Using Religious Beliefs to Reduce Symptoms of Depression

Chronically ill patients with major depression can benefit from religiously integrated cognitive behavioral therapy (RCBT) at least as much as conventional cognitive therapy (CCBT), according to a study published in the Journal of Alzheimer’s Disease.

Researchers from Wolters Kluwer in Alphen aan den Rijn, the Netherlands examined 132 patients with major depression and chronic illness in order to evaluate and account for their religious beliefs. The researchers examined the efficacy of CCBT versus RCBT in these patients (67 into the CCBT and 65 in the RCBT groups). The sessions were delivered via 10 telephone sessions lasting 50 minutes each.

Both of the approaches focused on forgiveness, gratefulness, altruism, and engagement in social activities; the groups differed in that RCBT included the explicit use of the patients’ religious beliefs to identify and replace unhelpful thoughts and behaviors. Most of the RCBT patients were Christian, though other faiths (Judaism, Muslim, Hindu, and Buddhist) were included.

After 10 sessions, RCBT and CCBT produced similar improvement in depression scores, the researchers said. Both types of therapy yielded about half of the patients experiencing remission of their depressive symptoms. Patients that identified as highly religious demonstrated slightly greater improvement in depression scores with RCBT than those assigned to CCBT. Additionally, highly religious patients appeared to complete more sessions if assigned to RCBT compared to CCBT.

“Historically, there has been little common ground between religious and psychological concepts of mental health,” wrote author Harold G. Koenig, MD. The authors added that mental health professionals may have a negative opinion of religious patients, but those patients can view psychological treatment as “unsympathetic to their religious beliefs and values.”

The authors commented that although their study is small, and cannot show whether RCBT and CCBT are truly equivalent treatments, the results of their study seem to indicate that RCBT patients is effective treatment for major depression in chronically ill patients “who are at least somewhat religious,” the authors wrote.

Additionally, RCBT patients may have been more effective for patients that were highly religious, the results seemed to demonstrate. RCBT “may increase the access of religious persons with depression and chronic medical illness to a psychotherapeutic treatment that they might otherwise not seek, and those who are highly religious may be more likely to adhere to this type of therapy and benefit from it,” the authors concluded. “Integrating religious clients’ beliefs into CBT does not appear to significantly reduce its effectiveness, especially in religious clients.”