Religion & Spirituality in Counseling

1. Religion & Spirituality in Counseling Janeé R. Avent, MS, LPCA, NCC The University of North Carolina at Greensboro

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

3. Presentation Overview • Counselor self-awareness • Spirituality & religion • Effects on physical & mental health • Assessment • Religious Coping

4. 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)

5. Thinking about your spiritual journey…

7. Spirituality vs. Religion

8. Spirituality vs. Religion Spirituality 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) • “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

9. 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?

10. 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)

11. 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!

12. 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

13. 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)

14. 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)

15. Discussion Questions • What might be difficult about spiritual assessments? • How do you see yourself incorporating these assessments into your particular settings? • Others?

16. Activity! Divide into groups of 3-4 Review Case Studies Brainstorm questions to assess for spirituality How might you integrate into traditional intake sessions? What questions do you still have?

17. Ethical Considerations Mindful of professional competence Malfeasance – Beneficence

18. 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)

19. 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)

20. 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)

21. 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)

22. Maladaptive Religious Coping • Spiritual discontent, punishing God’s reappraisals, interpersonal religious discontent, demonic appraisal, and reappraisal of God’s power (Pargamentet al., 1998) • Effects can include: depression, decreased emotional sensitivity to others, lower levels of quality of life (Bjorck & Thurman, 2007; Pargament et al., 1998)

23. 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

24. 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)

25. Discussion • Thoughts/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?

26. Closing Activity! Spiritual Timeline

27. Activities with Clients • If life were a movie… • Spiritual timeline • Spiritual Genogram • Music chronology • Others?

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

29. 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