As we near the beginning of a new millennium, there are many signs of hope and healing amid the reports of violence and destruction in U.S. society. The evidence is everywhere. Corporate America has re-examined both leadership and corporate roles and realized that the individuals who form the corpus of their organizations are made up of body, mind, and spirit and that to have a more effectively operated organization, nurturing the whole person is important to the corporation (Gouillart & Kelly, 1995; Hammer & Champy, 1993; Pappas, 1996). The president of the United States began his day of inauguration with prayer. At least four programs on television directly address the need to nurture people's spirits: Early Edition, Seventh Heaven, Promised Land, and Touched by an Angel. What the creators of these programs have recognized is that audiences are searching for the sacred, for spiritual meaning in their lives, and that many people are on vision quests to reclaim and care for their souls. Articles in Newsweek, Time, and Life magazines have discussed the beliefs and spiritual practices of people in the United States (Begley, 1994; Kantrowitz, 1994; Woodward, 1994). And recently self-help authors have begun to use religious language in their books. Estes (1995), in Women Who Run with the Wolves, reintroduces women to their spiritual side, their feminine soul. Canfield and Hansen's Chicken Soup for the Soul (1993) series have become best-sellers. Even rappers are rapping the word of God.
In the past scientists and astrologers desacralized scientific discoveries and relegated religious practices to institutional churches. While medical science was making great strides in technology that enhanced physical healing and made survival possible for people of all ages, the relationship between physical healing and spiritual nurturing was largely ignored until recently. Now even nonreligious scientists see the work of a higher power in scientific discoveries (Begley, 1994).
SPIRITUALITY AND ASSESSMENT
What about social workers involved in the process of healing? Like psychotherapists, for the past 40 years social workers have secularized the search for the sacred by recodifying the concept as personal transformation, self-fulfillment, or self-esteem. Social workers accepted these concepts as social work values. As medical social workers prepare to embark on reform and managed care, what tools and skills will we need to create a healing ambiance for clients who are chronically or terminally ill? Will the NASW Code of Ethics (NASW, 1996) be enough? What are the signs of the times telling us? Will the profession, like corporate America, re-engineer social work so that our practice takes a holistic approach? Yes, we do teach students about working with the whole person, and we introduce the ecological approach. Yet what is "holistic" about our practice? How is our practice contributing to healing and wholeness? How do we as social workers integrate the spiritual aspects of our clients? How do we nurture our clients' spirits? How can we say we value the person without nurturing the part that is spiritual?
Social workers have used transpersonal theory as an approach to practice that takes the spiritual into account (Cowley, 1993; Smith, 1995). Smith used transpersonal theory in addressing the psychospiritual distress of death. However, most risk factors clients face in health care settings, although potentially life threatening, do not result in death. Ill or injured clients experience a loss of bodily integrity that may include mental, physical, or sensory impairment, disfigurement, disability, or deterioration and that may limit daily activities or require a total lifestyle change.
With the recent move to a short-term team approach to practice in health care settings, it is critical to identify risk factors as quickly as possible. To serve the whole person, social workers making assessments as part of service teams need to include questions in their risk index that identify both individual strengths and indications of spiritual health. …