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Integrating Religion and Spirituality into Counseling

Dr. Ajita M. Robinson

Spiritual ProcessesPargament (2007) Spiritually Integrated Psychotherapy

Involves psychological processes

Used in the search for the sacred; conservation of the

sacred; spiritual struggle, coping, and transformation

An organizing dynamic for one’s life that influences

meaning-making, identity, behavior, and other

psychological processes

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Spiritually Integrated Psychotherapy:

Ways of Understanding

All individuals possess the capacity for Spirituality

Spirituality aids individuals in coping with stress, and can be the source of stress

Spirituality can be the source of good behavior or bad behavior

Spiritual distress goes hand in hand with psychological distress while spiritual

growth and development goes hand in hand with psychological growth and

development

Spirituality is affected by culture, religious belief, and human development

Spirituality:

involves a search for the sacred, and that includes anything that would be

associated with what one would believe to possess a spiritual dynamic

includes a human capacity for experiencing self-transcendence and the

awareness of sacred immanence

Spirituality provides a context for meaning-making, and purposeful living

Spiritually Integrated Psychotherapy

Ways of Understanding

Developing the Sight and Hearing

Spiritual Growth: a process that involves a transformation from one way of

understanding (meaning), feeling or behavior to something beyond (transcendent)

the original understanding or behavior leading to new or enhanced spiritual

content (Hinterkopf)

increases an individual’s self-other compassion

Spiritual Loss/Trauma: when spiritual dynamics are threatened, whether they be

beliefs, relationships, objects, spiritual conflict/struggle ensues that could lead to a

type of spiritual trauma or spiritual loss => such events can lead the victim to

blame the sacred (Kusner & Pargament)

appraisal, post trauma/loss perspectives/beliefs, internal vigilance, cognitive

(personal filters) and affective distortions (fear, avoidance, defenses),

relationship with the sacred must be tended

tending to these dynamics may lead to post-traumatic spiritual growth (Kusner

& Pargament)

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Spiritually Integrated Psychotherapy:

Ways of Being The Spiritually Integrated Therapist

Pargament pp. 187 - 200

Spiritually Integrated Therapists possess:

knowledge => personal story of spirituality and religion

openness and tolerance => genuine respect and appreciation for diversity

while being open to learning

self-awareness => identifies the limits of their own spirituality

authenticity (transparency) => capable of appropriate self-disclosure

willingness to address religious/spiritual dynamics

Spiritually Dis-integrated Therapist demonstrate:

Dismissiveness, intolerance, judgmentalism, and/or rejecting of spirituality

The paradox of spiritual exclusiveness => without humility it becomes

intolerance; evangelizes or proselytizes, self-serving preaching

Spiritual illiteracy

*

*Interventions need to be intentional and evidence based

*Assessing religion and spirituality (R/S) needs to be

incorporated with other assessment protocols

*Assessment is a process that is ongoing

*A comprehensive protocol to assess R/S involves six dynamics

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*

➢ Salience: clinician assess the importance of R/S in the life of

the client

➢ Integration: clinician assesses how clients use R/S in their daily

lives

➢ R/S Experiences including beliefs, values, affiliations and

practices: clinician assesses clients comprehension of the

sacred

➢ Coping: clinician assesses how clients use R/S to cope and how

effective are those tools

➢ Struggles/Conflicts: clinician assesses the extent to which the

struggles/conflicts are attributed to R/S

➢ Potential Impact on Treatment: clinician assesses clients’

valuing R/S aid

*

*When using R/S in the session the clinician must

* Have done a comprehensive assessment of the client’s understanding and use of R/S

* Obtain informed consent to use R/S and continually engage the client in discussions regarding the client’s comfort in using R/S

* Establish protocols for client feedback on the process

* Self-assess the ability to use R/S competently

*Current literature indicates that the use of R/S interventions

* Is not consistent or systematic across clinicians

* Influenced by the clinician’s personal commitments

* Varies to the degree of the clinician’s involvement in explicit R/S behavior

* Research suggests that clinicians tend to be unsure about how to involve R/S or how far to go with R/S in the session

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Implicit Spiritual Assessment

Implicit Spiritual Assessment (Pargament, pg. 217-218)

Questions that hint at the possibility of a deeper dimension for the client =>

Where do you find peace, or the strength and courage to continue? What are

you striving for in your life? What are you living for? What causes you the

greatest despair or suffering?

Gill, Harper & Dailey in Cashwell & Young: Chapter 7: When have you felt most

alive? What would you like your legacy to be? What sustains you during difficult

times? What do you hold sacred? What are those things in your life right now

for which you feel grateful?

Turning on your “spiritual radars,” i.e. listening for the spiritual in your client’s

story => what gives them meaning; where do they find life exciting, invigorating;

comments made indicating a vague sense of understanding; being aware of a

change in the emotional climate in the session

Explicit Spiritual AssessmentPargament Chapter 11

Locate the client in their search of the Sacred via eliciting the client’s spiritual story.

Determine the degree of the client’s spiritual integration: to what extent does

spirituality matter to the client. Where is God in all of this?

Evaluate the efficacy of the client’s spirituality: how does the client utilize their

spirituality to manage bio-psycho-spiritual struggles?

Consider what role spirituality can play in the therapeutic process.

Encourage/support the client’s mission and or purpose in life, i.e. the place of deep

meaning and desire for the client.

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Spiritually Integrated Psychotherapy

Ways of Intervening

Empathy, respect, honesty, caring, unconditional positive regard (Elkins)

Helping the client discover his or her soul nourishing activities (Elkins)

What experiences have touched me most deeply, i.e. events in which I have

experienced reverence, awe, wonder, humility, gratitude, that stirred my soul?

(Elkins)

Other interventions:

writing a letter to God (Kusner & Pargament)

Empty Chair with parts split off (Hinterkopf)

Gently challenging the distorted and maladaptive religious belief, especially

when it has emerged in the wake of spiritual loss/trauma (Kusner &

Pargament)

Spiritually Integrated Psychotherapy

Ways of Intervening

Humanistic Interventions: Engaging in the Spiritual Processing (Hinterkopf)

Recognizing the vague, bodily sense, not just the cognitive belief system, where the feelings are hard to

describe

Recognizing the discrepancy between experience and spiritual content, e.g. I’m supposed to love God

and yet, I can’t understand why my child has cancer. (Slattery & Park)

focus on the dialectic by attending to the situational meanings (cancer or other traumatic

experiences) in comprehensive ways appreciating how spiritual processing can influence or

inhibit coping

“focusing on the felt sense”: staying with the vague, subtle feelings that lead to an overarching theme =>

implicit sense of meaning, through focusing, becomes a more explicit meaning

"What is it about this whole situation that leaves me feeling this way?"

"What is the worst (or best) about this whole situation for me?"

“What does this whole thing need right now?"

“How would all of this feel if you had a friendly attitude toward it?”

learning how to integrate other parts of the self

the “felt shift” that speaks of new meaningsDoes the increase of a more

compassionate attitude toward

the self automatically

make it spiritual development?

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Drawing on Spiritual Resources

What is the interpersonal and intrapersonal coping culture of your client, and how, if at all,

does spirituality fit into that culture?

This data assists you in assisting the client in accessing that which leads to healing, growth, and

well-being, and aids the client in his or her relationship with the sacred.

Techniques/Interventions: writing a letter to the sacred, writing one’s obituary (good life, not

so good life), accessing one’s “wise mind,” listing one’s personal strivings and determining

which are sacred or other-imposed, offer a powerful image that motivates reflection/behavior

and alters values, draw on religious texts, present individuals who model behavior,

mindfulness meditation, pray and prayers that have meaning, teaching your client about what

prayer is.

What types of spiritual issues should we stay away from?

* Pargament: Broadening and Deepening Spiritual Pathways

* Encouraging clients to find room for compassion, forgiveness and positive emotions

* Unpacking the history behind the client’s IOG and finding avenues to enhance the IOG that includes unconditional love

* Engaging the “spiritual processes” associated with rituals, beliefs, values, behaviors, and concepts related to R/S

* Dealing with spiritual inflexibility through enhancing beliefs, not changing them, drawing on spiritual resources to encourage flexibility (e.g. show where God is depicted changing his mind in scripture)

* Promoting acceptance, serenity, and explore new spiritual niches

* Building greater spiritual discernment practices when considering spiritually influenced behavior; promote critical spiritual thinking

* Gill, Harper & Dailey in Cashwell & Young: diagnosis and treatment

* Addressing spiritual issues that mask relational conflicts => God made me or didn’t make me do it;

* Determining the difference between a “dark night” and depression

* Assessing when a client’s focus on spirituality has become excessive and/or distressing => by its fruits you shall know

* Assessing a client’s functional R/S beliefs vs delusions that may require a neuro-psychological work-up

* Intrinsic vs extrinsic religiosity; internal vs external locus of control

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Bibliography

Elkins, D. (2005). A humanistic approach to spiritually oriented psychotherapy, in Sperry,

L. (Ed.), Shafranske, E.P., (Ed.): Spiritually Oriented Psychotherapy, APA:DC

Hinterkopf, E. (2005). The experiential focusing approach, in Sperry, L. (Ed.), Shafranske,

E.P., (Ed.): Spiritually Oriented Psychotherapy, APA:DC

Kusner, K. & Pargament, K. (2012). Shaken to the core: Understanding and addressing the

spiritual dimension of trauma, in Trauma Therapy in Context: The science and craft of

evidence-based practice. McMackin, R.A. (Ed.), Newman, E. (Ed.), Fogler, J.M. (Ed.),

Keane, T.M. (Ed.), APA:DC

Slattery, J.M. & Park, C.L. (2011). Meaning making and spiritually oriented interventions, in

Spiritually Oriented Interventions for Counseling and Psychotherapy, Aten, J.D. (Ed.),

McMinn, M.R. (Ed.), Worthington, E.L. jr. (Ed.), APA:DC

Bibliography

C. S. Gill, M.C. Harper, & S. F. Dailey (2012). Assessing the Spiritual and

Religious Domain. In C. S. Cashwell & J.S. Young (Eds.). Integrating Spirituality

and Religion into Counseling: A guide to competent practice 2nd ed. (pp. 141-

162). Alexandria, VA: ACA

K. I. Pargament (2007). Spiritually Integrated Psychotherapy. New York, NY:

Guilford Press