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- Cities as environments
- Faith as coping mechanism
- Benefits of trauma

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- Should cities be more environmentally friendly?
- Why should there be more natural ground than cities?
- Why should there be more cities than natural ground?

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- Should faith be used as a coping mechanism against hardship?
- WHY should faith be used as a coping mechanism against hardship?

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- Can trauma be beneficial, just as healthy stress?
- Is false hope beneficial when being resilient?

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Should faith be used as a coping mechanism against hardship?

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Coping Strategies as Predictors of Well-Being in Youth Adult

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Coping Strategies as Predictors of Well-Being in Youth Adult

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This study aimed to determine the effects of two types of coping strategies on wellbeing in a sample of 405 young people using structural equation modeling. A survey research design was employed. Two constructs were measured: coping strategies and well-being. Goodness of fit indices was analyzed to select, the best structural equation model of coping as a potential predictor of well-being, as measured by Ryff's well-being scales. Problem-focused coping positively predicted a significant portion of variance in well-being, while emotion-focused coping negatively predicted well-being. Religion as a coping strategy did not end up in the final model. The results' impact within the literature on youth well-being is discussed. It was concluded that young people do not typically use religion or magical thinking as coping strategies, and the use of negative auto-focused coping was associated with lower problem-focused coping.

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Since its foundation in 1974, Social Indicators Research has become regarded as the leading journal for the publication of the results of research dealing with problems related to the measurement of all aspects of the quality of life. These studies - empirical, philosophical and methodological - take in the whole spectrum of society, including the individual, public and private organizations, and municipal, country, regional, national and international systems. Topics covered include health, population, shelter, transportation, the natural environment, social customs and morality, mental health, law enforcement, politics, education, religion, the media and the arts, science and technology, economics, poverty, and welfare.

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This is a preview. Log in through your library. This study aimed to determine the effects of two types of coping strategies on wellbeing in a sample of 405 young people using structural equation modeling. A survey research design was employed. Two constructs were measured: coping strategies and well-being.

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How religious coping is used relative to other coping strategies depends on the individual's level of religiosity and spirituality

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How religious coping is used relative to other coping strategies depends on the individual's level of religiosity and spirituality

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file:///C:/Users/SanieZ25/Downloads/Krgelohetal2012JRH.pdf

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How religious coping is used relative to other coping strategies depends on the individual’s level of religiosity and spirituality - PubMed

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Results from empirical studies on the role of religiosity and spirituality in dealing with stress are frequently at odds, and the present study investigated whether level of religiosity and spirituality is related to the way in which religious coping is used relative to other coping strategies. A sa…

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Religiousness and Mental Health: A Review

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Religiousness and Mental Health: A Review

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file:///C:/Users/SanieZ25/Downloads/religiousnessmentalhealth_RBP06%20(1).pdf

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doi: 10.1590/s1516-44462006000300018.

Affiliation

¹ Department of Psychiatry, Center for the Study of Religious and Spiritual Problems, Universidade de São Paulo, São Paulo, SP, Brazil. alexma@usp.br

doi: 10.1590/s1516-44462006000300018.

Affiliation

¹ Department of Psychiatry, Center for the Study of Religious and Spiritual Problems, Universidade de São Paulo, São Paulo, SP, Brazil. alexma@usp.br

Abstract

Objective: The relationship between religiosity and mental health has been a perennial source of controversy. This paper reviews the scientific evidence available for the relationship between religion and mental health.

Method: The authors present the main studies and conclusions of a larger systematic review of 850 studies on the religion-mental health relationship published during the 20th Century identified through several databases. The present paper also includes an update on the papers published since 2000, including researches performed in Brazil and a brief historical and methodological background.

Discussion: The majority of well-conducted studies found that higher levels of religious involvement are positively associated with indicators of psychological well-being (life satisfaction, happiness, positive affect, and higher morale) and with less depression, suicidal thoughts and behavior, drug/alcohol use/abuse. Usually the positive impact of religious involvement on mental health is more robust among people under stressful circumstances (the elderly, and those with disability and medical illness). Theoretical pathways of the religiousness-mental health connection and clinical implications of these findings are also discussed.

Conclusions: There is evidence that religious involvement is usually associated with better mental health. We need to improve our understanding of the mediating factors of this association and its use in clinical practice.

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Religiousness and mental health: a review - PubMed

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"About 85% of the world's people identify with a religion."

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A religion is a system of faith or worship that influences the way a person thinks about, views, and interacts with the world. A person’s religion is often the main source of their ethical and moral beliefs. For many believers, religion is a source of great comfort, perhaps even purpose.

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The Prevalence of Religious Coping Among Persons With Persistent Mental Illness

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The Prevalence of Religious Coping Among Persons With Persistent Mental Illness

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Religious coping in adolescents: new evidence and relevance

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Religious coping in adolescents: new evidence and relevance

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Introductory remark

Two perceptions about adolescents and young generations in Western countries are widely assumed nowadays. They are much more vulnerable than previous generations to psychological and social pathologies-like anxiety, depression and distress-and their religiosity levels are lower than those observed in similar cohorts in previous decades. It is too hasty to deduce that both trends are related. Indeed, many variables converge in the social context in which adolescents live and grow. In any case, it is worth asking, whether the religious dimension still plays a positive and healthy role in their development, considering that this is by no means the only helping or positive factor in that life stage, facing many trials and threatening trouble.

A good place to start is exploring the field of "Religious coping". This is a wide research program that offers a many published studies, discussions and assessments, with new research papers available every year and engrossing a quite broad repertoire that is difficult to render in systematic terms. The common trait of all this research is their attempt to assess to what extent religion and spirituality help to cope with life struggles and crisis.

The present research connects the current literature to new empirical survey, exploring with an extensive questionnaire to what extent Spanish adolescents resort to religious coping strategies; how they perceive that available resource; and how does it relate to other possible coping strategies. This study tries first to assess the outcomes from published studies relevant for this specific realm, and then introduces the survey we proposed and the performed analysis from the obtained data. In a last step, these analyses will offer some new information and nuances to the existing literature and to open new hypothetic application areas.

Literature review

Standard studies on religious coping usually show how measures of religious adaptation are related to indicators of health and well-being in individuals and groups, to their self-esteem and personal satisfaction levels. Such studies are used subsequently by health researchers to develop interventions to assist patients suffering several diseases and problems. In many studies in that field, religion appears as a factor that can promote self-control, influences how projects and goals are selected and enhanced; facilitates attention to regulate situations; and determines and promotes competences in a set of self-regulating behaviors (Pargament et al., 2000; McCullong and Willoughby, 2009).

Kenneth Pargament ( 1997) is probably the pioneer and better-known scholar in the field of religious coping. He described religion in terms of a search for meaning related to the sacred, and found that it becomes an integral part of meaning systems for many people, a specific approach from which to understand the world, the interactions with others and a global reference frame to order and interpret human events. The coping capacity of religion seems linked to its ability to provide meaning and purpose, especially in more stressful and difficult life conditions (see for an extensive review on meaning: Park, 2010). Other studies point out that belief in God can become an internal interlocutor to motivate personal behaviors through a process similar to what happens in social relationships (Luhrmann, 2020). Thus, people with high levels of religiosity can see God as a safe haven, a figure in which strong attachment feelings converge, close to those developed with parents, an affectionate God who is sensitive to the needs of believers, and involved in human affairs. All this provides individuals with a sense of intimacy and trust with God, offering comfort in adverse situations. However, those who have increased their awareness of sin and sinfulness often accompanied by feelings of moral inadequacy and personal deprivation, may present lower levels of life satisfaction and lower self-esteem (Jung, 2015). According to Hisham and Pargament ( 2015) many people in all religious traditions rely on spiritual teachings, beliefs and practices to face challenges, transform perspectives and attain comfort. Everything points to the positive aspects of prayer to control anxiety and depression, develop empathy and improve cognitive and intellectual functioning.

Religious coping as a research program has known several revisions and has raised doubts and some skepticism concerning its theoretical and its methodological approach (Folkman and Moskowitz, 2004; Gall and Guirguis-Younger, 2013). The present research connects with a sound tradition and attempts to contribute to its maturity and progress.

Many studies of adolescents have tried to apply to that developmental stage that research program to better know to what extent these religious coping strategies are applied in those life levels and their effectiveness. Considering the published evidence regarding religious coping in adolescents, the relevant literature, will be first systematically reviewed, looking for an answer to our query. In all 76 published studies (until 2016) analyze strategies of religious coping to evaluate its effectiveness addressing different juvenile problems and psychopathologies, such as: stress/depression, consumption of abusive substances, and anorexia/bulimia.

The review has found that religious beliefs and practices had a modest but positive association with the psychological well-being in these young cohorts in 70% of the selected articles. Regarding issues related to mental health, like stress and depression, the studies indicated that the impact of negative events in youths' lives was reduced in those who reported a high level of positive religious coping. On the contrary, abandonment of religious practices, like prayer or meditation, showed a growing negative effect (Carpenter et al., 2012; Pargament et al., 2003). The evidence indicates that adolescents who consider religion important for their lives, resort to it as a guide in decision-making (Rose et al., 2014). Other authors stated that religious assistance to adolescents in a mild depressive situation helps to cope with it, although it is uncertain whether that effect depends just or mostly on the religious factor (Carleton et al., 2008).

Some studies have addressed the relationship between stress and religion. In general, the available research revealed a moderate positive association between religious attendance or participation and reduced anxiety in middle adolescence, especially for those grown up in societies in which God is more frequently invoked, becoming an appropriate and acceptable practice for most social segments (Jung, 2015; Peterman et al., 2014). The negative results obtained in some cases result from: voluntary abandonment of religious practices; perceived conflict in personal relationships with God and others; doubts and confusion when trying to respond to problems related to stress (Carpenter et al., 2012; Pargament et al., 2003). Some ambiguity in the collected results may be the consequence of too many cross-sectional designs in research. Experts in this area invited to conduct more prospective studies to clarify the causal and interpretative ambiguities among available data (Jung, 2015; Hisham and Pargament, 2015).

On a different level, concerning the influence of religiosity on toxic substances consumption, two approaches will be outlined. The first one argues for an existentialist view that explains consumption of psychoactive substances or substance abuse in young people as a result of meaninglessness of life and existential void (Wilchek-Aviad and Ne'eman-Haviv, 2015). The second approach focuses on studies that highlight the presence of vital stress as a factor in risky behavior (Wills et al., 2003). By observing the consistency of buffering effects against substance abuse in adolescents, possible protective resources can be conceived to counteract such stressors (Wills et al., 2003). In that sense, the reviewed research reveals how spirituality or religiosity predicts positive changes in behavior over time. Religiosity has a clear attenuation effect against those risky factors among participants (Duque and Giancola, 2013; Desrosiers et al., 2011; Rostosky et al., 2008; Bjarnason et al., 2005; Mason and Windle, 2002; Brown et al., 2001). Furthermore, the data suggest in general a prosocial attitude correlated with religion.

A different critical issue, equally important in adolescent development, is related to eating disorders, and here religious coping also appears as relevant. The studies carried out to date show that religious and spiritual variables play an important sociocultural influence in such pathological attitudes (Castellini et al., 2014; Inman et al., 2014). Analyzing a non-clinical sample with subjects at risk associated with their dissatisfaction with, or distortion of their body image, and belonging to different religions groups, it was observed how an increase in levels of religiosity prevents the incidence of such developmental disorders (Latzer et al., 2015). Positive religious adaptation has been shown to be associated with an improvement in psychological adjustment, reduced anxiety, and higher life quality for people who suffer chronic diseases or who have suffered some trauma in interpersonal relationships (Pirutinsky et al., 2012), producing better results in mental and physical health (Carpenter et al., 2012). On the contrary, these same studies agree that higher rates of negative religious adaptation are significantly related to lower levels of self-esteem, an important risk factor linked to eating disorders. Consequently, religious or spiritual factors could exacerbate or mitigate symptoms depending on the individual's coping style (Rider et al., 2014). A more accurate approach to this issue is offered by studies on religious/spiritual struggles. This concept describes tensions, doubts and internal or external trials and conflicts around one's own religious beliefs (Exline, 2013; Exline et al. 2014). It is expected from this view that those struggles clearly influence the coping style, the meaning-making process, and could determine the outcomes from religious beliefs and practices in critical circumstances (Exline et al., 2011).

As can be seen from this review, religious coping in adolescents covers a broad spectrum ranging from issues related to personal health and well-being, to means to managing threats and dangers of different kinds. The gathered studies should be complemented by more recent entries that enrich the already abundant list. For instance, recent years have seen new studies on religious coping before depression and anxiety in students; and more recently several studies have focused specifically on coping before Covid-19 pandemic and its threatening effects (Francis et al., 2019; Thomas and Barbato, 2020). The general impression is that religious coping covers a broad field comprising many positive effects on physical and psychological health, and raising several questions regarding its effectiveness and styles.

In general, the reviewed studies reveal a positive religious effect on several problems and risks present in adolescent development. However, such an effect often depends on the coping and religious style, or religious struggling. The outcomes reviewed may be related to cultural environments. Sometimes the evidence is tainted with other uncontrolled factors. This perception of the current research discourages an overall and simple theory, and invites further the research looking for new evidence to clarify aspects that could help to develop a more nuanced view about the supposed benefits of religion in youth development.

After this introductory background, the present study will examine religious coping in a sample of Spanish adolescents. The research tries to mitigate the scarcity of studies on religious coping in younger Spanish populations (an exception being Pérez and Cánovas, 2002). A growing concern for the quoted problems and the lack of more focused studies justify the present investigation and its attempt to fill the gaps, and to assess the extent that renders religious coping a valid coping strategy in very secularized environments, where alternative coping strategies are available in this life stage.

Based on previous studies, three working hypotheses are advanced:

Religious coping moderates the impact of negative life events on adolescents and young people through cognitive and attitudinal mechanisms.

Adolescents who resort to religious coping in times of crisis also use secular coping methods when struggling with life difficulties.

The different degrees of religious coping are related to adolescent development levels.

An empirical study on religious coping in Spanish teenagers

A quantitative research study was developed to assess to what extent religious coping is still an available strategy for Spanish teenagers in a very secularized milieu, the possible coping styles, and the perceived efficacy of such strategy. The research measures the extent of religious aspects in adolescence, and uses a person-centered approach to illustrate and gather information about different levels of religious adaptation. Those data were used to see to what extent religious beliefs and behaviors could counteract the adverse situations that afflict an adolescent generation quite far from religious practices and-to some extent-from the experience of faith. as a valid mechanism to process emotions or as an instance of consolation in the face of big life struggles.

Before giving further steps, a note on religious levels of Spanish adolescents and youths will help to better contextualize the proposed research. The most recent data come from the December 2020 CIS Barometro, an official polling agency1. Those in the cohort between 18 and 24 years that declare to be "practicing Catholic" amount to a modest 10.2%, compared with 20.1% of total Spanish sample. "Not-practicing catholic" are 22.4% among the younger teenagers, while in the whole sample of teenagers it is 41.6%. Then, adding the categories of "agnostics", "indifferent" and "atheists", we get 61.1% for the youngest cohort, and 34.4 for the whole sample. However, oddly, the levels of weekly attendance to religious services are similar in both cohorts (around 13%).

The same polling agency data from ten years earlier, i.e., December 2010, shows that the youngest cohort self-describing as Catholics-practicing or not-were 54.9% and 73.6% in the entire sample; 39.8% non-believers plus atheists, among the youngest, and 22.5% for the total. The weekly assistance to a religious service was 4.5% for the younger, and 13.2% for the total. We have a confirmation for the former series from Fundación SM, a Catholic research institute; in its 2010 report shows that 53.5% of a youth cohort confess to be Catholics, while 42.4% consider themselves as no-religious; weekly attendance to religious services were 9.1%, probably a rather optimistic figure (González-Anleo et al., 2010, pp. 182-199). Alternative data come from Pew Research Center, an American Polling Agency; its study Being Christian in Western Europe, from May 20182, reveals that 26% of Spanish parents without religious affiliation educate their children in the Christian faith and values.

In any case, these figures clearly point to a sharp decline in religious indicators in most adolescent and youth, when comparing data in the last 10 years. Spanish adolescents are becoming the less religious cohort among the Spanish population.

Method and data

In order to collect new data for a quantitative study on adolescents' coping strategies, an instrument has been designed, and a set of high schools was selected, public and Catholic private, located in the South-East Spanish regions of Murcia and Valencia. The instrument consists of an ad hoc questionnaire on religious coping built after a standardized scale, the RCOPE questionnaire designed by Kenneth Pargament (Pargament et al., 2000), and adapted to Spanish adolescents. This instrument has been previously applied and tested by Pargament and his collaborators (Pargament et al., 2011), and in several other published research on religious coping among the youth (Carpenter et al., 2012; Talik, 2013; Lord et al., 2015). The present version contains a reduced number of items (60 in total from the 105 original) to suit that sample and to avoid redundancies.

This Spanish adapted RCOPE version keeps many sub-scales related to different coping strategies and religious styles. Here are the summary of scales and their distribution in number of items:

Negative and struggling coping strategies

The stressor is seen as a divine punishment: 3 items

Self-management: coping without God's help (friends, alcohol, drugs, internet, television, self-help, insulation): 14 items.

The stressor is attributed to the devil: 1 item

Passive waiting, religious postponement to solve problems: 1 item

Spiritual discontent, anger in the relationship between God and individual: 4 items

Reassessment of God's power and influence in the stressful situation: 4 items

Positive coping strategies

Religion transforms one's own life, providing new direction: 7 items

Voluntary Surrender, yielding to God's control to address the problems: 9 items

Advocate for divine intercession or miracles: 6 items

Spiritual support: ask for and give support to others: 6 items

Active practicing: 5 items

A Likert scale of 4 levels has been used in this instrument: 1 = Never, not at all; 2 = Occasionally; 3 = on several occasions; 4 = often or very often.

Participants

Prior to undertaking the full survey, a sample was administered to 20 students to assess their understanding and the items fitting. It was distributed to students between 16 and 20 years (mid- and late adolescents) in several high schools, public (300) and private-Catholic (231) in the regions of Murcia and Valencia. A total of 531 were selected after rejecting 20.

The sample's variety allows for a broad view of the intended target; indeed, the students who answered the questionnaire come from different social and cultural backgrounds and represent a variety of educational curricula.

The questionnaires have been distributed to the students in the classrooms during the academic year 2014-2015 and in lesson time, in the presence of teachers or tutors. In every case the privacy and ethical protocols have been strictly observed; the participants and involved parties have been informed about the nature and scope of the research; and the needed permissions were asked and obtained from the concerned responsible.

Results

a. Descriptive statistics

The sample demographics shows a quite representative distribution: 46.4% was male students and the average age was 17.3 (S.D. = 2.0).

Regarding religious behavior and self-assessment, three items revealed low commitment levels, as could be expected from a secularized cultural environment: weekly religious attendance scores 1.47 (the scale has 4 levels); daily prayer 1.57; and the assessment as a religious person gives 1.82 in the same scale. Possibly some gap persists between religious belief and practice, in the sense that could be described as "believing without much practicing", adding some nuance and complexity to the well-known category coined by Grace Davie, "Believing without belonging (Davie, 1997; Tromp et al., 2020).

The means table revealed that most students did not resort to religious coping or look for alternative coping strategies in the presence of serious problems or suffering. Anticipating data from a factor analysis that will be later exposed, a factor gathering six related items (alpha = 0,725) describing absence of religious coping in this sample registers a rather high average: 2.75 (1-4) ("To fix my problems I leave God aside"; "I had my doubts about God's power"; "I trust on my own strength without God's help"...).

Preferred coping strategies are secular in their orientation: seeking help from friends (2.99); laughing about one's own problems (2.77), isolation (2.34); and some resignation about positive consequences from bad moments. An item wording is quite revealing in this respect: "difficult situations helped me to grow and improve" (3.18). Religious coping is registered through a wide set composed of 11 related items (Cronbach's alpha = 0.910); in this case the recorded mean is quite low: 1.84, revealing the prevalence of secular over religious coping strategies in this sample

b. Analytical statistics

A first step consisted in reducing variables through factor analysis. This allowed the construct validity and reliability of the questionnaire administered to students to be measured; internal validity was measured with Cronbach's alpha, which showed the internal consistency of a first factor including most items, and its validity as a test to measure the extent of religious coping in students. Appendix table 1 describes the results from the factor analysis with Varimax rotation and describes five reliable extracted factors.

The factor analysis was intended to assess what dimensions explain the variability of responses by adolescents to the questionnaire items, after reducing the many items into clusters. This analysis only detects a factor that includes 30 items with loadings over 0.4 (see the complete questionnaire in Supplementary Materials [The Supplementary Materials link is missing in the appendix]). The other four listed factors are composed by few items and hence they can be neglected. That first single factor explains 21.5% of the variance and indicates that religious coping affects 21.5% of the adolescents. The explanation percentage is high enough given the diffuse nature of what is being measured, which allows to state that the first factor provides a good test to measure of religious coping. That first factor has a Cronbach's alpha = 0.944, which shows its high internal consistency. In addition, each of the other factors fail to explain each one >5% of the variance.

Analyzing the frequencies of the scores obtained by the test of religious coping it is clearly shown that the higher frequency arises around 1-2 scores, with an acceptable frequency in scores between 2 and 3, confirming that religious coping in adolescents maintains a low level.

A second step has produced a multivariate cluster analysis. It was intended to see how many groups can be separated by the questionnaire items. The result shows the presence of four groups or clusters, distributed as follows (514 valid, lost: 17):

1. 1.
175 members

2. 2.
237

3. 3.
30

4. 4.
72

The variance analysis done with these 4 groups depending on factor 1 shows that that factor separates perfectly the four groups, and shows that the groups order regarding their religious coping can be described as follows: 2 < 3 < 1 < 4; in other words, group 4 includes those students who resort more to religious coping; group 1 to some extent; and then the other two groups few or very little.

Next step produced a discriminant analysis aimed to obtain a minimal test that allows to get a measure of religious coping of adolescents by selecting a minimum number of items that discriminate the four groups with a high hitting percentage. Following this analysis of self-report items except for age and course, the following items appear as discriminant:

V61: Age

V14: I sought solace in God

V15: I trusted that God would be on my side

V2: To fix my problems leave aside God

V34: I prayed for others

V59: Seeking support I need in the Church

V16: I do what I can, and the rest I trust God

V35: I have wondered if God had abandoned me

V57: I pray at least once a day

V40: I have asked God to help me to help others

V31: I thought that my life is part of a great spiritual strength

V17: I tried to make a deal with God that He help me

V26: Some tough times have brought me closer to God

V10: I prayed to stop thinking about my problems

V63: Course (1st, 2nd Bachelor)

V39: I think that the solution to my problems is inside me and not on God

V56: I go to church or other religious service at least once a week

V46: I have some devotions-the Virgin, a saint-and call upon them when I need their help

With the information from these items, the percentage of correct reclassifications is 94%, which is the measure of reliability for this test. Furthermore, each group reclassifies well: 90.9% in group (1); 97% group (2); 100% of Group (3), and Group (4), 88.9%. It is therefore a fairly reliable test.

Now several tests with selected variables have been conducted looking for significant outcomes. First, age has been considered. It can be observed that group (1) is associated with students 16 years old. In addition, also those belonging to group (2) are associated with students 17 year old (group with less religious coping). This indicates that students from 17 to 19 years old know a crisis regarding religious coping, therefore young people move from moderate to low religious coping. Moreover, Group (3)-those over 20 years are associated with best religious coping, i.e., there is a recovery of such coping strategy, even overcoming the level registered by those belonging to 16 years old cohort.

Second, the item "I sought solace in God" has also been tested too. Based on the analyzed data, Group (4) has a significant frequency of high scores, for example, we see that from 45 high scores, 36 correspond to group (4). Accordingly, this group corresponds to those who more often are seeking solace in God. However, the figure from group (2) puts us in the opposite direction, those who never seek solace in God.

Third, regarding the variable on personal prayer for other people, group (4) is again associated with subjects who pray more often for others, since they gather 36 from the 72 scoring the highest level. Group (2) is related to adolescents with lowest scores.

Fourth, the item about "seeking support in the Church" has been tested. Group (4) gathers those who seek more support in the Church to face crisis. In the opposite extreme are those belonging to group (2). Looking at the figures, "finding support in the Church" often lacks frequency in this sample. It is a variable that makes the difference, those with more religious coping are seeking more support in the Church.

Regarding religious service attendance, a similar pattern arises: group (2) does not attend Mass or any other religious services once a week, corresponding with an absence of religious coping; group (4) assists on several occasions and group (1) on some occasion. These two groups would represent different levels of religious coping.

The last item to test is the one with the expression "I think that the solution to my problems lays inside me and not in God". The results show that Group (2) gives an affirmative and decided answer to solving their problems by themselves. In group (4) scores are much lower, while group 1 would be more distributed, part of them would score in high, and other in low levels, revealing different coping strategies.

c. Results and formulated hypothesis

Now, coming back the three hypotheses formulated at the paper's introduction, the first one stated the moderating effect of religious coping in life stressful events. Overall, the data in this study confirm that the minority cluster with higher religious levels in believing and practice, perceive the beneficial effects of their faith and prayer. Indeed groups (4) and (1)-that attend religious services on several occasions or at some time-present higher levels of religious coping and report a more positive adaptation to difficulties.

The second hypothesis foretells the entrenchment of religious and secular coping strategies. Indeed, our data points to a double coping strategy: adolescents who, in times of crisis, resort to religious coping can, in turn, apply secular coping methods. Our study highlights how often coping strategies are built on a personal search in which the peer group acquires relevance along with the avoidance tactics. The analyzed sample offers this evidence for groups (1) and (3). It is obvious that adolescents use different coping strategies in times of distress and that any stressful situation implies an exchange between person and his/her environment in which the individual develops. That exchange acquires varying forms according to the many factors involved and the events lived. In other words, it is pointless to try to isolate the religious or spiritual variable, which often is very entrenched with other circumstances, especially with one's own relationships-including family-personality, past experiences, and expectations.

The third hypothesis pointed to a developmental dimension in religious coping. The data from the sample in Group (1), (2) and age range between 16 and 19, reflecting lower religious coping, match the theory describing faith stages according to Fowler and Dell ( 2004); these stages are predictable, invariable, sequential and occur in all individuals without exception. However, the data from this study reveal that from the age 20 on, a recovery of religious coping strategies takes place, associated with individuals in group (3), which indicates some progress in the process of personal autonomy and the development of self-identity characterized by a personal selection of one's own values, convictions and beliefs. The progress is determined by the passage to an individual reflexive faith, able to build spaces of introversion in which the perception of God becomes more abstract.

Our research supports that each stage of adolescence is shaped by its own cognitive, social, psychological and behavioral changes, with late adolescence presenting a minor religious coping associated with the Group (2). In addition, the passage from a conventional faith to an individual and reflexive faith marks a recovery of religious coping strategies associated with the older Group (3), those moving beyond teen years. In this way verification of the third hypotheses raised in the investigation "different degrees of religious coping are related to stages of adolescent development".

d. Other relevant results

Trust in God

Within the analysis group (4) includes adolescents who seek consolation in God, and trust that He will be on their side in difficult times, with scores 3 and 4 in the Likert scale. On the other hand, the group (2) places us in an opposite position in both situations: out of a total of 237 students belonging to this group, 185 never seek consolation in God and 172 of the total express distrust, have no experience of how God can fit in situations of crisis or life struggle.

In our analysis, the students of group (4) showed positive religious coping, their connection with the sacred led them to establish trusting relationships with God; the group (2) seems to express spiritual discontent or possibly a spiritual struggle. Maybe the personal and social situation in which those adolescents live could justify searching for faith in difficult moments, and probably they might experience at the same time help, hindrances and frustration, in their attempt to control very problematic situations. These are conditions and trials necessary to reach maturity and adulthood, and in such struggles-including those related to religious or spiritual beliefs-the role played by faith is undecided, and quite often can be perceived as useless or disappointing.

Looking for support in the Church

Belief strength, personal religious practices and religious motivation are factors that load religiosity with positive effects on the adolescents and the lives of youth. Despite this evidence, many teenagers avoid such support; indeed, the data from our study reveal that the search for support in the church is very low in the group (2)-the bigger in members. This trend probably reveals high distrust levels before ecclesiastical authority; or this segment considers many moral impositions too burdensome for their lives; or they fail to integrate the tension between faith and culture, or perhaps many of their beliefs are rather vague and indefinite, resulting from a superficial faith. Apparently, not a single factor justifies the observed distrust towards the church, rather a set of experiences seem to trigger such negative effects resulting in abandonment.

Prayer frequency

The data in our sample reveal that groups (1), (3) and (4) pray with more or less frequency, while group (2) could be associated with some of the current tendencies: atheist, agnostic, "no practitioner", "religious without affiliation", "spiritual but not religious" or "religious in a private way". The choice in one way or another directly affects the individual; everybody can build an intimate relationship with divine figures and use means such as: prayer, or assistance to religious services as a source of empowerment in difficulties, or when all this fails, to resort to other alternatives.

Praying for others: solidarity

The group with the highest religious coping (4) of the study reveals this trend. Consequently, the three dimensions that converge in the process of religious coping: intra-personal, interpersonal and sound attachment relationships with the divine build spaces of spiritual connection with others. It is evident that other forms of prosociality and altruism happen in the secular world involving mechanisms such as learning, social / personal values, or emotion activation; all this points to a different design in which the spiritual dimension and cooperation with God are absent.

Looking for solution to problems in one's own self

According to González-Anleo et al. ( 2010), a bulk of individualism and self-centeredness accompanies the identification and religious search of Spanish youths. Young people believe that it is possible to live religious faith individually, privately, without reference or any community; religious or spiritual beliefs and practices are thus disconnected from ecclesial institutions. Possibly group (2) in our survey represents the large group of adolescents and young people who perceive spirituality as positive behavior, relationships or feelings, but live it away from established religion. The tendency in those belonging to this group is related to the lowest religiosity levels in the whole study. However, spiritual experiences provided by the organizational and cultural religious contexts can help to strengthen and unite moral commitments in adolescents' lives, with positive and constructive results in most cases.

When considering the collected literature and our own data, the main coping source for adolescents seems to move to interpersonal interactions. Indeed, new emergent religiosity is less related to group and more isolated from community life, far from social networks and resources that a spiritual community can provide to enforce adolescents' development. Such provision includes activities of control, follow-up, normative regulation and establishment of personal goals that emerge in the interaction between a person and his/her environment.

Furthermore, to dispense with the community reference or the social network with which the individual shares religious or spiritual beliefs and practices entails a weakening in the available social capital (Good and Willoughby, 2006). This situation is reflected in our study: even though adolescence is a privileged period for exploration and commitment to religious or spiritual beliefs, most members in our sample-with the exception of group (4)-reveal moderate levels of religious disaffiliation in the groups (1) and (3) and indifference about any connection with the sacred in the group (2).

Discussion

The present investigation measured the extent of religious coping in Spanish adolescents. Based on these objectives, three hypotheses were formulated. as a basis to develop the present research. All three found significant statistical evidence. Furthermore, the collected data have allowed for a more nuanced view on how Spanish adolescents believe and organize their meaning systems to cope with distress, life risks and unexpected negative events.

The study demonstrated that religious coping is limited for Spanish adolescents immersed in a very secularized culture, despite the apparent benefits that such strategy reports in the available studies. Even such an instrumental view does not help to convince Spanish teenagers about religion's utility. However, some nuances have been highlighted through the proposed analysis. First, religious coping changes along adolescent stages, reflecting broad and deep variations through that development, as those described by Fowler, Oser, and others (Fowler, 1981; Fowler and Dell, 2004; Oser and Gmünder, 1991). The passage from a conventional religious style to an individual/reflective faith could indicate a recovery of religious coping. Identifying patterns of coping strategies in adolescence could help religious communities to find out more fitting approaches to assist teenagers before stressful events.

The second important finding of this research is linked to the trust relationships that a segment of adolescents establishes with God to motivate their behavior and develop personal beliefs similar to those born from attachment feelings with their parents. In this sense, the highest religious levels and attendance at religious services by parents are reflective of religious values in adolescence. Disruptive events lived by family or in Church life bear as a consequence neglect and decline in the process of religious coping.

On the other hand, the characteristics of group (4), reporting highest levels of religious coping in this sample (4) reflect a more positive adaptation to difficulties than other groups; thus, the results suggest that religious coping expands the range of possibilities to deal with adversity through cognitive and attitudinal mechanisms over their non-religious peers.

The final research finding reveals the emergence of new models of religiosity with weakened institutional belonging in the current scenario. Sociologists of religion have tried in the last decades to better describe such a complex environment, giving rise to forms of "believing without belonging" (Davie, 1997; Tromp et al., 2020); "belonging without believing" (Mcintosh, 2015); and the many expressions of unaffiliated or loosely affiliated religiosity, comprising "believing without practicing" and unaffiliated spiritual beliefs and practices. As can be seen, the religious milieu becomes in in these modern times too complex to allow for a simple model connecting religiosity and coping. The church framework is clearly in decline and new models substitute traditional religious coping based on intra-personal, interpersonal and sound attachments with divinity. Instead, inner search or self-reliance is predominant. However, the study reveals that the highest levels of religious coping include institutional and personal religious commitment by adolescents. When the community link is absent, then religious/spiritual beliefs suffer a clear weakening, observable in the contrast between groups (4) and (2). Nevertheless, different coping strategies coexist and share in the adolescent repertoire, without excluding anyone or assuming an exclusive role. The context and circumstances help to decide which strategy could become more useful, and in many cases a "joint approach" between secular and religious means is the rule.

After presenting our research and its outcomes, it is convenient to summarize the problems associated with such a program. A general question regards the observed limits in religious coping research, as already mentioned. Broad studies and systematic reviews highlight those limits regarding measurement, nomenclature and effectiveness of studied coping strategies (Folkman and Moskowitz, 2004; Gall and Guirguis-Younger, 2013). Then, a related set of doubts arise regarding the adequacy of Pargament instrument RCOPE and its scales, a specific issue on measurement; indeed, several studies have shown their concerns regarding what is really measured and what is left out (Alma et al., 2003; Ahmadi, 2006; Kwilecki, 2004; Xu, 2016; Saarelainen, 2016). Moreover, a third source of criticism regards the probable confusion between religious and secular items in the most used scales, or the difficulty to distinguish between more religious and more secular strategies when both appear as deeply entrenched. This is the case, for instance, of items pointing to consolation and support in friends, or looking for community and company. The "entrenchment issue" looms indeed in all this program and makes a neat distinction between religious and secular coping styles difficult to discern.

The exposed research presents its own limits: this study is quite local and has resorted to a convenience sample. Furthermore, it is limited in time, and does not provide data on how religious coping in the surveyed adolescents would evolve in near future and in different situations. To that end, a long-term longitudinal study would be necessary. Furthermore, a relevant issue that needs to be studied in forthcoming research is the implementation of programs that encourage and test religious coping in educational settings, to assess their validity and application when trying to prevent and help to cope with the current anxieties and troubles many adolescents still have to tackle.

Concluding remarks: current relevance of religious coping for adolescence studies

The surveyed data provide psychologists, educators and religious pastors with more information and criteria to better know that difficult life stage and to deal with young people and their problems in a more focused way. A pending issue concerns the meaning and value of religious coping studies-in general-and our particular and localized research, inside a program that values empirical data and analysis inside a more interdisciplinary approach.

To our own view, at least Four important issues emerge: from the undertaken study that help for a better discernment in the scientific study of religion and offer insights for further development. The first one (1) regards the application range of these data. It is well-known to what extent religious coping has been used as a mean to show the positive side of religious faith, an argument to contrast other negative effects associated with religious beliefs and behaviors. The present study, in line with most published literature on that topic, clearly shows that such positive effect is rather moderate and can hardly be used as a definite strategy to justify or support religious faith; we need to be more modest when trying such an application. However, that modesty should not discourage a conscious use of religious coping research to better describe the place and role of religious faith in different societies and environments; this could be part of programs in "contextual theology" and religious studies.

The second (2) orientation deals with soteriology or the study of religion as salvation systems. The need to offer a renewed content to salvation as the core of religion, could be helped by religious coping studies: in all modesty, these studies fill a gap and provide data showing a direction in which salvation becomes more concrete and to the point, even if translating salvation traditional expressions into the language of coping can raise some questions; this is indeed just a partial and limited expression: religious coping does not exhaust-by no means-the extent and richness of salvation announced by most religions.

The third (3) issue regards the difficulty in separating religious, and secular, sacred and profane, supernatural and natural when dealing with coping strategies. Such finding appears in line with a view in theology and philosophy of religion that tries to overcome such dualisms and to find out the divine not just in some reality sections or specific events, but extending beyond such limits.

The fourth issue relates to (4) how religious coping and search for meaning before difficulties are so closely related that they need to be studied in the same cluster. Indeed, many data and studies invite to think that we are talking about the same family of attitudes and beliefs when we refer to coping and when we talk about meaning-making. Probably there are just some nuances, or the distinctions reflect different research programs, but it is important to point out to this closely relationship to avoid useless and one-sided reductions (Park, 2010; La Cour and Hvidt, 2010).

The described issues need a better development and assessment after considering the amount of published literature and the extent to which a more empirically inspired study of religion can help to fix several issues present in the current reflection and debates. We hope that our research can add some piece more to the broad and complex mosaic that results from the many published studies on religious coping, and still more those focusing on young populations, in which, due to their development and circumstances, probably coping forms assume a specific style and characteristics.

Author information

Authors and Affiliations

1. Instituto Teológico de Murcia, Murcia, Spain

Josefa Torralba

2. Pontificia Università Antonianum, Roma, Italy

Lluis Oviedo

3. Universidad de Murcia, Murcia, Spain

Manuel Canteras

Corresponding author

Correspondence to Lluis Oviedo.

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Appendix

Appendix

Table 1

Table 1 Main extracted factors from factor analysis with Varimax rotation.

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Torralba, J., Oviedo, L. & Canteras, M. Religious coping in adolescents: new evidence and relevance. Humanit Soc Sci Commun 8, 121 (2021). https://doi.org/10.1057/s41599-021-00797-8
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Religious coping in adolescents: new evidence and relevance - Humanities and Social Sciences Communications

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Adolescence is frequently seen as a troubled age. In many Western societies this is also a time of sharp religious decline. The question arises as to what extent religious faith and practice could help teenagers cope with their distress, especially when religion fades away in secularized environments and stops being a common coping resource.

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Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study

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Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study

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Abstract

Despite evidence that faith-based and spiritual coping supports people's mental health, stigmata prevail in the aid sector around the need for psychological support in general and around this coping mechanism in particular. This qualitative research examines female aid workers' experiences and aims to elucidate how this mechanism supports mental health in stressful, conflict, or disaster-affected living and working environments. Inductive thematic analysis of 14 semi-structured interviews reveals three themes around (a) specificities of the aid work context, (b) benefits and gains through this coping mechanism and related processes, and (c) potential downsides. Interview findings suggest a faith-based and spiritual approach helped interviewees feel grounded, calm, resilient, and present in difficult environments. Participants experienced a resolute identity, space for self-care, as well as access to community, belonging, and connection across national, faith, and spiritual boundaries. Results raise the importance of de-stigmatizing faith-based and spiritual coping and invite further discussion among practitioners.

"... look around for that goodness. Like that small flower or the treat someone brought you " (Aid worker, Iraq).

Introduction

Today's global humanitarian needs are higher, more complex, and more difficult to fulfil than ever before. Resources are under a lot of strain, and one major resource in the aid world are the people itself who deliver such aid: humanitarian and development aid workers who continue to 'stay and deliver' in the most difficult and dangerous circumstances (Jackson & Zyck, 2017; OCHA - UN Office for the Coordination of Humanitarian Affairs, 2011). Living and working as an aid worker comes with many physical and psychological challenges. This paper will discuss the implications for aid workers' mental health and their potential responses to cope with psychological difficulties. It will present two of the major challenges being a reluctance to acknowledge mental health issues and more so a reluctance to acknowledge diverse approaches to mental well-being in the aid world. This research will outline and discuss (a) the pervading reality of mental health challenges in the aid world and (b) a hesitance vis-à-vis faith and spiritual coping as a valid coping mechanism, demonstrating a lack of a holistic approach to aid workers' well-being. This is even more pertinent as this coping mechanism is widespread among staff and populations in the countries where much of the aid work is delivered (Cardozo et al. 2013; Pew Research Centre 2015). The paper aims to demystify faith-based and spiritual coping, demonstrate its mechanisms and argue for such coping not to go unnoticed or under-utilized when discussing mental well-being needs of aid workers and holistic responses. Outcomes of this research call to remove stigma regarding expression of emotion, needs, and mental health issues as well as stigma regarding faith-based and spiritual coping.

Danger and stressors for aid workers

Aid workers by nature of their work in unsafe and threatening environments are regularly exposed to situations that may have a negative and long-lasting impact on their psychological well-being (Bryant 2006; Mao et al. 2018; Musa and Hamid 2008). Practitioners publish statistics that exemplify the physical dangers: in 2016, nearly 290 aid workers were injured or killed in nearly 160 security incidents reported globally, and in 2017, this number rose to over 310 aid worker victims, including kidnappings, across 22 countries (Humanitarian Outcomes 2017, 2018). Aid workers face higher death rates than military personnel in peacekeeping operations (Stoddard et al. 2009) and are increasingly seen as legitimate targets (Sheik et al. 2000). Three kinds of stressors for aid workers have been identified (Cardozo and Salama 2002): traumatic, chronic, and organizational. Traumatic stressors include experiencing or witnessing first-hand situations that are life-threatening, direct attacks on one's own person (physical or sexual assault, rape) or on offices, accommodation, restaurants, or the incessant threat thereof; bombings, the use of improvised explosive devices, and war in the immediate vicinity, as well as indirect exposure by, for example, encountering mass graves or witnessing people die of malnutrition (Eriksson et al. 2015), and listening to the traumatic experiences of colleagues or of people in need (Connorton et al. 2011). Chronic stressors include hardship living or environmental factors, such as lack of privacy, movement, or medical care. Organizational stressors include dysfunctional management and team issues, such as constant staff turnover, an overwhelming workload, unpredictable contracts, unclear terms of reference, or under-resourcing (Antares Foundation 2012; Connorton et al. 2011). A longitudinal study shows that a typical international humanitarian aid worker experiences at least one to two traumatic events during a single field deployment (Antares Foundation 2012). Cross-sectional studies across Guatemala, Jordan, Sri Lanka, and Uganda of nearly 1200 national staff reveal that national staff, often survivors of war or disaster themselves, may suffer from additional stressors compared with international staff (Ager et al. 2012; Cardozo et al. 2013; Eriksson et al. 2013b; Putman et al. 2009).

'Occupational risks'-implications for mental health

These concrete 'occupational risks' and stressors suggest that aid workers' mental health, too, may be threatened. Various studies showed a greater prevalence of affective disorders, post-traumatic stress symptoms and disorder among aid workers than among the general population in the US or western Europe (Cardozo et al. 2005; Connorton et al. 2011; Eriksson et al. 2013a). Similarly, a Global Well-Being Survey conducted in 2015 across 11 United Nations entities worldwide showed that about half of the surveyed 17,000 staff members, aid workers, and others had mental health symptoms requiring follow-up and higher levels of depression, anxiety, or post-traumatic stress (UNS - United Nations System, Chief Executive Board for Coordination, High-Level Committee on Management 2018). A longitudinal study covering 154 staff from 17 nongovernmental organizations (Cardozo et al. 2012) demonstrated that occurrence of anxiety, depression, and psychological distress were higher after field deployment than before. Prevalence of increased depression, psychological distress, and lower life satisfaction persisted when measured 6 months after deployment, signifying longer-term impact. A phenomenological study (McCormack and Joseph 2013) of the experiences of two humanitarian aid workers post-mission emphasized the "long-term psychological distress including shame, moral doubt, betrayal and narcissistic coping" (p.147).

Do aid organizations talk about mental health?

Aid worker anecdotes and blogs note the prevailing 'cowboy' culture (Edwards 2017) which requires aid workers to overcome direct or secondary trauma "as if nothing happened" Ten years ago I was sent to DR Congo as an aid worker without security training 2017, p.4). Alternatively, the industry's culture may deem aid workers unfit for the job (Young 2015). Scientific studies, too, highlight the "'macho' culture of denial" of the psychological impact of aid work (Barron 1999; Ehrenreich and Elliot 2004, p.55). There is no evidence that aid workers receive regular, special training for secondary trauma-defined as the "natural consequential behaviours and emotions ... resulting from knowing about a traumatizing event ... and the stress resulting from helping or wanting to help a traumatized or suffering person" (Figley 1995, p.7)-despite high exposure, reported by over 60 and 80% of aid staff in Uganda and Sri Lanka, respectively (Ager et al. 2012; Cardozo et al. 2013). Pre-mission trainings usually do not include psychological first aid despite availability of training manuals (World Health Organization 2011) or the recommendation to seek psychological support before, during, and after deployment (Connorton et al. 2011; Cardozo et al. 2012). Although mental health issues are a regular occurrence and a 'normal' reaction to abnormal situations people face (Bjerneld et al. 2004), less than half of the 376 national aid workers in Uganda across 21 humanitarian aid agencies reported the existence of psychological support systems in their organizations (Ager et al. 2012). However, recent developments look promising: agencies place increased emphasis on, and enhance access to, mental health services (Antares Foundation 2012; Cardozo et al. 2005; Eriksson et al. 2009; Eriksson et al. 2013a; UNS - United Nations System, Chief Executive Board for Coordination, High-Level Committee on Management 2018; Welton-Mitchell 2013). This is in line with agencies' 'duty of care' principles that aim to attenuate predictable risks, particularly in high-risk environments that may place staff in harm's way (Creta 2018). Practically, these principles are not only expressed in the provision of armoured vehicles and bullet-proof vests but also policies on occupational safety and health. The well-established origins of the concept stem from a UN General Assembly Resolution calling to ensure fullest measures of protection for UN agents (UNGA - United Nations General Assembly 1948). While not every agency offers a psychosocial support policy or direct and immediate access to a counsellor due to resource, logistic, or security restrictions, practitioners concede that while caring for people in need, it is crucial to care for their own staff, too (IASC - Inter-Agency Standing Committee 2007).

Moderating factors and coping

Exposure to aid work risks and psychological distress can be moderated by support systems, positive attitudes towards seeking help, or other coping mechanisms to protect psychological well-being (Connorton et al. 2011). One such mechanism is religious coping which is defined as "the use of religious beliefs or behaviours to facilitate problem-solving to prevent or alleviate the negative emotional consequences of stressful life circumstances" (Koenig et al. 1998, p. 513).

For the purpose of this research, religious coping shall include aspects of faith and spirituality which are understood as a sense of meaning, purpose, and hope (Peres et al. 2007) related to a connection with God or gods, nature, or a life force. Faith-based and spiritual coping among aid workers has not been extensively researched despite the altruistic nature of aid work: in line with faith-based principles of service and altruism, 96% of 214 aid workers across 19 Nongovernmental Organizations indicated prior to their deployment to be motivated to "contribute to a better world and help those less fortunate" (Eriksson et al. 2013a, p.45). Faith and spirituality remain important across cultures, particularly in many countries where international and national aid workers operate (Pew Research Centre 2015). Despite this awareness, there is a risk that faith and spirituality are viewed unfavourably. As an example, the head of the ethics office of a major humanitarian organization claimed spiritual aspects remain explicitly excluded in day-to-day office life (personal communication, 6 March 2018).

Research into the use of faith-based or spiritual practice has yielded mixed results. Some studies do not show correlations between a faith-based or spiritual practice and better mental health outcomes (Connor et al. 2003; Ellison et al. 2014; Fitchett et al. 1999; Kirkpatrick et al. 1999; Pargament et al. 2001). However, there is a growing body of evidence that establishes the benefits of a faith-based or spiritual practice on mental and physical well-being (Koenig 2001; Moreira-Almeida et al. 2014; Seybold and Hill 2001). For example, research has found positive correlations between mental health, cognitive capacities, and physical health with the frequency of prayer (Maltby et al. 1999) and attendance of religious services, giving the comfort of a social support group (Dein et al. 2012; Ellison and Fan 2008; Ellison 1998; Hackney and Sanders 2003; Koenig et al. 1999). Hourani et al. ( 2012), analysing data collected from 24,000 randomly selected active US military personnel, demonstrated that high spirituality had a significant protective effect for depression symptoms.

In addition, aid workers self-report the use of faith-based and spiritual practices as a coping mechanism. In a study of Sri Lankan national aid workers, over 55% of 398 workers surveyed on factors affecting mental health highlighted religion as an important coping mechanism for stress (Cardozo et al. 2013). This is in line with research as whole; a meta-analysis of 49 relevant studies on religious coping and psychological adjustment to stress, including several studies with longitudinal design, such as Pargament et al. ( 1994) or Tix and Frazier ( 1998), shows that religious coping methods are reliably correlated with better psychological outcomes, hope, stress-related growth, less depression, anxiety and distress, etc. (Ano and Vasconcelles 2005). A systematic review of four qualitative and seven quantitative studies (Shaw et al. 2005) noted that religion and spirituality were usually beneficial to people dealing with the aftermath of trauma. Trauma and recovery studies recommended research to "include a focus on spiritual issues and spiritual well-being" (Park 2017, p.305). Mental health practitioners are encouraged to introduce spiritual and religious practices in psychological interventions for coping with trauma, e.g. among refugee women (Smigelsky et al. 2017). Empirical research showed such practices reduced burnout in clergy (Eriksson et al. 2009). Psychologists reported that spiritual and religious issues were relevant in their practice 83% of the time, with the majority recognizing the beneficial aspects of religiosity and spirituality for individuals (Delaney et al. 2007).

However, the intersection between potentially traumatic events, living and working conditions of aid workers, and their faith and spirituality remains very specific and empirically and qualitatively under-researched (Currier and Eriksson 2017). This study qualitatively examines the interplay of these aspects among female aid workers. The outcomes provide employers, therapeutic practitioners, and other aid workers with insights into how aid workers with a faith-based and spiritual practice cope in stressful living and working environments in conflict or disaster-affected areas. It reveals how aid workers experience the challenges of their context and how their practice contributes to their well-being and the specific mechanisms thereof. Speaking about faith and spirituality may be very intimate and not self-evident to generalize and quantify (King and Crowther 2004; Wartenweiler and Eiroa-Orosa 2016); therefore, qualitative research was selected as the most appropriate design to give voice to aid workers' experiences. This qualitative research moves beyond the realm of anecdotes and provides insights into the depth of the lives of aid workers. Through inductive thematic analysis of semi-structured interviews, this paper allows an exploration of the experiences of these female aid workers without reducing collected data to numbers (Pyett 2003; Silverman 2000). Acknowledging the importance of context in which aid work, faith, and spirituality are experienced, this design is adequate to study personal, potentially traumatizing experiences and pursue vulnerable discussions about faith, spirituality, God/gods, prayer, community, etc. with the "desire to know people's own perspectives and meanings" (Braun and Clarke 2013, p.21).

Method

Participants

Participants were recruited through personal networks and an aid worker social media forum with 19,000 members. Purposive sampling narrowly followed the inclusion criteria of being female aid workers, regardless of nationality, duty station country, or type of contract, having worked in a conflict or disaster-affected area within the last 5 years and following a faith-based or spiritual practice or life approach. The latter criterion was held deliberately wide due to the intimate, individual nature of these concepts. Faith and spirituality were defined as a sense of meaning and purpose, hope, and faith which could be an explicit belief in God, feeling connected with nature or the force of life, or a collection of clear values, transcending the self (Drescher 2006; McKay 2010). All participants with a self-reported practice or life approach were interviewed. Inclusion in this study was deliberately limited to female aid workers with the aim to support homogeneity in the data. While some research highlighted how different genders experience challenges in aid work differently (Armagan et al. 2006; Holtz et al. 2002), this was not a factor in focusing on women. Longitudinal studies (e.g. by Cardozo et al. 2012) on psychological distress, depression, anxiety, and burnout among international humanitarian aid workers, involving 59% women, did not find gender differences. Purvanova and Muros' meta-analysis on burnout ( 2010) covering 183 studies reveals that both genders suffer burnout, with women being slightly more emotionally exhausted and men slightly more withdrawn or cynical. However, the deliberate choice to limit this study to women in line with principles of homogeneity aimed to give a detailed insight into the specific phenomenon of religious coping. A focus on women enabled a detailed investigation of processes relating to the research question on religious coping (Ritchie et al. 2003); Chan and Rhodes' ( 2013) analysis of multiple studies summarized that religious coping is more common among women. Other, qualitative studies show the importance of spirituality in women for overcoming trauma, e.g. childhood abuse (Shaw et al. 2005). This study wanted to take advantage of outcomes of such prior research to achieve clear results that were not potentially modified by a gender factor. A total of 14 participants from seven countries and six faith and spiritual backgrounds were interviewed and fulfilled all criteria. The sample size is adequate and in line with criteria for qualitative research (Vasileiou et al. 2018). Participants included three women acquainted with the researchers prior to the study which required managing a dual relationship. This meant interviewers carefully balanced relationships with interviewees as colleagues/acquaintances and as independent researchers during and after interviews (Garton and Copland 2010). One participant each originated from Australia, India, Philippines, Syria, and an undisclosed Asian country; three were from the UK, and six were from the USA with varying ethnic backgrounds. Nine participants identified as Christian, and five participants identified as Christian-Buddhist, Hindu, Muslim, Muslim-Buddhist, Yogini, and Meditator, respectively. Their practices varied from daily or occasional prayer, Scripture studies to nature contemplations, yoga, and insight meditation. They ranged in age from 29 to 48 years ( M = 37). Eleven participants have worked as international aid workers (i.e. in countries other than their own), two participants have worked as national aid workers, and one participant has worked nationally and internationally. The field duty stations the aid workers have worked in and mentioned during the interviews span across the globe: Afghanistan, Armenia, Bangladesh, Bolivia, China, Democratic Republic of the Congo, Djibouti, Egypt, Ethiopia, Haiti, India, Iraq, Jordan, Kenya, Lebanon, Libya, Myanmar, Nepal, Pakistan, Palestine, Philippines, South Sudan, Sri Lanka, Syria, Tunisia, and Uganda.

Procedures

In line with ethical standards (British Psychological Society 2018), researchers provided information about the project, obtained participants' consent, and offered the option to ask questions, raise complaints, and withdraw at any point. Additional resources for mental health and psychological support specific to aid workers were shared after the interviews.

Data collection

Data were collected in semi-structured, confidential, one-to-one interviews respecting the personal nature and sensitivity of the topic and allowing for an open and flexible discussion. The interview guide covered aspects of aid and spirituality and was discussed with a mental health counsellor of a major international humanitarian organization for reality cross-checking before application (Smith 1995). The conception of open-ended questions avoided any predetermined themes (Terry et al. 2017). The interviews were audio-recorded, transcribed verbatim, anonymized, and approached with thematic qualitative analysis for prevalent and repeating themes (Braun and Clarke 2006).

Reflexivity

The research team have all had experience in aid work in both sectarian and non-sectarian settings. In an attempt to facilitate discussion, the primary researchers did disclose previous aid work experience. In addition, the data collection was completed by women researchers with the hope this would alleviate any issues around gender. Despite the research team's personal and spiritual background, specifics were not divulged during the research process to avoid the perception that only positive outcomes regarding spiritual coping were sought. This research team acknowledged that individual experiences were part of a broader social and cultural context that have shaped and validated this research interest (Lazard and McAvoy 2017). Coming from both aid work and faith-based experiences allowed for a familiarity and connection with participants. However, previous sectarian and non-sectarian experiences of the research team or experiences of spirituality as protective mechanism may not reflect the participants' experiences. Consequently, the researchers acknowledged the potential of negative effects of a faith-based and spiritual practice. This was managed by paying attention to explicit and implicit bias to encourage as much neutrality as possible.

Analysis approach

Using thematic analysis as a very flexible yet systematic approach to qualitative research allowed for identification, analysis and reporting of codes and themes within the data, independent from theory or epistemology (Braun and Clarke 2006). While the ramifications of working in aid and the model of spiritual coping are acknowledged and part of the research questions, the analysis of the participants' experience was inductive and data-driven. As per the contextualised method, this analysis made space for the reality of the participants and their meaning-making while acknowledging the wider social and political context of aid work that may influence their experience and interpretation. The digital theme map demonstrates the grouping and relationship of three themes (see Fig. 1).

Results

Three themes were identified in response to the research question how a self-reported degree of faith or spirituality may contribute to better coping in the face of stressful living and working environments in conflict or disaster-affected areas. To understand the phenomenon of faith-based and spiritual coping in aid work, the first theme outlines the overall context of working in the aid world: a demanding environment that requires non-stop full capacity of its workers ( The context: The aid 'world'). The second theme outlines the primary outcome, benefits and gains, of faith-based and spiritual practices, and the underlying supportive processes reflected in respecting one's values and needs ( 'Filling one's own cup'). The third theme outlines secondary, negative implications of such practices that might threaten one's balance ( When the cup has a crack).

Theme-The context: the aid 'world'

This theme provides a frame of reference for the experience of participants. It highlights in three subthemes their faith-based or spiritual motivations to enter the profession, its demands, dangers, and psychological impact, as well as the culture of aid work.

Subtheme: motivation and expectations

Subtheme: demands, dangers, and impact

Working in aid, particularly in humanitarian aid, participant 4 noted that "the expectations are so high... everything is an emergency...there is no such thing as personal time", and subsequently, there was not much time for reflection. Statements about "crazy hours ... crazy living conditions, ...crazy risk disaster environment" (participant 5) summarized the demands. Aid workers were expected to react with flexibility, versatility, and inventiveness in all situations: An immediate travel request for an emergency response operation was answered with "' no problem' and I basically packed my bag. The next morning, I was on a plane" (participant 11). "There were no security plans for things like ... if we were attacked, so all of us ... were constantly trying to come up with our own plans" (participant 6). While being faced with a "pile of dead bodies" (participant 5), refugees and internally displaced persons' dire living conditions (participant 1), suicide attacks on project sites and accommodation (participants 6 and 12), threats of kidnapping and sexual assaults (several participants), aid workers were exposed to both direct and secondary trauma. Participant 7 noted after a traffic accident "mobs will just hack you, and we saw a number of people killed that way". Under such conditions, aid workers were left "burnt out" (participant 3), drained of "not only physical energy but emotional and spiritual" (participant 14) and subject to "anxiety" (several participants), unprocessed grief and trauma, and the isolation of having to "manage it alone" (participant 2). After many humanitarian emergency missions without the space to reflect and release emotions or recharge spiritually (participant 14), participant 5 claimed "there's a bit of me that's dead", one potential response to secondary trauma.

Subtheme: the culture of aid

Aid workers had a reputation of being courageous and efficient, " they go in, they stitch people up, they deal with any ...emergency" (participant 11). They were known to successfully accomplish their "fast-paced work where decisions need to be made very fast" (participant 2). Part of the culture also was the never-ending nature of work and how "people become workaholics because you have to give your life to it, almost" (participant 4). Several aid workers spoke of the 'cowboy' or 'cowgirl' image of aid workers who were

Participants experienced the culture as one of bravery but also stigma where coping through potentially self-destructive behaviours seemed more accessible than sharing psychological struggles or how they coped better thanks to their faith or spirituality (participant 4). Participant 6 and others observed potentially adverse coping mechanisms such as "alcoholism, ...drugs,...indiscriminate sex...a wild lifestyle that accompany aid work especially in conflict countries because that's the way that people choose to deal with their stress".

Theme-The primary outcome: 'filling one's own cup'

A crucial thread seemed to be expressed in the theme of 'filling one's own cup': "You really have to realise I need to fill myself up so I can give to others" (participant 14). Two subthemes with four components each denote (a) what a 'full cup' meant to them and (b) what mechanisms were used to fill the cup, i.e. what aspects of their faith-based or spiritual practice specifically recharged the participants.

Subtheme: What is a 'full cup'?

Participants experienced varying states and emotions when their 'cup' was filled.

Component 1: grounded and calm amidst chaos

Confronted with suddenly losing her job, one participant noted:

Component 2: resilience

Participants' practices fed their resilience and ability to withstand (e.g. secondary trauma) (participants 11 and 14) or "bounce back" (participants 6). Faith " forces you to look around for that goodness.... When I was in a place where we saw so much darkness I really felt a lot of light" (participant 14). After "spending some time with God", participant 2 remained persistent and refused "giving up", while participants 3 and 7 noted that their "connection to God" kept them going and continue in aid work. It "made me stronger and more able to deal with the refugee stories that we'd hear every day" (participant 7).

Component 3: "I am more present"

The practice across different faith traditions, while acknowledging the temporary nature of this world, also enhanced the ability to deal with death, grief, and stories of violence and sexual assaults (participants 8, 9, 10, and 11). Recounting the strength of raped Congolese survivors, participant 7 remained hopeful despite such hardship: " God is still with us, and listening and answering... That presence is the promise". Participants felt that their practices enabled them to listen better and be "more present with the people I was interviewing in the camps" (participant 11), to be a "balm to the wound" (participant 7) and be able to "walk with people as they were suffering" (participant 3). Without her spiritual practice, participant 1 notes "I wouldn't have found my job as fulfilling. I wouldn't have been as good with refugees...and able to give them the time that they needed".

Component 4: "Give it to God" and non-attachment

Participants felt their balance was restored when they practiced in moments when they did not have control over their environment (participant 1). They conceded that "God is in control" (participant 7), and they are "powerless in the scheme of the Universe and ... release it to a Higher Power" (participant 13). Participant 11 experienced rest in a place of "complete acceptance whether it is joy or suffering". Knowing that they were not in charge of events that were beyond any human control provided a certain relief.

Participant 10 and others noted: "I could die anywhere when my time's up", and therefore felt non-attached and safe, including in challenging security contexts.

Subtheme: How is the cup filled? Values and needs

This subtheme expressed the particular mechanisms which are specific to participants' faith-based and spiritual approach and which caused the 'refill' to enable them to better cope.

Component 1: identity and belonging

Component 2: space for self-care-physical, mental, emotional

In their work context, space was not always available, be it physical space, such as living quarters and choice of housemates (participants 12 and 14), or space to process the demands, dangers and impact and to acknowledge the related emotions:

A faith-based or spiritual practice supported and facilitated the creation of metaphorical space for self-care on the physical, mental, and emotional levels. Participant 11 experienced her meditation practice as a life-guard for her physical health as it "prevented further damage that may never have been able to be repaired", and participant 1 "would have continued to engage in things that were more self-destructive than helpful to me" without her yoga practice. Participant 4 admitted she "would have drank a lot more, I would have smoked a lot more" without her faith, while participant 3 felt her centering prayer practice made her "just able to ... take steps back.... I'm not so in it and emotionally ... invested". Pursuing their practices was " carving out that bit of the day for me, but it's also a way of processing and acknowledging emotions" (participant 5). Her practice gave her "the freedom and the ability... to ... observe it neutrally and then, take action" (participant 13).

Component 3: community and belonging: virtual and in the flesh

Component 4: connection across boundaries

In line with the felt sense of community was the connection across the experienced divide between nationals and internationals, staff and other, and across faith boundaries. "So you all have your own take on it and you all come from very different backgrounds ..., all of that can be hard but if you have something in common it helps bring it together" (participant 14). A faith-based or spiritual approach and identity created an environment where national and international aid workers of different spiritual practices, beliefs, languages, and cultures could connect and discuss (participant 8). This felt connection enabled a Christian international aid worker to respond to a Muslim national aid worker to " just pray and Allah will give you a dream" and to "have those conversations about faith" (participant 5).

Most participants felt being more accepted, integrated, and respected by national colleagues for having a faith-based or spiritual practice than by international colleagues: "They were delighted that I had a faith" (participant 5), " they saw it very highly ... because all of them ... value their faith and see it as an essential part of their life and identity and so seeing me as a Westerner who actually had faith meant a lot to them" (participant 4). Participants felt connected through their shared humanity (participants 3 and 8).

Theme-Secondary outcome: when the cup has a crack

This theme covers potentially adverse consequences of a faith-based and spiritual practice.

Subtheme: Can you ever do enough for God?

A related aspect to the subtheme of motivation which increased the burden on faithful or spiritually minded aid workers was the question if you can ever "do enough for God" (participant 5). There might also be an additional burden of "representing a good, religious person ... with a responsibility for my faith" (participant 9). Participant 3 conceded " that connection with God... drove me to ... probably push myself when I needed to maybe step back and take some time ... to work out whatever I was feeling". This aspect demonstrated that some parts of a faith-based or spiritual approach might increase the chance of burnout, rather than relieving it and 'filling your cup'. In line with their motivation and the culture of aid, " often ...we expend ourselves" (participant 3) and "often ...we do get burnt out...we start thinking things are not going to work without us" (participant 12).

Subtheme: You need a crutch?!

Many participants noted that the international aid environment was less welcoming to expressions of faith-based or spiritual practices (participant 4). Participant 1 experienced lack of acknowledgment of the value and benefits of a spiritual practice: "It's kind of like 'Science vs. Spirituality'" and participant 13 experienced attitudes in the West as " sneery about the positive ...effects". Participant 7 noticed a "general sense of ambivalence or apathy towards" her faith and some even felt ridiculed:

Regarding not engaging in adverse common coping mechanisms to "let off steam" (participant 6), some also feared judgment and felt that they did not "want to be judged for my faith, saying ... I don't want to do this for this and this reason, so that's a challenge" (participant 4).

Discussion

Summary and synthesis

The study expected to find how a self-reported degree of faith or spirituality may contribute to better psychological coping in the face of stressful living and working environments in conflict or disaster-affected areas. Inductive thematic analysis of 14 semi-structured interviews revealed three related themes, " The context: The aid 'world'", the "Primary outcome: 'Filling one's own cup'", and the " Secondary outcome: When the cup has a crack". The findings reflect previous quantitative research with large and varied samples on religious coping and its multidimensional character (Pargament et al. 1998): Findings suggested that a faith-based and spiritual approach provided participant aid workers with a groundedness and calm amidst an environment of chaos and direct and secondary trauma. Participants gained a sense of enhanced resilience and ability to be present for their personal needs, work demands, and the needs of people they served. A faith-based and spiritual approach allowed participants to let go of the impulse to try and control every situation that arose in the aid context but other times also challenged them to push themselves beyond their capacities. To some degree, participants experienced ostracism due to their faith and spirituality. The identified supportive mechanisms were represented by the participants' strong identity characterized by their faith-based or spiritual beliefs, the availability of community support, and the connection experienced across cultural, national or faith-based and spiritual boundaries. An important mechanism was revealed by the creation of emotional processing space following exposure to stressors and direct and secondary trauma.

Outcomes reflected in psychological theory

Some of the supportive mechanisms and related outcomes revealed in this research are reflected in certain psychological theories, e.g., in the framework of the mindfulness-based Acceptance and Commitment Therapy (ACT) (Hayes 2004; Hayes et al. 2001; Hayes et al. 1999). Participants viewed themselves as self-as-context through a solid understanding of their identity, a 'continuous sense of self' (McLean and Follette 2016, p.145). This means their sense of self was not determined by the limiting context they lived or worked in. Rather, their sense of self determined how they viewed their context. Their aid experiences did not restrict participants' sense of personhood. Rather, their identity as faith-based or spiritual persons, in instances, supported them to continue their work in the aid world while being in line with their own values (Hayes et al. 2006).

Escaping and avoiding emotions, thoughts, and memories is "one of the most pathological processes known (as)...experiential avoidance...even when the attempt to do so causes psychological harm" (Hayes 2004, pp.649-650; Hayes et al. 1996). Accordingly, by practicing their faith and spirituality, participants gained the chance to accept and process these emotions, thoughts, and memories by taking space for self-care, instead of engaging in experiential avoidance. This could decrease the occurrence of psychological harm (Hayes et al. 2006). The more control someone has over their work, the lower their stress levels (Bond and Bunce 2003). In the aid context, participants outlined that such control was not always available, given war and conflict situations, direct or secondary traumatic events. However, they felt a groundedness and greater ability to be present for themselves and for others by accepting certain circumstances as beyond their control. They acknowledged their lack of control which, indeed, may protect from burnout (Johnson 2001; Maslach and Jackson 1981) and psychologically accepted related emotions (Bond and Hayes 2002).

Social support in community and connection

In line with social psychology research, participants' experiences reflected the need to belong (Baumeister 2012): Their practice enabled them to be part of and to create communities, both in-country and virtually, as well as building connections to the people in the countries where they worked. Participants' feelings of being 'sheltered' and supported as part of prayer or meditation communities is in line with previous research on the impact of religious communities (e.g. Nicholson et al. 2009). Social support sustains mental health through e.g. a regular joint spiritual practice (Hill and Pargament 2003), which, over time, can enhance resilience (Comoretto et al. 2015). While religiousness and social support do not necessarily correlate positively with each other in secular contexts (Kvande et al. 2015), the latter is not the contextual reality of the majority of the world population-about 90% actively pursue some form of religious or spiritual custom (Schafer 2010; Pew Research Centre 2015). This indicates that such practices may be important and beneficial to social support in most global contexts, for example for national aid workers. Feeling connected across cultural and religious boundaries was not ubiquitous but sufficiently important and rewarding for participants' well-being. The connections, thanks to their beliefs and practices, across what some of them perceived as a separation between national and international staff were particularly meaningful in the context of aid challenges and culture.

Implications for policy and practice

Aid organizations have power in removing stigma around mental health difficulties and in challenging such stigmatization which was regarded part of aid culture (McCall and Salama 1999).

Removal of stigma regarding expression of emotions, needs, and mental health

The demands in the aid world require aid workers to successfully deliver projects to save lives. The endeavour to fulfil high expectations while neglecting personal needs without adequate physical, psychological, or social organizational resources may lead to higher levels of burnout (Bakker and Costa 2014). The head of the ethics office of a major humanitarian organization noted "a gap between what some people believe and do in their personal life - mindfulness, faith-based and therapeutic interventions - versus what they bring in to their professional lives: There is no holistic approach that would include our emotions, body sensations, etc. There is an alarming 'illiteracy' in dealing with emotions and in reading one's own emotions and those of colleagues, in the work place" (personal communication, 6 March 2018). Such observations demonstrate the responsibility of aid organizations for the psychological welfare of their employees (Comoretto et al. 2015): The organizational culture is a major factor in this. Connorton et al. ( 2011, p.147) claim "there is no evidence base regarding how to prepare relief workers for occupational trauma and stress". Admittedly, humanitarian agencies' guidelines on mental health and psychosocial support with focus on beneficiaries do suggest some actions and resources on how to "prevent and manage problems in mental health and psychosocial wellbeing among staff and volunteers" (IASC - Inter-Agency Standing Committee 2007, p.87). Some organizations have demonstrated key initiative to look into staff needs (Welton-Mitchell 2013). Agencies offer access to staff counsellors at Headquarters and field duty stations, availability of internal training materials on stress management and mental health, or organizational access to commercial mindfulness training apps (personal communication with staff counsellor of major humanitarian organization, 28 March 2018). However, more is required to institute cultural change and satisfy the psychological needs of aid workers and thus enable them to better fulfil the high work demands and achieve organizational goals.

The potential impact of the aid work context on mental health requires more conversations, training, preventive interventions, continuous support, and debriefings. To illustrate, psychological therapists are exposed to secondary trauma through the recounts of their patients. The related recommendations for this occupational group are to engage in peer discussions and to obtain additional training on prevention and impact (Trippany et al. 2004). Aid workers, similarly exposed to secondary trauma, require e.g. "peer support networks ... during or after deployment" (Cardozo et al. 2012, p. 11) and additional psychological training on self-care. It remains important to continue working towards de-stigmatization of mental health difficulties. Organizations could support their staff through structured exercises to build community and enable environments where 'weakness' is redefined and having a 'crutch' is deemed helpful and essential.

Removal of stigma regarding faith-based and spiritual coping

Participants shared how difficult it is to discuss their faith-based and spiritual coping mechanisms with colleagues, indicating the lack of an inclusive approach. While organizations as the Headington Institute offer documentation and training on spirituality and humanitarian work (McKay 2010), it is difficult to advertise such a mechanism within aid agencies: Agencies' codes of conduct prohibit the promotion of a particular religious standpoint (Schafer 2010). However, it is important to differentiate between organizational programme delivery and personal welfare aspects. While respecting codes of conduct, agencies may address all available coping mechanisms, including faith-based and spiritual, in agency-internal stress-management trainings. For example, agencies could facilitate "time for the exercise of spiritual practices as part of recreational life and well-being for staff" (Eriksson et al. 2015, p.21). Psychological therapists and staff counsellors could be further sensitized on faith-based and spiritual coping, integrating it into the treatment and healing process of staff (Pargament 2012; Smith 2004). Client-driven discussions on multiple coping mechanisms should be incorporated. Agency staff counsellor teams could include interfaith chaplains to address faith-based and spiritual coping and integrate both psychological and spiritual needs of multi-cultural staff teams. As such, aid agencies would follow the examples of hospitals, mental health institutions, law enforcement agencies, and universities which offer the services of chaplains. Such steps would be particularly helpful to address the needs of national staff considering that the vast majority of aid staff are national, e.g. 95% of International Nongovernmental Organizations' staff (ALNAP 2010), and faith is an important factor for them (McCall and Salama 1999). Opening up mental health support with spiritual emphasis for aid workers would also reflect current considerations of a faith-sensitive approach among aid organizations regarding mental health and psychosocial programming in humanitarian aid IASC - Inter-Agency Standing Committee Reference Group Mental Health and Psychosocial Support in Emergency Settings 2018). With increased attention on resilience-building among aid workers and the existence of spiritual constructs in resilience, faith, and spirituality as coping mechanisms must be recognized as important factors for aid workers' well-being and thus productivity (Peres et al. 2007; Selby et al. 2009; Wartenweiler and Eiroa-Orosa 2016).

Both "social support and organizational support each remained significantly related to less" burnout (Eriksson et al. 2009, p.682) and practitioners acknowledge that staff "who feel ...psychologically secure are more likely to be productive and engaged" (Konterra Group 2017, p.2). This indicates the importance of supportive relationships, policies, and procedures at the organizational level. Such networks are important even after aid workers' deployments end, potentially supporting faster staff recovery (Cardozo et al. 2012).

Limitations

This research outlines self-selected participants' experiences and a larger, quantitative sample would be required to enable generalization. The strength of the chosen method however is the chance to glimpse into the reality of people's lives as aid workers with a faith-based or spiritual practice, their difficulties, hopes, and strengths beyond mere anecdotes. While many different faiths and expressions of spirituality were represented, most respondents were from industrialised and Christian-majority countries. However, the recruitment through social media beyond personal networks and avoiding official organizational channels allowed a neutral and independent approach to participants and thus the data.

Recommendations for future research

This research focussed on women to obtain largely homogenous data and follow up on available research about women and religious coping. Further research could hone in on participants' specific experience as women in aid. Future similar research could target male aid workers and the potential stigma around mental health issues men may face, and their access to faith and spirituality for coping. An important aspect would be the role that faith plays among national staff and how it can be integrated in mental health-related and stress management trainings targeting national aid workers. Future research should target follow-up on implementation of recommendations to test their effectiveness.

Conclusion

A faith-based and spiritual practice can be an effective coping mechanism through processes that are linked to humanity's primary needs of identity, space for self-care, community, belonging, and connection. The participant aid workers' experiences revealed the potential ongoing presence of stigma around mental health challenges and this coping mechanism. An organizational and social culture change is required to acknowledge the need for and utility of this psychological mechanism. While participants here have experienced challenges in their aid work contexts despite their faith-based and spiritual practices, they also reported that they have struggled less and coped better because of their practices which were integral to their coping. Opening up the discussion and allowing space for faith and spirituality might help reveal and remove stigma and improve aid workers' well-being and thus productivity in the field.

Availability of data and materials

The dataset that supports the findings of this study is available on request from the corresponding author. The dataset is not publicly available due to privacy and ethical restrictions.

References

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Acknowledgments

The researcher wishes to express gratitude to each of the female aid workers who shared their stories with generosity and trust for their continuous courage and work in the field.

Funding

No outside funding was used to support this work.

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Authors and Affiliations

Clinical Psychology, School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK

Ozgul Ozcan, Mark Hoelterhoff & Eleanor Wylie

Contributions

The corresponding author is the principal author. The co-authors have been involved in editing and advice, and data collection, respectively. The authors read and approved the final manuscript.

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Correspondence to Ozgul Ozcan.

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The researcher declares no potential conflicts of interest with respect to the authorship and/or potential publication of this article. The views expressed herein are those of the author and do not necessarily reflect the views of the United Nations.

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Ozcan, O., Hoelterhoff, M. & Wylie, E. Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study. Int J Humanitarian Action 6, 15 (2021). https://doi.org/10.1186/s41018-021-00100-z
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Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study - Journal of International Humanitarian Action

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Despite evidence that faith-based and spiritual coping supports people's mental health, stigmata prevail in the aid sector around the need for psychological support in general and around this coping mechanism in particular. This qualitative research examines female aid workers' experiences and aims to elucidate how this mechanism supports mental health in stressful, conflict, or disaster-affected living and working environments.

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Coping Mechanisms - StatPearls - NCBI Bookshelf

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Coping is defined as the thoughts and behaviors mobilized to manage internal and external stressful situations.[1] It is a term used distinctively for conscious and voluntary mobilization of acts, different from ‘defense mechanisms’ that are subconscious or unconscious adaptive responses, both of wh…

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In their Own Words: Resilience among Haitian Survivors of the 2010 Earthquake

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In their Own Words: Resilience among Haitian Survivors of the 2010 Earthquake

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Abstract

Social sciences literature highlights the importance of resilience in relation to risk and trauma. The 2010 Haitian earthquake compounded trauma for a nation that has endured slavery/despotic leadership, structural violence and poverty. Since 2010, various sources broadly describe Haitian survivors as resilient. We reviewed definitions of resilience published between 1990 and 2013, comparing them with perspectives of earthquake survivors from economically diverse communities in Haiti who, participated in semi-structured interviews (n=38) and in six focus groups (n=63) between 2010-2011. Haitian resilience accords with some definitions from the literature. It also comprises independent, discrete, and isolated contextual resignation and intentional choice to survive and function-when there is no alternative course of action. Understanding Haitian resilience, can inform health/mental health and policy interventions, if these are taken as cultural resources. Intervention efforts should incorporate survivors' input as key informants on what constitute resilience and reconstruction goals for them.

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In their Own Words: Resilience among Haitian Survivors of the 2010 Earthquake - PubMed

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Social sciences literature highlights the importance of resilience in relation to risk and trauma. The 2010 Haitian earthquake compounded trauma for a nation that has endured slavery/despotic leadership, structural violence and poverty. Since 2010, various sources broadly describe Haitian survivors ...