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Defining Spiritually Sensitive Social Work Practice

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 Book Review Essay
Defining Spiritually Sensitive Social Work Practice:
An Essay Review of Spiritual Diversity in Social Work Practice:
The Heart of Helping
Michael J. Sheridan
S pirituality is currently a popular topic with
society at large and with various helping pro-
fessions, including medicine, nursing, psychol-
ogy, marriage and family therapy, and social
work. This interest is evidenced in social work
by a substantial increase in publications and
presentations on the topic, steady growth in the
number of courses on spirituality offered in
schools of social work, and the establishment of
the Society for Spirituality and Social Work—
an international organization of social work
practitioners, educators, and students. One key
concept that has emerged from this increased
attention is that of “spiritually sensitive social
work”; analogous in many ways to the develop-
ment of “culturally sensitive or culturally com-
petent social work” within the profession. Ed-
ward R. Canda, PhD, and Leola Dyrud Furman,
PhD, attempt to define and explicate spiritually
sensitive social work in their recent book Spiri-
tual Diversity in Social Work Practice: The Heart
of Helping (1999). To achieve this task, the au-
thors draw from an extensive knowledge base,
including information from historical docu-
ments; sectarian, nonsectarian, and philosophi-
cal writings; cross-cultural studies and other
empirical research; and narratives rooted in
practice-wisdom.
Canda and Furman identify two broad ob-
jectives of their text. The first is to provide a
comprehensive framework of knowledge, val-
ues, and skills for social workers attempting to
use a spiritually sensitive approach in their
work. The second is to present material in such
a way as to promote personal and professional
growth in the reader. They hope that these two
objectives will result in the larger goal of read-
Sheridan / An Essay Review of Spiritual Diversity in Social Work Practice: The Heart ofCCC Code: 0037-8046/01 $3.00 © 2001
87
ers “develop(ing) a personal framework that
is congruent with their own values, profes-
sional commitments, and areas of practice” (p.
xvii).
This review explores how well the authors
reach their goal through an overview of the
content and organization of the text, an analysis
of the strengths and limitations of the book,
and an assessment of the extent to which the
material informs three larger issues currently
facing social work.
Content and Organization
The authors begin with an introduction that
identifies five principles that served as guides
for their writing: (1) demonstrating value clar-
ity, (2) respecting spiritual diversity, (3) being
reflective, (4) supporting strengths and empow-
erment, and (5) taking a holistic perspective.
They also state that they used a “comparative
educational approach” in presenting material,
which means that both similarities and differ-
ences among perspectives at all levels are exam-
ined from various vantage points. Thus, content
is considered through broad theoretical lenses
(for example, consideration of religion and
spirituality as general or universal aspects of
human experience), more specific worldviews
(for example, comparisons of how different re-
ligious and nonsectarian spiritual perspectives
approach social service), particular analytical
frameworks (for example, assessment of under-
lying assumptions, strengths, and weaknesses of
various perspectives), and personal, experiential
viewpoints (for example, the reader’s reflections
on his or her own assumptions, experiences,
and reactions).
Helping
National Association of Social Workers, Inc.
 The remainder of the text is divided into
three parts. Part 1 presents central values and
concepts for spiritually sensitive social work.
Using themes, stories, and symbols from vari-
ous personal, professional, and religious per-
spectives, this section explores the role of com-
passion and the call to service in professional
social work. It also suggests how the six core
values set forth in the NASW Code of Ethics
(service, social justice, dignity and worth of the
person, importance of human relationships,
integrity, and competence) could be applied
within the context of spiritually sensitive prac-
tice. Part 1 also discusses the challenges inher-
ent in defining and operationalizing spirituality
(and differentiating it from religion), as well as
presenting opposing viewpoints from the cur-
rent debate about the inclusion of spirituality in
social work practice and education.
In Part 2, the authors turn their attention to
issues of diversity, providing chapters on both
religious and nonsectarian spiritual perspectives
and discussing their respective implications for
social service and insights for social work prac-
tice. They also provide information on the reli-
gious and spiritual diversity found in the
United States and include a historical analysis
of the not-always-easy relationship between re-
ligion and social work. Finally, they address
some of the often difficult issues that arise when
spiritual diversity intersects with other forms of
human diversity, such as ethnicity, gender, and
sexual orientation.
In Part 3 the authors address the “how-to”s
of spiritually sensitive social work practice.
Chapters in this section include content on how
to create a spiritually sensitive context for prac-
tice; how to understand and assess spiritual de-
velopment, spiritual propensity, and the influ-
ence of participation in religious or spiritual
groups; how to use various spiritually sensitive
practice skills and techniques at both the direct
practice and organizational/community prac-
tice levels; and how to apply ethical guidelines
in determining the appropriateness of using
spiritually-derived interventions.
Given this vast array of content, Spiritual Di-
versity in Social Work Practice displays many
positive features, as well as some limitations. In
assessing these features, I draw largely on my
Social Work / Volume 46, Number 1 / January 2001
88
experiences using the text in a graduate course
on spirituality and social work practice, as well
as my own reading and scholarship in the area.
Strengths and Limitations
When considering the authors’ first objective—
to provide a comprehensive framework of
knowledge, values, and skills for spiritually sen-
sitive practice—it is apparent that they have
taken on an immense task. Not only does this
require that the text cover a lot of ground, but
also that it do so in an area that has only just
begun to produce conceptual and empirical
knowledge specific to social work. Given this,
the text does offer the most complete roadmap
to date on how to incorporate spirituality into
social work practice.
In terms of knowledge, the scope of content
previously discussed reveals that the authors
have included a wealth of information that can
serve as a basic foundation for spiritually sensi-
tive practice. One area that clearly needs to be
expanded, however, is content on working with
clergy and other spiritual leaders or groups. Al-
though there is mention of making referrals and
working collaboratively with such resources in
the discussion of ethical guidelines, more speci-
ficity regarding when and how to make such
linkages is needed. Toward this end, inclusion
of material from Delgado and Humm-Delgado
(1982), Bilich and Carlson (1994), and
Holcomb, (1993), which discuss various aspects
of working with spiritual leaders and support
systems, could be helpful in providing more
substance and detail in this area.
Some reorganization and additions to part 1
on spiritual diversity also would be helpful. As
presently written, Buddhism, Christianity, Hin-
duism, Islam, Judaism, and Shamanism are all
grouped together as religious perspectives. The
inclusion of Shamanism in this chapter is some-
what confusing, in that the authors state, “It
(Shamanism) does not refer to a particular reli-
gion, but rather to certain common underlying
features of many religions associated with di-
verse cultures and American ethnic groups” (p.
145). It is my view that Shamanism would be
better categorized as a nonsectarian, indigenous
spiritual perspective. However, the chapter
entitled “Nonsectarian Spiritual Perspectives”
includes discussion of only existentialism and
transpersonal theory, which are perhaps better
categorized as philosophical perspectives.
Therefore, I recommend that Shamanism be
included with other nonsectarian perspectives
currently not covered in the book, such as the
more earth-based traditions of Wicca and God-
dess/Feminist spirituality and that deep ecology
be included with existentialism and transper-
sonal theory as philosophical perspectives. Al-
though Canda and Furman have appropriately
stated that their purpose is only to provide an
introductory overview of the beliefs, values, and
ideals of service of various sectarian and non-
sectarian spiritual perspectives as they relate to
social work (this is not meant to be a religious
studies text), it is important to include the in-
creasingly diverse voices that exist in our cul-
ture today and clarify their common threads
and distinctions.
In terms of the other two dimensions of the
proposed framework—values and skills—
Canda and Furman provide state-of-the-art in-
struction. The book does exceptionally well at
delving into the often tricky area of values. As
stated previously, they explicitly relate the core
values of the NASW Code of Ethics to spiritually
sensitive social work. They also consistently en-
courage the reader to examine his or her own
values—both personal and professional—
throughout the text, which will be discussed more
fully in assessing the book’s second objective.
Content related to skills is primarily ad-
dressed in part 3 of the text, which identifies the
kinds of expertise needed at different points of
the service delivery process and provides exer-
cises for practicing such skills. Included in this
material is a listing of 47 “spiritually-oriented
helping activities” for practice with individuals,
families, groups, organizations, and communi-
ties. These helping activities were selected on
the basis of several criteria (for example, non-
sectarian in form, applicable to different prac-
tice situations, involving low risk), and general
contradictions, cautions, and indications are
provided also. Readers who expect the book to
be a training manual for a host of spiritually
based interventions will be disappointed, how-
ever, as the authors’ rightfully do not view that
as the purpose of the book. They do cover in
Sheridan / An Essay Review of Spiritual Diversity in Social Work Practice: The Heart of Helping
89
some detail four basic exercises (paying atten-
tion, intentional breathing, equipoise, and con-
sistency) and four additional practices (focused
relaxing, caring for the body, doing ritual and
ceremony, and practicing forgiveness) that
could be used in spiritually sensitive practice.
All of these helping activities are discussed in
light of their potential for spiritual growth and
their application to various purposes of social
work practice.
Given the noted strengths and limitations of
the authors’ presentation of a framework of
knowledge, values, and skills for spiritually sen-
sitive social work, it is apparent that Canda and
Furman do a good job of meeting their first ob-
jective. They are even more successful in
achieving their second objective—promoting
the personal and professional growth of the
reader. They achieve this by steadfastly adhering
to the five principles introduced in the begin-
ning of their book.
First of all, the importance of “value clarity”
is taken seriously. The authors consistently
highlight the need for social workers to be clear
and honest about the influence of their personal
and professional values when working with reli-
gious or spiritual matters, and they also model
this principle through explicit sharing of their
own values. Respect for spiritual diversity is evi-
dent throughout the text, as no particular reli-
gious or spiritual perspective is either promoted
or denigrated, even when critical reflection of
various perspectives is urged or discussed. In-
stead, the major emphasis is on learning how to
respond with sensitivity and competence to all
forms of religious and nonreligious spirituality
found among the individuals, families, groups,
organizations, and communities served by so-
cial workers. The benefit of being reflective
when addressing such complex and deeply per-
sonal material is stressed through various exer-
cises and direct discussion about what is re-
quired to reach a state of “reflectivity” (for
example, personal engagement, the willingness
to approach material with openness and a sense
of being in dialogue, the ability to be mindful
and introspective). A strengths and empower-
ment perspective is apparent throughout the
text as client systems at all levels are presented
as having inherent capacities for resilience,
creativity, and transformative action. Although
the supports and benefits of incorporating
spirituality into social work practice is a major
focus of the text, the problems or impediments
that religion and spirituality can produce for
both individual functioning and social justice
also are addressed. And finally, a holistic per-
spective is evident through the integration of
content on spirituality with the biological, psy-
chological, and social dimensions of the human
experience, as well as exercises that attempt to
engage the reader in a multisensory journey of
thought, feeling, and action.
Careful attention to these five principles sets
a tone for the book that is probably its greatest
strength. The book is written in such a way that
it fosters deep engagement of the material and
respectful dialogue among readers. In particu-
lar, students enjoy the use of first-person ac-
counts presented in a narrative style (clearly
identifying each author’s voice), which are in-
termixed with the more traditional third-per-
son approach to presenting academic material.
This literary device makes it easier to reflect on
one’s own attitudes and experiences and then
share them with others. The creative and varied
experiential and self-reflective exercises at the
end of each chapter also support authentic self-
exploration and interpersonal communication.
If approached as the authors suggest—as a jour-
ney, rather than as an academic exercise—it
would indeed be difficult to escape some degree
of both personal and professional growth in
reading this book.
One of the most fundamental lessons that
frequently emerges is the realization that one
can maintain one’s own particular spiritual per-
spective or faith commitment while becoming
open to the worldviews of others. It is the con-
stant emphasis on self-awareness and respectful
dialogue that makes this possible.
Informing Larger Issues
Canda and Furman’s text on spirituality and
social work is being introduced to the profes-
sion at a time when there are still differing
views about the appropriateness of the topic for
social work. Thus, one of their implicit goals is
to demonstrate both the relevance and utility of
including spirituality within the field. Some will
Social Work / Volume 46, Number 1 / January 2001
90
undoubtedly accuse the authors of shying away
from or not putting to rest several potentially
conflicting, yet relevant, issues. Canda and
Furman do discuss several concerns raised by
others (Clark, 1994; Sullivan, 1994; Weisman,
1997) in their presentation of the spirituality
debate in social work (for example, concerns
that addressing religion violates church–state
separation, focusing on spirituality results in an
overly micro perspective at the expense of a
macro justice perspective, social workers are ill-
prepared to deal with religious or spiritual is-
sues). But three issues in particular demand
more in-depth exploration; if not by the au-
thors, then by the profession.
The first issue involves two arguments that
have been posed as rationales for including a
focus on spirituality in social work. The first
can be phrased as “Religious and spiritual be-
liefs and practices are part of multicultural di-
versity,” and the second as “There’s another di-
mension of human existence beyond the
biopsychosocial framework currently used to
understand human behavior.” Although both of
these arguments have received relatively high
levels of endorsement in studies of social work
practitioners, faculty, and students, the “diversity”
rationale consistently is rated higher than the
“spiritual dimension” proposition (Sheridan,
Bullis, Adcock, Berlin, & Miller, 1992; Sheridan,
Wilmer, & Atcheson, 1994; Sheridan & Amato-
von Hemert, 1999). Inclusion of spirituality
based on the need to understand and to serve
diverse client populations effectively is not a
difficult proposal for most social workers to af-
firm. Inclusion based on the spiritual being a
legitimate dimension of reality (as opposed to a
social or psychological phenomenon), produces
far less consensus. It is at this point that discus-
sion moves into issues of ontology and cosmol-
ogy; matters that some would say are best left to
theologians and philosophers.
It is also at this point that the discussion
crosses over into the “ways of knowing” debate,
as the “spiritual dimension” is a prime example
of one of those concepts that is not easily mea-
sured; at least not though traditional research
methods. Canda and Furman recognize this
through their discussion of the “ineffability of
mystical experience and the irreducibility of the
nature of religion or spirituality” (p. 40). How-
ever, they point out that many aspects of spiri-
tuality can be defined and measured and offer
an operational model of spirituality that contains
six specific indicators: spiritual drives, spiritual
experiences, functions of spirituality, spiritual
development, contents of an individual’s or
group’s spiritual perspective, and religious ex-
pressions in individuals and groups. A review of
these six areas reveals that, indeed, they can and
are being studied using both positivist and
constructivist research methods.
The authors’ further suggest that we avoid an
“either/or” position in terms of defining spiri-
tuality or determining the best way of discover-
ing “truth.” They state that key terms pertaining
to spirituality and religion need to be carefully
defined to enhance understanding and usage in
both practice and research, but at the same
time, they ask us to remember that concepts
can never fully capture phenomena—spiritual
or otherwise. This challenges us to gain clarity
about the most appropriate role of spirituality
in social work while using multiple means of
developing knowledge in this area.
A second critical issue concerns the dividing
line between religion and social work practice.
If social workers engage in spiritually sensitive
social work, will they be blurring the roles be-
tween themselves and religious or spiritual
leaders? When, for example, does spiritually
sensitive practice become spiritual direction? In
its attempt to be holistic, is social work moving
into areas that are best left to other disciplines
and professions? Canda and Furman address
some of these questions by offering specific
ethical guidelines, which outline certain neces-
sary conditions for the use of spiritually based
activities. Based on the presence or absence of
these conditions (for example, a conducive
practice setting, the client’s expression of inter-
est, the nature of the client-worker relationship,
and specific worker qualifications), practition-
ers are advised whether it would be appropriate
to engage in private spiritually based activities,
refer to outside spiritual support systems, ac-
tively collaborate with such support systems,
directly use spiritually based activities on re-
quest of the client, or use such activities based
on the worker’s own initiative.
Sheridan / An Essay Review of Spiritual Diversity in Social Work Practice: The Heart of Helping
91
This proposed model of ethical consider-
ations is an important contribution to the field;
one that is very much needed based on the re-
sults of a recent study of licensed clinical social
workers (Sheridan, 2000). Findings showed
that most respondents did not use the ethical
guidelines suggested by Canda and Furman in
determining either their personal comfort with
or their views about the appropriateness of 24
different spiritually based interventions. Fur-
thermore, results revealed both over- and
underutilization of such interventions, raising
concerns about both ethical and effective prac-
tice with clients. As significant percentages of
practitioners continue to address religious or
spiritual issues in practice (Canda & Furman,
1999; Derezotes, 1995; Sheridan, Bullis, Adcock,
Berlin & Miller, 1992), it is even more impera-
tive that clarity about the appropriate bound-
aries of social work practice be delineated.
Finally, the third—and perhaps most diffi-
cult—issue is what to do with religious or
spiritual perspectives that hold beliefs or values
that are in direct conflict with social work val-
ues, especially in the area of diversity. How do
we value and create space for all forms of reli-
gious and spiritual diversity when some per-
spectives take a nonvaluing or exclusionary
stance toward other religious or spiritual tradi-
tions or other forms of human diversity? Such
potential for conflict abounds in our society.
For example, is not the recent call for Southern
Baptists to pray for the conversion of believers
of other religious groups, such as Jews and
Muslims, contrary to the social work value of
self-determination? Is not the position of ad-
herents of several orthodox belief systems re-
garding homosexuality (whether it be con-
demning the person or the behavior)
incompatible with social work’s commitment
to social justice for oppressed groups? What
about a myriad of other issues—such as abor-
tion, the death penalty, the role of the wife in
marriage, means of child discipline, involve-
ment in war—which can all pose real dilemmas
for social workers? And how should we respond
to those who report that the profession dis-
criminates against adherents of conservative or
orthodox beliefs (Ressler & Hodge, 2000) and
promotes its own particular brand of liberal or
progressive ideology that everyone is expected
to follow (Hill, 1987)?
These questions can produce considerable
discomfort in social worker practitioners and
educators, either when they engage in work with
clients or students or when they arise within
themselves or with colleagues. Canda and Furman
generally do not provide explicit answers to
such questions. They come closest to taking a
particular stand in their discussion of four pos-
sible Christian ideological positions on homo-
sexuality, suggesting that responses that condemn
either the person or the behavior are not consis-
tent with social work values. Instead, they con-
tinually stress the need for open and respectful
dialogue about such differences or conflicts, an
approach that is probably not only prudent at
this point in our evolution, but has the most
promise of being productive. What does some
seem clear, however, is that taking an “out of
sight, out of mind” approach to such issues will
not produce any satisfactory resolutions for in-
dividual social workers or the profession.
These larger issues—defining the scope of
social work and developing a relevant knowl-
edge base, determining the appropriate bound-
aries of social work practice, and specifying so-
cial work’s stance on various social justice
concerns—are all central to the profession and
have emerged numerous times before the cur-
rent conversation about spirituality. Although
Canda and Furman’s text does not provide ab-
solutes as to how these issues should be handled
in regard to spiritually sensitive social work
practice, it does set the stage for thoughtful and
meaningful discussion and, most important,
provides a process for how to begin to talk with
one another. This, coupled with the invaluable
content and other positive features of the text
that have already been highlighted, makes their
work a major contribution, not only to the
study of spirituality, but also to the overall pro-
fession as well. It is critical that the rest of us
join with them in a process of honest self-reflec-
tion and authentic dialogue as we continue our
exploration of this important topic. ■
References
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clergy working together: Linking the psychologi-
Social Work / Volume 46, Number 1 / January 2001
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Michael J. Sheridan, PhD, is associate professor,
School of Social Work, Virginia Commonwealth
University, 1001 West Franklin Street, Box
842027, Richmond, VA, 23284-2027; e-mail:
msheri@atlas.vcu.edu.