Viewing Volume 9 Issue 2 Summer 2006
Spiritual assessments: Keep them Simple, but not too simple.
By Douglas C. Smith, MA, MS, MDiv
Abridged article published in ADEC Forum, Spring 2006.
In my early years in hospice, pain and symptom control seemed to be the only important issues for our terminally ill clients. Recent advances in pharmacology have changed much of that. In getting their pain and symptoms under control fairly quickly, hospice clients now have found themselves travelling up Maslow’s hierarchy of needs, now addressing greater concerns such as spirituality. Because of these advancements in pharmacology the terminally ill are not only now turning to chaplains and clergy, but also to nurses, social workers and psychotherapists, wanting to explore spiritual things. How can we as caregivers understand our clients’ spiritual perspective and struggles? How can we assess their spirituality?
A typical spiritual assessment may often take this form: “What’s the name of your faith community? What’s the name of your minister? What’s his/her telephone number? “ End of assessment.
What has that told me? - Nothing. Let me suggest the following two spiritual assessments as ways of discovering people’s spiritual vocabulary. These assessments are simple, but not so simple that we get no valuable information. The first assessment focuses upon the words strength and peace, two words often associated with peoples spirituality.
Spiritual Assessment: My Strength and My Peace.
Concerning strength: (1) What is strength for you? (2) Where can you go to get it? (3) Who gives it to you? (4) How can you get more? Concerning peace: (1) What is peace for you? (2) Where can you go to get it? (3) Who gives it to you? (4) How can you get more?
With this assessment I have had clients describe where they go to get peace in the following ways: (1) “I go sit by the ocean and just watch the waves.” (2) “I go deep inside myself and meditate.” (3) “I go to my synagogue.” (4) “I go to my best friends house and just chat about anything I want.” (5) “I go read a favourite book in a favourite chair.” Given these client responses I have a basis for conversation with them, a clue as to their beliefs and values, a foundation for possible therapeutic interventions. Because of those responses I now know something about them, a lot more than if I were to know what religion they are and who their minister is. Another approach I could use to get at someone’s spiritual vocabulary is the following assessment. Here we would focus upon meaningful symbols in their life.
Spiritual Assessment: My Meaningful Symbols.
A client would be asked to gather three to six objects to place on a small table in his/her home. These objects would symbolise what is most important in the person’s life, what gives this person’s life meaning and purpose, what this person cherishes about his/her life. The objects could be described as the glue that holds the persons life together. Possible objects could include: (1) books, (2) photographs, (3) religious objects, (4) mementoes, (5) art work, (6) materials gathered from nature, (7) a letter or other personal documents, or (8) a record, CD, video or tape.
After this assessment I once again have the basis for some constructive dialogue, the basis for helpful interactions.
If someone places a bible on the table, I have a point of reference for some conversation, a starting point for discovering the clients beliefs and values, an indication of where I may turn to offer comfort to this person. If someone places an old worn copy of a Passover liturgy on the table, I know I can begin a meaningful relationship by focusing on such concepts as family, tradition and/or ritual. If someone places a picture of the family dog on the table and tells me of that dogs unconditional love towards the family, I know what is most important to this person and I have done some important ground work in figuring out what my care plans need to be.
Spiritual assessments do not have to be elaborate or complicated; they can be quite simple. However, we do not want them to be so simple that we gather no valuable information whatsoever.
Our terminally ill clients, as well as those we work with who are grieving, are searching and struggling over spiritual things. We need to be ready for conversation and we cannot have a constructive conversation if we do not know our clients language, value and beliefs. The above assessments give simple, but not too simple, approaches to discovering these aspects to enable us to have valuable conversations.
About the Author.
Doug Smith lives in Madison, WI. He is a full time speaker for CMI Education Institute where he conducts workshops on terminal illness, grieving and spiritual care.
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AT
BOOK REVIEW
“New Approaches to Integration in Psychotherapy”.
Psychotherapy is an area that has seen huge growth in prominence and practice. The range of theoretical schools that have emerged means that practitioners are striving to amalgamate and synthesise new approaches and theories. This book provides a snapshot of the latest theoretical and clinical developments in the field of integration. O’Leary and Murphy bring together contributors from a range of theoretical backgrounds, who reflect on their experiences with integration, critique existing research and provide a thorough overview of the historical development of psychotherapy itself. The book is divided into three sections, covering the following subjects in depth:
Frameworks and theoretical integrations.
Professional and clinical integrations and special populations.
Issues for professional consideration.
This book will be welcomed by anyone interested in investigating approaches to psychotherapy. In particular, it will have direct relevance to academics involved in training and research on psychotherapy, psychotherapists, counsellors and clinical psychologists.
By:Edited by Eleanor O’Leary & Mike Murphy
University College Cork, Ireland.
ISBN 1-5891-754-3 HB
ISBN 1-58391-755-1 PB
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