Spiritual Assessment in Counseling: Methods and Practice
Oakes, K. Elizabeth, Raphel, Mary M., Counseling and Values
Given the widely expanding professional and empirical support for integrating spirituality into counseling, the authors present a practical discussion for raising counselors' general awareness and skill in the critical area of spiritual assessment. A discussion of rationale, measurement, and clinical practice is provided along with case examples. D. R. Hodge's (2001) spiritual life map is highlighted as an assessment tool. The authors also discuss the influence of counselor-client values and beliefs in therapy and the need to incorporate developmental and cultural influences in spiritual assessment.
The conceptualization of spirituality as an intervention domain in counseling has evolved as its relative importance has grown. Historically, research in psychology and counseling began to focus first on spirituality as a phenomenon in clinical treatment and then as an indispensable domain of investigation for understanding human nature and psychology. Today, spirituality is a widely investigated research variable in counseling and psychological treatment with several established theoretical and clinical frameworks available for integrating it into treatment (see Cashwell & Young, 2005; Faiver, Ingersoll, O'Brien, & McNally, 2001; Miller, 1999; Pargament, 1997; Richards & Bergin, 1997; Shafranske, 1996).
In actual practice, the ability to integrate spirituality into treatment requires the counseling professional to be skilled in spiritual assessment. Consequently, there is increasing clinical and empirical recognition of the importance of assessment in understanding spirituality (Curtis & Davis, 1999; Faiver & O'Brien, 1993; Hodge, 2003; Lovinger, 1996; Oakes, 2002; Raphel, 2001; Richards & Bergin, 1997) and growing emphasis on developing clinical assessment protocols for integrating spirituality into treatment (Richards & Bergin, 2000; Young, Cashwell, Wiggins-Frame, & Belaire, 2002). The purpose of this article is to (a) present an overview of the conceptualization and rationale of spiritual assessment, (b) discuss specific spiritual assessment methods and related practices, and (c) illumine these methods and practices with actual clinical case examples.
Spiritual Assessment: What is it?
Sperry (2001) defined spiritual assessment as the process of "eliciting a client's spiritual and religious history" (p. 103) within the development of an overall clinical appraisal. Consistent with this perspective, research and clinical experience have demonstrated that spirituality can be a significant strength that may be used to overcome psychological problems (Frame, 2003; Miller & Thoresen, 1999; Richards & Bergin, 1997). Therefore, conducting a spiritual assessment provides an important framework for eliciting the spiritual assets of the client that are then integrated into treatment (Hodge, 2001; Wiggins, 2000).
When considering spirituality as a treatment domain, it is important both to define the domain and to describe it within specific measurement and evaluation contexts. Empirical and clinical evidence have determined that spiritual assessment is driven by the multifaceted aspect of human nature and that spirituality is a facet of human nature that has a significant positive and negative influence over emotional and cognitive well-being (Ciarrocchi, Piedmont, & Williams, 2003; Diener, 1984; Diener, Suh, Lucas, & Smith, 1999).
As with other clinical evaluation process, spiritual assessment requires specific knowledge and skills (i.e., competencies), which are currently being developed within the counseling profession (see Young et al., 2002). In addition, there is clinical evidence that spiritual assessment models should be holistic and interdisciplinary, drawing from medicine, social work, counseling, and psychology (Raphel, 2001). Furthermore, counselors should know that any assessment of spirituality must be conducted within the interrelated contexts of religion, culture, and psychopathology (Cashwell & Young, 2005; Frame, 2003; Lovinger, 1996; Oakes, 2000; Richards & Bergin, 2000; Sperry, 2001). …