Spiritual Psychotherapeutic Model of Health

Human illness is a mixture of biomedical and molecular biology, which requires the need to focus on the whole person treatment that includes the physical, psychological, and social, dimensions. The biological assessment deals with an understanding of the causes of the illness from the biological factors, and the psychological assessment deals with the psychological factors like self-control, mental disorder, and negative outcomes of the illness. The social assessment investigates how social factors like the socioeconomic status of the patient and culture can influence patients' terminally ill experiences. The spiritual domain on the other hand focuses on the individual relationship with the transcendent being influencing the individual health conditions.

In developed countries, spirituality is a topic that drives people's interest in health, well-being, and palliative end-of-life care. It is the concept of the dying individual that there is a transcendent dimension that constructs a sense of hope for meaning and purpose in life in the face of medical helplessness. It is through the hope that exists in the individual belief the terminal patient finds peace, which is an integral component in coping with death and dying. Spiritual psychotherapeutic interventions can attend to and satisfy the core needs of the patients. Even clinicians attending to the spiritual needs of dying patients can experience inner peace, besides the effective deliverance of quality of life to the patient and family. Relaying in the transcendent being and prayer play an important role in alleviating pain symptoms and promoting good health in the clinical setting. Spirituality is the key factor having the potential to enhance patient subjective well-being through promoting healthy personal living. It provides meaning in suffering and ensures social support in the community. In wider understanding spirituality is the one mechanism that serves as a source of strength, comfort, and hope. It also helps in decreasing disease risk and enhances health and well-being. Spiritual psychotherapy is a platform to fulfill the dying patient's wishes before the inevitable death strikes. It is the only mechanism that delivers peaceful death and makes dying as normal as death in terminal experiences.

The Meaning-Making Process: Spirituality is not only the factor that contributes to the health of many but is also recognized as central to the dying individual. Several findings also acknowledge spirituality as the factor that decreases the fear of death and delivers a sense of control over emotional helplessness. It is a universal belief that a strong sense of spirituality in oneself serves as the structure for effective coping mechanisms and experiencing more connectedness to self, others, and the transcendent being amid painful ill experiences. Generally, in the first two stages of the cancer experience patients usually hope for a cure and the absence of illness from their physical body. However, in the third and the fourth stages where cure becomes completely impossible, the patient shifts from cure to healing through quality times of togetherness with their loved ones. Spiritual psychotherapeutic intervention can deliver general life orientation and personal significance. It serves as a coping mechanism that improves the sense of meaning and purpose in life. Spirituality is the most effective mechanism against mental disharmony and psychological traumas. Spirituality serves as the central component and an important agent that safeguards patients from end-of-life despair and suffering.

Spirituality is the factor that gives patients to discover the deeper meaning of existence amid suffering and self-awareness to both the spiritual and non-spiritual patients. As an effective coping mechanism, it helps the dying individual to adjust to their illness, delivers longer life expectancy, and the ability to deal effectively with the pain symptoms. It is the therapy that decreases the amount of depression and anxiety and is successful in reducing the risk behind substance abuse and suicidal activity. Even for loved ones and family, the spiritual psychotherapeutic intervention also serves as a source of meaning and hope, which is less associated with depressive stress symptoms that ignite self-esteem. Spirituality is an essential element for the person-centered care assessment not only increases the rate of patient's positive emotion but also helps in reducing the emotional disorder through its meaning-making policy. Most importantly, spirituality provides an optimistic worldview to the dying patient in the face of medical helplessness and makes sense of their terminal experience.??Spirituality in its broader understanding gives meaning to terminal experiences mainly when mental disharmony, depression, and stress strike in the course of illness. Dying in the modern era should be made as natural as that of human birth; it should be a meaningful experience for those facing death and dying. It should be the time when every dying individual finds meaning in their suffering, and the various dimensional needs of the patients are addressed and fulfilled.?However, the absence of whole-person treatment in the Indian health care system failed to address the needs of the dying individual and the wishes unfulfilled. Symptoms like depression, anxiety, and other psychological-related issues are considered symptoms not to be treated in its clinical setting.

The impact of spirituality on health and well-being can be considered invariant regardless of the individual’s religious status. The study found a strong impact of spirituality intended as the human desire for transcendence, introspection, interconnectedness, and the quest for meaning in life. This relationship appears the same regardless of the individual’s religious status. The finding shows that 85% of terminally ill patients and families felt the need for physicians to acknowledge and address their spiritual needs. However, less than 10% of the patients and families reported their physicians discussing their spiritual beliefs and related issues. The 90% of terminally ill patients and families agreed that physicians/clinicians acknowledging their spiritual needs would strengthen them in the face of inevitable death. Another 97% of inpatients and outpatients for whom spirituality was not important also wanted their physicians to address their spiritual needs and be sensitive towards their beliefs and values framework. Even 80% of the patients who don’t believe in any form of an existing religion, do feel the importance of physicians inquiring about their spiritual insights in case of serious illness. The following table will show the data on how terminally ill patients used spirituality as a coping mechanism and a pathway to recovery.

The term health and well-being are not merely free from any physical illness, rather health includes the criteria like mental, physical, psychological, economic, and most importantly the spiritual domain of an individual concerned. It is increasingly visible that both the clinicians and the terminal patients acknowledge the spiritual domain of health care as an important factor of supportive health care in terminal diagnosis to deliver well-being and quality of life. Spirituality is the mechanism that deals effectively with treatment issues like pain and symptom control, inappropriate prolongation of death and dying, and a patient's feeling of being burdensome to others and loved ones. In concerns the positive impacts of spiritual psychotherapy, Manitoba's Spiritual Health Care Partners stated that; spirituality has an impact on the way the terminal patient understand their illness, recovery, and punishment Versus regrettable suffering; quality decision-making about their treatment policy and; building a quality relationship between the terminal patient and the clinicians that usually produces trust and acceptance. Spirituality becomes the central focus in the face of medical helplessness; it helps in effectively coping with a terminal illness and becomes part of their existence that serves as health to many dying patients. The essences of spirituality have the potential to be in communion with self, with others, nature, and with the transcendent being, which delivers the whole person treatment with regards to self-identity, inner peace, love, reconciliation, inspiration, creativity, hope, and gratitude.

Recent research on spirituality in terminal illness intervention found that patients with a higher level of spirituality have a lower risk of depression and anxiety. Through spirituality, the dying individual can effectively construct meaning and purpose in suffering that facilitates a positive role in patients' coping with their illness. The findings stated that even 45% of people with no religious beliefs also felt the need for spiritual assessment in one way or the other and 94% of the cancer patients want their physicians to deliver the spiritual assessment. In many cases, spirituality is seen as the mechanism that has healing potentiality on individual health, influences patient decision-making, and plays an important role in delaying a patient's physical disability which usually occurs in the latter part of any terminal illness. On the other hand, patients with a lower level of spirituality encountered higher rates of stress and depression in their terminally ill experiences. The new paradigm of spiritual pain and suffering has the sense of emotional diffusion, which is directly related to meaninglessness, and the underlying factor in that pain lies in failing to meet the needs of the dying individual. So, when individuals approach near-death and dying, they usually experience a sense of hopelessness, a burden to others, and lose a sense of dignity in self which usually leads to a loss of will to live.

Thus, spiritual well-being becomes an important dimension that is positively related to the patient's subjective well-being, source of hope, and purpose in life. It is also associated with positive mood stress and the overall quality of life in terminal experience. The importance of spirituality in palliative end-of-life care lies in focusing on the patient's spiritual despair (alienation, loss of oneself, and dissonance); spiritually related workload (forgiveness, self-exploration, search for meaning and balancing life), and well-being of the whole (connectedness, self-actualization, and living in consonance with self and others). At end-of-life, it is evident that terminally ill patients experience mental disharmony, anger, sadness, guilt feeling, anxiety, hopelessness, and the painful feelings of being separated from their loved ones meaning-making becomes a crucial factor. Spirituality, on the other hand, can successfully deliver the immediate context in which dying individuals can make sense of their lives and cope with their illness through the sense of hope that delivers inner peace amid several existential challenges in end-of-life care.