Academic journal article Social Work

Spiritually Modified Cognitive Therapy: A Review of the Literature

Academic journal article Social Work

Spiritually Modified Cognitive Therapy: A Review of the Literature

Article excerpt

Spiritual interventions can be understood as therapeutic strategies that incorporate a spiritual or religious dimension as a central component of the intervention. Studies indicate that many social workers use spiritual interventions in practice settings (Canda & Furman, 1999; Derezotes, 1995; Furman, Benson, Grimwood, & Canda, 2004; Mattison, Jayaratne, & Croxton, 2000; Murdock, 2004; Sheridan, 2004). One nationally representative study of NASW-affiliated direct practitioners (N = 2,069) found that the majority of respondents had used a number of spiritual interventions in their work with clients (Canda & Furman). Nearly 70 percent, for example, reported incorporating religious language or concepts into their clinical work.

Although the extent to which social workers use spiritual interventions is beginning to be understood, few guidelines have emerged regarding their use. Studies repeatedly have found that most social workers have received little or no training in the use of spirituality in practice settings (Canda & Furman, 1999; Furman et al., 2004; Murdock, 2004; Sheridan & Amato-von Hemert, 1999). As observers have noted, questions concerning the empirical validity of spiritual interventions and their use in clinical settings have yet to be addressed in the academic literature (Mattison et al., 2000; Sahlein, 2002). This represents a significant gap in the literature. The importance of basing practice decisions on the empirical literature is widely recognized (Crisp, 2004; Gambrill, 2003; Gibbs, 2003; Proctor, 2003). Clients have a right to expect social workers to select interventions that have been associated with positive outcomes (Rosen, Proctor, & Staudt, 1999). Indeed, the use of empirically based approaches is arguably an ethical requirement. Even in newly emerging areas, such as spirituality, the NASW Code of Ethics (2000, sect. 1.04) stipulates that practitioners should use interventions only after engaging in appropriate exploration and study of the approach under consideration.

Given the importance of basing intervention decisions on empirical research, this study reviewed the relevant literature on spiritually modified cognitive therapy. Traditional cognitive therapy, and its closely related variant, cognitive-behavioral therapy, is one of the more prominent therapeutic modalities in social work practice (Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2006). This modality, pioneered by people such as Beck (1976) and Ellis (1996), focuses on identifying unhealthy thought patterns that underlie unproductive behaviors, which are then replaced with more salutary schema that foster enhanced functioning. A substantial body of empirical evidence attests to the effectiveness of traditional cognitive therapy and, consequently, has been used to assist clients wrestling with a wide variety of problems, including anger, anxiety, phobia, stress, and, perhaps particularly, depression (Beck, 1995; Chambless & Ollendick, 2001; Hepworth et al., 2006).

Much like traditional cognitive therapy, spiritually modified cognitive therapy centers on helping clients identify unproductive thoughts that underlie problems and assisting them to substitute more functional self-statements in their place (Nielsen, Johnson, & Ridley, 2000). Spiritually modified therapy is distinguished from traditional cognitive therapy by the precepts used to foster enhanced functioning. Although the traditional approach uses secular protocols, the spiritually modified approach uses spiritual precepts that are derived from the client's spiritual worldview. A number of studies have explored the effectiveness of this form of treatment.


In the social science literature, spirituality and religion are increasingly conceptualized as distinct but interconnected constructs (Canda & Furman, 1999). …

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