Excelsia College

School of Counselling
Ethical Issues and Practice
Week 8A
Spiritual And Religious Values In
Counselling

1
 Devotion

Now, faith is the substance of things hoped for, the

evidence of things not seen.
Hebrews 11:1

Why are you in despair, O my soul? And why are you

disturbed within me? Hope in God, for I shall again praise
Him, the help of my countenance and my God.
Psalm 43:5

2
 Relating Religion and Therapy

“Spirituality is a necessary condition for a psychology of

human experience” and “people are cultural and spiritual
beings” (Sue et al., 1999, p. 1065)
Models:
• Psychotherapy first: integrate spiritual elements within
therapeutic practice
• Complementary: draw equally from spiritual
and psychological theory, values and research
• Religion first: include psychological elements
within spiritual framework

3
 The Role of Spiritual Values in
Counselling

• There is increasing evidence in scientific literature of

the link between spirituality/ religion and individual
health, well-being, positive mental health and
decreased risk factors

• Research since the 1980s has indicated a positive

relationship between religion/spirituality and mental
health in many cases (e.g. Koenig, 2001; Kirkpatrick,
2005; Miner, 2009; VanderWeele et al, 2016)

4
 The Role of Spiritual Values in
Counselling

CCAA Code of Ethics (2017, 3.10, p. 5):

“Counsellors need to respect the religious convictions
of clients and strive to understand their belief system.
Bearing in mind the considerable influence
counsellors have over clients, they need to avoid any
of their own faith, spirituality or religious practices.”

5
 The Role of Spiritual Values in
Counselling

• Helps a client to ponder “Who am I” and “What is the

meaning of life?”

• Fosters growth and healing through an exploration of

the self, learning to accept the self, admitting areas of
weakness, dealing with guilt, and learning to let go of
self-defeating patterns of thinking, feeling and
behaviour

6
 The Role of Spiritual Values in
Counselling

• What does it look like to be spiritual? Religious?

• Spirituality is often described in personal and/or experiential
terms and is understood as individual
• Religion generally includes personal and institutional beliefs
and practices, and associated with a specific community of
believers
• People can be spiritual without being religious and vice
versa

7
 The Role of Spiritual Values in
Counselling

• Spiritual development is defined as:

• “…the process of growing the intrinsic human capacity
for self-transcendence, in which the self is embedded in
something greater than the self, including the sacred. It
propels the search for connectedness, meaning,
purpose and contribution. It is shaped both within and
outside of religious traditions, beliefs, and practices.”

(Benson, Roehlkepartain & Rude, 2003, p.207)

8
 Religious/Spiritual Competence

• Plante (2014) concludes in his paper that:

• It is important to examine religious and spiritual
diversity as much as ethnicity, race, gender, gender
identity, etc… suggesting to ignore it is unethical
and could lead to malpractice
• “[Religion is the] last bastion of bias and prejudice”
• As counsellors, we must overcome our “own
personal biases about religion to fully comply with
and embrace our ethical obligations to be aware of
and respect (religious) diversity.” (p.291)

9
 Religious/Spiritual Competence

Four steps to improve religious/spiritual competence

(Plante, 2014):

1. Be aware of biases

2. Consider religion just as you would other types of

diversity

3. Take advantage of available resources

4. Consult colleagues, including church and spiritual

leaders (e.g. clerics, priests, pastors, rabbis, etc…)

10
 Religious/Spiritual Competence:
Discussion – Biases

1. What stressors might you be feeling as you face

someone who does not believe what you believe?
2. What might you expect your Counsellor to know about
your spirituality in session?
3. What aspects of your spirituality or spiritual practices
do you find most helpful?
4. How does your spiritual/religious community support
you in times of emotional stress?
5. What bias might you need to overcome?

11
 Using Religious Techniques:
Implicit and Explicit Use

• Tan (1999) distinguishes implicit and explicit

integration of religion/spirituality in counselling

• Implicit is where there is no open discussion or use of

religious materials and techniques but the Counsellor
may privately pray for the client

• Explicit integration involves the use of spiritual concepts

and techniques in the session, with the informed consent
of the client

12
 Ethical Issues:
Faith-Based/Christian Counselling

• Often a client who states that faith plays a very

important role in his or her life will choose a therapist
who shares his or her worldview

• Fully informed consent

• To your specific spiritual elements at all stages

• Ensure counselling is provided, not spiritual advice or a

pastoral visit (Christian)

13
 Ethical Issues:
Faith-Based/Christian Counselling

• Take care not to impose your values and

interpretations on clients

• Maintain confidentiality if in church-based (or place

of worship) practice

• Dual relationships: if client is part of your church or

spiritual group

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 Ethical Issues:
Faith-Based/Christian Counselling

• Working with clients whose beliefs and behaviour

may differ from yours, e.g. issues such as:
• Abortion
• Affairs
• Homosexuality
• Transgenderism
• Such clients may require you to take on closer
supervision or refer them to someone else, but
consider the Bruff legal case (Priest & Wickel,
2011).

15
 CCAA Code of Ethics

CCAA (2017, 4.8.3, p. 8):

“Counselling is a different process to Prayer Ministry or Prayer
Counselling and all types of Prayer Ministry including
Theophostic, Word of Knowledge, Demonic Deliverance, Spiritual
Discernment, Prophecy and other similar practices are not
counselling per se; they are practices of the Christian Church.
Those engaged in such Prayer Ministries who are untrained
Counsellors are not covered by this Code of Ethics. There is a
distinction between people who engage in Prayer Ministries and
those who engage in Counselling. In the case where Prayer
Counselling is requested, it is preferable for the Christian
Counsellor to refer to a specialised Prayer Counsellor.”

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 Implications for Religious Therapy and
Counselling

• If client’s life goals are spiritual, then therapy must

include the goal of spiritual well-being

• If this is to be part of therapy, then spiritual

assessments and interventions are needed

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 Where Religion Impacts Disorders

• Psychosis – distinguishing delusions from religious

experiences

• Stress responses, especially PTSD – trauma violating

‘assumptive systems’ and creating existential anxieties

• Mood disorders – especially issues of guilt and

forgiveness

18
 What Factors Might Influence the Growth
of Faith?

• Relationship with parents and spiritual community

• Parenting and cultural parenting styles

• Level and type of attachment, i.e. internal working

models of close relationships

• School values and attitudes

• Parents’ values and beliefs, level or moral development

• A person’s own developmental level

19
 What Factors Might Influence the Growth
of Faith?

• Person’s capacity for resilience in negative

circumstances

• Availability of protective factors in negative

circumstances

This is the domain of counselling!

20
 Including Spiritual Values in Counselling

• How does a counsellor begin to assess the

importance that spirituality plays in the life of his or
her client?
• When a client reveals that his/her spirituality plays a
central part in his/her life and decision making as
spiritual assessment may be recommended:
• Richards and Bergin (2003) Religious-Spiritual
Assessment during the intake interview (9 areas).
• Pulchalski (2003) – acronym- FICA

21
 Including Spiritual Values in Counselling

• Richards and Bergin (2003) - Religious-Spiritual Assessment

during the intake interview covering:
1. Metaphysical worldview
2. Religious affiliation
3. Religious orthodoxy
4. Religious problem-solving style
5. Spiritual identity
6. God image
7. Value-lifestyle congruence
8. Doctrinal knowledge
9. Religious and spiritual health
and maturity
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 Including Spiritual Values in Counselling

Christina Pulchalski (2003) – FICA spiritual assessment:

• F - Faith: "What do you believe in that gives meaning to
your life?"
• I - Importance and Influence: "How important is your faith
(or religion or spirituality) to you?"
• C - Community: "Are you a part of a religious or spiritual
community?"
• A - Address or Application: "How would you like me to
address these issues in your health care?"

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 Including Spiritual Values in Counselling

• For the client who rates religion or spirituality as very

significant, it is very likely that religious or spiritual
interventions may be important in the treatment plan

• Counselling can help clients to gain insight into the

ways their core beliefs, values and self-image are
reflected in their struggles and how they may need
re-examining

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 Including Spiritual Values in Counselling

• If spirituality is a sustaining source of strength and

meaning, a client can be helped to draw solace and
comfort
• If clients are misinterpreting the spiritual, they can be
helped to let go of guilt, anger and worthlessness that
often accompany a false image of God
How can we do this ethically?

25
 References

Benson, P. L., Roehlkepartain, E. C., & Rude, S. P. (2003). Spiritual development in

childhood and adolescence: Toward a field of inquiry. Applied Developmental
Science, 7(3), 205-213. doi:10.1207/s1532480xads0703_12
Bergin, A. E., & Richards, P. S. (2003). Casebook for a Spiritual Strategy in Counseling
and Psychotherapy. APA PsycBooks.
Christian Counsellors Association of Australia (CCAA) (2020). CCAA Code of Ethics.
CCAA-CODE- OF-ETHICS-Nov-2020-1.pdf
Kirkpatrick, L., (2005). Attachment, Evolution, and the Psychology of Religion. Guildford
Press.
Koenig, H.G. & Larson, D.B. (2001). Religion and mental health: Evidence for an
association. International Review of Psychiatry, 13(2), 67-78.
Miner, M. (2009). The impact of child-parent attachment, attachment to God and
religious orientation on psychological adjustment. Journal of Psychology and
Theology, 37(2), 114-124.
Oxhandler, H.K., Pargament, K.I., Pearce, M.J., Vieten, C. & Moffatt, K.M. (2021).
Current mental health clients’ attitudes regarding religion and spirituality in
treatment: a national survey. Religions, 12(6). https://www.mdpi.com/2077-
1444/12/6/371/htm
26
 References

Plante, T. (2014). Four steps to improve religious/spiritual cultural competence in professional

psychology. Spirituality in Clinical Practice, 1(4), 288-292.
Priest, J.B. & Wickel, K. (2011). Religious therapists, and clients in same-sex relationships: Lessons
from the court case of Bruff v. North Mississippi Health Service, inc. The American Journal of
Family Therapy, 39, 193-148.

Pulchalski, C. (2003). Psychosocial and spiritual aspects of care: FICA - a spiritual assessment tool.
In James Hallenbeck, Palliative care perspectives (1st ed.) (pp.55-56). Oxford University
Press.
Sue, D. W. (1999). The diversification of psychology: A multicultural revolution. American
Psychologist, 54(12), 1061-1069.
https://www.researchgate.net/publication/8378886_The_diversification_of_psychology_A_m
ulticultural_revolution
Tan, S.-Y. (2003). Integrating Spiritual Direction into Psychotherapy: Ethical Issues and Guidelines.
Journal of Psychology and Theology, 31(1), 14–23.
https://doi.org/10.1177/009164710303100102.
Trusty, W.T., Swift, J.K., Black, S.W., Dimmick, A.A. & Penix, E.A. (2022). Religious microaggressions
in psychotherapy: a mixed methods examination of client perspectives. Psychotherapy,
59(3), 351-362. http://dx.doi.org/10.1037/pst0000408
VanderWeele, T., Jackson, J., Li, S., VanderWeele, T.J. & Jackson, J.W. (2016). Causal inference and
longitudinal data: a case study of religion and mental health. Social Psychiatry & Psychiatric
Epidemiology, 51(11), 1457-1466. 27