Spiritually and religiously oriented health interventions.

Controlled intervention studies offer considerable promise to better understand relationships and possible mechanisms between spiritual and religious factors and health. Studies examining spiritually augmented cognitive-behavioral therapies, forgiveness interventions, different meditation approaches, 12-step fellowships, and prayer have provided some evidence, albeit modest, of efficacy in improving health under specific conditions. Researchers need to describe spiritual and religious factors more clearly and precisely, as well as demonstrate that such factors independently influence treatment efficacy. Inclusion of potential moderating and mediating variables (e.g. extent of religious commitment, intrinsic religiousness, specific religious coping strategy) in intervention designs could help explain relationships and outcomes. Using a variety of research designs (e.g. randomized clinical trials, single-subject experimental designs) and assessment methods (e.g. daily self-monitoring, ambulatory physiological measures, in-depth structured interviews) would avoid current limitations of short-term studies using only questionnaires.