Spiritual Diversity in Social Work Practice Professor Edward Canda, MA, MSW, Ph.D. University of Kansas School of Social Welfare Copyright 2014 Note: Much of this material is presented in the book, Spiritual Diversity in Social Work Practice, by Edward R. Canda and Leola D. Furman (Oxford University Press, 2010) white red circle star Welcome nIntroduction of instructor nProfessional and personal background nStudent self introductions: field of practice interest; what you hope to learn n white red circle star Discussion nWhat do spirituality and religion mean to you? nHow would you translate these terms? n white red circle star Small Group Discussion nWhat ways can spirituality be a source of strength and resources for clients? nWhat ways can religion be a source of strength and resources for clients? n n nWhat ways can spirituality create hindrance, discrimination, or oppression for clients? nWhat ways can religion create hindrance, discrimination, or oppression for clients? n MCj04344110000[1] MCj04344110000[1] MCj04344030000[1] Cautions about making assumptions across cultural and spiritual perspectives nWhat happens when we assume… n nExample of ‘bowing’ in Korea n n n n MCj03329200000[1] Example: Mystery of the Billiken 4fb06f32-a2df-4482-bdc3-342aaae4a423 Mascot of St. Louis University (left) Japanese Billiken (right) www Alternatives for Intercultural and Interreligious Relations nHazards of nEthnocentrism nRacism nDiscrimination nOppression nColonialism nGenocide MCj03972960000[1] nMonoculturality: restricted to 1 culture/spiritual perspective (SP) nMarginality: disconnected in-between cultures/SPs nBiculturality: respectful, competent and comfortable connectedness between 2 cultures/SPs n n Multiculturality: n n respectful, competent, comfortable n connectedness between n multiple cultures/SPs Transculturality and Spiritual Diversity Center Point of Unity Connections of Respect, Competence, and Comfort Between Differences Consciousness, behavior, and teamwork include and transcend multiple perspectives (C&F, pp. 297-299) Pros and Cons re Addressing Spirituality in Social Work nConsider your own position nPrepare to explain in professional terms why and how this is relevant and appropriate nPrepare to respond to detractors nStory of resistant professor nViews of social work practitioners (next slide) MCj02991170000[1] MCj03043410000[1] Table 1.2 Appropriate to Raise Topic of Religion/Spirituality by Client Issue >50% Religion Spirituality Raise topic of religion/spirituality with . . . % Agree mean S % Agree mean s Terminal illness 74.9 3.81 1.06 86.1 4.15 0.92 Substance abuse 53.1 3.37 1.10 72.8 3.84 0.99 Foster parent 56.8 3.43 1.09 63.6 3.66 1.03 Adoptive parent 58.2 3.45 1.10 64.7 3.67 1.03 Difficult child or adolescent development 37.5 3.09 1.06 55.2 3.51 1.02 Sexual abuse 46.6 3.24 1.11 64.6 3.67 1.05 Partner violence 44.4 3.20 1.09 61.9 3.62 1.04 Suffering effects of natural disaster 56.3 3.43 1.08 71.2 3.78 1.02 Bereaved 72.1 3.75 1.03 81.9 4.05 0.91 Chronic mental disorder 36.5 3.06 1.08 52.2 3.45 1.06 Loss of job 37.1 3.08 1.06 54.0 3.48 1.05 Difficulty in family relations 43.7 3.19 1.05 59.6 3.56 1.01 Criminal justice 37.5 3.09 1.07 52.8 3.46 1.03 And for vulnerable populations: religious beliefs (religion) and race, gender, sexual orientation, older adults, political beliefs, religious beliefs, disability, and poverty (spirituality). [Table 1.3] Table 1.4 Guiding Principles n1. Demonstrating Value Clarity nSelf-reflection nAppropriate self-disclosure nDialogue n n2. Respecting Diversity nAppreciation of all types of human diversity nNondiscrimination nInterreligious, interdisciplinary, and international collaboration nAffirmation of human rights and responsibilities nProvisional approach to spiritually sensitive practice nEngagement with locality- specific and culturally-specific approaches n Cont. n3. Being Reflective nIntrospection and reflection between self and world nSilent mindfulness nTransformational learning n n4. Supporting Strengths and Empowerment nRelating to people as whole beings nEmphasizing strengths, resources, capacities, aspirations nOvercoming personal, interpersonal, and structural obstacles nAction for well-being and justice nConsidering helpful and harmful impacts of religion and spirituality n Cont. n5. Taking a Holistic Perspective nUnderstanding person/environment wholeness nEngaging thinking, feelings, sensing, intuiting, and relating nFocusing on direct practice within wider systems and transpersonal view nConnecting local and global n n6. Applying Best Practices nCompetence nEvidence from an expanded view of inquiry nMultiple ways of knowing nTheoretical sophistication nGrounding in professional mission and values nClient-centered determination of ‘best’ n Figure 1.1 Transperspectival View: Transcending Absolutism and Relativism ……............................................. Relativism: Every point is true in its own context Absolutism: Only this point is true for every context Lines of Dialogue: Leading to an inclusive & transcendent perspective Reflections on compassion nThe heart/mind (shim) in East Asian thought Illustration 2 DSC03691 Gwanseum Bosal (Kuan Yin) At Jingwang Temple, S Korea (09) Compassion nEngaging life, self, and relationships ‘with passion’ nEmpathy, but not enmeshment nSaying of a Korean Zen master nNonjudgmental, clear awareness nSkillful reaching out nCaring nonattachment to fruits of actions n Illustration 2 Illustration 2 Sacred Heart of Jesus Street Mural, Chicago (~07) Untitled Drawing, by Orville Milk, gift from artist Is there a ‘common humane heartedness’? Self-Reflection Exercise nThink back to why you decided to become a social worker. nWhere did this motivation come from? nDid any mentors, relatives, friends, or exemplars inspire you? nWas there any key event that triggered your sense of compassion and dedication to serve? nJot down a few thoughts. nDiscuss. Common Hazards for Burnout nInternal confusion nOverwork nIndirect trauma nInhumane or dangerous work conditions nInhumane ways of relating with clients nExistential angst nImbalanced empathy MPj04018760000[1] Self-Assessment Question nRate your present general state of well-being or satisfaction in relation to your path of service: nMiserable? Adequate? Flourishing? MCj04244800000[1] MCj04375570000[1] Cause for Hope: Stress can Become Eustress (good stress) nConvert constrained or misdirected energy into freely flowing enthusiasm nStretch and breathe nWhat kind of practices do you regularly use for preventing distress, promoting eustress, relaxing, centering, and re-energizing? nBrief relaxation exercise Quiet Time Kansas sunflower farm and blue white sky Sunflower farm near Tonganoxie, KS, 09 Challenges of Defining Spirituality nThe Dao that can be named is not the real Dao nParticular vs. Universal: emic/etic/transperspectival nExpressible vs. Inexpressible nIneffable mystical experiences nConcepts as pointers nUse of metaphor, parable, paradox, poetry, symbolism, allegory nToward an Open Conceptualization MMj02971100000[1] Spirituality is: nA process of human life and development nfocusing on the search for a sense of meaning, purpose, morality, and well-being; nin relationship with oneself, other people, other beings, the universe, and ultimate reality however understood; norienting around centrally significant priorities; and nengaging a sense of transcendence (experienced as deeply profound, sacred, or transpersonal). yellow red Features of Spirituality nIndividuals and groups may express spirituality in religious and nonreligious ways. nThey may express it in private ways and in public, shared ways. nSpirituality may or may not permeate an individual’s daily life and a group’s culture. nAs a universal feature of persons and cultures, everyone has spirituality, though they vary in amount of focus on it. nHealthy spirituality encourages a sense of personal integrity, wholeness, and well-being. nIt fosters transpersonal experiences, the emergence of transpersonal levels of consciousness, and an expanded sense of identity and connectedness. Features of Spirituality continued: nHealthy spirituality engenders individual’s virtues, such as compassion and justice, as well as relational webs of caring, respect, and support extending outward to other people and beings. nHowever, spirituality does not always manifest in healthy ways. n‘Spirit’ may or may not be understood literally nE.g. in terms of nonphysical beings or forces vs. sense of vitality n Religion is: nAn institutionalized (i.e. systematic and organized) pattern of values, beliefs, symbols, behaviors, and experiences that involves nspirituality na community of adherents ntransmission of traditions over time, and nCommunity support functions (e.g. organizational structure, material assistance, emotional support, n or political advocacy) that are directly or indirectly related to spirituality. n MMj03366860000[1] MMj03366830000[1] Features of Religion: nReligion always involves public and shared experience. nIt may or may not permeate a person’s daily life and a group’s culture. nNot all individuals or societies are religious. n Healthy religiousness, as an expression of spirituality, encourages a sense of well-being, transpersonal development, virtues, and relational webs of caring, respect, and support. nHowever, religiousness does not always manifest in healthy ways. Faith relates to: nA person’s religious belief system, nespecially commitment to doctrines nand sense of relationship with a sacred or divine higher power (such as God). nThe term is used most commonly in theistic religions. nWe will address so-called faith-based social services later. nNote: why we did not use the term ‘faith’ in the Aotearoa New Zealand survey n Common Descriptors in Surveys of Social Workers: USA, UK, Norway, ANZ: a good fit to our definitions nSpirituality nAll countries (>60%): meaning, personal, values nUSA (1997 & 2008, top 6): meaning, personal, purpose, values, belief, higher power nReligion nAll countries (>60%): belief, ritual, values, prayer, scripture [community at 59%] nUSA (1997 & 2008, top 6): ritual, belief, organization, scripture, prayer, community nFaith nAll countries, except ANZ omitted (> 60%): belief nUSA (1997 & 2008, top 6): belief, higher power, personal, meaning, purpose, prayer n BC9A534F Figure 3.3 An operational model of spirituality B9C2B355 Figure 3.4 A holistic model of spirituality •Centering on breath exercise •Who am I? awareness exercise Given these definitions, spirituality is the source of religion, but it is not limited to religion. Spirituality includes and transcends religion. Spirituality Religion Figure 3.1 Spirituality Including and Transcending Religion Client-Focused Understanding nClients vary in their own definitions of religion and spirituality. nProfessional definitions set themes for possible exploration with clients, but client’s own terms, definitions, and interests relating to these themes should set the tone for communication in the helping relationship. nIt is not necessary to use the terms religion or spirituality in order to get at the themes explained above. nOf course, many clients may view spirituality as a wider concept than religion, as in the professional definition (especially baby boomers and younger). Measures of s/r nUsing qualitative, phenomenological, and transpersonal research methods to address holistic and ineffable qualities of spirituality nUsing multiple quantitative and qualitative methods to explore operational aspects of spirituality (including religiousness) nSpiritual well-being as process and outcome of healthy spirituality nClinical assessment will be addressed later MCj04412790000[1] MCj04366380000[1] Systematic Relaxation Exercise nBiofeedback nSelf-monitoring nExperience now, nprinciples later n Alpine Ridge and Flowers 7-07 •Discussion of experience Austrian Alps, ca 06 An Example of Macro Level Response to Oppression: Gandhian Nonviolent Activism nSelf-realization as the purpose of human existence: self has personal, community, and cosmic dimensions. nSolidarity of all people; Unity of all things. nPursuit of Truth (satyagraha) through nonviolence (ahimsa). nSeeking welfare of all (sarvodaya), especially starting with the oppressed. nBeginning with local action (swadeshi), in context of global awareness. n(see sources in Hinduism section of book) Ebenezer%20Baptist%20Church,%20Dr Gandhi%20Statue At MLK National Historic Site, Atlanta, GA Statue of Mahatma Gandhi Interactions of spiritual diversity and other forms of diversity: personal reflection nJot down a brief description of your spiritual perspective(s), whether religious or nonreligious: Jot down one way you have directly or indirectly experienced discrimination or oppression toward yourself, based on your spiritual perspective. Jot down one way you could prevent this or respond well in the future. Jot down one way you have directly or indirectly engaged in discrimination or oppression toward someone different from yourself, based on your spiritual perspective. Jot down one way you could prevent this in the future. Discussion General Types of Religious Perspectives nCautions about generalizations n nTheistic (e.g. Judaism, Christianity, Islam) nPolytheistic (e.g. popular Hinduism) nNontheistic (e.g. Confucianism, Zen Buddhism, Vedantic Hinduism) nAnimistic (e.g. many Indigenous and tribal religions, including those with shamanism) nOthers? Christianity and Social Work nMore than 900 denominations in USA: interdenominational, intradenominational, nondenominational, and ‘unchurched’ varieties nSocial Work related websites examples nNorth American Association of Christians in Social Work (NACSW, at http://www.nacsw.org/2008/2008-index.shtml) nCatholic Charities (http://www.catholiccharitiesusa.org/NetCommunity/Page.aspx?pid=193) nLutheran Social Services in Greater Kansas City n(Metro Lutheran Services) http://www.mlmkc.org/ nCounseling, church-based in KC area nhttp://www.northridgesabetha.com/Viewable_Pages/Ministries/Christian_Counseling.htm n Basic Tenets nSee Canda & Furman, p. 149 nTheistic and trinitarian nBiblical, traditional, and faith based beliefs nSin and forgiveness nLove of God and neighbor nCharity and justice nCaritas in helping relationship nServing whole person, community, and world as divine calling nMay use witnessing, prayer, sacrament, clergy as appropriate to social work ethics nWhat about titling yourself as a ‘Christian social worker’ to clients UM Cross United Methodist Logo, DeSoto, KS Example of Contemplative Prayer nJesus’ retreat and fast in the desert n(Matthew 4) nLord’s Prayer and injunction to pray privately n(Matthew 6:5-14) nMoving from monastic practice to laity and daily life nBrief case example of contemplative Catholic msotw9_temp0 Christian Contemplative Centering Prayer nA spiritual discipline to foster loving communion with God nBeyond images and conversation to silent awareness nUse of prayerful word as focus (e.g. God, love, Jesus, peace) or simple inward gaze nBegin with clear intention, verbal prayer nAt end, reflect or journal nExtend to daily life Description of Contemplative Prayer Based on the Cloud of Unknowing MCj00896760000[1] > > Cloud of Forgetting Cloud of Unknowing Send a sharp dart of longing love upward Divine loving grace moves downward Drop egoic preoccupations, even devout ones All discursive dualistic mentality falls away Sit with calm, nonjudging awareness of being, receptive to the divine Example of Speaking in Tongues nBased on 1 Corinthians, 12 and 13 and Acts, 2: ‘speaking and interpreting tongues’ as a gift of the Holy Spirit, rooted in love nVideo: Devotion with emotion nCross-cultural phenomenon: glossolalia n“Nonsensical sounds that mimic the rhythms and inflections of actual speech. Glossolalia may be seen in deep sleep or in trance states. It is also the scientific term for the trance-induced religious phenomena known as "speaking in tongues.“” (MedicineNet.com) nConsider bias implicit in this definition nImportance of differential culturally-appropriate assessment Christian Faith-Based Social Services nMajor religiously sponsored professional organizations, such as Salvation Army, Lutheran Social Services, Catholic Social services nCongregation based parish nursing and social work nReligiously connected volunteerism, philanthropy, and policy advocacy nIssues of referral and collaboration nOf course, FB services can relate to any religion NASW Position (2002) re: H.R. 7, Faith-Based and Community Services Act nFB entities receive government funds while retaining religious character nRecognizes history of charitable organizations and history of social work/religious collaborations nConcerns: nVoluntary access to services without discrimination nNeed accountability and transparency nAppropriate, qualified staffing nSeparation of church and state nMaintaining government responsibility Case Example: Health Through Faith and Community Project (see Spiritual Diversity and Social Work Resource Center) nFunding by United Methodist Health Ministry Fund, 2000-2005 nDevelopment of curriculum for congregation based adult education linking spirituality to health and justice nProcess of reaching mutual understanding and cooperation for ecumenical approach nStories of publishing representative, conference attendee, advisory board UM Cross Buddhism and Ideals for Helping nMajor branches of Buddhism nTheravada nMahayana nVajrayana nThe Four Noble Truths as basis of all types: nSakyamuni as the Medicine Buddha n msotw9_temp0 Medicine Buddha, Bomun Temple, Korea Case Example: Cooperation or conflict in refugee resettlement nExample of Lao roommates Young%20Man%20Entering%20Monkhood Young man entering temporary monkhood, Lao temple in Midwest Enlightenment Buddha%20in%20Touching%20Earth%20Pose,%20ca Buddha in Touching Earth Pose, Namsan Mountain, Gyeongju, Korea ca. 8th century, 2006 Haetal (Korean): breaking free of the cocoon Buddhism as a Human Service System nTraditionally, village life connected with temples in many countries nTemples provide(d) supports e.g. sheltering orphans and solitary elders; distributing grain; providing rituals at times of life transition or crisis (e.g. death and after-death); teaching meditation and rituals as means to ‘merit,’ ‘blessings,’ and enlightenment. nCurrently, Buddhist immigrants and refugees in US re-establish temples as mutual support systems; ‘American style’ Buddhism also provides training in meditation and socially engaged service Young%20Man%20Entering%20Monkhood Young Lao-American man entering temporary monkhood at Midwestern temple, 1988 Procession%20to%20River Tibetan monk with procession to river near Kansas City Museum of Art, 1997 >>> A Zen Buddhist View of Spiritual Development: Ox Herding Pictures 6,%20Harmonized Through persistent training of awareness, rediscover your true nature. Woodcut prints by Tomikichiro Tokuriki, Japan; Paintings at Daejo and Seungga Temples, Korea Searching for the Ox •Anxious awareness of having lost one’s true mind n 1, Searching for the Ox 1,%20Losing%20the%20Ox Seeing the Traces 2, Seeing the Traces 2,%20Seeking%20the%20Ox • nFinding guidance for training nErratic progress Finding the Ox nFirst realizing one’s true nature nInitial enlightenment (opening up, awake) 3, Seeing the Ox 3,%20Finding%20the%20Ox Catching the Ox nNever letting go of earnest practice nVexations still distract 4, Catching the Ox 4,%20Subduing%20the%20Ox Herding the Ox (Resting with the Ox) nHarmonizing with true nature nIntensified practice and insight (e.g. by using paradoxical teaching cases, koan) 5, Herding the Ox 5,%20Resting%20with%20the%20Ox Riding the Ox Home nSecurely on way home to true self nEffortless practice nClear unenmeshed awareness of world nSamadhi (meditative concentration) and precepts well established 6, Coming Home on the Ox's Back 6,%20Harmonized Ox Forgotten, Person Alone 7, The Ox Forgotten, Leaving the Man Alone 8,%20Returned%20Home • Returned home • Attachment and aversion no longer afflict the mind • Nothing to do; everything as it is No Person, No Ox nOneness with original Buddha-nature nNo self, no nature nNondual consciousness 8, The Ox and the Man Both Gone Out of Sight 7,%20All%20One Returning to the Source nManifest world is itself realm of enlightenment nNo attachment nEverything can be a means to help others toward enlightenment nHonors conventions but not constrained nEverything is complete as it is 9, Returning to the Origin, Back to the Source 18 Re-entering the City (or Home) 10, Entering the City with Bliss Bestowing Hands nThe homeless monk serves others nBodhisattva ideal 20 Generic Principles for Meditation and Relaxation (see C&F, Tables 10.1-3) n nExtrapolations for nonreligious, generic applications, e.g. DBT, mindfulness stress reduction, spiritually oriented cognitive behavioral therapy nGoals: enlightenment or healthy outcomes? Meditating%20%20Buddha%20and%20Sweeper Amida Buddha at Kamakura, Japan, 1999 Kotoku-In Monastery For free online meditation course, including research overview, see: http://www.csh.umn.edu/mindbody/med/index.html (Spirituality and Healing Center at Un. of Minnesota Existentialism and SW Practice nAbsurdity of life (Camus’ jail story; Book of Job) nResponse to the absurd: confrontation of the absurd with courage, solidarity, authentic meaning/faith nTheistic style (e.g. Kierkegaard, Buber) nAtheistic style (e.g. Camus, Sartre) nNontheistic style (e.g. Brandon’s Zen SW) Sculptural%20Mural%20Depicting%20Concentration%20Camp%20En Memorial, Buchenwald Concentration Camp Weimar, Germany •Story of David Chethlahe Paladin Example of Coming to Terms with Death nDeath on Your Back nPlayfulness with Death Skull%20on%20Man's%20Back%20Sculpture Skeleton%20Puppeteer Scenes from Prague, Czech Republic Story of Friend’s Death: Palliative Care and Social Work nDance of Death n n Death%20Dances%20with%20Pope%20and%20King Totentanz Theme, St. Anna Chapel and Museum, Fussen, Germany 2006 nRapid, sudden death of spiritual mentor nSetting up palliative care in the hospital with interdisciplinary team nMaking her room into a sacred space nNurturing by friends nJust sitting with her nFuneral in honor of her life nTragedy on the way to the grave nCarrying on From%20Mural,%20Seeds,%20Sun%20Eagle,%20Lawrence,%20KS,%2006 A funny thing happened on the way… nFlying to Hong Kong on my birthday nBook’s opening surprise nAirplane problems nFellow passenger nArrival n n See: Canda, E. R. (2007). Fall Forest Letter, 27(5), November. Reproduced by permission of Shantivanam, Forest of Peace House of Prayer, Easton, Kansas. http://www.socwel.ku.edu/canda/Articles/fall forest letter.pdf Discussion of your practice experience nShare story of how help client deal with death or a major life crisis nWhat nonreligious spiritual approaches did (could) you take? nWhat religious spiritual approaches did (could) you take, if appropriate? From%20Mural,%20Seeds,%20Sun%20Eagle,%20Lawrence,%20KS,%2006 Relaxation Exercise nFind balanced sitting posture nClose eyes nPay attention to each moment without judgment nLet yourself naturally relax nTake in one deep breath and release, settling into gentle rhythm nCount breaths, 1 to 10 nStart over if lose count; no problem nPractice for 5 minutes (increase time with practice) nDiscuss results n nHelpful website-- http://stress.pmibooks.com/index.html, Preventive Measures Overview of Transpersonal Theory Banff%20National%20Park%20Mountains%202 Rocky Mountains, Canada, near Banff Key Concepts in Transpersonal Theories nTranspersonal Experiences, e.g. nExperiences of God, Brahman, Buddha Nature, Cosmic Consciousness. nConnections with ancestors, spirit powers of nature, angels and demons. nNear death experiences. nExtrasensory perceptions. nSubtle energies, e.g. chi, kundalini. Cross%20at%20Podbrdo%20Hill%20Marian%20Apparition%20Site Marian vision site at Medjugorye, Bosnia Maslow’s peak, nadir, and plateau experiences nPeak: rising above ordinary body/ego limit. nNadir: falling into a pit of crisis. nPlateau: integrating growth into life; subtle yet deep insights. Banff%20National%20Park%20Mountains%202 Wilber’s Pre/Trans Egoic Distinctions nPre-egoic phase: infancy and early childhood sense of fusion with significant others and fantasy. nEgoic phase: adolescence and adulthood sense of bounded body/ego and individuated self. nTrans-egoic phase: includes and transcends earlier phases in expanded consciousness and identity. MCDD01518_0000[1] The Theme of TRANSformation white%20and%20ruby%20irises Developmental potential is already in the seed— And is drawn up in beauty by the light. Irises in the Canda garden Poas%20Volcano Vital energy transforms all things, sometimes with volcanic force. Mount Poas Volcano, Costa Rica Carpenter%27s%20Shop%20with%20Crucifixes Death of the self is an opening to spiritual rebirth. “You must be born anew.” -- Gospel of John 3:7 Purification%20(Sweat)%20Lodge%20Frame,%20KS%20,%2090,%20En “The willows which make the frame of the sweat lodge are set up in such a way that they mark the four corners of the universe; thus, the whole lodge is the universe in an image, and the two-legged, four-legged, and winged peoples, and all things of the world are contained within it, for all peoples and things too must be purified before they can send a voice to Wakan-Tanka.” -- Black Elk to Joseph Eppes Brown (The Sacred Pipe, Penguin, 1971, p. 23.) Sweat lodge frame, Kansas Shaman%20on%20Knife%20Blades%20Top%20of%20Scaffold Trance / Balance Ecstasy / Catharsis: Salpuri Korean shaman in Seoul dancing on knife blades, praying to the 5 directions. Ritual Honoring Taegam spirit (the home overseer), 1977. msotw9_temp0 Developmental Dynamics nSteps of increasing levels of consciousness inclusiveness and complexity (epigenetic levels). nStructure of identity, awareness, and function at each stage. nWave like flowing overlapping stages. nProgress, regress, fluctuation. nLines or streams of aspects of development (e.g. cognition, morality, sociality). nGenetic and environmental and choice influences. nTemporary peak and pit experiences. nExpanding concentric spheres. nAscending spiral. n MCDD01518_0000[1] What is happening in your practice? nLet’s start talking about how spirituality is addressed in your practice setting… nIntake and assessment? nTraining in specific helping practices? nSpiritually sensitive helping relationship? nReligious or nonreligious approaches? nMonitoring outcomes? nFormal policies or off-hand comments? n Table 7.3 Rating Form for Assessing Spiritual Sensitivity in HSO Culture Instructions: Rate your organization for the level it meets on each quality criterion (see Table 7.2, pp. 238-9 for explanation) on a scale of 0 to 5, from 0 [nonexistent] to 5 [excellent]. Think of your reasons for each rating and an example and write brief notes. Tally the total score. In discussing your rating with colleagues, feel free to include musings or disagreements regarding any of the criteria. Discuss your overall impression of the organization's spiritual sensitivity. Identify at least one specific suggestion for innovation by building on the HSO's strengths or addressing its limitations. General Structure and Functioning 1. Spiritually Attuned Mission, Goals, and Objectives. RATING (0-5) _____ 2. Human scale. RATING (0-5) _____ 3. Functional flexibility and integration. RATING (0-5) _____ 4. Rule flexibility. RATING (0-5) _____ 5. Work environment aesthetics. RATING (0-5) _____ 6. Convivial technology. RATING (0-5) _____ 7. Preparedness for spiritually sensitive practice RATING (0-5) _____ Meaningful Interconnectedness 8. Staff composition. RATING (0-5) _____ 9. Meritorious shared leadership. RATING (0-5) _____ 10. Participatory decision making. RATING (0-5) _____ 11. Spiritual diversity innovation planning group. RATING (0-5) _____ 12. Interpersonal communication. RATING (0-5) _____ 13. Holistic satisfaction of personnel aspirations. RATING (0-5) _____ 14. Climate among colleagues. RATING (0-5) _____ 15. Social and cultural environment rapport. RATING (0-5) _____ 16. Natural environment rapport. RATING (0-5) _____ TOTAL SCORE (0-80) __________ NOTES ON RATINGS AND OVERALL IMPRESSIONS: RECOMMENDATION FOR ONE INNOVATION, WITH SPECIFIC ACTION PLAN: Meditation Exercise nSelecting a mantra or meaningful focus word nChoose a word or brief phrase that is meaningful to you nIt should be brief enough to harmonize with each breath nUse the basic meditation technique, but rather than counting breaths, use the mantra to add focus to breath awareness nIf one word or phrase, repeat silently on the in-breath and release the out-breath in silence nPause slightly between each breath in/out nLet the out-breath be about twice as long as in-breath nIf two words/phrases, use one word on in-breath and one on out-breath (e.g. peace… to all) Applications to Assessment nTo be done within context of spiritually sensitive relationship and strengths assessment nInitially determine if relevant to situation and purpose of helping, client’s goals nE.g. only concrete service? (if so, still can be spiritually sensitive) nClarifies whether there is interest and purpose for engagement of spirituality by social worker in treatment setting or in discharge planning nIn own work with client nIn referral/collaboration red and violet star burst Spiritually Focused Assessment nPurposes for Spiritual Assessment nSpiritual assessment can be therapeutic in itself, engendering client insight. nSpiritual assessment can identify: MCj04344110000[1] MCj04375570000[1] MCj04398000000[1] nImportance of spirituality in the client's life and family, community context nComponents of the client's spiritual perspective relevant to the focus of helping nThe spiritual aspect of the person/environment in a holistic strengths oriented assessment nClient's interest in addressing spirituality within the helping process nProper fit between client's spiritual perspective and the social worker or agency n nClient's desire for referral to or collaboration with spiritual mentors of particular religious or nonreligious spiritual perspectives and styles nWays in which the client's past and present spiritual beliefs, values, practices, and group participation (if any) are helpful or harmful to self-esteem, coping, wellbeing, and to dealing with the presenting issue n ·Specific spiritual strengths, such as inspirational religious or philosophical texts, music, art; enjoyable participation in religious or nonreligious spiritual support groups; personal practices of prayer, meditation, rituals; spiritually motivated healthy lifestyles; nurturing connection with God, nature, and other sources of profound meaning, sacredness, or transcendence; sense of life meaning and purpose; sources of joy, peace, harmony; qualities of empathy, compassion, wisdom, kindness, generosity, and other virtues; ability to forgive and be forgiven; effective ways of working through crises; spiritual mentors, healers, and friends; commitment to benefit family, society and world n Lotus%20Flower%20and%20Pads%20Close%20Up nSpiritually based complementary or alternative healthcare and support practices (such as prayer, ritual, healing visualization, yoga, acupuncture, herbs) that might interact with possible helping activities and medications nAttitudes about death and the afterlife, especially in bereavement counseling and hospice nThe nature of past or recent peak or pit experiences that shape the presenting issue nIntergenerational and current family patterns pertaining to spiritual perspective and relationship dynamics n nComplications of mental disorders due to religious beliefs, such as in delusions, hallucinations, unrealistic fears nStruggle with spiritual problems not necessarily related to mental disorders, such as spiritual emergencies; feeling of estrangement from God; religiously based inappropriate anxiety, shame, guilt; loss of life meaning or purpose; deep moral perplexity; loss of faith; loss of hope; sense of attack by harmful spirits or magic; abuse by clergy or other spiritual authorities; abuse by parents or caregivers under religious rationales; experience of religiously or ideologically based discrimination or oppression; alienation from or conflict with religious groups; collective persecution and genocide based on membership in an oppressed spiritual (religious or nonreligious) group n From Canda And Furman, 2010 Class Exercise and discussion nDraw your own spiritual development timeline nNot necessary to use word ‘spiritual’ nChoose a span of age/years for focus (e.g. one semester, since entering university, since mid childhood nAdd images or symbols or notes to timeline nAdapt to your preferences nConsider questions at bottom of figure nIdentify one key insight about yourself nDiscuss with partner Table 8.8 Common Qualities of Severe Mental Disorders and Spiritual Crises Contrasts Severe Mental Disorders Spiritual Crises Underlying biochemical/organic pathology Absence of underlying physical pathology Long term duration Short term duration Meaningless chaos Meaningful transformation Functional disabilities Brief functional disabilities with intensified perceptual sensitivities and insights Incoherent communication Poetic, metaphoric, and paradoxical communication Religious delusions Spiritual inspirations and insights Hallucinations Mystical visions or heightened consciousness Involuntary dissociation Spontaneous or induced trance Ego confusion or inflation Ego transcendence and expanded love Psychosocial debilitation Psychosocial reorganization nIssues of Further Complexity nPsychopathology, medical crises, and spiritual crises can intersect nMental and physical illnesses can be opportunities for spiritual growth nStandards for normality vary by cultural and religious context nInterpretations of transpersonal experiences may shift over time nSpiritual import of a mental illness or crisis may unfold over a lifetime nThorough assessment requires in-depth dialogue with client Lotus%20Flower%20and%20Pads%20Close%20Up Ethical Challenges and Dilemmas nDiscussion of challenging situations nRaise awareness of own values, ethics nConsider professional ethical issues involved nDemonstrate complexity and subtlety nSuggest possible solutions and open alternative views nAccept real life ambiguities white red circle star Ethical Challenges and Dilemmas nSome of the reasons nNoncompliance with ethical standards nTension between personal and professional values nCompetition between ‘goods’ nE.g. protection of child vs parents’ right to religious freedom nOthers? MCj04344030000[1] Clip art Examples of cultural/spiritual incongruence between practitioner and client n nCoining and cupping vs. child abuse n n nJehovah’s Witnesses and refusal of blood products nSee youtube.com “Bloodless Transfusions: Jehovah’s Witnesses” (4:51) MCj02436610000[1] Clip art Examples of mixed motives nDSM diagnosis of a person in spiritual crisis (V Code for spiritual or religious problem) in terms of a mental disorder nProfit considerations? nMisdiagnosis due to lack of knowledge? nWanting to provide service to client unable to pay? nRefusal to allow Indigenous client in substance abuse recovery program to participate in his/her Native American Church due to use of peyote nAgency rules? nMisunderstanding of controlled substances laws? nCultural/religious discrimination? §See youtube.com or fliiby.com “Sacred Peyote” (8:36) Guidelines for Use of Spiritually Based Helping Practices nReminder of key ethical considerations nInsights from practitioners Canda, E., Nakashima, M., & Furman, L. (2004). Ethical considerations about spirituality in social work: Insights from a national qualitative survey. Families in Society, 85(1), 1-9. nNot imposing on clients nWorker competency nFitting client’s goals, timing, comfort nEstablishing spiritually sensitive helping relationship nImportance of spiritual assessment to determine ‘what’s next’ nMost controversial: intrusive prayer and touch n white red circle star Ethical Considerations from Canda & Furman, Table 9.2 nConditions for Determining When Activities are Appropriate nA. Client has not expressed interest in spirituality (religious or nonreligious) nB. Client has expressed interest in spirituality nC. Spiritually sensitive relationship is well established nD. Worker has relevant qualifications for particular spiritually based activities white red circle star nOptions for Activities n n1. Private spiritually based activities by worker to enhance readiness for practice ne.g. prayer, meditation, relaxation, journaling, receiving spiritual mentoring n n2. Implicit spiritually sensitive relationship, context, assessment, and helping activities ne.g. strengths based case management, existential therapy, mindfulness, dialectical behavior therapy, art therapies, or wilderness retreats white red circle star n3. Brief explicit spiritual assessment ne.g. MIMBRA assessment n n4. Referral to outside spiritual support systems ne.g. spiritually sensitive colleagues in interdepartmental and interagency networks or community based clergy, spiritual mentors, traditional healers, or other resources matching client interests n5. Cooperation with outside spiritual support systems ne.g. coordinated helping activities with spiritually sensitive colleagues or community based resources matching client interests n n6. Direct use of spiritual activities by client’s request ne.g. any activities in Table 9.1 or others matching client request n n7. Direct use of spiritual activities by worker’s invitation ne.g. any activities in Table 9.1 or others matching client interest Table 9.2 Ethical Considerations for Using Spiritually Based Helping Activities in Social Work Conditions for Determining When Activities are Appropriate A. Client has not expressed interest in spirituality (religious or nonreligious) B. Client has expressed interest in spirituality C. Spiritually sensitive relationship is well established D. Worker has relevant qualifications for particular spiritually based activities Options for Activities 1. Private spiritually based activities by worker to enhance readiness for practice ·e.g. prayer, meditation, relaxation, journaling, receiving spiritual mentoring 2. Implicit spiritually sensitive relationship, context, assessment, and helping activities ·e.g. strengths based case management, existential therapy, mindfulness, dialectical behavior therapy, art therapies, or wilderness retreats 3. Brief explicit spiritual assessment ·e.g. MIMBRA assessment 4. Referral to outside spiritual support systems ·e.g. spiritually sensitive colleagues in interdepartmental and interagency networks or community based clergy, spiritual mentors, traditional healers, or other resources matching client interests 5. Cooperation with outside spiritual support systems ·e.g. coordinated helping activities with spiritually sensitive colleagues or community based resources matching client interests 6. Direct use of spiritual activities by client’s request ·e.g. any activities in Table 9.1 or others matching client request 7. Direct use of spiritual activities by worker’s invitation ·e.g. any activities in Table 9.1 or others matching client interest · Conditions Present Appropriate Options A 1,2; 3 and 4 with caution B 1, 2, 3, 4; 5 with caution B and C 1, 2, 3, 4, 5; 6 with caution B, C and D 1, 2, 3, 4, 5, 6; 7 with caution Application of the Guidelines nCase of a Hmong refugee family at intersection of health and child welfare systems nWhat would you do? MCj02958600000[1] Clip art nCaution about private or surreptitious attempts to influence the client by spiritual means (e.g. directive prayer) nInformed consent nNonmanipulation nHumility white red circle star quilt 09001 Quilt/mandala of unity in diversity • •Each student design quilt piece •Length goes up/down •If stray pencil marks, use other side •Return to me •I will arrange, copy, and bring to last session