National surveys reveal that a very high proportion of the population professes belief in some transcendent force (Aten and Hernandez, 2002). Thus, psychologists providing assessment, psychotherapy and supervision are very likely to encounter patients for whom matters of religious/spiritual faith are salient.
In fact, Stewart and Gale (1994) have asserted that religion/spirituality may be the most important cultural consideration for at least some individuals. Unfortunately, few doctoral programs (Brawer et al., 2002) or pre-doctoral internships (Russell and Yarhouse, 2006) offer systematic training in working with religious/spiritual material. It is hoped that this article will offer some initial guidance in opening a dialogue about religion/spirituality early in supervision (Borders and Brown, 2005).
One of the most important supervision tasks is to aid the trainee in developing emotional awareness (Borders and Brown, 2005). An understanding of one’s own beliefs, morals, ethics and opinions regarding various faiths is a vital first step in working effectively with the faith systems of clients (Polanski, 2003).
One tool available toward this end is Frame’s (2001) spiritual genogram. Although constructed similarly to the familiar genogram of family therapy, the spiritual genogram is used to make sense of one’s religious/spiritual heritage with respect to affiliations, moral beliefs and religiously proscribed conduct in one’s family of origin. This type of exercise helps increase the supervisee’s awareness of his or her attitudes to issues of faith, how these might impact psychotherapy and any related “unfinished business” that he or she may have.
Also, within this supervisory task falls the supervisor’s helping the trainee manage his or her countertransferential reactions to the religious/spiritual material presented by the patient (Aten and Hernandez, 2002). These could include apparently negative manifestations, such as negative or condescending attitudes, harsh judgments and pathologizing; seemingly positive expressions, such as over familiarity, assumptions regarding health or a shift to being less curious about an aspect of the client’s life than usual; to the ostensibly benign, such as ignoring it all together.
Yet any countertransference manifestation should be opened for exploration with respect to the dynamics of the supervisee, the patient and the therapeutic relationship.
The growing number of resources for understanding the basics of the client’s faith should be accessed. Although this suggestions comes with a caution against overgeneralization, having basic information about the principles and practices of the patient’s faith will help with assessment, conceptualization and intervention with a specific individual.
For example, having some knowledge of the contemplative practices of Buddhism can help the clinician assess whether a particular individual’s involvement is defensive or salubrious (see Finn and Rubin, 2000 for further explanation).
Finally, the suitability of any particular intervention must be carefully considered. Some common interventions or suggestions may be in conflict with a particular patient’s faith system and those interventions drawing from specific religious and spiritual traditions may require additional discussion with a patient.
Helping supervisees thoughtfully and respectfully engage their patients around this dimension of their lives can add power to treatment; sources of strength can be accessed in the service of therapeutic progress and defensive and potentially damaging uses of faith can be examined.
References available from the author.
Mitchell Hicks, Ph.D., a licensed clinical psychologist practicing in Arlington Heights, Ill., specializing in men’s issues, sexual compulsivity and religious/spiritual issues. He is on faculty at Walden University. His e-mail is email@example.com.