integrating religion and spirituality into...
TRANSCRIPT
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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