Spiritual Competence refers to the ability to understand, respect, and effectively respond to the spiritual beliefs, practices, and needs of individuals from diverse backgrounds.

(1)

Spiritual Competence: What It Is, Why It Is Necessary, and How to Develop It

Article in Journal of Ethnic & Cultural Diversity in Social Work · September 2016

DOI: 10.1080/15313204.2016.1228093

CITATIONS

65

READS

6,518

1 author:

David R. Hodge Arizona State University 255PUBLICATIONS 7,126CITATIONS

SEE PROFILE

All content following this page was uploaded by David R. Hodge on 15 November 2017.

The user has requested enhancement of the downloaded file.

(2)

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=wecd20

Download by: [Arizona State University Libraries] Date: 15 November 2017, At: 05:46 ISSN: 1531-3204 (Print) 1531-3212 (Online) Journal homepage: http://www.tandfonline.com/loi/wecd20

Spiritual Competence: What It Is, Why It Is Necessary, and How to Develop It

David R. Hodge

To cite this article: David R. Hodge (2016): Spiritual Competence: What It Is, Why It Is Necessary, and How to Develop It, Journal of Ethnic & Cultural Diversity in Social Work, DOI:

10.1080/15313204.2016.1228093

To link to this article: http://dx.doi.org/10.1080/15313204.2016.1228093

Published online: 20 Sep 2016.

Submit your article to this journal

Article views: 144

View related articles

View Crossmark data

(3)

Spiritual Competence: What It Is, Why It Is Necessary, and How to Develop It

David R. Hodge^a,b

aSchool of Social Work, Arizona State University, Phoenix, Arizona, USA;^bProgram for Research on Religion and Urban Civil Society, University of Pennsylvania, Philadelphia, Pennsylvania, USA

ABSTRACT

Various professional standards underscore the importance of providing effective services to all people, including those from diverse religious backgrounds. Yet despite these standards, studies have repeatedly found that most social workers receive little training in navigating this aspect of diversity during their graduate educa- tions. To address this lack of training, the present article discusses a concept that is foundational for effective service provision with spiritual clients from diverse religious backgrounds—spiritual competence. More specifically, this article outlines what spiritual competence is and why it is important in therapeutic work, and then offers a number of strategies for developing spiritual competence.

As such, this article helps equip practitioners to provide more ethical, effective services in a nation characterized by increasing religious diversity.

KEYWORDS

Cultural competence; direct practice; religion; spirituality;

spiritual competence

The social work profession is ethically committed to providing effective services to all clients. As the National Association of Social Workers (NASW)Code of Ethics (2008) states in its preamble,“the primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people.”

All people obviously includes clients who self-identity as spiritual or religious.

Indeed, the NASW Code of Ethics (2008, 1.05) specifically singles out the importance of obtaining training in cultural competence in the area of religion.

Similarly, the International Federation of Social Workers’ (IFSW; 2012) Statement of Ethical Principles calls practitioners to uphold and defend each person’s spiritual integrity and well-being. In turn, these ethical principles are reflected in the profession’s educational policies. For instance, the Council on Social Work Education’s (CSWE; 2015) Educational Policy and Accreditation Standards highlight the importance of being able to engage diversity and difference in the area of spirituality and religion in practice settings.

It is questionable, however, whether or not practitioners have received sufficient training to operationalize these professional standards in clinical settings. Studies have repeatedly found that most social workers report

CONTACTDavid R. Hodge School of Social Work, Arizona State University, Mail Code 3920, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004-0689, USA.

Downloaded by [Arizona State University Libraries] at 05:46 15 November 2017

(4)

receiving little training in spirituality during their educational careers (Canda

& Furman,2010; Oxhandler, Parrish, Torres, & Achenbaum,2015; Sheridan, 2009). Such findings underscore the need for additional content to help practitioners conform to the profession’s ethical mandates.

To address this need, the present article discusses a concept that is foundational for effective service provision with spiritual clients from diverse religious backgrounds—namely spiritual competence. More specifically, this article outlines what spiritual competence is and why it is important in clinical work, and then offers a number of strategies for developing spiritual competence, particularly with clients from commonly encountered religious traditions or cultures. A concluding section briefly reviews the current professional status of spiritual competence, highlighting positive developments as well as challenges. Before delineating the basic parameters of spiritual competence, the concepts of spirituality, religion, and culture are defined to help readers understand the subsequent content.

Spirituality, religion, and culture

For the purposes of this article, spirituality and religion are defined as distinct but overlapping constructs (Derezotes, 2006). Specifically, spirituality is con- ceptualized as an individual’s subjective relationship with God (Wuthnow, 2007), or more broadly the sacred or transcendent (Hodge, 2013a). Religion is defined as a culturally shared set of beliefs, values, and practices that have been developed over time by those who share similar experiences of the transcendent (Praglin, 2004). Accordingly, religion is one manifestation of culture, which can be defined as a worldview or value system shared by a relatively large group of people (Scollon, Scollon, & Jones,2012).

It should be underscored that clients may not concur with these definitions. People define spirituality and religion, as well as the relationship between these two constructs, in a variety of ways (Canda & Furman, 2010). Some view spirituality as the broader construct. Others view religion as the broader construct, and yet others use the two terms interchangeably (Ammerman,2013; Gallup & Jones,2000). This diversity of views should be kept in mind in clinical work. Clients’definitions of spirituality and religion should be allowed to drive the therapeutic dialogue. As will be seen in this article, a central tenet of spiritual competence is the importance of working within the parameters of clients’ definitional narratives.

What is spiritual competence?

Spiritual competence can be understood as a form of cultural competence that deals with spirituality and religion, specifically clients’individually constructed spiritual worldviews. The concept was originally proposed by Hodge

(5)

(2004), drawing on a seminal article in counseling psychology by Sue, Arredondo, and McDavis (1992). The concept was developed and illustrated by Hodge and Bushfield in a subsequent article (2006).

Spiritual competence can be defined as a dynamic process characterized by three, interrelated dimensions: (a) an awareness of one’s personal value- informed worldview along with its associated assumptions, limitations, and biases, (b) an empathic, strengths-based understanding of the client’s spiritual worldview, and (c) the ability to design and implement intervention strategies that are appropriate, relevant, and sensitive to the client’s spiritual worldview (Hodge, 2004). Each dimension is briefly reviewed next.

Understanding one’s personal worldview

The first dimension is developing an in-depth awareness of one’s personally constructed worldview. Everyone views reality through the prism of a particular, value-informed worldview. These worldviews may be secular or spiritual in nature. Regardless of their metaphysical assumptions, they serve important functions, such as helping adherents understand and interpret life experiences (Soenke, Landau, & Greenberg,2013).

Although personal worldviews play an essential role in making sense of reality, they also function to refract understandings of the world. No one has a completely objective view of reality (Lyotard, 1979/1984). Every worldview is based upon certain assumptions which, in turn, serve to foreground some information while simultaneously backgrounding other data (Kuhn, 1970).

This process is often largely unconscious (Scollon et al.,2012). Consequently, it is important to develop awareness of the limitations and biases associated with one’s worldview to help ensure that they do not negatively impact the therapeutic relationship.

Understanding the client’s worldview

The second dimension is developing an empathic, strengths-based understanding of the client’s spiritual worldview. This understanding should move beyond a simple cognitive knowledge of clients’ beliefs and values. Rather, the aim is to develop a deep psychological appreciation for clients’ worldviews and their associated strengths. This appreciation involves understanding, experiencing, and responding to clients’ emotional state, ideas, and values (Segal & Wagaman,2015).

To be clear, this does not entail agreement with clients’worldviews. As the NASW’s (2001) Standards for Cultural Competence in Social Work Practice state, social workers do not have to agree with the values held by clients.

They do, however, need to cultivate an appreciation of clients’worldviews as legitimate understandings of reality.

(6)

Developing client-centered interventions

The third dimension is the ability to design and implement client-centered interventions. As Gilligan (1993) artfully illustrated, interventions typically reflect the worldview of the individuals responsible for their design and development. The values inherent in standardized interventions may, or may not, be congruent with clients’belief systems (Blume & de la Cruz,2005).

Accordingly, practitioners should work with clients to construct interventions that build upon or reflect the internal logic of clients’ belief systems (Hodge, Limb, & Cross, 2009). Ideally, the resulting therapeutic strategies make sense within the context of clients’ worldviews. The created interventions resonate with clients’ values to such an extent that implementation flows naturally from the construction process.

As noted earlier, the three dimensions of spiritual competence are intertwined with one another (Sue & Sue,2013). Recognizing the limitations and biases of one’s personal worldview helps create space for acknowledging and understanding that other worldviews also represent legitimate understandings of reality. Likewise, the creation of therapeutic strategies that resonate with clients’value systems is contingent upon developing an empathic understanding of the internal logic of clients’worldviews.

Spiritual competence is not a static entity, but a dynamic set of attitudes, knowledge, and skills regarding different religious traditions that can be developed over time (Furness & Gilligan, 2010). Accordingly, practitioners have different levels of competence with different religious traditions. For example, practitioners who share the same religion with their clients are often better positioned to develop client-centered interventions due to the shared knowledge base. Like other important clinical attributes, it takes time and effort to develop spiritual competence with the various groups practitioners regularly encounter in their work. This implicitly raises the question as to why practitioners—who are often pressed for time—should expend this effort.

Why is spiritual competence necessary?

There are a number of reasons why practitioners should develop their spiritual competence. In brief, these rationales are related to religious diversity, value conflicts, clients’ challenges, clinical rapport and outcomes, and clients’spiritual strengths. Each rationale is briefly reviewed next.

Increasing Religious Diversity

Western nations are characterized by increasing religious diversity. The United States, for example, is the most religiously diverse nation in the world (Eck,2001). These different religions typically affirm culturally distinct

(7)

value systems that differ from the value system affirmed in the dominant secular culture.

In turn, clients’ value systems inform beliefs and practices in a host of areas that intersect service provision, ranging from child birth and care, to gender and marital relations, to grieving and burial practices (Richards &

Bergin, 2014). Given that values permeate clinical work, it is to be expected that value differences will emerge between practitioners and some clients.

Indeed, such value conflicts can be expected to occur with some frequency when working with clients from a different religious culture (Hamilton &

Levine, 2006).

Negotiating potential value conflicts

How practitioners navigate these value conflicts can have a dramatic effect on outcomes. Interactions that are incongruent with clients’ worldviews can damage the therapeutic relationship (Sue & Sue,2013). For instance, assum- ing that“I statements”represent the most salutary communication style can be disconcerting to Muslims who often favor less direct communication styles that safeguard others’feelings.

In some instances, spiritual insensitivity can harm clients. For example, asking American Indians about certain spiritual rituals or ceremonies is often culturally inappropriate and can engender negative affect (King & Trimble, 2013). In some tribal cultures, spiritual rituals are understood to play a critical role in fostering healing and wellness. Yet, these rituals can only be discussed with other tribal members. Inquiring about such potential interventions is often experienced as stressful and can result in clients terminating services.

Enhancing insight into clients’challenges

Furthermore, the nexus between clients’presenting problems and spirituality is often complex. As the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association [APA], 2013) acknowledges, the symptoms of psychopathology are often culturally contingent. Beliefs and practices that are normative in religious cultures can be understood as indicators of psychopathology when evaluated from the perspective of the secular culture.

For example, the emphasis upon selflessness, detachment, and dharma in Hinduism may result in some Hindu clients appearing to have an “under- developed ego” from a psychodynamic perspective (Roland, 1997).

Suggesting normative spiritual practices represent a manifestation of mental illness typically has a negative effect on the therapeutic relationship and subsequent outcomes (Gardner, 2011).

(8)

Improving clinical rapport and outcomes

Conversely, interactions that are congruent with clients’ value systems can have a salutary effect. Empathic communication that respects clients’worldviews tends to foster rapport (Hepworth, Rooney, Rooney, & Strom- Gottfried, 2013). Spiritually animated clients, just like other people, typically respond positively to practitioners that they perceive are engaging in affirm- ing, respectful exchanges.

Similarly, therapeutic strategies that are congruent with clients’ value systems typically enhance client buy-in (Sue & Sue, 2013). Interventions that resonate with clients’values are more likely to be adopted, and faithfully implemented, including continued implementation after treatment termina- tion. In short, interventions that resonate with clients’ spiritual values can potentially speed recovery, facilitate wellness, and prevent relapse.

Accessing spiritual strengths

Indeed, numerous studies indicate that spirituality is a strength that can frequently be operationalized to facilitate health and wellness (Koenig, King, & Carson, 2012). Individuals coping with problems frequently turn to spirituality to help deal with the challenges (Pargament, 2007). Most people believe that spirituality can help address their problems, particularly members of traditionally disenfranchised populations for whom spirituality tends to be most salient (Boorstin & Schlachter, 2000; Newport,2012).

Yet, despite the potential spirituality holds as an asset in clinical settings, many clients are hesitant to discuss spirituality with practitioners (Hodge, 2015). Spirituality is often a very sensitive and private matter. Clients are frequently hesitant to trust practitioners—who are often assumed to be secular—with this sacred content (Boorstin & Schlachter, 2000). The situa- tion is analogous to others whose experiences are frequently misunderstood in the dominant culture. A person who is African-American, for example, may experience similar concerns around issues of race when interacting with European-American practitioners (Griffith & Griffith, 2002). Unless trust and rapport is established, valuable clinical strengths remain untapped.

As the content just discussed implicitly illustrates, spiritual competence is essential to effective work with spiritually different clients. It equips practitioners to establish trust and rapport. In addition to enhancing the therapeutic relationship, spiritual competence helps practitioners avoid detrimental clinical interactions, access clients’ spiritual strengths, and enhance clinical outcomes. Although working across different value systems is usually a complex task, developing spiritual competence can position practitioners to successfully navigate the challenges presented by dissimilar

(9)

value systems. These benefits suggest that social workers can benefit from increasing their levels of competence.

Strategies for developing spiritual competence

As noted previously, spiritual competence is a dynamic set of attitudes, knowledge, and skills regarding different religious worldviews. In keeping with the dynamic nature of the construct, it is possible to develop spiritual competence over time through implementing a number of strategies related to self-assessment, consultation, religious norms, and especially, epistemol- ogy humility. In the same way that the three dimensions of spiritual competence are intertwined, the strategies discussed next should not be understood as discrete, but as mutually reinforcing approaches that facilitate the development of spiritual competence.

Self-assessment

Identifying one’s values and biases is fundamental to developing spiritual competence. Cultivating awareness of one’s personal values is a critical first step in this process. As alluded to previously, our values impact beliefs and practices in a wide array of areas including, for example, animals, burial practices, celebrations, child birth and care, clothing, communication styles, coping practices, diet, emotional expressiveness, finances, gender interactions, grieving, healing, health, marital relations, medical care, recreation, schooling, and wellness (Richards & Bergin, 2014). Identifying and owning one’s values in these and other areas that intersect service provision represents a significant landmark on the road to self-awareness.

To begin this process, practitioners might read works on moral foundation (Graham, Haidt, & Nosek,2009) and epistemological theory (Hunter,1991).

This content acquaints readers with the internal logic of differing cultural value systems at a macro level. People tend to subconsciously view their larger understanding of reality as morally normative—the way things should be. Moral foundation and epistemological theory can help cognitively de- center such understandings by relating the existence of different moral systems of thought and juxtaposing them with culturally dominant moral frameworks.

At a deeper level beyond cognitive awareness, introspection plays an important role in fostering self-awareness. Social workers are ethically called to treat each person in a caring manner that respects their cultural values (NASW, 2008). This can be difficult, however, in cross-cultural settings where clients and practitioners hold different values. For instance, a feminist practitioner who favors egalitarian gender roles can experience difficulty

(10)

working with a Latter-day Saint (LDS) couple who prefer complementary gender relations (Fife & Whiting, 2007).

Attending to situations that engender a sense of uncomfortableness can aid in identifying personal biases that can impact service provision (Furness

& Gilligan, 2010). Encountering values that one disagrees with strongly often engenders an emotional response. Such responses can negatively impact service provision if they are allowed to bleed into the therapeutic relationship. Cultivating an awareness of shifts in affect can help illuminate limitations in one’s worldview that inhibit the provision of respectful, client-centered services.

Conducting spiritual self-assessments can also be helpful in this process (Willow, Tobin, & Toner,2009). A number of different diagrammatic assessment tools have been developed, including spiritual lifemaps, genograms, ecomaps, and ecograms (Hodge, 2015). Using these various tools to delineate one’s personal spiritual journey—however conceived—on paper can help elicit fresh insights.

For instance, certain people have negative feelings toward their childhood religious traditions. Some data suggest that roughly one in five social workers holds negative sentiments toward the religious tradition of their family of origin (Canda & Furman, 1999; Shafranske & Cummings, 2013). Unless identified and managed, these negative feelings can bias interactions with clients from the traditions in question. For example, secular practitioners who rejected the Catholicism of their family of origin may experience difficulty providing caring and respectful services to devout Catholic clients due to spiritual countertransference biases.

In much the same way that practitioners from a divorced family may experience countertransference biases when working with couples consider- ing a divorce, the unresolved sentiments associated with negative childhood experiences can elicit spiritual countertransference biases (Vogel, McMinn, Peterson, & Gatherecoal,2013). Animosities rooted in childhood experiences may be projected onto clients, resulting in a less empathic posture and increased negative appraisals. Practitioners may unconsciously attempt to pathologize clients’ values, implicitly framing them as unhelpful, or attempt to convert them to the values affirmed by the secular dominant culture. In some cases, these biases may be projected on all clients who affirm values that differ from common secular values (Yancey, 2014). Charting one’s relationship with the sacred with a diagrammatic assessment tool can help social workers identify such biases.

After identifying one’s values and biases, it is possible to manage them.

As self-awareness is developed, it is possible to grow in one’s ability to manage the responses so that they don’t negatively impact the clinical relationship. Consultation can also play an important role in this process as well.

(11)

Consultation

Knowledge limitations characterize every worldview. Consultation with informed experts can help shed light on these limitations, illuminating perspectives that were previously unconsciously held (Furness & Gilligan, 2010). Ideally, consultation is conducted in tandem with introspection to identify and manage areas of bias.

For instance, troubling emotional responses can be processed with trusted colleagues and supervisors. Such individuals are often better positioned to identify blind spots, process the results of self-assessments, and suggest alternative perspectives. As outside observers, these people can often see manifestations of bias of which practitioners are unaware (Fife & Whiting, 2007).

It is important, however, that such professional “sounding boards” have sufficient levels of spiritual competence themselves. As stated in the NASW Code of Ethics (2008), social workers should only seek consultation from colleagues who have expertise and competence in the area at hand (2.05b).

Research suggests that many spiritual minorities are underrepresented in the profession (Wuest,2009), and, as noted previously, most social workers have received little content or training on spirituality during their graduate educa- tions (Canda & Furman,2010; Oxhandler et al.,2015; Sheridan, 2009).

This raises the possibility that biases will be accentuated, rather than identified and managed in some consultative contexts. This may be particularly likely if both the practitioner and the colleague share similar worldviews and backgrounds. For instance, an evangelical Christian practitioner consult- ing with an evangelical Christian supervisor may not be the best choice in terms of managing biases stemming from work with clients who are committed members of the Metropolitan Community Church (MCC).

Accordingly, it is important to ensure that the individuals selected for consultation do, in fact, have some degree of expertise in spiritual competence. This does not necessarily mean that the colleague has to have expertise in every religious tradition, or even most religious traditions (Griffith &

Griffith, 2002). Often, practitioners are attempting to develop their level of spiritual competence regarding the traditions they commonly encounter in clinical work. Thus, the central issue is whether or not the colleague has the necessary degree of spiritual competence in the tradition at hand.

It should be noted that simply identifying as a member of a given tradition does not mean that the individual is an expert in that tradition. Many people identify with a particular tradition but their commitment, knowledge, and understanding of its value system are limited (Newport, 2012; Smith, 2003).

In addition, as noted earlier, people can hold negative sentiments toward a tradition they have rejected, although there is not a necessary relationship

(12)

between leaving a tradition and animosity as people leave traditions for a variety of reasons (Chaves, 2011).

In short, to get the most out of consultation, it is important that the colleague have expertise and competence in the tradition in which the practitioner is attempting to develop spiritual competence. This should include some degree of proficiency in all three dimensions of spiritual competence. Put differently, the colleague should be bicultural, fluent in both a given religious culture and professional social work culture, and able to relate the norms from one culture to the other.

In addition to professional colleagues, it can also be beneficial to establish consultative relationships with various clergy members (Yarhouse &

Johnson, 2013). Clergy are experts on spirituality within the context of their particular religious tradition or culture. As such, they are well situated to provide insights on normative beliefs and practices that intersect practitioners’experience. They can also serve as a valuable source of knowledge on religious norms.

Religious norms

Developing knowledge of the values of the religious cultures practitioners commonly encounter also plays a central role in developing spiritual competence. Such knowledge implicitly helps reveal the limitations in practitioners’

worldviews by highlighting other constructions of reality that many people find viable and life-promoting. It also positions practitioners to create interventions that are congruent with clients’ worldviews.

A number of resources have been developed to explicate common values within various religious traditions (e.g., Koenig, 2013; Pargament, 2013;

Richards & Bergin, 2014; Van Hook, Hugen, & Aguilar, 2001). These texts typically feature religious cultures that are commonly encountered in North America (e.g., Buddhism, Catholicism, evangelical Christianity, Hinduism, Islam, Mainline Protestantism, etc.). In addition, some delineate religious cultures that are shaped by race/ethnicity (e.g., African-American, American Indian, Asian, Latino).

It may be helpful at this junction to reiterate that religion is a communally shared construct. Formalized religious value systems are rarely adopted with- out qualification. Rather, they are typically individualized to some extent.

Other factors that shape clients’personal spiritual value systems can include ethnicity, nation of origin, and the degree of assimilation to the dominant secular culture (Loewenthal, 2013). Such factors, in tandem with clients’

religion, all serve to shape and influence clients’ unique spiritual value systems. Accordingly, it is helpful to think of religious worldviews as malle- able templates that suggest the presence of a certain set of values that clients may hold, rather than require it.

(13)

Some compilations of case studies have also been published (Richards &

Bergin, 2004; Scales et al., 2002). These texts encourage practitioners to reflect on how they might incorporate and address spirituality with clients from different traditions in various practice settings. For instance, Nielsen (2004) depicts the construction of a spiritually adapted cognitive behavioral therapy (CBT) intervention that resonates with a Muslim client’s value system.

As alluded to earlier, clergy can help practitioners understand common beliefs and practices within a given tradition (Yarhouse & Johnson,2013). In some situations, it may be possible to collaborate with clergy to develop interventions that resonate with clients’ spirituality. Although the construction of interventions is dependent upon a number of factors—including the nature of the presenting problem, practitioners’ theoretical orientation, and clients’spiritual values—clergy can often assist practitioners design interventions that reflect the internal logic of clients’beliefs.

Clergy can also play an important role in helping practitioners determine the appropriateness of certain beliefs and behaviors. Some clients may claim a religious justification for certain practices that seem harmful to themselves or others. As experts in religious norms within their respective traditions, clients’ clergy can provide some sense of whether or not such practices are legitimate expressions of spirituality. When having such discussions, it is important to assume the best regarding clients’intentions in keeping with the precepts of epistemological humility.

Epistemological Humility

The success of the spiritual competence enterprise is largely contingent upon practitioners’attitude when encountering spiritually different clients. Spiritually animated clients typically view the world through a different metaphysical lens, a lens that differs from the materialistic lens that informs secular culture (Gellner, 1992). Given this reality, clients are often extremely sensitive to practitioners’

attitude toward their spirituality (Boorstin & Schlachter, 2000).

To address this concern, it is imperative that social workers cultivate an attitude of cultural humility, or more broadly, epistemological humility (Ortega & Faller, 2011). Epistemological humility involves recognizing that many ways of knowing exist. Included among these different ways are paths that prioritize, non-empirical, spiritual avenues to knowledge.

Developing epistemological humility is a lifelong process that involves an examination of power and privilege, in tandem with self-evaluation and critique. For instance, practitioners might reflect upon the fact that influen- tial theorists such as Sigmund Freud (1927/1964), and Albert Ellis (1980) posited that devout spirituality represents a form of mental illness. Put differently, what are the implications for practice with spiritual clients

(14)

when key thinkers develop therapeutic frameworks that explicitly discount and stigmatize the reality of clients?

In the epistemological humility model, practitioners seek to develop a collaborative attitude that privileges clients’ perspective (Ortega & Faller, 2011). Toward that end, they might cultivate an ability to acknowledge their lack of expertise regarding clients’ spiritual values, proactively ask forgiveness for interactions that might inadvertently be offensive, and create space for clients to express discomfort, unease, and raise questions at any time. In short, nurture an attitude that implicitly views clients as experts who are valued, contributing partners in the therapeutic enterprise.

To sum up, at the micro level, practitioners can develop their levels of spiritual competence by practicing self-assessment, consultation with knowl- edgeable peers, learning about the religious norms of frequently encountered groups, and demonstrating epistemological humility in work with clients.

This implicitly raises questions about practices that might facilitate spiritual competence at the macro level. In the following section, positive professional developments are reviewed along with some of the challenges that continue to exist and steps that might be taken to overcome these challenges.

Current professional status of spiritual competence

The concept of spiritual competency was introduced in the social work literature more than a decade ago. Since that time there have been some positive professional developments. For instance, the number of articles dealing with spirituality and religion in the profession’s literature has increased and the new online edition of the NASWEncyclopedia of Social Workincluded an entry on spirituality in social work (Hodge,2013b). This entry included information on recent developments in the areas of spiritual assessment and intervention, concepts that are foundational to the concept of spiritual competence.

CSWE has also implemented a number of positive changes. At its annual program meeting, a new track has been added on Islam and Muslims, supplementing an existing track on spirituality. CSWE (2016) has also created an online Religion and Spirituality Clearinghouse to promote effective practice that takes into account diverse expressions of spirituality and religion. This website includes various curricular resources designed to operationalize the mission of the Clearinghouse.

Despite these encouraging changes, significant challenges still remain.

According to a recent national study of licensed clinical social workers, 87%

reported taking no courses on spirituality or religion (Oxhandler et al.,2015). In addition, 74% reported receiving no content on spirituality or religion in their field or clinical training. These findings are similar to those reported in studies conducted a couple decades ago (Canda & Furman, 1999; Sheridan, 2009), suggesting little progress has occurred in the critical realm of education.

(15)

This highlights the need for educational programs to include content designed to enhance spiritual competence. Such content can be provided in stand-alone courses on spirituality and religion or integrated into existing clinical courses (Derezotes,2006). As long as students are exposed to relevant material, either option is acceptable. To conserve time, instructors might focus on content that is most relevant to the catchment area served by the school. For instance, a social work program located in an area with a significant population of LDS might supplement general content on spiritual competence with specific material on this religious culture.

A number of additional steps might be taken to help create a professional climate that facilitates the development of spiritual competence. For instance, CSWE could create a council on spirituality and religion, analogous to those that currently exist in the areas of disability, race, gender, and sexual orientation. The Society of Social Work Research (SSWR) might add a cluster/topic on spirituality and religion. NASW might host practitioner-oriented webcasts on developing spiritual competence with various religious groups to assist practitioners currently in the field. Implementing these and similar changes would help the profession move toward more effective, culturally relevant service provision.

Conclusion

The United States is the most religiously diverse nation in the world (Eck,2001).

Yet, most social workers have received little training in navigating this aspect of diversity, in spite of ethical and educational standards that emphasize the importance of such training (Oxhandler et al.,2015). Give this disjunction, the present article reviewed the concept of spiritual competence and, perhaps most impor- tantly, adds to the profession’s knowledge base by presenting strategies for developing spiritual competence with commonly encountered traditions. As such, it helps expand our professional knowledge by assisting practitioners provide ethical and effective services to spiritual people from diverse religious traditions. More broadly, this article helps move us a little bit closer, as a profession, to our shared ethical mission of providing effective services to all clients.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author.

Ammerman, N. T. (2013). Spiritual but not religious? Beyond binary choices in the study of religion. Journal for the Scientific Study of Religion, 52(2), 258–278. doi:10.1111/

jssr.2013.52.issue-2

Blume, A. W., & de la Cruz, B. G. (2005). Relapse prevention among diverse populations. In G. A. Marlatt & D. M. Donovan (Eds.),Relapse prevention (pp. 45–64).New York, NY:

Guilford Press.

(16)

Boorstin, B., & Schlachter, E. (2000). American Association of Pastoral Counselors and Samaritan Institute report. Washington, DC: Greenberg Quinlan Research, Inc.

Canda, E. R., & Furman, L. D. (1999).Spiritual diversity in social work practice. New York, NY: The Free Press.

Canda, E. R., & Furman, L. D. (2010).Spiritual diversity in social work practice: The heart of helping(2nd ed.). New York, NY: Oxford University Press.

Chaves, M. (2011). American religion: Contemporary trends. Princeton, NJ: Princeton University Press.

Council on Social Work Education (CSWE). (2015). Educational policy and accreditation standards. Retrieved fromhttp://www.cswe.org/File.aspx?id=81660

Council on Social Work Education (CSWE). (2016).Religion and Spirituality Clearinghouse.

Retrieved fromhttp://www.cswe.org/CentersInitiatives/CurriculumResources/50777.aspx Derezotes, D. S. (2006). Spiritually oriented social work practice. Boston, MA: Pearson

Education.

Eck, D. L. (2001).A new religious America. New York, NY: HarperCollins.

Ellis, A. (1980). The case against religion: A psychotherapist’s view and the case against religiosity. Austin, TX: American Atheist Press.

Fife, S. T., & Whiting, J. B. (2007). Values in family therapy practice and research: An invitation for reflection. Contemporary Family Therapy, 29(1–2), 71–86. doi:10.1007/

s10591-007-9027-1

Freud, S. (1964). The future of an illusion, civilization and its discontents and other works (vol. 21) J. Strachey, Trans.). London, UK: Hogarth Press. (Original work published 1927) Furness, S., & Gilligan, P. (2010).Religion, belief and social work: Making a difference. Bristol,

UK: Policy Press.

Gallup, G. J., & Jones, T. (2000).The next American spirituality: Finding God in the twenty- first century. Colorado Springs, CO: Victor.

Gardner, F. (2011).Critical spirituality: A holistic approach to contemporary practice. Surrey, England: Ashgate Publishing.

Gellner, E. (1992).Postmodernism, reason and religion. New York, NY: Routledge.

Gilligan, C. (1993). In a different voice: Psychological theory and women’s development.

Cambridge, MA: Harvard University Press.

Graham, J., Haidt, J., & Nosek, B. A. (2009). Liberals and conservatives rely on different sets of moral foundations. Journal of Personality and Social Psychology, 96(5), 1029–1046.

doi:10.1037/a0015141

Griffith, J. L., & Griffith, M. E. (2002).Encountering the sacred in psychotherapy. New York, NY: Guilford Press.

Hamilton, J. L., & Levine, J. P. (2006). Neo-Pagan patients’ preferences regarding physician discussion of spirituality.Family Medicine,38(2), 83–84.

Hepworth, D. H., Rooney, R. H., Rooney, G. D., & Strom-Gottfried, K. (2013).Direct social work practice: Theory and skills(9th ed.). Belmont, CA: Brooks/Cole.

Hodge, D. R. (2004). Spirituality and people with mental illness: Developing spiritual competency in assessment and intervention. Families in Society, 85(1), 36–44. doi:10.1606/

1044-3894.257

Hodge, D. R. (2013a). Implicit spiritual assessment: An alternative approach for assessing client spirituality.Social Work,58(3), 223–230. doi:10.1093/sw/swt019

Hodge, D. (2013b). Spirituality in social work. InEncyclopedia of social work. Retrieved from http://socialwork.oxfordre.com/view/10.1093/acrefore/9780199975839.001.0001/acrefore- 9780199975839-e-1084?rskey=qWZme6&result=1

Hodge, D. R. (2015). Spiritual assessment in social work and mental health practice.

New York, NY: Columbia University Press.

(17)

Hodge, D. R., & Bushfield, S. (2006). Developing spiritual competence in practice.Journal of Ethnic and Cultural Diversity in Social Work, 15(3–4), 101–127. doi:10.1300/

J051v15n03_05

Hodge, D. R., Limb, G. E., & Cross, T. L. (2009). Moving from colonization toward balance and harmony: A Native American perspective on wellness. Social Work,54(3), 211–219.

doi:10.1093/sw/54.3.211

Hunter, J. D. (1991).Culture wars. New York, NY: Basic Books.

International Federation of Social Workers (IFSW). (2012).Statement of ethical principles.

(2012). Retrieved fromhttp://ifsw.org/policies/statement-of-ethical-principles/

King, J., &Trimble, J. E. (2013). The spiritual and the sacred among North American Indians and Alaska Natives: Mystery, wholeness, and connectedness in a relational world. In K. I. Pargament (Ed.),APA handbook of psychology, religion, and spirituality: Vol. 1. Context, theory, and research (pp. 565–580). Washington, DC: American Psychological Association.

Koenig, H. G. (2013).Spirituality in patient care: Why, how, when, and what(3rd ed.). West Conshohocken, PA: Templeton Press.

Koenig, H. G., King, D., & Carson, V. B. (2012).Handbook of religion and health(2nd ed.).

New York, NY: Oxford University Press.

Kuhn, T. S. (1970).The structure of scientific revolutions(2nd ed.). Chicago, IL: University of Chicago.

Loewenthal, K. M. (2013). Religion, spirituality, and culture: Clarifying the direction and effects. In K. I. Pargament (Ed.),APA handbook of psychology, religion, and spirituality:

Vol. 1. Context, theory, and research (pp. 239–255). Washington, DC: American Psychological Association.

Lyotard, J.-F. (1979/1984).The postmodern condition: A report on knowledge(G. Bennington

& B. Massumi, Trans.). Minneapolis, MN: University of Minnesota Press.

National Association of Social Workers (NASW). (2001).Standards for cultural competence in social work practice. Retrieved from http://www.socialworkers.org/practice/standards/

NASWCulturalStandards.pdf

National Association of Social Workers (NASW). (2008). Code of ethics. Retrieved from http://www.socialworkers.org/pubs/code/code.asp

Newport, F. (2012).God is alive and well: The future of religion in America. New York, NY:

Gallup Press.

Nielsen, S. L. (2004). A Mormon rational emotive behavior therapist attempts Qur’anic rational emotive behavior therapy. In P. S. Richards & A. E. Bergin (Eds.), Casebook for a spiritual strategy in counseling and psychotherapy (pp. 213–230).Washington, DC:

American Psychological Association.

Ortega, R. M., & Faller, K. C. (2011). Training child welfare workers from an intersectional cultural humility perspective: A paradigm shift.Child Welfare,90(5), 27–49.

Oxhandler, H. K., Parrish, D. E., Torres, L. R., & Achenbaum, W. A. (2015). The integration of clients’religion and spirituality in social work practice: A national survey.Social Work, 60(3), 228–237. doi:10.1093/sw/swv018

Pargament, K. I. (2007).Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York, NY: Guilford Press.

Pargament, K. I. (Ed.). (2013). APA handbook of psychology, religion, and spirituality.

Washington, DC: American Psychological Association.

Praglin, L. J. (2004). Spirituality, religion, and social work: An effort towards interdisciplinary conversation.Journal of Religion & Spirituality in Social Work,23(4), 67–84. doi:10.1300/

J377v23n04_05

Richards, P. S., & Bergin, A. E. (Eds.). (2004).Casebook for a spiritual strategy in counseling and psychotherapy. Washington, DC: APA.

(18)

Richards, P. S., & Bergin, A. E. (Eds.). (2014). Handbook of psychotherapy and religious diversity(2nd ed.). Washington, DC: American Psychological Association.

Roland, A. (1997). How universal is psychoanalysis? The self in India, Japan, and the United States. In D. Allen (Ed.),Culture and self(pp. 27–39).Boulder, CO: Westview Press.

Scales, T. L., Wolfer, T. A., Sherwood, D. A., Garland, D. R., Hugen, B., & Pittman, S. W.

(Eds.). (2002).Spirituality and religion in social work practice: Decision cases with teaching notes. Alexandria, VA: CSWE.

Scollon, R., Scollon, S. W., & Jones, R. H. (2012).Intercultural communication: A discourse approach(3rd ed.). Malden, MA: John Wiley & Sons.

Segal, E. A., & Wagaman, M. A. (2015, January14–18).Social empathy as a framework to infuse competency in advancement of social and economic justice in social work education.

New Orleans, LA: Society for Social Work Research.

Shafranske, E. P., & Cummings, J. P. (2013). Religious and spiritual beliefs, affiliations, and practices of psychologists. In K. I. Pargament (Ed.),APA handbook of psychology, religion, and spirituality: Vol. 2. An applied psychology of religion and spirituality (pp. 23–41).

Sheridan, M. (2009). Ethical issues in the use of spiritually based interventions in social work practice: What we are doing and why.Journal of Religion and Spirituality in Social Work, 28(1/2), 99–126. doi:10.1080/15426430802643687

Smith, C. (2003).The secular revolution. Berkeley, CA: University of California Press.

Soenke, M., Landau, M. J., & Greenberg, J. (2013). Sacred armor: Religion’s role as a buffer against the anxieties of life and the fear of death. In K. I. Pargament (Ed.),APA handbook of psychology, religion, and spirituality: Vol. 1. Context, theory, and research(pp. 105–122).

Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling & Development, 70(4), 477–486. doi:10.1002/j.1556-6676.1992.tb01642.x

Sue, D., & Sue, D. (2013). Counseling the culturally diverse: Theory and practice (6th ed.).

Hoboken, NJ: John Wiley & Sons.

Van Hook, M., Hugen, B., & Aguilar, M. A. (Eds.). (2001). Spirituality within religious traditions in social work practice. Pacific Grove, CA: Brooks/Cole.

Vogel, M. J., McMinn, M. R., Peterson, M. A., & Gatherecoal, K. A. (2013). Examining religion and spirituality as diversity training: A multidimensional look at training in the American Psychological Association.Professional Psychology: Research and Practice,44(3), 158–167. doi:10.1037/a0032472

Willow, R. A., Tobin, D. J., & Toner, S. (2009). Assessment of the use of spiritual genograms in counselor education. Counseling and Values, 53(3), 214–223. doi:10.1002/(ISSN)2161- 007X

Wuest, L. G. (2009). Factors associated with inclusion of spirituality in secular social work education.Dissertation and Theses. (Paper 301). Retrieved fromhttp://pdxscholar.library.

pdx.edu/cgi/viewcontent.cgi?article=1300&context=open_access_etds

Wuthnow, R. (2007).After the baby boomers: How twenty- and thirty-somethings are shaping the future of American religion. Princeton, NJ: Princeton University Press.

Yancey, G. A. (2014).Dehumanizing Christians: Cultural competition in a multicultural world.

New Brunswick, NJ: Transaction Publishers.

Yarhouse, M. A., & Johnson, V. (2013). Values and ethical issues: The interface between psychology and religion. In K. I. Pargament (Ed.),APA handbook of psychology, religion, and spirituality: Vol. 2. An applied psychology of religion and spirituality (pp. 43–70).

View publication stats