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Spiritually Integrated Counseling:AssessmentKenneth I. PargamentDepartment of PsychologyBowling Green State [email protected] Presented to CASC ConferenceHamilton, ONApril 15, 2015

The Process of Spiritual AssessmentSetting the Stagefor SpiritualDialogue

Setting the Stage forSpiritual Dialogue Communicatingan openness to learning Communicating an openness to sharing

Being Explicit about Values“It is vital that we be more explicit about valuesbecause we use them, however unconsciously, as ameans of therapeutic change. . . being explicitactually protects our clients. The more subtle ourvalues, the more likely we are to be hiddenpersuaders. The more open we are about our view,the more choice clients will have in electing to beinfluenced or not to be influenced” (Bergin, 1985,p. 107).

The Process of Spiritual AssessmentSetting the Stagefor SpiritualDialogueInitialSpiritualAssessment

Initial Spiritual Assessment SALIENCE OF SPIRITUALITY:Do you see yourself as a religious or spiritual person? If so, in what way? SALIENCE OF RELIGIOUS AFFILIATION:Are you affiliated with a religious or spiritual denomination or community? Ifso, which one? SALIENCE OF SPIRITUALITY TO THE PROBLEM:Has your problem affected you religiously or spiritually? If so, in what way? SALIENCE OF SPIRITUALITY TO THE SOLUTION?Has your religion or spirituality been involved in the way you have coped withyour problem? If so, in what way?

SIGNS OF SPIRITUAL STRUGGLE DIVINE ISTRUGGLESfeel like I am being punished by God. I feel angry with God for what has happened. I feel like God has abandoned me. I wonder whether God really loves me. I wonder whether the devil has anything to do with thissituation. I feel I have let God down.

SIGNS OF SPIRITUAL STRUGGLE INTRAPSYCHIC ISTRUGGLESam having doubts about my faith. I am not sure what I really believe anymore. I know what’s right but I keep doing what’s wrong. I don’t know why I am really alive. I feel guilty about the way I think, feel, or act.

SIGNS OF SPIRITUAL STRUGGLE INTERPERSONAL ISTRUGGLESfeel my church has abandoned me. I disagree with what my church wants me to believe. I disagree with my family or friends about spiritualmatters. I feel like my family or friends are spiritual hypocrites. I hope God will have his vengeance on the people whohurt me.

SIGNS OF SPIRITUAL RESOURCES PATHWAY OF KNOWINGI study the Bible or other sacred texts. I watch religious television. I read books to grow spiritually. PATHWAY OF ACTINGI meditate or pray regularly. I engage in regular religious rituals (e.g., prayer before meals) I engage in activities I call spiritual (e.g., walking, gardening)

SIGNS OF SPIRITUAL RESOURCES PATHWAYOF RELATING Iam part of a spiritual community. I turn to my pastor for help. I feel a spiritual connection with people in my life. PATHWAY IOF EXPERIENCEfeel close to God when I pray. I have spiritual experiences every day. I see life as sacred.

SIGNS OF SPIRITUAL RESOURCES PATHWAY IOF COPINGlook to God for strength, support, and guidance. I try to find the lesson from God in my problems. I do what I can and put the rest in God’s hands. I ask for forgiveness for my sins. I seek a higher purpose in life. I try to give spiritual strength to other people.

The Process of Spiritual AssessmentSetting the Stagefor tSpiritualAssessment

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Implicit Spiritual Assessment Questions Fromabout Resources and Pathwayswhat sources do you draw strength and courageto go on? Where do you find peace? Who truly understands your situation? When you are afraid or in pain, how do you findcomfort? For what are you deeply grateful? What sustains you in the midst of your troubles?

Implicit Spiritual Assessment Questions about DestinationsWhat are you striving for in your life? Why is it important that you are here in this world? What legacy would you like to leave behind in your life? To what or whom are you most devoted? Who is your true self? To whom, or what, do you feel most freely express love? When have you felt most deeply and fully alive?

Implicit Spiritual Assessment Questions about Struggles and TransformationWhat are the deepest questions your situation has raised for you? What causes you the greatest despair and suffering? How has this experience changed you at your deepest levels? How has this situation shaken your faith? What has this experience taught you that you wish you had neverknown? What are your deepest regrets? What would you like to be able to let go of in your life? When in your life have you experience forgiveness?

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The Process of Spiritual AssessmentSetting the Stagefor tSpiritualAssessmentExplicitSpiritualAssessment

Explicit Spiritual Assessment Askingspiritual questions

Explicit Spiritual Assessment TAKING A HISTORY, TAKING A FUTURE Describe the spiritual/religious tradition you grew up in. How did you familyexpress its spirituality?What sort of spiritual experiences stood out for you when you were growingup?How did you envision the sacred?How have your spiritual practices and beliefs changed since you were a child?Have you had periods in your life when you feel like you’ve lost the sacred?How would you describe your current spiritual orientation?What do you see yourself striving for now and where does the sacred fit in?How do you see yourself changing spiritually in the future?

Explicit Spiritual Assessment SACRED WhatDESTINATIONSdo you hold sacred in your life? What do you feel God wants from you? When do you feel the presence of the sacred in your lifemost strongly? When do you feel the sacred is not there? Do you ever have mixed thoughts and feelings aboutthe sacred? What are they like?

Explicit Spiritual Assessment SACRED PATHWAYS What has helped nurture your spirituality?What has been damaging to your spirituality?Who supports you spiritually? How so?Who does not support you spiritually? How so?What spiritual practices and beliefs are especially meaningful to you?Where do you go to feel the presence of the sacred?In what ways has your spirituality helped you understand or deal with yourproblems?In what ways has your spirituality been less helpful to you in understanding ordealing with your problems?What gets in the way of your spirituality?

Explicit Spiritual Assessment SACRED EFFICACYHow has your spirituality changed your life for the better? How has your spirituality changed your life for the worst? In what degree has your spirituality give you pleasure?Meaning? A sense of connection to others, to the divine? Hope?Confidence in yourself? To what degree has your spirituality been a source of pain?Guilt? Anger? Confusion and doubt? Anxiety? Fear? Feelingsof personal insignificance? Feelings of alienation from others?

Explicit Spiritual Assessment Questions about Spirituality as a Coping Resource andProblemHas your spirituality been involved in the way you’ve tried tocope with your problems? If so, how? How helpful has itbeen? Has your spirituality been affected by the problems you’reexperiencing? In what way? Would you say that you are in some ways strugglingspiritually? If so, how? Have you been having any questions or doubts about yourreligion or spirituality?

Explicit Spiritual Assessment Questions about the Client and GodHow do you envision God? Have you ever had the feeling that God is present in your life?What was that like? Where did you feel that presence? Are there times when you don’t feel the presence of God in yourlife? What are those times like and how are they different? When you say that your life is in God’s hands can you tell mewhat you mean by that? Is it all in God’s hands? Do you have apart to play too? Have you ever felt that God has let you down? Have you ever felt that God is punishing you?

Explicit Spiritual Assessment Questions Whatabout Spirituality and Communitypeople in your life bring out your best spiritualqualities? Where can you go to replenish yourself spiritually? Where do you encounter the holy in your life? What would you like from your congregation or clergyat this time? Has your congregation or clergy been there for youduring this time?

Explicit Spiritual Assessment Questions Doabout Ritual and Prayeryou engage in any regular rituals in your life? Whatare they like? Do you pray or meditate? If so, what are your prayerslike? What do you pray for? Do you feel that youreceive a response at times? What are those times like?What is it like when you don’t receive a response?

Explicit Spiritual Assessment Askingspiritual questions Attending to the nonverbal What’snot being said Emotions The incongruous

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Explicit Spiritual Assessment Askingspiritual questions Attending to the nonverbal What’snot being said Emotions The incongruous Gatheringspiritual information quantitatively

Spirituality Assessment MeasuresSpiritual History Scale (Hays, 2001) RCOPE (Pargament, 2000)– religious RSS (Exline et al., 2014) – religious and spiritualstruggles Spiritual Strivings Scale (Mahoney, 2005) Hindu Spiritual Pathways Scale (Tarakeshwar, 2003) Religious Internalization (Ryan, 1993) – religiousmotivation Spiritual Well-Being Scale (Paloutzian, 1982) FACIT Spiritual Well-Being Scale (Peterman, 2002)

Explicit Spiritual Assessment Asking spiritual questionsAttending to the nonverbal What’s not being said Emotions The incongruousGathering spiritual information quantitatively Gathering spiritual information in other ways Spiritual autobiography Letter writing Spiritual genogram

Explicit Spiritual Assessment Askingspiritual questions Attending to the nonverbal What’snot being said Emotions The incongruous Gatheringspiritual information quantitatively Placing the client in context

The Importance of Context“In some African communities, a person would beconsidered insane not to believe that the spirits ofthe dead actively influence an individual’s life”(Miller & Kelley, 2005, p. 471).

RSS (Exline et al., 2014) – religious and spiritual struggles Spiritual Strivings Scale (Mahoney, 2005) Hindu Spiritual Pathways Scale (Tarakeshwar, 2003) Religious Internalization (Ryan, 1993) – religious motivation Spiritual Well-Being Scale (Paloutzian, 1982) FACIT