients use spirituality in coping w. chr
medical illness yet only 39% physicians believe it is important.
Operational Definition of Spirituality
Spirituality is distinguished from its consequences – human
values, morals, meaning, purpose, peace, connectedness to
others, feelings of awe and wonder – by its link to the
transcendent. The transcendent is that which is outside of the
self, and yet also within the self – and in Western traditions is
called God, Allah, Ha Shem or a Higher Power, and in Eastern
traditions is called Ultimate Truth or Reality, Vishnu, Krishna, or
Buddha. Spirituality is intimately connected to religion, and in
fact, lies at its core (the traditional understanding). Spirituality is
a process that involves traveling along the path that leads from
non-consideration of the transcendent, to a decision to believe,
to the conforming of life to that belief, to devotion and worship
of the transcendent, and ultimately to total surrender of all
(Koenig, 2010).
Selected Measurement of Spirituality
• Duke University Religion Index (DUREL): A 5 Item Measure for Use in
Epidemiological Studies (Koenig & Bussing, 2010), Religions, 1, 78-85.
• Paloutzian, R. & Ellison, C.W.; The Spiritual Well-Being Scale (SWBS, 1982);
Bufford, R., SWBS Short Form.
• Pargament, K.I., Koenig, H.G., & Perez, L.M. (2000). The many methods of
religious coping: development and initial validation of the RCOPE. Journal
of Clinical Psychology, 56(4), 519-543.
• C.W. Ellison’s Psycho-Spiritual Needs Inventory (PNI, 1994); Chin & Chen,
PNI Factor Analysis, underway. In From Stress To Well-Being, Ellison, CW.
• Benson, P., Donahue, M. & Erikson, J. (1993). The faith maturity scale:
conceptualization, measurement and empirical validation. In Lynn &
Moberg (1993) Research in the Social Scientific Study of Religion, JAI Press.
• Hill, P. & Hood, R. (1999). Measures of Religiosity, Religious Educational
Press; compendium of published scales through 1999.
• Allport, G. & Ross, J. (1967). Personal religious orientation and prejudice.
Journal of Personality and Social Psychology, 5, 432-443; (11 item measure
of intrinsic-extrinsic religiosity).
Current State of Research on the
Relationship Between Health & Spirituality
• Robust Findings From Replicated Correlational Large
Scale Epidemiological Surveys and Studies.
• Findings Applicable to Intrinsically Religious Only,
And Not To Extrinsically Religious.
• Randomized Controlled Trials (RCTs) Currently
Underway at Duke University & Other Sites.
• Limited Empirically Supported Psychotherapy
Treatment (EST) Research on Christian
Accommodated Physical and Mental Health
Interventions (See IVP Book By Worthington,
Johnson, Hook & Atien, 2013).
Selected Empirical Findings Thus Far
• Religious involvement is related to greater
well-being and happiness.
• Religious involvement is related to less
depression & faster recovery from depression.
• Religious involvement is related to greater
meaning, hope & purpose in life.
• Religious involvement is negatively related to
suicide & suicidal ideations.
• Religious involvement is related to less alcohol
& drug use, especially among youth.
Selected Empirical Findings Thus Far
• Religious involvement is related to greater
social support.
• Religious involvement is related to more
exercise and physical activity.
• Religious involvement is related to less
cigarette smoking, esp. among youth.
• Religious involvement is related to lower
blood pressure & less coronary artery disease.
• Religious involvement is related to longevity.
Highest Priorities in Research Agenda
As Recommended by H. G. Koenig, MD
• IN MENTAL HEALTH: 1. Course of mental disorders & spirituality, 2. Course
& exacerbations of chronic mental disorders & spirituality, 3. emotional
and behavioral disorders in children including substance abuse &
delinquency & spirituality, 4. mental disorders in the elderly & spirituality.
• IN PHYSICAL HEALTH: 1. Prospective studies of common medical illnesses
with psychosomatic influences (e.g., heart disease, cancer, hypertension,
stroke, asthma, Alzheimer’s) & spirituality, 2. outcomes following surgery,
physiology of healing & spirituality, 3. Interactions with biological
treatments (e.g., antibiotics in infection or chemotherapy in cancer) &
spirituality, 4. studies on immune parameters (e.g., cytokines, NK cells, CD4 count, t-lymphocytes) & spirituality.
behaviors (e.g., diet, exercise, weight control) in religiously active vs nonreligious, 2. Studies of disease screening & detention in religiously active
vs non-religious people, 3. Studies of outcome effectiveness of health
ministries in faith communities (esp. in minority communities).
Theoretical Considerations in the
Research Agenda
• Ellison, C.W. (1994). From Stress to Well-Being, Word Press,
Waco, TX.
• Johnson, E.L. (2007). Foundations for Soul Care: A Christian
Psychology Proposal, Inter Varsity Press, Downers Grove, IL.
• Johnson, E.L., Ed. (2010). Psychology & Christianity: Five
Views, IVP Academic, Downers Grove, IL.
• Chin, J. & Ellison, C.W. (2012). Expanded psycho-spiritual
model: foundations and implications, Edification, 5(2), 125136.
• Theological/psychological work of: Apostle Paul, St. Augustine,
Thomas Aquinas, John Calvin, Jonathan Edwards
• Work of William James, Varieties of Religious Experience, 1902
Published Studies/Texts/Articles That Supports
These Research Findings By H.G. Koenig, MD
• Handbook of Religion and Health, 2nd ed., 2012, Oxford
University Press.
• Spirituality in Patient Care, 3rd ed., 2013, Templeton Press.
• Medicine, Religion and Health, 2008, Templeton Press.
• The Link Between Religion and Health: Psychoneuroimmunology and the Faith Factor, 2002, HGK with Harvey J.
Cohen, Oxford University Press.
• Baetz, M., Griffin, R., Bowen, R., Koenig, H.G., Marcoux, E. The
relationship between spiritual and religious involvement and
depressive symptoms in a Canadian population. Journal of
Nervous and Mental Disease, Vol 192(12), Dec 2004, 818-822
• Koenig, H.G., Zaben, F.A., Khalifa, D.A. Religion, spirituality
and mental health in the West and the Middle East. Asian
Journal of Psychiatry, 2012, 5(2), 180-182.
Additional Studies/Texts/Articles That Supports
These Research Findings
Worthington, E.L, Kurusu, T.A., McCullough, M.E. & Sandage, S.J. (1996). Empirical
research on religion and psycho-therapeutic processes and outcomes: a 10 year
review and research prospectus, Psychological Bulletin, 119(3), 448-487.
McCullough, M.E. & Willoughby, B.L.B. (2009). Religion, Self-regulation and self
control: associations, explanations and implications, Psychological Bulletin, 135(1),
Levin, J., Chatters, L.M., Taylor, R.J. (2011). Theory of religion, aging and health: an
overview. Journal of Religion and Health, 50(2), 180-182.
Worthington, E.L., Hook, J.N., Davis, D.E., McDaniel, M.A. (2011). Religion and
spirituality. Journal of Clinical Psychology, 67(2), 204-214.
Atien, J.D., McMinn, M.R. & Worthington, E.L. (Eds, 2011). Spiritually Oriented
Interventions for Counseling and Psychotherapy. APA Press, Wash. DC.
Huguelett, Philippe and Koenig, Harold G. (Eds., 2012). Religion and Spirituality in
Psychiatry, Cambridge University Press.
Worthington, E.L., Johnson, E.L., Hook, J.N. & Atien, J.D. (Eds., 2013). EvidenceBased Practices for Christian Counseling and Psychotherapy. Inter-Varsity
Press, Downers Grove, IL.
Resources in Writing & Funding Research Grants
• Inouye, S.K & Fielin, D.A. (2005), An evidence-based
guide to writing grant proposals for clinical research,
Annals of Internal Medicine, 142, 274-282.
• Reif-Lehrer, L. (2004). Grant Application Writer’s
Handbook, 4th edition, Jones & Bartlett Learning.
• NIH Grant Writing Tutorial;
• Templeton Foundation Funding Inquiry,
• George Family Foundations Grants;
Newsletters, Internet & Contacts
• For Crossroads Newsletter,
• For Christian Psychology Around the World
• For Society of Christian Psychology,
• For American Association of Christian
Counselors (AACC),
Addressing the Research Agenda at
Nyack College
 Stimulating a Research Atmosphere with Ongoing Research
Studies at Nyack College, Supported by Faculty &
Administration, Research Training for Students
 Foster a Community of Empirical Researchers with Mutual
Support and Academic Collaboration
 Establishment of a Formal Institutional Review Board (IRB)
 Budgeting for Personnel and Resources to Promote an
Empirical Research Agenda, Support Grant Writing
 Policies and Procedures to Promote and Reward Published
Empirical Research(ers)
 More Fulfillment of Institution’s Core Values for: Academically
Excellent, Socially Relevant and Globally Engaged.
• Dr. Kwi-Ryung Yun, Professor, Director of Social Work,
• Dr. Brian Roland, Assistant Professor, Dept. of Social
Work, NCMC
• Dr. Ching-Ching Ruan, Assistant Professor, Marriage
and Family Program, AGSC, Nyack
• Dr. James Chin, Professor, Mental Health Counseling
& Director Psy.D. Program, NCMC