The Selah study protocol of three interventions to manage stress among clergy: a preference-based randomized waitlist control trial.

Journal Article (Journal Article)


Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms.

Methods and analysis

The overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control.

Ethics and dissemination

Ethical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community.

Strengths and limitations of this study

While evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals. Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training. If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day. This study is limited by the inclusion of Christian clergy of only one denomination.

Trial registration NCT04625777 . November 12, 2020.

Full Text

Duke Authors

Cited Authors

  • Tice, LC; Eagle, DE; Rash, JA; Larkins, JS; Labrecque, SM; Platt, A; Yao, J; Proeschold-Bell, RJ

Published Date

  • December 2021

Published In

Volume / Issue

  • 22 / 1

Start / End Page

  • 892 -

PubMed ID

  • 34886896

Pubmed Central ID

  • PMC8655493

Electronic International Standard Serial Number (EISSN)

  • 1745-6215

International Standard Serial Number (ISSN)

  • 1745-6215

Digital Object Identifier (DOI)

  • 10.1186/s13063-021-05845-x


  • eng