Bruce Victor discussed the principles of transpersonal psychopharmacology, and transpersonal psychiatry's relationship to mind-altering medication. Other attempts to reconcile psychopharmacology with transpersonal psychiatry has been suggested by Gary Bravo and Charles Grob. David Lukoff and Francis Lu considered the role of religious and spiritual issues in a clinical setting, and listed the most common types of psychiatric problems that can occur when a person is confronted with these issues. Among the problems associated with the area of religion was: loss or questioning of faith; change in denominational membership or conversion to a new religion; intensification of adherence to the beliefs and practices of one's own faith; joining, participating in, or leaving a new religious movement or cult. Among the problems associated with the area of spirituality was: distress related to a mystical experience; distress related to a near-death experience; distress related to a spiritual emergence or emergency; distress related to meditation. John Hiatt described his experiences with the transpersonal care program, an outpatient program that aimed to reintegrate spiritual considerations into health care. Moran, who reported on the program in 2000, noted that the treatment included individual psychotherapy, medication clinics, and group therapy. According to Mick Collins, who addressed the topic of spiritual emergency from a social-political perspective, Transpersonal psychiatry provides a much needed impetus for establishing differential diagnosis and appropriate treatment for those people who need additional support through a spiritual-transformational crisis. The concept of transpersonal psychiatry is also featured in the construction of psychological instruments. In 2008 Grabovac, Clark and McKenna  developed the "Course Impact Questionnaire" as part of their effort to evaluate the “Interface between Psychiatry, Religion and Spirituality” in an academic curriculum. The instrument (questionnaire) had three items on transpersonal psychiatry. In his review of the "Textbook of Transpersonal psychiatry and psychology" Paul Grof notes that the field has been subjected to criticism. He suggests that this criticism is the result of misunderstandings. However, commentators have offered both recognition and skepticism towards the concept of transpersonal psychiatry. In 1999 the journal Psychiatric Annals dedicated a large portion of its August issue to the topic of transpersonal psychiatry. The Issue was guest edited by Bruce W. Scotton. According to the editor at the time of publication, Jan Fawcett, the issue discussed transpersonal psychiatry and encouraged its readers to broaden their "concept of psychiatry to include such issues as cultural norms, religious meanings, and spiritual issues" in their practice of psychiatry. The issue resulted in both positive and negative reactions from readers.