Infusing
Spirituality and Religion into Social Work Practice
A NACSW Audio Conference
April 29, 2002
All practice happens within multiple contexts. Two important factors are the agency framework of the worker and the belief structure of both the worker and the client.
Five different kinds of organizations in which social workers are employed can each influence the degree and way in which one talks about matters of faith and spirituality:
• In private practice, there are generally not organizational constraints.
• In Christian counseling agencies, there is an expectation by the clients that a Christian framework will be used in the therapy process. John Cheydleur’s book, Called to Counsel, provides instructions on counseling in this environment, in which, for example, one would use verses of scripture as part of the work;
• In faith-based (or faith-associated) social service agencies, there is sometimes the expectation that workers will bring issues of faith into the work and most often the latitude to do so. On the part of some clients, the expectation exists that religion will be a part of the process;
• In secular non-profit social service agencies, it may be difficult to generalize about the ways in which social workers can bring matters of religion and spirituality into their work. It may be safe to say there is greater latitude to do so than in governmental social service agencies;
• In governmental social service agencies, social workers are often fearful of bringing religion and faith into the helping process, even if clients mention their faith orientation, because of concern of the separation of church and state.
The religious
and spiritual orientation (or lack thereof) of the worker and client is also
critical. This table illustrates different combinations seen in helping
situations:
Worker |
Clients |
Clients |
Clients |
Clients |
Clients |
|
Christians |
Actively
practicing Christians |
Not
actively practicing Christians |
Actively
practicing adherents of other religions |
Not
actively practicing adherents of
other religions |
Non-believers |
|
Adherents
to other faiths |
Actively
practicing adherents of the same religion |
Not
actively practicing adherents of the same religion |
Actively
practicing adherents of other religions (includes Christians) |
Not
actively practicing adherents of
other religions (includes Christians) |
Non-believers |
|
Non-believers |
Actively
practicing adherents |
Not
actively practicing adherents |
|
|
Non-believers |
While the
terms "spirituality" and "religion" are often used
interchangeably, the words differ in important ways.
Spirituality is seen as a set of personal beliefs which come from an individual’s perception of self and his or her relationship to both the natural world and some world or reality beyond that which can be seen. As individuals try to understand the meaning and purpose of life, they often seek answers from a higher power in comprehending the sources of belonging and isolation, faith and doubt, hope and despair, suffering and joy.
Religion is viewed more narrowly than spirituality. It can be seen as a structured mode of spirituality that typically has a group following, whereas spirituality can include an individual experience, with or without a structured belief system. Religions have beliefs and moral codes that their members generally share, and a religion will have rituals and worship practices.
The distinctions between religion and spirituality are not always clear. People may raise spiritual issues outside of the structure of organized religion, and believers in a religion may rarely raise spiritual issues1.
Faith can be seen as a conscious alignment of one’s will in accordance with a transcendent power. A faith involves trusting that one’s belief in the ultimate meaning in the universe is true. In contrast to both spirituality and religion, faith is deeper, richer, more personal. It is engendered by a religious tradition, in some cases and to some degree by its doctrines; but it is a quality of the person, not of the system. It is an orientation of the personality, to oneself, to one’s neighbors, to the universe; a total response; a way of seeing whatever one sees, and of handling whatever one handles; a capacity to live at more than a mundane level; to see, to feel, to act in terms of a transcendent dimension2. One can have a strong faith based on one’s religious beliefs, and the term is sometimes (but less often) used to describe the depth of one’s spiritual beliefs.
In this workshop, references will be made largely to the integration of religion and spirituality, with some assessment approaches geared to understanding the meaning and importance of client’s faith.
1. Miley, K. (1992)
Religion and spirituality as social work concerns. Paper presented at the Midwest Biennial
Social Work Conference, April 9-10.
2. Hammons, Stacy. (1991) Faith and practice: A critical integration. Social Work & Christianity 18(1), 6-28.
There need not be a
distinction between effective social work practice and practice which embodies
Christian values. Jon Wallace1
shows the integration of the National Association of Social Workers (NASW) Code
of Ethics (in boldface) and the
teaching of Jesus Christ:
According to the NASW Code of Ethics, the primary mission of the social work profession is to enhance human well-being and to help meet the basic human needs of all people, for I was hungry and you gave me food; I was thirsty and you gave me drink, with particular attention to needs and empowerment of people who are vulnerable, oppressed, and living in poverty. I was naked and you clothed me; I was sick and you visited me; A historic and defining feature of social work is the profession’s focus on individual well-being in a social context and the well-being of society. I was a stranger and you took me in. Fundamental to social work is attention to the environmental forces that create, contribute to and address problems in living. I was in prison and you came to me. ( this relates to the goals of Social Work) And the King will answer and say to them, Assuredly, I say to you, inasmuch as you did to one of the least of these my brethren you did it to me (Matthew 25:35-36, 40).
There are two things that we can offer people who come looking for help. We hope that we can help them with their concerns, and we can offer them the gift of being treated with dignity.
• To treat people
with dignity is to treat them as persons that are more than the sum of their
woes, persons who are important just because they are human.
• If individuals seeking help do not feel they’re being treated with dignity and respect, they are less likely to talk openly about their life issues if they sense that they are being judged.
• To treat a person or family with dignity, it is important to:
o See people as individuals, not lump them into a category like “the mentally ill” or "the homeless".
o Be aware of the need for autonomy, predictability, and power. A lack of autonomy leads to a sense of powerlessness.
• When we treat people with dignity, we are treating them as individuals with a future. This can lead to a rebirth of hope about the possibility of times and life getting better.
______
1 Wallace,
Jon R. “Faith-Based Casework: Toward a
Synthesis Model for Social Work Practice”,
Presentation to The Salvation Army Division Social Services Seminar,
Stephens Point, Wisconsin, October 28, 1998.
Victor
Frankl, the Holocaust survivor and author of Man’s Search for Meaning, states that those who ignore people’s
spiritual side are giving away one of their most valuable resources.
Religious beliefs can be a
strength
• The
presenter has heard more than one homeless parent struggling to find a place to
live, a job, a way to support their family has been heard to say “God put me on
this earth to do something”. The belief
that one’s life has purpose and meaning can both sustain and energize people in
difficult times.
• In reviewing the role of spirituality with people of color,
Thomas1 found that those who maintained a connection to their
spiritual beliefs tended to be more satisfied with their lives than those who
did not believe in a higher power.
Individuals may have a strong moral code based on religious
beliefs. This can include
values of right wrong and a
clear sense of one’s own roles and responsibilities2
Recent research indicates
that religious attendance leads to less antisocial or irresponsible
behavior. Adolescents who attend
religious services have lower rates of crime, smoking, drinking, and using
drugs3.
A Community of Believers Supports
Church Members, Especially in Times of Trouble
• Individuals who are church members report
greater levels of support in their lives, and in some areas (such as
African-American youth and high school completion) are far more successful in
dealing with life issues that comparable non-church-goers.
• In Christian churches, people often are
living out Galatians 6:2: “Bear one another’s burden, and so fulfill the law of
Christ”.
Prayer and Spiritual Practices
Help Individuals Cope with Physical and Mental Health Issues
• Research is increasingly showing the value
of faith, prayer, and other spiritual practices on one’s physical and mental
health.
• In the areas of addiction, cancer and other physical ailments, and mental health, there is convincing evidence that spiritual and religious practices are an invaluable resource for many people who are suffering4.
______
1 Thomas, N.D. (2000) Generalist practice with people
of color. In Poulin, J. (and contributors) Collaborative
Social Work: Strengths-Based Generalist Practice. Itasca, IL; F.E. Peacock
Publishers.
2 Pellebon, Dwain A. and Anderson, C. Stephen
(1999). Understanding the Life Issues
of Spiritually-Based Clients. Families in Society, 87(3), 229-238.
3 Cnaan, Ram A. with Robert J. Wineburg and Stephanie C.
Boddie (1999). The Newer Deal: Social Work and Religion in Partnership. New
York: Columbia University Press
4Koenig, Harold (1999). The Healing Power of Faith: Science Explores
Medicine’s Last Great Frontier. New
York: Simorn and Schuster.
Engaging with clients is generally a prerequisite for
effective work. Clients need to know that the worker understands (to the degree
possible their situation) and cares about them. In their study of social work with inner-city Boston residents,
the authors of The Power to Care: Clinical Practice Effectiveness with
Overwhelmed Clients found that caring,
along with flexibility, were the most
important characteristics of the worker in the client being successful1.
When human needs are met with caring and dignity, the client’s whole
being is touched.
• It
is easier to define what dignity is NOT than to specify a meaning. Sometimes, people are treated as if they are
no more than their circumstances. A
woman who is homeless loses all other identity except as a member of a group
“the homeless”. A man who fights with
his alcohol addiction is referred to only as an alcoholic. People can find themselves being looked
down on by the larger society and/or by service providers—for their appearance,
for their present problems.
One can “let God’s light shine” into the lives of clients without ever mentioning religion, faith, or spirituality.
• It is almost
impossible to overestimate the ministry
of presence. Gordon Bingham,
Western Territorial Social Services Secretary of The Salvation Army, states:
Those we serve (in emergency assistance) are hurting, frustrated,
understandably angry people. If we
offer them a service that is loving, sensitive to their hurt, that does not
seek to impose our agenda, but responds to their own, I think we will in many
instances find opportunity in other ways to address those issues that go beyond
today’s survival. If we do not, I think
we only confirm them in their cynicism and alienation2.
• Alan Keith-Lucas stated “What we can do
as social workers—and we have a wonderful opportunity to do so—is to show such
love and forgiveness that a confused and desperate person can understand the
Spirit’s message when it comes” 3.
______
1 Hopps, J., Pinderhughes, E., and Shankar, R.. (1995).
The power to care. New York: The Free Press.
2 Bingham, Gordon (1989). The Theology of Social
Work. Presentation at The Salvation
Army National Social Services Conference, St. Louis, Missouri, March 12,
1989. p. 16.
3 Keith-Lucas, Alan (1972). Giving and Taking Help.
Chapel Hill: University of North Carolina Press.
The term “assessment” is commonly used to describe the process by which a worker evaluates a situation to acquire an understanding of what caused a problem and what can be changed to minimize its impact or to resolve it1.
• However, the process of assessment can be done in ways that both involve and respect clients.
• Assessment can be a process that helps clients define their situations and assists them in evaluating and giving meaning to those factors that affect their situations2.
• Holistic assessments incorporate understanding issues of spirituality and religion by paying attention to the whole person in the person’s whole environment.
• One of the hallmarks of social work practice is working with the person-in-environment. However, the beliefs and culture of the person are usually not adequately considered, and the environment is also thought of in a narrow sense.
• Culture can be defined as a set of meanings or understandings shared by a group of people that makes sense of the world. Cultural belief systems and expected behaviors influence people’s ideas, customs, and skills. These can be valuable resources or can become obstacles for effective functioning and reaching goals.
• Culture is often narrowly defined to include only those differences in worldviews and practices associated with ethnic and racial groups outside the dominant culture.
• While the person-in-situation approach requires that social workers understand people from the standpoint of their culture, there has been some reluctance to recognize conservative Christianity as a separate culture. For example, growing up in a devout home places people in a distinct subculture, perhaps even a counterculture3.
• Assessments need to go beyond noting
whether people belong to a faith community to comprehending how and to what
degree that belonging influences their thinking and actions. For example, the
religious beliefs of families who are Baptist or Jehovah's Witness, for
example, may reassure them in different ways in dealing with the death of a
child from Sudden Infant Death Syndrome4.
_______
1Kirst-Ashman and Hull, 1999 Understanding Generalist Practice.
Pacific Grove, CA: Brooks/Cole.
2Saleebey, Dennis, Editor (1997). The
Strengths Perspective in Social Work Practice. New York: Addison-Wesley Longman.
Hodge, D.R. (2001) Spiritual
genograms: A generational approach to assessing spirituality. Families
in Society, 82(1), 35-48.
Van Hook, Mary P. Incorporating Religious Issues in the
Assessment Process with Individuals and Families in Hugen, Beryl, ed. (1998) Christianity and Social Work: Readings on
the Integration of Christian Faith and
Social Work Practice.
Botsford, CT: NACSW.
• The way that
people organize what they do and have done, what is being done and has been
done to them, and how they experience all of that is their story.
• Traditional
assessment instruments will not capture the meaning that individuals give to
actions and experiences, and therefore it is important to listen to how clients
make meaning in their lives.
Exploring the story enables
the worker and client to understand the present situation within the life
experience of the client, as one chapter in their life.
• When social workers first meet clients, the clients often are at times
in their life in which they are beset by sorrows and woes, confronted with
issues and difficulties. In doing
crisis intervention or in working with people who have been hospitalized for
mental distress, we see only the person in crisis, not functioning well. Our tendency is to not see the person as
someone who has functioned well in other times of her or his life1.
• Even when social workers explore
the spiritual dimension of clients’ lives and their connection with faith
communities, they may miss much in focusing only on the present.
• Religious activity
characterizes most Americans, but three-quarters of the population become
inactive at some point in their lives, typically during their twenties2. Assessments need to capture not only what is
present in their lives but what was significant at other times.
When a person’s religion or sense of spirituality is central to their
lives, they frame their own story within the context of a much bigger story.
• The client’s words can
recount not only how significant a part of their life their spiritual/religious
beliefs and participation in a faith community are, but also the specific ways
in which it is central or specific.
____
1Caplan, G.
(1974). Support systems and community mental health; lectures on concept
development. New York: Behavioral
Publications.
2O’Connor, T.P., Alexander, E., Hoge, D., Pankh, C.,
and Grunder, S. (1999, November).Baptist,
Catholic and Methodist teenagers become adults: A 24-year follow-up study of
religious behavior and attitudes.
Religious Research Association, Boston.
3Locke, B., Garrison, R., and Winship, J. (1998)
Generalist Social Work Practice: Context, Story, and Partnerships. Thousand
Oaks, CA: Brooks/Cole.
Open questions (and equivalent statements such as “Please tell me more about that”) put into practice the values of dignity, self-determination, and emphasis on clients’ strengths. When asked with genuine curiosity, open questions put clients in the role of the experts in their own lives, unique individuals with their own dreams and ways of dealing with the world1.
The use of open-ended questions in initial assessments can lead to clients’ talking about strengths and resources in general and also bringing up issues of their spiritual or religious beliefs or membership in faith communities that are significant to them.
When a worker asks “What are your greatest sources of strength?” or “What gets you through the bad times?” a client may answer “My children”. She may also take the opportunity to talk about spiritual beliefs and religious practices. Those can then be clarified with other questions.
Following is a list of questions that can be used in initial assessment that may “open the doors” to clients talking about issues of religion and spirituality:
· Who or what provides you with strength or hope?
· What gives your life meaning and purpose?
· What makes you get up and get out of bed every morning and do what you need to do?
· What is your greatest source of strength?
· On what is your hope based?
· What gives meaning to your life?
· How do you understand hope? What do you hope for?
·
What gets you through the bad times?
Pencil and paper assessments here refer to single page sheets which clients fill out (or the worker and client fill out jointly, especially when literacy is a barrier). The author, in his work with homeless women, has found that the two examples of pencil and paper assessments presented here often have yielded far more information than was provided in just talking. When individuals are asked to think about their life by putting information into categories, there is often a greater number of details and examples provided.
The Social Support Map is a version of an eco-map which is widely used in social work practice. The six “pieces of the pie” are Family, Friends, Work/School, Neighbors, Formal Helpers, and Churches/Social Organizations. In filling out the Social Support Map, clients are asked to indicate the sources from which they receive support. When individuals indicate that there is support from a church or religious organization, follow-up questions can determine the extent of the support (and often the nature and depth of the person’s faith). Workers can also use the Social Support Map later in the helping process. Especially in looking for assistance in reaching goals, the worker can ask “In which areas would you like to have more support?”. At times clients indicate they would like to have greater involvement with their churches or faith communities.
The sheet Assessing Concerns, Strengths and Resources enables clients to describe their present concerns, the strengths/positives in this area of life, and resources that they have used in the past in six different areas: Housing and Daily Living, Financial, Work/Education, Social Supports, Physical/Emotional Health, and Spiritual Well-Being (a seventh area on the sheet is “Other” for adding in what may be “salient for a given client). In the first column, clients indicate present concerns, in the second they describe current strengths/ positives/resources, and in the third column they answer the question “What resources have I used in the past?” Resources, either spiritual practices or membership in faith communities that were significant in the past often surface here.
Going beyond initial assessments, in some circumstances spiritual genograms can be used in work with families to understand spiritually-based interactions over several generations. This can especially be useful in situations where marital conflict occurs because of difference in beliefs and religious practices, and in recent immigrant families where there is greater cohesion and interdependency than in many other families. An in-depth treatment of spiritual genograms and information on how to construct and use a spiritual assessment is found in David Hodge’s article, “Spiritual genograms: A generational approach to assessing spirituality” in the journal Families in Society, 82(1), 2001, pp.35-48.
Prayer
is worshipful communication with God, with a higher power. It is a universal means of self-expression
that reflects culture, religious beliefs and other practices, social class, and
other aspects of diversity, while remaining highly personal1.
Some
research indicates that prayer has positive effects on physical and mental
health and individuals’ ability to make changes in their lives:
• People who pray believe that prayer has helped them overcome
physical and physiological suffering;
• Prayer can shift the focus from the individual’s difficulties
(in not drinking, for example) to living the life that God wants them to live
(which can include not drinking);
• Prayer, contemplation, and meditation based on Christian
traditions can have more profound healing effects with religious or spiritual
clients than secular strategies that have eliminated all religious or spiritual
content2.
Dr.
Diana Garland, Professor of Social Work and Director
of Baylor University’s MSW program, writes about the need for social workers to
be understand the client’s understanding of prayer before beginning to pray
with the client. She writes that she
needs to:
• frame my work as
incomplete and flawed. Often we
need to make explicit our sense of failure or inadequacy, to ourselves, to
God—and to our client. When we place
our work in the hands of God, asking for guidance, and presence, we move from a
position of control.
• “center” our work with
the client in the purpose and meaning of the client’s life. Often a time of prayer together helps to
frame the issue that is being confronted within the entire life situation of
the client.
• identify the client’s
spiritual self, or the spiritual relationship between the persons of a
multi-person client system.
• claim the promises of God
and generate hope. Those promises
may be for forgiveness and redemption, for peace, for God’s presence with us.
• claim the promises of God
and generate hope. To teach prayer. You may model ways to pray, to
meditate, to use the prayers of others.
Garland
cites these as several inappropriate objectives for prayer.
• Prayer should not be
used to exert influence over the other, either during prayer (“God, help this
poor soul to choose sobriety”) or after (“I think God would have you do it this
way”).
• Prayer should not be
used as a way to prove the social worker’s spirituality to the client—this
should be apparent in all of the relationships.
• Prayer should not be used when the social worker does not know what to say.
________
1Washington, O. and Moxley, D. (2001) The use of prayer
in group work with African-American women recovering from chemical dependency. Families in Society, 82(1), 49-60.
2Richards, P.S. and Bergin, A. E. (1997) A Spiritual Strategy for Counseling and
Psychotherapy. Washington, D.C.:
American Psychological Association.
3 Garland, Diana R. (1991). The Role of Faith in Practice with Clients. Social Work and Christianity , 18(2), 75-89.
Please go to: http://www.nacsw.org/AudioConf/042902bHandouts.htm for a map depicting important social supports.
Please go to: http://www.nacsw.org/AudioConf/042902cHandouts.htm
for a graphic listing key strengths, concerns, and resources in the assessment
process.