Ethical considerations of integrating spiritual direction into psychotherapy

Integrating spirituality and religion into clinical practice or psychotherapy has become a significant area of interest in the mental health field today. This article focuses more specifically on integrating spiritual direction into psychotherapy, discusses ethical issues involved, and suggests ethical guidelines for the appropriate and helpful use of spiritual direction in the context of psychotherapy and counseling.     

New faces of spiritual pride

Contemporary counseling and psychotherapy, including pastoral counseling and psychotherapy, frequently claim as their domain the total person, including the spiritual dimension. Within the traditions of spiritual direction is a deep concern for the phenomenon of spiritual pride, If counseling and psychotherapy are to deal with the person's spiritual development, counselors ought to be aware of this disruptive dynamic. It is suggested that the counselor's own personhood may be a primary condition for leading to spiritual pride and that the process of termination may be a specific illustration of this phenomenon. The negative power of spiritual pride is significant in that it leads to premature closure relative to the growth process.     

The sociology of regulation: the case of psychotherapy and counselling and the experience of the arts therapies

ABSTRACT

This article draws on insights from the sociology of professions to explore the regulatory debate in the psychotherapy and counselling field contrasted with the regulation of arts therapists (art, drama and music therapists). A partial explanation is offered, illustrating the applicability of theory to these groups, but with adaptations to reflect the modern context in which professions and regulation now exist.     

Spiritual Psychotherapy for Antisocial and Psychopathic Personalities: Some Theoretical Building Blocks

Until now a profound theoretical model for spiritual psychotherapy, which is constructed specifically for nonreligious antisocial and psychopathic patients who have spiritual and philosophical interests, is missing. In this paper some important theoretical issues with respect to spiritual psychotherapy for antisocial and psychopathic patients will be discussed such as the links between spirituality on one hand and authenticity, vanity; emotional, moral, and social capacity; reality testing; creativity; and faith in life on the other. Furthermore, the spiritual psychotherapist's attitude towards his or her patients will be explored.     

The baby and the bathwater: 'Professionalisation' in psychotherapy and counselling

The current rush to professionalisation in the field of counselling and psychotherapy, and some of its deleterious effects, are examined. The parallels between this process and the experience of psychoanalysis in the USA in the 1940s and early 1950s are demonstrated, quoting from contemporary critics; and comparisons are drawn with the American phenomenon of managed care. An account is offered of what is happening in terms of the sociology of professions, suggesting that 'expert systems' are being substituted for 'local knowledges—skills and wisdoms which cannot be fully systematised. The argument that this process is for 'the good of the client' is considered and rejected. Finally, some thoughts are presented about the likely future for counselling and psychotherapy, arguing that the victory of professionalisation and expertise is unlikely to be complete.     

The practice of psychotherapy and spiritual direction

The author compares and contrasts insight-oriented psychotherapy, supportive psychotherapy, and spiritual direction in relation to goals and methods; management of resistance, transference, and countertransference; and selection criteria. The enhancement of spiritual formation through insight-oriented psychotherapy and supportive psychotherapy is also discussed.     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

An empirically-based rationale for a spiritually-integrated psychotherapy

In this paper, we offer an empirically-based rationale, for a particular kind of psychotherapy, spiritually-integrated psychotherapy. Drawing on several lines of research we note that: (1) spirituality can be a part of the solution to psychological problems; (2) spirituality can be a source of problems in and of itself; (3) people want spiritually sensitive help; and (4) spirituality cannot be separated from psychotherapy. We then discuss the defining characteristics of spiritually-integrated psychotherapy. It is based on a theory of spirituality, empirically-oriented, ecumenical, and capable of integration into virtually any form of psychotherapy. The paper concludes by considering potential problems associated with spiritually-integrated psychotherapy, including the risks of trivializing spirituality as simply a tool for mental health, reducing spirituality to presumably more basic motivations and drives, imposing spiritual values on clients, and overstating the importance of spirituality. Perhaps the greatest danger, however, is to neglect the spiritual dimension in psychotherapy. This paper sets the stage for the articles in this special issue of MHRC which describe the development and evaluation of several innovative approaches to spiritually-integrated psychotherapy.     

Recovery,Spirituality and Psychotherapy

This article concerns the relationship between addiction recovery, spirituality and psychotherapy. Since its founding, members of AA have been encouraged to pursue a spiritual life. They have also sought psychotherapy. A paradox obtains, because 51 % of therapists are atheists. Others have little awareness of the dynamics of the spiritual life. The developmental process of the spiritual life is discussed, and suggestions are made regarding how a therapist might be helpful in this process.     

In Search of a Paradigm for Psychological and Spiritual Growth: Implications for Psychotherapy and Spiritual Direction

This article presents categories, drawn from the work of Abraham Maslow and Paul Tillich, which can be used to explore the similarities and differences in psychological and spiritual growth. While both dimensions of growth are interrelated, they are neither synonymous as terms nor fused as processes. Models for psychological growth cannot be superimposed onto spiritual growth because of some significant differences in the way in which self-awareness, spirit, and self-transcendence are defined and used by psychology and theology. It follows that psychotherapy and spiritual direction make unique contributions to human growth and need not be perceived as synonymous or competitive. There is a point at which psyche and spirit, psychotherapy and spiritual direction, meet: the place of healing.     

Ambiguity: Spiritual and psychotherapeutic aspects

Ambiguity is treated here as one of the interfaces between spirituality and psychotherapy. The multiplicity of spiritualities and the characteristics of spiritual leaders are discussed, the latter contrasted with the tenets of traditional psychotherapy. Similar and integrative aspects of spiritual and psychotherapeutic sojourners are examined.     

Bridging Psychology and Theology When Counseling Older Adults

SUMMARY

Seniors raise many questions for counselors; some of these questions directly impact what can be called spiritual concerns. Yet, finding a consistent definition of what a “spiritual concern” is has challenged all of the major counseling professions. In this paper the author calls upon the work of Paul Tillich in dialogue with that of Viktor Frankl to bridge the theological definitions of spiritual concern with psychological intervention.     

Psychotherapy and Religion: Rapprochement or Antithesis?

Religion and psychotherapy have long maintained separate directions, currently manifested in four viewpoints: orthodox, atheistic, neutralist, and moderate. Although each therapeutic viewpoint is distinct, each contains the seed for rapprochement. The need for a rapprochement that provides professional psychotherapy capable of addressing religious issues is clearly voiced by laypersons, who are clients or potential clients, and by members of the clergy and psychotherapeutic professions. Increasing numbers of ministers now receive professional preparation for pastoral counseling. It is timely for those in the counseling professions to consider seriously specialized education and certification in religious counseling for secular psychotherapists.     

Everything you always wanted to know about therapy (but were afraid to ask): Social,political, economic and clinical fragments of a critical psychotherapy

Three seemingly consensual propositions concerning psychotherapy and counselling are examined critically. All turn out to be unreliable, tendentious and even damaging: (i) Psychotherapy and counselling can be free and independent professions provided therapists, acting together, fight for them to be that way. (ii) Psychotherapy and counselling are private and personal activities, operating in the realms of feelings and emotions – the psyche, the unconscious, affects rooted in the body. Above all other factors, the single most important thing is the therapy relationship between two people. (iii) Psychotherapy and counselling, and psychotherapy are vocations, not jobs. Therapists are not only motivated by money. In developing his critiques of these propositions, the author utilizes social, political and economic perspectives. The author reviews new clinical thinking on the active role of the client in therapeutic process and suggests that a turn to the legendary figure of the Trickster might be of benefit to the field. The author locates his arguments in his experience of the politics and practices of psychotherapy and counselling, and engages in self-criticism.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

Effects of Childhood Sexual Abuse on Client Spiritual Well‐Being

Forty‐three individuals receiving psychotherapy for childhood sexual abuse and 34 clients who sought psychotherapy for other reasons were compared on several aspects of spiritual functioning. The 2 groups did not differ significantly in spiritual well‐being. However, both groups scored lower than samples of medical outpatients and hospice workers. Most reported initiating and discussing spiritual issues during therapy, were satisfied and comfortable with these discussions, and rated spirituality as important to problem resolution. They also listed several obstacles to spiritual development. Possible research and practice implications are discussed.     

Therapist Spiritual and Religious Values in Psychotherapy

In training and in supervision, counselors learn to be cognizant of personal values (e.g., spirituality, religiosity), yet they are enjoined to except them from practice. This article examines the nature of therapist spiritual and religious values and the impact of these values on the practice of psychotherapy. A goal of effective treatment should be the integration of therapist spiritual and religious values with therapist epistemic values in order to accommodate the spiritual and religious needs of both client and counselor. Counselor spiritual and religious values can contribute to therapy, even when the therapist is engaged in a dialectic involving personal and epistemic values.     

Sprirtual aspects of psychotherapy

This article addresses the relevance of spirituality to psychology and psychotherapy. It argues that spiritual experience is phenomenologically legitimate and worthy of study, especially by students of mental health. It utilizes Fox's (1985) definition of spirituality as unitive experience to show that spiritual experience is often present, overtly or covertly, within the ritual of psychotherapy. The paper argues that the therapist's adoption of an empathic posture is essentially a spiritual position. This position consists of a sense of peace, eternity, forgiveness, faith, love, truth, and God. These aspects are part of an integrated spiritual gestalt which is, though generally unacknowledged, fundamental to the communal healing process of psychotherapy. The paper concludes by asserting that greater involvement with the unitive (as opposed to the disunitive) represents a positive paradigmatic shift for psychology and humanity.     

Researching the “therapeutic relationship” in psychoanalysis,counselling psychology and psychotherapy—a qualitative inquiry

This paper reports the methodology of a research project based on and including a review of almost 1000 texts and more than 20 years of learning and supervised practice as clinician and supervisor in the psychotherapeutic professions on the nature of the therapeutic relationship. Following a pilot study by five years, the findings were reported in a 165,000 word document which encompasses poetry, personal experience, many textual extracts of theory or therapeutic dialogue, other research reports, theoretical considerations, clinical reflections, syllabus constructions—a postmodernist assemblage which nonetheless attempts coherence, validity and reliability. The findings have also been tested in the field for example by: (a) providing the framework for at least one four-year psychotherapy training course from which the first students have recently graduated by external assessment and (b) an independent psychotherapy accreditation process by a case study submission. It is argued that clinical practice or supervision should be inseparable from research—Particularly qualitative research in psychology.