Academic journal article Social Work

Using Spiritual Interventions in Practice: Developing Some Guidelines from Evidence-Based Practice

Academic journal article Social Work

Using Spiritual Interventions in Practice: Developing Some Guidelines from Evidence-Based Practice

Article excerpt

Spiritual interventions can be defined as "therapeutic strategies that incorporate a spiritual or religious dimension as a central component of the intervention" (Hodge, 2006a, p. 157). Many social work practitioners are interested in using spiritual interventions in practice (Sheridan, 2009). Yet, in spite of widespread interest, Sheridan's review of 15 studies found that respondent social workers frequently reported receiving minimal training on this general topic during their graduate education.

Lack of training on the proper use of spiritual interventions is a significant problem. Without appropriate guidelines to inform interactions with clients, unethical practices may result (Canda, Nakashima, & Furman, 2004). In some instances, harm may even be done to vulnerable clients as ethical and professional boundaries are breached (Hodge, 2004b).

The purpose of this article is to develop some guidelines for using spiritual interventions in practice settings.The aim is not to regulate the use of such interventions, but to enhance wellness. The NASW (1996) Code of Ethics affirms the importance of using interventions in an ethical, professional manner that fosters client well-being. Given the growing importance attributed to evidence-based practice (EBP) as a vehicle to help ensure this goal, these guidelines are drawn from this movement. Accordingly, the article begins by defining the concept of EBP.

DEFINING EVIDENCE-BASED PRACTICE

Originating in the field of medicine, evidence-based practice remains controversial in some social work circles (Adams, Matto, & LeCroy, 2009; Campbell, 2003; Morago, 2006). Despite this controversy, a growing number of scholars support the concept (Cnaan & Dichter, 2008; Drake, Jonson-Reid & Mayas, 2007; Gambrill, 2003; Kessler, Gira, & Poertner, 2005; Rubin, 2007). Further, the evidence-based movement is international in scope. Over the course of the past decade, the concept has gained popularity in Australia (Plath, 2006), the United States (Zlotnik, 2007), and the United Kingdom (Saks & Allsop, 2007), with various levels of government moving to incorporate evidence-based language into human service protocols.

Although a consensus may be emerging in support of EBP, there is no universal understanding of what the concept signifies (Chambless & Ollendick, 2001; Gambrill, 2006; Rubin & Parrish, 2007). Perhaps the most widely used definition in social work is based on Sackett, Straus, Richardson, Rosenberg, and Haynes's (2000) influential work in the field of medicine (Gilgun, 2006; McNeece & Thyer, 2004; Yunong & Fengzhi, 2009). Drawing on this work, McNeece and Thyer (2004) defined evidence-based practice as "the integration of the best research evidence with clinical expertise and client values" (p. 9). Similarly, the American Psychological Association (APA) Presidential Task Force on Evidence-based Practice (2006) defined it as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences" (p. 273).

A number of guidelines flow from these definitions that inform the use of spiritual interventions in practice settings. Although these guidelines are presented sequentially here, it may be helpful to bear in mind that they are more typically considered simultaneously in clinical settings. These guidelines can be summarized under the following four rubrics: (1) client preference, (2) evaluation of relevant research, (3) clinical expertise, and (4) cultural competency (Gilgun, 2006).

CLIENT PREFERENCE

Perhaps the most important guideline to consider regarding the use of spiritual interventions is client preference. The ethical principle of self-determination is featured prominently in the NASW (1996) Code of Ethics. Client autonomy is a central social work value that informs essentially all social work practice. …

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