John D. Hawkins Jr., M.S., C.A.P., Registered Mental Health Intern

Spirituality seems to have experienced a renaissance over the last several decades. Everything from Shirley McClaine and the New Age movement to mega churches and the publishing success of their charismatic leaders, such as Rick Warren and Joel Osteen to the popularity of religious focused films, such as The Passion of the Christ and Conversations with God. After the increase of agnosticism and atheism in the sixties and seventies, the recent era seems to have undergone a resurgence in all things divine.

Occurrences in the field of therapy, not coincidentally, appear to have paralleled changes in the dominant culture. Throughout the sixties and the seventies the behavioral approach reigned supreme. According to this view, human behavior and personality are shaped by basically nothing more than positive and negative reinforcement. In essence, we are automatons and the universe is dictated by an unalterable, deterministic cause and effect. An analysis of human thought was believed to be basically unnecessary. We were equated as easy to manipulate as B.F. Skinner’s pigeons.

During the course of this period, many considered spirituality in counseling not only unnecessary but an inappropriate topic of discussion for therapy. There were many therapist of this era who unapologetically refused to discuss such topics; even believing it was unethical to do so. But unacknowledged by such individuals was an imposition of their worldview on their clients. To assert that spirituality was unsuitable subject matter was a clear violation of the ethical duty to not exert undue influence in the therapeutic relationship.

Fortunately, other schools, and lines of thought, arose within psychology to refute many of the rigid assertions of behaviorism, such as cognitive therapy. Concurrently, a variety of individuals in the mainstream society were finding life centered on unabashed materialism and devoid of anything transcendent somewhat empty and meaningless. Furthermore, in times of distress and suffering, life without faith seemed unmoored for many. Finally, others recognized without an unarbitrary standard for morality, society may eventually descend into an anarchy of relativity. Therapists who either refused or were uncomfortable discussing topics related to spirituality began to steadily lose clients whose spirituality was an important component of their life and self-identity.

Current research indicates between 80 -90% of clients desire to have their spirituality respected and incorporated as part of their therapy. However, evidence further alludes to the fact they do not wish to have their therapists views imposed upon them. As mentioned earlier, to refuse to discuss aspects of a client’s reality, such as their spirituality, is an imposition of a worldview. It is now the view of many within the therapeutic field that neutrality not only does not exist but also is ultimately unattainable no matter how intently sought after. Today’s ethics call for value-informed therapy.

As a practicing therapist, my clients are comprised of Christians, Jewish, Buddhists, New Age, Muslims, Agnostics and Atheists. My role is not to influence them to my worldview or belief system but to respect their freedom to choose their own and to assist them in incorporating whatever strengths and assets they possess, such as their spirituality, in an effort to facilitate attainment of their therapeutic goals. While at the same time being open and honest about how my belief system influences who I am and how I approach others. Many times my role has been, just as with other important issues, to aid clients in clarifying their own views. My goal is for my client’s to have full awareness of all the ramifications and consequences of their choices, whether faith or any other facet of their life, and support them subsequent to the decision they choose in a compassionate and non-judgmental manner.

My particular faith is Christianity. I am open and informative to my client’s about the way this will influence the therapeutic relationship I have with them. Due to my beliefs, I see every individual as possessing intrinsic value and unique gifts and abilities, no matter how latent and presently unidentifiable they may be. Furthermore, I believe every client has an essential need to find meaning and purpose to their life. That meaning is for them to discover, not for me to impose. It is my client’s right to choose what they will work on in their therapy, and it may or may not be issues related to deeper meaning and spirituality. That is their prerogative. However, I will always acknowledge and respect their significance, worth, and freedom.

Almost every client I have worked with has requested at some point in therapy a discussion and examination of their spirituality. The comments I receive from clients former therapy experiences indicate that more therapists are respecting and incorporating clients’ faith into their treatments. The only negative feedback disclosed by clients is their previous therapist did not refuse to discuss their spirituality but was not equipped to do so. Being competent to explore spiritual issues with clients does not necessitate being an expert in that particular faith. But just as cultural competence is a prerequisite in today’s pluralistic society, one should be sensitive and adequately conversant of major world religions to follow each client in the direction they desire.

I believe therapists should adhere to being client led, whether it is spirituality, therapeutic goals, or the topic of a particular session. This exhibits respect for clients as free-willed agents to choose not only the course of their therapy but for life direction as well.