Page 192 - Creating Spiritual and Psychological Resilience
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“To Do No Harm” Spiritual Care and Ethnomedical Competence   161


                 expectations  and  unsubstantiated  assumptions  (Norris  &  Alegría,
                 2006; Vega, 1992).
               3. “Attempts from outside Aceh to ‘train’ various community leaders in
                 how they might respond to widespread psychological distress at a com-
                 munity level, using western constructs of community reconstruction
                 and development, may be misguided and will probably be unwelcome”
                 (WHO, 2005, p. 4).
               4. “Standardized instruments are useful for evaluating outcomes in rela-
                 tion to standard psychosocial interventions, but they may not encompass
                 local constructions of mental distress, reasons for seeking traditional
                 healing, or definitions of successful treatment, which may be grounded
                 in spiritual cosmologies” (Patel, Kirkwood, & Weiss, 2005).
               5. A Sri Lankan academic, Janaka Jayawickrama (2006), offers this analy-
                 sis: “… unplanned and uncoordinated humanitarian assistance without
                 a clear vision may create as much distress as the disaster. To catego-
                 rize affected communities as ‘traumatized’ and in need of psychologi-
                 cal or psychosocial support—and on the basis of assumptions that owe
                 nothing to the voices of the people themselves—is to miss important
                 opportunities to provide humanitarian assistance that will be valued by
                 recipients.”

              Clearly, spiritual care interventions are vulnerable to the above pit-
            falls, especially if the field of spiritual care pursues generalizability and
            protocol-driven  interventions.  If,  however,  spiritual  care  aligns  itself
            appropriately with local traditions and holistic healers—while evolving
            practice norms—it can stimulate highly relevant IPR, while minimizing
            harm. With this in mind, what follows are relevant recommendations
            from different sources:


                   Box 3: rECommEndations for utilizing rEligious,
                     spiritual, and traditional ViEws in disastEr


               1. The religious construction of meaning surrounding the disaster may
                 mean that efforts to deal with psychological and social consequences
                 of the disaster in ways that are not consonant with such religious and
                 cultural values and beliefs (e.g., trauma-focused counseling, psychiatric
                 approaches) will be both ineffective and unacceptable. (WHO, 2005)
               2. Authors  Carballo,  Heal,  and  Hernandez  (2005,  p.  398)  observed
                 improved resilience in tsunami-affected populations utilizing spiritual
                 grounding and religious leaders. They suggest the following: “Some of
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