March/April 2008

Spirituality in Social Work — the Journey From Fringe to Mainstream
By Edie Weinstein-Moser, MSW, LSW
Social Work Today
Vol. 8 No. 2 P. 32

Resistance to recognizing spirituality in social work practice diminishes as clients and clinicians raise spiritual issues and science studies the mind-body-spirit connection.

“We are not human beings having a spiritual experience. We are spiritual beings having a human experience.”

— Pierre Teilhard de Chardin

The social work profession has never been one to shy away from controversial subjects. Because spirituality is at the center of existence for many people and its reach is so broad, it is ideally suited to be integrated into responsible and respectful approaches to therapeutic intervention with clients.

The combination of spirituality and social work has implications in the areas of trauma, end-of-life issues, aging, illness, cultural competence, addiction treatment, ethics, relationships, forgiveness, chronic mental illness, the meaning of life, and attempting to answer the age old question, “Why is this happening?” Social workers often address these issues in their own lives while helping clients face them. They are increasingly examining how their spiritual values affect practice of the profession, as well as how clients' spirituality impacts world view, coping skills, and ability to manage adversity.

Professional Perspectives — Forgiveness and Self-Care
For Ann Weaver Nichols, DSW, ACSW, spirituality was a seed cultivated when she became involved with the American Friends Service Committee. A Columbia University School of Social Work graduate, she has been a member of the Arizona State University (ASU) School of Social Work faculty since 1970. She teaches social policy, community organizing, and human behavior. Ten years ago, her attention was drawn to the subject of forgiveness, as she describes it “both from a micro and a macro level. I was interested in the truth and reconciliation process in South Africa and ways communities could work toward reconciliation and healing.”

When the Society for Spirituality and Social Work was seeking a new location, she offered ASU. For the past three years, she has been at the helm of the organization. Weaver Nichols defines spirituality as “giving meaning to our lives, what our purpose and calling is. It is our ability to make connections with other people and be aware of the oneness of all creation and the brotherhood and sisterhood of all people.” Her belief is that “we are all spiritual beings; we all have a divine spark and an inner light. Cultivating our spirituality or reaching for spiritual strength in other people, helping them in coping, is helping them get in touch with that inner light and sense of wholeness that sometimes gets covered up by a lot of bad things happening to us.”

Spiritual self-care was even more essential for those who provided emotional care for others following September 11, 2001. Weaver Nichols recalls that “a group of us gathered together with others to share some of the pain we were feeling. We opened it up to students and faculty. We created a space and a time, and we called it Gatherings.” This included sitting in silence, as well as praying, talking, and singing in unison. She found that it “helped people cope with the uncertainty that came around September 11th and gave people a better sense of direction. September 11th was a pivotal event that caused many people to come face-to-face with their own mortality and realize how precious our connections are to other people.”

A life transition prompted David Wilde, JD, MSW, LCSW, to reconsider his connection with the divine. His original career path was that of an attorney, and he attended Brooklyn Law School and Hunter College. But he is now a spiritually oriented psychotherapist who divides his practice time between Bucks County, PA, and New York City, working with a broad demographic and diagnostic range of clients.

“I don’t initiate the topic of spirituality with my clients,” says Wilde. “I am open to their bringing up their own version of what their spiritual goals or needs are. I work within whatever paradigm the client presents. Many follow a belief system and I work within that, be it Christianity, Islam, or Judaism, and some don’t believe in a higher power and don’t have a belief system.” He considers that a belief system in and of itself.

Like Weaver Nichols, Wilde believes that the concept of forgiveness is key. “The word forgiveness in Sanskrit translates to ‘surrender,’” he says. “It is not a condoning of behavior. It is actually a releasing of energetic hold or binding that is freeing to the person who is doing the forgiving. All growth means letting go of something.” For many clients, this is a revolutionary idea since habitual patterns of anger and resentment may keep them anchored to a painful past and coping mechanisms that no longer serve them.

Mindfulness Models
Social workers can assist their clients by maintaining a mindful witnessing perspective. Such is the belief of Charles May, MSS, LSW, a therapist and a case manager in an adult partial hospital program at the Horsham Clinic in Ambler, PA, who was trained as a clinical social worker at Bryn Mawr Graduate School of Social Work and Social Research.

Without attempting to impose his spiritual values, May recognizes that much of what he does “includes mindfulness meditation now being integrated into Western models. There is a nice confluence there.” Teaching mindfulness is an integral component of the day program where he works. “Spirituality sensitizes me to my own way of seeing clients as being just like me. Using spiritual models, I think of them as Buddhas, goddesses, and gods, Christlike already. I relate to them as if that is so. There are just obscurations and misunderstandings in the way,” he explains.

For May, spirituality is a way of life and an essential perspective. “It is like breathing,” he says of integrating it into his work with clients. “It is the theme of my existence. That’s my context for understanding my experience.” According to Wilde, spirituality is “a person’s individual relationship with the universe and however he or she conceives of that. It may include his or her definition of a higher power, God, the spiritual source.”

What assists May in maneuvering through a potentially frustrating job, working with people who carry many emotional wounds and behaviors that would be easy to judge, is his choice to “see myself as being as likely to have experienced similar symptoms had I had similar circumstances.”

A more academic approach to infusing spirituality into social work practice is offered by Mo Yee Lee, PhD, a professor at the College of Social Work at Ohio State University and author of Solution-Focused Treatment of Domestic Violence Offenders: Accountability for Solutions. With a clinical background in solution-focused brief therapy, Lee embodies spirituality in her life in a cohesive manner: “Spirituality entails cognitive, philosophical, experiential, emotional, as well as behavioral aspects. I personally believe in interconnectedness of phenomena and different domains of human experiences, as well as with the broader system. I try not to treat myself or others as objects or compartmentalized bits. Of course, such a belief affects my professional pursuit. I embrace a systems perspective, strengths-based, and/or body-mind-spirit approach in my clinical practice and intervention research.” Part of her work entails exploring the benefits of meditation on mental health outcomes of clients.

Historical Perspective
Ed Canda, MA, MSW, PhD, sees himself as someone who draws people together. He has been the professor and the chair of the doctoral program in social work at the University of Kansas since 1989. Fascinated with the topic of spirituality and social work since the early 1980s, it remains his primary focus of research and teaching. In 1990, he founded the Society for Spirituality and Social Work.

Canda thinks of spirituality as “the universal aspect of human existence and a search for meaning and purpose, fulfilling relations and connections between other people and myself. But while spirituality has been present in social work in some form since the beginning, within social work education it’s been neglected.”

When he began his pioneering work in the field, Canda found that not many people were teaching the subject, and it was discussed only in limited settings. “Because social work promoted a holistic perspective and sensitivity to cultural diversity, the topic of religion and spirituality sometimes came up in those contexts, but the standard approaches to research and education didn’t focus on it and sometimes discouraged it.” There were concerns about social workers infusing their beliefs into their practices or “agencies that were religiously affiliated requiring that clients participate in their religious practices and violating church/state separation.”

Joining with other colleagues, Canda found that they were also feeling isolated, and their agencies were not supportive of the topic. “The society helped people to connect not only with regard to sharing information but to develop relationships and a mutual support network.” He calls it a “web of interest and synergy across the country.”

Canda’s spiritually aware practice enhances his sensibilities as a social worker. “One of the most important principles of a spiritually sensitive practice is to have ground rules between one’s personal life and one’s practice because if we are going to educate students to have sensitivity to client’s spirituality, we need to be developing continuously our own clarity around spiritual issues,” he says. “If we don’t do our own inner work, then we can’t really model what spiritually sensitive practice is. My clients bring up issues in the clinical setting or in the larger community context of faith-based initiatives.”

Weaver Nichols adds that “for a long time, it was very difficult to talk about or write about spirituality. It was brushed off as being kind of flaky. In academic circles, it was not seen as a suitable topic for research or writing.”

Lee observes that “historically, social work has part of its root in spirituality although the upsurge of positivist paradigm has contributed to the separation of spirituality and social work treatment, which I think is also influenced by an attempt of the social work profession to gain prominence in a social and academic environment that prefers a scientific mode of inquiry. Of course, such a mode of inquiry does not endorse something so vague and nonscientific as spirituality. However, it’s quite clear that spirituality is becoming more and more prominent in social work practice probably because of experience, feedback from clients, and more scientific studies supporting mind-body connection.”

Current Practice and Future Goals
In the late 1990s, Canda and his colleague Lee Fuhrman surveyed National Association of Social Workers members, and most respondents indicated that many clients were raising issues related to spirituality. The respondents addressed the concerns but felt ill prepared by their social work education. It became a matter of competency.

Canda believes the trend has shifted since the late 1990s. Many schools now have electives related to spirituality and social work, but it is still a fringe topic. Current social work practice includes the biopsychosocialspiritual assessment that evaluates the strengths and spiritual resources of clients. The Joint Commission, which monitors healthcare facilities, mandates the routine assessment of spiritual needs and requires that the spiritual component of a person’s life be considered in health assessments.

According to Weaver Nichols, “Spirituality has become more acceptable to talk about, use in practice, write about, and research, but it is still considered by some people to be a little bit on the fringe.”

Canda believes that more empirical study is needed to examine the way spirituality is addressed in practice at different levels, from micro to macro, and to evaluate outcomes. Regarding professional self-care, Canda says, “We need to do more in our education to go beyond intellectual and skills-based training to help students dig more deeply into self-cultivation and their life journey and how it interfaces with their practice.”

Nurturing the Nurturer
To maintain what he considers self-care and good mental health, Wilde practices what he preaches. “I try to stay as unfettered by judgment, self-doubt, and fear as possible. I start my day usually with a spiritual practice that may include meditation, imagination, affirmation, or some combination of the above,” he explains. “I remind myself at night to reconnect with who I am and why I am here. That is essential not only for my own life, but as a therapist, to stay sane, peaceful, and calm inside.” This is a powerful means of warding off the vicarious traumatization that can occur when working day after day with people who are experiencing pain.

Canda finds the “need to recharge, reenergize, and keep ourselves centered” and that “much of my work is about ‘building our own resilience.’ Spirituality is integral to that. Someone can practice centering, moment-to-moment clarity, empathy, and unconditional positive regard without basing it on specific religious ideas and symbols.”

May’s spiritual practice allows him to “work with the ideas that have personal impact,” adding that “I meditate. I do martial arts, yoga—activities that integrate mind and body. When I’m on my game, I’m remembering to be mindful.”

He also finds humor in even the most challenging situations. “I do it on purpose. It also helps to have other people around me sharing a lot of similar ideas and values as a treatment team. By myself, I would run down. We charge each other up.”

What allows Lee to stay centered is “jogging, staying close to nature, living a simple life, breathing, setting aside a little quiet time for myself despite my hectic work schedule, connecting with loved ones, listening to my inner voice.”

For me, self-care falls into the realm of daily attitude adjustment, creating an intention even before setting foot out of bed to “have an extraordinary day and connect with amazing people.” It reflects the work done on the inpatient unit of the psychiatric hospital where I work, creating a direct route to healing based in the mind and heart of the thinker. This approach embraces an eclectic spiritual practice that, when used within the discretion of the client, can be an effective therapeutic tool.

— Edie Weinstein-Moser, MSW, LSW, is a clinician, writer, speaker, and minister based in Dublin, PA.

Self-Care Reminders

Since March is National Social Work Month, it is timely to remind ourselves of some of the available self-care tools. With high stress levels, large caseloads, and the mandate to serve clients in seemingly impossible circumstances, it is easy for social workers to fall prey to compassion fatigue and burnout, what I refer to as tater tot syndrome—feeling like a crispy fried potato by the end of the day. We must keep our cups full if we are to help fill those of our clients. The following are suggestions gleaned from those professionals who contributed to this article:

Meditation
Daily exercise
Walking in nature
Yoga/martial arts
Listening to inspiring music
Massage
Art appreciation
Attending retreats
Prayer
Dancing
Drumming
Reading
Laughter
Time with kindred spirits
Sleep
Healthy eating
Singing/chanting

— EWM