Introduction of Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT) in The Netherlands: Translation and Adaptation of a Psychotherapy Protocol for Mental Health Care

Round 1

Reviewer 1 Report

-Excellent paperwork with an exciting topic inside the actual journal's theme and its enterprise's general purpose!

However though, after reading the entire well-structured and detailed described manuscript...The disappointing part is that this "study" becomes incomplete by its end and, as such, useless since it only contains a description of the organization of the implementation of an assessment tool and not the actual part of the research that all the workers in the field are interested in. The vital parts are still missing to create a study that will bring citations and not just reading: the sample of people, its application, its results, tables and charts made with a statistical program, data interpretations, etc.

Disappointed by the abrupt, unfinished ending, as with a series where I know that season 2 is necessary, but who knows when it will arrive on the market to conclude the image created in the first part.

Keep editing until it comes to an end!

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

The article is well done and its looks to provide adequate contribution to the field and to the country of the Netherlands.

Author Response

Reviewer 2

The article is well done and its looks to provide adequate contribution to the field and to the country of the Netherlands.

We want to thank the reviewer for this positive feedback.

Reviewer 3 Report

I started reading this article with great interest, as its topic clearly intersects with my own research. This is a well conceived and important project to integrate the SPIRIT approach to psychiatric therapy in a different context as the original.

The literature referenced is almost exhaustive, but some readers could miss the ongoing work on religious coping, with hundreds of new published studies every year, many devoted to mental health and religion; Pargament, for instance, could be a good entry in this area.

I have some doubts after reading the article, and I would like to ask the authors to address these concerns before proceeding to a new submission

The first one regards the lack of clarity about how this method is applied. Possibly other readers might be familiar with this therapeutic approach, but not everybody, and I am really curious to learn more on it. It seems that such method has offered some positive outcomes in the USA, but I am not sure about the level of evidence and how strong or moderate are such influence.

The second point concerns a thorny question the authors try to deal with, but probably it needs more discussion and data. A consistent body of research in religious coping and religion and wellbeing, points to the difficulty to ascertain the right kind of religiosity and spirituality that better works in those cases. It appears that some religious forms are rather negative and counter-adaptive, but, it seems too, according to other studies, that a too light religious form is little efficient in order to cope. It is not so much about more or less religion, but the type or religious style.

The third concern regards the recently published data on healing through intercessory prayer. A team of Dutch scholars lead by Dr. Kruijthoff has reviewed many cases of reported healing after prayer. The question is whether Netherlands is perhaps entering some post-secularization stage, where confessional prayer and attendance of traditional religious services become a cue for health. If we admit this point, the authors could feel reassured in proposing a more explicit religious expression, as the more efficient approach.

The last point regards the proposal of meaning making, after quoting the studies of Crystal Park and others. I agree about their importance, but again the suggested intervention could easily fall into a circle: proposing meaning or looking for meaning, is the big question. It is not that just relating to it would solve the spiritual quest of many lost souls, if we cannot offer something more than that, to ground the need for meaning.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

the improvement of this paper looks well, rises it to a better version, and creates a suitable way for readers to become acquainted with SPIRIT and its purpose. Congrats!

Reviewer 3 Report

I find very well addressed the questions I raised in my former review.