{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:27:16Z","timestamp":1777598836711,"version":"3.51.4"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["10960102310035"],"award-info":[{"award-number":["10960102310035"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Spiritually integrated group therapy aims to support coping, meaning-making, and existential recovery in patients receiving psychiatric care. SPIRIT (Spiritual Psychotherapy for Inpatient, Residential and Intensive Treatment) is a structured, flexible protocol implementing this approach into intensive or residential settings. This study examines (1) the impact of SPIRIT on patients\u2019 lives and (2) their needs in terms of aftercare to determine whether and how its benefits can be sustained long term. Data were collected from multiple sources: patient evaluation forms (n = 118); in-depth interviews with patients (n = 19) and caregivers providing the therapy (n = 8); and two focus groups with both caregivers and patients. Transcripts were analyzed using qualitative content analysis. Results indicate that for most participants, the therapy positively impacted their lives through increased awareness or behavioral change, highlighting the relevance of maintaining these insights after group therapy, either at home or within the treatment setting. We recommend broader training of mental health professionals, and the introduction of programs like these to the entire care team to ensure awareness and support. A \u2018dual motor model\u2019 is proposed. Addressing religious, spiritual, and meaning-related themes in ongoing therapy and the psychosocial and pastoral support network can support recovery both by reducing symptoms and by fostering a health-promoting context.<\/jats:p>","DOI":"10.3390\/ijerph23020176","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T17:38:34Z","timestamp":1769794714000},"page":"176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From Meaning, Spirituality, and Religion in Acute Psychiatry to Public Health: A \u2018Dual Motor\u2019 Model"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8405-2198","authenticated-orcid":false,"given":"Bart","family":"van den Brink","sequence":"first","affiliation":[{"name":"GGz Centraal, Mental Health Care, 3818 EW Amersfoort, The Netherlands"},{"name":"Department of Practical Theology, Theological University Apeldoorn, 7316 BT Apeldoorn, The Netherlands"},{"name":"University Medical Central Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda van","family":"Parijs","sequence":"additional","affiliation":[{"name":"Altrecht Mental Health Care, 3512 PG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-3211","authenticated-orcid":false,"given":"Joke C.","family":"van Nieuw Amerongen-Meeuse","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences and Humanities, Lived Religion and Society, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands"},{"name":"Center for Research and Innovation in Christian Mental Health Care, 3871 MR Hoevelaken, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janieke I.","family":"Tjepkema","sequence":"additional","affiliation":[{"name":"University Medical Central Utrecht, 3584 CX Utrecht, The Netherlands"},{"name":"Center for Research and Innovation in Christian Mental Health Care, 3871 MR Hoevelaken, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5069-0239","authenticated-orcid":false,"given":"Rogier","family":"Hoenders","sequence":"additional","affiliation":[{"name":"Lentis Mental Health Care, 9725 AG Groningen, The Netherlands"},{"name":"Faculty of Religion, Culture and Society, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). World Mental Health Today, WHO."},{"key":"ref_2","unstructured":"World Health Organization (2024). Mental Health Atlas 2024, WHO."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1080\/10503307.2023.2241626","article-title":"The evaluation of religious and spirituality-based therapy compared to standard treatment in mental health care: A multi-level meta-analysis of randomized controlled trials","volume":"34","author":"Koelen","year":"2024","journal-title":"Psychother. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1002\/jclp.22681","article-title":"Integrating clients\u2019 religion and spirituality within psychotherapy: A comprehensive meta-analysis","volume":"74","author":"Captari","year":"2018","journal-title":"J. Clin. Psychol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1037\/a0036448","article-title":"Religiously integrated cognitive behavioral therapy: A new method of treatment for major depression in patients with chronic medical illness","volume":"52","author":"Pearce","year":"2015","journal-title":"Psychotherapy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1080\/10503300500497388","article-title":"Effectiveness of religiously tailored interventions in clinical settings: A meta-analysis","volume":"17","author":"Wade","year":"2007","journal-title":"Psychother. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Shonin, E., Van Gordon, W., and Griffiths, M.D. (2015). Mindfulness in Christian and Buddhist spiritual traditions: Connections with mental and physical health. Mindfulness and Buddhist-Derived Approaches in Mental Health and Addiction, Springer.","DOI":"10.1007\/978-3-319-22255-4"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/jclp.23666","article-title":"Temporal associations between meaning in life, ultimate meaning struggles, and mental health outcomes in a spiritually integrated inpatient program","volume":"80","author":"Currier","year":"2024","journal-title":"J. Clin. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/NMD.0000000000001150","article-title":"Conversations and beyond: Religious\/Spiritual care needs among clinical mental health patients in the Netherlands","volume":"208","author":"Westerbroek","year":"2020","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1176\/appi.psychotherapy.20180046","article-title":"Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment","volume":"72","author":"Rosmarin","year":"2019","journal-title":"Am. J. Psychother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1176\/appi.ps.202000331","article-title":"Predictors of patients\u2019 responses to Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT)","volume":"72","author":"Rosmarin","year":"2021","journal-title":"Psychiatr. Serv."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Van Nieuw Amerongen-Meeuse, J.C., Ouwehand, E., Graaf, N.D., Parijs, L.V., Schaap-Jonker, H., Braam, A., Verhagen, P.J., Rosmarin, D.H., and Van den Brink, B. (2024). Introduction of Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT) in The Netherlands: Translation and Adaptation of a Psychotherapy Protocol for Mental Health Care. Religions, 15.","DOI":"10.3390\/rel15030253"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1037\/pst0000400","article-title":"Why is Spiritual Psychotherapy for Inpatient, Residential, and Inpatient Treatment (SPIRIT) more effective when provided by nonreligious clinicians?","volume":"59","author":"Rosmarin","year":"2022","journal-title":"Psychotherapy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1176\/appi.prcp.20210026","article-title":"Effects of sexual orientation on Spiritual Psychotherapy for Inpatient, Residential & Intensive Treatment","volume":"4","author":"Schuttenberg","year":"2022","journal-title":"Psychiatr. Res. Clin. Pract."},{"key":"ref_15","first-page":"e52263","article-title":"Ensuring Continuity of Care: Effective Strategies for the Post-hospitalization Transition of Psychiatric Patients in a Family Medicine Outpatient Clinic","volume":"16","author":"Ojo","year":"2024","journal-title":"Cureus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e300831","DOI":"10.1136\/bmjment-2023-300831","article-title":"Individualisation, personalisation and person-centeredness in mental healthcare: A scoping review of concepts and linguistic network visualisation","volume":"26","author":"Mayer","year":"2023","journal-title":"BMJ Ment. Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Slade, M. (2009). Personal Recovery and Mental Illness: A Guide for Mental Health Professionals, Cambridge University Press.","DOI":"10.1017\/CBO9780511581649"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Flick, U. (2018). An Introduction to Qualitative Research, SAGE. [6th ed.].","DOI":"10.4135\/9781529622737"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J. Adv. Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1609406920968700","DOI":"10.1177\/1609406920968700","article-title":"Structuring a team-based approach to coding qualitative data","volume":"19","author":"Giesen","year":"2020","journal-title":"Int. J. Qual. Methods"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2158244014522633","DOI":"10.1177\/2158244014522633","article-title":"Qualitative content analysis: A focus on trustworthiness","volume":"4","author":"Elo","year":"2014","journal-title":"SAGE Open"},{"key":"ref_22","first-page":"121","article-title":"Change mechanisms and effectiveness of small group treatments","volume":"69","author":"Burlingame","year":"2013","journal-title":"J. Clin. Psychol."},{"key":"ref_23","first-page":"38","article-title":"The role of spirituality in coping with chronic illness","volume":"1","author":"Ghezelseflou","year":"2023","journal-title":"J. Personal. Psychosom. Res."},{"key":"ref_24","first-page":"1","article-title":"Pain, spirituality, and meaning making: What can we learn from the literature?","volume":"2","author":"Zinnbauer","year":"2011","journal-title":"Religions"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1176\/appi.ps.54.11.1491","article-title":"Integrating treatment with rehabilitation for persons with major mental illnesses","volume":"54","author":"Kopelowicz","year":"2003","journal-title":"Psychiatr. Serv."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/13674676.2018.1553029","article-title":"The \u201creligiosity gap\u201d in a clinical setting: Experiences of mental health care consumers and professionals","volume":"21","author":"Schuhmann","year":"2018","journal-title":"Ment. Health Relig. Cult."},{"key":"ref_27","unstructured":"Yalom, I.D., and Leszcz, M. (2005). The Theory and Practice of Group Psychotherapy, Basic Books. [5th ed.]."},{"key":"ref_28","first-page":"396","article-title":"Recovery-oriented mental health services: A review of the evidence","volume":"19","author":"Stickley","year":"2012","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4103\/jfmpc.jfmpc_260_19","article-title":"Salutogenesis: A Bona Fide Guide towards Health Preservation","volume":"9","author":"Bhattacharya","year":"2020","journal-title":"J. Family Med. Prim. Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3390\/rel2010051","article-title":"The Brief RCOPE: Current psychometric status of a short measure of religious coping","volume":"2","author":"Pargament","year":"2011","journal-title":"Religions"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1192\/bjp.bp.110.083733","article-title":"A conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis","volume":"199","author":"Leamy","year":"2011","journal-title":"Br. J. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1037\/a0036465","article-title":"The Religious and Spiritual Struggles Scale: Development and initial validation","volume":"6","author":"Exline","year":"2014","journal-title":"Psychol. Relig. Spiritual."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"The Lancet Public Health (2024). Mental Health: A Public Health Crisis Unfolding. Lancet Public Health, 10, e890.","DOI":"10.1016\/S2468-2667(25)00261-0"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/2\/176\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:36:29Z","timestamp":1770384989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/2\/176"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["ijerph23020176"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23020176","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}