Although the majority of Americans in some form of God, only a quarter of graduate training programs in psychology offer even one course in religion or spirituality (Schafer et al. 2011). While a vast majority of mental health practitioners believe that these topics should be addressed in the therapeutic context (Vieten et al. 2015), few are properly equipped to do so, particularly when faced with clients whose religious or spiritual values differ from theirs.
The first step in handling an interaction with a client who comes from a background or tradition that differs from your own is to review your own personal religious or spiritual history. That could be done simply through a short or extensive group of questions, completed orally or in writing, or by creating a spiritual lifemap (Hodge, 2005) of your experiences.
Here are some sample questions:
- Describe the tradition you grew up in.
- How did your family express its religiosity or spirituality?
- When did you first personally discover or learn about the sacred?
- What do you hold sacred in your life?
- How has your understanding or experience of the sacred changed since you were a child?
- What do you feel God or spirit wants from you?
Expression and Experience of Spirituality:
- When/where do you feel most connected to the sacred?
- What spiritual rituals or practices are important to you?
- When/where do you feel closest to God?
- Has your spirituality changed your life for better, or worse?
- To what degree has your spirituality been a source of strength? Of pain? Frustration? Guilt? Confusion and doubt? Pleasure? Meaning? Joy?
The spiritual lifemap is, simply put, a pictorial outline of the main events in your life and the influences they had on your spirituality. This life review in pictures can be discussed with a peer for your own process, or with a client at length, noting the resources that may or may not have been provided by religion or spirituality. It’s a life review that includes a spiritual or religious view as well.
The two types of history taking shown above can be used first by the clinician for herself, and again for the client. A key element of any history taking in this realm is to focus on a person’s lived experience. One Methodist’s experience may differ widely from another’s, and certainly a Catholic’s religious or spiritual experience may not look much like that of someone from the Unity Church. However, it is important to explore your client’s perspective to fully understand his or her world view. It may be surprising what you find out.
The spiritual life map is a great starting point, but in order to more fully understand your client’s worldview, here are some additional tips for spiritual and religious competency:
- Learn more about how various religious and spiritual groups may have experienced persecution and discrimination historically and may still.
- Notice how these groups are portrayed in popular culture and how that might affect your ideas as well as theirs.
- Talk to spiritual or religious leaders to learn more about this other group.
- Go on the Internet or to your library to find out more about the underlying tenets and ongoing practices of this particular group.
- Ask the client directly how their worldview has been influenced by their religious upbringing or spiritual life.
As clinicians, we’re responsible for determining what is within the boundaries of our competence and training, and if something occurs beyond that, it’s wiser to refer out.
If you need further guidance in this area, check out Spiritual and Religious Competencies for Clinical Practice: Guidelines for Psychotherapists and Mental Health Professionals.
This article was originally published at newharbinger.com/blog.
Hodge, D. R. (2005). Spiritual lifemaps: A client-centered pictorial instrument for spiritual assessment, planning, and intervention. Social Work 50(1): 77–87.
Schafer, R. M., Handal, P. J., Brawer, P. A., & Ubinger, M. (2011). Training and education in religion/spirituality within APA-accredited clinical psychology programs: 8 years later. Journal of Religion and Health 50(2): 232–239.
Vieten, C., Scammell, S, Pierce, A, Pilato, R., Ammondson, I., Pargament, K.I., Lukoff, D. (2015) Competencies for Psychologists in the Domains of Religion and Spirituality. Spirituality in Clinical Practice. TBA.