religion & spirituality in counseling janeé r. avent, ms, lpca, ncc the university of north...

Religion & Spirituality in Counseling

Janeé R. Avent, MS, LPCA, NCC The University of North Carolina at

Greensboro

“Your sacred space is where you can find yourself over and over again.”

Joseph Campbell

Presentation Overview Counselor self-awareness

Spirituality & religion

Effects on physical & mental health

Assessment

Religious Coping

Counselor Self-Awareness

Self-reflection, self-awareness, introspection

Questions for reflection: “Who am I? Where am I going? What does life mean?” (Helminak, 2001, p. 163)

Exploration through coursework, supervision, consultation

Exploring one’s own value system

(Cashwell & Young, 2005)

Thinking about your

spiritual journey

…

Spirituality vs. Religion

Spirituality vs. Religion Spirituality

“a sense of relationship with a belief in a higher power or entity greater than oneself that involves a search for wholeness and harmony” (Belcher & Benda, 2005, p. 63)

Spiritualis – one possesses the Holy Spirit, usually a minister

More difficult to define because of individualist nature

Religion

Can be both public and private in practice and rituals (Koenig, 2009; Molock, Puri, Matlin, & Barksdale, 2006)

Implies a mandate of obedience, creedal beliefs, and in some religions belief in a supreme being

Defined by constructs of church attendance, religiosity, denomination affiliation, religious coping, and spirituality (Powell, Shahabi, & Thoresen, 2003)

Discussion…Pair & Share!

Think about your population of interest…

How might religion/spirituality apply to that population?

How might religion and spirituality come up in counseling sessions?

Effects on Mental Health

Psychological benefits to psychological health: increased self esteem, joy, compassion, hope, happiness, increased social support, respect, purpose, meaning, and overall life satisfaction (Oman & Thoresen, 2005; Taylor, Chatters, & Levin, 2004; Kelly, 1995; Matthews et al., 1998; Diener, Tay, & Myers, 2011)

Providing clarity for difficult life situations/transitions (Kelly, 1995; Matthews et al., 1998)

Decreasing depression and anxiety symptomatology

On the other hand…exasperating symptoms of anxiety (Koenihg, 209; Wing & Scott, 2005)

Effects on Physical Health

Spirituality/Religion correlates with positive physical health outcomes (Matthews et al., 1998)

Positive effects: decrease in blood pressure, relief of pain in patients suffering from cancer, decrease in heart disease, 30% decrease in mortality (Matthews et al., 1998;

Oman & Thoresen, 2005; Powell et al., 2003)

Again, on the other hand…there are conflicting reports!

In Assessment…ASERVIC Competency 10: During the intake and assessment processes, the professional counselor strives to understand a client’s spiritual and/or religious perspective by gathering information from the client and/or other sources.

Can provide context for presenting concerns

Bio-Psycho-Social-Spiritual Model

Qualitative Assessment Flexible and exploratory

Use of client’s language

Allows for client self-reflection and processing

Behavior observations

Interviews

Sentence completion

Spiritual autobiographies

Spiritual genogram

(Cashwell & Young, 2005)

Quantitative Assessment

Structured, time efficient

Can assess values, beliefs, experiences

Spiritual Health Inventory

Spiritual Well-Being Scale

The Index of Core Spiritual Experiences

(Cashwell & Young, 2005)

Discussion Questions

What might be difficult about spiritual assessments?

How do you see yourself incorporating these assessments into your particular settings?

Others?

Activity!

Divide into groups of 3-4 Review Case StudiesBrainstorm questions to assess for spirituality How might you integrate into traditional intake sessions?What questions do you still have?

Ethical Considerations

Mindful of professional competence Malfeasance – Beneficence

A Counselor’s Responsibility

Respond appropriately to spiritual and religious issues that arise in counseling process (CACREP, 2009; Robertson & Young, 2011)

When clients profess no spiritual or religious affiliation

Assess and integrate into the helping relationship

Recognizing personal limitations

Refer when necessary

(Cashwell & Young, 2005)

Religious Coping Relatively available & Relatively compelling (Pargament, 1997)

Purpose(s): spiritual, self-development, resolve, sharing, restraint

Utilizing specific rituals and spiritual practices

Redefining stressful life incidents

Often enacted when people feel fearful or threatened that some psychological, biological, social, or spiritual goal will not be met (Folkman & Moskowitz, 2004)

Used when faced with existential concerns (Pieper, 2004)

Not limited to “religious” individuals

Can be indicative of one’s religious affiliation or spiritual beliefs (Bhui et al., 2008)

2 Sides to the Story Categorized as adaptive and maladaptive

Can be both at the same time

“Faith can be a source of strength and a source of contention.” (Burke et al., 2011, p. 291)

Active participation vs. deferring responsibility (Wachboltz et al., 2007)

Adaptive Religious Coping

Seeking spiritual support, religious forgiveness, collaborative coping, spiritual connection, religious purification, benevolent religious appraisal, religious focus (Pargament, 1998)

Positive results (i.e. psychological well-being, decreased anxiety symptomatology) from adaptive religious coping (Pieper, 2004)

Maladaptive Religious Coping

Spiritual discontent, punishing God’s reappraisals, interpersonal religious discontent, demonic appraisal, and reappraisal of God’s power (Pargament et al., 1998)

Effects can include: depression, decreased emotional sensitivity to others, lower levels of quality of life (Bjorck & Thurman, 2007; Pargament et al., 1998)

Spiritual Bypass Maladaptive religious coping style

Premature (or false) transcendence

Manifestations: spiritual narcissism, spiritual addiction, spiritual materialism, blindly following a leader, abandoning personal responsibility (Booth, 1991;

Cashwell, Myers, & Shurts, 2004; Ellis, 2000; Rosenthal, 1987; Welwood, 1984, 2000; West, 2000)

Symptoms of spiritual bypass (avoidant coping): increased frequency in overeating and smoking, correlated with symptoms of depression and anxiety (Billings, 1981;Cashwell, Glosoff, & Hammond, 2010)

Assessment

View of God

View of God > life circumstance in influencing type of religious coping.

Religious coping styles seems to not be situation specific

Self directing style correlates with viewing God as benevolent, omni, guiding and stable

Viewing God as benevolent, stable, and powerful was positively correlated with religious and spiritual importance and religious attendance

(Maynard et al., 2001)

DiscussionThoughts/reactions about adaptive and maladaptive coping?

How might you talk with client about adaptive and maladaptive coping?

How could you assess if someone were in spiritual bypass?

How might you incorporate spiritual bypass into conceptualization and treatment recommendations?

Closing Activity!

Spiritual Timeline

Activities with Clients

If life were a movie…

Spiritual timeline

Spiritual Genogram

Music chronology

Others?

Questions/Comments/Reflections For more information contact: jravent@uncg.edu

Resources

Association for Spiritual, Ethical, and Religious Values in Counseling http://www.aservic.org/

Cashwell, C., & Young, J. (Eds.) (2005). Integrating spirituality and religion into counseling. Alexandria, VA: American Counseling Association