Toward effective service to individuals, and divorcing families and stepfamilies

Spiritual Assessment and Interventions - p. 1of 3

Tap Your and Your Clients' Spiritual Resources!

By Peter K. Gerlach, MSW

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The Web address of this article is http://sfhelp.org/pro/gwc/spirituality.htm

        Clicking links here will open a new window or an informational popup, so turn off your browser's popup blocker or accept popups from this nonprofit, ad-free site . If the windows distract you, read the article before following any links.

        This article is one of a series on effective professional counseling, coaching, and therapy with (a) low-nurturance (dysfunctional) families and with (b) typical survivors of childhood neglect and trauma. These articles for professionals are under construction.

        This series assumes you're familiar with:

        Before continuing, pause and reflect - why are you reading this article? What do you need?

+ + +

        This three-page Web article focuses on an often-neglected aspect of clinical service to persons and families - using clients' spiritual resources. This page offers ...

  • key semantic definitions;

  • a self-assessment inventory about your spirituality and your workplace;

  • a core reason to include spirituality in clinical work with divorcing families and stepfamilies;

  • basic perspective on, and premises about spirituality and clinical spirituality interventions; and...

  • potential benefits of including spirituality in the work with receptive clients. 

        Page 2 offers (a) perspective on toxic spirituality, and options for (b) assessing client spirituality, and (c) effective spiritual interventions with these clients.

        Page 3 suggests spirituality-interventions with co-parents with (a) nurturing and (b) toxic spiritual beliefs, and (c ) hilights key questions that arise from spirituality assessments and interventions.

        To get the most from this article, first please read...

  • this perspective on the difference between spirituality and religion,

  • this article on healthy and toxic spiritual and religious beliefs and practices; and...

  • this article for stepfamily adults on options for managing family values and/or loyalty conflicts about religion or spirituality.

        This article is not a sales pitch for God or a religion. It invites you to reflect and clarify your own beliefs on using spirituality in your life and work. I write this as a seeker and fellow explorer, not an authority. Though every client, clinician, and case is unique, my experience suggests some general benefits to selectively including spirituality in helping clients achieve desired systemic changes.

 Terminology

        Clear semantic definitions promote effective thinking and communication - specially on a topic as primary, abstract, and controversial as this one. Compare these definitions to yours. In these articles...

        Spirituality means "the innate human ability to experience mind-body-spirit states of awe, reverence, and faith in one or more transpersonal, numinous presences and powers (spirits) which can provide significant comfort, hope, guidance, and serenity." Even in this age of unprecedented scientific knowledge, most people explain the unexplainable and counteract despair via faith in a spiritual reality greater than themselves. Faith is trusting something to be true or real without being able to "prove," demonstrate, or replicate it.

        Healthy spirituality means personal, family, and organizational beliefs and related behaviors about interacting with a benign Higher Power which consistently _ promote inner-family (personality) harmony, and _ fill current primary personal needs. Toxic spiritual beliefs and behaviors, like spiritual and religious abuse,   neglect, and addiction ; (a) promote false-self wounds , (b) inhibit personal wholistic health , and (c) lower a family's nurturance level .

        Spirituality assessment is intentionally forming an opinion about an individual's or group's _ attitudes about and _ faith in an accessible, impactful Higher Power in their lives, and about _ whether they want or expect to include spiritual faith in clinical work.

        A spiritual intervention is any unconscious or intentional clinician behavior acknowledging or including a Higher Power which causes some meaningful shift in one or more client-family members - according to someone. Shift includes changes in attitudes, focus, moods, awareness, expectations, roles, communication, and behaviors. Successful spirituality interventions improve a client family's wholistic health and nurturance level, as judged by family members.

        Praying is intentionally or reflexively focusing on a personal Higher Power and venting, requesting something, and/or expressing thanks. People with genuine spiritual faith can feel comfort [hope, connection (vs. isolation), and potency (vs. helplessness)] in the act of praying alone or together whether they "get a response" or not. Clinician's can ask "Is your praying one-way, or do you expect a response?" They also can decide if, when, and how to pray with (vs. for) receptive clients. Do you have an opinion on "What is an effective prayer?"

        Spiritual or pastoral counseling aims to _ help seekers clarify their personal beliefs about a Higher Power, _ identify and resolve questions about religion, _ expand their spiritual awareness and experiences, and _ harmonize spiritual faith with other aspects of life. Clients may seek these, or clinicians who feel qualified may choose to focus on client spirituality as part of the work.

        Religion refers to the man-made beliefs, rituals, Holy book/s, and organizations that groups of like-minded worshippers co-create. Being "religious" does not necessarily mean "spiritual." Worship and prayer are intentional personal and group behaviors which focus on experiencing meaningful communion with a Higher Power. Attending church can fill personal needs for structure, relationship harmony, inspiration, and social companionship, support, and normalcy without being spiritual.  And...

        Theology is a coherent or vague set of beliefs about the interrelationships of God and/or other spiritual entities, the Earth, the universe, living things, souls, humans, religion, origins, good and evil, and what happens after death. Psychologically wounded and unaware people tend to have an undeveloped or a rigid, c/overtly elitist personal theology. A family's theology may range from harmonious and unified to fragmented and conflictual.

        I invite you to use these definitions to clarify your own. Let's use them now to explore some key basics...

 Perspective

        The keystone question here is "What do you believe now about spirituality, the "human condition," and your work?" You'll get the most from what follows if you're _ non-distracted, and _ your team of subselves is guided by your true Self. Learn about yourself by reflecting on these and related questions. As you do, notice your "self talk." Option: journal about your reaction to these questions now or later...

Are you a spiritual (vs. religious) person? if so, what does that mean?

What percentage of your past and present _ clients and _ colleagues would you say were or are "significantly spiritual"?

Do you feel a person can be wholistic healthy without having some meaningful, coherent spiritual beliefs and experiences?

Do you feel spirituality can be toxic? Do spiritual or religious aggression, abuse, and neglect exist? Spiritual or religious addiction? If you say "yes," on a range of 1 (not at all) to 10 (extremely), how qualified are you now to clinically assess and intervene with each of those now?

What are your current _ personal and _ workplace policies about including "appropriate spirituality interventions" (using personal and client spiritual faith to promote desired systemic change) in clinical work?

From 1 to 10, how qualified do you feel now to provide meaningful spirituality interventions to receptive clients? If you don't feel able enough, what do you need, specifically, to gain such qualification?

Can you recall instances where spirituality seemed a significant positive factor in your and/or others' clinical outcomes?

In discussing cases with colleagues and supervisors, is it common for you all to include spirituality assessments and intervention strategies? How does spirituality affect your clinical assessment-intervention paradigm ?

If a young teen asked you to describe spiritual health, how would you respond?

How would you describe your ethical _ responsibilities and _ boundaries towards promoting clients' spiritual health and well-being - specially if they don't ask you to?

If you judge a client person's or a family's spirituality to be significantly toxic, what do you do now? What would your clinical mentor/s or hero/ines do?

Do you believe that focused genuine (vs. rote) spiritual faith and prayer can permanently reduce _ psychological distress and/or _ cause lasting physiological change ("healing")?

If your clinical mentors and hero/ines use spirituality in their life work, how - and with what personal and professional effects?

How do you currently react to any significant differences in spiritual faith with your clients, specially if they infer or declare that your beliefs are "wrong"?

Do you believe your Higher Power is present and accessible in typical - or all - client sessions? If so, do you openly _ acknowledge that, and/or _ ask for guidance, courage, and inspiration?  If so, how do your clients typically respond?

Do you feel it's _ safe and _ appropriate to discuss spirituality assessment and interventions with your supervisor, case manager, and/or consultants? If not - why?

Do you believe that each person has a latent or active personality subself or "higher Self" whose gift is spiritual awareness, sensitivity, and communion? Is it useful to you to acknowledge or define a human soul? 

Do you feel "spiritual assessment and intervention options" would be a useful clinical in-service topic? How would your colleagues feel about this?

Do you feel that a child's or adult's beliefs affect their _ behaviors and _ openness to second-order systemic change? Do you see client beliefs (in general) as potentially-useful intervention opportunities?

        Pause, breathe, and reflect - what other questions or awarenesses about spirituality and clinical work occur to you now? Have you ever meditated on or discussed a set of questions like these before?

        Is spirituality a valid clinical focus with these clients? I believe so, with some limits. Here's why:

        My professional experience since 1979 is that typical mental-health workers feel ambivalent or cautious about including spirituality in their work, except pastoral counselors. I've also experienced that fewer than ~25% of my (white, suburban Chicago-area) clients spontaneously brought up "God" in 36 years' clinical practice. It seems that our ancestry and culture teach average clients to expect that spirituality is outside the boundaries while "seeing a counselor" - except in a church setting or with a pastoral professional. Yet recent CNN polls suggest a high majority of Americans believe in a Higher Power, and well over half believe in "miracles."

        I write this as a former atheist. My 29-year recovery from growing up with two alcoholic (i.e. psychologically wounded) parents has led me to solid faith in the reality of a benign God. This belief-shift has many roots: my 12-step ACoA (Adult Child of Alcoholics) work, the writings of many recovery and clinical mentors, the Unitarian and Unity church movements, hundreds of recovering clients and friends, informal study of Buddhism and other Eastern beliefs, and my aging and other life experiences. I've cautiously used my emerging spiritual faith in working with clients who seemed open to it. Where I have, believing and affirming the strength and guidance of a Higher Power to be present during and outside the work has always expanded our therapeutic alliance and options.

        I estimate that over 80% of the many hundreds of therapy clients and students I've worked with since 1981 have shown clear symptoms of childhood neglect and significant false-self wounds . Most were used to living chaotic, stressful - or numb - inner and outer  lives shaped by major anxieties , guilts, shame, losses, frustrations, and confusions.

        These self-referred men and women have ranged from spiritually cynical to indifferent to blindly religious to truly spiritual. The great potential for easing their journey and nurturing their kids by weaving respectful spirituality interventions into our clinical work went untapped, until my own recovery from false-self dominance freed me to do that.

        In this clinical model, Lesson 1 focuses on identifying  and healing psychological wounds in clients and clinicians. From my personal and clinical experience, true (vs. pseudo) healing is far more likely for persons believing in an unconditionally-loving, accessible Higher Power. If "healthy spirituality" is necessary for personal wholistic health and high-nurturance (need-fulfilling) relationships and groups, then ethically and practically, effective clinical work needs to include it in assessments, goals, and interventions. This premise needs to be formally researched and validated or rejected.

        Because spiritual faith and religious practices are subjective and personal, using "strategic spirituality interventions" in clinical work raises ethical, moral, and procedural debates. Each human-service professional and policy-maker must evolve their own values and priorities. Textbook, rote, and classroom answers appeal to people who haven't yet needed to clarify their personal theology, and integrate it into their professional choices and behaviors.


Basic Premises about Spirituality and Relationships

        Expand your self-awareness by musing on these ideas. Try responding to each with A(gree), D(isagree), or "?" - i.e. "I'm unsure now, or it depends (on what?)". Take your time.

        This clinical model proposes that...

        1)  Human spirituality is real, innate, and ranges from nurturing (health-promoting) to toxic. A corollary is that every personality includes a latent or active subself whose gift is spiritual sensitivity, wisdom, and connection with a or the Higher Power. This subself can manifest as "the still small voice within" and "intuitive wisdom." People have varied conceptions of and names for this entity, including Guardian Angel, fairy (Godmother), "Old Ones," totems, spirit guides and councils, "My higher Self," "God within," and others.

       2)  Part (or most?) of the emptiness, alienation, and numbness that significantly-wounded people experience comes from excessive shame, distrust, and rejecting their spiritual subself and meaningful communion with a nurturing Higher Power. Until true (vs. pseudo) recovery progress occurs, wounded people typically self-medicate their relentless inner pain via one or more addictions and/or relationships with people, pets, plants, and/or fantasies. (A  D  ?)

        3) Spiritual beliefs can significantly affect emotional and physiological dis/comfort. This implies that spiritual and religious abuse , aggression, neglect , and addiction are real, and can promote significant  psychological wounds . It also implies that nurturing spirituality can promote recovery from psychological wounds. A corollary: religions range from wholistically nurturing to personally and socially toxic in their beliefs and practices. (A  D  ?)

        4)  Individual spiritual and religious beliefs and practices are strongly shaped by ancestral and societal traditions and the primal need to feel and be seen as "normal," so ruling subselves resist changing them. Personal, family, clan, and religious-denominational scripts (belief systems) are based on inherited tradition and fear of scorn and rejection, not logic. Therefore, reasoning is rarely effective in promoting second-order change in client's (or a clinician's) toxic spiritual beliefs. (A  D  ?)

        5) One person inferring or proclaiming that they know the real truth about God, Heaven, Hell, worship, and "salvation" and another person doesn't usually promotes repressed or open resentment and conflict. Even when framed as "But I'm trying to save your soul!", the insulting implication is "I don't accept you as you are - you are not OK." Despite noble intentions, trying to c/overtly change another person's beliefs ("help them") is implicitly disrespectful if they aren't seeking help: "I know better than you, so you're 1-down ." This dynamic can cause major strife as new stepfamily members try to blend their belief systems and traditions. (A  D  ?)

        6)  Personal and family spiritual beliefs and practices change spontaneously with maturity and life experience. By definition, such changes are second-order (core attitude). (A  D  ?)

        7)  Inter-subself and interpersonal disputes over spirituality and religion are always surface conflicts. The underlying primary discomforts are unrecognized or unhealed psychological wounds , amplified by unawareness of _ the seven communication skills , and _ how to spot and resolve values conflicts . (A  D  ?)

        8) Every clinician and human-service organization has covert or stated policies (belief and value sets) on personal and client spirituality. These policies shape clinical outcomes in minor or major ways. "No policy" is a policy. (A  D  ?)

         9) Clinicians can shift their policies on spirituality at any time if _ they're consistently guided by their true Selves and _ they work in a high-nurturance organization. (A  D  ?) And ...

         10)  A clinician may or may not believe that prayer can promote desired client changes. What is more relevant for effective clinical work is what each client adult and child believes and expects.

         11) Well-designed, respectful spirituality interventions can promote personal healing and growth, in clients who are ready for second-order (personality) change. (A  D  ?)

         12) One indicator of a clinician's true spirituality is whether s/he believes something like "God works through me to nurture my clients" or something like "I often ask God for help when I'm stymied or conflicted about my clients." The fundamental question is "Who directs this work - my and my client's true Selves, God, or all of us?" The answer affects how relevant and useful the Serenity Prayer is to clinicians, supervisors, and case managers; and if, how, when, and what spirituality interventions seem appropriate. (A  D  ?)

        Pause and reflect - why are you reading this article? What do you need? Try summing up your basic belief about including spirituality in your work in one or two sentences. To augment or clarify your beliefs, see how you feel about these...


 Potential Clinical Benefits

... of using strategic spirituality assessments and interventions. Recall: "effective spirituality interventions" _ raise an inner-family's or client-family's nurturance level, and _ help client family members and clinicians fill their needs in a way that feels good to all participants. See how you feel about these possible clinical benefits to including respectful (vs. authoritarian) spirituality in your work with receptive clients...

    1) Overtly agreeing on a Higher Power greater than themselves can strengthen the client-clinician alliance. It also creates the options of a whole class of spirituality interventions not otherwise available, including the clinician and attending clients praying together. Have you ever experienced this as a client or professional? Shared belief in a responsive Higher Power suggests that the clinician need not feel solely responsible for clinical decisions and outcomes. The responsibility is shared by clinician's and clients' respective ruling subselves, as influenced by their Higher Power. Acknowledging God's caring presence in each session can feel like having a real time "supervisor" and mentor advising and guiding. This can be specially reassuring with highly wounded, conflicted, reactive, and "hostile" client adults and kids. 

    2) Focusing strategically on a client's spiritual beliefs and practices may disclose new ways they can increase personal and family harmony and wholistic health. One example is raising a client's _ awareness of toxic spiritual faith and practices (page 2), and their motivation to change these.

    3) The clinician may initiate strategic spiritual experiences that expand the client's awareness and options - e.g. guided imagery involving interaction with a spiritual presence or icon like Jesus or Buddha. A potentially powerful therapeutic question to Christian clients is "What would Jesus say about (or do in) this situation?" Or in inner-family work, the clinician can suggest "Get quiet, breathe well, and focus on the young part of you who is terrified of abandonment... Have a safe three-way inner conversation between that subself, your true Self, your Nurturer,  and your Higher Power (or God, your Spiritual part, your Guardian Angel, your Spirit Guide, etc.). I'll be quiet while you do that." 

    4) The undeniable global success of the 12-step "Anonymous" philosophy in controlling toxic compulsions (i.e. false-self dominance) is based on recoverers' choosing to abandon fruitless attempts to control the uncontrolable, and "turning such problems over" to a responsive, benign Higher Power of their own conception. In accord with that, my 12-year experience with inner-family therapy ( phase-threework in this model) is that client + clinician faith in the reality of an accessible, caring Higher Power is essential for genuine progress.

    5) Spirituality interventions may promote using the client's religious community, if any, as a resource in the work. Alternatively, they may raise awareness about, and reduce the influence of, a low-nurturance (toxic) church community.

        A final potential benefit to including spirituality assessment and intervention in working with these clients is...

    6) Exploring spirituality issues can illuminate repressed or minimized personal and family conflicts, alliances, coalitions, cut offs, scripts, and secrets that may contribute to the client family's current presenting and/or underlying problems. ("So your wife's grandmother scorns you as a father and son-in-law because she feels you're an unrepentant, arrogant sinner?")

        Can you think of other benefits? Each unique case may present benefits beyond these generic ones.

        This Web page continues exploring spirituality (vs. religion) as a clinical resource and/or client stressor. The first page proposes...

  • some key semantic definitions;

  • a self-assessment inventory about your spirituality and your workplace;

  • a reason to include spirituality in clinical work with divorcing families and stepfamilies;

  • basic perspective on, and premises about spirituality and clinical spirituality interventions; and...

  • potential benefits of including spirituality in the work with receptive clients. 

        This page ...

  • describes psychologically-toxic spirituality,

  • outlines ideas on assessing client spirituality, and ...

  • offers ideas on how to use the clinician's and client's spirituality with client-families whose spirituality seems non-toxic. 

        The final page offers intervention-options for clients with toxic spiritual or religious beliefs and practices.


 About Toxic Spirituality ...

        This site promotes high-nurturance (wholistically healthy) family relationships. "Toxic" means anything that significantly blocks or degrades that, in someone's informed view. Because spirituality is one of  four core ingredients of personal and family wholistic health, I propose that some spiritual and religious values, beliefs, and practices can be unquestionable toxic. Some people believe that accepting our spiritual "One-ness" is the core human health issue.

        Let's define toxic spirituality or religion as beliefs that promote excessive shame, guilt fear(e.g. of Satan, demons, Hell, Purgatory, and/or "eternal damnation"), hatred, scorn, pretense, intolerance, distrust , righteous superiority , black/white and fuzzy thinking, aggression ("you must believe the one true Word!"), dependence on a Holy Book for rote values ands answers instead of self-aware personal judgment and instinct; and reality distortions (e.g. the Salem witchcraft persecutions). When present, these attributes usually indicate false-self dominance , unawareness , and denials .

        This model proposes that spiritual neglect, abuse, and aggression are major toxic stressors. They each (1) indicate _ a low-nurturance setting and _ major adult wounds ; and (2) significantly degrade personal and family-system balance and health. Premises:

  • spiritual neglect occurs in a family when co-parents don't value or intentionally try to help kids' _ understand and _ experience a nurturing Higher Power, _ honestly answer kids' questions about their own spirituality (or lack of it), and _ respect every person's right to form their own spiritual and religious beliefs and practices over time.

  • spiritual abuse occurs when one person (like a co-parent) forces toxic spiritual beliefs and/or religious practices on a dependent person who cannot defend themselves or withdraw. A common example is the innocent traditional child's prayer "Now I lay me down to sleep," which implies the adult calmly believes each night that the child may "die before (s/he) wakes." 

  • spiritual aggression occurs when one person insists that another person must accept some (undesired or repugnant) spiritual beliefs or religious practices without regard for that person's opinions or needs. The distinction between abuse and aggression can be vague an subjective. It may be relevant only if "abuse," "abused," and "abuser" are highly-provocative terms to one or more participants.

        Righteous belief in the concept of evil (purposeful, malevolent intentions and actions) can be toxic, depending on how that belief affects actions and relationships. Judging a person or a personality subself to be evil (vs. wounded and unaware) makes the judger "1-up" (superior). This prevents mutually-respectful communication and relationships, and fosters resentment, defensiveness, and retaliation or withdrawal. I suspect that people who need to label others as evil and themselves as good are unaware of being chronically ruled by excessively-shamed subselves. 

        Nurturing spirituality is faith in a benign, accessible Higher Power which promotes genuine acceptance, love, and respect of self and others; serenity (vs. inner pain); healthy bonding and grieving; wholistic healing and growth; forgiveness and compassion; selective trusts; realistic optimism (vs. rigid idealism or cynicism) and hope; and self awareness and actualization.

        Implication: some beliefs and actions based rigidly on the Hebrew/Christian Old Testament are psychologically toxic. That book's demand of absolute obedience to a "wrathful, vengeful God" promotes fear, guilt, and shame just for being born human - specially when amplified by a stern, judgmental church community. The belief that rejecting Jesus the Christ as a personal Savior dooms a person to "burn forever in Hell" is psychologically toxic beyond dispute - specially to a vulnerable child. Notice your reaction: indignation, defensiveness, pity, and scorn are sure signs of false-self dominance.

        Christian and similar concepts of "original sin" can be toxic to persons and families. If over-emphasized and taken literally, this idea promotes (a) chronic guilt, shame, anxiety, self doubt, and (b) rote reliance on reported beliefs of people dead for millennia, vs. personal judgment and inner spiritual wisdom. Yes, the concept of personal or mortal sin can promote morally-right actions, but (I fear) at the risk of significant psychological wounding, stunted personal development, and chronic shame and anxiety.

        Taken literally, modern manifestations of the ancient Persian (pre-Christian) concept of "Hell" and "the Devil" can also be psychologically toxic, because they promote spiritual aggression and abuse, and terror. These encourage false-self dominance and related wounds - specially in young children. Earnest proponents warn that Satan constantly schemes to snare unwary persons' souls, depriving them of (Christian) salvation and Heavenly peace. This promotes choosing Christian beliefs and affiliations because of fear and distrust.

        As a grateful believer in an unconditionally-loving God, I am not Bible-bashing here. I am proposing there's a toxic price tag to not seeing Holy books as offering useful symbolic and metaphoric guidance, inspiration, and moral encouragements, vs. Divine instruction and "law." Zealots' mindless beliefs that God or Allah - via  the Bible or Koran - demand that they kill "infidels" and "unbelievers" to be "righteous" and "attain Paradise or Heaven" is one of the bloodiest tragedies in the human saga. Incidentally, can you recall reading or hearing of militant Buddhist, Quaker, or Hindu "fanatics"? 

        You probably know adults who make major life decisions based on rigid religious credos (and needs for social inclusion and approval), rather than on their own inner spiritual/rational wisdom. After 77 years on Earth and over a decade of experience with inner-family therapy , I propose that people who don't know they're controlled by a false self risk stunted, distorted, or toxic spirituality. This seems specially likely in low-nurturance human environments. Unaware, wounded co-parents risk uncritical reliance on charismatic, fervent religious leaders for life-guidance, rather than on their inner Spirit and true Self. Whose beliefs are shaping your life?

        I invite you to reflect now on what you believe about _ nurturing and toxic spirituality, and _ how your beliefs and related moral (right/wrong) values affect the professional service you provide. Notice your self talk now...

        We've briefly reviewed ideas on _ why include spirituality in clinical work with these clients, and _  toxic and nurturing spirituality. Let's use these ideas now to explore options for...


 Assessing Client Spirituality

        Have you evolved an effective conscious way to learn about your clients' spirituality now? If you belief spirituality is a valid aspect of clinical work, four relevant questions are: assess for _ what, _ when, and _ how?

Assess What?

        Typical questions to research are...

  • Does spirituality or religion significantly shape this family's nurturance level ? The clinician may judge "significantly" differently than the family's leader/s.

  • If not, is this a symptom of the family's leaders bearing significant psychological wounds? To answer, the clinician must first assess _ "Who comprises this family system now?," and _ "Who leads it recently?"  

  • If so, where do the impacts of each of these two factors fall on a line between "highly toxic" and "highly nurturing"?

    • If "significantly nurturing," how can I best use this to promote effective clinical service with this family?"

    • If "significantly toxic": is there credible evidence of spiritual _ neglect, _ abuse, or _ aggression affecting members of this family? If so, _ how do these relate to the client's presenting problems, and _ what are my clinical options?

  • If this client-family's spiritual beliefs and/or religious practices differ significantly from mine, does that hinder my respect for, and objectivity with them? If so, what is my best option?

  • If any client adult judges my spiritual and religious beliefs, does this help or hinder our work? What are my options?

  • Do this family's spirituality or religious preferences and practices significantly bias _ an ex mate and/or relatives, _ my supervisor, _ any consultant/s working with the family, or _ anyone else who affects this family's nurturance level? And...

  • How receptive are these client adults to discussing and using spirituality openly to enhance our work together?

        Reflect on current or recent divorcing or stepfamily clients - have you assessed any of these questions with them? If so, has this helped or hindered your service to them, so far? If you need to discuss this with anyone, _ who and _ why?

Is There a Best Time to Assess Client Spirituality?

        At intake: The answer depends on your and/or your organization's policy on this: "If I or we ask about client spirituality and religion as part of the intake process, how may that affect the work? In religiously homogenous communities ("Chattanooga is largely Baptist"), this may be clear. Insecure (wounded) client adults may be uncomfortable with or resent such questions, feeling "It's none of your business!," or "That has no bearing on our (presenting) problems!" Conversely, "religious" clients may find the question appropriate and reassuring. An intake-questionnaire item asking clients to define "Family religious preference, if any: ______" may be an acceptable compromise for average clients.

          After intake: If the clinician or agency doesn't ask at intake, clients may reveal their spiritual or religious identities and beliefs spontaneously as sessions unfold. When and how they do, in the context of the work, will suggest whether to ask for more information or not. If the clinician notices no such spontaneous information, s/he has more strategic options earlier if s/he asks some general question/s during initial conversations: "Do you feel someone's spirituality is affecting your (presenting) problem in any significant way?" First asking "Do your family members see spirituality and religion as the same, or different?" is a stylistic choice. Be prepared for something like: "We've never talked about that." 

         Special situations: as client members reveal themselves, some key situations make spirituality and religious assessment specially relevant and useful - e.g.

  • "Addicted" families: if one or more family members appear to have any of the four addictions ,  describing and/or referring clients to a 12-step program should include telling them to expect it to invite them to turning unmanageable life situations over to a personal Higher Power. This may prevent atheist and agnostic (wounded) clients from following such referral.

  • Individual recovery (inner-family) work: many children and adults ruled by false selves are significantly stressed by subselves excessively guilty, shamed , and scared by toxic religious beliefs. At some point in the work, it can be productive to focus respectfully on these subselves. Assessment options include exploring _ what they believe about God, Satan, Heaven, Hell, sin, evil, etc., _ where they got their beliefs, _ who they fear would disapprove of their shifting beliefs, and _ how other subselves react to these beliefs. There are many variations.

  • Families majorly conflicted over religious prejudice - the three or more extended biofamilies comprising stepfamilies are specially vulnerable to significant values conflicts over spirituality and religion. Some divorced bioparents develop serious conflicts over their children's religious training. Most client co-parents haven't developed a unified, effective strategy to resolve values conflicts in general. Doing so is part of safeguard Lesson 2  here.

  • Families significantly stressed by blocked grief . A major resource in healthy grieving is (a) accepting that we can't control many aspects of our relationships and environment, and (b) "turning them over" to a caring Higher Power. People with clear spiritual faith may temporarily lose it when reacting to some incomprehensible loss ("If there's a loving God, how could He allow this?"). They need to progress on the spiritual level of mourning, which (a) finds some answer to that question (e.g. "I accept that I can't know why God does what He does."), and (b) eventually restores a stable spiritual faith.

  • Families stressed by a media or social source of toxic religious beliefs or practices - e.g. a church, cult, or "movement." Can you think of any in media headlines recently?  

  • Families unintentionally neglecting the spiritual development of dependent children.

Some options apply to all five client types . In what follows, "God" can be any title, label, or Prophet you feel is most relevant:

  • Include one or several questions on any intake forms or checklists - e.g. "On a scale of 1 to 10 (10 = "extremely"), how important would you say spirituality (vs. religion) is to your immediate family recently?"
     

  • When appropriate, ask generic questions like ...

    "What does 'spirituality' mean to you?"

    "Do you believe in a Higher Power now? 'No' is perfectly OK with me."

    "Do you feel that God can help you with this problem?"

    "How are you most comfortable accessing God?"

    "Do you feel God is present in and with us right now?"

    "How comfortable would you be in our asking for God's help as we work together?"

    "Have you ever had an experience where you felt God's presence or intervention?"

    "What did each of your childhood caregivers teach you about spirituality?"

    "If God spoke to you now about your problem, what do you feel you'd hear?"

    "Do you have a spiritual mentor now?", or "Have you ever had a spiritual mentor or teacher?"

    "How would others in your family feel about our using our spirituality to help us in our work?"

        The way attending clients answer questions like these (mindlessly, timidly, anxiously, vaguely, confidently,...) reveals as much as their answers. My experience is that responses to questions like these usually suggest follow-on assessment questions which help develop a "sense" of individuals' and the family's client's spiritual and religious beliefs, rules (boundaries), morals, and priorities.

When Assessment Timing

        Is there a best time in the work to assess a client's spiritual resources and limits? Because assessment is an organic, phased process, and spirituality or religion can be highly-charged topics, clinical flexibility helps, here. Experience suggests that building a solid therapeutic alliance and gaining a sense of the clients' traits and situation first, is a good guide for if and when to ask assessment questions like those above. In part, the timing will depend on _ the clinician's style and comfort level with this topic, _ cues provided by the attending clients, and _ the presenting problems. 

        Some clients will bring up spiritual or religious issues spontaneously, creating an opportunity to assess. With those who don't, the clinician's Self will guide them to wait until a "lull" or an impasse occurs in the flow of the work. Clinical impasses are "windows of opportunity" that can open new intervention possibilities. Example: the clinician asks ...

"I confess, I feel stuck right now. I'd like us to be quiet for a few moments, and see if (God, Higher Power, Inner Voice, ...) will give you or me a direction that we're not seeing yet. Would you feel OK doing that?" 

        Such a question is both an assessment and a teaching intervention. My experience since 1981 is that most clients with prior clinical experience have never _ had a professional admit to being "stuck," and/or _ heard a question like that. What's your experience?


 


 


The Right Conditions

        What "conditions" promote successful clinical spirituality interventions with typical divorcing and stepfamily clients?

  • The clinician's inner family (personality)  is clearly under the guidance of their true Self (vs. false self) and a meaningful Higher Power. Otherwise spirituality interventions may be contrived, insincere, ambivalent, or covertly manipulative or shaming.

  • The client and clinician mutually respect each other's theology, even if they clearly disagree on some elements.

  • Both agree that the clinician (other than an invited spiritual counselor) is not  trying to instruct the client on what or how to believe, or how to worship. Nor is s/he  judging the "rightness" of what the client believes - unless their beliefs seem toxic to the client and/or others. "Toxic" means significantly degrading the client's or dependent kid's wholistic health by promoting excessive fear, guilt, shame, distrust, bigotry, and/or confusion. In this site, "client" means the attending person/s' nuclear family.  

        Other "right circumstances" include ...
  • The clinician's choices about spirituality interventions are  self-motivated and authentic, and  are acceptable to co-workers, supervisor, and clinical or program director, if any. If not, overt or unspoken values' conflicts with colleagues may promote inner conflict ("ambivalence") in session, which can confuse and hinder the client's trust in the clinician.

  • The attending client/s are receptive enough (per their judgment) to the clinician's respectfully exploring spirituality issues and resources - among others - in assessing and filling the client's unfilled needs; and ...

  • The clinician is able to flex to adapt to the client's spiritual concepts and language, rather than requiring or implying that the client should use the clinician's concepts and terminology. A corollary is that the clinician needs to avoid imposing their own spiritual biases about if or how a Supreme Being may or may not help in the work; And ...

  • any other conditions you feel are necessary before making valid spirituality interventions.

 Options for Using (Clinician + Client) Spirituality Effectively

        If the right conditions are met and the timing is right, how can a clinician or other professional use their own and the client's spiritual resources to help reach their human- service goals? Because clinician personality and paradigm, clients, and situations are unique, specific answers must be unique also. Options are that the clinician perceives the client-family's spirituality is...

  • irrelevant to presenting problems, and clinical goals and interventions, or...

  • a potential resource to them and the work; or...

  • the client's faith and religious practices and/or environment (e.g. church community) seem to _ reduce client-family's nurturance level, _ promote significant psychological wounds, and _ contribute to the client's presenting problems.

These scenarios raise different procedural and boundary questions, and invite different interventions. Let's look at each, briefly ...

1) Client Spirituality Seems Benign (Non-toxic)

        Spirituality-intervention options vary with the client type, their problems, and the (non-marital > marital >personal) phase of the work.

Options With Courting-stepfamily Clients

        These clients typically don't know what they don't know about psychological wounds and stepfamily realities and implications . Typically, they're muting, intellectualizing, or avoiding any significant conflicts about spirituality or religion (and other things). Exceptions are client couples from different conservative religious denominations (e.g. fundamental Christian and Orthodox Jewish, or Muslim and Baptist) whose extended-family or social environment promotes mutual judgment (prejudice) and rejection. Stepfamily research suggests that cross-denominational unions are significantly more likely in American re/marriages than first marriages.

        With this in mind, assessment and intervention options with these clients include ...

  • Assess for nurturing (vs. toxic), shared couple spirituality (vs. religious compatibility), and overtly include those among the couple's current strengths. Doing so helps offset scary warnings of major stepfamily conflict and re/divorce risk;

  • If one or both partners are divorced, assess for significant inner or intra-family values conflicts over that (like "divorce is a sin"), and how each divorced partner is coping with any related shame, guilts, anxieties , and confusion. Also ask the couple's opinion about how co-parenting ex mates are doing with the same questions. Seed the vision of healing each of these intra-personal stressors, and how that will benefit any kids involved, long-term;

  • If one partner identifies as "spiritual" or "religious," and the other doesn't, assess whether the couple has meaningfully considered how that values difference will affect their co-parenting decisions and child-visitation harmony. If "no," are they motivated to do so? Serious open or muted conflicts here can lead into assessing and teaching the couple about their inevitable stepfamily values and loyalty conflicts. Intervention option: explain and facilitate Projects 2 and 9 .

  • Assess whether _ you and _ the client-couple think that spirituality or religion is a strength or stressor in the past and current relationship between ex mates, and/or their extended families. If the latter, facilitate the couple's resolving that, vs. ignoring, minimizing, or enduring.

  • If one or both partners or a co-parenting ex mate appears to be significantly ruled by a false self, assess for possible worship or religious addiction . If you suspect it, indicated interventions are the same as with any other symptom of false-self dominance.

  • Alert receptive couples to the PREPARE (MC) and REFOCCUS pre-re/marriage assessment services. These may inspire the couple to do the more detailed self-improvement Lessons proposed here. Both computer-"scored" assessments are usually facilitated by trained clergypersons in various church denominations. 

Options for Spirituality Interventions with the Other Four Client Types

Representative Spirituality Interventions with "Non-toxic"

Divorcing Biofamilies and Divorcing Stepfamilies

Clinical Focus and Phase

Marital
problems
Inner-family
(individual) work
      1) If attending clients are ambivalent about divorce (ruled by a false self), and their surface reasons for divorce include serious spiritual or religious conflicts, see if the clients are open to _ learning about using effective problem-solving skills _ to reduce such values conflicts to "tolerable." If not, seed awareness of those. yes yes - focus: inner-family conflicts
      2) If co-parents seem distracted from using existing inner and outer spiritual and religious resources (e.g. pastoral counseling, prayer, and/or church-community support) effectively, _ identify that respectfully, and _ encourage them to proactively overcome the distractions. If they're psychologically wounded, they probably won't, and seeding the idea may still help. yes True recovery naturally invites proactive use of spiritual resources
      3) If one or both co-parents seem enmeshed with or codependent on extended family or church community members over religious beliefs, respectfully confront the couple with their letting other people's beliefs, and underlying guilt and fear of disapproval and rejection break up their marriage. Option: give such couples copies of this, and encourage them to apply it. yes yes
      4) Pray with and for consenting clients for guidance, resilience, and hope with receptive clients yes
      5) Use inner-family systems therapy or equivalent to facilitate _ internal recognition and _ balanced participation of the client's Spiritual subself seed with 
receptive clients
yes
      6) In session, acknowledge impasses and invite all present to get mentally and physically quiet and listen to their "still small (spiritual) voice" for inspiration and direction. If a positive experience, encourage clients to do that outside clinical meetings. with receptive clients yes
      7) Strategically use the clinician's own spirituality to illustrate, inspire, and guide attending clients. yes yes
      8) Encourage clients to meditate, pray, and journal, as their process unfolds yes yes
      9) Teach attending clients the three levels of healthy grief,  help them identify their divorce-related losses, and explore the spiritual level of their grieving. If clients aren't open to this now, seed this healing task. Alert them to their children's and key relatives' primary need for the same three-level healing.  with receptive clients yes, and with other (prior) losses
      10) Refer co-parents as indicated to - or network with - a competent spiritual "coach" or pastoral counselor, and/or a spiritually- compatible "marriage-saver" program, book, or divorce-support group. Ideally, counselors and facilitators will know stepfamily basics. yes yes

        These are illustrative suggestions, not comprehensive. Every case will merit or invite uniquely appropriate spirituality interventions like these. Recall this site's premise that effective clinical work has long-term effects on client families. Therefore, if full interventions like these aren't feasible or timely now, seeding client spiritual awareness and nurturance can still be potentially helpful, long-term.

.

        If you haven't recently, please read the brief perspective about these pages and the series they belong to. This Web page continues exploring a vital branch of clinically assessing and intervening with the five client types we're focused on here: client spirituality (vs. religion), as a clinical resource or client stressor. The first page proposes some ...

  • key semantic definitions, and basic perspective and premises about spirituality and clinical spirituality interventions;

  • a core reason to proactively include spirituality in clinical work with these complex clients;

  • a self-assessment inventory about your spirituality and your workplace; and...

  • the key potential benefits of including spirituality in the work with receptive clients

        The second page... 

  • offers ideas on psychologically toxic spirituality and religion; ...

  • outlines spirituality-assessment questions and timing options; and ...  

  • proposes intervention-options with courting and divorcing client families who's spirituality seems nurturing, vs. toxic. 

This article...

  • suggests spirituality-intervention options with spiritually nurturing client families,

  • adds intervention options with client families whose spirituality seems toxic, and ...

  • highlights some inexorable personal and ethical questions that arise from spirituality assessments and interventions.

Representative Spirituality Interventions with

 "Spiritually nurturing" Client Families

Clinical Focus and Phase

Non-marital problems

Marital problems

Inner-family
(individual) work

1) If attending clients' presenting problems include serious spiritual or religious conflicts, see if the clients are open to _ learning about using effective problem-solving skills _ to reduce such values conflicts to "tolerable." If not, seed awareness of those. yes yes yes - focus: inner-family conflicts
2) If co-parents seem distracted from acknowledging and using existing inner and outer spiritual and religious resources (e.g. pastoral counseling, prayer, and/or church-community support) effectively, _ identify that respectfully, and _ encourage them to proactively overcome the distractions. If co-parents are psychologically wounded, they probably won't - and seeding the idea may still help. yes yes True recovery naturally invites proactive use of spiritual resources
3) If one or more co-parents seem enmeshed with, or codependent on, extended family or church community members over religious beliefs, respectfully confront the co-parents with their letting other people's beliefs - and underlying guilt and fear of disapproval and rejection - stress their marriage and nuclear family. Option: give such co-parents copies of this, and encourage them to apply it. yes yes yes
4) Pray with and for consenting clients for guidance, resilience, and hope yes yes yes
5) Use inner-family-systems therapy or equivalent to facilitate _ internal recognition and _ balanced participation of attending client's Spiritual subselves seed seed yes
6) In session, acknowledge impasses and invite all present to get mentally and physically quiet and listen to their "still small (spiritual) voice" for inspiration and direction. If a positive experience, encourage clients to do that outside clinical meetings. yes yes yes
7) Strategically use the clinician's own spirituality to illustrate, inspire, and guide attending clients. if clients are receptive if clients are receptive yes
8) Encourage clients to meditate, pray, and journal, as their process unfolds if clients are receptive if clients are receptive yes
9) Teach attending clients the three levels of healthy grief,  help them identify their prior losses (including re/marital and co-habiting losses), and explore the spiritual level of their grieving. If clients aren't open to this now, seed this healing task. Alert them to their children's - and key relatives' - need for the same three-level healing.  yes yes yes, and with other (prior) losses
10) Refer co-parents as indicated to, or network with,  _ a competent nurturing spiritual "coach" or pastoral counselor, and/or _ a spiritually-compatible co-parent- support group. Ideally, counselors and facilitators will know stepfamily basics yes yes yes

        Again, these ideas are illustrative, not comprehensive.

2) Options if the Client-family's Spirituality Seems Toxic

        If the clinician assumes responsibility for confronting or changing toxic client spiritual or religious beliefs, s/he must choose between either (a) trying to cause a second-order (core attitude) change in the client's family system (within the context of the presenting problems), or (b) seeding such a change. I believe significantly toxic spiritual and religious beliefs and practices are always a sign of significant denied psychological wounding. What do you think?

        If true, this implies that educating the client on false-self dominance and wounds, and on the benefits of healing those, must usually (always?) precede any attempt to seed changes in toxic spiritual beliefs and practices. Tactically, education on personality subselves and recovery is usually best begun in the middle (marital) phase of the work. Most false-self dominated clients won't act on trying to empower their true Selves (and shift spiritual beliefs and rituals) until they solidly refocus from family and marital problems to personal healing and growth work.

        One class of interventions here has to do with the clinician's judging the client co-parents to be significantly neglectful or abusive spiritually with dependents. The prerequisite is the clinician _ forming a clear opinion on what constitutes spiritual neglect and abuse, and then _ deciding what her or his moral obligation to the clients and society are if either of those are assessed. If the clinician is ruled by a false self, they're less likely to 

Representative Interventions With

 "Toxic-spirituality" Client families

Clinical Focus and Phase

Non-marital problems

Marital problems

Inner-family
(individual) work

1)  Ask attending clients if they feel spirituality or religious factors are increasing or reducing their (presenting) problems. yes yes yes
2 If excessive guilt and/or shame from toxic spiritual or religious rules seems a significant part of current surface conflicts, investigate the clients' willingness to explore and change that. If not, seed doing so as beneficial future work for adults and kids.  yes yes yes (inner-family subselves carrying old guilt and shame)
3)        

 


Questions ...

        Because spirituality is a profound, complex, personal, and "irrational" subject (not subject to "logic"), making clinical assessments and interventions about spirituality creates tough values' and procedural questions. My premise is that clinicians, supervisors, and program directors who have evolved clear answers to their own personal theological and and organizational (policy) questions, will feel more authentic, spontaneous, and serene in weaving spirituality into their work (or not). 

        What "values' and procedural questions"? Some that occur to me are ...

Q 1)  The group that begins the prior page, for each person in the provider organization; and ...

Q 2)  What is a "clinical spirituality intervention"? What's an effective spirituality intervention? Who's qualified to judge that?

Q 3)  Should I (the clinician) describe my own spirituality to my clients? Should I demonstrate it, during the work (e.g. mention God, or ask God's help, when I think it appropriate)?

Q 4)  In my role as a hired professional, do I have the right to assess and intervene in the spiritual aspect of my client's lives if they don't ask me to? If they do ask me to? Do I have the authority? Where does such authority "come from"? Who do I grant the authority to guide me on this? 

Q 5)  If there is such a thing as "toxic spirituality or religion," _ what is it, _ what are it's symptoms, _  what is my responsibility if I perceive the symptoms in a client family, and _ what are moral and ethical guidelines for my intervening - specially if the client doesn't feel or acknowledge that toxic spirituality as a problem?

Q 6)  To honor my integrity and dignity and theirs, how should I best handle major spiritual-faith values conflicts with _ clients, _ colleagues, and _ organizational superiors?

Q 7)  When, if ever, is it appropriate to bring up Heaven, Hell, the devil, demons, angels, the Bible (or Koran, Torah, Sutras, or other Holy books) with clients?

Q 8)  Is there a best way to advise typical divorced-family and stepfamily clients on how to resolve major inter-family values conflicts over _ spirituality, _ religion, and _ religious education for children? 

Q 9)  When, if ever, is it appropriate to pray with clients, during the work?

Q 10)  If there is such a thing as "spiritual or religious abuse ," _ what is it, _ what are it's symptoms, and _ what should I do if I assess that in a client family?

Q 11)  If there is such a thing as "spiritual or religious neglect ," _ what is it, _ what are it's symptoms, and _ what should I do if I assess that in a client family?

Q 12)  If there is such a thing as "spiritual or religious addiction"  _ what is it, _ what are it's symptoms, and _ what should I do if I assess that in a client family? Perspective: see "When God Becomes a Drug - Breaking the Chains of Religious Addiction and Abuse," by Father Leo Booth.

Q 13)  Is a client ignoring or denying a benign Higher Power, or inhibiting their children's spiritual curiosity and learning, neglectful or toxic? If so - what should I do about that?

Q 14)  If my client has toxic spiritual or religious beliefs, am I ethically and morally right to use them strategically toward promoting healthy change? For example: "It seems to me that you're letting the Devil triumph here, by locking your stepson in his room during dinner."

Q 15)  What are the traits of a competent, qualified "spiritual mentor and guide? According to whom? If I feel unqualified myself, who do I feel ethically and morally right about referring spiritually-needy clients to? What if I and my colleagues and/or organizational superiors disagree over this?

Q 16)  Where I work, who is responsible for _ generating and _ enforcing an organizational (clinical) policy on making spirituality assessments and interventions? If my organization lacks a clear policy statement, should I suggest one? On what grounds?

Q 17)  Are _ atheists and _ agnostics bad, sick, inferior, or doomed people? Do I have any bias about this that subliminally or obviously affects my clinical conduct?

         Add your own questions about clinical spirituality assessment and interventions... Option: Use some or all of these questions as the focus in one or several staff in-service training sessions.


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Updated August 12, 2015