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Emmaus community: efficacy of a treatment program for women religious.

This study was designed as a confirmation of the empirical evaluation of the efficacy of Emmaus Community, a residential treatment facility for women in religious life. Although a previous evaluation by Borrine and Handal (1989) provided preliminary support for the program's efficacy, their study was vulnerable to the internal threats to validity of history, maturation and statistical regression. This study provided controls for these threats and analyzed data from another cohort of participants. Results revealed that participants reported significant decrements in their level of pathological distress; they moved from an impaired to a non-impaired status on an empirically validated measure of psychological adjustment. Also, they reported significant improvements in their interpersonal relationships and their ability to express and receive a variety of affects.

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During the past 20 years, there has been a marked increase in the establishment of treatment facilities for psychologically distressed men and women in religious life (e.g. Derham Community, Emmaus Community, St. Luke's, Southdown). The designs of some of these treatment programs, namely St. Luke's and Southdown, have been based on traditional pathology or medical model approaches and appear similar to treatment programs typically used outside of religious settings. Other programs, like the Derham and Emmaus communities, have designed treatment programs based on a wellness model which assumes that individuals are responsible for their own life choices, decisions, commitments, relationships and activities. This is in contrast to the traditional pathology or medical model, which assumes that the individual is sick or ill and therefore not responsible for his or her choices. Unfortunately, it appears that only two published articles are available that describe the components and efficacy of wellness treatment programs (Derham Community, see Cummings, Handal, Mink & Mink, 1979; Emmaus Community, see Borrine & Handal, 1989). However the methodological flaws in the designs of these studies prevented the authors from providing sound evidence for the efficacy of this type of treatment program.

Cummings et al. (1979) reported favorable outcome data for participants in Derham Community, but the results were criticized since the reported treatment efficacy was based on unstandardized interviews, and data was not systematically collected at both pre- and post-treatment (Borrine & Handal, 1989). Borrine & Handal (1989) attempted to correct these flaws in their evaluation of Emmaus Community, a residential treatment program for psychologically distressed religious women which was modeled after Derham Community.

Description of Emmaus Program

Emmaus community is an intercongregational center which was established to assist in the personal growth and development of women in religious life within the context of a religious community setting. Consistent with Derham Community, Emmaus Community is based on a wellness model which values individual dignity and assumes that each person is responsible for her own life choices, decisions, commitments, relationships and activities. At Emmaus, religious women experiencing personal adjustment problems and psychological distress are encouraged to recognize and assess the life patterns, and to affirm them or attempt to effect appropriate change. This is accomplished through participants and staff living together as a religious community.

Required components of this program included the following: a weekly conference with the director which focuses on the goals, intentions, and directions the sister has chosen for her time at the personal growth community (i.e. identification of problem areas, setting goals, and developing a plan of implementation); a small group which meets twice weekly with a staff member and other program participants; and large community groups where participants, the director, and staff members meet weekly to explore personal and interpersonal issues in a supportive environment.

Optional components of this program included the following: individual conferences with a team member of choice which are used to discuss current or ongoing questions and concerns related to the goals the sister has set for herself; weekly group dynamics, which facilitate the development of communication skills; liturgy and prayer; celebration of feast days, birthdays, and other holidays; and meal preparation, which affords the participants an opportunity to examine attitudes, and learn and practice skills while collaborating with others. Mini courses, cultural opportunities, entertainment, lectures and other activities are also available. Books and tapes relevant to personal growth are available for individual study and discussion. Objective personality tests and vocational interest tests are available for individual testing and interpretation, as well as formal and informal opportunities for the development of a holistic approach to physical and personal well-being. Cooperative gardening of vegetables and flowers, which allows for the experience of individual and joint effort; the option of part-time work, which allows participants to learn or practice skills, try different work experiences, and identify and understand sources of stress related to work are also available. The required and optional program components provide experience in three essential areas: dyadic, small groups, and large groups, all of which are germane to living in religious life.

Emmaus Community is staffed by a director who is a certified M.S. counselor, a house manager, and paraprofessional team members who are religious women supervised by the director. They attend continuing education workshops. The structure of the staff at Emmaus Community is consistent with Rappaport's (1977) ideas regarding the use of an "Educational Pyramid" for the delivery of mental health services. Essentially, he argues that the use of nonprofessional or paraprofessionals in this context can help overcome the failure of the traditional mental health system in meeting the needs of variety of groups.

This program is open-ended. Participants are accepted on a space-available basis, and at the discretion of the director and team members. The average length of stay is approximately 12 to 15 months.

Research on Emmaus Community

Borrine & Handal (1989) assessed the treatment efficacy of Emmaus Community by using a pre-post research design. The psychological adjustment of the participants was assessed before and after treatment using the Langner Symptom Survey (LSS, Langner, 1962; Srole, Langner, Michael, Opler, and Rennie, 1962), a measure of psychological adjustment with an empirically validated cutoff score (4 or greater) for the identification of individuals in distress and in need of treatment. Other variables were also evaluated using a standardized questionnaire which assessed the following areas of functioning: psychological, family relationships, religious congregation, local community, ministry, interpersonal, decision-making, coping with stress, prayer life, religious life commitment, sexuality, physical, quality and degree of closeness of relationships, and the expression and reception of various emotional states. Borrine & Handal (1989) found that the Emmaus Community participants showed statistically significant and clinically meaningful improvement in overall psychological adjustment as measured by the LSS (i.e., participants' aggregated scores exceeded 4 prior to treatment and were below 4 at post treatment). Additionally they reported significant improvement in 9 out of the 12 other assessed variables.

Although Borrine & Handal's (1989) methodology showed an improvement over that used by Cummings et al. (1979), the absence of a no-treatment comparison group in their study weakened their results because of the possibility that maturation, history, and/or statistical regression, could be considered alternate explanations for the changes in psychological functioning apparent in the responses of the participants. The current study was designed to control for and minimize these internal threats to validity by using a cohort comparison group and a pre-post no treatment comparison sample.

Specifically, cohort comparisons were made by comparing their data using pre-post data from participants who received treatment between 1984-1987 (Cohort 1) to the pre-post data from participants who received treatment between 1987-1994 (Cohort 2). This enabled each Cohort to act as both a comparison group and a control group for the other, thus reducing the effects of history. Specifically, any historical force would have had to operate twice if it were to explain the superior psychological adjustment scores of Cohorts 1 and 2 at post-treatment in comparison to pre-treatment.

Haberman (1965) reported stability data on the Langner System Survey (LSS) from a pre-post (3 year) no treatment sample. Data from this sample permitted a control for the passage of time, and statistical regression. Additionally this data also permitted a control for simple maturation over time.

These two methodological improvements, cohort comparison analyses and use of an untreated comparison group, addressed the internal validity threats of maturation and history, and provided a comparison baseline against which to ascertain the presence of statistical regression. Together, these added empirical analyses better answer the overall research question concerning the therapeutic efficacy of the Emmaus Community treatment program for religious women.

METHOD

Participants

Participants were 72 religious women who were enrolled at Emmaus Community, a residential treatment facility for women, between 1984-1994. They ranged in age from 35 to 72 with an average age of 50.45 (SD = 8.72) years. Their length of service in religious life ranged from 14 years to 55 years (M = 31.85 years; SD = 8.96). These women entered religious life between 13 and 31 years of age with a mean age of entry of 18.60 (SD = 2.93) years.

Procedure

Emmaus Community sample. Participants completed the pre-treatment questionnaires and the LSS after they were accepted to Emmaus Community but before they actually began the program. Average length of stay was 16.97 (SD = 12.43) months; participants completed post-treatment questionnaires 10.93 (SD = 12.43) months after leaving the program. Therefore, the average length of time between pre- and post-test questionnaires was 27.64 (SD = 16.65) months.

Sample sizes for Cohort 1 and Cohort 2 were 26 and 46, respectively. Participants from Cohort 1 exited before participants from Cohort 2 entered the program. Although the span of time for data collection was different for each of the two Cohorts (Cohort 1: 3 years; Cohort 2: 7 years), both of the treatment cohort groups consisted of religious women who had completed comparable courses of treatment; average Cohort 1 treatment stay = 16.6 months, Cohort 2 mean = 17.01), for similar types of psychological distress.

Use of a cohort design improved the experimental design and subsequent statistical analyses since each Cohort acted as both a comparison group and a control group for the other. Specifically, it was hypothesized that Cohort 1 pre-treatment scores for Areas I, II, III, and the LSS would not significantly differ from Cohort 2 pre-treatment scores. Similarly, it was hypothesized that Cohort 1 post-treatment scores would indicate significantly less distress in comparison to Cohort 2 pre-treatment scores.

Measures

Langner Symptom Survey (LSS) (Langner, 1962; Srole et al., 1962) is an empirically validated measure of current point-in-time psychological distress. It consists of 22 items which measure psychological symptoms, such as, depression, anxiety and psychophysiological symptoms. Items are scored either 1 or 0 for presence or absence of symptoms; consequently scores range from 0 to 22, with higher scores reflecting greater psychological distress or impairment. Stability correlation coefficients, test-retest, for the LSS are: .80 for 2 weeks (Edwards, Yarvis, Mueller, Zingale, & Wagman, 1978); .55 for 2 years (Eaton, 1978), and .54 for 3 years (Haberman, 1965).

Langner (1962) reported that a score of 4.00 or more on the LSS significantly differentiated outpatients and former patients from non-patients and that it identified 84% of those who were incapacitated. Manis, Brawer, Hunt & Kercher (1963) concluded that the LSS is a valid measure of group differences for mental health. Cochrane (1980) also provided mean LSS scores and standard deviations for different groups: patients of a mental hospital: 7.67 (SD = 5.12); a community of respondents: 3.02 (SD = 3.35); female respondents from that community: 3.70 (SD = 3.66); and unmarried respondents from that community: 3.46 (SD = 3.52). These scores reflected an absence of psychological distress, LSS score below 4.00, for those groups from a typical, community setting, while the average score of the patients from the mental hospital indicated psychological maladjustment.

Haberman (1965) provided mean LSS scores for a 3-year test-retest period. He reported a mean LSS score of 3.4 at the initial interview, and a score of 3.6 approximately three years later (standard deviations were not provided).

Other measures. Pre and Post-treatment questionnaires were developed by Borrine & Handal (1989) in consultation with the staff at Emmaus Community. In addition to requesting demographic information, Area I of the pre-treatment adjustment survey asked participants to rate on a 5-point scale the frequency with which they experienced distress in 12 areas: psychological, family relationships, religious congregation, local community, ministry, interpersonal, decision making, coping with stress, prayer life, religious life commitment, sexuality, and physical. Area II of the survey asked the participants to rate on a 5-point scale the degree of closeness and intimacy they had in relationships with peers and supervisors; the quality of their relationships at work with peers, those in authority and those served; their satisfaction with their ministry and local community; and their satisfaction with relationships in their local community and with those in authority. Area III of the survey asked participants to rate on a 5 point scale their ability to express, to receive, and deal with a variety of affective states: anger, love/affection, sadness, criticism, fear, anxiety, and ambiguity.

The post-treatment questionnaire included the same questions as the pre-treatment questionnaire except that the subjects were asked to respond in terms of perceived improvement/nonimprovement since their entrance into Emmaus Community. Specifically, post-treatment ratings of Area I, the 12 problem areas were rated on a 6-point scale; Area II, feelings of closeness, satisfaction, and quality of relationships, were rated on a 5-point scale; and Area III, expression, reception in dealing with various affective states were rated on a five point scale. Ratings of psychological distress using the LSS were again obtained.

RESULTS

Table 1 presents the means and standard deviations separately for participants in Cohorts 1 and 2, and for the total sample for the LSS, and Areas I, II, and III. Lower scores reflect better adjustment. As can be seen in Table 1 the mean pre-treatment LSS score for Cohorts 1 and 2 and the combined data exceeded the cut-off score of 4. Consequently the religious women would be considered distressed and in need of treatment. Mean pre-treatment scores for Areas I, II, and III reflect problems in each of the broad areas.

In order to control for the effects of history three analyses were computed using t tests: Cohort 1 pre and post LSS scores were compared, Cohort 2 pre and post LSS scores were compared, and Cohort 1 post LSS scores were compared with Cohort 2 pre LSS scores. The results of these analyses revealed significant differences (t = 5.12, df = 25, p < .01) between Cohort 1 pre (M = 6.04) and post (M = 2.04) LSS scores; a significant difference (t = 4.65, df = 45, p < .01) between Cohort 2 pre (M = 4.74) and post (M = 1.93) LSS scores; and a significant difference (t = 4.50, df = 70, p < .01) between Cohort 2 pre (M = 4.74) and Cohort 1 post (M = 2.04) LSS scores. If history were operative it would have had to occur twice to explain the superior adjustment scores of Cohorts 1 and 2 at post-treatment in comparison to their pre-treatment LSS scores. Additionally, if history were operating continuously then significant differences should not have occurred between Cohort 2 pre-treatment LSS scores and Cohort 1 post-treatment LSS scores.

In order to determine whether Cohorts 1 and 2 were comparable and to determine the efficacy of the treatment program a 2 (Cohorts 1 and 2) X 2 (Time/pre-post) ANOVA with repeated measures on the second factor was computed using the LSS scores as the dependent variable. Results of this analysis yielded no significant interaction F (2, 70) = 5.91, no main effect for Cohort F (1, 70) = 1.62 and a significant main effect for pre-post F (1, 70) = 5.08, p < .01. These results revealed that the pretreatment scores of Cohorts 1 and 2 do not differ significantly nor do the post treatment scores of Cohorts 1 and 2 differ significantly, and consequently the groups can be combined. Additionally, results revealed that pre-treatment scores for the total sample were significantly higher (M = 5.21, SD = 3.67) than the post-treatment scores (M = 1.97, SD = 1.66). These results are both statistically significant and clinically meaningful because participants moved from a distressed and in need of treatment status to a nondistressed and not in need of treatment status.

In order to determine whether the additional clinical data summarized in Areas I, II, and III indicated similar statistical improvement for Cohorts 1 and 2, three MANOVAs were performed. For each of Areas I, II, and III a 2 (Cohorts I and 2) X 2 (Time/pre-post treatment scores) MANOVA with repeated measures on the second factor was performed. For Areas I, II, and III results revealed that neither the interaction effect F (1, 26)=1.94, F(1, 21)=1.54, F(1, 22)=.93, respectively, or the main effect for Cohort F(1, 26)=.96, F(1, 27)=1.12, F(1, 22)=.73, respectively, were significant. These results indicated that for each of Areas 1, II, and III Cohort 1 pre treatment scores did not differ from Cohort 2 pre treatment scores, and Cohort 1 post treatment scores did not differ from Cohort 2 post treatment scores.

However, for each of Areas I, II, and III the results for the repeated measures pre-post main effect were significant, F(1, 26)=24.58, p < .01, F(1, 27)=7.19, p < .01, and F(1, 43)=4.99, p < .01, respectively. This suggests that for each of Areas I, II, and III pretreatment scores were significantly different from post treatment scores. In each area follow-up univariate F tests to determine significant within subjects main effects were conducted, and all were significant as is reflected in Table 1. The results from the three MANOVA analyses permitted the data from Cohort 1 and Cohort 2 to be aggregated as is reflected in Table 1.

In summary, all interactions and main effects for Cohort were non-significant, indicating that there were no differences between the two cohort groups. Within subjects repeated measures factors (Time: pre-treatment, post-treatment), however, were significant, indicating that there are statistically significant differences from pre-treatment to post-treatment for the Emmaus Community treatment sample. Mean scores for the LSS, Area I, II, and III decreased from pre- to post-treatment. This indicated a statistically significant reduction in psychological distress and clinically meaningful improvement for those participants in the Emmaus Community program.

DISCUSSION

Results of the study yielded both statistically significant and clinically meaningful results which support the treatment efficacy of Emmaus Community. Specifically the LSS scores of participants reflected a significant pre- to post-treatment decrease which in the aggregate went from the status of distressed and in need of treatment to not distressed and therefore not in need of treatment. Supporting the efficacy of the program are additional results which revealed significant pre-treatment to post-treatment decreases in participants' experience of distress in 12 areas, a significant pre to post increase in satisfaction with relationships across a spectrum of arenas, and a significant pre to post increase in participants report of receiving and giving various affective states.

Although randomized assignment for treatment did not occur in the study, several factors lend support to our results and minimize the probability of internal threats to validity, (history, maturation, or statistical regression) as alternate explanations for our results. First, the use of a cohort group mitigates against history as an rival explanation because the same event would have had to occur twice if it were to explain the superior psychological adjustment scores of Cohorts 1 and 2 at post-treatment, compared to pre-treatment.

Second, Haberman's (1965) results from a no treatment test-retest sample argue against maturation as an explanation of our results. Using the LSS he assessed and reassessed with a three-year interval, and reported test-retest mean scores of 3.4 and 3.6 which were not significantly different. If maturation was an explanation for our results then his retest scores should have been significantly lower.

Third, it does not appear that statistical regression adequately explains our results despite the fact that pre-treatment scores were high. For regression to be supported, post-treatment scores should have regressed to the mean for the scale which is generally reported in the range of 3.3 to 3.6. Rather, our post-treatment means were 2.04 and 1.93 for Cohorts 1 and 2 respectively (1.97 total sample). These post-treatment scores are clearly regressed well beyond the mean of the scale. Interestingly, the variance of the pre and post scores reflects considerable homogeneity and reduced variance, again supporting the efficacy of the Emmaus treatment program.

The foregoing results support the efficacy of the Emmaus Community program; however, they do not address what aspects of the program may contribute to its success. Previous research (Borrine and Handal, 1989) addressed this issue. Participants rated the level of experienced helpfulness of each program component, both required and optional, on a 6-point scale ranging from 1 = very helpful to 6 = harmful. The results indicated that all three required program components, namely, a weekly session with a director, participation in twice weekly small groups with staff members, and participation in the large community meetings were rated 1.04, 1.31, and 1.25 respectively. Optional components that were rated below 2 included interaction with community members, intercongregational living experience, staff as community members, presence of a house manager, unstructured time, house celebrations, holiday at Emmaus Community, emphasis on self determination, emphasis on goal setting, emphasis on affirmation, and numerous others. The fact that participants in this program lived together in an intercongregational religious community in which the staff of the program, with the exception of the director, also resided appears to be a critical component contributing to the efficacy of this program. It appears that providing a residential treatment program with-in the context of an ongoing religious community provides a consistency of experience that is congruent with participants' life in their own religious communities at the local level. This allows for the experience of life in a local community as well as an exposure to, and practice with, new ways of dealing with emerging issues. This, coupled with the fact that each of the required program components address life in the arenas of individual behavior, dyadic behavior, and large group or community behavior appear to be salient dimensions since they are the same dimensions that provide the lived experience of individuals in religious life.

The fact that participants were living in a religious community along with staff members allowed for the lived experience of authority, accountability, and responsibility to operate. While staff were not named as superiors within the community, by virtue of their staff position, they were perceived by residents as having some additional leadership and authority compared to participants in the program. This permitted individuals participating in the program to experience a different kind of exercise of authority in that participants were asked to be wise in making their decisions and to be accountable to one another as well as the community for their decisions.

While other residential treatment programs for individuals in religious life are residential in nature, they do not entail the ongoing lived experience in the context of a religious community. Rather, participants in these treatment programs reside in a facility in which the treatment occurs but, they do not live a shared religious community life. In addition, Emmaus community systematically collected pre and post treatment data with a view toward evaluating the effectiveness of the program and disseminating the efficacy information to participating congregations. At least at this point, it does not appear that other residential treatment programs are disseminating efficacy data and, it is unknown whether they are systematically collecting such data.

The results of this study demonstrated that the Emmaus Program had statistically significant as well as clinically meaningful results in terms of the participants. Based on their LSS scores they entered the program distressed and in need of treatment and exited the program not distressed or in need of treatment. These effects were supported by the additional findings that significant improvement also occurred in terms of participants satisfaction with relationships across a broad spectrum of arenas ranging from peers to authority figures. Additionally, significant decreases in distress occurred across a range of arenas ranging from family through ministry to congregation and local community relationships. Finally, participants reported a greater capacity to express emotions to significant groups ranging from peers to superiors as well as to receive affective comments and responses from these groups. Overall, our findings indicate that the Emmaus Community program was effective across a broad range of functioning for the participants.
Table 1 Means and Standard Deviations of Emmaus Participant Variables
Before and After Treatment. Divided into Cohorts for Comparison
Analyses, and Univariate Follow-up F Values.

Variables Cohort 1 Cohort 2
for Pre-Post Pre-test Post-test Pre-test Post-test
Data Mean SD Mean SD Mean SD Mean SD

Area I: Areas of Distress and the Frequency of Distress (12)
Psychological 3.60 .76 1.35 .49 3.22 .91 1.43 .59
Family
 Relationships 3.12 .83 2.19 1.10 2.57 1.06 2.35 1.04
Religious
 Congregation 3.23 .65 1.84 .69 2.98 .85 2.11 .86
Local
 Community 3.38 .70 1.96 .86 3.23 .71 1.90 .87
Ministry 3.12 .53 1.87 .97 3.50 .78 1.74 .86
Interpersonal 3.38 .64 1.69 .88 3.31 .79 1.89 .72
Decision
 Making 3.62 .75 1.35 .63 3.22 1.04 1.66 .81
Coping with
 Stress 4.04 .72 1.62 .70 3.74 .86 1.77 .72
Prayer Life 3.26 .86 2.20 1.08 3.18 .81 2.15 1.14
Religious Life
 Commitment 2.68 .72 2.13 1.12 2.46 .88 2.20 1.10
Sexuality 3.08 .81 2.46 1.14 2.70 .94 2.25 1.10
Physical 2.08 1.11 2.45 1.24 2.76 .99 2.35 1.04
Langner
 Symptom 6.04 3.65 2.04 1.40 4.74 3.63 1.93 1.81
Survey

Area II: Quality of Relationships (10)
Closeness to:
 Peers 2.23 .71 1.58 .58 2.29 .81 1.78 .59
 Superors 2.38 .80 2.00 .57 2.46 .78 2.20 .65
Satisfaction with:
 Ministry 3.62 1.27 1.56 .76 3.10 1.45 1.90 1.02
 Local
 Community 2.58 .99 1.61 .50 2.39 .97 1.77 .58

Satisfaction with Relationships in Local Community
 Peers 2.73 1.08 1.57 .59 2.73 .97 1.90 .55
 Authority 1.88 .82 1.54 .59 2.24 .95 1.59 .55
 Authority in
 Congregation 3.50 1.36 2.08 1.32 3.27 1.27 2.02 .66
Quality of Relationships at Work:
 Peers 3.00 .69 2.0 .76 2.70 .97 1.84 .93
 Authority 2.92 .86 1.65 .59 2.88 .84 2.00 .62
 Those Served 2.38 .80 1.72 .68 2.59 .92 2.22 .59

Area III: Expression and Reception of Emotions (22)
Anger Expression:
 Peers 3.58 1.03 2.27 .53 3.07 .89 2.54 .72
 Superiors 3.96 .92 2.46 .71 3.30 1.05 2.75 .77
Reception
 Peers 3.58 .95 2.46 .71 2.96 1.03 2.40 .58
 Superiors 3.77 1.14 2.58 .76 3.14 1.06 2.73 .62
Love Expression
 Peers 2.54 .81 2.04 .77 2.63 .80 2.13 .69
 Superiors 2.85 .88 2.15 .88 2.98 .79 2.47 .76
Reception
 Peers 2.58 .90 1.92 .63 2.46 .81 2.02 .58
 Superiors 2.69 .84 2.00 .75 2.73 .87 2.29 .69
Criticism Expression
 Peers 3.42 .86 2.46 .58 3.4 .85 2.65 .67
 Superiors 3.65 .94 2.65 .69 3.39 .93 2.84 .71
Reception
 Peers 3.50 .81 2.35 .63 3.26 .80 2.48 .59
 Superiors 3.50 .91 2.54 .76 3.20 .99 2.69 .63
Fear Expression and Ability to Respond to:
 Peers 3.38 .80 2.12 .77 2.93 .83 2.30 .66
 Superiors 3.42 .86 2.19 .75 3.04 .889 2.44 .72
Anxiety Expression and Ability to Respond to:
 Peers 3.35 .880 2.12 .71 2.96 .79 2.43 .65
 Superiors 3.46 .86 2.23 .65 3.17 .85 2.53 .66
Ambiguity Expression and Ability to Respond to:
 Peers 3.54 .81 2.46 .81 3.22 .87 2.76 .71
 Superiors 3.62 .75 2.62 .85 3.43 .96 2.84 .74

Variables Total Sample F Test, p Levels, & df
for Pre-Post Pre-test Post-test for Pre-Post Data
Data Mean SD Mean SD df (1,37)

Area I: Areas of Distress and the Frequency of Distress (12)
Psychological 3.36 .87 1.40 .55 136.71 **
Family
 Relationships 2.78 1.01 2.29 1.06 8.08 **
Religious
 Congregation 3.07 .79 2.01 .81 37.95 **
Local
 Community 3.29 .70 1.92 .86 45.65 **
Ministry 3.35 .72 1.79 .90 60.24 **
Interpersonal 3.34 .74 1.81 .79 55.15 **
Decision
 Making 3.37 .95 1.54 .76 84.13 **
Coping with
 Stress 3.85 .82 1.71 .71 84.13 **
Prayer Life 3.21 .83 2.17 1.11 143.57 **
Religious Life
 Commitment 2.85 .91 2.33 1.10 37.09 **
Sexuality 2.85 .91 2.33 1.11 6.08 *
Physical 2.81 1.03 2.39 1.11 4.83 *
Langner
 Symptom 5.21 3.67 1.97 1.66 3.99 **
Survey

Area II: Quality of Relationships (10)
Closeness to:
 Peers 2.21 .77 1.71 .59 24.57 **
 Superors 2.43 .78 2.13 .63 7.76 **
Satisfaction with:
 Ministry 3.29 1.39 1.77 .97 37.62 **
 Local
 Community 2.46 .97 1.71 .55 15.90 **
Satisfaction with Relationships in Local Community
 Peers 2.73 1.01 1.78 .58 41.17 **
 Authority 2.11 .91 1.57 .56 10.79 **
 Authority in
 Congregation 3.36 1.30 2.04 .94 49.28 **
Quality of Relationships at Work:
 Peers 2.82 .88 .90 .87 34.34 **
 Authority 2.90 .85 1.88 .62 43.00 **
 Those Served 2.51 .88 2.04 .66 11.97 **

Area III: Expression and Reception of Emotions (22)
Anger Expression:
 Peers 3.25 .97 2.44 .67 46.97 **
 Superiors 3.54 1.05 2.66 .75 61.37 **
Reception
 Peers 3.18 1.04 2.42 .62 31.65 **
 Superiors 3.38 1.13 2.67 .68 33.46 **
Love Expression
 Peers 2.60 .80 2.10 .72 15.73 **
 Superiors 2.93 .82 2.35 .81 24.60
Reception
 Peers 2.50 .84 1.99 .59 19.31 **
 Superiors 2.71 .85 2.18 .72 23.21 **
Criticism Expression
 Peers 3.31 .85 2.58 .64 41.71 **
 Superiors 3.49 .93 2.77 .70 37.88 **
Reception
 Peers 3.35 .81 2.43 .60 73.39 **
 Superiors 3.31 .96 2.63 .68 34.72 **
Fear Expression and Ability to Respond to:
 Peers 3.10 .84 2.24 .70 43.92 **
 Superiors 3.18 .89 2.35 .74 59.52 **
Anxiety Expression and Ability to Respond to:
 Peers 3.10 .81 2.32 .69 33.24 **
 Superiors 3.28 .86 2.42 .67 56.98 **
Ambiguity Expression and Ability to Respond to:
 Peers 3.33 .86 2.65 .75 28.20 **
 Superiors 3.50 .89 2.76 .78 33.06 **

**=.01 *=.05


REFERENCES

Borrine, M. L., & Handal, P. H. (1989). Emmaus Community: A preliminary investigation of a treatment facility for religious women. Journal of Pastoral Counseling, 24(2), 122-134.

Cochrane, R. (1980). A comparative evaluation of the symptom rating test and the Langner 22-item index for use in epidemiological surveys. Psychological Medicine, 10, 115-124.

Cummings, M. J., Handal, P. J., Mink, S. H., & Mink, W. D. (1979). Derham Community. Journal of Pastoral Counseling, 14, 46-57.

Eaton, W. W. (1978). Life events, social supports, and psychiatric symptoms: A re-analysis of the New Haven data. Journal of Health and Social Behavior, 19(June), 230-234.

Edwards, D. W., Yarvis, R. M., Mueller, D. P., Zingale, H. C., & Wagman, W. J. (1978). Test-taking and the stability of adjustment scales: Can we assess patient deterioration? Evaluation Quarterly, 2(2), 275-291.

Haberman, P. W. (1965). An analysis of retest scores for an index of psycho-physiological disturbance. Journal of Health and Human Behavior, 6, 257-260.

Langner, T. S. (1962). A 22-item screening score of psychiatric symptoms indicating impairment. Journal of Health and Human Behavior, 3, 269-276.

Manis, J. G., Brawer, M. J., Hunt, C. L., & Kercher, L. C. (1963). Validating a mental health scale. American Sociological Review, 28(February), 108-116.

Rappaport, J. (1977). Community psychology: Values research and action. New York: F-loft, Reinhart and Winston.

Srole, L., Langner, T. 5, Michael, S. T., Opler, M. K., & Rennie, T. A. (1962). Mental health in the metropolis: The Midtown Manhattan study. New York: McGraw-Hill.

PAUL J. HANDAL, CHRISTLNE RANKLN, AND FRANK H. GILNER

Saint Louis University

AUTHORS

HANDAL, PAUL, J. Address: Saint Louis University, Psychology Department, 221 North Grand Ave, Saint Louis, MO 63103. Title: Professor of Psychology. Degrees: BS, MS(R), PhD, Saint Louis University. Specializations: Clinical Psychology; community psychology and primary prevention; religion, spirituality, religious coping and their relationship to positive and negative psychological adjustment; perceived conflict, conflict avoidance, and conflict resolutions and their relationship to positive and negative psychological adjustment.

RANKIN, CHRISTINE MARIE. Address: Saint Louis University, Psychology Department, 221 North Grand Ave, Saint Louis, MO 63103. Title: Independent Practice. Degrees: BS, MS(R), PhD, Saint Louis University. Specializations: Clinical Psychology; effectiveness of interventions with individuals diagnosed with Asperger's Disorder.

GILNER, FRANK H. Address: Saint Louis University, Psychology Department, 221 North Grand Ave, Saint Louis, MO 63103. Title: Professor of Psychology. Degrees: BS, MA, PhD, Purdue University. Specializations: Clinical Psychology, assertion training, self esteem therapy, cognitive behavior therapy.

Correspondence concerning this article may be sent to Paul Handal, PhD, Saint Louis University, Department of Psychology, Shannon Hall 212, 3511 Laclede, St. Louis, MO 63103. Email: handalpj@slu.edu
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Article Details
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Author:Gilner, Frank H.
Publication:Journal of Psychology and Theology
Geographic Code:1USA
Date:Dec 22, 2004
Words:5702
Previous Article:A multivariate theory of God concept, religious motivation, locus of control, coping, and Spiritual Well-Being.
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