From Meaning, Spirituality, and Religion in Acute Psychiatry to Public Health: A ‘Dual Motor’ Model

Abstract

Highlights: Public health relevance—how does this work relate to a public health issue? Meaning, spirituality, and religion are related to mental health and recovery from mental illness. Group-based therapies that integrate meaning, spirituality, and religion, such as SPIRIT, can contribute to recovery from mental illness and increase wellbeing and mental health at the population level. Public health significance—why is this work of significance to public health? This study provides insight into the perceived effects of spiritually integrated cognitive behavioral therapy and identifies factors needed to sustain these effects over time. By examining needs in terms of aftercare, this research addresses a knowledge gap on how psychotherapeutic interventions can contribute sustainably to (existential) recovery. Public health implications—what are the key implications for practice, policy, and research? A ‘dual-motor’ model is proposed: meaning-focused therapies promote both coping and a broader recovery-oriented contextualization in therapy and at home. The integration of meaning, spirituality, and religion in acute psychiatry requires team-wide implementation. Structural attention to follow-up and integration into subsequent treatment may contribute to more sustainable recovery. 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’ 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 ‘dual motor model’ 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.