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Bibliography expanded and updated to reflect recent research and scholarship. Discussion of definition of spirituality expanded. New information added about NASW practice standards and CSWE website, Religion and Spirituality Clearinghouse.

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Human Needs: Religion and Spirituality

Abstract and Keywords

This entry provides a brief introduction to social work's approach to spirituality and religion, focusing on definitions, history, current practices, ethical and human-diversity issues, relevance to clients, practice applications, best-practices research, and controversies. Emphasis is given to a spiritually sensitive and culturally competent approach to social work that honors diverse religious and nonreligious spiritual perspectives of clients and their communities. Although American social work is the focus, some international developments are included. References and websites are listed to facilitate identification of resources for addressing spiritual diversity in practice.

Keywords: diversity, ethics, faith, history, international, religion, spirituality, values

Since the late 1980s, the social work profession has come to recognize religion and spirituality as significant aspects of human needs and cultures that often are relevant to practice (Canda 1988, 1997; Hodge, Langer, & Nadir, 2006). Since the late 1990s, guidelines for spiritually sensitive practice with people of diverse religious and nonreligious spiritual perspectives have emerged (Canda & Furman, 2010; Derezotes, 2006; Van Hook, Hugen, & Aguilar, 2001).

Definitions

Social work literature typically distinguishes between religion and spirituality as related but distinct concepts (Canda & Furman, 2010). Surveys of social workers in the United States, the United Kingdom, Norway, and New Zealand suggest that distinction between these concepts is internationally common (Furman, Benson, & Canda, 2005; Furman, Zahl, Benson, & Canda, 2007; Stirling, Furman, Benson, Canda, and Grimwood 2010). Spirituality is often a broad concept, defined variously by themes referring to the human search for a sense of meaning, purpose, morality, and well-being in the context of relationships with self, others, the universe, and ultimate reality. Common understandings of ultimate reality include materialism (as in certain atheistic and scientific views), theism (such as Christianity, Islam, and Judaism), animism (as in many traditional Indigenous cultures), polytheism (as in some forms of Hinduism), nondual or unitary consciousness (as in Vedantic Hinduism and Buddhism), and combinations of these. Spirituality sometimes engages people in a sense of deep profundity, connection with the sacred, and/or transcending the ordinary limits of body, ego, space, and time. Spirituality sets life priorities around people's most significant concerns, developmental goals, standards of conduct, and principles for justice. Therefore, it often establishes central motivations, values, beliefs, and practices of individuals, families, and communities. Clients' understanding of problems, oppression, strengths, resources, and capacity for resilience and empowerment often rests on the foundation of spirituality, whether or not clients use the term. Indeed, in many traditional cultures, spirituality is inseparable from culture in daily life (for example, McKenzie & Morrissette, 2003; Nash & Stewart, 2002).

Religion is commonly defined as a systematic set of values, beliefs, and behaviors related to spirituality that is organized and shared within a community and is transmitted over time (Canda & Furman, 2010; Moss, 2005). Considering this distinction, all people have spirituality, but many are not religious. Spirituality may be expressed in religious or nonreligious forms. Since most people in the United States are religious, many clients intertwine religion and spirituality. This is less common in countries with higher rates of secularization and lower rates of religious participation.

Culturally appropriate and spiritually sensitive social work practice focuses on the worldviews, values, goals, and priorities of clients and their communities. Accordingly, professional definitions of spirituality and religion are best used as guidelines for professional discourse and for identifying key themes (for example, meaning, purpose, morality, well-being, connectedness, sacredness, transcendence, religion, faith) that may be explored with clients, as relevant, using whatever terms are preferred by clients (Canda & Furman, 2010; Nelson-Becker, Nakashima, & Canda, 2007).

History

The social work profession in North America developed in the early 1900s, with a strong influence from religious ideologies of service (especially Christianity and Judaism) and humanistic spiritual views (Leiby, 1985; Loewenberg, 1988). The Charity Organization Society, the Settlement House movement, and Jewish communal services are examples. Within First Nations' communities, Indigenous spiritually based traditions of mutual support and healing existed long before the arrival of religions brought by colonists. Likewise, African spiritual traditions fueled efforts for survival and empowerment ever since the period of slavery. Non–Euro-American traditions of service, however, have become acknowledged in professional social work literature only recently (for example, Canda, Nakashima, Burgess, Russel, & Barfield, 2003; Nash & Stewart, 2002; Patel, Naik, & Humphries, 1997; Van Hook et al., 2001).

As social work became more strongly established as a profession from the 1920s to the 1970s, more emphasis in the preparation of social workers was placed on secular theories and therapies as well as governmental contexts for service (Robbins, Chatterjee, & Canda, 2012). Some approaches to practice, such as Freudianism, behaviorism, and Marxism, were strongly suspicious of religion, usually conflated with spirituality. They tended to view religiosity in clients as a sign of immaturity, low critical awareness, or irrationality. More recent trends in clinical social work since the 1970s utilized humanistic psychotherapy approaches (such as existential, Gestalt, and Rogerian). These approaches often address spiritual issues without religious terminology. There are several reasons for the reticence to address issues of religion in social work practice (Canda & Furman, 2010; Moss, 2005; Sullivan, 1994; Thyer & Walton, 2007). These include a focus on the scientific basis of human behavior, professional values supporting diversity and clientele from diverse backgrounds, and legal concerns about the separation of church and state. Social work, like many professions, eschewed religiously based explanations for problems and solutions (such as sin and conversion) and moralistic judgmentalism, although religiously based agencies continued as important venues for social work.

During the 1950s and 1960s, spiritual needs were alluded to in curriculum guidelines of the Council on Social Work Education (CSWE), but CSWE guidelines in the 1970s and 1980s eliminated allusions to religion and spirituality. At the same time, during the 1980s, some scholars began to call for a way to address spirituality in practice while respecting its diverse religious and nonreligious expressions (Joseph, 1987; Siporin, 1985). They responded to increasing cultural and spiritual diversity in the United States and spiritual movements within popular culture and national politics. This encouraged a return to a focus on spirituality, but without restriction to sectarian or secular divisiveness. This development was a flowering of inclusive ideals from prior leaders, such as Jane Addams (early 1900s), Charlotte Towle (1940s), and Sue Spencer (1950s). During the 1990s and early 2000s, more scholars introduced theoretical understandings of spirituality that draw on cross-cultural and global knowledge, such as postmodernism, transpersonal theory, and deep ecology (Besthorn, 2001).

In 1990, the Society for Spirituality and Social Work was founded in the United States, linking practitioners, educators, and researchers to promote attention to spirituality in its diverse forms. Since then, national and international conference presentations and publications on this topic have increased significantly. The CSWE returned to recognition of religion and spirituality in its guidelines since 1995. In 2011, the CSWE established on its website the Religion and Spirituality Clearinghouse to promote social workers’ ethical and effective practice addressing diverse expressions of religion and spirituality. The National Association of Social Workers (NASW) Code of Ethics and (since 2000) its practice standards for working with substance-use disorders, family caregivers of older adults, health care settings, child welfare, palliative and end of life care, and cultural competence acknowledged the relevance of religion and spirituality. This trend has an international counterpart. For example, it is evinced in ongoing symposia at the Inter-University Center of Dubrovnik, in Croatia; increasing spirituality topics at international conferences; the first International Conference on Spirituality and Social Work, in 2000; the establishment of the Canadian Society for Spirituality and Social Work, in 2002; and the creation of the International Network on Spiritual Diversity in Social Work, in 2004. Independent movements of interest in various countries are now beginning to link through initiatives for a global, mutually respectful, nonhegemonic approach to dialogue and collaboration (Canda, 2005a; Graham, 2006).

Since the mid-1990s, surveys of practitioners have shown that most respondents report religion and spirituality to be relevant to social work but feel unprepared to address the issues (Canda & Furman, 2010; Furman et al., 2005, 2007; Kvarfordt & Sheridan, 2007). Although social work textbooks and education increasingly address spirituality, it is still an underutilized topic in North America and even more so elsewhere in the world (Canda, 2002; Graham, 2006).

Many interdisciplinary fields of practice, such as grief and loss counseling, substance-abuse treatment, hospice, hospital-based practice, mental-health recovery, and gerontology now expect spirituality to be included in assessment and service if relevant (Gregoire, 1995; Hodge, 2006; Morell, 1996; Nelson-Becker, Nakashima, & Canda, 2007; Van Hook, Hugen et al., 2001). Some human-service organizations attend to the spiritual needs of workers and clients in support of effective practice and satisfying work climate. Certain social movements for peace and justice draw on religious or broad spiritual principles, such as Jewish communal services, the Catholic Worker movement, Gandhian social work, socially engaged Buddhism, deep ecology, ecofeminism, and the human rights activism inspired by the Rev. Martin Luther King, Jr. (Coates, 2004; Pandey, 1996; Pyles, 2009; Robbins et al., 2012; Walz & Ritchie, 2000). In addition, a large portion of social services around the world is delivered through religiously based agencies, often with clients who wish their services to have connection with their religious beliefs. In particular, in the United States, most people affiliate with a religion, believe in God, and report transpersonal experiences. So it is not surprising that American clients often bring up issues related to religion and spirituality in any setting. For example, social workers in health care settings will quite likely encounter clients who utilize prayer to cope with illness; connect with religious congregations for material, emotional, and social support; desire referral or collaboration with clergy and spiritual mentors; raise questions about the spiritual meaning of their health crises; and draw on their beliefs about death and the afterlife when facing their own deaths or the deaths of loved ones (Dunbar, Mueller, Medina, & Wolf, 1998; Koenig, 2007). Spirituality (including religious participation) is now widely recognized as a contributor to mental-health recovery by many consumers, mental-health centers, and the strengths model of case management (Rapp & Goscha, 2012; Starnino, 2009).

Ethical and Diversity Issues

The ethical mandate for competency implies that workers need to gain knowledge and skills appropriate to the spiritual perspectives of their clients. Many practitioners recognize that more widespread education is needed to meet this mandate. Some authors argue that values of client self-determination and respect for diversity require that religion and spirituality be addressed as relevant to clients' interests, aspirations, readiness, and cultures (Canda, 2005b; Canda, Nakashima, & Furman, 2004).

Diversity has been a central concern of spiritually sensitive practice since the mid-1980s (Bullis, 1996; Canda, 1988; Canda & Furman, 2010; Derezotes, 2006; Ellor, Netting, & Thibault, 1999; Graham, 2006; Loewenberg, 1988; Van Hook et al., 2001). Some practice principles may be derived from these authors' observations that spiritual diversity intersects with numerous other aspects of diversity, such as culture, ethnicity, gender, disability, age, and sexual orientation, resulting in complexity and variety. First of all, culturally specific or particular religious beliefs, knowledge, values, and helping activities may be useful for clients who share them, but they should not be imposed on anyone by social workers. Second, workers must be careful to avoid using narrow assumptions about normality or morality that lead to inappropriate judgments and efforts to control clients. Third, religious and nonreligious spiritual support systems are often crucial strengths and resources for people experiencing adversity, poverty, and oppression. Fourth, spirituality is commonly found to be a factor promoting resilient response to disability, chronic illness, and challenges of aging and dying (Saleebey, 2006). Fifth, to address the particular and local qualities of individuals and communities, it is necessary to understand and to respectfully work within the spiritual institutions, healing systems, symbolisms, and rituals relevant to clients (for example, Al-Krenawi & Graham, 2009; Gray, Coates, & Yellow Bird, 2008; Van Hook et al., 2001). For example, it often would be difficult to practice on a micro or macro level in the Black community without understanding and utilizing the Black church in reaching and engaging the population (Martin & Martin, 2002). Sixth, mutual understanding, dialogue, and collaboration across religiously and secularly based governmental and nongovernmental institutions are necessary in many fields of practice, such as work with immigrants, refugees, and international relief services. Social workers in these situations need to develop perspectives and skills that honor distinct spiritual perspectives and also connect them in a peaceful and constructive manner.

Practice Interventions

Since the social work profession is committed to well-being and justice for all people, religion and spirituality are crucial considerations. Well-being involves fulfillment of physical, mental, and social needs in the context of one's sense of meaning and purpose in life (that is, spiritual concerns) and, for many people, participation in religious communities or nonreligious spiritual support groups. For this reason, social work assessment is moving toward holistic bio-psycho-social-spiritual assessment (for example, Canda & Furman, 2010; Hodge, 2006; Nelson-Becker et al., 2007). According to Canda and Furman (2010), as the profession is committed to understanding the whole person in the context of the environment, it is incumbent on practitioners to consider any relevant spiritual aspects of clients, their possible involvement in religious communities, and their sense of connection with other beings, including the possibility of divine or nonphysical entities, such as God, angels, or the spirits of nature. It is not always necessary for a worker to share the same beliefs as the client, but it is necessary to understand and respect their significance. Further, social work widely recognizes that helping relationships should be characterized by empathy, rapport, unconditional positive regard, respect, and practice wisdom. These are qualities of spiritually sensitive practice not requiring explicit mention of religion or spirituality.

Many kinds of spiritually focused practices can be used when appropriate for clients' needs, goals, strengths, and life context (see Social Work Textbooks section in the Canda et al. bibliography (2003); Canda & Furman, 2010). These practices may be undertaken by clients outside the professional helping encounter or as therapeutic assignments. These may also occur within the helping encounter, with the provisos that the client is fully supportive and that the worker is comfortable and properly experienced in the practices. They may also occur through collaboration with or referral to clergy and other spiritual helpers, healers, and mentors.

Clinical practices with a spiritual (but not necessarily religious) focus might include spiritual-developmental assessment; therapeutic use of imagery; art therapies; biofeedback, meditation, and relaxation techniques; narrative therapy emphasizing stories of meaning, purpose, and transformation; designing ceremonies and rituals of celebration for achievements and life transitions or coping with loss and grief; dream analysis; reflective journaling; forgiveness; conflict mediation, reconciliation, and restorative justice; and connecting with the beautiful, energizing, and inspiring aspects of nature. Clinical practices with a specifically religious focus might include any of the above tailored to the client's religious orientation, if any. For example, these might involve prayer; meditation; religious community events, celebrations, rituals and ceremonies; religious symbols and stories of healing and transformation; and cooperating with the religious community's willingness to provide physical, mental, social, and spiritual supports that fit the client's goals and needs (Canda & Furman, 2010; Derezotes, 2006; Ellor et al., 1999; Helmeke & Sori, 2006).

Meso and macro practices with a spiritual focus can also be religious or nonreligious in nature. They might include developing spiritually sensitive human-service organizational cultures; mobilizing volunteers and philanthropic donors; cooperating with leadership in religious organizations in community organizing and advocacy work; human rights, peace, and justice advocacy; addressing spiritual components of culture in communities; engaging in win–win (mutually beneficial) mediation between or among conflicting groups; lobbying and social activism by humanistic or religiously based groups; seeking reform of criminal-justice policies and procedures to become restorative rather than merely punitive; promoting respect for human diversity and proper training of workers and volunteers within faith-based service organizations; advocating for environmental policies that promote well-being of local and planetary ecologies; organizing groups to prevent or ameliorate environmental racism; and leading organizations and social service agencies in a manner that supports fulfillment of both clients and staff (Bailey, 2006; Canda & Furman, 2010; Cnaan, Wineberg, & Boddie, 1999; Coates, 2004; McLaughlin & Davidson, 1994); Pyles, 2009.

Spirituality is also featured in recent efforts to create integrative and holistic models of social work practice that draw on Ken Wilber’s Integral Theory and blends of Eastern and Western therapies (for example, Lee, Ng, Leung, Chan, and Leung, 2009; Robbins et al., 2012).

Research on Best Practices

Relatively little systematic empirical research has been reported within social work about the effectiveness of spiritually based practices, including faith-based programs (Thyer & Walton, 2007). A significant amount of evidence has been published across helping professions, however. United States-based empirical studies about associations between religious participation and well-being are numerous (Koenig, King, & Carson, 2012). They tend to show that higher levels of reported spiritual well-being (for example, a positive sense of meaning and purpose) and religious-community participation are related to higher levels of overall subjective well-being, greater resilient response to crises and illnesses, and lower levels of depression, suicide, family violence, psychoactive substance abuse, and distress. Further, some studies suggest physiological and psychological benefits of prayer, meditation, and mindfulness-based practices (for example, in dialectical behavioral therapy and stress reduction) for individuals in particular situations (Baer, 2006). These studies are generating considerable interest and controversy in medicine, psychology, nursing, and social work. For example, implications of this research for innovations in clinical practice are tempered by challenges to the rigor of research methodology and concerns over possible harmful effects of religious involvement (Koenig, 2007; Sloan et al., 2000; Thyer & Walton, 2007). Most studies give general support for the claim that religious participation and a sense of spiritual well-being can be beneficial for some clients. Yet much more social work research is needed on the processes and outcomes of spiritually based helping practices, including benefits and harms.

Challenges

Many in the profession have objected to the incorporation of religion and spirituality into social work because of concerns about inappropriate proselytization, confusion between personal and professional boundaries, blurring role distinctions between clergy and social workers, inappropriate moralistic judgmentalism, separation of church and state in governmentally sponsored social welfare, and mistrust of religiously or philosophically based understandings of human behavior. Concerns about appropriate professional standards for linkage between social welfare (especially governmentally sponsored) and religion have grown in response to the faith-based initiatives that began with the Clinton and Bush administrations (Cnaan & Boddie, 2002; Sherman, 2001; Wineberg, 2001). The National Association of Social Workers (2002) statement of priorities on faith-based human services initiatives emphasizes that government-funded organizations should not require people seeking aid to convert or to participate in religious activities and that they should not exercise arbitrary exclusionary criteria such as race, religion, or sexual orientation. It advocates for mechanisms of accountability and use of staff who are appropriately qualified to deliver social services, especially when complex issues are involved.

Another type of controversy relates to claims and counterclaims that the social work profession systematically discriminates against people of conservative religious views in education and practice because of a predominance of elitist, liberal, and secular views (see Dessel, Bolen, & Shepardson, 2012; Hodge, 2002; Social Work, 2003).

These controversies highlight the challenge and opportunity of spiritually sensitive practice. Since the inception of the profession, it has striven to become ever more inclusive of diversity while upholding a commitment to well-being and justice for all people. This means that the profession must maintain ethical standards that prohibit discrimination and oppression by its members, even when such behaviors are given religious rationalizations. Simultaneously, practitioners must be prepared to respond respectfully, knowledgeably, and skillfully to the full range of spiritual perspectives of clients and to respect those who express none. This challenge grows as the profession becomes global in outlook, given the tremendous variety of cultural and religious worldviews and the frequent polarization and conflict within and among various religious and secular groups.

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                                                                                                                          Suggested Links

                                                                                                                          Canadian Society for Spirituality and Social Work www.stu.ca/~spirituality/

                                                                                                                          Center for Spirituality and Social Work cssw.cua.edu/

                                                                                                                          Council on Social Work Education’s Religion and Spirituality Clearinghouse www.cswe.org/CentersInitiatives/CurriculumResources/50777.aspx

                                                                                                                          Global Alliance for a Deep Ecological Social Work, www.ecosocialwork.org/

                                                                                                                          North American Association of Christians in Social Work, www.nacsw.org

                                                                                                                          Spiritual Diversity and Social Work Resource Center, www.socwel.ku.edu/canda

                                                                                                                          Society for Spirituality and Social Work, http://societyforspiritualityandsocialwork.com/