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Articles 31 - 60 of 198
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Mental Illness And The Role Of The Church, Shelle Mathis
Mental Illness And The Role Of The Church, Shelle Mathis
Doctoral Dissertations and Projects
Mental illness remains a growing concern in society, prompting increased focus on the church’s role in offering support. The purpose of this qualitative phenomenological study was to explore the beliefs, attitudes, and perceptions of pastors and congregants regarding mental illness and the stigmas associated with it. Sixteen adult participants, ages 31 to 65, from churches in Elyria and Lorain, Ohio, were interviewed through semi-structured questions. Thematic analysis revealed five key themes: stigma, overspiritualization, education and training, collaboration with mental health professionals, and resource accessibility and advocacy needs. Pastors with lived experience of mental illness expressed greater empathy and recognized the …
Cognitive-Behavioral Psychoeducational Community Music Therapy For Enhancing Students’ Learning Motivation, Dominikus David Biondi Situmorang
Cognitive-Behavioral Psychoeducational Community Music Therapy For Enhancing Students’ Learning Motivation, Dominikus David Biondi Situmorang
Buletin Konseling Inovatif
Motivation is an important determinant for students’ academic achievement; however, many pupils report that their learning motivation decreases in particular prior to exams. Preventive steps, guidance and counseling teachers or school counselors reported lack of concentration, high anxiety, and low enthusiasm among high school students. This study investigated the utility of a Cognitive-Behavioral Psychoeducational Community Music Therapy Seminar/Workshop in improving students' motivation to learn before exams. A pre-experimental one-group pretest-posttest design was used with 213 senior high school students in Jakarta, Indonesia, aged between 15 to 18 years old. The Motivated Strategies for Learning Questionnaire (MSLQ) was employed to assess …
Integrating Mental Health And Pastoral Counseling At Calvary Baptist Church, Jacqueline Y. Ghee
Integrating Mental Health And Pastoral Counseling At Calvary Baptist Church, Jacqueline Y. Ghee
Doctoral Dissertations and Projects
There is a critical need to provide mental health support to the congregation in the Black church, especially at Calvary Baptist Church. During the research study, the participants have made it clear that they need more support when it comes to emotional help for those who are facing mental health challenges. To address this, initiatives such as mental health training for clergy, establishing support groups, or partnering with mental health professionals can be implemented. Based on the outcome of the one-on-one interviews, the focus group participants from Calvary shared their disappointment with the pastor and leaders for not being able …
A Phenomenological Study Exploring The Role Of Resilience In Trauma Recovery Of Those Living In Southeastern Rural America, Summer D. Loduca
A Phenomenological Study Exploring The Role Of Resilience In Trauma Recovery Of Those Living In Southeastern Rural America, Summer D. Loduca
Doctoral Dissertations and Projects
This qualitative phenomenological study explored the ways in which adults who live in rural communities in the Southeastern United States convalesce from trauma within the framework of barriers and limited access to mental health services. Garmezy’s (1991) developmental psychology approach to resilience, which highlights internal and external protective factors, guides this study as personal resilience, and how it contributes to trauma recovery in underserved settings, is explored. Ten participants aged 32 to 49, engaged in semi-structured interviews as they shared their lived experiences of coping with, and healing from, trauma. Five principal themes were reach in analyzing the data through …
Exploring The Stigma Of Mental Health In Oneness Pentecostal Churches From A Pastoral Perspective, Jannett Liburd
Exploring The Stigma Of Mental Health In Oneness Pentecostal Churches From A Pastoral Perspective, Jannett Liburd
Doctoral Dissertations and Projects
The purpose of this phenomenological study was to explore the stigma of mental health in Oneness Pentecostal churches in the Northeast from a pastoral perspective. The theory guiding this study is Sigmund Freud’s object relational theory (ORT), as it focuses on the past experiences an individual has with an object, person, or event, and how the experience, whether negative or positive, shapes the person’s attitude and behavior in the future. Mental health stigma is a phenomenon with which individuals may have had a harmful experience. In the study, the central research question was: What are the lived experiences of Oneness …
Pastoring The Pastor: Self-Care Among African American Clergy, Alexander Jamerison
Pastoring The Pastor: Self-Care Among African American Clergy, Alexander Jamerison
Doctoral Dissertations and Projects
When self-care is effectively implemented, it can help individuals avoid or reduce mental health challenges throughout their lives (Luis et al., 2021). Unfortunately, research indicates numerous mental health challenges faced by clergy (Chan & Chen, 2019; Jackson, 2013; Gallagher, 2019; Edward, 2020). To assist ministers in cultivating a healthier life and a more effective ministry, this study will specifically explore the relationship between self-care and mental health challenges among African American clergy. The literature on this subject will identify historical, cultural, and spiritual influences. It will also examine specific mental health concerns, effective self-care practices, and relevant outcomes. Although research …
Building Resilience In Ministry With Effective Supports Amid The Covid-19 Pandemic: A Phenomenological Study Of Long-Tenured Pastors In The Southeastern United States, Tina Marie Powell
Building Resilience In Ministry With Effective Supports Amid The Covid-19 Pandemic: A Phenomenological Study Of Long-Tenured Pastors In The Southeastern United States, Tina Marie Powell
Doctoral Dissertations and Projects
This phenomenological study, which involved long-tenured pastors in a southeastern state in the United States, explored how these pastors framed resiliency in ministry during COVID-19 and what tools or practices helped them to be resilient. The study also explored the effects of social distancing on the demands of ministry, on pastors, and their congregations, and if earlier resiliency practices continued to suffice. Pastors were often the first professionals people went to when guidance was needed in every aspect of life. Pastors aided with not only spiritual guidance, but also, they were sought after for guidance in mental health and emotional …
Examining The Relationship Between Biblical Characters And Mental Health: Identifying A Christian's Well-Being, Shanetia Sharie Chapman
Examining The Relationship Between Biblical Characters And Mental Health: Identifying A Christian's Well-Being, Shanetia Sharie Chapman
Masters Theses
This thesis aims to examine the intersection between biblical texts and mental health within the framework of Christian belief systems. Through a critical analysis of key biblical narratives involving figures who exhibit experiences analogous to contemporary psychological struggles, this study investigates the influence of scriptural interpretation on believers’ perceptions of mental health and their coping mechanisms. By employing textual analysis, the research seeks to evaluate the potential of biblical teachings as therapeutic resources. Ultimately, this thesis aims to contribute to developing culturally and theologically informed approaches to mental health awareness and support within Christian communities.
Emotional And Spiritual Support Assessment For Clinical Outpatient Staff At Lower Cape Fear Lifecare, Jamie Champion
Emotional And Spiritual Support Assessment For Clinical Outpatient Staff At Lower Cape Fear Lifecare, Jamie Champion
Doctoral Dissertations and Projects
This action project in the field of pastoral counseling is designed to assess the level of emotional and spiritual support that clinical outpatient workers receive at Lower Cape Fear Lifecare. The problem is that clinical outpatient workers do not utilize spiritual care services for themselves, and the purpose of this study is to create and implement tools to increase chaplain utilization amongst team members. This action project utilizes qualitative and quantitative methods to collect data including surveys and interviews and a workshop, newsletters, and videos to disseminate to team members for education and encouragement. This project will help to identify …
African American Pastors' Experiences With Intimate Partner Violence Among Church Members, Nickeshia Evans-Gordon
African American Pastors' Experiences With Intimate Partner Violence Among Church Members, Nickeshia Evans-Gordon
Doctoral Dissertations and Projects
The purpose of this phenomenological study was to describe the perspectives of African-American pastors’ experiences with (IPV) among their congregation members. This study applied the religious coping theory (RCT) to the experiences of African American pastors with IPV among church members. This helped the study provide valuable insights into how pastors utilize religious beliefs, practices, and support systems in addressing and supporting individuals affected by IPV. African-American pastors may encourage individuals experiencing IPV to seek solace, strength, and guidance through their religious faith. Understanding how pastors utilize religious coping strategies has contributed to fostering safer environments and more effective support …
Qualitative Analysis Of Chaplains’ Experiences Supporting Military Service Members And Veterans With Moral Injury, Marangely Mesa
Qualitative Analysis Of Chaplains’ Experiences Supporting Military Service Members And Veterans With Moral Injury, Marangely Mesa
Doctoral Dissertations and Projects
This transcendental phenomenological study explored the frequent themes identified by chaplains while supporting service members and veterans (SM/V) from diverse Christian denominations, such as Catholics, Protestants, and other Christian groups, who have suffered a moral injury. I described the lived experience of chaplains using in-depth surveys as part of a phenomenological approach to data collection. In the qualitative interview, the interest is hearing the chaplains’ thoughts on the nature and manifestations of moral injury in chaplaincy contexts. The study explored chaplains’ observations concerning what service members and veterans have in common when they experience moral injury. This qualitative research approach …
A Theology Of Hope For Missing Persons And Lost Causes, Joelle Yanko
A Theology Of Hope For Missing Persons And Lost Causes, Joelle Yanko
Salubritas: International Journal of Spirit-Empowered Counseling
This paper explores how unresolved tragedies—particularly missing person cases and lost causes—serve as profound reflections of the human condition and reveal the necessity of Christian eschatological hope. Missing person cases touch the deepest questions of the human soul and reveal a deep, universal longing for justice and resolution—longings that cannot be fully met within the bounds of this present life. Drawing from theological reflection, the paper argues that both suffering and miraculous resolution ultimately point toward a greater hope found in the Christian vision of union with God. This future-oriented hope, grounded in the resurrection of Christ, invites believers to …
Walking In Promise, Living In Reality: Exploring The Mental Health Implications Of The Pentecostal Discourse Of Divine Calling, Robert D. Mcbain
Walking In Promise, Living In Reality: Exploring The Mental Health Implications Of The Pentecostal Discourse Of Divine Calling, Robert D. Mcbain
Salubritas: International Journal of Spirit-Empowered Counseling
Pentecostalism places a strong emphasis on the discourse of divine calling, where individuals believe they are purposefully created, guided, and empowered by God to fulfill a specific mission. This sense of calling profoundly shapes Pentecostals’ sense of identity and purpose. Using Grounded Theory, this study analyzes open, in-depth interviews with Pentecostals in the U.S. to explore the impact of the Pentecostal discourse of divine calling on their mental health. The metaphor of ‘walking in’ one’s calling emerges as the central theme used by participants to explain the interaction between their perception of divine calling, their lived realities, and their mental …
Taking A Stand: A Phenomenological Study Of Black Christian Pastors' Experiences Of Domestic Violence/Intimate Partner Violence In The Church & Community, Karen Elaine Simmons-Clifton
Taking A Stand: A Phenomenological Study Of Black Christian Pastors' Experiences Of Domestic Violence/Intimate Partner Violence In The Church & Community, Karen Elaine Simmons-Clifton
Doctoral Dissertations and Projects
The purpose of this phenomenological study is to describe black pastors’ lived experiences of counseling and/or ministering to female victims (congregants & non-congregants) and survivors of Intimate Partner Violence (IPV) in Texas. These acts of violation against women occur at staggering rates worldwide, often leaving the victims and survivors with damages and issues they dare trust to share with a spiritual figure. In many communities, the Black Christian pastor is often the person these wounded women seek as their counselor, spiritual guide, and safe place, despite the pastor’s lack of education and/or training in IPV. Research indicates that these women …
Exploring Clergy's Use Of Suicide Risk Factor Knowledge: A Qualitative Descriptive Study, Matilda Swanson
Exploring Clergy's Use Of Suicide Risk Factor Knowledge: A Qualitative Descriptive Study, Matilda Swanson
Doctoral Dissertations and Projects
This qualitative descriptive study explored clergy members’ understanding of mental health literacy in relations to suicide risk factors and the interventions they used to prevent suicidality among congregants in Central Florida. Guided by Anthony Jorm’s mental health literacy theory, the study explored clergy members’ understanding of mental health literacy related to their knowledge of suicide risk factors and interventions they use to address suicide risk among church congregants. Data collection was through semi-structured interviews and two focus groups. A total of 14 clergy members participated in the study. The findings were analyzed using Braun and Clarke’s six-step thematic analysis, leading …
Ecclesiological Support For Veterans Suffering From Moral Injury: A Phenomenological Study, Douglas Guy Wood
Ecclesiological Support For Veterans Suffering From Moral Injury: A Phenomenological Study, Douglas Guy Wood
Doctoral Dissertations and Projects
For many military service members, the cost of their service is through the psychological, physiological, emotional, sociological, and spiritual scars from the trauma of conflict. This trauma is most associated with the diagnoses of Post-Traumatic Stress Disorder (PTSD) and Moral Injury (MI). Existing literature primarily focuses on a humanistic underlying philosophy to symptoms and patient care or uses a non-specific definition/categorization of religion/spirituality (e.g., Ames et al., 2019; Hill et al., 2000; Sharma et al., 2017). Studies have addressed psychological, physiological, emotional, and sociological healing (e.g., Åkerblom et al., 2020; Drescher et al., 2011; Gray et al., 2012; Nash & …
Revealing Roots: Examining The Intersection Of Trauma, Mental Health, And Bioecological Impact On Pentecostal Black Male Pastors, Dreama Delicia Cole
Revealing Roots: Examining The Intersection Of Trauma, Mental Health, And Bioecological Impact On Pentecostal Black Male Pastors, Dreama Delicia Cole
Doctoral Dissertations and Projects
The purpose of this hermeneutic phenomenological study was to describe Pentecostal Black male pastors in their understanding of (or experiences with) trauma and mental health in the context of the inclusion of bioecological effects and any thoughts about the potential impact on their congregations in California. The chosen theories complement the lived experiences of these pastors. Based on the research questions, interview questions, and data analysis, the following themes and one subtheme emerged: Their Roots Tell a Story: Lived Experiences of Identity Formation and Early Trauma with subtheme Rejection: Lived Experience of Exclusion and Emotional Wounding, Revelation: Lived Experiences of …
Improving The Mq For Pastoral Counseling At Hesed Counseling Ministries To Benefit Pro-Life Victims Of Pro-Abortionist Violence, Sean Michael Patrick Ferreiro
Improving The Mq For Pastoral Counseling At Hesed Counseling Ministries To Benefit Pro-Life Victims Of Pro-Abortionist Violence, Sean Michael Patrick Ferreiro
Doctoral Dissertations and Projects
Biblical Christianity has ubiquitously denounced abortion. Unfortunately, an unprecedented number of physical attacks on the pro-ministry’s volunteers and properties have resulted in traumatic experiences. Counseling services are the natural recommendation for these volunteers thereafter. However, secular counselors are often incongruent with the values of the pro-life ministry. Hesed Counseling Ministries offers counseling services for pro-life volunteers. As a group of solution-focused practitioners, they utilize the miracle-question (MQ). To create a counseling milieu congruent to the unique subculture of the pro-life ministry, they created their own MQ. It was bereft of the voices and verbiage of the pro-life ministry. Therefore, the …
The Ties That Bind: A Comprehensive Pastoral Counseling Approach To Bridge The Gap Between Christians Struggling With Same-Sex Attraction And Cornerstone Church, Barbara Pringle Taylor
The Ties That Bind: A Comprehensive Pastoral Counseling Approach To Bridge The Gap Between Christians Struggling With Same-Sex Attraction And Cornerstone Church, Barbara Pringle Taylor
Doctoral Dissertations and Projects
This dissertation project explores the need for a faith-based counseling program that aligns with biblical principles while fostering inclusivity and support for Christians experiencing same-sex attraction (SSA). The study addresses the challenges faced by individuals in the church community who often encounter isolation, shame, and rejection. It proposes a comprehensive pastoral counseling program to train church leaders in providing compassionate, transformative care. This project employs qualitative research methods, including focus groups and individual interviews, to gather insights from church leaders and members. It analyzes theological, psychological, and pastoral perspectives to build a robust spiritual and emotional support framework. The research …
Parallel Journeys: Supporting Wounded Healers In Counselor Education, Susannah C. Coaston
Parallel Journeys: Supporting Wounded Healers In Counselor Education, Susannah C. Coaston
Journal of Counselor Preparation and Supervision
Much has been written about the motivations for wounded healers to pursue work in the helping professions. Those with painful life experiences can have a unique ability to understand the pain of others, and through their recovery, they may gain insight and understanding to benefit others. The counselor development process can be fraught with challenges that may have a detrimental impact on wounded healers. As such, counselor educators can benefit from amending their approaches to ensure that wounded healers gain the skills necessary to support their mental health and well-being, effectiveness, and personal and professional development. This article introduces a …
Emotional Turbulence Of Children Of The Clergy, The Lived Experiences And Emotional Development Of Adult Children Of The Clergy: A Transcendental Phenomenological Study, Tabitha L. Bennett
Emotional Turbulence Of Children Of The Clergy, The Lived Experiences And Emotional Development Of Adult Children Of The Clergy: A Transcendental Phenomenological Study, Tabitha L. Bennett
Doctoral Dissertations and Projects
The current study is a Phenomenological qualitative approach to understanding the lived experience of adult Children of the Clergy and exploring the various pressures and expectations faced by Children of the Clergy versus other church members. Everyone experiences external and internal pressures, but this will delve into whether it is an added layer simply from being a child of the clergy. The current study will investigate multiple families to understand family dynamics and the effects of growing up as Children of the Clergy into adulthood. Through phenomenological testing, utilizing the Bowen Family Theory and a sub-theory of the Labeling theory, …
Pentecostal Christian’S Influence On Marital Satisfaction And Longevity, Rebecca Burgess
Pentecostal Christian’S Influence On Marital Satisfaction And Longevity, Rebecca Burgess
Doctoral Dissertations and Projects
This research study aimed to explore the influence of Pentecostalism on marital satisfaction and longevity within the context of individuals who identify as Pentecostal Christians. By employing PENTECOSTALISM AND MARITAL SATISFACTION 3 phenomenology, the study sought to gain a deeper understanding of the experiences, perspectives, and beliefs of participants regarding the impact of Pentecostalism on their marriages. The research involves in-depth interviews with married individuals adhering to Pentecostal beliefs, examining their experiences and interpretations of how Pentecostal teachings and practices influence their marital satisfaction and relationship longevity. This study included a sample size of 10 participants, consisting of 5 married …
Inside The Circle 2025: Exploring The Ontario Cpe Supervisors' Lived Experience Of The Interpersonal Relations Group Process Portion Of Cpe, Kelly L. Collins
Inside The Circle 2025: Exploring The Ontario Cpe Supervisors' Lived Experience Of The Interpersonal Relations Group Process Portion Of Cpe, Kelly L. Collins
Theses and Dissertations (Comprehensive)
This research used a philosophical phenomenological (primarily Gadamer) methodology and asked the question, “What is the lived experience of Ontario Clinical Psychospiritual Education (CPE) Supervisors in the Interpersonal Relationships (IPR) group process portion of CPE?” It used a 90-minute, semi-structured interview format as it sought to understand the supervisor experience of safety in the group. 11 Ontario Certified Supervisors were interviewed and explored this question in relationship to participant supervisors’ experience as students and/or as educators. In the history of CPE, there has been significant harm done to students by some supervisors who were well-meaning, but unaware of their impact …
Effectiveness Of Compassion-Focused Group Therapy To Increase Self-Compassion And Forgiveness In High School Students, Kristin Melliyati Benu, Mungin Eddy Wibowo, Mulawarman Mulawarman
Effectiveness Of Compassion-Focused Group Therapy To Increase Self-Compassion And Forgiveness In High School Students, Kristin Melliyati Benu, Mungin Eddy Wibowo, Mulawarman Mulawarman
Jurnal Kajian Bimbingan dan Konseling
Self-compassion and forgiveness are inseparable in the lives of adolescents because adolescents are vulnerable to various conflicts due to social changes and demands that cause negative emotions and other psychological problems. Adolescents need self-compassion and forgiveness to be able to regulate negative emotions in dealing with difficult situations. Compassion focused group therapy is an approach that focuses on compassion so that it can help adolescents to foster kindness to themselves, accept themselves and difficult situations as human and be able to provide forgiveness to themselves and others. This study aims to test the effectiveness of compassion-focused group therapy to increase …
Solution-Focused Pastoral Counseling For Bereavement, Wayne A. Benner
Solution-Focused Pastoral Counseling For Bereavement, Wayne A. Benner
Doctoral Dissertations and Projects
The topic of this action research is Solution-Focused Pastoral Counseling for grief and bereavement. The need for the research completed is for hospice chaplains to have a workable tool to use for grief and bereavement. The problem is that many hospice chaplains do not have a framework to use for counseling in grief. The action researcher worked on the thesis of if chaplains use Solution-Focused Pastoral Counseling for grief they will be more effective. The research was completed using Solution-Focused Pastoral Counseling to counsel six participants in grief. Each participant completed a pre-counseling questionnaire and a post-counseling questionnaire to assess …
Addressing A Lack Of Counseling Programs To Diminish The Psychological, Emotional, And Mental Impacts Of Church Closure Grief, Marcel Berrios
Addressing A Lack Of Counseling Programs To Diminish The Psychological, Emotional, And Mental Impacts Of Church Closure Grief, Marcel Berrios
Doctoral Dissertations and Projects
Besides spiritual activities, the social activities that happen in church buildings are vital to the functioning of most communities; therefore, churches play a central role in the social fabric and social infrastructure of communities in ways not necessarily thought about until they are no longer around. The looming absence of this role or function of the church becomes the overarching focus to address when an announcement is made that a church is permanently closing. Lost in navigating the business and community aspects of a church closure is the congregation's metamorphic spiritual, emotional, and psychological journey. Subsequently, many church members are …
A Legacy Of Trauma: A Phenomenological Study Of African American Pastors' Perspectives On Mental Health In Delaware Churches, Donell M. Winder
A Legacy Of Trauma: A Phenomenological Study Of African American Pastors' Perspectives On Mental Health In Delaware Churches, Donell M. Winder
Doctoral Dissertations and Projects
This hermeneutic phenomenological qualitative study aimed to explore the perceptions and practices of african american evangelical pastors in delaware regarding mental health care within their congregations. the study sought to understand how pastors integrate their spiritual beliefs with mental health practices and how cultural factors influence their roles as mental health advocates. anchored in social constructivism, the research examined the cultural and contextual factors that shape pastors' approaches to mental health issues. eight senior pastors from evangelical churches across delaware were selected through purposive sampling, and semi-structured interviews served as the primary data collection method. thematic analysis identified several key …
A Phenomenological Study Of Pastors' Experiences Counseling Combat Veterans, Yvette M. Rolle
A Phenomenological Study Of Pastors' Experiences Counseling Combat Veterans, Yvette M. Rolle
Doctoral Dissertations and Projects
When combat veterans make the transition to civilian life, whether permanently or between deployments, they face mental, physical, and spiritual adjustment (Grimell, 2019; Zogas, 2017). Although the Veterans Administration and local health providers offer services, some combat veterans prefer to seek their pastor’s advice instead or in addition (Bonner et al., 2013). Pastors, even those with little or no formal training in counseling or therapy, are uniquely equipped to guide combat veterans in the spiritual aspect of healing, or at least to accompany them with empathy and the consolation of faith. Yet a gap exists in the literature regarding clergy’s …
Enhancing Spousal Abuse Awareness Among Church Leaders Of The Haitian Seventh-Day Adventist Church, Peggy Filossaint
Enhancing Spousal Abuse Awareness Among Church Leaders Of The Haitian Seventh-Day Adventist Church, Peggy Filossaint
Doctoral Dissertations and Projects
There is a critical need for Christian church leaders to actively combat spousal abuse, emphasizing that churches must break their silence on this issue, protect victims, and join the fight against domestic violence. The study specifically focused on enhancing awareness and knowledge of spousal abuse among leaders of the Maranatha Haitian Seventh-day Adventist Church. The primary purpose of this research was to equip church leaders with the necessary tools and understanding to effectively address spousal abuse within their congregation. The project aimed to develop a comprehensive protocol for annual training, ensuring that church leaders are well-prepared to navigate the complexities …
Acpe’S Spiritually Integrated Psychotherapy (Sip) Training Program: Clinical Competencies For Integrating Religion And Spirituality In Counseling, Carol Za Mcginnis, Maya Georgieva, Mary Elizabeth Toler
Acpe’S Spiritually Integrated Psychotherapy (Sip) Training Program: Clinical Competencies For Integrating Religion And Spirituality In Counseling, Carol Za Mcginnis, Maya Georgieva, Mary Elizabeth Toler
Journal of Faith Integration Counseling (JFIC)
Clients frequently seek psychotherapy that will incorporate their unique religious or spiritual values into the therapeutic process, yet they are discouraged by practitioners who are not equipped to provide those services. Licensed mental health practitioners can receive this training and certification from the ACPE Spiritually Integrated Psychotherapy Training Program. Spiritual competencies exclusive to this integrative process have been designed to guide and support SIP-certified practitioners in alignment with other professional ethical codes. It is our hope that students, educators, and licensed practitioners from all mental health fields will find this information helpful in understanding the ethical integration of spirituality into …