Counseling has traditionally focused on four forces: psychodynamics, behaviorism, humanism, and multiculturalism, but spirituality is becoming the fifth force (Sandhu, as cited in Stanard, Sandhu, & Painter, 2000). To speak about spirituality is to speak about an individual's value system and it is evident that a client's values enter into counseling. Concerns about client values, beliefs and attitudes have long been considered a central part of the rehabilitation process (Patterson, 1959; Jenkins, Patterson & Szymanski, 1992; Wright, 1983) and western Christian religious practices are arguably at the core of early rehabilitation philosophy (Kilpatrick & McCullough, 1999; Patterson, 1960; Rubin & Roessler, 1995). Traditionally rehabilitation practice articulates the importance of addressing a client's values, beliefs and attitudes, therefore examining how rehabilitation counseling integrates spirituality as a central theme is important. However, incorporating spirituality into rehabilitation counselor training programs may create conflict for counselor educators and counselors because of differing views of the importance of spirituality and even differing perceptions on the nature of spirituality.
Spirituality and Religion: The Eternal Conundrum
Any professional literature search on the topic of spirituality will bring up hundreds of articles and nearly as many definitions of spirituality. In addition to helping professions such as medicine, occupational therapy, counseling and social work, professional journals from engineering, business, and athletic training fields address the issue of incorporating spirituality into their respective disciplines as well. A common theme found in many articles is the problem of distinguishing spirituality from religion (Stanard et al., 2000). Most authors assert spirituality is usually confused with religion, but Benjamin and Looby (1998) differentiate the two in terms of universality; religion may of may not be universal, but spirituality is universal. They acknowledge spirituality as "alive" both in and out of a religious context.
In order to recognize the value differences between clients and counselors, four types of helping orientations to spiritual and religious natures have been identified: rejectionism, exclusivism, constructivism, and pluralism (Zinnbauer & Pargament, 2000). Rejectionism denies the existence of God or heaven and spiritual supporters. Exclusivism is a belief in the ontological proof of religious or spiritual aspects of existence. Constructivism denies absolute religious or spiritual reality, but believes individuals construct their own reality. Finally, pluralism affirms absolute religious or spiritual reality and allows for a variety of interpretations toward that reality (Zinnbauer & Pargament, 2000). While each of these methods differ slightly in their approach, they all combine spirituality with religion.
Spirituality can be expressed as an internal component of an individual's perception of reality, whereas religion is its external manifestation with practices and rituals shared with like-minded people (Hodge, 2000). Spirituality can be defined as:
A relationship with a Transcendent Being that fosters a sense of meaning,
purpose, and mission in life. In turn, this relationship produces salutary
change, such as an increased sense of altruistic love, which has a
discernible effect upon one's relationship to creation, self, others, and
the Most High (p.219).
Religion and spirituality may sometimes be used interchangeably. Occasionally the unique characteristics of each may mesh together creating similarities, however, they are two distinct concepts (Hodge, 2000).
Adams et al., (2000) suggest that common threads exist to weave together the fabric of spirituality. "They include a sense of meaning and purpose in life, connectedness to self, the environment, or a higher power, and a belief in a life force (p. …