Social work professionals realize more and more that spirituality plays an important role in fostering health and wellness.
To help practitioners understand this relationship in clients’ lives, a spiritual assessment is commonly recommended as a routine component of practice. Administering a spiritual assessment—as part of a larger bio-psycho-social-spiritual assessment—provides a more holistic understanding of clients’ realities, which in turn provides the basis for subsequent practice decisions.
Traditional assessment approaches, however, may be ineffective with clients who are uncomfortable with spiritual language, or who are otherwise hesitant to discuss spirituality openly.
In a recent issue of Social Work, David R. Hodge, an associate professor of social work at Arizona State University, and a senior nonresident fellow with the Program for Research on Religion in Urban Civil Society at the University of Pennsylvania, outlines what is called an “implicit spiritual assessment” which functions as an alternative approach that may be more valid with such clients. Hodge’s article discusses the process of administering an implicit spiritual assessment, provides sample questions to help operationalize the approach, and offers suggestions to integrate this assessment with more traditional assessment approaches.
Spirituality is expressed in various ways, both religious and non-religious. One way to think of spirituality is as a connectedness to what one perceives to be sacred or transcendent. In other words, spirituality can be seen as a fundamental human drive for transcendent meaning and purpose that involves connectedness with oneself, others and ultimate reality.
While some social work clients are comfortable discussing their spiritual and/or religious beliefs and practices openly, others are not. For some clients, the spiritual or religious language used in an explicit preliminary assessment does not resonate with their personal worldviews. As implied above, however, essentially anything can be imbued with transcendent significance. In many cases, people construct a sense of meaning, purpose, and identity outside the confines of traditional spiritual or religious settings.
For example, the sacred can include art, collecting, gardening, sports, nature, and many other activities or passions. These can provide a transcendent sense of purpose and connectivity for some individuals. However, the typical language associated with spirituality may sound foreign to such persons, and they may even find it offensive. To overcome this barrier to assessing clients’ spirituality, practitioners need to become attuned to ways clients speak about what gives their lives meaning, purpose and transcendence.
Hodge provides a sample list of questions to ask in an implicit spirituality assessment, and divides them into “Past Spirituality,” “Present Spirituality,” and “Future Spirituality.” For instance, the practitioner may ask:
- When were you happiest (or most joyful)?
- When do you feel most fully alive?
- How do you commemorate special occasions/accomplishments?
- What are your goals for the future?
By using terminology that is implicitly spiritual in nature, practitioners can identify and work with dimensions of clients’ experiences that may be critical to effective service provision but would otherwise be overlooked by traditional spiritual assessments. This technique provides a means for exploring the transcendent dimension when working with clients who believe spiritual language is irrelevant to their lives. Furthermore, Hodge notes:
…an implicit assessment offers practitioners a way to build trust and rapport when clients are hesitant to trust practitioners with a highly sensitive subject. …Consequently, it is an approach that essentially all practitioners can benefit from incorporating into their “assessment toolbox.”