Spiritual assessments in social work practice

Social Work: Spiritual Assessment
Instruments for Spiritual Assessment
One of the five instruments for spiritual assessment is the spiritual history. This is the only verbal instrument. A practitioner using spiritual history obtains a client’s spiritual information using two sets of questions. The first set of questions seeks to help the client tell their story from childhood to the present. The second set helps the practitioner elicit spiritual information from the client by assessing the dimensions of the soul (cognition, will, and affect) and the spirit (intuition, conscience, and communion).
The second instrument is the spiritual life map, which is a diagrammatic or pictorial account of a client’s relationship with God. It shows where the client is coming from, where they are, and where they are going in regard to their relationship with God. The client sketches their spiritual journey from birth to the present, and continuing to death and the afterlife. They depict key events along the journey, the various trials they have faced, and the strategies they used to overcome these (Hodge, 2005).
A practitioner could also opt for the spiritual genogram, which is a graphic representation extending over at least three generations. The genogram serves more or less like a family tree, helping the practitioner understand complex intergenerational spiritual interactions. From the genogram, a practitioner can deduce the strength of the spiritual relationships with family members as well as the flow of spiritual resources (Hodge, 2005).
The fourth instrument is the spiritual ecomap which, unlike the other instruments, focuses on the client’s current spiritual relationships as opposed to their spiritual history. The ecomap is similar to the genogram in presenting the nature and strength of an individual’s spiritual relationships. However, the ecomap only focuses on those parts of the clients’ key events and spiritual challenges occurring in present space (Hodge, 2005). The practitioner can deduce a client’s spiritual system within the family and outside as well as their present relationship with God from the ecomap (Hodge, 2005).
Finally, there is the spiritual ecogram, which combines the features of both genograms and ecomaps in a single assessment approach. Ecograms tap information that exists in the present space as well as that from history. In so doing, ecograms help to depict the connections between present and past functioning.
Why it is important for social workers to assess spirituality
First, assessing spirituality provides a window for social workers to understand the worldviews of clients from different cultures, and to consequently tailor services in a manner that aligns with these worldviews. One’s spirituality shapes their attitudes and views on multiple facets of life including medicine, marital relations, family relations, diet, and child care among others. For instance, most Muslims are uncomfortable receiving care from members of the opposite sex unless another member of the same sex such as a family member is present. It is through spiritual assessment that social workers get to understand how to handle such clients.
Secondly, spiritual assessment provides a means for the social worker to identify spiritual assets in a client’s life that they could operationalize in treatment and discharge planning (Hodge, 2005). Spiritual assets such as spiritual groups, clergy consultations, scripture reading, worship, and prayer can facilitate coping and well-being for a client upon discharge. A social worker, however, needs to assess an individual client’s spiritual context to choose the most plausible spiritual asset for their client. For instance, a Christian with a mental illness may find the support of their church beneficial in helping them cope and prevent relapse. On the other hand, a Hindu client battling mental illness may benefit more from spiritual practices such as the puja ritual and meditation.
The third reason why social workers need to assess spirituality is because regulatory agencies require them to conduct such assessments. For instance, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recommends that social workers conduct a spiritual assessment that at the least determines the client’s denomination and important spiritual practices or beliefs (Hodge, 2005). The JCAHO recommendation is founded on two goals – to identify the effect of a client’s spirituality on service provision and to help in determining whether a comprehensive spiritual assessment of the client would be required.
Express and evaluate your confidence using Hodge’s assessment tools
I would say that I am very confident about my ability to use spiritual histories in assessing a client’s spirituality. First, there is a standard set of guiding narrative and anthropological questions, and it is not up to the practitioner to determine what elements of a client’s spiritual journey to include in the assessment. As such, the risk of subjective bias is minimal. Moreover, I am verbally-oriented and can easily build rapport with a verbally-oriented client by relating their experiences to my own.
Of the five instruments, the spiritual lifemap is the one with which I am most uncomfortable. I am not an artistic person, which implies that I may not accurately interpret pictorial representations and relate the same to a client’s spiritual journey or beliefs. For instance, I may not immediately interpret a cut-out picture on a client’s life map, which could create a negative image on the client. In my view, this tool is best suited for use with more artistic practitioners who can comfortably engage the client and even give suggestions on what elements to include to give a more accurate view of the client’s spirituality.
Throughout the course, we have been assessing clients presenting for psychotherapy due to mental health issues. Genogram development and case formulations are both crucial parts of these assessments. Thanks to these assessments, I can accurately develop and interpret a genogram and develop formulations on how a client’s past experiences shaped their present behavior. I am, therefore, confident that I can adequately use the spiritual genogram instrument to obtain insights into a client’s spirituality. Spiritual ecomaps make use of the present situation without reference to past events in a client’s history. I am confident that I can accurately use this instrument particularly because it eliminates the need to formulate hypotheses as is the case with the genogram. Since I am confident in my ability to use both spiritual genograms and ecomaps, then I can also confidently use the spiritual ecogram which combines elements of both.
References
Hodge, D. R. (2005). Developing a Spiritual Assessment Toolbox: A Discussion of the Strengths and Limitations of Five Different Assessment Methods. Health and Social Work, 30(4), 314-24.