Expert Shares Tips for Talking About Religion, Spirituality in a Clinical Setting

Q&A with Baylor Social Work Professor, Researcher

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WACO, Texas (Nov. 4, 2015) – A 2015 Baylor University study, published in the journal Social Work, showed that many licensed clinical social workers are not discussing religion and spirituality with their clients, even when there's an understanding that such conversations are beneficial to treatment.

"Clients want to talk about it but feel it's taboo, so they wait on the practitioner to bring it up. Meanwhile, practitioners are willing to talk about it if the client brings it up," said study co-author Holly Oxhandler, Ph.D., assistant professor in Baylor's Diana R. Garland School of Social Work.

"I recognize there is a great deal of courage and risk involved with initiating this conversation, but a competent social worker will respect, honor and integrate this area of their clients' lives into their treatment, or refer them to someone who may be better able to help with their current situation and personal preferences that may include the clients' religious or spiritual beliefs."

In the following Q&A, Oxhandler offers tips to break the stalemate and open up those meaningful conversations between licensed social workers and their clients in appropriate ways.

Q: Your research shows that LCSWs believe that talking about religion and spirituality is beneficial, yet they're not engaging their clients in these discussions. What are some ways practitioners can prompt these conversations?

A: By assessing clients' religious or spiritual beliefs (if any) as a part of intake, social workers are not only better positioned to understand how clients' religious and spiritual beliefs may be positively or negatively connected with what brought the client in for services in the first place, but social workers are also communicating to the client that they recognize this area of a client's life is as important to understand as their physical issues, psychological makeup and social support.

For example, if a client is suffering from generalized anxiety, she might not feel comfortable openly sharing with the social worker that she prays often to release her worries, since religion and spirituality can be a bit of a taboo topic; however, the social worker can open the door for the client to share this information by asking up front about the roles religion and spirituality play in her life, including her anxiety.

Q: What are inappropriate tactics?

A: In social work, we highly value clients' self-determination, or their ability to identify and clarify their goals, and to always meet the client where he or she is at in the presenting circumstance. It is not our job to impose our values, beliefs or opinions onto our clients, who are often very vulnerable when they come to see us for help. Additionally, our code of ethics calls us to respect religious diversity, to not discriminate based on clients' religion and to practice competently with regard to religious diversity. Therefore, it would be extremely inappropriate to impose what we believe onto the client or to encourage clients to engage in religious practices that we might utilize, but that are outside the client's religious beliefs or practices.

Similarly, it would be unethical for us to try to coerce clients to believe what we believe in, especially due to how vulnerable they are when they see us. As social workers, it is our job to identify what clients believe in (if anything), how it relates to the presenting issue and treatment plan and to work within and respect their belief system to deliver the best services available.

Q: Is it appropriate for LCSWs to share their personal faith during these conversations?

A: Since the social worker should always be focused on the client's views, beliefs, and needs, it would be inappropriate for social workers to freely share their faith or make their faith a central point of conversation with clients. However, I recognize that there are times the social worker's faith comes up.

For example, some clients may only want to see a Christian counselor, and so the social worker's beliefs do come into consideration when the client is determining which counselor to see. Other times, after a social worker and client have been working together for a while, the client may ask the social worker about his/her beliefs. I think in cases such as this, it would first be important for the social worker to ask why the client would like to or need to know this information and to explore this before disclosing their beliefs. The point is to remain focused on the client's faith rather than the social worker's.

Additionally, though social workers may have religious or spiritual symbols in their office, it is important to be mindful of how clients might receive even those subtle messages of a cross hanging on their door, a statue of Buddha on a shelf or a religious verse framed. Some clients may find comfort in these symbols, while other clients may have had a negative experience with a religious figure or community and experience distress over the symbol. Regardless of how it is brought up, I think one major step the social worker can take is by continuously practicing awareness of and communicating that the focus is on the client and how the client's beliefs relate to treatment.

Q: What are some steps social workers can take to avoid proselytizing or the image of proselytizing?

A: Outside of the direct contact with clients, a critical step would be for social workers to practice self-awareness and identify blind spots that relate to religion and spirituality in practice. By this, I mean, as social workers, we do a lot of background work on our own views, experiences, opinions, prejudices, beliefs and personal values during our professional training. However, oftentimes our religious and spiritual beliefs aren't explicitly included in this process, and even if they were, our thoughts about these personal dimensions of our lives change as we grow, age and experience new things.

Given that my research has found intrinsic religiosity is the strongest predictor of social workers' views and integration of clients' religion/spirituality in practice, it is critical that social workers take the time to reflect on their personal religious/spiritual beliefs, how they relate to practice and how they influence the social worker's views of other belief systems. I would also recommend that social workers seek supervision or consultation on this topic with a senior practitioner or someone well-trained in this area, especially if it has been a while since personally exploring their own beliefs, and to read about other belief systems outside of their own.

Q: Do you encourage clients of faith to seek out faith-based social workers?

A: Though many social workers may not have received training on this practice area in the past, I have found that they recognize this is an important area of clients' lives and are seeking continuing education opportunities to learn more. Therefore, if you are a client of faith, I encourage you to seek out the social worker who will deliver the best, empirically supported treatment available for the issue you are struggling with, but to not be afraid to honestly communicate to the social worker that your faith is important to you (if it is) and how it relates to what you are seeking services for, if at all.

For example, if you're experiencing a season of depression and wondering where your higher power is during this time, identify the best social worker for treating depression in your community, and if the social worker does not ask about your religious/spiritual beliefs, let them know how your beliefs relate to your situation.

Helpful Resources:

• Link to news release: "Study: Why Social Workers Aren't Discussing Religion and Spirituality with Clients"

ABOUT HOLLY OXHANDLER, PH.D., L.M.S.W.
Holly Oxhandler, Ph.D., is an assistant professor in Baylor University's Diana R. Garland School of Social Work. Her research focuses on the intersection between ethical and effective integration of clients' religious and spiritual beliefs and the evidence-based practice process in clinical practice. She developed the Religious/Spiritually Integrated Practice Assessment Scale, which assesses social work practitioners' attitudes, perceived feasibility, self-efficacy and behaviors surrounding integrating clients' religion/spirituality in practice. She is particularly interested in examining the application of religion/spirituality and the evidence-based practice process with older adults.

ABOUT BAYLOR UNIVERSITY
Baylor University is a private Christian University and a nationally ranked research institution, characterized as having "high research activity" by the Carnegie Foundation for the Advancement of Teaching. The University provides a vibrant campus community for approximately 16,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. Baylor sponsors 19 varsity athletic teams and is a founding member of the Big 12 Conference.

ABOUT THE DIANA R. GARLAND SCHOOL OF SOCIAL WORK
Baylor University's Diana R. Garland School of Social Work is home to one of the leading graduate social work programs in the nation with a research agenda focused on the integration of faith and practice. Upholding its mission of preparing social workers in a Christian context for worldwide service and leadership, the School offers a baccalaureate degree (BSW), a Master of Social Work (MSW) degree and three joint-degree options (MSW/Master of Business Administration, MSW/Master of Divinity and MSW/Master of Theological Studies) through a partnership with Baylor's Hankamer School of Business and George W. Truett Theological Seminary, and a Ph.D. program. Visit www.baylor.edu/social_work to learn more.