What is the right balance between science and faith when it comes to
helping a client recover from mental illness? Are spiritual needs adequately
addressed when we provide care? Are faith leaders in the community playing the
In part 3 of our Spiritual Care series, we meet three CAMH experts in
clinical care, research and ethics. Here are their perspectives on the sometimes
delicate balance between science and faith.
“Growing depth and diversity:” Dr. Peter Voore, Medical
Director, Ambulatory Care and Structured
How are spiritual elements integrated into clinical practice?
We’ve seen the evolution of mindfulness as a valuable tool to help clients
with anxiety and mood disorders. Mindfulness helps a client live in the moment,
be aware of their body and manage thoughts and feelings. This therapeutic tool
has its roots in eastern religion. Scientifically, we can see the positive
impacts on the brain, and on client outcomes. It’s a great example of how
spirituality can be adapted into clinical practice.
What’s your experience addressing spirituality with clients?
There are times when I’ve sought a new dimension for a client, for example,
reaching out to a client’s pastor. A client of mine who had chronic depression
discussed her suicidal thoughts with her pastor and found this discussion very
comforting, and a helpful addition to the psychotherapy she was doing with me.
I’ve also had times where it’s important to have a client’s faith leader on
board when it comes to supporting medication compliance.
How has CAMH evolved to balance science and faith?
Earlier in my career, the spirituality options for
clients were limited – there was a weekly service on site, mostly based on
Christian faith. We’ve seen a growth in the depth and diversity of options for
clients when it comes to spirituality. Another good example is spiritual
ceremonies offered through Aboriginal Services. The CAMH Spiritual
Care team now offers diverse services to
clients. I think we can go further to integrate spiritual supports to clients in
psychiatric treatment, to take a more formal approach to this issue during the
client assessment phase. CAMH Spiritual Services is working on that initiative.
I believe that will benefit clients in future.
Religion and faith “can be integral:” Gursharan
Virdee, Research Analyst, Schizophrenia Division, Complex Mental Illness
You are working on a study looking at the meaning of faith and community
for more than 30 clients with psychosis. What trends have emerged?
One important theme is how religion and spirituality act as a source of
community for clients. Many clients find a deep sense of peace in a faith
setting such as a mosque or church. Religion and faith can promote inclusion and
enhance a client’s sense of self. Another relates to the role of faith leaders
in the community. We found that they could play a key role to boost a client’s
sense of inclusion, both social and psychological.
What are the pain points when it comes to integrating mental health care
The risk is we can undermine the significance of religion and spirituality in
treating a patient. Research has shown that mental health clinicians may be
uncomfortable in discussing spirituality with a client. Clinicians may be less
likely to belong to a faith group than their client population. But for some
clients, religion or faith may be integral to how they understand their
What are some solutions to the issues you’ve raised?
When it comes to mainstream mental health services, we can go further to
incorporate religion and spirituality into a client’s care when appropriate –
for example, providing a pass for the client to attend a faith service. It comes
down to the issue of client choice and finding the best route for the client. At
a community level, there are opportunities for mental health providers to engage
with faith communities so that clients are supported in a more holistic way.
Faith leaders may need better education on mental health. Connecting both of
these worlds can enhance recovery and healing for our clients.
“Discovering what we believe ourselves to be:” Kevin
Reel, CAMH Ethicist and Interim Discipline Co-Chief for Occupational
Science versus spirituality: Where do you see the common ground and
Neither science nor spirituality can hold or find all the 'answers' to the
human condition, so we'd do well to try to appreciate the merits of each, and
the limitations. I have always felt the aims are similar: seeking to better the
world, albeit through different means. Conflict can arise when respect is
As an ethicist, you said that what gets upset in a moral
dilemma is a person's spiritual core.
The challenging thing is that many of us struggle to uphold our values at all
times. Stress, fatigue, the unexpected: all of these things can cause us to act
in ways that might not be in keeping with 'who' we think we are. When this
happens, we feel moral distress, which is akin to spiritual distress. An example
is a client who is struggling with addiction. Deep inside, they may feel this is
not part of who they feel themselves to be. But making this change is immensely
difficult. We can work with them to help align their values/spirit with their
Your background is in Occupational Therapy. How does spirituality fit into
the OT practice?
The Canadian Model of Occupational Performance and Engagement describes
client dimensions including physical, cognitive, affective and spiritual. The
spiritual dimension is placed at the centre. There was much debate about this,
but it was felt to be appropriate. We ask the client to help us understand what
spirituality means to them. We then work with this essential part of them.
This is part three of
a series dedicated to CAMH Communications Specialist Joan Chang, a talented and
passionate communicator who appreciated the value of spiritual care. Joan
developed a story framework to shine the spotlight on spiritual care at CAMH,
and completed some interviews for the series. She died suddenly in June, 2015. A
tribute to Joan is included
on the CAMH Foundation website.
Also in the Spiritual Care Series: