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Resources for Spirituality and Religion in Counseling


Addressing Spirituality and Religion in Counseling:
A Resource for Counselors and Other Helping Professionals
Compiled by Elaine Casquarelli, LMHC
Doctoral Candidate, Counseling and Counselor Education, University of Rochester
Past President, New Mexico Association for Spiritual, Ethical, and Religious Values in Counseling
President, New Mexico Counseling Association
Member, ASERVIC Spiritual and Religious Values Committee

Staircase in Boulder

 
Welcome to my resource page on addressing spirituality and religion in counseling!  
 
The idea to create this resource for counseling and helping professionals came out of the present process of working on my dissertation, a qualitative study on the experiences of counselors as they work with clients whose spirituality and/or religion is very different then their own.  I became interested in this topic after reading the literature about the difficulties experienced by counselors and psychotherapists as they addressed issues of religion and spirituality with their clients in session.  In reviewing the literature, I found myself wishing I had some of these resources earlier in my counseling career; so, I thought I would create a space to share these resources with others.  As I complete my dissertation study, I will also be sharing some of my findings on this site.  If you would like to share your own ideas, experience, or interests in working with spirituality and religion in counseling, I invite you to do so on The Gloaming's Facebook page.  I also welcome requests for specific resources or information you would like to see me offer on this page.  I look forward to sharing this important information with you and hearing from you as you are interested!
 
Activities: Working with and through Religious or Spiritual Countertransference
The following is a list of activities that can help you reflect upon and gain greater awareness of your own religious or spiritual beliefs and work through any religious/spiritual countertransference you may experience in your work with clients.

 
 Create and Reflect Upon a Spiritual Genogram
Genograms are diagrams that map multigenerational family history, relationships, values, and characteristics (McGoldrick, 2011).   They can promote self-awareness, growth, and development in a number of ways.  By visually representing family members and their relational dynamics, people can gain greater insight into their own patterns, resources, and struggles. Spiritual genograms, in particular, focus on the religious and/or spiritual values, practices, and experiences of family members (Hodge, 2001; Frame, 2000a).  They include information about family members’ religion (including their level and perception of participation in their religious community), spirituality, significant religious or spiritual experiences, and religious conversion or transition events (Frame, 2000a; Hodge, 2001). Also important to record are religious or spiritual conflicts among family members and any existing family secrets as they relate to religion or spirituality (Frame, 2000a).

 

Include following information on the genogram:

·      Religion/denomination of which your family member was/is a part; if none, please indicate

·      Religious/spiritual beliefs and/or values; please also include agnostic, atheist perspectives.

·      Extent of religious/spiritual practice

 

Reflect and Journal About the Patterns You Notice

Once the spiritual genogram has been created, journaling activities and clinical supervision sessions can be utilized to help you explore the experience of creating a genogram as well as its personal clinical implications.  The literature is replete with examples of questions that can be used to help you process religious and spiritual family dynamics (Dunn & Massey, 2006; Frame, 2000a; Frame, 2000b; Hodge, 2001; McGoldrick, 2011).  Questions should focus on the values and beliefs held within the family, the processes by which those values were inculcated (including any ensuing conflict), and the implications of those dynamics for your work with clients.  

Journaling Questions

·      How have the religious/spiritual values and experiences in your family impacted your own religious/spiritual development and beliefs?

·      Which member listed in the genogram has impacted you the most and why?  Was there a specific religious/spiritual event that was most influential to your growth, beliefs, and/or practices?  If so, explain.

·      What did/does your religious/spiritual tradition say other religious or spiritual paths?  How have these beliefs affected you and your extended family?

·      What patterns of behavior and relationship resulting from religion/spirituality emerge for you as you study your genogram?  How are you maintaining or diverting from those patterns in your current household?

·      In what ways are your family traditions similar to or different from those of your students/clients?  How have, or how do you expect, these similarities or differences affected your clinical work with your students or clients?

·      What ethical concerns are raised for you based on the results of your spiritual genogram and the issues raised by your clients?


Nurturing Non-Reactivity in Counseling: Meditation and Contemplative Prayer

If you are someone whose religion or spirituality promotes engagement in contemplative practices (meditation and/or contemplative prayer), these activities can be used to promote non-reactivity in counseling.  While there are a number of practices that can be used for this purpose, we will focus here on mindfulness practices.

Mindfulness activities provide a specific structure for practitioners to become aware of internal and external sensations in the moment without assigning negative judgments or evaluations to the experiences (Dekeyser, Raes, Leijissen, Leysin, & Dewulf, 2008; Roemer & Orsillo, 2007; Sears & Kraus, 2009). Mindfulness activities invite people to refocus their attention on the present moment through a variety of tasks.  These tasks can include focusing on the breath, attending to all the physical sensations in the body while walking purposefully and slowly, engaging in yoga, participating in sitting meditation, and/or focusing on physical sensations as a meal is slowly consumed.  As practitioners engage in these activities, most will return to their ruminating thoughts.  When this happens, they are invited to notice the thoughts and any accompanying emotions without judging them.  In the process of noticing thoughts in a nonevaluative manner, practitioners begin to learn more about their thought patterns and may gain greater comfort managing their emerging cognitions and emotions in everyday situations (Bogels & Mansell, 2004; Sears and Kraus, 2009).  Hence, practicing this form of awareness and non-reactivity can aid in the process of noticing and working through potential countertransference.  

Cultivating Greater Acceptance and Compassion: Creative Visualization

Creative visualization can be used as a helpful tool in developing greater acceptance and empathy for persons of different religious or spiritual backgrounds and practices, particularly in cases when you experience value conflicts in counseling practice.  The following visualization script is meant to help nurture greater acceptance for self and others in instances when religious or spiritual value conflicts arise in session or when difficult religious or spiritual issues are otherwise triggered in a counseling relationship.

Please note, visualizations can result in a range of emotional responses.  The visualization that follows is meant to promote acceptance, peace, and compassion.  However, for some, difficult emotions may be triggered.  Therefore, it may be helpful to have someone else with you to process your reactions, journal about them afterwards, or process the experience in clinical supervision.  Actually, the visualization exercise may be a useful one to conduct in the context of clinical supervision. 

Know that, at any point in the visualization, if you are feeling uncomfortable or if you need to go in a different direction than the words seem to be taking you, trust your reactions and do what is must beneficial to your own experiences and processes.  You are the expert on yourself and your personal and professional growth needs; so, go in the direction that is most meaningful, important, or useful for you.

  The Field Beyond Wrongdoing and Rightdoing

By Elaine Casquarelli

Sitting comfortably in your chair or cushion, I invite you to notice your breath.  Breathing in and breathing out.  Breathing in and breathing out.  Notice the sensations in your body with each inhale and each exhale.  Notice the sensations in your body – from head to toe – as you breathe in and out.  Notice the parts of you that feel relaxed…and notice the parts of you that feel less relaxed…perhaps that feel more pressure.  If there are places and spaces in your body that feel pressure, I invite you to imagine breathing calming air into them….and, as you breathe out, imagine letting go of the stress and pressure you hold in those places.  Breathing in calmness and peace, and breathing out stress.  Breathing in calmness and breathing out any obstacles to calmness…knowing that you can gather it back up again later, if you like.  Breathing in acceptance and presence and breathing out anything that is not useful to you right now.  Breathing in….and breathing out.  Breathing in….and breathing out.

Now, I invite you to remember…or imagine…a place where you feel safe and secure.  A place where you can be truly and authentically yourself, knowing that you are fully accepted and perfect.  A place, as Rumi said, that exists beyond rightdoing and wrongdoing….a place to simply be…to meet yourself.  I invite you to notice the place or space that comes to mind.  Perhaps, you will see several places and can choose one among them.  Perhaps the place that feels most safe to you will come to mind automatically.  Perhaps it will take some time to find.  Take whatever time you need to find your special place…and once you have found it, notice what you see.  What are the sights, sounds, sensations, or feelings you notice?  Are you alone…or are there others with you?  If others are present, who are they?  Spend a few moments taking in all you see and feel.

Feeling self-acceptance and peace within yourself, I invite you to welcome someone else into your safe space whose religion or spiritual beliefs you have found difficult or troubling in the past.  If this is too difficult for you right now, imagine both of you meeting in a neutral space…a space beyond right and wrong.  You may invite someone you actually know, a representative of that faith or tradition, or someone else who represents those experiences and/or beliefs.  You can invite them to enter the space, as feels best to you, at a closeness or distance that also feels best to you…and where you yourself feel safe.  Take some time to talk…or be…or move with this person in a way that embodies acceptance for both of you.  See yourself saying what you want or need to say in a loving way and listen to their responses as offered in a space of love and acceptance.  If you are someone whose spirituality includes connection with the Sacred, I invite you to ask that Sacred element or experience to join you and the other.  Take a few more moments to allow your words, presence, and time together to unfold.

When you are ready, I invite you to thank all who were present.  See yourself thanking them in whatever way feels best to you.  This may be in words, silences, or movements.

When you are ready….and if you are not already there…see yourself returning to your safe space, taking in all the nourishing and centering sensations it holds for you.  

When you are ready…I invite you to begin returning to the place where you began…the room or space where you started this visualization. I invite you to return, knowing that you can always return to your safe space whenever you need or like.  It will always be there for you.  Now, I invite you, as you are ready, to begin sensing your physical body.  Notice the sensations in your arms…the sensations in your legs.  Notice how your body feels in its seated position.  You may want to begin moving your toes or your fingers…or shifting a bit in you chair.

Again, notice your breath.  Breathing in and breathing out.  And again, breathing in and breathing out. 

  And as you are ready, open your eyes and continue to slowly move your body until it is ready to stand up.  It may also be helpful to slowly walk around the room as you re-acclimate to ordinary awareness.

Utilizing Clinical Supervision to Process Countertransference

Counselors have reported a variety of counter-transference reactions when exploring religion or spirituality with their clients.  Some found work with clients to trigger their own unresolved religious or spiritual tensions (Gubi & Jacobs, 2009; Magadi-Dopman, Park-Taylor, & Ponterotto, 2011), which created confusion and ambiguity about how to proceed best with psychotherapy. In some instances, psychotherapists used psychological language to describe clients’ religious or spiritual concerns and patterns, but did not do so when describing their own spiritual identity (Magaldi-Dopman, et al., 2011). The researchers surmised that the disparity served to help psychotherapists distance themselves from potentially troubling religious or spiritual content.

Other counter-transference reactions were experienced when counselors over-identified with the religious or spiritual beliefs and struggles described by the client (Lijtmaer, 2009; Meissner, 2009). Because of perceived similarities in belief or experience, clients may not be invited to explore fully their own religious or spiritual perspectives (Meissner, 2009).  Some counselors may also choose to discuss theology instead of focusing on client issues and dynamics (Abernethy & Lancia, 1998; Meissner, 2009; Peteet, 2009).  Some may harbor the expectation that religious or spiritual communal involvement will lead to greater benefits than they actually produce (Peteet, 2009).  Additionally, because of their own commitment to their religion or spirituality, toleration of a client’s religious or spiritual questioning or doubts may prove difficult (Lijtmaer, 2009). 

Counselors whose religion or spirituality is different from their clients’ may judge the clients’ beliefs as irrational (Lijtmaer, 2009), harbor wishes to convert the client away from his or her religious or spiritual beliefs (Abernethy & Lancia, 1998; Lijtmaer, 2009), or desire to change a specific religious or spiritual understanding (Gubi & Jacobs, 2009; Peteet, 2009).  Some counselors, including those who identify as agnostic or atheist, have reported feeling envious of clients’ religious or spiritual commitment and certainty (Lijtmaer, 2009).  Also, counselors may fail to address thoroughly religion or spirituality as a result of the anxiety they experience in relation to their own religious or spiritual conflicts (Abernethy & Lancia, 1998; Lijtmaer, 2009; Zeiger & Lewis, 1998).

Clinical supervision can provide a useful context in which to work through many of these experiences.  Within our profession, it is the primary vehicle through which professional development is fostered. When counselors did report self-perceived competency in integrating religion and/or spirituality into their work, they identified experiential training and supervision as critical to the development of their clinical skills (Walker, Gorsuch, & Tan, 2005). Unfortunately, research shows that some supervisors report feeling uncomfortable or unprepared to address religious or spiritual issues in counseling and supervision (Gorsedene, 2011; Gubi & Jacobs, 2009; Wardle, 2011; West, 1997, 1998, 2011b).  Therefore, when wishing to process religious or spiritual counter-transference, it is recommended that counselors seek out a supervisor who has experience integrating religious and/or spiritual issues into counseling and supervision activities.  Important concerns to explore in supervision include (1) unresolved religious or spiritual issues that were triggered in response to clinical dialogue, (2) religious or spiritual value conflicts that surfaced during sessions, (3) ways in which religious/spiritual similarities or differences between the counselor and client may be enhancing or inhibiting counseling activities that ultimately may prove beneficial to the client, (4) any potential secondary gains counselors may experience from exploring religious/spiritual issues with their clients, and (5) methods or processes by which counselors can become aware of their counter-transference experiences in the moment and use them to foster client wellness.

 

Bibliography

Clinical Supervision

  • Aten, J. D. & Hernandez, B. C. (2004). Addressing religion in clinical supervision: A model.  Psychotherapy: Theory, Research, Practice, Training, 41(2), 152-160. doi: 10.1037/0033-3204.41.2.152
  • Frame, M. W. (2001). The spiritual genogram in training and supervision. The Family Journal, 9(2), 109-115. doi: 10.1177/1066480701092004
  • Gingrich, F. & Worthington, Jr., E. L. (2007). Supervision and the integration of faith  into clinical practice: Research considerations. Journal of Psychology and Christianity, 26(4), 342-355.
  • Ogden, K. R. W. & Sias, S. M. (2011). An integrative spiritual development model of supervision for substance abuse counselors-in-training. Journal of Addictions & Offender Counseling, 32(1-2), 84-96. doi: 10.1037/t06102-000
Counseling/Therapy
  • Cashwell, C. S. & Young, J. S. (2005). Integrating spirituality and religion into counseling: An introduction. In C. S. Cashwell & J. S. Young (Eds.), Integrating spirituality and religion into counseling: A guide to competent practice (pp. 1-9). Alexandria: American Counseling Association.
  • Cook, S. W., Dixon, L.S., & Fukuyama, M. A. (2011). Integrating sacred writings in therapy. In J. D. Aten, M. R. McMinn, & E. L. Worthington, Jr. (Eds.), Spiritually oriented interventions for counseling and psychotherapy (pp. 277-301). Washington, DC: American Psychological Association.
  • Ferguson, J. K., Willemsen, E. W., & Castaneto, M. V. (2010). Centering prayer as a healing  response to everyday stress: A psychological and spiritual process.Pastoral Psychology,  59(3), 305-329. doi: 10.1007/s11089-099-0225-7
  • Frame, M. W. (2003). Integrating religion and spirituality into counseling: A comprehensive approach. Belmont, CA: Brooks/Cole.
  • Gorsedene, C. (2011). Assessing a counsellor's use of a seemingly spiritual gift. In W. West (Ed.), Exploring therapy, spirituality and healing [Kindle DX Version] (location 3437 - 3718).  Retrieved from Amazon.com.
  • Griffith, J. L. (2010). Religion that heals, religion that harms: A guide for clinical  practice. New York, NY: Guilford Press.
  • Gubi, P. M. (2001). An exploration of the use of Christian prayer in mainstream counselling. British Journal of Guidance & Counselling, 29(4), 425-434.
  • Gubi, P. M. (2009). A qualitative exploration into how the use of prayer in counseling and psychotherapy might be ethically problematic. Counseling and Psychotherapy Research, 9(2), 115-121. doi: 10.1080/14733140802685312
  • Hall, C. R., Dixon, W.A., & Mauzey, E.D. (2004). Spirituality and religion: Implications for  counselors. Journal of Counseling and Development, 82(4), 504-507
  • Lines, D. (2006). Spirituality in counselling and psychotherapy. Thousand Oaks, CA:  SAGE  Publications.
  • Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York, NY: Guilford Press.
  • Walker, D. F., Gorsuch, R. L. & Tan, S.Y. (2005). Therapists’ use of religious and spiritual interventions in Christian counseling: A preliminary report. Counseling and Values, 
    49(2), 107-119. doi: 10.1002/j.2161-007X.2005.tb00257.x
  • Walker, D. F. & Moon, G. W. (2011). Prayer. In J. D. Aten, M.R. McMinn, & E. L. Worthington, Jr. (Eds.), Spiritually oriented interventions for counseling and psychotherapy (pp. 139-167). Washington, DC: American Psychological Association.
  • Wardle, M. (2011). Psychic energy in counseling. In W. West (Ed.), Exploring therapy, spirituality and healing [Kindle DX Version] (location 3726 - 3998). Retrieved from Amazon.com.
  • West, W. (1997). Integrating counselling, psychotherapy and healing: An inquiry into counselors and psychotherapists whose work includes healing. British Journal of Guidance & Counselling, 25(3), 291-311. doi: 10.1080/03069889708253810
  • West, W. (2000). Psychotherapy & spirituality: Crossing the line between therapy and religion. Thousand Oaks, CA: Sage Publications.
  • West, W. (2011a). Spirituality and therapy: The tensions and possibilities. In W. West (Ed.), Exploring therapy, spirituality and healing [Kindle DX Version] (location 497 - 799). Retrieved from Amazon.com.
  • West, W. (2011b). When counseling becomes healing. In W. West (Ed.), Exploring therapy, spirituality and healing [Kindle DX Version] (location 2900-3124). Retrieved from Amazon.com.
  • Young, J. S., Frame, M. W., & Cashwell, C. S. (2007). Spirituality and counselor competence: A national survey of American Counseling Association members. Journal of Counseling & Development, 85(1), 47-52. doi: 10.1002/j.1556-6678.2007.tb00443.x          
  • Young, J. S. & Cahswell, C. S. (2011). Integrating spirituality and religion into counseling: An introduction. In C. S. Cashwell & J. S. Young (Eds.), Integrating spirituality and religion into counseling: A guide to competent practice, 2nd Edition (pp. 1-24). Alexandria: American Counseling Association.
Counselor Religion and/or Spirituality
  • Magaldi-Dopman, D., Park-Taylor, & J. Ponterotto, J. G. (2011). Psychotherapists’ spiritual, religious, atheist or agnostic idnetiy and their practice of psychotherapy: Agrounded theory study. Psychotherapy Research, 21(3), 286-303
  • Morrison, M. & Borgen, W. A. (2010). How Christian spiritual and religious beliefs help and hinder counselors’ empathy toward clients. Counseling and Values, 55(1), 25-45. 
  • Smith, D. P., & Orlinsky, D. E. (2004). Religious and spiritual experience among psychotherapists. Psychotherapy: Theory Research, Practice, Training, 41(2), 144 - 151. doi: 10.1037/0033-3204.41.2.144
  • van Asselt, K. W. & Senstock, T. D. B. (2009). Influence of counselor spirituality and training on treatment focus and self-perceived competence. Journal of Counseling & Development, 87(4), 412-419.
  • West, W. (1998). Developing practice in a context of religious faith: A study of psychotherapists who are Quakers. British Journal of Guidance & Counselling, 26(3), 365-375.
Counselor Training
  • Hage, S. M., Hopson, A., Siegel, M. Payton, G., & DeFanti, E. (2006). Multicultural training in  spirituality: An interdisciplinary review. Counseling and Values, 50(3), 217 – 234.
  • Prest, L. A., Russel, R., & D’Souza, H. (1999). Spirituality and religion in training, practice and personal development. Journal of Family Therapy, 21(1), 60-77. doi: 10.1111/1467-6427.00104
  • Souza, K. Z. (2002). Spirituality in counseling: What do counseling students think about it? Counseling and Values, 46(3), 213-217.
Effectiveness Research
  • Curtis, R. & Robertson, P. (2009). Prayer and meditation: A review of research. Counselling and Spirituality, 28(2), 11-32.
  • Hodge, D. R. (2007). A systematic review of the empirical literture on intercessory prayer.  Research on Social Work Practice, 17(2), 174-187. doi: 10.1177/1049731506296170
  • Hook, J. N., Worthington, Jr., E. L., Davis, D. E., Jennings II, D. J., & Gartner, A. L. (2010).  Empirically supported religious and spiritual therapies. Journal of Clinical Psychology,  66(1), 46-72. Doi: 10.1002/jclp.20626
  • Pachula, C., Paul, S., Kennedy, C., & Mehl-Madrona, L. (2010). Using traditional spirituality to reduce domestic violence within Aboriginal communities. The Journal of Alternative and Complementary Medicine, 16(1), 89-96. doi: 10.1089=acm.2009.0213
  • Tan, S-Y. (2007). Use of prayer and Scripture in cognitive-behavioral therapy. Journal of Psychology and Christianity, 26(2), 101-111.
LGBT Concerns
  • Fallon, K. M., Dobmeier, R. A., Reiner, S. M., Casquarelli, E. J., Giglia, L. A., & Goodwin, E. (2013). Reconciling spiritual values conflicts for counselors and lesbian and gay clients. Adultspan Journal, 12(1), 38-53. Doi: 10.1002/j.21610029.2013.00014.x
  • Glassgold, J. M. (2008). Bridging the divide: Integrating lesbian identity and Orthodox  Judaism. Women & Therapy, 31(1), 59-72.
  • Hermann, M. A. & Herlihy, B. R. (2006). Legal and ethical implications of refusing to counsel  homosexual clients. Journal of Counseling & Development, 94(4), 414-418. doi: 10.1002/j.1556-6678.2006.tb00425.x
  • Hodge, D. R. (2005). Epistemological frameworks, homosexuality, and religion: How people of faith understand the intersection between homosexuality and religion. Social Work,  50(3), 207-218.

Religious or Spiritual Countertransference

  • Abernethy, A. D. & Lancia, J. J. (1998). Religion and the psychotherapeutic relationship: Transferential and countertransferential dimensions. Journal of Psychotherapy
  • Aronson, S. (2007). Balancing the fiddlers on my roof: On wearing a yarmulke and working as a psychoanalyst. Contemporary Psychoanalysis, 43(3), 451-459.
  • Lijtmaer, R. M. (2009). The patient who believes and the analyst who does not. Journal of The  American Academy of Psychoanalysis and Dynamic Psychiatry, 37(1), 99-110.
  • Meissner, W. W. (2009). Religion in the psychoanalytic relationships – some aspects of transference and countertransference. Journal of The American Academy of Psychoanalysis and Dynamic Psychiatry, 37(1), 123-136.
  • Parlow, S. & Goodman, D. M. (2010). The transformative action of the transference/countertransference relationship: A case example. Journal of Psychology and Christianity, 29(2), 116-120.
  • Peteet, J. R. (2009). Struggles with God: Transference and religious countertransference in the treatment of a trauma survivor. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 37(1), 165-174.
  • Zeiger, M. & Lewis, J. E. (1998). The spiritually responsible therapist: Religious material in the psychotherapeutic setting. Psychotherapy, 35(3), 415 – 424.