Revisiting the Meaning Systems Interview: Progress and Potential for Medical Staff
Stuart Nelson, Masters (Religious Studies), Vice President, Institute for Spirituality and Health
Interactions between patients and physicians regarding religious and spiritual matters have been found to increase quality of care and patient satisfaction. While patients and physicians alike report the desire to engage in religious and spiritual (R/S) discussions, physicians report that worries about intrusiveness, manipulation, and cultural competency often prevent them from doing so. Several spiritual assessments, including the popular FICA and HOPE models, have been promoted as means to address these concerns.
Of course, while spiritual assessments are most often given to patients, R/S discussion are a two way street. Is there potential for spiritual reflection and inquiry on the part of physicians and other medical staff? How does the practice of medicine fit into one’s overall “system of meaning?”
This paper revisits the Meaning Systems Interview (MSI), an assessment tool introduced in Boston in 2015, with a fresh perspective.
To create MSI, a research team (UC Santa Barbara) modified and infused James Fowler’s Faith Development Interview with language compatible with Ann Taves’ Building Blocks Approach for the study of religions, which is rooted in cognitive linguistics, psychology of religion, and the comparative history of religions. The result is an interdisciplinary, cross-culturally stable means for understanding and evaluating systems of meaning within or without the context of religious traditions.
Originally, MSI was created to evaluate meaning-system narratives that had been both recorded and preserved historically and elicited clinically and ethnographically. The team who created the interview asked: How can we gather data (analyze narratives) in a more systematic way that will allow us to:
• Examine what scholars place under the heading of “religion” and “spirituality” as broadly conceived as possible and without worrying about whether we capture “too much”
• In a way that is workable (translatable) across times and cultures
• And amenable to both humanistic (qualitative) and scientific (quantitative) modes of analysis?
There is potential for the interview to be used by physicians to clarify their own beliefs, values, and commitments, thereby helping to “break through the intellectualization, rationalization, and disenchantment in an era of evidence-based medicine.” Indeed, over the past year the MSI has been tested on healthcare professionals, allowing for genuine self-reflection and unconstrained discussion about religious identity. In some cases it has prompted “breakthroughs” in terms of articulating one’s spiritual and religious identity, and their relationship to the practice of medicine.
In settings such as urban hospitals where medical professionals profess a wide variety of religious and spiritual orientations, an interdisciplinary, cross culturally stable tool such as MSI seems ideal. The interview has been tested both formally and informally over the last two years in diverse contexts, yielding encouraging results that speak to its efficacy as an assessment.
In summary, this paper covers the creation and implementation of MSI, with special attention to its use amongst physicians and other medical staff for the purpose of clarifying how religious beliefs and practices relate to medicine to constitute individual “systems of meaning.”
Interactions between patients and physicians regarding religious and spiritual matters have been found to increase quality of care and patient satisfaction. While patients and physicians alike report the desire to engage in religious and spiritual (R/S) discussions, physicians report that worries about intrusiveness, manipulation, and cultural competency often prevent them from doing so. Several spiritual assessments, including the popular FICA and HOPE models, have been promoted as means to address these concerns.
Of course, while spiritual assessments are most often given to patients, R/S discussion are a two way street. Is there potential for spiritual reflection and inquiry on the part of physicians and other medical staff? How does the practice of medicine fit into one’s overall “system of meaning?”
This paper revisits the Meaning Systems Interview (MSI), an assessment tool introduced in Boston in 2015, with a fresh perspective.
To create MSI, a research team (UC Santa Barbara) modified and infused James Fowler’s Faith Development Interview with language compatible with Ann Taves’ Building Blocks Approach for the study of religions, which is rooted in cognitive linguistics, psychology of religion, and the comparative history of religions. The result is an interdisciplinary, cross-culturally stable means for understanding and evaluating systems of meaning within or without the context of religious traditions.
Originally, MSI was created to evaluate meaning-system narratives that had been both recorded and preserved historically and elicited clinically and ethnographically. The team who created the interview asked: How can we gather data (analyze narratives) in a more systematic way that will allow us to:
• Examine what scholars place under the heading of “religion” and “spirituality” as broadly conceived as possible and without worrying about whether we capture “too much”
• In a way that is workable (translatable) across times and cultures
• And amenable to both humanistic (qualitative) and scientific (quantitative) modes of analysis?
There is potential for the interview to be used by physicians to clarify their own beliefs, values, and commitments, thereby helping to “break through the intellectualization, rationalization, and disenchantment in an era of evidence-based medicine.” Indeed, over the past year the MSI has been tested on healthcare professionals, allowing for genuine self-reflection and unconstrained discussion about religious identity. In some cases it has prompted “breakthroughs” in terms of articulating one’s spiritual and religious identity, and their relationship to the practice of medicine.
In settings such as urban hospitals where medical professionals profess a wide variety of religious and spiritual orientations, an interdisciplinary, cross culturally stable tool such as MSI seems ideal. The interview has been tested both formally and informally over the last two years in diverse contexts, yielding encouraging results that speak to its efficacy as an assessment.
In summary, this paper covers the creation and implementation of MSI, with special attention to its use amongst physicians and other medical staff for the purpose of clarifying how religious beliefs and practices relate to medicine to constitute individual “systems of meaning.”