Relevance of Spirituality in Counselling

Current statistics tell us a significant number of Australians identify with a religious or other spiritual beliefs. For this reason, the spiritual competence of Australian counsellors is important in therapeutic relationships. Even though spirituality is identified by the Psychotherapy and Counselling Federation of Australia (PACFA) as within the scope of counselling and something requiring a counsellor’s competence, research indicates that the topic often gets neglected, avoided, or seen as being outside the scope of counselling. Spiritual growth is simply an aspect of human development and an area clients may need support with from time to time (Psychotherapy and Counselling Federation of Australia, 2022). While relevant for most of the population at different life stages, research indicates that spiritual growth may be at the forefront for certain clients. The purpose of this article is to explore the relevance of spirituality in counselling, the benefits, harm and ethical considerations that need to be considered when integrating spirituality in counselling.

The term spirituality can be defined as the capacity or tendency towards knowledge, love, meaning, peace, hope, connectedness, wellness, and wholeness – and can be addressed from various perspectives including religious, atheist and agnostic views (ASERVIC, 1988, as cited in Steen et al., 2006). Here, the term spirituality is used to include religious as well as non-religious views. National statistics show that there is a significant number of Australians who either identify with a religion or identify as “spiritual although not religious” (Australian Bureau of Statistics, 2022 & McCrindle, 2017). According to the Australian Bureau of Statistics (ABS), 52 per cent of the Australian population identified with a specific denomination of religion in 2021(ABS, 2022). A national study on faith and belief conducted in 2017 found that 14 per cent of Australians identified as “spiritual but not religious” (McCrindle, 2017). Given the nation’s stance, the relevance of spirituality cannot be denied when considering the Australian population’s mental health and wellbeing.

PACFA College of Counselling includes spirituality as an area within the professional bounds of a counselling relationship, in addition to core concerns of identity, relationships with self and others, grief, loss and trauma, domestic violence and other experiences (PACFA, n.d.). In addition, the Australian Counselling Association (ACA) Code of Ethics identifies three aspects for anti-discriminatory practice in the counselling profession: namely, client respect, client autonomy and counsellor awareness (ACA, 2022). To fulfil these obligations, it is necessary for counsellors to respect any spiritual beliefs that the client may hold, provide a conducive environment for clients to freely express their beliefs, and maintain an awareness of the clients’ spiritual beliefs, separate from one’s own beliefs.

Literature on multicultural research also suggests that the spiritual dimension is one aspect of multicultural competency that often gets overlooked (Hage et al., 2006; Arredondo et al., 1996). A person’s culture is the totality of that individual; including significant historic moments, human influences and various social, economic, and political factors including spirituality (Hage et al., 2006). ignoring the spiritual aspect will lead to counselling only addressing parts of the client. Apart from the need to integrate spirituality for the purpose of fulfilling a duty of care by providing an anti-discriminatory and culturally appropriate counselling service, certain clients may also present with a “moral injury” that requires spiritual interventions (Dumulescu et al., 2022).

Moral injury can be understood as perpetrating, failing to prevent, experiencing, bearing witness to, or hearing about an act that creates dissonance due to violation of personal values about what is right and wrong, such as a traumatic incident (Dumulescu et al., 2022). Moral injuries typically lead to social isolation, a potential lack of meaning and challenges to one’s spiritual beliefs (Dumulescu et al., 2022). When moral injuries present themselves in counselling, it requires the counsellor to move beyond cognitive or emotion focussed interventions and be open to integrate spirituality with psychotherapy (Dumulescu et al., 2022). Given the existential nature of counselling, encountering the spiritual dimension within the therapeutic relationship may be inevitable and counsellors need to be prepared to embrace the opportunity (Hategan, 2021).

Addressing spirituality from a biased viewpoint by imposing a counsellor’s own spiritual views on the client, focussing too much on spiritual aspects rather than therapeutic goals or stepping outside the boundaries of one’s professional competence are some factors that can harm the therapeutic process (Morrison et al., 2009; Steen et al., 2006). If counsellors are inflexible in their view of spirituality, it reduces their availability to sit with the client’s “not knowing”. When clients sense that the counsellor is unavailable to sit with their spiritual exploratory process, it can lead to foreclosure (Kail & Cavanaugh, 2019), where clients take on their counsellor’s view on the matter, or drop out of therapy, both of which may hinder the client’s spiritual development (Steen et al., 2006).

If counsellors can learn how to open a line of conversation regarding a client’s spirituality that is unhindered by their personal beliefs, it enables the client to integrate their beliefs and continue growing (Steen et al., 2006). Simply discussing one’s spiritual beliefs may very well serve as a useful exploratory exercise for the client. It has been proven that higher spiritual orientation is a statistically significant predictor in weakening the impact of negative life experiences (Young et al., 2000). Hence, a counselling approach that provides the environment where spiritual exploration is accepted can positively influence the client’s welfare (Steen et al., 2006).

It is essential that counsellors don’t force any spiritual discussion on unwilling clients but simply remain open and willing when the spiritual discussion naturally arises (Steen et al., 2006). To ethically meet the needs of a diverse clientele, counsellors must recognise the existence of spiritual dimension in clients’ lives but remain open for varied views on the matter (Zinnbauer & Pargament, 2000). Maintaining awareness of one’s professional competence, biases, cultural orientation, and values, applies to spiritual discussions as much as any other matters addressed in counselling (Steen et al., 2006). If a counsellor recognises that their personal spiritual views may hinder the client’s growth, it is their ethical obligation to refer the client to another counsellor who is more flexible or has similar beliefs to the client (Steen et al., 2006).

To truly explore clients’ spirituality, it is essential that counsellors explore their own spirituality first, and become clear on their views (Hategan, 2021) even if it is to realise that spirituality is not of interest to them as a counsellor. It can be helpful for counsellors to use reflective questions (Corey, 2006) to assess if spirituality has been a constructive force in their personal life. Upon self-reflection, counsellors can decide if they wish to develop their spiritual competence or choose to refer clients elsewhere. If the counsellor chooses to include spiritual competence in their skillset, they can then source available tools, interventions and strategies that can help address the topic of spirituality.

Opening the topic skilfully and early in the therapy process can normalise discussion around the topic of spirituality. Discussing spirituality during the intake session is an easy way to open the topic and gauge client’s inclination towards it (Kelley 1995 & Stanard et al, 2000, as cited in Nichols & Hunt, 2011). Exploratory questions are a non-intrusive way to conduct spiritual assessments. Questions such as “What brings meaning to your life”, “Where do you turn to in times of stress”, “What brings you peace or joy in your life” are examples of exploratory questions that counsellors can use (Nichols & Hunt, 2011). Formal assessments such as Spiritual Health Inventory (SHI) are also available for counsellors to explore client’s spirituality further, if the client indicates interest (Stanard et al., 2000, as cited in Nichols & Hunt, 2011).

So long as counsellors can remain flexible to move on from the topic if the client seems reluctant or says it is not a personally relevant area, clients will benefit from being given the option to integrate spirituality in therapy (Nichols & Hunt, 2011). Specific spiritual interventions can later be utilised if the client has indicated openness to spiritual exploration. Strategies such as prayer, meditation, breathing exercises, relaxation, guided visualisation and helping the client develop their own rituals can assist – as well as creative methods such as art, journaling, music, or poetry depending on the client’s interest (Cashwell & Young, 2005, as cited in Nichols & Hunt, 2011). Creating a spiritual genogram is also a helpful way to support clients explore who they are, where they come from, where they are and where they wish to go (Nichols & Hunt, 2011).

Integrating spirituality in counselling can ensure a culturally appropriate, inclusive, anti-discriminatory practice that can support clients move forward from moral injuries. The potential benefits of integrating spirituality in counselling include fostering client welfare, enabling client’s growth in the spiritual dimension of general human development, building strong therapeutic relationships based on multicultural awareness and positively influencing therapeutic outcomes. The possible harms involved in not addressing spirituality effectively include a counsellor’s own bias and the chance of imposing personal spiritual views on the client. To ensure professional and ethical considerations are met while integrating spirituality in counselling, counsellors need to develop awareness of their spiritual values, remain flexible in their approach to support varied spiritual beliefs based on a client’s cultural influence, and refer clients elsewhere when their views conflict with the client’s. Counsellors can fulfill their duty of care towards a client’s spiritual inclination by engaging in self-reflection, using exploratory questions, spiritual assessment tools, and specific spiritual interventions that align with their client’s beliefs.