The role of spirituality in South African specialist psychiatric practice and training
Date
2012-01-31
Authors
Janse van Rensburg, Albert Bernard-Repsold
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Abstract
Introduction: An increasingly important role for spirituality has been observed in health, mental
health and psychiatry. In South Africa it has become particularly apparent in how the Western
scientific biomedical model has increasingly been regarded as only one approach in parallel to
local African traditional faith and healing practices. It is currently important for local
psychiatrists themselves to consider from within the discipline, as to what they would
judge the role of spirituality to be in specialist psychiatric practice and teaching.
Methods: This study is an explorative, descriptive, contextual, phenomenological and theorygenerating
qualitative investigation. In-depth, semi-structured interviews with individual
academic specialist psychiatrists affiliated to a local South African university were conducted as
primary data source. Considering selected journal articles from a review of the international
literature as secondary data items, the content of the conducted interviews was subsequently
compared and integrated with the content of the literature on the subject. A layered grounded
analysis was made of the interview and literature content. Final categories of concepts were
identified from the integrated content, as well as one single core concept for model construction.
The elements of the core concept were defined by determining their dictionary (denotative) and
subject (connotative) meaning. Essential and related criteria were established for the definition
of each element. A practice-orientated model was developed based on the defined single core
concept. The steps adopted for the construction of the model referred in particular to the
methodology for nursing theory development.
Results: The local interviews and the international literature revealed a strong consensus that
the role of spirituality should be incorporated into the current approach to local specialist
psychiatry, mainly because of its important role in the lives of people in general. Incorporation of
this role should, however, only be considered within the parameters of the professional and
ethical scope of the discipline, and with all faith traditions and belief systems accommodated
equally. The model accounted for the two-fold nature of this central core concept, by drawing an
analogy with the comparable counterbalanced two-directional transportation systems of large
trees, to describe the structure and relationships of the elements of the concept. The model was
operationalised, providing guidelines for its implementation in different practice and training
scenarios.
Discussion: The model may contribute to the acknowledgement of, and participation in, the
discourse on the place of spirituality in local psychiatry, clinical medicine, health and mental
health. Defining terminology, specifically what exactly “spirituality” and “religion” would mean in
a particular scenario and for the study, proved to be one of the most critical elements of this
investigation. Appropriate guidelines for clinical care, for ethical practice and training, and for the
referral of patients to relevant spiritual professionals are necessary. Academic institutions in
South Africa may have to reconsider their approach to the training of specialist psychiatry and of
clinical medicine in general, in order to account for the currently increasingly important role of
defined spirituality in local practice and training.
Description
Ph.D., Faculty of Health Sciences, University of the Witwatersrand, 2011