Spirituality in Psychiatric Social Work Practice

Chairperson: Dr. R. Parthasarathy Discussant: Mr. Ubahara Sahayaraj Presenter: Jobin Tom
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Order of Presentation
‡ Spirituality ± Meaning ± Components ± Difference between Religion and Spirituality ± Spirituality in atheist and theist ‡ Spiritual Intelligence ± Meaning ± Components ± Measurement

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Order of Presentation
‡ ‡ ‡ ‡ Social Work evolution out of Spirituality Spirituality and Mental Health Evolution of PSW using spirituality Application of spirituality in PSW
± ± ± ± Prevention Promotion Treatment Rehabilitation

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Order of Presentation
‡ Spirituality and Client ‡ Spirituality and Therapist ‡ Spirituality and Treatment methods ‡ Barriers in therapy related to spirituality ‡ For Better Psychiatric Social Work Practice

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Spirituality
Meaning:‡ animating force ‡ incorporeal consciousness ‡ lacking material form or substance ‡ intangible [out-of-body experience ‡ heavenly mindedness

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Altruism 6 . Acceptance of the sacredness of nature and of all human experience 4. Belief in a greater self or personal self 2. A sense of purpose in life and quest for meaning 3. Knowledge that ultimate fulfillment is found in spirituality and not in material things 5.Spirituality (David Elkins 1990) 1.

Awareness of suffering and death 8.Spirituality (David Elkins 1990) 6. and whatever they consider to be ultimate 9. Leading life that has a positive effect on people. Idealism 7. Transcendent reality 7 . nature.

‡ Spirituality is a word that has been used to describe the human need for meaning and value in life and the desire for relationship with a transcendent power (Clineball. 1995) 8 .

making sense of life) ‡ Value (Having cherished beliefs and standards) ‡ Transcendence (Appreciating a dimension that is beyond the self) ‡ Connecting (Relating to others. ultimate others) ‡ Becoming (Which involves reflection. nature.Spirituality Includes The Following Aspects ‡ Meaning (having purpose. allowing life to unfold. and knowing who one is) 9 .

practices. laws. and prescribed rituals (Worthington. which are linked to an explanation of the creation and governance of the universe. cumulative traditions. rituals. ‡ Religion may be defined as an organized system of faith. worship. 1989) 10 . and assignments of authority.Religion ‡ Religion may be understood sociologically as a formal set of beliefs. doctrines.

So it is that virtually all religions seek to bind their members or followers to vows or covenants of acceptance 11 . in the sense that we are bound to the promises we make.‡ The basic definition of religion is to bind.

or other supernatural phenomena is not required for one to have spiritual experiences. Gods. Belief in God. do not even subscribe to the idea of God or gods! 12 . it is not. In fact. In fact some organized religions including Buddhism.Spirituality and Atheist ‡ There are many who would find the phrase 'atheist spirituality' to be a contradiction in terms.

Spiritual experiences are almost universal to the human experience.‡ While many express their spirituality through their religious practices religion doesn't have a monopoly on spirituality itself. it may be difficult to recognize and identify spiritual elements in the atheist's life but nevertheless. they can usually be found. 13 . Without the trappings of religion.

Spirituality Vs Religiosity Spirituality ‡ Not organized ‡ Value oriented ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Religiosity Organized system Holy Days Sacred Writings Sacred Symbols Prayer and Meditation Beliefs Affecting Diet/ Nutrition Beliefs Related To Healing Beliefs Related To Dress Beliefs Related Birth Beliefs Related Death 14 .

the intelligence with which we can place our actions and our lives in a wider. the intelligence with which we can assess that one course of action or one life path is more meaningful than another (Zohar & Marshall). richer. 15 .Spiritual Intelligence ‡ Spiritual Intelligence is the ultimate intelligence which we address and solve problems of meaning and value. meaning-giving context.

3. 6. 5. 9. 10. 2. 4. Getting the Big Picture Exploring our Values Our Life Vision and Purpose Understanding yourself and others : Compassion Give and receive :Charity and Gratitude Power of Laughter Child like qualities Power of rituals Peace Love 16 .Components Of Spiritual Intelligence 1. 7. 8.

‡ Spiritual intelligence is self actualization (Maslow) ‡ Creativity ‡ Playful ‡ Joyful ‡ Tolerance ‡ Sense of purpose ‡ Mission to help others ‡ Happiness and bliss .

Equanimity Equanimity 18 .

Indicators Of Spiritual Health ± ± ± ± ± ± ± ± ± Faith Hope Meaning and purpose in life Achievement of spiritual world Feelings of peacefulness Ability to love Ability to forgive Ability to pray Ability to worship 19 .

Indicators of spiritual health ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Spiritual experiences Participation in spiritual rites and Participation in meditation Participation in spiritual reading Interaction with spiritual leaders Expression through song/music Expression through writing Expression through art passage 20 .

feelings and beliefs 21 .Indicators of spiritual health ‡ Connectedness with inner self ‡ Connectedness with others ‡ Interaction with others to share thoughts.

22 . Hodge (2005) expressed concern that the field may be faithblind which may be harmful to religious groups who have a history of oppression.Social Work Evolution Out Of Spirituality ‡ The field of social work has historically been concerned about imposing religion or spirituality onto clients.

religion. as often does when change occurs. Anything related to religion was seen as bad and thus taken out of social work. what happened. the baby was thrown out with the bath water. and social work in this way. 23 .‡ Krieglstein (2006) explains the change in the relationship between spirituality.

24 . ‡ Presence of another dimension of human existence beyond the biopsychosocial framework used to currently understand human behavior. ‡ Religious and spiritual beliefs and practices are part of multicultural diversity.Rationale For Including A Focus On Religion And Spirituality In Social Work.

25 .‡ Spirituality is inherent in the human condition so in whatever setting a social worker is working. I cannot think of a single biopsycho-social problem that does not have a spiritual component (Miller. 2001). these issues will be relevant and It s a part of the human condition.

26 .Religion and Mental Health ‡ The meta analysis provided by Larson et al (1992) is the most comprehensive review of the field examining 200 psychiatric and psychological studies which repeatedly asserted the connection between religious involvement and desirable mental health outcomes.

and stress. lower levels of crime and delinquency.‡ Ellison & Levin (1998) state there is a connection between religious involvement which promotes health related conduct. in some instances there is an inverse relationship between religious involvement and substance use and abuse. 27 .

‡ Additionally. ± Increased support. Ellison & Levin (1998) have found religious involvement correlated to ± Greater marital quality. ± self-worth. 28 . ± Enhanced feelings of self-esteem. ± Self-efficacy.

self efficacy. and decreased depression for elder Korean and Chinese Americans (Lee. 2007) and for Orthodox Jews (Flannelly.al) 29 . et. K.‡ Religious coping skills and greater forgiveness were associated with increased life satisfaction.

Psychotherapist therefore literally means servant or attendant of the soul. 1992) 30 . (Tick.Evolution Of Psychotherapy Using Spirituality ‡ The word Psychotherapist is derived from the Greek word Psyche meaning soul or breath of life and therapeia denoting attendant of the soul.

‡ Counseling and psychotherapy have spiritual origins to be found in practices of witches. (Benner. and given to medical professional. ‡ In 20th century people are taken care by professionals than others. 31 . priests etc. 1988) ‡ In 19th century care of the mentally ill was taken away from church and others.

‡ Carl Jung said that spirituality and spiritual experiences are potential healthy aspect of our being. 32 .

and deeds.Application of spirituality in PSW To Prevent Mental Illness & To Promote Mental Health ± Adopting healthy values ± Self Understanding Limits and Levels of functioning ± Religion of Love Helpfulness in thoughts. words. ± Enjoying ordinary occurrences 33 .

Treatment of Mental Illness ± Strengthening of optimism ± Acceptance of Difficulties ± Improved self efficacy ± Avoid self Glorification of the therapist ± Clients needs and problems are given prime importance 34 .

± Seeking social support for recovery and aftercare 35 . family and community ± Being compassionate and instilling compassion in others.Rehabilitation of Mentally ill ± Exploration of all possible potentials of Rehabilitation in the individual.

36 . to maintain serenity ± Acceptance of the illness and its consequence ± Readiness to take appropriate action.Spirituality and Client ± Motivated to take positive actions ± Failure in the process is not discouraging ± Trust in the therapist strengthened ± Facilitated to practice yoga/meditation.

Therapists should examine their own prejudices and biases around spirituality and religion. both positive and negative 37 .Spirituality and Therapist 1.

Therapists should familiarize themselves with some of the literature around spiritual experience and pastoral therapy and spiritual direction 38 .2.

Therapists should explore a religion from different culture than their own including attending a religious service 39 .Spirituality for practicing psychotherapists and counselors 3.

Spirituality for practicing psychotherapists and counselors 4. Therapists should address the assessment issues involved 40 .

Spirituality for practicing psychotherapists and counselors 5. Therapists should develop a sense of some of the main maps and theories of spiritual development 41 .

Therapists should study implicit and explicit spiritual forms of counselling 42 .Spirituality for practicing psychotherapists and counselors 6.

Spirituality for practicing psychotherapists and counselors 7. Therapists should clarify the differences and overlaps between spiritual direction. 43 . pastoral care and counselling or psychotherapy.

44 . Therapists should be engaged in their own form of spiritual development.Spirituality for practicing psychotherapists and counselors 8.

men s and women s groups) Use spiritual language or metaphors Pray privately for client Explore spiritual elements in dreams Use or recommend spiritual books Bullis (1996) 45 ‡ ‡ ‡ ‡ .Spirituality and Treatment Methods ‡ ‡ ‡ ‡ Explore client s spiritual background Explore client s religious background Help clients to clarify spiritual values Recommend participation in spiritual programmes (Mediation groups. 12 step programmes.

Spiritual Practices Affecting Patient Care ‡ Assess client s spiritual needs. 46 . resources and preferences ‡ Follow the client s expressed wishes regarding spiritual care ‡ Do not prescribe or urge clients to adopt certain spiritual beliefs or practices and do not pressurize them to relinquish such beliefs and practices ‡ Strive to understand personal spirituality and how it influences care giving ‡ Provide spiritual care in a way that is consonant with personal beliefs.

have limited denominational expertise and are spiritually immature . spiritual interventions are less likely to be used effectively and ethically by therapists who lack multi cultural and religious sensitivity and awareness. 1997 47 . Richards & Bergin.Of course.

Barriers in applying spirituality in PSW ‡ PSWs are not trained to help patients to resolve complex spiritual problems related to physical or emotional illness. ‡ Lack of supervision ‡ Chance to misunderstanding by other professionals ‡ Blurring of professionalism ‡ Professional or pastoral work.doubts 48 .

For Better Psychiatric Social Work Practice ‡ Self understanding on the part of the therapist is a must Less egoism leads to more happiness. ‡ Believe in the forces beyond us ‡ Respect others religious/spiritual outlook ‡ Have healthy values in life ‡ Be solution focussed in our approach ‡ Have good sense of Humour ‡ Be ready to learn from others ‡ Practice religion of love 49 .

Thamasoma jyothirgamaya Thank You 50 .

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