Daniel Stillwell, MA, Saint Louis University [email protected] Overview • The United States is an increasingly diverse • landscape in which meaning in therapy is often made through spirituality. • Practicing Licensed Marriage and Family • Therapists (LMFTs) are encountering this diversity in their practices but are often not trained to meet the spiritual needs of their • clients. There have been some attempts to measure spiritual competency in the mental health field, but it has often been with students • or other highly supervised populations. This study hopes to add to this line of inquiry by using an online survey to gather similar data from practicing MFTs. Another limitation of the previous studies is that they focused solely on the quantitative aspect of measuring spiritual competency. Without the additional qualitative data, the picture of spiritual competency in the MFT field would be incomplete. The purpose of this study is to measure and explore the self-perceived spiritual competency of practicing LMFTs. Measuring Spiritual Competency Linda Robertson’s Spiritual Competency Scale • • • • • • • Measures perceived spiritual competency of self Population: MA-level student counselors Evidence for ASERVIC competencies American Counseling Association Psychometrically reliable and valid 2008 (Original, 90 item), 2011 (Current, 21 item) Dissertation (Original) David Hodge’s Spiritual Competence Scale • • • • • • • Perceived spiritual competency of academic program Population: MA-level student social workers Evidence for spiritual competency as valid construct National Association of Social Workers Psychometrically reliable and valid 2007 (8 item) Article Procedures • Concurrent nested mixed-methodology strategy. • Population: Actively practicing LMFTs in the USA. • Sample: Respondents from all participating state MFT associations, COAMFTE accredited schools, and state MFT regulatory boards. Additionally, some emails were accessed through “Therapist Locator” for underrepresented areas of the country. Participants must be fully LMFT and practicing at least an average of 2 direct client hours/week. • Access to emails or listservs is run through gatekeeper permission for each organization. • A link to the online Qualtrics survey is on the different websites, flyers, and emails with basic information about the survey. • When participants go to the survey, they encounter the cover letter. After agreeing to participate, they proceed with the rest of the survey. • It was anticipated that the survey will take around 30 minutes on average for participants to take. Two participants have taken less than 17 minutes and two almost an hour. • Those who elect to, give contact information to possibly win a $25 Amazon.com gift certificate. • The contact information is destroyed after a winner is selected. • Since the larger dissertation study will be focused on LMFTs and LMFTs are historically difficult to participate in research, a pilot study used an alternate form of this population. Provisionally licensed MFTs (PLMFTs) have nearly all the same qualifications as LMFTs, just without the final amount of supervised hours of practice and should be able to give useful feedback toward taking the survey. Dissertation Current Status • Work is being done to complete the Introduction, Literature Review, and Methodology chapters with the dissertation committee in order to propose within the next few months. • All the organizations have been contacted and the majority of the organizations have given feedback on their participation status. Additionally, over 1,000 emails have been accrued toward the national sample sought. • There is a possibility that the qualitative aspects of the study will be dropped for efficiency’s sake. Selected Pilot Qualitative Results How would you define spirituality? A. Believing in a higher power and seeking wisdom from the source B. Practices and beliefs related to the sacred C. An individual's belief of concept of their connection to a higher being or power. D. An inner set up being, a set of beliefs and values How would you define spiritual competency, as it pertains to being a therapist? A. Being able to work within a client's own spirituality framework without forcing your own beliefs. B. Taking into account a person's spiritual beliefs and history when working with them in therapy, just as you would their relationship history, etc. C. Being accepting, supportive, and non-judgmental of individual differences in spirituality, allowing the client to be the expert of their own spiritual experience and educate the therapist, and being open to making the client's spirituality a part of the therapy experience. D. Use of self and one's spirituality in therapy in a way that is respectful, non-judgmental, and helpful to our clients, without disrespect to their own spirituality. What is the best advice you have ever been given on how to work with spiritual matters in therapy? A. For me to keep God as my own priority and allow Him to direct me when working with clients. This was not advice given from my graduate program. B. To let the client lead the way. C. The client is the expert on their own experience. Let them teach you. D. Be yourself, be transparent. How does your spiritual history, if any, impact your self-of-the-therapist? A. It has allowed me to grow as an individual, but also as a therapist. My spirituality is of utmost importance to me as an individual and working through my own "baggage" with God has allowed me to connect with my clients not only therapeutically, but also spiritually. B. It impacts it quite a bit, as my spiritual development is tied up with my human development and life cycle development. It's all intertwined to make me the person and therapist that I am. C. It impacts me by reminding me how important acceptance can be to the therapeutic relationship. When we feel free and safe to talk about what is important to us, we are more open. D. The search for my own spirituality has made me open to different ideas and understanding of spirituality and religion. This, I believe, gives me level of comfort to bring up spirituality in counseling and incorporate it in my treatment. Definitions of Spiritual Competency • Froma Walsh: 1) Inquire respectfully about the meaning and importance of spiritual beliefs and practices in clients’ lives and in relation to presenting problems and coping efforts. Track signiﬁcant changes (e.g., from family-of-origin, with conversion, marriage/remarriage, crisis events). Genograms and spiritually oriented assessment tools can be helpful. 2) Explore any spiritual concerns that contribute to suffering or block healing/ problem-solving (e.g., guilt, anger at God, abusive practices, sexual orientation, worry about sin or afterlife, a spiritual void). 3) Facilitate communication, understanding, and mutual respect around religious/spiritual conﬂicts in couples and families (e.g., interfaith marriage; conversion). 4) Facilitate compassion and possibilities for forgiveness and reconciliation of relational wounds, drawing on clients’ faith beliefs to support efforts. 5) Identify spiritual resources (current, past, or potential) that might contribute to healing and resilience. Encourage couples and families to draw on those that ﬁt their values and preferences, including: contemplative practices, rituals; relationship with God, Higher Power involvement in a faith community; pastoral guidance interconnectedness with the natural world expressive/creative arts community service; social activism. • David Hodge & Suzanne Bushfield: An active, ongoing process characterized by the interrelated dimensions: 1) Growing awareness of one’s own value-informed, spiritual worldview and its associated assumptions, limitations, and biases, 2) Developing empathic understanding of the client’s spiritual worldview that is devoid of negative judgment and, 3) Increasing ability to design and implement intervention strategies that are appropriate, relevant, and sensitive to the client’s spiritual worldview. • Association for Spiritual, Ethical, and Religious Values in Counseling: (division of ACA) • Culture and Worldview 1. The professional counselor can describe the similarities and differences between spirituality and religion, including the basic beliefs of various spiritual systems, major world religions, agnosticism, and atheism. 2. The professional counselor recognizes that the client’s beliefs (or absence of beliefs) about spirituality and/or religion are central to his or her worldview and can influence psychosocial functioning. • Counselor Self-Awareness 3. The professional counselor actively explores his or her own attitudes, beliefs, and values about spirituality and/or religion. 4. The professional counselor continuously evaluates the influence of his or her own spiritual and/or religious beliefs and values on the client and the counseling process. 5. The professional counselor can identify the limits of his or her understanding of the client’s spiritual and/or religious perspective and is acquainted with religious and spiritual resources, including leaders, who can be avenues for consultation and to whom the counselor can refer. • Human and Spiritual Development 6. The professional counselor can describe and apply various models of spiritual and/or religious development and their relationship to human development. • Communication 7. The professional counselor responds to client communications about spirituality and/or religion with acceptance and sensitivity. 8. The professional counselor uses spiritual and/or religious concepts that are consistent with the client’s spiritual and/or religious perspectives and that are acceptable to the client. 9. The professional counselor can recognize spiritual and/or religious themes in client communication and is able to address these with the client when they are therapeutically relevant. • Assessment 10. During the intake and assessment processes, the professional counselor strives to understand a client’s spiritual and/or religious perspective by gathering information from the client and/or other sources. • Diagnosis and Treatment 11. When making a diagnosis, the professional counselor recognizes that the client’s spiritual and/or religious perspectives can a) enhance well-being; b) contribute to client problems; and/or c) exacerbate symptoms. 12. The professional counselor sets goals with the client that are consistent with the client’s spiritual and/or religious perspectives. 13. The professional counselor is able to a) modify therapeutic techniques to include a client’s spiritual and/or religious perspectives, and b) utilize spiritual and/or religious practices as techniques when appropriate and acceptable to a client’s viewpoint. 14. The professional counselor can therapeutically apply theory and current research supporting the inclusion of a client’s spiritual and/or religious perspectives and practices Hypotheses – Pilot Quantitative Results 1. MFTs who score lower on the SCS–Self will score higher on the SCS–Program. – Unclear 2. MFTs who score lower on the SCS–Self will report higher frequencies of spiritual matters manifesting themselves in practice. – Evidence against 3. MFTs who score lower on the SCS–Self will report they spend more minutes in therapy devoted to conversations of a spiritual nature. – Evidence against 4. 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