Spirituality in

Psychiatric Social Work

Practice
Chairperson: Dr. R. Parthasarathy
Discussant: Mr. Ubahara
Sahayaraj
Presenter: Jobin Tom
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 Order of Presentation
• Spirituality
– Meaning
– Components
– Difference between Religion and Spirituality
– Spirituality in atheist and theist
• Spiritual Intelligence
– Meaning
– Components
– Measurement

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 Order of Presentation
• Social Work evolution out of Spirituality
• Spirituality and Mental Health
• Evolution of PSW using spirituality
• Application of spirituality in PSW
– Prevention
– Promotion
– Treatment
– Rehabilitation

3
 Order of Presentation
• Spirituality and Client
• Spirituality and Therapist
• Spirituality and Treatment methods

• Barriers in therapy related to spirituality

• For Better Psychiatric Social Work Practice

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 Spirituality
Meaning:-
• “animating force”
• “incorporeal consciousness”
• “lacking material form or substance”
• “intangible [out-of-body experience”
• “heavenly mindedness”

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 Spirituality (David Elkins 1990)

1. Belief in a ‘greater self’ or personal self

2. A sense of purpose in life and quest for meaning
3. Acceptance of the sacredness of nature and of all
human experience
4. Knowledge that ultimate fulfillment is found in
spirituality and not in material things
5. Altruism

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 Spirituality (David Elkins 1990)

6. Idealism
7. Awareness of suffering and death
8. Leading life that has a positive effect on
people, nature, and whatever they consider
to be ultimate
9. Transcendent reality

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• Spirituality is a word that has been used to
describe the human need for meaning and
value in life and the desire for relationship
with a transcendent power (Clineball, 1995)

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Spirituality Includes The Following Aspects
• Meaning (having purpose, making sense of life)
• Value (Having cherished beliefs and standards)
• Transcendence (Appreciating a dimension that is
beyond the self)
• Connecting (Relating to others, nature, ultimate
others)
• Becoming (Which involves reflection, allowing life to
unfold, and knowing who one is)

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 Religion
• Religion may be understood sociologically as a
formal set of beliefs, doctrines, laws, practices,
rituals, and assignments of authority, which are
linked to an explanation of the creation and
governance of the universe.
• Religion may be defined as an organized system
of faith, worship, cumulative traditions, and
prescribed rituals (Worthington, 1989)

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• The basic definition of “religion” is to bind, in
the sense that we are bound to the promises
we make. So it is that virtually all religions
seek to bind their members or followers to
vows or covenants of acceptance

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 Spirituality and Atheist
• There are many who would find the phrase
'atheist spirituality' to be a contradiction in
terms. In fact, it is not. Belief in God, Gods, or
other supernatural phenomena is not required
for one to have spiritual experiences. In fact
some organized religions including Buddhism,
do not even subscribe to the idea of God or
gods!

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• While many express their spirituality through
their religious practices religion doesn't have
a monopoly on spirituality itself. Spiritual
experiences are almost universal to the
human experience. Without the trappings of
religion, it may be difficult to recognize and
identify spiritual elements in the atheist's life
but nevertheless, they can usually be found.

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 Spirituality Vs Religiosity
Spirituality Religiosity
• Not organized • Organized system
• Value oriented • Holy Days
• Sacred Writings
• Sacred Symbols
• Prayer and Meditation
• Beliefs Affecting Diet/ Nutrition
• Beliefs Related To Healing
• Beliefs Related To Dress
• Beliefs Related Birth
• Beliefs Related Death

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 Spiritual Intelligence
• Spiritual Intelligence is the ultimate
intelligence which we address and solve
problems of meaning and value, the
intelligence with which we can place our
actions and our lives in a wider, richer,
meaning-giving context, the intelligence with
which we can assess that one course of action
or one life path is more meaningful than
another (Zohar & Marshall).
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Components Of Spiritual Intelligence
1. Getting the Big Picture
2. Exploring our Values
3. Our Life Vision and Purpose
4. Understanding yourself and others :
Compassion
5. Give and receive :Charity and Gratitude
6. Power of Laughter
7. Child like qualities
8. Power of rituals
9. Peace
10. Love 16
• Spiritual intelligence is self actualization
(Maslow)
• Creativity
• Playful
• Joyful
• Tolerance
• Sense of purpose
• Mission to help others
• Happiness and bliss
Equanimity
Equanimity

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 Indicators Of Spiritual Health

– Faith
– Hope
– Meaning and purpose in life
– Achievement of spiritual world
– Feelings of peacefulness
– Ability to love
– Ability to forgive
– Ability to pray
– Ability to worship

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 Indicators of spiritual health

• Spiritual experiences
• Participation in spiritual rites and passage
• Participation in meditation
• Participation in spiritual reading
• Interaction with spiritual leaders
• Expression through song/music
• Expression through writing
• Expression through art
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 Indicators of spiritual health

• Connectedness with inner self

• Connectedness with others
• Interaction with others to share thoughts,
feelings and beliefs

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 Social Work Evolution Out Of
Spirituality
• The field of social work has historically been
concerned about imposing religion or
spirituality onto clients. Hodge (2005)
expressed concern that the field may be
‘faithblind’ which may be harmful to religious
groups who have a history of oppression.

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• Krieglstein (2006) explains the change in the
relationship between spirituality, religion, and
social work in this way, “what happened, as
often does when change occurs, the baby was
thrown out with the bath water.” Anything
related to religion was seen as bad and thus
taken out of social work.

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 Rationale For Including A Focus On
Religion And Spirituality In Social Work.
• “Religious and spiritual beliefs and practices
are part of multicultural diversity.”
• “Presence of another dimension of human
existence beyond the biopsychosocial
framework used to currently understand
human behavior.”

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• “Spirituality is inherent in the human
condition so in whatever setting a social
worker is working, these issues will be
relevant” and “It’s a part of the human
condition. I cannot think of a single bio-
psycho-social problem that does not have a
spiritual component” (Miller, 2001).

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 Religion and Mental Health
• The meta analysis provided by Larson et al
(1992) is the most comprehensive review of
the field examining 200 psychiatric and
psychological studies which repeatedly
asserted the connection between religious
involvement and desirable mental health
outcomes.

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• Ellison & Levin (1998) state there is a
connection between religious involvement
which promotes health related conduct, in
some instances there is an inverse
relationship between religious involvement
and substance use and abuse, lower levels of
crime and delinquency, and stress.

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• Additionally, Ellison & Levin (1998) have found
religious involvement correlated to
– Greater marital quality,
– Increased support,
– Enhanced feelings of self-esteem,
– self-worth,
– Self-efficacy.

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• Religious coping skills and greater forgiveness
were associated with increased life
satisfaction, self efficacy, and decreased
depression for elder Korean and Chinese
Americans (Lee, 2007) and for Orthodox Jews
(Flannelly, K. et.al)

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 Evolution Of Psychotherapy
Using Spirituality
• The word Psychotherapist is derived from the
Greek word Psyche meaning soul or breath of
life and therapeia denoting attendant of the
soul. Psychotherapist therefore literally means
servant or attendant of the soul. (Tick, 1992)

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• Counseling and psychotherapy have spiritual
origins to be found in practices of witches,
priests etc. (Benner, 1988)
• In 19th century care of the mentally ill was
taken away from church and others, and given
to medical professional.
• In 20th century people are taken care by
professionals than others.

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• Carl Jung said that spirituality and spiritual
experiences are potential healthy aspect of
our being.

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 Application of spirituality in PSW

To Prevent Mental Illness & To Promote Mental

Health
– Adopting healthy values
– Self Understanding – Limits and Levels of
functioning
– Religion of Love – Helpfulness in thoughts, words,
and deeds.
– Enjoying ordinary occurrences

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Treatment of Mental Illness
– Strengthening of optimism
– Acceptance of Difficulties
– Improved self efficacy
– Avoid self Glorification of the therapist
– Clients needs and problems are given prime
importance

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Rehabilitation of Mentally ill
– Exploration of all possible potentials of
Rehabilitation in the individual, family and
community
– Being compassionate and instilling compassion in
others.
– Seeking social support for recovery and aftercare

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Spirituality and Client
– Motivated to take positive actions
– Failure in the process is not discouraging
– Trust in the therapist strengthened
– Facilitated to practice yoga/meditation, to
maintain serenity
– Acceptance of the illness and its consequence
– Readiness to take appropriate action.

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 Spirituality and Therapist
1. Therapists should examine their own
prejudices and biases around spirituality
and religion, both positive and negative

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2. Therapists should familiarize themselves with
some of the literature around spiritual
experience and pastoral therapy and spiritual
direction

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Spirituality for practicing psychotherapists
and counselors

3. Therapists should explore a religion from

different culture than their own including
attending a religious service

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Spirituality for practicing psychotherapists
and counselors

4. Therapists should address the assessment

issues involved

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Spirituality for practicing psychotherapists
and counselors

5. Therapists should develop a sense of some of

the main maps and theories of spiritual
development

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Spirituality for practicing psychotherapists
and counselors

6. Therapists should study implicit and explicit

spiritual forms of counselling

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Spirituality for practicing psychotherapists
and counselors

7. Therapists should clarify the differences and

overlaps between spiritual direction, pastoral
care and counselling or psychotherapy.

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Spirituality for practicing psychotherapists
and counselors

8. Therapists should be engaged in their own

form of spiritual development.

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 Spirituality and Treatment Methods
• Explore client’s spiritual background
• Explore client’s religious background
• Help clients to clarify spiritual values
• Recommend participation in spiritual
programmes (Mediation groups, 12 step
programmes, men’s and women’s groups)
• Use spiritual language or metaphors
• Pray privately for client
• Explore spiritual elements in dreams
• Use or recommend spiritual books
Bullis (1996)
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Spiritual Practices Affecting Patient Care

• Assess client’s spiritual needs, resources and

preferences
• Follow the client’s expressed wishes regarding
spiritual care
• Do not prescribe or urge clients to adopt certain
spiritual beliefs or practices and do not pressurize
them to relinquish such beliefs and practices
• Strive to understand personal spirituality and how it
influences care giving
• Provide spiritual care in a way that is consonant with
personal beliefs.
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“ Of course, spiritual interventions are less likely
to be used effectively and ethically by
therapists who lack multi cultural and religious
sensitivity and awareness, have limited
denominational expertise and are spiritually
immature”.

Richards & Bergin, 1997

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Barriers in applying spirituality in PSW

• PSWs are not trained to help patients to

resolve complex spiritual problems related to
physical or emotional illness.
• Lack of supervision
• Chance to misunderstanding by other
professionals
• Blurring of professionalism
• Professional or pastoral work- doubts
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 For Better
Psychiatric Social Work Practice
• Self understanding on the part of the therapist is a
must – Less egoism leads to more happiness.
• Believe in the forces beyond us
• Respect others’ religious/spiritual outlook
• Have healthy values in life
• Be solution focussed in our approach
• Have good sense of Humour
• Be ready to learn from others
• Practice religion of love
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Thamasoma jyothirgamaya

Thank You 50