Like any family, the Christian Church, whether a Catholic parish, or Non-Denominational congregation all have unique talents and gifts within the individuals who participate in the life of the church. Whether these gifts are spiritual, or financial, or in organization, they all bring special aspects to properly function from both material and spiritual parts. Since the dawn of Pentecost, the Apostles set forth and founded Christian communities and Churches throughout the Roman Empire. The apostles organized these small Christian churches with guidelines and blue prints to function both physically and spiritually. In the spiritual sense, the Church collectively was seen as the Body of Christ, Christ the head and all baptized believers various members of the body with different functions. Ecclesiastically, the presbyters and deacons played a key role in local communities, answering to apostles and disciples who founded the various churches. These communities were diverse depending on their location within the Roman Empire but all shared one common faith.
The Christian Church is like any family that has spiritual and temporal needs. Good Christian leaders can help guide and unite them
Like today, those communities came together to celebrate the Eucharist, share Christian values and spread the word of Christ. Yet also like today, they shared in their own local issues. They too had to get along with each other and many differences did arise. For instance, the issue of circumcision for non-Jewish converts was a hotly debated church issue that divided even Peter and Paul. Yet, all these issues were usually resolved with Christian charity despite grave differences of opinion.
Today, many churches have missions and goals and ideas how to best serve Christ, but within the local church exists numerous opinions that sometimes come at odds with one another. This can lead to un-Christian behaviors and sometimes division within the Church. It can lead to resentment, frustration, isolation and division between members. In some ways the local church can become a club where others wish to be heard or seen more than others or push their agendas above others. In fact, many “religious” individuals may be very well superficial in faith and look more for human favor among the members that serves their own egos rather than serving Christ. Others may have an agenda and that agenda while good may consume them and when rejected by others become a personal slight. Hence the church while serving a spiritual goal and agenda can and does become a political and social club many times. Some may wish simply to show up Sunday and be done with the church politics, while others may find church social life rewarding, but it is important to treat the church not as a social club or a place to be seen but instead as a supernatural unit dedicated to spreading the Gospel. Sometimes financial discussions and social discussions are needed and can raise temperatures of individuals in debate on how funds should be allocated, but ultimately, the primary goal and mission statement of any church is to spread the Gospel and when that spirituality is lost, then the church might as well become a social hall than a spiritual organism.
On a larger scale, other issues may also look to divide the faithful. Politics can be a very divisive tool used by Satan. Only moral issues in the public sphere should be discussed within the Church, such as abortion or marriage laws. Support of a particular candidate or shunning others of a different political thought or party has no place within the Church. Christ clearly divided Caesar and God and so does the United States constitution. The Church as a tax exempt organization should never show support for any party or politician nor dismiss others who disagree with the majority. Politics has no place in any church and can be a poison to the unity and spirituality of the Church.
In addition, theological issues can divide the faithful. Issues of a woman’s role in the Church, homosexual marriage and rights, and other theological issues and differences on interpretation of Scripture can divide members. It is important to maintain the creed of Christ, the Bible and dogma of the Church, but there is also in some cases wiggle room for more conservative and liberal members to give and take on current church law or human made institutions. What is most dangerous is when one openly rejects a tenet of the faith or when one becomes so self righteous as to condemn others. The pastor or priest must play the role of mediator and teacher in these instances
Even within spiritual discussions human ego can emerge. Arguments over liturgical music, or how a ceremony should be organized or what date can all play roles for more church politics. In essence, everyone sometimes wants to be heard, seen, or approved. When these things do not occur, then the inner arguing and jealousies can emerge much to Satan’s delight. Unfortunately, this is human nature and will almost always occur. Pastors, ministers, priests, and leaders within the congregation all have to manage these emotions as the early apostles did. The first step always is remembering the spiritual goal and mission statement first and harboring a strong spirituality to weed out those who are there for themselves instead of God.
Because of divisions, human arguments and bad behaviors it is important to set forth guidelines for meetings. It is also crucial to set forth proper meeting agenda rules, schedules and formats to maximize time. This involves articulate communication skills, as well as organization. Those with ideas should be respected and listened to with empathy and charity. When differences arise, the commonality of Christ and the grace of the Holy Spirit should guide the conversation. Whether it is budget or liturgical music selections, every conversation in meetings should be monitored and regulated to avoid over speaking of each other and insults. Again, the Church is also a spiritual place and it should reflect the early apostles in their spirit of spreading the Gospel whether in different ways or not. This involves basic skills of communicating, listening and showing respect. Ultimately the success of these meetings or events relies heavily upon the leadership of the Christian leader.
Christian Leadership and Mission Statements and Goals of the Church
It is important to return to the goals of the church which is bring Christ to the world. Mission statements may be worded differently but each church serves a spiritual purpose to make the world a better place. The church while physical on earth is also spiritual. The Church Militant on earth serves to spread the Gospel and to share the truths of Christ through the sacramental life of the Eucharist. When these goals and mission statements are lost, then the church can become more temporally orientated. This is not to say festivals, or fund raisers or social picnics are not wonderful things to bring the community together, collect funds for the church and poor, as well as pay the bills to keep the lights on, but it when these things become so much that they cloud the goal and mission statements of the church, then the spirituality of the faith can be damaged. This is where more secular minded members thrive with festivals and games and fund raisers. Some may be good financial advisors and serve the church economically well but others may only see this social status.
The Christian leader, pastor or priest answers sometimes a lonely call that demands many qualities to properly lead the church
What gets lost in this? Food drives, collections for the poor, counseling services, marriage and divorce support, spiritual events, prayer groups, and other ministry based projects. How many more are concerned with the social outings than the spiritual meetings of prayer? A parish or local church’s spiritual life is correlated with its spiritual practices. Within Catholic parishes, are groups more concerned about Bingo or the festival, or more so about Eucharistic adoration, prayer, or food drives? Does the Church pride itself on the size of its festival and how much collected each week, or on its outreach programs to the local poor as well as services to guide the youth, troubled, grieving and promotion of theological education?
Christianity is not just a singular religion but a social one. It involves interaction and giving back to the Body of Christ. Even the most spiritual saints understood they could not escape the cry of the Christian population. Those close to Christ always find themselves returning to the people and finding Christ in them as well. Hence those in Christian leadership are critical to controlling the secular impulses of the congregation as well as regulating emotional outbursts and petty jealousies. While one would assume Christians would already adhere to a particular ethical rule of business as treating each other as Christ, this is hardly the reality. So sometimes it involves laying forth a set of rules and ways Christian people conduct church or parish meetings. This involves starting all meetings with prayers and blessings that look to dismiss hubris, to focus on the necessary temporal but understand the greater importance of the spiritual goals and missions of the church. It involves carving out a Christ like description of meeting rules which shows mutual respect, understanding, nonjudgement and empathy to fellow parish members. It involves setting forth a way committees treat each other as well as dismissing bullying or other forms of harassment.
When leadership is lacking and events or meetings occur, it can sometimes seem like a club meeting or a job with individuals who need authority somewhere in life and finally find it in the wrong place, namely the church.
So one must turn to the early Church and apostles as examples of best leadership. A Christian leader understands his/her own limitations and finds the charisms and talents within the congregation to aid the growth of the church. The Christian leader is able to take criticism with humility, bridge diverging opinions, bring the best out of others and encourage others in Christ. A Christian leader is humble and understands the first will be last in heaven. While utilizing authority when needed, the Christian leader is gentle and compassionate in decisions. The Christian leader leads by example not commands. Like Christ, the Christian leader “washes” the feet of the “apostles”. The Christian leader embodies service, shepherding, stewardship while exhibiting humility. A Christian leader in many ways is called by Christ to lead. It is a sacred vocation accepted by the congregation.
However, within any church or parish, it is essential to respect authority. The Church has never been a true democracy within itself. There has always been a emphasis on spiritual authority. When spiritual authority is disregarded or a church leader dismissed, then there is no shepherd for the flock. Every flock needs a leader and respect to that authority is essential. Unfortunately, due to scandal and abuse, many have lost faith in leadership within Christian Churches. Only through good example and accountability can this authority again earn respect. Because of this, the Christian leader is also called to the highest standards of ethical and moral behavior. The Christian leader is not sinless, but strives to give the best example as possible. The Christian leader hence needs mutual support from other leaders. Confession, or counsel should come from other trusted mentors or fellow leaders to help one with self care, spirituality and possible times of desolation. Christian leaders continue to learn, study and focus on spirituality and discernment of the fulfillment of their calling.
Conclusion
The Church is a dynamic organism. Within Scripture, it is a living body with Christ as its head. It involves those on earth and those in heaven, who collectively work together as one body. This spiritual calling is primary but due to temporal existence the church is also a building that needs upkept. Finances emerge. Festivals and fun outings need planned. But when these things overshadow the mission statement and goal to spread Christ to the world and share and enhance each others spirituality, then the church can lose its spiritual identity.
Please also review AIHCP’s Christian Counseling Certification
Within the Church, like any family, there will exist divisions and arguments, but they need to be maintained in a charitable way with rules and regulations. Christian leaders are more than priests and pastors but also organizers and communicators. They not only preach and heal, but also lead and unify. It is essential despite differences in theology, meeting disagreements, or event planning that the Christian communities work together and constantly behave with Christian charity with one another. Ultimately Church is not a social club to be seen or heard or abuse authority or demean others, but a place to grow together in Christ and spread the Gospel. This involves humility, charity and prayer in all Church gatherings.
Please also review AIHCP’s Christian Counseling Certification and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification. The program is especially beneficially for training of ministers and clergy or professionals within the church community who are looking to offer basic spiritual direction and counseling services at a non clinical level.
Additional Resources
Tenny-Brittian. “The Effective Church Group”. Access here
Neffiner, V. (2019) “Here Are 8 of the Most Controversial Issues in the Church Today”. Crosswalk. Access here
“20 ways to prevent and resolve conflict in the church” (2023). NC Baptists. Access here
Perry, T (2020). “Effective Christian Leadership for Today: Key Aspects, Stages & More”. Access here
Faulkner, B. (2024). “7 Biblical Models of Leadership”. LifeWay. Access here
Sometimes emotions get the best of individuals. Individuals may be overwhelmed, dealing with multiple stressors or losses, overworked, or dealing with anxiety and stress. These individuals may finally hit the final straw and face an occurrence known as emotional flooding. First coined by John Gottman, this phenomenon can occur in workplaces, at home between couples and also between parents and children.
Emotional Flooding can occur when someone is overworked, over stressed and not getting enough self care. Please also review AIHCP’s Anger Management and Stress Management programs
Emotional Flooding can lead to an outburst or even a withdraw. The individual loses ability to communicate rationally and becomes emotionally overcome. This is quite similar to Fight or Flight responses, where the individual is put into a survival mode situation. Obviously, emotional flooding can lead to drastic problems in relationships, mental health and legal situations especially in cases of anger. It is hence important to utilize both Stress Management and Anger Management skills to help one face emotional flooding situations and hopefully prevent it.
Who is More at Risk for Emotional Flooding Situations?
Individuals who already have high levels of stress and anxiety or various anxiety disorders. PTSD or depression have a higher risk of emotional flooding occurring, as well as those with border line personality disorders as well as attachment disorders. Traditionally, males more so than females also have greater chances of outbursts, but many females still experience the problem. Those with higher sensitivity issues are also more prone to becoming overcome with emotional flooding.
Emotional Flooding, like any stress response, is a fight or flight response that will either push the person to emotional react without rationale or retreat. With higher level of stress, the body will pump cortisol into the blood stream and one’s blood pressure and heart rate will increase, muscles will tighten to prepare the body for fight or flight moments. In addition, rapid breathing and shortness of breath may occur, with loss of focus and increased anxious states.
These types of lapses are obviously huge problems at work places, arguments between couples and when parents are dealing with unruly children. It is important to identify the triggers and symptoms, as well as understand one’s current level of stress to better prepare for a total flooding moment. Emotional Flooding hence has huge negative impacts on mental health, physical health and social life. This in turn leads to worst anxiety, poor decisions, broken relationships, legal issues, lost jobs and physical break down of health.
Dealing with Emotional Flooding
When facing and dealing with stress and anxiety, the first step is a good defense. Individuals need to identify stress loads and mental health issues. These need addressed and treated as needed to prevent a flooding moment. Those who sense burnout is approaching, need to address mental and physical health issues to better address stressors. In addition, individuals need to identify triggers that can set them off. Those who see life as all or nothing or catastrophize things also need to readdress and realign their mental outlook on life. Reframing can be a huge help to maintain a reasonable outlook when things go wrong or when one is over flooding with emotion.
Individuals who are facing emotional stress at a larger level hence need to take a good inventory of their life and their emotions. They need to practice self care and give themselves time to reflect. They need to set boundaries with others if too many things are overtaking them and they also need to find time to meditate, breath, or rest. In addition, when facing an outburst, it may be helpful to practice breathing exercises, or grounding techniques seen in PTSD where the individual uses physical touch or grabbing of an item to help keep connection to reality. It is important to identify triggers and emotions beforehand and to see how they can suddenly sabotage a person’s day. Thinking about reactions and practicing reactions when in a peaceful situation can also help reframe reactions. This is usually conducted in therapy.
When individuals lives begin to spiral out of control due to outbursts, then it is time to seek professional help. Individuals may begin to isolate, lose sleep, lose appetite, become depressed, or lose important relationships. Higher levels of anxiety may begin to creep into the person’s life and professional help may be required to help not only manage anger and stress but to also cognitively reframe reality. In addition, if dealing with higher levels of anxiety or depression, certain medications may be temporarily needed to help a person again find balance in life.
According to therapist Maggie Holland, “Emotional flooding can be an extremely overwhelming and intense experience, but help is available. By working through your triggers, learning to self-regulate, making healthy lifestyle changes, or working with a therapist, you can feel more confident when navigating difficult situations and emotions (2024)”.
Helping a Loved One through Emotional Flooding
Of course no-one should ever permit themselves to be emotionally and physically abused. It may sometimes be important to remove oneself from the situation. While trying to help others through emotional flooding issues, one can help the other person cognitively through supporting the person and understanding the condition and triggers. Focus, listening and empathy can help the person face the emotional surge. Avoiding quick judgement and feeding the anxiety is also key. One can help the loved one breathe and calm down by presenting a calm and caring voice.
Conclusion
Selfcare, identifying triggers and grounding can help one deal with emotional flooding. Please also review AIHCP’s Stress and Anger Management programs
Obviously Emotional Flooding can be acute or chronic with an individual. Some individuals are dealing with immediate stressors and overloaded while others may have anxiety, depression, PTSD, or Borderline Personality issues which would make the emotional breakdowns more common. Regardless, it is important to practice good Stress Management skills and Anger Management skills to avoid worse breakdowns during flooding. This involves identifying triggers, understanding one’s mental state and emotions, and grounding oneself. One can also practice self care, meditation, and set greater boundaries to prevent overload. With work, family life, partners and children at risk, it is critical to regain control of one’s life.
Please also review AIHCP’s Stress Management and Anger Management Certifications. The programs are online and independent study and open to qualified professionals seeking a four year certification. Many healthcare as well as behavioral healthcare professionals seek these additional certifications to enhance their work resume and specialty practices.
Reference
Holland, M. (2024) “Emotional Flooding: Definition, Symptoms, & How to Cope”. Choosing Therapy. Access here
Additional Resources
Gould, R. (2023) “How to Navigate the Storm of Emotional Flooding”. VeryWellMind. Access here
Romanelll, A. (2020). “Flooding: The State That Ruins Relationships”. Psychology Today. Access here
Malik. J. et., al. (2021). “Emotional Flooding in Response to Negative Affect in Couple Conflicts: Individual Differences and Correlates”. J Fam Psychol. 2020 Mar; 34(2): 145–154. Library of Medicine. Access here
“Expert Tips: How To Navigate And Overcome Emotional Flooding”. Mind Help. Access here
Salutogenesis instead of looking at negative stressors that cause stress looks at healthy ways to remain unstressed. It is a different approach to stress management and can a play key role in prevention for a better overall healthy life. Please also review AIHCP’s Stress Management Consulting Certification program and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification
Facing stress through healthier life styles and prevention. Please also review AIHCP’s Stress Management Consulting Certification
Holistic care in nursing represents a comprehensive approach to patient well-being, integrating physical, emotional, and spiritual aspects of health. This concept recognizes that healing and spirituality are interconnected, emphasizing the importance of addressing a patient’s entire being rather than solely focusing on physical symptoms. As healthcare evolves, there is growing recognition of the significance of spirituality in healthcare and its potential to enhance patient outcomes and overall quality of care.
Holistic Care in nursing involves recognizing the spirituality of patients and incorporating that into care
The integration of spiritual practices in nursing has become an essential component of holistic patient care. This approach acknowledges the diverse spiritual beliefs of patients and aims to provide spiritual care that respects individual perspectives. Nurses play a crucial role in this process, as they are often at the forefront of patient interactions and have the opportunity to address spiritual needs. To effectively implement this holistic care approach, nursing education must evolve to include training in spiritual care competencies, enabling nurses to better support patients’ spiritual health and growth within the broader context of holistic health care.
Spirituality in healthcare represents a multifaceted concept that has gained significant recognition in recent decades. As medical professionals strive to provide holistic care, there has been a renewed focus on integrating spiritual aspects into patient treatment. This shift acknowledges that until modern times, spirituality was often closely linked with healthcare practices. Those involved in pastoral care and care of the dying also need to have a strong understanding of the role of spirituality in patients.
Defining Spirituality
Spirituality encompasses a broad spectrum of human experiences and beliefs. It involves serving the whole person, addressing not only physical needs but also emotional, social, and spiritual aspects. This comprehensive approach to care recognizes that true healing often requires more than just treating physical symptoms.
Spirituality can mean different things to different individuals. For some, it may involve searching for meaning and purpose in life, while for others, it might be about finding the best relationship with themselves, others, society, or nature. It’s important to note that spirituality is not synonymous with religious beliefs, although for some people, it may involve religious elements.
Importance of Spiritual Care
Spiritual care has become an integral part of healthcare, particularly in palliative settings. Research has shown that spiritual wellbeing has important implications for an individual’s overall health and quality of life. Patients who receive adequate spiritual care often report higher satisfaction with their hospital treatment and care.
The benefits of addressing spiritual needs in healthcare are numerous:
Greater tolerance of physical and emotional stress
Improved management of illness
Lower levels of anxiety and pain
Reduced risk of depression and suicide
Enhanced coping mechanisms for dealing with disease and facing death
Conversely, unmet spiritual needs can have adverse effects on patient wellbeing, including reduced quality of life, increased risk of depression, and diminished perceptions of spiritual peace.
Spiritual Needs of Patients
Patients’ spiritual needs can vary widely and may change over time, especially when faced with a terminal illness. These needs might include:
Seeking meaning, purpose, and value in life
Desiring love and a sense of belonging
Searching for hope, peace, and gratitude
When diagnosed with a serious illness, patients may experience shifts in their spiritual needs. They might feel a sudden urge to repair broken relationships, deal with unfinished business, or reflect on the meaning of life more deeply than ever before.
Healthcare professionals play a crucial role in addressing these spiritual needs. By practicing compassionate presence and being fully attentive to patients, they can provide support for all aspects of suffering: physical, emotional, and spiritual. Obtaining a spiritual history and incorporating appropriate spiritual practices can be valuable tools in this process.
It’s essential to recognize that while patients primarily seek medical care for their physical conditions, healthcare providers can respectfully acknowledge and address the spiritual dimension of patients’ lives. This approach aligns with the growing emphasis on patient-centered care and the recognition that spirituality forms the basis of meaning and purpose for many individuals.
The Role of Nurses in Spiritual Care
Holistic care is beyond merely care of the body but also the mind and soul
Nurses and especially Holistic Nurses play a crucial role in providing holistic care, which includes addressing the spiritual needs of patients. Their unique position allows them to interact closely with patients throughout the day, making them ideally suited to assist with spiritual care. However, research suggests that nurses do not consistently engage in spiritual care or assess their patients’ spiritual needs, despite patients valuing such interactions. Many nurses are tried in pastoral care or other holistic modalities.
Assessing Spiritual Needs
Spiritual assessment is a vital component of nursing care. The Joint Commission requires healthcare organizations to conduct spiritual assessments upon patient admission. These assessments may include questions such as:
Who or what provides you with strength or hope?
How do you express your spirituality?
What spiritual needs can we advocate for you during this healthcare experience?
To improve the precision of spiritual assessments, researchers are developing new scales. Understanding the strengths, weaknesses, and theoretical bases of these instruments can provide a foundation for creating future measures and revising existing ones. The goal is to establish a manageable database of scientifically validated instruments that can be used according to individual patient needs.
Providing Spiritual Support
Nurses provide spiritual care through various means:
Therapeutic presence: By being fully present, especially when patients appear depressed or upset, nurses can offer comfort and support.
Unconditional acceptance and compassion: These qualities help patients find hope and meaning in their life experiences.
Active listening: This involves being attentive when talking, asking questions, and picking up on patient cues.
Facilitating expression of beliefs: Nurses enable patients to express their personal beliefs and support them in participating in their religious and cultural practices.
Addressing spiritual distress: Nurses should be prepared to provide spiritual care whenever needed, as spiritual distress may occur at any point during a patient’s journey.
Despite the importance of spiritual care, nurses often face challenges in delivering it consistently. Reasons for this include time constraints, fear of patient reactions, cultural and religious differences, and a perceived lack of skill or preparation in this area. Many nurses report feeling underprepared and lacking confidence in providing spiritual care, highlighting the need for additional training and education in this aspect of nursing.
Collaborating with Chaplains
In many healthcare settings, nurses work alongside professionally trained chaplains to address the spiritual, religious, and emotional needs of patients, family members, and staff. Chaplains support and encourage people of all religious faiths and cultures, customizing their approach to each individual’s background, age, and medical condition.
Collaboration between nurses and chaplains can enhance the spiritual care provided to patients. Chaplains can assist patients and their family members in developing a spiritual perspective on serious illness, injury, or death, which can promote coping and healing. Nurses can identify when a patient might benefit from a chaplain’s services and facilitate this connection.
To improve the quality and quantity of spiritual care delivery, it is essential to address the barriers that nurses face. This includes providing adequate training, addressing time constraints, and clarifying the nurse’s role in spiritual care. By enhancing nurses’ knowledge, skills, and confidence in this area, healthcare organizations can ensure that patients receive comprehensive, holistic care that addresses their spiritual needs alongside their physical and emotional well-being.
Integrating Spiritual Practices in Nursing
The integration of spiritual practices in nursing has gained significant attention as healthcare professionals recognize the importance of holistic care. This approach acknowledges the interconnectedness of physical, emotional, and spiritual well-being, aiming to address the diverse needs of patients. Nurses, as frontline caregivers, play a crucial role in incorporating spiritual practices into their daily routines to enhance patient care and their own well-being.
Mindfulness and Meditation
Mindfulness has emerged as a powerful tool in nursing practice, offering benefits for both patients and healthcare providers. This practice involves maintaining present-moment awareness in a non-judgmental manner, which has the potential to positively impact well-being and resilience. Research suggests that engaging in mindfulness can enhance the holistic well-being of nursing students and practicing nurses alike.
For undergraduate nursing students, mindfulness interventions have shown promising results. These practices can help students manage the stress associated with clinical training, equipping them with valuable skills to maintain their well-being in future clinical practice. Studies have indicated that participating in mindfulness programs can reduce symptoms of anxiety and stress among nursing students, ultimately improving their quality of life.
Mindfulness-based stress reduction (MBSR) programs have gained popularity in healthcare settings. These programs typically include class instruction and practice in mindfulness techniques, meditation, and Hatha yoga. Through MBSR training, nurses learn to accept their lived experiences, including moments of pain, which can lead to decreased stress and burnout.
The benefits of mindfulness extend beyond personal well-being. Nurses who practice mindfulness have reported an increased capacity for “being with” patients and developing deeper connections. This enhanced presence can lead to improved decision-making through better situational awareness, ultimately benefiting patient care.
Prayer and Religious Rituals
While mindfulness offers a secular approach to spiritual practice, prayer and religious rituals remain important aspects of spiritual care for many patients. Nurses should be prepared to facilitate the expression of patients’ personal beliefs and support their participation in religious and cultural practices.
Taking a spiritual history can be a valuable tool in understanding patients’ spiritual needs. This process communicates to patients that the healthcare provider is interested in their whole experience and provides a context for conversations about their illness. It also offers an opportunity to discuss beliefs that may serve as barriers or promoters to certain health actions.
However, it’s important to note that the nurse’s role is not to provide spiritual guidance. Instead, nurses should be prepared to refer patients to appropriate pastoral care to address any spiritual needs that arise. Collaboration between nurses and chaplains can enhance the spiritual care provided to patients, especially in hospital settings where chaplains are readily available.
Creating Sacred Spaces
The concept of sacred spaces in healthcare settings has gained recognition as an important aspect of spiritual care. These spaces can exist anywhere in a healthcare facility and should be protected to ensure patient privacy and dignity.
Sacred spaces in nursing practice include:
Patient rooms: This is the ultimate sacred space that should be protected at all costs. Nurses should be mindful that patients and their family members can hear conversations in the hallways.
Hallways in front of patient rooms: These areas should be treated with the same respect as patient rooms, as conversations can easily be overheard.
Nurses’ stations: While not directly accessible to patients, these areas should still be considered sacred spaces where professional conduct is maintained.
To enhance the concept of sacred spaces, nurses can adopt certain practices:
Posting positive messages in sacred spaces, such as affirmations on patient whiteboards or in hallways.
Creating rituals before entering patient rooms, such as pausing, taking a deep breath, and softly saying “sacred space” as a reminder of the special nature of the space.
Defining department-specific sacred spaces and establishing guidelines for behavior in these areas.
By integrating these spiritual practices into nursing care, healthcare providers can create a more holistic and compassionate environment for patients while also supporting their own well-being and resilience.
Challenges in Providing Spiritual Care
Despite the growing recognition of the importance of spiritual care in nursing, healthcare professionals face numerous challenges in effectively addressing patients’ spiritual needs. These obstacles can hinder the delivery of holistic care and impact patient outcomes. This section explores the key challenges nurses encounter when providing spiritual care.
Lack of Training
One of the primary barriers to delivering spiritual care is the inadequate preparation of nursing staff. Many nurses report feeling underprepared and lacking confidence in providing spiritual care due to insufficient education and training in this area. The absence of spiritual care content in undergraduate nursing curricula and textbooks has led to a limited understanding of the concept among many nurses.
Research has shown that nurses who receive specialized training in spiritual care are more likely to meet patients’ spiritual needs effectively. However, the current educational landscape often falls short in equipping nurses with the necessary knowledge and skills to address spiritual concerns. This gap in education can result in confusion about the nurse’s role in spiritual care and assessment, making them less likely to engage in this aspect of patient care.
AIHCP offers a Holistic Nursing Certification as well as a Pastoral Thanatology Certification to help nurses become more attune with healing and caring for the entire person
To address this challenge, there is an urgent need for relevant training to enhance nurses’ abilities to provide spiritual care. Continuing education programs and specialized courses can help nurses develop their spiritual care competencies, improving their confidence and effectiveness in this area. AIHCP offers a Integrative and Holistic Healthcare Program for nurses. It also offers a Pastoral Thanatology program for healthcare professionals.
Time Constraints
The demanding nature of nursing work often leaves little time for addressing patients’ spiritual needs. Nurses frequently cite time constraints as a significant barrier to providing comprehensive spiritual care. The shortage of nursing staff, heavy workloads, and non-standard nurse-to-patient ratios contribute to this challenge.
In busy clinical settings, nurses may prioritize physical care tasks over spiritual care, viewing the latter as less urgent or outside their primary responsibilities. This time pressure can lead to missed opportunities for addressing spiritual distress and supporting patients’ spiritual well-being.
To overcome this challenge, healthcare organizations need to consider strategies for optimizing nurse-to-patient ratios and workload distribution. Additionally, integrating spiritual care assessments into routine nursing practices can help ensure that spiritual needs are not overlooked amidst other care priorities.
Personal Beliefs
Nurses’ personal beliefs and comfort levels can significantly impact their ability to provide spiritual care. The diverse nature of patients’ spiritual and religious backgrounds can present challenges for nurses who may not share the same beliefs or may feel uncomfortable discussing spiritual matters.
Being mindful of one’s own belief systems is crucial for effective spiritual care delivery. Without self-awareness, nurses may struggle to provide unbiased and patient-centered spiritual support. Cultural and religious differences between nurses and patients can also affect the ability to provide appropriate spiritual care.
Moreover, some nurses may fear overstepping boundaries or receiving negative reactions from patients when attempting to address spiritual concerns. This apprehension can lead to hesitation in initiating conversations about spirituality or providing spiritual support.
To address this challenge, nurses need to develop cultural competence and self-awareness. Training programs that focus on understanding diverse spiritual perspectives and practicing non-judgmental approaches can help nurses navigate the complexities of providing spiritual care across different belief systems.
In conclusion, addressing these challenges requires a multifaceted approach involving education, organizational support, and personal development. By overcoming these barriers, nurses can enhance their ability to provide comprehensive spiritual care, ultimately improving patient outcomes and satisfaction.
Benefits of Spiritual Care in Nursing
Improved Patient Outcomes
Spiritual care has emerged as a crucial component of holistic nursing practice, with significant implications for patient well-being. Research has consistently demonstrated that addressing patients’ spiritual needs has a positive impact on their overall health outcomes. Patients who receive adequate spiritual care often experience enhanced resilience, decreased pain, and reduced stress levels. Moreover, spiritual care has been linked to a decrease in negative emotions and a lower risk of depression and suicide.
The impact of spiritual care extends beyond psychological benefits. Studies have shown that patients who receive spiritual care report higher levels of satisfaction with both medical and nursing treatments. This increased satisfaction can contribute to improved patient compliance with treatment plans and better overall health outcomes. Conversely, unmet spiritual needs have been associated with adverse effects on patient well-being, including reduced quality of life and diminished perceptions of spiritual peace.
Enhanced Nurse-Patient Relationship
The integration of spiritual care into nursing practice has the potential to significantly enhance the nurse-patient relationship. By addressing patients’ spiritual needs, nurses can establish a deeper connection with their patients, fostering trust and understanding. This enhanced relationship allows nurses to provide more personalized and compassionate care, which can lead to improved patient outcomes and increased patient satisfaction.
Spiritual care also enables nurses to engage in meaningful conversations with patients about their beliefs, values, and sources of strength. This open dialog can help nurses better understand their patients’ perspectives and tailor their care accordingly. By incorporating spirituality into their practice, nurses can create a more holistic and patient-centered approach to care, which aligns with the fundamental principles of nursing.
Reduced Stress for Nurses
While the benefits of spiritual care for patients are well-documented, it is equally important to recognize the positive impact on nurses themselves. Engaging in spiritual care practices can help nurses cope with the emotional and spiritual tolls of their demanding profession, particularly in challenging times such as the COVID-19 pandemic.
Incorporating spirituality and soft skills into nursing orientation and ongoing professional development can provide nurses with valuable tools to manage stress and maintain their own well-being. By reconnecting with their sense of meaning and purpose, nurses can enhance their spiritual resilience and reduce the risk of burnout and compassion fatigue.
Furthermore, creating a positive spiritual climate within healthcare organizations has been associated with improved teamwork, enhanced safety climates, and reduced intention to leave among nursing staff. This positive environment can contribute to increased job satisfaction and better retention rates for nursing professionals.
In conclusion, the benefits of spiritual care in nursing extend to both patients and healthcare providers. By integrating spiritual care practices into their daily routines, nurses can improve patient outcomes, enhance their relationships with patients, and reduce their own stress levels. As the healthcare landscape continues to evolve, recognizing and prioritizing the spiritual aspects of care will be essential for providing truly holistic and compassionate nursing care.
Developing Spiritual Care Competencies
It is important for healthcare professionals to develop multicultural competencies in spirituality when working with patients
The development of spiritual care competencies is essential for nurses to provide holistic, patient-centered care. As healthcare evolves, there is a growing recognition of the importance of addressing patients’ spiritual needs alongside their physical and emotional well-being. To enhance the quality and quantity of spiritual care delivery, nurses must focus on three key areas: education and training programs, self-reflection and personal growth, and cultural competence.
Education and Training Programs
The foundation for developing spiritual care competencies lies in comprehensive education and training programs. Many nurses report feeling underprepared and lacking confidence in providing spiritual care due to insufficient education in this area. To address this gap, nursing schools and healthcare organizations should incorporate spiritual care content into their curricula and continuing education programs.
Effective training programs should cover topics such as:
Understanding spirituality and its impact on health outcomes
Assessing patients’ spiritual needs
Providing spiritual support within the nursing role
Collaborating with chaplains and other spiritual care specialists
Research has shown that nurses who receive specialized training in spiritual care are more likely to meet patients’ spiritual needs effectively. However, it is important to note that the degree of emphasis on spirituality in nursing curricula does not always directly correlate with nurses’ awareness of spirituality or their use of strategies to address patients’ spiritual needs.
Self-Reflection and Personal Growth
Developing spiritual care competencies requires nurses to engage in self-reflection and personal growth. As nurses explore their inner selves and strengthen their personal spirituality, they become better equipped to provide compassionate and effective spiritual care to their patients.
Self-care practices play a crucial role in this process. Nurses can adopt various strategies to enhance their spiritual resilience and meet their own need for consolation in demanding work environments. Some recommended practices include:
Prayer: Engaging in personal prayer or meditation can help nurses connect with their own spirituality and find inner strength.
Meditative walking: This practice combines physical activity with mindfulness, allowing nurses to reflect and rejuvenate.
Mindfulness body scanning: This technique involves focusing attention on different parts of the body, promoting relaxation and self-awareness.
By incorporating these practices into their daily routines, nurses can develop a deeper understanding of spirituality and enhance their ability to provide spiritual care to patients.
Cultural Competence
Cultural competence is a vital component of developing spiritual care competencies. As patient populations become increasingly diverse, nurses must be able to provide culturally sensitive spiritual care that respects individual beliefs and practices.
Cultural competence in nursing care involves:
Awareness of one’s own cultural worldview
Attitudes toward cultural differences
Knowledge of different cultural practices and worldviews
Cross-cultural skills
To enhance cultural competence, nurses should:
Participate in cultural competence training programs
Seek opportunities to interact with diverse patient populations
Continuously educate themselves about different cultural and religious practices
Reflect on their own biases and assumptions
Research has shown that multicultural experiences, ethnocentric attitudes, organizational competence support, and coping strategies have significant impacts on cultural competence. By developing these competencies, nurses can provide more effective spiritual care across diverse patient populations.
In conclusion, developing spiritual care competencies requires a multifaceted approach that combines education, self-reflection, and cultural awareness. By focusing on these areas, nurses can enhance their ability to provide comprehensive, patient-centered spiritual care, ultimately improving patient outcomes and satisfaction.
Ethical Considerations in Spiritual Care
The integration of spiritual care in nursing practice raises important ethical considerations that healthcare professionals must navigate carefully. As the recognition of spirituality’s role in patient well-being grows, so does the need for ethical reflection to guide healthcare providers in their approach to spiritual care.
Spiritual care does not push one’s own faith but is able to show general empathy to the spiritual reality of a patient and to help them find peace in both mind and soul
Respecting Patient Autonomy
Respecting patient autonomy is a fundamental ethical principle in healthcare, and it extends to spiritual care as well. Healthcare professionals should be attuned to patients’ spiritual resources and needs without imposing their own beliefs or practices. This requires a delicate balance between offering support and allowing patients to guide their own spiritual journey.
To ensure respect for patient autonomy, healthcare providers should:
Obtain a spiritual history in a non-intrusive manner
Ask patients about their spiritual preferences
Refrain from making assumptions based solely on religious designations in medical records
It is crucial to recognize that patients bring their own spiritual strengths and resources to the clinical setting. By acknowledging these resources, healthcare professionals can open opportunities for genuine spiritual cooperation while respecting the patient’s autonomy.
Avoiding Proselytizing
One of the most critical ethical considerations in spiritual care is the avoidance of proselytizing. The clinical setting is not an appropriate place for promoting religion or particular spiritual practices. Healthcare professionals must refrain from using their position of authority or the vulnerability of patients to influence their spiritual beliefs.
To maintain ethical boundaries:
Focus on the patient’s established spirituality
Avoid introducing personal religious beliefs
Refrain from attempting to convert patients to a particular faith
Healthcare providers should aim to be attuned to the patient’s spirituality without seeking to change or challenge their beliefs. The goal is to provide comfort and support within the patient’s existing spiritual framework.
Maintaining Professional Boundaries
Maintaining professional boundaries is essential when providing spiritual care. Healthcare professionals must strike a balance between offering compassionate support and preserving the integrity of the professional relationship. This involves recognizing the power differential inherent in the healthcare provider-patient relationship and ensuring that spiritual care does not compromise this dynamic.
Key aspects of maintaining professional boundaries include:
Assessing whether spiritual interventions, such as prayer, would be welcome
Avoiding any hint of coercion when offering spiritual support
Respecting patients’ decisions to decline spiritual care
Healthcare professionals should also be aware of their own motivations when providing spiritual care. If the desire to offer spiritual support stems from personal needs or a desire to comfort oneself, it may be unethical and potentially harmful to the nurse-patient relationship.
In conclusion, ethical considerations in spiritual care require healthcare professionals to navigate complex terrain with sensitivity and respect. By prioritizing patient autonomy, avoiding proselytizing, and maintaining professional boundaries, healthcare providers can offer meaningful spiritual support while upholding ethical standards. This approach ensures that spiritual care remains an integral part of holistic patient care without compromising the trust and integrity of the healthcare relationship.
Conclusion
The integration of spiritual practices in nursing has a profound impact on patient care and healthcare outcomes. By addressing the spiritual needs of patients alongside their physical and emotional well-being, nurses can provide truly holistic care that enhances the healing process. This approach not only improves patient satisfaction and outcomes but also strengthens the nurse-patient relationship, creating a more compassionate and supportive healthcare environment.
Please review AIHCP’s Holistic Nursing Program as well as its Pastoral Thanatology Program to help give balance to patient care with emphasis in spirituality
As healthcare continues to evolve, the importance of spiritual care in nursing will likely grow. To meet this need, it’s crucial to develop spiritual care competencies through education, self-reflection, and cultural awareness. By doing so, nurses can overcome the challenges they face in providing spiritual care and fully embrace their role in supporting patients’ spiritual well-being. This holistic approach to nursing has the potential to transform healthcare, making it more patient-centered and ultimately more effective in promoting healing and well-being.
1. How can spiritual care be incorporated into the nursing process?
To effectively integrate spiritual care, nurses should be aware of their own and others’ perceptions of death and dying, perform spiritual assessments, distinguish between religious and spiritual needs, and determine suitable spiritual care interventions.
2. What does a holistic approach to spirituality entail?
A holistic approach to spirituality considers all aspects of an individual’s being, including psychological, physical, and social components, as essential elements of their overall health and spirituality.
3. What is meant by holistic spiritual care?
Holistic spiritual care involves addressing not only the physical, psychological, and social facets of a person’s well-being but also incorporating their spiritual needs, which are often neglected in healthcare settings.
4. What is the role of spirituality in holistic health?
The spiritual dimension of holistic health is connected to a person’s sense of purpose in life, which can be derived from religious beliefs or personal philosophies. Individuals who perceive a clear purpose in life are generally considered healthier than those who do not.
Additional Resources
Southard, M. et, al. (2020). “Spirituality: The Missing Link for Holistic Health Care”. Sage Journals. Access here
Rachel, H. et, al. (2019). “Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses”. Acta Biomed. 2019; 90(Suppl 4): 44–55. doi: 10.23750/abm.v90i4-S.8300. National Library of Medicine. Access here
“The Importance of Holistic Nursing Care: How to Completely Care for your Patients” (2024). Practical Nursing org. Access her
Hackett, J, (2017). “The Importance of Holistic Care at the End of Life”. Ulster Med J. 2017 May; 86(2): 143–144. Published online 2017 May 20. National Library of Medicine. Access here
The intricate relationship between stress and hair loss has garnered significant attention in recent years. Chronic stress has an impact on various aspects of health, including the condition of one’s hair. This connection has led many to question: does stress cause hair loss? Research indicates that prolonged periods of mental stress and anxiety can indeed contribute to hair thinning and shedding, making stress management a crucial aspect of maintaining healthy hair.
This article aims to explore the mechanisms behind stress-related hair loss and provide practical strategies to address this issue. It will delve into the signs of stress-induced hair loss, common stressors that trigger it, and lifestyle changes to promote hair health. Additionally, the discussion will cover natural remedies, medical treatments, and prevention strategies for stress-related hair loss. By understanding these factors, individuals can take proactive steps to mitigate the effects of stress on their hair and overall well-being.
Understanding the Link Between Stress and Hair Loss
Stress and hair loss. Please also review AIHCP’s Stress Management Consulting Certification
The connection between stress and hair loss has been a subject of significant scientific inquiry in recent years. Research has shown that chronic stress has an impact on various aspects of health, including the condition of one’s hair. This relationship is complex and involves multiple biological mechanisms that affect hair growth cycles and follicle health.
Types of stress-related hair loss
Stress can lead to different types of hair loss, each with its own characteristics and underlying mechanisms:
Telogen effluvium: This is the most common form of stress-related hair loss. It occurs when a significant number of hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle. Telogen effluvium can be acute, lasting less than six months, or chronic, persisting for longer periods. It typically results in diffuse thinning of hair on the scalp.
Alopecia areata: This autoimmune disorder causes patchy hair loss and is thought to be triggered by environmental factors, including stress. It affects the immune and hormonal microenvironments of the hair follicle, leading to hair loss in well-defined areas.
Trichotillomania: Also known as hair-pulling disorder, this condition is associated with obsessive-compulsive disorder (OCD) and can be exacerbated by stress. Individuals with trichotillomania experience an irresistible urge to pull out their own hair.
How stress affects hair growth cycles
The hair growth cycle consists of three main phases: anagen (growth), catagen (degeneration), and telogen (rest). Stress has a significant influence on this cycle:
Prolonged resting phase: Chronic stress can cause hair follicles to remain in the telogen phase for extended periods, leading to increased hair shedding and reduced growth.
Premature transition: Stress can force hair follicles in the anagen phase to prematurely enter the telogen phase, resulting in increased hair loss.
Stem cell regulation: Research has shown that stress hormones, particularly corticosterone in mice (equivalent to cortisol in humans), prevent dermal papilla cells from secreting Gas6, a molecule that activates hair follicle stem cells. This inhibition can significantly impair hair regrowth.
Hormonal changes during stress
Stress triggers various hormonal changes in the body, which have direct and indirect effects on hair growth:
Cortisol elevation: During periods of stress, the body produces higher levels of cortisol, often referred to as the “stress hormone.” Elevated cortisol levels have been shown to reduce the synthesis and accelerate the degradation of important skin elements, including hyaluronan and proteoglycans, by approximately 40%.
Androgen activity: Stress can influence the conversion of testosterone to dihydrotestosterone (DHT), a hormone associated with androgenetic alopecia. DHT binds to androgen receptors in hair follicles, leading to the shortening of the anagen phase and prolongation of the telogen phase.
Immune system modulation: Chronic stress can alter immune system function, potentially contributing to autoimmune conditions like alopecia areata. Some individuals with this condition may experience a reduced expression of glucocorticoids due to a weak response to acute physiological stressors.
Understanding these mechanisms provides valuable insights into the complex relationship between stress and hair loss. It also highlights the importance of stress management in maintaining healthy hair growth and preventing stress-related hair loss conditions.
Recognizing Signs of Stress-Induced Hair Loss
Stress-induced hair loss has distinct characteristics that differentiate it from other types of hair thinning. Individuals experiencing this condition may observe several key signs that indicate their hair loss is related to stress. Understanding these signs can help in identifying the problem and seeking appropriate solutions.
Excessive shedding
One of the primary indicators of stress-related hair loss is an increase in hair shedding. While it is normal to lose between 50 to 100 hairs per day, individuals experiencing stress-induced hair loss may notice a significant increase in this number. In cases of telogen effluvium, a common form of stress-related hair loss, a person may shed up to 300 strands of hair daily.
This excessive shedding often becomes apparent in various situations:
Increased hair accumulation in hairbrushes or combs
More hair visible in the shower drain after washing
Hair strands frequently found on pillows or clothing
Noticeable hair loss when touching or running fingers through the hair
It is important to note that this increased shedding typically occurs gradually over a period of 3-6 months following a stressful event. This delay is due to the hair growth cycle, where stress pushes more hair follicles into the resting (telogen) phase before shedding.
Thinning hair
As stress-induced hair loss progresses, individuals may observe a general thinning of their hair, particularly on the top of the scalp. This thinning is often more noticeable than in other areas, such as the back or sides of the head. The American Academy of Dermatology (AAD) recognizes this pattern as a common manifestation of telogen effluvium.
Key characteristics of stress-related hair thinning include:
Overall reduction in hair volume
Scalp becoming more visible through the hair
Thinning that appears evenly distributed rather than in specific patterns
Hair that feels drier and falls out more easily
It is worth noting that while the hair may appear thinner, the scalp itself typically remains healthy-looking without scales or rashes.
Bald patches
In some cases, stress-induced hair loss can manifest as distinct bald patches. This is often associated with a condition called alopecia areata, an autoimmune disorder that can be triggered or exacerbated by stress. Unlike the diffuse thinning seen in telogen effluvium, alopecia areata presents as well-defined areas of hair loss.
Characteristics of bald patches in stress-related hair loss include:
Small, round patches of baldness on the scalp or other parts of the body
Patches that may expand or join together over time
Possibility of total loss of scalp or body hair in severe cases
Hair follicles remain intact, allowing for potential regrowth
It is important to recognize that the onset of these symptoms typically follows a major stressful life event. Such events may include trauma, the death of a loved one, illness, surgery, emotional turmoil, or rapid weight loss. The hair loss usually becomes noticeable a few months after the stressful event occurs, reflecting the delay in the hair growth cycle’s response to stress.
Common Stressors That Can Trigger Hair Loss
There are numerous stressors than cause hair loss
Stress-induced hair loss has been linked to various life events and circumstances that place significant pressure on individuals. Understanding these common stressors can help in identifying potential triggers and managing their impact on hair health. Stress management can help identify stressors.
Work-related stress
The workplace has emerged as a significant source of stress that can contribute to hair loss. Research has shown that individuals with little control over their workload face an increased risk of health issues, including hair thinning. A study conducted in 2014 by UK hair care brand Percy & Reed revealed that 50% of men and 75% of women attributed their thinning hair to work-related stress. Interestingly, the study also found that one in five individuals earning over £75,000 per year considered their stressful job as the cause of their hair loss, compared to one in ten for those earning £15,000 or less annually.
Financial stress
Financial difficulties have been identified as a major stressor that can have an impact on hair health. The Consumer Credit Counseling Service (CCCS) in the UK conducted a survey that highlighted the health consequences of mounting debts during economic downturns. The study found that 46% of respondents believed their financial problems had affected their health, with symptoms including hair loss among other issues. Financial stress can manifest in various forms, such as:
Business-related financial problems
Mounting debts
Job loss or income reduction
Economic downturns
Relationship issues
Emotional stress stemming from relationship problems has been recognized as a significant trigger for hair loss. Some common relationship stressors include:
Divorce or separation
Loss of a loved one
Heartbreak
Parenting challenges
Heartbreak, in particular, has been identified as one of the most common causes of hair loss due to emotional stress or trauma. The duration of hair loss in these cases can persist for as long as the emotional distress continues, with an additional 7 to 8 months required for proper hair regrowth.
Health concerns
Various health-related issues and events can act as stressors that trigger hair loss. These may include:
Major surgeries or medical procedures
Recovery from illness
High fever
Excessive weight loss
Childbirth
Stopping birth control pills
In some cases, health-related stress can lead to specific types of hair loss, such as alopecia areata. This condition is characterized by sudden bald patches on the scalp and can be triggered by extreme stress or traumatic events. Additionally, individuals with post-traumatic stress disorder (PTSD) may experience prolonged hair loss due to persistently elevated stress hormone levels, which can prevent hair regrowth after shedding.
It is important to note that while stress is a significant factor in hair loss, genetic predisposition can also play a role in conditions like alopecia areata. Furthermore, the impact of stress on hair loss can vary depending on the severity and duration of the stressful situation. In some cases, acute stress may lead to temporary hair shedding, while chronic stress can result in more persistent hair loss issues.
Lifestyle Changes to Reduce Stress and Promote Hair Health
Stress Management Techniques
Stress has a significant impact on hair health, potentially leading to conditions such as telogen effluvium. To combat this, individuals can adopt various stress management techniques. Mindfulness and meditation have emerged as powerful tools to manage stress and promote relaxation. These practices, when incorporated into daily routines, can improve overall well-being and support healthy hair growth.
One effective technique is square breathing, which involves slow, deep breaths to calm the mind and body. To practice this, one should inhale deeply through the nose, hold the breath for a few seconds, and exhale slowly through the mouth. Repeating this process several times while focusing on the sensation of each breath can help reduce stress levels.
Another beneficial practice is the body scan technique. This mindfulness and relaxation method involves mentally scanning the body from head to toe, paying attention to physical sensations and areas of tension. Regular practice of body scans can help individuals become more attuned to their body’s needs and better manage physical and mental tension.
Guided visualization is another effective mindfulness and meditation technique. It involves using mental imagery to create a state of deep relaxation, focus, and clarity. In a guided visualization session, a facilitator or recorded script guides individuals through a series of mental images and sensory experiences, helping them enter a calm and reflective state.
Healthy Diet for Hair Growth
A balanced diet plays a crucial role in maintaining hair health and promoting growth. Consuming foods rich in essential nutrients can support hair follicles and minimize stress-induced hair loss. Some key nutrients and foods to include in a hair-healthy diet are:
Iron and Vitamin C: Spinach is an excellent source of iron, and when combined with vitamin C-rich foods, it enhances iron absorption. A spinach salad with mushrooms or hard-boiled eggs, both rich in vitamin D, can help reduce hair loss.
Copper and Zinc: These minerals are essential for proper body function and healthy hair growth. Foods rich in zinc include oysters, black sesame seeds, spinach, eggs, walnuts, green peas, chickpeas, sunflower seeds, oatmeal, and wheat germ.
Protein: As hair is primarily composed of protein, it is crucial to include adequate protein in the diet. Salmon, a marine-based protein loaded with vitamins and omega-3 fatty acids, has been shown to be particularly effective at boosting hair growth.
Beta Carotene: Found in orange-colored vegetables and fruits such as pumpkin, carrots, mangoes, sweet potatoes, and sweet melons, beta carotene protects hair from becoming dull and dry. It also stimulates the production of sebum, an oily fluid essential for healthy hair.
Exercise and Its Benefits
Regular physical activity plays a significant role in maintaining overall well-being, including hair health. Exercise enhances blood circulation, ensuring that vital nutrients and oxygen reach the hair follicles. This improved blood flow supports the nourishment of hair follicles, fostering hair growth and minimizing hair loss.
Cardio exercises, such as running, biking, or swimming, can help improve blood circulation throughout the body, including the scalp. These workouts elevate heart rate and promote blood flow, supplying more oxygen and essential nutrients to the roots of the hair. Incorporating 30 minutes of cardio sessions into daily routines can yield optimal results.
Strength training exercises, like lifting weights or using resistance bands, can also have positive effects on overall hair health. These exercises aid in muscle development and indirectly contribute to promoting healthy hair growth. Additionally, participating in strength training can help lower stress levels, which in turn benefits hair health.
High-Intensity Interval Training (HIIT) is another effective form of exercise for hair health. HIIT involves engaging in bursts of physical activity followed by periods of rest or less strenuous exercise. These workouts are beneficial for increasing blood circulation and triggering the production of growth hormones, which can contribute to promoting hair growth. HIIT sessions can be completed in 10-15 minutes and incorporated into weekly routines multiple times.
Natural Remedies for Stress-Related Hair Loss
Herbal supplements
Herbal remedies have long been utilized in various beauty and hair care routines, with some evidence suggesting their potential to promote hair growth through different mechanisms. Several herbs have shown promise in addressing stress-related hair loss:
Horsetail (Equisetum arvense): Rich in silica, horsetail penetrates hair follicles and the hair matrix, potentially thickening hair and reducing hair loss.
Red clover (Trifolium pratense): Studies indicate that red clover may block the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone, a hormone associated with hair loss. Additionally, it has been shown to help lower inflammation, potentially aiding hair growth.
Stinging nettle (Urtica dioica): Research suggests that stinging nettle extract may increase dermal papilla cell growth, which plays a crucial role in regulating hair growth. It is also rich in beta-sitosterol, a plant chemical that may stimulate hair growth factors.
Essential oils
Essential oils have gained popularity for their potential benefits in improving hair health, with some oils showing promise in promoting hair growth and addressing stress-related hair issues:
Rosemary oil: Known for its anti-inflammatory properties, rosemary oil may promote hair growth, prevent premature graying, and combat dandruff. It has been shown to improve circulation and encourage nerve growth when applied to the scalp.
Peppermint oil: The menthol in peppermint oil acts as a vasodilator, potentially improving blood flow and circulation in the scalp, which may encourage faster and stronger hair growth.
Lavender oil: Studies have demonstrated lavender oil’s ability to promote faster cell growth and repair. It may also help reduce stress levels, potentially minimizing hair loss during high-stress periods.
Cedarwood oil: With antibacterial and antifungal properties, cedarwood oil may help treat scalp conditions contributing to dandruff or hair loss. It has been found to help balance oil-producing glands in the scalp.
Thyme oil: This oil has been shown to stimulate the scalp and potentially prevent hair loss. However, due to its potency, it should be used sparingly and diluted with a carrier oil.
Tea tree oil: Known for its cleansing, antifungal, and antimicrobial properties, tea tree oil may help unclog hair follicles and promote faster hair growth when applied topically.
Scalp massage
Scalp massage has emerged as a promising natural remedy for stress-related hair loss. Research suggests that this technique may help promote hair growth and improve overall scalp health:
Increased blood flow: Scalp massage enhances blood circulation to the hair follicles, potentially encouraging hair growth and improving the delivery of nutrients to the scalp.
Stress reduction: The relaxing effect of scalp massage may help lower stress levels, which can be beneficial in combating stress-induced hair loss.
Mechanical stimulation: Studies using finite element method analysis have demonstrated that scalp massage results in horizontal movement of the skin surface and displacement of subcutaneous tissue, potentially inducing mechanical stress on hair follicle cells.
Gene expression changes: Research has shown that scalp massage may lead to changes in gene expression in human dermal papilla cells, which play a crucial role in hair growth.
Increased hair thickness: A study conducted on healthy Japanese men found that standardized scalp massage resulted in increased hair thickness.
To perform a scalp massage, individuals can use their fingertips to apply light to medium pressure to the scalp, moving in small circles. Alternatively, a scalp massaging tool can be used. For enhanced benefits, essential oils such as lavender or peppermint can be incorporated into the massage routine, as animal studies have shown their potential to promote hair growth.
Medical Treatments for Stress-Induced Hair Loss
There are numerous medications to help slow or prevent hair loss due to stress
Topical Medications
Topical minoxidil has emerged as a primary treatment for stress-induced hair loss. This FDA-approved medication has shown efficacy in treating various types of hair loss, including androgenetic alopecia, alopecia areata, and telogen effluvium. Available as a foam or liquid, minoxidil is applied directly to the scalp twice daily. It works by shortening the telogen phase and prolonging the anagen phase of the hair growth cycle, leading to increased hair diameter and length.
Minoxidil’s mechanism of action involves several pathways. It acts as a vasodilator, enhancing blood flow to hair follicles. Additionally, it induces the Wnt/β-catenin signaling pathway and has anti-androgenic and anti-inflammatory properties. The medication also increases vascular endothelial growth factor (VEGF) expression, which plays a crucial role in maintaining the anagen phase of hair growth.
It’s important to note that visible results may take four months to a year, and initial increased shedding is common. Side effects are generally mild and may include scalp redness and irritation.
Oral Medications
For cases where topical treatments prove insufficient, oral medications offer alternative solutions. Finasteride, primarily prescribed for male pattern baldness, inhibits the production of dihydrotestosterone (DHT), a hormone associated with hair follicle destruction. Taken once daily, finasteride typically shows results after four months, with significant hair growth potentially visible after a year.
Low-dose oral minoxidil has recently gained attention as a treatment for various hair disorders. Studies have shown that doses ranging from 0.25 to 5 mg daily can be effective for both male and female pattern hair loss, with lower doses (0.25-1.25 mg) showing promise in treating female pattern hair loss, traction alopecia, and telogen effluvium. Higher doses (2.5-5 mg) have demonstrated effectiveness in treating male pattern hair loss.
For women experiencing female pattern baldness, antiandrogen medications such as spironolactone and oral contraceptives containing estrogen may be prescribed. These medications work by inhibiting androgens that can damage hair follicles.
In cases of autoimmune-related hair loss, corticosteroids may be prescribed to suppress the immune system’s attack on hair follicles. These can be administered topically, through injections, or orally, depending on the severity and type of hair loss.
Hair Restoration Procedures
When medication alone is insufficient, hair restoration procedures offer more advanced solutions. Platelet-Rich Plasma (PRP) treatment utilizes the body’s natural healing compounds to stimulate new hair growth. This procedure involves extracting platelet-rich plasma from the patient’s blood and injecting it into various sites on the scalp.
Another innovative approach is Adipose Stem Cell Treatment, which involves injecting stem cells extracted from body fat deposits into the scalp. These stem cells have remarkable regenerative properties that can help spur new hair growth.
PDO Threading is a newer treatment that uses dissolving polydioxanone (PDO) surgical threads implanted just below the skin on the scalp. This technique triggers a natural healing response that can rejuvenate dormant hair follicles.
For more severe cases, surgical options such as hair grafting and scalp reduction may be considered. Grafting involves transplanting hair from one part of the body to bald areas of the scalp, while scalp reduction removes non-hair-bearing skin to stretch remaining hair-bearing skin over bald areas.
These medical treatments and procedures offer a range of options for individuals experiencing stress-induced hair loss. The choice of treatment depends on various factors, including the type and severity of hair loss, overall health, and individual preferences. It’s crucial to consult with a healthcare provider to determine the most appropriate treatment plan.
Prevention Strategies for Stress-Related Hair Loss
Regular self-care routines
Implementing regular self-care routines has a significant impact on preventing stress-related hair loss. One crucial aspect of self-care is maintaining a healthy diet. Experts recommend consuming adequate protein, especially for vegetarians and vegans, with a daily intake of 40 to 60 grams. The Mediterranean diet, rich in fruits, vegetables, and lean proteins, has shown promise in minimizing hair loss.
Ensuring proper nutrition through vitamins and minerals is essential for hair health. Vitamins A, B, C, D, E, as well as zinc, biotin, and iron, contribute to maintaining healthy hair, skin, and muscle tissue. However, it is advisable to consult a healthcare provider before adding new supplements to one’s diet. A blood test can determine if there are any nutritional deficiencies that may be contributing to hair loss.
Regular exercise has emerged as an effective strategy for managing stress and promoting overall well-being. Incorporating physical activity into one’s routine can help reduce stress levels and improve blood circulation, which is beneficial for hair health. Additionally, getting enough sleep is crucial, with most adults requiring between seven and nine hours per night. Adequate sleep has been shown to decrease stress levels and support overall health.
Maintaining a healthy work-life balance
Preventing hair loss starts with stress management
Achieving a healthy work-life balance is paramount in preventing stress-related hair loss. This balance involves distributing time effectively between personal and professional obligations. For individuals running their own businesses, such as salon owners, setting strict work-life boundaries is crucial to avoid burnout.
To maintain this balance, experts suggest several strategies:
Drawing a clear line between work and home life
Establishing regular meal times and prioritizing healthy eating habits
Practicing “switching off” from technology and work-related communications
Outsourcing tasks when possible to reduce workload
Taking regular breaks, including long weekends or short vacations
Learning to say “no” to excessive demands on time and energy
It is important to recognize that work-life balance may look different for everyone. The key is to ensure that not all non-sleeping hours are dedicated to work or work-related thoughts. Making time for enjoyable activities, hobbies, and social interactions is essential for maintaining overall well-being and reducing stress levels.
Seeking professional help when needed
When stress-related hair loss becomes a concern, seeking professional help is a crucial step in prevention and management. Experts recommend making an appointment with a board-certified dermatologist as soon as hair loss is noticed. Dermatologists can provide tailored advice and treatment options based on individual needs and the specific cause of hair loss.
For individuals experiencing high levels of stress that impact their mental health, consulting a therapist can be beneficial. Many employers offer employee assistance programs that can connect individuals with mental health professionals experienced in stress management. Counselors trained in Stress Management can help clients find better ways to manage stress.
In some cases, stress-related hair loss may be associated with conditions such as alopecia areata, telogen effluvium, or trichotillomania. These conditions often require professional diagnosis and treatment. A healthcare provider can assess the situation and recommend appropriate interventions, which may include medication, therapy, or lifestyle changes.
It is important to remember that seeking help is not a sign of weakness but a proactive step towards managing stress and preventing further hair loss. Early intervention can lead to better outcomes and help individuals regain control over their hair health and overall well-being.
Conclusion
The connection between stress and hair loss has a significant impact on many individuals’ lives, affecting both their physical appearance and emotional well-being. This article has explored various aspects of stress-induced hair loss, from its biological mechanisms to practical strategies to manage and prevent it. By understanding the signs of stress-related hair loss, recognizing common triggers, and implementing lifestyle changes, individuals can take proactive steps to maintain healthy hair and reduce the effects of stress on their overall health.
There are numerous medications to help slow or prevent hair loss due to stress
Ultimately, addressing stress-related hair loss requires a holistic approach that combines self-care, medical interventions when necessary, and a commitment to maintaining a balanced lifestyle. By incorporating stress management techniques, adopting a nutrient-rich diet, staying physically active, and seeking professional help when needed, individuals can minimize the impact of stress on their hair health. Remember, hair loss due to stress is often reversible, and with the right approach, it’s possible to regain not just hair growth, but also a sense of confidence and well-being.
Please also review AIHCP’s Stress Management Consulting Certification and see if it matches your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification.
FAQs
How can I prevent my hair from falling out due to stress?
To treat hair loss related to stress, ensure you get adequate sleep (aim for 7-8 hours nightly), hydrate well, and maintain a balanced diet. Limit your intake of sugar and caffeine. Engage in regular physical activities and consider stress-reduction practices such as yoga, meditation, or mindfulness. It’s also beneficial to discuss your concerns with someone.
Is it possible for hair to regrow after loss due to stress?
Yes, hair can regrow following stress-related loss. This type of hair loss, known as telogen effluvium, typically results in hair thinning, especially on the top of the head. While there are treatments available to help reverse this condition, hair usually begins to regrow naturally within three to six months.
What supplements are beneficial for hair loss due to stress?
Supplements like biotin, iron, and omega-3 fatty acids may help to reverse hair loss caused by stress. These supplements support healthy hair growth and can improve hair density. However, it’s important to consult with a healthcare provider before beginning any new supplement regimen.
How can I cope mentally with hair loss?
If hair loss is causing you to feel depressed or anxious, consider engaging in talk therapy. Losing hair can significantly affect your self-esteem and self-perception. Talking with a therapist or mental health professional can help you manage negative emotions, provide context to your hair loss, and help you plan your next steps.
Additional Resources
Flavin, D. (2023). “Can stress cause hair loss?”. Mayo Clinic. Access here
Bryant, E. (2021). “How stress causes hair loss”. National Institute of Health. Access here
Jay, K. (2019). “Does Stress Cause Hair Loss?”. Healthline. Access here
“Telogen Effluvium”. Cleveland Clinic. Access here
Grief while universal to humanity is expressed differently across cultures. Latino Americans due to their own unique culture, family structures, spiritualty and life values can face grief and cope with it in different ways. They also face different internal and external stressors than can complicate the grieving process.
The fastest growing minority group within the United States are Latino Americans (Pedersen, 2018, p. 164). Hence counselors are very likely to come into contact with the Latino American communities which are comprised of multiple different locations comprised of Hispanic mixtures ranging from the Mexico to the Caribbean islands such as Puerto Rico and Cuba to Central America throughout South America. All of these Latino ethnic groups share a common heritage but also a very diverse one in regards to the differing nations and local traditions. Most of these groups will stem from deeply religious groups with Roman Catholicism being the dominant faith, with other Protestant denominations existing within the population due to Protestant missions to Latin America as well as exposure to the United States and its many non-denominational faiths.
Latino/a Americans are the fastest growing minority in the USA and have their own unique counseling needs
When helping these populations with grief, Grief Counselors need to have a larger understanding of their struggles, social needs and norms, and need for family ties. In particular, Grief Counselors who are also Grief Diversity Specialists can play a key role.
Latino Americans and the Importance of Family as Structure
Latino Americans have strong family ties (Pederson, 2018, p. 176). Individualism is replaced with a collective need to work together and cooperate instead of competition. The needs of the family and respect of the family is key. This leads to a deep sense of commitment and also obligation to family needs before one’s own needs. Caretaking and protecting of family in times of distress and illness are calls to action which brings the family unit together. Family events, birthdays, holidays and deaths are more emphasized and prioritized as a time of coming together in happiness and sorrow and sharing of life and death. The family dynamic is hence critical to the emotional and mental health of many Latino-Americans.
Within the family unit, there are also extensions to friends and non blood relatives, such as god parents, best friends or individuals who share special roles within the family dynamic. Elders are given maximum respect, while children are expected to be obedient and respectful. Men are expected to display strong machismo typo characteristics that provide for the family while women are expected to be submissive, nurturing and self-sacrificing for the needs of the family. There does exist some forms of emancipated women where Latino women are more liberated and provide for the family as well, so again, over generalization can be counter productive because diversity still exists within any family dynamic. Also, while exploring the need of family over individual, Latino Americans still have a sense of cultivating individualism of inner qualities that build towards self worth. This is tied greatly to their very spiritual and religious backgrounds that mold many of them in their daily lives.
External and Internal Challenges that Affect Grief and Loss in Latino Americans
Latinos in America deal with a variety of external and internal challenges that can affect grief and loss in their lives. According to Pedersen, Latinos face racism, segregation, discrimination, poverty, significant educational disadvantages and immigration trauma. Issues dealing with fitting in and acculturation also can become stressors and factors for some. These issues can lead a variety of internal and external stressors that can cause distress to many Latinos, whether born in the United States or immigrated to it. Some may arrive illegally and have a constant stress of being deported, while others deal with the disconnection from the family at home. Those who are alone in the United States can suffer greatly without the importance of the family structure to help them cope with daily stressors or losses. This fear leads to the immigrant in possibly never seeing his or her family again and pushes him/her to find new surrogate families or find local Latino American communities to find commonality.
Many Latino/a Americans face immigration issues, isolation from family and racism in the United States
With internal strife and fear, and external factors such as poverty or racism, the need for counseling among many Latino Americans is necessary but many refuse to look for external helps outside the family structure, or if male, feel it as a sign of weakness to seek state services.
Counseling with Latino Americans
Obviously the diversity of Latino Americans prevents one sole solution for all. Some Latino Americans are second generation and fully acculturated. Some may be partially acculturated in public but have a very strong sense of culture at home. Of course, acculturation is the term to describe when two cultures come into first contact and when the primary ethnicity of the person adjusts to the new dominantly present culture (Pederson, 2018. p. 174). When acculturation presents itself to isolated immigrants or those with strong cultural identities, this can lead to issues with mental health (Pederson, 2018, p. 174). Grief Counselors need to take into account the degree of acculturation has occurred for different individuals. When dealing with any minority group, it is critical to identify a three dimensional model in which the first reviews acculturation degree, the locus of the problem and the goals for helping (Pedersen, 2018, p. 176).
In the case of Latino Americans, this may involve an indepth inquiry about the nature of the Latino Americans life history. Is the Latino client born in the United States, a legal or illegal immigrant as well as his/her family support systems? Is the Latino client alone or does the Latino client with family? Is the Latino client a male and displaying traditional macho behaviors that may hurt the healing process, or is the Latino client a woman displaying overtly submissive behaviors? All of these issues can affect grief from internal and external pressures in how one can cope with a loss or deal with a stressor. One can definitely not dismiss the role of racism and prejudice that many Latino Americans also face which can complicate grieving. According to Pedersen, any minority or immigrant is more than likely to experience some form of racism (2018, P. 174).
Finally, it is sometimes difficult to convince Latino Americans about the credibility of the counseling process (Pederson, 2018, p. 175). This can be partly due to the Latino attitude of utilizing family support to deal with emotional and mental issues as well as avoiding including strangers into their problems. Many Latinos utilize spirituality and family strength as a source to cope and find resilience (Pedersen, 2018, p. 176). With this understanding, counselors should utilize family when available as well as spiritual resources to help Latinos sometimes face issues. Family support in counseling can play a large difference in outcomes.
Conclusion
Numerous Latino/a Americans face different levels of acculturation. Please also review AIHCP’s Grief Diversity Specialist Program
Without overtly over-generalizing in light of different individuals, one can basically state that most Latino Americans are spiritual, family based, and value centered individuals. As an ethnic minority, all face racism to some extent, while immigrants face an even tougher uphill battle that sometimes involves isolation from family or illegally present, fear of deportation. With such strong family ties and certain emotional grieving patterns, outside counseling can sometimes be difficult but grief counselors need to remember the various internal and external issues they face to better understand their grief and help them better cope. Utilizing spirituality and family ties, if present, can be useful tools in helping Latino Americans in counseling.
Please also review AIHCP’s Grief Counseling Certification, as well as its Grief Diversity Specialist Program for already certified Grief Counselors. The programs are online and independent study and open to qualified professionals seeking a four year certification.
References
Cuellar, I., & Paniagua, F.A. (2000).Handbook of multicultural mental health: Assessment and treatment of diverse populations. San Diego, CA: Academic Press. McGoldrick, M., Giordano, J., & Garcia-Preto, N. (Eds.) (2005).Ethnicity and family therapy(3rded.). New York: Guilford Press. Schwarzbaum, S. E., & Thomas, A. J. (2008).Dimensions of multicultural counseling.Los Angeles: Sage Publications. Sue, D. W., & Sue, D. (2003).Counseling the culturally diverse: Theory and practice(4th ed.). New York: John Wiley and Sons.
Pedersen, P. et al. (2018). Counseling Across Cultures (7th ed.). Sage
Additional Online Resources
Fortuna, L. “Working with Latino/a and Hispanic Patients”. APA. Access here
Benton, E (2023). “8 Mental Health Resources for the Latino Community”. Very Well Mind. Access here
Mental Health Disparities: Hispanics and Latinos. APA. Access here
Hari, L, et, al. (2020). “Mental Health Needs of an Emerging Latino Community”. J. BehavHealth Serv Res. 2020; 47(3): 388–398. Published online 2020 Jan 30. doi: 10.1007/s11414-020-09688-3. National Library of Medicine. Access here
Overcoming Mental Health Stigma in the Latino Community (2017). Cleveland Clinic. Access here
In counseling, understanding the insights of a client is key. During intake and initial sessions, the counselor can learn about the client’s needs and story. The story many times if filled with subjective issues that sometimes needs guided. This is why during counseling, one teaches the client the real story and helps them find the right story.
Helping clients understand the whole counseling story. Please also review AIHCP’s Grief Counseling Certification
The video below looks at the story, real story and right story and how grief counselors and other types of counselors can help clients find the correct path. Please also review AIHCP’s Grief Counseling Certification and see if the program meets your academic and professional goals. The program is online and independent study and open to qualified professionals.
The role of a Christian Counselor is twofold. On one hand, the counselor is a professional who must adhere to ethical standards of the field echoing the axion “do not harm”. On other the hand, the Christian counselor is called to bear witness to the faith. These ideals can collide when a counselor is also a clinical professional counselor working in the secular realm where personal bias and religious conviction are separated from the counseling process. While the divine mandate to preach to all nations is important, in professional settings, such religious proclamations are not only inappropriate but also counter productive. Showing Christian example in these cases are always better than words. As for the Christian Counselor, who may be licensed or non-licensed in counseling, the opportunity to express Christian doctrine is ethical because the client is seeking Christian answers for his/her issues in life. Of course, the Christian Counselor is still called to express empathy, love and non-judgement to those who express different gender or moral questions.
With this guideline in place, it is important for Christian Counselors or counselors who are Christian to have a better understanding regarding the conflict between Christianity and the role of gender ideology and oppression. Please also review AIHCP’s Christian Counseling Certification.
Christianity and Oppression
The Church is divinely founded institution by Jesus Christ but made for human beings Human beings are imperfect and hence subject to corruption. The Church while divinely inspired via the Holy Spirit still makes mistakes because of its human element. These mistakes are highlighted throughout history through the numerous atrocities made in the name of Christ through discrimination, persecution and war. It is unfair to say Christianity is the sole religion to be hijacked by fanatics and misused. Throughout history, human beings have used religion as a way a propaganda tool for horrendous things, but does this dismiss the faith itself? Humanity would find new vehicles to promote hate and war if faith ceased to exist. An atheistic world would find ways promote different groups against one or the other. Still, those who wish to divide, hate and control misuse religion. Christianity itself has been utilized for evil ends never intended by Christ Himself.
Christianity’s essence is anti-oppression because Christ frees us all from sin.
Jesus Christ came to free the oppressed, namely every soul under the oppression of Satan and the sin of Adam. Christianity within its founding is non-oppression creed that looks to find equality within Christ. St Paul states that whether Gentile or Jew, slave or free, male or female we are all equal and one under Christ (Gal;3:28). Yet despite this, evil men and women have corrupted the faith throughout the centuries and caused great pain and suffering to various oppressed groups throughout Europe. In turn, Christianity as the major cultural identifying and unifying force of Europe became an instrument and tool to imprison and enslave the world under the promise of saving souls. Numerous European nations, used faith as a justification to subjugate Africa, the Americas and Asia. While the sweet gift of Christ was awarded to many individuals and spiritual salvation was found, the enormous cultural and ethnic raping of other civilizations created the third world that we know today. European pride, colonization and imperialism became associated with Christianity for many others.
It is important as counselors within the Christian tradition to understand this historical reality. Christianity is seen by many diverse groups as an oppressor due to its affiliation with Christian nations of Europe and also Christian missionaries who behaved like colonizing agents of change instead of messengers of the Gospel. This is not to dismiss the great work of many missionaries in both Protestant and Catholic traditions. Many good people spread the Gospel. Many saw the equality of all cultures and their beauty while trying to share Christ, but many also looked to Europeanize and destroy the indigenous culture. These scars and hatreds against the Church are real.
So while as a faith, Christianity is non-oppressive, in action, imperfect human beings have utilized it as an oppressive agent within Europe and across the world. Jesus Christ, Himself, would spew these bad examples of faith, as He did the numerous Pharisees of His time, but this sometimes brings little comfort to those who have faced oppression through the Church. As a Christian Counselor, one must understand that Christianity is seen to many as the “common enemy” and not be naive to think everyone sees the face of a Christian as an inspiration, especially in counseling.
Oppression Ideologies
Oppression is real in the world and to deny it because one has not seen it is a grave error. While many Christians, especially those of European descent, may exist in a bubble of the perfect world, many other Christians and non-Christians alike in different cultures experience oppression and racism daily. Whether at the micro-level, or at higher levels, individuals suffer numerous slights and injustices. These potential clients also bring to the counseling room these injustices and Christian Counselors or merely counselors who are Christian must be aware of their target populations and the injustices associated with them.
Approaches to facing oppression exist within and without Christianity. Liberation Theology in Latin America is a critical theory that combines Christian values with Marxist ideologies. Karl Marx, the social philosopher and Father of Socialism taught that there is a clash between the classes. Between the haves and have nots, there has also existed class warfare, whether slaves and owners, serfs and lords, or workers and labor barons. Different names and times but the same class war has always existed, according to Marx. Liberation occurs when the masses take control and find justice through constant revolution. Liberation Theology took a critical look at the Church and its structure as a hierarchal structure of class between clergy and the people. This of course also analyzed the role of women as an oppressed group within the faith and the power of the clergy within the faith. As a Jesuit Catholic theory, it questioned the power of the papacy and hierarchy, as well as questions regarding women priesthood.
Unfortunately, throughout history, the cross has been used by evil men to subjugate, but this far from the message of Christ. Please also review AIHCP’s Christian Counseling Certification
Ultimately, the outgroup or group that suffered discrimination looks to find a seat at the table. Ways to address these issues are found usually in two common theories, the Common Humanity Theory or the Common Enemy Theory. Those under the umbrella of the Common Humanity school look to rectify social injustice and inequality by denouncing differences and injustices and condemning inequality and seek to emphasize that all human beings are equal in dignity. Humanity must work together to resolve past injustices and eliminate present examples of racism or oppression. Common Humanity approaches embrace solidarity and the common human solution. In contrast, Common Enemy, focuses more on the oppressor. It searches to eliminate racism and oppression by turning on past oppressors or institutions and weakening their power. In many ways, the ideology looks to burn it all down. It is more Marxist in thought and identifies the “other” more so than the common. Hence those associated with the oppressing past through no fault of their own must be educated and balance must be restored through recognition of division.
There is good from both ideologies and usually a mixed approach is best. Common Humanity can sometimes dismiss differences which are important to understanding oppression but also the diversity within humanity. While it embraces a beautiful Christian concept that we are all children of God and one people, it over generalizes and can dismiss how these differences are real and important while still attempting to eliminate oppression. It can sometimes belittle past injustices and only wish to push forward. Common Enemy obviously is more destructive and dividing with its Marxist ideology. It can make progress difficult because it looks to divide between the haves and have nots and punish those who are descendants of the oppressing group. It essence it can seek to attribute punishment on the descendants of the past oppressive group. This ultimately turns the past oppressor into a new outgroup that faces its own discrimination. Christianity and white males face discrimination for white privilege or Christian morality that finds some acts immoral. Personal belief becomes bigotry and this is wrong.
A mixed road acknowledges common humanity and how everyone must work together to eliminate oppression but this mixed road also accepts the past wrongs and histories and acknowledges privilege in a non-hostile fashion. The common road recognizes the past but also works towards a common future while identifying the beauty of diversity. In the world today, we see protestors demanding the churches be torn down, or statues defaced, or absurd reparations for actions hundreds of years ago, while we also see individuals ignoring history , their own privilege and blessings because of their race or ethnicity, or not willing to offer fair compensation to certain cultures such as Native Americans or oppressed African Americans.
Dealing with Gender Based Ideologies in Christian Counseling
With these important guidelines have been set, one must carefully identify the pain of gender based groups that include women, homosexuals and transgenders. In counseling, many Christians who counsel or in fact perform Christian Counseling services may come across the marginalized within these groups. It is critical within our purpose to present a mixed approach that recognizes the pain of these groups, the wrongs of the Church but also a presentation that defends the integrity of Christ’s original message. This unfortunately, while condemning oppression, lead to extremely different moral outcomes that need to be mutually respected by both sides. Unfortunately, as an ex oppressing group, many Christians are not given this common and mutual respect of disagreement and can be labeled as medieval, prejudice or misogynistic. In order for true freedom to exist, Christian morality cannot become the newly oppressed. Yet, if the counselor, one must sometimes withhold personal opinions or beliefs, or if within Christian Counseling itself, withhold anger or judgement against an an angry client or one who professes a different life style. In counseling, empathy and healing is the desired result and the client is also a patient in which one must do no harm.
Feminism
Women have unjustly been discriminated throughout human history. Women have been seen as the weaker sex due to physical limitations. Various gender roles have attempted according to different cultures to place women in certain stations instead of validating individualism. Different cultures have different disparities of gender based oppression (Pedersen, 2018, p. 211). Many men have experienced a privilege based on the group they belong to and not based on what they have done or not done (Pedersen, 2018, p. 211). Hence women have been held back in many social spheres in religion, politics, work and the family. Women who are of a certain ethnic minority suffer a second oppression as well. This is referred to as double minority status (Pederson, 2018, p.214).
The feminist moment in the late 19th and early 20th Centuries looked to alter the oppression faced by women. It sought to remove the illusion of male superiority over females based on merely biological appearances. From a Christian perspective, movement within itself embraced the idea that God created both male and female and that all under Christ are one. Its success led to multiple triumphs in woman rights including the right to vote, as well as the appearance of women participating in politics and governance. While opening women to the work force, there still exists unequal pay barriers as well as natural prejudices that exist within social norms of Western civilization. While women have made great leaps in gaining equal treatment in society, there still exists numerous prejudices and inequalities. These issues are common problems for many women in counseling sessions and counselors need to address these issues and also advocate. This is especially the case in rape and domestic abuse which is a critical issue for women world wide.
The Christian faith recognizes the advances against oppression but still rejects radical elements of these movements that attack gender, sexuality and marriage
Yet, despite these great advances, the Church finds itself at odds with many Feminist ideologies. Some denominations pending on their level of conservative values have less friction than others but for the most part, radical feminist ideologies remain in contrast to the Christian faith. Working from least to most controversial, the role of women within the Church has greatly changed since the 1960s. Women are more seen in the Church in regards to liturgical presence than ever before. In Protestant denominations, many women serve as ministers or even bishops. In Catholicism and Orthodoxy, while the priesthood remains for males only, women now participate in liturgical services as lectors, servers, and eucharistic ministers. Permitting this has laid to rest many class/gender war ideologies within the Church but still many within the Catholic and Orthodox Churches see the theological dogma of a male only priesthood as a class struggle as identified in Liberation Theology instead of a moral absolute.
However, radical feminism has pushed into other areas there is little debate within Christian morality. Feminism pushed for a less constrained morality of the female body. Radical feminism, not true feminism, assaulted the role of husband and wife within the Sacrament of Marriage, the nature of the conjugal or sexual act, as well as attacking the rights of the unborn child. Ironically, early feminist movements condemned birth control and abortion as ways males escaped accountability. Recent radicalism has seen it as autonomy of the woman over male restrictions. All of these cases of oppression whether it is state of a woman’s role within the Church to sexual rights have disguised these questions about oppression. Radical groups have taken issues of oppression into issues of faith and morals. The radical movements look to not seek relief from oppression but looks to alter the institution and the morality of Christianity- and turn any Christian, male or female, who opposes it as an oppressor and bigot. Unfortunately, movements against oppression, or least some parts of it, can become radicalized and seek to cause damage and turn those who profess the faith as the newly oppressed.
Still, as Christian Counselors, we need to identify and show empathy with women who face true discrimination issues but also show patience with those who become angry with the Church and its morality. Those who are secular counselors must learn to balance profession and faith and attempt to focus more so on the issues female clients face without further angering or enraging them but instead listening and understanding the pain they experience as women in an unfair world and when appropriate showing action on their behalf.
Sexuality
One group that has faced extreme oppression are those who express different forms of sexual orientation or preferences. The LGBTQ movement has looked to cause awareness regarding the plight and suffering of these marginalized groups. Obviously the dominant group and socially accepted is the hetero-sexual community which makes up most sexual orientations. Those with hetero-sexual inclinations are seen as “normal” and experience far less bias and social hate. Heterosexism is the belief that any sexual relationship that is not between a man or woman is not normal and inferior (Pederson, 2018, p. 221). In addition, Homosexuals have been targeted throughout history with hate crimes and club shootings solely based on their sexual orientation. Only since the 1990s have stigmas of social outcasts been removed and the right to marry and other legal statuses granted, yet, hate still permeates under the cracks of society and this marginalized group still faces discrimination, jokes, hate and violent crimes.
Of course, this type of oppression is condemned by Christianity and Christ commands to love one’s neighbor. While Christianity continues to recognize the homosexual act as unnatural and sinful, the Catechism of the Catholic Church points out that the feelings and the urges themselves are not sin but a result of one’s broken nature, like any impure thoughts, they are to dismissed. The catechism also calls for those with this un-natural inclinations to live a life of purity and prayer. The Church forbids any hatred to the person who expresses this life style but condemns the action itself. Radical movements would label this as oppression but the Church and most of Christianity holds a moral absolute principle. It in no way seeks to restrict homosexuals in public and secular life but holds them accountable if they wish to confess the Christian creed. Restrictions within the faith are not oppressions. Christians are restricted from many moral acts, homosexuality is just one of many and if one wishes to follow Christ, one must take up one’s cross and follow the commandments.
Christian Counselors can find themselves in a delicate situation when navigating faith and counseling with cases such as transgenderism
Christian Counselors are ethically held to show nothing but love and empathy for any homosexual clients and must while highlighting the moral truths of the faith show patience and non judgement. In addition, ideas such as conversion therapy can be very dangerous to the mental health of homosexuals who come to Christian Counseling. Many who wish to live chaste lives struggle and to ignore or pretend the emotions are not real can cause intense mental damage. Every moral temptation, for whichever vice in life, needs to be acknowledged, understood and coped with as a cross in life. Attempting to make a person who is homosexual to heterosexual in terms of what they find attractive is something beyond mere wishing or desiring but a true feeling that needs to be discussed. When this feeling is cast aside as dirty or evil or fake, then this can leave a person in a very dark place. As for those Christians in secular counseling, the counselor must restrain their own bias and look to help the client despite any moral disagreements. In cases of extreme distress in counseling between counselor and client, a mutual agreement can be made for reference to another counselor but this to must be done with the utmost professionalism and concern for the well being of the patient. It is unethical to abandon any client due to moral differences.
In addition to homosexuality within the LGBTQ movement are transgenders who identify as a different sex and gender than biologically born as. Pederson points out that transphobia ranges from fear, disgust as well as hatred towards those who alter their gender or cross dress (2018, p.215). Transgender people have faced sharp ridicule and are also victim to many hate crimes, as well as discrimination. Pedersen labels those of one gender as possessing cisgender privilege without the discrimination faced by the transgender community (2018, p.215). Pederson lists various definitions of sex, gender, gender identity and gender role. He states sex is the biological traits that determine a male or female, while gender is defined as learned behavior or social construct that influences gender and its role (2018, p. 210). Gender identity, according to Pedersen, is the perception of one’s own gender as a man, woman, boy, girl, non-gendered, bigendered, or transgender (2018, p. 210).
As a counselor, those facing transgender issues or homosexuality issues face other issues beyond discrimination but a variety of conflicts within. Many experience high levels of depression, anxiety, low self esteem and abandonment. Families and friends can abandon them leaving them without support and leaving them in total isolation.. In addition, many may experience suicidal ideation. The conflict of who I feel I am and what I was born or what my faith states can cause great internal torment. Many may feel guilt or shame or become obsessed with radical alterations.
While gender roles play a part in social norms of society of how a boy or girl acts, it is important to note that certain gender roles can be constrictive to expression of individuals and sometimes within themselves harmful to emotional outlets. For instance, men should never cry, or women are meant to stay at home, or boys should play with trucks and girls with dolls are prominent in society. These are social norms, but when individuals look to express their individuality, then these norms can be dangerous, however, what about when they constrict gender discovery? Christian Counseling does not find the Pederson definitions as binding. Christian Counseling conforms with a conservative psychology perspective that transgenderism is a dysphoria from reality vs the current mainstream definition. With only main stream protocol currently accepted, counselors are encouraged to help clients identify and associate with the self that best fits and to find support and groups that affirm one’s feelings. Because of this , within the modern era for Christian Counselors, it has become the unfavorable statement albeit the most obvious that something is mentally wrong . Yet due to the highly flammable and emotional state, only the most highly trained counselor should attempt to discuss these issues since the person is already extremely distressed. When treating a transgender person, a counselor must approach it very carefully to protect the client against suicide and to not only discuss the external oppressions but also the internal anguish of conflict that exists within the person and how to properly cope and address these intense feelings in a healthy way. This is why in secular counseling, a counselor must leave personal bias aside and address the symptoms.
While oppression exists within these communities and it must be acknowledged and addressed by counselors, there is a deeper issue and more dividing issue when radical forces attempt to challenge Christian morality. In Genesis, God created them both male and female. In Christianity, one’s gender is more than one’s biological shell but an intimate part of the human person tying together the body, mind and soul. In St. Pope John Paul II sermons ranging from 1978 to 1984 regarding the human body, formerly referred to as the Theology of the Body, John Paul II paints a beautiful image of the journey of the body and soul throughout life and its continued existence in the glorified body after the General Resurrection. Hence the body and its gender plays a large role in the total person, body, mind and soul, not just the body itself. Of course, other religious traditions place less emphasis on the body but for the Christian Counselor, ones sexuality and essence are closely tied together through the creation of God. This can lead to issues of moral disagreement between the transgender community as well as the Christian community. The radical movement will label Christian morality regarding transgenderism as oppression while the Christian community will label it merely as a sin and choice that is rejected. This does not mean the Christian community wishes to oppress, but it looks to make a moral statement on a moral issue that best fits its own moral code. In many cases, the Christian community can then become oppressed like the transgender community because of non Christian values that see it as prejudice or oppressive.
As counselors, one must do no harm and perform according to the standard in helping someone with this diagnosis. It is important to acknowledge their oppression and the hate that exists against them, but many would say not to confront it but to merely show empathy and help the person find happiness. In a secular counseling session, this may be the best course of action. However, within the Christian Counseling setting, again, one is more free to discuss gender dysphoria, as well as the scriptural elements of gender, especially since the client is asking for Christian guidance. Christian Counseling is able to escape the restrictions of secular limitations when discussing immorality.
Conclusion
Multicultural counseling with groups who experience oppression require sensitive approaches that acknowledge oppression an advocate for social justice. Approaches that utilize Common Humanity and Common Enemy are best utilized as a combination to solve the oppression issues within the world. Christianity unfortunately has been misused by evil individuals throughout the centuries to perpetrate oppression. Sometimes, Due to religious and moral differences, attempts can be made to label Christians as bigots, when in reality they are merely holding to a belief.
Multicultural counseling demands respect for others with different moral backgrounds or gender ideologies. Please also review AIHCP’s Christian Counseling Certification
In addition, gender and choice of sexuality continues to be a difficult issue addressed in counseling for counselors who are Christian, as well as those who provide Christian Counseling to those targeted groups. Differences in faith and moral choices can be a conflict for a counselor, especially within transgender ideology. Counselors nonetheless are held to hold to the axiom of do no harm and treat each patient with empathy and non judgement. Christian Counselors have more freedom than secular counselors but while able to address morality still must show love and not abandon their client. Any issue of oppression is evil and must be rectified. The groups discussed are targeted for gender or sexuality and this is wrong within a secular society. Some of the movements answered great injustices while other aspects of it became radicalized. Be careful not to over generalize. From a Christian perspective, it is OK to disagree with certain parts but still agree on others. Believing something is a sin or wrong does not make someone a bigot. However, when one seeks to oppress or hate another group, then one commits an even greater sin of hate. Between alt left groups who wish to catalogue believing Christians as bigots regarding gender morality and alt right groups hoping to ignore history and hate the person but not the sin, little dialogue can occur. Believing Christians and social progressives can find common ground by respecting each other and finding commonality. Ultimately, Christ calls all to love one another. Christ alone judges.
Please also review AIHCP’s Christian Counseling Certification and see if it matches your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification as a Christian Counselor.
Resource
Pedersen, P, et, al. “Counseling Across Cultures” (7th). Sage.
Additional Resources
Keathley, K. (2024). “Thinking Biblically about Transgenderism: A Biblical Response to Current Trends”. Center for Faith and Culture. Access here
Lynn, S. (2019). “How should Christians respond to those experiencing gender dysphoria?”. Christian Post. Access here
“Guidelines for Psychological Practice With Transgender and Gender Nonconforming People” APA. Access here
“Transgender: Ensuring Mental Health” Cleveland Clinic. Access here
“Voices of women and girls essential to fight for human rights” (2022). United Nations. Access here
“The 11 biggest hurdles for women’s equality by 2030”. (2023). UNwomen. Access here
Hancock, K. (2006). “APA’s Guidelines for Psychotherapy with Lesbian, Gay and Bisexual Clients: The Fundamentals for Practice”. APA. Access here
Hays, D. et, al. (2007). “Addressing Privilege and Oppression in Counselor Training and Practice: A Qualitative Analysis” . Journal of Counseling & Development ■ Summer 2007 ■ Volume 85. Access here
Environmental health and holistic nursing are interconnected fields that have a profound influence on patient care and public well-being. As healthcare faces growing challenges from environmental factors, the need to define holistic approaches in nursing has become increasingly important. Holistic nursing practice integrates environmental awareness with comprehensive patient care, recognizing the complex relationships between human health and ecological systems.
Environmental health is a key component of holistic nursing
This article explores the intersection of environmental health and holistic nursing, examining their roles in modern healthcare. It delves into the foundations of holistic nursing and its connection to environmental determinants of health. The discussion covers global environmental challenges, the nurse’s role in protecting environmental health, and efforts to green the healthcare sector. Additionally, the article addresses the integration of environmental health into nursing education and emerging trends in holistic health nursing, providing insights into the evolving landscape of holistic care in nursing. Please also review AIHCP’s Holistic and Integrative Health Care Certification Program
Understanding Environmental Health in the Context of Holistic Nursing
Definitions and Scope
Environmental health is a critical aspect of nursing practice that has a profound impact on individual and community well-being. The American Nurses Association (ANA) has established an Environmental Health standard, which states that “The registered nurse practices in a manner that advances environmental safety and health.” This standard underscores the importance of environmental considerations in nursing care.
The environment encompasses the air we breathe, the water we drink, the food we eat, and the places where we live, work, and play. Environmental health hazards are substances or pathogens that have the potential to cause adverse health effects in individuals or communities. These hazards can be categorized into five main areas: housing, occupational, atmospheric, foodborne diseases, and waterborne diseases.
Examples of environmental hazards include air contaminants, toxic waste, radiation, disease-causing microorganisms and plants, pesticides, heavy metals, chemicals in consumer products, and extreme temperatures and weather events. Recognizing these hazards enables community health nurses to provide valuable information to community members and implement prevention strategies that promote positive outcomes.
Interdisciplinary Nature
Environmental health issues rarely have simple solutions that can be addressed by a single discipline. The complex nature of these issues, the rapidly advancing science base, and the need for primary prevention strategies often require collaborative efforts from various fields. Effective interventions for environmentally related illnesses necessitate interdisciplinary teamwork.
Holistic Nurses offer a unique and invaluable perspective on environmentally related health issues. However, to incorporate environmental health concerns into their practice, nurses need to function as members of interdisciplinary teams. This collaborative approach, with some overlap of function, allows members of various disciplines to interact with a shared overall mission.
Relevance to Nursing Practice
Environmental determinants of health and disease are integral to all components of nursing practice, including assessment, diagnosis, intervention, planning, and evaluation. However, environmental factors affecting health are often overlooked in routine patient assessments. By taking a proactive approach, nurses can initiate preventive actions to address hazards before they manifest as diseases.
The nursing process, consisting of assessment, diagnosis, planning/outcomes, intervention, and evaluation, is central to all nursing actions. Applying this process to environmental health issues may require nurses to employ various phases in new ways. For instance, interventions might involve recommending changes that affect entire neighborhoods or communities.
Holistic Nurses have a crucial role in assessing and addressing environmental health issues. This aligns with the nursing profession’s values regarding disease prevention and social justice. The International Council of Nurses (ICN) has emphasized that nurses need to be concerned with the promotion, maintenance, and restoration of the natural environment’s health.
As the largest group of workers in the healthcare industry, nurses have an ethical obligation to address health disparities and equity issues associated with environmental exposures. They can determine the probability of risk, conduct risk assessments, and design risk management plans that address policy development, engineering strategies, education on risk, and legal remedies for securing a “place at the table” for nurses as decision-makers.
The Foundations of Holistic Nursing
Holistic nursing is a comprehensive approach to healthcare that considers the interconnectedness of the mind, body, spirit, emotions, and environment in patient care. This practice is grounded in a body of knowledge, evidence-based research, and sophisticated skill sets, all of which are underpinned by a philosophy of living and being that emphasizes caring, relationship, and interconnectedness.
Theoretical Frameworks
The foundation of holistic nursing is supported by several theoretical frameworks that guide practice. These theories provide a structure for understanding the complex interplay between various aspects of human health and well-being. Some of the key theories that inform holistic nursing include:
King’s Theory of Goal Attainment
Neuman’s Systems Model
Rogers’ Theory of Unitary Human Beings
Nightingale’s Environment Theory
Watson’s Philosophy and Science of Caring
These theoretical frameworks help holistic nurses to conceptualize care that addresses the whole person, recognizing that individuals are more than just their illnesses or symptoms.
Core Values
The practice of holistic nursing is built upon a set of core values that reflect an integrated approach to caring for the whole person. These values, as outlined by the Academy of Integrative Health and Medicine (AIHM), include:
Prevention as the best intervention
Integration of healing systems
Relationship-centered care
Individualized care
Teaching by example
Recognition of innate healing powers
Embracing all experiences as learning opportunities
Acknowledging the healing power of love
Optimal health as the primary goal
These core values guide holistic nurses in their practice, ensuring that they address not only the physical needs of patients but also their psychological, social, and spiritual needs. This comprehensive approach recognizes that all these aspects combine to create the person, and therefore, to heal the person, all aspects must be considered.
Holistic Assessment and Interventions
Holistic nursing assessment is a crucial component of this practice, involving a systematic and continual collection, validation, and analysis of data about a patient within their bio-psychosocial context. This assessment goes beyond traditional questions about symptoms to inquire about relationships, coping mechanisms, emotional responses, routines, and lifestyle factors that can impact overall well-being.
The components of a holistic nursing assessment include:
Physical assessment
Psychological assessment
Social assessment
Spiritual assessment
Based on these comprehensive assessments, holistic nurses employ a variety of interventions that address the multifaceted nature of human health. These may include:
Relaxation and breathing techniques
Mindfulness and meditation practices
Aromatherapy
Reiki and therapeutic touch
Herbal remedies
The implementation of these techniques involves tailoring the approach to each patient’s unique needs and preferences, always considering the individual’s beliefs and values concerning holistic care.
By integrating these foundations, core values, and holistic assessment and intervention techniques, holistic nursing strives to provide care that is not only comprehensive but also deeply respectful of the individual’s unique experiences and needs. This approach has shown to result in higher rates of patient satisfaction and improved health outcomes compared to conventional care, highlighting the significance of holistic nursing in modern healthcare practice.
Environmental Determinants of Health
Clean air is pivotal to patient health. Numerous pollutants can cause numerous issues for patient health
Environmental determinants of health encompass a wide range of physical, social, and built factors that significantly influence human health and well-being. These determinants play a crucial role in shaping health outcomes and contribute to health disparities across different populations.
Physical Environment
The physical environment where individuals live, learn, work, and play has a profound impact on their health. It includes the air people breathe, the water they drink, and the spaces they inhabit. Environmental pollutants in the physical environment can lead to various health problems, including respiratory diseases, heart disease, and certain types of cancer.
Air pollution, in particular, has been associated with increased rates of asthma, lung diseases, and premature deaths from heart and lung conditions. Similarly, contaminated water sources can result in illnesses, infections, and elevated risks of cancer. The World Health Organization estimates that more than 12 million people worldwide die annually due to living or working in unhealthy environments.
It is important to note that exposure to environmental hazards is not equally distributed. People with low incomes are more likely to reside in polluted areas and have unsafe drinking water. Additionally, children and pregnant women face higher risks of health problems related to pollution.
Social Environment
The social environment plays a significant role in determining health outcomes. Social and cultural factors, such as socioeconomic status, education, and access to resources, can influence health throughout an individual’s life course. Disadvantaged neighborhoods often face multiple challenges, including exposure to more air pollution due to proximity to heavy traffic, lack of local amenities like grocery stores and health clinics, and exposure to signs of social disorder.
These social determinants of health can lead to stark differences in health outcomes between and within communities. People with low incomes and people of color are disproportionately affected by these disparities, which are rooted in a long history of discrimination, disinvestment, and exploitation in the United States.
Built Environment
The built environment refers to the human-made surroundings that provide the setting for human activity. It includes aspects such as urban planning, transportation systems, and the availability of health-promoting resources. The design of the built environment can significantly impact health behaviors and social interactions.
For instance, the proximity to healthy or unhealthy food stores has been linked to dietary behaviors and related chronic disease outcomes. Food availability and advertising influence energy intake and the nutritional value of foods consumed. Similarly, access to recreational facilities, land use mix, and urban design features affect walking and physical activity levels.
The built environment can also contribute to health risks. Spread-out suburban designs often facilitate reliance on automobiles, increasing pollution and decreasing time spent walking. This has multiple health effects, including increased respiratory and cardiopulmonary illnesses due to pollution, reduced leisure time for health-promoting activities, and increased risk of traffic accidents.
Addressing these environmental determinants of health requires interventions and policy changes at local, state, and federal levels. Strategies such as providing opportunities for walking and biking in communities, improving access to healthy foods, and reducing exposure to environmental pollutants can help promote health and reduce health disparities.
Global Environmental Health Challenges
Global health is directly related with environmental health issues
Air pollution and respiratory health
Air pollution continues to be a significant concern to public health worldwide, posing challenges for both developed and developing countries. Individuals with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma are particularly vulnerable to the detrimental effects of air pollutants. Studies have linked particle pollution exposure to various respiratory health effects, including cough, phlegm, wheeze, and acute, reversible decrements in pulmonary function.
Particle pollution has been associated with inflammation of the airways and lungs, bronchial hyperreactivity, and an acute phase reaction. These effects can lead to respiratory infections, increased emergency department visits, and hospitalizations. Long-term exposure to fine particles has been linked to decreased lung function growth in children and chronic loss of pulmonary function in adults.
People with heart or lung disease, children, individuals with diabetes, and certain demographic groups are at greater risk of particle pollution-related health effects. The extent of pulmonary inflammation depends on particle dose and composition, with organic carbon particles and transition metals from combustion sources eliciting a strong inflammatory response.
Water scarcity and waterborne diseases
Despite water covering 70% of our planet, freshwater—essential for drinking, bathing, and irrigation—is incredibly scarce. Only 3% of the world’s water is fresh, and two-thirds of that is unavailable for use. As a result, approximately 1.1 billion people worldwide lack access to water, and 2.7 billion experience water scarcity for at least one month of the year.
Inadequate sanitation affects 2.4 billion people, exposing them to waterborne diseases such as cholera, typhoid fever, and other illnesses. Alarmingly, two million people, mostly children, die annually from diarrheal diseases alone. Climate change is exacerbating this situation by altering patterns of weather and water around the world, causing shortages and droughts in some areas and floods in others.
Water pollution from various sources, including pesticides, fertilizers, untreated human wastewater, and industrial waste, further compounds the problem. Even groundwater is not safe from contamination, as pollutants can leach into underground aquifers. The effects of water pollution can be immediate, as with harmful bacteria from human waste, or may take years to manifest, as with toxic substances from industrial processes.
Toxic exposures and chronic diseases
Exposure to toxicants in the environment has been linked to the rapid increase in chronic, noncommunicable diseases worldwide. Escalating rates of neurocognitive, metabolic, autoimmune, and cardiovascular diseases cannot be attributed solely to genetics, lifestyle, and nutrition. Early life and ongoing exposures to bioaccumulated toxicants may also contribute to chronic disease development.
Studies have shown that exposure to chemicals in everyday products used to build and maintain homes, as well as pesticides and combustion products, can lead to a condition known as Toxicant-induced Loss of Tolerance (TILT). TILT represents a new class of environmentally induced diseases that share the same underlying bio-mechanism, involving the activation of mast cells, which are the “first responders” to foreign substances like chemicals and viruses.
The consequences of these exposures are particularly concerning for children, who are more susceptible to the effects of environmental toxicants. The complex web of disease and environmental contributors requires a multifaceted approach to address these global environmental health challenges, with potential for significant benefits in improved health and productivity worldwide.
The Holistic Nurse’s Role in Environmental Health Protection
Nurses play a crucial role in protecting environmental health through various strategies and interventions. Their unique position in healthcare allows them to address environmental health concerns at individual, community, and policy levels.
Risk Assessment
Environmental health risk assessment is a fundamental aspect of nursing practice. Nurses integrate environmental health components into routine patient assessments by including questions about prior exposure to chemical, physical, or biological hazards. They also explore temporal relationships between the onset of symptoms and activities performed before or during the occurrence of symptoms.
The Environmental Protection Agency (EPA) employs a four-step risk assessment process to evaluate potential pollution and hazards:
Hazard Identification: Identifying potential negative outcomes from exposure to specific agents.
Dose Response: Determining the relationship between exposure amount and health effects.
Exposure Assessment: Quantifying the extent, frequency, and length of human contact with environmental agents.
Risk Characterization: Synthesizing information to provide an overall understanding of risks and uncertainties.
Nurses can utilize these steps to conduct individual environmental health assessments, which are essential tools for identifying, preventing, and educating individuals about environmental health concerns. These assessments consider a broad range of potential environmental exposures, including indoor agents, outdoor air pollution, water sources, and exposure to pesticides or industrial waste.
Health Promotion
Health promotion is a powerful tool that nurses use to create a positive, lasting impact on patients’ lives. The three basic health promotion strategies are:
Health communication: Helping people better understand health needs and equipping them for important individual health decisions.
Health education: Teaching people about different health conditions to bolster prevention or early treatment.
Policy, systems, and environmental change (PSEs): Implementing changes at various levels to address health challenges.
Nurses can work with these strategies to promote health within the communities they treat. They can act as educators by speaking at community gatherings and becoming involved in community-level activities related to the environment and human health. Additionally, nurses may participate in risk or hazard communication for public health agencies.
Environmental Justice
Nurses have a significant role in promoting environmental justice by addressing disparities in environmental health risks. Home health assessments are critical for promoting health equity by addressing disparities in housing quality. For example, programs to improve home indoor air quality have been proven to reduce the incidence of asthma among BIPOC children and children residing in substandard housing.
Community health assessments provide information about potential and real environmental risks faced by individuals living, working, or recreating in a particular community. Nurses can conduct windshield surveys to visually identify potential environmental risks, such as the location of industries, hazardous waste, dumps, major thoroughfares, pests, the use of pesticides, air quality, and housing conditions.
By engaging in these activities, nurses contribute to the broader goal of environmental health protection, ensuring that all individuals and communities have access to a safe and healthy environment. Their role extends beyond individual patient care to advocacy for policies and practices that promote environmental health and justice on a larger scale.
Greening the Healthcare Sector
The healthcare industry has a significant environmental impact, contributing to carbon emissions, plastic use, and waste generation. However, there is a growing recognition of the need for sustainability in healthcare facilities. This shift towards greening the healthcare sector encompasses various aspects, including sustainable hospital design, eco-friendly medical products, and effective waste management strategies.
Sustainable Hospital Design
Sustainable hospital design has gained momentum in recent years, with the US Green Building Council’s Leadership in Energy and Environmental Design (LEED) standards serving as a benchmark for green building construction. These eco-friendly hospitals aim to reduce energy costs and improve patient outcomes while minimizing their environmental footprint.
Key principles of sustainable hospital design include:
Maximizing natural light: Increasing the use of natural light through transparent openings, skylights, and low-power LED lighting can reduce energy consumption and positively impact patient well-being.
Improving indoor air quality: Incorporating indoor plants and using materials with low volatile organic compounds (VOCs) can enhance air quality within the facility.
Utilizing green building materials: Selecting materials that resist the growth of pathogenic bacteria, fungi, and viruses contributes to a healthier indoor environment.
Integrating gardens and landscaping: Green spaces not only enhance esthetics but also provide therapeutic benefits to patients and staff.
Optimizing building orientation: Carefully designing facades and envelopes to match climatic preferences and solar orientation can significantly reduce energy consumption and cooling demands.
Eco-friendly Medical Products
The medical device industry is increasingly recognizing the importance of sustainability in product design and manufacturing. Eco-friendly medical devices aim to reduce environmental impact throughout their lifecycle, from production to disposal.
Examples of sustainable medical product innovations include:
Reusable insulin pens: Novo Nordisk’s NovoPen Echo and NovoPen Echo Plus are designed for easy disassembly and recycling, reducing waste generation.
Propellant-free inhalers: The Breezhaler by Novartis eliminates the need for hydrofluoroalkane propellants, reducing the device’s carbon footprint.
Sustainable packaging: Manufacturers are exploring ways to minimize packaging materials and increase the use of recyclable or biodegradable options.
Waste Management Strategies
Effective waste management is crucial for reducing the environmental impact of healthcare facilities. Hospitals and clinics generate various types of waste, including hazardous, medical, pharmaceutical, and general waste.
Key strategies for improving waste management in healthcare include:
Waste segregation: Implementing color-coded bins and clear signage to facilitate proper waste separation at the point of generation.
Staff training: Providing comprehensive education on waste management protocols, infection control measures, and environmental sustainability.
Waste reduction: Analyzing waste streams to identify opportunities for reducing waste production and implementing better diversion strategies.
Exploring alternatives to incineration: Utilizing greener sterilization methods for regulated medical waste when possible.
Implementing reusable products: Transitioning from disposable to reusable medical supplies can significantly reduce waste generation, particularly in operating rooms.
By adopting these sustainable practices, healthcare facilities can reduce their environmental impact, lower costs, and contribute to a more sustainable future for the industry.
Integrating Environmental Health into Nursing Education
Integrating environmental health issues into nursing training is key for holistic schools of thought
The integration of environmental health into nursing education has become increasingly important as the healthcare sector recognizes the significant impact of environmental factors on human health. This integration encompasses various levels of nursing education, from undergraduate curricula to graduate programs and professional development opportunities.
Professional Development
Continuing education and professional development opportunities are essential for practicing nurses to stay current with environmental health issues. Organizations like the AIHCP offers a Holistic and Integrative Healthcare Program for nurses to earn a four year certification as a Holistic Nurse.
These professional development initiatives often include monthly webinars on relevant environmental health topics, emphasizing environmental justice and health equity. Participants are encouraged to hold educational sessions for fellow health professionals, sharing their learning and experiences in environmental health nursing.
By integrating environmental health into nursing education at all levels, the profession is better equipped to address the complex interplay between environmental factors and human health, ultimately contributing to improved public health outcomes and environmental sustainability.
Emerging Trends in Environmental Health and Holistic Nursing
Technological Innovations
The healthcare industry has witnessed a significant transformation due to technological advancements. Since the COVID-19 pandemic, developing and applying nursing technology has become a top priority, with new technologies revolutionizing patient care. These innovations include predictive analytics, mobile robotic systems, artificial intelligence (AI), and telehealth services. Predictive analytics, powered by AI, considers data from past patients to suggest optimal treatment courses, improving patient outcomes. Clinical mobility devices, such as handheld computers and smartphones, allow nurses to create convenient points of care and share real-time patient data with their teams. Robots are now capable of completing common nursing duties, such as making point-to-point deliveries and conducting contactless triage interviews.
Alternative Therapies
The integration of complementary and alternative medicine (CAM) into nursing practice has gained significant traction. Patients are increasingly seeking alternative therapies, prompting nurses to familiarize themselves with various CAM modalities. Common CAM therapies include acupuncture, aromatherapy, hypnosis, massage therapy, meditation, Tai Chi, therapeutic touch, and herbal supplements. These therapies have shown efficacy in various healthcare settings, such as reducing anxiety and pain post-surgery, improving balance in older adults, and aiding in addiction treatment. Nurses are encouraged to obtain appropriate education and clinical experience to maintain competency in CAM, as it complements conventional medical regimes and provides additional tools to boost overall quality of life and patient compliance with wellness programs.
Community-Based Interventions
Community and public health specialist nurses (CPHSNs) have emerged as key influencers in climate action, empowering communities to actively engage in achieving socio-political change. These nurses play a fundamental role in health promotion, supporting healthier lifestyle choices and advocating for adequate decisions from policymakers in urban settings. CPHSNs identify and diagnose environmental hazards resulting from climate change impact in urban areas and determine interventions that might lead to behavioral changes. Nurses worldwide are following United Nations recommendations for climate action within cities, helping individuals and families either mitigate their negative environmental impact or adapt to climate change impact by increasing their resilience. Planning for social innovation may involve reclaiming green infrastructures and sustainable designs for climate-resilient cities, such as greenways, which offer communities healthier lives by improving non-motorized routes and mitigating pollution in cities.
Conclusion
The intersection of environmental health and holistic nursing has a profound influence on patient care and public well-being. This comprehensive approach recognizes the complex relationships between human health and ecological systems, addressing not only physical symptoms but also psychological, social, and environmental factors. The integration of environmental health into nursing education and practice equips healthcare professionals to tackle global challenges such as air pollution, water scarcity, and toxic exposures. This holistic perspective allows nurses to play a crucial role in promoting health equity and environmental justice.
Please also review AIHCP’s Holistic Nursing Certification
Looking ahead, the field of environmental health and holistic nursing is poised for exciting developments. Technological innovations are causing a revolution in patient care, while alternative therapies are gaining recognition as valuable complements to conventional treatments. Community-based interventions led by nurses are empowering individuals and communities to adapt to climate change and create more sustainable urban environments. These emerging trends highlight the evolving nature of holistic nursing and its potential to shape a healthier, more sustainable future for all.
Please also review AICHP’s Holistic Nursing Program and see if it meets your academic and professional goals. The program is online and independent study and open to qualified nurses looking to implement holistic and integrative strategies into their nursing practice.
FAQs
What does holistic nursing entail?
Holistic nursing is a field of nursing that aims to heal the individual as a whole. This approach is applicable across various settings, including acute care hospitals, hospices, academic institutions, and private practices.
What responsibilities do nurses have in environmental health?
Nurses involved in environmental health undertake a variety of roles such as providing direct patient care, advocating for health, educating the public, developing health policies, assessing health and environmental risks, conducting research, and communicating the risks linked to environmental health hazards.
How is holistic health defined?
Holistic health focuses on the comprehensive care of an individual, addressing physical, mental, spiritual, and social needs. It emphasizes that an imbalance in any of these aspects can affect overall health.
Can you explain Florence Nightingale’s approach to holistic nursing?
Florence Nightingale, recognized as the pioneer of Holistic Nursing, emphasized the holistic principles of unity, wellness, and the interconnectedness of humans and their environment. Holistic Nursing, according to Nightingale, is an integral part of nursing practice rather than an isolated aspect.
Additional Resources
Correll, R. (2024). “What is Environmental Health and What Critical Issues Impact Our Health?”. Very Well Health. Access here
Multicultural counseling proficiencies are essential to good counseling. Since Western counseling initially emerged from Europe it is culturally immersed with European culture values. European culture is very individualistic, self-centered and free of many forms of oppression due to the fact Europe was the colonizing force between the 16th and 19th Centuries. Furthermore, while Europe’s secular awakening drove a wedge between its Christian culture and itself, Christianity still plays a key part of life in millions of individuals of European descent, as well as a driving force behind the intent of nations to colonize. With these things in mind, the classic male European descent counselor must be aware of his cultural identity and how that same identity translates his world views, as well as how others of different cultures perceive him as a person when counseling. Within melting pots nations, such as the United States or Canada, many minority cultures can look upon counseling itself with suspicion as a Western custom created by white men.
Grief and loss is also cultural and is expressed differently. This type of difference that inherently exists within different grieving cultures needs to be understood and respected within the grief counseling session itself. Kastenbaum points out that many from a different culture can misinterpret expressions of grief or rituals within another culture (2018, p.372). Please also review AIHCP’s Grief Counseling Certification, as well as its Grief Diversity Counseling Certification to learn more about responding better to other cultures during times of grief.
The African American Experience and Counseling
It is important to have a strong understanding of African American heritage but also African American oppression to fully help individual blacks in counseling
African American culture has an intense pride in its African heritage and its rich spiritual and cultural beliefs and rituals. While many in America have been culturally separated from the home continent and completely interwoven into a unique African American culture with its own history and adaptations, there still remains a strong echo of the past for many who look to rediscover their roots. African consciousness possesses ancestral wisdom, naturalistic attitudes, rhythm, and creativity (Pedersen, 2018, p. 147), These images help many African Americans tie to a greater power and consciousness to face the oppression they have faced for centuries. This consciousness helps blacks create a stronger self concept, self esteem and self image about themselves that was stolen so many centuries ago (Pedersen, 2018, p.147)
Due to imperialism, oppression and the slave trade, many African Americans cannot trace their lineage and families as European Americans. Many tribes of the Congo, Yoruba, Wolof and Ibo were targeted for the salve trade (Pederson, 2018. p. 145). Many of the records and identities of abducted human beings into the slave trade were erased from history and replaced with new roles and titles on various American plantations. In many cases, these individuals took upon the name of the slave owner or when emancipation occurred chose a simple American name. Hence some African Americans have a yearning to reconnect to their cultural heritage that was stolen from them.
When counseling with African Americans, there is large diversity to consider. Many marginalized blacks in America have been robbed of economic stability for generations. This has led to a succession of poverty, less education and less opportunity. Some blacks have been able to bridge the gap and are successful and resent the idea that they are marginalized and find pride in their work ethic and success. Some black communities are very religious and hold strong to the Christian faith, especially in Baptist congregations. Immigrant Africans hold stronger to the older ways of tribalism, honor, family, ancestors and have a far more spiritualistic religion than many Christian blacks. Some African immigrants share a combined spiritualism and Christian belief system as well.
Yet, within all the diversity, their exists the soul wound of imperialism and slave trade that forever scarred the continent of Africa. Whether from Africa and enduring genocide and civil wars due to European imperialism of the 18th and 19th Centuries, or from the United States and scarred from the history of slavery, segregation, economic theft, and racism, both African groups have historically faced collective wounds that have been transmitted from one generation to the next. This type of historical disadvantage has created numerous imbalanced economic opportunities. In addition, overt racism or systematic racism that exists within the system, has made the African American experience a far different experience than the European experience. Racial profiling, job discrimination and prejudices continue to haunt the black community. These incidents make even a random police stop into an entirely different ordeal for an African American than a white person. Hence when counseling a black client, one must realize racism and oppression have shaped the development and experiences of black people worldwide (Pedersen, 2018, p. 145).
It is important also when counseling African Americans to understand the value of family and groups within their grieving processes as well as life issues. Many African Americans turn to family and support and church before they look for mental health care. Group therapy and community interventions are more relatable to these social structures and can be beneficial for many African Americans (Pedersen, 2018, p.154). African Americans in general also prefer more naturalistic healing interventions, and prefer more so to face personal issues with action (Pedersen, 2018, p. 155). Again, these are collective statistics and each individual is different. When counseling across culture, it is important to remember the dictum of Kluckhohn and Murray (1949) that “each person is like all other persons, like some other persons and like no other person (Pedersen, 2016. p.42)”.
When helping African Americans who are grieving it is important to understand the numerous social issues that apply daily anxiety and sadness to the unique black experience in America. In addition, utilizing African American spirituality, family and church structures as well as modeling coping strategies after African American strengths can all play a key role in helping African Americans grieve in a more healthy way.
Counseling Mistakes with African Americans
Like many minorities, there can exist a mistrust for white mental health counselors. Even though African Americans make up the second largest non-white group in America, they still only represent 12 percent of the population (Pedersen, 2018, p. 144). With this in mind, counselors need to understand that blacks may not always be comfortable with a white counselor or someone from a different socio-economic background. Many blacks do not feel that the suburban American truly understands their concerns or fears.
It is important to understand the role of oppression, slavery, racism and discrimination when counseling African Americans.
White counselors need to understand the importance to acknowledge the concept of “White Privilege”. This refers to the unearned societal awards that are given to the white culture based on color of skin (Pedersen, 2018, p. 146). While liberals sometimes have taken the notion to far as to dismiss personal achievement and ignore poor life choices of others, one must conclude due to the centuries of oppression as well as economic imbalance given to the black community that better life opportunities have been granted overall to more whites than blacks in the present day. It is important to acknowledge this in counseling as well as publicly. It helps heal past soul wounds and helps generate awareness to possible past thefts against the black community and present day attempts to rectify those injustices. Again, this does not justify a black person to live a life of crime but it does suggest a better understanding of why so many blacks fall victim to a life of crime due to inherited poverty due to past injustices against their community. Hence in counseling, it is important for a white counselor to check him/herself and understand the role their color and experiences brings to the counseling room (Pedersen, 2018, p. 146).
In addition, Pedersen points out that ignoring race in counseling can also be negative. He refers to this concept as “Color Blindness” (2018, p. 146). When one attempts to ignore the role of color and race in a client’s life struggles and problems, then the counselor can miss the importance that oppression and soul wounds can play on a particular group’s mental health. The APA suggests that counselors always consider how racism and discrimination can be sources of distress for black populations (Pedersen, 2018, p. 146). In addition, conversely, imagining no color exists between counselor and client can also play a negative role in the counselor understanding his/her color as a factor in the counseling process.
Another mistake to avoid is the historically and inherently prejudice studies on black populations. Assumptions on African American attitudes and reactions to life have in the past resulted in an over diagnosis of schizophrenia and an under diagnosis of depression and anxiety (Pedersen, 2018, p. 152). While African American communities have historically suffered less from suicide due to family and church connections, studies also show like anyone, if an African American suffers from depression or substance abuse, his or her chance of suicide rises like anyone else. Also, it is important to note that when working with African Americans, there is a far higher chance of the clients exposure to violence or PSTD (Pedersen, 2018. p. 153). This greatly leads to a higher trajectory of African Americans who suffer from depression, grief, loss and anxiety.
Conclusion
Helping African Americans through grief by utilizing the deep spirituality within the heritage can be useful for healing. Please also review AIHCP’s Grief Counseling Certification
African American heritage is rich and beautiful with family, heritage, ritual, and spiritual life. Tapping into these elements give blacks a higher appreciation of self and worth and tie them to a greater story. Unfortunately, slavery and oppression stole this identity centuries ago and many African Americans in the United States suffer intense soul wounds associated with the history of slavery, oppression, racism and discrimination. These things cannot be ignored but must be understood in factors leading to many modern day issues African Americans face. Counselors need to be aware of these issues as well as their own color and race when working interracially with a black person. White persons must understand that differences exist and sometimes need addressed to help promote healing. Also, like in all multi cultural issues, counselors must be alert not to over generalize or under generalize a person. Each person is unique but at the same time within a particular race or culture usually shares some common issues or problems.
Please also review AIHCP’s Grief Counseling Certification. The program is online and independent study with mentorship. For those who are already a Certified Grief Counselor, then please also review AIHCP’s Grief Diversity Counseling Certification and see if it meets your academic and professional goals in working with diverse populations.
Reference
Pedersen, P. et. al (2018). “Counseling Across Cultures”. (7th). Sage
Additional Resources
Williams, M. (2011). “Why African Americans Avoid Psychotherapy”. Psychology Today. Access here
Watkins, S. & Andrews, A. (2021). “Creating & Maintaining Safe Therapeutic Spaces for Black Clients”. Advances in Addition Recovery (Winter 2021). Access here
Alang, S. (2019). “Mental health care among blacks in America: Confronting racism and constructing solutions”. Health Serv Res. 2019 Apr; 54(2): 346–355. Published online 2019 Jan 27. doi: 10.1111/1475-6773.13115. National Library of Medicine. Access here
Carrouthers, Z. (2014). “Yes, There’s a Stigma with Counseling in the African-American Community”. ThriveWorks. Access here
