Spiritually Integrated Psychotherapy:

1. Spiritually Integrated Psychotherapy: A Partial Map of a Small Piece of the Territory for Pastoral Counselors and Their Colleagues

2. Agenda • Introduction, results, questions (45) • Group conversation (5-7 people, 20 min) • Responses from groups (20)

3. Methodology Explained Rob Gonsalves “Unfinished Puzzle”

4. Grounded Theory • Qualitative research • Extension of ethnography (Strauss, Corbin, Charmaz) • Constant-comparative method • Construction of intermediate theory grounded in data (vs. testing a theory with data)

5. Procedures I • Proposal & MAP Grant in Collaboration with TSCTF • Identifying general boundaries • Search of academic institutions with SI in description • Search of counseling agencies with SI in description • Search of counselors’ websites with SI in description • Defining “Pastoral Counselors and those who work with them” • Sample • Maximum diversity frame (note limitations) • Email blast to all AAPC members asking to ID self and someone in community not AAPC who practices SIP • Ed. Institutions selected from websites that met criteria • Counseling centers selected that met criteria • Individual practitioners from email blast & referred from email blast, center or ed. Institution (you really should talk to…)

6. Sample Characteristics

12. Procedures II • Interviews • Open questions; Recorded • Continuous coding using NVIVO; constant comparison in scheduling interviews • Note limitations…diversity, Canada • Interpretation of results (constant-comparison method) • Axial coding, building categories, using NVIVO • Model building using NVIVO • Now testing validity/truthfulness

13. Some Results General Theoretical Framework M C Escher “Drawing Hands”

14. General Theoretical Frameworks for SIP Alternative Medicine PC Traditional Prof. Multicultural framework for SIP Phenomenological-Existential Humanistic Sacramental Assumptions Black Church Community SIP & Spiritual Direction Faith Based Practice A Multiversal Construction Implicit/organic understanding of spirituality

15. PC Traditional • Part of Christian ordained ministry & training • Rooted in religious community & hospitality • Strong theological training • CPE & Psychodynamic/conflict theories • Strong sense of counseling as sacred • Christian heritage (but not Christian Counseling) • Connects people to God • Not spiritual director, but open to big questions • SIP a new way to market PC

16. Faith-Based Framework • Religious people want religious counseling • God incarnated in therapist for salvation of others • Strong theological training • Salvation is health • Kerygma perspective • Spirit of God talks • What does God want for this person • Seeking God in each session • Christ is active presence in therapy • Therapy grounded in human fallenness

17. Humanistic Framework • Spirituality & therapy = self-discovery • Absolute client centered approach • Therapy helps client generate own theology • Therapy expresses grace in human relationships • Human connection between therapist & client is central

18. Phenomenological Framework • Focus on mystical presence • Therapy empowers transcendence • Existential therapy—mindfulness, meditation • Sacred is revealed in therapeutic vulnerability • Self-transcendence is central

19. Multicultural Framework • Spirituality is one of many multicultural factors • Working with spirituality IS multicultural counseling; one competency among others • Deals with differences • Attends to faith or faiths of “others” • Requires competency in multicultural counseling • Utilizes microskills • Respectful of and conversant with various spiritual traditions

20. Spiritual Director & SIP Framework • Therapy begins in spiritual direction • Spiritual direction as certified discipline used throughout process of therapy • Focus on preventive care

21. Black Church Community • SIP in the action of preaching in Black Church • SIP in the action of the community in Black Church • SIP in the action of pastoral counselors serving, often without license in Black Church • Black Church as therapeutic experience

22. “Sacramental”-- Mediating Variable* • God is present in sessions • Christ’s active presence • Connects people to God • God-focused incarnation • God’s desire for people central • TX Sacred safe space • Casts goodness • Rigorous self-exploration • People reveal selves • For the spirit to grow • TX is process of surrender to Holy/God/Deity • Seeking God in each session • Priestly dimension of TX • Ministerial identity • TX mediates forgiveness • Grace made real in TX relationship • Grace linked to positive psychology • Counseling as sacrament • TX empties self for client • TX creates conditions for Holy Spirit activity • Spirit is motivating energy • Follows the spirit’s lead • The “glue” in personality & TX *Mediating in the sense that it creates important connection between categories

23. Practices….. Practices…

24. Client-Centered never therapist Therapist initiates Attend Carefully to Belief System Loving the Client Use-refer religious community Who initiates? General Therapy-orienting Practices Create place of safety Everything in therapy is spiritual Trust Therapist’s instincts & intuition Use of religious symbols Transcends Boundaries of Traditional TX

25. Teach-use Xn Spiritual Practices Formal Methods-Alternative Med Assessment Assessment Black Church Preaching-Communal Experience Uses Spiritual-Religious Symbols Therapist Language Specific Practices in Therapy Models Therapist’s own Spiritual Practices Music as Spiritual Mediator Proactively Raise Spiritual Questions Prayer Teaches Spiritual Practices Scripture

26. Therapist Use of Self Guided by Psychological Theory Therapy anchored in TX own Spiritual and religious life Use of Self Spirituality is the core connection between client & TX Priestly Presence/Action Culturally Aware & Competent--Bilingual

27. Questions for Groups (20 min.) • How does this description/model fit your experience? • Whose voices are we missing? • What would you want the research team to know from your group’s discussion? • What questions did we forget to ask?

28. Group Feedback…

29. Implications for PracticeEspecially with Strategic Plan’s Mandate in Mind • Multiversal/polydoxy—not one model/not one truth • Plurality of models requires contextual definition by clinicians • Claiming-defining location and meanings • Similar to identifying models of therapy used • Transparency for self, clients, supervisees and other clinicians • Plurality of models requires consideration and research • Clarity—better description and definition of approaches/models • Contextualization—what model is appropriate for whom and in what context? • Contextualization—multicultural factors and religious plurality • Contextualization—models, intended outcomes and populations • How to communicate model/location • Generous listening • Plurality of models points to care in PC training and collaboration • Plurality and defining terms • Clarifying procedures, practices and outcomes • Clarifying and contexualizing therapist use of self and resources • Generosity • Communicating model/location

30. Survey….

31. Assessment • No specific assessment or reference to assessment (30%) • Religious-Spiritual questions on intake form (25%) • Therapist intuition (17%) • Overtly asks clients in first session (13%) • Attend carefully in session (11%) • Fitchett’ assessment model (2%) • Pargament’s assessment sometimes (2%) • Center has them, don’t use them…

32. Teach-Use Christian Spirituality • Christian prayer (29%) • Scripture reading (10%) • Use for in-session reflection • Reciting scripture as homework • Useful examples from Christian tradition • Meditation • Devotional practices (2%) • Fasting (2%) • Laying on hands (2%) • Meditation on Christian principles (2%) • Practices of Ignatius (2%)

33. Formal Practices-Alternative Medicine:Teaching and Using: • Acupuncture • Biofeedback • Body work-Yoga &Tai Chi • Brainspotting • Breathing techniques • Cranial-sacral Therapy • Emotional Freedom Therapy • Energy medicine • Guided Imagery • Healing touch • Heart Math • Ignatius practices • Meditation • Mindfulness • Reiki • Rejects medical model • Relaxation • Spiritual Direction • Wellness & exercise

34. Prayer57 references to prayer by 23 respondents* • Christian prayer as practice (6) • Always prays for clients & therapy (8) • Tells every client that she/he prays for them (3) • Never prays in or for therapy (5) • Encourages Centering Prayer (2) • Asks clients if they want to pray (2) • Prays with clients in session (4) • Prayer used as alternative medicine (2) • Ethical concerns about covert prayer (1) *Numbers in parenthesis are higher than 23 due to Some respondents falling in more than 1 category

35. Priestly Presence/Action • Use of self as ordained minister • Interpreting scripture, tradition, etc. • Sacraments, etc. • Called to do what God did—incarnate presence with others • Mediator of God’s grace through therapy • Counselor is a symbol of God’s grace • Counseling itself is sacramental presence/action

36. Therapy an Expression of Therapist’s Own Religious/Spiritual Life • Genuineness about spiritual life • Personal theology and beliefs guide therapy • Therapist brackets personal beliefs and theology • Therapists trusts own instincts and intuitions • Therapists own spirituality is at the center of therapy encounters • Uses own spiritual practices—teaches, models

37. Sample Characteristics

38. Procedures • Proposal & MAP Grant in Collaboration with TSCTF • Identifying general boundaries • Search of academic institutions with SI in description • Search of counseling agencies with SI in description • Search of counselors’ websites with SI in description • Defining “Pastoral Counselors and those who work with them” • Sample • Maximum diversity frame (note limitations) • Email blast to all AAPC members asking to ID self and someone in community not AAPC who practices SIP • Ed. Institutions selected from websites that met criteria • Counseling centers selected that met criteria • Individual practitioners from email blast & referred from email blast, center or ed. Institution (you really should talk to…) • Interviews • Open questions; Recorded • Continuous coding using NVIVO; constant comparison in scheduling interviews • Note limitations…diversity, Canada • Interpretation of results (constant-comparison method) • Axial coding, building categories, using NVIVO • Model building using NVIVO • Now testing validity/truthfulness