Establishing the Validity of the Spirituality in Clinical Training Scale: Measuring the Level of Integration of Spirituality and Religion in Family Therapy Training

The existing literature suggests that family therapy training programs are not adequately preparing students to address spiritual and/or religious beliefs as a resource for change in therapy. Therefore, this study sought to validate the Spirituality in Clinical Training Scale (SCTS) as a measure of the level of integration of spirituality and/or religion in family therapy training. Additionally, this study examined the latent associations among the subscales of the SCTS and measures of personal importance of spirituality, spiritual clinical competence, and spiritual self-exploration. Finally, given that the type of educational institution (i.e., religious compared to non-religious schools) may influence the extent to which spirituality is addressed in training, this study examined whether attending a religious or non-religious institution moderated the associations among the SCTS and constructs used to assess validity. A sample of 341 master’s and doctoral family therapy students completed an on-line survey for this study. The results suggest that the SCTS is a reliable and valid measure for assessing integration of spirituality into family therapy training. The establishment of this measure is important given that no previous scale measuring the integration of spirituality into therapy training exists. The results also suggest that spiritual self-exploration is associated with increased use of interventions that integrate spirituality into therapy. Implications for clinical training are discussed.     

Couple Therapy and Spirituality and Religion

Abstract

The current state of the art of the integration of couple therapy with spirituality and religion is presented. Each of three waves of this integration identified in this article have seen an increase in the literature in this area, although only a limited amount in each wave has addressed couple therapy specifically. In the first wave, from 1990–1994, articles set forth arguments for why spirituality should be integrated in therapy. During the second wave, 1995–1999, publications focused on the ways that including spirituality in therapy can enhance as well as harm the therapeutic process. In the third wave, 2000-present, attention has shifted away from whether to include spirituality to how it should be included, and the literature of this period features many practical interventions and suggested guidelines for integrating spirituality and religion into therapy and training. The article concludes with recommendations for further developing the integration of spirituality and religion into couple therapy models, research, and training.     

Spirituality and religion in training, practice and personal development

In the midst of a revitalized interest in spirituality and religion in Western societies, there has been reported a resurgence of activity regarding spirituality and religion in the mental health professions, including marriage and family therapy (MFT). Little is known, however, about the beliefs, behaviours, and training experiences of MFT graduate students. Therefore it is important to examine the training (education and supervision) needs in this area. For this initial study, a sample of US MFT graduate students were surveyed regarding their spiritual and religious attitudes and practices in their personal and professional lives. In most areas, graduate students were found to be similar to the previously published reports of practising professionals. In other areas, they report even more investment in spirituality and religion. The results of the survey suggest a need to include systematic attention to these areas in graduate training curricula and in the professional supervision process.     

Connections and Themes of Spirituality in Family Therapy

In this article, we provide an overview of current considerations of spirituality in family therapy literature and practice. We suggest that whatever practice of therapy is undertaken, implicity or explicitly it will reflect views on the connection between spirituality and family therapy--connections involving clients' and therapists' beliefs. A thematic framework based on dimensions of the instrumental and metaphysical is outlined. Clinical approaches and practices within these connections are discussed.     

Integrating Religion and Spirituality in Marriage and Family Counseling

In the fields of counseling and psychology, interest in religious and spiritual issues is expanding. The authors examined integrating religion and spirituality with marriage and family counseling. They explored potential obstacles and negative consequences for this integration, as well as clinical implications. The positive impact of incorporating a religious or spiritual perspective into clinical practice is discussed. Ethical considerations, techniques, and strategies are presented.     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

Gendered Training: Men and Men's Issues in Marriage and Family Therapy Programs

Few studies examine men's experiences in becoming a therapist. Only a modicum of attention appears to be paid to men's professional training needs in MFT training programs as expressed in the family therapy literature. Five recommendations, based on the author's experiences and male student voices, are provided for how to best meet the needs of male students in MFT training programs. These recommendations are (1) be aware of men's experiences and don't assume silence means disinterest, (2) develop depth in clinical training on men's issues, (3) incorporate theories of masculinity into curriculum, (4) engage male students in the training process, and (5) provide support to male students through mentorship and support groups.     

Spiritual and Religious Discussions in Family Therapy: Activities to Promote Dialogue

Spirituality and religion are valued constructs for a large population in America. Each person carries a set of values and beliefs that may aid in their well-being. Spiritual and religious discussions within therapy can be essential for treatment. As therapists, we are expected to provide a safe therapeutic atmosphere for our clients. Therefore the therapist has the responsibility to be aware of personal issues and to integrate spiritual/ religious discussions. In addition, levels of differentiation are important in understanding the self of the therapist. The authors propose that therapists must be aware of their personal level of differentiation in order to effectively integrate spiritual/religious discussions in therapy.     

Therapists' Integration of Religion and Spirituality in Counseling: A Meta‐Analysis

The authors conducted a 26‐study meta‐analysis of 5,759 therapists and their integration of religion and spirituality in counseling. Most therapists consider spirituality relevant to their lives but rarely engage in spiritual practices or participate in organized religion. Marriage and family therapists consider spirituality more relevant and participate In organized religion to a greater degree than therapists from other professions. Across professions, most therapists surveyed (over 80%) rarely discuss spiritual or religious issues in training. In mixed samples of religious and secular therapists, therapists' religious faith was associated with using religious and spiritual techniques in counseling frequently, willingness to discuss religion in therapy, and theoretical orientation.     

Religion and Spirituality in Variously Accredited Counselor Training Programs: A Comment on Pate and High (1995)

Accreditation standards for counselor preparation have the potential for bringing appropriate consideration of religious and spiritual issues into the training of counselors. This article extends Pate and High's (1995) study of CACREP-accredited programs and includes data comparing the attention given to religion and spirituality in programs accredited by several different counselor and therapist-training accrediting bodies.     

Spiritual,Religious, Nonspiritual,and Nonreligious Narratives in Marginalized Older Adults: A Typology of Coping Styles

SUMMARY

Narrative therapy is an important tool in the phenomenological framing of life events with older clients. Seventy-nine older adults who lived independently in four subsidized high-rise housing facilities in Chicago were interviewed in a research project about managing life challenges. Cases represent four types in a spiritual-religious typology: religious and spiritual, religious only, spiritual only, and neither religious nor spiritual (Zinnbauer, 1997). This article explores how older adults managed adversity and maintained a sense of self-efficacy. Findings indicate that older adults use many references to religion and spirituality in their narratives, either embracing these domains or defining themselves in contrast to them. Narrative therapy suggests that the implications of religious and spiritual resources addressed in client stories may reinforce coping capacity and promote aging well.     

The Imagination of Images and Images of Imagination: How the Imagination Relates to Aging,Health, and Spirituality

ABSTRACT

Psychological literature suggests that religion and spirituality increase in late adulthood. Yet, operational definitions of spirituality and religiosity remain widely debated and inadequate for the concepts they are designed to measure. The empirical studies of religion and spirituality as one ages are of poor design and often measure only limited aspects of religion or spirituality. Few empirical studies exist which have been conceived to only study religiosity and spirituality in late adulthood. The purpose of this study was to determine the defining aspects of religiosity and spirituality using the Allport, Ross Intrinsic, Extrinsic Religiosity Scale, Ellison's Spiritual Well-Being Scale, and Neugarten's Life Satisfaction Instrument. Using a principal component factor analysis, the study examined the factor structure using an older adult sample of 320 individuals 65 years of age and older. Having a purpose in life combines with intrinsic religious questions for the first factor. Life satisfaction questions group together on two factors and extrinsic religiosity is clearly one factor. The scales used hold together well when combined. A new, shortened scale to measure aspects of religiosity and spirituality is proposed.     

Community,Affect, and Family Relations: A Cross-Cultural Study of Spiritual Resiliency in Eight Old Women

ABSTRACT

Paying attention to emotionally resilient persons is long overdue, particularly resilient old persons. Because seniors frequently cite religious faith as a primary source of strength during difficult losses and transitions, we asked how old women might be empowered by their spirituality to transcend significant losses and traumatic family events. Using triangulated methods, a feminist perspective and symbolic interactionism, we conducted focus groups and eight in-depth interviews with women over 65 in the United States and Germany. Themes of community, affect, and relationality occurred repeatedly in the narratives, revealing both unique and universal aspects of the women's spiritualities and confirming the centrality of religion as a neglected factor in family studies research.     

Dropping Out of Couple Therapy

Abstract

Current literature on dropouts in marriage and family therapy includes few studies that focus exclusively on couple therapy and only a limited number of qualitative studies. Clients' perceptions of premature termination are seldom considered. This qualitative case study describes, from both the clients' and the therapist's perspectives, one couple's experience of dropping out of couple therapy after three, sessions. Findings from this case study are compared with existing literature and a fourfold typology of dropouts is proposed. We offer recommendations for future research of dropouts in couple therapy.     

Psychodrama: Rehearsal for Living

Abstract

The current study examined therapist characteristics that are related to the use of spiritual and religious interventions in group therapy and to perceived barriers to attending to spirituality in group therapy among a sample of experienced group therapists. Results demonstrated that greater therapist spirituality was associated with more frequent use of both spiritual and religious interventions, as well as lower perceived barriers to attending to spirituality in group therapy. Religious commitment was only uniquely related to perceived barriers, such that therapists with higher religious commitment actually perceived greater barriers. Training in religion and spirituality and comfort with spiritual discussions was also related to therapists’ use of religious and spiritual interventions and perceived barriers.     

Religion and spirituality along the suicidal path

The inner experience of spiritual and religious feelings is an integral part of the everyday lives of many individuals. For over 100 years the role of religion as a deterrent to suicidal behavior has been studied in various disciplines. We attempt to systematize the existing literature investigating the relationship between religion/spirituality and suicide in this paper. After an overview of the attitudes of the dominant religions (e.g., Catholicism, Islam, and Buddhism) toward suicide, the three main theories that have speculated regarding the link between religion and suicide are presented: "integration theory" (Durkheim, 1897/1997), "religious commitment theory" (Stack, 1983a; Stark, 1983), and "network theory" (Pescosolido & Georgianna, 1989). Subsequent to this theoretical introduction, we report on studies on religion/spirituality keeping the suicidal path as a reference: from suicidal ideation to nonlethal suicidal behavior to lethal suicidal behavior. Studies presenting indications of religious beliefs as a possible risk factor for suicidal behavior are also presented. The last section reviews possible intervention strategies for suicidal patients and suicide survivors. Indications for future research, such as more studies on nonreligious forms of spirituality and the use of qualitative methodology to achieve a better and deeper understanding of the spiritual dimension of suicidal behavior and treatment, are offered.     

How to Talk to Christian Clients About Their Spiritual Lives: Insights From Postmodern Family Therapy

Responding to literature calling for the integration of Christian spirituality and postmodern thinking, this article presents a more specific discussion of how postmodern family therapy approaches can be used to open therapy to the spiritual lives of Christian clients. In this article, postmodern family therapy approaches are described and the compatibility of postmodern family therapies and Christian thinking are examined. Finally, we see how a clinical practice based upon postmodern ideas can provide pastoral counselors with useful tools for talking with Christian clients about their spiritual lives. P. Gregg Blanton is Professor of Human Services at Montreat College. He is affiliated with the Pastoral Counseling and Growth Center in Asheville, NC.