Spirituality in Psychiatry Residency Training at a Religiously-Affiliated Hospital: Unique Opportunities and Challenges
Vitaliy Voytenko, PsyD., Director of Clinical Training, Assistant Professor of Psychology, Wheaton College and Michigan State University College of Human Medicine
William Sanders, DO, MS, Pine Rest Christian Mental Health Services, Michigan State University College of Human Medicine
There is increasing recognition of the importance of incorporating issues of spirituality into undergraduate and graduate medical education. The majority of U.S. medical schools now teach students how to take a basic spiritual history and the Accreditation Council for Graduate Medical Education (ACGME) now requires that psychiatry residents learn about major religious worldviews and their implications for the practice of psychiatry. Several model curricula in spirituality in psychiatry (including those incorporating religion/spirituality under the umbrella of cultural psychiatry) have been submitted to the American Association of Directors of Psychiatric Residency Training and described in peer-reviewed literature. Pine Rest Christian Mental Services (Pine Rest)—one of the five largest free-standing behavioral health providers in the U.S.—has developed a comprehensive vertical curriculum in religion/spirituality covering all four years of training for its psychiatry residency program. The curriculum, now is its third year of pilot implementation, includes required coursework (e.g. Religion, Spirituality, and Worldview in Psychiatry, Transcultural Psychiatry, and Spiritually-Integrated Psychotherapy), a bi-annual lecture series, quarterly multidisciplinary case conferences, and several elective training activities.
Pine Rest—formed over a century ago by and for members of two Dutch Reformed Christian denominations—today employs and provides care to people of all cultural and religious backgrounds. However, the non-profit hospital has maintained an explicitly Christian identity and mission. Introducing a religion/spirituality curriculum into its ACGME- and AOA-accredited psychiatry residency training program, affiliated with Michigan State University College of Human Medicine, has presented a unique set of opportunities and challenges. On the one hand, the organization’s religious identity and personal religious commitments of many of the program’s faculty have lent themselves to a greater appreciation for the role of spirituality in patients’ lives and for its place in the training of residents. The curriculum has enjoyed strong organizational support, including the provision of internal funding for its development and implementation. In addition, the organization’s Christian identity has attracted residents who themselves are practicing Christians and who are interested in learning how to intentionally and thoughtfully integrate their faith and vocation. At Pine Rest, residents are offered elective training opportunities, such as the monthly “Christian Integration” lunch discussion and the opportunity to participate in conducting research in spirituality and mental health. On the other hand, the spirituality curriculum has at times been met with a degree of suspicion and resistance from non-religious residents who may be wary of a hidden agenda (i.e. proselytism) or an over-emphasis on the issues of spirituality at the expense of biological or psychological considerations. In addition, in light of Pine Rest’s Christian identity, practitioners of other major world religions and worldviews (e.g. Judaism, Buddhism, atheism, etc.) are under-represented on its clinical staff and residency faculty, which has made it more difficult to effectively cover respective topics in the curriculum using in-house resources. Despite these challenges, the residents have positively reviewed the religion/spirituality curriculum regardless of their personal religious affiliation, with the Transcultural Psychiatry course receiving some of the most positive evaluations among all of the residency didactics.
William Sanders, DO, MS, Pine Rest Christian Mental Health Services, Michigan State University College of Human Medicine
There is increasing recognition of the importance of incorporating issues of spirituality into undergraduate and graduate medical education. The majority of U.S. medical schools now teach students how to take a basic spiritual history and the Accreditation Council for Graduate Medical Education (ACGME) now requires that psychiatry residents learn about major religious worldviews and their implications for the practice of psychiatry. Several model curricula in spirituality in psychiatry (including those incorporating religion/spirituality under the umbrella of cultural psychiatry) have been submitted to the American Association of Directors of Psychiatric Residency Training and described in peer-reviewed literature. Pine Rest Christian Mental Services (Pine Rest)—one of the five largest free-standing behavioral health providers in the U.S.—has developed a comprehensive vertical curriculum in religion/spirituality covering all four years of training for its psychiatry residency program. The curriculum, now is its third year of pilot implementation, includes required coursework (e.g. Religion, Spirituality, and Worldview in Psychiatry, Transcultural Psychiatry, and Spiritually-Integrated Psychotherapy), a bi-annual lecture series, quarterly multidisciplinary case conferences, and several elective training activities.
Pine Rest—formed over a century ago by and for members of two Dutch Reformed Christian denominations—today employs and provides care to people of all cultural and religious backgrounds. However, the non-profit hospital has maintained an explicitly Christian identity and mission. Introducing a religion/spirituality curriculum into its ACGME- and AOA-accredited psychiatry residency training program, affiliated with Michigan State University College of Human Medicine, has presented a unique set of opportunities and challenges. On the one hand, the organization’s religious identity and personal religious commitments of many of the program’s faculty have lent themselves to a greater appreciation for the role of spirituality in patients’ lives and for its place in the training of residents. The curriculum has enjoyed strong organizational support, including the provision of internal funding for its development and implementation. In addition, the organization’s Christian identity has attracted residents who themselves are practicing Christians and who are interested in learning how to intentionally and thoughtfully integrate their faith and vocation. At Pine Rest, residents are offered elective training opportunities, such as the monthly “Christian Integration” lunch discussion and the opportunity to participate in conducting research in spirituality and mental health. On the other hand, the spirituality curriculum has at times been met with a degree of suspicion and resistance from non-religious residents who may be wary of a hidden agenda (i.e. proselytism) or an over-emphasis on the issues of spirituality at the expense of biological or psychological considerations. In addition, in light of Pine Rest’s Christian identity, practitioners of other major world religions and worldviews (e.g. Judaism, Buddhism, atheism, etc.) are under-represented on its clinical staff and residency faculty, which has made it more difficult to effectively cover respective topics in the curriculum using in-house resources. Despite these challenges, the residents have positively reviewed the religion/spirituality curriculum regardless of their personal religious affiliation, with the Transcultural Psychiatry course receiving some of the most positive evaluations among all of the residency didactics.