6 MINUTE READ

From Luke’s Journal October 2023  |  Vol.28 No.3  |  Mental Health I

Introduction

The Saline Process, owned by IHS Global, has been running in Australia since 2009. It has been taken up by the Christian Medical and Dental Fellowship of Australia (CMDFA), Nurses Christian Fellowship of Australia (NCFA) and Healthcare Christian Fellowship of Oceania (HCFO). There is a network of teachers across Australia who have trained 900+ Australian healthcare workers.

Traditionally, the Saline Process is presented as a full-day course. There is also an established one-hour Saline Taster to introduce people to the concepts of spiritual health in clinical care. This Saline Taster Workshop is a hybrid of these, lasting two hours and giving the opportunity for learning and practising skills in spiritual history-taking. It was hoped that this format would encourage people to attend a full-day course, whilst acknowledging that time pressure is an obstacle for some.

Report

This Saline Taster Workshop was organised by Dr Catherine Hollier of Christian Medical and Dental Fellowship Australia (CMDFA) and Georgie Hoddle RN (NCFA). It was attended by eight people from diverse disciplines. Attendees included two registered nurses, a paediatrician, an obstetrician, a GP, a relational therapist, a social worker, and a speech pathologist.

The standard set of twenty slides approved by IHS Global for a Saline Process Taster were presented within the context of a workshop in which attendees were invited to discuss the content of the slides and participate in four activities. The worksheets had been used previously after approval by the NCFI Saline Process Coordinator and IHS Global.

There were many interactive moments and lively discussion, and all attendees completed their worksheets. Three of the four activities were compiled on paper. The third activity involved role plays taking a spiritual history.

Activity 1:
The Context was personalised by each attendee and built on during the Taster.

The usual figure of the case study “John” had been redesigned to be contextually appropriate to non-hospital healthcare settings. The information provided to attendees, (originally the fruit of discussion during Saline Scenarios* 2023) was elaborated on appropriate to each attendee’s context. 

Patient/Client/Friend’s journey	Case facts	Related activity	Discussion focus
e.g. ANXIETY GP referred to MH clinic Reactive? Establish boundaries Regulation	Stay broad NOT SPECIFIC eg. borderline personality disorder (BPD), etc.	Supportive action in taking a spiritual history and support network. AHPRA Guidelines.	Type of mental health issue: – be cautious. – requires. experience. – delicate. – see the literature.
Additional scenarios	proposed by participants: (summary of sheets)
Pt with a panic attack.	Chest pain / SOB / palpitations /parathesia Hx. anxiety/depression Situational stress from home/work. undergoing a procedure or given a concerning diagnosis
Paediatrics Child 1: anxious parents/parental concern. Child 2: anxious/ family complexity. Anxious parent: single with young child.	– stability at home? Are their needs being met? – Diagnosis? Do they require meds? Psychosocial circumstances?	– minimal supports but proactive.
GP referred pt with reactionary anxiety.	Lives with her daughter and is always anxious that something will happen to her.
Woman in late twenties with one child and a chaotic life.	Chronic pelvic pain with multiple laparoscopies. Requesting a hysterectomy. Works as a ***. No joy in the public system. Mother will pay for surgery privately.	Some spiritual background.
Relational therapy Anxious couple – reactive fight and flight.	Lack of intimate connection. See each other as the enemy. Get caught up in assumptions misreading each other. Lack of healthy relationships. Family breakdown.	Ask if we can do breathing and meditation exercises.
Social work Social anxiety/depression but looking to re-integrate.	Talking as a self-defence. Requiring one specific social worker to leave the house.	Seeks validation and connection.	Borderline personality disorder?

Comments from the attendees (summarised)

Activity 2:
Demonstration of Barriers

After the specific slides had been presented a lengthy discussion amongst the attendees followed. 

The EMOTIONAL barriers could involve anger, fear, anxiety, hostility, and frustration. The patient may not want to press on with the idea as they may be already going through a lot and may look at this in a negative light. There could also be mistrust and disconnection with low self-esteem (“Why should Jesus care about me?”). They could also be embarrassed.  The patient could be lonely (“Jesus can’t give me connection”) and also angry (“If he cares, why doesn’t he help me out?”). “Pain is causing all my problems!” The patient may have suffered trauma, negative health/faith, relationship, and life experiences as well as past injustices.

The INTELLECTUAL barriers involve disbelief, suffering, the meaning of life and priorities, ignorance, misconceptions and erroneous beliefs. The patient could be atheist, have cultural taboos or consider faith matters outside of expectation of the health model. There may be other concerns they feel are greater, as well as other beliefs. Different world views/beliefs lead to questions such as, “Does God even exist?” or “Why would he make me this way?” The patient may say they know what is best for them.

The patient may not be aware (or yet had their minds opened by the Holy Spirit) of evidence of the Bible. They could also have an intellectual/developmental disability.  They may not understand what is being said and perceive the message in a different way.

There may be a lack of spiritual/emotional/religious language and understanding. Spiritual experiences may seem foreign. They may be side-tracked by rights vs responsibilities.  They may believe that a hysterectomy will solve all their problems!

VOLITIONAL barriers were identified as a patient not willing to consider faith matters – perhaps they have had a negative past experience with religion. One attendee saw this barrier as related to emotional barriers and a need for control and certainty.  There is generally societal hostility towards Christianity.

“I know what I need!” might be their attitude, maintaining a continued desire to serve self. They may be worried about “What will I be giving up to follow Jesus?”

Patients may be afraid of changes that need to happen after already giving so much or have an unwillingness to change. They may be bound by social and practical pressures, or focussing on other priorities such as their physical ailment and the reason they attended hospital.   They may have time and life pressures.

Activity 3: 
Spiritual assessment with FICA was presented and teams of 2 and 3 role-played the interview.

Each attendee had the opportunity to act as themselves and also role-play being the patient.  Appreciation of active practice in taking a spiritual history was evident by the enthusiastic participation.

Activity 4:
Faith flags and faith stories

Worksheets were returned by most participants after an in-depth discussion post slide presentation. Some faith stories are very personal.

Conclusion

The Saline Taster Workshop was very well received by all participants. This two-hour option made it possible for a married couple (both involved in healthcare) to organise baby-sitting and to attend together. One participant went on to join the next full-day training course in Sydney a few months later. Two participants had attended the full-day course previously but appreciated an update on the changed standards of medical care and also a refresher of spiritual history-taking.  All participants agreed that the opportunity to hear from a wide range of experiences and the chance to learn and practise spiritual history-taking were invaluable.  The trainers were encouraged to present this to IHS Global as a further option for training.

*Saline Scenarios run for an hour on the first Wednesday of every month from 8.30pm. Zoom details can be requested from Georgie Hoddle: ncfa.salineprocess@protonmail.com

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