Appendix

RELIGION, SPIRITUALITY, AND TRAUMA: AN ANNOTATED BIBLIOGRAPHY

FRED C. GINGRICH

This appendix is an extensive annotated bibliography referred to in the introduction and in chapter one. The references include both conceptual and empirical studies. Please note that this is not a bibliography on trauma and trauma treatment but rather includes literature that specifically incorporates the dimensions of religion and spirituality as they relate to trauma.

The references are organized into categories as follows:

• R/S and Trauma (390-97)

• R/S Resources for Coping, Resilience, and Posttraumatic Growth (PTG) (398-404)

• R/S and Trauma Treatment (404-8)

• R/S and Specific Strategies and Techniques for Trauma Treatment (408-15)

• R/S Related to Specific Types of Trauma and Populations (416-53)

  • ■ Military personnel and veteran trauma (416-22)

  • ■ Interpersonal trauma (422-32)

  • ■ Disasters and trauma (432-40)

  • ■ Violent and collective trauma (440-43)

  • ■ Additional types and populations (444-53)

Note: “R/S” refers to religious/spiritual (or religion/spirituality); “MHP” to mental health professional; “tx” to treatment; “PTSD” to posttraumatic stress disorder; “PTG” to posttraumatic growth; “CSA” to child(hood) sexual abuse; “IPV” to interpersonal violence. Assume that the referenced documents are from academic journals unless otherwise indicated.*1

R/S and Trauma

Author (date)	Abi Hashem (2012)
Focus	Religious and pastoral responses to trauma
Type of document	Book chapter; conceptual
Abstract highlights	A brief encyclopedia article in a secular publication.

Author (date)	Aten & Walker (2012); Walker & Aten (2012)
Focus	Introduction and conclusion to a special journal issue on R/S and trauma
Type of document	Conceptual
Abstract highlights	Shares lessons learned from the research and clinical practice in area of trauma, as well as future directions for study and research. Refers to child-abuse prevention and tx, intimate partner violence, responding to survivors of natural disasters, and theological and theoretical integrative approaches to trauma tx.

Author (date)	Bowland (2015)
Focus	R/S issues in psychotherapy with trauma survivors
Type of document	Review
Abstract highlights	Review of Walker, Courtois, and Aten (2015).

Author (date)	Doehring (1993)
Focus	R/S during and after trauma
Type of document	Book; conceptual
Abstract highlights	Trauma results in the internal experience of “desecration” and changes one’s representations of God.

Author (date)	Gostecnik, Slavic, Lukek, & Cvetek (2014)
Focus	R/S and trauma
Type of document	Conceptual
Abstract highlights	Retraumatization often develops a highly ambivalent relationship to God, and all religiosity can be extremely conflictual. People blame God either for not having protected them, for having left them to feel so alone, or for having been indifferent to them, or they may even turn their wrath on God as the source of cruelty. Frequently trauma prompts people to turn to God and religion in search of help. Need for research to answer why some turn to religion while others turn away.

Author (date)	Grame, Tortorici, Healey, Dillingham, & Winklebaur (1999)
Focus	R/S issues for those who have a history of trauma
Type of document	Conceptual
Abstract highlights	MHPs and clergy need to collaborate in tx; need for cross-professional training for both MHPs and clergy; R/S assessment and tx plans needed. Body-soul connection is well-established in trauma. Implications of (1) attachment theory, (2) self-psychology theory, (3) Thomas Aquinas’s theology of embodiment, and (4) object relations theory.

Author (date)	Grand (2015)
Focus	Responding to the problem of evil and suffering
Type of document	Book chapter; conceptual, case study
Abstract highlights	Cruelty perpetrated by one human being on another in war, genocide, terrorism, torture, mass rape, and mass shootings occurred throughout history; so the question that has been posed from time immemorial, without adequate answer, is, Do we as humans possess an innate propensity for evil? Can goodness somehow contain and heal? Humans can be conceptualized as having multiple self-states with each state presenting an ethical marker; sometimes people behave as perpetrators and sometimes as rescuers. Encouraging dialogue between victim self-states and perpetrator self-states creates potential for new life.

Author (date)	Grant (1999)
Focus	R/S and trauma
Type of document	Conceptual
Abstract highlights	Trauma presents psychological and spiritual challenges that are unfamiliar to the average person. MHPs need to recognize that organizations of self and God are often thrown into question or destroyed by experiences of trauma. Deconstructive power of trauma exposes the lack of substance and cohesiveness that comprises identity and images of God.

Author (date)	Hall & Johnson (2001)
Focus	Theodicy, therapy, and the problem of suffering
Type of document	Conceptual
Abstract highlights	Theodicies are philosophical/theological attempts to reconcile the presence of evil and suffering in the world with the idea of an all-powerful and good creator God. Evaluates the usefulness of theodicies in responding to the suffering person’s needs. Epstein’s CEST theory and Stolorow’s theory of trauma are discussed to clarify the needs of the sufferer. It is concluded that theodicy, particularly in some forms, can be helpful in changing the sufferer’s theory of reality through an experiential encounter with God.

Author (date)	Harper & Pargament (2015)
Focus	Trauma and R/S pathways to healing
Type of document	Book chapter; conceptual
Abstract highlights	Explores the complex and dynamic ways in which R/S is embedded in the posttraumatic recovery process. R/S affects people’s understandings of traumatic events, the selection of methods to cope with adversity and the coping methods themselves, and the short- and long-term outcomes of trauma. Provides summary of ways in which R/S can be integrated into the posttraumatic recovery process, accompanied by promising outcome data from spiritually integrated intervention studies.

Author (date)	Harris, Erbes, Winskowski, Engdahl, & Nguyen (2014)
Focus	Social support and trauma symptoms
Type of document	Empirical (quantitative)
Abstract highlights	Variables: social support, religious comfort, and trauma symptoms. Tested theory that R/S variables serve as a proxy for social support because individuals in spiritual communities access higher levels of social support than those with no such community. Social support, religious comfort, and religious fear and guilt make independent contributions to posttraumatic adjustment, whereas social support partially mediates the relationship between alienation from one’s higher power, religious rifts, and trauma symptoms.

Author (date)	Harris, Leak, Dubke, & Voecks (2015)
Focus	Religious strain and postconventional religiousness in trauma survivors
Type of document	Empirical (quantitative)
Abstract highlights	Postconventional religious reasoning has been one of the best defined indicators of R/S development in the literature. Attempted to identify the types of religious challenges most relevant to the development of postconventional religiousness. Participants who reported higher levels of postconventional religiousness included those who had experienced (a) more total trauma exposure, (b) more religious rifts with others in their faith group or family, (c) lower levels of religious fear and guilt, and (d) lower levels of religious comfort.

Author (date)	Hipolito et al. (2014)
Focus	R/S and empowerment in trauma informed care
Type of document	Empirical (quantitative)
Abstract highlights	R/S may serve a protective function in the posttrauma period, but few studies have systematically examined the process through which this occurs. Tested a theoretical model that examines the protective roles of R/S and personal empowerment in the relationship between childhood and adulthood experiences of violence and mental health/well-being. Need to develop trauma-informed practice protocols that incorporate spirituality.

Author (date)	Kalsched (2013)
Focus	R/S and developmental interruptions due to trauma
Type of document	Book; conceptual; case studies
Abstract highlights	Delves into the mystical or spiritual moments that often occur around the intimacies of psychoanalytic work in the area of trauma. Includes stories of ordinary patients and ordinary psychotherapists who, through working together, glimpse the reality of the human soul and the depth of the spirit and are changed by the experience.

Author (date)	Kusner, & Pargament (2012)
Focus	R/S and trauma
Type of document	Book chapter; conceptual
Abstract highlights	R/S struggles, doubts, and uncertainties can be triggered by trauma. Support, solace, and peace can be gained from spiritual resources after trauma. Explores spiritual character of trauma, spiritual ways of coping with trauma, and the spiritual outcomes of trauma. How can spirituality be addressed in the context of tx to promote growth and resilience and to prevent the development of serious problems?

Author (date)	Park & Gutierrez (2013)
Focus	Psychological well-being and global and situational meanings in the context of trauma
Type of document	Empirical (quantitative)
Abstract highlights	Examined the relationship between global and appraised meaning and well-being in a sample of 189 college students who had experienced a highly stressful event in the past five years. Elements of both global meaning (especially self-esteem beliefs) and situational meaning (especially appraisals of the event as violating one’s goals) were independently related to a range of well-being outcomes, including depression, anxiety, stress, subjective happiness, and life satisfaction. Demonstrates the importance of both global and situational meanings in adjusting to life stress.

Author (date)	Rambo (2015)
Focus	R/S and trauma
Type of document	Conceptual
Abstract highlights	Life following an overwhelming event of violence is fundamentally changed; survivors struggle to reconcile their present experience of life (including the trauma) with their experience of faith. When individuals and religious communities try to put the events behind them and proclaim the good news before it’s time, they fail to attend to the ongoing realities of a death that does not go away. Explores a theology that witnesses to what remains after the trauma.

Author (date)	Reinert, Campbell, Bandeen-Roche, Sharps, & Lee (2015)
Focus	Gender and race variations in religious involvement, early trauma, and adult health
Type of document	Empirical (quantitative)
Abstract highlights	Sought to determine gender and race variations in regard to the influence of religious involvement as a moderator of the effects of early traumatic stress on health-related quality of life among adult survivors of child abuse. Cross-sectional predictive design used to study Seventh-day Adventist adults in North America (N = 10,283). Findings suggest gender and racial differences must be considered when devising holistic interventions for improving health outcomes of early trauma survivors.

Author (date)	Severson, Becker, & Goodman (2016)
Focus	Psychological and philosophical reflections on trauma and suffering
Type of document	Conceptual; edited book
Abstract highlights	Trauma is difficult to understand and to deal with, yet the process of wrestling with it can be transformative. Interdisciplinary essays discuss influential thinkers such as Augustine, Foucault, Freud, Heidegger, and Lacan, along with literature from Homer, the book of Job, and Shakespeare.

Author (date)	Smith (2004)
Focus	R/S and trauma
Type of document	Conceptual
Abstract highlights	Positive and negative impact of R/S on coping. Inconsistent results in the literature concerning the relationship between trauma and R/S. Different roles clergy and MHPs can play in tx.

Author (date)	Starnino (2016)
Focus	R/S, trauma, and mental illness
Type of document	Empirical (qualitative, case study)
Abstract highlights	Identifies spirituality as a helpful resource for dealing with various types of trauma experiences and encourages the role of spirituality within trauma-related theory (e.g., spiritual coping, meaning making, and PTG). Little is known about the relationship between trauma and spirituality among people with severe psychiatric disorders, yet a high percentage of those with psychiatric disabilities are known to have trauma histories, and a majority self-identify as R/S. Provides a hermeneutic, phenomenological, qualitative study of two cases with co-occurring psychiatric disabilities and trauma histories. Offers useful examples of how spirituality and trauma can affect one another and how people with psychiatric disabilities draw on spirituality to cope as they strive for recovery.

Author (date)	van den Blink (2010)
Focus	R/S and trauma
Type of document	Conceptual
Abstract highlights	Offers an account of how an appreciation of theology and practice of Christian spirituality can benefit victims. Summarizes the contributions of neuroscience to understanding the physiology and psychology of trauma. Provides an explanation of the important contribution that contemplative prayer can make to those who have suffered trauma and abuse and those who want to help them.

Author (date)	Van Deusen & Courtois (2015)
Focus	R/S and complex developmental trauma
Type of document	Book chapter; conceptual; case study
Abstract highlights	Observes the effects of multiple, repetitive traumas occurring primarily over the course of childhood on an individual’s spiritual development. Using the work of Erik Erikson and James Fowler, assesses how and when experiences of complex trauma affect standard developmental trajectories. Looks at how the five primary domains of complex PTSD (CPTSD) influence a survivor’s ability to develop a healthy sense of faith that fosters positive identity and hope. Includes case of a client with dissociative identity disorder to illustrate how extreme emotional dysregulation and trauma-related expectations of relationships affect spirituality, attachment to God, and faith development; specific strategies for integrating issues of spirituality into each of the three main phases of tx for CPTSD.

Author (date)	Van Hook (2016)
Focus	R/S as a resource for coping with trauma
Type of document	Conceptual
Abstract highlights	Addresses ways in which trauma is experienced, potential interactions between trauma and spirituality, and possibilities for promoting healing.

Author (date)	Van Hook, Furman, & Benson (2016)
Focus	R/S and trauma
Type of document	Special issue; conceptual
Abstract highlights	Role of trauma in the lives of individuals, families, and communities and pathways to healing. Articles address a wide range of life experiences, cultural aspects, and contexts and highlight the potential interaction between trauma and spirituality or religion.

Author (date)	Whitmire (2015)
Focus	R/S and self-care for counselors working with trauma
Type of document	Dissertation; empirical (qualitative)
Abstract highlights	Addresses the trauma counselor’s perspective on spirituality and self-care using a phenomenological perspective of 10 practicing, professional trauma counselors working in six trauma settings to determine (1) their understanding of spirituality and (2) whether or not spirituality is a viable tool in self-care for alleviating vicarious traumatization Six major themes were identified across the interviews: current self-care practices, core beliefs and values, influence of core beliefs and values, individual spirituality, spirituality and self-care, and trauma’s affect on spirituality, personally and professionally.
Abstract highlights (continued)	Individual spirituality ameliorated vicarious traumatization for trauma counselors. Implications for clinical practice include specialized training, education, supervision, and implementation of strategies and techniques for ongoing adjustment and recovery. Recommendations for future research include effectiveness of existing training on R/S topics and current competencies of counselors working with R/S diversity.

Author (date)	Woodcock (2001)
Focus	R/S and trauma
Type of document	Book chapter; conceptual
Abstract highlights	Existential change frequently makes sense from within an R/S framework, but beliefs and practices with respect to trauma, suffering, and change vary depending on the religious tradition. Therapists can maintain their capacity for effective practice by making good use of their current experience and working across the boundaries of spiritual and cultural differences.

Author (date)	Wortmann, Park, & Edmondson (2011)
Focus	R/S struggles, PTSD symptoms, and trauma
Type of document	Empirical (quantitative)
Abstract highlights	Among the mechanisms that may predict PTSD symptoms is R/S struggle, a set of negative religious cognitions related to understanding or responding to stressful events. Assessed exposure to trauma and nontrauma events during the first year of college, R/S due to the most stressful event, and PTSD symptoms resulting from the index event. R/S struggle partially mediated the relationship between trauma and PTSD symptoms. Some individual subscales of R/S (specifically, punishing God reappraisal, reappraisal of God’s powers, and spiritual discontent) partially mediated the relationship between trauma and PTSD symptoms; however, reappraisal of the event to evil forces did not relate to PTSD symptoms. Results suggest that R/S struggle is an important cognitive mechanism for many trauma victims and may have relevance for cognitive therapy for PTSD.

Author (date)	Zenkert, Brabender, & Slater (2014)
Focus	MHP and R/S perspectives on trauma clients
Type of document	Mixed methods
Abstract highlights	As compared to working with nontrauma clients, therapists view attention to R/S in trauma therapy as necessary. Emphasis on R/S within a traumatized population possesses distinctive qualities in comparison to other populations.

R/S Resources for Coping, Resilience,
and Posttraumatic Growth (PTG)

Author (date)	Boehnlein (2007)
Focus	R/S after trauma
Type of document	Book chapter; conceptual; case studies
Abstract highlights	Trauma raises R/S questions, challenges a person’s core belief systems, involves an examination of previously stable cultural and religious assumptions that were the foundations of a person’s life. Clinical issues arise such as healing in the context of R/S belief systems, psychotherapy for PTSD, and interpersonal and social reintegration. Discusses psychological challenges after trauma related to R/S, the role of the healing process in restructuring values and meaning after trauma, and the therapeutic relationship.

Author (date)	Bonanno (2004)
Focus	Resilience after extremely aversive events
Type of document	Conceptual
Abstract highlights	Trauma theorists have often viewed resilience as either rare or even pathological. Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Resilience represents a distinct trajectory for recovery; resilience in the face of loss or potential trauma is more common than is often believed; there are multiple and sometimes unexpected pathways to resilience.

Author (date)	Brewer-Smyth & Koenig (2014)
Focus	R/S and resilience in survivors of childhood trauma
Type of document	Conceptual
Abstract highlights	Examines the neurobiological, behavioral, and health outcomes for survivors. R/S can promote emotional, neurotic, and psychotic consequences. R/S can be a powerful source of hope, meaning, peace, comfort, and forgiveness for the self and others. Faith-based communities can promote forgiveness rather than retaliation, opportunities for cathartic emotional release, and social support.

Author (date)	Brooks (2012)
Focus	R/S and PTG
Type of document	Dissertation; empirical (qualitative)
Abstract highlights	Used Tedeschi and Calhoun’s (1996) Posttraumatic Growth Inventory (PTGI) with five dimensions. Assessed for relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. Traumatic life experiences can be identified as spiritual marker events. For MHPs, seek training, increase knowledge and understanding of the PTG process; assess individuals’ strengths along the five PTG factors; take trauma and R/S histories; incorporate personal strengths and spirituality as resources in the recovery process.

Author (date)	de Castella & Simmonds (2013)
Focus	R/S growth following trauma
Type of document	Empirical (qualitative)
Abstract highlights	Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, as well as positive changes in existential or R/S matters. Ten Christian women who experienced R/S growth following trauma were analyzed using Interpretative Phenomenological Analysis. Religion provided a framework that assisted participants to incorporate life changes and to find meaning in their suffering. Trauma prompted a process of questioning and meaning making that facilitated deeply experienced personal and spiritual growth and was related to intrinsic religiosity.

Author (date)	Eriksson & Yeh (2012)
Focus	Resilience to trauma
Type of document	Book chapter; conceptual
Abstract highlights	Discusses R/S aspects of abuse, interpersonal violence, cancer, and combat exposure. Offers framework of spiritual development as a guide to tx; resources to encourage thriving, meaning making, and coping. Explores religious coping, the importance of the religio-cultural context, the reality of spiritual crisis, and potential for PTG and transformation.

Author (date)	Farley (2007)
Focus	Connection between R/S, trauma, and resiliency
Type of document	Conceptual; case studies
Abstract highlights	A model of individual resiliency from family-based trauma; characteristics are explored for their compatibility with spiritual practices. Case examples from various practice settings are given to exemplify application of R/S practices to the development of resiliency traits. Implications for practice include increased understanding of the use of spirituality as a tool to enhance adaptability and coping.

Author (date)	Gear Haugen (2012)
Focus	Effects of traumatic events on R/S
Type of document	Dissertation; empirical (longitudinal)
Abstract highlights	Investigation of 85 emerging adults’ experiences of adversity, religiousness, and spirituality. About half of all participants reported at least some level of negative spiritual appraisals (desecration and sacred loss) of events that had occurred to them. Significant PTG for five of eight factors of R/S and posttraumatic R/S change among those with high levels of trauma.

Author (date)	Gerber, Boals, & Schuettler (2011)
Focus	Positive and negative R/S coping, PTG, and PTSD
Type of document	Empirical (quantitative)
Abstract highlights	Assessed relationships between religious coping, gender, PTSD, and PTG with a sample of 1,016 participants. Positive religious coping was more strongly related to PTG, and negative religious coping was more strongly related to PTSD; remained significant after controlling for traditional coping methods, gender, and race. Positive religious coping partially mediated the relationship between gender and PTG, and positive correlations were also observed between negative religious coping and PTG and between positive religious coping and PTSD.

Author (date)	Harris et al. (2008)
Focus	Christian R/S functioning and trauma outcomes
Type of document	Empirical (quantitative)
Abstract highlights	Some trauma survivors find their faith helpful in recovery, others find it a source of distress, and still others abandon their faith. Used measures of religious action and behaviors in a community sample of 327 church-going, self-identified trauma survivors. Principal components analysis of positive and negative religious coping, religious comforts and strains, and prayer functions identified two dimensions: seeking spiritual support, which was positively related to PTG, and religious strain, which was positively related to posttraumatic symptoms.

Author (date)	Harris et al. (2010)
Focus	Coping functions of prayer and PTG
Type of document	Empirical (quantitative)
Abstract highlights	Those who pray more report more PTG. Which types of prayer may be operating with which types of trauma experienced. Participants (N = 327) completed questionnaires assessing trauma history, prayer coping functions, and PTG. Praying for calm and focus was independently related to higher levels of PTG; however, the relationship between prayer for calm and focus and PTG was not significant for those whose most significant trauma was interpersonal in nature, but was significant for those with non-interpersonal trauma.

Author (date)	Mijares (2005)
Focus	Trauma and transformed identities within a psychospiritual paradigm
Type of document	Book chapter; conceptual; case studies
Abstract highlights	Alternative methods for treating posttraumatic reactions to violence and sexual abuse. Trauma can open doors to transformation when treated within an integrative, psychospiritual paradigm. Examples from tx based on the work of Jung, Campbell, Gilligan, Assagioli, and mystical teachings from religious traditions. Client narratives are presented to illustrate how trauma and psychospiritual tx can lead to transformed identities.

Author (date)	Pargament (2001)
Focus	Psychology of religion and coping
Type of document	Book; conceptual
Abstract highlights	An overview of the theoretical underpinnings and research regarding the benefits and dangers of R/S in psychological coping. Religion helps some people cope, while for others it does not. Religious belief can serve as a defense or a form of denial, but faith can also help people in crisis and in times of stress.

Author (date)	Pargament (2007)
Focus	Spiritually integrated model of counseling
Type of document	Book; conceptual
Abstract highlights	Resources for creating a spiritual dialogue with clients, assessing spirituality as a part of their problems and solutions, and helping them draw on spiritual resources in times of stress. R/S can serve as a foundation to help cope, and it can serve to transform life and produce growth.

Author (date)	Pargament & Cummings (2010)
Focus	Religion as a resilience factor
Type of document	Book chapter; conceptual
Abstract highlights	Religiousness can play a significant role in response to major life stressors; challenges stereotypes of religiousness as a defense or source of pathology; religiousness is a significant resilience factor for many people. There is evidence that religiousness can help people move beyond prior levels of adjustment to achieve fundamental positive transformation; however, some forms of religiousness may exacerbate rather than mitigate the effects of major life stressors.

Author (date)	Pargament, Desai, & McConnell (2006)
Focus	R/S as a pathway to PTG or decline
Type of document	Book chapter; conceptual
Abstract highlights	Spirituality can play a critical role in how traumas are understood, how they are managed, and how they are ultimately resolved; however, spirituality can be potentially helpful (PTG) or harmful (decline). Considers factors that may determine whether spirituality leads ultimately to growth or decline. Discusses practical implications of this body of theory and research for efforts to help people cope with major trauma including the meaning of R/S and its place in the context of coping with life traumas.

Author (date)	Peres, Moreira-Almeida, Nasello, & Koenig (2007)
Focus	R/S and resilience in trauma victims
Type of document	Conceptual
Abstract highlights	The way people process stressors is critical in determining whether or not trauma will be experienced. Clinical and neuroimaging findings suggest that PTSD patients experience difficulty in synthesizing the traumatic experience in a comprehensive personal narrative. Building narratives based on healthy R/S beliefs may facilitate the integration of traumatic sensorial fragments in a new cognitive synthesis, thus working to decrease posttraumatic symptoms. The role of spirituality in fostering resilience in trauma survivors advances our understanding of human adaptation to trauma.

Author (date)	Schultz, Tallman, & Altmaier (2010)
Focus	R/S factors such as forgiveness in coping with interpersonal trauma
Type of document	Empirical (quantitative)
Abstract highlights	Examined the roles of forgiveness and the importance of religion and spirituality in PTG after a significant interpersonal transgression among a diverse sample of 146 adults. PTG may follow the experience of being significantly hurt by another person. Transgression severity was negatively related to forgiveness; the more distressing the event, the more revenge and avoidance were endorsed in response to the offender; benevolence toward the offender predicted growth in the area of relating to others; positive relationship between forgiveness and PTG was mediated by the importance of religion and spirituality; however, the relationship between unforgiveness and lack of growth was not similarly mediated. R/S variables may influence how individuals respond to significant interpersonal transgressions through positive processes.

Author (date)	Shaw, Joseph, & Linley (2005)
Focus	R/S and PTG
Type of document	Research review
Abstract highlights	Reviewed 11 studies that reported links between R/S and PTG. These studies show that R/S is usually, though not always, beneficial to people in dealing with the aftermath of trauma; traumatic experiences can lead to a deepening of R/S; positive religious coping, religious openness, readiness to face existential questions, religious participation, and intrinsic religiousness are typically associated with PTG.

Author (date)	Tan (2013)
Focus	Christian R/S factors, resilience, and PTG
Type of document	Conceptual
Abstract highlights	There are various pathways to resilience, and the factors influence how effectively people deal with trauma and adversities in their lives. Research literature shows evidence (a) for resilience in returning service members and their families, (b) for resilience in civilian populations, and (c) that the majority of individuals who have gone through a traumatic event, in whatever form, end up exhibiting resilience. Resilience can be enhanced or increased by a number of clinical strategies or applications gleaned from research that can be used in practice in the following six major areas of fitness: physical fitness, interpersonal fitness, emotional fitness, thinking fitness, behavioral fitness and spiritual fitness. The world’s major religions, such as Christianity, Judaism, Islam, Buddhism, and Hinduism, all teach that suffering is part and parcel of life and that growth or transformation can be the eventual outcome.

Author (date)	ter Kuile & Ehring (2014)
Focus	Changes in R/S after trauma
Type of document	Empirical (quantitative)
Abstract highlights	After a traumatic experience, religious beliefs and activities can either increase or decrease. 293 trauma survivors responded to questionnaires related to traumatic experiences and religiosity. Nearly half of the sample reported changes in religious beliefs and activities as a consequence of the trauma; as hypothesized, shattered assumptions and prior religiosity interacted to predict a decrease in religious beliefs and activities; increases in religiosity were related to the use of religion as a coping mechanism and to currently living in a religious environment; a decrease in religious beliefs was related to higher levels of PTSD.

Author (date)	Werdel, Dy-Liacco, Ciarrocchi, Wicks, & Breslford (2014)
Focus	Positive affect, personality, gender, perceived stress, social support, faith maturity, and spiritual struggle in PTG
Type of document	Empirical (quantitative)
Abstract highlights	109 male and 320 female volunteers were investigated as to the unique contributions and moderating effects of positive and negative experiences of spirituality in predicting variance in stress-related growth. Examined whether there was a positive effect over and above the variance explained by social support, perceived stress, gender, and the domains of the Five-Factor Model of Personality. Faith maturity predicted variance in stress-related growth after controlling for the influence of personality and gender. Faith maturity and spiritual struggle predicted significant unique additional variance in positive affect over and above the variance predicted by personality, social support, and stress-related growth. Spiritual struggle moderated the relationship between stress-related growth and positive affect. Results are discussed in light of Park’s model of religion as a meaning-making framework.

R/S and Trauma Treatment

Author (date)	Bennet (1999)
Focus	Training model
Type of document	Dissertation; training model
Abstract highlights	Clinical training model on religious, spiritual, and exceptional experiences in the tx of trauma and dissociation.

Author (date)	Berrett, Hardman, O’Grady, & Richards (2007)
Focus	R/S in the tx of trauma and eating disorders
Type of document	Conceptual
Abstract highlights	Both trauma and eating disorders can distance women from their own spirituality, which undermines a potentially important tx resource. Suggestions based on the authors’ clinical experience for helping eating disorder patients who have suffered trauma to rediscover their faith and spirituality. How spirituality can be used as a resource to assist women throughout tx and in recovery.

Author (date)	Brown (2008)
Focus	Cultural competence in trauma psychotherapy
Type of document	Book; conceptual; case studies
Abstract highlights	Tx of trauma survivors must take into account the complexity of an individual’s unique background and multilayered identities. Identity includes age, social class, ethnicity, religious faith, sexual orientation, and immigrant status. Multiple strategies are given for treating patients with awareness of both dominant group privilege and one’s own identity and culture.

Author (date)	Bryant-Davis et al. (2012)
Focus	R/S in trauma recovery for children and adolescents
Type of document	Conceptual
Abstract highlights	Much of the research in R/S and trauma refers to adults and has less emphasis on children and adolescents. Delineates ways to incorporate and acknowledge R/S in tx for children and adolescents who are trauma survivors.

Author (date)	Brymer et al. (2006)
Focus	Psychological First Aid (PFA) field operations guide for community religious professionals
Type of document	Conceptual
Abstract highlights	PFA is an evidence-informed modular approach to help children, adolescents, adults, and families in the immediate aftermath of disaster and terrorism. Designed to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping. Principles and techniques meet four basic standards: (1) consistent with research evidence on risk and resilience following trauma, (2) applicable and practical in field settings, (3) appropriate for developmental levels across the lifespan, and (4) culturally informed and delivered in a flexible manner.

Author (date)	Courtois (2015)
Focus	Ethics of attending to R/S issues in trauma tx
Type of document	Conceptual
Abstract highlights	Healing from trauma is fundamentally a spiritual process or a quest for spirituality involving a deep need for meaning and value. Some traumatized individuals are assaulted and/or neglected by perpetrators who are related to them as parents or through other blood ties or kinship, friendship, or professional and fiduciary associations, including clergy and other representatives of faith traditions, teachers, coaches, therapists, doctors, military commanders, and supervisors. Attention to how their R/S beliefs were altered by the trauma is within the domain of psychotherapy and is in the interest of healing, renewal, and transformation. Evidence-based strategies are now available for the tx of trauma symptoms, and trauma-informed care overtly includes attention to spiritual issues. R/S intervention guidelines and tx guidance for symptoms of classic and complex PTSD include attention to R/S factors. Discusses ethical imperative to “do no more harm” and to include within tx attention to R/S. Discusses ethical risks and dilemmas that are relatively unique in trauma tx and can challenge the psychotherapist’s competence and personal worldview, including faith and spiritual beliefs.

Author (date)	Frawley-O’Dea (2015)
Focus	God image and sexual abuse survivors
Type of document	Book chapter; conceptual
Abstract highlights	To the extent that one’s image of God is a relationally and experientially constructed phenomenon, it is organic and can be cast and recast throughout the life cycle. When people have been subject to developmental betrayal trauma (e.g., sexual abuse), and perhaps especially sexual abuse by a member of the clergy, their internalized relationships with the divine can be harnessed to the trauma for the rest of their lives. Offers a relational paradigm of an individual’s development of a God image, then discusses the potential impact of sexual abuse on the victim’s relationship with the divine. Focuses particularly on the role of the therapist as a transformational or transitional figure.

Author (date)	Kalayjian (2002)
Focus	Biopsychosocial impact and R/S factors in tx
Type of document	Book chapter; case studies
Abstract highlights	Discusses biological, psychosocial, and spiritual impact of trauma on communities, families, and individuals, including the intergenerational impact. Offers six-step model for tx of current trauma.

Author (date)	Richards, Hardman, Lea, & Berrett (2015)
Focus	R/S assessment of trauma survivors
Type of document	Book chapter; conceptual; case study
Abstract highlights	Discusses why the assessment of the spiritual dimension of trauma survivors’ lives is crucial for effective tx. Describes a multilevel, multidimensional approach to assessment and offers some process suggestions and clinical questions that can facilitate a spiritual assessment. Discusses R/S issues that may be relevant in the tx of trauma survivors, as well as several standardized R/S measures that can be helpful in assessment and outcome research.

Author (date)	Sigmund (2003)
Focus	Clergy and the tx of PTSD
Type of document	Conceptual; case studies
Abstract highlights	There is a dearth of controlled scientific studies evaluating the effectiveness of spiritual interventions; need for controlled studies to verify the usefulness of spiritual assessment and intervention in patients with PTSD. A more rigorous analysis of how clergy can best serve this population is needed.

Author (date)	Stone (2013)
Focus	Treating religious trauma and spiritual harm
Type of document	Conceptual
Abstract highlights	Religion can be a source of harm and trauma, yet this fact is underreported in the literature; spirituality can negatively affect mental health when it is used to bypass problems, feelings, and needs. Addresses need to explore the potentially harmful effects of religion and spirituality. Looks at role of secure attachment and the combination of individual and group therapy to treat religious trauma and spiritual struggles.

Author (date)	Walker, Courtois, & Aten (2015)
Focus	R/S and traumatized clients
Type of document	Book chapter; conceptual
Abstract highlights	Spirituality is a diversity variable that should be addressed in case conceptualization and tx. Particular types of damage to relational spirituality are a consequence of complex interpersonal trauma. Gives models for addressing spiritual issues in psychotherapy. Provides overview of spiritually oriented trauma-focused cognitive behavior therapy (SO-TF-CBT), an example of a secular trauma tx that has been adapted to include spiritual content.

Author (date)	Wilson & Moran (1998)
Focus	R/S and PTSD tx
Type of document	Conceptual
Abstract highlights	Traumatic life events affect the body, self-structure, and soul of the survivor, including the psychological dimension of the self and the faith systems and spirituality that give meaning to one’s life. Psychological trauma caused by natural disasters, accidental disasters, disasters of human origin, and violence often leave the spiritual domain in disarray. Offers practical considerations for mental health practitioners and pastoral counselors from whom the victims of severe trauma seek help. Various religions and belief systems can facilitate recovery from significant psychological trauma and PTSD. Encourages those who respond to victims of trauma to develop a holistic model of tx designed to revitalize, transform, and heal their clients.

R/S and Specific Strategies and
Techniques for Trauma Treatment

Author (date)	Abdul-Hamid & Hughes, (2015)
Focus	R/S (Sufism), EMDR, and trauma psychotherapy
Type of document	Conceptual
Abstract highlights	Eye movements seem to be the most effective form of bilateral stimulation (BLS) in EMDR. Summarizes the cultural applicability of EMDR as well as the value of incorporating R/S into psychotherapy. Islamic Sufism, in common with other traditional religions, has long been known to have a psychotherapeutic perspective and has been used over time to help people to overcome trauma and stress. The ritual movements associated with the Sufi Dhikr may involve a form of BLS, and this might underline some of the therapeutic effectiveness of it. This could give EMDR an even wider and more popular acceptance in the Middle East and the Muslim world.

Author (date)	Agger, Igreja, Kiehle, & Polatin (2012)
Focus	R/S and testimonial therapy for torture survivors in Asian countries
Type of document	Conceptual
Abstract highlights	Considers the therapeutic impact of including culturally and religiously adapted ceremonies within testimonial therapy with torture survivors. Discusses the development of testimonial therapy, Asian healing practice and interception, and embodied spirituality and healing. Suggests a need to study the potential benefit of including mindfulness, an embodied approach facilitating interception, and other spiritual practices into trauma tx.

Author (date)	Altmaier (2013)
Focus	Meaning making in response to trauma
Type of document	Conceptual
Abstract highlights	Meaning-making is an intentional process whereby the use of stories and similar narrative forms of communication with others and with oneself create the context in which meaning can develop. Various R/S beliefs, such as those pertaining to the ultimate purpose in life, contribute to development of meaning after trauma. R/S provides a holding context in which to experience deep and frightening emotions. Developing meaning is a primary way in which individuals respond to traumatic events that allow them to achieve a deep assimilation of previously unacceptable events and to experience emotional and behavioral resolution.

Author (date)	Ballaban (2014)
Focus	Traumatic biblical narratives and spiritual recovery from trauma
Type of document	Case study
Abstract highlights	Identity is tied to the narratives we create more than to the events that occur in life. Traumatic events in life can create discontinuities in that narrative that interfere with functioning. Traumatic biblical narratives in pastoral counseling assist clients in articulating personal traumatic episodes and beginning the process of integrating traumatic experiences and initiating growth.

Author (date)	Chopko & Schwartz (2009)
Focus	Mindfulness and PTG
Type of document	Empirical (quantitative)
Abstract highlights	Research on the reactions of first responders (e.g., police officers, firefighters) to traumatic incidents has largely focused on negative symptoms (e.g., PTSD) rather than aspects promoting mental health. Studied the relationship between mindfulness (using the Kentucky Inventory of Mindfulness Skills) and PTG (using the Post-Traumatic Growth Inventory) among 183 police officers. Effort toward spiritual growth was positively correlated, and accepting events without judgment was negatively correlated, with PTG.

Author (date)	Dagmang (2012)
Focus	God-talk as a means of healing through novel writing and auto-analysis
Type of document	Conceptual
Abstract highlights	Examines communication with divine presence and creativity through the trauma/PTSD described in the novel Candlelights: Memories of a Former Religious Brother Seminarian. Describes the author’s remembrance, reenactment, disclosure, and domestication of the original but hidden sources of trauma and their psychic and somatic effects. Illustrates the significance of the novel as an art that facilitated the discovery of trauma’s truth; led the author to realign his personal history via the classic stories of Teresa de Ávila, Juan de la Cruz, and Thérèse de Lisieux, and toward a salvific regard for Jesus of Nazareth, whose own narrative of suffering theologically is integrated into every story of suffering.

Author (date)	Follette, Briere, Rozelle, Hopper, & Rome (2015)
Focus	Mindfulness-oriented and contemplative interventions for trauma
Type of document	Edited book; case studies
Abstract highlights	Elements of the contemplative traditions may sharpen the effectiveness of existing empirically based therapies and how to apply them safely; integrates mindfulness and other contemplative practices into clinical work with trauma survivors. Discusses specific tx approaches, including mindfulness-based stress reduction, acceptance and commitment therapy, dialectical behavior therapy, mindfulness-based cognitive therapy, and mindful self-compassion. Addresses the neurobiological foundations of mindfulness-oriented work and the fundamental physiological processes as they relate to trauma and recovery. Describes innovative tx applications for different trauma populations, such as clients with chronic pain, military veterans, underserved communities, and children and adolescents.

Author (date)	Kick & McNitt (2016)
Focus	Trauma, spirituality, mindfulness, and hope
Type of document	Conceptual
Abstract highlights	Discusses how the use of terror management theory can assist the trauma victim in conceptualizing the world as a “just place” and helps create a space for the person’s spiritual views and belief system. In military contexts, duty to country and one’s battle buddies (service before self) results in shame and guilt when the military member is unable to manage fear and anxiety upon returning to civilian life.

Author (date)	Maltby & Hall (2012)
Focus	Trauma, attachment, and R/S
Type of document	Case study
Abstract highlights	How to address the interaction of trauma, R/S, and attachment in long-term attachment-based psychoanalysis. Summarizes the convergence of attachment theory and psychoanalysis, and reviews literature on attachment to God and trauma, including complex traumatic stress. Recommendations are made about dealing with trauma and R/S issues from an attachment-based perspective.

Author (date)	Mayer (2013)
Focus	EMDR, R/S, and healing in children
Type of document	Conceptual
Abstract highlights	EMDR is an integrative approach shown to be effective in dealing with posttrauma symptoms in children, adolescents, and adults. The process can move clients to R/S meaning making that fosters more positive emotional states and adaptive behaviors. Theoretical support from theologians, religious educators, and EMDR specialists is presented especially in regard to clients’ self-transcendent experiences.

Author (date)	Montes (2015)
Focus	Tx approaches to R/S issues in trauma therapy
Type of document	Dissertation; empirical (qualitative)
Abstract highlights	Childhood abuse can have positive, negative, or both positive and negative effects on R/S. R/S often provides both positive and negative forms of coping. Explores therapist-reported approaches to addressing faith issues in trauma therapy in light of previously published recommendations and protocols.

Author (date)	C. L. Park (2009)
Focus	Overview of theoretical perspectives in tx of trauma
Type of document	Book chapter; conceptual
Abstract highlights	People report positive changes through their struggles with adversity and often claim to experience improved relationships with family and friends, a clearer sense of their own strengths and resilience, changed priorities about what is important in life, and various other positive changes after struggling with stressful or traumatic events. What factors influence personal growth, and what effect does growth have on physical and mental health? Focuses on how positive life change might be fostered in the context of medical illness.

Author (date)	C. L. Park (2013)
Focus	Trauma and meaning making
Type of document	Book chapter; conceptual
Abstract highlights	Includes cognitive, emotional, motivation, philosophical, social, and cultural perspectives on meaning making in the aftermath of trauma. Meaning is particularly important when individuals confront highly stressful and traumatic life experiences. Provides an overview of current conceptual and empirical work on meaning in the context of trauma, as well as suggestions for future research.

Author (date)	C. L. Park, Cohen, & Murch (1996)
Focus	Assessment and prediction of stress-related growth
Type of document	Empirical (quantitative)
Abstract highlights	Development of the Stress-Related Growth Scale (SRGS) and its use in a study examining determinants of stress-related positive outcomes for college students. The SRGS has acceptable internal and test-retest reliability, and scores are not influenced by social desirability. Showed that college students’ SRGS responses were significantly related to those provided by friends and relatives on their behalf. Tested the determinants of stress-related growth longitudinally. Significant predictors of the SRGS were (a) intrinsic religiousness, (b) social support satisfaction, (c) stressfulness of the negative event, (d) positive reinterpretation and acceptance coping, and (e) number of recent positive life events.

Author (date)	C. L. Park, Edmondson, & Mills (2010)
Focus	R/S worldviews and stressful encounters
Type of document	Book chapter; conceptual
Abstract highlights	R/S is a central part of the meaning-making framework for many people; influences people’s appraisal of, and coping with, both normative transitions and unexpected crises. The meaning-making framework is broad enough to encompass the coping challenges that are considered within both the stressful life events approach and the developmental or normative transition approach. The interaction of R/S meaning systems and stressful life events is best conceptualized as an ongoing and recursive process of mutual influence.

Author (date)	E. A. Park (2014)
Focus	Creative and expressive therapies to explore R/S themes with traumatized children
Type of document	Dissertation; conceptual
Abstract highlights	Explores the conceptual relationship between trauma, spirituality, and the use of art therapy within a family psychology framework in the tx of traumatized children and their families. Because of the developmental limitations of children’s language capability to articulate their experiences, artistic expression may be a viable way of accessing and exploring children’s spirituality. Fits within a broader systems framework that is holistic, nonreductionist, and culturally sensitive.

Author (date)	Partridge & Walker (2015)
Focus	R/S struggles using spiritually oriented trauma-focused cognitive behavioral therapy
Type of document	Case study
Abstract highlights	Demonstrates the struggles experienced by a child with complex trauma involving child abuse who later became a Christian. Examines the cultural backdrop, client demographics, history of the trauma, and the client’s spiritual functioning. Considerations for using spiritually oriented interventions within the context of trauma-focused cognitive behavioral therapy (TF-CBT).

Author (date)	Pressley & Spinazzola (2015)
Focus	Complex trauma tx model in a Christian context
Type of document	Conceptual; case study
Abstract highlights	Disrupted systems of meaning are a core domain in which adults with a complex trauma history are affected, often leading to adversely affected belief systems. For adult survivors of childhood trauma, experiences related to shame, betrayal, meaning making, and mourning often complicate their R/S beliefs. Introduces and illustrates the relevance of a complex trauma intervention (Component-Based Psychotherapy) framework in the context of spiritually informed tx with adult Christian clients. Particular focus on the ways in which clients’ faith beliefs and practices can serve as a potential resource and/or barrier in tx.

Author (date)	Slattery & Park (2015)
Focus	R/S and meaning making with trauma survivors
Type of document	Book chapter; conceptual
Abstract highlights	Outlines the meaning-making framework and meaning response styles of people exposed to trauma. Systems of meaning help people interpret and label experiences (e.g., good/bad, fair/unfair, dangerous/desirable), which then creates the emotional and behavioral impact of these experiences as well as later encounters. Trauma is an event so discrepant from a person’s meaning system that it alters or damages that person’s meaning system (and sometimes those of their family and friends). Trauma damages or even “shatters” meaning, whereas focusing on meaning and creating an adaptive and growth-promoting sense of meaning can be part of healing from trauma.

Author (date)	Verbeck et al. (2015)
Focus	R/S and the working alliance with trauma survivors
Type of document	Book chapter; conceptual; case material
Abstract highlights	After a traumatic event, clients often attempt to use their R/S knowledge to try to make meaning out of their experiences, and the conclusions they reach in these circumstances can profoundly affect mood and decisions about future action. Likewise, psychotherapists sometimes struggle with their own reactions to clients’ religious interpretations of an event; they may also struggle to use interventions tailored to their clients’ beliefs. R/S issues are difficult to negotiate in trauma tx, especially when clinicians are expected to be adept enough to juggle countertransference. Both research and case vignettes are used to illustrate the authors’ professional experience, including approaches to the more common choice points in the therapy working alliance, such as interventions and disclosure of beliefs.

Author (date)	Walker, Reese, Hughes, & Troskie (2010)
Focus	R/S issues in trauma-focused cognitive behavior therapy (TF-CBT) for children and adolescents
Type of document	Conceptual; case studies
Abstract highlights	TF-CBT has emerged as a leading tx for trauma recovery. Examines role of R/S in TF-CBT for children and teens; development of a model for assessing and treating R/S in TF-CBT. Focuses on the client’s preexisting R/S functioning, as well as on changes in R/S after abuse. Model will assist clients from various R/S affiliations to process childhood abuse.

Author (date)	Wimberly (2011)
Focus	Narrative approaches to treating trauma
Type of document	Conceptual
Abstract highlights	Presents a narrative or storytelling approach to managing trauma. Helping R/S caregivers, as first responders, to manage the impact of trauma on victims as well as on their own lives as caregivers. Caregivers come from a wide range of traditions that draw on creation spirituality. Reviews the literature supporting evidenced-based trauma intervention and its importance to narrative intervention.

Author (date)	Zimmermann (2011)
Focus	Eastern spirituality and recovery from childhood trauma
Type of document	Dissertation; empirical (qualitative)
Abstract highlights	Informed by constructivist, humanistic, transpersonal perspectives, and meditation and other Eastern pathways, examined the trajectory of 10 female childhood trauma survivors’ journeys of psychological healing and spiritual awakening. Participants had engaged in Eastern spiritual practices aiming at self-realization as well as in Western psychotherapeutic approaches aiming at ego integration. All interviewees portrayed ways in which psychological healing and spiritual awakening interfaced to promote PTG. Six key themes emerged: (1) untiring aspiration, (2) opening to the mystery, (3) undoing the story, (4) healing connections, (5) repairing the split, and (6) reclaiming the body. Narratives revealed significant psychological and spiritual transformation even after severe child abuse. Discusses the clinical implications of East/West integration in tx.